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.
3.Nausea sicca.Dry nausea. Consists in a quiescence or torpor of the mucous or salivary glands, and precedes their inverted motions, described in nausea humida, ClassI. 3. 2. 3. 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.
M. M. Lemonade. Tasteful food. A blister. Warm bath.
4.Ægritudo ventriculi.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.
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 ClassI. 3. 2. 3. 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.
M. M. A blister on the back. An emetic. Opium. Crude mercury. Covering the head in bed. See Sect. XXV. 16. ClassIV. 1. 1. 2. and3.
5.Cardialgia.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 ClassI. 3. 1. 3. andIV. 2. 2. 5.
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 ClassII. 1. 3. 17. andIV. 1. 2. 13.
6.Arthritis Ventriculi.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.
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.
M. M. Opium. Vinous spirit. Volatile alcali. Spice. Warmth applied externally to the stomach by hot cloths or fomentation.
7.Colica flatulenta.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.
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.
M. M. Spirit of wine and warm water, one spoonful of each. Opium one grain. Spice. Volatile alcali. Warm fomentation externally. Rhubarb.
8.Colica saturnina.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.
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.
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.
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.
9.Tympanitis.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.
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.
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 ClassI. 2. 4. 5.
10.Hypochondriasis.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.
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.
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.
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,I. 2. 4. 5.
11.Cephalæa.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.
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 ClassIV. 2. 2. 7. 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 ClassIV. 2. 2. 7. &8.
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 ClassIV. 2. 2. 7. and8.
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.IV. 2. 6.
12.Odontalgia.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.
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.
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.
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.
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, ClassII. 1. 4. 7. andIV. 2. 2. 8.
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.
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.
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?
13.Otalgia.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 ClassII. 1. 4. 8. 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.
14.Pleurodyne chronica.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 ClassI. 1. 3. 12. 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.
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.
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.
15.Sciatica frigida.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 ClassII. 1. 2. 18.
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.
16.Lumbago frigida.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 ClassII. 1. 2. 17.
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.
17.Hysteralgia frigida.Cold pain of the uterus preceding or accompanying menstruation. It is attended with cold extremities, want of appetite, and other marks of general debility.
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.
18.Proctalgia frigida.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.
M. M. Calomel. A cathartic. Spice. Clyster, with 30 drops of laudanum. Sitting over warm water. If chalybeates after evacuation? See ClassI. 2. 3. 23. andI. 2. 1. 6.
19.Vesicæ felleæ inirritabilitas.The inirritability of the gall-bladder probably occasions one kind oficterus, 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.
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.
The spissitude of the bile is another cause of jaundice, as mentioned in ClassI. 1. 3. 8. 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.
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.
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.
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.
A strong aerated alcaline water is sold by J. Schweppe, No. 8, King's-street, Holborn. See ClassI. 1. 3. 10.
20.Pelvis renalis inirritabilitas.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 ClassI. 1. 3. 9.
1.Stultitia inirritabilis.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.
2.Visus imminutus.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 ClassI. 2. 3. 26.; 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.
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. ClassI. 1. 3. 14.I. 2. 3. 25.IV. 2. 1. 11.
3.Muscæ volitantes.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.
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.
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.
4.Strabismus.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.
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?
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.
5.Amaurosis.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.
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.
6.Auditus imminutus.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.
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 ClassIV. 2. 1. 15.
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.
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.
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.
7.Olfactus imminutus.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. ClassIV. 2. 1. 16.
M. M. Mild errhines.
8.Gustus imminutus.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.I. 1. 3. 1.IV. 2. 1. 16.
M. M. Warm subacid liquids taken frequently.
9.Tactus imminutus.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 ClassIV. 2. 1. 16.
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.
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.
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.
M. M. Friction alone, or with camphorated oil, warm bath. Ether. Volatile alcali and water. Internally spice, salt. Incitantia. Secernentia.
10.Stupor.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.
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.
"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 calledcrimping. 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."
"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 calledcrimping. 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."
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."
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.
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.
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.
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.
1.Ruminatio.In the rumination of horned cattle theretrogrademotions 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.
There are histories of ruminating men, and who have taken pleasure in the act of chewing their food a second time. Philos. Transact.
2.Ructus.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.
3.Apepsia.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 ClassII. 1. 4. 6.. This disease differs from Cardialgia, ClassI. 2. 4. 5. 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.
M. M. A blister, rhubarb, a grain of opium twice a day. Soap, iron-powder. Tin-powder.
4.Vomitus.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.
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.
5.Cholera.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 ClassII. 1. 2. 11.
The cramps of the legs, which are liable to attend cholera, are explained in ClassIII. 1. 1. 14.
6.Ileus.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.
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.
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?
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 ClassII. 1. 2. 11.
7.Globus hystericus.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.
M. M. Tincture of castor. Tinct. of opium of each 15 drops. See Hysteria, ClassI. 3. 1. 10.
8.Vomendi conamen inane.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.
M. M. Blister. Opium. Crude mercury.
9.Borborigmus.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.
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 ClassI. 2. 4. 9.
10.Hysteria.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, ClassI. 2. 4. 10. See Sect. XVI. 8. 1.
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.
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.
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.
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.VI. 2. 1.
11.Hydrophobia.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 ClassIII. 1. 1. 15. andIV. 1. 2. 7.
1.Catarrhus lymphaticus.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.
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.
Could such a discharge be produced by strong errhines, and excite an absorption of the congestion of lymph in the dropsy of the brain?
2.Salivatio lymphatica.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.
3.Nausea humida.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 ClassI. 2. 4. 3. andI. 2. 4. 4.
M. M. Subacid liquids. Wine. Opium. A blister.
4.Diarrhœa lymphatica.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.
5.Diarrhœa chylifera, cœliaca.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.
6.Diabætes.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.
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.
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.
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.
M. M. Alum. Earth of Alum. Cantharides. Calomel. Bark. Steel. Rosin. Opium. See Sect. XXIX. 4.
7.Sudor lymphaticus.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.