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top:0.7ex; left:0.4em;} + .nobo {border: thin;} + .red {color: red;} + .figure, .figcenter, .figright, .figleft + {padding: 1em; margin: 0; text-align: center; font-size: 0.8em;} + .figure img, .figcenter img, .figright img, .figleft img + {border: none;} + .figure p, .figcenter p, .figright p, .figleft p + {margin: 0; text-indent: 1em;} + .figure p.in, .figcenter p.in, .figright p.in, .figleft p.in + {margin: 0; text-indent: 8em;} + .figcenter p.poem + {margin-left: 1em; text-align: left; text-indent: 0;} + .figcenter {margin: auto;} + .figright {float: right;} + .figleft {float: left;} + img.middle { border: none; vertical-align: middle } + + hr.pg { width: 100%; + margin-top: 3em; + margin-bottom: 0em; + margin-left: auto; + margin-right: auto; + height: 4px; + border-width: 4px 0 0 0; /* remove all borders except the top one */ + border-style: solid; + border-color: #000000; + clear: both; } + pre {font-size: 85%;} + // --> + </style> +</head> +<body> +<h1>The Project Gutenberg eBook, Zoonomia, Vol. II, by Erasmus Darwin</h1> +<pre> +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at <a href = "http://www.gutenberg.org">www.gutenberg.org</a></pre> +<p>Title: Zoonomia, Vol. II</p> +<p> Or, the Laws of Organic Life</p> +<p>Author: Erasmus Darwin</p> +<p>Release Date: December 23, 2008 [eBook #27600]</p> +<p>Language: English</p> +<p>Character set encoding: ISO-8859-1</p> +<p>***START OF THE PROJECT GUTENBERG EBOOK ZOONOMIA, VOL. II***</p> +<p> </p> +<h3>E-text prepared by Robert Shimmin, Greg Alethoup, Keith Edkins,<br /> + and the Project Gutenberg Online Distributed Proofreading Team<br /> + (http://www.pgdp.net)</h3> +<p> </p> +<table border="0" cellpadding="10" style="background-color: #ccccff;"> +<tr> +<td style="width:25%; vertical-align:top"> +Transcriber's note: +</td> +<td> +A few typographical errors have been corrected. They +appear in the text <span class="correction" title="explanation will pop up">like this</span>, and the +explanation will appear when the mouse pointer is moved over the marked +passage. +</td> +</tr> +</table> +<p> </p> +<hr class="pg" /> +<p> </p> +<p> </p> +<p> </p> + +<h1>ZOONOMIA;</h1> + +<p class="cenhead">OR,</p> + +<h3>THE LAWS</h3> + +<p class="cenhead">OF</p> + +<h2>ORGANIC LIFE.</h2> + +<h3>VOL. II.</h3> + +<h3><i>By ERASMUS DARWIN, M.D. F.R.S.</i></h3> + +<p class="cenhead">AUTHOR OF THE BOTANIC GARDEN.</p> + + <p><br style="clear:both" /></p> +<hr /> + + <div class="contents"> + <div class="stanza"> + <p>Principiò cœlum, ac terras, camposque liquentes,</p> + <p>Lucentemque globum lunæ, titaniaque astra,</p> + <p>Spiritus intùs alit, totamque infusa per artus</p> + <p>Mens agitat molem, et magno se corpore miscet.—<span class="sc">Virg.</span> Æn. vi.</p> + </div> + + <div class="stanza"> + <p>Earth, on whose lap a thousand nations tread,</p> + <p>And Ocean, brooding his prolific bed,</p> + <p>Night's changeful orb, blue pole, and silvery zones,</p> + <p>Where other worlds encircle other suns,</p> + <p>One Mind inhabits, one diffusive Soul</p> + <p>Wields the large limbs, and mingles with the whole.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<p class="cenhead">LONDON:<br /> +PRINTED FOR. J. JOHNSON, IN ST. PAUL'S CHURCH-YARD.<br /> +1796.</p> + +<h4>Entered at Stationers' Hall.</h4> + + <p><br style="clear:both" /></p> +<hr /> + +<h2>ZOONOMIA;</h2> + +<h3>OR,</h3> + +<h3>THE LAWS OF ORGANIC LIFE.</h3> + +<h3>PART II.</h3> + +<p class="cenhead">CONTAINING</p> + +<h3>A CATALOGUE OF DISEASES</h3> + +<p class="cenhead">DISTRIBUTED INTO</p> + +<h3>NATURAL CLASSES ACCORDING TO THEIR PROXIMATE CAUSES,</h3> + +<p class="cenhead">WITH THEIR</p> + +<h3>SUBSEQUENT ORDERS, GENERA, AND SPECIES,</h3> + +<p class="cenhead">AND WITH</p> + +<h3>THEIR METHODS OF CURE.</h3> + + <p><br style="clear:both" /></p> +<hr /> + +<blockquote class="b1n"> + + <p>Hæc, ut potero, explicabo; nec tamen, quasi Pythius Apollo, certa ut + sint et fixa, quæ dixero; sed ut Homunculus unus e multis probabiliora + conjecturâ sequens.—<span class="sc">Cic. Tusc. Disp.</span> l. 1. + 9.</p> + +</blockquote> + + <p><br style="clear:both" /></p> +<hr /> + +<h2>PREFACE.</h2> + + <p>All diseases originate in the exuberance, deficiency, or retrograde + action, of the faculties of the sensorium, as their proximate cause; and + consist in the disordered motions of the fibres of the body, as the + proximate effect of the exertions of those disordered faculties.</p> + + <p>The sensorium possesses four distinct powers, or faculties, which are + occasionally exerted, and produce all the motions of the fibrous parts of + the body; these are the faculties of producing fibrous motions in + consequence of irritation which is excited by external bodies; in + consequence of sensation which is excited by pleasure or pain; in + consequence of volition which is excited by desire or aversion; and in + consequence of association which is excited by other fibrous motions. We + are hence supplied with four natural classes of diseases derived from + their proximate causes; which we shall term those of irritation, those of + sensation, those of volition, and those of association.</p> + + <p>In the subsequent classification of diseases I have not adhered to the + methods of any of those, who have preceded me; the principal of whom are + the great names of Sauvages and Cullen; but have nevertheless availed + myself, as much as I could, of their definitions and distinctions.</p> + + <p>The essential characteristic of a disease consists in its proximate + cause, as is well observed by Doctor Cullen, in his Nosologia Methodica, + T. ii. Prolegom. p. xxix. Similitudo quidem morborum in similitudine + causæ eorum proximæ, qualiscunque sit, reverâ consistit. I have taken the + proximate cause for the classic character. The characters of the orders + are taken from the excess, or deficiency, or retrograde action, or other + properties of the proximate cause. The genus is generally derived from + the proximate effect. And the species generally from the locality of the + disease in the system.</p> + + <p>Many species in this system are termed genera in the systems of other + writers; and the species of those writers are in consequence here termed + varieties. Thus in Dr. Cullen's Nosologia the variola or small-pox is + termed a genus, and the distinct and confluent kinds are termed species. + But as the infection from the distinct kind frequently produces the + confluent kind, and that of the confluent kind frequently produces the + distinct; it would seem more analogous to botanical arrangement, which + these nosologists profess to imitate, to call the distinct and confluent + small-pox varieties than species. Because the species of plants in + botanical systems propagate others similar to themselves; which does not + uniformly occur in such vegetable productions as are termed + varieties.</p> + + <p>In some other genera of nosologists the species have no analogy to + each other, either in respect to their proximate cause, or to their + proximate effect, though they may he somewhat similar in less essential + properties; thus the thin and saline discharge from the nostrils on going + into the cold air of a frosty morning, which is owing to the deficient + action of the absorbent vessels of the nostrils, is one species; and the + viscid mucus discharged from the secerning vessels of the same membrane, + when inflamed, is another species of the same genus, Catarrhus. Which + bear no analogy either in respect to their immediate cause or to their + immediate effect.</p> + + <p>The uses of the method here offered to the public of classing diseases + according to their proximate causes are, first, more distinctly to + understand their nature by comparing their essential properties. + Secondly, to facilitate the knowledge of the methods of cure; since in + natural classification of diseases the species of each genus, and indeed + the genera of each order, a few perhaps excepted, require the same + general medical treatment. And lastly, to discover the nature and the + name of any disease previously unknown to the physician; which I am + persuaded will be more readily and more certainly done by this natural + system, than by the artificial classifications already published.</p> + + <p>The common names of diseases are not well adapted to any kind of + classification, and least of all to this from their proximate causes. + Some of their names in common language are taken from the remote cause, + as worms, stone of the bladder; others from the remote effect, as + diarrhœa, salivation, hydrocephalus; others from some accidental + symptom of the disease, as tooth-ach, head-ach, heart-burn; in which the + pain is only a concomitant circumstance of the excess or deficiency of + fibrous actions, and not the cause of them. Others again are taken from + the deformity occasioned in consequence of the unnatural fibrous motions, + which constitute diseases, as tumours, eruptions, extenuations; all these + therefore improperly give names to diseases; and some difficulty is thus + occasioned to the reader in endeavouring to discover to what class such + disorders belong.</p> + + <p>Another difficulty attending the names of diseases is, that one name + frequently includes more than one disease, either existing at the same + time or in succession. Thus the pain of the bowels from worms is caused + by the increased action of the membrane from the stimulus of those + animals; but the convulsions, which sometimes succeed these pains in + children, are caused by the consequent volition, and belong to another + class.</p> + + <p>To discover under what class any disease should be arranged, we must + first investigate the proximate cause; thus the pain of the tooth-ach is + not the cause of any diseased motions, but the effect; the tooth-ach + therefore does not belong to the class of Sensation. As the pain is + caused by increased or decreased action of the membranes of the tooth, + and these actions are owing to the increase or decrease of irritation, + the disease is to be placed in the class of irritation.</p> + + <p>To discover the order it must be inquired, whether the pain be owing + to increased or defective motion of the pained membrane; which is known + by the concomitant heat or coldness of the part. In tooth-ach without + inflammation there is generally a coldness attends the cheek in its + vicinity; as may be perceived by the hand of the patient himself, + compared with the opposite cheek. Hence odontalgia is found to belong to + the order of decreased irritation. The genus and species must be found by + inspecting the synopsis of the second order of the class of Irritation. + See Class <a href="#species_I_2_4_12">I. 2. 4. 12</a>.</p> + + <p>This may be further elucidated by considering the natural operation of + parturition; the pain is occasioned by the increased action or distention + of the vessels of the uterus, in consequence of the stimulus of the + fetus; and is therefore caused by increased irritation; but the action of + the abdominal muscles in its exclusion are caused by the pain, and belong + to the class of increased sensation. See Class <a + href="#species_II_1_1_12">II. 1. 1. 12</a>. Hence the difficulty of + determining, under what class of diseases parturition should be arranged, + consists in there being two kinds of diseased actions comprehended under + one word; which have each their different proximate cause.</p> + + <p>In Sect. XXXIX. 8. 4. and in Class <a href="#species_II_1_1_1">II. 1. + 1. 1</a>. we have endeavoured to give names to four links of animal + causation, which conveniently apply to the classification of diseases; + thus in common nictitation, or winking with the eyes without our + attention to it, the increased irritation is the proximate cause; the + stimulus of the air on the dry cornea is the remote cause; the closing of + the eyelid is the proximate effect; and the diffusion of tears over the + eye-ball is the remote effect. In some cases two more links of causation + may be introduced; one of them may be termed the pre-remote cause; as the + warmth or motion of the atmosphere, which causes greater exhalation from + the cornea. And the other the post-remote effect; as the renewed + pellucidity of the cornea; and thus six links of causation may be + expressed in words.</p> + + <p>But if amid these remote links of animal causation any of the four + powers or faculties of the sensorium be introduced, the reasoning is not + just according to the method here proposed; for these powers of the + sensorium are always the proximate causes of the contractions of animal + fibres; and therefore in true language cannot be termed their remote + causes. From this criterion it may always be determined, whether more + diseases than one are comprehended under one name; a circumstance which + has much impeded the investigation of the causes, and cures of + diseases.</p> + + <p>Thus the term fever, is generally given to a collection of morbid + symptoms; which are indeed so many distinct diseases, that sometimes + appear together, and sometimes separately; hence it has no determinate + meaning, except it signifies simply a quick pulse, which continues for + some hours; in which sense it is here used.</p> + + <p>In naming diseases I have endeavoured to avoid the affectation of + making new compound Greek words, where others equally expressive could be + procured: as a short periphrasis is easier to be understood, and less + burthensome to the memory.</p> + + <p>In the Methodus Medendi, which is marked by M.M. at the end of many of + the species of diseases, the words incitantia, sorbentia, torpentia, + &c. refer to the subsequent articles of the Materia Medica, + explaining the operations of medicines.</p> + + <p>The remote causes of many diseases, their periods, and many + circumstances concerning them, are treated of in the preceding volume; + the descriptions of many of them, which I have omitted for the sake of + brevity, may be seen in the Nosologia Methodica of Sauvages, and in the + Synopsis Nosologiæ of Dr. Cullen, and in the authors to which they + refer.</p> + + <p>In this arduous undertaking the author solicits the candour of the + critical reader; as he cannot but foresee, that many errors will be + discovered, many additional species will require to be inserted; and + others to be transplanted, or erased. If he could expend another forty + years in the practice of medicine, he makes no doubt, but that he could + bring this work nearer perfection, and thence render it more worthy the + attention of philosophers.——As it is, he is induced to hope, + that some advantages will be derived from it to the science of medicine, + and consequent utility to the public, and leaves the completion of his + plan to the industry of future generations.</p> + + <div class="poem"> + <div class="stanza"> + <p><span class="sc">Derby</span>, <i>Jan.</i> 1, 1796.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h2>ZOONOMIA.</h2> + +<h3>PART II.</h3> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>CLASSES OF DISEASES.</h3> + + <p><br style="clear:both" /></p> +<hr /> + + <div class="contents"> + <div class="stanza"> + <p><a href="#class_I">I</a>. DISEASES OF IRRITATION.</p> + </div> + + <div class="stanza"> + <p><a href="#class_II">II</a>. DISEASES OF SENSATION.</p> + </div> + + <div class="stanza"> + <p><a href="#class_III">III</a>. DISEASES OF VOLITION.</p> + </div> + + <div class="stanza"> + <p><a href="#class_IV">IV</a>. DISEASES OF ASSOCIATION.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3><i>The Orders and Genera of the First Class of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS <a name="class_I">I</a>.</h3> + +<p class="cenhead">DISEASES OF IRRITATION.</p> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_I_1_1">1</a>. With increased actions of the sanguiferous system.</p> + <p><a href="#genusi_I_1_2">2</a>. With increased actions of the secerning system.</p> + <p><a href="#genusi_I_1_3">3</a>. With increased actions of the absorbent system.</p> + <p><a href="#genusi_I_1_4">4</a>. With increased actions of other cavities and membranes.</p> + <p><a href="#genusi_I_1_5">5</a>. With increased actions of the organs of sense.</p> + </div> + </div> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_I_2_1">1</a>. With decreased actions of the sanguiferous system.</p> + <p><a href="#genusi_I_2_2">2</a>. With decreased actions of the secerning system.</p> + <p><a href="#genusi_I_2_3">3</a>. With decreased actions of the absorbent system.</p> + <p><a href="#genusi_I_2_4">4</a>. With decreased actions of other cavities and membranes.</p> + <p><a href="#genusi_I_2_5">5</a>. With decreased actions of the organs of sense.</p> + </div> + </div> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Irritative Motions.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_I_3_1">1</a>. Of the alimentary canal.</p> + <p><a href="#genusi_I_3_2">2</a>. Of the absorbent system.</p> + <p><a href="#genusi_I_3_3">3</a>. Of the sanguiferous system.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><i>The Orders, Genera, and Species, of the First Class of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS I.</h3> + +<p class="cenhead">DISEASES OF IRRITATION.</p> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genusi_I_1_1">I</a>.</h3> + +<h3><i>With Increased Actions of the Sanguiferous System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_I_1_1_1">1</a>. <i>Febris irritativa.</i></td><td>Irritative fever.</td></tr> +<tr><td><a href="#species_I_1_1_2">2</a>. <i>Ebrietas.</i></td><td>Drunkenness.</td></tr> +<tr><td><a href="#species_I_1_1_3">3</a>. <i>Hæmorrhagia arteriosa.</i> </td><td>Arterial hæmorrhage.</td></tr> +<tr><td><a href="#species_I_1_1_4">4</a>. <i>Hæmoptoe arteriosa.</i></td><td>Spitting of arterial blood.</td></tr> +<tr><td><a href="#species_I_1_1_5">5</a>. <i>Hæmorrhagia narium.</i></td><td>Bleeding from the nose.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_1_2">II</a>.</h3> + +<h3><i>With Increased Actions of the Secerning System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_1_2_1">1</a>. <i>Calor febrilis.</i></td><td>Febrile heat.</td></tr> +<tr><td> <a href="#species_I_1_2_2">2</a>. <i>Rubor febrilis.</i></td><td>Febrile redness.</td></tr> +<tr><td> <a href="#species_I_1_2_3">3</a>. <i>Sudor calidus.</i></td><td>Warm sweat.</td></tr> +<tr><td> —— <i>febrilis.</i></td><td>Sweat in fevers.</td></tr> +<tr><td> —— <i>a labore.</i></td><td>—— from exercise.</td></tr> +<tr><td> —— <i>ab igne.</i></td><td>—— from fire.</td></tr> +<tr><td> —— <i>a medicamentis.</i></td><td>—— from medicines.</td></tr> +<tr><td> <a href="#species_I_1_2_4">4</a>. <i>Urina uberior colorata.</i> </td><td>Copious coloured urine.</td></tr> +<tr><td> <a href="#species_I_1_2_5">5</a>. <i>Diarrhœa calida.</i></td><td>Warm diarrhoea.</td></tr> +<tr><td> —— <i>febrilis.</i></td><td>—— from fever.</td></tr> +<tr><td> —— <i>crapulosa.</i></td><td>—— from indigestion.</td></tr> +<tr><td> —— <i>infantum.</i></td><td>—— of infants.</td></tr> +<tr><td> <a href="#species_I_1_2_6">6</a>. <i>Salivatio calida.</i></td><td>—— salivation.</td></tr> +<tr><td> <a href="#species_I_1_2_7">7</a>. <i>Catarrhus calidus.</i></td><td>—— catarrh.</td></tr> +<tr><td> <a href="#species_I_1_2_8">8</a>. <i>Expectoratio calida.</i></td><td>—— expectoration.</td></tr> +<tr><td> <a href="#species_I_1_2_9">9</a>. <i>Exsudatio pone aures.</i></td><td>Discharge behind the ears.</td></tr> +<tr><td><a href="#species_I_1_2_10">10</a>. <i>Gonorrhœa calida.</i></td><td>Warm gonorrhœa.</td></tr> +<tr><td><a href="#species_I_1_2_11">11</a>. <i>Fluor albus calidus.</i></td><td>—— fluor albus.</td></tr> +<tr><td><a href="#species_I_1_2_12">12</a>. <i>Hæmorrhois alba.</i></td><td>White piles.</td></tr> +<tr><td><a href="#species_I_1_2_13">13</a>. <i>Serum e visicatorio.</i></td><td>Discharge from a blister.</td></tr> +<tr><td><a href="#species_I_1_2_14">14</a>. <i>Perspiratio fœtida.</i></td><td>Fetid perspiration.</td></tr> +<tr><td><a href="#species_I_1_2_15">15</a>. <i>Crines novi.</i></td><td>New hairs.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_1_3">III</a>.</h3> + +<h3><i>With increased Actions of the Absorbent System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_1_3_1">1</a>. <i>Lingua arida.</i></td><td>Dry tongue.</td></tr> +<tr><td> <a href="#species_I_1_3_2">2</a>. <i>Fauces aridæ.</i></td><td>Dry throat.</td></tr> +<tr><td> <a href="#species_I_1_3_3">3</a>. <i>Nares aridi.</i></td><td>Dry nostrils.</td></tr> +<tr><td> <a href="#species_I_1_3_4">4</a>. <i>Expectoratio solida.</i></td><td>Solid expectoration.</td></tr> +<tr><td> <a href="#species_I_1_3_5">5</a>. <i>Constipatio alvi.</i></td><td>Costiveness.</td></tr> +<tr><td> <a href="#species_I_1_3_6">6</a>. <i>Cutis arida.</i></td><td>Dry skin.</td></tr> +<tr><td> <a href="#species_I_1_3_7">7</a>. <i>Urina parcior colorata.</i></td><td>Diminished coloured urine.</td></tr> +<tr><td> <a href="#species_I_1_3_8">8</a>. <i>Calculus felleus et icterus.</i></td><td>Gall-stone and jaundice.</td></tr> +<tr><td> <a href="#species_I_1_3_9">9</a>. —— <i>renis.</i></td><td>Stone of the kidney.</td></tr> +<tr><td><a href="#species_I_1_3_10">10</a>. —— <i>vesicæ.</i></td><td>Stone of the bladder.</td></tr> +<tr><td><a href="#species_I_1_3_11">11</a>. —— <i>arthriticus.</i></td><td>Gout-stone.</td></tr> +<tr><td><a href="#species_I_1_3_12">12</a>. <i>Rheumatismus chronicus.</i> </td><td>Chronic rheumatism.</td></tr> +<tr><td><a href="#species_I_1_3_13">13</a>. <i>Cicatrix vulnerum.</i></td><td>Healing of ulcers.</td></tr> +<tr><td><a href="#species_I_1_3_14">14</a>. <i>Corneæ obfuscatio.</i></td><td>Scar on the cornea.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_1_4">IV</a>.</h3> + +<h3><i>With increased Actions of other Cavities and Membranes.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_1_4_1">1</a>. <i>Nictitatio irritativa.</i></td><td>Irritative nictitation.</td></tr> +<tr><td> <a href="#species_I_1_4_2">2</a>. <i>Deglutitio irritativa.</i></td><td>Irritative deglutition.</td></tr> +<tr><td> <a href="#species_I_1_4_3">3</a>. <i>Respiratio et tussis.</i></td><td>Respiration and cough.</td></tr> +<tr><td> <a href="#species_I_1_4_4">4</a>. <i>Exclusio bilis.</i></td><td>Exclusion of the bile.</td></tr> +<tr><td> <a href="#species_I_1_4_5">5</a>. <i>Dentitio.</i></td><td>Toothing.</td></tr> +<tr><td> <a href="#species_I_1_4_6">6</a>. <i>Priapismus.</i></td><td>Priapism.</td></tr> +<tr><td> <a href="#species_I_1_4_7">7</a>. <i>Distensio mamularum.</i> </td><td>Distention of the nipples.</td></tr> +<tr><td> <a href="#species_I_1_4_8">8</a>. <i>Descensus uteri.</i></td><td>Descent of the uterus.</td></tr> +<tr><td> <a href="#species_I_1_4_9">9</a>. <i>Prolapsus ani.</i></td><td>Descent of the rectum.</td></tr> +<tr><td><a href="#species_I_1_4_10">10</a>. <i>Lumbricus.</i></td><td>Round worm.</td></tr> +<tr><td><a href="#species_I_1_4_11">11</a>. <i>Tænia.</i></td><td>Tape-worm.</td></tr> +<tr><td><a href="#species_I_1_4_12">12</a>. <i>Ascarides.</i></td><td>Thread-worms.</td></tr> +<tr><td><a href="#species_I_1_4_13">13</a>. <i>Dracunculus.</i></td><td>Guinea-worm.</td></tr> +<tr><td><a href="#species_I_1_4_14">14</a>. <i>Morpiones.</i></td><td>Crab-lice.</td></tr> +<tr><td><a href="#species_I_1_4_15">15</a>. <i>Pediculi.</i></td><td>Lice.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_1_5">V</a>.</h3> + +<h3><i>With increased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_1_5_1">1</a>. <i>Visus acrior.</i></td><td>Acuter sight.</td></tr> +<tr><td> <a href="#species_I_1_5_2">2</a>. <i>Auditus acrior.</i></td><td>—— hearing.</td></tr> +<tr><td> <a href="#species_I_1_5_3">3</a>. <i>Olfactus acrior.</i></td><td>—— smell.</td></tr> +<tr><td> <a href="#species_I_1_5_4">4</a>. <i>Gustus acrior.</i></td><td>—— taste.</td></tr> +<tr><td> <a href="#species_I_1_5_5">5</a>. <i>Tactus acrior.</i></td><td>—— touch.</td></tr> +<tr><td> <a href="#species_I_1_5_6">6</a>. <i>Sensus caloris acrior.</i></td><td>—— sense of heat.</td></tr> +<tr><td> <a href="#species_I_1_5_7">7</a>. —— <i>extensionis acrior.</i> </td><td>—— sense of extension.</td></tr> +<tr><td> <a href="#species_I_1_5_8">8</a>. <i>Titillatio.</i></td><td>Tickling.</td></tr> +<tr><td> <a href="#species_I_1_5_9">9</a>. <i>Pruritus.</i></td><td>Itching.</td></tr> +<tr><td><a href="#species_I_1_5_10">10</a>. <i>Dolor urens.</i></td><td>Smarting.</td></tr> +<tr><td><a href="#species_I_1_5_11">11</a>. <i>Consternatio.</i></td><td>Surprise.</td></tr> +</table> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genusi_I_2_1">I</a>.</h3> + +<h3><i>With decreased Actions of the Sanguiferous System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_2_1_1">1</a>. <i>Febris inirritativa.</i></td><td>Inirritative fever.</td></tr> +<tr><td> <a href="#species_I_2_1_2">2</a>. <i>Paresis inirritativa.</i></td><td>—— debility.</td></tr> +<tr><td> <a href="#species_I_2_1_3">3</a>. <i>Somnus interruptus.</i></td><td>Interrupted sleep.</td></tr> +<tr><td> <a href="#species_I_2_1_4">4</a>. <i>Syncope.</i></td><td>Fainting.</td></tr> +<tr><td> <a href="#species_I_2_1_5">5</a>. <i>Hæmorrhagia venosa.</i> </td><td>Venous hæmorrhage.</td></tr> +<tr><td> <a href="#species_I_2_1_6">6</a>. <i>Hæmorrhois cruenta.</i></td><td>Bleeding piles.</td></tr> +<tr><td> <a href="#species_I_2_1_7">7</a>. <i>Hæmorrhagia renum.</i></td><td>—— from the kidneys.</td></tr> +<tr><td> <a href="#species_I_2_1_8">8</a>. —— <i>hepatis.</i></td><td>—— from the liver.</td></tr> +<tr><td> <a href="#species_I_2_1_9">9</a>. <i>Hæmoptoe venosa.</i></td><td>Spitting of venous blood.</td></tr> +<tr><td><a href="#species_I_2_1_10">10</a>. <i>Palpitatio cordis.</i></td><td>Palpitation of the heart.</td></tr> +<tr><td><a href="#species_I_2_1_11">11</a>. <i>Menorrhagia.</i></td><td>Exuberant menstruation.</td></tr> +<tr><td><a href="#species_I_2_1_12">12</a>. <i>Dysmenorrhagia.</i></td><td>Deficient menstruation.</td></tr> +<tr><td><a href="#species_I_2_1_13">13</a>. <i>Lochia nimia.</i></td><td>Too great lochia.</td></tr> +<tr><td><a href="#species_I_2_1_14">14</a>. <i>Abortio spontanea.</i></td><td>Spontaneous abortion.</td></tr> +<tr><td><a href="#species_I_2_1_15">15</a>. <i>Scorbutus.</i></td><td>Scurvy.</td></tr> +<tr><td><a href="#species_I_2_1_16">16</a>. <i>Vibices.</i></td><td>Extravasations of blood.</td></tr> +<tr><td><a href="#species_I_2_1_17">17</a>. <i>Petechiæ.</i></td><td>Purple spots.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_2_2">II</a>.</h3> + +<h3><i>With decreased Actions of the Secerning System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_2_2_1">1</a>. <i>Frigus febrile.</i></td><td>Coldness in fevers.</td></tr> +<tr><td> —— <i>chronicum.</i></td><td>—— permanent.</td></tr> +<tr><td> <a href="#species_I_2_2_2">2</a>. <i>Pallor fugitivus.</i></td><td>Paleness fugitive.</td></tr> +<tr><td> —— <i>permanens.</i></td><td>—— permanent.</td></tr> +<tr><td> <a href="#species_I_2_2_3">3</a>. <i>Pus parcius.</i></td><td>Diminished pus.</td></tr> +<tr><td> <a href="#species_I_2_2_4">4</a>. <i>Mucus parcior.</i></td><td>Diminished mucus.</td></tr> +<tr><td> <a href="#species_I_2_2_5">5</a>. <i>Urina parcior pallida.</i></td><td>Pale diminished urine.</td></tr> +<tr><td> <a href="#species_I_2_2_6">6</a>. <i>Torpor hepaticus.</i></td><td>Torpor of the liver.</td></tr> +<tr><td> <a href="#species_I_2_2_7">7</a>. <i>Torpor pancreatis.</i></td><td>Torpor of the pancreas.</td></tr> +<tr><td> <a href="#species_I_2_2_8">8</a>. <i>Torpor renis.</i></td><td>Torpor of the kidney.</td></tr> +<tr><td> <a href="#species_I_2_2_9">9</a>. <i>Punctæ mucosæ vultus.</i> </td><td>Mucous spots on the face.</td></tr> +<tr><td><a href="#species_I_2_2_10">10</a>. <i>Maculæ cutis fulvæ.</i></td><td>Tawny blots on the skin.</td></tr> +<tr><td><a href="#species_I_2_2_11">11</a>. <i>Canities.</i></td><td>Grey hairs.</td></tr> +<tr><td><a href="#species_I_2_2_12">12</a>. <i>Callus.</i></td><td>Callus.</td></tr> +<tr><td><a href="#species_I_2_2_13">13</a>. <i>Cataracta.</i></td><td>Cataract.</td></tr> +<tr><td><a href="#species_I_2_2_14">14</a>. <i>Innutritio ossium.</i></td><td>Innutrition of the bones.</td></tr> +<tr><td><a href="#species_I_2_2_15">15</a>. <i>Rachitis.</i></td><td>Rickets.</td></tr> +<tr><td><a href="#species_I_2_2_16">16</a>. <i>Spina distortio.</i></td><td>Distortion of the spine.</td></tr> +<tr><td><a href="#species_I_2_2_17">17</a>. <i>Claudicatio coxaria.</i></td><td>Lameness of the hip.</td></tr> +<tr><td><a href="#species_I_2_2_18">18</a>. <i>Spina protuberans.</i></td><td>Protuberant spine.</td></tr> +<tr><td><a href="#species_I_2_2_19">19</a>. <i>Spina bifida.</i></td><td>Divided spine.</td></tr> +<tr><td><a href="#species_I_2_2_20">20</a>. <i>Defectus palati.</i></td><td>Defect of the palate.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_2_3">III</a>.</h3> + +<h3><i>With decreased Actions of the Absorbent System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_2_3_1">1</a>. <i>Mucus faucium frigidus.</i></td><td>Cold mucus from the throat.</td></tr> +<tr><td> <a href="#species_I_2_3_2">2</a>. <i>Sudor frigidus.</i></td><td>—— sweat.</td></tr> +<tr><td> <a href="#species_I_2_3_3">3</a>. <i>Catarrhus frigidus.</i></td><td>—— catarrh.</td></tr> +<tr><td> <a href="#species_I_2_3_4">4</a>. <i>Expectoratio frigida.</i></td><td>—— expectoration.</td></tr> +<tr><td> <a href="#species_I_2_3_5">5</a>. <i>Urina uberior pallida.</i></td><td>Copious pale urine.</td></tr> +<tr><td> <a href="#species_I_2_3_6">6</a>. <i>Diarrhœa frigida.</i></td><td>Cold diarrhœa.</td></tr> +<tr><td> <a href="#species_I_2_3_7">7</a>. <i>Fluor albus frigidus.</i></td><td>—— fluor albus.</td></tr> +<tr><td> <a href="#species_I_2_3_8">8</a>. <i>Gonarrhœa frigida.</i></td><td>—— gonorrhœa.</td></tr> +<tr><td> <a href="#species_I_2_3_9">9</a>. <i>Hepatis tumor.</i></td><td>Swelling of the liver.</td></tr> +<tr><td><a href="#species_I_2_3_10">10</a>. <i>Chlorosis.</i></td><td>Green sickness.</td></tr> +<tr><td><a href="#species_I_2_3_11">11</a>. <i>Hydrocele.</i></td><td>Dropsy of the vagina testis.</td></tr> +<tr><td><a href="#species_I_2_3_12">12</a>. <i>Hydrocephalus internus.</i></td><td>—— of the brain.</td></tr> +<tr><td><a href="#species_I_2_3_13">13</a>. <i>Ascites.</i></td><td>—— of the belly.</td></tr> +<tr><td><a href="#species_I_2_3_14">14</a>. <i>Hydrothorax.</i></td><td>—— of the chest.</td></tr> +<tr><td><a href="#species_I_2_3_15">15</a>. <i>Hydrops ovarii.</i></td><td>—— of the ovary.</td></tr> +<tr><td><a href="#species_I_2_3_16">16</a>. <i>Anasarca pulmonum.</i></td><td>—— of the lungs.</td></tr> +<tr><td><a href="#species_I_2_3_17">17</a>. <i>Obesitas.</i></td><td>Corpulency.</td></tr> +<tr><td><a href="#species_I_2_3_18">18</a>. <i>Splenis tumor.</i></td><td>Swelling of the spleen.</td></tr> +<tr><td><a href="#species_I_2_3_19">19</a>. <i>Genu tumor albus.</i></td><td>White swelling of the knee.</td></tr> +<tr><td><a href="#species_I_2_3_20">20</a>. <i>Bronchocele.</i></td><td>Swelled throat.</td></tr> +<tr><td><a href="#species_I_2_3_21">21</a>. <i>Scrophula.</i></td><td>King's evil.</td></tr> +<tr><td><a href="#species_I_2_3_22">22</a>. <i>Schirrus.</i></td><td>Schirrus.</td></tr> +<tr><td><a href="#species_I_2_3_23">23</a>. —— <i>recti.</i></td><td>—— of the rectum.</td></tr> +<tr><td><a href="#species_I_2_3_24">24</a>. —— <i>urethræ.</i></td><td>—— of the urethra.</td></tr> +<tr><td><a href="#species_I_2_3_25">25</a>. —— <i>œsophagi.</i></td><td>—— of the throat.</td></tr> +<tr><td><a href="#species_I_2_3_26">26</a>. <i>Lacteorum inirritabilitas.</i></td><td>Inirritability of the lacteals.</td></tr> +<tr><td><a href="#species_I_2_3_27">27</a>. <i>Lymphaticorum inirritabilitas.</i> </td><td>Inirritability of the lymphatics.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_2_4">IV</a>.</h3> + +<h3><i>With decreased Actions of other Cavities and Membranes.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_2_4_1">1</a>. <i>Sitis calida.</i></td><td>Thirst warm.</td></tr> +<tr><td> —— <i>frigida.</i></td><td>—— cold.</td></tr> +<tr><td> <a href="#species_I_2_4_2">2</a>. <i>Esuries.</i></td><td>Hunger.</td></tr> +<tr><td> <a href="#species_I_2_4_3">3</a>. <i>Nausea sicca.</i></td><td>Dry Nausea.</td></tr> +<tr><td> <a href="#species_I_2_4_4">4</a>. <i>Ægritudo ventriculi.</i></td><td>Sickness of stomach.</td></tr> +<tr><td> <a href="#species_I_2_4_5">5</a>. <i>Cardialgia.</i></td><td>Heart-burn.</td></tr> +<tr><td> <a href="#species_I_2_4_6">6</a>. <i>Arthritis ventriculi.</i></td><td>Gout of the stomach.</td></tr> +<tr><td> <a href="#species_I_2_4_7">7</a>. <i>Colica flatulenta.</i></td><td>Flatulent colic.</td></tr> +<tr><td> <a href="#species_I_2_4_8">8</a>. <i>Colica saturnina.</i></td><td>Colic from lead.</td></tr> +<tr><td> <a href="#species_I_2_4_9">9</a>. <i>Tympanitis.</i></td><td>Tympany.</td></tr> +<tr><td><a href="#species_I_2_4_10">10</a>. <i>Hypochondriasis.</i></td><td>Hypochondriacism.</td></tr> +<tr><td><a href="#species_I_2_4_11">11</a>. <i>Cephalæa frigida.</i></td><td>Cold head-ach.</td></tr> +<tr><td><a href="#species_I_2_4_12">12</a>. <i>Odontalgia.</i></td><td>Tooth-ach.</td></tr> +<tr><td><a href="#species_I_2_4_13">13</a>. <i>Otalgia.</i></td><td>Ear-ach.</td></tr> +<tr><td><a href="#species_I_2_4_14">14</a>. <i>Pleurodyne chronica.</i></td><td>Chronical pain of the side.</td></tr> +<tr><td><a href="#species_I_2_4_15">15</a>. <i>Sciatica frigida.</i></td><td>Cold sciatica.</td></tr> +<tr><td><a href="#species_I_2_4_16">16</a>. <i>Lumbago frigida.</i></td><td>—— lumbago.</td></tr> +<tr><td><a href="#species_I_2_4_17">17</a>. <i>Hysteralgia frigida.</i></td><td>—— pain of the uterus.</td></tr> +<tr><td><a href="#species_I_2_4_18">18</a>. <i>Proctalgia frigida.</i></td><td>—— pain of the rectum.</td></tr> +<tr><td><a href="#species_I_2_4_19">19</a>. <i>Vesicæ felleæ inirritibilitas et icterus.</i> </td><td>Inirritability of the gall-bladder and jaundice.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_2_5">V</a>.</h3> + +<h3><i>With decreased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_2_5_1">1</a>. <i>Stultitia inirritabilis.</i> </td><td>Folly from inirritability.</td></tr> +<tr><td> <a href="#species_I_2_5_2">2</a>. <i>Visus imminutus.</i></td><td>Impaired vision.</td></tr> +<tr><td> <a href="#species_I_2_5_3">3</a>. <i>Muscæ volitantes.</i></td><td>Dark moving specks.</td></tr> +<tr><td> <a href="#species_I_2_5_4">4</a>. <i>Strabismus.</i></td><td>Squinting.</td></tr> +<tr><td> <a href="#species_I_2_5_5">5</a>. <i>Amaurosis.</i></td><td>Palsy of the optic nerve.</td></tr> +<tr><td> <a href="#species_I_2_5_6">6</a>. <i>Auditus imminutus.</i></td><td>Impaired hearing.</td></tr> +<tr><td> <a href="#species_I_2_5_7">7</a>. <i>Olfactus imminutus.</i></td><td>—— smell.</td></tr> +<tr><td> <a href="#species_I_2_5_8">8</a>. <i>Gustus imminutus.</i></td><td>—— taste.</td></tr> +<tr><td> <a href="#species_I_2_5_9">9</a>. <i><span class="correction" title="Original reads `Tactu,' (compare main text).">Tactus</span> imminutus.</i></td><td>—— touch.</td></tr> +<tr><td><a href="#species_I_2_5_10">10</a>. <i>Stupor.</i></td><td>Stupor.</td></tr> +</table> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Irritative Motions.</i></h3> + +<h3>GENUS <a name="genusi_I_3_1">I</a>.</h3> + +<h3><i>Of the Alimentary Canal.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_3_1_1">1</a>. <i>Ruminatio.</i></td><td>Chewing the cud.</td></tr> +<tr><td> <a href="#species_I_3_1_2">2</a>. <i>Ructus.</i></td><td>Eructation.</td></tr> +<tr><td> <a href="#species_I_3_1_3">3</a>. <i>Apepsia.</i></td><td>Indigestion, water-qualm.</td></tr> +<tr><td> <a href="#species_I_3_1_4">4</a>. <i>Vomitus.</i></td><td>Vomiting.</td></tr> +<tr><td> <a href="#species_I_3_1_5">5</a>. <i>Cholera.</i></td><td>Cholera.</td></tr> +<tr><td> <a href="#species_I_3_1_6">6</a>. <i>Ileus.</i></td><td>Iliac passion.</td></tr> +<tr><td> <a href="#species_I_3_1_7">7</a>. <i>Globus hystericus.</i></td><td>Hysteric strangulation.</td></tr> +<tr><td> <a href="#species_I_3_1_8">8</a>. <i>Vomendi conamen inane.</i> </td><td>Vain efforts to vomit.</td></tr> +<tr><td> <a href="#species_I_3_1_9">9</a>. <i>Borborigmus.</i></td><td>Gurgling of the bowels.</td></tr> +<tr><td><a href="#species_I_3_1_10">10</a>. <i>Hysteria.</i></td><td>Hysteric disease.</td></tr> +<tr><td><a href="#species_I_3_1_11">11</a>. <i>Hydrophobia.</i></td><td>Dread of water.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_3_2">II</a>.</h3> + +<h3><i>Of the Absorbent System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_I_3_2_1">1</a>. <i>Catarrhus lymphaticus.</i> </td><td>Lymphatic catarrh.</td></tr> +<tr><td> <a href="#species_I_3_2_2">2</a>. <i>Salivatio lymphatica.</i></td><td>Lymphatic salivation.</td></tr> +<tr><td> <a href="#species_I_3_2_3">3</a>. <i>Nausea humida.</i></td><td>Moist nausea.</td></tr> +<tr><td> <a href="#species_I_3_2_4">4</a>. <i>Diarrhœa lymphatica.</i></td><td>Lymphatic flux.</td></tr> +<tr><td> <a href="#species_I_3_2_5">5</a>. <i>Diarrhœa chylifera.</i></td><td>Flux of chyle.</td></tr> +<tr><td> <a href="#species_I_3_2_6">6</a>. <i>Diabætes.</i></td><td>Diabetes.</td></tr> +<tr><td> <a href="#species_I_3_2_7">7</a>. <i>Sudor lymphaticus.</i></td><td>Lymphatic sweat.</td></tr> +<tr><td> <a href="#species_I_3_2_8">8</a>. <i>Sudor asthmaticus.</i></td><td>Asthmatic sweat.</td></tr> +<tr><td> <a href="#species_I_3_2_9">9</a>. <i>Translatio puris.</i></td><td>Translation of matter.</td></tr> +<tr><td><a href="#species_I_3_2_10">10</a>. —— <i>lactis.</i></td><td>—— of milk.</td></tr> +<tr><td><a href="#species_I_3_2_11">11</a>. —— <i>urinæ.</i></td><td>—— of urine.</td></tr> +</table> + +<h3>GENUS <a name="genusi_I_3_3">III</a>.</h3> + +<h3><i>Of the Sanguiferous System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_I_3_3_1">1</a>. <i>Capillarium motus retrogressus.</i> </td><td>Retrograde motion of the capillaries.</td></tr> +<tr><td><a href="#species_I_3_3_2">2</a>. <i>Palpitatio cordis.</i></td><td>Palpitation of the heart.</td></tr> +<tr><td><a href="#species_I_3_3_3">3</a>. <i>Anhelatio spasmodica.</i></td><td>Spasmodic panting.</td></tr> +</table> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>CLASS I.</h3> + +<p class="cenhead">DISEASES OF IRRITATION.</p> + +<h3>ORDO <a name="ordo_I_1">I</a>.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_1_1">I</a>.</h3> + +<h3><i>With increased Actions of the Sanguiferous System.</i></h3> + + <p>The irritability of the whole, or of part, of our system is + perpetually changing; these vicissitudes of irritability and of + inirritability are believed to depend on the accumulation or exhaustion + of the sensorial power, as their proximate cause; and on the difference + of the present stimulus, and of that which we had previously been + accustomed to, as their remote cause. Thus a smaller degree of heat + produces pain and inflammation in our hands, after they have been for a + time immersed in snow; which is owing to the accumulation of sensorial + power in the moving fibres of the cutaneous vessels during their previous + quiescence, when they were benumbed with cold. And we feel ourselves cold + in the usual temperature of the atmosphere on coming out of a warm room; + which is owing to the exhaustion of sensorial power in the moving fibres + of the vessels of the skin by their previous increased activity, into + which they were excited by unusual heat.</p> + + <p>Hence the cold fits of fever are the occasion of the succeeding hot + ones; and the hot fits contribute to occasion in their turn the + succeeding cold ones. And though the increase of stimulus, as of heat, + exercise, or distention, will produce an increased action of the + stimulated fibres; in the same manner as it is produced by the increased + irritability which was occasioned by a previous defect of stimulus; yet + as the excesses of irritation from the stimulus of external things are + more easily avoided than the deficiencies of it; the diseases of this + country, except those which are the consequences of drunkenness, or of + immoderate exercise, more frequently begin with torpor than with orgasm; + that is, with inactivity of some parts, or of the whole of the system, + and consequent coldness, than with increased activity, and consequent + heat.</p> + + <p>If the hot fit be the consequence of the cold one, it may be asked if + they are proportionate to each other: it is probable that they are, where + no part is destroyed by the cold fit, as in mortification or death. But + we have no measure to distinguish this, except the time of their + duration; whereas the extent of the torpor over a greater or less part of + the system, which occasions the cold fit; or of the exertion which + occasions the hot one; as well as the degree of such torpor or exertion, + are perhaps more material than the time of their duration. Besides this + some muscles are less liable to accumulate sensorial power during their + torpor, than others, as the locomotive muscles compared with the + capillary arteries; on all which accounts a long cold fit may often be + followed by a short hot one.</p> + + <p><a name="page_14_after_line_20"></a></p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_1_1_1">1</a>. <i>Febris irritativa.</i> Irritative + fever. This is the synocha of some writers, it is attended with strong + pulse without inflammation; and in this circumstance differs from the + febris inirritativa of Class <a href="#species_I_2_1_1">I. 2. 1. 1</a>. + which is attended with weak pulse without inflammation. The increased + frequency of the pulsation of the heart and arteries constitutes fever; + during the cold fit these pulsations are always weak, as the energy of + action is then decreased throughout the whole system; and therefore the + general arterial strength cannot be determined by the touch, till the + cold part of the paroxysm ceases. This determination is sometimes + attended with difficulty; as strong and weak are only comparative degrees + of the greater or less resistance of the pulsation of the artery to the + compression of the finger. But the greater or less frequency of the + pulsations affords a collateral evidence in those cases, where the degree + of strength is not very distinguishable, which may assist our judgment + concerning it. Since a moderately strong pulse, when the patient is in a + recumbent posture, and not hurried in mind, seldom exceeds 120 strokes in + a minute; whereas a weak one often exceeds 130 in a recumbent posture, + and 150 in an erect one, in those fevers, which are termed nervous or + putrid. See Sect. XII. 1. 4.</p> + + <p>The increased frequency of the pulsation of the heart and arteries, as + it is occasioned either by excess or defect of stimulus, or of sensorial + power, exists both in the cold and hot fits of fever; but when the cold + fit ceases, and the pulse becomes strong and full as well as quick, in + consequence of the increased irritability of the heart and arteries, it + constitutes the irritative fever, or synocha. It is attended with + considerable heat during the paroxysm, and generally terminates in a + quarter of a lunation, without any disturbance of the faculties of the + mind. See Class <a href="#species_IV_1_1_8">IV. 1. 1. 8</a>.</p> + + <p>M. M. Venesection. Emetics. Cathartics. Cool the patient in the hot + fit, and warm him in the cold one. Rest. Torpentia.</p> + + <p><a name="species_I_1_1_2">2</a>. <i>Ebrietas.</i> Drunkenness. By the + stimulus of wine or opium the whole arterial system, as well as every + other part of the moving system, is excited into increased action. All + the secretions, and with them the production of sensorial power itself in + the brain, seem to be for a time increased, with an additional quantity + of heat, and of pleasureable sensation. See Sect. XXI. on this subject. + This explains, why at the commencement of the warm paroxysm of some + fevers the patient is in greater spirits, or vivacity; because, as in + drunkenness, the irritative motions are all increased, and a greater + production of sensation is the consequence, which when in a certain + degree, is pleasureable, as in the diurnal fever of weak people. Sect. + XXXVI. 3. 1.</p> + + <p><a name="species_I_1_1_3">3</a>. <i>Hæmorrhagia arteriosa.</i> + Arterial hæmorrhage. Bleeding with a quick, strong, and full pulse. The + hæmorrhages from the lungs, and from the nose, are the most frequent of + these; but it sometimes happens, that a small artery but half divided, or + the puncture of a leech, will continue to bleed pertinaciously.</p> + + <p>M. M. Venesection. Cathartic with calomel. Divide the wounded artery. + Bind sponge on the puncture. If coffee or charcoal internally? If air + with less oxygen?</p> + + <p><a name="species_I_1_1_4">4</a>. <i>Hæmoptoe arteriosa.</i> Spitting + of arterial blood. Blood spit up from the lungs is florid, because it has + just been exposed to the influence of the air in its passage through the + extremities of the pulmonary artery; it is frothy, from the admixture of + air with it in the bronchia. The patients frequently vomit at the same + time from the disagreeable titillation of blood about the fauces; and are + thence liable to believe, that the blood is rejected from the + stomach.</p> + + <p>Sometimes an hæmoptoe for several successive days returns in gouty + persons without danger, and seems to supply the place of the gouty + paroxysms. Is not the liver always diseased previous to the hæmoptoe, as + in several other hæmorrhages? See Class <a href="#species_I_2_1_9">I. 2. + 1. 9</a>.</p> + + <p>M. M. Venesection, a purge, a blister, diluents, torpentia; and + afterwards sorbentia, as the bark, the acid of vitriol, and opium. An + emetic is said to stop a pulmonary hæmorrhage, which it may effect, as + sickness decreases the circulation, as is very evident in the great + sickness sometimes produced by too large a dose of digitalis + purpurea.</p> + + <p>Dr. Rush says, a table spoonful or two of common salt is successful in + hæmoptoe; this may be owing to its stimulating the absorbent systems, + both the lymphatic, and the venous. Should the patient respire air with + less oxygen? or be made sick by whirling round in a chair suspended by a + rope? One immersion in cold water, or a sudden sprinkling all over with + cold water, would probably stop a pulmonary hæmorrhage. See Sect. XXVII. + 1.</p> + + <p><a name="species_I_1_1_5">5</a>. <i>Hæmorrhagia narium.</i> + <i>Epistaxis</i>. Bleeding at the nose in elderly subjects most + frequently attends those, whose livers are enlarged or inflamed by the + too frequent use of fermented liquors.</p> + + <p>In boys it occurs perhaps simply from redundancy of blood; and in + young girls sometimes precedes the approach of the catamenia; and then it + shews a disposition contrary to chlorosis; which arises from a deficiency + of red blood.</p> + + <p>M. M. It is stopped by plunging the head into cold water, with + powdered salt hastily dissolved in it; or sometimes by lint strewed over + with wheat flour put up the nostrils; or by a solution of steel in brandy + applied to the vessel by means of lint. The cure in other respects as in + hæmoptoe; when the bleeding recurs at certain periods, after venesection, + and evacuation by calomel, and a blister, the bark and steel must be + given, as in intermittent fevers. See Section XXVII. 1.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_1_2">II</a>.</h3> + +<h3><i>With increased Actions of the Secerning System.</i></h3> + + <p>These are always attended with increase of partial or of general heat; + for the secreted fluids are not simply separated from the blood, but are + new combinations; as they did not previously exist as such in the blood + vessels. But all new combinations give out heat chemically; hence the + origin of animal heat, which is always increased in proportion to the + secretion of the part affected, or to the general quantity of the + secretions. Nevertheless there is reason to believe, that as we have a + sense purposely to distinguish the presence of greater or less quantities + of heat, as mentioned in Sect. XIV. 6. so we may have certain minute + glands for the secretion of this fluid, as the brain is believed to + secrete the sensorial power, which would more easily account for the + instantaneous production of the blush of shame, and of anger. This + subject deserves further investigation.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_1_2_1">1</a>. <i>Calor febrilis.</i> The heat in + fevers arises from the increase of some secretion, either of the natural + fluids, as in irritative fevers; or of new fluids, as in infectious + fevers; or of new vessels, as in inflammatory fevers. The pain of heat is + a consequence of the increased extension or contraction of the fibres + exposed to so great a stimulus. See <span class="sc">Class</span> <a + href="#species_I_1_5_6">I. 1. 5. 6</a>.</p> + + <p><a name="species_I_1_2_2">2</a>. <i>Rubor febrilis.</i> Febrile + redness. When the cold fit of fever terminates, and the pulsations of the + heart and arteries become strong as well as quick from the increase of + their irritability after their late quiescence, the blood is impelled + forwards into the fine extremities of the arteries, and the anastomozing + capillaries, quicker than the extremities of the veins can absorb and + return it to the heart. Hence the pulse at the wrist becomes full, as + well as quick and strong, and the skin glows with arterial blood, and the + veins become empty and less visible.</p> + + <p>In elderly people the force of the heart and arteries becomes less, + while the absorbent power of the veins remains the same; whence the + capillary vessels part with the blood, as soon as it is received, and the + skin in consequence becomes paler; it is also probable, that in more + advanced life some of the finer branches of the arteries coalesce, and + become impervious, and thus add to the opacity of the skin.</p> + + <p><a name="species_I_1_2_3">3</a>. <i>Sudor calidus.</i> Warm sweat may + be divided into four varieties, according to their remote causes. + <i>First</i>, the perspirable matter is secreted in as great quantity + during the hot fit of fever, as towards the end of it, when the sweat is + seen upon the skin. But during the hot fit the cutaneous absorbents act + also with increased energy, and the exhalation is likewise increased by + the greater heat of the skin; and hence it does not appear in drops on + the surface, but is in part reabsorbed, and in part dissipated in the + atmosphere. But as the mouths of the cutaneous absorbents are exposed to + the cool air or bedclothes; whilst those of the capillary glands, which + secrete the perspirable matter, are exposed to the warmth of the + circulating blood; the former, as soon as the fever-fit begins to + decline, lose their increased action first; and hence the absorption of + the sweat is diminished, whilst the increased secretion of it continues + for some hours afterwards, which occasions it to stand in drops upon the + skin.</p> + + <p>As the skin becomes cooler, the evaporation of the perspirable matter + becomes less, as well as the absorption of it. And hence the dissipation + of aqueous fluid from the body, and the consequent thirst, are perhaps + greater during the hot fit, than during the subsequent sweat. For the + sweats do not occur, according to Dr. Alexander's experiments, till the + skin is cooled from 112 to 108 degrees of heat; that is, till the + paroxysm begins to decline. From this it appears, that the sweats are not + critical to the hot fit, any more than the hot fit can be called critical + to the cold one; but simply, that they are the natural consequence of the + decline of the hot fit, commencing with the decreased action of the + absorbent system, and the decreased evaporation from the skin. And from + hence it may be concluded, that a fever-fit is not in general an effort + of nature to restore health, as Sydenham considered it, but a necessary + consequence of the previous torpor; and that the causes of fevers would + be less detrimental, if the fever itself could be prevented from + existing; as appears in the cool treatment of the small-pox.</p> + + <p>It must be noted that the profuse sweats on the skin are more frequent + at the decline of fever-fits than the copious urine, or loose stools, + which are mentioned below; as the cutaneous absorbents, being exposed to + the cool air, lose their increased action sooner than the urinary or + intestinal absorbents; which open into the warm cavities of the bladder + and intestines; but which are nevertheless often affected by their + sympathy with the cutaneous absorbents. Hence few fevers terminate + without a moisture of the skin; whence arose the fatal practice of + forcing sweats by the external warmth of air or bedclothes in fevers; for + external warmth increases the action of the cutaneous capillaries more + than that of the other secerning vessels; because the latter are + habituated to 98 degrees of heat, the internal warmth of the body; + whereas the cutaneous capillaries being nearer the surface are habitually + kept cooler by the contact of the external air. Sweats thus produced by + heat in confined rooms are still more detrimental; as the air becomes + then not only deprived of a part of its oxygene by frequent respiration, + but is loaded with animal effluvia as well as with moisture, till it can + receive no more; and in consequence, while the cutaneous secretion stands + upon the skin in drops for want of exhalation, the lungs are exposed to + an insalubrious atmosphere.</p> + + <p>I do not deny, that sweating may be so managed as to be serviceable in + preventing the return of the cold paroxysm of fevers; like the warm bath, + or any other permanent stimulus, as wine, or opium, or the bark. For this + purpose it should be continued till past the time of the expected cold + fit, supported by moderate doses of wine-whey, with spirit of hartshorn, + and moderate degrees of warmth. Its salutary effect, when thus managed, + was probably one cause of its having been so much attended to; and the + fetid smell, which when profuse is liable to accompany it, gave occasion + to the belief, that the supposed material cause of the disease was thus + eliminated from the circulation.</p> + + <p>When too great external heat is applied, the system is weakened by + excess of action, and the torpor which causes the cold paroxysm recurs + sooner and more violently. For though some stimuli, as of opium and + alcohol, at the same time that they exhaust the sensorial power by + promoting increase of fibrous action, may also increase the production or + secretion of it in the brain, yet experience teaches us, that the + exhaustion far out-balances the increased production, as is evinced by + the general debility, which succeeds intoxication.</p> + + <p>In respect to the fetor attending copious continued sweats, it is + owing to the animalized part of this fluid being kept in that degree of + warmth, which most favours putrefaction, and not suffered to exhale into + the atmosphere. Broth, or other animal mucus, kept in similar + circumstances, would in the same time acquire a putrid smell; yet has + this error frequently produced miliary eruptions, and increased every + kind of inflammatory or sensitive fever.</p> + + <p>The ease, which the patient experiences during sweating, if it be not + produced by much external heat, is similar to that of the warm bath; + which by its stimulus applied to the cutaneous vessels, which are + generally cooler than the internal parts of the system, excites them into + greater action; and pleasureable sensation is the consequence of these + increased actions of the vessels of the skin. From considering all these + circumstances, it appears that it is not the evacuation by sweats, but + the continued stimulus, which causes and supports those sweats, which is + serviceable in preventing the returns of fever-fits. And that sweats too + long continued, or induced by too great stimulus of warmth, clothes, or + medicines, greatly injure the patient by increasing inflammation, or by + exhausting the sensorial power. See Class <a href="#species_I_1_2_14">I. + 1. 2. 14</a>.</p> + + <p><i>Secondly</i>, The sweats produced by exercise or labour are of the + warm kind; as they originate from the increased action of the capillaries + of the skin, owing to their being more powerfully stimulated by the + greater velocity of the blood, and by a greater quantity of it passing + through them in a given time. For the blood during violent exercise is + carried forwards by the action of the muscles faster in the arteries, + than it can be taken up by the veins; as appears by the redness of the + skin. And from the consequent sweats, it is evinced, that the secretory + vessels of the skin during exercise pour out the perspirable matter + faster, than the mouths of the absorbent vessels can drink it up. Which + mouths are not exposed to the increased muscular action, or to the + stimulus of the increased velocity and quantity of the blood, but to the + cool air.</p> + + <p><i>Thirdly</i>, the increased secretion of perspirable matter + occasioned by the stimulus of external heat belongs likewise to this + place; as it is caused by the increased motions of the capillary vessels; + which thus separate from the blood more perspirable matter, than the + mouths of their correspondent absorbent vessels can take up; though these + also are stimulated by external heat into more energetic action. If the + air be stationary, as in a small room, or bed with closed curtains, the + sweat stands in drops on the skin for want of a quicker exhalation + proportioned to the quicker secretion.</p> + + <p>A <i>fourth</i> variety of warm perspiration is that occasioned by + stimulating drugs, of which opium and alcohol are the most powerful; and + next to these the spices, volatile alkali, and neutral salts, especially + sea salt; that much of the aqueous part of the blood is dissipated by the + use of these drugs, is evinced by the great thirst, which occurs a few + hours after the use of them. See Art. <span class="correction" + title="There is no such article: I cannot determine a correction.">III. + 2. 12.</span> and Art. <a href="#art_III_2_1">III. 2. 1</a>.</p> + + <p>We may from hence understand, that the increase of this secretion of + perspirable matter by artificial means, must be followed by debility and + emaciation. When this is done by taking much salt, or salted meat, the + sea-scurvy is produced; which consists in the inirritability of the + bibulous terminations of the veins arising from the capillaries; see + Class <a href="#species_I_2_1_14">I. 2. 1. 14</a>. The scrophula, or + inirritability of the lymphatic glands, seems also to be occasionally + induced by an excess in eating salt added to food of bad nourishment. See + Class <a href="#species_I_2_3_21">I. 2. 3. 21</a>. If an excess of + perspiration is induced by warm or stimulant clothing, as by wearing + flannel in contact with the skin in the summer months, a perpetual + febricula is excited, both by the preventing the access of cool air to + the skin, and by perpetually goading it by the numerous and hard points + of the ends of the wool; which when applied to the tender skins of young + children, frequently produce the red gum, as it is called; and in grown + people, either an erysipelas, or a miliary eruption, attended with fever. + See Class <a href="#species_II_1_3_12">II. 1. 3. 12</a>.</p> + + <p>Shirts made of cotton or calico stimulate the skin too much by the + points of the fibres, though less than flannel; whence cotton + handkerchiefs make the nose sore by frequent use. The fibres of cotton + are, I suppose, ten times shorter than those of flax, and the number of + points in consequence twenty times the number; and though the + manufacturers singe their calicoes on a red-hot iron cylinder, yet I have + more than once seen an erysipelas induced or increased by the stimulus of + calico, as well as of flannel.</p> + + <p>The increase of perspiration by heat either of clothes, or of fire, + contributes much to emaciate the body; as is well known to jockeys, who, + when they are a stone or two too heavy for riding, find the quickest way + to lessen their weight is by sweating themselves between blankets in a + warm room; but this likewise is a practice by no means to be recommended, + as it weakens the system by the excess of so general a stimulus, brings + on a premature old age, and shortens the span of life; as may be further + deduced from the quick maturity, and shortness of the lives, of the + inhabitants of Hindostan, and other tropical climates.</p> + + <p>M. Buffon made a curious experiment to shew this circumstance. He took + a numerous brood of the butterflies of silkworms, some hundreds of which + left their eggs on the same day and hour; these he divided into two + parcels; and placing one parcel in the south window, and the other in the + north window of his house, he observed, that those in the colder + situation lived many days longer than those in the warmer one. From these + observations it appears, that the wearing of flannel clothing next the + skin, which is now so much in fashion, however useful it may be in the + winter to those, who have cold extremities, bad digestions, or habitual + coughs, must greatly debilitate them, if worn in the warm months, + producing fevers, eruptions, and premature old age. See Sect. XXXVII. 5. + Class <a href="#species_I_1_2_14">I. 1. 2. 14</a>. Art. <a + href="#art_III_2_1">III. 2. 1</a>.</p> + + <p><a name="species_I_1_2_4">4</a>. <i>Urina uberior colorata.</i> + Copious coloured urine. Towards the end of fever-fits a large quantity of + high coloured urine is voided, the kidneys continuing to act strongly, + after the increased action of the absorbents of the bladder is somewhat + diminished. If the absorbents continue also to act strongly, the urine is + higher coloured, and so loaded as to deposit, when cool, an earthy + sediment, erroneously thought to be the material cause of the disease; + but is simply owing to the secretion of the kidnies being great from + their increased action; and the thinner parts of it being absorbed by the + increased action of the lymphatics, which are spread very thick on the + neck of the bladder; for the urine, as well as perhaps all the other + secreted fluids, is produced from the kidnies in a very dilute state; as + appears in those, who from the stimulus of a stone, or other cause, + evacuate their urine too frequently; which is then pale from its not + having remained in the bladder long enough for the more aqueous part to + have been reabsorbed. The general use of this urinary absorption to the + animal œconomy is evinced from the urinary bladders of fish, which + would otherwise be unnecessary. High coloured urine in large quantity + shews only, that the secreting vessels of the kidnies, and the absorbents + of the bladder, have acted with greater energy. When there is much earthy + sediment, it shews, that the absorbents have acted proportionally + stronger, and have consequently left the urine in a less dilute state. In + this urine the transparent sediment or cloud is mucous; the opake + sediment is probably coagulable lymph from the blood changed by an animal + or chemical process. The floating scum is oil. The angular concretions to + the sides of the pot, formed as the urine cools, is microcosmic salt. + Does the adhesive blue matter on the sides of the glass, or the blue + circle on it at the edge of the upper surface of the urine, consist of + Prussian blue?</p> + + <p><a name="species_I_1_2_5">5</a>. <i>Diarrhœa calida.</i> Warm + diarrhœa. This species may be divided into three varieties deduced + from their remote causes, under the names of diarrhœa febrilis, + diarrhœa crapulosa, and diarrhœa infantum. The febrile + diarrhœa appears at the end of fever-fits, and is erroneously + called critical, like the copious urine, and the sweats; whereas it + arises from the increased action of those secerning organs, which pour + their fluids into the intestinal canal (as the liver, pancreas, and + mucous glands), continuing longer than the increased action of the + intestinal absorbents. In this diarrhœa there is no appearance of + curdled chyle in the stools, as occurs in cholera. <a + href="#species_I_3_1_5">I. 3. 1. 5</a>.</p> + + <p>The <i>diarrhœa crapulosa</i>, or diarrhœa from + indigestion, occurs when too great a quantity of food or liquid has been + taken; which not being compleatly digested, stimulates the intestines + like any other extraneous acrid material; and thus produces an increase + of the secretions into them of mucus, pancreatic juice, and bile. When + the contents of the bowels are still more stimulant, as when drastic + purges, or very putrescent diet, have been taken, a cholera is induced. + See Sect. XXIX. 4.</p> + + <p>The <i>diarrhœa infantum</i>, or diarrhœa of infants, is + generally owing to too great acidity in their bowels. Milk is found + curdled in the stomachs of all animals, old as well as young, and even of + carnivorous ones, as of hawks. (Spallanzani.) And it is the gastric juice + of the calf, which is employed to curdle milk in the process of making + cheese. Milk is the natural food for children, and must curdle in their + stomachs previous to digestion; and as this curdling of the milk destroys + a part of the acid juices of the stomach, there is no reason for + discontinuing the use of it, though it is occasionally ejected in a + curdled state. A child of a week old, which had been taken from the + breast of its dying mother, and had by some uncommon error been suffered + to take no food but water-gruel, became sick and griped in twenty-four + hours, and was convulsed on the second day, and died on the third! When + all young quadrupeds, as well as children, have this natural food of milk + prepared for them, the analogy is so strong in favour of its salubrity, + that a person should have powerful testimony indeed of its disagreeing, + before he advises the discontinuance of the use of it to young children + in health, and much more so in sickness. The farmers lose many of their + calves, which are brought up by gruel, or gruel and old milk; and among + the poor children of Derby, who are thus fed, hundreds are starved into + the scrophula, and either perish, or live in a state of wretched + debility.</p> + + <p>When young children are brought up without a breast, they should for + the first two months have no food but new milk; since the addition of any + kind of bread or flour is liable to ferment, and produce too much + acidity; as appears by the consequent diarrhœa with green + dejections and gripes; the colour is owing to a mixture of acid with the + natural quantity of bile, and the pain to its stimulus. And they should + never be fed as they lie upon their backs, as in that posture they are + necessitated to swallow all that is put into their mouths; but when they + are fed, as they are sitting up, or raised up, when they have had enough, + they can permit the rest to run out of their mouths. This circumstance is + of great importance to the health of those children, who are reared by + the spoon, since if too much food is given them, indigestion, and gripes, + and diarrhœa, is the consequence; and if too little, they become + emaciated; and of this exact quantity their own palates judge the + best.</p> + + <p>M. M. In this last case of the diarrhœa of children, the food + should be new milk, which by curdling destroys part of the acid, which + coagulates it. Chalk about four grains every six hours, with one drop of + spirit of hartshorn, and half a drop of laudanum. But a blister about the + size of a shilling is of the greatest service by restoring the power of + digestion. See Article <a href="#art_III_2_1">III. 2. 1</a>. in the + subsequent Materia Medica.</p> + + <p><a name="species_I_1_2_6">6</a>. <i>Salivatio calida.</i> Warm + salivation. Increased secretion of saliva. This may be effected either by + stimulating the mouth of the gland by mercury taken internally; or by + stimulating the excretory duct of the gland by pyrethrum, or tobacco; or + simply by the movement of the muscles, which lie over the gland, as in + masticating any tasteless substance, as a lock of wool, or mastic.</p> + + <p>In about the middle of nervous fevers a great spitting of saliva + sometimes occurs, which has been thought critical; but as it continues + sometimes two or even three weeks without the relief of the patient, it + may be concluded to arise from some accidental circumstance, perhaps not + unsimilar to the hysteric ptyalisms mentioned in Class <a + href="#species_I_3_2_2">I. 3. 2. 2</a>. See Sect. XXIV.</p> + + <p>M. M. Cool air, diluents, warm bath, evacuations.</p> + + <p><a name="species_I_1_2_7">7</a>. <i>Catharrhus calidus.</i> Warm + catarrh. Consists in an increased secretion of mucus from the nostrils + without inflammation. This disease, which is called a cold in the head, + is frequently produced by cold air acting for some time on the membranes, + which line the nostrils, as it passes to the lungs in respiration. Whence + a torpor of the action of the mucous glands is first introduced, as in <a + href="#species_I_2_3_3">I. 2. 3. 3</a>. and an orgasm or increased action + succeeds in consequence. Afterwards this orgasm and torpor are liable to + alternate with each other for some time like the cold and hot fits of + ague, attended with deficient or exuberant secretion of mucus in the + nostrils.</p> + + <p>At other times it arises from reverse sympathy with some extensive + parts of the skin, which have been exposed too long to cold, as of the + head, or feet. In consequence of the torpor of these cutaneous + capillaries those of the mucous membrane of the nostrils act with greater + energy by reverse sympathy; and thence secrete more mucus from the blood. + At the same time the absorbents, acting also with greater energy by their + reverse sympathy with those of some distant part of the skin, absorb the + thinner parts of the mucus more hastily; whence the mucus is both thicker + and in greater quantity. Other curious circumstances attend this disease; + the membrane becomes at times so thickened by its increased action in + secreting the mucus, that the patient cannot breathe through his + nostrils. In this situation if he warms his whole skin suddenly by fire + or bed-clothes, or by drinking warm tea, the increased action of the + membrane ceases by its reverse sympathy with the skin; or by the + retraction of the sensorial power to other parts of the system; and the + patient can breathe again through the nostrils. The same sometimes occurs + for a time on going into the cold air by the deduction of heat from the + mucous membrane, and its consequent inactivity or torpor. Similar to this + when the face and breast have been very hot and red, previous to the + eruption of the small-pox by inoculation, and that even when exposed to + cool air, I have observed the feet have been cold; till on covering them + with warm flannel, as the feet have become warm, the face has cooled. See + Sect. XXXV. 1. 3. Class <a href="#species_II_1_3_5">II. 1. 3. 5</a>. <a + href="#species_IV_2_2_10">IV. 2. 2. 10</a>. <a + href="#species_IV_1_1_5">IV. 1. 1. 5</a>.</p> + + <p>M. M. Evacuations, abstinence, oil externally on the nose, warm + diluent fluids, warm shoes, warm night-cap.</p> + + <p><a name="species_I_1_2_8">8</a>. <i>Expectoratio calida.</i> Warm + expectoration consists of the increased secretion of mucus from the + membrane, which lines the bronchiæ, or air-cells of the lungs, without + inflammation. This increased mucus is ejected by the action of coughing, + and is called a cold, and resembles the catarrh of the preceding article; + with which it is frequently combined.</p> + + <p>M. M. Inhale the steam of warm water, evacuations, warm bath, + afterwards opium, sorbentia.</p> + + <p><a name="species_I_1_2_9">9</a>. <i>Exsudatio pone aures.</i> A + discharge behind the ears. This chiefly affects children, and is a morbid + secretion; as appears from its fetor; for if it was owing to defect of + absorption, it would be saline, and not fetid; if a morbid action has + continued a considerable time, it should not be stopped too suddenly; + since in that case some other morbid action is liable to succeed in its + stead. Thus children are believed to have had cholics, or even + convulsions, consequent to the too sudden healing of these morbid + effusions behind their ears. The rationale of this is to be explained + from a medical fact, which I have frequently observed; and that is, that + a blister on the back greatly strengthens the power of digestion, and + removes the heart-burn in adults, and green stools in children. The + stimulus of the blister produces sensation in the vessels of the skin; + with this additional sensorial power these vessels act more strongly; and + with these the vessels of the internal membranes of the stomach and + bowels act with greater energy from their direct sympathy with them. Now + the acrid discharge behind the ears of children produces sensation on + that part of the skin, and so far acts as a small blister. When this is + suddenly stopped, a debility of the digestive power of the stomach + succeeds from the want of this accustomed stimulus, with flatulency, + green stools, gripes, and sometimes consequent convulsions. See Class <a + href="#species_II_1_5_6">II. 1. 5. 6</a>. and <a + href="#species_II_1_4_6">II. 1. 4. 6</a>.</p> + + <p>M. M. If the matter be absorbed, and produces swelling of the + lymphatics of the neck, it should be cured as soon as possible by dusting + the part with white lead, cerussa, in very fine powder; and to prevent + any ill consequence an issue should be kept for about a month in the arm; + or a purgative medicine should be taken, every other day for three or + four times, which should consist of a grain of calomel, and three or four + grains of rhubarb, and as much chalk. If there be no appearance of + absorption, it is better only to keep the parts clean by washing them + with warm water morning and evening; or putting fuller's earth on them; + especially till the time of toothing is past. The tinea, or scald head, + and a leprous eruption, which often appears behind the ears, are + different diseases.</p> + + <p><a name="species_I_1_2_10">10</a>. <i>Gonorrhea calida.</i> Warm + gleet. Increased discharge of mucus from the urethra or prostrate gland + without venereal desire, or venereal infection. See Class <a + href="#species_I_2_3_8">I. 2. 3. 8</a>.</p> + + <p>M. M. Cantharides, balsams, rhubarb, blister in perinæum, cold bath, + injections of metallic salts, flannel shirt, change of the form of the + accustomed chair or saddle of the patient.</p> + + <p><a name="species_I_1_2_11">11</a>. <i>Fluor albus calidus.</i> Warm + fluor albus. Increased secretion of mucus in the vagina or uterus without + venereal desire or venereal infection. It is distinguished from the fluor + albus frigidus by the increased sense of warmth in the part, and by the + greater opacity or spissitude of the material discharged; as the thinner + parts are reabsorbed by the increased action of the absorbents, along + with the saline part, whence no smarting or excoriation attends it.</p> + + <p>M. M. Mucilage, as isinglass, hartshorn jelly, gum arabic. Ten grains + of rhubarb every night. Callico or flannel shift, opium, balsams. See + Class <a href="#species_I_2_3_7">I. 2. 3. 7</a>.</p> + + <p><a name="species_I_1_2_12">12</a>. <i>Hæmorrhois alba.</i> White + piles. An increased discharge of mucus from the rectum frequently + mistaken for matter; is said to continue a few weeks, and recur like the + bleeding piles; and to obey lunar influence. See Class <a + href="#species_I_2_1_6">I. 2. 1. 6</a>.</p> + + <p>M. M. Abstinence from vinous spirit. Balsam of copaiva. Spice + swallowed in large fragments, as ten or fifteen black pepper-corns cut in + half, and taken after dinner and supper. Ward's paste, consisting of + black pepper and the powdered root of Helenium Enula.</p> + + <p><a name="species_I_1_2_13">13</a>. <i>Serum e vesicatorio.</i> + Discharge from a blister. The excretory ducts of glands terminate in + membranes, and are endued with great irritability, and many of them with + sensibility; the latter perhaps in consequence of their facility of being + excitable into great action; instances of this are the terminations of + the gall-duct in the duodenum, and of the salivary and lachrymal glands + in the mouth and eye; which produce a greater secretion of their adapted + fluids, when the ends of their excretory ducts are stimulated.</p> + + <p>The external skin consists of the excretory ducts of the capillaries, + with the mouths of the absorbents; when these are stimulated by the + application of cantharides, or by a slice of the fresh root of bryonia + alba bound on it, the capillary glands pour an increased quantity of + fluid upon the skin by their increased action; and the absorbent vessels + imbibe a greater quantity of the more fluid and saline part of it; whence + a thick mucous or serous fluid is deposited between the skin and + cuticle.</p> + + <p><a name="species_I_1_2_14">14</a>. <i>Perspiratio fœtida.</i> + Fetid perspiration. The uses of the perspirable matter are to keep the + skin soft and pliant, for the purposes of its easier flexibility during + the activity of our limbs in locomotion, and for the preservation of the + accuracy of the sense of touch, which is diffused under the whole surface + of it to guard us against the injuries of external bodies; in the same + manner as the secretion of tears is designed to preserve the cornea of + the eye moist, and in consequence transparent; yet has this cutaneous + mucus been believed by many to be an excrement; and I know not how many + fanciful theories have been built on its supposed obstruction. Such as + the origin of catarrhs, coughs, inflammations, erysypelas, and + herpes.</p> + + <p>To all these it may be sufficient to answer, that the antient Grecians + oiled themselves all over; that some nations have painted themselves all + over, as the Picts of this island; that the Hottentots smear themselves + all over with grease. And lastly, that many of our own heads at this day + are covered with the flour of wheat and the fat of hogs, according to the + tyranny of a filthy and wasteful fashion, and all this without + inconvenience. To this must be added the strict analogy between the use + of the perspirable matter and the mucous fluids, which are poured for + similar purposes upon all the internal membranes of the body; and besides + its being in its natural state inodorous; which is not so with the other + excretions of feces, or of urine.</p> + + <p>In some constitutions the perspirable matter of the lungs acquires a + disagreeable odour; in others the axilla, and in others the feet, emit + disgustful effluvia; like the secretions of those glands, which have been + called odoriferæ; as those, which contain the castor in the beaver, and + those within the rectum of dogs, the mucus of which has been supposed to + guard them against the great costiveness, which they are liable to in hot + summers; and which has been thought to occasion canine madness, but + which, like their white excrement, is more probably owing to the + deficient secretion of bile. Whether these odoriferous particles attend + the perspirable matter in consequence of the increased action of the + capillary glands, and can properly be called excrementitous; that is, + whether any thing is eliminated, which could be hurtful if retained; or + whether they may only contain some of the essential oil of the animal; + like the smell, which adheres to one's hand on stroking the hides of some + dogs; or like the effluvia, which is left upon the ground, from the feet + of men and other creatures; and is perceptible by the nicer organs of the + dogs, which hunt them, may admit of doubt.</p> + + <p>M. M. Wash the parts twice a day with soap and water; with lime water; + cover the feet with oiled silk socks, which must be washed night and + morning. Cover them with charcoal recently made red hot, and beaten into + fine powder and sifted, as soon as cold, and kept well corked in a + bottle, to be warned off and renewed twice a day. Internally rhubarb + grains vi. or viii. every night, so as to procure a stool or two + extraordinary every day, and thus by increasing one evacuation to + decrease another. Cool dress, diluting liquids?</p> + + <p><a name="species_I_1_2_15">15</a>. <i>Crines novi.</i> New hairs. The + black points on the faces of some people consist of mucus, which is + become viscid, and which adheres in the excretory ducts of the glands of + the skin; as described in Class <a href="#species_I_2_2_9">I. 2. 2. + 9</a>. and which may be pressed out by the fingers, and resembles little + worms. Similar to this would seem the fabrication of silk, and of cobweb + by the silk worm and spider; which is a secreted matter pressed through + holes, which are the excretory ducts of glands. And it is probable, that + the production of hair on many parts of the body, and at different + periods of life, may be effected by a similar process; and more + especially as every hair may be considered as a slender flexible horn, + and is an appendage of the skin. See Sect. XXXIX. 3. 2. Now as there is a + sensitive sympathy between the glands, which secrete the semen, and the + throat, as appears in the mumps; see Hydrophobia, Class <a + href="#species_IV_1_2_7">IV. 1. 2. 7</a>. and Parotitis, Class <a + href="#species_IV_1_2_19">IV. 1. 2. 19</a>. The growth of the beard at + puberty seems to be caused by the greater action of the cutaneous glands + about the chin and pubes in consequence of their sympathy with those of + the testes. But this does not occur to the female sex at their time of + puberty, because the sensitive sympathy in them seems to exist between + the submaxillary glands, and the pectoral ones; which secrete the milk, + and afford pleasure both by that secretion, and by the erection of the + mamulæ, or nipples; and by delivering the milk into the mouth of the + child; this sensitive sympathy of the pectoral and submaxillary glands in + women is also observable in the Parotitis, or mumps, as above referred + to.</p> + + <p>When hairs grow on the face or arms so as to be disagreeable, they may + be thus readily removed without pain or any ill consequence. Warm the + ends of a pair of nippers or forceps, and stick on them a little rosin, + or burgundy pitch; by these means each single hair may be taken fast hold + of; and if it be then plucked off slowly, it gives pain; but if plucked + off suddenly, it gives no pain at all; because the vis inertiæ of the + part of the skin, to which it adheres, is not overcome; and it is not in + consequence separated from the cellular membrane under it. Some of the + hairs may return, which are thus plucked off, or others may be induced to + grow near them; but in a little time they may be thus safely destroyed; + which is much to be preferred to the methods said to be used in Turkey to + eradicate hair; such as a mixture of orpiment and quick lime; or of liver + of sulphur in solution; which injure the skin, if they are not very + nicely managed; and the hair is liable to grow again as after shaving; or + to become white, if the roots of it have been much inflamed by the + causticity of the application. See Class <a href="#species_I_2_2_11">I. + 2. 2. 11</a>. on grey hairs.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_1_3">III</a>.</h3> + +<h3><i>With increased Actions of the Absorbent System.</i></h3> + + <p>These are not attended with so great increase of heat as in the former + genus, because the fluids probably undergo less chemical change in the + glands of the absorbent system; nor are the glands of the absorbent + vessels so numerous or so extensive as those of the secerning ones. Yet + that some heat is produced by the increased action of the absorbents + appears from the greater general warmth of the skin and extremities of + feeble patients after the exhibition of the peruvian bark, and other + medicines of the article Sorbentia.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_1_3_1">1</a>. <i>Lingua arida.</i> Dry tongue + occurs in those fevers, where the expired air is warmer than natural; and + happens to all those, who sleep with their mouths open; the currents of + air in respiration increasing the evaporation. There is also a dryness in + the mouth from the increased action of the absorbent vessels, when a sloe + or a crab-apple are masticated; and after the perforation has been much + increased by eating salt or spice, or after other copious secretions; as + after drunkenness, cathartics, or fever fits, the mucus of the mouth + becomes viscid, and in small quantity, from the increased absorption, + adhering to the tongue like a white slough. In the diabætes, where the + thirst is very great, this slough adheres more pertinaciously, and + becomes black or brown, being coloured after a few days by our aliment or + drink. The inspissated mucus on the tongue of those, who sleep with their + mouths open, is sometimes reddened as if mixed with blood, and sometimes + a little blood follows the expuition of it from the fauces owing to its + great adhesion. When this mucus adheres long to the papillæ of the + tongue, the saliva, which it contains in its interstices, like a sponge, + is liable to become putrid, and to acquire a bitter taste, like other + putrid animal substances; which is generally mistaken for an indication + of the presence of bile.</p> + + <p>M. M. Warm subacid liquids. See Class <a href="#species_I_2_5_8">I. 2. + 5. 8</a>.</p> + + <p><a name="species_I_1_3_2">2</a>. <i>Fauces aridæ.</i> Dry throat. The + expuition of a frothy mucus with great and perpetual hawking occurs in + hydrophobia, and is very distressing to the patient; which may be owing + to the increased irritability or sensibility of the upper part of the + œsophagus, which will not permit any fluid to rest on it.</p> + + <p>It affects some people after intoxication, when the lungs remain + slightly inflamed, and by the greater heat of the air in expiration the + mucus becomes too hastily evaporated, and is expectorated with difficulty + in the state of white froth.</p> + + <p>I knew a person, who for twenty years always waked with his tongue and + throat quite dry; so that he was necessitated to take a spoonful of + water, as soon as he awoke; otherwise a little blood always followed the + forcible expuition of the indurated mucus from his fauces. See Class <a + href="#species_II_1_3_17">II. 1. 3. 17</a>.</p> + + <p>M. M. Steel-springs fixed to the night-cap so as to suspend the lower + jaw and keep it closed; or springs of elastic gum. Or a pot of water + suspended over the bed, with a piece of list, or woollen cloth, depending + from it, and held in the mouth; which will act like a syphon, and slowly + supply moisture, or barley water should be frequently syringed into the + mouth of the patient.</p> + + <p><a name="species_I_1_3_3">3</a>. <i>Nares aridi.</i> Dry nostrils with + the mucus hardening upon their internal surface, so as to cover them with + a kind of skin or scale, owing to the increased action of the absorbents + of this membrane; or to the too great dryness of the air, which passes + into the lungs; or too great heat of it in its expiration.</p> + + <p>When air is so dry as to lose its transparency; as when a tremulous + motion of it can be seen over corn fields in a hot summer's day; or when + a dry mist, or want of transparency of the air, is visible in very hot + weather; the sense of smell is at the same time imperfect from the + dryness of the membrane, beneath which it is spread.</p> + + <p><a name="species_I_1_3_4">4</a>. <i>Expectoratio solida.</i> Solid + expectoration. The mucus of the lungs becomes hardened by the increased + absorption, so that it adheres and forms a kind of lining in the + air-cells, and is sometimes spit up in the form of branching vessels, + which are called polypi of the lungs. See Transact. of the College, + London. There is a rattling or weezing of the breath, but it is not at + first attended with inflammation.</p> + + <p>The Cynanche trachealis, or Croup, of Dr. Cullen, or Angina polyposa + of Michaelis, if they differ from the peripneumony of infants, seem to + belong to this genus. When the difficulty of respiration is great, + venesection is immediately necessary, and then an emetic, and a blister. + And the child should be kept nearly upright in bed as much as may be. See + Tonsillitis, Class <a href="#species_II_1_3_3">II. 1. 3. 3</a>.</p> + + <p>M. M. Diluents, emetics, essence of antimony, fœtid gums, + onions, warm bath for half an hour every day for a month. Inhaling the + steam of water, with or without volatile alcali. Soap.</p> + + <p><a name="species_I_1_3_5">5</a>. <i>Constipatio alvi.</i> Costiveness + from increased action of the intestinal absorbents. The feces are + hardened in lumps called scybala; which are sometimes obliged to be + extracted from the rectum with a kind of marrow spoon. This is said to + have happened from the patient having taken much rust of iron. The mucus + is also hardened so as to line the intestines, and to come away in skins, + rolled up as they pass along, so as to resemble worms, for which they are + frequently mistaken; and sometimes it is evacuated in still larger + pieces, so as to counterfeit the form of the intestines, and has been + mistaken for a portion of them. Balls of this kind, nearly as heavy as + marble, and considerably hard, from two inches to five in diameter, are + frequently found in the bowels of horses. Similar balls found in goats + have been called Bezoar.</p> + + <p>M. M. Cathartics, Diluents, fruit, oil, soap, sulphur, warm bath. + Sprinkling with cold water, cool clothing. See Class <a + href="#species_I_2_4_18">I. 2. 4. 18</a>.</p> + + <p><a name="species_I_1_3_6">6</a>. <i>Cutis arida.</i> Dry skin. This + dry skin is not attended with coldness as in the beginning of fever-fits. + Where this cutaneous absorption is great, and the secreted material upon + it viscid, as on the hairy scalp, the skin becomes covered with hardened + mucus; which adheres so as not to be easily removed, as the scurf on the + head; but is not attended with inflammation like the Tinea, or Lepra. The + moisture, which appears on the skin beneath resinous or oily plasters, or + which is seen to adhere to such plasters, is owing to their preventing + the exhalation of the perspirable matter, and not to their increasing the + production of it, as some have idly imagined.</p> + + <p>M. M. Warm bathing, oil externally, oil-skin gloves, resinous + plasters. Wax.</p> + + <p><a name="species_I_1_3_7">7</a>. <i>Urina parca colorata.</i> + Diminished urine, which is high coloured, and deposits an earthy + sediment, when cold, is owing to the great action of the urinary + absorbents. See Class <a href="#species_I_1_2_4">I. 1. 2. 4</a>. In some + dropsies the cutaneous absorbents are paralytic, as well as those opening + into the cellular membrane; and hence, no moisture being acquired from + the atmosphere, or from the cellular membrane, great thirst is excited; + and great absorption from all parts, where the absorbents are still + capable of action. Hence the urine is in very small quantity, and of deep + colour, with copious sediment; and the kidneys are erroneously blamed for + not doing their office; stimulant diuretic medicines are given in vain; + and very frequently the unhappy patient is restrained from quenching his + thirst, and dies a martyr to false theory.</p> + + <p>M. M. Diluent liquids, and warm bathing, are the natural cure of this + symptom; but it generally attends those dropsies, which are seldom + curable; as they are owing to a paralysis both of the cutaneous and + cellular lymphatics.</p> + + <p><a name="species_I_1_3_8">8</a>. <i>Calculus felleus.</i> Gall-stone. + From the too hasty absorption of the thinner parts of the bile, the + remainder is left too viscid, and crystallizes into lumps; which, if too + large to pass, obstruct the ductus choledochus, producing pain at the pit + of the stomach, and jaundice. When the indurated bile is not harder than + a boiled pea, it may pass through the bile-duct with difficulty by + changing its form; and thus gives those pains, which have been called + spasms of the stomach; and yet these viscid lumps of bile may afterwards + dissolve, and not be visible among the feces.</p> + + <p>In two instances I have seen from thirty to fifty gall-stones voided + after taking an oil vomit as below. They were about the size of peas, and + distinguishable when dry by their being inflammable like bad wax, when + put into the flame of a candle. For other causes of jaundice, see Class + <a href="#species_I_2_4_19">I. 2. 4. 19</a>.</p> + + <p>M. M. Diluents, daily warm bathing. Ether mixed with yolk of egg and + water. Unboiled acrid vegetables, as lettice, cabbage, mustard, and + cresses. When in violent pain, four ounces of oil of olives, or of + almonds, should be swallowed; and as much more in a quarter of an hour, + whether it stays or not. The patient should lie on the circumference of a + large barrel, first on one side, and then on the other. Electric shocks + through the gall-duct. Factitious Selter's water made by dissolving one + dram of Sal Soda in a pint of water; to half a pint of which made + luke-warm add ten drops of marine acid; to be drank as soon as mixed, + twice a day for some months. Opium must be used to quiet the pain, if the + oil does not succeed, as two grains, and another grain in half an hour if + necessary. See Class <a href="#species_IV_2_2_4">IV. 2. 2. 4</a>.</p> + + <p><a name="species_I_1_3_9">9</a>. <i>Calculus renis.</i> Stone of the + kidney. The pain in the loins and along the course of the ureter from a + stone is attended with retraction of the testicle in men, and numbness on + the inside of the thigh in women. It is distinguished from the lumbago or + sciatica, as these latter are seldom attended with vomiting, and have + pain on the outside of the thigh, sometimes quite down to the ankle or + heel. See Herpes and Nephritis.</p> + + <p>Where the absorption of the thinner parts of the secretion takes place + too hastily in the kidnies, the hardened mucus, and consequent calculous + concretions, sometimes totally stop up the tubuli uriniferi; and no urine + is secreted. Of this many die, who have drank much vinous spirit, and + some of them recover by voiding a quantity of white mucus, like chalk and + water; and others by voiding a great quantity of sand, or small calculi. + This hardened mucus frequently becomes the nucleus of a stone in the + bladder. The salts of the urine, called microcosmic salt, are often + mistaken for gravel, but are distinguishable both by their angles of + crystallization, their adhesion to the sides or bottom of the pot, and by + their not being formed till the urine cools. Whereas the particles of + gravel are generally without angles, and always drop to the bottom of the + vessel, immediately as the water is voided.</p> + + <p>Though the proximate cause of the formation of the calculous + concretions of the kidneys, and of chalk-stones in the gout, and of the + insoluble concretions of coagulable lymph, which are found on membranes, + which have been inflamed in peripneumony, or rheumatism, consists in the + too great action of the absorbent vessels of those parts; yet the remote + cause in these cases is probably owing to the inflammation of the + membranes; which at that time are believed to secrete a material more + liable to coagulate or concrete, than they would otherwise produce by + increased action alone without the production of new vessels, which + constitutes inflammation. As defined in Class <a href="#genus_II_1_2">II. + 1. 2</a>.</p> + + <p>The fluids secreted from the mucous membranes of animals are of + various kinds and consistencies. Hair, silk, scales, horns, fingernails, + are owing to natural processes. Gall-stones, stones found in the + intestines of horses, scurf of the skin in leprosy, stones of the kidnies + and bladder, the callus from the inflamed periosteum, which unites broken + bones, the calcareous cement, which repairs the injured shells of snails, + the calcareous crust on the eggs of birds, the annually renewed shells of + crabs, are all instances of productions from mucous membranes, afterwards + indurated by absorption of their thinner parts.</p> + + <p>All these concretions contain phosphoric acid, mucus, and calcareous + earth in different proportions; and are probably so far analogous in + respect to their component parts as well as their mode of formation. Some + calcareous earth has been discovered after putrefaction in the coagulable + lymph of animals. Fordyce's Elements of Practice. A little calcareous + earth was detected by Scheel or Bergman in the calculus of the bladder + with much phosphoric acid, and a great quantity of phosphoric acid is + shewn to exist in oyster-shells by their becoming luminous on exposing + them a while to the sun's light after calcination; as in the experiments + of Wilson. Botanic Garden, P. 1. Canto 1. l. 182, note. The exchange of + which phosphoric acid for carbonic acid, or fixed air, converts shells + into limestone, producing mountains of marble, or calcareous strata.</p> + + <p>Now as the hard lumps of calcareous matter, termed crabs' eyes, which + are found in the stomachs of those animals previous to the annual renewal + of their shells, are redissolved, probably by their gastric acid, and + again deposited for that purpose; may it not be concluded, that the stone + of the bladder might be dissolved by the gastric juice of fish of prey, + as of crabs, or pike; or of voracious young birds, as young rooks or + hawks, or even of calves? Could not these experiments be tried by + collecting the gastric juice by putting bits of sponge down the throats + of young crows, and retracting them by a string in the manner of + Spallanzani? or putting pieces of calculus down the throat of a living + crow, or pike, and observing if they become digested? and lastly could + not gastric juice, if it should appear to be a solvent, be injected and + born in the bladder without injury by means of catheters of elastic + resin, or caoutchouc?</p> + + <p>M. M. Diluents. Cool dress. Frequent change of posture. Frequent + horizontal rest in the day. Bathe the loins every morning with a sponge + and cold water. Aerated alcaline water internally. Abstinence from all + fermented or spirituous liquors. Whatever increases perspiration injures + these patients, as it dissipates the aqueous particles, which ought to + dilute the urine. When the constitution begins to produce gravel, it may + I believe be certainly prevented by a total abstinence from fermented or + spirituous liquors; by drinking much aqueous fluids; as toast and water, + tea, milk and water, lemonade; and lastly by thin clothing, and sleeping + on a hardish bed, that the patient may not lie too long on one side. See + Class <a href="#species_IV_2_2_2">IV. 2. 2. 2</a>. There is reason to + believe, that the daily use of opium contributes to produce gravel in the + kidnies by increasing absorption, when they are inflamed; in the same + manner as is done by fermented or spirituous liquor. See Class <a + href="#species_I_3_2_11">I. 3. 2. 11</a>.</p> + + <p>When the kidnies are so obstructed with gravel, that no urine passes + into the bladder; which is known by the external appearance of the lower + part of the abdomen, which, when the bladder is full, seems as if + contracted by a cord between the navel and the bladder; and by the + tension on the region of the bladder distinguishable by the touch; or by + the introduction of the catheter; the following methods of cure are + frequently successful. Venesection to six or eight ounces, ten grains of + calomel, and an infusion of senna with salts and oil, every three hours, + till stools are procured. Then an emetic. After the patient has been thus + evacuated, a blister on the loins should be used; and from ten to twenty + electric shocks should be passed through the kidnies, as large as can be + easily borne, once or twice a day. Along with this method the warm bath + should be used for an hour once or twice a day. After repeated + evacuations a clyster, consisting of two drams of turpentine dissolved by + yolk of egg, and sixty drops of tincture of opium, should be used at + night, and repeated, with cathartic medicines interposed, every night, or + alternate nights. Aerated solution of alcali should be taken internally, + and balsam of copaiva, three or four times a day. Some of these patients + recover after having made no water for nine or ten days.</p> + + <p>If a stone sticks in the ureter with incessant vomiting, ten grains of + calomel must be given in small pills as above; and some hours afterwards + infusion of senna and salts and oil, if it can be made to stay on the + stomach. And after the purge has operated four or five times, an opiate + is to be given, if the pain continues, consisting of two grains of opium. + If this does not succeed, ten or twenty electric shocks through the + kidney should be tried, and the purgative repeated, and afterwards the + opiate. The patient should be frequently put into the warm bath for an + hour at a time. Eighty or an hundred drops of laudanum given in a + glyster, with two drams of turpentine, is to be preferred to the two + grains given by the stomach as above, when the pain and vomiting are very + urgent.</p> + + <p><a name="species_I_1_3_10">10</a>. <i>Calculus vesicæ.</i> Stone of + the bladder. The nucleus, or kernel, of these concretions is always + formed in the kidney, as above described; and passing down the ureter + into the bladder, is there perpetually increased by the mucus and salts + secreted from the arterial system, or by the mucus of the bladder, + disposed in concentric strata. The stones found in the bowels of horses + are also formed on a nucleus, and consist of concentric spheres; as + appears in sawing them through the middle. But as these are formed by the + indurated mucus of the intestines alone without the urinary salts, it is + probable a difference would be found on their analysis.</p> + + <p>As the stones of the bladder are of various degrees of hardness, and + probably differ from each other in the proportions at least of their + component parts; when a patient, who labours under this afflicting + disease, voids any small bits of gravel; these should be kept in warm + solutions of caustic alcali, or of mild alcali well aerated; and if they + dissolve in these solutions, it would afford greater hopes, that that + which remains in the bladder, might be affected by these medicines taken + by the stomach, or injected into the bladder.</p> + + <p>To prevent the increase of a stone in the bladder much diluent drink + should be taken; as half a pint of water warmed to about eighty degrees, + three or four times a day: which will not only prevent the growth of it, + by preventing any microcosmic salts from being precipitated from the + urine, and by keeping the mucus suspended in it; but will also diminish + the stone already formed, by softening, and washing away its surface. To + this must be added cool dress, and cool bed-clothes, as directed above in + the calculus renis.</p> + + <p>When the stone is pushed against or into the neck of the bladder, + great pain is produced; this may sometimes be relieved by the + introduction of a bougie to push the stone back into the fundus of the + bladder. Sometimes by change of posture, or by an opiate either taken + into the stomach, or by a clyster.</p> + + <p>A dram of sal soda, or of salt of tartar, dissolved in a pint of + water, and well saturated with carbonic acid (fixed air), by means of Dr. + Nooth's glass-apparatus, and drank every day, or twice a day, is the most + efficacious internal medicine yet discovered, which can be easily taken + without any general injury to the constitution. An aerated alcaline water + of this kind is sold under the name of factitious Seltzer water, by J. + Schweppe, at N<sup>o</sup> 8, King's-street, Holborn, London; which I am + told is better prepared than can be easily done in the usual + glass-vessels, probably by employing a greater pressure in wooden + ones.</p> + + <p>Lythotomy is the last recourse. Will the gastric juice of animals + dissolve calculi? Will fermenting vegetable juices, as sweet-wort, or + sugar and water in the act of fermentation with yest, dissolve any kind + of animal concretions?</p> + + <p><a name="species_I_1_3_11">11</a>. <i>Calculus arthriticus.</i> + Gout-stones are formed on inflamed membranes, like those of the kidnies + above described, by the too hasty absorption of the thinner and saline + parts of the mucus. Similar concretions have been produced in the lungs, + and even in the pericardium; and it is probable, that the ossification, + as it is called, of the minute arteries, which is said to attend old age, + and to precede some mortifications of the extremities, may be a process + of this kind.</p> + + <p>As gout-stones lie near the surface, it is probable, that ether, + frequently applied in their early state, might render them so liquid as + to permit their reabsorption; which the stimulus of the ether might at + the same time encourage.</p> + + <p><a name="species_I_1_3_12">12</a>. <i>Rheumatismus chronicus.</i> + Chronic rheumatism. After the acute rheumatism some inspissated mucus, or + material similar to chalk-stones of the gout, which was secreted on the + inflamed membrane, is probably left, owing to the too hasty absorption of + the thinner and saline part of it; and by lying on the fascia, which + covers some of the muscles, pains them, when they move and rub against + it, like any extraneous material.</p> + + <p>The pain of the shoulder, which attends inflammations of the upper + membrane of the liver, and the pains of the arms, which attend asthma + dolorificum, or dropsy of the pericardium, are distinguished from the + chronic rheumatism, as in the latter the pain only occurs on moving the + affected muscles.</p> + + <p>M. M. Warm bath, cold bath, bandage of emplastrum de minio put on + tight, so as to compress the part. Cover the part with flannel. With + oiled silk. Rub it with common oil frequently. With ether. A blister. A + warmer climate. Venesection. A grain of calomel and a grain of opium for + ten successive nights. The Peruvian bark.</p> + + <p><a name="species_I_1_3_13">13</a>. <i>Cicatrix vulnerum.</i> The scar + after wounds. In the healing of ulcers the matter is first thickened by + increasing the absorption in them; and then lessened, till all the matter + is absorbed, which is brought by the arteries, instead of being deposed + in the ulcer.</p> + + <p>M. M. This is promoted by bandage, by the sorbentia externally, as + powder of bark, white lead; solution of sugar of lead. And by the + sorbentia internally after evacuations. See Sect. XXXIII. 3. 2.</p> + + <p>In those ulcers, which are made by the contact of external fire, the + violent action of the fibres, which occasions the pain, is liable to + continue, after the external heat is withdrawn. This should be relieved + by external cold, as of snow, salt and water recently mixed, ether, or + spirits of wine suffered to evaporate on the part.</p> + + <p>The cicatrix of an ulcer generally proceeds from the edges of it; but + in large ones frequently from the middle, or commences in several places + at the same time; which probably contributes to the unevenness of large + scars.</p> + + <p><a name="species_I_1_3_14">14</a>. <i>Corneæ obfuscatio.</i> Opacity + of the cornea. There are few people, who have passed the middle of life, + who have not at some time suffered some slight scratches or injuries of + the cornea, which by not healing with a perfectly smooth surface, + occasion some refractions of light, which may be conveniently seen in the + following manner: fill a tea-saucer with cream and tea, or with milk, and + holding it to your lips, as if going to drink it, the imperfections of + the cornea will appear like lines or blotches on the surface of the + fluid, with a less white appearance than that surface. Those blemishes of + the eye are distinguished from the muscæ volitantes described in Class <a + href="#species_I_2_5_3">I. 2. 5. 3</a>. by their being invariably seen at + any time, when you look for them.</p> + + <p>Ulcers may frequently be seen on the cornea after ophthalmy, like + little pits or indentations beneath the surface of it: in this case no + external application should be used, lest the scar should be left uneven; + but the cure should be confined to the internal use of thirty grains of + bark twice a day, and from five to ten drops of laudanum at night, with + five grains of rhubarb, if necessary.</p> + + <p>After ulcers of the cornea, which have been large, the inequalities + and opacity of the cicatrix obscures the sight; in this case could not a + small piece of the cornea be cut out by a kind of trephine about the size + of a thick bristle, or a small crow-quill, and would it not heal with a + transparent scar? This experiment is worth trying, and might be done by a + piece of hollow steel wire with a sharp edge, through which might be + introduced a pointed steel screw; the screw to be introduced through the + opake cornea to hold it up, and press it against the cutting edge of the + hollow wire or cylinder; if the scar should heal without losing its + transparency, many blind people might be made to see tolerably well by + this slight and not painful operation. An experiment I wish strongly to + recommend to some ingenious surgeon or oculist.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_1_4">IV</a>.</h3> + +<h3><i>With increased Actions of other Cavities and Membranes.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_I_1_4_1">1</a>. <i><span class="correction" + title="Original reads `Nectitatio' (compare contents list)." + >Nictitatio</span> irritativa.</i> Winking of the eyes is performed every + minute without our attention, for the purpose of cleaning and moistening + the eye-ball; as further spoken of in Class <a + href="#species_II_1_1_8">II. 1. 1. 8</a>. When the cornea becomes too + dry, it becomes at the same time less transparent; which is owing to the + pores of it being then too large, so that the particles of light are + refracted by the edges of each pore, instead of passing through it; in + the same manner as light is refracted by passing near the edge of a + knife. When these pores are filled with water, the cornea becomes again + transparent. This want of transparency of the cornea is visible sometimes + in dying people, owing to their inirritability, and consequent neglect of + nictitation.</p> + + <p>The increase of transparency by filling the pores with fluid is seen + by soaking white paper in oil; which from an opake body becomes very + transparent, and accounts for a curious atmospheric phenomenon; when + there exists a dry mist in a morning so as to render distant objects less + distinct, it is a sign of a dry day; when distant objects are seen very + distinct, it is a sign of rain. See Botan. Garden, Part I. add. note xxv. + The particles of air are probably larger than those of water, as water + will pass through leather and paper, which will confine air; hence when + the atmosphere is much deprived of moisture, the pores of the dry air are + so large, that the rays of light are refracted by their edges instead of + passing through them. But when as much moisture is added as can be + perfectly dissolved, the air becomes transparent; and opake again, when a + part of this moisture collects into small spherules previous to its + precipitation. This also accounts for the want of transparency of the + air, which is seen in tremulous motions over corn-fields on hot + summer-days, or over brick-kilns, after the flame is extinguished, while + the furnace still remains hot.</p> + + <p><a name="species_I_1_4_2">2</a>. <i>Deglutitio irritativa.</i> The + deglutition of our saliva is performed frequently without our attention, + and is then an irritative action in consequence of the stimulus of it in + the mouth. Or perhaps sometimes for the purpose of diffusing a part of it + over the dry membranes of the fauces and pharinx; in the same manner as + tears are diffused over the cornea of the eye by the act of nictitation + to clean or moisten it.</p> + + <p><a name="species_I_1_4_3">3</a>. <i>Respiratio et Tussis + irritativæ.</i> In the acts of respiration and of coughing there is an + increased motion of the air-cells of the lungs owing to some stimulating + cause, as described above in Class <a href="#species_I_1_2_8">I. 1. 2. + 8</a>. and <a href="#species_I_1_3_4">I. 1. 3. 4</a>. and which are + frequently performed without our attention or consciousness, and are then + irritative actions; and thus differ from those described in Class <a + href="#species_II_1_1_2">II. 1. 1. 2</a>. and <a + href="#species_II_1_1_5">5</a>. To these increased actions of the + air-cells are superadded those of the intercostal muscles and diaphragm + by irritative association. When any unnatural stimulus acts so violently + on the organs of respiration as to induce pain, the sensorial power of + sensation becomes added to that of irritation, and inflammation of the + membranes of them is a general consequence.</p> + + <p><a name="species_I_1_4_4">4</a>. <i>Exclusio bilis.</i> The exclusion + of the bile from the gall-bladder, and its derivation into the duodenum, + is an irritative action in consequence of the stimulus of the aliment on + the extremity of the biliary duct, which terminates in the intestine. The + increased secretion of tears is occasioned in a similar manner by any + stimulating material in the eyes; which affects the excretory ducts of + the lacrymal glands. A pain of the external membrane of the eye sometimes + attends any unusual stimulus of it, then the sensorial power of sensation + becomes added to that of irritation, and a superficial inflammation is + induced.</p> + + <p><a name="species_I_1_4_5">5</a>. <i>Dentitio.</i> Toothing. The pain + of toothing often begins much earlier than is suspected; and is liable to + produce convulsions; which are sometimes relieved, when the gum swells, + and becomes inflamed; at other times a diarrhœa supervenes, which + is generally esteemed a favourable circumstance, and seems to prevent the + convulsions by supplying another means of relieving the pain of dentition + by irritative exertion; and a consequent temporary exhaustion of + sensorial power. See Class <a href="#species_I_1_2_5">I. 1. 2. 5</a>. + Sect. XXXV. 2. 1.</p> + + <p>The convulsions from toothing generally commence long before the + appearance of the teeth; but as the two middle incisors of the lower jaw + generally appear first, and then those of the upper, it is adviseable to + lance the gums over these longitudinally in respect to the jaw-bones, and + quite down to the periosteum, and through it.</p> + + <p>As the convulsions attending the commencement of toothing are not only + dangerous to life in their greatest degree, but are liable to induce + stupor or insensibility by their continuance even in a less degree, the + most efficacious means should be used to cure them.</p> + + <p>M. M. Lance the gum of the expected teeth quite through the periosteum + longitudinally. Venesection by the lancet or by two or three leeches. One + grain of calomel as a purge. Tincture of jalap, five or six drops in + water every three hours til it purges, to be repeated daily. After + evacuations a small blister on the back or behind the ears. And lastly, + two or three drops of laudanum according to the age of the child. Warm + bath. See Class <a href="#species_III_1_1_5">III. 1. 1. 5</a>. and <a + href="#species_III_1_1_6">6</a>.</p> + + <p><a name="species_I_1_4_6">6</a>. <i>Priapismus chronicus.</i> I have + seen two cases, where an erection of the penis, as hard as horn, + continued two or three weeks without any venereal desires, but not + without some pain; the easiest attitude of the patients was lying upon + their backs with their knees up. At length the corpus cavernosum urethræ + became soft, and in another day or two the whole subsided. In one of them + a bougie was introduced, hoping to remove some bit of gravel from the + caput gallinaginis, camphor, warm bathing, opium, lime-water, cold + aspersion, bleeding in the veins of the penis, were tried in vain. One of + them had been a free drinker, had much gutta rosacea on his face, and + died suddenly a few months after his recovery from this complaint. Was it + a paralysis of the terminations of the veins, which absorb the blood from + the tumid penis? or from the stimulus of indurated semen in the seminal + vessels? In the latter case some venereal desires should have attended. + Class <a href="#species_III_1_2_16">III. 1. 2. 16</a>.</p> + + <p>The priapismus, which occurs to vigorous people in a morning before + they awake, has been called the signum salutis, or banner of health, and + is occasioned by the increase of our irritability or sensibility during + sleep, as explained in Sect. XVIII. 15.</p> + + <p><a name="species_I_1_4_7">7</a>. <i>Distentio mamularum.</i> The + distention of the nipples of lactescent women is at first owing to the + stimulus of the milk. See Sect. XIV. 8. and Sect. XVI. 5. See Class <a + href="#species_II_1_7_10">II. 1. 7. 10</a>.</p> + + <p><a name="species_I_1_4_8">8</a>. <i>Descensus uteri.</i> This is a + very frequent complaint after bad labours, the fundus uteri becomes + inverted and descends like the prolapsus ani.</p> + + <p>M. M. All the usual pessaries are very inconvenient and ineffectual. A + piece of soft sponge about two inches diameter introduced into the vagina + gives great ease to these patients, and supports the uterus; it should + have a string put through it to retract it by.</p> + + <p>There are also pessaries now made of elastic gum, which are said to be + easily worn, and to be convenient, from their having a perforation in + their centre.</p> + + <p><a name="species_I_1_4_9">9</a>. <i>Prolapsus ani.</i> The lower part + of the rectum becomes inverted, and descends after every stool chiefly in + children; and thus stimulates the sphincter ani like any other extraneous + body.</p> + + <p>M. M. It should be dusted over with very fine powder of gum sandarach, + and then replaced. Astringent fomentations; as an infusion of oak-bark, + or a slight solution of alum. Horizontal rest frequently in the day.</p> + + <p><a name="species_I_1_4_10">10</a>. <i>Lumbricus.</i> Round worm. The + round worm is suspected in children when the belly is tumid, and the + countenance bloated and pale, with swelling of the upper lip. The + generation of these worms is promoted by the too dilute state of the + bile, as is evident in the fleuke-worm found in the biliary ducts and + substance of the liver in sheep; and in water-rats, in the livers of + which last animals they were lately detected in large numbers by Dr. + Capelle. Transactions of the college at Philadelphia, v. i.</p> + + <p>Now as the dilute state of the bile depends on the deficiency of the + absorption of its thinner parts, it appears, that the tumid belly, and + bloated countenance, and swelled upper lip, are a concomitant + circumstance attending the general inactivity of the absorbent system; + which is therefore to be esteemed the remote cause of the generation of + worms.</p> + + <p>The simplicity of the structure of worms probably enables them to + exist in more various temperatures of heat; and their being endued with + life prevents them from being destroyed by digestion in the stomach, + probably in the same manner as the powers of life prevent the + fermentation and putrefaction of the stomach itself. Hence I conclude, + that worms are originally taken into our alimentary canal from without; + as I believe similar worms of all kinds are to be found out of the + body.</p> + + <p>M. M. The round worm is destroyed by a cathartic with four or six + grains of calomel; and afterwards by giving six or eight grains of + filings of iron twice a day for a fortnight. See Hepatis tumor, Class <a + href="#species_I_2_3_9">I. 2. 3. 9</a>. As worms are liable to come away + in fevers, whether of the hectic or putrid kind, could they be removed by + purulent matter, or rotten egg, or putrid flesh, since in those fevers + from the enfeebled action of the intestines the fæces become highly + putrid?</p> + + <p><a name="species_I_1_4_11">11</a>. <i>Tænia.</i> Tape-worm consists of + a chain of animals extending from the stomach to the anus. See Sect. + XXXIX. 2. 3. It frequently exists in cats, rats, and geese, and probably + in many other animals.</p> + + <p>The worms of this genus possess a wonderful power of retaining life. + Two of them, which were voided by a pointer dog in consequence of violent + purgatives, each of which were several feet in length, had boiling water + poured on them in a bason; which seemed not much to inconvenience them. + When the water was cool, they were taken out and put into gin or whiskey + of the strongest kind, in which their life and activity continued + unimpaired; and they were at length killed by adding to the spirit a + quantity of corrosive sublimate. Medic. Comment. for 1791, p. 370.</p> + + <p>The tape-worm is cured by an amalgama of tin and quicksilver, such as + is used on the back of looking-glasses; an ounce should be taken every + two hours, till a pound is taken; and then a brisk cathartic of Glauber's + salt two ounces, and common salts one ounce, dissolved in two wine pints + of water, half a pint to be taken every hour till it purges. The worm + extends from the stomach to the anus, and the amalgama tears it from the + intestine by mechanical pressure, acting upon it the whole way. Electric + shocks through the duodenum greatly assists the operation. Large doses of + tin in powder. Iron filings in large doses. The powder of fern-root seems + to be of no use, as recommended by M. Noufflier.</p> + + <p><a name="species_I_1_4_12">12</a>. <i>Ascarides.</i> Thread-worms. + These worms are said to be more frequent in some parts of this kingdom + than in others, as near the fens of Lincolnshire. Do they escape from the + body and become flies, like the bott-worm in horses? Do they crawl from + one child to another in the same bed? Are they acquired from flies or + worms, which are seen in putrid necessary houses, as these worms as well + as the tapeworms, are probably acquired from without? this may account + for their re-appearance a few weeks or months after they have been + destroyed; or can this happen from the eggs or parts of them + remaining?</p> + + <p>Ascarides appear to be of two kinds, the common small ones like a + thread; which has a very sharp head, as appears in the microscope; and + which is so tender, that the cold air soon renders it motionless; and a + larger kind above an inch long, and nearly as thick as a very small + crow-quill, and which is very hard in respect to its texture, and very + tenacious of life. One of these last was brought to me, and was + immediately immersed in a strong solution of sugar of lead, and lived in + it a very long time without apparent inconvenience.</p> + + <p>M. M. Ascarides are said to be weakened by twenty grains of cinnabar + and five of rhubarb taken every night, but not to be cured by this + process. As these worms are found only in the rectum, variety of clysters + have been recommended. I was informed of a case, where solutions of + mercurial ointment were used as a clyster every night for a month without + success. Clysters of Harrowgate water are recomended, either of the + natural, or of the factitious, as described below, which might have a + greater proportion of liver of sulphur in it. As the cold air soon + destroys them, after they are voided, could clysters of iced water be + used with advantage? or of spirit of wine and water? or of ether and + water? Might not a piece of candle, about an inch long, or two such + pieces, smeared with mercurial ointment, and introduced into the anus at + night, or twice a day, be effectual by compressing their nidus, as well + as by the poison of the mercury.</p> + + <p>The clysters should be large in quantity, that they may pass high in + the rectum, as two drams of tobacco boiled a minute in a pint of water. + Or perhaps what might be still more efficacious and less inconvenient, + the smoke of tobacco injected by a proper apparatus every night, or + alternate nights, for six or eight weeks. This was long since + recommended, I think by Mr. Turner of Liverpool; and the reason it has + not succeeded, I believe to have been owing to the imperfections of the + joints of the common apparatus for injecting the smoke of tobacco, so + that it did not pass into the intestine, though it was supposed to do so, + as I once observed. The smoke should be received from the apparatus into + a large bladder; and it may then be certainly injected like the common + clyster with sufficient force; otherwise oiled leathers should be nicely + put round the joints of the machine; and a wet cloth round the injecting + pipe to prevent the return of the smoke by the sides of it. Clysters of + carbonated hydrogen gas, or of other factitious airs, might be tried.</p> + + <p>Harrowgate water taken into the stomach, so as to induce six or seven + stools every morning, for four or six weeks, is perhaps the most + efficacious method in common use. A factitious Harrowgate water may be + made probably of greater efficacy than the natural, by dissolving one + ounce of marine salt, (called bay salt) and half an ounce of magnesia + Glauber's salt, (called Epsom salt, or bitter purging salt) in + twenty-eight ounces of water. A quarter or half a pint of this is to be + taken every hour, or two hours in the morning, till it operates, with a + tea-spoonful of a solution of liver of sulphur, which is to be made by + putting an ounce of hepar sulphuris into half a pint of water. See Class + <a href="#species_IV_1_2_9">IV. 1. 2. 9</a>.</p> + + <p><a name="species_I_1_4_13">13</a>. <i>Dracunculus.</i> A thin worm + brought from the coast of Guinea. It is found in the interstices of the + muscles, and is many yards long; it makes a small ulcer; which is cured + by extracting an inch of the worm a day, and wrapping the extracted part + slowly round a bit of tobacco pipe till next day, so as not to break it. + I have twice seen long worms, like a thick horse-hair, in water in July + in this country, which appeared hard and jointed.</p> + + <p><a name="species_I_1_4_14">14</a>. <i>Morpiones.</i> Crab-lice. The + excrement of this animal stains the linen, and appears like diluted + blood.</p> + + <p>M. M. Spirit of wine. Mercurial ointment, shaving the part. Oil + destroys other insects, if they be quite covered with it, as the ticks on + dogs, and would probably therefore destroy these. Its manner of operation + is by stopping up or filling their spiracula, or breathing pores; a few + drops of oil poured on a wasp, so as to cover it, destroys it in a few + seconds.</p> + + <p><a name="species_I_1_4_15">15</a>. <i>Pediculi.</i> Lice. There is + said to be a disease, in which these animals are propagated in + indestructible numbers, so as to destroy the patient.</p> + + <p>M. M. Cleanliness, mercurial ointment, stavis acria in powder, or the + tincture of it in spirit of wine. Spirit of wine alone? Bath of oil?</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_1_5">V</a>.</h3> + +<h3><i>With Increased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_I_1_5_1">1</a>. <i>Visus acrior.</i> Acuter sight. + There have been instances of people, who could see better in the gloom of + the evening, than in the stronger light of the day; like owls, and bats, + and many quadrupeds, and flying insects. When the eye is inflamed, great + light becomes eminently painful, owing to the increased irritative + motions of the retina, and the consequent increased sensation. Thus when + the eye is dazzled with sudden light, the pain is not owing to the motion + of the iris; for it is the contraction of the iris, which relieves the + pain from sudden light; but to the too violent contractions of the moving + fibres, which constitute the extremities of the optic nerve.</p> + + <p><a name="species_I_1_5_2">2</a>. <i>Auditus acrior.</i> The irritative + ideas of hearing are so increased in energy as to excite our attention. + This happens in some diseases of the epileptic kind, and in some fevers. + Hence the whispering of the currents of air in a room, the respiration of + the company, and noises before unperceived, become troublesome; and + sounds louder than usual, or unexpected, produce starting, and + convulsions.</p> + + <p>M. M. Put oil of almonds into the ears. Stop the meatus auditorius + with cotton wool. Set the feet of the patient's bed on cushions, or + suspend it by cords from the ceiling.</p> + + <p><a name="species_I_1_5_3">3</a>. <i>Olfactus acrior.</i> The + irritative ideas of smell from the increased action of the olfactive + nerve excite our attention. Hence common odours are disagreeable; and are + perceived from variety of objects, which were before thought inodorous. + These are commonly believed to be hallucinations of the sense.</p> + + <p>M. M. Snuff starch up the nostrils.</p> + + <p><a name="species_I_1_5_4">4</a>. <i>Gustus acrior.</i> The irritative + ideas of taste, as of our own saliva, and even of the atmospheric air, + excite our attention; and common tastes are disagreeably strong.</p> + + <p>M. M. Water. Mucilage. Vegetable acids. Scrape the tongue clean. Rub + it with a sage-leaf and vinegar.</p> + + <p><a name="species_I_1_5_5">5</a>. <i>Tactus acrior.</i> The irritative + ideas of the nerves of touch excite our attention: hence our own pressure + on the parts, we rest upon, becomes uneasy with universal soreness.</p> + + <p>M. M. Soft feather-bed. Combed wool put under the patients, which + rolls under them, as they turn, and thus prevents their friction against + the sheets. Drawers of soft leather. Plasters of cerate with calamy.</p> + + <p><a name="species_I_1_5_6">6</a>. <i>Sensus caloris acrior.</i> Acuter + sense of heat occurs in some diseases, and that even when the perceptible + heat does not appear greater than natural to the hand of another person. + See Class <a href="#genus_I_1_2">I. 1. 2</a>. See Sect. XIV. 8. All the + above increased actions of our organs of sense separately or jointly + accompany some fevers, and some epileptic diseases; the patients + complaining of the perception of the least light, noises in their ears, + bad smells in the room, and bad tastes in their mouths, with soreness, + numbness, and other uneasy feels, and with disagreeable sensations of + general or partial heat.</p> + + <p><a name="species_I_1_5_7">7</a>. <i>Sensus extensionis acrior.</i> + Acuter sense of extension. The sense of extension was spoken of in Sect. + XIV. 7. and XXXII. 4. The defect of distention in the arterial system is + accompanied with faintness; and its excess with sensations of fulness, or + weight, or pressure. This however refers only to the vascular muscles, + which are distended by their appropriated fluids; but the longitudinal + muscles are also affected by different quantities of extension, and + become violently painful by the excess of it.</p> + + <p>These pains of muscles and of membranes are generally divided into + acute and dull pains. The former are generally owing to increase of + extension, as in pricking the skin with a needle; and the latter + generally to defect of extension, as in cold head-aches; but if the edge + of a knife, or point of a pin, be gradually pressed against the fibres of + muscles or membranes, there would seem to be three states or stages of + this extension of the fibres; which have acquired names according to the + degree or kind of sensation produced by the extension of them; these are + 1. titillation or tickling. 2. itching, and the 3. smarting; as described + below. See Sect. XIV. 9.</p> + + <p><a name="species_I_1_5_8">8</a>. <i>Titillatio.</i> Tickling is a + pleasureable pain of the sense of extension above mentioned, and + therefore excites laughter; as described in Sect. XXXIV. 1. 4. The + tickling of the nostrils, which precedes the efforts of sneezing, is + owing to the increased irritation occasioned by external stimulus; and is + attended with a pleasureable sensation in consequence of the increased + action of the part. When this action is exerted in a greater degree, the + sensation becomes painful, and the convulsion of sneezing ensues; as the + pain in tickling the soles of the feet of children is relieved by + laughter.</p> + + <p>A lady after a bruise on her nose by a fall was affected with + incessant sneezing, and relieved by snuffing starch up her nostrils. + Perpetual <span class="correction" title="Original reads `sneeezings'." + >sneezings</span> in the measles, and in catarrhs from cold, are owing to + the stimulus of the saline part of the mucous effusion on the membrane of + the nostrils. See Class <span class="correction" title="Original reads `II. 1. 1. 2.'." + ><a href="#species_II_1_1_3">II. 1. 1. 3</a></span>.</p> + + <p><a name="species_I_1_5_9">9</a>. <i>Pruritus.</i> Itching seems to be + a greater degree of titillation, and to be owing to the stimulus of some + acrid material, as the matter of the itch; or of the herpes on the + scrotum, and about the anus; or from those universal eruptions, which + attend some elderly people, who have drank much vinous spirit. It occurs + also, when inflammations are declining, as in the healing of blisters, or + in the cure of ophthalmia, as the action of the vessels is yet so great + as to produce sensation; which, like the titillations that occasion + laughter, is perpetually changing from pleasure to pain.</p> + + <p>When the natural efforts of scratching do not relieve the pain of + itching, it sometimes increases so as to induce convulsions and madness. + As in the furor uterinus, and satyriasis, and in the sphincter ani and + scrotum. See Class <a href="#species_II_1_4_14">II. 1. 4. 14</a>. <a + href="#species_IV_2_2_6">IV. 2. 2. 6</a>.</p> + + <p>M. M. Warm bath. Fomentation. Alcohol externally. Poultice. Oiled + silk. Mercurial ointments on small surfaces at once. See Class <a + href="#species_II_1_4_12">II. 1. 4. 12</a>. Solutions of lead on small + surfaces at once.</p> + + <p><a name="species_I_1_5_10">10</a>. <i>Dolor urens.</i> Smarting + follows the edge of a knife in making a wound, and seems to be owing to + the distention of a part of a fibre, till it breaks. A smarting of the + skin is liable to affect the scars left by herpes or shingles; and the + callous parts of the bottoms of the feet; and around the bases of corns + on the toes; and frequently extends after sciatica along the outside of + the thigh, and of the leg, and part of the foot. All these may be owing + to the stimulus of extension, by blood or serum being forced into vessels + nearly coalesced.</p> + + <p>M. M. Emplastrum de minio put like a bandage on the part. Warm + fomentation. Oil and camphor rubbed on the part. Oil-silk covering. A + blister on the part. Ether, or alcohol, suffered to evaporate on the + part.</p> + + <p><a name="species_I_1_5_11">11</a>. <i>Consternatio.</i> Surprise. As + our eyes acquaint us at the same time with less than half of the objects, + which surround us, we have learned to confide much in the organ of + hearing to warn us of approaching dangers. Hence it happens, that if any + sound strikes us, which we cannot immediately account for, our fears are + instantly alarmed. Thus in great debility of body, the loud clapping of a + door, or the fall of a fire-shovel, produces alarm, and sometimes even + convulsions; the same occurs from unexpected sights, and in the dark from + unexpected objects of touch.</p> + + <p>In these cases the irritability is less than natural, though it is + erroneously supposed to be greater; and the mind is busied in exciting a + train of ideas inattentive to external objects; when this train of ideas + is dissevered by any unexpected stimulus, surprise is excited; as + explained in Sect. XVII. 3. 7. and XVIII. 17. then as the sensibility in + these cases is greater, fear becomes superadded to the surprise; and + convulsions in consequence of the pain of fear. See Sect. XIX. 2.</p> + + <p>The proximate cause of surprise is the increased irritation induced by + some violent stimulus, which dissevers our usual trains of ideas; but in + diseases of inirritability the frequent starting or surprise from sounds + not uncommon, but rather louder than usual, as the clapping of a door, + shews, that the attention of the patient to a train of sensitive ideas + was previously stronger than natural, and indicates an incipient + delirium; which is therefore worth attending to in febrile diseases.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_I_2">II</a>.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_2_1">I</a>.</h3> + +<h3><i>With decreased Action of the Sanguiferous System.</i></h3> + + <p>The reader should be here apprized, that the words strength and + debility, when applied to animal motions, may properly express the + quantity of resistance such motions may overcome; but that, when they are + applied to mean the susceptibility or insusceptibility of animal fibres + to motion, they become metaphorical terms; as in Sect. XII. 2. 1. and + would be better expressed by the words activity and inactivity.</p> + + <p>There are three sources of animal inactivity; first, the defect of the + natural quantity of stimulus on those fibres, which have been accustomed + to perpetual stimulus; as the arterial and secerning systems. When their + accustomed stimulus is for a while intermitted, as when snow is applied + to the skin of the hands, an accumulation of sensorial power is produced; + and then a degree of stimulus, as of heat, somewhat greater than that at + present applied, though much less than the natural quantity, excites the + vessels of the skin into violent action. We must observe, that a + deficiency of stimulus in those fibres, which are not subject to + perpetual stimulus, as the locomotive muscles, is not succeeded by + accumulation of sensorial power; these therefore are more liable to + become permanently inactive after a diminution of stimulus; as in strokes + of the palsy, this may be called inactivity from defect of stimulus.</p> + + <p>2. A second source of animal inactivity exists, when the sensorial + power in any part of the system has been previously exhausted by violent + stimuli; as the eyes after long exposure to great light; or the stomach, + to repeated spirituous potation; this may be termed inactivity from + exhaustion of sensorial power. See Sect. XII. 2. 1.</p> + + <p>3. But there is a third source of inactivity owing to the deficient + production of sensorial power in the brain; and hence stimuli stronger + than natural are required to produce the accustomed motions of the + arterial system; in this case there is no accumulation of sensorial power + produced; as in the inactivity owing to defect of stimulus; nor any + previous exhaustion of it, as in the inactivity owing to excess of + stimulus.</p> + + <p>This third kind of inactivity causes many of the diseases of this + genus; which are therefore in general to be remedied by such medicines as + promote a greater production of sensorial power in the brain; as the + incitantia, consisting of wine, beer, and opium, in small repeated + quantities; and secondly of such as simply stimulate the arterial and + glandular system into their natural actions; as small repeated blisters, + spices, and essential oils. And lastly the sorbentia, which contribute to + supply the more permanent strength of the system, by promoting the + absorption of nourishment from the stomach, and intestines; and of the + superfluous fluid, which attends the secretions.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_2_1_1">1</a>. <i>Febris inirritativa.</i> + Inirritative fever. This is the typhus mitior, or nervous fever of some + writers; it is attended with weak pulse without inflammation, or symptoms + of putridity, as they have been called. When the production of sensorial + power in the brain is less than usual, the pulse becomes quick as well as + weak; and the heart sometimes trembles like the limbs of old age, or of + enfeebled drunkards; and when this force of the contractions of the heart + and arteries is diminished, the blood is pushed on with less energy, as + well as in less quantity, and thence its stimulus on their sides is + diminished in a duplicate ratio. In compressions of the brain, as in + apoplexy, the pulse becomes slower and fuller; for in that disease, as in + natural sleep, the irritative motions of the heart and arteries are not + diminished, volition alone is suspended or destroyed.</p> + + <p>If the absorption of the terminations of the veins is not equally + impaired with the force of the heart and arteries, the blood is taken up + by the veins the instant it arrives at their extremities; the capillary + vessels are left empty, and there is less resistance to the current of + the blood from the arteries; hence the pulse becomes empty, as well as + weak and quick; the veins of the skin are fuller than the arteries of it; + and its appearance becomes pale, bluish, and shrunk. See Class <a + href="#species_II_1_3_1">II. 1. 3. 1</a>.</p> + + <p>When this pulse persists many hours, it constitutes the febris + inirritativa, or typhus, or nervous fever, of some writers; it is + attended with little heat, the urine is generally of a natural colour, + though in less quantity; with great prostration of strength, and much + disturbance of the faculties of the mind. Its immediate cause seems to be + a deficient secretion of the sensorial power from the inaction of the + brain; hence almost the whole of the sensorial power is expended in the + performance of the motions necessary to life, and little of it can be + spared for the voluntary actions of the locomotive muscles, or organs of + sense, see Class <a href="#species_I_2_5_3">I. 2. 5. 3</a>. Its more + remote cause may be from a paralysis or death of some other part of the + body; as of the spleen, when a tumour is felt on the left side, as in + some intermittents; or of the kidnies, when the urine continues pale and + in small quantity. Does the revivescence of these affected parts, or + their torpor, recurring at intervals, form the paroxysms of these fevers? + and their permanent revivescence establish the cure? See Class <a + href="#species_IV_2_1_19">IV. 2. 1. 19</a>.</p> + + <p>M. M. Wine and opium in small quantities repeated every three hours + alternately; small repeated blisters; warm but fresh air; sorbentia; + nutrientia; transfusion of blood. Small electric shocks passed through + the brain in all directions. Oxygene air?</p> + + <p><a name="species_I_2_1_2">2</a>. <i>Paresis inirritativa.</i> + Inirritative debility. A defective action of the irritative motions + without increase of the frequency of the pulse. It continues three or + four weeks like a fever, and then either terminates in health, or the + patient sinks into one kind of apoplexy, and perishes. Many symptoms, + which attend inirritative fevers, accompany this disease, as cold hands + and feet at periodic times, scurf on the tongue, want of appetite, muddy + urine, with pains of the head, and sometimes vertigo, and vomiting.</p> + + <p>This disease differs from the inirritative fever by the pulse not + being more frequent than in health. The want of appetite and of digestion + is a principal symptom, and probably is the cause of the universal + debility, which may be occasioned by the want of nourishment. The vertigo + is a symptom of inirritability, as shewn in Class <span + class="correction" title="Original reads `IV. 1. 2. 6.'."><a + href="#species_IV_2_1_16">IV. 2. 1. 16</a></span>. the muddy urine is + owing to increased absorption from the bladder in consequence of the + diminished cutaneous and cellular absorption, as in anasarca, explained + in Sect. XXIX. 5. 1. and is therefore a consequence of the inirritability + of that part of the system; the foul tongue is owing to an increased + absorption of the thinner part of the mucus in consequence of the general + deficiency of fluid, which should be absorbed by the skin and stomach. + The sickness is owing to decreased action of the stomach, which is + probably the primary disease, and is connected with the vertigo.</p> + + <p>M. M. An emetic. Calomel, grains iv. once or twice. Then a blister. + Peruvian bark. Valerian. Columbo. Steel. Opium and wine in small + quantities, repeated alternately every three hours. Small electric + percussions through the stomach.</p> + + <p><a name="species_I_2_1_3">3</a>. <i>Somnus interruptus.</i> + Interrupted sleep. In some fevers, where the inirritability is very + great, when the patient falls asleep, the pulse in a few minutes becomes + irregular, and the patient awakes in great disorder, and fear of dying, + refusing to sleep again from the terror of this uneasy sensation. In this + extreme debility there is reason to believe, that some voluntary power + during our waking hours is employed to aid the irritative stimuli in + carrying on the circulation of the blood through the lungs; in the same + manner as we use voluntary exertions, when we listen to weak sounds, or + wish to view an object by a small light; in sleep volition is suspended, + and the deficient irritation alone is not sufficient to carry on the + pulmonary circulation. This explanation seems the most probable one, + because in cases of apoplexy the irritative motions of the arterial + system do not seem to be impaired, nor in common sleep. See Incubus <a + href="#species_III_2_1_13">III. 2. 1. 13</a>.</p> + + <p>M. M. Opium in very small doses, as three drops of laudanum. A person + should watch the patient, and awaken him frequently; or he should measure + the time between slumber and slumber by a stop-watch, and awaken the + patient a little before he would otherwise awake; or he should keep his + finger on the pulse, and should forcibly awaken him, as soon as it + becomes irregular, before the disorder of the circulation becomes so + great as to disturb him. See Class <a href="#species_I_2_1_9">I. 2. 1. + 9</a>. and Sect. XXVII. 2.</p> + + <p><a name="species_I_2_1_4">4</a>. <i>Syncope.</i> Fainting consists in + the decreased action of the arterial system; which is sometimes + occasioned by defect of the stimulus of distention, as after venesection, + or tapping for the dropsy. At other times it arises from great emotions + of the mind, as in sudden joy or grief. In these cases the whole + sensorial power is exerted on these interesting ideas, and becomes + exhausted. Thus during great surprise or fear the heart stops for a time, + and then proceeds with throbbing and agitation; and sometimes the vital + motions become so deranged, as never to recover their natural successive + action; as when children have been frightened into convulsions. See Sect. + XII. 7. 1.</p> + + <p>Miss ——, a young lady of Stafford, in travelling in a + chaise was so affected by seeing the fall of a horse and postillion, in + going down a hill, though the carriage was not overturned, that she + fainted away, and then became convulsed, and never spoke afterwards; + though she lived about three days in successive convulsions and + stupor.</p> + + <p><a name="species_I_2_1_5">5</a>. <i>Hæmorrhagia venosa.</i> A bleeding + from the capillaries arising from defect of venous absorption, as in some + of those fevers commonly termed putrid. When the blood stagnates in the + cellular membrane, it produces petechiæ from this torpor or paralysis of + the absorbent mouths of the veins. It must be observed, that those people + who have diseased livers, are more liable to this kind of hæmorrhages, as + well as to the hæmorrhagia arteriosa; the former, because patients with + diseased livers are more subject to paralytic complaints in general, as + to hemiplegia, and to dropsy, which is a paralysis of the lymphatics; and + the latter is probably owing to the delay of the circulation in the vena + porta by the torpor of this hepatic vessel, when the liver is not much + enlarged; and to its pressure on the vena cava, when it is much + enlarged.</p> + + <p>M. M. Vitriolic acid, opium, steel, bark. Sponge bound on the part. + Steel dissolved in spirit of wine externally. Flour.</p> + + <p><a name="species_I_2_1_6">6</a>. <i>Hæmorrhois cruenta.</i> In the + bleeding piles the capillary vessels of the rectum become distended and + painful from the defect of the venous absorption of the part, and at + length burst; or the mucous glands are so dilated as to give a passage to + the blood; it is said to observe lunar periods.</p> + + <p>M. M. Venesection, poultices, cathartics, spice, cold bath, and + sorbentia. External compression by applying lint, sponge, or cotton. + Internal compression by applying a bit of candle smeared with mercurial + ointment. Strangulate the tumid piles with a silk string. Cut them off. + See Class <a href="#species_I_2_3_22">I. 2. 3. 22</a>.</p> + + <p>Mrs. —— had for twelve or fifteen years, at intervals of a + year or less, a bleeding from the rectum without pain; which however + stopped spontaneously after she became weakened, or by the use of + injections of brandy and water. Lately the bleeding continued above two + months, in the quantity of many ounces a day, till she became pale and + feeble to an alarming degree. Injections of solutions of lead, of bark + and salt of steel, and of turpentine, with some internal astringents, and + opiates, were used in vain. An injection of the smoke of tobacco, with + ten grains of opium mixed with the tobacco, was used, but without effect + the two first times on account of the imperfection of the machine; on the + third time it produced great sickness, and vertigo, and nearly a fainting + fit; from which time the blood entirely stopped. Was this owing to a + fungous excrescence in the rectum; or to a blood-vessel being burst from + the difficulty of the blood passing through the vena porta from some + hepatic obstruction, and which had continued to bleed so long? Was it + stopped at last by the fainting fit? or by the stimulus of the + tobacco?</p> + + <p><a name="species_I_2_1_7">7</a>. <i>Hæmorrhagia renum.</i> Hæmorrhage + from the kidnies, when attended with no pain, is owing to defect of + venous absorption in the kidney. When attended with pain on motion, it is + owing to a bit of gravel in the ureter or pelvis of the kidney; which is + a much more frequent disease than the former. See Sect. XXVII. 1.</p> + + <p>M. M. 1. Venesection in small quantity, calomel, bark, steel, an + opiate; cold immersion up to the navel, the upper part of the body being + kept cloathed. Neville-Holt water. 2. Alcalized water aerated. Much + diluent liquids. Cool dress. Cool bed-room.</p> + + <p>Cows are much subject to bloody urine, called foul water by the + farmers; in this disease about sixty grains of opium with or without as + much rust of iron, given twice a day, in a ball mixed with flour and + water, or dissolved in warm water, or warm ale, is, I believe, an + efficacious remedy, to which however should be added about two quarts of + barley or oats twice a day, and a cover at night, if the weather be + cold.</p> + + <p><a name="species_I_2_1_8">8</a>. <i>Hæmorrhagia Hepatis.</i> + Hæmorrhage from the liver. It sometimes happens in those, who have the + gutta rosea, or paralytic affections owing to diseased livers induced by + the potation of fermented liquors, that a great discharge of black viscid + blood occasionally comes away by stool, and sometimes by vomiting: this + the ancients called Melancholia, black bile. If it was bile, a small + quantity of it would become yellow or green on dilution with warm water, + which was not the case in one experiment which I tried; it must remain + some time in the intestines from its black colour, when it passes + downwards, and probably comes from the bile-ducts, and is often a fatal + symptom. When it is evacuated by vomiting it is less dangerous, because + it shews greater remaining irritability of the intestinal canal, and is + sometimes salutary to those who have diseased livers.</p> + + <p>M. M. An emetic. Rhubarb, steel, wine, bark.</p> + + <p><a name="species_I_2_1_9">9</a>. <i>Hæmoptoe venosa.</i> Venous + hæmoptoe frequently attends the beginning of the hereditary consumptions + of dark-eyed people; and in others, whose lungs have too little + irritability. These spittings of blood are generally in very small + quantity, as a tea-spoonful; and return at first periodically, as about + once a month; and are less dangerous in the female than in the male sex; + as in the former they are often relieved by the natural periods of the + menses. Many of these patients are attacked with this pulmonary + hæmorrhage in their first sleep; because in feeble people the power of + volition is necessary, besides that of irritation, to carry on + respiration perfectly; but, as volition is suspended during sleep, a part + of the blood is delayed in the vessels of the lungs, and in consequence + effused, and the patient awakes from the disagreeable sensation. See + Class <a href="#species_I_2_1_3">I. 2. 1. 3</a>. <a + href="#species_II_1_6_6">II. 1. 6. 6</a>. <a + href="#species_III_2_1_10">III. 2. 1. 10</a>.</p> + + <p>M. M. Wake the patient every two or three hours by an alarum clock. + Give half a grain of opium at going to bed, or twice a day. Onions, + garlic, slight chalybeates. Issues. Leeches applied once a fortnight or + month to the hemorrhoidal veins to produce a new habit. Emetics after + each period of hæmoptoe, to promote expectoration, and dislodge any + effused blood, which might by remaining in the lungs produce ulcers by + its putridity. A hard bed, to prevent too sound sleep. A periodical + emetic or cathartic once a fortnight.</p> + + <p><a name="species_I_2_1_10">10</a>. <i>Palpitatio cordis.</i> The + palpitation of the heart frequently attends the hæmoptoe above mentioned; + and consists in an ineffectual exertion of the heart to push forwards its + contents in due time, and with due force. The remote cause is frequently + some impediment to the general circulation; as the torpor of the + capillaries in cold paroxysms of fever, or great adhesions of the lungs. + At other times it arises from the debility of the action of the heart + owing to the deficient sensorial power of irritation or of association, + as at the approach of death.</p> + + <p>In both these cases of weak exertion the heart feels large to the + touch, as it does not completely empty itself at each contraction; and on + that account contracts more frequently, as described in Sect. XXXII. 2. + 2. Another kind of palpitation may sometimes arise from the retrograde + motions of the heart, as in fear. See Class <a href="#species_I_3_1_2">I. + 3. 1. 2</a>. and <a href="#species_IV_3_1_6">IV. 3. 1. 6</a>.</p> + + <p><a name="species_I_2_1_11">11</a>. <i>Menorrhagia.</i> Continued flow + of the catamenia. The monthly effusion of blood from the uterus or vagina + is owing to a torpor of the veins of those membranes in consequence of + the defect of venereal stimulus; and in this respect resembles the mucus + discharged in the periodical venereal orgasm of the female <span + class="correction" title="Original reads `quadupeds'.">quadrupeds</span>, + which are secluded from the males. The menorrhagia, or continued flow of + this discharge, is owing to a continued defect of the venous absorption + of the membranes of the uterus or vagina. See Class <a + href="#species_IV_2_4_7">IV. 2. 4. 7</a>.</p> + + <p>M. M. Venesection in small quantity. A cathartic. Then opium, a grain + every night. Steel. Bark. A blister. Topical aspersion with cold water, + or cold vinegar.</p> + + <p><a name="species_I_2_1_12">12</a>. <i>Dysmenorrhagia.</i> A difficulty + of menstruation attended with pain. In this complaint the torpor of the + uterine vessels, which precedes menstruation, is by sympathy accompanied + with a torpor of the lumbar membranes, and consequent pain; and + frequently with cold extremities, and general debility. The small + quantity and difficulty of the discharge is owing to arterial inactivity, + as in chlorosis. Whence it happens, that chalybeate medicines are of + efficacy both to stop or prevent too great menstruation, and to promote + or increase deficient menstruation; as the former is owing to + inirritability of the veins, and the latter of the arteries of the + uterus. See Article <a href="#art_IV_2_6">IV. 2. 6</a>. in the Materia + Medica.</p> + + <p>M. M. Opium, steel, pediluvium. Warm bath.</p> + + <p><a name="species_I_2_1_13">13</a>. <i>Lochia nimia.</i> Too great + discharge after delivery. In that unnatural practice of some hasty + accoucheurs of introducing the hand into the uterus immediately after the + delivery of the child, and forcibly bringing away the placenta, it + frequently happens, that a part of it is left behind; and the uterus, not + having power to exclude so small a portion of it, is prevented from + complete contraction, and a great hæmorrhage ensues. In this circumstance + a bandage with a thick compress on the lower part of the belly, by + appressing the sides of the uterus on the remaining part of the placenta, + is likely to check the hæmorrhage, like the application of a pledget of + any soft substance on a bleeding vessel.</p> + + <p>In other cases the lochia continues too long, or in too great + quantity, owing to the deficiency of venous absorption.</p> + + <p>M. M. An enema. An opiate. A blister. Slight chalybeates. Peruvian + bark. Clothes dipped in cold vinegar and applied externally. Bandages on + the limbs to keep more blood in them for a time have been + recommended.</p> + + <p><a name="species_I_2_1_14">14</a>. <i>Abortio spontanea.</i> Some + delicate ladies are perpetually liable to spontaneous abortion, before + the third, or after the seventh, month of gestation. From some of these + patients I have learnt, that they have awakened with a slight degree of + difficult respiration, so as to induce them to rise hastily up in bed; + and have hence suspected, that this was a tendency to a kind of asthma, + owing to a deficient absorption of blood in the extremities of the + pulmonary or bronchial veins; and have concluded from thence, that there + was generally a deficiency of venous absorption; and that this was the + occasion of their frequent abortion. Which is further countenanced, where + a great sanguinary discharge precedes or follows the exclusion of the + fetus.</p> + + <p>M. M. Opium, bark, chalybeates in small quantity. Change to a warmer + climate. I have directed with success in four cases half a grain of opium + twice a day for a fortnight, and then a whole grain twice a day during + the whole gestation. One of these patients took besides twenty grains of + Peruvian bark for several weeks. By these means being exactly and + regularly persisted in, a new habit became established, and the usual + miscarriages were prevented.</p> + + <p>Miscarriages more frequently happen from eruptive fevers, and from + rheumatic ones, than from other inflammatory diseases. I saw a most + violent pleurisy and hepatitis cured by repeated venesection about a week + or ten days before parturition; yet another lady whom I attended, + miscarried at the end of the chicken pox, with which her children were at + the same time affected. Miscarriages towards the termination of the small + pox are very frequent, yet there have been a few instances of children, + who have been born with the eruption on them. The blood in the small pox + will not inoculate that disease, if taken before the commencement of the + secondary fever; as shewn in Sect. XXXIII. 2. 10. because the contagious + matter is not yet formed, but after it has been oxygenated through the + cuticle in the pustules, it becomes contagious; and if it be then + absorbed, as in the secondary fever, the blood of the mother may become + contagious, and infect the child. The same mode of reasoning is + applicable to the chicken pox. See Class <a href="#species_IV_3_1_7">IV. + 3. 1. 7</a>.</p> + + <p><a name="species_I_2_1_15">15</a>. <i>Scorbutus.</i> Sea-scurvy is + caused by salt diet, the perpetual stimulus of which debilitates the + venous and absorbent systems. Hence the blood is imperfectly taken up by + the veins from the capillaries, whence brown and black spots appear upon + the skin without fever. The limbs become livid and edematous, and lastly + ulcers are produced from deficient absorption. See Sect. XXXIII. 3. 2. + and Class <a href="#species_II_1_4_13">II. 1. 4. 13</a>. For an account + of the scurvy of the lungs, see Sect. XXVII. 2.</p> + + <p>M. M. Fresh animal and vegetable food. Infusion of malt. New beer. + Sugar. Wine. Steel. Bark. Sorbentia. Opium?</p> + + <p><a name="species_I_2_1_16">16</a>. <i>Vibices.</i> Extravasations of + blood become black from their being secluded from the air. The + extravasation of blood in bruises, or in some fevers, or after death in + some patients, especially in the parts which were exposed to pressure, is + owing to the fine terminations of the veins having been mechanically + compressed so as to prevent their absorbing the blood from the + capillaries, or to their inactivity from disease. The blood when + extravasated undergoes a chemical change before it is sufficiently fluid + to be taken up by the lymphatic absorbents, and in that process changes + its colour to green and then yellow.</p> + + <p><a name="species_I_2_1_17">17</a>. <i>Petechiæ.</i> Purple spots. + These attend fevers with great venous inirritability, and are probably + formed by the inability of a single termination of a vein, whence the + corresponding capillary becomes ruptured, and effuses the blood into the + cellular membrane round the inert termination of the vein. This is + generally esteemed a sign of the putrid state of the blood, or that state + contrary to the inflammatory one. As it attends some inflammatory + diseases which are attended with great inirritability, as in the + confluent small pox. But it also attends the scurvy, where no fever + exists, and it therefore simply announces the inactivity of the + terminations of some veins; and is thence indeed a bad symptom in fevers, + as a mark of approaching inactivity of the whole sanguiferous system, or + death. The blue colour of some children's arms or faces in very cold + weather is owing in like manner to the torpor of the absorbent + terminations of the veins, whence the blood is accumulated in them, and + sometimes bursts them.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_2_2">II</a>.</h3> + +<h3><i>Decreased Action of the Secerning System.</i></h3> + + <p>These are always attended with decrease of partial, or of general + heat; for as the heat of animal bodies is the consequence of their + various secretions, and is perpetually passing away into the ambient air, + or other bodies in contact with them; when these secretions become + diminished, or cease, the heat of the part or of the whole is soon + diminished, or ceases along with them.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_2_2_1">1</a>. <i>Frigus febrile.</i> Febrile + coldness. There is reason to believe, that the beginning of many + fever-fits originates in the quiescence of some part of the absorbent + system, especially where they have been owing to external cold; but that, + where the coldness of the body is not owing to a diminution of external + heat, it arises from the inaction of some part of the secerning system. + Hence some parts of the body are hot whilst other parts are cold; which I + suppose gave occasion to error in Martyn's Experiments; where he says, + that the body is as hot in the cold paroxysms of fevers as at other + times.</p> + + <p>After the sensorial power has been much diminished by great preceding + activity of the system, as by long continued external heat, or violent + exercise, a sudden exposure to much cold produces a torpor both greater + in degree and over a greater portion of the system, by subtracting their + accustomed stimulus from parts already much deprived of their + irritability. Dr. Franklin in a letter to M. Duberge, the French + translator of his works, mentions an instance of four young men, who + bathed in a cold spring after a day's harvest work; of whom two died on + the spot, a third on the next morning, and the other survived with + difficulty. Hence it would appear, that those, who have to travel in + intensely cold weather, will sooner perish, who have previously heated + themselves much with drams, than those who have only the stimulus of + natural food; of which I have heard one well attested instance. See + Article <a href="#art_VII_2_3">VII. 2. 3</a>. Class <a + href="#species_III_2_1_17">III. 2. 1. 17</a>.</p> + + <p><i>Frigus chronicum.</i> Permanent coldness. Coldness of the + extremities, without fever, with dry pale skin, is a symptom of general + debility, owing to the decreased action of the arterial system, and of + the capillary vessels; whence the perspirable matter is secreted in less + quantity, and in consequence the skin is less warm. This coldness is + observable at the extremities of the limbs, ears, and nose, more than in + any other parts: as a larger surface is here exposed to the contact of + the air, or clothes, and thence the heat is more hastily carried + away.</p> + + <p>The pain, which accompanies the coldness of the skin, is owing to the + deficient exertion of the subcutaneous vessels, and probably to the + accumulation of sensorial power in the extremities of their nerves. See + Sect. XII. 5. 3. XIV. 6. XXXII. 3. and Class <a + href="#species_I_2_4_1">I. 2. 4. 1</a>.</p> + + <p>M. M. A blister. Incitantia, nutrientia, sorbentia. Exercise. Clothes. + Fire. Joy. Anger.</p> + + <p><a name="species_I_2_2_2">2</a>. <i>Pallor fugitivus.</i> The fugitive + paleness, which accompanies the coldness of the extremities, is owing to + a less quantity of blood passing through the capillaries of the skin in a + given time; where the absorbent power of the veins is at the same time + much diminished, a part of the blood lingers at their junction with the + capillary arteries, and a bluish tinge is mixed with the paleness; as is + seen in the loose skin under the eye-lids, and is always a mark of + temporary debility. See Class <a href="#species_II_1_4_4">II. 1. 4. + 4</a>. Where the paleness of the skin is owing to the deficiency of red + globules in the blood, it is joined with a yellowish tinge; which is the + colour of the serum, with which the blood then abounds, as in chlorosis, + and in torpor or paralysis of the liver, and is often mistaken for a + superabundance of bile.</p> + + <p>A permanent paleness of the skin is owing to the coalescence of the + minute arteries, as in old age. See Class <a href="#species_I_2_2_9">I. + 2. 2. 9</a>. There is another source of paleness from the increased + absorption of the terminations of the veins, as when vinegar is applied + to the lips. See Sect. XXVII. 1. and another from the retrograde motions + of the capillaries and fine extremities of the arteries. See Class <span + class="correction" title="This seems to be a reference to the Genus `Of the arterial system'. omitted in Ordo II. 3." + >II. 3. 1. 1</span>.</p> + + <p>M. M. A blister, nutrientia, incitantia, exercise, oxygene gas.</p> + + <p><a name="species_I_2_2_3">3</a>. <i>Pus parcius.</i> Diminished pus. + Dryness of ulcers. In the cold fits of fever all the secretions are + diminished, whether natural or artificial, as their quantity depends on + the actions of the glands or capillaries, which then share in the + universal inaction of the system. Hence the dryness of issues and + blisters in great debility, and before the approach of death, is owing to + deficient secretion, and not to increased absorption.</p> + + <p>M. M. Opium, wine in very small quantities, Peruvian bark.</p> + + <p><a name="species_I_2_2_4">4</a>. <i>Mucus parcior.</i> Diminished + mucus. Dryness of the mouth and nostrils. This also occurs in the cold + fits of intermittents. In these cases I have also found the tongue cold + to the touch of the finger, and the breath to the back of one's hand, + when opposed to it, which are very inauspicious symptoms, and generally + fatal. In fevers with inirritability it is generally esteemed a good + symptom, when the nostrils and tongue become moist after having been + previously dry; as it shews an increased action of the mucous glands of + those membranes, which were before torpid. And the contrary to this is + the facies Hippocratica, or countenance so well described by Hippocrates, + which is pale, cold, and shrunk; all which are owing to the inactivity of + the secerning vessels, the paleness from there being less red blood + passing through the capillaries, the coldness of the skin from there + being less secretion of perspirable matter, and the shrunk appearance + from there being less mucus secreted into the cells of the cellular + membrane. See Class <a href="#species_IV_2_4_11">IV. 2. 4. 11</a>.</p> + + <p>M. M. Blisters. Incitantia.</p> + + <p><a name="species_I_2_2_5">5</a>. <i>Urina parcior pallida.</i> Paucity + of pale urine, as in the cold fits of intermittents; it appears in some + nervous fevers throughout the whole disease, and seems to proceed from a + palsy of the kidnies; which probably was the cause of the fever, as the + fever sometimes ceases, when that symptom is removed: hence the + straw-coloured urine in this fever is so far salutary, as it shews the + unimpaired action of the kidnies.</p> + + <p>M. M. Balsams, essential oil, asparagus, rhubarb, a blister. + Cantharides internally.</p> + + <p><a name="species_I_2_2_6">6</a>. <i>Torpor hepaticus.</i> Paucity of + bile from a partial inaction of the liver; hence the bombycinous colour + of the skin, grey stools, urine not yellow, indigestion, debility, + followed by tympany, dropsy, and death.</p> + + <p>This paralysis or inirritability of the liver often destroys those who + have been long habituated to much fermented liquor, and have suddenly + omitted the use of it. It also destroys plumbers, and house-painters, and + in them seems a substitute for the colica saturnina. See Sect. XXX.</p> + + <p>M. M. Aloe and calomel, then the bark, and chalybeates. Mercurial + ointment rubbed on the region of the liver. Rhubarb, three or four + grains, with opium half a grain to a grain twice a day. Equitation, warm + bath for half an hour everyday.</p> + + <p><a name="species_I_2_2_7">7</a>. <i>Torpor Pancreatis.</i> Torpor of + the pancreas. I saw what I conjectured to be a tumour of the pancreas + with indigestion, and which terminated in the death of the patient. He + had been for many years a great consumer of tobacco, insomuch that he + chewed that noxious drug all the morning, and smoaked it all the + afternoon. As the secretion from the pancreas resembles saliva in its + general appearance, and probably in its office of assisting digestion, by + preventing the fermentation of the aliment; as would appear by the + experiments of Pringle and Macbride; there is reason to suspect, that a + sympathy may exist between the salivary and pancreatic glands; and that + the perpetual stimulus of the former by tobacco might in process of time + injure the latter. See Tobacco, Article <a href="#art_III_2_2">III. 2. + 2</a>.</p> + + <p><a name="species_I_2_2_8">8</a>. <i>Torpor renis.</i> Inirritability + or paralysis of the kidnies is probably frequently mistaken for gravel in + them. Several, who have lived rather intemperately in respect to + fermented or spirituous liquors, become suddenly seized about the age of + sixty, or later, with a total stoppage of urine; though they have + previously had no symptoms of gravel. In these cases there is no water in + the bladder; as is known by the introduction of the catheter, of which + those made of elastic gum are said to be preferable to metallic ones; or + it may generally be known by the shape of the abdomen, either by the eye + or hand. Bougies and catheters of elastic gum are sold at N<sup>o</sup> + 37, Red Lion-street, Holborn, London.</p> + + <p>M. M. Electric shocks, warm bath. Emetics. See calculus renis, Class + <a href="#species_I_1_3_9">I. 1. 3. 9</a>. When no gravel has been + previously observed, and the patient has been a wine-drinker rather than + an ale-drinker, the case is generally owing to inirritability of the + tubuli uriniferi, and is frequently fatal. See Class <a + href="#species_I_2_4_20">I. 2. 4. 20</a>.</p> + + <p><a name="species_I_2_2_9">9</a>. <i>Punctæ mucosæ vultûs.</i> Mucous + spots on the face. These are owing to the inactivity of the excretory + ducts of the mucous glands; the thinner part of this secretion exhales, + and the remainder becomes inspissated, and lodges in the duct; the + extremity of which becomes black by exposure to the air.</p> + + <p>M. M. They may be pressed out by the finger-nails. Warm water. Ether + frequently applied. Blister on the part?</p> + + <p><a name="species_I_2_2_10">10</a>. <i>Maculæ cutis fulvæ.</i> Morphew + or freckles. Tawny blotches on the skin of the face and arms of elderly + people, and frequently on their legs after slight erysipelas. The + freckles on the face of younger people, who have red hair, seem to be a + similar production, and seem all to be caused by the coalescence of the + minute arteries or capillaries of the part. In a scar after a wound the + integument is only opake; but in these blotches, which are called morphew + and freckles, the small vessels seem to have become inactive with some of + the serum of the blood stagnating in them, from whence their colour. See + Class <a href="#species_III_1_2_12">III. 1. 2. 12</a>.</p> + + <p>M. M. Warm bathing. A blister on the part?</p> + + <p><a name="species_I_2_2_11">11</a>. <i>Canities.</i> Grey hair. In the + injection of the vessels of animals for the purposes of anatomical + preparations, the colour of the injected fluid will not pass into many + very minute vessels; which nevertheless uncoloured water, or spirits, or + quicksilver will permeate. The same occurs in the filtration of some + coloured fluids through paper, or very fine sand, where the colouring + matter is not perfectly dissolved, but only diffused through the liquid. + This has led some to imagine, that the cause of the whiteness of the hair + in elderly people may arise from the diminution, or greater tenuity, of + the glandular vessels, which secrete the mucus, which hardens into hair; + and that the same difference of the tenuity of the secerning vessels may + possibly make the difference of colour of the silk from different + silk-worms, which is of all shades from yellow to white.</p> + + <p>But as the secreted fluids are not the consequence of mechanical + filtration, but of animal selection; we must look out for another cause, + which must be found in the decreasing activity of the glands, as we + advance in life; and which affects many of our other secretions as well + as that of the mucus, which forms the hair. Hence grey hairs are produced + on the faces of horses by whatever injures the glands at their roots, as + by corrosive blisters; and frequently on the human subject by external + injuries on the head; and sometimes by fevers. And as the grey colour of + hair consists in its want of transparency, like water converted into + snow; there is reason to suppose, that a defect of secreted moisture + simply may be the cause of this kind of opacity, as explained in + Cataracta, Class <a href="#species_I_2_2_13">I. 2. 2. 13</a>.</p> + + <p>M. M. Whatever prevents the inirritability and insensibility of the + system, that is, whatever prevents the approach of old age, will so far + counteract the production of grey hairs, which is a symptom of it. For + this purpose in people, who are not corpulent, and perhaps in those who + are so, the warm bath twice or thrice a week is particularly serviceable. + See Sect. XXXIX. 5. 1. on the colours of animals, and Class <a + href="#species_I_1_2_15">I. 1. 2. 15</a>.</p> + + <p><a name="species_I_2_2_12">12</a>. <i>Callus.</i> The callous skin on + the hands and feet of laborious people is owing to the extreme vessels + coalescing from the perpetual pressure they are exposed to.</p> + + <p>As we advance in life, the finer arteries lose their power of action, + and their sides grow together; hence the paleness of the skins of elderly + people, and the loss of that bloom, which is owing to the numerous fine + arteries, and the transparency of the skin, that encloses them.</p> + + <p>M. M. Warm bath. Paring the thick skin with a knife. Smoothing it with + a pumice stone. Cover the part with oiled silk to prevent the evaporation + of the perspirable matter, and thus to keep it moist.</p> + + <p><a name="species_I_2_2_13">13</a>. <i>Cataracta</i> is an opacity of + the crystalline lens of the eye. It is a disease of light-coloured eyes, + as the gutta serena is of dark ones. On cutting off with scissars the + cornea of a calf's eye, and holding it in the palm of one's hand, so as + to gain a proper light, the artery, which supplies nutriment to the + crystalline humour, is easily and beautifully seen; as it rises from the + centre of the optic nerve through the vitreous humour to the crystalline. + It is this point, where the artery enters the eye through the cineritious + part of the optic nerve, (which is in part near the middle of the nerve,) + which is without sensibility to light; as is shewn by fixing three + papers, each of them about half an inch in diameter, against a wall about + a foot distant from each other, about the height of the eye; and then + looking at the middle one, with one eye, and retreating till you lose + sight of one of the external papers. Now as the animal grows older, the + artery becomes less visible, and perhaps carries only a transparent + fluid, and at length in some subjects I suppose ceases to be pervious; + then it follows, that the crystalline lens, losing some fluid, and + gaining none, becomes dry, and in consequence opake; for the same reason, + that wet or oiled paper is more transparent than when it is dry, as + explained in Class <a href="#species_I_1_4_1">I. 1. 4. 1</a>. The want of + moisture in the cornea of old people, when the exhalation becomes greater + than the supply, is the cause of its want of transparency; and which like + the crystalline gains rather a milky opacity. The same analogy may be + used to explain the whiteness of the hair of old people, which loses its + pellucidity along with its moisture. See Class <a + href="#species_I_2_2_11">I. 2. 2. 11</a>.</p> + + <p>M. M. Small electric shocks through the eye. A quarter of a grain of + corrosive sublimate of mercury dissolved in brandy, or taken in a pill, + twice a day for six weeks. Couching by depression, or by extraction. The + former of these operations is much to be preferred to the latter, though + the latter is at this time so fashionable, that a surgeon is almost + compelled to use it, lest he should not be thought an expert operator. + For depressing the cataract is attended with no pain, no danger, no + confinement, and may be as readily repeated, if the crystalline should + rise again to the centre of the eye. The extraction of the cataract is + attended with considerable pain, with long confinement, generally with + fever, always with inflammation, and frequently with irreparable injury + to the iris, and consequent danger to the whole eye. Yet has this + operation of extraction been trumpeted into universal fashion for no + other reason but because it is difficult to perform, and therefore keeps + the business in the hands of a few empyrics, who receive larger rewards, + regardless of the hazard, which is encountered by the flattered + patient.</p> + + <p>A friend of mine returned yesterday from London after an absence of + many weeks; he had a cataract in a proper state for the operation, and in + spite of my earnest exhortation to the contrary, was prevailed upon to + have it extracted rather than depressed. He was confined to his bed three + weeks after the operation, and is now returned with the iris adhering on + one side so as to make an oblong aperture; and which is nearly, if not + totally, without contraction, and thus greatly impedes the little vision, + which he possesses. Whereas I saw some patients couched by depression + many years ago by a then celebrated empyric, Chevalier Taylor, who were + not confined above a day or two, that the eye might gradually be + accustomed to light, and who saw as well as by extraction, perhaps + better, without either pain, or inflammation, or any hazard of losing the + eye.</p> + + <p>As the inflammation of the iris is probably owing to forcing the + crystalline through the aperture of it in the operation of extracting it, + could it not be done more safely by making the opening behind the iris + and ciliary process into the vitreous humour? but the operation would + still be more painful, more dangerous, and not more useful than that by + depressing it.</p> + + <p><a name="species_I_2_2_14">14</a>. <i>Innutritio ossium.</i> + Innutrition of the bones. Not only the blood effused in vibices and + petechiæ, or from bruises, as well as the blood and new vessels in + inflamed parts, are reabsorbed by the increased action of the lymphatics; + but the harder materials, which constitute the fangs of the first set of + teeth, and the ends of exfoliating bones, and sometimes the matter of + chalk-stones in the gout, the coagulable lymph, which is deposited on the + lungs, or on the muscles after inflammation of those parts, and which + frequently produces difficulty of breathing, and the pains of chronic + rheumatism, and lastly the earthy part of the living bones are dissolved + and absorbed by the increased actions of this system of vessels. See + Sect. XXXIII. 3. 1.</p> + + <p>The earthy part of bones in this disease of the innutrition of them + seems to suffer a solution, and reabsorption; while the secerning vessels + do not supply a sufficient quantity of calcareous earth and phosphoric + acid, which constitute the substance of bones. As calcareous earth + abounds every where, is the want of phosphoric acid the remote cause? One + cause of this malady is given in the Philosophic Transactions, where the + patient had been accustomed to drink large quantities of vinegar. Two + cases are described by Mr. Gouch. In one case, which I saw, a + considerable quantity of calcareous earth, and afterwards of bone-ashes, + and of decoction of madder, and also of sublimate of mercury, were given + without effect. All the bones became soft, many of them broke, and the + patient seemed to die from the want of being able to distend her chest + owing to the softness of the ribs.</p> + + <p>M. M. Salt of urine, called sal microcosmicum, phosphorated soda. + Calcined hartshorn. Bone-ashes. Hard or petrifying water, as that of + Matlock, or such as is found in all limestone or marly countries. The + calcareous earth in these waters might possibly be carried to the bones, + as madder is known to colour them. Warm bath. Volatile or fixed alcali as + a lotion on the spine, or essential oils.</p> + + <p>The innutrition of the bones is often first to be perceived by the + difficulty of breathing and palpitation of the heart on walking a little + faster than usual, which I suppose is owing to the softness of the ends + of the ribs adjoining to the sternum; on which account they do not + perfectly distend the chest, when they are raised by the pectoral and + intercostal muscles with greater force than usual. After this the spine + becomes curved both by the softness of its vertebræ, and for the purpose + of making room for the disturbed heart. See Species <a + href="#species_I_2_2_16">16</a> of this genus.</p> + + <p>As these patients are pale and weak, there would seem to be a + deficiency of oxygene in their blood, and in consequence a deficiency of + phosphoric acid; which is probably produced by oxygene in the act of + respiration.</p> + + <p>Mr. Bonhome in the Chemical Annals, August, 1793, supposes the rickets + to arise from the prevalence of vegetable or acetous acid, which is known + to soften bones out of the body. Mr. Dettaen seems to have espoused a + similar opinion, and both of them in consequence give alcalies and + testacea. If this theory was just, the soft bones of such patients should + shew evident marks of such acidity after death; which I believe has not + been observed. Nor is it analogous to other animal facts, that nutritious + fluids secreted by the finest vessels of the body should be so little + animalized, as to retain acetous or vegetable acidity.</p> + + <p>The success attending the following case in so short a time as a + fortnight I ascribed principally to the use of the warm bath; in which + the patient continued for full half an hour every night, in the degree of + heat, which was most grateful to her sensation, which might be I suppose + about 94. Miss ——, about ten years of age, and very tall and + thin, has laboured under palpitation of her heart, and difficult + breathing on the least exercise, with occasional violent dry cough, for a + year or more, with dry lips, little appetite either for food or drink, + and dry skin, with cold extremities. She has at times been occasionally + worse, and been relieved in some degree by the bark. She began to bend + forwards, and to lift up her shoulders. The former seemed owing to a + beginning curvature of the spine, the latter was probably caused to + facilitate her difficult respiration.</p> + + <p>M. M. She used the warm bath, as above related; which by its warmth + might increase the irritability of the smallest series of vessels, and by + supplying more moisture to the blood might probably tend to carry further + the materials, which form calcareous or bony particles, or to convey them + in more dilute solution. She took twice a day twenty grains of extract of + bark, twenty grains of soda phosphorata, and ten grams of chalk, and ten + of calcined hartshorn mixed into a powder with ten drops of laudanum; + with flesh food both to dinner and supper; and port wine and water + instead of the small beer, she had been accustomed to; she lay on a sofa + frequently in a day, and occasionally used a neck-swing.</p> + + <p><a name="species_I_2_2_15">15</a>. <i>Rachitis.</i> Rickets. The head + is large, protuberant chiefly on the forepart. The smaller joints are + swelled; the ribs depressed; the belly tumid, with other parts emaciated. + This disease from the innutrition or softness of the bones arose about + two centuries ago; seems to have been half a century in an increasing or + spreading state; continued about half a century at its height, or + greatest diffusion; and is now nearly vanished: which gives reason to + hope, that the small-pox, measles, and venereal disease, which are all of + modern production, and have already become milder, may in process of time + vanish from the earth, and perhaps be succeeded by new ones! See the + preceding species.</p> + + <p><a name="species_I_2_2_16">16</a>. <i>Spinæ distortio.</i> Distortion + of the spine is another disease originating from the innutrition or + softness of the bones. I once saw a child about six years old with + palpitation of heart, and quickness of respiration, which began to have a + curvature of the spine; I then doubted, whether the palpitation and quick + respiration were the cause or consequence of the curvature of the spine; + suspecting either that nature had bent the spine outwards to give room to + the enlarged heart; or that the malformation of the chest had compressed + and impeded the movements of the heart. But a few weeks ago on attending + a young lady about ten years old, whose spine had lately began to be + distorted, with very great difficulty and quickness of respiration, and + alarming palpitation of the heart, I convinced myself, that the + palpitation and difficult respiration were the effect of the change of + the cavity of the chest from the distortion of the spine; and that the + whole was therefore a disease of the innutrition or softness of the + bones.</p> + + <p>For on directing her to lie down much in the day, and to take the + bark, the distortion became less, and the palpitation and quick + respiration became less at the same time. After this observation a + neck-swing was directed, and she took the bark, madder, and bone-ashes; + and she continues to amend both in her shape and health.</p> + + <p>Delicate young ladies are very liable to become awry at many boarding + schools. This is occasioned principally by their being obliged too long + to preserve an erect attitude, by sitting on forms many hours together. + To prevent this the school-seats should have either backs, on which they + may occasionally rest themselves; or desks before them, on which they may + occasionally lean. This is a thing of greater consequence than may appear + to those, who have not attended to it.</p> + + <p>When the least tendency to become awry is observed, they should be + advised to lie down on a bed or sofa for an hour in the middle of the day + for many months; which generally prevents the increase of this deformity + by taking off for a time the pressure on the spine of the back, and it at + the same time tends to make them grow taller. Young persons, when nicely + measured, are found to be half an inch higher in a morning than at night; + as is well known to those, who inlist very young men for soldiers. This + is owing to the cartilages between the bones of the back becoming + compressed by the weight of the head and shoulders on them during the + day. It is the same pressure which produces curvatures and distortions of + the spine in growing children, where the bones are softer than usual; and + which may thus be relieved by an horizontal posture for an hour in the + middle of the day, or by being frequently allowed to lean on a chair, or + to play on the ground on a carpet.</p> + + <p>Young ladies should also be directed, where two sleep in a bed, to + change every night, or every week, their sides of the bed; which will + prevent their tendency to sleep always on the same side; which is not + only liable to produce crookedness, but also to occasion diseases by the + internal parts being so long kept in uniform contact as to grow together. + For the same reason they should not be allowed to sit always on the same + side of the fire or window, because they will then be inclined too + frequently to bend themselves to one side.</p> + + <p>Another great cause of injury to the shape of young ladies is from the + pressure of stays, or other tight bandages, which at the same time cause + other diseases by changing the form or situation of the internal parts. + If a hard part of the stays, even a knot of the thread, with which they + are sewed together, is pressed hard upon one side more than the other, + the child bends from the side most painful, and thus occasions a + curvature of the spine. To counteract this effect such stays, as have + fewest hard parts, and especially such as can be daily or weekly turned, + are preferable to others.</p> + + <div class="figcenter" style="width:33%;"> + <a href="images/v2p099.png"><img style="width:100%" src="images/v2p099.png" + alt="Chair to assist in straightening the spine." title="Chair to assist in straightening the spine." /></a> + </div> + <p>Where frequent lying down on a sofa in the day-time, and swinging + frequently for a short time by the hands or head, with loose dress, do + not relieve a beginning distortion of the back; recourse may be had to a + chair with stuffed moveable arms for the purpose of suspending the weight + of the body by cushions under the arm-pits, like resting on crutches, or + like the leading strings of infants. From the top of the back of the same + chair a curved steel bar may also project to suspend the body + occasionally, or in part by the head, like the swing above mentioned. The + use of this chair is more efficacious in straightening the spine, than + simply lying down horizontally; as it not only takes off the pressure of + the head and shoulders from the spine, but at the same time the inferior + parts of the body contribute to draw the spine straight by their weight; + or lastly, recourse may be had to a spinal machine first described in the + Memoires of the academy of surgery in Paris, Vol. III. p. 600, by M. Le + Vacher, and since made by Mr. Jones, at N<sup>o</sup> 6, North-street, + Tottenham-court Road, London, which suspends the head, and places the + weight of it on the hips. This machine is capable of improvement by + joints in the bar at the back of it, to permit the body to bend forwards + without diminishing the extension of the spine.</p> + + <p>The objections of this machine of M. Vacher, which is made by Mr. + Jones, are first, that it is worn in the day-time, and has a very + unsightly appearance. Mr. Jones has endeavoured to remedy this, by taking + away the curved bar over the head, and substituting in its place a forked + bar, rising up behind each ear, with webs fastened to it, which pass + under the chin and occiput. But this is not an improvement, but a + deterioration of M. Vacher's machine, as it prevents the head from + turning with facility to either side. Another objection is, that its + being worn, when the muscles of the back are in action, it is rather + calculated to prevent the curvature of the spine from becoming greater, + than to extend the spine, and diminish its curvature.</p> + + <div class="figcenter" style="width:40%;"> + <a href="images/v2p102.png"><img style="width:100%" src="images/v2p102.png" + alt="Steel bow to diminish the curvature of the spine." title="Steel bow to diminish the curvature of the spine." /></a> + </div> + <p>For this latter purpose I have made a steel bow, as described in the + annexed plate, which receives the head longitudinally from the forehead + to the occiput; having a fork furnished with a web to sustain the chin, + and another to sustain the occiput. The summit of the bow is fixed by a + swivel to the board going behind the head of the bed above the pillow. + The bed is to be inclined from the head to the feet about twelve or + sixteen inches. Hence the patient would be constantly sliding down during + sleep, unless supported by this bow, with webbed forks, covered also with + fur, placed beneath the chin, and beneath the occiput. There are also + proper webs lined with fur for the hands to take hold off occasionally, + and also to go under the arms. By these means I should hope great + advantage from gradually extending the spine during the inactivity of the + muscles of the back; and that it may be done without disturbing the sleep + of the patient, and if this should happen, the bow is made to open by a + joint at the summit of it, so as to be instantly disengaged from the neck + by the hand of the wearer. This bow I have not yet had opportunity to + make use of, but it may be had from Mr. Harrison, whitesmith, + Bridge-gate, Derby.</p> + + <p>It will be from hence easily perceived, that all other methods of + confining or directing the growth of young people should be used with + great skill; such as back-boards, or bandages, or stocks for the feet; + and that their application should not be continued too long at a time, + lest worse consequences should ensue, than the deformity they were + designed to remove. To this may be added, that the stiff erect attitude + taught by some modern dancing masters does not contribute to the grace of + person, but rather militates against it; as is well seen in one of the + prints in Hogarth's Analysis of Beauty; and is exemplifyed by the easy + grace of some of the ancient statues, as of the Venus de Medici, and the + Antinous, and in the works of some modern artists, as in a beautiful + print of Hebe feeding an Eagle, painted by Hamilton, and engraved by + Eginton, and many of the figures of Angelica Kauffman.</p> + + <p>Where the bone of one of the vertebræ of the back has been swelled on + both sides of it, so as to become protuberant, issues near the swelled + part have been found of great service, as mentioned in Species <a + href="#species_I_2_2_18">18</a> of this genus. This has induced me to + propose in curvatures of the spine, to put an issue on the outside of the + curve, where it could be certainly ascertained, as the bones on the + convex side of the curve must be enlarged; in one case I thought this of + service, and recommend the further trial of it.</p> + + <p>In the tendency to curvature of the spine, whatever strengthens the + general constitution is of service; as the use of the cold bath in the + summer months. This however requires some restriction both in respect to + the degree of coldness of the bath, the time of continuing in it, and the + season of the year. Common springs, which are of forty-eight degrees of + heat, are too cold for tender constitutions, whether of children or + adults, and frequently do them great and irreparable injury. The coldness + of river water in the summer months, which is about sixty-eight degrees, + or that of Matlock, which is about sixty-eight, or of Buxton, which is + eighty-two, are much to be preferred. The time of continuing in the bath + should be but a minute or two, or not so long as to occasion a trembling + of the limbs from cold. In respect to the season of the year, delicate + children should certainly only bathe in the summer months; as the going + frequently into the cold air in winter will answer all the purposes of + the cold bath.</p> + + <p><a name="species_I_2_2_17">17</a>. <i>Claudicatio coxaria.</i> + Lameness of the hip. A nodding of the thigh-bone is said to be produced + in feeble children by the softness of the neck or upper part of that bone + beneath the cartilage; which is naturally bent, and in this disease bends + more downwards, or nods, by the pressure of the body; and thus renders + one leg apparently shorter than the other. In other cases the end of the + bone is protruded out of its socket, by inflammation or enlargement of + the cartilages or ligaments of the joint, so that it rests on some part + of the edge of the acetabulum, which in time becomes filled up. When the + legs are straight, as in standing erect, there is no verticillary motion + in the knee-joint; all the motion then in turning out the toes further + than nature designed, must be obtained by straining in some degree this + head of the thigh-bone, or the acetabulum, or cavity, in which it moves. + This has induced me to believe, that this misfortune of the nodding of + the head by the bone, or partial dislocation of it, by which one leg + becomes shorter than the other, is sometimes occasioned by making very + young children stand in what are called stocks; that is with their heels + together, and their toes quite out. Whence the socket of the thigh-bone + becomes inflamed and painful, or the neck of the bone is bent downward + and outwards.</p> + + <p>In this case there is no expectation of recovering the straightness of + the end of the bone; but these patients are liable to another misfortune, + that is, to acquire afterwards a distortion of the spine; for as one leg + is shorter than the other, they sink on that side, and in consequence + bend the upper part of their bodies, as their shoulders, the contrary + way, to balance themselves; and then again the neck is bent back again + towards the lame side, to preserve the head perpendicular; and thus the + figure becomes quite distorted like the letter S, owing originally to the + deficiency of the length of one limb. The only way to prevent this + curvature of the spine is for the child to wear a high-heeled shoe or + patten on the lame foot, so as to support that side on the same level + with the other, and thus to prevent a greater deformity.</p> + + <p>I have this day seen a young lady about twelve, who does not limp or + waddle in walking; but nevertheless, when she stands or sits, she sinks + down towards her right side, and turns out that toe more than the other. + Hence, both as she sits and stands, she bends her body to the right; + whence her head would hang a little over her right shoulder; but to + replace this perpendicularly, she lifts up her left shoulder and + contracts the muscles on that side of the neck; which are therefore + become thicker and stronger by their continued action; but there is not + yet any very perceptible distortion of the spine.</p> + + <p>As her right toe is turned outward rather more than natural, this + shews the disease to be in the hip-joint; because, when the limb is + stretched out, the toe cannot turn horizontally in the least without + moving the end of the thigh-bone; although when the knee is bent, the toe + can be turned through one third or half of a circle by the rotation of + the tibia and fibula of the leg round each other. Hence if children are + set in stocks with their heels touching each other as they sit, and are + then made to rise up, till they stand erect, the socket or head of the + thigh-bone becomes injured, especially in those children, whose bones are + soft; and a shortness of that limb succeeds either by the bending of the + neck of the thigh-bone, or by its getting out of the acetabulum; and a + consequent rising of one shoulder, and a curvature of the spine is + produced from so distant a cause.</p> + + <p>M. M. An elastic cushion made of curled hair should be placed under + the affected hip, whenever she sits; or should be fitted to the part by + means of drawers, so that she cannot avoid sitting on it. A neck-swing, + and lying down in the day, should be occasionally used to prevent or + remove any curvature of the spine. The rest as in Species <a + href="#species_I_2_2_13">13</a> and <a href="#species_I_2_2_15">15</a> of + this genus.</p> + + <p><a name="species_I_2_2_18">18</a>. <i>Spina protuberans.</i> + Protuberant spine. One of the bones of the spine swells, and rises above + the rest. This is not an uncommon disease, and belongs to the innutrition + of the bones, as the bone must become soft before it swells; which + softness is owing to defect of the secretion of phosphorated calcareous + earth. The swelling of the bone compresses a part of the brain, called + the spinal marrow, within the cavity of the back-bones; and in + consequence the lower limbs become paralytic, attended sometimes with + difficulty of emptying the bladder and rectum.</p> + + <p>M. M. Issues put on each side of the prominent bone are of great + effect, I suppose, by their stimulus; which excites into action more of + the sensorial powers of irritation and sensation, and thus gives greater + activity to the vascular system in their vicinity. The methods + recommended in distortion of the spine are also to be attended to.</p> + + <p><a name="species_I_2_2_19">19</a>. <i>Spina bifida.</i> Divided spine, + called also Hydrorachitis, as well as the Hydrocephalus externus, are + probably owing in part to a defect of ossification of the spine and + cranium; and that the collection of fluid beneath them may originate from + the general debility of the system; which affects both the secerning, and + absorbent vessels.</p> + + <p>A curious circumstance, which is affirmed to attend the spina bifida, + is, that on compressing the tumor with the hand gently, the whole brain + becomes affected, and the patient falls asleep. I suppose the same must + happen on compressing the hydrocephalus externus? See Sect. XVIII. + 20.</p> + + <p><a name="species_I_2_2_20">20</a>. <i>Ossis palati defectus.</i> A + defect of the bone of the palate, which frequently accompanies a division + of the upper lip, occurs before nativity; and is owing to the deficient + action of the secerning system, from whence the extremities are not + completed. From a similar cause I have seen the point of the tongue + deficient, and one joint of the two least fingers, and of the two least + toes, in the same infant; who was otherwise a fine girl. See Sect. XXXIX. + 4. 4.</p> + + <p>The operation for the hare-lip is described by many surgical writers; + but there is a person in London, who makes very ingenious artificial + palates; which prevents that defect of speech, which attends this + malformation. This factitious palate consists of a thin plate of silver + of the shape and form of the roof of the mouth; from the front edge to + the back edge of this silver plate four or five holes are made in a + straight line large enough for a needle to pass through them; on the back + of it is then sewed a piece of sponge; which when expanded with moisture + is nearly as large as the silver plate. This sponge is slipped through + the division of the bone of the palate, so as to lie above it, while the + silver plate covers the aperture beneath, and is suspended by the + expanding sponge. This is removed every night and washed, and returned + into its place in the morning; on this account it is convenient to have + five or six of them, for the sake of cleanliness. I have been more + particular in describing this invention, as I do not know the name, or + place of residence, of the maker.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_2_3">III</a>.</h3> + +<h3><i>The Decreased Action of the Absorbent System.</i></h3> + + <p>Some decrease of heat attends these diseases, though in a less degree + than those of the last genus, because the absorbent system of glands do + not generate so much heat in their healthy state of action as the + secerning system of glands, as explained in Class <a + href="#genus_I_1_3">I. 1. 3</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_2_3_1">1</a>. <i>Mucus <span class="correction" + title="Original reads `fancium' (compare contents list).">faucium</span> + frigidus.</i> Cold mucus from the throat. Much mucus, of rather a saline + taste, and less inspissated than usual, is evacuated from the fauces by + hawking, owing to the deficient absorption of the thinner parts of it. + This becomes a habit in some elderly people, who are continually spitting + it out of their mouths; and has probably been brought on by taking snuff, + or smoking tobacco; which by frequently stimulating the fauces have at + length rendered the absorbent vessels less excitable by the natural + stimulus of the saline part of the secretion, which ought to be + reabsorbed, as soon as secreted.</p> + + <p>M. M. A few grains of powder of bark frequently put into the mouth, + and gradually diffused over the fauces. A gargle of barley water.</p> + + <p><a name="species_I_2_3_2">2</a>. <i>Sudor frigidus.</i> The cold + dampness of the hands of some people is caused by the deficient + absorption of perspirable matter; the clammy or viscid feel of it is + owing to the mucous part being left upon the skin. The coldness is + produced both by the decreased action of the absorbent system, and by the + evaporation of a greater quantity of the perspirable matter into the air, + which ought to have been absorbed.</p> + + <p>M. M. Wash the hands in lime water, or with a small quantity of + volatile alcali in water.</p> + + <p><a name="species_I_2_3_3">3</a>. <i>Catarrhus frigidus.</i> The thin + discharge from the nostrils in cold weather. The absorbent vessels become + torpid by the diminution of external heat, sooner than the secerning + ones, which are longer kept warm by the circulating blood, from which + they select the fluid they secrete; whereas the absorbent vessels of the + nostrils drink up their fluids, namely the thin and saline part of the + mucus, after it has been cooled by the atmosphere. Hence the absorbents + ceasing to act, and the secerning vessels continuing some time longer to + pour out the mucus, a copious thin discharge is produced, which trickles + down the nostrils in cold weather. This discharge is so acrid as to + inflame the upper lip; which is owing to the neutral salts, with which it + abounds, not being reabsorbed; so the tears in the fistula lacrymalis + inflame the cheek. See Class <a href="#species_I_1_2_7">I. 1. 2. + 7</a>.</p> + + <p><a name="species_I_2_3_4">4</a>. <i>Expectoratio frigida.</i> Cold + expectoration. Where the pulmonary absorption is deficient, an habitual + cough is produced, and a frequent expectoration of thin saline mucus; as + is often seen in old enfeebled people. Though the stimulus of the saline + fluid, which attends all secretions, is not sufficient to excite the + languid absorbent vessels to imbibe it; yet this saline part, together + with the increased quantity of the whole of the secreted mucus, + stimulates the branches of the bronchia, so as to induce an almost + incessant cough to discharge it from the lungs. A single grain of opium, + or any other stimulant drug, as a wine-posset with spirit of hartshorn, + will cure this cold cough, and the cold catarrh of the preceding article, + like a charm, by stimulating the torpid mouths of the absorbents into + action. Which has given rise to an indiscriminate and frequently + pernicious use of the warm regimen in coughs and catarrhs of the warm or + inflammatory kind, to the great injury of many.</p> + + <p>M. M. Half a grain of opium night and morning promotes the absorption + of the more fluid and saline parts, and in consequence thickens the + mucus, and abates its acrimony. Warm diluent drink, wine-whey, with + volatile alcali.</p> + + <p><a name="species_I_2_3_5">5</a>. <i>Urina uberior pallida.</i> On + being exposed naked to cold air, or sprinkled with cold water, a quantity + of pale urine is soon discharged; for the absorbents of the bladder + become torpid by their sympathy with those of the skin; which are + rendered quiescent by the diminution of external heat; but the kidnies + continue to secrete the urine, and as no part of it is absorbed, it + becomes copious and pale. This happens from a similar cause in cold fits + of agues; and in less degree to many debilitated constitutions, whose + extremities are generally cold and pale. The great quantity of limpid + water in hysteric cases, and in diabætes, belongs to Class <a + href="#species_I_3_1_10">I. 3. 1. 10</a>. <a href="#species_I_3_2_6">I. + 3. 2. 6</a>.</p> + + <p>M. M. Tincture of cantharides, opium, alum, sorbentia. Flannel shirt + in cold weather. Animal food. Beer. Wine. Friction. Exercise. Fire.</p> + + <p><a name="species_I_2_3_6">6</a>. <i>Diarrhœa frigida.</i> Liquid + stools are produced by exposing the body naked to cold air, or sprinkling + it with cold water, for the same reason as the last article.</p> + + <p>But this disease is sometimes of a dangerous nature; the intestinal + absorption being so impaired, that the aliment is said to come away + undiminished in quantity, and almost unchanged by the powers of + digestion, and is then called lientery.</p> + + <p>The mucus of the rectum sometimes comes away like pellucid hartshorn + jelly, and liquefies by heat like that, towards the end of inirritative + fevers, which is owing to the thinner part of the mucus not being + absorbed, and thus resembles the catarrh of some old people.</p> + + <p>M. M. Opium, campechy wood, armenian bole. Blister. Flannel shirt in + cold weather. Clysters with opium. Friction on the bowels morning and + night. Equitation twice a day.</p> + + <p><a name="species_I_2_3_7">7</a>. <i>Fluor albus frigidus.</i> Cold + fluor albus. In weak constitutions, where this discharge is pellucid and + thin, it must proceed from want of absorption of the mucous membrane of + the vagina, or uterus, and not from an increased secretion. This I + suspect to be the most frequent kind of fluor albus; the former one + described at Class <a href="#species_I_1_2_11">I. 1. 2. 11</a>. attends + menstruation, or is a discharge instead of it, and thus resembles the + venereal orgasm of female quadrupeds. The discharge in this latter kind + being more saline, is liable to excoriate the part, and thus produce + smarting in making water; in its great degree it is difficult to + cure.</p> + + <p>M. M. Increase the evacuation by stool and by perspiration, by taking + rhubarb every night, about six or ten grains with one grain of opium for + some months. Flannel shirt in winter. Balsam copaiva. Gum kino, bitters, + chalybeates, friction over the whole skin with flannel morning and night. + Partial cold bath, by sprinkling the loins and thighs, or sponging them + with cold water. Mucilage, as isinglass boiled in milk; blanc mange, + hartshorn jelly, are recommended by some. Tincture of cantharides + sometimes seems of service given from ten to twenty drops or more, three + or four times a day. A large plaster of burgundy pitch and armenian bole, + so as to cover the loins and lower part of the belly, is said to have + sometimes succeeded by increasing absorption by its compression in the + manner of a bandage. A solution of metallic salts, as white vitriol, + sixty grains to a pint; or an infusion of oak-bark may be injected into + the vagina. Cold bath.</p> + + <p><a name="species_I_2_3_8">8</a>. <i>Gonorrhœa frigida.</i> Cold + gleet. Where the gleet is thin and pellucid, it must arise from the want + of absorption of the membranes of the urethra, rather than from an + increased secretion from them. This I suppose to be a more common disease + than that mentioned at Class <a href="#species_I_1_2_10">I. 1. 2. + 10</a>.</p> + + <p>M. M. Metallic injections, partial cold bath, internal method as in + the fluor albus above described. Balsam of copaiva. Tincture of + cantharides.</p> + + <p><a name="species_I_2_3_9">9</a>. <i>Hepatis tumor.</i> The liver + becomes enlarged from defect of the absorption of mucus from its cells, + as in anasarca, especially in feeble children; at the same time less bile + is secreted from the torpid circulation in the vena portæ. And as the + absorbents, which resume the thinner parts of the bile from the + gall-bladder and hepatic ducts, are also torpid or quiescent, the bile is + more dilute, as well as in less quantity. From the obstruction of the + passage of the blood through the compressed vena porta these patients + have tumid bellies, and pale bloated countenances; their paleness is + probably owing to the deficiency of the quantity of red globules in the + blood in consequence of the inert state of the bile.</p> + + <p>These symptoms in children are generally attended with worms, the + dilute bile and the weak digestion not destroying them. In sleep I have + seen fleuke-worms in the gall-ducts themselves among the dilute bile; + which gall-ducts they eat through, and then produce ulcers, and the + hectic fever, called the rot. See Class <a href="#species_I_1_4_10">I. 1. + 4. 10</a>. and Article <a href="#art_IV_2_6">IV. 2. 6</a>.</p> + + <p>M. M. After a calomel purge, crude iron-filings are specific in this + disease in children, and the worms are destroyed by the returning + acrimony and quantity of the bile. A blister on the region of the liver. + Sorbentia, as worm-seed, santonicum. Columbo. Bark.</p> + + <p><a name="species_I_2_3_10">10</a>. <i>Chlorosis.</i> When the defect + of the due action of both the absorbent and secerning vessels of the + liver affects women, and is attended with obstruction of the catamenia, + it is called chlorosis; and is cured by the exhibition of steel, which + restores by its specific stimulus the absorbent power of the liver; and + the menstruation, which was obstructed in consequence of debility, + recurs.</p> + + <p>Indigestion, owing to torpor of the stomach, and a consequent too + great acidity of its contents, attend this disease; whence a desire of + eating chalk, or marl. Sometimes a great quantity of pale urine is + discharged in a morning, which is owing to the inaction of the + absorbents, which are distributed on the neck of the bladder, during + sleep. The swelling of the ankles, which frequently attends chlorosis, is + another effect of deficient action of the absorbent system; and the pale + countenance is occasioned by the deficient quantity of red globules of + blood, caused by the deficient quantity or acrimony of the bile, and + consequent weakness of the circulation. The pulse is so quick in some + cases of chlorosis, that, when attended with an accidental cough, it may + be mistaken for pulmonary consumption. This quick pulse is owing to the + debility of the heart from the want of stimulus occasioned by the + deficiency of the quantity, and acrimony of the blood.</p> + + <p>M. M. Steel. Bitters. Constant moderate exercise. Friction with + flannel all over the body and limbs night and morning. Rhubarb five + grains, opium half a grain, every night. Flesh diet, with small beer, or + wine and water. The disease continues some months, but at length subsides + by the treatment above described. A bath of about eighty degrees, as + Buxton Bath, is of service; a colder bath may do great injury.</p> + + <p><a name="species_I_2_3_11">11</a>. <i>Hydrocele.</i> Dropsy of the + vagina testis. Dropsies have been divided into the incysted and the + diffused, meaning those of the cellular membrane, the cells of which + communicate with each other like a sponge, and those of any other cavity + of the body. The collections of mucous fluids in the various cells and + cavities of the body arise from the torpor of the absorbent vessels of + those parts. It is probable, that in dropsies attended with great thirst + the cutaneous absorbents become paralytic first; and then from the great + thirst, which is thus occasioned by the want of atmospheric moisture, the + absorption of the fat ensues; as in fevers attended with great thirst, + the fat is quickly taken up. See Obesitas <span class="correction" + title="Original reads `I. 2. 3. 16'."><a href="#species_I_2_3_17">I. 2. + 3. 17</a></span>. Some have believed, that the cellular and adipose + membranes are different ones; as no fat is ever deposited in the eye-lids + or scrotum, both which places are very liable to be distended with the + mucilaginous fluid of the anasarca, and with air in Emphysema. Sometimes + a gradual absorption of the accumulated fluid takes place, and the + thinner parts being taken up, there remains a more viscid fluid, or + almost a solid in the part, as in some swelled legs, which can not easily + be indented by the pressure of the finger, and are called scorbutic. + Sometimes the paralysis of the absorbents is completely removed, and the + whole is again taken up into the circulation.</p> + + <p>The Hydrocele is known by a tumor of the scrotum, which is without + pain, gradually produced, with fluctuation, and a degree of pellucidity, + when a candle is held behind it; it is the most simple incysted dropsy, + as it is not in general complicated with other diseases, as ascites with + schirrous liver, and hydrocephalus internus, with general debility. The + cure of this disease is effected by different ways; it consists in + discharging the water by an external aperture; and by so far inflaming + the cyst and testicle, that they afterwards grow together, and thus + prevent in future any secretion or effusion of mucus; the disease is thus + cured, not by the revivescence of the absorbent power of the lymphatics, + but by the prevention of secretion by the adhesion of the vagina to the + testis. This I believe is performed with less pain, and is more certainly + manageable by tapping, or discharging the fluid by means of a trocar, and + after the evacuation of it to fill the cyst with a mixture of wine and + water for a few minutes till the necessary degree of stimulus is + produced, and then to withdraw it; as recommended by Mr. Earle. See also + Medical Commentaries by Dr. Duncan, for 1793.</p> + + <p><a name="species_I_2_3_12">12</a>. <i>Hydrocephalus internus</i>, or + dropsy of the ventricles of the brain, is fatal to many children, and + some adults. When this disease is less in quantity, it probably produces + a fever, termed a nervous fever, and which is sometimes called a worm + fever, according to the opinion of Dr. Gilchrist, in the Scots Medical + essays. This fever is attended with great inirritability, as appears from + the dilated pupils of the eyes, in which it corresponds with the dropsy + of the brain. And the latter disease has its paroxysms of quick pulse, + and in that respect corresponds with other fevers with + inirritability.</p> + + <p>The hydrocephalus internus is distinguished from apoplexy by its being + attended with fever, and from nervous fever by the paroxysms being very + irregular, with perfect intermissions many times in a day. In nervous + fever the pain of the head generally affects the middle of the forehead; + in hydrocephalus internus it is generally on one side of the head. One of + the earliest criterions is the patient being uneasy on raising his head + from the pillow, and wishing to lie down again immediately; which I + suppose is owing to the pressure of the water on the larger trunks of the + blood-vessels entering the cavity being more intolerable than on the + smaller ones; for if the larger trunks are compressed, it must + inconvenience the branches also; but if some of the small branches are + compressed only, the trunks are not so immediately incommoded.</p> + + <p>Blisters on the head, and mercurial ointment externally, with calomel + internally, are principally recommended in this fatal disease. When the + patient cannot bear to be raised up in bed without great uneasiness, it + is a bad symptom. So I believe is deafness, which is commonly mistaken + for stupor. See Class <a href="#species_I_2_5_6">I. 2. 5. 6</a>. And when + the dilatation of the pupil of either eye, or the squinting is very + apparent, or the pupils of both eyes much dilated, it is generally fatal. + As by stimulating one branch of lymphatics into inverted motion, another + branch is liable to absorb its fluid more hastily; suppose strong + errhines, as common tobacco snuff to children, or one grain of turpeth + mineral, (Hydrargyrus vitriolatus), mixed with ten or fifteen grains of + sugar, was gradually blown up the nostrils? See Class <a + href="#species_I_3_2_1">I. 3. 2. 1</a>. I have tried common snuff upon + two children in this disease; one could not be made to sneeze, and the + other was too near death to receive advantage. When the mercurial + preparations have produced salivation, I believe they may have been of + service, but I doubt their good effect otherwise. In one child I tried + the tincture of Digitalis; but it was given with too timid a hand, and + too late in the disease, to determine its effects. See Sect. XXIX. 5. + 9.</p> + + <p>As all the above remedies generally fail of success, I think frequent, + almost hourly, shocks of electricity from very small charges might be + passed through the head in all directions with probability of good event. + And the use of the trephine, where the affected side can be + distinguished. See Strabismus, Class <a href="#species_I_2_5_4">I. 2. 5. + 4</a>. When one eye is affected, does the disease exist in the ventricule + of that side?</p> + + <p><a name="species_I_2_3_13">13</a>. <i>Ascites.</i> The dropsy of the + cavity of the abdomen is known by a tense swelling of the belly; which + does not sound on being struck like the tympany; and in which a + fluctuation can be readily perceived by applying one hand expanded on one + side, and striking the tumour on the other.</p> + + <p>Effusions of water into large cavities, as into that of the abdomen or + thorax, or into the ventricules of the brain or pericardium, are more + difficult to be reabsorbed, than the effusion of fluids into the cellular + membrane; because one part of this extensive sponge-like system of cells, + which connects all the solid parts of the body, may have its power of + absorption impaired, at the same time that some other part of it may + still retain that power, or perhaps possess it in an increased degree; + and as all these cells communicate with each other, the fluid, which + abounds in one part of it, can be transferred to another, and thus be + reabsorbed into the circulation.</p> + + <p>In the ascites, cream of tartar has sometimes been attended with + success; a dram or two drams are given every hour in a morning till it + operates, and is to be repeated for several days; but the operation of + tapping is generally applied to at last. Dr. Sims, in the Memoirs of the + Medical Society of London, Vol. III. has lately proposed, what he + believes to be a more successful method of performing this operation, by + making a puncture with a lancet in the scar of the navel, and leaving it + to discharge itself gradually for several days, without introducing a + canula, which he thinks injurious both on account of the too sudden + emission of the fluid, and the danger of wounding or stimulating the + viscera. This operation I have twice known performed with less + inconvenience, and I believe with more benefit to the patient, than the + common method.</p> + + <p>After the patient has been tapped, some have tried injections into the + cavity of the abdomen, but hitherto I believe with ill event. Nor are + experiments of this kind very promising of success. First because the + patients are generally much debilitated, most frequently by spirituous + potation, and have generally a disease of the liver, or of other viscera. + And secondly, because the quantity of inflammation, necessary to prevent + future secretion of mucus into the cavity of the abdomen, by uniting the + peritoneum with the intestines or mesentery, as happens in the cure of + the hydrocele, would I suppose generally destroy the patient, either + immediately, or by the consequence of such adhesions.</p> + + <p>This however is not the case in respect to the dropsy of the ovarium, + or in the hydrocele.</p> + + <p><a name="species_I_2_3_14">14</a>. <i>Hydrops thoracis.</i> The dropsy + of the chest commences with loss of flesh, cold extremities, pale + countenance, high coloured urine in small quantity, and general debility, + like many other dropsies. The patient next complains of numbness in the + arms, especially when elevated, with pain and difficulty of swallowing, + and an absolute impossibility of lying down for a few minutes, or with + sudden starting from sleep, with great difficulty of breathing and + palpitation of his heart.</p> + + <p>The numbness of the arms is probably owing more frequently to the + increased action of the pectoral muscles in respiration, whence they are + less at liberty to perform other offices, than to the connexion of nerves + mentioned in Sect. XXIX. 5. 2. The difficulty of swallowing is owing to + the compression of the œsophagus by the lymph in the chest; and the + impossibility of breathing in an horizontal posture originates from this, + that if any parts of the lungs must be rendered useless, the inability of + the extremities of them must be less inconvenient to respiration; since + if the upper parts or larger trunks of the air-vessels should be rendered + useless by the compression of the accumulated lymph, the air could not + gain admittance to the other parts, and the animal must immediately + perish.</p> + + <p>If the pericardium is the principal seat of the disease, the pulse is + quick and irregular. If only the cavity of the thorax is hydropic, the + pulse is not quick nor irregular.</p> + + <p>If one side is more affected than the other, the patient leans most + that way, and has more numbness in that arm.</p> + + <p>The hydrops thoracis is distinguished from the anasarca pulmonum, as + the patient in the former cannot lie down half a minute; in the latter + the difficulty of breathing, which occasions him to rise up, comes on + more gradually; as the transition of the lymph in the cellular membranes + from one part to another of it is slower, than that of the effused lymph + in the cavity of the chest.</p> + + <p>The hydrops thoracis is often complicated with fits of convulsive + breathing; and then it produces a disease for the time very similar to + the common periodic asthma, which is perhaps owing to a temporary + anasarca of the lungs; or to an impaired venous absorption in them. These + exacerbations of difficult breathing are attended with cold extremities, + cold breath, cold tongue, upright posture with the mouth open, and a + desire of cold air, and a quick, weak, intermittent pulse, and contracted + hands.</p> + + <p>These exacerbations recur sometimes every two or three hours, and are + relieved by opium, a grain every hour for two or three doses, with ether + about a dram in cold water; and seem to be a convulsion of the muscles of + respiration induced by the pain of the dyspnea. As in Class <a + href="#species_III_1_1_9">III. 1. 1. 9</a>.</p> + + <p>M. M. A grain of dried squill, and a quarter of a grain of blue + vitriol every hour for six or eight hours, unless it vomit or purge. A + grain of opium. Blisters. Calomel three grains every third day, with + infusion of senna. Bark. Chalybeates. Puncture in the side.</p> + + <p>Can the fluctuation in the chest be heard by applying the ear to the + side, as Hippocrates asserts? Can it be felt by the hand or by the + patient before the disease is too great to admit of cure by the + paracentesis? Does this dropsy of the chest often come on after + peripneumony? Is it ever cured by making the patient sick by tincture of + digitalis? Could it be cured, if on one side only, by the operation of + puncture between the ribs, and afterwards by inflaming the cavity by the + admission of air for a time, like the cure of the hydrocele; the pleura + afterwards adhering wholly to that lobe of the lungs, so as to prevent + any future effusion of mucus?</p> + + <p><a name="species_I_2_3_15">15</a>. <i>Hydrops ovarii.</i> Dropsy of + the ovary is another incysted dropsy, which seldom admits of cure. It is + distinguished from ascites by the tumour and pain, especially at the + beginning, occupying one side, and the fluctuation being less distinctly + perceptible. When it happens to young subjects it is less liable to be + mistaken for ascites. It affects women of all ages, either married or + virgins; and is produced by cold, fear, hunger, bad food, and other + debilitating causes. I saw an elegant young lady, who was shortly to have + been married to a sensible man, with great prospect of happiness; who, on + being overturned in a chaise in the night, and obliged to walk two or + three miles in wet, cold, and darkness, became much indisposed, and + gradually afflicted with a swelling and pain on one side of the abdomen; + which terminated in a dropsy of the ovary, and destroyed her in two or + three years. Another young woman I recollect seeing, who was about + seventeen, and being of the very inferior class of people, seemed to have + been much weakened by the hardship of a cold floor, and little or no bed, + with bad food; and who to these evils had to bear the unceasing obloquy + of her neighbours, and the persecution of parish officers.</p> + + <p>The following is abstracted from a letter of my friend Mr. Power, + surgeon, at Bosworth in Leicestershire, on examining the body of an + elderly lady who died of this disease, March 29, 1793. "On opening the + abdomen I found a large cyst attached to the left ovarium by an elastic + neck as thick as the little finger, and so callous as not to admit of + being separated by scissars without considerable difficulty. The + substance of the cyst had an appearance much resembling the gravid uterus + near the full period of gestation, and was as thick. It had no attachment + to the peritonæum, or any of the viscera, except by the hard callous neck + I have mentioned; so that the blood must with difficulty have been + circulated through it for some time. Its texture was extremely tender, + being easily perforated with the finger, was of a livid red colour, and + evidently in a sphacelated state. It contained about two gallons of a + fluid of the colour of port wine, without any greater tenacity. It has + fallen to my lot to have opened two other patients, whose deaths were + occasioned by incysted dropsy of the ovarium. In one of these the ovarium + was much enlarged with eight or ten cysts on its surface, but there was + no adhesion formed by any of the cysts to any other part; nor had the + ovarium formed any adhesion with the peritonæum, though in a very + diseased state. In the other the disease was more simple, being only one + cyst, without any attachment but to the ovarium.</p> + +<blockquote class="b1n"> + + <p>"As the ovarium is a part not necessary to life, and dropsies of this + kind are so generally fatal in the end, I think I shall be induced, + notwithstanding the hazard attending wounds, which penetrate the cavity + of the abdomen, to propose the extirpation of the diseased part in the + first case, which occurs to me, in which I can with precision say, that + the ovarium is the seat of the disease, and the patient in other respects + tolerably healthy; as the cavity of the abdomen is often opened in other + cases without bad consequences."</p> + +</blockquote> + + <p>An argument, which might further countenance the operation thus + proposed by Mr. Power, might be taken from the disease frequently + affecting young persons; from its being generally in these subjects local + and primary; and not like the ascites, produced or accompanied with other + diseased viscera; and lastly, as it is performed in adult quadrupeds, as + old sows, with safety, though by awkward operators.</p> + + <p><a name="species_I_2_3_16">16</a>. <i>Anasarca pulmonum.</i> The + dropsy of the cellular membrane of the lungs is usually connected with + that of the other parts of the system. As the cells of the whole cellular + membrane communicate with each other, the mucaginous fluid, which remains + in any part of it for want of due absorption, sinks down to the most + depending cells; hence the legs swell, though the cause of the disease, + the deficiency of absorption, may be in other parts of the system. The + lungs however are an exception to this, since they are suspended in the + cavity of the thorax, and have in consequence a depending part of their + own.</p> + + <p>The anasarca of the lungs is known by the difficulty of respiration + accompanied with swelled legs, and with a very irregular pulse. This last + circumstance has generally been ascribed to a dropsy at the same time + existing in the pericardium, but is more probably owing to the difficult + passage of the blood through the lungs; because I found on dissection, in + one instance, that the most irregular pulse, which I ever attended to, + was owing to very extensive adhesions of the lungs; insomuch that one + lobe intirely adhered to the pleura; and secondly, because this kind of + dropsy of the lungs is so certainly removed for a time along with the + anasarca of the limbs by the use of digitalis.</p> + + <p>This medicine, as well as emetic tartar, or squill, when given so as + to produce sickness, or nausea, or perhaps even without producing either + in any perceptible degree, by affecting the lymphatics of the stomach, so + as either to invert their motion, or to weaken them, increases by reverse + sympathy the action, and consequent absorbent power of these lymphatics, + which open into the cellular membrane. But as those medicines seldom + succeed in producing an absorption of those fluids, which stagnate in the + larger cavities of the body, as in the abdomen, or chest, and do + generally succeed in this difficulty of breathing with irregular pulse + above described, I conclude that it is not owing to an effusion of lymph + into the pericardium, but simply to an anasarca of the lungs.</p> + + <p>M. M. Digitalis. See Art. <a href="#art_V_2_1">V. 2. 1</a>. Tobacco. + Squill. Emetic tartar (antimonium tartarizatum). Then Sorbentia. + Chalybeates. Opium half a grain twice a day. Raisin wine and water, or + other wine and water, is preferred to the spirit and water, which these + patients have generally been accustomed to.</p> + + <p>The usual cause of anasarca is from a diseased liver, and hence it + most frequently attends those, who have drank much fermented or + spirituous liquors; but I suspect that there is another cause of + anasarca, which originates from the brain; and which is more certainly + fatal than that, which originates from a diseased liver. These patients, + where the anasarca originates from, or commences in, the brain, have not + other symptoms of diseased liver; have less difficulty of breathing at + the beginning; and hold themselves more upright in their chair, and in + walking. In this kind of dropsy I suspect the digitalis has less or no + effect; as it particularly increases the absorption from the lungs.</p> + + <p><a name="species_I_2_3_17">17</a>. <i>Obesitas.</i> Corpulency may be + called an anasarca or dropsy of fat, since it must be owing to an + analogous cause; that is, to the deficient absorption of fat compared to + the quantity secreted into the cells which contain it. See Class <a + href="#species_II_1_1_4">II. 1. 1. 4</a>.</p> + + <p>The method of getting free from too much fat without any injury to the + constitution, consists, first, in putting on a proper bandage on the + belly, so that it can be tightened or relaxed with ease, as a tightish + under waistcoat, with a double row of buttons. This is to compress the + bowels and increase their absorption, and it thus removes one principal + cause of corpulency, which is the looseness of the skin. Secondly, he + should omit one entire meal, as supper; by this long abstinence from food + the absorbent system will act on the mucus and fat with greater energy. + Thirdly, he should drink as little as he can with ease to his sensations; + since, if the absorbents of the stomach and bowels supply the blood with + much, or perhaps too much, aqueous fluid, the absorbents of the cellular + membrane will act with less energy. Fourthly, he should use much salt or + salted meat, which will increase the perspiration and make him thirsty; + and if he bears this thirst, the absorption of his fat will be greatly + increased, as appears in fevers and dropsies with thirst; this I believe + to be more efficacious than soap. Fifthly, he may use aerated alcaline + water for his drink, which may be supposed to render the fat more + fluid,—or he may take soap in large quantities, which will be + decomposed in the stomach. Sixthly, short rest, and constant + exercise.</p> + + <p><a name="species_I_2_3_18">18</a>. <i>Splenis tumor.</i> Swellings of + the spleen, or in its vicinity, are frequently perceived by the hand in + intermittents, which are called Ague-cakes, and seem owing to a + deficiency of absorption in the affected part.</p> + + <p>Mr. Y——, a young man about twenty-five years of age, who + lived intemperately, was seized with an obstinate intermittent, which had + become a continued fever with strong pulse, attended with daily + remission. A large hard tumour on the left side, on the region of the + spleen, but extending much more downward, was so distinctly perceptible, + that one seemed to get one's fingers under the edge of it, much like the + feel of the brawn or shield on a boar's shoulder. He was repeatedly bled, + and purged with calomel, had an emetic, and a blister on the part, + without diminishing the tumour; after some time he took the Peruvian + bark, and slight doses of chalybeates, and thus became free from the + fever, and went to Bath for several weeks, but the tumour remained. This + tumour I examined every four or five years for above thirty years. His + countenance was pale, and towards the end of his life he suffered much + from ulcers on his legs, and died about sixty, of general debility; like + many others, who live intemperately in respect to the ingurgitation of + fermented or spirituous liquors.</p> + + <p>As this tumour commenced in the cold fit of an intermittent fever, and + was not attended with pain, and continued so long without endangering his + life, there is reason to believe it was simply occasioned by deficient + absorption, and not by more energetic action of the vessels which + constitute the spleen. See Class <a href="#species_II_1_2_13">II. 1. 2. + 13</a>.</p> + + <p>M. M. Venesection. Emetic, cathartic with calomel; then sorbentia, + chalybeates, Peruvian bark.</p> + + <p><a name="species_I_2_3_19">19</a>. <i>Genu tumor albus.</i> White + swelling of the knee, is owing to deficient absorption of the lymphatics + of the membranes including the joint, or capsular ligaments, and + sometimes perhaps of the gland which secretes the synovia; and the ends + of the bones are probably affected in consequence.</p> + + <p>I saw an instance, where a caustic had been applied by an empiric on a + large white swelling of the knee, and was told, that a fluid had been + discharged from the joint, which became anchylosed, and healed without + loss of the limb.</p> + + <p>M. M. Repeated blisters on the part early in the disease are said to + cure it by promoting absorption; saturnine solutions externally are + recommended. Bark, animal charcoal, as burnt sponge, opium in small + doses. Friction with the hand.</p> + + <p><a name="species_I_2_3_20">20</a>. <i>Bronchocele.</i> Swelled throat. + An enlargement of the thyroid glands, said to be frequent in mountainous + countries, where river water is drank, which has its source from + dissolving snows. This idea is a very ancient one, but perhaps not on + that account to be the more depended upon, as authors copy one another. + Tumidum guttur quis miratur in alpibus, seems to have been a proverb in + the time of Juvenal. The inferior people of Derby are much subject to + this disease, but whether more so than other populous towns, I can not + determine; certain it is, that they chiefly drink the water of the + Derwent, which arises in a mountainous country, and is very frequently + blackened as it passes through the morasses near its source; and is + generally of a darker colour, and attended with a whiter foam, than the + Trent, into which it falls; the greater quantity and whiteness of its + froth I suppose may be owing to the viscidity communicated to it by the + colouring matter. The lower parts of the town of Derby might be easily + supplied with spring water from St. Alkmond's well; or the whole of it + from the abundant springs near Bowbridge: the water from which might be + conveyed to the town in hollow bricks, or clay-pipes, at no very great + expence, and might be received into frequent reservoirs with pumps to + them; or laid into the houses.</p> + + <p>M. M. Twenty grains of burnt sponge with ten of nitre made with + mucilage into lozenges, and permitted to dissolve slowly under the tongue + twice a day, is asserted to cure in a few months; perhaps other animal + charcoal, as candle-snuffs, might do the same.</p> + + <p>I have directed in the early state of this disease a mixture of common + salt and water to be held in the mouth, particularly under the tongue, + for a few minutes, four or six times a day for many weeks, which has + sometimes succeeded, the salt and water is then spit out again, or in + part swallowed. Externally vinegar of squills has been applied, or a + mercurial plaster, or fomentations of acetated ammoniac; or ether. Some + empirics have applied caustics on the bronchocele, and sometimes, I have + been told, with success; which should certainly be used where there is + danger of suffocation from the bulk of it. One case I saw, and one I was + well informed of, where the bronchocele was cured by burnt sponge, and a + hectic fever supervened with colliquative sweats; but I do not know the + final event of either of them.</p> + + <p>De Haen affirms the cure of bronchocele to be effected by flowers of + zinc, calcined egg-shells, and scarlet cloth burnt together in a close + crucible, which was tried with success, as he assured me, by a late + lamented physician, my friend, Dr. Small of Birmingham; who to the + cultivation of modern sciences added the integrity of ancient manners; + who in clearness of head, and benevolence of heart, had few equals, + perhaps no superiors.</p> + + <p><a name="species_I_2_3_21">21</a>. <i>Scrophula.</i> King's evil is + known by tumours of the lymphatic glands, particularly of the neck. The + upper lip, and division of the nostrils is swelled, with a florid + countenance, a smooth skin, and a tumid abdomen. Cullen. The absorbed + fluids in their course to the veins in the scrophula are arrested in the + lymphatic or conglobate glands; which swell, and after a great length of + time, inflame and suppurate. Materials of a peculiar kind, as the + variolous and venereal matter, when absorbed in a wound, produce this + torpor, and consequent inflammation of those lymphatic glands, where they + first arrive, as in the axilla and groin. There is reason to suspect, + that the tonsils frequently become inflamed, and suppurate from the + matter absorbed from carious teeth; and I saw a young lady, who had both + the axillary glands swelled, and which suppurated; which was believed to + have been caused by her wearing a pair of new green gloves for one day, + when she had perspired much, and was much exhausted and fatigued by + walking; the gloves were probably dyed in a solution of verditer.</p> + + <p>These indolent tumours of the lymphatic glands, which constitute the + scrophula, originate from the inirritability of those glands; which + therefore sooner fall into torpor after having been stimulated too + violently by some poisonous material; as the muscles of enfeebled people + sooner become fatigued, and cease to act, when exerted, than those of + stronger ones. On the same account these scrophulous glands are much + longer in acquiring increase of motion, after having been stimulated into + inactivity, and either remain years in a state of indolence, or suppurate + with difficulty, and sometimes only partially.</p> + + <p>The difference between scrophulous tumours, and those before + described, consists in this; that in those either glands of different + kinds were diseased, or the mouths only of the lymphatic glands were + become torpid; whereas in scrophula the conglobate glands themselves + become tumid, and generally suppurate after a great length of time, when + they acquire new sensibility. See Sect. XXXIX. 4. 5.</p> + + <p>These indolent tumours may be brought to suppurate sometimes by + passing electric shocks through them every day for two or three weeks, as + I have witnessed. It is probable, that the alternate application of snow + or iced water to them, till they become painfully cold, and then of warm + flannel or warm water, frequently repeated, might restore their + irritability by accumulation of sensorial power; and thence either + facilitate their dispersion, or occasion them to suppurate. See Class <a + href="#species_II_1_4_13">II. 1. 4. 13</a>.</p> + + <p>This disease is very frequent amongst the children of the poor in + large towns, who are in general ill fed, ill lodged, and ill clothed; and + who are further weakened by eating much salt with their scanty meal of + insipid vegetable food, which is seldom of better quality than water + gruel, with a little coarse bread in it. See diarrhœa of infants, + Class <a href="#species_I_1_2_5">I. 1. 2. 5</a>. Scrophulous ulcers are + difficult to heal, which is owing to the deficiency of absorption on + their pale and flabby surfaces, and to the general inirritability of the + system. See Class <a href="#species_I_1_3_13">I. 1. 3. 13</a>.</p> + + <p>M. M. Plentiful diet of flesh-meat and vegetables with small-beer. + Opium, from a quarter of a grain to half a grain twice a day. Sorbentia. + Tincture of digitalis, thirty drops twice a day. Externally sea-bathing, + or bathing in salt and water, one pound to three gallons, made warm. The + application of Peruvian bark in fine powder, seven parts, and white lead, + (cerussa) in fine powder one part, mixed together and applied on the + ulcers in dry powder, by means of lint and a bandage, to be renewed every + day. Or very fine powder of calamy alone, lapis calaminaris. If powder of + manganese?</p> + + <p><a name="species_I_2_3_22">22</a>. <i>Schirrus.</i> After the + absorbent veins of a gland cease to perform their office, if the + secerning arteries of it continue to act some time longer, the fluids are + pushed forwards, and stagnate in the receptacles or capillary vessels of + the gland; and the thinner part of them only being resumed by the + absorbent system of the gland, a hard tumour gradually succeeds; which + continues like a lifeless mass, till from some accidental violence it + gains sensibility, and produces cancer, or suppurates. Of this kind are + the schirrous glands of the breasts, of the lungs, of the mesentery, and + the scrophulous tumours about the neck and the bronchocele.</p> + + <p>Another seat of schirrus is in the membranous parts of the system, as + of the rectum intestinum, the urethra, the gula or throat; and of this + kind is the verucca or wart, and the clavus pedum, or corns on the toes. + A wen sometimes arises on the back of the neck, and sometimes between the + shoulders; and by distending the tendinous fascia produces great and + perpetual pain.</p> + + <p>M. M. Mercurial ointment. Cover the part with oiled silk. Extirpation. + Electric shocks through the tumour. An issue into the substance of the + wen. Opium. Ether externally.</p> + + <p><a name="species_I_2_3_23">23</a>. <i>Schirrus recti intestini.</i> + Schirrus of the rectum. A schirrus frequently affects a canal, and by + contracting its diameter becomes a painful and deplorable disease. The + canals thus obstructed are the rectum, the urethra, the throat, the + gall-ducts, and probably the excretory ducts of the lymphatics, and of + other glands.</p> + + <p>The schirrus of the rectum is known by the patient having pain in the + part, and being only able to part with liquid feces, and by the + introduction of the finger; the swelled part of the intestine is + sometimes protruded downwards, and hangs like a valve, smooth and hard to + the touch, with an aperture in the centre of it. See a paper on this + subject by J. Sherwin. Memoirs of a London Medical Society, Vol. II. p. + 9.</p> + + <p>M. M. To take but little solid food. Aperient medicines. Introduce a + candle smeared with mercurial ointment. Sponge-tent. Clysters with forty + drops of laudanum. Introduce a leathern canula, or gut, and then either a + wooden maundril, or blow it up with air, so as to distend the contracted + part as much as the patient can bear. Or spread mercurial plaster on + thick soft leather, and roll it up with the plaster outwards to any + thickness and length, which can be easily introduced and worn; or two or + three such pieces may be introduced after each other. The same may be + used to compress bleeding internal piles. See Class <a + href="#species_I_2_1_6">I. 2. 1. 6</a>.</p> + + <p><a name="species_I_2_3_24">24</a>. <i>Schirrus urethræ.</i> Schirrus + of the urethra. The passage becomes contracted by the thickened membrane, + and the urine is forced through with great difficulty, and is thence + liable to distend the canal behind the stricture; till at length an + aperture is made, and the urine forces its way into the cellular + membrane, making large sinuses. This situation sometimes continues many + months, or even years, and so much matter is evacuated after making + water, or at the same time, by the action of the muscles in the vicinity + of the sinuses, that it has been mistaken for an increased secretion from + the bladder, and has been erroneously termed a catarrh of the bladder. + See a paper by Dr. R. W. Darwin in the Medical Memoirs.</p> + + <p>M. M. Distend the part gradually by catgut bougies, which by their + compression will at the same time diminish the thickness of the membrane, + or by bougies of elastic gum, or of horn boiled soft. The patient should + gain the habit of making water slowly, which is a matter of the utmost + consequence, as it prevents the distention, and consequent rupture, of + that part of the urethra, which is between the stricture and the neck of + the bladder.</p> + + <p>When there occurs an external ulcer in the perinæum, and the urine is + in part discharged that way, the disease can not be mistaken. Otherwise + from the quantity of matter, it is generally supposed to come from the + bladder, or prostate gland; and the urine, which escapes from the + ruptured urethra, mines its way amongst the muscles and membranes, and + the patient dies tabid, owing to the want of an external orifice to + discharge the matter. See Class <a href="#species_II_1_4_11">II. 1. 4. + 11</a>.</p> + + <p><a name="species_I_2_3_25">25</a>. <i>Schirrus œsophagi.</i> A + schirrus of the throat contracts the passage so as to render the + swallowing of solids impracticable, and of liquids difficult. It affects + patients of all ages, but is probably most frequently produced by + swallowing hard angular substances, when people have lost their teeth; by + which this membrane is over distended, or torn, or otherwise injured.</p> + + <p>M. M. Put milk into a bladder tied to a canula or catheter; introduce + it past the stricture, and press it into the stomach. Distend the + stricture gradually by a sponge-tent fastened to the end of whale-bone, + or by a plug of wax, or a spermaceti candle, about two inches long; which + might be introduced, and left there with a string only fixed to it to + hang out of the mouth, to keep it in its place, and to retract it by + occasionally; for which purpose the string must be put through a catheter + or hollow probang, when it is to be retracted. Or lastly introduce a gut + fixed to a pipe; and then distend it by blowing wind into it. The + swallowing a bullet with a string put through it, to retract it on the + exhibition of an emetic, has also been proposed. Externally mercurial + ointment has been much recommended. Poultice. Oiled silk. Clysters of + broth. Warm bath of broth. Transfusion of blood into a vein three or four + ounces a day? See Class <a href="#species_III_1_1_15">III. 1. 1. + 15</a>.</p> + + <p>I directed a young woman about twenty-two years of age, to be fed with + new milk put into a bladder, which was tied to a catheter, and introduced + beyond the stricture in her throat; after a few days her spirits sunk, + and she refused to use it further, and died. Above thirty years ago I + proposed to an old gentleman, whose throat was entirely impervious, to + supply him with a few ounces of blood daily from an ass, or from the + human animal, who is still more patient and tractable, in the following + manner. To fix a silver pipe about an inch long to each extremity of a + chicken's gut, the part between the two silver ends to be measured by + filling it with warm water; to put one end into the vein of a person + hired for that purpose, so as to receive the blood returning from the + extremity; and when the gut was quite full, and the blood running through + the other silver end, to introduce that end into the vein of the patient + upwards towards the heart, so as to admit no air along with the blood. + And lastly, to support the gut and silver ends on a water plate, filled + with water of ninety-eight degrees of heat, and to measure how many + ounces of blood was introduced by passing the finger, so as to compress + the gut, from the receiving pipe to the delivering pipe; and thence to + determine how many gut-fulls were given from the healthy person to the + patient. See Class <a href="#species_IV_2_4_11">IV. 2. 4. 11</a>. Mr. + —— considered a day on this proposal, and then another day, + and at length answered, that "he now found himself near the house of + death; and that if he could return, he was now too old to have much + enjoyment of life; and therefore he wished rather to proceed to the end + of that journey, which he was now so near, and which he must at all + events soon go, than return for so short a time." He lived but a few days + afterwards, and seemed quite careless and easy about the matter.</p> + + <p><a name="species_I_2_3_26">26</a>. <i>Lacteorum inirritabilitas.</i> + Inirritability of the lacteals is described in Sect. XXVIII. under the + name of paralysis of the lacteals; but as the word paralysis has + generally been applied to the disobedience of the muscles to the power of + volition, the name is here changed to inirritability of the lacteals, as + more characteristic of the disease.</p> + + <p><a name="species_I_2_3_27">27</a>. <i>Lymphaticorum + inirritabilitas.</i> The inirritability of the cellular and cutaneous + lymphatics is described in Sect. XXIX. 5. 1. and in Class <a + href="#species_I_2_3_16">I. 2. 3. 16</a>. The inirritability of the + cutaneous lymphatics generally accompanies anasarca, and is the cause of + the great thirst in that malady. At the same time the cellular lymphatics + act with greater energy, owing to the greater derivation of sensorial + power to them in consequence of the less expenditure of it by the + cutaneous ones; and hence they absorb the fat, and mucus, and also the + thinner parts of the urine. Whence the great emaciation of the body, the + muddy sediment, and the small quantity of water in this kind of + dropsy.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_2_4">IV</a>.</h3> + +<h3><i>With Decreased Actions of other Cavities and Membranes.</i></h3> + + <p>Many of the diseases of this genus are attended with pain, and with + cold extremities, both which cease on the exhibition of wine or opium; + which shews, that they originate from deficient action of the affected + organ. These pains are called nervous or spasmodic, are not attended with + fever, but are frequently succeeded by convulsions and madness; both + which belong to the class of volition. Some of them return at periods, + and when these can be ascertained, a much less quantity of opium will + prevent them, than is necessary to cure them, when they are begun; as the + vessels are then torpid and inirritable from the want of sensorial power, + till by their inaction it becomes again accumulated.</p> + + <p>Our organs of sense properly so called are not liable to pain from the + absence of their appropriated stimuli, as from darkness or silence; but + the other senses, which may be more properly called appetites, as those + by which we perceive heat, hunger, thirst, lust, want of fresh air, are + affected with pain from the defect or absence of their accustomed + stimuli, as well as with pleasure by the possession of them; it is + probable that some of our glands, whose sense or appetite requires or + receives something from the circulating blood, as the pancreas, liver, + testes, prostate gland, may be affected with aching or pain, when they + cannot acquire their appropriated fluid.</p> + + <p>Wherever this defect of stimulus occurs, a torpor or inaction of the + organ ensues, as in the capillaries of the skin, when exposed to cold; + and in the glands, which secrete the gastric juice, when we are hungry. + This torpor however, and concomitant pain, which is at first owing to + defect of stimulus, is afterwards induced by other associations or + catenations, and constitutes the beginning of ague fits.</p> + + <p>It must be further observed, that in the diseases of pain without + fever, the pain is frequently not felt in the part where the cause of the + disease resides; but is induced by sympathy with a distant part, whose + irritability or sensibility is greater or less than its own. Thus a stone + at the neck of the bladder, if its stimulus is not very great, only + induces the pain of strangury at the glans penis. If its stimulus be + greater, it then induces pain at the neck of the bladder. The concretions + of bile, which are protruded into the neck of the gall-bladder, when the + disease is not very great, produce pain at the other extremity of the + bile-duct, which enters the duodenum immediately under the pit of the + stomach; but, when the disease is great from the largeness of the + bile-stone, the pain is felt in the region of the liver at the neck of + the gall-bladder.</p> + + <p>It appears from hence, that the pains enumerated in this genus are + consequences of the inactivity of the organ; and, as they do not occasion + other diseases, should be classed according to their proximate cause, + which is defective irritation; there are nevertheless other pains from + defect of stimulus, which produce convulsions, and belong to Class <a + href="#genus_III_1_1">III. 1. 1</a>.; and others, which produce pains of + some distant part by association, and belong to Class <a + href="#genus_IV_2_2">IV. 2. 2</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_2_4_1">1</a>. <i>Sitis.</i> Thirst. The senses of + thirst and of hunger seem to have this connection, that the former is + situated at the upper end, and the latter at the lower end of the same + canal. One about the pharinx, where the œsophagus opens into the + mouth, and the other about the cardia ventriculi, where it opens into the + stomach. The extremities of other canals have been shewn to possess + correspondent sensibilities, or irritabilities, as the two ends of the + urethra, and of the common gall-duct. See <a href="#species_IV_2_2_2">IV. + 2. 2. 2</a>. and <a href="#species_IV_2_2_4">4</a>.</p> + + <p>The membrane of the upper end of the gullet becomes torpid, and + consequently painful, when there is a deficiency of aqueous fluid in the + general system; it then wants its proper stimulus. In the same manner a + want of the stimulus of more solid materials at the other end of the + canal, which terminates in the stomach, produces hunger; as mentioned in + Sect. XIV. 8. The proximate causes of both of them therefore consist in + deficient irritation, when they are considered as pains; because these + pains are in consequence of the inactivity of the organ, according to the + fifth law of animal causation. Sect. IV. 5. But when they are considered + as desires, namely of liquid or solid aliment, their proximate cause + consists in the pain of them, according to the sixth law of animal + causation. So the proximate cause of the pain of coldness is the + inactivity of the organ, and perhaps the consequent accumulation of + sensorial power in it; but the pain itself, or the consequent volition, + is the proximate cause of the shuddering and gnashing the teeth in cold + fits of intermittent fevers. See Class <a href="#species_I_2_2_1">I. 2. + 2. 1</a>.</p> + + <p>Thirst may be divided into two varieties alluding to the remote cause + of each, and may be termed sitis calida, or warm thirst, and sitis + frigida, or cold thirst. The remote cause of the former arises from the + dissipation of the aqueous parts of our fluids by the increased secretion + of perspirable matter, or other evacuations. And hence it occurs in hot + fits of fever, and after taking much wine, opium, spice, salt, or other + drugs of the Art. incitantia or secernentia. The thirst, which occurs + about three hours after eating a couple of red herrings, to a person + unaccustomed to salted meat, is of this kind; the increased action of the + cutaneous vessels dissipates so much of our fluids by insensible + perspiration, as to require above two quarts of water to restore the + fluidity of the blood, and to wash the salt out of the system. See Art. + <a href="#art_III_2_1">III. 2. 1</a>.</p> + + <p>M. M. Cold water. Vegetable acids. Warm bath.</p> + + <p>The remote cause of sitis frigida, or cold thirst, is owing to the + inaction of the cutaneous, pulmonary, urinary, and cellular absorbents; + whence the blood is deprived of the great supply of moisture, which it + ought to receive from the atmosphere, and from the cells of the cellular + membrane, and from other cysts; this cause of thirst exists in dropsies, + and in the cold fits of intermittents. The desire of fluids, like that of + solids, is liable to acquire periods, and may therefore readily become + diseased by indulgence in liquids grateful to the palate.</p> + + <p>Of diseased thirst, the most common is either owing to defect of the + action of the numerous absorbent vessels on the neck of the bladder, in + which the patient makes much paleish water; or to the defective + absorption of the skin and lungs, in which the patient makes but little + water, and that high-coloured, and with sediment. In both the tongue and + lips are liable to become very dry. The former in its greatest degree + attends diabætes, and the latter anasarca.</p> + + <p>M. M. Warm water, warm wine, warm bath. Opium. Cold bath. Iced water. + Lemonade. Cyder.</p> + + <p><a name="species_I_2_4_2">2</a>. <i>Esuries.</i> Hunger has been + fancifully ascribed to the sides of the stomach rubbing against each + other, and to the increased acidity of the gastric juice corroding the + coats of it. If either of these were the cause of hunger, inflammation + must occur, when they had continued some time; but, on the contrary, + coldness and not heat are attendant on hunger; which evinces, that like + thirst it is owing to the inactivity of the membrane, which is the seat + of it; while the abundant nerves about the cardia ventriculi, and the + pain of hunger being felt in that part, gives great reason to conclude, + that it is there situated.</p> + + <p>The sense of hunger as well as of thirst is liable to acquire habits + in respect to the times of its returning painfulness, as well as in + respect to the quantity required to satiate its appetency, and hence may + become diseased by indulgence, as well as by want of its appropriate + stimulus. Those who have been accustomed to distend their stomach by + large quantities of animal and vegetable food, and much potation, find a + want of distention, when the stomach is empty, which occasions faintness, + and is mistaken for hunger, but which does not appear to be the same + sensation. I was well informed, that a woman near Lichfield, who eat much + animal and vegetable food for a wager, affirmed, that since distending + her stomach so much, she had never felt herself satisfied with food; and + had in general taken twice as much at a meal, as she had been accustomed + to, before she eat so much for a wager.</p> + + <p><a name="species_I_2_4_3">3</a>. <i>Nausea sicca.</i> Dry nausea. + Consists in a quiescence or torpor of the mucous or salivary glands, and + precedes their inverted motions, described in nausea humida, Class <a + href="#species_I_3_2_3">I. 3. 2. 3</a>. In the same manner as sickness of + the stomach is a quiescence of that organ preceding the action of + vomiting, as explained in Sect. XXXV. 1. 3. This is sometimes induced by + disagreeable drugs held in the mouth, at other times of disgustful ideas, + and at other times by the association of these actions with those of the + stomach; and thus according to its different proximate causes may belong + to this, or to the second, or to the fourth class of diseases.</p> + + <p>M. M. Lemonade. Tasteful food. A blister. Warm bath.</p> + + <p><a name="species_I_2_4_4">4</a>. <i>Ægritudo ventriculi.</i> Sickness + of stomach is produced by the quiescence or inactivity of that organ, as + is explained in Sect. XXXV. 1. 3. It consists in the state between the + usual peristaltic motions of that organ, in the digestion of our aliment, + and the retrograde motions of it in vomiting; for it is evident, that the + direct motions of it from the cardia to the pylorus must stop, before + those in a contrary direction can commence. This sickness, like the + nausea above described, is sometimes produced by disgustful ideas, as + when nasty objects are seen, and nasty stories related, as well as by the + exhaustion of the sensorial power by the stimulus of some emetic drugs, + and by the defect of the production of it, as in enfeebled drunkards.</p> + + <p>Sickness may likewise consist in the retrograde motions of the + lymphatics of the stomach, which regurgitate into it the chyle or lymph, + which they have lately absorbed, as in Class <a + href="#species_I_3_2_3">I. 3. 2. 3</a>. It is probable, that these two + kinds of sickness may be different sensations, though they have acquired + but one name; as one of them attends hunger, and the other repletion; + though either of them may possibly be induced by association with + nauseous ideas.</p> + + <p>M. M. A blister on the back. An emetic. Opium. Crude mercury. Covering + the head in bed. See Sect. XXV. 16. Class <a href="#species_IV_1_1_2">IV. + 1. 1. 2</a>. and <a href="#species_IV_1_1_3">3</a>.</p> + + <p><a name="species_I_2_4_5">5</a>. <i>Cardialgia.</i> Heartburn + originates from the inactivity of the stomach, whence the aliment, + instead of being subdued by digestion, and converted into chyle, runs + into fermentation, producing acetous acid. Sometimes the gastric juice + itself becomes so acid as to give pain to the upper orifice of the + stomach; these acid contents of the stomach, on falling on a marble + hearth, have been seen to produce an effervescence on it. The pain of + heat at the upper end of the gullet, when any air is brought up from the + fermenting contents of the stomach, is to be ascribed to the sympathy + between these two extremities of the œsophagus rather than to the + pungency of the carbonic gas, or fixed air; as the sensation in + swallowing that kind of air in water is of a different kind. See Class <a + href="#species_I_3_1_3">I. 3. 1. 3</a>. and <a + href="#species_IV_2_2_5">IV. 2. 2. 5</a>.</p> + + <p>M. M. This disease arising from indigestion is often very + pertinacious, and afflicting; and attended with emaciation of the body + from want of sufficient chyle. As the saliva swallowed along with our + food prevents its fermentation, as appears by the experiments of Pringle + and Macbride, some find considerable relief by chewing parched wheat, or + mastic, or a lock of wool, frequently in a day, when the pain occurs, and + by swallowing the saliva thus effused; a temporary relief is often + obtained from antiacids, as aerated alcaline water, Seltzer's water, + calcareous earths, alcaline salts made into pills with soap, soap alone, + tin, milk, bitters. More permanent use may be had from such drugs as + check fermentation, as acid of vitriol; but still more permanent relief + from such things as invigorate the digestion, as a blister on the back; a + due quantity of vinous spirit and water taken regularly. Steel. + Temperance. A sleep after dinner. A waistcoat made so tight as slightly + to compress the bowels and stomach. A flannel shirt in winter, not in + summer. A less quantity of potation of all kinds. Ten black pepper-corns + swallowed after dinner. Half a grain of opium twice a day, or a grain. + The food should consist of such things as do not easily ferment, as + flesh, shell-fish, sea-biscuit, toasted cheese. I have seen toasted + cheese brought up from the stomach 24 hours after it had been swallowed, + without apparently having undergone any chemical change. See Class <a + href="#species_II_1_3_17">II. 1. 3. 17</a>. and <a + href="#species_IV_1_2_13">IV. 1. 2. 13</a>.</p> + + <p><a name="species_I_2_4_6">6</a>. <i>Arthritis Ventriculi.</i> Sickness + of the stomach in gouty cases is frequently a consequence of the torpor + or inflammation of the liver, and then it continues many days or weeks. + But when the patient is seized with great pain at the stomach with the + sensation of coldness, which they have called an ice-bolt, this is a + primary affection of the stomach, and destroys the patient in a few + hours, owing to the torpor or inaction of that viscus so important to + life.</p> + + <p>This primary gout of the stomach, as it is a torpor of that viscus, is + attended with sensation of coldness, and with real defect of heat, in + that part, and may thence be distinguished from the pain occasioned by + the passage of a gall-stone into the duodenum, as well as by the weak + pulse, and cold extremities; to which must be added, that it affects + those only, who have been long afflicted with the gout, and much + debilitated by its numerous attacks.</p> + + <p>M. M. Opium. Vinous spirit. Volatile alcali. Spice. Warmth applied + externally to the stomach by hot cloths or fomentation.</p> + + <p><a name="species_I_2_4_7">7</a>. <i>Colica flatulenta.</i> The + flatulent colic arises from the too great distention of the bowel by air, + and consequent pain. The cause of this disease is the inactivity or want + of sufficiently powerful contraction of the coats of the bowel, to carry + forwards the gas given up by the fermenting aliment. It is without fever, + and generally attended with cold extremities.</p> + + <p>It is distinguished, first, from the pain occasioned by the passage of + a gall-stone, as that is felt at the pit of the stomach, and this nearer + the navel. Secondly, it is distinguished from the colica saturnina, or + colic from lead, as that arising from the torpor of the liver, or of some + other viscus, is attended with greater coldness, and with an aching pain; + whereas the flatulent cholic being owing to distention of the muscles of + the bowel, the pain is more acute, and the coldness less. Thirdly, it is + distinguished from inflammation of the bowels, or ileus, as perpetual + vomiting and fever attend this. Fourthly, it is distinguished from + cholera, because that is accompanied with both vomiting and + diarrhœa. And lastly, from the colica epileptica, or hysteric + colic, as that is liable to alternate with convulsion, and sometimes with + insanity; and returns by periods.</p> + + <p>M. M. Spirit of wine and warm water, one spoonful of each. Opium one + grain. Spice. Volatile alcali. Warm fomentation externally. Rhubarb.</p> + + <p><a name="species_I_2_4_8">8</a>. <i>Colica saturnina.</i> Colic from + lead. The pain is felt about the navel, is rather of an aching than acute + kind at first, which increases after meals, and gradually becomes more + permanent and more acute. It terminates in paralysis, frequently of the + muscles of the arm, so that the hand hangs down, when the arm is extended + horizontally. It is not attended with fever, or increase of heat. The + seat of the disease is not well ascertained, it probably affects some + part of the liver, as a pale bluish countenance and deficiency of bile + sometimes attends or succeeds it, with consequent anasarca; but it seems + to be caused immediately by a torpor of the intestine, whether this be a + primary or secondary affection, as appears from the constipation of the + bowels, which attends it; and is always produced in consequence of the + great stimulus of lead previously used either internally for a length of + time, or externally on a large surface.</p> + + <p>A delicate young girl, daughter of a dairy farmer, who kept his milk + in leaden cisterns, used to wipe off the cream from the edges of the lead + with her finger; and frequently, as she was fond of cream, licked it from + her finger. She was seized with the saturnine colic, and semi-paralytic + wrists, and sunk from general debility.</p> + + <p>A feeble woman about 40 years of age sprained her ancle, and bruised + her leg and thigh; and applied by ill advice a solution of lead over the + whole limb, as a fomentation and poultice for about a fortnight. She was + then seized with the colica saturnina, lost the use of her wrists, and + gradually sunk under a general debility.</p> + + <p>M. M. First opium one or two grains, then a cathartic of senna, jalap, + and oil, as soon as the pain is relieved. Oleum ricini. Alum. Oil of + almonds. A blister on the navel. Warm bath. The stimulus of the opium, by + restoring to the bowel its natural irritability in this case of painful + torpor, assists the action of the cathartic.</p> + + <p><a name="species_I_2_4_9">9</a>. <i>Tympanitis.</i> Tympany consists + in an elastic tumor of the abdomen, which sounds on being struck. It is + generally attended with costiveness and emaciation. In one kind the air + is said to exist in the bowels, in which case the tumor is less equal, + and becomes less tense and painful on the evacuation of air. In the other + kind the air exists in the cavity of the abdomen, and sometimes is in a + few days exchanged for water, and the tympany becomes an ascites.</p> + + <p>Air may be distinguished in the stomach of many people by the sound on + striking it with the fingers, and comparing the sound with that of a + similar percussion on other parts of the bowels; but towards the end of + fevers, and especially in the puerperal fever, a distention of the + abdomen by air is generally a fatal symptom, though the ease, and often + cheerfulness, of the patient vainly flatters the attendants.</p> + + <p>M. M. In the former case a clyster-pipe unarmed may be introduced, and + left some time in the rectum, to take off the resistance of the + sphincter, and thus discharge the air, as it is produced from the + fermenting or putrefying aliment. For this purpose, in a disease somewhat + similar in horses, a perforation is made into the rectum on one side of + the sphincter; through which fistula the air, which is produced in such + great excess from the quantity of vegetable food which they take, when + their digestions are impaired, is perpetually evacuated. In both cases + also, balsams, essential oil, spice, bandage on the abdomen, and, to + prevent the fermentation of the aliment, acid of vitriol, saliva. See + Class <a href="#species_I_2_4_5">I. 2. 4. 5</a>.</p> + + <p><a name="species_I_2_4_10">10</a>. <i>Hypochondriasis.</i> The + hypochondriac disease consists in indigestion and consequent flatulency, + with anxiety or want of pleasureable sensation. When the action of the + stomach and bowels is impaired, much gas becomes generated by the + fermenting or putrescent aliment, and to this indigestion is catenated + languor, coldness of the skin, and fear. For when the extremities are + cold for too long a time in some weak constitutions, indigestion is + produced by direct sympathy of the skin and the stomach, with consequent + heart-burn, and flatulency. The same occurs if the skin be made cold by + fear, as in riding over dangerous roads in winter, and hence conversely + fear is produced by indigestion or torpor of the stomach by + association.</p> + + <p>This disease is confounded with the fear of death, which is an + insanity, and therefore of a totally different nature. It is also + confounded with the hysteric disease, which consists in the retrograde + motions of the alimentary canal, and of some parts of the absorbent + system.</p> + + <p>The hypochondriasis, like chlorosis, is sometimes attended with very + quick pulse; which the patient seems to bear so easily in these two + maladies, that if an accidental cough attends them, they may be mistaken + for pulmonary consumption; which is not owing primarily to the debility + of the heart, but to its direct sympathy with the actions of the + stomach.</p> + + <p>M. M. Blister. A plaster on the abdomen of Burgundy pitch. Opium a + grain twice a day. Rhubarb six grains every night. Bark. Steel. Spice. + Bath-water. Siesta, or sleep after dinner. Uniform hours of meals. No + liquor stronger than small beer, or wine and water. Gentle exercise on + horseback in the open air uniformly persisted in. See Cardialgia, <a + href="#species_I_2_4_5">I. 2. 4. 5</a>.</p> + + <p><a name="species_I_2_4_11">11</a>. <i>Cephalæa.</i> Head-ach + frequently attends the cold paroxysm of intermittents; afflicts + inebriates the day after intoxication; and many people who remain too + long in the cold bath. In all which cases there is a general inaction of + the whole system, and as these membranes about the head have been more + exposed to the variations of heat and cold of the atmosphere, they are + more liable to become affected so far as to produce sensation, than other + membranes; which are usually covered either with clothes, or with + muscles, as mentioned in Sect. XXXIII. 2. 10.</p> + + <p>The promptitude of the membranes about the scalp to sympathize with + those of other parts of the system is so great, that this cephalæa + without fever, or quickness of pulse, is more frequently a secondary than + a primary disease, and then belongs to Class <span class="correction" + title="Original reads `IV. 1. 2. 11.'."><a href="#species_IV_2_2_7">IV. + 2. 2. 7</a></span>. The hemicrania, or partial head-ach, I believe to be + almost always a disease from association; though it is not impossible, + but a person may take cold on one side of the head only. As some people + by sitting always on the same side of the fire in winter are liable to + render one side more tender than the other, and in consequence more + subject to pains, which have been erroneously termed rheumatic. See Class + <span class="correction" title="Original reads `IV. 2. 1. 7.'."><a + href="#species_IV_2_2_7">IV. 2. 2. 7</a></span>. & <a + href="#species_IV_2_2_8">8</a>.</p> + + <p>M. M. The method of cure consists in rendering the habit more robust, + by gentle constant exercise in the open air, flesh diet, small beer at + meals with one glass of wine, regular hours of rest and rising, and of + meals. The cloathing about the head should be warmer during sleep than in + the day; because at that time people are more liable to take cold; that + is, the membranous parts of it are more liable to become torpid. As + explained in Sect. XVIII. 15. In respect to medicine, two drams of + valerian root in powder three or four times a day are recommended by + Fordyce. The bark. Steel in moderate quantities. An emetic. A blister. + Opium, half a grain twice a day. Decayed teeth should be extracted, + particularly such as either ache, or are useless. Cold bath between 60 + and 70 degrees of heat. Warm bath of 94 or 98 degrees every day for half + an hour during a month. See Class <a href="#species_IV_2_2_7">IV. 2. 2. + 7</a>. and <a href="#species_IV_2_2_8">8</a>.</p> + + <p>A solution of arsenic, about the sixteenth part of a grain, is + reported to have great effect in this disease. It should be taken thrice + a day, if it produces no griping or sickness, for two or three weeks. A + medicine of this kind is sold under the name of tasteless ague-drops; but + a more certain method of ascertaining the quantity is delivered in the + subsequent materia medica, Art. <a href="#art_IV_2_6">IV. 2. 6</a>.</p> + + <p><a name="species_I_2_4_12">12</a>. <i>Odontalgia.</i> Tooth-ach. The + pain has been erroneously supposed, where there is no inflammation, to be + owing to some acrid matter from a carious tooth stimulating the membrane + of the alveolar process into violent action and consequent pain; but the + effect seems to have been mistaken for the cause, and the decay of the + tooth to have been occasioned by the torpor and consequent pain of the + diseased membrane.</p> + + <p>First, because the pain precedes the decay of the tooth in regard to + time, and is liable to recur, frequently for years, without certainly + being succeeded at last by a carious tooth, as I have repeatedly + observed.</p> + + <p>Secondly, because any stimulant drug, as pyrethrum, or oil of cloves, + applied to the tooth, or ether applied externally to the cheek, so far + from increasing the pain, as they would do if the pained membrane, + already acted too strongly, that they frequently give immediate relief + like a charm.</p> + + <p>And thirdly, because the torpor, or deficient action of the membrane, + which includes the diseased tooth, occasions the motions of the membranes + most connected with it, as those of the cheek and temples, to act with + less than their natural energy; and hence a coldness of the cheek is + perceived easily by the hand of the patient, comparing it with the other + cheek; and the pain of hemicrania is often produced in the temple of the + affected side.</p> + + <p>This coldness of the cheek in common tooth-ach evinces, that the pain + is not then caused by inflammation; because in all inflammations so much + heat is produced in the secretions of new vessels and fluids, as to give + heat to the parts in vicinity. And hence, as soon as the gum swells and + inflames along with the cheek, heat is produced, and the pain ceases, + owing to the increased exertions of the torpid membrane, excited by the + activity of the sensorial power of sensation; which previously existed in + its passive state in the painful torpid membrane. See Odontitis, Class <a + href="#species_II_1_4_7">II. 1. 4. 7</a>. and <a + href="#species_IV_2_2_8">IV. 2. 2. 8</a>.</p> + + <p>M. M. If the painful tooth be found, venesection. Then a cathartic. + Afterwards two grains of opium. Camphor and opium, one grain of each held + in the mouth; or a drop or two of oil of cloves put on the painful tooth. + Ether. If the tooth has a small hole in it, it should be widened within + by an instrument, and then stopped with leaf-gold, or leaf-lead; but + should be extracted, if much decayed. It is probable that half a small + drop of a strong solution of arsenic, put carefully into the hollow of a + decayed aching tooth, would destroy the nerve without giving any + additional pain; but this experiment requires great caution, lest any of + the solution should touch the tongue or gums.</p> + + <p>Much cold or much heat are equally injurious to the teeth, which are + endued with a fine sensation of this universal fluid. The best method of + preserving them is by the daily use of a brush, which is not very hard, + with warm water and fine charcoal dust. A lump of charcoal should be put + a second time into the fire till it is red hot, as soon as it becomes + cool the external ashes should be blown off, and it should be immediately + reduced to fine powder in a mortar, and kept close stopped in a phial. It + takes away the bad smell from decayed teeth, by washing the mouth with + this powder diffused in water immediately. The putrid smell of decaying + stumps of teeth may be destroyed for a time by washing the mouth with a + weak solution of alum in water. If the calcareous crust upon the teeth + adheres very firmly, a fine powder of pumice-stone may be used + occasionally, or a tooth instrument.</p> + + <p>Acid of sea-salt, much diluted, may be used; but this very rarely, and + with the greatest caution, as in cleaning sea-shells. When the gums are + spongy, they should be frequently pricked with a lancet. Should black + spots in teeth be cut out? Does the enamel grow again when it has been + perforated or abraded?</p> + + <p><a name="species_I_2_4_13">13</a>. <i>Otalgia.</i> Ear-ach sometimes + continues many days without apparent inflammation, and is then frequently + removed by filling the ear with laudanum, or with ether; or even with + warm oil, or warm water. See Class <a href="#species_II_1_4_8">II. 1. 4. + 8</a>. This pain of the ear, like hemicrania, is frequently the + consequence of association with a diseased tooth; in that case the ether + should be applied to the cheek over the suspected tooth, or a grain of + opium and as much camphor mixed together and applied to the suspected + tooth. In this case the otalgia belongs to the fourth class of + diseases.</p> + + <p><a name="species_I_2_4_14">14</a>. <i>Pleurodyne chronica.</i> + Chronical pain of the side. Pains of the membranous parts, which are not + attended with fever, have acquired the general name of rheumatic; which + should, nevertheless, be restricted to those pains which exist only when + the parts are in motion, and which have been left after inflammation of + them; as described in Class <a href="#species_I_1_3_12">I. 1. 3. 12</a>. + The pain of the side here mentioned affects many ladies, and may possibly + have been owing to the pressure of tight stays, which has weakened the + action of the vessels composing some membranous part, as, like the cold + head-ach, it is attended with present debility; in one patient, a boy + about ten years old, it was attended with daily convulsions, and was + supposed to have originated from worms. The disease is very frequent, and + generally withstands the use of blisters on the part; but in some cases I + have known it removed by electric shocks repeated every day for a + fortnight through the affected side.</p> + + <p>Pains of the side may be sometimes occasioned by the adhesion of the + lungs to the pleura, after an inflammation of them; or to the adhesion of + some abdominal viscera to their cavity, or to each other; which also are + more liable to affect ladies from the unnatural and ungraceful pressure + of tight stays, or by sitting or lying too long in one posture. But in + these cases the pain should be more of the smarting, than of the dull + kind.</p> + + <p>M. M. Ether. A blister. A plaster of Burgundy pitch. An issue or seton + on the part. Electric shocks. Friction on the part with oil and camphor. + Loose dress. Frequent change of posture both in the day and night. + Internally opium, valerian, bark.</p> + + <p><a name="species_I_2_4_15">15</a>. <i>Sciatica frigida.</i> Cold + sciatica. The pain along the course of the sciatic nerve, from the hip + quite down to the top of the foot, when it is not attended with fever, is + improperly termed either rheumatism or gout; as it occurs without + inflammation, is attended with pain when the limb is at rest; and as the + pain attends the course of the nerve, and not the course of the muscles, + or of the fascia, which contains them. The theory of Cotunnius, who + believed it to be a dropsy of the sheath of the nerve, which was + compressed by the accumulated fluid, has not been confirmed by + dissection. The disease seems to consist of a torpor of this sheath of + the nerve, and the pain seems to be in consequence of this torpor. See + Class <span class="correction" title="Original reads `II. 1. 2. 13.'." + ></span><a href="#species_II_1_2_18">II. 1. 2. 18</a>.</p> + + <p>M. M. Venesection. A cathartic. And then one grain of calomel and one + of opium every night for ten successive nights. And a blister, at the + same time, a little above the knee-joint on the outside of the thigh, + where the sciatic nerve is not so deep seated. Warm bath. Cold bath. + Cover the limb with oiled silk, or with a plaster-bandage of emplastrum + de minio.</p> + + <p><a name="species_I_2_4_16">16</a>. <i>Lumbago frigida.</i> Cold + lumbago. When no fever or inflammation attends this pain of the loins, + and the pain exists without motion, it belongs to this genus of diseases, + and resembles the pain of the loins in the cold fit of ague. As these + membranes are extensive, and more easily fall into quiescence, either by + sympathy, or when they are primarily affected, this disease becomes very + afflicting, and of great pertinacity. See Class <a + href="#species_II_1_2_17">II. 1. 2. 17</a>.</p> + + <p>M. M. Venesection. A cathartic. Issues on the loins. Adhesive plaster + on the loins. Blister on the os sacrum. Warm bath. Cold bath. Remove to a + warmer climate in the winter. Loose dress about the waist. Friction daily + with oil and camphor.</p> + + <p><a name="species_I_2_4_17">17</a>. <i>Hysteralgia frigida.</i> Cold + pain of the uterus preceding or accompanying menstruation. It is attended + with cold extremities, want of appetite, and other marks of general + debility.</p> + + <p>M. M. A clyster of half a pint of gruel, and 30 drops of laudanum; or + a grain of opium and six grains of rhubarb every night. To sit over warm + water, or go into a warm bath.</p> + + <p><a name="species_I_2_4_18">18</a>. <i>Proctalgia frigida.</i> Cold + pain at the bottom of the rectum previous to the tumor of the piles, + which sometimes extends by sympathy to the loins; it seems to be similar + to the pain at the beginning of menstruation, and is owing to the torpor + or inirritability of the extremity of the alimentary canal, or to the + obstruction of the blood in its passage through the liver, when that + viscus is affected, and its consequent delay in the veins of the rectum, + occasioning tumors of them, and dull sensations of pain.</p> + + <p>M. M. Calomel. A cathartic. Spice. Clyster, with 30 drops of laudanum. + Sitting over warm water. If chalybeates after evacuation? See Class <a + href="#species_I_2_3_23">I. 2. 3. 23</a>. and <a + href="#species_I_2_1_6">I. 2. 1. 6</a>.</p> + + <p><a name="species_I_2_4_19">19</a>. <i>Vesicæ felleæ + inirritabilitas.</i> The inirritability of the gall-bladder probably + occasions one kind of <i>icterus</i>, or jaundice; which is owing to + whatever obstructs the passage of bile into the duodenum. The jaundice of + aged people, and which attends some fevers, is believed to be most + frequently caused by an irritative palsy of the gall-bladder; on which + account the bile is not pressed from the cyst by its contraction, as in a + paralysis of the urinary bladder.</p> + + <p>A thickening of the coats of the common bile-duct by inflammation or + increased action of their vessels so as to prevent the passage of the + bile into the intestine, in the same manner as the membrane, which lines + the nostrils, becomes thickened in catarrh so as to prevent the passage + of air through them, is probably another frequent cause of jaundice, + especially of children; and generally ceases in about a fortnight, like a + common catarrh, without the aid of medicine; which has given rise to the + character, which charms have obtained in some countries for curing the + jaundice of young people.</p> + + <p>The spissitude of the bile is another cause of jaundice, as mentioned + in Class <a href="#species_I_1_3_8">I. 1. 3. 8</a>. This also in children + is a disease of little danger, as the gall-ducts are distensible, and + will the easier admit of the exclusion of gall-stones; but becomes a more + serious disease in proportion to the age of the patient, and his habits + of life in respect to spirituous potation.</p> + + <p>A fourth cause of jaundice is the compression of the bile-duct by the + enlargement of an inflamed or schirrous liver; this attends those who + have drank much spirituous liquor, and is generally succeeded by dropsy + and death.</p> + + <p>M. M. Repeated emetics. Mild cathartics. Warm bath. Electricity. + Bitters. Then steel, which, when the pain and inflammation is removed by + evacuations, acts like a charm in removing the remainder of the + inflammation, and by promoting the absorption of the new vessels or + fluids; like the application of any acrid eye-water at the end of + ophthalmia; and thus the thickened coats of the bile-duct become reduced, + or the enlargement of the liver lessened, and a free passage is again + opened for the bile into the intestine. Ether with yolk of egg is + recommended, as having a tendency to dissolve inspissated bile. And a + decoction of madder is recommended for the same purpose; because the bile + of animals, whose food was mixed with madder, was found always in a + dilute state. Aerated alcaline water, or Seltzer's water. Raw cabbage, + and other acrid vegetables, as water-cresses, mustard. Horses are said to + be subject to inspissated bile, with yellow eyes, in the winter season, + and to get well as soon as they feed on the spring grass.</p> + + <p>The largest bile-stone I have seen was from a lady, who had parted + with it some years before, and who had abstained above ten years from all + kinds of vegetable diet to prevent, as she supposed, a colic of her + stomach, which was probably a pain of the biliary duct; on resuming the + use of some vegetable diet, she recovered a better state of health, and + formed no new bilious concretions.</p> + + <p>A strong aerated alcaline water is sold by J. Schweppe, No. 8, + King's-street, Holborn. See Class <a href="#species_I_1_3_10">I. 1. 3. + 10</a>.</p> + + <p><a name="species_I_2_4_20">20</a>. <i>Pelvis renalis + inirritabilitas.</i> Inirritability of the pelvis of the kidney. When the + nucleus of a stone, whether it be inspissated mucus, or other matter, is + formed in the extremity of any of the tubuli uriniferi, and being + detached from thence falls into the pelvis of the kidney, it is liable to + lodge there from the want of due irritability of the membrane; and in + that situation increases by new appositions of indurated animal matter, + in the same manner as the stone of the bladder. This is the general cause + of hæmorrhage from the kidney; and of obtuse pain in it on exercise; or + of acute pain, when the stone advances into the ureter. See Class <a + href="#species_I_1_3_9">I. 1. 3. 9</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Irritation.</i></h3> + +<h3>GENUS <a name="genus_I_2_5">V</a>.</h3> + +<h3><i>Decreased Action of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_I_2_5_1">1</a>. <i>Stultitia inirritabilis.</i> Folly + from inirritability. Dulness of perception. When the motions of the + fibrous extremities of the nerves of sense are too weak to excite + sensation with sufficient quickness and vigour. The irritative ideas are + nevertheless performed, though perhaps in a feeble manner, as such people + do not run against a post, or walk into a well. There are three other + kinds of folly; that from deficient sensation, from deficient volition, + and from deficient association, as will be mentioned in their places. In + delirium, reverie, and sleep, the power of perception is abolished from + other causes.</p> + + <p><a name="species_I_2_5_2">2</a>. <i>Visus imminutus.</i> Diminished + vision. In our approach to old age our vision becomes imperfect, not only + from the form of the cornea, which becomes less convex, and from its + decreased transparency mentioned in Class <span class="correction" + title="This reference is surely wrong: I cannot determine a correction." + ><a href="#species_I_2_3_26">I. 2. 3. 26</a></span>.; but also from the + decreased irritability of the optic nerve. Thus, in the inirritative or + nervous fever, the pupil of the eye becomes dilated; which in this, as + well as in the dropsy of the brain, is generally a fatal symptom. A part + of the cornea as well as a part of the albuginea in these fevers is + frequently seen during sleep; which is owing to the inirritability of the + retina to light, or to the general paresis of muscular action, and in + consequence to the less contraction of the sphincter of the eye, if it + may be so called, at that time.</p> + + <p>There have been instances of some, who could not distinguish certain + colours; and yet whose eyes, in other respects, were not imperfect. + Philos. Transact. Which seems to have been owing to the want of + irritability, or the inaptitude to action, of some classes of fibres + which compose the retina. Other permanent defects depend on the diseased + state of the external organ. Class <a href="#species_I_1_3_14">I. 1. 3. + 14</a>. <span class="correction" title="This reference is surely wrong: I cannot determine a correction." + ><a href="#species_I_2_3_25">I. 2. 3. 25</a></span>. <a + href="#species_IV_2_1_11">IV. 2. 1. 11</a>.</p> + + <p><a name="species_I_2_5_3">3</a>. <i>Muscæ volitantes.</i> Dark spots + appearing before the eyes, and changing their apparent place with the + motions of the eyes, are owing to a temporary defect of irritability of + those parts of the retina, which have been lately exposed to more + luminous objects than the other parts of it, as explained in Sect. XL. 2. + Hence dark spots are seen on the bed-clothes by patients, when the optic + nerve is become less irritable, as in fevers with great debility; and the + patients are perpetually trying to pick them off with their fingers to + discover what they are; for these parts of the retina of weak people are + sooner exhausted by the stimulus of bright colours, and are longer in + regaining their irritability.</p> + + <p>Other kinds of ocular spectra, as the coloured ones, are also more + liable to remain in the eyes of people debilitated by fevers, and to + produce various hallucinations of sight. For after the contraction of a + muscle, the fibres of it continue in the last situation, till some + antagonist muscles are exerted to retract them; whence, when any one is + much exhausted by exercise, or by want of sleep, or in fevers, it is + easier to let the fibres of the retina remain in their last situation, + after having been stimulated into contraction, than to exert any + antagonist fibres to replace them.</p> + + <p>As the optic nerves at their entrance into the eyes are each of them + as thick as a crow-quill, it appears that a great quantity of sensorial + power is expended during the day in the perpetual activity of our sense + of vision, besides that used in the motions of the eye-balls and eyelids; + as much I suppose as is expended in the motions of our arms, which are + supplied with nerves of about the same diameters. From hence we may + conclude, that the light should be kept from patients in fevers with + debility, to prevent the unnecessary exhaustion of the sensorial power. + And that on the same account their rooms should be kept silent as well as + dark; that they should be at rest in an horizontal posture; and be cooled + by a blast of cool air, or by washing them with cold water, whenever + their skins are warmer than natural.</p> + + <p><a name="species_I_2_5_4">4</a>. <i>Strabismus.</i> Squinting is + generally owing to one eye being less perfect than the other; on which + account the patient endeavours to hide the worst eye in the shadow of the + nose, that his vision by the other may not be confused. Calves, which + have an hydatide with insects inclosed in it in the frontal sinus on one + side, turn towards the affected side; because the vision on that side, by + the pressure of the hydatide, becomes less perfect; and the disease being + recent, the animal turns round, expecting to get a more distinct view of + objects.</p> + + <p>In the hydrocephalus internus, where both eyes are not become + insensible, the patient squints with only one eye, and views objects with + the other, as in common strabismus. In this case it may be known on which + side the disease exists, and that it does not exist on both sides of the + brain; in such circumstances, as the patients I believe never recover as + they are now treated, might it not be adviseable to perforate the cranium + over the ventricule of the affected side? which might at least give room + and stimulus to the affected part of the brain?</p> + + <p>M. M. If the squinting has not been confirmed by long habit, and one + eye be not much worse than the other, a piece of gauze stretched on a + circle of whale-bone, to cover the best eye in such a manner as to reduce + the distinctness of vision of this eye to a similar degree of + imperfection with the other, should be worn some hours every day. Or the + better eye should be totally darkened by a tin cup covered with black + silk for some hours daily, by which means the better eye will be + gradually weakened by the want of use, and the worse eye will be + gradually strengthened by using it. Covering an inflamed eye in children + for weeks together, is very liable to produce squinting, for the same + reason.</p> + + <p><a name="species_I_2_5_5">5</a>. <i>Amaurosis.</i> Gutta serena. Is a + blindness from the inirritability of the optic nerve. It is generally + esteemed a palsy of the nerve, but should rather be deemed the death of + it, as paralysis has generally been applied to a deprivation only of + voluntary power. This is a disease of dark eyes only, as the cataract is + a disease of light eyes only. At the commencement of this disease, very + minute electric shocks should be repeatedly passed through the eyes; such + as may be produced by putting one edge of a piece of silver the size of a + half-crown piece beneath the tongue, and one edge of a piece of zinc of a + similar size between the upper lip and the gum, and then repeatedly + bringing their exterior edges into contact, by which means very small + electric sparks become visible in the eyes. See additional note at the + end of the first volume, p. 567. and Sect. XIV. 5.</p> + + <p>M. M. Minute electric shocks. A grain of opium, and a quarter of a + grain of corrosive sublimate of mercury, twice a day for four or six + weeks. Blister on the crown of the head.</p> + + <p><a name="species_I_2_5_6">6</a>. <i>Auditus imminutus.</i> Diminished + hearing. Deafness is a frequent symptom in those inflammatory or + sensitive fevers with debility, which are generally called putrid; it + attends the general stupor in those fevers, and is rather esteemed a + salutary sign, as during this stupor there is less expenditure of + sensorial power.</p> + + <p>In fevers of debility without inflammation, called nervous fevers, I + suspect deafness to be a bad symptom, arising like the dilated pupil from + a partial paralysis of the nerve of sense. See Class <a + href="#species_IV_2_1_15">IV. 2. 1. 15</a>.</p> + + <p>Nervous fevers are supposed by Dr. Gilchrist to originate from a + congestion of serum or water in some part of the brain, as many of the + symptoms are so similar to those of hydrocephalus internus, in which a + fluid is accumulated in the ventricules of the brain; on this idea the + inactivity of the optic or auditory nerves in these fevers may arise from + the compression of the effused fluid; while the torpor attending putrid + fever may depend on the meninges of the brain being thickened by + inflammation, and thus compressing it; now the new vessels, or the blood, + which thickens inflamed parts, is more frequently reabsorbed, than the + effused fluid from a cavity; and hence the stupor in one case is less + dangerous than in the other.</p> + + <p>In inflammatory or sensitive fevers with debility, deafness may + sometimes arise from a greater secretion and absorption of the ear-wax, + which is very similar to the bile, and is liable to fill the meatus + auditorius, when it is too viscid, as bile obstructs the gall-ducts.</p> + + <p>M. M. In deafness without fever Dr. Darwin applied a cupping-glass on + the ear with good effect, as described in Phil. Trans. Vol. LXIV. p. 348. + Oil, ether, laudanum, dropped into the ears.</p> + + <p><a name="species_I_2_5_7">7</a>. <i>Olfactus imminutus.</i> Inactivity + of the sense of smell. From our habits of trusting to the art of cookery, + and not examining our food by the smell as other animals do, our sense of + smell is less perfect than theirs. See Sect. XVI. 5. Class <a + href="#species_IV_2_1_16">IV. 2. 1. 16</a>.</p> + + <p>M. M. Mild errhines.</p> + + <p><a name="species_I_2_5_8">8</a>. <i>Gustus imminutus.</i> Want of + taste is very common in fevers, owing frequently to the dryness or scurf + of the tongue, or external organ of that sense, rather than to any injury + of the nerves of taste. See Class. <a href="#species_I_1_3_1">I. 1. 3. + 1</a>. <a href="#species_IV_2_1_16">IV. 2. 1. 16</a>.</p> + + <p>M. M. Warm subacid liquids taken frequently.</p> + + <p><a name="species_I_2_5_9">9</a>. <i>Tactus imminutus.</i> Numbness is + frequently complained of in fevers, and in epilepsy, and the touch is + sometimes impaired by the dryness of the cuticle of the fingers. See + Class <a href="#species_IV_2_1_16">IV. 2. 1. 16</a>.</p> + + <p>When the sense of touch is impaired by the compression of the nerve, + as in sitting long with one thigh crossed over the other, the limb + appears larger, when we touch it with our hands, which is to be ascribed + to the indistinctness of the sensation of touch, and may be explained in + the same manner as the apparent largeness of objects seen through a mist. + In this last case the minute parts of an object, as suppose of a distant + boy, are seen less distinctly, and therefore we instantly conceive them + to be further from the eye, and in consequence that the whole subtends a + larger angle, and thus we believe the boy to be a man. So when any one's + fingers are pressed on a benumbed limb, the sensation produced is less + than it should be, judging from visible circumstances; we therefore + conceive, that something intervened between the object and the sense, for + it is felt as if a blanket was put between them; and that not being + visibly the case, we judge that the limb is swelled.</p> + + <p>The sense of touch is also liable to be deceived from the acquired + habits of one part of it acting in the vicinity of another part of it. + Thus if the middle finger be crossed over either of the fingers next to + it, and a nut be felt by the two ends of the fingers so crossed at the + same time, the nut appears as if it was two nuts. And lastly, the sense + of touch is liable to be deceived by preconceived ideas; which we believe + to be excited by external objects, even when we are awake. It has + happened to me more than once, and I suppose to most others, to have put + my hands into an empty bason standing in an obscure corner of a room to + wash them, which I believed to contain cold water, and have instantly + perceived a sensation of warmth, contrary to that which I expected to + have felt.</p> + + <p>In some paralytic affections, and in cold fits of ague, the sensation + of touch has been much impaired, and yet that of heat has remained, See + Sect. XIV. 6.</p> + + <p>M. M. Friction alone, or with camphorated oil, warm bath. Ether. + Volatile alcali and water. Internally spice, salt. Incitantia. + Secernentia.</p> + + <p><a name="species_I_2_5_10">10</a>. <i>Stupor.</i> The stupor, which + occurs in fevers with debility, is generally esteemed a favourable + symptom; which may arise from the less expenditure of sensorial power + already existing in the brain and nerves, as mentioned in species 6 of + this genus. But if we suppose, that there is a continued production of + sensorial power, or an accumulation of it in the torpid parts of the + system, which is not improbable, because such a production of it + continues during sleep, to which stupor is much allied, there is still + further reason for believing it to be a favourable symptom in inirritable + fevers; and that much injury is often done by blisters and other powerful + stimuli to remove the stupor. See Sect. XII. 7. 8. and XXXIII. 1. 4.</p> + + <p>Dr. Blane in his Croonian Lecture on muscular motion for 1788, among + many other ingenious observations and deductions, relates a curious + experiment on salmon, and other fish, and which he repeated upon eels + with similar event.</p> + +<blockquote class="b1n"> + + <p>"If a fish, immediately upon being taken out of the water, is stunned + by a violent blow on the head, or by having the head crushed, the + irritability and sweetness of the muscles will be preserved much longer, + than if it had been allowed to die with the organs of sense entire. This + is so well known to fishermen, that they put it in practice, in order to + make them longer susceptible of the operation called <i>crimping</i>. A + salmon is one of the fish least tenacious of life, insomuch, that it will + lose all signs of life in less than half an hour after it is taken out of + the water, if suffered to die without any farther injury; but if, + immediately after being caught, it receives a violent blow on the head, + the muscles will shew visible irritability for more than twelve hours + afterwards."</p> + +</blockquote> + + <p>Dr. Blane afterwards well remarks, that "in those disorders in which + the exercise of the senses is in a great measure destroyed, or suspended, + as in the hydrocephalus, and apoplectic palsy, it happens not uncommonly, + that the appetite and digestion are better than in health."</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_I_3">III</a>.</h3> + +<h3><i>Retrograde Irritative Motions.</i></h3> + +<h3>GENUS <a name="genus_I_3_1">I</a>.</h3> + +<h3><i>Of the Alimentary Canal.</i></h3> + + <p>The retrograde motions of our system originate either from defect of + stimulus, or from defect of irritability. Thus sickness is often induced + by hunger, which is a want of stimulus; and from ipecacuanha, in which + last case it would seem, that the sickness was induced after the violence + of the stimulus was abated, and the consequent torpor had succeeded. + Hence spice, opium, or food relieves sickness.</p> + + <p>The globus hystericus, salivation, diabætes, and other inversions of + motion attending hysteric paroxysms, seem to depend on the want of + irritability of those parts of the body, because they are attended with + cold extremities, and general debility, and are relieved by wine, opium, + steel, and flesh diet; that is, by any additional stimulus.</p> + + <p>When the longitudinal muscles are fatigued by long action, or are + habitually weaker than natural, the antagonist muscles replace the limb + by stretching it in a contrary direction; and as these muscles have had + their actions associated in synchronous tribes, their actions cease + together. But as the hollow muscles propel the fluids, which they + contain, by motions associated in trains; when one ring is fatigued from + its too great debility, and brought into retrograde action; the next + ring, and the next, from its association in train falls into retrograde + action. Which continue so long as they are excited to act, like the + tremors of the hands of infirm people, so long as they endeavour to act. + Now as these hollow muscles are perpetually stimulated, these retrograde + actions do not cease as the tremors of the longitudinal muscles, which + are generally excited only by volition. Whence the retrograde motions of + hollow muscles depend on two circumstances, in which they differ from the + longitudinal muscles, namely, their motions being associated in trains, + and their being subject to perpetual stimulus. For further elucidation of + the cause of this curious source of diseases, see Sect. XXIX. 11. 5.</p> + + <p>The fluids disgorged by the retrograde motions of the various vascular + muscles may be distinguished, 1. From those, which are produced by + secretion, by their not being attended by increase of heat, which always + accompanies increased secretion. 2. They may be distinguished from those + fluids, which are the consequence of deficient absorption, by their not + possessing the saline acrimony, which those fluids possess; which + inflames the skin or other membranes on which they fall; and which have a + saline taste to the tongue. 3. They may be distinguished from those + fluids, which are the consequence both of increased secretion and + absorption, as these are attended with increase of warmth, and are + inspissated by the abstraction of their aqueous parts. 4. Where chyle, or + milk, are found in the feces or urine, or when other fluids, as matter, + are translated from one part of the system to another, they have been the + product of retrograde action of lymphatic or other canals. As explained + in Sect. XXIX. 8.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_I_3_1_1">1</a>. <i>Ruminatio.</i> In the rumination + of horned cattle the <span class="correction" title="Original reads `retograde'." + >retrograde</span> motions of the œsophagus are visible to the eye, + as they bring up the softened grass from their first stomach. The + vegetable aliment in the first stomach of cattle, which have filled + themselves too full of young clover, is liable to run into fermentation, + and distend the stomach, so as to preclude its exit, and frequently to + destroy the animal. To discharge this air the farmers frequently make an + opening into the stomach of the animal with success. I was informed, I + believe by the late Dr. Whytt of Edinburgh, that of twenty cows in this + situation two had died, and that he directed a pint of gin or whisky, + mixed with an equal quantity of water, to be given to the other eighteen; + all of which eructed immense quantities of air, and recovered.</p> + + <p>There are histories of ruminating men, and who have taken pleasure in + the act of chewing their food a second time. Philos. Transact.</p> + + <p><a name="species_I_3_1_2">2</a>. <i>Ructus.</i> Eructation. An + inverted motion of the stomach excluding through its upper valve an + elastic vapour generated by the fermentation of the aliment; which + proceeds so hastily, that the digestive power does not subdue it. This is + sometimes acquired by habit, so that some people can eruct when they + please, and as long as they please; and there is gas enough generated to + supply them for this purpose; for by Dr. Hale's experiments, an apple, + and many other kinds of aliment, give up above six hundred times their + own bulk of an elastic gas in fermentation. When people voluntarily eject + the fixable air from their stomachs, the fermentation of the aliment + proceeds the faster; for stopping the vessels, which contain new wines, + retards their fermentation, and opening them again accelerates it; hence + where the digestion is impaired, and the stomach somewhat distended with + air, it is better to restrain than to encourage eructations, except the + quantity makes it necessary. When wine is confined in bottles the + fermentation still proceeds slowly even for years, till all the sugar is + converted into spirit; but in the process of digestion, the saccharine + part is absorbed in the form of chyle by the bibulous mouths of the + numerous lacteals, before it has time to run into the vinous + fermentation.</p> + + <p><a name="species_I_3_1_3">3</a>. <i>Apepsia.</i> Indigestion. + Water-qualm. A few mouthfuls of the aliment are rejected at a time for + some hours after meals. When the aliment has had time to ferment, and + become acid, it produces cardialgia, or heart-burn. This disease is + perhaps generally left after a slight inflammation of the stomach, called + a surfeit, occasioned by drinking cold liquors, or eating cold + vegetables, when heated with exercise. This inflammation of the stomach + is frequently, I believe, at its commencement removed by a critical + eruption on the face, which differs in its appearance as well as in its + cause from the gutta rosea of drunkards, as the skin round the base of + each eruption is less inflamed. See Class <span class="correction" + title="Original reads `II. 1. 4. 7.'."><a href="#species_II_1_4_6">II. 1. + 4. 6</a></span>.. This disease differs from Cardialgia, Class <a + href="#species_I_2_4_5">I. 2. 4. 5</a>. in its being not uniformly + attended with pain of the cardia ventriculi, and from its retrograde + motions of a part of the stomach about the upper orifice of it. In the + same manner as hysteria differs from hypochondriasis; the one consisting + in the weakness and indigestion of the same portions of the alimentary + canal, and the other in the inverted motions of some parts of it. This + apepsia or water-qualm continues many years, even to old age; Mr. + G—— of Lichfield suffered under this disease from his + infancy; and, as he grew old, found relief only from repeated doses of + opium.</p> + + <p>M. M. A blister, rhubarb, a grain of opium twice a day. Soap, + iron-powder. Tin-powder.</p> + + <p><a name="species_I_3_1_4">4</a>. <i>Vomitus.</i> An inverted order of + the motions of the stomach and œsophagus with their absorbent + vessels, by which their contents are evacuated. In the act of vomiting + less sensorial power is employed than in the usual peristaltic motion of + the stomach, as explained in Sect. XXXV. 1. 3. Whence after the operation + of an emetic the digestion becomes stronger by an accumulation of + sensorial power during its decreased action. This decreased action of the + stomach may be either induced by want of stimulus, as in the sickness + which attends hunger; or it may be induced by temporary want of + irritability, as in cold fits of fever; or from habitual want of + irritability, as the vomiting of enfeebled drunkards. Or lastly, by + having been previously too violently stimulated by an emetic drug, as by + ipecacuanha.</p> + + <p>M. M. A blister. An emetic. Opium. Warmth of a bed, covering the face + for a while with the bed-clothes. Crude mercury. A poultice with opium or + theriaca externally.</p> + + <p><a name="species_I_3_1_5">5</a>. <i>Cholera.</i> When not only the + stomach, as in the last article, but also the duodenum, and ilium, as low + as the valve of the colon, have their motions inverted; and great + quantities of bile are thus poured into the stomach; while at the same + time some branches of the lacteals become retrograde, and disgorge their + contents into the upper part of the alimentary canal; and other branches + of them disgorge their contents into the lower parts of it beneath the + valve of the colon; a vomiting and purging commence together, which is + called cholera, as it is supposed to have its origin from increased + secretion of bile; but I suppose more frequently arises from putrid food, + or poisonous drugs, as in the case narrated in Sect. XXV. 13. where other + circumstances of this disease are explained. See Class <a + href="#species_II_1_2_11">II. 1. 2. 11</a>.</p> + + <p>The cramps of the legs, which are liable to attend cholera, are + explained in Class <span class="correction" title="Original reads `III. 1. 1. 15.'." + ><a href="#species_III_1_1_14">III. 1. 1. 14</a></span>.</p> + + <p><a name="species_I_3_1_6">6</a>. <i>Ileus.</i> Consists in the + inverted motions of the whole intestinal canal, from the mouth to the + anus; and of the lacteals and absorbents which arise from it. In this + pitiable disease, through the valve of the colon, through the pylorus, + the cardia, and the pharinx, are ejected, first, the contents of the + stomach and intestines, with the excrement and even clysters themselves; + then the fluid from the lacteals, which is now poured into the intestines + by their retrograde motions, is thrown up by the mouth; and, lastly, + every fluid, which is absorbed by the other lymphatic branches, from the + cellular membrane, the skin, the bladder, and all other cavities of the + body; and which is then poured into the stomach or intestines by the + retrograde motions of the lacteals; all which supply that amazing + quantity of fluid, which is in this disease continually ejected by + vomiting. See Sect. XXV. 15. for a further explanation of this + disease.</p> + + <p>M. M. Copious venesection. Twenty grains of calomel in small pills, or + one grain of aloe every hour till stools are procured. Blisters. Warm + bath. Crude mercury. Clyster of ice-water. Smear the skin all over with + grease, as mentioned in Sect. XXV. 15.</p> + + <p>As this malady is occasioned sometimes by an introsusception of a part + of the intestine into another part of it, especially in children, could + holding them up by their heels for a second or two of time be of service + after venesection? Or the exhibition of crude quicksilver two ounces + every half hour, till a pound is taken, be particularly serviceable in + this circumstance? Or could half a pound, or a pound, of crude mercury be + injected as a clyster, the patient being elevated by the knees and thighs + so as to have his head and shoulders much lower than his bottom, or even + for a short time held up by the heels? Could this also be of advantage in + strangulated hernia?</p> + + <p>Where the disease is owing to strangulated hernia, the part should be + sprinkled with cold water, or iced water, or salt and water recently + mixed, or moistened with ether. In cases of strangulated hernia, could + acupuncture, or puncture with a capillary trocar, be used with safety and + advantage to give exit to air contained in the strangulated bowel? Or to + stimulate it into action? It is not uncommon for bashful men to conceal + their being afflicted with a small hernia, which is the cause of their + death; this circumstance should therefore always be enquired into. Is the + seat or cause of the ileus always below the valve of the colon, and that + of the cholera above it? See Class <a href="#species_II_1_2_11">II. 1. 2. + 11</a>.</p> + + <p><a name="species_I_3_1_7">7</a>. <i>Globus hystericus.</i> Hysteric + suffocation is the perception of a globe rolling round in the abdomen, + and ascending to the stomach and throat, and there inducing + strangulation. It consists of an ineffectual inversion of the motions of + the œsophagus, and other parts of the alimentary canal; nothing + being rejected from the stomach.</p> + + <p>M. M. Tincture of castor. Tinct. of opium of each 15 drops. See + Hysteria, Class <span class="correction" title="Original reads `I. 3. 1. 9.'." + ><a href="#species_I_3_1_10">I. 3. 1. 10</a></span>.</p> + + <p><a name="species_I_3_1_8">8</a>. <i>Vomendi conamen inane.</i> An + ineffectual effort to vomit. It frequently occurs, when the stomach is + empty, and in some cases continues many hours; but as the lymphatics of + the stomach are not inverted at the same time, there is no supply of + materials to be ejected; it is sometimes a symptom of hysteria, but more + frequently attends irregular epilepsies or reveries; which however may be + distinguished by their violence of exertion, for the exertions of + hysteric motions are feeble, as they are caused by debility; but those of + epilepsies, as they are used to relieve pain, are of the most violent + kind; insomuch that those who have once seen these ineffectual efforts to + vomit in some epilepsies, can never again mistake them for symptoms of + hysteria. See a case in Sect. XIX. 2.</p> + + <p>M. M. Blister. Opium. Crude mercury.</p> + + <p><a name="species_I_3_1_9">9</a>. <i>Borborigmus.</i> A gurgling of the + bowels proceeds from a partial invertion of the peristaltic motions of + them, by which the gas is brought into a superior part of the bowel, and + bubbles through the descending fluid, like air rushing into a bottle as + the water is poured out of it. This is sometimes a distressing symptom of + the debility of the bowels joined with a partial inversion of their + motions. I attended a young lady about sixteen, who was in other respects + feeble, whose bowels almost incessantly made a gurgling noise so loud as + to be heard at a considerable distance, and to attract the notice of all + who were near her. As this noise never ceased a minute together for many + hours in a day, it could not be produced by the uniform descent of water, + and ascent of air through it, but there must have been alternately a + retrograde movement of a part of the bowel, which must again have pushed + up the water above the air; or which might raise a part of the bowel, in + which the fluid was lodged, alternately above and below another portion + of it; which might readily happen in some of the curvatures of the + smaller intestines, the air in which might be moved backward and forward + like the air-bubble in a glass-level.</p> + + <p>M. M. Essential oil. Ten corns of black pepper swallowed whole after + dinner, that its effect might be slower and more permanent; a small pipe + occasionally introduced into the rectum to facilitate the escape of the + air. Crude mercury. See Class <a href="#species_I_2_4_9">I. 2. 4. + 9</a>.</p> + + <p><a name="species_I_3_1_10">10</a>. <i>Hysteria.</i> The three last + articles, together with the lymphatic diabætes, are the most common + symptoms of the hysteric disease; to which sometimes is added the + lymphatic salivation, and fits of syncope, or convulsion, with + palpitation of the heart (which probably consists of retrograde motions + of it), and a great fear of dying. Which last circumstance distinguishes + these convulsions from the epileptic ones with greater certainty than any + other single symptom. The pale copious urine, cold skin, palpitation, and + trembling, are the symptoms excited by great fear. Hence in hysteric + diseases, when these symptoms occur, the fear, which has been usually + associated with them, recurs at the same time, as in hypochondriasis, + Class <a href="#species_I_2_4_10">I. 2. 4. 10</a>. See Sect. XVI. 8. + 1.</p> + + <p>The convulsions which sometimes attend the hysteric disease, are + exertions to relieve pain, either of some torpid, or of some retrograde + organ; and in this respect they resemble epileptic convulsions, except + that they are seldom so violent as entirely to produce insensibility to + external stimuli; for these weaker pains cease before the total + exhaustion of sensorial power is produced, and the patient sinks into + imperfect syncope; whereas the true epilepsy generally terminates in + temporary apoplexy, with perfect insensibility to external objects. These + convulsions are less to be dreaded than the epileptic ones, as they do + not originate from so permanent a cause.</p> + + <p>The great discharge of pale urine in this disease is owing to the + inverted motions of the lymphatics, which arise about the neck of the + bladder, as described in Sect. XXIX. 4. 5. And the lymphatic salivation + arises from the inverted motions of the salivary lymphatics.</p> + + <p>Hysteria is distinguished from hypochondriasis, as in the latter there + are no retrograde motions of the alimentary canal, but simply a debility + or inirritability of it, with distention and flatulency. It is + distinguished from apepsia and cardialgia by there being nothing ejected + from the stomach by the retrograde motions of it, or of the + œsophagus.</p> + + <p>M. M. Opium. Camphor. Assafœtida. Castor, with sinapisms + externally; to which must be added a clyster of cold water, or iced + water; which, according to Mons. Pomme, relieves these hysteric symptoms + instantaneously like a charm; which it may effect by checking the + inverted motions of the intestinal canal by the torpor occasioned by + cold; or one end of the intestinal canal may become strengthened, and + regain its peristaltic motion by reverse sympathy, when the other end is + rendered torpid by ice-water. (Pomme des Affections Vaporeuses, p. 25.) + These remove the present symptoms; and bark, steel, exercise, coldish + bath, prevent their returns. See Art. <a href="#art_VI_2_1">VI. 2. + 1</a>.</p> + + <p><a name="species_I_3_1_11">11</a>. <i>Hydrophobia.</i> Dread of water + occasioned by the bite of a mad dog, is a violent inversion of the + motions of the œsophagus on the contact or even approach of water + or other fluids. The pharinx seems to have acquired the sensibility of + the larinx in this disease, and is as impatient to reject any fluid, + which gets into it. Is not the cardia ventriculi the seat of this + disease? As in cardialgia the pain is often felt in the pharinx, when the + acid material stimulates the other end of the canal, which terminates in + the stomach. As this fatal disease resembles tetanus, or locked jaw, in + its tendency to convulsion from a distant wound, and affects some other + parts by association, it is treated of in Class <a + href="#species_III_1_1_15">III. 1. 1. 15</a>. and <span + class="correction" title="Original reads `IV. 2. 1. 7.'."><a + href="#species_IV_1_2_7">IV. 1. 2. 7</a></span>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Irritative Motions.</i></h3> + +<h3>GENUS <a name="genus_I_3_2">II</a>.</h3> + +<h3><i>Of the Absorbent System.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_I_3_2_1">1</a>. <i>Catarrhus lymphaticus.</i> + Lymphatic catarrh. A periodical defluxion of a thin fluid from the + nostrils, for a few hours, occasioned by the retrograde motions of their + lymphatics; which may probably be supplied with fluid by the increased + absorption of some other lymphatic branches in their vicinity. It is + distinguished from that mucous discharge, which happens in frosty weather + from decreased absorption, because it is less salt to the taste; and from + an increased secretion of mucus, because it is neither so viscid, nor is + attended with heat of the part. This complaint is liable to recur at + diurnal periods, like an intermittent fever, for weeks and months + together, with great sneezing and very copious discharge for an hour or + two.</p> + + <p>I have seen two of these cases, both of which occurred in delicate + women, and seemed an appendage to other hysteric symptoms; whence I + concluded, that the discharge was occasioned by the inverted motions of + the lymphatics of the nostrils, like the pale urine in hysteric cases; + and that they might receive this fluid from some other branches of + lymphatic vessels opening into the frontal or maxillary cavities in their + vicinity.</p> + + <p>Could such a discharge be produced by strong errhines, and excite an + absorption of the congestion of lymph in the dropsy of the brain?</p> + + <p><a name="species_I_3_2_2">2</a>. <i>Salivatio lymphatica.</i> + Lymphatic salivation. A copious expuition of a pellucid insipid fluid, + occasioned by the retrograde motions of the lymphatics of the mouth. It + is sometimes periodical, and often attends the hysteric disease, and + nervous fevers; but is not accompanied with a saline taste, or with heat + of the mouth, or nausea.</p> + + <p><a name="species_I_3_2_3">3</a>. <i>Nausea humida.</i> Moist nausea + consists in a discharge of fluid, owing to the retrograde motions of the + lymphatics about the fauces, without increase of heat, or saline taste, + together with some retrograde motions of the fauces or pharinx; along + with this nausea a sickness generally precedes the act of vomiting; which + may consist of a similar discharge of mucus or chyle into the stomach by + the retrograde motions of the lymphatics or lacteals, which open into it. + See Class <a href="#species_I_2_4_3">I. 2. 4. 3</a>. and <a + href="#species_I_2_4_4">I. 2. 4. 4</a>.</p> + + <p>M. M. Subacid liquids. Wine. Opium. A blister.</p> + + <p><a name="species_I_3_2_4">4</a>. <i>Diarrhœa lymphatica.</i> + Lymphatic diarrhœa. A quantity of mucus and lymph are poured into + the intestines by the inverted motions of the intestinal lymphatics. The + feces are less fetid and more liquid; and it sometimes portends the + commencement of a diabætes, or dropsy, or their temporary relief. This + lymphatic diarrhœa sometimes becomes chronical, in which the + atmospheric moisture, absorbed by the cutaneous and pulmonary lymphatics, + is poured into the intestines by the retrograde motions of the lacteals. + See Section XXIX. 4. 6. where some cases of this kind are related.</p> + + <p><a name="species_I_3_2_5">5</a>. <i>Diarrhœa chylifera, + cœliaca.</i> Chyliferous diarrhœa. The chyle drank up by the + lacteals of the upper intestines is poured into the lower ones by the + retrograde motions of their lacteals, and appears in the dejections. This + circumstance occurs at the beginning of diarrhœa crapulosa, where + the patient has taken and digested more aliment than the system can + conveniently receive, and thus eliminates a part of it; as appears when + there is curdled chyle in some of the dejections. See Sect. XXIX. 4. 7. + It differs from the lymphatic diarrhœa, as the chyliferous diabætes + differs from the aqueous and mucaginous diabætes.</p> + + <p><a name="species_I_3_2_6">6</a>. <i>Diabætes.</i> By the retrograde + motions of the urinary lymphatics, an immense quantity of fluid is poured + into the bladder. It is either termed chyliferous, or aqueous, or + mucaginous, from the nature of the fluid brought into the bladder; and is + either a temporary disease, as in hysteric women, in the beginning of + intoxication, in worm cases, or in those exposed to cold damp air, or to + great fear, or anxiety, or in the commencement of some dropsies; or it + becomes chronical.</p> + + <p>When the urinary lymphatics invert their motions, and pour their + refluent contents into the bladder, some other branch of the absorbent + system acts with greater energy to supply this fluid. If it is the + intestinal branch, the chyliferous diabætes is produced: if it is the + cutaneous or pulmonary branch, the aqueous diabætes is produced: and if + the cellular or cystic branches, the mucaginous diabætes. In the two last + the urine is pellucid, and contains no sugar.</p> + + <p>In dropsies the fluid is sometimes absorbed, and poured into the + bladder by the retrograde motions of the urinary lymphatics, as during + the exhibition of digitalis. In the beginning of the dropsies of infirm + gouty patients, I have frequently observed, that they make a large + quantity of water for one night, which relieves them for several days. In + these cases the patient previously feels a fulness about the precordia, + with difficult respiration, and symptoms similar to those of hysteria. + Perhaps a previous defect of absorption takes place in some part of the + body in those hysteric cases, which are relieved by a copious discharge + of pale urine. See Diabætes explained at large, Section XXIX. 4.</p> + + <p>A discharge of blood sometimes attends the diabætes, which was + occasionally a symptom of that disease in Mr. Brindley, the great + navigable canal maker in this country. Which may be accounted for by the + communication of a lymphatic branch with the gastric branch of the vena + portarum, as discovered by J. F. Meckel. See Section XXVII. 2.</p> + + <p>M. M. Alum. Earth of Alum. Cantharides. Calomel. Bark. Steel. Rosin. + Opium. See Sect. XXIX. 4.</p> + + <p><a name="species_I_3_2_7">7</a>. <i>Sudor lymphaticus.</i> Profuse + sweats from the inverted motions of the cutaneous lymphatics, as in some + fainting fits, and at the approach of death; and as perhaps in the sudor + anglicanus. See Sect. XXIX. 5. These sweats are glutinous to the touch, + and without increased heat of the skin; if the part is not covered, the + skin becomes cold from the evaporation of the fluid. These sweats without + heat sometimes occur in the act of vomiting, as in Sect. XXV. 9. and are + probably the cause of the cold sweaty hands of some people. As mentioned + in Sect. XXIX. 4. 9. in the case of R. Davis, which he cured by frequent + application of lime. Though it is possible, that cold sweaty hands may + also arise from the want of due absorption of the perspirable matter + effused on them, and that the coldness may be owing to the greater + evaporation in consequence.</p> + + <p>The acid sweats described by Dr. Dobson, which he observed in a + diabætic patient, and ascribes to the chyle effused on the skin, must be + ascribed to the retrograde action of the cutaneous lymphatics. See Sect. + XXIX. 6.</p> + + <p><a name="species_I_3_2_8">8</a>. <i>Sudor asthmaticus.</i> The cold + sweats in this disease only cover the head, arms, and breast, and are + frequently exceedingly profuse. These sweats are owing to the inverted + motions of the cutaneous lymphatics of the upper part of the body, and at + the same time the increased absorption of the pulmonary absorbents: hence + these sweats when profuse relieve the present fit of asthma. There is no + other way to account for sweats appearing on the upper parts of the body + only, but by the fluid having been absorbed by the lymphatic branch of + the lungs, and effused on the skin by the retrograde movements of the + cutaneous lymphatics; which join those of the lungs before they enter + into the venous circulation. For if they were occasioned, as generally + supposed, by the difficulty of the circulation of the blood through the + lungs, the whole skin must be equally affected, both of the upper and + lower parts of the body; for whatever could obstruct the circulation in + the upper part of the venous system, must equally obstruct it in the + lower part of it. See Sect. XXIX. 6. In the convulsive asthma these + sweats do not occur; hence they may be distinguished; and might be called + the hydropic asthma, and the epileptic asthma.</p> + + <p><a name="species_I_3_2_9">9</a>. <i>Translatio puris.</i> Translation + of matter from one part of the system to another can only be explained + from its being absorbed by one branch of the lymphatic system, and + deposited in a distant part by the retrograde motions of another branch; + as mentioned Sect. XXIX. 7. 1. It is curious, that these translations of + matter are attended generally, I believe, with cold fits; for less heat + is produced during the retrograde action of this part of the system, as + no secretion in the lymphatic glands of the affected branches can exist + at the same time. Do any ineffectual retrograde motions occasion the cold + fits of agues? The time when the gout of the liver ceases, and the gout + in the foot commences, is attended with a cold fit, as I have observed in + two instances, which is difficult to explain, without supposing the new + vessels, or the matter produced on the inflamed liver, to be absorbed, + and either eliminated by some retrograde motion, or carried to the newly + inflamed part? See Class <a href="#species_IV_1_2_15">IV. 1. 2. + 15</a>.</p> + + <p><a name="species_I_3_2_10">10</a>. <i>Translatio lactis.</i> + Translation of milk to the bowels in puerperal fevers can only be + explained by the milk being absorbed by the pectoral branch of + lymphatics, and carried to the bowels by the retrograde motions of the + intestinal lymphatics or lacteals. See many instances of this in Sect. + XXIX. 7. 4.</p> + + <p><a name="species_I_3_2_11">11</a>. <i>Translatio urinæ.</i> + Translation of urine. There is a curious case related in the Transaction + of the College of Physicians at Philadelphia, Vol. I. p. 96. of a girl, + who labouring under an iscuria vomited her urine for many months; which + could not be distinguished from that which was at other times drawn off + by the catheter. After having taken much opium, she seems at length to + have formed gravel, some of which was frequently brought up by vomiting. + Dr. Senter ascribes this to the retrograde motions of the lymphatics of + the stomach, and the increased ones of those of the bladder, and refers + to those of Sect. XXIX. of this work; which section was first published + in 1780; and to Macquire's Dictionary of Chemistry, Art. Urine.</p> + + <p>The patient above described sometimes had a discharge of urine by the + navel, and at other times by the rectum, and sometimes by urinous + sweats.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Irritative Motions.</i></h3> + +<h3>GENUS <a name="genus_I_3_3">III</a>.</h3> + +<h3><i>Of the Sanguiferous System.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_I_3_3_1">1</a>. <i>Capillarium motus + retrogressus.</i> In microscopic experiments it is usual to see globules + of blood regurgitate from the capillary vessels again and again, before + they pass through them; and not only the mouths of the veins, which arise + from these capillaries, are frequently seen by microscopes to regurgitate + some particles of blood during the struggles of the animal; but a + retrograde motion of the blood in the veins of these animals, from the + very heart to the extremities of the limbs, is observable by intervals + during the distresses of the dying creature. Haller, Elem. Phys. T. i. p. + 216. See Section XXIX. 3. 8.</p> + + <p><a name="species_I_3_3_2">2</a>. <i>Palpitatio cordis.</i> May not the + ineffectual and weak unequal motions of the heart in hysteric cases be + ascribed to the retrograde motions of it, which continue for a short + time, or terminate in syncope? See Class <a href="#species_IV_3_1_6">IV. + 3. 1. 6</a>.</p> + + <p><a name="species_I_3_3_3">3</a>. <i>Anhelatio spasmodica.</i> In some + asthmas may not the difficulty of respiration arise from the inverted + action of the finer branches of the bronchia, or of the pulmonary artery + or vein, like those of the capillaries above described in No. 1. of this + genus?</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3><i>The Orders and Genera of the Second Class of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS <a name="class_II">II</a>.</h3> + +<p class="cenhead">DISEASES OF SENSATION.</p> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_II_1_1">1</a>. With increased action of the muscles.</p> + <p><a href="#genusi_II_1_2">2</a>. With the production of new vessels by internal membranes or glands with fever.</p> + <p><a href="#genusi_II_1_3">3</a>. With the production of new vessels by external membranes or glands with fever.</p> + <p><a href="#genusi_II_1_4">4</a>. With the production of new vessels by internal membranes or glands without fever.</p> + <p><a href="#genusi_II_1_5">5</a>. With the production of new vessels by external membranes or glands without fever.</p> + <p><a href="#genusi_II_1_6">6</a>. With fever consequent to the production of new vessels or fluids.</p> + <p><a href="#genusi_II_1_7">7</a>. With increased action of the organs of sense.</p> + </div> + </div> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Sensation.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_II_2_1">1</a>. With decreased actions of the general system.</p> + <p><a href="#genusi_II_2_2">2</a>. With decreased actions of particular organs.</p> + </div> + </div> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Sensitive Motions.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><span class="correction" title="Original reads `3'. after 1. Of the arterial system. 2. Of the absorbent system. which do not exist"><a href="#genusi_II_3_1">1</a>. Of the excretory ducts</span>.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><i>The Orders, Genera, and Species, of the Second Class +Of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS II.</h3> + +<h3>DISEASES OF SENSATION.</h3> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genusi_II_1_1">I</a>.</h3> + +<h3><i>With Increased Action of the Muscles.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_1_1">1</a>. <i>Deglutitio.</i></td><td>Deglutition.</td></tr> +<tr><td> <a href="#species_II_1_1_2">2</a>. <i>Respiratio.</i></td><td>Respiration.</td></tr> +<tr><td> <a href="#species_II_1_1_3">3</a>. <i>Sternutatio.</i></td><td>Sneezing.</td></tr> +<tr><td> <a href="#species_II_1_1_4">4</a>. <i>Anhelitus.</i></td><td>Panting.</td></tr> +<tr><td> <a href="#species_II_1_1_5">5</a>. <i>Tussis ebriorum.</i></td><td>Cough of inebriates.</td></tr> +<tr><td> <a href="#species_II_1_1_6">6</a>. <i>Syngultus.</i></td><td>Hiccough.</td></tr> +<tr><td> <a href="#species_II_1_1_7">7</a>. <i>Asthma humorale.</i></td><td>Humoral asthma.</td></tr> +<tr><td> <a href="#species_II_1_1_8">8</a>. <i>Nictitatio sensitiva.</i></td><td>Winking from pain.</td></tr> +<tr><td> <a href="#species_II_1_1_9">9</a>. <i>Oscitatio et pandiculatio.</i> </td><td>Yawning and stretching.</td></tr> +<tr><td><a href="#species_II_1_1_10">10</a>. <i>Tenesmus.</i></td><td>Tenesmus.</td></tr> +<tr><td><a href="#species_II_1_1_11">11</a>. <i>Stranguria.</i></td><td>Strangury.</td></tr> +<tr><td><a href="#species_II_1_1_12">12</a>. <i>Parturitio.</i></td><td>Parturition.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_2">II</a>.</h3> + +<h3><i>With the Production of new Vessels by internal Membranes or Glands, +with Fever.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_2_1">1</a>. <i>Febris sensitiva irritata.</i> </td><td>Sensitive irritated fever.</td></tr> +<tr><td> <a href="#species_II_1_2_2">2</a>. <i>Ophthalmia interna.</i></td><td>Inflammation of the eye.</td></tr> +<tr><td> <a href="#species_II_1_2_3">3</a>. <i>Phrenitis.</i></td><td>—— of the brain.</td></tr> +<tr><td> <a href="#species_II_1_2_4">4</a>. <i>Peripneumonia.</i></td><td>—— of the lungs.</td></tr> +<tr><td> —— <i>trachealis.</i></td><td>—— the croup.</td></tr> +<tr><td> <a href="#species_II_1_2_5">5</a>. <i>Pleuritis.</i></td><td>—— of the pleura.</td></tr> +<tr><td> <a href="#species_II_1_2_6">6</a>. <i>Diaphragmitis.</i></td><td>—— of the diaphragm.</td></tr> +<tr><td> <a href="#species_II_1_2_7">7</a>. <i>Carditis.</i></td><td>—— of the heart.</td></tr> +<tr><td> <a href="#species_II_1_2_8">8</a>. <i>Peritonitis.</i></td><td>—— of the peritoneum.</td></tr> +<tr><td> <a href="#species_II_1_2_9">9</a>. <i>Mesenteritis.</i></td><td>—— of the mesentery.</td></tr> +<tr><td><a href="#species_II_1_2_10">10</a>. <i>Gastritis.</i></td><td>—— of the stomach.</td></tr> +<tr><td><a href="#species_II_1_2_11">11</a>. <i>Enteritis.</i></td><td>—— of the bowels.</td></tr> +<tr><td><a href="#species_II_1_2_12">12</a>. <i>Hepatitis.</i></td><td>—— of the liver.</td></tr> +<tr><td><a href="#species_II_1_2_13">13</a>. <i>Splenitis.</i></td><td>—— of the spleen.</td></tr> +<tr><td><a href="#species_II_1_2_14">14</a>. <i>Nephritis.</i></td><td>—— of the kidney.</td></tr> +<tr><td><a href="#species_II_1_2_15">15</a>. <i>Cystitis.</i></td><td>—— of the bladder.</td></tr> +<tr><td><a href="#species_II_1_2_16">16</a>. <i>Hysteritis.</i></td><td>—— of the womb.</td></tr> +<tr><td><a href="#species_II_1_2_17">17</a>. <i>Lumbago sensitiva.</i></td><td>—— of the loins.</td></tr> +<tr><td><a href="#species_II_1_2_18">18</a>. <i>Ischias.</i></td><td>—— of the pelvis.</td></tr> +<tr><td><a href="#species_II_1_2_19">19</a>. <i>Paronychia interna.</i></td><td>—— beneath the nails.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_3">III</a>.</h3> + +<h3><i>With the Production of new Vessels by external Membranes or Glands, +with Fever.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_3_1">1</a>. <i>Febris sensitiva inirritata.</i></td><td>Sensitive inirritated fever.</td></tr> +<tr><td> <a href="#species_II_1_3_2">2</a>. <i>Erysipelas irritatum.</i></td><td>Erysipelas irritated.</td></tr> +<tr><td> —— <i>inirritatum.</i></td><td>—— inirritated.</td></tr> +<tr><td> —— <i>sensitivum.</i></td><td>—— sensitive.</td></tr> +<tr><td> <a href="#species_II_1_3_3">3</a>. <i>Tonsillitis interna.</i></td><td>Angina internal.</td></tr> +<tr><td> —— <i>superficialis.</i></td><td>—— superficial.</td></tr> +<tr><td> —— <i>inirritata.</i></td><td>—— inirritated.</td></tr> +<tr><td> <a href="#species_II_1_3_4">4</a>. <i>Parotitis suppurans.</i></td><td>Mumps suppurative.</td></tr> +<tr><td> —— <i>mutabilis.</i></td><td>—— mutable.</td></tr> +<tr><td> —— <i>felina.</i></td><td>—— of cats.</td></tr> +<tr><td> <a href="#species_II_1_3_5">5</a>. <i>Catarrhus sensitivus.</i></td><td>Catarrh inflammatory.</td></tr> +<tr><td> <a href="#species_II_1_3_6">6</a>. —— <i>contagiosus.</i></td><td>—— contagious.</td></tr> +<tr><td> —— <i>equinus et caninus.</i></td><td>—— among horses and dogs.</td></tr> +<tr><td> <a href="#species_II_1_3_7">7</a>. <i>Peripneumonia <span class="correction" title="Original reads `superficialie' (compare main text).">superficialis</span>.</i> </td><td>Superficial peripneumony.</td></tr> +<tr><td> <a href="#species_II_1_3_8">8</a>. <i>Pertussis.</i></td><td>Chin-cough.</td></tr> +<tr><td> <a href="#species_II_1_3_9">9</a>. <i>Variola discreta.</i></td><td>Small-pox distinct.</td></tr> +<tr><td> —— <i>confluens.</i></td><td>—— confluent.</td></tr> +<tr><td> —— <i>inoculata.</i></td><td>—— inoculated.</td></tr> +<tr><td><a href="#species_II_1_3_10">10</a>. <i>Rubeola irritata.</i></td><td>Measles irritated.</td></tr> +<tr><td> —— <i>inirritata.</i></td><td>—— inirritated.</td></tr> +<tr><td><a href="#species_II_1_3_11">11</a>. <i>Scarlatina mitis.</i></td><td>Scarlet fever mild.</td></tr> +<tr><td> —— <i>maligna.</i></td><td>—— malignant.</td></tr> +<tr><td><a href="#species_II_1_3_12">12</a>. <i>Miliaria sudatoria.</i></td><td>Miliary fever sudatory.</td></tr> +<tr><td> —— <i>irritata.</i></td><td>—— irritated.</td></tr> +<tr><td> —— <i>inirritata.</i></td><td>—— inirritated.</td></tr> +<tr><td><a href="#species_II_1_3_13">13</a>. <i>Pestis.</i></td><td>Plague.</td></tr> +<tr><td> —— <i>vaccina.</i></td><td>—— of horned cattle.</td></tr> +<tr><td><a href="#species_II_1_3_14">14</a>. <i>Pemphigus.</i></td><td>Bladdery fever.</td></tr> +<tr><td><a href="#species_II_1_3_15">15</a>. <i>Varicella.</i></td><td>Chicken-pox.</td></tr> +<tr><td><a href="#species_II_1_3_16">16</a>. <i>Urticaria.</i></td><td>Nettle rash.</td></tr> +<tr><td><a href="#species_II_1_3_17">17</a>. <i>Aptha sensitiva.</i></td><td>Thrush sensitive.</td></tr> +<tr><td> —— <i>irritata.</i></td><td>—— irritated.</td></tr> +<tr><td> —— <i>inirritata.</i></td><td>—— inirritated.</td></tr> +<tr><td><a href="#species_II_1_3_18">18</a>. <i>Dysenteria.</i></td><td>Bloody flux.</td></tr> +<tr><td><a href="#species_II_1_3_19">19</a>. <i>Gastritis superficialis.</i></td><td>Superficial inflam. of the stomach.</td></tr> +<tr><td><a href="#species_II_1_3_20">20</a>. <i>Enteritis superficialis.</i></td><td>—— of the bowels.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_4">IV</a>.</h3> + +<h3><i>With the Production of new Vessels by internal Membranes or Glands, +without Fever.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_4_1">1</a>. <i>Ophthalmia superficialis.</i> </td><td>Ophthalmy superficial.</td></tr> +<tr><td> —— <i>lymphatica.</i></td><td>—— lymphatic.</td></tr> +<tr><td> —— <i>equina.</i></td><td>—— of horses.</td></tr> +<tr><td> <a href="#species_II_1_4_2">2</a>. <i>Pterigion.</i></td><td>Eye-wing.</td></tr> +<tr><td> <a href="#species_II_1_4_3">3</a>. <i>Tarsitis palpebrarum.</i></td><td>Red eyelids.</td></tr> +<tr><td> <a href="#species_II_1_4_4">4</a>. <i>Hordeolum.</i></td><td>Stye.</td></tr> +<tr><td> <a href="#species_II_1_4_5">5</a>. <i>Paronychia superficialis.</i></td><td>Whitlow.</td></tr> +<tr><td> <a href="#species_II_1_4_6">6</a>. <i>Gutta rosea hepatica.</i></td><td>Pimpled face hepatic.</td></tr> +<tr><td> —— <i>stomatica.</i></td><td>—— stomatic.</td></tr> +<tr><td> —— <i>hereditaria.</i></td><td>—— hereditary.</td></tr> +<tr><td> <a href="#species_II_1_4_7">7</a>. <i>Odontitis.</i></td><td>Inflamed tooth.</td></tr> +<tr><td> <a href="#species_II_1_4_8">8</a>. <i>Otitis.</i></td><td>—— ear.</td></tr> +<tr><td> <a href="#species_II_1_4_9">9</a>. <i>Fistula lacrymalis.</i></td><td>Fistula lacrymalis.</td></tr> +<tr><td><a href="#species_II_1_4_10">10</a>. <i>Fistula in ano.</i></td><td>Fistula in ano.</td></tr> +<tr><td><a href="#species_II_1_4_11">11</a>. <i><span class="correction" title="Entry omitted in original and subsequent entries wrongly numbered.'.">Fistula urethræ.</span></i></td><td>Fistula urethræ.</td></tr> +<tr><td><a href="#species_II_1_4_12">12</a>. <i>Hepatitis chronica.</i></td><td>Chronical hepatitis.</td></tr> +<tr><td><a href="#species_II_1_4_13">13</a>. <i>Scrophula suppurans.</i></td><td>Suppurating scrophula.</td></tr> +<tr><td><a href="#species_II_1_4_14">14</a>. <i>Scorbutus suppurans.</i></td><td>Suppurating scurvy.</td></tr> +<tr><td><a href="#species_II_1_4_15">15</a>. <i>Schirrus suppurans.</i></td><td>Suppurating schirrus.</td></tr> +<tr><td><a href="#species_II_1_4_16">16</a>. <i>Carcinoma.</i></td><td>Cancer.</td></tr> +<tr><td><a href="#species_II_1_4_17">17</a>. <i>Arthrocele.</i></td><td>Swelling of the joints.</td></tr> +<tr><td><a href="#species_II_1_4_18">18</a>. <i>Arthropuosis.</i></td><td>Suppuration of the joints.</td></tr> +<tr><td><a href="#species_II_1_4_19">19</a>. <i>Caries ossium.</i></td><td>Caries of the bones.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_5">V</a>.</h3> + +<h3><i>With the Production of new Vessels by external Membranes or Glands, +without Fever.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_5_1">1</a>. <i>Gonorrhœa venerea.</i> </td><td>Clap.</td></tr> +<tr><td> <a href="#species_II_1_5_2">2</a>. <i>Syphilis.</i></td><td>Venereal disease.</td></tr> +<tr><td> <a href="#species_II_1_5_3">3</a>. <i>Lepra.</i></td><td>Leprosy.</td></tr> +<tr><td> <a href="#species_II_1_5_4">4</a>. <i>Elephantiasis.</i></td><td>Elephantiasis.</td></tr> +<tr><td> <a href="#species_II_1_5_5">5</a>. <i>Framboesia.</i></td><td>Framboesia.</td></tr> +<tr><td> <a href="#species_II_1_5_6">6</a>. <i>Psora.</i></td><td>Itch.</td></tr> +<tr><td> <a href="#species_II_1_5_7">7</a>. <i>Psora ebriorum.</i></td><td>Itch of drunkards.</td></tr> +<tr><td> <a href="#species_II_1_5_8">8</a>. <i>Herpes.</i></td><td>Herpes.</td></tr> +<tr><td> <a href="#species_II_1_5_9">9</a>. <i>Zona ignea.</i></td><td>Shingles.</td></tr> +<tr><td><a href="#species_II_1_5_10">10</a>. <i>Annulus repens.</i></td><td>Ring-worm.</td></tr> +<tr><td><a href="#species_II_1_5_11">11</a>. <i>Tinea capitis.</i></td><td>Scald-head.</td></tr> +<tr><td><a href="#species_II_1_5_12">12</a>. <i>Crusta lactea.</i></td><td>Milk-crust.</td></tr> +<tr><td><a href="#species_II_1_5_13">13</a>. <i>Trichoma.</i></td><td>Plica polonica.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_6">VI</a>.</h3> + +<h3><i>With Fever consequent to the Production of new Vessels or Fluids.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_6_1">1</a>. <i>Febris sensitiva.</i></td><td>Sensitive fever.</td></tr> +<tr><td> <a href="#species_II_1_6_2">2</a>. —— <i>a pure <span class="correction" title="Original reads `clanso' (compare main text).">clauso</span>.</i></td><td>Fever from concealed matter.</td></tr> +<tr><td> <a href="#species_II_1_6_3">3</a>. —— <i>a vomica.</i></td><td>—— from vomica.</td></tr> +<tr><td> <a href="#species_II_1_6_4">4</a>. —— <i>ab empyemate.</i></td><td>—— from empyema.</td></tr> +<tr><td> <a href="#species_II_1_6_5">5</a>. —— <i>mesenterica.</i></td><td>—— mesenteric.</td></tr> +<tr><td> <a href="#species_II_1_6_6">6</a>. —— <i>a pure aerato.</i></td><td>—— from aerated matter.</td></tr> +<tr><td> <a href="#species_II_1_6_7">7</a>. —— <i>a phthisi.</i></td><td>—— from consumption.</td></tr> +<tr><td> <a href="#species_II_1_6_8">8</a>. —— <i>scrophulosa.</i></td><td>—— scrophulous.</td></tr> +<tr><td> <a href="#species_II_1_6_9">9</a>. —— <i>ischiadica.</i></td><td>—— from ischias.</td></tr> +<tr><td><a href="#species_II_1_6_10">10</a>. —— <i>arthropuodica.</i></td><td>—— from joint-evil.</td></tr> +<tr><td><a href="#species_II_1_6_11">11</a>. —— <i>a pure contagioso.</i></td><td>—— from contagious matter.</td></tr> +<tr><td><a href="#species_II_1_6_12">12</a>. —— <i>variolosa secundaria.</i> </td><td>—— secondary of small-pox.</td></tr> +<tr><td><a href="#species_II_1_6_13">13</a>. —— <i>carcinomatosa.</i></td><td>—— cancarous.</td></tr> +<tr><td><a href="#species_II_1_6_14">14</a>. —— <i>venerea.</i></td><td>—— venereal.</td></tr> +<tr><td><a href="#species_II_1_6_15">15</a>. —— <i>a sanie contagiosa.</i></td><td>—— from contagious sanies.</td></tr> +<tr><td><a href="#species_II_1_6_16">16</a>. —— <i>puerpera.</i></td><td>—— puerperal.</td></tr> +<tr><td><a href="#species_II_1_6_17">17</a>. —— <i>a sphacelo.</i></td><td>—— from sphacelus.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_1_7">VII</a>.</h3> + +<h3><i>With increased Action of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_II_1_7_1">1</a>. <i>Delirium febrile.</i></td><td>Delirium of fevers.</td></tr> +<tr><td> <a href="#species_II_1_7_2">2</a>. —— <i>maniacale.</i></td><td>—— maniacal.</td></tr> +<tr><td> <a href="#species_II_1_7_3">3</a>. —— <i>ebrietatis.</i></td><td>—— of drunkenness.</td></tr> +<tr><td> <a href="#species_II_1_7_4">4</a>. <i>Somnium.</i></td><td>Dreams.</td></tr> +<tr><td> <a href="#species_II_1_7_5">5</a>. <i>Hallucinatio visûs.</i></td><td>Deception of sight.</td></tr> +<tr><td> <a href="#species_II_1_7_6">6</a>. —— <i>auditus.</i></td><td>—— of hearing.</td></tr> +<tr><td> <a href="#species_II_1_7_7">7</a>. <i>Rubor a calore.</i></td><td>Blush from heat.</td></tr> +<tr><td> <a href="#species_II_1_7_8">8</a>. —— <i><span class="correction" title="Original reads `jucunditalis' (compare main text).">jucunditatis</span>.</i></td><td>—— from joy.</td></tr> +<tr><td> <a href="#species_II_1_7_9">9</a>. <i>Priapismus amatorius.</i> </td><td>Amorous priapism.</td></tr> +<tr><td><a href="#species_II_1_7_10">10</a>. <i>Distentio mamularum.</i></td><td>Distention of the nipples.</td></tr> +</table> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Sensation.</i></h3> + +<h3>GENUS <a name="genusi_II_2_1">I</a>.</h3> + +<h3><i>With decreased Action of the general System.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_II_2_1_1">1</a>. <i>Stultitia insensibilis.</i> </td><td>Folly from insensibility.</td></tr> +<tr><td><a href="#species_II_2_1_2">2</a>. <i>Tædium vitæ.</i></td><td>Irksomeness of life.</td></tr> +<tr><td><a href="#species_II_2_1_3">3</a>. <i>Paresis sensitiva.</i></td><td>Sensitive debility.</td></tr> +</table> + +<h3>GENUS <a name="genusi_II_2_2">II</a>.</h3> + +<h3><i>With decreased Actions of particular Organs.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_II_2_2_1">1</a>. <i>Anorexia.</i></td><td>Want of appetite.</td></tr> +<tr><td><a href="#species_II_2_2_2">2</a>. <i>Adipsia.</i></td><td>Want of thirst.</td></tr> +<tr><td><a href="#species_II_2_2_3">3</a>. <i>Impotentia.</i></td><td>Impotence.</td></tr> +<tr><td><a href="#species_II_2_2_4">4</a>. <i>Sterilitas.</i></td><td>Barrenness.</td></tr> +<tr><td><a href="#species_II_2_2_5">5</a>. <i>Insensibilitas artuum.</i> </td><td>Insensibility of the limbs.</td></tr> +<tr><td><a href="#species_II_2_2_6">6</a>. <i>Dysuria insensitiva.</i></td><td>Insensibility of the bladder.</td></tr> +<tr><td><a href="#species_II_2_2_7">7</a>. <i>Accumulatio alvina.</i></td><td>Accumulation of feces.</td></tr> +</table> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Sensitive Motions.</i></h3> + +<h3>GENUS <a name="genusi_II_3_1">I</a>.</h3> + +<h3><i>Of Excretory Ducts.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <i>Motus retrogressus</i> </td><td>Retrograde motion.</td></tr> +<tr><td><a href="#species_II_3_1_1">1</a>. —— <i>ureterum.</i></td><td>—— of the ureters.</td></tr> +<tr><td><a href="#species_II_3_1_2">2</a>. —— <i>urethræ.</i></td><td>—— of the urethra.</td></tr> +<tr><td><a href="#species_II_3_1_3">3</a>. —— <i>ductus choledoci.</i> </td><td>—— of the bile-duct.</td></tr> +</table> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>CLASS II.</h3> + +<p class="cenhead">DISEASES OF SENSATION.</p> + +<h3>ORDO <a name="ordo_II_1">I</a>.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_1">I</a>.</h3> + +<h3><i>With Increased Action of the Muscles.</i></h3> + + <p>The actions belonging to this genus are those which are immediately + excited by the sensations of pain or pleasure, but which are neither + followed by inflammation, nor by convulsion. The former of which belong + to the subsequent genera of this order, and the latter to the class of + voluntary motions.</p> + + <p>The criterion between the actions, which are the immediate consequence + of painful sensation, and convulsive actions properly so called, consists + in the former having a tendency to dislodge the stimulating cause, which + induces the painful sensation; and the latter being exerted for the + purpose of expending the sensorial power, and thus dulling or destroying + the general sensation of the system. See Class <a href="#ordo_III_1">III. + 1</a>.</p> + + <p>There is a degree of heat produced in the affected part by these + sensitive actions without inflammation, but in much less quantity than + when attended by inflammation; as in the latter there is a production of + new vessels. See Sect. XXXIII. 2. 3.</p> + + <p>Some of the species of this genus cannot properly be termed diseases + in their natural state, but become so by their defect or excess, and are + here inserted to facilitate the explanation of the others.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_1_1">1</a>. <i>Deglutitio.</i> Swallowing our + food is immediately caused by the pleasureable sensation occasioned by + its stimulus on the palate or fauces and is acquired long before the + nativity of the animal. Afterwards the pain of hunger previously produces + the various voluntary exertions to procure the proper material, but the + actions of masticating and of swallowing it are effected by the sensorial + power of sensation; which appears by their not being always controulable + by the will, as when children in vain attempt to swallow nauseous drugs. + See Class <a href="#species_IV_1_3_1">IV. 1. 3. 1</a>. The masticated + food stimulates the palate, which is an organ of sense, into so much + action, as to produce agreeable sensation; and the muscles subservient to + deglutition are brought into action by the sensation thus produced. The + pleasureable sensation is the proximate cause; the action of the fibres + of the extremities of the nerves of taste is the remote cause; the + sensorial power of irritation exciting these fibres of the nerves of + taste into increased action is the pre-remote cause; the action of the + muscles of deglutition is the proximate effect; the pushing the food into + the stomach is the remote effect; and the nutrition of the body is the + post-remote effect.</p> + + <p>Though the muscles subservient to deglutition have their actions + previously associated, so as to be excited into synchronous tribes or + successive trains, either by volition, as when we swallow a disagreeable + drug; or by sensation, as when we swallow agreeable food; or by + irritation, as when we inattentively swallow our saliva; yet do all those + three kinds of deglutition belong to the respective classes of volition, + sensation, and irritation; because the first links of these tribes or + trains of muscular action are excited by those sensorial powers, and the + associated links, which accompany or succeed them, are excited by the + combined powers either of volition, or of sensation, or of irritation, + along with that of association.</p> + + <p><a name="species_II_1_1_2">2</a>. <i>Respiratio.</i> Respiration is + immediately caused by the sensorial power of sensation in consequence of + the baneful want of vital air; and not from the accumulation of blood in + the lungs, as that might be carried on by inhaling azote alone, without + the oxygenous part of the atmosphere. The action of respiration is thus + similar to that of swallowing our food to appease the pain of hunger; but + the lungs being surrounded with air, their proper pabulum, no + intermediate voluntary exertions are required, as in hunger, to obtain + and prepare the wanted material.</p> + + <p>Respiration is similar to slow combustion; the oxygenous part of the + atmosphere is received through the moist membranes, which line the + air-cells of the lungs, and uniting with the inflammable part of the + blood generates an acid, probably the phosphoric acid; a portion of + carbonic acid is likewise produced in this process; as appears by + repeatedly breathing over lime-water, which then becomes turbid. See + Botanic Garden, P. I. Canto I. l. 401. note.</p> + + <p><a name="species_II_1_1_3">3</a>. <i>Sternutatio.</i> Sneezing + consists of muscular actions produced by the sensorial faculty of + sensation; and is an effort to dislodge, by means of air forcibly + impelled through the nostrils, some material; which stimulates the + membrane, which lines them, into too great action, and might thence + injure the sense of smell which is diffused on it.</p> + + <p>In this operation the too great action of the vessels of the membrane + of the nostrils is the remote cause; the sensation thence induced is the + proximate cause; and the muscular actions are the proximate effect.</p> + + <p>This action of sneezing frequently precedes common respiration in + new-born children, but I believe not always; as like the latter it cannot + have been previously acquired in the uterus.</p> + + <p>It is produced in some people by sudden light, as by looking up at the + sky in a morning, when they come out of a gloomy bed-chamber. It then + becomes an associate action, and belongs to Class <a + href="#species_IV_1_2_2">IV. 1. 2. 2</a>.</p> + + <p>M. M. When it is exerted to excess it may be cured by snuffing starch + up the nostrils. See Class <a href="#species_I_1_2_13">I. 1. 2. + 13</a>.</p> + + <p><a name="species_II_1_1_4">4</a>. <i>Anhelitus.</i> Panting. The quick + and laborious breathing of running people, who are not accustomed to + violent exercise, is occasioned by the too great conflux of blood to the + lungs. As the sanguiferous system, as well as the absorbent system, is + furnished in many parts of its course with valves, which in general + prevent the retrograde movement of their contained fluids; and as all + these vessels, in some part of their course, lie in contact with the + muscles, which are brought into action in running, it follows that the + blood must be accelerated by the intermitted swelling of the bellies of + the muscles moving over them.</p> + + <p>The difficulty of breathing, with which, very fat people are + immediately affected on exercise, is owing to the pressure of the + accumulated fat on the veins, arteries, and lymphatics; and which, by + distending the skin, occasions it to act as a tight bandage on the whole + surface of the body. Hence when the muscles are excited into quicker + action, the progress of the blood in the veins, and of the lymph and + chyle in the absorbent system, is urged on with much greater force, as + under an artificial bandage on a limb, explained in Art. <a + href="#art_IV_2_10">IV. 2. 10</a>. and in Sect. XXXIII. 3. 2. Hence the + circulation is instantly quickened to a great degree, and the difficulty + of breathing is the consequence of a more rapid circulation through the + lungs. The increased secretion of the perspirable matter is another + consequence of this rapid circulation; fat people, when at rest, are + believed to perspire less than others, which may be gathered from their + generally having more liquid stools, more and paler urine, and to their + frequently taking less food than many thin people; and lastly, from the + perspiration of fat people being generally more inodorous than that of + lean ones; but when corpulent people are put in motion, the sweat stands + in drops on their skins, and they "lard the ground" as they run. The + increase of heat of corpulent people on exercise, is another consequence + of their more rapid circulation, and greater secretion. See Class <a + href="#species_I_2_3_17">I. 2. 3. 17</a>.</p> + + <p>Other causes of difficult or quick respiration will be treated of + under Asthma, Pertussis, Peripneumony, Tonsillitis.</p> + + <p><a name="species_II_1_1_5">5</a>. <i>Tussis ebriorum.</i> Sensitive + cough is an exertion of the muscles used in expiration excited into more + violent action by the sensorial power of sensation, in consequence of + something which too powerfully stimulates the lungs. As the saline part + of the secreted mucus, when the absorption of it is impeded; or the too + great viscidity of it, when the absorption is increased; or the too great + quantity of the mucus, when the secretion is increased; or the + inflammation of the membranes of the lungs; it is an effort to dislodge + any of these extraneous materials.</p> + + <p>Of this kind is the cough which attends free-drinkers after a debauch; + it consists of many short efforts to cough, with a frequent expuition of + half a tea-spoonful of frothy mucus, and is attended with considerable + thirst. The thirst is occasioned by the previous dissipation of the + aqueous parts of the blood by sensible or insensible perspiration; which + was produced by the increased action of the cutaneous and pulmonary + capillaries during the stimulus of the wine. In consequence of this an + increased absorption commences to replace this moisture, and the skin and + mouth become dry, and the pulmonary mucus becomes inspissated; which + stimulates the bronchia, and is raised into froth by the successive + currents of air in evacuating it. This production of froth is called by + some free-drinkers "spitting sixpences" after a debauch. This subsequent + thirst, dry mouth, and viscid expectoration in some people succeeds the + slightest degree of intoxication, of which it may be esteemed a + criterion. See Class <a href="#species_IV_2_1_8">IV. 2. 1. 8</a>.</p> + + <p>As coughs are not always attended with pain, the muscular actions, + which produce them, are sometimes excited by the sensorial faculty of + irritation, as in Class <a href="#species_I_1_2_8">I. 1. 2. 8</a>. <a + href="#species_I_1_3_4">I. 1. 3. 4</a>. <a href="#species_I_1_4_3">I. 1. + 4. 3</a>. <a href="#species_I_2_3_4">I. 2. 3. 4</a>. Coughs are also + sometimes convulsive, as in Class <a href="#species_III_1_1_10">III. 1. + 1. 10</a>. and sometimes sympathetic, as Class <a + href="#species_IV_2_1_7">IV. 2. 1. 7</a>.</p> + + <p>M. M. Venesection, when the cough is attended with inflammation. + Mucilages. Opium. Torpentia. Blister.</p> + + <p><a name="species_II_1_1_6">6</a>. <i>Singultus.</i> Hiccough is an + exertion of the muscles used in inspiration excited into more violent + action by the sensorial power of sensation, in consequence of something + which too powerfully stimulates the cardia ventriculi, or upper orifice + of the stomach. As when solid food is too hastily taken without + sufficient dilution. And is an effort to dislodge that offensive + material, and push it to some less sensible part of the stomach, or into + the middle of the contained aliment.</p> + + <p>At the end of fatal fevers it may arise from the acrimony of the + undigested aliment, or from a part of the stomach being already dead, and + by its weight or coldness affecting the surviving part with disagreeable + sensation. The pain about the upper orifice of the stomach is the + proximate cause, the too great or too little action of the fibres of this + part of the stomach is the remote cause, the action of the muscles used + in inspiration is the proximate effect, and the repercussion of the + offending material is the remote effect.</p> + + <p>Hiccough is sometimes sympathetic, occasioned by the pain of gravel in + the kidney or ureter, as in Class <a href="#species_IV_1_1_7">IV. 1. 1. + 7</a>. and is sometimes a symptom of epilepsy or reverie, as in Sect. + XIX. 2.</p> + + <p>M. M. Oil of cinnamon from one drop gradually increased to ten, on + sugar, or on chalk. Opium. Blister. Emetic.</p> + + <p><a name="species_II_1_1_7">7</a>. <i>Asthma humorale.</i> The humoral + asthma probably consists in a temporary anasarca of the lungs, which may + be owing to a temporary defect of lymphatic absorption. Its cause is + nevertheless at present very obscure, since a temporary deficiency of + venous absorption, at the extremities of the pulmonary or bronchial + veins, might occasion a similar difficulty of respiration. See Abortio, + Class <a href="#species_I_2_1_14">I. 2. 1. 14</a>. Or it might be + supposed, that the lymph effused into the cavity of the chest might, by + some additional heat during sleep, acquire an aerial form, and thus + compress the lungs; and on this circumstance the relief, which these + patients receive from cold air, would be readily accounted for.</p> + + <p>The paroxysms attack the patient in his first sleep, when the + circulation through the lungs in weak people wants the assistance of the + voluntary power. Class <a href="#species_I_2_1_3">I. 2. 1. 3</a>. And + hence the absorbents of the lungs are less able to fulfil the whole of + their duty. And part of the thin mucus, which is secreted into the + air-cells, remains there unabsorbed, and occasions the difficult + respiration, which awakes the patient. And the violent exertions of the + muscles of respiration, which succeed, are excited by the pain of + suffocation, for the purpose of pushing forwards the blood through the + compressed capillaries, and to promote the absorption of the effused + lymph.</p> + + <p>In this the humoral differs from the convulsive asthma, treated of in + Class <a href="#species_III_1_1_10">III. 1. 1. 10</a>. as in that there + is probably no accumulated fluid to be absorbed; and the violent + respiration is only an exertion for the purpose of relieving pain, either + in the lungs or in some distant part, as in other convulsions, or + epilepsy; and in this respect the fits of humoral and convulsive asthma + essentially differ from each other, contrary to the opinion expressed + without sufficient consideration in Sect. XVIII. 15.</p> + + <p>The patients in the paroxysms both of humoral and convulsive asthma + find relief from cold air, as they generally rise out of bed, and open + the window, and put out their heads; for the lungs are not sensible to + cold, and the sense of suffocation is somewhat relieved by there being + more oxygen contained in a given quantity of cold fresh air, than in the + warm confined air of a close bed-chamber.</p> + + <p>I have seen humoral asthma terminate in confirmed anasarca, and + destroy the patient, who had been an excessive drinker of spirituous + potation. And M. Savage asserts, that this disease frequently terminates + in diabetes; which seems to shew, that it is a temporary dropsy relieved + by a great flow of urine. Add to this, that these paroxysms of the asthma + are themselves relieved by profuse sweats of the upper parts of the body, + as explained in Class <a href="#species_I_3_2_8">I. 3. 2. 8</a>. which + would countenance the idea of their being occasioned by congestions of + lymph in the lungs.</p> + + <p>The congestion of lymph in the lungs from the defective absorption of + it is probably the remote cause of humoral asthma; but the pain of + suffocation is the immediate cause of the violent exertions in the + paroxysms. And whether this congestion of lymph in the air-cells of the + lungs increases during our sleep, as above suggested, or not; the pain of + suffocation will be more and more distressing after some hours of sleep, + as the sensibility to internal stimuli increases during that time, as + described in Sect. XVIII. 15. For the same reason many epileptic fits, + and paroxysms of the gout, occur during sleep.</p> + + <p>In two gouty cases, complicated with jaundice, and pain, and sickness, + the patients had each of them a shivering fit, like the commencement of + an ague, to the great alarm of their friends; both which commenced in the + night, I suppose during their sleep; and the consequence was a cessation + of the jaundice, and pain about the stomach, and sickness; and instead of + that the gout appeared in their extremities. In these cases I conjecture, + that there was a metastasis not only of the diseased action from the + membranes of the liver to those of the foot; but that some of the new + vessels, or new fluids, which were previously produced in the inflamed + liver, were translated to the feet during the cold fit, by the increased + absorption of the hepatic lymphatics, and by the retrograde motions of + those of the affected limbs.</p> + + <p>This I think resembles in some respects a fit of humoral asthma, where + stronger motions of the absorbent vessels of the lungs are excited, and + retrograde ones of the correspondent cutaneous lymphatics; whence the + violent sweats of the upper parts of the body only are produced; and for + a time the patient becomes relieved by the metastasis and elimination of + the offending material by sensitive exertion. For a further account of + this intricate subject see Class <a href="#species_III_1_1_10">III. 1. 1. + 10</a>.</p> + + <p>M. M. To relieve the paroxysm a tea-spoonful of ether may be given + mixed with water, with 10 drops of laudanum, to be repeated three or four + times. Venesection. An emetic. A blister. Afterwards the Peruvian bark, + with a grain of opium at night, and two or three of aloes. A flannel + shirt in winter, but not in summer. Issues. Digitalis?</p> + + <p>In this species of asthma, there is great reason to believe, that the + respiration of an atmosphere, with an increased proportion of oxygen, + will prove of great advantage; some well-observed and well-attested cases + of which are published by Dr. Beddoes; as this purer air invigorates the + circulation, and the whole system in consequence, perhaps not only by its + stimulus, but by its supplying the material from which the sensorial + power is extracted or fabricated. In spasmodic asthma, on the contrary, + Dr. Ferriar has found undoubted benefit from an atmosphere mixed with + hydrogen. See Sect. XVIII. 15. and Class <a + href="#species_III_1_1_10">III. 1. 1. 10</a>.</p> + + <p><a name="species_II_1_1_8">8</a>. <i>Nictitatio sensitiva.</i> Winking + of the eyes is performed every minute, without our attention, for the + purpose of diffusing the tears over them, which are poured into the eye a + little above the external corner of it, and which are afterwards absorbed + by the lacrymal points above and below the internal corner of it. When + this operation is performed without our attention, it is caused by the + faculty of irritation, and belongs to Class <a href="#species_I_1_4_1">I. + 1. 4. 1</a>. but when it is produced by a stronger stimulus of any + extraneous material in the eye, so as to cause pain, the violent and + frequent nictitation is caused by the faculty of sensation.</p> + + <p>This disease is sometimes produced by the introversion of the edge of + the lower eyelid, which bends the points of the hairs of the eyelash upon + the ball of the eye, which perpetually stimulate it into painful + sensation. This introversion of the eyelid is generally owing to a tumor + of the cellular membrane below the edge of the eyelid, and though a very + troublesome complaint may often be cured by the following simple means. A + little common plaster spread on thin linen, about a quarter of an inch + long, must be rolled up so as to be about the size of a crow-quill, this + must be applied immediately below the eyelash on the outside of the eye; + and must be kept on by another plaster over it. This will then act as a + slight compression on the tumor under the eyelash, and will prevent the + hairs from touching the eye-ball. In a week or two the compression will + diminish the tumor it lies over, and cure this painful deformity.</p> + + <p><a name="species_II_1_1_9">9</a>. <i>Oscitatio et pandiculatio.</i> + Yawning and stretching of the limbs is produced either by a long + inactivity of the muscles now brought into action, as sometimes happens + after sleep, or after listening a long time to a dull narrative; or it is + produced by a too long continued action of the antagonist muscles. In the + former case there is an accumulation of sensorial power during the + quiescence of the muscles now brought into action; which probably + constitutes the pain or wearisomeness of a continued attitude. In the + latter case there is an exhaustion of sensorial power in the muscles, + which have lately been acting violently, and a consequent accumulation in + the muscles, which are antagonists to them, and which were at rest.</p> + + <p>These involuntary motions are often seen in paralytic limbs, which are + at the same time completely disobedient to the will; and are frequently + observable in very young children; and from thence we may conclude, that + these motions are learnt before nativity; as puppies are seen to open + their mouths before the membranes are broken. See Sect. XVI. 2.</p> + + <p>Where these motions are observed in limbs otherwise paralytic, it is + an indication that electric shocks may be employed with advantage, as the + excitability of the limb by irritation is not extinct, though it be + disobedient both to volition and sensation.</p> + + <p><a name="species_II_1_1_10">10</a>. <i>Tenesmus</i> consists in + violent and frequent ineffectual efforts to discharge the contents of the + rectum, owing to pain of the sphincter. The pain is produced by indurated + feces, or by some acrid material, as the acidity of indigested aliment; + and the efforts are attended with mucus from the pained membrane. The + feces must sometimes be taken away by the end of a marrow-spoon, as + cathartics and even clyster will pass without removing them. It is + sometimes caused by sympathy with the urethra, when there is a stone at + the neck of the bladder. See Class <a href="#species_II_2_2_7">II. 2. 2. + 7</a>. and <a href="#species_IV_1_2_8">IV. 1. 2. 8</a>.</p> + + <p>M. M. Fomentation, an enema with mucilage and laudanum.</p> + + <p>The common exclusion of the feces from the rectum is a process similar + to this, except that the muscles of the sphincter ani, and those of the + abdomen, which act along with them by the combined powers of sensation + and association, are in tenesmus excited by painful sensation, and in the + latter by a sensation, which may in some instances be almost called + pleasurable, as relieving us from a painful one in the exclusion of the + feces.</p> + + <p><a name="species_II_1_1_11">11</a>. <i>Stranguria.</i> Strangury + consists in painful efforts to discharge the contents of the urinary + bladder. It is generally owing to a stone in the sphincter of the + bladder; or to the inflammation of the neck of it occasioned by + cantharides. It is sometimes caused by sympathy with the piles; and then + is liable in women to occasion convulsions, from the violence of the pain + without inflammation. See Class <a href="#species_IV_2_2_2">IV. 2. 2. + 2</a>. and <a href="#species_IV_2_2_3">3</a>.</p> + + <p>M. M. Fomentation clyster with oil and laudanum, push the stone back + with a bougie; if from cantharides give half a pint of warm water every + ten minutes. Mucilage of gum arabic and tragacanth.</p> + + <p>The natural evacuation of the urine is a process similar to this, + except that the muscular fibres of the bladder, and the muscles of the + abdomen, which act in concert with them by the combined powers of + sensation and of association, are, in the former case of strangury, + excited into action by painful sensation; and in the latter by a + sensation, which may almost be termed pleasurable, as it relieves us from + a previous uneasy one.</p> + + <p>The ejectio feminis is another process in some respects similar to + strangury, as belonging to the same sensible canal of the urethra, and by + exciting into action the accelerator muscles; but in the strangury these + muscles are excited into action by painful sensation, and in the ejection + of the semen by pleasureable sensation.</p> + + <p><a name="species_II_1_1_12">12</a>. <i>Parturitio.</i> Parturition is + not a disease, it is a natural process, but is more frequently + unfortunate in high life than amongst the middle class of females; which + may be owing partly to fear, with which the priests of <span + class="sc">Lucina</span> are liable to inspire the ladies of fashion to + induce them to lie in in town; and partly to the bad air of London, to + which they purposely resort.</p> + + <p>There are however other causes, which render parturition more + dangerous to the ladies of high life; such as their greater general + debility from neglect of energetic exercise, their inexperience of the + variations of cold and heat, and their seclusion from fresh air. To which + must be added, that great source of the destruction of female grace and + beauty, as well as of female health, the tight stays, and other bandages, + with which they are generally tortured in their early years by the active + folly of their friends, which by displacing many of the viscera impedes + their actions, and by compressing them together produces adhesions of one + part to another, and affects even the form and aperture of the bones of + the pelvis, through which the nascent child must be protruded.</p> + + <p>As parturition is a natural, not a morbid process, no medicine should + be given, where there is no appearance of disease. The absurd custom of + giving a powerful opiate without indication to all women, as soon as they + are delivered, is, I make no doubt, frequently attended with injurious, + and sometimes with fatal consequences. See Class <a + href="#species_II_1_2_16">II. 1. 2. 16</a>.</p> + + <p>Another thing very injurious to the child, is the tying and cutting + the navel-string too soon; which should always be left till the child has + not only repeatedly breathed, but till all pulsation in the cord ceases. + As otherwise the child is much weaker than it ought to be; a part of the + blood being left in the placenta, which ought to have been in the child; + and at the same time the placenta does not so naturally collapse, and + withdraw itself from the sides of the uterus, and is not therefore + removed with so much safety and certainty. The folly of giving rue or + rhubarb to new-born children, and the danger of feeding them with gruel + instead of milk, is spoken of in Class <a href="#species_I_1_2_5">I. 1. + 2. 5</a>. and <a href="#species_II_1_2_16">II. 1. 2. 16</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_2">II</a>.</h3> + +<h3><i>With the Production of new Vessels by internal Membranes or Glands, +with Fever.</i></h3> + + <p>In the first class of diseases two kinds of fevers were described, one + from excess, and the other from defect of irritation; and were in + consequence termed irritative, and inirritative fevers. In this second + class of diseases another kind of fever occurs, which is caused by excess + of sensation, and termed in consequence Sensitive Fever. But there is no + fever from defect of sensation, because the circulation is carried on in + health without our consciousness, that is, without any sensation + attending it.</p> + + <p>But as excess of sensation may exist with excess or defect of + irritation, two other kinds of fever arise from a combination of + sensitive fever with the irritative, and inirritative ones. Making five + kinds in all.</p> + + <p>1. Irritative fever, described in Class <a href="#species_I_1_1_1">I. + 1. 1. 1</a>.</p> + + <p>2. Inirritative fever. Class <a href="#species_I_2_1_1">I. 2. 1. + 1</a>.</p> + + <p>3. Sensitive fever. Class <a href="#species_II_1_6_1">II. 1. 6. + 1</a>.</p> + + <p>4. Sensitive irritated fever. Class <a href="#species_II_1_2_1">II. 1. + 2. 1</a>.</p> + + <p>5. Sensitive inirritated fever. Class <a href="#species_II_1_3_1">II. + 1. 3. 1</a>.</p> + + <p>As the sensitive irritated fever attends all the diseases enumerated + under the genus about to be described, it is placed at the head of it. + And as the sensitive inirritated fever accompanies the greatest number of + the species enumerated under the third genus of this order, it is placed + at the head of them. And as the sensitive fever attends the diseases of + the sixth genus, it is placed at the head of them. But as every febrile + paroxysm consists of disordered tribes or trains of associated motions, + it may be doubted, whether they ought not all to have been placed in the + fourth class, amongst the diseases of association. See Class <a + href="#species_IV_2_4_11">IV. 2. 4. 11</a>.</p> + + <p>All the subsequent species of this genus are attended with sensitive + irritated fever; there are nevertheless some superficial inflammations, + which affect the same situations without much fever, as the scrophulous + ophthalmy and spurious peripneumony, which belong to other genera.</p> + + <p>Inflammation is uniformly attended with the production or secretion of + new fibres constituting new vessels; this therefore may be esteemed its + essential character, or the criterion of its existence. The extension of + the old vessels seems rather a consequence than a cause of the + germination, or pullulation, of these new ones; for the old vessels may + be enlarged, and excited with unusual energy, without any production of + new ones, as in the blush of shame or of anger.</p> + + <p>When these new vessels are formed, if they are not reabsorbed into the + circulation, they secrete a new fluid called purulent matter; which + generally opens itself a passage on the external skin, and produces an + ulcer, which either gradually heals, or spreads, and is the cause of + hectic fever; or they secrete contagious matter, which has the property + of exciting the same kind of inflammation, and of producing the same kind + of contagious matter, when inserted by inoculation into the skin of other + persons. These contagious matters form ulcers, which either heal + spontaneously, or by art; or continue to spread, and destroy the patient, + by other kinds of hectic fever.</p> + + <p>In this genus there is an increase of the sensorial power of + irritation as well as of sensation; whence great arterial energy is + produced, and the pulse becomes strong and full, as well as quick; and + the coats of the arteries feel hard under the finger, being themselves + thickened and distended by inflammation. The blood drawn, especially at + the second bleeding, is covered with a tough size; which is probably the + mucus from the inflamed internal surface of the arteries, increased in + quantity, and more coagulable than in its natural state; the thinner part + being more perfectly absorbed by the increased action of the inflamed + absorbents. See Sect. XXXIII. 2. 2. This is rendered more probable, + because the hard feel of the pulse, and the abundance of coagulable lymph + commence, exist, and cease together.</p> + + <p>Great heat is produced from the new chemical combinations arising in + the secretion of new fibres, and great pain from the distention of old + ones, or from their increased action. The increased quantity of sensation + from a topical inflammation or phlegmon is the immediate cause of the + febris sensitiva irritata, or inflammatory fever; as when it arises from + the pain of pleurisy, or paronychia; but generally an irritative fever + precedes this topical inflammation, which occurs during the hot fit of + it; and then the irritative fever is changed into a sensitive irritated + fever, by the additional cause of the sensorial power of sensation + besides that of irritation.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_2_1">1</a>. <i>Febris sensitiva irritata.</i> + Sensitive irritated fever, or inflammatory fever. Phlegmasia. A strong + full pulse, with inflammation of the coats of the arteries, constitutes + this disease. It originates from some topical inflammation, which, if the + fever is not subdued, terminates in suppuration; and differs from + irritative fever in respect to the painful sensation which accompanies + it. For as pleasurable sensation is the cause of the growth of the new + vessels, and distention of the old ones, in the natural enlargement of + the body during our infancy; so a painful sensation is the cause of the + unnatural production of new vessels, and enlargement of old ones in + inflammatory diseases.</p> + + <p>When matter is thus formed in any internal viscus, or in the cellular + membrane, as in the lungs or liver; so long as this abscess remains + without admission of air, this inflammatory fever is liable to continue, + receiving only temporary relief by bleeding or emetics, or cathartics; + till the patient, after a month, or two, or three, expires. But, if air + be admitted to these internal abscesses, this kind of fever is changed + into a hectic fever in a single day. It also sometimes happens, that when + the abscess remains unopened to the air, if the matter has become putrid, + that hectic fever supervenes, with colliquative sweats, or + diarrhœa; the matter in both cases is sometimes absorbed, and the + sides of the abscess grow together again without an external aperture. + See Class <a href="#species_II_1_4_1">II. 1. 4. 1</a>. and <a + href="#species_II_1_4_2">2</a>. Another termination of inflammation is in + gangrene, but this belongs to the inflammation of the external skin; as + the production of purulent matter belongs to inflammation of the internal + or mucous membranes. Thus when the external skin is the seat of + inflammation, as in erythema, or erysipelas, and produces sensitive + irritated fever, no collection of purulent matter can be formed; but a + material oozes out, and lies upon the surface, like that in the confluent + small-pox, and the cuticle at length peels off, or gangrene supervenes. + It must be noted, that these kinds of inflammation can exist together; + and some parts of the cellular membrane may suppurate at the same time + that the external skin is affected with erythema, or erysipelas.</p> + + <p>M. M. Venesection. Cathartics. Diluents. Cool air. Torpentia. Cold + Bath? See Sect. XII. 6.</p> + + <p>The increased arterial action in this sensitive irritated fever is not + simply owing to the increased irritability of the arterial system, or to + the stimulus of the distention of the vessels, but also to the increased + acrimony or pungency of the blood; which has now so far changed its + nature as to become more fluid, more dense, and to be loaded with + coagulable lymph. Hence it becomes necessary not only to lessen the + quantity of blood by venesection and by cathartics, but also to dilute + its acrimony, or pungency, by the introduction of aqueous and + mucilaginous fluids, such as barley water, cream and water, sugar and + water, weak broths; to which may be added so much of some vegetable + essential oil, as may render them grateful to the stomach, and thus + promote their absorption, as by infusing parsley or cellery and turneps + in the broth; or by balm, mint, or sage teas.</p> + + <p>The following species of this genus only distinguish the situation of + the part previously inflamed, and which is the remote cause of the + sensitive irritated, or inflammatory fever, which attends it.</p> + + <p><a name="species_II_1_2_2">2</a>. <i>Ophthalmia interna.</i> + Inflammation of the eye is attended with the production of new vessels, + which spread over the tunica adjunctiva, and over the cornea; these new + vessels are easily seen, as they lie on a white ground, and give ocular + demonstration of their production in inflammation. When this inflammation + of the cornea suppurates, it is liable to leave little ulcers, which may + be seen beneath the surface in the form of little excavations; and as + these heal, they are liable to be covered with an opake scar. This scar, + in some months or years, is liable to wear away, and become transparent, + without the assistance of any polishing powder, as of very finely + levigated glass, as some have recommended. But when the cornea is + affected through all its thickness, the return of its transparency + becomes hopeless. See Class <a href="#species_I_1_3_14">I. 1. 3. + 14</a>.</p> + + <p>In violent degrees of ophthalmy the internal parts, as the retina, + optic artery, iris, ciliary process, become inflamed, as well as the + external ones; hence the least light admitted to the eye occasions + intolerable pain. This curious circumstance cannot be owing to the action + of light on the inflamed vessels of the cornea; it therefore shews, that + the extremity of the optic nerve or retina is also rendered more + exquisitely sensible to light, by partaking of the inflammation; and I + have been told, that red colours are in these cases sometimes painfully + perceived even in perfect darkness. This shews that the retina is excited + into motion by the stimulus of light; and that, when it is inflamed, + these motions give great pain, like those of other inflamed parts, as the + muscles, or membranes. And secondly, that the ideas of colours consist in + the motions of the retina; which ideas occasion pain, when the extremity + of the moving nerve is inflamed.</p> + + <p>M. M. Venesection. Cathartics. Diluents. Torpentia. Frequently moisten + the eye with cold water by means of a rag. Cool airy room. Darkness. When + the inflammation begins to decline, white vitriol gr. vi. in an ounce of + water is more efficacious to moisten the eye than solutions of lead. + Tincture of opium diluted. New vessels from the inflamed tunica adnata + frequently spread like a fly's wing upon the transparent cornea, which is + then called Pterigium. To stop the growth of this, the principal vessels + should be cut through with a lancet. When the inflammation begins to + decline, after due evacuation any stimulating material put into the eye + increases the absorption, which soon removes the new red vessels; which + has given rise to a hundred famous eye-waters, and eye-doctors; if these + stimulating materials are used too soon, the inflammation is increased by + them. See Sect. XXXII. 2. 10.</p> + + <p>There is another ophthalmia, which attends weak children, and is + generally esteemed a symptom of scrophula, as described in Class <span + class="correction" title="Original reads `II. 1. 5. 3.'."><a + href="#species_II_1_4_1">II. 1. 4. 1</a></span>. and another, which is of + venereal origin, mentioned in Class <a href="#species_II_1_5_2">II. 1. 5. + 2</a>. both which may be termed ophthalmia superficialis.</p> + + <p><a name="species_II_1_2_3">3</a>. <i>Phrenitis.</i> Inflammation of + the brain is attended with intolerance of light and sound; which shews, + that the extremities of the nerves of those senses are at the same time + inflamed; it is also attended with great pain of the head, with + watchfulness, and furious delirium. The violent efforts, these patients + are said sometimes to exert, are owing to the increased secretion of + sensorial power in the brain; as all other inflamed glands have a greater + circulation of blood passing through them, and a greater secretion in + consequence of their peculiar fluids, as in the hepatitis much more bile + is generated.</p> + + <p>M. M. Venesection. Cathartics. Torpentia. Foment the head with cold + water for hours together. Or with warm water. Cool airy room. Afterwards + cupping on the occiput. Leeches to the temples. When the patient is + weakened a blister on the head, and after further exhaustion five or six + drops of tincture of opium.</p> + + <p><a name="species_II_1_2_4">4</a>. <i>Peripneumonia.</i> Inflammation + of the lungs. The pulse is not always hard, sometimes soft; which is + probably owing to a degree of sickness or inaction of the stomach; with + dull pain of the chest; respiration constantly difficult, sometimes with + erect posture; the face bloated and purplish; cough generally with moist + expectoration, often stained with blood.</p> + + <p>When the difficulty of respiration is very great, the patient is not + able to cough; in this situation, after copious bleeding, the cough is + liable to return, and is so far a favourable symptom, as it shews some + abatement of the inflammation.</p> + + <p>A peripneumony frequently occurs in the chin-cough, and destroys the + patient, except immediate recourse be had to the lancet, or to four or + five leeches; when blood cannot be otherwise taken.</p> + + <p>The peripneumony is very fatal to young children, especially as I + believe it is frequently mistaken for a spasmodic asthma, or for the + croup, or cynanche trachealis of Cullen. Both which, however, when they + occur, require immediate venesection by the lancet or by leeches, as well + as the peripneumony.</p> + + <p>The croup is an inflammation of the upper part, and the peripneumony + of the lower part of the same organ, viz. the trachea or windpipe. See + Class <a href="#species_I_1_3_4">I. 1. 3. 4</a>. But as the inflammation + is seldom I suppose confined to the upper part of the trachea only, but + exists at the same time in other parts of the lungs, and as no + inflammation of the tonsils is generally perceptible, the uncouth name of + cynanche trachealis should be changed for <i>peripneumonia + trachialis</i>. The method of cure consists in immediate and repeated + bleeding. A vomit. A grain of calomel or other mild cathartic. Bathing in + subtepid water, and in breathing over the steam of warm water, with or + without a little vinegar in it. And lastly, by keeping the child raised + high in bed. <a name="Page_197_after_line_8"></a></p> + + <p>Inflammation of the lungs is also liable to occur in the measles, and + must be attacked by venesection at any time of the disease; otherwise + either a present death, or an incurable consumption, is the + consequence.</p> + + <p>The peripneumony is frequently combined with inflammation of the + pleura, and sometimes with that of the diaphragm; either of these may + generally be distinguished, not only by the pain which attends + inflammation of these membranes, but by inspecting the naked chest, and + observing whether the patient breathes more by elevating the ribs, or by + depressing the diaphragm.</p> + + <p>A crisis happens in children about the sixth day with much pale urine, + which must be waited for after evacuations have been used, as far as can + be done with safety; in this situation the warm bath twice a day, and + small blisters repeatedly in succession, are of peculiar service.</p> + + <p>After the termination of peripneumony a collection of coagulable lymph + is frequently left in the cavity of the chest unabsorbed; or a common + anasarca of the lungs occurs from the present inaction of the absorbent + vessels, which had previously been excited too violently. This difficulty + of breathing is cured or relieved by the exhibition of digitalis. See + Art. <a href="#art_IV_2_8">IV. 2. 8</a>.</p> + + <p>M. M. The lancet is the anchor of hope in this disease; which must be + repeated four or five times, or as often as the fever and difficulty of + breathing increase, which is generally in the evening; antimonials, + diluents, repeated small blisters about the chest, mucilage, pediluvium, + warm bath. Is a decoction of seneka-root of use? Do not neutral salts + increase the tendency to cough by their stimulus, as they increase the + heat of urine in gonorrhœa? Children in every kind of difficult + breathing, from whatever cause, should be kept as upright in bed as may + be, and continually watched; since, if they slip down, they are liable to + be immediately suffocated. After the patient is greatly debilitated, so + that no further evacuation can be admitted, and the difficult breathing + and cough continue, I have given four or five drops of tincture of opium, + that is, about a quarter of a grain of solid opium, with great advantage, + and I believe in several cases I have saved the patient. A greater + quantity of opium in this state of debility cannot be used without + hazarding the life of the person. This small quantity of an opiate should + be given about six in the evening, or before the access of the evening + paroxysm, and repeated three or four nights, or longer.</p> + + <p>There is a peripneumony with weak pulse, which may be termed + <i>peripneumonia inirritata</i>, as described in Sect. XXVII. 2. which + belongs to this place. See also Superficial Peripneumony, Class <a + href="#species_II_1_3_7">II. 1. 3. 7</a>.</p> + + <p><a name="species_II_1_2_5">5</a>. <i>Pleuritis.</i> Pleurisy. + Inflammation of the pleura, with hard pulse, pain chiefly of the side, + pungent, particularly increased during inspiration; lying on either side + uneasy, the cough very painful, dry at the beginning, afterwards moist, + often bloody.</p> + + <p>One cause of pleurisy is probably a previous adhesion of the lungs to + a part of the pleura, which envelops them. This in many cases has been + produced in infancy, by suffering children to lie too long on one side. + Or by placing them uniformly on one side of a fire, or window, to which + they will be liable always to bend themselves.</p> + + <p>When matter is produced during peripneumony or pleurisy in one side of + the chest, so long as it is a concealed vomica, the fever continues, if + the disease be great, for many weeks, and even months; and requires + occasional venesection, till the patient sinks under the inflammatory or + sensitive irritated fever. But if air be admitted, by a part of the + abscess opening itself a way into the air-vessels of the lungs, a hectic + fever, with colliquitive sweats or diarrhœa, supervenes, and + frequently destroys the patient; or the abscess heals the lungs adhering + to the pleura.</p> + + <p>M. M. The lancet must be used copiously, and repeated as often as the + pain and difficult respiration increase. A blister on the pained part. + Antimonial preparations. Diluents. Cool air. Do neutral salts increase + the tendency to cough? Pediluvium or semicupium frequently repeated.</p> + + <p><a name="species_II_1_2_6">6</a>. <i>Diaphragmitis.</i> Inflammation + of the diaphragm. Pain round the lower ribs as if girt with a cord. + Difficult respiration performed only by elevating the ribs and in an + erect posture. The corners of the mouth frequently retracted into a + disagreeable smile, called risus Sardonicus.</p> + + <p>Those animals, which are furnished with clavicles, or collar-bones, + not only use their foremost feet as hands, as men, monkies, cats, mice, + squirrels, &c. but elevate their ribs in respiration as well as + depress the diaphragm for the purpose of enlarging the cavity of the + chest. Hence an inflammation of the diaphragm is sudden death to those + animals, as horses and dogs, which can only breaths by depressing the + diaphragm; and is I suppose the cause of the sudden death of horses that + are over-worked; whereas, in the human animal, when the diaphragm is + inflamed, so as to render its motions impossible from the pain they + occasion, respiration can be carried on, though in a less perfect manner, + by the intercostal muscles in the elevation of the ribs. In pleurisy the + ribs are kept motionless, and the respiration is performed by the + diaphragm, as may be readily seen on inspecting the naked chest, and + which is generally a bad symptom; in the diaphragmitis the ribs are + alternately elevated, and depressed, but the lower part of the belly is + not seen to move.</p> + + <p>M. M. As in pleurisy and peripneumony. When the patient becomes + delirious, and smiles disagreeably by intervals, and is become so weak, + that evacuations by the lancet could be used no further, and I have + almost despaired of my patient, I have found in two or three instances, + that about five or six drops of tinct. thebaic, given an hour before the + evening exacerbation, has had the happiest effect, and cured the patient + in this case, as well as in common peripneumony; it must be repeated two + or three evenings, see Class <a href="#species_II_1_2_4">II. 1. 2. 4</a>. + as the exacerbation of the fever and difficult respiration and delirium + generally increase towards night.</p> + + <p>The stimulus of this small quantity of opium on a patient previously + so much debilitated, acts by increasing the exertion of the absorbent + vessels, in the same manner as a solution of opium, or any other + stimulant, put on an inflamed eye after the vessels are previously + emptied by evacuations, stimulates the absorbent system, so as to cause + the remaining new vessels to be immediately reabsorbed. Which same + stimulants would have increased the inflammation, if they had been + applied before the evacuations. See Class <a href="#species_II_1_2_2">II. + 1. 2. 2</a>. Sect. XXXIII. 3. 1. When the sanguiferous system is full of + blood, the absorbents cannot act so powerfully, as the progress of their + contents is opposed by the previous fulness of the blood-vessels; whence + stimulants in that case increase the action of the secerning system more + than of the absorbent one; but after copious evacuation this resistance + to the progress of the absorbed fluids is removed; and when stimulants + are then applied, they increase the action of the absorbent system more + than that of the secerning one. Hence opium given in the commencement of + inflammatory diseases destroys the patient; and cures them, if given in + very small doses at the end of inflammatory diseases.</p> + + <p><a name="species_II_1_2_7">7</a>. <i>Carditis.</i> Inflammation of the + heart is attended with unequal intermitting pulse, palpitation, pain in + the middle of the sternum, and constant vomiting. It cannot certainly be + distinguished from peripneumony, and is perhaps always combined with + it.</p> + + <p><a name="species_II_1_2_8">8</a>. <i>Peritonitis.</i> Inflammation of + the peritonæum is known by pain all over the abdomen, which is increased + on erecting the body. It has probably most frequently a rheumatic origin. + See Class <a href="#species_II_1_2_17">II. 1. 2. 17</a>.</p> + + <p><a name="species_II_1_2_9">9</a>. <i>Mesenteritis.</i> Inflammation of + the mesentery is attended with pains like colic, and with curdled or + chyle-like stools. It is a very frequent and dangerous disease, as the + production of matter more readily takes place in it than in any other + viscus. The consequence of which, after a hard labour, is probably the + puerperal fever, and in scrophulous habits a fatal purulent fever, or + hopeless consumption.</p> + + <p>M. M. Venesection. Warm bath. Emollient clysters.</p> + + <p><a name="species_II_1_2_10">10</a>. <i>Gastritis.</i> In inflammation + of the stomach the pulse is generally soft, probably occasioned by the + sickness which attends it. The pain and heat of the stomach is increased + by whatever is swallowed, with immediate rejection of it. Hiccough.</p> + + <p>This disease may be occasioned by acrid or indigestible matters taken + into the stomach, which may chemically or mechanically injure its + interior coat. There is however a slighter species of inflammation of + this viscus, and perhaps of all others, which is unattended by much + fever; and which is sometimes induced by drinking cold water, or eating + cold insipid food, as raw turnips, when the person has been much heated + and fatigued by exercise. For when the sensorial power has been + diminished by great exertion, and the stomach has become less irritable + by having been previously stimulated by much heat, it sooner becomes + quiescent by the application of cold. In consequence of this slight + inflammation of the stomach an eruption of the face frequently ensues by + the sensitive association of this viscus with the skin, which is called a + surfeit. See Class <a href="#species_IV_1_2_13">IV. 1. 2. 13</a>. and <a + href="#species_II_1_4_6">II. 1. 4. 6</a>. and <a + href="#species_II_1_3_19">II. 1. 3. 19</a>.</p> + + <p>M. M. Venesection. Warm bath. Blister. Anodyne clysters. Almond soap. + See Class <a href="#species_II_1_3_17">II. 1. 3. 17</a>.</p> + + <p><a name="species_II_1_2_11">11</a>. <i>Enteritis.</i> Inflammation of + the bowels is often attended with soft pulse, probably owing to the + concomitant sickness; which prevents sometimes the early use of the + lancet, to the destruction of the patient. At other times it is attended + with strong and full pulse like other inflammations of internal + membranes. Can the seat of the disease being higher or lower in the + intestinal canal, that is, above or below the valve of the colon, produce + this difference of pulse by the greater sympathy of one part of the + bowels with the stomach than another? In enteritis with strong pulse the + pain is great about the navel, with vomiting, and the greatest difficulty + in procuring a stool. In the other, the pain and fever is less, without + vomiting, and with diarrhœa. Whence it appears, that the enteritis + with hard quick pulse differs from Ileus, described in Class <a + href="#species_I_3_1_6">I. 3. 1. 6</a>. only in the existence of fever in + the former and not the latter, the other symptoms generally + corresponding; and, secondly, that the enteritis with softer quick pulse, + differs from the cholera described in Class <a href="#species_I_3_1_5">I. + 3. 1. 5</a>. only in the existence of fever in the former, and not the + latter, the other symptoms being in general similar. See Class <a + href="#species_II_1_3_20">II. 1. 3. 20</a>.</p> + + <p>Inflammation of the bowels sometimes is owing to extraneous + indigestible substances, as plum-stones, especially of the damasin, which + has sharp ends. Sometimes to an introsusception of one part of the + intestine into another, and very frequently to a strangulated hernia or + rupture. In respect to the first, I knew an instance where a damasin + stone, after a long period of time, found its way out of the body near + the groin. I knew another child, who vomited some damasin stones, which + had lain for near twenty hours, and given great pain about the navel, by + the exhibition of an emetic given in repeated doses for about an hour. + The swallowing of plum-stones in large quantities, and even of + cherry-stones, is annually fatal to many children. In respect to the + introsusception and hernia, see Ileus, Class <a + href="#species_I_3_1_6">I. 3. 1. 6</a>.</p> + + <p>M. M. Repeated venesection. Calomel from ten to twenty grains given in + small pills as in Ileus; these means used early in the disease generally + succeed. After these evacuations a blister contributes to stop the + vomiting. Warm bath. Crude mercury. Aloes one grain-pill every hour will + frequently stay in the stomach. Glauber's salt dissolved in pepper-mint + water given by repeated spoonfuls.</p> + + <p>When the patient is much reduced, opium in very small doses may be + given, as a quarter of a grain, as recommended in pleurisy. If the pain + suddenly ceases, and the patient continues to vomit up whatever is given + him, it is generally fatal; as it indicates, that a mortification of the + bowel is already formed. Some authors have advised to join cathartic + medicines with an opiate in inflammation of the bowels, as recommended in + colica saturnina. This may succeed in slighter cases, but is a dangerous + practice in general; since, if the obstruction be not removed by the + evacuation, the stimulus of the opium is liable to increase the action of + the vessels, and produce mortification of the bowel, as I think I have + seen more than once.</p> + + <p><a name="species_II_1_2_12">12</a>. <i>Hepatitis.</i> Inflammation of + the liver is attended with strong quick pulse; tension and pain of the + right side; often pungent as in pleurisy, oftner dull. A pain is said to + affect the clavicle, and top of the right shoulder; with difficulty in + lying on the left side; difficult respiration; dry cough; vomiting; + hiccough.</p> + + <p>There is another hepatitis mentioned by authors, in which the fever, + and other symptoms, are wanting, or are less violent; as described in + Class <span class="correction" title="Original reads `II. 1. 4. 11.'."><a + href="#species_II_1_4_12">II. 1. 4. 12</a></span>. and which is probably + sometimes relieved by eruptions of the face; as in those who are + habituated to the intemperate use of fermented liquors.</p> + + <p>M. M. Hepatic inflammation is very liable to terminate in suppuration, + and the patient is destroyed by the continuance of a fever with sizy + blood, but without night-sweats, or diarrhœa, as in other unopened + abscesses. Whence copious and repeated venesection is required early in + the disease, with repeated doses of calomel, and cathartics. Warm bath. + Towards the end of the disease small doses of opium before the evening + paroxysms, and lastly the Peruvian bark, and chalybeate wine, at first in + small doses, as 20 drops twice a day, and afterwards, if necessary, in + larger. See Art. <a href="#art_IV_2_6">IV. 2. 6</a>.</p> + + <p>Mrs. C. a lady in the last month of her pregnancy, was seized with + violent hepatitis, with symptoms both of peripneumony and of pleurisy, + for it seldom happens in violent inflammations, that one viscus alone is + affected; she wanted then about a fortnight of her delivery, and after + frequent venesection, with gentle cathartics, with fomentation or warm + bath, she recovered and was safely delivered, and both herself and child + did well. Rheumatic and eruptive fevers are more liable to induce + abortion.</p> + + <p><a name="species_II_1_2_13">13</a>. <i>Splenitis.</i> Inflammation of + the spleen commences with tension, heat, and tumour of the left side, and + with pain, which is increased by pressure. A case is described in Class + <a href="#species_I_2_3_18">I. 2. 3. 18</a>. where a tumid spleen, + attended with fever, terminated in schirrus of that viscus.</p> + + <p><a name="species_II_1_2_14">14</a>. <i>Nephritis.</i> Inflammation of + the kidney seems to be of two kinds; each of them attended with different + symptoms, and different modes of termination. One of them I suppose to be + an inflammation of the external membrane of the kidney, arising from + general causes of inflammation, and accompanied with pain in the loins + without vomiting; and the other to consist in an inflammation of the + interior parts of the kidney, occasioned by the stimulus of gravel in the + pelvis of it, which is attended with perpetual vomiting, with pain along + the course of the ureter, and retraction of the testis on that side, or + numbness of the thigh.</p> + + <p>The former of these kinds of nephritis is distinguished from lumbago + by its situation being more exactly on the region of the kidney, and by + its not being extended beyond that part; after three or four days I + believe this inflammation is liable to change place; and that a herpes or + erysipelas, called zona, or shingles, breaks out about the loins in its + stead; at other times it is cured by a cathartic with calomel, with or + without previous venesection.</p> + + <p>The other kind of nephritis, or inflammation of the interior part of + the kidney, generally arises from the pain occasioned by the stimulus of + a stone entering the ureter from the pelvis of the kidney; and, which + ceases when the stone is protruded forwards into the bladder; or when it + is returned into the pelvis of the kidney by the retrograde action of the + ureter. The kidney is nevertheless inflamed more frequently, though in a + less degree, from other causes; especially from the intemperate + ingurgitation of ale, or other fermented or spirituous liquors. This less + degree of inflammation is the cause of gravel, as that before mentioned + is the effect of it. The mucus secreted to lubricate the internal surface + of the uriniferous tubes of the kidney becomes secreted in greater + quantity, when these vessels are inflamed; and, as the correspondent + absorbent vessels act more energetically at the same time, the absorption + of its more fluid parts is more powerfully effected; on both these + accounts the mucus becomes both changed in quality and more indurated. + And in this manner stones are produced on almost every mucous membrane of + the body; as in the lungs, bowels, and even in the pericordium, as some + writers have affirmed. See Class <a href="#species_I_1_3_9">I. 1. 3. + 9</a>.</p> + + <p>M. M. Venesection. Ten grains of calomel given in small pills, then + infusion of sena with oil. Warm bath. Then opium a grain and half. See + Class <a href="#species_I_1_3_9">I. 1. 3. 9</a>. for a further account of + the method of cure.</p> + + <p><a name="species_II_1_2_15">15</a>. <i>Cystitis.</i> Inflammation of + the bladder is attended with tumor and pain of the lower part of the + belly; with difficult and painful micturition; and tenesmus. It generally + is produced by the existence of a large stone in the bladder, when in a + great degree; or is produced by common causes, when in a slighter + degree.</p> + + <p>The stone in the bladder is generally formed in the kidney, and + passing down the ureter into the bladder becomes there gradually + increased in size; and this most frequently by the apposition of + concentric spheres, as may be seen by sawing some of the harder calculi + through the middle, and polishing one surface. These new concretions + superinduced on the nucleus, which descended from the kidney, as + described in Class <a href="#species_I_1_3_9">I. 1. 3. 9</a>. and in the + preceding article of this genus, is not owing to the microcosmic salt, + which is often seen to adhere to the sides of chamber-pots, as this is + soluble in warm water, but to the mucus of the bladder, as it rolls along + the internal surface of it. Now when the bladder is slightly inflamed, + this mucus of its internal surface is secreted in greater quantity, and + is more indurated by the absorption of its more liquid part at the + instant of secretion, as explained in Class <a href="#species_I_1_3_9">I. + 1. 3. 9</a>. and <a href="#species_II_1_2_14">II. 1. 2. 14</a>. and thus + the stimulus and pain of a stone in the bladder contributes to its + enlargement by inflaming the interior coat of it.</p> + + <p>M. M. Venesection. Warm bath. Diluents. Anodyne clysters. See Class <a + href="#species_I_1_3_9">I. 1. 3. 9</a>.</p> + + <p><a name="species_II_1_2_16">16</a>. <i>Hysteritis.</i> Inflammation of + the womb is accompanied with heat, tension, tumor, and pain of the lower + belly. The os uteri painful to the touch. Vomiting. This disease is + generally produced by improper management in the delivery of pregnant + women. I knew an unfortunate case, where the placenta was left till the + next day; and then an unskilful accoucheur introduced his hand, and + forcibly tore it away; the consequence was a most violent inflammatory + fever, with hard throbbing pulse, great pain, very sizy blood, and the + death of the patient. Some accoucheurs have had a practice of introducing + their hand into the uterus immediately after the birth of the child, to + take away the placenta; which they said was to save time. Many women I + believe have been victims to this unnatural practice.</p> + + <p>Others have received injury, where inflammation has been beginning, by + the universal practice of giving a large dose of opium immediately on + delivery, without any indication of its propriety; which, though a proper + and useful medicine, where the patient is too feeble, when given in a + small dose, as 10 drops of tincture of opium, or half a grain of solid + opium, must do a proportionate injury, when it is given improperly; and + as delivery is a natural process, it is certainly more wise to give no + medicines, except there be some morbid symptom, which requires it; and + which has only been introduced into custom by the ill-employed activity + of the Priests or Priestesses of <span class="sc">Lucina</span>; like the + concomitant nonsense of cramming rue or rheubarb into the mouth of the + unfortunate young stranger, who is thus soon made to experience the evils + of life. See Class <a href="#species_II_1_1_12">II. 1. 1. 12</a>. and <a + href="#species_I_1_2_5">I. 1. 2. 5</a>. Just so some over-wise beldames + force young ducks and turkeys, as soon as they are hatched, to swallow a + peppercorn.</p> + + <p>M. M. Venesection repeatedly; diluents; fomentation; the patient + should be frequently raised up in bed for a short time, to give + opportunity of discharge to the putrid lochia; mucilaginous clysters. See + Febris Puerpera.</p> + + <p><a name="species_II_1_2_17">17</a>. <i>Lumbago sensitiva.</i> + Sensitive lumbago. When the extensive membranes, or ligaments, which + cover the muscles of the back are torpid, as in the cold paroxysm of + ague, they are attended with pain in consequence of the inaction of the + vessels, which compose them. When this inaction continues without a + consequent renewal or increase of activity, the disease becomes + chronical, and forms the lumbago frigida, or irritativa, described in + Class <a href="#species_I_2_4_16">I. 2. 4. 16</a>. But when this cold fit + or torpor of these membranes, or ligaments or muscles of the back, is + succeeded by a hot fit, and consequent inflammation, a violent + inflammatory fever, with great pain, occurs, preventing the erect posture + of the body; and the affected part is liable to suppurate, in which case + a very dangerous ulcer is formed, and a part of one of the vertebrae is + generally found carious, and the patient sinks after a long time under + the hectic fever occasioned by the aerated or oxygenated matter.</p> + + <p>This disease bears no greater analogy to rheumatism than the + inflammation of the pleura, or any other membranous inflammation; and has + therefore unjustly been arranged under that name. It is distinguished + from nephritis, as it is seldom attended with vomiting, I suppose never, + except the ureter happens to be inflamed at the same time.</p> + + <p>The pain sometimes extends on the outside of the thigh from the hip to + the ankle, heel, or toes, and is then called sciatica; and has been + thought to consist in an inflammation of the theca, or covering of the + sciatic nerve, as the pain sometimes so exactly attends the principal + branches of that nerve. See Class <a href="#species_I_2_4_15">I. 2. 4. + 15</a>. <a href="#species_I_2_4_16">16</a>.</p> + + <p>M. M. Venesection repeatedly; calomel; gentle cathartics; diluents; + warm bath; poultice on the back, consisting of camomile flowers, + turpentine, soap, and opium; a burgundy-pitch plaster. A debility of the + inferior limbs from the torpor of the muscles, which had previously been + too much excited, frequently occurs at the end of this disease; in this + case electricity, and issues on each side of the lumber vertebræ, are + recommended. See Class <a href="#species_I_2_4_16">I. 2. 4. 16</a>.</p> + + <p><a name="species_II_1_2_18">18</a>. <i>Ischias.</i> The ischias + consists of inflammatory fever, with great pain about the pelvis, the os + coccigis, and the heads of the thigh-bones, preventing the patient from + walking or standing erect, with increase of pain on going to stool. This + malady, as well as the preceding, has been ascribed to rheumatism; with + which it seems to bear no greater analogy, than the inflammations of any + other membranes.</p> + + <p>The patients are left feeble, and sometimes lame after this disease; + which is also sometimes accompanied with great flow of urine, owing to + the defective absorption of its aqueous parts; and with consequent thirst + occasioned by the want of so much fluid being returned into the + circulation; a lodgment of fæces in the rectum sometimes occurs after + this complaint from the lessened sensibility of it. See Class <a + href="#species_I_2_4_15">I. 2. 4. 15</a>.</p> + + <p>M. M. Venesection; gentle cathartics; diluents; fomentation; poultice + with camomile flowers, turpentine, soap, and opium; afterwards the bark. + See Class <a href="#species_I_1_3_5">I. 1. 3. 5</a>.</p> + + <p>When this inflammation terminates in suppuration the matter generally + can be felt to fluctuate in the groin, or near the top of the thigh. In + this circumstance, my friend Mr. Bent, Surgeon near Newcastle in + Staffordshire, proposes to tap the abscess by means of a trocar, and thus + as often as necessary to discharge the matter without admitting the air. + Might a weak injection of wine and water, as in the hydrocele, be used + with great caution to inflame the walls of the abscess, and cause them to + unite? See Class <a href="#species_II_1_6_9">II. 1. 6. 9</a>.</p> + + <p><a name="species_II_1_2_19">19</a>. <i>Paronychia interna.</i> + Inflammation beneath the finger-nail. The pain occasioned by the + inflammatory action and tumor of parts bound down between the nail on one + side and the bone on the other, neither of which will yield, is said to + occasion so much pain as to produce immediate delirium, and even death, + except the parts are divided by a deep incision; which must pass quite + through the periosteum, as the inflammation is said generally to exist + beneath it. This disease is thus resembled by the process of toothing in + young children; where an extraneous body lodged beneath the periosteum + induces pain and fever, and sometimes delirium, and requires to be set at + liberty, by the lancet.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_3">III</a>.</h3> + +<h3><i>With the Production of new Vessels by external Membranes or Glands +with Fever.</i></h3> + + <p>The diseases of this genus are perhaps all productive of contagious + matter; or which becomes so by its exposure to the air, either through + the cuticle, or by immediate contact with it; such are the matters of the + small-pox and measles. The purulent matter formed on parts covered from + the air by thicker membranes or muscles, as in the preceding genus, does + not induce fever, and cannot therefore be called contagious; but it + acquires this property of producing fever in a few hours, after the + abscess has been opened, so as to admit the air to its surface, and may + then be said to consist of contagious miasmata. This kind of contagious + matter only induces fever, but does not produce other matter with + properties similar to its own; and in this respect it differs from the + contagious miasmata of small-pox or measles, but resembles those which + have their origin in crowded jails; for these produce fever only, which + frequently destroys the patient; but do not produce other matters similar + to themselves; as appears from none of those, who died of the jail-fever, + caught at the famous black assizes at Oxford, at the beginning of this + century, having infected their physicians or attendants.</p> + + <p>If indeed the matter has continued so long as to become putrid, and + thus to have given out air from a part of it, it acquires the power of + producing fever; in the same manner as if the ulcer had been opened, and + exposed to the common air; instances of which are not unfrequent. And + from these circumstances it seems probable, that the matters secreted by + the new vessels formed in all kinds of phlegmons, or pustles, are not + contagious, till they have acquired something from the atmosphere, or + from the gas produced by putrefaction; which will account for some + phenomena in the lues venerea, cancer, and of other contagious secretions + on the skin without fever, to be mentioned hereafter. See Class <a + href="#species_II_1_4_14">II. 1. 4. 14</a>.</p> + + <p>The theory of contagion has been perplexed by comparing it with + fermenting liquors; but the contagious material is shewn in Section + XXXIII. to be produced like other secreted matters by certain animal + motions of the terminations of the vessels. Hence a new kind of gland is + formed at the terminations of the vessels in the eruptions of the + small-pox; the animal motions of which produce from the blood variolous + matter; as other glands produce bile or saliva. Now if some of this + matter is introduced beneath the cuticle of a healthy person, or enters + the circulation, and excites the extremities of the blood-vessels into + those kinds of diseased motions, by which it was itself produced, either + by irritation or association, these diseased motions of the extremities + of the vessels will produce other similar contagious matter. See Sect. + XXXIII. 2. 5. and 9. Hence contagion seems to be propagated two ways; + one, by the stimulus of contagious matter applied to the part, which by + an unknown law of nature excites the stimulated vessels to produce a + similar matter; as in venereal ulcers, which thus continue to spread; or + as when variolous matter is inserted beneath the cuticle; or when it is + supposed to be absorbed, and diffused over the body mixed with the blood, + and applied in that manner to the cutaneous glands. The other way, by + which contagion seems to be diffused, is by some distant parts + sympathizing or imitating the motions of the part first affected; as the + stomach and skin in the eruptions of the inoculated small-pox, or in the + bite of a mad dog; as treated of in Sect. XXII. 3. 3.</p> + + <p>In some of the diseases of this genus the pulse is strong, full, and + hard, constituting the sensitive irritated fever, as described in the + preceding genus; as in one kind of erysipelas, which requires repeated + venesection. In others the arterial action is sometimes moderate, so as + to constitute the sensitive fever, as in the inoculated small-pox; where + the action of the arteries is neither increased by the sensorial power of + irritation, as in the sensitive irritated fever; nor decreased by the + defect of that power, as in the sensitive inirritated fever. But in the + greatest number of the diseases of this genus the arterial action is + greatly diminished in respect to strength, and consequently the frequency + of pulsation is proportionally increased, as explained in Sect XXXII. 2. + 1. Which is owing to the deficiency of the sensorial power of irritation + joined with the increase of that of sensation, and thus constitutes the + sensitive inirritated fever; as in Scarlatina with gangrenous + tonsils.</p> + + <p>From this great debility of the action of the arteries, there appears + to be less of the coagulable lymph or mucus secreted on their internal + surfaces; whence there is not only a defect of that buff or size upon the + blood, which is seen on the surface of that, which is drawn in the + sensitive irritated fever; but the blood, as it cools, when it has been + drawn into a bason, scarcely coagulates; and is said to be dissolved, and + is by some supposed to be in a state of actual putrefaction. See Sect. + XXXIII. 1. 3. where the truth of this idea is controverted. But in the + fevers of both this genus and the preceding one great heat is produced + from the chemical combinations in the secretions of new vessels and + fluids, and pain or uneasiness from the distention of the old ones; till + towards the termination of the disease sensation ceases, as well as + irritation, with the mortification of the affected parts, and the death + of the patient.</p> + + <p>Dysenteria, as well as tonsillitis and aphtha, are enumerated amongst + the diseases of external membranes, because they are exposed either to + the atmospheric air, which is breathed, and swallowed with our food and + saliva; or they are exposed to the inflammable air; or hydrogen, which is + generated in the intestines; both which contribute to produce or promote + the contagious quality of these fluids; as mentioned in Class <a + href="#genus_II_1_5">II. 1. 5</a>.</p> + + <p>It is not speaking accurate language, if we say, that in the diseases + of this genus the fever is contagious; since it is the material produced + by the external membranes, which is contagious, after it has been exposed + to air; while the fever is the consequence of this contagious matter, and + not the cause of it. As appears from the inoculated small-pox, in which + the fever does not commence, till after suppuration has taken place in + the inoculated arm, and from the diseases of the fifth genus of this + order, where contagion exists without fever. See Class <a + href="#genus_II_1_5">II. 1. 5</a>. and <a href="#species_II_1_3_18">II. + 1. 3. 18</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_3_1">1</a>. <i>Febris sensitiva inirritata.</i> + Sensitive inirritated fever. Typhus gravior. Putrid malignant fever. Jail + fever. The immediate cause of this disease is the increase of the + sensorial power of sensation, joined with the decrease of the sensorial + power of irritation; that is, it consists in the febris sensitiva joined + with the febris inirritativa of Class <a href="#species_I_2_1_1">I. 2. 1. + 1</a>. as the febris sensitiva irritata of the preceding genus consists + of the febris sensitiva joined with the febris irritativa of Class <a + href="#species_I_1_1_1">I. 1. 1. 1</a>. In both which the word irritata, + and inirritata, are designed to express more or less irritation than the + natural quantity; and the same when applied to some of the diseases of + this genus.</p> + + <p>This fever is frequently accompanied with topical inflammation, which + is liable, if the arterial strength is not supported, to end in + sphacelus; and as mortified parts, such as sloughs of the throat, if they + adhere to living parts, soon become putrid from the warmth and moisture + of their situation; these fevers have been termed putrid, and have been + thought to owe their cause to what is only their consequence. In hot + climates this fever is frequently induced by the exhalations of + stagnating lakes or marshes, which abound with animal substances; but + which in colder countries produce fevers with debility only, as the + quartan ague, without inflammation.</p> + + <p>The sensitive inirritated, or malignant, fever is also frequently + produced by the putrid exhalations and stagnant air in prisons; but + perhaps most frequently by contact or near approach of the persons, who + have resided in them. These causes of malignant fevers contributed to + produce, and to support for a while, the septic and antiseptic theory of + them; see Sect. XXXIII. 1. 3. The vibices or bruises, and petechiæ or + purples, were believed to be owing to the dissolved state of the blood by + its incipient putrefaction; but hydrostatical experiments have been made, + which shew the sizy blood of the patient in sensitive irritated or + inflammatory fever, with strong pulse, is more fluid, while it is warm, + than this uncoagulable blood taken in this sensitive inirritated, or + malignant fever; from whence it is inferred, that these petechiæ, and + vibices, are owing to the deficient power of absorption in the + terminations of the veins, See Class <a href="#species_I_2_1_5">I. 2. 1. + 5</a>.</p> + + <p>This sensitive inirritated fever, or typhus gravior, is distinguished + from the inirritative fever, or typhus mitior, in the early stages of it, + by the colour of the skin; which in the latter is paler, with less heat, + owing to the less violent action of the capillaries; in this it is higher + coloured, and hotter, from the greater energy of the capillary action in + the production of new vessels. In the more advanced state petechiæ, and + the production of contagious matter from inflamed membranes, as the + aphthæ of the mouth, or ulcers of the throat, distinguishes this fever + from the former. Delirium, and dilated pupils of the eyes, are more + frequent in nervous fevers; and stupor with deafness more frequent + attendants on malignant fevers. See Class <a href="#species_I_2_5_6">I. + 2. 5. 6</a>.</p> + + <p>There is another criterion discernible by the touch of an experienced + finger; and that is, the coat of the artery in inflammatory fevers, both + those attended with strength of pulsation, and these with weak pulsation, + feels harder, or more like a cord; for the coats of the arteries in these + fevers are themselves inflamed, and are consequently turgid with blood, + and thence are less easily compressed, though their pulsations are + nevertheless weak: when the artery is large or full with an inflamed + coat, it is called hard; and when small or empty with an inflamed coat, + it is called sharp, by many writers.</p> + + <p>M. M. The indications of cure consist, 1. In procuring a regurgitation + of any offensive material, which may be lodged in the long mouths of the + lacteals or lymphatics, or in their tumid glands. 2. To excite the system + into necessary action by the repeated exhibition of nutrientia, + sorbentia, and incitantia; and to preserve the due evacuation of the + bowels. 3. To prevent any unnecessary expenditure of sensorial power. 4. + To prevent the formation of ulcers, or to promote the absorption in them, + for the purpose of healing them.</p> + + <p>1. One ounce of wine of ipecacuanha, or about ten grains of the + powder, should be given as an emetic. After a few hours three or four + grains of calomel should be given in a little mucilage, or conserve. + Where something swallowed into the stomach is the cause of the fever, it + is liable to be arrested by the lymphatic glands, as the matter of the + small-pox inoculated in the arm is liable to be stopped by the axillary + lymphatic gland; in this situation it may continue a day or two, or + longer, and may be regurgitated during the operation of an emetic or + cathartic into the stomach or bowel, as evidently happens on the + exhibition of calomel, as explained in Sect. XXIX. 7. 2. For this reason + an emetic and cathartic, with venesection, if indicated by the hardness + and fulness of the pulse, will very frequently remove fevers, if + exhibited on the first, second, or even third day.</p> + + <p>2. Wine and opium, in small doses repeated frequently, but so that not + the least degree of intoxication follows, for in that case a greater + degree of debility is produced from the expenditure of sensorial power in + unnecessary motions. Many weak patients have been thus stimulated to + death. See Sect. XII. 7. 8. The Peruvian bark should be given also in + repeated doses in such quantity only as may strengthen digestion, not + impede it. For these purposes two ounces of wine, or of ale, or cyder, + should be given every six hours; and two ounces of decoction of bark, + with two drachms of the tincture of bark, and six drops of tincture of + opium, should be given also every six hours alternately; that is, each of + them four times in twenty-four hours. As much rhubarb as may induce a + daily evacuation, should be given to remove the colluvies of indigested + materials from the bowels; which might otherwise increase the distress of + the patient by the air it gives out in putrefaction, or by producing a + diarrhœa by its acrimony; the putridity of the evacuations are in + consequence of the total inability of the digestive powers; and their + delay in the intestines, to the inactivity of that canal in respect to + its peristaltic motions.</p> + + <p>The quantities of wine or beer and opium, and bark, above mentioned, + may be increased by degrees, if the patient seems refreshed by them; and + if the pulse becomes slower on their exhibition; but this with caution, + as I have seen irrecoverable mischief done by greater quantities both of + opium, wine, and bark, in this kind of fever; in which their use is to + strengthen the digestion of the weak patient, rather than to stop the + paroxysms of fever; but when they are administered in intermittents, much + larger quantities are necessary.</p> + + <p>The stimulus of small blisters applied in succession, one every three + or four days, when the patient becomes weak, is of great service by + strengthening digestion, and by preventing the coldness of the + extremities, owing to the sympathy of the skin with the stomach, and of + one part of the skin with another.</p> + + <p>In respect to nutriment, the patient should be supplied with wine and + water, with toasted bread, and sugar or spice in it; or with sago with + wine; fresh broth with turnips, cellery, parsley; fruit; new milk. Tea + with cream and sugar; bread pudding, with lemon juice and sugar; chicken, + fish, or whatever is grateful to the palate of the sick person, in small + quantity repeated frequently; with small beer, cyder and water, or wine + and water, for drink, which may be acidulated with acid of vitriol in + small quantities.</p> + + <p>3. All unnecessary motions are to be checked, or prevented. Hence + horizontal posture, obscure room, silence, cool air. All the parts of the + skin, which feel too hot to the hand, should be exposed to a current of + cool air, or bathed with cold water, whether there are eruptions on it or + not. Wash the patient twice a day with cold vinegar and water, or cold + salt and water, or cold water alone, by means of a sponge. If some parts + are too cold, as the extremities, while other parts are too hot, as the + face or breast, cover the cold parts with flannel, and cool the hot parts + by a current of cool air, or bathing them as above.</p> + + <p>4. For the healing of ulcers, if in the mouth, solution of alum in + water about 40 grains to an ounce, or of blue vitriol in water, one grain + or two to an ounce may be used to touch them with three or four times a + day. Of these perhaps a solution of alum is to be preferred, as it + instantly takes away the stench from ulcers I suppose by combining with + the volatile alcali which attends it. For this purpose a solution of alum + of an ounce to a pint of water should be frequently injected by means of + a syringe into the mouth. If there are ulcers on the external skin, fine + powder of bark seven parts, and cerusia in fine powder one part, should + be mixed, and applied dry on the sore, and kept on by lint, and a + bandage.</p> + + <p>As sloughs in the mouth are frequently produced by the previous + dryness of the membranes, which line it, this dryness should be prevented + by frequently moistening them, which may be effected by injection with a + syringe, or by a moist sponge, or lastly in the following manner. Place a + glass of wine and water, or of milk and sugar, on a table by the bedside, + a little above the level of the mouth of the patient; then, having + previously moistened a long piece of narrow listing, or cloth, or + flannel, with the same liquor, leave one end of it in the glass, and + introduce the other into the mouth of the patient; which will thus be + supplied with a constant oozing of the fluid through the cloth, which + acts as a capillary syphon.</p> + + <p>The viscid phlegm, which adheres to the tongue, should be coagulated + by some austere acid, as by lemon-juice evaporated to half its quantity, + or by crab-juice; and then it may be scraped off by a knife, or rubbed + off by flannel, or a sage leaf dipped in vinegar, or in salt and + water.</p> + + <p><a name="species_II_1_3_2">2</a>. <i>Erysipelas</i>, St. Anthony's + fire, may be divided into three kinds, which differ in their method of + cure, the irritated, the inirritated, and the sensitive erysipelas.</p> + + <p><i>Erysipelas irritatum</i> is attended with increase of irritation + besides increase of sensation; that is, with strong, hard, and full + pulse, which requires frequent venesection, like other inflammations with + arterial strength. It is distinguished from the phlegmonic inflammations + of the last genus by its situation on the external habit, and by the + redness, heat, and tumour not being distinctly circumscribed; so that the + eye or finger cannot exactly trace the extent of them.</p> + + <p>When the external skin is the seat of inflammation, and produces + sensitive irritated fever, no collection of matter is formed, as when a + phlegmon is situated in the cellular membrane beneath the skin; but the + cuticle rises as beneath a blister-plaster, and becomes ruptured; and a + yellow material oozes out, and becomes inspissated, and lies upon its + surface; as is seen in this kind of erysipelas, and in the confluent + small-pox; or if the new vessels are reabsorbed the cuticle peels off in + scales. This difference of the termination of erysipelatous and + phlegmonic inflammation seems to be owing in part to the less + distensibility of the cuticle than of the cellular membrane, and in part + to the ready exhalation of the thinner parts of the secreted fluids + through its pores.</p> + + <p>This erysipelas is generally preceded by a fever for two or three days + before the eruption, which is liable to appear in some places, as it + declines in others; and seems frequently to arise from a previous scratch + or injury of the skin; and is attended sometimes with inflammation of the + cellular membrane beneath the skin; whence a real phlegmon and collection + of matter becomes joined to the erysipelas, and either occasions or + increases the irritated fever, which attends it.</p> + + <p>There is a greater sympathy between the external skin and the meninges + of the brain, than between the cellular membrane and those meninges; + whence erysipelas is more liable to be preceded or attended, or + succeeded, by delirium than internal phlegmons. I except the mumps, or + parotitis, described below; which is properly an external gland, as its + excretory duct opens into the air. When pain of the head or delirium + precedes the cutaneous eruption of the face, there is some reason to + believe, that the primary disease is a torpor of the meninges of the + brain; and that the succeeding violent action is transferred to the skin + of the face by sensitive association; and that a similar sympathy occurs + between some internal membranes and the skin over them, when erysipelas + appears on other parts of the body. If this circumstance should be + supported by further evidence, this disease should be removed into Class + IV. along with the rheumatism and gout. See Class <a + href="#species_IV_1_2_17">IV. 1. 2. 17</a>.</p> + + <p>This supposed retropulsion of erysipelas on the brain from the + frequent appearance of delirium, has prevented the free use of the lancet + early in this disease to the destruction of many; as it has prevented the + subduing of the general inflammation, and thus has in the end produced + the particular one on the brain. Mr. B——, a delicate + gentleman about sixty, had an erysipelas beginning near one ear, and + extending by degrees over the whole head, with hard, full, and strong + pulse; blood was taken from him four or five times in considerable + quantity, with gentle cathartics, with calomel, diluents, and cool air, + and he recovered without any signs of delirium, or inflammation of the + meninges of the brain. Mr. W——, a strong corpulent man of + inferior life, had erysipelas over his whole head, with strong hard + pulse: he was not evacuated early in the disease through the timidity of + his apothecary, and died delirious. Mrs. F—— had erysipelas + on the face, without either strong or weak pulse; that is, with sensitive + fever alone, without superabundance or deficiency of irritation; and + recovered without any but natural evacuations. From these three cases of + erysipelas on the head it appears, that the evacuations by the lancet + must be used with courage, where the degree of inflammation requires it; + but not where this degree of inflammation is small, nor in the erysipelas + attended with inirritation, as described below.</p> + + <p>M. M. Venesection repeated according to the degree of inflammation. An + emetic. Calomel three grains every other night. Cool air. Diluents, + emetic tartar in small doses, as a quarter of a grain every six hours. + Tea, weak broth, gruel, lemonade, neutral salts. See Sect. XII. 6.</p> + + <p>Such external applications as carry away the heat of the skin may be + of service, as cold water, cold flour, snow, ether. Because these + applications impede the exertions of the secerning vessels, which are now + in too great action; but any applications of the stimulant kind, as + solutions of lead, iron, copper, or of alum, used early in the disease, + must be injurious; as they stimulate the secerning vessels, as well as + the absorbent vessels, into greater action; exactly as occurs when + stimulant eye-waters are used too soon in ophthalmy. See Class <a + href="#species_II_1_2_2">II. 1. 2. 2</a>. But as the cuticle peels off in + this case after the inflammation ceases, it differs from ophthalmy; and + stimulant applications are not indicated at all, except where symptoms of + gangrene appear. For as a new cuticle is formed under the old one, as + under a blister, the serous fluid between them is a defence to the new + cuticle, and should dry into a scab by exhalation rather than be + reabsorbed. Hence we see how greasy or oily applications, and even how + moist ones, are injurious in erysipelas; because they prevent the + exhalation of the serous effusion between the old and new cuticle, and + thus retard the formation of the latter.</p> + + <p><i>Erysipelas inirritatum</i> differs from the former in its being + attended with weak pulse, and other symptoms of sensitive inirritated + fever. The feet and legs are particularly liable to this erysipelas, + which precedes or attends the sphacelus or mortification of those parts. + A great and long coldness first affects the limb, and the erysipelas on + the skin seems to occur in consequence of the previous torpor of the + interior membranes. As this generally attends old age, it becomes more + dangerous in proportion to the age, and also to the habitual intemperance + of the patient in respect to the use of fermented or spirituous + liquor.</p> + + <p>When the former kind, or irritated erysipelas, continues long, the + patient becomes so weakened as to be liable to all the symptoms of this + inirritated erysipelas; especially where the meninges of the brain are + primarily affected. As in that case, after two or three efforts have been + made to remove the returning periods of torpor of the meninges to the + external skin, those meninges become inflamed themselves, and the patient + sinks under the disease; in a manner similar to that in old gouty + patients, where the torpor of the liver or stomach is relieved by + association of the inflammation of the membranes of the feet, and then of + other joints, and lastly the power of association ceasing to act, but the + excess of sensation continuing, the liver or stomach remains torpid, or + become themselves inflamed, and the patient is destroyed.</p> + + <p>M. M. Where there exists a beginning gangrene of the extremities, the + Peruvian bark, and wine, and opium, are to be given in large quantities; + so as to strengthen the patient, but not to intoxicate, or to impede his + digestion of aliment, as mentioned in the first species of this genus. + Class <a href="#species_II_1_2_1">II. 1. 2. 1</a>. But where the brain is + inflamed or oppressed, which is known either by delirium, with quick + pulse; or by stupor, and slow respiration with slow pulse; other means + must be applied. Such as, first, a fomentation on the head with warm + water, with or without aromatic herbs, or salt in it, should be continued + for an hour or two at a time, and frequently repeated. A blister may also + be applied on the head, and the fomentation nevertheless occasionally + repeated. Internally very gentle stimulants, as camphor one grain or two + in infusion of valerian. Wine and water or small beer, weak broth. An + enema. Six grains of rhubarb and one of calomel. Afterwards five drops of + tincture of opium, which may be repeated every six hours, if it seems of + service. Might the head be bathed for a minute with cold water? or with + ether? or vinegar?</p> + + <p><i>Erysipelas sensitivum</i> is a third species, differing only in the + kind of fever which attends it, which is simply inflammatory, or + sensitive, without either excess of irritation, as in the first variety; + or the defect of irritation, as in the second variety: all these kinds of + erysipelas are liable to return by periods in some people, who have + passed the middle of life, as at periods of a lunation, or two lunations, + or at the equinoxes. When these periods of erysipelas happen to women, + they seem to supply the place of the receding catamenia; when to men, I + have sometimes believed them to be associated with a torpor of the liver; + as they generally occur in those who have drank vinous spirit + excessively, though not approbriously; and that hence they supply the + place of periodical piles, or gout, or gutta rosea.</p> + + <p>M. M. As the fever requires no management, the disease takes its + progress safely, like a moderate paroxysm of the gout; but in this case, + as in some of the former, the erysipelas does not appear to be a primary + disease, and should perhaps be removed to the Class of Association.</p> + + <p><a name="species_II_1_3_3">3</a>. <i>Tonsillitis.</i> Inflammation of + the tonsils. The uncouth term Cynanche has been used for diseases so + dissimilar, that I have divided them into Tonsillitis and Parotitis; and + hope to be excused for adding a Greek termination to a Latin word, as one + of those languages may justly be considered as a dialect of the other. By + tonsillitis the inflammation of the tonsils is principally to be + understood; but as all inflammations generally spread further than the + part first affected; so, when the summit of the windpipe is also much + inflamed, it may be termed tonsillitis trachealis, or croup. See Class <a + href="#species_I_1_3_4">I. 1. 3. 4</a>. and <a + href="#species_II_1_2_4">II. 1. 2. 4</a>.; and when the summit of the + gullet is much inflamed along with the tonsil, it may be called + tonsillitis pharyngea, as described in Dr. Cullen's Nosologia, Genus X. + p. 92. The inflammation of the tonsils may be divided into three kinds, + which require different methods of cure.</p> + + <p><i>Tonsillitis interna.</i> Inflammation of the internal tonsil. When + the swelling is so considerable as to produce difficulty of breathing, + the size of the tonsil should be diminished by cutting it with a proper + lancet, which may either give exit to the matter it contains, or may make + it less by discharging a part of the blood. This kind of angina is + frequently attended with irritated fever besides the sensitive one, which + accompanies all inflammation, and sometimes requires venesection. An + emetic should be given early in the disease, as by its inducing the + retrograde action of the vessels about the fauces during the nausea it + occasions, it may eliminate the very cause of the inflammation; which may + have been taken up by the absorbents, and still continue in the mouths of + the lymphatics or their glands. The patient should then be induced to + swallow some aperient liquid, an infusion of senna, so as to induce three + or four evacuations. Gargles of all kinds are rather hurtful, as the + action of using them is liable to give pain to the inflamed parts; but + the patients find great relief from frequently holding warm water in + their mouths, and putting it out again, or by syringing warm water into + the mouth, as this acts like a warm bath or fomentation to the inflamed + part. Lastly, some mild stimulant, as a weak solution of salt and water, + or of white vitriol and water, may be used to wash the fauces with in the + decline of the disease, to expedite the absorption of the new vessels, if + necessary, as recommended in ophthalmy.</p> + + <p><i>Tonsillitis superficialis.</i> Inflammation of the surface of the + tonsils. As the tonsils and parts in their vicinity are covered with a + membrane, which, though exposed to currents of air, is nevertheless + constantly kept moist by mucus and saliva, and is liable to diseases of + its surface like other mucous membranes, as well as to suppuration of the + internal substance of the gland; the inflammation of its surface is + succeeded by small elevated pustules with matter in them, which soon + disappears, and the parts either readily heal, or ulcers covered with + sloughs are left on the surface.</p> + + <p>This disease is generally attended with only sensitive fever, and + therefore is of no danger, and may be distinguished with great certainty + from the dangerous inflammation or gangrene of the tonsils at the height + of the small-pox, or scarlet fever, by its not being attended with other + symptoms of those diseases. One emetic and a gentle cathartic is + generally sufficient; and the frequent swallowing of weak broth, or + gruel, both without salt in them, relieves the patient, and absolves the + cure. When these tumours of the tonsils frequently return I have + sometimes suspected them to originate from the absorption of putrid + matter from decaying teeth. See Class <a href="#species_I_2_3_21">I. 2. + 3. 21</a>. and <span class="correction" title="This reference is surely wrong: I cannot determine a correction." + ><a href="#species_II_2_2_1">II. 2. 2. 1</a></span>.</p> + + <p><i>Tonsillitis inirritata.</i> Inflammation of the tonsils with + sensitive inirritated fever is a symptom only of contagious fever, + whether attended with scarlet eruption, or with confluent small-pox, or + otherwise. The matter of contagion is generally diffused, not dissolved + in the air; and as this is breathed over the mucaginous surface of the + tonsils, the contagious atoms are liable to be arrested by the tonsil; + which therefore becomes the nest of the future disease, like the inflamed + circle round the inoculated puncture of the arm in supposititious + small-pox. This swelling is liable to suffocate the patient in small-pox, + and to become gangrenous in scarlet fever, and some other contagious + fevers, which have been received in this manner. The existence of + inflammation of the tonsil previous to the scarlet eruption, as the arm + inflames in the inoculated small-pox, and suppurates before the variolous + eruption, should be a criterion of the scarlet fever being taken in this + manner.</p> + + <p>M. M. All the means which strengthen the patient, as in the sensitive + inirritated fever, Class <a href="#species_II_1_2_1">II. 1. 2. 1</a>. As + it is liable to continue a whole lunation or more, great attention should + be used to nourish the patient with acidulous and vinous panada, broth + with vegetables boiled in it, sugar, cream, beer; all which given + frequently will contribute much to moisten, clean, and heal the + ulcuscles, or sloughs, of the throat; warm water and wine, or acid of + lemon, should be frequently applied to the tonsils by means of a syringe, + or by means of a capillary syphon, as described in Class <span + class="correction" title="Original reads `II. 1. 2. 1.'."><a + href="#species_II_1_3_1">II. 1. 3. 1</a></span>. A slight solution of + blue vitriol, as two grains to an ounce, or a solution of sugar of lead + of about six grains to an ounce, may be of service; especially the + latter, applied to the edges of the sloughs, drop by drop by means of a + small glass tube, or small crow-quill with the end cut off, or by a + camel's-hair pencil or sponge; to the end of either of which a drop will + conveniently hang by capillary attraction; as solutions of lead evidently + impede the progress of erysipelas on the exterior skin, when it is + attended with feeble pulse. Yet a solution of alum injected frequently by + a syringe is perhaps to be preferred, as it immediately removes the fetor + of the breath, which must much injure the patient by its being + perpetually received into the lungs by respiration.</p> + + <p><a name="species_II_1_3_4">4</a>. <i>Parotitis.</i> Mumps, or branks, + is a contagious inflammation of the parotis and maxillary glands, and has + generally been classed under the word Cynanche or Angina, to which it + bears no analogy. It divides itself into two kinds, which differ in the + degree of fever which attends them, and in the method of cure.</p> + + <p><i>Parotitis suppurans.</i> The suppurating mumps is to be + distinguished by the acuteness of the pain, and the sensitive, irritated, + or inflammatory fever, which attends it.</p> + + <p>M. M. Venesection. Cathartic with calomel three or four grains + repeatedly. Cool air, diluents. This antiphlogistic treatment is to be + continued no longer than is necessary to relieve the violence of the + pain, as the disease is attended with contagion, and must run through a + certain time, like other fevers with contagion.</p> + + <p><i>Parotitis mutabilis.</i> Mutable parotitis. A sensitive fever only, + or a sensitive irritated fever, generally attends this kind. And when the + tumor of the parotis and maxillary glands subsides, a new swelling occurs + in some distant part of the system; as happens to the hands and feet, at + the commencement of the secondary fever of the small-pox, when the tumor + of the face subsides. This new swelling in the parotitis mutabilis is + liable to affect the testes in men, and form a painful tumor, which + should be prevented from suppuration by very cautious means, if the + violence of the pain threaten such a termination; as by bathing the part + with coldish water for a time, venesection, a cathartic; or by a blister + on the perinæum, or scrotum, or a poultice.</p> + + <p>When women are affected with this complaint, after the swelling of the + parotis and maxillary glands subsides, a tumor with pain is liable to + affect their breasts; which, however, I have never seen terminate in + suppuration.</p> + + <p>On the retrocession of the tumor of the testes above described, and I + suppose of that of the breasts in women, a delirium of the calm kind is + very liable to occur; which in some cases has been the first symptom + which has alarmed the friends of the patient; and it has thence been + difficult to discover the cause of it without much inquiry; the previous + symptoms having been so slight as not to have occasioned any complaints. + In this delirium, if the pulse will bear it, venesection should be used, + and three or four grains of calomel, with fomentation of the head with + warm water for an hour together every three or four hours.</p> + + <p>Though this disease generally terminates favourably, considering the + numbers attacked by it, when it is epidemic, yet it is dangerous at other + times in every part of its progress. Sometimes the parotis or maxillary + glands suppurate, producing ulcers which are difficult to cure, and + frequently destroy the patient, where there was a previous scrophulous + tendency. The testis in men is also liable to suppurate with great pain, + long confinement, and much danger; and lastly the affection of the brain + is fatal to many.</p> + + <p>Mr. W. W. had a swelled throat, which after a few days subsided. He + became delirious or stupid, in which state he was dying when I saw him; + and his friends ascribed his death to a coup de soleil, which he was said + to have received some months before, when he was abroad.</p> + + <p>Mr. A. B. had a swelling of the throat, which after a few days + subsided. When I saw him he had great stupor, with slow breathing, and + partial delirium. On fomenting his head with warm water for an hour these + symptoms of stupor were greatly lessened, and his oppressed breathing + gradually ceased, and he recovered in one day.</p> + + <p>Mr. C. D. I found walking about the house in a calm delirium without + stupor; and not without much inquiry of his friends could get the + previous history of the disease; which had been attended with parotitis, + and swelled testis, previous to the delirium. A few ounces of blood were + taken away, a gentle cathartic was directed, and his head fomented with + warm water for an hour, with a small blister on the back, and he + recovered in two or three days.</p> + + <p>Mr. D. D. came down from London in the coach alone, so that no + previous history could be obtained. He was walking about the house in a + calm delirium, but could give no sensible answers to any thing which was + proposed to him. His pulse was weak and quick. Cordials, a blister, the + bark, were in vain exhibited, and he died in two or three days.</p> + + <p>Mr. F. F. came from London in the same manner in the coach. He was + mildly delirious with considerable stupor, and moderate pulse, and could + give no account of himself. He continued in a kind of cataleptic stupor, + so that he would remain for hours in any posture he was placed, either in + his chair, or in bed; and did not attempt to speak for about a fortnight; + and then gradually recovered. These two last cases are not related as + being certainly owing to parotitis, but as they might probably have that + origin.</p> + + <p>The parotitis suppurans, or mumps with irritated fever, is at times + epidemic among cats, and may be called <i>parotitis felina</i>; as I have + reason to believe from the swellings under the jaws, which frequently + suppurate, and are very fatal to those animals. In the village of + Haywood, in Staffordshire, I remember a whole breed of Persian cats, with + long white hair, was destroyed by this malady, along with almost all the + common cats of the neighbourhood; and as the parotitis or mumps had not + long before prevailed amongst human beings in that part of the country, I + recollect being inclined to believe, that the cats received the infection + from mankind; though in all other contagious diseases, except the rabies + canina can be so called, no different genera of animals naturally + communicate infection to each other; and I am informed, that vain efforts + have been made to communicate the small-pox and measles to some + quadrupeds by inoculation. A disease of the head and neck destroyed + almost all the cats in Westphalia. Savage, Nosol. Class X. Art. 30. + 8.</p> + + <p><a name="species_II_1_3_5">5</a>. <i>Catarrhus sensitivus</i> consists + of an inflammation of the membrane, which lines the nostrils and fauces. + It is attended with sensitive fever alone, and is cured by the steam of + warm water externally, and by diluents internally, with moderate + venesection and gentle cathartics. This may be termed catarrhus + sensitivus, to distinguish it from the catarrhus contagiosus, and is in + common language called a violent cold in the head; it differs from the + catarrhus calidus, or warm catarrh, of Class <a + href="#species_I_1_2_7">I. 1. 2. 7</a>. in the production of new vessels, + or inflammation of the membrane, and the consequent more purulent + appearance of the discharge.</p> + + <p><span class="correction" title="Original reads `Rancedo'." + >Raucedo</span> catarrhalis, or catarrhal hoarseness, is a frequent + symptom of this disease, and is occasioned by the pain or soreness which + attends the thickened and inflamed membranes of the larynx; which + prevents the muscles of vocallity from sufficiently contracting the + aperture of it. It ceases with the inflammation, or may be relieved by + the steam of warm water alone, or of water and vinegar, or of water and + ether. See Paralytic Hoarseness, Class <a href="#species_III_2_1_4">III. + 2. 1. 4</a>.</p> + + <p><a name="species_II_1_3_6">6</a>. <i>Catarrhus contagiosus.</i> This + malady attacks so many at the same time, and spreads gradually over so + great an extent of country, that there can be no doubt but that it is + disseminated by the atmosphere. In the year 1782 the sun was for many + weeks obscured by a dry fog, and appeared red as through a common mist. + The material, which thus rendered the air muddy, probably caused the + epidemic catarrh, which prevailed in that year, and which began far in + the north, and extended itself over all Europe. See Botanic Garden, Vol. + II. note on Chunda, and Vol. I. Canto IV, line 294, note; and was + supposed to have been thrown out of a volcano, which much displaced the + country of Iceland.</p> + + <p>In many instances there was reason to believe, that this disease + became contagious, as well as epidemic; that is, that one person might + receive it from another, as well as by the general unsalutary influence + of the atmosphere. This is difficult to comprehend, but may be conceived + by considering the increase of contagious matter in the small-pox. In + that disease one particle of contagious matter stimulates the skin of the + arm in inoculation into morbid action so as to produce a thousand + particles similar to itself; the same thing occurs in catarrh, a few + deleterious atoms stimulate the mucous membrane of the nostrils into + morbid actions, which produce a thousand other particles similar to + themselves. These contagious particles diffused in the air must have + consisted of animal matter, otherwise how could an animal body by being + stimulated by them produce similar particles? Could they then have had a + volcanic origin, or must they not rather have been blown from putrid + marshes full of animal matter? But the greatest part of the solid earth + has been made from animal and vegetable recrements, which may be + dispersed by volcanos.—Future discoveries must answer these + questions.</p> + + <p>As the sensitive fever attending these epidemic catarrhs is seldom + either much irritated or inirritated, venesection is not always either + clearly indicated or forbid; but as those who have died of these catarrhs + have generally had inflamed livers, with consequent suppuration in them, + venesection is adviseable, wherever the cough and fever are greater than + common, so as to render the use of the lancet in the least dubious. And + in some cases a second bleeding was necessary, and a mild cathartic or + two with four grains of calomel; with mucilaginous subacid diluents; and + warm steam occasionally to alleviate the cough, finished the cure.</p> + + <p>The catarrhus contagiosus is a frequent disease amongst horses and + dogs; it seems first to be disseminated amongst these animals by miasmata + diffused in the atmosphere, because so many of them receive it at the + same time; and afterwards to be communicable from one horse or dog to + another by contagion, as above described. These epidemic or contagious + catarrhs more frequently occur amongst dogs and horses than amongst men; + which is probably owing to the greater extension and sensibility of the + mucous membrane, which covers the organ of smell, and is diffused over + their wide nostrils, and their large maxillary and frontal cavities. And + to this circumstance may be ascribed the greater fatality of it to these + animals.</p> + + <p>In respect to horses, I suspect the fever at the beginning to be of + the sensitive, irritated, or inflammatory kind, because there is so great + a discharge of purulent mucus; and that therefore they will bear once + bleeding early in the disease; and also one mild purgative, consisting of + about half an ounce of aloe, and as much white hard soap, mixed together. + They should be turned out to grass both day and night for the benefit of + pure air, unless the weather be too cold (and in that case they should be + kept in an open airy stable, without being tied), that they may hang down + their heads to facilitate the discharge of the mucus from their nostrils. + Grass should be offered them, or other fresh vegetables, as carrots and + potatoes, with mashes of malt, or of oats, and with plenty of fresh warm + or cold water frequently in a day. When symptoms of debility appear, + which may be known by the coldness of the ears or other extremities, or + when sloughs can be seen on the membrane which lines the nostrils, a + drink consisting of a pint of ale with half an ounce of tincture of opium + in it, given every six hours, is likely to be of great utility.</p> + + <p>In dogs I believe the catarrh is generally joined with symptoms of + debility early in the disease. These animals should be permitted to go + about in the open air, and should have constant access to fresh water. + The use of being as much as may be in the air is evident, because all the + air which they breathe passes twice over the putrid sloughs of the + mortified parts of the membrane which lines the nostrils, and the + maxillary and frontal cavities; that is, both during inspiration and + expiration; and must therefore be loaded with contagious particles. Fresh + new milk, and fresh broth, should be given them very frequently, and they + should be suffered to go amongst the grass, which they sometimes eat for + the purpose of an emetic; and if possible should have access to a running + stream of water. As the contagious mucus of the nostrils, both of these + animals and of horses, generally drops into the water they attempt to + drink. Bits of raw flesh, if the dog will eat them, are preferred to + cooked meat; and from five to ten drops of tincture of opium may be given + with advantage, when symptoms of debility are evident, according to the + size of the dog, every six hours. If sloughs can be seen in the nostrils, + they should be moistened twice a day, both in horses and dogs, with a + solution of sugar of lead, or of alum, by means of a sponge fixed on a + bit of whale bone, or by a syringe. The lotion may be made by dissolving + half an ounce of sugar of lead in a pint of water.</p> + + <p>Ancient philosophers seem to have believed, that the contagious + miasmata in their warm climates affected horses and dogs previous to + mankind. If those contagious particles were supposed to be diffused + amongst the heavy inflammable air, or carbonated hydrogen, of putrid + marshes, as these animals hold their heads down lower to the ground, they + may be supposed to have received them sooner than men. And though men and + quadrupeds might receive a disease from the same source of + marsh-putrefaction, they might not afterwards be able to infect each + other, though they might infect other animals of the same genus; as the + new contagious matter generated in their own bodies might not be + precisely similar to that received; as happened in the jail-fever at + Oxford, where those who took the contagion and died, did not infect + others.</p> + + <div class="poem"> + <div class="stanza"> + <p>On mules and dogs the infection first began,</p> + <p>And, last, the vengeful arrows fix'd on man.</p> + <p class="i24"><span class="sc">Pope's</span> Homer's Iliad, I.</p> + </div> + </div> + + <p><a name="species_II_1_3_7">7</a>. <i>Peripneumonia superficialis.</i> + The superficial or spurious peripneumony consists in an inflammation of + the membrane, which lines the bronchia, and bears the same analogy to the + true peripneumony, as the inflammations of other membranes do to that of + the parenchyma, or substantial parts of the viscus, which they surround. + It affects elderly people, and frequently occasions their death; and + exists at the end of the true peripneumony, or along with it; when the + lancet has not been used sufficiently to cure by reabsorbing the inflamed + parts, or what is termed by resolution.</p> + + <p>M. M. Diluents, mucilage, antimonials, warmish air constantly changed, + venesection once, perhaps twice, if the pulse will bear it. Oily volatile + draughts. Balsams? Neutral salts increase the tendency to cough. Blisters + in succession about the chest. Warm bath. Mild purgatives. Very weak + chicken broth without salt in it. Boiled onions. One grain of calomel + every night for a week. From five drops to ten of tincture of opium at + six every night, when the patient becomes weak. Digitalis? See Class <a + href="#species_II_1_6_7">II. 1. 6. 7</a>.</p> + + <p><a name="species_II_1_3_8">8</a>. <i>Pertussis.</i> Tussis convulsiva. + Chin-cough resembles peripneumonia superficialis in its consisting in an + inflammation of the membrane which lines the air-vessels of the lungs; + but differs in the circumstance of its being contagious; and is on that + account of very long duration; as the whole of the lungs are probably not + infected at the same time, but the contagious inflammation continues + gradually to creep on the membrane. It may in this respect be compared to + the ulcers in the pulmonary consumption; but it differs in this, that in + chin-cough some branches of the bronchia heal, as others become + inflamed.</p> + + <p>This complaint is not usually classed amongst febrile disorders, but a + sensitive fever may generally be perceived to attend it during some part + of the day, especially in weak patients. And a peripneumony very + frequently supervenes, and destroys great numbers of children, except the + lancet or four or six leeches be immediately and repeatedly used. When + the child has permanent difficulty of breathing, which continues between + the coughing fits: unless blood be taken from it, it dies in two, three, + or four days of the inflammation of the lungs. During this permanent + difficulty of breathing the hooping-cough abates, or quite ceases, and + returns again after once or twice bleeding; which is then a good symptom, + as the child now possessing the power to cough shews the difficulty of + breathing to be abated. I dwell longer upon this, because many lose their + lives from the difficulty there is in bleeding young children; where the + apothecary is old or clumsy, or is not furnished with a very sharp and + fine-pointed lancet. In this distressing situation the application of + four leeches to one of the child's legs, the wounds made by which should + continue to bleed an hour or two, is a succedaneum; and saves the + patient, if repeated once or twice according to the difficulty of the + respiration.</p> + + <p>The chin-cough seems to resemble the gonorrhœa venerea in + several circumstances. They are both received by infection, are both + diseases of the mucous membrane, are both generally cured in four or six + weeks without medicine. If ulcers in the cellular membrane under the + mucous membrane occur, they are of a phagedenic kind, and destroy the + patient in both diseases, if no medicine be administered.</p> + + <p>Hence the cure should be similar in both these diseases; first general + evacuations and diluents, then, after a week or two, I have believed the + following pills of great advantage. The dose for a child of about three + years old was one sixth part of a grain of calomel, one sixth part of a + grain of opium, and two grains of rhubarb, to be taken twice a day.</p> + + <p>The opium promotes absorption from the mucous membrane, and hence + contributes to heal it. The mercury prevents ulcers from being formed + under the mucous membrane, or cures them, as in the lues venerea; and the + rhubarb is necessary to keep the bowels open.</p> + + <p>M. M. Antimonial vomits frequently repeated. Mild cathartics. Cool + air. Tincture of cantharides, or repeated blisters; afterwards opiates in + small doses, and the bark. Warm bath frequently used. The steam of warm + water with a little vinegar in it may be inhaled twice a day. Could the + breathing of carbonic acid gas mixed with atmospheric air be of service? + Copious venesection, when a difficulty of breathing continues between the + fits of coughing; otherwise the cough and the expectoration cease, and + the patient is destroyed. Ulcers of the lungs sometimes supervene, and + the phthisis pulmonalis in a few weeks terminates in death. Where the + cough continues after some weeks without much of the hooping, and a + sensitive fever daily supervenes, so as to resemble hectic fever from + ulcers of the lungs; change of air for a week or fortnight acts as a + charm, and restores the patient beyond the hopes of the physician.</p> + + <p>Young children should lie with their heads and shoulders raised; and + should be constantly watched day and night; that when the cough occurs, + they may be held up easily, so as to stand upon their feet bending a + little forwards; or nicely supported in that posture which they seem to + put themselves into. A bow of whalebone, about the size of the bow of a + key, is very useful to extract the phlegm out of the mouths of infants at + the time of their coughing; as an handkerchief, if applied at the time of + their quick inspirations after long holding their breath, is dangerous, + and may suffocate the patient in an instant, as I believe has sometimes + happened.</p> + + <p><a name="species_II_1_3_9">9</a>. <i>Variola discreta.</i> The + small-pox is well divided by Sydenham into distinct and confluent. The + former consists of distinct pustules, which appear on the fourth day of + the fever, are circumscribed and turgid; the fever ceasing when the + eruption is complete. Head-ach, pain in the loins, vomiting frequently, + and convulsive fits sometimes, precede the eruption.</p> + + <p>The distinct small-pox is attended with sensitive fever only, when + very mild, as in most inoculated patients; or with sensitive irritated + fever, when the disease is greater: the danger in this kind of small-pox + is owing either to the tumor and soreness of the throat about the height, + or eighth day of the eruption; or to the violence of the secondary fever. + For, first, as the natural disease is generally taken by particles of the + dust of the contagious matter dried and floating in the air, these are + liable to be arrested by the mucus about the throat and tonsils in their + passage to the lungs, or to the stomach, when they are previously mixed + with saliva in the mouth. Hence the throat inflames like the arm in + inoculated patients; and this increasing, as the disease advances, + destroys the patient about the height.</p> + + <p>Secondly, all those upon the face and head come out about the same + time, namely, about one day before those on the hands, and two before + those in the trunk; and thence, when the head is very full, a danger + arises from the secondary fever, which is a purulent, not a variolous + fever; for as the matter from all these of the face and head is + reabsorbed at the same time, the patient is destroyed by the violence of + this purulent fever; which in the distinct small-pox can only be abated + by venesection and cathartics; but in the confluent small-pox requires + cordials and opiates, as it is attended with arterial debility. See Sect. + XXXV. 1. and XXXIII. 2. 10.</p> + + <p>When the pustules on the face recede, the face swells; and when those + of the hands recede, the hands swell; and the same of the feet in + succession. These swellings seem to be owing to the absorption of + variolous matter, which by its stimulus excites the cutaneous vessels to + secrete more lymph, or serum, or mucus, exactly as happens by the + stimulus of a blister. Now, as a blister sometimes produces strangury + many hours after it has risen; it is plain, that a part of the + cantharides is absorbed, and carried to the neck of the bladder; whether + it enters the circulation, or is carried thither by retrograde movements + of the urinary branch of lymphatics; and by parity of reasoning the + variolous matter is absorbed, and swells the face and hands by its + stimulus.</p> + + <p><i>Variola confluens.</i> The confluent small-pox consists of numerous + pustules, which appear on the third day of the fever, flow together, are + irregularly circumscribed, flaccid, and little elevated; the fever + continuing after the eruption is complete; convulsions do not precede + this kind of small-pox, and are so far to be esteemed a favourable + symptom.</p> + + <p>The confluent small-pox is attended with sensitive inirritated fever, + or inflammation with arterial debility; whence the danger of this disease + is owing to the general tendency to gangrene, with petechiæ, or purple + spots, and hæmorrhages; besides the two sources of danger from the tumor + of the throat about the height, or eleventh day of the eruption, and the + purulent fever after that time; which are generally much more to be + dreaded in this than in the distinct small-pox described above.</p> + + <p>M. M. The method of treatment must vary with the degree and kind of + fever. Venesection may be used in the distinct small-pox early in the + disease, according to the strength or hardness of the pulse; and perhaps + on the first day of the confluent small-pox, and even of the plague, + before the sensorial power is exhausted by the violence of the arterial + action? Cold air, and even washing or bathing in cold water, is a + powerful means in perhaps all eruptive diseases attended with fever; as + the quantity of eruption depends on the quantity of the fever, and the + activity of the cutaneous vessels; which may be judged of by the heat + produced on the skin; and which latter is immediately abated by exposure + to external cold. Mercurial purges, as three grains of calomel repeated + every day during the eruptive fever, so as to induce three or four + stools, contribute to abate inflammation; and is believed by some to have + a specific effect on the variolous, as it is supposed to have on the + venereal contagion.</p> + + <p>It has been said, that opening the pock and taking out the matter has + not abated the secondary fever; but as I had conceived, that the pits, or + marks left after the small-pox, were owing to the acrimony of the matter + beneath the hard scabs, which not being able to exhale eroded the skin, + and produced ulcers, I directed the faces of two patients in the + confluent small-pox to be covered with cerate early in the disease, which + was daily renewed; and I was induced to think, that they had much less of + the secondary fever, and were so little marked, that one of them, who was + a young lady, almost entirely preserved her beauty. Perhaps mercurial + plasters, or cerates, made without turpentine in them, might have been + more efficacious, in preventing the marks, and especially if applied + early in the disease, even on the first day of the eruption, and renewed + daily. For it appears from the experiments of Van Woensel, that calomel + or sublimate corrosive, triturated with variolous matter, incapacitates + it from giving the disease by inoculation. Calomel or sublimate given as + an alterative for ten days before inoculation, and till the eruptive + fever commences, is said with certainty to render the disease mild by the + same author. Exper. on Mercury by Van Woensel, translated by Dr. Fowle, + Salisbury.</p> + + <p><i>Variola inoculata.</i> The world is much indebted to the great + discoverer of the good effects of inoculation, whose name is unknown; and + our own country to Lady Wortley Montague for its introduction into this + part of Europe. By inserting the variolous contagion into the arm, it is + not received by the tonsils, as generally happens, I suppose, in the + natural small-pox; whence there is no dangerous swelling of the throat, + and as the pustules are generally few and distinct, there is seldom any + secondary fever; whence those two sources of danger are precluded; hence + when the throat in inoculated small-pox is much inflamed and swelled, + there is reason to believe, that the disease had been previously taken by + the tonsils in the natural way.—Which also, I suppose, has + generally happened, where the confluent kind of small-pox has occurred on + inoculation.</p> + + <p>I have known two instances, and have heard of others, where the + natural small-pox began fourteen days after the contagion had been + received; one of these instances was of a countryman, who went to a + market town many miles from his home, where he saw a person in the + small-pox, and on returning the fever commenced that day fortnight: the + other was of a child, whom the ignorant mother carried to another child + ill of the small-pox, on purpose to communicate the disease to it; and + the variolous fever began on the fourteenth day from that time. So that + in both these cases fever commenced in half a lunation after the + contagion was received. In the inoculated small-pox the fever generally + commences on the seventh day, or after a quarter of a lunation; and on + this circumstance probably depends the greater mildness of the latter. + The reason of which is difficult to comprehend; but supposing the facts + to be generally as above related, the slower progress of the contagion + indicates a greater inirritability of the system, and in consequence a + tendency to malignant rather than to inflammatory fever. This difference + of the time between the reception of the infection and the fever in the + natural and artificial small-pox may nevertheless depend on its being + inserted into a different series of vessels; or to some unknown effect of + lunar periods. It is a subject of great curiosity, and deserves further + investigation.</p> + + <p>When the inoculated small-pox is given under all the most favourable + circumstances I believe less than one in a thousand miscarry, which may + be ascribed to some unavoidable accident, such as the patient having + previously received the infection, or being about to be ill of some other + disease. Those which have lately miscarried under inoculation, as far as + has come to my knowledge, have been chiefly children at the breast; for + in these the habit of living in the air has been confirmed by so short a + time, that it is much easier destroyed, than when these habits of life + have been established by more frequent repetition. See Sect. XVII. 3. + Thus it appears from the bills of mortality kept in the great cities of + London, Paris, and Vienna, that out of every thousand children above + three hundred and fifty die under two years old. (Kirkpatrick on + Inoculation.) Whence a strong reason against our hazarding inoculation + before that age is passed, especially in crowded towns; except where the + vicinity of the natural contagion renders it necessary, or the + convenience of inoculating a whole family at a time; as it then becomes + better to venture the less favourable circumstances of the age of the + patient, or the chance of the pain from toothing, than to risk the + infection in the natural way.</p> + + <p>The most favourable method consists in, first, for a week before + inoculation, restraining the patients from all kinds of fermented or + spirituous liquor, and from animal food; and by giving them from one + grain to three or four of calomel every other day for three times. But if + the patients be in any the least danger of taking the natural infection, + the inoculation had better be immediately performed, and this abstinence + then began; and two or three gentle purges with calomel should be given, + one immediately, and on alternate days. These cathartics should not + induce more than two or three stools. I have seen two instances of a + confluent small-pox in inoculation following a violent purging induced by + too large a dose of calomel.</p> + + <p>Secondly, the matter used for inoculation should be in a small + quantity, and warm, and fluid. Hence it is best when it can be recently + taken from a patient in the disease; or otherwise it may be diluted with + part of a drop of warm water, since its fluidity is likely to occasion + its immediate absorption; and the wound should be made as small and + superficial as possible, as otherwise ulcers have been supposed sometimes + to ensue with subaxillary abscesses. Add to this, that the making two + punctures either on the same, or one on each arm, secures the success of + the operation in respect to communicating the infection.</p> + + <p>Thirdly, at the time of the fever or eruption the application of cool + air to those parts of the skin, which are too warm, or appear red, or are + covered with what is termed a rash, should be used freely, as well as + during the whole disease. And at the same time, if the feet or hands are + colder than natural, these should be covered with flannel. See Class <a + href="#species_IV_2_2_10">IV. 2. 2. 10</a>.</p> + + <p><a name="species_II_1_3_10">10</a>. <i>Rubeola irritata, morbilli.</i> + The measles commence with sneezing, red eyes, dry hoarse cough, and is + attended with sensitive irritated fever. On the fourth day, or a little + later, small thick eruptions appear, scarcely eminent above the skin, + and, after three days, changing into very small branny scales.</p> + + <p>As the contagious material of the small-pox may be supposed to be + diffused in the air like a fine dry powder, and mixing with the saliva in + the mouth to infect the tonsils in its passage to the stomach; so the + contagious material of the measles may be supposed to be more completely + dissolved in the air, and thus to impart its poison to the membrane of + the nostrils, which covers the sense of smell; whence a catarrh with + sneezing ushers in the fever; the termination of the nasal duct of the + lacrymal sac is subject to the same stimulus and inflammation, and + affects by sympathy the lacrymal glands, occasioning a great flow of + tears. See Sect. XVI. 8. And the redness of the eye and eyelids is + produced in consequence of the tears being in so great quantity, that the + saline part of them is not entirely reabsorbed. See Sect. XXIV. 2. 8.</p> + + <p>The contagion of the measles, if it be taken a sufficient time before + inoculation, so that the eruption may commence before the variolous fever + comes on, stops the progress of the small-pox in the inoculated wound, + and delays it till the measle-fever has finished its career. See Sect. + XXXIII. 2. 9.</p> + + <p>The measles are usually attended with inflammatory fever with strong + pulse, and bear the lancet in every stage of the disease. In the early + periods of it, venesection renders the fever and cough less; and, if any + symptoms of peripneumony occur, is repeatedly necessary; and at the + decline of the disease, if a cough be left after the eruption has ceased, + and the subsequent branny scales are falling off, venesection should be + immediately used; which prevents the danger of consumption. At this time + also change of air is of material consequence, and often removes the + cough like a charm, as mentioned in a similar situation at the end of the + chin-cough.</p> + + <p><i>Rubeola inirritata.</i> Measles with inirritated fever, or with + weak pulse, has been spoken of by some writers. See London Med. Observ. + Vol. IV. Art. XI. It has also been said to have been attended with sore + throat. Edinb. Essays, Vol. V. Art. II. Could the scarlet fever have been + mistaken for the measles? or might one of them have succeeded the other, + as in the measles and small-pox mentioned in Sect. XXXIII. 2. 9.?</p> + + <p>From what has been said, it is probable that inoculation might disarm + the measles as much as the small-pox, by preventing the catarrh, and + frequent pulmonary inflammation, which attends this disease; both of + which are probably the consequence of the immediate application of the + contagious miasmata to these membranes. Some attempts have been made, but + a difficulty seems to arise in giving the disease; the blood, I + conjecture, would not infect, nor the tears; perhaps the mucous discharge + from the nostrils might succeed; or a drop of warm water put on the + eruptions, and scraped off again with the edge of a lancet; or if the + branny scales were collected, and moistened with a little warm water? + Further experiments on this subject would be worthy the public + attention.</p> + + <p><a name="species_II_1_3_11">11</a>. <i>Scarlatina mitis.</i> The + scarlet fever exists with all degrees of virulence, from a flea-bite to + the plague. The infectious material of this disease, like that of the + small-pox, I suppose to be diffused, not dissolved, in the air; on which + account I suspect, that it requires a much nearer approach to the sick, + for a well person to receive the infection, than in the measles; the + contagion of which I believe to be more volatile, or diffusible in the + atmosphere. But as the contagious miasmata of small-pox and scarlet fever + are supposed to be more fixed, they may remain for a longer time in + clothes or furniture; as a thread dipped in variolous matter has given + the disease by inoculation after having been exposed many days to the + air, and after having been kept many months in a phial. This also + accounts for the slow or sporadic progress of the scarlet fever, as it + infects others at but a very small distance from the sick; and does not + produce a quantity of pus-like matter, like the small-pox, which can + adhere to the clothes of the attendants, and when dried is liable to be + shook off in the form of powder, and thus propagate the infection.</p> + + <p>This contagious powder of the small-pox, and of the scarlet fever, + becomes mixed with saliva in the mouth, and is thus carried to the + tonsils, the mucus of which arrests some particles of this deleterious + material; while other parts of it are carried into the stomach, and are + probably decomposed by the power of digestion; as seems to happen to the + venom of the viper, when taken into the stomach. Our perception of bad + tastes in our mouths, at the same time that we perceive disagreeable + odours to our nostrils, when we inhale very bad air, occasions us to spit + out our saliva; and thus, in some instances, to preserve ourselves from + infection. This has been supposed to originate from the sympathy between + the organs of taste and smell; but any one who goes into a sick room + close shut up, or into a crowded assembly-room, or tea-room, which is not + sufficiently ventilated, may easily mix the bad air with the saliva on + his tongue so as to taste it; as I have myself frequently attended + to.</p> + + <p>Hence it appears that these heavy infectious matters are more liable + to mix with the saliva, and inflame the tonsils, and that either before + or at the commencement of the fever; and this is what generally happens + in the scarlet fever, always I suppose in the malignant kind, and very + frequently in the mild kind. But as this infection may be taken by other + means, as by the skin, it also happens in the most mild kind, that there + is no inflammation of the tonsils at all; in the same manner as there is + generally no inflammation of the tonsils in the inoculated small-pox.</p> + + <p>In the mild scarlatina on the fourth day of the fever the face swells + a little, at the same time a florid redness appears on various parts of + the skin, in large blotches, at length coalescing, and after three days + changing into branny scales.</p> + + <p>M. M. Cool air. Fruit. Lemonade. Milk and water.</p> + + <p><i>Scarlatina maligna.</i> The malignant scarlet fever begins with + inflamed tonsils; which are succeeded by dark drab coloured sloughs three + or five lines in diameter, flat, or beneath the surrounding surface; and + which conceal beneath them spreading gangrenous ulcers. The swellings of + the tonsils are sensible to the eye and touch externally, and have an + elastic rather than an œdematous feel, like parts in the vicinity + of gangrenes. The pulse is very quick and weak, with delirium, and the + patient generally dies in a few days; or if he recovers, it is by slow + degrees, and attended with anasarca.</p> + + <p>M. M. A vomit once. Wine. Beer. Cyder. Opium. Bark; in small repeated + doses. Small successive blisters, if the extremities are cooler than + natural. Cool air on the hot parts of the skin, the cool extremities + being at the same time covered. Iced lemonade. Broth. Custards. Milk. + Jellies. Bread pudding. Chicken. Touch the ulcers with a dry sponge to + absorb the contagious matter, and then with a sponge filled with vinegar, + with or without sugar of lead dissolved in it, about six grains to an + ounce; or with a very little blue vitriol dissolved in it, as a grain to + an ounce; but nothing so instantaneously corrects the putrid smell of + ulcers as a solution of alum; about half an ounce to a pint of water, + which should be a little warmish, and injected into the fauces gently by + means of a syringe. These should be repeated frequently in a day, if it + can be done easily, and without fatigue to the child. A little powder of + bark taken frequently into the mouth, as a grain or two, that it may mix + with the saliva, and thus frequently stimulate the dying tonsils. Could a + warm bath made of decoction of bark, or a cold fomentation with it, be of + service? Could oxygene gas mixed with common air stimulate the languid + system? Small electric shocks through the tonsils every hour? ether + frequently applied externally to the swelled tonsils?</p> + + <p>As this disease is attended with the greatest degree of debility, and + as stimulant medicines, if given in quantity, so as to produce more than + natural warmth, contribute to expend the already too much exhausted + sensorial power; it appears, that there is nothing so necessary to be + nicely attended to, as to prevent any unnecessary motions of the system; + this is best accomplished by the application of cold to those parts of + the skin, which are in the least too hot. And secondly, that the + exhibition of the bark in such quantity, as not to oppress the stomach + and injure digestion, is next to be attended to, as not being liable to + increase the actions of the system beyond their natural quantity; and + that opium and wine should be given with the greatest caution, in very + small repeated quantity, and so managed as to prevent, if possible, the + cold fits of fever; which probably occur twice in 25 hours, obeying the + lunations like the tides, as mentioned in Sect. XXXII. 6. that is, I + suppose, the cold periods, and consequent exacerbations of fever, in this + malignant scarlatina, occur twice in a lunar day; which is about ten + minutes less than 25 hours; so that if the commencement of one cold fit + be marked, the commencement of the next may be expected, if not disturbed + by the exhibition of wine or opium, or the application of blisters, to + occur in about twelve hours and a half from the commencement of the + former; or if not prevented by large doses of the bark.</p> + + <p>No one could do an act more beneficial to society, or glorious to + himself, than by teaching mankind how to inoculate this fatal disease; + and thus to deprive it of its malignity. Matter might be taken from the + ulcers in the throat, which would probably convey the contagion. Or warm + water might be put on the eruption, and scraped off again by the edge of + a lancet. These experiments could be attended with no danger, and should + be tried for the public benefit, and the honour of medical science.</p> + + <p><a name="species_II_1_3_12">12</a>. <i>Miliaria.</i> Miliary fever. An + eruption produced by the warmth, and more particularly by the stimulus of + the points of the wool in flannel or blankets applied to the skin, has + been frequently observed; which, by cool dress, and bed-clothes without + flannel, has soon ceased. See Class <a href="#species_I_1_2_3">I. 1. 2. + 3</a>. This, which maybe called <i>miliaria sudatoria</i>, has been + confounded with other miliary fevers, and has made the existence of the + latter doubted. Two kinds of eruptions I have seen formerly attended with + fever, but did not sufficiently mark their progress, which I conceived to + be miliary eruptions, one with arterial strength, or with sensitive + irritated fever, and the other with arterial debility, or with sensitive + inirritated fever.</p> + + <p>In the former of these, or <i>miliaria irritata</i>, the eruptions + were distinct and larger than the small-pox, and the fever was not + subdued without two or three venesections, and repeated cathartics with + calomel.</p> + + <p>The latter, or <i>miliaria inirritata</i>, was attended with great + arterial debility; and during the course of the fever pellucid points + appeared within the skin, particularly on the soft parts of the fingers. + And, in one patient, whom I esteemed near her end, I well recollect to + have observed round pellucid globules, like what are often seen on vines + in hot-houses, no larger than the smallest pins' heads, adhere to her + neck and bosom; which were hard to the touch, but were easily rubbed off. + These diseases, if they are allied, do not differ more than the kinds of + small-pox; but require many further observations.</p> + + <p>The eruption so often seen on children in the cradle, and called by + the nurses red-gum, and which is attended with some degree of fever, I + suspect to be produced by too great warmth, and the contact of flannel + next their tender skins, like the miliaria sudatoria; and like that + requires cool air, cool clothes, and linen next their skin.</p> + + <p><a name="species_II_1_3_13">13</a>. <i>Pestis.</i> The plague, like + other diseases of this class, seems to be sometimes mild, and sometimes + malignant; according to the testimony of different writers. It is said to + be attended with inflammation, with the greatest arterial debility, and + to be very contagious, attended at an uncertain time of the fever with + buboes and carbuncles. Some authors affirm, that the contagion of the + plague may be repeatedly received, so as to produce the disease; but as + this is contrary to the general analogy of all contagious diseases, which + are attended with fever, and which cure themselves spontaneously; there + is reason to suspect, that where it has been supposed to have been + repeatedly received, that some other fever with arterial debility has + been mistaken for it, as has probably universally been the case, when the + small-pox has been said to have been twice experienced.</p> + + <p>M. M. Venesection has been recommended by some writers on the first + day, where the inflammation was supposed to be attended with sufficient + arterial strength, which might perhaps sometimes happen, as the bubo + seems to be a suppuration; but the carbuncle, or anthrax, is a gangrene + of the part, and shews the greatest debility of circulation. Whence all + the means before enumerated in this genus of diseases to support the + powers of life are to be administered. Currents of cold air, cold water, + ice, externally on the hot parts of the skin.</p> + + <p>The methods of preventing the spreading of this disease have been much + canvassed, and seem to consist in preventing all congregations of the + people, as in churches, or play-houses; and to remove the sick into tents + on some airy common by the side of a river, and supply them with fresh + food, both animal and vegetable, with beer and wine in proper quantities, + and to encourage those who can, daily to wash both their clothes and + themselves.</p> + + <p>The <i>pestis vaccina</i>, or disease amongst the cows, which + afflicted this island about half a century ago, seems to have been a + contagious fever with great arterial debility; as in some of them in the + latter stage of the disease, an emphysema could often be felt in some + parts, which evinced a considerable progress of gangrene beneath the + skin. In the sensitive inirritated fevers of these animals, I suppose + about sixty grains of opium, with two ounces of extract of oak-bark, + every six hours, would supply them with an efficacious medicine; to which + might be added thirty grains of vitriol of iron, if any tendency to + bloody urine should appear, to which this animal is liable. The method of + preventing the infection from spreading, if it should ever again gain + access to this island, would be immediately to obtain an order from + government to prevent any cattle from being removed, which were found + within five miles of the place supposed to be infected, for a few days; + till the certainty of the existence of the pestilence could be + ascertained, by a committee of medical people. As soon as this was + ascertained, all the cattle within five miles of the place should be + immediately slaughtered, and consumed within the circumscribed district; + and their hides put into lime-water before proper inspectors.</p> + + <p><a name="species_II_1_3_14">14</a>. <i>Pemphigus</i> is a contagious + disease attended with bladdery eruptions appearing on the second or third + day, as large as filberts, which, remain many days, and then effuse a + thin ichor. It seems to be either of a mild kind with sensitive fever + only, of which I have seen two instances, or with irritated, or with + inirritated fever, as appears from the observations of M. Salabert. See + Medical Comment, by Dr. Duncan, Decad. II. Vol. VI.</p> + + <p><a name="species_II_1_3_15">15</a>. <i>Varicella.</i> Chicken-pox is + accompanied with sensitive fever, pustules break out after a mild fever + like the small-pox, seldom suppurate, and generally terminate in scales + without scars. I once saw a lady, who miscarryed during this disease, + though all her children had it as slightly as usual. It sometimes leaves + scars or marks on the skin. This disease has been mistaken for the + small-pox, and inoculated for it; and then the small-pox has been + supposed to happen twice to the same person. See Trans. of the College + London. It is probable that the pemphigus and urticaria, as well as this + disease, have formerly been diseases of more danger; which the habit of + innumerable generations may have rendered mild, and will in process of + time annihilate. In the same manner as the small-pox, venereal disease, + and rickets, seem to become milder or less in quantity every half + century. While at the same time it is not improbable, that other new + diseases may arise, and for a season thin mankind!</p> + + <p><a name="species_II_1_3_16">16</a>. <i>Urticaria.</i> Nettle-rash + begins with mild sensitive fever, which is sometimes scarcely + perceptible. Hence this eruption has been thought of two sorts, one with + and the other without fever. On the second day red spots, like parts + stung with nettles, are seen; which almost vanish during the day, and + recur in the evening with the fever, succeeded in a few days by very + minute scales. See Trans. of the College, London.</p> + + <p><a name="species_II_1_3_17">17</a>. <i>Aphtha.</i> Thrush. It has been + doubted, whether aphtha or thrush, which consists of ulcers in the mouth, + should be enumerated amongst febrile diseases; and whether these ulcers + are always symptomatic, or the consequence rather than the cause of the + fevers which attend them. The tongue becomes rather swelled; its colour + and that of the fauces purplish; sloughs or ulcers appear first on the + throat and edges of the tongue, and at length over the whole mouth. These + sloughs are whitish, sometimes distinct, often coalescing, and remain an + uncertain time. Cullen. I shall concisely mention four cases of aphtha, + but do not pretend to determine whether they were all of them symptomatic + or original diseases.</p> + + <p><i>Aphtha sensitiva.</i> A lady during pregnancy was frequently seized + with ulcers on her tongue and cheeks, or other parts of the mouth, + without much apparent fever; which continued two or three weeks, and + returned almost every month. The thrush in the mouths of young children + seems to be a similar disease. These ulcers resemble those produced in + the sea-scurvy, and have probably for their cause an increased action of + the secerning system from increased sensation, with a decreased action of + the absorbent system from decreased irritation. See Class <span + class="correction" title="Original reads `I. 2. 1. 14.'."><a + href="#species_I_2_1_15">I. 2. 1. 15</a></span>.</p> + + <p>M. M. Solutions of alum, of blue vitriol. Powder of bark taken + frequently into the mouth in very small quantity. See Class <a + href="#species_II_1_3_1">II. 1. 3. 1</a>.</p> + + <p><i>Aphtha irritata.</i> Inflammatory aphtha. A case of this kind is + related under the title of suppurative rheumatism. Class <span + class="correction" title="Original reads `IV. 2. 1. 16.'."><a + href="#species_IV_1_2_16">IV. 1. 2. 16</a></span>.</p> + + <p><i>Aphtha inirritata.</i> Sloughs or ulcers of the mouth, attended + with sensitive fever with great arterial debility. They seem to spread + downwards from the throat into the stomach, and probably through the + whole intestinal canal, beginning their course with cardialgia, and + terminating it with tenesmus; and might perhaps be called an erysipelas + of this mucous membrane.</p> + + <p>M. M. Cool air. A small blister on the back. Bark. Wine. Opium in + small repeated quantities. Soap neutralizes the gastric acid without + effervescence, and thus relieves the pain of cardialgia, where the + stomach is affected. Milk also destroys a part of this acid. Infusion of + sage leaves two ounces, almond soap from five grains to ten, with sugar + and cream, is generally both agreeable and useful to these patients. See + <a href="#species_I_2_4_5">I. 2. 4. 5</a>.</p> + + <p>Where the stomach may be supposed to be excoriated by poisons + containing acid, as sublimate of mercury or arsenic; or if it be + otherwise inflamed, or very sensible to the stimulus of the gastric acid; + or where it abounds with acid of any kind, as in cardialgia; the + exhibition of soap is perhaps a preferable manner of giving alcali than + any other, as it decomposes in the stomach without effervescence; while + the caustic alcali is too acrid to be administered in such cases, and the + mild alcali produces carbonic gas. If a drop of acid of vitriol be put on + cap paper, it will be long before it destroys the paper; but if a drop of + mild alcali be added, a sudden effervescence arises, and the paper is + instantly destroyed by the escape of the fixed air; in the same manner as + lumps of solid lime are broken into powder by the escape of the steam + produced from the water, which is poured on them. This shews why a + succession of acid and of alcaline caustics sooner destroys a part, than + either of them applied separately.</p> + + <p><a name="species_II_1_3_18">18</a>. <i>Dysenteria.</i> Bloody-flux is + attended with sensitive fever generally with arterial debility; with + frequent mucous or bloody stools; which contain contagious matter + produced by the membranes of the intestines; the alimentary excrement + being nevertheless retained; with griping pains and tenesmus.</p> + + <p>M. M. Emetics. Antimonials. Peruvian bark. Opium and calomel of each a + grain every night. Bolus armeniæ. Earth of alum. Chalk. Calcined + hartshorn. Mucilage. Bee's wax mixt with yolk of egg. Cerated glass of + antimony. Warm bath. Flannel clothing next to the skin. Large clysters + with opium. With ipecacuanha, with smoke of tobacco? Two dysenteric + patients in the same ward of the infirmary at Edinburgh quarrelled, and + whipped each other with horsewhips a long time, and were both much better + after it, owing perhaps to the exertion of so much of the sensorial power + of volition; which, like real insanity, added excitement to the whole + system.</p> + + <p>The prevention of this contagion must consist principally in + ventilation and cleanliness; hence the patients should be removed into + cottages distant from each other, or into tents; and their fæces buried + as soon as may be; or conveyed into a running stream; and themselves + should be washed with cold or warm water after every evacuation. For the + contagious matter consists in the mucous or purulent discharge from the + membrane which lines the intestines; and not from the febrile + perspiration, or breath of the patients. For the fever is only the + consequence and not the cause of contagion; as appears from <a + href="#genus_II_1_5">Genus the Fifth</a> of this Order, where contagion + exists without fever.</p> + + <p><a name="species_II_1_3_19">19</a>. <i>Gastritis superficialis.</i> + Superficial inflammation of the stomach. An erysipelatous inflammation of + the stomach is mentioned by Dr. Cullen from his own observations; which + is distinguished from the inflammatory gastritis by less pain, and fever, + and by an erysipelatous redness about the fauces. Does this disease + belong to aphtha?</p> + + <p><a name="species_II_1_3_20">20</a>. <i>Enteritis superficialis.</i> + Superficial inflammation of the bowels is also mentioned by Dr. Cullen + from his own observation under the name of enteritis erythematica; and is + said to be attended with less pain and fever, without vomiting, and with + diarrhœa. May not this disease be referred to aphtha, or to + dysentery?</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_4">IV</a>.</h3> + +<h3><i>With the Production of new Vessels by internal Membranes or Glands, +without Fever.</i></h3> + + <p>Where inflammation is produced in a small part, which has not great + natural sensibility, the additional sensation does not produce an + increased action of the arterial system; that is, the associated motions + which are employed in the circulation of the blood, those for instance of + the heart, arteries, glands, capillaries, and their correspondent veins, + are not thrown into increased action by so small an addition of the + sensorial power of sensation. But when parts, which naturally possess + more sensibility, become inflamed, the quantity of the sensorial power of + sensation becomes so much increased, as to affect the associated motions + belonging to the circulation, occasioning them to proceed with greater + frequency; that is, a fever is induced. This is well exemplified in the + internal and superficial paronychia, one of which is attended with great + pain and fever, and the other with little pain and no fever. See Class <a + href="#species_II_1_2_19">II. 1. 2. 19</a>. and <a + href="#species_II_1_4_5">II. 1. 4. 5</a>.</p> + + <p>From hence it appears, that the sensitive fever is an accidental + consequence of the topical phlegmon, or inflammation, and not a cause of + it; that it is often injurious, but never salutary; and should therefore + always be extinguished, as soon as may be, either by the lancet and + cathartics, and diluents, and cold air, when it is of the irritated kind; + or by the bark, opium, cool air, and nutrientia, when it is of the + inirritated kind.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_4_1">1</a>. <i>Ophthalmia superficialis.</i> As + the membranes, which cover the eye, are excluded from the air about one + third part of the twenty-four hours; and are moistened by perpetual + nictitation during the other sixteen; they may be considered as internal + membranes; and from the analogy of their inflammation to that of other + internal membranes, it is arranged under this genus; whilst the + tonsillitis is esteemed an inflammation of an external membrane, because + currents of air are perpetually passing both day and night over the + fauces.</p> + + <p>The superficial ophthalmy has generally been esteemed a symptom of + scrophula, when it recurs frequently in young persons; but is probably + only a concomitant of that disease, as a symptom of general debility; + ramifications of new red vessels, and of enlarged old ones, are spread + over the white part of the eye; and it is attended with less heat, less + pain, and less intolerance of light than the ophthalmia interna, + described in Class <a href="#species_II_1_2_2">II. 1. 2. 2</a>. It occurs + in those of feeble circulation, especially children of a scrophulous + tendency, and seems to arise from a previous torpor of the vessels of the + tunica albuginea from their being exposed to cold air; and from this + torpor being more liable to occur in habits, which are naturally + inirritable; and therefore more readily fall into quiescence by a smaller + deduction of the stimulus of heat, than would affect stronger or more + irritable habits; the consequence of this torpor is increased action, + which produces pain in the eye, and that induces inflammation by the + acquisition of the additional sensorial power of sensation.</p> + + <p><i>Ophthalmia lymphatica</i> is a kind of anasarca of the tunica + adnata; in this the vessels over the sclerotica, or white part of the + eye, rise considerably above the cornea, which they surround, are less + red than in the ophthalmia superficialis, and appear to be swelled by an + accumulation of lymph rather than of blood; it is probably owing to the + temporary obstruction of a branch of the lymphatic system.</p> + + <p>M. M. If the pain be great, venesection by leeches on the temple, or + cutting the temporal artery, and one purge with three or four grains of + calomel should be premised. Then the Peruvian bark twice a day. Opium + from a quarter to half a grain twice a day for some weeks. Bathe the eye + frequently with cold water alone, or with cold water, to a pint of which + is added half an ounce of salt. White vitriol six grains dissolved in one + ounce of water; a drop or two to be put between the eyelids twice a day. + Take very small electric sparks from the eyes every day for a fortnight. + Bathe the whole head with salt and water made warm every night for some + months. Send such children to a school near the sea for the convenience + of sea-bathing for many months annually; such schools are to be found in + or near Liverpool.</p> + + <p>When a child is afflicted with an inflamed eye of this kind, he should + always sit with his back to the window or candle; but it is generally not + necessary to cover it, or if the uneasy sensation of light makes this + proper, the cover should stand off from the eye, so as not much to + exclude the cool air from it. As covering an eye unnecessarily is liable + to make that eye weaker than the other, from its not being sufficiently + used, and thence to produce a squinting for ever afterwards.</p> + + <p>Nevertheless, when the pain is great, a poultice must be applied to + keep the eyes moist, or a piece of oiled silk bound lightly over them. Or + thus, boil an egg till it is hard, cut it longitudinally into two + hemispheres, take out the yolk, sew the backs of the two hollow + hemispheres of the white to a ribbon, and bind them over the eyes every + night on going to bed; which, if nicely fitted on, will keep the eyes + moist without any disagreeable pressure. See Class <a + href="#species_I_1_3_14">I. 1. 3. 14</a>.</p> + + <p><i>Ophthalmia equina.</i> An inflammation of this kind is liable to + affect the eyes of horses; one cause of which is owing to a silly custom + of cutting the hair out of horses' ears; by which they are not only + liable to take cold at the ear, but grass seeds are liable to fall into + their ears from the high racks in stables; and in both cases the eye + becomes inflamed by sympathy. I once directed the temporal artery of a + horse to be opened, who had frequent returns of an inflamed eye; and I + believed it was of essential service to him; it is probable that the + artery was afterwards contracted in the wounded part, and that thence + less blood was derived to the eye: the hæmorrhage was stopped by two + persons alternately keeping their fingers on the orifice, and afterwards + by a long bandage of broad tape.</p> + + <p><a name="species_II_1_4_2">2</a>. <i>Pterigion.</i> Eye-wing. A spot + of inflammation sometimes begins on the inside of the lower eyelid, or on + the tunica albuginea, and spreads an intertexture of red vessels from it, + as from a center, which extend on the white part of the eye, and have the + appearance of the wing of a fly, from whence its name.</p> + + <p>M. M. Cut the ramifications of vessels again and again with the point + of a lancet close to the center of inflammation.</p> + + <p><a name="species_II_1_4_3">3</a>. <i>Tarsitis palpebrarum.</i> + Inflammation of the edges of the eyelids. This is a disease of the + glands, which produce the hairs of the eye-lashes, and is frequently the + cause of their falling off. After this inflammation a hard scar-like + ridge is left on the edge of the eyelid, which scratches and inflames the + eyeball, and becomes a very troublesome disease.</p> + + <p>The Turkish ladies are said to colour the edge of the eyelash with + crude antimony in very fine powder, which not only gives lustre to the + eye, as a diamond set on a black soil, but may prevent extraneous light + from being reflected from these edges into the eye, and thus serve the + purpose of the black feathers about the eyes of swans, described in Sect. + XXXIX. 5. 1. and may also prevent the edges of the eyelids from being + inflamed by the frequent stimulus of tears on them. Black lead in fine + powder might be better for all these purposes than antimony, and might be + put on with a camel's hair brush.</p> + + <p>M. M. Mercurial ointment smeared at night on the edges of the eyelids. + Burnt alum sixty grains, hog's grease half an ounce, well rubbed into an + ointment to be smeared on them in the night. Cold water frequently in the + day. See Class <a href="#species_II_1_1_8">II. 1. 1. 8</a>.</p> + + <p><a name="species_II_1_4_4">4</a>. <i>Hordeolum.</i> Stye. This + inflammation begins either on or near the edges of the eyelids, or in the + loose skin of them, and is sometimes very slow either in coming to + suppuration or in dispersing. The skin beneath the lower eyelid is the + most frequent seat of this tumor, which sometimes never suppurates at + all, but becomes an incysted tumor: for as this skin is very loose for + the purpose of admitting great motion to the eyelid, the absorbent power + of the veins seems particularly weak in this part; whence when any person + is weakened by fatigue or otherwise, a darker shade of colour is seen + beneath the eyes; which is owing to a less energetic action of the + absorbent terminations of the veins, whence the currents of dark or + venous blood are delayed in them. This dark shade beneath the eyes, when + it is permanent, is a symptom of habitual debility, or inirritability of + the circulating system. See Class <a href="#species_I_2_2_2">I. 2. 2. + 2</a>.</p> + + <p>M. M. Smear the tumors with mercurial ointment, moisten them + frequently with ether. To promote their suppuration they may be wounded + with a lancet, or slit down the middle, or they may be cut out. A caustic + leaves a large scar.</p> + + <p><a name="species_II_1_4_5">5</a>. <i>Paronychia superficialis.</i> + Whitlow. An inflammation about the roots of the nail beneath the skin, + which suppurates without fever, and sometimes destroys the nail; which is + however gradually reproduced. This kind of abscess, though not itself + dangerous, has given opportunity for the inoculation of venereal matter + in the hands of accoucheurs, and of putrid matter from the dissection of + diseased bodies; and has thus been the cause of disease and death. When + putrid matter has been thus absorbed from a dead body, a livid line from + the finger to the swelled gland in the axilla is said to be visible; + which shews the inflammation of the absorbent vessel along its whole + course to the lymphatic gland; and death has generally been the + consequence.</p> + + <p>M. M. In the common paronychia a poultice is generally sufficient. In + the absorption of putrid matter rub the whole hand and arm with mercurial + ointment three or four times a day, or perpetually. Could the swelled + axillary gland be exsected? In the absorption of venereal matter the + usual methods of cure in syphilis must be administered, as in Class <span + class="correction" title="Original reads `II. 1. 5. 1.'."><a + href="#species_II_1_5_2">II. 1. 5. 2</a></span>.</p> + + <p><a name="species_II_1_4_6">6</a>. <i>Gutta rosea.</i> The rosy drop on + the face is of three kinds. First, the <i>gutta rosea hepatica</i>, or + the red pimples on the faces of drunkards, which are probably a kind of + crisis, or vicarious inflammation, which succeeds, or prevents, a torpor + of the membranes of the liver. This and the succeeding species properly + belong to Class <a href="#species_IV_1_2_14">IV. 1. 2. 14</a>.</p> + + <p>Secondly, the pimpled face in consequence of drinking cold water, or + eating cold turnips, or other insipid food, when much heated with + exercise; which probably arises from the sympathy between the skin of the + face and the stomach; and may be called the <i>gutta rosea stomatica</i>. + Which is distinguished from the former by the habits of the patient in + respect to drinking; by the colour of the eruptions being less deep; and + by the patient continuing generally to be troubled with some degree of + apepsia. See Class <a href="#species_I_3_1_3">I. 3. 1. 3</a>. I knew a + lady, who had long been afflicted with pain about the region of the + stomach; and, on drinking half a pint of vinegar, as a medicine, she had + a breaking out commenced on her face; which remained, and she became free + from the pain about the stomach. Was this a stomachic, or an hepatic + disease?</p> + + <p>Thirdly, there is a red face, which consists of smaller pimples than + those above mentioned; and which is less liable to suppurate; and which + seems to be hereditary, or at least has no apparent cause like those + above mentioned; which may be termed <i>gutta rosea hereditaria</i>, or + puncta rosea.</p> + + <p>Mrs. S. had a pimpled face, which I believe arose from potation of + ale. She applied alum in a poultice to it, and had soon a paralytic + stroke, which disabled her on one side, and terminated in her death.</p> + + <p>Mrs. L. had a red pimpled face, which seemed to have been derived from + her mother, who had probably acquired it by vinous potation; she applied + a quack remedy to it, which I believe was a solution of lead, and was + seized with epileptic fits, which terminated in palsy, and destroyed her. + This shews the danger of using white paint on the face, which is called + bismuth, but is in reality white lead or cerussa.</p> + + <p>Mr. Y—— had acquired the gutta rosea on his nose, and + applied a saturnine solution on it for a few nights, and was then seized + with paralysis on one side of his face; which however he gradually + recovered, and has since acquired the gutta rosea on other parts of his + face.</p> + + <p>These fatal effects were probably caused by the disagreeable sensation + of an inflamed liver, which used before to be relieved of the sympathetic + action and consequent inflammation of the skin of the face, which was now + prevented by the stronger stimulus of the application of calx of lead. + The manner in which disagreeable sensations induce epilepsy and palsy is + treated of in Class <a href="#class_III">III</a>. In some cases where + habitual discharges, or eruptions, or ulcers are stopped, a torpor of the + system may follow, owing to the want of the accustomed quantity of + sensation or irritation. See Class <a href="#species_I_1_2_9">I. 1. 2. + 9</a>. and <a href="#species_II_1_5_6">II. 1. 5. 6</a>. In both these + situations some other stimulus should be used to supply the place of that + which is taken away; which may either be perpetual, as an issue; or + periodical, as a cathartic repeated once a fortnight or month.</p> + + <p>Miss W. an elegant young lady of about twenty, applied a mercurial + lotion to her face, which was covered with very small red points; which + seemed to have been not acquired by any known or avoidable means; she was + seized with inflammation of her liver, and after repeated bleeding and + cathartics recovered, and in a few weeks the eruption appeared as + before.</p> + + <p>M. M. Five grains of calomel once a month, with a cathartic, five + grains of rhubarb and a quarter of a grain of emetic tartar every night + for many weeks. With this preparation mercurial plasters, made without + turpentine, and applied every night, and taken off every morning, will + sometimes succeed, and may be used with safety. But blistering the face + all over the eruption, beginning with a part, succeeds better than any + other means, as I have more than once experienced.—Something like + this is mentioned in the Letters of Lady Mary Wortley Montague, who + blistered her face with balsam of Mecca.</p> + + <p>Mrs. F. had for many years had a disagreeably looking eruption on her + chin, after a cathartic with calomel, she was advised to blister her + whole chin; on the healing of the blister a few eruptions again appeared, + which ceased on the application of a second blister. She took rhubarb + five grains, and emetic tartar a quarter of a grain every night for many + weeks.</p> + + <p>Miss L. a young lady about eighteen, had tried variety of advice for + pimples over the greatest part of her face in vain. She took the above + medicines internally, and blistered her face by degrees all over and + became quite beautiful. A spot or two now and then appeared, and on this + account she frequently slept with parts of her face covered with + mercurial plaster, made without turpentine, which was held on by a + pasteboard mask, and taken off in the mornings; if any part of the + plaster adhered, a little butter or oil destroyed the adhesion.</p> + + <p><a name="species_II_1_4_7">7</a>. <i>Odontitis.</i> Inflammatory + tooth-ach is occasioned by inflammation of the membranes of the tooth, or + a caries of the bone itself. The gum sometimes suppurates, otherwise a + swelling of the cheek succeeds by association, and thus the violence of + the pain in the membranes of the tooth is relieved, and frequently cured; + and when this happens the disease properly belongs to Class <a + href="#class_IV">IV</a>. as it so far resembles the translations of + morbid actions in the gout and rheumatism.</p> + + <p>At other times the tooth dies without caries, especially in people + about sixty years of age, or before; and then it stimulates its involving + membrane, like any other extraneous substance. The membrane then becomes + inflamed and thickened, occasioning some pain, and the tooth rises + upwards above the rest, and is gradually pushed out whole and undecayed; + on its rising up a pus-like mucus is seen discharged from the gum, which + surrounds it; and the gum seems to have left the tooth, as the fangs or + roots of it are in part naked.</p> + + <p>M. M. Where the tooth is sound it can only be saved by evacuations by + venesection, and a cathartic; and after its operation two grains of + opium, a blister may also be used behind the ear, and ether applied to + the cheek externally. In slighter cases two grains of opium with or + without as much camphor may be held in the mouth, and suffered to + dissolve near the affected tooth, and be gradually swallowed. See Class + <a href="#species_I_2_4_12">I. 2. 4. 12</a>. Odontalgia may be + distinguished from otitis by the application of cold water to the + affected tooth; for as the pain of common tooth-ach is owing to torpor, + whatever decreases stimulus adds to the torpor and consequent pain; + whereas the pain of an inflamed tooth being ceased by the increased + action of the membranes of it is in some measure alleviated by the + application of cold.</p> + + <p><a name="species_II_1_4_8">8</a>. <i>Otitis.</i> Inflammation and + consequent suppuration of some membranes of the internal ear frequently + occur in children, who sleep in cold rooms, or near a cold wall, without + a night-cap. If the bones are affected, they come out in a long process + of time, and the child remains deaf of that ear. But in this case there + is generally a fever attends this inflammation; and it then belongs to + another genus.</p> + + <p>M. M. A warmer night-cap. Warmish water should be gently syringed into + the ear to keep it clean twice a day; and if it does not heal in a week, + a little spirit of wine should be added; first about a fourth part, and + it should be gradually increased to half rectified spirit and half water: + if it continues long to discharge matter with a very putrid smell, the + bones are injured, and will in time find their exit, during which time + the ear should be kept clean by filling it with a weaker mixture of + spirit of wine and water; or a solution of alum in water; which may be + poured into the ear, as the head is inclined, and shook out again by + turning the head, two or three times morning and evening. See Class <span + class="correction" title="This reference is surely wrong: I cannot determine a correction." + ><a href="#species_II_1_4_10">II. 1. 4. 10</a></span>.</p> + + <p><a name="species_II_1_4_9">9</a>. <i>Fistula lacrymalis.</i> The + lacrymal sack, with its puncta lacrymalia and nasal duct, are liable to + be destroyed by suppuration without fever; the tears then run over the + eyelids, and inflame the edges of them, and the cheeks, by their + perpetual moisture, and saline acrimony.</p> + + <p>M. M. By a nice surgical operation a new aperture is to be made from + the internal corner of the eye into the nostril, and a silver tube + introduced, which supplies the defect by admitting the tears to pass + again into the nostril. See Melanges de Chirurgie par M. Pouteau; who + thinks he has improved this operation.</p> + + <p><a name="species_II_1_4_10">10</a>. <i>Fistula in ano.</i> A mucous + discharge from the anus, called by some white piles, or matter from a + suppurated pile, has been mistaken for the matter from a concealed + fistula. A bit of cotton wool applied to the fundament to receive the + matter, and renewed twice a day for a week or two, should always be used + before examination with the probe. The probe of an unskilful empyric + sometimes does more harm in the loose cellular membrane of these parts + than the original ulcer, by making a fistula he did not find. The cure of + a fistula in ano of those, who have been much addicted to drinking + spirituous liquor, or who have a tendency to pulmonary consumption, is + frequently of dangerous consequence, and is succeeded by ulcers of the + lungs, and death.</p> + + <p>M. M. Ward's paste, or 20 black pepper-corns taken after each meal + twice a day; the pepper-corns should be cut each into two or three + pieces. The late Dr. Monro of Edinburgh asserted in his lectures, that he + had known a fistula in ano cured by injecting first a mixture of + rectified spirit of wine and water; and by gradually increasing the + strength of it, till the patient could bear rectified spirit alone; by + the daily use of which at length the sides of the fistula became callous, + and ceased to discharge, though the cavity was left. A French surgeon has + lately affirmed, that a wire of lead put in at the external opening of + the ulcer, and brought through the rectum, and twisted together, will + gradually wear itself through the gut, and thus effect a cure without + much pain. The ends of the leaden wire must be twisted more and more as + it becomes loose. Or, lastly, it must be laid open by the knife.</p> + + <p><a name="species_II_1_4_11">11</a>. <i>Fistula urethræ.</i> Where a + stricture of the urethra exists, from whatever cause, the patient, in + forcing the stream of urine through the structure, distends the urethra + behind it; which after a time is liable to burst, and to become + perforated; and some of the urine is pushed into the cellular membrane, + occasioning fistulas, which sometimes have large surfaces producing much + matter, which is pressed out at the time of making water, and has been + mistaken for a catarrh of the bladder; these fistulas sometimes acquire + an external opening in the perinæum, and part of the urine is discharged + that way.</p> + + <p>Can this matter be distinguished from mucus of the bladder by the + criterion delivered in Class <a href="#species_II_1_6_6">II. 1. 6. + 6</a>?</p> + + <p>M. M. The perpetual use of bougies, either of catgut or of <span + class="correction" title="Original reads `coartchouc'." + >caoutchouc</span>. The latter may be had at No. 37, Red-lion street, + Holborn, London. The former are easily made, by moistening the catgut, + and keeping it stretched till dry, and then rounding one end with a + pen-knife. The use of a warm bath every day for near an hour, at the heat + of 94 or 96 degrees, for two or three months, I knew to be uncommonly + successful in one case; the extensive fistulas completely healing. The + patient should introduce a bougie always before he makes water, and + endeavour to make it as slowly as possible. See Class <a + href="#species_I_2_3_24">I. 2. 3. 24</a>.</p> + + <p><a name="species_II_1_4_12">12</a>. <i>Hepatitis chronica.</i> + Chronical inflammation of the liver. A collection of matter in the liver + has frequently been found on dissection, which was not suspected in the + living subject. Though there may have been no certain signs of such a + collection of matter, owing to the insensibility of the internal parts of + this viscus; which has thus neither been attended with pain, nor induced + any fever; yet there may be in some cases reason to suspect the existence + of such an abscess; either from a sense of fulness in the right + hypochondre, or from transient pains sometimes felt there, or from pain + on pressure, or from lying on the left side, and sometimes from a degree + of sensitive fever attending it.</p> + + <p>Dr. Saunders suspects the acute hepatitis to exist in the inflammation + of the hepatic artery, and the chronical one in that of the vena + portarum. Treatise on the Liver. Robinson. London.</p> + + <p><a name="species_II_1_4_13">13</a>. <i>Scrophula suppurans.</i> + Suppurating scrophula. The indolent tumors of the lymphatic glands are + liable, after a long time, to regain their sensibility; and then, owing + to their former torpor, an increased action of the vessels, beyond what + is natural, with inflammation, is the consequence of their new life, and + suppuration succeeds. This cure of scrophula generally happens about + puberty, when a new energy pervades the whole system, and unfolds the + glands and organs of reproduction.</p> + + <p>M. M. See Class <a href="#species_I_2_3_21">I. 2. 3. 21</a>. Where + scrophulous ulcers about the neck are difficult to heal, Dr. Beddoes was + informed, in Ireland, that an empyric had had some success by inflaming + them by an application of wood sorrel, oxalis acetosella, the leaves of + which are bruised in a mortar, and applied on the ulcers for two or three + days, and then some more lenient application is used.</p> + + <p>A poor boy, about twelve years old, had a large scrophulous ulcer on + one side of the chest beneath the clavicle, and another under his jaw; he + was directed, about three weeks ago, to procure a pound of dry oak-bark + from the tanners, and to reduce it to fine powder, and to add to it one + ounce of white lead in fine powder, and to cover the ulcers daily with + it, keeping it on by brown paper and a bandage. He came to me a few + minutes ago, to shew me that both the ulcers are quite healed. The + constant application of linen rags, moistened with a solution of an ounce + of sugar of lead in a pint of water, I think I have seen equally + efficacious.</p> + + <p><a name="species_II_1_4_14">14</a>. <i>Scorbutus suppurans.</i> In the + sea-scurvy there exists an inactivity of venous absorption, whence + vibices and petechiæ, and sometimes ulcers. As the column of blood + pressing on the of origins of the veins of the lower extremities, when + the body is erect, opposes the ascent of the blood in them, they are more + frequently liable to become enlarged, and to produce varixes, or vibices, + or, lastly, ulcers about the legs, than on the upper parts of the body. + The exposure to cold is believed to be another cause of ulcers on the + extremities; as happens to many of the poor in winter at Lisbon, who + sleep in the open air, without stockings, on the steps of their churches + or palaces. See Class <a href="#species_I_2_1_15">I. 2. 1. 15</a>.</p> + + <p>M. M. A bandage spread with plaster to cover the whole limb tight. + Rags dipped in a solution of sugar of lead. A warm flannel stocking or + roller. White lead and oak bark, both in fine powder. Horizontal + rest.</p> + + <p><a name="species_II_1_4_15">15</a>. <i>Scirrhus suppurans.</i> When a + scirrhus affects any gland of no great extent or sensibility, it is, + after a long period of time, liable to suppurate without inducing fever, + like the indolent tumors of the conglobate or lymphatic glands above + mentioned; whence collections of matter are often found after death both + in men and other animals; as in the liver of swine, which have been fed + with the grounds of fermented mixtures in the distilleries. Another + termination of scirrhus is in cancer, as described below. See Class <a + href="#species_I_2_3_22">I. 2. 3. 22</a>.</p> + + <p><a name="species_II_1_4_16">16</a>. <i>Carcinoma.</i> Cancer. When a + schirrous tumor regains its sensibility by nature, or by any accidental + hurt, new vessels shoot amongst the yet insensible parts of it, and a new + secretion takes place of a very injurious material. This cancerous matter + is absorbed, and induces swelling of the neighbouring lymphatic glands; + which also become schirrous, and afterwards cancerous.</p> + + <p>This cancerous matter does not seem to acquire its malignant or + contagious quality, till the cancer becomes an open ulcer; and the matter + secreted in it is thus exposed to the air. Then it evidently becomes + contagious, because it not only produces hectic fever, like common matter + in ulcers open to the air; but it also, as it becomes absorbed, swells + the lymphatic glands in its vicinity; as those of the axilla, when the + open cancer is on the breast. See Class <a href="#genus_II_1_3">II. 1. + 3</a>.</p> + + <p>Hence exsection before the cancer is open is generally a cure; but + after the matter has been exposed to the air, it is seldom of service; as + the neighbouring lymphatic glands are already infected. I have observed + some of these patients after the operation to have had diseased livers, + which might either have previously existed, or have been produced by the + fear or anxiety attending the operation.</p> + + <p>Erosion with arsenic, after the cancer is become an open ulcer, has + generally no better effect than exsection, but has been successful before + ulceration. The best manner of using arsenic, is by mixing one grain with + a dram of lapis calaminaris, and strewing on the cancer some of the + powder every day, till the whole is destroyed.</p> + + <p>Cancers on the face are said to arise from the periosteum, and that + unless this be destroyed by the knife, or by caustics, the cancer + certainly recurs. After the cancer becomes an open ulcer of some extent, + a purulent fever supervenes, as from other open ulcers, and gradually + destroys the patient. See Class <a href="#species_II_1_6_13">II. 1. 6. + 13</a>.</p> + + <p>Two very interesting cases have been lately published by Dr. Ewart, of + Bath, in which carbonic acid gas, or fixed air, was kept constantly in + contact with the open cancerous ulcers of the breast; which then healed + like other common ulcers. This is rather to be ascribed to the exclusion + of oxygen, than to any specific virtue in the carbonic acid. As in common + ulcers the matter does not induce hectic fever, till it has been exposed + to the air, and then probably united with oxygen.</p> + + <p>The manner of applying the fixed air, is by including the cancer in + one half or hemisphere of a large bladder; the edges are made to adhere + to the skin by adhesive plaster, or perhaps a mixture of one part of + honey with about twenty parts of carpenter's glue might better suit some + tender skins. The bladder is then kept constantly filled with carbonic + acid gas, by means of a pipe in the neck of it; and the matter let out at + a small aperture beneath.</p> + + <p><a name="species_II_1_4_17">17</a>. <i>Arthrocele.</i> Swelling of the + joints seems to have its remote cause in the softness of the bones, for + they could not swell unless they were previously softened, see Class + <span class="correction" title="Original reads `I. 2. 2. 12.'."><a + href="#species_I_2_2_14">I. 2. 2. 14</a></span>. The epiphyses, or ends + of the bones, being naturally of a looser texture, are most liable to + this disease, and perhaps the cartilages and capsular ligaments may also + become inflamed and swelled along with the heads of the bones. This + malady is liable to distort the fingers and knees, and is usually called + gout or rheumatism; the former of which is liable to disable the fingers + by chalk-stones, and thence to have somewhat a similar appearance. But + the arthrocele, or swelling of the joints, affects people who have not + been intemperate in the use of fermented or spirituous liquors; or who + have not previously had a regular gout in their feet; and in both these + circumstances differs from the gout. Nor does it accord with the + inflammatory rheumatism, as it is not attended with fever, and because + the tumors of the joints never entirely subside. The pain or sensibility, + which the bones acquire, when they are inflamed, may be owing to the new + vessels, which shoot in them in their soft state, as well as to the + distention of the old ones.</p> + + <p>M. M. Half a grain of opium twice a day, gradually increased to a + grain, but not further, for many months. Thirty grains of powder of bark + twice a day for many months. Ten grains of bone-ashes, or calcined + hartshorn, twice a day, with decoction of madder? Soda phosphorata?</p> + + <p><a name="species_II_1_4_18">18</a>. <i>Arthropuosis.</i> Joint-evil. + This differs from the former, as that never suppurates; these ulcers of + the joints are generally esteemed to arise from scrophula; but as + scrophula is a disease of the lymphatic or absorbent system, and this + consists in the suppuration of the membranes, or glands, or cartilages + about the joints, there does not seem a sufficient analogy to authorize + their arrangement under the same name.</p> + + <p>The white swelling of the knee, when it suppurates, comes under this + species, with variety of other ulcers attended with carious bones.</p> + + <p><a name="species_II_1_4_19">19</a>. <i>Caries ossium.</i> A caries of + the bones may be termed a suppuration of them; it differs from the above, + as it generally is occasioned by some external injury, as in decaying + teeth; or by venereal virus, as in nodes on the tibia; or by other matter + derived to the bone in malignant fevers; and is not confined to the ends + of them.</p> + + <p>The separation of the dead bone from the living is a work of some + time. See Sect. XXXIII. 3. 1.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_5">V</a>.</h3> + +<h3><i>With the Production of new Vessels by external Membranes or Glands, +without Fever.</i></h3> + + <p>The ulcers, or eruptions, which are formed on the external skin, or on + the mouth or throat, or on the air-cells of the lungs, or on the + intestines, all of which are more or less exposed to the contact of the + atmospheric air, which we breathe, and which in some proportion we + swallow with our food and saliva; or to the contact of the inflammable + air, or hydrogen, which is set at liberty by the putrefying aliment in + the intestines, or by putrefying matter in large abscesses; all of them + produce contagious matter; which, on being inoculated into the skin of + another person, will produce fever, or a similar disease.</p> + + <p>In some cases even the matter formed beneath the skin becomes in some + degree contagious, at least so much so as to produce fever of the hectic + or malignant kind, as soon as it has pierced through the skin, and has + thus gained access to some kind of air; as the fresh puss of a common + abscess; or the putrid pus of an abscess, which has been long confined; + or of cancerous ulcers.</p> + + <p>From this analogy there is reason to suspect, that the matter of all + contagious diseases, whether with or without fever, is not infectious + till it has acquired something from the air; which, by oxygenating the + secreted matter, may probably produce a new acid. And secondly, that in + hectic fever a part of the purulent matter is absorbed; or acts on the + surface of the ulcer; as variolous matter affects the inoculated part of + the arm. And that hectic fever is therefore caused by the matter of an + open ulcer; and not by the sensation in the ulcer independent of the + aerated pus, which lies on it. Which may account for the venereal matter + from buboes not giving the infection, according to the experiments of the + late Mr. Hunter, and for some other phenomena of contagion. See Variola + discreta, Class <a href="#species_II_1_3_9">II. 1. 3. 9</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_5_1">1</a>. <i>Gonorrhœa venerea.</i> A + pus-like contagious material discharged from the urethra after impure + cohabitation, with smarting or heat on making water; which begins at the + external extremity of the urethra, to which the contagious matter is + applied, and where it has access to the air.</p> + + <p>M. M. In this state of the venereal disease once venesection, with + mild cathartics of senna and manna, with mucilage, as almond emulsion, + and gum arabic, taken for two or three weeks, absolve the cure. Is + camphor of use to relieve the ardor urinæ? Do balsams increase or lessen + the heat of urine? Neutral salts certainly increase the smarting in + making water, by increasing the acrimony of the urine.</p> + + <p>Can the discharge from the urethra be soon stopped by saturnine + injections, or mercurial ones, or with solution of blue vitriol, at first + very dilute, and gradually made stronger? And at the same time lest the + syphilis, or general disease, should supervene, the patient might take a + quarter of a grain of corrosive sublimate of mercury twice a day, as + directed below?</p> + + <p><a name="species_II_1_5_2">2</a>. <i>Syphilis.</i> Venereal disease. + The contagion shews itself in ulcers on the part first inoculated, as + chancres; ulcers on the tonsils succeed, with eruption on the skin, + especially about the roots of the hair; afterwards on other parts of the + skin, terminating in dry scabs; and lastly, with pain and swelling of the + bones.</p> + + <p>The corona veneris, or crown of Venus, consists of the eruptions at + the roots of the hair appearing most round the forehead; which is + occasioned by this part being more exposed to the air; which we observed, + at the beginning of this genus, either produces or increases the + virulence of contagious matter. But it is difficult to conceive from this + history, why the throat should be first affected; as it cannot be + supposed, that the disease is so often taken by the saliva, like the + small-pox, though this may sometimes occur, perhaps very often. The + connection between the genitals in men and the throat, is treated of in + Class <a href="#species_IV_1_2_7">IV. 1. 2. 7</a>. Hydrophobia.</p> + + <p>M. M. A quarter of a grain of corrosive sublimate of mercury, taken + thrice a day for five or six weeks, made into a pill with breadcrumbs, or + dissolved in a spoonful of brandy and water, is a very efficacious and + almost certain cure. When it does not succeed, it is owing either to the + drug being bad, or to its having precipitated from the brandy, or from + its being spoiled in the pill by long keeping. Opium contributes much to + expedite the cure both of the simple gonorrhœa, and of venereal + ulcers, by increasing absorption both from the mucous membrane, and from + the surface of ulcers.</p> + + <p><a name="species_II_1_5_3">3</a>. <i>Lepra.</i> Leprosy. Leprosy of + the Greeks. The skin is rough with white branny scales, which are full of + chinks; often moist beneath, and itching. The scales on the head or arms + of some drinking people are a disease of this kind. The perspirable + matter designed for the purpose of lubricating the external skin is + secreted in this disease in a too viscid state, owing to the inflammation + of the subcutaneous vessels; and, as the absorbents act too strongly at + the same time, a viscid mucus is left adhering to the surface of the + skin.</p> + + <p>In the leprosy of the Jews, described in the thirteenth and fourteenth + chapters of Leviticus, the depression of the sore beneath the surface of + the skin, and the hairs in it becoming white, seem to have been the + principal circumstances, which the priest was directed to attend to for + the purpose of ascertaining the disease.</p> + + <p>M. M. Essence of antimony from 20 drops to 100 twice or thrice a day, + with half a pint of decoction of elm-bark; or tincture of cantharides + from 20 to 60 drops four times a day; or sublimate of mercury, with much + diluting fluid. Acid of vitriol? Perhaps the cure chiefly depends on much + dilution with water, from two to four pints a day, in which elm-bark, or + pine-buds, or juniper-tops, may be boiled. Bath or Buxton water drank in + large quantities. Warm bath. Oil-skin bound on the part to confine the + perspirable matter. Ointment of tar and suet; or poultice for two or + three days, and then cerate with lapis calaminaris. Diet of raisins and + bread. Abstinence from wine, beer, and all spirits.</p> + + <p><a name="species_II_1_5_4">4</a>. <i>Elephantiasis.</i> Leprosy of the + Arabs. A contagious disease; the skin is thickened, wrinkled, rough, + unctuous, destitute of hair, without any sensation of touch in the + extremities of the limbs; the face deformed with tubercles; the voice + hoarse, and with a nasal tone. Cullen.</p> + + <p><a name="species_II_1_5_5">5</a>. <i>Framboesia.</i> Yaws is said to + be contagious and hereditary. It principally affects the negroes in the + West Indies. Edinb. Essays, Vol. VI.</p> + + <p><a name="species_II_1_5_6">6</a>. <span class="correction" + title="Original reads `Psory' (compare contents list & index)." + ><i>Psora.</i></span> Itch. A contagious prurient eruption. There are two + kinds of itch, that which appears between the fingers, and under the + joints of the knees and elbows; and that which seldom is seen in these + places, but all over the other parts of the body. The latter is seldom + thought to be the itch, as it does not easily infect even a bedfellow, + and resists the usual means of cure by brimstone.</p> + + <p>If the itch be cured too hastily by rubbing mercurial or arsenical + preparations over the whole body, or on too great a part of it, many bad + symptoms are produced; as weakness of digestion, with pale bloated + countenance, and tendency to dropsy. I have twice seen St. Vitus's dance + occur from the use of a mercurial girdle; and once a swelled liver. I + have also seen a swelled spleen and swelled legs from the external use of + arsenic in the cure of the itch. And very numerous and large phlegmons + commonly succeed the too hasty cure of it by other means.</p> + + <p>There does not appear a strict analogy between the hasty cure of the + itch, and the retrocession of the pustles in the secondary fever of the + small-pox; because in that the absorption of the matter is evinced by the + swelling of the face and hands, as the pustles recede, as explained in + Class <a href="#species_II_1_3_9">II. 1. 3. 9</a>. Variola discreta. And + a fever is produced by this absorption; neither of which happen, when the + pustles of the itch are destroyed by mercury or arsenic.</p> + + <p>Nor can these inconveniences, which occur on the too hasty cure of the + itch, be explained by those which follow the cure of some kinds of gutta + rosea, Class <a href="#species_II_1_4_6">II. 1. 4. 6</a>. as in those the + eruptions on the face were an associated disease with inflammation of the + liver or stomach, which they were accustomed to relieve; whereas the itch + is not known to have had any previous catenation with other diseases.</p> + + <p>In the itch there exists not only great irritation in the production + of the pustles, but great sensation is caused by their acrimony + afterwards; insomuch that the pain of itching, without the interrupted + smarting occasioned by scratching, would be intolerable. This great + excitement of the two sensorial powers of irritation and sensation is so + great, when the pustles are diffused over the whole surface of the body, + that a torpor succeeds the sudden ceasing of it; which affects those + parts of the system, which were most catenated with the new motions of + the skin, as the stomach, whence indigestion and flatulency; or which are + generally most liable to fall into torpor, as the numerous glands, which + form the liver. Whence the diseases consequent to the hasty cure of the + itch are diseases of debility, as tumid viscera, œdematous + swellings, and St. Vitus's dance, which is a debility of association. In + the same manner indigestion, with green evacuations, are said to follow + an injudicious application of cerussa to stop too hastily the exsudation + behind the ears of children, Class <a href="#species_I_1_2_9">I. 1. 2. + 9</a>. And dropsies are liable to succeed the cure of old ulcers of the + legs, which have long stimulated the system.</p> + + <p>M. M. The size of a large pea, of an ointment consisting of one part + of white precipitate of mercury to six parts of hogs' lard well + triturated together, to be rubbed on a part of the body every night, and + washed off with soap and water next morning, till every part is cleared; + with lac sulphuris twenty grains to be taken every morning inwardly. Warm + saline bath, with white vitriol in it. Flowers of sulphur mixed with + thick gruel, with hogs fat. With either of which the body may be smeared + all over.</p> + + <p><a name="species_II_1_5_7">7</a>. <i>Psora ebriorum.</i> Elderly + people, who have been much addicted to spirituous drinks, as beer, wine, + or alcohol, are liable to an eruption all over their bodies; which is + attended with very afflicting itching, and which they probably propagate + from one part of their bodies to another with their own nails by + scratching themselves. I saw fatal effects in one such patient, by a too + extensive use of a solution of lead; the eruption disappeared, he became + dropsical, and died; I suppose from the too suddenly ceasing of the great + stimulus caused by the eruptions over the whole skin, as in the preceding + article.</p> + + <p>M. M. The patient should gradually accustom himself to half his usual + quantity of vinous potation. The warm bath, with one pound of salt to + every three gallons. Mercurial ointments on small parts of the skin at a + time. A grain of opium at night instead of the usual potation of wine or + beer.</p> + + <p><a name="species_II_1_5_8">8</a>. <i>Herpes.</i> Herpes consists of + gregarious spreading excoriations, which are succeeded by branny scales + or scabs. In this disease there appears to be a deficient absorption of + the subcutaneous mucus, as well as inflammation and increased secretion + of it. For the fluid not only excoriates the parts in its vicinity by its + acrimony, but is very saline to the taste, as some of these patients have + assured me; I believe this kind of eruption, as well as the tinea, and + perhaps all other cutaneous eruption, is liable to be inoculated in other + parts of the body by the finger-nails of the patients in scratching + themselves.</p> + + <p>It is liable to affect the hands, and to return at distant periods; + and is probably a secondary disease, as well as the zona ignea, or + shingles, described below.</p> + + <p>M. M. Poultice the eruption with bread and milk, or raw carrots + grated, for two or three whole days, to dilute or receive the discharged + fluid, and abate the inflammation; then cover the parts with fresh cerate + mixed with lapis calaminaris. On the parts not excoriated mercurial + ointment, made of one part of white calx of mercury and six of hogs' fat. + Internally, after venesection, gentle repeated cathartics. Lastly, the + bark. Acid of vitriol. Bolus Armeniæ, or testacia. Antimonials. Decoction + of interior bark of elm.</p> + + <p><a name="species_II_1_5_9">9</a>. <i>Zona ignea.</i> Shingles. This + eruption has been thought a species of herpes by some writers, and by + others a species of erysipelas. Yellow or livid vesicles appear, + producing a corrosive ichor, which is sometimes attended with a degree of + fever. It is said to infest sometimes the thorax and ribs, but its most + general situation is on the small of the back, over one kidney, extending + forward over the course of one of the ureters.</p> + + <p>There is reason to suspect, that this also is a secondary or + sympathetic disease, as well as the preceding one; but future + observations are required, before it can be removed to the fourth class, + or diseases of association. In three patients I have been induced to + believe, that the eruption on the loins was a translation of inflammation + from the external membrane of the kidney to the skin. They had, for a day + or two before the appearance of the eruption, complained of a dull pain + on the region of one kidney, but without vomiting; by which it was + distinguished from nephritis interna, or gravel; and without pain down + the outside of the thigh, by which it was distinguished from sciatica. In + other situations the shingles may sympathize with other internal + membranes, as in a case published by Dr. Russel (De Tabe Glandulari), + where the retrocession of the shingles was succeeded by a serious + dyspnæa.</p> + + <p>M. M. Venesection, if the pulse is strong. Calomel three or four + grains, very mild repeated cathartics. Poultice for a few days, then + cerate of lapis calaminaris, as in herpes. A grain of emetic tartar + dissolved in a pint of water, and taken so as to empty the stomach and + intestines, is said much to hasten the cure; compresses soaked in a + saturnine solution are recommended externally on the eruption; and cerate + where there are ulcerations. Desanet's Surgical Journal, Vol. II. p. 378. + If this be a vicarious disease, it should continue half a lunation; lest, + on its ceasing, the bad habits of motion of the primary disease should + not have been so perfectly dissevered, but that they may recur.</p> + + <p><a name="species_II_1_5_10">10</a>. <i>Annulus repens.</i> Ring-worm. + A prurient eruption formed in a circle, affecting children, and would + seem to be the work of insects, according to the theory of Linnæus, who + ascribes the itch and dysentery to microscopic animalcula. These + animalcula are probably the effect, and not the cause, of these + eruptions; as they are to be seen in all putrescent animal fluids. The + annular propagation of the ring-worm, and its continuing to enlarge its + periphery, is well accounted for by the acrimony of the ichor or saline + fluid eroding the skin in its vicinity.</p> + + <p>M. M. Cover the eruption daily with ink. With white mercurial + ointment, as described above in herpes. With solution of white vitriol + ten grains to an ounce. These metallic calces stimulate the absorbents + into stronger action, whence the fluid has its saline part reabsorbed, + and that before it has access to the air, which probably adds to its + acrimony by oxygenating it, and thus, producing a new acid.</p> + + <p><a name="species_II_1_5_11">11</a>. <i>Tinea.</i> Scald head. This + contagious eruption affects the roots of the hair, and is generally most + virulent around the edges of the hair on the back part of the head; as + the corona veneris appears most on the edges of the hair on the forepart + of the head; for in these parts the eruption about the roots of the hair + is most exposed to the external air, by which its acrimony or noxious + quality is increased.</p> + + <p>The absorption of the matter thus oxygenated swells the lymphatics of + the neck by its stimulus, occasioning many little hard lumps beneath the + seat of the eruption; when this happens, the sooner it is cured the + better, lest the larger lymphatics of the neck should become + affected.</p> + + <p>M. M. The art of curing these eruptions consists, first, in abating + the inflammation, and consequent secretion of a noxious material. + Secondly, to prevent its access to the air, which so much increases its + acrimony. And thirdly, to promote the absorption of it, before it has + been exposed to the air; for these purposes venesection once, and gentle + cathartics, which promote absorption by emptying the blood-vessels. Next + poultices and fomentations, with warm water, abate inflammation by + diluting the saline acrimony of the secreted fluid, and abating the + painful sensation. Afterwards cerate joined with some metallic calx, as + of zinc or lead, or solution of lead, mercury, or copper, or iron, which + may stimulate the absorbent system into stronger action.</p> + + <p>Cover the shaved head with tar and suet, and a bladder; this, by + keeping the air from the secreted fluid, much contributes to its + mildness, and the stimulus of the tar increases its absorption. See the + three preceding species of this genus.</p> + + <p><a name="species_II_1_5_12">12</a>. <i>Crusta lactea.</i> Milk-crust + is a milder disease than tinea, affecting the face as well as the hairy + scalp of very young children. It is not infectious, nor liable to swell + the lymphatics in its vicinity like the tinea.</p> + + <p>M. M. Cover the eruption with cerate made with lapis calaminaris, to + be renewed every day. Mix one grain of emetic tartar with forty grains of + chalk, and divide into eight papers, one to be taken twice a day, or with + magnesia alba, if stools are wanted. The child should be kept cool and + much in the air.</p> + + <p><a name="species_II_1_5_13">13</a>. <i>Trichoma.</i> Plica polonica. A + contagious disease, in which the hair is said to become alive and bleed, + forming inextricable knots or plaits of great length, like the fabled + head of Medusa, with intolerable pain, so as to confine the sufferer on + his bed for years.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_6">VI</a>.</h3> + +<h3><i>With Fever consequent to the Production of new Vessels or Fluids.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_6_1">1</a>. <i>Febris sensitiva.</i> Sensitive + fever, when unmixed with either irritative or inirritative fever, may be + distinguished from either of them by the less comparative diminution of + muscular strength; or in other words, from its being attended with less + diminution of the sensorial power of irritation. An example of unmixed + sensitive fever may generally be taken from the pulmonary consumption; in + this disease patients are seen to walk about with ease, and to do all the + common offices of life for weeks, and even months, with a pulse of 120 + strokes in a minute; while in other fevers, whether irritated or + inirritated, with a pulse of this frequency, the patient generally lies + upon the bed, and exerts no muscular efforts without difficulty.</p> + + <p>The cause of this curious phenomenon is thus to be understood; in the + sensitive fever a new sensorial power, viz. that of sensation, is + superadded to that of irritation; which in other fevers alone carries on + the increased circulation. Whence the power of irritation is not much + more exhausted than in health; and those muscular motions, which are + produced in consequence of it, as those which are exerted in keeping the + body upright in walking, riding, and in the performance of many customary + actions, are little impaired. For an account of the irritated sensitive + fever, see Class <a href="#species_II_1_2_1">II. 1. 2. 1</a>.; for the + inirritated sensitive fever, Class <a href="#species_II_1_3_1">II. 1. 3. + 1</a>. <a href="#species_IV_2_4_11">IV. 2. 4. 11</a>.</p> + + <p><a name="species_II_1_6_2">2</a>. <i>Febris a pure clauso.</i> Fever + from inclosed matter is generally of the irritated sensitive kind, and + continues for many weeks, and even months, after the abscess is formed; + but is distinguished from the fever from aerated matter in open ulcers, + because there are seldom any night-sweats, or colliquative diarrhœa + in this, as in the latter. The pulse is also harder, and requires + occasional venesection, and cathartics, to abate the inflammatory fever; + which is liable to increase again every three or four days, till at + length, unless the matter has an exit, it destroys the patient. In this + fever the matter, not having been exposed to the air, has not acquired + oxygenation; in which a new acid, or some other noxious property, is + produced; which acts like contagion on the constitution inducing + fever-fits, called hectic fever, which terminate with sweats or + diarrhœa; whereas the matter in the closed abscess is either not + absorbed, or does not so affect the circulation as to produce diurnal or + hectic fever-fits; but the stimulus of the abscess excites so much + sensation as to induce perpetual pyrexia, or inflammatory fever, without + such marked remissions. Nevertheless there sometimes is no fever + produced, when the matter is lodged in a part of little sensibility, as + in the liver; yet a white pus-like sediment in those cases exists I + believe generally in the urine, with occasional wandering pains about the + region of the liver or chest.</p> + + <p><a name="species_II_1_6_3">3</a>. <i>Vomica.</i> An abscess in the + lungs is sometimes produced after peripneumony, the cough and shortness + of breath continue in less degree, with difficulty in lying on the well + side, and with sensitive irritated fever, as explained in the preceding + article.</p> + + <p>The occasional increase of fever, with hard pulse and sizy blood, in + these patients, is probably owing to the inflammation of the walls of the + vomica; as it is attended with difficulty of breathing, and requires + venesection. Mr. B——, a child about seven years old, lived + about five weeks in this situation, with a pulse from 150 to 170 in a + minute, without sweats, or diarrhœa, or sediment in his water, + except mucus occasionally; and took sufficient nourishment during the + whole time. The blood taken was always covered with a strong cupped size, + and on his death three or four pints of matter were found in one side of + the chest; which had probably, but lately, been effused from a vomica. + This child was frequently induced to swing, both in a reciprocating and + in a rotatory swing, without any apparent absorption of matter; in both + these swings he expressed pleasure, and did not appear to be + vertiginous.</p> + + <p>M. M. Repeated emetics. Digitalis? Perseverance in rotatory swinging. + See Class <a href="#species_II_1_6_7">II. 1. 6. 7</a>.</p> + + <p>Mr. I. had laboured some months under a vomica after a peripneumony, + he was at length taken with a catarrh, which was in some degree endemic + in March 1795, which occasioned him to sneeze much, during which a + copious hæmorrhage from the lungs occurred, and he spit up at the same + time half a pint of very fetid matter, and recovered. Hence errhines may + be occasionally used with advantage.</p> + + <p><a name="species_II_1_6_4">4</a>. <i>Empyema.</i> When the matter from + an abscess in the lungs finds its way into the cavity of the chest, it is + called an empyema. A servant man, after a violent peripneumony, was + seized with symptoms of empyema, and it was determined, after some time, + to perform the operation; this was explained to him, and the usual means + were employed by his friends to encourage him, "by advising him not to be + afraid." By which good advice he conceived so much fear, that he ran away + early next morning, and returned in about a week quite well. Did the + great fear promote the absorption of the matter, like the sickness + occasioned by digitalis? Fear renders the external skin pale; by this + continued decrease of the action of the absorbents of the skin might not + those of the lungs be excited into greater activity? and thus produce + increased pulmonary absorption by reverse sympathy, as it produces pale + urine, and even stools, by direct sympathy?</p> + + <p>M.M. Digitalis?</p> + + <p><a name="species_II_1_6_5">5</a>. <i>Febris Mesenterica.</i> Fever + from matter formed in the mesentery is probably more frequent than is + suspected. It commences with pain in the bowels, with irritated sensitive + fever; and continues many weeks, and even months, requiring occasional + venesection, and mild cathartics; till at length the continuance of the + pyrexia, or inflammatory fever, destroys the patient. This is an + affection of the lymphatic glands, and properly belongs to scrophula; but + as the matter is not exposed to the air, no hectic fever, properly so + called, is induced.</p> + + <p><a name="species_II_1_6_6">6</a>. <i>Febris a pure aerato.</i> Fever + from aerated matter. A great collection of matter often continues a long + time, and is sometimes totally absorbed, even from venereal buboes, + without producing any disorder in the arterial system. At length, if it + becomes putrid by its delay, and one part of the matter thus becomes + aerated by the air given out by the other part; or if the ulcer has been + opened, so that any part of it has been exposed to the air for but one + day, a hectic fever is produced. Whence the utility arises of opening + large abscesses by setons, as in that case little or no hectic fever is + induced; because the matter is squeezed out by the side of the spongy + threads of cotton, and little or no air is admitted; or by tapping the + abscess with a trocar, as mentioned in ischias, Class <a + href="#species_II_1_2_18">II. 1. 2. 18</a>.</p> + + <p>In this fever the pulse is about 120 in a minute, and its access is + generally in an evening, and sometimes about noon also, with sweats or + purging towards morning, or urine with pus-like sediment; and the + patients bear this fever better than any other with so quick a pulse; and + lastly, when all the matter from a concealed ulcer is absorbed, or when + an open ulcer is healed, the hectic fever ceases. Here the absorbed + matter is supposed to produce the fever, and the diarrhœa, sweats, + or copious muddy urine, to be simply the consequence of increased + secretion, and not to consist of the purulent matter, which was supposed + to be absorbed from the ulcer. See Sudor calidus, Class <a + href="#species_I_1_2_3">I. 1. 2. 3</a>.</p> + + <p>The action of the air on ulcers, as we have already shewn, increases + the acrimony of the purulent matter, and even converts it into a weaker + kind of contagious matter; that is, to a material inducing fever. This + was ascribed to the union of the azotic part of the atmosphere with the + effused pus in Sect. XXVIII. 2. but by contemplating more numerous facts + and analogies, I am now induced to believe, that it is by the union of + oxygen with it; first, because oxygen so greedily unites with other + animal substances, as the blood, that it will pass through a moist + bladder to combine with it, according to the experiment of Dr. Priestley. + Secondly, because the poisons of venomous creatures are supposed to be + acids of different kinds, and are probably formed by the contact of air + after their secretion. And lastly, because the contagious matter from + other ulcers, as in itch, or small-pox, are formed on external membranes, + and are probably combinations of animal matter and oxygen, producing + other new acids; but further experiments must determine this + question.</p> + + <p>It was thought a subject of consequence by the Æsculapian Society at + Edinburgh, to find a criterion which should distinguish pus from mucus, + for the purpose of more certainly discovering the presence of ulcers in + pulmonary diseases, or in the urinary passages. For this purpose that + society offered their first gold medal, which was conferred on the late + Mr. Charles Darwin, in the year 1778, for his experiments on this + subject. From which he deduces the following conclusions:</p> + +<blockquote class="b1n"> + + <p>"1. Pus and mucus are both soluble in the vitriolic acid, though in + very different proportions, pus being much the less soluble.</p> + + <p>2. The addition of water to either of these compounds decomposes it; + the mucus thus separated, either swims on the mixture, or forms large + flocci in it; whereas the pus falls to the bottom, and forms on agitation + a uniform turbid mixture.</p> + + <p>3. Pus is diffusible through a diluted vitriolic acid, though mucus is + not; the same occurs with water, or a solution of sea salt.</p> + + <p>4. Nitrous acid dissolves both pus and mucus; water added to the + solution of pus produces a precipitate; and the fluid above becomes clear + and green; while water and the solution of mucus form a dirty coloured + fluid.</p> + + <p>5. Alkaline lixivium dissolves (though sometimes with difficulty) + mucus, and generally pus.</p> + + <p>6. Water precipitates pus from such a solution, but does not + mucus.</p> + + <p>7. Where alkaline lixivium does not dissolve pus, it still + distinguishes it from mucus; as it then prevents its diffusion through + water.</p> + + <p>8. Coagulable lymph is neither soluble in diluted nor concentrated + vitriolic acid.</p> + + <p>9. Water produces no change on a solution of serum in alkaline + lixivium, until after long standing, and then only a very slight sediment + appears.</p> + + <p>10. Corrosive sublimate coagulates mucus, but does not pus.</p> + + <p>From the above experiments it appears, that strong vitriolic acid and + water, diluted vitriolic acid, and caustic alkaline lixivium and water + will serve to distinguish pus from mucus; that the vitriolic acid can + separate it from coagulable lymph, and alkaline lixivium from serum.</p> + + <p>And hence, when a person has any expectorated material, the + composition of which he wishes to ascertain, let him dissolve it in + vitriolic acid, and in caustic alkaline lixivium; and then add pure water + to both solutions: and if there is a fair precipitation in each, he may + be assured that some pus is present. If in neither a precipitation + occurs, it is a certain test, that the material is entirely mucus. If the + material cannot be made to dissolve in alkaline lixivium by time and + trituration, we have also reason to believe that it is pus." Experiments + on Pus and Mucus. Cadell. London.</p> + +</blockquote> + + <p><a name="species_II_1_6_7">7</a>. <i>Phthisis pulmonalis.</i> In + pulmonary consumption the fever is generally supposed to be the + consequence of the stimulus of absorbed matter circulating in the + blood-vessels, and not simply of its stimulus on their extremities in the + surface of the ulcers; as mentioned in Class <a href="#genus_II_1_5">II. + 1. 5</a>. and Class <a href="#species_II_1_3_9">II. 1. 3. 9</a>. The + ulcers are probably sometimes occasioned by the putrid acrimony of + effused blood remaining in the air-cells of the lungs after an hæmoptoe. + See Class <a href="#species_I_2_1_9">I. 2. 1. 9</a>. The remote cause of + consumption is ingeniously ascribed by Dr. Beddoes to the + hyper-oxygenation of the blood, as mentioned Section XXVIII. 2.</p> + + <p>As the patients liable to consumption are of the inirritable + temperament, as appears by the large pupils of their eyes; there is + reason to believe, that the hæmoptoe is immediately occasioned by the + deficient absorption of the blood at the extremities of the bronchial + vein; and that one difficulty of healing the ulcers is occasioned by the + deficient absorption of the fluids effused into them. See Sect. XXX. 1. + and 2.</p> + + <p>The difficulty of healing pulmonary ulcers may be owing, as its remote + cause, to the incessant motion of all the parts of the lungs; whence no + scab, or indurated mucus, can be formed so as to adhere on them. Whence + these naked ulcers are perpetually exposed to the action of the air on + their surfaces, converting their mild purulent matter into a contagious + ichor; which not only prevents them from healing, but by its action on + their circumferences, like the matter of itch or tinea, contributes to + spread them wider. See the preceding article, and Sect. XXXIII. 2. 7. + where the pulmonary phthisis is supposed to be infectious.</p> + + <p>This acidifying principle is found in all the metallic calces, as in + lapis calaminaris, which is a calciform ore of zinc; and in cerussa, + which is a calx of lead; two materials which are powerful in healing + excoriations, and ulcers, in a short time by their external application. + How then does it happen, that the oxygen in the atmosphere should prevent + pulmonary ulcers from healing, and even induce them to spread wider; and + yet in its combination with metals, it should facilitate their healing? + The healing of ulcers consists in promoting the absorption of the fluids + effused into them, as treated of in Section XXXIII. 3. 2. Oxygen in + combination with metals, when applied in certain quantity, produces this + effect by its stimulus; and the metallic oxydes not being decomposed by + their contact with animal matter, no new acid, or contagious material, is + produced. So that the combined oxygen, when applied to an ulcer, simply I + suppose promotes absorption in it, like the application of other + materials of the articles sorbentia or incitantia, if applied externally; + as opium, bark, alum. But in the pulmonary ulcers, which cannot protect + themselves from the air by forming a scab, the uncombined oxygen of the + atmosphere unites with the purulent matter, converting it into a + contagious ichor; which by infection, not by erosion, enlarges the + ulcers, as in the itch or tinea; which might hence, according to Dr. + Beddoes's ingenious theory of consumption, be induced to heal, if exposed + to an atmosphere deprived of a part of its oxygen. This I hope future + experiments will confirm, and that the pneumatic medicine will alleviate + the evils of mankind in many other, as well as in this most fatal + malady.</p> + + <p>M. M. First, the respiration of air lowered by an additional quantity + of azote, or mixed with some proportion of hydrogen, or of carbonic acid + air, may be tried; as described in a late publication of Dr. Beddoes on + the medicinal use of factitious airs. Johnson, London. Or lastly, by + breathing a mixture of one tenth part of hydro-carbonate mixed with + common air, according to the discovery of Mr. Watt, which has a double + advantage in these cases, of diluting the oxygen of the atmospheric air, + and inducing sickness, which increases pulmonary absorption, as mentioned + below. An atmosphere diluted with fixed air (carbonic acid) might be + readily procured by setting tubs of new wort, or fermenting beer, in the + parlour and lodging-room of the patient. For it is not acids floating in + the air, but the oxygen or acidifying principle, which injures or + enlarges pulmonary ulcers by combining with the purulent matter.</p> + + <p>Another easy method of adding carbonic acid gas to the air of a room, + would be by means of an apparatus invented by Mr. Watt, and sold by + Bolton and Watt at Birmingham, as described in Dr. Beddoes' Treatise on + Pneumatic Medicine. Johnson, London. It consists of an iron pot, with an + arm projecting, and a method of letting water drop by slow degrees on + chalk, which is to be put into the iron pot, and exposed to a moderate + degree of heat over a common fire. By occasionally adding more and more + chalk, carbonic acid gas might be carried through a tin pipe from the arm + of the iron pot to any part of the room near the patient, or from an + adjoining room. In the same manner a diffusion of solution of flowers of + zinc might be produced and breathed by the patient, and would be likely + much to contribute to the healing of pulmonary ulcers; as observed by Mr. + Watt. See the treatise above mentioned.</p> + + <p>Breathing over the vapour of caustic volatile alkali might easily be + managed for many hours in a day; which might neutralize the acid poison + formed on pulmonary ulcers by the contact of oxygen, and thus prevent its + deleterious quality, as other acids become less caustic, when they are + formed into neutral salts with alkalis. The volatile salt should be put + into a tin canister, with two pipes like horns from the top of it, one to + suck the air from, and the other to admit it.</p> + + <div class="figright" style="width:40%;"> + <a href="images/v2p302.png"><img style="width:100%" src="images/v2p302.png" + alt="Device for the external application of powders to ulcers in the lungs." title="Device for the external application of powders to ulcers in the lungs." /></a> + </div> + <p>Secondly, the external ulcers in scrophulous habits are pale and + flabby, and naturally disinclined to heal, the deposition of fluids in + them being greater than the absorption; these ulcers have their + appearance immediately changed by the external application of metallic + calxes, and the medicines of the article Sorbentia, such as cerussa and + the bark in fine powder, see Class <a href="#species_I_2_3_21">I. 2. 3. + 21</a>. and are generally healed in a short time by these means. Induced + by these observations, I wished to try the external application of such + powders to ulcers in the lungs, and constructed a box with a circulating + brush in it, as described in the annexed plate; into this box two ounces + of fine powder of Peruvian bark were put, and two drams of cerussa in + fine powder; on whirling the central brush, part of this was raised into + a cloud of powder, and the patient, applying his mouth to one of the tin + pipes rising out of the box, inhaled this powder twice a day into his + lungs. I observed it did not produce any cough or uneasiness. This + patient was in the last stage of consumption, and was soon tired of the + experiment, nor have I had such patients as I wished for the repetition + of it. Perhaps a fine powder of manganese, or of the flowers of zinc, or + of lapis calaminaris, might be thus applied to ulcers of the lungs with + greater advantage? Perhaps air impregnated with flowers of zinc in their + most comminuted state, might be a better way of applying this powder to + the lungs, as discovered by Mr. Watt. See Dr. Beddoes on Pneumatic + Medicine. Johnson.</p> + + <p>Thirdly, as the healing of an ulcer consists in producing a tendency + to absorption on its surface greater than the deposition on it; see Sect. + XXXIII. 3. 2. other modes of increasing pulmonary absorption, which are + perhaps more manageable than the preceding ones, may be had recourse to; + such as by producing frequent nausea or sickness. See Sect. XXIX. 5. 1. + and Art. <a href="#art_IV_2">IV. 2</a>. The great and sudden absorption + of fluid from the lungs in the anasarca pulmonum by the sickness induced + by the exhibition of digitalis, astonishes those who have not before + attended to it, by emptying the swelled limbs, and removing the + difficulty of breathing in a few hours.</p> + + <p>The most manageable method of using digitalis is by making a saturated + tincture of it, by infusing two ounces of the powder of the leaves in a + mixture of four ounces of rectified spirit of wine, and four ounces of + water. Of this from 30 to 60 drops, or upwards, from a two-ounce phial, + are to be taken twice in the morning part of the day, and to be so + managed as not to induce violent sickness. If sickness nevertheless comes + on, the patient must for a day or two omit the medicine; and then begin + it again in reduced doses.</p> + + <p>Mr. ——, a young man about twenty, with dark eyes, and + large pupils, who had every symptom of pulmonary ulcers, I believed to + have been cured by digitalis, and published the case in the Transactions + of the College, Vol. III. But about two years afterwards I heard that he + relapsed and died. Mr. L——, a corpulent man, who had for some + weeks laboured under a cough with great expectoration, with quick pulse, + and difficulty of breathing, soon recovered by the use of digitalis taken + twice a day; and though this case might probably be a peripneumonia + notha, or catarrh, it is here related as shewing the power of pulmonary + absorption excited by the use of this drug.</p> + + <p>Another method of inducing sickness, and pulmonary absorption in + consequence, is by sailing on the sea; by which many consumptive patients + have been said to have received their cure; which has been erroneously + ascribed to sea-air, instead of sea-sickness; whence many have been sent + to breathe the sea-air on the coasts, who might have done better in + higher situations, where the air probably contains less oxygen gas, which + is the heaviest part of it. See a Letter from Dr. T. C. below.</p> + + <p>A third method of inducing sickness, and consequent pulmonary + absorption, is by the vertigo occasioned by swinging; which has lately + been introduced into practice by Dr. Smith, (Essay on Pulmonary + Consumption), who observed that by swinging the hectic pulse became + slower, which is explained in Class <a href="#species_IV_2_1_10">IV. 2. + 1. 10</a>. The usual way of reciprocating swinging, like the oscillations + of a pendulum, produces a degree of vertigo in those, who are unused to + it; but to give it greater effect, the patient should be placed in a + chair suspended from the ceiling by two parallel cords in contact with + each other, the chair should then be forcibly revolved 20 or 40 times one + way, and suffered to return spontaneously; which induces a degree of + sickness in most adult people, and is well worthy an exact and + pertinacious trial, for an hour or two, three or four times a day for a + month.</p> + + <p>The common means of promoting absorption in ulcers, and of thickening + the matter in consequence, by taking the bark and opium internally, or by + metallic salts, as of mercury, steel, zinc, and copper, in small + quantities, have been repeatedly used in pulmonary consumption; and may + have relieved some of the symptoms. As mercury cures venereal ulcers, and + as pulmonary ulcers resemble them in their not having a disposition to + heal, and in their tendency to enlarge themselves, there were hopes, from + analogy, that it might have succeeded. Would a solution of gold in aqua + regia be worth trying? When vinegar is applied to the lips, it renders + them instantly pale, by promoting the venous absorption; if the whole + skin was moistened with warmish vinegar, would this promote venous + absorption in the lungs by their sympathy with the skin? The very + abstemious diet on milk and vegetables alone is frequently injurious. + Flesh-meat once a day, with small wine and water, or small beer, is + preferable. Half a grain of opium twice a day, or a grain, I believe to + be of great use at the commencement of the disease, as appears from the + subsequent case.</p> + + <p>Miss ——, a delicate young lady, of a consumptive family, + when she was about eighteen, had frequent cough, with quick pulse, a pain + of her side, and the general appearances of a beginning consumption. She + took about five drops of laudanum twice a day in a saline draught, which + was increased gradually to ten. In a few weeks she recovered, was + afterwards married, bore three or four children, and then became + consumptive and died.</p> + + <p>The following case of hereditary consumption is related by a physician + of great ability and very extensive practice; and, as it is his own case, + abounds with much nice observation and useful knowledge; and, as it has + been attended with a favourable event, may give consolation to many, who + are in a similar situation; and shews that Sydenham's recommendation of + riding as a cure for consumption is not so totally ineffectual, as is now + commonly believed.</p> + +<blockquote class="b1n"> + + <p>"J. C. aged 27, with black hair, and a ruddy complexion, was subject + to cough from the age of puberty, and occasionally to spitting of blood. + His maternal grandfather died of consumption under thirty years of age, + and his mother fell a victim to this disease, with which she had long + been threatened, in her 43d year, and immediately after she ceased to + have children. In the severe winter of 1783-4, he was much afflicted with + cough; and being exposed to intense cold, in the month of February he was + seized with peripneumony. The disease was violent and dangerous, and + after repeated bleedings as well as blisterings, which he supported with + difficulty, in about six weeks he was able to leave his bed. At this time + the cough was severe, and the expectoration difficult. A fixed pain + remained on the left side, where an issue was inserted; regular hectic + came on every day about an hour after noon, and every night heat and + restlessness took place, succeeded towards morning by general + perspiration.</p> + + <p>The patient, having formerly been subject to ague, was struck with the + resemblance of the febrile paroxysm, with what he had experienced under + that disease, and was willing to flatter himself it might be of the same + nature. He therefore took bark in the interval of fever, but with an + increase of his cough, and this requiring venesection, the blood was + found highly inflammatory. The vast quantity of blood which he had lost + from time to time, produced a disposition to fainting, when he resumed + the upright posture, and he was therefore obliged to remain almost + constantly in a recumbent position. Attempting to ride out in a carriage, + he was surprised to find that he could sit upright for a considerable + time, while in motion, without inconvenience, though, on stopping the + carriage, the disposition to fainting returned.</p> + + <p>At this time, having prolonged his ride beyond the usual length, he + one day got into an uneven road at the usual period of the recurrence of + the hectic paroxysms, and that day he missed it altogether. This + circumstance led him to ride out daily in a carriage at the time the + febrile accession might be expected, and sometimes by this means it was + prevented, sometimes deferred, and almost always mitigated.</p> + + <p>This experience determined him to undertake a journey of some length, + and Bristol being, as is usual in such cases, recommended, he set out on + the 19th of April, and arrived there on the 2d of May. During the greater + part of this journey (of 175 miles) his cough was severe, and being + obliged to be bled three different times on the road, he was no longer + able to sit upright, but at very short intervals, and was obliged to lie + at length in the diagonal of a coach. The hectic paroxysms were not + interrupted during the journey, but they were irregular and indistinct, + and the salutary effects of exercise, or rather of gestation, were + impressed on the patient's mind.</p> + + <p>At Bristol he stayed a month, but reaped no benefit. The weather was + dry and the roads dusty; the water insipid and inert. He attempted to + ride on horseback on the downs, but was not able to bear the fatigue for + a distance of more than a hundred yards. The necessity of frequent + bleedings kept down his strength, and his hectic paroxysms continued, + though less severe. At this time, suspecting that his cough was irritated + by the west-winds bearing the vapour from the sea, he resolved to try the + effects of an inland situation, and set off for Matlock in + Derbyshire.</p> + + <p>During the journey he did not find the improvement he expected, but + the nightly perspirations began to diminish; and the extraordinary + fatigue he experienced proceeded evidently from his travelling in a + post-chaise, where he could not indulge in a recumbent position. The + weather at Bristol had been hot, and the earth arid and dusty. At + Matlock, during the month of June 1784, there was almost a perpetual + drizzle, the soil was wet, and the air moist and cold. Here, however, the + patient's cough began to abate, and at intervals he found an opportunity + of riding more or less on horseback. From two or three hundred yards at a + time, he got to ride a mile without stopping; and at length he was able + to sit on horseback during a ride from Mason's Bath to the village of + Matlock along the Derwent, and round on the opposite banks, by the works + of Mr. Arkwright, back to the house whence he started, a distance of five + miles. On dismounting, however, he was seized with diliquium, and soon + after the strength he had recovered was lost by an attack of the + hæmorrhoids of the most painful kind, and requiring much loss of blood + from the parts affected.</p> + + <p>On reflection, it appeared that the only benefit received by the + patient was during motion, and continued motion could better be obtained + in the course of a journey than during his residence at any particular + place. This, and other circumstances of a private but painful nature, + determined him to set out from Matlock on a journey to Scotland. The + weather was now much improved, and during the journey he recruited his + strength. Though as yet he could not sit upright at rest for half an hour + together without a disposition to giddiness, dimness of sight, and + deliquium, he was able to sit upright under the motion of a post-chaise + during a journey of from 40 to 70 miles daily, and his appetite began to + improve. Still his cough continued, and his hectic flushings, though the + chills were much abated and very irregular.</p> + + <p>The salutary effects of motion being now more striking than ever, he + purchased a horse admirably adapted to a valetudinarian in Dumfriesshire, + and being now able to sit on horseback for an hour together, he rode out + several times a day. He fixed his residence for a few weeks at Moffat, a + village at the foot of the mountains whence the Tweed, the Clyde, and the + Annan, descend in different directions; a situation inland, dry, and + healthy, and elevated about three hundred feet above the surface of the + sea. Here his strength recovered daily, and he began to eat animal food, + which for several months before he had not tasted. Persevering in + exercise on horseback, he gradually increased the length of his rides, + according to his strength, from four to twenty miles a day; and returning + on horseback to Lancashire by the lakes of Cumberland, he arrived at + Liverpool on the first of September, having rode the last day of his + journey forty miles.</p> + + <p>The two inferences of most importance to be drawn from this narrative, + are, first, the extraordinary benefit derived from gestation in a + carriage, and still more the mixture of gestation and exercise on + horseback, in arresting or mitigating the hectic paroxysm; and secondly, + that in the florid consumption, as Dr. Beddoes terms it, an elevated and + inland air is in certain circumstances peculiarly salutary; while an + atmosphere loaded with the spray of the sea is irritating and noxious. + The benefit derived in this case from exercise on horseback, may lead us + to doubt whether Sydenham's praise of this remedy be as much exaggerated + as it has of late been supposed. Since the publication of Dr. C. Smyth on + the effects of swinging in lowering the pulse in the hectic paroxysm, the + subject of this narrative has repeated his experiments in a great variety + of cases, and has confirmed them. He has also repeatedly seen the hectic + paroxysm prevented, or cut short, by external ablution of the naked body + with tepid water.</p> + + <p>So much was his power of digestion impaired or vitiated by the immense + evacuations, and the long continued debility he underwent, that after the + cough was removed, and indeed for several years after the period + mentioned, he never could eat animal food without heat and flushing, with + frequent pulse and extreme drowsiness. If this drowsiness was encouraged, + the fever ran high, and he awoke from disturbed sleep, wearied and + depressed. If it was resolutely resisted by gentle exercise, it went off + in about an hour, as well as the increased frequency of the pulse. This + agitation was however such as to incapacitate him during the afternoon + for study of any kind. The same effects did not follow a meal of milk and + vegetables, but under this diet his strength did not recruit; whereas + after the use of animal food it recovered rapidly, notwithstanding the + inconvenience already mentioned. For this inconvenience he at last found + a remedy in the use of coffee immediately after dinner, recommended to + him by his friend Dr. Percival. At first this remedy operated like a + charm, but by frequent use, and indeed by abuse, it no longer possesses + its original efficacy.</p> + + <p>Dr. Falconer, in his Dissertation on the Influence of the Passions and + Affections of the Mind on Health and Disease, supposes that the + cheerfulness which attends hectic fever, the ever-springing hope, which + brightens the gloom of the consumptive patient, increases the diseased + actions, and hastens his doom. And hence he is led to enquire, whether + the influence of fear might not be substituted in such cases to that of + hope with advantage to the patient? This question I shall not presume to + answer, but it leads me to say something of the state of the mind in the + case just related.</p> + + <p>The patient, being a physician, was not ignorant of his danger, which, + some melancholy circumstances served to impress on his mind. It has + already been mentioned, that his mother and grandfather died of this + disease. It may be added, that in the year preceding that on which he + himself was attacked, a sister of his was carried off by consumption in + her 17th year; that in the same winter in which he fell ill, two other + sisters were seized with the same fatal disorder, to which one of them + fell a victim during his residence at Bristol, and that the hope of + bidding a last adieu to the other was the immediate cause of his journey + to Scotland, a hope which, alas! was indulged in vain. The day on which + he reached the end of his journey, her remains were committed to the + dust! It may be conjectured from these circumstances, that whatever + benefit may be derived from the apprehension of death, must in this case + have been obtained. The expectation of this issue was indeed for some + time so fixed that it ceased to produce much agitation; in conformity to + that general law of our nature, by which almost all men submit with + composure to a fate that is foreseen, and that appears inevitable. As + however the progress of disease and debility seemed to be arrested, the + hope and the love of life revived, and produced, from time to time, the + observations and the exertions already mentioned.</p> + + <p>Wine and beer were rigorously abstained from during six months of the + above history; and all the blood which was taken was even to the last + buffy." Feb. 3, 1795.</p> + +</blockquote> + + <p><a name="species_II_1_6_8">8</a>. <i>Febris scrophulosa.</i> The + hectic fever occasioned by ulcers of the lymphatic glands, when exposed + to the air, does not differ from that attending pulmonary consumption, + being accompanied with night-sweats and occasional diarrhœa.</p> + + <p>M. M. The bark. Opium internally. Externally cerussa and bark in fine + powder. Bandage. Sea-bathing. See Class <a href="#species_I_2_3_21">I. 2. + 3. 21</a>. and <span class="correction" title="Original reads `II. 1. 4. 12.'." + ><a href="#species_II_1_4_13">II. 1. 4. 13</a></span>.</p> + + <p><a name="species_II_1_6_9">9</a>. <i>Febris ischiadica.</i> A hectic + fever from an open ulcer between the muscles of the pelvis, which differs + not from the preceding. If the matter in this situation lodges till part + of it, I suppose, becomes putrid, and aerates the other part; or till it + becomes absorbed from some other circumstance; a similar hectic fever is + produced, with night-sweats, or diarrhœa.</p> + + <p>Mrs. ——, after a lying in, had pain on one side of her + loins, which extended to the internal part of the thigh on the same side. + No fluctuation of matter could be felt; she became hectic with copious + night-sweats, and occasional diarrhœa, for four or five weeks; and + recovered by, I suppose, the total absorption of the matter, and the + reunion of the walls of the abscess. See Class <a + href="#species_II_1_2_18">II. 1. 2. 18</a>.</p> + + <p><a name="species_II_1_6_10">10</a>. <i>Febris Arthropuodica.</i> Fever + from the matter of diseased joints. Does the matter from suppurating + bones, which generally has a very putrid smell, produce hectic fever, or + typhus? See Class <a href="#species_II_1_4_16">II. 1. 4. 16</a>.</p> + + <p><a name="species_II_1_6_11">11</a>. <i>Febris a pure contagioso.</i> + Fever from contagious pus. When the contagious matters have been produced + on the external habit, and in process of time become absorbed, a fever is + produced in consequence of this reabsorption; which differs with the + previous irritability or inirritability, as well as with the sensibility + of the patient.</p> + + <p><a name="species_II_1_6_12">12</a>. <i>Febris variolosa + secundaria.</i> Secondary fever of small-pox. In the distinct small-pox + the fever is of the sensitive irritated or inflammatory kind; in the + confluent small-pox it is of the sensitive inirritated kind, or typhus + gravior. In both of them the swelling of the face, when the matter there + begins to be absorbed, and of the hands, when the matter there begins to + be absorbed, shew, that it stimulates the capillary vessels or glands, + occasioning an increased secretion greater than the absorbents can take + up, like the action of the cantharides in a blister; now as the + application of a blister on the skin frequently occasions the strangury, + which shews, that some part of the cantharides is absorbed; there is + reason to conclude, that a part of the matter of small-pox is absorbed, + and thus produces the secondary fever. See Class <a + href="#species_II_1_3_9">II. 1. 3. 9</a>. And not simply by its stimulus + on the surface of the ulcers beneath the scabs. The exsudation of a + yellow fluid from beneath the confluent eruptions on the face before the + height is spoken of in Class <a href="#species_II_1_3_2">II. 1. 3. + 2</a>.</p> + + <p>The material thus absorbed in the secondary fever of small-pox differs + from that of open ulcers, as it is only aerated through the elevated + cuticle; and secondly, because there is not a constant supply of fresh + matter, when that already in the pustules is exhausted, either by + absorption, or by evaporation, or by its induration into a scab. Might + not the covering the face assiduously and exactly with plasters, as with + cerate of calamy, or with minium plaster, by precluding the air from the + pustules, prevent their contracting a contagious, or acescent, or + fever-producing power? and the secondary fever be thus prevented + entirely. If the matter in those pustules on the face in the confluent + small-pox were thus prevented from oxygenation, it is highly probable, + both from this theory, and from the facts before mentioned, that the + matter would not erode the skin beneath them, and by these means no marks + or scars would succeed.</p> + + <p><a name="species_II_1_6_13">13</a>. <i>Febris carcinomatosa.</i> Fever + from the matter of cancer. In a late publication the pain is said to be + relieved, and the fever cured, and the cancer eradicated, by the + application of carbonic acid gas, or fixed air. See Class <a + href="#species_II_1_4_16">II. 1. 4. 16</a>.</p> + + <p><a name="species_II_1_6_14">14</a>. <i>Febris venerea.</i> From the + absorption of the matter from venereal ulcers and suppurating bones. See + Syphilis, <a href="#species_II_1_5_2">II. 1. 5. 2</a>.</p> + + <p>M. M. Any mercurial calx. Sarsaparilla? Mezereon?</p> + + <p><a name="species_II_1_6_15">15</a>. <i>Febris a sanie putrida.</i> + Fever from putrid sanies. When parts of the body are destroyed by + external violence, as a bruise, or by mortification, a putrefaction soon + succeeds; as they are kept in that degree of warmth and moisture by their + adhesion to the living parts of the body, which most forwards that + process. Thus the sloughs of mortified parts of the tonsils give fetor to + the breath in some fevers; the matter from putrefying teeth, or other + suppurating bones, is particularly offensive; and even the scurf, which + adheres to the tongue, frequently acquires a bitter taste from its + incipient putridity. This material differs from those before mentioned, + as its deleterious property depends on a chemical rather than an animal + process.</p> + + <p><a name="species_II_1_6_16">16</a>. <i>Febris puerpera.</i> Puerperal + fever. It appears from some late dissections, which have been published, + of those women who have died of the puerperal fever, that matter has been + formed in the omentum, and found in the cavity of the abdomen, with some + blood or sanies. These parts are supposed to have been injured by the + exertions accompanying labour; and as matter in this viscus may have been + produced without much pain, this disease is not attended with arterial + strength and hard full pulse like the inflammation of the uterus; and as + the fever is of the inirritative or typhus kind, there is reason to + believe, that the previous exhaustion of the patient during labour may + contribute to its production; as well as the absorption of a material not + purulent but putrid; which is formed by the delay of extravasated or dead + matter produced by the bruises of the omentum, or other viscera, in the + efforts of parturition, rather than by purulent matter, the consequence + of suppuration. The pulse is generally about 120 when in bed and in the + morning; and is increased to 134, or more, when the patient sits up, or + in the evening paroxysm. The pulse of all very weak patients increases in + frequency when they sit up; because the expenditure of sensorial power + necessary to preserve an erect posture deducts so much from their general + strength; and hence the pulse becomes weaker, and in consequence quicker. + See Sect. XII. 1. 4.</p> + + <p>In this fever time must be allowed for the absorption of the matter. + Very large and repeated quantities of the bark, by preventing sufficient + food from being taken, as bread, and wine, and water, I have thought has + much injured the patient; for the bark is not here given as in + intermittent fevers to prevent the paroxysm, but simply to strengthen the + patient by increasing the power of digestion. About two ounces of + decoction of bark, with four drops of laudanum, and a dram of sweet + spirit of vitriol, once in six hours, and a glass of wine between those + times, with panada, or other food, I have thought of most advantage, with + a small blister occasionally.</p> + + <p>Where not only the stomach but also the bowels are much distended with + air, so as to sound on striking them with the fingers, the case is always + dangerous, generally hopeless; which is more so in proportion to the + quickness of the pulse. Where the bowels are distended two drops of oil + of cinnamon should be given in the panada three or four times a day.</p> + + <p><a name="species_II_1_6_17">17</a>. <i>Febris a sphacelo.</i> Fever + from mortification. This fever from absorption of putrid matter is of the + inirritative or typhus kind. See the preceding article.</p> + + <p>M. M. Opium and the bark are frequently given in too great quantity, + so as to induce consequent debility, and to oppress the power of + digestion.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_1_7">VII</a>.</h3> + +<h3><i>With increased Action of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_II_1_7_1">1</a>. <i>Delirium febrile.</i> + Paraphrosyne. The ideas in delirium consist of those excited by the + sensation of pleasure or pain, which precedes them, and the trains of + other ideas associated with these, and not of those excited by external + irritations or by voluntary exertion. Hence the patients do not know the + room which they inhabit, or the people who surround them; nor have they + any voluntary exertion, where the delirium is complete; so that their + efforts in walking about a room or rising from their bed are unsteady, + and produced by their catenations with the immediate affections of + pleasure or pain. See Section XXXIII. 1. 4.</p> + + <p>By the above circumstances it is distinguished from madness, in which + the patients well know the persons of their acquaintance, and the place + where they are; and perform all the voluntary actions with steadiness and + determination. See Sect. XXXIV. 2. 2.</p> + + <p>Delirium is sometimes less complete, and then a new face and louder + voice stimulate the patient to attend to them for a few moments; and then + they relapse again into perfect delirium. At other times a delirium + affects but one sense, and the person thinks he sees things which do not + exist; and is at the same time sensible to the questions which are asked + him, and to the taste of the food which is offered to him.</p> + + <p>This partial delirium is termed an hallucination of the disordered + organ; and may probably arise from the origin of one nerve of sense being + more liable to inflammation than the others; that is, an exuberance of + the sensorial power of sensation may affect it; which is therefore thrown + into action by slighter sensitive catenations, without being obedient to + external stimulus, or to the power of volition.</p> + + <p>The perpetual flow of ideas in delirium is owing to the same + circumstance, as of those in our dreams; namely, to the defect or + paralysis of the voluntary power; as in hemiplagia, when one side of the + body is paralytic, and thus expends less of the sensorial power, the + limbs on the other side are in constant motion from the exuberance of it. + Whence less sensorial power is exhausted in delirium, than at other + times, as well as in sleep; and hence in fevers with great debility, it + is perhaps, as well as the stupor, rather a favourable circumstance; and + when removed by numerous blisters, the death of the patient often follows + the recovery of his understanding. See Class <a + href="#species_I_2_5_6">I. 2. 5. 6</a>. and <a + href="#species_I_2_5_10">I. 2. 5. 10</a>.</p> + + <p>Delirium in diseases from inirritability is sometimes preceded by a + propensity to surprise. See Class <span class="correction" + title="Original reads `I. 1. 5. 12.'."><a href="#species_I_1_5_11">I. 1. + 5. 11</a></span>.</p> + + <p>M. M. Fomentations of the shaved head for an hour repeatedly. A + blister on the head. Rising from bed. Wine and opium, and sometimes + venesection in small quantity by cupping, if the strength of the arterial + system will allow it.</p> + + <p><a name="species_II_1_7_2">2</a>. <i>Delirium maniacale.</i> Maniacal + delirium. There is another kind of delirium, described in Sect. XXXIII. + 1. 4. which has the increase of pleasureable or painful sensation for its + cause, without any diminution of the other sensorial powers; but as this + excites the patient to the exertion of voluntary actions, for the purpose + of obtaining the object of his pleasureable ideas, or avoiding the object + of his painful ones, such as perpetual prayer, when it is of the + religious kind, it belongs to the insanities described in Class <a + href="#species_III_1_2_1">III. 1. 2. 1</a>, and is more properly termed + hallucinatio maniacalis.</p> + + <p><a name="species_II_1_7_3">3</a>. <i>Dilirium ebrietatis.</i> The + drunken delirium is in nothing different from the delirium attending + fevers except in its cause, as from alcohol, or other poisons. When it is + attended with an apoplectic stupor, the pulse is generally low; and + venesection I believe sometimes destroys those, who would otherwise have + recovered in a few hours.</p> + + <p>M. M. Diluting liquids. An emetic.</p> + + <p><a name="species_II_1_7_4">4</a>. <i>Somnium.</i> Dreams constitute + the most complete kind of delirium. As in these no external irritations + are attended to, and the power of volition is entirely suspended; so that + the sensations of pleasure and pain, with their associations, alone + excite the endless trains of our sleeping ideas; as explained in Sect. + XVIII. on Sleep.</p> + + <p><a name="species_II_1_7_5">5</a>. <i>Hallucinatio visûs.</i> Deception + of sight. These visual hallucinations are perpetual in our dreams; and + sometimes precede general delirium in fevers; and sometimes belong to + reverie, and to insanity. See Class <a href="#species_III_1_2_1">III. 1. + 2. 1</a>. and <a href="#species_III_1_2_2">2</a>. and must be treated + accordingly.</p> + + <p>Other kinds of visual hallucinations occur by moon-light; when objects + are not seen so distinctly as to produce the usual ideas associated with + them, but appear to us exactly as they are seen. Thus the trunk of a tree + appears a flat surface, instead of a cylinder as by day, and we are + deceived and alarmed by seeing things as they really are seen. See + Berkley on Vision.</p> + + <p><a name="species_II_1_7_6">6</a>. <i>Hallucinatio auditûs.</i> + Auricular deception frequently occurs in dreams, and sometimes precedes + general delirium in fevers; and sometimes belongs to vertigo, and to + reverie, and to insanity. See Sect. XX. 7. and Class <a + href="#species_III_1_2_1">III. 1. 2. 1</a>. and <a + href="#species_III_1_2_2">2</a>.</p> + + <p><a name="species_II_1_7_7">7</a>. <i>Rubor a calore.</i> The blush + from heat is occasioned by the increased action of the cutaneous vessels + in consequence of the increased sensation of heat. See Class <a + href="#species_I_1_2_1">I. 1. 2. 1</a>. and <a + href="#species_I_1_2_3">3</a>.</p> + + <p><a name="species_II_1_7_8">8</a>. <i>Rubor jucunditatis.</i> The blush + of joy is owing to the increased action of the capillary arteries, along + with that of every moving vessel in the body, from the increase of + pleasurable sensation.</p> + + <p><a name="species_II_1_7_9">9</a>. <i>Priapismus amatorius.</i> + Amatorial priapism. The blood is poured into the cells of the corpora + cavernosa much faster than it can be reabsorbed by the vena penis, owing + in this case to the pleasurable sensation of love increasing the arterial + action. See Class <a href="#species_I_1_4_6">I. 1. 4. 6</a>.</p> + + <p><a name="species_II_1_7_10">10</a>. <i>Distentio mamularum.</i> The + teats of female animals, when they give suck, become rigid and erected, + in the same manner as in the last article, from the pleasurable sensation + of the love of the mother to her offspring. Whence the teat may properly + be called an organ of sense. The nipples of men do the same when rubbed + with the hand. See Class <a href="#species_I_1_4_7">I. 1. 4. 7</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_II_2">II</a>.</h3> + +<h3><i>Decreased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_2_1">I</a>.</h3> + +<h3><i>Of the General System.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_II_2_1_1">1</a>. <i>Stultitia insensibilis.</i> Folly + from insensibility. The pleasure or pain generated in the system is not + sufficient to promote the usual activity either of the sensual or + muscular fibres.</p> + + <p><a name="species_II_2_1_2">2</a>. <i>Tædium vitæ.</i> Ennui. + Irksomeness of life. The pain of laziness has been thought by some + philosophers to be that principle of action, which has excited all our + industry, and distinguished mankind from the brutes of the field. It is + certain that, where the ennui exists, it is relieved by the exertions of + our minds or bodies, as all other painful sensations are relieved; but it + depends much upon our early habits, whether we become patient of + laziness, or inclined to activity, during the remainder of our lives, as + other animals do not appear to be affected with this malady; which is + perhaps left owing to deficiency of pleasurable sensation, than to the + superabundancy of voluntary power, which occasions pain in the muscles by + its accumulation; as appears from the perpetual motions of a squirrel + confined in a cage.</p> + + <p><a name="species_II_2_1_3">3</a>. <i>Paresis sensitiva.</i> Weakness + of the whole system from insensibility.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Sensation.</i></h3> + +<h3>GENUS <a name="genus_II_2_2">II</a>.</h3> + +<h3><i>Of Particular Organs.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_II_2_2_1">1</a>. <i>Anorexia.</i> Want of appetite. + Some elderly people, and those debilitated by fermented liquors, are + liable to lose their appetite for animal food; which is probably in part + owing to the deficiency of gastric acid, as well as to the general decay + of the system: elderly people will go on years without animal food; but + inebriates soon sink, when their digestion becomes so far impaired. Want + of appetite is sometimes produced by the putrid matter from many decaying + teeth being perpetually mixed with the saliva, and thence affecting the + organ of taste, and greatly injuring the digestion.</p> + + <p>M. M. Fine charcoal powder diffused in warm water held in the mouth + frequently in a day, as in Class <span class="correction" title="Original reads `I. 1. 4. 4.'." + ><a href="#species_I_2_4_12">I. 2. 4. 12</a></span>. or solution of alum + in water. Extract the decayed teeth. An emetic. A blister. Chalybeates. + Vitriolic acid. Bile of an ox inspissated, and made into pills; 20 grains + to be taken before dinner and supper. Opium half a grain twice a day.</p> + + <p>All the strength we possess is ultimately derived from the food, which + we are able to digest; whence a total debility of the system frequently + follows the want of appetite, and of the power of digestion. Some young + ladies I have observed to fall into this general debility, so as but just + to be able to walk about; which I have sometimes ascribed to their + voluntary fasting, when they believed themselves too plump; and who have + thus lost both their health and beauty by too great abstinence, which + could never be restored.</p> + + <p>I have seen other cases of what may be termed anorexia epileptica, in + which a total loss of appetite, and of the power of digestion, suddenly + occurred along with epileptic fits. Miss B. a girl about eighteen, + apparently very healthy, and rather plump, was seized with fits, which + were at first called hysterical; they occurred at the end of + menstruation, and returned very frequently with total loss of appetite. + She was relieved by venesection, blisters, and opiates; her strength + diminished, and after some returns of the fits, she took to her bed, and + has survived 15 or 20 years; she has in general eaten half a potato a + day, and seldom speaks, but retains her senses, and had many years + occasional returns of convulsion. I have seen two similar cases, where + the anorexia, or want of appetite, was in less degree; and but just so + much food could be digested, as supplied them with sufficient strength to + keep from the bed or sofa for half the day. As well as I can recollect, + all these patients were attended with weak pulse, and cold pale skin; and + received benefit by opium, from a quarter of a grain to a grain four + times a day. See Class <a href="#species_III_1_1_7">III. 1. 1. 7</a>. and + <a href="#species_III_1_2_1">III. 1. 2. 1</a>. and <a + href="#species_III_1_2_20">III. 1. 2. 20</a>.</p> + + <p><a name="species_II_2_2_2">2</a>. <i>Adipsia.</i> Want of thirst. + Several of the inferior people, as farmers wives, have a habit of not + drinking with their dinner at all, or only take a spoonful or two of ale + after it. I have frequently observed these to labour under bad digestion, + and debility in consequence; which I have ascribed to the too great + stimulus of solid food undiluted, destroying in process of time the + irritability of the stomach.</p> + + <p><a name="species_II_2_2_3">3</a>. <i>Impotentia</i> (agenesia). + Impotency much seldomer happens to the male sex than sterility to the + female sex. Sometimes a temporary impotence occurs from bashfulness, or + the interference of some voluntary exertion in the production of an + effect, which should be performed alone by pleasurable sensation.</p> + + <p>One, who was soon to be married to a lady of superior condition to his + own, expressed fear of not succeeding on the wedding night; he was + advised to take a grain of opium before he went to bed, and to accustom + himself to sleep with a woman previously, but not to enjoy her, to take + off his bashfulness; which succeeded to his wish.</p> + + <p>M. M. Chalybeates. Opium. Bark. Tincture of cantharides.</p> + + <p><a name="species_II_2_2_4">4</a>. <i>Sterilitas.</i> Barrenness. One + of the ancient medical writers asserts, that the female sex become + pregnant with most certainty at or near the time of menstruation. This is + not improbable, since these monthly periods seem to referable the monthly + venereal orgasm of some female quadrupeds, which become pregnant at those + times only; and hence the computation of pregnancy is not often + erroneous, though taken from the last menstruation. See Section XXXVI. 2. + 3.</p> + + <p>M. M. Opium a grain every night. Chalybeates in very small doses. + Bark. Sea-bathing.</p> + + <p><a name="species_II_2_2_5">5</a>. <i>Insensibilitas artuum.</i> As in + some paralytic limbs. A great insensibility sometimes accompanies the + torpor of the skin in cold fits of agues. Some parts have retained the + sense of heat, but not the sense of touch. See Sect. XVI. 6.</p> + + <p>M. M. Friction with flannel. A blister. Warmth.</p> + + <p><a name="species_II_2_2_6">6</a>. <i>Dysuria insensitiva.</i> + Insensibility of the bladder. A difficulty or total inability to make + water attends some fevers with great debility, owing to the insensibility + or inirritability of the bladder. This is a dangerous but not always a + fatal symptom.</p> + + <p>M. M. Draw off the water with a catheter. Assist the patient in the + exclusion of it by compressing the lower parts of the abdomen with the + hands. Wine two ounces, Peruvian bark one dram in decoction, every three + hours alternately. Balsam of copaiva. Oil of almonds, with as much + camphor as can be dissolved in it, applied as a liniment rubbed on the + region of the bladder and perinæum, and repeated every four hours, was + used in this disease with success by Mr. Latham. Med. Comment. 1791, p. + 213.</p> + + <p><a name="species_II_2_2_7">7</a>. <i>Accumulatio alvina.</i> An + accumulation of feces in the rectum, occasioned by the torpor, or + insensibility, of that bowel. But as liquids pass by these accumulations, + it differs from the constipatio alvi, which is owing to too great + absorption of the alimentary canal.</p> + + <p>Old milk, and especially when boiled, is liable to induce this kind of + costiveness in some grown persons; which is probably owing to their not + possessing sufficient gastric acid to curdle and digest it; for as both + these processes require gastric acid, it follows, that a greater quantity + of it is necessary, than in the digestion of other aliments, which do not + previously require being curdled. This ill digested milk not sufficiently + stimulating the rectum, remains till it becomes a too solid mass. On this + account milk seldom agrees with those, who are subject to piles, by + inducing costiveness and large stools.</p> + + <p>M. M. Extract the hardened scybala by means of a marrow-spoon; or by a + piece of wire, or of whale-bone bent into a bow, and introduced. + Injections of oil. Castor oil, or oil of almonds, taken by the mouth. A + large clyster of smoak of tobacco. Six grains of rhubarb taken every + night for many months. Aloes. An endeavour to establish a habit of + evacuation at a certain hour daily. See Class <a + href="#species_I_1_3_5">I. 1. 3. 5</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_II_3">III</a>.</h3> + +<h3><i>Retrograde Sensitive Motions.</i></h3> + +<h3>GENUS <a name="genus_II_3_1">I</a>.</h3> + +<h3><i>Of Excretory Ducts.</i></h3> + + <p>The retrograde action of the œsophagus in ruminating animals, + when they bring up the food from their first stomach for the purpose of a + second mastication of it, may probably be caused by agreeable sensation; + similar to that which induces them to swallow it both before and after + this second mastication; and then this retrograde action, properly + belongs to this place, and is erroneously put at the head of the order of + irritative retrograde motions. Class <a href="#species_I_3_1_1">I. 3. 1. + 1</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_II_3_1_1">1</a>. <i>Ureterum motus retrogressus.</i> + When a stone has advanced into the ureter from the pelvis of the kidney, + it is sometimes liable to be returned by the retrograde motion of that + canal, and the patient obtains fallacious ease, till the stone is again + pushed into the ureter.</p> + + <p><a name="species_II_3_1_2">2</a>. <i>Urethræ motus retrogressus.</i> + There have been instances of bougies being carried up the urethra into + the bladder most probably by an inverted motion of this canal; for which + some have undergone an operation similar to that for the extraction of a + stone. A case is related in some medical publication, in which a catgut + bougie was carried into the bladder, and after remaining many weeks, was + voided piece-meal in a semi-dissolved state. Another case is related of a + French officer, who used a leaden bougie; which at length found its way + into the bladder, and was, by injecting crude mercury, amalgamated and + voided.</p> + + <p>In the same manner the infection from a simple gonorrhœa is + probably carried further along the course of the urethra; and small + stones frequently descend some way into the urethra, and are again + carried up into the bladder by the inverted action of this canal.</p> + + <p><a name="species_II_3_1_3">3</a>. <i>Ductus choledochi motus + retrogressus.</i> The concretions of bile, called gall-stones, frequently + enter the bile-duct, and give violent pain for some hours; and return + again into the gall-bladder, by the retrograde action of this duct. May + not oil be carried up this duct, when a gall-stone gives great pain, by + its retrograde spasmodic action? See Class <a href="#species_I_1_3_8">I. + 1. 3. 8</a>.</p> + + <p>M. M. Opium a grain and half.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3><i>The Orders and Genera of the Third Class of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS <a name="class_III">III</a>.</h3> + +<p class="cenhead">DISEASES OF VOLITION.</p> + +<h3>ORDO I.</h3> + +<h3><i>Increased Volition.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_III_1_1">1</a>. With increased actions of the muscles.</p> + <p><a href="#genusi_III_1_2">2</a>. With increased actions of the organs of sense.</p> + </div> + </div> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Volition.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_III_2_1">1</a>. With decreased actions of the muscles.</p> + <p><a href="#genusi_III_2_2">2</a>. With decreased actions of the organs of sense.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><i>The Orders, Genera, and Species, of the Third Class +of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS III.</h3> + +<h3>DISEASES OF VOLITION.</h3> + +<h3>ORDO I.</h3> + +<h3><i>Increased Volition.</i></h3> + +<h3>GENUS <a name="genusi_III_1_1">I</a>.</h3> + +<h3><i>With Increased Actions of the Muscles.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_III_1_1_1">1</a>. <i>Jactitatio.</i></td><td>Restlessness.</td></tr> +<tr><td> <a href="#species_III_1_1_2">2</a>. <i>Tremor febrilis.</i></td><td>Febrile trembling.</td></tr> +<tr><td> <a href="#species_III_1_1_3">3</a>. <i>Clamor.</i></td><td>Screaming.</td></tr> +<tr><td> <a href="#species_III_1_1_4">4</a>. <i>Risus.</i></td><td>Laughter.</td></tr> +<tr><td> <a href="#species_III_1_1_5">5</a>. <i>Convulsio.</i></td><td>Convulsion.</td></tr> +<tr><td> —— <i>debilis.</i></td><td>—— weak.</td></tr> +<tr><td> <a href="#species_III_1_1_6">6</a>. —— <i>dolorifica.</i></td><td>—— painful.</td></tr> +<tr><td> <a href="#species_III_1_1_7">7</a>. <i>Epilepsia.</i></td><td>Epilepsy.</td></tr> +<tr><td> <a href="#species_III_1_1_8">8</a>. —— <i>dolorifica.</i></td><td>—— painful.</td></tr> +<tr><td> <a href="#species_III_1_1_9">9</a>. <i>Somnambulismus.</i></td><td>Sleep-walking.</td></tr> +<tr><td><a href="#species_III_1_1_10">10</a>. <i>Asthma convulsivum.</i> </td><td>Asthma convulsive.</td></tr> +<tr><td><a href="#species_III_1_1_11">11</a>. —— <i>dolorificum.</i></td><td>—— painful.</td></tr> +<tr><td><a href="#species_III_1_1_12">12</a>. <i>Stridor dentium.</i></td><td>Gnashing of the teeth.</td></tr> +<tr><td><a href="#species_III_1_1_13">13</a>. <i>Tetanus trismus.</i></td><td>Cramp of the jaw.</td></tr> +<tr><td><a href="#species_III_1_1_14">14</a>. —— <i>dolorificus.</i></td><td>—— painful.</td></tr> +<tr><td><a href="#species_III_1_1_15">15</a>. <i>Hydrophobia.</i></td><td>Dread of water.</td></tr> +</table> + +<h3>GENUS <a name="genusi_III_1_2">II</a>.</h3> + +<h3><i>With increased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_III_1_2_1">1</a>. <i>Mania mutabilis.</i></td><td>Mutable madness.</td></tr> +<tr><td> <a href="#species_III_1_2_2">2</a>. <i>Studium inane.</i></td><td>Reverie.</td></tr> +<tr><td> <a href="#species_III_1_2_3">3</a>. <i>Vigilia.</i></td><td>Watchfulness.</td></tr> +<tr><td> <a href="#species_III_1_2_4">4</a>. <i>Erotomania.</i></td><td>Sentimental love.</td></tr> +<tr><td> <a href="#species_III_1_2_5">5</a>. <i>Amor sui.</i></td><td>Vanity.</td></tr> +<tr><td> <a href="#species_III_1_2_6">6</a>. <i>Nostalgia.</i></td><td>Desire of home.</td></tr> +<tr><td> <a href="#species_III_1_2_7">7</a>. <i>Spes religiosa.</i></td><td><span class="correction" title="Original reads `Supestitious'.">Superstitious</span> hope.</td></tr> +<tr><td> <a href="#species_III_1_2_8">8</a>. <i>Superbia stemmatis.</i></td><td>Pride of family.</td></tr> +<tr><td> <a href="#species_III_1_2_9">9</a>. <i>Ambitio.</i></td><td>Ambition.</td></tr> +<tr><td><a href="#species_III_1_2_10">10</a>. <i>Mæror.</i></td><td>Grief.</td></tr> +<tr><td><a href="#species_III_1_2_11">11</a>. <i>Tædium vitæ.</i></td><td>Irksomeness of life.</td></tr> +<tr><td><a href="#species_III_1_2_12">12</a>. <i>Desiderium pulchritudinis.</i> </td><td>Loss of beauty.</td></tr> +<tr><td><a href="#species_III_1_2_13">13</a>. <i>Paupertatis timor.</i></td><td>Fear of poverty.</td></tr> +<tr><td><a href="#species_III_1_2_14">14</a>. <i>Lethi timor.</i></td><td>—— of death.</td></tr> +<tr><td><a href="#species_III_1_2_15">15</a>. <i>Orci timor.</i></td><td>—— of hell.</td></tr> +<tr><td><a href="#species_III_1_2_16">16</a>. <i>Satyriasis.</i></td><td>Lust.</td></tr> +<tr><td><a href="#species_III_1_2_17">17</a>. <i>Ira.</i></td><td>Anger.</td></tr> +<tr><td><a href="#species_III_1_2_18">18</a>. <i>Rabies.</i></td><td>Rage.</td></tr> +<tr><td><a href="#species_III_1_2_19">19</a>. <i>Citta.</i></td><td>Depraved appetite.</td></tr> +<tr><td><a href="#species_III_1_2_20">20</a>. <i>Cacositia.</i></td><td>Aversion to food.</td></tr> +<tr><td><a href="#species_III_1_2_21">21</a>. <i>Syphilis imaginaria.</i></td><td>Imaginary pox.</td></tr> +<tr><td><a href="#species_III_1_2_22">22</a>. <i>Psora imaginaria.</i></td><td>—— itch.</td></tr> +<tr><td><a href="#species_III_1_2_23">23</a>. <i>Tabes imaginaria.</i></td><td>—— tabes.</td></tr> +<tr><td><a href="#species_III_1_2_24">24</a>. <i>Sympathia aliena.</i></td><td>Pity.</td></tr> +<tr><td><a href="#species_III_1_2_25">25</a>. <i>Educatio heroica.</i></td><td>Heroic education.</td></tr> +</table> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Volition.</i></h3> + +<h3>GENUS <a name="genusi_III_2_1">I</a>.</h3> + +<h3><i>With decreased Actions of the Muscles.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_III_2_1_1">1</a>. <i>Lassitudo.</i></td><td>Fatigue.</td></tr> +<tr><td> <a href="#species_III_2_1_2">2</a>. <i>Vacillatio senilis.</i></td><td>See-saw of old age.</td></tr> +<tr><td> <a href="#species_III_2_1_3">3</a>. <i>Tremor senilis.</i></td><td>Tremor of old age.</td></tr> +<tr><td> <a href="#species_III_2_1_4">4</a>. <i>Brachiorum paralysis.</i></td><td>Palsy of the arms.</td></tr> +<tr><td> <a href="#species_III_2_1_5">5</a>. <i>Raucedo paralytica.</i></td><td>Paralytic hoarseness.</td></tr> +<tr><td> <a href="#species_III_2_1_6">6</a>. <i>Vesicæ urinariæ paralysis.</i> </td><td>Palsy of the bladder.</td></tr> +<tr><td> <a href="#species_III_2_1_7">7</a>. <i>Recti paralysis.</i></td><td>Palsy of the rectum.</td></tr> +<tr><td> <a href="#species_III_2_1_8">8</a>. <i>Paresis voluntaria.</i></td><td>Voluntary debility.</td></tr> +<tr><td> <a href="#species_III_2_1_9">9</a>. <i>Catalepsis.</i></td><td>Catalepsy.</td></tr> +<tr><td><a href="#species_III_2_1_10">10</a>. <i>Hemiplegia.</i></td><td>Palsy of one side.</td></tr> +<tr><td><a href="#species_III_2_1_11">11</a>. <i>Paraplegia.</i></td><td>Palsy of the lower limbs.</td></tr> +<tr><td><a href="#species_III_2_1_12">12</a>. <i>Somnus.</i></td><td>Sleep.</td></tr> +<tr><td><a href="#species_III_2_1_13">13</a>. <i>Incubus.</i></td><td>Night-mare.</td></tr> +<tr><td><a href="#species_III_2_1_14">14</a>. <i>Lethargus.</i></td><td>Lethargy.</td></tr> +<tr><td><a href="#species_III_2_1_15">15</a>. <i>Syncope epileptica.</i></td><td>Epileptic fainting.</td></tr> +<tr><td><a href="#species_III_2_1_16">16</a>. <i>Apoplexia.</i></td><td>Apoplexy.</td></tr> +<tr><td><a href="#species_III_2_1_17">17</a>. <i>Mors a frigore.</i></td><td>Death from cold.</td></tr> +</table> + +<h3>GENUS <a name="genusi_III_2_2">II</a>.</h3> + +<h3><i>With decreased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_III_2_2_1">1</a>. <i>Recollectionis jactura.</i> </td><td>Loss of recollection.</td></tr> +<tr><td><a href="#species_III_2_2_2">2</a>. <i>Stultitia voluntaria.</i></td><td>Voluntary folly.</td></tr> +<tr><td><a href="#species_III_2_2_3">3</a>. <i>Credulitas.</i></td><td>Credulity.</td></tr> +</table> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>CLASS III.</h3> + +<p class="cenhead">DISEASES OF VOLITION.</p> + +<h3>ORDO <a name="ordo_III_1">I</a>.</h3> + +<h3><i>Increased Volition.</i></h3> + +<h3>GENUS <a name="genus_III_1_1">I</a>.</h3> + +<h3><i>Increased Actions of the Muscles.</i></h3> + + <p>We now step forward to consider the diseases of volition, that + superior faculty of the sensorium, which gives us the power of reason, + and by its facility of action distinguishes mankind from brute animals; + which has effected all that is great in the world, and superimposed the + works of art on the situations of nature.</p> + + <p>Pain is introduced into the system either by excess or defect of the + action of the part. (Sect. IV. 5.) Both which circumstances seem to + originate from the accumulation of sensorial power in the affected organ. + Thus when the skin is exposed to great cold, the activity of the + cutaneous vessels is diminished, and in consequence an accumulation of + sensorial power obtains in them, because they are usually excited into + incessant motion by the stimulus of heat, as explained in Sect. XII. 5. + 2. Contrarywise, when the vessels of the skin are exposed to great heat, + an excess of sensorial power is also produced in them, which is derived + thither by the increase of stimulus above what is natural.</p> + + <p>This accounts for the relief which is received in all kinds of pain by + any violent exertions of our muscles or organs of sense; which may thus + be in part ascribed to the exhaustion of the sensorial power by such + exertions. But this relief is in many cases so instantaneous, that it + seems nevertheless probable, that it is also in part owing to the + different manner of progression of the two sensorial powers of sensation + and volition; one of them commencing at some extremity of the sensorium, + and being propagated towards the central parts of it; and the other + commencing in the central parts of the sensorium, and being propagated + towards the extremities of it; as mentioned in Sect. XI. 2. 1.</p> + + <p>These violent voluntary exertions of our muscles or ideas to relieve + the sensation of pain constitute convulsions and madness; and are + distinguished from the muscular actions owing to increased sensation, as + in sneezing, or coughing, or parturition, or ejectio feminis, because + they do not contribute to dislodge the cause, but only to prevent the + sensation of it. In two cases of parturition, both of young women with + their first child, I have seen general convulsions occur from excess of + voluntary exertion, as above described, instead of the actions of + particular muscles, which ought to have been excited by sensation for the + exclusion of the fetus. They both became insensible, and died after some + hours; from one of them the fetus was extracted in vain. I have heard + also of general convulsions being excited instead of the actions of the + musculi acceleratores in the ejectio feminis, which terminated fatally. + See Class <a href="#species_III_1_1_7">III. 1. 1. 7</a>.</p> + + <p>These violent exertions are most frequently excited in consequence of + those pains, which originate from defect of the action of the part. See + Sect. XXXIV. 1. and 2. The pains from excess and defect of the action of + the part are distinguishable from each other by the former being attended + with increase of heat in the pained part, or of the whole body; while the + latter not only exist without increase of heat in the pained part, but + are generally attended with coldness of the extremities of the body.</p> + + <p>As soon as these violent actions of our muscular or sensual fibres for + the purpose of relieving pain cease to be exerted, the pain recurs; + whence the reciprocal contraction and relaxation of the muscles in + convulsion, and the intervals of madness. Otherwise these violent + exertions continue, till so great a part of the sensorial power is + exhausted, that no more of it is excitable by the faculty of volition; + and a temporary apoplexy succeeds, with snoring as in profound sleep; + which so generally terminates epileptic fits.</p> + + <p>When these voluntary exertions become so connected with certain + disagreeable sensations, or with irritations, that the effort of the will + cannot restrain them, they can no longer in common language be termed + voluntary; but nevertheless belong to this class, as they are produced by + excess of volition, and may still not improperly be called depraved + voluntary actions. See Sect. XXXIV. 1. where many motions in common + language termed involuntary are shewn to depend on excess of + volition.</p> + + <p>When these exertions from excess of volition, which in common language + are termed involuntary motions, either of mind or body, are perpetually + exerted in weak constitutions, the pulse becomes quick; which is + occasioned by the too great expenditure of the sensorial power in these + unceasing modes of activity. In the same manner as in very weak people in + fevers, the pulse sometimes increases in frequency to 140 strokes in a + minute, when the patients stand up or endeavour to walk; and subsides to + 110, when they lie down again in their beds. Whence it appears, that when + a very quick pulse accompanies convulsion or insanity, it simply + indicates the weakness of the patient; that is, that the expenditure of + sensorial power is too great for the supply of it. But if the strength of + the patient is not previously exhausted, the exertions of the muscles are + attended with temporary increase of circulation, the reciprocal swellings + and elongations of their bellies push forwards the arterial blood, and + promote the absorption of the venous blood; whence a temporary increase + of secretion and of heat, and a stronger pulse.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_III_1_1_1">1</a>. <i>Jactitatio.</i> Restlessness. + There is one kind of restlessness attending fevers, which consists in a + frequent change of posture to relieve the uneasiness of the pressure of + one part of the body upon another, when the sensibility of the system, or + of some parts of it, is increased by inflammation, as in the lumbago; + which may sometimes be distinguished in its early stage by the incessant + desire of the patient to turn himself in bed. But there is another + restlessness, which approaches towards writhing or contortions of the + body, which is a voluntary effort to relieve pain; and may be esteemed a + slighter kind of convulsion, not totally unrestrainable by opposite or + counteracting volitions.</p> + + <p>M. M. A blister. Opium. Warm bath.</p> + + <p><a name="species_III_1_1_2">2</a>. <i>Tremor febrilis.</i> Reciprocal + convulsions of the subcutaneous muscles, originating from the pain of the + sense of heat, owing to defect of its usual stimulus, and consequent + accumulation of sensorial power in it. The actual deficiency of heat may + exist in one part of the body, and the pain of cold be felt most vividly + in some other part associated with it by sensitive sympathy. So a + chillness down the back is first attended to in ague-fits, though the + disease perhaps commences with the torpor and consequent coldness of some + internal viscus. But in whatever part of the system the defect of heat + exists, or the sensation of it, the convulsions of the subcutaneous + muscles exerted to relieve it are very general; and, if the pain is still + greater, a chattering of the teeth is added, the more suddenly to exhaust + the sensorial power, and because the teeth are very sensible to cold.</p> + + <p>These convulsive motions are nevertheless restrainable by violent + voluntary counteraction; and as their intervals are owing to the pain of + cold being for a time relieved by their exertion, they may be compared to + laughter, except that there is no interval of pleasure preceding each + moment of pain in this as in the latter.</p> + + <p>M. M. See <a href="#species_I_2_2_1">I. 2. 2. 1</a>.</p> + + <p><a name="species_III_1_1_3">3</a>. <i>Clamor.</i> Screaming from pain. + The talkative animals, as dogs, and swine, and children, scream most, + when they are in pain, and even from fear; as they have used this kind of + exertion from their birth most frequently and most forcibly; and can + therefore sooner exhaust the accumulation of sensorial power in the + affected muscular or sensual organs by this mode of exertion; as + described in Sect. XXXIV. 1. 3. This facility of relieving pain by + screaming is the source of laughter, as explained below.</p> + + <p><a name="species_III_1_1_4">4</a>. <i>Risus.</i> The pleasurable + sensations, which occasion laughter, are perpetually passing into the + bounds of pain; for pleasure and pain are often produced by different + degrees of the same stimulus; as warmth, light, aromatic or volatile + odours, become painful by their excess; and the tickling on the soles of + the feet in children is a painful sensation at the very time it produces + laughter. When the pleasurable ideas, which excite us to laugh, pass into + pain, we use some exertion, as a scream, to relieve the pain, but soon + stop it again, as we are unwilling to lose the pleasure; and thus we + repeatedly begin to scream, and stop again alternately. So that in + laughing there are three stages, first of pleasure, then pain, then an + exertion to relieve that pain. See Sect. XXXIV. 1. 3.</p> + + <p>Every one has been in a situation, where some ludicrous circumstance + has excited him to laugh; and at the same time a sense of decorum has + forbid the exertion of these interrupted screams; and then the pain has + become so violent, as to occasion him to use some other great action, as + biting his tongue, and pinching himself, in lieu of the reiterated + screams which constitute laughter.</p> + + <p><a name="species_III_1_1_5">5</a>. <i>Convulsio.</i> Convulsion. When + the pains from defect or excess of motion are more distressing than those + already described, and are not relievable by such partial exertions, as + in screaming, or laughter, more general convulsions occur; which vary + perhaps according to the situation of the pained part, or to some + previous associations formed by the early habits of life. When these + convulsive motions bend the body forwards, they are termed + emprosthotonoi; when they bend it backward, they are termed opisthotonoi. + They frequently succeed each other, but the opisthotonoi are generally + more violent; as the muscles, which erect the body, and keep it erect, + are naturally in more constant and more forcible action than their + antagonists.</p> + + <p>The causes of convulsion are very numerous, as from toothing in + children, from worms or acidity in their bowels, from eruption of the + distinct small-pox, and lastly, from breathing too long the air of an + unventilated bed-room. Sir G. Baker, in the Transactions of the College, + described this disease, and detected its cause; where many children in an + orphan-house were crowded together in one chamber without a chimney, and + were almost all of them affected with convulsion; in the hospital at + Dublin, many died of convulsions before the real cause was understood. + See Dr. Beddoes's Guide to Self-preservation. In a large family, which I + attended, where many female servants slept in one room, which they had + contrived to render inaccessible to every blast of air; I saw four who + were thus seized with convulsions, and who were believed to have been + affected by sympathy from the first who fell ill. They were removed into + more airy apartments, but were some weeks before they all regained their + perfect health.</p> + + <p>Convulsion is distinguished from epilepsy, as the patient does not + intirely lose all perception during the paroxysm. Which only shews, that + a less exhaustion of sensorial power renders tolerable the pains which + cause convulsion, than those which cause epilepsy. The hysteric + convulsions are distinguished from those, owing to other causes, by the + presence of the expectation of death, which precedes and succeeds them, + and generally by a flow of pale urine; these convulsions do not + constantly attend the hysteric disease, but are occasionally superinduced + by the disagreeable sensation arising from the torpor or inversion of a + part of the alimentary canal. Whence the convulsion of laughter is + frequently sufficient to restrain these hysteric pains, which accounts + for the fits of laughter frequently attendant on this disease.</p> + + <p>M. M. To remove the peculiar pain which excites the convulsions. + Venesection. An emetic. A cathartic with calomel. Warm-bath. Opium in + large quantities, beginning with smaller ones. Mercurial frictions. + Electricity. Cold-bath in the paroxysm; or cold aspersion. See Memoirs of + Med. Society, Lon. V. 3. p. 147. a paper by Dr. Currie.</p> + + <p><i>Convulsio debilis.</i> The convulsions of dying animals, as of + those which are bleeding to death in the slaughter-house, are an effort + to relieve painful sensation, either of the wound which occasions their + death, or of faintness from want of due distention of the blood-vessels. + Similar to this in a less degree is the subsultus tendinum, or starting + of the tendons, in fevers with debility; these actions of the muscles are + too weak to move the limb, but the belly of the acting muscles is seen to + swell, and the tendon to be stretched. These weak convulsions, as they + are occasioned by the disagreeable sensation of faintness from inanition, + are symptoms of great general debility, and thence frequently precede the + general convulsions of the act of dying. See a case of convulsion of a + muscle of the arm, and of the fore-arm, without moving the bones to which + they were attached, Sect. XVII. 1. 8. See twitchings of the face, Class + <span class="correction" title="Original reads `IV. 3. 2. 2.'."><a + href="#species_IV_1_3_2">IV. 1. 3. 2</a></span>.</p> + + <p><a name="species_III_1_1_6">6</a>. <i>Convulsio dolorifica.</i> + Raphania. Painful convulsion. In this disease the muscles of the arms and + legs are exerted to relieve the pains left after the rheumatism in young + and delicate people; it recurs once or twice a-day, and has been mistaken + for the chorea, or St. Vitus's dance; but differs from it, as the undue + motions in that disease only occur, when the patient endeavours to exert + the natural ones; are not attended with pain; and cease, when he lies + down without trying to move: the chorea, or dance of St. Vitus, is often + introduced by the itch, this by the rheumatism.</p> + + <p>It has also been improperly called nervous rheumatism; but is + distinguished from rheumatism, as the pains recur by periods once or + twice a day; whereas in the chronic rheumatism they only occur on moving + the affected muscles. And by the warmth of a bed the pains of the chronic + rheumatism are increased, as the muscles or membranes then become more + sensible to the stimulus of the extraneous mucaginous material deposited + under them. Whereas the pains of the raphania, or painful convulsion, + commence with coldness of the part, or of the extremities. See + Rheumatismus chronicus, Class <a href="#species_I_1_3_12">I. 1. 3. + 12</a>.</p> + + <p>The pains which accompany the contractions of the muscles in this + disease, seem to arise from the too great violence of those contractions, + as happens in the cramp of the calf of the leg; from which they differ in + those being fixed, and these being reiterated contractions. Thus these + convulsions are generally of the lower limbs, and recur at periodical + times from some uneasy sensation from defect of action, like other + periodic diseases; and the convulsions of the limbs relieve the original + uneasy painful sensation, and then produce a greater pain from their own + too vehement contractions. There is however another way of accounting for + these pains, when they succeed the acute rheumatism; and that is by the + coagulable lymph, which may be left still unabsorbed on the membranes; + and which may be in too small quantity to affect them with pain in common + muscular exertions, but may produce great pain, when the bellies of the + muscles swell to a larger bulk in violent action.</p> + + <p>M. M. Venesection. Calomel. Opium. Bark. One grain of calomel and one + of opium for ten successive nights. A bandage spread with emplastrum de + minio put tight on the affected part.</p> + + <p><a name="species_III_1_1_7">7</a>. <i>Epilepsia</i> is originally + induced, like other convulsions, by a voluntary exertion to relieve some + pain. This pain is most frequently about the pit of the stomach, or + termination of the bile-duct; and in some cases the torpor of the + stomach, which probably occasioned the epileptic fits, remains + afterwards, and produces a chronical anorexia; of which a case is related + in Class <a href="#species_II_2_2_1">II. 2. 2. 1</a>. There are instances + of its beginning in the heel, of which a case is published by Dr. Short, + in the Med. Essays, Edinb. I once saw a child about ten years old, who + frequently fell down in convulsions, as she was running about in play; on + examination a wart was found on one ancle, which was ragged and inflamed; + which was directed to be cut off, and the fits never recurred.</p> + + <p>When epilepsy first commences, the patients are liable to utter one + scream before they fall down; afterwards the convulsions so immediately + follow the pain, which occasions them, that the patient does not + recollect or seem sensible of the preceding pain. Thus in laughter, when + it is not excessive, a person is not conscious of the pain, which so + often recurs, and causes the successive screams or exertions of laughter, + which give a temporary relief to it.</p> + + <p>Epileptic fits frequently recur in sleep from the increase of + sensibility at that time, explained in Sect. XVIII. 14. In two such + cases, both of young women, one grain of opium given at night, and + continued many months, had success; in one of them the opium was omitted + twice at different times, and the fit recurred on both the nights. In the + more violent case, described in Sect. XVIII. 15, opium had no effect.</p> + + <p>Epileptic fits generally commence with setting the teeth, by which + means the tongue is frequently wounded; and with rolling the eyeballs in + every kind of direction; for the muscles which suspend the jaw, as well + as those which move the eyes, are in perpetual motion during our waking + hours; and yet continue subservient to volition; hence their more facile + and forcible actions for the purpose of relieving pain by the exhaustion + of sensorial power. See Section XXXIV. 1. 4.</p> + + <p>Epileptic convulsions are not attended with the fear of death, as in + the hysteric disease, and the urine is of a straw colour. However it must + be noted, that the disagreeable sensations in hysteric diseases sometimes + are the cause of true epileptic convulsions, of syncope, and of + madness.</p> + + <p>The pain, which occasions some fits of epilepsy, is felt for a time in + a distant part of the system, as in a toe or heel; and is said by the + patient gradually to ascend to the head, before the general convulsions + commence. This ascending sensation has been called aura epileptica, and + is said to have been prevented from affecting the head by a tight bandage + round the limb. In this malady the pain, probably of some torpid + membrane, or diseased tendon, is at first only so great as to induce + slight spasms of the muscular fibres in its vicinity; which slight spasms + cease on the numbness introduced by a tight bandage; when no bandage is + applied, the pain gradually increases, till generally convulsions are + exerted to relieve it. The course of a lymphatic, as when poisonous + matter is absorbed; or of a nerve, as in the sciatica, may, by the + sympathy existing between their extremities and origins, give an idea of + the ascent of an aura or vapour.</p> + + <p>In difficult parturition it sometimes happens, that general + convulsions are excited to relieve the pain of labour, instead of the + exertions of those muscles of the abdomen and diaphragm, which ought to + forward the exclusion of the child. See Class <a + href="#genus_III_1_1">III. 1. 1</a>. That is, instead of the particular + muscular actions, which ought to be excited by sensation to remove the + offending cause, general convulsions are produced by the power of + volition, which still the pain, as in common epilepsy, without removing + the cause; and, as the parturition is not thus promoted, the convulsions + continue, till the sensorial power is totally exhausted, that is, till + death. In patients afflicted with epilepsy from other causes, I have seen + the most violent convulsions recur frequently during pregnancy without + miscarriage, as they did not tend to forward the exclusion of the + fetus.</p> + + <p>M. M. Venesection. A large dose of opium. Delivery.</p> + + <p>The later in life epileptic fits are first experienced, the more + dangerous they may be esteemed in general; as in these cases the cause + has generally been acquired by the habits of the patient, or by the decay + of some part, and is thus probably in an increasing state. Whereas in + children the changes in the system, as they advance to puberty, sometimes + removes the cause. So in toothing, fits of convulsion with stupor + frequently occur, and cease when the tooth advances; but this is not to + be expected in advanced life. Sir ——, about sixty years of + age, had only three teeth left in his upper jaw, a canine tooth, and one + on each side of it. He was seized with epileptic fits, with pain + commencing in these teeth. He was urged to have them extracted, which he + delayed too long, till the fits were become habitual, and then had them + extracted in vain, and in a few months sunk under the disease.</p> + + <p>Mr. F——, who had lived intemperately, and had been + occasionally affected with the gout, was suddenly seized with epileptic + fits; the convulsions were succeeded by apoplectic snoring; from which he + was, in about 20 minutes, disturbed by fresh convulsions, and had + continued in this situation above four-and-twenty hours. About eight + ounces of blood were then taken from him; and after having observed, that + the apoplectic's torpor continued about 20 minutes, I directed him to be + forcibly raised up in bed, after he had thus lain about fifteen minutes, + to gain an interval between the termination of the sleep, and the + renovation of convulsion. In this interval he was induced to swallow + forty drops of laudanum. Twenty more were given him in the same manner in + about half an hour, both which evidently shortened the convulsion fits, + and the consequent stupor; he then took thirty more drops, which for the + present removed the fits. He became rather insane the next day, and after + about three more days lost the insanity, and recovered his usual state of + health.</p> + + <p>The case mentioned in Sect. XXVII. 2. where the patient was left after + epileptic fits with a suffusion of blood beneath the tunica adjunctiva of + the eye, was in almost every respect similar to the preceding, and + submitted to the same treatment. Both of them suffered frequent relapses, + which were relieved by the same means, and at length perished, I believe, + by the epileptic fits.</p> + + <p>In those patients, who have not been subject to epilepsy before they + have arrived to about forty years of age, and who have been intemperate + in respect to spirituous potation, I have been induced to believe, that + the fits were occasioned by the pain of a diseased liver; and this became + more probable in one of the above subjects, who had used means to repel + eruptions on the face; and thus by some stimulant application had + prevented an inflammation taking place on the skin of the face instead of + on some part of the liver. Secondly, as in these cases insanity had + repeatedly occurred, which could not be traced from an hereditary source; + there is reason to believe, that this as well as the epileptic + convulsions were caused by spirituous potation; and that this therefore + is the original source both of epilepsy and of insanity in those + families, which are afflicted with them. This idea however brings some + consolation with it; as it may be inferred, that in a few sober + generations these diseases may be eradicated, which otherwise destroy the + family.</p> + + <p>M. M. Venesection. Opium. Bark. Steel. Arsenic. Opium one grain twice + a day for years together. See the preceding article.</p> + + <p><a name="species_III_1_1_8">8</a>. <i>Epilepsia dolorifica.</i> + Painful epilepsy. In the common epilepsy the convulsions are immediately + induced, as soon as the disagreeable sensation, which causes them, + commences; but in this the pain continues long with cold extremities, + gradually increasing for two or three hours, till at length convulsions + or madness come on; which terminate the daily paroxysm, and cease + themselves in a little time afterwards.</p> + + <p>This disease sometimes originates from a pain about the lower edge of + the liver, sometimes in the temple, and sometimes in the pudendum; it + recurs daily for five or six weeks, and then ceases for several months. + The pain is owing to defect of action, that is, to the accumulation of + sensorial power in the part, which probably sympathizes with some other + part, as explained in Sect. XXXV. 2. XII. 5. 3. and Class <a + href="#species_II_1_1_11">II. 1. 1. 11</a>. and <a + href="#species_IV_2_2_3">IV. 2. 2. 3</a>.</p> + + <p>It is the most painful malady that human nature is liable + to!—See Sect. XXXIV. 1. 4.</p> + + <p>Mrs. C—— was seized every day about the same hour with + violent pain on the right side of her bowels about the situation of the + lower edge of the liver, without fever, which increased for an hour or + two, till it became totally intolerable. After violent screaming she fell + into convulsions, which terminated sometimes in fainting, with or without + stertor, as in common epilepsy; at other times a tempory insanity + supervened; which continued about half an hour, and the fit ceased. These + paroxysms had returned daily for two or three weeks, and were at length + removed by large doses of opium, like the fits of reverie or + somnambulation. About half an hour before the expected return of the fit + three or four grains of opium were exhibited, and then tincture of opium + was given in warm brandy and water about 20 or 30 drops every half hour, + till the eyes became somewhat inflamed, and the nose began to itch, and + by the sharp movements of the patient, or quick speech, an evident + intoxication appeared; and then it generally happened that the pain + ceased. But the effects of this large dose of opium was succeeded by + perpetual sickness and efforts to vomit, with great general debility all + the succeeding day.</p> + + <p>The rationale of this temporary cure from the exhibition of opium and + vinous spirit depends on the great expenditure of sensorial power in the + increased actions of all the irritative motions, by the stimulus of such + large quantities of opium and vinous spirit; together with the production + of much sensation, and many movements of the organs of sense or ideas in + consequence of that sensation; and lastly, even the motions of the + arterial system become accelerated by this degree of intoxication, all + which soon exhausted so much sensorial power as to relieve the pain; + which would otherwise have caused convulsions or insanity, which are + other means of expending sensorial power. The general debility on the + succeeding day, and the particular debility of the stomach, attended in + consequence with sickness and frequent efforts to vomit, were occasioned + by the system having previously been so strongly stimulated, and those + parts in particular on which the opium and wine more immediately acted. + This sickness continued so many hours as to break the catenation of + motions, which had daily reproduced the paroxysm; and thus it generally + happened, that the whole disease ceased for some weeks or months from one + great intoxication, a circumstance not easily to be explained on any + other theory.</p> + + <p>The excess or defect of motion in any part of the system occasions the + production of pain in that part, as in Sect. XII. 1. 6. This defect or + excess of fibrous action is generally induced by excess or defect of the + stimulus of objects external to the moving organ. But there is another + source of excessive fibrous action, and consequent pain, which is from + excess of volition, which is liable to affect those muscles, that have + weak antagonists; as those which support the under jaw, and close the + mouth in biting, and those of the calf of the leg; which are thus liable + to fixed or painful contractions, as in trismus, or locked jaw, and in + the cramp of the calf of the leg; and perhaps in some colics, as in that + of Japan: these pains, from contraction arising from excess of volition + in the part from the want of the counteraction of antagonist muscles, may + give occasional cause to epileptic fits, and may be relieved in the same + way, either by exciting irritative and sensitive motions by the stimulus + of opium and wine; or by convulsions or insanity, as described above, + which are only different methods of exhausting the general quantity of + sensorial power.</p> + + <p>Considering the great resemblance between this kind of painful + epilepsy and the colic of Japan, as described by Kemfer; and that that + disease was said to be cured by acupuncture, or the prick of a needle; I + directed some very thin steel needles to be made about three inches long, + and of such a temper, that they would bend double rather than break; and + wrapped wax thread over about half an inch of the blunt end for a handle. + One of these needles, when the pain occurred, was pushed about an inch + into the painful part, and the pain instantly ceased; but I was not + certain, whether the fear of the patient, or the stimulus of the + puncture, occasioned the cessation of pain; and as the paroxysm had + continued some weeks, and was then declining, the experiment was not + tried again. The disease is said to be very frequent in Japan, and its + seat to be in the bowels, and that the acupuncture eliminates the air, + which is supposed to distend the bowel. But though the aperture thus made + is too small to admit of the eduction of air; yet as the stimulus of so + small a puncture may either excite a torpid part into action, or cause a + spasmodic one to cease to act; and lastly, as no injury could be likely + to ensue from so small a perforation, I should be inclined at some future + time to give this a fairer trial in similar circumstances.</p> + + <p>Another thing worth trial at the commencement of this deplorable + disease would be electricity, by passing strong shocks through the + painful part; which, whether the pain was owing to the inaction of that + part, or of some other membrane associated with it, might stimulate them + into exertion; or into inactivity, if owing to fixed painful + contraction.</p> + + <p>And lastly, the cold bath, or aspersions with cold water on the + affected part, according to the method of Dr. Currie in the Memoirs of a + Med. Soc. London, V. iii. p. 147, might produce great effect at the + commencement of the pain. Nevertheless opium duly administered, so as to + precede the expected paroxysm, and in such doses, given by degrees, as to + induce intoxication, is principally to be depended upon in this + deplorable malady. To which should be added, that if venesection can be + previously performed, even to but few ounces, the effect of the opium is + much more certain; and still more so, if there be time to premise a brisk + cathartic, or even an emetic. The effect of increased stimulus is so much + greater after previous defect of stimulus; and this is still of greater + advantage where the cause of the disease happens to consist in a + material, which can be absorbed. See Art. <a href="#art_IV_2_8">IV. 2. + 8</a>.</p> + + <p>M. M. Venesection. An emetic. A cathartic. Warm bath. Opium a grain + every half hour. Wine. Spirit of wine. If the patient becomes intoxicated + by the above means, the fit ceases, and violent vomitings and debility + succeed on the subsequent day, and prevent a return. Blisters or + sinapisms on the small of the leg, taken off when they give much pain, + are of use in slighter convulsions. Acupuncture. Electricity. Aspersion + with cold water on the painful part.</p> + + <p><a name="species_III_1_1_9">9</a>. <i>Somnambulismus.</i> + Sleep-walking is a part of reverie, or studium inane, described in Sect. + XIX. In this malady the patients have only the general appearance of + being asleep in respect to their inattention to the stimulus of external + objects, but, like the epilepsies above described, it consists in + voluntary exertions to relieve pain. The muscles are subservient to the + will, as appears by the patient's walking about, and sometimes doing the + common offices of life. The ideas of the mind also are obedient to the + will, because their discourse is consistent, though they answer imaginary + questions. The irritative ideas of external objects continue in this + malady, because the patients do not run against the furniture of the + room; and when they apply their volition to their organs of sense, they + become sensible of the objects they attend to, but not otherwise, as + general sensation is destroyed by the violence of their voluntary + exertions. At the same time the sensations of pleasure in consequence of + ideas excited by volition are vividly experienced, and other ideas seem + to be excited by these pleasurable sensations, as appears in the case of + Master A. Sect. XXXIV. 3. 1. where a history of a hunting scene was + voluntarily recalled, with all the pleasurable ideas which attended it. + In melancholy madness the patient is employed in voluntarily exciting one + idea, with those which are connected with it by voluntary associations + only, but not so violently as to exclude the stimuli of external objects. + In reverie variety of ideas are occasionally excited by volition, and + those which are connected with them either by sensitive or voluntary + associations, and that so violently as to exclude the stimuli of external + objects. These two situations of our sensual motions, or ideas, resemble + convulsion and epilepsy; as in the former the stimulus of external + objects is still perceived, but not in the latter. Whence this disease, + so far from being connected with sleep, though it has by universal + mistake acquired its name from it, arises from excess of volition, and + not from a suspension of it; and though, like other kinds of epilepsy, it + often attacks the patients in their sleep, yet those two, whom I saw, + were more frequently seized with it while awake, the sleep-walking being + a part of the reverie. See Sect. XIX. and XXXIV. 3. and Class <a + href="#species_II_1_7_4">II. 1. 7. 4</a>. and <a + href="#species_III_1_2_18">III. 1. 2. 18</a>.</p> + + <p>M. M. Opium in large doses before the expected paroxysm.</p> + + <p><a name="species_III_1_1_10">10</a>. <i>Asthma convulsivum.</i> The + fits of convulsive asthma return at periods, and are attended with cold + extremities, and so far resemble the access of an intermittent fever; + but, as the lungs are not sensible to the pain of cold, a shivering does + not succeed, but instead of it violent efforts of respiration; which have + no tendency, as in the humoral asthma, to dislodge any offending + material, but only to relieve the pain by exertion, like the shuddering + in the beginning of ague-fits, as explained Class <a + href="#species_III_1_1_2">III. 1. 1. 2</a>.</p> + + <p>The insensibility of the lungs to cold is observable on going into + frosty air from a warm room; the hands and face become painfully cold, + but no such sensation is excited in the lungs; which is another argument + in favour of the existence of a peculiar set of nerves for the purpose of + perceiving the universal fluid matter of heat, in which all things are + immersed. See Sect. XIV. 6. Yet are the lungs nevertheless very sensible + to the deficiency of oxygen in the atmosphere, as all people experience, + when they go into a room crowded with company and candles, and complain, + that it is so close, they can scarcely breathe; and the same in some hot + days in summer.</p> + + <p>There are two diseases, which bear the name of asthma. The first is + the torpor or inability of the minute vessels of the lungs, consisting of + the terminations of the pulmonary and bronchial arteries and veins, and + their attendant lymphatics; in this circumstance it resembles the + difficulty of breathing, which attends cold bathing. If this continues + long, a congestion of fluid in the air-cells succeeds, as the absorbent + actions cease completely before the secerning ones; as explained in Class + <a href="#species_I_1_2_3">I. 1. 2. 3</a>. And the coldness, which + attends the inaction of these vessels, prevents the usual quantity of + exhalation. Some fits cease before this congestion takes place, and in + them no violent sweating nor any expuition of phlegm occurs. This is the + humoral asthma, described at Class <a href="#species_II_1_1_7">II. 1. 1. + 7</a>.</p> + + <p>The second kind of asthma consists in the convulsive actions in + consequence of the disagreeable sensations thus induced; which in some + fits of asthma are very great, as appears in the violent efforts to raise + the ribs, and to depress the diaphragm, by lifting the shoulders. These, + so long as they contribute to remove the cause of the disease, are not + properly convulsions, but exertions immediately caused by sensation; but + in this kind of asthma they are only efforts to relieve pain, and are + frequently preceded by other epileptic convulsions.</p> + + <p>These two kinds of asthmas have so many resembling features, and are + so frequently intermixed, that it often requires great attention to + distinguish them; but as one of them is allied to anasarca, and the other + to epilepsy, we shall acquire a clearer idea of them by comparing them + with those disorders. A criterion of the humoral or hydropic asthma is, + that it is relieved by copious sweats about the head and breast, which + are to be ascribed to the sensitive exertions of the pulmonary vessels to + relieve the pain occasioned by the anasarcous congestion in the + air-cells; and which is effected by the increased absorption of the + mucus, and its elimination by the retrograde action of those lymphatics + of the skin, whose branches communicate with the pulmonary ones; and + which partial sweats do not easily admit of any other explanation. See + Class <a href="#species_I_3_2_8">I. 3. 2. 8</a>. Another criterion of it + is, that it is generally attended with swelled legs, or other symptoms of + anasarca. A criterion of the convulsive asthma may be had from the + absence of these cold clammy sweats of the upper part of the body only, + and from the patient having occasionally been subject to convulsions of + the limbs, as in the common epilepsy.</p> + + <p>It may thus frequently happen, that in the humoral asthma some + exertions of the lungs may occur, which may not contribute to discharge + the anasarcous lymph, but may be efforts simply to relieve pain; besides + those efforts, which produce the increased absorption and elimination of + it; and thus we have a bodily disease resembling in this circumstance the + reverie, in which both sensitive and voluntary motions are at the same + time, or in succession, excited for the purpose of relieving pain.</p> + + <p>It may likewise sometimes happen, that the disagreeable sensation, + occasioned by the congestion of lymph in the air-cells in the humoral or + hydropic asthma, may induce voluntary convulsions of the respiratory + organs only to relieve the pain, without any sensitive actions of the + pulmonary absorbents to absorb and eliminate the congestion of serous + fluid; and thus the same cause may occasionally induce either the humoral + or convulsive asthma.</p> + + <p>The humoral asthma has but one remote cause, which is the torpor of + the pulmonary vessels, like that which occurs on going into the cold + bath; or the want of absorption of the pulmonary lymphatics to take up + the lymph effused into the air-cell. Whereas the convulsive asthma, like + other convulsions, or epilepsies, may be occasioned by pain in almost any + remote part of the system. But in some of the adult patients in this + disease, as in many epilepsies, I have suspected the remote cause to be a + pain of the liver, or of the biliary ducts.</p> + + <p>The asthmas, which have been induced in consequence of the recess of + eruptions, especially of the leprous kind, countenance this opinion. One + lady I knew, who for many years laboured under an asthma, which ceased on + her being afflicted with pain, swelling, and distortion of some of her + large joints, which were esteemed gouty, but perhaps erroneously. And a + young man, whom I saw yesterday, was seized with asthma on the + retrocession, or ceasing of eruptions on his face.</p> + + <p>The convulsive asthma, as well as the hydropic, are more liable to + return in hot weather; which may be occasioned by the less quantity of + oxygen existing in a given quantity of warm air, than of cold, which can + be taken into the lungs at one inspiration. They are both most liable to + occur after the first sleep, which is therefore a general criterion of + asthma. The cause of this is explained in Sect. XVIII. 15. and applies to + both of them, as our sensibility to internal uneasy sensation increases + during sleep.</p> + + <p>When children are gaining teeth, long before they appear, the pain of + the gums often induces convulsions. This pain is relieved in some by + sobbing and screaming; but in others a laborious respiration is exerted + to relieve the pain; and this constitutes the true asthma convulsivum. In + other children again general convulsions, or epileptic paroxysms, are + induced for this purpose; which, like other epilepsies, become + established by habit, and recur before the irritation has time to produce + the painful sensation, which originally caused them.</p> + + <p>The asthma convulsivum is also sometimes induced by worms, or by + acidity in the stomachs of children, and by other painful sensations in + adults; in whom it is generally called nervous asthma, and is often + joined with other epileptic symptoms.</p> + + <p>This asthma is distinguished from the peripneumony, and from the + croup, by the presence of fever in the two latter. It is distinguished + from the humoral asthma, as in that the patients are more liable to run + to the cold air for relief, are more subject to cold extremities, and + experience the returns of it more frequently after their first sleep. It + is distinguished from the hydrops thoracis, as that has no intervals, and + the patient sits constantly upright, and the breath is colder; and, where + the pericardium is affected, the pulse is quick and unequal. See Hydrops + Thoracis, <a href="#species_I_2_3_14">I. 2. 3. 14</a>.</p> + + <p>M. M. Venesection once. A cathartic with calomel once. Opium. <span + class="correction" title="Original reads `Assafætida'." + >Assafœtida</span>. Warm bath. If the cause can be detected, as in + toothing or worms, it should be removed. As this species of asthma is so + liable to recur during sleep, like epileptic fits, as mentioned in + Section XVIII. 15. there was reason to believe, that the respiration of + an atmosphere mixed with hydrogen, or any other innocuous air, which + might dilute the oxygen, would be useful in preventing the paroxysms by + decreasing the sensibility of the system. This, I am informed by Dr. + Beddoes, has been used with decided success by Dr. Ferriar. See Class <a + href="#species_II_1_1_7">II. 1. 1. 7</a>.</p> + + <p><a name="species_III_1_1_11">11</a>. <i>Asthma dolorificum.</i> Angina + pectoris. The painful asthma was first described by Dr. Heberden in the + Transactions of the College; its principal symptoms consist in a pain + about the middle of the sternum, or rather lower, on every increase of + pulmonary or muscular exertion, as in walking faster than usual, or going + quick up a hill, or even up stairs; with great difficulty of breathing, + so as to occasion the patient instantly to stop. A pain in the arms about + the insertion of the tendon of the pectoral muscle generally attends, and + a desire of resting by hanging on a door or branch of a tree by the arms + is sometimes observed. Which is explained in Class <a + href="#species_I_2_3_14">I. 2. 3. 14</a>. and in Sect. XXIX. 5. 2.</p> + + <p>These patients generally die suddenly; and on examining the thorax no + certain cause, or seat, of the disease has been detected; some have + supposed the valves of the arteries, or of the heart, were imperfect; and + others that the accumulation of fat about this viscus or the lungs + obstructed their due action; but other observations do not accord with + these suppositions.</p> + + <p>Mr. W——, an elderly gentleman, was seized with asthma + during the hot part of last summer; he always waked from his first sleep + with difficult respiration, and pain in the middle of his sternum, and + after about an hour was enabled to sleep again. As this had returned for + about a fortnight, it appeared to me to be an asthma complicated with the + disease, which Dr. Heberden has called angina pectoris. It was treated by + venesection, a cathartic, and then by a grain of opium given at going to + bed, with ether and tincture of opium when the pain or asthma required, + and lastly with the bark, but was several days before it was perfectly + subdued.</p> + + <p>This led me to conceive, that in this painful asthma the diaphragm, as + well as the other muscles of respiration, was thrown into convulsive + action, and that the fibres of this muscle not having proper antagonists, + a painful fixed spasm of it, like that of the muscles in the calf of the + leg in the cramp, might be the cause of death in the angina pectoris, + which I have thence arranged under the name of painful asthma, and leave + for further investigation.</p> + + <p>From the history of the case of the late much lamented John Hunter, + and from the appearances after death, the case seems to have been of this + kind, complicated with vertigo and consequent affection of the stomach. + The remote cause seems to have arisen from ossifications of the coronary + arteries; and the immediate cause of his death from fixed spasm of the + heart. Other histories and dissections are still required to put this + matter out of doubt; as it is possible, that either a fixed spasm of the + diaphragm, or of the heart, which are both furnished with but weak + antagonists, may occasion sudden death; and these may constitute two + distinct diseases.</p> + + <p>Four patients I have now in my recollection, all of whom I believed to + labour under the angina pectoris in a great degree; which have all + recovered, and have continued well three or four years by the use, as I + believe, of issues on the inside of each thigh; which were at first large + enough to contain two pease each, and afterwards but one. They took + besides some slight antimonial medicine for a while, and were reduced to + half the quantity or strength of their usual potation of fermented + liquor.</p> + + <p>The use of femoral issues in angina pectoris was first recommended by + Dr. Macbride, physician at Dublin, Med. Observ. & Enquir. Vol. VI. + And I was further induced to make trial of them, not only because the + means which I had before used were inadequate, but from the ill effect I + once observed upon the lungs, which succeeded the cure of a small sore + beneath the knee; and argued conversely, that issues in the lower limbs + might assist a difficult respiration.</p> + + <p>Mrs. L——, about fifty, had a small sore place about the + size of half a pea on the inside of the leg a little below the knee. It + had discharged a pellucid fluid, which she called a ley-water, daily for + fourteen years, with a great deal of pain; on which account she applied + to a surgeon, who, by means of bandage and a saturnine application, soon + healed the sore, unheedful of the consequences. In less than two months + after this I saw her with great difficulty of breathing, which with + universal anasarca soon destroyed her.</p> + + <p>The theory of the double effect of issues, as above related, one in + relieving by their presence the asthma dolorificum, and the other in + producing by its cure an anasarca of the lungs, is not easy to explain. + Some similar effects from cutaneous eruptions and from blisters are + mentioned in Class <a href="#species_I_1_2_9">I. 1. 2. 9</a>. In these + cases it seems probable, that the pain occasioned by issues, and perhaps + the absorption of a small quantity of aerated purulent matter, stimulate + the whole system into greater energy of action, and thus prevent the + torpor which is the beginning of so many diseases. In confirmation of + this effect of pain on the system, I remember the case of a lady of an + ingenious and active mind, who, for many of the latter years of her life, + was perpetually subject to great pains of her head from decaying teeth. + When all her teeth were gone, she became quite low spirited, and + melancholy in the popular sense of that word, and after a year or two + became universally dropsical and died.</p> + + <p>M. M. Issues in the thighs. Five grains of rhubarb, and one sixth of a + grain of emetic tartar every night for some months, with or without half + a grain of opium. No stronger liquor than small beer, or wine diluted + with twice its quantity of water. Since I wrote the above I have seen two + cases of hydrops thoracis, attended with pain in the left arm, so as to + be mistaken for asthma dolorificum, in which femoral issues, though + applied early in the disease, had no effect.</p> + + <p><a name="species_III_1_1_12">12</a>. <i>Stridor dentium.</i> The + clattering of the teeth on going into cold water, or in the beginning of + ague-fits, is an exertion along with the tremblings of the skin to + relieve the pain of cold. The teeth and skin being more sensible to cold + than the more internal parts, and more exposed to it, is the reason that + the muscles, which serve them, are thrown into exertion from the pain of + cold rather than those of respiration, as in screaming from more acute + pain. Thus the poet,</p> + + <div class="poem"> + <div class="stanza"> + <p>Put but your toes into cold water,</p> + <p>Your correspondent teeth will clatter.</p> + <p class="i24"><span class="sc">Prior.</span></p> + </div> + </div> + + <p>In more acute pains the jaws are gnashed together with great + vehemence, insomuch that sometimes the teeth are said to have been broken + by the force. See Sect. XXXIV. 1. 3. In these cases something should be + offered to the patient to bite, as a towel, otherwise they are liable to + tear their own arms, or to bite their attendants, as I have witnessed in + the painful epilepsy.</p> + + <p><a name="species_III_1_1_13">13</a>. <i>Tetanus trismus.</i> Cramp. + The tetanus consists of a fixed spasm of almost all the muscles of the + body; but the trismus, or locked jaw, is the most frequent disease of + this kind. It is generally believed to arise from sympathy with an + injured tendon. In one case where it occurred in consequence of a broken + ankle from a fall from a horse, it was preceded by evident hydrophobia. + Amputation was advised, but not submitted to; two wounds were laid into + one with scissors, but the patient died about the seventh day from the + accident. In this case the wounded tendon, like the wounds from the bite + of a mad dog, did not produce the hydrophobia, and then the locked jaw, + till several days after the accident.</p> + + <p>I twice witnessed the locked jaw from a pain beneath the sternum, + about the part where it is complained of in painful asthma, or angina + pectoris, in the same lady at some years distance of time. The last time + it had continued two days, and she wrote her mind, or expressed herself + by signs. On observing a broken tooth, which made a small aperture into + her mouth, I rolled up five grains of opium like a worm about an inch + long, and introducing it over the broken tooth, pushed it onward by means + of a small crow-quill; as it dissolved I observed she swallowed her + saliva, and in less than half an hour, she opened her mouth and conversed + as usual.</p> + + <p>Men are taught to be ashamed of screaming from pain in their early + years; hence they are prone to exert the muscles of the jaws instead, + which they have learnt to exert frequently and violently from their + infancy; whence the locked jaw. This and the following spasm have no + alternate relaxations, like the preceding ones; which is perhaps owing, + first, to the weakness of their antagonist muscles, those which elevate + the jaw being very strong for the purpose of biting and masticating hard + substances, and for supporting the under jaw, with very weak antagonist + muscles; and secondly, to their not giving sufficient relief even for a + moment to the pain, or its preceding irritation, which excited them.</p> + + <p>M. M. Opium in very large quantities. Mercurial ointment used + extensively. Electricity. Cold bath. Dilate the wound, and fill it with + lint moistened with spirit of turpentine; which inflames the wound, and + cures or prevents the convulsions. See a case, Transact. of American + Society, Vol. II. p. 227.</p> + + <p>Wine in large quantities in one case was more successful than opium; + it probably inflames more, which in this disease is desirable. Between + two or three ounces of bark, and from a quart to three pints of wine a + day, succeeded better than opium. Ib.</p> + + <p><a name="species_III_1_1_14">14</a>. <i>Tetanus dolorificus.</i> + Painful cramp. This kind of spasm most frequently attacks the calf of the + leg, or muscles of the toes; it often precedes paroxysms of gout, and + appears towards the end of violent diarrhœa, and from indigestion, + or from acid diet. In these cases it seems to sympathize with the bowels, + but is also frequently produced by the pain of external cold, and to the + too great previous extension of the muscles, whence some people get the + cramp in the extensor muscles of the toes after walking down hill, and of + those of the calf of the leg after walking up a steep eminence. For the + reason why these cramps commence in sleep, see Sect. XVIII. 15.</p> + + <p>The muscle in this disease contracts itself to relieve some smaller + pain, either from irritation or association, and then falls into great + pain itself, from the too great action of its own fibres. Hence any + muscle, by being too vehemently exerted, falls into cramp, as in swimming + too forcibly in water, which is painfully cold; and a secondary pain is + then induced by the too violent contraction of the muscle; though the + pain, which was the cause of the contraction, ceases. Which accounts for + the continuance of the contraction, and distinguishes this disease from + other convulsions, which are relaxed and exerted alternately. Hence + whatever may be the cause of the primary pain, which occasions the cramp + of the calf of the leg, the secondary one is relievable by standing up, + and thus by the weight of the body on the toes forcibly extending the + contracted muscles. For the cause, which induces these muscles of the + calf of the leg to fall into more violent contraction than other + spasmodic muscles, proceeds from the weakness of their antagonist + muscles; as they are generally extended again after action by the weight + of the body on the balls of the toes. See the preceding article.</p> + + <p>M. M. Rub the legs with camphor dissolved in oil, and let the patient + wear stockings in bed. If a foot-board be put at the bed's feet, and the + bed be so inclined, that he will rest a little with his toes against the + foot-board, that pressure is said to prevent the undue contractions of + the musculi gastrocnemii, which constitute the calf of the leg. In gouty + patients, or where the bowels are affected with acidity, half a grain of + opium, and six grains of rhubarb, and six of chalk, every night. + Flesh-meat to supper. A little very weak warm spirit and water may be + taken for present relief, when these cramps are very troublesome to weak + or gouty patients.</p> + + <p><a name="species_III_1_1_15">15</a>. <i>Hydrophobia.</i> Dread of + water generally attending canine madness. I was witness to a case, where + this disease preceded the locked jaw from a wound in the ankle, + occasioned by a fall from a horse; as mentioned in the preceding article. + It came on about the sixth day after the accident; when the patient + attempted to swallow fluids, he became convulsed all over from the pain + of this attempt, and spurted them out of his mouth with violence. It is + also said to happen in some hysterical cases. Hence it seems rather the + immediate consequence of a pained tendon, than of a contagious poison. + And is so far analogous to tetanus, according with the opinions of Doctor + Rusch and Doctor Percival.</p> + + <p>In other respects, as it is produced by the saliva of an enraged + animal instilled into a wound, it would seem analogous to the poison of + venomous animals. And from the manner of its access so long after the + bite, and of its termination in a short time, it would seem to resemble + the progress of contagious fevers. See Sect. XXII. 3. 3.</p> + + <p>If the patient was bitten in a part, which could be totally cut away, + as a finger, even after the hydrophobia appears, it is probable it might + cure it; as I suspect the cause still remains in the wounded tendon, and + not in a diffused infection tainting the blood. Hence there are generally + uneasy sensations, as cold or numbness, in the old cicatrix, before the + hydrophobia commences. See a case in Medical Communications, Vol. II. p. + 190.</p> + + <p>If the diseased tendon could be inflamed without cutting it out, as by + cupping, or caustic, or blister after cupping, and this in the old wound + long since healed, after the hydrophobia commences, might prevent the + spasms about the throat. As inflaming the teeth by the use of mercury is + of use in some kinds of hemicrania. Put spirit of turpentine on the + wound, wash it well. See Class <a href="#species_I_3_1_11">I. 3. 1. + 11</a>. <a href="#species_IV_1_2_7">IV. 1. 2. 7</a>.</p> + + <p>M. M. Wine, musk, oil, internally. Opium, mercurial ointment, used + extensively. Mercurial fumigation. Turpeth mineral. To salivate the + patient as soon as possible. Exsection or a caustic on the scar, even + after the appearance of hydrophobia. Put a tight bandage on the limb + above the scar of the old wound to benumb the pained tendon, however long + the wound may have been healed. Could a hollow catheter of elastic gum, + <span class="correction" title="Original reads `coartchouc'." + >caoutchouc</span>, be introduced into the œsophagus by the mouth + or nostril, and liquid nourishment be thus conveyed into the stomach? See + Desault's Journal, Case I. where, in an ulcer of the mouth, such a + catheter was introduced by the nostril, and kept in the œsophagus + for a month, by which means the patient was nourished and preserved.</p> + + <p>It is recommended by Dr. Bardsley to give oil internally by a similar + method contrived by Mr. John Hunter. He covered a probang with the skin + of a small eel, or the gut of a lamb or cat. It was tied up at one end + above and below the sponge, and a slit made above the upper ligature; to + the other end of the eel-skin or gut was fixed a bladder and pipe. The + probang thus covered was introduced into the stomach, and the liquid food + or medicine was put into the bladder and squeezed down through the + eel-skin. Mem. of Society at Manchester. See Class <a + href="#species_I_2_3_25">I. 2. 3. 25</a>.</p> + + <p>Dr. Bardsley has endeavoured to prove, that dogs never experience the + hydrophobia, or canine madness, without having been previously bitten or + infected; and secondly, that the disease in this species of animal always + shews itself in five or six weeks; and concludes from hence, that this + dreadful malady might be annihilated by making all the dogs in Great + Britain perform a kind of quarantine, by shutting them up for a certain + number of weeks. Though the disease from the bite of the mad dog is + perhaps more analogous to those from the wounds inflicted by venomous + animals than to those from other contagious matter, yet these + observations are well worthy further attention; which the author + promises.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Volition.</i></h3> + +<h3>GENUS <a name="genus_III_1_2">II</a>.</h3> + +<h3><i>With increased Actions of the Organs of Sense.</i></h3> + + <p>In every species of madness there is a peculiar idea either of desire + or aversion, which is perpetually excited in the mind with all its + connections. In some constitutions this is connected with pleasurable + ideas without the exertion of much muscular action, in others it produces + violent muscular action to gain or avoid the object of it, in others it + is attended with despair and inaction. Mania is the general word for the + two former of these, and melancholia for the latter; but the species of + them are as numerous as the desires and aversions of mankind.</p> + + <p>In the present age the pleasurable insanities are most frequently + induced by superstitious hopes of heaven, by sentimental love, and by + personal vanity. The furious insanities by pride, anger, revenge, + suspicion. And the melancholy ones by fear of poverty, fear of death, and + fear of hell; with innumerable others.</p> + + <div class="poem"> + <div class="stanza"> + <p>Quicquid agunt homines, votum, timor, ira, voluptas,</p> + <p>Gaudia, discursus, nostri est farrago libelli.</p> + <p class="i30"><span class="sc">Juven.</span> I. 85.</p> + </div> + </div> + + <p>This idea, however, which induces madness or melancholy, is generally + untrue; that is, the object is a mistaken fact. As when a patient is + persuaded he has the itch, or venereal disease, of which he has no + symptom, and becomes mad from the pain this idea occasions. So that the + object of madness is generally a delirious idea, and thence cannot be + conquered by reason; because it continues to be excited by painful + sensation, which is a stronger stimulus than volition. Most frequently + pain of body is the cause of convulsion, which is often however exchanged + for madness; and a painful delirious idea is most frequently the cause of + madness originally, but sometimes of convulsion. Thus I have seen a young + lady become convulsed from a fright, and die in a few days; and a + temporary madness frequently terminates the paroxysms of the epilepsia + dolorifica, and an insanity of greater permanence is frequently induced + by the pains or bruises of parturition.</p> + + <p>Where the patient is debilitated a quick pulse sometimes attends + insane people, which is nevertheless generally only a symptom of the + debility, owing to the too great expenditure of sensorial power; or of + the paucity of its production, as in inirritative, or in sensitive + inirritated fever. See <a href="#genus_III_1_1">III. 1. 1</a>.</p> + + <p>But nevertheless where the quick pulse is permanent, it shews the + presence of fever; and as the madness then generally arises from the + disagreeable sensations attending the fever, it is so far a good symptom; + because when the fever is cured, or ceases spontaneously, the insanity + most frequently vanishes at the same time.</p> + + <p>The stimulus of so much volition supports insane people under variety + of hardships, and contributes to the cure of diseases from debility, as + sometimes occurs towards the end of fevers. See Sect. XXXIV. 2. 5. And, + on the same account, they bear large doses of medicines to procure any + operation on them; as emetics, and cathartics, which, before they produce + their effect in inverting the motions of the stomach in vomiting, or of + the absorbents of the bowels in purging, must first weaken the natural + actions of those organs, as shewn in Sect. <span class="correction" + title="Original reads `XXXV. 1. 13.'.">XXXV. 1. 3</span>.</p> + + <p>From these considerations it appears, that the indications of cure + must consist in removing the cause of the pain, whether it arises from a + delirious idea, or from a real fact, or from bodily disease; or secondly, + if this cannot be done, by relieving the pain in consequence of such idea + or disease. The first is sometimes effected by presenting frequently in a + day contrary ideas to shew the fallacy, or the too great estimation, of + the painful ideas. 2dly. By change of place, and thus presenting the + stimulus of new objects, as a long journey. 3dly. By producing + forgetfulness of the idea or object, which causes their pain; by removing + all things which recal it to their minds; and avoiding all conversation + on similar subjects. For I suppose no disease of the mind is so perfectly + cured by other means as by forgetfulness.</p> + + <p>Secondly, the pain in consequence of the ideas or bodily diseases + above described is to be removed, first, by evacuations, as venesection, + emetics, and cathartics; and then by large doses of opium, or by the + vertigo occasioned by a circulating swing, or by a sea-voyage, which, as + they affect the organs of sense as well as evacuate the stomach, may + contribute to answer both indications of cure.</p> + + <p>Where maniacs are outrageous, there can be no doubt but coercion is + necessary; which may be done by means of a straight waistcoat; which + disarms them without hurting them; and by tying a handkerchief round + their ankles to prevent their escape. In others there can be no doubt, + but that confinement retards rather than promotes their cure; which is + forwarded by change of ideas in consequence of change of place and of + objects, as by travelling or sailing.</p> + + <p>The circumstances which render confinement necessary, are first, if + the lunatic is liable to injure others, which must be judged of by the + outrage he has already committed. 2dly. If he is likely to injure + himself; this also must be judged of by the despondency of his mind, if + such exists. 3dly. If he cannot take care of his affairs. Where none of + these circumstances exist, there should be no confinement. For though the + mistaken idea continues to exist, yet if no actions are produced in + consequence of it, the patient cannot be called insane, he can only be + termed delirious. If every one, who possesses mistaken ideas, or who puts + false estimates on things, was liable to confinement, I know not who of + my readers might not tremble at the sight of a madhouse!</p> + + <p>The most convenient distribution of insanities will be into general, + as mania mutabilis, studium inane, and vigilia; and into partial + insanities. These last again may be subdivided into desires and + aversions, many of which are succeeded by pleasurable or painful ideas, + by fury or dejection, according to the degree or violence of their + exertions. Hence the analogy between the insanities of the mind, and the + convulsions of the muscles described in the preceding genus, is curiously + exact. The convulsions without stupor, are either just sufficient to + obliterate the pain, which occasions them; or are succeeded by greater + pain, as in the convulsio dolorifica. So the exertions in the mania + mutabilis are either just sufficient to allay the pain which occasions + them, and the patient dwells comparatively in a quiet state; or those + exertions excite painful ideas, which are succeeded by furious + discourses, or outrageous actions. The studium inane, or reverie, + resembles epilepsy, in which there is no sensibility to the stimuli of + external objects. Vigilia, or watchfulness, may be compared to the + general writhing of the body; which is just a sufficient exertion to + relieve the pain which occasions it. Erotomania may be compared to + trismus, or other muscular fixed spasm, without much subsequent pain; and + mæror to cramp of the muscles of the leg, or other fixed spasm with + subsequent pain. All these coincidences contribute to shew, as explained + in Sect. III. 5, that our ideas are motions of the immediate organs of + sense obeying the same laws as our muscular motions.</p> + + <p>The violence of action accompanying insanity depends much on the + education of the person; those who have been proudly educated with + unrestrained passions, are liable to greater fury; and those, whose + education has been humble, to greater despondency. Where the delirious + idea, above described, produces pleasurable sensations, as in personal + vanity or religious enthusiasm; it is almost a pity to snatch them from + their fool's paradise, and reduce them again to the common lot of + humanity; lest they should complain of their cure, like the patient + described in Horace,</p> + + <div class="poem"> + <div class="stanza"> + <p>————Pol! me occidistis, amici,</p> + <p>Non servastis, ait, cui sic extorta voluptas,</p> + <p>Et demptus per vim mentis gratissimus error!</p> + </div> + </div> + + <p>The disposition to insanity, as well as to convulsion, is believed to + be hereditary; and in consequence to be induced in those families from + slighter causes than in others. Convulsions have been shewn to have been + most frequently induced by pains owing to defect of stimulus, as the + shuddering from cold, and not from pains from excess of stimulus, which + are generally succeeded by inflammation. But insanities are on the + contrary generally induced by pains from excess of stimulus, as from the + too violent actions of our ideas, as in common anger, which is an + insanity of short duration; for insanities generally, though not always, + arise from pains of the organs of sense; but convulsions generally, + though not always, from pains of the membranes or glands. And it has been + previously explained, that though the membrane and glands, as the stomach + and skin, receive great pain from want of stimulus; yet that the organs + of sense, as the eye and ear, receive no pain from defect of + stimulus.</p> + + <p>Hence it follows, that the constitutions most liable to convulsion, + are those which most readily become torpid in some part of the system, + that is, which possess less irritability; and that those most liable to + insanity, are such as have excess of sensibility; and lastly, that these + two circumstances generally exist in the same constitution; as explained + in Sect. XXXI. 2. on Temperaments. These observations explain why + epilepsy and insanity frequently succeed or reciprocate with each other, + and why inirritable habits, as scrophulous ones, are liable to insanity, + of which I have known some instances.</p> + + <p>In many cases however there is no appearance of the disposition to + epilepsy or insanity of the parent being transmitted to the progeny. + First, where the insanity has arisen from some violent disappointment, + and not from intemperance in the use of spirituous liquors. Secondly, + where the parent has acquired the insanity or epilepsy by habits of + intoxication after the procreation of his children. Which habits I + suppose to be the general cause of the disposition to insanity in this + country. See Class <a href="#species_III_1_1_7">III. 1. 1. 7</a>.</p> + + <p>As the disposition to gout, dropsy, epilepsy, and insanity, appears to + be produced by the intemperate use of spirituous potation, and is in all + of them hereditary; it seems probable, that this disposition gradually + increases from generation to generation, in those families which continue + for many generations to be intemperate in this respect; till at length + these diseases are produced; that is, the irritability of the system + gradually is decreased by this powerful stimulus, and the sensibility at + the same time increased, as explained in Sect. XXXI. 1. and 2. This + disposition is communicated to the progeny, and becomes still increased, + if the same stimulus be continued, and so on by a third and fourth + generation; which accounts for the appearance of epilepsy in the children + of some families, where it was never known before to have existed, and + could not be ascribed to their own intemperance. A parity of reasoning + shews, that a few sober generations may gradually in the same manner + restore a due degree of irritability to the family, and decrease the + excess of sensibility.</p> + + <p>From hence it would appear probable, that scrophula and dropsy are + diseases from inirritability; but that in epilepsy and insanity an excess + of sensibility is added, and the two faulty temperaments are thus + conjoined.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_III_1_2_1">1</a>. <i>Mania mutabilis.</i> Mutable + madness. Where the patients are liable to mistake ideas of sensation for + those from irritation, that is, imaginations for realities, if cured of + one source of insanity, they are liable in a few months to find another + source in some new mistaken or imaginary idea, and to act from this new + idea. The idea belongs to delirium, when it is an imaginary or mistaken + one; but it is the voluntary actions exerted in consequence of this + mistaken idea, which constitute insanity.</p> + + <p>In this disease the patient is liable carefully to conceal the object + of his desire or aversion. But a constant inordinate suspicion of all + people, and a carelessness of cleanliness, and of decency, are generally + concomitants of madness. Their designs cannot be counteracted, till you + can investigate the delirious idea or object of their insanity; but as + they are generally timid, they are therefore less to be dreaded.</p> + + <p>Z. Z. called a young girl, one of his maid-servants, into the parlour, + and, with cocked pistols in his hands, ordered her to strip herself + naked; he then inspected her with some attention, and dismissed her + untouched. Then he stripped two of his male servants in the same manner, + to the great terror of the neighbourhood. After he was secured, with much + difficulty he was persuaded to tell me, that he had got the itch, and had + examined some of his servants to find out from whom he had received it; + though at the same time there was not a spot to be seen on his hands, or + other parts. The outrages in consequence of this false idea were in some + measure to be ascribed to the pride occasioned by unrestrained education, + affluent wealth, and dignified family.</p> + + <p>Madness is sometimes produced by bodily pain, particularly I believe + of a diseased liver, like convulsion and epilepsy; at other times it is + caused by very painful ideas occasioned by external circumstances, as of + grief or disappointment; but the most frequent cause of insanity arises + from the pain of some imaginary or mistaken idea; which may be termed + hallucinatio maniacalis. This hallucination of one of the senses is often + produced in an instant, and generally becomes gradually weakened in + process of time, by the perpetual stimulus of external objects, or by the + successions of other catenations of ideas, or by the operations of + medicines; and when the maniacal hallucination ceases, or is forgotten, + the violent exertions cease, which were in consequence of it, and the + disease is cured.</p> + + <p>Mr. ——, a clergyman, about forty years of age, who was + rather a weak man, happened to be drinking wine in jocular company, and + by accident swallowed a part of the seal of a letter, which he had just + then received; one of his companions seeing him alarmed, cried out in + humour, "It will seal your bowels up." He became melancholy from that + instant, and in a day or two refused to swallow any kind of nourishment. + On being pressed to give a reason for this refusal, he answered, he knew + nothing would pass through him. A cathartic was given, which produced a + great many evacuations, but he still persisted, that nothing passed + through him; and though he was frightened into taking a little broth once + or twice by threats, yet he soon ceased intirely to swallow any thing, + and died in consequence of this insane idea.</p> + + <p>Miss ——, a sensible and ingenious lady, about thirty, said + she had seen an angel; who told her, that she need not eat, though all + others were under the necessity of supporting their earthly existence by + food. After fruitless persuasions to take food, she starved herself to + death.—It was proposed to send an angel of an higher order to tell + her, that now she must begin to eat and drink again; but it was not put + into execution.</p> + + <p>Mrs. ——, a lady between forty and fifty years of age, + imagined that she heard a voice say to her one day, as she was at her + toilet, "Repent, or you will be damned." From that moment she became + melancholy, and this hallucination affected her in greater or less degree + for about two years; she then recovered perfectly, and is now a cheerful + old woman.</p> + + <p>Mrs. ——, a farmer's wife, going up stairs to dress, found + the curtains of her bed drawn, and on undrawing them, she believed that + she saw the corpse of her sister, who was then ill at the distance of + twenty miles, and became from that time insane; and as her sister died + about the time, she could not be produced to counteract the insane + hallucination, but she perfectly recovered in a few months.</p> + + <p>Mrs. ——, a most elegant, beautiful, and accomplished lady, + about twenty-two years of age, had been married about two months to an + elegant, polished, and affluent young man, and it was well known to be a + love-match on both sides. She suddenly became melancholy, and yet not to + so great a degree, but that she could command herself to do the honours + of her table with grace and apparent ease. After many days intreaty, she + at length told me, that she thought her marrying her husband had made him + unhappy; and that this idea she could not efface from her mind day or + night. I withstood her being confined, as some had advised, and proposed + a sea-voyage to her, with expectation that the sickness, as well as + change of objects, might remove the insane hallucination, by introducing + other energetic ideas; this was not complied with, but she travelled + about England with her friends and her husband for many months, and at + length perfectly recovered, and is now I am informed in health and + spirits.</p> + + <p>These cases are related to shew the utility of endeavouring to + investigate the maniacal idea, or hallucination; as it may not only + acquaint us with the probable designs of the patient, from whence may be + deduced the necessity of confinement; but also may some time lead to the + most effectual plan of cure.</p> + + <p>I received good information of the truth of the following case, which + was published a few years ago in the newspapers. A young farmer in + Warwickshire, finding his hedges broke, and the sticks carried away + during a frosty season, determined to watch for the thief. He lay many + cold hours under a hay-stack, and at length an old woman, like a witch in + a play, approached, and began to pull up the hedge; he waited till she + had tied up her bottle of sticks, and was carrying them off, that he + might convict her of the theft, and then springing from his concealment, + he seized his prey with violent threats. After some altercation, in which + her load was left upon the ground, she kneeled upon her bottle of sticks, + and raising her arms to heaven beneath the bright moon then at the full, + spoke to the farmer already shivering with cold, "Heaven grant, that thou + never mayest know again the blessing to be warm." He complained of cold + all the next day, and wore an upper coat, and in a few days another, and + in a fortnight took to his bed, always saying nothing made him warm, he + covered himself with very many blankets, and had a sieve over his face, + as he lay; and from this one insane idea he kept his bed above twenty + years for fear of the cold air, till at length he died.</p> + + <p>M. M. As mania arises from pain either of our muscles or organs of + sense, the arts of relieving pain must constitute the method of cure. See + Sect. XXXIV. 3. 4. Venesection. Vomits of from five grains to ten of + emetic tartar, repeated every third morning for three or four times; with + solution of gum-ammoniac, and soluble tartar, so as to purge gently every + day. Afterwards warm bath for two or three hours a day. Opium in large + doses. Bark. Steel.</p> + + <p>Dr. Binns gave two scruples (40 grains) of solid opium at a dose, and + twenty grains four hours afterwards; which restored the patient. Dr. + Brandreth gave 400 drops of laudanum to a maniac in the greatest possible + furor, and in a few hours he became calm and rational. Med. Comment for + 1791, p. 384.</p> + +<p class="cenhead"><i>Prognostic.</i></p> + + <p>The temporary quick pulse attending some maniacal cases is simply a + symptom of debility, and is the consequence of too great exertions; but a + permanent quick pulse shews the presence of fever, and is frequently a + salutary sign; because, if the life of the patient be safe, when the + fever ceases, the insanity generally vanishes along with it, as mentioned + above. In this case the kind of fever must direct the method of curing + the insanity; which must consist of moderate evacuations and diluents, if + the pulse be strong; or by nutrientia, bark, and small doses of opium, if + the pulse be weak.</p> + + <p>Where the cause is of a temporary nature, as in puerperal insanity, + there is reason to hope, that the disease will cease, when the bruises, + or other painful sensations attending this state, are removed. In these + cases the child should be brought frequently to the mother, and applied + to her breast, if she will suffer it, and this whether she at first + attends to it or not; as by a few trials it frequently excites the + storgè, or maternal affection, and removes the insanity, as I have + witnessed.</p> + + <p>When the madness is occasioned by pain of the teeth, which I believe + is no uncommon case, these must be extracted; and the cure follows the + extinction of the pain. There is however some difficulty in detecting the + delinquent tooth in this case, as in hemicrania, unless by its apparent + decay, or by some previous information of its pain having been complained + of; because the pain of the tooth ceases, as soon as the exertions of + insanity commence.</p> + + <p>When a person becomes insane, who has a family of small children to + solicit his attention, the prognostic is very unfavourable; as it shews + the maniacal hallucination to be more powerful than those ideas which + generally interest us the most.</p> + + <p><a name="species_III_1_2_2">2</a>. <i>Studium inane.</i> Reverie + consists of violent voluntary exertions of ideas to relieve pain, with + all the trains or tribes connected with them by sensations or + associations. It frequently alternates with epileptic convulsions; with + which it corresponds, in respect to the insensibility of the mind to the + stimuli of external objects, in the same manner as madness corresponds + with common convulsion, in the patient's possessing at the same time a + sensibility of the stimuli of external objects.</p> + + <p>Some have been reported to have been involved in reverie so perfectly, + as not to have been disturbed by the discharge of a cannon; and others to + have been insensible to torture, as the martyrs for religious opinions; + but these seem more properly to belong to particular insanities than to + reverie, like nostalgia and erotomania.</p> + + <p>Reverie is distinguished from madness as described above; and from + delirium, because the trains of ideas are kept consistent by the power of + volition, as the person reasons and deliberates in it. Somnambulismus is + a part of reverie, the latter consisting in the exertions of the + locomotive muscles, and the former of the exertions of the organs of + sense; see Class <span class="correction" title="Original reads `I. 1. 1. 9.'." + ><a href="#species_III_1_1_9">III. 1. 1. 9</a></span>. and Sect. XIX. + both which are mixed, or alternate with each other, for the purpose of + relieving pain.</p> + + <p>When the patients in reverie exert their volition on their organs of + sense, they can occasionally perceive the stimuli of external objects, as + explained in Sect. XIX. And in this case it resembles sometimes an + hallucination of the senses, as there is a mixture of fact and + imagination in their discourse; but may be thus distinguished: + hallucinations of the lenses are allied to delirium, and are attended + generally with quick pulse, and other symptoms of great debility; but + reverie is without fever, and generally alternates with convulsions; and + so much intuitive analogy (see Sect. XVII. 3. 7.) is retained in its + paroxysms, as to preserve a consistency in the trains of ideas.</p> + + <p>Miss G——, whose case is related in Sect. III. 5. 8. said, + as I once sat by her, "My head is fallen off, see it is rolled to that + corner of the room, and the little black dog is nibbling the nose off." + On my walking to the place which she looked at, and returning, and + assuring her that her nose was unhurt, she became pacified, though I was + doubtful whether she attended to me. See Class <a + href="#species_III_1_1_9">III. 1. 1. 9</a>. and Class <a + href="#species_III_1_2_2">III. 1. 2. 2</a>.</p> + + <p>M. M. Large doses of opium given before the expected paroxysm, as in + epilepsia dolorifica, Class <a href="#species_III_1_1_8">III. 1. 1. + 8</a>.</p> + + <p>The hallucinatio studiosa, or false ideas in reverie, differ from + maniacal hallucinations above described, as no insane exertions succeed, + and in the patients whom I have seen they have always been totally + forgotten, when the paroxysm was over.</p> + + <p>Master ——, a school-boy about twelve years old, after he + came out of a convulsion fit and sat up in bed, said to me, "Don't you + see my father standing at the feet of the bed, he is come a long way on + foot to see me." I answered, no: "What colour is his coat!" He replied, + "A drab colour." "And what buttons?" "Metal ones," he answered, and + added, "how sadly his legs are swelled." In a few minutes he said, with + apparent surprise, "He is gone," and returned to his perfect mind. Other + cases are related in Sect. XIX. and XXXIV. 3. and in Class <a + href="#species_III_1_2_2">III. 1. 2. 2</a>. with further observations on + this kind of hallucination; which however is not the cause of reverie, + but constitutes a part of it, the cause being generally some uneasy + sensation of the body.</p> + + <p><a name="species_III_1_2_3">3</a>. <i>Vigilia.</i> Watchfulness + consists in the unceasing exertion of volition; which is generally caused + by some degree of pain either of mind or of body, or from defect of the + usual quantity of pleasurable sensation; hence if those, who are + accustomed to wine at night, take tea instead, they cannot sleep. The + same happens from want of solid food for supper, to those who are + accustomed to use it; as in these cases there is pain or defect of + pleasure in the stomach.</p> + + <p>Sometimes the anxiety about sleeping, that is the desire to sleep, + prevents sleep; which consists in an abolition of desire or will. This + may so far be compared to the impediment of speech described in Sect. + XVII. 1. 10. as the interference of the will prevents the effect + desired.</p> + + <p>Another source of watchfulness may be from the too great secretion of + sensorial power in the brain, as in phrenzy, and as sometimes happens + from the exhibition of opium, and of wine; if the exhaustion of sensorial + power by the general actions of the system occasioned by the stimulus of + these drugs can be supposed to be less than the increased secretion of + it.</p> + + <p>M. M. 1. Solid food to supper. Wine. Opium. Warm bath. 2. The patient + should be told that his want of sleep is of no consequence to his health. + 3. Venesection by cupping. Abstinence from wine. 4. A blister by + stimulating the skin, and rhubarb by stimulating the bowels, will + sometimes induce sleep. Exercise. An uniform sound, as of a pausing drop + of water, or the murmur of bees. Other means are described in Sect. + XVIII. 20.</p> + + <p><a name="species_III_1_2_4">4</a>. <i>Erotomania.</i> Sentimental + love. Described in its excess by romance-writers and poets. As the object + of love is beauty, and as our perception of beauty consists in a + recognition by the sense of vision of those objects, which have before + inspired our love, by the pleasure they have afforded to many of our + senses (Sect. XVI. 6); and as brute animals have less accuracy of their + sense of vision than mankind (ib.); we see the reason why this kind of + love is not frequently observable in the brute creation, except perhaps + in some married birds, or in the affection of the mother to her + offspring. Men, who have not had leisure to cultivate their taste for + visible objects, and who have not read the works of poets and + romance-writers, are less liable to sentimental love; and as ladies are + educated rather with an idea of being chosen, than of choosing; there are + many men, and more women, who have not much of this insanity; and are + therefore more easily induced to marry for convenience or interest, or + from the flattery of one sex to the other.</p> + + <p>In its fortunate gratification sentimental love is supposed to supply + the purest source of human felicity; and from the suddenness with which + many of those patients, described in Species <a + href="#species_III_1_2_1">I</a>. of this genus, were seized with the + maniacal hallucination, there is reason to believe, that the most violent + sentimental love may be acquired in a moment of time, as represented by + Shakespeare in the beginning of his Romeo and Juliet.</p> + + <p>Some have endeavoured to make a distinction between beauty and grace, + and have made them as it were rivals for the possession of the human + heart; but grace may be defined beauty in action; for a sleeping beauty + cannot be called graceful in whatever attitude she may recline; the + muscles must be in action to produce a graceful attitude, and the limbs + to produce a graceful motion. But though the object of love is beauty, + yet the idea is nevertheless much enhanced by the imagination of the + lover; which appears from this curious circumstance, that the lady of his + passion seldom appears so beautiful to the lover after a few months + separation, as his ideas had painted her in his absence; and there is, on + that account, always a little disappointment felt for a minute at their + next interview from this hallucination of his ideas.</p> + + <p>This passion of love produces reverie in its first state, which + exertion alleviates the pain of it, and by the assistance of hope + converts it into pleasure. Then the lover seeks solitude, lest this + agreeable reverie should be interrupted by external stimuli, as described + by Virgil.</p> + + <div class="poem"> + <div class="stanza"> + <p>Tantum inter densas, umbrosa cacumina, fagos</p> + <p>Assiduè veniebat, ibi hæc incondita solus</p> + <p>Montibus et sylvis studio jactabat inani.</p> + </div> + </div> + + <p>When the pain of love is so great, as not to be relieved by the + exertions of reverie, as above described; as when it is misplaced on an + object, of which the lover cannot possess himself; it may still be + counteracted or conquered by the stoic philosophy, which strips all + things of their ornaments, and inculcates "nil admirari." Of which + lessons may be found in the meditations of Marcus Antoninus. The maniacal + idea is said in some lovers to have been weakened by the action of other + very energetic ideas; such as have been occasioned by the death of his + favourite child, or by the burning of his house, or by his being + shipwrecked. In those cases the violence of the new idea for a while + expends so much sensorial power as to prevent the exertion of the + maniacal one; and new catenations succeed. On this theory the lover's + leap, so celebrated by poets, might effect a cure, if the patient escaped + with life.</p> + + <p>The third stage of this disease I suppose is irremediable; when a + lover has previously been much encouraged, and at length meets with + neglect or disdain; the maniacal idea is so painful as not to be for a + moment relievable by the exertions of reverie, but is instantly followed + by furious or melancholy insanity; and suicide, or revenge, have + frequently been the consequence. As was lately exemplified in Mr. + Hackman, who shot Miss Ray in the lobby of the playhouse. So the poet + describes the passion of Dido,</p> + + <div class="poem"> + <div class="stanza"> + <p>—————Moriamur inultæ?—</p> + <p>At moriamur, ait,—sic, sic, juvat ire sub umbras!</p> + </div> + </div> + + <p>The story of Medæa seems to have been contrived by Ovid, who was a + good judge of the subject, to represent the savage madness occasioned by + ill-requited love. Thus the poet,</p> + + <div class="poem"> + <div class="stanza"> + <p>Earth has no rage like love to hatred turn'd,</p> + <p>Nor hell a fury like a woman scorn'd.</p> + <p class="i24"><span class="sc">Dryden.</span></p> + </div> + </div> + + <p><a name="species_III_1_2_5">5</a>. <i>Amor sui.</i> Vanity consists of + an agreeable reverie, and is well ridiculed in the story of Narcissus, + who so long contemplated his own beautiful image in the water, that he + died from neglect of taking sustenance. I once saw a handsome young man, + who had been so much flattered by his parents, that his vanity rose so + near to insanity, that one might discern by his perpetual attention to + himself, and the difficulty with which he arranged his conversation, that + the idea of himself intruded itself at every comma or pause of his + discourse. In this degree vanity must afford great pleasure to the + possessor; and when it exists within moderate bounds, may contribute much + to the happiness of social life.</p> + + <p>My friend Mr. —— once complained to me, that he was much + troubled with bashfulness in company, and believed that it arose from his + want of personal vanity; on this account he determined on a journey to + Paris, when Paris was the center of politeness; he there learnt to dress, + to dance, and to move his hands gracefully in conversation; and returned + a most consummate coxcomb. But after a very few years he relapsed into + rusticity of dress and manners.</p> + + <p>M. M. The cure of vanity may be attempted by excess of flattery, which + will at length appear ridiculous, or by its familiarity will cease to be + desired. I remember to have heard a story of a nobleman in the court of + France, when France had a court, who was so disagreeably vain in + conversation, that the king was pleased to direct his cure, which was + thus performed. Two gentlemen were directed always to attend him, one was + to stand behind his chair, and the other at a respectful distance before + him; whenever his lordship began to speak, one of them always pronounced, + "Lord Gallimaufre is going to say the best thing in the world." And, as + soon as his lordship had done speaking, the other attendant pronounced, + "Lord Gallimaufre has spoken the best thing in the world." Till in a few + weeks this noble lord was so disgusted with praise that he ceased to be + vain; and his majesty dismissed his keepers.</p> + + <p><a name="species_III_1_2_6">6</a>. <i>Nostalgia.</i> Maladie de Pais. + Calenture. An unconquerable desire of returning to one's native country, + frequent in long voyages, in which the patients become so insane as to + throw themselves into the sea, mistaking it for green fields or meadows. + The Swiss are said to be particularly liable to this disease, and when + taken into foreign service frequently to desert from this cause, and + especially after hearing or singing a particular tune, which was used in + their village dances, in their native country, on which account the + playing or singing this tune was forbid by the punishment of death. + Zwingerus.</p> + + <div class="poem"> + <div class="stanza"> + <p>Dear is that shed, to which his soul conforms,</p> + <p>And dear that hill, which lifts him to the storms.</p> + <p class="i30"><span class="sc">Goldsmith.</span></p> + </div> + </div> + + <p><a name="species_III_1_2_7">7</a>. <i>Spes religiosa.</i> + Superstitious hope. This maniacal hallucination in its milder state + produces, like sentimental love, an agreeable reverie; but when joined + with works of supererogation, it has occasioned many enormities. In India + devotees consign themselves by vows to most painful and unceasing + tortures, such as holding up their hands, till they cannot retract them; + hanging up by hooks put into the thick skin over their shoulders, sitting + upon sharp points, and other self torments. While in our part of the + globe fasting and mortification, as flagellation, has been believed to + please a merciful deity! The serenity, with which many have suffered + cruel martyrdoms, is to be ascribed to this powerful reverie.</p> + + <p>Mr. ——, a clergyman, formerly of this neighbourhood, began + to bruise and wound himself for the sake of religious mortification, and + passed much time in prayer, and continued whole nights alone in the + church. As he had a wife and family of small children, I believed the + case to be incurable; as otherwise the affection and employment in his + family connections would have opposed the beginning of this insanity. He + was taken to a madhouse without effect, and after he returned home, + continued to beat and bruise himself, and by this kind of mortification, + and by sometimes long fasting, he at length became emaciated and died. I + once told him in conversation, that "God was a merciful being, and could + not delight in cruelty, but that I supposed he worshipped the devil." He + was struck with this idea, and promised me not to beat himself for three + days, and I believe kept his word for one day. If this idea had been + frequently forced on his mind, it might probably have been of + service.</p> + + <p>When these works of supererogation have been of a public nature, what + cruelties, murders, massacres, has not this insanity introduced into the + world!—A commander, who had been very active in leading and + encouraging the bloody deeds of St. Bartholomew's day at Paris, on + confessing his sins to a worthy ecclesiastic on his death-bed, was asked, + "Have you nothing to say about St. Bartholomew?" "On that day," he + replied, "God Almighty was obliged to me!"—The fear of hell is + another insanity, which will be spoken of below.</p> + + <p><a name="species_III_1_2_8">8</a>. <i>Superbia stemmatis.</i> Pride of + family has frequently formed a maniacal hallucination, which in its mild + state has consisted in agreeable reverie, but when it has been so painful + as to demand homage from others, it has frequently induced insane + exertions. This insanity seems to have existed in the flourishing state + of Rome, as now all over Germany, and is attacked by Juvenal with great + severity, a small part of which I shall here give as a method of cure. + Sat. 8.</p> + + <div class="poem"> + <div class="stanza"> + <p>Say, what avails the pedigree, that brings</p> + <p>Thy boasted line from heroes or from kings;</p> + <p>Though many a mighty lord, in parchment roll'd,</p> + <p>Name after name, thy coxcomb hands unfold;</p> + <p>Though wreathed patriots crowd thy marble halls,</p> + <p>Or steel-clad warriors frown along the walls;</p> + <p>While on broad canvas in the gilded frame</p> + <p>All virtues flourish, and all glories flame?—</p> + <p>Say,—if ere noon with idiot laugh you lie</p> + <p>Wallowing in wine, or cog the dubious die,</p> + <p>Or act unshamed, by each indignant bust,</p> + <p>The midnight orgies of promiscuous lust!—</p> + <p class="i2">Go, lead mankind to Virtue's holy shrine,</p> + <p>With morals mend them, and with arts refine,</p> + <p>Or lift, with golden characters unfurl'd,</p> + <p>The flag of peace, and still a warring world!—</p> + <p>—So shall with pious hands immortal Fame</p> + <p>Wreathe all her laurels round thy honour'd name,</p> + <p>High o'er thy tomb with chissel bold engrave,</p> + <p>"<span class="sc">The truly noble are the good and brave.</span>"</p> + </div> + </div> + + <p><a name="species_III_1_2_9">9</a>. <i>Ambitio.</i> Inordinate desire + of fame. A carelessness about the opinions of others is said by Xenophon + to be the source of impudence; certainly a proper regard for what others + think of us frequently incites us to virtuous actions, and deters us from + vicious ones; and increases our happiness by enlarging our sphere of + sympathy, and by flattering our vanity.</p> + + <div class="poem"> + <div class="stanza"> + <p>Abstract what others feel, what others think,</p> + <p>All pleasures sicken, and all glories sink.</p> + <p class="i24"><span class="sc">Pope.</span></p> + </div> + </div> + + <p>When this reverie of ambition excites to conquer nations, or to + enslave them, it has been the source of innumerable wars, and the + occasion of a great devastation of mankind. Cæsar is reported to have + boasted, that he had destroyed three millions of his enemies, and one + million of his friends.</p> + + <p>The works of Homer are supposed to have done great injury to mankind + by inspiring the love of military glory. Alexander was said to sleep with + them always on his pillow. How like a mad butcher amid a flock of sheep + appears the hero of the Iliad, in the following fine lines of Mr. Pope, + which conclude the twentieth book.</p> + + <div class="poem"> + <div class="stanza"> + <p class="i2">His fiery coursers, as the chariot rolls,</p> + <p>Tread down whole ranks, and crush out heroes' souls;</p> + <p>Dash'd from their hoofs, as o'er the dead they fly,</p> + <p>Black bloody drops the smoaking chariot dye;—</p> + <p>The spiky wheels through heaps of carnage tore,</p> + <p>And thick the groaning axles dropp'd with gore;</p> + <p>High o'er the scene of death <span class="sc">Achilles</span> stood,</p> + <p>All grim with dust, all horrible with blood;</p> + <p>Yet still insatiate, still with rage on flame,</p> + <p>Such is the lust of never-dying fame!</p> + </div> + </div> + + <p>The cure must be taken from moral writers. Woolaston says, Cæsar + conquered Pompey; that is, a man whose name consisted of the letters C. + æ. s. a. r. conquered a long time ago a man, whose name consisted of the + letters P. o. m. p. e. y. and that this is all that remains of either of + them. Juvenal also attacks this mode of insanity, Sat. X. 166.</p> + + <div class="poem"> + <div class="stanza"> + <p>—I, demens, et sævas curre per alpes,</p> + <p>Ut pueris placeas, et declamatio fias!</p> + </div> + </div> + + <p>Which is thus translated by Dr. Johnson,</p> + + <div class="poem"> + <div class="stanza"> + <p>And left a name, at which the world grew pale,</p> + <p>To point a moral, or adorn a tale!</p> + </div> + </div> + + <p><a name="species_III_1_2_10">10</a>. <i>Mæror.</i> Grief. A perpetual + voluntary contemplation of all the circumstances of some great loss, as + of a favourite child. In general the painful ideas gradually decrease in + energy, and at length the recollection becomes more tender and less + painful. The letter of Sulpicius to Cicero on the loss of his daughter is + ingenious. The example of David on the loss of his child is heroic.</p> + + <p>A widow lady was left in narrow circumstances with a boy and a girl, + two beautiful and lively children, the one six and the other seven years + of age; as her circumstances allowed her to keep but one maid-servant, + these two children were the sole attention, employment, and consolation + of her life; she fed them, dressed them, slept with them, and taught them + herself; they were both snatched from her by the gangrenous sore throat + in one week: so that she lost at once all that employed her, as well as + all that was dear to her. For the first three or four days after their + death, when any friend visited her, she sat upright, with her eyes wide + open, without shedding tears, and affected to speak of indifferent + things. Afterwards she began to weep much, and for some weeks talked to + her friends of nothing else but her dear children. But did not for many + years, even to her dying hour, get quite over a gloom, which was left + upon her countenance.</p> + + <p>In violent grief, when tears flow, it is esteemed a good symptom; + because then the actions caused by sensitive association take the place + of those caused by volition; that is, they prevent the voluntary + exertions of ideas, or muscular actions, which constitute insanity.</p> + + <p>The sobbing and sighing attendant upon grief are not convulsive + movements, they are occasioned by the sensorial power being so expended + on the painful ideas, and their connections, that the person neglects to + breathe for a time, and then a violent sigh or sob is necessary to carry + on the blood, which oppresses the pulmonary vessels, which is then + performed by deep or quick inspirations, and laborious expirations. + Sometimes nevertheless the breath is probably for a while voluntarily + held, as an effort to relieve pain. The paleness and ill health + occasioned by long grief is spoken of in Class <span class="correction" + title="This reference is surely wrong: I cannot determine a correction." + ><a href="#species_IV_2_1_9">IV. 2. 1. 9</a></span>.</p> + + <p>The melioration of grief by time, and its being at length even + attended with pleasure, depends on our retaining a distinct idea of the + lost object, and forgetting for a time the idea of the loss of it. This + pleasure of grief is beautifully described by Akenside. Pleasures of + Imagination, Book II. l. 680.</p> + + <div class="poem"> + <div class="stanza"> + <p class="i2">—————Ask the faithful youth,</p> + <p>Why the cold urn of her, whom long he loved,</p> + <p>So often fills his arms; so often draws</p> + <p>His lonely footsteps at the silent hour</p> + <p>To pay the mournful tribute of his tears?</p> + <p>Oh! he will tell thee, that the wealth of worlds</p> + <p>Should ne'er seduce his bosom to forego</p> + <p>That sacred hour; when, stealing from the noise</p> + <p>Of care and envy, sweet remembrance soothes</p> + <p>With Virtue's kindest looks his aching breast,</p> + <p>And turns his tears to rapture.</p> + </div> + </div> + + <p>M. M. Consolation is best supplied by the Christian doctrine of a + happy immortality. In the pagan religion the power of dying was the great + consolation in irremediable distress. Seneca says, "no one need be + unhappy unless by his own fault." And the author of Telemachus begins his + work by saying, that Calypso could not console herself for the loss of + Ulysses, and found herself unhappy in being immortal. In the first hours + of grief the methods of consolation used by uncle Toby, in Tristram + Shandy, is probably the best; "he sat down in an arm chair by the bed of + his distressed friend, and said nothing."</p> + + <p><a name="species_III_1_2_11">11</a>. <i>Tædium vitæ.</i> The inanity + of sublunary things has afforded a theme to philosophers, moralists, and + divines, from the earliest records of antiquity; "Vanity of vanities!" + says the preacher, "all is vanity!" Nor is there any one, I suppose, who + has passed the meridian of life, who has not at some moments felt the + nihility of all things.</p> + + <p>Weariness of life in its moderate degree has been esteemed a motive to + action by some philosophers. See Sect. XXXIV. 2. 3. But in those men, who + have run through the usual amusements of life early in respect to their + age; and who have not industry or ability to cultivate those sciences, + which afford a perpetual fund of novelty, and of consequent + entertainment, are liable to become tired of life, as they suppose there + is nothing new to be found in it, that can afford them pleasure; like + Alexander, who is said to have shed tears, because he had not another + world to conquer.</p> + + <p>Mr. ——, a gentleman about fifty, of polished manners, who + in a few months afterwards destroyed himself, said to me one day, "a ride + out in the morning, and a warm parlour and a pack of cards in the + afternoon, is all that life affords." He was persuaded to have an issue + on the top of his head, as he complained of a dull head-ach, which being + unskilfully managed, destroyed the pericranium to the size of an inch in + diameter; during the time this took in healing, he was indignant about + it, and endured life, but soon afterwards shot himself.</p> + + <p>Mr. ——, a gentleman of Gray's Inn, some years ago was + prevailed upon by his friends to dismiss a mistress, by whom he had a + child, but who was so great a termagant and scold, that she was believed + to use him very ill, and even to beat him. He became melancholy in two + days from the want of his usual stimulus to action, and cut his throat on + the third so completely, that he died immediately.</p> + + <p>Mr. Anson, the brother to the late Lord Anson, related to me the + following anecdote of the death of Lord Sc——. His Lordship + sent to see Mr. Anson on the Monday preceding his death, and said, "You + are the only friend I value in the world, I determined therefore to + acquaint you, that I am tired of the insipidity of life, and intend + to-morrow to leave it." Mr. Anson said, after much conversation, that he + was obliged to leave town till Friday, and added, "As you profess a + friendship for me, do me this last favour, I entreat you, live till I + return." Lord Sc—— believed this to be a pious artifice to + gain time, but nevertheless agreed, if he should return by four o'clock + on that day. Mr. Anson did not return till five, and found, by the + countenances of the domestics, that the deed was done. He went into his + chamber and found the corpse of his friend leaning over the arm of a + great chair, with the pistol on the ground by him, the ball of which had + been discharged into the roof of his mouth, and passed into his + brain.</p> + + <p>Mr. —— and Mr. ——, two young men, heirs to + considerable fortunes, shot themselves at the age of four or five and + twenty, without their friends being able to conjecture any cause for + those rash actions. One of them I had long known to express himself with + dissatisfaction of the world; at eighteen years of age he complained, + that he could not entertain himself; he tried to study the law at + Cambridge, and afterwards went abroad for a year or two by my advice; but + returned dissatisfied with all things. As he had had an eruption for some + years on a part of his face, which he probably endeavoured to remove by + external applications; I was induced to ascribe his perpetual ennui to + the pain or disagreeable sensation of a diseased liver. The other young + gentleman shot himself in his bed-room, and I was informed that there was + found written on a scrap of paper on his table, "I am impotent, and + therefore not fit to live." From whence there was reason to conclude, + that this was the hallucinatio maniacalis, the delirious idea, which + caused him to destroy himself. The case therefore belongs to mania + mutabilis, and not to tædium vitæ.</p> + + <p>M. M. Some restraint in exhausting the usual pleasures of the world + early in life. The agreeable cares of a matrimonial life. The cultivation + of science, as of chemistry, natural philosophy, natural history, which + supplies an inexhaustible source of pleasurable novelty, and relieves + ennui by the exertions it occasions.</p> + + <p>In many of these cases, whence irksomeness of life has been the + ostensible cause of suicide, there has probably existed a maniacal + hallucination, a painful idea, which the patient has concealed even to + his dying hour; except where the mania has evidently arisen from + hereditary or acquired disease of the membranous or glandular parts of + the system.</p> + + <p><a name="species_III_1_2_12">12</a>. <i><span class="correction" + title="Original reads `Pulchitudinis' (compare contents list)." + >Pulchritudinis</span> desiderium.</i> The loss of beauty, either by + disease, as by the small-pox, or by age, as life advances, is sometimes + painfully felt by ladies, who have been much flattered on account of it. + There is a curious case of this kind related in Le Sage's Bachelor of + Salamanca, which is too nicely described to be totally imaginary.</p> + + <p>In this situation some ladies apply to what are termed cosmetics under + various names, which crowd the newspapers. Of these the white has + destroyed the health of thousands; a calx, or magistery, of bismuth is + supposed to be sold in the shops for this purpose; but it is either, I am + informed, in part or entirely white lead or cerussa. The pernicious + effects of the external use of those saturnine applications are spoken of + in gutta rosea, Class <a href="#species_II_1_4_6">II. 1. 4. 6</a>. The + real calx of bismuth would probably have the same ill effect. As the red + paint is prepared from cochineal, which is an animal body, less if any + injury arises from its use, as it only lies on the skin like other + filth.</p> + + <p>The tan of the skin occasioned by the sun may be removed by lemon + juice evaporated by the fire to half its original quantity, or by diluted + marine acid; which cleans the cuticle, by eroding its surface, but + requires much caution in the application; the marine acid must be diluted + with water, and when put upon the hand or face, after a second of time, + as soon as the tan disappears, the part must be washed with a wet towel + and much warm water. Freckles lie too deep for this operation, nor are + they in general removeable by a blister, as I once experienced. See Class + <a href="#species_I_2_2_9">I. 2. 2. 9</a>.</p> + + <p>It is probable, that those materials which stain silk, or ivory, might + be used to stain the cuticle, or hair, permanently; as they are all + animal substances. But I do not know, that any trials of this kind have + been made on the skin. I endeavoured in vain to whiten the back of my + hand by marine acid oxygenated by manganese, which so instantly whitens + cotton.</p> + + <p>The cure therefore must be sought from moral writers, and the + cultivation of the graces of the mind, which are frequently a more + valuable possession than celebrated beauty.</p> + + <p><a name="species_III_1_2_13">13</a>. <i>Paupertatis timor.</i> The + fear of poverty is one kind of avarice; it is liable to affect people who + have left off a profitable and active business; as they are thus deprived + of their usual exertions, and are liable to observe the daily expenditure + of money, without calculating the source from whence it flows. It is also + liable to occur with a sudden and unexpected increase of fortune. Mr. + ——, a surgeon, about fifty years of age, who was always + rather of a parsimonious disposition, had a large house, with a fortune + of forty thousand pounds, left him by a distant relation; and in a few + weeks became insane from the fear of poverty, lamenting that he should + die in a jail or workhouse. He had left off a laborious country business, + and the daily perception of profit in his books; he also now saw greater + expences going forwards in his new house, than he had been accustomed to + observe, and did not so distinctly see the source of supply; which seems + to have occasioned the maniacal hallucination.—This idea of + approaching poverty is a very frequent and very painful disease, so as to + have induced many to become suicides, who were in good circumstances; + more perhaps than any other maniacal hallucination, except the fear of + hell.</p> + + <p>The covetousness of age is more liable to affect single men, than + those who have families; though an accumulation of wealth would seem to + be more desirable to the latter. But an old man in the former situation, + has no personal connections to induce him to open his purse; and having + lost the friends of his youth, and not easily acquiring new ones, feels + himself alone in the world; feels himself unprotected, as his strength + declines, and is thus led to depend for assistance on money, and on that + account wishes to accumulate it. Whereas the father of a family has not + only those connections, which demand the frequent expenditure of money, + but feels a consolation in the friendship of his children, when age may + render their good offices necessary to him.</p> + + <p>M. M. I have been well informed of a medical person in good <span + class="correction" title="Original reads `cir-circumstances' over line break." + >circumstances</span> in London, who always carries an account of his + affairs, as debtor and creditor, in his pocket-book; and looks over it + frequently in a day, when this disease returns upon him; and thus, by + counteracting the maniacal hallucination, wisely prevents the increase of + his insanity. Another medical person, in London, is said to have cured + himself of this disease by studying mathematics with great attention; + which exertions of the mind relieved the pain of the maniacal + hallucination.</p> + + <p>Many moral writers have stigmatised this insanity; the covetous, they + say, commit crimes and mortify themselves without hopes of reward; and + thus become miserable both in this world and the next. Thus Juvenal:</p> + + <div class="poem"> + <div class="stanza"> + <p>Cum furor haud dubius, cum sit manifesta phrenitis,</p> + <p>Ut locuples moriaris, egenti vivere fato!</p> + </div> + </div> + + <p>The covetous man thought he gave good advice to the spendthrift, when + he said, "Live like me," who well answered him,</p> + + <div class="poem"> + <div class="stanza"> + <p>—————"Like you, Sir John?</p> + <p>"That I can do, when all I have is gone!"</p> + <p class="i24"><span class="sc">Pope.</span></p> + </div> + </div> + + <p><a name="species_III_1_2_14">14</a>. <i>Lethi timor.</i> The fear of + death perpetually employs the thoughts of these patients; hence they are + devising new medicines, and applying to physicians and quacks without + number. It is confounded with hypochondriasis, Class <span + class="correction" title="Original reads `I. 2. 3. 9.'."><a + href="#species_I_2_4_10">I. 2. 4. 10</a></span>. in popular conversation, + but is in reality an insanity.</p> + + <p>A young gentleman, whom I advised to go abroad as a cure for this + disease, assured me, that during the three years he was in Italy and + France he never passed a quarter of an hour without fearing he should + die. But has now for above twenty years experienced the contrary.</p> + + <p>The sufferers under this malady are generally at once discoverable by + their telling you, amidst an unconnected description of their complaints, + that they are nevertheless not afraid of dying. They are also easily led + to complain of pains in almost any part of the body, and are thus soon + discovered.</p> + + <p>M. M. As the maniacal hallucination has generally arisen in early + infancy from some dreadful account of the struggles and pain of dying, I + have sometimes observed, that these patients have received great + consolation from the instances I have related to them of people dying + without pain. Some of these, which I think curious, I shall concisely + relate, as a part of the method of cure.</p> + + <p>Mr. ——, an elderly gentleman, had sent for me one whole + day before I could attend him; on my arrival he said he was glad to see + me, but that he was now quite well, except that he was weak, but had had + a pain in his bowels the day before. He then lay in bed with his legs + cold up to the knees, his hands and arms cold, and his pulse scarcely + discernible, and died in about six hours. Mr. ——, another + gentleman about sixty, lay in the act of dying, with difficult + respiration like groaning, but in a kind of stupor or coma vigil, and + every ten or twelve minutes, while I sat by him, he waked, looked up, and + said, "who is it groans so, I am sure there is somebody dying in the + room," and then sunk again into a kind of sleep. From these two cases + there appeared to be no pain in the act of dying, which may afford + consolation to all, but particularly to those who are afflicted with the + fear of death.</p> + + <p><a name="species_III_1_2_15">15</a>. <i>Orci timor.</i> The fear of + hell. Many theatric preachers among the Methodists successfully inspire + this terror, and live comfortably upon the folly of their hearers. In + this kind of madness the poor patients frequently commit suicide; + although they believe they run headlong into the hell, which they dread! + Such is the power of oratory, and such the debility of the human + understanding!</p> + + <p>Those, who suffer under this insanity, are generally the most innocent + and harmless people; who are then liable to accuse themselves of the + greatest imaginary crimes, and have so much intellectual cowardice, that + they dare not reason about those things, which they are directed by their + priests to believe, however contradictory to human apprehension, or + derogatory to the great Creator of all things. The maniacal hallucination + at length becomes so painful, that the poor insane flies from life to + become free from it.</p> + + <p>M. M. Where the intellectual cowardice is great, the voice of reason + is ineffectual; but that of ridicule may save many from those mad-making + doctors; though it is too weak to cure those, who are already + hallucinated. Foot's Farces are recommended for this purpose.</p> + + <p><a name="species_III_1_2_16">16</a>. <i>Satyriasis.</i> An + ungovernable desire of venereal indulgence. The remote cause is probably + the stimulus of the semen; whence the phallus becomes distended with + blood by the arterial propulsion of it being more strongly excited than + the correspondent venous absorption. At the same time a new sense is + produced in the other termination of the urethra; which, like itching, + requires some exterior friction to facilitate the removal of the cause of + the maniacal actions, which may probably be increased in those cases by + some associated hallucinations of ideas. It differs from priapismus + chronicus in the desire of its appropriated object, which is not + experienced in the latter, Class <a href="#species_I_1_4_6">I. 1. 4. + 6</a>. and from the priapismus amatorius, Class <a + href="#species_II_1_7_9">II. 1. 7. 9</a>. in the maniacal actions in + consequence of desire. The furor uterius, or nymphomania, is a similar + disease.</p> + + <p>M. M. Venesection. Cathartics. Torpentia. Marriage.</p> + + <p><a name="species_III_1_2_17">17</a>. <i>Ira.</i> Anger is caused by + the pain of offended pride. We are not angry at breaking a bone, but + become quite insane from the smallest stroke of a whip from an inferior. + Ira furor brevis. Anger is not only itself a temporary madness, but is a + frequent attendant on other insanities, and as, whenever it appears, it + distinguishes insanity from delirium, it is generally a good sign in + fevers with debility.</p> + + <p>An injury voluntarily inflicted on us by others excites our exertions + of self-defence or of revenge against the perpetrator of it; but anger + does not succeed in any great degree unless our pride is offended; this + idea is the maniacal hallucination, the pain of which sometimes produces + such violent and general exertions of our muscles and ideas, as to + disappoint the revenge we meditate, and vainly to exhaust our sensorial + power. Hence angry people, if not further excited by disagreeable + language, are liable in an hour or two to become humble, and sorry for + their violence, and willing to make greater concessions than + required.</p> + + <p>M. M. Be silent, when you feel yourself angry. Never use loud oaths, + violent upbraidings, or strong expressions of countenance, or + gesticulations of the arms, or clenched fists; as these by their former + associations with anger will contribute to increase it. I have been told + of a sergeant or corporal, who began moderately to cane his soldiers, + when they were awkward in their exercise, but being addicted to swearing + and coarse language, he used soon to enrage himself by his own + expressions of anger, till toward the end he was liable to beat the + delinquents unmercifully.</p> + + <p><a name="species_III_1_2_18">18</a>. <i>Rabies.</i> Rage. A desire of + biting others, most frequently attendant on canine madness. Animals in + great pain, as in the colica saturnina, are said to bite the ground they + lie upon, and even their own flesh. I have seen patients bite the + attendants, and even their own arms, in the epilepsia dolorifica. It + seems to be an exertion to relieve pain, as explained in Sect. XXXIV. 1. + 3. The dread of water in hydrophobia is occasioned by the repeated + painful attempts to swallow it, and is therefore not an essential or + original part of the disease called canine madness. See Class <a + href="#species_III_1_1_15">III. 1. 1. 15</a>.</p> + + <p>There is a mania reported to exist in some parts of the east, in which + a man is said to run a muck; and these furious maniacs are believed to + have induced their calamity by unlucky gaming, and afterwards by taking + large quantities of opium; whence the pain of despair is joined with the + energy of drunkenness; they are then said to sally forth into the most + populous streets, and to wound and slay all they meet, till they receive + their own death, which they desire to procure without the greater guilt, + as they suppose, of suicide.</p> + + <p>M. M. When there appears a tendency to bite in the painful epilepsy, + the end of a rolled-up towel, or a wedge of soft wood, should be put into + the mouth of the patient. As a bullet is said sometimes to be given to a + soldier, who is to be severely flogged, that he may by biting it better + bear his punishment.</p> + + <p><a name="species_III_1_2_19">19</a>. <i>Citta.</i> A desire to swallow + indigestible substances. I once saw a young lady, about ten years of age, + who filled her stomach with the earth out of a flower-pot, and vomited it + up with small stones, bits of wood, and wings of infects amongst it. She + had the bombycinous complexion, and looked like a chlorotic patient, + though so young; this generally proceeds from an acid in the stomach.</p> + + <p>M. M. A vomit. Magnesia alba. Armenian bole. Rhubarb. Bark. Steel. A + blister. See Class <a href="#species_I_2_4_5">I. 2. 4. 5</a>.</p> + + <p><a name="species_III_1_2_20">20</a>. <i>Cacositia.</i> Aversion to + food. This may arise, without disease of the stomach, from connecting + nauseous ideas to our usual food, as by calling a ham a hog's + a——. This madness is much inculcated by the stoic philosophy. + See Antoninus' Meditations. See two cases of patients who refused to take + nourishment, Class <a href="#species_III_1_2_1">III. 1. 2. 1</a>.</p> + + <p>Aversions to peculiar kinds of food are thus formed early in life by + association of some maniacal hallucination with them. I remember a child, + who on tasting the gristle of sturgeon, asked what gristle was? And being + told it was like the division of a man's nose, received an ideal + hallucination; and for twenty years afterwards could not be persuaded to + taste sturgeon.</p> + + <p>The great fear or aversion, which some people experience at the sight + of spiders, toads, crickets, and the like, have generally had a similar + origin.</p> + + <p>M. M. Associate agreeable ideas with those which disgust; as call a + spider ingenious, a frog clean and innocent; and repress all expressions + of disgust by the countenance, as such expressions contribute to + preserve, or even to increase, the energy of the ideas associated with + them; as mentioned above in Species <a href="#species_III_1_2_17">17</a>. + Ira.</p> + + <p><a name="species_III_1_2_21">21</a>. <i>Syphilis imaginaria.</i> The + fear that they are infested with the venereal disease, when they have + only deserved it, is a very common insanity amongst modest young men; and + is not to be cured without applying artfully to the mind; a little + mercury must be given, and hopes of a cure added weekly and gradually by + interview or correspondence for six or eight weeks. Many of these + patients have been repeatedly salivated without curing the mind!</p> + + <p><a name="species_III_1_2_22">22</a>. <i>Psora imaginaria.</i> I have + twice seen an imaginary itch, and twice an imaginary diabætes, where + there was not the least vestige of either of those diseases, and once an + imaginary deafness, where the patient heard perfectly well. In all these + cases the hallucinated idea is so powerfully excited, that it is not to + be changed suddenly by occular sensation, or reason. Yet great + perseverance in the frequently presenting contrary ideas will sometimes + slowly remove this hallucination, or in great length of time oblivion, or + forgetfulness, performs a cure, by other means in vain attempted.</p> + + <p><a name="species_III_1_2_23">23</a>. <i>Tabes imaginaria.</i> This + imaginary disease, or hallucination, is caused by the supposed too great + frequency of parting with the semen, and had long imposed upon the + physician as well as the patient, till Mr. John Hunter first endeavoured + to shew, that in general the morbid effects of this pollution was in the + imagination; and that those were only liable to those effects in general, + who had been terrified by the villainous books, which pretend to prevent + or to cure it, but which were purposely written to vend some quack + medicine. Most of those unhappy patients, whom I have seen, had evidently + great impression of fear and self-condemnation on their minds, and might + be led to make contradictory complaints in almost any part of the body, + and if their confessions could be depended on, had not used this + pollution to any great excess.</p> + + <p>M. M. 1. Assure them if the loss of the semen happens but twice a + week, it will not injure them. 2. Marry them. The last is a certain cure; + whether the disease be real or imaginary. Cold partial bath, and + astringent medicines frequently taken, only recal the mind to the + disease, or to the delinquency; and thence increase the imaginary effects + and the real cause, if such exists. Mr. —— destroyed himself + to get free from the pain of fear of the supposed ill consequences of + self-pollution, without any other apparent disease; whose parents I had + in vain advised to marry him, if possible.</p> + + <p><a name="species_III_1_2_24">24</a>. <i>Sympathia aliena.</i> Pity. + Our sympathy with the pleasures and pains of others distinguishes men + from other animals; and is probably the foundation of what is termed our + moral sense and the source of all our virtues. See Sect. XXII. 3. 3. When + our sympathy with those miseries of mankind, which we cannot alleviate, + rises to excess, the mind becomes its own tormentor; and we add to the + aggregate sum of human misery, which we ought to labour to diminish; as + in the following eloquent lamentation from Akenside's Pleasures of + Imagination, Book II. 1. 200.</p> + + <div class="poem"> + <div class="stanza"> + <p>————————Dark,</p> + <p>As midnight storms, the scene of human things</p> + <p>Appear'd before me; deserts, burning sands,</p> + <p>Where the parch'd adder dies; the frozen south;</p> + <p>And desolation blasting all the west</p> + <p>With rapine and with murder. Tyrant power</p> + <p>Here sits enthroned in blood; the baleful charms</p> + <p>Of superstition there infect the skies,</p> + <p>And turn the sun to horror. Gracious Heaven!</p> + <p>What is the life of man? Or cannot these,</p> + <p>Not these portents thy awful will suffice?</p> + <p>That, propagated thus beyond their scope,</p> + <p>They rise to act their cruelties anew</p> + <p>In my afflicted bosom, thus decreed</p> + <p>The universal sensitive of pain,</p> + <p>The wretched heir of evils not its own!</p> + </div> + </div> + + <p>A poet of antiquity, whose name I do not recollect, is said to have + written a book describing the miseries of the world, and to have + destroyed himself at the conclusion of his task. This sympathy, with all + sensitive beings, has been carried so far by some individuals, and even + by whole tribes, as the Gentoos, as not only to restrain them from + killing animals for their support, but even to induce them to permit + insects to prey upon their bodies. Such is however the condition of + mortality, that the first law of nature is, "Eat or be eaten." We cannot + long exist without the destruction of other animal or vegetable beings, + either in their mature or their embryon state. Unless the fruits, which + surround the seeds of some vegetables, or the honey stolen from them by + the bee, may be said to be an exception to this assertion. See <span + class="correction" title="Original reads `Botannic'.">Botanic</span> + Garden, P. I. Cant. I. l. 278. Note. Hence, from the necessity of our + nature, we may be supposed to have a right to kill those creatures, which + we want to eat, or which want to eat us. But to destroy even insects + wantonly shews an unreflecting mind or a depraved heart.</p> + + <p>Nevertheless mankind may be well divided into the selfish and the + social; that is, into those whose pleasures arise from gratifying their + appetites, and those whose pleasures arise from their sympathizing with + others. And according to the prevalence of these opposing propensities we + value or dislike the possessor of them.</p> + + <p>In conducting the education of young people, it is a nice matter to + inspire them with so much benevolent sympathy, or compassion, as may + render them good and amiable; and yet not so much as to make them unhappy + at the sight of incurable distress. We should endeavour to make them + alive to sympathize with all remediable evils, and at the same time to + arm them with fortitude to bear the sight of such irremediable evils, as + the accidents of life must frequently present before their eyes. About + this I have treated more at large in a plan for the conduct of a boarding + school for ladies, which I intend to publish in the course of the next + year.</p> + + <p><a name="species_III_1_2_25">25</a>. <i>Educatio heroica.</i> From the + kinds and degrees of insanities already enumerated, the reader will + probably recollect many more from his own observation; he will perceive + that all extraordinary exertions of voluntary action in consequence of + some false idea or hallucination, which strongly affects us, may + philosophically, though not popularly, be termed an insanity; he will + then be liable to divide these voluntary exertions into disagreeable, + pernicious, detestable, or into meritorious, delectable, and even + amiable, insanities. And will lastly be induced to conceive, that a good + education consists in the art of producing such happy hallucinations of + ideas, as may be followed by such voluntary exertions, as may be termed + meritorious or amiable insanities.</p> + + <p>The old man of the mountain in Syria, who governed a small nation of + people called Assassines, is recorded thus to have educated those of his + army who were designed to assassinate the princes with whom he was at + war. A young man of natural activity was chosen for the purpose, and + thrown into a deep sleep by opium mixed with his food; he was then + carried into a garden made to represent the paradise of Mahomet, with + flowers of great beauty and fragrance, fruits of delicious flavor, and + beautiful houries beckoning him into the shades. After a while, on being + a second time stupified with opium, the young enthusiast was reconveyed + to his apartment; and on the next day was assured by a priest, that he + was designed for some great exploit, and that by obeying the commands of + their prince, immortal happiness awaited him.</p> + + <p>Hence it is easy to collect how the first impressions made on us by + accidental circumstances in our infancy continue through life to bias our + affections, or mislead our judgments. One of my acquaintance can trace + the origin of his own energies of action from some such remote sources; + which justifies the observation of M. Rousseau, that the seeds of future + virtues or vices are oftener sown by the mother, than the tutor.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_III_2">II</a>.</h3> + +<h3><i>Decreased Volition.</i></h3> + +<h3>GENUS <a name="genus_III_2_1">I</a>.</h3> + +<h3><i>With decreased Actions of the Muscles.</i></h3> + + <p>Our muscles become fatigued by long contraction, and cease for a time + to be excitable by the will; owing to exhaustion of the sensorial power, + which resides in them. After a short interval of relaxation the muscle + regains its power of voluntary contraction; which is probably occasioned + by a new supply of the spirit of animation. In weaker people these + contractions cease sooner, and therefore recur more frequently, and are + attended with shorter intervals of relaxation, as exemplified in the + quickness of the pulse in fevers with debility, and in the tremors of the + hands of aged or feeble people.</p> + + <p>After a common degree of exhaustion of the sensorial power in a + muscle, it becomes again gradually restored by the rest of the muscle; + and even accumulated in those muscles, which are most frequently used; as + in those which constitute the capillaries of the skin after having been + rendered torpid by cold. But in those muscles, which are generally + obedient to volition, as those of locomotion, though their usual quantity + of sensorial power is restored by their quiescence, or in sleep (for + sleep affects these parts of the system only), yet but little + accumulation of it succeeds. And this want of accumulation of the + sensorial power in these muscles, which are chiefly subservient to + volition, explains to us one cause of their greater tendency to paralytic + affection.</p> + + <p>It must be observed, that those parts of the system, which have been + for a time quiescent from want of stimulus, as the vessels of the skin, + when exposed to cold, acquire an accumulation of sensorial power during + their inactivity; but this does not happen at all, or in much less + quantity, from their quiescence after great expenditure of sensorial + power by a previous excessive stimulus, as after intoxication. In this + case the muscles or organs of sense gradually acquire their natural + quantity of sensorial power, as after sleep; but not an accumulation or + superabundance of it. And by frequent repetitions of exhaustion by great + stimulus, these vessels cease to acquire their whole natural quantity of + sensorial power; as in the schirrous stomach, and schirrous liver, + occasioned by the great and frequent stimulus of vinous spirit; which may + properly be termed irritative paralysis of those parts of the system.</p> + + <p>In the same manner in common palsies the inaction of the paralytic + muscle seems not to be owing to defect of the stimulus of the will, but + to exhaustion of sensorial power. Whence it frequently follows great + exertion, as in Sect. XXXIV. 1. 7. Thus some parts of the system may + cease to obey the will, as in common paralysis; others may cease to be + obedient to sensation, as in the impotency of age; others to irritation, + as in schirrous viscera; and others to association, as in impediment of + speech; yet though all these may become inexcitable, or dead, in respect + to that kind of stimulus, which has previously exhausted them, whether of + volition, or sensation, or irritation, or association, they may still in + many cases be excited by the others.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_III_2_1_1">1</a>. <i>Lassitudo.</i> Fatigue or + weariness after much voluntary exertion. From the too great expenditure + of sensorial power the muscles are with difficulty brought again into + voluntary contraction; and seem to require a greater quantity or energy + of volition for this purpose. At the same time they still remain obedient + to the stimulus of agreeable sensation, as appears in tired dancers + finding a renovation of their aptitude to motion on the acquisition of an + agreeable partner; or from a tired child riding on a gold-headed cane, as + in Sect. XXXIV. 2. 6. These muscles are likewise still obedient to the + sensorial power of association, because the motions, when thus excited, + are performed in their designed directions, and are not broken into + variety of gesticulation, as in St. Vitus's dance.</p> + + <p>A lassitude likewise frequently occurs with yawning at the beginning + of ague-fits; where the production of sensorial power in the brain is + less than its expenditure. For in this case the torpor may either + originate in the brain, or the torpor of some distant parts of the system + may by sympathy affect the brain, though in a less proportionate degree + than the parts primarily affected.</p> + + <p><a name="species_III_2_1_2">2</a>. <i>Vacillatio senilis.</i> Some + elderly people acquire a see-saw motion of their bodies from one side to + the other, as they sit, like the oscillation of a pendulum. By these + motions the muscles, which preserve the perpendicularity of the body, are + alternately quiescent, and exerted; and are thus less liable to fatigue + or exhaustion. This therefore resembles the tremors of old people above + mentioned, and not those spasmodic movements of the face or limbs, which + are called tricks, described in Class <span class="correction" + title="Original reads `IV. 3. 2. 2.'."><a href="#species_IV_1_3_2">IV. 1. + 3. 2</a></span>. which originate from excess of sensorial power, or from + efforts to relieve disagreeable sensation, and are afterwards continued + by habit.</p> + + <p><a name="species_III_2_1_3">3</a>. <i>Tremor senilis.</i> Tremor of + old age consists of a perpetual trembling of the hands, or of the head, + or of other muscles, when they are exerted; and is erroneously called + paralytic; and seems owing to the small quantity of animal power residing + in the muscular fibres. These tremors only exist when the affected + muscles are excited into action, as in lifting a glass to the mouth, or + in writing, or in keeping the body upright; and cease again, when no + voluntary exertion is attempted, as in lying down. Hence these tremors + evidently originate from the too quick exhaustion of the lessened + quantity of the spirit of animation. So many people tremble from fear or + anger, when too great a part of the sensorial power is exerted on the + organs of sense, so as to deprive the muscles, which support the body + erect, of their due quantity.</p> + + <p><a name="species_III_2_1_4">4</a>. <i>Brachiorum paralysis.</i> A + numbness of the arms is a frequent symptom in hydrops thoracis, as + explained in Class <a href="#species_I_2_3_14">I. 2. 3. 14</a>. and in + Sect. XXIX. 5. 2.; it also accompanies the asthma dolorificum, Class <a + href="#species_III_1_1_11">III. 1. 1. 11</a>. and is owing probably to + the same cause in both. In the colica saturnina a paralysis affects the + wrists, as appears on the patient extending his arm horizontally with the + palm downwards, and is often attended with a tumor on the carpal or + metacarpal bones. See Class <span class="correction" title="Original reads `IV. 2. 2. 10.'." + ><a href="#species_IV_1_2_10">IV. 1. 2. 10</a></span>.</p> + + <p>Mr. M——, a miner and well-sinker, about three years ago, + lost the power of contracting both his thumbs; the balls or muscles of + the thumbs are much emaciated, and remain paralytic. He ascribes his + disease to immersing his hands too long in cold water in the execution of + his business. He says his hands had frequently been much benumbed before, + so that he could not without difficulty clench them; but that they + recovered their motion, as soon as they began to glow, after he had dried + and covered them.</p> + + <p>In this case there existed two injurious circumstances of different + kinds; one the violent and continued action of the muscles, which + destroys by exhausting the sensorial power; and the other, the + application of cold, which destroys by defect of stimulus. The cold seems + to have contributed to the paralysis by its long application, as well as + the continued exertion; but as during the torpor occasioned by the + exposure to cold, if the degree of it be not so great as to extinguish + life, the sensorial power becomes accumulated; there is reason to + believe, that the exposing a paralytic limb to the cold for a certain + time, as by covering it with snow or iced water for a few minutes, and + then covering it with warm flannel, and this frequently repeated, might, + by accumulation of sensorial power, contribute to restore it to a state + of voluntary excitability. As this accumulation of sensorial power, and + consequent glow, seems, in the present case, several times to have + contributed to restore the numbness or inability of those muscles, which + at length became paralytic. See Class <a href="#species_I_2_3_21">I. 2. + 3. 21</a>.</p> + + <p>M. M. Ether externally. Friction. Saline warm bath. Electricity.</p> + + <p><a name="species_III_2_1_5">5</a>. <i>Raucedo paralytica.</i> + Paralytic hoarseness consists in the almost total loss of voice, which + sometimes continues for months, or even years, and is occasioned by + inability or paralysis of the recurrent nerves, which serve the muscles + of vocality, by opening or closing the larynx. The voice generally + returns suddenly, even so as to alarm the patient. A young lady, who had + many months been affected with almost a total loss of voice, and had in + vain tried variety of advice, recovered her voice in an instant, on some + alarm as she was dancing at an assembly. Was this owing to a greater + exertion of volition than usual? like the dumb young man, the son of + Crœsus, who is related to have cried out, when he saw his father's + life endangered by the sword of his enemy, and to have continued to speak + ever afterwards. Two young ladies in this complaint seemed to be cured by + electric shocks passed through the larynx every day for a fortnight. See + Raucedo catarrhalis, Class <a href="#species_II_1_3_5">II. 1. 3. + 5</a>.</p> + + <p>M. M. An emetic. Electric shocks. Mustard-seed, a large spoonful + swallowed whole, or a little bruised, every morning. Valerian. Burnt + sponge. Blisters on each side of the larynx. Sea-bathing. A gargle of + decoction of seneca. Friction. Frequent endeavours to shout and sing.</p> + + <p><a name="species_III_2_1_6">6</a>. <i>Vesicæ urinariæ paralysis.</i> + Paralysis of the bladder is frequently a symptom in inirritative fever; + in this case the patient makes no water for a day or two; and the tumor + of the bladder distended with urine may be seen by the shape of the + abdomen, as if girt by a cord below the navel, or distinguished by the + hand. Many patients in this situation make no complaint, and suffer great + injury by the inattention of their attendants; the water must be drawn + off once or twice a day by means of a catheter, and the region of the + bladder gently pressed by the hand, whilst the patient be kept in a + sitting or erect posture.</p> + + <p>M. M. Bark. Wine. Opium, a quarter of a grain every six hours. Balsam + of copaiva or of Peru. Tincture of cantharides 20 drops twice a day, or + repeated small blisters.</p> + + <p><a name="species_III_2_1_7">7</a>. <i>Recti paralysis.</i> Palsy of + the rectum. The rectum intestinum, like the urinary bladder in the + preceding article, possesses voluntary power of motion; though these + volitions are at times uncontrollable by the will, when the acrimony of + the contained feces, or their bulk, stimulate it to a greater degree. + Hence it happens, that this part is liable to lose its voluntary power by + paralysis, but is still liable to be stimulated into action by the + contained feces. This frequently occurs in fevers, and is a bad sign as a + symptom of general debility; and it is the sensibility of the muscular + fibres of this and of the urinary bladder remaining, after the + voluntarity has ceased, which occasions these two reservoirs so soon to + regain, as the fever ceases, their obedience to volition; because the + paralysis is thus shewn to be less complete in those cases than in common + hemiplegia; as in the latter the sense of touch, though perhaps not the + sense of pain, is generally destroyed in the paralytic limb.</p> + + <p>M. M. A sponge introduced within the sphincter ani to prevent the + constant discharge, which should have a string put through it, by which + it may be retracted.</p> + + <p><a name="species_III_2_1_8">8</a>. <i>Paresis voluntaria.</i> + Indolence; or inaptitude to voluntary action. This debility of the + exertion of voluntary efforts prevents the accomplishment of all great + events in life. It often originates from a mistaken education, in which + pleasure or flattery is made the immediate motive of action, and not + future advantage; or what is termed duty. This observation is of great + value to those, who attend to the education of their own children. I have + seen one or two young married ladies of fortune, who perpetually became + uneasy, and believed themselves ill, a week after their arrival in the + country, and continued so uniformly during their stay; yet on their + return to London or Bath immediately lost all their complaints, and this + repeatedly; which I was led to ascribe to their being in their infancy + surrounded with menial attendants, who had flattered them into the + exertions they then used. And that in their riper years, they became + torpid for want of this stimulus, and could not amuse themselves by any + voluntary employment; but required ever after, either to be amused by + other people, or to be flattered into activity. This I suppose, in the + other sex, to have supplied one source of ennui and suicide.</p> + + <p><a name="species_III_2_1_9">9</a>. <i>Catalepsis</i> is sometimes used + for fixed spasmodic contractions or tetanus, as described in Sect. XXXIV. + 1. 5. and in Class <a href="#species_III_1_1_13">III. 1. 1. 13</a>. but + is properly simply an inaptitude to muscular motion, the limbs remaining + in any attitude in which they are placed. One patient, whom I saw in this + situation, had taken much mercury, and appeared universally torpid. He + sat in a chair in any posture he was put, and held a glass to his mouth + for many minutes without attempting to drink, or withdrawing his hand. He + never spoke, and it was at first necessary to compel him to drink broth; + he recovered in a few weeks without relapse.</p> + + <p><a name="species_III_2_1_10">10</a>. <i>Hemiplegia.</i> Palsy of one + side consists in the total disobedience of the affected muscles to the + power of volition. As the voluntary motions are not perpetually exerted, + there is little sensorial power accumulated during their quiescence, + whence they are less liable to recover from torpor, and are thus more + frequently left paralytic, or disobedient to the power of volition, + though they are sometimes still alive to painful sensation, as to the + prick of a pin, and to heat; also to irritation, as in stretching and + yawning; or to electric shocks. Where the paralysis is complete the + patient seems gradually to learn to use his limbs over again by repeated + efforts, as in infancy; and, as time is required for this purpose, it + becomes difficult to know, whether the cure is owing to the effect of + medicines, or to the repeated efforts of the voluntary power.</p> + + <p>The dispute, whether the nerves decussate or cross each other before + they leave the cavities of the skull or spine, seems to be decided in the + affirmative by comparative anatomy; as the optic nerves of some fish have + been shewn evidently to cross each other; as seen by Haller, Elem. + Physiol. t. v. p. 349. Hence the application of blisters, or of ether, or + of warm fomentations, should be on the side of the head opposite to that + of the affected muscles. This subject should nevertheless be nicely + determined, before any one should trepan for the hydrocephalus internus, + when the disease is shewn to exist only on one side of the brain, by a + squinting affecting but one eye; as proposed in Class <a + href="#species_I_2_5_4">I. 2. 5. 4</a>. Dr. Sommering has shewn, that a + true decussation of the optic nerves in the human subject actually + exists, Elem. of Physiology by Blumenbach, translated by C. Caldwell, + Philadelphia. This further appears probable from the oblique direction + and insertion of each optic nerve, into the side of the eye next to the + nose, in a direct line from the opposite side of the brain.</p> + + <p>The vomiting, which generally attends the attack of hemiplegia, is + mentioned in Sect. XX. 8. and is similar to that attending vertigo in + sea-sickness, and at the commencement of some fevers. Black stools + sometimes attend the commencement of hemiplegia, which is probably an + effusion of blood from the biliary duct, where the liver is previously + affected; or some blood may be derived to the intestines by its escaping + from the vena cava into the receptacle of chyle during the distress of + the paralytic attack; and may be conveyed from thence into the intestines + by the retrograde motions of the lacteals; as probably sometimes happens + in diabætes. See Sect. XXVII. 2. Palsy of one side of the face is + mentioned in Class <a href="#species_II_1_4_6">II. 1. 4. 6</a>. Paralysis + of the lacteals, of the liver, and of the veins, which are described in + Sect. XXVIII. XXX. and XXVII. do not belong to this class, as they are + not diseases of voluntary motions.</p> + + <p>M. M. The electric sparks and shocks, if used early in the disease, + are frequently of service. A purge of aloes, or calomel. A vomit. + Blister. Saline draughts. Then the bark. Mercurial ointment or sublimate, + where the liver is evidently diseased; or where the gutta rosea has + previously existed. Sudden alarm. Frequent voluntary efforts. Externally + ether. Volatile alcali. Fomentation on the head. Friction. When children, + who have suffered an hemiplegia, begin to use the affected arm, the other + hand should be tied up for half an hour three or four times a day; which + obliges them at their play to use more frequent voluntary efforts with + the diseased limb, and thus sooner to restore the dissevered associations + of motion.</p> + + <p>Dr. J. Alderson has lately much recommended the leaves of rhus + toxicodendon (sumach), from one gr. to iv. of the dried powder to be + taken three or four times a day. Essay on Rhus Toxic. Johnson, London, + 1793. But it is difficult to know what medicine is of service, as the + movements of the muscles must be learned, as in infancy, by frequent + efforts.</p> + + <p><a name="species_III_2_1_11">11</a>. <i>Paraplegia.</i> A palsy of the + lower half of the body divided horizontally. Animals may be conceived to + have double bodies, one half in general resembling so exactly the other, + and being supplied with separate sets of nerves; this gives rise to + hemiplegia, or palsy of one half of the body divided vertically; but the + paraplegia, or palsy of the lower parts of the system, depends on an + injury of the spinal marrow, or that part of the brain which is contained + in the vertebræ of the back; by which all the nerves situated below the + injured part are deprived of their nutriment, or precluded from doing + their proper offices; and the muscles, to which they are derived, are in + consequence disobedient to the power of volition.</p> + + <p>This sometimes occurs from an external injury, as a fall from an + eminence; of which I saw a deplorable instance, where the bladder and + rectum, as well as the lower limbs, were deprived of so much of their + powers of motion, as depended on volition or sensation; but I suppose not + of that part of it, which depends on irritation. In the same manner as + the voluntary muscles in hemiplegia are sometimes brought into action by + irritation, as in stretching or pendiculation, described in Sect. VII. 1. + 3.</p> + + <p>But the most frequent cause of paraplegia is from a protuberance of + one of the spinal vertebræ; which is owing to the innutrition or softness + of bones, described in Class <a href="#species_I_2_2_17">I. 2. 2. 17</a>. + The cure of this deplorable disease is frequently effected by the + stimulus of an issue placed on each side of the prominent spine, as first + published by Mr. Pott. The other means recommended in softness of bones + should also be attended to; both in respect to the internal medicines, + and to the mechanical methods of supporting, or extending the spine; + which last, however, in this case requires particular caution.</p> + + <p><a name="species_III_2_1_12">12</a>. <i>Somnus.</i> In sleep all + voluntary power is suspended, see Sect. XVIII. An unusual quantity of + sleep is often produced by weakness. In this case small doses of opium, + wine, and bark, may be given with advantage. For the periods of sleep, + see Class <a href="#species_IV_2_4_1">IV. 2. 4. 1</a>.</p> + + <p>The subsequent ingenious observations on the frequency of the pulse, + which sometimes occurs in sleep, are copied from a letter of Dr. Currie + of Liverpool to the author.</p> + +<blockquote class="b1n"> + + <p>"Though rest in general perhaps renders the healthy pulse slower, yet + under certain circumstances the contrary is the truth. A full meal + without wine or other strong liquor does not increase the frequency of my + pulse, while I sit upright, and have my attention engaged. But if I take + a recumbent posture after eating, my pulse becomes more frequent, + especially if my mind be vacant, and I become drowsy; and, if I slumber, + this increased frequency is more considerable with heat and flushing.</p> + + <p>"This I apprehend to be a general truth. The observation may be + frequently made upon children; and the restless and feverish nights + experienced by many people after a full supper are, I believe, owing to + this cause. The supper occasions no inconvenience, whilst the person is + upright and awake; but, when he lies down and begins to sleep, especially + if he does not perspire, the symptoms above mentioned occur. Which may be + thus explained in part from your principles. When the power of volition + is abolished, the other sensorial actions are increased. In ordinary + sleep this does not occasion increased frequency of the pulse; but where + sleep takes place during the process of digestion, the digestion itself + goes on with increased rapidity. Heat is excited in the system faster + than it is expended; and operating on the sensitive actions, it carries + them beyond the limitation of pleasure, producing, as is common in such + cases, increased frequency of pulse.</p> + + <p>"It is to be observed, that in speaking of the heat generated under + these circumstances, I do not allude to any chemical evolution of heat + from the food in the process of digestion. I doubt if this takes place to + any considerable degree, for I do not observe that the parts incumbent on + the stomach are increased in heat during the most hurried digestion. It + is on some parts of the surface, but more particularly on the extremities + of the body, that the increased heat excited by digestion appears, and + the heat thus produced arises, as it should seem, from the sympathy + between the stomach and the vessels of the skin. The parts most affected + are the palms of the hands and the soles of the feet. Even there the + thermometer seldom rises above 97 or 98 degrees, a temperature not higher + than that of the trunk of the body; but three or four degrees higher than + the common temperature of these parts, and therefore producing an uneasy + sensation of heat, a sensation increased by the great sensibility of the + parts affected.</p> + + <p>"That the increased heat excited by digestion in sleep is the cause of + the accompanying fever, seems to be confirmed by observing, that if an + increased expenditure of heat accompanies the increased generation of it + (as when perspiration on the extremities or surface attends this kind of + sleep) the frequent pulse and flushed countenance do not occur, as I know + by experiment. If, during the feverish sleep already mentioned, I am + awakened, and my attention engaged powerfully, my pulse becomes almost + immediately slower, and the fever gradually subsides."</p> + +</blockquote> + + <p>From these observations of Dr. Currie it appears, that, while in + common sleep the actions of the heart, arteries, and capillaries, are + strengthened by the accumulation of sensorial power during the suspension + of voluntary action, and the pulse in consequence becomes fuller and + slower; in the feverish sleep above described the actions of the heart, + arteries, and capillaries, are quickened as well as strengthened by their + consent with the increased actions of the stomach, as well as by the + stimulus of the new chyle introduced into the circulation. For the + stomach, and all other parts of the system, being more sensible and more + irritable during sleep, Sect. XVIII. 15. and probably more ready to act + from association, are now exerted with greater velocity as well as + strength, constituting a temporary fever of the sensitive irritated kind, + resembling the fever excited by wine in the beginning of intoxication; or + in some people by a full meal in their waking hours. Sect. XXXV. 1.</p> + + <p>On waking, this increased sensibility and irritability of the system + ceases by the renewed exertions of volition; in the same manner as more + violent exertions of volition destroy greater pains; and the pulse in + consequence subsides along with the increase of heat; if more violent + efforts of volition are exerted, the system becomes still less affected + by sensation or irritation. Hence the fever and vertigo of intoxication + are lessened by intense thinking, Sect. XXI. 8; and insane people are + known to bear the pain of cold and hunger better than others, Sect. + XXXIV. 2. 5; and lastly, if greater voluntary efforts exist, as in + violent anger or violent exercise, the whole system is thrown into more + energetic action, and a voluntary fever is induced, as appears by the red + skin, quickened pulse, and increase of heat; whence dropsies and fevers + with debility are not unfrequently removed by insanity.</p> + + <p>Hence the exertion of the voluntary power in its natural degree + diminishes the increased sensibility, and irritability, and probably the + increased associability, which occurs during sleep; and thus reduces the + frequency of the pulse in the feverish sleep after a full meal. In its + more powerful state of exertion, it diminishes or destroys sensations and + irritations, which are stronger than natural, as in intoxication, or + which precede convulsions, or insanity. In its still more powerful + degree, the superabundance of this sensorial power actuates and + invigorates the whole moving system, giving strength and frequency to the + pulse, and an universal glow both of colour and of heat, as in violent + anger, or outrageous insanities.</p> + + <p>If, in the feverish sleep above described, the skin becomes cooled by + the evaporation of much perspirable matter, or by the application of + cooler air, or thinner clothes, the actions of the cutaneous capillaries + are lessened by defect of the stimulus of heat, which counteracts the + increase of sensibility during sleep, and the pulsations of the heart and + arteries become slower from the lessened stimulus of the particles of + blood thus cooled in the cutaneous and pulmonary vessels. Hence the + admission of cold air, or ablution with subtepid or with cold water, in + fevers with hot skin, whether they be attended with arterial strength, or + arterial debility, renders the pulse slower; in the former case by + diminishing the stimulus of the blood, and in the latter by lessening the + expenditure of sensorial power. See Suppl. I. <a + href="#suppl_VIII">8</a>. and <a href="#suppl_XV">15</a>.</p> + + <p><a name="species_III_2_1_13">13</a>. <i>Incubus.</i> The night-mare is + an imperfect sleep, where the desire of locomotion is vehement, but the + muscles do not obey the will; it is attended with great uneasiness, a + sense of suffocation, and frequently with fear. It is caused by violent + fatigue, or drunkenness, or indigestible food, or lying on the back, or + perhaps from many other kinds of uneasiness in our sleep, which may + originate either from the body or mind.</p> + + <p>Now as the action of respiration is partly voluntary, this complaint + may be owing to the irritability of the system being too small to carry + on the circulation of the blood through the lungs during sleep, when the + voluntary power is suspended. Whence the blood may accumulate in them, + and a painful oppression supervene; as in some hæmorrhages of the lungs, + which occur during sleep; and in patients much debilitated by fevers. See + Somnus interruptus, Class <a href="#species_I_2_1_3">I. 2. 1. 3</a>. and + <a href="#species_I_2_1_9">I. 2. 1. 9</a>.</p> + + <p>Great fatigue with a full supper and much wine, I have been well + informed by one patient, always produced this disease in himself to a + great degree. Now the general irritability of the system is much + decreased by fatigue, as it exhausts the sensorial power; and secondly, + too much wine and stimulating food will again diminish the irritability + of some parts of the system, by employing a part of the sensorial power, + which is already too small, in digesting a great quantity of aliment; and + in increasing the motions of the organs of sense in consequence of some + degree of intoxication, whence difficulty of breathing may occur from the + inirritability of the lungs, as in Class <a href="#species_I_2_1_3">I. 2. + 1. 3</a>.</p> + + <p>M. M. To sleep on a hard bed with the head raised. Moderate supper. + The bark. By sleeping on a harder bed the patient will turn himself more + frequently, and not be liable to sleep too profoundly, or lie too long in + one posture. To be awakened frequently by an alarm clock.</p> + + <p><a name="species_III_2_1_14">14</a>. <i>Lethargus.</i> The lethargy is + a slighter apoplexy. It is supposed to originate from universal pressure + on the brain, and is said to be produced by compressing the spinal + marrow, where there is a deficiency of the bone in the spina bifida. See + Sect. XVIII. 20. Whereas in the hydrocephalus there is only a partial + pressure of the brain; and probably in nervous fevers with stupor the + pressure on the brain may affect only the nerves of the senses, which lie + within the skull, and not those nerves of the medulla oblongata, which + principally contribute to move the heart and arteries; whence in the + lethargic or apoplectic stupor the pulse is slow as in sleep, whereas in + nervous fever the pulse is very quick and feeble, and generally so in + hydrocephalus.</p> + + <p>In cases of obstructed kidneys, whether owing to the tubuli uriniferi + being totally obstructed by calculous matter, or by their paralysis, a + kind of drowsiness or lethargy comes on about the eighth or ninth day, + and the patient gradually sinks. See Class <a href="#species_I_1_3_9">I. + 1. 3. 9</a>.</p> + + <p><a name="species_III_2_1_15">15</a>. <i>Syncope epileptica</i>, is a + temporary apoplexy, the pulse continuing in its natural state, and the + voluntary power suspended. This terminates the paroxysms of epilepsy.</p> + + <p>When the animal power is much exhausted by the preceding convulsions, + so that the motions from sensation as well as those from volition are + suspended; in a quarter or half an hour the sensorial power becomes + restored, and if no pain, or irritation producing pain, recurs, the fit + of epilepsy ceases; if the pain recurs, or the irritation, which used to + produce it, a new fit of convulsion takes place, and is succeeded again + by a syncope. See Epilepsy, Class <a href="#species_III_1_1_7">III. 1. 1. + 7</a>.</p> + + <p><a name="species_III_2_1_16">16</a>. <i>Apoplexia.</i> Apoplexy may be + termed an universal palsy, or a permanent sleep. In which, where the + pulse is weak, copious bleeding must be injurious; as is well observed by + Dr. Heberden, Trans. of the College.</p> + + <p>Mr. ——, about 70 years of age, had an apoplectic seizure. + His pulse was strong and full. One of the temporal arteries was opened, + and about ten ounces of blood suddenly taken from it. He seemed to + receive no benefit from this operation; but gradually sunk, and lived but + a day or two.</p> + + <p>If apoplexy arises from the pressure of blood extravasated on the + brain, one moderate venesection may be of service to prevent the further + effusion of blood; but copious venesection must be injurious by weakening + the patient; since the effused blood must have time, as in common vibices + or bruises, to undergo a chemico-animal process, so to change its nature + as to fit it for absorption; which may take two or three weeks, which + time a patient weakened by repeated venesection or arteriotomy may not + survive.</p> + + <p>Mrs. ——, about 40 years old, had an apoplectic seizure + after great exertion from fear; she had lain about 24 hours without + speech, or having swallowed any liquid. She was then forcibly raised in + bed, and a spoonful of solution of aloes in wine put into her mouth, and + the end of the spoon withdrawn, that she might more easily swallow the + liquid.—This was done every hour, with broth, and wine and water + intervening, till evacuations were procured; which with other means had + good effect, and she recovered, except that a considerable degree of + hemiplegia remained, and some imperfection of her speech.</p> + + <p>Many people, who have taken so much vinous spirit as to acquire the + temporary apoplexy of intoxication, and are not improperly said to be + dead-drunk, have died after copious venesection, I suppose in consequence + of it. I once saw at a public meeting two gentlemen in the drunken + apoplexy; they were totally insensible with low pulse, on this account + they were directed not to lose blood, but to be laid on a bed with their + heads high, and to be turned every half hour; as soon as they could + swallow, warm tea was given them, which evacuated their stomachs, and + they gradually recovered, as people do from less degrees of + intoxication.</p> + + <p>M. M. Cupping on the occiput. Venesection once in moderate quantity. + Warm fomentations long continued and frequently repeated on the shaved + head. Solution of aloes. Clysters with solution of aloe and oil of amber. + A blister on the spine. An emetic. Afterwards the bark, and small doses + of chalybeates. Small electric shocks through the head. Errhines. If + small doses of opium?</p> + + <p><a name="species_III_2_1_17">17</a>. <i>Mors a frigore.</i> Death from + cold. The unfortunate travellers, who almost every winter perish in the + snow, are much exhausted by their efforts to proceed on their journey, as + well as benumbed by cold. And as much greater exercise can be borne + without fatigue in cold weather than in warm; because the excessive + motions of the cutaneous vessels are thus prevented, and the consequent + waste of sensorial power; it may be inferred, that the fatigued traveller + becomes paralytic from violent exertion as well as by the application of + cold.</p> + + <p>Great degrees of cold affect the motions of those vessels most, which + have been generally excited into action by irritation; for when the feet + are much benumbed by cold, and painful, and at the same time almost + insensible to the touch of external objects, the voluntary muscles retain + their motions, and we continue to walk on; the same happens to the + fingers of children in throwing snow-balls, the voluntary motions of the + muscles continue, though those of the cutaneous vessels are benumbed into + inactivity.</p> + + <p>Mr. Thompson, an elderly gentleman of Shrewsbury, was seized with + hemiplegia in the cold bath; which I suppose might be owing to some great + energy of exertion, as much as to the coldness of the water. As in the + instance given of Mr. Nairn, who, by the exertion to save his relation, + perished himself. See Sect. XXXIV. 1. 7.</p> + + <p>Whence I conclude, that though heat is a fluid necessary to muscular + motion, both perhaps by its stimulus, and by its keeping the minute + component parts of the ultimate fibrils of the muscles or organs of sense + at a proper distance from each other; yet that paralysis, properly so + called, is the consequence of exhaustion of sensorial power by exertion. + And that the accumulations of it during the torpor of the cutaneous + vessels by exposure to cold, or of some internal viscus in the cold fits + of agues, are frequently instrumental in recovering the use of paralytic + limbs, or of the motions of other paralytic parts of the system. See + Spec. <a href="#species_III_2_1_4">4</a>. of this genus.</p> + + <p>Animal bodies resist the power of cold probably by their exertions in + consequence of the pain of cold, see Botan. Gard. V. 1. additional note + xii. But if these increased exertions be too violent, so as to exhaust + the sensorial power in producing unnecessary motions, the animal will + probably sooner perish. Thus a moderate quantity of wine or spirit + repeated at proper intervals of time might be of service to those, who + are long exposed to excessive cold, both by increasing the action of the + capillary vessels, and thus producing heat, and perhaps by increasing in + some degree the secretion of sensorial power in the brain. But the + contrary must happen when taken immoderately, and not at due intervals. A + well attested history was once related to me of two men, who set out on + foot to travel in the snow, one of whom drank two or three glasses of + brandy before they began their journey, the other contented himself with + his usual diet and potation; the former of whom perished in spite of any + assistance his companion could afford him; and the other performed his + journey with safety. In this case the sensorial power was exhausted by + the unnecessary motions of incipient intoxication by the stimulus of the + brandy, as well as by the exertions of walking; which so weakened the + dram-drinker, that the cold sooner destroyed him; that is, he had not + power to produce sufficient muscular or arterial action, and in + consequence sufficient heat, to supply the great expenditure of it. Hence + the capillaries of the skin first cease to act, and become pale and + empty; next those which are immediately associated with them, as the + extremities of the pulmonary artery, as happens on going into the cold + bath. By the continued inaction of these parts of the vascular system the + blood becomes accumulated in the internal arteries, and the brain is + supposed to be affected by its compression; because these patients are + said to sleep, or to become apoplectic, before they die. I overtook a + fishman asleep on his panniers on a very cold frosty night, but on waking + him he did not appear to be in any degree of stupor. See Class <a + href="#species_I_2_2_1">I. 2. 2. 1</a>.</p> + + <p>When travellers are benighted in deep snow, they might frequently be + saved by covering themselves in it, except a small aperture for air; in + which situation the lives of hares, sheep, and other animals, are so + often preserved. The snow, both in respect to its component parts, and to + the air contained in its pores, is a bad conductor of heat, and will + therefore well keep out the external cold; and as the water, when part of + it dissolves, is attracted into the pores of the remainder of it, the + situation of an animal beneath it is perfectly dry; and, if he is in + contact with the earth, he is in a degree of heat between 48, the medium + heat of the earth, and 32, the freezing point; that is, in 40 degrees of + heat, in which a man thus covered will be as warm as in bed. See Botan. + Garden, V. II. notes on Anemone, Barometz, and Muschus. If these facts + were more generally understood, it might annually save the lives of + many.</p> + + <p>After any part of the vascular system of the body has been long + exposed to cold, the sensorial power is so much accumulated in it, that + on coming into a warm room the pain of hotach is produced, and + inflammation, and consequent mortification, owing to the great exertion + of those vessels, when again exposed to a moderate degree of warmth. See + Sect. XII. 5. Whence the propriety of applying but very low degrees of + heat to limbs benumbed with cold at first, as of snow in its state of + dissolving, which is at 32 degrees of heat, or of very cold water. A + French writer has observed, that if frozen apples be thawed gradually by + covering them with thawing snow, or immersing them in very cold water, + that they do not lose their taste; if this fact was well ascertained, it + might teach us how to preserve other ripe fruits in ice-houses for winter + consumption.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Volition.</i></h3> + +<h3>GENUS <a name="genus_III_2_2">II</a>.</h3> + +<h3><i>With decreased Actions of the Organs of Sense.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_III_2_2_1">1</a>. <i>Recollectionis jactura.</i> Loss + of recollection. This is the defect of memory in old people, who forget + the actions of yesterday, being incapable of voluntary recollection, and + yet remember those of their youth, which by frequent repetition are + introduced by association or suggestion. This is properly the paralysis + of the mind; the organs of sense do not obey the voluntary power; that + is, our ideas cannot be recollected, or acted over again by the will.</p> + + <p>After an apoplectic attack the patients, on beginning to recover, find + themselves most at a loss in recollecting proper names of persons or + places; as those words have not been so frequently associated with the + ideas they stand for, as the common words of a language. Mr. + ——, a man of strong mind, of a short necked family, many of + whom had suffered by apoplexy, after an apoplectic fit on his recovering + the use of speech, after repeated trials to remember the name of a person + or place, applauded himself, when he succeeded, with such a childish + smile on the partial return of his sagacity, as very much affected + me.—Not long, alas! to return; for another attack in a few weeks + destroyed the whole.</p> + + <p>I saw a child after the small-pox, which was left in this situation; + it was lively, active, and even vigorous; but shewed that kind of + surprise, which novelty excites, at every object it viewed; and that as + often as it viewed it. I never heard the termination of the case.</p> + + <p><a name="species_III_2_2_2">2</a>. <i>Stultitia voluntaria.</i> + Voluntary folly. The absence of voluntary power and consequent incapacity + to compare the ideas of present and future good. Brute animals may be + said to be in this situation, as they are in general excited into action + only by their present painful or pleasurable sensations. Hence though + they are liable to surprise, when their passing trains of ideas are + dissevered by violent stimuli; yet are they not affected with wonder or + astonishment at the novelty of objects; as they possess but in a very + inferior degree, that voluntary power of comparing the present ideas with + those previously acquired, which distinguishes mankind; and is termed + analogical reasoning, when deliberatively exerted; and intuitive analogy, + when used without our attention to it, and which always preserves our + hourly trains of ideas consistent with truth and nature. See Sect. XVII. + 3. 7.</p> + + <p><a name="species_III_2_2_3">3</a>. <i>Credulitas.</i> Credulity. Life + is short, opportunities of knowledge rare; our senses are fallacious, our + reasonings uncertain, mankind therefore struggles with perpetual error + from the cradle to the coffin. He is necessitated to correct experiment + by analogy, and analogy by experiment; and not always to rest satisfied + in the belief of facts even with this two-fold testimony, till future + opportunities, or the observations of others, concur in their + support.</p> + + <p>Ignorance and credulity have ever been companions, and have misled and + enslaved mankind; philosophy has in all ages endeavoured to oppose their + progress, and to loosen the shackles they had imposed; philosophers have + on this account been called unbelievers: unbelievers of what? of the + fictions of fancy, of witchcraft, hobgobblins, apparitions, vampires, + fairies; of the influence of stars on human actions, miracles wrought by + the bones of saints, the flights of ominous birds, the predictions from + the bowels of dying animals, expounders of dreams, fortune-tellers, + conjurors, modern prophets, necromancy, cheiromancy, animal magnetism, + with endless variety of folly? These they have disbelieved and despised, + but have ever bowed their hoary heads to Truth and Nature.</p> + + <p>Mankind may be divided in respect to the facility of their belief or + conviction into two classes; those, who are ready to assent to single + facts from the evidence of their senses, or from the serious assertions + of others; and those, who require analogy to corroborate or authenticate + them.</p> + + <p>Our first knowledge is acquired by our senses; but these are liable to + deceive us, and we learn to detect these deceptions by comparing the + ideas presented to us by one sense with those presented by another. Thus + when we first view a cylinder, it appears to the eye as a flat surface + with different shades on it, till we correct this idea by the sense of + touch, and find its surface to be circular; that is, having some parts + gradually receding further from the eye than others. So when a child, or + a cat, or a bird, first sees its own image in a looking-glass, it + believes that another animal exists before it, and detects this fallacy + by going behind the glass to examine, if another tangible animal really + exists there.</p> + + <p>Another exuberant source of error consists in the false notions, which + we receive in our early years from the design or ignorance of our + instructors, which affect all our future reasoning by their perpetual + intrusions; as those habits of muscular actions of the face or limbs, + which are called tricks, when contracted in infancy continue to the end + of our lives.</p> + + <p>A third great source of error is the vivacity of our ideas of + imagination, which perpetually intrude themselves by various + associations, and compose the farrago of our dreams; in which, by the + suspension of volition, we are precluded from comparing the ideas of one + sense with those of another, or the incongruity of their successions with + the usual course of nature, and thus to detect their fallacy. Which we do + in our waking hours by a perpetual voluntary exertion, a process of the + mind above mentioned, which we have termed intuitive analogy. Sect. XVII. + 3. 7.</p> + + <p>This analogy presupposes an acquired knowledge of things, hence + children and ignorant people are the most credulous, as not possessing + much knowledge of the usual course of nature; and secondly, those are + most credulous, whose faculty of comparing ideas, or the voluntary + exertion of it, is slow or imperfect. Thus if the power of the magnetic + needle of turning towards the north, or the shock given by touching both + sides of an electrized coated jar, was related for the first time to a + philosopher, and to an ignorant person; the former would be less ready to + believe them, than the latter; as he would find nothing similar in nature + to compare them to, he would again and again repeat the experiment, + before he would give it his entire credence; till by these repetitions it + would cease to be a single fact, and would therefore gain the evidence of + analogy. But the latter, as having less knowledge of nature, and less + facility of voluntary exertion, would more readily believe the assertions + of others, or a single fact, as presented to his own observation. Of this + kind are the bulk of mankind; they continue throughout their lives in a + state of childhood, and have thus been the dupes of priests and + politicians in all countries and in all ages of the world.</p> + + <p>In regard to religious matters, there is an intellectual cowardice + instilled into the minds of the people from their infancy; which prevents + their inquiry: credulity is made an indispensable virtue; to inquire or + exert their reason in religious matters is denounced as sinful; and in + the catholic church is punished with more severe penances than moral + crimes. But in respect to our belief of the supposed medical facts, which + are published by variety of authors; many of whom are ignorant, and + therefore credulous; the golden rule of David Hume may be applied with + great advantage. "When two miraculous assertions oppose each other, + believe the less miraculous." Thus if a person is said to have received + the small-pox a second time, and to have gone through all the stages of + it, one may thus reason: twenty thousand people have been exposed to the + variolous contagion a second time without receiving the variolous fever, + to every one who has been said to have thus received it; it appears + therefore less miraculous, that the assertor of this supposed fact has + been deceived, or wishes to deceive, than that it has so happened + contrary to the long experienced order of nature.</p> + + <p>M. M. The method of cure is to increase our knowledge of the laws of + nature, and our habit of comparing whatever ideas are presented to us + with those known laws, and thus to counteract the fallacies of our + senses, to emancipate ourselves from the false impressions which we have + imbibed in our infancy, and to set the faculty of reason above that of + imagination.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3><i>The Orders and Genera of the Fourth Class of Diseases.</i></h3> + +<h3>CLASS <a name="class_IV">IV</a>.</h3> + +<h3>DISEASES OF ASSOCIATION.</h3> + +<h3>ORDO I.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_IV_1_1">1</a>. Catenated with irritative motions.</p> + <p><a href="#genusi_IV_1_2">2</a>. Catenated with sensitive motions.</p> + <p><a href="#genusi_IV_1_3">3</a>. Catenated with voluntary motions.</p> + <p><a href="#genusi_IV_1_4">4</a>. Catenated with external influences.</p> + </div> + </div> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_IV_2_1">1</a>. Catenated with irritative motions.</p> + <p><a href="#genusi_IV_2_2">2</a>. Catenated with sensitive motions.</p> + <p><a href="#genusi_IV_2_3">3</a>. Catenated with voluntary motions.</p> + <p><a href="#genusi_IV_2_4">4</a>. Catenated with external influences.</p> + </div> + </div> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENERA.</h3> + + <div class="contents"> + <div class="stanza"> + <p><a href="#genusi_IV_3_1">1</a>. Catenated with irritative motions.</p> + <p><a href="#genusi_IV_3_2">2</a>. Catenated with sensitive motions.</p> + <p><a href="#genusi_IV_3_3">3</a>. Catenated with voluntary motions.</p> + <p><a href="#genusi_IV_3_4">4</a>. Catenated with external influences.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><i>The Orders, Genera, and Species, of the Fourth Class +of Diseases.</i></h3> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>CLASS IV.</h3> + +<h3>DISEASES OF ASSOCIATION.</h3> + +<h3>ORDO I.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENUS <a name="genusi_IV_1_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_1_1_1">1</a>. <i>Rubor vultûs pransorum.</i></td><td>Flushing of the face after dinner.</td></tr> +<tr><td><a href="#species_IV_1_1_2">2</a>. <i>Sudor stragulis immersorum.</i></td><td>Sweat from covering the face in bed.</td></tr> +<tr><td><a href="#species_IV_1_1_3">3</a>. <i>Cessatio ægritudinis cute excitata.</i> </td><td>Cure of sickness by stimulating the skin.</td></tr> +<tr><td><a href="#species_IV_1_1_4">4</a>. <i>Digestio aucta frigore cutaneo.</i></td><td>Digestion increased by coldness of the skin.</td></tr> +<tr><td><a href="#species_IV_1_1_5">5</a>. <i>Catarrhus a frigore cutaneo.</i></td><td>Catarrh from cold skin.</td></tr> +<tr><td><a href="#species_IV_1_1_6">6</a>. <i>Absorptio cellularis aucta vomitu.</i></td><td>Cellular absorption increased by vomiting.</td></tr> +<tr><td><a href="#species_IV_1_1_7">7</a>. <i>Syngultus nephriticus.</i></td><td>Nephritic hiccough.</td></tr> +<tr><td><a href="#species_IV_1_1_8">8</a>. <i>Febris irritativa.</i></td><td>Irritative fever.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_1_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_IV_1_2_1">1</a>. <i>Lacrymarum fluxus sympatheticus.</i> </td><td>Sympathetic tears.</td></tr> +<tr><td> <a href="#species_IV_1_2_2">2</a>. <i>Sternutatio a lumine.</i></td><td>Sneezing from light.</td></tr> +<tr><td> <a href="#species_IV_1_2_3">3</a>. <i>Dolor dentium a Stridore.</i></td><td>Tooth-edge from grating sounds.</td></tr> +<tr><td> <a href="#species_IV_1_2_4">4</a>. <i>Risus sardonicus.</i></td><td>Sardonic smile.</td></tr> +<tr><td> <a href="#species_IV_1_2_5">5</a>. <i>Salivæ fluxus cibo viso.</i></td><td>Flux of saliva at sight of food.</td></tr> +<tr><td> <a href="#species_IV_1_2_6">6</a>. <i>Tensio mamularum viso puerulo.</i></td><td>Tension of the nipples of lactescent women at sight of the child.</td></tr> +<tr><td> <a href="#species_IV_1_2_7">7</a>. <i>Tensio penis in hydrophobia.</i></td><td>Tension of the penis in hydrophobia.</td></tr> +<tr><td> <a href="#species_IV_1_2_8">8</a>. <i>Tenesmus calculosus.</i></td><td>Tenesmus from stone.</td></tr> +<tr><td> <a href="#species_IV_1_2_9">9</a>. <i>Polypus narium ex ascaride.</i></td><td>Polypus of the nose from ascarides.</td></tr> +<tr><td><a href="#species_IV_1_2_10">10</a>. <i>Crampus surarum in diarrhœa.</i></td><td>Cramp from diarrhœa.</td></tr> +<tr><td><a href="#species_IV_1_2_11">11</a>. <i>Zona ignea nephritica.</i></td><td>Nephritic shingles.</td></tr> +<tr><td><a href="#species_IV_1_2_12">12</a>. <i>Eruptio variolarum.</i></td><td>Eruption of small-pox.</td></tr> +<tr><td><a href="#species_IV_1_2_13">13</a>. <i>Gutta rosea stomatica.</i></td><td>Stomatic rosy drop.</td></tr> +<tr><td><a href="#species_IV_1_2_14">14</a>. —— <i>hepatica.</i></td><td>Hepatic rosy drop.</td></tr> +<tr><td><a href="#species_IV_1_2_15">15</a>. <i>Podagra.</i></td><td>Gout.</td></tr> +<tr><td><a href="#species_IV_1_2_16">16</a>. <i>Rheumatismus.</i></td><td>Rheumatism.</td></tr> +<tr><td><a href="#species_IV_1_2_17">17</a>. <i>Erysipelas.</i></td><td>Erysipelas.</td></tr> +<tr><td><a href="#species_IV_1_2_18">18</a>. <i>Testium tumor in gonorrhœa.</i></td><td>Swelled testis in gonorrhœa.</td></tr> +<tr><td><a href="#species_IV_1_2_19">19</a>. —— <i>in parotitide.</i></td><td>—— in mumps.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_1_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_1_3_1">1</a>. <i>Deglutitio invita.</i></td><td>Involuntary deglutition.</td></tr> +<tr><td><a href="#species_IV_1_3_2">2</a>. <i>Nictitatio invita.</i></td><td>—— nictitation.</td></tr> +<tr><td><a href="#species_IV_1_3_3">3</a>. <i>Risus invitus.</i></td><td>—— laughter.</td></tr> +<tr><td><a href="#species_IV_1_3_4">4</a>. <i>Lusus digitorum invitus.</i></td><td>—— actions with the fingers.</td></tr> +<tr><td><a href="#species_IV_1_3_5">5</a>. <i>Unguium morsiuncula invita.</i> </td><td>—— biting the nails.</td></tr> +<tr><td><a href="#species_IV_1_3_6">6</a>. <i>Vigilia invita.</i></td><td>—— watchfulness.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_1_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_1_4_1">1</a>. <i>Vita ovi.</i></td><td>Life of an egg.</td></tr> +<tr><td><a href="#species_IV_1_4_2">2</a>. <i>Vita hiemi-dormientium.</i></td><td>Life of winter-sleepers.</td></tr> +<tr><td><a href="#species_IV_1_4_3">3</a>. <i>Pullulatio arborum.</i></td><td>Budding of trees.</td></tr> +<tr><td><a href="#species_IV_1_4_4">4</a>. <i>Orgasmatis venerei periodus.</i> </td><td>Periods of venereal desire.</td></tr> +<tr><td><a href="#species_IV_1_4_5">5</a>. <i>Brachii concussio electrica.</i></td><td>Electric shock through the arm.</td></tr> +<tr><td><a href="#species_IV_1_4_6">6</a>. <i>Oxygenatio sanguinis.</i></td><td>Oxygenation of the blood.</td></tr> +<tr><td><a href="#species_IV_1_4_7">7</a>. <i>Humectatio corporis.</i></td><td>Humectation of the body.</td></tr> +</table> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENUS <a name="genusi_IV_2_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_IV_2_1_1">1</a>. <i>Cutis frigida pransorum.</i></td><td>Chillness after dinner.</td></tr> +<tr><td> <a href="#species_IV_2_1_2">2</a>. <i>Pallor urinæ pransorum.</i></td><td>Pale urine after dinner.</td></tr> +<tr><td> <a href="#species_IV_2_1_3">3</a>. —— <i>a frigore cutaneo.</i></td><td>—— from cold skin.</td></tr> +<tr><td> <a href="#species_IV_2_1_4">4</a>. <i>Pallor ex ægritudine.</i></td><td>Paleness from sickness.</td></tr> +<tr><td> <a href="#species_IV_2_1_5">5</a>. <i>Dyspnœa a balneo frigido.</i></td><td>Shortness of breath from cold bathing.</td></tr> +<tr><td> <a href="#species_IV_2_1_6">6</a>. <i>Dyspepsia a pedibus frigidis.</i></td><td>Indigestion from cold feet.</td></tr> +<tr><td> <a href="#species_IV_2_1_7">7</a>. <i>Tussis a pedibus frigidis.</i></td><td>Cough from cold feet.</td></tr> +<tr><td> <a href="#species_IV_2_1_8">8</a>. —— <i>hepatica.</i></td><td>Liver-cough.</td></tr> +<tr><td> <a href="#species_IV_2_1_9">9</a>. —— <i>arthritica.</i></td><td>Gout-cough.</td></tr> +<tr><td><a href="#species_IV_2_1_10">10</a>. <i>Vertigo rotatoria.</i></td><td>Vertigo rotatory.</td></tr> +<tr><td><a href="#species_IV_2_1_11">11</a>. —— <i>visualis.</i></td><td>—— visual.</td></tr> +<tr><td><a href="#species_IV_2_1_12">12</a>. —— <i>ebriosa.</i></td><td>—— inebriate.</td></tr> +<tr><td><a href="#species_IV_2_1_13">13</a>. —— <i>febriculosa.</i></td><td>—— feverish.</td></tr> +<tr><td><a href="#species_IV_2_1_14">14</a>. —— <i>cerebrosa.</i></td><td>—— from the brain.</td></tr> +<tr><td><a href="#species_IV_2_1_15">15</a>. <i>Murmur aurium vertiginosum.</i></td><td>Noise in the ears.</td></tr> +<tr><td><a href="#species_IV_2_1_16">16</a>. <i>Tactus, gustus, olfactus vertiginosi.</i> </td><td>Vertiginous touch, taste, smell.</td></tr> +<tr><td><a href="#species_IV_2_1_17">17</a>. <i>Pulsus mollis a vomitione.</i></td><td>Soft pulse in vomiting.</td></tr> +<tr><td><a href="#species_IV_2_1_18">18</a>. —— <i>intermittens a ventriculo.</i></td><td>Intermittent pulse from the stomach.</td></tr> +<tr><td><a href="#species_IV_2_1_19">19</a>. <i>Febris inirritativa.</i></td><td>Inirritative fever.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_2_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_IV_2_2_1">1</a>. <i>Torpor genæ a dolore dentis.</i></td><td>Coldness of the cheek from tooth-ach.</td></tr> +<tr><td> <a href="#species_IV_2_2_2">2</a>. <i>Stranguria a dolore vesicæ.</i></td><td>Strangury from pain of the bladder.</td></tr> +<tr><td> <a href="#species_IV_2_2_3">3</a>. —— <i>convulsiva.</i></td><td>Convulsive strangury.</td></tr> +<tr><td> <a href="#species_IV_2_2_4">4</a>. <i>Dolor termini ductûs choledochi.</i></td><td>Pain of the end of the bile-duct.</td></tr> +<tr><td> <a href="#species_IV_2_2_5">5</a>. <i>Dolor pharyngis ab acido gastrico.</i></td><td>Pain of the throat from gastric acid.</td></tr> +<tr><td> <a href="#species_IV_2_2_6">6</a>. <i>Pruritus narium a vermibus.</i></td><td>Itching of the nose from worms.</td></tr> +<tr><td> <a href="#species_IV_2_2_7">7</a>. <i>Cephalæa.</i></td><td>Head-ach.</td></tr> +<tr><td> <a href="#species_IV_2_2_8">8</a>. <i>Hemicrania et otalgia.</i></td><td>Partial head-ach, and ear-ach.</td></tr> +<tr><td> <a href="#species_IV_2_2_9">9</a>. <i>Dolor humeri in <span class="correction" title="Original reads `hepatidide'.">hepatitide</span>.</i></td><td>Pain of shoulder in hepatitis.</td></tr> +<tr><td><a href="#species_IV_2_2_10">10</a>. <i>Torpor pedum variolâ erumpente.</i></td><td>Cold feet in eruption of small-pox.</td></tr> +<tr><td><a href="#species_IV_2_2_11">11</a>. <i>Testium dolor nephriticus.</i></td><td>Nephritic pain of testis.</td></tr> +<tr><td><a href="#species_IV_2_2_12">12</a>. <i>Dolor digiti minimi sympatheticus.</i> </td><td>Pain of little finger from sympathy.</td></tr> +<tr><td><a href="#species_IV_2_2_13">13</a>. <i>Dolor brachii in hydrope pectoris.</i></td><td>Pain of the arm in dropsy of the chest.</td></tr> +<tr><td><a href="#species_IV_2_2_14">14</a>. <i>Diarrhœa a dentitione.</i></td><td>Diarrhœa from toothing.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_2_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_2_3_1">1</a>. <i>Titubatio linguæ.</i></td><td>Impediment of speech.</td></tr> +<tr><td><a href="#species_IV_2_3_2">2</a>. <i>Chorea sancti viti.</i></td><td>St. Vitus' dance.</td></tr> +<tr><td><a href="#species_IV_2_3_3">3</a>. <i>Risus.</i></td><td>Laughter.</td></tr> +<tr><td><a href="#species_IV_2_3_4">4</a>. <i>Tremor ex irâ.</i></td><td>Trembling from anger.</td></tr> +<tr><td><a href="#species_IV_2_3_5">5</a>. <i>Rubor ex irâ.</i></td><td>Redness from anger.</td></tr> +<tr><td><a href="#species_IV_2_3_6">6</a>. —— <i>criminati.</i></td><td>Blush of guilt.</td></tr> +<tr><td><a href="#species_IV_2_3_7">7</a>. <i>Tarditas paralytica.</i> </td><td>Slowness from palsy.</td></tr> +<tr><td><a href="#species_IV_2_3_8">8</a>. —— <i>senilis.</i></td><td>—— of age.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_2_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td> <a href="#species_IV_2_4_1">1</a>. <i>Somni periodus.</i></td><td>Periods of sleep.</td></tr> +<tr><td> <a href="#species_IV_2_4_2">2</a>. <i>Studii inanis periodus.</i></td><td>—— of reverie.</td></tr> +<tr><td> <a href="#species_IV_2_4_3">3</a>. <i>Hemicraniæ periodus.</i></td><td>—— of head-ach.</td></tr> +<tr><td> <a href="#species_IV_2_4_4">4</a>. <i>Epilepsiæ dolorificæ periodus.</i></td><td>—— of painful epilepsy.</td></tr> +<tr><td> <a href="#species_IV_2_4_5">5</a>. <i>Convulsionis dolorificæ periodus.</i> </td><td>—— of painful convulsion.</td></tr> +<tr><td> <a href="#species_IV_2_4_6">6</a>. <i>Tussis periodicæ periodus.</i></td><td>—— of periodic cough.</td></tr> +<tr><td> <a href="#species_IV_2_4_7">7</a>. <i>Catameniæ periodus.</i></td><td>—— of catamenia.</td></tr> +<tr><td> <a href="#species_IV_2_4_8">8</a>. <i>Hæmorrhoidis periodus.</i></td><td>—— of the piles.</td></tr> +<tr><td> <a href="#species_IV_2_4_9">9</a>. <i>Podagræ periodus.</i></td><td>—— of the gout.</td></tr> +<tr><td><a href="#species_IV_2_4_10">10</a>. <i>Erysipelatis periodus.</i></td><td>—— of erysipelas.</td></tr> +<tr><td><a href="#species_IV_2_4_11">11</a>. <i>Febrium periodus.</i></td><td>—— of fevers.</td></tr> +</table> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENUS <a name="genusi_IV_3_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_3_1_1">1</a>. <i>Diabætes irritata.</i></td><td>Diabetes from irritation.</td></tr> +<tr><td><a href="#species_IV_3_1_2">2</a>. <i>Sudor frigidus in asthmate.</i> </td><td>Cold sweat in asthma.</td></tr> +<tr><td><a href="#species_IV_3_1_3">3</a>. <i>Diabætes a timore.</i></td><td>Diabetes from fear.</td></tr> +<tr><td><a href="#species_IV_3_1_4">4</a>. <i>Diarrhœa a timore.</i></td><td>Diarrhœa from fear.</td></tr> +<tr><td><a href="#species_IV_3_1_5">5</a>. <i>Pallor et tremor a timore.</i></td><td>Paleness and trembling from fear.</td></tr> +<tr><td><a href="#species_IV_3_1_6">6</a>. <i>Palpitatio cordis a timore.</i></td><td>Palpitation of the heart from fear.</td></tr> +<tr><td><a href="#species_IV_3_1_7">7</a>. <i>Abortio a timore.</i></td><td>Abortion from fear.</td></tr> +<tr><td><a href="#species_IV_3_1_8">8</a>. <i>Hysteria a timore.</i></td><td>Hysterics from fear.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_3_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_3_2_1">1</a>. <i>Nausea idealis.</i></td><td>Nausea from ideas.</td></tr> +<tr><td><a href="#species_IV_3_2_2">2</a>. —— <i>a conceptu.</i></td><td>Nausea from conception.</td></tr> +<tr><td><a href="#species_IV_3_2_3">3</a>. <i>Vomitio vertiginosa.</i></td><td>Vomiting from vertigo.</td></tr> +<tr><td><a href="#species_IV_3_2_4">4</a>. —— <i>a calculo in uretere.</i></td><td>—— from stone in the ureter.</td></tr> +<tr><td><a href="#species_IV_3_2_5">5</a>. —— <i>ab insultu paralytico.</i></td><td>—— from stroke of palsy.</td></tr> +<tr><td><a href="#species_IV_3_2_6">6</a>. —— <i>titilatione faucium.</i> </td><td>—— from tickling the throat.</td></tr> +<tr><td><a href="#species_IV_3_2_7">7</a>. —— <i>cute sympathetica.</i></td><td>—— from sympathy with the skin.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_3_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_3_3_1">1</a>. <i>Ruminatio.</i></td><td>Rumination.</td></tr> +<tr><td><a href="#species_IV_3_3_2">2</a>. <i>Vomitio voluntaria.</i></td><td>Voluntary vomiting.</td></tr> +<tr><td><a href="#species_IV_3_3_3">3</a>. <i>Eructatio voluntaria.</i> </td><td>—— eructation.</td></tr> +</table> + +<h3>GENUS <a name="genusi_IV_3_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + +<h3>SPECIES.</h3> + +<table class="nobctr"> +<tr><td><a href="#species_IV_3_4_1">1</a>. <i>Catarrhus periodicus.</i> </td><td>Periodical catarrh.</td></tr> +<tr><td><a href="#species_IV_3_4_2">2</a>. <i>Tussis periodica.</i></td><td>Periodic cough.</td></tr> +<tr><td><a href="#species_IV_3_4_3">3</a>. <i>Histeria a frigore.</i></td><td>Hysterics from cold.</td></tr> +<tr><td><a href="#species_IV_3_4_4">4</a>. <i>Nausea pluvialis.</i></td><td>Sickness against rain.</td></tr> +</table> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>CLASS IV.</h3> + +<p class="cenhead">DISEASES OF ASSOCIATION.</p> + +<h3>ORDO <a name="ordo_IV_1">I</a>.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_1_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motion.</i></h3> + + <p>The importance of the subsequent class not only consists in its + elucidating all the sympathetic diseases, but in its opening <i>a road to + the knowledge of fever</i>. The difficulty and novelty of the subject + must plead in excuse for the present imperfect state of it. The reader is + entreated previously to attend to the following circumstances for the + greater facility of investigating their intricate connections; which I + shall enumerate under the following heads.</p> + + <div class="poem"> + <div class="stanza"> + <p><a href="#head_IV_1_1_A">A.</a> Associate motions distinguished from catenations.</p> + <p><a href="#head_IV_1_1_B">B.</a> Associate motions of three kinds.</p> + <p><a href="#head_IV_1_1_C">C.</a> Associations affected by external influences.</p> + <p><a href="#head_IV_1_1_D">D.</a> Associations affected by other sensorial motions.</p> + <p><a href="#head_IV_1_1_E">E.</a> Associations catenated with sensation.</p> + <p><a href="#head_IV_1_1_F">F.</a> Direct and reverse sympathy.</p> + <p><a href="#head_IV_1_1_G">G.</a> Associations affected four ways.</p> + <p><a href="#head_IV_1_1_H">H.</a> Origin of associations.</p> + <p><a href="#head_IV_1_1_I">I.</a> Of the action of vomiting.</p> + <p><a href="#head_IV_1_1_K">K.</a> Tertian associations.</p> + </div> + </div> + + <p><a name="head_IV_1_1_A"></a></p> + +<p class="cenhead">A. <i>Associate Motions distinguished from Catenations.</i></p> + + <p>Associate motions properly mean only those, which are caused by the + sensorial power of association. Whence it appears, that those fibrous + motions, which constitute the introductory link of an associate train of + motions, are excluded from this definition, as not being themselves + caused by the sensorial power of association, but by irritation, or + sensation, or volition. I shall give for example the flushing of the face + after dinner; the capillary vessels of the face increase their actions in + consequence of their catenation, not their association, with those of the + stomach; which latter are caused to act with greater energy by the + irritation excited by the stimulus of food. These capillaries of the face + are associated with each other reciprocally, as being all of them excited + by the sensorial power of association; but they are only catenated with + those of the stomach, which are not in this case associate motions but + irritative ones. The common use of the word association for almost every + kind of connection has rendered this subject difficult; from which + inaccuracy I fear some parts of this work are not exempt.</p> + + <p><a name="head_IV_1_1_B"></a></p> + +<p class="cenhead">B. <i>Associate Motions of three Kinds.</i></p> + + <p>Those trains or tribes of associate motions, whose introductory link + consists of an irritative motion, are termed irritative associations; as + when the muscles of the eyelids close the eye in common nictitation. + Those, whose introductory link consists of a sensitive motion, are termed + sensitive associations; as when the pectoral and intercostal muscles act + in sneezing. And lastly, those, whose introductory link consists of a + voluntary motion, are termed voluntary associations; as when the muscles + of the lower limbs act in concert with those of the arm in fencing.</p> + + <p><a name="head_IV_1_1_C"></a></p> + +<p class="cenhead">C. <i>Associations affected by external Influences.</i></p> + + <p>Circles of associate motions, as well as trains and tribes of them, + are liable to be affected by external influences, which consist of + etherial fluids, and which, by penetrating the system, act upon it + perhaps rather as a causa sine quâ non of its movements, than directly as + a stimulus; except when they are accumulated in unusual quantity. We have + a sense adapted to the perception of the excess or defect of one of these + fluids; I mean that of elementary heat; in which all things are immersed. + See Class <a href="#species_IV_1_4_7">IV. 1. 4. 7</a>. But there are + others of them, which as we have no power to evade their influence, so we + have no sense to perceive it; these are the solar, and lunar, and + terrestrial gravitation, in which also all things are immersed; the + electric aura, which pervades us, and is perpetually varying, See Class + <a href="#species_IV_1_4_5">IV. 1. 4. 5</a>; the magnetic fluid, Class + <span class="correction" title="Original reads `IV. 1. 4. 6'."><a + href="#species_IV_1_4_5">IV. 1. 4. 5</a></span>; and lastly, the great + life-preserver oxygen gas, and the aqueous vapour of the atmosphere, see + Class <a href="#species_IV_1_4_6">IV. 1. 4. 6</a>. and <a + href="#species_IV_1_4_7">7</a>. and <a + href="#species_IV_1_4_2">2</a>.</p> + + <p>Of these external influences those of heat, and of gravity, have + diurnal periods of increase and decrease; besides their greater periods + of monthly or annual variation. The manner in which they act by + periodical increments on the system, till some effect is produced, is + spoken of in Sect. XXXII. 3. and 6.</p> + + <p><a name="head_IV_1_1_D"></a></p> + +<p class="cenhead">D. <i>Associations affected by other Sensorial Motions.</i></p> + + <p>Circles and trains of associate motions are also liable to be affected + by their catenations with other sensorial powers, as of irritation, or + sensation, or volition; which other sensorial powers either thus simply + form some of the links of the catenation, or add to the energy of the + associated motions. Thus when vomiting is caused by the stimulus of a + stone in the ureter, the sensation of pain seems to be a link of the + catenation rather than an efficient cause of the vomiting. But when the + capillary vessels of the skin increase their action from the influence of + external heat, they are excited both by the stimulus of unusual heat, as + well as by the stimulus of the blood, and by their accustomed association + with the actions of the heart and arteries. And lastly, in the blush of + anger the sensorial power of volition is added to that of association, + and irritation, to excite the capillaries of the face with increased + action. See Class <a href="#species_IV_2_3_5">IV. 2. 3. 5</a>.</p> + + <p><a name="head_IV_1_1_E"></a></p> + +<p class="cenhead">E. <i>Associations catenated with Sensation.</i></p> + + <p>Pain frequently accompanies associate trains or circles of motion + without its being a cause, or a link, of them, but simply an attendant + symptom; though it frequently gives name to the disease, as head-ach. + Thus in the cramp of the calves of the legs in diarrhœa, the + increased sensorial power of association is the proximate cause; the + preceding increased action of the bowels is the remote cause; and the + proximate effect is the violent contractions of the musculi gastrocnemii; + but the pain of these muscles is only an attendant symptom, or a remote + effect. See Sect. XVIII. 15. Other sensitive associations are mentioned + in Class <a href="#genus_IV_1_2">IV. 1. 2</a>. and <a + href="#species_IV_1_2_15">IV. 1. 2. 15</a>.</p> + + <p>Thus, if the flushing of the face above mentioned after dinner be + called a disease, the immediate or proximate cause is the increased power + of association, the remote cause is the increased irritative motions of + the stomach in consequence of the stimulus of food and wine. The disease + or proximate effect consists in the increased actions of the cutaneous + vessels of the face; and the sensation of heat, the existence of heat, + and the red colour, are attendants or symptoms, or remote effects, of the + increased actions of these cutaneous vessels.</p> + + <p><a name="head_IV_1_1_F"></a></p> + +<p class="cenhead">F. <i>Direct and reverse Sympathy.</i></p> + + <p>The increased actions of the primary part of the trains of associated + motions are sometimes succeeded by increased actions of the secondary + part of the train; and sometimes by decreased actions of it. So likewise + the decreased actions of the primary part of a train of associate motions + are sometimes succeeded by decreased actions of the secondary part, and + sometimes by increased actions of it. The former of these situations is + called direct sympathy, and the latter reverse sympathy. In general I + believe, where the primary part of the train of associated motions is + exerted more than natural, it produces direct sympathy in strong people, + and reverse sympathy in weak ones, as a full meal makes some people hot, + and others chill. And where the primary part of the train is exerted less + than natural, it produces direct sympathy in weak people, and reverse + sympathy in strong ones, as on being exposed for a certain length of time + on horseback in a cold day gives indigestion and consequent heart-burn to + weak people, and strengthens the digestion, and induces consequent hunger + in strong ones. See Sect. XXXV. 1.</p> + + <p>This may perhaps be more easily understood, by considering strength + and weakness, when applied to animal bodies, as consisting in the + quantity of sensorial power residing in the contracting fibres, and the + quantity of stimulus applied, as shewn in Sect. XII. 2. 1. Now when + defective stimulus, within certain limits, is partially applied to parts + subject to perpetual motion, the expenditure of sensorial power is for a + while lessened, but not its general production in the brain, nor its + derivation into the weakly-stimulated part. Hence in strong people, or + such whose fibres abound with sensorial power, if the first tribe of an + associate train of motions be deprived in part of its accustomed + stimulus, its action becomes diminished; and the sensorial power becomes + accumulated, and by its superabundance, or overflowing as it were, + increases the action of the second tribe of the associate actions by + reverse sympathy. As exposing the warm skin for a moderate time to cold + air increases the action of the stomach, and thus strengthens the power + of digestion.</p> + + <p>On the reverse, when additional stimulus within certain limits is + partially applied to parts, which are deficient in respect to the natural + quantity of sensorial power, the expenditure of sensorial power is + increased, but in a less degree than the increased production of it in + the brain, or its increased derivation into the strongly-stimulated + organ. Hence in weak people, or such whose fibres are deficient of + sensorial power, if the first tribe of an associate train of motions be + subjected for a while to greater stimulus than usual, a greater + production of sensorial power, or a greater derivation of it into the + stimulated parts occurs; which by its excess, or overflowing as it were, + increases the actions of the second tribe of the associate motions by + direct sympathy. Thus when vomiting occurs with cold extremities, a + blister on the back in a few hours occasions universal warmth of the + skin, and stops the vomiting. And when a diarrhœa occurs with pale + skin and cold extremities, the pricking of the points of a flannel shirt, + worn next the skin, occasions universal warmth of it, and checks or cures + the diarrhœa.</p> + + <p>In some associate trains of action nevertheless reverse sympathies + more frequently occur than direct ones, and in others direct ones more + frequently than reverse ones. Thus in continued fever with debility there + appears to be a reverse sympathy between the capillary vessels of the + stomach and those of the skin; because there exists a total aversion to + solid food, and constant heat on the surface of the body. Yet these two + systems of vessels are at other times actuated by direct sympathy, as + when paleness attends sickness, or cold feet induces indigestion. This + subject requires to be further investigated, as it probably depends not + only on the present or previous plus or minus of the sensorial power of + association, but also on the introduction of other kinds of sensorial + power, as in Class <a href="#head_IV_1_1_D">IV. 1. 1. D</a>; or the + increased production of it in the brain, or the greater mobility of one + part of a train of actions than another.</p> + + <p>Thus when much food or wine is taken into the stomach, if there be no + superfluity of sensorial power in the system, that is, none to be spared + from the continual actions of it, a paleness and chillness succeeds for a + time; because now the expenditure of it by the increased actions of the + stomach is greater than the present production of it. In a little time + however the stimulus of the food and wine increases the production of + sensorial power in the brain, and this produces a superfluity of it in + the system; in consequence of which the skin now becomes warm and florid, + which was at first cold and pale; and thus the reverse sympathy is + shortly converted into a direct one; which is probably owing to the + introduction of a second sensorial power, that of pleasurable + sensation.</p> + + <p>On the contrary, when an emetic drug produces sickness, the skin is at + first pale for a time by direct sympathy with the capillaries of the + stomach; but in a few minutes, by the accumulation of sensorial power in + the stomach during its less active state in sickness, the capillaries of + the skin, which are associated with those of the stomach, act with + greater energy by reverse sympathy, and a florid colour returns. Where + the quantity of action is diminished in the first part of a train of + motions, whether by previous diminution of sensorial power, or present + diminution of stimulus, the second part of the train becomes torpid by + direct sympathy. And when the quantity of action of the first part + becomes increased by the accumulation of sensorial power during its + previous torpor, or by increase of stimulus, the actions of the second + part of it likewise become increased by direct sympathy.</p> + + <p>In moderate hunger the skin is pale, as before dinner, and in moderate + sickness, as no great accumulation of sensorial power has commenced; but + in violent hunger, and in greater torpor of the stomach, as from + contagious matter, the accumulation of sensorial power becomes so great + as to affect the arterial and capillary system, and fever is produced in + both cases.</p> + + <p>In contagious fevers with arterial debilities commencing with torpor + of the stomach, why is the action of the heart weakened, and that of the + capillaries increased? Is it because the mobility of the heart is less + than that of the stomach, and the mobility of the capillaries greater? Or + is it because the association between the muscular fibres of the stomach + and those of the heart have been uniformly associated by direct sympathy; + and the capillaries of the stomach and those of the skin have been more + frequently associated by reverse sympathy?</p> + + <p>Where the actions of the stomach have been previously exhausted by + long stimulus, as on the day after intoxication, little or no + accumulation of sensorial power occurs, during the torpor of the organ, + beyond what is required to replace the deficiency of it, and hence fever + seldom follows intoxication. And a repetition of the stimulus sometimes + becomes necessary even to induce its natural action, as in + dram-drinkers.</p> + + <p>Where there has been no previous exhaustion of sensorial power, and + the primary link of associate motions is violently actuated by the + sensorial power of sensation, the secondary link is also violently + actuated by direct sympathy, as in inflammatory fevers. Where however the + sensorial power of the system is less than natural, the secondary link of + associated motions becomes torpid by reverse sympathy, as in the + inoculated small-pox during the eruption on the face the feet are + frequently cold.</p> + + <p><a name="head_IV_1_1_G"></a></p> + +<p class="cenhead">G. <i>Associations affected four Ways.</i></p> + + <p>Hence associated trains or circles of motions may be affected four + different ways. 1. By the greater or less energy of action of the first + link with which they are catenated, and from which they take their names; + as irritative, sensitive, or voluntary associations. 2. By being excited + by two or more sensorial powers at the same time, as by irritation and + association, as in the instance of the application of the stimulus of + increased external heat to the cutaneous capillaries. 3. By catenation + with other sensorial powers, as with pain or pleasure, which are in this + case not the proximate cause of motion, but which, by becoming a link of + catenation, excites the sensorial power of association into action; as + the pain at the neck of the gall-bladder occasioned by a gall-stone is + transferred to the other end of that canal, and becomes a link of + catenation between the action of the two extremities of it. 4. The + influence of ethereal fluids, as of heat and gravitation. To which last + perhaps might be added moisture and oxygen gas as constituting necessary + parts of the system, rather than stimuli to excite it into action.</p> + + <p><a name="head_IV_1_1_H"></a></p> + +<p class="cenhead">H. <i>The Origin of Associations.</i></p> + + <p>Some trains or circles of associate motions must have been formed + before our nativity, as those of the heart, arteries, and capillaries; + others have been associated, as occasion required them, as the muscles of + the diaphragm and abdomen in vomiting; and others by perpetual habit, as + those of the stomach with the heart and arteries directly, as in weak + pulse during sickness; with the capillaries directly, as in the flushed + skin after dinner; and lastly, with the cellular absorbents reversely, as + in the increased absorption in anasarca during sickness; and with the + irritative motions of the organs of sense reversely, as in vertigo, or + sea-sickness. Some of these associations shall be here shortly described + to facilitate the investigation of others.</p> + + <p>First, other congeries of glands occupy but a particular part of the + system, or constitute a particular organ, as the liver, or kidneys; but + those glands, which secrete the mucus, and perspirable matter, which are + called capillaries, are of very great extent; they receive the blood from + the arteries, separate from it the mucus, which lines every cell, and + covers every cavity of body; and the perspirable matter, which softens + and lubricates the whole surface of the skin, and the more extensive + surface of the air-vessels, which compose the lungs. These are supplied + with blood by the perpetual action of the heart and arteries, and have + therefore their motions associated with the former, and with each other, + by sympathy, which is sometimes direct, and sometimes reverse.</p> + + <p>One branch of this association, the capillaries of the skin, are very + irritable by the increased quantities of cold and heat, another branch, + that of the lungs, has not the perception of cold and heat, but is liable + by direct sympathy to act in concert with the former, as in going into + the cold bath. And it is probable the capillaries of the internal + membranes are likewise directly affected by their sympathy with those of + the skin, as appears from the defect of secretion in ulcers during the + cold fits of agues.</p> + + <p>The motions of this extensive system of capillaries, thus associated + by direct sympathy, are also associated with those of the heart and + arteries, sometimes by reverse and sometimes by direct sympathy; and thus + constitute simple fever. The cold paroxysm of which consists in their + torpor, and the hot one in their orgasm, or increased activity.</p> + + <p><a name="head_IV_1_1_I"></a></p> + +<p class="cenhead">I. <i>Of the Action of Vomiting.</i></p> + + <p>The manner, in which the stomach and the diaphragm and abdominal + muscles acquire their associate action in vomiting, requires some + attention. It is not probable, that this action of vomiting occurs before + nativity; as the uniform application of the nutritive liquor amnii to the + mouth of the fœtus, and the uniform expenditure of its nourishment, + would not seem to give occasion to too great temporary repletion of the + stomach; and would preclude the deglutition of any improper material. + After nativity the stomach of the child may be occasionally too much + distended with milk; as previous hunger may induce it to overgorge + itself; and by repeated efforts the act of vomiting is learned, as a + means of getting free from a disagreeable sensation. Thus when any + disgustful material, as a bitter drug, is taken into the mouth; certain + retrograde motions of the tongue and lips are produced, for the purpose + of putting the disagreeable material out of the mouth again.</p> + + <p>When the stomach is disagreeably stimulated by the distention or + acrimony of the aliment, a similar effort to regurgitate it must occur; + and by repeated trials the action of the diaphragm and abdominal muscles + by squeezing the stomach assists its retrograde exertion to disgorge its + contents. In the same manner when a piece of gravel is pushed into the + urethra, or a piece of indurated bile into the neck of the gall-bladder, + after they have been in vain pressed forward by the usual motions of + those ducts, they return into the bladders of gall and urine by the + retrograde motions of them.</p> + + <p>That this is one mode, in which vomiting is induced, appears from the + instantaneous rejection from the stomach occasioned by some nauseous + drug, or from some nauseous idea; and lastly, from the voluntary power, + which some people have been said to have acquired, of emptying their + stomachs, much in the same manner as ruminating animals bring up the + grass from their first stomach.</p> + + <p>There are nevertheless many modes by which these inverted motions of + the stomach and œsophagus are induced, and which it is of + consequence to distinguish from each other. The first is the mode above + described, where an effort is made to dislodge something, which + stimulates the stomach into disagreeable sensation; and which is returned + by repeated exertions; as when a nauseous drug is taken into the mouth, + or a bit of sand falls into the eye, or a drop of water into the + wind-pipe. In this the peristaltic motions of the stomach are first + stopped, and then reverted by painful sensation; and the abdominal + muscles and diaphragm by repeated efforts become associated with them. + Now as less sensorial power is expended on the retrograde actions of the + stomach, and of the lymphatics, which open their mouths on its surface, + than by their natural motions, an accumulation of sensorial power in the + fibres of the stomach follows the exhibition of an emetic, and on that + account an emetic will sometimes stop a spontaneous vomiting which was + owing to sensorial deficiency. See Sect. XXXV. 1. 3. and Art. <a + href="#art_V_2_1">V. 2. 1</a>.</p> + + <p>As bitters and metallic salts, exhibited in small doses, stimulate the + stomach into greater action, as appears by their increasing the power of + digestion, and yet become emetic, when given in larger doses; one might + suspect, that they became emetic by inducing debility, and consequent + retrograde actions of the stomach, by their previously exhausting the + sensorial power by their great stimulus; which might be effected in a + moment without producing pain, and in consequence without our perceiving + it. But on the contrary, there does not in general appear on the + exhibition of emetics to be any previous exhaustion of sensorial power; + because there is evidently an accumulation of it during the sickness, as + appears from the digestion being stronger afterwards; and from the + increased action of the cellular and cutaneous absorbents during its + operation. See Art. <a href="#art_V_2_1">V. 2. 1</a>.</p> + + <p>Another mode, by which vomiting is induced, is owing to debility or + deficiency of sensorial power, from the previous exhaustion of it; as on + the day after intoxication, or which occurs in people enfeebled with the + gout, and in dropsy, and in some fevers with debility. In these, when the + vomiting ceases, there is no appearance of accumulation of sensorial + power, as the digestion still remains weak and imperfect.</p> + + <p>Another mode by which sickness or vomiting is induced, is by defect of + stimulus, as in great hunger; and in those, who have been habituated to + spice and spirit with their meals, who are liable to be sick after taking + food without these additional stimuli. Other means of inducing sickness + by vertigo, or by nauseous ideas, will be mentioned below.</p> + + <p>We shall only add, that the motions of the muscular fibres of the + stomach are associated with those of the heart and arteries by direct + sympathy, as appears by the weakness of the pulse during the exhibition + of an emetic; and that the absorbents of the stomach are associated with + the cellular and cutaneous absorbents by reverse sympathy, as is shewn by + the great absorption of the mucus of the cells in anasarca during + sickness; at the same time that the absorbents of the stomach invert + their actions, and pour the mucus and water thus absorbed into that + viscus.</p> + + <p>In cold paroxysms of fever the stomach partakes of the general torpor, + and vomiting is induced by its debility, either by its association with + the torpid capillaries, or other torpid parts, or by its own torpor + commencing first, and causing the cold fit. The disordered motions of the + stomach frequently seem to be the cause or primary seat of fever, as + where contagious miasmata are swallowed with the saliva, and where fever + is produced by sea-sickness, which I once saw. Nevertheless a disorder of + the stomach does not always induce fever, as in that case it should + constantly attend indigestion, and vertigo, and sea-sickness; but is + itself frequently induced by association with the disordered movements of + other parts of the system, as when it arises from gravel in the ureter, + or from a percussion on the head.</p> + + <p>The connexion of the motions of the stomach with irritative ideas, or + motions of the organs of sense, in vertigo, is shewn in Sect. XX. and + thus it appears, that many circles of association are either directly or + reversely associated, or catenated, with this viscus; which will much + contribute to unfold some of the symptoms of fever.</p> + + <p><a name="head_IV_1_1_K"></a></p> + +<p class="cenhead">K. <i>Tertian Associations.</i></p> + + <p>The third link of associate trains of motion is sometimes actuated by + reverse sympathy, with the second link, and that by reverse sympathy with + the first link; so that the first and third link may act by direct + sympathy, and the intermediate one by reverse sympathy. Of this instances + are given in the syngultus nephriticus, Class <a + href="#species_IV_1_1_7">IV. 1. 1. 7</a>. and <a href="#genus_IV_2_1">IV. + 2. 1</a>. At other times the tertian or quartan links of associate + motions are actuated by direct sympathy; and that sometimes forwards and + sometimes backwards in respect to the usual order of those trains of + associate motions, as in Class <a href="#species_IV_1_2_1">IV. 1. 2. + 1</a>.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_1_1_1">1</a>. <i>Rubor vultûs prandorum.</i> + Flushing of the face after dinner is explained in Sect. XXXV. 1. In the + beginning of intoxication the whole skin becomes florid from the + association of the actions of the cutaneous arteries with those of the + stomach, because vinous spirit excites the fibres of the stomach into + more violent action than the stimulus of common food; and the cutaneous + capillaries of the face, from their more frequent exposure to the + vicissitudes of cold and heat, possess more mobility or irritability than + those of other parts of the skin, as further explained in Sect. XXXIII. + 2. 10. Vinegar is liable to produce this flushing of the face, which + probably is owing to the quantity of vinous spirit it contains, as I + believe the unfermented vegetable acids do not produce this effect. In + every kind of blush the arterial blood is propelled into the capillaries + faster than the venous absorption can carry it forwards into the veins, + in this respect resembling the tensio phalli.</p> + + <p>Can the beginning vinous or acetous fermentation of the aliment in + weak stomachs contribute to this effect? or is it to be ascribed to the + greater power of association between the arteries of the face and the + fibres of the stomach in some people than in others?</p> + + <p>M. M. Eat and drink less at a time, and more frequently. Put 20 drops + of weak acid of vitriol into water to be drank at meals. Let the dress + over the stomach and bowels be loose. Use no fermented liquors, or + vinegar, or spice.</p> + + <p><a name="species_IV_1_1_2">2</a>. <i>Sudor stragulis immersorum.</i> + Sweat from being covered in bed. In the commencement of an epidemic + fever, in which the perpetual efforts to vomit was a distressing symptom, + Dr. Sydenham discovered, that if the patient's head was for a short time + covered over with the bed clothes, warmth was produced, and a sweat broke + out upon the skin, and the tendency to vomit ceased. In this curious fact + two trains of associated motions are excited into increased action. + First, the vessels of the lungs are known to have their motion associated + with those of the skin by the difficulty of breathing on going into the + cold bath, as described in Sect. XXXII. 3. 2. Hence, when the vessels of + the lungs become excited into stronger action, by the bad air under the + bed clothes, warmed and adulterated by frequent breathing, those of the + external skin soon become excited by their association into more + energetic action, and generate more heat along with a greater secretion + of perspirable matter. Secondly, the sympathy between the stomach and + skin is evident in variety of circumstances; thus the cold air of frosty + days applied to the skin for a short time increases the action of the + stomach by reverse sympathy, but decreases it if continued too long by + direct sympathy; so in the circumstance above mentioned the action of the + stomach is increased by direct sympathy with that of the skin; and the + tendency to vomit, which was owing to its diminished action, ceases.</p> + + <p><a name="species_IV_1_1_3">3</a>. <i>Cessatio ægritudinis cute + excitatâ.</i> The cure of sickness by stimulating the skin. This is + explained in the preceding article; and further noticed in <a + href="#species_IV_2_2_4">IV. 2. 2. 4</a>. and in <a + href="#head_IV_1_1_F">IV. 1. 1. f.</a></p> + + <p>Similar to these is the effect of a blister on the back in relieving + sickness, indigestion, and heart-burn; and, on the contrary, by these + symptoms being frequently induced by coldness of the extremities. The + blister stimulates the cutaneous vessels into greater action; whence + warmth and pain are produced at the same time, and the fibres of the + stomach are excited into greater action by their association with those + of the skin. It does not appear, that the concomitant pain of the blister + causes the increased energy of the stomach, because the motions of it are + not greater than natural; though it is sometimes difficult to determine, + whether the primary part of some associated trains be connected with + irritative or sensitive motions.</p> + + <p>In the same manner a flannel shirt, to one who has not been in the + habit of wearing one, stimulates the skin by its points, and thus stops + vomiting in some cases; and is particularly efficacious in checking some + chronical diarrhœas, which are not attended with fever; for the + absorbents of the skin are thus stimulated into greater action, with + which those of the intestines consent by direct sympathy.</p> + + <p>This effect cannot be ascribed to the warmth alone of the flannel + shirt, as being a covering of loose texture, and confining air in its + pores, like a sponge, which air is known to be a bad conductor of heat, + since in that case its use should be equally efficacious, if it were worn + over a linen shirt; and an increased warmth of the room of the patient + would be equally serviceable.</p> + + <p><a name="species_IV_1_1_4">4</a>. <i>Digestio aucta frigore + cutaneo.</i> Digestion increased by coldness of the skin. Every one has + experienced the increase of his appetite after walking in the cool air in + frosty days; for there is at this time not only a saving of sensorial + power by the less exertion of the cutaneous vessels; but, as these + consent with those of the stomach and bowels, this saving of sensorial + power is transferred by reverse sympathy from the cutaneous capillaries + and absorbents to those of the stomach and intestines.</p> + + <p>Hence weak people should use the cold air of winter as a cold bath; + that is, they should stay in it but a short time at once, but should + immerse themselves in it many times a day.</p> + + <p><a name="species_IV_1_1_5">5</a>. <i>Catarrhus a frigore cutaneo.</i> + Catarrh from cold skin. This has been already explained in Class <a + href="#species_I_1_2_7">I. 1. 2. 7</a>. and is further described in Sect. + XXXV. 1. 3. In this disease the vessels of the membrane, which lines the + nostrils, are excited into greater action; when those of the skin, with + which they are associated, are excited into less action by the deficiency + of external heat, by reverse sympathy; and though the pain of cold + attends the torpor of the primary link of this association, yet the + increased motions of the membrane of the nostrils are associated with + those of the cutaneous vessels, and not with the pain of them, because no + inflammation follows.</p> + + <p><a name="species_IV_1_1_6">6</a>. <i>Absorptio cellularis aucta + vomitu.</i> In the act of vomiting the irritative motions of the stomach + are inverted, and of the absorbents, which open their mouths into it; + while the cutaneous, cellular, and pulmonary absorbents are induced, by + reverse sympathy with them, to act with greater energy. This is seen in + cases of anasarca, when long sickness and vomiting are caused by squills, + or antimonial salts, or most of all by the decoction of digitalis + purpurea, foxglove; and Mr. J. Hunter mentions a case, in which a large + bubo, which was just ready to break, was absorbed in a few days by + sickness at sea. Treatise on the Blood, p. 501, which is thus accounted + for; less sensorial power is expended during sickness by the decreased + action of the fibres of the stomach, and of its absorbents; as shewn in + Sect. XXXV. 1. 3. whence an accumulation of it is produced, and there is + in consequence a greater quantity of sensorial power for the exertion of + those motions, which are associated with the absorbents of the stomach by + reverse sympathy.</p> + + <p>The reverse sympathy between the lacteal and lymphatic branches of the + absorbent system have been produced by the one branch being less excited + to act, when the other supplies sufficient fluid or nutriment to the + sanguiferous vessels. Thus when the stomach is full, and the supply of + chyle and mucus and water is in sufficient quantity; the pulmonary, + cellular, and cutaneous lymphatics are not excited into action; whence + the urine is pale, and the skin moist, from the defect of absorption on + those surfaces.</p> + + <p><a name="species_IV_1_1_7">7</a>. <i>Syngultus nephriticus.</i> When a + stone irritates the ureter, and that even without its being attended with + pain or fever, sometimes a chronical hiccough occurs, and continues for + days and weeks, instead of sickness or vomiting; which are the common + symptoms. In this case the motions of the stomach are decreased by their + sympathy with those of the ureter, which are increased by the stimulus of + the stone in it; and the increased motions of the diaphragm seem to exist + in consequence of their association with the stomach by a second reverse + sympathy. This hiccough may nevertheless admit of another explanation, + and be supposed to be a convulsive exertion of the diaphragm to relieve + the disagreeable sensation of the stomach in consequence of its + disordered irritative associations; and in that case it would belong to + Class <a href="#genus_III_1_1">III. 1. 1</a>. See Class <a + href="#genus_IV_2_1">IV. 2. 1</a>. for another example of tertiary + association.</p> + + <p>M. M. Venesection. Emetic. Calomel. Cathartic, opium, oil of cinnamon + from two to ten drops. Aerated alcaline water. Peruvian bark.</p> + + <p><a name="species_IV_1_1_8">8</a>. <i>Febris irritativa.</i> Irritative + fever, described in Class <a href="#species_I_1_1_1">I. 1. 1. 1</a>. The + diseases above explained in this genus are chiefly concerning the + sympathies of the absorbent system, or the alimentary canal, which are + not so much associated with the arterial system, as to throw it into + disorder, when they are slightly deranged; but when any great congeries + of conglomerate glands, which may be considered as the extremities of the + arterial system, are affected with torpor, the whole arterial system and + the heart sympathize with the torpid glands, and act with less energy; + which constitutes the cold fit of fever; which is therefore at first a + decreased action of the associate organ; but as this decrease of action + is only a temporary effect, and an increase of exertion both of the + torpid glands, and of the whole arterial system, soon follows; the hot + fit of irritative fever, or fever with strong pulse, properly belongs to + this class and genus of diseases.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_1_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + + <p>The primary links of the associated actions of this genus are either + produced or attended by painful or pleasurable sensation. The secondary + links of the first ten species are attended with increased motions + without inflammation, those of the remainder are attended with + inflammation. All inflammations, which do not arise in the part which was + previously torpid, belong to this genus; as the gout, rheumatism, + erysipelas. It is probable many other inflammations may, by future + observation, require to be transplanted into this class.</p> + + <p>The circles of sensitive associate motions consist chiefly of the + excretory ducts of the capillaries and of the mouths of the absorbent + vessels, which constitute the membranes; and which have been induced into + action at the same time; or they consist of the terminations of canals; + or of parts which are endued with greater sensibility than those which + form the first link of the association. An instance of the first of those + is the sympathy between the membranes of the alveolar processes of the + jaws, and the membranes above or beneath the muscles about the temples in + hemicrania. An instance of the second is in the sympathy between the + excretory duct of the lacrymal gland, and the nasal duct of the lacrymal + sack. And an instance of the third is the sympathy between the membranes + of the liver, and the skin of the face in the gutta rosea of + inebriates.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_1_2_1">1</a>. <i>Lacrymarum fluxus + sympatheticus.</i> A flow of tears from grief or joy. When the + termination of the duct of the lacrymal sac in the nostrils becomes + affected either by painful or pleasurable sensations, in consequence of + external stimulus, or by its association with agreeable or disagreeable + ideas, the motions of the lacrymal gland are at the same time exerted + with greater energy, and a profusion of tears succeeds by sensitive + association, as explained in Sect. XVI. 8. 2.</p> + + <p>In this case there exists a chain of associated actions, the secretion + of the lacrymal gland is increased by whatever stimulates the surface of + the eye, at the same time the increased abundance of tears stimulates the + puncta lacrymalia into greater action; and the fluid thus absorbed + stimulates the lacrymal sac, and its nasal duct in the nose into greater + action. In a contrary direction of this chain of association the present + increase of action is induced. First, the nasal duct of the lacrymal sac + is excited into increased action by some pleasurable or painful idea, as + described in Sect. XVI. 8. 2. 2d. The puncta lacrymalia or other + extremity of the lacrymal sac sympathizes with it (as the two ends of all + other canals sympathize with each other). 3d. With these increased + motions of the puncta lacrymalia those of the excretory duct of the + lacrymal gland are associated from their having so perpetually acted + together. And, lastly, with the increased actions of the excretory duct + of this gland are associated those of the other end of it by their + frequently acting together; in the same manner as the extremities of + other canals are associated; and thus a greater flow of tears is poured + into the eye.</p> + + <p>When a flow of tears is produced in grief, it is believed to relieve + the violence of it, which is worthy a further inquiry. Painful + sensations, when great, excite the faculty of volition; and the person + continues voluntarily to call up or perform those ideas, which occasion + the painful sensation; that is, the afflicted person becomes so far + insane or melancholy; but tears are produced by the sensorial faculty of + association, and shew that the pain is so far relieved as not to excite + the excessive power of volition, or insanity, and are therefore a sign of + the abatement of the painful state of grief, rather than a cause of that + abatement. See Class <a href="#species_III_1_2_10">III. 1. 2. 10</a>.</p> + + <p><a name="species_IV_1_2_2">2</a>. <i>Sternutatio a lumine.</i> Some + persons sneeze from looking up at the light sky in a morning after coming + out of a dark bedroom. The olfactory nerves are brought into too great + action by their sympathy with the optic nerves, or by their respective + sympathies with some intervening parts, as probably with the two + extremities of the lacrymal sac; that is, with the puncta lacrymalia and + the nasal duct. See Class <a href="#species_II_1_1_3">II. 1. 1. + 3</a>.</p> + + <p><a name="species_IV_1_2_3">3</a>. <i>Dolor dentium Stridore.</i> + Tooth-edge from grating sounds, and from the touch of certain substances, + and even from imagination alone, is described and explained in Sect. XVI. + 10. The increased actions of the alveolar vessels or membranes are + associated with the ideas, or sensual motions of the auditory nerves in + the first case; and of those of the sense of touch, in the second case; + and by imagination, or ideas exerted of painful sensation alone, in the + last.</p> + + <p><a name="species_IV_1_2_4">4</a>. <i>Risus sardonicus.</i> A + disagreeable smile attends inflammations of the diaphragm arising from + the associations of the reiterated exertions of that muscle with those of + the lips and cheeks in laughing. See Diaphragmitis, Class <a + href="#species_II_1_2_6">II. 1. 2. 6</a>.</p> + + <p><a name="species_IV_1_2_5">5</a>. <i>Salivæ fluxus cibo viso.</i> The + flow of saliva into the mouths of hungry animals at the sight or smell of + food is seen in dogs standing round a dinner-table. The increased actions + of the salivary glands have been usually produced by the stimulus of + agreeable food on their excretory ducts during the mastication of it; and + with this increased action of their excretory ducts the other + terminations of those glands in the capillary arteries have been excited + into increased action by the mutual association of the ends of canals; + and at the same time the pleasurable ideas, or sensual motions, of the + sense of smell and of sight have accompanied this increased secretion of + saliva. Hence this chain of motions becomes associated with those visual + or olfactory ideas, or with the pleasure, which produces or attends + them.</p> + + <p><a name="species_IV_1_2_6">6</a>. <i>Tensio mamularum viso + puerulo.</i> The nipples of lactescent women are liable to become turgid + at the sight of their young offspring. The nipple has generally been + rendered turgid by the titillation of the lips or gums of the child in + giving suck; the visible idea of the child has thus frequently + accompanied this pleasurable sensation of parting with the milk, and + turgescence of the tubes, which constitute the nipple. Hence the visual + idea of the child, and the pleasure which attends it, become associated + with those increased arterial actions, which swell the cells of the + mamula, and extend its tubes; which is very similar to the tensio phalli + visâ muliere nudâ etiam in insomnio.</p> + + <p><a name="species_IV_1_2_7">7</a>. <i>Tensio penis in hydrophobia.</i> + An erection of the penis occurs in the hydrophobia, and is a troublesome + symptom, as observed by Cœlius Aurelianus, Fothergill, and Vaughn, + and would seem to be produced by an unexplained sympathy between the + sensations about the fauces and the penis. In men the hair grows about + both these parts, the voice changes, and the neck thickens at puberty. In + the mumps, when the swellings about the throat subsides, the testicles + are liable to swell. Venereal infection received by the penis is very + liable to affect the throat with ulcers. Violent coughs, with soreness or + rawness about the fauces are often attended with erection of the penis; + which is also said to happen to male animals, that are hanged; which last + circumstance has generally been ascribed to the obstruction of the + circulation of the blood, but is more probably occasioned by the stimulus + of the cord in compressing the throat; since if it was owing to impeded + circulation it ought equally to occur in drowning animals.</p> + + <p>In men the throat becomes so thickened at the time of puberty, that a + measure of this is used to ascertain the payment of a poll-tax on males + in some of the islands of the Mediterranean, which commences at puberty; + a string is wrapped twice round the thinnest part of the neck, the ends + of it are then put into each corner of the mouth; and if, when thus held + in the teeth, it passes readily over the head, the subject is + taxable.</p> + + <p>It is difficult to point out by what circumstance the sensitive + motions of the penis and of the throat and nose become associated; I can + only observe, that these parts are subjected to greater pleasurable + sensations than any other parts of the body; one being designed to + preserve ourselves by the pleasure attending the smell and deglutition of + food, and the other to ensure the propagation of our species; and may + thus gain an association of their sensitive motion by their being + eminently sensible to pleasure. See Class <a href="#species_I_3_1_11">I. + 3. 1. 11</a>. and <a href="#species_III_1_1_15">III. 1. 1. 15</a>. and + Sect. XVI. 5.</p> + + <p>In the female sex this association between the face, throat, nose, and + pubis does not exist; whence no hair grows on their chins at the time of + puberty, nor does their voices change, or their necks thicken. This + happens probably from there being in them a more exquisite sensitive + sympathy between the pubis and the breasts. Hence their breasts swell at + the time of puberty, and secrete milk at the time of parturition. And in + the parotitis, or mumps, the breasts of women swell, when the tumor of + the parotitis subsides. See Class <a href="#species_I_1_2_15">I. 1. 2. + 15</a>. Whence it would appear, that their breasts possess an + intermediate sympathy between the pubis and the throat; as they are the + seat of a passion, which men do not possess, that of suckling + children.</p> + + <p><a name="species_IV_1_2_8">8</a>. <i>Tenesmus calculosus.</i> The + sphincter of the rectum becomes painful or inflamed from the association + of its sensitive motions with those of the sphincter of the bladder, when + the latter is stimulated into violent pain or inflammation by a + stone.</p> + + <p><a name="species_IV_1_2_9">9</a>. <i>Polypus narium ex + ascaridibus?</i> The stimulation of ascarides in the rectum produces by + sensitive sympathy an itching of the nose, as explained in <a + href="#species_IV_2_2_6">IV. 2. 2. 6</a>; and in three children I have + seen a polypus in the nose, who were all affected with ascarides; to the + perpetual stimulation of which, and the consequent sensitive association, + I was led to ascribe the inflammation and thickening of the membrane of + the nostrils.</p> + + <p><a name="species_IV_1_2_10">10</a>. <i>Crampus surarum in cholera.</i> + A cramp of the muscles of the legs occurs in violent diarrhœa, or + cholera, and from the use of too much acid diet in gouty habits. This + seems to sympathize with uneasy sensation in the bowels. See Class <a + href="#species_III_1_1_14">III. 1. 1. 14</a>. This association is not + easily accounted for, but is analogous in some degree to the paralysis of + the muscles of the arms in colica saturnina. It would seem, that the + muscles of the legs in walking get a sympathy with the lower parts of the + intestines, and those of the arms in variety of employment obtain a + sympathy with the higher parts of them. See Cholera and Ileus.</p> + + <p><a name="species_IV_1_2_11">11</a>. <i>Zona ignea nephritica.</i> + Nephritic shingles. The external skin about the loins and sides of the + belly I suppose to have greater mobility in respect to sensitive + association, than the external membrane of the kidney; and that their + motions are by some unknown means thus associated. When the torpor or + beginning inflammation of this membrane ceases, the external skin becomes + inflamed, in its stead, and a kind of herpes, called the shingles, covers + the loins and sides of the belly. See Class <a + href="#species_II_1_5_9">II. 1. 5. 9</a>.</p> + + <p><a name="species_IV_1_2_12">12</a>. <i>Eruptio variolarum.</i> After + the inflammation of the inoculated arm has spread for a quarter of a + lunation, it affects the stomach by reverse sympathy; that is, the + actions of the stomach are associated with those of the skin; and as much + sensorial power is now exerted on the inflamed skin, the other part of + this sensitive association is deprived of its natural share, and becomes + torpid, or inverts its motions. After this torpor of the stomach has + continued a time, and much sensorial power is thus accumulated; other + parts of the skin, which are also associated with it, as that of the face + first, are thrown into partial inflammation; that is, the eruptions of + the small-pox appear on the face.</p> + + <p>For that the variolous matter affects the stomach previous to its + eruption on the skin appears from the sickness at the commencement of the + fever; and because, when the morbid motions affect the skin, those of the + stomach cease; as in the gout and erysipelas, mentioned below. The + consent between the stomach and the skin appears in variety of other + diseases; and as they both consist of surfaces, which absorb and secrete + a quantity of moisture, their motions must frequently be produced + together or in succession; which is the foundation of all the sympathies + of animal motions, whether of the irritative, sensitive, or voluntary + kinds.</p> + + <p>Now as the skin, which covers the face, is exposed to greater + variations of heat and cold than any other part of the body; it probably + possesses more mobility to sensitive associations, not only than the + stomach, but than any other part of the skin; and is thence affected at + the eruption of the small-pox with violent action and consequent + inflammation, by the association of its motions with those of the + stomach, a day before the other parts of the skin; and becomes fuller of + pustules, than any other part of the body. See Class <a + href="#species_II_1_3_9">II. 1. 3. 9</a>.</p> + + <p>It might be supposed, that the successive swelling of the hands, when + the face subsides, at the height of the small-pox, and of the feet, when + the hands subside, were governed by some unknown associations of those + parts of the system; but these successions of tumor and subsidence more + evidently depend on the times of the eruption of the pustules on those + parts, as they appear a day sooner on the face than on the hands, and a + day sooner on the hands than on the feet, owing to the greater + comparative mobility of those parts of the skin.</p> + + <p><a name="species_IV_1_2_13">13</a>. <i>Gutta rosea stomatica.</i> + Stomatic red face. On drinking cold water, or cold milk, when heated with + exercise, or on eating cold vegetables, as raw turnips, many people in + harvest-time have been afflicted with what has been called a surfeit. The + stomach becomes painful, with indigestion and flatulency, and after a few + days an eruption of the face appears, and continues with some relief, but + not with entire relief; as both the pimpled face and indigestion are + liable to continue even to old age.</p> + + <p>M. M. Venesection. A cathartic with calomel. Then half a grain of + opium twice a day for many weeks. If saturated solution of arsenic three + or five drops twice or thrice a day for a week?</p> + + <p><a name="species_IV_1_2_14">14</a>. <i>Gutta rosea hepatica.</i> The + rosy drop of the face of some drinking people is produced like the gout + described below, in consequence of an inflamed liver. In these + constitutions the skin of the face being exposed to greater variation of + heat and cold than the membranes of the liver, possesses more mobility + than those hepatic membranes; and hence by whatever means these membranes + are induced to sympathize, when this sensitive association occurs, the + cutaneous vessels of the face run into greater degrees of those motions, + which constitute inflammation, than previously existed in the membranes + of the liver; and then those motions of the liver cease. See Class <a + href="#species_II_1_4_6">II. 1. 4. 6</a>.</p> + + <p>An inflammation of the liver so frequently attends the great potation + of vinous spirit, there is reason to suspect, that this viscus itself + becomes inflamed by sensitive association with the stomach; or that, when + one termination of the bile-duct, which enters the duodenum is stimulated + violently, the other end may become inflamed by sensitive + association.</p> + + <p><a name="species_IV_1_2_15">15</a>. <i>Podagra.</i> The gout, except + when it affects the liver or stomach, seems always to be a secondary + disease, and, like the rheumatism and erysipelas mentioned below, begins + with the torpor of some distant part of the system.</p> + + <p>The most frequent primary seat of the gout I suppose to be the liver, + which is probably affected with torpor not only previous to the annual + paroxysms of the gout, but to every change of its situation from one limb + to another. The reasons, which induce me to suspect the liver to be first + affected, are not only because the jaundice sometimes attends the + commencement of gout, as described in Sect. XXIV. 2. 8. but a pain also + over the pit of the stomach, which I suppose to be of the termination of + the bile-duct in the duodenum, and which is erroneously supposed to be + the gout of the stomach, with indigestion and flatulency, generally + attends the commencement of the inflammation of each limb. See Arthritis + ventriculi, Class <a href="#species_I_2_4_6">I. 2. 4. 6</a>. In the two + cases, which I saw, of the gout in the limbs being preceded by jaundice, + there was a cold shivering fit attended the inflammation of the foot, and + a pain at the pit of the stomach; which ceased along with the jaundice, + as soon as the foot became inflamed. This led me to suspect, that there + was a torpor of the liver, and perhaps of the foot also, but nevertheless + the liver might also in this case be previously inflamed, as observed in + Sect. XXIV. 2. 8.</p> + + <p>Now as the membranes of the joints of the feet suffer greater + variations of heat and cold than the membranes of the liver, and are more + habituated to extension and contraction than other parts of the skin in + their vicinity; I suppose them to be more mobile, that is, more liable to + run into extremes of exertion or quiescence; and are thence more + susceptible of inflammation, than such parts as are less exposed to great + variations of heat and cold, or of extension and contraction.</p> + + <p>When a stone presses into the sphincter of the bladder, the glans + penis is affected with greater pain by sympathy, owing to its greater + sensibility, than the sphincter of the bladder; and when this pain + commences, that of the sphincter ceases, when the stone is not too large, + or pushed too far into the urethra. Thus when the membrane, which covers + the ball of the great toe, sympathizes with some membranous part of a + torpid or inflamed liver; this membrane of the toe falls into that kind + of action, whether of torpor or inflammation, with greater energy, than + those actions excited in the diseased liver; and when this new torpor or + inflammation commences, that with which it sympathises ceases; which I + believe to be a general law of associated inflammations.</p> + + <p>The paroxysms of the gout would seem to be catenated with solar + influence, both in respect to their larger annual periods, and to their + diurnal periods—See Sect. XXXVI. 3. 6.—as the former occur + about the same season of the year, and the latter commence about an hour + before sun-rise; nevertheless the annual periods may depend on the + succession of great vicissitudes of cold and heat, and the diurnal ones + on our increased sensibility to internal sensations during sleep, as in + the fits of asthma, and of some epilepsies. See Sect. XVIII. 15.</p> + + <p>In respect to the pre-remote cause or disposition to the gout, there + can be no doubt of its individually arising from the potation of + fermented or spirituous liquors in this country; whether opium produces + the same effect in the countries, where it is in daily use, I have never + been well informed. See Sect. XXI. 10, where this subject is treated of; + to which I have to add, that I have seen some, and heard of others, who + have moderated their paroxysms of gout, by diminishing the quantity of + fermented liquors, which they had been accustomed to; and others who, by + a total abstinence from fermented liquors, have entirely freed themselves + from this excruciating malady; which otherwise grows with our years, and + curtails or renders miserable the latter half, or third, of the lives of + those, who are subject to it. The remote cause is whatever induces + temporary torpor or weakness of the system; and the proximate cause is + the inirritability, or defective irritation, of some part of the system; + whence torpor and consequent inflammation. The great Sydenham saw the + beneficial effects of the abstinence from fermented liquors in preventing + the gout, and adds, "if an empiric could give small-beer only to gouty + patients as a nostrum, and persuade them not to drink any other + spirituous fluids, that he might rescue thousands from this disease, and + acquire a fortune for his ingenuity." Yet it is to be lamented, that this + accurate observer of diseases had not resolution to practise his own + prescription, and thus to have set an example to the world of the truth + of his doctrine; but, on the contrary, recommends Madeira, the strongest + wine in common use, to be taken in the fits of the gout, to the detriment + of thousands; and is said himself to have perished a martyr to the + disease, which he knew how to subdue!</p> + + <p>As example has more forcible effect: than simple assertion, I shall + now concisely relate my own case, and that of one of my most respected + friends. E. D. was about forty years of age, when he was first seized + with a fit of the gout. The ball of his right great toe was very painful, + and much swelled and inflamed, which continued five or six days in spite + of venesection, a brisk cathartic with ten grains of calomel, and the + application of cold air and cold water to his foot. He then ceased to + drink ale or wine alone; confining himself to small beer, or wine diluted + with about thrice its quantity of water. In about a year he suffered two + other fits of the gout, in less violent degree. He then totally abstained + from all fermented liquors, not even tasting small-beer, or a drop of any + kind of wine; but eat plentifully of flesh-meat, and all kinds of + vegetables, and fruit, using for his drink at meals chiefly water alone, + or lemonade, or cream and water; with tea and coffee between them as + usual.</p> + + <p>By this abstinence from fermented liquors he kept quite free from the + gout for fifteen or sixteen years; and then began to take small-beer + mixed with water occasionally, or wine and water, or perry and water, or + cyder and water; by which indulgence after a few months he had again a + paroxysm of gout, which continued about three days in the ball of his + toe; which occasioned him to return to his habit of drinking water, and + has now for above twenty years kept in perpetual health, except + accidental colds from the changes of the seasons. Before he abstained + from fermented or spirituous liquors, he was frequently subject to the + piles, and to the gravel, neither of which he has since experienced.</p> + + <p>In the following case the gout was established by longer habit and + greater violence, and therefore required more cautious treatment. The + Rev. R. W. was seized with the gout about the age of thirty-two, which + increased so rapidly that at the age of forty-one he was confined to his + room seven months in that year; he had some degree of lameness during the + intervals, with chalky swellings of his heels and elbows. As the disease + had continued so long and so violently, and the powers of his digestion + were somewhat weakened, he was advised not entirely to leave off all + fermented liquors; and as small-beer is of such various strength, he was + advised to drink exactly two wine glasses, about four ounces, of wine + mixed with three or four times its quantity of water, with or without + lemon and sugar, for his daily potation at dinner, and no other fermented + liquor of any kind; and was advised to eat flesh-meat with any kind of + boiled vegetables, and fruit, with or without spice. He has now + scrupulously continued this regimen for above five years, and has had an + annual moderate gouty paroxysm of a few weeks, instead of the confinement + of so many months, with great health and good spirits during the + intervals.</p> + + <p>The following is a more particular account of the history of this + case; being part of a letter which Mr. Wilmot wrote on that subject at my + entreaty.</p> + +<blockquote class="b1n"> + + <p>"I entered into the army with an excellent constitution at the age of + fifteen. The corps I served in was distinguished by its regularity, that + is, the regular allowance of the mess was only one pint of wine per man + each day; unless we had company to dine with us; then, as was the general + custom of the time, the bottle circulated without limit. This mode of + living, though by no means considered as excess for men, was certainly + too great for a youth of my age. This style of living I continued, when + with the regiment, till the latter end of the year 1769, when I had the + misfortune to sleep in a damp bed at Sheffield on a journey to York, but + arrived there before I felt the ill effects of it. I was then seized with + a violent inflammatory rheumatism with great inflammation of my eyes, and + was attended by Dr. Dealtry; so violent was the disorder, that I was bled + for it eight times in less than a fortnight; and was three months, before + I could consider my health perfectly re-established. Dr. Dealtry told me, + that I should be subject to similar attacks for many years; and that he + had no doubt, from the tendency he found in my habit to inflammation, + that, when I was farther advanced in life, I should change that complaint + for the gout. He predicted truly; for the three succeeding winters I had + the same complaint, but not so violently; the fourth winter I escaped, + and imputed my escape to the continuance of cold bathing during the whole + of that winter; after that I never escaped it, till I had a regular and + severe fit of the gout: after the first attack of rheumatic fever I was + more abstemious in my manner of living, though when in company I never + subjected myself to any great restraint. In the year 1774 I had quitted + the army, and being in a more retired situation, was seldom led into any + excess; in 1776 and 1777 I was in the habit of drinking a good deal of + wine very frequently, though not constantly. After that period till the + year 1781, I drank a larger quantity of wine regularly, but very seldom + to any degree of intoxication. I lived much at that time in the society + of some gentlemen, who usually drank nearly a bottle of wine daily after + dinner. I must here however observe, that at no part of my life was I + accustomed to drink wine in an evening, and very seldom drank any thing + more than a single half-pint glass of some sort of spirits diluted with + much water. Till the year 1781 I had always been accustomed to use very + violent and continued exercise on horseback; in the winter months I + pursued all field diversions, and in the summer months I rode frequent + and long journeys; and with this exercise was liable to perspire to great + excess; besides which I was subject to very profuse night-sweats, and had + frequently boils break out all over me, especially in the spring and + autumn; for which I took no medicine, except a little flour of sulphur + with cream of tartar in honey.</p> + + <p>"You will observe I bring every thing down to the date of 1781. In the + month of October in that year, when I was just entered into the + thirty-second year of my age, I had the first attack of gout; that fit + was very severe, and of many weeks continuance. I now determined upon a + more abstemious method of living, in respect to wine; and indeed the + society, in which I had before been accustomed to live, being + considerably changed, I had less frequent temptations to excess. From + this time I enjoyed the most perfect good state of health till August + 1784, when I had my second attack of gout. I never perfectly recovered + from this attack through the succeeding winter, and in March 1785 was + advised to try the Bath waters, and drank them under the direction of one + of the faculty of that place. I was there soon seized with a fever, and a + slight attack of gout in one knee. I should observe, that when I set out + from home, I was in a weak and low state, and unequal to much fatigue; as + appeared by my having a fainting fit one day on the road, after having + travelled only about fifty miles; in the course of the summer I had two + or three more slight attacks of gout of less consequence, till the month + of October; when I was afflicted with it all over me in such a manner, as + to be without the possibility of the least degree of removal for some + days; and was about two months without being able to get into the air. + This was the severest attack I had then experienced; though I have since + had several equally severe. In the course of this summer I had a fall + with my horse; and soon after it, having discovered an enlargement on one + elbow, I concluded I had hurt it at that time; but in the course of this + last attack having a similar enlargement on the other elbow, I found my + mistake, and that they were collections of gouty matter; these increased + to the size of pullet's eggs, and continue in that state. I had soon + after similar enlargements on my heels; the right heel being severely + bruised, I was under the necessity of having it lanced, and a large + quantity of chalky matter was discharged from it; and have since that + time frequently had chalky matter taken from it, and sometimes small bits + of apparently perfect chalk. My right hand soon was afflicted in the same + way, and I have scarcely a joint on those fingers now in a natural state. + My left hand has escaped tolerably well. After this last attack (viz. + October 1785), I had two or three slight attacks before the month of June + 1787, when I had a very severe intermittent fever; from that time I + continued very well till the latter end of the year, when I began to feel + the gout about me very much, but was not confined by it. I was in this + state advised to try what is called the American Recipe (gum guaiacum and + nitre dissolved in spirits); it had apparently been of essential service + to a friend of mine, who from the inability to walk a mile for some + years, was believed to be restored by the use of this medicine to a good + state of health, so as to walk ten miles a day. In addition to this + medicine I drank, as my common beverage with my meals, spruce beer. I had + so high an opinion of this medicine in the gout, and of spruce beer as an + antiscorbutic, that I contemplated with much satisfaction, and with very + little doubt, the perfect restoration of my health and strength; but I + was miserably deceived; for in September 1788 I was seized with the gout + in a degree that none but arthritics, and indeed but few of those, can + easily conceive. From this time till August 1789 I scarcely ever passed a + comfortable day; seven months of this time I had been confined, my health + seemed much impaired, my strength was diminished, and my appetite almost + gone. In this state my friends pressed me to consult you. I was unwilling + for some time to do it, as I had lost all hope of relief; however, when I + had determined to apply to you, I likewise determined to give up every + prejudice of my own respecting my case, and to adhere most strictly to + your advice. On the 20th of August 1789 I consulted you, on the 25th I + entered upon the regimen, which you prescribed, and which was as + follows.</p> + + <p>"Drink no malt liquor on any account. Let your beverage at dinner + consist of two glasses of wine diluted with three half-pints of water. On + no account drink any more wine or spirituous liquors in the course of the + day; but, if you want more liquid, take cream and water, or milk and + water, or lemonade, with tea, coffee, chocolate. Use the warm bath twice + a week for half an hour before going to bed, at the degree of heat which + is most grateful to your sensations. Eat meat constantly at dinner, and + with it any kind of tender vegetables you please. Keep the body open by + two evacuations daily, if possible without medicine, if not take the size + of a nutmeg of lenitive electuary occasionally, or five grains of rhubarb + every night. Use no violent exercise, which may subject yourself to + sudden changes from heat to cold; but as much moderate exercise as may + be, without being much fatigued or starved with cold. Take some supper + every night; a small quantity of animal food is preferred; but if your + palate refuses this, take vegetable food, as fruit pie, or milk; + something should be eaten, as it might be injurious to you to fast too + long." To the whole of this I adhered most scrupulously, and soon found + my appetite improve, and with it my strength and spirits. I had in + December a fevere attack, and two or three slight ones in the course of + twelve months; but the improvement in the general state of my health + induced me to persevere. On the 18th of August 1790 I had another severe + attack, but it went off easier than before, and I soon recovered + sufficiently to go to Buxton, which you advised me to, and from which I + reaped great benefit; nevertheless on the 29th of December I had a slight + attack in comparison of some that I had before experienced, and from that + time I was free from gout, and enjoyed my health perfectly well till the + fourth week in October 1791; from that till the third week in October + 1792; from that till the third week in October 1793; and from that till + June 1794. From what happened for the last three years I dreaded the + month of October; but I escaped then, and have enjoyed my health most + perfectly ever since till within the last week, that I have had a slight + attack in one knee, which is nearly gone, without any symptom to lead me + to suppose that it will go further.</p> + + <p>"I adhered to your advice most scrupulously for the first year; and in + regard to the not drinking malt liquor, and taking only the two glasses + of wine with water, I have never deviated but two days; and then the + first day I only drank one glass of ale and one glass of Champaigne; on + the second only one glass of Champaigne. With regard to the warm bath, I + only use it now when I have gouty symptoms upon me, and in such + situations I find it of infinite service; and in other respects I + continue to live according to your direction.</p> + + <p>"Many persons have laughed at the idea of my perseverance in a system, + which has not been able to <i>cure</i> the gout after five years trial; + but such persons are either ignorant of what I before suffered, or + totally unacquainted with the nature of the disorder. Under the blessing + of Providence, by an adherence to your advice, I am reaping all the + benefit you flattered me I might expect from it, viz. my attacks less + frequent, my sufferings less acute, and an improvement in the general + state of my health.</p> + + <p>"I have been particular in this account of myself at your request, and + am, Sir, &c.</p> + + <div class="poem"> + <div class="stanza"> + <p><span class="sc">Morley</span>, near <span class="sc">Derby</span>,</p> + <p>February 10th, 1795.</p> + <p><span class="sc">Robert Wilmot.</span>"</p> + </div> + </div> + +</blockquote> + + <p>There are situations nevertheless in which a paroxysm of gout has been + believed to be desirable, as relieving the patient from other + disagreeable diseases, or debilities, or sensations. Thus when the liver + is torpid, a perpetual uneasiness and depression of spirits occur; which + a fit of gout is supposed to cure by a metastasis of the disease. Others + have acquired epileptic fits, probably from the disagreeable sensation of + a chronically inflamed liver; which they suppose the pain and + inflammation of gout would relieve. When gouty patients become much + debilitated by the progress of the disease, they are liable to dropsy of + the chest, which they suppose a fit of the gout would relieve. But in all + these cases the attempt to procure a paroxysm of gout by wine, or + aromatics, or volatiles, or blisters, or mineral waters, seldom succeeds; + and the patients are obliged to apply to other methods of relief adapted + to their particular cases. In the two former situations small repeated + doses of calomel, or mercurial unction on the region of the liver may + succeed, by giving new activity to the vessels of the liver, either to + secrete or to absorb their adapted fluids, and thus to remove the cause + of the gout, rather than to promote a fit of it. In the last case the + tincture of digitalis, and afterwards the class of sorbentia, must be + applied to.</p> + + <p>M. M. In young strong patients the gout should be cured by venesection + and cathartics and diluents, with poultices externally. But it has a + natural crisis by producing calcareous matter on the inflamed membrane, + and therefore in old enfeebled people it is safest to wait for this + crisis, attending to the natural evacuations and the degree of fever; and + in young ones, where it is not attended with much fever, it is customary + and popular not to bleed, but only to keep the body open with aloes, to + use gentle sudorifics, as neutral salts, and to give the bark at the + decline of the fit; which is particularly useful where the patient is + much debilitated. See Arthritis ventriculi, Class <a + href="#species_I_2_4_6">I. 2. 4. 6</a>. and Sect. XXV. 17.</p> + + <p>When there is not much fever, and the patient is debilitated with age, + or the continuance of the disease, a moderate opiate, as twenty drops of + tincture of opium, or one grain of solid opium, may be taken every night + with advantage. Externally a paste made with double the quantity of yeast + is a good poultice; and booterkins made with oiled silk, as they confine + the perspirable matter, keep the part moist and supple, and thence + relieve the pain like poultices.</p> + + <p>The only safe way of moderating the disease is by an uniform and equal + diminution, or a total abstinence from fermented liquors, with the + cautions directed in Sect. XII. 7. 8. The continued use of strong + bitters, as of Portland's powder, or bark, has been frequently injurious, + as spoken of in the Materia Medica, Art. <a href="#art_IV_2_11">IV. 2. + 11</a>.</p> + + <p>One of my acquaintance, who was much afflicted with the gout, + abstained for about half a year from beer and wine; and not having + resolution to persist, returned to his former habits of potation in less + quantity; and observed that he was then for one winter stronger and freer + from the gout than usual. This however did not long continue, as the + disease afterwards returned with its usual or increased violence. This I + think is a circumstance not unlikely to occur, as opium has a greater + effect after its use has been a while intermitted; and the debility or + torpor, which is the cause of gout, is thus for a few months prevented by + the greater irritability of the system, acquired during the lessened use + of fermented liquor.</p> + + <p>For the same reason an ounce of spirituous tincture of guaiacum, or of + bark, is said to have for some time prevented returns of the gout; which + has afterwards, like all other great stimuli when long continued, been + succeeded by greater debility, and destroyed the patient. This seems to + have been exemplified in the case of the ingenious Dr. Bown, see Preface + to his Elementa Medicinæ; he found temporary relief from the stimulus of + wine, regardless of its future effects.</p> + + <p><a name="species_IV_1_2_16">16</a>. <i>Rheumatismus.</i> Acute + rheumatism. There is reason to suspect, that rheumatic inflammations, + like the gouty ones, are not a primary disease; but that they are the + consequence of a translation of morbid action from one part of the system + to another. This idea is countenanced by the frequent change of place of + rheumatic-like gouty inflammations, and from their attacking two similar + parts at the same time, as both ankles and both wrists, and these attacks + being in succession to each other. Whereas it is not probable that both + feet or both hands should at the same time be equally exposed to any + external cause of the disease, as to cold or moisture; and less so that + these should occur in succession. Lastly, from the inflammatory diathesis + in this disease being more difficult to subdue, and more dangerous in + event, than other common inflammations, especially to pregnant women, and + in weak constitutions.</p> + + <p>From this idea of the rheumatism being not a primary disease, like the + gout, but a transferred morbid action owing to the previous torpor of + some other part of the system, we perceive why it attacks weak people + with greater pertinacity than strong ones; resisting or recurring again + and again after frequent evacuations, in a manner very different from + primary inflammations; because the cause is not removed, which is at a + distance from the seat of the inflammation.</p> + + <p>This also accounts for rheumatic inflammations so very rarely + terminating in suppuration, because like the gout the original cause is + not in the inflamed part, and therefore does not continue to act after + the inflammation commences. Instead of suppuration in this disease, as + well as in the gout, a quantity of mucus or coagulable lymph is formed on + the inflamed membrane; which in the gout changes into chalkstones, and in + the rheumatism is either reabsorbed, or lies on the membrane, producing + pains on motion long after the termination of the inflammation, which + pains are called chronic rheumatism. The membranes, which have thus been + once or repeatedly inflamed, become less mobile, or less liable to be + affected by sympathy, as appears by the gout affecting new parts, when + the joints of the foot have been frequently inflamed by it; hence as the + cause of the inflammation does not exist in the inflamed part, and as + this part becomes less liable to future attacks, it seldom + suppurates.</p> + + <p>Secondly, when rheumatism affects the muscles of the chest, it + produces symptoms similar to pleurisy, but are distinguished from that by + the patient having previously suffered rheumatic affections in other + parts, and by the pertinacity or continuance of the inflammatory state of + the patient, this should be termed pleurodyne rheumatica.</p> + + <p>Thirdly, when rheumatic inflammation affects the bowels, it produces a + disease very different from enteritis, or common inflammation of the + bowels, and should be termed enteralgia rheumatica. The pain is less than + in enteritis, and the disease of longer continuance, with harder pulse, + and the blood equally sizy. It is attended with frequent dejections, with + much mucus, and previous griping pains, but without vomiting; and differs + perhaps from dysentery from its not being attended with bloody stools, + and not being infectious.</p> + + <p>Fourthly, there is another kind of rheumatism attended with debility, + which suppurates, and should be termed rheumatismus suppurans. It is + generally believed to be the gout, till suppuration takes place on the + swelled joint; and, as the patient sinks, there are sloughs formed over + the whole mouth; and he seems to be destroyed by inflammation or gangrene + of the mucous membranes. I have twice seen this disease in patients about + sixty. Some other diseases are erroneously called rheumatic, as + hemicrania, and odontalgia. See Sect. XXVI. 3.</p> + + <p>M.M. In the three former kinds venesection repeatedly. Cathartics. + Antimonials. Diluents. Neutral salts. Oil. Warm bath. Afterwards the + bark. Opium with or without ipecacuanha; but not till the patient is + considerably weakened. Sweats forced early in the disease do injury. + Opium given early in the disease prolongs it. In the last kind, gentle + stimulants, as wine and water, mucilage, sorbentia.</p> + + <p>The following is a case of suppurative rheumatism. Mr. + F——, about sixty, was supposed to have the gout in his hand, + which however suppurated, and it was then called the suppurative + rheumatism. He had lived rather intemperately in respect to wine, and was + now afflicted with a tendency to inflammation of the mucous membranes. As + he lay on the bed half resupine, propped up with pillows, and also slept + in that posture, his lower jaw dropped by its own weight, when the + voluntary power of the muscles was suspended. The mucus of his mouth and + throat became quite dry, and at length was succeeded with sloughs; this + was a most distressing circumstance to him, and was in vain endeavoured + to be relieved by supporting his jaw by slender steel springs fixed to + his night-cap, and by springs of elastic gum. The sloughs spread and + seemed to accelerate his death. See Class <a href="#species_I_1_3_2">I. + 1. 3. 2</a>.</p> + + <p><a name="species_IV_1_2_17">17</a>. <i>Erysipelas.</i> The erysipelas + differs from the zona ignea, and other species of herpes, in its being + attended with fever, which is sometimes of the sensitive irritated or + inflammatory kind, with strong and full pulse; and at other times with + weak pulse and great inirritability, as when it precedes or attends + mortifications. See Class <a href="#species_II_1_3_2">II. 1. 3. + 2</a>.</p> + + <p>Like the zona ignea above described, it seems to be a secondary + disease, having for its primary part the torpor or inflammation of some + internal or distant membrane, as appears from its so frequently attending + wounds; sometimes spreading from issues over the whole limb, or back, by + sympathy with a tendon or membrane, which is stimulated by the pease in + them. In its more violent degree I suppose that it sympathizes with some + extensive internal membranes, as of the liver, stomach, or brain. Another + reason, which countenances this idea, is, that the inflammation gradually + changes its situation, one part healing as another inflames; as happens + in respect to more distant parts in gout and rheumatism; and which seems + to shew, that the cause of the disease is not in the same place with the + inflammation. And thirdly, because the erysipelas of the face and head is + liable to affect the membranes of the brain; which were probably in these + cases the original or primary seat of the disease; and lastly, because + the fits of erysipelas, like those of the gout, are liable to return at + certain annual or monthly periods, as further treated of in Class <a + href="#species_II_1_3_2">II. 1. 3. 2</a>.</p> + + <p>Many cases of erysipelas from wounds or bruises are related in + Default's Surgical Journal, Vol. II. in which poultices are said to do + great injury, as well as oily or fatty applications. Saturnine solutions + were sometimes used with advantage. A grain of emetic tartar given to + clear the stomach and bowels, is said to be of great service.</p> + + <p><a name="species_IV_1_2_18">18</a>. <i>Testium tumor in + gonorrhœa.</i> Mr. Hunter in his Treatise on the Venereal Disease + observes, that the tumor of the testes in gonorrhœa arises from + their sympathy with the inflammation of the urethra; and that they are + not similar to the actions arising from the application of venereal + matter, whether by absorption or otherwise; as they seldom or never + suppurate; and when suppuration happens, the matter produced is not + venereal. Treatise on Venereal Disease, p. 53.</p> + + <p><a name="species_IV_1_2_19">19</a>. <i>Testium tumor in + parotidite.</i> The sympathy between some parts about the throat and the + genitals has been treated of in Class <a href="#species_IV_1_2_7">IV. 1. + 2. 7</a>. The swelling of the testes, when that of the parotis subsides, + seems to arise from the association of successive action; as the tension + of the penis in hydrophobia appears to arise from the previous + synchronous associations of the sensitive motions of these parts; but the + manner of the production of both these associations is yet very obscure. + In women a swelling of the breasts often succeeds the decline of the + mumps by another wonderful sympathy. See Class <a + href="#species_IV_1_2_7">IV. 1. 2. 7</a>. and <a + href="#species_I_1_2_15">I. 1. 2. 15</a>. In many persons a delirium + succeeds the swelling of the parotis, or the subsequent ones of the + testes or breasts; which is sometimes fatal, and seems to arise from a + sympathy of successive action, and not of synchronous action, of the + membranes of the brain with those of the parotide glands. Sometimes a + stupor comes on instead of this delirium, which is relieved by fomenting + the shaved head for an hour or two. See Class <a + href="#species_II_1_3_4">II. 1. 3. 4</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_1_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_1_3_1">1</a>. <i>Deglutitio invita.</i> When any + one is told not to swallow his saliva, and that especially if his throat + be a little sore, he finds a necessity of immediately swallowing it; and + this the more certainly, the more he voluntarily endeavours not to do + so.</p> + + <p>In this case the voluntary power exerted by our attention to the + pharinx renders it more sensible to irritation, and therefore occasions + it to be more frequently induced to swallow the saliva. Here the + irritation induces a volition to swallow it, which is more powerful than + the desire not to swallow it. See XXIV. 1. 7. So in reverie, when the + voluntary power was exerted on any of the senses, as of sight or taste, + the objects of those senses became perceived; but not otherwise. Sect. + XIX. 6. This is a troublesome symptom in some sore throats.</p> + + <p>M. M. Mucilage, as sugar and gum arabic. Warm water held in the mouth + frequently, as a fomentation to the inflamed throat.</p> + + <p><a name="species_IV_1_3_2">2</a>. <i>Nictitatio invita.</i> + Involuntary winking with the eye-lids, and twitchings of the face, are + originally induced by an endeavour to relieve some disagreeable + sensations about inflamed eyes, as the dazzling of light; and afterwards + these motions become catenated with other motions or sensations, so as + not to be governed by the will. Here the irritation first produces a + volition to wink, which by habit becomes stronger than the anti-volition + not to wink.</p> + + <p>This subject is rendered difficult from the common acceptation of the + word, volition, including previous deliberation, as well as the voluntary + exertion, which succeeds it. In the volitions here spoken of there is no + time for deliberation or choice of objects, but the voluntary act + immediately succeeds the sensation which excites it.</p> + + <p>M. M. Cover the affected parts with a sticking plaster or a blister. + Pass a fine needle and thread through a part of the skin over the muscle, + which moves, and attach the other end of the thread by a sticking plaster + to a distant part. An issue behind the ear. To practise daily by a + looking-glass to stop the motions with the hand. See the cure of a case + of the leaping of a muscle of the arm, Sect. XVII. 1. 8. See Convulsio + debilis, Class <a href="#species_III_1_1_5">III. 1. 1. 5</a>.</p> + + <p><a name="species_IV_1_3_3">3</a>. <i>Risus invitus.</i> Involuntary + laughter. When the pleasure arising from new combinations of words and + ideas, as in puns; or of other circumstances, which are so trivial, as to + induce no voluntary exertion to compare or consider their present + importance or their future consequence; the pleasure is liable to rise + into pain; that is, the ideas or sensual motions become exerted too + violently for want of some antithetistic ideas; in the same manner as + those muscles, which have weak antagonists, as those of the calf of the + leg, are liable to fall into cramp or painful contraction. In this + situation a scream is begun to relieve this pain of ideas too violently + exerted, which is stopped again soon, as explained in Sect. XXXIV. 1. 4. + and Class <a href="#species_III_1_1_4">III. 1. 1. 4</a>. and <a + href="#species_IV_2_3_3">IV. 2. 3. 3</a>.</p> + + <p>The pain, into which this pleasure rises, which would excite the + scream of laughter, has been felt forcibly by every one; when they have + been under such circumstances, as have induced them to restrain it by a + counter-volition; till at length the increased associate motions produce + so much pain as to overcome the counter-volition, and the patient bursts + out into indecent laughter, contrary to his will in the common + acceptation of that word.</p> + + <p><a name="species_IV_1_3_4">4</a>. <i>Lusus digitorum invitus.</i> An + awkward playing with the fingers in speaking in public. These habits are + began through bashfulness, and seem rather at first designed to engage + the attention in part, and thus prevent the disagreeable ideas of + mauvaise hont; as timorous boys whistle, when they are obliged to walk in + the dark; and as it is sometimes necessary to employ raw soldiers in + perpetual manœuvres, as they advance to the first charge.</p> + + <p><a name="species_IV_1_3_5">5</a>. <i>Unguium morsiuncula invita.</i> + Biting the nails is a depraved habit arising from similar causes as those + of the last article.</p> + + <p>M. M. Dip the fingers in solution of aloes.</p> + + <p><a name="species_IV_1_3_6">6</a>. <i>Vigilia invita.</i> Watchfulness, + where the person wishes, and endeavours to fall asleep, properly belongs + to this place, as the wish or volition to sleep prevents the desired + effect; because sleep consists in an abolition of volition. See Class <a + href="#species_III_1_2_3">III. 1. 2. 3</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO I.</h3> + +<h3><i>Increased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_1_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_1_4_1">1</a>. <i>Vita ovi.</i> Life of an egg. The + eggs of fowls were shewn by Mr. J. Hunter to resist the freezing process + in their living state more powerfully, than when they were killed by + having the yolk and white shook together. Philos. Trans. It may be asked, + does the heat during the incubation of eggs act as a stimulus exciting + the living principle into activity? Or does it act simply as a causa sine + quâ non, as an influence, which penetrating the mass, removes the + particles of it to a greater distance from each other, so as to allow + their movement over each other, in the same manner as heat is conceived + to produce the fluidity of water; not by stimulus, but by its penetrating + influence? Or may elementary heat in its uncombined state be supposed to + act only as an influence necessary to life in its natural quantity; + whence torpor and death follows the eduction of it from the body; but in + its increased state above what is natural, or usual, that it acts as a + stimulus; which we have a sense to perceive; and which excites many parts + of the system into unnatural action? See Class <a + href="#head_IV_1_1_C">IV. 1. 1. C</a>.</p> + + <p><a name="species_IV_1_4_2">2</a>. <i>Vita hiemi-dormientium.</i> The + torpor of insects, and birds, and quadrupeds, during the cold season, has + been called sleep; but I suppose it must differ very much from that state + of animal life, since not only all voluntary power is suspended, but + sensation and vascular motion has ceased, and can only be restored by the + influence of heat. There have been related instances of snails, which + have recovered life and motion on being put into water after having + experienced many years of torpidity, or apparent death, in the cabinets + of the curious. Here the water as well as the heat are required not only + as a stimulus, but as a causa sine quâ non of fluidity and motion, and + consequent life.</p> + + <p><a name="species_IV_1_4_3">3</a>. <i>Pullulatio arborum.</i> The + annual revivescence of the buds of trees seems not only to be owing to + the influence of the returning warmth of the spring, but also to be + catenated with solar gravitation; because seeds and roots and buds, which + are analogous to the eggs of animals, put forth their shoots by a less + quantity of heat in spring, than they had undergone in the latter part of + autumn, which may however be ascribed to their previous torpid state, and + consequent accumulation of sensorial power, or irritability; as explained + in Botanic Garden, Part II. Cant. I. l. 322. note. Other circumstances, + which countenance the idea, that vegetation is affected by solar + gravitation, as well as by heat, may be observed in the ripening of the + seeds of plants both in those countries where the summers are short, and + in those where they are long. And by some flowers closing their bells at + noon, or soon after; and hence seem to sleep rather at solar diurnal + periods, than from the influence of cold, or the deficiency of light.</p> + + <p><a name="species_IV_1_4_4">4</a>. <i>Orgasmatis venerei periodus.</i> + The venereal orgasm of birds and quadrupeds commences or returns about + the vernal or autumnal equinoxes, and thence seems in respect to their + great periods to be governed by solar influence. But if this orgasm be + disappointed of its object, it is said to recur at about monthly periods, + as observed in mares and bitches in this respect resembling the female + catamenia. See Sect. XXXVI. 2. 3. and Sect. XVI. 13.</p> + + <p><a name="species_IV_1_4_5">5</a>. <i>Brachii concussio electrica.</i> + The movement of the arm, even of a paralytic patient, when an electric + shock is passed through it, is owing to the stimulus of the excess of + electricity. When a piece of zinc and silver, each about the size of a + crown-piece, are placed one under the upper lip, and the other on the + tongue, so as the outer edges may be brought into contact, there is an + appearance of light in the eyes, as often as the outer edges of these + metals are brought into contact or separated; which is another instance + of the stimulus of the passage of electric shocks through the fibres of + the organs of sense, as well as through the muscular fibres. See Sect. + XII. 1. 1. and first addit. note to Vol. I. of this work. But in its + natural state electricity seems only to act as an influence on animal and + vegetable bodies; of the salutary or injurious effects of which we have + yet no precise knowledge.</p> + + <p>Yet if regular journals were kept of the variations of atmospheric + electricity, it is probable some discoveries of its influence on our + system might in time be discovered. For this purpose a machine on the + principle of Mr. Bennet's electric doubler might be applied to the + pendulum of a clock, so as to manifest, and even to record the daily or + hourly variations of aerial electricity. Which has already been executed, + and applied to the pendulum of a Dutch wooden clock, by Mr. Bennet, + curate of Wirksworth in Derbyshire.</p> + + <p>Besides the variations of the degree or kind of atmospheric + electricity, some animals, and some men, seem to possess a greater power + of accumulating this fluid in themselves than others. Of which a famous + history of a Russian prince was lately published; who, during the clear + and severe frosts of that country, could not move himself in bed without + luminous corruscations. Such may have been the case of those people, who + have been related to have taken fire spontaneously, and to have been + reduced to ashes. The electric concussion from the gymnotus electricus, + and torpedo, are other instances of the power of the animal system to + accumulate electricity, as in these it is used as a weapon of defence, or + for the purpose of taking their prey.</p> + + <p>Some have believed that the accumulation or passage of the magnetic + fluid might affect the animal system, and have asserted that the + application of a large magnet to an aching tooth has quickly effected a + cure. If this experiment is again tried in odontalgia, or hemicrania, the + painful membrane of the tooth or head should be included between the + south and north poles of a horse-shoe magnet, or between the contrary + poles of two different magnets, that the magnetism may be accumulated on + the torpid part.</p> + + <p><a name="species_IV_1_4_6">6</a>. <i>Oxygenatio sanguinis.</i> The + variation of the quantity of oxygen gas existing in the atmosphere must + affect all breathing animals; in its excess this too must be esteemed a + stimulus; but in its natural quantity would seem to act as an influence, + or cause, without which, animal life cannot exist even a minute. It is + hoped that Dr. Beddoes's plan for a pneumatic infirmary, for the purpose + of putting this and various other airs to the test of experiment, will + meet with public encouragement, and render consumption, asthma, cancer, + and many diseases conquerable, which at present prey with unremitted + devastation on all orders and ages of mankind.</p> + + <p><a name="species_IV_1_4_7">7</a>. <i>Humectatio corporis.</i> Water, + and probably the vapour of water dissolved or diffused in the atmosphere, + unites by mechanical attraction with the unorganized cuticle, and softens + and enlarges it; as may be seen in the loose and wrinkled skin of the + hands of washerwomen; the same probably occurs to the mucous membrane of + the lungs in moist weather; and by thickening it increases the difficulty + of respiration of some people, who are said to be asthmatical. So far + water may be said to act as an influx or influence, but when it is taken + up by the mouths of the absorbent system, it must excite those mouths + into action, and then acts as a stimulus.</p> + + <p>There appears from hence to be four methods by which animal bodies are + penetrated by external things. 1. By their stimulus, which induces the + absorbent vessels to imbibe them. 2. By mechanical attraction, as when + water softens the cuticle. 3. By chemical attraction, as when oxygen + passes through the membranes of the air-vessels of the lungs, and + combines with the blood. And lastly, by influx without mechanical + attraction, chemical combination, or animal absorption, as the universal + fluids of heat, gravitation, electricity, magnetism, and perhaps of other + ethereal fluids yet unknown.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_IV_2">II</a>.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_2_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motions.</i></h3> + + <p>As irritative muscular motions are attended with pain, when they are + exerted too weakly, as well as when they are exerted too strongly; so + irritative ideas become attended with sensation, when they are exerted + too weakly, as well as when they are exerted too strongly. Which accounts + for these ideas being attended with sensation in the various kinds of + vertigo described below.</p> + + <p>There is great difficulty in tracing the immediate cause of the + deficiences of action of some links of the associations of irritative + motions; first, because the trains and tribes of motions, which compose + these links, are so widely extended as to embrace almost the whole animal + system; and secondly, because when the first link of an associated train + of actions is exerted with too great energy, the second link by reverse + sympathy may be affected with torpor. And then this second link may + transmit, as it were, this torpor to a third link, and at the same time + regain its own energy of action; and it is possible this third link may + in like manner transmit its torpor to a fourth, and thus regain its own + natural quantity of motion.</p> + + <p>I shall endeavour to explain this by an example taken from sensitive + associated motions, as the origin of their disturbed actions is more + easily detected. This morning I saw an elderly person, who had gradually + lost all the teeth in his upper jaw, and all of the under except three of + the molares; the last of these was now loose, and occasionally painful; + the fangs of which were almost naked, the gums being much wasted both + within and without the jaw. He is a man of attentive observation, and + assured me, that he had again and again noticed, that, when a pain + commenced in the membranes of the alveolar process of the upper jaw + opposite to the loose tooth in the under one (which had frequently + occurred for several days past), the pain of the loose tooth ceased. And + that, when the pain afterwards extended to the ear and temple on that + side, the pain in the membranes of the upper jaw ceased. In this case the + membranes of the alveolar process of the upper jaw became torpid, and + consequently painful, by their reverse sympathy with the too violent + actions of the inflamed membranes of the loose tooth; and then by a + secondary sympathy the membranes about the ear and temple became torpid, + and painful; and those of the alveolar process of the upper jaw regained + their natural quantity of action, and ceased to be painful. A great many + more nice and attentive observations are wanted to elucidate these + curious circumstances of association, which will be found to be of the + greatest importance in the cure of many diseases, and lead us to the + knowledge of fever.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_2_1_1">1</a>. <i>Cutis frigida pransorum.</i> + Chillness after dinner frequently attends weak people, or those who have + been exhausted by exercise; it arises from the great expenditure of the + sensorial power on the organs of digestion, which are stimulated into + violent action by the aliment; and the vessels of the skin, which are + associated with them, become in some measure torpid by reverse sympathy; + and a consequent chillness succeeds with less absorption of atmospheric + moisture. See the subsequent article.</p> + + <p><a name="species_IV_2_1_2">2</a>. <i>Pallor urinæ pransorum.</i> The + paleness of urine after a full meal is an instance of reverse + association; where the secondary part of a train of associate motions + acts with less energy in consequence of the greater exertions of the + primary part. After dinner the absorbent vessels of the stomach and + intestines are stimulated into greater action, and drink up the newly + taken aliment; while those, which are spread in great number on the neck + of the bladder, absorb less of the aqueous part of the urine than usual, + which is therefore discharged in a more dilute state; and has been termed + crude by some medical writers, but it only indicates, that so great a + proportion of the sensorial power is expended on digestion and absorption + of the aliment, that other parts of the system act for a time with less + energy. See Class <a href="#species_IV_1_1_6">IV. I. 1. 6</a>.</p> + + <p><a name="species_IV_2_1_3">3</a>. <i>Pallor urinæ a frigore + cutaneo.</i> There is a temporary discharge of pale water, and a + diarrhœa, induced by exposing the skin to the cold air; as is + experienced by boys, who strip themselves before bathing. In this case + the mouths of the cutaneous lymphatics become torpid by the subduction of + their accustomed degree of heat, and those of the bladder and intestines + become torpid by direct sympathy; whence less of the thinner part of the + urinary secretion, and of the mucus of the intestines, is reabsorbed. See + Sect. XXIX. 4. 6. This effect of suddenly cooling the skin by the + aspersion of cold water has been used with success in costiveness, and + has produced evacuations, when other means have failed. When young + infants are afflicted with griping joined with costiveness, I have + sometimes directed them to be taken out of a warm bed, and carried about + for a few minutes in a cool room, with almost instant relief.</p> + + <p><a name="species_IV_2_1_4">4</a>. <i>Pallor ex ægritudine.</i> When + sickness of stomach first occurs, a paleness of the skin attends it; + which is owing to the association or catenation between the capillaries + of the stomach and the <span class="correction" title="Original reads `cataneous'." + >cutaneous</span> ones; which at first act by direct sympathy. But in a + short time there commences an accumulation of the sensorial power of + association in the cutaneous capillaries during their state of + inactivity, and then the skin begins to glow, and sweats break out, from + the increased action of the cutaneous glands or capillaries, which is now + in reverse sympathy with those of the stomach. So in continued fevers, + when the stomach is totally torpid, which is known by the total aversion + to solid food, the cutaneous capillaries are by reverse sympathy in a + perpetual state of increased activity, as appears from the heat of the + skin.</p> + + <p><a name="species_IV_2_1_5">5</a>. <i>Dyspnœa a balneo + frigido.</i> The difficulty of breathing on going up to the middle in + cold water is owing to the irritative association or catenation of the + action of the extreme vessels of the lungs with those of the skin. So + that when the latter are rendered torpid or inactive by the application + of sudden cold, the former become inactive at the same time, and retard + the circulation of the blood through the lungs, for this difficulty of + breathing cannot be owing to the pressure of the water impeding the + circulation downwards, as it happens equally by a cold shower-bath, and + is soon conquered by habitual immersions. The capillaries of the skin are + rendered torpid by the subduction of the stimulus of heat, and by the + consequent diminution of the sensorial power of irritation. The + capillaries of the lungs are rendered torpid by the diminution of the + sensorial power of association, which is now excited in less quantity by + the lessened actions of the capillaries of the skin, with which they are + catenated. So that at this time both the cutaneous and pulmonary + capillaries are principally actuated, as far as they have any action, by + the stimulus of the blood. But in a short time the sensorial powers of + irritation, and of association, become accumulated, and very energetic + action of both these membranes succeed. Which thus resemble the cold and + hot fit of an intermittent fever.</p> + + <p><a name="species_IV_2_1_6">6</a>. <i>Dyspepsia a pedibus frigidis.</i> + When the feet are long cold, as in riding in cold and wet weather, some + people are very liable to indigestion and consequent heart-burn. The + irritative motions of the stomach become torpid, and do their office of + digestion imperfectly, in consequence of their association with the + torpid motions of the vessels of the extremities. Fear, as it produces + paleness and torpidity of the skin, frequently occasions temporary + indigestion in consequence of this association of the vessels of the skin + with those of the stomach; as riding in very bad roads will give + flatulency and indigestion to timorous people.</p> + + <p>A short exposure to cold air increases digestion, which is then owing + to the reverse sympathy between the capillary vessels of the skin, and of + the stomach. Hence when the body is exposed to cold air, within certain + limits of time and quantity of cold, a reverse sympathy of the stomach + and the skin first occurs, and afterwards a direct sympathy. In the + former case the expenditure of sensorial power by the skin being + lessened, but not its production in the brain; the second link of the + association, viz. the stomach, acquires a greater share of it. In the + latter case, by the continuation of the deficient stimulus of heat, the + torpor becomes extended to the brain itself, or to the trunks of the + nerves; and universal inactivity follows.</p> + + <p><a name="species_IV_2_1_7">7</a>. <i>Tussis a pedibus frigidis.</i> On + standing with the feet in thawing snow, many people are liable to + incessant coughing. From the torpidity of the absorbent vessels of the + lungs, in consequence of their irritative associations with those of the + skin, they cease to absorb the saline part of the secreted mucus; and a + cough is thus induced by the irritation of this saline secretion; which + is similar to that from the nostrils in frosty weather, but differs in + respect to its immediate cause; the former being from association with a + distant part, and the latter from defect of the stimulus of heat on the + nostrils themselves. See Catarrhus frigidus, Class <a + href="#species_I_2_3_3">I. 2. 3. 3</a>.</p> + + <p><a name="species_IV_2_1_8">8</a>. <i>Tussis hepatica.</i> The cough of + inebriates, which attends the enlargement of the liver, or a chronical + inflammation of its upper membrane, is supposed to be produced by the + inconvenience the diaphragm suffers from the compression or heat of the + liver. It differs however essentially from that attending hepatitis, from + its not being accompanied with fever. And is perhaps rather owing to + irritative association, or reverse sympathy, between the lungs and the + liver. As occurs in sheep, which are liable to a perpetual dry cough, + when the fleuk-worm is preying on the substance of their livers. See + Class <a href="#species_II_1_1_5">II. 1. 1. 5</a>.</p> + + <p>M. M. From half a grain to a grain of opium twice a day. A drachm of + mercurial ointment rubbed on the region of the liver every night for + eight or ten times.</p> + + <p><a name="species_IV_2_1_9">9</a>. <i>Tussis arthritica.</i> + Gout-cough. I have seen a cough, which twice recurred at a few years + distance in the same person, during his fits of the gout, with such + pertinacity and violence as to resist venesection, opiates, bark, + blisters, mucilages, and all the usual methods employed in coughs. It was + for a time supposed to be the hooping-cough, from the violence of the + action of coughing; it continued two or three weeks, the patient never + being able to sleep more than a few minutes at once during the whole + time, and being propped up in bed with pillows night and day.</p> + + <p>As no fever attended this violent cough, and but little expectoration, + and that of a thin and frothy kind, I suspected the membrane of the lungs + to be rather torpid than inflamed, and that the saline part of the mucus + not being absorbed stimulated them into perpetual exertion. And lastly, + that though the lungs are not sensible to cold and heat, and probably + therefore less mobile; yet, as they are nevertheless liable to consent + with the torpor of cold feet, as described in Species <a + href="#species_IV_2_1_6">6</a> of this Genus, I suspected this torpor of + the lungs to succeed the gout in the feet, or to act a vicarious part for + them.</p> + + <p><a name="species_IV_2_1_10">10</a>. <i>Vertigo rotatoria.</i> In the + vertigo from circumgyration the irritative motions of vision are + increased; which is evinced from the pleasure that children receive on + being rocked in a cradle, or by swinging on a rope. For whenever + sensation arises from the production of irritative motion with less + energy than natural, it is of the disagreeable kind, as from cold or + hunger; but when it arises from their production with greater energy than + natural, if it be confined within certain limits, it is of the + pleasurable kind, as by warmth or wine. With these increased irritative + motions of vision, I suppose those of the stomach are performed with + greater energy by direct sympathy; but when the rotatory motions, which + produce this agreeable vertigo, are continued too long, or are too + violent, sickness of the stomach follows; which is owing to the decreased + action of that organ from its reverse sympathy with the increased actions + of the organ of vision. For the expenditure of sensorial power by the + organ of vision is always very great, as appears by the size of the optic + nerves; and is now so much increased as to deprive the next link of + association of its due share. As mentioned in Article <a + href="#species_IV_2_1_6">6</a> of this Genus.</p> + + <p>In the same manner the undulations of water, or the motions of a ship, + at first give pleasure by increasing the irritative motions belonging to + the sense of vision; but produce sickness at length by expending on one + part of the associated train of irritative actions too much of that + sensorial power, which usually served the whole of it; whence some other + parts of the train acquire too little of it, and perform their actions in + consequence too feebly, and thence become attended with disagreeable + sensation.</p> + + <p>It must also be observed, that when the irritative motions are + stimulated into unusual action, as in inebriation, they become succeeded + by sensation, either of the pleasurable or painful kind; and thus a new + link is introduced between the irritative motions thus excited, and those + which used to succeed them; whence the association is either dissevered + or much weakened, and thus the vomiting in sea-sickness occurs from the + defect of the power of association, rather than from the general + deficiency of sensorial power.</p> + + <p>When a blind man turns round, or when one, who is not blind, revolves + in the dark, a vertigo is produced belonging to the sense of touch. A + blind man balances himself by the sense of touch, which being a less + perfect means of determining small quantities of deviation from the + perpendicular, occasions him to walk more carefully upright than those, + who balance themselves by vision. When he revolves, the irritative + associations of the muscular motions, which were used to preserve his + perpendicularity, become disordered by their new modes of successive + exertion; and he begins to fall. For his feet now touch the floor in + manners or directions different from those they have been accustomed to; + and in consequence he judges less perfectly of the situation of the parts + of the floor in respect to that of his own body, and thus loses his + perpendicular attitude. This may be illustrated by the curious experiment + of crossing one finger over the next to it, and feeling of a nut or + bullet with the ends of them. When, if the eyes be closed, the nut or + bullet appears to be two, from the deception of the sense of touch.</p> + + <p>In this vertigo from gyration, both of the sense of sight, and of the + sense of touch, the primary link of the associated irritative motions is + increased in energy, and the secondary ones are increased at first by + direct sympathy; but after a time they become decreased by reverse + sympathy with the primary link, owing to the exhaustion of sensorial + power in general, or to the power of association in particular; because + in the last case, either pleasurable or painful sensation has been + introduced between the links of a train of irritative motions, and has + dissevered, or much enfeebled them.</p> + + <p>Dr. Smyth, in his Essay on Swinging in Pulmonary Consumption, has + observed, that swinging makes the pulse slower. Dr. Ewart of Bath + confirmed this observation both on himself and on Col. Cathcart, who was + then hectic, and that even on shipboard, where some degree of vertigo + might be supposed previously to exist. Dr. Currie of Liverpool not only + confirmed this observation frequently on himself, when he was also + phthisical, but found that equitation had a similar effect on him, + uniformly retarding his pulse. This curious circumstance cannot arise + from the general effect of exercise, or fatigue, as in those cases the + pulse becomes weaker and quicker; it must therefore be ascribed to a + degree of vertigo, which attends all those modes of motion, which we are + not perpetually accustomed to.</p> + + <p>Dr. Currie has further observed, that "in cases of great debility the + voluntary muscular exertion requisite in a swing produces weariness, that + is, increases debility; and that in such instances he had frequently + noticed, that the diminution of the frequency of the pulse did not take + place, but the contrary." These circumstances may thus be accounted + for.</p> + + <p>The links of association, which are effected in the vertigo occasioned + by unusual motion, are the irritative motions of the sense of vision, + those of the stomach, and those of the heart and arteries. When the + irritative ideas of vision are exerted with greater energy at the + beginning of vertigo, a degree of sensation is excited, which is of the + pleasurable kind, as above mentioned; whence the associated trains of + irritative motions of the stomach, and heart, and arteries, act at first + with greater energy, both by direct sympathy; and by the additional + sensorial power of sensation. Whence the pulse of a consumptive patient + becomes stronger and consequently slower.</p> + + <p>But if this vertigo becomes much greater in degree or duration, the + first link of this train of associated irritative motions expends too + much of the sensorial power, which was usually employed on the whole + train; and the motions of the stomach become in consequence exerted with + less energy. This appears, because in this degree of vertigo sickness + supervenes, as in sea-sickness, which has been shewn to be owing to less + energetic action of the stomach. And the motions of the heart and + arteries then become weaker, and in consequence more frequent, by their + direct sympathy with the lessened actions of the stomach. See Supplement, + <a href="#suppl_XII">I. 12</a>. and Class <a href="#species_II_1_6_7">II. + 1. 6. 7</a>. The general weakness from fatigue is owing to a similar + cause, that is, to the too great expenditure of sensorial power in the + increased actions of one part of the system, and the consequent + deficiency of it in other parts, or in the whole.</p> + + <p>The abatement of the heat of the skin in hectic fever by swinging, is + not only owing to the increased ventilation of cool air, but to the + reverse sympathy of the motions of the cutaneous capillaries with those + of the heart and arteries; which occurs in all fevers with arterial + debility, and a hot or dry skin. Hence during moderate swinging the + action of the heart and arteries becomes stronger and slower, and the + action of the capillaries, which was before too great, as appeared by the + heat of the skin, now is lessened by their reverse sympathy with that of + the heart and arteries. See Supplement, <a href="#suppl_VIII">I. + 8</a>.</p> + + <p><a name="species_IV_2_1_11">11</a>. <i>Vertigo visualis.</i> Visual + vertigo. The vertigo rotatoria described above, was induced by the + rotation or undulation of external objects, and was attended with + increased action of the primary link of the associated motions belonging + to vision, and with consequent pleasure. The vertigo visualis is owing to + less perfect vision, and is not accompanied with pleasurable sensation. + This frequently occurs in strokes of the palsy, and is then succeeded by + vomiting; it sometimes precedes epileptic fits, and often attends those, + whose sight begins to be impaired by age.</p> + + <p>In this vertigo the irritative ideas of the apparent motions of + objects are less distinct, and on that account are not succeeded by their + usual irritative associations of motion; but excite our attention. Whence + the objects appear to librate or circulate according to the motions of + our heads, which is called dizziness; and we lose the means of balancing + ourselves, or preserving our perpendicularity, by vision. So that in this + vertigo the motions of the associated organs are decreased by direct + sympathy with their primary link of irritation; as in the preceding case + of sea-sickness they are decreased by reverse sympathy.</p> + + <p>When vertigo affects people about fifty years of age, their sight has + generally been suddenly impaired; and from their less accurate vision + they do not soon enough perceive the apparent motions of objects; like a + person in a room, the walls of which are stained with the uniform figures + of lozenges, explained in Sect. XX. 1. This is generally ascribed to + indigestion; but it ceases spontaneously, as the patient acquires the + habit of balancing himself by less distinct objects.</p> + + <p>A gentleman about 50 was seized with an uncommon degree of vertigo, so + as to fall on the ground, and not to be able to turn his head, as he sat + up either in his chair or in his bed, and this continued eight or ten + weeks. As he had many decayed teeth in his mouth, and the vertigo was + preceded and sometimes accompanied by pains on one side of his head, the + disease of a tooth was suspected to be the cause. And as his timidity was + too great to admit the extraction of those which were decayed; after the + trial of cupping repeatedly, fomentations on his head, repeated blisters, + with valerian, Peruvian bark, musk, opium, and variety of other + medicines; mercurials were used, both externally and internally, with + design to inflame the membranes of the teeth, and by that means to + prevent the torpor of the action of the membranes about the temple, and + parietal bone; which are catenated with the membranes of the teeth by + irritative association, but not by sensitive association. The event was, + that as soon as the gums became sore with a slight ptyalism, the pains + about the head and vertigo gradually diminished, and during the soreness + of his gums entirely ceased; but I believe recurred afterwards, though in + less degree.</p> + + <p>The idea of inflaming the membranes of the teeth to produce increased + sensation in them, and thus to prevent their irritative connection with + those of the cranium, was taken from the treatment of trismus, or locked + jaw, by endeavouring to inflame the injured tendon; which is said to + prevent or to remove the spasm of the muscles of the jaw. See Class <a + href="#species_III_1_1_13">III. 1. 1. 13</a>. and <a + href="#species_III_1_1_15">15</a>.</p> + + <p>M. M. Emetics. Blisters. Issues about the head. Extraction of decayed + teeth. Slight salivation. Sorbentia. Incitantia.</p> + + <p><a name="species_IV_2_1_12">12</a>. <i>Vertigo ebriosa.</i> Vertigo + from intoxication is owing to the association of the irritative ideas of + vision with the irritative motions of the stomach. Whence when these + latter become much increased by the immoderate stimulus of wine, the + irritative motions of the retina are produced with less energy by reverse + sympathy, and become at the same time succeeded by sensation in + consequence of their decreased action. See Sect. XXI. 3. and XXXV. 1. 2. + So conversely when the irritative motions of vision are increased by + turning round, or by our unaccustomed agitation at sea, those of the + stomach become inverted by reverse sympathy, and are attended in + consequence with disagreeable sensation. Which decreased action of the + stomach is in consequence of the increased expenditure of the sensorial + power on the irritative ideas of vision, as explained in Vertigo + rotatoria.</p> + + <p>Whence though a certain quantity of vinous spirit stimulates the whole + system into increased action, and perhaps even increases the secretion of + sensorial power in the brain; yet as soon as any degree of vertigo is + produced, it is a proof, that by the too great expenditure of sensorial + power by the stomach, and its nearest associated motions, the more + distant ones, as those of vision, become imperfectly exerted. From hence + may be deduced the necessity of exhibiting wine in fevers with weak pulse + in only appropriated quantity; because if the least intoxication be + induced, some part of the system must act more feebly from the + unnecessary expenditure of sensorial power.</p> + + <p><a name="species_IV_2_1_13">13</a>. <i>Vertigo febriculosa.</i> + Vertigo in fevers either proceeds from the general deficiency of + sensorial power belonging to the irritative associations, or to a greater + expenditure of it on some links of the trains and tribes of associated + irritative motions. There is however a slighter vertigo attending all + people, who have been long confined in bed, on their first rising; owing + to their having been so long unused to the apparent motions of objects in + their erect posture, or as they pass by them, that they have lost in part + the habit of balancing themselves by them.</p> + + <p><a name="species_IV_2_1_14">14</a>. <i>Vertigo cerebrosa.</i> Vertigo + from injuries of the brain, either from external violence, or which + attend paralytic attacks, are owing to the general deficiency of + sensorial power. In these distressful situations the vital motions, or + those immediately necessary to life, claim their share of sensorial power + in the first place, otherwise the patient must die; and those motions, + which are less necessary, feel a deficiency of it, as these of the organs + of sense and muscles; which constitute vertigo; and lastly the voluntary + motions, which are still less immediately necessary to life, are + frequently partially destroyed, as in palsy; or totally, as in + apoplexy.</p> + + <p><a name="species_IV_2_1_15">15</a>. <i>Murmur aurium vertiginosum.</i> + The vertiginous murmur in the ears, or noise in the head, is compared to + the undulations of the sound of bells, or to the humming of bees. It + frequently attends people about 60 years of age; and like the visual + vertigo described above is owing to our hearing less perfectly from the + gradual inirritability of the organ on the approach of age; and the + disagreeable sensation of noise attending it is owing to the less + energetic action of these irritative motions; which not being + sufficiently distinct to excite their usual associations become succeeded + by our attention, like the indistinct view of the apparent motions of + objects mentioned in vertigo visualis. This may be better understood from + considering the use, which blind men make of these irritative sounds, + which they have taught themselves to attend to, but which escape the + notice of others. The late blind Justice Fielding walked for the first + time into my room, when he once visited me, and after speaking a few + words said, "this room is about 22 feet long, 18 wide, and 12 high;" all + which he guessed by the ear with great accuracy. Now if these irritative + sounds from the partial loss of hearing do not correspond with the size + or usual echoes of the places, where we are; their catenation with other + irritative ideas, as those of vision, becomes dissevered or disturbed; + and we attend to them in consequence, which I think unravels this + intricate circumstance of noises being always heard in the head, when the + sense of hearing begins to be impaired, from whatever cause it + occurs.</p> + + <p>This ringing in the ears also attends the vertigo from intoxication; + for the irritative ideas of sound are then more weakly excited in + consequence of the deficiency of the sensorial power of association. As + is known by this also being attended with disagreeable sensation, and by + its accompanying other diseases of debility, as strokes on the head, + fainting fits, and paralytic seizures. For in this vertigo from + intoxication so much sensorial power in general is expended on the + increased actions of the stomach, and its nearest connections, as the + capillaries of the skin; that there is a deficiency for the purposes of + the other irritative associations of motions usually connected with it. + This auditory vertigo attends both the rotatory and the visual vertigo + above mentioned; in the former it is introduced by reverse sympathy, that + is, by the diminution of sensorial power; too great a quantity of it + being expended on the increased irritative motions of vision; in the + latter it is produced either by the same causes which produce the visual + vertigo, or by direct sympathy with it. See Sect. XX. 7.</p> + + <p>M. M. Stimulate the internal ear by ether, or with essential oil + diluted with expressed oil, or with a solution of opium in wine, or in + water. Or with salt and water.</p> + + <p><a name="species_IV_2_1_16">16</a>. <i>Tactus, gustus, olfactius + vertiginosi.</i> Vertiginous touch, taste, and smell. In the vertigo of + intoxication, when the patient lies down in bed, it sometimes happens + even in the dark, that the bed seems to librate under him, and he is + afraid of falling out of it. The same occurs to people, who are sea-sick, + even when they lie down in the dark. In these the irritative motions of + the nerves of touch, or irritative tangible ideas, are performed with + less energy, in one case by reverse sympathy with the stomach, in the + other by reverse sympathy with the nerves of vision, and in consequence + become attended with sensation, and produce the fear of falling by other + associations.</p> + + <p>A vertigo of the sense of touch may be produced, if any one turns + round for a time with his eyes shut, and suddenly stops without opening + them; for he will for a time seem to be still going forwards; which is + difficult to explain. See the notes at the end of the first and second + volume belonging to Sect. XX. 6.</p> + + <p>In the beginning of some fevers, along with incessant vomiting, the + patients complain of disagreeable tastes in their mouth, and disagreeable + odours; which are to be ascribed to the general debility of the great + trains and tribes of associated irritative motions, and to be explained + from their direct sympathy with the decreased action of a sick stomach; + or from the less secretion of sensorial power in the brain. These organs + of sense are constantly stimulated into action by the saliva or by the + air; hence, like the sense of hunger, when they are torpid from want of + stimulus, or from want of sensorial power, pain or disagreeable sensation + ensues, as of hunger, or faintness, or sickness in one case; and the + ideas of bad tastes or odours in the other. This accords with the laws of + causation, Sect. IV. 5.</p> + + <p><a name="species_IV_2_1_17">17</a>. <i>Pulsus mollis in vomitione.</i> + The softness of the pulse in the act of vomiting is caused by direct + association between the heart and the stomach; as explained in Sect. XXV. + 17. A great slowness of the pulsation of the heart sometimes attends + sickness, and even with intermissions of it, as in the exhibition of too + great a dose of digitalis.</p> + + <p><a name="species_IV_2_1_18">18</a>. <i>Pulsus intermittens a + ventriculo.</i> When the pulse first begins to intermit, it is common for + the patient to bring up a little air from his stomach; which if he + accomplishes before the intermission occurs, always prevents it; whence + that this debility of the heart is owing to the direct association of its + motions with those of the stomach is well evinced. See Sect. XXV. 17.</p> + + <p>I this morning saw Mr. ——, who has long had at times an + unequal pulse, with indigestion and flatulency, and occasional asthma; he + was seized two days ago with diarrhœa, and this morning with + sickness, and his pulse was every way unequal. After an emetic his pulse + still continued very intermittent and unequal. He then took some + breakfast of toast and butter, and tea, and to my great surprise his + pulse became immediately perfectly regular, about 100 in a minute, and + not weak, by this stimulus on his stomach.</p> + + <p>A person, who for many years had had a frequent intermission of his + pulse, and occasional palpitation of his heart, was relieved from them + both for a time by taking about four drops of a saturated solution of + arsenic three or four times a day for three or four days. As this + intermission of the pulse is occasioned by the direct association of the + motions of the heart with those of the stomach, the indication of cure + must be to strengthen the action of the stomach by the bark. Spice. + Moderate quantities of wine. A blister. Half a grain of opium twice a + day. Solution of arsenic?</p> + + <p><a name="species_IV_2_1_19">19</a>. <i>Febris inirritativa.</i> + Inirritative fever described in Class <a href="#species_I_2_1_1">I. 2. 1. + 1</a>. belongs to this place, as it consists of disordered trains and + tribes of associated irritative motions, with lessened actions of the + associated organs. In this fever the pulsations of the heart and arteries + are weakened or lessened, not only in the cold paroxysm, as in the + irritative fever, but also in the hot paroxysm. The capillary arteries or + glands have their actions nevertheless increased after the first cold + fit, as appears by the greater production of heat, and the glow of + arterial blood, in the cutaneous vessels; and lastly, the action of the + stomach is much impaired or destroyed, as appears by the total want of + appetite to solid food. Whence it would seem, that the torpid motions of + the stomach, whatever may occasion them, are a very frequent cause of + continued fever with weak pulse; and that these torpid motions of the + stomach do not sufficiently excite the sensorial power of association, + which contributes in health to actuate the heart and arteries along with + the irritation produced by the stimulus of the blood; and hence the + actions of these organs are weaker. And lastly, that the accumulation of + the sensorial power of association, which ought to be expended on the + motions of the heart and arteries, becomes now exerted on the cutaneous + and pulmonary capillaries. See Supplement I. <a href="#suppl_VIII">8</a>. + and Sect. XXXV. 1. 1. and XXXIII. 2. 10.</p> + + <p>I have dwelt longer on the vertiginous diseases in this genus, both + because of their great intricacy, and because they seem to open a road to + the knowledge of fever, which consists of associated trains and tribes of + irritative or sensitive motions, which are sometimes mixed with the + vertiginous ones, and sometimes separate from them.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_2_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + + <p>In this genus the sensorial power of association is exerted with less + energy, and thence the actions produced by it are less than natural; and + pain is produced in consequence, according to the fifth law of animal + causation, Sect. IV. This pain is generally attended with coldness of the + affected part, and is seldom succeeded by inflammation of it. This + decreased action of the secondary link of the associated motions, + belonging to this genus, is owing to the previous exhaustion of sensorial + power either in the increased actions of the primary link of the + associated motions, or by the pain which attends them; both which are + frequently the consequence of the stimulus of something external to the + affected fibres.</p> + + <p>As pain is produced either by excess or defect of the natural + exertions of the fibres, it is not, considered separately, a criterion of + the presence of either. In the associations belonging to this genus the + sensation of pain or pleasure produces or attends the primary link of the + associated motions, and very often gives name to the disease.</p> + + <p>When great pain exists without causing any fibrous motions, I + conjecture that it contributes to exhaust or expend the general quantity + of sensorial power; because people are fatigued by enduring pain, till at + length they sleep. Which is contrary to what I had perhaps erroneously + supposed in Sect. XXXV. 2. 3. If it causes fibrous motions, it then takes + the name of sensation, according to the definition of sensation in Sect. + II. 2. 9.; and increased fibrous action or inflammation is the + consequence. This circumstance of the general exhaustion of sensorial + power by the existence of pain will assist in explaining many of the + diseases of this genus.</p> + + <p>Many of the canals of the body, as the urethra, the bile-duct, the + throat, have the motions of their two extremities associated by having + been accustomed to feel pleasurable or painful sensations at the same + time or in succession. This is termed sensitive association, though those + painful or pleasurable sensations do not cause the motions, but only + attend them; and are thus perhaps, strictly speaking, only catenated with + them.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_2_2_1">1</a>. <i>Torpor genæ a dolore dentis.</i> + In tooth-ach there is generally a coldness of the cheek, which is + sensible to the hand, and is attended in some degree with the pain of + cold. The cheek and tooth have frequently been engaged in pleasurable + action at the same time during the masticating of our food; whence they + have acquired sensitive associations. The torpor of the cheek may have + for its cause the too great expenditure of sensorial power by the painful + sensation of the membranes of the diseased tooth; whence the membranes of + the cheek associated with those of the alveolar process are deprived of + their natural share of it, and become torpid; thus they produce less + secretions, and less heat, and the pain of cold is the consequence. This + torpor of the vessels of the cheek cannot be produced by the activity of + the sensorial power of sensation; for then they would act more violently + than natural, or become inflamed. And though the pain by exhausting so + much sensorial power may be a remote cause, it is the defeat of the power + of association, which is the immediate cause of the torpor of the + cheek.</p> + + <p>After some hours this pain occasioned by the torpor of the vessels of + the cheek either gradually ceases along with the pain of the diseased + tooth; or, by the accumulation of sensorial power during their state of + torpor, the capillaries of the cheek act with greater violence, and + produce more secretions, and heat, and consequent tumour, and + inflammation. In this state the pain of the diseased tooth ceases; as the + sensorial power of sensation is now expended on the inflamed vessels of + the cheek. It is probable that most other internal membranous + inflammations begin in a similar manner; whence there may seem to be a + double kind of sensitive association; first, with decreased action of the + associated organ, and then with increased action of it; but the latter is + in this case simply the consequence of the former; that is, the tumor or + inflammation of the cheek is in consequence of its previous quiescence or + torpor.</p> + + <p><a name="species_IV_2_2_2">2</a>. <i>Stranguria a dolore vesicæ.</i> + The strangury, which has its origin from pain at the neck of the bladder, + consists of a pain in the external extremity of the urethra or of the + glans penis of men, and probably in the external termination of the + urethra or of the clitoris of women; and is owing to the sympathy of + these with some distant parts, generally with the other end of the + urethra; an endeavour and difficulty of making water attends this + pain.</p> + + <p>Its remote cause is from the internal or external use of cantharides, + which stimulate the neck of the bladder; or from a stone, which whenever + it is pushed into the neck of the bladder, gives this pain of strangury, + but not at other times; and hence it is felt most severely in this case + after having made water.</p> + + <p>The sensations or sensitive motions of the glans penis, and of the + sphincter of the bladder, have been accustomed to exist together during + the discharge of the urine; and hence the two ends of the urethra + sympathize by association. When there is a stone at the neck of the + bladder, which is not so large or rough as to inflame the part, the + sphincter of the bladder becomes stimulated into pain; but as the glans + penis is for the purposes of copulation more sensitive than the sphincter + of the bladder, as soon as it becomes affected with pain by the + association above mentioned, the sensation at the neck of the bladder + ceases; and then the pain of the glans penis would seem to be associated + with the irritative motions only of the sphincter of the bladder, and not + with the sensitive ones of it. But a circumstance similar to this occurs + in epileptic fits, which at first are induced by disagreeable sensation, + and afterwards seem to occur without previous pain, from the suddenness + in which they follow and relieve the pain, which occasioned them. From + this analogy I imagine the pain of the glans penis is associated with the + pain of the sphincter of the bladder; but that <i>as soon as the greater + pain in a more sensible part is produced; the lesser one, which + occasioned it, ceases</i>; and that this is one of the laws of sensitive + association. See Sect. XXXV. 2. 1.</p> + + <p>A young man had by an accident swallowed a large spoonful or more of + tincture of cantharides; as soon as he began to feel the pain of + strangury, he was advised to drink large quantities of warmish water; to + which, as soon as it could be got, some gum arabic was added. In an hour + or two he drank by intervals of a few minutes about two gallons of water, + and discharged his urine every four or five minutes. A little blood was + voided towards the end, but he suffered no ill consequence.</p> + + <p>M. M. Warm water internally. Clysters of warm water. Fomentation. + Opium. Solution of fixed alkali supersaturated with carbonic acid. A + bougie may be used to push back a stone into the bladder. See Class <a + href="#species_I_1_3_10">I. 1. 3. 10</a>.</p> + + <p><a name="species_IV_2_2_3">3</a>. <i>Stranguria convulsiva.</i> The + convulsive strangury, like that before described, is probably occasioned + by the torpor or defective action of the painful part in consequence of + the too great expenditure of sensorial power on the primary link of the + associated motions, as no heat or inflammation attends this violent pain. + This kind of strangury recurs by stated periods, and sometimes arises to + so great a degree, that convulsion or temporary madness terminates each + period of it. It affects women oftener than men, is attended with cold + extremities without fever, and is distinguished from the stone of the + bladder by the regularity of its periods, and by the pain being not + increased after making water.</p> + + <p>On introducing the catheter sometimes part of the urine will come away + and not the whole, which is difficult to explain; but may arise from the + weakness of the muscular fibres of the bladder; which are not liable + suddenly to contract themselves so far as to exclude the whole of the + urine. In some old people, who have experienced a long retention of + urine, the bladder never regains the power of completely emptying itself; + and many who are beginning to be weak from age can make water a second + time, a few minutes after they supposed they had emptied the bladder.</p> + + <p>I have believed this pain to originate from sympathy with some distant + part, as from ascarides in the rectum, or from piles in women; or from + caruncles in the urethra about the caput gallinaginis in men; and that + the pain has been in the glans or clitoris by reverse sympathy of these + more sensible parts with those above mentioned.</p> + + <p>M. M. Venesection. Opium in large quantities. Warm bath. Balsams. + Bark. Tincture of cantharides. Bougie, and the treatment for hæmorrhoids. + Leeches applied to the sphincter ani. Aerated alcaline water. Soap and + sal soda. Opium in clysters given an hour before the expected return. + Smoke of tobacco in clysters. Arsenic?</p> + + <p><a name="species_IV_2_2_4">4</a>. <i>Dolor termini intestinalis ductûs + choledochi.</i> Pain at the intestinal end of the gall-duct. When a + gall-stone is protruded from the gall-bladder a little way into the end + of the gall-duct, the pain is felt at the other end of the gall-duct, + which terminates in the duodenum. For the actions of the two terminations + of this canal are associated together from the same streams of bile + passing through them in succession, exactly as the two terminations of + the urethra have their actions associated, as described in Species <a + href="#species_IV_2_2_2">2</a> and <a href="#species_IV_2_2_3">3</a> of + this genus. But as the intestinal termination of the bile-duct is made + more sensible for the purpose of bringing down more bile, when it is + stimulated by new supplies of food from the stomach, it falls into + violent pain from association; and then the pain on the region of the + gall-bladder ceases, exactly as above explained in the account of the + pain of the glans penis from a stone in the sphincter of the bladder.</p> + + <p>The common bile-duct opens into the intestine exactly at what is + called the pit of the stomach; and hence it has sometimes happened, that + this pain from association with the sensation of a gall-stone at the + other end of the bile-duct has been mistaken for a pain of the + stomach.</p> + + <p>For the method of cure see Class <a href="#species_I_1_3_8">I. 1. 3. + 8</a>. to which should be added the use of strong electric shocks passed + through the bile-duct from the pit of the stomach to the back, and from + one side to the other. A case of the good effect of electricity in the + jaundice is related in Sect. XXX. 2. And another case, where it promoted + the passage of a painful gall-stone, is described by Dr. Hall, + experienced on himself. Trans. of the College at Philadelphia, Vol. I. p. + 192.</p> + + <p>Half a pint of warm water two or three times a day is much recommended + to dilute the inspissated bile.</p> + + <p><a name="species_IV_2_2_5">5</a>. <i>Dolor pharyngis ab acido + gastrico.</i> The two ends of the throat sympathize by sensitive + association in the same manner as the other canals above mentioned, + namely, the urethra and the bile-duct; hence when too great acidity of + undigested aliment, or the carbonic acid air, which escapes in + fermentation, stimulates the cardia ventriculi, or lower end of the gula, + into pain; the pharinx, or upper end of it, is affected with greater + pain, or a disagreeable sensation of heat.</p> + + <p><a name="species_IV_2_2_6">6</a>. <i>Pruritus narium a vermibus.</i> + The itching of the nose from worms in the intestines is another curious + instance of the sensitive associations of the motions of membranes; + especially of those which constitute the canals of the body. Previous to + the deglutition of agreeable food, as milk in our earliest infancy, an + agreeable odour affects the membrane, which lines the nostrils; and hence + an association seems to take place between the agreeable sensations + produced by food in the stomach and bowels, and the agreeable sensations + of the nostrils. The existence of ascarides in the rectum I believe + produces this itching of the nostrils more than the worms in other parts + of the intestines; as we have already seen, that the terminations of + canals sympathize more than their other parts, as in the urethra and + gall-ducts. See Class <a href="#species_I_1_5_9">I. 1. 5. 9</a>. <a + href="#species_IV_1_2_9">IV. 1. 2. 9</a>.</p> + + <p><a name="species_IV_2_2_7">7</a>. <i>Cephalæa.</i> Head-ach. In cold + fits of the ague, the head-ach arises from consent with some torpid + viscus, like the pain of the loins. After drunkenness the head-ach is + very common, owing to direct sympathy of the membranes of the head with + those of the stomach; which is become torpid after the too violent + stimulus of the preceding intoxication; and is hence removeable by spirit + of wine, or opium, exhibited in smaller quantities. In some constitutions + these head-achs are induced, when the feet are exposed to much external + cold; in this case the feet should be covered with oiled silk, which + prevents the evaporation of the perspirable matter, and thence diminishes + one cause of external cold.</p> + + <p>M. M. Valerian in powder two drams three or four times a day is + recommended. The bark. Chalybeates. A grain of opium twice a day for a + long time. From five to ten drops of the saturated solution of arsenic + two or three times a day. See Class <a href="#species_I_2_4_11">I. 2. 4. + 11</a>. A lady once assured me, that when her head-ach was coming on, she + drank three pints (pounds) of hot water, as hastily as she could; which + prevented the progress of the disease. A solution of arsenic is + recommended by Dr. Fowler of York. Very strong errhines are said + sometimes to cure head-achs taken at the times the pain recurs, till a + few drops of blood issue from the nostrils. As one grain of turpeth + mineral (vitriolic calx of mercury) mixed with ten grains of fine sugar. + Euphorbium or cayan pepper mixed with sugar, and used with caution as an + errhine. See the M. M. of the next Species.</p> + + <p><a name="species_IV_2_2_8">8</a>. <i>Hemicrania.</i> Pain on one side + of the head. This disease is attended with cold skin, and hence whatever + may be the remote cause, the immediate one seems to be want of stimulus, + either of heat or distention, or of some other unknown stimulus in the + painful part; or in those, with which it is associated. The membranes in + their natural state are only irritable by distention; in their diseased + state, they are sensible like muscular fibres. Hence a diseased tooth may + render the neighbouring membranes sensible, and is frequently the cause + of this disease.</p> + + <p>Sometimes the stomach is torpid along with the pained membrane of the + head; and then sickness and inappetency attends either as a cause or + consequence. The natural cure of hemicrania is the accumulation of + sensorial power during the rest or sickness of the patient. Mrs. + —— is frequently liable to hemicrania with sickness, which is + probably owing to a diseased tooth; the paroxysm occurs irregularly, but + always after some previous fatigue, or other cause of debility. She lies + in bed, sick, and without taking any solid food, and very little of + fluids, and those of the aqueous kind, and, after about 48 or 50 hours, + rises free from complaint. Similar to this is the recovery from cold + paroxysms of fever, from the torpor occasioned by fear, and from syncope; + which are all owing to the accumulation of sensorial power during the + inactivity of the system. Hence it appears, that, though when the + sensorial power of volition is much exhausted by fatigue, it can be + restored by eight or ten hours of sleep; yet, when the sensorial power of + irritation is exhausted by fatigue, that it requires two whole solar or + lunar days of rest, before it can be restored.</p> + + <p>The late Dr. Monro asserted in his lectures, that he cured the + hemicrania, or megrim, by a strong vomit, and a brisk purge immediately + after it. This method succeeds best if opium and the bark are given in + due quantity after the operation of the cathartic; and with still more + certainty, if bleeding in small quantity is premised, where the pulse + will admit of it. See Sect. XXXV. 2. 1.</p> + + <p>The pain generally affects one eye, and spreads a little way on that + side of the nose, and may sometimes be relieved by pressing or cutting + the nerve, where it passes into the bone of the orbit above the eye. When + it affects a small defined part on the parietal bone on one side, it is + generally termed Clavus hystericus, and is always I believe owing to a + diseased dens molaris. The tendons of the muscles, which serve the office + of mastication, have been extended into pain at the same time, that the + membranous coverings of the roots of the teeth have been compressed into + pain, during the biting or mastication of hard bodies. Hence when the + membranes, which cover the roots of the teeth, become affected with pain + by a beginning decay, or perhaps by the torpor or coldness of the dying + part of the tooth, the tendons and membranous fascia of the muscles about + the same side of the head become affected with violent pain by their + sensitive associations: and as soon as this associated pain takes place, + the pain of the tooth entirely ceases, as explained in the second species + of this genus.</p> + + <p>A remarkable circumstance attends this kind of hemicrania, viz. that + it recurs by periods like those of intermittent fevers, as explained in + the Section on Catenation of Motions; these periods sometimes correspond + with alternate lunar or solar days like tertian agues, and that even when + a decaying tooth is evidently the cause; which has been evinced by the + cure of the disease by extracting the tooth. At other times they observe + the monthly lunations, and seem to be induced by the debility, which + attends menstruation.</p> + + <p>The dens sapientiæ, or last tooth of the upper jaw, frequently decays + first, and gives hemicrania over the eye on the same side. The first or + second grinder in the under-jaw is liable to give violent pain about the + middle of the parietal bone, or side of the head, on the same side, which + is generally called the Clavus hystericus, of which an instructive case + is related in Sect. XXXV. 2. 1.</p> + + <p>M. M. Detect and extract the diseased tooth. Cut the affected nerve, + or stimulate the diseased membrane by acu-puncture. Venesection to six + ounces by the lancet or by leeches. A strong emetic and a subsequent + cathartic; and then an opiate and the bark. Pass small electric shocks + through the pained membrane, and through the teeth on the same side. + Apply vitriolic ether externally, and a grain of opium with camphor + internally, to the cheek on the affected side, where a diseased tooth may + be suspected. Foment the head with warm vinegar. Drink two large + spoonfuls of vinegar. Stimulate the gums of the suspected teeth by oil of + cloves, by opium. See Class <a href="#species_I_1_4_4">I. 1. 4. 4</a>. + Snuff volatile spirit of vinegar up the nostrils. Lastly, in permanent + head-achs, as in permanent vertigo, I have seen good effect by the use of + mercurial ointment rubbed on the shaved head or about the throat, till a + mild salivation commences, which by inflaming the membranes of the teeth + may prevent their irritative sympathy with those of the cranium. Thus by + inflaming the tendon, which is the cause of locked jaw, and probably by + inflaming the wound, which is the cause of hydrophobia, those diseases + may be cured, by disuniting the irritative sympathy between those parts, + which may not possess any sensitive sympathy. This idea is well worth our + attention.</p> + + <p><i>Otalgia.</i> Ear-ach is another disease occasioned by the sympathy + of the membranes of the ear with those which invest or surround a + decaying tooth, as I have had frequent reason to believe; and is + frequently relieved by filling the ear with tincture of opium. See Class + <a href="#genus_I_2_4">I. 2. 4</a>.</p> + + <p><a name="species_IV_2_2_9">9</a>. <i>Dolor humeri in <span + class="correction" title="Original reads `hepatidide'." + >hepatitide</span>.</i> In the efforts of excluding the fæces and urine + the muscles of the shoulders are exerted to compress the air in the + lungs, that the diaphragm may be pressed down. Hence the distention of + the tendons or fibres of these muscles is associated with the distention + of the tendons or fibres of the diaphragm; and when the latter are pained + by the enlargement or heat of the inflamed liver, the former sympathize + with them. Sometimes but one shoulder is affected, sometimes both; it is + probable that many other pains, which are termed rheumatic, have a + similar origin, viz. from sensitive associations.</p> + + <p>As no inflammation is produced in consequence of this pain of the + shoulder, it seems to be owing to inaction of the membranous part from + defect of the sensorial power of association, of which the primary link + is the inflamed membrane of the liver; which now expends so much of the + sensorial power in general by its increased action, that the membranes + about the shoulder, which are links of association with it, become + deprived of their usual share, and consequently fall into torpor.</p> + + <p><a name="species_IV_2_2_10">10</a>. <i>Torpor pedum in eruptione + variolarum.</i> At the commencement of the eruption of the small-pox, + when the face and breast of children are very hot, their extremities are + frequently cold. This I ascribe to sensitive association between the + different parts of the skin; whence when a part acts too violently, the + other part is liable to act too weakly; and the skin of the face being + affected first in the eruption of the small-pox, the skin of the feet + becomes cold in consequence by reverse sympathy.</p> + + <p>M. M. Cover the feet with flannel, and expose the face and bosom to + cool air, which in a very short time both warms the feet and cools the + face; and hence what is erroneously called a rash, but which is probably + a too hasty eruption of the small-pox, disappears; and afterwards fewer + and more distinct eruptions of the small-pox supervene.</p> + + <p><a name="species_IV_2_2_11">11</a>. <i>Testium dolor nephriticus.</i> + The pain and retraction of the testicle on the same side, when there is a + stone in the ureter, is to be ascribed to sensitive association; whether + the connecting cause be a branch of the same nerve, or from membranes, + which have been frequently affected at the same time.</p> + + <p><a name="species_IV_2_2_12">12</a>. <i>Dolor digiti minimi + sympatheticus.</i> When any one accidentally strikes his elbow against + any hard body, a tingling pain runs down to the little finger end. This + is owing to sensitive association of motions by means of the same branch + of a nerve, as in hemicrania from a decaying tooth the pain is owing to + the sensitive association of tendons or membranes.</p> + + <p><a name="species_IV_2_2_13">13</a>. <i>Dolor brachii in hydrope + pectoris.</i> The pain in the left arm which attends some dropsies of the + chest, is explained in Sect. XXIX. 5. 2. 10. which resembles the pain of + the little finger from a percussion of the nerve at the elbow in the + preceding article. A numbness of this kind is produced over the whole + leg, when the crural nerve is much compressed by sitting for a time with + one leg crossed over the other.</p> + + <p>Mr. ——, about sixty, had for two years been affected with + difficulty of respiration on any exertion, with pain about the sternum, + and of his left arm; which last was more considerable than is usual in + dropsy of the chest; some months ago the pain of his arm, after walking a + mile or two, became excessive, with coldness and numbness; and on the + next day the back of the hand, and a part of the arm swelled, and became + inflamed, which relieved the pain; and was taken for the gout, and + continued several days. He after some months became dropsical both in + respect to his chest and limbs, and was six or seven times perfectly + relieved by one dram of saturated tincture of digitalis, taken two or + three times a day for a few days in a glass of peppermint water. He + afterwards breathed oxygen gas undiluted, in the quantity of six or eight + gallons a day for three or four weeks without any effect, and sunk at + length from general debility.</p> + + <p>In this instructive case I imagine the pressure or stimulus of one + part of the nerve within the chest caused the other part, which serves + the arm, to become torpid, and consequently cold by sympathy; and that + the inflammation was the consequence of the previous torpor and coldness + of the arm, in the same manner as the swelling and inflammation of the + cheek in tooth-ach, in the first species of this genus; and that many + rheumatic inflammations are thus produced by sympathy with some distant + part.</p> + + <p><a name="species_IV_2_2_14">14</a>. <i>Diarrhœa a + dentitione.</i> The diarrhœa, which frequently attends dentition, + is the consequence of indigestion; the aliment acquires chemical changes, + and by its acidity acts as a cathartic; and changes the yellow bile into + green, which is evacuated along with indigested parts of the coagulum of + milk. The indigestion is owing to the torpor of the stomach and + intestines caused by their association with the membranes of the gums, + which are now stimulated into great exertion with pain; both which + contribute to expend the general quantity of sensorial power, which + belongs to this membranous association; and thus the stomach and + intestines act with less than their natural energy. This is generally + esteemed a favourable symptom in difficult dentition, as the pain of the + alveolar membranes exhausts the sensorial power without producing + convulsions for its relief. See Class <a href="#species_I_1_4_5">I. 1. 4. + 5</a>. And the diarrhœa ceases, as the tooth advances.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_2_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_2_3_1">1</a>. <i>Titubatio linguæ.</i> Impediment + of speech is owing to the associations of the motions of the organs of + speech being interrupted or dissevered by ill-employed sensation or + sensitive motions, as by awe, bashfulness, ambition of shining, or fear + of not succeeding, and the person uses voluntary efforts in vain to + regain the broken associations, as explained in Sect. XVII. 1. 10. and + XVII. 2. 10.</p> + + <p>The broken association is generally between the first consonant and + the succeeding vowel; as in endeavouring to pronounce the word parable, + the p is voluntarily repeated again and again, but the remainder of the + word does not follow, because the association between it and the next + vowel is dissevered.</p> + + <p>M. M. The art of curing this defect is to cause the stammerer to + repeat the word, which he finds difficult to speak, eight or ten times + without the initial letter, in a strong voice, or with an aspirate before + it, as arable, or harable; and at length to speak it very softly with the + initial letter p, parable. This should be practised for weeks or months + upon every word, which the stammerer hesitates in pronouncing. To this + should be added much commerce with mankind, in order to acquire a + carelessness about the opinions of others.</p> + + <p><a name="species_IV_2_3_2">2</a>. <i>Chorea St. Viti.</i> In the St. + Vitus's dance the patient can at any time lie still in bed, which shews + the motions not to be convulsive; and he can at different times + voluntarily exert every muscle of his body; which evinces, that they are + not paralytic. In this disease the principal muscle in any designed + motion obeys the will; but those muscles, whose motions were associated + with the principal one, do not act; as their association is dissevered, + and thus the arm or leg is drawn outward, or inward, or backward, instead + of upward or forward, with various gesticulations exactly resembling the + impediment of speech.</p> + + <p>This disease is frequently left after the itch has been too hastily + cured. See Convulsio dolorifica, Class <a href="#species_III_1_1_6">III. + 1. 1. 6</a>. A girl about eighteen, after wearing a mercurial girdle to + cure the itch, acquired the Chorea St. Viti in so universal a manner, + that her speech became affected as well as her limbs; and there was + evidently a disunion of the common trains of ideas; as the itch was still + among the younger children of the family, she was advised to take her + sister as a bedfellow, and thus received the itch again; and the dance of + St. Vitus gradually ceased. See Class <a href="#species_II_1_5_6">II. 1. + 5. 6</a>.</p> + + <p>M. M. Give the patient the itch again. Calomel a grain every night, or + sublimate a quarter of a grain twice a day for a fortnight. Steel. Bark. + Warm-bath. Cold-bath. Opium. Venesection once at the beginning of the + disease. Electricity. Perpetual slow and repeated efforts to move each + limb in the designed direction, as in the titubatio linguæ above + described.</p> + + <p><a name="species_IV_2_3_3">3</a>. <i>Risus.</i> Laughter is a + perpetual interruption of voluntary exertion by the interposition of + pleasurable sensation; which not being checked by any important + consequences rises into pain, and requires to be relieved or moderated by + the frequent repetition of voluntary exertion. See Sect. XXXIV. 1. 4. and + Class <a href="#species_III_1_1_4">III. 1. 1. 4</a>. and <a + href="#species_IV_1_3_3">IV. 1. 3. 3</a>.</p> + + <p><a name="species_IV_2_3_4">4</a>. <i>Tremor ex irâ.</i> The trembling + of the limbs from anger. The interruption of the voluntary associations + of motions by anger, originates from too great a part of the sensorial + power being exerted on the organs of sense; whence the muscles, which + ought to support the body upright, are deprived of their due quantity, + and tremble from debility. See Class <a href="#species_III_2_1_1">III. 2. + 1. 1</a>.</p> + + <p><a name="species_IV_2_3_5">5</a>. <i>Rubor ex irâ.</i> Redness from + anger. Anger is an excess of aversion, that is of voluntarity not yet + employed. It is excited by the pain of offended pride; when it is + employed it becomes outrage, cruelty, insanity. The cutaneous + capillaries, especially those of the face, are more mobile, that is, more + easily excited into increased action, or more easily become torpid, from + less variation of sensorial power, than any other parts of the system, + which is owing to their being perpetually subject to the vicissitudes of + heat and cold, and of extension and corrugation. Hence, when an excess of + voluntarity exists without being immediately expended in the actions of + the large muscles, the capillary arteries and glands acquire more + energetic action, and a flushed skin is produced, with increased + secretion of perspirable matter, and consequent heat, owing to the pause + or interruption of voluntary action; and thus the actions of these + cutaneous vessels become associated between the irascent ideas and + irascent muscular actions, which are thus for a time interrupted.</p> + + <p><a name="species_IV_2_3_6">6</a>. <i>Rubor criminati.</i> The blushing + of accused people, whether guilty or not, appears to be owing to + circumstances similar to that of anger; for in these situations there is + always a sudden voluntarity, or wish, of clearing their characters arises + in the mind of the accused person; which, before an opportunity is given + for it to be expended on the large muscles, influences the capillary + arteries and glands, as in the preceding article. Whence the increased + actions of the capillaries, and the consequent redness and heat, become + exerted between the voluntary ideas of self-defence, and the muscular + actions necessary for that purpose; which last are thus for a time + interrupted or delayed.</p> + + <p>Even in the blush of modesty or bashfulness there is a + self-condemnation for some supposed defect or indecorum, and a sudden + voluntarity, or wish, of self-defence; which not being expended in + actions of the larger muscles excites the capillaries into action; which + in these subjects are more mobile than in others.</p> + + <p>The blush of young girls on coming into an assembly room, where they + expect their dress, and steps, and manner to be examined, as in dancing a + minuet, may have another origin; and may be considered as a hot fit of + returning confidence, after a previous cold fit of fear.</p> + + <p><a name="species_IV_2_3_7">7</a>. <i>Tarditas paralytica.</i> By a + stroke of the palsy or apoplexy it frequently happens, that those ideas, + which were associated in trains, whose first link was a voluntary idea, + have their connection dissevered; and the patient is under the necessity + by repeated efforts slowly to renew their associations. In this situation + those words, which have the fewest other words associated with them, as + the proper names of persons or places, are the most difficult to + recollect. And in those efforts of recollection the word opposite to the + word required is often produced, as hot for cold, winter for summer, + which is owing to our associating our ideas of things by their opposites + as well as by their similitudes, and in some instances perhaps more + frequently, or more forcibly. Other paralytic patients are liable to give + wrong names to external objects, as using the word pigs for sheep, or + cows for horses; in this case the association between the idea of the + animal and the name of it is dissevered; but the idea of the class or + genus of the thing remains; and he takes a name from the first of the + species, which presents itself, and sometimes can correct himself, till + he finds the true one.</p> + + <p><a name="species_IV_2_3_8">8</a>. <i>Tarditas senilis.</i> Slowness of + age. The difficulty of associating ideas increases with our age; as may + be observed from old people forgetting the business of the last hour, + unless they impress it strongly, or by frequent repetition, though they + can well recollect the transactions of their youth. I saw an elderly man, + who could reason with great clearness and precision and in accurate + language on subjects, which he had been accustomed to think upon; and yet + did not know, that he had rang the bell by his fire-side in one minute + afterwards; nor could then recollect the object he had wanted, when his + servant came.</p> + + <p>Similar to this is the difficulty which old people experience in + learning new bodily movements, that is, in associating new muscular + actions, as in learning a new trade or manufactury. The trains of + movements, which obey volition, are the last which we acquire; and the + first, which are disassociated.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO II.</h3> + +<h3><i>Decreased Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_2_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + + <p>As the diseases, which obey solar or lunar periods, commence with + torpor or inactivity, such as the cold paroxysms of fevers, the torpor + and consequent pain of hemicrania, and the pains which precede the fits + of epilepsy and convulsion, it would seem, that these diseases are more + generally owing to the diminution than to the excess of solar or lunar + gravitation; as the diseases, which originate from the influence of the + matter of heat, are much more generally in this country produced by the + defect than by the excess of that fluid.</p> + + <p>The periodic returns of so many diseases coincide with the diurnal, + monthly, and annual rounds of time; that any one, who would deny the + influence of the sun and moon on the periods of quotidian, tertian, and + quartan fevers, must deny their effect on the tides, and on the seasons. + It has generally been believed, that solar and lunar effect was exerted + on the blood; which was thus rendered more or less stimulant to the + system, as described in Sect. XXXII. 6. But as the fluid matter of + gravitation permeates and covers all things, like the fluid matter of + heat; I am induced to believe, that gravitation acts in its medium state + rather as a causa sine quâ non of animal motion, like heat; which may + disorder the system chemically or mechanically, when it is diminished; + but may nevertheless stimulate it, when increased, into animal + exertion.</p> + + <p>Without heat and motion, which some philosophers still believe to be + the same thing, as they so perpetually appear together, the particles of + matter would attract and move towards each other, and the whole universe + freeze or coalesce into one solid mass. These therefore counteract the + gravitation of bodies to one center; and not only prevent the planets + from falling into the sun, but become either the efficient causes of + vegetable and animal life, or the causes without which life cannot exist; + as by their means the component particles of matter are enabled to slide + over each other with all the various degrees of fluidity and + repulsion.</p> + + <p>As the attraction of the moon countervails or diminishes the terrene + gravitation of bodies on the surface of the earth; a tide rises on that + side of the earth, which is turned towards the moon; and follows it, as + the earth revolves. Another tide is raised at the same time on the + opposite side of the revolving earth; which is owing to the greater + centrifugal motion of that side of the earth, which counteracts the + gravitation of bodies near its surface. For the earth and moon may be + considered as two cannon balls of different sizes held together by a + chain, and revolving once a month round a common center of gravity + between them, near the earth's surface; at the same time that they + perform their annual orbits round the sun. Whence the centrifugal force + of that side of the earth, which is farthest from this center of motion, + round which the earth and moon monthly revolve, is considerably greater, + than the centrifugal force of that side of the earth, which is nearest + it; to which should be added, that this centrifugal force not only + contributes to diminish the terrene gravitation of bodies on the earth's + surface on that side furthest from this center of motion, but also to + increase it on that side, which is nearest it.</p> + + <p>Another circumstance, which tends to raise the tide on the part of the + earth's surface, which is most distant from the moon, is, that the + attraction of the moon is less on that part of the ocean, than it is on + the other parts of the earth. Thus the moon may be supposed to attract + the water on the side of the earth nearest it with a power equal to + three; and to attract the central parts of the earth with a power equal + to two; and the water on the part of the earth most distant from the moon + with a power only equal to one. Hence on the side of the earth most + distant from the moon, the moon's attraction is less, and the centrifugal + force round their common center of motion is greater; both which + contribute to raise the tides on that side of the earth. On the side of + the earth nearest the moon, the moon's attraction is so much greater as + to raise the tides; though the centrifugal force of the surface of the + earth round their common center of motion in some degree opposes this + effect.</p> + + <p>On these accounts, when the moon is in the zenith or nadir, the + gravitation of bodies on the earth's surface will be greatest at the two + opposite quadratures; that is, the greatest gravitation of bodies on the + earth's surface towards her center during the lunar day is about six + hours and an half after the southing, or after the northing of the + moon.</p> + + <p>Circumstances similar to these, but in a less degree, must occur in + respect to the solar influence on terrestrial bodies; that is, there must + be a diminution of the gravity of bodies, near the earth's surface at + noon, when the sun is over them; and also at midnight from the greater + centrifugal force of that side of the earth, which is most distant from + the center, round which the earth moves in her annual orbit, than on the + side nearest that center. Whence it likewise follows, that the + gravitation of bodies towards the earth is greatest about six hours after + noon, and after midnight.</p> + + <p>Now when the sun and moon have their united gravitation on the same + side of the earth, as at the new moon; or when the solar attraction + coincides with the greater centrifugal motion of that side of the earth, + which is furthest distant from the moon, as at the full moon; and when + this happens about noon or midnight, the gravitation of terrene bodies + towards the earth will be greater about six hours after noon, and after + midnight, than at any other part of the lunar period; because the + attraction of both these luminaries is then exerted on those sides of the + earth over which they hang, which at other times of the month are more or + less exerted on other parts of it.</p> + + <p>Lastly, as heat and motion counteract the gravitation of the particles + of bodies to each other, and hence become either the efficient causes of + vegetable and animal life, or the causes without which life cannot exist, + it seems to follow, that when our gravitation towards the earth's center + is greatest, the powers of life should be the least; and hence that those + diseases, which begin with torpor, should occur about six hours after the + solar or lunar noon, or about six hours after the solar or lunar + midnight; and this most frequently about six hours after or before the + new or full moon; and especially when these happen at noon or at + midnight; or lastly, according to the combination of these powers in + diminishing or increasing the earth's attraction to bodies on its + surface.</p> + + <p>The returns or exacerbations of many fevers, both irritative and + inflammatory, about six in the evening, and of the periodic cough + described in Sect. XXXVI. 3. 9. countenance this theory. Tables might be + made out to shew the combined powers of the sun and moon in diminishing + the gravitation of bodies on the earth's surface, at every part of their + diurnal, monthly, and annual periods; and which might facilitate the + elucidation of this subject. But I am well aware of the difficulty of its + application to diseases, and hope these conjectures may induce others to + publish more numerous observations, and more conclusive reasonings.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_2_4_1">1</a>. <i>Somni periodus.</i> The periods + of sleeping and of waking are shortened or prolonged by so many other + circumstances in animal life, besides the minute difference between + diurnal and nocturnal solar gravitation, that it can scarcely be ascribed + to this influence. At the same time it is curious to observe, that + vegetables in respect to their times of sleeping more regularly observe + the hour of the day, than the presence or absence of light, or of heat, + as may be seen by consulting the calendar of Flora. Botanic Garden, Part + II. Canto 2. l. 165. note.</p> + + <p>Some diseases, which at first sight might be supposed to be influenced + by solar periods, seem to be induced by the increasing sensibility of the + system to pain during our sleeping hours; as explained in Sect. XVIII. + 15. Of these are the fits of asthma, of some epilepsies, and of some + hæmoptoes; all which disturb the patient after some hours sleep, and are + therefore to be ascribed to the increase of our dormant sensibility. + There may likewise be some doubt, whether the commencement of the pain of + gout in the foot, as it generally makes its attack after sleep, should be + ascribed to the increased sensibility in sleep, or to solar + influence?</p> + + <p>M. M. When asthmatic or epileptic fits or hæmoptoe occur after a + certain number of hours of sleep, the patient should be forcibly awakened + before the expected time by an alarm clock, and drink a cup of chocolate + or lemonade.—Or a grain of opium should be given at going to + bed.—In one case to prevent the too great increase of sensibility + by shortening the time of sleep; and in the other by increasing the + irritative motions, and expending by that means a part of the sensorial + power.</p> + + <p><a name="species_IV_2_4_2">2</a>. <i>Studii inanis periodus.</i> Class + <a href="#species_III_1_2_2">III. 1. 2. 2</a>. The cataleptic spasm which + preceded the reverie and somnambulation in the patient, whose case is + related in Sect. XIX. 2. occurred at exactly the same hour, which was + about eleven in the morning for many weeks; till those periods were + disturbed by large doses of opium; and must therefore be referred to some + effect of solar gravitation. In the case of Master A. Sect. XXXIV. 3. as + the reverie began early in the morning during sleep, there may be a + doubt, whether this commenced with torpor of some organ catenated with + solar gravitation; or was caused by the existence of a previous torpid + part, which only became so painful as to excite the exertions of reverie + by the perpetual increase of sensibility during the continuance of sleep, + as in some fits of epilepsy, asthma, and hæmoptoe mentioned in the + preceding article.</p> + + <p><a name="species_IV_2_4_3">3</a>. <i>Hemicraniæ periodus.</i> Periods + of hemicrania. Class <a href="#species_IV_2_2_8">IV. 2. 2. 8</a>. The + torpor and consequent pain of some membranes on one side of the head, as + over one eye, is frequently occasioned by a decaying tooth, and is liable + to return every day, or on alternate days at solar or lunar periods. In + this case large quantities of the bark will frequently cure the disease, + and especially if preceded by venesection and a brisk cathartic; but if + the offending tooth can be detected, the most certain cure is its + extraction. These partial head-achs are also liable to return at the + greater lunar periods, as about once a month. Five drops from a two-ounce + phial of a saturated solution of arsenic twice a day for a week or two + have been said to prevent the returns of this disease. See a Treatise on + Arsenic by Dr. Fowler, of York. Strong errhines have also been + recommended.</p> + + <p><a name="species_IV_2_4_4">4</a>. <i>Epilepsiæ dolorificæ + periodus.</i> Class <a href="#species_III_1_1_8">III. 1. 1. 8</a>. The + pain which induces after about an hour the violent convulsions or + insanity, which constitute the painful epilepsy, generally observe solar + diurnal periods for four or five weeks, and are probably governed by + solar and lunar times in respect to their greater periods; for I have + observed that the daily paroxysms, unless disturbed by large doses of + opium, recur at very nearly the same hour, and after a few weeks the + patients have recovered to relapse again at the interval of a few months. + But more observations are wanted upon this subject, which might be of + great advantage in preventing the attacks of this disease; as much less + opium given an hour before its expected daily return will prevent the + paroxysm, than is necessary to cure it, after it has commenced.</p> + + <p><a name="species_IV_2_4_5">5</a>. <i>Convulsionis dolorificæ + periodus.</i> Class <a href="#species_III_1_1_6">III. 1. 1. 6</a>. The + pains, which produce these convulsions, are generally left after + rheumatism, and come on when the patients are become warm in bed, or have + been for a short time asleep, and are therefore perhaps rather to be + ascribed to the increasing sensibility of the system during sleep, than + to solar diurnal periods, as in Species first and second of this + Genus.</p> + + <p><a name="species_IV_2_4_6">6</a>. <i>Tussis periodicæ periodus.</i> + Periodic cough, Class <a href="#species_IV_2_1_9">IV. 2. 1. 9</a>. + returns at exact solar periods; that described in Sect. XXXVI. 3. 9. + recurred about seven in the afternoon for several weeks, till its periods + were disturbed by opium, and then it recurred at eleven at night for + about a week, and was then totally destroyed by opium given in very large + quantities, after having been previously for a few days omitted.</p> + + <p><a name="species_IV_2_4_7">7</a>. <i>Catameniæ periodus.</i> Periods + of menstruation. The correspondence of the periods of the catamenia with + those of the moon was treated of in Sect. XXXII. 6. and can admit of no + more doubt, than that the returns of the tides are governed by lunar + influence. But the manner in which this is produced, is less evident; it + has commonly been ascribed to some effect of the lunar gravitation on the + circulating blood, as mentioned in Sect. XXXII. 6. But it is more + analogous to other animal phenomena to suppose that the lunar gravitation + immediately affects the solids by its influx or stimulus. Which we + believe of the fluid element of heat, in which we are equally immersed; + and of the electric fluid, which also surrounds and pervades us. See + Sect. XXXVI. 2. 3.</p> + + <p>If the torpor of the uterine veins, which induces the monthly periods + of the catamenia, be governed by the increase of terrene gravitation; + that is, by the deficiency of the counter-influence of solar and lunar + gravitation; why does not it occur most frequently when the terrene + gravitation is the greatest, as about six hours after the new moon, and + next to that at about six hours after the full moon? This question has + its difficulty; first, if the terrene gravitation be greatest about six + hours after the new moon, it must become less and less about the same + time every lunar day, till the end of the first quarter, when it will be + the least; it must then increase daily till the full. After the full the + terrene gravitation must again decrease till the end of the third + quarter, when it will again be the least, and must increase again till + the new moon; that is, the solar and lunar counter-gravitation is + greatest, when those luminaries are vertical, at the new moon, and full + moon, and least about six hours afterwards. If it was known, whether more + menstruations occur about six hours after the moon is in the zenith or + nadir; and in the second and fourth quarters of the moon, than in the + first and third; some light would be thrown on this subject; which must + in that respect wait for future observations.</p> + + <p>Secondly, if the lunar influence produces a very small degree of + quiescence, suppose of the uterine veins, at first; and if that recurs at + certain periods, as of lunar days, or about 25 hours, even with less + power to produce quiescence than at first; yet the quiescence will daily + increase by the acquired habit acting at the same time, as explained in + Sect. XII. 3. 3. till at length so great a degree of quiescence will be + induced as to cause the inaction of the veins of the uterus, and + consequent venous hæmorrhage. See Sect. XXXII. 6. Class <a + href="#species_I_2_1_11">I. 2. 1. 11</a>. <a href="#species_IV_1_4_4">IV. + 1. 4. 4</a>. See the introduction to this Genus.</p> + + <p><a name="species_IV_2_4_8">8</a>. <i>Hæmorrhoidis periodus.</i> The + periods of the piles depend on the torpor of the veins of the rectum, and + are believed to recur nearly at monthly intervals. See Sect. XXVII. 2. + and Class <a href="#species_I_2_1_6">I. 2. 1. 6</a>.</p> + + <p><a name="species_IV_2_4_9">9</a>. <i>Podagræ periodus.</i> The periods + of gout in some patients recur at annual intervals, as in the case + related above in Class <a href="#species_IV_1_2_15">IV. 1. 2. 15</a>. in + which the gouty paroxysm returned for three successive years on nearly + the same day of the month. The commencement of the pain of each paroxysm + is generally a few hours after midnight, and may thence either be induced + by diurnal solar periods, or by the increasing sensibility during sleep, + as mentioned in the first species of this genus.</p> + + <p><a name="species_IV_2_4_10">10</a>. <i>Erysipelatis periodus.</i> Some + kinds of erysipelas which probably originate from the association of the + cutaneous vessels with a diseased liver, occur at monthly periods, like + the hæmorrhois or piles; and others at annual periods like the gout; as a + torpor of some part I suppose always precedes the erysipelatous + inflammation, the periods should accord with the increasing influence of + terrene gravitation, as described in the introduction to this Genus, and + in Species the seventh of it. Other periods of diseases referable to + solar and lunar influence are mentioned in Sect XXXVI. and many others + will probably be discovered by future observation.</p> + + <p><a name="species_IV_2_4_11">11</a>. <i>Febrium periodus.</i> Periods + of fevers. The commencement of the cold fits of intermittent fevers, and + the daily exacerbations of other fevers, so regularly recur at diurnal + solar or lunar periods, that it is impossible to deny their connection + with gravitation; as explained in Sect. XXXVI. 3. Not only these + exacerbations of fever, and their remissions, obey the diurnal solar and + lunar periods; but the preparatory circumstances, which introduce fevers, + or which determine their crisises, appear to be governed by the parts of + monthly lunar periods, and of solar annual ones. Thus the variolous fever + in the natural small-pox commences on the 14th day, and in the inoculated + small-pox on the seventh day. The fever and eruption in the distinct kind + take up another quarter of a lunation, and the maturation another + quarter.</p> + + <p>The fever, which is termed canine madness, or hydrophobia, is believed + to commence near the new or full moon; and, if the cause is not then + great enough to bring on the disease, it seems to acquire some strength, + or to lie dormant, till another, or perhaps more powerful lunation calls + it into action. In the spring, about three or four years ago, a mad dog + very much worried one swine confined in a sty, and bit another in the + same sty in a less degree; the former became mad, refused his meat, was + much convulsed, and died in about four days; this disease commenced about + a month after the bite. The other swine began to be ill about a month + after the first, and died in the same manner.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO <a name="ordo_IV_3">III</a>.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_3_1">I</a>.</h3> + +<h3><i>Catenated with Irritative Motions.</i></h3> + + <p>Those retrograde associate motions, the first links of which are + catenated with irritative motions, belong to this genus. All the + retrograde motions are consequent to debility, or inactivity, of the + organ; and therefore properly belong to the genera of decreased actions + both in this and the former classes.</p> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_3_1_1">1</a>. <i>Diabætes irritata.</i> When the + absorbents of the intestines are stimulated too strongly by spirit of + wine, as in the beginning of drunkenness, the urinary absorbents invert + their motions. The same happens from worms in the intestines. In other + kinds of diabetes may not the remote cause be the too strong action of + the cutaneous absorbents, or of the pulmonary ones? May not in such cases + oil externally or internally be of service? or warm bathing for an hour + at a time? In hysteric inversions of motion is some other part too much + stimulated? or pained from the want of stimulus?</p> + + <p><a name="species_IV_3_1_2">2</a>. <i>Sudor frigidus in asthmate.</i> + The cause of the paroxysms of humoral asthma is not well understood; I + suppose it to be owing to a torpidity or inaction of the absorbents + belonging to the pulmonary vessels, as happens probably to other viscera + at the commencement of intermittent fevers, and to a consequent + accumulation of fluids in them; which at length producing great + irritation or uneasy sensation causes the violent efforts to produce the + absorption of it. The motions of the cutaneous absorbent vessels by their + association with those of the pulmonary ones become retrograde, and + effuse upon the skin a fluid, which is said to be viscid, and which + adheres in drops.</p> + + <p>A few days ago I saw a young man of delicate constitution in what was + called a fit of the asthma; he had about two months before had a + peripneumony, and had been ever since subject to difficult respiration on + exertion, with occasional palpitation of his heart. He was now seized + about eight at night after some exertion of mind in his business with + cold extremities, and difficulty of breathing. He gradually became worse, + and in about half an hour, the palpitation of his heart and difficult + respiration were very alarming; his whole skin was cold and pale, yet he + did not shudder as in cold paroxysm of fever; his tongue from the point + to the middle became as cold as his other extremities, with cold breath. + He seemed to be in the act of dying, except that his pulse continued + equal in time, though very quick. He lost three ounces of blood, and took + ten drops of laudanum with musk and salt of hartshorn, and recovered in + an hour or two without any cold sweat.</p> + + <p>There being no cold sweat seems to indicate, that there was no + accumulation of serous fluid in the lungs; and that their inactivity, and + the coldness of the breath, was owing to the sympathy of the air-cells + with some distant part. There was no shuddering produced, because the + lungs are not sensible to heat and cold; as any one may observe by going + from a warm room into a frosty air, and the contrary. So the steam of hot + tea, which scalds the mouth, does not affect the lungs with the sensation + of heat. I was induced to believe, that the whole cold fit might be owing + to suppuration in some part of the chest; as the general difficulty of + breathing seemed to be increased after a few days with pulse of 120, and + other signs of empyema. Does the cold sweat, and the occurrence of the + fits of asthma after sleep, distinguish the humoral asthma from the cold + paroxysm of intermittents, or which attends suppuration, or which + precedes inflammation?—I heard a few weeks afterwards, that he spit + up much matter at the time he died.</p> + + <p><a name="species_IV_3_1_3">3</a>. <i>Diabætes a timore.</i> The + motions of the absorbent vessels of the neck of the bladder become + inverted by their consent with those of the skin; which are become torpid + by their reverse sympathy with the painful ideas of fear, as in Sect. + XVI. 8. 1. whence there is a great discharge of pale urine, as in + hysteric diseases.</p> + + <p>The same happens from anxiety, where the painful suspense is + continued, even when the degree of fear is small; as in young men about + to be examined for a degree at the universities the frequency of making + water is very observable. When this anxiety is attended with a sleepless + night, the quantity of pale urine is amazingly great in some people, and + the micturition very frequent.</p> + + <p>M. M. Opium. Joy. Consolations of friendship.</p> + + <p><a name="species_IV_3_1_4">4</a>. <i>Diarrhœa a timore.</i> The + absorbent vessels of the intestines invert their motions by direct + consent with the skin; hence many liquid stools as well as much pale + urine are liable to accompany continued fear, along with coldness of the + skin. The immediate cause of this is the decreased sensorial power of + association, which intervenes between the actions of the absorbents of + the cold skin, and those of the intestinal absorbents; the motions of the + latter become on that account weakened and at length retrograde. The + remote cause is the torpor of the vessels of the skin catenated with the + pain of fear, as explained in Sect. XVI. 8. 1.</p> + + <p>The capillaries of the skin consent more generally by direct sympathy + with those of the lower intestines, and of the bladder; but by reverse + sympathy more generally with those of the stomach and upper intestines. + As appears in fevers, where the hot skin accompanies indigestion of the + stomach; and in diarrhœas attended with cold extremities.</p> + + <p>The remote cause is the torpor of the skin owing to its reverse + sympathy with the painful sensual motions, or ideas, of fear; which are + now actuated with great energy, so as to deprive the second link of + associated motions of their due share of sensorial power. It is also + probable, that the pain of fear itself may contribute to exhaust the + sensorial power, even when it produces no muscular action. See Class <a + href="#genus_IV_2_2">IV. 2. 2</a>.</p> + + <p><a name="species_IV_3_1_5">5</a>. <i>Pallor et tremor a timore.</i> A + retrograde action of the capillaries of the skin producing paleness, and + a torpor of the muscular fibres of the limbs occasioning trembling, are + caused by their reverse associations with the ideas or imaginations of + fear; which are now actuated with violent energy, and accompanied with + great pain. The cause of these associations are explained in Sect XVI. 8. + 1.</p> + + <p>These torpid actions of the capillaries and muscles of the limbs are + not caused immediately by the painful sensation of fear; as in that case + they would have been increased and not decreased actions, as occurs in + anger; where the painful volition increases the actions of the + capillaries, exciting a blush and heat of the skin. Whence we may gain + some knowledge of what is meant by depressing and exciting passions; the + former confiding of ideas attended with pain, which pain occasions no + muscular actions, like the pain of cold head-ach; the latter being + attended with volitions, and consequent muscular exertions.</p> + + <p>That is, the pain of fear, and the pain of anger, are produced by the + exertion of certain ideas, or motions of certain nerves of sense; in the + former case, the painful sensation of fear produces no muscular actions, + yet it exhausts or employs so much sensorial power, that the whole system + acts more feebly, or becomes retrograde; but some parts of it more so + than others, according to their early associations described in Sect. + XVI. 8. 1. hence the tremor of the limbs, palpitation of heart, and even + syncope. In anger the painful volition produces violent muscular actions; + but if previous to these any deliberation occurs, a flushed countenance + sometimes, and a red skin, are produced by this superabundance of + volition exerted on the arterial system; but at other times the skin + becomes pale, and the legs tremble, from the exhaustion or expenditure of + the sensorial power by the painful volitions of anger on the organs of + sense, as by the painful sensations of fear above mentioned.</p> + + <p>Where the passion of fear exists in a great degree, it exhausts or + expends so much sensorial power, either simply by the pain which attends + it, or by the violent and perpetual excitement of the terrific + imaginations or ideas, that not only a cold and pale skin, but a + retrograde motion of the cutaneous absorbents occurs, and a cold sweat + appears upon the whole surface of the body, which probably sometimes + increases pulmonary absorption; as in Class <a + href="#species_II_1_6_4">II. 1. 6. 4</a>. and as in the cold sweats, + which attend the paroxysms of humoral asthma. Hence anxiety, which is a + continued pain of fear, so universally debilitates the constitution as to + occasion a lingering death; which happens much more frequently than is + usually supposed; and these victims of continued anxiety are said to die + of a broken heart. Other kinds of paleness are described in Class <a + href="#species_I_2_2_2">I. 2. 2. 2</a>.</p> + + <p>M. M. Opium. Wine. Food. Joy.</p> + + <p><a name="species_IV_3_1_6">6</a>. <i>Palpitatio cordis a timore.</i> + The palpitation of the heart from fear is owing to the weak action of it, + and perhaps sometimes to the retrograde exertion of the ventricules and + auricles; because it seems to be affected by its association with the + capillaries, the actions of which, with those of the arteries and veins, + constitute one great circle of associate motions. Now when the + capillaries of the skin become torpid, coldness and paleness succeed; and + with these are associated the capillaries of the lungs, whence difficult + respiration; and with these the weak and retrograde actions of the heart. + At the same time the absorbents of the skin, and of the bladder, and of + the intestines, sometimes become retrograde, and regurgitate their + contents; as appears by the pale urine in large quantities, which attends + hysteric complaints along with this palpitation of the heart; and from + the cold sweats, and diarrhœa; all which, as well as the hysteric + complaints, are liable to be induced or attended by fear.</p> + + <p>When fear has still more violently affected the system, there have + been instances where syncope, and sudden death, or a total stoppage of + the circulation, have succeeded: in these last cases, the pain of fear + has employed or exhausted the whole of the sensorial power, so that not + only those muscular fibres generally exerted by volition cease to act, + whence the patient falls down; and those, which constitute the organs of + sense, whence syncope; but lastly those, which perform the vital motions, + become deprived of sensorial power, and death ensues. See Class. <a + href="#species_I_2_1_4">I. 2. 1. 4</a>. and <a + href="#species_I_2_1_10">I. 2. 1. 10</a>. Similar to this in some + epileptic fits the patient first suddenly falls down, without even + endeavouring to save himself by his hands before the convulsive motions + come on. In this case the great exertion of some small part in + consequence of great irritation or sensation exhausts the whole sensorial + power, which was lodged in the extremities of the locomotive nerves, for + a short time, as in syncope; and as soon as these muscles are again + supplied, convulsions supervene to relieve the painful sensation. See + Class <a href="#species_III_1_1_7">III. 1. 1. 7</a>.</p> + + <p><a name="species_IV_3_1_7">7</a>. <i>Abortio a timore.</i> Women + miscarry much more frequently from a fright, than from bodily injury. A + torpor or retrograde motion of the capillary arteries of the internal + uterus is probably the immediate cause of these miscarriages, owing to + the association of the actions of those vessels with the capillaries of + the skin, which are rendered torpid or retrograde by fear. By this + contraction of the uterine arteries, the fine vessels of the placenta, + which are inserted into them, are detruded, or otherwise so affected, + that the placenta separates at this time from the uterus, and the fetus + dies from want of oxygenation. A strong young woman, in the fifth or + sixth month of her pregnancy, who has since borne many children, went + into her cellar to draw beer; one of the servant boys was hid behind a + barrel, and started out to surprise her, believing her to be the + maid-servant; she began to flood immediately, and miscarried in a few + hours. See Sect. XXXIX. 6. 5. and Class <a href="#species_I_2_1_14">I. 2. + 1. 14</a>.</p> + + <p><a name="species_IV_3_1_8">8</a>. <i>Hysteria a timore.</i> Some + delicate ladies are liable to fall into hysteric fits from sudden fright. + The peristaltic motions of the bowels and stomach, and those of the + œsophagus, make a part of the great circle of irritative motions + with those of the skin, and many other membranes. Hence when the + cutaneous vessels become torpid from their reverse sympathy with the + painful ideas of fear; these of the bowels, and stomach, and + œsophagus, become first torpid by direct sympathy with those of the + skin, and then feebly and ineffectually invert the order of their + motions, which constitutes a paroxysm of the hysteric disease. See Class + <a href="#species_I_3_1_10">I. 3. 1. 10</a>. These hysteric paroxysms are + sometimes followed by convulsions, which belong to Class <a + href="#class_III">III</a>. as they are exertions to relieve pain; and + sometimes by death. See Species 9 of this Genus, and Class <a + href="#species_I_2_1_4">I. 2. 1. 4</a>.</p> + + <p>Indigestion from fear is to be ascribed in the same manner to the + torpor of the stomach, owing to its association with the skin. As in + Class <a href="#species_IV_1_2_5">IV. 1. 2. 5</a>. <a + href="#genus_IV_2_1">IV. 2. 1</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_3_2">II</a>.</h3> + +<h3><i>Catenated with Sensitive Motions.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_3_2_1">1</a>. <i>Nausea idealis.</i> Nausea from + disgustful ideas, as from nauseous stories, or disgustful sights, or + smells, or tastes, as well as vomiting from the same causes, consists in + the retrograde actions of the lymphatics of the throat, and of the + œsophagus, and stomach; which are associated with the disgustful + ideas, or sensual motions of sight, or hearing, or smell, or taste; for + as these are decreased motions of the lymphatics, or of the + œsophagus, or stomach, they cannot immediately be excited by the + sensorial power of painful sensation, as in that case they ought to be + increased motions. So much sensorial power is employed for a time on the + disgustful idea, or expended in the production of inactive pain, which + attends it, that the other parts of the associated chain of action, of + which this disgustful idea is now become a link, is deprived of their + accustomed share; and therefore first stop, and then invert their + motions. Owing to deficiency of sensorial power, as explained more at + large in Sect. XXXV. 1. 3.</p> + + <p><a name="species_IV_3_2_2">2</a>. <i>Nausea a conceptu.</i> The + nausea, which pregnant women are so subject to during the first part of + gestation, is owing to the reverse sympathy between the uterus and + stomach, so that the increased action of the former, excited by the + stimulus of the growing embryon, which I believe is sometimes attended + with sensation, produces decreased actions of the latter with the + disagreeable sensation of sickness with indigestion and consequent + acidity. When the fetus acquires so much muscular power as to move its + limbs, or to turn itself, which is called quickening, this sickness of + pregnancy generally ceases.</p> + + <p>M. M. Calcined magnesia. Rhubarb. Half a grain of opium twice a day. + Recumbent posture on a sofa.</p> + + <p><a name="species_IV_3_2_3">3</a>. <i>Vomitio vertiginosa.</i> + Sea-sickness, the irritative motions of vision, by which we balance + ourselves, and preserve our perpendicularity, are disturbed by the + indistinctness of their objects; which is either owing to the similarity + of them, or to their distance, or to their apparent or unusual motions. + Hence these irritative motions of vision are exerted with greater energy, + and are in consequence attended with sensation; which, at first is + agreeable, as when children swing on a rope; afterwards the irritative + motions of the stomach, and of the absorbent vessels, which open their + mouths into it, become inverted by their associations with them by + reverse sympathy.</p> + + <p>For the action of vomiting, as well as the disagreeable sensation of + sickness, are shewn to be occasioned by defect of the sensorial power; + which in this case is owing to the greater expenditure of it by the sense + of vision. On the same account the vomiting, which attends the passage of + a stone through the ureter, or from an inflammation of the bowels, or in + the commencement of some fevers, is caused by the increased expenditure + of the sensorial power by the too great action of some links of the + associations of irritative motions; and there being in consequence a + deficiency of the quantity required for other links of this great + catenation.</p> + + <p>It must be observed, that the expenditure of sensorial power by the + retinas of the eyes is very great; which may be estimated by the + perpetual use of those organs during our waking hours, and during most of + our sleeping ones; and by the large diameters of the two optic nerves, + which are nearly the size of a quill, or equal to some of the principal + nerves, which serve the limbs.</p> + + <p><a name="species_IV_3_2_4">4</a>. <i>Vomitio a calculo in uretere.</i> + The action of vomiting in consequence of the increased or decreased + actions of the ureter, when a stone lodges in it. The natural actions of + the stomach, which consist of motions subject to intermitted irritations + from the fluids, which pass through it, are associated with those of the + ureter; and become torpid, and consequently retrograde, by intervals, + when the actions of the ureter becomes torpid owing to previous great + stimulus from the stone it contains; as appears from the vomiting + existing when the pain is least. When the motions of the ureter are thus + lessened, the sensorial power of association, which ought to actuate the + stomach along with the sensorial power of irritation, ceases to be + excited into action; and in consequence the actions of the stomach become + less energetic, and in consequence retrograde.</p> + + <p>For as vomiting is a decreased action of the stomach, as explained in + Sect. XXXV. 1. 3. it cannot be supposed to be produced by the pain of + gravel in the ureter alone, as it should then be an increased action, not + a decreased one.</p> + + <p>The perpetual vomiting in ileus is caused in like manner by the + defective excitement of the sensorial power of association by the bowel, + which is torpid during the intervals of pain; and the stomach sympathizes + with it. See Enteritis, Class <a href="#species_II_1_2_11">II. 1. 2. + 11</a>. Does this symptom of vomiting indicate, whether the disease be + above or below the valve of the colon? Does not the softer pulse in some + kinds of enteritis depend on the sympathy of the heart and arteries with + the sickness of the stomach? See Ileus and Cholera.</p> + + <p>Hence this sickness, as well as the sickness in some fevers, cannot be + esteemed an effort of nature to dislodge any offensive material; but like + the sea-sickness described above, and in Sect. XX. 4. is the consequence + of the associations of irritative or sensitive motions. See Class <a + href="#species_I_1_3_9">I. 1. 3. 9</a>.</p> + + <p><a name="species_IV_3_2_5">5</a>. <i>Vomitio ab insultu + paralytico.</i> Paralytic affections generally commence with vomiting, + the same frequently happens from a violent blow with a stick on the head; + this curious connection of the brain and stomach has not been explained; + as it resembles the sickness in consequence of vertigo at sea, it would + seem to arise from a similar cause, viz. from disturbed irritative or + sensitive associations.</p> + + <p><a name="species_IV_3_2_6">6</a>. <i>Vomitio a titillatione + faucium.</i> If the throat be slightly tickled with a feather, a nausea + is produced, that is, an inverted action of the mouths of the lymphatics + of the fauces, and by direct sympathy an inverted action of the stomach + ensues. As these parts have frequently been stimulated at the same time + into pleasurable action by the deglutition of our daily aliment, their + actions become strongly associated. And as all the food, we swallow, is + either moist originally, or mixed with our moist saliva in the mouth; a + feather, which is originally dry, and which in some measure repels the + moist saliva, is disagreeable to the touch of the fauces; at the same + time this nausea and vomiting cannot be caused by the disagreeable + sensation simply, as then they ought to have been increased exertions, + and not decreased ones, as shewn in Section XXXV. 1. 3. But the mouths of + the lymphatics of the fauces are stimulated by the dry feather into too + great action for a time, and become retrograde afterwards by the debility + consequent to too great previous stimulus.</p> + + <p><a name="species_IV_3_2_7">7</a>. <i>Vomitio cute sympathetica.</i> + Vomiting is successfully stopped by the application of a blister on the + back in some fevers, where the extremities are cold, and the skin pale. + It was stopped by Sydenham by producing a sweat on the skin by covering + the head with the bed-clothes. See Class <a href="#species_IV_1_1_3">IV. + 1. 1. 3</a>. and Suppl. I. <a href="#suppl_XI_6">11. 6</a>.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENUS <a name="genus_IV_3_3">III</a>.</h3> + +<h3><i>Catenated with Voluntary Motions.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_3_3_1">1</a>. <i>Ruminatio.</i> In the rumination + of horned cattle the food is brought up from the first stomach by the + retrograde motions of the stomach and œsophagus, which are + catenated with the voluntary motions of the abdominal muscles.</p> + + <p><a name="species_IV_3_3_2">2</a>. <i>Vomitio voluntaria.</i> Voluntary + vomiting. Some human subjects have been said to have obtained this power + of voluntary action over the retrograde motions of the stomach and + œsophagus, and thus to have been able to empty their stomach at + pleasure. See Sect. XXV. 6. This voluntary act of emptying the stomach is + possessed by some birds, as the pigeon; who has an organ for secreting + milk in its stomach, as Mr. Hunter observed; and softens the food for its + young by previously swallowing it; and afterwards putting its bill into + theirs returns it into their mouths. See Sect. XXXIX. 4. 8. The pelicans + use a stomach, or throat bag, for the purpose of bringing the fish, which + they catch in the sea to shore, and then eject them, and eat them at + their leisure. See Sect. XVI. 11. And I am well informed of a bitch, who + having puppies in a stable at a distance from the house, swallowed the + flesh-meat, which was given her, in large pieces, and carrying it + immediately to her whelps, brought it up out of her stomach, and laid it + down before them.</p> + + <p><a name="species_IV_3_3_3">3</a>. <i>Eructatio voluntaria.</i> + Voluntary eructation. Some, who have weak digestions, and thence have + frequently been induced to eruct the quantity of air discharged from the + fermenting aliment in their stomachs, have gradually obtained a power of + voluntary eructation, and have been able thus to bring up hogsheads of + air from their stomachs, whenever they pleased. This great quantity of + air is to be ascribed to the increase of the fermentation of the aliment + by drawing off the gas as soon as it is produced. See Sect. XXIII. 4.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ORDO III.</h3> + +<h3><i>Retrograde Associate Motions.</i></h3> + +<h3>GENUS. <a name="genus_IV_3_4">IV</a>.</h3> + +<h3><i>Catenated with External Influences.</i></h3> + +<h3>SPECIES.</h3> + + <p><a name="species_IV_3_4_1">1</a>. <i>Catarrhus periodicus.</i> + Periodical catarrh is not a very uncommon disease; there is a great + discharge of a thin saline mucous material from the membranes of the + nostrils, and probably from the maxillary and frontal sinuses, which + recur once a day at exact solar periods; unless it be disturbed by the + exhibition of opium; and resembles the periodic cough mentioned below. + See Class <a href="#species_I_3_2_1">I. 3. 2. 1</a>. It is probably owing + to the retrograde action of the lymphatics of the membranes affected, and + produced immediately by solar influence.</p> + + <p><a name="species_IV_3_4_2">2</a>. <i>Tussis periodica.</i> Periodic + cough, called nervous cough, and tussis serina. It seems to arise from a + periodic retrograde action of the lymphatics of the membrane, which lines + the air-cells of the lungs. And the action of coughing, which is + violently for an hour or longer, is probably excited by the stimulus of + the thin fluid thus produced, as well as by the disagreeable sensation + attending membranous inactivity; and resembles periodic catarrh not only + in its situation on a mucous membrane, but in the discharge of a thin + fluid. As it is partly restrainable, it does not come under the name of + convulsion; and as it is not attended with difficult respiration, it + cannot be called asthma; it is cured by very large doses of opium, see a + case and cure in Sect. XXXVI. 3. 9. see Class <a + href="#species_IV_2_4_6">IV. 2. 4. 6</a>. and seems immediately to be + induced by solar influence.</p> + + <p><a name="species_IV_3_4_3">3</a>. <i>Histeria a frigore.</i> Hysteric + paroxysms are occasioned by whatever suddenly debilitates the system, as + fear, or cold, and perhaps sometimes by external moisture of the air, as + all delicate people have their days of greater or less debility, see + Class <a href="#species_IV_3_1_8">IV. 3. 1. 8</a>.</p> + + <p><a name="species_IV_3_4_4">4</a>. <i>Nausea pluvialis.</i> Sickness at + the commencement of a rainy season is very common among dogs, who assist + themselves by eating the agrostris canina, or dog's grass, and thus empty + their stomachs. The same occurs with less frequency to cats, who make use + of the same expedient. See Sect. XVI. 11. I have known one person, who + from his early years has always been sick at the beginning of wet + weather, and still continues so. Is this owing to a sympathy of the + mucous membrane of the stomach with the mechanical relaxation of the + external cuticle by a moister atmosphere, as is seen in the corrugated + cuticle of the hands of washing-women? or does it sympathize with the + mucous membrane of the lungs, which must be affected along with the mucus + on its surface by the respiration of a moister atmosphere?</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + + <p><a name="supplement"></a></p> + +<h2>SUPPLEMENT +TO +CLASS IV.</h2> + +<h3><i>Sympathetic Theory of Fever.</i></h3> + + <p>As fever consists in the increase or diminution of direct or reverse + associated motions, whatever may have been the remote cause of them, it + properly belongs to the fourth class of diseases; and is introduced at + the end of the class, that its great difficulties might receive + elucidation from the preceding parts of it. These I shall endeavour to + enumerate under the following heads, trusting that the candid reader will + discover in these rudiments of the theory of fever a nascent embryon, an + infant Hercules, which Time may rear to maturity, and render serviceable + to mankind.</p> + +<table class="nobctr"> +<tr><td style="text-align:right"><a href="#suppl_I">I</a>.</td><td>Simple fever of two kinds.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_II">II</a>.</td><td>Compound fever.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_III">III</a>.</td><td>Termination of the cold fit.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_IV">IV</a>.</td><td>Return of the cold fit.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_V">V</a>.</td><td>Sensation excited in fever.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_VI">VI</a>.</td><td>Circles of associated motions.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_VII">VII</a>.</td><td>Alternations of cold and hot fits.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_VIII">VIII</a>.</td><td>Orgasm of the capillaries.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_IX">IX</a>.</td><td>Torpor of the lungs.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_X">X</a>.</td><td>Torpor of the brain.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XI">XI</a>.</td><td>Torpor of the heart and arteries.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XII">XII</a>.</td><td>Torpor of the stomach and intestines.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XIII">XIII</a>.</td><td>Case of continued fever explained.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XIV">XIV</a>.</td><td>Termination of continued fever.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XV">XV</a>.</td><td>Inflammation excited in fever.</td></tr> +<tr><td style="text-align:right"><a href="#suppl_XVI">XVI</a>.</td><td>Recapitulation.</td></tr> +</table> + +<p class="cenhead"><a name="suppl_I">I</a>. <i>Simple fever.</i></p> + + <p><a name="suppl_I_1">1</a>. When a small part of the cutaneous + capillaries with their mucous or perspirative glands are for a short time + exposed to a colder medium, as when the hands are immersed in iced water + for a minute, these capillary vessels and their glands become torpid or + quiescent, owing to the eduction of the stimulus of heat. The skin then + becomes pale, because no blood passes through the external capillaries; + and appears shrunk, because their sides are collapsed from inactivity, + not contracted by spasm; the roots of the hair are left prominent from + the seceding or subsiding of the skin around them; and the pain of + coldness is produced.</p> + + <p>In this situation, if the usual degree of warmth be applied, these + vessels regain their activity; and having now become more irritable from + an accumulation of the sensorial power of irritation during their + quiescence, a greater exertion of them follows, with an increased glow of + the skin, and another kind of pain, which is called the hot-ach; but no + fever, properly so called, is yet produced; as this effect is not + universal, nor permanent, nor recurrent.</p> + + <p><a name="suppl_I_2">2</a>. If a greater part of the cutaneous + capillaries with their mucous and perspirative glands be exposed for a + longer time to cold, the torpor or quiescence becomes extended by direct + sympathy to the heart and arteries; which is known by the weakness, and + consequent frequency of the pulse in cold fits of fever.</p> + + <p>This requires to be further explained. The movements of the heart and + arteries, and the whole of the circulatory vessels, are in general + excited into action by the two sensorial powers of irritation, and of + association. The former is excited by stimulus, the latter by the + previous actions of a part of the vital circle of motions. In the above + situation the capillaries act weakly from defect of irritation, which is + caused by deficient stimulus of heat; but the heart and arteries act + weakly from defect of association, which is owing to the weak action of + the capillaries; which does not now excite the sensorial power of + association into action with sufficient energy.</p> + + <p>After a time, either by the application of warmth, or by the increase + of their irritability owing to the accumulation of the sensorial power of + irritation during their previous quiescence, the capillary vessels and + glands act with greater energy than natural; whence the red colour and + heat of the skin. The heart and arteries acquire a greater strength of + pulsation, and continue the frequency of it, owing to the accumulation of + the sensorial power of association during their previous torpor, and + their consequent greater associability; which is now also more strongly + excited by the increased actions of the capillaries. And thus a fit of + simple fever is produced, which is termed Febris irritativa; and consists + of a torpor of the cutaneous capillaries with their mucous and + perspirative glands, accompanied with a torpor of the heart and arteries; + and afterwards of an increased action of all these vessels, by what is + termed direct sympathy.</p> + + <p>This fever, with strong pulse without inflammation, or febris + irritativa, described in Class <a href="#species_I_1_1_1">I. 1. 1. 1</a>. + is frequently seen in vernal intermittents, as the orgasm of the heart + and arteries is then occasioned by their previous state of torpor; but + more rarely I believe exists in the type of continued fever, except there + be an evident remission, or approximation to a cold fit; at which time a + new accumulation of the sensorial power of association is produced; which + afterwards actuates the heart and arteries with unnatural vigour; or + unless there be some stimulus perpetually acting on the system so as to + induce an increased secretion of sensorial power in the brain, as occurs + in slight degrees of intoxication. Since without one or other of these + circumstances in continued fevers without inflammation, that is, without + the additional sensorial power of sensation being introduced, it seems + difficult to account for the production of so great a quantity of + sensorial power, as must be necessary to give perpetual increase of + action to the whole sanguiferous system.</p> + + <p><a name="suppl_I_3">3</a>. On the contrary, while the cutaneous + capillaries with their mucous and perspirative glands acquire an + increased irritability, as above, by the accumulation of that sensorial + power during their previous quiescence, and thus constitute the hot fit + of fever; if the heart and arteries do not acquire any increase of + associability, but continue in their state of torpor, another kind of + simple fever is produced; which is generally of the continued kind, and + is termed Febris inirritativa; which consists of a previous torpor of the + capillaries of the skin, and of the heart and arteries by direct sympathy + with them; and afterwards of an orgasm or increased action of the + capillaries of the skin, with a decreased action, or continued torpor, of + the heart and arteries by reverse sympathy with them. This orgasm of the + cutaneous capillaries, which appears by the blush and heat of the skin, + is at first owing to the accumulation of the sensorial power of + irritation during their previous torpid state, as in the febris irritata + above described; but which is afterwards supported or continued by the + reverse sympathy of these capillaries with the torpid state of the heart + and arteries, as will be further explained in article <a + href="#suppl_VIII">8</a> of this Supplement.</p> + + <p><a name="suppl_I_4">4</a>. The renovated activity of the capillaries + commences as soon or sooner than that of the heart and arteries after the + cold fit of irritative fever; and is not owing to their being forced open + by the blood being impelled into them mechanically, by the renovated + action of the heart and arteries; for these capillaries of the skin have + greater mobility than the heart and arteries, as appears in the sudden + blush of shame; which may be owing to their being more liable to + perpetual varieties of activity from their exposure to the vicissitudes + of atmospheric heat. And because in inirritative fevers, or those with + arterial debility, the capillaries acquire increased strength, as is + evinced by the heat of the skin, while the pulsations of the heart and + arteries remain feeble.</p> + + <p><a name="suppl_I_5">5</a>. It was said above, that the cutaneous + capillaries, when they were rendered torpid by exposure to cold, either + recovered their activity by the reapplication of external warmth; or by + their increased irritability, which is caused by the accumulation of that + sensorial power during their quiescence. An example of the former of + these may be seen on emerging from a very cold bath; which produces a fit + of simple fever; the cold fit, and consequent hot fit, of which may be + prolonged by continuing in the bath; which has indeed proved fatal to + some weak and delicate people, and to others after having been much + exhausted by heat and exercise. See Sect. XXXII. 3. 2. An example of the + latter may be taken from going into a bath of about eighty degrees of + heat, as into the bath at Buxton, where the bather first feels a chill, + and after a minute becomes warm, though he remains in the same medium, + owing to the increase of irritability from the accumulation of that + sensorial power during the short time, which the chilness continued.</p> + + <p><a name="suppl_I_6">6</a>. Hence simple fevers are of two kinds; + first, the febris irritativa, or fever with strong pulse; which consists + of a previous torpor of the heart, arteries, and capillaries, and a + succeeding orgasm of those vessels. Secondly, the febris inirritativa, or + fever with weak pulse, which consists of a previous torpor of the heart, + arteries, and capillaries; and of a succeeding orgasm of the capillaries, + the torpor of the heart and arteries continuing. But as the frequency of + the pulse occurs both in the state of torpor, and in that of orgasm, of + the heart and arteries; this constitutes a criterion to distinguish fever + from other diseases, which are owing to the torpor of some parts of the + system, as paresis, and hemicrania.</p> + + <p><a name="suppl_I_7">7</a>. The reader will please to observe, that + where the cutaneous or pulmonary capillaries are mentioned, their mucous + and perspirative glands are to be understood as included; but that the + absorbents belonging to those systems of vessels, and the commencement of + the veins, are not always included; as these are liable to torpor + separately, as in anasarca, and petechiæ; or to orgasm, or increased + action, as in the exhibition of strong emetics, or in the application of + vinegar to the lips; yet he will also please to observe, that an + increased or decreased action of these absorbents and veins generally + occurs along with that of the capillaries, as appears by the dry skin in + hot fits of fever; and from there being generally at the same time no + accumulation of venous blood in the cutaneous vessels, which would appear + by its purple colour.</p> + +<p class="cenhead"><a name="suppl_II">II</a>. <i>Compound fever.</i></p> + + <p><a name="suppl_II_1">1</a>. When other parts of the system sympathize + with this torpor and orgasm of the cutaneous capillaries, and of the + heart and arteries; the fever-fit becomes more complicated and dangerous; + and this in proportion to the number and consequence of such affected + parts. Thus if the lungs become affected, as in going into very cold + water, a shortness of breath occurs; which is owing to the collapse or + inactivity (not to the active contraction, or spasm), of the pulmonary + capillaries; which, as the lungs are not sensible to cold, are not + subject to painful sensation, and consequent shuddering, like the skin. + In this case after a time the pulmonary capillaries, like the cutaneous + ones, act with increased energy; the breathing, which was before quick, + and the air thrown out at each respiration in less quantity, and cool to + the back of the hand opposed to it, now becomes larger in quantity, and + warmer than natural; which however is not accompanied with the sensation + of heat in the membrane, which lines the air-vessels of the lungs, as in + the skin.</p> + + <p><a name="suppl_II_2">2</a>. One consequence of this increased heat of + the breath is the increased evaporation of the mucus on the tongue and + nostrils. A viscid material is secreted by these membranes to preserve + them moist and supple, for the purposes of the senses of taste and of + smell, which are extended beneath their surfaces; this viscid mucus, when + the aqueous part of it is evaporated by the increased heat of the + respired air, or is absorbed by the too great action of the mucous + absorbents, adheres closely on those membranes, and is not without + difficulty to be separated from them. This dryness of the tongue and + nostrils is a circumstance therefore worthy to be attended to; as it + shews the increased action of the pulmonary capillaries, and the + consequent increased heat of the expired air; and may thus indicate, when + colder air should be admitted to the patient. See Class <a + href="#species_I_1_3_1">I. 1. 3. 1</a>. The middle part of the tongue + becomes dry sooner, and recovers its moisture later, than the edges of + it; because the currents of respired air pass most over the middle part + of it. This however is not the case, when the dryness of the tongue is + owing only to the increased mucous absorption. When however a frequent + cough attends pulmonary inflammation, the edges of the tongue are liable + to be as much furred as the middle of it; as during the action of + coughing the middle of the tongue is depressed, so as to form half a + cylinder, to give a greater aperture for the emission of air from the + larynx; and the edges of it become thus as much exposed to the currents + of air, as the middle parts of it.</p> + + <p><a name="suppl_II_3">3</a>. When the internal capillaries or glands + sympathize with the cutaneous capillaries; or when any of them are + previously affected with torpor, and the external or cutaneous + capillaries are affected secondarily; other symptoms are produced, which + render the paroxysms of fever still more complicate. Thus if the spleen + or pancreas are primarily or secondarily affected, so as to be rendered + torpid or quiescent, they are liable to become enlarged, and to remain so + even after the extinction of the fever-fit. These in some intermittent + fevers are perceptible to the hand, and are called ague-cakes; their + tumour seems to be owing to the permanent torpor of the absorbent system, + the secerning vessels continuing to act some time afterwards. If the + secretory vessels of the liver are affected first with torpor, and + afterwards with orgasm, a greater secretion of bile is produced, which + sometimes causes a diarrhœa. If a torpor of the kidneys, and of the + absorbents of the bladder occurs, either primarily, or by sympathy with + the cutaneous capillaries, the urine is in small quantity and pale, as + explained in Class <a href="#species_I_2_2_5">I. 2. 2. 5</a>.; and if + these secretory vessels of the kidneys, and the absorbents of the bladder + act more strongly than natural afterwards by their increased irritability + or associability, the urine becomes in larger quantity, and deeper + coloured, or deposits its earthy parts, as in Class <a + href="#species_I_1_2_4">I. 1. 2. 4</a>. which has been esteemed a + favourable circumstance. But if the urine be in small quantity, and no + sediment appears in it, after the hot fit is over; it shews, that the + secerning vessels of the kidneys and the absorbent vessels of the bladder + have not regained the whole of their activity, and thence indicates a + greater tendency to a return of the cold fit.</p> + + <p><a name="suppl_II_4">4</a>. When the stomach is affected with torpor + either primarily; or secondarily by its sympathy with the cutaneous + capillaries; or with some internal viscus; sickness occurs, with a total + want of appetite to any thing solid; vomiting then supervenes, which may + often be relieved by a blister on the skin, if the skin be cool and pale; + but not if it be hot and flushed. The intestines cease to perform their + office of absorption from a similar torpor; and a diarrhœa + supervenes owing to the acrimony of their putrid, or of their acid + contents. The loose undigested or fetid stools indicate the inability of + the intestines to perform their proper office; as the mucus and gastric + acid, which are vomited up, does that of the stomach; this torpor of the + stomach is liable to continue after the cold paroxysm ceases, and to + convert intermittent fevers into continued ones by its direct sympathy + with the heart and arteries. See article <a href="#suppl_X">10</a> of + this Supplement.</p> + + <p><a name="suppl_II_5">5</a>. If the meninges of the brain sympathize + with other torpid parts, or are primarily affected, delirium, stupor, and + perhaps hydrocephalus internus occur, see Class <a + href="#species_II_1_7_1">II. 1. 7. 1</a>. and <a + href="#species_I_2_5_10">I. 2. 5. 10</a>; and sometimes the pulse becomes + slow, producing paresis instead of fever. But if the membranes, which + cover the muscles about the head, or of the pericranium, become torpid by + their sympathy with other torpid parts, or are primarily affected, a + head-ach supervenes; which however generally ceases with the cold + paroxysm of fever. For as when the sensorial power of volition is + exhausted by labour, a few hours, or half a solar day, passed in sleep + recruits the system by accumulation of this sensorial power; so when the + sensorial power of irritation is exhausted, one or two solar or lunar + days of rest or quiescence of the affected part will generally restore + its action by accumulation of irritability, and consequent increase of + association, as in hemicrania, Class <a href="#species_IV_2_2_8">IV. 2. + 2. 8</a>. But when the heart and arteries become torpid, either + primarily, or by their sympathy with the stomach, this accumulation of + the sensorial power of irritation can take place but slowly; <i>as to + rest is death</i>! This explains the cause of the duration of fevers with + weak pulse, which continue a quarter, or half, or three quarters, or a + whole lunation, or still longer, before sufficient accumulation of + irritability can be produced to restore their natural strength of + action.</p> + + <p><a name="suppl_II_6">6</a>. If the absorbent vessels, which are spread + around the neck of the bladder, become torpid by their direct sympathy + with the absorbents of the skin in cold fits of fever; the urine, which + is poured into the bladder in but small quantity from the torpid kidneys, + has nevertheless none of its aqueous saline part reabsorbed; and this + saline part stimulates the bladder to empty itself frequently, though the + urine is in small quantity. Which is not therefore owing to any supposed + spasm of the bladder, for the action of it in excluding the urine is + weak, and as much controlable by the will as in ordinary micturition.</p> + + <p><a name="suppl_II_7">7</a>. If the beginnings or absorbent mouths of + the venous system remain torpid, petechiæ or vibices are produced in + fevers, similar to those which are seen in scurvy without fever. If the + skin was frequently moistened for an hour, and at the same time exposed + to the common air, or to oxygen gas, it might contribute to turn the + black colour of these points of extravasated blood into scarlet, and thus + by increasing its stimulus facilitate its reabsorption? For oxygen gas + penetrates moist animal membranes though not dry ones, as in the lungs + during respiration.</p> + + <p><a name="suppl_II_8">8</a>. When the sensorial power of sensation is + introduced into the arterial system, other kinds of compound fevers are + produced, which will be spoken of in their place.</p> + +<p class="cenhead"><a name="suppl_III">III</a>. <i>Termination of the cold Fit.</i></p> + + <p><a name="suppl_III_1">1</a>. If all the parts, which were affected + with torpor, regain their irritability, and associability, the cold + paroxysm of fever ceases; but as some of the parts affected were + previously accustomed to incessant action, as the heart and arteries, and + others only to intermitted action, as the stomach and intestines; and as + those, which are subjected during health to perpetual action, accumulate + sensorial power faster, when their motions are impeded, than those which + are subjected to intermitted action; it happens, that some of the parts, + which were affected with torpor during the cold fit, recover their + irritability or associability sooner than others, and more perfectly, or + acquire a greater quantity of them than natural; as appears by the + partial heat and flushings previous to the general hot fit.</p> + + <p>Hence if all the parts, which were previously torpid, regain their due + degree of irritability, or of associability, the disease is removed, and + health restored. If some or all of them acquire more than their natural + degree of these sensorial powers; increased actions, and consequent + increased secretions, and greater heat occur, and constitute the hot fit + of fever. If after this hot fit of fever all the parts, which had + acquired too great irritability, or associability, regain their natural + degree of it; the disease is removed, and health restored. But if some of + these parts do not regain their natural degree of these sensorial powers, + the actions of those parts remain imperfect, and are more or less + injurious to the system, according to the importance of their + functions.</p> + + <p><a name="suppl_III_2">2</a>. Thus if a torpor of the heart and + arteries remains; the quick pulse without strength, which began in the + cold fit, persists; and a continued fever is produced. If the torpor of + the stomach and intestines remains, which are known by sickness and + undigested stools, the fever is liable to be of considerable length and + danger; the same if the kidnies and absorbent system retain some degree + of torpor, as is shewn by the pale urine in not unusual quantity. If part + of the absorbent system remains torpid, as the absorbent vessels of the + spleen, a tumour of that viscus occurs, which may be felt by the hand; + the same sometimes happens to the liver; and these from their tendency to + more complete torpor are afterwards liable to give occasion to a return + of the cold fit. If the cellular absorbents do not completely recover + their activity, a pale and bloated countenance with swelled legs mark + their want of action.</p> + + <p><a name="suppl_III_3">3</a>. As the termination of the cold fit is + owing to the accumulation of the sensorial power of irritation and of + association during the previous quiescence of the system; and as those + parts, which are in perpetual action during health, are more subject to + this accumulation during their torpor, or quiescence; one should have + imagined, that the heart and arteries would acquire this accumulation of + sensorial power sooner or in greater degree than other parts. This indeed + so happens, where the pulse is previously strong, as in febris + irritativa; or where another sensorial power, as that of sensation, is + exerted on the arterial system, as in inflammations. The heart and + arteries in these cases soon recover from their torpor, and are exerted + with great violence.</p> + + <p>Many other parts of the system subject to perpetual motion in health + may rest for a time without much inconvenience to the whole; as when the + fingers of some people become cold and pale; and during this complete + rest great accumulation of irritability may be produced, But where the + heart and arteries are previously feeble, they cannot much diminish their + actions, and certainly cannot rest entirely, for that would be death; and + therefore in this case their accumulation of the sensorial power of + irritation or of association is slowly produced, and a long fever + supervenes in consequence; or sudden death, as frequently happens, + terminates the cold fit.</p> + + <p>Whence it appears, that in fevers with weak pulse, if the action of + the heart, arteries, and capillaries could be diminished, or stopped for + a short time without occasioning the death of the patient, as happens in + cold bathing, or to persons apparently drowned, that a great accumulation + of the sensorial powers of irritation or of association might soon be + produced, and the pulse become stronger, and consequently slower, and the + fever cease. Hence cold ablution may be of service in fevers with weak + pulse, by preventing the expenditure and producing accumulation of the + sensorial power of irritation or association. Stupor may be useful on the + same account. Could a centrifugal swing be serviceable for this purpose, + either by placing the head or the feet in the outward part of the circle, + as described in Art. <a href="#suppl_XV_7">15. 7</a>. of this + Supplement?</p> + +<p class="cenhead"><a name="suppl_IV">IV</a>. <i>Return of the cold Fit.</i></p> + + <p><a name="suppl_IV_1">1</a>. If the increased action of the cutaneous + and pulmonary capillaries, and of the heart and arteries, in febris + irritativa continues long and with violence, a proportional expenditure + or exhaustion of sensorial power occurs; which by its tendency to induce + torpor of some part, or of the whole, brings on a return of the cold + fit.</p> + + <p><a name="suppl_IV_2">2</a>. Another cause which contributes to induce + torpor of the whole system by the sympathy of its parts with each other, + is the remaining torpor of some viscus; which after the last cold + paroxysm had not recovered itself, as of the spleen, liver, kidnies, or + of the stomach and intestines, or absorbent vessels, as above + mentioned.</p> + + <p><a name="suppl_IV_3">3</a>. Other causes are the deficiency of the + natural stimuli, as hunger, thirst, and want of fresh air. Other causes + are great fatigue, want of rest, fear, grief, or anxiety of mind. And + lastly, the influence of external ethereal fluids, as the defect of + external heat, and of solar or lunar gravitation. Of the latter the + return of the paroxysms of continued fevers about six o'clock in the + evening, when the solar gravitation is the least, affords an example of + the influence of it; and the usual periods of intermittents, whether + quotidian, tertian, or quartan, which so regularly obey solar or lunar + days, afford instances of the influence of those luminaries on these + kinds of fevers.</p> + + <p><a name="suppl_IV_4">4</a>. If the tendency to torpor of some viscus + is considerable, this will be increased at the time, when the terrene + gravitation is greatest, as explained in the introduction to Class <a + href="#genus_IV_2_4">IV. 2. 4</a>. and may either produce a cold paroxysm + of quotidian fever; or it may not yet be sufficient in quantity for that + purpose, but may nevertheless become greater, and continue so till the + next period of the greatest terrene gravitation, and may then either + produce a paroxysm of tertian fever; or may still become greater, and + continue so till the next period of greatest terrene gravitation, and + then produce a paroxysm of quartan ague. And lastly, the periodical times + of these paroxysms may exceed, or fall short of, the time of greatest + diurnal terrene gravitation according to the time of day, or period of + the moon, in which the first fit began; that is, whether the diurnal + terrene gravitation was then in an increasing or decreasing state.</p> + +<p class="cenhead"><a name="suppl_V">V</a>. <i>Sensation excited in Fever.</i></p> + + <p><a name="suppl_V_1">1</a>. A curious observation is related by Dr. + Fordyce in his Tract on Simple fever, page 168. He asserts, that those + people, who have been confined some time in a very warm atmosphere, as of + 120 or 130 degrees of heat, do not feel cold, nor are subject to paleness + of their skins, on coming into a temperature of 30 or 40 degrees; which + would produce great paleness and painful sensation of coldness in those, + who had been some time confined in an atmosphere of only 86 or 90 + degrees. Analogous to this, an observing friend of mine assured me, that + once having sat up to a very late hour with three or four very ingenious + and humorous companions, and drank a considerable quantity of wine; both + contrary to his usual habits of life; and being obliged to rise early, + and to ride a long journey on the next day; he expected to have found + himself weak and soon fatigued; but on the contrary he performed his + journey with unusual ease and alacrity; and frequently laughed, as he + rode, at the wit of the preceding evening. In both these cases a degree + of pain or pleasure actuated the system; and thus a sensorial power, that + of sensation, was superadded to that of irritation, or volition. See + Sect. XXXIV. 2. 6.</p> + + <p><a name="suppl_V_2">2</a>. Similar to this, when the energetic + exertions of some parts of the system in the hot fit of fever arise to a + certain excess, a degree of sensation is produced; as of heat, which + particularly increases the actions of the cutaneous vessels, which are + more liable to be excited by this stimulus. When this additional + sensorial power of sensation exists to a greater degree, the pulse, which + was before full, now becomes hard, owing to the inflammation of the vasa + vasorum, or coats of the arteries. In these cases, whether there is any + topical inflammation or not, the fever ceases to intermit; but + nevertheless there are daily remissions and exacerbations of it; which + recur for the most part about six in the evening, when the solar + gravitation is the least, as mentioned in Sect. XXXVI. 3. 7.</p> + + <p><a name="suppl_V_3">3</a>. Thus the introduction of another sensorial + power, that of sensation, converts an intermittent fever into a continued + one. If it be attended with strong pulse, it is termed febris sensitiva + irritata, or pyrexia, or inflammation; if with a weak pulse, it is termed + febris sensitiva inirritata, or typhus gravior, or malignant fever. The + seat of the inflammation is in the glandular or capillary system, as it + consists in the secretion of new fluids, or new fibres, which form new + vessels, as they harden, like the silk of the silk-worm. See Art. <a + href="#suppl_XV">15</a>. of this Supplement.</p> + +<p class="cenhead"><a name="suppl_VI">VI</a>. <i>Circles of irritative Associate Motions.</i></p> + + <p><a name="suppl_VI_1">1</a>. There are some associate motions, which + are perpetually proceeding in our waking hours, and are catenated by + their first link, or in some subsequent parts of the chain, with the + stimuli or the influence of external things; which we shall here + enumerate, as they contribute to the knowledge of fever. Of these are the + irritative ideas, or sensual motions of the organs of sense, and the + muscular motions associated with them; which, when the chain is disturbed + or interrupted, excite the sensorial power of sensation, and proceed in + confusion. Thus if the irritative ideas of sight are disturbed, the + paralactic motions of objects, which in general are unperceived, become + sensible to us; and the locomotive muscles associated with them, which + ought to preserve the body erect, stagger from this decrease or + interruption of the sensorial power of association; and vertigo is + produced.</p> + + <p>When the irritative sensual motions, or ideas, belonging to one sense + are increased or diminished, the irritative sensual motions, or ideas, of + the other senses are liable to become disturbed by their general + catenations; whence occur noises in the ears, bad tastes in the mouth, + bad odours, and numbness or tingling of the limbs, as a greater or less + number of senses are affected. These constitute concomitant circles of + disturbed irritative ideas; or make a part of the great circle of + irritative ideas, or motions of the organs of sense; and when thus + disturbed occasion many kinds of hallucination of our other senses, or + attend on the vertigo of vision.</p> + + <p><a name="suppl_VI_2">2</a>. Another great circle of irritative + associated motions consists of those of the alimentary canal; which are + catenated with stimuli or with influences external to the system, but + continue to be exerted in our sleeping as well as in our waking hours. + When these associations of motion are disturbed by the too great or too + small stimulus of the food taken into the stomach, or by the too great + excess or deprivation of heat, or by indigestible substances, or by + torpor or orgasm occasioned by their association with other parts, + various diseases are induced under the names of apepsia, hypochondriasis, + hysteria, diarrhœa, cholera, ileus, nephritis, fever.</p> + + <p><a name="suppl_VI_3">3</a>. A third circle of irritative associate + motions consists of those of the absorbent system; which may be divided + into two, the lacteals, and the lymphatics. When the stomach and + intestines are recently filled with food and fluid, the lacteal system is + stimulated into great action; at the same time the cellular, cutaneous, + and pulmonary lymphatics act with less energy; because less fluid is then + wanted from those branches, and because more sensorial power is expended + by the lacteal branch. On this account these two systems of absorbents + are liable to act by reverse sympathy; hence pale urine is made after a + full dinner, as less of the aqueous part of it is imbibed by the urinary + lymphatics; and hence the water in anasarca of the lungs and limbs is + speedily absorbed, when the actions of the lacteals of the stomach or + intestines are weakened or inverted by the exhibition of those drugs, + which produce nausea, or by violent vomiting, or violent cathartics.</p> + + <p>Hence in diabetes the lacteal system acts strongly, at the same time + that the urinary lymphatics invert their motions, and transmit the chyle + into the bladder; and in diarrhœa from crapula, or too great a + quantity of food and fluid taken at a time, the lacteals act strongly, + and absorb chyle or fluids from the stomach and upper intestines; while + the lymphatics of the lower intestines revert their motions, and transmit + this over-repletion into the lower intestines, and thus produce + diarrhœa; which accounts for the speedy operation of some cathartic + drugs, when much fluid is taken along with them.</p> + + <p><a name="suppl_VI_4">4</a>. Other circles of irritative associate + motions of great importance are those of the secerning system; of these + are the motions of the larger congeries of glands, which form the liver, + spleen, pancreas, gastric glands, kidneys, salivary glands, and many + others; some of which act by direct and others by reverse sympathy with + each other. Thus when the gastric glands act most powerfully, as when the + stomach is filled with food, the kidneys act with less energy; as is + shewn by the small secretion of urine for the first hour or two after + dinner; which reverse sympathy is occasioned by the greater expenditure + of sensorial power on the gastric glands, and to the newly absorbed + fluids not yet being sufficiently animalized, or otherwise prepared, to + stimulate the secretory vessels of the kidneys.</p> + + <p>But those very extensive glands, which secrete the perspirable matter + of the skin and lungs, with the mucus, which lubricates all the internal + cells and cavities of the body, claim our particular attention. These + glands, as well as all the others, proceed from the capillary vessels, + which unite the arteries with the veins, and are not properly a part of + them; the mucous and perspirative glands, which arise from the cutaneous + and pulmonary capillaries, are associated by direct sympathy; as appears + from immersion in the cold bath, which is therefore attended with a + temporary difficult respiration; while those from the capillaries of the + stomach and heart and arteries are more generally associated by reverse + sympathy with those of the cutaneous capillaries; as appears in fevers + with weak pulse and indigestion, and at the same time with a hot and dry + skin.</p> + + <p>The disturbed actions of this circle of the associate motions of the + secerning system, when the sensorial power of sensation is added to that + of irritation, frequently produces inflammation, which consists in the + secretion of new fluids or new vessels. Nevertheless, if these disturbed + actions be of the torpid kind, the pain, which attends them, is seldom + productive of inflammation, as in hemicrania; but is liable to excite + voluntary actions, and thus to expend much sensorial power, as in the + shuddering in cold fits of fever, or in convulsions; or lastly the pain + itself, which attends torpid actions, is liable to expend or exhaust much + sensorial power without producing any increased actions; whence the low + pulse, and cold extremities, which usually attend hemicrania; and hence + when inert, or inactive sensation attends one link of associated action, + the succeeding link is generally rendered torpid, as a coldness of the + cheek attends tooth-ach.</p> + + <p><a name="suppl_VI_5">5</a>. A fifth important circle of irritative + motions is that of the sanguiferous system, in which the capillary + vessels are to be included, which unite the arterial and venous systems, + both pulmonary and aortal. The disturbed action of this system of the + heart and arteries, and capillaries, constitute simple fever; to which + may be added, that the secerning and absorbent vessels appending to the + capillaries, and the bibulous mouths of the veins, are in some measure at + the same time generally affected.</p> + + <p><a name="suppl_VI_6">6</a>. Now, though the links of each of these + circles of irritative motions are more strictly associated together, yet + are they in greater or less degree associated or catenated with each + other by direct or reverse sympathy. Thus the sickness, or inverted + irritative motions of the stomach, are associated or catenated with the + disturbed irritative ideas, or sensual motions, in vertigo; as in + sea-sickness. This sickness of the stomach is also associated or + catenated with the torpor of the heart and arteries by direct sympathy, + and with the capillaries and absorbents by reverse sympathy; and are thus + all of them liable occasionally to be disturbed, when one of them is + diseased; and constitute the great variety of the kinds or symptoms of + fevers.</p> + +<p class="cenhead"><a name="suppl_VII">VII</a>. <i>Alternation of the cold and hot Fits.</i></p> + + <p><a name="suppl_VII_1">1</a>. When any cause occurs, which diminishes + to a certain degree the supply of sensorial power in respect to the whole + system; as suppose a temporary inexertion of the brain; what happens? + First, those motions are exerted with less energy, which are not + immediately necessary to life, as the locomotive muscles; and those + ideas, which are generally excited by volition; at the same time this + deficiency of voluntary motion is different from that which occurs in + sleep; as in that the movements of the arterial system are increased in + energy though not in frequency. Next, the motions of the alimentary canal + become performed with less energy, or cease altogether; and a total want + of appetite to solid food occurs, or sickness, or a diarrhœa + occasioned by the indigested aliment. Then the absorbent vessels cease to + act with their due energy; whence thirst, and pale urine, though in small + quantities. Fourthly, the secerning vessels become affected by the + general diminution of sensorial power; whence all the secreted fluids are + produced in less quantity. And lastly, the sanguiferous canals feel the + general torpor; the pulsations of the heart and arteries become feeble, + and consequently quick; and the capillaries of the skin become inactive, + acquire less blood from the arteries, and are consequently paler and + shrunk.</p> + + <p>In this last circumstance of the torpor of the sanguiferous system + consists inirritative fever; as all the others are rather accidental or + concomitant symptoms, and not essential ones; as fewer or more of them + may be present, or may exist with a greater or less degree of + inactivity.</p> + + <p><a name="suppl_VII_2">2</a>. Now as the capillaries of the skin are + exposed to greater varieties of heat and cold, than the heart and + arteries, they are supposed to be more mobile, that is, more susceptible + of torpor or exertion, or to inflammation, by external stimuli or + influences, than the other parts of the sanguiferous system; and as the + skin is more sensible to the presence of heat, than the internal parts of + the body, the commencement of the cold paroxysms of fever generally + either first exists in, or is first perceived by, the coldness and + paleness of the skin; and the commencement of the hot fits by the heat + and redness of it.</p> + + <p><a name="suppl_VII_3">3</a>. The accumulation of sensorial power + occurs in these organs soonest, and in greatest quantity, during their + quiescence, which were most perpetually in action during health; hence + those parts of the system soonest recover from torpor in intermittent + fever, and soonest fall into the contrary extreme of increased activity; + as the sanguiferous system of the heart and arteries and capillaries. But + of these the capillaries seem first to acquire a renovation of their + action, as the heat of the skin becomes first renewed, as well as + increased beyond its natural quantity, and this in some parts sooner than + in others; which quantity of heat is however not to be estimated simply + by the rise of the mercury in the thermometer, but also by the quantity + carried away into the atmosphere, or diffused amongst other bodies in a + given time; as more heat passes through water, which boils vehemently, + than when it boils gently, though the rise of the thermometer in both + cases continues the same. This fact may be known by boiling an egg in + water, the white of which coagulates in much less time, if the water + boils vehemently, than if it boils moderately, though the sensible heat + of the water is the same in both cases.</p> + + <p>Another cause, which induces the cutaneous capillaries to renew their + actions sooner than the heart and arteries after immersion in the cold + bath, is, that their torpor was occasioned by defect of irritation; + whereas that of the heart and arteries was occasioned by defect of + association; which defect of association was owing to the decreased + actions of the capillaries, and is now again excited by their renewed + action; which excitement must therefore be subsequent to that increased + action of the capillaries; and in consequence the increased action of the + heart and arteries at the commencement of the hot fit of some fevers is + subsequent to the increased action of the cutaneous capillaries. There + is, however, in this case an accumulation of the sensorial power of + association in the heart and arteries, which must contribute to increase + their orgasm in the hot fit, as well as the increased excitement of it by + the increased action of the capillaries.</p> + + <p><a name="suppl_VII_4">4</a>. Now this increased action of the system, + during the hot fit, by exhausting the sensorial powers of irritation and + association, contributes to induce a renewal of the cold paroxysm; as the + accumulation of those sensorial powers in the cold fit produces the + increased actions of the hot fit; which two states of the system + reciprocally induce each other by a kind of libration, or a plus and + minus, of the sensorial powers of irritation and association.</p> + + <p>If the exhaustion of sensorial power during the hot fit of fever only + reduces the quantity of irritability and associability to its natural + standard, the fever is cured, not being liable to return. If the quantity + of these sensorial powers be reduced only so much, as not to produce a + second cold fit during the present quantity of external stimuli or + influences; yet it may be so far reduced, that a very small subtraction + of stimulus, or of influence, may again induce a cold fit; such as the + coldness of the night-air, or the diminution of solar or lunar + gravitation, as in intermittent fevers.</p> + + <p><a name="suppl_VII_5">5</a>. Another cause of the renovation of the + cold fits of fever is from some parts of the system not having completely + recovered from the former cold paroxysm; as happens to the spleen, liver, + or other internal viscus; which sometimes remains tumid, and either + occasions a return of the cold fit by direct sympathy with other parts of + the body, or by its own want of action causes a diminution of the general + quantity of heat, and thus facilitates the renovation of the torpor of + the whole system, and gives cause to intermittent fevers catenated with + lunar or solar influence.</p> + +<p class="cenhead"><a name="suppl_VIII">VIII</a>. <i>Orgasm of the Capillaries.</i></p> + + <p>As the remaining torpor of some less essential part of the system, as + of the spleen, when the hot fit ceases, produces after one, two, or three + days a return of cold fit by direct sympathy with the cutaneous + capillaries, when joined with some other cause of torpor, as the defect + of solar or lunar influences, or the exposure to cold or hunger, and thus + gives origin to intermittent fever; so the remaining torpor of some more + essential parts of the system, as of the stomach and intestines, is + probably the cause of the immediate recurrence of the cold paroxysm, at + the time the hot one ceases, by their direct sympathy with the cutaneous + capillaries, without the assistance of any other cause of torpor; and + thus produces remittent fever. And lastly the remaining torpor of some + still more essential parts of the system, as the heart and arteries, + after the hot fit ought to cease, is liable by reverse sympathy with the + cutaneous capillaries to continue their orgasm, and thus to render a + fever continual, which would otherwise remit or intermit.</p> + + <p>Many difficulties here occur, which we shall endeavour to throw some + light upon, and leave to future investigation; observing only that + difficulties were to be expected, otherwise fevers would long since have + been understood, as they have employed the unremitted attention of the + physicians of all ages of the world.</p> + + <p><a name="suppl_VIII_1">1</a>. Why do the same parts of successive + trains of action sometimes affect each other by direct, and sometimes by + reverse sympathy?—1st, When any irritative motion ceases, or + becomes torpid, which was before in perpetual action; it is either + deprived of its usual stimulus, and thence the sensorial power of + irritation is not excited; or it has been previously too much stimulated, + and the sensorial power has been thus exhausted.</p> + + <p>In the former case an accumulation of sensorial power soon occurs, + which is excitable by a renewal of the stimulus; as when the fingers, + which have been immersed some time in snow, are again exposed to the + usual warmth of a room. Or, secondly, the sensorial power of irritation + becomes so much accumulated, that the motions, which were torpid, are now + performed by less stimulus than natural; as appears by the warmth, which + soon occurs after the first chill in going into frosty air, or into the + bath at Buxton, which is about eighty degrees of heat. Or, lastly, this + accumulation of the sensorial power of irritation so far abounds, that it + increases the action of the next link of the associated train or tribe of + motions; thus on exposing the skin to cold air, as in walking out in a + frosty morning, the actions of the stomach are increased, and digestion + strengthened.</p> + + <p>But where the torpor of some irritative motion is owing to the + previous exhaustion of the sensorial power of irritation by too great + stimulus, the restoration of it occurs either not at all, or much more + slowly than in the former instances; thus after intoxication the stomach + is very slow in recovering its due quantity of the sensorial power of + irritation, and never shews any accumulation of it.</p> + + <p><a name="suppl_VIII_2">2</a>. When an associate motion, as described + in the introduction to Class <a href="#genus_IV_1_1">IV. 1. 1</a>. acts + with less energy, the sensorial power of association is either not + sufficiently excited by the preceding fibrous motions; or it has been + expended or exhausted by the too violent actions of the preceding fibrous + motions. In the former case there occurs an accumulation of the sensorial + power of association; exactly as, where the usual stimulus is withdrawn, + there occurs an accumulation of the sensorial power of irritation. Thus + when the actions of the capillaries of the skin are diminished by + immersion in cold water, the capillaries of the lungs are rendered torpid + by the want of the excitement of the sensorial power of association, + owing to the lessened actions of the previous fibrous motions, namely, of + those of the skin. Nevertheless as soon as the capillaries of the skin + regain their increased activity by the accumulation of the sensorial + power of irritation, these capillaries of the lungs act with greater + energy also owing to their accumulated sensorial power of association. + These are instances of direct sympathy, and constitute the cold and hot + paroxysms of intermittent fever; or the first paroxysm of a continued + one.</p> + + <p><a name="suppl_VIII_3">3</a>. When the first link of a train of + associated motions, which is subject to perpetual action, becomes a + considerable time torpid for want of being excited by the previous + exertions of the irritative motions, with which it is catenated; the + sensorial power of association becomes accumulated in so great a degree + as to affect the second link of the train of associated motions, and to + excite it into stronger action. Thus when the stomach is rendered torpid + by contagious matter swallowed into it mixed with the saliva, the heart + and arteries act more feebly; because the sensorial power of association, + which used to be excited by the fibrous motions of the stomach, is not + now excited; and in consequence the motions of the heart and arteries act + only by the sensorial power of irritation, which is excited by the + stimulus of the blood.</p> + + <p>But during this torpor of the stomach, and less action of the heart + and arteries, so great an accumulation of the sensorial powers of + irritation and of association occurs, that it adds to the action of the + next link of this vital circle of actions, that is, to that of the + cutaneous capillaries. Whence in this situation the torpor of the stomach + occasions a diminished action of the heart and arteries by direct + sympathy, and may be said to occasion an increased one of the cutaneous + capillaries by reverse sympathy; which constitute continued fever with + weak pulse.</p> + + <p>Nor is this increased action of the capillaries in consequence of the + decreased action of the heart and arteries, as in fevers with weak pulse, + a single fact in the animal economy; though it exists in this case in the + greatest degree or duration, because the heart and arteries are + perpetually in greater action than any other part of the system. But a + similar circumstance occurs, when the stomach is rendered inactive by + defective excitement of the sensorial power of association, as in + sea-sickness, or in nephritis. In these cases the sensorial power of + association becomes much accumulated in the stomach, and seems by its + superabundance to excite the absorbent system, which is so nearly + connected with it, into great increase of action; as is known by the + great quantity frequently in these situations rejected by vomit, which + could not otherways be supplied. It is probable the increase of digestion + by walking in frosty air, with many other animal facts, may by future + observations be found to be dependent on this principle, as well as the + increased action of the capillaries in continued fevers with weak + pulse.</p> + + <p>Whereas in continued fever with strong pulse, which may perhaps occur + sometimes on the first day even of the plague, the stomach with the heart + and arteries and the capillaries act by direct sympathy; that is, the + stomach is excited into stronger action by increased irritation owing to + the stimulus of contagious matter; these stronger irritative motions of + the stomach excite a greater quantity of the sensorial power of + association, which then actuates the heart and arteries with greater + energy, as these are catenated with the stomach; and in the same manner + the increased actions of the heart and arteries excite a greater quantity + of the sensorial power of association, which actuates the cutaneous + capillaries with increase of energy. See Class <a + href="#genus_IV_1_1">IV. 1. 1</a>.</p> + + <p><a name="suppl_VIII_4">4</a>. I shall dwell a little longer on this + intricate subject. The commencement of fever-fits is known by the + inactivity of the cutaneous capillaries, which inactivity is observable + by the paleness and coldness of the skin, and also by the pain of + coldness, which attends it. There is nevertheless in most cases, except + those which are owing to exposure to external cold, a torpor of the + capillaries of some internal viscus preceding this inactivity of the + cutaneous capillaries; which is known, by the tumour or hardness of the + viscus, or by an aching pain of it. The capillaries of the lungs are at + the same time rendered inactive or torpid, as appears by the difficulty + of breathing, and coldness of the breath in cold fits of fever, and in + going into the cold bath; but the lungs are not affected with the pain + either of coldness or of torpor.</p> + + <p>One cause of this synchronous or successive inactivity of the + cutaneous capillaries, in consequence of the previous torpor of some + internal viscus, may be owing to the deficiency of heat; which must + occur, when any part becomes inactive; because the secretions of that + part cease or are lessened, and the quantity of heat of it in + consequence. But the principal cause of it I suppose to be owing to the + defect of the sensorial power of association; which power of association + is excited by some previous or concomitant motions of the parts of every + great circle of actions. This appears on going into the cold bath, + because the shortness of breath instantly occurs, sooner than one can + conceive the diminution of the heat of the skin could affect the lungs by + the want of its stimulus; but not sooner than the defect of the sensorial + power of association could affect them; because this must cease to be + excited into action on the instant that the cutaneous capillaries cease + to act; whence in the first moment of contact of the cold water the + cutaneous capillaries cease to act from defect of irritation; which is + caused by defect of the stimulus of heat; and in the second moment the + capillaries of the lungs cease to act from the defect of association; + which is caused by the defect of the motions of the cutaneous + capillaries. Thus the universal torpor in the cold paroxysm of fever is + an example of direct sympathy, though occasioned in part by defect of + irritation, and in part by defect of association.</p> + + <p><a name="suppl_VIII_5">5</a>. Thus in walking out in a frosty morning + the skin is cooled by the contact of the cold air, whence the actions of + its capillaries are diminished for want of their usual stimulus of heat + to excite a sufficient quantity of the sensorial power of irritation. + Hence there is at first a saving of sensorial power of irritation for the + purpose of actuating the other parts of the system with greater energy. + Secondly the sensorial power of association, which used to be excited by + the motions of the cutaneous capillaries, is now not so powerfully + excited; and in consequence the parts, which constitute the next links of + the circles of associated motions, are for a time actuated with less + energy, and a temporary general chillness succeeds; which is so far + similar to the cold fit of intermittent fever.</p> + + <p>In this situation there is a curious circumstance occurs, which merits + peculiar attention: after a short time, though the external skin + continues cool by its exposure to the cold air, and the actions of its + capillaries are consequently diminished, yet the capillaries of the + stomach act with greater energy; as is known by increased digestion and + consequent hunger. This is to be ascribed to the accumulation of the + sensorial power of irritation, which now excites by its superabundance, + or overflowing, as it were, the stomach into increased action; though it + is at the same time excited less powerfully than usual by the sensorial + power of association. Thus the accumulation of the sensorial power of + irritation in the vessels of the skin increases in this case the action + of the stomach, in the same manner as an accumulation of the sensorial + power of association in the heart and arteries in fevers with weak pulse + increases the action of the capillaries.</p> + + <p>If nevertheless the coldness of the skin be too long continued, or + exists in too great a degree, so as in some measure to impair the life of + the part, no further accumulation of the sensorial power of irritation + occurs; and in consequence the actions of the stomach become less than + natural by the defect of the sensorial power of association; which has + ceased to be excited by the want of action of the cutaneous capillaries. + Whence continued coldness of the feet is accompanied with indigestion and + heartburn. See Class <a href="#species_IV_2_1_6">IV. 2. 1. 6</a>.</p> + + <p><a name="suppl_VIII_6">6</a>. Similar to this when the actions of the + stomach are rendered torpid by the previous stimulus of a violent emetic, + and its motions become retrograde in consequence, a great quantity of + sensorial power is exerted on the lymphatics of the lungs, and other + parts of the body; which excites them into greater direct action, as is + evinced by the exhibition of digitalis in anasarca. In this situation I + suppose the emetic drug stimulates the muscular fibres of the stomach + into too great action; and that in consequence a great torpor soon + succeeds; and that this inaction of the muscular parts of the stomach is + not followed by much accumulation of the sensorial power of irritation; + because that sensorial power is in great measure exhausted by the + previous excessive stimulus. But the lymphatics of the stomach have their + actions lessened by defect of the sensorial power of association, which + is not now excited into action, owing to the lessened motions of the + muscular parts of it, with which the lymphatics are associated. The + sensorial power of association becomes therefore accumulated in these + lymphatics of the stomach, because it is not excited into action; exactly + as the power of irritation becomes accumulated in the hand, when immersed + in snow; and this accumulated sensorial power of association excites the + lymphatic of the lungs and of other parts, which are most nearly + associated with those of the stomach, into more energetic actions. Thus + the muscular fibres of the stomach act with the lymphatics of that organ + in direct sympathy; and the lymphatics of the stomach act in reverse + sympathy with those of the lungs and of other parts of the body; the + former of which is caused by defect of the excitement of the sensorial + power of association, and the latter by the accumulation of it.</p> + + <p>Besides the efficient cause, as above explained, the final cause, or + convenience, of these organic actions are worthy our attention. In this + case of an acrid drug swallowed into the stomach the reverted actions of + the muscular fibres of the stomach tend to eject its enemy; the reverted + actions of its lymphatics pour a great quantity of fluids into the + stomach for the purpose of diluting or washing off the noxious drug; and + the increased actions of the other lymphatics supply these retrograde + ones of the stomach with an inconceivable supply of fluids, as is seen in + Ileus and Cholera.</p> + + <p><a name="suppl_VIII_7">7</a>. The inquisitive reader will excuse my + continuing this subject, though perhaps with some repetitions, as it + envelopes the very essence of fever. When the first link of a train of + actions is excited by excessive stimulus, or excessive irritability, and + thus acts with unusual energy by the increased quantity of irritation, + these increased motions excite a greater quantity of the sensorial power + of association, which causes increased motions in the second link, which + is catenated with the first; and then the excessive action of this second + link excites also a greater quantity of the sensorial power of + association, which increases the motions of the third link of this chain + of association, and thus the increase of the stimulus on the irritative + motions, to which the chain of association is catenated, increases the + action of the whole chain or circle of associated motions.</p> + + <p>After a time the irritative motions become torpid by expenditure of + the sensorial power of irritation, and then the power of association also + becomes less exerted, both because it has been in part exhausted by too + great action, and is now less excited by the lessened action of the + irritative motions, which used to excite it. These are both instances of + direct sympathy, and frequently constitute the cold and hot fit of + intermittents.</p> + + <p>But though the accumulation of the sensorial power of irritation + during the quiescence of some motion owing to want of stimulus generally + induces torpor in the first link of the train of associated motions + catenated with it; as the capillaries of the lungs become torpid + immediately on immersion of the skin into cold water; yet in some + situations an orgasm or excess of action is produced in the first link of + the associated motions thus catenated with irritative ones; as in the + increased action of the stomach, when the skin is for a time exposed to + cold air; which may in part be ascribed to the general increase of action + of the whole system, owing to the diminished expenditure of sensorial + power, but particularly of the parts, which have habitually acted + together; as when one arm is paralytic the other is liable to more + frequent or almost continual motion; and when one eye becomes blind the + other frequently becomes stronger; which is well known to farriers, who + are said sometimes to destroy the sight of one eye to strengthen that of + the other in diseased horses.</p> + + <p>Hence there is sometimes a direct sympathy, and sometimes a reverse + one succeeds the torpor occasioned by defect of stimulus, the latter of + which is perhaps owing to a certain time being required for the + production of an accumulation of the sensorial power of irritation by the + nervous branches of the torpid organ; which accumulation is now in part + or entirely derived to the next link of the association. Thus in going + into a coldish bath, as into a river in the summer months, we at first + experience a difficulty of breathing from the torpid action of the + pulmonary capillaries, owing to the deficient excitement of the sensorial + power of association in consequence of the torpor of the cutaneous + capillaries. But in a very short time, as in one minute, the sensorial + power of irritation becomes accumulated by the inactivity of the + cutaneous capillaries; and as its superabundance becomes now expended on + the pulmonary capillaries, the difficult respiration ceases; though the + cutaneous capillaries continue torpid by their contact with the cold + water, and consequently the sensorial power of association, which used to + contribute to actuate the pulmonary capillaries, is less excited.</p> + + <p><a name="suppl_VIII_8">8</a>. In like manner when there exists an + accumulation of the sensorial power of association, owing to defect of + its excitement by some previous irritative or associate motions, it is + generally accompanied for a certain time by a torpor not only of the link + first affected, but of the subsequent parts, or of the whole train of + associated motions, as in the cold fits of intermittent fevers. Yet after + a time an increased action of the next links of associated motions + succeeds the torpor of the first, as the absorbent vessels of the lungs + act more violently in consequence of the deficient action of those of the + stomach; and the skin at the commencement of sickness is pale and cold, + but in a little time becomes flushed and warm.</p> + + <p>Thus we see in associate motions, which are rendered torpid by defect + of excitement, that sometimes a direct, and sometimes a reverse sympathy + succeeds in the subsequent links of the chain. But I believe where a + torpor of irritative or of the associate motions is caused by a previous + too great expenditure or exhaustion of the sensorial powers of irritation + or association, no increase of action in the subsequent link ever occurs, + or not till after a very long time.</p> + + <p>Thus when the stomach becomes torpid by previous violent exertion, and + consequent exhaustion of the sensorial power of irritation, as after + intoxication with wine or opium, or after the exhibition of some violent + emetic drug, the torpor is communicated to the heart and arteries, as in + continued fevers with weak pulse. But where the torpor of the stomach is + produced from defective association, as in sea-sickness; or in the + sickness which occurs, when a stone stimulates the ureter; no torpor is + then communicated to the heart and arteries. For in the former case there + is no accumulation of sensorial power in the stomach, which was + previously exhausted by too great stimulus; but in the latter case the + accumulation of sensorial power in the stomach during its torpor is + evinced by this circumstance; that in sea-sickness the patients eat and + drink voraciously at intervals; and the pulse is generally not affected + by the sickness occasioned by a stone in the ureter. For the action of + the stomach is then lessened, and in consequence becomes retrograde, not + owing to the exhaustion of the sensorial power of irritation, but to the + want of excitement of the sensorial power of association; which is caused + by the defective action of the ureter, which becomes occasionally torpid + by the great stimulus of the stone it contains; or which is caused by the + great exhaustion of sensorial power by the pain; which affects the ureter + without exciting inflammation, or increased action of it.</p> + + <p><a name="suppl_VIII_9">9</a>. Thus though the stomach after the great + stimulus of intoxication from excess of wine or opium will continue many + hours without accumulation of sensorial power, as appears from the + patient's experiencing no appetite at the intervals of sickness; yet + after long abstinence from food, at length not only the exhausted + quantity of sensorial power is renewed, but an accumulation of it at + length occurs, and hunger returns. In this situation the stomach is + generally about a whole day before it regains its usual powers of + digestion; but if it has been still more violently stimulated, and its + actions further impaired, a still more permanent torpor along with a + continued fever with weak pulse is liable to occur; and a fourth part, or + a half, or three fourths, or a whole lunar period passes, before it + recovers its due irritability and consequent action.</p> + + <p>In similar manner, after a person has been confined in a very warm + room for some hours, the cutaneous capillaries, with their secretory and + absorbent vessels, become exhausted of their sensorial power of + irritation by the too great violent exertions occasioned by the unusual + stimulus of heat; and in coming into a colder atmosphere an inactivity of + the cutaneous vessels exists at first for some time without accumulation + of sensorial power; as is shewn by the continuance of the pain of cold + and the paleness; but after a time both the pain of cold and paleness + vanish, which now indicates an accumulation of the sensorial power of + irritation, as less degrees of heat stimulate the system into due + action.</p> + + <p>In the same manner, after any one has been some time in the summer + sunshine, on coming into a dark cell he continues much longer before he + can clearly distinguish objects, than if his eyes had only been + previously exposed to the light of a cloudy day in winter; because the + sensorial power of irritation, and consequent sensation, had in the first + case been previously much expended or exhausted; and therefore required a + much longer time before it could be produced in the brain, or derived to + the optic nerves, in such quantity as to restore the deficiency, and to + cause an accumulation of it; whereas in the latter case no deficiency had + occurred.</p> + + <p><a name="suppl_VIII_10">10</a>. Thus the accumulation or deficiency of + sensorial power in a torpid organ, which had previously been accustomed + to perpetual action, depends on the manner in which it becomes torpid; + that is, whether by great previous stimulus, or great previous excitement + of the power of association; or by defect of its accustomed stimulus, or + of its accustomed excitement of the power of association. In the former + case the sensorial power is in an exhausted state, and therefore is not + likely to become so soon accumulated, as after drunkenness, or exposure + to great heat, or to great light; in the latter a great accumulation of + sensorial power occurs, as after exposure to cold, or hunger, or + darkness.</p> + + <p>Hence when the stomach continues torpid by previous violent stimulus, + as in the exhibition of digitalis, no accumulation of sensorial power of + irritation supervenes; and in consequence the motions of the heart and + arteries, which are associated with those of the stomach, become weak, + and slow, and intermittent, from the defect of the excitement of the + sensorial power of association. But what follows? as the actions of the + heart and arteries are lessened by the deficient action of the sensorial + power of association, and not by previous increased excitement of it; a + great accumulation of the sensorial power of association occurs, which is + exerted on the pulmonary and cutaneous absorbents by reverse sympathy, + and produces a great absorption of the fluid effused into the cellular + membrane in anasarca, with dry skin; constituting one kind of + atrophy.</p> + + <p>But if at the same time the secerning vessels of the stomach are + stimulated into so violent activity as to induce great consequent torpor, + as probably happens when contagious matter is swallowed into the stomach + with our saliva, those of the heart and arteries act feebly from the + deficient excitement of the power of association; and then the cutaneous + and pulmonary secerning vessels act with greater force than natural, + owing to the accumulation of the sensorial power of association; and + unnatural heat of the skin, and of the breath succeed; but without + frequency of pulse, constituting the paresis irritativa of Class <a + href="#species_I_2_1_2">I. 2. 1. 2</a>. And lastly, if a paucity of blood + attends this paresis, or some other cause inducing a frequency of pulse, + the febris inirritativa, or fever with weak pulse, is produced.</p> + + <p>But on the contrary when the stomach has previously been rendered + torpid by defect of stimulus, as by hunger, if food be too hastily + supplied, not only great exertion of the stomach itself succeeds, but + fever with strong pulse is induced in consequence; that is, the heart and + arteries are excited into more energetic action by the excess of the + power of association, which catenates their motions with those of the + stomach. For the redundancy of sensorial power of irritation, which was + accumulated during the inactivity of the stomach, and is now called into + action by stimulus, actuates that organ with increased energy, and + excites by these increased motions the sensorial power of association; + which has also been accumulated during the inactivity of the heart and + arteries; and thus these organs also are now excited into greater + action.</p> + + <p>So after the skin has been exposed some hours to greater heat than + natural in the warm room, other parts, as the membranes of the nostrils, + or of the lungs, or of the stomach, are liable to become torpid from + direct sympathy with it, when we come into air of a moderate temperature; + whence catarrhs, coughs, and fevers. But if this torpor be occasioned by + defect of stimulus, as after being exposed to frosty air, the + accumulation of sensorial power is exerted, and a glow of the skin + follows, with increased digestion, full respiration, and more vigorous + circulation.</p> + + <p><a name="suppl_VIII_11">11</a>. It may be asked, Why is there a great + and constant accumulation of the sensorial power of association, owing to + the torpor of the stomach and heart and arteries, in continued fever with + weak pulse; which is exerted on the cutaneous and pulmonary capillaries, + so as to excite them into increased action for many weeks, and yet no + such exuberance of sensorial power produces fever in winter-sleeping + animals, or in chlorosis, or apepsia, or hysteria?</p> + + <p>In winter-sleeping animals I suppose the whole nervous system is + torpid, or paralysed, as in the sleep of frozen people; and that the + stomach is torpid in consequence of the inactivity or quiescence of the + brain; and that all other parts of the body, and the cutaneous + capillaries with the rest, labour under a similar torpor.</p> + + <p>In chlorosis, I imagine, the actions of the heart and arteries, as + well as those of the cutaneous and pulmonary capillaries, suffer along + with those of the stomach from the deficient stimulus of the pale blood; + and that though the liver is probably the seat of the original torpor in + this disease, with which all other parts sympathize from defect of the + excitation of the sensorial power of association; yet as this torpor + occurs in so small a degree as not to excite a shuddering or cold fit, no + observable consequences are in general occasioned by the consequent + accumulation of sensorial power. Sometimes indeed in chlorosis there does + occur a frequent pulse and hot skin; in which circumstances I suppose the + heart and arteries are become in some degree torpid by direct sympathy + with the torpid liver; and that hence not only the pulse becomes + frequent, but the capillaries of the skin act more violently by reverse + sympathy with the heart and arteries, owing to the accumulation of the + sensorial power of association in them during their torpid state, as + occurs in irritative fever. See Article <a href="#suppl_XI">11</a> of + this Supplement.</p> + + <p>In apepsia chronica the actions of the stomach are not so far impaired + or destroyed as totally to prevent the excitation of the sensorial power + of association, which therefore contributes something towards the actions + of the heart and arteries, though less than natural, as a weak pulse + always I believe attends this disease.</p> + + <p>There is a torpor of the stomach, and of the upper part of the + alimentary canal in hysteria, as is evident from the retrograde actions + of the duodenum, stomach, and œsophagus, which constitute the + globus hystericus, or sensation of a globe rising into the throat. But as + these retrograde actions are less than those, which induce sickness or + vomiting, and are not occasioned by previous exhaustion of the sensorial + power of irritation, they do not so totally prevent the excitement of the + sensorial power of association, as to lessen the motion of the heart and + arteries so much as to induce fever; yet in this case, as in apepsia, and + in chlorosis, the pulsations of the heart and arteries are weaker than + natural, and are sometimes attended with occasionally increased action of + the capillaries; as appears from the flushings of the face, and hot skin, + which generally form an evening febricula in diseases attended with weak + digestion.</p> + + <p><a name="suppl_VIII_12">12</a>. The increased action, or orgasm, of + the cutaneous, pulmonary, and cellular capillaries, with their secerning + and absorbent vessels, in those fevers which are attended with deficiency + of vital action, exhausts the patient both by the additional expenditure + of sensorial power on those organs of secretion, and by the too great + absorption of the mucus and fat of the body; whence great debility and + great emaciation. Hence one great indication of cure of continued fever + with arterial debility is to diminish the too great action of the + capillaries; which is to be done by frequent ablutions, or bathing the + whole skin in tepid or in cold water, as recommended by Dr. Currie of + Liverpool (Philos. Trans. for 1792), for half an hour, twice a day, or at + those times when the skin feels dryest and hottest. Much cool air should + also be admitted, when the breath of the patient feels hot to one's hand; + or when the tongue, especially its middle part, is dry, and covered with + a crust of indurated mucus; as these indicate the increased action of the + pulmonary capillaries; in the same manner as the dry and hot skin + indicates the orgasm of the cutaneous capillaries; and the emaciation of + the body that of the cellular ones.</p> + + <p>For this purpose of abating the action of the capillaries by frequent + ablution or fomentation, water of any degree of heat beneath that of the + body will be of service, and ought in accurate language to be called a + cold bath; but the degree of coldness, where the patient is sensible, + should in some measure be governed by his sensations; as it is probable, + that the degree of coldness, which is most grateful to him, will also be + of the greatest benefit to him. See Class <a + href="#species_III_2_1_12">III. 2. 1. 12</a>. and Article <a + href="#suppl_XV">15</a> of this Supplement.</p> + + <p>Another great use of frequent ablutions, or fomentations, or baths, in + fevers, where the stomach is in some degree torpid, is to supply the + system with aqueous fluid by means of the cutaneous absorbents; which is + dissipated faster by the increased action of the secerning capillaries, + than the stomach can furnish, and occasions great thirst at the intervals + of the sickness.</p> + +<p class="cenhead"><a name="suppl_IX">IX</a>. <i>Torpor of the Lungs.</i></p> + + <p><a name="suppl_IX_1">1</a>. The lungs in many cases of contagion may + first be affected with torpor, and the skin become cold by sympathy; in + the same manner as a cold skin on going into the cold bath induces + difficulty of breathing. Or the stomach may become affected with torpor + by its sympathy with the lungs, as in the experiments of Mr. Watt with + hydro-carbonate gas; a few respirations of which induced sickness, and + even syncope. When the stomach or skin is thus affected secondarily by + association, an accumulation of sensorial power occurs much sooner, than + when these parts become torpid in consequence of previous excess of + stimulus; and hence they sooner recover their accustomed action, and the + fever ceases. The particles of contagious matter thus received by + respiration somewhat resemble in their effects the acid gases from + burning sulphur, or from charcoal; which, if they do not instantly + destroy, induce a fever, and the patient slowly recovers.</p> + + <p><a name="suppl_IX_2">2</a>. I was some years ago stooping down to + look, which way the water oozed from a morass, as a labourer opened it + with a spade, to detect the source of the spring, and inhaled a vapour, + which occasioned an instant sense of suffocation. Immediately recoiling I + believe I inhaled it but once; yet a few hours afterwards in the cool of + the evening, when I returned home rather fatigued and hungry, a shivering + and cold fit occurred, which was followed by a hot one; and the whole + disease began and terminated in about twelve hours without return. In + this case the power of fear, or of imagination, was not concerned; as I + neither thought of the bad air of a morass before I perceived it; nor + expected a fever-fit, till it occurred.</p> + + <p>In this case the torpor commenced in the lungs, and after a few hours, + by the addition of fatigue, and cold, and hunger, was propagated by + direct sympathy to the rest of the system. An orgasm or increased action + of the whole system was then induced by the accumulation of sensorial + power of irritation in the lungs, and of association in the other organs; + and when these subsided, the disease ceased. It may be asked, could a + torpor of the capillaries of the air-vessels of the lungs be so suddenly + produced by great stimulation?—It appears probable, that it might, + because great exertion of irritative motions may be instantly produced + without our perceiving them; that is, without their being attended by + sensation, both in the lungs and stomach; and the organs may become + torpid by the great expenditure of the sensorial power of irritation in + an instant of time; as paralysis frequently instantly follows too great + an exertion of voluntary power.</p> + + <p><a name="suppl_IX_3">3</a>. When the capillaries of the lungs act too + violently, as in some continued fevers; which is known by the heat of the + breath, and by the dryness of the tongue, especially of the middle part + of it; not only cooler air might be admitted more freely into a sick room + to counteract this orgasm of the pulmonary capillaries; but perhaps the + patient might breathe with advantage a mixture of carbonic acid gas, or + of hydrogene gas, or of azote with atmospheric air. And on the contrary, + when there exists an evident torpor of the pulmonary capillaries, which + may be known by the correspondent chilness of the skin; and by a tickling + cough, which sometimes attends cold paroxysms of fever, and is then owing + to the deficient absorption of the pulmonary mucus, the saline parts of + which stimulate the bronchiæ, or air-vessels; a mixture of one part of + oxygen gas with 10 or 20 parts of atmospheric air might probably be + breathed with great advantage.</p> + +<p class="cenhead"><a name="suppl_X">X</a>. <i>Torpor of the Brain.</i></p> + + <p>As the inactivity or torpor of the absorbent vessels of the brain is + the cause of hydrocephalus internus; and as the deficiency of venous + absorption in the brain, or torpor of the extremities of its veins, is + believed frequently to be the cause of apoplexies; so there is reason to + conclude, that the torpor of the secerning vessels of the brain, which + are supposed to produce the sensorial power, may constitute the immediate + cause of some fevers with arterial debility. And also that the increased + action of these secerning vessels may sometimes constitute the immediate + cause of fevers with arterial strength.</p> + + <p>It is nevertheless probable, that the torpor or orgasm of the + sanguiferous, absorbent, or secerning vessels of the brain may frequently + exist as a secondary effect, owing to their association with other + organs, as the stomach or lungs; and may thus be produced like the torpor + of the heart and arteries in inirritative fevers, or like the orgasm of + those organs in irritative fevers, or inflammatory ones.</p> + + <p>Where there exists a torpor of the brain, might not very slight + electric shocks passed frequently through it in all directions be used + with advantage? Might not fomentations of 94 or 96 degrees of heat on the + head for an hour at a time, and frequently repeated, stimulate the brain + into action; as in the revival of winter-sleeping animals by warmth? + Ether externally might be frequently applied, and a blister on the shaved + head.</p> + + <p>Where the secerning vessels of the brain act with too great energy, as + in some inflammatory fevers, might it not be diminished by laying the + patient horizontally on a mill-stone, and whirling him, till sleep should + be produced, as the brain becomes compressed by the centrifugal force? + See Article <a href="#suppl_XV">15</a> of this Supplement.</p> + +<p class="cenhead"><a name="suppl_XI">XI</a>. <i>Torpor of the Heart and Arteries.</i></p> + + <p><a name="suppl_XI_1">1</a>. It was shewn in Class <a + href="#species_IV_1_1_6">IV. 1. 1. 6</a>. in <a + href="#species_IV_2_1_2">IV. 2. 1. 2</a>. and in Suppl. I. <a + href="#suppl_VI_3">6. 3</a>. that a reverse sympathy generally exists + between the lacteal and lymphatic branches of the absorbent system. + Hence, when the motions of the absorbents of the stomach are rendered + torpid or retrograde in fevers with arterial debility, those of the skin, + lungs, and cellular membrane, act with increased energy. But the actions + of the muscular fibres of the heart and arteries are at the same time + associated with those of the muscular fibres of the stomach by direct + sympathy. Both these actions occur during the operation of powerful + emetics, as squill, or digitalis; while the motions of the stomach + continue torpid or retrograde, the cellular and cutaneous absorbents act + with greater energy, and the pulsations of the heart and arteries become + weaker, and sometimes slower.</p> + + <p><a name="suppl_XI_2">2</a>. The increased action of the stomach after + a meal, and of the heart and arteries at the same time from the stimulus + of the new supply of chyle, seems originally to have produced, and to + have established, this direct sympathy between them. As the increased + action of the absorbents of the stomach after a meal has been usually + attended with diminished action of the other branches of the absorbent + system, as mentioned in Class <a href="#species_IV_1_1_6">IV. 1. 1. + 6</a>. and has thus established a reverse sympathy between them.</p> + + <p>2. Besides the reverse sympathy of the absorbent vessels and the + muscles of the stomach, and of the heart and arteries, with those of the + skin, lungs, and cellular membrane; there exists a similar reverse + sympathy between the secerning vessels or glands of the former of these + organs with those of the latter; that is the mucous glands of the heart + and arteries act generally by direct sympathy with those of the stomach; + and the mucous glands of the cellular membrane of the lungs, and of the + skin, act by reverse sympathy with them both.</p> + + <p>Hence when the stomach is torpid, as in sickness, this torpor + sometimes only affects the absorbent vessels of it; and then the + absorbents of the cellular membrane and the skin only act with increased + energy by reverse sympathy. If the torpor affects the muscular fibres of + the stomach, those of the heart and arteries act by direct sympathy with + it, and a weak pulse is produced, as in the exhibition of digitalis, but + without increase of heat. But if the torpor also affects the glands of + the stomach, the cutaneous and pulmonary glands act with greater energy + by their reverse sympathy with those of the stomach, and of the heart and + arteries; and great heat is produced along with increased perspiration + both from the skin and lungs.</p> + + <p><a name="suppl_XI_3">3</a>. There is some difficulty in explaining, + why the actions of the extensive system of capillary glands, which exist + on every other membrane and cell in the body for the purpose of secreting + mucus and perspirable matter, should so generally act by reverse sympathy + with those of the stomach and upper part of the intestines. It was shewn + in Class <a href="#species_IV_1_1_6">IV. 1. 1. 6</a>. that when the + stomach was filled with solid and fluid aliment, the absorbents of the + cellular membrane, and of the bladder, and of the skin acted with less + energy; as the fluids they were used to absorb and transmit into the + circulation, were now less wanted; and that hence by habit a reverse + sympathy obtained between these branches of the absorbents of the + alimentary canal, and those of the other parts of the body.</p> + + <p>Now, as at this time less fluid was absorbed by the cutaneous and + cellular lymphatics, it would happen, that less would be secreted by + their correspondent secerning vessels, or capillary glands; and that + hence by habit, these secerning vessels would acquire a reverse sympathy + of action with the secerning vessels of the alimentary canal.</p> + + <p>Thus when the absorption of the tears by the puncta lacrymalia is much + increased by the stimulus of snuff; or of an affecting idea, on the nasal + dusts, as explained in Sect. XVI. 8. 2. a great increase of the secretion + of tears from the lacrymal glands is produced by the direct sympathy of + the action of these glands with those of their correspondent absorbents; + and that though in this case they are placed at so great a distance from + each other.</p> + + <p><a name="suppl_XI_4">4</a>. A difficult question here occurs; why does + it happen, that in fevers with weak pulse the contractions of the heart + and arteries become at the same time more frequent; which also sometimes + occurs in chlorosis, and in some hysteric and hypochondriac diseases, and + in some insanities; yet at other times the weak pulse becomes at the same + time slow, as in the exhibition of digitalis, and in paresis irritativa, + described in Class <a href="#species_I_2_1_2">I. 2. 1. 2</a>. which may + be termed a fever with slow pulse? this frequency of pulse can not depend + on heat, because it sometimes exists without heat, as towards the end of + some fevers with debility.</p> + + <p>Now as apoplexies, which are sometimes ascribed to fulness of blood, + are attended with slow pulse; and as in animals dying in the slaughter + house from deficiency of blood the pulse becomes frequent in extreme; may + not the frequency of pulse in fevers with arterial debility be in general + owing to paucity of blood? as explained in Sect. XXXII. 2. 3. and its + slowness in paresis irritativa be caused by the debility being + accompanied with due quantity of blood? or may not the former + circumstance sometimes depend on a concomitant affection of the brain + approaching to sleep? or to the unusual facility of the passage of the + blood through the pulmonary and aortal capillaries? in which circumstance + the heart may completely empty itself at each pulsation, though its + contractions may be weak. While the latter depends on the difficulty of + the passage of the blood through the pulmonary or aortal capillaries, as + in the cold fits of intermittents, and in some palpitations of the heart, + and in some kinds of hæmoptoe? in these cases the increased resistance + prevents the heart from emptying itself, and in consequence a new + diastole sooner occurs, and thus the number of pulsations becomes greater + in a given time.</p> + + <p><a name="suppl_XI_5">5</a>. In respect to the sympathies of action, + which produce or constitute fever with debility, the system may be + divided into certain provinces, which are assentient or opposite to each + other. First, the lacteals or absorbent vessels of the stomach, and upper + part of the intestines; secondly, the lymphatics or all the other + branches of the absorbent vessels, which arise from the skin, mucous + membranes, cellular membranes, and the various glands. These two + divisions act by reverse sympathy with each other in the hot fits of + fever with debility, though by direct sympathy in the cold ones. The + third division consists of the secerning vessels of the stomach and upper + intestines; and the fourth of the secerning vessels of all the other + parts of the body, as the capillary glands of the skin, lungs, and + cellular membrane, and the various other glands belonging to the + sanguiferous system. Many of these frequently, but the capillaries + always, act by reverse sympathy with those of the third division above + mentioned in the hot fits of fever with debility, though by direct + sympathy with them in the cold fits. Fifthly, the muscular fibres of the + stomach, and upper intestines; and sixthly, the muscular fibres of the + heart and arteries. The actions of these two last divisions of moving + fibres act by direct sympathy with each other, both in the cold and hot + fits of fevers with debility.</p> + + <p>The efficient cause of those apparent sympathies in fevers with weak + pulse may be thus understood. In the cold paroxysm of fever with weak + pulse the part first affected I believe to be the stomach, and that it + has become torpid by previous violent exertion, as by swallowing + contagious matter mixed with saliva, and not by defect of stimulus, as + from cold or hunger. The actions of this important organ, which + sympathizes with almost every part of the body, being thus much + diminished or nearly destroyed, the sensorial power of association is not + excited; which in health contributes to move the heart and arteries, and + all the rest of the system; whence an universal torpor occurs.</p> + + <p>When the hot fit approaches, the stomach in fevers with strong pulse + regains its activity by the accumulation of the sensorial power of either + irritation, if it was the part first affected, or of association if it + was affected in sympathy with some other torpid part, as the spleen or + liver; which accumulation is produced during its torpor. At the same time + all the other parts of the system acquire greater energy of action by the + accumulation of the sensorial power of association, which was produced, + during their inactivity in the cold fit.</p> + + <p>But in fevers with weak pulse the stomach, whose sensorial power of + irritation had been previously exhausted by violent action, acquires no + such quick accumulation of sensorial power, but remains in a state of + torpor after the hot fit commences. The heart and arteries remain also in + a state of torpor, because there continues to be no excitement of their + power of association owing to the torpid motions of the stomach; but + hence it happens, that there exists at this time a great accumulation of + the power of association in the less active fibres of the heart and + arteries; which, as it is not excited and expended by them, increases the + associability of the next link of the associated chain of motions, which + consists of the capillaries or other glands; and that in so great a + degree as to actuate them with unnatural energy, and thus to produce a + perpetual hot fit of fever. Because the associability of the capillaries + is so much increased by the accumulation of this power, owing to the + lessened activity of the heart and arteries, as to over-balance the + lessened excitement of it by the weaker movements of the heart and + arteries.</p> + + <p><a name="suppl_XI_6">6</a>. When the accumulation of the sensorial + power of irritation caused by defect of stimulus is greater in the first + link of a train of actions, to which associated motions are catenated, + than the deficiency of the excitement of the sensorial power of + association in the next link, what happens?—the superabundance of + the unemployed sensorial power of the first link is derived to the + second; the associability of which thus becomes so greatly increased, + that it acts more violently than natural, though the excitement of its + power of association by the lessened action of the first link is less + than natural. So that in this situation the withdrawing of an accustomed + stimulus in some parts of the system will decrease the irritative motions + of that part, and at the same time occasion an increase of the associate + motion of another part, which is catenated with it.</p> + + <p>This circumstance nevertheless can only occur in those parts of the + system, whose natural actions are perpetual, and the accumulation of + sensorial power on that account very great, when their activity is much + lessened by the deduction of their usual stimulus; and are therefore only + to be found in the sanguiferous system, or in the alimentary canal, or in + the glands and capillaries. Of the first of which the following is an + instance.</p> + + <p>The respiration of a reduced atmosphere, that is of air mixed with + hydrogene or azote, quickens the pulse, as observed in the case of Mrs. + Eaton by Dr. Reynolds and Dr. Thornton; to which Dr. Beddoes adds in a + note, that "he never saw an instance in which a lowered atmosphere did + not at the moment quicken the pulse, while it weakened the action of the + heart and arteries." Considerations on Factitious Airs, by Thomas Beddoes + and James Watt, Part III. p. 67. Johnson, London. By the assistance of + this new fact the curious circumstance of the quick production of warmth + of the skin on covering the head under the bed-clothes, which every one + must at some time have experienced, receives a more satisfactory + explanation, than that which is given in Class <a + href="#species_IV_1_1_2">IV. 1. 1. 2</a>. which was printed before this + part of Dr. Beddoes's Considerations was published.</p> + + <p>For if the blood be deprived of its accustomed quantity of oxygen, as + in covering the head in bed, and thus breathing an air rendered impure by + repeated respiration, or by breathing a factitious air with less + proportion of oxygen, which in common respiration passes through the + moist membranes of the lungs, and mixes with the blood, the pulsations of + the heart and arteries become weaker, and consequently quicker, by the + defect of the stimulus of oxygen. And as these vessels are subject to + perpetual motion, the accumulation of the sensorial power of irritation + becomes so great by their lessened activity, that it excites the vessels + next connected, the cutaneous capillaries for instance, into more + energetic actions, so as to produce increased heat of the skin, and + greater perspiration.</p> + + <p>How exactly this resembles a continued fever with weak and quick + pulse!—in the latter the action of the heart and arteries are + lessened by defect of the excitement of the sensorial power of + association, owing to the torpor or lessened actions of the stomach; + hence the accumulation of the sensorial power of association in this + case, as the accumulation of that of irritation in the former, becomes so + abundant as to excite into increased action the parts most nearly + connected, as the cutaneous capillaries.</p> + + <p>In respect to the circumstance mentioned by Sydenham, that covering + the head in bed in a short time relieved the pertinacious sickness of the + patient, it must be observed, that when the action of the heart and + arteries become weakened by the want of the due stimulus of the proper + quantity of oxygen in the blood, that an accumulation of the sensorial + power of irritation occurs in the fibres of the heart and arteries, which + then is expended on those of the capillary glands, increasing their + actions and consequent secretions and heat. And then the stomach is + thrown into stronger action, both by the greater excitement of its + natural quantity of the sensorial power of association by the increased + actions of the capillaries, and also by some increase of associability, + as it had been previously a long time in a state of torpor, or less + activity than natural, as evinced by its perpetual sickness.</p> + + <p>In a manner somewhat similar to this, is the redness of the skin + produced in angry people by the superabundance of the unemployed + sensorial power of volition, as explained in Class <a + href="#species_IV_2_3_5">IV. 2. 3. 5</a>. Rubor ex irâ. From hence we + learn how, when people in fevers with weak pulse, or in dropsies, become + insane, the abundance of the unemployed sensorial power of volition + increases the actions of the whole moving system, and cures those + diseases.</p> + + <p><a name="suppl_XI_7">7</a>. As the orgasm of the capillaries in fevers + with weak pulse is immediately caused by the torpid actions of the heart + and arteries, as above explained, this supplies us with another + indication of cure in such fevers, and that is to stimulate these organs. + This may probably be done by some kind of medicines, which are known to + pass into the blood unchanged in some of their properties. It is possible + that nitre, or its acid, may pass into the blood and increase the colour + of it, and thus increase its stimulus, and the same may be supposed of + other salts, neutral or metallic? As rubia tinctoria, madder, colours the + bones of young animals, it must pass into the blood with its colouring + matter at least unchanged, and perhaps many other medicines may likewise + affect the blood, and thus act by stimulating the heart and arteries, as + well as by stimulating the stomach; which circumstance deserves further + attention.</p> + + <p>Another way of immediately stimulating the heart and arteries would be + by transfusing new blood into them. Is it possible that any other fluid + besides blood, as chyle, or milk, or water, could, if managed with great + art, be introduced safely or advantageously into the vein of a living + animal?</p> + + <p>A third method of exciting the heart and arteries immediately is by + increasing the natural stimulus of the blood, and is well worthy + experiment in all fevers with weak pulse; and that consists in supplying + the blood with a greater proportion of oxygen; which may be done by + respiration, if the patient was to breathe either oxygen gas pure, or + diluted with atmospheric air, which might be given to many gallons + frequently in a day, and by passing through the moist membranes of the + lungs, according to the experiments of Dr. Priestley, and uniting with + the blood, might render it more stimulant, and thus excite the heart and + arteries into greater action! May not some easier method of exhibiting + oxygen gas by respiration be discovered, as by using very small + quantities of hyper-oxygenated marine acid gas very much diluted with + atmospheric air?</p> + +<p class="cenhead"><a name="suppl_XII">XII</a>. <i>Torpor of the Stomach and upper Intestines.</i></p> + + <p><a name="suppl_XII_1">1</a>. The principal circumstance, which + supports the increased action of the capillaries in continued fever with + weak pulse, is their reverse sympathy with those of the stomach and upper + intestines, or with those of the heart and arteries. The torpor of the + stomach and upper intestines is apparent in continued fevers from the + total want of appetite for solid food, besides the sickness with which + fevers generally commence, and the frequent diarrhœa with + indigested stools, at the same time the thirst of the patient is + sometimes urgent at the intervals of the sickness. Why the stomach can at + this time take fluids by intervals, and not solids, is difficult to + explain; except it be supposed, as some have affirmed, that the lacteal + absorbents are a different branch from the lymphatic absorbents, and that + in this case the former only are in a state of permanent torpor.</p> + + <p><a name="suppl_XII_2">2</a>. The torpor of the heart and arteries is + known by the weakness of the pulse. When the actions of the absorbents of + the stomach are diminished by the exhibition of small doses of digitalis, + or become retrograde by larger ones, the heart and arteries act more + feebly by direct sympathy; but the cellular, cutaneous, and pulmonary + absorbents are excited into greater action. Whence in anasarca the fluids + in the cellular membrane throughout the whole body are absorbed during + the sickness, and frequently a great quantity of atmospheric moisture at + the same time; as appears by the very great discharge of urine, which + sometimes happens in these cases; and in ileus the prodigious evacuations + by vomiting, which are often a hundred fold greater than the quantity + swallowed, evince the great action of all the other absorbents during the + sickness of the stomach.</p> + + <p><a name="suppl_XII_3">3</a>. But when the stomach is rendered + permanently sick by an emetic drug, as by digitalis, it is not probable, + that much accumulation of sensorial power is soon produced in this organ; + because its usual quantity of sensorial power is previously exhausted by + the great stimulus of the foxglove; and hence it seems probable, that the + great accumulation of sensorial power, which now causes the increased + action of the absorbents, is produced in consequence of the inactivity of + the heart and arteries; which inactivity is induced by deficient + excitement of the sensorial power of association between those organs and + the stomach, and not by any previous exhaustion of their natural quantity + of sensorial power; whereas in ileus, where the torpor of the stomach, + and consequent sickness, is induced by reverse sympathy with an inflamed + intestine, that is, by dissevered or defective association; the + accumulation of sensorial power, which in that disease so violently + actuates the cellular, pulmonary, and cutaneous absorbents, is apparently + produced by the torpor of the stomach and lacteals, and the consequent + accumulation of the sensorial power of association in them owing to their + lessened action in sickness.</p> + + <p><a name="suppl_XII_4">4</a>. This accounts for the dry skin in fevers + with weak pulse, where the stomach and the heart and arteries are in a + torpid state, and for the sudden emaciation of the body; because the + actions of the cellular and cutaneous absorbents are increased by reverse + sympathy with those of the stomach, or with those of the heart and + arteries; that is by the expenditure of that sensorial power of + association, which is accumulated in consequence of the torpor of the + stomach and heart and arteries, or of either of them; this also explains + the sudden absorption of the milk in puerperal fevers; and contributes + along with the heat of the respired air to the dryness of the mucous + membrane of the tongue and nostrils.</p> + + <p><a name="suppl_XII_5">5</a>. Besides the reverse sympathy, with which + the absorbent vessels of the stomach and upper intestines act in respect + to all the other absorbent vessels, as in the exhibition of digitalis, + and in ileus; there is another reverse sympathy exists between the + capillaries, or secretory vessels of the stomach, and those of the skin. + Which may nevertheless be occasioned by the accumulation of sensorial + power by the torpor of the heart and arteries, which is induced by direct + sympathy with the stomach; thus when the torpor of the stomach remains in + a fever-fit which might otherwise have intermitted, the torpor of the + heart and arteries remains also by direct sympathy, and the increased + cutaneous capillary action, and consequent heat, are produced by reverse + sympathy; and the fever is thus rendered continual, owing primarily to + the torpor of the stomach.</p> + + <p><a name="suppl_XII_6">6</a>. The reverse sympathy, which exists + between the capillaries of the stomach and the cutaneous capillaries, + appears by the chillness of some people after dinner; and contrary-wise + by the digestion being strengthened, when the skin is exposed to cold air + for a short time; as mentioned in Class <a href="#species_IV_1_1_4">IV. + 1. 1. 4</a>. and <a href="#species_IV_2_1_1">IV. 2. 1. 1</a>. and from + the heat and glow on the skin, which attends the action of vomiting; for + though when sickness first commences, the skin is pale and cold; as it + then partakes of the general torpor, which induces the sickness; yet + after the vomiting has continued some minutes, so that an accumulation of + sensorial power exists in the capillaries of the stomach, and of the + skin, owing to their diminished action; a glow of the skin succeeds, with + sweat, as well as with increased absorption.</p> + + <p><a name="suppl_XII_7">7</a>. Nevertheless in some circumstances the + stomach and the heart and arteries seem to act by direct sympathy with + the cutaneous capillaries, as in the flushing of the face and glow of the + skin of some people after dinner; and as in fevers with strong pulse. In + these cases there appears to be an increased production of sensorial + power, either of sensation, as in the blush of shame; or of volition, as + in the blush of anger; or of irritation, as in the flushed face after + dinner above mentioned.</p> + + <p>This increased action of the capillaries of the skin along with the + increased actions of the stomach and heart is perhaps to be esteemed a + synchronous increase of action, rather than a sympathy between those + organs. Thus the flushing of the face after dinner may be owing to the + secretion of sensorial power in the brain being increased by the + association of that organ with the stomach, in a greater proportion than + the increased expenditure of it, or may be owing also to the stimulus of + new chyle received into the blood.</p> + + <p><a name="suppl_XII_8">8</a>. When the stomach and the heart and + arteries are rendered torpid in fevers, not only the cutaneous, cellular, + and pulmonary absorbents are excited to act with greater energy; but also + their correspondent capillaries and secerning vessels or glands, + especially perhaps those of the skin, are induced into more energetic + action. Whence greater heat, a greater secretion of perspirable matter, + and of mucus; and a greater absorption of them both, and of aerial + moisture. These reverse sympathies coincide with other animal facts, as + in eruption of small pox on the face and neck the feet become cold, while + the face and neck are much flushed; and in the hemiplagia, when one arm + and leg become disobedient to volition, the patient is perpetually moving + the other. Which are well accounted for by the accumulation of sensorial + power in one part of an associated series of actions, when less of it is + expended by another part of it; and by a deficiency of sensorial power in + the second link of association, when too much of it is expended by the + first.</p> + + <p><a name="suppl_XII_9">9</a>. This doctrine of reverse sympathy enables + us to account for that difficult problem, why in continued fevers the + increased action of the cutaneous, cellular, and pulmonary capillaries + proceeds without interruption or return of cold fit; though perhaps with + some exacerbations and remissions; and that during a quarter, or half, or + three quarters, or a whole lunation; while at the same time the + pulsations of the heart and arteries are weaker than natural.</p> + + <p>To this should be added the direct sympathy, which exists between the + peristaltic motions of the fibres of the stomach, and the pulsations of + the heart. And that the stomach has become torpid by the too great + stimulus of some poisonous or contagious matter; and this very intricate + idea of continued fever with feeble pulse is reduced to curious + simplicity.</p> + + <p>The direct sympathy of the stomach and heart and arteries not only + appears from the stronger and slower pulse of persons exhausted by + fatigue, after they have drank a glass of wine, and eaten a few + mouthfuls; but appears also from the exhibition of large doses of + digitalis; when the patient labours under great and incessant efforts to + vomit, at the same time that the actions of the absorbent system are + known to be much increased by the hasty absorption of the serous fluid in + anasarca, the pulsations of the heart become slow and intermittent to an + alarming degree. See Class <a href="#species_IV_2_1_17">IV. 2. 1. 17</a>. + and <a href="#species_IV_2_1_18">18</a>.</p> + + <p><a name="suppl_XII_10">10</a>. It would assist us much in the + knowledge and cure of fevers, if we could always determine, which part of + the system was primarily affected; and whether the torpor of it was from + previous excess or defect of stimulus; which the industry of future + observers must discover. Thus if the stomach be affected primarily, and + that by previous excess of stimulus, as when certain quantities of opium, + or wine, or blue vitriol, or arsenic, are swallowed, it is some time in + recovering the quantity of sensorial power previously exhausted by excess + of stimulus, before any accumulation of it can occur. But if it be + affected with torpor secondarily, by sympathy with some distant part; as + with the torpid capillaries of the skin, that is by defective excitement + of the sensorial power of association; or if it be affected by defect of + stimulus of food or of heat; it sooner acquires so much accumulation of + sensorial power, as to be enabled to accommodate itself to its lessened + stimulus by increase of its irritability.</p> + + <p>Thus in the hemicrania the torpor generally commences in a diseased + tooth, and the membranes about the temple, and also those of the stomach + become torpid by direct synchronous sympathy; and pain of the head, and + sickness supervene; but no fever or quickness of pulse. In this case the + torpor of the stomach is owing to defect of the sensorial power of + association, which is caused by the too feeble actions of the membranes + surrounding the diseased tooth, and thus the train of sympathy ceases + here without affecting the motions of the heart and arteries; but where + contagious matter is swallowed into the stomach, the stomach after a time + becomes torpid from exhaustion of the sensorial power of irritation, and + the heart and arteries act feebly from defect of the excitement of the + power of association. In the former case the torpor of the stomach is + conquered by accumulation of the power of association in one or two whole + days; in the latter it recovers by accumulation of the power of + irritation in three or four weeks.</p> + + <p>In intermittent fevers the stomach is generally I believe affected + secondarily by sympathy with the torpid cutaneous capillaries, or with + some internal torpid viscus, and on this account an accumulation of + sensorial power arises in a few hours sufficient to restore the natural + irritability of this organ; and hence the hot fit succeeds, and the fever + intermits. Or if this accumulation of sensorial power becomes excessive + and permanent, the continued fever with strong pulse is produced, or + febris irritativa.</p> + + <p>In continued fevers the stomach is frequently I suppose affected with + torpor by previous excess of stimulus, and consequent exhaustion of + sensorial power, as when contagious matter is swallowed with the saliva, + and it is then much slower in producing an accumulation of sensorial + power sufficient to restore its healthy irritability; which is a frequent + cause of continued fever with weak pulse or febris inirritativa. Which + consists, after the cold fit is over, in a more frequent and more feeble + action of the heart and arteries, owing to their direct sympathy with the + muscular fibres of the torpid stomach; together with an increased action + of the capillaries, glands, and absorbents of the skin, and cellular + membrane, owing to their reverse sympathy with the torpid capillaries, + glands, and absorbents of the stomach, or with those of the heart and + arteries.</p> + + <p>Or in more accurate language. 1. The febris inirritativa, or fever + with weak pulse, commences with torpor of the stomach, occasioned by + previous exhaustion of sensorial power of irritation by the stimulus of + contagious matter swallowed with the saliva. 2. The whole system becomes + torpid from defect of the excitement or the sensorial power of + association owing to the too feeble actions of the stomach, this is the + cold fit. 3. The whole system, except the stomach with the upper + intestines, and the heart and arteries, falls into increased action, or + orgasm, owing to accumulation of sensorial power of association during + their previous torpor, this is the hot fit. 4. The stomach and upper + intestines have not acquired their natural quantity of sensorial power of + irritation, which was previously exhausted by violent action in + consequence of the stimulus of contagious matter, and the heart and + arteries remain torpid from deficient excitement of the sensorial power + of association owing to the too feeble actions of the stomach. 5. The + accumulation of sensorial power of association in consequence of the + torpor of the heart and arteries occasions a perpetual orgasm, or + increased action of the capillaries.</p> + + <p><a name="suppl_XII_11">11</a>. From hence it may be deducted first, + that when the torpor of the stomach first occurs, either as a primary + effect, or as a secondary link of some associate train or circle of + motions, a general torpor of the system sometimes accompanies it, which + constitutes the cold fit of fever; at other times no such general torpor + occurs, as during the operation of a weak emetic, or during + sea-sickness.</p> + + <p>Secondly. After a time it generally happens, that a torpor of the + stomach ceases, and its actions are renewed with increase of vigour by + accumulation of sensorial power during its quiescence; as after the + operation of a weak emetic, or at the intervals of sea-sickness, or after + the paroxysm of an intermittent fever.</p> + + <p>Thirdly. The stomach is sometimes much slower in recovering from a + previous torpor, and is then the remote cause of continued fever with + weak pulse; which is owing to a torpor of the heart and arteries, + produced in consequence of the deficient excitement of the power of + association by the too weak actions of the stomach; and to an orgasm of + the capillaries of the other parts of the system, in consequence of the + accumulation of sensorial power occasioned by the inactivity of the heart + and arteries.</p> + + <p>Fourthly. The torpor of the stomach is sometimes so complete, that + probably the origin of its nerves is likewise affected, and then no + accumulation of sensorial power occurs. In this case the patient dies for + want of nourishment; either in three or four weeks, of the inirritative + fever; or without quick pulse, by what we have called paresis irritativa. + Or he continues many years in a state of total debility. When this torpor + suddenly commences, the patient generally suffers epileptic fits or + temporary insanity from the disagreeable sensation of so great a torpor + of the stomach; which also happens sometimes at the eruption of the + distinct small pox; whence we have termed this disease anorexia + epileptica. See Class <a href="#species_II_2_2_1">II. 2. 2. 1</a>. and <a + href="#species_III_1_1_7">III. 1. 1. 7</a>. and Suppl. I. <a + href="#suppl_XIV_3">14. 3</a>.</p> + + <p>Fifthly. When this torpor of the stomach is less in degree or extent, + and yet without recovering its natural irritability by accumulation of + sensorial power, as it does after the cold fit of intermittent fever, or + after the operation of mild emetics, or during syncope; a permanent + defect of its activity, and of that of the upper intestines, remains, + which constitutes apepsia, cardialgia, hypochondriasis, and hysteria. See + Class <a href="#species_I_3_1_3">I. 3. 1. 3</a>. and <a + href="#species_I_2_4_5">I. 2. 4. 5</a>.</p> + + <p>Sixthly. If the torpor of the stomach be induced by direct sympathy, + as in consequence of a previous torpor of the liver, or spleen, or skin, + an accumulation of sensorial power will sooner be produced in the + stomach; because there has been no previous expenditure of it, the + present torpor of the stomach arising from defect of association. Hence + some fevers perfectly intermit, the stomach recovering its complete + action after the torpor and consequent orgasm, which constitute the + paroxysm of fever, are terminated.</p> + + <p>Seventhly. If the torpor of the stomach be owing to defect of + irritation, as to the want of food, an accumulation of sensorial power + soon occurs with an increase of digestion, if food be timely applied; or + with violent inflammation, if food be given in too great quantity after + very long abstinence.</p> + + <p>Eighthly. If the torpor of the stomach be induced by defect of + pleasurable sensation, as when sickness is caused by the suggestion of + nauseous ideas; an accumulation of sensorial power soon occurs, and the + sickness ceases with the return of hunger; for in this case the + inactivity of the stomach is occasioned by the subduction of agreeable + sensation, which acts as a subduction of stimulus, and not by exhausting + the natural quantity of sensorial power in the fibres or nerves of the + stomach.</p> + + <p>Ninthly. If the torpor of the stomach be induced by a twofold cause, + as in sea-sickness. See Vertigo rotatoria. Class <a + href="#species_IV_2_1_10">IV. 2. 1. 10</a>. in which the first link of + association acts too strongly, and in consequence expends more than usual + of the sensorial power of <span class="correction" title="Original reads `iritation'." + >irritation</span>; and secondly in which sensation is produced between + the links of association, and dissevers or enfeebles them; the + accumulation of sensorial power soon occurs in the stomach; as no + previous expenditure of it in that organ has occurred. Whence in + sea-sickness the persons take food with eagerness at times, when the + vertigo <span class="correction" title="Original reads `cases'." + >eases</span> for a few minutes.</p> + + <p>Tenthly. If the gastric torpor be induced by previous violent + exertion, as after intoxication, or after contagious matter has been + swallowed, or some poisons, as digitalis, or arsenic; an accumulation of + sensorial power very slowly succeeds; whence long sickness, or continued + fever, because the quantity of sensorial power already wasted must first + be renewed, before an accumulation of it can be produced.</p> + + <p><a name="suppl_XII_12">12</a>. This leads us to a second indication of + cure in continued fevers, which consists in strengthening the actions of + the stomach; as the first indication consisted in decreasing the actions + of the cutaneous capillaries and absorbents. The actions of the stomach + may sometimes be increased by exhibiting a mild emetic; as an + accumulation of sensorial power in the fibres of the stomach is produced + during their retrograde actions. Besides the evacuation of any noxious + material from the stomach and duodenum, and from the absorbents, which + open their mouths on their internal surfaces, by their retrograde + motion.</p> + + <p>It is probable, that when mild emetics are given, as ipecacuanha, or + antimonium tartarizatum, or infusion of chamomile, they are rejected by + an inverted motion of the stomach and œsophagus in consequence of + disagreeable sensation, as dust is excluded from the eye; and these + actions having by previous habit been found effectual, and that hence + there is no exhaustion of the sensorial power of irritation. But where + strong emetics are administered, as digitalis, or contagious matter, the + previous exhaustion of the sensorial power of irritation seems to be a + cause of the continued retrograde actions and sickness of the stomach. An + emetic of the former kind may therefore strengthen the power of the + stomach immediately after its operation by the accumulation of sensorial + power of irritation during its action. See Class <a + href="#genus_IV_1_1">IV. 1. 1</a>.</p> + + <p>Another method of decreasing the action of the stomach for a time, and + thence of increasing it afterwards, is by the accumulation of the + sensorial power of irritation during its torpor; is by giving ice, iced + water, iced creams, or iced wine. This accounts for the pleasure, which + many people in fevers with weak pulse express on drinking cold beverage + of any kind.</p> + + <p>A second method of exciting the stomach into action, and of decreasing + that of the capillaries in consequence, is by the stimulus of wine, + opium, bark, metallic salts of antimony, steel, copper, arsenic, given in + small repeated quantities; which so long as they render the pulse slower + are certainly of service, and may be given warm or cold, as most + agreeable to the patient. For it is possible, that the capillaries of the + stomach may act too violently, and produce heat, at the same time that + the large muscles of it may be in a torpid state; which curious + circumstance future observations must determine.</p> + + <p>Thirdly. Hot fomentation on the region of the stomach might be of most + essential service by its stimulus, as heat penetrates the system not by + the absorbent vessels, but by external influence; whence the use of hot + fomentation to the head in torpor of the brain; and the use of hot bath + in cases of general debility, which has been much too frequently + neglected from a popular error occasioned by the unmeaning application of + the word relaxation to animal power. If the fluid of heat could be + directed to pass through particular parts of the body with as little + diffusion of its influence, as that of electricity in the shocks from the + coated jar, it might be employed with still greater advantage.</p> + + <p>Fourthly. The use of repeated small electric shocks through the region + of the stomach might be of service in fevers with weak pulse, and well + deserves a trial; twenty or thirty small shocks twice a day for a week or + two would be a promising experiment.</p> + + <p>Fifthly. A blister on the back, or sides, or on the pit of the + stomach, repeated in succession, by stimulating the skin frequently + strengthens the action of the stomach by exciting the sensorial power of + association; this especially in those fevers where the skin of the + extremities, as of the hands or nose or ears, sooner becomes cold, when + exposed to the air, than usual.</p> + + <p>Sixthly. The action of the stomach may be increased by preventing too + great expenditure of sensorial power in the link of previous motion with + which it is catenated, especially if the action of that link be greater + than natural. Thus as the capillaries of the skin act too violently in + fevers with weak pulse, if these are exposed to cold air or cold water, + the sensorial power, which previously occasioned their orgasm, becomes + accumulated, and tends to increase the action of the stomach; thus in + those fevers with weak pulse and hot skin, if the stomach be stimulated + by repeated small doses of bark and wine or opium, and be further excited + at the same time by accumulation of sensorial power occasioned by + rendering the capillaries torpid by cold air or water, this twofold + application is frequently attended with visible good effect.</p> + + <p>By thus stimulating the torpid stomach into greater action, the + motions of the heart and arteries will likewise be increased by the + greater excitement of the power of association. And the capillaries of + the skin will cease to act so violently, from their not possessing so + great a superfluity of sensorial power as during the greater quiescence + of the stomach and of the heart and arteries. Which is in some + circumstances similar to the curious phenomenon mentioned in Class <a + href="#species_IV_2_2_10">IV. 2. 2. 10</a>; where, by covering the chill + feet with flannel at the eruption of the small-pox, the points of the + flannel stimulate the skin of the feet into greater action, and the + quantity of heat, which they possess, is also confined, or insulated, and + further increases by its stimulus the activity of the cutaneous vessels + of the feet; and by that circumstance abates the too great action of the + capillaries of the face, and the consequent heat of it.</p> + +<p class="cenhead"><a name="suppl_XIII">XIII</a>. <i>Case of continued fever.</i></p> + + <p>The following case of continued fever which I frequently saw during + its progress, as it is less complicate than usual, may illustrate this + doctrine. Master S. D. an active boy about eight years of age, had been + much in the snow for many days, and sat in the classical school with wet + feet; he had also about a fortnight attended a writing school, where many + children of the lower order were instructed. He was seized on February + the 8th, 1795, with great languor, and pain in his forehead, with + vomiting and perpetual sickness; his pulse weak, but not very frequent. + He took an emetic, and on the next day, had a blister, which checked the + sickness only for a few hours; his skin became perpetually hot, and dry; + and his tongue white and furred; his pulse when asleep about 104 in a + minute, and when awake about 112.</p> + + <p>Fourth day of the disease. He has had another blister, the pain of his + head is gone, but the sickness continues by intervals; he refuses to take + any solid food, and will drink nothing but milk, or milk and water, cold. + He has two or three very liquid stools every day, which are somtimes + green, but generally of a darkish yellow, with great flatulency both + upwards and downwards at those times. An antimonial powder was once + given, but instantly rejected; a spoonful of decoction of bark was also + exhibited with the same event. His legs are bathed, and his hands and + face are moistened twice a day for half an hour in warmish water, which + is nevertheless much colder than his skin.</p> + + <p>Eighth day. His skin continues hot and dry without any observable + remissions, with liquid stools and much flatulency and sickness; his + water when observed was of a straw colour. He has asked for cyder, and + drinks nearly a bottle a day mixed with cold water, and takes three drops + of laudanum twice a day.</p> + + <p>Twelfth day. He continues much the same, takes no milk, drinks only + cyder and water, skin hot and dry, tongue hot and furred, with liquid + stools, and sickness always at the same time; sleeps much.</p> + + <p>Sixteenth day. Was apparently more torpid, and once rather <span + class="correction" title="Original reads `delious'.">delirious</span>; + pulse 112. Takes only capillaire and water; sleeps much.</p> + + <p>Twentieth day. Pulse 100, skin dry but less hot, liquid stools not so + frequent, he is emaciated to a great degree, he has eaten half a tea-cup + full of custard to day, drinks only capillaire and water, has thrice + taken two large spoonfuls of decoction of bark with three drops of + laudanum, refuses to have his legs bathed, and will now take nothing but + three drops of laudanum twice a day.</p> + + <p>Twenty-fourth day. He has gradually taken more custard every day, and + began to attend to some new play things, and takes wine syllabub.</p> + + <p>Twenty-eighth day. He daily grows stronger, eats eggs, and and butter, + and sleeps immediately after his food, can creep on his hands and knees, + but cannot stand erect.</p> + + <p>Thirty-second day. He cannot yet stand alone safely, but seems hourly + to improve in strength of body, and activity of mind.</p> + + <p>In this case the remote cause of his fever could not be well + ascertained, as it might be from having his feet cold for many successive + days, or from contagion; but the latter seems more probable, because his + younger brother became ill of a similar fever about three weeks + afterwards, and probably received the infection from him. The disease + commenced with great torpor of the stomach, which was shewn by his total + aversion to solid food, and perpetual sickness; the watery stools, which + were sometimes green, or of a darkish yellow, were owing to the acrimony, + or acidity, of the contents of the bowels; which as well as the + flatulency were occasioned by indigestion. This torpor of the stomach + continued throughout the whole fever, and when it ceased, the fever + ceased along with it.</p> + + <p>The contagious material of this fever I suppose to have been mixed + with the saliva, and swallowed into the stomach; that it excited the + vessels, which constitute the stomach, into the greatest irritative + motion like arsenic; <i>which might not be perceived, and yet might + render that organ paralytic or inirritable in a moment of time</i>; as + animals sometimes die by one single exertion, and consequent paralysis, + without a second struggle; as by lightning, or being shot through the + back part of the brain; of both which I have seen instances. I had once + an opportunity of inspecting two oxen, a few minutes after they were + killed by lightning under a crab-tree on moist ground in long grass; and + observed, that they could not have struggled, as the grass was not + pressed or bent near them; I have also seen two horses shot through the + cerebellum, who never once drew in their legs after they first stretched + them out, but died instantaneously; in a similar manner the lungs seem to + be rendered instantly inanimate by the fumes of burning sulphur.</p> + + <p>The lungs may be sometimes primarily affected with contagious matter + floating in the atmosphere as well as the stomach, as mentioned in + article <a href="#suppl_IX">9</a>. of this Supplement. But probably this + may occur much less frequently, because the oxygene of the atmosphere + does not appear to be taken into the blood by animal absorption, as the + saliva in the stomach, but passes through the moist membranes into the + blood, like the ethereal fluids of electricity or heat, or by chemical + attraction, and in consequence the contagious matter may be left behind; + except it may sometimes be absorbed along with the mucus; of which + however in this case there appeared no symptoms.</p> + + <p>The tonsils are other organs liable to receive contagious matter, as + in the small-pox, scarlet-fever, and in other sensitive inirritated + fevers; but no symptom of this appeared here, as the tonsils were at no + time of the fever inflamed, though they were in this child previously + uncommonly large.</p> + + <p>The pain of the forehead does not seem to have been of the internal + parts of the head, because the nerves, which serve the stomach, are not + derived from the anterior part of the brain; but it seems to have been + owing to a torpor of the external membranes about the forehead from their + direct sympathy with those of the stomach; that is, from the deficient + excitement of the sensorial power of association; and seemed in some + measure to be relieved by the emetics and blisters.</p> + + <p>The pulsations of the heart were weaker and in consequence quicker + than natural, owing to their direct sympathy with the torpid peristaltic + motions of the stomach; that is to the deficient excitement of the + sensorial power of association.</p> + + <p>The action of the cutaneous capillaries and absorbents were stronger + than natural, as appeared by the perpetual heat and dryness of the skin; + which was owing to their reverse sympathy with the heart and arteries. + This weaker and quicker action of the heart and arteries, and the + stronger action of the cutaneous capillaries and absorbents, continued + throughout the disease, and may be said to have constituted the fever, of + which the torpor of the stomach was the remote cause.</p> + + <p>His tongue was not very much furred or very dry, nor his breath very + hot; which shewed, that there was no great increase of the action of the + mucous absorbents, nor of the pulmonary capillaries, and yet sufficient + to produce great emaciation. His urine was nearly natural both in + quantity and colour; which shewed, that there was no increase of action + either of the kidnies, or of the urinary absorbents.</p> + + <p>The bathing his legs and hands and face for half an hour twice a day + seemed to refresh him, and sometimes made his pulse slower, and thence I + suppose stronger. This seems to have been caused by the water, though + subtepid, being much below the heat of his skin, and consequently + contributing to cool the capillaries, and by satiating the absorbents to + relieve the uneasy sensation from the dryness of the skin.</p> + + <p>He continued the use of three drops of tincture of opium from about + the eighth day to the twenty-fourth, and for the three preceding days + took along with if two large spoonfuls of an infusion of bark in equal + parts of wine and water. The former of these by its stimulus seemed to + decrease his languor for a time, and the latter to strengthen his + returning power of digestion.</p> + + <p>The daily exacerbations or remissions were obscure, and not well + attended to; but he appeared to be worse on the fourteenth or fifteenth + days, as his pulse was then quickest, and his inattention greatest; and + he began to get better on the twentieth or twenty-first days of his + disease; for the pulse then became less frequent, and his skin cooler, + and he took rather more food: these circumstances seemed to observe the + quarter periods of lunation.</p> + +<p class="cenhead"><a name="suppl_XIV">XIV</a>. <i>Termination of continued fever.</i></p> + + <p><a name="suppl_XIV_1">1</a>. When the stomach is primarily affected + with torpor not by defect of stimulus, but in consequence of the previous + exhaustion of its sensorial power; and not secondarily by its association + with other torpid parts; it seems to be the general cause of the weak + pulsations of the heart and arteries, and the consequent increased action + of the capillaries, which constitute continued fever with weak pulse. In + this situation if the patient recovers, it is owing to the renovation of + life in the torpid stomach, as happens to the whole system in + winter-sleeping animals. If he perishes, it is owing to the exhaustion of + the body for want of nourishment occasioned by indigestion; which is + hastened by the increased actions of the capillaries and absorbents.</p> + + <p><a name="suppl_XIV_2">2</a>. When the stomach is primarily affected by + defect of stimulus, as by cold or hunger; or secondarily by defect of the + power of association, as in intermittent fevers; or lastly in consequence + of the introduction of the sensorial power of sensation, as in + inflammatory diseases; the actions of the heart and arteries are not + diminished, as when the stomach is primarily affected with torpor by its + previous exhaustion of sensorial power, but become greatly increased, + producing irritative or inflammatory fever. Where this fever is + continued, though with some remissions and exacerbations, the excessive + action is at length so much lessened by expenditure of sensorial power, + as to gradually terminate in health; or it becomes totally exhausted, and + death succeeds the destruction of the irritability and associability of + the system.</p> + + <p><a name="suppl_XIV_3">3</a>. There is also another termination of the + diseases in consequence of great torpor of the stomach, which are not + always termed fevers; one of these is attended with so great and + universal torpor, that the patient dies in the first cold fit; that is, + within twelve hours or less of the first seizure; this is commonly termed + sudden death. But the quickness of the pulse, and the coldness with + shuddering, and with sick stomach, distinguished a case, which I lately + saw, from the sudden deaths occasioned by apoplexy, or ruptured + blood-vessels.</p> + + <p>In hemicrania I believe the stomach is always affected secondarily, as + no quickness of pulse generally attends it, and as the stomach recovers + its activity in about two whole days. But in the following case, which I + saw last week, I suppose the stomach suddenly became paralytic, and + caused in about a week the death of the patient. Miss ——, a + fine young lady about nineteen, had bathed a few times, about a month + before, in a cold spring, and was always much indisposed after it; she + was seized with sickness, and cold shuddering, with very quick pulse, + which was succeeded by a violent hot fit; during the next cold paroxysm + she had a convulsion fit; and after that symptoms of insanity, so as to + strike and bite the attendants, and to speak furious language; the same + circumstances occurred during a third fit, in which I believe a strait + waistcoat was put on, and some blood taken from her; during all this time + her stomach would receive no nutriment, except once or twice a little + wine and water. On the seventh day of the disease, when I saw her, the + extremities were cold, the pulse not to be counted and she was unable to + swallow, or to speak; a clyster was used with turpentine and musk and + opium, with warm fomentations, but she did not recover from that cold + fit.</p> + + <p>In this case the convulsion fit and the insanity seem to have been + violent efforts to relieve the disagreeable sensation of the paralytic + stomach; and the quick pulse, and returning fits of torpor and of orgasm, + evinced the disease to be attended with fever, though it might have been + called anorexia maniacalis, or epileptica.</p> + + <p><a name="suppl_XIV_4">4</a>. Might not many be saved in these fevers + with weak pulse for a few weeks by the introduction of blood into a vein, + once in two or three days; which might thus give further time for the + recovery of the torpid stomach? Which seems to require some weeks to + acquire its former habits of action, like the muscles of paralytic + patients, who have all their habits of voluntary associations to form + afresh, as in infancy.</p> + + <p>If this experiment be again tried on the human subject, it should be + so contrived, that the blood in passing from the well person to the sick + one should not be exposed to the air; it should not be cooled or heated; + and it should be measured; all which may be done in the following manner. + Procure two silver pipes, each about an inch long, in the form of + funnels, wide at top, with a tail beneath, the former something wider + than a swan-quill, and the latter less than a small crow-quill. Fix one + of these silver funnels by its wide end to one end of the gut of a + chicken fresh killed about four or six inches long, and the other to the + other end of the gut; then introduce the small end of one funnel into the + vein of the arm of a well person downwards towards the hand; and laying + the gut with the other end on a water-plate heated to 98 degrees in a + very warm room; let the blood run through it. Then pressing the finger on + the gut near the arm of the well person, slide it along so as to press + out one gutful into a cup, in order to ascertain the quantity by weight. + Then introduce the other end of the other funnel into a similar vein in + the arm of the sick person upwards towards the shoulder; and by sliding + one finger, and then another reciprocally, along the chicken's gut, so as + to compress it, from the arm of the well person to the arm of the sick + one, the blood may be measured, and thus the exact quantity known which + is given and received. See Class <a href="#species_I_2_3_25">I. 2. 3. + 25</a>.</p> + +<p class="cenhead"><a name="suppl_XV">XV</a>. <i>Inflammation excited in fever.</i></p> + + <p><a name="suppl_XV_1">1</a>. When the actions of any part of the system + of capillaries are excited to a certain degree, sensation is produced, + along with a greater quantity of heat, as mentioned in the fifth article + of this supplement. When this increased capillary action becomes still + more energetic, by the combined sensorial powers of sensation with + irritation, new fibres are secreted, or new fluids, (which harden into + fibres like the mucus secreted by the silk-worm, or spider, or pinna,) + from which new vessels are constructed; it is then termed inflammation: + if this exists in the capillary vessels of the cellular membrane or skin + only, with feeble pulsations of the heart and arteries, the febris + sensitiva inirritata, or malignant fever, occurs; if the coats of the + arteries are also inflamed, the febris sensitiva irritata, or + inflammatory fever, exists.</p> + + <p>In all these fevers the part inflamed is called a phlegmon, and by its + violent actions excites so much pain, that is, so much of the sensorial + power of sensation, as to produce more violent actions, and inflammation, + throughout the whole system. Whence great heat from the excited + capillaries of the skin, large and quick pulsations of the heart, full + and hard arteries, with great universal secretions and absorptions. These + perpetually continue, though with exacerbations and remissions; which + seem to be governed by solar or lunar influence.</p> + + <p><a name="suppl_XV_2">2</a>. In this situation there generally, I + suppose, exists an increased activity of the secerning vessels of the + brain, and consequently an increased production of sensorial power; in + less violent quantity of this disease however the increase of the action + of the heart and arteries may be owing simply to the accumulation of + sensorial power of association in the stomach, when that organ is + affected by sympathy with some inflamed part. In the same manner as the + capillaries are violently and permanently actuated by the accumulation of + the sensorial power of association in the heart and arteries, when the + stomach is affected primarily by contagious matter, and the heart and + arteries secondarily. Thus I suspect, that in the distinct small-pox the + stomach is affected secondarily by sympathy with the infected tonsils or + inoculated arm; but that in the confluent small-pox the stomach is + affected primarily, as well as the tonsils, by contagious matter mixed + with the saliva, and swallowed.</p> + + <p><a name="suppl_XV_3">3</a>. In inflammatory fevers with great arterial + action, as the stomach is not always affected with torpor, and as there + is a direct sympathy between the stomach and heart, some people have + believed, that nauseating doses of some emetic drug, as of antimonium + tartarizatum, have been administered with advantage, abating by direct + sympathy the actions of the heart. This theory is not ill founded, and + the use of digitalis, given in small doses, as from half a dram to a dram + of the saturated tincture, two or three times a day, as well as other + less violent emetic drugs, would be worth the attention of hospital + physicians.</p> + + <p>Sickness might also be produced probably with advantage by whirling + the patient in a chair suspended from the cieling by two parallel cords; + which after being revolved fifty or one hundred times in one direction, + would return with great circular velocity, and produce vertigo, similar I + suppose to sea-sickness. And lastly the sickness produced by respiring an + atmosphere mixed with one tenth of carbonated hydrogen, discovered by Mr. + Watt, and published by Dr. Beddoes, would be well worthy exact and + repeated experiment.</p> + + <p><a name="suppl_XV_4">4</a>. Cool air, cool fomentations, or ablutions, + are also useful in this inflammatory fever; as by cooling the particles + of blood in the cutaneous and pulmonary vessels, they must return to the + heart with less stimulus, than when they are heated above the natural + degree of ninety-eight. For this purpose snow and ice have been scattered + on the patients in Italy; and cold bathing has been used at the eruption + of the small pox in China, and both, it is said, with advantage. See + Class <a href="#species_III_2_1_12">III. 2. 1. 12</a>. and Suppl. I. <a + href="#suppl_VIII">8</a>.</p> + + <p><a name="suppl_XV_5">5</a>. The lancet however with repeated mild + cathartics is the great agent in destroying this enormous excitement of + the system, so long as the strength of the patient will admit of + evacuations. Blisters over the painful part, where the phlegmon or + topical inflammation is situated, after great evacuation, is of evident + service, as in pleurisy. Warm bathing for half an hour twice a day, when + the patient becomes enfeebled, is of great benefit, as in peripneumony + and rheumatism.</p> + + <p><a name="suppl_XV_6">6</a>. When other means fail of success in + abating the violent excitement of the system in inflammatory diseases, + might not the shaved head be covered with large bladders of cold water, + in which ice or salt had been recently dissolved; and changed as often as + necessary, till the brain is rendered in some degree torpid by + cold?—Might not a greater degree of cold, as iced water, or snow, + be applied to the cutaneous capillaries?</p> + + <p><a name="suppl_XV_7">7</a>. Another experiment I have frequently + wished to try, which cannot be done in private practice, and which I + therefore recommend to some hospital physician; and that is, to endeavour + to still the violent actions of the heart and arteries, after due + evacuations by venesection and cathartics, by gently compressing the + brain. This might be done by suspending a bed, so as to whirl the patient + round with his head most distant from the center of motion, as if he lay + across a millstone, as described in Sect. XVIII. 20. For this purpose a + perpendicular shaft armed with iron gudgeons might have one end pass into + the floor, and the other into a beam in the cieling, with an horizontal + arm, to which a small bed might be readily suspended.</p> + + <p>By thus whirling the patient with increasing velocity sleep might be + produced, and probably the violence of the actions of the heart and + arteries might be diminished in inflammatory fevers; and, as it is + believed, that no accumulation of sensorial power would succeed a torpor + of the origin of the nerves, either thus procured by mechanical + compression, or by the bladder-cap of cold water above described, the + lives of thousands might probably be saved by thus extinguishing the + exacerbations of febrile paroxysms, or preventing the returns of + them.</p> + + <p>In fevers with weak pulse sleep, or a degree of stupor, thus produced, + might prevent the too great expenditure of sensorial power, and thus + contribute to preserve the patient. See Class <a + href="#species_I_2_5_10">I. 2. 5. 10</a>. on stupor. What might be the + consequence of whirling a person with his head next the center of motion, + so as to force the blood from the brain into the other parts of the body, + might be discovered by cautious experiment without danger, and might + probably add to our ability of curing fever.</p> + +<p class="cenhead"><a name="suppl_XVI">XVI</a>. <i>Recapitulation.</i></p> + + <p><a name="suppl_XVI_1">1</a>. The sensorial power causes the + contraction of the fibres, and is excited into action by four different + circumstances, by the stimulus of external bodies, by pain or pleasure, + by desire or aversion, or by the previous motions of other contracting + fibres. In the first situation it is called the sensorial power of + irritation, in the second the sensorial power of sensation, in the third + the sensorial power of volition, and in the fourth the sensorial power of + association.</p> + + <p>Many parts of the body are excited into perpetual action, as the + sanguiferous vessels consisting of the heart, arteries, and veins; others + into nearly perpetual action, as the conglomerate and capillary glands; + and others into actions still somewhat less frequent, as the alimentary + canal, and the lacteal and lymphatic absorbents with their conglobate + glands: all these are principally actuated by the sensorial powers of + irritation, and of association; but in some degree or at some times by + those of sensation, and even of volition. There are three kinds of + stimulus, which may easily be occasionally diminished, that of heat on + the skin, of food in the stomach, and of the oxygenous part of the + atmosphere, which mixes with the blood in respiration, and stimulates the + heart and arteries.</p> + + <p><a name="suppl_XVI_2">2</a>. When any parts, which are naturally + excited into perpetual action by stimulus, become torpid or less active + from decrease of that stimulus; there first occurs a decrease of the + activity of the parts next catenated with them; thus going into cold + water produces a torpor of the capillary vessels of the lungs, as is + known by the difficult respiration, which immediately occurs; for the + sensorial power of association, which naturally contributes to actuate + the lungs, is now less excited by the decreased actions of the cutaneous + vessels, with which they are catenated. This constitutes the cold fit of + fever.</p> + + <p>There next occurs an accumulation of the sensorial power of irritation + in the parts, which were torpid from defect of stimulus, as the cutaneous + vessels for instance when exposed to cold air; and a similar accumulation + of the sensorial power of association occurs in the parts which were + catenated with the former, as the vessels of the lungs in the example + above mentioned. Whence, if the subduction of stimulus has not been too + great, so as to impair the health of the part, the activity of the + irritative motions returns, even though the stimulus continues less than + usual; and those of the associate motions become considerably increased, + because these latter are now excited by the previous fibrous motions, + which now act as strong or stronger than formerly, and have also acquired + an accumulation of the sensorial power of association. This accounts for + the curious event of our becoming warm in a minute or two after remaining + in water of about 80 degrees of heat, as in the bath at Buxton; or in the + cold air of a frosty morning of about 30 degrees of heat.</p> + + <p>But if the parts thus possessed of the accumulated sensorial powers of + irritation and of association be exposed again to their natural quantity + of stimulus, a great excess of activity supervenes; because the fibres, + which possess accumulated irritation, are now excited by their usual + quantity of stimulus; and those which possess accumulated association, + are now excited by double or treble the quantity of the preceding + irritative fibrous motions, with which they are catenated; this + constitutes the hot fit of fever.</p> + + <p>Another important circumstance occurs, when the parts, which are + torpid from decreased stimulus, do not accumulate a quantity of sensorial + power sufficient for the purpose of renewing their own natural quantity + of action; but are nevertheless not so torpid, as to have the life of the + part impaired. In this situation the superabundance of the accumulated + power of irritation contributes to actuate the associate motions next + catenated with them. Thus, when a person breathes air with less oxygene + than natural, as by covering his head in bed, and thus respiring the same + atmosphere repeatedly, the heart and arteries become less active by + defect of the stimulus of oxygene; and then the accumulation of sensorial + power of irritation becomes instantly very great, as these organs are + subject to perpetual and energetic action. This accumulation nevertheless + is not so great as to renew their own activity under this defect of + stimulus, but yet is in sufficient abundance to increase the + associability of the next link of catenation, that is, to actuate the + capillaries of the skin with great and perpetual increase of energy. This + resembles continued fever with weak pulse; in which the accumulation of + the sensorial power caused by the lessened motions of the heart and + arteries, actuates the capillaries with increase of energy.</p> + + <p><a name="suppl_XVI_3">3</a>. When the accumulation of the sensorial + power of association, which is caused as above explained by deficient + excitement owing to the lessened quantity of action of the irritative + fibrous motions, with which the associate train is catenated, is not in + quantity sufficient to renew the natural actions of the first link of an + associate train of motions; it is nevertheless frequently so abundant as + to actuate the next link of the associated train with unnatural energy by + increasing its associability; and that in a still greater degree if that + second link of the associated train was previously in a torpid state, + that is, had previously acquired some accumulation of the sensorial power + of association. This important circumstance of the animal economy is + worthy our most accurate attention. Thus if the heart and arteries are + deprived of their due quantity of the stimulus of oxygene in the blood, a + weak and quick pulse ensues, with an accumulation of the sensorial power + of irritation; next follows an increase of the action of the capillaries + by the superabundance of this accumulated power of irritation; but there + also exists an accumulation of the power of association in these acting + capillaries, which is not now excited by the deficient actions of the + heart and arteries; but which by its abundance contributes to actuate the + next link of association, which is the sick stomach in the case related + from Sydenham in Class <a href="#species_IV_1_1_2">IV. 1. 1. 2</a>. and + explained in this Supplement I. <a href="#suppl_IV">4</a>. And as this + sick stomach was in a previous state of torpor, it might at the same time + possess an accumulation of some sensorial power, which, if it was of + association, would be thus more powerfully excited by the increased + actions of the capillaries; which existed in consequence of the weak + action of the heart and arteries. This also resembles in some respects + the continued fevers with weak pulse, and with increased activity of the + capillaries.</p> + + <p><a name="suppl_XVI_4">4</a>. When a torpor of some irritative motions + occurs from a previous exhaustion of the sensorial power of irritation by + the action of some very great stimulus, it is long before any + accumulation of the sensorial power of irritation is produced; as is + experienced in the sickness and languor, which continues a whole day + after a fit of drunkenness. But nevertheless there occurs an accumulation + of the sensorial power of association in the first link of the associate + train of motions, which is catenated with these torpid irritative ones; + which accumulation is owing to deficient excitement of that sensorial + power in the first link of the associate train. This first link therefore + exists also in a less active or torpid state, but the accumulation of the + sensorial power of association by its superabundance contributes to + actuate the second link of the associate train with unnatural quantity of + motion; and that though its own natural quantity of the power of + association is not excited by the deficient action of preceding fibrous + motions.</p> + + <p>When this happens to the stomach, as after its irritative motions have + been much exerted from the unnatural stimulus of wine, or opium, or of + contagious matter mixed with the saliva, a torpor or inactivity of it + succeeds for a greater or less length of time; as no accumulation of the + sensorial power of irritation can occur, till the natural quantity, which + has been previously expended, is first restored. Then the heart and + arteries which are next in catenation, become less active from the want + of sufficient excitement of the sensorial power of association, which + previously contributed to actuate them. This sensorial power of + association therefore becomes accumulated, and by its superabundance + contributes to actuate the link next in association, which has thus + acquired so great a degree of associability, as to overbalance the less + quantity of the excitement of it by the torpid action of the previous or + first associate link. This happens to the capillaries, when the heart and + arteries are affected as above by the torpor of the stomach, when it is + occasioned by previous great expenditure of its sensorial power, and thus + constitutes fever with weak pulse, which is here termed inirritative + fever, typhus mitior.</p> + + <p><a name="suppl_XVI_5">5</a>. When a deficiency of stimulus is too + great or too long continued, so as to impair the life of the part, no + further accumulation of sensorial power occurs; as when the skin is long + exposed to cold and damp air. In that case the link in catenation, that + is, the first of the associate train, is rendered torpid by defect of + excitement of its usual quantity of the sensorial power of association, + and from there being no accumulation of the sensorial power of irritation + to increase its associability, and thus to contribute to actuate it by + overbalancing the defect of the excitement of its association.</p> + + <p>Thus on riding long and slowly on a cold and damp day, the exhalation + of the vapour, which is impinged on the skin, as the traveller proceeds, + carries away his warmth faster, than it is generated within the system; + and thus the capillaries of the skin have their actions so much impaired + after a time, that no accumulation of the sensorial power of irritation + occurs; and then the stomach, whose motions are catenated with those of + the capillaries, ceases to act from the deficient excitement of the power + of association; and indigestion and flatulency succeed, instead of the + increased digestion and hunger, which occur, when the cutaneous + capillaries are exposed to a less degree of cold, and for a shorter time. + In which latter situation the accumulation of the sensorial power of + irritation increases by its superabundance the associability of the + fibres of the stomach, so as to overbalance the defect of the excitement + of their association.</p> + + <p><a name="suppl_XVI_6">6</a>. The stomach is affected secondarily in + fevers with strong pulse, as in those with weak pulse it is affected + primarily. To illustrate this doctrine I shall relate the following case + of Mr. Y——. He was a young man rather intemperate in the use + of wine or beer, and was seized with a cold fit, and with a consequent + hot one with strong pulse; on examining his hypochondrium an oblong + tumour was distinctly felt on the left side of the stomach, which + extended six or eight inches downward, and was believed to be a tumour of + the spleen, which thus occasioned by its torpor the cold fit and + consequent hot fit of fever with strong pulse. This fever continued, + though with remissions, for two or three weeks; and the patient + repeatedly lost blood, used cathartics with calomel and sena, and had + frequent antimonial and saline medicines. And after he was much weakened + by evacuations, the peruvian bark and small doses of steel removed the + fever, but the tumour remained many years during the remainder of his + life.</p> + + <p>In this case the tumour of the spleen was occasioned by the torpor of + the absorbent vessels; while the secerning vessels continued somewhat + longer to pour their fluids into the cells of it. Then the inactivity of + this viscus affected the whole system with torpor by the deficient + excitement of the sensorial power of association, which contributes along + with the irritation caused by their specific stimuli to actuate the whole + sanguiferous, secerning, and absorbent vessels; and along with these the + stomach, which possesses perhaps greater mobility, or promptitude to + torpor or to orgasm, than any other part. And after a time all these + parts recover their actions by the accumulation of their sensorial power + of association. But the spleen not recovering its action from the + accumulation of its power of irritation, as appeared from the continuance + of the tumor, still affects the stomach by its defective irritative + motions ceasing to excite the association, which ought to contribute to + actuate it.</p> + + <p>Hence the stomach continues torpid in respect to its motions, but + accumulates its power of association; which is not excited into action by + the defective motions of the spleen; this accumulation of the sensorial + power of association now by its superabundance actuates the next link of + associate motions, which consists of the heart and arteries, into greater + energy of action than natural, and thus causes fever with strong pulse; + which, as it was supposed to be most frequently excited by increase of + irritation, is called irritative fever or synocha.</p> + + <p>Similar to this in the small pox, which is given by inoculation, the + stomach is affected secondarily, when the fever commences; and hence in + this small-pox the pulsations of the heart and arteries are frequently + stronger than natural, but never weaker, for the reasons above given. + Whereas in that small-pox, which is caused by the stomach being primarily + affected, by the contagious matter being swallowed with the saliva, + whether the tonsils are at the same time affected or not, the pulsations + of the heart and arteries become weak, and the inirritative fever is + produced, as explained above, along with the confluent small-pox. This + unfolds the cause of the mildness of the inoculated small-pox; because in + this disease the stomach is affected secondarily, whereas in the natural + small-pox it is frequently affected primarily by swallowing the + contagious matter mixed with saliva.</p> + + <p>In the measles I suppose the contagious matter to be dissolved in the + air, and therefore not liable to be mixed with the saliva; whereas the + variolous matter is probably only diffused in the air, and thence more + readily mixed with the saliva in the mouth during respiration. This + difference appears more probable, as the small-pox I believe is always + taken at a less distance from the diseased person than is necessary to + acquire the measles. The contagion of the measles affects the membranes + of the nostrils, and the secretion of tears in consequence, but never I + suspect the stomach primarily, but always secondarily; whence the + pulsation of the heart and arteries is always stronger than natural, so + as to bear the lancet at any period of the disease.</p> + + <p>The great mildness sometimes, and fatality at other times, of the + scarlet fever may depend on the same circumstance; that is, on the + stomach being primarily or secondarily affected by the contagious matter, + observing that the tonsils may be affected at the same time with the + stomach. Should this prove to be the case, which future observations must + determine, what certain advantage must arise from the inoculation of this + disease! When it is received by the skin primarily I suppose no sore + throat attends it, nor fever with weak pulse; when it is received by the + stomach primarily, the tonsils are affected at the same time, and the + torpor of the stomach produces inirritative fever, and the mortification + of the tonsils succeeds.</p> + + <p>We may hence conclude, that when the torpor of the stomach is either + owing to defect of stimulus, which is not so great as to impair the life + of the part, as in moderate hunger, or in swallowing iced water, or when + its torpor is induced by its catenation or association with other torpid + parts, as in the commencement of intermittent fevers, and inoculated + small-pox, that the subsequent action of the heart and arteries is + generally increased, producing irritative fever. Which is owing to the + accumulation, of the sensorial power of irritation in one case, and of + association in the other, contributing to actuate the next link of the + catenated or associated motions. But when the torpor of the stomach is + induced by previous exhaustion of its sensorial powers of irritation or + of association by continued violent action, as by the stimulus of + digitalis, or of contagious matter, or after intoxication from wine or + opium, a weaker action of the heart and arteries succeeds, because there + is no accumulation of sensorial power, and a deficient excitement of + association. And finally, as this weak action of the heart and arteries + is not induced by exhaustion of sensorial power, but by defect of the + excitement of association, the accumulation of this power of association + increases the action of the capillaries, and thus induces inirritative + fever.</p> + + <p><a name="suppl_XVI_7">7</a>. When any part of the system acts very + violently in fevers, the sensorial power of sensation is excited, which + increases the actions of the moving system; whereas the pain, which + arises from decreased irritative motions, as in hemicrania, seems to + exhaust a quantity of sensorial power, without producing or increasing + any fibrous actions.</p> + + <p>When the stomach is primarily affected, as in inirritative fevers from + contagion, and in such a manner as to occasion pain, the action of the + capillaries seems to be increased by this additional sensorial power of + sensation, whence extensive inflammation or mortification; but when the + stomach and consequently the heart and arteries continue their torpidity + of action; as in confluent small-pox, and fatal scarlatina; this + constitutes sensitive inirritative fever, or typhus gravior.</p> + + <p>But when the stomach is secondarily affected, if the sensorial power + of sensation is excited, as in pleurisy or peripneumony, the actions of + the heart and arteries are violently increased, and of all the moving + system along with them. Thus the peripneumony is generally induced by the + patient respiring very cold air, and this especially after being long + confined to warm air, or after being much fatigued and heated by + excessive labour or exercise. For we can cover the skin with more + clothes, when we feel ourselves cold; but the lungs not having the + perception of cold, we do not think of covering them, nor have the power + to cover them, if we desired it; and the torpor, thus produced is + greater, or of longer duration, in proportion to the previous expenditure + of sensorial power by heat or exercise.</p> + + <p>This torpor of the lungs affects the skin with shuddering, and the + stomach is also secondarily affected; next follows the violent action of + the lungs from the accumulation of the power of irritation, and an + inflammation of them follows this violent action. While the stomach + recovers its activity by the increase of the excitement of the sensorial + power of association, and along with it the heart and arteries, and the + whole moving system. Hence this inflammation occurs during the hot fit of + fever, and no cold fit succeeds, because the excess of the sensorial + power of sensation prevents a succeeding torpor.</p> + + <p>These new motions of certain parts of the system produce increased + secretions of nutritious or organic mucus, which forms new vessels; these + new vessels by their unusual motions produce new kinds of fluids; which + are termed contagious, because they have the power, when introduced into + a healthy body, of producing similar actions and effects, with or without + fever, as in the small-pox and measles, or in the itch and venereal + disease.</p> + + <p>If any of these contagious matters affect the stomach with torpor + either by their stimulus immediately applied, or by its sympathy with the + parts first diseased, a fever is produced with sickness and want of + appetite; as in small-pox, and scarlatina. If the stomach is not affected + by contagious matter, no fever succeeds, as in itch, tinea, syphilis.</p> + + <p>All these contagious matters are conceived to be harmless, till they + have been exposed to the air, either openly or through a moist membrane; + from which they are believed to acquire oxygene, and thence to become + some kinds of animal acids. As the preparations of mercury cure venereal + ulcers; as a quarter of a grain of sublimate dissolved in wine, and given + thrice a day; this effect, seems to be produced either by its stimulating + the absorbents in the ulcer to absorb the venereal matter before it has + acquired oxygene; or by afterwards uniting with it chemically, and again + depriving it of its acquired acidity. On either supposition it might + probably be given with advantage in small-pox, and in all infectious + diseases, both previous to their commencement, and during their whole + progress.</p> + + <p><a name="suppl_XVI_8">8</a>. The cold fits of intermittent fevers are + caused by the torpor of some part owing to deficient irritation, and of + the other parts of the system from deficient association. The hot fits + are owing first to the accumulation of irritation in the part primarily + affected, if it recovers its action, which does not always happen; and + secondly to the accumulation of association in the other parts of the + system, which during health are subject to perpetual action; and lastly + also to the greater excitement of the power of association, when the part + primarily affected recovers its irritability, and acts with greater + energy than natural.</p> + + <p>The deficient secretions in the cold fit depend on the torpor of the + glandular system; and the increased secretions in the hot fit on their + more energetic action. The thirst in the cold fit is owing to the + deficient absorption from the skin, cellular membrane, and bladder; the + thirst in the hot fit is owing to the too great dissipation of the + aqueous part of the blood. The urine is pale and in small <span + class="correction" title="Original reads `quanity'.">quantity</span> in + the cold fit from deficient secretion of it, and from deficient + absorption of its aqueous parts; it is high coloured, and sometimes + deposits a sediment, in the hot fit from the greater secretion of it in + the kidneys, and the greater absorption of its aqueous and saline part in + the bladder. The dryness and scurf on the tongue and nostrils is owing to + the increased heat of the air expired from the lungs, and consequent + greater evaporation of the aqueous part of the mucus. The sweats appear + in consequence of the declension of the hot fit, owing to the absorbent + vessels of the skin losing their increased action sooner than the + secerning ones; and to the evaporation lessening as the skin becomes + cooler. The returns of the paroxysms are principally owing to the torpor + of some less essential part of the system remaining after the termination + of the last fit; and are also dependent on solar or lunar diurnal + periods.</p> + + <p>The torpor of the part, which induces the cold paroxysm, is owing to + deficient irritation occasioned either by the subduction of the natural + stimuli of food, or water, or pure air, or by deficiency of external + influences, as of heat, or of solar or lunar gravitation. Or secondly, in + consequence of the exhaustion of sensorial power by great previous + exertions of some parts of the system, as of the limbs by great labour or + exercise, or of the stomach by great stimulus, as by contagious matter + swallowed with the saliva, or by much wine or opium previously taken into + it. Or lastly a torpor of a part may be occasioned by some mechanic + injury, as by a compression of the nerves of the part, or of their origin + in the brain; as the sitting long with one leg crossed over the other + occasions numbness, and as a torpor of the stomach, with vomiting + frequently precedes paralytic strokes of the limbs.</p> + + <p>As sleep is produced, either by defect of stimulus, or by previous + exhaustion of sensorial power; so the accumulation of the sensorial power + of volition in those muscles and organs of sense, which are generally + obedient to it, awakens the sleeping person; when it has increased the + quantity of voluntarity so much as to overbalance the defect of stimulus + in one case, and the exhaustion of sensorial power in the other; which + latter requires a much longer time of sleep than the former. So the cold + paroxysm of fever is produced either by defect of stimulus, or by + previous exhaustion of the sensorial power of some part of the system; + and the accumulation of the sensorial power of irritation in that part + renews the action of it, when it has increased its irritability so much + as to overbalance the defect of stimulus in one case and the exhaustion + of sensorial power in the other; which latter requires a much longer + torpor or cold fit than the former.</p> + + <p>But in the cold paroxysm of fever besides the torpor of one part of + the system from defect of irritation, the remainder of it becomes torpid + owing to defect of excitement of the sensorial power of association by + the lessened action of the part first affected. This torpor of the + general system remains, till the accumulation of the sensorial power of + association has increased the associability so much as to overbalance the + defect of the excitement of association; then the torpor ceases, and if + the first affected part has recovered its activity the other parts are + all thrown into excess of action by their increased associability, and + the hot fit of fever is produced.</p> + + <p><a name="suppl_XVI_9">9</a>. In the continued fevers with strong pulse + the stomach is affected secondarily, and thus acts feebly from deficient + excitement of the power of association; but the accumulation of the power + of association thus produced in an organ subject to perpetual and + energetic action, is so great as to affect the next link of the associate + train, which consists of the heart and arteries; these therefore are + exerted perpetually with increase of action.</p> + + <p>In continued fevers with weak pulse the torpid stomach is affected + primarily by previous exhaustion of its irritability by stimulus, as of + contagious matter swallowed into it. The heart and arteries act feebly + from deficient excitement of the power of association, owing to the + torpor of the stomach, with which they are catenated; but the + accumulation of the power of association, thus produced in organs subject + to perpetual and energetic motion, is so great, as to affect the next + link of the associate train; which consists of the capillaries of the + skin or other glands; these therefore are exerted perpetually with great + increase of action.</p> + + <p>The continued fevers with strong pulse terminate by the reduction or + exhaustion of the sensorial power by violent action of the whole system; + which is followed either by return of health with the natural quantity of + irritability, and of associability, or by a total destruction of them + both, and consequent death.</p> + + <p>In continued fevers with weak pulse the stomach remains torpid during + the whole course of the fever; and at length by the recovery of its + irritability and sensibility effects the cure of it. Which generally + happens about the first, second, or third quarter of the lunar period, + counted from the commencement of the disease, or continues a whole + lunation, and sometimes more; which gave rise to what are termed critical + days. See Sect. XXXVI. 4. on this subject. If the stomach does not + recover from its torpor, the patient becomes emaciated, and dies + exhausted by the continuance of the increased action of the capillaries + and absorbents, and the want of nourishment.</p> + + <p>The cure of continued fever with weak pulse consists first in + weakening the undue action of the capillaries of the skin by ablution + with cold water from 32 to 80 degrees of heat; or by exposing them to + cool air. Secondly by invigorating the actions of the stomach, by + decreasing them for a time, and thence accumulating the power of + irritation, as by an emetic, or by iced water, or iced wine. Or by + increase of stimulus, as by bark, wine, opium, and food, in small + quantities frequently repeated. Or by renewing the action of the stomach + by slight electric shocks. Or by fomenting it frequently with water + heated to 96 or 100 degrees. Or lastly by exciting its power of + association with other parts of the system, as by a blister; which + succeeds best when the extremities are cool; or by swinging, as in + vertigo rotatoria.</p> + + <p>If by the stimulus of the Peruvian bark on the fibres of the stomach, + they regain their due action, the heart and arteries also regain their + due action; as their sensorial power of association is now excited, and + expended as usual. And as there is then no accumulation of sensorial + power in the heart and arteries, the capillaries cease to act with too + great energy, and the fever is cured.</p> + + <p>Thirdly. If the heart and arteries could be themselves stimulated into + greater action, although the stomach remained torpid, they might probably + by expending a greater quantity of the sensorial power of irritation, + prevent an accumulation of the sensorial power of association, (for these + may possibly be only different modes of action of the spirit of + animation,) and thus the too great action of the capillaries might be + prevented and the fever cease. This new mode of cure might possibly be + accomplished, if the patient was to breathe a gallon or two of pure or + diluted oxygene gas frequently in a day; which by passing through the + moist membranes of the lungs and uniting with the blood might render it + more stimulant, and thus excite the heart and arteries into greater + action.</p> + + <p>Fourthly. Greater energy might probably be given to the whole system, + and particularly to those parts which act too feebly in fevers, as the + stomach and the heart and arteries, if the action of the secerning + vessels of the brain could be increased in energy; this is probably one + effect of all those drugs, which when given in large quantity induce + intoxication, as wine and opium. And when given with great caution in + small quantities uniformly repeated, as from three drops to five of the + tincture of opium, but not more, every six hours, I believe they supply + an efficacious medicine in fevers with great arterial debility; and the + more so, if the Peruvian bark be exhibited alternately every six hours + along with them. There are other means of exciting the vessels of the + brain into action; as first by decreasing the stimulus of heat by + temporary cold fomentation; secondly, increasing the stimulus of heat by + long continued warm fomentation; thirdly, by electricity, as very small + shocks passed through it in all directions; and lastly by blisters on the + head. All those require to be used with great caution, and especially + where there exists an evident stupor, as the removing of that is I + believe frequently injurious. See stupor, Class <a + href="#species_I_2_5_10">I. 2. 5. 10</a>.</p> + + <p>The cure of fever with strong pulse consists in the repeated use of + venesection, gentle cathartics, diluents; medicines producing sickness, + as antimonials, digitalis; or the respiration of carbonated hydrogen; or + by respiration of atmospheric air lowered by a mixture of hydrogen, + azote, or carbonic acid gas, or by compressing the brain by whirling in a + decumbent posture, as if lying across an horizontal mill-stone. See the + former parts of this supplement for the methods of cure both of fevers + with strong and weak pulse.</p> + + <p><a name="suppl_XVI_10">10</a>. When any difficulty occurs in + determining the weak pulse from the strong one, it may generally be + assisted by counting its frequency. For when an adult patient lies + horizontally in a cool room, and is not hurried or alarmed by the + approach of his physician, nor stimulated by wine or opium, the strong + pulse seldom exceeds 118 or 120 in a minute; and the weak pulse is + generally not much below 130, and often much above that number. <a + name="Page_625_line_1"></a> Secondly in sitting up in bed, or changing + the horizontal to a perpendicular posture, the quickness of the weak + pulse is liable immediately to increase 10 or 20 pulsations in a minute, + which does not I believe occur in the strong pulse, when the patient has + rested himself after the exertion of rising.</p> + +<p class="cenhead">XVII. <i>Conclusion.</i></p> + + <p>Thus have I given an outline of what may be termed the sympathetic + theory of fevers, to distinguish it from the mechanic theory of + Boerhaave, the spasmodic theory of Hoffman and of Cullen, and the putrid + theory of Pringle. What I have thus delivered, I beg to be considered + rather as observations and conjectures, than as things explained and + demonstrated; to be considered as a foundation and a scaffolding, which + may enable future industry to erect a solid and a beautiful edifice, + eminent both for its simplicity and utility, as well as for the + permanency of its materials,—which may not moulder, like the + structures already erected, into the sand of which they were composed; + but which may stand unimpaired, like the Newtonian philosophy, a rock + amid the waste of ages!</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h2>ADDITIONS.</h2> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>ADDITION <a name="add_I">I</a>.</h3> + +<blockquote class="b1n"> + + <p>At the end of the article Canities, in Class <a + href="#species_I_2_2_11">I. 2. 2. 11</a>. please to add the + following:</p> + +</blockquote> + + <p>As mechanical injury from a percussion, or a wound, or a caustic, is + liable to occasion the hair of the part to become grey; so I suspect the + compression of parts against each other of some animals in the womb is + liable to render the hair of those parts of a lighter colour; as seems + often to occur in black cats and dogs. A small terrier bitch now stands + by me, which is black on all those parts, which were external, when she + was wrapped up in the uterus, teres atque rotunda; and those parts white, + which were most constantly pressed together; and those parts tawny, which + were generally but less constantly pressed together. Thus the hair of the + back from the forehead to the end of the tail is black, as well as that + of the sides, and external parts of the legs, both before and behind.</p> + + <p>As in the uterus the chin of the whelp is bent down, and lies in + contact with the fore part of the neck and breast; the tail is applied + close against the division of the thighs behind; the inside of the hinder + thighs are pressed close to the sides of the belly, all these parts have + white hairs.</p> + + <p>The fore-legs in the uterus lie on each side of the face; so that the + feet cover part of the temples, and compress the prominent part of the + upper eye-brows, but are so placed as to defend the eye-balls from + pressure; it is curious to observe, that the hair of the sides of the + face, and of the prominent upper eye-brows, are tawny, and of the inside + of the feet and legs, which covered them; for as this posture admitted of + more change in the latter weeks of gestation, the colour of these parts + is not so far removed from black, as of those parts, where the contact or + compression was more uniform.</p> + + <p>Where this uterine compression of parts has not been so great as to + render the hair white in other animals, it frequently happens, that the + extremities of the body are white, as the feet, and noses, and tips of + the ears of dogs and cats and horses, where the circulation is naturally + weaker; whence it would seem, that the capillary glands, which form the + hair, are impeded in the first instance by compression, and in the last + by the debility of the circulation in them. See Class <a + href="#species_I_1_2_15">I. 1. 2. 15</a>.</p> + + <p>This day, August 8th, 1794, I have seen a negro, who was born (as he + reports) of black parents, both father and mother, at Kingston in + Jamaica, who has many large white blotches on the skin of his limbs and + body; which I thought felt not so soft to the finger, as the black parts. + He has a white divergent blaze from the summit of his nose to the vertex + of his head; the upper part of which, where it extends on the hairy + scalp, has thick curled hair, like the other part of his head, but quite + white. By these marks I supposed him to be the same black, who is + described, when only two years old, in the Transactions of the American + Philosophical Society, Vol. II. page 292, where a female one is likewise + described with nearly similar marks.</p> + + <p>The joining of the frontal bones, and the bregma, having been later + than that of the other sutures of the cranium, probably gave cause to the + whiteness of the hair on these parts by delaying or impeding its + growth.</p> + +<h3>ADDITION <a name="add_II">II</a>.</h3> + + <p>The following extract from a letter of Dr. Beddoes on hydrocephalus + internus, I esteem a valuable addition to the article on that subject at + Class <a href="#species_I_2_3_12">I. 2. 3. 12</a>.</p> + +<blockquote class="b1n"> + + <p>"Master L——, aged 9 years, became suddenly ill in the + night about a week before I saw him. On the day before the attack, he had + taken opening medicines, and had bathed afterwards. He had complained of + violently acute pain in his head, shrieked frequently, ground his teeth + hard, could not bear to have his head raised from the pillow, and was + torpid or deaf. His tongue was white, pulse 110 in the evening and full. + As yet the pupil of the eye was irritable, and he had no strabismus. He + had been bled with leeches about the head, and blistered. I directed + mercurial inunction, and calomel from 3 to 6 grains to be taken at first + every six, and afterwards every three hours. This plan produced no + sensible effect, and the patient died on the 18th day after the seizure. + He had convulsion fits two days preceding his death, and the well-known + symptoms of hydrocephalus internus all made their appearance. From what I + had seen and read of this disease, I believed it to belong to + inflammations, and at an earlier period I should be tempted to bleed as + largely as for pneumonia. The fluid found after death in the ventricules + of the brain I impute to debility of the absorbents induced by + inflammation. My reasons are briefly these; 1. The acuteness of the pain. + 2. The state of the pulse. In the above case for the first 9 or 10 days + it did not exceed 110, and was full and strong.</p> + + <p>3. To find out whether any febrile alternations took place, Master + L.'s feet were frequently felt, and they were found at times cold, and at + other times of a dry heat. I have many times seen this disease, but the + patients were too young, or too far advanced, to inform me, whether they + had chillness succeeded by heat at its onset. 4. The disorders to which + the young are more peculiarly liable afford a presumption, that + hydrocephalus internus is an inflammatory disease; and this is confirmed + by the regularity of the period, within which it finishes its course. And + lastly, does it not happen more frequently than is suspected from + external injury?</p> + + <p>I have just now been well informed, that Dr. Rush has lately cured + five out of six patients by copious bleedings. I relate here the reasons + for an opinion without pretending to a discovery. Something like this + doctrine may be found in certain modern publications, but it is delivered + in that vague and diffuse style, which I trust your example will banish + from medical literature."</p> + + <div class="poem"> + <div class="stanza"> + <p>Clifton, near Bristol,</p> + <p><i>July 28, 1795</i>.</p> + </div> + </div> + +</blockquote> + + <p>To this idea of Dr. Beddoes may be added, that the hydrocele generally + succeeds an injury, and consequent inflammation of the bag, which + contains it. And that other dropsies, which principally attend + inebriates, are consequent to too great action of the mucous membranes by + the stimulus of beer, wine, and spirits. And lastly, that as these cases + of hydrocephalus end so fatally, a new mode of treating them is much to + be desired, and deserves to be seriously attended to.</p> + +<h3>ADDITION <a name="add_III">III</a>. <span class="sc">On Vertigo.</span></h3> + +<p class="cenhead"><i>To be placed after the additional Note at the end of Vol. I. on +this Subject.</i></p> + + <p>Having reperused the ingenious Essay of Dr. Wells on Single Vision, + and his additional observations in the Gentleman's Magazine on the + apparent retrogression of objects in vertigo, I am induced to believe, + that this apparent retrogression of objects is not always owing to the + same cause.</p> + + <p>When a person revolves with his eyes closed, till he becomes + vertiginous, and then stands still without opening them, he seems for a + while to go forward in the same direction. This hallucination of his + ideas cannot be owing to ocular spectra, because, as Dr. Wells observes, + no such can have been formed; but it must arise from a similar + continuance or repetition of ideas belonging to the sense of touch, + instead of to the sense of vision; and should therefore be called a + tangible, not a visual, vertigo. In common language this belief of + continuing to revolve for some time, after he stands still, when a person + has turned round for a minute in the dark, would be called a deception of + imagination.</p> + + <p>Now at this time if he opens his eyes upon a gilt book, placed with + other books on a shelf about the height of his eye, the gilt book seems + to recede in the contrary direction; though his eyes are at this time + kept quite still, as well as the gilt book. For if his eyes were not kept + still, other books would fall on them in succession; which, when I + repeatedly made the experiment, did not occur; and which thus evinces, + that no motion of the eyes is the cause of the apparent retrocession of + the gilt book. Why then does it happen?—Certainly from an + hallucination of ideas, or in common language the deception of + imagination.</p> + + <p>The vertiginous person still imagines, that he continues to revolve + forwards, after he has opened his eyes; and in consequence that the + objects, which his eyes happen to fall upon, are revolving backward; as + they would appear to do, if he was actually turning round with his eyes + open. For he has been accustomed to observe the motions of bodies, + whether apparent or real, so much more frequently by the eye than by the + touch; that the present belief of his gyration, occasioned by the + hallucinations of the sense of touch, is attended with ideas of such + imagined motions of visible objects, as have always accompanied his + former gyrations, and have thus been associated with the muscular actions + and perceptions of touch, which occurred at the same time.</p> + + <p>When the remains of colours are seen in the eye, they are termed + ocular spectra; when remaining sounds are heard in the ear, they may be + called auricular murmurs; but when the remaining motions, or ideas, of + the sense of touch continue, as in this vertigo of a blindfolded person, + they have acquired no name, but may be termed evanescent titillations, or + tangible hallucinations.</p> + + <p>Whence I conclude, that vertigo may have for its cause either the + ocular spectra of the sense of vision, when a person revolves with his + eyes open; or the auricular murmurs of the sense of hearing, if he is + revolved near a cascade; or the evanescent titillations of the sense of + touch, if he revolves blindfold. All these I should wish to call + vanishing ideas, or sensual motions, of those organs of sense; which, + ideas, or sensual motions, have lately been associated in a circle, and + therefore for a time continue to be excited. And what are the ideas of + colours, when they are excited by imagination or memory, but the + repetition of finer ocular spectra? What the idea of sounds, but the + repetition of finer auricular murmurs? And what the ideas of tangible + objects, but the repetition of finer evanescent titillations?</p> + + <p>The tangible, and the auricular, and the visual vertigo, are all + perceived by many people for a day or two after long travelling in a boat + or coach; the motions of the vessel, or vehicle, or of the surrounding + objects, and the noise of the wheels and oars, occur at intervals of + reverie, or at the commencement of sleep. See Sect. XX. 5. These ideas, + or sensual motions, of sight, of hearing, and of touch, are succeeded by + the same effects as the ocular spectra, the auricular murmurs, and the + evanescent titillations above mentioned; that is, by a kind of vertigo, + and cannot in that respect be distinguished from them. Which is a further + confirmation of the truth of the doctrine delivered in Sect. III. of this + work, that the colours remaining in the eyes, which are termed ocular + spectra, are ideas, or sensual motions, belonging to the sense of vision, + which for too long a time continue their activity.</p> + +<h3>ADDITION <a name="add_IV">IV</a>. <span class="sc">Of Voluntary Motions.</span></h3> + + <p>A correspondent acquaints me, that he finds difficulty in + understanding how the convulsions of the limbs in epilepsy can be induced + by voluntary exertions. This I suspect first to have arisen from the + double meaning of the words "involuntary motions;" which are sometimes + used for those motions, which are performed without the interference of + volition, as the pulsations of the heart and arteries; and at other times + for those actions, which occur, where two counter volitions oppose each + other, and the stronger prevails; as in endeavouring to suppress + laughter, and to stop the shudderings, when exposed to cold. Thus when + the poet writes,</p> + + <div class="poem"> + <div class="stanza"> + <p>———video meliora, proboque,</p> + <p>Deteriora sequor.——</p> + </div> + </div> + + <p>The stronger volition actuates the system, but not without the + counteraction of unavailing smaller ones; which constitute + deliberation.</p> + + <p>A second difficulty may have arisen from the confined use of the words + "to will," which in common discourse generally mean to choose after + deliberation; and hence our will or volition is supposed to be always in + our own power. But the will or voluntary power, acts always from motive, + as explained in Sect. XXXIV. 1. and in Class <a + href="#species_IV_1_3_2">IV. 1. 3. 2</a>. and <a + href="#species_III_2_1_12">III. 2. 1. 12</a>. which motive can frequently + be examined previous to action, and balanced against opposite motives, + which is called deliberation; at other times the motive is so powerful as + immediately to excite the sensorial power of volition into action, + without a previous balancing of opposite motives, or counter volitions. + The former of these volitions is exercised in the common purposes of + life, and the latter in the exertions of epilepsy and insanity.</p> + + <p>It is difficult <i>to think without words</i>, which however all those + must do, who discover new truths by reasoning; and still more difficult, + when the words in common use deceive us by their twofold meanings, or by + the inaccuracy of the ideas, which they suggest.</p> + +<h3>ADDITION <a name="add_V">V</a>. <span class="sc">Of Figure.</span></h3> + + <p>I feel myself much obliged by the accurate attention given to the + first volume of Zoonomia, and by the ingenious criticisms bestowed on it, + by the learned writers of that article both in the Analytical and English + Reviews. Some circumstances, in which their sentiments do not accord with + those expressed in the work, I intend to reconsider, and to explain + further at some future time. One thing, in which both these gentlemen + seem to dissent from me, I shall now mention, it is concerning the + manner, in which we acquire the idea of figure; a circumstance of great + importance in the knowledge of our intellect, as it shews the cause of + the accuracy of our ideas of motion, time, space, number, and of the + mathematical sciences, which are concerned in the mensurations or + proportions of figure.</p> + + <p>This I imagine may have in part arisen from the prepossession, which + has almost universally prevailed, that ideas are immaterial beings, and + therefore possess no properties in common with solid matter. Which I + suppose to be a fanciful hypothesis, like the stories of ghosts and + apparitions, which have so long amused, and still amuse, the credulous + without any foundation in nature.</p> + + <p>The existence of our own bodies, and of their solidity, and of their + figure, and of their motions, is taken for granted in my account of + ideas; because the ideas themselves are believed to consist of motions or + configurations of solid fibres; and the question now proposed is, how we + become acquainted with the figures of bodies external to our organs of + sense? Which I can only repeat from what is mentioned in Sect. XIV. 2. 2. + that if part of an organ of sense be stimulated into action, as of the + sense of touch, that part so stimulated into action must possess figure, + which must be similar to the figure of the body, which stimulates it.</p> + + <p>Another previous prepossession of the mind, which may have rendered + the manner of our acquiring the knowledge of figure less intelligible, + may have arisen from the common opinion of the perceiving faculty + residing in the head; whereas our daily experience shews, that our + perception (which consists of an idea, and of the pleasure or pain it + occasions) exists principally in the organ of sense, which is stimulated + into action; as every one, who burns his finger in the candle, must be + bold to deny.</p> + + <p>When an ivory triangle is pressed on the palm of the hand, the figure + of the surface of the part of the organ of touch thus compressed is a + triangle, resembling in figure the figure of the external body, which + compresses it. The action of the stimulated fibres, which constitute the + idea of hardness and of figure, remains in this part of the sensorium, + which forms the sense of touch; but the sensorial motion, which + constitutes pleasure or pain, and which is excited in consequence of + these fibrous motions of the organ of sense, is propagated to the central + parts of the sensorium, or to the whole of it; though this generally + occurs in less degree of energy, than it exists in the stimulated organ + of sense; as in the instance above mentioned of burning a finger in the + candle.</p> + + <p>Some, who have espoused the doctrine of the immateriality of ideas, + have seriously doubted the existence of a material world, with which only + our senses acquaint us; and yet have assented to the existence of spirit, + with which our senses cannot acquaint us; and have finally allowed, that + all our knowledge is derived through the medium of our senses! They + forget, that if the spirit of animation had no properties in common with + matter, it could neither affect nor be affected by the material body. But + the knowledge of our own material existence being granted, which I + suspect few rational persons will seriously deny, the existence of a + material external world follows in course; as our perceptions, when we + are awake and not insane, are distinguished from those excited by + sensation, as in our dreams, and from those excited by volition or by + association as in insanity and reverie, by the power we have of comparing + the present perceptions of one sense with those of another, as explained + in Sect. XIV. 2. 5. And also by comparing the tribes of ideas, which the + symbols of pictures, or of languages, suggest to us, by intuitive analogy + with our previous experience, that is, with the common course of nature. + See Class <a href="#species_III_2_2_3">III. 2. 2. 3</a>. on + Credulity.</p> + +<h3>ADDITION <a name="add_VI">VI</a>.</h3> + +<p class="cenhead"><i>Please to add the following in <a href="#page_14_after_line_20">page 14, after line 20</a>.</i></p> + +<p class="cenhead"><i>Cold and hot Fit.</i></p> + + <p>As the torpor, with which a fit of fever commences, is sometimes owing + to defect of stimulus, as in going into the cold-bath; and sometimes to a + previous exhaustion of the sensorial power by the action of some violent + stimulus, as after coming out of a hot room into cold air; a longer time + must elapse, before there can be a sufficient accumulation of sensorial + power to produce a hot fit in one case than in the other. Because in the + latter case the quantity of sensorial power previously expended must be + supplied, before an accumulation can begin.</p> + + <p>The cold paroxysm commences, when the torpor of a part becomes so + great, and its motions in consequence so slow or feeble, as not to excite + the sensorial power of association; which in health contributes to move + the rest of the system, which is catenated with it. And the hot fit + commences by the accumulation of the sensorial power of irritation of the + part first affected, either so as to counteract its deficient stimulus, + or its previous waste of sensorial power; and it becomes general by the + accumulation of the sensorial power of association; which is excited by + the renovated actions of the part first affected; or becomes so great as + to overbalance the deficient excitement of it. On all these accounts the + hot fit cannot be supposed to bear any proportion to the cold one in + length of time, though the latter may be the consequence of the former. + See Suppl. I. <a href="#suppl_XVI_8">16. 8</a>.</p> + +<h3>ADDITION <a name="add_VII">VII</a>. <span class="sc">On Warmth.</span></h3> + +<p class="cenhead"><i>To be added at the end of the Species Sudor Calidus, in Class <a href="#species_I_1_2_3">I. 1. 2. 3</a>.</i></p> + + <p>When the heat of the body in weak patients in fevers is increased by + the stimulus of the points of flannel, a greater consequent debility + succeeds, than when it is produced by the warmth of fire; as in the + former the heat is in part owing to the increased activity of the skin, + and consequent expenditure of sensorial power; whereas in the latter case + it is in part owing to the influx of the fluid matter of heat.</p> + + <p>So the warmth produced by equitation, or by rubbing the body and limbs + with a smooth brush or hand, as is done after bathing in some parts of + the East, does not expend nearly so much sensorial power, as when the + warmth is produced by the locomotion of the whole weight of the body by + muscular action, as in walking, or running, or swimming. Whence the + warmth of a fire is to be preferred to flannel shirts for weak people, + and the agitation of a horse to exercise on foot. And I suppose those, + who are unfortunately lost in snow, who are on foot, are liable to perish + sooner by being exhausted by their muscular exertions; and might + frequently preserve themselves by lying on the ground, and covering + themselves with snow, before they were too much exhausted by fatigue. See + Botan. Garden, Vol. II. the note on Barometz.</p> + +<h3>ADDITION <a name="add_VIII">VIII</a>. <span class="sc">Puerperal Fever.</span></h3> + +<p class="cenhead"><i>To be added to Class <a href="#species_II_1_6_16">II. 1. 6. 16</a>.</i></p> + + <p>A very interesting account of the puerperal fever, which was epidemic + at Aberdeen, has been lately published by Dr. Alexander Gordon. + (Robinson, London.) In several dissections of those, who died of this + disease, purulent matter was found in the cavity of the abdomen; which he + ascribes to an erysipelatous inflammation of the peritonæum, as its + principal seat, and of its productions, as the omentum, mesentery, and + peritonæal coat of the intestines.</p> + + <p>He believes, that it was infectious, and that the contagion was always + carried by the accoucheur or the nurse from one lying-in woman to + another.</p> + + <p>The disease began with violent unremitting pain of the abdomen on the + day of delivery, or the next day, with shuddering, and very quick pulse, + often 140 in a minute. In this situation, if he saw the patient within 12 + or 24 hours of her seizure, he took away from 16 to 24 ounces of blood, + which was always sizy. He then immediately gave a cathartic consisting of + three grains of calomel, and 40 grains of powder of jalap. After this had + operated, he gave an opiate at night; and continued the purging and the + opiate for several days.</p> + + <p>He asserts, that almost all those, whom he was permitted to treat in + this manner early in the disease, recovered to the number of 50; and that + almost all the rest died. But that when two or three days were elapsed, + the patient became too weak for this method; and the matter was already + formed, which destroyed them. Except that he saw two patients, who + recovered after discharging a large quantity of matter at the navel. And + a few, who were relieved by the appearance of external erysipelas on the + extremities.</p> + + <p>This disease, consisting of an erysipelatous inflammation, may + occasion the great debility sooner to occur than in inflammation of the + uterus; which latter is neither erysipelatous, I suppose, nor contagious. + And the success of Dr. Gordon's practice seems to correspond with that of + Dr. Rush in the contagious fever or plague at Philadelphia; which + appeared to be much assisted by early evacuations. One case I saw some + time ago, where violent unceasing pain of the whole abdomen occurred a + few hours after delivery, with quick pulse; which ceased after the + patient had twice lost about eight ounces of blood, and had taken a + moderate cathartic with calomel.</p> + + <p>This case induces me to think, that it might be safer and equally + efficacious, to take less blood at first, than Dr. Gordon mentions, and + to repeat the operation in a few hours, if the continuance of the + symptoms should require it. And the same in respect to the cathartic, + which might perhaps be given in less quantity, and repeated every two or + three hours.</p> + + <p>Nor should I wish to give an opiate after the first venesection and + cathartic; as I suspect that this might be injurious, except those + evacuations had emptied the vessels so much, that the stimulus of the + opiate should act only by increasing the absorption of the new vessels or + fluids produced on the surfaces of the inflamed membranes. In other + inflammations of the bowels, and in acute rheumatism, I have seen the + disease much prolonged, and I believe sometimes rendered fatal, by the + too early administration of opiates, either along with cathartics, or at + their intervals; while a small dose of opium given after sufficient + evacuations produces absorption only by its stimulus, and much + contributes to the cure of the patient. We may have visible testimony of + this effect of opium, when a solution of it is put into an inflamed eye; + if it be thus used previous to sufficient evacuation, it increases the + inflammation; if it be used after sufficient evacuation, it increases + absorption only, and clears the eye in a very small time.</p> + + <p>I cannot omit observing, from considering these circumstances, how + unwise is the common practice of giving an opiate to every woman + immediately after her delivery, which must often have been of dangerous + consequence.</p> + +<p class="cenhead">END OF THE SECOND PART.</p> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h2>ZOONOMIÆ AUCTORI</h2> + +<h3><i>S.P.D.</i></h3> + +<h3>AMICUS.</h3> + + <p><br style="clear:both" /></p> +<hr /> + +<p class="cenhead"><i>CURRUS TRIUMPHALIS MEDICINÆ.</i></p> + + <p><br style="clear:both" /></p> +<hr /> + + <div class="contents"> + <div class="stanza"> + <p>Currus it Hygeiæ, Medicus movet arma triumphans,</p> + <p class="i2">Undique victa fugit lurida turma mali.——</p> + <p>Laurea dum Phœbi viridis tua tempora cingit,</p> + <p class="i2">Nec mortale sonans Fama coronat opus;</p> + <p>Post equitat trepidans, repetitque Senectus in aurem,</p> + <p class="i2">Voce canens stridulà, "sis memor ipse mori!"</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + + <p><a name="classindex"></a></p> + +<h3>INDEX OF THE CLASSES.</h3> + + <div class="contents"> + <div class="stanza"> + <p class="i16"><b>A.</b></p> + </div> + + <div class="stanza"> + <p>Abortion, <a href="#species_I_2_1_14">i. 2. 1. 14</a>.</p> + <p>—— from fear, <a href="#species_IV_3_1_7">iv. 3. 1. 7</a>.</p> + <p>—— not from epilepsy, <a href="#species_III_1_1_7">iii. 1. 1. 7</a>.</p> + <p>—— not from hepatitis, <a href="#species_II_1_2_12">ii. 1. 2. 12</a>.</p> + <p>Absorption of solids, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>—— of matter, <a href="#species_II_1_6_2">ii. 1. 6. 2</a>. and <a href="#species_II_1_6_6">6</a>.</p> + <p>—— cellular, <a href="#species_IV_1_1_6">iv. 1. 1. 6</a>.</p> + <p>—— from the lungs, <a href="#species_IV_3_1_5">iv. 3. 1. 5</a>. Suppl. i. <a href="#suppl_VIII_6">8. 6</a>.</p> + <p>Abstinence of young ladies, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>Accumulation of feces, <a href="#species_II_2_2_7">ii. 2. 2. 7</a>.</p> + <p>Acupuncture, <a href="#species_III_1_1_8">iii. 1. 1. 8</a>.</p> + <p>Adipsia, <a href="#species_II_2_2_2">ii. 2. 2. 2</a>.</p> + <p>Ægritudo ventriculi, <a href="#species_I_2_4_4">i. 2. 4. 4</a>.</p> + <p>—— See Sickness.</p> + <p>Agrypnia. See Vigilia.</p> + <p>Ague-cakes, Suppl. i. <a href="#suppl_II_3">2. 3</a>.</p> + <p>Alum in ulcers of the mouth, <a href="#species_II_1_3_1">ii. 1. 3. 1</a>.</p> + <p>Ambition, <a href="#species_III_1_2_9">iii. 1. 2. 9</a>.</p> + <p>Amaurosis, <a href="#species_I_2_5_5">i. 2. 5. 5</a>.</p> + <p>Anasarca of the lungs, <a href="#species_I_2_3_16">i. 2. 3. 16</a>.</p> + <p>Anger, <a href="#species_III_1_2_17">iii. 1. 2. 17</a>.</p> + <p>Anger, tremor of, <a href="#species_IV_2_3_4">iv. 2. 3. 4</a>.</p> + <p>—— blush of, <a href="#species_IV_2_3_5">iv. 2. 3. 5</a>.</p> + <p>Angina. See Tonsillitis.</p> + <p>—— pectoris. See Asthma painful.</p> + <p>Anhelitus, <a href="#species_II_1_1_4">ii. 1. 1. 4</a>.</p> + <p>Anhelatio spasmodica, <a href="#species_I_3_3_3">i. 3. 3. 3</a>.</p> + <p>Annulus repens, <a href="#species_II_1_5_10">ii. 1. 5. 10</a>.</p> + <p>Anorexia, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>—— maniacalis, Suppl. i. <a href="#suppl_XIV_3">14. 3</a>.</p> + <p>—— epileptica, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>. <a href="#species_III_1_1_7">iii. 1. 1. 7</a>.</p> + <p>Apepsia, <a href="#species_I_3_1_3">i. 3. 1. 3</a>. Suppl. i. <a href="#suppl_VIII_11">8. 11</a>.</p> + <p>Aphtha, <a href="#species_II_1_3_17">ii. 1. 3. 17</a>.</p> + <p>Apoplexy, <a href="#species_III_2_1_16">iii. 2. 1. 16</a>.</p> + <p>Appetite defective, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>—— depraved, <a href="#species_III_1_2_19">iii. 1. 2. 19</a>.</p> + <p>—— from abstinence, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>—— destroyed, <a href="#species_III_1_2_20">iii. 1. 2. 20</a>.</p> + <p>—— from epilepsy, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>Arm, pain of, <a href="#species_IV_2_2_13">iv. 2. 2. 13</a>.</p> + <p>—— palsy of, <a href="#species_III_2_1_4">iii. 2. 1. 4</a>.</p> + <p>Arsenic in tooth-ach, <a href="#species_I_2_4_12">i. 2. 4. 12</a>.</p> + <p>—— in head-ach, <a href="#species_I_2_4_11">i. 2. 4. 11</a>.</p> + <p>Arthrocele, <a href="#species_II_1_4_17">ii. 1. 4. 17</a>.</p> + <p>Arthropuosis, <a href="#species_II_1_4_18">ii. 1. 4. 18</a>.</p> + <p>Arthritis. See Gout.</p> + <p>Ascarides, <a href="#species_I_1_4_12">i. 1. 4. 12</a>. <span class="correction" title="Original reads `iv. 2. 1. 9.'."><a href="#species_IV_1_2_9">iv. 1. 2. 9</a></span>.</p> + <p>Ascites, <a href="#species_I_2_3_13">i. 2. 3. 13</a>.</p> + <p>Associations affected four ways, <a href="#head_IV_1_1_G">iv. 1. 1. G</a>.</p> + <p>—— how produced, <a href="#head_IV_1_1_H">iv. 1. 1. H</a>.</p> + <p>—— distinct from catenations, <a href="#head_IV_1_1_A">iv. 1. 1. A</a>.</p> + <p>—— three kinds of, <a href="#head_IV_1_1_B">iv. 1. 1. B</a>.</p> + <p>—— tertian, <a href="#head_IV_1_1_K">iv. 1. 1. K</a>.</p> + <p>—— of the fauces and pubis, <a href="#species_IV_1_2_7">iv. 1. 2. 7</a>.</p> + <p>—— sensitive, a law of, <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>—— sensitive <a href="#genus_IV_2_1">iv. 2. 1</a>.</p> + <p>—— accumulates, Suppl. i. <a href="#suppl_VIII_3">8. 3</a>. i. <a href="#suppl_XI_4">11. 4</a>.</p> + <p>Asthma humoral, <a href="#species_II_1_1_7">ii. 1. 1. 7</a>. <a href="#species_I_3_2_8">i. 3. 2. 8</a>.</p> + <p>—— of infants, <a href="#species_I_1_3_4">i. 1. 3. 4</a>.</p> + <p>—— convulsive, <a href="#species_III_1_1_10">iii. 1. 1. 10</a>.</p> + <p>—— painful, <a href="#species_III_1_1_11">iii. 1. 1. 11</a>.</p> + <p>Auditus acrior, <a href="#species_I_1_5_2">i. 1. 5. 2</a>.</p> + <p>—— imminutus, <a href="#species_I_2_5_6">i. 2. 5. 6</a>.</p> + <p>Azote, Suppl. i. <a href="#suppl_IX_3">9. 3</a>. <span class="correction" title="Original reads `i. 11. 4.'.">i. <a href="#suppl_XI_6">11. 6</a></span>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>B.</b></p> + </div> + + <div class="stanza"> + <p>Bandages, ill effect of, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>—— promote absorption, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + <p>Bath, cold, <a href="#species_I_2_2_1">i. 2. 2. 1</a>.</p> + <p>—— warm, Addit. <a href="#add_VII">vii</a>.</p> + <p>Beauty, <a href="#species_III_1_2_4">iii. 1. 2. 4</a>.</p> + <p>—— loss of, <a href="#species_III_1_2_12">iii. 1. 2. 12</a>.</p> + <p>Bile-duct, pain of, <a href="#species_IV_2_2_4">iv. 2. 2. 4</a>.</p> + <p>Bile crystalized, <a href="#species_I_1_3_8">i. 1. 3. 8</a>.</p> + <p>Bitter taste, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>—— not from bile, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>Bleeding. See Hæmorrhage.</p> + <p>Bladder, distention of, <a href="#species_II_2_2_6">ii. 2. 2. 6</a>.</p> + <p>—— stone of, <a href="#species_I_1_3_10">i. 1. 3. 10</a>.</p> + <p>—— catarrh of, <a href="#species_II_1_4_11">ii. 1. 4. 11</a>.</p> + <p>Blindness, <a href="#species_I_2_5_5">i. 2. 5. 5</a>.</p> + <p>Blush of anger, <a href="#species_IV_2_3_5">iv. 2. 3. 5</a>. Suppl. i. <a href="#suppl_XII_7">12. 7</a>.</p> + <p>—— of guilt, <a href="#species_IV_2_3_6">iv. 2. 3. 6</a>. Suppl. i. <a href="#suppl_XII_7">12. 7</a>.</p> + <p>Bones, innutrition of, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>—— caries of, <a href="#species_II_1_4_19">ii. 1. 4. 19</a>.</p> + <p>Borborigmus, <a href="#species_I_3_1_9">i. 3. 1. 9</a>.</p> + <p>Bougies, <a href="#species_II_1_4_11">ii. 1. 4. 11</a>.</p> + <p>Brachiorum paralysis, <a href="#species_III_2_1_4">iii. 2. 1. 4</a>.</p> + <p>Brain stimulated, Suppl. i. <a href="#suppl_XVI_9">16. 9</a>.</p> + <p>Bronchocele, <a href="#species_I_2_3_20">i. 2. 3. 20</a>.</p> + <p>Burns, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + <p>Butterflies, experiment on, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>C.</b></p> + </div> + + <div class="stanza"> + <p>Cacositia, <a href="#species_III_1_2_20">iii. 1. 2. 20</a>.</p> + <p>Calculi productio, <a href="#species_I_1_3_9">i. 1. 3. 9</a>. <a href="#species_II_1_2_14">ii. 1. 2. 14</a>.</p> + <p>—— renis, <a href="#species_I_1_3_9">i. 1. 3. 9</a>. <span class="correction" title="This reference is surely wrong: I cannot determine a correction."><a href="#species_IV_2_3_3">iv. 2. 3. 3</a></span>.</p> + <p>—— vesicæ, <a href="#species_I_1_3_10">i. 1. 3. 10</a>. <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>Callico shirts, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>Callus, <a href="#species_I_2_2_12">i. 2. 2. 12</a>.</p> + <p>Canities. See Hair grey.</p> + <p>Calor febrilis, <a href="#species_I_1_2_1">i. 1. 2. 1</a>.</p> + <p>Calves fed on gruel, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— hydatides of, <a href="#species_I_2_5_4">i. 2. 5. 4</a>.</p> + <p>Cancer, <a href="#species_II_1_4_16">ii. 1. 4. 16</a>. <a href="#species_II_1_6_13">ii. 1. 6. 13</a>.</p> + <p>Cantharides, large dose of, <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>Carbonic acid gas, Suppl. i. <a href="#suppl_IX_3">9. 3</a>.</p> + <p>Cardialgia, <a href="#species_I_2_4_5">i. 2. 4. 5</a>.</p> + <p>Carcinoma, <a href="#species_II_1_4_16">ii. 1. 4. 16</a>. <a href="#species_II_1_6_13">ii. 1. 6. 13</a>.</p> + <p>Caries ossium, <a href="#species_II_1_4_19">ii. 1. 4. 19</a>.</p> + <p>Cataract, <a href="#species_I_2_2_13">i. 2. 2. 13</a>.</p> + <p>Catarrh, warm, <a href="#species_I_1_2_7">i. 1. 2. 7</a>.</p> + <p>—— cold, <a href="#species_I_2_3_3">i. 2. 3. 3</a>.</p> + <p>—— lymphatic, <a href="#species_I_3_2_1">i. 3. 2. 1</a>.</p> + <p>—— sensitive, <a href="#species_II_1_3_5">ii. 1. 3. 5</a>.</p> + <p>—— epidemic, <a href="#species_II_1_3_6">ii. 1. 3. 6</a>.</p> + <p>—— of dogs and horses, <a href="#species_II_1_3_6">ii. 1. 3. 6</a>.</p> + <p>—— from cold skin, <a href="#species_IV_1_1_5">iv. 1. 1. 5</a>.</p> + <p>—— periodic, <a href="#species_IV_3_4_1">iv. 3. 4. 1</a>.</p> + <p>Catamenia, <span class="correction" title="Original reads `i. 2. 1. 10.'."><a href="#species_I_2_1_11">i. 2. 1. 11</a></span>. <a href="#species_IV_2_4_7">iv. 2. 4. 7</a>.</p> + <p>Catalepsis, <a href="#species_III_2_1_9">iii. 2. 1. 9</a>.</p> + <p>Cats, mumps of, <a href="#species_II_1_3_4">ii. 1. 3. 4</a>.</p> + <p>Cephalæa frigida, <a href="#species_I_2_4_11">i. 2. 4. 11</a>. <a href="#species_IV_2_2_7">iv. 2. 2. 7</a>.</p> + <p>Charcoal tooth-powder, <a href="#species_I_2_4_12">i. 2. 4. 12</a>.</p> + <p>Cheek, torpor of, <a href="#species_IV_2_2_1">iv. 2. 2. 1</a>.</p> + <p>Chicken pox, <a href="#species_II_1_3_15">ii. 1. 3. 15</a>.</p> + <p>Chin-cough, <a href="#species_II_1_3_8">ii. 1. 3. 8</a>.</p> + <p>Child-bed fever, <a href="#species_II_1_6_16">ii. 1. 6. 16</a>.</p> + <p>Children, new born, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>—— gripes and purging of, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>Chlorosis, <a href="#species_I_2_3_10">i. 2. 3. 10</a>. Suppl. i. <a href="#suppl_VIII_11">8. 11</a>.</p> + <p>Chorea St. Viti, <a href="#species_IV_2_3_2">iv. 2. 3. 2</a>.</p> + <p>Citta, <a href="#species_III_1_2_19">iii. 1. 2. 19</a>.</p> + <p>Clamor, <a href="#species_III_1_1_3">iii. 1. 1. 3</a>.</p> + <p>Clavicular animals, <a href="#species_II_1_2_6">ii. 1. 2. 6</a>.</p> + <p>Clavus hystericus, <a href="#species_IV_2_2_8">iv. 2. 2. 8</a>.</p> + <p>Claudicatio coxaria, <a href="#species_I_2_2_17">i. 2. 2. 17</a>.</p> + <p>Cold in the head. See Catarrh.</p> + <p>Colic, flatulent, <a href="#species_I_2_4_7">i. 2. 4. 7</a>.</p> + <p>—— from lead, <a href="#species_I_2_4_8">i. 2. 4. 8</a>.</p> + <p>—— hysteric, <a href="#species_I_2_4_7">i. 2. 4. 7</a>. <a href="#species_III_1_1_8">iii. 1. 1. 8</a>.</p> + <p>Cold air in fevers, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>. <a href="#species_IV_2_4_11">iv. 2. 4. 11</a>.</p> + <p>—— effects of, <a href="#species_III_2_1_17">iii. 2. 1. 17</a>.</p> + <p>—— how to be used, <a href="#species_IV_1_1_4">iv. 1. 1. 4</a>.</p> + <p>Compassion, <a href="#species_III_1_2_24">iii. 1. 2. 24</a>.</p> + <p>Consumption, <a href="#species_II_1_6_7">ii. 1. 6. 7</a>.</p> + <p>Convulsion, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>—— weak, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>—— from bad air, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>—— painful, <a href="#species_III_1_1_6">iii. 1. 1. 6</a>. <a href="#species_IV_2_4_5">iv. 2. 4. 5</a>.</p> + <p>Consternation, <span class="correction" title="Original reads `i. 1. 5. 12.'."><a href="#species_I_1_5_11">i. 1. 5. 11</a></span>.</p> + <p>Constipation, <a href="#species_I_1_3_5">i. 1. 3. 5</a>. <span class="correction" title="Original reads `ii. 2. 1. 7.'."><a href="#species_II_2_2_7">ii. 2. 2. 7</a></span>.</p> + <p>Contagious matter of two kinds, <a href="#genus_II_1_3">ii. 1. 3</a>.</p> + <p>—— is oxygenated, <a href="#genus_II_1_5">ii. 1. 5</a>.</p> + <p>—— produces fever, how, Suppl. i. <a href="#suppl_XVI_7">16. 7</a>.</p> + <p>Cornea to perforate, <a href="#species_I_1_3_14">i. 1. 3. 14</a>.</p> + <p>—— scars of seen on milk, <a href="#species_I_1_3_14">i. 1. 3. 14</a>.</p> + <p>Corpulency, <a href="#species_I_2_3_17">i. 2. 3. 17</a>.</p> + <p>Coryza. See Catarrh.</p> + <p>Costiveness, <a href="#species_I_1_3_5">i. 1. 3. 5</a>. <span class="correction" title="Original reads `ii. 2. 1. 7.'."><a href="#species_II_2_2_7">ii. 2. 2. 7</a></span>.</p> + <p>Cough of drunkards, <a href="#species_II_1_1_5">ii. 1. 1. 5</a>.</p> + <p>—— hooping, <a href="#species_II_1_3_8">ii. 1. 3. 8</a>.</p> + <p>—— hepatic, <a href="#species_IV_2_1_8">iv. 2. 1. 8</a>.</p> + <p>—— gouty, <a href="#species_IV_2_1_9">iv. 2. 1. 9</a>.</p> + <p>—— periodic, <a href="#species_IV_2_4_6">iv. 2. 4. 6</a>. <a href="#species_IV_3_4_2">iv. 3. 4. 2</a>.</p> + <p>—— from cold feet, <a href="#species_IV_2_1_7">iv. 2. 1. 7</a>.</p> + <p>Cows, pestilence of, <a href="#species_II_1_3_13">ii. 1. 3. 13</a>.</p> + <p>—— bloody urine of, <a href="#species_II_1_3_13">ii. 1. 3. 13</a>.</p> + <p>Cramp, <a href="#species_III_1_1_13">iii. 1. 1. 13</a>.</p> + <p>—— painful, <a href="#species_III_1_1_14">iii. 1. 1. 14</a>.</p> + <p>—— in diarrhœa, <a href="#species_IV_1_2_10">iv. 1. 2. 10</a>.</p> + <p>Crab-lice, <a href="#species_I_1_4_14">i. 1. 4. 14</a>.</p> + <p>Credulity, <a href="#species_III_2_2_3">iii. 2. 2. 3</a>.</p> + <p>Crines novi, <a href="#species_I_1_2_15">i. 1. 2. 15</a>.</p> + <p>Croup, <a href="#species_I_1_3_4">i. 1. 3. 4</a>. <a href="#species_II_1_2_4">ii. 1. 2. 4</a>. <a href="#species_II_1_3_3">ii. 1. 3. 3</a>.</p> + <p>Crusta lactea, <a href="#species_II_1_5_12">ii. 1. 5. 12</a>.</p> + <p>Cutis arida, <a href="#species_I_1_3_6">i. 1. 3. 6</a>.</p> + <p>Cynanche. See Tonsillitis.</p> + <p>—— parotidæa. See Parotitis.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>D.</b></p> + </div> + + <div class="stanza"> + <p>Darkness in fevers, <a href="#species_I_2_5_3">i. 2. 5. 3</a>.</p> + <p>Deafness, two kinds of, <a href="#species_I_2_5_6">i. 2. 5. 6</a>.</p> + <p>Debility, three kinds of, <a href="#genus_I_2_1">i. 2. 1</a>.</p> + <p>—— and strength metaphors, <a href="#genus_I_2_1">i. 2. 1</a>.</p> + <p>Decussation of nerves, <a href="#species_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>Deglutition, <a href="#species_II_1_1_1">ii. 1. 1. 1</a>.</p> + <p>—— involuntary, <a href="#species_IV_1_3_1">iv. 1. 3. 1</a>.</p> + <p>Dentition, <a href="#species_I_1_4_5">i. 1. 4. 5</a>.</p> + <p>Dentium dolor a stridore, <a href="#species_IV_1_2_3">iv. 1. 2. 3</a>.</p> + <p>Descent of the uterus, <a href="#species_I_1_4_8">i. 1. 4. 8</a>.</p> + <p>Diabetes, <a href="#species_I_3_2_6">i. 3. 2. 6</a>.</p> + <p>—— foul tongue in, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>—— irritative, <a href="#species_IV_3_1_1">iv. 3. 1. 1</a>.</p> + <p>—— from fear, <a href="#species_IV_3_1_3">iv. 3. 1. 3</a>.</p> + <p>Diarrhœa warm, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— of infants, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— lymphatic, <a href="#species_I_3_2_4">i. 3. 2. 4</a>.</p> + <p>—— chyliferous, <a href="#species_I_3_2_5">i. 3. 2. 5</a>.</p> + <p>—— cold, <a href="#species_I_2_3_6">i. 2. 3. 6</a>.</p> + <p>—— rheumatic, <span class="correction" title="Original reads `iv. 2. 1. 16.'."><a href="#species_IV_1_2_16">iv. 1. 2. 16</a></span>.</p> + <p>—— from fear, <a href="#species_IV_3_1_4">iv. 3. 1. 4</a>.</p> + <p>—— from toothing, <a href="#species_IV_2_2_14">iv. 2. 2. 14</a>.</p> + <p>—— in fevers, Suppl. i. <a href="#suppl_II_4">2. 4</a>.</p> + <p>—— cure of, <a href="#head_IV_1_1_F">iv. 1. 1. f.</a></p> + <p>Digestion increased by cold, <a href="#species_IV_1_1_4">iv. 1. 1. 4</a>.</p> + <p>—— decreased by cold, <span class="correction" title="Original reads `iv. 1. 2. 5.'."><a href="#species_IV_2_1_6">iv. 2. 1. 6</a></span>.</p> + <p>Dilirium febrile, <a href="#species_II_1_7_1">ii. 1. 7. 1</a>.</p> + <p>—— of drunkenness, <a href="#species_II_1_7_3">ii. 1. 7. 3</a>.</p> + <p>—— maniacal, <a href="#species_II_1_7_2">ii. 1. 7. 2</a>.</p> + <p>—— in parotitis, <span class="correction" title="Original reads `iv. 2. 1. 19.'."><a href="#species_IV_1_2_19">iv. 1. 2. 19</a></span>.</p> + <p>Diluents, use of, <a href="#species_II_1_2_1">ii. 1. 2. 1</a>.</p> + <p>Distention of the nipples, <a href="#species_II_1_7_10">ii. 1. 7. 10</a>. <a href="#species_IV_1_2_7">iv. 1. 2. 7</a>.</p> + <p>Diuretics useless in dropsy, <a href="#species_I_1_3_7">i. 1. 3. 7</a>.</p> + <p>Dizziness. See Vertigo.</p> + <p>Dogs, catarrh of, <a href="#species_II_1_3_6">ii. 1. 3. 6</a>.</p> + <p>Dolor digiti sympathet, <a href="#species_IV_2_2_12">iv. 2. 2. 12</a>.</p> + <p>—— ductus choledochi, <a href="#species_IV_2_2_4">iv. 2. 2. 4</a>.</p> + <p>—— humeri in <span class="correction" title="Original reads `hepatidite'.">hepatitide</span>, <a href="#species_IV_2_2_9">iv. 2. 2. 9</a>.</p> + <p>—— pharyngis ab acido, <a href="#species_IV_2_2_5">iv. 2. 2. 5</a>.</p> + <p>—— testium nephriticus, <a href="#species_IV_2_2_11">iv. 2. 2. 11</a>.</p> + <p>—— urens, <a href="#species_I_1_5_10">i. 1. 5. 10</a>.</p> + <p>Dracunculus, <a href="#species_I_1_4_13">i. 1. 4. 13</a>.</p> + <p>Dreams, <a href="#species_II_1_7_4">ii. 1. 7. 4</a>.</p> + <p>Dropsy of the brain, <a href="#species_I_2_3_12">i. 2. 3. 12</a>.</p> + <p>—— of the belly, <a href="#species_I_2_3_13">i. 2. 3. 13</a>.</p> + <p>—— of the chest, <a href="#species_I_2_3_14">i. 2. 3. 14</a>.</p> + <p>—— of the ovary, <a href="#species_I_2_3_15">i. 2. 3. 15</a>.</p> + <p>—— of the lungs, <a href="#species_I_2_3_16">i. 2. 3. 16</a>.</p> + <p>—— of the scrotum, <a href="#species_I_2_3_11">i. 2. 3. 11</a>.</p> + <p>Dysentery, <a href="#species_II_1_3_18">ii. 1. 3. 18</a>.</p> + <p>Dysmenorrhagia, <a href="#species_I_2_1_12">i. 2. 1. 12</a>.</p> + <p>Dyspnœa from cold bath, <a href="#species_IV_2_1_5">iv. 2. 1. 5</a>.</p> + <p>—— rheumatica, <span class="correction" title="Original reads `iv. 2. 1. 16.'."><a href="#species_IV_1_2_16">iv. 1. 2. 16</a></span>.</p> + <p>Dyspepsia, <a href="#species_I_3_1_3">i. 3. 1. 3</a>.</p> + <p>—— a frigore, <a href="#species_IV_2_1_6">iv. 2. 1. 6</a>.</p> + <p>Dysuria insensitiva, <a href="#species_II_2_2_6">ii. 2. 2. 6</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>E.</b></p> + </div> + + <div class="stanza"> + <p>Ears, discharge behind, <a href="#species_I_1_2_9">i. 1. 2. 9</a>.</p> + <p>—— noise in them, <a href="#species_IV_2_1_15">iv. 2. 1. 15</a>.</p> + <p>Ear-ach, <a href="#species_IV_2_2_8">iv. 2. 2. 8</a>.</p> + <p>Ebrietas, <a href="#species_I_1_1_2">i. 1. 1. 2</a>.</p> + <p>Education, <a href="#species_III_2_1_8">iii. 2. 1. 8</a>. <a href="#species_III_1_2_24">iii. 1. 2. 24</a>.</p> + <p>—— heroic, <a href="#species_III_1_2_25">iii. 1. 2. 25</a>.</p> + <p>Egg boiled for inflamed eyes, <a href="#species_II_1_4_1">ii. 1. 4. 1</a>.</p> + <p>—— boiled soonest, Suppl. i. <a href="#suppl_VII">7</a>.</p> + <p>—— life of, <a href="#species_IV_1_4_1">iv. 1. 4. 1</a>.</p> + <p>Electric shocks, <a href="#species_IV_1_4_5">iv. 1. 4. 5</a>.</p> + <p>Electrized zinc and silver, <a href="#species_I_2_5_5">i. 2. 5. 5</a>.</p> + <p>—— in paralysis, <a href="#species_II_1_1_9">ii. 1. 1. 9</a>.</p> + <p>—— in scrophula, <a href="#species_I_2_3_21">i. 2. 3. 21</a>.</p> + <p>—— in hoarseness, <a href="#species_III_2_1_5">iii. 2. 1. 5</a>.</p> + <p>Empyema, <a href="#species_II_1_6_4">ii. 1. 6. 4</a>.</p> + <p>Enteralgia rheumatica, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>Enteritis, <a href="#species_II_1_2_11">ii. 1. 2. 11</a>.</p> + <p>—— superficialis, <a href="#species_II_1_3_20">ii. 1. 3. 20</a>.</p> + <p>Epilepsy, <a href="#species_III_1_1_7">iii. 1. 1. 7</a>. <a href="#species_IV_3_1_6">iv. 3. 1. 6</a>.</p> + <p>—— painful, <a href="#species_III_1_1_8">iii. 1. 1. 8</a>. <a href="#species_IV_2_4_4">iv. 2. 4. 4</a>.</p> + <p>—— terminates with sleep, <a href="#genus_III_1_1">iii. 1. 1</a>.</p> + <p>—— in parturition, <a href="#species_III_1_1_7">iii. 1. 1. 7</a>.</p> + <p>—— with indigestion, <a href="#species_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>Epistaxis. See Hæmorraghia.</p> + <p>Epoulosis. See Cicatrix.</p> + <p>Erotomania, <a href="#species_III_1_2_4">iii. 1. 2. 4</a>.</p> + <p>Eructation, voluntary, <a href="#species_IV_3_3_3">iv. 3. 3. 3</a>.</p> + <p>Eruption of small-pox, <span class="correction" title="Original reads `iv. 2. 1. 12.'."><a href="#species_IV_1_2_12">iv. 1. 2. 12</a></span>. <a href="#species_IV_2_2_10">iv. 2. 2. 10</a>.</p> + <p>Erysipelas, <a href="#species_IV_1_2_17">iv. 1. 2. 17</a>. <a href="#species_II_1_3_2">ii. 1. 3. 2</a>. <a href="#species_IV_2_4_10">iv. 2. 4. 10</a>.</p> + <p>—— seldom suppurates, why, <a href="#species_II_1_3_2">ii. 1. 3. 2</a>.</p> + <p>Esuries, <a href="#species_I_2_4_2">i. 2. 4. 2</a>.</p> + <p>Evil, <a href="#species_I_2_3_21">i. 2. 3. 21</a>.</p> + <p>Expectoration, warm, <a href="#species_I_1_2_8">i. 1. 2. 8</a>.</p> + <p>—— solid, <a href="#species_I_1_3_4">i. 1. 3. 4</a>.</p> + <p>—— cold, <a href="#species_I_2_3_4">i. 2. 3. 4</a>.</p> + <p>Exsudation behind the ears, <a href="#species_I_1_2_9">i. 1. 2. 9</a>.</p> + <p>Eyes, blue under the, <a href="#species_I_2_2_2">i. 2. 2. 2</a>. <a href="#species_II_1_4_4">ii. 1. 4. 4</a>.</p> + <p>Eyelid inverted, cure of, <a href="#species_II_1_1_8">ii. 1. 1. 8</a>.</p> + <p>—— coloured with antimony, <a href="#species_II_1_4_3">ii. 1. 4. 3</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>F.</b></p> + </div> + + <div class="stanza"> + <p>Face, pimpled, <a href="#species_II_1_4_6">ii. 1. 4. 6</a>.</p> + <p>—— red after meals, Suppl. i. <a href="#suppl_XII_7">12. 7</a>.</p> + <p>—— flushed after dinner, <a href="#species_IV_1_1_1">iv. 1. 1. 1</a>.</p> + <p>Fat people why short breathed, <a href="#species_II_1_1_4">ii. 1. 1. 4</a>.</p> + <p>Fear, syncope from, <a href="#species_I_2_1_4">i. 2. 1. 4</a>.</p> + <p>—— abortion from, <span class="correction" title="Original reads `iv. 1. 3. 7.'."><a href="#species_IV_3_1_7">iv. 3. 1. 7</a></span>.</p> + <p>—— produces absorption, <a href="#species_II_1_6_4">ii. 1. 6. 4</a>.</p> + <p>—— paleness in, <span class="correction" title="Original reads `iv. 1. 3. 5.'."><a href="#species_IV_3_1_5">iv. 3. 1. 5</a></span>.</p> + <p>—— of death, <a href="#species_III_1_2_14">iii. 1. 2. 14</a>.</p> + <p>—— of hell, <a href="#species_III_1_2_15">iii. 1. 2. 15</a>.</p> + <p>—— of poverty, <a href="#species_III_1_2_13">iii. 1. 2. 13</a>.</p> + <p>Feet cold produces heartburn. Suppl. i. <a href="#suppl_VIII_5">8. 5</a>.</p> + <p>—— fetid, <a href="#species_I_1_2_14">i. 1. 2. 14</a>.</p> + <p>—— cold in small-pox, <a href="#species_IV_2_2_10">iv. 2. 2. 10</a>.</p> + <p>Fevers, five kinds, <a href="#genus_II_1_2">ii. 1. 2</a>. Suppl. i. <a href="#suppl_I_2">1. 2</a>.</p> + <p>—— irritative, <a href="#species_I_1_1_1">i. 1. 1. 1</a>. <a href="#species_IV_1_1_8">iv. 1. 1. 8</a>.</p> + <p>—— inirritative, <a href="#species_I_2_1_1">i. 2. 1. 1</a>. <a href="#species_IV_2_1_19">iv. 2. 1. 19</a>. Suppl. i. <a href="#suppl_I_2">1. 2</a>.</p> + <p>—— sensitive, <span class="correction" title="Original reads `ii. 1. 5. 1.'."><a href="#species_II_1_6_1">ii. 1. 6. 1</a></span>.</p> + <p>—— sensitive irritated, <a href="#species_II_1_2_1">ii. 1. 2. 1</a>.</p> + <p>—— sensitive inirritated, <a href="#species_II_1_3_1">ii. 1. 3. 1</a>.</p> + <p>—— intermit, why, <a href="#supplement">Suppl. i.</a></p> + <p>—— continue, why, <a href="#supplement">Suppl. i.</a></p> + <p>—— periods of, <a href="#species_IV_2_4_11">iv. 2. 4. 11</a>.</p> + <p>—— simple, Suppl. i. <a href="#suppl_I">1</a>.</p> + <p>—— compound, Suppl. i. <a href="#suppl_II">2</a>.</p> + <p>—— termination of cold fit, Suppl. i. <a href="#suppl_III">3</a>.</p> + <p>—— return of cold fit, <span class="correction" title="Original reads `Suppl. i. 3.'.">Suppl. i. <a href="#suppl_IV">4</a></span>.</p> + <p>—— sensation in, Suppl. i. <a href="#suppl_V">5</a>.</p> + <p>—— circles of motions in, Suppl. i. <a href="#suppl_VI">6</a>.</p> + <p>—— cold and hot fits, Suppl. i. <a href="#suppl_VII">7</a>.</p> + <p>—— continued, Suppl. i. <a href="#suppl_VIII">8</a>.</p> + <p>—— torpor of lungs in, Suppl. i. <a href="#suppl_IX_1">9. 1</a>.</p> + <p>—— not determinable in cold fit, <a href="#species_I_1_1_1">i. 1. 1. 1</a>.</p> + <p>—— frequency of pulse in, <a href="#species_I_1_1_1">i. 1. 1. 1</a>.</p> + <p>—— not an effort to cure, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— <span class="correction" title="Original reads `perpetual'.">puerperal</span>, <a href="#species_II_1_6_16">ii. 1. 6. 16</a>. <a href="#species_I_2_4_9">i. 2. 4. 9</a>.</p> + <p>—— from inclosed matter, <a href="#species_II_1_6_2">ii. 1. 6. 2</a>.</p> + <p>—— from aerated matter, <a href="#species_II_1_6_6">ii. 1. 6. 6</a>.</p> + <p>—— from contagious matter, <a href="#species_II_1_6_11">ii. 1. 6. 11</a>.</p> + <p>—— from contagious sanies, <a href="#species_II_1_6_15">ii. 1. 6. 15</a>.</p> + <p>—— torpor of the stomach, Suppl. i. <a href="#suppl_XII">12</a>.</p> + <p>—— case of, Suppl. i. <a href="#suppl_XIII">13</a>.</p> + <p>—— termination of, Suppl. i. <a href="#suppl_XIV">14</a>.</p> + <p>—— inflammation excited, Suppl. i. <a href="#suppl_XV">15</a>.</p> + <p>—— returns of, Suppl. i. <a href="#suppl_IV">4</a>.</p> + <p>—— when cold air in, Suppl. i. <a href="#suppl_II_2">2. 2</a>.</p> + <p>—— sympathetic, theory of, <a href="#supplement">Suppl. i.</a></p> + <p>—— duration of explained, Suppl. i. <a href="#suppl_II_5">2. 5</a>.</p> + <p>Fingers, playing with, <a href="#species_IV_1_3_4">iv. 1. 3. 4</a>.</p> + <p>—— pain of, <a href="#species_IV_2_2_12">iv. 2. 2. 12</a>.</p> + <p>Fish live longer with injured brain, <a href="#species_I_2_5_10">i. 2. 5. 10</a>.</p> + <p>Fistula in ano, <a href="#species_II_1_4_10">ii. 1. 4. 10</a>.</p> + <p>—— lacrymalis, <a href="#species_II_1_4_9">ii. 1. 4. 9</a>.</p> + <p>—— urethra, <a href="#species_II_1_4_11">ii. 1. 4. 11</a>.</p> + <p>Flannel shirt in diarrhœa, <a href="#species_IV_1_1_3">iv. 1. 1. 3</a>.</p> + <p>—— injurious in summer, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>Fluor albus warm, <a href="#species_I_1_2_11">i. 1. 2. 11</a>.</p> + <p>—— cold, <a href="#species_I_2_3_7">i. 2. 3. 7</a>.</p> + <p>Frigus febrile, <a href="#species_I_2_2_1">i. 2. 2. 1</a>.</p> + <p>—— chronicum, <span class="correction" title="Original reads `i. 2. 2. 2.'."><a href="#species_I_2_2_1">i. 2. 2. 1</a></span>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>G.</b></p> + </div> + + <div class="stanza"> + <p>Gall-stone, <a href="#species_I_1_3_8">i. 1. 3. 8</a>.</p> + <p>Gangreen, <span class="correction" title="There is no such class: I cannot determine a correction.">ii. 1. 6. 17</span>.</p> + <p>Gargles, <a href="#species_II_1_3_3">ii. 1. 3. 3</a>.</p> + <p>Gastritis, <a href="#species_II_1_2_10">ii. 1. 2. 10</a>.</p> + <p>—— superficialis, <a href="#species_II_1_3_19">ii. 1. 3. 19</a>.</p> + <p>Genu tumor albus, <a href="#species_I_2_3_19">i. 2. 3. 19</a>.</p> + <p>Gleet. See Gonorrhœa.</p> + <p>Globus hystericus, <a href="#species_I_3_1_7">i. 3. 1. 7</a>.</p> + <p>Gonorrhœa warm, <a href="#species_I_1_2_10">i. 1. 2. 10</a>.</p> + <p>—— cold, <a href="#species_I_2_3_8">i. 2. 3. 8</a>.</p> + <p>Gout, <a href="#species_IV_1_2_15">iv. 1. 2. 15</a>. <a href="#species_IV_2_4_9">iv. 2. 4. 9</a>.</p> + <p>—— of the liver, <a href="#species_II_1_1_7">ii. 1. 1. 7</a>.</p> + <p>—— cases of, <a href="#species_IV_1_2_15">iv. 1. 2. 15</a>.</p> + <p>—— cough, <a href="#species_IV_2_1_9">iv. 2. 1. 9</a>.</p> + <p>—— of the stomach, <a href="#species_I_2_4_6">i. 2. 4. 6</a>.</p> + <p>—— hæmorrhage in, <a href="#species_I_1_1_4">i. 1. 1. 4</a>.</p> + <p>Grace defined, <a href="#species_III_1_2_4">iii. 1. 2. 4</a>.</p> + <p>Gravel distinguished from salts, <a href="#species_I_1_3_10">i. 1. 3. 10</a>.</p> + <p>Gravitation, <a href="#genus_IV_2_4">iv. 2. 4</a>.</p> + <p>Green-sickness. See Chlorosis.</p> + <p>Grief, <a href="#species_III_1_2_10">iii. 1. 2. 10</a>.</p> + <p>Gripes of children, <a href="#species_I_1_2_5">i. 1. 2. 5</a>. <a href="#species_IV_2_1_3">iv. 2. 1. 3</a>.</p> + <p>Gustus acrior, <a href="#species_I_1_5_4">i. 1. 5. 4</a>.</p> + <p>—— imminutus, <a href="#species_I_2_5_8">i. 2. 5. 8</a>.</p> + <p>Gutta rosea, <a href="#species_II_1_4_6">ii. 1. 4. 6</a>. <a href="#species_IV_1_2_13">iv. 1. 2. 13</a>. and <a href="#species_IV_1_2_14">14</a>.</p> + <p>—— serena, <a href="#species_I_2_5_5">i. 2. 5. 5</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>H.</b></p> + </div> + + <div class="stanza"> + <p>Hæmorrhage arterial, <a href="#species_I_1_1_3">i. 1. 1. 3</a>.</p> + <p>—— of the lungs, <a href="#species_I_1_1_4">i. 1. 1. 4</a>.</p> + <p>—— of the nose, <a href="#species_I_1_1_5">i. 1. 1. 5</a>.</p> + <p>—— venous, <a href="#species_I_2_1_5">i. 2. 1. 5</a>.</p> + <p>—— of the rectum, <a href="#species_I_2_1_6">i. 2. 1. 6</a>.</p> + <p>—— of the kidnies, <a href="#species_I_2_1_7">i. 2. 1. 7</a>.</p> + <p>—— of the liver, <a href="#species_I_2_1_8">i. 2. 1. 8</a>.</p> + <p>Hæmoptoe arterial, <a href="#species_I_1_1_4">i. 1. 1. 4</a>.</p> + <p>—— venous, <a href="#species_I_2_1_9">i. 2. 1. 9</a>.</p> + <p>Hæmorrhois cruenta, <a href="#species_I_2_1_6">i. 2. 1. 6</a>. <a href="#species_IV_2_4_8">iv. 2. 4. 8</a>.</p> + <p>—— alba, <a href="#species_I_1_2_12">i. 1. 2. 12</a>.</p> + <p>Hair, grey, <a href="#species_I_2_2_11">i. 2. 2. 11</a>.</p> + <p>—— new, <a href="#species_I_1_2_15">i. 1. 2. 15</a>.</p> + <p>—— white by uterine pressure, Addit. <a href="#add_I">i</a>.</p> + <p>Hallucination of sight, <a href="#species_II_1_7_5">ii. 1. 7. 5</a>.</p> + <p>—— of hearing, <a href="#species_II_1_7_6">ii. 1. 7. 6</a>.</p> + <p>—— maniacal, <a href="#species_III_1_2_1">iii. 1. 2. 1</a>.</p> + <p>—— studiosa, <a href="#species_III_1_2_2">iii. 1. 2. 2</a>.</p> + <p>Harrogate water fact, <a href="#species_I_1_4_12">i. 1. 4. 12</a>.</p> + <p>Head-ach. See Hemicrania and Cephalæa.</p> + <p>Hearing acuter, <a href="#species_I_1_5_2">i. 1. 5. 2</a>.</p> + <p>—— diminished, <a href="#species_I_2_5_6">i. 2. 5. 6</a>.</p> + <p>Heart-burn, <a href="#species_I_2_4_5">i. 2. 4. 5</a>.</p> + <p>Heart stimulated, Suppl. i. <a href="#suppl_XI_7">11. 7</a>. i. <a href="#suppl_XVI_9">16. 9</a>.</p> + <p>Heat, animal, <a href="#species_I_1_2_1">i. 1. 2. 1</a>. <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— sense of acuter, <a href="#species_I_1_5_6">i. 1. 5. 6</a>.</p> + <p>—— elemental, <a href="#genus_IV_2_4">iv. 2. 4</a>.</p> + <p>—— hectic lessened by swinging, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>—— not perceived by the lungs, <a href="#species_III_1_1_10">iii. 1. 1. 10</a>.</p> + <p>—— not estimated by thermometers, Suppl. i. <a href="#suppl_VII">7</a>.</p> + <p>—— of the breath, Suppl. i. <a href="#suppl_II_2">2. 2</a>.</p> + <p>Hemicrania, <a href="#species_IV_2_2_8">iv. 2. 2. 8</a>. <a href="#species_IV_2_4_3">iv. 2. 4. 3</a>.</p> + <p>—— relieved by mercury, <a href="#species_IV_2_2_8">iv. 2. 2. 8</a>.</p> + <p>Hemiplegia, <a href="#species_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>Hepatis tumor, <a href="#species_I_2_3_9">i. 2. 3. 9</a>.</p> + <p>Hepatitis, <a href="#species_II_1_2_12">ii. 1. 2. 12</a>.</p> + <p>—— chronica, <a href="#species_II_1_4_12">ii. 1. 4. 12</a>.</p> + <p>Herpes, <a href="#species_II_1_5_8">ii. 1. 5. 8</a>.</p> + <p>—— nephritica, <a href="#species_IV_1_2_11">iv. 1. 2. 11</a>.</p> + <p>Hiccough, <a href="#species_II_1_1_6">ii. 1. 1. 6</a>. <a href="#species_IV_1_1_7">iv. 1. 1. 7</a>.</p> + <p>Hip-joint injured, <a href="#species_I_2_2_17">i. 2. 2. 17</a>.</p> + <p>Hoarseness, <a href="#species_II_1_3_5">ii. 1. 3. 5</a>. <span class="correction" title="Original reads `iii. 2. 1. 4.'."><a href="#species_III_2_1_5">iii. 2. 1. 5</a></span>.</p> + <p>Horses, broken wind of, <a href="#species_I_2_4_9">i. 2. 4. 9</a>.</p> + <p>Humectation of the body, <a href="#species_IV_1_4_7">iv. 1. 4. 7</a>.</p> + <p>Hunger, <a href="#species_I_2_4_2">i. 2. 4. 2</a>.</p> + <p>Hydatides in calves, <span class="correction" title="Original reads `i. 2. 5. 2.'."><a href="#species_I_2_5_4">i. 2. 5. 4</a></span>.</p> + <p>Hydrocele, <a href="#species_I_2_3_11">i. 2. 3. 11</a>.</p> + <p>Hydrocephalus inter, <a href="#species_I_2_3_12">i. 2. 3. 12</a>. <a href="#species_I_2_5_4">i. 2. 5. 4</a>. <a href="#species_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>—— from inflammation, Addit. <a href="#add_II">ii</a>.</p> + <p>Hydrogene gas. Suppl. i. <a href="#suppl_IX_3">9. 3</a>. <span class="correction" title="Original reads `i. 11. 4.'.">i. <a href="#suppl_XI_6">11. 6</a></span>.</p> + <p>—— in fevers, Suppl. i. <a href="#suppl_XI_6">11. 6</a>. i. <a href="#suppl_XVI_9">16. 9</a>.</p> + <p>Hydrothorax, <a href="#species_I_2_3_14">i. 2. 3. 14</a>. case of, <a href="#species_IV_2_2_13">iv. 2. 2. 13</a>.</p> + <p>Hydro-carbonate gas, Suppl. i. <a href="#suppl_IX_1">9. 1</a>. Suppl. i. <a href="#suppl_XV_3">15. 3</a>.</p> + <p>Hydrops ovarii, <a href="#species_I_2_3_15">i. 2. 3. 15</a>.</p> + <p>Hydrophobia, <a href="#species_I_3_1_11">i. 3. 1. 11</a>. <a href="#species_III_1_1_15">iii. 1. 1. 15</a>. <a href="#species_IV_1_2_7">iv. 1. 2. 7</a>.</p> + <p>Hypochondriasis, <a href="#species_I_2_4_10">i. 2. 4. 10</a>.</p> + <p>Hysteralgia frigida, <a href="#species_I_2_4_17">i. 2. 4. 17</a>.</p> + <p>Hysteria, <a href="#species_I_3_1_10">i. 3. 1. 10</a>. Suppl. i. <a href="#suppl_VIII_11">8. 11</a>.</p> + <p>—— from fear, <a href="#species_IV_3_1_8">iv. 3. 1. 8</a>.</p> + <p>—— from cold, <span class="correction" title="Original reads `iv. 3. 3. 3.'."><a href="#species_IV_3_4_3">iv. 3. 4. 3</a></span>.</p> + <p>—— convulsions in, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>—— laughter in, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>Hysteritis, <a href="#species_II_1_2_16">ii. 1. 2. 16</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>I.</b></p> + </div> + + <div class="stanza"> + <p>Jactitatio, <a href="#species_III_1_1_1">iii. 1. 1. 1</a>.</p> + <p>Jaundice, <a href="#species_I_1_3_8">i. 1. 3. 8</a>. <a href="#species_I_2_4_19">i. 2. 4. 19</a>.</p> + <p>Icterus, <a href="#species_I_1_3_8">i. 1. 3. 8</a>. <a href="#species_I_2_4_19">i. 2. 4. 19</a>.</p> + <p>Ileus, <a href="#species_I_3_1_6">i. 3. 1. 6</a>. <a href="#species_II_1_2_11">ii. 1. 2. 11</a>.</p> + <p>Impotentia, <a href="#species_II_2_2_3">ii. 2. 2. 3</a>.</p> + <p>Indigestion, <a href="#species_I_3_1_3">i. 3. 1. 3</a>.</p> + <p>—— See Anorexia and Apepsia.</p> + <p>—— from cold feet, <a href="#species_IV_2_1_6">iv. 2. 1. 6</a>. Sup. i. <a href="#suppl_VIII_5">8. 5</a>.</p> + <p>Incubus, <a href="#species_III_2_1_13">iii. 2. 1. 13</a>.</p> + <p>Infants, green stools of, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— new born, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>Inflammation of the eye, <a href="#species_II_1_2_2">ii. 1. 2. 2</a>.</p> + <p>—— superficial, <a href="#species_II_1_4_1">ii. 1. 4. 1</a>.</p> + <p>—— of the brain, <a href="#species_II_1_2_3">ii. 1. 2. 3</a>.</p> + <p>—— of the lungs, <a href="#species_II_1_2_4">ii. 1. 2. 4</a>.</p> + <p>—— superficial, <a href="#species_II_1_3_7">ii. 1. 3. 7</a>.</p> + <p>—— of the pleura, <a href="#species_II_1_2_5">ii. 1. 2. 5</a>.</p> + <p>—— of the diaphragm, <a href="#species_II_1_2_6">ii. 1. 2. 6</a>.</p> + <p>—— of the heart, <a href="#species_II_1_2_7">ii. 1. 2. 7</a>.</p> + <p>—— of the peritoneum, <a href="#species_II_1_2_8">ii. 1. 2. 8</a>.</p> + <p>—— of the mesentery, <a href="#species_II_1_2_9">ii. 1. 2. 9</a>.</p> + <p>—— of the stomach, <a href="#species_II_1_2_10">ii. 1. 2. 10</a>.</p> + <p>—— superficial, <a href="#species_II_1_3_19">ii. 1. 3. 19</a>.</p> + <p>—— of the bowels, <span class="correction" title="Original reads `ii. 1. 2. 3.'."><a href="#species_II_1_2_11">ii. 1. 2. 11</a></span>.</p> + <p>—— superficial, <a href="#species_II_1_3_20">ii. 1. 3. 20</a>.</p> + <p>—— of the liver, <a href="#species_II_1_2_12">ii. 1. 2. 12</a>.</p> + <p>—— chronical, <a href="#species_II_1_4_12">ii. 1. 4. 12</a>.</p> + <p>—— of the spleen, <a href="#species_II_1_2_13">ii. 1. 2. 13</a>. Sup. i. <a href="#suppl_XVI_6">16. 6</a>.</p> + <p>—— of the kidnies, <a href="#species_II_1_2_14">ii. 1. 2. 14</a>.</p> + <p>—— of the bladder, <a href="#species_II_1_2_15">ii. 1. 2. 15</a>.</p> + <p>—— of the womb, <a href="#species_II_1_2_16">ii. 1. 2. 16</a>.</p> + <p>—— of the tonsils, <a href="#species_II_1_3_3">ii. 1. 3. 3</a>.</p> + <p>—— of the parotis, <a href="#species_II_1_3_4">ii. 1. 3. 4</a>.</p> + <p>Inirritability of lacteals, <a href="#species_I_2_3_26">i. 2. 3. 26</a>.</p> + <p>—— of lymphatics, <a href="#species_I_2_3_27">i. 2. 3. 27</a>.</p> + <p>—— of the gall-bladder, <a href="#species_I_2_4_19">i. 2. 4. 19</a>.</p> + <p>—— of the kidney, <a href="#species_I_2_4_20">i. 2. 4. 20</a>.</p> + <p>—— of the spleen, Suppl. i. <a href="#suppl_XVI_6">16. 6</a>.</p> + <p>—— vicissitudes of, <a href="#genus_I_1_1">i. 1. 1</a>.</p> + <p>Inoculation, <a href="#species_II_1_3_9">ii. 1. 3. 9</a>.</p> + <p>Innutrition of bones, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>Insanity, quick pulse in, <a href="#genus_III_1_1">iii. 1. 1</a>.</p> + <p>—— from parturition, <a href="#genus_III_1_2">iii. 1. 2</a>.</p> + <p>—— with fever, <a href="#genus_III_1_2">iii. 1. 2</a>.</p> + <p>—— cure of, <a href="#genus_III_1_2">iii. 1. 2</a>.</p> + <p>—— confinement in, <a href="#genus_III_1_2">iii. 1. 2</a>.</p> + <p>Insensibility, <a href="#species_II_2_1_1">ii. 2. 1. 1</a>.</p> + <p>Ira, <a href="#species_III_1_2_17">iii. 1. 2. 17</a>.</p> + <p>Ischias, <a href="#species_II_1_2_18">ii. 1. 2. 18</a>. <a href="#species_I_2_4_15">i. 2. 4. 15</a>.</p> + <p>Issues, use of, <a href="#species_I_1_2_9">i. 1. 2. 9</a>. <a href="#species_III_1_1_11">iii. 1. 1. 11</a>.</p> + <p>Itch, <a href="#species_II_1_5_6">ii. 1. 5. 6</a>.</p> + <p>Itching, <a href="#species_I_1_5_9">i. 1. 5. 9</a>.</p> + <p>—— of the nose, <a href="#species_IV_2_2_6">iv. 2. 2. 6</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>L.</b></p> + </div> + + <div class="stanza"> + <p>Lacrymarum fluxus sym. <a href="#species_IV_1_2_1">iv. 1. 2. 1</a>.</p> + <p>Lameness of the hip, <a href="#species_I_2_2_17">i. 2. 2. 17</a>.</p> + <p>Lassitude, <a href="#species_III_2_1_1">iii. 2. 1. 1</a>.</p> + <p>Laughter, <a href="#species_IV_2_3_3">iv. 2. 3. 3</a>. <a href="#species_III_1_1_4">iii. 1. 1. 4</a>. <a href="#species_IV_1_3_3">iv. 1. 3. 3</a>.</p> + <p>—— See Risus.</p> + <p>Leg, one shorter, <a href="#species_I_2_2_17">i. 2. 2. 17</a>.</p> + <p>Lepra, <a href="#species_II_1_5_3">ii. 1. 5. 3</a>.</p> + <p>Lethargus, <a href="#species_III_2_1_14">iii. 2. 1. 14</a>.</p> + <p>Lethi timor, <a href="#species_III_1_2_14">iii. 1. 2. 14</a>.</p> + <p>Lice, <a href="#species_I_1_4_15">i. 1. 4. 15</a>.</p> + <p>Lientery, <a href="#species_I_2_3_6">i. 2. 3. 6</a>.</p> + <p>Light debilitates in fevers, <a href="#species_I_2_5_3">i. 2. 5. 3</a>.</p> + <p>Lingua arida, <a href="#species_I_1_3_1">i. 1. 3. 1</a>. <span class="correction" title="This reference is surely wrong: I cannot determine a correction."><a href="#species_IV_2_4_11">iv. 2. 4. 11</a></span>.</p> + <p>Liver, torpor of, <a href="#species_I_2_2_6">i. 2. 2. 6</a>.</p> + <p>—— tumor of, <a href="#species_I_2_3_9">i. 2. 3. 9</a>.</p> + <p>—— inflamed, <a href="#species_II_1_2_12">ii. 1. 2. 12</a>.</p> + <p>Lochia nimia, <span class="correction" title="Original reads `i. 2.'."><a href="#species_I_2_1_13">i. 2. 1. 13</a></span>.</p> + <p>Locked jaw, <a href="#species_III_1_1_13">iii. 1. 1. 13</a>.</p> + <p>Love, sentimental, <a href="#species_III_1_2_4">iii. 1. 2. 4</a>.</p> + <p>Lues venerea, <span class="correction" title="Original reads `ii. 1. 5. 8.'."><a href="#species_II_1_5_2">ii. 1. 5. 2</a></span>.</p> + <p>—— imaginaria, <a href="#species_III_1_2_21">iii. 1. 2. 21</a>.</p> + <p>Lumbago, <a href="#species_II_1_2_17">ii. 1. 2. 17</a>. <a href="#species_III_1_1_1">iii. 1. 1. 1</a>.</p> + <p>—— cold, <a href="#species_I_2_4_16">i. 2. 4. 16</a>.</p> + <p>Lumbricus, <a href="#species_I_1_4_10">i. 1. 4. 10</a>.</p> + <p>Lunar influence on the solids, <a href="#species_I_2_1_11">i. 2. 1. 11</a>.</p> + <p>Lungs, adhesions of, <a href="#species_II_1_2_5">ii. 1. 2. 5</a>.</p> + <p>—— not sensible to heat, <a href="#species_III_1_1_10">iii. 1. 1. 10</a>.</p> + <p>Lusus digitorum invitus, <a href="#species_IV_1_3_4">iv. 1. 3. 4</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>M.</b></p> + </div> + + <div class="stanza"> + <p>Maculæ vultus, <span class="correction" title="Original reads `i. 2. 1. 9.'."><a href="#species_I_2_2_10">i. 2. 2. 10</a></span>.</p> + <p>Madness, mutable, <a href="#species_III_1_2_1">iii. 1. 2. 1</a>.</p> + <p>Mammarum tumor, <span class="correction" title="Original reads `iv. 2. 1. 19.'."><a href="#species_IV_1_2_19">iv. 1. 2. 19</a></span>.</p> + <p>Mammularum tensio, <span class="correction" title="Original reads `iv. 2. 1. 6.'."><a href="#species_IV_1_2_6">iv. 1. 2. 6</a></span>. <a href="#species_I_1_4_7">i. 1. 4. 7</a>.</p> + <p>Mania mutabilis, <a href="#species_III_1_2_1">iii. 1. 2. 1</a>.</p> + <p>Matter variolous, <a href="#species_II_1_3_9">ii. 1. 3. 9</a>.</p> + <p>—— contagious, <a href="#genus_II_1_3">ii. 1. 3</a>. <a href="#species_II_1_6_11">ii. 1. 6. 11</a>.</p> + <p>—— inclosed, <a href="#species_II_1_6_2">ii. 1. 6. 2</a>.</p> + <p>—— oxygenated, <a href="#species_II_1_6_6">ii. 1. 6. 6</a>.</p> + <p>—— sanious, <a href="#species_II_1_6_15">ii. 1. 6. 15</a>.</p> + <p>Measles, <a href="#species_II_1_3_10">ii. 1. 3. 10</a>.</p> + <p>Membranes, what, <a href="#genus_IV_1_2">iv. 1. 2</a>.</p> + <p>Menorrhagia, <a href="#species_I_2_1_11">i. 2. 1. 11</a>.</p> + <p>Mercury crude, as a clyster, <a href="#species_I_3_1_6">i. 3. 1. 6</a>.</p> + <p>—— in all contagions, Suppl. i. <a href="#suppl_XVI_7">16. 7</a>.</p> + <p>—— in vertigo, <span class="correction" title="Original reads `iv. 1. 2. 11.'."><a href="#species_IV_2_1_11">iv. 2. 1. 11</a></span>.</p> + <p>Miliaria, <a href="#species_II_1_3_12">ii. 1. 3. 12</a>.</p> + <p>Milk new, for children, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— old, induces costiveness, <a href="#species_II_2_2_7">ii. 2. 2. 7</a>.</p> + <p>Milk-crust, <a href="#species_II_1_5_12">ii. 1. 5. 12</a>.</p> + <p>Miscarriage. See Abortion.</p> + <p>Mæror, <a href="#species_III_1_2_10">iii. 1. 2. 10</a>.</p> + <p>Mobility, <a href="#genus_IV_1_2">iv. 1. 2</a>.</p> + <p>—— of the skin, Suppl. i. <a href="#suppl_VII">7</a>.</p> + <p>Mollities ossium, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>Moon, effect of, <a href="#genus_IV_2_4">iv. 2. 4</a>.</p> + <p>Morbilli. See Rubeola.</p> + <p>Mortification, <a href="#species_II_1_6_17">ii. 1. 6. 17</a>.</p> + <p>Morpiones, <a href="#species_I_1_4_14">i. 1. 4. 14</a>.</p> + <p>Mucus diminished, <a href="#species_I_2_2_4">i. 2. 2. 4</a>.</p> + <p>—— of the throat cold, <a href="#species_I_2_3_1">i. 2. 3. 1</a>.</p> + <p>—— of the bowels, <a href="#species_I_2_3_6">i. 2. 3. 6</a>. <a href="#species_I_1_2_12">i. 1. 2. 12</a>.</p> + <p>—— of the lungs, <a href="#species_I_1_3_4">i. 1. 3. 4</a>.</p> + <p>—— forms stones, <a href="#species_I_1_3_9">i. 1. 3. 9</a>.</p> + <p>—— distinguished from pus, <a href="#species_II_1_6_6">ii. 1. 6. 6</a>.</p> + <p>Mumps, <a href="#species_II_1_3_4">ii. 1. 3. 4</a>.</p> + <p>Murmur aurium, <a href="#species_IV_2_1_15">iv. 2. 1. 15</a>.</p> + <p>Muscæ volitantes, <a href="#species_I_2_5_3">i. 2. 5. 3</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>N.</b></p> + </div> + + <div class="stanza"> + <p>Nails, biting of, <a href="#species_IV_1_3_5">iv. 1. 3. 5</a>.</p> + <p>Nares aridi, <a href="#species_I_1_3_3">i. 1. 3. 3</a>.</p> + <p>Nausea, dry, <a href="#species_I_2_4_3">i. 2. 4. 3</a>.</p> + <p>—— humid, <a href="#species_I_3_2_3">i. 3. 2. 3</a>.</p> + <p>—— ideal, <a href="#species_IV_3_2_1">iv. 3. 2. 1</a>.</p> + <p>—— from conception, <a href="#species_IV_3_2_2">iv. 3. 2. 2</a>.</p> + <p>Navel-string of infants, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>—— cut too soon, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>Neck thickens at puberty, <a href="#species_IV_1_2_7">iv. 1. 2. 7</a>.</p> + <p>Neck-swing, <a href="#species_I_2_2_16">i. 2. 2. 16</a>.</p> + <p>Nephritis, <a href="#species_II_1_2_14">ii. 1. 2. 14</a>. <a href="#species_I_1_3_9">i. 1. 3. 9</a>. <a href="#species_III_2_1_14">iii. 2. 1. 14</a>.</p> + <p>Nerves decussate, <a href="#species_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>Nictitation irritative, <a href="#species_I_1_4_1">i. 1. 4. 1</a>.</p> + <p>—— sensitive, <a href="#species_II_1_1_8">ii. 1. 1. 8</a>.</p> + <p>—— involuntary, <a href="#species_IV_1_3_2">iv. 1. 3. 2</a>.</p> + <p>Night-mare, <a href="#species_III_2_1_13">iii. 2. 1. 13</a>.</p> + <p>Nipples, tension of, <a href="#species_I_1_4_7">i. 1. 4. 7</a>. <span class="correction" title="Original reads `iv. 2. 1. 6.'."><a href="#species_IV_1_2_6">iv. 1. 2. 6</a></span>.</p> + <p>Nostalgia, <a href="#species_III_1_2_6">iii. 1. 2. 6</a>.</p> + <p>Nostrils, dry, <a href="#species_I_1_3_3">i. 1. 3. 3</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>O.</b></p> + </div> + + <div class="stanza"> + <p>Obesitas, <a href="#species_I_2_3_17">i. 2. 3. 17</a>.</p> + <p>Odontitis, <a href="#species_II_1_4_7">ii. 1. 4. 7</a>.</p> + <p>Odontalgia, <a href="#species_I_2_4_12">i. 2. 4. 12</a>.</p> + <p>Œsophagi schirrus, <a href="#species_I_2_3_25">i. 2. 3. 25</a>.</p> + <p>Olfactus acrior, <a href="#species_I_1_5_3">i. 1. 5. 3</a>.</p> + <p>—— imminutus, <a href="#species_I_2_5_7">i. 2. 5. 7</a>.</p> + <p>Oil destroys insects, <a href="#species_I_1_4_14">i. 1. 4. 14</a>.</p> + <p>—— essential of animals, <a href="#species_I_1_2_14">i. 1. 2. 14</a>.</p> + <p>—— why injurious in erysipelas, <a href="#species_II_1_3_2">ii. 1. 3. 2</a>.</p> + <p>Opium in catarrh, <a href="#species_I_2_3_3">i. 2. 3. 3</a>.</p> + <p>—— in diaphragmitis, <a href="#species_II_1_2_6">ii. 1. 2. 6</a>.</p> + <p>Ophthalmy, internal, <a href="#species_II_1_2_2">ii. 1. 2. 2</a>.</p> + <p>—— superficial, <a href="#species_II_1_4_1">ii. 1. 4. 1</a>.</p> + <p>Orci timor, <a href="#species_III_1_2_15">iii. 1. 2. 15</a>.</p> + <p>Oscitatio, <a href="#species_II_1_1_9">ii. 1. 1. 9</a>.</p> + <p>Ossium innutritio, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>Otitis, <a href="#species_II_1_4_8">ii. 1. 4. 8</a>.</p> + <p>Otalgia, <a href="#species_I_2_4_13">i. 2. 4. 13</a>. <a href="#species_IV_2_2_8">iv. 2. 2. 8</a>.</p> + <p>Otopuosis, <a href="#species_II_1_4_8">ii. 1. 4. 8</a>.</p> + <p>Ovary, dropsy of, <a href="#species_I_2_3_15">i. 2. 3. 15</a>.</p> + <p>—— exsection of, <a href="#species_I_2_3_15">i. 2. 3. 15</a>.</p> + <p>Oxygenation of blood, <a href="#species_IV_1_4_6">iv. 1. 4. 6</a>.</p> + <p>Oxygen gas, Suppl. i. <a href="#suppl_IX_3">9. 3</a>.</p> + <p>—— in fevers, Suppl. i. <a href="#suppl_XI_7">11. 7</a>. i. <a href="#suppl_XVI_9">16. 9</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>P.</b></p> + </div> + + <div class="stanza"> + <p>Pain exhausts sensorial power, <a href="#genus_IV_2_2">iv. 2. 2</a>.</p> + <p>—— greater prevents less, <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>—— nervous, <a href="#genus_I_2_4">i. 2. 4</a>.</p> + <p>—— of the little finger, symptom, <a href="#species_IV_2_2_12">iv. 2. 2. 12</a>.</p> + <p>—— of arm in hydrothorax, <a href="#species_IV_2_2_13">iv. 2. 2. 13</a>.</p> + <p>—— of the bile-duct, <a href="#species_IV_2_2_4">iv. 2. 2. 4</a>.</p> + <p>—— of the shoulder, <a href="#species_IV_2_2_9">iv. 2. 2. 9</a>.</p> + <p>—— of the pharynx, <a href="#species_IV_2_2_5">iv. 2. 2. 5</a>.</p> + <p>—— of the testis, <a href="#species_IV_2_2_11">iv. 2. 2. 11</a>.</p> + <p>—— smarting, <a href="#species_I_1_5_10">i. 1. 5. 10</a>.</p> + <p>—— of the side, <a href="#species_I_2_4_14">i. 2. 4. 14</a>. <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— of menstruation, <a href="#species_I_2_1_12">i. 2. 1. 12</a>.</p> + <p>—— use of, <a href="#species_III_1_1_11">iii. 1. 1. 11</a>. <a href="#species_I_1_2_9">i. 1. 2. 9</a>.</p> + <p>—— of the uterus, <a href="#species_I_2_4_17">i. 2. 4. 17</a>.</p> + <p>Paint, white, dangerous, <a href="#species_II_1_4_6">ii. 1. 4. 6</a>.</p> + <p>Palate, defect of, <a href="#species_I_2_2_20">i. 2. 2. 20</a>.</p> + <p>Paleness, <a href="#species_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>—— from fear, <a href="#species_IV_3_1_5">iv. 3. 1. 5</a>.</p> + <p>—— from sickness, <a href="#species_IV_2_1_4">iv. 2. 1. 4</a>.</p> + <p>—— of urine after dinner, <a href="#species_IV_2_1_2">iv. 2. 1. 2</a>.</p> + <p>—— from cold skin, <a href="#species_IV_2_1_1">iv. 2. 1. 1</a>.</p> + <p>Palpitation of heart, <a href="#species_I_3_3_2">i. 3. 3. 2</a>. <a href="#species_I_2_1_10">i. 2. 1. 10</a>.</p> + <p>—— from fear, <a href="#species_IV_3_1_6">iv. 3. 1. 6</a>.</p> + <p>—— relieved by arsenic, <a href="#species_IV_2_1_18">iv. 2. 1. 18</a>.</p> + <p>Pancreas, torpor of, <a href="#species_I_2_2_7">i. 2. 2. 7</a>.</p> + <p>Pandiculatio, <a href="#species_II_1_1_9">ii. 1. 1. 9</a>.</p> + <p>Panting, <a href="#species_II_1_1_4">ii. 1. 1. 4</a>. <a href="#species_I_3_3_3">i. 3. 3. 3</a>.</p> + <p>Paracentesis at the navel, <a href="#species_I_2_3_13">i. 2. 3. 13</a>.</p> + <p>Paralysis, <a href="#species_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>—— of the bladder, <a href="#species_III_2_1_6">iii. 2. 1. 6</a>.</p> + <p>—— of the rectum, <a href="#species_III_2_1_7">iii. 2. 1. 7</a>.</p> + <p>—— of the hands, <a href="#species_III_2_1_4">iii. 2. 1. 4</a>.</p> + <p>—— cure of, <a href="#species_III_2_1_4">iii. 2. 1. 4</a>.</p> + <p>Paraplegia, <a href="#species_III_2_1_11">iii. 2. 1. 11</a>.</p> + <p>Paresis inirritativa, <a href="#species_I_2_1_2">i. 2. 1. 2</a>. Suppl. i. <a href="#suppl_VIII_10">8. 10</a>.</p> + <p>—— sensitiva, <span class="correction" title="Original reads `i. 2. 1. 3.'."><a href="#species_II_2_1_3">ii. 2. 1. 3</a>.</span></p> + <p>—— voluntaria, <a href="#species_III_2_1_8">iii. 2. 1. 8</a>.</p> + <p>Paronychia internal, <a href="#species_II_1_2_19">ii. 1. 2. 19</a>.</p> + <p>—— superficial, <a href="#species_II_1_4_5">ii. 1. 4. 5</a>.</p> + <p>Parturition, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>. <a href="#species_II_1_2_16">ii. 1. 2. 16</a>.</p> + <p>—— more fatal in high life, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>—— with convulsion, <a href="#genus_III_1_1">iii. 1. 1</a>. <a href="#species_III_1_1_7">iii. 1. 1. 7</a>.</p> + <p>Parotitis, <a href="#species_II_1_3_4">ii. 1. 3. 4</a>.</p> + <p>Passions depressing and exciting, <a href="#species_IV_3_1_5">iv. 3. 1. 5</a>.</p> + <p>Paupertatis timor, <a href="#species_III_1_2_13">iii. 1. 2. 13</a>.</p> + <p>Pediculus, <a href="#species_I_1_4_15">i. 1. 4. 15</a>.</p> + <p>Pemphigus, <a href="#species_II_1_3_14">ii. 1. 3. 14</a>.</p> + <p>Penetration of animal bodies, <a href="#species_IV_1_4_7">iv. 1. 4. 7</a>.</p> + <p>Peripneumony, <a href="#species_II_1_2_4">ii. 1. 2. 4</a>.</p> + <p>—— tracheal, <a href="#species_II_1_2_4">ii. 1. 2. 4</a>.</p> + <p>—— superficial, <a href="#species_II_1_3_7">ii. 1. 3. 7</a>.</p> + <p>—— inirritated, <a href="#species_II_1_2_4">ii. 1. 2. 4</a>.</p> + <p>Peritonitis, <a href="#species_II_1_2_8">ii. 1. 2. 8</a>.</p> + <p>Perspiration not an excrement, <a href="#species_I_1_2_14">i. 1. 2. 14</a>.</p> + <p>—— greatest in the hot fit, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— fetid, <a href="#species_I_1_2_14">i. 1. 2. 14</a>.</p> + <p>Pertussis, <a href="#species_II_1_3_8">ii. 1. 3. 8</a>.</p> + <p>Pestis, <a href="#species_II_1_3_13">ii. 1. 3. 13</a>.</p> + <p>Petechiæ, <a href="#species_I_2_1_17">i. 2. 1. 17</a>.</p> + <p>—— cure of, Suppl. i. <a href="#suppl_II_7">2. 7</a>.</p> + <p>Pharynx, pain of, <a href="#species_IV_2_2_5">iv. 2. 2. 5</a>.</p> + <p>Phthisis, pulmonary, <a href="#species_II_1_6_7">ii. 1. 6. 7</a>.</p> + <p>Pimples on the face, <a href="#species_II_1_4_6">ii. 1. 4. 6</a>.</p> + <p>Piles, bleeding, <a href="#species_I_2_1_6">i. 2. 1. 6</a>.</p> + <p>—— white, <a href="#species_I_1_2_12">i. 1. 2. 12</a>.</p> + <p>Placenta, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>. <a href="#species_II_1_2_16">ii. 1. 2. 16</a>.</p> + <p>Plague, <a href="#species_II_1_3_13">ii. 1. 3. 13</a>.</p> + <p>Plasters, why moist, <a href="#species_I_1_3_6">i. 1. 3. 6</a>.</p> + <p>Pleurisy, <a href="#species_II_1_2_5">ii. 1. 2. 5</a>.</p> + <p>Pleurodyne chronica, <a href="#species_I_2_4_14">i. 2. 4. 14</a>.</p> + <p>—— rheumatica, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>Podagra, <a href="#species_IV_1_2_15">iv. 1. 2. 15</a>. <a href="#species_IV_2_4_9">iv. 2. 4. 9</a>.</p> + <p>Polypus of the lungs, <a href="#species_I_1_3_4">i. 1. 3. 4</a>.</p> + <p>—— of the nose from worms, <a href="#species_IV_1_2_9">iv. 1. 2. 9</a>.</p> + <p>Pregnancy, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>Priapismus, <a href="#species_I_1_4_6">i. 1. 4. 6</a>. <a href="#species_II_1_7_9">ii. 1. 7. 9</a>.</p> + <p>Proctalgia, <a href="#species_I_2_4_18">i. 2. 4. 18</a>.</p> + <p>Prolapsus ani, <a href="#species_I_1_4_9">i. 1. 4. 9</a>.</p> + <p>Pruritus, <a href="#species_I_1_5_9">i. 1. 5. 9</a>.</p> + <p>—— narium a vermibus, <a href="#species_IV_2_2_6">iv. 2. 2. 6</a>.</p> + <p>Psora, <a href="#species_II_1_5_6">ii. 1. 5. 6</a>.</p> + <p>—— imaginaria, <a href="#species_III_1_2_22">iii. 1. 2. 22</a>.</p> + <p>Ptyalismus. See Salivatio.</p> + <p>Pubis and throat sympathize, <span class="correction" title="Original reads `iv. 2. 1. 7.'."><a href="#species_IV_1_2_7">iv. 1. 2. 7</a></span>.</p> + <p>Puerperal fever, <a href="#species_I_2_4_9">i. 2. 4. 9</a>. <a href="#species_II_1_6_16">ii. 1. 6. 16</a>. Add. <a href="#add_VIII">8</a>.</p> + <p>—— insanity, <a href="#species_III_1_2_1">iii. 1. 2. 1</a>.</p> + <p>Pulchritudinis desiderium, <a href="#species_III_1_2_12">iii. 1. 2. 12</a>.</p> + <p>Pullulation of trees, <a href="#species_IV_1_4_3">iv. 1. 4. 3</a>.</p> + <p>Pulse full, why, <a href="#species_I_1_1_1">i. 1. 1. 1</a>.</p> + <p>—— strong, how determined, <a href="#species_I_1_1_1">i. 1. 1. 1</a>. Suppl. i. <a href="#suppl_XVI_10">16. 10</a>.</p> + <p>—— soft in vomiting, <a href="#species_IV_2_1_17">iv. 2. 1. 17</a>.</p> + <p>—— intermittent, <a href="#species_IV_2_1_18">iv. 2. 1. 18</a>.</p> + <p>—— quick from paucity of blood, Suppl. i. <a href="#suppl_XI_4">11. 4</a>.</p> + <p>—— quick sometimes in sleep, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>—— quick in weak people, <a href="#genus_III_2_1">iii. 2. 1</a>. Sup. i. <a href="#suppl_XI_4">11. 4</a>.</p> + <p>—— slower by swinging, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>—— quick in chlorosis, <a href="#species_I_2_3_10">i. 2. 3. 10</a>.</p> + <p>Punctæ mucosæ vultûs, <a href="#species_I_2_2_9">i. 2. 2. 9</a>.</p> + <p>Purging. See Diarrhœa.</p> + <p>Pus diminished, <a href="#species_I_2_2_3">i. 2. 2. 3</a>.</p> + <p>—— distinguished from mucus, <a href="#species_II_1_6_6">ii. 1. 6. 6</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>R.</b></p> + </div> + + <div class="stanza"> + <p>Rabies, <a href="#species_III_1_2_18">iii. 1. 2. 18</a>.</p> + <p>Rachitis, <a href="#species_I_2_2_15">i. 2. 2. 15</a>.</p> + <p>Raucedo catarrhal, <a href="#species_II_1_3_5">ii. 1. 3. 5</a>.</p> + <p>—— paralytic, <a href="#species_III_2_1_5">iii. 2. 1. 5</a>.</p> + <p>Recollection, loss of, <a href="#species_III_2_2_1">iii. 2. 2. 1</a>.</p> + <p>Recti paralysis, <a href="#species_III_2_1_7">iii. 2. 1. 7</a>.</p> + <p>—— schirrus, <a href="#species_I_2_3_23">i. 2. 3. 23</a>.</p> + <p>Red-gum, <a href="#species_II_1_3_12">ii. 1. 3. 12</a>. <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>Redness from heat, <a href="#species_II_1_7_7">ii. 1. 7. 7</a>.</p> + <p>—— of joy, <a href="#species_II_1_7_8">ii. 1. 7. 8</a>.</p> + <p>—— after dinner, <a href="#species_IV_1_1_1">iv. 1. 1. 1</a>.</p> + <p>—— of anger, <a href="#species_IV_2_3_5">iv. 2. 3. 5</a>.</p> + <p>—— of guilt, <a href="#species_IV_2_3_6">iv. 2. 3. 6</a>.</p> + <p>—— of modesty, <a href="#species_IV_2_3_6">iv. 2. 3. 6</a>.</p> + <p>Respiration, <a href="#species_II_1_1_2">ii. 1. 1. 2</a>.</p> + <p>—— quick in exercise, <span class="correction" title="Original reads `ii. 1. 1. 3.'."><a href="#species_II_1_1_4">ii. 1. 1. 4</a></span>.</p> + <p>—— in softness of bones, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>Restlessness, <a href="#species_III_1_1_1">iii. 1. 1. 1</a>.</p> + <p>Reverie, <a href="#species_III_1_2_2">iii. 1. 2. 2</a>. <a href="#species_IV_2_4_2">iv. 2. 4. 2</a>.</p> + <p>Rhaphania, <a href="#species_III_1_1_6">iii. 1. 1. 6</a>.</p> + <p>Rheumatism, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— of the joints, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— of the bowels, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— of the pleura, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— suppurating, <a href="#species_IV_1_2_16">iv. 1. 2. 16</a>.</p> + <p>—— from sympathy, <a href="#species_IV_2_2_13">iv. 2. 2. 13</a>.</p> + <p>—— chronical, <a href="#species_I_1_3_12">i. 1. 3. 12</a>. <a href="#species_III_1_1_6">iii. 1. 1. 6</a>.</p> + <p>Rickets, <a href="#species_I_2_2_15">i. 2. 2. 15</a>.</p> + <p>Ring-worm, <a href="#species_II_1_5_10">ii. 1. 5. 10</a>.</p> + <p>Risus, <a href="#species_III_1_1_4">iii. 1. 1. 4</a>. <a href="#species_IV_2_3_3">iv. 2. 3. 3</a>.</p> + <p>—— sardonicus, <a href="#species_IV_1_2_4">iv. 1. 2. 4</a>.</p> + <p>—— invitus, <a href="#species_IV_1_3_3">iv. 1. 3. 3</a>.</p> + <p>Rubeola, <a href="#species_II_1_3_10">ii. 1. 3. 10</a>.</p> + <p>Rubor a calore, <a href="#species_II_1_7_7">ii. 1. 7. 7</a>.</p> + <p>—— jucunditatis, <a href="#species_II_1_7_8">ii. 1. 7. 8</a>.</p> + <p>—— pransorum, <a href="#species_IV_1_1_1">iv. 1. 1. 1</a>.</p> + <p>Ructus, <a href="#species_I_3_1_2">i. 3. 1. 2</a>.</p> + <p>Ruminatio, <a href="#species_I_3_1_1">i. 3. 1. 1</a>. <a href="#species_IV_3_3_1">iv. 3. 3. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>S.</b></p> + </div> + + <div class="stanza"> + <p>Sailing in phthisis, <a href="#species_II_1_6_7">ii. 1. 6. 7</a>.</p> + <p>Salivation warm, <a href="#species_I_1_2_6">i. 1. 2. 6</a>.</p> + <p>—— lymphatic, <a href="#species_I_3_2_2">i. 3. 2. 2</a>.</p> + <p>—— sympathetic, <a href="#species_IV_1_2_5">iv. 1. 2. 5</a>.</p> + <p>—— in low fevers, <a href="#species_I_1_2_6">i. 1. 2. 6</a>.</p> + <p>Salt of urine, <a href="#species_I_1_2_4">i. 1. 2. 4</a>. <a href="#species_I_1_3_9">i. 1. 3. 9</a>.</p> + <p>Satyriasis, <a href="#species_III_1_2_16">iii. 1. 2. 16</a>.</p> + <p>Scabies. See Psora.</p> + <p>Scarlatina, <a href="#species_II_1_3_11">ii. 1. 3. 11</a>.</p> + <p>Scarlet fever, <a href="#species_II_1_3_11">ii. 1. 3. 11</a>.</p> + <p>Scald-head, <a href="#species_II_1_5_11">ii. 1. 5. 11</a>.</p> + <p>Sciatica frigida, <a href="#species_I_2_4_15">i. 2. 4. 15</a>.</p> + <p>Schirrus, <a href="#species_I_2_3_22">i. 2. 3. 22</a>.</p> + <p>—— suppurans, <a href="#species_II_1_4_15">ii. 1. 4. 15</a>.</p> + <p>—— of the rectum, <a href="#species_I_2_3_23">i. 2. 3. 23</a>.</p> + <p>—— of the urethra, <a href="#species_I_2_3_24">i. 2. 3. 24</a>.</p> + <p>—— of the œsophagus, <a href="#species_I_2_3_25">i. 2. 3. 25</a>.</p> + <p>Scorbutus, <a href="#species_I_2_1_15">i. 2. 1. 15</a>.</p> + <p>—— suppurans, <a href="#species_II_1_4_14">ii. 1. 4. 14</a>.</p> + <p>Scrophula, <a href="#species_I_2_3_21">i. 2. 3. 21</a>.</p> + <p>—— suppurating, <a href="#species_II_1_4_14">ii. 1. 4. 14</a>.</p> + <p>—— produces insanity, <a href="#genus_III_1_2">iii. 1. 2</a>.</p> + <p>Scurvy, <a href="#species_I_2_1_15">i. 2. 1. 15</a>.</p> + <p>—— suppurating, <a href="#species_II_1_4_14">ii. 1. 4. 14</a>.</p> + <p>Scurf of the head, <a href="#species_I_1_3_6">i. 1. 3. 6</a>.</p> + <p>—— of the tongue, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>Sea air in phthisis, <a href="#species_II_1_6_7">ii. 1. 6. 7</a>.</p> + <p>Seat, descent of, <a href="#species_I_1_4_9">i. 1. 4. 9</a>.</p> + <p>Seed, ejection of, <a href="#species_II_1_1_11">ii. 1. 1. 11</a>.</p> + <p>Sea-sickness, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>. Suppl. i. <a href="#suppl_VIII_3">8. 3</a>.</p> + <p>See-saw of old people, <a href="#species_III_2_1_2">iii. 2. 1. 2</a>.</p> + <p>Sensitive association, law of, <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>Sensation inert, Suppl. i. <a href="#suppl_VI_4">6. 4</a>.</p> + <p>Setons, <span class="correction" title="Original reads `ii. 1. 6.'."><a href="#species_II_1_6_6">ii. 1. 6. 6</a></span>.</p> + <p>Shingles, <a href="#species_II_1_5_9">ii. 1. 5. 9</a>.</p> + <p>Shoulder, pain of, <a href="#species_IV_2_2_9">iv. 2. 2. 9</a>.</p> + <p>Shrieking, <a href="#species_III_1_1_3">iii. 1. 1. 3</a>.</p> + <p>Sickness, <a href="#species_I_2_4_4">i. 2. 4. 4</a>. <a href="#species_I_3_2_3">i. 3. 2. 3</a>.</p> + <p>—— cured by a blister, <a href="#species_IV_1_1_3">iv. 1. 1. 3</a>.</p> + <p>—— by warm skin, <span class="correction" title="Original reads `iv. 1. 2. 2.'."><a href="#species_IV_1_1_2">iv. 1. 1. 2</a></span>. Suppl. i. <a href="#suppl_XI_4">11. 4</a>.</p> + <p>—— by whirling, <a href="#species_I_1_1_4">i. 1. 1. 4</a>.</p> + <p>—— by swinging, Suppl. i. <a href="#suppl_XV_3">15. 3</a>.</p> + <p>—— by hydrocarbonate gas, Suppl. i. <a href="#suppl_XV_3">15. 3</a>.</p> + <p>—— See Nausea.</p> + <p>Sight acuter, <a href="#species_I_1_5_1">i. 1. 5. 1</a>.</p> + <p>—— impaired, <a href="#species_I_2_5_2">i. 2. 5. 2</a>.</p> + <p>Side, chronical pain of, <a href="#species_I_2_4_14">i. 2. 4. 14</a>.</p> + <p>Sighing and sobbing, <a href="#species_III_1_2_10">iii. 1. 2. 10</a>.</p> + <p>Sitis calida, <a href="#species_I_2_4_1">i. 2. 4. 1</a>.</p> + <p>—— frigida, <a href="#species_I_2_4_1">i. 2. 4. 1</a>.</p> + <p>—— defectus, <a href="#species_II_2_2_2">ii. 2. 2. 2</a>.</p> + <p>Skin pale in old age, <a href="#species_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>—— from cold, <a href="#species_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>—— dry, <a href="#species_I_1_3_6">i. 1. 3. 6</a>.</p> + <p>—— yellowish, <a href="#species_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>—— bluish and shrunk, <a href="#species_I_2_1_1">i. 2. 1. 1</a>.</p> + <p>—— reddish, <a href="#species_II_1_3_1">ii. 1. 3. 1</a>.</p> + <p>—— cold after meals, <a href="#species_IV_2_1_1">iv. 2. 1. 1</a>.</p> + <p>Sleep, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>—— interrupted, <a href="#species_I_2_1_3">i. 2. 1. 3</a>.</p> + <p>—— periods in, <a href="#species_IV_2_4_1">iv. 2. 4. 1</a>.</p> + <p>—— with quick pulse, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>—— disturbed by digestion, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>Sleep-walkers, <a href="#species_III_1_1_9">iii. 1. 1. 9</a>.</p> + <p>Small-pox, <a href="#species_II_1_3_9">ii. 1. 3. 9</a>.</p> + <p>—— why distinct and confluent, Sup. i. <a href="#suppl_XV_2">15. 2</a>.</p> + <p>—— secondary fever of, <a href="#species_II_1_6_12">ii. 1. 6. 12</a>.</p> + <p>—— eruption of, <a href="#species_IV_1_2_12">iv. 1. 2. 12</a>.</p> + <p>Smarting, <a href="#species_I_1_5_10">i. 1. 5. 10</a>.</p> + <p>Smell acuter, <a href="#species_I_1_5_3">i. 1. 5. 3</a>.</p> + <p>—— impaired, <a href="#species_I_2_5_7">i. 2. 5. 7</a>.</p> + <p>Sneezing, <a href="#species_II_1_1_3">ii. 1. 1. 3</a>. <a href="#species_IV_1_2_2">iv. 1. 2. 2</a>.</p> + <p>Snow in scrophula, <a href="#species_I_2_3_21">i. 2. 3. 21</a>.</p> + <p>—— in paralysis, <a href="#species_III_2_1_4">iii. 2. 1. 4</a>.</p> + <p>Snuff in hydrocephalus, <a href="#species_I_2_3_12">i. 2. 3. 12</a>.</p> + <p>Somnambulism, <a href="#species_III_1_1_9">iii. 1. 1. 9</a>.</p> + <p>Somnium, <a href="#species_II_1_7_4">ii. 1. 7. 4</a>.</p> + <p>Somnus, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>. <a href="#species_IV_2_4_1">iv. 2. 4. 1</a>.</p> + <p>—— interruptus, <a href="#species_I_2_1_3">i. 2. 1. 3</a>.</p> + <p>Softness of bones, <a href="#species_I_2_2_14">i. 2. 2. 14</a>.</p> + <p>Spasm of diaphragm, <a href="#species_III_1_1_11">iii. 1. 1. 11</a>.</p> + <p>—— of the heart, <a href="#species_III_1_1_11">iii. 1. 1. 11</a>.</p> + <p>Spine distorted, <a href="#species_I_2_2_16">i. 2. 2. 16</a>.</p> + <p>—— protuberant, <a href="#species_I_2_2_18">i. 2. 2. 18</a>.</p> + <p>—— bifid, <a href="#species_I_2_2_19">i. 2. 2. 19</a>.</p> + <p>Spitting blood, <a href="#species_I_1_1_4">i. 1. 1. 4</a>. <a href="#species_I_2_1_9">i. 2. 1. 9</a>.</p> + <p>Spleen swelled, <a href="#species_I_2_3_18">i. 2. 3. 18</a>. Suppl. i. <a href="#suppl_XVI_6">16. 6</a>.</p> + <p>Splenitis, <span class="correction" title="Original reads `ii. 2. 2. 13.'."><a href="#species_II_1_2_13">ii. 1. 2. 13</a></span>.</p> + <p>Spots on the face, <a href="#species_I_2_2_9">i. 2. 2. 9</a>.</p> + <p>Spots seen on bed-clothes, <a href="#species_I_2_5_3">i. 2. 5. 3</a>.</p> + <p>Squinting, <a href="#species_I_2_5_4">i. 2. 5. 4</a>.</p> + <p>—— in hydrocephalus, <a href="#species_I_2_5_4">i. 2. 5. 4</a>.</p> + <p>Stammering, <a href="#species_IV_2_3_1">iv. 2. 3. 1</a>.</p> + <p>Stays tight, injurious, <a href="#species_II_1_1_12">ii. 1. 1. 12</a>.</p> + <p>Sterility, <a href="#species_II_2_2_4">ii. 2. 2. 4</a>.</p> + <p>Sternutatio, <a href="#species_II_1_1_3">ii. 1. 1. 3</a>. <a href="#species_IV_1_2_2">iv. 1. 2. 2</a>.</p> + <p>—— a lumine, <span class="correction" title="Original reads `iv. 2. 1. 2.'."><a href="#species_IV_1_2_2">iv. 1. 2. 2</a></span>.</p> + <p>Stimulants, their twofold effect, <a href="#species_II_1_2_6">ii. 1. 2. 6</a>.</p> + <p>Stocks for children dangerous, <span class="correction" title="Original reads `ii. 2. 2. 17.'."><a href="#species_I_2_2_17">i. 2. 2. 17</a></span>.</p> + <p>Stomach, torpor of, Suppl. i. <a href="#suppl_X">10</a>. i. <a href="#suppl_XVI_6">16. 6</a>.</p> + <p>—— inflammation of, <a href="#species_II_1_2_10">ii. 1. 2. 10</a>. <a href="#species_II_1_3_19">ii. 1. 3. 19</a>.</p> + <p>—— its association, <a href="#genus_IV_1_1">iv. 1. 1</a>.</p> + <p>—— cause of fever, Suppl. i. <a href="#suppl_VIII_8">8. 8</a>.</p> + <p>Stones in the bladder, See Calculi.</p> + <p>—— in horses, <a href="#species_I_1_3_5">i. 1. 3. 5</a>. <a href="#species_I_1_3_10">i. 1. 3. 10</a>.</p> + <p>Strabismus, <a href="#species_I_2_5_4">i. 2. 5. 4</a>.</p> + <p>Strangury, <a href="#species_II_1_1_11">ii. 1. 1. 11</a>. <a href="#species_IV_2_2_2">iv. 2. 2. 2</a>.</p> + <p>—— convulsive, <a href="#species_IV_2_2_3">iv. 2. 2. 3</a>.</p> + <p>Strength and debility metaphors, <a href="#genus_I_2_1">i. 2. 1</a>.</p> + <p>Stridor dentium, <a href="#species_III_1_1_12">iii. 1. 1. 12</a>.</p> + <p>Studium inane, <a href="#species_III_1_2_2">iii. 1. 2. 2</a>. <a href="#species_IV_2_4_2">iv. 2. 4. 2</a>.</p> + <p>Stultitia inirritabilis, <a href="#species_I_2_5_1">i. 2. 5. 1</a>.</p> + <p>—— insensibilis, <a href="#species_II_2_1_1">ii. 2. 1. 1</a>.</p> + <p>—— voluntaria, <a href="#species_III_2_2_2">iii. 2. 2. 2</a>.</p> + <p>Stupor, <a href="#species_I_2_5_10">i. 2. 5. 10</a>. Suppl. i. <a href="#suppl_XV">15</a>.</p> + <p>Subsultus tendinum, <a href="#species_III_1_1_5">iii. 1. 1. 5</a>.</p> + <p>Sudor. See Sweats.</p> + <p><span class="correction" title="No section number, does not seem to exist.">Suggestion, slow,</span></p> + <p>Surprise, <span class="correction" title="Original reads `i. 1. 5. 12.'."><a href="#species_I_1_5_11">i. 1. 5. 11</a></span>.</p> + <p>Sweats, warm, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— cold, <a href="#species_I_2_3_2">i. 2. 3. 2</a>.</p> + <p>—— lymphatic, <a href="#species_I_3_2_7">i. 3. 2. 7</a>.</p> + <p>—— asthmatic, <a href="#species_I_3_2_8">i. 3. 2. 8</a>. <a href="#species_IV_3_1_2">iv. 3. 1. 2</a>.</p> + <p>—— covered in bed, <a href="#species_IV_1_1_2">iv. 1. 1. 2</a>. Suppl. i. <a href="#suppl_XI_6">11. 6</a></p> + <p>—— in fever fits, why, <a href="#species_I_1_2_5">i. 1. 2. 5</a>.</p> + <p>—— from exercise, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— from heat, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>—— from medicines, <a href="#species_I_1_2_3">i. 1. 2. 3</a>.</p> + <p>Sweaty hands cured, <a href="#species_I_3_2_7">i. 3. 2. 7</a>.</p> + <p>Swinging, <a href="#species_II_1_6_7">ii. 1. 6. 7</a>.</p> + <p>—— makes the pulse slower, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>Swing centrifugal, Suppl. i. <a href="#suppl_XV">15</a> and <a href="#suppl_III">3</a>.</p> + <p>Sympathy direct and reverse, <a href="#head_IV_1_1_F">iv. 1. 1. f.</a></p> + <p>—— with others, <a href="#species_III_1_2_24">iii. 1. 2. 24</a>.</p> + <p>—— of various parts, Suppl. i. <a href="#suppl_XI_5">11. 5</a>.</p> + <p>—— reverse of lacteals and lymphatics, Suppl. i. <a href="#suppl_XI_5">11. 5</a></p> + <p>—— of capillaries, Suppl. i. <a href="#suppl_XI_5">11. 5</a>.</p> + <p>—— direct of stomach and heart, Sup. i. <a href="#suppl_XI_5">11. 5</a>.</p> + <p>—— of throat and pubis, <span class="correction" title="Original reads `iv. 2. 1. 7.'."><a href="#species_IV_1_2_7">iv. 1. 2. 7</a></span>.</p> + <p>Syncope, <a href="#species_I_2_1_4">i. 2. 1. 4</a>.</p> + <p>—— epileptic, <a href="#species_III_2_1_15">iii. 2. 1. 15</a>.</p> + <p>Syngultus, <a href="#species_II_1_1_6">ii. 1. 1. 6</a>.</p> + <p>—— nephriticus, <a href="#species_IV_1_1_7">iv. 1. 1. 7</a>.</p> + <p>Syphilis, <a href="#species_II_1_5_2">ii. 1. 5. 2</a>.</p> + <p>—— imaginaria, <a href="#species_III_1_2_21">iii. 1. 2. 21</a>.</p> + <p>Syphon capillary of cloth, <a href="#species_II_1_3_1">ii. 1. 3. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>T.</b></p> + </div> + + <div class="stanza"> + <p>Tactus acrior, <a href="#species_I_1_5_5">i. 1. 5. 5</a>.</p> + <p>—— imminutus, <a href="#species_I_2_5_6">i. 2. 5. 6</a>.</p> + <p>Tape-worm, <a href="#species_I_1_4_11">i. 1. 4. 11</a>.</p> + <p>Tapping at the navel, <a href="#species_I_2_3_13">i. 2. 3. 13</a>.</p> + <p>Taste. See Gustus.</p> + <p>—— bitter, not from bile, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>Tædium vitæ, <a href="#species_II_2_1_2">ii. 2. 1. 2</a>.</p> + <p>Tænia, <a href="#species_I_1_4_11">i. 1. 4. 11</a>.</p> + <p>Tears sympathetic, <a href="#species_IV_1_2_1">iv. 1. 2. 1</a>. <span class="correction" title="Original reads `iii. 1. 1. 10.'."><a href="#species_III_1_2_10">iii. 1. 2. 10</a></span>.</p> + <p>Teeth, to preserve, <a href="#species_I_1_4_5">i. 1. 4. 5</a>.</p> + <p>—— fall out whole, <a href="#species_II_1_4_7">ii. 1. 4. 7</a>.</p> + <p>Tenesmus, <a href="#species_II_1_1_10">ii. 1. 1. 10</a>.</p> + <p>—— calculosus, <a href="#species_IV_1_2_8">iv. 1. 2. 8</a>.</p> + <p>Testium dolor nephriticus, <a href="#species_IV_2_2_11">iv. 2. 2. 11</a>.</p> + <p>—— tumor in gonorrhœa, <a href="#species_IV_1_2_18">iv. 1. 2. 18</a>.</p> + <p>—— tumor in parotitide, <a href="#species_IV_1_2_19">iv. 1. 2. 19</a>.</p> + <p>Tetanus trismus, <a href="#species_III_1_1_13">iii. 1. 1. 13</a>.</p> + <p>—— doloroficus, <a href="#species_III_1_1_14">iii. 1. 1. 14</a>.</p> + <p>Thirst. See Sitis and Adipsia.</p> + <p>Thread-worm, <a href="#species_I_1_4_12">i. 1. 4. 12</a>.</p> + <p>Throat swelled, <a href="#species_I_2_3_20">i. 2. 3. 20</a>.</p> + <p>—— thickens at puberty, <a href="#species_IV_2_1_7">iv. 2. 1. 7</a>.</p> + <p>—— grown up, <a href="#species_I_2_3_25">i. 2. 3. 25</a>.</p> + <p>Thrush, <a href="#species_II_1_3_17">ii. 1. 3. 17</a>.</p> + <p>Tickling, <a href="#species_I_1_5_8">i. 1. 5. 8</a>.</p> + <p>Timor orci, <a href="#species_III_1_2_15">iii. 1. 2. 15</a>.</p> + <p>—— lethi, <a href="#species_III_1_2_14">iii. 1. 2. 14</a>.</p> + <p>—— paupertatis, <a href="#species_III_1_2_13">iii. 1. 2. 13</a>.</p> + <p>Tinea, <a href="#species_II_1_5_11">ii. 1. 5. 11</a>.</p> + <p>Tinnitus aurium, <span class="correction" title="Original reads `iv. 1. 1. 15.'."><a href="#species_IV_2_1_15">iv. 2. 1. 15</a></span>.</p> + <p>Titillatio, <a href="#species_I_1_5_8">i. 1. 5. 8</a>.</p> + <p>Titubatio linguæ, <a href="#species_IV_2_3_1">iv. 2. 3. 1</a>.</p> + <p>Tobacco, smoke of in piles, <a href="#species_I_2_1_6">i. 2. 1. 6</a>.</p> + <p>Tongue dry, <a href="#species_I_1_3_1">i. 1. 3. 1</a>. Suppl. i. <a href="#suppl_II">2</a>.</p> + <p>—— coloured mucus, <a href="#species_I_1_3_1">i. 1. 3. 1</a>.</p> + <p>Tonsillitis, <a href="#species_II_1_3_3">ii. 1. 3. 3</a>.</p> + <p>Tonsils swelled from bad teeth, <a href="#species_I_2_3_21">i. 2. 3. 21</a>. <a href="#species_II_1_3_3">ii. 1. 3. 3</a>.</p> + <p>Torpor of the liver, <span class="correction" title="Original reads `i. 1. 2. 6.'."><a href="#species_I_2_2_6">i. 2. 2. 6</a></span>.</p> + <p>—— of the pancreas, <a href="#species_I_2_2_7">i. 2. 2. 7</a>.</p> + <p>—— of the lungs, Suppl. 1. <a href="#suppl_IX">9</a>.</p> + <p>—— of the stomach, Suppl. i. <a href="#suppl_X">10</a>.</p> + <p>—— of the heart, Suppl. i. <a href="#suppl_X">10</a>.</p> + <p>Tooth-ach, <a href="#species_I_2_4_12">i. 2. 4. 12</a>. <a href="#species_II_1_4_7">ii. 1. 4. 7</a>.</p> + <p>Tooth-edge, <a href="#species_IV_1_2_3">iv. 1. 2. 3</a>.</p> + <p>Toothing, <a href="#species_I_1_4_5">i. 1. 4. 5</a>.</p> + <p>Tooth-powder, <a href="#species_I_1_4_5">i. 1. 4. 5</a>.</p> + <p>Touch. See Tactus.</p> + <p>—— deceived three ways, <a href="#species_I_2_5_9">i. 2. 5. 9</a>. <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>Transfusion of blood, <a href="#species_I_2_3_25">i. 2. 3. 25</a>. Suppl. i. <a href="#suppl_XIV_4">14. 4</a>.</p> + <p>Translation of matter, <a href="#species_I_3_2_9">i. 3. 2. 9</a>.</p> + <p>—— of milk, <a href="#species_I_3_2_10">i. 3. 2. 10</a>.</p> + <p>—— of urine, <a href="#species_I_3_2_11">i. 3. 2. 11</a>.</p> + <p>Transparency of cornea, <a href="#species_I_1_4_1">i. 1. 4. 1</a>.</p> + <p>—— of crystalline, <a href="#species_I_2_2_13">i. 2. 2. 13</a>.</p> + <p>—— of air before rain, <a href="#species_I_1_4_1">i. 1. 4. 1</a>.</p> + <p>Tremor of old age, <a href="#species_III_2_1_3">iii. 2. 1. 3</a>.</p> + <p>—— of fever, <a href="#species_III_1_1_2">iii. 1. 1. 2</a>.</p> + <p>—— of anger, <span class="correction" title="Original reads `iv. 3. 1. 4.'."><a href="#species_IV_2_3_4">iv. 2. 3. 4</a></span>.</p> + <p>—— of fear, <span class="correction" title="Original reads `iv. 1. 2. 5.'."><a href="#species_IV_3_1_5">iv. 3. 1. 5</a></span>.</p> + <p>Tussis ebriorum, <a href="#species_II_1_1_5">ii. 1. 1. 5</a>.</p> + <p>—— convulsiva, <a href="#species_II_1_3_8">ii. 1. 3. 8</a>.</p> + <p>—— hepatica, <span class="correction" title="Original reads `iv. 1. 2. 7.'."><a href="#species_IV_2_1_8">iv. 2. 1. 8</a></span>.</p> + <p>—— arthritica, <span class="correction" title="Original reads `iv. 1. 2. 8.'."><a href="#species_IV_2_1_9">iv. 2. 1. 9</a></span>.</p> + <p>—— periodica, <span class="correction" title="Original reads `iv. 1. 2. 9.'."><a href="#species_IV_3_4_2">iv. 3. 4. 2</a></span>.</p> + <p>—— a pedibus frigidis, <span class="correction" title="Original reads `iv. 1. 2. 6.'."><a href="#species_IV_2_1_7">iv. 2. 1. 7</a></span>.</p> + <p>Tympany, <a href="#species_I_2_4_9">i. 2. 4. 9</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>U.</b></p> + </div> + + <div class="stanza"> + <p>Ulcers, healing of, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + <p>—— of the cornea, <a href="#species_I_1_3_14">i. 1. 3. 14</a>.</p> + <p>—— from burns, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + <p>—— scrophulous, <a href="#species_II_1_4_13">ii. 1. 4. 13</a>.</p> + <p>—— of the throat, <a href="#species_II_1_3_3">ii. 1. 3. 3</a>. <a href="#species_II_1_3_11">ii. 1. 3. 11</a>.</p> + <p>—— of the legs, <span class="correction" title="Original reads `ii. 1. 4. 13.'."><a href="#species_II_1_4_14">ii. 1. 4. 14</a></span>.</p> + <p>Unguium morsiuncula, <a href="#species_IV_1_3_5">iv. 1. 3. 5</a>.</p> + <p>Urethra, scirrhus of, <a href="#species_I_2_3_24">i. 2. 3. 24</a>.</p> + <p>—— fistula of, <a href="#species_II_1_4_11">ii. 1. 4. 11</a>.</p> + <p>Urine copious, coloured, <a href="#species_I_1_2_4">i. 1. 2. 4</a>.</p> + <p>—— copious, pale, <a href="#species_I_2_3_5">i. 2. 3. 5</a>.</p> + <p>—— diminished, coloured, <a href="#species_I_1_3_7">i. 1. 3. 7</a>.</p> + <p>—— diminished, pale, <a href="#species_I_2_2_5">i. 2. 2. 5</a>.</p> + <p>—— its mucus, salts, Prussian blue, <a href="#species_I_1_2_4">i. 1. 2. 4</a>.</p> + <p>—— why less and coloured in dropsies, <a href="#species_I_1_3_7">i. 1. 3. 7</a>.</p> + <p>—— translation of, <a href="#species_I_3_2_11">i. 3. 2. 11</a>.</p> + <p>—— difficulty of, <a href="#species_III_2_1_6">iii. 2. 1. 6</a>.</p> + <p>—— not secreted, <a href="#species_I_2_2_8">i. 2. 2. 8</a>.</p> + <p>—— pale after meals, <a href="#species_IV_2_1_2">iv. 2. 1. 2</a>.</p> + <p>—— pale from cold skin, <a href="#species_IV_2_1_3">iv. 2. 1. 3</a>.</p> + <p>—— sediment in fevers, Suppl. i. <a href="#suppl_II_3">2. 3</a>.</p> + <p>—— pale in fevers, Suppl. i. <a href="#suppl_II_3">2. 3</a>. and <a href="#suppl_II_5">5</a>.</p> + <p>Urticaria, <a href="#species_II_1_3_16">ii. 1. 3. 16</a>.</p> + <p>Uteri descensus, <a href="#species_I_1_4_8">i. 1. 4. 8</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>V.</b></p> + </div> + + <div class="stanza"> + <p>Vacillatio senilis, <a href="#species_III_2_1_2">iii. 2. 1. 2</a>.</p> + <p>Varicella, <a href="#species_II_1_3_15">ii. 1. 3. 15</a>.</p> + <p>Variola, <a href="#species_II_1_3_9">ii. 1. 3. 9</a>.</p> + <p>—— eruption of, <span class="correction" title="Original reads `iv. 2. 1. 12.'."><a href="#species_IV_1_2_12">iv. 1. 2. 12</a></span>.</p> + <p>Vasorum capil retrogressio, <a href="#species_I_3_3_1">i. 3. 3. 1</a>.</p> + <p>Venereal orgasm, <a href="#species_IV_1_4_4">iv. 1. 4. 4</a>.</p> + <p>—— disease, <a href="#species_II_1_5_2">ii. 1. 5. 2</a>.</p> + <p>—— imaginary, <a href="#species_III_1_2_21">iii. 1. 2. 21</a>.</p> + <p>Ventriculi ægritudo, <a href="#species_I_2_4_4">i. 2. 4. 4</a>.</p> + <p>—— vesicatorio sanata, <a href="#species_IV_1_1_3">iv. 1. 1. 3</a>.</p> + <p>Vermes, <a href="#species_I_1_4_10">i. 1. 4. 10</a>.</p> + <p>Vertigo rotatory, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>—— of sight, <a href="#species_IV_2_1_11">iv. 2. 1. 11</a>.</p> + <p>—— inebriate, <a href="#species_IV_2_1_12">iv. 2. 1. 12</a>.</p> + <p>—— of fever, <a href="#species_IV_2_1_13">iv. 2. 1. 13</a>.</p> + <p>—— from the brain, <a href="#species_IV_2_1_14">iv. 2. 1. 14</a>.</p> + <p>—— of the ears, <a href="#species_IV_2_1_15">iv. 2. 1. 15</a>.</p> + <p>—— of the touch, Addit. <a href="#add_III">iii</a>.</p> + <p>—— of the touch, taste and smell, <a href="#species_IV_2_1_16">iv. 2. 1. 16</a>.</p> + <p>—— with vomiting, <span class="correction" title="Original reads `iv. 2. 3. 2.'."><a href="#species_IV_3_2_3">iv. 3. 2. 3</a></span>.</p> + <p>—— produces slow pulse, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>—— of blind men, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>—— use of mercurials in it, <a href="#species_IV_2_1_11">iv. 2. 1. 11</a>.</p> + <p>—— from ideas, Addit. <a href="#add_III">iii</a>.</p> + <p>Vibices, <a href="#species_I_2_1_16">i. 2. 1. 16</a>. Suppl. i. <a href="#suppl_II_7">2. 7</a>.</p> + <p>Vigilia, <a href="#species_III_1_2_3">iii. 1. 2. 3</a>. <a href="#species_IV_1_3_6">iv. 1. 3. 6</a>.</p> + <p>Vision acuter, <a href="#species_I_1_5_1">i. 1. 5. 1</a>.</p> + <p>—— diminished, <a href="#species_I_2_5_2">i. 2. 5. 2</a>.</p> + <p>—— expends much sensorial power, <a href="#species_I_2_5_3">i. 2. 5. 3</a>.</p> + <p>Vita ovi, <a href="#species_IV_1_4_1">iv. 1. 4. 1</a>.</p> + <p>—— hiemi-dormientium, <a href="#species_IV_1_4_2">iv. 1. 4. 2</a>.</p> + <p>Vitus's dance, <a href="#species_IV_2_3_2">iv. 2. 3. 2</a>.</p> + <p>Volition, three degrees of, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>—— lessens fever, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>. Suppl. i. <a href="#suppl_XI_6">11. 6</a>.</p> + <p>—— produces fever, <a href="#species_III_2_1_12">iii. 2. 1. 12</a>.</p> + <p>—— without deliberation, <a href="#species_IV_1_3_2">iv. 1. 3. 2</a>. Addit. <a href="#add_IV">iv</a>.</p> + <p>Vomica, <a href="#species_II_1_6_3">ii. 1. 6. 3</a>.</p> + <p>Vomitus, <a href="#species_I_3_1_4">i. 3. 1. 4</a>.</p> + <p>Vomendi conamen inane, <a href="#species_I_3_1_8">i. 3. 1. 8</a>.</p> + <p>Vomiting stopped, <a href="#species_IV_1_1_3">iv. 1. 1. 3</a>. <a href="#head_IV_1_1_F">iv. 1. 1. f.</a></p> + <p>—— voluntary, <a href="#species_IV_3_3_2">iv. 3. 3. 2</a>.</p> + <p>—— how acquired, <a href="#species_IV_1_1_2">iv. 1. 1. 2</a>.</p> + <p>—— vertiginous, <a href="#species_IV_3_2_3">iv. 3. 2. 3</a>.</p> + <p>—— from stone in ureter, <a href="#species_IV_3_2_4">iv. 3. 2. 4</a>.</p> + <p>—— from paralytic stroke, <a href="#species_IV_3_2_5">iv. 3. 2. 5</a>.</p> + <p>—— from tickling the throat, <a href="#species_IV_3_2_6">iv. 3. 2. 6</a>.</p> + <p>—— sympathizes with the skin, <a href="#species_IV_3_2_7">iv. 3. 2. 7</a>.</p> + <p>—— in hæmoptoe, <a href="#species_I_1_1_4">i. 1. 1. 4</a>.</p> + <p>—— from defect of association, <a href="#species_IV_2_1_10">iv. 2. 1. 10</a>.</p> + <p>Vulnerum cicatrix, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>W.</b></p> + </div> + + <div class="stanza"> + <p>Watchfulness, <a href="#species_III_1_2_3">iii. 1. 2. 3</a>. <span class="correction" title="Original reads `iv. 3. 2. 5.'."><a href="#species_IV_1_3_6">iv. 1. 3. 6</a></span>.</p> + <p>Water-qualm, <a href="#species_I_3_1_3">i. 3. 1. 3</a>.</p> + <p>Weakness, three kinds of, <a href="#genus_I_2_1">i. 2. 1</a>.</p> + <p>Whirling-chair, Suppl. i. <a href="#suppl_XV_3">15. 3</a>.</p> + <p>Whirling-bed, Suppl. i. <a href="#suppl_XV_7">15. 7</a>.</p> + <p>White swelling of the knee, <a href="#species_I_2_3_19">i. 2. 3. 19</a>.</p> + <p>Winking, <a href="#species_II_1_1_8">ii. 1. 1. 8</a>. <a href="#species_I_1_4_1">i. 1. 4. 1</a>. <span class="correction" title="Original reads `iv. 3. 2. 2.'."><a href="#species_IV_1_3_2">iv. 1. 3. 2</a></span>.</p> + <p>Wine in fevers, <a href="#species_II_1_3_1">ii. 1. 3. 1</a>. <a href="#species_IV_2_1_12">iv. 2. 1. 12</a>.</p> + <p>Winter-sleeping animals, <a href="#species_IV_1_4_2">iv. 1. 4. 2</a>.</p> + <p>Witlow, superficial, <a href="#species_II_1_4_5">ii. 1. 4. 5</a>.</p> + <p>—— internal, <a href="#species_II_1_2_19">ii. 1. 2. 19</a>.</p> + <p>Womb, descent of, <a href="#species_I_1_4_8">i. 1. 4. 8</a>.</p> + <p>—— inflammation of, <span class="correction" title="Original reads `ii. 1. 8. 16.'."><a href="#species_II_1_2_16">ii. 1. 2. 16</a></span>.</p> + <p>Worms, <a href="#species_I_1_4_10">i. 1. 4. 10</a>.</p> + <p>—— mucus counterfeits, <a href="#species_I_1_3_4">i. 1. 3. 4</a>.</p> + <p>—— in sheep, <a href="#species_I_2_3_9">i. 2. 3. 9</a>.</p> + <p>Wounds, healing of, <a href="#species_I_1_3_13">i. 1. 3. 13</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>Y.</b></p> + </div> + + <div class="stanza"> + <p>Yawning, <a href="#species_II_1_1_9">ii. 1. 1. 9</a>.</p> + <p>Yaws, <a href="#species_II_1_5_5">ii. 1. 5. 5</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>Z.</b></p> + </div> + + <div class="stanza"> + <p>Zona ignea, <a href="#species_II_1_5_9">ii. 1. 5. 9</a>. <a href="#species_IV_1_2_11">iv. 1. 2. 11</a>. <a href="#species_II_1_2_14">ii. 1. 2. 14</a>.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h2>ZOONOMIA;</h2> + +<h3>OR,</h3> + +<h3>THE LAWS OF ORGANIC LIFE.</h3> + +<h3>PART III.</h3> + +<p class="cenhead">CONTAINING</p> + +<h3>THE ARTICLES OF THE MATERIA MEDICA,</h3> + +<p class="cenhead">WITH AN ACCOUNT OF THE</p> + +<h3>OPERATION OF MEDICINES.</h3> + + <p><br style="clear:both" /></p> +<hr /> + + <div class="contents"> + <div class="stanza"> + <p>IN VIVUM CORPUS</p> + <p>AGUNT MEDICAMENTA.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>PREFACE.</h3> + + <p><span class="sc">The Materia Medica</span> includes all those + substances, which may contribute to the restoration of health. These may + be conveniently distributed under seven articles according to the + diversity of their operations.</p> + + <p><a href="#art_I">1. <span class="sc">Nutrientia</span></a>, or those + things which preserve in their natural state the due exertions of all the + irritative motions.</p> + + <p><a href="#art_II">2. <span class="sc">Incitantia</span></a>, or those + things which increase the exertions of all the irritative motions.</p> + + <p><a href="#art_III">3. <span class="sc">Secernentia</span></a>, or + those things which increase the irritative motions, which constitute + secretion.</p> + + <p><a href="#art_IV">4. <span class="sc">Sorbentia</span></a>, or those + things which increase the irritative motions, which constitute + absorption.</p> + + <p><a href="#art_V">5. <span class="sc">Invertentia</span></a>, or those + things which invert the natural order of the successive irritative + motions.</p> + + <p><a href="#art_VI">6. <span class="sc">Revertentia</span></a>, or those + things which restore the natural order of the inverted irritative + motions.</p> + + <p><a href="#art_VII">7. <span class="sc">Torpentia</span></a>, those + things which diminish the exertions of all the irritative motions.</p> + + <p>It is necessary to apprize the reader, that in the following account + of the virtues of Medicines their usual doses are always supposed to be + exhibited; and the patient to be exposed to the degree of exterior heat, + which he has been accustomed to, (where the contrary is not mentioned), + as any variation of either of these circumstances varies their + effects.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3>ARTICLES</h3> + +<p class="cenhead">OF THE</p> + +<h2>MATERIA MEDICA.</h2> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3><span class="sc">Art.</span> <a name="art_I">I</a>.</h3> + +<h3>NUTRIENTIA.</h3> + + <p><a name="art_I_1">I</a>. <a name="art_I_1_1">1</a>. Those things, + which preserve in their natural state the due exertions of all the + irritative motions, are termed nutrientia; they produce the growth, and + restore the waste, of the system. These consist of a variety of mild + vegetable and animal substances, water, and air.</p> + + <p><a name="art_I_1_2">2</a>. Where stronger stimuli have been long used, + they become necessary for this purpose, as mustard, spice, salt, beer, + wine, vinegar, alcohol, opium. Which however, as they are unnatural + stimuli, and difficult to manage in respect to quantity, are liable to + shorten the span of human life, sooner rendering the system incapable of + being stimulated into action by the nutrientia. See Sect XXXVII. 4. On + the same account life is shorter in warmer climates than in more + temperate ones.</p> + +<p class="cenhead"><a name="art_I_2">II</a>. <span class="sc">Observations on the Nutrientia.</span></p> + + <p><a name="art_I_2_1">I</a>. <a name="art_I_2_1_1">1</a>. The flesh of + animals contains more nourishment, and stimulates our absorbent and + secerning vessels more powerfully, than the vegetable productions, which + we use as food; for the carnivorous animals can fast longer without + injury than the graminivorous; and we feel ourselves warmer and stronger + after a meal of flesh than of grain. Hence in diseases attended with cold + extremities and general debility this kind of diet is preferred; as in + rickets, dropsy, scrophula, and in hysteric and hypochondriac cases, and + to prevent the returns of agues. Might not flesh in small quantities + bruised to a pulp be more advantageously used in fevers attended with + debility than vegetable diet?</p> + + <p>That flesh, which is of the darkest colour, generally contains more + nourishment, and stimulates our vessels more powerfully, than the white + kinds. The flesh of the carnivorous and piscivorous animals is so + stimulating, that it seldom enters into the food of European nations, + except the swine, the Soland goose (Pelicanus Bassanus), and formerly the + swan. Of these the swine and the swan are fed previously upon vegetable + aliment; and the Soland goose is taken in very small quantity, only as a + whet to the appetite. Next to these are the birds, that feed upon + insects, which are perhaps the most stimulating and the most nutritive of + our usual food.</p> + + <p>It is said that a greater quantity of volatile alkali can be obtained + from this kind of flesh, to which has been ascribed its stimulating + quality. But it is more probable, that fresh flesh contains only the + elements of volatile alkali.</p> + + <p><a name="art_I_2_1_2">2</a>. Next to the dark coloured flesh of + animals, the various tribes of shell-fish seem to claim their place, and + the wholesome kinds of mushrooms, which must be esteemed animal food, + both for their alkalescent tendency, their stimulating quality, and the + quantity of nourishment, which they afford; as oysters, lobsters, + crabfish, shrimps; mushrooms; to which perhaps might be added some of the + fish without scales; as the eel, barbolt, tench, smelt, turbot, + turtle.</p> + + <p>The flesh of many kinds of fish, when it is supposed to have undergone + a beginning putrefaction, becomes luminous in the dark. This seems to + shew a tendency in the phosphorus to escape, and combine with the oxygen + of the atmosphere; and would hence shew, that this kind of flesh is not + so perfectly animalized as those before mentioned. This light, as it is + frequently seen on rotten wood, and sometimes on veal, which has been + kept too long, as I have been told, is commonly supposed to have its + cause from putrefaction; but is nevertheless most probably of phosphoric + origin, like that seen in the dark on oyster-shells, which have + previously been ignited, and afterwards exposed to the sunshine, and on + the Bolognian stone. See Botan. Gard. Vol. I. Cant. I. line 1 and 2, the + note.</p> + + <p><a name="art_I_2_1_3">3</a>. The flesh of young animals, as of lamb, + veal, and sucking pigs, supplies us with a still less stimulating food. + The broth of these is said to become sour, and continues so a + considerable time before it changes into putridity; so much does their + flesh partake of the chemical properties of the milk, with which these + animals are nourished.</p> + + <p><a name="art_I_2_1_4">4</a>. The white meats, as of turkey, partridge, + pheasant, fowl, with their eggs, seem to be the next in mildness; and + hence are generally first allowed to convalescents from inflammatory + diseases.</p> + + <p><a name="art_I_2_1_5">5</a>. Next to those should be ranked the white + river-fish, which have scales, as pike, perch, gudgeon.</p> + + <p><a name="art_I_2_2">II</a>. <a name="art_I_2_2_1">1</a>. Milk unites + the animal with the vegetable source of our nourishment, partaking of the + properties of both. As it contains sugar, and will therefore ferment and + produce a kind of wine or spirit, which is a common liquor in Siberia; or + will run into an acid by simple agitation, as in the churning of cream; + and lastly, as it contains coagulable lymph, which will undergo the + process of putrefaction like other animal substances, as in old + cheese.</p> + + <p><a name="art_I_2_2_2">2</a>. Milk may be separated by rest or by + agitation into cream, butter, butter-milk, whey, curd. The cream is + easier of digestion to adults, because it contains less of the coagulum + or cheesy part, and is also more nutritive. Butter consisting of oil + between an animal and vegetable kind contains still more nutriment, and + in its recent state is not difficult of digestion if taken in moderate + quantity. See Art. <a href="#art_I_2_3_2">I. 2. 3. 2</a>. Butter-milk if + it be not bitter is an agreeable and nutritive fluid, if it be bitter it + has some putrid parts of the cream in it, which had been kept too long; + but is perhaps not less wholesome for being sour to a certain degree: as + the inferior people in Scotland choose sour milk in preference to skimmed + milk before it is become sour. Whey is the least nutritive and easiest of + digestion. And in the spring of the year, when the cows feed on young + grass, it contains so much of vegetable properties, as to become a + salutary potation, when drank to about a pint every morning to those, who + during the winter have taken too little vegetable nourishment, and who + are thence liable to bilious concretions.</p> + + <p><a name="art_I_2_2_3">3</a>. Cheese is of various kinds, according to + the greater or less quantity of cream, which it contains, and according + to its age. Those cheeses, which are easiest broken to pieces in the + mouth, are generally easiest of digestion, and contain most nutriment. + Some kinds of cheese, though slow of digestion, are also slow in changing + by chemical processes in the stomach, and therefore will frequently agree + well with those, who have a weak digestion; as I have seen toasted cheese + vomited up a whole day after it was eaten without having undergone any + apparent change, or given any uneasiness to the patient. It is probable a + portion of sugar, or of animal fat, or of the gravy of boiled or roasted + meat, mixed with cheese at the time of making it, might add to its + pleasant and nutritious quality.</p> + + <p><a name="art_I_2_2_4">4</a>. The reason, why autumnal milk is so much + thicker or coagulable than vernal milk, is not easy to understand, but as + new milk is in many respects similar to chyle, it may be considered as + food already in part digested by the animal it is taken from, and thence + supplies a nutriment of easy digestion. But as it requires to be curdled + by the gastric acid, before it can enter the lacteals, as is seen in the + stomachs of calves, it seems more suitable to children, whose stomachs + abound more with acidity, than to adults; but nevertheless supplies good + nourishment to many of the latter, and particularly to those, who use + vegetable food, and whose stomachs have not been much accustomed to the + unnatural stimulus of spice, salt, and spirit. See Class <a + href="#species_I_1_2_5">I. 1. 2. 5</a>.</p> + + <p><a name="art_I_2_3">III</a>. <a name="art_I_2_3_1">1</a>. The seeds, + roots, leaves, and fruits of plants, constitute the greatest part of the + food of mankind; the respective quantities of nourishment, which these + contain, may perhaps be estimated from the quantity of starch, or of + sugar, they can be made to produce: in farinaceous seeds, the mucilage + seems gradually to be converted into starch, while they remain in our + granaries; and the starch by the germination of the young plant, as in + making malt from barley, or by animal digestion, is converted into sugar. + Hence old wheat and beans contain more starch than new; and in our + stomachs other vegetable and animal materials are converted into sugar; + which constitutes in all creatures a part of their chyle.</p> + + <p>Hence it is probable, that sugar is the most nutritive part of + vegetables; and that they are more nutritive, as they are convertible in + greater quantity into sugar by the power of digestion; as appears from + sugar being found in the chyle of all animals, and from its existing in + great quantity in the urine of patients in the diabætes, of which a + curious case is related in Sect. XXIX. 4. where a man labouring under + this malady eat and drank an enormous quantity, and sometimes voided + sixteen pints of water in a day, with an ounce of sugar in each pint.</p> + + <p><a name="art_I_2_3_2">2</a>. Oil, when mixed with mucilage or + coagulable lymph, as in cream or new milk, is easy of digestion, and + constitutes probably the most nutritive part of animal diet; as oil is + another part of the chyle of all animals. As these two materials, sugar + and butter, contain much nutriment under a small volume, and readily + undergo some chemical change so as to become acid or rancid; they are + liable to disturb weak stomachs, when taken in large quantity, more than + aliment, which contains less nourishment, and is at the same time less + liable to chemical changes; because the chyle is produced quicker than + the torpid lacteals can absorb it, and thence undergoes a further + chemical process. Sugar and butter therefore are not so easily digested, + when taken in large quantity, as those things, which contain less + nutriment; hence, where the stomach is weak, they must be used in less + quantity. But the custom of some people in restraining children entirely + from them, is depriving them of a very wholesome, agreeable, and + substantial part of their diet. Honey, manna, sap-juice, are different + kinds of less pure sugar.</p> + + <p><a name="art_I_2_3_3">3</a>. All the esculent vegetables contain a + bland oil, or mucilage, or starch, or sugar, or acid; and, as their + stimulus is moderate, are properly given alone as food in inflammatory + diseases; and mixed with milk constitute the food of thousands. Other + vegetables possess various degrees and various kinds of stimulus; and to + these we are beholden for the greater part of our Materia Medica, which + produce nausea, sickness, vomiting, catharsis, intoxication, + inflammation, and even death, if unskilfully administered.</p> + + <p>The acrid or intoxicating, and other kinds of vegetable juices, such + as produce sickness, or evacuate the bowels, or such even as are only + disagreeable to the palate, appear to be a part of the defence of those + vegetables, which possess them, from the assaults of larger animals or of + insects. As mentioned in the Botanic Garden, Part II. Cant. I. line 161, + note. This appears in a forcible manner from the perusal of some travels, + which have been published of those unfortunate people, who have suffered + shipwreck on uncultivated countries, and have with difficulty found food + to subsist, in otherwise not inhospitable climates.</p> + + <p><a name="art_I_2_3_4">4</a>. As these acrid and intoxicating juices + generally reside in the mucilage, and not in the starch of many roots, + and seeds, according to the observation of M. Parmentier, the wholesome + or nutritive parts of some vegetables may be thus separated from the + medicinal parts of them. Thus if the root of white briony be rasped into + cold water, by means of a bread-grater made of a tinned iron plate, and + agitated in it, the acrid juice of the root along with the mucilage will + be dissolved, or swim, in the water; while a starch perfectly wholesome + and nutritious will subside, and may be used as food in times of + scarcity.</p> + + <p>M. Parmentier further observes, that potatoes contain too much + mucilage in proportion to their starch, which prevents them from being + converted into good bread. But that if the starch be collected from ten + pounds of raw potatoes by grating them into cold water, and agitating + them, as above mentioned; and if the starch thus procured be mixed with + other ten pounds of boiled potatoes, and properly subjected to + fermentation like wheat flour, that it will make as good bread as the + finest wheat.</p> + + <p>Good bread may also be made by mixing wheat-flour with boiled + potatoes. Eighteen pounds of wheat flour are said to make twenty-two + pounds and a half of bread. Eighteen pounds of wheat-flour mixed with + nine pounds of boiled potatoes, are said to make twenty-nine pounds and a + half of bread. This difference of weight must arise from the difference + of the previous dryness of the two materials. The potatoes might probably + make better flour, if they were boiled in steam, in a close vessel, made + some degrees hotter than common boiling water.</p> + + <p>Other vegetable matters may be deprived of their too great acrimony by + boiling in water, as the great variety of the cabbage, the young tops of + white briony, water-cresses, asparagus, with innumerable roots, and some + fruits. Other plants have their acrid juices or bitter particles + diminished by covering them from the light by what is termed blanching + them, as the stems and leaves of cellery, endive, sea-kale. The former + method either extracts or decomposes the acrid particles, and the latter + prevents them from being formed. See Botanic Garden, Vol. I. additional + note XXXIV. on the Etiolation of vegetables.</p> + + <p><a name="art_I_2_3_5">5</a>. The art of cookery, by exposing vegetable + and animal substances to heat, has contributed to increase the quantity + of the food of mankind by other means besides that of destroying their + acrimony. One of these is by converting the acerb juices of some fruits + into sugar, as in the baking of unripe pears, and the bruising of unripe + apples; in both which situations the life of the vegetable is destroyed, + and the conversion of the harsh juice into a sweet one must be performed + by a chemical process; and not by a vegetable one only, as the + germination of barley in making malt has generally been supposed.</p> + + <p>Some circumstances, which seem to injure the life of several fruits, + seem to forward the saccharine process of their juices. Thus if some + kinds of pears are gathered a week before they would ripen on the tree, + and are laid on a heap and covered, their juice becomes sweet many days + sooner. The taking off a circular piece of the bark from a branch of a + pear-tree causes the fruit of that branch to ripen sooner by a fortnight, + as I have more than once observed. The wounds made in apples by insects + occasion those apples to ripen sooner; caprification, or the piercing of + figs, in the island of Malta, is said to ripen them sooner; and I am well + informed, that when bunches of grapes in this country have acquired their + expected size, that if the stalk of each bunch be cut half through, that + they will sooner ripen.</p> + + <p>The germinating barley in the malt-house I believe acquires little + sweetness, till the life of the seed is destroyed, and the saccharine + process then continued or advanced by the heat in drying it. Thus in + animal digestion, the sugar produced in the stomach is absorbed by the + lacteals as fast as it is made, otherwise it ferments, and produces + flatulency; so in the germination of barley in the malt-house, so long as + the new plant lives, the sugar, I suppose, is absorbed as fast as it is + made; but that, which we use in making beer, is the sugar produced by a + chemical process after the death of the young plant, or which is made + more expeditiously, than the plant can absorb it.</p> + + <p>It is probably this saccharine process, which obtains in new + hay-stacks too hastily, and which by immediately running into + fermentation produces so much heat as to set them on fire. The greatest + part of the grain, or seeds, or roots, used in the distilleries, as + wheat, canary seed, potatoes, are not I believe previously subjected to + germination, but are in part by a chemical process converted into sugar, + and immediately subjected to vinous fermentation; and it is probable a + process may sometime be discovered of producing sugar from starch or + meal; and of separating it from them for domestic purposes by alcohol, + which dissolves sugar but not mucilage; or by other means.</p> + + <p>Another method of increasing the nutriment of mankind by cookery, is + by dissolving cartilages and bones, and tendons, and probably some + vegetables, in steam or water at a much higher degree of heat than that + of boiling. This is to be done in a close vessel, which is called Papin's + digester; in which, it is said, that water may be made red-hot, and will + then dissolve all animal substances; and might thus add to our quantity + of food in times of scarcity. This vessel should be made of iron, and + should have an oval opening at top, with an oval lid of iron larger than + the aperture; this lid should be slipped in endways, when the vessel is + filled, and then turned, and raised by a screw above it into contact with + the under edges of the aperture. There should also be a small tube or + hole covered with a weighted valve to prevent the danger of bursting the + digester.</p> + + <p>Where the powers of digestion are weakened, broths made by boiling + animal and vegetable substances in water afford a nutriment; though I + suppose not so great as the flesh and vegetables would afford, if taken + in their solid form, and mixed with saliva in the act of mastication. The + aliment thus prepared should be boiled but a short time, nor should be + suffered to continue in our common kitchen-utensils afterwards, as they + are lined with a mixture of half lead and half tin, and are therefore + unwholesome, though the copper is completely covered. And those soups, + which have any acid or wine boiled in them, unless they be made in + silver, or in china, or in those pot-vessels, which are not glazed by the + addition of lead, are truly poisonous; as the acid, as lemon-juice or + vinegar, when made hot, erodes or dissolves the lead and tin lining of + the copper-vessels, and the leaden glaze of the porcelain ones. Hence, + where silver cannot be had, iron vessels are preferable to tinned copper + ones; or those made of tinned iron-plates in the common tin-shops, which + are said to be covered with pure or block tin.</p> + + <p><a name="art_I_2_3_6">6</a>. Another circumstance, which facilitates + the nourishment of mankind, is the mechanic art of grinding farinaceous + seeds into powder between mill-stones; which may be called the artificial + teeth of society. It is probable, that some soft kinds of wood, + especially when they have undergone a kind of fermentation, and become of + looser texture, might be thus used as food in times of famine.</p> + + <p>Nor is it improbable, that hay, which has been kept in stacks, so as + to undergo the saccharine process, may be so managed by grinding and by + fermentation with yeast like bread, as to serve in part for the + sustenance of mankind in times of great scarcity. Dr. Priestley gave to a + cow for some time a strong infusion of hay in large quantity for her + drink, and found that she produced during this treatment above double the + quantity of milk. Hence if bread cannot be made from ground hay, there is + great reason to suspect, that a nutritive beverage may be thus prepared + either in its saccharine state, or fermented into a kind of beer.</p> + + <p>In times of great scarcity there are other vegetables, which though + not in common use, would most probably afford wholesome nourishment, + either by boiling them, or drying and grinding them, or by both those + processes in succession. Of these are perhaps the tops and the bark of + all those vegetables, which are armed with thorns or prickles, as + gooseberry trees, holly, gorse, and perhaps hawthorn. The inner bark of + the elm tree makes a kind of gruel. And the roots of fern, and probably + of very many other roots, as of grass and of clover taken up in winter, + might yield nourishment either by boiling or baking, and separating the + fibres from the pulp by beating them; or by getting only the starch from + those, which possess an acrid mucilage, as the white briony.</p> + + <p><a name="art_I_2_3_7">7</a>. However the arts of cookery and of + grinding may increase or facilitate the nourishment of mankind, the great + source of it is from agriculture. In the savage state, where men live + solely by hunting, I was informed by Dr. Franklin, that there was seldom + more than one family existed in a circle of five miles diameter; which in + a state of pasturage would support some hundred people, and in a state of + agriculture many thousands. The art of feeding mankind on so small a + grain as wheat, which seems to have been discovered in Egypt by the + immortal name of Ceres, shewed greater ingenuity than feeding them with + the large roots of potatoes, which seem to have been a discovery of + ill-fated Mexico.</p> + + <p>This greater production of food by agriculture than by pasturage, + shews that a nation nourished by animal food will be less numerous than + if nourished by vegetable; and the former will therefore be liable, if + they are engaged in war, to be conquered by the latter, as Abel was slain + by Cain. This is perhaps the only valid argument against inclosing open + arable fields. The great production of human nourishment by agriculture + and pasturage evinces the advantage of society over the savage state; as + the number of mankind becomes increased a thousand fold by the arts of + agriculture and pasturage; and their happiness is probably under good + governments improved in as great a proportion, as they become liberated + from the hourly fear of beasts of prey, from the daily fear of famine, + and of the occasional incursions of their cannibal neighbours.</p> + + <p>But pasturage cannot exist without property both in the soil, and the + herds which it nurtures; and for the invention of arts, and production of + tools necessary to agriculture, some must think, and others labour; and + as the efforts of some will be crowned with greater success than that of + others, an inequality of the ranks of society must succeed; but this + inequality of mankind in the present state of the world is too great for + the purposes of producing the greatest quantity of human nourishment, and + the greatest sum of human happiness; there should be no slavery at one + end of the chain of society, and no despotism at the other.—By the + future improvements of human reason such governments may possibly + hereafter be established, as may a hundred-fold increase the numbers of + mankind, and a thousand-fold their happiness.</p> + + <p><a name="art_I_2_4">IV</a>. <a name="art_I_2_4_1">1</a>. Water must be + considered as a part of our nutriment, because so much of it enters the + composition of our solids as well as of our fluids; and because + vegetables are now believed to draw almost the whole of their nourishment + from this source. As in them the water is decomposed, as it is perspired + by them in the sunshine, the oxygen gas increases the quantity and the + purity of the atmosphere in their vicinity, and the hydrogen seems to be + retained, and to form the nutritive juices, and consequent secretions of + rosin, gum, wax, honey, oil, and other vegetable productions. See Botanic + Garden, Part I. Cant. IV. line 25, note. It has however other uses in the + system, besides that of a nourishing material, as it dilutes our fluids, + and lubricates our solids; and on all these accounts a daily supply of it + is required.</p> + + <p><a name="art_I_2_4_2">2</a>. River-water is in general purer than + spring-water; as the neutral salts washed down from the earth decompose + each other, except perhaps the marine salt; and the earths, with which + spring-water frequently abounds, is precipitated; yet it is not + improbable, that the calcareous earth dissolved in the water of many + springs may contribute to our nourishment, as the water from springs, + which contain earth, is said to conduce to enrich those lands, which are + flooded with it, more than river water.</p> + + <p><a name="art_I_2_4_3">3</a>. Many arguments seem to shew, that + calcareous earth contributes to the nourishment of animals and + vegetables. First because calcareous earth constitutes a considerable + part of them, and must therefore either be received from without, or + formed by them, or both, as milk, when taken as food by a lactescent + woman, is decomposed in the stomach by the process of digestion, and + again in part converted into milk by the pectoral glands. Secondly, + because from the analogy of all organic life, whatever has composed a + part of a vegetable or animal may again after its chemical solution + become a part of another vegetable or animal, such is the general + transmigration of matter. And thirdly, because the great use of lime in + agriculture on almost all kinds of soil and situation cannot be + satisfactorily explained from its chemical properties alone. Though these + may also in certain soils and situations have considerable effect.</p> + + <p>The chemical uses of lime in agriculture may be, 1. from its + destroying in a short time the cohesion of dead vegetable fibres, and + thus reducing them to earth, which otherwise is effected by a slow + process either by the consumption of insects or by a gradual + putrefaction. Thus I am informed that a mixture of lime with oak bark, + after the tanner has extracted from it whatever is soluble in water, will + in two or three months reduce it to a fine black earth, which, if only + laid in heaps, would require as many years to effect by its own + spontaneous fermentation or putrefaction. This effect of lime must be + particularly advantageous to newly inclosed commons when first broken + up.</p> + + <p>Secondly, lime for many months continues to attract moisture from the + air or earth, which it deprives I suppose of carbonic acid, and then + suffers it to exhale again, as is seen on the plastered walls of new + houses. On this account it must be advantageous when mixed with dry or + sandy soils, as it attracts moisture from the air above or the earth + beneath, and this moisture is then absorbed by the lymphatics of the + roots of vegetables. Thirdly, by mixing lime with clays it is believed to + make them less cohesive, and thus to admit of their being more easily + penetrated by vegetable fibres. A mixture of lime with clays destroys + their superabundancy of acid, if such exists, and by uniting with it + converts it into gypsum or alabaster. And lastly, fresh lime destroys + worms, snails, and other insects, with which it happens to come in + contact.</p> + + <p>Yet do not all these chemical properties seem to account for the great + uses of lime in almost all soils and situations, as it contributes so + much to the melioration of the crops, as well as to their increase in + quantity. Wheat from land well limed is believed by farmers, millers, and + bakers, to be, as they suppose, thinner skinned; that is, it turns out + more and better flour; which I suppose is owing to its containing more + starch and less mucilage. In respect to grass-ground I am informed, that + if a spadeful of lime be thrown on a tussock, which horses or cattle have + refused to touch for years, they will for many succeeding seasons eat it + quite close to the ground.</p> + + <p>One property of lime is not perhaps yet well understood, I mean its + producing so much heat, when it is mixed with water; which may be owing + to the elementary fluid of heat consolidated in the lime. It is the steam + occasioned by this heat, when water is sprinkled upon lime, if the water + be not in too great quantity or too cold, which breaks the lime into such + fine powder as almost to become fluid, which cannot be effected perhaps + by any other means, and which I suppose must give great preference to + lime in agriculture, and to the solutions of calcareous earth in water, + over chalk or powdered limestone, when spread upon the land.</p> + + <p><a name="art_I_2_4_4">4</a>. It was formerly believed that waters + replete with calcareous earth, such as incrust the inside of tea-kettles, + or are laid to petrify moss, were liable to produce or to increase the + stone in the bladder. This mistaken idea has lately been exploded by the + improved chemistry, as no calcareous earth, or a very minute quantity, + was found in the calculi analysed by Scheel and Bergman. The waters of + Matlock and of Carlsbad, both which cover the moss, which they pass + through, with a calcareous crust, are so far from increasing the stone of + the bladder or kidnies, that those of Carlsbad are celebrated for giving + relief to those labouring under these diseases. Philos. Trans. Those of + Matlock are drank in great quantities without any suspicion of injury; + and I well know a person who for above ten years has drank about two + pints a day of cold water from a spring, which very much incrusts the + vessels, it is boiled in, with calcareous earth, and affords a copious + calcareous sediment with a solution of salt of tartar, and who enjoys a + state of uninterrupted health.</p> + + <p><a name="art_I_2_5">V</a>. <a name="art_I_2_5_1">1</a>. As animal + bodies consist much both of oxygen and azote, which make up the + composition of atmospheric air, these should be counted amongst + nutritious substances. Besides that by the experiments of Dr. Priestley + it appears, that the oxygen gains admittance into the blood through the + moist membranes of the lungs; and seems to be of much more immediate + consequence to the preservation of our lives than the other kinds of + nutriment above specified.</p> + + <p>As the basis of fixed air, or carbonic acid gas, is carbone, which + also constitutes a great part both of vegetable and animal bodies; this + air should likewise be reckoned amongst nutritive substances. Add to + this, that when this carbonic acid air is swallowed, as it escapes from + beer or cyder, or when water is charged with it as detruded from + limestone by vitriolic acid, it affords an agreeable sensation both to + the palate and stomach, and is therefore probably nutritive.</p> + + <p>The immense quantity of carbone and of oxygen which constitute so + great a part of the limestone countries is almost beyond conception, and, + as it has been formed by animals, may again become a part of them, as + well as the calcareous matter with which they are united. Whence it may + be conceived, that the waters, which abound with limestone in solution, + may supply nutriment both to animals and to vegetables, as mentioned + above.</p> + + <p><a name="art_I_2_6">VI</a>. <a name="art_I_2_6_1">1</a>. The manner, + in which nutritious particles are substituted in the place of those, + which are mechanically abraded, or chemically decomposed, or which vanish + by animal absorption, must be owing to animal appetency, as described in + Sect. XXXVII. 3. and is probably similar to the process of inflammation, + which produces new vessels and new fluids; or to that which constitutes + the growth of the body to maturity. Thus the granulations of new flesh to + repair the injuries of wounds are visible to the eye; as well as the + callous matter, which cements broken bones; the calcareous matter, which + repairs injured snail-shells; and the threads, which are formed by + silk-worms and spiders; which are all secreted in a softer state, and + harden by exsiccation, or by the contact of the air, or by absorption of + their more fluid parts.</p> + + <p>Whether the materials, which thus supply the waste of the system, can + be given any other way than by the stomach, so as to preserve the body + for a length of time, is worth our inquiry; as cases sometimes occur, in + which food cannot be introduced into the stomach, as in obstructions of + the œsophagus, inflammations of the throat, or in hydrophobia; and + other cases are not unfrequent in which the power of digestion is nearly + or totally destroyed, as in anorexia epileptica, and in many fevers.</p> + + <p>In the former of these circumstances liquid nutriment may sometimes be + got into the stomach through a flexible catheter; as described in Class + <a href="#species_III_1_1_15">III. 1. 1. 15</a>. In the latter many kinds + of mild aliment, as milk or broth, have frequently been injected as + clysters, together with a small quantity of opium, as ten drops of the + tincture, three or four times a day; to which also might be added very + small quantities of vinous spirit. But these, as far as I have observed, + will not long sustain a person, who cannot take any sustenance by the + stomach.</p> + + <p><a name="art_I_2_6_2">2</a>. Another mode of applying nutritive fluids + might be by extensive fomentations, or by immerging the whole body in a + bath of broth, or of warm milk, which might at the same time be + coagulated by rennet, or the acid of the calf's stomach; broth or whey + might thus probably be introduced, in part at least, into the + circulation, as a solution of nitre is said to have been absorbed in a + pediluvium, which was afterwards discovered by the manner in which paper + dipped frequently in the urine of the patient and dried, burnt and + sparkled like touch-paper. Great quantity of water is also known to be + absorbed by those, who have bathed in the warm bath after exercise and + abstinence from liquids. Cleopatra was said to travel with 4000 + milch-asses in her train, and to bathe every morning in their milk, which + she probably might use as a cosmetic rather than a nutritive.</p> + + <p><a name="art_I_2_6_3">3</a>. The transfusion of blood from another + animal into the vein of one, who could take no sustenance by the throat, + or digest none by the stomach, might long continue to support him; and + perhaps other nutriment, as milk or mucilage, might be this way + introduced into the system, but we have not yet sufficient experiments on + this subject. See Sect. XXXII. 4. and Class <a + href="#species_I_2_3_25">I. 2. 3. 25</a>. and Sup. I. <a + href="#suppl_XIV_2">14. 2</a>.</p> + + <p><a name="art_I_2_7">VII</a>. Various kinds of condiments, or sauces, + have been taken along with vegetable or animal food, and have been + thought by some to strengthen the process of digestion and consequent + process of nutrition. Of these wine, or other fermented liquors, vinegar, + salt, spices, and mustard, have been in most common use, and I believe to + the injury of thousands. As the stomach by their violent stimulus at + length loses its natural degree of irritability, and indigestion is the + consequence; which is attended with flatulency and emaciation. Where any + of these have been taken so long as to induce a habit, they must either + be continued, but not increased; or the use of them should be gradually + and cautiously diminished or discontinued, as directed in Sect. XII. 7. + 8.</p> + +<p class="cenhead"><a name="art_I_3">III</a>. <span class="sc">Catalogue of the Nutrientia.</span></p> + +<blockquote class="b1n"> + + <p><a name="art_I_3_1">I</a>. <a name="art_I_3_1_1">1</a>. Venison, beef, + mutton, hare, goose, duck, woodcock, snipe, moor-game.</p> + + <p><a name="art_I_3_1_2">2</a>. Oysters, lobsters, crabs, shrimps, + mushrooms, eel, tench, barbolt, smelt, turbot, sole, turtle.</p> + + <p><a name="art_I_3_1_3">3</a>. Lamb, veal, sucking-pig.</p> + + <p><a name="art_I_3_1_4">4</a>. Turkey, partridge, pheasant, fowl, + eggs.</p> + + <p><a name="art_I_3_1_5">5</a>. Pike, perch, gudgeon, trout, + grayling.</p> + + <p><a name="art_I_3_2">II</a>. Milk, cream, butter, buttermilk, whey, + cheese.</p> + + <p><a name="art_I_3_3">III</a>. Wheat, barley, oats, peas, potatoes, + turnips, carrots, cabbage, asparagus, artichoke, spinach, beet, apple, + pear, plum, apricot, nectarine, peach, strawberry, grape, orange, melon, + cucumber, dried figs, raisins, sugar, honey. With a great variety of + other roots, seeds, leaves, and fruits.</p> + + <p><a name="art_I_3_4">IV</a>. Water, river-water, spring-water, + calcareous earth.</p> + + <p><a name="art_I_3_5">V</a>. Air, oxygene, azote, carbonic acid gas.</p> + + <p><a name="art_I_3_6">VI</a>. Nutritive baths and clysters, transfusion + of blood.</p> + + <p><a name="art_I_3_7">VII</a>. Condiments.</p> + +</blockquote> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><span class="sc">Art.</span> <a name="art_II">II</a>.</h3> + +<h3>INCITANTIA.</h3> + + <p><a name="art_II_1">I</a>. <a name="art_II_1_1">1</a>. Those things, + which increase the exertions of all the irritative motions, are termed + incitantia. As alcohol, or the spirituous part of fermented liquors, + opium, and many drugs, which are still esteemed poisons, their proper + doses not being ascertained. To these should be added the exhilarating + passions of the mind, as joy, love: and externally the application of + heat, electricity, æther, essential oils, friction, and exercise.</p> + + <p><a name="art_II_1_2">2</a>. These promote both the secretions and + absorptions, increase the natural heat, and remove those pains, which + originate from the defect of irritative motions, termed nervous pains; + and prevent the convulsions consequent to them. When given internally + they induce costiveness, and deep coloured urine; and by a greater dose + intoxication, and its consequences.</p> + +<p class="cenhead"><a name="art_II_2">II</a>. <span class="sc">Observations on the Incitantia.</span></p> + + <p><a name="art_II_2_1">I</a>. <a name="art_II_2_1_1">1</a>. Opium and + alcohol increase all the secretions and absorptions. The increase of the + secretion of sensorial power appears from the violent exertions of + drunken people; the secretion of sweat is more certainly excited by opium + or wine than by any other medicine; and the increase of general heat, + which these drugs produce, is an evidence of their effect in promoting + all the secretions; since an increase of secretion is always attended + with increase of heat in the part, as in hepatic and other + inflammations.</p> + + <p><a name="art_II_2_1_2">2</a>. But as they at the same time promote + absorption; those fluids, which are secreted into receptacles, as the + urine, bile, intestinal and pulmonary mucus, have again their thinner + parts absorbed; and hence, though the quantity of secreted fluid was + increased, yet as the absorption was also increased, the excretion from + these receptacles is lessened; at the same time that it is deeper + coloured or of thicker consistence, as the urine, alvine feces, and + pulmonary mucus. Whereas the perspiration being secreted on the surface + of the body is visible in its increased quantity, before it can be + reabsorbed; whence arises that erroneous opinion, that opium increases + the cutaneous secretion, and lessens all the others.</p> + + <p><a name="art_II_2_1_3">3</a>. It must however be noted, that after + evacuations opium seems to promote the absorptions more than the + secretions; if you except that of the sensorial power in the brain, which + probably suffers no absorption. Hence its efficacy in restraining + hæmorrhages, after the vessels are emptied, by promoting venous + absorption.</p> + + <p><a name="art_II_2_1_4">4</a>. In ulcers the matter is thickened by the + exhibition of opium from the increased absorption of the thinner parts of + it; but it is probable, that the whole secretion, including the part + which is absorbed, is increased; and hence new fibres are secreted along + with the matter, and the ulcer fills with new granulations of flesh. But + as no ulcer can heal, till it ceases to discharge; that is, till the + absorption becomes as great as the excretion; those medicines, which + promote absorption only, are more advantageous for the healing an ulcer + after it is filled with new flesh; as the Peruvian bark internally; with + bandages and solutions of lead externally.</p> + + <p><a name="art_II_2_1_5">5</a>. There are many pains which originate + from a want of due motion in the part, as those occasioned by cold; and + all those pains which are attended with cold extremities, and are + generally termed nervous. These are relieved by whatever excites the part + into its proper actions, and hence by opium and alcohol; which are the + most universal stimulants we are acquainted with. In these cases the + effect of opium is produced, as soon as the body becomes generally warm; + and a degree of intoxication or sleep follows the cessation of the + pain.</p> + + <p>These nervous pains (as they are called) frequently return at certain + periods of time, and are also frequently succeeded by convulsions; in + these cases if opium removes the pain, the convulsions do not come on. + For this purpose it is best to exhibit it gradually, as a grain every + hour, or half hour, till it intoxicates. Here it must be noted, that a + much less quantity will prevent the periods of these cold pains, than is + necessary to relieve them after their access. As a grain and half of + opium given an hour before the expected paroxysm will prevent the cold + fit of an intermittent fever, but will not soon remove it, when it is + already formed. For in the former case the usual or healthy associations + or catenations of motion favour the effect of the medicine; in the latter + case these associations or catenations are disordered, or interrupted, + and new ones are formed, which so far counteract the effect of the + medicine.</p> + + <p>When opium has been required in large doses to ease or prevent + convulsions, some have advised the patient to omit the use of wine, as a + greater quantity of opium might then be exhibited; and as opium seems to + increase absorption more, and secretion less, than vinous spirit; it may + in some cases be useful to exchange one for the other; as in diseases + attended with too great evacuation, as diarrhœa, and dysentery, + opium may be preferable; on the contrary in tetanus, or locked-jaw, where + inflammation of the system might be of service, wine may be preferable to + opium; see Class <span class="correction" title="Original reads `III. 1. 1. 12.'." + ><a href="#species_III_1_1_13">III. 1. 1. 13</a></span>. I have generally + observed, that a mixture of spirit of wine and warm water, given + alternately with the doses of opium, has soonest and most certainly + produced that degree of intoxication, which was necessary to relieve the + patient in the epilepsia <span class="correction" title="Original reads `dolorofica'." + >dolorifica</span>.</p> + + <p><a name="art_II_2_1_6">6</a>. There is likewise some relief given by + opium to inflammatory pains, or those from excess of motion in the + affected part; but with this difference, that this relief from the pains, + and the sleep, which it occasions, does not occur till some hours after + the exhibition of the opium. This requires to be explained; after the + stimulus of opium or of alcohol ceases, as after common drunkenness, a + consequent torpor comes on; and the whole habit becomes less irritable by + the natural stimuli. Hence the head-achs, sickness, and languor, on the + next day after intoxication, with cold skin, and general debility. Now in + pains from excess of motion, called inflammatory pains, when opium is + given, the pain is not relieved, till the debility comes on after the + stimulus ceases to act; for then after the greater stimulus of the opium + has exhausted much of the sensorial power; the less stimulus, which + before caused the pain, does not now excite the part into unnatural + action.</p> + + <p>In these cases the stimulus of the opium first increases the pain; and + it sometimes happens, that so great a torpor follows, as to produce the + death or mortification of the affected part; whence the danger of giving + opium in inflammatory diseases, especially in inflammation of the bowels; + but in general the pain returns with its former violence, when the torpor + above mentioned ceases. Hence these pains attended with inflammation are + best relieved by copious venesection, other evacuations, and the class of + medicines called torpentia.</p> + + <p><a name="art_II_2_1_7">7</a>. These pains from excess of motion are + attended with increased heat of the whole, or of the affected part, and a + strong quick pulse; the pains from defect of motion are attended with + cold extremities, and a weak pulse; which is also generally more frequent + than natural, but not always so.</p> + + <p><a name="art_II_2_1_8">8</a>. Opium and alcohol are the only two + drugs, we are much acquainted with, which intoxicate; and by this + circumstance are easily distinguished from the secernentia and sorbentia. + Camphor, and cicuta, and nicotiana, are thought to induce a kind of + intoxication; and there are many other drugs of this class, whose effects + are less known, or their doses not ascertained; as atropa belladonna, + hyocyamus, stramonium, prunus laurocerasus, menispermum, cynoglossum, + some fungi, and the water distilled from black cherry-stones; the last of + which was once much in use for the convulsions of children, and was said + to have good effect; but is now improvidently left out of our + pharmacopias. I have known one leaf of the laurocerasus, shred and made + into tea, given every morning for a week with no ill consequence to a + weak hysteric lady, but rather perhaps with advantage.</p> + + <p><a name="art_II_2_1_9">9</a>. The pernicious effects of a continued + use of much vinous spirit is daily seen and lamented by physicians; not + only early debility, like premature age, but a dreadful catalogue of + diseases is induced by this kind of intemperance; as dropsy, gout, + leprosy, epilepsy, insanity, as described in Botanic Garden, Part II. + Canto III. line 357. The stronger or less diluted the spirit is taken, + the sooner it seems to destroy, as in dram-drinkers; but still sooner, + when kernels of apricots, or bitter almonds, or laurel-leaf, are infused + in the spirit, which is termed ratafia; as then two poisons are swallowed + at the same time. And vinegar, as it contains much vinous spirit, is + probably a noxious part of our diet. And the distilled vinegar, which is + commonly sold in the shops, is truly poisonous, as it is generally + distilled by means of a pewter or leaden alembic-head or worm-tube, and + abounds with lead; which any one may detect by mixing with it a solution + of liver of sulphur. Opium, when taken as a luxury, not as a medicine, is + as pernicious as alcohol; as Baron de Tott relates in his account of the + opium-eaters in Turkey.</p> + + <p><a name="art_II_2_1_10">10</a>. It must be observed, that a frequent + repetition of the use of this class of medicines so habituates the body + to their stimulus, that their dose may gradually be increased to an + astonishing quantity, such as otherwise would instantly destroy life; as + is frequently seen in those, who accustom themselves to the daily use of + alcohol and opium; and it would seem, that these unfortunate people + become diseased as soon as they omit their usual potations; and that the + consequent gout, dropsy, palsy, or pimpled face, occur from the debility + occasioned from the want of accustomed stimulus, or to some change in the + contractile fibres, which requires the continuance or increase of it. + Whence the cautions necessary to be observed are mentioned in Sect. XII. + 7. 8.</p> + + <p><a name="art_II_2_1_11">11</a>. It is probable, that some of the + articles in the subsequent catalogue do not induce intoxication, though + they have been esteemed to do so; as tobacco, hemlock, nux vomica, + stavisagria; and on this account should rather belong to other + arrangements, as to the secernentia, or sorbentia, or invertentia.</p> + + <p><a name="art_II_2_2">II</a>. <a name="art_II_2_2_1">1</a>. Externally + the application of heat, as the warm bath, by its stimulus on the skin + excites the excretory ducts of the perspirative glands, and the mouths of + the lymphatics, which open on its surface, into greater action; and in + consequence many other irritative motions, which are associated with + them. To this increased action is added pleasurable sensation, which adds + further activity to the system; and thus many kinds of pain receive + relief from this additional atmosphere of heat.</p> + + <p>The use of a warm bath of about 96 or 98 degrees of heat, for half an + hour once a day for three or four months, I have known of great service + to weak people, and is perhaps the least noxious of all unnatural + stimuli; which however, like all other great excitement, may be carried + to excess, as complained of by the ancients. The unmeaning application of + the words relaxation and bracing to warm and cold baths has much + prevented the use of this grateful stimulus; and the misuse of the term + warm-bath, when applied to baths colder than the body, as to those of + Buxton and Matlock, and to artificial baths of less than 90 degrees of + heat, which ought to be termed cold ones, has contributed to mislead the + unwary in their application.</p> + + <p>The stimulus of wine, or spice, or salt, increases the heat of the + system by increasing all or some of the secretions; and hence the + strength is diminished afterwards by the loss of fluids, as well as by + the increased action of the fibres. But the stimulus of the warm-bath + supplies heat rather than produces it; and rather fills the system by + increased absorption, than empties it by increased secretion; and may + hence be employed with advantage in almost all cases of debility with + cold extremities, perhaps even in anasarca, and at the approach of death + in fevers. In these cases a bath much beneath 98 degrees, as of 80 or 85, + might do injury, as being a cold-bath compared with the heat of the body, + though such a bath is generally called a warm one.</p> + + <p>The activity of the system thus produced by a bath of 98 degrees of + heat, or upwards, does not seem to render the patients liable to take + cold, when they come out of it; for the system is less inclined to become + torpid than before, as the warmth thus acquired by communication, rather + than by increased action, continues long without any consequent + chillness. Which accords with the observation of Dr. Fordyce, mentioned + in Sup. I. <a href="#suppl_V_1">5. 1</a>. who says, that those who are + confined some time in an atmosphere of 120 or 130 degrees of heat, do not + feel cold or look pale on coming into a temperature of 30 or 40 degrees; + which would produce great paleness and sensation of coldness in those, + who had been some time confined in an atmosphere of only 86 or 90 degrees + of heat. Treatise on Simple Fever, p. 168.</p> + + <p>Hence heat, where it can be confined on a torpid part along with + moisture, as on a scrophulous tumour, will contribute to produce + suppuration or resolution. This is done by applying a warm poultice, + which should be frequently repeated; or a plaster of resin, wax, or fat; + or by covering the part with oiled silk; both which last prevent the + perspirable matter from escaping as well as the heat of the part, as + these substances repel moisture, and are bad conductors of heat. Another + great use of the stimulus of heat is by applying it to torpid ulcers, + which are generally termed scrophulous or scorbutic, and are much easier + inclined to heal, when covered with several folds of flannel.</p> + + <p>Mr. —— had for many months been afflicted with an ulcer in + perinæo, which communicated with the urethra, through which a part of his + urine was daily evacuated with considerable pain; and was reduced to a + great degree of debility. He used a hot-bath of 96 or 98 degrees of heat + every day for half an hour during about six months. By this agreeable + stimulus repeated thus at uniform times not only the ulcer healed, + contrary to the expectation of his friends, but he acquired greater + health and strength, than he had for some years previously + experienced.</p> + + <p>Mrs. —— was affected with transient pains, which were + called nervous spasms, and with great fear of diseases, which she did not + labour under, with cold extremities, and general debility. She used a + hot-bath every other day of 96 degrees of heat for about four months, and + recovered a good state of health, with greater strength and courage, than + she had possessed for many months before.</p> + + <p>Mr. Z. a gentleman about 65 years of age, who had lived rather + intemperately in respect to vinous potation, and had for many years had + annual visits of the gout, which now became irregular, and he appeared to + be losing his strength, and beginning to feel the effects of age. He used + a bath, as hot as was agreeable to his sensations, twice a week for about + a year and half, and greatly recovered his health and strength with less + frequent and less violent returns of regular gout, and is now near 80 + years of age.</p> + + <p>When Dr. Franklin, the American philosopher, was in England many years + ago, I recommended to him the use of a warm-bath twice a week to prevent + the too speedy access of old age, which he then thought that he felt the + approach of, and I have been informed, that he continued the use of it + till near his death, which was at an advanced age.</p> + + <p>All these patients were advised not to keep themselves warmer than + their usual habits, after they came out of the bath, whether they went + into bed or not; as the design was not to promote perspiration, which + weakens all constitutions, and seldom is of service to any. Thus a + flannel shirt, particularly if it be worn in warm weather, occasions + weakness by stimulating the skin by its points into too great action, and + producing heat in consequence; and occasions emaciation by increasing the + discharge of perspirable matter; and in both these respects differs from + the effect of warm bathing, which communicates heat to the system at the + same time that it stimulates it, and causes absorption more than + exhalation.</p> + + <p><a name="art_II_2_2_2">2</a>. The effect of the passage of an electric + shock through a paralytic limb in causing it to contract, besides the + late experiments of Galvani and Volta on frogs, intitle it to be classed + amongst universal stimulants. Electric shocks frequently repeated daily + for a week or two remove chronical pains, as the pleurodyne chronica, + Class <a href="#species_I_2_4_14">I. 2. 4. 14</a>. and other chronic + pains, which are termed rheumatic, probably by promoting the absorption + of some extravasated material. Scrophulous tumours are sometimes + absorbed, and sometimes brought to suppurate by passing electric shocks + through them daily for two or three weeks.</p> + + <div class="figright" style="width:40%;"> + <a href="images/v2p694.png"><img style="width:100%" src="images/v2p694.png" + alt="Device for applying electric shocks to a tumour." title="Device for applying electric shocks to a tumour." /></a> + </div> + <p>Miss ——, a young lady about eight years of age, had a + swelling about the size of a pigeon's egg on her neck a little below her + ear, which long continued in an indolent state. Thirty or forty small + electric shocks were passed through it once or twice a day for two or + three weeks, and it then suppurated and healed without difficulty. For + this operation the coated jar of the electric machine had on its top an + electrometer, which measured the shocks by the approach of a brass knob, + which communicated with the external coating to another, which + communicated with the internal one, and their distance was adjusted by a + screw. So that the shocks were so small as not to alarm the child, and + the accumulated electricity was frequently discharged, as the wheel + continued turning. The tumour was inclosed between two other brass knobs, + which were fixed on wires, which passed through glass tubes, the tubes + were cemented in two grooves on a board, so that at one end they were + nearer each other than at the other, and the knobs were pushed out so far + as exactly to include the tumour, as described in the annexed plate, + which is about half the size of the original apparatus.</p> + + <p>Inflammations of the eyes without fever are frequently cured by taking + a stream of very small electric sparks from them, or giving the electric + sparks to them, once or twice a day for a week or two; that is, the new + vessels, which constitute inflammation in these inirritable + constitutions, are absorbed by the activity of the absorbents induced by + the stimulus of the electric aura. For this operation the easiest method + is to fix a pointed wire to a stick of sealing wax, or to an insulating + handle of glass, one end of this wire communicates with the prime + conductor, and the point is approached near the inflamed eye in every + direction.</p> + + <p><a name="art_II_2_3">III</a>. Externally the application of ether, and + of essential oils, as of cloves or cinnamon, seem to possess a general + stimulating effect. As they instantly relieve tooth-ach, and hiccough, + when these pains are not in violent degree; and camphor in large doses is + said to produce intoxication; this effect however I have not been witness + to, and have reason to doubt.</p> + + <p>The manner in which ether and the essential oil operate on the system + when applied externally, is a curious question, as pain is so immediately + relieved by them, that they must seem to penetrate by the great fluidity + or expansive property of a part of them, as of their odoriferous + exhalation or vapour, and that they thus stimulate the torpid part, and + not by their being taken up by the absorbent vessels, and carried thither + by the long course of circulation; nor is it probable, that these pains + are relieved by the sympathy of the torpid membrane with the external + skin, which is thus stimulated into action; as it does not succeed, + unless it is applied over the pained part. Thus there appears to be three + different modes by which extraneous bodies may be introduced into the + system, besides that of absorption. 1st. By ethereal transition, as heat + and electricity; 2d. by chemical attraction, as oxygen; and 3d. by + expansive vapour, as ether and essential oils.</p> + + <p><a name="art_II_2_4">IV</a>. The perpetual necessity of the mixture of + oxygen gas with the blood in the lungs evinces, that it must act as a + stimulus to the sanguiferous system, as the motions of the heart and + arteries presently cease, when animals are immersed in airs which possess + no oxygen. It may also subsequently answer another important purpose, as + it probably affords the material for the production of the sensorial + power; which is supposed to be secreted in the brain or medullary part of + the nerves; and that the perpetual demand of this fluid in respiration is + occasioned by the sensorial power, which is supposed to be produced from + it, being too subtle to be long confined in any part of the system.</p> + + <p>Another proof of the stimulant quality of oxygen appears from the + increased acrimony, which the matter of a common abscess possesses, after + it has been exposed to the air of the atmosphere, but not before; and + probably all other contagious matters owe their fever-producing property + to having been converted into acids by their union with oxygen.</p> + + <p>As oxygen penetrates the fine moist membranes of the air-vessels of + the lungs, and unites with the blood by a chemical attraction, as is seen + to happen, when blood is drawn into a bason, the lower surface of the + crassamentum is of a very dark red so long as it is covered from the air + by the upper surface, but becomes florid in a short time on its being + exposed to the atmosphere; the manner of its introduction into the system + is not probably by animal absorption but by chemical attraction, in which + circumstance it differs from the fluids before mentioned both of heat and + electricity, and of ether and essential oils.</p> + + <p>As oxygen has the property of passing through moist animal membranes, + as first discovered by the great Dr. Priestley, it is probable it might + be of use in vibices, and petechiæ in fevers, and in other bruises; if + the skin over those parts was kept moist by warm water, and covered with + oxygen gas by means of an inverted glass, or even by exposing the parts + thus moistened to the atmosphere, as the dark coloured extravasated blood + might thus become florid, and by its increase of stimulus facilitate its + reabsorption.</p> + + <p>Two weak patients, to whom I gave oxygen gas in as pure a state as it + can easily be procured from Exeter manganese, and in the quantity of + about four gallons a day, seemed to feel refreshed, and stronger, and to + look better immediately after respiring it, and gained strength in a + short time. Two others, one of whom laboured under confirmed hydrothorax, + and the other under a permanent and uniform difficulty of respiration, + were not refreshed, or in any way served by the use of oxygen in the + above quantity of four gallons a day for a fortnight, which I ascribed to + the inirritability of the diseased lungs. For other cases the reader is + referred to the publications of Dr. Beddoes; Confederations on the Use of + Factitious Airs, sold by Johnson, London.</p> + + <p>Its effects would probably have been greater in respect to the + quantity breathed, if it had been given in a dilute state, mixed with 10 + or 20 times its quantity of atmospheric air, as otherwise much of it + returns by expiration without being deprived of its quality, as may be + seen by the person breathing on the flame of a candle, which it enlarges. + See the Treatise of Dr. Beddoes above mentioned.</p> + + <p><a name="art_II_2_5">V</a>. Those passions, which are attended with + pleasurable sensation, excite the system into increased action in + consequence of that sensation, as joy, and love, as is seen by the flush + of the skin. Those passions, which are attended with disagreeable + sensation, produce torpor in general by the expence of sensorial power + occasioned by inactive pain; unless volition be excited in consequence of + the painful sensation; and in that case an increased activity of the + system occurs; thus paleness and coldness are the consequence of fear, + but warmth and redness are the consequence of anger.</p> + + <p><a name="art_II_2_6">VI</a>. Besides the exertions of the system + occasioned by increased stimuli, and consequent irritation, and by the + passions of the mind above described, the increased actions occasioned by + exercise belong to this article. These may be divided into the actions of + the body in consequence of volition, which is generally termed labour; or + secondly, in consequence of agreeable sensation, which is termed play or + sport; thirdly, the exercise occasioned by agitation, as in a carriage or + on horseback; fourthly, that of friction, as with a brush or hand, so + much used in the baths of Turkey; and lastly, the exercise of + swinging.</p> + + <p>The first of these modes of exercise is frequently carried to great + excess even amongst our own labourers, and more so under the lash of + slavery; so that the body becomes emaciated and sinks under either the + present hardships, or by a premature old age. The second mode of exercise + is seen in the play of all young animals, as kittens, and puppies, and + children; and is so necessary to their health as well as to their + pleasure, that those children, which are too much confined from it, not + only become pale-faced and bloated, with tumid bellies, and consequent + worms, but are liable to get habits of unnatural actions, as twitching of + their limbs, or of some parts of their countenance; together with an + ill-humoured or discontented mind.</p> + + <p>Agitation in a carriage or on horseback, as it requires some little + voluntary exertion to preserve the body perpendicular, but much less + voluntary exertion than in walking, seems the best adapted to invalids; + who by these means obtain exercise principally by the strength of the + horse, and do not therefore too much exhaust their own sensorial power. + The use of friction with a brush or hand, for half an hour or longer + morning and evening, is still better adapted to those, who are reduced to + extreme debility; and none of their own sensorial power is thus expended, + and affords somewhat like the warm-bath activity without self-exertion, + and is used as a luxury after warm bathing in many parts of Asia.</p> + + <p>Another kind of exercise is that of swinging, which requires some + exertion to keep the body perpendicular, or pointing towards the center + of the swing, but is at the same time attended with a degree of vertigo; + and is described in Class <a href="#species_II_1_6_7">II. 1. 6. 7</a>. <a + href="#species_IV_2_1_10">IV. 2. 1. 10</a>. Sup. I. <a + href="#suppl_III">3</a>. and <a href="#suppl_XV">15</a>.</p> + + <p>The necessity of much exercise has perhaps been more insisted upon by + physicians, than nature seems to demand. Few animals exercise themselves + so as to induce visible sweat, unless urged to it by mankind, or by fear, + or hunger. And numbers of people in our market towns, of ladies + particularly, with small fortunes, live to old age in health, without any + kind of exercise of body, or much activity of mind.</p> + + <p>In summer weak people cannot continue too long in the air, if it can + be done without fatigue; and in winter they should go out several times + in a day for a few minutes, using the cold air like a cold-bath, to + invigorate and render them more hardy.</p> + +<p class="cenhead"><a name="art_II_3">III</a>. <span class="sc">Catalogue of the Incitantia.</span></p> + + <p><a name="art_II_3_1">I</a>. Papaver somniferum; poppy, opium.</p> + +<blockquote class="b1n"> + + <p>Alcohol, wine, beer, cyder.</p> + + <p>Prunus lauro-cerasus; laurel, distilled water from the leaves.</p> + + <p>Prunus cerasus; black cherry, distilled water from the kernels.</p> + + <p>Nicotiana tabacum; tobacco? the essential oil, decoction of the + leaf.</p> + + <p>Atropa belladona; deadly nightshade, the berries.</p> + + <p>Datura stramoneum; thorn-apple, the fruit boiled in milk.</p> + + <p>Hyoscyamus reticulatus; henbane, the seeds and leaves.</p> + + <p>Cynoglossum; hounds tongue.</p> + + <p>Menispermum, cocculus; Indian berry.</p> + + <p>Amygdalus amarus; bitter almond.</p> + + <p>Cicuta; hemlock. Conium maculatum?</p> + + <p>Strychnos <span class="correction" title="Original reads `nuc'." + >nux</span> vomica?</p> + + <p>Delphinium stavisagria?</p> + +</blockquote> + + <p><a name="art_II_3_2">II</a>. Externally, heat, electricity.</p> + + <p><a name="art_II_3_3">III</a>. Ether, essential oils.</p> + + <p><a name="art_II_3_4">IV</a>. Oxygen gas.</p> + + <p><a name="art_II_3_5">V</a>. Passions of love, joy, anger.</p> + + <p><a name="art_II_3_6">VI</a>. Labour, play, agitation, friction.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3><span class="sc">Art. <a name="art_III">III</a>.</span></h3> + +<h3>SECERNENTIA.</h3> + + <p><a name="art_III_1">I</a>. Those things which increase the irritative + motions, which constitute secretion, are termed secernentia; which are as + various as the glands, which they stimulate into action.</p> + + <p><a name="art_III_1_1">1</a>. Diaphoretics, as aromatic vegetables, + essential oils, ether, volatile alcali, neutral salts, antimonial + preparations, external heat, exercise, friction, cold water for a time + with subsequent warmth, blisters, electric fluid.</p> + + <p><a name="art_III_1_2">2</a>. Sialagogues, as mercury internally, and + pyrethrum externally.</p> + + <p><a name="art_III_1_3">3</a>. Expectorants, as squill, onions, gum + ammoniac, seneka root, mucilage: some of these increase the pulmonary + perspiration, and perhaps the pulmonary mucus.</p> + + <p><a name="art_III_1_4">4</a>. Diuretics, as neutral salts, fixed + alcali, balsams, resins, asparagus, cantharides.</p> + + <p><a name="art_III_1_5">5</a>. Cathartics of the mild kind, as sena, + jalap, neutral salts, manna. They increase the secretions of bile, + pancreatic juice, and intestinal mucus.</p> + + <p><a name="art_III_1_6">6</a>. The mucus of the bladder is increased by + cantharides, and perhaps by oil of turpentine.</p> + + <p><a name="art_III_1_7">7</a>. The mucus of the rectum by aloe + internally, by clysters and suppositories externally.</p> + + <p><a name="art_III_1_8">8</a>. The mucus of the cellular membrane is + increased by blisters and sinapisms.</p> + + <p><a name="art_III_1_9">9</a>. The mucus of the nostrils is increased by + errhines of the milder kind, as marum, common snuff.</p> + + <p><a name="art_III_1_10">10</a>. The secretion of tears is increased by + volatile salts, the vapour of onions, by grief, and joy.</p> + + <p><a name="art_III_1_11">11</a>. All those medicines increase the heat + of the body, and remove those pains, which originate from a defect of + motion in the vessels, which perform secretion; as pepper produces a glow + on the skin, and balsam of Peru is said to relieve the flatulent cholic. + But these medicines differ from the preceding class, as they neither + induce costiveness nor deep coloured urine in their usual dose, nor + intoxication in any dose.</p> + + <p><a name="art_III_1_12">12</a>. Yet if any of these are used + unnecessarily, it is obvious, like the incitantia, that they must + contribute to shorten our lives by sooner rendering peculiar parts of the + system disobedient to their natural stimuli. Of those in daily use the + great excess of common salt is probably the most pernicious, as it enters + all our cookery, and is probably one cause of scrophula, and of + sea-scurvy, when joined with other causes of debility. See Botanic + Garden, Part II. Canto IV. line 221. Spices taken to excess by + stimulating the stomach, and the vessels of the skin by association, into + unnecessary action, contribute to weaken these parts of the system, but + are probably less noxious than the general use of so much salt.</p> + +<p class="cenhead"><a name="art_III_2">II</a>. <span class="sc">Observations on the Secernentia.</span></p> + + <p><a name="art_III_2_1">I</a>. <a name="art_III_2_1_1">1</a>. Some of + the medicines of this class produce absorption in some degree, though + their principal effect is exerted on the secerning part of our system. We + shall have occasion to observe a similar circumstance in the next class + of medicines termed Sorbentia; as of these some exert their effects in a + smaller degree on the secerning system. Nor will this surprise any one, + who has observed, that all natural objects are presented to us in a state + of combination; and that hence the materials, which produce these + different effects, are frequently found mingled in the same vegetable. + Thus the pure aromatics increase the action of the vessels, which secrete + the perspirable matter; and the pure astringents increase the action of + the vessels, which absorb the mucus from the lungs, and other cavities of + the body; hence it must happen, that nutmeg, which possesses both these + qualities, should have the double effect above mentioned.</p> + + <p>Other drugs have this double effect, and belong either to the class of + Secernentia or Sorbentia, according to the dose in which they are + exhibited. Thus a small dose of alum increases absorption, and induces + costiveness; and a large one increases the secretions into the intestinal + canal, and becomes cathartic. And this accounts for the constipation of + the belly left after the purgative quality of rhubarb ceases, for it + increases absorption in a smaller dose, and secretion in a greater. Hence + when a part of the larger dose is carried out of the habit by stools, the + small quantity which remains induces costiveness. Hence rhubarb exhibited + in small doses, as 2 or 3 grains twice a day, strengthens the system by + increasing the action of the absorbent vessels, and of the intestinal + canal.</p> + + <p><a name="art_III_2_1_2">2</a>. Diaphoretics. The perspiration is a + secretion from the blood in its passage through the capillary vessels, as + other secretions are produced in the termination of the arteries in the + various glands. After this secretion the blood loses its florid colour, + which it regains in its passage through the lungs; which evinces that + something besides water is secreted on the skins of animals.</p> + + <p>No statical experiments can ascertain the quantity of our + perspiration; as a continued absorption of the moisture of the atmosphere + exists at the same time both by the cutaneous and pulmonary + lymphatics.</p> + + <p><a name="art_III_2_1_3">3</a>. Every gland is capable of being excited + into greater exertions by an appropriated stimulus applied either by its + mixture with the blood immediately to the secerning vessel, or applied + externally to its excretory duct. Thus mercury internally promotes an + increased salivation, and pyrethrum externally applied to the excretory + ducts of the salival glands. Aloes stimulate the rectum internally mixed + with the circulating blood; and sea-salt by injection externally. Now as + the capillaries, which secrete the perspirable matter, lie near the + surface of the body, the application of external heat acts immediately on + their excretory ducts, and promotes perspiration; internally those drugs + which possess a fragrant essential oil, or spiritus rector, produce this + effect, as the aromatic vegetables, of which the number is very + great.</p> + + <p><a name="art_III_2_1_4">4</a>. It must be remembered, that a due + quantity of some aqueous vehicle must be given to support this + evacuation; otherwise a burning heat without much visible sweat must be + the consequence. When the skin acquires a degree of heat much above 108, + as appears by Dr. Alexander's experiments, no visible sweat is produced; + which is owing to the great heat of the skin evaporating it as hastily, + as it is secreted; and, where the sweat is secreted in abundance, its + evaporation cannot carry off the exuberant heat, like the vapour of + boiling water; because a great part of it is wiped off, or absorbed by + the bed-clothes; or the air about the patient is not changed sufficiently + often, as it becomes saturated with the perspirable matter. And hence it + is probable, that the waste of perspirable matter is as great, or + greater, when the skin is hot and dry, as when it stands in drops on the + skin; as appears from the inextinguishable thirst.</p> + + <p>Hence Dr. Alexander found, that when the heat of the body was greater + than 108, nothing produced sweats but repeated draughts of cold water; + and of warm fluids, when the heat was much below that degree. And that + cold water which procured sweats instantaneously when the heat was above + 108, stopped them as certainly when it was below that heat; and that + flannels, wrung out of warm water and wrapped round the legs and thighs, + were then most certainly productive of sweats.</p> + + <p><a name="art_III_2_1_5">5</a>. The diaphoretics are all said to + succeed much better, if given early in the morning, about an hour before + sun-rise, than at any other time; which is owing to the great + excitability of every part of the system after the sensorial power has + been accumulated during sleep. In those, who have hectic fever, or the + febricula, or nocturnal fever of debility, the morning sweats are owing + to the decline of the fever-fit, as explained in Sect. XXXII. 9. In some + of these patients the sweat does not occur till they awake; because then + the system is still more excitable than during sleep, because the + assistance of the voluntary power in respiration facilitates the general + circulation. See Class <a href="#species_I_2_1_3">I. 2. 1. 3</a>.</p> + + <p><a name="art_III_2_1_6">6</a>. It must be observed, that the skin is + very dry and hard to the touch, where the absorbents, which open on its + surface, do not act; as in some dropsies, and other diseases attended + with great thirst. This dryness, and shrivelled appearance, and + roughness, are owing to the mouths of the absorbents being empty of their + accustomed fluid, and is distinguishable from the dryness of the skin + above mentioned in the hot fits of fever, by its not being attended with + heat.</p> + + <p>As the heat of the skin in the usual temperature of the air always + evinces an increased perspiration, whether visible or not, the heat being + produced along with the increase of secretion; it follows, that a defect + of perspiration can only exist, when the skin is cold.</p> + + <p><a name="art_III_2_1_7">7</a>. Volatile alcali is a very powerful + diaphoretic, and particularly if exhibited in wine-whey; 20 drops of + spirit of hartshorn every half hour in half a pint of wine-whey, if the + patient be kept in a moderately warm bed, will in a few hours elicit most + profuse sweats.</p> + + <p>Neutral salts promote invisible perspiration, when the skin is not + warmed much externally, as is evinced from the great thirst, which + succeeds a meal of salt provisions, as of red herrings. When these are + sufficiently diluted with water, and the skin kept warm, copious sweats + without inflaming the habit, are the consequence. Half an ounce of + vinegar saturated with volatile alcali, taken every hour or two hours, + well answers this purpose; and is preferable perhaps in general to all + others, where sweating is advantageous. Boerhaave mentions one cured of a + fever by eating red-herrings or anchovies, which, with repeated draughts + of warm water or tea, would I suppose produce copious perspiration.</p> + + <p>Antimonial preparations have also been of late much used with great + advantage as diaphoretics. For the history and use of these preparations + I shall refer the reader to the late writers on the Materia Medica, only + observing that the stomach becomes so soon habituated to its stimulus, + that the second dose may be considerably increased, if the first had no + operation.</p> + + <p>Where it is advisable to procure copious sweats, the emetics, as + ipecacuanha, joined with opiates, as in Dover's powder, produce this + effect with greater certainty than the above.</p> + + <p><a name="art_III_2_1_8">8</a>. We must not dismiss this subject + without observing, that perspiration is designed to keep the skin + flexile, as the tears are intended to clean and lubricate the eye; and + that neither of these fluids can be considered as excretions in their + natural state, but as secretions. See Class <a href="#species_I_1_2_3">I. + 1. 2. 3</a>. And that therefore the principal use of diaphoretic + medicines is to warm the skin, and thence in consequence to produce the + natural degree of insensible perspiration in languid habits.</p> + + <p><a name="art_III_2_1_9">9</a>. When the skin of the extremities is + cold, which is always a sign of present debility, the digestion becomes + frequently impaired by association, and cardialgia or heartburn is + induced from the vinous or acetous fermentation of the aliment. In this + disease diaphoretics, which have been called cordials, by their action on + the stomach restore its exertion, and that of the cutaneous capillaries + by their association with it, and the skin becomes warm, and the + digestion more vigorous.</p> + + <p><a name="art_III_2_1_10">10</a>. But a blister acts with more + permanent and certain effect by stimulating a part of the skin, and + thence affecting the whole of it, and of the stomach by association, and + thence removes the most obstinate heartburns and vomitings. From this the + principal use of blisters is understood, which is to invigorate the + exertions of the arterial and lymphatic vessels of the skin, producing an + increase of insensible perspiration, and of cutaneous absorption; and to + increase the action of the stomach, and the consequent power of + digestion; and thence by sympathy to excite all the other irritative + motions: hence they relieve pains of the cold kind, which originate from + defect of motion; not from their introducing a greater pain, as some have + imagined, but by stimulating the torpid vessels into their usual action; + and thence increasing the action and consequent warmth of the whole skin, + and of all the parts which are associated with it.</p> + + <p><a name="art_III_2_2">II</a>. <a name="art_III_2_2_1">1</a>. + <i>Sialagogues.</i> The preparations of mercury consist of a solution or + corrosion of that metal by some acid; and, when the dose is known, it is + probable that they are all equally efficacious. As their principal use is + in the cure of the venereal disease, they will be mentioned in the + catalogue amongst the sorbentia. Where salivation is intended, it is much + forwarded by a warm room and warm clothes; and prevented by exposing the + patient to his usual habits of cool air and dress, as the mercury is then + more liable to go off by the bowels.</p> + + <p><a name="art_III_2_2_2">2</a>. Any acrid drug, as pyrethrum, held in + the mouth acts as a sialagogue externally by stimulating the excretory + ducts of the salivary glands; and the siliqua hirsuta applied externally + to the parotid gland, and even hard substances in the ear, are said to + have the same effect. Mastich chewed in the mouth emulges the salivary + glands.</p> + + <p><a name="art_III_2_2_3">3</a>. The unwise custom of chewing and + smoking tobacco for many hours in a day not only injures the salivary + glands, producing dryness in the mouth when this drug is not used, but I + suspect that it also produces schirrhus of the pancreas. The use of + tobacco in this immoderate degree injures the power of digestion, by + occasioning the patient to spit out that saliva, which he ought to + swallow; and hence produces that flatulency, which the vulgar + unfortunately take it to prevent. The mucus, which is brought from the + fauces by hawking, should be spit out, as well as that coughed up from + the lungs; but that which comes spontaneously into the mouth from the + salivary glands, should be swallowed mixed with our food or alone for the + purposes of digestion. See Class <a href="#species_I_2_2_7">I. 2. 2. + 7</a>.</p> + + <p><a name="art_III_2_3">III</a>. <a name="art_III_2_3_1">1</a>. + Expectorants are supposed to increase the secretion of mucus in the + branches of the windpipe, or to increase the perspiration of the lungs + secreted at the terminations of the bronchial artery.</p> + + <p><a name="art_III_2_3_2">2</a>. If any thing promotes expectoration + toward the end of peripneumonies, when the inflammation is reduced by + bleeding and gentle cathartics, small repeated blisters about the chest, + with tepid aqueous and mucilaginous or oily liquids, are more + advantageous than the medicines generally enumerated under this head; the + blisters by stimulating into action the vessels of the skin produce by + association a greater activity of those of the mucous membrane, which + lines the branches of the windpipe, and air-cells of the lungs; and thus + after evacuation they promote the absorption of the mucus and consequent + healing of the inflamed membrane, while the diluting liquids prevent this + mucus from becoming too viscid for this purpose, or facilitate its + expuition.</p> + + <p>Blisters, one at a time, on the sides or back, or on the sternum, are + also useful towards the end of peripneumonies, by preventing the evening + access of cold fit, and thence preventing the hot fit by their stimulus + on the skin; in the same manner as five drops of laudanum by its stimulus + on the stomach. For the increased actions of the vessels of the skin or + stomach excite a greater quantity of the sensorial power of association, + and thus prevent the torpor of the other parts of the system; which, when + patients are debilitated, is so liable to return in the evening.</p> + + <p><a name="art_III_2_3_3">3</a>. Warm bathing is of great service + towards the end of peripneumony to promote expectoration, especially in + those children who drink too little aqueous fluids, as it gently + increases the action of the pulmonary capillaries by their content with + the cutaneous ones, and supplies the system with aqueous fluid, and thus + dilutes the secreted mucus.</p> + + <p>Some have recommended oil externally around the chest, as well as + internally, to promote expectoration; and upon the nose, when its mucous + membrane is inflamed, as in common catarrh.</p> + + <p><a name="art_III_2_4">IV</a>. <a name="art_III_2_4_1">1</a>. + Diuretics. If the skin be kept warm, most of these medicines promote + sweat instead of urine; and if their dose is enlarged, most of them + become cathartic. Hence the neutral salts are used in general for all + these purposes. Those indeed, which are composed of the vegetable acid, + are most generally used as sudorifics; those with the nitrous acid as + diuretics; and those with the vitriolic acid as cathartics: while those + united with the marine acid enter our common nutriment, as a more general + stimulus. All these increase the acrimony of the urine, hence it is + retained a less time in the bladder; and in consequence less of it is + reabsorbed into the system, and the apparent quantity is greater, as more + is evacuated from the bladder; but it is not certain from thence, that a + greater quantity is secreted by the kidnies. Hence nitre, and other + neutral salts, are erroneously given in the gonorrhœa; as they + augment the pain of making water by their stimulus on the excoriated or + inflamed urethra. They are also erroneously given in catarrhs or coughs, + where the discharge is too thin and saline, as they increase the + frequency of coughing.</p> + + <p><a name="art_III_2_4_2">2</a>. Balsam of Copaiva is thought to promote + urine more than the other native balsams; and common resin is said to act + as a powerful diuretic in horses. These are also much recommended in + gleets, and in fluor albus, perhaps more than they deserve; they give a + violet smell to the urine, and hence probably increase the secretion of + it.</p> + + <p>Calcined egg-shells are said to promote urine, perhaps from the + phosphoric acid they contain.</p> + + <p><a name="art_III_2_4_3">3</a>. Cold air and cold water will increase + the quantity of urine by decreasing the absorption from the bladder; and + neutral and alcalious salts and cantharides by stimulating the neck of + the bladder to discharge the urine as soon as secreted; and alcohol as + gin and rum at the beginning of intoxication, if the body be kept cool, + occasion much urine by inverting the urinary lymphatics, and thence + pouring a fluid into the bladder, which never passed the kidnies. But it + is probable, that those medicines, which give a scent to the urine as the + balsams and resins, but particularly asparagus and garlic, are the only + drugs, which truly increase the secretion of the kidnies. Alcohol + however, used as above mentioned, and perhaps great doses of tincture of + cantharides, may be considered as drastic diuretics, as they pour a fluid + into the bladder by the retrograde action of the lymphatics, which are in + great abundance spread about the neck of it. See Sect. XXIX. 3.</p> + + <p><a name="art_III_2_5">V</a>. Mild cathartics. The ancients believed + that some purges evacuated the bile, and hence were termed Cholagogues; + others the lymph, and were termed Hydragogues; and that in most each + cathartic selected a peculiar humour, which it discharged. The moderns + have too hastily rejected this system; the subject well deserves further + observation.</p> + + <p>Calomel given in the dose from ten to twenty grains, so as to induce + purging without the assistance of other drugs, appears to me to + particularly increase the secretion of bile, and to evacuate it; aloe + seems to increase the secretion of the intestinal mucus; and it is + probable that the pancreas and spleen may be peculiarly stimulated into + action by some other of this tribe of medicines; whilst others of them + may simply stimulate the intestinal canal to evacuate its contents, as + the bile of animals. It must be remarked, that all these cathartic + medicines are supposed to be exhibited in their usual doses, otherwise + they become drastic purges, and are treated of in the Class of + Invertentia.</p> + + <p><a name="art_III_2_6">VI</a>. The mucus of the bladder is seen in the + urine, when cantharides have been used, either internally or externally, + in such doses as to induce the strangury. Spirit of turpentine is said to + have the same effect. I have given above a dram of it twice a day + floating on a glass of water in chronic lumbago without this effect, and + the patient gradually recovered.</p> + + <p><a name="art_III_2_7">VII</a>. Aloe given internally seems to act + chiefly on the rectum and, spincter ani, producing tenesmus and piles. + Externally in clysters or suppositories, common salt seems to act on that + bowel with greater certainty. But where the thread-worm or ascarides + exist, 60 or 100 grains of aloes reduced to powder and boiled in a pint + of gruel, and used as a clyster twice a week for three months, has + frequently destroyed them.</p> + + <p><a name="art_III_2_8">VIII</a>. The external application of + cantharides by stimulating the excretory ducts of the capillary glands + produces a great secretion of subcutaneous mucus with pain and + inflammation; which mucaginous fluid, not being able to permeate the + cuticle, raises it up; a similar secretion and elevation of the cuticle + is produced by actual fire; and by caustic materials, as by the + application of the juice of the root of white briony, or bruised + mustard-seed. Experiments are wanting to introduce some acrid application + into practice instead of cantharides, which might not induce the + strangury.</p> + + <p>Mustard-seed alone is too acrid, and if it be suffered to lie on the + skin many minutes is liable to produce a slough and consequent ulcer, and + should therefore be mixed with flour when applied to cold extremities. + Volatile alkali properly diluted might stimulate the skin without + inducing strangury.</p> + + <p><a name="art_III_2_9">IX</a>. The mild errhines are such as moderately + stimulate the membrane of the nostrils, so as to increase the secretion + of nasal mucus; as is seen in those, who are habituated to take snuff. + The stronger errhines are mentioned in Art. <a href="#art_V_2_3">V. 2. + 3</a>.</p> + + <p><a name="art_III_2_10">X</a>. The secretion of tears is increased + either by applying acrid substances to the eye; or acrid vapours, which + stimulate the excretory duct of the lacrymal gland; or by applying them + to the nostrils, and stimulating the excretory duct of the lacrymal sack, + as treated of in the Section on Instinct.</p> + + <p>Or the secretion of tears is increased by the association of the + motions of the excretory duct of the lacrymal sack with ideas of tender + pleasure, or of hopeless distress, as explained in Sect. XVI. 8. 2. and + 3.</p> + + <p><a name="art_III_2_11">XI</a>. The secretion of sensorial power in the + brain is probably increased by opium or wine, because when taken in + certain quantity an immediate increase of strength and activity succeeds + for a time, with consequent debility if the quantity taken be so great as + to intoxicate in the least degree. The necessity of perpetual respiration + shews, that the oxygen of the atmosphere supplies the source of the + spirit of animation; which is constantly expended, and is probably too + fine to be long contained in the nerves after its production in the + brain. Whence it is probable, that the respiration of oxygen gas mixed + with common air may increase the secretion of sensorial power; as indeed + would appear from its exhilarating effect on most patients.</p> + +<p class="cenhead"><a name="art_III_3">III</a>. <span class="sc">Catalogue of the Secernentia.</span></p> + + <p><a name="art_III_3_1">I</a>. Diaphoretics.</p> + +<blockquote class="b1n"> + + <p><a name="art_III_3_1_1">1</a>. Amomum zinziber, ginger. Caryophyllus + aromaticus, cloves. Piper indicum, pepper. Capsicum. Cardamomum. Pimento, + myrtus pimenta. Canella alba. Serpentaria virginiana, aristolochia + serpentaria, guaiacum. Sassafras, laurus sassafras. Opium. Wine.</p> + + <p><a name="art_III_3_1_2">2</a>. Essential oils of cinnamon, laurus + cinnamomum. Nutmeg, myristica moschata. Cloves, caryophyllus aromaticus. + Mint, mentha. Camphor, laurus camphora. Ether.</p> + + <p><a name="art_III_3_1_3">3</a>. Volatile salts, as of ammoniac and of + hartshorn. Sal cornu cervi.</p> + + <p><a name="art_III_3_1_4">4</a>. Neutral salts, as those with vegetable + acid; or with marine acid, as common salt. Halex. Red-herring, + anchovy.</p> + + <p><a name="art_III_3_1_5">5</a>. Preparations of antimony, as emetic + tartar, antimonium tartarizatum, wine of antimony. James's powder.</p> + + <p><a name="art_III_3_1_6">6</a>. External applications. Blisters. Warm + bath. Warm air. Exercise. Friction.</p> + + <p><a name="art_III_3_1_7">7</a>. Cold water with subsequent warmth.</p> + +</blockquote> + + <p><a name="art_III_3_2">II</a>. Sialagogues. Preparations of mercury, + hydrargyrus. Pyrethrum, anthemis pyrethrum, tobacco, cloves, pepper, + cowhage, stizolobium siliqua hirsuta. Mastich, pistacia lentiscus.</p> + + <p><a name="art_III_3_3">III</a>. Expectorants:</p> + +<blockquote class="b1n"> + + <p><a name="art_III_3_3_1">1</a>. Squill, scilla maritima, garlic, leek, + onion, allium, asafœtida, ferula asafœtida, gum ammoniac, + benzoin, tar, pix liquida, balsam of Tolu.</p> + + <p><a name="art_III_3_3_2">2</a>. Root of seneka, polygala seneka, of + elicampane, inula helenium.</p> + + <p><a name="art_III_3_3_3">3</a>. Marsh-mallow, althæa, coltsfoot, + tussilago farfara, gum arabic, mimosa nilotica, gum tragacanth, + astragalus tragacantha. Decoction of barley, hordeum distichon. Expressed + oils. Spermaceti, soap. Extract of liquorice, glycyrrhiza glabra. Sugar. + Honey.</p> + + <p><a name="art_III_3_3_4">4</a>. Externally blisters. Oil. Warm + bath.</p> + +</blockquote> + + <p><a name="art_III_3_4">IV</a>. Mild diuretics.</p> + +<blockquote class="b1n"> + + <p><a name="art_III_3_4_1">1</a>. Nitre, kali acetatum, other neutral + salts.</p> + + <p><a name="art_III_3_4_2">2</a>. Fixed alkali, soap, calcined + egg-shells.</p> + + <p><a name="art_III_3_4_3">3</a>. Turpentine. Balsam of Copaiva. Resin. + Olibanum.</p> + + <p><a name="art_III_3_4_4">4</a>. Asparagus, garlic, wild daucus. + Parsley, apium. Fennel fæniculum, pareira brava, Cissampelos?</p> + + <p><a name="art_III_3_4_5">5</a>. Externally cold air, cold water.</p> + + <p><a name="art_III_3_4_6">6</a>. Alcohol. Tincture of cantharides. + Opium.</p> + +</blockquote> + + <p><a name="art_III_3_5">V</a>. Mild cathartics.</p> + +<blockquote class="b1n"> + + <p><a name="art_III_3_5_1">1</a>. Sweet subacid fruits. Prunes, prunus + domestica. Cassia sistula. Tamarinds, crystals of tartar, unrefined + sugar. Manna. Honey.</p> + + <p><a name="art_III_3_5_2">2</a>. Whey of milk, bile of animals.</p> + + <p><a name="art_III_3_5_3">3</a>. Neutral salts, as Glauber's salt, + vitriolated tartar, sea-water, magnesia alba, soap.</p> + + <p><a name="art_III_3_5_4">4</a>. Gum guaiacum. Balsam of Peru. Oleum + ricini, castor-oil, oil of almonds, oil of olives, sulphur.</p> + + <p><a name="art_III_3_5_5">5</a>. Senna, cassia senna, jalap, aloe, + rhubarb, rheum palmatum.</p> + + <p><a name="art_III_3_5_6">6</a>. Calomel. Emetic tartar, antimonium + tartarizatum.</p> + +</blockquote> + + <p><a name="art_III_3_6">VI</a>. Secretion of mucus of the bladder is + increased by cantharides, by spirit of turpentine?</p> + + <p><a name="art_III_3_7">VII</a>. Secretion of mucus of the rectum is + increased by aloe internally, by various clysters and suppositories + externally.</p> + + <p><a name="art_III_3_8">VIII</a>. Secretion of subcutaneous mucus is + increased by blisters of cantharides, by application of a thin slice of + the fresh root of white briony, by sinapisms, by root of horse-radish, + cochlearia armoracia. Volatile alcali.</p> + + <p><a name="art_III_3_9">IX</a>. Mild errhines. Marjoram. Origanum. + Marum, tobacco.</p> + + <p><a name="art_III_3_10">X</a>. Secretion of tears is increased by + vapour of sliced onion, of volatile alcali. By pity, or ideas of hopeless + distress.</p> + + <p><a name="art_III_3_11">XI</a>. Secretion of sensorial power in the + brain is probably increased by opium, by wine, and perhaps by oxygen gas + added to the common air in respiration.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><span class="sc">Art. <a name="art_IV">IV</a>.</span></h3> + +<h3>SORBENTIA.</h3> + + <p><a name="art_IV_1">I</a>. Those things which increase the irritative + motions, which constitute absorption, are termed sorbentia; and are as + various as the absorbent vessels, which they stimulate into action.</p> + + <p><a name="art_IV_1_1">1</a>. Cutaneous absorption is increased by + austere acids, as of vitriol; hence they are believed to check + colliquative sweats, and to check the eruption of small-pox, and + contribute to the cure of the itch, and tinea; hence they thicken the + saliva in the mouth, as lemon-juice, crab-juice, sloes.</p> + + <p><a name="art_IV_1_2">2</a>. Absorption from the mucous membrane is + increased by opium, and Peruvian bark, internally; and by blue vitriol + externally. Hence the expectoration in coughs, and the mucous discharge + from the urethra, are thickened and lessened.</p> + + <p><a name="art_IV_1_3">3</a>. Absorption from the cellular membrane is + promoted by bitter vegetables, and by emetics, and cathartics. Hence + matter is thickened and lessened in ulcers by opium and Peruvian bark; + and serum is absorbed in anasarca by the operation of emetics and + cathartics.</p> + + <p><a name="art_IV_1_4">4</a>. Venous absorption is increased by acrid + vegetables; as water-cress, cellery, horse-radish, mustard. Hence their + use in sea-scurvy, the vibices of which are owing to a defect of venous + absorption; and by external stimulants, as vinegar, and by electricity, + and perhaps by oxygen.</p> + + <p><a name="art_IV_1_5">5</a>. Intestinal absorption is increased by + astringent vegetables, as rhubarb, galls; and by earthy salts, as alum; + and by argillaceous and calcareous earth.</p> + + <p><a name="art_IV_1_6">6</a>. Hepatic absorption is increased by + metallic salts, hence calomel and sal martis are so efficacious in + jaundice, worms, chlorosis, dropsy.</p> + + <p><a name="art_IV_1_7">7</a>. Venereal virus in ulcers is absorbed by + the stimulus of mercury; hence they heal by the use of this medicine.</p> + + <p><a name="art_IV_1_8">8</a>. Venesection, hunger, thirst, and violent + evacuations, increase all absorptions; hence sweating produces + costiveness.</p> + + <p><a name="art_IV_1_9">9</a>. Externally bitter astringent vegetables, + earthy and metallic salts, and bandages, promote the absorption of the + parts on which they are applied.</p> + + <p><a name="art_IV_1_10">10</a>. All these in their usual doses do not + increase the natural heat; but they induce costiveness, and deep coloured + urine with earthy sediment.</p> + + <p>In greater doses they invert the motions of the stomach and lacteals; + and hence vomit or purge, as carduus benedictus, rhubarb. They promote + perspiration, if the skin be kept warm; as camomile tea, and testaceous + powders, have been used as sudorifics.</p> + + <p>The preparations of antimony vomit, purge, or sweat, either according + to the quantity exhibited, or as a part of what is given is evacuated. + Thus a quarter of a grain of emetic tartar (if well prepared) will + promote a diaphoresis, if the skin be kept warm; half a grain will + procure a stool or two first, and sweating afterwards; and a grain will + generally vomit, and then purge, and lastly sweat the patient. In less + quantity it is probable, that this medicine acts like other metallic + salts, as steel, zinc, or copper in small doses; that is, that it + strengthens the system by its stimulus. As camomile or rhubarb in + different doses vomit, or purge, or act as stimulants so as to strengthen + the system.</p> + +<p class="cenhead"><a name="art_IV_2">II</a>. <span class="sc">Observations on the Sorbentia.</span></p> + + <p><a name="art_IV_2_1">I</a>. <a name="art_IV_2_1_1">1</a>. As there is + great difference in the apparent structure of the various glands, and of + the fluids which they select from the blood, these glands must possess + different kinds of irritability, and are therefore stimulated into + stronger or unnatural actions by different articles of the materia + medica, as shewn in the secernentia. Now as the absorbent vessels are + likewise glands, and drink up or select different fluids, as chyle, + water, mucus, with a part of every different secretion, as a part of the + bile, a part of the saliva, a part of the urine, &c. it appears, that + these absorbent vessels must likewise possess different kinds of + irritability, and in consequence must require different articles of the + materia medica to excite them into unusual action. This part of the + subject has been so little attended to, that the candid reader will find + in this article a great deal to excuse.</p> + + <p>It was observed, that some of the secernentia did in a less degree + increase absorption, from the combination of different properties in the + same vegetable body; for the same reason some of the class of sorbentia + produce secretion in a less degree, as those bitters which have also an + aroma in their composition; these are known from their increasing the + heat of the system above its usual degree.</p> + + <p>It must also be noted, that the actions of every part of the absorbent + system are so associated with each other, that the drugs which stimulate + one branch increase the action of the whole; and the torpor or quiescence + of one branch weakens the exertions of the whole; or when one branch is + excited into stronger action, some other branch has its actions weakened + or inverted. Yet though peculiar branches of the absorbent system are + stimulated into action by peculiar substances, there are other substances + which seem to stimulate the whole system, and that without immediately + increasing any of the secretions; as those bitters which possess no + aromatic scent, at the head of which stands the famed Peruvian bark, or + cinchona.</p> + + <p><a name="art_IV_2_1_2">2</a>. Cutaneous absorption. I have heard of + some experiments, in which the body was kept cold, and was thought to + absorb more moisture from the atmosphere than at any other time. This + however cannot be determined by statical experiments; as the capillary + vessels, which secrete the perspirable matter, must at the same time have + been benumbed by the cold; and from their inaction there could not have + been the usual waste of the weight of the body; and as all other muscular + exertions are best performed, when the body possesses its usual degree of + warmth, it is conclusive, that the absorbent system should likewise do + its office best, when it is not benumbed by external cold.</p> + + <p>The austere acids, as of vitriol, lemon-juice, juice of crabs and + sloes, strengthen digestion, and prevent that propensity to sweat so + usual to weak convalescents, and diminish the colliquative sweats in + hectic fevers; all which are owing to their increasing the action of the + external and internal cutaneous absorption. Hence vitriolic acid is given + in the small-pox to prevent the too hasty or too copious eruption, which + it effects, by increasing the cutaneous absorption. Vinegar, from the + quantity of alcohol which it contains, exerts a contrary effect to that + here described, and belongs to the incitantia; as an ounce of it promotes + sweat, and a flushing of the skin; at the same time externally it acts as + a venous absorbent, as the lips become pale by moistening them with it. + And it is said, when taken internally in great and continued quantity, to + induce paleness of the skin, and softness of the bones.</p> + + <p>The sweet vegetable acids, as of several ripe fruits, are among the + torpentia; as they are less stimulating than the general food of this + climate, and are hence used in inflammatory diseases.</p> + + <p>Where the quantity of fluids in the system is much lessened, as in + hectic fever, which has been of some continuance, or in spurious + peripneumony, a grain of opium given at night will sometimes prevent the + appearance of sweats; which is owing to the stimulus of opium increasing + the actions of the cutaneous absorbents, more than those of the secerning + vessels of the skin. Whence the secretion of perspirable matter is not + decreased, but its appearance on the skin is prevented by its more facile + absorption.</p> + + <p><a name="art_IV_2_1_3">3</a>. There is one kind of itch, which seldom + appears between the fingers, is the least infectious, and most difficult + to eradicate, and which has its cure much facilitated by the internal use + of acid of vitriol. This disease consists of small ulcers in the skin, + which are healed by whatever increases the cutaneous absorption. The + external application of sulphur, mercury, and acrid vegetables, acts on + the same principle; for the animalcula, which are seen in these pustules, + are the effect, not the cause, of them; as all other stagnating animal + fluids, as the semen itself, abounds with similar microscopic + animals.</p> + + <p><a name="art_IV_2_1_4">4</a>. Young children have sometimes an + eruption upon the head called Tinea, which discharges an acrimonius ichor + inflaming the parts, on which it falls. This eruption I have seen submit + to the internal use of vitriolic acid, when only wheat-flour was applied + externally. This kind of eruption is likewise frequently cured by + testaceous powders; two materials so widely different in their chemical + properties, but agreeing in their power of promoting cutaneous + absorption.</p> + + <p><a name="art_IV_2_2">II</a>. Absorption from the mucous membrane is + increased by applying to its surface the austere acids, as of vitriol, + lemon-juice, crab-juice, sloes. When these are taken into the mouth, they + immediately thicken, and at the same time lessen the quantity of the + saliva; which last circumstance cannot be owing to their coagulating the + saliva, but to their increasing the absorption of the thinner parts of + it. So alum applied to the tip of the tongue does not stop in its action + there, but independent of its diffusion it induces cohesion and + corrugation over the whole mouth. (Cullen's Mat. Med. Art. Astringentia.) + Which is owing to the association of the motions of the parts or branches + of the absorbent system with each other.</p> + + <p>Absorption from the mucous membrane is increased by opium taken + internally in small doses more than by any other medicine, as is seen in + its thickening the expectoration in coughs, and the discharge from the + nostrils in catarrh, and perhaps the discharge from the urethra in + gonorrhoea. The bark seems next in power for all these purposes.</p> + + <p>Externally slight solutions of blue vitriol, as two or three grains to + an ounce of water, applied to ulcers of the mouth, or to chancres on the + glans penis, more powerfully induces them to heal than any other + material.</p> + + <p>Where the lungs or urethra are inflamed to a considerable degree, and + the absorption is so great, that the mucus is already too thick, and + adheres to the membrane from its viscidity, opiates and bitter vegetable + and austere acids are improper; and mucilaginous diluents should be used + in their stead with venesection and torpentia.</p> + + <p><a name="art_IV_2_3">III</a>. <a name="art_IV_2_3_1">1</a>. Absorption + from the cellular membrane, and from all the other cavities of the body, + is too slowly performed in some constitutions; hence the bloated pale + complexion; and when this occurs in its greatest degree, it becomes an + universal dropsy. These habits are liable to intermittent fevers, + hysteric paroxysms, cold extremities, indigestion, and all the symptoms + of debility.</p> + + <p>The absorbent system is more subject to torpor or quiescence than the + secerning system, both from the coldness of the fluids which are applied + to it, as the moisture of the atmosphere, and from the coldness of the + fluids which we drink; and also from its being stimulated only by + intervals, as when we take our food; whereas the secerning system is + perpetually excited into action by the warm circulating blood; as + explained in Sect. XXXII.</p> + + <p><a name="art_IV_2_3_2">2</a>. The Peruvian bark, camomile flowers, and + other bitter drugs, by stimulating this cellular branch of the absorbent + system prevents it from becoming quiescent; hence the cold paroxysms of + those agues, which arise from the torpor of the cellular lymphatics, are + prevented, and the hot fits in consequence. The patient thence preserves + his natural heat, regains his healthy colour, and his accustomed + strength.</p> + + <p>Where the cold paroxysm of an ague originates in the absorbents of the + liver, spleen, or other internal viscus, the addition of steel to + vegetable bitters, and especially after the use of one dose of calomel, + much advances the cure.</p> + + <p>And where it originates in any part of the secerning system, as is + probably the case in some kinds of agues, the addition of opium in the + dose of a grain and half, given about an hour before the access of the + paroxysm, or mixed with chalybeate and bitter medicines, ensures the + cure. Or the same may be effected by wine given instead of opium before + the paroxysm, so as nearly to intoxicate.</p> + + <p>These three kinds of agues are thus distinguished; the first is not + attended with any tumid or indurated viscus, which the people call an + ague cake, and which is evident to the touch. The second is accompanied + with a tumid viscus; and the last has generally, I believe, the quartan + type, and is attended with some degree of arterial debility.</p> + + <p><a name="art_IV_2_3_3">3</a>. This class of absorbent medicines are + said to decrease irritability. After any part of our system has been + torpid or quiescent, by whatever cause that was produced, it becomes + afterwards capable of being excited into greater motion by small stimuli; + hence the hot fit of fever succeeds the cold one. As these medicines + prevent torpor or quiescence of parts of the system, as cold hands or + feet, which perpetually happen to weak constitutions, the subsequent + increase of irritability of these parts is likewise prevented.</p> + + <p><a name="art_IV_2_3_4">4</a>. These absorbent medicines, including + both the bitters, and metallic salts, and opiates, are of great use in + the dropsy by their promoting universal absorption; but here evacuations + are likewise to be produced, as will be treated of in the + Invertentia.</p> + + <p><a name="art_IV_2_3_5">5</a>. The matter in ulcers is thickened, and + thence rendered less corrosive, the saline part of it being reabsorbed by + the use of bitter medicines; hence the bark is used with advantage in the + cure of ulcers.</p> + + <p><a name="art_IV_2_3_6">6</a>. Bitter medicines strengthen digestion by + promoting the absorption of chyle; hence the introduction of hop into the + potation used at our meals, which as a medicine may be taken + advantageously, but, like other unnecessary stimuli, must be injurious as + an article of our daily diet.</p> + + <p>The hop may perhaps in some degree contribute to the production of + gravel in the kidnies, as our intemperate wine-drinkers are more subject + to the gout, and ale-drinkers to the gravel; in the formation of both + which diseases, there can be no doubt, but that the alcohol is the + principal, if not the only agent.</p> + + <p><a name="art_IV_2_3_7">7</a>. Vomits greatly increase the absorption + from the cellular membrane, as squill, and foxglove. The squill should be + given in the dose of a grain of the dried root every hour, till it + operates upwards and downwards. Four ounces of the fresh leaves of the + foxglove should be boiled from two pounds of water to one, and half an + ounce of the decoction taken every two hours for four or more doses. This + medicine by stimulating into inverted action the absorbents of the + stomach, increases the direct action of the cellular lymphatics.</p> + + <p>Another more convenient way of ascertaining the dose of foxglove is by + making a saturated tincture of it in proof spirit; which has the twofold + advantage of being invariable in its original strength, and of keeping a + long time as a shop-medicine without losing any of its virtue. Put two + ounces of the leaves of purple foxglove, digitalis purpurea, nicely + dried, and coarsely powdered, into a mixture of four ounces of rectified + spirit of wine and four ounces of water; let the mixture stand by the + fire-side twenty-four hours frequently shaking the bottle, and thus + making a saturated tincture of digitalis; which must be poured from the + sediment or passed through filtering paper.</p> + + <p>As the size of a drop is greater or less according to the size of the + rim of the phial from which it is dropped, a part of this saturated + tincture is then directed to be put into a two-ounce phial, for the + purpose of ascertaining the size of the drop. Thirty drops of this + tincture is directed to be put into an ounce of mint-water for a draught + to be taken twice or thrice a day, till it reduces the anasarca of the + limbs, or removes the difficulty of breathing in hydrothorax, or till it + induces sickness. And if these do not occur in two or three days, the + dose must be gradually increased to forty or sixty drops, or further.</p> + + <p>From the great stimulus of this medicine the stomach is rendered + torpid with consequent sickness, which continues many hours and even + days, owing to the great exhaustion of its sensorial power of irritation; + and the action of the heart and arteries becomes feeble from the + deficient excitement of the sensorial power of association; and lastly, + the absorbents of the cellular membrane act more violently in consequence + of the accumulation of the sensorial power of association in the torpid + heart and arteries, as explained in Suppl. I. <a + href="#suppl_XII">12</a>.</p> + + <p>A circumstance curiously similar to this occurs to some people on + smoking tobacco for a short time, who have not been accustomed to it. A + degree of sickness is presently induced, and the pulsations of the heart + and arteries become feeble for a short time, as in the approach to + fainting, owing to the direct sympathy between these and the stomach, + that is from defect of the excitement of the power of association. Then + there succeeds a tingling, and heat, and sometimes sweat, owing to the + increased action of the capillaries, or perspirative and mucous glands; + which is occasioned by the accumulation of the sensorial power of + association by the weaker action of the heart and arteries, which now + increases the action of the capillaries.</p> + + <p><a name="art_IV_2_3_8">8</a>. Another method of increasing absorption + from the cellular membrane is by warm air, or by warm steam. If the + swelled legs of a dropsical patient are inclosed in a box, the air of + which is made warm by a lamp or two, copious sweats are soon produced by + the increased action of the capillary glands, which are seen to stand on + the skin, as it cannot readily exhale in so small a quantity of air, + which is only changed so fast as may be necessary to permit the lamps to + burn. At the same time the lymphatics of the cellular membrane are + stimulated by the heat into greater action, as appears by the speedy + reduction of the tumid legs.</p> + + <p>It would be well worth trying an experiment upon a person labouring + under a general anasarca by putting him into a room filled with air + heated to 120 or 130 degrees, which would probably excite a great general + diaphoresis, and a general cellular absorption both from the lungs and + every other part. And that air of so great heat may be borne for many + minutes without great inconvenience was shewn by the experiments made in + heated rooms by Dr. Fordyce and others. Philos. Trans.</p> + + <p>Another experiment of using warmth in anasarca, or in other diseases, + might be by immersing the patient in warm air, or in warm steam, received + into an oil-skin bag, or bathing-tub of tin, so managed, that the current + of warm air or steam should pass round and cover the whole of the body + except the head, which might not be exposed to it; and thus the + absorbents of the lungs might be induced to act more powerfully by + sympathy with the skin, and not by the stimulus of heat. See Uses of Warm + Bath, <span class="correction" title="Original reads `Class IV. 2. 2. 1.'." + >Art. <a href="#art_II_2_2_1">II. 2. 2. 1</a></span>.</p> + + <p><a name="art_IV_2_4">IV</a>. <a name="art_IV_2_4_1">1</a>. Venous + absorption. Cellary, water-cresses, cabbages, and many other vegetables + of the Class Tetradynamia, do not increase the heat of the body (except + those whose acrimony approaches to corrosion), and hence they seem alone, + or principally, to act on the venous system; the extremities of which we + have shewn are absorbents of the red blood, after it has passed the + capillaries and glands.</p> + + <p><a name="art_IV_2_4_2">2</a>. In the sea-scurvy and petechial fever + the veins do not perfectly perform this office of absorption; and hence + the vibices are occasioned by blood stagnating at their extremities, or + extravasated into the cellular membrane. And this class of vegetables, + stimulating the veins to perform their natural absorption, without + increasing the energy of the arterial action, prevents future petechiæ, + and may assist the absorption of the blood already stagnated, as soon as + its chemical change renders it proper for that operation.</p> + + <p><a name="art_IV_2_4_3">3</a>. The fluids, which are extravasated, and + received into the cells of the cellular membrane, seem to continue there + for many days, so as to undergo some chemical change, and are then taken + up again by the mouths of the cellular absorbents. But the new vessels + produced in inflamed parts, as they communicate with the veins, are + probably absorbed again by the veins along with the blood which they + contain in their cavities. Hence the blood, which is extravasated in + bruises or vibices, is gradually many days in disappearing; but after due + evacuations the inflamed vessels on the white of the eye, if any + stimulant lotion is applied, totally disappear in a few hours.</p> + + <p>Amongst absorbents affecting the veins we should therefore add the + external application of stimulant materials; as of vinegar, which makes + the lips pale on touching them. Friction, and electricity.</p> + + <p><a name="art_IV_2_4_4">4</a>. Hæmorrhages are of two kinds, either + arterial, which are attended with inflammation; or venous, from a + deficiency in the absorbent power of this set of vessels. In the former + case the torpentia are efficacious; in the latter steel, opium, alum, and + all the tribe of sorbentia, are used with success.</p> + + <p><a name="art_IV_2_4_5">5</a>. Sydenham recommends vegetables of the + class Tetradynamia in rheumatic pains left after the cure of + intermittents. These pains are perhaps similar to those of the + sea-scurvy, and seem to arise from want of absorption in the affected + part, and hence are relieved by the same medicines.</p> + + <p><a name="art_IV_2_5">V</a>. <a name="art_IV_2_5_1">1</a>. Intestinal + absorption. Some astringent vegetables, as rhubarb, may be given in such + doses as to prove cathartic; and, after a part of it is evacuated from + the body, the remaining part augments the absorption of the intestines; + and acts, as if a similar dose had been exhibited after the operation of + any other purgative. Hence 4 grains of rhubarb strengthen the bowels, 30 + grains first empty them.</p> + + <p><a name="art_IV_2_5_2">2</a>. The earthy salts, as alum, increase the + intestinal absorption, and hence induce constipation in their usual dose; + alum is said sometimes to cure intermittents, perhaps when their seat is + in the intestines, when other remedies have failed. It is useful in the + diabætes by exciting the absorbents of the bladder into their natural + action; and combined with resin is esteemed in the fluor albus, and in + gleets. Lime-stone or chalk, and probably gypsum, possess effects in some + degree similar, and increase the absorption of the intestines; and thus + in certain doses restrain some diarrhœas, but in greater doses alum + I suppose will act as a cathartic. Five or ten grains produce + constipation, 20 or 30 grains are either emetic or cathartic.</p> + + <p><a name="art_IV_2_5_3">3</a>. Earth of alum, tobacco-pipe clay, marl, + Armenian bole, lime, crab's eyes or claws, and calcined hartshorn, or + bone ashes, restrain fluxes; either mechanically by supplying something + like mucilage, or oil, or rollers to abate the friction of the aliment + over inflamed membranes; or by increasing their absorption. The two last + consist of calcareous earth united to phosphoric acid, and the Armenian + bole and marl may contain iron. By the consent between the intestines and + the skin 20 grains of Armenian bole given at going into bed to hectic + patients will frequently check their tendency to sweat as well as to + purge, and the more certainly if joined with one grain of opium.</p> + + <p><a name="art_IV_2_6">VI</a>. <a name="art_IV_2_6_1">1</a>. Absorption + from the liver, stomach, and other viscera. When inflammations of the + liver are subdued to a certain degree by venesection, with calomel and + other gentle purges, so that the arterial energy becomes weakened, four + or eight grains of iron-filings, or of salt of steel, with the Peruvian + bark, have wonderful effect in curing the cough, and restoring the liver + to its usual size and sanity; which it seems to effect by increasing the + absorption of this viscus. The same I suppose happens in respect to the + tumours of other viscera, as of the spleen, or pancreas, some of which + are frequently enlarged in agues.</p> + + <p><a name="art_IV_2_6_2">2</a>. Hæmorrhages from the nose, rectum, + kidnies, uterus, and other parts, are frequently attendant on diseased + livers; the blood being impeded in the vena portarum from the decreased + power of absorption, and in consequence of the increased size of this + viscus. These hæmorrhages after venesection, and a mercurial cathartic, + are most certainly restrained by steel alone, or joined with an opiate; + which increase the absorption, and diminish the size of the liver.</p> + + <p>Chalybeates may also restrain these hæmorrhages by their promoting + venous absorption, though they exert their principal effect upon the + liver. Hence also opiates, and bitters, and vitriolic acid, are + advantageously used along with them. It must be added that some + hæmorrhages recur by periods like the paroxysms of intermittent fevers, + and are thence cured by the same treatment.</p> + + <p><a name="art_IV_2_6_3">3</a>. The jaundice is frequently caused by the + insipidity of the bile, which does not stimulate the gall-bladder and + bile-ducts into their due action; hence it stagnates in the gall-bladder, + and produces a kind of crystallization, which is too large to pass into + the intestines, blocks up the bile-duct, and occasions a long and painful + disease. A paralysis of the bile duct produces a similar jaundice, but + without pain.</p> + + <p><a name="art_IV_2_6_4">4</a>. Worms in sheep called flukes are owing + to the dilute state of the bile; hence they originate in the intestines, + and thence migrate into the biliary ducts, and corroding the liver + produce ulcers, cough, and hectic fever, called the rot. In human bodies + it is probable the inert state of the bile is one cause of the production + of worms; which insipid state of the bile is owing to deficient + absorption of the thinner parts of it; hence the pale and bloated + complexion, and swelled upper lip, of wormy children, is owing to the + concomitant deficiency of absorption from the cellular membrane. Salt of + steel, or the rust of it, or filings of it, with bitters, increase the + acrimony of the bile by promoting the absorption of its aqueous part; and + hence destroy worms, as well as by their immediate action on the + intestines, or on the worms themselves. The cure is facilitated by + premising a purge with calomel. See Class <a href="#species_I_2_3_9">I. + 2. 3. 9</a>.</p> + + <p><a name="art_IV_2_6_5">5</a>. The chlorosis is another disease owing + to the deficient action of the absorbents of the liver, and perhaps in + some degree also to that of the secretory vessels, or glands, which + compose that viscus. Of this the want of the catameniæ, which is + generally supposed to be a cause, is only a symptom or consequence. In + this complaint the bile is deficient perhaps in quantity, but certainly + in acrimony, the thinner parts not being absorbed from it. Now as the + bile is probably of great consequence in the process of making the blood; + it is on this account that the blood is so destitute of red globules; + which is evinced by the great paleness of these patients. As this serous + blood must exert less stimulus on the heart, and arteries, the pulse in + consequence becomes quick as well as weak, as explained in Sect. XII. 1. + 4.</p> + + <p>The quickness of the pulse is frequently so great and permanent, that + when attended by an accidental cough, the disease may be mistaken for + hectic fever; but is cured by chalybeates, and bitters exhibited twice a + day; with half a grain of opium, and a grain of aloe every night; and the + expected catamenia appears in consequence of a restoration of the due + quantity of red blood. This and the two former articles approach to the + disease termed paralysis of the liver. Sect. <span class="correction" + title="Original reads `XXX. 4.'.">XXX. 1. 4</span>.</p> + + <p><a name="art_IV_2_6_6">6</a>. It seems paradoxical, that the same + treatment with chalybeates, bitters, and opiates, which produces + menstruation in chlorotic patients, should repress the too great or + permanent menstruation, which occurs in weak constitutions at the time of + life when it should cease. This complaint is an hæmorrhage owing to the + debility of the absorbent power of the veins, and belongs to the + paragraph on venous absorption above described, and is thence curable by + chalybeates, alum, bitters, and particularly by the exhibition of a grain + of opium every night with five grains of rhubarb.</p> + + <p><a name="art_IV_2_6_7">7</a>. Metallic salts supply us with very + powerful remedies for promoting absorption in dropsical cases; which + frequently are caused by enlargement of the liver. First, as they may be + given in such quantities as to prove strongly cathartic, of which more + will be said in the article on invertentia; and then, when their + purgative quality ceases, like the effect of rhubarb, their absorbent + quality continues to act. The salts of mercury, silver, copper, iron, + zinc, antimony, have all been used in the dropsy; either singly for the + former purpose, or united with bitters for the latter, and occasionally + with moderate but repeated opiates.</p> + + <p><a name="art_IV_2_6_8">8</a>. From a quarter of a grain to half a + grain of blue vitriol given every four or six hours, is said to be very + efficacious in obstinate intermittents; which also frequently arise from + an enlarged viscus, as the liver or spleen, and are thence owing to the + deficient absorption of the lymphatics of that viscus. A quarter of a + grain of white arsenic, as I was informed by a surgeon of the army, cures + a quartan ague with great certainty, if it be given an hour before the + expected fit. This dose he said was for a robust man, perhaps one eighth + of a grain might be given and repeated with greater safety and equal + efficacy.</p> + + <p>Dr. Fowler has given many successful cases in his treatise on this + subject. He prepares it by boiling sixty-four grains of white arsenic in + a Florence flask along with as much pure vegetable fixed alcali in a pint + of distilled water, till it is dissolved, and then adding to it as much + distilled water as will make the whole exactly sixteen ounces. Hence + there are four grains of arsenic in every ounce of the solution. This + should be put into a phial of such a size of the edge of its aperture, + that sixty drops may weigh one dram, which will contain half a grain of + arsenic. To children from two years old to four he gives from two to five + drops three or four times a day. From five years old to seven, he directs + seven or eight drops. From eight years old to twelve, he directs from + seven to ten drops. From thirteen years old to eighteen he directs from + ten to twelve drops. From eighteen upwards, twelve drops. In so powerful + a medicine it is always prudent to begin with smaller doses, and + gradually to increase them.</p> + + <p>A saturated solution of arsenic in water is preferable I think to the + above operose preparation of it; as no error can happen in weighing the + ingredients, and it more certainly therefore possesses an uniform + strength. Put much more white arsenic reduced to powder into a given + quantity of distilled water, than can be dissolved in it. Boil it for + half an hour in a Florence flask, or in a tin sauce-pan; let it stand to + subside, and filter it through paper. My friend Mr. Greene, a surgeon at + Brewood in Staffordshire, assured me, that he had cured in one season + agues without number with this saturated solution; that he found ten + drops from a two-ounce phial given thrice a day was a full dose for a + grown person, but that he generally began with five.</p> + + <p><a name="art_IV_2_6_9">9</a>. The manner, in which arsenic acts in + curing intermittent fevers, cannot be by its general stimulus, because no + intoxication or heat follows the use of it; nor by its peculiar stimulus + on any part of the secreting system, since it is not in small doses + succeeded by any increased evacuation, or heat, and must therefore exert + its power, like other articles of the sorbentia, on the absorbent system. + In what manner it destroys life so suddenly is difficult to understand, + as it does not intoxicate like many vegetable poisons, nor produce fevers + like contagious matter. When applied externally it seems chemically to + destroy the part like other caustics. Does it chemically destroy the + stomach, and life in consequence? or does it destroy the action of the + stomach by its great stimulus, and life in consequence of the sympathy + between the stomach and the heart? This last appears to be the most + probable mode of its operation.</p> + + <p>The success of arsenic in the cure of intermittent fevers I suspect to + depend on its stimulating the stomach into stronger action, and thus, by + the association of this viscus with the heart and arteries, preventing + the torpor of any part of the sanguiferous system. I was led to this + conclusion from the following considerations.</p> + + <p>First. The effects of arsenic given a long time internally in small + doses, or when used in larger quantities externally, seem to be similar + to those of other great stimuli, as of wine or alcohol. These are a + bloated countenance, swelled legs, hepatic tumours, and dropsy, and + sometimes eruptions on the skin. The former of these I have seen, where + arsenic has been used externally for curing the itch; and the latter + appears on evidence in the famous trial of Miss Blandy at Chelmsford, + about forty years ago.</p> + + <p>Secondly. I saw an ague cured by arsenic in a child, who had in vain + previously taken a very large quantity of bark with great regularity. And + another case of a young officer, who had lived intemperately, and + laboured under an intermittent fever, and had taken the bark repeatedly + in considerable quantities, with a grain of opium at night, and though + the paroxysms had been thrice thus for a time prevented, they recurred in + about a week. On taking five drops of a saturated solution of arsenic + thrice a day the paroxysms ceased, and returned no more, and at the same + time his appetite became much improved.</p> + + <p>Thirdly. A gentleman about 65 years of age had for about ten years + been subject to an intermittent pulse, and to frequent palpitations of + his heart. Lately the palpitations seemed to observe irregular periods, + but the intermission of every third or fourth pulsation was almost + perpetual. On giving him four drops of a saturated solution of arsenic + from a two-ounce phial about every four hours for one day, not only the + palpitation did not return, but the intermission ceased entirely, and did + not return so long as he took the medicine, which was three or four + days.</p> + + <p>Now as when the stomach has its action much weakened by an over-dose + of digitalis, the pulse is liable to intermit, this evinces a direct + sympathy between these parts of the system, and as I have repeatedly + observed, that when the pulse begins to intermit in elderly people, that + an eructation from the stomach, voluntarily produced, will prevent the + threatened stop of the heart; I am induced to think, that the torpid + state of the stomach, at the instant of the production of air occasioned + by its weak action, caused the intermission of the pulse. And that + arsenic in this case, as well as in the cases of agues above mentioned, + produced its effects by stimulating the stomach into more powerful + action; and that the equality of the motions of the heart was thus + restored by increasing the excitement of the sensorial power of + association. See Sect. XXV. 17. Class <a href="#species_IV_2_1_18">IV. 2. + 1. 18</a>.</p> + + <p><a name="art_IV_2_6_10">10</a>. Where arsenic has been given as a + poison, it may be discovered in the contents of the stomach by the smell + like garlic, when a few grains of it are thrown on a red-hot iron. 2. If + a few grains are placed between two plates of copper, and subjected to a + red heat, the copper becomes whitened. 3. Dissolve arsenic in water along + with vegetable alcali, add to this a solution of blue vitriol in water, + and the mixture becomes of a fine green, which gradually precipitates, as + discovered by Bergman. 4. Where the quantity is sufficient, some wheat + may be steeped in a solution of it, which given to sparrows or chickens + will destroy them.</p> + + <p><a name="art_IV_2_7">VII</a>. Absorption of the matter from venereal + ulcers. No ulcer can heal, unless the absorption from it is as great as + the deposition in it. The preparations or oxydes of mercury in the cure + of the venereal disease seem to act by their increasing the absorption of + the matter in the ulcers it occasions; and that whether they are taken + into the stomach, or applied on the skin, or on the surface of the + ulcers. And this in the same manner as sugar of lead, or other metallic + oxydes, promote so rapidly the healing of other ulcers by their external + application; and probably when taken internally, as rust of iron given to + children affected with scrophulous ulcers contributes to heal them, and + solutions of lead were once famous in phthisis.</p> + + <p>The matter deposited in large abscesses does not occasion hectic + fever, till it has become oxygenated by being exposed to the open air, or + to the air through a moist membrane; the same seems to happen to other + kinds of matter, which produce fever, or which occasion spreading ulcers, + and are thence termed contagious. See Class <a href="#genus_II_1_3">II. + 1. 3</a>. <a href="#genus_II_1_5">II. 1. 5</a>. <a + href="#species_II_1_6_6">II. 1. 6. 6</a>. This may perhaps occur from + these matters not being generally absorbed, till they become oxygenated; + and that it is the stimulus of the acid thus formed by their union with + oxygen, which occasions their absorption into the circulation, and the + fever, which they then produce. For though collections of matter, and + milk, and mucus, are sometimes suddenly absorbed during the action of + emetics or in sea-sickness, they are probably eliminated from the body + without entering the circulation; that is, they are taken up by the + increased action of one lymphatic branch, and evacuated by the inverted + action of some other lymphatic branch, and thus carried off by stool or + urine.</p> + + <p>But as the matter in large abscesses is in general not absorbed, till + it becomes by some means exposed to air, there is reason to conclude, + that the stimulus of this new combination of the matter with oxygen + occasions its absorption; and that hence the absorption of matter in + ulcers of all kinds, is still more powerfully effected by the external + application or internal use of metallic oxydes; which are also acids + consisting of the metal united with oxygen; and lastly, because venereal + ulcers, and those of itch, and tinea, will not heal without some + stimulant application; that is, the secretion of matter in them continues + to be greater, than the absorption of it; and the ulcers at the same time + continue to enlarge, by the contagion affecting the edges of them; that + is, by the stimulus of the oxygenated matter stimulating the capillary + vessels in its vicinity into actions similar to those of the ulcer, which + produces it.</p> + + <p>This effect of the oxydes of mercury occurs, whether salivation + attends its use or not. Salivation is much forwarded by external warmth, + when mercury is given to promote this secretion; but as the cure of + venereal complaints depends on its absorbent quality, the act of + salivation is not necessary or useful. A quarter of a grain of good + corrosive sublimate twice a day will seldom fail of curing the most + confirmed pox; and will as seldom salivate, if the patient be kept cool. + A quarter of a grain thrice a day I believe to be infallible, if it be + good sublimate.</p> + + <p>Mercury alone when swallowed does not act beyond the intestines, its + active preparations are the salts formed by its union with the various + acids, as mentioned in the catalogue. Its union with the vegetable acid, + when triturated with manna, is said to compose Keyser's Pill. Triturated + with gum arabic it is much recommended by Plenk; and triturated with + sugar and a little essential oil, as directed in a former Edinburgh + Dispensatory, it probably forms some of the syrups sold as nostrums.</p> + + <p>United with sulphur it seldom enters the circulation, as when + cinnabar, or Æthiop's mineral, are taken inwardly. But united with fat + and rubbed on the skin, it is readily absorbed. I know not whether it can + be united to charcoal, nor whether it has been given internally when + united with animal fat.</p> + + <p><a name="art_IV_2_8">VIII</a>. <a name="art_IV_2_8_1">1</a>. + Absorptions in general are increased by inanition; hence the use of + evacuations in the cure of ulcers. Dr. Jurin absorbed in one night, after + a day's abstinence and exercise, eighteen ounces from the atmosphere in + his chamber; and every one must have observed, how soon his sheets became + dry, after having been moistened by sweat, if he throws off part of the + bed-clothes to cool himself; which is owing to the increased cutaneous + absorption after the evacuation by previous sweat.</p> + + <p><a name="art_IV_2_8_2">2</a>. Now as opium is an universal stimulant, + as explained in the article on Incitantia, it must stimulate into + increased action both the secretory system, and the absorbent one; but + after repeated evacuation by venesection, and cathartics, the absorbent + system is already inclined to act more powerfully; as the blood-vessels + being less distended, there is less resistance to the progress of the + absorbed fluids into them. Hence after evacuations opium promotes + absorption, if given in small doses, much more than it promotes + secretion; and is thus eminently of service at the end of inflammations, + as in pleurisy, or peripneumony, in the dose of four or five drops of the + tincture, given before the access of the evening paroxysm; which I have + seen succeed even when the risus sardonicus has existed. Some convulsions + may originate in the want of the absorption of some acrid secretion, + which occasions pain; hence these diseases are so much more certainly + relieved by opium after venesection or other evacuations.</p> + + <p><a name="art_IV_2_9">IX</a>. <a name="art_IV_2_9_1">1</a>. Absorption + is increased by the calces or solutions of mercury, lead, zinc, copper, + iron, externally applied; and by arsenic, and by sulphur, and by the + application of bitter vegetables in fine powder. Thus an ointment + consisting of mercury and hog's fat rubbed on the skin cures venereal + ulcers; and many kinds of herpetic eruptions are removed by an ointment + consisting of 60 grains of white precipitate of mercury and an ounce of + hog's fat.</p> + + <p><a name="art_IV_2_9_2">2</a>. The tumours about the necks of young + people are often produced by the absorption of a saline or acrid + material, which has been deposited from eruptions behind the ears, owing + to deficient absorption in the surface of the ulcer, but which on running + down on the skin below becomes absorbed, and swells the lymphatic glands + of the neck; as the variolous matter, when inserted into the arm, swells + the gland of the axilla. Sometimes the perspirative matter produced + behind the ears becomes putrid from the want of daily washing them, and + may also cause by its absorption the tumours of the lymphatics of the + neck. In the former case the application of a cerate of lapis + calaminaris, or of cerussa applied in dry powder, or of rags dipped in a + solution of sugar of lead, increases the absorption in the ulcers, and + prevents the effusion of the saline part of the secreted material. The + latter is to be prevented by cleanliness.</p> + + <p>After the eruptions or ulcers are healed a solution of corrosive + sublimate of one grain to an ounce of water applied for some weeks behind + the ear, and amongst the roots of the hair on one side of the head, where + the mouths of the lymphatics of the neck open themselves, frequently + removes these tumours.</p> + + <p><a name="art_IV_2_9_3">3</a>. Linen rags moistened with a solution of + half an ounce of sugar of lead to a pint of water applied on the + erysipelas on anasarcous legs, which have a tendency to mortification, is + more efficacious than other applications. White vitriol six grains + dissolved in one ounce of rose-water removes inflammations of the eyes + after evacuation more certainly than solutions of lead. Blue vitriol two + or three grains dissolved in an ounce of water cures ulcers in the mouth, + and other mucous membranes, and a solution of arsenic externally applied + cures the itch, but requires great caution in the use of it. See Class <a + href="#species_II_1_5_6">II. 1. 5. 6</a>.</p> + + <p><a name="art_IV_2_9_4">4</a>. Bitter vegetables, as the Peruvian bark, + quilted between two shirts, or strewed in their beds, will cure the ague + in children sometimes. Iron in solution, and some bitter extract, as in + the form of ink, will cure one kind of herpes called the ringworm. And I + have seen seven parts of bark in fine powder mixed with one part of + ceruss, or white lead, in fine powder, applied dry to scrophulous ulcers, + and renewed daily, with great advantage.</p> + + <p><a name="art_IV_2_9_5">5</a>. To these should be added electric sparks + and shocks, which promote the absorption of the vessels in inflamed eyes + of scrophulous children; and disperse, or bring to suppuration, + scrophulous tumours about the neck. For this last purpose smart shocks + should be passed through the tumours only, by inclosing them between two + brass knobs communicating with the external and internal coating of a + charged phial. See Art. <a href="#art_II_2_2_2">II. 2. 2. 2</a>.</p> + + <p><a name="art_IV_2_10">X</a>. <a name="art_IV_2_10_1">1</a>. Bandages + increase absorption, if they are made to fit nicely on the part; for + which purpose it is necessary to spread some moderately adhesive plaster + on the bandage, and to cut it into tails, or into shreds two inches wide; + the ends are to be wrapped over each other; and it must be applied when + the part is least tumid, as in the morning before the patient rises, if + on the lower extremities. The emplastrum de minio made to cover the whole + of a swelled leg in this manner, whether the swelling is hard, which is + usually termed scorbutic; or more easily compressible, as in anasarca, + reduces the limb in two or three days to its natural size; for this + purpose I have sometimes used carpenter's glue, mixed with one twentieth + part of honey to prevent its becoming too hard, instead of a resinous + plaster; but the minium plaster of the shops is in general to be + preferred. Nothing so much facilitates the cure of ulcers in the legs, as + covering the whole limb from the toes to the knee with such a + plaster-bandage; which increases the power of absorption in the surface + of the sore.</p> + + <p><a name="art_IV_2_10_2">2</a>. The lymph is carried along the + absorbent vessels, which are replete with valves, by the intermitted + pressure of the arteries in their neighbourhood. Now if the external skin + of the limb be lax, it rises, and gives way to the pressure of the + arteries at every pulsation; and thence the lymphatic vessels are subject + to the pressure of but half the arterial force. But when the external + skin is tightened by the surrounding bandage, and thence is not elevated + by the arterial diastole, the whole of this power is exerted in + compressing the lymphatic vessels, and carrying on the lymph already + absorbed; and thence the absorbent power is so amazingly increased by + bandage nicely applied. Pains are sometimes left in the fleshy parts of + the thighs or arms, after the inflammation is gone, in the acute + rheumatism, or after the patient is too weak for further evacuation; in + this case after internal absorbent medicines, as the bark, and opiates, + have been used in vain, I have successfully applied a plaster-bandage, as + above described, so as to compress the pained part.</p> + + <p><a name="art_IV_2_11">XI</a>. <a name="art_IV_2_11_1">1</a>. We shall + conclude by observing, that the sorbentia strengthen the whole habit by + preventing the escape of the fluid part of the secretions out of the + body, before it has given up as much nourishment, as it is capable; as + the liquid part of the secretion of urine, sweat, saliva, and of all + other secretions, which are poured into receptacles. Hence they have been + said to brace the body, and been called tonics, which are mechanical + terms not applicable to the living bodies of animals; as explained in + Sect. XXXII. 3. 2.</p> + + <p><a name="art_IV_2_11_2">2</a>. A continued use of bitter medicines for + years together, as of Portland's powder, or of the bark, is supposed to + induce apoplexy, or other fatal diseases. Two cases of this kind have + fallen under my observation; the patients were both rather intemperate in + respect to the use of fermented liquors, and one of them had been + previously subject to the gout. As I believe the gout generally + originates from a torpor of the liver, which instead of being succeeded + by an inflammation of it, is succeeded by an inflammation of some of the + joints; or by a pimpled face, which is another mode, by which the disease + of the liver is terminated. I conceive, that the daily use of bitter + medicine had in these patients prevented the removal of a gouty + inflammation from the liver to the membranes of the joints of the + extremities, or to the skin of the face, by preventing the necessary + torpor of these parts previous to the inflammation of them; in the same + manner as cold fits of fever are prevented by the same medicines; and, as + I believe, the returns of the gout have sometimes for two or three years + been prevented by them.</p> + + <p>One of these patients died of the apoplexy in a few hours; and the + other of an inflammation of the liver, which I believe was called the + gout, and in consequence was not treated by venesection, and other + evacuations. From hence it appears, that the daily use of hop in our malt + liquor must add to the noxious quality of the spirit in it, when taken to + excess, and contribute to the production of apoplexy, or inflammation of + the liver.</p> + +<p class="cenhead"><a name="art_IV_3">III</a>. <span class="sc">Catalogue of the Sorbentia.</span></p> + + <p><a name="art_IV_3_1">I</a>. Sorbentia affecting the skin.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_1_1">1</a>. Acid of vitriol, of sea-salt, lemons, + sloes, prunus spinosa, crabs, pyrus, quince, pyrus cydonia, opium.</p> + + <p><a name="art_IV_3_1_2">2</a>. Externally calx of zinc, of lead, of + mercury.</p> + +</blockquote> + + <p><a name="art_IV_3_2">II</a>. Sorbentia affecting the mucous + membranes.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_2_1">1</a>. Juice of sloes, crabs, Peruvian bark, + cinchona, opium.</p> + + <p><a name="art_IV_3_2_2">2</a>. Externally blue vitriol.</p> + +</blockquote> + + <p><a name="art_IV_3_3">III</a>. Sorbentia affecting the cellular + membrane.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_3_1">1</a>. Peruvian bark, wormwoods, artemisia + maritima, artemisia absynthium, worm-seed, artemisia santonicum, + chamomile, anthemis nobilis, tansey tanacetum, bogbean, menyanthes + trifoliata, centaury, gentiana centaurium, gentian, gentiana lutea, + artichoke-leaves, cynara scolymus, hop, humulus lupulus.</p> + + <p><a name="art_IV_3_3_2">2</a>. Orange-peel, cinnamon, nutmeg, mace.</p> + + <p><a name="art_IV_3_3_3">3</a>. Vomits, squill, digitalis, tobacco.</p> + + <p><a name="art_IV_3_3_4">4</a>. Bath of warm air, of steam.</p> + +</blockquote> + + <p><a name="art_IV_3_4">IV</a>. Sorbentia affecting the veins.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_4_1">1</a>. Water-cress, sisymbrium nasturtium + aquaticum, mustard, sinapis, scurvy-grass cochlearia hortensis, + horse-radish cochlearia armoracia, cuckoo-flower, cardamine, dog's-grass, + dandelion, leontodon taraxacon, cellery apium, cabbage brassica.</p> + + <p><a name="art_IV_3_4_2">2</a>. Chalybeates, bitters, and opium, after + sufficient evacuation.</p> + + <p><a name="art_IV_3_4_3">3</a>. Externally vinegar, friction, + electricity.</p> + +</blockquote> + + <p><a name="art_IV_3_5">V</a>. Sorbentia affecting the intestines.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_5_1">1</a>. Rhubarb, rheum palmatum, oak-galls, + gallæ quercinæ, tormentil, tormentilla erecta, cinquefoil potentilla, + red-roses, uva ursi, simarouba.</p> + + <p><a name="art_IV_3_5_2">2</a>. Logwood, hæmatoxylum campechianum, + succus acaciæ, dragon's blood, terra japonica, mimosa catechu.</p> + + <p><a name="art_IV_3_5_3">3</a>. Alum, earth of alum, Armenian bole, + chalk, creta, crab's claws, chelæ cancrorum, white clay, cimolia, + calcined hartshorn, cornu cervi calcinatum, bone-ashes.</p> + +</blockquote> + + <p><a name="art_IV_3_6">VI</a>. Sorbentia affecting the liver, stomach, + and other viscera. Rust of iron, filings of iron, salt of steel, sal + martis, blue vitriol, white vitriol, calomel, emetic tartar, sugar of + lead, white arsenic.</p> + + <p><a name="art_IV_3_7">VII</a>. Sorbentia affecting venereal ulcers. + Mercury dissolved or corroded by the following acids:</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_7_1">1</a>. Dissolved in vitriolic acid, called + turpeth mineral, or hydrargyrus vitriolatus.</p> + + <p><a name="art_IV_3_7_2">2</a>. Dissolved in nitrous acid, called + hydrargyrus nitratus ruber.</p> + + <p><a name="art_IV_3_7_3">3</a>. Dissolved in muriatic acid, mercurius + corrosivus sublimatus, or hydrargyrus muriatus.</p> + + <p><a name="art_IV_3_7_4">4</a>. Corroded by muriatic acid. Calomel.</p> + + <p><a name="art_IV_3_7_5">5</a>. Precipitated from muriatic acid, + mercurius precipitatus albus, calx hydrargyri alba.</p> + + <p><a name="art_IV_3_7_6">6</a>. Corroded by carbonic acid? The black + powder on crude mercury.</p> + + <p><a name="art_IV_3_7_7">7</a>. Calcined, or united with oxygen.</p> + + <p><a name="art_IV_3_7_8">8</a>. United with animal fat, mercurial + ointment.</p> + + <p><a name="art_IV_3_7_9">9</a>. United with sulphur. Cinnabar.</p> + + <p><a name="art_IV_3_7_10">10</a>. Partially united with sulphur. Æthiops + mineral.</p> + + <p><a name="art_IV_3_7_11">11</a>. Divided by calcareous earth. + Hydrargyrus cum cretâ.</p> + + <p><a name="art_IV_3_7_12">12</a>. Divided by vegetable mucilage, by + sugar, by balsams.</p> + +</blockquote> + + <p><a name="art_IV_3_8">VIII</a>. Sorbentia affecting the whole system. + Evacuations by venesection and catharsis, and then by the exhibition of + opium.</p> + + <p><a name="art_IV_3_9">IX</a>. Sorbentia externally applied.</p> + +<blockquote class="b1n"> + + <p><a name="art_IV_3_9_1">1</a>. Solutions of mercury, lead, zinc, + copper, iron, arsenic; or metallic calces applied in dry powder, as + cerussa, lapis calaminaris.</p> + + <p><a name="art_IV_3_9_2">2</a>. Bitter vegetables in decoctions and in + dry powders, applied externally, as Peruvian bark, oak bark, leaves of + wormwood, of tansey, camomile flowers or leaves.</p> + + <p><a name="art_IV_3_9_3">3</a>. Electric sparks, or shocks.</p> + +</blockquote> + + <p><a name="art_IV_3_10">X</a>. Bandage spread with emplastrum e minio, + or with carpenter's glue mixed with one twentieth part of honey.</p> + + <p><a name="art_IV_3_11">XI</a>. Portland's powder its continued use + pernicious, and of hops in beer.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ART. <a name="art_V">V</a>.</h3> + +<h3>INVERTENTIA.</h3> + + <p><a name="art_V_1">I</a>. Those things, which invert the natural order + of the successive irritative motions, are termed invertentia.</p> + + <p><a name="art_V_1_1">1</a>. Emetics invert the motions of the stomach, + duodenum, and œsophagus.</p> + + <p><a name="art_V_1_2">2</a>. Violent cathartics invert the motions of + the lacteals, and intestinal lymphatics.</p> + + <p><a name="art_V_1_3">3</a>. Violent errhines invert the nasal + lymphatics, and those of the frontal and maxillary sinuses. And medicines + producing nausea, invert the motions of the lymphatics about the + sauces.</p> + + <p><a name="art_V_1_4">4</a>. Medicines producing much pale urine, as a + certain quantity of alcohol, invert the motions of the urinary + absorbents; if the dose of alcohol is greater, it inverts the stomach, + producing the drunken sickness.</p> + + <p><a name="art_V_1_5">5</a>. Medicines producing cold sweats, + palpitation of the heart, globus hystericus; as violent evacuations, some + poisons, fear, anxiety, act by inverting the natural order of the + vascular motions.</p> + +<p class="cenhead"><a name="art_V_2">II</a>. <span class="sc">Observations on the Invertentia.</span></p> + + <p><a name="art_V_2_1">I</a>. <a name="art_V_2_1_1">1</a>. The action of + vomiting seems originally to have been occasioned by disagreeable + sensation from the distention or acrimony of the aliment; in the same + manner as when any disgustful material is taken into the mouth, as a + bitter drug, and is rejected by the retrograde motions of the tongue and + lips; as explained in Class <a href="#species_IV_1_1_2">IV. 1. 1. 2</a>. + and mentioned in Sect. XXXV. 1. 3. Or the disagreeable sensation may thus + excite the power of volition, which may also contribute to the retrograde + actions of the stomach and œsophagus, as when cows bring up the + contents of their first stomach to re-masticate it. To either of these is + to be attributed the action of mild emetics, which soon cease to operate, + and leave the stomach stronger, or more irritable, after their operation; + owing to the accumulation of the sensorial power of irritation during its + torpid or inverted action. Such appears to be the operation of + ipecacuanha, or of antimonium tartarizatum, in small doses.</p> + + <p><a name="art_V_2_1_2">2</a>. But there is reason to believe, that the + stronger emetics, as digitalis, first stimulate the absorbent vessels of + the stomach into greater action; and that the inverted motions of these + absorbents next occur, pouring the lymph, lately taken up, or obtained + from other lymphatic branches, into the stomach: the quantity of which in + some diseases, as in the cholera morbus, is inconceivable. This inverted + motion, first of the absorbents of the stomach, and afterwards of the + stomach itself, seems to originate from the exhaustion or debility, which + succeeds the unnatural degree of action, into which they had been + previously stimulated. An unusual defect of stimulus, as of food without + spice or wine in the stomachs of those, who have been much accustomed to + spice or wine, will induce sickness or vomiting; in this case the + defective energy of the stomach is owing to defect of accustomed + stimulus; while the action of vomiting from digitalis is owing to a + deficiency of sensorial power, which is previously exhausted by the + excess of its stimulus. See Sect. XXXV. 1. 3. and Class <a + href="#species_IV_1_1_2">IV. 1. 1. 2</a>.</p> + + <p>For first, no increase of heat arises from this action of vomiting; + which always occurs, when the secerning system is stimulated into action. + Secondly, the motions of the absorbent vessels are as liable to inversion + as the stomach itself; which last, with the œsophagus, may be + considered as the absorbent mouth and belly of that great gland, the + intestinal canal. Thirdly, the class of sorbentia, as bitters and + metallic salts, given in large doses, become invertentia, and vomit, or + purge. And lastly, the sickness and vomiting induced by large potations + of wine, or opium, does not occur till next day in some people, in none + till some time after their ingurgitation. And tincture of digitalis in + the dose of 30 or 60 drops, though applied in solution, is a considerable + time before it produces its effect; though vomiting is instantaneously + induced by a nauseous idea, or a nauseous taste in the mouth. At the same + time there seem to be some materials, which can immediately stimulate the + stomach into such powerful action, as to be immediately succeeded by + paralysis of it, and consequent continued fever, or immediate death; and + this without exciting sensation, that is, without our perceiving it. Of + these are the contagious matter of some fevers swallowed with the saliva, + and probably a few grains of arsenic taken in solution. See Suppl. I. <a + href="#suppl_VIII_8">8. 8</a>. Art. <a href="#art_IV_2_6_9">IV. 2. 6. + 9</a>.</p> + + <p><a name="art_V_2_1_3">3</a>. Some branches of the lymphatic system + become inverted by their sympathy with other branches, which are only + stimulated into too violent absorption. Thus when the stomach and + duodenum are much stimulated by alcohol, by nitre, or by worms, in some + persons the urinary lymphatics have their motion inverted, and pour that + material into the bladder, which is absorbed from the intestines. Hence + the drunken diabetes is produced; and hence chyle is seen in the urine in + worm cases.</p> + + <p>When on the contrary some branches of the absorbent systems have their + motions inverted in consequence of the previous exhaustion of their + sensorial power by any violent stimulus, other branches of it have their + absorbent power greatly increased. Hence continued vomiting, or violent + cathartics, produce great absorption from the cellular membrane in cases + of dropsy; and the fluids thus absorbed are poured into the stomach and + intestines by the inverted motions of the lacteals and lymphatics. See + Sect. XXIX. 4. and 5.</p> + + <p><a name="art_V_2_1_4">4</a>. The quantity of the dose of an emetic is + not of so great consequence as of other medicines, as the greatest part + of it is rejected with the first effort. All emetics are said to act with + greater certainty when given in a morning, if an opiate had been given + the night before. For the sensorial power of irritation of the stomach + had thus been in some measure previously exhausted by the stimulus of the + opium, which thus facilitates the action of the emetic; and which, when + the dose of opium has been large, is frequently followed on the next day + by spontaneous sickness and vomitings, as after violent intoxication.</p> + + <p>Ipecacuanha is the most certain in its effect from five grains to + thirty; white vitriol is the most expeditious in its effect, from twenty + grains to thirty dissolved in warm water; but emetic tartar, antimonium + tartarizatum, from one grain to four to sane people, and from thence to + twenty to insane patients, will answer most of the useful purposes of + emetics; but nothing equals the digitalis purpurea for the purpose of + absorbing water from the cellular membrane in the anasarca pulmonum, or + hydrops pectoris. See Art. <span class="correction" title="Original reads `II. 3. 7.'." + ><a href="#art_IV_2_3_7">IV. 2. 3. 7</a></span>.</p> + + <p><a name="art_V_2_2">II</a>. Violent cathartics. <a + name="art_V_2_2_1">1</a>. Where violent cathartics are required, as in + dropsies, the squill in dried powder made into small pills of a grain, or + a grain and a half, one to be given every hour till they operate briskly, + is very efficacious; or half a grain of emetic tartar dissolved in an + ounce of peppermint-water, and given every hour, till it operates. + Scammony, and other strong purges, are liable to produce hypercatharsis, + if they are not nicely prepared, and accurately weighed, and are thence + dangerous in common practice. Gamboge is uncertain in its effects, it has + otherwise the good property of being tasteless; and on that account some + preparation of it might be useful for children, by which its dose could + be ascertained, and its effects rendered more uniform.</p> + + <p><a name="art_V_2_2_2">2</a>. In inflammations of the bowels with + constipation calomel, given in the dose from ten to twenty grains after + due venesection, is most efficacious; and if made into very small pills + is not liable to be rejected by vomiting, which generally attends those + cases. When this fails, a grain of aloes every hour will find its way, if + the bowel is not destroyed; and sometimes, I believe, if it be, when the + mortification is not extensive. If the vomiting continues after the pain + ceases, and especially if the bowels become tumid with air, which sounds + on being struck with the finger, these patients seldom recover. Opiates + given along with the cathartics I believe to be frequently injurious in + inflammation of the bowels, though they may thus be given with advantage + in the saturnine colic; the pain and constipation in which disease are + owing to torpor or inactivity, and not to too great action.</p> + + <p><a name="art_V_2_3">III</a>. Violent errhines and sialagogues. <a + name="art_V_2_3_1">1</a>. Turpeth mineral in the quantity of one grain + mixed with ten grains of sugar answers every purpose to be expected from + errhines. Their operation is by inverting the motions of the lymphatics + of the membrane, which lines the nostrils, and the caverns of the + forehead and cheeks; and may thence possibly be of service in the + hydrocephalus internus.</p> + + <p>Some other violent errhines, as the powder of white hellebore, or + Cayan pepper, diluted with some less acrid powder, are said to cure some + cold or nervous head-achs; which may be effected by inflaming the + nostrils, and thus introducing the sensorial power of sensation, as well + as increasing that of irritation; and thus to produce violent action of + the membranes of the nostrils, and of the frontal and maxillary sinuses, + which may by association excite into action the torpid membranes, which + occasion the head-ach.</p> + + <p><a name="art_V_2_3_2">2</a>. A copious salivation without any increase + of heat often attends hysteric diseases, and fevers with debility, owing + to an inversion of the lymphatics of the mouth, see Class <a + href="#species_I_1_2_6">I. 1. 2. 6</a>. The same occurs in the nausea, + which precedes vomiting; and is also excitable by disagreeable tastes, as + by squills, or by nauseous smells, or by nauseous ideas. These are very + similar to the occasional discharge of a thin fluid from the nostrils of + some people, which recurs at certain periods, and differs from defective + absorption.</p> + + <p><a name="art_V_2_4">IV</a>. Violent diuretics. <a + name="art_V_2_4_1">1</a>. If nitre be given from a dram to half an ounce + in a morning at repeated draughts, the patient becomes sickish, and much + pale water is thrown into the bladder by the inverted action of the + urinary lymphatics. Hence the absorption in ulcers is increased and the + cure forwarded, as observed by Dr. Rowley.</p> + + <p><a name="art_V_2_4_2">2</a>. Cantharides taken inwardly so stimulate + the neck of the bladder as to increase the discharge of mucus, which + appears in the urine; but I once saw a large dose taken by mistake, not + less than half an ounce or an ounce of the tincture, by which I suppose + the urinary lymphatics were thrown into violent inverted motions, for the + patient drank repeated draughts of subtepid water to the quantity of a + gallon or two in a few hours; and during the greatest part of that time + he was not I believe two entire minutes together without making water. A + little blood was seen in his water the next day, and a soreness continued + a day longer without any other inconvenience.</p> + + <p><a name="art_V_2_4_3">3</a>. The decoction of foxglove should also be + mentioned here, as great effusions of urine frequently follow its + exhibition. See Art. <a href="#art_IV_2_3_7">IV. 2. 3. 7</a>. And an + infusion or tincture of tobacco as recommended by Dr. Fowler of York.</p> + + <p><a name="art_V_2_4_4">4</a>. Alcohol, and opium, if taken so as to + induce slight intoxication, and the body be kept cool, and much diluting + liquids taken along with them, have similar effect in producing for a + time a greater flow of urine, as most intemperate drinkers must + occasionally have observed. This circumstance seems to have introduced + the use of gin, and other vinous spirits as a diuretic, unfortunately in + the gravel, amongst ignorant people; which disease is generally produced + by fermented or spirituous liquors, and always increased by them.</p> + + <p><a name="art_V_2_4_5">5</a>. Fear and anxiety are well known to + produce a great frequency of making water. A person, who believed he had + made a bad purchase concerning an estate, told me, that he made five or + six pints of water during a sleepless night, which succeeded his bargain; + and it is usual, where young men are waiting in an anti-room to be + examined for college preferment, to see the chamber-pot often wanted.</p> + + <p><a name="art_V_2_5">V</a>. Cold sweats about the head, neck, and arms, + frequently attend those, whose lungs are oppressed, as in some dropsies + and asthma. A cold sweat is also frequently the harbinger of death. These + are from the inverted motions of the cutaneous lymphatic branches of + those parts.</p> + +<p class="cenhead"><a name="art_V_3">III</a>. <span class="sc">Catalogue of Invertentia.</span></p> + + <p><a name="art_V_3_1">I</a>. Emetics, ipecacuanha, emetic tartar, + antimonium tartarisatum, squill, scilla maritima, carduus benedictus, + cnicus acarna, chamœmile, anthemis nobilis, white vitriol, + vitriolum zinci, foxglove, digitalis purpurea, clysters of tobacco.</p> + + <p><a name="art_V_3_2">II</a>. Violent cathartics, emetic tartar, squill, + buckthorn, rhamnus catharticus, scammonium, convolvulus scammonia, + gamboge, elaterium, colocynth, cucumis colocynthis, veratrum.</p> + + <p><a name="art_V_3_3">III</a>. Violent errhines and sialagogues, Turpeth + mineral, <span class="correction" title="Original reads `hydragyrus'." + >hydrargyrus</span> vitriolatus, asarum europæum, euphorbium, capsicum, + veratrum, nauseous smells, nauseous ideas.</p> + + <p><a name="art_V_3_4">IV</a>. Violent diuretics, nitre, squill, seneka, + cantharides, alcohol, foxglove, tobacco, anxiety.</p> + + <p><a name="art_V_3_5">V</a>. Cold sudorifics, poisons, fear, approaching + death.</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3>ART. <a name="art_VI">VI</a>.</h3> + +<h3>REVERTENTIA.</h3> + + <p><a name="art_VI_1">I</a>. Those things, which restore the natural + order of the inverted irritative motions, are termed Revertentia.</p> + + <p><a name="art_VI_1_1">1</a>. As musk, castor, asafœtida, + valerian, essential oils.</p> + + <p><a name="art_VI_1_2">2</a>. Externally the vapour of burnt feathers, + of volatile salts, or oils, blisters, sinapisms.</p> + + <p>These reclaim the inverted motions without increasing the heat of the + body above its natural state, if given in their proper doses, as in the + globus hystericus, and palpitation of the heart.</p> + + <p>The incitantia revert these morbid motions more certainly, as opium + and alcohol; and restore the natural heat more; but if they induce any + degree of intoxication, they are succeeded by debility, when their + stimulus ceases.</p> + +<p class="cenhead"><a name="art_VI_2">II</a>. <span class="sc">Observations on the Revertentia.</span></p> + + <p><a name="art_VI_2_1">I</a>. The hysteric disease is attended with + inverted motions feebly exerted of the œsophagus, intestinal canal + and lymphatics of the bladder. Hence the borborigmi, or rumbling of the + bowels, owing to their fluid contents descending as the air beneath + ascends. The globus hystericus consists in the retrograde motion of the + œsophagus, and the great flow of urine from that of the lymphatics + spread on the neck of the bladder; and a copious salivation sometimes + happens to these patients from the inversion of the lymphatics of the + mouth; and palpitation of the heart owing to weak or incipient inversion + of its motions; and syncope, when this occurs in its greatest degree.</p> + + <p>These hysteric affections are not necessarily attended with pain; + though it sometimes happens, that pains, which originate from quiescence, + afflict these patients, as the hemicrania, which has erroneously been + termed the clavus hystericus; but which is owing solely to the inaction + of the membranes of that part, like the pains attending the cold fits of + intermittents, and which frequently returns like them at very regular + periods of time.</p> + + <p>Many of the above symptoms are relieved by musk, castor, the + fœtid gums, valerian, oleum animale, oil of amber, which act in the + usual dose without heating the body. The pains, which sometimes attend + these constitutions, are relieved by the secernentia, as essential oils + in common tooth-ach, and balsam of Peru in the flatulent colic. But the + incitantia, as opium, or vinous spirit, reclaim these morbid inverted + motions with more certainty, than the fœtids; and remove the pains, + which attend these constitutions, with more certainty than the + secernentia; but if given in large doses, a debility and return of the + hysteric symptoms occurs, when the effect of the opium or alcohol ceases. + Opiates and fœtids joined seem best to answer the purpose of + alleviating the present symptoms; and the sorbentia, by stimulating the + lymphatics and lacteals into continued action, prevent a relapse of their + inversion, as Peruvian bark, and rust of iron. See Class <a + href="#species_I_3_1_10">I. 3. 1. 10</a>.</p> + + <p><a name="art_VI_2_2">II</a>. Vomiting consists in the inverted order + of the motions of the stomach, and œsophagus; and is also attended + with the inverted motions of a part of the duodenum, when bile is + ejected; and of the lymphatics of the stomach and fauces, when nausea + attends, and when much lymph is evacuated. Permanent vomiting is for a + time relieved by the incitantia, as opium or alcohol; but is liable to + return, when their action ceases. A blister on the back, or on the + stomach, is more efficacious for restraining vomiting by their + stimulating into action the external skin, and by sympathy affecting the + membranes of the stomach. In some fevers attended with incessant vomiting + Sydenham advised the patient to put his head under the bed-clothes, till + a sweat appeared on the skin, as explained in Class <span + class="correction" title="Original reads `IV. 1. 1. 3.'."><a + href="#species_IV_1_1_2">IV. 1. 1. 2</a></span>.</p> + + <p>In chronical vomiting I have observed crude mercury of good effect in + the dose of half an ounce twice a day. The vomitings, or vain efforts to + vomit, which sometimes attend hysteric or epileptic patients, are + frequently instantly relieved for a time by applying flour of + mustard-seed and water to the small of the leg; and removing it, as soon + as the pain becomes considerable. If sinapisms lie on too long, + especially in paralytic cases, they are liable to produce troublesome + ulcers. A plaster or cataplasm, with opium and camphor on the region of + the stomach, will sometimes revert its retrograde motions.</p> + + <p><a name="art_VI_2_3">III</a>. Violent catharsis, as in diarrhœa + or dysentery, is attended with inverted motions of the lymphatics of the + intestines, and is generally owing to some stimulating material. This is + counteracted by plenty of mucilaginous liquids, as solutions of gum + arabic, or small chicken broth, to wash away or dilute the stimulating + material, which causes the disease. And then by the use of the intestinal + sorbentia, Art. <a href="#art_IV_2_5">IV. 2. 5</a>. as rhubarb, decoction + of logwood, calcined hartshorn, Armenian bole; and lastly, by the + incitantia, as opium.</p> + + <p><a name="art_VI_2_4">IV</a>. The <span class="correction" + title="Original reads `diabœtes'.">diabætes</span> consists in the + inverted motions of the urinary lymphatics, which is generally I suppose + owing to the too great action of some other branch of the absorbent + system. The urinary branch should be stimulated by cantharides, + turpentine, resin (which when taken in larger doses may possibly excite + it into inverted action), by the sorbentia and opium. The intestinal + lymphatics should be rendered less active by torpentia, as calcareous + earth, earth of alum; and those of the skin by oil externally applied + over the whole body; and by the warm-bath, which should be of 96 or 98 + degrees of heat, and the patient should sit in it every day for half an + hour.</p> + + <p><a name="art_VI_2_5">V</a>. Inverted motions of the intestinal canal + with all the lymphatics, which open into it, constitute the ileus, or + iliac passion; in which disease it sometimes happens, that clysters are + returned by the mouth. After venesection from ten grains to twenty of + calomel made into very small pills; if this is rejected, a grain of aloe + every hour; a blister; crude mercury; warm-bath; if a clyster of iced + water?</p> + + <p>Many other inverted motions of different parts of the system are + described in Class <a href="#ordo_I_3">I. 3</a>. and which are to be + treated in a manner similar to those above described. It must be noted, + that the medicines mentioned under number one in the catalogue of + revertentia are the true articles belonging to this class of medicines. + Those enumerated in the other four divisions are chiefly such things as + tend to remove the stimulating causes, which have induced the inversion + of the motions of the part, as acrimonious contents, or inflammation, of + the bowels in diarrhœa, diabetes, or in ileus. But it is probable + after these remote causes are destroyed, that the fetid gums, musk, + castor, and balsams, might be given with advantage in all these + cases.</p> + +<p class="cenhead"><a name="art_VI_3">III</a>. <span class="sc">Catalogue of Revertentia.</span></p> + + <p><a name="art_VI_3_1">I</a>. Inverted motions, which attend the + hysteric disease, are reclaimed, <a name="art_VI_3_1_1">1</a>. By musk, + castor. <a name="art_VI_3_1_2">2</a>. By asafœtida, galbanum, + sagapænum, ammoniacum, valerian. <a name="art_VI_3_1_3">3</a>. Essential + oils of cinnamon, nutmeg, cloves, infusion of penny-royal, mentha, + pulegium, peppermint, mentha piperita, ether, camphor. <a + name="art_VI_3_1_4">4</a>. Spirit of hartshorn, oleum animale, spunge + burnt to charcoal, black-snuffs of candles, which consist principally of + animal charcoal, wood-soot, oil of amber. <a name="art_VI_3_1_5">5</a>. + The incitantia, as opium, alcohol, vinegar. <a name="art_VI_3_1_6">6</a>. + Externally the smoke of burnt feathers, oil of amber, volatile salt + applied to the nostrils, blisters, sinapisms.</p> + + <p><a name="art_VI_3_2">II</a>. Inverted motions of the stomach are + reclaimed by opium, alcohol, blisters, crude mercury, sinapisms, camphor + and opium externally, clysters with asafœtida.</p> + + <p><a name="art_VI_3_3">III</a>. Inverted motions of the intestinal + lymphatics are reclaimed by mucilaginous diluents, and by intestinal + sorbentia, as rhubarb, logwood, calcined hartshorn, Armenian bole; and + lastly by incitantia, as opium.</p> + + <p><a name="art_VI_3_4">IV</a>. Inverted motions of the urinary + lymphatics are reclaimed by cantharides, turpentine, rosin, the + sorbentia, and opium, with calcareous earth, and earth of alum, by oil + externally, warm-bath.</p> + + <p><a name="art_VI_3_5">V</a>. Inverted motions of the intestinal canal + are reclaimed by calomel, aloe, crude mercury, blisters, warm-bath, + clysters with asafœtida, clysters of iced water? or of spring water + further cooled by salt dissolved in water contained in an exterior + vessel? Where there exists an introsusception of the bowel in children, + could the patient be held up for a time by the feet with his head + downwards, or be laid with his body on an inclined plane with his head + downwards, and crude mercury be injected as a clyster to the quantity of + two or three pounds?</p> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><span class="sc">Art. <a name="art_VII">VII</a>.</span></h3> + +<h3>TORPENTIA.</h3> + + <p><a name="art_VII_1">I</a>. Those things, which diminish the exertion + of the irritative motions, are termed torpentia.</p> + + <p><a name="art_VII_1_1">1</a>. As mucus, mucilage, water, bland oils, + and whatever possesses less stimulus than our usual food. Diminution of + heat, light, sound, oxygen, and of all other stimuli; venesection, + nausea, and anxiety.</p> + + <p><a name="art_VII_1_2">2</a>. Those things which chemically destroy + acrimony, as calcareous earth, soap, tin, alcalies, in cardialgia; or + which prevent chemical acrimony, as acid of vitriol in cardialgia, which + prevents the fermentation of the aliment in the stomach, and its + consequent acidity. Secondly, which destroy worms, as calomel, iron + filings or rust of iron, in the round worms; or amalgama of quicksilver + and tin, or tin in very large doses, in the tape-worms. Will ether in + clysters destroy ascarides? Thirdly, by chemically destroying extraneous + bodies, as caustic alcali, lime, mild alcali in the stone. Fourthly, + those things which lubricate the vessels, along which extraneous bodies + slide, as oil in the stone in the urethra, and to expedite the + expectoration of hardened mucus; or which lessen the friction of the + contents in the intestinal canal in dysentery or aphtha, as calcined + hartshorn, clay, Armenian bole, chalk, bone-ashes. Fifthly, such things + as soften or extend the cuticle over tumors, or phlegmons, as warm water, + poultices, fomentations, or by confining the perspirable matter on the + part by cabbage-leaves, oil, fat, bee's-wax, plasters, oiled silk, + externally applied.</p> + + <p>These decrease the natural heat and remove pains occasioned by excess + of irritative motions.</p> + +<p class="cenhead"><a name="art_VII_2">II</a>. <span class="sc">Observations on the Torpentia.</span></p> + + <p><a name="art_VII_2_1">I</a>. As the torpentia consist of such + materials as are less stimulating than our usual diet, it is evident, + that where this class of medicines is used, some regard must be had to + the usual manner of living of the patient both in respect to quantity and + quality. Hence wounds in those, who have been accustomed to the use of + much wine, are very liable to mortify, unless the usual potation of wine + be allowed the patient. And in these habits I have seen a delirium in a + fever cured almost immediately by wine; which was occasioned by the too + mild regimen directed by the attendants. On the contrary in great + inflammation, the subduction of food, and of spirituous drink, + contributes much to the cure of the disease. As by these means both the + stimulus from distention of the vessels, as well as that from the + acrimony of the fluids, is decreased; but in both these respects the + previous habits of diet of the patients must be attended to. Thus if tea + be made stronger, than the patient has usually drank it, it belongs to + the article sorbentia; if weaker, it belongs to the torpentia.</p> + + <p><span class="correction" title="Original reads `II. 2.'."><a + name="art_VII_2_2">II</a>.</span> Water in a quantity greater than usual + diminishes the action of the system not only by diluting our fluids, and + thence lessening their stimulus, but by lubricating the solids; for not + only the parts of our solids have their sliding over each other + facilitated by the interposition of aqueous particles; but the particles + of mucaginous or saccharine solutions slide easier over each other by + being mixed with a greater portion of water, and thence stimulate the + vessels less.</p> + + <p>At the same time it must be observed, that the particles of water + themselves, and of animal gluten dissolved in water, as the glue used by + carpenters, slide easier over each other by an additional quantity of the + fluid matter of heat.</p> + + <p>These two fluids of heat and of water may be esteemed the universal + solvents or lubricants in respect to animal bodies, and thus facilitate + the circulation, and the secretion of the various glands. At the same + time it is possible, that these two fluids may occasionally assume an + aerial form, as in the cavity of the chest, and by compressing the lungs + may cause one kind of asthma, which is relieved by breathing colder air. + An increased quantity of heat by adding stimulus to every part of the + system belongs to the article Incitantia.</p> + + <p><span class="correction" title="Original reads `III. 3. 1.'."><a + name="art_VII_2_3">III</a>. <a name="art_VII_2_3_1">1</a>.</span> The + application of cold to the skin, which is only another expression for the + diminution of the degree of heat we are accustomed to, benumbs the + cutaneous absorbents into inaction; and by sympathy the urinary and + intestinal absorbents become also quiescent. The secerning vessels + continuing their action somewhat longer, from the warmth of the blood. + Hence the usual secretions are poured into the bladder and intestines, + and no absorption is retaken from them. Hence sprinkling the skin with + cold water increases the quantity of urine, which is pale; and of stool, + which is fluid; these have erroneously been ascribed to increased + secretion, or to obstructed perspiration.</p> + + <p>The thin discharge from the nostrils of some people in cold weather is + owing to the torpid state of the absorbent vessels of the membrana + sneideriana, which as above are benumbed sooner than those, which perform + the secretion of the mucus.</p> + + <p>The quick anhelation, and palpitation of the heart, of those, who are + immersed in cold water, depends on the quiescence of the external + absorbent vessels and capillaries. Hence the cutaneous circulation is + diminished, and by association an almost universal torpor of the system + is induced; thence the heart becomes incapable to push forwards its blood + through all the inactive capillaries and glands; and as the terminating + vessels of the pulmonary artery suffer a similar inaction by association, + the blood is with difficulty pushed through the lungs.</p> + + <p>Some have imagined, that a spasmodic constriction of the smaller + vessels took place, and have thus accounted for their resistance to the + force of the heart. But there seems no necessity to introduce this + imaginary spasm; since those, who are conversant in injecting bodies, + find it necessary first to put them into warm water to take away the + stiffness of the cold dead vessels; which become inflexible like the + other muscles of dead animals, and prevent the injected fluid from + passing.</p> + + <p>All the same symptoms occur in the cold fits of intermittents; in + these the coldness and paleness of the skin with thirst evince the + diminution of cutaneous absorption; and the dryness of ulcers, and small + secretion of urine, evince the torpor of the secerning system; and the + anhelation, and coldness of the breath, shew the terminations of the + pulmonary artery to be likewise affected with torpor.</p> + + <p>After these vessels of the whole surface of the body both absorbent + and secretory have been for a time torpid by the application of cold + water; and all the internal secerning and absorbent ones have been made + torpid from their association with the external; as soon as their usual + stimulus of warmth is renewed, they are thrown into more than their usual + energy of action; as the hands become hot and painful on approaching the + fire after having been immersed some time in snow. Hence the face becomes + of a red colour in a cold day on turning from the wind, and the + insensible perspiration increased by repeatedly going into frosty air, + but not continuing in it too long at a time.</p> + + <p><a name="art_VII_2_3_2">2</a>. When by the too great warmth of a room + or of clothes, the secretion of perspirable matter is much increased, the + strength of the patient is much exhausted by this unnecessary exertion of + the capillary system, and thence of the whole secerning and arterial + system by association. The diminution of external heat immediately + induces a torpor or quiescence of these unnecessary exertions, and the + patient instantly feels himself strengthened, and exhilarated; the animal + power, which was thus wasted in vain, being now applied to more useful + purposes. Thus when the limbs on one side are disabled by a stroke of the + palsy, those of the other side are perpetually in motion. And hence all + people bear riding and other exercises best in cold weather.</p> + + <p>Patients in fevers, where the skin is hot, are immediately + strengthened by cold air; which is therefore of great use in fevers + attended with debility and heat; but may perhaps be of temporary + disservice, if too hastily applied in some situations of fevers attended + with internal topical inflammation, as in peripneumony or pleurisy, where + the arterial strength is too great already, and the increased action of + the external capillaries being destroyed by the cold, the action of the + internal inflamed part may be suddenly increased, unless venesection and + other evacuations are applied at the same time. Yet in most cases the + application of cold is nevertheless salutary, as by decreasing the heat + of the particles of blood in the cutaneous vessels, the stimulus of them, + and the distention of the vessels becomes considerably lessened. In + external inflammations, as the small-pox, and perhaps the gout and + rheumatism, the application of cold air must be of great service by + decreasing the action of the inflamed skin, though the contrary is too + frequently the practice in those diseases. It must be observed, that for + all these purposes the application of it should be continued a long time, + otherwise an increased exertion follows the temporary torpor, before the + disease is destroyed.</p> + + <p><a name="art_VII_2_3_3">3</a>. After immersion in cold water or in + cold air the whole system becomes more exciteable by the natural degree + of stimulus, as appears from the subsequent glow on the skin of people + otherwise pale; and even by a degree of stimulus less than natural, as + appears by their becoming warm in a short time during their continuance + in a bath, of about 80 degrees of heat, as in Buxton bath. See Sect XII. + 2. 1. XXXII. 3. 3.</p> + + <p>This increased exertion happens to the absorbent vessels more + particularly, as they are first and most affected by these temporary + diminutions of heat; and hence like the medicines, which promote + absorption, the cold-bath contributes to strengthen the constitution, + that is to increase its irritability; for the diseases attended with + weakness, as nervous fevers and hysteric diseases, are shewn in Section + XXXII. 2. 1. to proceed from a want of irritability, not from an excess + of it. Hence the digestion is greater in frosty weather, and the quantity + of perspiration. For these purposes the application of cold must not be + continued too long. For in riding a journey in cold weather, when the + feet are long kept too cold, the digestion is impaired, and cardialgia + produced.</p> + + <p><a name="art_VII_2_3_4">4</a>. If the diminution of external heat be + too great, produced too hastily, or continued too long, the torpor of the + system either becomes so great, that the animal ceases to live; or so + great an energy of motion or orgasm of the vessels succeeds, as to + produce fever or inflammation. This most frequently happens after the + body has been temporarily heated by exercise, warm rooms, anger, or + intemperance. Hence colds are produced in the external air by resting + after exercise, or by drinking cold water. See Class <a + href="#species_I_2_2_1">I. 2. 2. 1</a>.</p> + + <p>Frequent cold immersions harden or invigorate the constitution, which + they effect by habituating the body to bear a diminution of heat on its + surface without being thrown into such extensive torpor or quiescence by + the consent of the vessels of the skin with the pulmonary and glandular + system; as those experience, who frequently use the cold-bath. At first + they have great anhelation and palpitation of heart at their ingress into + cold water; but by the habit of a few weeks they are able to bear this + diminution of heat with little or no inconvenience; for the power of + volition has some influence over the muscles subservient to respiration, + and by its counter efforts gradually prevents the quick breathing, and + diminishes the associations of the pulmonary vessels with the cutaneous + ones. And thus though the same quantity of heat is subducted from the + skin, yet the torpor of the pulmonary vessels and internal glands does + not follow. Hence during cold immersion less sensorial power is + accumulated, and in consequence, less exertion of it succeeds on emerging + from the bath. Whence such people are esteemed hardy, and bear the common + variations of atmospheric temperature without inconvenience. See Sect. + XXXII. 3. 2.</p> + + <p><a name="art_VII_2_4">IV</a>. Venesection has a just title to be + classed amongst the torpentia in cases of fever with arterial strength, + known by the fulness and hardness of the pulse. In these cases the heat + becomes less by its use, and all exuberant secretions, as of bile or + sweat, are diminished, and room is made in the blood-vessels for the + absorption of mild fluids; and hence the absorption also of new vessels, + or extravasated fluids, the produce of inflammation, is promoted. Hence + venesection is properly classed amongst the sorbentia, as like other + evacuations it promotes general absorption, restrains hæmorrhages, and + cures those pains, which originate from the too great action of the + secerning vessels, or from the torpor of the absorbents. I have more than + once been witness to the sudden removal of nervous head-achs by + venesection, though the patient was already exhausted, pale, and feeble; + and to its great use in convulsions and madness, whether the patient was + strong or weak; which diseases are the consequence of nervous pains; and + to its stopping long debilitating hæmorrhages from the uterus, when other + means had been in vain essayed. In inflammatory pains, and inflammatory + hæmorrhages, every one justly applies to it, as the certain and only + cure.</p> + + <p><a name="art_VII_2_5">V</a>. When the circulation is carried on too + violently, as in inflammatory fevers, those medicines, which invert the + motions of some parts of the system, retard the motions of some other + parts, which are associated with them. Hence small doses of emetic + tartar, and ipecacuanha, and large doses of nitre, by producing nausea + debilitate and lessen the energy of the circulation, and are thence + useful in inflammatory diseases. It must be added, that if nitre be + swallowed in powder, or soon after it is dissolved, it contributes to + lessen the circulation by the cold it generates, like ice-water, or the + external application of cold air.</p> + + <p><a name="art_VII_2_6">VI</a>. The respiration of air mixed with a + greater proportion of azote than is found in the common atmosphere, or of + air mixed with hydrogen, or with carbonic acid gas, so that the quantity + of oxygen might be less than usual, would probably act in cases of + inflammation with great advantage. In consumptions this might be most + conveniently and effectually applied, if a phthisical patient could + reside day and night in a porter or ale brewery, where great quantities + of those liquors were perpetually fermenting in vats or open barrels; or + in some great manufactory of wines from raisins or from sugar.</p> + + <p>Externally the application of carbonic acid gas to cancers and other + ulcers instead of atmospheric air may prevent their enlargement, by + preventing the union of oxygen with matter, and thus producing a new + contagious animal acid.</p> + +<p class="cenhead"><a name="art_VII_3">III</a>. <span class="sc">Catalogue of Torpentia.</span></p> + + <p><a name="art_VII_3_1">1</a>. Venesection. Arteriotomy.</p> + + <p><a name="art_VII_3_2">2</a>. Cold water, cold air, respiration of air + with less oxygen.</p> + + <p><a name="art_VII_3_3">3</a>. Vegetable mucilages.</p> + +<blockquote class="b1n"> + + <p><i>a.</i> Seeds.—Barley, oats, rice, young peas, flax, cucumber, + melon, &c.</p> + + <p><i>b.</i> Gums.—Arabic, Tragacanth, Senegal, of + cherry-trees.</p> + + <p><i>c.</i> Roots.—Turnip, potatoe, althea, orchis, snow-drop.</p> + + <p><i>d.</i> Herbs.—Spinach, brocoli, mercury.</p> + +</blockquote> + + <p><a name="art_VII_3_4">4</a>. Vegetable acids, lemon, orange, currants, + gooseberries, apples, grape, &c. &c.</p> + + <p><a name="art_VII_3_5">5</a>. Animal mucus, hartshorn jelly, veal + broth, chicken water, oil? fat? cream?</p> + + <p><a name="art_VII_3_6">6</a>. Mineral acids, of vitriol, nitre, + sea-salt.</p> + + <p><a name="art_VII_3_7">7</a>. Silence, darkness.</p> + + <p><a name="art_VII_3_8">8</a>. Invertentia in small doses, nitre, emetic + tartar, ipecacuanha given so as to induce nausea.</p> + + <p><a name="art_VII_3_9">9</a>. Antacids.—Soap, tin, alcalies, + earths.</p> + + <p><a name="art_VII_3_10">10</a>. Medicines preventative of fermentation, + acid of vitriol.</p> + + <p><a name="art_VII_3_11">11</a>. Anthelmintics.—Indian pink, tin, + iron, cowhage, amalgama, smoak of tobacco.</p> + + <p><a name="art_VII_3_12">12</a>. Lithonthriptics, lixiv. saponarium, + aqua calcis, fixable air.</p> + + <p><a name="art_VII_3_13">13</a>. Externally, warm bath, and poultices, + oil, fat, wax, plasters, oiled silk, carbonic acid gas on cancers, and + other ulcers.</p> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>ADDENDA.</h3> + + <p><i><a href="#Page_625_line_1">Page 625, line 1</a>, after 'number' + please to add</i>, 'except when the patient has naturally a pulse slower + than usual in his healthy state.'</p> + + <p><i><a href="#Page_197_after_line_8">Page 197, after line 8</a>, please + to add</i>, 'Where the difficulty of breathing is very urgent in the + croup, bronchotomy is recommended by Mr. Field.' Memoir of a Medical + Society, London, 1773, Vol. IV.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h2>ADDITION.</h2> + + <p><br style="clear:both" /></p> +<hr class="short" /> + +<h3>INABILITY TO EMPTY THE BLADDER.</h3> + +<p class="cenhead">To be introduced at the end of Class <a href="#species_III_2_1_6">III. 2. 1. 6</a>. on Paralysis +Vesicæ Urinariæ.</p> + + <p>An inability to empty the bladder frequently occurs to elderly men, + and is often fatal. This sometimes arises from their having too long been + restrained from making water from accidental confinement in public + society, or otherwise; whence the bladder has become so far distended as + to become paralytic; and not only this, but the neck of the bladder has + become contracted so as to resist the introduction of the catheter. In + this deplorable case it has frequently happened, that the forcible + efforts to introduce the catheter have perforated the urethra; and the + instrument has been supposed to pass into the bladder when it has only + passed into the cellular membrane along the side of it; of which I + believe I have seen two or three instances; and afterwards the part has + become so much inflamed as to render the introduction of the catheter + into the bladder impracticable.</p> + + <p>In this situation the patients are in imminent danger, and some have + advised a trocar to be introduced into the bladder from the rectum; which + I believe is generally followed by an incurable ulcer. One patient, whom + I saw in this situation, began to make a spoonful of water after six or + seven days, and gradually in a few days emptied his bladder to about half + its size, and recovered; but I believe he never afterwards was able + completely to evacuate it.</p> + + <p>In this situation I lately advised about two pounds of crude + quicksilver to be poured down a glass tube, which was part of a barometer + tube, drawn less at one end, and about two feet long, into the urethra, + as the patient lay on his back; which I had previously performed upon a + horse; this easily passed, as was supposed, into the bladder; on standing + erect it did not return, but on kneeling down, and lying horizontally on + his hands, the mercury readily returned; and on this account it was + believed to have passed into the bladder, as it so easily returned, when + the neck of the bladder was lower than the fundus of it. But nevertheless + as no urine followed the mercury, though the bladder was violently + distended, I was led to believe, that the urethra had been perforated by + the previous efforts to introduce a catheter and bougee; and that the + mercury had passed on the outside of the bladder into the cellular + membrane.</p> + + <p>As the urethra is so liable to be perforated by the forcible efforts + to introduce the catheter, when the bladder is violently distended in + this deplorable disease, I should strongly recommend the injection of a + pound or two of crude mercury into the urethra to open by its weight the + neck of the bladder previous to any violent or very frequent essays with + a catheter whether of metal or of elastic resin.</p> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3>LINES</h3> + +<p class="cenhead">TO BE PLACED AT THE END OF</p> + +<h2>ZOONOMIA.</h2> + +<h3><i>BY A FRIEND.</i></h3> + + <p><br style="clear:both" /></p> +<hr /> + +<h3><i>JAMQUE OPUS EXEGI.</i></h3> + + <p><br style="clear:both" /></p> +<hr /> + + <div class="contents"> + <div class="stanza"> + <p>The work is done!—nor Folly's active rage,</p> + <p>Nor Envy's self, shall blot the golden page;</p> + <p>Time shall admire, his mellowing touch employ,</p> + <p>And mend the immortal tablet, not destroy.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3>INDEX</h3> + +<p class="cenhead">OF THE</p> + +<h2>ARTICLES.</h2> + + <div class="contents"> + <div class="stanza"> + <p class="i16"><b>A.</b></p> + </div> + + <div class="stanza"> + <p>Absorption, <a href="#art_IV_2_1">iv. 2. 1</a>.</p> + <p>—— cutaneous, mucous, cellular, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>—— of the veins, <a href="#art_IV_2_4">iv. 2. 4</a>.</p> + <p>—— of inflamed vessels, <a href="#art_IV_2_4_3">iv. 2. 4. 3</a>.</p> + <p>—— of intestines and liver, <a href="#art_IV_2_5">iv. 2. 5</a>.</p> + <p>—— of venereal ulcers, <a href="#art_IV_2_7">iv. 2. 7</a>.</p> + <p>—— not increased by cold, <a href="#art_IV_2_1">iv. 2. 1</a>.</p> + <p>—— increased by opium after evacuation, <a href="#art_II_2_1">ii. 2. 1</a>.</p> + <p>Acacia, <span class="correction" title="Original reads `iv. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Acids austere, <a href="#art_IV_2_1_2">iv. 2. 1. 2</a>. <a href="#art_IV_3_1">iv. 3. 1</a>.</p> + <p>—— vegetable, sweet, <a href="#art_VII_3_4">vii. 3. 4</a>. <a href="#art_IV_2_1_2">iv. 2. 1. 2</a>.</p> + <p>—— mineral, <a href="#art_VII_3_6">vii. 3. 6</a>.</p> + <p>Acrid plants, <a href="#art_IV_2_4">iv. 2. 4</a>.</p> + <p>Agriculture, <a href="#art_I_2_3_7">i. 2. 3. 7</a>.</p> + <p>Agues, three kinds, <a href="#art_IV_2_3_2">iv. 2. 3. 2</a>. <a href="#art_IV_2_5">iv. 2. 5</a>. <a href="#art_IV_2_6_8">iv. 2. 6. 8</a>.</p> + <p>Air nourishes, <a href="#art_I_2_5">i. 2. 5</a>.</p> + <p>—— warm bath of, <a href="#art_IV_2_3_8">iv. 2. 3. 8</a>.</p> + <p>Alcali vol. <span class="correction" title="Original reads `iii. 3. 3.'"><a href="#art_III_3_8">iii. 3. 8</a></span>.</p> + <p>Alcohol, <a href="#art_II_2_1">ii. 2. 1</a>. <a href="#art_V_2_4">v. 2. 4</a>.</p> + <p>Almond, bitter, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Althæa, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Allium, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Aloe, <a href="#art_III_2_5">iii. 2. 5</a>. <a href="#art_III_2_7">iii. 2. 7</a>. <span class="correction" title="Original reads `iii. 2. 5. 5.'"><a href="#art_III_3_5_5">iii. 3. 5. 5</a></span>. <a href="#art_VI_2_5">vi. 2. 5</a>.</p> + <p>Alum, <a href="#art_III_2_1">iii. 2. 1</a>. <span class="correction" title="Original reads `iv. 2. 1.'"><a href="#art_IV_2_2">iv. 2. 2</a></span>. <a href="#art_IV_2_5_2">iv. 2. 5. 2</a>. <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>.</p> + <p>Amalgama in worms, <span class="correction" title="Original reads `vii. 2. 2.'"><a href="#art_VII_1_2">vii. 1. 2</a></span>.</p> + <p>Amomum zinziber, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Amber, oil of, <span class="correction" title="Original reads `vi. 3. 4.'"><a href="#art_VI_3_1_4">vi. 3. 1. 4</a></span>.</p> + <p>Ammoniac gum, <a href="#art_VI_3_1">vi. 3. 1</a>. <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>—— salt or spirit, <span class="correction" title="Original reads `iii. 3. 3.'"><a href="#art_III_3_1_3">iii. 3. 1. 3</a></span>.</p> + <p>Anasarca, warm bath in, <a href="#art_II_2_2">ii. 2. 2</a>.</p> + <p>Anchovy, <a href="#art_III_2_1">iii. 2. 1</a>. <span class="correction" title="Original reads `iii. 2. 1. 4.'"><a href="#art_III_3_1_4">iii. 3. 1. 4</a></span>.</p> + <p>Animal food, <a href="#art_I_2_1_1">i. 2. 1. 1</a>.</p> + <p>Antimony prepared, <span class="correction" title="Original reads `iii. 2. 1. 5.'"><a href="#art_III_3_1_5">iii. 3. 1. 5</a></span>. <a href="#art_III_2_1">iii. 2. 1</a>. <a href="#art_IV_1_10">iv. 1. 10</a>.</p> + <p>Anthemis nobilis, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>—— pyrethum, <a href="#art_III_3_2">iii. 3. 2</a>.</p> + <p>Anxiety, <a href="#art_V_2_4">v. 2. 4</a>.</p> + <p>Apium, petroselinum, <span class="correction" title="Original reads `iii. 2. 4. 4.'"><a href="#art_III_3_4_4">iii. 3. 4. 4</a></span>.</p> + <p>Apoplexy, <a href="#art_IV_2_11">iv. 2. 11</a>.</p> + <p>Aristolochia serpentaria, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Armenian bole, <a href="#art_VI_2_3">vi. 2. 3</a>. <span class="correction" title="Original reads `vi. 3. 5. 3.'"><a href="#art_IV_3_5_3">iv. 3. 5. 3</a></span>.</p> + <p>Arsenic in ague, <a href="#art_IV_2_6_8">iv. 2. 6. 8</a>. <a href="#art_IV_3_6">iv. 3. 6</a>.</p> + <p>—— saturated solution of, <a href="#art_IV_2_6_8">iv. 2. 6. 8</a>.</p> + <p>—— in itch, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>—— how it acts, <a href="#art_IV_2_6_9">iv. 2. 6. 9</a>.</p> + <p>—— how to detect it, <a href="#art_IV_2_6_10">iv. 2. 6. 10</a>.</p> + <p>Artemisia maritima, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>—— absynthium, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>—— santonicum, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Artichoke-leaves, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Asa fœtida, <span class="correction" title="Original reads `ii. 3.'"><a href="#art_III_3">iii. 3</a></span>. <a href="#art_VI_3_1">vi. 3. 1</a>.</p> + <p>Asarum Europeum <a href="#art_V_3_3">v. 3. 3</a>.</p> + <p>Ascarides, <a href="#art_VII_1_2">vii. 1. 2</a>. <span class="correction" title="Original reads `iii. 2. 9. 7.'"><a href="#art_III_2_7">iii. 2. 7</a></span>.</p> + <p>Asparagus, <span class="correction" title="Original reads `iii. 2. 4. 4.'"><a href="#art_III_3_4_4">iii. 3. 4. 4</a></span>.</p> + <p>Astragalus tragacanth, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Atropa belladona, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Azote, <a href="#art_I_2_5">i. 2. 5</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>B.</b></p> + </div> + + <div class="stanza"> + <p>Balsams diuretic, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>Bandages promote absorption, <a href="#art_IV_2_10">iv. 2. 10</a>.</p> + <p>Bark, Peruvian, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>—— long used noxious, <a href="#art_IV_2_11">iv. 2. 11</a>.</p> + <p>Barley, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Bath, warm, <a href="#art_II_2_2_1">ii. 2. 2. 1</a>. <span class="correction" title="Original reads `iii. 2. 1. 6.'"><a href="#art_III_3_1_6">iii. 3. 1. 6</a></span>. <span class="correction" title="Original reads `iii. 2. 3. 4.'"><a href="#art_III_3_3_4">iii. 3. 3. 4</a></span>. <a href="#art_III_2_3_3">iii. 2. 3. 3</a>.</p> + <p>—— of warm air, <a href="#art_IV_2_3_8">iv. 2. 3. 8</a>.</p> + <p>—— of steam, <a href="#art_IV_2_3_8">iv. 2. 3. 8</a>.</p> + <p>—— cold, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— nutritive, <a href="#art_I_2_6_1">i. 2. 6. 1</a>.</p> + <p>Benzoin, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Bile of animals, <span class="correction" title="Original reads `iii. 2. 5. 2.'"><a href="#art_III_3_5_2">iii. 3. 5. 2</a></span>.</p> + <p>—— dilute state of, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Blisters, how they act, <a href="#art_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>—— cure heart-burn, <a href="#art_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>—— stop vomiting, <a href="#art_VI_2_2">vi. 2. 2</a>.</p> + <p>—— produce expectoration, <a href="#art_III_2_3_2">iii. 2. 3. 2</a>.</p> + <p>—— increase perspiration, <a href="#art_III_2_1_10">iii. 2. 1. 10</a>.</p> + <p>Blood, transfusion of, <span class="correction" title="Original reads `i. 2. 6. 2.'"><a href="#art_I_2_6_3">i. 2. 6. 3</a></span>.</p> + <p>Bog-bean, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Bole armeniæ, <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>.</p> + <p>Bone-ashes, <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>.</p> + <p>Bowels, inflammation of, <a href="#art_V_2_2_2">v. 2. 2. 2</a>.</p> + <p>Bryony, white, <a href="#art_III_3_8">iii. 3. 8</a>.</p> + <p>—— as a blister, <span class="correction" title="Original reads `iii. 2. 9.'"><a href="#art_III_2_8">iii. 2. 8</a></span>.</p> + <p>Butter, <a href="#art_I_2_3_2">i. 2. 3. 2</a>.</p> + <p>Butter-milk, <a href="#art_I_2_2_2">i. 2. 2. 2</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>C.</b></p> + </div> + + <div class="stanza"> + <p>Cabbage-leaves, <a href="#art_VII_1_2">vii. 1. 2</a>.</p> + <p>Calcareous earth, <a href="#art_I_2_4_3">i. 2. 4. 3</a>.</p> + <p>Calomel, <a href="#art_III_2_5">iii. 2. 5</a>. <a href="#art_VI_2_5">vi. 2. 5</a>.</p> + <p>—— in enteritis, <a href="#art_V_2_2_2">v. 2. 2. 2</a>.</p> + <p>Camphor, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Canella alba, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Cantharides, <a href="#art_III_2_6">iii. 2. 6</a>. <a href="#art_III_2_8">iii. 2. 8</a>. <a href="#art_V_2_4">v. 2. 4</a>. <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>Capillary action increased by tobacco, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>.</p> + <p>Capsicum, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Carbonic acid gas, <a href="#art_VII_2_6">vii. 2. 6</a>.</p> + <p>Cardamomum, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Caryophyllus aromat. <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Cardamine, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Cassia sistul, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>—— senna, <span class="correction" title="Original reads `iii. 2. 5. 5.'"><a href="#art_III_3_5_5">iii. 3. 5. 5</a></span>.</p> + <p>Castor, <a href="#art_VI_2_1">vi. 2. 1</a>. <a href="#art_VI_3_1">vi. 3. 1</a>.</p> + <p>Cathartics, mild, <a href="#art_III_2_5">iii. 2. 5</a>.</p> + <p>—— violent, <a href="#art_V_2_2">v. 2. 2</a>.</p> + <p>Cerussa in ulcers, <a href="#art_IV_2_9">iv. 2. 9</a>. <a href="#art_IV_2_7">iv. 2. 7</a>.</p> + <p>Chalk, <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>.</p> + <p>Chalybeates, <span class="correction" title="Original reads `iv. 2. 4. 2.'"><a href="#art_IV_3_4_2">iv. 3. 4. 2</a></span>.</p> + <p>Cheese, <a href="#art_I_2_2_3">i. 2. 2. 3</a>.</p> + <p>Cherries, black, <a href="#art_II_2_1_8">ii. 2. 1. 8</a>.</p> + <p>Chlorosis, <a href="#art_IV_2_6_5">iv. 2. 6. 5</a>.</p> + <p>Cicuta, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Cinchona, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>Cinnamon, <span class="correction" title="Original reads `iii. 3. 2.'"><a href="#art_III_3_1_2">iii. 3. 1. 2</a></span>.</p> + <p>Clay, <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>.</p> + <p>Cloves, <a href="#art_III_3_1">iii. 3. 1</a>. <a href="#art_III_3_2">iii. 3. 2</a>.</p> + <p>Cnicus acarna, <a href="#art_V_3_1">v. 3. 1</a>.</p> + <p>Cocculus indicus, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Cochlearia armoracia, <a href="#art_III_3_8">iii. 3. 8</a>. <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>—— hortensis, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Cold, continued application of, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— interrupted, <a href="#art_VII_2_3">vii. 2. 3</a>. <span class="correction" title="Original reads `iii. 2. 1. 7.'"><a href="#art_III_3_1_7">iii. 3. 1. 7</a></span>.</p> + <p>—— excessive, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— first affects lymphatics, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— produces rheum from the nose, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— quick anhelation, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>—— increases digestion, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>Cold-fit easier prevented than removed, <a href="#art_II_2_1">ii. 2. 1</a>.</p> + <p>Colic from lead, <a href="#art_V_2_2_2">v. 2. 2. 2</a>.</p> + <p>Condiments, <a href="#art_I_2_7">i. 2. 7</a>.</p> + <p>Convolvulus scammonium, <a href="#art_V_3_2">v. 3. 2</a>.</p> + <p>Convulsions, <a href="#art_IV_2_8">iv. 2. 8</a>.</p> + <p>Cookery, <a href="#art_I_2_3_5">i. 2. 3. 5</a>.</p> + <p>Copaiva balsam, <span class="correction" title="Original reads `iii. 2. 4. 3.'"><a href="#art_III_3_4_3">iii. 3. 4. 3</a></span>.</p> + <p>Cowhage, <a href="#art_III_3_2">iii. 3. 2</a>.</p> + <p>Crab-juice, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>Cream, <a href="#art_I_2_3_2">i. 2. 3. 2</a>. <a href="#art_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>Cucumis colocynthis, <a href="#art_V_3_2">v. 3. 2</a>.</p> + <p>Cynara scolymus, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Cynoglossum, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>D.</b></p> + </div> + + <div class="stanza"> + <p>Dandelion, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Datura stramonium, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Daucus sylvestris, <span class="correction" title="Original reads `iii. 2. 4. 4.'"><a href="#art_III_3_4_4">iii. 3. 4. 4</a></span>.</p> + <p>Delphinium stavisagria, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Diabetes, <a href="#art_IV_2_5">iv. 2. 5</a>.</p> + <p>—— warm bath in, <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>Diaphoretics, <a href="#art_III_3_1">iii. 3. 1</a>. <a href="#art_III_2_1_2">iii. 2. 1. 2</a>.</p> + <p>—— best in a morning, <a href="#art_III_2_1_5">iii. 2. 1. 5</a>.</p> + <p>Diarrhœa, <a href="#art_VI_2_3">vi. 2. 3</a>.</p> + <p>Digestion injured by cold, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>—— increased by cold, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>Digitalis, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>. <a href="#art_V_2_1_2">v. 2. 1. 2</a>.</p> + <p>—— tincture of, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>.</p> + <p>Dragon's blood, <span class="correction" title="Original reads `iv. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Dropsy, <a href="#art_IV_2_3_4">iv. 2. 3. 4</a>. <a href="#art_IV_2_6_7">iv. 2. 6. 7</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>E.</b></p> + </div> + + <div class="stanza"> + <p>Ears, eruption behind, <a href="#art_IV_2_9_2">iv. 2. 9. 2</a>.</p> + <p>Earth of bones, <a href="#art_IV_2_5">iv. 2. 5</a>.</p> + <p>—— of alum, <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>—— calcareous, <a href="#art_IV_2_5_3">iv. 2. 5. 3</a>. <a href="#art_VI_2_4">vi. 2. 4</a>. <a href="#art_I_2_4_3">i. 2. 4. 3</a>.</p> + <p>Eggs, <a href="#art_I_2_1_4">i. 2. 1. 4</a>.</p> + <p>Egg-shells diuretic, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>Electricity, <a href="#art_II_2_2_2">ii. 2. 2. 2</a>. <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Emetics, how they act, <a href="#art_V_2_1">v. 2. 1</a>.</p> + <p>Errhines mild, <a href="#art_III_2_9">iii. 2. 9</a>.</p> + <p>—— in hydrocephalus, <a href="#art_V_2_3_1">v. 2. 3. 1</a>.</p> + <p>—— violent, <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>—— in head-ach, <a href="#art_V_2_3_1">v. 2. 3. 1</a>.</p> + <p>Erysipelas, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Essential oils, <a href="#art_II_2_3">ii. 2. 3</a>.</p> + <p>Ether, vitriolic, <a href="#art_II_2_3">ii. 2. 3</a>. <a href="#art_III_3_1">iii. 3. 1</a>. <span class="correction" title="Original reads `vi. 3. 3.'"><a href="#art_VI_3_1_3">vi. 3. 1. 3</a></span>.</p> + <p>—— in ascarides, <a href="#art_VII_1_2">vii. 1. 2</a>.</p> + <p>Etiolation, <a href="#art_I_2_3_4">i. 2. 3. 4</a>.</p> + <p>Euphorbium, <a href="#art_V_3_3">v. 3. 3</a>.</p> + <p>Exercise, <span class="correction" title="Original reads `iii. 2. 1. 6.'"><a href="#art_III_3_1_6">iii. 3. 1. 6</a></span>. <a href="#art_II_2_6">ii. 2. 6</a>.</p> + <p>Eyes inflamed, <a href="#art_II_2_2_2">ii. 2. 2. 2</a>. <span class="correction" title="Original reads `iv. 2. 3.'"><a href="#art_IV_2_4_3">iv. 2. 4. 3</a></span>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>F.</b></p> + </div> + + <div class="stanza"> + <p>Famine, times of, <a href="#art_I_2_3_5">i. 2. 3. 5</a>. and <a href="#art_I_2_3_6">6</a>.</p> + <p>Fear, <a href="#art_V_2_4">v. 2. 4</a>.</p> + <p>Feathers, smoke of, <span class="correction" title="Original reads `vi. 3. 6.'"><a href="#art_VI_3_1_6">vi. 3. 1. 6</a></span>.</p> + <p>Fennel, <span class="correction" title="Original reads `iii. 2. 4. 4.'"><a href="#art_III_3_4_4">iii. 3. 4. 4</a></span>.</p> + <p>Ferula asafœtida, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Fish, <a href="#art_I_2_1_2">i. 2. 1. 2</a>. <a href="#art_I_2_1_5">i. 2. 1. 5</a>.</p> + <p>Flannel shirt, <a href="#art_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>Flesh of animals, <a href="#art_I_2_1">i. 2. 1</a>.</p> + <p>Fluke-worm, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Foxglove, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>. <a href="#art_V_2_1">v. 2. 1</a>. <a href="#art_V_2_4">v. 2. 4</a>.</p> + <p>—— tincture of, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>.</p> + <p>Friction, <span class="correction" title="Original reads `ii. 2. 5.'"><a href="#art_II_2_6">ii. 2. 6</a></span>. <span class="correction" title="Original reads `iii. 2. 1. 6.'"><a href="#art_III_3_1_6">iii. 3. 1. 6</a></span>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>G.</b></p> + </div> + + <div class="stanza"> + <p>Galanthus nivalis, <a href="#art_VII_3_3">vii. 3. 3</a>.</p> + <p>Galbanum, <a href="#art_VI_3_1">vi. 3. 1</a>.</p> + <p>Gall-stones, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Galls of oak, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + <p>Garlic, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Gentiana centaurium, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>—— lutea, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Ginger, <a href="#art_III_3_1">iii. 3. 1</a>. <span class="correction" title="This reference seems to be wrong: I cannot determine a correction."><a href="#art_III_3_4">iii. 3. 4</a></span>.</p> + <p>Gonorrhœa, <a href="#art_IV_2_2">iv. 2. 2</a>. <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>Gout, <a href="#art_IV_2_11_2">iv. 2. 11. 2</a>.</p> + <p>Guaiacum, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Gum arabic, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>—— tragacanth, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Glycyrrhiza glabra, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Gravel, <a href="#art_V_2_4_4">v. 2. 4. 4</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>H.</b></p> + </div> + + <div class="stanza"> + <p>Hartshorn, spirit and salt of, <span class="correction" title="This reference seems to be wrong: I cannot determine a correction, except a duplicate of the next."><a href="#art_III_3_3">iii. 3. 3</a></span>. <a href="#art_III_3_1">iii. 3. 1</a>. <span class="correction" title="Original reads `vi. 3. 4.'"><a href="#art_VI_3_1_4">vi. 3. 1. 4</a></span>.</p> + <p>—— calcined, <a href="#art_IV_2_5">iv. 2. 5</a>. <a href="#art_VI_2_3">vi. 2. 3</a>.</p> + <p>Hæmorrhages, <a href="#art_IV_2_4_4">iv. 2. 4. 4</a>. <a href="#art_IV_2_6_2">iv. 2. 6. 2</a>.</p> + <p>Hæmatoxylon campechianum, <span class="correction" title="Original reads `iv. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Hay, infusion of, <a href="#art_I_2_3_6">i. 2. 3. 6</a>.</p> + <p>Head-ach, snuff in, <a href="#art_V_2_3_1">v. 2. 3. 1</a>.</p> + <p>Heat, <a href="#art_II_2_2_1">ii. 2. 2. 1</a>. See Bath.</p> + <p>—— an universal solvent, <a href="#art_VII_2_2">vii. 2. 2</a>.</p> + <p>Helenium, <span class="correction" title="Original reads `iii. 2. 3. 2.'"><a href="#art_III_3_3_2">iii. 3. 3. 2</a></span>.</p> + <p>Herpes, <a href="#art_IV_2_1">iv. 2. 1</a>. <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Herrings, red, <span class="correction" title="Original reads `iii. 2. 1. 4.'"><a href="#art_III_3_1_4">iii. 3. 1. 4</a></span>.</p> + <p>Honey, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>. <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>Hop in beer, why noxious, <a href="#art_IV_2_3_6">iv. 2. 3. 6</a>. <a href="#art_IV_2_11_2">iv. 2. 11. 2</a>.</p> + <p>Hordeum distichon, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Humulus lupulus, <a href="#art_IV_2_3">iv. 2. 3</a>. <a href="#art_IV_2_11">iv. 2. 11</a>.</p> + <p>Hydrargyrus vitriolatus, <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>Hysteric disease, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + <p>—— pains, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + <p>—— convulsions, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>I.</b></p> + </div> + + <div class="stanza"> + <p>Jalapium, <span class="correction" title="Original reads `iii. 2. 5. 5.'"><a href="#art_III_3_5_5">iii. 3. 5. 5</a></span>.</p> + <p>Japan earth, <span class="correction" title="Original reads `iv. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Jaundice, <a href="#art_IV_2_6_3">iv. 2. 6. 3</a>.</p> + <p>Ileus, <a href="#art_VI_2_5">vi. 2. 5</a>.</p> + <p>Incitantia, <a href="#art_II">ii</a>.</p> + <p>Intermittents. See Agues.</p> + <p>Inverted motions, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + <p>—— in hysteric disease, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + <p>—— of the stomach, <a href="#art_VI_2_2">vi. 2. 2</a>.</p> + <p>—— intestinal canal, <a href="#art_VI_2_5">vi. 2. 5</a>.</p> + <p>—— of lymphatics, <a href="#art_VI_2_3">vi. 2. 3</a>.</p> + <p>Inula helenium, <span class="correction" title="Original reads `iii. 2. 3. 2.'"><a href="#art_III_3_3_2">iii. 3. 3. 2</a></span>.</p> + <p>Ipecacuanha, <a href="#art_V_2_1">v. 2. 1</a>.</p> + <p>Iron, rust of, <a href="#art_IV_3_6">iv. 3. 6</a>.</p> + <p>Irritability prevented, <a href="#art_IV_2_3_3">iv. 2. 3. 3</a>.</p> + <p>Itch, <a href="#art_IV_2_1_3">iv. 2. 1. 3</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>L.</b></p> + </div> + + <div class="stanza"> + <p>Laurus camphora, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>—— cinnamomum, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>—— sassafras, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Lead, <a href="#art_IV_3_6">iv. 3. 6</a>.</p> + <p>—— colic from, <a href="#art_V_2_2_2">v. 2. 2. 2</a>.</p> + <p>—— sugar of, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Leeks, <span class="correction" title="Original reads `iii. 2. 3. 1.'"><a href="#art_III_3_3_1">iii. 3. 3. 1</a></span>.</p> + <p>Legs, ulcers of, <a href="#art_IV_2_10">iv. 2. 10</a>.</p> + <p>Lemon-juice, <a href="#art_IV_2_1">iv. 2. 1</a>. <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>Leontodon taraxacum, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Life shortened by great stimulus, <a href="#art_I_1">i. 1</a>.</p> + <p>Lime, <a href="#art_I_2_4_3">i. 2. 4. 3</a>.</p> + <p>Liquorice, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Liver inflamed, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Logwood, <span class="correction" title="Original reads `iii. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Lymphatics, inverted motions of, <a href="#art_V_2_1">v. 2. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>M.</b></p> + </div> + + <div class="stanza"> + <p>Magnesia alba, <span class="correction" title="Original reads `iii. 2. 5. 3.'"><a href="#art_III_3_5_3">iii. 3. 5. 3</a></span>.</p> + <p>Malt, <a href="#art_I_2_3_5">i. 2. 3. 5</a>.</p> + <p>Manna, <a href="#art_III_3_5">iii. 3. 5</a>.</p> + <p>Marsh-mallows, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Marjoram, <a href="#art_III_3_9">iii. 3. 9</a>.</p> + <p>Marum, <a href="#art_III_3_9">iii. 3. 9</a>.</p> + <p>Mastich, <a href="#art_III_3_2">iii. 3. 2</a>. <span class="correction" title="This reference seems to be wrong: I cannot determine a correction."><a href="#art_III_3_3">iii. 3. 3</a></span>.</p> + <p>Menianthes trifoliata, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Menispermum cocculus, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Menstruation promoted, <a href="#art_IV_2_6_6">iv. 2. 6. 6</a>.</p> + <p>—— repressed, <a href="#art_IV_2_6_6">iv. 2. 6. 6</a>.</p> + <p>Mercury, <a href="#art_III_3_2">iii. 3. 2</a>. <a href="#art_VI_2_2">vi. 2. 2</a>.</p> + <p>—— preparations of, <a href="#art_IV_3_7">iv. 3. 7</a>. <a href="#art_IV_2_7">iv. 2. 7</a>. <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>—— injected as a clyster, <a href="#art_VI_3_5">vi. 3. 5</a>.</p> + <p>Metallic salts, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Milk, <a href="#art_I_2_2">i. 2. 2</a>.</p> + <p>Mimosa nilotica, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>—— catechu, <span class="correction" title="Original reads `iv. 2. 5. 2.'"><a href="#art_IV_3_5_2">iv. 3. 5. 2</a></span>.</p> + <p>Mint, <span class="correction" title="Original reads `vi. 3. 3.'"><a href="#art_VI_3_1_3">vi. 3. 1. 3</a></span>.</p> + <p>Mortification, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Mucilage, vegetable, <a href="#art_VII_3_3">vii. 3. 3</a>.</p> + <p>Mucus, animal, <a href="#art_VII_3_5">vii. 3. 5</a>.</p> + <p>Mushrooms, <a href="#art_I_2_1_2">i. 2. 1. 2</a>.</p> + <p>Musk, <a href="#art_VI_2_1">vi. 2. 1</a>. <a href="#art_VI_3_1">vi. 3. 1</a>.</p> + <p>Mustard, <a href="#art_IV_3_4">iv. 3. 4</a>. See Sinapism.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>N.</b></p> + </div> + + <div class="stanza"> + <p>Nausea in fevers, <a href="#art_VII_2_5">vii. 2. 5</a>.</p> + <p>Neutral salts diuretic, why, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>—— increase some coughs, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>—— increase heat of urine, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>Nicotiana tabacum, <a href="#art_III_3_9">iii. 3. 9</a>. <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Nitre, <a href="#art_III_3_4">iii. 3. 4</a>. <a href="#art_V_2_4">v. 2. 4</a>.</p> + <p>Nutmeg, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>Nutrientia, <a href="#art_I">i</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>O.</b></p> + </div> + + <div class="stanza"> + <p>Oil of almonds, <span class="correction" title="Original reads `iii. 2. 5. 4.'"><a href="#art_III_3_5_4">iii. 3. 5. 4</a></span>.</p> + <p>—— in cream, <a href="#art_I_2_3_2">i. 2. 3. 2</a>.</p> + <p>—— of amber, <a href="#art_VI_2_1">vi. 2. 1</a>.</p> + <p>—— expressed externally, <a href="#art_III_2_3">iii. 2. 3</a>.</p> + <p>—— essential, <a href="#art_II_2_3">ii. 2. 3</a>. <span class="correction" title="Original reads `iii. 3. 2.'"><a href="#art_III_3_1_2">iii. 3. 1. 2</a></span>.</p> + <p>Oiled silk, <a href="#art_VII_3_13">vii. 3. 13</a>.</p> + <p>Oleum, animale, <a href="#art_VI_2_1">vi. 2. 1</a>. <a href="#art_VI_3_4">vi. 3. 4</a>.</p> + <p>—— ricini, <span class="correction" title="Original reads `iii. 2. 5. 4.'"><a href="#art_III_3_5_4">iii. 3. 5. 4</a></span>.</p> + <p>Onions, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Opium, <a href="#art_II_2_1_2">ii. 2. 1. 2</a>. <a href="#art_IV_1_2">iv. 1. 2</a>.</p> + <p>—— in nervous pains, <a href="#art_II_2_1_5">ii. 2. 1. 5</a>.</p> + <p>—— in inflammatory pains, <a href="#art_II_2_1_6">ii. 2. 1. 6</a>.</p> + <p>—— increases all secretions and absorptions, <a href="#art_II_2_1_1">ii. 2. 1. 1</a>.</p> + <p>—— absorption after evacuation, <a href="#art_IV_2_8_2">iv. 2. 8. 2</a>. <a href="#art_II_2_1_3">ii. 2. 1. 3</a>.</p> + <p>—— stops sweats, <a href="#art_IV_2_1_2">iv. 2. 1. 2</a>.</p> + <p>—— intoxicates, <a href="#art_II_2_1_1">ii. 2. 1. 1</a>.</p> + <p>Oranges, their peel, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Orchis, <a href="#art_VII_3_3">vii. 3. 3</a>.</p> + <p>Oxygen gas, <a href="#art_II_2_4">ii. 2. 4</a>. <a href="#art_I_2_5">i. 2. 5</a>. <a href="#art_III_2_11">iii. 2. 11</a>. <a href="#art_IV_1_4">iv. 1. 4</a>.</p> + <p>—— produces and heals ulcers, <a href="#art_IV_2_7">iv. 2. 7</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>P.</b></p> + </div> + + <div class="stanza"> + <p>Papin's digester, <a href="#art_I_2_3_5">i. 2. 3. 5</a>.</p> + <p>Papaver somniferum, <a href="#art_II_3_1">ii. 3. 1</a>. <a href="#art_IV_3_2">iv. 3. 2</a>. See Opium.</p> + <p>Pains, periodic, cured by opium, <a href="#art_II_2_1">ii. 2. 1</a>.</p> + <p>Pareira brava, <span class="correction" title="Original reads `iii. 2. 4. 4.'"><a href="#art_III_3_4_4">iii. 3. 4. 4</a></span>.</p> + <p>Parsley, <a href="#art_III_3_4">iii. 3. 4</a>.</p> + <p>Passions, <a href="#art_II_2_5">ii. 2. 5</a>.</p> + <p>Pasturage, <a href="#art_I_2_3_7">i. 2. 3. 7</a>.</p> + <p>Pepper, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Peripneumony, <a href="#art_IV_2_8_2">iv. 2. 8. 2</a>.</p> + <p>Perspiration in a morning, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>—— not an excrement, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>Peru, balsam of, <span class="correction" title="Original reads `iii. 2. 5. 4.'"><a href="#art_III_3_5_4">iii. 3. 5. 4</a></span>.</p> + <p>Petechiæ, <a href="#art_IV_2_4_2">iv. 2. 4. 2</a>.</p> + <p>Pimento, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Piper indicum, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Pistacia lentiscus, <a href="#art_III_3_2">iii. 3. 2</a>.</p> + <p>Pix liquida, <span class="correction" title="Original reads `iii. 3. 2.'"><a href="#art_III_3_3">iii. 3. 3</a></span>.</p> + <p>Plaster-bandage, <a href="#art_IV_2_10">iv. 2. 10</a>.</p> + <p>Pleurisy, <a href="#art_IV_2_8_2">iv. 2. 8. 2</a>.</p> + <p>Polygala seneka, <span class="correction" title="Original reads `iii. 2. 3. 2.'"><a href="#art_III_3_3_2">iii. 3. 3. 2</a></span>.</p> + <p>Poppy. See Papaver.</p> + <p>Portland's powder noxious, why, <a href="#art_IV_2_11_2">iv. 2. 11. 2</a>.</p> + <p>Potatoe-bread, <a href="#art_I_2_3_4">i. 2. 3. 4</a>.</p> + <p>Potentilla, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + <p>Prunes, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>Prunus domestica, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>—— spinosa, <a href="#art_IV_3_1">iv. 3. 1</a>.</p> + <p>—— lauro-cerasus, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Pulegium, <span class="correction" title="Original reads `vi. 3. 3.'"><a href="#art_VI_3_1_3">vi. 3. 1. 3</a></span>.</p> + <p>Pulse, intermittent, relieved by arsenic, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Pyrethrum, <a href="#art_III_3_2">iii. 3. 2</a>.</p> + <p>Pyrus malus, <a href="#art_VII">vii</a>.</p> + <p>—— cydonia, <a href="#art_IV_3_1">iv. 3. 1</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>Q.</b></p> + </div> + + <div class="stanza"> + <p>Quassia, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>Quince, <a href="#art_IV_3_1">iv. 3. 1</a>.</p> + <p>Quinquefolium, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>R.</b></p> + </div> + + <div class="stanza"> + <p>Ratafie, why destructive, <a href="#art_II_2_1">ii. 2. 1</a>.</p> + <p>Resin diuretic, <a href="#art_III_2_4">iii. 2. 4</a>. <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>Rhamnus catharticus, <a href="#art_V_3_2">v. 3. 2</a>.</p> + <p>Rheumatism, <a href="#art_IV_2_4_5">iv. 2. 4. 5</a>. <a href="#art_IV_2_10_2">iv. 2. 10. 2</a>.</p> + <p>Rheum palmatum. See Rhubarb.</p> + <p>Rhubarb, <a href="#art_III_2_1">iii. 2. 1</a>. <a href="#art_IV_2_5_1">iv. 2. 5. 1</a>. <span class="correction" title="Original reads `iii. 2. 5. 5.'"><a href="#art_III_3_5_5">iii. 3. 5. 5</a></span>.</p> + <p>—— causes constipation, why, <a href="#art_III_2_1_1">iii. 2. 1. 1</a>.</p> + <p>Rice, <a href="#art_VII">vii</a>.</p> + <p>Roses, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + <p>Rot in sheep, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>S.</b></p> + </div> + + <div class="stanza"> + <p>Sago, <a href="#art_VII_3">vii. 3</a>.</p> + <p>Sagopænum, <a href="#art_VI_3_1">vi. 3. 1</a>.</p> + <p>Salivation not necessary, <a href="#art_IV_2_7">iv. 2. 7</a>.</p> + <p>—— hysteric, <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>Salt, common, unwholesome, <a href="#art_III_1_12">iii. 1. 12</a>.</p> + <p>—— muriatic, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>—— in clysters, <a href="#art_III_2_7">iii. 2. 7</a>.</p> + <p>Salts, why diuretic, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>—— neutral, <span class="correction" title="Original reads `iii. 2. 5. 3.'"><a href="#art_III_3_5_3">iii. 3. 5. 3</a></span>. <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>—— improper in coughs and gonorrhœa, <a href="#art_III_2_4">iii. 2. 4</a>.</p> + <p>Salt fish and salt meat increase perspiration, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>Sassafras, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Scammony, <a href="#art_V_2_2">v. 2. 2</a>.</p> + <p>Scarcity, times of, <a href="#art_I_2_3_5">i. 2. 3. 5</a>. and <a href="#art_I_2_3_6">6</a>.</p> + <p>Scilla maritima, <a href="#art_V_2_2">v. 2. 2</a>. <a href="#art_IV_2_3">iv. 2. 3</a>. <a href="#art_III_3_3">iii. 3. 3</a>. <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>Scorbutic legs, <a href="#art_IV_2_10">iv. 2. 10</a>.</p> + <p>Scrophulous tumours, <a href="#art_II_2_4">ii. 2. 4</a>. <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Sea-water, <span class="correction" title="Original reads `iii. 2. 5. 3.'"><a href="#art_III_3_5_3">iii. 3. 5. 3</a></span>.</p> + <p>Secernentia, <a href="#art_III">iii</a>.</p> + <p>Secretion of the bladder, <a href="#art_III_2_6">iii. 2. 6</a>.</p> + <p>—— of the rectum, <a href="#art_III_2_7">iii. 2. 7</a>.</p> + <p>—— of the skin, <a href="#art_III_2_8">iii. 2. 8</a>.</p> + <p>Seneka, <span class="correction" title="Original reads `iii. 2. 3. 2.'"><a href="#art_III_3_3_2">iii. 3. 3. 2</a></span>.</p> + <p>Senna, <span class="correction" title="Original reads `iii. 2. 5. 5.'"><a href="#art_III_3_5_5">iii. 3. 5. 5</a></span>.</p> + <p>Serpentaria virginiana, <a href="#art_III_3_1">iii. 3. 1</a>.</p> + <p>Sialagogues, <a href="#art_III_2_2">iii. 2. 2</a>. <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>Simarouba, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + <p>Sinapi, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Sinapisms, <a href="#art_VI_2_2">vi. 2. 2</a>. <a href="#art_III_2_8">iii. 2. 8</a>. <span class="correction" title="Duplicate?'"><a href="#art_VI_2_2">vi. 2. 2</a></span>.</p> + <p>Sisymbrium nasturtium, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Sloes, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>Snuffs of candles, <span class="correction" title="Original reads `vi. 3. 4.'"><a href="#art_VI_3_1_4">vi. 3. 1. 4</a></span>.</p> + <p>Society, <a href="#art_I_2_3_7">i. 2. 3. 7</a>.</p> + <p>Soot, <span class="correction" title="Original reads `vi. 3. 4.'"><a href="#art_VI_3_1_4">vi. 3. 1. 4</a></span>.</p> + <p>Sorbentia, various kinds, <a href="#art_IV_2_1">iv. 2. 1</a>.</p> + <p>Spasmodic doctrine exploded, <a href="#art_VII_2_3">vii. 2. 3</a>.</p> + <p>Spermaceti, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Spice noxious, <a href="#art_III_1_12">iii. 1. 12</a>.</p> + <p>Spirit of wine noxious, <a href="#art_II_2_1">ii. 2. 1</a>.</p> + <p>Sponge, burnt, <span class="correction" title="Original reads `vi. 3. 4.'"><a href="#art_VI_3_1_4">vi. 3. 1. 4</a></span>.</p> + <p>Squill. See Scilla.</p> + <p>Starch, <a href="#art_I_2_3_1">i. 2. 3. 1</a>.</p> + <p>—— from poisonous roots, <a href="#art_I_2_3_4">i. 2. 3. 4</a>.</p> + <p>Steam, bath of, <a href="#art_IV_2_3_8">iv. 2. 3. 8</a>.</p> + <p>Steel, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>—— forwards and represses menstruation, <a href="#art_IV_2_6">iv. 2. 6</a>.</p> + <p>Stizolobium siliqua hirsuta, <a href="#art_III_3_2">iii. 3. 2</a>. <a href="#art_VII_3_11">vii. 3. 11</a>.</p> + <p>Strychnos nux vomica, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Sublimate of mercury, <a href="#art_IV_2_7">iv. 2. 7</a>. <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>Sugar nourishing, <a href="#art_I_2_3_1">i. 2. 3. 1</a>. and <a href="#art_I_2_3_5">5</a>. <span class="correction" title="Original reads `iii. 2. 4. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>—— formed after the death of the plant, <a href="#art_I_2_3_5">i. 2. 3. 5</a>.</p> + <p>—— aperient, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>Sulphur, <span class="correction" title="Original reads `iii. 2. 5. 4.'"><a href="#art_III_3_5_4">iii. 3. 5. 4</a></span>.</p> + <p>Sweats in a morning, <span class="correction" title="Original reads `iii. 2. 1. 1.'"><a href="#art_III_2_1_5">iii. 2. 1. 5</a></span>.</p> + <p>—— on waking, <span class="correction" title="Original reads `iii. 2. 1. 1.'"><a href="#art_III_2_1_5">iii. 2. 1. 5</a></span>.</p> + <p>—— cold, <a href="#art_V_2_5">v. 2. 5</a>.</p> + <p>—— stopped by opium, <a href="#art_IV_2_1_2">iv. 2. 1. 2</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>T.</b></p> + </div> + + <div class="stanza"> + <p>Tænia, vermes. See Worms.</p> + <p>Tamarinds, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>.</p> + <p>Tansey, tanacetum, <a href="#art_IV_3_3">iv. 3. 3</a>.</p> + <p>Tar, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Tartar, crystals of, <span class="correction" title="Original reads `iii. 2. 5. 1.'"><a href="#art_III_3_5_1">iii. 3. 5. 1</a></span>. Class <a href="#species_I_2_3_13">i. 2. 3. 13</a>.</p> + <p>—— vitriolate, <span class="correction" title="Original reads `iii. 2. 5. 3.'"><a href="#art_III_3_5_3">iii. 3. 5. 3</a></span>.</p> + <p>—— emetic, <a href="#art_V_2_1">v. 2. 1</a>. <a href="#art_V_2_2">v. 2. 2</a>.</p> + <p>Tea, <a href="#art_VII_2_1">vii. 2. 1</a>.</p> + <p>Tears, <a href="#art_III_2_10">iii. 2. 10</a>.</p> + <p>Testaceous powders, <span class="correction" title="Original reads `iv. 2. 2.'"><a href="#art_IV_2_1">iv. 2. 1</a></span>.</p> + <p>Tetradynamia, plants of, <a href="#art_IV_2_4">iv. 2. 4</a>.</p> + <p>Tincture of digitalis, <a href="#art_IV_2">iv. 2</a>.</p> + <p>Tinea, herpes, <a href="#art_IV_2_1_4">iv. 2. 1. 4</a>.</p> + <p>Tobacco, <a href="#art_II_3_1">ii. 3. 1</a>. <a href="#art_III_3_9">iii. 3. 9</a>. <span class="correction" title="Original reads `iv. 2. 3. 8.'"><a href="#art_IV_2_3_7">iv. 2. 3. 7</a></span>.</p> + <p>—— injures digestion, <a href="#art_III_2_2_3">iii. 2. 2. 3</a>.</p> + <p>Tolu balsam, <a href="#art_III_3_3">iii. 3. 3</a>.</p> + <p>Tormentilla erecta, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + <p>Torpentia, <a href="#art_VII">vii</a>.</p> + <p>Tragacanth gum, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + <p>Turpentine, <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>—— spirit of, <a href="#art_III_2_6">iii. 2. 6</a>.</p> + <p>Turpeth mineral, <a href="#art_V_2_3">v. 2. 3</a>.</p> + <p>Tussilago farfara, <span class="correction" title="Original reads `iii. 2. 3. 3.'"><a href="#art_III_3_3_3">iii. 3. 3. 3</a></span>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>U.</b></p> + </div> + + <div class="stanza"> + <p>Ulcers, scrophulous, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>—— of the mouth, <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>—— cured by absorption, <a href="#art_II_2_1_4">ii. 2. 1. 4</a>. <a href="#art_IV_2_3_5">iv. 2. 3. 5</a>.</p> + <p>Uva ursi, <a href="#art_IV_3_5">iv. 3. 5</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>V.</b></p> + </div> + + <div class="stanza"> + <p>Valerian, <span class="correction" title="Original reads `vi. 3. 3.'"><a href="#art_VI_3_1">vi. 3. 1</a></span>.</p> + <p>Vegetable acids, <a href="#art_IV_2_1">iv. 2. 1</a>.</p> + <p>—— food, <a href="#art_I_2_1_2">i. 2. 1. 2</a>.</p> + <p>Venereal ulcers, <a href="#art_IV_2_7">iv. 2. 7</a>.</p> + <p>Venesection, <a href="#art_VII_2_4">vii. 2. 4</a>. <a href="#art_IV_2_8">iv. 2. 8</a>.</p> + <p>—— diminishes secretions, <a href="#art_VII_2_4">vii. 2. 4</a>.</p> + <p>—— increases absorptions, <a href="#art_VII_2_4">vii. 2. 4</a>.</p> + <p>Veratrum, <a href="#art_V_3_2">v. 3. 2</a>.</p> + <p>Vibices, <a href="#art_IV_2_4_3">iv. 2. 4. 3</a>.</p> + <p>Vinegar, <span class="correction" title="Original reads `iv. 2. 1. 9.'"><a href="#art_IV_2_1_2">iv. 2. 1. 2</a></span>. <a href="#art_IV_2_4_3">iv. 2. 4. 3</a>. <a href="#art_II_2_1_9">ii. 2. 1. 9</a>.</p> + <p>Vitriol blue in agues, <a href="#art_IV_2_6">iv. 2. 6</a>. <a href="#art_IV_2_2">iv. 2. 2</a>.</p> + <p>—— in ulcers, <a href="#art_IV_2_9">iv. 2. 9</a>.</p> + <p>—— white, <a href="#art_IV_3_6">iv. 3. 6</a>. <a href="#art_V_2_1">v. 2. 1</a>.</p> + <p>—— acid of, <a href="#art_IV_2_1">iv. 2. 1</a>.</p> + <p>—— in sweats, <a href="#art_IV_1_1">iv. 1. 1</a>.</p> + <p>—— in small-pox, <a href="#art_IV_1_1">iv. 1. 1</a>.</p> + <p>Volatile salt, <span class="correction" title="Original reads `vi. 3. 6.'"><a href="#art_VI_3_1_6">vi. 3. 1. 6</a></span>.</p> + <p>Vomiting, <a href="#art_V_2_2">v. 2. 2</a>.</p> + <p>Vomiting stopped by mercury, <a href="#art_VI_2_2">vi. 2. 2</a>.</p> + <p>Vomits, <a href="#art_IV_2_3_7">iv. 2. 3. 7</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>W.</b></p> + </div> + + <div class="stanza"> + <p>Warm bath, <a href="#art_II_2_2_1">ii. 2. 2. 1</a>.</p> + <p>—— in diabetes <a href="#art_VI_2_4">vi. 2. 4</a>.</p> + <p>Water, <a href="#art_I_2_4">i. 2. 4</a>.</p> + <p>—— dilutes and lubricates, <a href="#art_VII_2_2">vii. 2. 2</a>.</p> + <p>—— cold, produces sweats, <a href="#art_III_2_1">iii. 2. 1</a>.</p> + <p>—— iced, in ileus, <a href="#art_VI_2_5">vi. 2. 5</a>.</p> + <p>—— cresses, <a href="#art_IV_3_4">iv. 3. 4</a>.</p> + <p>Whey of milk, <span class="correction" title="Original reads `iii. 2. 5. 2.'"><a href="#art_III_3_5_2">iii. 3. 5. 2</a></span>. <a href="#art_I_2_2_2">i. 2. 2. 2</a>.</p> + <p>Wine, <a href="#art_II_3_1">ii. 3. 1</a>.</p> + <p>Worms, <a href="#art_VII_1_2">vii. 1. 2</a>. <a href="#art_III_2_7">iii. 2. 7</a>. <a href="#art_IV_2_6_4">iv. 2. 6. 4</a>.</p> + <p>—— in sheep, <a href="#art_IV_2_6_4">iv. 2. 6. 4</a>.</p> + </div> + + <div class="stanza"> + <p class="i16"><b>Z.</b></p> + </div> + + <div class="stanza"> + <p>Zinc, vitriol of, <a href="#art_V_3_1">v. 3. 1</a>.</p> + </div> + </div> + + <p><br style="clear:both" /></p> +<hr class="full" /> + +<h3>THE END.</h3> + +<p> </p> +<p> 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