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.
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 ClassI. 1. 2. 14.
Secondly, 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.
Thirdly, 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.
Afourthvariety 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.III. 2. 12.and Art.III. 2. 1.
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 ClassI. 2. 1. 14. 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 ClassI. 2. 3. 21. 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 ClassII. 1. 3. 12.
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.
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.
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. ClassI. 1. 2. 14. Art.III. 2. 1.
4.Urina uberior colorata.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?
5.Diarrhœa calida.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.I. 3. 1. 5.
Thediarrhœa crapulosa, 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.
Thediarrhœa infantum, 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.
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.
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 ArticleIII. 2. 1. in the subsequent Materia Medica.
6.Salivatio calida.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.
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 ClassI. 3. 2. 2. See Sect. XXIV.
M. M. Cool air, diluents, warm bath, evacuations.
7.Catharrhus calidus.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 inI. 2. 3. 3. 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.
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. ClassII. 1. 3. 5.IV. 2. 2. 10.IV. 1. 1. 5.
M. M. Evacuations, abstinence, oil externally on the nose, warm diluent fluids, warm shoes, warm night-cap.
8.Expectoratio calida.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.
M. M. Inhale the steam of warm water, evacuations, warm bath, afterwards opium, sorbentia.
9.Exsudatio pone aures.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 ClassII. 1. 5. 6. andII. 1. 4. 6.
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.
10.Gonorrhea calida.Warm gleet. Increased discharge of mucus from the urethra or prostrate gland without venereal desire, or venereal infection. See ClassI. 2. 3. 8.
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.
11.Fluor albus calidus.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.
M. M. Mucilage, as isinglass, hartshorn jelly, gum arabic. Ten grains of rhubarb every night. Callico or flannel shift, opium, balsams. See ClassI. 2. 3. 7.
12.Hæmorrhois alba.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 ClassI. 2. 1. 6.
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.
13.Serum e vesicatorio.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.
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.
14.Perspiratio fœtida.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.
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.
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.
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?
15.Crines novi.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 ClassI. 2. 2. 9. 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, ClassIV. 1. 2. 7. and Parotitis, ClassIV. 1. 2. 19. 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.
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 ClassI. 2. 2. 11. on grey hairs.
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.
1.Lingua arida.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.
M. M. Warm subacid liquids. See ClassI. 2. 5. 8.
2.Fauces aridæ.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.
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.
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 ClassII. 1. 3. 17.
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.
3.Nares aridi.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.
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.
4.Expectoratio solida.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.
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, ClassII. 1. 3. 3.
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.
5.Constipatio alvi.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.
M. M. Cathartics, Diluents, fruit, oil, soap, sulphur, warm bath. Sprinkling with cold water, cool clothing. See ClassI. 2. 4. 18.
6.Cutis arida.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.
M. M. Warm bathing, oil externally, oil-skin gloves, resinous plasters. Wax.
7.Urina parca colorata.Diminished urine, which is high coloured, and deposits an earthy sediment, when cold, is owing to the great action of the urinary absorbents. See ClassI. 1. 2. 4. 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.
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.
8.Calculus felleus.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.
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 ClassI. 2. 4. 19.
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 ClassIV. 2. 2. 4.
9.Calculus renis.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.
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.
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 ClassII. 1. 2.
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.
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.
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?
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 ClassIV. 2. 2. 2. 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 ClassI. 3. 2. 11.
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.
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.
10.Calculus vesicæ.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.
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.
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.
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.
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 No8, 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.
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?
11.Calculus arthriticus.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.
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.
12.Rheumatismus chronicus.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.
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.
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.
13.Cicatrix vulnerum.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.
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.
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.
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.
14.Corneæ obfuscatio.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 ClassI. 2. 5. 3. by their being invariably seen at any time, when you look for them.
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.
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.
1.Nictitatioirritativa.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 ClassII. 1. 1. 8. 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.
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.
2.Deglutitio irritativa.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.
3.Respiratio et Tussis irritativæ.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 ClassI. 1. 2. 8. andI. 1. 3. 4. and which are frequently performed without our attention or consciousness, and are then irritative actions; and thus differ from those described in ClassII. 1. 1. 2. and5. 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.
4.Exclusio bilis.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.
5.Dentitio.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 ClassI. 1. 2. 5. Sect. XXXV. 2. 1.
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.
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.
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 ClassIII. 1. 1. 5. and6.
6.Priapismus chronicus.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. ClassIII. 1. 2. 16.
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.
7.Distentio mamularum.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 ClassII. 1. 7. 10.
8.Descensus uteri.This is a very frequent complaint after bad labours, the fundus uteri becomes inverted and descends like the prolapsus ani.
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.
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.
9.Prolapsus ani.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.
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.
10.Lumbricus.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.
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.
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.
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, ClassI. 2. 3. 9. 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?
11.Tænia.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.
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.
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.
12.Ascarides.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?
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.
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.
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.
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 ClassIV. 1. 2. 9.
13.Dracunculus.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.
14.Morpiones.Crab-lice. The excrement of this animal stains the linen, and appears like diluted blood.
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.
15.Pediculi.Lice. There is said to be a disease, in which these animals are propagated in indestructible numbers, so as to destroy the patient.