NATIONAL LIBRARY OF MEDICINE
             Washington
Founded 1836
U. S. Department of Health, Education, and Welfare
             Public Health Serriee
 
 
 
 
 
Z 0  0  N 0 M I A;
OR,
The  Laws of Organic  Life.
 /f/L^/.  PART  SECOND.

    Br ERASMUS DARWIN, m. d*
A NEW EDITION
WITH
   An  IntroduBory  Addrefs>

               AND
     A SHORT APPENDIX,

   By  CHARLES CALDWELL,  m. d.
FELLOW OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA,
  MEMBER OF THE AMERICAN PHILOSOPHICAL SOCIETY,
?   VOL.  I.
        PHILADELPHIA;
PRINTED BY T. DOBSON, AT THE STONE HOUSE
     NO. 41, SOUTH SECOND STREET.
              1797. 
 
       ZOONOMI  A;


                    OR,


   The  Laws  of Organic  Life.


                 PART  II.

               CONTAINING

      A CATALOGUE OF DISEASES

               DISTRIBUTED INTO

  NATURAL CLASSES ACCORDING TO  THEIR
            PROXIMATE CAUSES,

                  WITH 7HEIR

SUBSEQUENT ORDERS,  GENERA, AND SPECIES,

                   AND WITH

         THEIR METHODS OF CURE.
Hicc, ut potero, explicabo ; nee tamen, quad Pythius Apollo, certa
   ut fint et fixa, qaas dixero ;  led ut Homunculus unus e multis
   probabiliora conjedtura. fequens.
                      Cic. Tusc. Disp. 1. i. 9. 
 
   INTRODUCTORY  ADDRESS.



 T<? the Country and Village PraBitioners
     of Medicine in the  United States of
     America,

    GENTLEMEN,

           ALLOW me  to invite your attention^
 and to folicit your extenfive and refpe&able patronage*
 to the following interefting and important publication.
 You are here prcfented with a  neat,  and  I  flatter
 myfelf I may add, a correct Philadelphia edition of
 the Second Part  of a late  medical  work,  entitled
 ZOONOMIA.  The entire  body of the work,  con-
 fidered in its collective refult, is  indeed an ingenious
 and an able expofition of certain  principles and laws,
 by which organized bodies are governed, while fufcep-
 tible of the diversified motions of life.  The Second
Part, which now fteps forward a candidate  for your.
attention,  embraces  an  elucidation of the theory of
difeafes, together with the application of appropriate
remedies,  and  is therefore more  immediately fubfer-
vient to the practice of the healing art.
  An attempt  to  advance the celebrity of the  fubfe-
quent fheets, or to add to the real weight of the mul-
tifarious matter they contain,  is by no means  the pur-
pofe for which I  now lift  my pen.   I  mean not to
                      a 3                   figure 
vi          INTRODUCTORY ADDRESS.
figore  in the language of  ftudied panegyric,  r.ci to
trumpet the work in accents  of extravagant and un-
conditional  praife.  My  only aim is to intimate, in
general terms, fomething of its character and merit—
my only wifh, to " fpeak of it as it  is.**  Here, gen-
tlemen, permit me to obferve, tnat although the name
of its illuftrious author be alone  fufficient to fecure to
it at leaf! a temporary, and perhaps an extenfive,  cur-
rency,  yet  a general dilfufion of the knowledge of its
practical utility  will conflitute the  belt bafis  for its
permanent  reputation.
   " Midtum in parvo," is  an antiquated motto,  very
ftrikingly characterise of  the following work.  For
although it be fomewhat voluminous in itfelf, yet from
its comprehenfive manner, and condenfed flyle. of com-
position, it is truly contracted when viewed in relation
to the immenfity of the matter it  contains.   In the
fubfequcnt pages is the public prefented, in detail,  with
an entire Syftem of the Theory  and Practice of Medi-
cine, accompanied by a fhort but general Treatife on
Materia Medica, correfponding in principle to the Pa-
thological fyftem premifed.   The  work, with refpedt
to  its  great  outlines, is  conceived with ftrength and
ingenuity ; while its fubordinate parts are finillied with
a nice and mafterly hand.  Though evidently a work
of much labour and fludy, it  appears  notwithftanding
to be the refult of accurate and profound obfervation,
rather than of extenfive and diverfified reading.  It  is
 in mod parts characterized by a  boldnefs, and perhaps
 I  may add,  an  originality  of thought •* but is feldom,
                                               very 
           INTROCUCTORY ADDRESS.          vii
very feldom, emblazoned by  the " purpurei panni" of
learning.  The author appears to have had in view a
detailed and faithful delineation  of what he conceived
to be the permanent truths of nature ;  not a fplendid
collection of the variable and often contradictory /pe-
culations  and opinions of men*
  The  work  mufl notwithftanding  be acknowledged
to be indeed  uncommonly rich,  with refpect both to
primary principles and  doctrinal combinations.   The
immenfity and variety of matter it  condenfes into a
narrow compafs,  declare it to be the production of a
mind poffefling an entire command of moft, if not all,
the  modern  difcoveries  relative to  the  fcience and
practice of the healing art.   Thus without intruding
on  the reader's time by lengthy quotations, or inter-
rupting his attention by a multiplicity of references, it
prefents him, in a new flyle and under a new arrange-
ment, with  moft of the practical truths which other
medical writings contain.   In a  word, it may be con.
fidered as a vaft lens of prime conftruction and power,
collecting to a luminous point the fcattcred and appa-
rently diverging rays, which fall at prefent on the ex-
panding  atmofphere of medical fcience.
  Though feveral diftinguiftied philofophers have con-
tended for perfectability, as  an  eftential attribute  of
the nature of man,  yet none, I believe, have ventured
to allege, that man has hitherto  attained to the point
of confummate perfection.  His humiliating deficiency
is particularly ftriking  in his  very limited  advance-
ment in  the  acquifition of  phylical fcience.   Even
                        a 4                Darwin 
viii         INTRODUCTORY ADDRESS.
Darwin himfelf is unable to boait an entire command
of the laws of JSJature,  which he fo much loves, and
to which his name and  memory will ever be fo dear.
In the  following publication there  exift fpeculations
and opinions not a few, which evidence  the  work  to
be the refult of the labours of an ingenious, yet falli-
ble man.  Were we difpofed to  analyfe, and examine
it with  a fpirit of rigid and critical feverity, we might
find confiderable ground for exception to our author's
nofological  claflification, or  general  arrangement  of
difeafes.   In his fpecific divifions,  his attempt  at un-
common minutenefs  and particularity would feem  to
have  led him to be fometimes  difagreeably tedious,
and to have, perhaps too juftly,  fubjected  him to the
general  charge of complexity in his fyftem.   Thus,
for inftance, many of thofe difeafes to which he has,
in his nomenclature afligned the  name, and in his fyf-
tem the  character and importance of diftinct  fpecies,
might without impropriety be confidered  as  nothing
more  than  mere varieties, or different  forms,  of the
fame original affection.  But  we have reafon to felici-
tate ourfelves that few,  if any, exifting evils are of an
afpect fo dark, or of a nature  fo  unmixed  and bitter
as not to be lightened by the dawn, and rendered at
leaft tolerable  by the influence of fome neceffarily con-
comitant good.  Let this  be our confolation  in the
cafe before us. For while we lament that our author's
minutenefs and prolixity  of divifion have,  in  a great
meafure, prevented us from being able to grafp,  at a
fingle view, the  aggregate of his  nofological  nomcn-
                                            ' !:t:urcT 
INTRODUCTORY ADDRESS.
iz
claturc, we muft notwithstanding derive pleafure from
reflecting, that thefe very  properties which we were
at firft  inclined to cenfure, afford  us an opportunity
of collecting, more in detail, his obfervations and opi-
nions relative to the difeafes of the fyftem of man.
   The  work,  gentlemen,  is  now  before  you, and
folicits your earneft and candid attention.  It is a work
of interefting and  important facts,  of ingenious com-
binations, and  of fair and logical deductions.  Be not
reluctant to examine it with care, to evicerate it with
avidity, for it  indeed  contains a hidden  treafure.   In
it you will be  prefented  with  an abundant and moft
delicious repaft, on  which  your appetites will not, I
am confident,  be eafily cloyed.—I had  almoft  called
it the book of Nature, and invited you to " explore
the wondrous work."   But I may,  at leaft, be per-
mitted  to recommend  it as a page  in nature's ftupen-
daus volume,  containing facts which  no future time
ihall  change, and  exhibiting many  principles and laws
which no daring opponent  will ever be able to inva-
lidate or deftroy.  Although  I do  not hefitate  to de-
clare, thus  publicly, my diffent in  many  particulars,
from the fpeculations  and opinions of our ingenious
author ;  yet,  confidering  the work  in its collective
merit, I cannot help  pronouncing  it a fplendid  and
towering monument of genius,  deftined long to furvive
its iiluftrious builder, and perhaps finally to  triumph
over the revolutions and ravages of time !  Full on the
front of this  monument  fhall the name of Darwin
blaze in gold,  when that  of the Ptolemies (hall have
                                              been? 
X
INTRODUCTORY ADDRESS.
 bceil long fince darned by the indignant  foot of timtf
 from thofe huge and unmeaning piles of folly,  which
 their pride  and ambition  vainly  prompted  them to
 rear!
   The following publication I hold as highly interefb
 ing and  important in a  peculiar point of view, in
 which it will  be but very feldom conlidered by the
 generality of readers.  It demonftrates, in a manner
 the moft pleafing  and Satisfactory,  what an immenfity
 of good may refult to fociety at large, and of fame to
 an individual ebaracler, from an  aftiduous and  well-
 directed application of talents, even amidft the  nume-
 rous and diftracting avocations of a  moft troublefomc
 and  laborious  profeflion.   Doctor Darwin has been,
 throughout the greater part of his life,  nothing more
 than a country,  or  at beft a village practitioner of me-
 dicine.  According to the moft accurate information I
have been able to  receive on this fubject,  his field of
 practice  has been  at all times  extenfive, while the
 principal portion of the harveft has been for the moft
part his own.   Your  own  perfonal  experience, gen-
 tlemen,  will therefore moft forcibly imprefs on  your
minds, how arduous muft have  been his duties, how
exceftive  his fatigues,  how numerous,  how  urgent,
how  diftracting his  calk!  Yet amidft a ceafeiefs com-
 bat with  fuch avowed and formidable foes to accuracy
of obfervation, extent of inquiry,  and  folidity  of
 thought, what  have,  or  rather  what  have not, the
 talents and exertions of Darwin effected ? To  fay enfo
 ikit they have raited Lira  to a lovel with the firft phy-
                                            ficiaai 
INTRODUCTORY ADDRESS.
Hi
ficians whom the world  has yet beheld, would indeed
bear the femblance of an attempt to be-little him by
a fordid penury of praife 1  His meed of fame Should
far exceed fuch narrow  limits.  For to pafs in filence
over the work immediately before us—a work of fuch
deep and  varied  phyfical refearch,  as  apparently  to
require  years of unmolefted leifure for its final accom-
plishment ;  his pen has given birth  to a philofophical
poem, fufficient alone to immortalize his country and
his age  !—A poem which^combines, in a manner fupe-
rior  perhaps to what the world has ever witneffed be-
fore, the refearches and decifions of the under/landings
with the fportings and flights of the imagination ; the
tranquil lights of philofophy with the bolder  beauties
of poefy and fongf In this oblation  to the Mufes has
our  illuftrious bard delivered  to  the wqrld a brilliant
and precious memorial  of his  talents  and his induftry,
which  Shall not ceafe  to attract the attention,  and
command the united applaufe of pofterity, while the
love  of genius  and merit Shall retain its  feat  in the
bofom of man,  while  literary taftc  fhall  be able to
preferve its exiftence, or the richeft beauties cf nature
 continue to be underftood or admired 1
   Permit me, gentlemen, with  pleafure to look for-
 ward to the time when, under fimi'ar circumftances,
 equal effects will  refult from a  happy coincidence  of
 equal talents and attention  on this  fide  the Atlantic.
 Such an event is douhtlefs far within the ken  of hope,
 and even within  the narrower fphere of rational pro-
 bability.  Such an event will, I am  confident, yet  oc-
                                                cur. 
xn         INTRODUCTORY ADDRESS.
cur.  The aufpicious period we  are not  indeed  fur-
niftied  with forecaft fufficient to defcry.   From  the
rapid and general diffufion of phyfical fcience through-
out our country,  and from  the growing tafte for the
beauties of literature acquiring fuch depth of  root in
the American  mind, we are however encouraged, at
leaft to flatter ourfeJves,  that it  is not  deeply buried
in the  ever-teeming matrix  of time.  Nor am I dif-
pofed to fearch for the  future  Darwin  of America
with fuch ftrength of anticipation in any other place,
as in fome of  the fecondary  towns or even villages of
oar common country.  For  truft  me, gentlemen, the
opportunities which you poffefs for your advancement
in the true and  unperverted fcience of nature, are
lefs, much lefs, inaufpicious than  you are yourfelves at
firft view willing to admit.  That you are indeed befet
by numerous  literary and focial  wants, and fubjected
to  the  uniform  preffure of  many  cumbrous  evils of
iituatien, is inconteftibly true;  but  doubtlefs  it  is
equally true,  that you at the fame time enjoy feveral
important advantages peculiar to yourfelves.
   What though you be  removed  from the accents of
the learned, the eloquent, and once-beloved profeffor's
voice,  and fituated far without the circulating fpherc
of voluminous and well-felected  libraries ? Can  you
not liften to the clearer voice of daily occurring facts ?
Can you not  confult the purer  book of nature,  ever
unfolded to your  view ? Can you not acquire the pre-
cious art of extracting,  from fuch abundant  fources,
the fwects of virgin .'ruth, uncontaminated by the gall 
           INTRODUCTORY ADDRESS.          ,iii
of poifonous error? By the ftudy of books you arc too
often made acquainted  with nothing more than the
fpeculative opinions of men ; while the ftudy of na-
ture will never fail to introduce you into the favourite
walks, and thus unveil *to you the  incftimable fecrets,
of fcience.  Though not fo heavily fraught  with learn-
ing  as  thofe  who enjoy a  more ready and conftant
accefs  to literary focieties, to academical lectures, and
to public libraries,  you may' notwithstanding poffefs a
fuperior Share of ufeful and practical truth.
   Univerfities and fubordinate inftitutions of inftruc-
tion are doubtlefs neceffary to the  advancement, and
peculiarly  effential  to  the  general  diffufion  of the
fcience  of  nature.  In my opinion  of the importance,
and in my good  wifihes  for  the profperity of fuch in-
ftitutions,  I will  be pardoned  when I declare,  that I
hold myfelf  fecond to no one.   But  it is a  truth,
the  pureft  fterling  coin  is  not   without  alloy—
Schools of medicine  have  been  long  denominated
the  repofitories, and confidered as in fome meafure the
perpetuators   of  antiquated  and  obfolete  opinions.
Though the  charge has been doubtlefs  by far too
pointed and general, yet it is,  perhaps, a circumftance
to  be lamented, that it has not been altogether defti-
tute of foundation.  I mean not a Shadow of difrefpect
to  the medical  fchools  of America.   Far, very far
from i t—I am too fenfible of the advantages, I flatter
myfelf, I  have already derived, and which I am fure
I am  even  now daily  deriving,  from one of  them,
not to feel towards it obligations of filial gratitude—
                                                 not 
v.v         INTRODUCTORY ADDRESS.
not to venerate it as my alma mater  in the fcience of
medicine.   Yet perhaps, even on this  fide the  At-
lantic, fuch inftitutions  may  be  fomewhat  influential
in propagating and in perpetuating phyfical principles
and opinions not  wholly unexceptionable.
   By being fituated, gentlemen, beyond  the mor* im-
mediate and authoritative  influence  of thefe  public
feminaries, you are in a great mcafure liberated from
the trammels and  prejudices in which they  are fo apt
to involve the unripened minds of youth.  Like  the
uncaged birds of  your forefts, your genius may take
wing, and range at large for food or paftime, through
the fair  and  unlimited  commons of nature.   Your
notes, though few, wild, and  Ample, rnuft be original,
bold,  and fweetly melodious.   Thus  fupported by
your  own  ftrength  of  mind,  unawed by the fanctity
of prefcribed opinion, and  unblinded  by  attachment
to diftinguifhed names,  you  are  at liberty to  make
truth  alone  the object  of  your  refearches,  and to
depend principally on experiment and obfervation as
your fureft means for its final attainment.   You  are
enlifted under the banner of no ambitious and inter-
eft ed kader, and are therefore urged by  no propenSty
to diftort facts and torture principles for the temporary
eftabliftiment of a favourite fyftem.   In  fuch  a fitua-
tion as this the giant mind of Darwin  grew and ripen-
ed—In fuch a fituation were materials for the follow-
ing work collected, digefted, and ultimately arranged
-r—And in  fuch a  fituation may fome of  you, o-entle-
ttemen, whpm I  have now the  honour of  addreffing
                                               at 
INTRODUCTORY ADDRESS.
IV
at a diftance,  yet  iffue  forth  the  future  Darwins of
the Weftern World!
   Had our illuftrious author been more intimately
connected with the medical teachers  of London and
of  Edinburgh, his writings would, no  doubt,  have
been more deeply tinctured by opinions  and principles
which  thofe gentlemen fo induftrioufly inculcate and
fo ably defend.  His  works might have thus,  indeed,
appeared  more  learned  and voluminous, but would
have been much lefs  ingenious, original, and  bold.
   To his infulated fituation, at a diftance from the pub-
lic fchools of the kingdom, may be attributed, in a great
meafure, the m;:n'y tone and confcious independence
of his mind.   In this detached fituation we may view
him in the light of his own teacher, and guide, for he
has at all times  experimented, obferved, and  thought
for himfelf.  Such are the happy effects of  his inde-
fatigable  refearches,  that in the fcience of the princi-
ples and laws  of living bodies, and in the knowledge
of the general  nature  and treatment of difeafes, he
appears to have far outftepped his national co-tempo-
raries, and may be juftly accounted the boaft of the
BritiSh ifle, no lefs in the real philofophy of medicine,
than  in the brilliant  imagery,  the poliShed elegance,
and the bold fublimity of fong.  Long may he yet con-
tinue the unrivalled pride of his country ! and may he
experience in the  fplendid evening of his life,  a ple-
nitude of that health and  happinefs he  has  fo ably
contributed to confer upon others!

     J          .._                        I cannot,
1 
xvi         INTRODUCTORY ADDRESS.

  I  cannot, gentlemen,  conclude  this  introductory
addrefs  without expreffmg  a  defire to  be favoured
with your obfervations and remarks, either through a
public or private channel, as well on the original text,
as on the fhort Appendix I  have taken the liberty of
fubjoining to the following Sheets.
  With fincere wifties for your individual fuccefs and
happinefs in life, and with fentiments of earneft folici-
tude for the intcreft and  advancement of our common
profeflion, I have the honour to be,

            Gentlemen,

                 Your moft obedient,

                      And very humble fervaut,

                            CH.  CALDWFXL.
    Philadelphia,  7
  January  iOth, 1797. J
N.  B.  / flatter myfelf no apology will  be  required by
     Dr. Darwin,  or  by the public  at large, for the
     liberty I have taken  of corretling occa/ional errors
     which had gained admiffion into  the London prefs,
     cwing,  I pre fume,  to the Work having been  origi-
     nally printed at a diftance from the eye and exami-
     nation of the author*
                                         C. C. 
PREFACE.
 ALL difeafes originate in the exuberance, defi-
 ciency,  or retrograde action, of the faculties of
 the fenforium,  as their  proximate caufe;  and
 confift in. the difordered motions of the fibres of
 the body, as the  proximate effect of the exertions
 of thofe difordered faculties.
    The fenforium  pofTeffes foUr diflindt powers,
 or faculties,  which are occafionally exerted,  and
 produce*  all the motions of the fibrous parts of
 the body ; thefe are the faculties  of producing
 fibrous   motions  in  confequence  of irritation
 which  is excited by external bodies ;  in  confe-
 quence of fenfation which is excited by pleafure
 or pain;  in confequence of volition  which is  ex-
 cited by defire or averfion ; and in  confequence
 of affociation which is  excited by  other fibrous
 motions.   We are hence fupplied with four na-
 tural clafTes of difeafes derived  from their pioxi-
 mate  caufes ; which we mall term  thofe of irri-
 tation, thofe of fenfation,  thofe of volition,  and
 thofe of affociation.
   In  the fubfequent claflification of difeafes I
 have not adhered to the methods of  any of thofe,
who have preceded me ; the principal of whom
                      b                    are 
xviii
PREFACE.
are the great  names of Sauvagcs and Cullen j
but have neverthelefs availed myfelf, as much as
I could, of their definitions and diftinctions.
   The effential charaaeriftic of a difeafe confifts
in its proximate caufe, as  is well obferved  by
Dr. Cullen, in his  Nofologia  Methodica, T. ii.
Prolegom. p. xxix.   Similitudo quidem morbo-
rum in fimilitudine caufis eorum proximae, qua-
lifcunque fit, revera confift it.  I  have taken the
proximate caufe for the claific character.  The
characters  of  the orders  are taken from the ex-
cefs, or deficiency, or retrograde action, or other
properties  of  the proximate caufe.   The genus
is generally derived from the proximate effect.
And  the fpecies  generally from  the locality of
the diieafe  in the  fyftem.
   JMany fpecies in this fyftem are termed genera
in the fyftems of ether writers ; and  the  fpecies
of thofe writers are in confequence here termed
varieties,   thus  in Dr. Cullen's Nofologia  the
variola or  fmall-pox is termed a genus,  and  the
diftinct and confluent kinds  are termed  fpecies.
Bur as  the infection from  the diftinct kind fre-
quently produces the confluent kind, and that of
the confluent kind frequently produces the dif-
tinct ; it would feem more analogous to botanical
arrangement,  which  thefe nofologifts profefs to
imitate, to  call the diftinct and confluent fmall-
pox  varieties  than fpecies.   Becaufe the fpeciea
of plants in botanical  fyftems propagate others
fimilar to themfeKcs; which does not uniformly
occur in fuch vegetable productions as are termed
varieties.
                                           la 
                 PREFACE.              xix

   In fome other genera of nofologifts the fpecies
.have no analogy to each other, either in refpect
to their proximate  caufe, or to their proximate
effect, though they may be  fomewhat  fimilar in
lefs effential properties; thus the thin and faiine
difcharge  from  the noftrils on  going  into  the
cold air of a frofty  morning, which is  owing to
the  deficient action of the abforbent veflels of
the noftrils, is one  fpecies ; and the vifcid mucus
difcharged from the iecerning veflels of the fame
membrane, when inflamed, is another fpecies of
the fame genus,  Catarrhuc.   Which bear no ana-
logy either in reipect to their immediate caufe or
to their immediate  effect.
   The ufes of  the method  here  offered to  the
public of  clafling  difeafes  according  to  their
proximate caufes are, firft, more diftinctly to un-
derftand their nature by comparing their effential
properties.  Secondly, to facilitate the knowledge
of the methods  of  cure ; fince in  natural clafii-
fication of difeafes the fpecies of each genus, and
indeed the  genera  of each order,  a few  perhaps
excepted,  require the fame general medical treat-
ment.   And laftly, to difcover the nature and
the name of any difeafe previoufly unknown to
the phyfician ;  which I am perfuaded  will be
more readily and more  certainly clone  by this
natural fyftem, than by the artificial claflifications
already publilhed.
   The common names of difeafes are not well
adapted to any kind of claflification, and lean: or
all  to  this from their proximate caufes.  Some
of their  names  in  common language are taken
                     b 2                 from 
XX
PREFACE.
from  the remote  caufe, as worms, itone of the
bladder;  others from the remote effect, as diar-
rhoea,  falivation, hydrocephalus ;  others from
fome accidental fymptom of the difeafe, as tooth-
ach, head-ach, heart-burn;  in which the  pain
is only a concomitant circumftance of the excefs
or deficiency of fibrous actions, and not the caufe
of them.   Others again  are taken from the de-
formity occafioned in confequence of the unna-
tural  fibrous  motions, which conltitute difeafes,
as tumours, eruptions,  extenuations; all  thefe
therefore improperly  give  names  to difeafes;
and fome difficulty is  thus occafioned  to the rea-
der in endeavouring  to  difcover to what  clafs
fuch diforders belong.
   Another difficulty  attending the names of dif-
eafes  is, that one  name frequently includes more
than one  difeafe, either exifting at the fame time
or in iucceffion.  Thus  the pain of the bowels
from worms is caufed by the increafed action of
the membrane from  the ftimulus  of* thofe  ani-
mals ; but the eonvulfions, which fcmetimes fuc-
ceed thefe  pains  in  children,  are caufed by the
confequent volition, and belong to another cla&.
   To  difcover under what  clafs  any difeafe
mould be  arranged,  we  muft firft  investigate
the  proximate caufe;  thus  the  pain  of the
tooth-ach is not the caufe of any difeafcd mo-
tions,  but  the  effect ;  the  tooth-ach therefore
does not  belong to  the clafs of Senfiition.  As
the  pain  is  caufed  by  increafed  or  decreafed
action of the membranes of the tooth, and thefe
actions are  owing to the increafe or decreafe of
                                     irritation. 
                PREFACE.              xxi

irritation, the difeafe is to be placed in the clafs
of Irritation.
  To  difcover the  order it muft  be  inquired,
whether the pain be owing to increafed or de-
fective motion of the pained membrane;  which
is known by the concomitant heat or coldnefs of
the part.   In tooth-ach without inflammation
there  is  generally a coldnefs attends the cheek
in its  vicinity ; as may be perceived by the hand
of the patient himfelf,  compared  with the oppo-
fite cheek.   Hence odontalgia is found to belong
to the order of decreafed irritation.   The genus
and fpecies muft be found by  infpedting  the
fynopfis of the fecond  order of the  Clafs of Irri-
tation.   See Clafs I. 2. 4.  12.
   This may be further elucidated by confidering
the natural operation  of parturition ; the pain
is occafioned  by the increafed action or diften-
fion of the veflels of the  uterus,  in confequence
of the ftimulus of the fetus ;  and is  therefore
caufed by increafed irritation ;  but  the action rjfj
the abdominal mufcles in its exclufion are caufed
by  the pain,  and belong to the clafs of increafed
fenfation.  See  Clafs II. 1. 1.  12.  Hence  the
difficulty  of determining,  under  what  clafs of
difeafes parturition  fhould  be arranged,  confifts
in  there  being  two kinds of difeafed  actions
comprehended under  one  word;  which have
each their different proximate caufe.
   In   Sed.  XXXIX.  8. 4. and  in  Clafs  IT.
 1. 1.  1.  we have endeavoured  to give names to
four links of animal caufation, which conveni-
                                         enth 
xx'ri             PREFACE.
ently apply to the claflification of difeafes;  thus
in common nictitation, or winking with the eyes
without our attention to  it,  the increafed irrita-
tion is the proximate caufe ; the ftimulus of the
air on the dry cornea is the remote caufe ; the
clofing of the eyelid is the proximate  effea ;
and the diffufion of tears over the eye-ball is the
remote effea.  In fome cafes two more links of
caufation may be introduced ;  one or. them may
be termed the pre-remote caufe;  -as the warmth
or  motion  of the  atmofphere,  which  caufes
greater exhalation from the cornea.   And the
other the poft-remote effect ; as the renewed pel-
lucidity of the cornea ; and thus fix links of cau-
fation may be expreffed in words.
   But if amid thefe remote links of animal cau-
fation any of the four powers or faculties of the
fenforium be  introduced, the  reafoning  is  not
juft: according to the method here propofed; for
thefe powers  of  the fenforium  are  always the
proximate caufes  of the  contraaions of  animal
fibres ; and  therefore in true language cannot be
termed their remote caufes.  From this criterion
it may always be determined, whether more dif-
eafes than one are  comprehended  under  one
name; a circumftance which has much impeded
the inveftigation of the caufes, and cures  of dif-
eafes.
   Thus  the  term  fever, is generally given to a
colleaion of morbid fymptoms; which  are in-
deed fo  many diftina  difeafes,  that fometimes
appear together, and fometimes feparately; hence
                                           it
n 
                PREFACE.            xxm

it has no determinate meaning, except it fignifies
limply a quick pulfe, which continues for fome
hours ; in which fenfe it is here ufed.
  In  naming difeafes  I  have endeavoured to
avoid the affeaation of making new compound
Greek  words,  where  others equally expreflive
could be procured :  as a fhort periphrafis is eafier
to be underftood,  and lefs burthenfome to the
memory.
  In  the Methodus Medendi, which is marked
by M, M. at the end of many of the fpecies of
difeafes, the words incitantia, forbentia, torpentia,
&c, refer to the fubfequent articles of the Ma-
teria Medica, explaining the  operations of me-
dicines.
   rI he remote caufes of many difeafes, their pe-
riods, and many circumfiances concerning them,
are treated of in the preceding volume ; the de-
fcriptions of many of them, which 1 have omit-
ted for  the fake of brevity, may  be feen in the
Nofologia fVIethcdica  of Sauvages, and  in the
Synopfis Nofologiae  of Dr. Cullen,  and in the
authors  to which they refer.
   In this arduous undertaking the author folicits
the candour  of the critical reader ; as he cannot
but  forefee, that many errors will  be difcovered,
many additional fpecies will  require to be in-
ferted ; and others to be tranfplanted, or erafed.
 If he could expend another forty years in the
 practice of medicine,  he  makes no doubt, but
 that he could bring this work nearer perfeaion,
 and thence render  it more worthy the attention
                                            of 
XXIV
PREFACE.
of philofophers.----As it  is, he  is induced to
hope, that fome advantages will be derived from
it  to the  fcience of  medicine, and confequent
utility to the public, and  leaves the completion
of his plan  to  the  induftry of future  genera-
tions.
Derby, Jan. i. 1796. 
Z    O    O    N    O    M     I     A

                           OR,

             THE   LAWS   OF

       ORGANIC   LIFE*
PART  II.
By ERASMUS DARWIN,  m. d.  f. r. s.
      author of  the botanic  garden.
Principid coelum, ac terras, campofque liquentes,
Lucentemque globum lunas, titaniaque aftra,
Spiritus intus alit, totamque infufa per artus
Mens agitat molem, et magno fe corpore mifcet.
                                   Virg. Ma. T

Earth, on whofe lap a thoufand nations tread,
And Ocean, brooding his prolific bed,
Night's changeful orb, blue pole, and filvery  zones,
Where  other worlds encircle  other funs,
One  Mind inhabits, one  diffufive Soul
Wields  the large limbs, and mingles with the whole. 
 
I 
 
Z O  O N O  M I A.
        PART  II.
CLASSES of DISEASES.
 I.  DISEASES OF IRRITATION.
 II.  DISEASES OF SENSATION.
III.  DISEASES OF VOLITION.
IV.  DISEASES OF ASSOCIATION.
B
TME 
DISEASES           [Class I
THE ORDERS AND GENERA  OF THE FIRST CLASS
               OF DISEASES.
                  CLASS   I.
             DISEASES  OF IRRITATION.

                    O R D O   I.
                 Increafed Irritation.

                    GENERA.
i. With increafed actions of the fanguiferous fyftem,
2. With increafed actions of the fecerning fyftem.
y With increafed actions of the abforbent fyftem.
4. With ina-eafed actions of other  cavities and mem-
     branes.
5. With increafed actions of. the organs of fenfe*

                   O R D O   II.
                Decreafed Irritation.

                   GENERA.
1. With decreafed actions of the fanguiferous fyftem.
2. With decreafed actions of the fecerning fyftem.
3. With decreafed actions of the abforbent fyftem.
4. With decreafed actions of other  cavities and mem-
     branes.
5. With decreafed actions of the organs of fenfe.
ORDO 
Class I. i. l.]     OF IRRITATION.

                   ORDO  III.
           Retrograde  Irritative Motions,

                   GENERA.
            i. Of the alimentary canal.
            2. Of the abforbent  fyftem*.
            3. Of the fanguiferous fyftem.
THE ORDERS, GENERA, AND SPECIES, OF THE
         FIRST CLASS OF DISEASES.
                CLASS   I.
            DISEASES  OF IRRITATION.

                   ORDO  I.
                Increafed Irritation.

                   GENUS  I.
   With increafed Aclions of the Sanguiferous Sydenh

                   SPECIES.
1.  Febris irritativa.       Irritative  fever.
2.  Ebrietas.              Drunkennefs.
3.  Hamorrhagia arteriofa. Arterial haemorrhage.
4.  Hamoptoe arteriofa.     Spitting of arterial blood,
5.  Hamorrhagia narium.   Bleeding  from the nofe.

                        B %                 GENUS 
t,
PISEASES      [Class I. i. z.
              GENUS  II.
With increafed Aclions of the  Secerning Sylkm.
SPECIES. 1* Color febrilis. Febrile heat. 2. Ruber febrilis. Febrile rednefs. 3. Sudor calidus. Warm fweat. Sudor febrilis. Sweat in fevers. ——i* a labore* <—-----from exercifc. ----- ab igne* ------from fire. —— a medicamentis*------from medicines. 4. Urina uberior colorata. Copious coloured urine. 5. Diarrhoea calida* Warm diarrhoea. ----------febrilis. <> from fever.	
	of infant0
6. Salivatio calida. j. Catarrhus calidus. 8. Expecloratio calida. 9. Exfudatio pone aures. 10. Gonorrhoea calida. 11. Fluor albus calidus. 12. Hamorrhois alba. 13. Serum e veficatorio. 1 a. Perfpiratio fxtida. 15. Crines norji.	------falivation. ------catarrh. ------expectoration. Difcharge behind the ears Warm gonorrhoea. ------fluor albus. White piles. Difcharge from a blifter. Fetid perfpiration. New hairs.
GENUS 
Class I. i. 4.]    OF IRRITATION.
S
                    GENUS  III.
     With increafed Aclions of the Abforbent Sy/lem.

                    SPECIES.
  1. Lingua arida.         Dry tongue.
  2. Fauces arida.          Dry throat.
  3. Nares aridi.           Dry noftrils.
  4. Expefioratio folida.     Solid expectoration.
  5. Conflipatio alvi.        Coftivenefs.
  6. Cutis arida.           Dry fkin.
  7.Urina par dor colorata.  Diminifhed coloured  urine.
  8. Calculusfelleuseticlerus. Gall-ftone and jaundice.
  9*-------rents.         Stone of the kidney.
 10.------+ vefica.        Stone of the  bladder.
 11--------arthriticus.    Gout-ftone.
 12. Rheumatifmuschronicus. Chronic rheumatifm.
 13. Cicatrix  vulnerum.      Healing of ulcers.
 14. Cornea  obfufcatio.       Scar on the cornea.

                   GENUS  IV.
With increafed Aclions of other Cavities and Membranes.

                    SPECIES.
 1. Niclitatio irritativa.    Irritative nictitation.
 2. Deglutitio irritativa.   Irritative deglutition.
 3. Refpiratio et fujfis.      Refpiration and cough.
 4. Exclufio bilis.          Exclufion of the bile.
 5. Dcntitio.               Toothing.
 6. Priapifmus.            Priapifm.
 7. Difientio  mamularum.  Diftenfion  of  the nipples.
                        B 3              8. Defcenfus 
6	DISEASES [Class T. 1.5	
8. Defcenfus uteri.		Defcent of the uterus.
9. Prolapfus ani.		Defcent of the rectum.
10. Lumbricus.		Round worm.
11. Tania.		Tape-worm.
12. Afcarides.		Thread-worm.
13. Dracunculus.		Guinea-worm.
14. Morpiones.		Crab-lice.
15. Pediculi.		Lice.
	GENUS V.	
With increafed	^c7/o«	r of the Organs of Senfe*
	SPECIES.	
\ 1. F//kr acrior.		Acuter fight.
1. Audit us acrior.		------hearing.
3. Olfaclus acrior.		------fmell.
4. Guflus acrior.		------tafte.
5. Taclus acrior.		------touch.
6. Senfus caloris acrior.		——— fenfe of heat.
7.-----extenftonis acrior		.------fenfe of extenfion.
8. Titillatie*		Tickling.
9. Pruritus.		Itching.
10. Do/or w/mr.		Smarting.
xi, Confternatio,		$urprife.
ORDO 
Class I. 2. 3.]     OF IRRITATION.
                   ORDO  II.
                Decreafed Irritation.
                   GENUS  I.
  With decreafed Aclions of the Sanguiferous Syfiem.
                   SPECIES-
 1. Febris inirrltativa*     Inirritative fever.
 2. Parefis inirritativa.    ———— debility.
 3. Somnus interruptus.    Interrupted fleep.
 4. Syncope.               Fainting.
 5. Hamorrhagia venofa.   Venous hemorrhage.
 6. Hamorrhois cruenta.    Bleeding piles.
 7. Hamorrhagia renum.
 g,--------------hepatis.
 9, Hamoptoe venofa.
1 o. Palpitatio cordis.
11. Menorrhagia.
12. Dyfmenorrhagia.
13. Lochia nimia.
14. Abortio fpontanea.
15. Scorbutus.
16. Vibiccs.
17. Petechia.
————- from the kidneys.
--------from the liver.
Spitting of venous blood.
Palpitation of the heart.
Exuberant menftruation.
Deficient menftruation.
Too great lochia.
Spontaneous abortion.
Scurvy.
Extravafations of blood.
Purple fpots.
                 GENUS  II.
  With decreafed Aclions of the Secerning Syfiem.
                  SPECIES.
1. Frigus febrile.         Coldnefs in fevers.
  — chronicum.        —----—- permanent.
B  4
2. Pall? 
DISEASES
[Class I. t* 3.
 2. Pallor fugitivus.
        - permanens.
 3. Pus parcius.
 a. Mucus parcior.
 5. Urina parcior pallida.
 6. Torpor hepaticus.
 7. Torpor pancreatis*
 8. Torpor renis.
 9. Puncla mucofa vultus.
10. Macula cutis fulva.
11. Canities.
12. Callus.
13. Cataracla.
14. lnnutritio ojfium.
15. Rachitis.
16. Spmtf diflortio.
17. Claudicatio coxaria.
18. Spina protuberans*
19. S/>/7za bifida.
30. Defeclus palati.
Palenefs fugitive.
—.------permanent.
Diminifhed pus.
Diminiflied mucus.
Pale diminifhed urine.
Torpor of the liver.
Torpor of the pancreas.
Torpor of the kidney.
Mucous fpots on the face.
Tawny blots on the fkin.
Grey hairs.
Callus.
Cataract.
Innutrition of the bones.
Rickets.
Diftortion  of the fpine*
Lamenefs of the hip.
Protuberant fpine.
 Divided fpine.
 Defect of the palate.
                 GENUS  III.
  With decreafed Aclions of the Abforbent Syfiem*

                  SPECIES.
1. Mucus fauciumfrigidus. Cold mucus from the throat.
2. Sudor frigidus.         -----fweat.
3. Catarrhus frigidus.     -----catarrh.
4. Expecloratio frigida.    -----expectoration.
k. Urina uberior pallida.  Copious pale urine.
                                       6. Diarrhoea 
Class I. z. 3.3     OF IRRITATION.
 6. Diarrhoea frigida.
 7. Fluor albus frigidufs.
 8. Gonorrhoea frigida.
 9. Hepatis tumor,
10. Chlorofis.
11. Hydrocele.
12. Hydrocephalus internus.
13. Afcites.
14. Hydrothorax.
15. Hydrops ovarii.
16. Ana/area pulmonum.
17. Obefitas.
18. Splenis tumor.
19. G^w« tawor #/£#/.
lo.Bronchocele.
21. Scrophula.
22. Schirrus.
23.       ■  raf?/.
24. ■*—-----urethra.
25--------tf/4
26. Lacleorwn inirritahili'
     tas.
27. Lymphaticorum inirita-
     bilitath.
Cold diarrhecn.
-----fluor albus.
-----gonorrhoea.
Swelling of the liver.
Green ficknefs.
Dropfy of the vagina teftis.
-------of the brain.
-------of the belly.
-—----of the cheft.
-------of the ovary.
-------of the lungs.
Corpulency.
Swelling of the fpleen.
White fwelling of the knee.
Swelled throat.
King's  evil.
Schirrus.
------- of the rectum.
-----— of the urethra.
------- of the throat.
Inirritalility of  the lacteals.

Inirritahili ty  of  the  lym-
phatics.
GE
xS «..'.*> 
t«
DISEASES
[Class I. ^^ 4-
                   GENUS   IV.
With decreafed aclions of other Cavities and Membranes*
                   SPE
 I. Sit is calida.
    ----frigida.
 2. Efuries. m
 3. Naufeaficea.
 4. JEgritudo ventricidi.
 5. Cardialgia*
 6. Arthritis ventriculi.
 7. Colica flatulent a.
 8. Colica faturnina.
 9. Tympanitis.
10. Hypochondriacs.
11. Cepbalaa frigida*
12. Odontalgia.
13. Otalgia.
14. Pleurodyne chronica.
15. Sciatica frigida*
16. Lumbago frigida*
17. Hy/leralgia frigida.
18. Proclalgia frigida.
19. Veficafellea inirritibili-
     tas et iclerus.
C I E S.
 Thirft warm.
 -----cold.
 Hunger.
 Dry naufea.
 Sicknefs of ftomach.
 Heart-burn.
 Gout of the ftomach.
 Flatulent colic.
 Colic from lead.
 Tympany.
 Hypochondriacifm.
 Cold head-ach.
 Tooth-ach.
 Ear-ach.
 Chronical pain of the fide.
 Cold fciatica.
 -----lumbago.
 -----pain of the uterus.
 -----pain of the rectum.
 Inirritability  of  the  gall-
    bladder and jaundice.
GENUS 
Class I. i. 2.]    OF IRRITATION.               11
              GENUS   V.
With decreafed Aclions of the Organs of Senfe.

              SPECIES.
 1. Stultitia inirritabilis.
 2. Vifus imminutus.
 3. Mufca volitantes.
 4. Strabifmus.
 5. Amaurofis.
 6. Auditus imminutus.
 7. Olfaclus imminutus.
 8. Guflus imminutus.
 9. Taclus imminutus.
10. Stupor.
Folly from inirritability.
Impaired vifion.
Dark moving fpecks.
Squinting.
Palfy of the optic nerve.
Impaired hearing.
--------fmell.
--------tafte.
--------touch.
Stupor.
                  ORDO  in.
          Retrograde Irritative Motions.

                  GENUS  I.
             Of the Alimentary Canal.

                  SPECIES.
1. Ruminatio.             Chewing the cud.
2. Ruclus.                Eructation.
3. Apepfia.               Indigeftion, water-qualm.
4. Vomitus.               Vomiting.
5. Cholera.               Cholera.
6. Ileus.                  Iliac paflion.
7. Globus hyflcricus.       Hyfteric ftrangulatiou
8.,  Vomendi conamen inane. Vain efforts to vomit.
                                    9. Barberig?n 
 \t               DISEASES      CClass I. 2. 1
  9. Bprborigmus.          Gurgling of the bowels.
 10. Hyfleria.              Hy ft eric difeafe.
 11. Hydrophobia.          Dread of water.

                   GENUS  II.
               Of the Abforbent Syfiem.

                   SPECIES.
  1. Catarrhus lymphaticus.  Lymphatic catarrh.
 2. Salivatio lymphatica.    Lymphatic falivation.v
 3. Naufea bumida.        Moift naufea,
 4. Diarrhoea lymphatica*   Lymphatic flux.
 5. Diarrhoea chylifera.     Flux of chyle.
 6. Diabates.              Diabetes.
 7. Sudor lymphaticus*      Lymphatic  fweat.
 8. Sudor aflhmaticus*      Aftmatic fweat.
 9. Tranjlatio puris.        Tranflation of matter.
1 o.---------laclis.       •---------of milk.
11.--------urina.---------of urine.

                  GENUS   III.
             Of the Sanguiferous Syfiem.

                  SPECIES.
 r. Capillarium  motus re- Retrograde motion  of the
    trogrefus.              capillaries.
 2. Palpitatio cordis.       Palpitation of the heart.
 3. Anhelatio fpafmodica*  . Spafmodic panting.
CLASS 
Class 1.1. i.]     OF IRRITATION.              13


                 CLASS   I.
            DISEASES OF IRRITATION.

                    ORDO  I.
                 Increafed Irritation.

                   GENUS  I.
   With increafed Aclions of the Sanguiferous Syfiem.

   The irritability of the whole, or of part, of our fyf-
tern is perpetually changing ;  thefe vieiflitudes of irri-
tability and of inirritability are believed to depend on
the accumulation or exhauftion of the fenforial power*
as their proximate caufe;  and on the difference of the
prefent ftimulus,  and of that which we  had previoufly
been  accuftomed to,  as  their remote caufe.  Thus a
fmaller degree of heat produces pain and inflammation
in our hands, after they have been for  a time immer-
fed in fnow;  which is owing to the accumulation of
fenforial power in the moving fibres of the cutaneous
veflels during their previous  quiefcence,  when  they
were  benumbed  with cold.  And we feel ourfelves
cold  in the ufual temperature of the atmofphere on
coming out of a warm room ; which is owing to the
exhauftion of  fenforial power  in the moving fibres of
the veflels of the fkin by their previous increafed ac-
tivity, into which they were excited by unufual heat.
   Hence the cold fits of fever are the occaflon of tlie
fucceeding hot ones j and the hot  fits contribute to
                                           occafio\s 
14                DISEASES       [Class!. *. i.
occafion in their turn the fucceeding cold ones.  And
though  the increafe  of ftimulus, as of heat, exercife,
or diftention, will  produce an increafed  action of the
ftimulated  fibres;  in the fame manner as  it  is  pro-
duced by the increafed irritability  which was  occa-
fioned  by  a  previous  defect of ftimulus;  yet as the
excefles  of irritation  from  the  ftimulus of external
things are more eafily avoided than the deficiencies of
it; the difeafes of this country, except thofe which
are the  confequences of drunkennefs, or of immode-
rate exercife, more frequently begin with torpor than
with orgafm ; that is, with inactivity of fome parts, or
of the whole of the fyftem, and confequent coldnefs,
than with increafed activity, and confequent heat.
   If the hot  fit be the confequence of the cold one,
it  may  be alked  if they are proportionate to each
other :  it is probable that they are, where no part is
deftroyed by the cold fit, as in mortification or death.
But we have no meafure  to  diftinguifti this, except
the time of their duration ; whereas the extent of  the
torpor over a greater or lefs part of the fyftem, which
occafions the cold  fit;  or of the exertion which occa-
fions the hot  one; as well as  the degree of fuch tor-
por or exertion, are perhaps more  material than  the
time of their duration.   Befides  this fome mufcles  are
lefs liable to accumulate fenforial power  during  their
torpor,  than  others,  as the locomotive  mufcles com-
pared with the capillary  arteries;  on all  which  ac-
counts a long cold fit  may  often  be  followed by a
fliort hot one.
                                          SPECIES,, 
Class I. i. i.]    OF IRRITATION.
>5
                   SPECIES.
   i. Febris irritativa.   Irritative fever.  This is the
fynocha of fome  writers :  it is attended with ftrong
pulfe without inflammation;  and in this circumftance
differs from the febris inirritativa of Clafs I. 2.  1. 1.
which is attended with  weak pulfe without inflamma-
tion.    The  increafed frequency of the  pulfation of
the heart and  arteries  constitutes fever; during the
cold fit  thefe pulfations  are always weak, as the ener-
gy of action is then decreafed throughout  the whole
fyftem;  and therefore  the general arterial ftrengtli
cannot  be determined  by the touch, till the cold part
of the  paroxyfm ceafes.  This determination is fome-
times attended with difficulty; as ftrong  and  weak
are only comparative degrees of the greater or lefs Te-
ndance of the  pulfation of the artery  to the compref-
fion of the finger.   But the greater or lefs frequency
of the pulfations  affords a collateral evidence in  thofe
cafes, where the degree of ftrength is  not very diftin-
guifhable, which may  aflift our judgment concerning
it.  Since a moderately ftrong  pulfe, when the pa-
tient  is in a recumbent pofture, and not  hurried ia
mind, feldom exceeds-120 ftrokes in a  minute ; where-
as a weak one  often exceeds  130 in a recumbent po£
ture, and 150 in an erect one, in thofe fevers, which
are termed nervous or putrid.   See Sect. XII. 1. 4.
   The  increafed frequency of  the pulfation  of the
 heart and arteries, as it is occafioned  either by  exceil
 or defect of ftimulus, or of fenforial power,  exifts botli
!•; 
16                DISEASES       [Class I. i. r.
in the cold and hot fits of fever; but when the cold fit
ceafes, and the pulfe becomes ftrong and full as well as
quick, in confequence of the increafed irritability of
the heart and arteries, it conftitutes the irritative  fe*
ver, or fynocha.  It is attended with confiderablc heat
daring the  paroxyfm, and generally terminates in a
quarter of  a lunation, without any difturbance of the
faculties  of tjie mind.  See Clafs IV. i. i. 8.
   M. M.  Venefection.  Emetics.  Cathartics.  Cool
the patient in the hot fit, and warm him in the cold
one.  Reft. Torpentia.

   2. Ebrietas.  Drunkennefs.   By the ftimulus of
wine or opium the  whole arterial  fyftem, as well as
every other part of the moving fyftem, is excited into
mcreafed action.  All the fecretions, and with  them
the production of fenforial power itfelf in the brain,
feem to be  for a time  increafed, with an  additional
quantity  of heat, and of pleafurable fenfation.    See
Sect. XXI.  on this fubject.   This explains,  why at
the  commencement of the warm  paroxyfm of fome
fevers the  patient  is in  greater  fpirits, or vivacity;
becaufe,  as in drunkennefs, the irritative  motions  are
all increafed, and a greater production  of fenfation  is
the confequence, which when in a certain degree,  is
pleafurable, as in the diurnal  fever of weak people.
Seft. XXXVI. 3. 1.

   3. Hamorrhagia  arteriofa.   Arterial hemorrhage.
Bleeding with a quick, ftrong, and full pulfe.   The
            2                         haemorrhage- 
Class I. r. i.J    OF IRRITATION.               i?
hemorrhages from the lungs, and  from the nofe, are
the moft frequent of thefe; but it fometimes happens,
that a fmall artery  but half divided, or the puncture
of a leech, will continue to bleed pertinacioufly.
  M. M.  Venefection.   Cathartic with calomel.   Di-
vide the wounded artery.   Bind fponge on the punc-
ture.  If  coffee or charcoal  internally ?  If air  with
lefs oxv^en ?

  4.  Hamoptoe arteriofa.  Spitting of arterial blood.
Blood fpit up  from the lungs is florid, becaufe it has
juft been expofed to the influence of the air in its paf-
fage  through  the  extremities of  the  pulmonary ar-
tery ; it is frothy, from the admixture of air with it
in the  bronchia.  The  patients frequently vomit at
the fame time from the difagreeable tidilation of blood
about the fauces;  and are thence liable to believe,
that the blood is rejected from the ftomach.
   Sometimes an hemoptoe for feveral fucceflive days
returns in gouty perfons without  danger, and feems
to fupply  the  place of the gouty paroxyfms.  Is not
the liver always difeafed previous to the hemoptoe,
as in feveral other hemorrhages ? See  Clafs La. 1. 9.
  M. M.   Venefection, a  purge,  a blifter, diluents,
torpentia; and afterv/ards forbentia, as the bark, the
acid of vitriol, and opium.   An emetic is faid to flop
a pulmonary  hemorrhage, which it  may effect, as
ficknefs dccreafes  the  circulation, as  is very evident
in the great ficknefs fometimes  produced by top large
a dofe of  digitalis purpurea.
                        C                     Dr 
 iS               DISEASES      [Class I. i. r.
   Dr. Rufli fays, a table fpoonful or two of common
 fait is fuccefsful in hemoptoe ;  this may be owing to
 its Stimulating the abforbent fyftcms,  both the lym-
 phatic,  and the venous.  Should  the  patient refpire
 air with lefs oxygen ? or be made  fick by whirling
 round in a chair fufpended by a rope ? One immerfion
 in cold  water,  or a fudden fprinkling  all over with
 cold water, would probably ftop a pulmonary hemor*
 rhage.   See Sect. XXVII. i.

   5. Hamorrhagia narium.  Epiflaxis.  Bleeding at
, the  nofe  in elderly  fubjects moft frequently attends
 thofe, whofe livers are  enlarged  or  inflamed by  the
 too frequent ufe of fermented liquors.
   In boys it  occurs perhaps fimply from redundancy
 of blood;  and in young girls  fometimes precedes  the
 approach of the  catamenia ; and  then it fhews a  dif-
 pofition contrary to chlorofis;  which arifes from a de-
 ficiency of red blood.
   M. M.  It  is  flopped by plunging the head into
 cold water, with powdered fait haftily diflblved  in it;
 or fomdtimes  by lint ftrewed  over with wheat flour
 put up the noftrils;  or by a folution of fteel in bran-
 dy applied to the veflel  by means of lint.   The cure
 in other reipects  as in hemoptoe ; when the bleeding
 recurs  at certain  periods,  after venefection, and eva-
 cuation by calomel,  and a blifter, the bark  and fteel
 muft be given, as in intermittent fevers.  See Section
 XXVII. 1.
ORDO 
Class I. 1.2.]     OF IRRITATION.               ig

                    ORDO   I.
                 Increafed Irritation.

                   GENUS   II.
    With increafed Aclions of the Secerning Syfiem.
   These are always attended with increafe of partial
or of general heat; for the  fecreted fluids are not Am-
ply feparated from the blood, but  are new combina-
tions ; as they did not  previoufly exift as fuch in  the
blood  veflels.   But all  new  combinations give  out
heat  chemically;  hence  the  origin of  animal heat,
which is always increafed in proportion to the fecre-
tion of the part affected, or to the general quantity of
the fecretions.   Neverthelefs there is  reafon  to  be-
lieve, that as  we have a fenfe  purpofely to diftinguifh
the prefence of greater or  lefs quantities of heat, as
mentioned  in Sect. XIV. 6. fo we may have  certain
minute glands  for the  fecretion of this  fluid,  as  the
brain is believed to fecrete the fenforial power, which
would more eafily account  for the inftantaneous pro-
duction of  the blufh of fhame, and of anger.  This
fubject deferves further investigation.

                   SPECIES.
   i.  Calor febrilis.   The heat in fevers arifes from
the increafe of fome fecretion, either of the natural
fluids, as in irritative fevers;  or of new fluids, as in
infectious fevers; or of new veflels, as in inflammatory
fevers.   The  pain of heat is a confequence ©f  the in-
                         C 2                creafed 
 20               DISEASES      [Class I. 1.2.
 creafed extenfion or contraction of the fibres expofed
 to fo great a ftimulus.  See Class I. 1.5. 6.

   2. Rubor febrilis.   Febrile rednefs.    When the
 cold fit of fever terminates, and the pulfations of the
 heart  and arteries become ftrong as well  as quick
 from the  increafe of their irritability after thetr late
 quiefcence,  the bbod is impelled forwards  into the
 fine extremities of the arteries, and the  anaftomozing
 capillaries, quicker than the  extremities of the  veins
 can abforb  and return it  to the heart.  Hence the
 pulfe at the wrift becomes full, as well  as quick and
 ftrong, and the /kin glows with arterial blood, and the
 veins become  empty and lefs vifiblc.
   In elderly people the force of the heart and  arte-
 ries becomes kfs, while the abforbent power of the
 veins remains the fame; whence the capillary veflels
 part with the blood, as foon as it is received, and the
 ikin m confequence becomes paler; it is atfc probable,
 that in more advanced life fome  of the finer branches
 of the arteries  coalefce,  and become  impervious, and
 thus add to the opacity of the flcm.

   3.  Sudor calidus*   Warm fweat  may  be  divided
 into four varieties,  according  to  their remote caufes.
 Firft, the perfpirable matter  is  fecreted in as great
 quantity during the hot fit -of fever, -as towards the
•end of tt,  when the fweat is feen upon the -ikin.  But
 during -the  hot fit  the cutaneous abforbents act alfb
 with increafed energy, and the exhalation is  likewiie
                                           increafed 
Class I. i. 2.]     Of IRRITATION.               21
increafed by the greater heat of the Skin ; and hence
it does not appear in drops on the furface, but is in
part reabforbed,  and in part diffipated in the atmo-
fphere.   But  as the mouths of the cutaneous abfor-
bents are expofed to the cool air or bedclothes ; whilft
thofe of the capillary glands, which fecrete the per-
fpirable matter, are expofed to the warmth of the cir-
culating blood; the former,  as foon as  the fever-fit
begins to decline, lofe their increafed action firft;  and
hence the abforption of the fweat is diminifhed, whilft
the increafed fecretion of it continues for fome hours
afterwards, which  occafions it to ftand in drops upon
the ikin.
   A* the Ikin becomes cooler, the evaporation of the
perfpirable matter becomes lefs,  as well as the abforp-
tion of it.  And hence the diflipation of aqueous fluid
from the  body, and the confequent thirft,  are  per-
haps greater during the hot fit, than during the fub-
fequent fweat.   For the fweats do  not occur, accord-
ing  to Dr. Alexander's  experiments, till the  fkin is
cooled from 112 to  108 degrees of heat; that is, till
the  paroxyfm  begins to decline.   From  this  it ap-
pears, that the fweats are not critical to the hot fit,
any more than the  hot fit  can be called critical to the
cold one;  but firaply, that they are the natural  con-
fequence of the decline of  the hot fit,  commencing
with the decreafed a&ion of the abforbent fyftem, and
the decreafed  evaporation  from the Skin.   And  from
hence it may be concluded,  that a fever-fit is  not in
general an effort of nature to  reftore health,  as Sy-
denham confidered  it, but a neceflary confequence of
                       C 3                     the 
2a                DISEASES      [Class I. i. 2.
the previous torpor ;  and that the caufes of fevers
would be lefs detrimental, if the fever  itfelf could be
prevented from exifting ;  as appears in the cool treat-
ment  of the fmall-pox.
   It muft be noted that the profufe fweats on the /kin
are more  frequent at the decline of fever-fits than the
copious urine, or loofe (tools, which are mentioned be-
low ;  as the cutaneous abforbents,  being expofed to
the cool air, lofe their increafed action  fooner than the
urinary or  inteftinal abforbents ; which open into the
warm cavities of the bladder and inteftines ; but which
are neverthelefs often affected by th^ir fympathy with
the cutaneous  abforbents.  Hence few fevers termi-
nate  without  a moifture of the /kin; whence arofe
the fatal practice of  forcing  fweats by  the  external
warmth of air or bedclothes in fevers;  for  external
warmth increafes the action of the cutaneous capilla-
ries more than that of the other fecerning veflels;
becaufe the latter  are habituated to  98 degrees  of
heat,  the internal warmth of the body ;  whereas the
cutaneous capillaries being nearer the  furface are ha^
bitually kept  cooler by the contact  of the external
air.   Sweats thus produced by heat in  confined rooms
are ftill  more detrimental ; as  the air becomes then
not only  deprived  of a part  of its oxygene by fre-
quent  refpiration, but is  loaded with  animal effluvia
as well as with moifture, till  it  can receive no more;
and in confequence,  while  the cutaneous  fecretion
Stands upon the ikin in drops  for want of exhalation,
£he lungs are expofed to an infalubrious atmofphere.
I do 
Class I. i. 2.]     OF IRRITATION.               23
  I do not deny, that fweating may be fo managed as
to be ferviceable in  preventing the return of the cold
paroxyfm of fevers ; like the warm bath, or any other
permanent ftimulus,  as wine,  or opium,  or the bark.
For  this purpofe it Should be continued till paft  the
time of the expected cold fit,  fupported  by moderate
dofes of wine-whey, with fpirit of hartfhorn, and mo-
derate degrees of warmth.  Its falutary effect,  when
thus managed,  was  probably  one  caufe  of its having
been fo much attended to;  and the fetid Smell, which
when profufe is liable to accompany it, gave occafion
to the belief, that the fuppofed material caufe of the
difeafe was thus eliminated from the circulation.
  When too great external heat is applied, the fyftem
is weakened by excefs of action, and the  torpor which
caufes tlie cold  paroxyfm recurs fooner and more vio-
lently.   For though fome  flimuii, as of  opium  and
alcohol, at the fame time that they exhauft the fenfo-
rial  power  by promoting  increafe of fibrous  action,
may alfo increafe the production  or  fecretion of it in
the brain, yet experience teaches us, that the exhauf-
tion far out-balances the  increafed production, as is
evinced by the general debility,  which  fucceeds in-
toxication.
   In refpect to  the fetor attending copious continued
fweats, it is owing to the animalized part of this fluid
being  kept  in that degree of  warmth, which moft fa-
vours putrefaction,  and not fuffered to exhale into the
atmofphere.  Broth, or other animal mucus, kept in
fimilar circumftances, would in the fame  time acquire
                        C 4              a putrid 
.24                DISEASES      [Class I. i. 2.
a putrid fmell; yet has this error frequently produceH
miliary eruptions* and increafed every kind of inflam-
matory or fenfitive fever.
   The eafc,  which  the patient experiences  during
Sweating, if it be not produced by much external heat,
is fimilar to that of the warm bath j  which by  its Sti-
mulus applied to the  cutaneous ve/Tels* which are  ge-
nerally cooler than the  internal  parts of the fyftem,
excites them into greater action ;  and pleafurable fen-
fation is the confequence of  thefe increafed actions  of
the  veffels  of the ikin.   From  considering all thefe
circumftances,  it appears that it is not the  evacuation
by fweats^ but  the continued Stimulus, which  caufes
and  fupports thofe fweats,  which is ferviceable in pre-
venting the  returns of fever-fits.    And that fweats too
Jong continued, or induced  by  too great Stimulus"  of
warmth, clothes, or medicines^ greatly injure  the pa-
tient by increafing inflammation, or by exhaufting the
fenforial power.   See Clafs I. 1. 2. 14,
   Secondly,  The fweats produced by exercife or  labour
are of the warm kind ;  as  they  originate from the in-
creafed action of the capillaries of the fkinj owing to
their being more powerfully  ftimulated by the greater
velocity of  the  blood, and by a  greater quantity  of
it  pafling through them in  a given  time.  For  the
blood during violent exercife is  carried  forwards by
the action of the mufcles fafter in  the arteries^  than it
can be taken up by the veins ; as appears by the red-
nefs of the Skin.   And from  the confequent fweats, it
?.s  evinced,  that  the fecretory veflels  of the /kin du^
                                                ring 
Class I. i. 2.]     OF IRRITATION.               25
ring exercife pour  out the perfpirable matter fafter,
than the mouths  of the abforbent veflels can drink it
up.   Which mouths are not expofed to the increafed
mufcular action,  or to the Stimulus of the  increafed
velocity  and quantity of the blood, but to the  ccoS
air.
   Thirdly,  The increafed fecretion of perfpirable mat-
ter occafioned by  the Stimulus of external heat be-
longs likewife to  this place \ as it is caufed by the in-
creafed motions  of the capillary  Veflels 5 which  thus
feparate from the blood more perfpirable matter,  than
the  mouths of their correspondent abforbent  veflels
can  take up ; though thefe al fo are Stimulated by ex-
ternal heat  into more energetic action-.   If  the air be
Stationary, as in a fmall room, or bed  with fclofed cur-
tails, the fweat  Stands in  drops on the ikin for want
of a quicker exhalation proportioned to the quicker
fecretion.
   A fourth variety of warm perfpiration is  that occa-
fioned by Stimulating drugs, of which opium and  alco-
hol  are the moft  powerful;  and next  to  thefe the
fpices, volatile alkali, and neutral falts,  efpecially fea
fait;  that much of  the aqueous part cf the blood is
diflipated by the ufe of thefe drugs,, is evinced by the
great thirft, which occurs a  few hours after  the ufe
of them-.  See Art. III. 2. 12.  and Art. HI. 2. 1.
   We may from hence underftandj that the  increafe
 of  this Secretion  of perfpirable  matter by artificial
 means,  muft be  followed  by debility  and emaciation.
 When this is done by taking much fait, or faltcd meat,
                                                 the 
 26                DISEASES       [Class I. 1. 2.
 the fea-fcurvy is produced;  which confifts in the  inir-
 ritability of  the bibulous  terminations  of' the veins
 arifing  from  the  capillaries; fee Clafs  I.  2.  i. 14.
 The  fcrophula,  or inirritability  of  the  lymphatic
 glands,  feems alfo  to  be occafionally induced by an
 excefs in eating fait added to food  of  bad nourifh-
 ment.   See Clafs I. 2. 3. 21.   If an excefs  of perfpi-
 ration is induced by warm or Stimulant clothing, as by
wearing flannel in contact with the ikin in the fummer
months, a perpetual febricula is excited,  both by the
preventing the accefs of cool  air to the /kin, and by
perpetually goading it by  the  numerous  and hard
points of the ends of the wool;  which when applied
 to the  tender  /kins of young children, frequently
 produce the red gum, as it is called ; and in grown
 people,  either  an eryfipelas, or a miliary  eruption,
 attended with  fever.   See  Clafs II.  1.  3.  12.
  Shirts made of cotton or calico Stimulate the Ikin
 too much  by the points of the fibres,   though lefs
 than  flannel; whence  cotton handkerchiefs make the
 nofe fore by frequent  ufe.  The fibres of cotton are,
 I fuppofe,  ten times  fhorter than thofe of flax, and
 the number  of points in confequence twenty  times
the number; and  though the  manufacturers  finge
their  calicoes on a red-hot iron cylinder, yet  I have
more than once feen an eryfipelas induced  or increa-
fed  by  the ftimulus of calico, as well as of flannel.
  The  increafe  of perfpiration  by  heat  either of
clothes, or of fire, contributes much  to emaciate the
body ; as is well known to jockeys; who, when  they
                                               are 
CtAss I. i. 2.]    OF IRRITATION.              27
are a Stone or two  too  heavy for  riding,  find the
quickeft  way to leflen their weight  is  by Sweating
themfelves between blankets in a warm room;  but
this  likewife  is a practice by no  means to be recom-
mended, as it weakens the fyftem by the excefs of
fo general a ftimulus, brings on a premature old age,
and  fhortens the fpan of  life;  as  may be   further
deduced from the quick  maturity,  and fliortnefs of
the lives, of the inhabitants of Hindoftan, and other
tropical climates.
   M. Buftbn made a curious experiment to fliew this
circumftance.  He took a numerous brood of the but-
terflies  of filkworms,  fome hundreds  of which left
their eggs on the fame day and hour; thefe he divi-
ded into two parcels ; and placing one parcel in the
fouth window, and the other in the  north window of
his houfe, he obferved, that thofe in the colder fitua-
tion lived many days longer than thofe in the warmer
one.   From  thefe obfervations it appears, that the
wearing of flannel clothing  next the  /kin, which is
now fo much in fafhion, however ufeful it may be in
the winter to thofe, who have cold extremities, bad
digeftions, or habitual coughs,  muft greatly debilitate
them, if worn in the warm months, producing fevers,
eruptions, and premature olcj age.  See Sect. XXXVII.
£. Clafs I. 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
.0Loured urine is voided,  the kidneys continuing to act
                                          ftrongly, 
28                DISEASES      [Class I. i. 2.
Strongly', after the increafed  action of the abforbents
of the bladder is fomewhat diminifhed.   If the abforb-
ents" continue alfo to  act ftrortgly, the urine is higher
coloured, and fo loaded as to depofit, when  cool, an
Earthy fediment,  erroneOufly  thought to be  the mate-
rial caufe of the difeafe;  but is fimply owing to the
fecretion of the kidneys being great from their in-
creafed action ; and the thinner parts of it being ab-
sorbed by thfc  increafed action of the  lymphatics,
which  are fpread very thick  on the neck of the blad-
der ; for the urine,  as well as perhaps all the  other
fecreted fluids, is produced from the kidneys in a very
dilute State ; as appears in thofe, who from  the Stimu-
lus of a  ftone,  or other  caufe, 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 reabforbed.   The general
ufe of this urinary abforption to the animal ceconomy
is  evinced  from  the  urinary bladders of fifh, which
would otherwife be unncceffary. High coloured urine
m large quantity fhews only,  that the fecreting veffels
bf the kidneys, and  the  abforbents  of the bladder,
have acted with  greater energy. When there is  much
earthy fediment, it lhew3, that the  abforbents have
a&ed proportionally Stronger, and have confequently
left the urine in a lefs dilute  State.  In  this urine the
tranfparent fediment  or cloud is mucous;  the opake
fediment is probably coagulablc lymph from the blood
changtd by an animal or chemical procefs.  The float-
iag &um is oil.  The angular concretions to the fides
                                                #f 
Class I. i. 2.]    OF IRRITATION.              29
of the pot,  formed as the urine cools, is microcofmic
fait.  Does the adhefive  blue matter  on the fides of
the glafs, or the blue circle  on it at  the edge of the
upper furface of the urine, confift of Pruflian blue ?

   5.  Diarrhoea calida.   Warm diarrhcea.  This fpe-
cies may be divided into three varieties deduced from
their  remote eaufes, under the names  of diarrhoea fe-
brilis, diarrhoea crapulofa,  and diarrhcea  infantum.
The febrile diarrhcea appears at the end of fever-fits,
and is  erroneoufly called  critical, like the copious
urine, and the fweats ; whereas it arifes from the in-
creafed action  of thofe fecerning organs, which pour
their  fluids  into the  inteftinal canal (as  the  liver,
pancreas, and mucous  glands),  continuing longer than
the increafed action of the  inteftinal  abforbents.  In
this diarrhcea there is no appearance  of curdled chyle
in the Stools, as occurs in cholera.   I.  3. 1.5.
   The diarrljcza crapulofa, or diarrhcea from indigef-
tion,  occurs when too great a quantity of food or li-
quid  has been  taken ;  which not being completely di-
gested, Stimulates the inteftines like  any other extra-
neous acrid material;  and thus produces an increafe
of the fecretions into them of mucus,  pancreatic juice,
and bile.   When the  contents  of the bowels are ftil!
more Stimulant, as when draftie purges, or  very pu-
trescent diet, have been taken,  a cholera  is induced.
See Sect. XXIX. 4.
   The diarrhcea infantum,  or diarrhcea of infants,  h
generally owing to too great acidity  in their bowels.
                                               Milk 
jo               DISEASES      [Class I. I. r.
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 gaftric
juice of the calf, which  is employed to curdle milk in
the procefs of making cheefe.   Milk is the natural
food for children, and muft curdle in their  Stomachs
previous to digeftion; and as this curdling of the milk
deftroys a part of the acid juices of the ftomach, there
is no reafon for difcontinuing the ufe of it,  though it
is occafionally ejected in a curdled Slate.  A child of
a week old,  which had been taken from the breaft of
its  dying mother, and had by fome uncommon error
been fuffered  to take  no food but water-gruel, be-
came fick and  griped in twenty-four hours,  and was
convulfed on the fecond day, and died  on the third!
When all young quadrupeds, as well as children, have
this natural food of milk prepared for them, the ana-
logy is fo  ftrong in favour of its falubrity, that  a per-
fon fhould have powerful teftimcny indeed of its disa-
greeing, before he advifes  the difcontinuance of the
ufe of it to young  children in health, and much more
fo in ficknefs.  The farmers lofe 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 ftarved into  the  fcrophula,
and either peri/h, or live in a State of wretched debility.
   When young  children are  brought up  without a
breaft, they Should for the firft two months have no
food but new milk ;  fince the  addition  of any kind of
bread  or  flour is liable to ferment, and produce too
                                              nnch 
Class I. i. 2.]     OF IRRITATION.               $1
much acidity ; as appears by the confequent diarrhcea
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 ftimulus.   And they mould never
be fed as  they lie upon their backs, as in that pofture
they  are  neceflitated to fwallow all  that is  put Into
their mouths;  but when they are fed, as they are fit-
ting up, or raifed up, when they have  had  enough,
they can permit the reft to run out of their  mouths.
This circumstance is of great  importance to the health
of thofe children, who are  reared by  the fpoon, fince
if too  much  food  is  given them, indigeftion, and
gripes,  and diarrhcea, is the  confequence ; and if too
little, they become emaciated ; and of this exact quan-
tity their own palates judge the belt.
   M. M.  In this laft cafe of the diarrhcea of children,
the food  fliould be new milk, which  by curdling de-
ftroys part of the acid, which coagulates it.   Chalk
about  four grains every  fix hours, with one  drop of
fpirit  of hartfhorn, and half a drop of laudanum.  But
a blifter about the fize of a Shilling is  of the greateft
fervice by reftoring the power of digeftion.   See Ar-
ticle in. 2.  i. in the fubfequent Materia Medica.

   6.  Salivatio calida.   Warm falivation.  Increafed
fecretion of faliva.  This may  be effected either by
ftimulating  the  mouth of the gland by mercury taken
internally ; or by ftimulating  the excretory duct of the
gland by  pyrethrum,  or tobacco; or  fimply by the
movement of the mufcles,  which lie  over  the gland,
                                                as 
3i               DISEASES      [Class I. i. 2.
as in mafticating any taftelefs fubftance, as a lock of
wool, or maftic.
   In about the middle of nervous fevers a great fpitting
of faliva fometimes occurs, which has been thought cri-
tical ; but as it continues fometimes two or even  three
weeks  without the relief of the  patient, it may be
concluded to arife from  forae accidental circumftance*
perhaps not unumilar to the hyfteric ptyalifras  men-
tioned  in Clafs I. 3. 2. 2.   See Sect. XXIV.
   M. M. Cool air, diluents, warm bath, evacuations.

   7. Catarrhus calidus.  Warm catarrh.   Confifts in
an increafed fecretion of mucus from the noftrils with-
out inflammation.  This difeafe, which is called a cold
in the head, is frequently produced by cold air acting
for fome time on the membranes, which line the nof-
trils, as it paffes to the lungs in refpiration.  Whence
a torpor  of the a&ion of the mucous glands is firft
introduced, as in I. 2. 3. 3. and an orgafm or increafed
action  fucceeds in confequence.   Afterwards this or-
gafm  and  torpor are  liable to  alternate with  each
other for fome time like the cold and hot fits of ague,
attended with deficient  or exuberant fecretion of mu-
cus in  the noftrils.
   At other times it arifes from reverfe fympathy with
fome extenfive parts of the Skin,  which have been ex-
pofed too long to cold, as of the head, or  feet.   In
confequence of  the torpor of thefe  cutaneous capilla-
ries thofe of the raucous membrane  of the noftrils act
with greater energy  by reverfe fympathy ; and thence
                         J                    fecretc 
Cla'ssI. i.2.]   • OF IRRITATION.               33
fecrete more  mucus  from the  blood.   At the  fame
time the abforbents,  acting alfo with greater  energy
by their reverfe fympathy with thofe of fome diftant
part of the fkin, abforb the thinner parts of the mucus
more haftily;  whence the mucus is both thicker and
in greater quantity.  Other curious  circumftances  at-
tend this difeafe ; the membrane becomes at times fo
thickened by its increafed action in fecreting  the mu-
cus, that the patient  cannot breathe  through his nof-
trils.   In this fituation if he warms his whole /kin
fuddenly by fire or bed-clothes," or by drinking warm
tea, the increafed  action of the membrane ceafes  by
its reverfe  fympathy with the ikin ; or by the retrac-
tion of the fenforial  power to  other parts of the fyf-
tem ; and the patient can breathe again through the
noftrils.   The fame fometimes occurs for a  time  on
going  into the cold air by the deduction of heat from
the mucous membrane, and" its confequent inactivity
or torpor.  Similar  to this when the face and breaft
have been very hot  and red,  previous to the eruption
of the fmall-pox by  inoculation, and  that even  when
expofed to cool air, I  have obferved  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. Clafs II. 1. 3. 5. IV. 2. 2.  10.
IV.  1.  1. 5.
   M.  M.  Evacuations, abstinence, oil  externally  on
the nofe, warm diluent fluids, warm flioes, warm night-
cap.

                        D                8. Expee* 
34                DISEASES     [Class I. i. ».
   8. Expecloratio calida.   Warm expectoration con-
fifts of the increafed fecretion of mucus from the mem-
brane, which lines  the bronchia?, or  air-cells  of the
lungs,  without inflammation.   This increafed mucus is
ejected by the action of coughing, and  is called a cold,
and refembles the  catarrh of the preceding article ;
with which it is frequently combined.
   M. M. Inhale the fteam of warm  water, evacua-
tions, warm bath, afterwards opium, forbentia.

   9.  Exfudatio pone aures*   A difcharge  behind the
ears.   This chiefly affects children, and is a morbid fe-
cretion ; as appears from its fetor; for if it was owing
to defect of abforption,  it would be  falfne,  and not
fetid ; if a  morbid action  has continued  a confider-
able time, it  fhould not be flopped too fuddenly ; fince
in that cafe  fome other morbid action is  liable to fuc-
cced in its Stead.  Thus children are believed to have
had cholics, or even convulfions,  confequen? to the too
 fudden healing of thefe morbid  effufions behind their
 ears.  The rationale of this is to be explained  from a
 medical  fact, which I have frequently  obferved ; and
 that is,  that a blifter on the  back greatly ftrengthens
 the power of digeftion, and removes the heart-burn in
 adults, and  green  ftools in children.  The ftimulus of
 the blifter produces fenfation in the veSTels of the Skin -7
 with  this  additional fenforial power  thefe veflels act
 more  Strongly;  and with  thefe the veSTels of the in-
 ternal membranes of the ftomach and  bowels act with
 greater  energy from their direct fympathy with them*
                                                Nov* 
Class I. i. 2.]     OF IRRITATION.              35
Now the acrid  difcharge behind  the ears of children
produces fenfation on that part of the ikin, and fo  far
acts as a fmall blifter.   When this is fuddenly flopped,
a debility of the digeftive power of the ftomach Suc-
ceeds from the want of this accuftomed ftimulus, with
flatulency,  green ftools,  gripes, and fometimes confe-
quent convulfions.   See Clafs II.  1. 5.  6.  and II.
1. 4. 6.
   M. M.  If  the matter be abforbed, and produces
Swelling  of the lymphatics of  the neck, it fhould be
cured as foon as poffible  by dufting  the part with
white lead, cerufla, in  very fine powder;  and to pre-
vent any ill confequence an  iflue Should  be kept  for
about a month in the  arm ;  or a purgative medicine
fhould be  taken every other day  for three  or  four
times, which Should confift of a grain  of calomel, and
three or four  grains of rhubarb, and as much chalk.
If there be no appearance of abforption,  it is better
only to keep the parts clean  by wafhing them with
warm water morning and evening ; or putting fuller's
earth on them; efpecially  till the time of toothing is
paft.  The tinea, or fcald head, and a leprous erup-
tion, which often  appears  behind the  ears, are differ-
ent difeafes.

   1 o. Gonorrhoea  calida.   Warm gleet.   Increafed
 difcharge of mucus from the urethra or proftate gland
 without venereal  defire, or  venereal infection.   See
 Clafs I.  2.  3. 8.
D 2
M. M. Can- 
 36               DISEASES       [Class I. I. 2.
   M. M.  Cantharides, balfams,  rhubarb,  blifter ia
 perineum, cold bath, injections of metallic falts, flan-
 nel fhirt, change of the form of the accuftomed chair
 or Saddle of the patient.

   11. Fluor alius  calidus.   Warm fluor albus.  In-
 creafed fecretion of mucus  in  the  vagina or uterus
 without venereal  defire or  venereal infection.   It  is
 diftinguiflied from  the  fluor albus frigidus  by the in-
 creafed fenfe of warmth in the part,  and by the  great-
 er opacity or fpiifitude of the material difcharged ; as
 the thinner parts are reabforbed by the mcreafed ac-
 tion of the  abforbents, along  with the Saline part,
 whence no Smarting or  excoriation attends it.
   M. M. Mucilage, as ifinglafs, hartfliorn jelly, gum
 arable.  Ten grains of rhubarb every night.  Callico
 or flannel Shift, opium,  balfams.  See Clafs I. 2. 3. 7.

   12. Hamorrhois  alba.  White piles.   An increafed
 difcharge of mucus from the rectum frequently mifta-
 ken for matter ; is faid to continue a few weeks,  and
 recur like the  bleeding  piles ; and  to obey lunar in-
 fluence.  See Clafs I. 2. 1. 6.
   M. M. Abftinence from vinous fpirit.  Balfam of
copaiva.   Spice fwallowed in large fragments,  as  ten
or fifteen black pepper-corns cut in half, and  taken
after dinner and fupper.  Ward's pafte, confifting of
black  pepper  and  the   powdered root  of  Helenium
Enuku
13. Serum 
 Class I. i. 2.]     OF IRRITATION.               3?
    13.  Serum e veficatorio*  Difcharge from a blifter.
 The excretory ducts  of  glands  terminate  in  mem-
 branes, and are endued with great irritability, and ma-
 ny of them with fenfibility; the latter perhaps in con-
 quence of their facility of being excitable  into great
 action; inftances  of this are the terminations of  the
 gall-duct in the duodenum, and of the falivary and la-
 chrymal glands in the mouth and eye ; which produce
 a greater  fecretion of  their adapted fluids,  when  the
 ends of their excretory  ducts are flimulated.
   The external ikin confifts of the excretory duets of
 the capillaries, with the mouths of the abforbents 5
 when thefe are  Stimulated  by the application of can-
 iharides, or by a Slice of the frefh root of bryonia alba
 bound  on  it, the capillary glands pour an increafed
 quantity of  fluid upon the Skin by their increafed
 action;  and  the  abforbent veflels imbibe a greater
 quantity  of  the  more fluid and faline  part of  itj
 whence a thick mucous or ferous fluid is depofited  be-
 tween  the ikin and cuticle.

   14.  Perfpiratio foetidd.   Fetid perfpiration.   The
 ufes of the perfpirable  matter  are  to keep  the ikin
 foft and pliant, for  the purpofes  of its eafier flexibi-
 lity during  the activity of our limbs  in locomotion,
and for the prefervation of the accuracy of the fenfe
 of touch, which is diffufed under  the whole furface
of it to guard us  againft the injuries  of external bo-
dies ; in the fame manner as the fecretion of tears is
defigned to preferve  the cornea  of the eye moift, and
                        D3                      in 
38               DISEASES      [Class I. 1. 2.
in confequence  tranfparent; 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 fuppofed obflruction.  Such as the
origin of catarrhs,  coughs, inflammations, eryfipelas,
and herpes.
  To all thefe it may be fufficient to anfwer, that the
ancient Grecians oiled themfelves all over;  that fome
nations have painted themfelves all over, as the Picts
of this ifland ; that the Hottentots fmear themfelves
all over with greafe.  And laftly,  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  wafteful fafhion, and all this without
^convenience.  To this muft be added the ftrict ana-
logy  between the ufe of the perfpirable matter and
the mucous fluids, which are poured for  fimilar  pur-
pofes upon all the internal membranes  of the body;
and  befides its  being in its natural State inodorous;
which is not fo with the other excretions of feces,  or
of urine.
  In fome constitutions  the perfpirable  matter of the
lungs acquires a difagreeable odour ; in others the axil-
la, and in others the feet, emit difguftful effluvia  ; like
the fecretions of thofe glands, which have been called
odorifere.;  as thofe, which contain the caftor m the
beaver, and thofe within the rectum of dogs, the mu-
cus of which has been fuppofed to guard them againft
the great coftivenefs, which  they  are liable to in hot
Cummers; and  which has  been thought to occafion
                                            canine 
 Class I. i. 2.]     OF IRRITATION.              319.
 canine  madnefs,  but  which, like their white  excre-
 ment, is more  probably owing to  the deficient  fecre-
 tion of bile.   Whether  thefe odoriferous particles at-
 tend  the perfpirable matter in confequence  of the in«
 creafed action  of  the  capillary glands, and can  pro*
 perly be called excrementitious;  that is, whether any
 thing is eliminated, which could be hurtful if retain-
 ed ;  or whether they may only  contain fome of the
 effential oil of  the animal; like the  fmell,  which ad-
 heres to  one's hand  on Stroking  the hides  of fome
 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. Wafh the parts twice a day with foap  and
 water ;  with lime  water;  cover  the feet  with oiled
 fiik focks,  which muft we  wafhed night and morning.
 Cover them with charcoal  recently made red hot, and
 beaten  into  fine powder and Sifted,  as foon  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, fo as to procure a ftool or two
 extraordinary every day, and thus by increafing  one
 evacuation to decreafe another.   Cool drefs,  diluting
 liquids ?

   15. Crines ncvi*  New hairs,   ^he black points
 on the  faces  of fome people confift of mucus, which is
 become vifcid,  and which  adheres in the  excretory
ducts  of the glands of the  ikin j  as defcribed  in Clafs
                       D 4              I-  2, a.-p. 
4©               DISEASES      [Class I. i. 2.
I. 2. 2. 9. and which maybe prefled  out  by the fin-
gers,  and rcfembles little  worms.   Similar  to  this
would feem the fabrication of Silk,  and of  cobweb by
the filk  worm and fpider ;  which is a fecreted matter
preflfed 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 procefs;
and more efpecially as  every  hair  may be confidered
as a Slender flexible horn, and  is an appendage of the
ikin.  See Sect. XXXIX.  3. 2.    Nov/ as there  is a
fenfitive fympathy between the glands, which fecrete
the femen, and the throat,  as appears in the mumps;
fee Hydrophobia,  Clafs IV. 1.  2. 7, and Parotitis,
Clafs IV, 1, 2. 19, the growth of the  beard at pu-
berty feems to be caufed by the greater action of the
cutaneous glands  about the chin and pubes in confe-
quence  of their  fympathy with thofe of the teftes.
But this does not occur to  the female fex at their time
of puberty,  becaufe the fenfitive fympathy  in  them
feems to exift between  the fubmaxillary glands, and
the pectoral ones;  which fecrete the  milk, and afford
pleafure both  by that fecretion, and  by  the erection
of the  mamule,  or nipples; and by delivering the
milk into the mouth of the child;  this fenfitive fym-
pathy of the pectoral and  fubmaxillary glands in wo-
men  is alfo obfervable in the  Parotitis, or mumps, as
 above referred to,
    When hairs grow on the face or arms fo as to be
 difagreeable, they may be thus readily removed  with-
     ...                . ,                   out 
Class I. 1.2.]    «F IRRITATION.               4,
out pain or any ill confequence.  Warm the ends of
a pair of nippers or forceps, and flick on them a little
rofin, or burgundy pitch;  by thefe means each fingle
hair may be taken fail  hold of; and if it  be then
plucked off" flowly, it  gives pain; but if plucked off
fuddenly, it gives no pain at all; becaufe the vis iner-
tie of the part of the Skin, to which it adheres, is not
overcome ; and it is not in confequence feparated 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 fafely deftroyed ;  which is much to
be preferred  to the method faid to be ufed in Turn-
key to eradicate hair; fuch as a mixture of orpiment
and quick lime;  or of  liver of fulphur  in  folution;
which injure the ikin, if they are  not very nicely ma-
 naged ; 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  caufticity of the applica-
 tion.   See Clafs I. 2. 2. 11. on grey hairs.
ORDO 
*yi
DISEASES      [ClassI. i. 3.
                    ORDO   I.
                 Increafed Irritation*

                   GENUS   III.
     With increafed Aclions of the Abforbent Syfiem.

   These are not attended with fo great increafe  of
 heat as in the  former  genus, becaufe  the  fluids pro-
 bably  undergo lefs chemical change in the glands  of
 the  abforbent  fyftem ;  nor are  the glands of the ab-
 forbent  veflels  fo  numerous or fo extenfive  as thofe
 of the fecerning  ones.   Yet that fome heat is  pro-
 duced by the increafed action  of  the  abforbents ap-
 pears  from the greater general warmth of  the  ikin
 and extremities of  feeble patients after the exhibition
 of the Peruvian bark, and other medicines of the ar-
 ticle Sorbentia.

                    SPECIES.
   1. Lingua arida.  Dry tongue  occurs in  thofe fe-
 vers, where the expired air  is  warmer than  natural;
 and  happens to all thofe, who fleep with their mouths
open;  the currents of air in refpiration increafing the
 evaporation.  There is alfo a  drynefs in the  mouth
 from the increafed  action  of   the abforbent veflels,
when a floe or a crab-apple  is  mafticated ; and after
the  perfpiration has been much increafed by  eating
fait  or  fpice, or after other copious  fecretions;   as
after drunkennefs, cathartics, or fever fits,  the  mucus
of the mouth becomes  vifcid, and in fmall quantity,
                                               from 
Class I. i. 3.]    OF IRRITATION.               43
from the increafed abforption, adhering to the tongue
like  a white Hough.   In the  diabetes, where the
thirft is very great, this Slough adheres riTore pertina-
cioufly, and becomes black or brown, being coloured
after a few days by our aliment or drink.  The infpif-
fated  mucus on the tongue of  thofe, who fleep with
their mouths open, is fometimes reddened as if mixed
with  blood, and fometimes a little blood follows the
expuition of it from the fauces owing to its great ad-
hefion.   When  this  mucus  adheres long to the pa-
pille of the tongue, the faliva, which it contains  in
its interftices,  like a  fponge, is liable  to  become pu-
trid,  and to acquire a  bitter  tafte, like  other putrid
animal fubftances ;  which is generally  mistaken for  an
indication of the prefence of bile.
   M. M. Warm fubacid liquids.  See Clafs I. 2. 5. 8.

   2. Fauces arida.   Dry  throat.   The  expuition  of
a frothy mucus  with great  and perpetual hawking
occurs in hydrophobia, and  is  very diftrefling to the
patient;  which may be owing to the increafed irri-
tability  or  fenfibility of the upper part  of the cefo-
ph'agus, which will not permit  any fluid to reft on it.
   It affects fome people after intoxication, when the
 lungs remain Slightly inflamed,  and  by the greater
 heat of the air in expiration the mucus  becomes too
 haftily evaporated,  and is expectorated with difficulty
 in the State of white froth.
   I  knew  a  perfon,  who  for twenty years always
 waked  with his tongue and throat quite  dry; fo that
                                                 he 
 4^               DISEASES      [Class I. i. 3.
 he was  neceflitated to take a fpoonful of water, as
 foon as  he awoke;  otherwife a little  bloojd always
 followed the  forcible expuition of the indurated mu-
 cus  from, his  fauces.  See Clafs  II.  1. 3. 17.
   M. M.  Steel-fprings fixed to  the  night-cap fo as
 to fufpend the  lower jaw and  keep it  clofed;  or
 fprings of elaftic gum.   Or a pot of water fufpend-
 ed over  the bed, with  a  piece  of lift,  or  woollen
 cloth, depending from   it,  and held  in the  mouth;
 which will act like a fyphon, and  flowly fupply moif-
 ture, or barley water fhould be  frequently fyringed
 into the mouth of the  patient.

   3.  Flares aridi.  Dry noftrils with the mucus har-
 dening upon  their internal  furface,  fo  as to cover
 them with a  kind  of ikin  or  fcale, owing to the  in-
 creafed action of the abforbents  of this membrane;
 or to  the  too great  drynefs of the air, which paffes
 into the lungs;  or too  great  heat of it in its expi-
 ration.
   When air  is  fo  dry as  to  lofe its  tranfparcncy ;
 as when a tremulous motion of it  can be feen over
 corn fields in  a hot Summer's day; or when a dry
 mift,  or  want of transparency of  the air, is vifible
 in very  hot   weather;   the fenfe  of  fmell is  at the
fame  time imperfect from  the drynefs of  the  mem>
 brane, beneath  which it is fpread.

   4. Expecloratio folida.  SoKd expectoration.   The
mucus of the  lungs becomes hardened by the increa-
                                                fed 
 Class I. i. 3.]     OF IRRITATION.              45
 fed abforption, fo that it adheres and forms a  kind of
 lining in the air-cells, and is  fometimes fpif up in the
 form of branching veSTels, which  are  called polypi of
 the lungs.   See Tranfaet.  of the  College, London.
 There is a rattling or wheezing of the breath, but it-
 is not at firft attended with inflammation.
   The Cynanche trachealis, or Croup, of Dr.  Cullen,
 or Angina polypofa of Michaelrs, if they differ from
 the peripneumony of infants, feem to belong to this
 genus.   When the difficulty of  refpiration is great,
 venefection  is immediately neceflary, and then an eme-
 tic, and  a blifter.  And the child fhould be kept nearly
 upright in bed as  much as  may  be.   See  Tonfillitis,
 Clafs IL  1. 3.  3.
   M. M. Diluents, emetks,  eflence of antimony, foe-
 tid gums, onions*  warm bath for half an hour every
 day for a month.   Inhaling the fleam  of  water,  with
 ©r without volatile alkali.  Soap.

   5. Conflipatio- alvi.  Coftivenefs from increafed ac-
 tion of the inteftinal abforbents.   The feces are  har-
 dened  in lumps called fcybala; which are fometimes
 obliged to be extracted from the  rectum with  a kind
 of marrow  fpoon.   This is  faid  to have  happened
 from the patient  having taken much  raft of iron.
 The mucus  is  alfo hardened  fo as to line the intef-
 tines, and to come away in Skins, rolled up as they
 pafs along, fo as to refemble worms, for which they
are  frequently  miftaken ; and fometimes it is evacua-
 ted in Still larger pieces,  fo as. to counterfeit the form
                                                 of 
46                DISEASES       [Class I. 1.3,
of  the  inteftines, and  has  been miftaken  for a por-
tion of them.  Balls of this kind, nearly as heavy as
marble, and confiderably  hard, from  two inches to
five in diameter,  are frequently found  in the  bowels
of horfes.   Similar  balls found  in  goats have  been
called Bezoar.
  M. M.   Cathartics,  diluents, fruit,  oil,  foap, Sul-
phur, warm bath.   Sprinkling with cold water, cool
clothing.   See Clafs I.  2. 4. 18.

  6.  Cutis  arida.  Dry Skin.   This dry  ikin is not
attended with coldnefs as in the beginning of fever-
fits.  Where this cutaneous abforption is great, and
the fecreted material upon it vifcid,  as on the hairy
fcalp, the  ikin becomes covered with hardened mucus;
which adheres fo as not to be  eafily removed,  as the
fcurf on the head; but is not attended with inflamma-
tion like the Tinea, or Lepra.   The moifture,  which
appears on the ikin beneath refinous or oily platters,
or which  is feen to adhere to  fuch  plafters, is owing
to their preventing the exhalation  of  the perfpirable
matter, and not to their increafing the production of
it, as fome have  idly imagined.
   M.  M.   Warm bathing,  oil externally,  oil-ikin
gloves,  refinous plafters.  Wax.

   7.  Urina parca colorata.   Diminifhed urine, which
is high coloured,  and  depofits  an earthy fediment,
when cold, is owing to the  great action of the  urinary
abforbents.  See Clafs I.  1. 2. 4.   In fome dropfie«
                                                th^ 
Class I. i. 3.I     OF  IRRITATION.               47
the cutaneous abforbents  are  paralytic,  a3  well as
thofe opening into the cellular membrane ;  and hence,
no moifture being  acquired  from the atmofphere, or
from the cellular membrane, great third  is excited;
and  great  abforption from all parts, where  the ab-
forbents are ftill capable of action.  Hence  the urine is
in very fmall quantity, and of deep colour, with copi-
ous fediment; and the kidneys are erroncoufly blamed
for not doing  their  office;  ftimulant  diuretic  medi-
cines are given in vain; and very frequently the un-
happy patient is  reftrained from  quenching his thirft,
and dies a martyr to falfe theory.
   M.  M.  Diluent  liquids, and warm bathing, are the
natural cure  of this fymptom ;  but  it generally  at-
tends  thofe  dropfies, which are feldom curable ; as
they are owing to a paralyfis both  of die cutaneous
and cellular lymphatics.

   8.  Calculus felleus.   Gall-ftone.    From the  too
 hafty abforption  of the  thinner parts of the  bile,  the
 remainder  is  left too  vifcid,  and   cryftallizes  into
 lumps;  which, if too large  to pafs,  obstruct the duc-
 tus choledochus, producing pain at the pit of the  Sto-
 mach, and jaundice.   When the indurated bile is  not
 harder  than a boiled pea,  it may pafs  through the
 bile-duct  with  difficulty by changing its form;  and
 thus gives thofe pains,  which have been called fpafms
 of the Stomach ; and yet thefe vifcid  lumps of bile may
 afterwards diflolve,  and not be  vifible among the fe-
 ces.
                                                  In 
4$                DISEASES      [Class I. 1.3,
   111 two inftances I have  feen from thirty  to  fifty
gall-Hones voided after  taking an oil  vomit as below.
They were about the fize of peas,  and diftinguifhable
when dry by their being inflammable  like bad wax,
when put into the flame of a candle.  For other caufes
of jaundice, fee Clafs I.  2. 4. 19.
  M. M. Diluents, daily warm bathing.   Ether mix-
ed with yolk of egg and water.  Unboiled acrid ve-
getables, as lettuce,  cabbage, muftard,  and  crefles.
When in violent pain, four  ounces of oil of olives, or
of almonds, Should be fwallowed ;  and as much more
in  a quarter of an  hour,  whether  it Slays  or  not.
The patient fhould lie on the circumference of a large
barrel, firft on one fide, and then on  the other. Elec-
tric fhocks  through the  gall-duct.   Factitious Selter
water made by diflblving 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
foon as mixed, twice a day for fome months.   Opium
muft  be ufed to quiet  the pain,  if the oil does not
Succeed,  as  two grains, and another grain in  half an
hour if neceflary.  See  Clafs IV. 2. 2. 4.

   9.  Calculus renis.   Stone of the kidney.  The pain
in the loins  and along the courfe of the ureter from a
ftone is attended with retraction of the tefticle in men,
and  numbnefs on  the infide of the thigh in  women.
It is diftinguifhed from  the lumbago or fciatica, as
thefe latter  are  feldom  attended  with vomiting,  and
have pain on the outfide of the thigh, fometimes quite
                             4               down 
Class 1.1. 3.]     OF IRRITATION.              49
down to  the ankle  or heel.   See  Herpes and Ne-
phritis.
   Where the abforption  of the thinner parts of the
fecretion takes  place too  haftily in the kidneys, the
hardened  mucus,  and confequent  calculous concre-
tions, fometimes totally flop up the tubuli uriniferi;
and  no urine is fecreted.    Of this  many die, who
have drank much vinous fpirit,  and fome of  them
recover by voiding  a  quantity of white  mucus, like
chalk and water;   and others  by  voiding  a  great
quantity  of fand, or  fmall calculi.   This hardened
mucus  frequently becomes  the nucleus of a ftone in
the  bladder.   The falts of the urine, called  micro-
cofmic  fait, are often miftaken for gravel, but  are
diftinguifhable both  by their angles  of  cryftallization,
 their adhefion to the fides or bottom of the  pot,
 and by their not being  formed till  the  urine  cools.
 Whereas  the particles of gravel  are generally with-
 out angles,  and always drop to the bottom of  the
 veSTel,  immediately  as the  water  is voided.
   Though the  proximate caufe of the formation of
 the calculous concretions  of the kidneys, and ofchalk-
 ftones in the gout,  and of the infoluble concretions of
 coagulable lymph,  which are found on membranes,
 which  have been inflamed in peripneumony, or rheu-
 matifm, confifts in the too great action of the abforb-
 ent  veflels of  thofe  parts;  yet the remote caufe in
 thefe cafes is probably owing to  the inflammation  of
 the membranes ; which at that time are believed to
 fecrete a material more liable to coagulate or concrete,,
                          E                     than 
$o               DISEASES      [Class I. i. 3.
than they would  otherwife produce by increafed  ac-
tion  alone without the  production of new  veflels,
which conftitutes inflammation.   As defined  in  Clafs
II. 1. 2.
  The fluids fecreted from the mucous membranes of
animals are of various kinds and confiftencies.  Hair,
filk,  fcales,  horns,  finger-nails,  are owing to natural
procelfes.   Gall-ftones,  ftones found in the inteftines
of horfes, fcurf of the ikin in leprofy, ftones of  the
kidneys and bladder, the callus from the inflamed pe-
riofteum,  which unites broken bones, the calcareous
cement, which repairs the injured fliells of fnails,  the
calcareous cruft on  the eggs of birds, the annually re-
newed Shells of crabs, are all inftances of productions
from mucous membranes, afterwards indurated by ab-
forption of  their thinner parts.
  All thefe concretions contain phofphoric acid, mu-
cus,  and  calcareous earth  in  different  proportions;
and  are probably fo far analogous in  refpect to their
component  parts  as well as their mode of formation.
Some calcareous earth has been difcovered  after  pu-
trefaction in the  cOagulable lymph of  animals.  For-
dyce's Elements of Practice.  A little calcareous earth
was  detected by Scheel  or  Bergman in the calculus of
the bladder with  much phofphoric  acid, and a  great
quantity of phofphoric acid is fhewn to exift in oyfter-
fhells by their becoming luminous on expofing them
a while to the fun's light after calcination ;  as in the
experiments of Wilfon.   Botanic Garden, P.  1. Canto
 \. 1, 182,  note.  The exchange of which phofphoric
                                               acid 
Class I. i. 3.]     OF IRRITATION.              51
acid for carbonic acid, or fixed air, converts Shells into
limeftone, producing mountains of marble,  or calcare-
ous Strata.
   Now as the hard lumps of calcareous matter, term-
ed crabs'  eyes,  which are found in the Stomachs  of
thofe animals previous  to the annual renewal of their
Shells, are redilfolved, probably by their gaftric acid,
and again depofited for that purpofe ; may it not be
concluded, that the ftone of the bladder might be dif-
folved by the gaftric juice of fifli  of prey, as of crabs,
or  pikes ; or  of voracious young birds, as young
rooks or  hawks, or even of calves ? Could not thefe
experiments be  tried by collecting the gaftric juice by
putting bits of fponge  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  obferving if
 they  become digefted?  and laftly, could not  gaftric
juice, if it Should appear to be a folvent,  be injected
 and born in the bladder  without injury by  means  of
 catheters of elaftic refin, or caoutchouc ?
    M. M.   Diluents.   Cool drefs.  Frequent change
 of  pofture.    Frequent  horizontal reft in the day.
 Bathe the loins every morning with a fponge and cold
 water.  Aerated alkaline water  internally.   Absti-
 nence from all  fermented or fpirituous liquors.  What-
 ever increafes perfpiration injures thefe  patients,  as it
 diflipates the aqueous particles,  which ought to dilute
 the urine.   When  the  constitution begins to produce
 gravel, it may 1 believe be certainly prevented by a
                        E 2                    total 
5*               BISEASE3      [Class I. i. 5,
\q\$ abftin«H.ej| from fermented or fpirituous liquors;
by  4rinking much aqueous fluids; as toaft and wa-
ter,  tea, milk  and water, lemonade ; and  laftly  by
t^n clothing, and fleeping on a, hardifh bed, that the
patient  may not lie too long  on one fide.  See  Clafs
IV.  2.  2.  2.   There  is reafon to believe, that the
dguty ufe of opium contributes to produce gravel in the
kidneys by increasing  abforption, when they are  in-
flamed ; in th^ fame  manner as is done by fermented
or (pirituous liquor.  See Clafs I. 3, 2. 11.
   "\Vhen  the  kidneys  are. fo obstructed  with  gravel,
that no urine pafles into the bladder ; which is known
by the external appearance of  the lower part of  the
abdomen, which,  when the bladder is full, feems as
if contracted  by a cord  between the navel and  the
bladder;  and  by the  tenfion on  the region of  the
bladder distinguishable by the touch ; or by the  intro-.
duction of  the catheter; the  following methods of
cure are frequently  fuccefsful.   Venefection to  fix or
eight ounces, ten grains of calomel, and an infufion of
fenna with falts and  oil,  every  three hours, till  ftools
are  procured.   Then  an emetic.   After  the patient
has been thus evacuated, a blifter on the loins, fhould
be ufed; and from ten  to  twenty electric Shocks fhould
be pajfed through the  kidneys, as large as can he ea-
fily  borne, once  or twice a day.  Along with  this
method  the warm  bath  Should be ufed for an hour
once or twice a day.  After repeated evacuations  a
clyfter, confifting of two drams of turpentine diifolved
by yolk of egg, and fixry drops  of tiacture of opium,
                                             Should 
I
Class I. i. 3.]     OF IRRITATION.              53
mould be ufed at night, and repeated, with cathartic
medicines interpofed, every night, or alternate nights.
Aerated  Solution of alkali fhould be taken internally,
and balfam of  copaiva, three or four times  a day.
Some of thefe patients recover after having made no
water for nine or ten days.
  If a ftone flicks in the ureter with incefiant vomit-
ing, ten grains of  calomel muft be given in fmall pills
as above ; and fome hours afterwards infufion of fenna
and falts and oil, if it can be made  to Slay on the fto-
mach.   And after the purge has  operated four or
five times,  an opiate is to be given, if the pain con-
tinues, confifting of two grains of opium.   If this does
not fucceed, ten or twenty electric Shocks through the
kidneys Should  be tried, and the purgative repeated,
and afterwards the opiate.   The patient fhould be fre-
quently put into the warm bath for an hour at a time.
Eighty or  an hundred  drops of laudanum given in a
clyfter, with two drams of turpentine, is to be pre-
ferred to  the  two grains given by the ftomach as
above, when the pain and vomiting  are very urgent.

   10.  Calculus vefica.  Stone of the bladder.   The
nucleus,  or  kernel,  of thefe concretions is  always
formed in  the  kidney, as above defcribed; and paf-
fing  down  the ureter  into the bladder,  is there per-
petually  increafed by  the mucus  and  falts  fecreted
from the arterial fyftem, or by the mucus of the blad-
der, difpofed in  concentric ftratn.   The  ftones  found
in the bowels of  horfes are  alfo formed On a nucleus,
                       E 3                    and 
54               DISEASES      [ClassI. 1.3.
and confift of concentric  fpheres; a^ appears  in faw-
ing them through the middle.   But as thefe are form-
ed  by  the  indurated  mucus  of  the inteftines alone
without the  urinary falts,  it is  probable a difference
would be found on their analyfis.
  As the ftones of the bladder are of various  degrees
of hardnefs, and  probably differ  from each other  in
the proportions  at leaft  of their component parts ;
when a patient, who  labours  under this afflicting dif-
eafe,  voids any fmall  bits of  gravel; thefe Should be
kept in warm  folutions of cauftic alkali, or  of  mild
alkali well aerated ; and if they diflblve in thefe folu-
tions, it would afford  greater  hopes,  that  that which
remains in  the bladder,  might be  affected  by thefe
medicines  taken  by the ftomach,  or injected  into the
bladder.
   To  prevent the increafe of a Stone in the  bladder
much diluent drink fhould 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 microcofmic  falts  from being
precipitated from the urine, and by keeping the mu-
cus fufpended in it; but will  alfo diminifh the  ftone
already formed, by foftening  and wafliing  away  its
furface.   To this muft be added cool drefs,  and cool
bed-clothes, as directed above in the calculus renis.
   When the ftone is  pufhed againft or into  the neck
of  the  bladder, great  pain  is produced; this  may
fometimes be  relieved by the  introduction of a bou-
gie to pufh  the ftone  back into the fundus of the blad-
                                               der, 
Class I. 1.3.]    OF IRRITATION.               55
der.  Sometimes by change of pofture, or by an or U
ate either taken into the ftomach, or by a clyfter.
   A dram of fal foda, or of fait  of tartar, diflblved in
a pint of water, and well faturated with carbonic acid
(fixed air), by means of Dr. Nooth's glafs-apparatus,
and drank every day, or twice a day, is the moft effi-
cacious internal  medicine yet difcovered,  which can
be eafily taken without  any general injury to the con-
stitution.   An aerated alkaline  water of this kind is
fold under the name of factitious Seltzer wTater,  by J.
Schweppe,  at  N°  8,  King's Street, Holborn, Lon-
don ; which  I am told is better  prepared than can be
eafily done in the ufual glafs-veffels, probably by em-.
ploying a greater prefTure  in  wooden ones.
   Lythotomy is  the laft recourfe.  Will  the  gaftric
juice of  animals  diifolve calculi ? Will fermenting ve-
getable juices, as fweet-wort, or fugar and water in
the act of fermentation  with yeft, diifolve any  kind
of animal concretions ?

   n.   Calculus arthriticus.  Gout-ftones are formed
on inflamed  membranes,  like thofe  of  the kidneys
above  defcribed, by the too  hafty abforption of the
thinner and  Saline  parts of the  mucus.   Similar con-
cretions have been  produced in the lungs, and  even
in the pericardium ;  and it is probable, that the offi-
fication,  as it is called, of the minute arteries, which
is faid to attend old age,  and  to  precede fome mor-
tifications of the extremities, may be a  proccfs  of
this kind. 
5«               DISEASES      [Class I. 1.3.
   As gout-ftones lie near the furface,  it is probable,
that ether,  frequently applied  in  their early State,
might  render them fo liquid as  to  permit  their re-
abforption;  which the Stimulus  of the ether  might
at the fame  time encourage.

   12.  Rheumatifmus chronicus*   Chronic rheumatifm.
After the acute  rheumatifm fome  infpiflated  mucus,
or material fimilar to chalk-ftones of the gout, which
was fecreted on  the  inflamed membrane, is probably
left, owing to the too hafty abforption of the thin-
ner and faline part of it;  and by  lying on the faf-
cia, which covers fome  of the mufcles, pains them,
when they move and rub againft it,  like any extra-
neous material.
   The pain of the Shoulder, which  attends inflamma-
tions of the  upper membrane of the liver, and the
pains of  the arms, which attend afthma dolorificum,
or  dropfy of the pericardium, are distinguished from
the chronic  rheumatifm,  as in the  latter  the pain
only occurs  on  moving the  affected mufcles.
   M. M.  Warm bath,  cold  bath, bandage  of em-
plaftrum  de  minio  put on  tight, fo  as to comprefs
the part.-  Cover the part with flannel.  With oiled
filk.   Rub  it with common oil frequently.   With
ether.   A blifter.  A warmer climate.  Venefection.
A  grain  of calomel  and a grain of  opium for tea
fuc:effive  nights..  The Peruvian bark.

   13,  Cicatrix  vulnerum.   The fear after wounds.
jn the healing of ulcers  the matter is  firft thickened
                                               by 
Class I. i. 3.]     OF IRRITATION.               ^
by increafing the abforption in them; and then leflen-
ed, till all  the matter is abforbed, which is brought
by the arteries, inftead of being depofited in the ulcer.
  M. M. This is promoted by bandage, by the for-
bentia externally,  as powder of bark, white  lead;
folution of fugar of lead.   And by the forbentia  in-
ternally after evacuations.   See Sect, XXXIII. 3. 2.
  In thofe ulcers, which are made by  the  contact of
external fire, the  violent action of the  fibres, which
occafions the pain, is liable to continue, after the ex-
ternal heat is withdrawn.  This fhould be relieved by
external cold,  as of fnow, fait and water recently mix-
ed, ether, or Spirits of wine fuffered 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  feveral  places at the
fame time ; which probably contributes to the uneven-
nefs of large fears.

   14.  Cornea  obfufcatio*    Opacity of the cornea.
There are few people, who have paffed  the middle of
life, who have not at fome time fuffered fome flight
fcratches or injuries of the cornea, which by not heal-
ing with a perfectly fmooth furface, occafion fome re-
fractions of light, which may be  conveniently feen in
the following manner:  fill a  tea-faucer 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 13ne> or  bio- dies en the  furface of the
                                              fluid, 
5$                DISEASFrS      [Class I. 1.3.
fluid, with a lefs white appearance than that furface.
Thofe blemifhes of the eye are diftinguifhed  from the
mufce volitantes defcribed in Clafs I. 2. 5. 3. by their
being invariably feen at any time, when you look for
them.
  Ulcers may frequently be  feen on the  cornea after
ophthalmy,  like little pits or indentations  beneath the
furface of  it:  in this  cafe  no  external   application
fliould be ufed, left the fear fliould be left uneven ;
but the cure fliould be confined to the internal ufe  of
thirty grains of bark  twice a  day, and  from five  to
ten drops of laudanum at night, with five grains  of
rhubarb, if neceflary.
  After ulcers of the cornea, which have  been large,
the inequalities  and  opacity  of the cicatrix obfeures
the fight; in this cafe could not  a fmall  piece of the
cornea be cut  out by a kind of trephine about the
Size of a thick brittle, or a fmall crow-quill, and would
it not heal with a tranfparent fear ? This experiment
is worth trying, and might be done by a  piece of hol-
low  fteel wire with a Sharp  edge, through which
might be introduced a pointed fteel fcrew  ;  the fcrew
to be introduced through the opake cornea to hold it
it up, and prefs it againft the cutting edge of the hol-
low wire  or cylinder ; if the fear Should heal without
lofing its  tranfparency, many blind  people might  be
made to fee tolerably well by this flight and not pain-
ful operation.   An experiment I wifh Strongly to  re-
commend to fome ingenious furgeon or oculift.
ORDO 
Class I. 1.4.]     OF IRRITATION.
59
                   ORDO  I.
                 Increafed Irritation*

                  GENUS  IV.
With increafed Aclions of other Cavities and Membranes*

                   SPECIES.

   1.  ISliclitatio irritativa.   Winking  of the eyes is
performed every minute without our attention, for the
purpofe  of  cleaning  and moiftening  the eye-ball; as
further fpoken of in Clafs II. 1. 1. 8.  When  the
cornea becomes too dry,  it becomes  at the fame time
lefs tranfparent; which is owing to the pores of it be-
ing then too large, fo that  the particles of light  are
refracted by the edges of each pore, inftead of paifing
through it; in the fame manner as light is refracted
by pafling near the  edge of a knife.    When thefe
pores are filled with water, the cornea becomes again
tranfparent.   This want of transparency of the cor-
nea is vifible fometimes in dying people, owing to their
inirritability, and confequent neglect of nictitation.
   The increafe of tranfparency by  filling the  porei
with  fluid  is feen by foaking white  paper in oil;
which from an opake body becomes  very  tranfpa-
rent, and accounts  for a  curious atmofpheric  phe-
nomenon;-when there exifts a dry-mift in a  morning
fo  as to render  diftant objects  Ufs  diftinct, it  is a
fign  of a dry day;   when diftant objects  are feen
                                               very 
6o
DISEASES
[Class I. 1.4.
very diftinct, it is a fign of rain.   Sec Botan. Garden/
Part I. add. note xxv.   The particles  of air are pro-
bably larger than  thofe of water, as  water will pafs
through  leather and paper, which  will confine air ;
hence when the atmofphere is much deprived  of moi-
fture, the^pores of the dry air are fo large, that the
rays of light are  refracted by their  edges inftead of
paSEng through them.   But  when as  much moifture
is added as  can be perfectly diflolved, the air becomes
tranfparent; and  opake  again, when a part of  this
moifture collects into  fmall  fpherules previous  to its
precipitation.   This alfo accounts for  the want of
transparency of the air, which is feen in tremulous mo-
tions  over  corn-fields  on hot  fummer-days, or over
brick-kilns,  after the flame is extinguifhed, while the
furnace ftill remains hot.

   2.  Deglufitio irritativa.   The deglutition of our fa-
liva is performed  frequently without! our attention,
and is then  an  irritative action in confequence  of the
ftimulus of  it in the mouth.   Or perhaps  fometimes;
for the purpofe of diffufing a part of  it  over  the dry
membranes  of the fauces and  pharynx ; in the fame
manner  as tears are diffufed over the cornea of the
eye by the act  of nictitation to clean or moiften it.

   3. Refpiratio et Tuffs irritativa.   In the acts of re-
fpiration and of coughing there is an increafed motion*
of the air-cells  of the lungs owing to fome  ftimulating
caufe,  as defcribed above in  Clafs  I.  1. 2. 8. and I.
                                            1. 3. 4. 
Class I. r. 4.]     OF IRRITATION.               *i
1. 3. 4.  and which are frequently performed without
our attention or confcioufnefs,  and are then  irritative
actions ;  and thus differ  from thofe defcribed in Clafs
II. 1. 1.  2. and  5.   To  thefe increafed actions of the
air-cells are fuperadded thofe of the intercoftal mufcles
and  diaphragm  by irritative  aflbciation.   When any
unnatural ftimulus acts fo violently on the organs of
refpiration as to  induce  pain,  the fenforial power of
fenfation becomes added to that of irritation, and in-
flammation of the membranes of them is a general con-
fequence.

   4. Exclufio bills.   The exclufion  of the  bile from
the gall-bladder, and its  derivation into the duodenum,
is an irritative action in confequence of the ftimulus of
the aliment on the extremity of the biliary duct, which
terminates in the inteftine.   The increafed fecretion
of tears  is  occafioned in a fimilar manner by any fti-
mulating material in the eyes;  which affects the  ex-
cretory ducts of the lacrymal glands. A pain of the
external membrane of the eye  fometimes attends any
unufual  ftimulus of it, then the fenforial power of fen-
fation becomes  added to that of irritation,  and a fo-
perficial inflammation  is induced.

   5.  Dentitio.    Toothing.   The  pain of toothing
 often begins much earlier than is fufpected ;  and is
 liable to produce convulfions; which are  fometimes
 relieved, when  the gum fvvells, and becomes inflamed y
 at other times a  diarrhcea Supervenes, which is gene-
                                                rally 
6z               DISEASES      [Class I. i. 4.
rally efteemed a favourable circumftance, and feems to
prevent the convulfions by fupplying another means of
relieving the  pain of dentition by irritative exertion ;
and a  confequent  temporary exhauftion of fenforial
power.   See  Clafs I.  1.2. 5. Sect. XXXV. 2. 1.
  The convulfions from toothing generally commence
long before the appearance of the teeth ;  but as  the
two middle incifors of the lower jaw generally appear
firft, and then thofe of the upper, it  is advifeable to
lance the gums over thefe longitudinally in refpect to
the jaw-bones, and quite down to the periofteum, and
through it.
  As the convulfions  attending the commencement of
toothing are not only dangerous to life in their greateft
degree, but are liable to induce Stupor or infenfibility
by their continuance even in a lefs  degree, the moft
efficacious means Should be ufed to cure them.
  M. M. Lance the gum of the expected teeth quite
through the  periofteum  longitudinally.   Venefection
by the lancet or by two or three leeches   One grain
of calomel as a purge.  Tincture of jalap, five or fix
drops in water every three hours till  it purges, to be
repeated daily.   After evacuations a fmall  blifter on
the back or behind  the  ears.   And laftiy, two or
three drops of laudanum  according  to the age of the
s.'.l;L&.   Warm bath.   See Clafs III. 1. 1. 5. and 6.

  6.  Priapifmus chronicus.   I have  feen  two cafes,
where  an erection  of the penis, as hard ,as horn, con-
\inued two or three weeks  without any venereal de-
                                              fires,, 
Class I. 1.4.]     OF IRRITATION.               63
fires, but  not without fome pain;  the eafieft attitude
of the patients was lying upon their backs with their
knees up.  At length the corpus cavernofum urethre
became foft, and in another day or two the whole fub-
fided.  In  one of  them  a bougie  was  introduced,
hoping to remove fome bit of gravel from the caput
gallinaginis, camphor, warm  bathing,  opium,  lime-
wrater, cold afperfion, bleeding in the veins of the pe-
nis, were tried in vain.   One  of them had been a free
drinker, had much gutta rofacea  on his face, and died
fuddenly a few months after  his  recovery  from this
complaint.   Was it  a paralyfis of the terminations of
the veins, which abfprb the blood from the tumid pe-
nis ? or from  the ftimulus of indurated femen in the
feminal veflels ? In  the latter  cafe fome venereal de-
fires fhould have attended.  Clafs  III. 1. 2.  16.
   The priapifmus, which occurs to vigorous people in
the morning before  they awake,  has been called the
fignum falutis, or banner of health, and is occafioned
by the increafe of our irritability or fenfibility during
fleep, as explained in Sect. XVIII. 15.

   7. Difientio mamularum.  The diftention of the nip-
ples  of ladtefcent women is at firft owing to the fti-
mulus of the  milk.    See  Sect.  XIV. 8.  and Sect.
XVI. 5.  See Clafs  II.  1. 7. 10.

   8.  Defcenfus uteri.   This is a  very frequent  com-
plaint after bad  labours,  the fundus uteri  becomes
hvened and  defcends  like the prolapfus  ani.
                                        M,  M. Ail 
64               DISEASES      [Class I. i. 4.
  M. M.  All  the  ufual peflaries are very inconve-
nient and ineffectual.  A piece of foft  fponge about
two inches diameter introduced into  the vagina gives
great eafe to thefe  patients, and fupports the uterus ;
it fhould  have  a String put  through it to retract it
by.
  There  are alfo peflfaries now made of elaftic gum,
which are faid to be  eafily worn,  and  to be conve-
nient, from their having a perforation in their centre.

  9.  Prolapfus ani*  The  lower  part of the rectum
becomes inverted, and defcends after every ftool chiefly
in children; and thus Stimulates the fphincter ani like
any other extraneous  body.
  M. M.  It Should be dufted over with very  fine
powder of gum fandarach, and then replaced.  Astrin-
gent  fomentations;  as an  infufion of oak-bark, or a
flight folution  of alum.    Horizontal reft frequently
in  the  day.

   10. Lumbricus.   Round  worm.   The round worm
is fufpedted in children when the belly is tumid, and
the countenance bloated and pale,  with Swelling of
the upper lip.   The generation of thefe worms is
promoted by  the too dilute State of the bile,  as is
evident in the fleuke-worm found in  the biliary ducts
and fubftance of the  liver  in  fheep ;  and in  water-
rats,  in  the livers of which laft animals they were
lately detected in  large  numbers  by  Dr.  Capelle*
Tranfactions of the College at Philadelphia, v.  i.
                          z                   Now 
 Class I. i. 4.]     OF IRRITATION.               6$
   Now as the dilute Slate of the  bile depends on the
 deficiency  of the abforption  of  its thinner parts, it
 appears, that the tumid belly, and bloated counte-
 nance, and Swelled  upper lip, are a concomitant cir-
 cumftance  attending the  general  inactivity of the ab-
 forbent fyftem ;  which is therefore to be efteemed the
 remote caufe of the generation of  worms.
   The  fimplicity of the Structure  of worms probably
 enables them to exift in more various temperatures of
 heat; and their being endued  with life prevents them
 from being deftroyed by digeftion  in the ftomach, pro-
 bably in  the fame manner  as  the powers of life pre-
 vent the fermentation and putrefaction of the ftomach
 itfelf.  Hence I conclude,  that worms are originally
 taken into  our  alimentary canal  from without;  as I
 believe fimilar worms of all kinds  are to be found out
 of the body.
   M. M. The* round worm is deftroyed by a cathar-
 tic with four or fix grains of calomel; and afterwards
 by giving fix or  eight grains of filings of iron twice a
 day  for  a fortnight.   See Hepatis tumor, Clafs I.
 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
 flefli, fince in thofe fevers from the enfeebled action of
 the inteftines the feces become highly putrid ?

   11.  Tania.  Tape-worm confifts of a chain of ani-
mals extending from the ftomach to the anus.   See
Sect. XXXIX. 2. 3.  It frequently exifts in cats,  rats,
and gecfe, and probably in many other animals.
                        F                    The 
66               DISEASES      [Class I. i. 4.
  The worms of this genus poffefs a wonderful power
of retaining life.  Two of them, which  were voided
by a pointer dog in confequence of violent purgatives,
each of whicji were feveral feet in length, had boiling
water poured on them in a bafon ; which feemed not
much to inconvenience  them.   When  the w ater was
cool, they were taken out and put into gin or whilkey
of the Strongest kind, in which their life and  activity
continued unimpaired; and they were at  length killed
by adding to the fpirit a quantity of  corrofive fubli-
mate.   Medic. Comment, for  1791,  p. 370.
  The tape-worm is cured by an amalgama of tin and
quickfilver,  fuch as  is  ufed  on the back of looking-
glaffes; an ounce fhould be  taken  every two hours,
till a pound is taken; and then a bri/k cathartic of
Glauber's  fait  two  ounces,  and common falts one
ounce,  diffolved in  two wine pints of water, half a
pint to be taken every hour till it purges.  The worm
extends from the ftomach to the anus, and the amal-
gama tears it from  the inteftine by mechanical pref-
fure, acting upon it the whole way.   Electric fhocks
through the duodenum greatly affifts the operation.
Large dofes of tin  in powder.  Iron  filings in  large
4ofes.   The  powder of fern-root feems to be of no
ufe, as recommended by M. Noufflier.

   12. Afcarides.  Thread-worms.  Thefe worms are
faid to be more frequent  in fome  parts  of this  king-
dom than in others, as near the fens of Lincolnfhire.
Do they efeape from the  body and become flies, like
the bott-worm in horfes ? Do they crawl from one
                                             child 
  Class I. i. 4.]    OF IRRITATION.              €7
  child to another in the fame bed ? Are they acquired
  from flies or  worms,  which are feen in putrid necef-
  fary houfes, as thefe worms as well as the tape-worms^
  are  probably acquired  from  without ? this may ac-
  count for their re-appearance  a few weeks or  months
  after they have .been deftroyed;  or can  this  happen
  from the eggs or parts of them remaining ?
    Afcarides appear to be of two kinds,  the common
  fmall ones like a thread; which has a very Sharp head,
  as appears in the microfcope;  and which is fo  tender,
  that the cold air foon  renders it motionlefs;  and a
  larger kind above an inch long, and nearly as thick as
.  a very fmall crow-quill,  and which is very hard in re-
  fpect to its texture, and very tenacious of life.  One of
  thefe laft was  brought  to  me, and  was  immediately
  immerfed in a ftrong folution of fugar of lead, and lived
  in it a very long time without apparent inconvenience.
    M.  M.  Afcarides are faid to  be weakened  by
  twenty grains of cinnabar and five of rhubarb taken
  every  night,  but not to be  cured  by this procefs.
  As  thefe worms  are found only in the rectum, variety
  of clyfters have been recommended.   I was informed
  of a cafe, where folutions of mercurial ointment were
  ufed as  a clyfter every  night for a month without
  fuccefs.   Clyfters  of Harrowgate water are recom-
  mended, either of the  natural,  or  of the  factitious,
  as defcribed below, which might  have a greater pro-
  portion  of liver  of  fulphur in it.   As  the cold air
  fo©n deftroys them, after they are voided, could cly-
  fters of iced  water  be  ufed with advantage?  or of
                        F  2                   fpirit. 
6S
DISEASES      [Class I. i. 4.
fpirit  of wine and water ? or  of ether  and water ?
M}ight not a  piece of candle,  about an inch long, or
two fuch pieces, fmeared with mercurial ointment, and
introduced into the anus at night,  or twice a day, be
effectual by compreSfing their nidus, as well as by the
poifon of the mercury.
  The  clyfters fhould be  large in  quantity, that they
may pafs high in the  rectum,  as two drams of to-
bacco boiled a minute in a pint  of water.  Or per-
haps  what  might  be ftill more efficacious and  lefs
inconvenient,  the fmoke of tobacco injected by a pro-
per apparatus every night, or alternate nights,  for
fix or eight  weeks.  This was  long fince recommend-
ed, I think   by  Mr. Turner of Liverpool;  and the
reafon it has not  fucceeded, I believe  to  have been
owing to the imperfections of the joints of the com-
mon apparatus for injecting  the  fmoke  of  tobacco,
fo that  it did not pafs into  the  inteftine, though it
was  fuppofed to  do fo,  as  I once obferved.    The
fmoke fliould be received from the apparatus  into a
large bladder; and  it  may then  be certainly injected
like  the common clyfter with, fufficient force  ; other-
wife oiled leathers fhould be  nicely put  round the
joints of the machine  ;  and a wet cloth  round the
injecting pipe to prevent the  return of the fmoke by
the fides of  it.    Clyfters of carbonated hydrogen
gas, or  of other factitious airs, might be  tried.
  Harrowgate water taken into the ftomach, fo as to
induce  fix or feven ftools every morning, for four or
fix weeks,  is perhaps the moft efficacious  method in
                                           common 
Class I. i. 4.J    OF IRRITATION.              €9
common ufe.  A factitious Harrowgate water may be
made probably of greater efficacy than the natural, by
diflblving  one ounce of marine fait, (called  bay fait)
and half an ounce of magnefia Glauber's fait,  (called
Epfom fait,  or  bitter purging  fait)  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-fpoonful of a folution  of
liver of fulphur,  which is to be made by putting an
ounce of hepar fulphuris into half a pint of water. See
Clafs IV. 1.  2. 9.

   13. Dracunculus.   A thin worm brought from the
coaft of Guinea.   It is found in the  interftices of the
mufcles, and is many yards long; it makes a fmall ul-
cer ; which is cured by extracting an inch of the worm
a day, and  wrapping the extracted part  flowly round
a bit of tobacco pipe till next day,  fo  as  not to break
it.  I have twice feen long worms, like a thick horfe-
hair, in water in July in this country,  which appeared
hard and jointed.

   14.  Morpiones.   Crab-lice.    The  excrement of
this animal  ftains the linen, and appears like  diluted
blood.
   M. M.  Spirit of wine. Mercurial ointment,  Shaving
the part.  Oil deftroys other infects,  if they be quite
covered with it,  as the ticks on dogs5  and would pro-
bably therefore  deftroy thefe.  Its manner  of opera-
tion  is  by flopping up or filling  their  fpiracula,  or
                        F 3                breathing 
7«                DISEASES       [Class^. 1.5.
breathmg pores; a few drops of oil poured on a wafp,
fo as to cover it, deftroys it in a few fecon<Js.

   15.   Pediculi*   Lice.  There is  faid to be a dif-
eafe, in which  thefe animals  are propagated in inde-
ftructible number*, fo as to deftroy the patient.
   M. M. Cleanlinefs, mercurial ointment, ftavis acria
in powder, or the  tincture of it in fpirit of wine.  Spi-
rit of wine alone ?  Bath of oil ?
                    ORDO  I.
                Increafed Irritation*

                   GENUS  V.
    With increafed Aclions of the Organs of Senfe*

                   SPECIES.
   1.  Vifus  acrior*   Acuter  fight.  There have been
inftances of people, who could fee better in the gloom
of the evening, than in the ftronger light of the day ;
like owls, and bats, and many quadrupeds, and flying
infects.   When the eye is inflamed, great, light be-
comes eminently painful, owing to the  increafed irri-
tative motions of  the  retina, and the  confequent in-
creafed fenfation.   Thus when the eye is dazzled with
fudden  light, the  pain is not owing  to  the  motion of
the iris; for it is  the  contraction  of the iris, which
relieves the pain  from  fudden light;  but  to the too
                                              violent 
Class I. i. 5.]]     OF IRRITATION.               71
violent  contractions of the moving fibres, which con*
ftitute the extremities of the optic nerve.

   2. Auditus acrior.   The irritative ideas of hearing
are fo increafed  in energy as to excite our attention.
This  happens in fome difeafes  of the epileptic kind,
and in  fome fevers.   Hence the whifpering of the
currents of  air in a room, the refpiration of the com-
pany, and noifes  before unperceived, become trouble-
fome;  and founds  louder than ufual,  or unexpected,
produce flarting, and convulfions.
   M. M. Put oil of almonds into the ears.   Stop the
meatus auditorius with cotton wool.   Set the feet of
the patient's bed on  cufliions, or  fufpend it by  cords
from the ceiling.

   3.  Olfaclus  acrior.  The  irritative ideas of fmell
from the increafed  action  of the olfactive nerve excite
our attention.  Hence common odours  are  difagree-
able; and are perceived from variety of objects, which
were before thought  inodorous.  Thefe are commonly
believed to be hallucinations of the fenfe.
   M. M.  Snuff ftarch up  the noftrils.

   4.  Guflus acrior*   The irritative ideas of tafte, as
of our  own faliva, and even of the atmofpheric  air,
excite our attention ; and common taftes are difagree-
ably ftrong.
   M. M. Water. Mucilage.  Vegetable acids. Scrape
the tongue clean. Rub it  with a fage-leaf and vinegar.
                       F 4               5. Taclus 
72               DISEASES      [[Class I. i. 5.
   5.  Taclus acrior.   The irritative ideas of the nerves
of touch excite our  attention : hence  our own pref-
fure on the parts, we reft upon, becomes uneafy, with
univerfal forenefs.
  M. M.  Soft feather-bed.   Combed wool put under
the patients, which rolls under them as they turn,  and
thus prevents their friction againft the Sheets.   Draw-
ers of foft leather.   Plafters of cerate with calamy.

   6.  Senfus caloris acrior.   Acuter fenfe of heat  oc-
curs in fome difeafes, and that even when the percep-
tible heat does not appear greater than natural to the
hand  of another perfon.   See Clafs  I. 1.  2.  See
Sect.  XIV. 8.   AH  the above increafed  actions of our
organs of fenfe Separately or jointly accompany fome
fevers, and fome epileptic difeafes ; the patients com-
plaining of the perception of the leaft light, noifes in
their ears^ bad fmells in the room, and bad tafles in
their mouths, with forenefs, numbnefs, and  other un-
eafy feels, and with difagreeable fenfations of general
or partial beat.

    7.  Senfus extenfionis acrior.  Acuter fenfe of exten-
 sion.   The fenfe of extenfion was fpoken of in  Sect.
 XIV. 7. and XXXII. 4.   The defect of diftention in
 the arterial fyftem is accompanied with faintnefs; and
 its excefs with fenfations  of falnefs, or weight, or
 preffure^  This however refers  only to the vafcular
 mufcles, which are  diftended by their appropriated
 £uids; but the longitudinal mufcles are alfo affected
                                                  by 
Class I. i. 5.]     OF IRRITATION.               .73
by different quantities of extenfion,  and become vio-
lently painful  by the excefs of it.
  Thefe pains of mufcles and of membranes are gene-
rally  divided into acute  and dull pains.  The former
are generally owing to  increafe  of extenfion,. as in
pricking the ikin with a needle; and the latter gene-
rally  to defect of extenfion,  as in cold head-achs;  but
if the edge of a knife, or point of a pin, be gradually
pre/Ted  againft  the fibres of mufcles  or  membranes,
there would feem  to be three Slates or ftages of  this
extenfion of the fibres ; which have acquired  names
according to the degree or kind of fenfation produced
by the  extenfion of them;  thefe  are  1. titillation or
tickling. 2. itching, and the 3. fmarting ;  as defcribed
below.   See  Sect. XIV. 9.

   8. Titillatio.   Tickling is a pleafurable pain of the
. fenfe of extenfion above mentioned,  and therefore ex-
 cites laughter; as defcribed in Sect.  XXXIV.  1. 4.
 The tickling  of the noftrils,  which precedes the efforts
 of fneezing,  is owing  to the  increafed irritation occa-
 fioned  by externa?! ftimulus ;  and is attended with a
 pleafurable fenfation in confequence of the increafed
 action of the  part.   When this action is exerted in a
 greater degree, the fenfation becomes painful, and the
 convulfion  of  fneezing  enfues;  as  the pain in tick-
 ling  the foles  of  the  feet of  children is relieved by
 laughter.
   A lady after a bruife on her nofe by  a fall wras af-
 fected  with inceffant fneezing, and relieved by fnuf-
                                                 fing 
74                DISEASES      [Class!. 1.5.
fing ftarch up her noftrils.  Perpetual fneezings in the
meafles, and in catarrhs  from cold,  are owing to the
ftimulus of the faline part  of the mucous  effufion on
the membrane of the noftrils.   See Clafs II. 1. 1.  2.

  9. Pruritus*    Itching feems  to  be a  greater  de-
gree of titillation, and to  be owing to the ftimulus
of fome acrid material,  as the  matter of the itch;
or of  the herpes  on the  fcrotum,  and about  the
anus;  or from thofe univerfal eruptions, which at-
tend fome elderly people,  who have  drank much vi-
nous fpirit.  ' It occurs alfo, when  inflammations  are
declining, as in the healing of blifters, or in the cure
of ophthalmia, as the action of the veffels  is yet fo
great as to produce  fenfation; which, like the titil-
lations that occafion laughter, is perpetually changing
from pleafure to  pain.
  When the natural efforts of Scratching  do not re-
lieve the pain of  itching,  it fometimes increafes fo as
to induce convulfions and  madnefs.   As in the furor
uterinus, and fatyriafis,  and in the  fphincter ani  and
fcrotum.  See Clafs  II. 1. 4. 14. IV. 2. 2. 6.
  M. M. Warm  bath.   Fomentation.  Alcohol  ex-
ternally.  Poultice.   Oiled filk.  Mercurial ointments
on  fmall furfaces  at  once.   See Clafs II.  1.  4.  12.
Solutions of lead on  fmall furfaces at once.

   10.  Dolor urens.   Smarting follows the edge of a
knife in making  a wound, and feems to be owing
to  the  distention of a part of a fibre, till it  breaks.
                                          A fmart- 
Class I. 1/5.]    OF IRRITATION.               n
A fmarting of the ikin  is liable to affect the  fears
left by herpes or fhingles; and the callous parts of
the bottoms  of the feet; and around  the  bafes of
corns on the  toes; and frequently  extends  after fci-
atica along the outfide of the thigh, and of the leg,
and  part of  the foot.   All  thefe may  be  owing to
the Stimulus  of extenfion, by  blood or  ferum being
forced into veffels nearly  coalefced.
   M. M.  Emplaftrum de minio put like a bandage
on the  part.    Warm fomentation.   Oil  and camphor
rubbed on the part.   Oil-Silk covering.   A blifter
on the part.   Ether, or alcohol, fuffered to evapo-
 rate on the  part.

   11.  Conflernatio.  Surprife.   As our eyes acquaint
 us at  the  fame time  with lefs than half of the ob-
jects,  which furround  us,  we have learned to con-
 fide much in  the organ of hearing to warn us  of
 approaching dangers.  Hence it happens, that  if any
 found Strikes us, which we  cannot immediately ac-
 count for, our fears  are inftantly alarmed.  Thus in
 great  debility of body, the loud clapping of a door,
 or the fall of a fire-fhovel, produces alarm, and fome-
 times  even convulfions; the  fame occurs from unex-
 pected fights, and in the dark  from unexpected ob-
 jects of touch.
   In  thefe cafes  the  irritability is  lefs  than natural,
 though it  is erroneoufly fuppofed to be greater ; and
 the mind  is bufied in exciting a train  of  ideas inat-
 tentive to external objects 5  when  this train of ideas
                                                  is 
 J6              DISEASES      CClassI. 1.5.
 is diffevered by any unexpected ftirimlus, furprife is
 excited; as explained in Sect. XVII. 3. 7. and XVIH.
 17.  then as the fenfibility in thefe cafes  is greater,
 fear becomes fuperadded to  the furprife;  and  con-
 valfions in confequence of the pain of fear.  See Sect.
 XIX. 2.
   The  proximate  caufe 6f furprife is  the increafed
irritation induced  by fome violent ftimulus,  which
diflevers  our ufual trains of ideas; but in difeafes of
kimtabiiity the frequent  ftarting  or furprife  from
founds not uncommon,  but rather louder  than ufual,
as the clapping of a door, Shews*  that  the attention
of the patient to a train of fenfitive ideas was pre-
vioufly Stronger  than  natural,  and indicates an  inci-
pient delirium;  which  is  therefore worth attending
to in febrile difeafes.
ORDO 
Cla$s I. 2. i.]     OF IRRITATION.
7?
                   ORDO   II.
                Decreafed Irritation.
                   GENUS  I.
   With decreafed Aclion of the Sanguiferous Syfiem.
  The. reader fhould be here apprifed, that the words
ftrength and debility, when applied to animal motions,
may properly exprefs the quantity of refiftance  fuch
motions may overcome; but that,  when they are ap-
plied to mean the  fufceptibility or infufceptibility  of
animal fibres  to motion,  they become  metaphorical
terms; as in Sect. XII.  2.  1. and would be better ex-
preffed by the words activity and inactivity.
  There are three foqrces of animal inactivity ;  firft,
the defect of the natural quantity of ftimulus  on thofe
fibres, which have been accuftomed to perpetual ftimu-
lus ; as the arterial and fecerning fyftems.  When their
accuftomed ftimulus is for a while intermitted, as when
fnow is applied to the ikin of the hands, an accumula-
tion  of fenforial power is produced  ; and then a degree
of Stimulus, as of heat,  fomewhat greater than that at
prefent applied,  though  much lefs  than  the natural
quantity, excites the veffels of the ikin  into violent
action.  We muft obferve, that a deficiency  of ftimu-
lus in thofe fibres, which are not fubject  to perpetual
ftimulus, as the locomotive mufcles, is not Succeeded
by accumulation of  fenforial power; thefe therefore
are more liable to become  permanently inactive after
a diminution  of ftimulus;  as  in Strokes of the palfy,
this  may be called inactivity from  defect of ftimulus.
                                             2.  A 
78
DISEASES      [Class I. 2. 1.
   2.  A fecond fource of animal inactivity exifts, when
the fenforial power in  any part of the fyftem has
been  previoufly exhaufted by violent ftimuli;  as the
eyes after long expofure to great light; or  the fto-
mach, to repeated fpirituous potation; this  may be
termed inactivity from  exhauftion of fenforial power.
See Sea. XII.  2. r.
   3.  But there is a third fource of inactivity owing to
the deficient production of fenforial power  in  the
brain ; and  hence ftimuli Stronger than natural are re-
quired to produce the accuftomed motions  of the ar-
terial fyftem;  in this cafe there is no accumulation of
fenforial  power produced;   as in the inactivity owing
to defect of ftimulus;  nor  any previous exhauftion of
it, as in  the inactivity owing to excefs of ftimulus.
   This third  kind  of inactivity  caufes  many of the
difeafes of this genus; which are therefore in general
to be remedied by fuch medicines as promote a greater
production  of fenforial  power  in the  brain;  as the
incitantia, confifting of wine, beer, and opium, in fmall
repeated  quantities; and fecondly of fuch  as  Simply
Stimulate the arterial and glandular  fyftem into their
natural actions; as  fmall repeated blifters, fpiees, and
effential oils.  And laftly the forbentia, which  contri-
bute to  fupply the more  permanent ftrength  of the
fyftem, by promoting the abforption of nourifhment
from the ftomach, and  inteftines; and  of the fuper-
fluous  fluid, which attends the fecretions.
SPECIEG 
Class I 2. 1.]     OF IRRITATION.
:$
                    SPECIES.
   1.  Febris inirritativa.  Inirritative  fever.  This  is
the typhus mitior,  or nervous  fever of fome writers;
it is attended  with  weak pulfe without  inflammation,
or fymptoms  of putridity, as  they  have been called,
When the production of fenforial power in the brain
is lefs than ufual,  the pulfe becomes quick as well as
weak;  and  the  heart  fometimes  trembles like  the
limbs of  old  age,  or  of enfeebled  drunkards ;  and
when this  force of the contractions of the heart and
arteries is diminifhed, the blood is pufhed on with lefs
energy, as well as in lefs quantity, and  thence its fti-
mulus on  their fides is diminifhed m a duplicate ratio.
In comprefiions of the brain, as in apoplexy, the pulfe
becomes flower and fuller; for in that difeafe, as in
natural  fleep, the irritative motions of the heart and
arteries are not diminiflied, volition alone is fufpended
or deftroyed.
   If  the abforption of the terminations of the veins
is not equally impaired with  the force  of the  heart
and arteries,  the blood is taken  up by the veins  the
inftant it  arrives at  their extremities;  the capillary
veflels are left empty,  and there is lefs  refiftance to
the current of the blood from  the arteries; hence the
pulfe becomes empty, as well as weak  and  quick ; the
veins  of the  Skin  are fuller than the arteries of it;
and its appearance becomes pale,  bluifh, and Shrunk.
See Clafs  II. 1. 3. 1.
When 
 8&                DISEASES       [Class I. 2.1
   When this pulfe perfifts  many hours, it conftitutes
 the febris inirritativa, or typhus, or nervous fever, of
 fome writers ; it is attended with little heat, the urine
 is generally of a natural colour, though in lefs quan-
 tity ; with great proftration of ftrength, and much dif-
 turbance of the  faculties of the mind.   Its immediate
 caufe feems to be a deficient fecretion of the  fenforial
 power from  the inaction of the brain ; hence almoft
 the whole of the fenforial  power is expended  in  the
 performance of the motions neceffary to life, and little
 of it  can be fpared for the voluntary actions of  the
 locomotive  mufcles, or  organs of fenfe, fee  Clafs I.
 2. 5.  3.   Its more remote caufe may be from a para-
 lyfis  or death of fome other part  of the body ; as of
 the fpleen, when a  tumour is  felt  on the left fide,  as
 in fome intermittents;  or of  the  kidneys, when  the
 urine continues  pale and in  fmall quantity.  Does the
revivefcence  of  thefe  affected parts,  or their torpor,
recurring  at intervals,  form  the  paroxyfms  of thefe
fevers? and their permanent revivefcence eftablifh the
cure?  See  Glafs IV. 2.  1.  19.
  M. M. Wine  and opium in fmall quantities repeated
every three  hours alternately ; fmall repeated blifters ;
warm but  frefli air ; forbentia ; nutrientia ; transfufion
of blood.   Small electric Shocks  paffed through the
brain in all directions.   Oxygene air ?

 . 2.  Parefis inirritativa.   Inirritative debility.    A
defective action  of the  irritative motions without  in-
creafe  of  the frequency  of the pulfe.  It continues 
  Class I. 2. 1.]    OF IRRITATION.               81
  three or  four weeks Tike a  fever, and then either ter-
  minates in health,  or the patient finks into one  kind
  of apoplexy, and perifhes.   Many fymptoms, which
  attend inirritative fevers, accompany  this difeafe,  as
  cold  hands and  feet at periodic  times, fcurf on the
  tongue, want of appetite, muddy urine, with pains of
  the head, and fometimes vertigo, and vomiting.
    This difeafe differs from the inirritative fever by
  the  pulfe not being more frequent than in health.
  The  want of appetite  and of digeftion is a principal
  Symptom, and probably is  the  caufe of the  univerfal
  debility,  which may be occafioned by the want of
  nourifhment.   The vertigo is a  fymptom  of  inirrita-
  bility, as fliewn in Clafs IV. 1.  2. 6. the muddy urine
  is owing to increafed abforption from the bladder in
  confequence of  the diminifhed cutaneous and cellular
  abforption, as in anafarca, explained in Sect. XXIX.
  5. 1. and is  therefore a confequence of the inirrita-
  bility of  that part  of the  fyftem ; the foul tongue is
  owing to an increafed abforption of the thinner part
  of the mucus in confequence of the general deficiency
  of fluid, which  fhould be  abforbed by the  ikin and
  ftomach.   The  ficknefs  is owing to decreafed action
  of the ftomach, which is probably the primary difeafe,
  and is connected with the vertigo.
    M. M.  An emetic.   Calomel, grains iv. once  or
  twice.   Then a blifter.  Peruvian bark.  Valerian-
  Columbo.  Steel.   Opium and wine in fmall quanti-
*  ties,' repeated  alternately  every three  hours.   Small
  electric percuflions through  the ftomach.
                         G              3. Scfnnus 
82               D r-S E A S E S      [Class I. 2. *.
  3. Sotmius inierruptus*   Interrupted fleep.  In fome
fevers, where the inirritability  is very great, when
the patient falls afleep, the pulfe in a few minutes be-
comes irregular, and the patient awakes in great dif-
order, and fear of dying,  refufing to fleep again from
the terror of this uneafy  fenfation.  In this  extreme
debility there  is reafon to believe, that fome volun-
tary power during our waking hours is employed  to
aid the irritative ftimuli in carrying on the circulation
of the blood through the lungs; in the fame manner
as we ufe voluntary exertions, when we liften to  weak
founds, or wifli to view an object by a fmall light ;  in
fleep volition is fufpended, and the deficient irritation
alone is not Sufficient to carry on the pulmonary cir-
culation.  This explanation feems the  moft probable
one, becaufe in cafes of apoplexy the irritative motions
of the arterial fyftem do  not feem to be impaired, nor
in common fleep.  See Incubus III. 2.  1. 13.
   M. M. Opium in very fmall  dofes, as  three  drops
of laudanum.   A perfon  Should  watch the  patient,
and awaken  him frequently ; or  he fliould meafure
the time between /lumber and /lumber by a ftop-watch,
and awaken  the patient a  little before he  would
otherwife awake ; or he  fhould keep his finger on the
pulfe,  and fliould forcibly awaken him, as foon  as it
becomes irregular, before the diforder of the circula-
tion becomes fo great as  to difturb him.  See Clafs I.
 2.  1. 9.  and Sect. XXVII. 2.

                                         '4. Syncope.
\ 
Glass 1.2. 1.]     OF IRRITATION.               83
   4. Syncope.  Fainting confifts in the decreafed action
of the arterial fyftem ;  which is fometimes occafioned
by defect of the ftimulus  of  distention, as after vene-
fection, or tapping  for the dropfy;   At other times it
arifes from  great emotions of the mind, as in  fudden
joy or grief.  In thefe cafes the whole fenforial power
is exerted_on thefe interefting ideas, and becomes ex-
hausted.  Thus during great furprife or fear  the heart
ftops for a  time, and then  proceeds with throbbing
and  agitation: and fometimes  the  vital motions be-
come fo deranged,  as never to  recover  their natural
fucceffive action ; as when children have been  fright-
ened  into convulfions.  See Sect; XII. 7. 1.
   Mifs —---, a young lady of Stafford, in  travelling
in a chaife was fo affected by feeing the fall of a horfe
and poftilion,  in going down a hill, though the car-
riage was not overturned, that fhe fainted away, and
then became convulfed, and never fpoke afterwards;
though flie  lived about three days  in fucceffive con-
vulfions  and ftupor.

   5.  Hamorrhagia venofa.   A bleeding from  the ca-
pillaries  arifing  from defect of venous  abforption,  as
in fome of thofe  fevers commonly  termed  putrid.
When the blood Stagnates in the cellular membrane,
it produces  petechie from this  torpor or paralyfis of
the  abforbent  mouths of the veins.  It muft be ob-
ferved, that thofe people  who have difeafed livers, are
more liable  to this  kind of hemorrhages, as well as to
the  hemorrhagia  arteriofa; the former, becaufe pa-
                       G  2                  tients 
H                DISEASES      [Class I. 2. 1.
tients with cfifeafed livers are more fubject to paralytic
Complaints in general, as to hemiplegia, and to dropfy,
which is a paralyfis of the  lymphatics;  and the latter
h probably owing to the delay of the  circulation  in
the vena  porta  by the torpor of  this hepatic veffcl,
when the liver is not much enlarged ; and to  its pref-
fure on the vena cava, when  it is much enlarged.
  M. M. Vitriolic acid, opium,  fteel, bark.   Sponge
bound on  the part.   Steel diffolved in  fpirit  of wine
externally.  Flour.

  6.  Hamorrhois cruenta.  In the bleeding piles  the
capillary veflels of the rectum become  diftended and
painful from  the defect of the  venous  abforption  of
the part, and at length burft ; or  the mucous glands
are fo dilated  as to give a paffage  to the blood ; it is
faid to obferve lunar periods.
  M.  M.  Venefection, poultices,  cathartics,  fpice,
cold bath,  and forbentia.   External compre/fion by
applying lint,  fponge, or cotton.   Internal  compref-
fion by applying a bit of candle fmeared with mercu-
rial ointment.  Strangulate the tumid piles with a filk
firing.  Cut them off.  See  Clafs  I. 2.  3.  22.
  Mrs. —*-* had for twelve  or fifteen years, at inter-
vals  of a year  or  lefs,  a  bleeding from the rectum
without pain ', which however  Slopped fpontaneoufly
after She became weakened,  or by  the  ufe of  injec-
tions of brandy and water.   Lately the  bleeding con-
tinued above  two months, in  the quantity of  many
esnces a day, till fhe became pale  and feeble to an
                                           alarming 
Class L 2. 1.3     OF IRRITATION.               tS
alarming degree.   Injections of folutions  of lead, of
bark and fait of fteel,  and of turpentine, with fome
internal aftringents, and opiates, were ufed in vain.
An injection of the fmoke of tobacco, with ten grains
of opium mixed with the tobacco, was ufed, but with-
out effect the two firft times on account of the imper-
fection of the machine; on the third time it  produced
great ficknefs, and vertigo, and nearly a fainting  fit;
from which  time the blood entirely flopped.  Was
this owing  to a  fungous  excrefcence in the rectum ;
or to a blood-veffel being burft from the difficulty of
the blood pafling  through  the vena porta from fome
hepatic obstruction, and which had continued to bleed
fo long ? Was  it  Stopped at laft by the fainting fit ?
or by the ftimulus of the tobacco ?

   7.  Hamorrhagia  renum.   Hemorrhage  from the
kidneys, when attended with no pain,  is owing to de-
fect of venous  abforption  in the kidney.    When at-
tended with  pain  on motion, it  is owing to  a bit of
gravel in the ureter or pelvis of the  kidney; which is
a much more frequent difeafe than  the former.   See
Sect. XXVII.  1.
   M. M.  1. Venefection in fmall  quantity, calomel,
bark, fteel,  an opiate;  cold immerfion  up to the na-
vel, the upper part of the  body being kept cloathed.
Neville-Holt  water.   2.  Alkalized  water aerated.
Much diluent liquids.   Cool drefs.  Cool bed-room.
    Cows are much fubject to bloody  urine, called fouf
tvater by  the  farmers ;  in  this difeafe  about  fixty
                        Q  3                  grains 
?$               DISEASES      [Class I. 2.1.
grains of opium with or without as much ruft of iron,
given twice a day, in a ball mixed with flour and wa-
ter, or diffolved in warm water, or warm  ale, is,  I
believe,  an  efficacious  remedy, to  which  however
fliould be added about two quarts of barley or oats.
twice a day, and a cover at night, if the weather be
cold.

   8.  Hamorrhagia  Hepatis.  Hemorrhage from  the
liver.  It fometimes  happens in thofe, who have the
gutta rofea, or paralytic  affections owing to difeafed
livers induced by the  potation of  fermented liquors,
that a great  difcharge of black vifcid blood occafion-
ally comes away by  Stool, and fometimes by vomiting :
this the ancients called Melancholia, black bile.  If it
was  bile, a fmall quantity of it would become yel-
low or green on dilution with warm water, which was
not the cafe in one  experiment which  I tried ; it muft
remain fome time in the inteftines from its  black  co-
lour, when it paffes'downwards, and probably  comes
from the bile-ducts,- and  is often a  fatal fymptom.
When it is evacuated by vomiting it is lefs dangerous,
becaufe it fhews  greater remaining irritability of the
intetinal canal, and is fometimes falutary to thofe who
have difeafed livers.
   M. M. An emetic.  Rhubarb, fteel, wine, bark.

   9.  Hamopfoe venofa.   Venous hemoptoe frequently
attends the beginning  of the hereditary confumptions
of dark-eyed people ; and in others, whpfe lungs have
                                               too 
Class I. 2. i.]     OF IRRITATION.               S7
too little irritability.  Thefe fpittings of blood are ge-
nerally  in very fmall quantity, as a tea-fpoonful ; ancl
return at  firft  periodically, as about once a  •month;
and are lefs dangerous in the  female than in the male
fex; as  in the former they are often  relieved by the
natural  periods of the menfes.   Many of thefe pati-
ents are attacked with tins pulmonary hemorrhage in
their firft fleep ;  becaufe in feeble people the power
of volition is  neceflary,  befides  that of irritation,  to
carry on  refpiration perfectly;  but,  as  volition is
fufpended during fleep, a part of the blood is delayed
in the veffels of the lungs, and in confequence effufcd,
and ' the patient  awakes from the difagreeable fenfa-
tion.    See Clafs I.  2. 1. 3. II.  1. ,6. 6. III.  2. 1.  10,
   M. M. Wake the patient every two or three hours
by an alarum  clock.   Give half a grain of opium  at
going  to bed, or twice a day.   Onions, 'garlic, flight
chalybeates.  Iflues.  Leeches  applied once  a fort-
night or month to the hemorrhoidal  veins to produce
a new habit,  Emetics after each period of hemoptoe^
to  promote expectoration, and  dillodge any  effufed
blood,  which  might  by remaining in the lungs  pro-
duce ulcers by its putridity.   A  hard bed, to prevent
too  found  fleep.   A periodical emetic or  cathartic
once a fortnight.

   10. Palpitatio cordis.  The palpitation of the heart
frequently attends  the hemoptoe above mentioned ;
and confilts in  an ineffectual exertion of the  heart to
rum forwards  its  contents  in  due time,  and with due
                        Q 4                  force. 
88               DISEASES      [Class I. 2.1.
force.   The remote caufe is frequently fome impedi-
ment to the general circulation ; as the torpor of the
capillaries in cold paroxyfms of fever, or great adhe-
fions of the lung?.   At other times it arifes from the
debility of the action of the heart owing  to  the defi-
cient fenforial  power of irritation  or  of affociation,  as
at the  approach  of death.
   In both thefe cafes of weak exertion the heart feels
large to the touch,  as it  does not completely empty
itfelf at each  contraction; and on that  account con-
tracts  more frequently,  as defcribed in Sect. XXXII.
2.  2.   Another kind of palpitation may  fometimes
arife from the retrograde motions of the heart, as in
fear.  See Clafs I, 3. 1. 2. and IV. 3, 1. 6*

    11.  Menorrhagia.  Continued flow of the catame-
nia.   The monthly effufion of blood from the uterus
pr vagina is  owing to a torpor of the veins of thofe
membranes in confequence  of the defect of  venereal
ftimulus ; and in this refpect refembles the mucus dif-
 charged  in the  periodical venereal orgafm of the  fe-
male quadrupeds, which are fecluded from the males.
The menorrhagia,  or continued flow  of this difcharge,
 is  owing to a continued  defect of the venous abforp-
 tion of the membranes of the uterus or vagina.   See
 Clafs  IV, 2. 4.  7.
    M. M. Venefection in fmall  quantity.   A cathar-
 tic.   Then opium, a grain every  night.   Steel.  Bark.
 A blifter.  Topical afperfion with cold water, or cold
 -, inegar,
                                            1* D)fi 
Class I. 2. 1.]     OF IRRITATION.              89
   12.  Dyfmenorrhagia.   A difficulty  of menftruation
attended with pain.  In this complaint  the  torpor of
the uterine veffels, which precedes menftruation, is by
fympathy accompanied  with a torpor of the lumbar
membranes,  and  confequent pain;  and frequently
with cold extremities, and general debility.  The fmall
quantity and difficulty of the  difcharge is  owing to
arterial inactivity, as in  chlorofis.  Whence  it hap-
pens, that chalybeate medicines are  of efficacy both
to  Stop  or prevent too great menftruation,  and to
promote or increafe deficient menftruation; as  the for-
mer is  owing  to inirritability of the veins, and the
latter of the arteries of the uterus.  See Article IV.
2. 6. in the Materia Medica.
   M. M. Opium, fteel, pediluvium.  Warm bath.

   13.  Lochia nimia.  Too  great  difcharge after de-
livery.   In that unnatural  practice of fome hafty  ac-
coucheurs of introducing the hand into  the uterus im-
mediately after the delivery of the child, and  forcibly
bringing away  the  placenta, it frequently happens,
that a part  of it is left behind; and the uterus, not
having power to  exclude  fo fmall a portion of it,  is
prevented from complete contraction,  and a  great he-
morrhage enfues.   In this circumftance a bandage
with a thick comprefs on the lower part of  the belly,
by appreffing the fides of the uterus  on the  remain-
ing part of the  placenta,  is likely to  check the he-
morrhage,  like  the  application  of a  pledget of any
fpft fubftanee pn a bleeding veffel.
                                                la 
9*>                DISEASES       [Class 1 2. i.
   In other cafes the lochia  continues too long,'  or in
too great  quantity, owing to the deficiency of venous
abforption.
   M. M.  Ah encr.a.   An  opiate.  A blifter.  Slight
chaiybeates.  Peruvian bark.   Clothes dipped in cold
vinegar,. and applied  externally.   Bandages on  the
limbs to  keep  more  blood  in  them for a  time have
been recommended.

   14.  Abortio  fpontanea.   Some  delicate ladies are
perpetually liable to fpontaneous abortion, before the
third, or after the feventh, month of geftation.  From
fome  of thefe  patients I have learnt, that they  have
awakened with a  flight  degree of difficult  refpira-
tion,  fo as to induce  them to rife  haftily  up in bed;
and have hence fufpected,  that  this  was  a tendency
to a kind of aftlima,  owing to a deficient  abforption
of blood  in  the  extremities  of the  pulmonary  or
bronchial veins ;  and have concluded  from thence,
that there was  generally a deficiency  of venous ab-
forption ;  and  that this  was the  occafion of their fre-
quent  abortion.    Which  is  further countenanced,
where a great  fanguinary difcharge precedes or fol-
lows  the  exclufion of the fetus.
 .. Ivl, M.  Opium, bark, chaiybeates in fmall  quan-
tity.   Change  to  a warmer climate.   I have directed
with fuccefs  in four cafes half a grain of opium twice
a  day for a  fortnight, and then a whole grain twice
a  day during the whole geftation.   One of thefe pa-
tients  took bellies twenty  grains  of  Peruvian  bark
                                                for 
Class 1.2. 1.]     OF IRRITATION.              gi
for feveral weeks.    By thefe  means being  exactly
and regularly perfifted in, a  new  habit became efta-
bliftted, and the ufual mifcarriages were  prevented.
   Mifcarriages  more frequently happen from eruptive
fevers,  and from  rheumatic ones, than  from other
inflammatory difeafes.   I faw a moft violent pleurify
and  hepatitis cured by.repeated venefection about a
week or  ten days  before  parturition ;  yet another
lady whom I attended, mifcarried at  the end of the
chicken  pox, with which her children were   at  the
fame time affected.   Mifcarriages towards  the termi-
nation  of the  fmall pox are very frequent, yet there
have been a few inftances of children,  who have been
born with the  eruption on them.  The blood in the
fmall pox will  not inoculate  that difeafe,  if taken be-
fore  the  commencement of  the fecondary  fever ;  as
Shewn  in  Sect. XXXIII. 2.  10.^  becaufe the conta-
 gious matter is not yet formed, but after it has been
 oxygenated through the cuticle in the puftules, it be-
 comes  contagious;  and if  it be then abforbed, as in
 the fecondary  fever,  the  blood of the mother  may
become contagious, and infect the child.  The  fame
 mode of reafoning is applicable to the chicken pox.
See Clafs IV.  3.  1. 7.

    15.  Scorbutus.   Sea-fcurvy  is  caufed by fait  diet,
 the perpetual ftimulus of which debilitates the venous
 and  abforbent fyftems.   Hence  the blood is imper-
 fectly taken up by  the  veins from  the  capillaries,
 whence brown and black fpots appear upon the ikin
                                            withput 
**                DISEASES      [Class I. 2. f.
without fever.   The limbs become livid  and edema-
tous,  and laftly  ulcers are  produced from deficient
abforption.   See Sect.  XXXIII. 3. 2. and Clafs II.
i, 4.  13.   For an account of the fcurvy of the lungs,
fee Sea. XXVII.  2.
   M. M.  Frefh animal and vegetable food.  Infufion
©f malt.   New beer.   Sugar.   Wine.  Steel.  Bark.
Sorbentia.   Opium ?

   16. Vibices*  Extravafations  of blood become black
from  their being fecluded from the air.   The extra-
vafation of blood in bruifes, or in fome  fevers,  or
after  death in  fome patients,  efpecially in the parti
which were expofed to preffure, is owing to the fine
terminations  of the veins having been mechanically
eompreffed fo as  to prevent their abforbing the blood
from  the  capillaries,  or to their inactivity from  dif-
eafe.   The blood when extravafated undergoes a che-
mical change before it  is fufficiently fluid to be taken
«p by the lymphatic abforbents, and in  that procefa
ehangcs its colour to green and then yellow.

 <  17. Petechia.   Purple fpots.  Thefe attend fevers
with  great  venous  inirritability,  and are probably
formM by  the inability  of  a  Angle termination of a
vein, wncnce the corresponding capillary becomes rup-
tured, and  effufes the blood  into  the cellular mem-
brane round the inert termination of the vein.   This
h generally efteemed a fign of the putrid Slate of the
)>lood, or that State  contrary to the inflammatory one.
                                                As 
Class I. 2. 2.3    OF IRRITATION.              9j
As it  attends fome  inflammatory  difeafes  which  are
attended with great  inirritability,  as in the confluent
fmall pox.  But it alfo attends the fcurvy, where no
fever exifts,  and  it  therefore  fimply announces  the
inactivity  of  the terminations of fome veins; and is
thence indeed a bad fymptom in  fevers,  as a  mark
of approaching  inactivity of the  whole fanguiferous
fyftem, or death.  The blue colour of fome children's
arms or  face* in very  cold weather is  owing in like
manner to the  torpor of the abforbent terminations
of the veins,  whence  the  blood  is  accumulated in
tfeem,  and fometimes burfts  them.
                   ORDO   II.
                Decreafed Irritation*

                   GENUS  II.
       Decreafed Aclion of the Secerning Syfiem,
   These are always attended with decreafe  of par-
tial, or of general heat; for  as the heat of anima!
bodies is  the confequence of their various fecretions,
and is perpetually pafling away into the ambient air,
or other bodies in contact with them;  when  thefe
fecretions  become  diminiflied,  or ceafe, the  heat of
the part or of the whole is foon diminished, or ceafes
along with them.
SPECIES. 
*+                DISEASES      [Class I. a. ».

                   SPECIES.
   i.  Frigus febrile.  Febrile coldnefs.   There is rea-
fon to believe, that the beginning of  many fever-fits
originates in the quiefcence of fome part of  the ab-
forbent fyftem, efpecially where they have been owing
to external cold ;  but that,  where the coldnefs of the
body  is not owing to a diminution of external  heat, it
arifes  from the inaction  of fome part of the fecerning
fyftem.   Hence fome parts of the body are hot whilft
other  parts are cold ; which  I fuppofe gave occafion to
error  in Martyn's Experiments; where he fays, that the
body  is as hot in the cold  paroxyfms  of fevers  as at
other  times.
  After the fenforial power  has been much diminiflied
by  great  preceding activity  of the fyftem,  as by long
continued external heat, or violent exercife, a fudden
expofure to much cold produces a torpor both greater
in degree and over a greater  portion  of  the  fyftem,
by  fubtracting their  accuftomed  ftimulus  from parts
already much  deprived of their  irritability./    Dr.
Franklin in a letter to M. Duberge, the French tranf-
lator  of his works, mentions an inftance of four young
men,  who bathed in a cold fpring after a day's har-
veft work ; of whom two died on the fpot, a third on
the next  morning,  and  the  other  furvived with diffi-
culty.  Hence it would appear, that thofe, who have
to travel in intenfely cold weather, will fooner perifh,
who have  previoufly heated  themfelves  much  with
drams, than thofe who have only the ftimulus of na-
                                              tural 
Cass I. 2. 2.]     OF IRRITATION.               r?
tural  food ; of which  I have heard  one well attefted
inftance.  See Article VII.  2.  3.  Clafs III.  2.  1. 17.

   Frfcus chronicum.   Permanent coldnefs.   Coldnefi
of the extremities, without fever, with dry  pale /kin,
is a fymptom of general debility,  owing to the de-
creafed action  of the arterial  fyftem, and of the ca-
pillary  veffels;  whence the perfpirable matter is fe-
creted  in lefs quantity, and in confequence the  /kin
is lefs  warm.  This coldnefs  is obfervable  at the ex-
tremities  of the  limbs,  ears,  and  nofe, more than in
any other  parts : as  a larger  furface is  here expofed
to the contact of the air,  or  clothes,  and thence the
heat  is more haftily carried away.
   The pain, which accompanies the coldnefs  of the
ikin, is owing to the deficient exertion  of the  fub-
cutaneous veflels, and probably to the  accumulation
 of fenforial power  in the extremities of their nerves.
 See Sect.  XII. 5. 3. XIV. oh  XXXII. 3.  and Clafs I.
 2, 4. 1.
   M.  M. A blifter.  Incitantia, nutrientia, forbentia.
 Exercife.   Clothes.   Fire.  Joy.   Anger.

    2.  Pallor fugitivus.  The  fugitive palenefs, which
 accompanies the  coldnefs  of the extremities, is owing
 to a lefs quantity of  blood pafling  through the capil-
 laries of the /kin in a given time ;  where the  abforb-
 ent power of the veins is at the fame time much  dimi-
 niflied, a part of the blood  lingers at  their junction
 with the capillary arteries, and a blutfh tinge is mixed
                                                with 
 0                DISEASES      [Class I. 2.2.
 with the palenefs; as is  feen in the loofe ikin under
 the eye-lids, and is always a mark of temporary debi-
 lity.   See Clafs II.  1. 4. 4.  Where the palenefs of
 the ikin is owing  to the deficiency of red globules in
 the blood, it is joined with a  yellowifh tinge ;  which
 is the colour of the ferum, with  which the blood then
 abounds, as  in chlorofis, and in torpor or paralyfis of
 the liver,  and is often mistaken  for a fuperabundance
 of bile.
   A permanent palenefs of the /kin is owing to the
 coalefcence of the minute arteries, as in  old age.   See
 Clafs I.  2. 2. 9.  There is another fource of palenefs
 from the increafed abforption of the terminations of
 the veins, as when vinegar is applied to the lips.   See
 Sect. XXVII. 1. and another from the retrograde mo-
 tions of  the capillaries and fine extremities of the arte-
 ries.  See Clafs II. 3. 1. 1.
   M. M.  A blifter, nutrientia, incitantia,  exercife,
 oxygene gas.

   3.  Pus parcius.  Diminifhed pus.  Drynefs of ul-
cers.   In the cold  fits of fever all the  fecretions  are
diminiflied, whether natural or artificial, as their quan-
tity depends  on the actions of the glands or capilla-
ries, which then Share in the univerfal inaction of  the
fyftem.   Hence the drynefs of  iffues  and blifters in
great debility,  and before the  approach of death, is
owing to deficient  fecretion,  and not to increafed  ab-
forption.
>
M. M.  Opium, 
Class I* 2. 2.]    OF IRRITATION.               57
   M. M. Opium, wine in very fmall quantities, Peru*
vian bark.

   4.  Mucus parcior.   Diminiflied mucus.  Drynefs of
the mouth  and noftrils.  This  alfo occurs  in the cold
fits of intermittents.   In thefe cafes I have alfo found
the tongue cold to the touch  of the finger, and the
breath to the back of one's hand, when  oppofed to
it, which  are very inaufpicious  fymptoms, and gene-
rally fatal.   In fevers with inirritability it is generally
efteemed  a  good  fymptom,  when the noftrils  and
tongue become moift after having been previoufly  dry ;
as it fhews an increafed action of the mucous glands of
thofe membranes, which were before torpid.  And the
contrary to this is the facies Hippocratica,  or counte-
nance fo well defcribed by Hippocrates, which is  pale,
cold, and fhrunk ; all which  are owing to the inacti-
vity of the fecerning veffels,  the  palenefs  from there
being lefs red blood  pafling through  the  capillaries,
the coldnefs of the ikin from there being lefs fecretion
of perfpirable matter, and the fhrunk appearance  from
there being lefs mucus fecreted into  the cells of the
cellular membrane.   See Clafs IV. 2. 4. 11.
   M. M. Blifters.   Incitantia.

   5.  Urina parcior pallida.  Paucity of pale urine, as
in the cold  fits of intermittents; it appears in  fome
nervous  fevers  throughout  the whole difeafe,   and
feems to proceed from a palfy of the kidneys; which
probably was the caufe  of the  fever,  as the fever
                        H               fometimes  \ 
9&               DISEASED      [Class I. 2. r.
fometimes ceafes,  when that  fymptom is removed  :
hence  the ftraw-coloured urine in this  fever is fo far
falutary, as it  fhews the unimpaired  action of  the
kidneys.
  Mi-M,- Balfams, effential oil, afparagus, rhubarb,  %
blifter..   Cantharides internally.

  6. Torpor hepaticus.   Paueity of bile from a partial
inaction of the liver ; hence the bombycinous colour
of the /kin,  grey ftools, urine not yellow, indigestion^.
debility, followed by tympany, dropfy,  and death.
  This  paralyfis or inirritability of the liver often de-
stroys thofe who have been long habituated  to much
fermented liquor, and have fuddenly omitted  the ufe
of it.   It alfo deftroys  plumbers, and houfe-pailiters,
and in them feems a fubftitute for the colica fatusnina.
See Seft. XXX.
  M. M. Aloe and calomel, then the bark,  and cha-
iybeates.  Mercurial ointment rubbed  on  the region
of the liver.   Rhubarb, three or four grains,  with
opium half a grain to- a grain twice a day.   Equita-
tion,, warm bath for half an hour every day.

   7.  Torpor Pancreatis*  Torpor of the pancreas*   I
faw what I  conjectured to be a  tumour  of the pan-
creas with  indigeftion,  and  which terminated in the
death of the patient.   He had been  for many years  a
great confumer of tobacco, infomuch that  he chewed
that noxious drug all  the morning, and fmoaked it all
the afternoon.  As the fecretion from the pancreas re-
                                            fembles. 
 Class I. 2. 2.]     OF IRRITATION.              ^
 fembles faliva in its general appearance, and probably
 in its  office  of affifting digeftion,  by preventing the
 fermentation of the aliment ; as would appear by the
 experiments of Pringle and Macbride ;  there is reafon
 to fufpect, that a  fympathy may exift between the fa-
 livary and pancreatic  glands ;  and that the perpetual
 ftimulus of the former by tobacco might in procefs of
 time injure the latter. See Tobacco, Article III.  2. 2.
   8.  Torpor renis.   Inirritability or  paralyfis  of the
 kidneys is probably frequently mistaken for gravel in
 them.   Several, who have lived rather intemperately
 in refpect to.fermented  or  Spirituous liquors,  become
 fuddenly feized about the age of fixty,  or later, with
 a total  Stoppage of urine ; though they have previoufly
 had no fymptoms  of  gravel.  In thefe  cafes there is
 no  water  in the bladder ;  as is known by the intro-
 duction of the catheter, of which thofe made of elaftic
 gum  are faid to be preferable  to metallic ones ;  or it
 may generally be  known by the Shape of  the abdo^
 men,  either by the eye or hand.   Bougies and cathe-
 ters of elaftic gum are fold at N°  $y', Red Lion-ftreer,
 Holborn, London.
  M. M. Electric  fhocks, warm bath.   Emetics.   Sec
calculus  renis, Clafs  I.  1. 3. 9.   When no gravel
has been previoufly  obferved,  and the  patient has
been,  a  wine-drinker  rather than an  ale-drinker, the
cafe is  general!/ owing  to  inirritability of the tubuli
urmiferi, and  is frequently fatal.  See Clafs I.  2. 4.
30.
II 2
Q.  Panels 
roo              DISEASES      [Class I. 2. r.
   9. Puncla mucofa vultus   Mucous fpots on the face.
Thefe  are  owing to the inactivity of the excretory
ducts of the mucous glands ;  the  thinner  part of this
fecretion exhales, and the remainder becomes infpif-
fated, and lodges in the duct; the extremity  of which
becomes black by expofure to the air.
   M. M.   They may be  preffed  out  by the  finger-
nails.  Warm water.  Ether frequently applied.  Blif-
ter on  the part I

   10.  Macula  cutis fulva.   Morphew  or  freckles*
Tawny blotches on the ikin  of the face  and arms of
elderly people, and  frequently on their legs after flight
eryfipelas.   The freckles on  the face of younger peo-
ple, who have  red hair,  feem  to be a  Similar pro-
duction, and feem all to be caufed by the coalefcence
of the minute arteries or capillaries of the part.  In
a  fear after a  wound the integument is  only opake;
but  in  thefe blotches, which are  called morphew and
freckles,  the fmall veffels feem to have become  in-
active  with fome of the ferum of the blood Stagnating
in them,  from  whence their colour.   See Clafs III.
 1. 2.  12.
   M,  M.  Warm bathing.  A blifter on the part I

   11.  Canities.  Grey hair.   In the injection of the
veffels  of animals for the  purpofes of anatomical pre-
 parations,  the  colour of the  injected fluid will  not
 pafs into many very minute veffels; which  neverthe-
 *cfs uncoloured water, or fpirits, or quickfilver will
                                           permeate^ 
 Class I. 2.-2.3    OF IRRITATION.              lor
-permeate.   The fame occurs in the filtration  of fome
 coloured  fluids through paper,  or very fine  fand,
 where the colouring matter  is not perfectly diffolved,
 but only  diffufed through the liquid.   This has led
 fome to imagine, that the caufe of the  whitenefs of
 the hair in elderly  people  may arife from the dimi-
 nution, or greater tenuity, of the  glandular veffelsi,
 which fecrete the mucus, which hardens into hair ;
and that the  fame difference of the tenuity of  the
 fecerning  veflels may poffibly make the difference of
colour of the filk from different filk-worms, which is
 of  all fhades  from yellow to  white.
   But as the  fecreted fluids  are not the  confequence
of mechanical filtration, but  of animal  feledtion ;  we
 muft look out for another caufe, which muft be found
 in the decreafing activity of the glands, as we advance
 in life ; and which  affects many of our  other fecre-
 tions as  well  as that of the  mucus, which forms  the
hair.  Hence grey hairs are produced on the faces of
horfes by whatever injures the  glands at  their roots,
as by corrofive blifters; and frequently on the human
Subject by external injuries on  the head ; and fome-
times by fevers. *And as the grey colour of hair con-
fifts in its want of tranfparency, like water converted
into fnow ; there is reafon to fuppofe, that a defect of
fecreted moifture fimply may  be the caufe of this kind
of opacity, as explained in Cataracta, Clafs I. 2. 2.  13,
   M. M.  Whatever prevents the inirritability and in-
fcnfibility of the fyftem, that  is, whatever prevents  the
approach of  old age, will fo far counteract the pro-
                       H 3                 duction 
102              DISEASES      [Class I. 2. a.
duction of grey hairs, which is a fymptom of it.  For
this  purpofe  in people, who are not  corpulent, and
perhaps in thofe who are fo,  the warm bath twice  or
thrice  a  week  is  particularly ferviceable.   See Sect.
XXXIX. 5. 1.  on the colours of animals,  and Clafs
I.  1. 2. 15.

   12.  Callus.  The  callous  /kin on the hands and
feet  of laborious  people is owing to the extreme vef-
fels  coaicfcing  from the perpetual  preffure they  are
expofed to.
   As  we- advance  in life, the finer arteries lofe their
power of action, and their fides grow together ; hence
the  palenefs  of the /kins of elderly people,  and the
Jofs  of that bloom,  which is owing to the numerous
fine  arteries, and the tranfparency  of the  fihin, that
cnclofes them.
   M.  M. Warm bath.   Paring  the thick  ikin with
a  knife.  Smoothing it with a pumice ftone.    Cover
the  part with  oiled  filk  to  prevent the evaporation
of the perfpirable matter,  and  thus  to keep it moift.

   13.  Cataracla is  an  opacity of the cryftalline lens
of the eye.   It is a  difeafe of light-coloured eyes, as
the gutta ferena is of dark ones.  On cutting off with
fciffars the cornea of a calf's eye,  and holding it in
the palm of one's hand, fo as to gain a proper light,
the artery, which fupplies nutriment to the cryftalline
humour, is eafily and beautifully feen; as it rifes from
                                                the 
Class I. 2. 2.J    OF IRRITATION.              ro3
the centre of the  optic nerve  through the vitreous
humour to the cryftalline.  It is this point, where the
artery enters the eye through the cineritious part of
the optic  nerve (which  is in  part near the middle of
the nerve,) which is without  fenfibility to light;  as is
Shewn by  fixing three papers, each of them about half
an inch in diameter, againft a wall about a foot diftant
from  each other, about the height of the eye ; and
then looking at the middle one, with one eye, and re-
treating till you  tofe fight of one of the external pa-
pers.  Now as the  animal grows older, the artery be-
comes lefs vifible, and perhaps carries only a tranfpa-
rent fluid, and at  length in fome fubjects I fuppofe
ceafes to be  pervious ;  then  it follows, that the cry-
ftalline lens, lofing  fome fluid, and gaming none, be-
comes dry, and in  confequence opake; for the fame
reafon, that wet  or oiled paper  is more tranfparent
than when it is dry,  as explained in Clafs  I.  1.4. 1.
The want of moifture  in the cornea of old  people,
when the exhalation becomes greater than the fupply,
is  the caufe of its  -want of tranfparency ;  and which
like the cryftalline gains rather a milky opacity.   The
fame analogy may be  ufed to explain  the whitenefs of
the hair of old people, which  lofes its pellucidity along
with its moifture.   See  Clafs I. 2. 2.  11.
   M. M.  Small  electric  Shocks through the eye.   A
quarter  of a grain  of corrofive fublimate of mercury
diflblved in brandy, or taken in a  pill, twice a day for
fix weeks.   Couching by depreifion, or by  extraction.
jThe former  of thefe operations is much to  be prefer-
                       H  4                     re>J 
104              DISEASES      [Class t. 2. 2.
red  to the latter, though the latter is  at this time fo
fafhionable, that  a  furgeon is almoft compelled to ufe
it, left he fhould not be thought  an expert operator,
For  deprefling the cataract is attended  with  no  pain,
no danger, no confinement, and may be as readily re-
peated, if the cryftalline fhould rife again to the centre
of the eye.  The extraction of the cataract is attendee!
with considerable pain, with long confinement,  gene-
rally with fever,  always with inflammation,  and fre-
quently with irreparable injury  to  the iris, and confe-
quent danger to the whole eye,   Yet  has this opera-
tion of extraction  been trumpeted  into univerfal fa-
shion for  no other reafon  but becaufe it is difficult to
perform, and therefore keeps the bufinefs in the hands
of a few  empirics,  who  receive larger  rewards,  re-
gardlefs of  the hazard, which is encountered by  the  *
flattered patient,
   A friend of  mine returned yefterday  from London
after an abfence of many weeks;  he had a cataract in
a proper State for the  operation, and  in fpite of my
earneft exhortation  to the  contrary, was prevailed  up-
on to  have it  extracted rather than depreffed.   He
was  confined to his bed three weeks after the opera-
tion, and is now returned with the iris adhering on
one fide fo as to make an oblong aperture ; and which
is nearly,  if not totally, without contraction,  and thus
greatly impedes the little vifion,  which he  poffeffes.
Whereas  I  faw fome patients couched  by depre/fion
many years  ago  by a then celebrated  empiric,  Che-
valier Taylor, who  were not confined above  a day or 
Class 1.2. 2.]    OF IRRITATION.              105
two,  that the eye might gradually  be accuftomed to
light, and who faw as well as by extraction, perhaps
better,  without  either pain, or inflammation, or any
hazard of lofing  the eye.
   As the inflammation of the  iris  is probably owing
to forcing the cryftalline through the aperture of it in
the operation of extracting it,  could  it not  be done
more fafely by making the opening behind the iris and
ciliary procefs into the vitreous humour ? but the ope-
ration would ftill be  more  painful, more dangerous,
and not more ufeful than that by depreifing it.

   14. Innutritio  off urn.   Innutrition of the bones. Not
only the blood effufed in  vibices and petechie, or from
bruifes,  as well  as  the blood  and  new  veffels  in in-
flamed parts, are reabforbed by  the increafed action
of the  lymphatics; but  the  harder materials, which
conftitute the fangs of the firft fet  of teeth,  and the
ends  of exfoliating  bones,  and fometimes the matter
of chalk-ftones  in  the  gout, the coagulable lymph,
which is depofited  on the lungs, or on the mufcles
after inflammation of thofe parts,  and which frequent-
ly produces difficulty of  breathing,  and  the  pains of
chronic rheumatifm, and laftly the  earthy part of the
living bones are  diffolved and abforbed by the increafed
actions  of this  fyftem of veffels.  See Sect. XXXIIL

   The  earthy part of bones in this difeafe of the innu-
trition of them  fee»is  to Suffer a folution,  and reab-
fo/ption ; while the fecerning veffels do  not fupply  a
                                           fufficient
• 
rot)               DISEASES      [Class T. 2. 2.
fcifiicient quantity  of calcareous earth and  phofphoric
acid,  which  constitute the  fubftance of bones.   As
calcareous earth abounds every where, is the want of
phofphorie acid the remote caufe ? One caufe of this
malady is given in  the Pliilofophic Tranfactions, where
the patient had been  accuftomed to drink large quan-
tities  of vinegar.   Two cafes  are defcribed by Mr.
Gouch.  In  one  cafe, which  I faw, a confiderabic
quantity of calcareous earth, and afterwards  of bone-
afhes, and of decoction of madder,  and alfo of fubli-
mate of mercury,  were given without effect.   All the
bones became foft, many of them brok^, and the pa-
tient feemed  to die from  the  want  of beinf able to
                                          O
diftend her cheft owing to the foftnefs  of the ribs.
   M. M.  Salt of urine,  called fal  microcofmicum,
phofphorated foda.  Calcined hartfhorn.  Bone-aflies.
Hard or  petrifying water, as that of Matlock, or fuch
as is found in all  limeftone or marly  countries.   The
calcareous  earth  in thefe  waters might poffibly  be
carried to  the bones, as madder  is  known to colour
them.   Warm bath.  Volatile or fixed alkali   as a
lotion on the fpine, or effential oils.
   The innutrition  of the bones is often firft to be per-
ceived by the difficulty of breathing and palpitation of
the heart on  walking a little fafter than ufual, which
I fuppofe is  owing to the foftnefs of the ends of the
ribs adjoining to the Sternum ; on which account they
do not perfectly diftend the  cheft, when they are raifed
by the pectoral and intercoftal  mufcles with  greater
force than -ufuah   After this the fpine becomes curved
                                               both
* 
Class I. 2. 2.]    OF IRRITATION.              107
both by the foftnefs of its vertebre, and for the pur-
pofe  of making room for the difturbed heart.  See
Species 16 of this genus.
   As thefe patients are pale and weak, there would
feem to be a deficiency of oxygene in thc:r blood, and
in confequence a deficiency of phofphoric acid ; which
is probably produced by oxygene  in  the act  of ref-
piration.
   Mr.  Bonhome  in  the Chemical Annals, Auguft,
 1793, fuppofes the rickets toarife from the prevalence
of vegetable or acetous acid, which is known to foften
bones out of the body.  Mr. Dettaen feems to have
efpoufed  a Similar opinion,  and  both  of them  in con-
fequence  give  alkalies  and teftacea.   If this  theory
was juft,  the foft bones  of fuch patients fliould Shew
 evident marks  of fuch  acidity  after  death; which I
 believe has not been obferved.   Nor  is it analogous
 to other animal facts, that nutritious fluids fecreted
 by the fineft veffels of the body fliould be fo little ani-
 malized,  as to retain acetous or vegetable acidity.
   The fuccefs attending the following cafe in  fo fliort
 a time as s. fortnight I afcribed principally to  the ufe
 of the warm bath ; in which the patient continued for
 full half  an hour every night,  in the degree of heat,
 which was moft grateful to her fenfation, which might
 be I fuppofe about 94.   Mifs-----,  about ten years
 of age,  and very tall and thin, has  laboured under
 palpitation  of her heart,  and difficult breathing on
 the leaft  exercife, with occasional violent dry cough,
 for  a year or  more,  with  dry lips, liitle  appetite
                                              either 
 rc&               DISEASES      [Class I. 2. 2.
either for food or drink,  and dry ikin, with cold ex-
tremities.  She has at times been occafionally worfe,
and been relieved in fome  degree by the  bark.  She
began to bend forwards, and to lift  up her fhoulders.
3The former feemed owing to a  beginning curvature
cf the fpine,  the latter was probably caufed to facili-
tate her difficult refpiration.
   M. M. She ufed the warm bath, as above related ;
which by its warmth might increafe  the irritability of
the fmalleft feries of veffels,  and by fupplying more
moifture  to the  blood might probably tend to carry
further the materials, which form calcareous or bony
particles, or  to  convey them in more dilute  folution.
She took twice a day twenty grains of extract of bark,
twenty grains of foda phofphorata,  and ten grains of
chalk, and ten of calcined  hartfhorn mixed  into  a
powder with  ten drops of  laudanum ; with flefh food
both to dinner and fupper ; and port wine and water
inftead of the fmall beer, She had been accuftomed to;
fhe lay on a fofa frequently in a day, and occafionally
ufed a neck-fwing.

   15. Rachitis.   Rickets.   The head  is large, pro-
tuberant chiefly on the forepart.  The fmaller joints
are  fwelled;  the  ribs depreffed;  the belly  tumid,
with  other  parts  emaciated.   This  difeafe from  the
innutrition  or foftnefs of  the bones arofe about two
centuries ago; feems to have been half a century in
an increafing or fpreading ftate ; continued about half
a century at its height, or greateft  diffufion ; and is 
Class I. 2.2-3     OF* IRRITATION.             109
now nearly vanifhed: which gives reafon to hope,
that  the   fmall-pox, meafles, and venereal difeafe,
which are all of modern production, and have already
become milder, may in procefs of time vanifli from
the earth,  and perhaps be fucceeded by new ones!
See the preceding fpecies.

   16. Spina diftortio*  Diftortion of the fpine is  ano-
ther difeafe originating from  the  innutrition  or  foft-
nefs of the bones.  I once faw a child about fix years
old with palpitation of heart, and quicknefs  of refpi-
ration,  which began to have a curvature of the fpine;
1 then  doubted,  whether  the palpitation and quick
refpiration were the caufe  or confequence of  the cur-
vature of the fpine ;  fufpecting either that nature had
bent the fpine outwards to give room to the enlarged
heart;  or that the malformation of the cheft had  com-
preffed and impeded the movements of the heart. But
a few weeks ago on attending a young lady about ten
years old, whofe fpine  had lately began to be distort-
ed,  with very great  difficulty and quicknefs of refpi-
ration,  and alarming palpitation of the heart, I con-
vinced myfelf, that the  palpitation and  difficult ref-
piration were the effect of the change of the cavity of
the cheft from the diftortion of  the  fpme;  and that
the whole was therefore a difeafe  of the innutrition or
 foftnefs of the bones.
   For on  directing her to lie down much in the day,
 and to take the bark, the diftortion became lefs, and
 tlie palpitation and quick refpiration  became lefs at
                                                the 
  110              DISEASES   -   [Class!. 2.2,
  the fame time.  After this  obfervation a neck-fwing
  was  directed, and  flie took the bark, madder, and
  bone-afhes; and She  continues to amend both in her
  Shape and health.
   Delicate young  ladies  are  very liable to become
 awry at many boarding  Schools.   This is occafioned
 principally by their being obliged too long to preferve
 an erect attitude, by  fitting on forms many hours  to-
 gether.   To prevent this the fohool-feats fhould have
 either backs,  on which  they  may occafionally reft
 themfelves ; or  defks  before  them, on  which  they
 nay occafionally lean.   This is  a thing of greater con-
 fequence than may  appear to thofe, who have not  at-.
 tended to it.
   When the leaft  tendency to  become awry is ob-
■fcrved,  they fliould be advifed to lie down  on a bed
 or fofa for an hour in  the middle of the day  for many
 months; which generally prevents the  increafe of this
 deformity by taking off for a time the preffure on the
 foiiie of the back,  and it  at the fame time tends to
 make them grow taller.  Young perfons, when nicely
 meafured, are  found to be half  an inch higher  in  a
 morning than at night; as is well known to thofe, who
 iniift very young men for foldiers.   This  is  owing to
 the cartilages between the  bones of the back becom-
 ing compreffed by the  weight of the head and Shoul-
 ders on  them during the day.  It  is the fame preffure
 which  produces  curvatures and distortions of the
 fpine in growing children,  where  the bones are fofter
 than ufual; and which ir.ay thus"  be  relieved  by  an
                                        horizontal 
Class I. 2. 2.3     OF IRRITATION.              n*
horizontal pofture for an  hour in the  middle of the
day, or by being frequently allowed to lean on a chair,
or to play on the ground on a carpet.
   Young ladies  fliould alfo be directed, where two
fleep in a bed, to change every night, or every week,
their  fides cf the bed ;  which will prevent their ten-
dency to fleep always on the fame fide;  which is not
only liable to produce crookednefs, but alfo to occafion
difeafes by the internal parts being fo long kept in uni-
form  contact as to grow together.   For the fame rea-
fon they fliould not be  allowed to fit always on the
fame fide of the fire or window, becaufe they will then
be inclined too  frequently to bend themfelves to one
fide.
   Another great caufe of injury to the Shape of young
ladies is from  the preffure of Stays, or other tight
bandages, which at the fame time caufe other difeafes
by changing the form or fituation of the internal parts.
If a hard part of the Stays, even a knot  of the thread,
with which  they are fewed together, is preffed hard
upon one fide more than the  other, the child bends
from the Side moft painful, and  thus occafions a cur-
vature of the fpine.  To counteract  this effect fuch
Stays, as have  feweft hard  parts,  and efpecially fuch
as can  be daily or weekly turned, are preferable to
others.
   Where frequent lying down on a fofa in the day-
time, and Swinging frequently for a fhort time by  the
 hands or head,  with foofe  drefs,  do not relieve a  be-
ginning diftortion of the back ; recourfe may be had 
 tit              DISEASES      [Class I. 2.2.
 to a chair with fluffed moveable arms for the purpofe of*
 fufpending the weight of the body by cufliions under the
 arm-pits, like refting on crutches, or like the leading
 firings of infants.   From the top of the back of the
 fame chair a curved fteel bar may alfo  project to fuf-
 pend the body occafionally,  or  in part  by the head,
 like the fwing above mentioned.  The ufe of this chair
 is more efficacious  in  Straightening the fpine,  than
 Simply lying down horizontally ; as it not only takes
 off the preffure of the head  and  Shoulders from  the
fpine, but at the fame  time the inferior parts of the
body contribute to  draw the fpine ftraight by their
 Weight; or laftly, recourfe may be had to a fpinal
 machine firft defcribed in the Memoires of the academy
 of forgery  in Paris, Vol.  III.  p. 600,  by  M.  Le
 Vacher, and fince  made  by Mr.  Jones, at N°  6,
 North-ftreet, Tottenham-court Road, London, which
fofpends the head, and  places the weight of it on the
 hips.   This  machine is capable  of improvement by
joints in the  bar at the back  of it, to permit the body
 to bend forwards  without diminifhing the extenfion of
 the fpine.
   The objections  to this machine of M. Vacher, which
 Is made by Mr. Jones,  are firft, that it is worn in the
 day-time, and has a very unfightly appearance.   Mr.
 Jones has endeavoured to remedy this, by taking away
 the curved bar over the head, and Substituting in its
 place a forked bar, rifing  up behind each ear,  with
 webs faftened to  it, which pafs under the chin and
 occiput.  But this is not an improvement, but a de-
        j                                terioration 
Class I. 2. 2.]     OF IRRITATIOM.              n$
terioration of M.  Vacher's machine, as it prevents the
head from turning with facility to either fide. Another
objection is, that  its being worn, when the mufcles of
the back are  in  action, it is  rather calculated to pre-
vent the curvature of the fpine from becoming greater,
than to extend the fpine, and diminish is curvature.
   For this latter  purpofe  I  have  made  a  fteel bow,
as defcribed in the annexed plate,  which receives the
head longitudinally from the forehead to the occiput;
having  a fork  furnifhed with a  web  to  fuftain the,
chin, and another to fuftain the occiput.  The fummit
of the  bow  is fixed by a Swivel to the  board going
behind the head of the bed above the pillow.  The
bed is to be  inclined from the head to the feet about
twelve or Sixteen  inches.   Hence  the patient  would
be conftantly Sliding  down during fleep,  unlefs fup-
ported by this bow, with webbed forks, covered alfo
with  fur, placed beneath the chin, and beneath the
occiput.  There  are alfo proper webs lined with fur
for the hands to take hold  of occafionally,  and alfo to  .
go under the arms.   By thefe  means I  fhould hope
great advantage  from gradually  extending the fpine
during the inactivity of the mufcles of the back;  and
that  it may  be  done without disturbing the fleep of
the patient,  and if  this Should happen, the  bow  is
made to open by a joint at the fummit of it, fo as to
be inftantly difengaged from the neck by the hand of
the wearer.  This bow I  have not  yet had  oppor-
tunity to make ufe of, but it may be had from  Mr.
Harrifon, whitefmith, Bridge-gate, Derby.
                        I                        It 
ii*               DISEASES     [Class 1.1. 2,
   It will be from hence eafily perceived, that all other
methods of confining or directing the growth of young
people Should  be ufed with great Skill y fuch as back-
boards, or bandages,  or Stocks  for  the feet;  and
that their application fliould not be continued too long
at a time, left worfe confequences fhould enfue,  than
the deformity they were defigned  to remove.   To this
may be added,  that the ftiff  erect attitude taught by
fome  modern  dancing  mafters docs not contribute to
the grace of perfon, but rather militates againft ft; as
is well feen in one  of the prints in Hogarth's Analyfis
of Beauty ;  and is exemplified by the  eafy grace of
fome of theantient Statues, as. of the Venus de Medici,
and the Antinous, and in the works of fome modern
artifts, as in a  beautiful print of Hebe  feeding  an
Eagle, painted by  Hamilton,  and engraved  by Egin-
ton, and many of the figures of Angelica Kauffmam
   Where the bone of one of the vertebre of the back
has been  Swelled on both fides of it,  fo as to become
protuberant,  iffues near the Swelled part  have been
found of great fervice,  as mentioned in Species 18 of
this genus.  This has induced me to propofe in cur-
vatures of the fpine,  to put an iffue on the outfide of
the curve, where it could be  certainly afcertained, as
the bones on the convex fide of the curve muft be en-
larged ; in one cafe I thought thj^of fervice, and re-
commend the further trial of it.
  In the tendency to curvature of the fpine,  whatever
Strengthens- the  general constitution  is of fervice -x as
the ufe of the cold bath in the fummer months.  This
                                          however 
Class I. 2.2.]     OF IRRITATION.              *i$
however requires fome restriction both  in refpect  to
the degree of coldnefs of the bath, the time of continu-
ing in it, and the feafon of the year. Common fprings,
which are of forty-eight degrees of heat, are too cold
for tender constitutions, whether of children or adults,
and frequently do them great and irreparable injury*
The coldnefs of river  water  in the Summer  months,
which is about fixty-eight degrees, or that of Matlock,
which  is about  fixty eight,  or of  Buxton,  which is
eighty-two,  are much  to be preferred..  The time  of
continuing in the bath  Should be but a minute or two,
or not fo long as to occafion  a  trembling of the limbs
from cold.   In refpect  to the  feafon of the year, deli-
cate children fliould certainly only bathe in  the fum-
mer months;  as  the going frequently  into  the cold
air in  winter will anfwer all  the purpofes of the cojd
bath.

    17. Claudicatio  coxaria.  Lamenefs  of  the  hip.
A nodding of the thigh-bone  is  faid  to be produced  in
feeble  children by  the foftnefs  of the  neck  or upper
part of that bone beneath the cartilage ; which is na-
turally bent, and in this difeafe bends more  down-
wards, or nods,  by the preffure of  the body;  and
thus renders one leg apparently Shorter than the other.
In other  cafes the end of the  bone is protruded out
ofitsfocket, by inflammation or enlargement  of the
cartilages or ligaments  of the joint,  fo that it refts on
fome  part of the edge of the  acetabulum,  which in
time becomes filled  up.   When the legs are Straight*
                        I 2                      as 
ir<?              DISEASES      [Class I. 2. z.
as in Standing erect, there is no vertieillary motion in
the knee-joint; all the motion theri in turning  out the
toes further than nature  defigned, muft  be obtained
by  Straining in fome degree  this head  of the thigh-
bone,  or the  acetabulum,   or  cavity,  in  which  it
moves.   This has induced me to believe, that this mis-
fortune of the nodding of the head  by the bone,  or
partial dislocation of  it,  by  which one  leg becomes
Shorter  than the other,  is  fometimes occafioned  by
making very young children Stand in what are called
Stocks; that is  with  their  heels  together, and their
toes quite out.  Whence the Socket of the thigh-bone
becomes inflamed and painful, or the neck of the bone
is bent downward and outwards.
   In this cafe there is no  expectation  of recovering
the ftraightnefs  of  the end  of the bone; but  thefe
patients are liable to  another misfortune, that is,  to
acquire  afterwards a  diftortion of the  fpine; for as
one leg is Shorter than the other, they fink  on that
fide, and in confequence bend the upper part  of their
bodies, as their  Shoulders,  the  contrary  way, to ba-
lance  themfelves ;  and then again the  neck  is bent
back again towards the lame fide,  to preferve the head
perpendicular;  and  thus the figure becomes  quite
distorted like the letter S, owing originally to the de-
ficiency of the length  of one limb.  The only way to
prevent this curvature of the fpine is for'the c^ild to
wear a high-heeled fhoe  or patten  on  the lam& foot,
fo as  to fupport  that  fide on the fame level with the
ether,  and thus to prevent a greater  deformity.
                                             I have 
Class I. 2.2.]     OF IRRITATION.              115
   I  have this day feen a young lady about twelve,
who does not limp or waddle in walking ;  but never-
thelefs, when fhe ftands or fits, fhe finks down towards
her right fide, and turns out that toe more than the
other.  Hence,  both as fhe fits and  Stands, fhe bends
her body to the  right;  whence her head would hang
a little over her  right flioulder : but to replace this
perpendicularly,  flie lifts up her left flioulder and con-
tracts the mufcles on that fide of the  peck ; which are
therefore become thicker and ftronger by their con-
tinued action; but there is not yet  any very percep-
tible diftortion of the fpine.
   As her right toe is turned outward rather more than
natural, this Shews the difeafe to be  in  the hip-joint;
becaufe, when the limb Is Stretched out, the toe can-
not  turn horizontally in the leaft without moving the
end of the thigh-bone ;  although when the knee is
hent, the toe can be turned through one third or half
of a circle by  the rotation of the tibia  and fibula of
the leg round each other.  Hence if children are fet
in Stocks  with their heels touching each other as they
fit, and are then made to rife up,  till they Stand  erect,
the focket or head of the thigh-bone becomes injured,
efpecially in thofe children, whofe bones are foft; and
a fliortnefs of that limb fucceeds either by the bending
of the neck of the thigh-bone,  or by its getting out
of the acetabulum ;  and a confequent  rifing of one
Shoulder, and a  curvature of the fpine is produced
from fo diftant a caufe.
                                                 1
                         I 3             M. M. An 
H«              DISEASES       [Class I. 2.3.
   M, M.  An  elaftic cufliion made of  curled hair
fhould be placed under the affected hip, whenever fhe
fits; or Should be  fitted to  the part by means of
drawers, fo  that  fhe  cannot  avoid fitting  on it.   A
neck-fwing,  and lying down in the day, fhould be oc-
cafionally ufed to prevent or remove  any  curvature of
the fpine.   The reft as in Species 13 and  15 of  this
genus,
                       «r
   18. Spina protuberans.   Protuberant  fpine.   One
of the bones of the fpine fwells, and rifes above the
reft.   This is  not an uncommon difeafe, and belongs
to the innutrition of the bones,  as the bone  muft be-
come  foft  before it  fwells ;  which foftnefs is owing to
defect  of  the  fecretion of  phofphorated calcareous
earth.  The fwelling of the bone compreffes a part of
the brain, called the fpinal  marrow,  within the cavity
of the backrbones;  and in confequence  the lower
limbs become paralytic, attended fometimes with diffi-
culty  of emptying the bladder, and rectum.
   M, M-  Iffues put  on each fide of the prominent
bone are of great effect, I fuppofe, by their ftimulus;
which excites into action more of the fenforial powers
of irritation and fenfation, and  thus  gives  greater ac-
tivity to the vafcular fyftem  in their vicinity.   The
methods  recommended in distortion pf  the  fpine are
alfo to be attended  to.

   19. Spina bifida.  Divided fpine, called  alfo  Hy-
drorachitis,. as  well as  the  Hydrocephalus  externus,
                                                are 
Class I. 2. 2.]     OF IRRITATION.             119
are probably owing in  part  to a  defect of oSfification
of the fpine and cranium ;  and that the collection of
fluid beneath  them may  originate from  the general
debility of the fyftem ;  which affects both the fecer-
ning, and abforbent veffels.
  A curious circumftance, which  is affirmed to attend
the fpina bifida, is, that on comprefling the tumor
with the hand gently, the whole brain becomes aflcct-
ed, and the patient falls afleep.   I fuppofe the fame
muft happen on comprefling the hydrocephalus exter-
nus ? See Sect. XVIII.  20.

   20. Offis palati defeclus*  A defect  of the bone of
the  palate,  which frequently accompanies  a division
of the upper lip, occurs before nativity ;  and is owing
to the  deficient action  of the  fecerning fyftem,  from
whence the extremities  are  not  completed.   From a
fimilar caufe I have feen the point of the tongue de-
ficient,  and one joint of the two  leaft fingers, and of
the  two leaft toes,  in the fame infant;  who was
otherwife a  fine girl.  See Se£t. XXXIX. 4. 4.
   The operation for the hare-lip is defcribed by  many
Surgical writers; but tliere is a  perfon in London,
who makes very  ingenious artificial palates;  which
prevents that defect  of Speech,   which attends this
malformation.  This factitious palate confifts of a thin
plate of filver of  the fliape and form of the roof of
the mouth ; from  the front  edge  to the back edge of
this  filver  plate four  or five  holes  are made in a
ftraight fine large  enough for a needle  to pafs through
                       I  4                  them j 
 120              DISEASES      [Class I. 2.3.
 them; on  the  back of it is then  fewed a  piece  of
 fponge; which when expanded with moifture is nearly
 as large as the filver plate.  This fponge  is flipped
 through the  divifion of the bone of the palate, fo as
 to lie above it,  while the filver plate covers the  aper-
 ture  beneath, and  is  fufpended  by  the  expanding
 fponge.   This is  removed every night and wafhed,
 and returned into its place in the morning ;  on this
 account  it  is convenient  to have five or fix of them,
for the fake of cleanlinefs.   I  have been more, parti-
cular in  defcribing this  invention, as  I do not know
the name, or place of refidence, of the maker.
                   ORDO   II.
                Decreafed Irritation.

                  GENUS   III.
     The decreafed Aclion of the Abforbent Syflmn.
   Some  decreafe  of  heat attends  thefe  difeafes,
though  in a lefs degree than thofe of the laft genus,
becaufe the abforbent fyftein of glands do not gene-
rate  fo  much  heat  in  their healthy  ftate of  action as
the fecerning  fyftem of glands, as explained in Clafs
I. 1. 3*

                   SPECIES.
   1.  Mucus fauciumfrigidus.   Cold mucus from the
throat.   Much mucus, of rather a faline tafte, and
                                               lefs 
Class I. 2. 3.]     OF IRRITATION.              i2t
lefs infpiffated than ufual, is evacuated from the fauces
by  hawking, owing to the deficient  abforption of the
thinner parts of  it.   This becomes  a habit in fome
elderly  people, who are continually fpitting it out of
their  mouths ;  and has probably been brought on by
taking fnuff, or  fmoaking  tobacco;  which  by fre-
cuiently ftimulating the fauces have at length rendered
the abforbent veffels  lefs excitable by the natural fti-
mulus of the faline part of the fecretion, which ought
to be reabforbed,  as foon  as fecreted.
   M. M. A few grains of powder of bark  frequently
put into the mouth,  and gradually diffufed over the
fauces.  A gargle of barley water.

   2.  Sudor frigidus.  The cold dampnefs  of the hands
of  fome people is  caufed by the deficient abforption
of  perfpirable  matter;  the  clammy or vifcid  feel of
it is  owing to the mucous  part being left  upon the
ikin.  The coldnefs is produced  both by the decreafed
action of the abforbent fyftem, and by  the evapora-
tion  of a greater quantity  of the perfpirable matter
into  the air, which ought  to have been abforbed.
   M. M. WaSh the hands  in  lime water, or with a
fmall quantity of volatile alkali in water.

    3. Catarrhus  frigidus.    The  thin difcharge  from
 the noftrils in cold weather.   The abforbent veffels
 become torpid  by  the diminution  of external  heat,
 fooner than the fecerning ones,  which are longer kept
 warm by the circulating blood,  from which they  felect
                                                 the 
 122               DTSEASES      [Class I. z. 3.
 the  fluid  they fecrete; whereas the abforbent veffels
 of the noftrils drink up their fluids, namely the thin
 and  faline part of the mucus, after it has been cooled
 by  the atmofphere.  Hence the abforbents ceafing to
 act,  and  the fecerning veffels  continuing fome  time
 longer to pour out the mucus, a copious  thin dif-
 charge is  produced,  which trickles  down the noftrils
 in cold weather.   This  difcharge is  fo acrid as  to
 inflame the upper  lip ; which is owing  to  the  neu-
 tral falts,  with which it abounds, not being  reabforb-
ed;  fo the tears in  the fiftula  lacrymalis inflame the
 cheek.  See Clafs  I.  1.  2.  7.

  4. Expecloratio frigida.  Cold expectoration. Where
 the  pulmonary abforption is deficient,  an habitual
 cough  is  produced, and a  frequent expectoration  of
 thin faline mucus ; as is often feen in old enfeebled
 people.   Though  the  ftimulus of  the faline fluid,
 which  attends all fecretions, is  not fufficient to excite
 the  languid abforbent veffels to imbibe  it; yet this
 faline part, together  with  the  increafed quantity  of
 the  whole  of  the fecreted  mucus,  ftimulates  the
 branches  of the bronchia,  fo as to  induce an almoft
 inceffant cough to  difcharge it  from the lungs.   A
 Single grain of opium, or any  other ftimulant drug,
 as a wine-pofiet with fpirit of hartfhorn,  will  cure
 this  cold  cough, and the  cold catarrh  of  the  pre-
 ceding article,  like  a charm, by ftimulating the torpid
 mouths of the  abforbents into  action.     Which has
 given rife  to  an indifcriminate  and frequently perni-
                                               cious 
Class I. 2.3.]     OF  IRRITATION.             t2$
cious ufe of the warm regimen- in coughs  and ca-
tarrhs of the  warm  or inflammatory kind, to the
great injury  of many.
   M. M. Half a grain of opium night and morning
promotes the abforption of the more  fluid and faline
parts,  and in confequence  thickens the  mucus, and
abates its acrimony.    Warm  diluent drink,  wine-
whey, with  volatile alkali.

   5. Urina uberior pallida.   On being expofed naked
to cold air,  or Sprinkled with cold  water, a quantity
of pale urine  is foon difcharged ;  for  the abforbents
of the bladder become torpid by their fympathy with
thofe of the  ikin ;  which are rendered quiefcent by
the diminution of external heat; but the kidneys con-
tinue to  fecrete the urine, and as no part of it is ab^
forbed,  it becomes copious and pale.   This  happens
from a fimilar caufe in cold fits of agues;  and in lefs
degree to many debilitated conftitutions, whofe ex-
tremities are generally cold and  pale. The great quan-
tity of limpid water in hyfteric cafes, and in diabetes,
belongs  to Clafs I. 3. 1. 10. I. 3. 2. 6.
   M. M. Tincture of cantharides,  opium, alum, for-
bentia.  Flannel fhirt in cold weather.  Animal food.
 Beer.  Wine.  Friction.  Exerciie.  Fire.

    6.  Diarrhoea frigida.   Liquid ftools are  produced
 by  expofing the body naked to cold air, or fprinklino-
 it with cold water, for the fame reafon as Hie laft ar-
 ticle,
                                               But 
 124              DISEASES       [Class 1.2.3.
   But this difeafe is fometimes of a dangerous nature ;
 the inteftinal  abforption being fo impaired,  that  the
 aliment is faid to come away undiminished in quantity,
 and almoft unchanged by the powers of digeftion, and
 is then called lientery.
   The  mucus of the  rectum fometimes comes  away
 like pellucid hartfhorn jelly, and liquefies by heat like
 that, towards  the  end of inirritative fevers,  which is
 owing to the thinner part of the mucus not being ab-
 forbed,  and thus refembles the catarrh of fome  old
 people.
   M. M. Opium, campechy wood, armenian  bole.
 Blifter.   Flannel Shirt in cold weather.   Clyfters with
 opium.   Friction  on the bowels morning and  night.
 Equitation twice a day.

   7. Fluor albus frigidus.   Cold fluor albus.  In weak
 constitutions, where  this difcharge is pellucid and thin,
 it muft proceed from want  of abforption  of the mu-
cous  membrane  of  the vagina,  or uterus, and not
 from an increafed fecretion.  This I fu/pect to be the
 moft frequent  kind of fluor albus;  the former one de-
 fcribed at Clafs I. 1. 2. 11.  attends menftruation, or
is a difcharge inftead of it,  and thus refembles the ve-
 nereal orgafm  of female quadrupeds.   The difcharge
 in this latter kind being more faline,  is liable to  exco-
riate the part, and thus produce fmarting  in making
water;  in its great degree  it is  difficult to cure.
  M. M.  Increafe the evacuation by flool and by per-
fpiration, by taking  rhubarb every night, about  fix
                                                or 
Class I. 2.3.]     OF IRRITATION.              i2-
or  ten grains with  one  grain of opium for fome
months.   Flannel fhirt in  winter.   Balfam copaiva*
Gum  kino,  bitters,  chaiybeates,  friction  over  the
whole ikin with flannel morning and  night.   Partial
cold  bath,  by  fprinkling  the  loins  and thighs, or
fponging them with cold water.   Mucilage, as ifin-
glafs boiled in milk ; blanc mange, hartfliom  jelly, are
recommended by fome.  ' Tincture of cantharides fome-
times feems of fervice given from ten to twenty drops
or more, three or four times a day.   A large blifter
of burgundy  pitch and armenian bole, fo as to cover
the loins  and lower part of the belly,  Is faid to have
fometimes  fucceeded  by increafing abforption  by  its
compreSfion in the manner  of a  bandage.  A folution
of metallic falts, as white vitriol, fixty grains to  a pint;
or an  infufion of oak-bark  may be injected  into  the.
vagina.  Cold bath.

   8.  Gonorrhoea  frigida.    Cold gleet.  Where  the
gleet  is thin  and pellucid, it muft arife from the want
of abforption of the membranes  of  the urethra, rather
than from  an increafed fecretion from them.   This I
fuppofe to be a  more common difeafe than that men-
tioned at Clafs I.  1. 2. 10.
   M.  M.  Metallic injections, partial cold bath, inter-
nal method  as  in  the fluor  albus above defcribed.
Balfam ot copaiva.  Tincture of cantharides.

   9.   Hepatis tumor.   The  liver  becomes enlarged
from  defect of the abforption of mucus from its cells, 
 125               DISEASES       [Class 1.2. 3*
as in anafarca, efpecially in feeble  children; at  the
fame time lefs bile is fecreted from the torpid circula-
tion in the vena porte.   And as the abforbents, which
refume  the  thinner parts of the bile from the gall-
bladder and hepatic ducts, are alfo torpid or quiefcent,
the bile is more dilute,  as  well as  in  lefs quantity.
From  the obstruction of  the paffage  of the  blood
through the compreffed vena porta thefe patients have
tumid bellies, and  pale  bloated  countenances; their
palenefs is  probably owing to  the  deficiency of  the
quantity of  red globules in the blood in confequence
of the inert  ftate of the bile.
   Thefe fymptoms in children are generally attended
with  worms,  the  dilute bile and the weak digeftion
not destroying them.  In Sheep  I have feen fleuke-
worms in the gall-ducts themfelves among the  dilute
bile ;  which gall-duCts  they  eat through, and then
produce ulcers, and the hectic fever, called the  rot.
See Clafs I. 1. 4.  10. and Article IV. 2. 6.
   M. M. After a calomel  purge,  crude iron-filings
are Specific in this  difeafe in children, and the worms
are deftroyed by the  returning acrimony and quantity
of the  bile.  A blifter on  the  region  of the  liver.
Sorbentia,  as  worm-feed,  fantonicum.   Columbo.
Bark.

   io. Chlorofis*   When the defect  of the due  action
of both the abforbent and Secerning veffels of the liver
affects women, and is attended with  obstruction  of the
catamenia,  it is called chlorofis;  and is cured by the
                                          exhibition 
 Class I. 2.3.]     OF IRRITATION.              r-7
 exhibition of fteel, which reftores by its fpecific ftimu-
 lus the abforbent  power  of the liver; and the men-
 ftruation, which was obstructed  in confequence of de-
 bility, recurs.
    Indigeftion, owing to torpor of the ftomach, and  a
 confequent too great acidity of its contents, attends this
 difeafe ;  whence a defire  of eating chalk, or  marl.
 Sometimes a great quantity of pale urine is difcharged
 in a morning, which is owing to the inaction of the ab-
 forbents,  which are distributed on the  neck of the
 bladder, during fleep.   The fwelling of the ankles,
 which frequently attends chlorofis, is another effeCt of
 deficient action of the abforbent fyftem; and the pale
 countenance is occafioned by the deficient quantity  of
 red globules of blood, caufed by the deficient quantity
 or acrimony of  the bile, and confequent  weaknefs of
 the circulation.   The pulfe  is fo quick in fome cafes
 of chlorofis, that,  when  attended with an  accidental
 cough, it may be mistaken for pulmonary confumption.
 This quick  pulfe is owing  to the debility  of the heart
 from the want of ftimulus occafioned by the deficiency
1 of the quantity, and acrimony of the blood.
    M. M. Steel.  Bitters.  Conftant  moderate exer-
 cife.   Friction with flannel all over the body and limbs
 night and morning.   Rhubarb five grains, opium half
 a grain, every night.  Flefh diet, with fmall beer,  or
 wine and water.  The difeafe continues fome months,
 but  at length  fubfides  by the treatment above de-
 fcribed.   A bath of about eighty degrees, as Buxton
 Bath, is. of fervice ;  a colder bath may do great injiary.
                                          11.  Hvdro- 
128               DISEASES      [Class 1.2. 3.
   11.  Hydrocele*  Dropfy of the vagina teftis.  Drop-
fies have been divided into the incyfted  and the dif-
fufed,  meaning thofe of the cellular membrane, the
cells ©f which communicate with each other like a
fponge, and thofe of any other  cavity of the  body.
The collections of mucous fluids  in  the  various cells
and cavities of the body  arife from the torpor of the
abforbent veffels of thofe  parts.   It  is  probable,  that
in dropfies attended with  great thirft  the cutaneous
abforbents become paralytic firft ; and then from the
great thirft, which is thus occafioned by the want of
atmofpheric moifture, the  abforption of the fat enSues;
as in  fevers attended with great  thirft,  the  fat  id
quickly taken  up.  See Obefitas I.  2. 3. 16.  Some
have  believed, that the  cellular and  adipofe  mem-
branes are different ones ;  as  no  fat is ever depofited
in the  eye-lids or fcrotum, both which  places are very
liable to be diftended  with the  mucilaginous fluid of
the anafarca, and with air  in Emphyfema.   Sometimes
a gradual abforption of the accumulated fluid  takes
place, and the thinner parts being taken up, there re-
mains a more vifcid fluid, or almoft a folid in the part,
as in fome Swelled legs, which  can not  eafily  be in-
dented  by the preffure of  the finger, and are called
fcorbutic.  Sometimes  the paralyfis of the abforbents
is completely removed, and the whole is  again taken
up into the circulation.
   The Hydrocele is known by a tumor  of  the fcro-
tum, which is without pain, gradually  produced, with
fluctuation, and a degree of pellucidity, when a candle
                         a                        is 
Class I. 2. 3,]    OF IRRITATION.              i2p
is held behind it;  it is  the moft fimple incyfted drop-
fy,  as it is not in general complicated with other dif-
eafes, as afcites with fchirrous liver, and hydrocepha-
lus internus, with general debility.   The cure  of  this
difeafe is effected by different ways;  it confifts in dif-
charging the water by an external aperture ;  and by
fo far inflaming the cyft and tefticle, that they after-
wards grow together, and thus prevent in  future  any
fecretion or  effufion of mucus ; the  difeafe  is  thus
cured, not by the revivefcence of the abforbent power
of the lymphatics, but  by the prevention of fecretion
by the adhefion of the  vagina to the teftis.   This  I
believe is performed with lefs puin,  and is more cer-
tainly manageable by tapping, or difcharging the fluid
by means of a trocar, and after the evacuation  of it to
fill the cyft with a mixture of wine and water for a  few
minutes till  the neceffary degree of ftimulus  is  pro-
duced,  and then to  withdraw it; as recommended by
Mr.  Earle.   See  alfo Medical Commentaries  by  Dr.
Duncan, for 1793.

   12.  Hydrocephalus internus, or dropfy of the ventri-
cles of the brain, is  fatal to  many children,  and fome
adults.   When this  difeafe is lefs in quantity,  it pro-
bably  produces a fever, termed a nervous fever,  and
which is fometimes called a  worm fever, according to
the opinion  of Dr. Gilchrift, in the Scots Medical
effays.  This fever is attended with great inirritability,
as appears  from  the  dilated pupils  of the eyes, in
which it correfponds with  the  dropfy of the brain.
                         K                    And 
*3°              DISEASES      CClassI. 2.3.
And the  latter difeafe  has its  paroxyfms of  quick
pulfe, and in that refpect correfponds with other fevers
with inirritabil'ty.
   The hydrocephalus internus  is distinguished from
apoplexy by its being attended with  fever, and from
nervous fever  by the paroxyfms being very irregular,
with perfect intermiffions  many times in a day.   In
nervous  fever the pain of  the head  generally affects
the middle of the forehead ;  in hydrocephalus inter-
nus it is generally on one fide of the head.   One of
the earlieft criterions is the patient being  uneafy on
raifmg his head from the  pillow, and  wifliing  to lie
down again immediately; which I fuppofe is owing to
the preffure of the water on the larger trunks of the
blood-veffels entering the cavity being more intolera-
ble than  on the Smaller one ; for if the larger trunks
arc compreffed, it  muft inconvenience the branches
alfo ; but if fome of the fmall branches are compreffed
only, the trunks are  not fo immediately incommoded.
   BliMers on the head, and mercurial ointment exter-
nally, with  calomel  internally, are principally recom-
mended in this fatal  difeafe.  When  the  patient can-
not bear  to be  raifed up in bed without great unea-
finefs, it is a bad fymptom.   So I believe is deafnefs,
which is  commonly mistaken for Stupor.   See Clafs. I.
2. 5. 6.  And when the  dilatation  of the pupil of
cither eye, or  the fquinting is very apparent, or  the
pupils of both eyes much dilated, it is generally fatal.
As by Stimulating one  branch  of lymphatics into in-
verted  motion, another branch  is liable to  abforb its
                                              fluid 
  Class I. 2. 3.]     OF IRRITATION.              t3I
  fluid more haftily ; fuppofe ftrong errhines, as common
  tobacco fnuff to children, or one grain of turpeth  mi-
  neral, (Hydrargyrus vitriolatus),  mixed  with  ten or
  fifteen grains of fugar, was  gradually blown up  the
  noftrils ?  See Clafs I.  3.  2. 1.  I have tried common
 fnuff upon two children in this difeafe; one could  not
 be made to fneeze, and the other was  too near death
  to receive  advantage.   When the mercurial  prepara-
 tions  have produced  falivation, I believe they may
 have been of fervice, but I doubt their  good effect
 otherwife.  In one child I tried the tinfture  of Di?i-
 talis ; but  it  was  given with too timid a hand,  and
 too late  in  the difeafe, to  determine its effects.   See
 Sect, XXIX.  5. 9.
   As all the above remedies generally  fail of fuccefs,
 I think  frequent,  almoft hourly,  Shocks of electricity
 from very fmall charges might be paffed through  the
 head in  all directions with probability of good event.
 And  the ufe  of the trephine, where the affected fide
 can be distinguished.  See Strabifmus, Clafs I.  2. 5. 4.
 When one eye is affected, does the difeafe  exift in the
 ventricule of that fide ?

   13.  Afcites.   The dropfy of the cavity  of  the ab-
 domen is known by a  tenfe  fwelling  of  the belly ;
 which does  not  found on  being iiruck like the tym-
 pany ; and in which a fluctuation can  be  readily
perceived by applying one hand expanded on one fide,
and Striking the tumour on the other.
K. 2
Effufions 
132               DISEASES      [Class I. 2 3".
   Effufions  of water into large cavities, as into that
of the abdomen or  thorax,  or into  the ventricule9
of the brain or pericardium,  are more difficult to be
reabforbed,  than the effufion of fluids into the cel-
lular membrane ; becaufe one  part of this  extenfive
fpong°-lihe fyftem of cells,  which connects all the
folid parts of the body, may have its  power of ab-
forption impaired, at the fame  time  that fome  other
part of it may ftill retain  that power,  or perhaps
poffefs it  in an increafed  degree ; and as all  thefe
celk communicate  with each other,  the fluid, which
abounds in one part  of  it,  can  be transferred to an-
other,  and thus be reabforbed into the circulation.
   In the afcitcs, crtam  of  tartar has  fometimes been
attended with fuccefs;  a dram or two drams are  given
every hour  in  a morning till it operates, and  is  to
be  repeated  for feveral days;   but the  operation  of
tapping is generally  applied to  at laft.  Dr. Sims,  in
the Memoirs of the Medical  Society of London, Vol.
III. has lately propofed,  what he believes to be a
more  fuccefsful  method of performing this operation,
by making a puncture with a lancet in the fear of the
navel, and leaving it to difcharge itfelf gradually for
feveral days, without introducing a canula, which he
thinks injurious both  on account of  the too fudden
emi/fion  of the fluid,  and  the danger of wounding
or Stimulating the vifcera.   This operation  I  have
twice known  performed with lefs inconvenience, and
I believe with  more benefit  to  the patient, than the
common method.
                                              After 
Cla€s I. 2. 3.]    OF IRRITATION.              1..33
   After the patient has been tapped, fome have tried
injections into the cavity of the abdomen, but hitherto I
believe with ill event.  Nor are experiments of this kind
very promifing  of fuccefs.   Firft becaufe the patients
are  generally  much  debilitated, moft  frequent!)  by
fpirituous potation, and have  generally a  difeafe of
the liver, or of other vifcera.   And fecondly, becaufe
the  quantity of inflammation,  neceflary to prevent
future fecretion of mucus into the cavity of the  ab-
domen, by uniting the peritoneum  with the inteftines
or mefentery, as happens in  the cure of the hydrocele,
would I fuppofe  generally deftroy  the  patient, either
immediately, or by the confequence of fuch adhefions.
   This  however is  not  the  cafe  in  refpect to  the
drofpy of the ovarium, or in the hydrocele.
   14. Hydrops  thoracis.   The dropfy of the cheft
commences  with lofs  of fiefli,  cold extremities, pale
countenance, high coloured urine  in fmall  quantity,
and general debility,  like many other dropfies.   The
patient next complains of numbnefs in the arms, efpe-
cially when eleyated, with pain and difficulty of Swal-
lowing,  and  an abfolute impoffibility of lying  down
for a few minutes, or with fudden  ftarting from Sleep,
with great difficulty  of breathing  and palpitation of
his heart.
   The numbnefs of the arms is probably owing more
 frequently to the increafed action of the pectoral muf-
cles in refpiration, whence  they are. lefs at liberty to
perform other  offices, than to the connexion of nerves
mentioned in  Sect.  XXIX.  5. 2.   The difficulty of
                         K 3             fwallowing 
13+              DISEASES      [Class I. 2. 3.
fwallowing is owing to the compreffion of the cefopha-
gus b  the lymph in the cheft ; and  the impoffibility
of breathing in an horizontal  pofture originates  from
this, that if any parts of the  lungs  muft be render-
ed ufelefs, the inability of the extremities  of  them
mv.ft be  ler, inconvenient to refpiration ; fince if the
ii'v-ier '-'ans  or larger trunks of the air-veffels fliould
be  rendered ufelefs by  the compreffion of the  accu-
mulated  lymph, the air  could  not gain admittance to
the  other parts, and  the animal muft immediately
peri Sli.
   If the pericardium is the principal feat of the dif-
eafe, the pulfe is quick and  irregular.   If only the
cavity of the thorax is hydropic, the pulfe is not quick
nor  irregular.
   If one fide is more affected than the other,  the pa-
tient leans moft that way, and has more numbnefs in
that arm.
   The hydrops thoracis is diftinguifhed from  the ana-
farca pulmonum,  as  the patient in the former cannot
lie down half a minute  ;  in the latter the difficulty of
breathing, which occafions  him to rife up, comes on
more gradually;  as the tranfition of  the  lymph in
the cellular membranes  from one part  to another of
it is flower, than that  of the effufed lymph in. the
cavity of the cheft.
   The  hydrops thoracis Is often  complicated with fits
of  convulsive breathing ; and then it products  a dif-
eafe for  the time very Similar to the  common periodic
afthma,  which is perhaps owing to  a temporary an. -
                                              f. ~^, 
Class I. 2. 3.]     OF IRRITATION.             I3y
farea of the lungs; or to an impaired venous abforp*
tion in them.  Thefe exacerbations of difficult breath-
ing are attended with cold extremities, cold breath,
cold tongue, upright  pofture with  the  mouth  open,
and a defire of  cold air, and a quick, weak, intermit-
tent pulfe, and contracted hands.
  Thefe exacerbations' recur fometimes  every two or
three  hours, and are relieved by opium, a grain every
hour for two or three dofes, with ether  about a dram
in cold wacer ;  and feem to be a  convulfion  of the
mufcles of refpiration induced by  the  pain of  the
dyfpncca.   As  in Clafs III. 1. 1.  9.
  M. M.  A grain of dried fquill, and a quarter of a
grain of blue vitriol every hour for fix or eight hours,
unlefs it vomit or purge.  A grain of opium, Blifters,
Calomel three  grains every third day,  with  infufion
of fenna.  Bark.  Chaiybeates.  Puncture in the fide.
  Can the fluctuation in  the cheft be heard by apply-
ing the ear to the fide,  as Hippocrates afferts ? Can
it be felt  by the hand or by  the patient before the
difeafe is too great  to admit of cure  by the paracen-
tefis ?   Does this dropfy of the cheft often come on
after peripneumony ?   Is  it ever cured by making the
patient  fick by  tincture  of digitalis ?   Could  it  be
cured,  if on one fide only, by the operation of punc-
ture between the ribs, and afterwards  by inflaming
the cavity  by the admiffion  of air for  a time,  like
the cure  of the hydrocele ;  the  pleura afterwards
0 .Iherbg wholly to that  lobe  of  the  lungs, fo as to
prevent any future effufion of mucus?
                      R3              15* Hydrops 
136              DISEASES      [Class I. 2. 3.
   15. Hydrops ovarii.  Dropfy of the ovary is another
incyfted dropfy, which feldom admits  of cure.   It  is
diftinguifhed from afcites  by  the  tumour and pain,
efpecially at the beginning,. occupying one  fide,  and
the fluctuation being lefs distinctly perceptible.  When
it happens  to young Subjects it is lefs liable to be mif-
taken for afcites.   It affects women of all ages, either
married or virgins; and  is produced  by cold, fea.r,
hunger, bad food,  and  other debilitating  caufes.  I
faw an elegant young lady, who was Shortly to have
been married to a fenfible man, with great profpeCt of
happinefs ; who,  on being overturned in a . chaife in
the night,  and obliged to walk two or three miles  in
wet, cold, and darknefs,  became much  indifpofed,
and gradually afflicted with a fwelling and pain on one
fide of the abdomen ;  which  terminated in a dropfy
of the ovary, and deftroyed her in two or three years,
Another young woman I recollect feeing, who was
about feventeen,  and being of the very inferior clafs
of people,  feemed to  have  been much weakened by
the hardship of a  cold floor, and little or  no bed, with
bad food ; and who to thefe evils had  to bear the un»
ceafing obloquy of her neighbours, and the perfecution
of pariSli officers,
   The following is abstracted from  a  letter  of my
friend Mr. Power,  furgeon, at Bofworth in Leicester-
shire, on examining.the body of an elderly lady who
died of this difeafe, March  29, 1793.   " &n open-
ing the abdomen  I found a large cyft attached  to  the
left ovarium by an elaftic  neck as thick as  the little
                                             finger, 
Class I. 2. 3.]     OF IRRITATION.              i37
finger, and fo callous as not to admit of being  fepa-
rated by fciffars without confiderable difficulty.  The
iubltance of the cyft had an appearance much refem-
bling the gravid uterus near the full period of gefta-
tion,  and was as  thick.   It had no attachment  to the
peritoneum, or any of the vifcera,  except by the hard
callous neck I have mentioned ; fo  that the blood muft
with  difficulty  have been  circulated  through  it for
fome time.  Its texture was extremely tender, being
eafily perforated  with  the  finger,  was of a livid red
colour, and evidently in a Sphacelated ftate.   It con-
tained about two gallons of a fluid  of.the colour of
port wine, without any greater tenacity.  It has fal-
len to my lot to  have opened  two other patients,
whofe deaths were occafioned by incyfted  dropfy of
the ovarium.  In one of thefe the ovarium was much
enlarged with  eight or ten  cyfts on its furface, but
there was no adhefion  formed by  any of the cyfts to
any other part ;  nor had the ovarium formed any ad-
hefion with the peritoneum, though in a very difeafed
ftate.  In the other the diieafe was more Simple, being
only  one cyft,  without any attachment  but  to the
ovarium.  *
   " As the ovarium is a  part not  neceffary to life,
and dropSies of this kind are  fo generally fatal in the
end, 1 think I Shall be induced,  notwithstanding the
hazard attending wounds,  which penetrate the cavity
of the abdomen, to  propofe the extirpation  of the
.difeafed  part in the fint cafe,  which  occurs to me,  in
■which I  can with precision fay,  that  the  ovarium is
                                               the 
 »38              DISEASES      [Class I. 2. 3.
 the feat of the difeafe, and  the  patient in other re-
 fpects tolerably healthy ;  as the cavity of the abdo-
 men is often  opened  in other cafes without bad con-
 fequences."
   An argument,  which might further countenance
 the operation thus propofed by Mr. Power, might be
 taken from the difeafe frequently affecting young per-
 fons; from its being generally in thefe fubjects local
 and primary ;  and not like  the  afcites, produced or
 accompanied with other difeafed vifcera;  and laftly,
 as it is performed  in adult quadrupeds, as old fows,
 with fafety, though by awkward operators.

   16. Anafarca pulmonum.  The dropfy of the cel-
 lular membrane of the lungs is ufually connected w ith
 that of the other parts of the fyftem.  As the cells of
 the whole cellular membrane communicate  with each
 ©ther, the mucaginous fluid, which  remains  in  any
 part of it for want of  due  abforption, finks down to
 the moft depending cells; hence the legs fwell, though
 the caufe of the difeafe, the deficiency of abforption,
 may be in other parts of the fyftem.   The lungs how-
 ever are an exception  to this, fince they are fufpend-
 ed in the cavity  of the thorax,  and have  in  confe-
 quence a depending part of their own.
  The anafarca of the lungs is known by the difficulty
of refpiration  accompanied with  fwelled  legs,  and
with a very irregular  pulfe.  This  laft circumftance
has generally been afcribed to  a dropfy at the fame
time existing in the pericardium, but i? more probably
               1                             owing 
Class 1.2.3.]     OF IRRITATION.              139
owing to the difficult paffage  of the blood through
the lungs ; becaufe I found on diffection, in one  in-
ftance, that the moft irregular pulfe, which I ever at-
tended to,  was owing  to  very extenfive adhefions of
the lungs ; infomuch  that  one lobe intirely adhered
to the pleura; and fecondly,  becaufe  this  kind of
dropfy of the lungs is fo certainly removed for a time
along with the anafarca of the limbs by  the  ufe of
digitalis.
   This medicine,  as well as emetic tartar, or fquill,
when given fo as  to produce  ficknefs,  or  naufea, or
perhaps even without producing either in any per-
ceptible degree,  by affecting  the  lymphatics  of  the
Stomach,  fo  as  either  to  invert their  motion, or to
weaken them, increafes by reverfe  fympathy  the ac-
tion, and confequent  abforbent power of thefe lym-
phatics, which open into the cellular membrane.   But
as thofe medicines feldom Succeed in producing an ab-
 forption of  thofe fluids, which Stagnate in the larger
 cavities of the body, as in the abdomen, or cheft,  and
 do generally fucceed  in  this  difficulty of breathing
 with irregular pulfe above  defcribed,  I conclude  that
 it is not owing to an effufion of lymph into  the pericar-
 dium, but (imply to an anafarca of the lungs.
    M. M. Digitalis.   See  Art. V. 2.  1.  Tobacco.
 Squill.   Emetic tartar  (antimonium  tartarizatum).
 Then Sorbentia.  Chaiybeates.  Opium half a grain
 twice a  day.  Raifin wine and water, or other wine
 and  water,  is preferred to the Spirit and water, which
 thefe patients have generally been accuftomed to.
                                                The 
 140              DISEASES        [Class I. 2. 3.
   The ufual caufe of anafarca is from a difeafed liver,
and  hence  it  moft frequently attends  thofe,  who
have drank much fermented or fpirituous liquors ;  but
I fufpeCt that there is another caufe of anafarca, which
originates from the brain ; and which  is more cer-
tainly fatal  than that,  which originates  from a  dif-
eafed liver.  Thefe patients, where  the  anafarca' ori-
ginates from, or  commences in, the brain,  have not
other fymptoms of difeafed liver ;  have lefs  difficulty
of breathing at the beginning ; and hold themfelves
more upright in their chair, and in walking.  In  this
kind of dropfy  I  fufpeCt  the  digitalis  has lefs  or no
effect; as it particularly increafes  the abforption from
the lungs.

   17. Obcfitas.   Corpulency may be called an  ana-
farca  or dropfy of fat,  fince it  muft be  owing to an
analogous caufe; that  is, to  the deficient abforption
of fat compared to the quantity fecreted  into the cells
which contain it.  See Clafs II. 1. 1. 4.
   The  method  of  getting  free  from too  much fat
without any injury  to  the constitution, confifts,  firft,
in putting on a proper bandage  on the belly, fo that,
it can be tightened or relaxed  with eafe,  as a tightifti
underwaiftcoat, with a double row of buttons.  This
is to comprefs the  bowels and increafe  their abforp-
tion,  and it thus removes one principal  caufe of cor-
pulency, which is the loofenefs of the ikin.  Secondly,
he fliould omit one entire  meal,  as  fupper ; by this
long abftinence from  food  the  abforbent fyftem  will
                                                aa 
Class 1.2. 3.]     OF IRRITATION.             141
act on the mucus and fat with greater energy. Thirdly,
he Should drink  as  little  as he  can with  eafe to his
fenfations ;  fince, if the  abforbents of  the  ftomach
and bowels fupply the blood with  much,  or perhaps
too much,  aqueous fluid,  the abforbents of the cel-
lular membrane  will act with lefs energy.  Fourthly,
he Should ufe  much fait  or faked meat, which will
increafe the perfpiration  and make him thirfty ; and
if he bears this thirft,  the abforption of his fat will be
greatly  increafed, as  appears in fevers  and dro,jfies
with thirft ; this I believe  to be more  efficacious than
foap.   Fifthly,  he may ufe aerated alkaline water for
his drink, which may  be fuppofed  to render the fat
more fluid,—or  he may take foap in large quantities,
which will  be decompofed in the ftomach.  Sixthly,
Short reft,  and conftant exercife.

    18. Splenis tumor.  Swellings of the fpleen,  or in
its vicinity, are  frequently perceived  by  the  hand in
intermittents, which are  called  Ague-cakes, and feem
owing to a deficiency of abforption  in  the  affected
part.
   Mr. Y----,  a young man about twenty-five years
of age, who lived  intemperately, was feized with an
obftinate intermittent, which had become a continued
fever with ftrong pulfe,  attended with daily remiflion.
A large hard  tumour on the left fide, on the region       /
of the fpleen, but extending much more  downward,
was fo distinctly perceptible, that  one feemed  to get
one's fingers under the e<.\gc of it, much like the feel
                                                  of 
142  v            DISEASES      [Class I. 2. 3.
of the brawn or fhield on a boar's flioulder.   He was
repeatedly  bled,  and purged  with calomel, had  an
emetic,  and a blifter on the part, without diminifhing
the tumour; after  fome time he took  the  Peruvian
bark, and  flight  dofes  of chaiybeates,  and thus be-
came free from the  fever,  and went to Bath for  feve-
ral weeks,  but  the tumour remained.   This tumour
I examined every four or five years for above thirty
years.   His countenance was  pale, and  towards the
end of his life he fuffered much from ulcers on his legs,
and died about fixty, of general debility; like many
others,  who live intemperately in refpect to the ingur-
gitation of fermented or fpirituous liquors.
   As this tumour commenced in the cold fit of an  in-
termittent fever,  and was not attended with pain, and
continued fo long without endangering his life, there
is reafon to believe it  was fimply  occafioned  by de-
ficient abforption, and not by more energetic action of
the veffels which  conftitute the  fpleen.  See Clafs  II.
1.  2. 13.
   M. M. Venefection.  Emetic,  cathartic with  calo-
mel ; then forbentia, chaiybeates, Peruvian bark.

   19. Genu tumor albus. White fwelling of the knee,
h owing to deficient abforption of  the lymphatics  of
the membranes including the joint, or capfular  liga-
ments, and  fometimes  perhaps of  the  gland which
fecretes  the fyncvia; and the ends of the bones are
probably affected in  confequence.
I faw 
Class I. 2. 3.]    OF IRRITATION.              143
   I  faw an inftance, where a cauftic  had been  ap-
plied by an empiric on a lar^e  white fwelling of the
knee, and was told, that a fluid had been difcharged
from the joint, which became anchylofed, and healed
without lofs of the limb.
   M. M. Repeated blifters  on the "part early in the
difeafe are faid  to  cure it by promoting  abforption;
faturnine folutions externally are recommended.  Bark,
animal charcoal, as burnt fponge, opium in fmall dofes.
Friction with the hand.

   20. Br-oiichocelc.   Swelled throat.   An enlargement
of the thyroid  glands, faid  to be frequent  in moun-
tainous countries, where river water is  drank, which
has its fource  from diffolving  fnows.   This  idea is a
very ancient one, but perhaps not on that account to
be the  more depended upon,  as authors copy  one
another. Tumidum guttur quis miratur in alpibus, feems
to have been a proverb in the time of Juvenal.   The
inferior  people of Derby are much fubject to this dif-
eafe, but whether more fo than  other populous towns,
I can not determine ; certain it is, that they chiefly
drink  the  water of the Derwent, which arifes  in a
mountainous country, and is very  frequently blacken-
ed as it paffes through  the moraffes  near its  fource;
and is generally of  a darker  colour, and attended with
a whiter foam,  than the Trent, into which it falls;
the greater quantity and whitenefs of its  froth I  fup-
pofe may be owing to the  vifcidlty communicated to
it by the colouring matter.   The  lower parts of the
                                              town 
t44              DISEASES      [Class I 2 3.
town of Derby might be  eafily  fupplied with fpring
water from St. Alkmond^'s well ; or the whole of it
from the abundant Springs near Bowbridge :  the wa-
ter from  which might be conveyed to the town in
hollow bricks,  or clay-pipes, at no very great  ex-
pence,  and might be received into frequent refervoirs
with pumps to them ; or laid into the houfes.
   M. M.  Twenty grains of burnt fponge with ten of
nitre made with mucilage into lozenges, and permitted
to diffolve flowly under the tongue twice a day, is af-
ferted to cure in a few months ;  perhaps other animal
charcoal, as candle-fnuffs, might do the fame.
   I have directed in the/ early ftate  of  this  difeafe a
mixture of common  fait and water to be held in the
mouth, particularly under  the tongue,  for a  few mi-
nutes,  four or fix times a day for many  weeks, which
has fometimes fucceeded,  the fait and  water is  then
fpit out again, or in  part  fwallowed.  Externally vi-
negar  of fquills has  been applied,  or  a  mercurial
plafter,  or fomentations of acetated ammoniac ;  cr
ether.   Some empirics  have applied cauftics on  the
bronchocele, and fometimes, I have  been told, with
foccefs ; which  fliould certainly be  ufed where there
is  danger of Suffocation  from  the bulk  of it.   One
cafe  1 faw, and one I was  well  informed of, where
the bronchocele wras cured  by burnt fponge, and a
hectic fever fupervened with colliquative fweats ; but
I do not know the final event of  either of them.
   De  Haen  affirms the cure of bronchocele to be
effected by flowers  of zinc,  calcined egg-fhells  and,
                                            fcarlet 
Cl\ss I. 2. 3 ]     OF IRRITATION.              HS
fcarlet cloth burnt together in a clofe crucible, which
was tried with fuccefs, as he affured me,  by a late
lamented phyfician, my friend, Dr. Small of Birming-
ham ; who to the cultivation of modern fciences added
the integrity of ancient manners; who in clearnefs of
head, and benevolence of heart, had few equals, per-
haps no fuperiors.

   21. Scrophula.  King's evil is  known by tumours
of the lymphatic glands, particularly of the neck.  The
upper lip, and divifion of the noftrils is Swelled,  with
a florid countenance, a Smooth Skin, and  a  tumid ab-
domen.  Cullen.  The abforbed fluids in their courfe
to the veins in the fcrophula are arretted in the lym-
phatic  or  conglobate glands; which fwell, and after
a great length of time, inflame and fuppurate.   Mate-
rials of a peculiar kind, as the variolous and venereal
matter, when abforbed in a wound, produce this tor-
por, and confequent inflammation of thofe lymphatic
glands, where they firft  arrive, as  in the  axilla and
groin.   There is reafon to fufpeCt, that the tonfils fre-
quently become inflamed, and fuppurate from the mat-
ter abforbed from carious teeth; and  I  faw a young
lady, who had both the  axillary glands fwelled, and
which fuppurated ;  which was believed  to  have been
caufed by her wearing a  pair of new green gloves for
one day, when flie had perfpired much, and was much
exhausted and fatigued by walking ; the gloves  were
probably dyed in a folution of verditer.
L
Thefe 
i4fi              DISEASES      [Class 1.2. 3.
   Thefe indolent tumours of the lymphatic  glandsr
which conftitute the fcrophula, originate from  the  in-
irritability of thofe glands ; which therefore fooner fall
into torpor after having been Stimulated  too violently
by fome poifonous material;  as the mufcles of enfee-
bled people fooner become fatigued,  and ceafe to act,
when exerted, than  thofe of  ftronger ones.   On the
fame account thefe fcrophulous glands are much longer
in acquiring increafe of motion, after having been  Sti-
mulated into inactivity, and either remain years in a
ftate  of indolence,  or fuppurate- with difficulty, and
fometimes only partially.
   The difference between fcrophulous tumours, and
thofe before defcribed, confifts  in this ; that  in thofe
either glands of different  kinds were difeafed,  or  the
mouths only of the lymphatic glands were become tor-
pid ; whereas in fcrophula the conglobate glands them-
felves become tumid, and generally fuppurate after a
great length of time, when  they acquire new feasibi-
lity.  See Seft. XXXIX.  4.  c.
   Thefe indolent tumours may be brought to fuppu-
rate  fometimes by  paffing  electric Shocks  through
them every day for two  or  three  weeks, as  I have
witneffed.   It  is probable, that the alternate applica-
tion of fnow  or iced water to them, till they become
painfully cold, and  then of warm flannel or warm wa-
ter, frequently repeated, might reftore their irritability
by accumulation of fenforial power; and thence either
facilitate their difperfion, or occafion them to fuppurate.
See Clafs II. 1.4.  13.
                                              This 
Class I. 2. 3.]     OF IRRITATION.              i4j
   This difeafe is very  frequent  amongft the children
of the poor in large towns, who  are  in  general ill
fed, ill lodged,  and ill clothed ;  and who are further
weakened by eating much fait with their fcanty meal
of infipid vegetable food, which is feldom  of better
quality than water gruel, with a little coarfe bread in
it.   See diarrhcea of infants, Clafs I. 1. 2.  5.  Scro-
phulous  ulcers  are difficult to heal, which  is  owing
to the deficiency of abforption on their pale and flabby
furfaces, and to the general iniritability  of the fyftem.
See  Clafs I. 1. 3. 13.
   M. M. Plentiful diet  of flefh-meat and vegetables
with fmall-beer.  Opium,  from a quarter of a grain
to half a grain twice a day.  Sorbentia.  Tincture of
digitalis, thirty drops  twice  a  day.  Externally  fea-
bathing, or bathing  in fait and water,  one  pound  to
three gallons, made warm.   The application of Peru-
vian bark in fine powder, feven parts, and white lead,
(ceruffa) in fine powder one part, mixed together and
applied on the  ulcers in dry powder, by  means  of
lint  and a bandage,  to  be renewed every day.   Or
very fine powder  of calamy alone, lapis calaminaris.
If powder of manganefe ?

  2 2.  Schirrus.  After the abforbent veins of a gland
ceafe to perform their office, if the fecerning arteries
of it continue to act fome time  longer,  the fluids  are
pufhed forwards,  and Stagnate  in  the  receptacles  or
capillary veffels of the  gland ;  and the thinner part of
them only being refumed by the abforbent  fyftem  of
                         L 2                    the 
H»              DISEASES      [Class I. 2. 3.
the gland, a hard tumour  gradually fucceeds; which
Continues like a lifelefs mafs, till from fome accidental
violence it gains fenfibility, and produces cancer, or
fuppurates.   Of this kind are the fchirrous glands of
the breafts,  of the  lungs, of the mefentery,  and the
krophulous  tumours  about the neck and the bron-
chocele.
   Another feat of fchirrus is in the membraneous parts
of the fyftem, as of the reClum inteftinum, the urethra,
the gula or throat; and of this kind is the veruca or
wart, and the clavus pedum, or corns on the toes.  A
wen fometimes  arifes on  the  back of the neck,  and
fometimes between  the   Shoulders; and by  distend-
ing the tendinous fafcia produces great and perpetual
pain.
   M. M. Mercurial ointment.   Cover  the part with
oiled filk.  Extirpation.   Electric  fliocks through the
tumour.  An  iffue into  the  fubftance  of the  wen.
Opium.   Ether externally.

   23. Schirrus recli inteftini.   Schirrus of the rectum.
A fchirrus frequently affects a canal, and by contract-
ing its diameter becomes a painful and deplorable dif-
eafe.  The  canals thus obstructed are the rectum, the
urethra, the throat, the  gall-duCts, and  probably the
excretory ducts of the lymphatics, and of other glands.
   The fchirrus  of the rectum is known by the patient
having pain in the part,  and being only able to  part
with liquid feces, and  by the introduction of the finger;
the Swelled part of the inteftine is fometimes protruded
                                        downwards, 
Class I. 2.3.]     OF IRRITATION.              i49
downwards, and hangs, like a valve, fmooth and hard
to the touch, with  an aperture in the centre of it.
See a paper on this fubjeCt by J. Sherwin.  Memoirs
of a London Medical Society, Vol. II. p. 9.
   M.  M.  To  take but little  folid food.   Aperient
medicines.   Introduce  a candle  fmeared with mercu-
rial  ointment.    Sponge-tent.    Clyfters  with  forty
drops of laudanum.  Introduce a leathern  canula, or
gut,   and then  either a wooden maundril, or  blow
it  up  with air, fo as to diftend the contracted part as
much as the patient can bear.   Or fpread mercurial
plafter on thick foft leather, and roll it up with the
plafter outwards  to any thicknefs and length,  which
can be eafily introduced and worn ; or two or  three
fuch pieces may be  introduced after each other.   The
fame may be ufed to comprefs bleeding internal  piles.
See Clafs I. 2.  1. 6.

   24. Schirrus  urethra.    Schirrus  of the  urethra.
The  paffage becomes  contracted by the thickened
membrane, and the urine is forced through with great
difficulty, and is thence liable to diftend the canal be-
hind the Stricture ;  till at length an  aperture is made,
and the urine  forces  its way into the cellular  mem-
brane, making large finufes.  This fituation fometimes
continues many months, or even  years, and fo  much
matter  is evacuated after  making water,  or at  the
fame  time, by the action of the mufcles in the vicinity
of the finufes,  that it has  been mistaken for an in-
creafed fecretion from the bladder, and has been erro-
                       L  3                 neoufly 
150              DISEASES      [Class I. 2.3.
neoufly termed a catarrh of the bladder.   See a paper
by Dr. R. W. Darwin in the Medical Memoirs.
  M. M. Diftend  the  part gradually by catgut  bou-
gies, which by their compreSfion will at the fame time
diminish the thicknefs of the membrane, or by bougies
of elaftic gum,  or of horn boiled foft.   The  patient
fhould gain the  habit  of making water  flowly, which
is a matter of the utmoft  confequence,  as it prevents
the diftention,  and confequent  rupture,  of that part
of the urethra,  which is between the Stricture and the
neck of the bladder.
   When there  occurs an  external  ulcer in the peri-
neum, and the urine is in part difcharged that  way,
the difeafe can  not be  miftaken.  Otherwife from the
quantity of matter,  it is  generally fuppofed to come
from the bladder, or proftate gland; and the urine,
which efcapes  from the ruptured  urethra, mines its
way  amongft the mufcles and membranes, and the pa-
 tient dies tabid, owing to the want of an external ori-
 fice to difcharge the matter.   See Clafs II,  1, 4. 11,

   25. Schirrus oefophagi.    A  fchirrus  of the throat
 contracts the paffage fo as  to render the fwallowing of
 folids impracticable, and of liquids difficult.   It affects
 patients of all  ages,  but  is  probably moft frequently
 produced by fwallowing hard angular fubftances, when
 people have loft their teeth ; by which  this membrane
 is over diftended, or torn, or otherwife injured.
    M. M.  Put  milk into  a  bladder tied  to a  canula
 or catheter ; introduce it paft the Stricture, and prefs
                                                 it 
Class T. 2. 3/]     OF IRRITATION              151
it into the  ftomach.   Diftend  the ftricture  gradually
by a fponge-tent  faftened to the end of whalebone,
or by a  plug of wax,  or a fpermaceti  candle, about
two  inches long;  which  might be  introduced, and
left  there  with  a String only fixed to it to hang out
of the mouth, to keep it  in its place,  and to retract
it by occafionally ; for which purpofe the String muft
be put through a catheter or hollow probang,  when
it is  to be  retracted.   Or  laftly introduce  a gut fixed
to a pipe ;  and  then  diftend it  by blowing wind into
it.  The Swallowing a bullet with a String put through
it, to retraCt it  on the  exhibition  of an emetic, has
alfo  been  propofed.   Externally mercurial ointment
has been much recommended.   Poultice.   Oiled filk.
Clyfters of broth.  Warm  bath of broth.  Transfu-
fion  of blood into a vein three or four ounces a  day ?
See  Clafs  III. 1. 1. 15.
   I  directed a young woman about twenty-two years
of age,  to be fed with  new milk put into  a bladder,
which was tied  to a catheter, and introduced beyond
the ftricture in her throat; after a few days her  Spirits
funk,  and flie  refufed  to  ufe  it further,  and  died.
 Above thirty years ago I propofed to an old gentle-
man, whofe throat was entirely impervious, to fupply
 him  with  a few ounces of blood  daily from an afs,
 or from the human animal, who is ftill more patient
 and tradable, in the following manner.  To  fix a fil-
 ver  pipe  about  an inch long to each  extremity of a
■chicken's  gut, the part between the two filver ends to
 be meafured  by filling  it with warm  water.; to put
 one end into the vein of a perfon  hired for that pur-
                        L 4                   pofe, 
152              DISEASES      [Class I. 2. 3.
pofe, fo as to receive the blood returning from the ex-
tremity ;  and when the gut was quite full, and the
blood running through  the other filver end, to intro-
duce that end into the vein of the patient upwards to-
wards the heart, fo as to admit no air along with the
blood.   And laftly, to  Support the gut and filver ends
on a water plate, filled with water of ninety-eight de-
grees of heat,  and to  meafure how many ounces of
blood was introduced by paffing  the  finger, fo as to
comprefs the gut, from the receiving  pipe to the de-
livering  pipe;  and  thence to determine how many
gut-fulls were given from the healthy perfon  to the
patient.   See Clafs IV. 2. 4. 11. L.  Mr.----- con-
fidered a day on this propofal, and then  another day,
and  at length anfwered, that " he now found himfelf
near the houfe of death ; and  that if he could return,
he was now too old to  have much enjoyment of life ;
and  therefore he wifhed rather to proceed to the end
of that journey, which  he was  now fo near, and which
he muft at all events foon go, than return for fo Short
a time."  He  lived but a few days  afterwards, and
feemed quite carelefs and eafy about the matter.

    26. Lacleorum inirritabilitas.   Inirritability of the
 laCteals  is defcribed in  Sect. XXVIII.  under the name
of paralyfis of the laCteals; but as the word paralyfis
 has generally been applied to  the difobedience of the
 mufcles  to the  power  of volition,  the name  is here
 changed to inirritability of the  lacteal^,  as more cha-
 racteristic of the difeafe.
27. Lym- 
Class I. 2.4.]     OF IRRITATION.              i5S
   27. Lymphaticorum inirritabilitas.  The inirritability
of the cellular and cutaneous  lymphatics  is defcribed
in Sect. XXIX.  5.  1. and  in Clafs I. 2. 3.  16.   The
inirritability of the  cutaneous  lymphatics generally ac-
companies anafarca, and is  the caufe of the great thirft
in that malady.   At the fame time the  cellular  lym-
phatics aft with greater energy, owing to the greater
derivation of fenforial  power to them in confequence
of the lefs expenditure  of  it by the cutaneous ones;
and hence  they abforb the fat, and mucus, and  alfo
the thinner  parts  of the  urine.   Whence the great
emaciation of the body, the muddy fediment, and the
fmall quantity of water in this kind of dropfy.
                   ORDO  II.
                Decreafed Irritation.

                  GENUS  IV.
With decreafed Aclions of other Cavities and Membranes.

   Many of the difeafes  of this genus are attended
with pain, and with cold extremities, both which ceafe
on the exhibition  of  wine  or opium ; which  fhews,
that they originate from deficient action of the affected
organ.   Thefe pains are called nervous or fpafmodic,
are not  attended with fever, but  are frequently fuc-
ceeded by convulfions and madnefs; both which be-
                                               long 
 154              DISEASES      [Class 1.2. 4.
 long to the clafs of volition.   Some of them return at
 periods, and when thefe can be afcertained, a much lefs
 quantity of opium will prevent them, than is neceflary
 to cure them,  when  they are begun ; as the  veffels
 are then torpid and inirritable from the want of fen-
 forial power, till by  their inaction  it becomes again
 accumulated.
   Our organs of fenfe properly fo called are not liable
 to pain from the abfence of their appropriated ftimuli,
 as from  darknefs  or  filence;  but the other fenfes,
 which may be more properly called appetites, as thofe ■
 by which  we perceive heat, hunger, thirft, luft, want
of frefli air, are affected with pain from the defect or
abfence of their accuftomed ftimuli,  as  well.as with
pleafure by the poffeffion of them ; it is probable that
fome of our glands, whofe  fenfe or appetite  requires
or receives  fomething  from the circulating blood, as
the pancreas, liver, teftes, proftate  gland,  may  be
affeCted with aching or pain, when they cannot  ac-
quire their appropriated fluid.
   Wherever this defeCt of Stimulus  occurs,  a torpor
or inaction of the organ enfues, as in the capillaries of
the Skin, when expofed  to  cold;  and in  the glands,
which  fecrete the gaftric juice, when we  are hungry.
This torpor however,  and concomitant pain,  which is
at firft owing to defect of ftimulus,  is afterwards  in-
duced by other affociations or catenations, and consti-
 tutes the beginning of ague fits.
   It muft be further obferved,  that in the difeafes of
pain without fever, the pain is frequently not felt in
                                                the 
Class I. 2. 4.]     OF IRRITATION.              ,55
the part where the caufe of the difeafe refides; but is
induced by  fympathy with  a diftant part, whofe irri-
tability or fenfibility is greater or lefs than its own.
Thus a ftone at the neck of the bladder, if its ftimulus
is not very great, only induces  the pain of ftrangury
at the glans penis.  If its ftimulus be greater, it then
induces pain at the neck of the bladder.  The concre-
tions of bile,  which are  protruded into the neck of
the gall-bladder, when the difeafe is  not  very great,
produce pain  at the other extremity of the  bile-duct,
which enters the duodenum immediately under the pit
of the ftomach ; but,  when the  difeafe is great from
the  largenefs of the bile-Stone, the pain is felt in the
region of the liver at  the neck of the  gall-bladder.
   It appears from hence,  that the pains  enumerated
 in this genus are confequences of the  inactivity of the
 organ;  and,  as they  do  not  occafion other difeafes,
 fhould be claffed  according to their proximate caufe,
 which is  defective irritation; there  are neverthelefs
 other pains from defect of ftimulus,  which  produce
 convulfions, and belong to Clafs III. 1. 1.; and others,
 which produce pains  of fome diftant part by affocia-
 tion, and belong to Clafs IV. 2. 2.

                    SPECIES.
     1. Sitis.  Thirft.  The fenfes of thirft and of hun-
  ger feem  to have this connection, that the former is
  fituated at the upper end, and the latter at the lower
  end  of the fame canal.   One about  the  pharinx,
  where the cefophagus opens into the mouth, and the
                                                other 
 55*              DISEASES      [Class I. 2. 4.
 other about the cardia ventriculi, where it opens into
 the ftomach.  The extremities of other canals have
 been fiiewn to poffefs correspondent fenfibilities,   or
 irritabilities, as the two ends of the urethra,  and of
 the common gall-duCt.   See IV. 2. 2. 2. and 4.
   The membrane of  the upper end of the  gullet
 becomes torpid, and confequently painful, when there
 is  a deficiency of aqueous fluid in the general fyf-
 tem ; it then wants its proper ftimulus.  In the fame
 manner a want  of the ftimulus of more folid mate-
 rials at the other end of the canal,  which terminates
 in  the ftomach,  produces hunger;  as mentioned  in
 Sect. XIV. 8.  The proximate caufes of both of them
 therefore confift in deficient irritation, when they are
confidered as pains ;  becaufe thefe pains are in con-
 fequence  of the  inactivity of the organ, according to
 the fifth  law of animal caufation.  SeCt. IV. 5.  But
 when they are confidered as defires, namely of liquid
 or folid aliment, their proximate caufe confifts in the
 pain of them, according to  the fixth law of  animal
 caufation.   So  the  proximate caufe of the pain  of
 coldnefs is the  inactivity of the organ, and  perhaps
 the confequent accumulation of fenforial power in it;
 but  the  pain itfelf, or the confequent volition, is the
 proximate caufe of the fliuddering and gnafhing the
 teeth in  cold fits  of  intermittent fevers.   See Clafs
 I.  2. 2. 1.
   Thirft may  be  divided into  two varieties  alluding
 to the remote caufe  of each,  and may be  termed
 fitis calida,  or warm  thirft,  and litis  frigida, or cold
                                             thirft. 
Class I. 2.4.]     OF IRRITATION.              iJ7
thirft.   The remote caufe of the former arifes from
the diffipation of the aqueous  parts of our fluids by
the increafed fecretion of perfpirable matter, or other
evacuations.  And  hence it occurs  in hot fits of fe-
ver, and after  taking much wine, opium, fpice, ialt,
or other drugs  of  the Art. incitantia or fecernentia.
The thirft,  which occurs  about three hours after eat-
ing a  couple of red  herrings,  to a perfon  unaccus-
tomed to falted  meat,  is of this  kind;  the increafed
action  of the cutaneous veffels diffipates fo much of
our  fluids  by  infenfible perfpiration,  as to require
above two  quarts  of  water to reftore the fluidity of
the blood,  and to  wafh  the fait out  of the fyftem.
See Art. III. 2. 1.
   M. M. Cold water.  Vegetable acids.  Warm bath.

   The remote  caufe of fitis frigida,  or cold  thirft,
is owing to the inaction of the cutaneous, pulmo-
nary,  urinary, and cellular abforbents;  whence the
blood is deprived  of the  great  fupply of  moifture,
which it ought  to receive  from  the atmofphere, and
from the cells of  the  cellular  membrane,  and from
other cyfts ; this caufe of thirft exifts in dropfies, and
 in the cold fits of intermittents.  The defire of fluids,
 like that of folids, is  liable  to acquire periods, and
 may  therefore  readily become  difeafed by indulgence
in liquids  grateful to  the  palate.
   Of difeafed thirft,  the moft common is either owing
 to defect of the action of  the numerous  abforbent
 veffels on the neck of the bladder, in which  the  pa-
                                               tient* 
  *5S               DISEASES      [Class I. 2.4.
  tient makes much paleifli  water; or to the defective
  abforption of  the  ikin and lungs, in which  the pa-
  tient makes but little  water,  and that high-coloured,
  and  with fediment.   In both the tongue and  lips are
  liable to become very  dry.  The former in its greateft
  degree attends diabetes,  and the latter anafarca.
    M.  M. Warm water,  warm wine,  warm  bath.
  Opium.  Cold bath.  Iced water.  Lemonade.  Cyder.

    2. Efuries.   Hunger has  been fancifully  afcribed
  to the fides  of  the  ftomach  rubbing  againft  each
'  other, and to  the  increafed acidity of the gaftric juice
  corroding the coats  of it.   If either of thefe  were
  the  caufe of hunger, inflammation muft occur,  when
  they had  continued fome time ; but, on the contrary,
  coldnefs and not heat  are attendant on hunger  ; which
  evinces,  that  like thirft it is owing to the inactivity
  of the membrane, which  is  the feat of it;  while the
  abundant nerves  about the cardia ventriculi,  and the
  pain of hunger being felt in that part,  gives  great
  reafon to conclude,  that  it  is  there fituated.
    The fenfe of hunger as  well as of thirft is liable to
  acquire habits in  refpect  to the times  of its  return-
  ing  painfulnefs, as well  as in refpect to the quantity
  required  to fatiate its appetency, and hence may be-
  come difeafed by indulgence, as well as by  want «f
  its appropriate ftimulus.   Thofe who have been  ac-
  cuftomed to diftend their  ftomach  by  large  quanti-
  ties  of animal and vegetable food, and much potation,
  find a want of diftenfion,  when the ftomach is empty,
                                              which 
Class I. 2. 4.]     OF IRRITATION.              x$9
which occafions faintnefs,  and is miftaken for hunger,
but which does not appear to be the fame fenfation.
I was well informed,  that  a woman near  Lichfield,
who eat much animal and vegetable food for a wager,
affirmed, that fince diftending  her  ftomach fo much,
fhe had never felt herfelf fatisfied with food ; and had
in general taken twice as much at a meal, as  flie had
been  accuftomed  to, before fhe eat  fo much for a
wager.

   3.  Naufea ficca.   Dry naufea.  Confifts in  a quief-
cence or torpor of the mucous or falivary glands, and
precedes their  inverted motions, defcribed  in naufea
humida,  Clafs I.  3.  2.  3.   In the fame  manner as
ficknefs of the Stomach is a quiefcence  of that organ
preceding  the aCtion of vomiting, as explained in Sect.
XXXV.  1. 3.   This is  fometimes induced  by difa-
greeable  drugs held in the  mouth,  at other times of
difguftful ideas, and at other times  by  the  affociatioa
of thefe actions with thofe  of the ftomach  ; and thus
according to its different proximate caufes may belong
to this, or to  the fecond,  or  to the fourth  clafs of
difeafes.       *
   M. M.  Lemonade.  Tafteful food. A blifter. Warm
 bath.

   4. JEgritudo ventriculi.   Sicknefs of ftomach is pro-
 duced by the quiefcence or inactivity of that organ,
 as is explained in Sect. XXXV. 1.3.   It confifts in
 th^ ftate between the ufual periftaltic motions of that
                                             organ, 
 i<5e              DISEASES      [Class I. 2.4.
 organ, in the digeftion of our aliment, and the retro-
 grade motions of it in vomiting ;  for it is evident, that
 the direct motions of it from the cardia to the pylorus
 muft  Slop, before thofe in  a contrary  direction can
 commence.   This ficknefs, like the naufea  above de-
 fcribed, is fometimes produced by difguftful  ideas,  as
 when natty objects are feen, and nafty ftories related,
 as well as by  the  exhauftion of the fenforial  power  by
 the ftimulus  of fome emetic drugs, and by the defect
 of the production  of it, as in enfeebled drunkards.
   Sicknefs may likewife confift  in the retrograde mo-
 tions of the  lymphatics of the ftomach,  which regur-
 gitate into it the chyle or lymph, which they have
 lately abforbed,  as in Clafs I. 3.  2. 3.  It is probable,
 that thefe two kinds of ficknefs may  be  different fen-
 fations, though they have acquired but one  name ;  as
 one of them attends hunger, and the other repletion ;
 though either of them may  poffibly  be induced  by
 affociation with naufeous ideas.
   M. M.  A blifter on the back.  An emetic.  Opium.
 Crude  mercury.  Covering the head  in  bed.  See
 Sect. XXV. 16. Clafs IV. 1. 1.2. and 3.

   5. Cardialgia.   Heartburn originates  from the in-
activity of the Stomach, whence  the  aliment, inftead
of being fubdued by  digeftion, and converted  into
chyle, runs into  fermentation, producing acetous acid.
 Sometimes the gaftric juice itfelf becomes fo acid as  to
give pain to the upper orifice of the  ftomach; thefe
acid  contents of the ftomach, en falling on a marble
      4                                    heanh, 
Class I. 2. 4.]     OF IRRITATION.              ift
hearth, have been  feen  to  produce an  effervefcence
on it.  The pain of heat at the upper end of the gul-
let, when any air is brought up from  the fermenting
contents of the ftomach, is  to be afcribed to the fym-
pathy between thefe two extremities of the cefophagus
rather than to  the pungency of the carbonic gas,  or
fixed air ; as the fenfation  in fwallowing that kind of
air in water is of a different kind.  See  Clafs I. 3. f.
3. and IV. 2.  2. 5.
  M. M.  This difeafe arifing from Indigeftion Is often
very  pertinacious,  and  afflicting ; and attended with
emaciation of the body  from want  of fufficient chyle.
As the faliva fwallowed along with our food prevents
its fermentation, as appears  by the experiments  of
Pringle and Macbride, fome find considerable relief by
chewing parched wheat, or maftic,  or a  lock of wool,
frequently  in  a  day, when the pain occurs, and by
fwallowing the faliva thus effufed;  a temporary relief
is  often obtained from  antiacids, as aerated alkaline
water, Seltzer  water,   calcareous   earths,   alkaline
falts made into pills with foap, foap alone, tin,  milk,
bitters.   More permanent ufe may  be  had from fuch
drugs as check  fermentation, as acid  of vitriol; but
ftill more  permanent  relief  from fuch  things as invi-
gorate the digeftion, as  a blifter on the back ; a due
quantity  of vinous  Spirit and water taken regularly.
Steel.  Temperance.  A Sleep after dinner.  A waift-
coat made fo tight  as Slightly to comprefs  the bowels
and ftomach.  A flannel Shirt in winter,  not in fum-
nier.   A  lefs  quantity of potation of all kinds.  Ten
                        M                   black 
k6s              DISEASES      [Class I. 2.4.
black pepper-corns fwallowed  after dinner.   Haifa
grain of opium twice a day, or  a grain.   The food
fliould confift of fuch things as  do not eafily ferment,
as flefh,  Shell-fifli,  fea-bifcuit, toafted cheefe.   I have
feen toafted cheefe brought  up from  the  ftomach  24
hours after it had been fwallowed, without apparently
having undergone any chemical  change.   See Clafs II.
1. 3. 17. and IV. 1.  2. 13.

   6. Arthritis Ventriculi.  Sicknefs of  the ftomach ft?
gouty cafes is frequently a confequence of the  torpor
or  inflammation of the liver,  and  then  it  continues
many days or weeks.  But when the patient is feized
with great pain at the Stomach with  the  fenfation of
coldnefs, which they have called  an ice-bolt, this is a
primary  affeCtion of the  ftomach,  and deftroys*  the
patient  in  a few  hours, owing  to the torpor or in-
action of that vifcus fo important to life.
   This primary gout of the ftomach, as it is a torpor
of  that vifcus, is  attended  with  fenfation of coldnefs,
and with real defect  of heat, in  that  part,  and may
thence be  distinguished from the pain  occafioned  by
the paffage of a gall-ftone into the duodenum., as well
as by the weak puKe, and cold extremities; to which
muft be  added,  that  it affects  thofe  only, who have
been long afflicted with the gout,  and much debilitated
by  its numerous attacks.
   M. M.  Opium.   Vinous fpirit.   Volatile  alkali.
                             0
Spice.  Warmth applied externally to the ftomach by
hot cloths or fomentation.
                                           7. Colica 
Class I. 2. 4.]    OF IRRITATION.              16}
   7. Colica flatulenta.  The flatulent colic arifes from
the too great diftention of the bowels by air, and con-
fequent pain.   The caufe of this difeafe is the inactivity
or  want  of  Sufficiently powerful contraction  of the
coats of the bowels  to carry forwards the gas given up
by the fermenting  aliment.  It is without fever,  and
generally attended with cold extremities.
  It is diftinguifhed,  firft, from  the pain  occafioned
by the paffage  of a  gall-ftone, as that is felt at the pit
of the Stomach, and this nearer the navel.   Secondly,
it is  distinguished from the  colica faturnina, or colic
from lead, as that arifmg from the torpor of the liver,
or of fome other vifcus, is attended with greater cold-
nefs, and with an aching pain ; whereas  the flatulent
colic being owing to diftention of the mufcles  of the
bowels, the pain is more acute, and  the coldnefs lefs.
Thirdly, it is  diftinguifhed  from inflammation of the
bowels, or ileus, as perpetual vomiting  and fever at-
tend this.  Fourthly, it is diftinguifhed  from cholera,
becaufe that  is accompanied  with both vomiting  and
diarrhcea.  And laftly, from the  colica epileptica, or
hyfteric colic, as that is liable  to alternate with con-
vulfion, and  fometimes with infanity  ; and returns by
periods.
  M. M.  Spirit of wine and  warm water, one fpoon-
ful of each.  Opium one grain.   Spice.  Volatile al-
kali.   Warm fomentation externally.   Rhubarb.

  8. Colica faturnina.   Colic from lead.   The pain is
felr about the navel, is rather of an aching than acute
                       M 2                    kind 
164               DISEASES      fCLAssI. 2.4.
kind at firft, which increafes after  meals, and gra-
dually  becomes more permanent and more  acute.   It
terminates  in  paralyfis,  frequently of the mufcles  of
the arm, fo that the hand hangs down, wnen the arm
is  extended  horizontally.  It  is not attended  with
fever,  or  increafe of heat.  The feat of the difeafe &
not well afcertained, it probably affeCb  fome part  of
the liver,  as a  pale bluifh countenance and deficiency
of bile fometimes attends or fucceeds  it, with confe-
quent anafarca; but it feems to be caufed immediately
by a torpor of the inteftine,  whether this be a pri-
mary or fecondary affection, as appears from the con*
ftipation of the bowels,  which attends it; and is  al-
ways produced in  confequence of the great ftimulu*
of lead previoufly ufed either  internally for a length
of time, or externally on a large furface.
   A delicate young girl, daughter of a dairy  farmer,
who kept his  milk in leaden cyfterns, ufed  to wip*
off the cream  from the  edgei  of the lead with her
finger; and frequently,  as  She was  fond of cream,
licked it from her finger.  She was feized with the  fa-
turnine colic,  and femi-paralytic wrifts, and funk from
general debility.
   A feeble woman about 40 years of age fprained her
ankle, and bruifed  her leg and thigh ;  and applied  by
ill advice a folution of lead over the whole  limb,  as
a fomentation and poultice for about a fortnight.  She
was then feized with the colica faturnina,  loft the ufe
of her wrifts,  and gradually funk under a  general de-
bility..
                                       M. M. Firft. 
 Class I. 2. 4.]    OF IRRITATION.             165
   M. M. Firft opium one or  two grains,  then a ca-
 thartic of fenna, jalap,  and oil, as foon as the pain
 is relieved.   Oleum ricini.  Alum.   Oil of almonds.
 A blifter  on  the navel.   Warm bath.  The ftimulus
 of the opium, by  reftoring  to the  bowel  its natural
irritability in this  cafe  of painful torpor,  affifts  the
 action of the cathartic

   9.  Tympanitis*   Tympany  confifts ■ in  an elaftic
 tumor of the abdomen,  which founds on being ftruck.
 It is generally attended  with coftivenefs and emacia-
 tion.   In one  kind  the  air  is faid  to exift in  the
 bowels, in which  cafe  the  tumor is  lefs  equal,  and
 becomes lefs tenfe  and  painful on  the evacuation of
 air.  In the  other kind  the  air exifts in the cavity of
 the abdomen,  and fometimes is  in a few days  ex-
 changed for  water, and  the  tympany  becomes an
 afcites.
   Air may be diftinguifhed in the Stomach of many
 people by the found  on Striking  it with the fingers,
 and comparing the found with that of a Similar per-
 cuffion on other parts of the bowels; but towards the
 end of fevers, and efpecially in the puerperal fever,  a
 diftention of the abdomen by air  is generally a fatal
 fymptom, though the eafe, and often cheerfiilnefs, of
 the patient vainly flatters the attendants.
   M. M. In the former cafe  a clyfter-plpe unarmed
 may be introduced, and left fome time in the rectum,
 to take off the refiftance  of the fphincter, and thus dif-
 charge  the air, as it is produced from the fermenting
                        M 3                    or 
 I&6              DISEASES      [Class 1.2.4.
 or putrefying aliment.   For this purpofe, in a difeafe
 fomewhat fimilar in horfes, a perforation is made into
 the  rectum on one  fide  of the fphinCter; through
 which fiftula the air, which is produced in fuch great
 excefs from the quantity of vegetable food which they
 take, when their digeftions are impaired, is  perpe-
 tually evacuated.   In both cafes alfo,  balfams,  effen-
 tial oil,  fpice,  bandage on the abdomen, and, to pre-
vent  the fermentation of the aliment, acid of vitriol,
faliva.   See Clafs I. 2.  4. 5.

   10.  Hypochondriafis.   The  hypochondriac  difeafe
confifts in indigeftion and confequent flatulency, with
anxiety  or want of pleafurable fenfation.   When  the
action of the ftomach  and bowels is impaired,  much
gas becomes generated  by the fermenting or putref-
cent  aliment, and to this indigeftion is  catenated lan-
guor, coldnefs of the ikin, and fear.    For  when  the
extremities are cold for too long a time in fome weak
conftitutions, indigeftion is  produced by direct fym-
pathy of the Skin and  the ftomach, with confequent
heart-burn, and  flatulency.  The fame occurs  if the
Skin  be  made cold by fear, as in riding over dange-
rous roads  in winter, and  hence converfely fear is
produced by indigeftion or torpor of the ftomach by
 affociation.
   This difeafe is confounded with the  fear of death,
 which is an infanity, and therefore of a totally different
 nature.  It is  alfo confounded with the hyfteric  dif-
 eafe, which confifts in the retrograde  motions of the
                                         alimentary 
 Class I. 2.4.3    OF IRRITATION.              rf-)
 alimentary canal, and of fome  parts of the abforbent
 fyftem.
   The hypochondriasis,  like  chlorofis, is  fometimes
 attended with  very quick pulfe ; which the patient
 feems to bear fo eafily in thefe two  maladies, that if
 an accidental cough attends them,  they may  be mif-
 taken  for  pulmonary  confumption;  which  is  not
 owing .primarily  to  the  debility of the heart, but to
 fts direct fympathy with the actions of the ftomach.
   M. M. Blifter.   A plafter on the abdomen of Bur-
 gundy pitch.   Opium a grain twice a day.  Rhubarb
 fix grains every night.  Bark.   Steel.  Spice.   Bath-
 water.  Siefta, or fleep after dinner.  Uniform hours
 of meals.   No liquor ftronger than fmall  beer,  or
 wine  and  water.  Gentle exercife on horfeback  in
 the open air uniformly perfifted in.  See Cardialgia,
 I. 2. 4. 5.

   11.  Cephalaa.   Head-ach frequently  attends  the
cold paroxyfm of intermittents; afflicts inebriates the
 day after intoxication ; and many  people who remain
 too long in the cold bath.  In  all which cafes there ii
 a general inaction  of the whole fyftem,  and  as thefe
 membranes about  the head have  been more  expofed
 to the variations of heat  and cold  of the atmofphere,
 they are more liable to become affected  fo far as to
 produce fenfation, than other membranes; which are
 ufually covered either with clothes,  or with mufcles,
 as mentioned in Sect. XXXIII.  2. 10.

                      M 4                    The
>, 
:5S              DISEASES      [Class I. 2. 4.
   The promptitude of the membranes about the fcalp
to fympathize  with thofe of other parts of the fyftem
is fo great, that this cephalea without fever,  or quick-
nefs of pulfe, is  more frequently a fecondary than a
primary difeafe, and then belongs to Clafs  IV. 1.2.
11.  The hemicrania,  or partial head-ach,  I believe
to be almoft always, a difeafe from affociation ; though
it  is not impoffible, but a  perfon may take cold on
one fide of the head only.  As fome people by fit-
ting always  on the fame fide of the fire in winter are
liable to render one fide more tender  than the other,
and in  confequence more Subject  to pains,  which have
been erroncoufly  termed  rheumatic.  See  Clafs  IV.
2. 1. 7. &8.
   M. M.  The method  of cure  confifts in rendering
the habit  more  robuft,  by gentle conftant exercife in
the open air,  flefli diet, fmall beer at meals with one
glafs of wine,  regular hours of reft and rifing, and of
meals.   The  cloathing about  the head  fliould  be
warmer during fleep  than in the  day ; becaufe 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 re,
fpect to medicine,  two drams of  valerian root in pow-
der three or four  times a day are  recommended  by
Fordyce.  The bark.  Steel in  moderate quantities.
An emetic.  A  blifter.   Opium, half a grain .twice
a  day.  Decayed teeth  Should be  extracted,  par-
ticularly  fuch  as  either ache, or are ufelefs.  Cold
bath between  60  and  70  degrees  of heat.  Warm
                                             bath 
Class I. 2.4.]     OF IRRITATION.             169
bath  of 94  or 98  degrees every day for half an
hour  during  a month.    See Clafs  IV.  2.  2. 7.
and  8.
   A folution of arfenic, about the Sixteenth  part  of a
grain,  is reported to have  great effect  in this  difeafe.
It fhould be taken thrice a day, if it produces no grip-
ing or ficknefs,  for two or three  weeks.  A medicine
of this kind is fold under the name of taftelefs ague-
drops ;  but a more certain method of afcertaining the
quantity is delivered in the fubfequent materia mediea,
Art. IV. 2. 6.

   12.  Odontalgia.  Tooth-ach.   The  pain-has been
crroneoufly fuppofed, where there is no inflammation,
to be owing  to fome acrid matter from a carious tooth
ftimulating the membrane  of the alveolar procefs into
violent  action  and confequent pain;  but  the  effect
feems to have been  mistaken for the  caufe, and the
decay  of the tooth  to have been occafioned  by the
torpor  and  confequent pain  of  the  difeafed mem-
brane.
   Firft, becaufe the pain  precedes the decay of the
tooth in regard to time, and is liable to recur, fre-
quently for years, without  certainly being  fucceeded
at laft  by a carious tooth, as I have repeatedly ob-
fcrved.
   Secondly,  becaufe  any  Stimulant drug,  as  pyre-
thrum, or oil of cloves, applied to the  tooth, or eth^r
applied externally to the cheek,  fo far from  increafing
the pain,  as they would do if the pained membrane,
                                            already 
  -*?•              DISEASES      [Class I. 2. 4.
■  already acted too Strongly, that they frequently give
  immediate relief like a charm.
     And thirdly, becaufe the torpor, or deficient action
  of the membrane,  which includes the difeafed  tooth,
  occafions the morions of the membranes moft connect-
  ed with it,  as thofe of  the cheek and temples, to aCtv
  with lefs than their natural energy ;  and hence a cold-
  nefs  of the  cheek is perceived  eafily by the hand of
  the patient, comparing it with  the  other cheek;  and
  the pain of the hemicrania is often produced  in the
  temple of the affected fide.
     This  coldnefs of the  cheek  in common tooth-ach
  evinces, that the pain is not then caufed by inflamma-
  tion ; becaufe in all inflammations fo much heat  is pro-
  duced in the fecretions of new veflels and fluids, as to
  give heat to the parts in vicinity. And hence, as foon
  as the gum fwells and inflames along with the  cheek,
  heat  is  produced, and the pain ceafes,  owing  to the
  increafed  exertions of the torpid membrane,  excited
  by the activity of the  fenforial power of fenfation;
  which previoufly  exifted  in  its  paffive ftate  in the.
  painful  torpid membrane.   See Odontitis, Clafs II.
  1. 4. 7.  and IV. 2. 2. 8.
     M. M. If the painful tooth be found,  venefection.
  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 fmall hole
  in it, it Should be widened  within  by an  instrument,
  and  then  Stopped  with leaf-gold,  or  leaf-lead ; but
                                               fliould 
Class I. 2. 4.]    OF IRRITATION.              i7i
fliould be extracted, if much decayed.  It is probable
that half a fmall drop of a ftrong folution of arfenic,
put  carefully  into  the  hollow of a  decayed aching
tooth, would  deftroy the  nerve  without giving any
additional pain ; but this  experiment requires  great
caution,  left  any  of the  folution  fliould touch the
tongue or gums.
   Much cold or much heat are equally  injurious to
the  teeth, which  are  endued with a fine fenfation
of this univerfal fluid.  Itie belt method  of preferring
them is by the daily ufe of a brufh, which is not very
hard,  with warm water and fine charcoal  dull.   A
lump of charcoal fhould be put a fecond  time into the
fire  till it is red hot, as  foon as  it becomes cool the
external afhes fhould  be  blown off,  and it  fhould
be immediately reduced to fine powder in a mortar,
and kept clofe flopped in a phial.   It takes away the
bad fmell from decayed teeth,  by wafhing the  mouth
with this powder diffufed in water immediately.   The
putrid fmell of decaying Stumps of teeth iuay be de-
stroyed for a time by waShing the mouth with a weak
folution of alum  in  water.   If  the  calcareous cruft
upon  the teeth adheres very firmly, a fine  powder  of
pumice-ftone may be ufed  occafionally, or a tooth in-
strument.
   Acid of fea-falt, much  diluted,  may be ufed ; but
 this very rarely, and with the greateft caution, as  in
 cleaning fea-fliells.   When the gums are fpongy,
 they  fliould   be  frequently pricked with a  lancet.
 Should  black fpots  in  teeth  be  cut out ?  Does the
                                            enamel 
 ■7*             DISEASES      ^Class I. *. 4.
 enamel grow again  when it has been perforated or
 abraded?

   13.  Otalgia.    Ear-ach fometimes continues many
days without apparent inflammation, and is then fre-
quently removed by filling the ear with laudanum, or
with ether; or even with warm oil, or  warm water.
See  Clafs II.  1.  4. 8.   This pain of the  ear,  like
hemicrania, is frequently the confequence of  affocia-
tion  with a v difeafed  tooth ; in that cafe the ether
mould  be  applied to  the  cheek  over the  fufpected
tooth, or a grain of opium and as much camphor mixed
together and applied to the  fufpeCted tooth.  In this
cafe the otalgia belongs to the fourth clafs of difeafes.

   14. Pleurodyne  chronica.  Chronical pain of the fide.
Pains of the membranous parts,  which are not attend-
ed with  fever, have  acquired the general  name of
rheumatic; which fhould, nevertheless,  be  restricted
to thofe pains which exift only when the parts are in
motion, and which have been left after  inflammation
of them ; as defcribed in  Clafs I. 1, 3. 12.   The pain
of the fide here  mentioned affects many ladies,  and,
may poffibly have been owing to the preffure of tight
flays, which has  weakened  the action of the veffels
compofing  fome membranous  part, as, like  the cold
head-ach, it is attended with prefent debility ;  in one
patient, a  boy about ten years old, it  was attended
with daily convulfions, and  was fuppofed to have ori-
ginated from worms.   The  difeafe ia very  frequent,
                                               and 
Clas* I. 2.4.]    OF IRRITATION.              I7j
and  generally withstands  the ufe of blifters on the
part; but in fome cafes I have known it removed by
electric  Shocks repeated  every  day for a  fortnight
through the affected fide.
  Pains of the fide fflay be fometimes occafioned by
the adhefion of the lungs  to the pleura, after an in-
flammation of them;  or  to  the adhefion of fome ab-
dominal  vifcera  to their  cavity,  or to each  other;
which alfo are more liable to affect ladies from the un-
natural  And ungraceful preffure of tight Stays, or by
fitting or lying too long in one pofture.  But in  thefe
cafes the-pain fliould be more of the fmarting, than of
the dull kind.
   M. M. Ether.  A blifter.  A plafter of Burgundy
pitch.  An iffue or feton on the part.  Electric Shocks.
Friction on  the  part  with oil and camphor.  Loofe
drefs.  Frequent change  of pofture both  in the day
ftnd night.  Internally opium, valerian, bark.

   15. Sciatica frigida. • Cold fciatica*  The pain along
the  courfe of the feiatie  nerve,  from the hip  quite
ctawft to the top of the foot, when it is not attended with
fever, is improperly termed either rheumatifm or gout;
as it occurs  without inflammation, is attended with
pain when the limb is at reft; and as the pain attends
the  courfe of the nerve,  and not the courfe of the
mufcles, or  of the fafcia, which contains them.  The
theory  of Cotunnius, who believed it to be a dropfy
of the Sheath of the nerve,  which was compreffed by
the  accumulated fluid, has not been- confirmed by dik
                                            feCtibn.. 
 »74              DISEASES       [Class I. 2.4
 feCtion.  The difeafe feems to confift of a  torpor  of
 this Sheath of the nerve, and the pain feems to be  in
 confequence of this  torpor.  See Clafs II. 1.  2. 13.
   M.  M.  Venefection.   A cathartic.   And  then one
grain of calomel and one of opium every night for
ten fucceffive nights.  And a blifter, at the fame time,
a  little above  the  knee-joint on the outfide of the
thigh, where the fciatic nerve is  not fo deep feated.
Warm bath.   Cold bath.  Cover the limb with oiled
filk, or with a plafter-bandage of emplaftrum de minio.

   16. Lumbago frigida.   Cold lumbago.  When no
fever  or  inflammation attends this  pain of the loins,
and the pain  exifts without motion,  it belongs to  this
genus of difeafes, and refembles the pain of  the Ioin3
in the cold fit of ague.   As thefe membranes are ex-
tenfive, and more eafily fall into quiefcence, either by
fympathy,  or when they are primarily affected,, this
difeafe becomes very afflicting, and of  great pertina-
city.   See Clafs IL 1. 2. 17.
   M.  M.  Venefection.   A  cathartic.  Iffues on the
loins.   Adhefive plafter  on the loins.   Blifter on the
os facrum.   Warm bath.  Cold bath.  Remove to a
warmer climate in the winter.   Loofe drefs about the
waift.  Friction daily with oil and camphor..

   17.  Hyfleralgia frigida.  Cold  pain  of the uteru3
preceding or accompanying menftruation. It is attend-
ed with cold  extremities, want of appetite, and other
marks of general debility.
                                            M.M. 
Class I. 2. 4.]    OF IRRITATION.              j7j
   M. M. A clyfter of half a pint  of gruel, and 30
drops of laudanum ; or a grain of opium and fix grains
of rhubarb every night.   To fit over warm water, or
go into a warm bath.

   18. Proclalgia frigida.   Cold  pain at the bottom
of the reClum previous to the tumour of the  piles,
which fometimes extends by fympathy to the loins; it
feems to be  fimilar  to  the pain at the  beginning of
menftruation, and is  owing to the torpor or inirritabi-
lity of the extremity of the alimentary canal, or to the
obstruction  of the blood in ifs%paffage through the
liver, when that vifcus is  affected,  and its confequent
delay in the veins of the rectum, occasioning tumours
of them, and dull fenfations of pain.
   M.  M.  Calomel.   A cathartic.   Spice.  Clyfter,
with 30 drops of laudanum.  Sitting over warm water.
If chaiybeates after evacuation ? See Clafs I.  2. 3. 21.
and I. 2. 1. 6.

   19. Vefica fellea  inirritabilitas.   The inirritability
of the  gall-bladder  probably  occafions  one kind of
iclerus, or  jaundice;  which is owing to whatever ob-
structs the paffage of bile  into  the  duodenum.  The
jaundice of aged people, and which attends fome fevers,
is believed  to be moft frequently caufed by an irrita-
 tive palfy of the gall-bladder ;  on which account the
bile is not preffed from the cyft by its contraction, as
 in a paralyfis of the urinary bladder.
A thick- 
 i'i ■>               DISEASES      [Class I. 2. 4.
   A thickening of  the  coats of ilii common 'bile-duct
by inflammation or increafed action of their veffels fo
as to prevent the paffage of the bile into the inteftine,
in the fame manner as the membrane, which lines the
noftrils, becomes  thickened in catarrh fo as to prevent
the paffage of air through them, is probably another
frequent caofe of jaundice*, efpecially of children ; and
generally ceafes in about a fortnight, like  a common
catarrh, without the aid of medicine ; which has given
rife to  the character, which charms  have obtained in
fome  countries for  curing  the jaundice  of young
people.
  The  fpiffitiide  of the bile is' another  caufe  of jaun-
dice, as  mentioned  in  Clafs  I.  1. 3. 8.    This alfo
in children is a difeafe  of  little clanger, as the gall-
ducts are diftenfible, and will the eafier admit of  the
exclufion of gall-ftofies; but becomes a more  ferious
difeafe m proportion to the age of the patient, and
his habits of lire in refpect to fpirituous  potation*
  A fourth caufe of jaundice is the compreffion of the
bile-duct by the enlargement of an inflamed or fchir-
rous liver ; this attends thofe who have drank  much
fpirituous liquor, and is  generally fueeeeded by dropfy
and death.
  M. M. Repeated emetics. Mild cathartics.  Warm
bath.   Electricity.  Bitters. Then fteel, which, wheti
the pain  and inflammation is removed by evacuations,
aCts like  a charm in removing the remainder of the in-
flammation, and by promoting the abforption of til*
new veffels or fluids; like the application of any acrid
                                               ever 
Class I. 2.4.]     OF IRRITATION.              I77
eye-water  at  the  end of opthalmia;  and thus  the
thickened coats of the bile-duct become reduced,  or
the enlargement of the liver leffened, and a free paf-
fage is again opened for the  bile into the inteftine.
Ether with yolk of egg is  recommended, as having a
tendency to diffolve infpiffated bile.  And a decoction
of madder is recommended for the fame purpofe;  be-*
caufe the bile of animals, whofe food was mixed with
madder, was found always in a dilute ftate.   Aerated
alkaline water,  or Seltzer water.   Raw cabbage, and
other acrid vegetables,  as water-creffes,  muftard.
Horfes are faid to be fubject to infpiffated bile, with
yellow eyes, in the winter  feafon, and to get well as
foon as they feed on the fpring grafs.
   The largeft bile-Stone I have feen was from a lady,
who had parted with it fome years before, and who
had abstained  above ten years from all kinds of vege-
table diet to prevent, as fhe fuppofed, a colic of her
ftomach, which was probably a  pain of the  biliary
duct; on refuming the ufe of fome vegetable diet, She
recovered a better ftate of health, and formed no new
bilious concretions.
   A ftrong aerated alkaline water is   fold   by  J.
Schweppe,  No. 8, King's-ftreet.  Holborn.  See Clafs
I. 1. 3. 10.

 ,  20.  Pelvis  renalis inirritabilitas.    inirritability of
the  pelvis of the  kidney.   When the  nucleus of a
ftone, whether it be infpiffated mucus, or other mat-
ter, is formed  in the extremity  of any of the tubuli
                        N                 uriniferi. 
 *7&               DISEASES      [Class I. 2. 5.
 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 fituation increafes by new appofitions of in-
 durated animal matter in the fame manner as the ftone
of the  bladder.   This is the general caufe  of hemor-
rhage from  the kidney; and of obtufe  pain in it on
exercife;-or of acute  pain,  when the ftone advances
into the ureter.   See Clafs I. 1. 3. 9.
                    ORDO  II.
                 Decreafed Irritation.
                    GENUS  V.
        Decreafed Aclion of the Organs of Senfe.
                    SPECIES.
   1. Stultitia  inirritabilis.   Folly from inirritability.
Dulnefs of perception.   When  the motions of  the
fibrous  extremities of the nerves of fenfe are too weak
to excite fenfation with fufficient quicknefs and vigour.
The irritative ideas are neverthelefs performed, though
perhaps in a feeble manner, as fuch people do not run
againft  a poft,  or walk into a well.  There are three
other kinds  of folly ;  that  from deficient  fenfation,
from deficient volition, and from  deficient affociation,
as will be mentioned in their places.  In delirium,  re-
verie, and fleep,  the power of perception  is abolished
from other caufes.
                                            2. Vtfus 
Class I.  2/5.]    0F IRRITATION.              179
   2. Vifus imminutus.  Diminifhed vifion.   In our ap-
proach to old age our vifion becomes imperfect, not only
from the form of the cornea, which becomes lefs con-
vex, and from its decreafed tranfparency mentioned in
Clafs  I.  2.  3.  26. ; but  alfo from the decreafed irri-
tability 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  dropfy  of  the brain,
is generally a fatal-fymptom.   A part  of the cornea
as well as  a part  of the albuginea  in thefe fevers is
frequently  feen  during fleep ; which is  owing to the
inirritability  of the  retina to light,  or to the general
parefis of mufcular  action, and in confequence to the
lefs contraction of  the fphincter of the eye, if it may
bq fo called, at  that time.
   There have been  inftances of fome, who could not
diftinguifh  certain colours;  and yet  whofe eyes, in
other refpeds, were not  imperfect.  Philof. Tranfact.
Which feems to have been owing to the want  of irri-
tability, or the inaptitude to action, of fome claffes of
fibres which  compofe  the retina.  Other permanent
defects depend  on the difeafed ftate  of the external
organ.    Clafs I. 1.  3. 14. I. 2.  3. 25.  IV. 2. 1. 11.

   3. Mufca volitantes.   Dark fpots appearing before
the eyes,  and changing their apparent place with the
motions of the eyes, are owing to a temporary defect
of irritability of thofe parts  of the retina, which have
been lately expofed  to more  luminous objects than the
oiher parts of it, as explained in Sect, XL. 2.   Hence
                       N 2                   dark 
ito              DISEASES      [Class I. 2.5.
dark  fpots are feen on  the bed-clothes  by patients,
when the optic nerve is become lefs irritable, as in fe-
vers with great debility  ; and the patients are perpe-
tually trying to pick them off with their fingers to dif-
cover what they arc ; for thefe parts of the retina  of
weak  people are fooner  exhaufted by the ftimulus  of
bright colours, and are longer in regaining their irri-
tability.
   Other kinds of ocular  fpeCtra, as the coloured ones,
are alfo more liable  to remain in the  eyes  of people
debilitated by fevers, and to produce various halluci-
nations of fight.  For  after the contraction of a muf-
cle, the fibres of it continue in  the laft fituation, till
fome antagonist mufcles  are exerted to retract them \
whence, when any one is much exhaufted by exercife,
or by  want of fleep, or in fevers, it is eafier to let the
fibres of the retina  remain in  their laft fituation, after
having been ftimulated into contraction, than to exert
any antagonift 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  fenforial power  is  expended
during the day in the  perpetual activity of  our fenfe
of vifion, befides that  ufed  in the motions of the eye-
balls and eye-lids;  as much I fuppofe as  is expended
in the motions  of our  arms, which are Supplied  with
nerves of about the fame diameters.   From hence wc
may conclude, that  the light fhould be kept from pa-
tients in fevers with debility,  to prevent the unnecef-
farv exhauftion of the fenforial power.  And that  on
                                                the 
  lass I. 2. 5.]     OF IRRITATION. '            i8j
 the fame account their  rooms fhould be kept filent as
 well  as dark ;  that they fhould be  at reft in an hori-
 zontal pofture ; and be cooled by  a blaft of cool  air,
 or  by wafhing them with cold water, whenever their
 Skins are warmer than natural.

   4. Strabifmus*  Squinting is generally owing to one
 eye being  lefs perfect  than the other; on  which ac-
 count the patient endeavours to hide the worft eye in
 the fhadow of the nofe, that his vifion  by the other
 may not be confufed.   Calves, which  have an hyda-
 tide with infects enclofed in it in the frontal finus on
 one fide, turn towards the affected fide; becaufe  the
 vifion on that fide, by the preffure of the  hydatide,
 becomes lefs perfect; and the difeafe being recent,  the
 animal  turns round,  expecting  to  get a  more diftinet
 view of objects.
   In the hydrocephalus internus, where both eyes  are
 not become infenfible, the patient fquints with only one
 eye, and views objects with the  other, as in common
 Strabifmus.   In this cafe it may be known on  which
 fide the  difeafe exifts,  and that it  does  not exift on
 both  fides of the brain ;  in fuch  circumftances, as the
 patients I believe never recover as they are now treat-
 ed, might it not be  advifeable  to perforate the era-
mum over the ventricule of the affected  fide ?  which
 might at leaft give room'and  ftimulus to the affected
 part of the brain ?
   M. M. If the fquinting has not been confirmed  by
 long habit, and one eye be not much worfo  than  the
                       N  3                  other, 
I"              DISEASES      [Class I. 2.5.
other, a piece of gauze ftretched on a circle of whale-
bone, to cover the beft eyevin fuch a manner as to re-
duce the diftinctnefs of vifion  of this eye to a Similar
degree of imperfection with the other, fliould be worn
fome hours every day.  Or the  better eye fhould be
totally darkened by a tin cup  covered with black filk
for fome hours daily, by which means  the  better eye
will be gradually weakened by the want of ufe, and
the worfe eye will be gradually ftrengthened by ufing
it.   Covering an inflamed  eye in children  for weeks
together,  is* very liable to produce fquinting, for  the
fame reafon,

.   5.  Amaurofis.  Gutta ferena.  Is a blindnefs from
the  inirritability  of  the optic nerve.  It is generally
efteemed a palfy  of the nerve,  but Should rather be
deemed the death of it, as  paralyfis has generally been
applied to  a deprivation  only of voluntary  power.
This is a difeafe  of  dark eyes only, as the cataract is
a difeafe of light eyes only.   At  the commencement
of this difeafe, very minute electric Shocks fliould be
repeatedly paffed through the eyes; fuch as may be
produced  by putting one edge of a piece of filver the
fize of a  half-crown  piece beneath the tongue, and
one edge  of a piece of zinc of a fimilar fize between
the  upper  lip  and  the  gum,  and then  repeatedly
bringing their exterior edges  into  contact, by which
means very fmall electric fparks become  vifible in the
eyes.  See additional note at  the end of the firft vo-
lume, p. $67. and Sect, XIV. 5.
                                        M.  M. Mi- 
 Class I.  2. 5."]    OF IRRITATION.              183
   M. M.  Minute electric fliocks.   A grain of opium,
 and a quarter of a  grain  of corrofive fublimate of.
 mercury, twice a day  for  four or fix  weeks.   Blif-
 ter on the crown of the head.

   6.  Auditus imminutus*  Diminiflied hearing.   Deaf-
 nefs is • a frequent  fymptom in thofe inflammatory or
 fenfitive  fevers with  debility, which  are generally
 called putrid; it attends the general ftupor in thofe
 fevers, and is rather  efteemed a  falutary Sign, as du-
 ring  this ftupor  there is lefs expenditure of fenforial
 power.
   In  fevers of debility without  inflammation,  called
 nervous  fevers, I fufpeCt deafhefs  to be a bad  fymp-
 tom,  arifing  like the dilated pupil from a partial pa-
 ralyfis of the  nerve of fenfe.  See Clafs IV. 2.  1. 15.
   Nervous fevers are  fuppofed by Dr. Gilchrift to
 originate from a  congestion  of ferum or water in fome
 part of  the brain,  as many of the fymptoms are fo
 Similar to  thofe 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 thefe fevers may arife from the compreflion
 of the effufed fluid ;  while  the torpor attending pu-
 trid fever may depend  on the meninges of the brain
 being thickened  by  inflammation, and  thus compref-
 ling it;  now the new veffels, or  the  blood,  which
 thickens  inflamed parts, is  more frequently reabforb-
ed, than  the effufed fluid from a cavity ; and hence the
 ftupor in one  cafe is lefs dangerous than in the other.
                       N 4                      In 
J«4               DISEASES     [Class 1.2. 5.
   In  inflammatory or  fenfitive  fevers' with  debility,
deafhefs may fometimes arife from a greater  fecretion
and abforption of the ear-wax,  which is very fimilar
to the bile, and  is liable to fill the meatus  audito-
rius, when it  is too vifcid, as bile obstructs the gall-
ducts.
   M. M.  In deafnefs without fever Dr. Darwin  ap-
plied  a cupping-glafs on  the ear with  good  effect,
as defcribed in Phil. Tranf. Vol. LXIV. p. 348.  Oil,
ether, laudanum, dropped into  the ears,

   7.  Olfaclus imminutus.   Inactivity of the fenfe of
fmell.   From  our habits of trufting to the art of cook-
ery, and not examining our food by the fmell as other
animals do, our  fenfe of  (mell  is  lefs  perfeCt than
theirs.  See Sect. XVI.  5.  Clafs IV. %. 1, 16.
   M. M, Mild errhines.

   8.  Giiftus imminutus.  Want  of tafte is very com-
mon  in fevers, owing frequently to the  drynefs or
fcurf of the tongue, or external organ  of that fenfe,
rather than to any injury of the nerves of tafte.   See
Clafs I. 1. 3.  1. IV. 2. 1.  16.
   M. M. Warm fubacid liquids taken frequently.

   9.  Taclus imminutus.  Numbnefs  is frequently com-
plained of in fevers, and in epilepfy, and the touch is
fometimes impaired by the  drynefs  of  the cuticle of
the fingers.   See Clafs IV. 2,  1.  16.
When 
Class I. 2. 5.}    OF IRRITATION.              185
   When the fenfe of touch is impaired by the com-
preffion of the nerve, as in fitting long with one thigh
croffed over the other, the limb appears larger, when
we touch it with our hands, which  is to  be afcribed
to  the  indiftinChiefs of the fenfation of  touch,  and
may be explained in the fame manner as the apparent
largenefs of objects feen  through a mift.  In this laft
cafe the minute parts of an object,  as fuppofe  of a
diftant boy, are feen lefs  distinctly, and therefore we
inftantly conceive  them to be further from the  eye,
and in confequence that  the whole fubtends  a larger
angle, and thus we believe the boy to be  a man.   So
 when any one's fingers  are preffed  on  a benumbed
 limb, the  fenfation  produced is lefs'than it fliould be,
judging from vifible circumftances;  we therefore con-
 ceive,  that fomething intervened  between the objeCi:
 and the fenfe, for it is felt as if a blanket* was put be*
 tween  them ; and that not being visibly  the cafe, we
 judge that the limb is Swelled.
    The fenfe of touch is alfo liable to be deceived  from
 the acquired habits of one part  of it adlng in the
 vicinity of another part of it.  Thus if the middle fin-
 ger  be croffed over either of the fingers next  to it,
 and a nut be felt by the two ends of the fingers fo
 croffed at the fame time, the nut appears as if it was
 two nuts.  And  laftly, the fenfe 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 onee, and
 I fup'pofe to moft others,  to have  put my hands into
                                                 an 
 i&6   .            DISEASES      [Class I. 2. 5-.
 an empty bafon Standing in  an obfcure comer of a
 room to wafh them, which I  believed to contain cold
 water, and  have inftantly perceived a fenfation  of
 warmth, contrary to that wdikh I expected to have felt.
   In fome paralytic affections, and in cold fits of ague,
 the fenfation 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 alkali  and water.   In-
 ternally fpice, fak.  Incitantia.  Secernentia.

    10. Stupor.   The ftupor,  which occurs in fevers
 with  debility, is generally efteemed a favourable fymp-
 tom ;  which  may arife from  the lefs  expenditure  of
 fenforial  power  already  existing  in  the  brain  and
 nerves, as mentioned in fpecies 6 of this genus.   But
 if we  fuppofe, that there is a  continued production of
 fenforial power, or an accumulation of it in the torpid
 parts of-the fyftem, which is not improbable,  becaufe
 fuch a production of it continues during Sleep, to which
 ftupor is much allied, there is  Still further  reafon  for
 believing  it to be a favourable fymptom  in inirritable
 fevers; and that much injury is often done by blifters
 and other pow erful ftimuli to remove the ftupor.  See
 Sect.  XII. 7.  8. and XXXIII.  1. 4.
   Dr. Blane  in his Croonian Lecture on mufcular mo-
 tion for 1788, among many other  ingenious obferva-
 tions and  deductions, relates a  curious experiment on
falmon, and  other fifh,  and which he  repeated upon
crh w ith  fimilar event.
                                              "If 
Class I. 2. 5.]    OF IRRITATION.              187
   " If a fifli, immediately upon  being taken  out of
the water, is ftunned by a violent blow on the head,
or by having the head cruflied,  the irritability  and
fweetnefs  of the  mufcles  will  be  preferved  much
longer, than if it had been allowed to die with the
organs of fenfe entire.   This is fo well known to fifh-
ermen, that they put  it in practice, in order to make
them longer fufceptible of the operation called crimp-
ing.   A falmon is one of the fifli leaft tenacious of life,
infomuch,  that it will lofe all figns of life in lefs than
half  an hour after it  is taken  out of the water,  if
fuffered to die without any farther injury ; but if, im-
mediately  after being  caught,  it  receives  a  violent
blow on the  head, the mufcles will fhew vifible irrita-
bility for more than twelve hours afterwards."
   Dr. Blane afterwards well remarks, that " in thofe
diforders  in  which the exercife of  the fenfes  is in a
great meafure destroyed, or fufpended, as in the hy-
drocephalus, and apoplectic palfy, it  happens not un-
commonly, that the appetite and digeftion are better
than  in health."
ORDO 
 »88               DISEASES      [Class t. 3. r.

                   ORDO  III.
            Retrograde Irritative Motion*.

                   GENUS   I.
              Of the Alimentary Canal.
   The  retrograde  motions of our fyftem originate
either from defect of ftimulus, or from defect of irrita-
bility.   Thus  ficknefs is  often induced  by hunger,
which is a want  of ftimulus; and  from ipecacuanha,
in which laft cafe it would feem,1 that the ficknefs was
induced after the violence of the ftimulus was abated,
and  the confequent  torpor had fucceeded.    Hence
fpice, opium, or food  relieves ficknefs.
   The  globus  hyftericus,  falivation,  diabetes,  and
other inversions  of motion  attending hyfteric  parox-
yfms, feem to depend  on the  want of irritability of
thofe parts of the body, becaufe they are attended
with  cold  extremities,  and  general debility, and are
relieved by wine, opium, fteel, and flefh diet;  that is,
by any additional ftimulus.
   When the longitudinal mufcles are fatigued by long
action, or are habitually weaker than natural, the an-
tagonist mufcles replace  the limb by ftretching  it  in a
contrary direction;  and as thefe  mufcles  have  had
their  actions affociated  in  Synchronous tribes,  their
actions ceafe together.   But as the hollow mufcles pro-
pel the fluids, which  they  contain, by  motions affo-
ciated in trains;  when  one  ring is fatigued from its
tpo great debility, and brought into retrograde action ;
                                                the 
 Class I. 3. 1.]     OF IRRITATION.             189
 the next ring, and the next, from  its affociation in
 train falls into retrograde action.   Which continue fo
 long  as they are excited to act, like the tremors of the
 hands of infirm people, fo long as they endeavour to-
 ad.  Now  as  thefe hollow  mufcles are  perpetually
'ftimulated, thefe retrograde actions do not  ceafe as the
 tremors  of the longitudinal  mufcles,  which are gene-
 rally  excited only by volition.   Whence the  retro-
 grade motions of hollow mufcles depend  on two cir-
 cumstances, in which they differ from the longitudinal
 mufcles, namely,  their motions being affociated in
 trains,  and their being fubject to perpetual ftimulus.
 For further elucidation of the  caufe of this curious
 fource of difeafes, fee Sect. XXIX.  11. 5.
   The fluids difgorged  by the retrograde  motions of
 the various  vafcular mufcles may be  distinguished, i.
 From thofe, which are produced by fecretion, by their
 not being attended by increafe of heat,  which always
 accompanies  increafed  fecretion.   2.  They  may be
 diftinguifhed from  thofe fluids,  which are the confe-
 quence of deficient abforption, by their not poffeffing
 the faline acrimony, which thofe fluids poffefs ; which
 inflames  the ikin or other membranes on which tliey
 fall;  and which have a faline  tafte to the tongue.  3.
 They may be diftinguifhed from thofe fluids, which
 are the  confequence both of increafed fecretion  and
 abforption,  as thefe are attended  with  increafe of
 warmth, and are infpiffated 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 
 i$0               DISEASES      [Class 1.5. 1.
 are tranflated from one part of the fyftem  to another,
 they have been  the product of retrograde action of
 lymphatic or other  canals.  As  explained in  Sect.
 XXIX. 8.

                   SPECIES.
   1.  Ruminatio.   In the rumination of horned cattle
 the retrograde motions of the cefophagus are vifible to
 the eye,  as they bring up the foftened grafs from their
 firft  ftomach.  The vegetable aliment in  the  firft
 ftomach of cattle, which have filled themfelves  too full
 of young clover, is  liable to run  into fermentation,
 and  diftend the ftomach,  fo as to preclude its exit,
 and frequently to  deftroy  the animal.  To difcharge
 this air the farmers frequently make an opening into
 the ftomach of the  animal with fuccefs.   I was  inform-
 ed, I believe by the late Dr. Whytt of Edinburgh,
 that of twenty  cows in this fituation 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 immenfe quan-
 tities of air, and recovered.
  There are histories  of ruminating men, and who
 have taken pleafure in the act of chewing their food a
 fecond time.  Philof. TranfaCt.

  2. Ruclus.  Eructation.  An inverted motion of the
ftomach excluding through its upper valve an elaftic
 vapour generated by the fermentation of the aliment;
which  proceeds  fo haftily, that the digeftive power
                                              does 
 Class I.. 3- I-]     OF IRRITATION.             i9i
 does  not  fubdue it.   This  is  fometimes acquired
 by habit,  fo that fome  people can eruct when they
 pleafe, and  as long as they pleafe ; and there is gas
 enough  generated to fupply them  for this purpofe;
 for by Dr. Flak's experiments, an apple,  and many
 other  kinds  of aliment, give  up above  fix hundred
 times  their own bulk of an elaftic gas  in fermentation.
 When people voluntarily  eject the fixable air from
 their Stomachs, the  fermentation of the aliment pro-
 ceeds  the fafter ;  for ftopping the veffels, which con-
 tain new wines, retards their fermentation,  and open-
 ing  them  again   accelerates it; hence where  the di-
 geftion is  impaired, and the  ftomach fomewhat dif-
 tended with air,  it is better to reftrain than to encou-
 rage eructations,  except the quantity makes it  necef-
 fary.  When wine  is confined in  bottles  the fermen-
 tation ftill  proceeds flowly  even for years,  till all the
 fugar  is converted into fpirit; but  in the  procefs of
 digeftion,  the faccharine part is abforbed in the form
 of chyle by the  bibulous  mouths  of the  numerous
 laCteals,  before it has time  to run into the-vinous fer-
 mentation.

   3.  Apepfia.  Indigeftion.   Water-qualm.  A few
 mouthfuls  of the  aliment are rejected at a time for
 fome hours after  meals.   When  the aliment has had
 time to  ferment,  and  become acid, it produces car-
 dialgia, or heart-burn.   This difeafe is perhaps gene-
rally left after a flight inflammation of the ftomach,
called a furfcit, occafioned by  drinking cold liquors,
or 
i)t             DISEASES       [Class I. 3. I.
or eating cold vegetables, when  heated with exercife.
This inflammation of the ftomach is frequently, I be-
lieve, at  its commencement removed by a critical
eruption on  the  face,  which differs in its  appearance
as well as in its caufe from the gutta rofea of drun-
kards, as  the ikin round  the  bafe of each eruption
is lefs inflamed.  See  Clafs II.  1.  4. 7.   This difeafe
differs from Cardialgia, Clafs I. 2. 4. 5.  in its being
not uniformly attended with pain  of the  cardia ven-
triculi, and  from its retrograde motions of a part of
the ftomach about the  upper orifice of it.   In the fame
manner as hyfteria differs from hypochondriafis ;  the
one confifting in the weaknefs and indigeftion of the
fame portions of the alimentary canal, and the  other
in the inverted  motions of fome  parts of it.  This
apepfia or water-qualm continues many years, even to
old ape ; Mr. G-----of Lichfield  fuffered under  thn
difeafe from his  infancy ; and, as he grew old,  found
relief only from repeated dofes of opium.
   M. M.  A blifter, rhubarb,  a grain of opium twice
a day.  Soap, iron-powder.  Tin-powder.

   4.  Vomitus.   An inverted order of the motions of
the ftomach and cefophagus with their abforbent vef-
fels, by which their contents are evacuated.  In  the
act of vomiting lefs fenforial powder  is employed than
in the ufual  periftaltic  motion  of the ftomach,  as ex-
plained  in Sect.  XXXV.  1. 3.   Whence  after the
operation  of an emetic  the  digeftion  becomes ftronger
by an accumulation of fenforial power during its de-
                           4              creafed 
 Class  I. 3. !.]    OF IRRITATION.              i93
 creafed action.   This decreafed action of the Stomach
 may be either induced by want of ftimulus, as in the
 ficknefs  which attends hunger ;  or it may be induced
 by temporary wrant  of irritability, as  in  cold fits of
 fever; or. from habitual  want of irritability,  as the
 vomiting of enfeebled drunkards.   Or laftly, by ha-
 ving been previously too violently ftimulated by an
 emetic drug, as by ipecacuanha.
   M. M. A blifter.   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 ftomach, as in the
 laft article, but alfo the duodenum, and ilium, as low
 as the valve of the colon,  have their motions invert-
 ed ;  and great quantities of bile are thus poured into
 the ftomach; while at the fame time fome branches of
 the laCteals become retrograde, and difgorge their con-
 tents into the upper  part of the alimentary canal; and
 other branches of them difgorge their contents into the
 lower parts of it beneath the valve of the colon; a vomit-
 ing and purging commence together, which is called cho-
 lera, as it is fuppofed to have its origin from increafed
 fecretion of bile ;  but I fuppofe more frequently arifes
 from  putrid  food, or poifonous drugs, as in the cafe
 narrated in Sect. XXV. 13. where other circumstances
 of this difeafe are explained. •  See Clafs II. 1.2.  11.
   The cramps  of the legs,  which are liable to attend
 cholera, are explained in Clafs III. 1. 1* i£U-
                        O                  6 Ileus. 
194              DISEASES       [Class I. 3. 1.
   6. Ileus.   Confifts in the  inverted  motions of  the
wfiole inteftinal canal, from the  mouth to the anus;
and of the laCteals and abforbents which arife from it.
In this pitiable difeafe, through the valve of the colon,
through  the pylorus, the cardia, and the,  pharinx,
are ejected, firft,  the contents of  the ftomach and in-
teftines,  with the excrement and even clyfters  them-
felves ;  then the fluid from the laCteals, which is now
poured into the  inteftines by their  retrograde motions,
is thrown up by the mouth ;  and, laftly, every fluid,
which is abforbed by the other lymphatic branches,
from the cellujar membrane, the Skin, the bladder,
and all other cavities of the body; and which  is then
poured   into the ftomach  or  inteftines by the retro-
grade motions of the laCteals; all which fupply  that
amazing quantity of fluid,  which is in this difeafe  con-
tinually  ejected by vomiting.  See Sect. XXV. 15. for
a further explanation of  this difeafe.
   M. M.  Copious venefection.  Twenty grains of
calomel  in fmall pills, or one grain of aloe every hour
till ftools are procured.  Blifters. Warm bath.  Crude
mercury.  Clyfter of ice-water.  Smear  the  ikin all
over with greafe, as mentioned  in Sect. XXV.  15.
   As this  malady is occafioned fometimes  by  an in-
trofufception of a part  of the  inteftine  into another
part of it, efpecially in  children,  could holding them
up by their heels for a fecond or two of time be of
fervice after venefection ? Or the exhibition of crude
quickfilver  two ounces  every half hour,  till a pound
is  taken, .be .particularly ferviceable in this circum-
                                             ftance ? 
Claw I. 3. 1.]    OF IRRITATION.              i95
Stance ? Or could half a pound, or a pound, of crude
mercury be  injected  as  a clyfter,  the patient being
elevated by  the knees and  thighs fo  as to have his
head and fhoulders  much  lower than  his bottom,  or
even for a Short time held up by  the heels ? Could
this alfo be of advantage in Strangulated hernia ?
   Where the difeafe is owing to Strangulated hernia, the
part fhould be fprinkled with cold water, or iced water,
or fait and water  recently mixed,  or  moiftened with
ether. In cafes of Strangulated hernia, could acupuncture,
or punCture with a capillary trocar, be ufed with fafety
and advantage to give exit  to air contained in  the
Strangulated  bowel ?  Or to Stimulate  it into  action ?
It is not uncommon  for bafhful men  to conceal their
being afflicted with  a  fmall hernia, which is the caufe
of their death; this circumftance fliould  therefore
always be enquired into.  Is the feat or caufe of the
ileus always  below  the valve of the colon, and that of
the cholera above it? See Clafs II.  1. 2. 11,

   7. Globus hyflericus.   Hyfteric fuffocation is the per-
ception of a globe rolling round in the abdomen,  and
afcending  to the ftomach and throat,  and there  in-
ducing ftrangulation.   It  confifts of an ineffectual in-
verfion of  the motions of the cefophagus, and other
parts of the alimentary canal;  nothing  being  rejected
from the ftomach.
   M. M.  Tincture  of caftor.  TinCt.  of  opium  of
each 15 drops.   See  Hyfteria, Clafs I. 3. 1. 9.
O 2              8. Vomendi 
196              DISEASES      [Class I. j. r.
   8. Vomtndi conamen inane.  An ineffectual effort to
 vomit.  It frequently  occurs, when the  ftomach it
 empty,  and in fome cafes continues many hours ;  but
 as the lymphatics of the ftomach are not  inverted at
 the fame time,  there is no fupply  of materials to  be
 ejected; it  is fometimes a fymptom of hyfteria,  but
 more frequently attends  irregular epilepfies  or  re-
 veries ;  which however may be diftinguiflied by  their
 violence of exertion, for the exertions of hyfteric mo-
 tions are  feeble, as they are caufed by debility ;  but
 thofe of epilepfies, as they are ufed to relieve pain, are
 of the  moft violent kind;  infomuch that thofe who
 have once  feen thefe  ineffectual efforts  to vomit in
 fome epilepfies, can never  again  miftake them  for
 fymptoms of hyfteria.  See a cafe in Sect. XIX. 2.
   M. M. Blifter.   Opium.  Crude mercury.

   9. Borborigmus.   A gurgling of the  bowels  pro-
 ceeds from a partial invertion of the periftaltie  motions
 of them,  by which  the gas is brought into a fuperior
 part of the bowel, and bubbles through the  defcend-
 ing fluid, like  air ruffling into  a bottle as the water
 is poured out of it.   This  is fometimes a diftreffing
 fymptom  of the debility of  the bowels joined with a
 partial  inverfion of their motions. . I attended a young
 lady  about Sixteen,  who was in other refpeCts feeble,
 whofe bowels almoft inceffantly made a gurgling noife
 fo loud as to be heard at a considerable diftance, and
 to attract the notice of all  who w ere near her.   As
 this noife never ceafed a  minute  together for many
                                             hours 
Class 1-3.  i-3     OF IRRITATION.             1^7
hours in a day, it could not be produced by the uni-
form defcent of water, and afcent of air through it,
but there muft  have been alternately  a retrograde
movement of a part  of  the bowel, which muft again
have puflied  up the water above  the air; or which
might raife a part  of the  bowel,  in which the fluid
was  lodged, alternately above  and below  another
portion  of it;  which might  readily  happen in fome of
the  curvatures of  the  fmallef inteftines, the air in
which might be moved backward and forward like the
air-bubble  in a glafs-level.
   M. M. Effential oil.   Ten corns  of black  pepper
fwallowed whole  after dinner,  that its eifect might be
flower and more permanent;  a fmall  pipe occafionally
introduced into the  rectum to facilitate the efcape of
the air.   Crude mercury.  See Clafs I.  2. 4. 9.

   10.   Hyfleria.   The  three laft articles, together
with the lymphatic  diabetes, are the moft common
fymptoms of the hyfteric difeafe; to which fometimes
is added the lymphatic  falivation, and fits of fyncope,
or convulfion, with palpitation of the  heart  (which
probably  confifts of retrograde motions of it), and a
great fear of dying.   Which laft circumftance diftin-
guifhes  thefe  convulfions from the  epileptic ones with
greater certainty than any other fingle fymptom.  The
pale copious  urine, cold ikin, palpitation, and trem-
bling, are the fymptoms excited by great fear.  Hence
in hyfteric difeafes,  when  thefe fymptoms occur, the
fear, which  has  been  ufually  affociated  with  them,
                        O 3                 recurs 
198              DISEASES      [Class I. 3 1.
recurs at the fame time, as in hypochondriafis,  Clafs
I.  2. 4.  10.   See Sect XVI. 8. 1.
   The convulfions which fometimes attend the hyfteric
difeafe, are exertions  to relieve  pain,  either of fome
torpid, or of fome retrograde organ ; and  in this re-
fpect they refemble epileptic  convulfions,  except that
they are feldom fo violent  as  entirely  to  produce in-
fenfibility to external ftimuli; for thefe weaker pains
ceafe before the total exhauftion of fenforial power is
produced, and the  patient finks  into imperfect Syn-
cope ; whereas the true epilepfy generally terminates
in temporary apoplexy, with perfect infenfibility to
external  objects.   Thefe  convulfions  are  lefs  to be
dreaded than  the epileptic ones, as  they  do not  ori-
ginate from fo permanent a caufe.
   The great difcharge of pale  urine in  this difeafe
is owing  to the inverted  motions of  the  lymphatics,
which arife about  the neck  of the bladder,  as de-
fcribed in Sect.  XXIX.  4.  5.   And the lymphatic
falivation arifes from  the inverted motions of the  fali-
Tary  lymphatics.
   Hyfteria is diftinguifhed from hypochondriafis, as in
the latter there are no retrograde motions of the ali-
mentary canal, but fimply a debility  or  inirritat^Jity
of it, with  diftention and flatulency.   It is diftinguifli-
ed from apepfia and cardialgia by there being nothing
ejected from the ftomach by the retrograde motions of
it, or of the cefophagus.
   M. M. Opium. Camphor.  Afafcetida. Caftor, with
 finapifms externally ;  to which muft be added a clyfter
                                                 of 
Class I. 3.1.]     OF IRRITATION.             199
of cold water, or  iced  water; which according to
Monf. Pomme, relieves  thefe hyfteric fymptoms in-
Slantaneoufly like a charm; which  it  may  effect by
checking the inverted motions of the inteftinal canal
by the torpor occafioned by cold ; or one end of the
inteftinal canal may become ftrengthened,  and regain
its periftaltic motion by reverfe fympathy, when the
other end is  rendered torpid by ice-water.   (Pomme
des Affections Vaporeufes, p. 25.J  Thefe remove the
prefent fymptoms;  and bark, fteel, exercife, coldifh
bath, prevent their returns.  See Art. VI. 2. 1,

   11. Hydrophobia.  Dread of water occafioned by the
bite of a mad dog, is a violent inverfion of the motions of
the cefophagus on the contact or even approach of water
•r other fluids.   The pharinx feems to have acquired
the fenfibility of the larinx  in this  difeafe,  and  is as
impatient to reject any fluid, which gets into it.  Is not
the cardia ventriculi the feat  of  this  difeafe ? 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 ftomach.   As this fatal difeafe
refembles  tetanus, or locked jaw, in its tendency to
convulfion  from a  diftant  wound, and' affeCts fome
other parts by affociation, it is treated of in  Clafs III.
 1. 1. 15. and IV. 2. 1. 7.
04
ORDO 
20©              DISEASES      [Class I. 3. 2,

                  ORDO   III.
            Retrograde Irritative Motions,

                  GENUS   II.
              Of the Abforbent Syfiem.

                   SPECIES.
   I* Catarrhus lymphaticus.   Lymphatic catarrh.   A
periodical defluxion of a thin fluid  from the  noftrils,
for a few hours, occafioned by the retrograde motions
of their lymphatics; which may probably be fupplied
with fluid by the increafed abforption of fome other
lymphatic branches in  their vicinity.  It is diftinguifh-
ed from  that mucous  difcharge,  which  happens in
frofty weather from decreafed abforption, becaufe it is
lefs fait to the tafte ; and from an  increafed fecretion
of mucus, becaufe it is neither fo vifcid, nor is attend-
ed 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 fneezing
and very copious difcharge for an hour or two.
   I have feen two of thefe cafes, both of  which oc-
curred in delicate women, and  feemed  an appendage
to  other hyfteric  fymptoms;  whence I concluded,
that the difcharge was occafioned by the inverted mo-
tions of the lymphatics of the noftrils,  like the pale
urine in hyfteric cafes; and  that they might receive
this fluid from fome other branches of lymphatic veffels
opening into the frontal or maxillary cavities in their
vicinity,
                                              Could 
Class I. 3.2.]    OF IRRITATION.              201
  Could fuch a difcharge be produced by ftrong er-
rhines, and  excite an abforption of the  congestion of
lymph in the dropfy of the brain ?

  2. Salivatio lymphatica.  Lymphatic falivation.  A
copious expuition of a pellucid infipid fluid, occafioned
by  the  retrograde motions of the lymphatics of the
mouth.   It is fometimes  periodical, and often attends
the hyfteric difeafe,  and nervous  fevers ; but is not
accompanied with  a  faline tafte, or  with heat of the
mouth,  or naufea.

   3.  Naufea hwnida.  Moift naufea confifts  in  a dif-
charge  of fluid, owing to the retrograde motions of
the lymphatics about  the fauces,  without increafe of
heat, or faline tafte,  together with fome retrograde
motions of the fauces or  pharinx ; along with this
naufea a ficknefs generally precedes  the act of vomit-
ing ;  which may confift of a fimilar difcharge of mucus
or  chyle into the  ftomach by the retrograde motions
of the lymphatics or laCteals, which open into it.  See
Clafs I. 2. 4. 3. and 1, 2. 4. 4.
   M. M. Subacid liquids.  Wine.  Opium. A blifter.

   4.  Diarrhoea lymphatica.   Lymphatic diarrhcea.  A
quantity of mucus and lymph are poured into the in-
 teftines by the inverted motions of the inteftinal lym-
 phatics.  The feces are lefs fetid and  more liquid;
 and it fometimes  portends the commencement of a di-
 abetes, or dropfy,  or their  temporary relief.  This
                                          lymphatic 
 **
za              DISEASES      [Class I. 3. 2.
lymphatic diarrhcea fometimes becomes chronical, in
which the atmofpheric moifture,  abforbed by the cu-
taneous and plumonary lymphatics, is poured into the
inteftines by the retrograde motions of the laCteals  See
Section XXIX. 4. 6.  where  fome cafes of this  kind
are related.

   5. Diarrhoea chylifera, caliaca. Chyliferous diarrhcea.
The chyle drank up by the  laCteals of the upper  in-
teftines is poured into the lower ones by the retrograde
motions of their laCteals, and appears in the dejeCtions.
This  circumftance  occurs at the beginning of diarrhcea
crapulofa, where  the patient has taken  and digefted
more aliment than the fyftem can conveniently receive,
and thus eliminates  a  part  of  it;  as appears when
there is curdled chyle in fome of the dejections.   Sec
Sect.  XXIX. 4. 7.   It  differs from  the lymphatic
diarrhcea, as the chyliferous diabetes differs from  the
aqueous and mucaginous diabetes.

   6.  Diabafes*   By the retrograde motions of  the
urinary lymphatics, an immenfe quantity of  fluid is
poured into  the bladder.   It is either termed chyli-
ferous, or aqueous, or mucaginous, from the nature
of the fluid  brought into the bladder; and is either
a temporary difeafe, as in  hyfteric  women,  in  the
beginning of intoxication, in worm cafes, or in thofe
expofed to cold damp air,  or to great fear, or anxi-
ety,  or in the commencement of fome  dropfies;  or
it  becomes chronical.
                                             When 
Class 1.3.2.]     OF IRRITATION.             203
   When  the urinary lymphatics invert their motions,
and pour their  refluent contents   into the  bladder,
fome other  branch of the abforbent fyftem acts with
greater energy  to fupply this fluid.   If it is the in-
teftinal branch,  the chyliferous diabetes is produced:
if it is the cutaneous or pulmonary branch, the aque-.
ous diabetes is  produced :  and if  the cellular or cyf-
tic branches,  the mucaginous diabetes.   In  the two
laft the urine is pellucid, and  contains no fugar.
   In dropfies the fluid is fometimes  abforbed,  and
poured into the bladder by  the  retrograde motions
of the urinary lymphatics, as during the exhibition of
digitalis.   In the beginning  of the dropfies of infirm
gouty patients,  I have frequently obferved, that they
make a large quantity of wrater for one night, which
 relieves  them for feveral days.    In thefe cafes the
 patient previoufly feels a fulnefs about the precordia,
 with difficult refpiration, and fymptoms fimilar to thofe
 of hyfteria.  Perhaps  a  previous defect of abforption
 takes place in  fome part of the body in thofe hyfteric
 cafes, which are relieved by a copious difcharge of
 pale urine.   See Diabetes explained at large, Section
 XXIX. 4.
    A difcharge of blood fometimes  attends  the  dia-
 betes, which was occafionally a fymptom of that dif-
 eafe 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
 gaftric  branch of the vena portarum, as difcovered
 by J, F. Meckel.   See Section  XXVII. 2.
                                       M. M.  Alum. 
204              DISEASES      [Class I. 3. 2.
   M. M. Ahim. Earth of Alum.  Cantharides.  Calo-
mel.  Bark.   Steel.   Rofin:  Opium.   See Sect.
XXIX.  4.

   7. Sudor lymphaticus.  Profufe  fweats from the in-
verted  motions of  the cutaneous  lymphatics,  as  in
fome fainting  fits,  and at the approach  of death;
and as perhaps in  the fudor anglicanus.   See Sect.
XXIX.  5.  Thefe  fweats are glutinous to the touch,
and without  increafed heat of the fkin;  if the part
is not  covered, the fkin  becomes  cold from the eva-
poration  of the  fluid.    Thefe fweats without heat
Ibmetirnes occur in the act of vomiting, as in Sect.
XXV.  9.  and are probably the  caufe  of the cold
fweaty hands of fome people.   As mentioned in Sect.
XXIX.  4. 9. in the cafe of R. Davis, which he cured
by frequent application of lime.   Though it  is pot
fible, that cold fweaty hands may  alfo arife from  the
want of due abforption of the perfpirable matter ef-
fbfed on them, and that  the coldnefs may be owing
to the  greater evaporation in confequence.
   The acid fweats defcribed by Dr. Dobfon, which
he obferved in a diabetic patient,  and afcribes to the
chyle effufed on the  fkin,  muft   be  afcribed  to  the
retrograde action of the cutaneous lymphatics.  See
Sect. XXIX.  6.

   8, Sudor afthmcrticus.  The cold fweats in this dif-
eafe only cover the head, arms, and breaft, and are
frequently exceedingly profufe.   Thefe  fweats  are
                                             owing 
Class I. 3. 2. J    OF IRRITATION.             ^5
owing to the inverted motions of the cutaneous lym-
phatics of the upper part  of the body, and at the
fame time the increafed abforption of the pulmonary
abforbents:  hence thefe fweats when profufe relieve
the prefenj fit of afthma.   There is  no other way  to
account for  fweats appearing  on the upper parts  of
the body  only, but by the fluid having been abforbed
by the lymphatic branch of the lungs,  and effufed  on
the ikin by the retrograde  movements  of the cutane-
ous lymphatics ; which join thofe of the  lungs before
they enter into  the  venous circulation.   For if they
were occafioned, as  generally fuppofed,  by the diffi-
culty of the circulation of the  blood through the lungs,
the whole ikin muft  be equally affected, both of the
upper and lower  parts of the  body; for  whatever
eould obftruCt the circulation  in the upper part of the
venous fyftem, muft  equally obstruct it in the lower
part  of it.   See Sect.  XXIX.  6.  In  the  convulfivc
afthma thefe fweats do not occur ; hence  they may be
diftinguifhed;  and  might be  called  the  hydropic
afthma, and the epileptic afthma.

   9. Tranflatio puris.   Translation of  matter from
cne part of the fyftem to another can only be explain-
ed from its being abforbed by one branch of the lym-
phatic fyftem, and depofited  in a diftant part by  the
retrograde motions of another branch ; as mentioned
Sect. XXIX.  7. 1.  It is  curious, that thefe transla-
tions of matter are attended generally, I believe, with
cold fits; for lefs  heat is  produced  during the retro-
                                             grade 
\
s»6              DISEASES      [Class 1.3. 2.
grade action of this part of the fyftem, as no fecretion
in the lymphatic glands, of the affected branches  can
exift at the fame time.  Do any ineffectual retrograde
motions occafion the  cold fits. of agues ?  The  time
when the gout of the liver ceafes, and the gout in the
foot commences, is attended with a cold  fit, as I have
obferved in two inftances, which is difficult to explai%
without fuppofing the new veffels, or the matter pro-
duced on the inflamed liver, to be abforbed, and cither
eliminated  by  fome  retrograde motion,  or  carried to
the newly inflamed part ? See Clafs IV.  1. 2. 15.

   10. Tranflatio laclis.  Tranflation of milk to  the
bowels in  puerperal fevers can only be  explained by
the milk being abforbed  by the pectoral branch  of
lymphatics, and carried to the bowels  by the retro-
grade motions  of the inteftinal lymphatics or laCteals.
See many inftances of this in Sect. XXIX. 7.  4.

   ii.  Tranflatio urina.  Tranflation of urine. There
is a curious cafe related in the Tranfactions of the Col-
lege of Phyficians at Philadelphia, Vol. I. p. 96. of a
girl, who labouring under an ifcuria vomited her urine
for many months; which could  not be  diftinguifhed
from that which was at  other times drawn off by the
catheter.   After having taken much opium, She feems
at length to have formed gravel, fome of which  was
frequently  brought  up  by vomiting.   Dr. Senter
afcribes this to the retrograde motions of the lympha-
tics of the Stomach, and the increafed ones,  of thofe of
          a                                    the 
Class I. 3. 3.]     OF IRRITATION.              20;
the bladder,  and refers  to.thofe of Sect. XXIX. of
this work ; which feCtion was firft publifhed in 1780;
and  to Macquire's  Dictionary  of  Chemifiry,  Art.
Urine.
   The  patient  above defcribed fometimes had a dif-
eharge of urine by the navel, and  at  other times  by
jjae rectum, and fometimes by urinous fweats.
                   ORDO III.
           Retrograde Irritative Motions*

                   GENUS III.
             Of the Sanguiferous Sy/iem*

                   SPECIES.
   1.  Capillarium motus  retrogreffus.   In microfcopic
experiments it is ufual to fee globules of blood regur-
gitate from the capillary veffels  again and again, be-
fore they pafs through them; and not only the meuths
of the veins, which arife from  thefe capillaries, are
frequently feen by microfcopes to regurgitate  fome
particles of blood during the Struggles of the animal;
but a retrograde motion of the  blood in the veins of
thefe animals, from the very heart to the extremities
ef the limbs, is obfervable by intervals during the dif-
treffes of the dying creature.   Haller,  Elem.  Phyf.
T. i. p. 216.   See  Section XXIX. 3. 8.
2. Palpitaili 
208               DISEASES      [Class I. 3.3.
   1*  Palpitatio cordis.  May not the  ineffectual and
weak unequal motions of the heart in hyfteric cafes  be
afcribed to the retrograde motions of it, which continue
for a fhort time, or terminate in fyncope ?   See Clafs
IV. 3. 1. 6.

   3. Anhelatio fpafmodica.   In  fome afthmas may not
the difficulty  of refpiration  arife from the inverted
action of the finer branches  of the bronchia, or of the
pulmonary artery or vein, like  thofe of the capillaries
above defcribed in No. r. of this genus ?
t
THE 
Class II.]        OF IRRITATION.
209
THE ORDERS AND GENERA OF THE SECOND CLASS
                OF DISEASES.
                 CLASS   II.

             DISEASES OF SENSATION.

                    ORDO  I.
                Increafed Senfation.

                   GENERA.
1. With increafed  action of the mufcles.
2. With the production of new  veffels by internal
     membranes or glands with fever.
3. With the production  of new veffels by external
     membranes or glands with  fever.
4. With the production  of new  veffels by internal
     membranes or glands without fever.
5. With the production  of new  veffels by external
     membranes or glands without fever.
6. With fever  confequent  to  the production of new
     veffels  or  fluids.
7. With increafed  action of the  organs of fenfe.

                  ORDO   II.
                Decreafed Senfation.

                  GENERA.
1. With decreafed  actions of the  general fyftem.
:'. With decreafed  actions of particular organs.
                         P                  ORDO 
*ro              DISEASES      [Class II. i.t.
       ORDO  III.
Retrograde Senfitive Motions.

       GENERA.
i. Of the arterial  fyftem.
2. Of the abforbent fyftem.
3. Of the excretory dncts.
THE ORDERS, GENERA, AND SPECIES, OF THE
        SECOND CLASS  OF DISEASES.
    CLASS   II.

DISEASES OF  SENSATION.

      ORDO  I.
               Increafed Senfation*

                  GENUS  I.
       With Increafed Aclion of the Mufcles.
                  SPECIES.
1, Deglutitio.             Deglutition.
2. Refpiratio.             Refpiration.
3. Sternutatio.            Sneezing.
4. Anhelitus.             Panting.
5. Tuffs ebriorum.        Cough of inebriates.
§". Singultus.             Hiccough.
                                         7. Afthmr 
Class II. i. 2.]    OF SENSATION.
 7. Aflhma humcrale.      Humoral afthma.
 8. Niclitatio fenfitiva.     Winking from pain.
 9. Ofcitatio et pandiculatio. Yawning and ftretching.
10. Tenefmus.              Tenefmus.
11. Stranguria.            Strangury.
12. Parturitio.            Parturition.
211
                   GENUS  II.
With the Produclion of new Veffels by internal Membranes
               or Glands, with Fever..

                   SPECIES.
  1. Febris fenfitiva irritata. Senfitive irritated fever.
 2. Ophthalmia interna.    Inflammation of the eye.
 3. Phrenitis.------------of the brain.
 4. Peripneumonia.         ------------of the lungs.
   ------------trachealis.------------the croup.
                          ------------of the pleura.
                          ------------of  the  dia-
 5. Pleuritis.
 $. Diaphragmitis.

 7. Carditis.
 8. Peritonitis.

 9. Mefenteritis.

1 o. Gaflritis.

11. Enteritis.
12. Hepatitis.
1 3. Splenitis.
phragm.
of the heart.
of the perito-
neum.
tery.
mach.
P 2
— of the mefen-

— of   the  fto-

  of the bowels.
  of the liver.
  of the fpleen.
   14. Nephritis* 
2iz               DISEASES      [Class II. i. j.
14. Nephritis,              Inflammation of the kidney.
15. Cyflitis.------------of  the  blad-
                               der.
16. Hyfleritis.------------of the womb.
17. Lumbago fenfitiva.      --------.---of the loins.
18. Ifchias*                 ----------— of the pelvis.
19. Paronychia interna*     ----------- beneath  the
                               nails.
                   GENUS   III.
With the Produclion of new Veffels by external Membranes
                or Glands, with Fever.
                    SPECIES.
 1. Febris fenfitiva  inirri- Senfitive inirritated fever.
     tata.
 2. Eryfipelas irritatum.     Eryfipelas irritated.
    ---------inirritatum.----------inirritated.
    ---------fenfitivum----------fenfitive.
 3. Tonfillitis interna.      Angina internal.
    ---------fuperficialis*  -------»  fuperficial.
    ---------mirritata.    -------inirritated.
 4. Parotitis fuppurans.    Mumps fuppurativc.
    --------mutabilis.------ mutable.
    --------felina.------of cats.
 5. Catarrhus fenfitivus.    Cattarrh inflammatory.
 6.----------contagiofus.--------eontaglous,
   ----------equinus et ca---------among horfes and
     ninus.                     dogs.
 7. Peripneumonia fuperfi-  Superficial peripneumony. -
     c'w.lis.
                                              8. Per- 
Class II. i. 3.]     OF  SENSATION.
 8. Pertuffis.
 9. Variola difcreta.
    ------confiuens.
    -------inoculata.
1 o. Rubeola irritata.
    -------- inirritata.
213
11. Scarlatina mitis.
    ----------maligna.
12. Miliaria fudatoria.
   \--------irritata.
    --------inirritata.
i3.Peflis.
vaccina.
14. Pemphigus.
15. Varicella.
16. Urticaria.
17. Apth a fenfitiva.
    ------irritata.
    ------inirritata.
18. Dyfenteria.
19. Gaftritis fuperficialis.

20. Enteritis fuperficialis.
Chin-Cough.
Small-pox diftinct.
----------confluent.
----------inoculated.
Meafles irritated.
--------Inirritated.
Scarlet fever mild.
------malignant.
Miliary fever fudatory.
--------irritated.
—------inirritated.
Plague.
of horned cattle.
Bladdery fever.
Chicken-pox.
Nettle rafh.
Thrufh fenfitive.
--------irritated.
■-------inirritated.
Bloody flux.
Superficial inflammation  of
     the ftomach.
------------------------of
     the bowels.
P3
GENUS 
2i4              BISEASES      [Class II. i. 4.
                  GENUS  IV.
With the Production of new Veffels by internal Membranes
              or Glands, without Fever.

                    SPECIES.
  1. Ophthalmia fuperficialis. Ophthalmy fuperficial.
    ----------lymphatica.         ■ ■ - lymphatic.
    ----------equina.----------of horfes,
  2. Pterigion.             Eye-wing.
  3. Tarfitis palpebrarum*   Red eyelids,
  4. Hordeolum.             Stye.
  5. Paronychia fuperficialis. Whitlow.
  6. Gutta rofea  hepatica*   Pimpled face  hepatic.
    ----------fiomatica*   ----«— ftomatic.
    ---------- hereditaria.     >   ■ hereditary,
  7. Odontitis.              Inflamed tooth.
  8. Otitis.                 --------ear.
  9. Fiflula lacrymalis.      Fiftula lacrymalis,
 10. Fiflula in ano          Fiftula in ano.
 11. Hepatitis chronica.      Chronical hepatitis,
 12.  Scrophula fuppurans.   Suppurating fcrophula,
 13. Scorbutus fuppurans.   Suppurating fcurvy.
 14. Schirrus fuppurans.     Suppurating fchirrus.
 15. Carcinoma.             Cancer.
 16. Arthrocele.             Swelling of the  joints.
 17. Arthropuofis.          Suppuration  of  the joints.
 18. Caries offium.          Caries of the bones.
GENUS 
Class II. i. 6.]     OF SENSATION.
*»5
                   GENUS   V.
With the Preduclhn of new Veffels by external Membranes
              or Glands, without Fever*
SPECIES.
i. Gonorrhoea venerea.	Clap.
3. Syphilis*	Venereal difeafe.
3. Lepra*	Leprofy.
4. Elephantiafis*	Elephantiafis.
5. Framboefia.	Framboefia.
6. Pfora.	Itch,
7. Pfora ebriorum.	Itch of drunkards.
8. Herpes.	Herpes.
9. Zona ignea.	Shingles.
10. Annulus repens.	Ring-worm.
11. Tinea capitis.	Scald-head.
12. Crufta laclea.	Milk-cruft.
13. Trichoma.	Plica polonica.
                   GENUS   VI.
With Fever confequent to the Produclion of new  Veffels
                      or Fluids.

                    SPECIES.
  1. Febris fenfitiva.        Senfitive fever.
  2.-----a pure claufo*   Fever from concealed mat-
                               ter.
  3.-----a vomica.-----from vomica.
  4.-----ab empyemate.-----from empyema.
  5. — mefenterica*-----mefenteric.
                       P 4                  6, Febris 
216             DISEASES       [Class II. i. 7.
 6. Febris a pure aerato.   Fever from aerated matter.
 7''-----& phthifi.-----from confumption.
 8------ fcrophulofa.-----fcrophulous.
 9------ifchiadica.-----from ifchias.
10.-----arthropuodica*-----from joint-evil.
11.-----a pure contagiofo.-----from contagious mat-
                               ter.
12.-----variolofafecunda------fecondary of  fmall-
     ria.                       pox.
13.-----carcinomatofa.-----cancerous.
14.-----venerea.        -----venereal.
*5«-----afanie contagiofa.-----from contagious  fa-
                               mes.
16.      - puerpera.       -----puerperal.
17* — afphacelo*-----from fphacelus.

                  GENUS  VII.
    With increafed Aclion of the Organs of Senfe.

                   SPECIES.
 I. Delirium febrile.        Delirium of fevers.
 2.-------maniacale.-------maniacal
 3.-------ebrietatis.-------of drunkennefs.
 4. Somnium.              Dreams.
 5. Hallucinatio vifus.      Deception of fight.
 6.           - auditus.    ---------of hearing.
 7. Rubor a calore.        Blufh from heat.
 8. —— jucunditalis.     -----from joy.
 9. Priapifmus amatorius.  Amorous priapifm.
10. Difientio mamularum.   Distention of the nipples.
                                             ORDO 
Class II. 2. 2.]    OF SENSATION.               21?

                    ORDO  II.
                 Decreafed Senfation,

                    GENUS  I.
     With Decreafed Afftion of the general Syfiem.

                    SPECIES.
  1. Stultitia infenfibilis.     Folly from infenfibility.
  2. Tadium vita.          Irkfomenefs of life.
  3. Pare/is fenfitiva.       Senfitive debility.

                    GENUS  II.
     With decreafed Aclions of particular Organs.

                    SPECIES.
  I. Anorexia.             Want of appetite.
  2. Adipfia.               Want of thirft.
  3. Impotentia*             Impotence.
  4. Sterilitas.             Barrennefs.
  5. Infenfibilitas artuum.   Infenfibility of the limbs.
  6. Dyfuria infenfitiva.    Infenfibility of the bladder.
  7. Accumulatio alvina*    Accumulation of feces.
ORDO 
r*              DISEASES      [Class II. 3.1.
                     t
                  ORDO  III.
           Retrograde Senfitive Motions.

                  GENUS  I.
                Of Excretory Duels.

                  SPECIES.
   Motus retrogreffus.     Retrograde motion.
1.------ureterum.       ----------of the ureters,
2.----- urethra.        ----------of the urethra.
3.------ duclus choledoci*---------- of the bile-duCt.
CLASS 
Class II. i. i.]     OF SENSATION.
2TC
                 CLASS  II.
             DISEASES  OF SENSATION.

                    ORDO  I.
                Increafed Senfation.

                   GENUS  I.
        With increafed Aclion of the Mufcles.
  The aCtions belonging  to this genus are thofe which
are immediately excited by  the fenfations  of pain or
pleafure, but which  are neither followed by inflamma-
tion, nor  by convulfion.   The former of which  be-
long to the fubfequent genera of this  order, and  the
latter to the clafs of voluntary motions.
   The criterion  between the actions, which  are the
immediate confequence  of painful  fenfation, and con-
vulfive actions properly fo called, confifts in the former
having a tendency to diflodge the ftimulating caufe,
which induces  the  painful fenfation; and  the latter
being  exerted for the purpofe of expending the fenfo-
rial power, and thus dulling or destroying the  general
fenfation of the fyftem.   See Clafs III. i.
   There is a degree of heat produced in the  affected
part  by thefe  fenfitive actions without  inflammation,
but in much lefs  quantity than  when attended by in-
flammation ; as in  the latter there is  a production  of
new veffels.   See Sect. XXXIII.  2. 3,
Some 
s^o               DISEASES     [Class II. i. i.
  Some of the fpecies of this genus cannot  properly
be termed difeafes in their natural  ftate,  but become
fo by their defect  or excefs,  and are here inferted to
facilitate the explanation of the others.

                   SPECIES.
  i.  Deglutitio*  Swallowing our food is immediately
caufed by the pleafurable  fenfation occafioned by its
ftimulus  on the palate or fauces, and is acquired  long
before the  nativity of the animal.  Afterwards the
pain of hunger previoufly produces the  various volun-
tary exertions to procure the proper material, but the
actions of mafticating and  of fwallowing it are effected
by the fenforial power of fenfation ; which appears by
their not being  always controlable  by  the will, as
when children in vain attempt  to fwallow  naufeous
drugs.   See Clafs IV. i. 3.  1.   The mafticated food
Stimulates the palate, which  is an organ of fenfe, into
fo much action,  as to produce agreeable fenfation ;
and the mufcles fubfervient to deglutition are brought
into  action by the fenfation thus  produced.   The
pleafurable  fenfation  is the  proximate  caufe;  the
aCtion of the fibres of the  extremities of the  nerves of
tafte  is the remote caufe ; the fenforial power of irrita-
tion exciting thefe fibres of the  nerves of tafte into in-
creafed action is the pre-remote caufe; the action of
the mufcles of deglutition  is  the proximate effeCt; the
pufhing the food into the ftomach is the remote effect;
and the nutrition of the body is the poll-remote effect.
Though 
Class II. i. i.]     OF SENSATION              221
   Though the mufcles fubfervient to deglutition have
their actions previoufly affociated, fo as to be excited
into fynchronous tribes or  fucceffive trains, either by
volition, as when we fwallow a difagreeable drug ; or
by fenfation, as when we fwallow agreeable food ; or
by irritation,  as  when we inattentively fwallow  our
faliva ;  yet do all thofe three kinds of deglutition be-
long to the refpeCtive claffes of volition, fenfation, and
irritation ; becaufe the  firft links of  thefe tribes or
trains of mufcular action are excited by thofe fenforial
powers, and the affociated  links, which accompany or
fucceed  them, are excited by  the  combined powers
either of volition, or of  fenfation, or  of irritation,
along with that of affociation.

   2. Refpiratio.   Refpiration  is immediately caufed
by the fenforial power of fenfation in  confequence of
the baneful want of vital air; and not from the accu-
mulation of blood in the lungs,  as that might be car-
ried on  by inhaling azote alone, without the oxyge-
nous part of the  atmofphere.   The  action  of refpira-
tion is thus fimilar to that of fwallowing our food to
appeafe the pain of hunger ; but the  lungs being fur-
rounded with air, their proper pabulum, no  interme-
diate voluntary exertions  are required,  as in hunger,
to obtain and prepare the wanted material.
    Refpiration is  fimilar to flow combuftion ;  the ox-
ygenous part of the atmofphere is received  through
the moift  membranes,  which line the air-cells of the
lungs,  and uniting with the inflammable part of the
blood  generates  an  acid, probably  the  phofphoric
                                                acid 
22i               DISEASES      [Class II. i. r.
acid ; a portion of carbonic acid is likewife produced
in this procefs;  as appears  by repeatedly breathing
over lime-water,  which then  becomes turbid.    See
Botanic Garden, P. I.  Canto I. 1. 401.  note.

   3. Sternutatio*  Sneezing confifts of mufcular actions
produced by the fenforial faculty of fenfation ;  and is
an effort to diflodge, by means of air forcibly impelled
through the noftrils, fome material; which ftimulates
the membrane, which lines them, into too great action,
and  might thence injure the  fenfe of fmell which  is
diffufed on it.
   In this operation the too  great action of the veffels
of the membrane  of the noftrils is the remote caufe ;
the fenfation thence  induced is the proximate caufe ;
and the mufcular actions are the proximate effect.
   This aCtion of fneezing frequently precedes common
refpiration  in new-born  children,  but  I  believe not
always ; as like the latter it cannot have  been  previ-
oufly acquired in the uterus.
   It is produced in fome people by fudden light, as
by looking up at  the Sky in a morning,  when they
come out of a gloomy bed-chamber.   It then becomes
anaffociate action, and belongs to Clafs  IV. 1. 2. 2.
   M. M.  When it is exerted to excefs  it may be
cured by Snuffing  Starch up the noftrils.   See Clafs  I.
1. 2. 13.

   4. Anhelitus.   Panting.   The quick  and laborious
breathing of running people, who  arc not accuftomed
to violent exercifc, is occafioned by  the too great con-
                                              flux 
Class II. i. i.]     OF SENSATION.               2*j
flux of blood to the lungs.  As the fanguiferous  fyf.
tern, as well as the abforbent fyftem,  is furniflied in
many parts of its courfe with valves, which in general
prevent the retrograde movement of their  contained
fluids; and as  all  thefe veffels, in fome part  of their
courfe,  lie  in  contact with the mufcles,  which  are
brought  into  aCtion in running,  it follows  that  the
blood muft be accelerated by the intermitted  fwelling
of the bellies of the mufcles moving over them.
   The  difficulty of breathing, with which'very fat
people are immediately affected on  exercife, is owing
to the preffure of  the  accumulated fat on  the veins,
arteries,  and lymphatics;  and which,  by diftending
the ikin, occafions it to act as a tight  bandage on the
whole furface of the body.   Hence when the mufcles
are excited into quicker  action, the progrefs of the
blood in the verrir, and of the lymph and chyle in the
abforbent fyftem, is urged on with much greater force,
as under an artificial bandage on a limb, explained in
Art. IV. 2. 10. and in Sect. XXXIII.  3. 2.   Hence
the circulation is inftantly quickened to a great degree,
and the difficulty of breathing is the confequence of a
more rapid  circulation through the lungs.   The in-
creafed fecretion of the perfpirable matter is another
confequence of this rapid circulation; fat people, when
at reft, are believed to perfpire lefs. than others, which
may be  gathered from  their  generally having more
liquid ftools, more and paler urine, and to their  fre-
quently taking lefs food than  many thin people ;  and
laftiy, from the perfpiration of fat people being gene-*
                                              rally 
"4               DISEASES     [Class II. 1.1.
rally more inodorous than that  of lean ones;  but
when corpulent people are put in motion, the fweat
Stands  in  drops  on their Skins,  and they " lard the
ground" as they run.   The  increafe of heat of cor-
pulent people  on exercife, is  another confequence of
their  more rapid  circulation, and greater  fecretion.
See Clafs  I. 2. 3.  17.
  Other caufes of difficult or quick refpiration will be
treated of under  Afthma, Pertuifis, Peripneumony,
Tonfillitis.

  5.  Tuffis ebriorum.   Senfitive cough is an exertion
of the mufcles ufed in  expiration  excited into more
violent aCtion  by the  fenforial power of fenfation,  in
confequence of fomething which too powerfully ftimu-
lates the lungs.  As the faline  part  of the fecreted
mucus, when the abforption of it is impeded ; or the
too great  vifcidity of. it, when  the abforption is in-
creafed ; or the too great quantity of the mucus, when
the fecretion is increafed;  or the inflammation of the
membranes of the lungs; it  is  an effort to diflodge
any of thefe extraneous  materials.
  Of  this kind is the  cough which attends free-
drinkers after a debauch ; it confifts of many fhort ef-
forts to cough,  with a  frequent expuition  of half  a
tea-fpoonful  of  frothy mucus, and is attended  with
confiderable  thirft.  The  thirft is occafioned by the
previous diffipation of the aqueous parts of the blood
by  fenfible or infenfible  perfpiration; which was pro-
duced by the increafed action  of the  cutaneous and
     4                                  pulmonarv 
Class II. i. i.]     OF SENSATION.              225
pulmonary capillaries during the ftimulus of the wine.
In confequence  of this  an increafed  abforption com-
mences to  replace  this moifture, and the ikin and
mouth become  dry, and the  pulmonary mucus  be-
comes infpiffated ; which ftimulates the bronchia, and
is raifed into froth by the  fucceffive currents of air in
evacuating it.   This  production of froth is called by
fome  free-drinkers  " fpitting fixpences"  after  a de-
bauch.  This fubfequent thirft, dry mouth, and vifcid
expectoration in fome people fucceeds the flighteft de-
gree of intoxication,  of which  it may be efteemed a
criterion.   See Clafs IV. 2. 1.8.
   As coughs are  not always attended with pain, the
mufcular aCtions, which produce them, are fometimes
excited by the fenforial faculty of irritation, as in Clafs
I.  1. 2. 8. I. 1. 3. 4. I. 1. 4.  3. I.  2. 3. 4. Coughs
are alfo fometimes convulsive, as in Clafs III. 1. 1. 10.
and fometimes fympathetic, as Clafs IV. 2.  1. 7.
   M. M. Venefection,  when the  cough  is attended
with inflammation.   Mucilages.  Opium.  Torpentia.
Blifter.

   6. Singultus.   Hiccough is an exertion of the muf-
cles ufed in infpiration excited into more violent aCtion
by the fenforial power of fenfation, in confequence of
fomething which too powerfully ftimulates  the cardia
ventricufi, or upper orifice  of the ftomach.   As when
folid food is too haftily taken  without fufficient  dilu-
tion.    And is an  effort to diflodge that offenfive
material,  and  pufh  it  to  fome lefs  fenfible part  of
                        Q^                      the 
**°              DISEASES      [Class II. i. ».
the ftomach, or  into  the  middle of  the contained
aliment.
   At the end of fatal fevers  it may arife from the
acrimony of the undigested aliment, or from a part of
the ftomach being already dead, and  by its weight or
coldnefs affecting the furviving part with difagreeable
fenfation.   The  pain about  the upper orifice of the
ftomach is  the  proximate caufe, the too great or too
little action of the fibres of  this part of  the  ftomach
is the remote caufe,  the action of the mufcles ufed in
infpiration is the proximate effect, and the repercuffion
of the offending material is the remote effeCt.
   Hiccough is  fometimes fympathetic, occafioned by
the pain of gravel in the kidney or ureter, as  in  Clafs
IV. i. i. 7. and  is fometimes a fymptom of  epilepfy
or reverie, as in Sect. XIX. 2.
   M. M.  Oil  of cinnamon from one drop gradually
increafed to ten, on fugar,  or on  chalk.   Opium.
Blifter.   Emetic.

   7.  Afthma humor ale.   The humoral  afthma pro-
bably confifts in  a  temporary anafarca of the lungs,
which may  be owing to a temporary defect of lym-
phatic abforption.   Its caufe is nevertheless at prefent
very obfcure, fince a  temporary deficiency of venous
abforption, at the  extremities of  the pulmonary  or
bronchial veins,  might occafion  a fimilar difficulty of
refpiration.  See  Abortio,  Clafs I.  2. 1.  14.   Or it
might be fuppofed,  that the  lymph effufed  into the
cavity of the  cheft  might,  by  fome additional heat
                                            during 
 Class II. r. i.]     OF SENSATION.              227
 during  fleep, acquire an aerial form, and thus comprefs
 the lungs; and on this circumftance the relief, which
 thefe patients receive from cold air, would be readily
 accounted for.
   The paroxyfms attack  the patient in his firft  fleep,
 when the  circulation through the lungs in weak peo-
 ple wants the affiftance of the voluntary power.  Clafs
 I. 2.  1. 3.   And  hence  the  abforbents of the  lungs
 are lefs able  to fulfil the whole of their duty.   And
 part of the thin mucus, which is fecreted into the air-
 cells, remains there unabforbed, and occafions the dif-
 ficult refpiration, which awakes the patient.  And the
 violent exertions  of the mufcles  of refpiration, which
 fucceed, are excited by the pain  of fuffocation, for the
purpofe of  pufliing forwards the blood  through the
 compreffed capillaries,  and to promote  the abforption
 of the effufed lymph.
   In this  the humoral  differs  from  the convulfive
 afthma, treated of in Clafs  III.  1. 1.  10. as in  that
 there is  probably no accumulated fluid to be abforbed;
and the violent refpiration is only an exertion for the
purpofe of relieving pain,  either in the  lungs  or in
fome diftant part, as in other convulfions, or epilepfy ;
and  in this refpect the fits of humoral  and convulfive
afthma effentially differ from each other, contrary to
 the opinion expreffed without fufficient consideration
in Sea.  XVIII. 15.
   The patients in the paroxyfms both of humoral and
convulfive afthma find relief from cold air, as  they ge-
nerally rife out of bed, and open  the window,  and
                      Q^2                      put 
225              DISEASES     [Class II. i. f.
put out their heads ;  for the lungs are not fenfible to
cold, and the fenfe of fuffocation is fomewhat relieved
by  there being  more  oxygen  contained in a given
quantity of cold frefli air, than In the warm confined
air of a clofe bed-chamber.
  I have feen humoral afthma terminate in  confirmed
anafarca, and  deftroy the patient, who had been an
exceflive drinker of fpirituous potation.  And  M. Sa-
vage afferts, that this difeafe frequently terminates in
diabetes ; which feems to Shew, that it is a temporary
dropfy relieved by a great flow of urine. Add  to this,
that thefe paroxyfms of the  afthma are themfelves re-
lieved  by  profufe fweats of the upper parts of the
body,  as explained in  Clafs I.  3. 2. 8. which would
countenance the idea of their being occafioned  by con-
gestions of lymph  in the lungs.
   The congestion  of lymph in the lungs from  the de-
fective  abforption of it is probably the remote caufe
of humoral afthma ; but the pain of fuffocation is the
immediate caufe  of the violent exertions in  the  pa-
roxyfms.   And whether  this congestion of lymph in
the air-cells of the  lungs increafes  during  our fleep,
as above  fuggefted, or not;  the pain of  fuffocation
will be more and more diftreffing after fome hours of
fleep,  as the fenfibility  to  internal ftimuli increafes
during that time, as  defcribed in Sect. XVIII.  15.
 For the fame reafon many epileptic fits, and  paroxyfms
 of the gout, occur during fleep.
    In two gouty cafes, complicated with jaundice, and
 pain,  and ficknefs-,  the patients had each  of  them a
                                          fhivering 
Class II. i. i.J     OF SENSATION.              22g
fliivering fit, like the commencement of an ague, to
the great alarm of their friends ;  both which  com-
menced in the night, I fuppofe during their fleep ; and
the confequence was a ceffation of  the jaundice, and
pain about the  Stomach, and ficknefs; and inftead of
that the gout appeared in their extremities.   In thefe
cafes I conjecture, that there was a metaftafis not only
of the difeafed aCtion from the membranes of the liver
to thofe of the foot; but that fome of the new veffels,
or new fluids, which were previoufly produced in the
inflamed liver, were translated to the feet during the
cold Sit, by the increafed abforption of the hepatic
lymphatics, and by the retrograde motions of thofe of
the affected limbs.
  This  I think refembles in fome refpeCts a fit of hu-
moral afthma, where  ftronger motions of the  abfor-
bent veffels of the lungs are  excited, and retrograde
ones  of the  correfpondent  cutaneous  lymphatics;
whence the violent fweats of the upper parts of the
body only are produced; and for a time  the patient
becomes relieved by the metaftafis and elimination of
the offending  material by  fenfitive  exertion.   For a
further  account of  this intricate Subject  fee Clafs 111.
I. I.  10.
  M. M.  To relieve the paroxyfm  a tea-fpoonful of
ether may be given mixed with water, with 10 drops
of  laudanum, to be  repeated  three or  four  times,.
Venefection.  An emetic.  A blifter.  Afterwards the
Peruvian bark,  with a grain of opium at  night, and
two or three of aloes.   A flannel fliirt in winter, but
not in fummer.  Iffues.  Digitalis ? 
23»              DISEASES     [Class II. i. r.
   In this fpecies  of afthma, there is great reafon to
believe,  that the refpiration of an atmofphere, with
an increafed proportion of oxygen, will prove of great
advantage ;  fome well-obferved and well-attefted cafes
of which are published by Dr. Beddoes;  as this purer
air invigorates  the  circulation, and the  whole fyftem
in confequence, perhaps  not only by its  ftimulus,  but
by its  fupplying the material from which the fenforial
power is extracted or fabricated.  In fpafmodic afthma,
on the contrary, Dr. Ferriar  has  found  undoubted
benefit from an atmofphere mixed with hydrogen.  See
Seft. XVIII. 15. and Clafs III.  1. 1. 10.

   8. Niclitatiofenfitiva.   Winking of the eyes is per-
formed every minute, without our attention,  for the
purpofe  of diffufing the  tears over them, which are
poured into the eye a little above the external corner
of it, and  which  are  afterwards abforbed  by  the
lacrymal points above and below the internal corner
of it.  When this operation is  performed without our
attention, it is caufed by the faculty of irritation,  and
belongs  to  Clafs I.  1. 4. 1. but when it is produced
by  a  ftronger ftimulus of any extraneous material in
 the eye, fo as to caufe pain, the violent and frequent
niaitation is caufed by the faculty of fenfation.
   This  difeafe is fometimes produced by the introver-
 sion of the edge of the lower eyelid,  which bends the
 points of the hairs of the  eyelafh ^upon  the ball of the
 eye, which  perpetually Stimulate it  into painful fen-
 fation.  This  introverfion  of  the eyelid  is generally
 owing to a tumor of the cellular membrane below the 
Class II. i. i.]    OF SENSATION.              231
edge  of the eyelid, and though  a  very tronblefome
complaint may often be cured by  the following fimple
means.   A little common plafter fpread on thin linen,
about a quarter of an inch long, muft be rolled up fo
as to  be about  the fize of a  crow-quill, this muft be
applied  immediately below the eyelafli  on the outfide
of the eye ; and muft be kept on by  another plafter
over it.   This will then aa as  a flight  compreffion on
the tumor under the eyelafli,  and will  prevent  the
hairs  from touching the eye-ball.  In a week or two
the compreffion will diminish the tumor it lies over,
and cure this painful deformity.

   9.  Ofcitatio et pandiculatio.   Yawning and ftretching
-of the limbs is produced either by a long inaaivity of
the mufcles  now brought into aaion, as fometimes
happens after Sleep,  or after listening a long time to
a dull narrative;  ©r it Is produced by  a too long con-
tinued aaion of the antagonist mufcles.   In the former
cafe there is an accumulation of fenforial power during"
the quiefcence of the mufcles now  brought into aaion ;
which probably  constitutes the pain or wearifomenefs
of a continued attitnde.  In the latter  cafe there is an
exhauftion of fenforial  power  in the  mufcles,  which
have  lately been aaing violently, and a confequent
accumulation in the mufcles, which are antagonists to
them, and which were at reft.
   Thefe  involuntary  motions are often feen in para-
lytic limbs,  which are at the fame time  completely dif-
obcdient to the will;  and are  frequently obfervable in
                       0^4                   ver}- 
 23*               DISEASES     [Class II. i. i.
 very young children;  and from thence we may con-
 dude, that thefe motions are learnt before nativity; as
 puppies are feen to open their mouths before the mem-
 branes are broken.  See Sea. XVI. 2.
   Where thefe motions are obferved in limbs other-
 wife paralytic,  it is an indication  that  elearic Shocks
 may be employed with advantage, as the excitability
 of the limb by irritation is  not extina, though it be
 difobedient both to volition and fenfation.

   10. Tenefmus confifts in  violent  and frequent in-
 effeaual efforts to difcharge  the contents of the rec-
 tum, owing to pain of the  fphinaer.   The  pain is
 produced by indurated feces, or by fome acrid mate-
 rial, as the acidity of indigested aliment; and the ef-
 forts are attended with  mucus from the pained mem-
 brane.  The feces muft fometimes be taken away by
 the  end of a  marrow-fpoon, as cathartics and even
 clyfter will pafs without removing them.   It is fome-
 times caufed by  fympathy  with  the urethra, when
 there is a ftone at the neck of the bladder.   See Clafs
 II. 2. 2. 7. and IV. 1.  2.  8.
   M. M. Fomentation,  an enema with mucilage and
 laudanum.
   The common exclufion of the feces from the reCtum
is a procefs fimilar to  this, except that the mufcles of
the fphinaer ani, and thofe of the abdomen, which
act along with them by the  combined  powers of fen-
fation and affociation, are  in tenefmus excited by pain-
 ful fenfation, and in the latter  by a fenfation, which
                                              may 
Class II. i. i.]    OF  SENSATION.
23J
may in fome inftances be almoft called pleafurable,
as relieving us from a  painful one in the exclufion of
the feces.

   11.  Stranguria.  Strangury confifts in painful ef-
forts to difcharge the contents of the urinary bladder.
It is generally owing to a ftone in the fphinaer of the
bladder ; or to the inflammation  of the neck of it oc-
cafioned by cantharides.  It  is fometimes caufed by
fympathy with the piles; and then is liable in women
to occafion convulfions, from the violence of the  pain
without inflammation.   See Clafs IV. 2. 2. 2. and 3.
   M.  M.  Fomentation, clyfter  with oil and  lauda-
num,  pufli the ftone  back with  a  bougie ;  if from
cantharides give  half  a pint  of  warm water every
ten minutes.  Mucilage  of  gum arabic and  traga-
canth.
   The natural evacuation of  the urine  is a procefs
fimilar to  this, except  that the mufcular fibres of the
bladder, and the mufcles of the  abdomen, which aa
in concert with them by the  combined powers of fen-
fation and  of affociation, are, in the  former cafe of
ftrangury,  excited into aaion by painful  fenfation;
and in  the  latter by  a  fenfation, which  may almoft
be termed  pleafurable,  as  it relieves us  from  a  pre-
vious  uneafy  one.
   The ejeaio feminis is  another  procefs  in   fome re-
fpeCts fimilar to ftrangury, as belonging  to the fame
fenfible canal of the  urethra, and by  exciting  into
aaion  the  accelerator  mufcles; but  in the ftrangury
                                             thefe 
 234               DISEASES     [Class II. i. i.
thefe mufcles are  excited into aaion  by painful fen-
fation, and in the ejeaion of the femen by pleafurable
fenfation.

   12. Parturitio.  Parturition is not a difeafe, it is
a natural procefs, but is more frequently unfortunate
in high life than amongft the middle clafs of females;
which may be  owing  partly to fear, with which  the
priefts of Luc in a are liable to infpire  the  ladies of
fafhion to induce them 10 lie in in town ; and partly
to the bad air of London, to which they purpofely
refort.
   There are  however  other caufes, which  render
parturition more dangerous to the ladies of high life;
fuch as their greater general debility from neglea of
energetic exercife, their  inexperience of the variations
of cold and heat,  and their  feclufion  from  freSh  air.
To which  muft  be  added, that  great Source  of the
deftruaion of female  grace and beauty, as well as of
female health, the tight ftays^ and other bandages,
with which they are generally  tortured in their early
years by the aaive folly of their friends, which by
difplacing many of the  vifcera impedes their aaions,
and by comprefling them together produces adhefions
of one part to another, and affects even the form  and
aperture of the bones of the pelvis,  through  which
the nafcent child  muft be protruded.
   As parturition is  a natural, not  a morbid procefs,
no medicine fhould be given, where there  is  no ap-
pearance of difeafe.   The abfurd  cuftom of giving a
                                           powerful 
Class II. i. i.]    OF SENSATION.              235
powerful  opiate without indication to all women,  as
foon as they are delivered, is,  I make no doubt, fre-
quently attended with  injurious,  and fometimes with
fatal confequences.   See Clafs II.  1. 2. 16.
  Another  thing very  injurious  to the child,  is the
tying  and cutting  the  navel-ftring too  foon ; which
fhould always be left till the child has  not only repeat-
edly breathed,  but till all pulfation in the cord ceafes.
As  otherwife the child is much weaker than it ought
to be ; a part of the blood being  left in the placenta,
which ought to have been in  the child; and  at the
fame time the placenta does  not fo naturally collapfe,
and withdraw itfelf from the fides of the uterus, and
is not therefore removed with fo much fafety and cer-
tainty.  The folly  of giving rue  or rhubarb to new-
born children,  and the danger of feeding them with
gruel inftead of milk, is fpoken of in Clafs I.  1. 2.  5.
and II. 1. 2. 16.
ORDO 
236
DISEASES      [Class II. i. j.
                    ORDO  I.

                 Increafed Senfation.

                    GENUS  II.
With the Produclion of new Veffels by internal Membranes
               or Glands, with Fever.

   In the  firft clafs of difeafes two kinds of fevers were
flefcribed, one from excefs, and the other from defea
of irritation ; and were in confequence termed  irri-
tative,  and inirritative fevers.  In this fecond clafs of
difeafes another kind of fever occurs, which is caufed
by excefs of fenfation,  and termed in confequence Sen-
fitive Fever.   But  there is  no  fever  from  defea of
fenfation, becaufe the circulation  is carried on in health
without our  confeioufnefs, that  is, without any fen-
iation attending it.
   But  as excefs  of fenfation may exift with excefs or
defea of  irritation, two other  kinds  of fever arife
from a  combination of fenfitive fever  with the irrita-
tive,  and inirritative ones.  Making five kinds in all.
   i. Irritative fever, defcribed in Clafs I. i. i. i.
   2. Inirritative fever.  Clafs I.  2. 1. 1.
   3. Senfitive fever.   Clafs II. 1. 6.  1.
   4. Senfitive irritated fever.  Clafs II.  1.  2. 1.
   5, Senfitive inirritated fever.   Clafs II. 1.3. 1.
   As the fenfitive irritated fever attends all the dif-
eafes enumerated under the genus  about to be  de-
                                              fcribed. 
Class II. i. 2.]    OF SENSATION.              237
fcribed, it is  placed  at the  head of it.   And as the
fenfitive  inirritated fever accompanies  the  greateft
number  of the  fpecies enumerated under  the third
genus of this  order, it is  placed at the head of them.
And  as the fenfitive fever attends the difeafes of the
fixth  genus, it is placed at the head of them.   But as
every febrile  paroxyfm confifts of difordered tribes or
 trains of affociated motions,  it may be doubted,  whe-
 ther  they ought  not all to have  been placed in the
 fourth  clafs,  amongft the difeafes of affociation.   See
 Clafs IV. 2. a. 11.
    All the fubfequent fpecies of this genus are attended
 with fenfitive irritated fever; there  are neverthelefs
 fome fuperficial inflammations, which affea the  fame
 fituations without much fever, as the fcrophulous oph-
 thalmy and fpurious  peripneumony, which belong to-
 other genera.
    Inflammation is uniformly attended with the pro-
 duaion  or fecretion of new fibres  conftituting new
 veffels;  this therefore may be efteemed  its effential
 charaaer, or the criterion of its existence.   The ex-
 tenfion of the old veffels feems  rather a confequence
  than a caufe of the germination, or pullulation, of
  thefe new ones  ; for the old veffels may be enlarged,
  and excited  with unufual  energy, without any pro-
  duaion of new ones, as in the  blufli of Shame or of
  anger.
     When thefe  new veffels  are formed,  if they are  not
  reabforbed  into  the circulation, they  fecrete  a new
  fluid  called purulent matter ;  which generally opens
                                                itfelf 
 «3*               DISEASES     [Class II. i. 2.
 itfelf a paffage on the external ikin,  and produces an
 ulcer, which either  gradually heals,  or fpreads,  and
 is the caufe of heaic fever ; or they fecrete contagious
 matter, which has the property of exciting  the  fame
 kind of inflammation, and of producing the fame kind
 of  contagious matter, when  inferted by  inoculation
 into the  ikin of other  perfons.   Thefe  contagious
 matters form ulcers,  which either heal fpontaneoufly,
 or by art  ; or continue to fpread,  and deftroy the pa-
 tient, by  other kinds of heaic fever.
  In this  genus  there is an increafe  of the fenforial
 power of irritation  as  well as of fenfation; whence
 great arterial  energy is produced, and the  pulfe be-
 comes ftrong and full, as well as quick ; and  the coats
 of the arteries feel hard under the finger, being them-
 felves thickened and diftended  by inflammation. .  The
 blood  drawn, efpecially at the  fecond bleeding, is
 covered with a tough  fize ; which is probably the mu-
 cus from  the inflamed internal furface of the arteries,
 increafed in quantity, and more coagulable than in its
 natural ftate; the thinner part  being more  perfeaiy
 abforbed  by  the increafed aaion  of  the inflamed  ab-
forbents.   See Sea.  XXXIII.  2. 2.   This is rendered
 more probable, becaufe the hard feel of the pulfe, and
the abundance of coagulable lymph commence, exift,
and ceafe  together.
  Great  heat  is  produced from  the new  chemical
combinations arifing  in the fecretion of new fibres,
and great  pain from the diftention  of old  ones, or
from their increafed  aCtion.  The  increafed  quantity
                                                of 
Class II. i. 2.]    OF SENSATION.              3-39
of fenfation from a topical  inflammation or phlegmon
is the immediate caufe of the febris fenfitiva irritata,
or  inflammatory  fever ; as  when  it  arifes  from the
pain of pleurify,  or paronychia ; but  generally an ir-
ritative fever  precedes  this  topical  inflammation,
which  occurs  during the hot fit of it;  and then the
irritative  fever  is changed  into a  fenfitive  irritated
fever,  by the additional caufe of the fenforial power of
fenfation befidesthat of irritation.

                   SPECIES.
   1. Febris fenfitiva irritata.  Senfitive irritated fever,
or  inflammatory  fever.   Phlegmasia.   A ftrong full
pulfe,  with inflammation of the coats of the arteries,
constitutes this difeafe.   It  originates from fome to-
pical  inflammation,  which, if the  fever is  not fub-
dued,  terminates in fuppuration;  and differ-;  from
irritative  fever  in  refpea  to  the painful  fenSation
which  accompanies it.  For as pleafurable fenfation is
the caufe of the growth  of the new veffels, and dif-
tention of the old  ones, in the natural enlargement
of the  body during our infancy ; fo a painful fenfation
is the caufe of the unnatural produaion of new veffels,
and enlargement  of old  ones in  inflammatory dif-
eafes.
   When  matter is thus formed in  any internal vifcus,
or in the  cellular membrane,  as in  the lungs or liver ;
fo long as this abfcefs remains without admiflion of air,
this inflammatory fever is liable to continue,  receiving
only temporary  relief by bleeding or emedcs,  or ca-
                                           thartics ; 
 24*               DISEASES     [Class II. i. 2.
 thartics;  till the patient, after a month,  or two, or
 three, expires.  But, if air  be admitted  to thefe in-
 ternal abfceffes, this kind of fever  is changed into a
 heaic fever in a fingle day.   It alfo  fometimes hap-
 pens, that when the abfcefs remains unopened to the
 air,  if the matter has become putrid,  that heaic fever
 Supervenes, with   colliquative  fweats, or  diarrhcea;
 the matter in both cafes is  fometimes abforbed, and
 the fides of the abfcefs grow together again without
 an external aperture.   See Clafs II.  i. 4. i. and 2.
 Another termination of inflammation is in gangrene,
 but  this belongs  to the inflammation of the external
 ikin  ; as the  produaion of purulent matter belongs to
 inflammation of the internal or  mucous  membranes*
 Thus when the external Skin  is the feat of inflamma-
 tion, as in erythema, or eryfipelas,  and produces fen.
 fitive irritated fever, no collection of purulent matter
 can  be formed;  but a material oozes out, and lies
 upon the furface, like that in the confluent fmall-pox,
 and  the cuticle at length peels off, or gangrene Super-
 venes.  It muft be noted,  that thefe kinds of inflam-
 mation can exift together ;  and  fome parts of the cel-
 lular membrane may fuppurate at the fame  time that
 the external ikin  is  affeaed  with erythema,  or ery-
 fipelas.
  M. M.  Venefeaion.   Cathartics,  diluents.  Cool
 air.   Torpentia.   Cold Bath ? See Sea. XII. 6.
  The increafed arterial aaion in this fenfitive irritated
fever is not fimply  owing to the increafed irritability
of the arterial fyftem, or to the ftimulus of the diften-
                        4                      tion 
Class II. i. 2 ]    OF SENSATION.              24I
tion of the veffels, but alfo to the increafed acrimony
or pungency  of the blood ; which has now fo far
changed  its nature as to become more fluid, more
denfe, and to be loaded with coagulable lymph. Hence
it becomes neceffary not only to leffen the quantity of
blood by venefeaion and  by cathartics, but  alfo to
dilute its acrimony, or pungency,  by the introduaion
of aqueous  and mucilaginous fluids, fuch  as barley
water, cream and water,  fugar and  water, weak
broths;  to which may be added fo  much of fome ve-
getable effential  oil, as may render them grateful to
the ftomach, and thus promote their abforption, as by
infufing parlley or cellery and turnips in the  broth ;
or by balm, mint, or fage teas.
  The following fpecies of this genus only distinguish
the  fituation  of the  part  previoufly inflamed,  and
which is the remote caufe of the fenfitive irritated, or
inflammatory fever, which attends it.

  2.  Opthalmia  interna.   Inflammation of the eye is
attended with the produaion of new veffels, which
fpread over the tunica adjunaiva,  and over the cor-
nea ; thefe new veffels are eafily  feen, as they lie on
a white ground, and give ocular demonstration of their
produaion in inflammation.   When  this inflammation
of the cornea fuppurates,  it is liable to leave  little
ulcers, which may be feen beneath the furface in the
form of little excavations;  and as thefe heal, they are
liable to be covered with an opake  fear.   This fear,
ja fom« months  or years, is liable to  wear away, and
                        R.                 become 
242              DISEASES      [Class II. 1.1.
become tranfparent, without the affiftance of any po-
lifliing powder, as of very finely levigated  glafs,  as-
fome have recommended.   But when the cornea is
affeaed through  all its  thicknefs,  the return  of  its
tranfparency becomes hopelefs.   See Clafs I. i.  3.  14.
   In violent degrees of opthalmy the  internal  parts,
as the retina, optic artery, iris, ciliary procefs, become
inflamed, as well as the external ones;  hence the leaft
light admitted to the eye  occafions intolerable pain.
This  curious  circumftance  cannot  be  owing  to  the
aaion of light on the inflamed  veffels of the cornea ;
it therefore Shew*,  that  the  extremity of  the optic
nerve or retina is  alfo rendered more  exquisitely fen-
fible to light, by  partaking of the  inflammation; and
I have  been told, that red colours  are in thefe cafes
fometimes  painfully  perceived  even in perfea dark-
nefs.   This Shews that the retina is excited into mo-
tion by the ftimulus of light; and that, when it is in-
flamed, thefe  motions give great pain, like thofe of
other inflamed parts,  as  the mufcles, or  membranes.
And; fecondly, that the ideas of colours confift  in  the
motions of the retina; which ideas occafion pain, when
the extremity of the moving nerve is inflamed.
   M. M. Venefeaion.  Cathartics.'  Diluents.   Tor-
pentia.  Frequently moiften the eye with cold water
by means  of a  rag.   Cool airy  room.  Darknefs.
When  the  inflammation begins to decline, white  vi-
triol gr. vi. in an ounce of water is more efficacious
to moiften the eye than  folutions of lead.   Tinaure
of opium  diluted.  New  veffels from the  inflamed
                                             tunica 
Class If. i. O     ^F SENSATION.              243
tunica adnata frequently fpread like a fly's wing upon
the tranfparent cornea, which is then called Pterigium.
To Stop the growth of this, the principal veflels Should
be cut through with a lancet.  When  the  iiiilamma-
tion begins to decline,  after due evacuation any ftimu-
lating material  put into  the eye  increafes the abforp-
tion,  which foon removes the new red veffels ; which
has given rife  to  a  hundred famous  eye-waters, and
eye-doaors; if thefe ftimulating materials are ufed too
foon,  the inflammation is increafed  by  them.   See
Sea.  XXXII. 2.  10.
   There  is another opthalmia,  which attends  weak
children,  and  is  generally  efteemed a .Symptom  of
fcrophula, as defcribed in Clafs II.  1. 5. 3. and ano-
ther,  which is of venereal origin, mentioned  in Clafs
II.  1. 5.  2. both which may be  termed opthalmia fu-
perficialis.

   3.  Phrenitis.  Inflammation  of the brain is attended
with  intolerance of light and found ;  which Shews,
that the  extremities of the nerves of thofe fenfes are
at the  f; me time inflamed ;  it is alfo  attended with
great pain of the head, with watchfulnefs, and furious
delirium.  The violent efforts, thefe  patients  are Said
fometimes to  exert,  are owing to the increafed fecre-
tion of fenforial power in the brain; as  all other in-
flamed glands  have a greater circulation of blood paf-
fing through  them,  and a greater fecretion in confe-
quence of their peculiar fluids,  as in the hepatitis  much
more bile is generated.
                       R  2            M. M. Vene- 
S44              DISEASES      [Class II. i. a.
   M. M.  Venefeaion.   Cathartics.  Torpentia.  Fo-
ment  the  head with cold water  for hours together.
Or with warm water.   Cool airy room.  Afterwards
cupping on  the  occiput.   Leeches to the  temples.
When the patient is weakened a blifter on the head,
and after further  exhauftion five or fix drops of tinc-
ture of opium.

   4. Peripneumonia.  Inflammation of the lungs. The
pulfe  is  not  always hard,  fometimes  foft ;  which is
probably owing to a degree of ficknefs or inaaion  of
fhe ftomach ; with dull pain of the cheft ; refpiration;
constantly difficult, fometimes with erea pofture ; the
face bloated and ptirplifh ; cough generally with moift
txpeaoraticn, often Stained with blood.
   When Jie difficulty of refpiration is very great, the
patient is not able to cough ;  in  this fituation,  after
copious  bleeding, the cough is liable to return, and is
fo far a favourable fymptom, as  it Shews fome abate-
ment  of the inflammation.
   A  peripneumony frequency occurs in the  chin-
cough,  and  deftroys the  patient,  except immediate
recourle be had  to  the lancet,  or to four  or five
leeches ; when blood cannot be otherwife taken.
   The peripneumony is very fatal to young children,
f Specially as  I believe it is frequently mistaken for a
fpafmodic afthma, or for the croup, or cynanche tra-
rheaiis of Cullen.   Beth which, however,, when they
occur, require immediate venefeaion by the e<mcet oS
by leeches,, as well as the revipnev.mony.*
                                              The' 
 Class II. i. 2.]     OF SENSATION.              245
   The croup is an inflammation of  the  upper part
 and the peripneumony of the  lower part  of the fame
 organ, viz. the trachea or wind-pipe.  See Clafs I.
 1. 3. 4.  But as the inflammation is feldom I fuppofe
 confined  to the upper part of the trachea only, but
 exifts at the lame time in other parts of the lungs,
 and as no inflammation of the tonfils is generally per-
 ceptible,  the uncouth name  of cynanche trachealis
 fhould be changed for peripneumonia trachealis..  The
 method  of cure  confifts  in  immediate and repeated
 bleeding.  A vomit.  A grain of calomel or other
 mild  cathartic.  Bathing  in  fubtepid water,  and in
 breathing over the Steam of warm water, with or with-
 out a little vinegar in it.  And laftly,  by keeping the
 child raifed high in bed.
   Inflammation  of the lungs  is alfo liable to occur in
 the meafles, and muft be attacked by venefeaion at
 any  time of the difeafe ;  otherwife either a  prefent
 death,  or an  incurable  confumption, is  the  confe-
 quence.
   The peripneumony is frequently combined with  in-
flammation of the  pleura,  and fometimes with  that of
 ? lie diaphragm;  either of  thefe may generally be dif-
 tinguiflied, not only by the pain which attends inflam-
 mation  of thefe membranes,  but by iiifpefting  the
 naked cheft,  and obferving whether  the  park;:!:
 breathes more by elevating the ribs, or by depreifing
 the diaj hragrn.
   A crifis  hap  ens in  children  about the fxih day
wi;h much pale ur.ne, which muft be waited for after
                      R 3             evacuations 
n6               DISEASES     [Class II. i. 2.
cvacua^or^  b.-v- been  ufed,  as far as* can be done
vvii.Ii iutety ;  in  this Situation the warm  bath twice a
day, and fmall blifters repeatedly in-iuccefhon,  ere of
peculiar Service.
   After the  termination of peripneumony a coileaion
of coagulable lymph  is frequently left in the cavity of
the   .ft un abforbed ;  or a common anafarca  of tie
lun-i o-;eu:s from  the y-rcihnt inaaion of the abforb-
ent  veffels,  which  had  previoufly been  excited too
violently.   This  difficulty of breathing is cured or
 relieved by the exhibition of  digitalis.  See  Art. IV.
 3. 8.
   M. M.   The lancet is the mrchor of hope in this
 difeafe ; which muft be  repeated  four  or  five times,
 or as often as the fever and dhbeulty of .breathing in-
 creafe, which is generally in the evcnir.;;'; antimonials,
 diluents, repeated fmall blifters  ah out the cheft, muci-
 lage, pediiuvmm, warm bath.  Is a decoction of feneka-
 root of ufe ?  Do not neutral falts increafe  the ten-
 Jen :y to comr/h by "heir fthmihir,, as they increafe the
 heat of urine in gonorrhoea ?  Children  in  every  kind
 of dimcuk breathing, from whatever caufe,  fnould be
 kept as  upright  in bed  as may  be, and continually
 watched ;  fince,  if they flip down,  they are liable  to
 be immediately forTocated. After the patient is greatly
 debiii rated, fo that no further evacuation can be ad-
 mitted, and the difficult  breathing and cough continue,
 I have given four or five drops of tinaure of opium,
  ihat is, about a  quarter of a  grain of Solid opium,
  with great advantage, send I believe in  feveral cafes'I
                                                have 
Class II. i. 2.]     OF SENSATION.               247
Have faved the  patient.   A greater quantity of opium
in this ftate of debility cannot be ufed without hazard-
ing the life of the* perfon.   This fmall quantity of an
opiate  Should be given about fix in  the  evening, or
before the accefs  of the evening paroxyfm,  and re-
peated three or four nights, or longer.
   There is a peripneumony with  weak pulfe, which
may be termed peripneumonia  inirritata, as defcribed
in Sea." XXVII. 2. which belongs to this  place.  See
alfo Superficial Peripneumony, Clafs II. 1. 3. 7.

   5. Pleuritis.  Pleurify.  Inflammation of the pleura,
with  hard pulfe, pain chiefly of the fide, pungent,
particularly increafed during infpiration ;  lying on ei-
ther fide uneafy, the cough very painful, dry at the
beginning, afterwards moift, often bloody.
   One caufe of  pleurify is probably  a previous ad-
hefion  of the  lungs to a part of the pleura, which
envelopes them.   This in many cafes has been pro-
duced  in  infancy, by fuffering children to lie too long
on  one fide.   Or by placing them uniformly on one
fide of a fire,  or window, to which they  will be
liable  always to  bend themfelves.
   When matter is produced during peripneumony or
pleurify in one fide of the cheft, fo  long as it is a
concealed vomica, the fever continues, if the difeafe
be great, for  many weeks, and even  months;  and
requires  occafional  venefeaion,  till the patient  finks
under  the inflammatory  or fenfitive  irritated fever.
But if air be admitted, by a part of the abfcefs open-
                       R 4                    ing 
M*              DISEASES     [Class il. i. a.
ing itfelf a way into the air-veffels of the lungs, a
heaic fever, with colliquative fweats or diarrhcea, fu-
pervenes, and frequently deftroys the patient;  or the
abfcefs heals, the lungs adhering to the pleura.
   M. M. The lancet muft  be ufed copioufly, and re-
peated as often as the pain and difficult refpiratio»
increafe.   A blifter  on the pained part.  Antimonial
preparations.  Diluents.  Cool  air.   Do neutrai Salts
increafe the tendency to cough ? Pediiuvium- or femi-
cupium frequently repeated.

   6.  Diaphragmi/is.  Inflammation ©f the diaphragm.
Pain round the lower ribs as if girt with a cord.  Dif-
ficult refpiration performed only by elevating  the rib*
$nd in an ereft pofture.   The corners  of the mouth
frequently  retraaed into a  difagreeable Smile, called
rifus Sardonicus.
   Thofe animals, which are furnifhed  with clavicles,
or collar-bones,,  not  only  ufe their foremoft  feet as
bands,, as  men,  monkies,. cats,, mice,  fqairrels,  &c.
but elevate their ribs in refpiration as well as deprefs
•the 4iaphragm for the purpofe of enlarging the cavity
of the cheft. Hence an inflammation of the diaphragm
is fudden death to thofe animals, as  horfes and dogs,
which can only breathe by ctepreffmg  the diaphragm;
and is I fuppofe the caufe of  the fudden death of
 horfes that are overworked ; whereas,  in the human
 animal, when the diaphragm is  inflamed', fo as to renr
 der its motions impoffible from the pain they occafion,
 refpiration can be carried  on, though in a lefs perfee^
                                            manner. 
eLAss II. i. 2.]     OF SENSATION,              i+f
manner, by tlie intercoftal mufcles  in fhe elevation of
the ribs.   In  pleurify  the ribs  are  kept motionlefs,
and the refpiration is performed by the diaphragm, as.
may be  readily feen on mfpeaing the naked cheft, and
which is generally a bad fymptom ;  in  the diaphrag-
mitis the ribs are  alternately elevated, and depreffed,
but the lower part of the belly is not feea to move.
   M. M. As  in pleurify and peripneumony.  When
the patient becomes delirious, and fmiles difagrecably
by intervals, and is become fo weak, that evacuations
by the lancet could be ufed no  further, and I  have
almoft defpaired of my patient, I have found in two
©r  three inftances, that  about  five or fix  drops of
tina.  thebaic, given an hour before the evening exa-
cerbation, has had  the happieft  effea, and cured the
patient  in this cafe, as well as in  common peripneu-
mony ;  it muft be repeated two or  three evenings, fee
Clafs II. i. 2. 4. as the exacerbation of the fever and
difficult refpiration  and delirium generally increafe to-
wards night.
   The  ftimulus of this fmall quantity of opium on a
patient  previoufly fo  much debilitated, aas by in-
creafing tlie exertion of the abforbent veffels, in the
Same  manner  as a folution of opium,  or  any other
Stimulant, put on an inflamed eye after the veffels are
previoufly emptied  by evacuations, ftimulates the ab-
forbent fyftem, fo  as to caufe the  remaining new vef-
fels to  be  immediately reabforbed.  Which  fame Sti-
mulants would  have increafed  the inflammation,  if
fihey had been applied before the evacuations.   See
                                              Clais 
*5^              DISEASES     [Class II. x. 2.
Clafs II.  1.  2. 2. Sea.  XXXIII. 3.  1.   "When the
fanguiferous  fyftem is full of blood,  the abforbents
cannot ait fo powerfully, as the progrefs of their con-
tents is oppofed by the previous fulnefs of the blood-
veffels  ; whence ftimulants  in  that cafe increafe the
aaion  of the fecerning fyftem more  than  of the ab-
forbent one; but after copious evacuation  this refift-
ance to the progrefs of the abforbed fluids is removed ;
and  when ftimulants  are then  applied, they increafe
the aaion of the abforbent  fyftem more than that of
the fecerning one.   Hence  opium given  in the  com-
mencement of inflammatory difeafes deftroys the pa-
tient ;  and cures them, if given in very fmall dofes at
the end of inflammatory difeafes.

   7. Carditis.   Inflammation of the heart is attended
with unequal intermitting  pulfe,  palpitation, pain in
the middle of the Sternum,  and conftant vomiting.  It
cannot certainly be diftinguifhed from  peripneumony,
and is  perhaps always combined with it.

   8. Peritonitis.  Inflammation of the peritoneum is
known by pain all over  the abdomen, which  is in-
creafed on ereaing the body.   It has  probably moft
frequently u rheumatic origin.  See Clafs II. 1.  2. 17.

   9. Mefcnterltix*   Inflammation  of the  mefentery is
attended  with pains like colic, and with curdled or
chyle-like ftooh.  It is a very frequent and  dangerous
cbfeafe.. as the prodebhon of nutter more readily takes
                                             phc<*. 
Class II. i. 2.]    OF SENSATION.              251
place in it than in any other vifcus.   The confequence
of which,  after a hard labour, is probably the  puer-
peral fever, and in fcrophulous habits a fatal  purulent
fever, or hopelefs confumption.
   M. M. Venefeaion. Warm bath. Emollient clyfters.

   10. Gafiritis.   In inflammation of the ftomach the
pulfe  is generally foft, probably  occafioned by the
ficknefs  which attends it.   The pain and heat of the
ftomach is  increafed by whatever  is fwallowed, with
 immediate rejeaion of it.   Hiccough.
   This difeafe may  be occafioned by acrid  or indigesti-
 ble  matters taken into the ftomach, which  may che-
 mically  or mechanically injure its interior coat.   There
 is however  a flighter  fpecies of inflammation of this
 vifcus, and perhaps of all others, which is unattended
 by much fever; and wtiich  is fometimes  induced by
 drinking  cold  water, or  eating cold infipid food,  as
 raw turnips, when  the perfon has  been much  heated
 and  fatigued by exercife.    For  when  the fenforial
 power  has been diminiflied by great exertion, and the
 ftomach has become lefs irritable by having been pre-
 vioufly ftimulated  by much heat, it fooner becomes
  quiefcent by the application  of cold.   In confequence
  of this flight inflammation of the  ftomach an eruption
  of the  face frequently  enfues by  the Senfitive  affocia-
  tion of this vifcus with the Skin, which is ceiled a for-
  feit.   See Clafs IV. 1.2. 13. and II. 1.  4. 6. and II.
M. M. Vcnc- 
 -5*             DISEASES      [Class II. i. 2.
   M. M. Venefeaion.  Warm bath.   Blifter.   Ano-
 dyne clyfters.  Almond foap.  See Clafs II. 1.3.  iy.

   11. Enteritis.   Inflammation of the  bowels  is ofren
 attended with foft  pulfe, probably owing to the con-
 comitant ficknefs; which prevents fometimes the early
 uk of the lancet,  to the  deftruaion  of the  patient.
 At other times  it is  attended with ftrong and  full
 pulfe like other inflammations  of internal membranes.
 Can the  feat of  the difeafe being higher or lower in
 the inteftinal canal, that is, above or below the valve
of the colon,  produce this  difference of  pulfe  by  the
greater  fympathy of one part of the bowels with  the
ftomach  than  another?  In  enteritis with  ftrong pulfe
the pain is great about the  navel, with vomiting, and
 the greateft difficulty in procuring a  Stool.   In  the
other, the pain and fever  is  lefs, without vomiting,
 and with diarrhcea.   Whence it appears,  that the en-
 teritis with hard  quick pulfe differs from Ileus,  de-
 fcribed in Clafs I.  3.  1. 6. only in the exiftence  of
 fever in  the former and  not the latter,  the other fymp-
 toms generally correfponding; and, fecondly, that  the
 enteritis with fofter quick pulfe, differs from the cho-
 lera defcribed in Clafs I. 3. 1. 5. only  in the exiftence
 of fever  in the former,  and not the latter,  the other
 fymptoms being in general  fimilar.   See  Clafs II,
 1, 3. 20.
   Inflammation of the bowels fometimes  is  owing to
 extraneous  indigestible  fubftances, as   plum-Stones,
 efpecially of the damafin, which has Sharp ends. Some,
                                              times. 
Class TI. i. 2.]    OF SENSATION.              2jj
times to an  introfufception  of one part of the  m-
teftine into another, and very frequently to a Stran-
gulated hernia or rupture.   In refpea to the firft, I
knew an inftance where a damafin ftone, after a long
period of time,  found its way out of the  body near
the groin.  I knew another child, who vomited fome
damafin ftones, which had lain for near twenty hours,
and  given  great pain about the navel, by the exhibi-
tion  of an emetic given In repeated dofes for about
an  hour.  The fwallowing of plum-ftones in  large
quantities,  and  even of cherry-ftones, is annually fa-
tal  to many children.   In  refpea to the introfufcep-
tion and hernia, lee Ileus, Clafs I. 3. 1. 6,
   M. M. Repeated venefeaion.  Calomel from ten to
twenty grains given in fmall pills as in Ileus ;  thefe
means ufed  early  in  the difeafe generally fucceed.
After theSe evacuations a blifter contributes to Stop
the vomiting.   Warm bath.  Crude mercury.  Aloer,
one grain-pill  every hour will  frequently Stay in  the
ftomach.   Glauber's fait diffolved in pepper-mint wa-
ter given by  repeated  Spoonfuls.
   When the  patient is much reduced, opium in very
fmall dofes may be given, as a quarter of  a grain, as
recommended in pleurify.   If the pain fuddenly ceafes,
and the patient continues to vomit  up whatever is
given him, it is generally fatal; as  it indicates, that
a mortification of the bowel is already formed.   Some
authors have advifed to join cathartic medicines with
an  opiate in inflammation of the bowels, as recom-
mended in colica  faturnina-   This may  fucceed i:?
                                            fl'gh^e;' 
254              DISEASES       [Class II. r. 2.
Slighter cafes, but  is a dangerous praaice in general;
Since, if the obftruaion be not removed by the  eva-
cuation, the ftimulus of  the opium is liable to increafe
the aaion  of the  veffels, and  produce morrinc ition
of the bowel, as  I think I have feen more than once.

   12. Hepatitis.   Inflammation of the liver is attend-
ed with Strong quick pulfe ;  tenfion and pain  of tlie
right fide ; often pungent as  in  pleurify; oftener  chel.
A pain is faid to  affea the  clavicle, and top  of rhe
right Shoulder; with difficulty in lying on the left fide ;
difficult refpiration ; dry cough ; vomiting ;  hiccough.
   There is another hepatitis mentioned by authors,
in which the fever, and other fymptoms, are wanting,
or are lefs violent; as defcribed in Clafs II.  i. 4. 11.
and  which is probably fometimes relieved  by erup-
tions of the face;  as in thofe who are habituaced  to
the intemperate ufe of fermented liquors.
   M. M. Hepatic inflammation  is very liable to ter-
minate in  fuppuration, and  the patient is  deftroycd
by the  continuance  of  a fever with fizy blood, but
without night-fweats, or diarrhcea, as in other un-
opened abfceffes.   Whence copious and  repeated ve-
nefeaion is required early in the difeafe, with repeat-
ed, dofes of  calomel, and  cathartics.   Warm  ba>h.
Towards the end of the difeafe fmall dofes of opium
before the  evening paroxyfms, and laftly the Peruvian
bark, and chalybeate wine, at firft in  fmall  dofes,  as
20 drops twice a day, and afterwards,  if neceffary,  in
larger.   See Art.  IV, 2. 6.
                                              Mrs. 
Ciass II. i. 2.]     OF SENSATION.              i53
   Mrs. C. a lady in the laft month of her pregnancy,
was feized with violent hepatitis,  with fymptoms both
of peripneumony and of pleurify, for it feldom hap-
pens in violent inflammations,  that one vifcus alone is
affeaed ;  She wanted then  about a fortnight of her
delivery,  and after frequent venefeaion, with  gentle
cathartics, with fomentation or warm bath, She reco-
vered and was fafely delivered, and both herfelf and
child did  well.   Rheumatic and  eruptive  fevers are
more liable  to induce abortion.

   13. Splenitis.  Inflammation of the fpleen commences
with  tenfion, heat, and tumour of  the left fide, and
with  pain,  which  is  increafed by  preffure.  A cafe
is defcribed in Clafs I. 2. 3. 18. where a tumid  fpleen,
attended  with  fever,  terminated in fchirrus of that
vifcus.

   14. Nephritis.   Inflammation  of the  kidney feems
to be  of two kinds;  each of them  attended with dif-
ferent fymptoms,  and different modes of termination.
One of them I fuppofe to be an inflammation  of the
external membrane of the kidney,  ariling  from gene-
 ral caufes of inflammation, and accompanied with pain
 in the loins without vomiting ; and the other to confift
 in an inflammation of the interior parts of the kidney,
 occafioned  by the ftimulus of gravel in the pelvis of
 it, which is attended with perpetual vomiting, with
 pain along the courfe of the ureter, and retraaion of
 the teftis on that fide,  or numbnefs of the thigh.
                                               The 
 »5<5              DISEASES     [Class I. i. t.
   The former of thefe kinds  of nephritis  is  diftin-
guifhed from lumbago by its fituation being  more ex-
aaiy on the region of the kidney, and by its not be-
ing extended beyond that  part; after  three  or four
days I believe this  inflammation  is  liable to  change
place ; and that a herpes  or eryfipelas,  called  zona,
or  fhingles, breaks  out about the loins in  its  Stead ;
at other times it is  cured  by a cathartic with calo-
mel, with or without previous venefeaion.
   The other kind  of nephritis,  or  inflammation  of
the interior part of the kidney, generally arifes from
the pain occafioned by  the ftimulus of a ftone enter?-
ing the ureter from  the pelvis of the kidney ; and
which  ceafes  when the ftone is  protruded forwards
into the  bladder ; or  when  it is  returned into the
pelvis  of the kidney  by the retrograde aaion  of the
ureter.  The kidney is neverthelefs inflamed more fre-
quently, though in a lefs degree,  from other caufes ;
efpecially  from  the intemperate ingurgitation of ale,
or other fermented  or fpirituous  liquors.   This lefs
degree of inflammation  is the caufe of gravel, as that
before mentioned is the effea  of  it.   The mucus fe-
creted  to lubricate the internal furface of  the urinife-
rous tubes  of the kidney becomes  fecreted in greater
quantity, when  thefe veffels are  inflamed; and,  as
the correfpondent abforbent veffels aa more energe-
tically  at the fame  time, the  abforption of its more
fluid parts  is more powerfully affeaed; on both thefe
accounts  the mucus becomes  both changed in qua-
lity and more indurated.  And in this manner ftones
                        i                       are 
Class II. i. 2.]     OF SENSATION.              2J7
are produced on  almoft every mucous  membrane of
the body; as in the lungs, bowels, and even in the
pericardium,  as fome  writers  have affirmed.    Sec
Clafs I. 1. 3. 9.
  M. M.  Venefeaion.  Ten grains  of  calomel given
in fmall pills.  Then  infufion of fenna with oil.  Warm
bath.   Then opium  a  grain  and  half.   See Clafs
I. 1. 3. 9. for  a further  account  of the method of
cure.

   15.  Cyfkitis.    Inflammation of the bladder is at-
tended with  tumor and pain of the lower part of the
belly ; with  difficult and painful miaurition; and te-
nefmus.   It generally is produced by the exiftence of
a large ftone in the bladder, when in a great degree;
or is produced  by common caufes, when in a Slighter
degree.
  The ftone  In the bladder is generally  formed in the
kidney, and  paffing  down the ureter into the bladder
becomes there  gradually  increafed  in  fize; and  this
moft frequently by the appofition of concentric fpheres,
as may be feen by fawing fome of  the harder culculi
through the middle,  and polifliing one furface.   Thefe
new concretions fuperinduced on the nucleus,  which
defcended from  the kidney,  as  defcribed in Clafs I. 1.
3. 9. and in the  preceding article  of  this genus,  is
not owing to  the microcotmic fait, which  is often
feen to  adhere  to  the  fides  of  chamber-pots,  as
this is foluble in  warm water,  but  to  the mucus of
the bladder,  as  it rolls along the internal furface of it.
                        S                     Now 
258               DISEASES     [Class II. 1.2.
Now when the bladder is Slightly inflamed, this mucus
of its internal furface  is fecreted in greater quantity,
and is more indurated  by the abforption  of  its more
liquid part at the inftant of fecretion,  as  explained in
Clafs I.  1.3. 9. and II.  1. 2. 14. and  thus  the fti-
mulus and pain  of a ftone in the bladder contributes
to its enlargement by inflaming the interior coat of it.
  M. M. Venefeaion.  Warm bath.  Diluents.  Ano-
dyne clyfters.  See Clafs I. 1.3. 9.

   16. Hyfteritis.   Inflammation of the womb is ac-
companied with heat,  tenfion,  tumor,  and  pain  of
the lower belly.  The os uteri painful to the touch.
Vomiting.  This difeafe is generally produced by im-
proper management in the delivery of pregnant wo-
men.  I know an unfortunate cafe, where  the pla-
centa was left till the next day ;  and then an  unfkilful
accoucheur introduced his hand, and forcibly tore  it
away ; the confequence was a moft violent inflamma-
tory  fever,  with  hard throbbing  pulfe, great pain,
very fizy blood, and the death of the patient.  Some
accoucheurs  have had  a praaice of introducing their
hand into the uterus immediately  after  the  birth of
the  child, to take  away  the  placenta;  which  they
faid was  to  fave time.   Many women I believe have
been  viaims to this unnatural praaice.
   Others have received injury,  where  inflammation
has been beginning, by the univerfal praaice of giv-
 ing a large dofe of opium immediately  on  delivery,
 without any indication of its propriety ; which, though
                                           a proper 
Class II. i. 2.]     OF SENSATION.             259
a proper  and ufeful medicine,  where the  patient is
too feeble, when given in a fmall dofe, as 10  drops
of tinaure of opium, or half a grain of folid opium,
muft do a proportionate injury, when it is  given  im-
properly ;  and as delivery is a  natural  procefs, it is
certainly more wife to give no medicines, except there
be  fome  morbid fymptom, which requires it;  and
which has only  been introduced  into cuftom by  the
ill-employed  aaivity  of  the Priefts or  Priefteffes of
Luc in a;  like  the concomitant  nonfenfe of  cram-
ming  rue or rhubarb  into the mouth of the  unfor-
tunate young ftranger, who is thus foon made  to ex-
perience the evils of life.   See  Clafs II.  1. 1.  12.
and I. 1.2. 5.  Juft fo fome over-wife beldames force-
young ducks and turkeys, as foon as they are hatched,
to fwallow a pepper-corn.
   M. M.  Venefeaion repeatedly ; diluents; fomen-
tation ; the patient fliould be frequently raifed  up in
bed for a fhort time, to give opportunity of difcharge
to the putrid  lochia; mucilaginous  clyfters. See Fe-
bris Puerpera.

   1 j. Lumbago fenfitiva.   Senfitive  Lumbago.   When
the extenfive membranes, or ligaments, which  cover
the mufcles of the back are  torpid, as in the cold
paroxyfm of ague,  they  are  attended  with pain ill
confequence of the inaaion of the veffels, which com-
pofe  them.   When this  inaaion  continues  without a
confequent renewal or increafe of aaivity,  the  difeafe
becomes chronical, and  forms the lumbago frigida,
                        S 2                     or 
260             DISEASES      [Class II. i. z.
or irritativa, defcribed  in  Clafs  I. 2.  4.  16.   But
when this cold fit  or  torpor of thefe  membranes,  or
ligaments or mufcles of the back,  is fucceeded by a
hot fit, and confequent inflammation, a violent inflam-
matory fever,  with great pain, occurs, preventing the
erea pofture of the body; and  the  affeaed part  is
liable to  fuppurate, in  which cafe  a very dangerous
ulcer is  formed, and  a  part of one of  the  vertebrce
is generally found  carious,  and the  patient finks after
a long time under the heaic  fever occafioned by the
aerated or oxygenated matter.
   This difeafe bears no greater analogy  to rheumatifm
than  the inflammation  of the pleura,  or any other
membranous inflammation;  and  has  therefore  un-
juftly been arranged under that  name.   It is  diftin-
guifhed from nephritis,  as  it is feldom attended with
vomiting, I fuppofe never, except the ureter happens
to be inflamed at the fame time.
   The pain fometimes  extends on the  outfide  of the
thigh from the hip to the ankle,  heel, or toes,  and is
then called fciatica ; and has  been thought to  confift
in an inflammation of the theca, or  covering of the
fciatic nerve, as the pain fometimes fo exaaiy attends
the principal branches of that nerve.  See Clafs I. 2.
4.'15. 16.
   M. M. Venefeaion  repeatedly ; calomel;   gentle
cathartics ;  diluents ; warm  bath ;  poultice on the
back,  confifting   of  camomile   flowers, turpentine,
foap, and opium;  a burgundy-pitch  plafter.  A de-
bility of  the inferior  limbs  from the  torpor of the
                                           muffle?, 
Class II. I. 2.]    OF SENSATION.             261
mufcles, which had previoufly been too much excited,
frequently occurs at the end of this difeafe; in this
cafe elearicity, and iffues on each fide of the lumbar
vertebra?,  are recommended.   See Clafs I. 2.  4. 16.

   18. Ifchias.   The  Ifchias confifts of inflammatory
fever, with great pain about the pelvis, the  os coc-
cigis, and  the heads of the .thigh bones, preventing
the  patient from t walking or Standing erea, with in-
creafe of pain on going to ftool.   This malady,  as
well as the preceding, has  been afcribed to rheuma-
tifm ; with which it feems to bear no greater analogy,
than the inflammations of any other membranes.
   The  patients  are  left feeble,  and fometimes lame
after this difeafe ;  which is alfo fometimes accompanied
with great flow of urine, owing to the defeaive ab-
forption of its aqueous  parts ;  and with confequent
thirft occafioned  by  the want of fo  much fluid being
returned into  the circulation; a lodgment of  feces in
the reaum fometimes occurs after this complaint from
the leffened fenfibility of it.   See Clafs I. 2. 4.  15.
   M. M.  Venefeaion ; gentle cathartics;  diluents ;
fomentation ;  poultice with  camomile flowers,  turpen-
tine, foap, and  opium ; afterwards the  bark.   See
Clafs L 1. 3. 5.
   When this inflammation terminates in fuppuration
the  matter generally can be felt  to fluauate in the
groin,  or near the top of the thigh.   In this  circum-
ftance,  my friend Mr.  Bent, Surgeon  near Newcaftle
-in Staffordshire, propofes to  tap the abfcefs by means of
                        S3               a trocar. 
26z              DISEASES     [Class II. r. ».
a trocar, and thus as often as  neceffary to difcharge
the matter without admitting the air.   Might a weak
injeaion of wine  and water, as in the  hydrocele, be
ufed with great caution to inflame the walls  of the
abfcefs, and caufe them to  unite?   See Clafs II.
i. 6. 9.

   19.  Paronychia interna.  Inflammation beneath the
finger-nail.   The pain occafioned by the inflammatory
aaion and tumor of  parts bound  down between  the
nail on one fide and the bone on the other, neither of
which  will yield, is faid  to occafion fo  much pain as
to produce immediate  delirium, and even death, ex-
cept the parts are divided by a deep incifion; which
muft pafs quite through the periofteum,  as the inflam-
mation is faid generally to exift beneath it.  This dif-
eafe  is thus refembled by the procefs of toothing in
young  children;  where  an  extraneous body lodged
beneath the periofteum induces pain and fever, and
fometimes delirium, and requires to be fet at liberty
by the lancet.        *
ORDO 
Class II. i. 3.]     OF SENSATION.
263
                   ORDO   I.
                 Increafed Senfation.

                  GENUS   III.
With  the  Production of new Veffels by external Mem-
           branes or Glands, with  Fever.
  The difeafes  of this genus are perhaps all produc-
tive  of contagious matter; or which becomes fo by
its expofure to the air, either through the cuticle,  or
by immediate contaa with it;   fuch are the matters of
the  fmall-pox and  meafles.   The purulent  matter,
formed on parts covered from the air by thicker mem-
branes  or mufcles, as in the  preceding  genus, does
not induce fever,  and cannot therefore be called con-
tagious ;  but it  acquires  this  property  of producing
fever in a few hours, after  the abfcefs has been open-
ed, fo as  to admit the air to its furface, and  may then
be faid to confift of contagious miafmata.  This kind
of contagious matter only induces fever,  but  does not
produce  other  matter with properties  fimilar to its
own ; and in this refpea  it   differs from the conta-
gious miafmata of fmall-pox or meafles, but refembles
thofe which have their origin  in crowded jails; for
thefe produce fever only,  which  frequently deftroys
the patient; but do not produce other matters fimilar
to themfelves; as appears  from none of  thofe, who
died of the jail-fever, caught at  the famous  black af-
fizes  at  Oxford, at the beginning  of this century,
having infeaed their phyficians or attendants.
                         S4                      tf 
26+              DISEASES     [Class II. i. 3.
   If indeed the  matter has continued fo long  as to
become putrid, and thus to have given out air from
a part of it, it acquires the power of producing fever;
in the fame manner as  if the ulcer had been opened,
and expofed to the  common  air ; inftances  of which
are not  unfrequent.   And from thefe circumftances
it feems probable, that the matters  fecreted by the
new veffels formed  in all kinds  of phlegmons, or puf-
tules, are not contagious, till they have acquired fome-
thing from the atmofphere, or  from the gas produced
by putrefaaion ; which will account  for fome pheno-
mena in the lues venerea,  cancer, and of other  con-
tagious  fecretions on  the ikin without fever,  to be
mentioned hereafter.   See Clafs II. 1. 4. 14.
   The  theory  of  contagion has been  perplexed by
comparing it with fermenting  liquors ; but the con-
tagious  material is fhewn in  Seaion XXXIII. to be
produced  like other  fecreted  matters by certain ani-
mal motions of the terminations of the veffels.   Hence
a new kind of gland is formed at the terminations of
 the veffels in the eruptions of the fmall-pox ;  the ani-
mal motions of which produce from  the  blood  vario-
lous  matter;  as other glands  produce bile or faliva.
Now if fome of this matter is  introduced beneath the
cuticle of a healthy perfon, or enters the circulation,
and  excites  the extremities of the blood-veffels into
thofe kinds of difeafed motions, by which it was itfelf
produced, either by irritation or affociation, thefe dif-
 eafed motions of the extremities of the veffels will pro-
 duce other   Similar contagious  matter.    See  Sea.
                                           XXXIII. 
Class II. i. 3.]     OF  SENSATION.             265
XXXIII. 2. 5. and 9.   Hence  contagion feems to be
propagated two ways ;  one, by the ftimulus  of con-
tagious matter applied  to  the  part, which by an un-
known law of nature excites the ftimulated veffels to
produce a fimilar matter ; as in venereal ulcers, which
thus continue to  fpread ; or  as when variolous mat-
ter is inferted beneath the cuticle ; or when it is fup-
pofed  to  be abforbed, and  diffufed  over the body
mixed with the blood,  and applied in that manner to
the cutaneous glands.   The other way, by which con-
tagion feems to be diffufed, is  by fome diftant parts
Sympathizing or imitating the motions of the part firft
affeaed ; as the ftomach and Skin in the eruptions of
 the inoculated fmall-pox, or in the bite of a mad dog; ,
 as treated of in Sea. XXII. 3.3.
   In  fome of the  difeafes of this genus the pulfe is
 ftrong, full, and  hard, constituting  the fenfitive irri-
 tated fever, as defcribed in the preceding genus;  as
 in one kind of eryfipelas, which requires  repeated
 venefeaion.  In others the arterial aaion is fometimes
 moderate,  fo as  to constitute the fenfitive fever,  as
 in the inoculated fmall-pox; where  the aaion of the
 arteries is neither increafed by the fenforial power of
 irritation, as in the fenfitive  irritated fever; nor de-
 creafed by the defea  of that power,  as  in the fenfitive
 inirritated fever.   But in the  greateft  number of the
 difeafes of  this genus the arterial  aaion  is  greatly
 diminifhed  in  refpea to Strength,  and confequently
 the frequency of pulfation is  proportionally increafed,
 as explained in Sea.  XXXII. 2. 1.   Which is owing
 to  the deficiency of  the fenforial power of irritation
                                               joined 
                  DISEASES     [Class II. i. 5.
j >!fled with the increafe of that of fenfation, and thus
  onftitutes the fenfitive inirritated fever; as in Scarla-
tina with gangrenous tonfils.
   From this great debility of the aaion of the arte-
ries, there appears to be lefs of the coagulable lymph
or mucus fecreted on their internal furfaces; whence
there  is not only a defea  of that buff or fize upon
the blood, which is feen on the furface of that,  which
is drawn in the fenfitive irritated fever ; but the blood,
as it cools, when it  has  been drawn  into  a bafon,
fcarcely coagulates ; and is faid to be diffolved,  and
is by fome fuppofed to be  in a ftate of aaual  putre-
faaion.   See Sea.  XXXIII.  1.  3. where the truth
of this idea is controverted.   But in the fevers of both
this genus and  the preceding  one great heat is pro-
duced  from the  chemical combinations in  the  fecre-
tions of new veffels and fluids, and pain or uneafinefs
from the distention of the old  ones;  till towards the
termination of the difeafe fenfation ceafes,  as well as
irritation, with  the mortification of the affeaed  parts,
and the death of the patient.
  Dyfenteria, as  well as tonfillitis  and aphtha, arc
enumerated amongft  the  difeafes of  external  mem-
branes, becaufe  they are expofed either  to  the at-
mofpheric air, which  is breathed,  and fwallowed with
our food  and faliva;  or  they are expofed  to the in-
flammable air, or hydrogen, which is generated  in the
inteftines; both which contribute to  produce or pro-
mote the  contagious quality  of thefe  fluids;  as men-
tioned in Clafs  II. 1. 5.
It 
Class II. i. 3.]     OF SENSATION.               267
   It is not fpeaking accurate language, if we fay, that
in the difeafes of this genus the fever is contagious;
fince it is the material produced by the external mem-
branes, which  is  contagious,  after it has  been  ex-
pofed to air; while the fever is the confequence of
this contagious matter, and not the caufe of it.  As
appears from the  inoculated fmall-pox, in which  the
fever does  not commence, till after fuppuration  ha*
taken place in the  inoculated arm, and from the  dif-
eafes  of the fifth genus of  this order, where con-
tagion exifts without  fever.   See Clafs II.  1. 5.  and
II.  1. 3. 18.

                    SPECIES.
   1.  Febris fenfitiva inirritata.   Senfitive inirritated
fever.    Typhus  gravior.    Putrid malignant fever.
Jail fever.  The immediate caufe of this difeafe is  the
increafe of the fenforial power of fenfation, joined with
the decreafe of the fenforial power of irritation ; that
is, it confifts  in  the febris fenfitiva  joined  with  the
febris inirritativa of Clafs I. 2. 1. 1.  as the febris fen-
fitiva irritata of the preceding  genus confifts of the
febris fenfitiva joined with the febris irritativa of Clafs
I.  1. 1. 1.  In  both which the word  irritata, and in-
irritata,  are defigned to exprefs more or lefs  irritation
than the natural quantity ; and the fame when applied
to fome of the  difeafes of this genus.
   This fever is frequently accompanied with topical
inflammation,  which is  liable,  if the arterial ftrength
is not  fupported,  to end in fphacelus;  and  as morti-
                                                 fied
* 
 268               DISEASES     [Class II. i. 3.
 ficd parts, fuch as Sloughs of the throat,  if they ad-
 here to living  parts, foon become  putrid from the
 warmth and moifture of their fituation ;  thefe  fevers
 have been termed putrid,  and have been  thought to
 owe their caufe to what  is  only  their confequence.
 In hot climates this fever is frequently induced by the
 exhalations  of Stagnating  lakes or  marflies,  which
 abound with animal fubftances ; but which in colder
 countries  produce fevers with  debility  only,  as the
 quartan ague, without inflammation.
  The  fenfitive inirritated, or malignant fever, is alfo
 frequently produced  -by  the  putrid  exhalations  and
 Stagnant air in  prifons;  but perhaps moft frequently
 by contaa or near approach of the  perfons, who have
 refided  in them.   Thefe caufes of malignant  fevers
 contributed  to produce,  and to fupport for a  while,
 the feptic and antifeptic theory  of them  ; fee Sea.
 XXXIII.  1. 3.   The vibices or bruifes, and petechia?
 or purples, were believed to be owing to the diffolved
 ftate of the blood by its incipient  putrefaaion ;  but
 hydroftatical experiments have been made, which Shew
 the fizy blood of the patient  in  fenfitive irritated or
 inflammatory fever,  with ftrong pulfe, is more fluid,
while it is warm,  than this uncoagulable blood taken
 in this fenfitive inirritated, or malignant fever ; from
whence it is inferred, that thefe petechix, and vibices,
 are owing to the deficient power of abforption  in the
 terminations of the veins.   See Clafs  I.  2.  1, 5.
  This fenfitive  inirritated fever, or typhus gravior,.
is diftinguiflied from the  inirritative fever, or typhus
                                            tnitior, 
Class II. i. 3.]     OF SENSATION.              269
mitior, in the early ftages of  it, by the  colour of the
fkin;  which  in  the  latter is paler,  with lefs  heat,
owing to the  lefs  violent aaion of the capillaries;  in
this it is  higher coloured, and hotter,  frorii the greater
energy of the capillary aaion in the  produaion  of
new veffels.  In  the  more advanced ftate  petechia?,
and the produaion of contagious matter from inflamed
membranes, as the aphtha? of the mouth,  or ulcers of
the throat, distinguishes  this fever from  the  former.
Delirium,  and dilated pupils of the eyes, are more
frequent in nervous fevers  ; and  ftupor with deafnefs
more frequent attendants  on malignant fevers.  See    ^m
Clafs I.  2. 5. 6.
   There is another  criterion difcernible by the touch
of an experienced finger ; and that is, the coat of the
artery in  inflammatory  fevers,  both thefe attended
with ftrength of pulfation, and thofe with weak pulfa-
tion, feels harder, or more like a cord  ; for the coats
of  the arteries in thefe fevers are  themfelves inflamed,
and are  confequently turgid  with blood,  and thence
are lefs e'dfily compreffed,  though their pulfations are
neverthelefs  weak :  when the artery is  large or full
with an  inflamed coat,  it  is called  hard ;  and. when
fmall or  empty with an inflamed coat,  it  is called Sharp,
by many writers.
    M. M.  The indications  of cure confift,  1. In pro-
 curing a regurgitation of any offenfive material, which
 may be  lodged in the long mouths of  the  taaeals or
 lymphatics, or in their  tumid  glands,   if** To excite
 the fyftem into  neceffary aaion by the repeated exhi-
                                              bition 
270              DISEASES     [Class II. i. 3.
bition of nutrientia, forbentia, and incltantia ; and to
preferve the due evacuation  of the bowels.  3. To
prevent any unneceffary expenditure of fenforial power.
4. To prevent the formation of ulcers, or to promote
the abforption  in them, for the purpofe  of healing
them.
   1. One ounce of wine of ipecacuanha, or about ten
grains of the powder, fliould be given as an emetic.
After a few hours three  or  four  grains  of calomel
fhould  be  given in  a little mucilage,  or conferve.
Where  fomething fwallowed  into  the ftomach is the
caufe of the fever, it is liable to be arrefted by the  lym-
phatic glands, as the matter of the fmall-pox inoculated
in the arm  is liable to be Stopped  by the axillary lym-
phatic gland ;  in this  fituation it may continue a day
or two, or longer,  and may be  regurgitated during
the operation of an emetic or cathartic  into the Sto-
mach or bowel,  as  evidently  happens on  the exhibi-
tion  of calomel,  as explained in Sea. XXIX.  7. '2.
For this reafon an emetic and cathartic, with venefec-
tion, if indicated by  the hardnefs and  fulnefs of the
pulfe, will very frequently remove fevers, if exhibited
on the firft, fecond, or even third day.
   2. Wine and  opium, in fmall dofes repeated fre-
quently, but  fo that not the  leaft degree of intoxica-
tion follows,  for in  that cafe  a greater degree of de-
bility is produced from the  expenditure  of fenforial
power in unneceffary  motions.   Many weak  patients
have been  thus  ftimulated  to death.  See Sea.  XII.
7. 8.   The Peruvian  bark  fliould be given  alfo in re-
                                            peated
* 
Class II. i. 3.]    OF SENSATION               267
peated dofes in fuch quantity only as may Strengthen
digeftion, not impede it.   For thefe  purpofes  two
ounces of wine, or of ale,  or cyder, fhould be given
every fix hours ; and two ounces of decoaion of bark,
with  two  drachms of the  tinaure of  bark,  and fix
drops of tinaure of opium, fhould be given alfo every
fix hours alternately ; that is, each of them four times
in twenty-four hours.  As much  rhubarb as may in-
duce  a daily evacuation, fhould be given to remove
the colluvies of indigefted materials from the bowels;
which might otherwife increafe the diftrefs of the pa-
tient by the air it gives out in putrefaaion, or by pro-
ducing a diarrhcea  by its acrimony ; the  putridity of
the evacuations are  in confequence  of the total inability
of the digeftive powers; and their delay  in the intef-
tines, to the inaaivity of that  canal in refpea to its
peristaltic motions.
   The quantities of wine  or beer and opium,  and
bark,  above mentioned, may be increafed  by degrees,
if the patient feems refreffied by them ;  and if the
pulfe  becomes  flower on their  exhibition ;  but  this
with  caution, as I have feen irrecoverable mifchief
done by greater quantities both of opium, wine, and
bark, in this kind  of fever;  in which  their ufe  is to
ftrengthen  the digeftion  of the weak  patient, rather
than to Slop the  paroxyfms of fever;  but when  they
are adminiftered  in intermittents,  much larger quan-
tities  are  neceffary.
  The  ftimulus of fmall blifters applied in fucceffion,
one every  three  or four  days,  when the  patient be-
                                             comes 
272              DISEASES      [Class II. i. 3.
comes weak, is of  great  fervice by ftrengthening
digeftion, and by preventing the coldnefs of the ex-
tremities, owing to the  fympathy  of the Skin with
the Stomach, and of one part of the Skin  with ano-
ther.
  In  refpea to nutriment,  the patient Should be fup-
plied  with wine and water, with toafted bread,  and
fugar or fpice  in it;  or with fago  with wine ; frefli
broth with turnips, celery,  parfley ;  fruit; new milk.
Tea with cream and fugar  ;_ bread  pudding, with le-
mon juice  and  fugar;  chicken,  fifli,  or whatever  is
grateful  to  the  palate of  the  fick  perfon,  in fmall
quantity repeated frequently ;  with  fmall beer, cyder
and water,  or  wine and water, for drink, which may
be acidulated with acid of  vitriol in fmall quantities.
  3.  All unneceffary  motions are to be checked, or
prevented.   Hence horizontal pofture, obfcure room,
Silence, cool air.   All the  parts of the Skin, which
feel  too hot to  the hand,   Should be  expofed  to a
current of cool air, or bathed with cold water, whe-
ther there are  eruptions on it or not.   WaSh  the
patient twice a day with cold vinegar and  water, or
cold fait and water,  or cold water alone,  by means
of a  fponge.   If fome parts are  too cold,  as the ex-
tremities, while  other parts are too hot, as the face
or breaft,  cover the cold parts with flannel, and cool
the hot  parts  by a current of  cool  air, or bathing
them as above.
  4.  For the healing of ulcers, if  in  the mouth, fo-
lution of alum  in water about 40 grains to an ounce,
                           4                     or 
«las8II. i.3-!l     OF SENSATION.              27$
or of. blue vitriol in  water,  one grain  or two to an
ounce may be ufed to  touch  them with three or four
times a day.  Of thefe  perhaps a folution  of alum
is  to be preferred,  as  it inftantly takes away  the
ftench  from ulcers  I fuppofe by  combining with  the
volatile alkali which attends it.  For this purpofe a
folution of alum  of an ounce to a pint of water fliould
be frequently injeaed by means of a  fyringe into the
mouth.   If there are ulcers on the external ikin,  fine
powder of bark  feven parts,  and ceruffa in fine pow-
der  one part, fhould be mixed,  and applied dry  on
the  fore,  and kept on by lint, and a  bandage.
   As floughs in the mouth  are  frequently produced
by the previous  drynefs of  the  membranes, which
line  it, this drynefs Should be prevented  by frequently
moiftening them, which  may be  effeaed  by injeaion
with a  fyringe, or by a  moift fponge, or  laftly in the
following manner.  Place a  glafs of wine and water,
or of milk and  fugar, on a table by the bed-fide, a
little above the  level of the moutji of the  patient;
then, having previoufly moistened a long piece of nar-
row  lifting, or cloth, or  flannel, with the fame liquor,
leave one end of it in the  glafs, and  introduce  the
other into the mouth of  the  patient;  which will thus
be fupplied with  a conftant oozing of the fluid through
the  cloth, which aas  as a  capillary  fyphon.
   The  vifcid  phlegm, which adheres to  the tongue,
fhould be coagulated by fome auftere acid, as by le-
mon juice evaporated to  half its quantity, or  by crab-
juice;  and then  it may  be  Scraped off by  a knife,
                        T                       or 
*7<f              ^DISEASES     CClassM. i.ji
or rubbed off by flannel,  or a fage leaf dipped in vi-
negar, or in fait and water-

   2m Eryfipelas, St. Anthony*s fire, may be  divided
into three kinds, which  differ in their method of cure,
the irritated, the inirritated, and the fenfitive eryfipelas.
   Eryfipelas irritatum is attended  with increafe of ir-
ritation befides increafe  of fenfation ; that Ls, with
ftrong, hard, and full pulfe, which requires frequent
venefeaion, like other  inflammations with  arterial
ftrength.  It is  diftinguifhed from the  phlegmonic in-.
flammations of the  laft  genus by  its fituation on the
external habit, and  by the rednefs, heat,  and tumour
not being diftinaiy circumferibed ; fo  that the eye or
finger cannot exaaiy trace the extent of them.
   When the external Skin is the feat of inflammation,
and produces fenfitive irritated fever, no colfeaion of
matter is formed, as when a phlegmon is fituated in
the cellular membrane beneath the Skin;  bat  the cu-
ticle rifes as  beneath a  blifter-plafter, and becomes
ruptured;  and a yellow material oozes out, and  be-
comes infpiflated, and lies upon its furface ;  as is feem
in this kind of eryfipelas, and in the confluent fmall-
pox ;  or if the new veffels are reabforbed the cuticle
peels  off in fcales.   This difference of the termination
of eryfipelatous and plilegmonic inflammation feems tpj
be owing in part to the  lefs  diftenfibility of the cuticle
than of the cellular membrane, and in  part to  the
ready exhalation of the  thinner parts  of  the  fecreted
fluids  through its pores.
                                              This 
Class II. i. 3.]    OF SENSATION.              275
   This  eryfipelas  is generally preceded by a fever for
two or three days before the eruption, which is liable
to appear in fome  places, as it declines in others; and
feems frequently to arife from a previous fcratch or
injury ©f the Skin ; and is attended fometimes with in-
flammation of the cellular  membrane beneath the
Skin ; whence a real phlegmon and colleaion of mat-
ter becomes joined to the eryfipelas,  and  either occa-
fions or increafes the irritated fever,  which attends it.
   There is a greater  fympathy between the external
Skin and the meninges of the brain, than between the
cellular  membrane  and thofe meninges ; whence  ery-
fipelas is more liable  to be preceded or attended, or
fucceeded,  by delirium than  internal phlegmons.  I
except  the mumps,  or parotitis,  defcribed below ;
which is properly  an  external gland, as its excretory
dua opens into  the air.   When pain of  the head or
delirium precedes the  cutaneous eruption  of the face,
there is fome reafon to  believe,  that  the primary dif-
eafe  is  a torpor of the meninges of  the  brain;  and
that  the fucceeding violent aaion is transferred  to the
Skin  of  the face by fenfitive  affociation ;  and  that a
fimilar fympathy occurs between fome internal mem-
branes  and the  fkin over  them,  when eryfipelas ap-
pears on other  parts  of the body.   If this c'rcum-
ftance fliould  be fupported by further  evidence, this
difeafe  fliould be  removed into Clafs IV. along with
the rheumatifm and gout.   See Clafs IV.  1. 2. 17.
   This  fuppofed retropulfion of eryfipelas  on the brain
from the frequent  appearance of delirium, has  pre-
                       T  2                  vented 
  276               DISEASES     [Class It. i. J,
  vented the free ufe of the lancet early in  this difeafe
  to the deftruaion of many ;  as it  has prevented the
  fubduing of the general inflammation, and thus has in
  the end produced the particular one on the brain. Mr.
  B-----, a delicate gentleman about fixty, had, an ery-
  fipelas beginning near  one ear, and extending  by de-
  grees over the whole head, with hard, full, and ftrong
  pulfe ; blood was taken from him four or five times in
-  considerable quantity, with gentle  cathartics, with ca-
  lomel, diluents, and cool air, and he  recovered with-
  out any Signs  of delirium, or inflammation of the me-
  ninges of the  brain.  Mr. W-----, a ftrong corpulent
  man  of inferior  life,  had  eryfipelas  over his  whole
  head,  with ftrong hard pulfe: he was not evacuated
  early in the  difeafe through the  timidity of his apo-
  thecary, and  died  delirious.   Mrs. F------had eryfi-
  pelas on the face, without either ftrong or weak pulfe;
  that is, with fenfitive fever alone,  without fuperabun-
  dance or deficiency of irritation ; and recovered with-
  out any but  natural evacuations.   From  thefe three
  cafes of eryfipelas on  the  head it appears,  that the
  evacuations by the lancet muft be ufed with courage,
  where the degree of inflammation  requires it; but not
  where this degree of inflammation  is fmall, nor in the
  eryfipelas attended with inirritation, as defcribed be-
  low,
    M. M. Venefeaion  repeated according to  the de-
  gree  of inflammation.   An  emetic.   Calomel  three
  (■rains every other night.  Cool air.   Diluents, eme-
  tic  tartar in fmall dofes,  as a  quarter of a  grain
                                               every 
Cla« II. i. 3.]     OF SENSATION.              277
every fix'"hours.   Tea, weak broth, gruel,  lemonade,
neutral falts.  See Sea. XII. 6".
   Such external  applications as  carry away the heat
of the  Skin may be  of fervice,  as cold water, cold
flour, fnow, ether.   Becaufe thefe applications impede
the exertions of the fecerning veffels,  which are now
in too great aaion ; but any applications of the  Stimu-
lant kind, as folutions of  lead,  iron, copper,  or of
alum,  ufed early in the difeafe, muft be  injurious ; as
they Stimulate the fecerning veffels, as well as the ab-
forbent veffels, into  greater aaion ; exaaly as occurs
when  Stimulant eye-waters  are ufed too foon in oph-
thalmy.   See  Clafs  II.  1. 2. 2.   But as the cuticle
peels off in this cafe after the inflammation ceafes,  it
differs from ophthalmy; and ftimulant  applications
are not indicated at  all, except  where  fymptoms of
gangrene appear.  For as  a new cuticle  is formed
under the old one, as under a blifter, the  ferous fluid
between them is a defence to  the new cuticle,  and
fhould dry into a fcab by exhalation rather than  be re-
abforbed.   Hence we fee how greafy or oily applica-
tions, and even how moift ones,  are injurious in eryfi-
pelas ;  becaufe  they prevent the  exhalations of the
ferous effufion between the old and  new cuticle, and
thus retard the formation of the latter.
   Enfipelas inirritatum differs from  the former in its
being attended with  weak pulfe, and other fymptoms
of fenfitive inirritated fever.  The feet and legs are
 particularly liable to  this  eryfipelas, which precedes  or
 attends the Sphacelus or mortification of thofe parts.
                        T  3                A great 
27$             DISEASES      [Clasj II. i- 3.
A great and long coldnefs firft  affeas  the  limb,  and
the  eryfipelas on  the  ikin feems to occur  in  confe-
quence of the previous torpor of the interior mem-
branes.   As this generally attends old age, it becomes
more dangerous  in proportion  to the age, and alfo to
the habitual  intemperance of the patient in refpea to
the ufe of fermented or fpirituous liquor.
   When the former kind, or irritated eryfipelas, con-
tinues long, the  patient becomes fo weakened as to be
liable to all the fymptoms of this inirritated eryfipelas ;
efpecially where  the meninges of the brain are prima-
rily  affeaed.   As  in that cafe,  after two or three ef-
forts have been made to remove the returning periods
of torpor of the meninges to the external ikin, thofe
meninges become inflamed themfelves, and the  patient
finks under the  difeafe;  in a manner fimilar  to  that
in old gouty patients, where the torpor of the liver
or ftomach is  relieved  by affociation of. the inflamma-
tion of the membranes of the feet, and then of other
joints,  and laftly the power of  affociation  ceafing to
aa, but the excefs of fenfation continuing, the liver or
ftomach  remains torpid,  or become  themfelves  in-
flamed, and the patient is c)eftroyed.
   M. M,   Where there exifts a beginning gangrene
of the extremities, the  Peruvian bark, and  wine,  and
opium, are to be given in large  quantities ; fo as to
Strengthen  the patient, but not to  intoxicate, or to
impede his digeftion of aliment, as mentioned  in the
firft  fpecies of this  genus.   Clafs II.   1. 2. 1.   But
erherc  tfrc brain is  inflamed or  oppreffed, which  is
                                            known 
TkAssIi.*.2.;i        OF SENSATION.          279
known either by1 delirium, with quick pulfe; or by
ftupor,  and  flow refpiration with flow pulfe; other
means muft be applied.   Such as,  firft, a fomentation
on  the  head with  warm  water,  with or  without
aromatic herbs, or fait in it, Should be continued for
an  hour or two  at  a time,  and frequently repeated.
A blifter may alfo be applied on the  head,  and the
fomentation neverthelefs occafionally repeated.   Inter-
nally very gentle Stimulants, as camphor one grain or
two in infufion of valerian.    Wine and water or fmall
beer, weak broth. An enema.   Six" grains of rhubarb
and one of calomel.  Afterwards five drops of tinaure
of  opium, which may be  repeated  every  fix hour's,
if it  feems  of fervice.   Might  the  head  be  bathed
for a minute with  cold water ? or  with ether ? or
vinegar ?
   Eryfipelas fenfitivumh' a third Species, differing only
in the kind of fever which attends it, which is fimply
inflammatory, or fenfitive,  without  either excefs  of
iiritation, as in  the  firft variety;  or the defea of ir-
ritation, as in the fecond  variety: all thefe  kinds of
eryfipelas are liable  to return by periods in fome peo-
ple, who have paffed the middle of life, as at periods
of  a  lunation, or two lunations, or at the equinoxes.
When thefe periods of eryfipelas  happen to  women,
they  feem to fupply the  place of  the  receding  cata-
menia ; when to men, I have fometimes believed them
to be affociated  with a  torpor of the  liver;  as they
generally occur in thofe who have drank vinous  fpirit
exceffively, though not opprobrioufly ;  and that hence
                       T  4                  they 
280              DISEASES     [Class II. i. $.
they fupply the place of periodical piles, or  gout, or
gutta rofea.
  M. M.  As the fever requires no management^ the
difeafe takes  its progrefs fafely, like  a moderate pa-
roxyfm of the gout;  but in  this  cafe, as in fome  of
the former, the  eryfipelas does  not  appear to  be a
primary difeafe, and  fliould  perhaps  be  removed  to
the Clafs of Affociation.
   3.  Tonfillitis.  Inflammation of the tonfils.  The un-
couth term Cynanche  has been  ufed for difeafes  fo
diffimilar,  that I have divided  them into  Tonfillitis
and Parotitis; and hope  to  be excufed for adding a
Greek termination to a Latin word,  as  one of thofe
fanguages may juftly be confidered as a diafea of the
other.  . By tonfillitis  the inflammation of the tonfils
is  principally to be underftood ; but as all  inflamma-
tions generally fpread further than the  part  firft af-
feaed ; fo, when the fummit of  the windpipe is alfo
much inflamed, it may be termed tonfillitis  trachealis,
or croup.   See Clafs I. 1.3. 4. and II.  1, 2.  4.; and
when the  fummit of the gullet is  much inflamed along
with the tonfil, it may be called  tonfillitis pharyngea,
as defcribed in Dr.  Cullen's Nofologia, Genus X.  p.
92.   The inflammation of the tonfils may be divided
into three kinds, which require different methods  of
cure.
   Tonfillitis interna.   Inflammation  of the  Internal
tonfil.   When  the  fwelling is fo confiderable as  to
produce difficulty of breathing, the fize  of the  tonfil
jhould be  diminiflied  by  cutting  it  with a  proper
                                             lancet, 
 Class II. i. 3-]     OF SENSATION.              281
 lancet,  which may either give exit to the matter  it
 contains,  or may make it lefs by  discharging a part
 of the  blood.   This kind of angina is frequently at-
 tended  with irritated  fever  befides the fenfitive one,
 which accompanies  all inflammation,  and  fometimes
 requires venefeaion.   An  emetic fliould be given
 early in the difeafe, as by its inducing the retrograde
 aaion of the veffels about the fauces during the naufea
 it occafions, it may eliminate  the very caufe of the
 inflammation ;  which may have been taken  up by the
 abforbents, and  ftill continue  in  the mouths of the
 lymphatics or their glands. ( The patient fhould then
 be induced to fwallow  fome aperient liquid,  an infu-
 fion  of fenna, fo as to induce three or  four evacua-
 tions.   Gargles of all kinds are rather hurtful, as
 the aaion of ufing them is  liable  to give pain to the
 inflamed   parts;  but  the  patients  find great relief
 from frequently  holding warm water in  their mouths,
 and. putting it out again, or by fyringing warm water
^into the  mouth, as this aas  like a  warm  bath or
 fomentation to the inflamed part,   Laftly,  fome mild
 Stimulant,  as a  weak  folution  of  fait and  water, or
 of white  vitriol  and  water, may be  ufed  to  wafh
 the fauces with in the decline of the difeafe,  to expe-
 dite the  abforption of the  new veffels, if neceffary,
 as recommended in ophthalmy.
    Tonfillitis juperficialis.   Inflammation of the furface
 of the tonfils.   As the tonfils and parts in their vici-
 nity are covered with a membrane, which, though
 expofed to currents of air,  Is neverthelefs constantly
                                               kept 
282              DISEASES"      [Cla«sII. 1.3.
kept molft by mucus  and faliva, and  is  liable  to
difeafes of its furface like other mucous membranes,
as well as to fuppuration of the internal fubftance  of
the gland ; the inflammation of its furface is fucceed-
ed by  fmall  elevated puftules with matter in them,
which  foon difappears, and  the parts  either readily*
heal, or ulcers covered with floughs are left on the
furface.
   This difeafe is generally attended with  only fenfi-
tive fever, and therefore is  of no danger, and may
be diftinguifhed with great certainty from the danger-
ous inflammation or gangrene of the tonfils at the
height  of the fmall-pox, or fcarlet fever, by  its not
being attended with other fymptoms of thofe difeafes.
One emetic and a  gentle cathartic is generally fuffi-
cient ;  and the frequent fwallowing of  weak broth,
or  gruel, both without fait in them, relieves the pa-
tient, and abfolves the cure.  When thefe  tumours*
of the tonfils frequently return I  have fometimes fuf-
pected them to originate from the abforption of putrid
matter  from decaying teeth.   See Clafs I. 2. 3. 21.
and II. 2. 2. 1.
   Tonfillitis inirritata.   Inflammation of  the  tonfils
with fenfitive inirritated fever is a fymptom only of con-
tagious fever, whether attended with fcarlet eruption,
or with confluent fmall-pox, or otherwife.  The matter
of contagion is generally diffufed, not diffolved in the
air; and as this  is breathed  over  the mucaginous
furface of the tonfils, the contagious atoms are liable
!o be arretted by the tonfil;  which therefore becomes
                                                the 
Class II. t. 3.3    OF SENSATION.               .2*3
the neft  of the future difeafe, like the inflamed circle
round the inoculated punaure  of the arm in fuppo-
fititious fmall-pox.  This fwelling is. liable  to fuffocate
the patient  in fmall-pox, and to become  gangrenous  -
in fcarlet fever,  and  fome  other contagious  fevers,
which have been received in this manner.  The ex-
istence of inflammation of the tonfil previous to the
fcarlet eruption, as  the arm inflames  in the inoculated
fmall-pox,  and fuppurates  before the  variolous erup-
tion,  fliould be a criterion of the fcarlet fever being
taken  in this manner.
   M. M. All the means which Strengthen the patient,
as in the fenfitive  inirritated fever, Clafs II. 1.  2. 1.
As it is  liable  to continue a  whole  lunation or more,
great attention Should be  ufed  to nourifli the patient
with  acidulous and vinous panada, broth with vege-
tables boiled  in  it, fugar,  cream,  beer;  all which
given  frequently will  contribute much to  moiften,
clean, and heal the  ulcufcles,  or floughs, of the throat;
warm water and wine, or acid  of  lemon, fliould be
frequently applied to the tonfils by means of a fyringe,
or by means of a  capillary  Syphon,  as  defcribed in
Clafs II. 1.  2. 1.   A flight folution  of blue vitriol, as
two grains to an ounce, or a folution of fugar of lead
of about fix grains to an  ounce, may be of fervice;
efpecially the latter, applied t© the edges of the floughs,
drop  by drop by means of a fmall glafs  tube, or fmall
crow-quill with the end cut off,  or by  a camel's-hair
pencil or fponge ;  to the end  of either of which a
drpp will conveniently hang by capillary attraaion;
                                                 as 
z&4              DISEASES      [Class II. r. 3.
as folutions of lead evidently impede the progrefs of
eryfipelas on the  exterior Skin, when it is attended
with feeble pulfe.  Yet a folution of alum  injeaed
frequently by a fyringe is perhaps to be preferred, as
it immediately removes the fetor of the breath, which
muft much injure the  patient by its being perpetually
received into the lungs by refpiration.

  4. Parotitis.  Mumps, or branks,  is  a  contagious
inflammation of the parotis and maxillary glands, and
has generally been claffed under the word  Cynanchc
or Angina,  to which  it bears no analogy.   It divides
itfelf into two kinds, which  differ in the  degree of
fever  which attends them, and in the method of cure.
  Parotitis fuppurans.  The fuppurating mumps  is to
be diftinguiflied by the acutenefs of the pain, and the
fenfitive, irritated, or inflammatory fever,  which at-
tends'it.
  M. M. Venefeaion.   Cathartic with calomel three
or four grains repeatedly.   Cool  air, diluents.   This
antiphlogistic treatment is  to  be continued  no longer
than is neceffary to relieve the violence  of the pain,
as the difeafe is  attended with contagion, and  muft
run through a certain time, like  other  fevers  with
contagion.
  Parotitis mutabilis.   Mutable parotitis.   A fenfitive
fever  only, or a  fenfitive irritated fever,  generally
attendsthis kind.   And when the tumor of the parotis
and maxillary glands  fubfides, a  new fwelling occurs
in fome diftant part of the fyftem; as happens to the
                                             hands 
Class II. i. 3.]    OF SENSATION.              285
hands and feet,  at  the  commencement of the fecon-
dary fever  of the fmall-pox,  when the tumor  of the
face fubfides.  This new fwelling in the parotitis mu-
tabilis is liable to affea  the teftes in men, and  form a
painful tumor, which Should be prevented from fup-
puration by very cautious means,  if the violence of the
pain threaten fuch a termination ;  as by bathing  the
part with coldiSh water  for a time, venefeaion, a ca-
thartic ; or by a  blifter on the perinaeum, or fcrotum,
or a poultice.
  When women are affeaed with  this complaint, after
the fwelling of the  parotis and maxillary glands  fub-
fides, a tumor with  pain is liable to affea their breafts;
which, however,  I  have never feen terminate  in fup-
puration.
  On the retroceflion of the tumor of the teftes above
defcribed, and I fuppofe of that of the breafts  in
women, a delirium  of the calm kind is very liable to
occur; which in fome cafes has  been the firft fymp-
tom which  has alarmed the  friends  of the patient;
and it  has  thence  been difficult to difcover the caufe
of it without  much  inquiry ; the  previous fymptoms
having been fo flight as not  to have occafioned any
complaints.   In this delirium, if the pulfe  will  bear
it,  venefeaion fhould be  ufed,  and three or  four
grains of calomel, with  fomentation of the head  with
warm water for an hour together every three  or four
hours.
  Though this difeafe generally terminates favourably,
confidering the  numbers  attacked by  it, when it is
                                         epidemic, 
iS5             D I S E A S E$     I Class II. i. 3.
epidemic, yet it  is  dangerous at other times in every
part of its progrefs.  Sometimes the parotis or maxillary"
glands fuppurate, producing ulcers which are difficult
to cure, and frequently deftroy the patient, where there
was  a previous fcrophulous tendency.  The teftis in
men is alfo liable to filppurate with great pain,  long
confinement, and much danger; and laftly the affeaion
of the brain is fatal  to many.
  Mr. W. W.  had a Swelled throat, which  after  a
few  days fubfided.   He  became  delirious or Stupid,
in which ftate he was  dying when I faw him ; and
his friends afcribed his death to a coup de foleil, which
he was faid to have  received  fome  months  before,
when he wras abroad.
  Mr. A. B.  had a fwelling of the throat, which
after  a few days fubfided.  When I faw  him he had
great ftupor, with flow breathing, and partial delirium.
On fomenting his head with warm water for an houf
thefe fymptoms of ftupor were greatly leffened, anc?
his oppreffed breathing gradually ceafed, and he reco-
vered in  one day.
  Mr. C. D. I  found walking  about  the houfe  in  a
calm delirium without ftupor ; and not without  much
inquiry of his friends could get the  previous hiftory
of the difeafe;  which had been attended with  paro-
titis, and Swelled teftis, previous to the delirium.  A
few  ouiices of blood  were  taken away, a  gentle
cathartic was direaed, and his head fomented  with
warm water for an hour, with  a  fmall blifter on the
back, and he recovered in two or three days.
                                              Mr.- 
Class II. i. 3/}    OF SENSATION.              2&?
  Mr. D. D.  came down from London in the coach
alone, fo that no  previous hiftory could be obtained.
He was walking  about the houfe  in a calm delirium,
but could give no fenfible anfwers to any thing which
was propofed to him.  His pulfe was weak and quick.
Cordials,  a  blifter,  the bark, were in vain exhibited,
and he died  in two or three days.
  Mr. F. F. came from London  in the fame manner
In the coach.  He was mildly delirious with consider-
able ftupor,  and moderate pulfe, and could give no ac-
count of himfelf.  He continued in a kind of cataleptic
ftupor, fo that he would  remain for hours in any pof-
ture he was placed,  either  in  his chair,  or in bed ;
and did not attempt  to fpeak for about a fortnight •
and then gradually recovered.  Thefe two laft cafes
are not related as being  certainly owing  to parotitis
but as they  might probably have that origin.
  The parotitis fuppurans, or mumps with irritated
fever, is  at times epidemic  among cats, and  may  be
called parotitis felina ; as I have reafon to  believe from
the fwellings under the jaws, which frequently fuppu-
rate,  and are very fatal to thofe animals.   In  the vil-
lage  of  Haywood,  in  Staffordshire, I remember  a
whole breed of  Perfian  cats, with long white hair,
was destroyed by this malady,  along with almoft  all
the common cats of the  neighbourhood ; and as the
parotitis or mumps had  not  long  before prevailed
amongft human  beings in that part  of the country,
I recolfea being  inclined to believe,  that the cats re-
ceived  the  infeaion from mankind; though  in  all
                                             other 
 2U               DISEASES     [Class II. t. 3.
 other contagious difeafes, except the rabies canina can
 be fo called, no different genera  of animals naturally
 communicate infeaion to each other;  and I am in-
 formed, that vain efforts  have  been made to commu-
 nicate  the fmall-pox and meafles to  fome quadrupeds
 by inoculation.  A difeafe of the  head and neck de-
 stroyed almoft all  the cats  in  Weftphalia.  Savage,
 Nofol. Clafs X. Art. 30. 8.

   5. Catarrhus fenfiiivus confifts of an inflammation
 of the  membrane,  which lines the noftrils and fauces.
 It is attended with  fenfitive fever alone, and is cured
by the Steam of warm water externally, and by dilu-
ents internally, with moderate venefeaion and  gentle
cathartics.   This may be  termed  catarrhus fenfitivus,
to diftinguifh it from the catarrhus contagiofus, and is
in common language called a violent cold in the head ;
it differs from the  catarrhus calidus, or  warm catarrh,
of Clafs I. 1. 2.  7.  in the produaion of new  veffels,
or inflammation  of the membrane, and the confequent
more purulent appearance of the difcharge.
  .Rancedo  catarrhalis, or  catarrhal  hoarfenefs,  is a
frequent fymptom of this difeafe, and  is occafioned by
the pain or  forenefs which attends  the  thickened and
inflamed membranes of the larynx ;  which prevents
the mufcles of vocallity from fufficiently contraaing
the aperture of  it.   It ceafes with the inflammation,
or may be relieved by the fleam of warm water alone,
or of water and vinegar, or of water and ether.   Sec
Paralytic Hoarfenefs, Clafs III. 2. 1. 4.
              1                        6. Catarrh:-* 
 Class II. i. 3.]    OF SENSATION.              289
    6.  Catarrhus  cohtagiofus.   This malady attacks fo
 many at  the fame time, and fpreads gradually over fo
 gKeat an  extent  of country,  that  there can  be  no
 doubt but that  it is diffeminated by the atmofphere.
 In the year  1782 the fun was  for many weeks  ob-
 feured by a dry fog, and appeared red as through a
 common mift.  The material, which thus rendered the
 air muddy,  probably  caufed  the epidemic catarrh,
 which prevailed in that year, and which began far in
 the north, and  extended itfelf over all Europe.   See
 Botanic Garden, Vol. II. note on Chunda, and  Vol. I.
 Canto IV. line  294, note ; and was fuppofed to have
 been  thrown out of a volcano, which  much  difplaced
 the country of Iceland.
    In many inftances there was reafon to believe, that
 this difeafe became  contagious, as well as epidemic ;
 that is, that one perfon might receive it from another,
 as well as by the general  unfalutary influence  of the
 atmofphere.   This is difficult to comprehend, but may
 be conceived by considering  the increafe of contagious
 matter in  the fmall-pox.   In that difeafe one particle
 of contagious matter ftimulates the Skin of the  arm in
 inoculation into  morbid  aaion  fo as  to  produce  a
 thoufand particles fimilar to  itfelf; the fame thing oc-
 curs in catarrh, a few deleterious atoms Stimulate the
 mucous membrane of the noftrils into morbid aaions,
 which produce a thoufand  other  particles fimilar to
 themfelves.   Thefe  contagious particles diffufed in
 the air muft have confifted  of animal  matter, other-
' wife how could an  animal body by  being ftimulated
                        U                      bj 
-<>o              DISEASES    [Class II. i. 3.
by  them produce fimilar particles' ? Could they then
have had a volcanic origin, or muft they not rather
have been blown  from putrid marflies full  of  animal
matter ?  But the greateft part  of the folid earth has
been made  from  animal and  vegetable recrements,
which may be difperfed by volcanoes..—Future difco-
veries muft anfwer thefe queftions.
  As the fenfitive fever attending thefe epidemic ca-
tarrhs is  feldom either  much  irritated or  inirritated,
venefeaion is not always either  clearly indicated  or
forbid ; but as thofe who have died of thefe catarrhs
have  generally had inflamed livers,  with confequent
fuppuration in them, venefeaion is advifable, wherever
the cough  and fever are greater than common,  fo as
to render the  ufe of the lancet  in the leaft dubious.
And in fome cafes a fecond bleeding was neceffary,
and a  mild cathartic or two with four grains of calo-
mel ;  with mucilaginous fubacid  diluents;  and warm
fleam occafionally to alleviate the cough, finifhed the
cure.
  The  catarrhus contagiofus  is  a  frequent  difeafe
amongft horfes and  dogs; it feems firft to be diffemi-
nated amongft thefe animals by miafmata  diffufed in
the atmofphere, becaufe fo many of them receive it at
the fame time;  and  afterwards to be communicable
from one horfe or  dog to another by contagion, as
above  defcribed.   Thefe  epidemic  or contagious ca-
tarrhs more frequently occur amongft dogs and horfes
than amongft  men ; which is  probably owing to the
greater extenfion  and  fenfibility  of the  mucous mem-
                                            brane, 
Class II. i. 3.]     OF SENSATION.              291
brane, which covers the  organ of fmell,  and is dif-
fufed over their wide noftrils, and their large maxillary
and frontal  cavities.  And  to  this circumftance  may
be afcribed the greater fatality of it to thefe animals.
  In refpea to horfes, I fufpea the fever at the be-
ginning to be of the fenfitive, irritated, or inflammatory
kind, becaufe there is fo great a difcharge of purulent
mucus;  and that therefore they will bear once bleed-
ing early in the difeafe ; and alfo  one mild purgative,
confifting of about  half an ounce of aloe, and as much
white  hard  foap,  mixed together.   They fliould be
turned out to grafs  both day and night for the benefit
of pure  air, unlefs the weather be too cold fand in
that cafe they fhould be kept  in an open  airy flable,
without  being tiedjl,  that they may hang  down  their
heads to facilitate the difcharge of the mucus from their
noftrils.   Grafs fhould be offered them, or other frefli
vegetables, as carrots and potatoes,  with mafhes of
malt,  or of oats, and with  plenty of frefh  warm or
cold water  frequently in a day.  When fymptoms of
debility  appear, which may be known by the coldnefs
of the ears or  other  extremities, or when floughs can
be feen on the membrane which  lines the noftrils, a
drink  confifting of a  pint of ale with half an ounce of
tinaure  of opium in it, given every fix hours, is likely
to be of great utility.
   In dogs  I believe the catarrh is  generally joined
with fymptoms of debility early in the difeafe. Thefe
animals  Should be permitted to go about in the  open
air,  and fliould have conftant accefs to frefli water.
                       U  2                   The 
-■$;               DISEASES     [Class II. r. 3.
The ufe of being  as  much  as  may be in  the  air is
evident, becaufe all the air  which they breathe  paffes
twice over the putrid floughs of the mortified parts
of  the  membrane   which lines the noftrils, and  the
maxillary  and frontal cavities; that is, both during
infpiration  and  expiration ;  and  muft therefore be
loaded  with  contagious  particles.   Frefh new  milk,
and frefli broth, fliould be given them very frequently,
and they fliould  be fuffered  to go  amongft  the  grafs,
which they fometimes eat for the purpofe of an emetic ;
and if poffible fhould have accefs to a  running ftream
of water.   As  the contagious mucus of the noftrils,
both of thefe animals and of horfes, generally  drops
into the water  they attempt to drink.  Bits of raw
flefli, if  the dog will eat them, are preferred to cooked
meat ; and from five to ten drops of tinaure of opium
may be given with advantage, when fymptoms  of de-
bility are evident,  according to the fize of the dog,
every fix hours.  If floughs can be  feen in the noftrils,
they Should be moiftened twice a day,  both in  horfes
and dogs, with a folution of fugar of lead, or of alum,
by means of  a fponge fixed  on  a  bit of whale  bone,
or  by a fyringe.   The  lotion  may be made by dif-
folving  half an ounce of fugar of lead in  a pint of
water.
   Ancient philofophers  feem  to  have believed, that
the contagious miafmata in their warm climates affeaed
horfes and dogs previous to mankind.  If thofe con-
tagious  particles were fuppofed to be diffufed amongft
the heavy inflammable air, or carbonated hydrogen, of
                                             putrid 
Class II. r. 3.]     OF SENSATION.              ^;
putrid marines, as thefe animals hold their heads down
lower to the ground, they may be  fuppofed to have
received them fooner than men.  And though men
and quadrupeds might receive a difeafe from the fame
fource of marlh-putrefaaion, they  might  not after-
wards be able to infea each other, though they might
infea other  animals  of  the fame genus; as the new
contagious matter generated in their own bodies might
not be precifely fimilar to that received ; as happened
in the jail-fever at Oxford, where thofe who took the
contagion and died, did not infea others.
      On mules and dogs the infe<ftion firft began,
      And, laft, the vengeful arrows fix*d on man.
                             Pope's Homer's Iliad, I.

   7.  Peripneumonia fuperficialis.   The fuperficial or
fpurious peripneumony  confifts  in  an inflammation of
the membrane, which lines the bronchia,  and bears
the fame analogy  to the true peripneumony, as the
inflammations of other membranes  do to  that of the
parenchyma, or fubftantial  parts of the vifcus, which
they Surround.   It  affeas elderly people, and fre-
quently occafions their  death; and exifts  at  the end
of the true peripneumony, ©r along with it; when the
lancet has not been ufed fufficiently  to cure by reab-
forbing  the  inflamed parts, or what is termed by r«-
folution.
   M. M. Diluents,  mucilage, antimonials,  warmifh
air conftantly changed,  venefeaion once,  perhaps
twice, if the pulfe  will bear it. Oily  volatile draughts.
                       IT  3                Balfams? 
294
DISEASES      [Class II. i. 3.
Balfams?  Neutral  falts  increafe  the  tendency  to
cough.  Blifters in fucceSfion about the cheft.   Warm
bath.   Mild  purgatives.   Very  weak chicken broth
without fait in it.  Boiled onions.  One grain of calo-
mel every night for a week. • From five drops to  ten
of tinaure of opium at  fix every night, when the pa-
tient becomes weak.  Digitalis?  See Clafs II. t. 6. 7.

   8.  Pertuffis.  Tuffis convulfiva.    Chin-cough  re-
fembles peripneumonia  fuperficialis  in its confifting in
an inflammation of the  membrane which lines the air-
veffels of the lungs;  but  differs in the circumftance of
its being contagious; and is on that account  of very
long duration ; as the whole of the lungs are probably
not infeaed  at the fame  time, but the contagious in-
flammation continues gradually to creep on the mem-
brane.  It may in  this  refpea  be compared to the
ulcers in  the pulmonary confumption ;  but it differs
in  this, that  in  chin-cough  fome branches  of   the
bronchia heal, as others  become inflamed.
   This complaint is not  ufually claffed amongft febrile
diforders, but a fenfitive fever may generally be per-
ceived to attend it during fome part of the  day,  efpe-
cially in  weak patients.  And a peripneumony  very
frequently fupervenes,  and  deftroys great numbers
of children,  except  the  lancet or four or fix leeches
be immediately and repeatedly ufed.  When the child
has permanent difficulty  of breathing, which continues
 between  the coughing  fits:  unlets  blood be taken
 from it, it  dies in  two, three,  or four days of the
                                       inflammation 
Class II. i. 3-]    OF SENSATION.              395
inflammation of the  lungs.  During this permanent
difficulty of breathing the \i hooping-cough abates, or
quite ceafes, and  returns  again after once or twice
bleeding ; which is then a good fymptom, as the child
now poffeffing the power to cough Shews the difficulty
of breathing to be abated.   I dwell longer upon this,
becaufe many lofe their lives from the difficulty there
is  in bleeding young children;  where  the apothecary
is  old or clumfy, or is not furniflied witn a very Sharp
and fine-pointed lancet.  In this  diftreffing fituation
the  application  of four leeches to one of the child's
legs, the wounds made by  which Should continue to
bleed an hour or two,  is a fuccedaneum;  and faves
the patient, if repeated once or twice according to the
difficulty of the refpiration.
   The  chin-cough  feems to refemble the gonorrhoea
venerea in  feveral circumftances.  They are both re-
ceived by infeaion, are both difeafes of the  mucous
membrane,  are both generally cured in four or fix
weeks without  medicine.   If ulcers in the  cellular
membrane  under  the mucous membrane occur,  they
are of a phagedenic kind, and deftroy the  patient in
both difeafes, if no medicine be administered.
   Hence the  cure  fliould be fimilar in both thefe dif-
eafes ;  firft  general  evacuations  and  diluents, then,
after a week  or  two, I have believed the following
pills  of great  advantage.   The dofe for a  child of
about three years  old  was one Sixth part of a grain
of calomel,  one fixth  part  of a grain of opium,  and
two grains of rhubarb, to be taken twice a day.
                        U 4                    The 
296               DISEASES    [Class II. 1. 3.
   The opium promotes  abforption from the mucous
membrane, and hence contributes to heal  it.   The
mercury prevents ulcers from being formed under the
mucous  membrane,  or  cures  them, as  in the lues
venerea ; and the  rhubarb is  neceffary  to keep the
bowels open.
   M. M.  Antimonial vomits  frequently  repeated.
Mild  cathartics. Cool air.  Tinaure  of cantharides^
or repeated bfifters ;  afterwards opiates in fmall dofes,
and the  bark.   Warm bath frequently ufed.  The
fleam of warm water with a little vinegar in it may be
inhaled twice a day.   Could the breathing of carbonic
2Cid gas mixed with atmofpheric air be of fervice ?
Copious  venefeaion, when a difficulty of breathing
continues between the fits of coughing ;  otherwife the
cough and the expeaoration ceafe,  and  the patient is
deftroyed.   Ulcers of the lungs fometimes fupervene,
and the  phthifis pulmonalis in a few  weeks termi-
nates in death.  Where the cough  continues after
fome  weeks without much of the whooping, and a fen-
fitive fever daily fupervenes, fo as to  refemble heaic
fever from  ulcers of the  lungs; change of air for a
week or  fortnight aas as a charm, and reftores  the
patient beyond the hopes of the phyfician.
   Young children Should lie with  their heads and
Shoulders raifed;  and fliould  be constantly watched
day and  night;  that when the  cough  occurs, they
may be held up eafily, fo as to ftand  upon their feet
bending a little forward ; or nicely fupported in that
pofture which they feem to put themfelves  into.   A
                                              bow 
Class II. i. 3.]    OF SENSATION.      '        792
bow of  whalebone, about the fize of the  bow of a
key, is very ufeful  to extraa the phlegm out of the
mouths of infants  at  the time of  their coughing;
as an handkerchief, if applied at the time of their
quick  infpirations after long  holding their breath,  is
dangerous, and may fuffocate the patient in an inftant,
as I believe has fometimes happened.

   9.  Variola difcreta.  The  fmall-pox is well divided
by Sydenham into  diftina and confluent.  The for-
mer confifts  of  diftina  puftules, which appear  on
the  fourth day  of the  fever, are circumfcribed and
turgid ;  the  fever  ceafing when the eruption is com-
plete.    Headach,  pain  in  the  loins,  vomiting fre-
quently, and  convulfive fits fometimes, precede the
eruption.
   The  diftina fmall-pox is attended with  fenfitive
fever  only, when  very  mild,  as in moft  inoculated
patients ;  or  with  fenfitive  irritated  fever, when the
difeafe is greater:  the danger  in this kind  of fmall-
pox is owing either  to  the  tumor and forenefs of the
throat about the  height, or eighth day of the erup-
tion ;  or to the violence  of the fecondary fever.  For,
firft, as the natural difeafe is generally taken by par-
ticles  of the duft of the contagious matter dried and
 floating in the air, thefe are  liable to be arretted by
 the mucus about the throat  and tonfils in their paffage
 to the lungs, or to the ftomach, when they are pre-
 viously mixed with faliva in the mouth.   Hence the
 throat inflames like  the ;:rm  in  inoculated patients ;
                                                and 
292               DISEASES    [Class II. i. 3.
and this increafing, as the  difeafe advances, deftroys
the patient about the height.
   Secondly, all thofe upon the face and  head come
out about the fame  time,  namely, about  one day
before thole on the  hands, and two before thofe in
the trunk; and thence, when the head is very full,
a danger arifes from the fecondary fever,  which is  a
purulent,  not  a variolous  fever ; for  as  the  matter
from all thefe  of the face and head  is reabforbed  at
the fame  time, the  patient is destroyed  by the vio-
lence  of this  purulent  fever; which  in  the  diftina
fmall-pox can only be abated by   venefeaion and ca-
thartics ;  but in the  confluent fmall-pox requires cor-
dials  and  opiates, as  it  is  attended  with  arterial
debility.   See Sea.  XXXV.  1.  and XXXIII.   2. 10.
   When  the  puftules on  the face recede, the face
fwells ; and when thofe of the hands recede, the hands
fwell; and  the  fame of the feet in fucceffion. Thefe
fwellings feem to be owing to the abforption of variolous
matter, which by  its ftimulus excites the cutaneous
veffels to fecrete  more lymph,  or ferum, or  mucus,
exaaiy as happens by the ftimulus of a blifter.   Now,
as a blifter fometimes produces ftrangury  many hours
after  it lias rifen ; it is plain, that a part of the can-
tharides  is abforbed, and carried to  the  neck of the
bladder;   whether  it enters the  circulation,  or  is
carried thither by retrograde movements of the urinary
branch of lymphatics; and by parity of reafoning the
variolous matter is abforbed, and fwells the face and
hands by its ftimulus.
                                             Variola 
Class II. i. 3.]    OF SENSATION.               299
  Variola confiuens.  The confluent fmall-pox confifts
of numerous puftules,  which appear on the third day
of the fever,   flow  together, are irregularly circum-
fcribed, flaccid, and little  elevated;  the fever  conti-
nuing  after the eruption is complete; convulfions do
not  precede  this kind of fmall-pox, and are fo far to
be efteemed a  favourable fymptom.
   The confluent  fmall-pox  is attended with fenfitive
inirritated fever, or inflammation with arterial debility;
whence the danger of  this difeafe is owing to the.
general tendency to gangrene, with petechia?, or pur-
ple fpots, and hcemorrhages; befides the two fources
of danger  from the tumor of  the throat about the
height,  or eleventh day  of the eruption,  and the
purulent  fever after that  time; which  are generally
much more to be dreaded in this than in the diftina
 fmall-pox defcribed above.
   M. M. The method of treatment  muft  vary with
 the degree and kind of fever.   Venefeaion may be
 ufed in the  diftina fmall-pox early  in the difeafe,
 according to the ftrength  or hardnefs of the  pulfe;
 and perhaps on the firft day  of the  confluent fmall-
 pox,  and even  of  the plague, before the fenforial
 power is exhaufted by the violence of the arterial
 aaion ?   Cold air,  and even  wafliing or bathing in
 cold water, is a powerful means in perhaps  all erup-
 tive difeafes attended with fever; as the quantity of
 eruption depends on the  quantity of the fever, and
 the aaivity of the cutaneous veflels ; which may  be
 judged  of by the heat produced on the  Skin ; and
                                              which 
300               DISEASES.     [Class II. i. 3.
which latter  is immediately abated by expofure to ex-
ternal cold.   Mercurial  purges, as three  grains  of
calomel repeated every day during the eruptive fever,
fo as to induce three or four ftools, contribute to abate
inflammation  ; and is believed by fome to have  a Spe-
cific effea on the variolous,  as  it is fuppofed to have
<m the venereal contagion.
   It has been faid,  that opening the pock  and taking
out the matter has not  abated  the fecondary  fever;
but as I had  conceived,  that  the pits,  or marks  left
after  the  fmall-pox,  were owing to the acrimony of
the matter beneath the hard  fcabs, winch not being
able to exhale eroded the Skin,  and  produced  ulcers,
I direaed  the faces of two patients in the confluent
fmall-pox  to  be covered with cerate* early in  the dif-
eafe,  which was daily  renewed ; and I was induced to
think, that they had much lefs of the fecondary fever,
and were  fo little  marked,  that one of  them, who
was   a  young lady,  almoft  entirely  preferved  her
beauty.  Perhaps mercurial plafters, or cerates, made
without turpentine  in  them,  might have  been more
efficacious  in preventing the marks, and efpecially if
applied early in the difeafe, even on  the firft day of
the eruption, and renewed daily.  For it appears from
the experiments of Van Woenfel, that calomel  or fub-
limate  corrofive,  triturated  with  variolous  matter,
incapacitates it from  giving, the difeafe  by inocula-
tion.    Calomel or fublimate  given as an alterative
for ten days  before inoculation,  and till the eruptive
fever commences,  is faid with certainty to render the
                                             'difeafe 
Class II. i. 3.]    OF SENSATION.              3o,
difeafe mild by the fame author.  Fxper. on  Mercury
by Van Woenfel, translated by Dr. Fowlc, Salisbury.
  Variola inoculata.   The world  is much indebted  to
the great difcoverer of the good effeas of inoculation,
whofe name  is unknown; and  our  own  country  to
Lady Wortley Montague for  its introduaion into this
part of Europe.   By inferting the variolous contagion
into the arm, it is not received by the tonfils, as ge-
nerally happens,  I fuppofe, in the natural  fmall-pox;
whence there is no dangerous fwelling of  the throat,
and  as the puftules are  generally few and diftina,
there is  feldom  any fecondary fever; whence thofe
two fources of danger are precluded ;  hence when the
throat in  inoculated fmall-pox is much inflamed and
fwelled, there is  reafon to believe,  that  the  difeafe
had been previoufly taken by  the tonfils in the natural
way.—Which alfo, I fuppofe, has generally happened,
where the confluent kind of fmall-pox has occurred  on
inoculation.
  I  have known  two inftances, and have  heard  of
others,  where the  natural fmall-pox began fourteen
days  after the contagion  had been received;  one  of
thefe inftances was of  a countryman, who went to a
market town many miles  from his home, where  he
faw  a perfon  in  the fmall-pox, and  on returning the
fever commenced that day fortnight:  the other was of
a child, whom the ignorant mother carried to another
child ill of the fmall-pox,  on purpofe to communicate
the difeafe to it;  and the variolous fever began on the
fourteenth day from that time.   So that in both thefe
                                             cafes. 
 jo;                DISEASES    [Class II. i. 5.
 cafes fever commenced in half a lunation after the con-
 tagion was received.  In the inoculated fmall-pox the
 fever generally commences on the feventh day, or after
 a  quarter of  a lunation ;  and  on this  circumftance
 probably depends the  greater mildnefs of the  latter.
 The reafon of which  is difficult to comprehend; but
 fuppofing the faas to be generally as above related, the
 flower progrefs of  the contagion  indicates a greater
 inirritability of the fyftem, and  in confequence a ten-
 dency to malignant rather than to inflammatory  fever.
 This difference of the  time between the  reception  of
 the infeaion and the fever in the natural  and artificial
 fmall-pox may neverthelefs depend on its being inferted
 into a different feries of veffels;  or to fome unknown
 effea of lunar periods.  It is a fubjea of great curiofity,
and deferves further investigation.
   When the inoculated  fmall-pox is  given under all
 the moft favourable circumftances  I believe lefs than
 one in a thoufand mifcarry, which  may be afcribed  to
 fome unavoidable accident,  fuch  as the patient having
 previoufly received the infeaion, or being about to be
 ill of fome other  difeafe.   Thofe which have  lately
mifcarried under inoculation,  as  far as has come to my
knowledge,  have been chiefly children at the breaft ;
 for in thefe the habit of  living in the  air has been
confirmed by  fo fhort a time,  that it is much  eafier
 deftroy ed, than when thefe habits of life have been
 cftablifhed  by  more  frequent repetition.  See  Sea.
 XVII. 3.  Thus it appears  from the bills of mortality
 kept in  the great cities of London, Paris, and Vienna,
                                              that 
Class II. i. 3.]    OF SENSATION.              3*3
that out of every thoufand children above three hun-
dred  and fifty die under two years old.  (Kirkpatrick
on Inoculation.)  Whence a ftrong reafon againft our
hazarding inoculation before that age is paffed, efpe-
cially in crowded towns ; except where the vicinity of
the natural contagion renders it neceffary, or the con-
venience of inoculating  a  whole family at a time ; as
it then becomes better to venture  the lefs favourable
circumftances of the age of the patient, or the chance
of the pain from toothing, than .to  rifle  the infeaion in
the natural way.
   The moft favourable method confifts in, firft, for a
week before  inoculation, reftraining  the patients from
all kinds of fermented or fpirituous liquor, and from
animal food ; and by giving them from one grain to
three or  four  of calomel  every other day for  three
times.  But if the patients be in any the leaft danger
of  taking the  natural infeaion, the inoculation had
better be immediately performed, and  this abstinence
then began;  and two  or  three gentle  purges with
calomel  fhould be   given, one  immediately, and on
alternate  days.  Thefe cathartics fhould not  induce
more than two  or three ftools.  I have feen  two ir>
ftances of a confluent fmall-pox in inoculation follow-
ing a violent  purging induced by  too large a dofe of
calomel.
   Secondly,  the matter ufed for inoculation fliould be
in a fmall quantity, and warm, and fluid.  Hence it is
belt when it can be recently taken from a patient  in
the difeafe ;  or otherwife it may be  diluted  with part
                                                of 
3©4              DISEASES     [Class II.  i. 3.
of a drop of warm water, fince its fluidity is  likely  to
occafion  its immediate abforption ;  and the wound
lliould be made as fmall and fuperficial as poffible,  as
otherwife ulcers have been fuppofed  fometimes  to en-
fue with  fubaxillary abfceffes.  Add to this,  that the
making two punaures either on the  fame,  or one  on
each  arm, fecures the fuccefs  of the operation in  re-
fpea to communicating the infeaion.
   Thirdly, at  the time of the  fever  or  eruption the
application of cool air to thofe  parts of the Skin, which
are too  warm, or  appear red,  or are  covered with
what  is termed a ralh, fliould  be ufed freely, as well
as during the  whole difeafe.   And at the fame time,
if the  feet or hands  are  colder than natural, thefe
fhould be  covered  with  flannel.    See  Clafs  IV.
2. 2.  10.

   10. Rubeola irritata, ?norbilli.  The  meafles com-
mence with fneezing,  red eyes, dry hoarfe cough, and
is attended with fenfitive irritated  fever.  On the
fourth day, or a little later, fmall thick  eruptions ap-
pear, fcarcely  eminent above the Skin, and, after three
days, changing into very fmall branny fcales.
   As the contagious material of the  fmall-pox may  be
fuppofed to be diffufed in  the air like a fine dry pow-;
der, and mixing with the faliva in the mouth to infea
the tonfils  in its paffage to the Stomach ; fo the  con-
tagious material of the meafles may be fuppofed to  be
more completely diffolved in the air, and thus  to  im-
part it* poifon to  :hr membrane of the noftrils, which
4
covers 
 Class II. i. 3.]    OF SENSATION.              305
 covers  the fenfe of fmell; whence  a catarrh with
 fneezing ufliers in the fever ;  the termination  of the
 nafal dua of the lacrymal fac is fubjea to the fame
 ftimulus and  inflammation, and affeas by fympathy
 the lacrymal glands, occafioning a great flow of tears.
 See  Sea. XVI. 8.  And  the rednefs  of the eye and
 eyelids is produced in confequence of .the tears being
 in fo great quantity,  that  the faline part  of them  is
 not entirely reabforbed.   See Sea. XXIV. 2. 8.
   The contagion of the meafles, if it  be taken a fuf-
 ficient time  before inoculation,  fo that the  eruption
 may commence before the variolous fever  comes on,
 ftops the progrefs of the  fmall-pox in the inoculated
 wound, and delays it till the meafle-fever  has finifhed
 its career.   See  Sea. XXXIII.  2. 9.
   The meafles are  ufually attended with inflamma-
 tory  fever  with ftrong pulfe,  and bear the  lancet in
 every ftage of the difeafe.  In  the early  periods of
 it, venefeaion renders the  fever  and cough lefs; and,
 if any fymptoms of peripneumony occur,  is repeat-
 edly  neceffary ;  and at the decline of the  difeafe, if
 a cough be left  after the eruption  has  ceafed,  and
 the fubfequent branny fcales are falling  off, venefec-
 tion  Should be immediately ufed ;  which prevents the
 danger of confumption.   At this time alfo change of
 air is of material confequence, and often removes the
 cough like a charm,  as  mentioned in  a fimilar fitua-
 tion  at tlie  end of the chin-cough.
   Rubeola inirritata.   Meafles with inirritated  fever,
or with weak  pulfe,  has been  fpoken of by fome wri-
                        X                    ters. 
306              DISEASES     [Class II. *. 3,
ters.  See London Med. Obferv. Vol. IV.  Art. XI.
It has alfo been faid to have been attended  with fore
throat.  Edinb. Effays,  Vol.  V. Art. II.  Could the
icarfet  fever have been miftaken for the meafles ? or
might one of them have fucceeded the other, as in the
meafles  and fmall-pox  mentioned  in  Sea.  XXXIII.
2. 9. ?
  From what has been faid, it is probable that inocu-
lation might difarm the  meafles as much  as the fmall-
pox, by preventing the catarrh and frequent  pulmo-
nary inflammation, which attends  this difeafe ;  both
of which arc probably the confequence of the imme-
diate application  of the contagious  miafmata to thefe
membranes.   Some attempts  have been  made, but a
difficulty feems  to arife in giving the  difeafe ; the
blood, I conjeaure, would not infea, nor the tears ;
perhaps the mucous difcharge from the noftrils might
fucceed ; or a drop of warm water put  on  the erup-
tions, and feraped off again with the edge of a lancet;
or if the branny fcales  were  colleacd, and moiftened
with a  little warm  water?  Further  experiments  on
this fubjea would be worthy the public attention.

   11.  Scarlatina mitis.   The fcarlet fever exifts with
all degrees of virulence, from  a flea-bite to the plague.
The infeaious material of this difeafe, like that of the
fmall-pox, I fuppofe  to be diffufed, not diffolved, in
the air; on which account I fufpea,  that it requires
a much nearer approach  to the fick,  for a  well per-
fon to receive  the infection, than in the  meafles; .the
                                         contagion 
Class II. I. 3.]    OF SENSATION.              307
contagion of which I believe to be more volatile, or
diffufible in the atmofphere.   But as the contagious
miafmata of fmall-pox and fcarlet  fever  are fuppofed
to be more fixed,  they may remain for  a longer time
in clothes or furniture ; as a thread dipped in vario-
lous matter has given the difeafe by inoculation after
having been expofed many days to  the air,  and after
having been kept many months in a phial.   This alfo
accounts for the flow or fporadic progrefs of the fear-  „
let fever,  as  it infeas  others at but a very fmall dif-
tance from the fick ; and does not produce a quantity
of pus-like matter, like the fmall-pox, which can ad-
here to the clothes of the  attendants,  and when dried
is liable to be fhook off in the form  of  powder, and
thus propagate the infeaion.
   This contagious powder of the  fmall-pox,  and of
the  fcarlet fever,  becomes mixed with  faliva  in the
mouth,  and is thus carried to the  tonfils, the mucus
of which arrefts fome particles of this deleterious ma-
terial ;  while other parts of it are carried into the
ftomach, and  are probably decompofed  by the power
of digeftion ;  as  feems to happen to the venom of
the  viper, when  taken into  the ftomach.  Our per-
ception  of bad  taftes in our mouths,   at the  fame
time that we perceive difagrceable odours to our nof-
trils, when we inhale very bad  air, occafions us to
fpit  out  our faliva; and  thus, in fome  inftances, to
preferve ourfelves from infeaion.   This has been fup*
pofed to originate from  the  fympathy  between the
organs of tafte and fmell; but any  one-who' goes into
                       X 2                  -a fick 
30S              DISEASES      [Class II. i. 3.
a fick room clofe fhut up, or into a crowded affembly-
room, or tea-room, which is not fufficiently ventilated,
may eafily mix  the  bad air with  the faliva on  his
tongue fo as to  tafte it; as I have myfelf frequently
attended to.
   Hence it appears that thefe heavy infeaious matters
are more liable to mix with the faliva, and inflame the
tonfils, and that either before or at the commencement
o'" the fever ; and this is  what generally happens ift
the fcarlet fever, always  I fuppofe in the malignant
kind, and very frequently in the mild kind.  But as
this infeaion may be taken by other means, as by the
ikin, it  alfo happens in the moft mild kind, that there
is no inflammation of the tonfils at  all;  in the fame
manner as there is  generally no inflammation of the
toniils in the inoculated fmall-pox.
   In the mild Scarlatina on the fourth day of the fever
the face fwells a little, at the fame time a florid  red-
nefs  appears on various  parts of  the Skin,  in large
blotches, at length  coalefcing, and after three days
changing into branny fcales.
   M. M.  Cool air.  Fruit.   Lemonade.  Milk  and
water-

   Scarlatina maligna.   The  malignant  fcarlet fever
begins with  inflamed tonfils;  which are  fucceeded by  '
 dark drab-coloured  floughs  three or five lines  in dia-
 meter,  flat,  or beneath the furrounding  furface ;  and
which  conceal  beneath them  Spreading gangrenous
 nkers.   The fwellings of the tonfils are fenfible to the
eye 
Class «. i. 3 J     OF SENSATION.             3°9
eye and touch externally, and have an elaftic  rather
than an ocdematous feel,  like parts in the vicinity of
o-angrenes.  The pulfe is very quick  and weak, with
delirium, and the patient generally dies in a few days ;
or if he recovers, it is by flow degrees, and attended
with anafarca.
  M. M.  A  vomit  once.   Wine.   Beer.   Cyder.
Opium.   Bark, in fmall repeated dofes.   Small, fuc-
ceffive blifters, if the extremities are cooler than natu-
ral.   Cool air on the hot parts of the ikin,  the cool
extremities being  at  the  fame  time  covered.   Iced
lemonade.  Broth.  Cuftards. Milk.   Jellies.   Bread
pudding.   Chicken.   Touch the  ulcers  with a dry
fponge to abforb the contagious matter, and then with
a fponge filled with vinegar, with or without fugar of
lead diffolved in it, about  fix grains to an ounce ; or
with a very little blue vitriol diffolved in it, as a grain
to an ounce;  but  nothing fo inftantaneoufly correas
the putrid fmell of ulcers as a folution of alum, about
half  an ounce to a pint of water, which  Should be a
little warmiSh, and injeaed  into the fauces gently by
means of  a fyringe.  Thefe Should be repeated  fre-
quently in a day, if it can be done eafily, and without
fatigue  to the child.   A little powder of bark taken
frequently into the mouth, as a grain or two, that  it
may mix with the faliva, and thus frequently ftimulate
the dying tonfils.  Could  a  warm  bath  made of de-
coaion of bark, or a  cold  fomentation with it, be of
Service?  Could  oxygsne gas mixed with  common air
Stimulate  the  languid fyftem ?  Small elearic  fliocks
                       X 3                 through 
3io              DISEASES     [Class II. i. 3,
through the tonfils every hour ?  ether  frequently ap-
plied externally to the Swelled tonfils ?
   As this difeafe is attended with the greateft degree
of debility, and as Stimulant  medicines, if given in
quantity, fo as to produce more than natural warmth,
contribute to expend the already too much exhaufted
fenforial power; it  appears,  that there is nothing fo
neceffary to be nicely attended to,  as to prevent any
unneceffary motions of the fyftem ; this is beft accom-
plifhed by thp application of cold  to thofe  parts of
the Skin,  which are  in  the leaft too  hot.   And fe-
condly, that the exhibition of the bark in fuch quan-
tity, as not  to opprefs the ftomach and injure digef-
tion, is next to be attended to, as not being liable to
increafe the aaions  of the fyftem beyond their natural
quantity;  and that opium and wine fliould be given
with the greateft caution, in very fmall repeated quan-
tity, and fo managed as to prevent, if poflible, the
cold fits  of fever; which probably occur  twice in 25
hours, obeying the lunations like  the tides,  as men-
tioned in Sea. XXXII. 6, that is, I fuppofe, the cold
periods, and confequent exacerbations of fever, in this
malignant  fcarlatina,  occur  twice  in  a lunar  day ;
which is  about ten minutes  Jefs than  25 hours;  fo
that if the commencement of  one cold fit  be marked,
the commencement of  the next may be expeaed,  if
not difturbed by the exhibition of wine or opium, or
the application of blifters, to occur  in about twelve
hours and  a half from the commencement  of the for-
mer •* or if not prevented by large  dofes of the bark.
                                               No 
 Class II. i. 3 ]     OF SENSATION.             3n
   No one could do' an aa more beneficial  to  fociety,
 or glorious to himfelf, than by teaching mankind how
 to inoculate this fatal difeafe;  and  thus to deprive it
 of its  malignity.  Matter  might  be taken from the
 ulcers in  the  throat,  which Would probably'convey
 the  contagion.   Or warm water might be put on the
 eruption, and fcraped off again  by the edge of a  lan-
 cet.   Thefe experiments could be attended with no
 danger,  and Should be  tried for the public  benefit,
 and  the honour of medical fcience.

   12. Miliaria.   Miliary fever.    An  eruption pro-
 duced by the warmth, and  more particularly by the
 ftimulus of the points of the wool  in flannel or blan-
 kets applied to the Skin, has been frequently obferved ;
 which, by  cool  drefs, and bed-clothes  without flan-
 nel,  has foon ceafed.   See  Clafs I.  i, 2. 3.   This,
 which may be called miliaria fudatoria, has been con-
 founded  with other miliary fevers, and has made the
 exiftence of the latter doubted.   Two kinds of erup-
 tions I have feen formerly attended with fever,  but
 did not  fufficiently mark their progrefs, which I con-
 ceived to  be  miliary eruptions,  one  with  arterial
 ftrength,  or with  fenfitive irritated fever,  and  the
 other with arterial debility, or with fenfitive inirritated
 fever.
   In the  former of thefe,   or  miliaria irritata,  the
 eruptions were diftina and larger  than  the fmall-pox,
and the fever was not  fubdued without  two or three
 vcnefeaions, and repeated cathartics with calomel.
                      X 4                     The. 
312             DISEASES      [Class II. 1.3.
   The latter, or miliaria inirritata, was attended with
great arterial debility; and during the courfe of the
fever pellucid  points appeared within  the fkin, par-
ticularly on the foft parts of the fingers.  And, in one
patient,  whom I efteemed near her end, I well recol-
fea  to  have obferved  round  pellucid  globules; like
what are Often feen  on  vines in hot-houfe$; no larger
than the fmaHeft pins' heads, adhere to her neck and
bofom ; which were hard to the touch, but were eafity
rubbed off.  Thefe  difeafes, if they are allied, do not
differ more than the kinds of  fmall-pox ; but require
many further obfervations.
   The eruption fo often feen ori children in the cradle,
and called by t)ie nurfes  red-gum;  and which is  at-
tended  with, fome degree of fever, I fufp'ea to be pro-
duced by too great warmth, and  the contaa  of flannel
next their  tender  Skins,  like  the miliaria fudatoria ;
and like that requires cool air, cool clothes,  and linen
next their Skin,

   13. Pefilis,   The plague, like other difeafes of this
clafs, feems to be fometimes mild, and fometimes ma-
lignant ; according to the testimony  of different wri-
ters.   It  is faid  to be  attended with inflammation,
with the greateft arterial debility, and to be very con-
tagious, attended  at an  uncertain time of the  fever
with buboes and  carbuncles.  Some  authors affirm,
that the contagion of the plague may be repeatedly
received, fo as to  produce the difeafe; but as this
H contrary to the  general analogy of all contagious
                                            difeafes, 
Class II. i. 3.]    OF SENSATION.              313
difeafes,  which are attended with fever, and  which
cure themfelves fpontan'eoufly; there is reafon  to fuf-
pca,  that  where it has been  fuppofed to  have been
repeatedly received, that fome other fever  with arte-
rial debility has been miftaken for it,  as  has probably
univerfally been the cafe, when the fmall-pox has been
faid to have been twice experienced.
   M. M. Venefeaion has been recommended by fome
writers on  the  firft day,  where the inflammation was
fuppofed to be attended with fufficient arterial Strength,
which might perhaps fometimes happen,  as the bubo
feems to be a fuppuration; but the carbuncle, or an-
thrax, Is a  gangrene of the part, and Shews the greateft
debility of circulation.  Whence all the  means before
enumerated in  this genus  of difeafes  to fupport the
powers of life  are to be administered.  Currents of
cold air, cold water,  ice, externally on the hot parts
of the Skin.
   Tlie  methods  of preventing the fpreading  of this
difeafe have been much canvaffed, and feem to conSift
in preventing all congregations  of the people, as in
churches, or play-houfes ; and to remove the fick into
tents on  fome airy common by the fide of a river, and
fupply them with frefli food, both animal  and vege-
table, with beer and wine in proper quantities, and to
encourage  thofe  who  can,  daily to wafh  both their
clothes and themfelves.
   The pefilis vaccina, or  difeafe  amongft the cows,
which affliaed  this  iiland about  half a  century ago,
feems to have been a conir.gious  fever with great ar-
                                              terial 
 314              DISEASES      [Class II. x. j.
terial debility;  as  in fome of them in the latter ftage
of the difeafe,  an emphyfema  could  often  be felt  in
fome  parts, which evinced a confiderable progrefs  of
gangrene  beneath the ikin.  In the fenfitive inirritated
fevers of thefe animals,  I fuppofe  about fixty grains
of opium, with two  ounces of cxtraa  of  oak-bark,
every fix hours, would fupply them  with an  efficacious
medicine ; to which might  be added thirty grains of
vitriol of iron, if any  tendency to bloody urine fhould
appear, to which this animal is liable.   The  method
of preventing the infeaion from fpreading, if it fhould
ever again gain accefs to  this ffland,  would be imme-
diately to obtain an order from government to prevent.
any  cattle from being removed,  which were found
within five miles of the place fuppofed to be infeaed,
for a  few days; till the certainty of the exiftence of
the peftilence could be afcertained, by a  committee of
medical people.   As  foon as this was afcertained, all
the cattle within five miles of the place fhould be im-
mediately flaughtered, and  confumed within  the cir-
cumfcribed diftria; and their hides put into lime-water
before proper infpeaors.

   14. Pemphigus is a  contagious difeafe attended  with
bladdery eruptions  appearing on the  fecond or  third
day, as large as filberts, which remain many  days, and
then effufe  a thin ichor.  It feems  to be either  of a
mild kind with fenfitive fever only, of which I  have
feen two  inftances, or with irritated, or with inirri-
tated  fever, as appears from the obfervations of M.
                                          Salabert. 
Class II. i. 3 J     OF SENSATION.              315
Salabert.   See Medical  Comment,  by Dr. Duncan,
Decad. II. Vol. VI.

   15. Varicella.   Chicken-pox is accompanied with
fenfitive fever,  puftulcs break out after  a mild  fever
like the fmall-pox, feldom  fuppurate,  and generally
terminate in fcales without fears.   I  once faw a lady,
who  mifcarried  during  this  difeafe, though all her
children had it as Slightly as ufual.    It fometimes
leaves fears or marks  on the  fkin.  This difeafe has
been miftaken for the Sinall-pox, and inoculated for
it; and then the fmall pox has been fuppofed to hap-
 pen twice to the fame perfon.  Sec  Tranf. of the Col-
 lege, London.   It is probable that the pemphigus and
 urticaria, as well as  this difeafe, have formerly been
 difeafes of more danger ;  which the habit of innume-
 rable generations  may have rendered mild, and will in
 procefs  of  time  annihilate.   In  the fame manner as
 the fmall-pox, the venereal difeafe,  and rickets, feem
 to become  milder or lefs in quantity every half cen-
 tury.  While  at the  fame time it  is not improbable,
 that  other  new  difeafes  may  arife,  and for a  feafon
 thin  mankind!

    16.  Urticaria,   Nettle-rafli begins with  mild fen-
 fitive fever, which is fometimes fcarcely  perceptible.
 Hence this eruption  has been thought of two forts,
 one  with and the other without fever.  On the  fecond
 day  red fpots, like parts Stung with nettles,  are feen;
 which almoft vanifh during the day, and recur  in the
                                            evening 
 3i<5              DISEASES     [Class IT. i. 3.
 evening with the fever, fucceeded in a  few days  by
 very minute fcales.   See Tranf. of the College,  Lon-
 don.

   17. Aphtha.  Thrufh.  It has been doubted, whether
 aphtha  or thrufh, which confifts of ulcers in the mouth,
 fliould  be enumerated amoftgft febrile difeafes; and
 whether thefe ulcers are always fymptofflatic, Or the
 confequence rather than the caufe of the fevers which
 attend them.   The  tongue  becomes rather Swelled ;
 its colour  and that of the fauces purplifh ; floughs  or
 ulcers  appear firft on  the throat and edges  of the
 tongue, and at  length over the whole  mouth.  Thefe
 floughs  are whitifh, fometimes diftina, often coalefcing,
 and remain an uncertain time.   Cullen.   I Shall  con-
 cifely mention four cafes of aphtha, but do not pretend
 to determine whether they were all of them  fympto-
 matic or original difeafes.
  Aphtha fenfitiva.  A  lady  during  pregnancy was
 frequently feized with ulcers on her tongue and cheeks,
 or other parts of the mouth, without  much  apparent
fever;   which  continued two  or three weeks,  and
returned  almoft  every  month.   The  thrufli  in the
mouths  of young children feems to be a fimilar difeafe.
Thefe ulcers refertible thofe produced in the fea-fcurvy,
and have probably for their caufe an  increafed aaion
of the fecerning fyftem from increafed fenfation,  with
a decreafed aaion of the abforbent fyftem from de-
creafed  irritation.  See Clafs I. 2. 1.  14.
M. M. So- 
Class II. i. 3.]     OF SENSATION.              3,7
   M. M. Solutions of alum, of blue vitriol.   Powder
of birk taken frequently into the mouth in very fmall
qn,.: dty.   See Clafs II.  1. 3. 1.
   Aphtha irritata.  Inflammatory aphtha.  A cafe of
this  kind is related under  the  title of fuppurative
rheumatifm.   Clafs  IV. 2. 1.  16.
   Aphtha inirritata.   Sloughs or ulcers of the mouth,
attended with fenfitive fever with great  arterial debi-
lity.  They feem to fpread downwards from the tkroat
into the Stomach, and probably through the whole
inteftinal canal, beginning their courfe with cardialgia,
and terminating it with tenefmus  ; and might perhaps
be called an eryfipelas of this mucous membrane.
   M. M.  Cool  air.  A fmall  blifter on the  back.
Bark.  Wine.  Opium in  fmall  repeated quantities.
Soap neutralizes the gaftric acid without effervefeence,
and thus  relieves the pain of cardialgia, where  the
ftomach is affeaed.   Milk alfo deftroys a part of this
acid.   Infufion of fage leaves two ounces, almond foap
from five grains to ten, with fugar and cream, is  gene-
rally both agreeable and ufeful to thefe patients.  See
I.  2. 4. 5.
   Where the ftomach may be fuppofed  to be  exco-
riated by poifons containing acid,  as fublimate of mer-
cury or arfenic;  or if it  be otherwife inflamed, or
very fenfible to the  Stimulus  of  the  gaftric  acid; or
where it abounds  with acid of any kind, as  in  cardi-
algia ; the exhibition of foap is  perhaps a preferable
manner of giving  alkali than any other,  as it decom-
pofes  in the ftomach without effervefeence; while  the
cauftic alkali is too  acrid to  be  administered in fuch
                                              cafes, 
3*8             Diseases      [Classit. t.$.
cafes, and the mild alkali produces carbonic gas.   If
a drop of acid of vitriol be put on cap paper, it will
be long before it deftroys the paper; but if a drop
of mild alkali be added, a fudden effervefeence arifes,
and  the paper is inftantly  deftroyed by  the efcape of
the fixed air ;  in the fame  manner as lumps  of folid
lime  are broken into powder by the efcape of the  fleam
produced from the  water, which  is poured on them.
This  Shows  why a fucceffion of acid and  of alkaline
cauftics fooner deftroys a part, than  either of  them
applied feparately.

   18. Dyfenteria.   Bloody-flux \i attended with fenfi-
tive fever generally with arterial debility; with frequent
mucous or  bloody ftools ; which  contain  contagious
matter produced by the membranes of the inteftines;
the alimentary excrement being neverthelefs retained;
with griping pains and  tenefmus.          '
   M. M. Emetics, Antimonials, Peruvian bark. Opium
and calomel  of each a grain every night.  Bolus arme-
nia?.   Earth of alum.   Chalk.   Calcined hartfliom.
Mucilage.   Bee's wax  mixt with yolk of egg.  Cera-
ted glafs of Antimony.   Warm bath.   Flannel cloath-
ing next to the fkin. Large clyfters with opium.  With
ipecacuanha, with fmoke of tobacco ?  Two dyfenteric
patients in the fame ward of the infirmary  at Edinburgh
quarrelled and whipped each other with  horfewhips a
long time, and were both much better after it, owing
perhaps to  the  exertion of fo much  of the fenforial
power of volition ; which,  like real infanity, added
excitement to the whole fyftem.
                                              The 
*lass II. x. 3.3    OF SENSATION.              3-T9
   The  prevention of this contagion muft confift prin-
cipally in ventilation and cleanlinefs ; hence the patients
fhould  be  removed  into  cottages diftant from  each
other, or into tents;  and their faeces buried as foon
as may  be ; or conveyed into a  running ftream ; and
themfelves  fhould be wafhed with cold or warm water
after  every evacuation.   For the contagious matter
confifts  in the mucous or purulent difcharge  from the
membrane  which lines the inteftines;  and not  from
the febrile perfpiration, or  breath of  the  patients.
For the fever is only the  confequence and  not the
caufe  of contagion ;  as appears from Genus  the  Fifth
of this Order, where contagion  exifts without fever.

   19. Gaftritis fuperficialis.   Superficial inflammation
of the  ftomach.    An  eryfipelatous inflammation of
the ftomach is mentioned by Dr. Cullen from his own
obfervation8; which is diftinguifhed from the inflam-
matory  gaftritis  by lefs  pain and fever, and by an
eryfipelatous rednefs  about  the  fauces.  Does this
difeafe belong to aphtha ?

   20. Enteritis fuperficialis.   Superficial inflammation
of tlie bowels is alfo mentioned by Dr. Cullen  from
his own obfervation under the name of enteritis ery-
rhematica ;  and is faid to be  attended with  lefs  pain
and fever, without vomiting, and with diarrhcea.   May
20I this  difeafe be referred to aphtha, or to dyfentery ?
ORD<> 
3*o
DISEASES     [Class II. r. 4.
                   ORDO   I.
                 Increafed Senfation.

                  GENUS   IV.
With the Production of new Veffels by internal Membranes
              or  Glands, without Fever.
  Where,  inflammation is produced in a fmall part,
which  has not great natural fenfibility, the additional
fenfation does not produce an  increafed aaion of the
arterial fyftem ;  that is, the affociated motions which
are employed in the circulation of the blood, thofe for
inftance of the heart, arteries, glands, capillaries,  and
their correspondent veins, are not thrown into increafed
aaion by fo fmall an  addition of the fenforial power
of fenfation.   But when parts, which naturally poffefs
more .fenfibility, become inflamed, the quantity of the
fenforial  power of fenfation becomes fo much increafed,
as to affea the  affociated motions  belonging to  the
circulation, occasioning them to  proceed with greater
frequency ;  that  is, a fever is  induced.   This is well
exemplified in the internal and fuperficial paronychia,
one of which is attended with great pain and fever,
and the other with little pain and no fever.  See Clafs
II. 1. 2.  19. and  II. 1. 4. 5.
  From  hence it  appears,  that the fenfitive fever is an
accidental confequence of the  topical phlegmon, or
inflammation,  and not a caufe of it;  that it  is often
injurious, but  never  falutary ;  and fliould therefore
always be extinguished, as foon as may be, either by
            1                                   the 
Glass II. i. 4.]    OF SENSATION.              321
the lancet and cathartics, and diluents, and cold air,
when it is  of the  irritated kind ; or by the bark,
opium,  cool  air, and nutrientia, when it is of the
inirritated kind.
                   SPECIES.
   1.  Ophthalmia fuperficialis.   As  the  membranes,
which cover the  eye,  are excluded from the air about
one third part of the twenty-four hours; and are moi-
stened by perpetual niaitation during the other fixteen;
they may be confidered as Internal  membranes; and
from the analogy of their inflammation to that of other
internal membranes,  it is arranged under this genus;
whilft the  tonfillitis \s efteemed  an inflammation of an
external membrane, becaufe  currents  of  air  are per-
petually paffmg both day and night over the fauces.
   The  fuperficial  ophthalmy has  generally been  ef-
teemed a fymptom  of fcrophula,  when  it recurs fre-
quently  in young  perfons;  but  is probably only a
concomitant of  that  difeafe, as a fymptom of general
debility;  ramifications  of new red  veffels,  and  of
enlarged  old  ones, are fpread over the white part of
the eye; and it is attended with lefs heat,  lefs pain,
and lefs intolerance  of light than the ophthalmia  in-
terna, defcribed in  Clafs II.  1. 2. 2,  It occurs  in
thofe  of feeble circulation,  efpecially children  of a
fcrophulous tendency, and feems  to  arife from a pre-
vious  torpor of the veffels  of the tunica  albuginea
from their being  expofed to cold air ; and from this
torpor  being more liable to occur  in habits, which
                         Y                      are 
 322              DISEASES    [Class II. i. 4.
 are naturally inirritable ;  and therefore  more readily
 fall into quiefcence by a Smaller  deduaion  of  the
 Stimulus of heat, than would  affea ftronger or more
 irritable  habits;  the confequence of this torpor  h
 increafed  aaion,  which  produces  pain in  the eye,
 and th..t induces inflammation by the acquisition of the
 additional fenforial power of fenfation.
    Ophthalmia  lymphatica  is a kind of anafarca of the
 tunica adnata ; in this the  veffels over the fclerotica,
 or white part of  the eye, rife considerably above the
 cornea,  which they Surround,  are lefs red than  in the
 ophthalmia fuperficialis, and appear to be fwelled  by
 an accumulation of lymph rather  than of blood ; it is
 probably  owing to  the  temporary obftruaion  of a
 branch of the lymphatic fyftem.
    M. M.  If the pain be great,  venefeaion by leeches
 on the  temple, or  cutting the temporal  artery,  and
 one purge with three or four grains of calomel Should
 be premifed.   Then the Peruvian bark twice a day.
 Opium  from a quarter to half a grain  twice a day  for
 fome weeks.    Bathe  the eye frequently with cold
 water alone, or with cold water, to a pint of  which
 is added half an ounce of fait.  White vitriol fix  grains
 diffolved in one ounce of  water ; a drop or two to be
 put between  the eyelids twice a day.   Take  very
I fmall  elearic fparks from  the  eyes every day  for a
 fortnight.  Bathe the whofe head with  fait and water
 made warm every night for fome  months.  Send fuch
 children to a fchool near the fea  for the  convenience
 of fea-bathing for many months annually ;  fuch fchook
 are to be found in or near Liverpool.
                                             Whea 
 Class II. i. 4]    OF SENSATION*              323
   When a child is aflliaed  with an inflamed eye of
 this kind,  he Should always  fit with his  back to the
 window or  candle;  but it is generally not neceffary
 to cover it,  or if the uneafy fenfation of light makes
 this proper, the cover fliould ftand off from  the  eye,
 fo as  not much to exclude the cool air from it.   As
 covering an  eye unneceffarily  is liable to make  that
 eye weaker than the other, from its not being fuflici*
 ently ufed,  and  thence to  produce a fquinting for
 ever afterwards.
  Neverthelefs, when  the pain is  great,  a poultice
 muft be applied to keep the eyes moift, or a piece of
 oiled filk bound lightly over them.   Or thus, boil an
 egg till  it is hard, cut it longitudinally into two hemif-
 pheres, take out the yolk, few the backs of the two hol-
 low hemifpheres of the white  to a ribbon, and  bind
 them over  the eyes every night on going to bed;
 which, if nicely fitted on, will keep the eyes moift with-
 out any difagreeable  preffure.   See Clafs I. 1. 3. 14.
  Ophthalmia equina.   An inflammation of this kind
 is liable to  affea the  eyes of horfes;  one caufe of
 which  is owing to a filly cuftom of cutting the  hair
 out of horfes' ears ;  by which they are not  only lia-
 ble  to  take cold at  the  ear, but grafs feeds are liable
 to fall into their ears from the  high racks in ftables;
 and in both cafes  the  eye becomes inflamed by fym-
 pathy.  I once dlreaed the temporal artery of a horfe
 to be opened,  who had  frequent  returns of  an in-
flamed eye ;  and I  believed it was of effential fervice
to him;  it  is probable that the artery was afterwards
                    Y 2                 contraaed 
3H            DISEASES       [Class II. i. +
contraaed in  the  wounded part,  and that  thence lefs
blood was derived to the eye :  the haemorrhage was
Stopped by two perfons  alternately  keeping their fin-
gers on the orifice, and afterwards by a long bandage
of broad tape.

   2. Pterigion.  Eye-wing.   A  fpot  of inflammation
fometimes begins on  the  infide of the lower' eyelid,
or on the tunica  albuginea,  and fpreads  an intertex-
ture of red  veffels from it,  as from a center, which
extend on the white part of the eye, and have the
appearance of the wing of a fly, from whence its name.
   M. M.  Cut the  ramifications of veffels again and
again with the point  of a lancet clofe to the centre of
inflammation.

   3. Tarfitis palpebrarum.  Inflammation of the  edges
of the eyelids.  This is  a difeafe of the glands, which
produce the hairs  of  the  eyelaflies,  and  is  frequently
the caufe of their falling off.   After this inflammation
a  hard fear-like ridge is left on the edge of the eyelid,
which fcratches and inflames the eyeball, and becomes
a very troublefome difeafe.
   The Turkish ladies are faid to colour the edge of
the eyelafli with crude antimony In very  fine powder,
which not only gives  luftre to the eye, as  a diamond
fet on a black foil, but may prevent extraneous light
from being reflcfted  from thefe  edges into  the eye,
and thus ferve the purpofe of the black feathers  about
fhe eyes of fwans, defcribed in Sea.  XXXIX.  5. ?.
                                              and 
 Class II. i. 4 ]    OF SENSATION.              325
 and may alfo prevent the edges  of the eyelids from
 being inflamed by the frequent  ftimulus of tears on
 them.   Black lead in fine powder might be better for
 all thefe  purpofes than  antimony, and might be put
 on with  a camel's hair brulh.
   M. M. Mercurial ointment Smeared at night on the
 edges of the eyelids.  Burnt alum Sixty grains, hog's
 greafe half an ounce, well rubbed into  an ointment
 to be Smeared on them in  the night.   Cold water
 frequently in the day.   See Clafs IL 1. 1. 8,

   4.  Hordeolum.  Stye.   This inflammation begins
 either on or near the  edges  of the eyelids,  or in the
 loofe Skin of them, and is  fometimes very Slow either
 in coming to fuppuration or in difperfing.   The Skin
 beneath the  lower eyelid is  the moft frequent feat of
 this tumor, which fometimes never fuppurates at all,
 but becomes an  incyfted tumor: for as  this  Skin is
 very  loofe for the purpofe of admitting great motion
 to the eyelid,  the abforbent power of the veins feems
 particularly weak in this part; whence when any per-
 fon is weakened by  fatigue  or otherwife,   a  darker
 Shade  of  colour  is feen beneath the eyes; which is
owing to  a lefs energetic aaion of  the abforbent ter-
 minations of the veins, whence the currents of cb rk
 or venous blood are delayed in them, This dark Shade
beneath the eyes, when it is permanent, is a fymptom
of habitual debility, or inirritability of the circulating
fyftem.  See Clafs I. 2.  2. 2.
   !\J. M.  Smear the tumors with mercurial ointment,
                    Y 3                   moiften 
326             DISEASES      [Class II. i. 4.
moiften them frequently  with ether.   To promote
their fuppuration they may be wounded with a lancet,
or flit down the middle, or they may be cut out.   A
cauftic leaves a large fear.

   Paronychia fuperficialis.   Whitlow.   An inflamma-
tion about the roots of the  nail beneath  the  ikin,
which fuppurates  without fever,  and  fometimes de-
ftroys  the  nail ; which is  however gradually repro-
duced.  This kind of abfcefr, though not hfelf dan-
gerous, has given  opportunity for the  inoculation of
venereal matter in  the hands  of accoucheurs, and of
putrid matter from the diffeaion of difeafed bodies ;
and has thus been the  caufe of difeafe and death.
When  putrid matter has  been thus abforbed from a
dead  body, a livid line from the finger  to the Swelled
gland in the axilla  is faid  to be vifible ; which Shews
the inflammation of the abforbent veffel along its whole
courfe to the lymphatic gland; and death has gene-
rally been the confequence.
   M.  M.  In the  common paronychia  a poultice  is
generally fufficient. In the abforption of putrid matter
rub the whole hand  and arm with mercurial ointment
three  or  four  times  a day, or perpetually.   Could
the  fvvelled  axillary  gland be exfeaecl ?  In the ab.
forption of venereal matter the ufual methods of cure
in Syphilis  muft be administered, as in Clafs II. 1.5. 1.

   6.  Gutta rfca.   Tne rofy  drop on the face  is  of
three  kinds.  Firft, the gutta  t'fea  hepatica,  or  the
                                               red 
Class II. i. 4.]     OF SENSATION.             527
red  pimples  on the faces of drunkards, which are
probably a kind of crifis, or  vicarious  inflammation,
which fucceeds, or prevents,  a  torpor  of the mem-
branes of the liver.   This and the fucceeding fpecies
properly belong to Clafs IV. 1. 2. 14.
   Secondly,  the pimpled face in conSequence of drink-
ing cold water, or eating cold turnips, or other infipid
food, when much heated with  exercife;  which pro-
bably arifes from  the fympathy between the Skin of
the  face and the ftomach ;  and  may  be called the
gutta rofea fiomatica.   Which  is  diftinguiflied  from
the former by  the habits  of the patient in refpea to
drinking; by the colour of  the eruptions  being lefs
deep ; and by  the patient  continuing generally to be
troubled with fome degree of  apepfia.   See Clafs L
3. 1. 3.   I  knew a lady,  who had long been affliaed
with pain about the region of the ftomach; and, on
drinking half a pint  of vinegar,  as  a  medicine, flie
had a  breaking out  commenced on her face; which
remained,  and fhe became free  from the pain about
the Stomach.   Was  this a  Stomachic, or an hepatic
difeafe ?
   Thirdly,  there is  a red  face,  which  confifts  of
fmaller pimples than  thofe above  mentioned ;  and
which is lefs liable to  fuppurate  ; and which  feems  to
be hereditary, or at  leaft lias no  apparent  caufe like
thofe above mentioned ; which  may be termed gutta
rofea hereditaria, or punaa rofea.
   Mrs.  S.  had a pimpled face,  which I believe arofe
frpm potation of ale.   She applied alum in  a poultice
                        Y  4                    to
^ 
32S               DISEASES     [Class II. i. 4.
to it,  and  had foon  a  paralytic Stroke, which dif-
abled her on one  fide, and terminated in her death.
   Mrs. L. had a red pimpled  face, which feemed  to
have been derived from her mother, who  had pro-
bably acquired it  by vinous potation ; She applied a
quack remedy to it, which I believe was a folution  of
lead,  and was feized with epileptic fits, which termi-
nated in palfy, and deftroyed her.   This  fhews  the
danger  of ufing white paint  on the face,   which is
called  bifmuth,  but  is  in reality  white  lead   or
ceruffa.
   Mr.  Y-----had acquired the gutta  rofea  on  his
nofe, and applied a faturnine folution on it  for a few
nights, and was then feized with paralyfis on one fide
of his face; which however he  gradually recovered,
and has fince acquired the gutta rofea on other parts
of his face.
   Thefe fatal effeas were  probably caufed by the dif-
agreeable fenfation of an inflamed liver, which ufed
before  to be relieved by the  Sympathetic aaion and
confequent inflammation of the ikin of the face, which
was now  prevented by  the ftronger ftimulus of the
application  of calx of lead.  The manner  in  which
difagreeable fenfations induce epilepfy  and  palfy  is
treated of in Clafs III.   In fome cafes where habitual
difcharges,  or  eruptions,   or  ulcers  are  flopped, a
torpor of the  fyftem may  follow, owing to the want
of the accuftomed  quantity of fenfation or  irritation.
See Clafs I.  1.2. 9. and II. 1.  5. 6.  In both thefe
Situations fome other ftimulus Should be ufed to fupply
                                                the
/
 
Class II. i. 4.]     OF SENSATION.              329
the place of that  which is taken away;  which may
either be perpetual, as an  iffue;  or periodical, as  a
cathartic repeated once a fortnight or month.
   Mifs W. an elegant  young  lady of about twenty,
applied a mercurial lotion to her face, which was  co-
hered with very fmall red  points;  which feemed to
have been not acquired by any known or avoidable
means ; flie was feized with inflammation of her liver,
and after repeated bleeding and cathartics recovered,
and in  a few weeks the eruption appeared as before.
   M. M. Five grains of  calomel once a  month,  with
 a cathartic, five grains of rhubarb and a quarter  of a
 grain of  emetic tartar  every night for  many  weeks.
 With  this preparation mercurial plafters, made with-
out turpentine, and applied every night, and taken off
 every morning, will fometimes fucceed,  and  may be
 ufed with fafety.    But blistering the face all over the
 eruption, beginning with a part,  fucceeds better  than
 any  other means,  as I have more than once experien-
 ced.—Something like this is  mentioned in the Letters
 of Lady Mary Wortley Montague, who bliftered her
 face with balfam  of Mecca.
    Mrs. F. had for many years  had a difagreeably
 looking eruption  on her chin, after a cathartic  with
 calomel, flie was  advifed  to blifter her whole chin ;  on
 the  healing of the blifter a few  eruptions again ap^
 peared,  which ceafed on the application of a fecond
 blifter.   She took rhubarb five grains, and emetic tar-
  jtar a quarter of a grain every night for many  weeks.

                                                Mih
*v« 
350              DISEASES     [Class II. i. 4.
   Mifs L. a young lady about  eighteen, had  tried
variety of advice for pimples over the greateft part of
her face in vain.   She took  the  above medicines in-
ternally,  and  bliftered her face by degrees all  over
and became quite beautiful.   A fpot or two now and
then  appeared,  and on  this account  fhe  frequently
Slept  with  parts of her face  covered  with mercurial
plafter, made without turpentine, which was  held on
by a  pafteboard mafk, and taken off in the mornings;
if any part of the plafter  adhered, a little butter or oil
deftroyed the adhefion.

   7.  Odontitis.  Inflammatory tooth-ach  is occafioned
by inflammation of the membranes of the tooth, or a
caries of the bone itfelf.   The gum fometimes fuppu-
rates, otherwife a fwelling of the cheek fucceeds by
affociation,  and  thus the violence  of  the pain in the
membranes of the  tooth is relieved,  and frequently
cured; and when this happens the difeafe properly
belongs to Clafs IV. as it fo far refembles the tranfla-
tions of morbid aaions in the gout  and rheumatifm.
   At other times the tooth dies without caries,  efpe-
cially in people about fixty years  of age, or before ;
and  then it ftimulates its  involving membrane, like any
other extraneous fubftance.   The membrane  then be-
comes inflamed and thickened,  occafioning fome pain,
• ana the  tooth rifes upwards above the reft, and  is
gradually puflied out  whole and  undecaycd ;  on its
rifing up a pus-like mucus is  feen difcharged from the
£inn, which furrounds it; and  the  gmu feems to have
                                               left
 
Class II. i. 4-]    OF SENSATION.              331
left the tooth, as  the fangs or roots of it  are in part
naked.
  M. M. Where the tooth is found it can only be
faved by evacuations by venefeaion, and a cathartic ;
and  after its operation two grains  of opium, a blifter
may alfo be ufed behind the ear, and ether applied to
the cheek externally.  In flighter cafes two grains of
opium with  or without as much camphor may be held
in the mouth, and fuffered to diffolve near  the affeaed
tooth, and  be gradually  fwallowed.   See  Clafs I.
2. 4. 12. Odontalgia may be distinguished from otitis
by the application of cold water to the affeaed tooth ;
for as the pain of common  tooth-ach is  owing to  tor-
por, whatever decreafes  ftimulus adds  to the torpor
and confequent pain  ; whereas the  pain of an inflamed
tooth being  caufed  by the  increafed aaion  of the
membranes  of it is in fome meafure  alleviated bv the
application  of cold.

   8. Otitis.  Inflammation and confequent  fuppuration
of fome membranes  of the  internal ear   frequently
occur  in children, who fleep in cold rooms, or near
a cold  wall, without a night-cap.   If the bones are
affeaed, they come  out  in  a long  procefs of time,
and the child remains deaf of that  ear.  But in this
cafe there is  generally a  fever attends  this inflam-
mation ; and it then belongs to another  genus.
   M. M.   A warmer night-cap.    Warmifh  water
fliould  be  gently iyringed into  the ear   to keep it
clean  twice a day ;  ami if it dot: not heal in a  week,
                                           a little 
33-              DISEASES       [Class II. i. 4.
a little fpirit of wine fliould  be added ;  firft about
a fourth part,  and  it fliould be gradually increafed
to half reaified fpirit  and half water :  if it continues
long to difcharge  matter with a  very putrid fmell,
the bones  are  injured,  and  will in time  find their
exit, during which time  the ear fliould be kept clean
by  filling it with  a weaker mixture  of fpirit of wine
and water; or a  folution  of  alum in water ; which
may be poured into  the ear,  as the head is inclined,
and Shook  out  again  by turning the  head,  two or
three  times,  morning  and  evening.    See Clafs II.
1. 4.   TO.

  9. Fiflula  lacrymalis.  The lacrymal  fac, with its
punaa lacrymalia and  nafal dua, are liable to be de-
ftroyed by  fuppuration without fever;  the tears then
run over the eye-lids, and inflame  the edges of them,
and the cheeks, by their perpetual moifture, and faline
acrimony.
  M. M. By a nice  furgical operation a new aperture
is to be made from the internal corner of the eye into
the noftril,  and a  filver tube  introduced, which  fup-
plies the defea  by admitting  the tears to pafs again
into the noftril.  See Melanges de Chirurgie  par M.
Pouteau ; who thinks he has improved this operation.

   1 o.  Fiflula in ano.   A mucous difcharge from the
anus,  called by fome  white piles, or  matter  from a
fuppurated pile,  has been miftaken  for the matter
from a concealed fiftula.  A bit of  cotton  wool ap-
                                              plied 
Class II. i. 4.]    OF SENSATION.             ^Z
plied  to the fundament to receive the matter, and re-
newed twice a day for a week or two, fliould always
be  ufed before  examination  with the  probe.   The
probe of an unSkilful empyric fometimes does more
harm in the loofe cellular  membrane of thefe parts
than the original ulcer, by making a fiftula he did not
find.   The cure of a fiftula in ano of thofe, who have
been much addiaed to drinking fpirituous  liquor, or
who have  a tendency to pulmonary  confumption, is
frequently  of dangerous confequence, and is fucceeded
by ulcers of the lungs, and death.
   M. M. Ward's pafte,  or twenty black pepper-corns
taken after each meal twice a day ;  the pepper-corns
Should  be  cut each  into two or three  pieces.   The
late Dr. Monro of Edinburgh afferted in his feaures,
that he had known a fiftula in ano cured by injeaing
firft a  mixture of reaified  fpirit  of wine and water;
and by gradually increafing the ftrength of it, till the
patient could bear reaified fpirit alone ; by the daily
ufe of which at length the fides of the  fiftula became
callous, and ceafed to  difcharge, though  the cavity
was left.   A  French furgeon has lately affirmed, that
a wire of lead put in at the external opening of the
ulcer, and brought through  the  reaum, and twilled
 together,  will  gradually wear itfelf  through the  gut,
 and thus effea a cure without much pain.   The ends
 of the  leaden wire muft be  twilled more and more as
 it becomes loofe.  Or,  laftly, it muft be laid open by
 the knife.
11. Fiflulc 
 Sit               DISEASES     [Class II. t. 4.
   ri.  Fiftula  urethra.   Where a ftriaure  of  the
 urethra exifts,  from whatever  caufe, the patient, in
 forcing the ftream of urine through the ftriaure,  dif-
 tends  the urethra  behind it;  which after a  time is
 liable to burft, and to  become  perforated ; and fome
 of the urine  is  puflied into the cellular membrane,
 occasioning fiftulas,  which fometimes  have large fur-
 faces producing  much matter, which is preffed out at
 the time of making water, and has been miftaken for
 a catarrh of the bladder; thefe fiftulas fometimes ac-
 quire an external opening in the perinseum, and part
 of the urine is  difcharged that way.
   Can this matter be diftinguifhed from mucus of the
 bladder by the criterion delivered in Clafs II.  1. 6. 6 ?
   M. M.  The perpetual ufe of bougies, either of cat-
 gut  or of coartchouc.  The latter may be had at No.
 37,  Red-lion Street, Holborn,  London.  The former
 are eafily made, by moiftening  the  catgut, and keep-
 ing it ftretched  till dry, and then rounding  one end
 w ith a penknife.  The ufe of a warm bath every day
 for near  an  hour, at the  heat  of 94 or 96 degrees,
 for two or three months,  I  knew to be  uncommonly
 fuccefsful in  one  cafe;  the extenfive  fiftulas com-
 pletely healing.  The patient fliould  introduce a bou-
 gie always  before he makes water,  and endeavour to
make it as fiowly as poifible.   See  Clafs I. 2. 3.  24.

   12.  Hepatitis  chronica.  Chronical inflammation of
 the liver.  A colleaion of matter in the  liver has fre-
quently been  found on dilfeaion, which was  not fuf-
                                            peaed 
Class II. i. 4]    OF SENSATION.              535
peaed in the living fubjea.  Though there may have
been  no certain figns of fuch a  colfeaion of matter,
owing to the infenfibility  of the internal parts of this
vifcus; which has thus  neither been  attended with
pain,  nor  induced any fever;  yet there may be in
fome  cafes reafon to fufpea the exiftence of  fuch an
abfcefs ; either from  a fenfe of fulnefs in the right hy-
pochondre,   or  from transient  pains  fometimes felt
there, or from pain on preffure, or from  lying on the
left fide, and fometimes  from  a  degree  of  fenfitive
fever attending it.
   Dr. Saunders fufpeas the acute hepatitis to exift in
the inflammation of  the hepatic  artery, and the chro-
nical one in that of  the vena portarum.   Treatife on
tlie Liver.    Robinfon.  London.  -

   13.  Scrophula fuppurans.   Suppurating fcrophula.
The  indolent tumors of  the  lymphatic  glands are
liable, after  a long  time, to regain their  fenfibility;
and  then,  owing to  their former torpor, an increafed
aaion of the veffels, beyond what  is natural,  with
inflammation, is the confequence  of  their new life,
and  fuppuration fucceeds.   This cure  of fcrophula
generally happens about puberty,  when a new energy
pervades the whole  fyftem^  and  unfolds  the  glands
and  organs of reproduaion.
   M. M.  See  Clafs I.  2.  3.  2r.  Where  fcrophu-
lous  ulcers about the neck are difficult  to heal, Dr.
Beddoes was informed,  in Ireland,  that  an  empyric
had  had fome fuccefs by inflaming  them  by an ap-
                                           plication 
3$S              DISEASES      [Class H.  t. 44
plication of wood forrel, oxalis  acetofella, the leaves
of which  are bruifed in a mortar,  and applied on the
ulcers for two  or three  days,  and  then fome more
lenient application is  ufed.
  A poor boy, about twelve years old,  had a large
fcrophulous  ulcer on  one fide  of the cheft beneath
the clavicle,  and another  under  his jaw ;  he  was
direaed, about three weeks ago, to procure a  pound
of dry oak-bark  from the tanners,  and to reduce it
to fine powder, and to add  to it  one ounce of white
lead in  fine powder,  and  to cover  the  ulcers daily
with it, keeping  it on by brown paper  and a ban-
dage.  He came  to me  a  few minutes ago, to Shew
me  that both the  ulcers  are quite  healed.   The con-
ftant application of linen rags, moistened  with a folu-
tion of  an ounce of fugar of lead in a pint of  wa-
ter,  I think  I  have feen equally  efficacious.

  14. Scorbutus fuppurans.   In  the fea-fcurvy there
exifts an  inaaivity of  venous abforption, whence
vibices and  petechia?, and fometimes  ulcers.   As the
column  of blood  prefiing on the origins  of the veins
of the lower extremities,  when the body is  erea,
oppofes the afcent  of the blood in them,  they are
more frequently liable to  become enlarged,  and to
produce varices,  or vibices,  or, laftly,  ulcers  about
the legs, than on the  upper parts of the body.   The
expofure to cold  is believed  to be another  caufe of
ulcers on the extremities; as  happens to many of the
poor in winter at  Lifbon, who fleep  in the open air,
                        1                  without 
Class II. i.>]        OF SENSATION.           337
without  ftockings,  on the fteps of their churches or
palaces.   See Clafs I.  2.  1.  15.
   M. M.  A bandage fpread with  plafter  to  cover
the whole limb tight.   Rags dipped in a folution of
fugar of lead.    A warm flannel flocking or roller.
White lead and oak bark, both in fine powder.  Ho-
rizontal  reft.

   14.  Schirrus fuppurans.  When a fchirrus affeas
any gland of no great extent or fenfibility, it is, after
a  long period of time, liable to fuppurate without in-
ducing fever,  like the indolent tumors of the conglo-
bate or lymphatic glands above mentioned;  whence
colfeaions of matter are  often found  after death both
in men  and other animals; as in the liver of fwine,
v/hich  have been fed with the grounds  of fermented
mixtures  in the distilleries.  Another termination of
fchirrus  is in cancer,  a* defcribed below.  See  Clafs
L 2. 3.  22.

   16.  Carcinoma.   Cancer.  When a fchirrous tumor
regains its  fenfibility by nature, or by any accidental
hurt, new veffels fhoot amongft the yet infenfible parts
of it, and a new fecretion takes place  of a very in-
jurious  material.   This cancerous matter is  abforbed,
and  induces fwelling  of the neighbouring lymphatic
glands;  which alfo become fchirrous, and afterwards
cancerous.
   This cancerous matter does not feem to acquire its
malignant or  contagious  quality, till the  cancer  be-
                        Z                     comes 
5,"             DISEASES      [Class II.  i. 4.
comes an open ulcer ; and the  matter fecreted in it is
thus expofed to  the air.   Then it evidently becomes
contagious, becaufe it not only produces heaic fever,
like common matter in ulcers open to the air ;  but it
alfo, as  it becomes  abforbed, fwells  the  lymphatic
glands  in its vicinity ; as thofe  of the axilla, when the
open cancer is on the breaft.   See Clafs II.  1. 3.
   Hence exfeaion  before the cancer is open is gene-
rally a cure ;  but after the matter  has been expofed
to the air, it is feldom of fervice ; as the neighbouring
lymphatic glands are already  infeaed.   I  have ob-
ferved fome of thefe patients after the  operation to
have had difeafed livers, which might either have previ-
oufly exifted, or have been produced  by the fear or
anxiety attending the operation.
   Erofion with  arfenic, after the cancer is become an
open ulcer, has generally no better effea than exfec-
tion, but has  been fuccefsful before ulceration.   The
beft manner of  ufing arfenic,  is by mixing one  grain
with a dram of  lapis calaminaris, and ftrewing  on  the
cancer fome of the  powder  every day, till  the whole
is deftroyed.
   Cancers on the  face  are faid to arife from the peri-
 ofteum, and that unlets this  be deftroyed by the knife,
 or by cauftics, the cancer certainly recurs.   After the
 cancer becomes an open ulcer  of fome extent,  a  puru-
 lent fever fupervenes, as  from other open ulcers, and
 gradually deftroys the patient.  See Clafs II. 1.6. 13.
    Two very interesting cafes have been.lately pub-
 lished by Dr. Ewart, of Bath, in which  carbonic acid 
 Class II. 1.4.]    OF SENSATION.              3}g
 gas, or fixed air, was  kept constantly in contaa with
 the open cancerous ulcers of the breaft;  which then
 healed like other common  ulcers.   This is rather to
 be  afcribed to  the exclufion of oxygen, than to  any
 fpecific virtue  in  the carbonic  acid.  As in common
 ulcers the matter does not  induce  heaic fever,  till it
 has been expofed to the air, and then probably united
 with oxygen.
  The manner of applying the fixed air, is by  in-
 cluding the cancer in one half or hemifphere of a
 large bladder  ; the edges  are  made to  adhere to  the
 Skin by adhefive plafter, or perhaps a mixture of  one
 part of honey with about  twenty  parts of carpenter's
 glue might better fuit fome tender ffdns.  The bladder
 is theri kept constantly filled with carbonic acid gas,
 by  means of a pipe in the  neck of it;  and the matter
 let  out at a fmall  aperture beneath.

   i 7.  Arthrocele.   Swelling of the joints feems to have
 its remote caufe in the foftnefs of the bones, for they
 could not fwell  unlefs they were  previoufly foftened,
 fee  Clafs I. 2. 2.  12.  The epiphytes, or ends of  the
 bones, being  naturally of  a loofer texture,  are moft
 liable to  this difeafe, and perhaps  the  cartilages  and
 capfular  ligaments may  alfo  become  inflamed  and
 fwelled along with the heads of the bones.  This
 malady is liable to diftort the fingers  and  knees,  and
 is ufually called gout or rheumatifm; the  former of
 which  is .liable to difable  the fingers by chalk-Stones,
.and thence to  have Somewhat a  Similar  appearance.
                       Z  2                    But 
34^             DISEASES      [Class II. i. 4,.
But  the arthrocele,  or fwelling of the joints, affeas
people who have not been intemperate in the ufe of
fermented  or  fpirituous  liquors ;  or who have  not
previoufly had a regular  gout in their  feet ;  and in
both thefe circumstances  differs from  the gout.  Nor
does it accord with the  inflammatory rheumatifm, as
it  is not attended with fever, and becaufe the tumors
of the  joints  never entirely fubfide.   The pain or
fenfibility,  which the bones  acquire, when  they are
inflamed,  may be  owing to  the  new veffels,  which
Shoot in them  in  their foft  ftate, as well as to the
diftention of the  old  ones. .
   M. M. Flalf a grain of opium  twice a day, gra-
dually increafed to a grain, but not  further, for many
months.  Thirty grains  of powder  of  bark twice a
day for many months.   Ten grains  of  bone-aflies, or
calcined hartfliom, twice a  day,  with  decoaion of
madder ?  Soda phofphorata ?

   18. Arihropuofis.   Joint-evil.  This differs from the
former, as that never fuppurates ;  thefe ulcers of the
joints are generally efteemed  to arife from fcrophula ;
but  as  fcrophula is  a  difeafe  of the lymphatic or
abforbent fyftem, and  this confifts  in the  fuppuration
of the membranes,  or glands,  or  cartilages about
the joints, there  does not feem a fufficient analogy to
authorize their arrangement  under the fame name.
   The white fwelling of the knee, when it fuppurates,
comes under this fpecies, with variety of other ulcers
attended with carious bones,
                                         19. Carle j 
Class II. 1.5.]     OF SENSATION.              34i
   19;  Caries offium.   A caries  of the bones may be
termed  a fuppuration  of  them;  it differs from the
above, as it generally is occafioned by fome external
injury, as in decaying teeth ;  or by venereal virus, as
in nodes on the tibia;  or by  other matter derived to
the bone in malignant fevers; and is not confined to
the ends of them.
   The feparation of the dead bone from the living is
a work of fome time.   See Sea. XXXIII. 3. i<
                    ORDO  I,
                 Increafed Senfation.

                   GENUS  V.
With the Produclion  of new  Veffels by external Mem-
          branes or  Glands, without Fever.
   The ulcers, or eruptions, which are formed on the
external Skin, or on  the  mouth or throat, or  on the
air-cells  of  the  lungs, or  on the inteftines,  all  of
which  are more or lefs expofed to the contaa of the
atmofpheric air,  which we breathe,   and which  in
fome proportion  we fwallow with our food and faliva ;
or to the contaa of the inflammable air, or hydrogen,
which  is fet at liberty by the putrefying aliment in
the inteftines,  or by  putrefying  matter in large  ab-
fceffes ;  all of  them  produce  contagious  matter;
which,  on being inoculated  into  the  fkin of another
perfon,  will produce fever^  or  a fimilar difeafe.
                      Z  3                        In 
342              DISEASES     [Class II. i. 5.
   In fome cafes even the matter formed beneath the
ikin becomes in fome  degree contagious, at  leaft fo
much fo as to produce fever of the heaic or malignant
kind,  as foon  as  it has  pierced  dirough  the  ikin,
and has thus gained accefs to fome kind of air ; as the
frefli pus of a  common abfcefs ; or the putrid pus of
an abfcefs,  which has been long confined ;  or of can-
cere es ulcers.
   From  this analogy  there is reafon to fufpea, that
the matter of all contagious  difeafes, whether with or
without fever,  is  not  infeaious till  it  has  acquired
fomething from the air; which, by  oxygenating the
fecreted  matter,  may probably produce a new  acid.
And  fecondly,  that in heaic  fever  a part of the
purulent matter is abforbed ; or aas on the furface of
the  ulcer ;  as  variolous matter affeas  the inoculated
part of  the arm.   And that heaic  fever is therefore
caufed by the matter of an  open ulcer ; and not by
the  fenfation in the  ulcer independent of the aerated
pus, which lies on  it.  Which may account for the
venereal matter from buboes not giving the infeaion,
according to the experiments of the  late Mr. Hunter,
and  for  fome  other phenomena  of  contagion.   Sec
Variola difcreta,  Clafs II. 1. 3. 9.

                   SPECIES.
   1. Gonorrhoea venerea.   A pus-like contagious ma-
terial difcharged from the urethra after  impure coha-
bitation,  with fmarting or  heat  on  making water;
which begins at the external extremity of the urethra,
                                                to 
Class II. i. 5.]     OF SENSATION.              343
to which the contagious  matter is applied, and where
it has accefs to the air.
   M. M.  In  this  ftate of the venereal  difeafe  once
Venefeaion, with mild cathartics  of fenna and manna,
with mucilage,  as almond emulfion, and gum arabic,
taken  for two or three  weeks, abfolve the cure.  Is
camphor of ufe  to relieve the ardor urina? ?   Do bal-
fams increafe or  leffen  the heat  of urine ?  Neutral
falts certainly increafe the fmarting in making water,
by increafing the acrimony of the urine.
   Can the difcharge from the urethra be foon flopped
by Saturnine  injeaions,  or mercurial  ones,  or  with
folution of blue vitriol, at firft very dilute, and  gra-
dually  made ftronger ?   And at the fame  time left the
fyphilis,  or  general difeafe,  fliould fupervene,   the
patient might take a quarter of a grain of corrofive
fublimate of mercury twice a day, as direaed below ?

   2. Syphilis.  Venereal difeafe.  The contagion Shews
itfelf in ulcers on the part firft inoculated, as chancres ;
ulcers  on the  tonfils  fucceed, with eruption on the
fkin, efpecially  about  the roots of the  hair ; after-
wards on other parts of  the  ikin, terminating in dry
fcabs;   and  laftly,  with  pain and fwelling  of the
bones.
   The corona veneris, or crown  of Venus, confifts of
the eruptions at the roots of the hair appearing  moft
round the forehead ; which is occafioned by this  pai-L
being more expofed  to the air;  which we obferved,
at the  beginning  of this genus,  either  produces or
                      Z  4                 increafes 
344               DISEASES      [Class II. i. y.
increafes the virulence of contagious matter.  But it is
difficult to conceive from this hiftory, why the throat
Should be firft affeaed ;  as it cannot be fuppofed, that
the difeafe is  fo often taken  by the faliva,  like  the
fmall-pox, though this may fometimes occur, perhaps
very  often.  The conneaion between the genitals in
men and the throat, is treated of in  Clafs IV. 1. 2. 7.
Hydrophobia.
   M. M.  A quarter of a grain  of corrofive  fublimate
of mercury,  taken  thrice a day for  five or fix weeks,
made into a pill with bread-crumbs, or  diffolved in a
fpoonful of brandy and water, is a very efficacious and
almoft certain cure.   When it does  not  fucceed, ic is
owing either to the drug being bad, or to its having
precipitated from the brandy, or from its being fpoiled
in the  pill by long keeping.   Opium contributes much
to expedite the cure both of the fimple gonorrhoea, and
of venereal ulcers, by increafing abforption both from
the  mucous membrane, and from the furface  of
ulcers.

   3.  Lepra.  Leprofy.  Leprofy of the Greeks. The
ikin is rough with white branny Shales,  which are full
of chinks; often moift beneath, and itching. The fcales
on the head  or  arms of fome drinking people  are a
difeafe of  this kind.  The perfpirable matter defigned
for the purpofe  of lubricating  the external ikin is
fecreted in this difeafe in a too vifcid ftate, owing to
the inflammation of the fubcutaneous veffels; and,  as
the abforbents aa too ftrongly  at  the fame time, a
                                              vifcid 
Class II. i. 5.]    OF SENSATION.              345
vifcid mucus is left  adhering to the furface of the
ikin.
   In the leprofy of the  Jews, defcribed  in  the thir-
teenth and  fourteenth chapters of Leviticus, the de-
preffion of the fore beneath the furface of  the Skin,
and the hairs in it becoming white, feem to have been
the  principal  circumftanccs, which  the  prieft was
direaed to attend  to for the purpofe of afcertaining
the difeafe.
   M. M. Effence of antimony from 20 drops to 100
twice or thrice a day, with half a pint of decoaion of
 elm-bark ;  or  tinaure of cantharides from 20  to  60
drops  four times  a day ; or fublimate of  mercury,
with much diluting find.  Acid of vitriol ?   Perhaps
the cure chiefly depends on much dilution with water,
from two to four  pints a day, in which elm-bark,  or
pine-buds, or  juniper-tops,  may be boiled.   Bath  or
Buxton water  drank in large quantities.  Warm bath.
Oil-Skin bound on the part  to confine the perfpirable
matter.   Ointment  of  tar  and fuet; or poultice for
two or three days,  and  then cerate with lapis calami-
naris.   Diet of raifins  and bread.  Abstinence from
wine,  beer,  and all fpirits.

   4.. Elephantiafis.   Leprofy of the Arabs.   A con-
 tagious difeafe ; the Skin is thickened, wrinkled, rough,
 unauous, deftitute of  hair, without  any fenfation of
 touch in the  extremities  of the limbs ; the face  de-
 formed with tubercles ; the voice hoarfe, and with a
 nafal tone.   Cullen.
                                      5. Framboefia. 
 346              DISEASES      [Class II. i. £.
   5.  Tramboc/ia*   Yaws is  -raid to be contagious and
hereditary.  It principally  aifeas  the negroes in the
 Weft Indies.   Edinb. Eflays, Vol. VI.
   6.  Pfory.  IlCh.   A contagious prurient  eruption.
There are two  kinds of itch,  that which appears
between the "fingers,  and under the joints of the knees
and elbows ;  and that which feldom is  feen in thefe
places,  but all over the other parts of the body.  The
latter is feldom thought to be the  itch, as it does not
eafily infea  eyen a  bedfellow, and  refills  the ufual
means of cure by brimftone.
   If the itch be cured too haftily  by  rubbing  mercu-
rial or  arfenical preparations over  the  whole  body,
or on too great  a  part  of  it,  many  bad  fymptoms
are produced; as weaknefs  of digeftion,  with pale
bloated  countenance,  and tendency to dropfy.  I have
twice feen St. Vitus's dance occur from the ufe of a
mercurial  girdle; and once a fwelled liver.  I have
alfo feen  a fwelled fpleen  and fwelled  legs from the
external ufe of arfenic in the cure of the itch.   And
very numerous and large phlegmons commonly fucceed
the too  hafty cure of it by other means.
   There does not appear a ftria analogy between the
hafty  cure of the heh,  and the  retrocession  of the
puftules is the fecondary fever of the fmall-pox ; be-
caufe  in that the ahforption of the  matter is evinced
by the fwelling of the face and hands, as the puftules
recede,  as explained in Clafs  II.  1. 3. 9.  Variola
difcreta.   And a fever is  produced by this abforption ;
neither  of which happen,  when the puftules of the
itch are deftroyed by mercury or arfenic.
                                              Nor 
Class II. i. $.] -   OF SENSATION.              347
  Nor can thefe  inconveniencies, which occur on the
too hafty cure of the itch, he explained by thofe which
follow the cure of fome kinds of gutta rofea,  Clafs II.
i. 4. 6.  as in thofe the eruptions on the face were an
affociated difeafe with  inflammation of the liver or
ftomach, which  they  were accuftomed to  relieve;
whereas the itch is not known  to have had any pre-
vious catenation  with other difeafes.
   In the itch  there exifts not only great irritation  in
the  produaion of the puftules, but great fenfation  is
caufed by their  acrimony afterwards;  infomuch that
 the pain of itchier, without the interrupted fmarting
 occafioned by fcratching, would be intolerable.   This
 great excitement of  the two fenforial powers of irri-
 tation and fenfation is fo great, when the puftules are
 diffufed over the whole furface of the body, that  a
 torpor Succeeds the fudden ceafing of it;  which affeas
 thofe parts of the fyftem,  which were moft catenated
 with  the  new  motions of  the  fkin,  as  the ftomach,
 whence Indigeftion and flatulency ; or  which  are ge-
 nerally moft liable to fall into torpor, as the numerous
 glands, which  form the liver.  Whence the difeafes
 confequent to the hafty cure of the itch are  difeafes
 ©f  debility, as  tumid vifcera, cedematous  fwellings,
 and St. Vitus's dance, which is a debility of affocia-
 tion.  In the fame  manner indigeftion, with  green
 evacuations,  are faid to follow  an injudicious  applica-
 tion of ceruffa to Stop too haftily the exfudation behind
 the ears of children,  Clafs I.  1.2. 9.  And dropfies
 are liable to fucceed the cure of old ulcers of the legs,
 which have long ftimulated the fyftem.
                                              M.M. 
 5*«               DISEASES     [Class II. i. £
   M. M. The fize of a  large pea, of an  ointment
 confifting of one part of white precipitate of mercury
 to fix parts of hogs' lard  well  triturated together, t6
 be rubbed on a part of the body  every  night,  and
 waffled off  with foap  and  water next morning, till
 every part is cleared ; with lac fulphuris twenty grains
 to be. taken every  morning inwardly.   Warm faline
 bath, with  white vitriol  in  it.   Flowers  of fulphur
 mixed with  thick gruel, with hogs fat.  With either
 of which the body may be Smeared all over.

   7. Pfora ebriorum. Elderly people, who have been
 much addiaed to  fpirituous  drinks, as beer,  wine,
 or alcohol,   are  liable  to an eruption  all over  their
 bodies ;  which is attended with very affliaing itching,
 and which they probably propagate from one part of
 their'bodies to another with their own nails by fcratch-
 ing themfelves.   I faw fatal effeas in one fuch patient
 by a  too extenfive ufe of a folution of  lead;  the
 eruption disappeared, he became dropfical, and died;
. I fuppofe from the  too fuddenly ceafing of the great
 ftimulus  caufed by the eruptions  over the whole Skin,
 us in the preceding article.
   M. M. The patient fliould gradually accuftom him-
 felf  to half his ufual  quantity  of  vinous  potation.
 The warm bath,  with one pound of fait to every three
 gallons.   Mercurial ointments on fmall parts  of the
 Skin at a time.  A grain of opium  at night inftead
 of  the ufual potation of wine or beer.
                                         8. Herpes. 
Class II. i. 5.]     OF SENSATION.               349
   8.  Herpes.   Herpes confifts of gregarious fpreading
excoriations, which are fucceeded  by  branny fcales
or fcabs.  In this difeafe there appears to be a deficient
abforption of the Subcutaneous mucus, as well as in-
flammation and increafed fecretion of it.   For the fluid
not only excoriates the parts in  its vicinity by its acri-
mony,  but  is very faline  to  the  tafte,  as fome  of
thefe patients have affured me ;  I believe this  kind of
eruption, as well as the tinea, and perhaps all other
cutaneous eruption, is liable to be inoculated in other
parts of the body by the finger-nails of the patients in
fcratching themfelves.
   It is liable  to affea  the hands, and to return at
 diftant periods ;  and is probably a fecondary difeafe
 as well  as the  zona  ignea,  or  Shingles, defcribed
 below.
    M. M. Poultice  the eruption with bread and milk,
 or raw carrots grated,  for two  or three whole days,
 to dilute or receive the difcharged fluid, and abate  the
 inflammation ;  then cover the  parts with frefh cerate
 mixed with lapis calaminaris.   On the parts not ex-
 coriated mercurial ointment, made of one part of white
 calx of mercury and fix of hogs' fat.   Internally, after
 venefeaion, gentle repeated cathartics.  Laftly* ti'-.c
 bark.  Acid of vitriol.  Bolus Armenia?, or teftacia.
 Antimonials.   Decoaion of interior bark of elm.

    9.  Zona ignea.  Shingles.  This eruption  has  been
  thought a fpecies  of herpes by fome writers, and by
  others a fpecies of  eryfipelas.  Yellow or livid veficles
                                              appear, 
35*             DISEASES      [Class II. i. 5.
appear, producing a corrofive ichor, which  is fome-
times attended with a degree of  fever.  It is faid  to
infeft fometimes the thorax  and ribs,  but  its  moft
general fituation is on the  fmall of the back, over
one kidney,  extending forward over the courfe of one
of the ureters.
   There is reafon  to fufpea, that this alfo is a fecon-
dary or fympathetic difeafe, as well  as the preceding
one ; but future obfervations are required, before it
can be removed to the  fourth  clafs, or difeafes of af-
fociation.  In three patients I have been induced to be-
lieve, that the eruption on the loins was a tranflation
of inflammation from the external  membrane of the
kidney to the Skin.  They  had, for a day or two
before the appearance of the eruption, complained  of
a  dull pain on the region of one kidney, but without
vomiting ; by  which it was diftinguiflied from nephritis
interna, or gravel; and  without pain down the out-
fide of the thigh, by-which it was  diftinguifhed from
fciatica. In other fituations the Shingles may fympathize
with other internal membranes,  as in  a cafe published
by Dr. Ruffel (De  Tabe   Glandulari),  where  the
retroceflion of the Shingles was fucceeded by a ferious
»:yfpncea.
   M. M. Venefeaion,  if the pulfe is ftrong.  Calomel
three or four grains, very mild repeated cathartics.
Poultice  for a few days,  then  cerate of lapis calami-
naris, as in herpes.  A grain of emetic tartar diffolved
in a pint of water, and taken fo as  to empty the fto-
mach and inteftines, is faid much to haften the  cure;
                                         compreffes 
Class II. i. 5.]     OF SENSATION.              35I
compreffes foaked in a Saturnine folution  are  recom-
mended externally on the eruption ; and cerate where
there are  ulcerations.   Defr.net's  Surgical Journal,
Vol, II. p. 378. If this be a vicarious difeafe, it fliould
continue half a lunation ;  left, on its ceafing, the  bad
habits of motion of the primary difeafe fliould not have
been fo perfeaiy diffevcred, but that they may recur.

   10. Annulus repens.  Ring-warm.  A prurient erup-
tion formed in a circle,  affeaing children, and would
feem to be the work of infeas, according to the theory
of Linna?us,  who afcribes the itch and dyfentery to
microfcopic anlmalcula.    Thefe animalcula are  pro-
bably the effea,  and not  the caufe, of thefe eruptions;
as  they  are to be feen  in all  putrefcent an inn! fluids.
 The annular propagation of the rirg-worm,  and  its
continuing to enlarge its  periphery, is  well accounted
for by the acrimony of the ichor or faline fluid  erod-
 ing the Skin in its vicinity.
   M. M.  Cover  the eruption daily with  ink.   With
 white  mercurial  ointment,  as defcribed  above  hi
herpes.   With folution of white vitriol ten grains to
 an ounce,   Thefe metallic calces Stimulate the  abfor-
 bents into ftronger  aaion,  whence  the fluid has  h:;
 faline part re-abforbed,  and that  before it lias accef,
 to the  air,  which probably  adds  to its acrimony  by
 oxygenating  it,  and thus producing a new acid.

    11.  Tinea.  Scald head.   This contagious eruption
 affeas  the roots of the hair,  and is  generally ,moit
         2                                   viruJcnt 
 35*               DISEASES     [Class II. i. j.
 virulent around the edges of the hair on the back part
 of the head ;  as  the corona veneris appears moft on
 the  edges  of  the hair on the forepart of the  head ;
 for in thefe parts the eruption about the roots  of the
 hair is moft expofed to the external air, by which its
 acrimony or noxious quality is increafed.
   The  abforption  of the  matter   thus  oxygenated
 fwells the lymphatics of the neck by  its  ftimulus, oc-
 casioning  many little hard lumps beneath the  feat of
 the eruption :  when this happens, the fooner it is cured
 the better, left the larger lymphatics of the neck fhould
 become affeaed.
   M. M. The art of  curing thefe  eruptions confifts,
 firft,  in abating  the  inflammation,  and  confequent
 fecretion of a noxious material.  Secondly, to prevent
 its accefs to the air, which fo much increafes its acri-
 mony.  And thirdly, to  promote the abforption of it,
 before it has been expofed  to the air ; for thefe  pur-
 pofes venefeaion  once, and gentle cathartics,  which
 promote abforption  by  emptying  the blood-veffels.
 Next poultices and fomentations, with warm water,
 abate inflammation by diluting the faline acrimony of
 the fecreted fluid, and abating the  painful fenfation.
Afterwards cerate joined  with fome metallic calx, as of
zinc  or lead, or folution of lead, mercury,  or copper,
or iron, which may ftimulate the abforbent fyftem  into
ftronger  aaion.
  Cover the Shaved  head with tar  and fuet,  and a
bladder; this, by keeping the  air from  the fecreted
fluid, much contributes to its mildnefs, and the ftimulus
                                                of 
Class  II. i. 5.]     OF SENSATION.              353
of the  tar increafes its abforption.  See the three pre-
ceding fpecies of this genus.

   12.  Crufia laclea.   Milk-cruft  is a milder difeafe
than tinea, affeaing  the face as well as the hairy fcalp
of very young children.   It is not infeaious, nor liable
to fwell the lymphatics in its vicinity like the tinea.
   M. M. Cover the eruption with cerate made with
lapis calaminaris, to  be renewed  every day.  Mix one
grain of emetic tartar with forty grains  of chalk, and
divide  into eight papers,  one to  be taken twice a day,
or with magnefia  alba,  if  ftools  are  wanted.  The
child fhould  be  kept cool and much in the air.

   13.  Trichoma.  Plica polonica.  A contagious dif-
eafe, in which  the  hair  is  faid to become alive and
bleed,  forming  inextricable knots or plaits of great
length, like  the fabled head of  Medufa, with  intole-
rable pain, fo as to  confine the fufferer on his bed  for
vears.
A a
ORDO 
35**               DISEASES     [Class II. i. fig,

                    ORDO  I.
                 Increafed Senfation.

                   GENUS  VI.
With Fever confequent to the Produclion of new VefjeU
                     or Fluids.

                    SPECIES.
   i.  Febris fenfitiva.   Senfitive fever, when unmixed
with either  irritative or inirritative fever, may be dif-
tinguiflied from either of them by the lefs comparative
diminution of mufcular ftrength;  or in  other words,
from its  being attended  with lefs diminution of the
fenforial power of irritation.  An example of unmixed
fenfitive fever may generally be taken from the pulmo-
nary confumption ;  in this difeafe patients  are feen to
walk about  with  eafe,  and to  do all  the common
offices  of life  for weeks, and even months, with  a
pulfe of 120 ftrokes  in a minute; while  in, other
fevers,  whether irritated ©r inirritated, with a pulfe of
this frequency, the  patient generally lies upon  the
bed, and exerts no mufcular efforts  without difficulty.
   The  caufe of this curious phenomenon is thus to be
understood;   in  the fenfitive  fever  a new fenforial
power, viz. that of fenfation, is fuperadded to that of
irritation ; which  in other fevers alone carries on the
increafed circulation.  Whence the power of irritation
is not much more  exhaufted than in health  ; and thofe
mufcular motions,  which are produced in confequence
                                                  of 
Class II. i. 6.]      OF SENSATION.              35*
of it, as thofe which are exerted in keeping the body
upright in walking, riding, and in the performance of
many cuftomary aaions, are little impaired.  For an
account of the  irritated fenfitive  fever,  fee Clafs IL
1.2. i. ; for the inirritated fenfitive fever, Clafs II.
i. 3. 1.  IV.  2. 4. 11.     ■

   2.  Febris a pure claufo.  Fever from inclofed matter
is generally of the irritated  fenfitive kind,  and  con-
tinues for many  weeks, and even months, after the
abfcefs is formed ;  but is diftinguiflied from the fever
from aerated matter in open ulcers, becaufe there are
feldom any night-fwcats, or colliquative diarrhcea in
this, as in the latter.  The  pulfe  is alfo harder, and
requires occafional venefeaion, and cathartics, to abate
the  inflammatory fever ; which is - liable to increafe
again every three or four  days, till  at  length, unlets
the matter has  an exit, it deftroys the  patient.  In
this  fever the matter,  not having been expofed  to the
air, has  not  acquired oxygenation ; in which  a new
acid, or fome other  noxious property,   is produced;
which aas like contagion on the conftitution inducing
fever-iits, called  heaic fever,  which terminate with
fweats or diarrhcea; whereas the  matter in the clofed
abfcefs is either not abforbed, or does not fo affea the
circulation as to produce  diurnal  or heaic fever-fits ;
but the ftimulus of the abfcefs excites fo much  fenfa-
tion as to induce perpetual  pyrexia, or  inflammatory
fever, without  fuch marked  remiffions.   Nevertheless
there fometimes  is no  fever  produced,  when the mat-
                       A  a  2 .                  ter 
 3S«               DISEASES     [Class II. i. tf,
 ter is  lodged  in a  part of little fenfibility, as in the
 Kver;  yet a  white pus-like  fediment  in  thofe  cafes
 exifts I believe generally in the urine, with occasional
 wandering pains about the region of the liver or cheft.

   3, Vomica.   An abfcefs in the lungs is fometimes
• produced after peripneumony, the cough and fliortnefs
 of breath continue in lefs  degree,  with difficulty in
 lying  on the well  fide,  and with fenfitive  irritated
 fever, as explained in the preceding article.
   The occasional increafe of fever,  with hard  pulfe
 and fizy blood, in thefe patients, is probably owing to
 the  inflammation of the walls of the vomica;  as it is
 attended with difficulty of breathing, and requires ve-
 nefeaion.   Mr. B-----, a child about feven years old>
 lived about five weeks in this  fituation, with a pulfe
 from 150 to 170 in a minute, without fweats, or diar-
 rhcea, or fediment in his water, except mucus  occa-
 fionally  ; and  took fufficient nourishment during the
 whole time.  The blood  taken was always covered
 with a ftrong cupped  fize,  and on his death three or
 four pints of matter were  found in one  fide of the
 cheft ; which had  probably,  but lately, been effufed
 from a vomica.   This child was frequently induced to
 fwing, both in a reciprocating and in a rotatory Swing,
 without any apparent abforption  of matter; in both
 thefe fwings he expreffed pleafure, and did not appear
 to be vertiginous.
   M. M. Repeated emetics.  Digitalis ? Perfeverance
 in rotatory Swinging,  See  Clafs II. 1. 6.  7.
                                                Mr. 
Class II. i. 6.]     OF SENSATION.             35J
   Mr. I. had laboured fome months under a vomica
after a peripneumony, he was at length taken with a
catarrh, which was in fome degree endemic in March
 1795, which occafioned him to fneeze much, during
which a copious haemorrhage from the lungs occurred,
and he fpit  up at the fame time half a  pint of very
fetid matter, and recovered.  Hence errhines may be
occafionally  ufed with advantage.

   4. Empyema.  When the matter from an abfcefs in
the lungs finds its way into the cavity of the cheft, it
is called an  empyema.   A fervant man, after a violent
peripneumony, was feized with fymptoms of empyema,
and  it was  determined,  after fome time,  to perform
the operation; this  was explained  to him, and the
ufual means were employed by his  friends to encou-
rage him,  " by advifing him not  to be afraid.'*   By
which good advice he conceived fo much fear, that he
ran away early next morning, and returned in about a
week quite well.  Did the great fear promote the ab-
forption of the matter, like the ficknefs occafioned by
digitalis ? Fear renders the external Skin pale ; by this
continued decreafe of the aaion of the abforbents  of
the Skin might not thofe of the  lungs  be excited into
greater aaivity ? and thus produce increafed pulmonary
abforption  by reverfe fympathy, as it produces pale
urine, and  even ftools, by direa fympathy ?
   M. M. Digitalis ?

   5. Febris Mefenterica.  Fever from matter  formed
in the mefentery is  probably more frequent  than  is
                     A a 3               fufpc&ed. 
358              DISEASES     [Class II. 1.6.
fufpeaed.  It commences with pain in the  bowels,
with  irritated  fenfitive  fever; and continues many
weeks, and even months, requiring occasional venefec-
tion,  and mild cathartics; till at length the continu-
ance of  the  pyrexia, or inflammatory fever, deftroys
the patient.   This is an affeaion  of  the lymphatic
glands, and properly  belongs to fcrophula; but as the
matter  is not expofed to the air, no heaic fever, pro-
perly fo called, is induced,

   6.  Febris  a pure aerato.  Fever from  aerated mat-
ter.  A great colfeaion of matter often  continues  a
Jong  time,  and  is fometimes totally abforbed, even
from venereal buboes, without producing any diforder
in  the arterial fyftem.   At length,  if it becomes pu-
trid by  its  delay,  and  one part of the  matter thus
.becomes aerated by  the air  given  out by  the other
 part; or  if the ulcer  has been opened, fo that any
 part  of it has been expofed to the air for but one day,
 a heaic fever is produced.  Whence the  utility arifes
 of opening large abfeeffes by fetons,  as  in that  cafe
 little or no  heaic fever is induced ;  becaufe the mat-
 ter is fqueezed out by  the fide of the  Spongy threads
 of cotton, and little or no air is admitted ; or by tap-
 ping  the abfcefs with a trocar, as mentioned in  ifchias,
 Clafs II. 1.  2. 18.
   In this fever the pulfe is about  120 in a  minute,
 and its accefs is generally  in an  evening,  and fome-
 times about noon alfo,  with fweats  or  purging to-
 wards  morning,  or urine  with  pus-like  fediment;
 and the patients bear this fever better than any othe*
                                                with 
Class II. i. 6.]    OF SENSATION.              3-59
with fo quick a pulfe; and laftly, when all the matter
from a concealed ulcer is abforbed, or when an open
ulcer is healed, the heaic fever ceafes.  Here the ab-
forbed matter is fuppofed to produce the fever,  and
the diarrhcea, fweats,  or copious muddy urine, to be
fimply  the confequence of increafed fecretion, and not
to confift of the purulent matter,  which was fuppofed
to be  abforbed from the ulcer.  See  Sudor calidus,
Clafs I. 1.2. 3.
   The aaion of the air on ulcers,  as we have already
Shewn, increafes the acrimony of the purulent matter,
and even converts it into  a weaker kind of contagious
matter; that is, to  a material  inducing fever.  This
was afcribed  to the union of the azotic part  of the
atmofphere with  the effufed pus in Sea. XXVIII. 2.
but by contemplating more numerous faas  and  ana-
logies, I am now induced to believe, that  it  is by the
union  of  oxygen 'with  it ; firft,  becaufe oxygen fo
greedily unites with other animal fubftances,  as  the
blood,  that it will  pafs  through a moift bladder to
combine with it,  according to  the experiment of  Dr.
Prieftley.  Secondly, becaufe the poifons of venomous
creatures are  fuppofed to be acids of different kinds,
and are probably formed by the  contaa of air after
their fecretion.   And laftly, becaufe the contagious
matter from other ulcers, as in itch, or fmall-pox,  are
formed  on  external membranes,  and  are  probably
combinations of animal matter  and oxygen, producing
other new acids;  but further experiments muft deter-
mine this queftion.
                      A a 4                     It 
$6*               DISEASES    [Class II. i. 6.
  It was thought a  fubjea of confequence by  the
JEfculapian Society at  Edinburgh,  to find a  criterion
which fhould diftinguifh pus from mucus,  for the pur-
pofe of  more  certainly difcovering the  pretence of
ulcers in  pulmonary difeafes,  or in the urinary  paf-
fages.  For this purpofe that foeiety offered their firft;
gold medal,  which was conferred on  the  late  Mr.
Charles Darwin, in the year 1778, for his experiments
on this fubjea.  From  which he deduces the follow-
ing conclusions :
   " 1.  Pus  and mucus are both  foluble in the vitri-
olic  acid, though  in  very different proportions,  pus
being much  the lefs  foluble.
   " 2.  The  addition of water to either of thefe com-
pounds   decompofes  it;  the mucus thus feparated,
either fwims on the  mixture, or  forms  large flocci
in it; whereas the pus falls to the bottom, and forms
on agitation a  uniform turbid  mixture.
   " 3. Pus is diffufible through a diluted vitriolic acid,
though mucus is  not;  the fame occurs  with water,
or a folution of fea  fait.
   " 4.   Nitrous acid  diffolves both  pus  and mucus;
water added to the  folution  of pus produces a pre-
cipitate ; and the fluid above becomes clear and green;
while water and the  folution of mucus form  a dirty
coloured  fluid.
   "5.  Alkaline lixivium diffolves (though fometimes
with difficulty) mucus, and generally  pus.
   " 6.  Water precipitates pus from fuch a folution,
but  does not mucus.
                                      '  7.  " Where 
Class II. i. 6.]     OF SENSATION               36t
   " 7.  Where alkaline lixivium does not diffolve pus,
it ftill diftinguifhes it from mucus;  as it  then prevents
its diffufion through  water.
   " 8.  Coagulable lymph is neither foluble in diluted
nor  concentrated  vitriolic acid.
   "9.  Water produces no change on a folution of fo-
rum  in alkaline lixivium, until after  long Standing,
and then only a  very flight fediment appears.
   "10. Corrofive  fublimate coagulates mucus, but does
not  pus.
   " From the above experiments it appears, that Strong
Vitriolic acid  and water, diluted  vitriolic  acid,  and
cauftic  alkaline lixivium and water will ferve to dif-
tinguifh pus  from mucus; that the vitriolic acid can
feparate it from  coagulable lymph, and alkaline lix-
ivium from ferum.
   " And  hence,  when  a perfon has any expeaorated
 material, the compofition of which  he wiflies to  afcer-
 tain, let him diffolve it in vitriolic acid,  and in cauftic
 alkaline lixivium; and  then add pure water  to  both
 folutions: and if there is a fair precipitation  in each,
 he  may be affured that fome pus  is prefent.   If in
 neither a precipitation occurs, it is a certain teft, that
 the material is entirely mucus.   If the material cannot
 be  made  to diffolve in alkaline lixivium by time and
 trituration, we have alfo reafon to believe that it is pus."
 Experiments on  Pus and Mucus.   Cadell.  London.

    7. Phthifis pulmonalis.  In  pulmonary confumption
 the fever is generally fuppofed to be the confequence
                                                   of 
3^2              DISEASES      [Class II. i. &
of the  ftimulus of abforbed matter circulating in  the
blood-veffels, and not fimply of its ftimulus  on their
extremities in the furface of the ulcers;  as mentioned
in Clafs II. 1.5. and Clafs  II. 1. 3. 9.   The ulcers
arc  probably  fometimes occafioned  by  the  putrid
acrimony of effufed blood remaining in  the  air-cells
of the lungs after an hcemoptoe.   See Clafs I. 2. 1.
9.  The  remote  caufe of confumption is ingenioufly
aferibed by  Dr. Beddoes to  the hyper-oxygenation of
the blood,  as mentioned Seaion XXVIII. 2.
  As the patients  liable to confumption are of  the
inirritabfe temperament, as appears by the large pupils
of their eyes; there is  reafon to believe,  that  the
hcemoptoe is immediately occafioned by the deficient
abforption  of the  blood at the extremities  of  the
bronchial vein ; and that one difficulty of healing  the
ulcers is occafioned  by the deficient abforption of  the
fluids effufed into them.  See  Sea. XXX. 1. and 2.
  The difficulty of  healing pulmonary ulcers  may be
owing, as its remote caufe,  to  the inceffant motion of
alf the parts of the  lungs;  whence no fcab,  or  indu-
rated mucus, can  be formed  fo  as to adhere  on them.
Whence thefe naked ulcers are perpetually expofed to
the aaion of the air on their furfaces, converting their
mtld purulent matter into a contagious ichor ; which  not
only prevents them  from healing, but  by its aaion on
their circumferences, like the matter of itch or tinea,
contributes to fpread them wider.  See the preceding
article and Sea. XXXIII. 2.  7. where the pulmonary
phthuis is fuppofed to be infeaious.
                                              This 
Class II. i. 6.]    OF SENSATION.                ■/,$
   This acidifying principle is found in all the metallic
calces, as  in lapis  calaminaris,  which is a calciform
ore of zinc ; and in ceruffa, which is a. calx of  lead;
two materials which are powerful in  healing excoria-
tions, and ulcers  in  a Short  time by their external
application.   How then  does  it  happen,  that  the
oxygen in the atmofphere  fliould prevent pulmonary
ulcers from healing, and even induce them to Spread
wider; and  yet in its  combination with  metals, it
fliould facilitate  their healing ? The healing of  ulcers
confifts in promoting the abforption of the fluids effufed
into them, as  treated  of  in  Seaion XXXIII.  3. 2.
Oxygen in combination with metals, when applied in
certain quantity, produces  this effea by its ftimulus;
and the metallic oxydes not being decompofed by their
contaa with animal matter, no new acid, or contagious
material, is produced.  So that the combined oxygen,
 when applied to an ulcer, fimply 1 fuppofe promotes
abforption in it, like the application of other materials
 of the  articles forbentia or ineitantia, if applied  exter-
 nally ; as opium, bark, alum.   But in the  pulmonary
 ulcers, which cannot protea themfelves  from the air
 by  forming a  fcab, the  uncombined oxygen  of  the
 atmofphere unites  with the purulent matter, converting
 it into a contagious ichor ; which by infeaion, not by     \
 erofion, enlarges the ulcers, as in the itch  or  tinea ;
 which might hence, according to Dr. Beddoes's inge-
 nious theory of confumption, be induced  to  heal, if
 expofed to an  atmofphere deprived  of  a  part  of  it.^
 oxygen.  This I hope future experiments will confirm,
                                                 and 
 3&4              DISEASES      [Class  II. 1. 6i
 and  that  the pneumatic  medicine will alleviate the
 evils of  mankind  in  many other,  as well  as  in this
 moft fatal malady.
   M. M.  Firft,  the refpiration of  air lowered by an
 additional quantity of azote,  or  mixed  with  fome
»proportion of hydrogen, or of carbonic acid air, may
 be tried ; as defcribed in a  late publication  of Dr.
 Beddoes on the medicinal ufe of faaitious am*.  John-
 fan, London.  Or laftly, by breathing a mixture  of
 one tenth part of hydro-carbonate mixed with common
 air, according to the  difcovery of  Mr. Watt,  which
 has a double advantage in thefe cafes, of diluting the
 oxygen of ,the atmofpheric air,  and inducing ficknefs,
 which  increafes  pulmonary abforption, as  mentioned
 below.   An atmofphere diluted with  fixed air  fcar-
 bonic acid) might be readily procured by fetting tubs
 of new wort, or fermenting  beer, in the parlour and
 lodging-room of the  patient.  For it is  not  acids
 floating in the air, but the oxygen or acidifying'prin-
 ciple, which injures or enlarges pulmonary  ulcers by
 combining with the purulent matter.
   Another eafy method of adding  carbonic acid gas
 to the air of a room,  would be by  means of an appa-
 ratus invented by Mr. Watt, and fold by' Bolton and
 Watt at  Birmingham, as defcribed in Dr. Beddoes'
Treatife on Pneumatic Medicine.   Johnfon, London.
 It confifts of an  iron pot,  with an arm projeaing, and
 a method  of  letting water drop by flow degrees on
chalk, which  is  to be put  into the iron  pot, and
 expofed to a  moderate degree of heat over a com-
                                               mon 
Class II. i. 6.]     OF SENSATION.              3$5
mon fire.  By  occafionally adding more and more
chalk, carbonic acid gas  might be  carried through a
tin pipe  from the  arm of the iron pot to any part of
the room near the patient, or from  an adjoining room.
In the fame manner a diffufion  of  folution of  flowers
of zinc  might  be produced and  breathed  by  the
patient,  and would be likely much to contribute to
the healing of pulmonary ulcers; as obferved by Mr.
Watt.   See  the treatife above mentioned.
   Breathing over the vapour of cauftic volatile alkali
might  eafily be  managed for  many hours in  a day ;
-which might  neutralize the  acid  poifon  formed  on
pulmonary ulcers by  the contaa of oxygen, and thus
prevent  its deleterious quality,  as other acids become
fefs cauftic, when they are formed into neutral falts
with  alkalis.  The volatile fait  fliould be  put into a
tin canifter, with two pipes like horns from  the top
of it,  one to fuck the  air from,  and the other to
admit  it.
   Secondly, the external ulcers in fcrophulous habits
are pale and flabby,  and naturally  difinclined  to heal,
the  depofition of fluids in them being greater  than
the  abforption ; thefe ulcers have their  appearance
immediately changed by the  external  application of
metallic  calxes, and the medicines of the article  Sor-
bentia, fuch as ceruffa and  the  bark in  fine powder,
fee Clafs I.  2.  3.  21. and are generally  healed in a
fhort time by thefe means.  Induced by thefe obfer-
vations,  I  wifhed to  try  the external  application of
fuch powders to ulcers in the lungs, and  conftru&ed
                                             a box 
 366                DISEASES    [Class XI. i. &
 a  box with a circulating bruffi in it, as defcribed in
 the annexed plate ; into this  box two  ounces of fine
 powder of Peruvian bark were put, and two drams
 of ceruffa  in  fine  powder;  on whirling the central
 bruffi, part of this  was raifed into a cloud of powder,
 and the patient,  applying his mouth to one of the tin
 pipes  rifing out  of the box,  inhaled  this powder
 twice a day  into his lungs.   I obferved  it did not
 produce any cough or uneafinefs.   This patient  was
 in the laft ftage  of confumption,  and was  foon  tired
 of the experiment,  nor have  I had fuch  patients  as I
 wifhed for the repetition of it.  Perhaps a fine powder
 of manganefe, or of the flowers of  zinc, or of  lapis
 calaminaris, might  be  thus applied  to ulcers of the
 lungs with greater advantage ? Perhaps air impreg-
 nated with  flowers of zinc  in their moft comminuted
 ftate,  might be a better way  of applying this powder
 to the lungs,  as  difcovered by  Mr. Watt.  See  Dr.
 Beddoes on Pneumatic Medicine.   Johnfon.
   Thirdly, as the healing of  an ulcer confifts in  pro-
 ducing a tendency to abforption on its furface greater
 than  the depofition on it; fee Sea. XXXIII. 3.  2.
 other  modes of increafing pulmonary abforption, which
 are perhaps  more  manageable  than the  preceding
ones,  may be had recourfe  to ;  fuch  as by producing
frequent naufea  or ficknefs.  fee Sea. XXIX. 5. 1.
 and Art. IV.  2.  The great and fudden  abforption
 of fluid from  the lungs in  the anafarca pulmonum
by the ficknefs  induced by the  exhibition of digitalis,
 aftonifhes thofe who have  not before attended to it,
                                               by 
Class II. 1.6.3    OF SENSATION.             3:7
by  emptying  the fwelled limbs,  and  removing the
difficulty of breathing in a few hours.
  The moft manageable method of ufing digitalis is
by making a faturated tinaure of it, by infufing two
ounces of the pov/der of the leaves in a  mixture  of
four ounces of reaified fpirit of wine, and four ounces
of water.   Of this from 30  to 60 drops, or upwards,
from a two-ounce phial,  are to be taken twice in the
morning part of the day, and to be  fo  managed  as
not to induce violent ficknefs.  If ficknefs neverthelefs
comes on, the patient muft for a day or two  omit
the  medicine; and  then  begin it again in  reduced
dofes.
  Mr.----,  a young man  about twenty, with dark
eyes, and  large pupils,  who had  every  fymptom  of
pulmonary ulcers,  I believed  to  have been cured by
digitalis,  and pubjifhed  the cafe  in the  Tranfaaions
of  the College, Vol. III.    But about  two years
afterwards  I  heard that he relapfed  and died.  Mr.
L----,  a corpulent  man, who had for fome weeks
laboured under a cough with great expeaoration, with
quick pulfe, and difficulty of breathing, foon recovered
by  the ufe of digitalis taken twice a day ; and though
this cafe might probably be a peripneumonia notha, or
catarrh, it  is here  related as Shewing the power of
pulmonary  abforption  excited by the  ufe  of this
drug.
   Another method  of inducing ficknefs, and pulmo-
nary  abforption  in  confequence, is  by failing  on the
iea ;  bv which many confumptive patients have  been
                                              laid 
S6«               DISEASES     [Class II. 1.6.
faid  to have  received  their cure; which has  been
crroneoufly aferibed to fea-air, inftead  of  fea-ficknefs ;
whence many have been fent to breathe the fea-air
on the coafts,  who might have done better in higher
Situations, where the air probably contains lefs oxygen
gas,  which is the heavieft part of it.  See  a Letter
from Dr. T. C. below.
  A third method of inducing ficknefs, and confe-
quent  pulmonary abforption, is by the vertigo  occa-
fioned  by twinging ;  which has lately been introduced
into  praaice  by  Dr.  Smith, (Effay  on Pulmonary
Confumption), who obferved  that by fwinging the
heaic  pulfe  became flower, which  is  explained in
Clafs IV. 2. i. 10.  The  ufual way of reciprocating
fwinging,  like the ofcillations of  a pendulum,  pro-
duces a degree of vertigo  in thofe, who are unufed
to it;  but to  give it greater  effea, the patient fhould
be placed  in  a chair fufpended from the ceiling by
two  parallel  cords in contaa  with each other, the
chair fliould then be forcibly revolved 20 or  40 times
one way, and fuffered to return fpontaneoufly ; which
induces a degree  of ficknefs in moft adult  people,
and is  well worthy  an exaa and  pertinacious  trial,
for an hour or two, three  or four times  a day for a
month.
  The common  means of promoting abforption in
ulcers, and of thickening the matter  in confequence,
by taking the bark and opium internally, or by metallic
falts, as of mercury, fteel, zinc, and copper,  in  fmall
quantities, have  been  repeatedly ufed in pulmonary
            4                        confumption; 
 Class II. i. 6.J    OF SENSATION.              359
 confumption ;  and  may have  relieved fome of the
 fymptoms.   As mercury cures venereal ulcers, and as
 pulmonary  ulcers refemble them in their not having
 a difpofition to heal, and in their tendency to enlarge
 themfelves, there were hopes, from analogy, that It
 might have fucceeded.   Would  a folution of gold in
 aqua regia be worth trying ? When vinegar is applied
 to the lips, it renders them  inftantly  pale,  by pro-
 moting the  venous abforption ; if the whole fkin was
 moiftened with warmifli vinegar, would this promote
 Venous abforprion in the lungs by their fympathy uith
 the ikin ? The very abstemious  diet on milk  and ve-
 getables alone is frequently injurious. FleSh-meat once
 a day, with fmall wine and water, or fmall beer, is
 preferable.   Half a grain of opium  twice  a day, or a
 grain, I believe to  be of great ufe at the  commence-
 ment of the difeafe,  as appears  from the  fubfequent
 cafe.
   Mifs-----, a delicate young lady, of a confumptive
 family, when flie  was  about  eighteen, had frequent
cough, with quick pulfe, a pain other fide, and the
general appearances  of a beginning confumption. She
took  about  five drops  of laudanum  twice a day in a
faline  draught, which  was increafed gradually to ten.
In a  few weeks  flie  recovered, was afterwards mar-
ried,  bore  three  or  four children,  and then  became
confiunptive and died.
   The following cafe of hereditary confumption  is re-
lated  by a phyfician of great ability and very extenfive
practice ; and,  as  it  is his  own cafe, abounds with
                       B b                    much 
ST              DISEASES     Class II. i. 6.3
much nice obfervation and ufeful knowledge ;  and. as
it has  been attended with a  favourable event,  may
give confolation to many, who are in a fimilar  fitua-
tion ; and fliews that Sydenham's lecommendation of
riding as a cure for confumption is not  fo totally mef-
feaual, as is now commonly believed.
   " J. C.  aged 27,  with  black hair, and  a ruddy
complexion, was fubjea to cough from the age of pu-
berty, and occasionally to fpitting of blood.   His ma-
ternal grandfather died of confumption  under thirty
years of age, and his  mother fell a viaim  to this dif-
eafe, with which flie had long been threatened, in her
43d year,  and immediately after flie ceafed  to have
children.   In the fevere winter of 1783-4,  he was
much affliaed with cough; and being expofed to in-
tenfe cold, in the month  of February he was feized
'with peripneumony.   The  difeafe was violent and
dangerous,  and after  repeated  bleedings as  well r<^
bufferings,  which  he  fupported with  difficulty, in
about fix weeks  he was able to leave his  bed.   At
this time the cough  was fevere,  and the expectoration
difficult.   A fixed  pain remained on  the  left fide,
where an iffue was inferted ; regular heaic  came on
every day about an  hour after noon, and every night
heat  and reftieffnefs took place, fucceeded  toward*,
morning by  general perfpiration.
   " The patient, having formerly been fubjea  to ague,
was Struck with the  refemblanee of the febrile parox-
yfm, v/ith what he had experienced under that difeafe,
and was willing to flatter himfelf it might  be of the
                                               fame 
Class II. 1.6.]    OF SENSATION.              £7!
fame nature.   He therefore took bark in the interval
of fever, but  with an increafe of his cough, and this
requiring venefeaion, the blood was found highly in-
flammatory.  The  vaft quantity of blood which he
had loft from time  to time, produced a difpofition to
fainting, when he  refumed the upright  pofture,  and
he was  therefore obliged  to remain almoft constantly
in a recumbent pofition.   Attempting to ride out in a-
carriage, he was furprifed to find that he could fit up-
right for a  confiderable time, while in motion, without
inconvenience,  though, on ftopping  the carriage, the
difpofition to fainting returned.
   " At this time, having prolonged his ride beyond the
ufual length, he one day got into  an uneven road at
the ufual periocl  of the recurrence  of the heaic pa-
roxyfms, and that day he miffed it  altogether.   This*
circumftance led him to ride out daily in a carriage at
the time the febrile acceffion might  be expeaed, and
fometimes by this means it was  prevented, fometimes
deferred, and almoft always mitigated.
   " This experience determined him to  undertake  a
journey of fome length, and Briftol  being, as is ufual
in fuch  cafes, recommended,  he fet out on the 19th
of April, and arrived there on the 2d of May. During
the greater part of this  journey (of 175 miles) his
cough was  fevere, and being obliged to be bled three
different times on the road, he was no longer able to
fit upright, but at  very Short intervals,  and  was
obliged  to  lie at length  in the diagonal of a coach.
The heaic  paroxyfms were not interrupted during the
                      B    2              journey, 
37*              DISEASES    [Class II. i. 6.
journey, but they were irregular and indiftina, and
the falutary effeas of exercife, or rather of geftation,
were impreffed on the patient's  mind.
   " At Briftol he flayed a month, but reaped no bene-
fit.  The weather was dry and the roads  dully;  the
water  infipid and inert.    He  attempted  to  ride  on
horfeback on the downs,  but  was not able to bear
the fatigue  for a diftance  of more than  a  hundred
yards.  The neceffity of frequent bleedings kept down
his  ftrength,  and  his heaic  paroxyfms  continued,
though lefs fevere.   At this time,  fufpeaing  that his
cough  was irritated by the  weft-winds bearing the va-
pour from the fea, he refolved to  try the effeas of an
inland  fituation, and fet off for Matlock in Derbyfliire.
   " During the journey he did not find the improve-
ment he expeaed, but the  nightly perfpirations began
to diminifh ; and the extraordinary fatigue he  expe-
rienced  proceeded evidently from his travelling in  a
poft-chaife, where he could not indulge in a recumbent
pofition.  The weather at  Briftol had been hot, and
the earth arid and dufty.   At Matlock,  during  the
month of June  1784, there was  almoft a perpetual
drizzle,  the foil was  wet,  and  the air moift and cold.
Here,  however, the patient's cough began to abate,
and at intervals  he  found  an  opportunity of  riding
more or lefs on horfeback.   From two or three hun-
dred yards  at a  time, he got to  ride a  mile without
ftopping ; and at length he was able to fit on  horfe-
back during a ride from Mafon's bath to the village
of Matlock along the Derwent, and round on the op-
                                             pofitc 
 Class II. i. 6-]    OF SENSATION.               373
pofite  banks, by the works of Mr.  Arkwright, back
to the houfc whence he  Started, a diftance of  five
miles.   On difmounting, however, he was feized with
deliquium, and  foon after  the ftrength he had reco-
covered was loft by an attack of the hemorrhoids of
the  moft painful  kind, and  requiring much  lofs of
blood  from the parts affeaed.
   " On refleaion, it appeared that the  only  benefit
received by the  patient  was during  motion,  and con-
tinued motion could better be obtained in the courfe
of a journey than during his refidence at any particular
place.   This, and other circumftances of a private but
painful nature,   determined him to  fet out from Mat-
lock on a journey to  Scotland. The weather  was
now much improved,  and  during the journey he re-
cruited his ftrength.   Though as yet he  could not fit
 upright  at reft  for half an hour together without a
 difpofition to giddinefs, dimnefs of fight, and deli-
 quium, he was able to fit upright under the motion of
 a poft-chaife  during, a journey of from 40  to 70 miles
 daily,  and his  appetite began  to improve,   Still his
 cough continued, and his heaic flufliings, though the
 chills  were much abated and very irregular.
   " The falutary effeas of motion being now more
 ftriking than ever, he purchafed  a horfe admirably
 adapted to a valetudinarian in Dumfriesfhire, and be-
 ing now able to fit on horfeback for an hour together,
 he  rode out feveral times a  day.   He fixed his  refi-
 dence for a few weeks at Moffat, a village at the foot
 of the mountains whence the Tweed, the  Clyde, and
                      B b 3                   the 
374                DISEASES    [Class II. i. 6.
the Annan, defcend in different direaions;  a  fituation
inland, dry,  and healthy,  and  elevated about  three
hundred  feet above the furface of the fea.  Here his
ftrength recovered daily, and  he began to eat animal
food, which  for feveral months before he  had not
tatted.  Perfevering in  exercife on horfeback, he gra-
dually increafed the length of his rides, according  to
his ftrength,  from four to  twenty miles a day ; and
returning on  horfeback  to Lancafliire by the lakes of
Cumberland, he arrived at Liverpool  on the SlrSt  of
September, having rode the  laft day of his journey
40 miles.
  " The two inferences of moft importance to be drawn
from this narrative, are, firft, the extraordinary benefit
derived from geftation  in a  carriage, and ftill  more
the mixture of geftation and exercife on horfeback,  in
arrefting or mitigating the  heaic paroxyfm; and fe-
condly, that in the florid confumption, as Dr. Beddoes
terms it,  an elevated and inland  air is in certain cir-
cumstances peculiarly falutary;  while  an atmofphere
loaded with the  fpray of the fea is irritating and  nox-
ious.   The benefit  derived in this  cafe from exercife
on horfeback, may lead us  to  doubt whether  Syden-
ham's  praife  of  this remedy be as much exaggerated
as it has of late been fuppofed.  Since the publication
of Dr. C, Smyth on the effeas of fwinging in lower-
ing the pulfe  in the heaic paroxyfm, the fubjea of this
narrative has  repeated his experiments in a great va-
riety of cafes, and has confirmed them.   He has alfo
repeatedly  feen the heaic paroxyfm prevented, or cut
                                             Short' 
Class II. 1.6.]     OF SENSATION.              375
fhort,  by external ablution  of the naked  body with
tepid water.
   " So much was his power of digeftion impaired or
vitiated by  the immenfe evacuations,  and the long
continued debility he underwent, that after the cough
was removed, and indeed for feveral years after the
period mentioned,  he never  could  eat animal  food
without  heat and ffufhing,  with  frequent  pulfe  and
extreme  drowfinefs.  If  this drowfinefs  was  encou-
raged, the fever ran high,  and he awoke  from  dif-
turbed fleep, wearied and  depreffed.  If it was refo-
lutely refilled by gentle exercife, it went off in about
an hour, as  well  as  the  increafed frequency  of the
pulfe.  This agitation was however  fuch as to inca-
pacitate  him during the afternoon for ftudy of  any
kind.   The  fame effeas did  not follow a meal of milk
and  vegetables, but under  this diet his ftrength did
not recruit; whereas after  the ufe of animal food it
recovered rapidly, notwithftanding the inconvenience
already mentioned.   For this inconvenience he at laft
found a remedy in the ufe of coffee immediately after
dinner, recommended to  him by his friend Dr. Perci-
val.   At firft this remedy operated like a charm,  but
by frequent  ufe,  and indeed  by abufe, it no longer
poffeffes its original efficacy.
  " Dr. Falconer, in his Differtation on the Influence of
the Paffions  and ASfeaions of the Mind on Health  and
Difeafe,  fuppofes that the cheerfulnefs which  attends
heaic fever,  the ever-Springing hope, which brightens
the gloom of the consumptive patient,  increafes the
                   B b  4                  difeafed 
3;6               DISEASES     [Class If. i. 6.
difeafed aaion?, and haftens  his doom.  And hence
he  is led  to enquire, whether the influence of fear
might not be fubltituted in fuch cafes  to that of hope
with advantage to the patient ?  This queftion 1 Shall
not prefume to anfwer, but  it leads me to fay Some-
thing of  the  ftate of  the mind in the cafe  juft re-
lated. *            #
   " The  patient,  being a phyfician, was not ignorant
of his danger,  which fome melancholy circumftances
ferved to imprefs on his mind.  It  has already been
mentioned,  that his mother and  grandfather  died  of
this difeafe.   It may be  added, that in the year pre-
ceding that on which he himfelf was attacked,  a filter
of  his was carried off by confumption in her  17th
year ; that in the fame winter in  which  he  fell ill,
two other fitters were feized with the fame fatal difor-
der, to which one  of them fell  a  viaim  during his
refidence  at Briftol, and  that the hope of bidding a
laft adieu  to the other was the immediate caufe of his
journey to Scotland, a hope which, alas ! was indulged
in vain.   The day on which he reached the end of his
journey, her remains were committed to the duft!  It
may be conjeaured from thefe circumftance3,  that
whatever  benefit may be derived from the apprehenfion
of death,  muft in this cafe have been obtained.  The
expectation  of this iffue  was  indeed for fome time fo
fixed that  it  ceafed to produce  much agitation; in
conformity  to  that  general  law  of our  nature,  by
 v Ire h  almoft all men fubmit with  compofure to a fate
 • hat h forefeen. and that  appears inevitable.  As how-
                                              ever 
Class II. i. 6.}     OF SENSATION.              377
ever the progrefs of difeafe and debility feemed to  be
arretted,  the hope and the love of life revived, and
produced, from time to time, the obfervations and the
exertions already mentioned.
  " Wine and  beer were rigoroufly abftained from
during fix months  of the above  hiftory ; and  all the
blood which was taken was even *to the laft b'uffy."
Feb. 3, 1795.

  8. Febris fcrophulofa.  The heaic fever occafioned
by ulcers  of the  lymphatic glands, when expofed to
the air, does not differ from that attending pulmonary
confumption, being accompanied with night-fweats and
occafional diarrhcea.
  M. M.  The bark.  Opium internally.  Externally
ceruffa  and bark  in  fine  powder.  Bandage.  Sea-
bathing.   See Clafs I. 2. 3. 21.  and II. 1.4. 12.

   9. Febris ifchiadica.   A heaic fever from an open
ulcer between the mufcles of the pelvis, which differs
not from the preceding.  If the matter  in this fituation
lodges till part  of it, I fuppofe, becomes putrid, and
aerates the other  part :  or till  it  becomes abforbed
from fome other circumftance ; a fimilar heaic fever is
produced, with night-fweats, or diarrhoea.
   Mrs.-----, after a  lying in,  had pain  on one fide
of her loins, which extended to the internal  part of
the thigh on the Slime  fide.  No fluauation of matter
could be felt;  flie became heaic  with copious night-
fweats,  and  occafional  diarrhoea,  for four  or five
                                            weeks { 
 37*              DISEASES      [Class II. i. 6.
 weeks;  and recovered  by, I fuppofe, the total  ab-
 forption of the matter, and  the reunion of the  walls
 of the abfcefs.   See Clafs II.  i. 2. 18.

   ro. Febris  Arthrcpuodica.   Fever from  the matter
 of difeafed joints.   Does the matter from fuppurating
 bones, which  generally has a very putrid fmell, pro-
 duce heaic fever, or typhus ?   See Clafs II. 1.4. 16.

   11. Febris a pure confagiofo.  Fever  from  contagious
 pus.   When the contagious  matters  have been pro-
 duced on the external fiabit,  and  in  procefs of time
 become abforbed,  a fever is produced in confequence
 of this  reabforption; which differs with the previous
 irritability or inirritability,  as  well as with the  fenfibi-
 lity of the patient.

   12. Febris  variolofa  fecundaria:  Secondary fever
 of fmall-pox.   In  the  diftina fmall-pox the fever is
 of the fenfitive  irritated or inflammatory kind ;  in the
 confluent fmall-pox  it  is of  the  fenfitive  inirritated
 kind, or typhus gravior. In both of them the fwelling
 of the face, when  the matter there begins to be ab-
 forbed, and of the hands, when the  matter there begins
 to be abforbed, fhew, that it ftimulates the capillary
veffels or glands,  occafioning  an  increafed  fecretion
greater than the  abforbents  can  take  up,  like the
aaion of the cantharides in a  blifter ;  now as the ap-
plication  of a blifter on the Skin  frequently  occafions
rhe ftrangury,   which  fhews,  that fome part of the
                                        cantharides 
Class II. i. 6.]    OF SENSATION.              379
cantharides is abforbed ; there is reafon to  conclude,
that a part of the matter of fmall-pox is abforbed, and
thus produces  the  fecondary fever.   See Clafs II. 1.
3. 9.   And not fimply  by its ftimulus on the furface
of the ulcers beneath the  fcabs.  The exfudation of a
yellow fluid  from beneath  the confluent eruptions on
the face before the height is fpoken of in Clafs II.
 1. 3. 2.
   The material thus abforbed in the fecondary fever
of fmall-pox  differs from  that of open ulcers, as it  is
 only aerated  through  the elevated  cuticle; and fe-
condly,  becaufe there is not a conftant fupply of frefh
 matter,  when that already in the puftules is  exhaufted,
 either by abforption,  or by  evaporation,  or by  its
 induration into a  feab.   Might  not the  covering the
 face afliduouily and exaaiy with plafters, as with ce-
 rate of calamy, or with minium plafter,  by precluding
 the air from the puftules, prevent their contraaing a
 contagious,  or acefcent,  or  fever-producing power?
 and  the fecondary fever be  thus prevented entirely.
 If the matter in thofe  puftules on the face  in the con-
 fluent fmall-pox were thus prevented from oxygenation,
 it is highly probable, both from this  theory, and from
 the faas before mentioned, that the matter would not
 erode the fkin beneath them, and by thefe means  no
 marks or fears would fucceed.

    13. Febris  carcinomatofa.   Fever  from  the matter
 of cancer.   In a late publication the  pain is faid to be
 relieved, and the  fever  cured,  and  the cancer eradi-
                                              cated, 
3F^               DISEASES      [Class II. i. 6.
cated, by the application of carbonic acid gas,  or fixed
air.   See Clafs II. i. 4.  16.

   14. Febris  venerea.  From,  the  abforption of the
matter from  venereal ulcers  and fuppurating bones,
See Syphilis,  II. 1.5. 2.
   M. M. Any  mercurial  calx.  Sarfaparilla ?   Me-
zereon ?

   15. Febris  a fanie putrida.  Fever  from  putrid
fanies.  When parts of the  body  are  deftroyed by
external  violence, as a bruife,  or by mortification, a
putrefaaion foon fucceeds ; as they  are  kept in that
degree of warmth and  moifture by their adhefion to
the living parts of the body, which moft forwaids that
procefs.   Thus  the  Sloughs of mortified  parts of  the
tonfils give  fetor  to the breath in fome fevers ;  the
matter from  putrefying teeth,  or  other  fuppurating
bones, is  particularly offensive ; and even the  fcurf,
which adheres to the tongue, frequently acquires a
bitter tafte from its incipient putridity.  This material
differs from  thofe before mentioned, as its deleterious
property depends on  a chemical rather than an animal
proeeh.

   16. Febris puerpera.   Puerperal  fever.  It appears
from  fome late diffeftions, which have been published,
of thofe women who have died of the puerperal  fever,
that  matter has been formed  in  the omentum,  and
fcund in  the  cavity of the  ahdomen,  with fome
                                              blood 
Class II. i. 6.]    OF SENSATION.               3?j
blood or fanies.  Thefe parts are fuppofed to have
been injured  by the exertions accompanying labour;
and as  matter in this vifcus may have been produced
without much pain,  this difeafe is not attendee  with
arterial  ftrength and hard full pulfe like the infl . ama-
tion of the uterus ;  and as the fever is of the  inh rita-
tivecr typhus kind, there is reafon to believe, that'he
previous exhauftion of the patient during  labour may
contribute to its produaion ;  as well as the abiorp ion
of a material  not purulent but putrid ;  which is  formed
by the delay  of extravafated or dead matter produced
by the  bruifes  of the omentum, or other vifcera, in
the efforts of  parturition,  rather than  by purulent
matter,  the confequence of fuppuration.   The pulfe
is generally about  120 when in bed and  in the morn-
ing ;  and is increafed  to  134, or more, when the
patient  Sits up, or  in  the evening paroxyfm.  The
pulfe of all very  weak patients increafes  in frequency
when they fit up ; becaufe the expenditure of fenforial
power neceffary to preferve an erea pofture deduas fo
much from their general Strength ; and hence the pulfe
becomes weaker, and in confequence quicker.   See
Sea.  XII. 1.4.
   In  this fever time muft be allowed for the abforption
of the matter.   Very large and repeated  quantities of
the bark,  by  preventing fufficient food  from being
taken,  as bread, and wine, and water, I have thought
has much injured the patient;  for the  bark is not here
given as in intermittent fevers to prevent the paroxyfin,
but fimply to ftrengthen the  patient by increafing the
                                            power 
3&2                DISEASES    [Class II. I. 6.
power of digeftion.  About  two ounces of decoaion
of bark, with four drops  of  laudanum,  and a dram
of fweet fpirit of vitriol, once in fix hours, and a glafs
of wine between  thofe times, with panada, or other
food, I have thought of moft  advantage,  with a fmall
blifter occafionally.
  Where not  only the  ftomach but alfo the  bowels
arc much diftended with air, fo as to found on ftriking
them with the fingers,  the cafe is always dangerous,
generally  hopelefs; which is  more fo in proportion
to the quicknefs  of the pulfe.   Where the  bowels
are diftended two drops  of  oil  of cinnamon fliould
be given in the panada three  or four times a day.

  17.  Febris a fphacelo.   Fever from  mortification.
This  fever  from  abforption  of   putrid matter is of
the inirritative  or typhus  kind.   See the preceding
article.
  M. M.  Opium and the bark are frequently given in
too great quantity, fo as tojnduce confequent debility,
and to opprefs the power of digeftion.
ORDO 
Class II. i. 7/J -   OF SENSATION.
3*3
                   ORDO   I.
                Increafed Senfation.

                  GENUS  VII.
    With increafed Aclion cf the Organs of Senfe.

                   SPECIES.
   I. Delirium febrile.   Paraphrofyne.  Tlie ideas  in
delirium confift  of thofe  excited by the fenfation  of
pleafure or pain, which precedes them, and the trains
of other  ideas  affociated with  thefe, and not of thofe
excited by external irritations or by voluntary exer-
tion. Hence the patients do not know the room which
they inhabit, or the people who furround them ; nor
have they any voluntary exertion, where the delirium
is complete ; fo that their efforts  in walking about a
room or rifing from their bed  are unfteady,  and pro-
duced  by their catenations with the immediate affec-
tions of pleafure or pain.   See Seaion XXXIII.  1. 4.
   By  the above circumstances it is diftinguiflied  from
madnefs, in which the patients well know  the per-
fons of their acquaintance, and the place where they
are; and perform all the voluntary actions with ftea-
dinefs  and determination.  See Sea.  XXXIV.  2. 2.
   Delirium is fometimes  lefs complete,  and  then a
new face  and  louder voice ftimulate the patient to
attend to  them for a few moments; and then they
relapfe again  into  perfea delirium.  At other  times
a delirium  affeas but one fenfe, and the perfon thinks
                                                 he 
384              DISEASES     [Class II. i. 7.
he fees things which do not exift; and is  at the fame
time fenfible to the questions which  are  aSked him,
and  to  the tafte of the food which is offered  to him.
  This  partial  delirium is termed an  hallucination of
the difordered  organ; and may probably arife  from
the origin of one nerve of fenfe being more liable to
inflammation than the others ; that is, an exuberance
of the fenforial power of fenfation may effea it; which
is therefore thrown into  aaion by  Slighter  fenfitive
catenations, without being  obedient to external ftimu-
lus, or to the power of volition.
  The perpetual flow of ideas in delirium is owing to
the fame  circumftance, as of thofe in  our dreams ;
namely, to  the defea or  paralyfis of the voluntary
power; as in hemiplagia,  when  one fide of the body
is paralytic, and thus expends  lefs of the fenforial
power, the limbs on the other fide are in conftant mo-
tion  from the exuberance of it.   Whence lefs fenforial
power is exhaufted  in delirium,  than  at other times,
as well  as in fleep ; and hence  in fevers  with great
debility, it is perhaps, as well as the ftupor, rather a
favourable circumftance; and when removed  by nu-
merous  blifters, the death of the patient often  follows
the recovery of his understanding. See Clafs I.  2. 5.6.
and I. 2. 5. ic.
  Delirium in difeafes from inirritability  is fometimes
preceded by a  propenfity  to furprife.  See   Clafs I.
1. 5. 12.
  M. M.  Fomentations of the Shaved  head  for an
hour repeatedly.  A blifter on the head.   Riling from
                       1                       bed. 
Class II. i. 7.]     OF SENSATION-.              385
bed.   Wine and opium, and fometimes venefeaion in
fmall quantity by cupping, if the ftrength of the arte-
rial fyftem will allow it.

   2. Delirium mdniacale.   Maniacal delirium.  There
is another kind of delirium, defcribed in Sea. XXXIII.
1. 4. which has the  increafe of pleafurable  or  painful
fenfation for its caufe,  without any diminution of the
other fenforial powers; but as this excites the patient
to the  exertion of voluntary aaions,  for the purpofe
of obtaining the objea of  his pleafurable ideas, or
avoiding the objea of his painful ones, fuch as perpe-
tual prayer, when  it  is  of the religious kind, it be-
longs to the infanities defcribed in Clafs III.  1. 2. 1.
and is more properly termed hallucinatio maniacalis.

   3.  Delirium ebrietatis.   The drunken delirium is in
nothing different from the  delirium  attending fevers
except in its caufe, as  from alcohol, or other  poifons.
When it is attended with  an apopleaic ftupor, the
pulfe is generally low  ; and venefeaion I believe fome-
times deftroys  thofe, who  would otherwife have reco-
vered  in a few hours.
   M.  M. Diluting  liquids.   An emetic.

   4. Somnium.  Dreams constitute the moft complete
kind of delirium.  As in thefe no external irritations
are attended to, and  ihe power of volition is entirely
fufpended ; So that the fenfations of pleafure and pain,
v. :th their  affociations, alone excite the endlefs trains
                        Cc                      of 
3.56              DISEASES      [Class II. i. 7.
of our fleeping ideas ; as explained in Sea. XVIII. on
Sleep.

   5.  Hallucinatio vifu's.   Deception of fight.   Thefe
vifual hallucinations are perpetual in our dreams ; and
fometimes  precede general  delirium  in  fevers ; and
fometimes  belong to reverie,  and  to infanity.   See
Clafs III.  1. 2. 1. and 2. and muft be treated accord-
ingly.
   Other kinds of vifual hallucinations  occur by moon-
light ; when  objeas  are not feen So diftinaiy  as to
produce the ulual ideas affociated with them, but  ap-
pear to us exaaiy as they are  feen.   Thus the trunk
of a tree appears a flat Surface,  inftead of a  cylinder
as by day, and \* e are deceived and alarmed by  feeing
things as they really are feen.  See Berkley on Vifion.

   6.  Hallucinatio auditus.  Auricular  deception fre-
quently  occurs in dreams, and  fometimes  precedes  ge-
neral delirium in fevers; and fometimes belongs to
vertigo, and to reverie,  and to  infanity.  See  Sea.
XX.  7.  and Clafs III.  1.  2. 1.  and 2.

   7.  Rubor a colore.  The bluSh from heat  is  occa-
fioned by the increafed aaion of the cutaneous veffels
in confequence of the increafed fenfation of heat.  See
 Clafs I.  1. 2. 1. and  3.

   8. Rubor jucunditatis.  The bluSh  of  joy is  owing
to the increafed aaion of the capillary arteries,  along
                                               with 
Class II. i. 7-]    OF SENSATION.              367
with that of every moving  veffel  in  the body, from
the increafe of pleafurable fenfation.

   9.  Priapifmus amatorius.  Amatorial priapifm. The
blood is poured into the cells of the corpora cavernofa
much fafter  than  it can  be reabforbed by the vena
penis, owing in  this cafe  to the pleafurable fenfation
of love increafing the arterial  aaion.   See  Clafs  I.
1. 4.  6.

   10.   Difientio mamularum.   The  teats  of female
animals,  when they give lick, become rigid and erea-
cd, in the fame manner as  in  the laft article,  from
the pleafurable fenfation of the love of the mother to
her  offspring.  Whence  the teat  may  properly be
called an organ of fenfe.   The nipples of men do the
fame  when  rubbed with the  hand.    See Clafs  I.
1, 4. 7,
C c 2
ORDO 
J88  >
DISEASES     [Class II. z. u
                   ORDO  II.
.^               Decreafed Senfation.

                    GENUS  I.
                Of the General Syfiem.
                   SPECIES.
   i. Stultitia  infenfibilis.    Folly   from  infenfibility.
 The pleafure or pain generated in the fyftem is  not
 fufficient  to promote the ufual aaivity either of  the
 fenfual or mufcular fibres.

   2. Tccdium  vita.   Ennui.    Irkfomenefs  of  life.
 The pain of lazinefs has been  thought by fome philo-
 fophers to be that principle of aaion,  which has  ex-
 cited all our induftry, and distinguished mankind from
 the brutes of the field.  It is  certain that, where  the
 ennui  exifts, it  is  relieved  by  the exertions of our
 minds or bodies, as all other painful fenfations arc re-
 lieved ;  but it depends  much  upon our early habits,
 whether we become patient of lazinefs, or inclined to
 aaivity, during the remainder of our  lives, as other
 animals do not appear to be affeaed with this malady ;
 which is perhaps lefs owing to  deficiency of pleafurable
 fenfation,  than  to the  fuperabundancy of voluntary
 power, which occafions  pain in the mufcles by its  ac-
 cumulation ; as appears from the perpetual motions of
 a fquirrel confined in a cage.

   3. Partfis fenfitiva.   Weaknefs of the whole fyftem
 from infenfibility,
                                              ORDO 
Class II. 2. r.]    OF SENSATION.
3S9
                   ORDO  II.
                Decreafed Senfation.

                   GENUS  II.
               Of Particular Organs.

                   SPECIES.
   1. Anorexia.    Want of appetite.   Some elderly
people,  and thofe  debilitated  by fermented liquors,
are liable to lofe their appetite for animal food ; which
is  probably in part owing to  the deficiency  of gaftric
acid,  as well  as to the general  decay of the fyftem :
elderly people will go on years without animal food;
but inebriates foon fink, when their digeftion becomes
fo far impaired.   Want of appetite is fometimes pro-
duced by the putrid matter from  many decaying teeth
being perpetually mixed  with the  faliva, and thence
affeaing the organ of tafte,  and greatly injuring the
digeftion.
   M. M. Fine charcoal powder diffufed in warm wa-
ter held in  the mouth frequently  in  a day, as in Clafs
I.  1. 4. 4.  or folution of alum in  water.  Extraa the
decayed  teeth.  An emetic.   A blifter.  Chaiybeates.
Vitriolic acid.  Bile of an ox infpiffated, and made
into pills;  20 grains to be taken  before dinner and
fupper.   Opium half a grain  twice a day.
   All the  ftrength we  poffefs is  ultimately derived
from the food, which we are  able to digeft  ; whence
a  total  debility of the  fyftem frequently follows the
                      C c 3                  want 
39©               DISEASES     [Class II. 2. 2,
want  of appetite,  and of  the power of  digeftion.
Some young ladies I have obferved to fall  into this
general  debility,  fo as but juft  to be able  to -walk
about; which 1 have fometimes aferibed to their volun-
tary fafting, when they believed themfelves too plump ;
and who have thus loft both their health and beaiuy
by too great abstinence, which could never be reftored.
  I have feen other cafes  of what  may  be termed
anorexia epileptica, in which a total lofs of  appetite,
and  of  the  power of digeftion, fuddenly  occurred
along  with epileptic  fits.    Mifs  B. a  girl  about
eighteen, apparently very healthy,  and rather plump,
was feized with fits, which  were at firft called  hyfte-
rical; they occurred at the  end  of  menftruation, and
returned very frequently with total lofs of  appetite.
She was relieved by venefeaion, blifters, and opiates ;
her ftrength  diminifhed, and after fome returns  of the
fits, She took to her bed, and has  furvived  15  or 20
years ;  She has in general eaten half a potatoe a day,
and feldom fpeaks, but retains her fenfes,  and had
many years occafional returns of convulfion.  I have
feen two fimilar cafes,  where  the  anorexia, or want
of appetite, was in lefs degree ; and but juft fo  much
food could be digefted, as fupplied them with fufficient
Strength to keep  from the bed or Sofa for half the
day.   As  well  as I can recollea, all thefe patients
were attended with weak pulfe, and  cold pale Skin ;
and received benefit by opium,  from  a quarter of a
grain to a grain four times  a day.  See Clafs  III. 1.
 1. 7. and III. 1.  2.  1. and III. 1. 2. 20.
                                         2* Adipfio, 
Class II. 2. 2.]    OF SENSATION.              3,91
   2. Adipfia.  Want of thirft.  Several of the inferior
people, as  farmers wives, have a habit of not  drink-
ing with their  dinner  at all, or only take a  fpoon-
ful or  two of ale  after it.   I have  frequently ob-
ferved thefe to  labour  under bad digeftion, and de-
bility in confequence ;  which I have  aferibed to the
too great  ftimulus  of  folid food undiluted, destroy-
ing  in  procefs  of  time the  irritability  of  the Sto-
mach.

   3. Impotentia (agenefia").  Impotency much feldomer
happens to the male fex than fterility to the  female
fex.   Sometimes a  temporary impotence occurs from
baShfulnefs, or   the  interference  of  fome  voluntary
exertion in the produaion of an effea, which  Should
be performed alone by pleafurable fenfation.
   One, who was foon  to  be married to a lady of
fuperior condition to his own, expreffed  fear  of not
fucceeding on the wedding night; he  was  advifed fo
take a  grain of opium before he went  to  bed, and
to accuftom himfelf to  fleep with a woman previoufly,
but  not to  enjoy  her,  to take off his baflifulnefs;
which fucceeded to his  wifli.
   M. M. Chaiybeates.  Opium.  Bark.  Tinaure of
cantharides.

   4. Sfcrilitas.   Barrcnnefs.   One of the ancient me-
dical writers  afferts that  the female fex become preg-
nant  with moft certainty at or near  the time of,
menstruation.    This  is  not  improhable,  fince thefe
                      C c 4                 monthly 
39*             DISEASES      [Class II. 2. 2.
monthly periods feem  to refemble the monthly  vene-
real orgafm  of fome  female  quadrupeds, which  be-
come  pregnant at thofe times  only ; and hence  the
computation  of pregnancy  is  not  often erroneous,
though taken from the laft menftruation.  See Seaion
XXXVI. 2. 3.
   M. M.  Opium a grain every night.   Chaiybeates
in very fmall dofes.   Bark.   Sea-bathing.

   5.  Infenfibilitas artuum.   As in fome paralytic limbs.
A great infenfibility fometimes accompanies the torpor
of the fkin  in  cold fits of agues.   Some parts have
retained the fenfe of heat, but  not the fenfe of touch.
See Sea. XVI. 6.
   M. M. Friaion with flannel.   A blifter.   Warmth.

   6.  Dyfuria infenfitiva*   Infenfibilty of  the bladder.
A difficulty or total  inability to make water  attends
fome  fevers with great debility,  owing to the  infenfi-
bility or inirritability  of the bladder.   This  is  a dan-
gerous but not always a fatal fymptom,
   M. M. Draw off the water with a catheter.  Affift
the patient in the exclufion  of  it by comprefling the
lower parts of the abdomen  with  the hands.   Wine
two ounces.  Peruvian bark one dram  in  decoaion,
 every three hours  alternately.  Balfam of copaiva.
 Oil of almonds, with as  much camphor  as  can be
 diffolved in it, applied as  a liniment rubbed on  the
 region of  the bladder  and  perinneum, and  repeat-
 ed every  four hours, was ufed in this difeafe  with
             1                               fuccefQ 
Class II. 2. 2.J     OF SENSATION.             393
fuccefs by Mr. Latham.  Med. Comment.  1791, p.
213.

   7.  Accumulatio alvina.  An  accumulation  of feces
in the reaum, occafioned by the torpor,  or infenfi-
bility, of  that  bowel.  But  as liquids pafs  by thefe
accumulations,  it  differs  from the conftipatio alvi,
which is  owing to too great  abforption of the alimen-
tary canal.
   Old milk, and efpecially when boiled, is  liable to
induce this kind of coftivenefs in fome grown  perfons ;
which is probably owing to'their not poffeffing fufficient
gaftric acid to curdle and digeft it; for as both thefe
proceffes  require gaftric acid, it follows, that a greater
quantity  of it is  neceffary,  than in the digeftion of
other aliments, which do  not previously require being
curdled.   This ill digefted milk not  Sufficiently ftimu-
lating the reaum, remains till  it becomes a  too folid
mafs.   On this account milk  feldom agrees with thofe,
who  are  fubjea to  piles,  by inducing  coftivenefs and
large ftools.
   i.'.'l, M. Extraa the hardened fcybala by means  of
a marrow-fpoon ; or by a piece of wire, or of whale-
bone bent into a bow, and introduced.  Injeaions  of
oil.   Caftor oil, or oil of almonds, taken by the mouth.
 A large  clyfter of fmoke of tobacco.  Six  grains  of
 rhubarb  taken every night for many months.  Aloes.
 An endeavour to eftabliSh a habit of evacuation at a
 certain hour daily.   See  Clafs I.  1.3. 5.

                                             ORDO 
  394             DISEASES      [<£lass II. 3. 1.

                     ORDO  III.
             Retrograde Senfitive Motions.

                     GENUS  I.
                 Of Excretory Duels.
    The retrograde aaion of the cefophagus in rumi-
 nating animals, when  they bring up  the food  from
 their firft ftomach for the purpofa of a fecond mafti-
 cation  of it, may probably be caufed by agreeable
 fenfation:  fimilar to  that  which  induces  them  to
 fwallow it both before and after this  fecond *rloca-
 tion ; and then this retrograde aaion properly^belongs
 to this  place,  and is erroneously put at the head  of
 '.he order of irritative retrograde motions.   Clafs I.  c;.
 1. 1.

                   SPECIES.
    1. Ureterum motus  retrogreffus.   When a ftone has
 advanced into the ureter from the pelvis of the kidney,
 it is fometimes liable to be returned by the retrograde
 motion  of that canal, and the patient  obtains fallacious
 eafe, till the ftone is again puflied into  the ureter.

   2. Urethra; motus  retrogreffus.   There have been
 inftances  of bougies being carried  up the  urethra
 into the bladder moft probably by an inverted motion
 of  this  canal; for which fome  have  undergone an
operation fimilar to that for the extraaion  of  a ftone.
 A  cafe  is related  in fome  medical  publication, in
                                             which 
Class II. 3- 1.]     OF SENSATION.             395
which a  catgut bougie was  carried into the bladder,
and  after remaining many weeks, was  voided  piece-
meal in a femi-diffolved ftate.  Another  cafe is related
of a  French officer, who ufed a leaden bougie ;  which
at length found  its way  into the bladder,  and was,
by injeaing crude mercury,  amalgamated and voided.
   In the fame manner the infeaion from a  fimple
gonorrhoea is probably carried further along the courfe
of the urethra ;  and fmall  ftones frequently defcend
fome way into the urethra,  and are again carried  up
into  the  bladder by the inverted aaion of this canal.

   3. Duel us choledochi motus  retrogreffus.  The concre-
tions of bile, called gall-ftones, frequently  enter the
bile-dua, and give violent pain for fome hours; and
return again into the gall-bladder, by the  retrograde
aaion of this dua.   May not  oil be carried  up this
dua, when a gall-ftone gives great pain, by its retro-
grade fpafmodic aaion ?   See Clafs I. 1. 3.  8.
   M. M. Opium a grain  and half.
■S'liL 
39<5               DISEASES         [Class III.


   1HE ORDERS AND GENERA OF THE THIRD CLASS
                    OF DISEASES.
              CLASS   III.
           DISEASES OF  VOLITION.

                 ORDO  I.
               Increafed Volition*

                 GENERA.
i. With increafed aaions of the mufcles.
i. With increafed aaions of the organs of fenfe.

                 ORDO  II.
               Decreafed Volition.

                 GENERA.
i. With decreafed aaions of the mufcles.
2. With decreafed aaions of the organs of fenfe.
THE 
Class III. i. i.]     OF VOLITION.
397
THE ORDERS, GENERA, AND SPECIES, OF THE
        THIRD CLASS OF DISEASES.
        CLASS  III.

      DISEASES  OF VOLITION.

            ORDO  I.
         Increafed Volition.

           GENUS  I.
With Increafed Aclions of the Mufcles*

           SPECIES.
 i. faclitatio.
 2. Tremor febrilis.
 3. Clamor.
 4. Rifus.
 5. Convulfio.
  -------- debilis.
 6.-------dolorifica.
 7. Epilepfia.
 8. ———- dolorifica.
 9. Somnambulifmus.
10. Afihma  convulfivum.
14.-----dolorificum.
12. Stridor dentium.
13. Tetanus trifmus.
14.------dolorificus.
15. Hydrophobia.
Reftleffnefs.
Febrile trembling.
Screaming.
Laughter.
Convulfion.
--------weak.
--------painful.
Epilepfy.
------painful.
Sleep-walking.
Afthma convulfive.
—:----painful.
Gnafhing of the teeth.
 Cramp of the jaw.     ,«
   •  — painful.
Dread of water.
                   GENUS 
DISEASES     [Class III. 1.2.
              GENUS   II.
With increafed Aclions of the Organs of Senfe*
              SPECIES.
 1.
 2.
 3-
 4-
 5-
 6.
 7-
 8.
 9-
10.
11.
12.

i3-
14.
15-
16.

18.
19-
20.
21.
22.
23-
24-
Mania mutabilis*
Studium inane.
Vigilia.
Erotomania.
Amorfui.
Nofialgia.
Spes religiofa.
Superbiaftemmatis.
Ambitio.
Maror.
Tcedium vita.
Mutable madnefs.
Reverie.
Watchfulnefs.
Sentimental love.
Vanity.
Defire of home.
Superftitious hope.
Pride of family.
Ambition.
Grief.
Irkfomencfs of life.
Defiderium pulchriiudi- Lofs of beauty.
 Paupcrlatis timor.
 Let hi timor.
 Orci timor.
 Satyr iafis,
 Ira.
 Rabies.
 Citta.
 Cacofitia.
 Syphilis imaginaria.
, Pfora imaginaria.
 Tabes imaginaria.
 Sympathia alicna.
, EducMio  heroica*
Fear of poverty.
-----of death.
-----of hell.
Luft.
Anger.
Rage.
Depraved appetite.
Averfion to food.
Imaginary pox.
.---------itch.
---------tabes.
Pity.
Heroic education.
ORDO 
Class III. 2. 1.]
OF VOLITION.
39?
            ORDO  II.
         Decreafed Volition.

            GENUS  I.
With decreafed Aclions of the Mufcles.

           SPECIES.
 1. Laffitudo.
 2. Vacillatio fcnilis.
 3. Tremor fenilis.
 a. Brachiorum paralyfis.
 5. Raucedo paralytica.
 6. Vefica urinaria paraly-
    fis.
 7. Recli paralyfis.
 8. Parefis voluntaria.
 9. Catalepfis.
10. Hemiplegia.
11. Paraplegia.
12. Somnus.
13. Incubut.
1 a. Lethargus.
15. Syncope epileptica.
16. Apoplexia.
17. -Mors a frigore.
Fatigue.
See-faw of old age.
Tremor of old age.
Palfy of the  arms.
Paralytic hoarfenefs.
Palfy of the  bladder.

Palfy of the reaum.
Voluntary debility.
Catalepfy.
Palfy of one fide.
Palfy of the lower limbs.
Sleep.
Night-mare.
Lethargy.
Epileptic fainting.
Apoplexy.
Death from cold.
GENUS 
DISEASES       [Class III. 2. 2.
                  GENUS   II.
    With decreafed Aclions of the Organs of Senfe.

                   SPECIES.
1. Recolleclionis jaclura.   Lofs of recolfeaion.
2. Siultitia voluntaria.^   Voluntary folly.
3. Crcdulitas.             Credulity.
 
Class III. I. 1.]     OF VOLITION.               4-*

                 CLASS  III.
             J&ISEASES OF VOLITION.

                    ORDO  I.
                 Increafed Volition.

                   GENUS  I.
          Increafed Aclions of  the  Mufcles.
   We now Step  forward  to  confider the difeafes of
volition,  that fuperior faculty of the fenforium, which
gives us the power of reafon, and by  its facility of
aaion diftinguiflies mankind from brute animals ; which
has effeaed all that is great in the world, and fuper-
impofed the works of art on the Situations of nature.
   Pain is introduced into the fyftem  either by excefs
or defea of  the  aaion  of the part.  (Sea. IV. 5.)
Both which circumftances feem to  originate from the
accumulation of fenforial power in  the affeaed organ.
Thus when the  Skin  is expofed to  great cold,  the
aaivity of the cutaneous veffels is  diminiflied, and in
confequence an accumulation of fenforial power obtains
in them,  becaufe  they are ufually excited into inceffant
motion by the ftimulus of heat, as explained in Sea.
XII. 5. 2.  Contrary wife,  when the veffels of the Skin
are expofed to great heat,  an excefs of fenforial power
is alfo produced  in them, which  is  derived thither
by the increafe of ftimulus  above what is natural.
   This accounts for the relief which is received  in all
kinds of pain by any violent extertions of our mufcles
                          D d                   or 
40*             DISEASES      [Class III. i. t,
or organs of fenfe; which may thus be in part af-
eribed to the exhauftion of the fenforial power by fuch
exertions.   But this relief is in many cafes fo instan-
taneous, that it feems neverthelefs probable,  that it is
alfo in part  owing to  the different manner of progref-
fion of  the  two fenforial powers of fenfation and voli-
tion ;  one of them commencing at fome  extremity of
the fenforium,  and being propagated towards the cen-
tral parts of it;  and the other commencing  in the
central  parts of the fenforium, and being  propagated
towards the extremities of it; as mentioned in  Sea.
XI. 2.  I.
   Thefe violent voluntary exertions of our mufcles or
ideas to relieve the fenfatfon of pain constitute convul-
fions  and madnefs; and are  distinguished from the
mufcular aaions  owing  to  increafed fenfation, as in
fneezing, or coughing, or  parturition,  or ejeaio fe-
minis,  becaufe they do not contribute to diflodge the
caufe,  but  only to prevent the fenfation  of k*  In two
cafes of parturition,  both of young women with their
firft child,  I have feen general convulfions occur from
 excefs  of voluntary exertion, as above  defcribed,  in-
 stead of the aaions of particular mufcles,  which ought
 to have been excited by fenfation for the  exclufion of
 the  fetus.   They both became infenfible,  and died
 after fome  hours;  from one of them the fetus was
 cxtraacd in vain.  I have  heard alfo of general con-
 vulfions being  excited inftead of the aaions of the muf-
 culi acceleratores in the ejeaio feminis, which termi-
 *ated fatally.  See Clafs III.  i. i. 7.
                                              Thefe 
Class III. i. i.]    OF VOLITION.               40$
   Thefe violent exertions are moft frequently excited
in confequence of thofe pains,  which originate from
defea  of the aaion of  the part.  See Sea. XXXIV.
1. and 3.  The pains from  excefs and defea of  the
aaion of the part are diftinguifliable  from each other
by the former being attended with increafe of heat in
the pained  part,  or  of the whole body ;  while  the
latter not only exift without increafe of heat  in  the
pained part,  but are generally attended with coldnefs
of the extremities of the body.
   As foon as thefe violent aaions  of our  mufcular or
fenfual fibres for the purpofe of relieving pain ceafe to
be exerted,  the  pain  recurs; whence the reciprocal
eontraaion and relaxation of the mufcles in convulfion,
and the intervals of madnefs.   Otherwife thefe violent
exertions continue, till fo great  a part of the fenforial
power is exhaufted, that no  more of it is excitable by
the faculty  of volition; and  a temporary apoplexy
fucceeds, with fnoring as in profound fleep; which fo
generally terminates epileptic fits.
   When thefe voluntary exertions become fo connea-
ed with certain difagreeable fenfations, or with irri-
tations,  that the  effort of the will cannot reftrain
them,  they can  no longer in  common language  be
termed  voluntary ; but  neverthelefs belong  to this
clafs,  as they are produced by excefs of volition, and
may ftill not  improperly be called depraved  voluntary
aaions.  See Sea.  XXXIV. 1.  where many motions
in common language termed involuntary are Shewn to
depend on excefs of volition.
                      D d  2                  When 
4*4               DISEASES    [Class III. i. u
   When thefe exertions from excefs of volition, which
in common language are termed involuntary motions,
cither  of mind  or body, are perpetually exerted in
weak constitutions,  the pulfe  becomes quick ; which
is occafioned by the too great expenditure  of the fen-
forial power in thefe unceafing modes of aaivity.   In
the fame manner as in very weak people in fevers, the
pulfe fometimes increafes in frequency to  140 Stroke*
m a minute, when the  patients ftand up or endeavour
to walk;  and fubfides to no, when they lie down
again in their beds. Whence  it appears, that when
a very quick pulfe accompanies convulfion  or infanity,
it fimply indicates the weaknefs of the patient; that is,
that the expenditure of  fenforial power is too great
for the fupply of  it.   But if  the ftrength of the pa-
tient is not previoufly exhaufted,  the  exertions of the
mufcles are attended with temporary increafe of circu-
lation,  the reciprocal fwellings and elongations of their
bellies puSh forwards tliG arterial  blood, and promote
the abforptidn of the venous blood ;  whence a tempo-
rary increafe of fecretion and of heat, and a ftronger
pulfe.
                   SPECIES.
   1. Jaclitatio.   Reftleffnefs.  There is one kind of
rcftleffnefs attending fevers, which  confifts in  a fre-
quent  change of pofture to relieve the uneafinefs of the
preffure of one part of the  body  upon another, when
the fenfibility of tJ   fyftem,  or of fome parts of it,  is
increafed by mflammauon,  as  in the lumbago '% which
                                              may 
 Class III J. i.]     OF VOLITION.               4,05
 may fometimes be  diftinguifhed in its early ftage by
 the inceffant defire of the patient to turn himfelf in bed.
 But there is  another reftleffncfs, which approaches
 towards writhing or contortions of the body,  which is
 a voluntary effort to relieve pain ;  and may be efteemed
 a flighter kind of convulfion, not  totally unreSfrainable
 by oppofite orcounter-aaing volitions.
   M. M. A blifter.   Opium.   Warm bath.

   2.  Tremor febrilis.  Reciprocal convulfions of the
fubcutaneous mufcles, originating from  the  pain of
 the fenfe of heat, owing  to defea of its ufual ftimulus,
 and confequent  accumulation of fenforial  power in it.
 The aaual deficiency of heat may exift in  one  part of
 the body, and the pain' of cold be felt moft vividly in
 fome other part,  anociated  with it by fenfitive fym-
 pathy.  So a chillnefs down the back is firft attended
 to in ague-fits,  though the difeafe perhaps commences
 with the torpor and confequent coldnefs  of fome inter-
 nal vifcus.  But in whatever  part of the fyftem  the
 defea of heat  exifts, or the fenfation of  it,  the  con-
 vulfions of the fubcutaneous mufcles exerted to relieve
 it are very general; and, if the pain is ftill greater, a
chattering of fhe teeth is added, the" more  fuddenly to
cxhauft the fenforial power, and becaufe the teeth are
very fenfible to cold.
   Thefe convulfive motions  are neverthelefs  reftraln-
 able by violent voluntary counteraaion ; and  as their
 intervals are owing to the pain of cold being for a
 time relieved by  their exertions, they may be compared
                      D d 3                    t« 
4«6              DISEASES     [Class III. i. i.
to laughter, except that there is no interval of pleafure
preceding each moment of pain in this as in the latter.
   M. M.  See I. 2. 2.  1.

   3.  Clamor.   Screaming from pain.   The  talkative
animals,  as  dogs,  and  fwine,  and  children, fcream
moft, when they are in pain, and even  from fear ;  as
they  have ufed this kind of exertion from their birth
moft frequently and moft forcibly ; and can  therefore
fooner cxhauft the accumulation of fenforial  power  in
the affeaed mufcular or fenfual  organs by this mode of
exertions ; as defcribed in Sea. XXXIV.  1. 3,  This
facility of relieving pain by fcreaming is the  fource of
laughter,  as explained below.

   4.  Rifus.   The pleafurable fenfations, which occa-
fion laughter, are  perpetually paffing into  the bounds
of pain ;  for pleafure and pain are often produced by
different  degrees of the fame ftimulus;  as  warmth,
light, aromatic or  volatile odours, become painful by
their  excefs ;  and  the  tickling on the foles of the feet
in children is  a painful fenfation at  the very time it
produces  laughter.    When the pleafurable   ideas,
which excite us to laugh, pafs into pain, we  ufe feme
exertion,  as  a fcream, to  relieve the pain,  but foon
Stop it again, as we are unwilling to  lofe the pleafure ;
and  thus we repeatedly begin to  fcream,   and Stop
again, alternately. So that in laughing there  are three
ftages, firft  of pleafure, then pain,  then  an exertion
to relieve that pain.   See Sea. XXXIV. 1.  3.
                                             Every 
Class III. i. i.]     OF VOLITION.              4^>
  Every one  has been in a fituation, where fome
ludicrous circumftances has excited him to laugh ;  and
at the fame time a fenfe of decorum has forbid the ex-
ertion of thefe interrupted fcreams ;  and then the pain
has become fo violent, as to occafion him to ufe fome
other great aaion, as biting his tongue, and pinching
himfelf, in lieu of the reiterated fcreams which consti-
tute laughter.

   5. CoHvulfio.   Convulfion.   When the pains from
defea or excefs  of  motion are more diftreffing than
thofe already defcribed, and are not relievable by  fuch
partial  exertions,  as in fcreaming, or laughter, more
general  convulfions occur; which vary perhaps acr
cording to the fituation of the pained part,  or to fome
previous  affociations formed by the early habits  of
life.   When thefe convulfive motions  bend the body
forwards, they  are termed  emprofthotonoi; when
 they bend it backward,  they are termed opifthotonoi,
 They frequently fucceed each other, but the opiftho-
 tonoi are generally more violent;  as the mufcles,
 which erea the body, and keep it erea,' are naturally
 in  more conftant and more forcible aaion  than  their
 antagonists.
    The  caufes of convulfion are very numerous, as
 from toothing in  children, from worms or acidity in
 their bowels, from eruption of  the diftina fmall-pox,
 and laftly,  from breathing too long the air of an un-
 ventilated bed-room.  Sir G.  Baker, in  the Tranf-
 aftions of the College, defcribed this difeafe, and de-
                       D d 4                 tcfted 
408              DISEASES     [Class III. i. :
teaed its caufe ; where many children in an orphan-
houfe were crowded  together in one chamber without
a chimney, and were almoft all  of them affeaed with
convulfion;  in the hofpital at Dublin,  many  died of
convulfions  before  the  real caufe  was  underftood.
See  Dr. Beddoes's Guide to Self-prefervation.  In a
large family,  which I attended, where many female
fervants flept in one room, which they had  contrived
to render inacceffible to every blaft of air; I faw four
who were thus feized with convulfions, and who were
believed to have been affeaed by  fympathy from the
firft who fell ill.   They were removed into more airy
apartments, but were fome weeks before they all re-
gained their perfea health.
   Convulfion is diftinguifhed from epilepfy, as  the pa-
tient does not intirely lofe  all perception during the
paroxyfm.   Which only Shews,  that  a lefs exhauftion
of fenforial power renders tolerable  the pains which
caufe convulfion,  than  thofe which caufe  epilepfy.
The hyfteric convulfions are  distinguished from thofe,
owing to other caufes, by the pretence of the expec-
tation of death, which precedes and fucceeds them,
and generally by a flow of pale urine; thefe convul-
fions do not conftantly  attend the hyfteric difeafe, but
are occafionally fuperinduced by the  difagreeable fen-
fation arifing from the torpor or inverfion of a  part of
the  alimentary canal.   Whence  the  convulfion  of
laughter is frequently fufficient to reftrain thefe hyfteric
pains, which accounts for  the  fits  of laughter fre-
quently attendant on this difeafe,
                                        M.  M. To 
Class III. i. i.]    OF VOLITION,              40*
   M. M. To  remove the peculiar pain which- excites
the convulfions.  Venefeaion.   An emetic.  A ca-
thartic with calomel.   Warm-bath.  Opium in  large
quantities, beginning with  fmaller ones.   Mercurial
friaions.   Efearicity.   Cold-bath  in  the paroxyfm;
or cold afperfion.  See Memoirs of Med. Society, Lon.
V. 3. p. 147.  a paper by Dr. Currie.

   Convulfio debilis.  The convulfions of dying animals,
as of thofe which are bleeding to death in the flaugh-
ter-houfe, are an effort to  relieve painful  fenfation,
either of the wound which occafions their death, or of
faintnefs from want of due diftention of the  blood-vef-
fels.   Similar to  this in a lefs degree is the fubfultus
tendinum, or ftarting  of  the  tendons, in fevers with
debility ; thefe aaions of the mufcles are too weak to
move the limb, but the belly of  the aaing mufcles is
feen  to Swell, and the tendon  to be ftretched.   Thefe
weak convulfions, as they are  occafioned by the dif-
agreeable fenfation of faintnefs from inanition,  are
fymptoms of great general debility,  and  thence fre-
quently precede  the general convulsions of the aa of
 dying.  See a cafe of convulfion  of a mufcle of the
 arm, and of the fore-arm, without moving the  bones
 to which they were attached,  Sea. XVII.  i.  8. See
 twitchings of the face,  Clafs IV. 3. 2. 2.

   6.  Convulfio dolorifica.   Raphania.   Painful con-
 vulfion.   In this difeafe the mufcles of  the arms and
 legs are exerted to relieve the pains left after the rheu-
 matifm in young and delicate people ;  it recurs once or
                                               twice 
4i»              DISEASES     [Class III. i. I.-
twice a day, and has been miftaken for the chorea,  or
St. Vitus*s dance;  but differs from it, as the undue
motions in that difeafe only occur, when the patient
endeavours to exert  the natural ones; are not attended
with  pain ; and ceafe, when he  lies down without
trying to move : the chorea, or dance  of St.  Vitus, is
®ften introduced by the itch, this by the rheumatifm.
   It has alfo been improperly called nervous rheuma-
tifm ;  but is  distinguished from rheumatifm, as  the
pains recur by periods once or twice a day ; whereas
in the chronic rheumatifm they only occur on moving
the affeaed mufcles.   And by the warmth of a bed
the pains of the chronic  rheumatifm are increafed, as
the mufcles or membranes  then become more fenfible
to the ftimulus of the extraneous  mucaginous material
deppfited under them.  Whereas the pains of the  ra-
phania,  or painful  convulfions,  commence with cold-
nefs of the part, or of the extremities.  See Rheumatif-
mus chronicus,  Clafs I.  i.  3. 12.
   The pains which accompany the contraaions of the
mufcles in this difeafe, feem to arife from the too great
violence of thofe contraaions, as happens in the cramp
of the calf of the leg ;  from which they diifer in thofe
being fixed, and thefe being reiterated  Contraaions.
Thus thefe  convulfions are  generally  of the lower
limbs, and recur at periodical times from fome uneafy
fenfation from defea  of aaion,  like other periodic
 difeafes) and the convulfion? of the limbs relieve  the
original uneafy painful fenfation,  and then  produce a
 greater pain from their own  too vehement contrac-
 tions.  There  is however another way  of accounting
                                                for 
Class III. i. i.]     OF VOLITION.              411
for thefe pains,  when they fucceed the acute rheuma-
tifm ; and  that  is by the coagulable  lymph, which
may be left ftill unabforbed on the membranes ; and
which may be  in too  fmall quantity  to  affea them
with pain  in common mufcular exertions, but may
produce great pain, when the  bellies  of  the mufcles
fwell to a larger bulk in violent aaion.
   M. M.  Venefeaion.    Calomel.  Opium.   Bark.
One grain of calomel  and one of opium for ten fuc-
ceffive nights.   A bandage fpread with emplaftrum de
minio put tight oh the affeaed part.

   7. Epilepfia is originally induced, like other convul-
 fions, by a voluntary exertion to relieve fome pain.
 This pain is moft frequently  about the pit of the fto-
 mach,  or termination of the bile-dua;  and in fome
 cafes the torpor of the  ftomach, which probably occa-
 fioned the epileptic fits, remains afterwards, and pro-
 duces a chronical anorexia ; of which a cafe is related
 in Clafs II. 2. 2. 1.  There are inftances of its begin-
 ning in the heel, of which a cafe is publifhed by Dr.
 Short, in the  Med. Effays, Edinb.   I once faw a
 child about  ten years  old, who  frequently fell down
 in  convulfions,  as flie was running about  in play ; on
 examination a  wart was  found on  one ancle, which
 was ragged and inflamed; which was direaed to be
 cut off, and the fits never recurred.
    When  epilepfy  firft commences,  the patients  are
 liable  to utter one fcream before they fall down;
 afterwards the convulfions fo  immediately follow the
                                              pain, 
4'i              DISEASES    [Class III. r. t.
pain, which occafions them, that the patient does not
recolfea or feem fenfible of the preceding pain.  Thus
in laughter, when it is not exccffive,  a  perfon is not
confcious of the pain, which fo often recurs, and caufe's
the fucceffive fcreams or exertions of laughter,  which
give a temporary relief to it.
   Epileptic fits frequently recur in fleep from the in-
creafe of fenfibility at*that time, explained in Sea.
XVIII. 14. In two fuch cafes, both of young women,
one grain of opium given at night, and continued many
months, had fuccefs;  in  one of them the opium was
omitted twice at different  times, and the fit recurred
on both  the  nights.  In  the  more violent cafe,  de-
fcribed in Sea. XVIII. 15. opium had no effea.
   Epileptic fits  generally commence  with fetting the
teeth, by which means the tongue is frequently wound-
ed ;  and with rolling  the eye-balls in  every kind of
direaion ; for the mufcles which fufpend the jaw, as
well as thofe which move the  eyes,  are in perpetual
 motion during our  waking hours; and  yet continue
 fubfervient to volition ; hence  their  more  facile  and
 forcible aaions for the purpofe of relieving pain by
 the exhauftion of fenforial power.   See Sea. XXXIV.
  1. 4.
    Epileptic convulfions are not attended with the fear
 of death, as in the hyfteric difeafe, and the urine is of
 a ftraw colour.  However it muft be noted, that the
 difagreeable  fenfations in hyfteric difeafes fometimes
  are the caufe of true epileptic  convulfions, of fyncope,
  and of madnefs.
                                                The 
Class III. i. i.]     OF VOLITION.              4r?
   The pain, which occafions fome fits of epilepfy,  is
felt for  a time in a diftant part of the fyftem, as in a
toe or heel; and is faid  by the  patient gradually  to
afcend to  the head,  before the  general convulfions
commence.  This afcending fenfation has been called
aura epileptica,  and is  faid to have been  prevented
from affeaing the head by a tight bandage round the
limb.  In this malady the pain* probably of fome tor-
pid membrane,  or difeafed tendon,  is  at firft only  fo
great as to  induce flight fpafms of the mufcular fibres,
in its vicinity;  which flight fpafms ceafe on  the numb-
nefs introduced by a tight bandage ; when no bandage
is applied, the pain gradually increafes, till generally
convulfions are exerted to relieve it.   The  courfe of
a lymphatic, as when poifonous matter is  abforbed;
or of a  nerve, as in the fciatica, may, by the fympathy
cxifting  between  their  extremities  and origins, give
an idea of the afcent of an aura or vapour.
   In difficult parturition it fometimes happens, that
general convulfions are  excited to relieve the pain of
 labour, inftead of the exertions of thofe mufcles of the
abdomen and diaphragm, which ought to forward the
 exclufion of the child.'   See Clafs HI. i. i.   That is.
 inftead of the particular  mufcular aaions, which ought
 to be excited  by fenfation to remove the offending
 caufe,  general convulfions  are produced by the power
 of volition, which ftill the pain, as in common epilepfy,
 without removing tlie caufe ;  and,  as  the  parturition
 is not  thus promoted,  the convulfions continue,  till
 the fenforial  power  is totally exhaufted,  that  is,  till
                                              death. 
4'4              DISEASES     [Class III. r. i.'
death.   In patients affliaed with epilepfy from  other
caufes, I have feen the moft violent  convulfions recur
frequently during pregnancy without mifcarriagc, as
they did not tend to forward the exclufion of the fetus.
   M.  M. Venefeaion.   A large dofe of opium.   De-
livery.
   The later in life  epileptic fits are  firft experienced,
the more dangerous they may be efteemed in general;
as in  thefe cafes the caufe has generally  been acquired
by the habits of the patient, or by the  decay of fome
part,   and is  thus  probably in an  increafing ftate.
Whereas in children the changes in the fyftem, as they
advance to puberty, fometimes remove the caufe.  So
in toothing, fits of convulfion with ftupor  frequently
occur, and ceafe when the tooth advances ; but  this
is not  to be expeaed in advanced  life.  Sir------,
about  fixty years of age,  had  only three teeth left in
his upper jaw, a canine tooth,  and  one on  each fide
of it.   He was feized with epileptic fits,  with  pain
commencing in thefe teeth.  He was urged to  have
them extraaed, which he delayed too long,  till the fits
were  become  habitual, and then had them extraaed
in vain, and in a few months funk under the difeafe.
   Mr. F----, who had lived intemperately, and had
been occafionally affeaed with the gout,  was fuddenly
feized  with epileptic fits ;  the  convulfions  were fuc-
ceeded by apopkaic fnoring ; from which he was, in
about 20 minutes, difturbed by frefh  convulsions,  and
had continued in  this fituation above four-and-twenty
hours.   About eight ounces of blood were then taken
                                             from 
Class III. i. i.]     OF VOLITION.              4t5
from him ; and after  having obferved, that the apo-
pfeaic's torpor continued about 20 minutes, I dire&ed
him to be forcibly raifed up  in bed, after he had thus
Iain about fifteen minutes, to gain an interval between
the termination  of the fleep, and the renovation of
convulfion.  In this interval he was induced  to fwal-
low forty drops of laudanum.  Twenty  more were
given him in the fame manner  in about half an hour,
both  which evidently Shortened  the convulfion  fits,
and the  confequent ftupor ;  he then took thirty more
drops, which  for the prefent removed  the fits.  He
became rather infane the next day, and after about
three more  days loft  the  infanity, and  recovered his
ufual ftate of health.
   The cafe mentioned in  Sea.  XXVII. 2. where the
patient  was left after epileptic  fits with a  fuffufion
of blood beneath the tunica adjunaiva of the eye, was
in almoft every refpea fimilar to the preceding, and
fubmitted to the fame treatment.  Both of them fuf-
fered frequent relapfes,  which were relieved by  the
fame means, and at length perifhed, I believe,  by the
«pileptic fits.
   In thofe patients, who have not been fubjea to epi-
 lepfy before they have arrived to about forty years of
 age, and who have been intemperate in refpea to fpiri-
 tuous potation,  I  have  been induced to believe, that
 the fits were occafioned by the  pain  of a  difeafed
 liver ; and this became more probable in one of the
 above fubjeas, who had ufed means to repel eruptions
 en the  face; and  thus by  fome  Stimulant application
      4                                         had 
4>«              DISEASES      [Class III. i. i.
had  prevented an inflammation taking place on  the
fkin  of  the face inftead of on fome part of the  liver.
Secondly, as in thefe cafes infanity had  repeatedly oc-
curred,  which could not be traced from an hereditary
fource;  there is reafon to believe, that this as well as
the epileptic convulfions were caufed by fpirituous po-
tation ;  and that this therefore  is the original fource
both  of epilepfy and of infanity in  thofe  families,
which arc affliaed with them.   This  idea  however
brings fome confolation with it; as it may be inferred,
that  in  a few fober generations thefe difeafes may be
eradicated, which otherwife deftroy the family.
   M. M.  Venefeaion. Opium.   Bark.  Steel.  Ar-
fenic.   Opium one grain twice  a day for years toge-
ther.  See the preceding article.

   8. Epilepfia  dolorifica.  Painful epilepfy.   In  the
common epilepfy the  convulfions are immediately in-
duced,  as foon as the difagreeable  fenfation,  which
caufes them,  commences; but in this the  pain conti-
nues long with cold extremities, gradually increafing
for two  or three  hours,  till at length convulfions or
madnefs come on; which terminate the daily parox-
yfm, and ceafe themfelves in a  little time afterwards.
   This  difeafe fometimes originates from a pain about
the lower edge of the liver, fometimes in the temple,
and fometimes in the  pudendum; it recurs daily for
five or  fix weeks, and then ceafes for feveral months.
The pain  is owing to defea of  aaion, that is, to the
accumulation of  fenforial power in the part, which
                                           probably 
Class III. i. i.]    OF VOLITION.              4*7
probably fympathizes  With fome other part,  as ex-
plained in  Sea. XXXV. 2. XII. 5. 3. and  Clafs II.
1, 1.  n. and IV. 2. 2. 3.
   It is the  moft painful malady that human  nature is
liable to !—See Seel. XXXIV. 1. a.
   Mrs. C----- was feized every day about the fame
hour  with violent pain on the right fide of her bowels
about the  fituation of the lower edge of the liver,
without fever, which increafed for an hour or two,
till it became totally intolerable.  After violent fcream-
ing She fell into convulfions, which terminated fome-
times in fainting, with or without ftertor,  as in com-
mon  epilepfy;  at other times  a temporary infanity
fupervened ;  which continued  about half  an hour,
and the fit ceafed.   Thefe paroxyfms had returned
daily for  two  or three weeks,  and  were at length
removed by large dofes of opium,   like the  fits  of
reverie or fomnambulation.  About half an hour be-
fore  the  expeaed return of the fit three or four
grains  of opium were exhibited, and then tinaure of
opium  was given in  warm brandy and  water about
 20 or 30  drops every half  hour, till the  eyes  became
fomcwhat  inflamed, and the nofe began to itch, and
by the fbarp  movements  of  the patient,  or quick
 fpeech, an evident intoxication appeared ;  and then
 it  generally happened that the pain  ceafed.  But the
 effeas  of this  large dofe of opium was  fucceeded by
 perpetual  ficknefs  and  efforts to vomit,  with  great
 general debility  all the Succeeding dav.
E  c
The 
4*8             DISEASES     [Class III. i. i.
   The rationale of this temporary cure from  the ex-
hibition of opium and vinous fpirit depends  on the
great expenditure of fenforial power in the increafed
aaions of all  the  irritative motions,  by the Stimulus
of fuch large  quantities of opium and  vinous fpirit;
together with the produaion of much  fenfation, and
many movements  of the organs of fenfe  or ideas  in
confequence of  that fenfation ;  and  laftly, even the
motions of the  arterial fyftem become accelerated by
this  degree  of intoxication, all which foon exhaufted
fo much fenforial power as  to relieve the pain; which
would otherwife have  caufed convulfions  or infanity,
which are other means of  expending fenforial power.
The general debility on  the fucceeding day, and the
particular debility of the ftomach,  attended in con-
fequence with ficknefs  and frequent efforts  to vomit,
were occafioned  by the fyftem having previoufly been
fo Strongly ftimulated,  and thofe parts in particular
on which the opium and wine more immediately aaed.
This  ficknefs  continued  fo many hours as  to break
the catenation of  motions, which  had daily  repro-
duced the paroxyfm ; and thus it generally happened,
that  the whole  difeafe  ceafed for fome   weeks  or
months  from one  great  intoxication, a circumftance
not eafily to be explained on any  other  theory.
   The  excefs or defea of motion in any  part of the
fyftem occafions  the produaion of pain in that  part,
as in Sea. XII.  i. 6.   This defea or excefs of fibrous
aaion is generally induced by excefs  or defea of the
ftimulus of objects  external  to the moving organ.   But
                                              there 
Class III. i. i.]     OF VOLITION.              4*9
there is another fource of exceSfive fibrous aaion, and
confequent pain, which is from  excefs of volition,
which is liable to affea thofe mufcles, that have weak
antagonists; as  thofe which fupport  the  under jaw,
and clofe the mouth in  biting, and thofe  of the calf
of the leg; which  are thus liable  to  fixed or  painful
contraaions,  as in trifmus,  or locked  jaw,  and in the
cramp of the  calf  of the leg ; and  perhaps in fome
colics, as in that of Japan :  thefe pains, from contrac-
tion arifing from excefs of volition in the part from
the want of the counteraction of antagonist mufcles,
may  give  occafional caufe  to epileptic fits, and may
be relieved in the  fame way, either  by exciting irri-
tative and fenfitive motions by the ftimulus of opium
 and wine ; or by convulfions  or infanity, as defcribed
 above, which are only different methods of exhaufting
 the general  quantity of fenforial power.
    Confidering  the great  refemblance between  this
 kind  of painful epilepfy and the colic of Japan,  as
 defcribed by Kemfer ;  and that that difeafe was faid
 to be cured by acupunaure,  or the prick of a needle ;
 "I directed fome very thin Steel needles to be made about
 three  inches long, and of fuch  a temper, that they
 would bend double rather  than break ; and  wrapped
 wax thread over about half an inch of the blunt end
 for a handle.  One of thefe needles,  when  the pain
  occurred, was pufhed about an  inch  into the painful
  part,  and the pain inftantly ceafed ; but I was  not
  certain, whether the fear of the patient, or the ftimulus
  of the punaure, occafioned the ceffation of pain j  and
                          E  e 2                   as 
4*o             DISEASES     [Class III. r. t.
as the paroxyfm had continued feme weeks,  and was
then declining,  the experiment  was not  tried again.
The difeafe is faid to be very frequent in  Japan, and
its feat to be in the bowels,  and that the  acupunaurc
eliminates the air, which  is fuppofed to diftend  the
bowel.   But though the aperture thus  made is  too
fmall  to  admit  of the eduaion  of air ;  yet  as  the
ftimulus  of fo fmall  a punaure may  either excite  a
torpid part into aaion,  or caufe a fpafmodic one  to
ceafe  to" aa; and laftly, as no injury could be  likely
to enfue from  fo  fmall a perforation, I fliould be
inclined at fome future  time to give this a fairer trial
in fimilar circumftances.
   Another thin? wrorth trial at the commencement  of
this deplorable difeafe would be efearicity, by paffing
ftrong Shocks through the painful part;  which, whether
the pain  was owing to the inaaion of that part, or of
fome  other membrane affociated with it,  might ftimu-
late  them into  exertion ;  or into  inaaivity,  if owing
to fixed painful contraaion.
   And laftly, the cold bath, or afperfions with  cold
water on the affeaed part, according  to  the method
of Dr. Currie in the memoirs of a Med. Soc. London,
V.  iii. p.  147, might  produce great effea at  the
commencement of the pain.  Neverthelcfs opium duly
administered, fo  as to precede the expeaed paroxyfm,
and in fuch  dofes, given by  degrees, as to  induce
intoxication, is  principally to  be  depended upon in
this deplorable malady.  To which fhould be added,
that if venefeaion can be  previoufly performed, even
                                                to 
 Class III. i. i.}    OF VOLITION.              4*«
to but few ounces, the effea of the opium is much
more certain; and ftill more fo, if there  be  time  to
premife a brilk  cathartic, or  even an  emetic.   The
effea of increafed ftimulus  is fo much greater after
previous defea of Stimulus ; and this is ftill of greater
advantage where the caufe of the difeafe happens  to
confift in a  material, which  can  be abforbed.  See
Art.  IV. 2.  8.
   M. M.  Venefeaion.   An emetic.  A  cathartic.
Warm bath.  Opium a grain every half hour.  Wine.
Spirit of wine.   If the patient becomes intoxicated
by the above means,  the fit ceafes, and violent vomit-
ings and debility fucceed on the fubfequent day, and
prevent a return.   Blifters or fmapifms on the fmall
of the leg,  taken off when they give much pain,  are
of ufe in Slighter convulfions.  Acupunaure.   Elec-
 tricity,   Afperfion  with cold water on  the painful
 part.

   9. Somnambulifmus.   Sleep-walking  is  a part  of
 reverie,  or  fludium in^ne,  defcribed in  Sea.  XIX.
 In this  malady the  patients  have only  the general
 appearance  of being  afleep in refpea to their inatten-
 tion to  the ftimulus of external objeas, but, like the
 epilepfies above defcribed,  it  confifts  in  voluntary
 exertions to relieve pain.  The mufcles are fubfervient
 to the will, as appears by the patient's walking about,
 and fometimes doing the common offices of life.  The
 ideas of the  mind  alfo  are obedient to  the will,
 becaufe their  difcourfe  is  confident,  though  they
                         ft c 3                anfwer 
 *22              DISEASES    [Class III. i. t.
 anfwer imaginary queftions.   The  irritative ideas  of
 external objects continue in  this malady, becaufe the
 patients do not run againft the furniture of the room ;
 a id when they apply their volition to their organs  of
 fenfe, they become fenfible of the objeas they attend
 to, bur not otherwife, as general fenfation is deftroyed
 by the violence of their voluntary exertions.   At the
 fame time the fenfations of pleafure in confequence  of
ideas excited by volition are   vividly experienced, and
 other ideas feem  to be excited by thefe pleafurable
 fenfations, as appears in  the cafe of Mafter A.  Sea.
 XXXIV.  3.  1. where  a hiftory of a hunting  fcene
 was voluntarily recalled, with all the pleafurable ideas
which attended it.   In melancholy madnefs the patient
is employed in voluntarily  exciting one  idea,  with
thofe which are conneaed with jt by voluntary aflb-
ciations only,  but  not  fo violently as  to exclude the
Stimuli of external objeas.  In reverie variety of ideas
arc  occafionally excited by volition,  and thofe which
are conneaed with them either by fenfitive or voluntary
affociations, and that fo  violently  as to exclude the
ftimuli of external objeas.   Thefe  two fituations of
our fenfual motions,  or ideas, refemble convulfion and
epilepfy; as in the former  the ftimulus of  external
objeas is ftill perceived, but not in the latter. Whence
this difeafe, fo far from being conneaed with fleep,
though it has by univerfal miftake  acquired its name
from it,  arifes from excefs of volition', and not  from
a fufpenfion of it; and  though, like other kinds of
epilepfy, it often attacks  the patients in their fleep,
                                                yet 
Class III. i. i.]    OF VOLITION.               423
yet thofe  two, whom  I  faw,  were  more  frequently
feized  with it while  awake, the  fleep-walking being
a part  of the reverie.   See Sea. XIX. and XXXIV.
3. and Clafs II. 1. 7. 4. and III. 1.  2. 18.
   M. M. Opium in  large dofes before the expeaed
paroxyfm.

   10.  Afthma convulfivum.    Tlie  fits  of convulfive
afthma return at periods, and  are attended with cold
extremitie ,  and  fo  far refemble  the  accefs  of  an
intemittent fever ; but, as the lungs are not fenfible
to die pain  of cold, a Shivering does not fucceed,  but
inftead of it violent efforts of refpiration ;  which have
no tendency, as  in the  humoral afthma,  to  diflodge
any offending material, but only to relieve the pain
by exertion, like the fliuddering  in  the beginning of
ague-fits, as explained Clafs III.  1.  1. 2.
   The infenfibility of  the lungs to  cold is obfervable
on  going into  frofty  air from  a  warm  room;  the
hands and  face become painfully cold, but  no fuch
fenfation is  excited  in the  lungs;  which  is another
argument in favour of the exiftence of a  peculiar fet
 of nerves for the purpofe of perceiving the univerfal
fluid matter of heat, in which all things are immerfed.
    See Sea. XIV. 6.   Yet  are the lungs  nevertheless
 very  fenfible  to  the  deficiency of oxygen  in the
 atmofphere, as all people experience, when they go
 into a room crowded with company and candles, and
 complain, that it is fo clofe, they can fiercely breathe ;
 and the Tame in fome  hot days in fummer.    ,.
                         E e 4               There 
424              DISEASES     [Class III. i. '.
   There are two difeafes,  which  bear the name  of
afthma.  The firft  is  the  torpor  or  inability of  the
minute veffels of the lungs, confifting of the tcrmin?.-
tions of the  pulmonary  and  bronchi;.! arteries and
veins,  and their attendant lymphatics; in this circum-
ftance  it refembles the  difficulty of breathing, which
attends cold bathing.  If this  continues long,  a con-
gestion of  fluid in the air-cells fucceeds, as the abforb-
ent  aaions  ceafe completely  before  the fecerning
ones;  as  explained in Clafs  I.  i. 2. 3.  And  the
coldnefs, which  attends the inaaion of thefe veffels,
prevents the ufual quantity of exhalation,  Some fits
ceafe before this congestion takes  place, and in them
no  violent fweating nor  any expuition  of phlegm
occurs.  This is the  humoral  afthma,  defcribed  at
Clafs II. 1. 1. 7,
   The fecond kind of afthma confifts in the convulfive
aaions in  confequence  of the difagreeable fenfations
thus induced; which in fome fits  of afthma are very
great, as  appears in the  violent  efforts  to raife  the
ribs, and  to deprefs the  diaphragm,  by lifting the
Shoulders.    Thefe,  fo long  as  they  contribute  to
remove  the  caufe  of  the  difeafe, are not  properly
convulfions,  but exertions  immediately caufed by fen-
fation ; but  in  this kind  of  afthma they are  only
efforts to relieve pain, and are frequently preceded by
other  epileptic convulsions..
   Thefe two kinds of afihmas have  fo  many refem-
 bling  features, and are fo  frequently intermixed, that
 »t.  often require £rcat attention to difliugulfli them;
                                                but 
Class III. i. i.J    OF VOLITION.               42$
but  as  one of them is  allied  to anafarca, and the
other to epilepfy, we fliall acquire  a clearer idea of
them by comparing them with  thofe diforders.  A
criterion of  the humoral or hydropic afthma is, that
it is  relieved by copious fweats about the head and
breaft,  which  are to be aferibed to the fenfitive exer-
tions of  the  pulmonary  veffels  to  relieve the pain
occafioned by the anafar.cous congestion  in the air-
cells ; and which is effeaed by the increafed abforption
of the  mucus, and its elimination by the retrograde
aaion of thofe lymphatics of the Skin, whofe branches
communicate  with  the pulmonary  ones;  and  which
partial fweats  do not eafily admit of any other  expla-
nation.   See Clafs I. 3. 2. 8.   Another criterion of it
is, that it is generally attended with fwelled legs, or
other fymptoms of anafarca.  A criterion  of the con-
vulfive  afthma may be had from the abfence of thefe
cold clammy fweats of the upper part of the body only,
and  from the patient having occafionally been fubjea to
convulfions  of the limbs,  as in the common epilepfy.
   It may thus frequently happen, that in  the humoral
afthma  fome exertions of the lungs may occur, which
may not contribute to difcharge the anafarcous lymph,
but  may be  efforts fimply to relieve pain ;  befides
thofe efforts, which produce  the  increafed abforption
and  elimination of  it; and  thus we have a  bodily
difeafe  refembling in this circumftance the reverie, in
which both fenfitive and voluntary motions are at the
fame lime, or  in fucccfllcn, excited for the purpofe of
relieving pain.
                                                 I- 
425             DISEASES     [Class III. i. i.
  It may likewlfe fometimes happen,  that  the dif-
agreeable fenfation, occafioned by  the  congestion of
lymph  in the air-cells in  the  humoral or hydropic
afthma, may induce voluntary convulfions of the refpi-
ratory  organs only to relieve the pain,  without any
fenfitive aaions of the pulmonary abforbents to abforb
and eliminate the congeftion of ferous fluid ; and thus
the fame caufe  may  occafionally induce  either the
humoral or convulfive  afthma.
  The  humoral afthma has  but  one remote  caufe,
which  is the torpor  of  the pulmonary veffels, like
that which occurs  on  going  into  the  cold bath ; or
the want of abforption  of the pulmonary  lympha-
tics to take up the lymph effufed  into the  air-cell.
Whereas the convulfive afthma, like other convulfions,
or epilepfies, may be occafioned  by pain in almoft
any remote  part of the fyftem.   But in fome of the
adult patients in this difeafe,  as in  many epilepfies, I
have fufpeaed the remote caufe to  be  a pain of the
liver, or of the biliary duas.
  The  afthmas, which have been  induced in confe-
quence  of  the recefs  of  eruptions,  efpecially of the
leprous kind, countenance this opinion.  One lady I
knew,  who for many years laboured under an afthma,
which ceafed on her being affliaed  with pain, fwelling,
and diftortion of fome  of her large joints, which  were
efteemed gouty, but  perhaps erroneoufly.    And a
young  man, whom  I  faw yefterday, was feized with
afthma on  the retroceffion,  or  ceafing of eruptions
©n his  face.
                                             The 
Class III. i. i.]     OF VOLITION.              427
   The convulfive afthma, as well as the hydropic, are
more liable to return in hot weather;  which may  be
occafioned by the lefs quantity of oxygen existing in a
given quantity  of warm  air, than of cold, which can
be taken into  the lungs at one infpiration.   They are
both moft liable to occur after  the firft  fleep, which is
therefore a general criterion of afthma.  The caufe of
this is explained  in Sea. XVIII.  15.  and applies to
both of them,  as our fenfibility to internal uneafy
fenfation increafes during  fleep.
   When children are gaining teeth, long before they
appear,  the  pain of  the gums  often induces convul-
fions.  This pain is relieved  in fome  by fobbing and
fcreaming ;  but in others  a laborious refpiration  is ex-
erted to relieve the pain ; and this constitutes the true
afthma convulfivum.  In  other  children again general
convulfions,  or epileptic  paroxyfms, are induced for
 this  purpofe ; which, like other epilepfies,  become
 eftablifhed by habit, and recur before  the irritation
 has time to produce the  painful fenfation,  which ori-
 ginally caufed  them.
    The afthma convulfivum is alfo fometimes induced
 by worms, or by acidity in the Stomachs of children,
 and by other painful fenfations  in adults ; in whom it
 is -generally called nervous afthma, and is often joined
 with other epileptic fymptoms.
    This  afthma is  distinguished from  the peripneumo-
 ny, and from the  croup, by the  pretence of fever in
 the two  latter.  It is diftinguiflied from  the humoral
 .i.fthma,  as in that the patients  are more liable  to run
                                                  to 
 4^8              DISEASES     [Cla<s III. i. r.
 to the  cold  air for relief,  are  more fubjea  to cold
 extremities,  and experience the returns of it more
 frequently after  their firft  fleep.   It is distinguished
 from the hydrops thoracis, as that has no intervals,
 and  the patient fits constantly upright, and the breath
 is colder; and, where the pericardium is affeaed, the
 pulfe is quick and unequal.   See  Hydrops Thoracis,
 I. 2. 3.  14,
   M. M. Venefeaion once,   A cathartic with calomel
 once.   Opium.  Afafcetida.  Warm bath.   If the
 caufe can  be deteaed, as in toothing  or worms,  it
 fliould be removed.  As this fpecies of afthma is fo liable
 to recur during fleep, like epileptic fits, as mentioned
 in Seaion XVIII.  15. there  was  reafon to  believe,
 that  the refpiration of an  atmofphere mixed with hy-
 drogen,  or any other innocuous  air, which might di-
 lute  the oxygen, would be ufeful  in preventing the pa-
 roxyfms by decreasing the  fenfibility of  the  fyftem.
 This, I am informed by Dr.  Beddoes, has been ufed
 with decided fuccefs by  Dr. Ferriar.   See Clafs II.
 1. 1. 7.

   n. Afthma  dolorificum.   Angina  peaoris.   The
 painful  afthma was firft  defcribed  by Dr. Heberden
 h the Tranfaaions of the College ;  its principal fymp-
toms confift in a pain about the middle of the Sternum,
or rather lower,  on every increafe of pulmonary or
mufcular exertion,  as in  walking  fafter  than  ufual,
or going quick up a hill,  or even up Stairs;  with
great difficulty of breathing, fo  as  to  occafion the
                                            patient 
  Class III. i. i.]    OF VOLITION.               4;g
  patient inftantly to Stop.   A  pain in the arms about
  the infertion  of  the 'tendon  of  the peaoral mufcle
  generally attends, and  a  defire of  refting by hanging
  on a door  or branch of a tree  by the arms is Some-
  times obferved.  Which is explained in Clafs I. 2. 3.
  14. and in Sea. XXIX. 5. 2.
    Thefe patients generally  die  fuddenly ;  and  on
  examining the thorax no certain caufe, or feat,  of the
  difeafe  has been deteaed; fome have fuppofed the
  valves  of the  arteries,  or of  the heart,  were imper-
 . fea ; and others that  the accumulation of fat about
  this  vifcus  or the lungs obftruaed their due aaions;
  but other obfervations do not accord with thefe fup-
  pofitions.
    Mr.   W-----,  an elderly  gentleman,  was  feized
  with afthma during  the hot part of laft Summer;  he
  always waked from  his firft fleep with difficult refpi-
  ration,  and pain in  the  middle  of his fternum, and
  after about an hour  was  enabled to fleep again.   As
  this had returned for about a  fortnight, it appeared to
  me to  be an afthma  complicated  with  the difeafe,
  which  Dr. Heberden has called  angina peaoris.   It
  was treated by venefeaion, a cathartic, and then by
  a grain of opium given at going to bed, with  ether
  and  tinaure  of opium when  the  pain or afthma  re-
  curred, and  laftly  with the  bark,  but was feveral
  days before it was perfeaiy fubdued.
     This led me to conceive, that in this painful afthma
  the diaphragm, as well as the other mufcles  of refpi-
. ration, was  thrown into convulfive aaion,  and thai
                                                 the 
43°              DISEASES    [Class III. I. l.
the fibres of this mufcle not having proper antagonifts,
a painful fixed fpafm of it, like that  of the mufcles
in the calf of  the  leg in the  cramp, might be the
caufe of death in  the  angina peaoris,  which I have
thence arranged under the  name of painful afthma,
and leave for further investigation.
   From  the  hiftory of the  cafe of the late much la-
mented John Hunter,  and from the appearances after
death, the cafe feems to have been of this kind, com-
plicated  with vertigo and confequent affeaion  of the
ftomach.  The remote  caufe feems to have arifen from
offifications of the coronary arteries; and the  imme-
diate caufe of his death from fixed fpafm of the heart.
Other hiftories and diffeaions are Still required  to put
this  matter out of doubt; as it is poffible, that either
a  fixed fpafm of  the  diaphragm,  or of the  heart,
which are both furniflied with  but  weak  antagonifts,
may  occafion fudden death ;  and  thefe may constitute
two diftina difeafes.
   Four patients I have now in  my recolfeaion,  all of
whom I believed to labour under the angina peaoris
in a great degree ; which have all recovered, and have
continued  well three or four years by  the  ufe, as I
believe, of iffues on the infide of each  thigh ;  which
were at firft large enough to contain  two peafe each,
and  afterwards but one.   They took befides fome
flight antimonial medicine for a while,  and were re-
 duced to half the  quantity or  ftrength  of their ufual
 potation of fermented liquor.
The 
Class III. i. i.]     OF VOLITION.               431
   The ufe of femoral iffues in angina peaoris was  firft
recommended by  Dr. Macbride,  phySIcian at Dublin,
Med. Obferv. & Enquir. Vol. VI.  And I was  fur-
ther induced to make trial of them, not  only becaufe
the means which I had before ufed were inadequate,
but from the  ill effea I once obferved upon the lungs,
which fucceeded the cure  of a fmall fore beneath the
knee ; and argued converfely,  that  iffues in the lower
limbs might aflift a difficult refpiration.
   Mrs. L-----,  about fifty,  had a fmall fore place
about the fize of half a pea on the infide of the leg a
little below the knee.  It  had difcharged a pellucid
fluid, which  She called a ley-water, daily for fourteeii
years, with a great deal  of pain;  on  which account
She applied to a furgeon,  who, by means  of bandage
and a faturnine application, foon  healed the  fore, un-
heedful of the confequences.  In lefs than two months
after this I   faw  her with great difficulty of breath-
ing, which with univerfal  anafarca foon deftroyed her.
   The  theory of the  double effea  of iffues, as above
related, one  in relieving by their pretence the afthma
dolorificum,  and  the other in producing by its cure an
anafarca of  the iungs, is not eafy to explain.  Some
fimilar effeas from cutaneous  eruptions and from blif-
ters are mentioned in Clafs I. 1.  2. 9.   In thefe cafes
it feems probable, that the pain  occafioned by iffues,
and perhaps  the abSbrption  of  a fmall quantity of
aerated purulent  matter,  ftimulate the  whole fyftem
into  greater energy  of  aaion, and thus prevent the
torpor  which is  the beginning  of fo many difeafes.
In confirmation of this effea of pain on  the fyftem,  I
                                         remember 
 t\iz               DISEASES     [Class III. i. I.
 remember the cafe of a lady of an ingenious and aaive
 mind, who,  for many of the latter years of her life,
 was perpetually  fubjea to great pains  of her head
 from decaying teeth.  When all her teeth were gone,
 fhe became quite low fpirited, and  melancholy in the
 popular fenfe of that word, and after  a year or two
 became univerfally dropfical and died.
   M. M. Iflues in  the  thighs.   Five grains of rhu-
 barb, and one fixth  of a grain of emetic tartar every
flight for fome  months, with or without half a grain
 of opium.  No ftronger liquor than  Small beer,  or
 wine diluted with  twice its quantity of water.   Since
 I wrote  the above I have feen two cafes of hydrops'
 thoracis,  attended with  pain in the left  arm, fo as to
 be miftaken for afthma  dolorificum, in  which  femo-
 ral iffues, though  applied early in the  difeafe, had  no
 effea.

   12. Stridor dentium.  The clattering of the teeth
 on going into cold water, or in the beginning of ague-
 fits,  is an exertion along with  the tremblings of the
 fkin to  relieve  the pain of  cold.  The  teeth and Skin
 being more  fenfible  to cold than  the more  internal
 parts, and more expofed to it, is the  reafon that the
 mufcles, which  ferve  them, are thrown into exertion
 from the pain of cold rather than thofe of refpiration,
 as in fcreaming from more acute  pain.   Thus the
 poet,
            Put but your toes into cold water,
            Your correspondent tee:h will cl;Uter.
                                     Prior.
                          i                       In 
Class III. r. i.]    OF VOLITION. -            433
   In more acute pains the jaws  are gnafhed together
with great vehemence,  infomuch that  fometimes the
teeth are faid to have been broken by the force.  See
Sea. XXXIV. 1.3.  In thefe cafes fomething Should
be offered to the  patients to bite, as a towel, other-
wife they are liable to tear their own arms, or to
bite their attendants, as  I have witneffed in the pain-
ful epilepfy.

   13.  Tetanus trifmus.  Cramp.   The tetanus confifts
of a fixed fpafm of almoft all the mufcles of the body ;
but the trifmus, or locked  jaw,  is the moft frequent
difeafe of this  kind.  It is generally believed to arife
from fympathy with an  injured tendon.  In one cafe
where  it occurred in confequence of a broken ancle
from a fall from a horfe, it was  preceded  by evident
hydrophobia.  Amputation was advifed, but not Sub-
mitted to ; two wounds  were laid into  one with fcif-
fors, but the patient died about the feventh day from
the accident.  In this cafe the wounded tendon, like
the wounds from the bite of a mad dog, did not pro-
duce the hydrophobia, and then the locked jaw, till
feveral days after the accident.
  I twice witneffed  the locked jaw from  a pain be-
neath the fternum, about the part where  it is com-
plained of in painful  afthma, or angina peaoris, in the
fame lady at  fome years diftance of time.   The laft
time it had continued two  days, and  She wrote her
mind, or expreffed herfelf by figns.  On obferving  a
broken tooth, which made  a fmall aperture into her
                       F f                 mouth, 
4J+              DISEASES    [Class III. i. l.
mouth, I roiled up  five grains  of opium like a worm
about an inch long, and introducing it over the broken
tooth,  pufhed it  onward  by means of a fmall crow-
quill; as it diffolved  I obferved flie fwallowed her faliva,
and in  lefs  than  half an hour, She opened her mouth
and converted as  ufual.
   Men are taught to be afliamed of fcreaming from pain
in their early years; hence they are prone to exert the
mufcles of the jaws inftead, which they have learnt to ex-
ert frequently and violently from their infancy; whence
the locked jaw.  This and the following fpafm  have no
alternate relaxations, like the preceding ones ;  which is
 perhaps owing, firft, to the weaknefs of their antagonist
 mufcles, thofe which elevate the jaw being very ftrong
 for the purpofe  of biting and mafticating  hard fub-
 flances, and for  fupporting the under  jaw,  with very
 weak  antagonift mufcles; and fecondly,  to their not
 giving fufficient  relief even for a moment to the pain,
 or its preceding  irritation, which excited them.
    M. M.  Opium  in very large quantities.   Mercurial
 ointment  ufed   extenfively.   Efearicity.   Cold bath.
 Dilate the wound, and fill it with lint moistened with
 fpirit  of turpentine ;  which inflames the wound, and
 cures or prevents  the convulfions.  See a cafe, Tranf-
 aa. of American Society, Vol. II. p.  227.
    Wine in large quantities  in one cafe was more fuc-
 cefsful than opium ;  it probably inflames more, which
 in this difeafe is defirable. Between two or three ounces
 of bark,  and from a quart to three pints of wine a
  day,  fucceeded better than opium.  lb.
                                        14. Tetanus 
Class IIL i. t.]    OF VOLITION;              43^
   14. Tetanus dolorificus.   Painful cramp.   This kind
of fpafm moft frequently attacks  the calf of the leg,
or mufcles of the toes ; it often precedes paroxyfms of
gout, and  appears towards  the  end of violent diar-
rhcea,  and  from  indigeftion, or from acid diet.   In
thefe cafes  it feems to Sympathize with the bowels,
but is alfo frequently produced by the pain of external
cold, and to the too great previous extenfion  of the
mufcles, whence fome people get  the cramp in the ex-
tenfor mufcles  of the toes after  walking  down hill,
and of thofe of the calf of the leg after walking up a
Sleep eminence.  For  the  reafon why  thefe cramps
commence in fleep, fee Sea. XVIII.  15.
   The mufcle  in this difeafe contraas itfelf to relieve
fome fmaller pain, either from irritation or affociation,
and  then falls into great pain itfelf, from the too great
aaion of its own fibres.   Hence any mufele, by being
too vehemently  exerted,  falls into cramp, as in Swim-
ming too forcibly in water,  which is  painfully cold;
and  a fecondary pain is then  induced by the too vio-
lent  contraaion  of the mufcle;  though  the  pain,
which was the caufe of the  contraaion, ceafes. Which
accounts for the continuance of  the contraaion, and
diftinguiflies this difeafe from other convulfions, which
are relaxed and exerted alternately.  Hence whatever
may be  the caufe of the primary pain, which occafions
the cramp of the calf of the leg, the fecondary one is
relievable by ftanding up, and thus by  the weight  of
the body on the toes forcibly extending the contraaed
mufcles.  For the caufe, which induces thefe mufcles
                      F f  2                      of 
43^             DISEASES     [Class III. r. *.
of the calf of the leg to fall into more violent contrac-
tion than other fpafmodie mufcles, proceeds from  the
weaknefs of their antagonist  mufcles ;  as they are  ge-
nerally extended again after  a&ion by the  weight of
the body on the balls of the toes.  See the preceding
article.
   M.. M. Rub the legs with camphor diffolved in  oil,
and let the patient wear ftockings in bed.  If a foot-
board be put  at  the bed's  feet, and the  bed be fo
inclined, that he will reft a little with his toes againft
the foot-board, that preffure is  faid to prevent  the
undue contraaions of the mufculi gaftrocnemii, which
constitute the calf of the leg.   In gouty patients, or
where the bowels are  affeaed with acidity,  half a
grain of opium, and fix grains of rhubarb, and fix of
chalk, every night.   Ffefh-meat to  fupper.   A little
very  weak warm  fpirit and water may be taken for
prefent relief, when thefe cramps are very troublefome
to weak or  gouty patients.

   15. Hydrophobia.    Dread of water generally   at-
tending canine madnefs.    I was witnefs  to a cafe,
where this  difeafe preceded the locked jaw from a
wound in the ancle,  occafioned by a fall from a horfe1;
as  mentioned in the preceding article.   It came on
about the Sixth day after  the accident;   when  the
patient attempted to fwallow  fluids, he became con-
vulfed all over from the pain of this attempt,   and
fpirted them out of his mouth with violence.  It is
alfo  kid to happen in fome hyfterical cafes.  Hence
                                                 it 
Class III. i. i.]    OF VOLITION.              437
it  feems rather the immediate confequence of a pained
tendon, than of a contagious poifon.  And is fo far
analogous to tetanus, according  with the opinions of
Doaor  Rufh and Doaor Pereival.
   In other  refpeas, as  it is produced by  the faliva
ef an enraged animal inftilled into a wound, it would
feem analogous to  the  poifon of venomous animals.
And from  the  manner of its accefs fo  long after the
bite, and of its termination in a Short time, it would
feem to  refemble  the progrefs of contagious  fevers.
See Sea. XXII. 3, 3.
   If the patient was bitten in a part, which could  be
totally cut away,  as a  finger, even after the  hydro-
phobia  appears, it is probable it might cure it; as I
fufpea the caufe Still remains in the wounded tendon,
and  not  in  a diffufed  infeaion  tainting the blood.
Hence  there are  generally uneafy fenfations,  as cold
or numbnefs, in  the old cicatrix, before the  hydro-
phobia commences.  See  a  cafe  in  Medical Commu-
nications, Vol. II,  p. 190.
   If  the difeafed  tendon could  be  inflamed without
cutting it  out, as  by cupping,  or cauftic,  or blifter
after  cupping, and this in the old  wound  long fince
healed, after the hydrophobia commences,  might pre-
vent the  fpafms about the  throat.   As inflaming the
teeth by  the ufe of mercury is of  ufe in fome kinds
of hemicrania.  Put fpirit of turpentine on the wound,
wafhit well.   See Clafs I. 3. 1. 11. IV.  1. 2.  7.
   M. M.  Wine, mufk, oil, internally.   Opium, mer-
curial ointment, ufed extenfively.  Mercurial  fumigar
                        F f 3                 tion. 
438              DISEASES    [Class III. r. i.
tion.  Turpeth mineral.  To falivate the patient as
foon as  poffible.  Exfeaion  or a  cauftic  on the fear,
even after  the appearance of  hydrophobia.   Put a
tight bandage  on the limb above the fear of the old
wound to benumb the pained tendon,  however long
the wound  may have been healed.   Could a hollow
catheter of elaftic gum, caoutchouc, be introduced into
the cefophagus by the mouth  or  noftril, and liquid
nourishment be thus conveyed into the  ftomach ? See
Default's Journal,  Cafe I. where,  in an  ulcer of the
mouth,  fuch a catheter was introduced  by the noftril,
and kept in  the cefophagus  for a  month, by which
means the patient was nourished and preferved.
   It is recommended by Dr.  Bardfley to give oil inter-
nally  by a  fimilar  method  contrived  by Mr. John
Hunter.  He  covered a  probang  with the Skin of a
fmall eel, or the gut of a  lamb or cat.   It was tied up
at one end  above  and below the fponge, and a  flit
made above the upper ligature ; to the other end  of
the eel-Skin or gut was fixed a bladder and pipe. The
probang thus covered was introduced into the ftomach,
and the liquid food or medicine  was put into the blad-
der and fqueezed down through the eel-Skin.  Mem.
of Society at Manchester. See Clafs I. 2. 3. 25.
   Dr. Bardfley has endeavoured to prove,  that dogs
never experience the hydrophobia, or canine madnefs,
without  having been previously  bitten or  infected ;
and fecondly,  that the difeafe in. this fpecies of animal
always fhews itfelf in five  or fix weeks;  and concludes
from hence, that this dreadful malady might be anni-
                                            hilated 
Class III. i. 2.]    OF VOLITION.               439
hilated by making all  the dogs in Great Britain per-
form a kind of quarantine, by Shutting them up for a
certain number of weeks.   Though  the difeafe from
the bite of the mad dog is perhaps more analogous to
thofe from the wounds infliaed by venomous animals
than to thofe  from  other contagious matter,  yet thefe
obfervations are well worthy  further attention ; which
the author promifes.
                   ORDO  I.
                 Increafed Volition.

                   GENUS   II.
    With increafed Aclions of the Organs of Senfe.
   In every fpecies of madnefs there is a peculiar idea
either of defire  or  averfion, which is perpetually ex-
cited  in the mind  with  all its conneaions.  In fome
constitutions this is conneaed  with pleafurable ideas
without  the  exertion of  much mufcular aaion,  in
others it produces violent mufcular aaion to gain  or
avoid the objea of it, in others  it  is attended with
defpair and inaaion.   Mania is the general word for
the two former of thefe, and melancholia for the  lat-
ter ;  but the  fpecies of  them are as  numerous as the
defires and averfions of  mankind.
   In the  prefent  age the pleafurable  infanities  are
moft  frequently induced  by  fuperftitious hopes of
heaven, by fentimental love, and by perfonal vanity.
                        F f a                  The 
44P               DISEASES     [Class III. i. 2.
The furious infanities by pride,  anger, revenge, fuf-
picion.   And the melancholy ones by fear of poverty,
fear of  death,  and fear of hell;  with innumerable
others.
  Quicquld agunt homines,  votum, timor, ira, voluptas,
  Gaudia, difcurfus, noftri eft Sarrago libelli.
                                     Juven. I. 85.
   This idea, however, which induces madnefs  or me-
lancholy, is generally untrue ;  that is, the objea is a
miftaken faa.  As when a patient is perfuaded he has
the  itch, or venereal difeafe,  of which  he has no
fymptom, and .becomes  mad from the pain  this  idea
occafions.   So that the objea of madnefs is  generally
a delirious idea, and  thence cannot be conquered by
reafon ;  becaufe it continues to be excited  by painful
fenfation, which is a ftronger  ftimulus  than volition.
Moft frequently pain of body is the caufe of convul-
fion, which is often however exchanged for madnefs;
and  a painful delirious  idea  is  moft frequently the
caufe of madnefs originally, but  fometimes of convul-
fion.   Thus I have  feen a  young  lady  become con-
vulfed from a fright,  and  die  in a few days; and a
temporary madnefs frequently  terminates the  parox-
yfms  of  the  epilepfia dolorifica, and an  infanity of
greater permanence is frequently  induced by  the pains
or bruifes of parturition.
   Where the patient is debilitated a quick pulfe fome-
times attends infane  people,  which  is neverthelefs
generally only a fymptom  of the debility,  owing  to
the too great expenditure  of fenforial power; or  of
                                               the 
Class III. i. 2.]     OF VOLITION.              441
the paucity of its produaion,  as  in inirritative, or in
fenfitive inirritated fever.   See III. 1. 1.
   But neverthelefs where the quick  pulfe is perma-
nent, it fhews the pretence of fever;  and as the mad-
nefs then generally arifes from the difagreeable fenfa-
tions attending the fever, it is fo far a good fymptom;
becaufe when the fever  is cured, or  ceafes fpontane-
oufly, the infanity moft frequently vanifhes at  the fame
time.
   The ftimulus of fo much volition  fupports infane
people under variety  of hardfhips, and contributes  to
the cure of difeafes from debility,  as fometimes occurs
towards the  end of fevers.   See Sea. XXXIV. 2. 5.
And, on  the fame account, they bear large dofes  of
medicines  to procure  any operation  on them;  as
emetics, and cathartics, which,  before they  produce
their effea in inverting the motions of the ftomach in
vomiting, or of the abforbents of the bowels in purg-
ing,  muft  firft weaken the natural  aaions   of thofe
 organs, as fhewn in  Sea. XXXV. 1.  13.
    From thefe  considerations  it appears,  that the  in-
dications of  cure muft confift  in  removing the caufe
 of the pain,  whether it arifes from a delirious  idea,
 or from a real  faa, or from bodily difeafe; or  fe-
 condly, if this cannot be done,  by relieving the pain
 in confequence of fuch  idea  or  difeafe.  The firft is
 fometimes effeaed by prefenting frequently  in a day
 contrary ideas to fhew the fallacy,  or the too great
 eftimation,  of the painful ideas.   2dly. By  change of
 place, and thus  prefenting the ftimuius of new objeas,
                                                  as 
44*               DISEASES    [Class III. 1.2.
as a long journey.   3<lly. By producing forgetfulnefs
of the idea or objea,  which caufes their pain ; by re-
moving all things which  recal it to their minds; and
avoiding all  converfation  on fimilar fubjeas.  For I
fuppofe no difeafe of the mind is fo perfeaiy  cured by
other means as by forgetfulnefs.
   Secondly,  the pain in confequence of the ideas or
bodily difeafes above defcribed is to be removed, firft,
by evacuations, as venefeaion, emetics, and cathar-
tics ;  and then  by  large dofes of opium, or by the
vertigo occafioned by a circulating fwing, or by a fea-
voyage, which, as they affea the  organs of fenfe as
well as  evacuate  the ftomach, may contribute  to an-
fwer both indications of cure.
   Where  maniacs are outrageous, there can be no
doubt but coercion is neceffary ; which may be  done
by means  of a  Strait   waiftcoat ;  which  difarms
them  without hurting them ; and by tying a handker-
chief  round their  ancles  to prevent their efcape.   In
others there can be  no doubt, but that confinement
retards rather than promotes their cure; which is for-
warded by change of ideas  in confequence of change
of place and of objeas, as by travelling or failing.
   The  circumftances which render confinement ne-
ceffary, are  firft,  if the  lunatic  is liable  to injure
others,  which muft  be judged of by the  outrage  he
has already  committed.   2dly. If he is likely to in-
jure himfelf; this alfo muft  be  judged of by the ^ef-
pondency of his mind, if fuch exifts.   3dly.  If he can-
not take care of his affairs.   Where none of thefe cir-
                                        cumftances 
Class III. i. 2]     OF VOLITION.              443
cumftances exift,  there  fliould be no  confinement.
For  though the miftaken idea continues to exift, yet
if no aaions  are produced  in confequence of it, the
patient cannot be called infane,  he can only be termed
delirious.   If every one,  who poffeffes miftaken ideas,
or who puts  falfe  eftimates  on things,  was liable to
confinement,  I know not who of my readers might
not tremble at the fight of a madhoufe!
  The.moft convenient distribution of infanities will be
into  general,  as mania mutabilis, ftudium inane, and
vigilia; and  into partial infanities.  Thefe laft again
may  be  fubdivided  into defires and  averfions,  many
of which are  fucceeded by pleafurable or painful ideas,
by  fury  or  dejeaion,  according  to the degree or
violence  of their  exertions.   Hence  the analogy be-
tween the infanities of the mind, and the convulfions
of the  mufcle/s  defcribed in the preceding genus, is
curioufly exaa.   The convulfions without ftupor, are
either juft fufficient to obliterate the  pain, which oc-
cafions them ; or are fucceeded by greater pain, as in
the  convulfio dolorifica.   So  the exertions  in the
mania mutabilis are either juft fufficient to allay  the
pain which  occafions them, and  the patient  dwells
comparatively in a quiet ftate ;  or thofe exertions ex-
cite  painful ideas, which are fucceeded by furious dif-
courfes,  or outrageous aaions.  The ftudium inane,
or reverie, refembles epilepfy,  in  which there is no
fenfibility to  the ftimuli  of external objeas.   Vigilia,
or   watchfulnefs,  may be  compared to  the  general
writhing of the body ;  which is juft  a  fufficient exer-
                                               tion 
444               DISEASES     [Class III. i. ai
tion to relieve the pain which occafions it.  Eroto-
mania may be compared to trifmus, or other mufcular
fixed  fpafm,  without  much  fubfequent pain;  and
xna?ror to cramp  of the mufcles of the leg, or other
fixed fpafm with  fubfequent pain.  All thefe coinci-
dences contribute to Shew, as explained in Sea. III. 5,
that our ideas  are motions  of the immediate organs
of  fenfe  obeying the  fame  laws as  our mufcular
motions.
   The violence  of aaion accompanying  infanity  de-
pends much on  the  education  of the perfon;  thofe
who  have been  proudly  educated with  unrcftrained
paffions, arc liable to greater fury ; and thofe, whofe
education has been humble, to greater defpondency.
Where the delirious  idea, above defcribed, produces
pleafurable  fenfations, as in perfonal  vanity or  reli-
gious  en^hufiafm; it is almoft a  pity to fnatch them
from their fool's  paradife, and reduce them again to
the  common lot  of humanity; left they Should com-
plain  of their cure, like  the  patient  defcribed  in
Horace,
    ._________Pol!  me oce'diftis, amici,
    Nen fervaftis, ait, cui fie extorta roluptas,
    Et demptus per vim mentis gratiffimus error!
   The difpofition to infanity, as well as to convulfion,
is believed to be hereditary;  and in  confequence to
be induced in thofe families from flighter caufes than
in  others.  Convulfions have been  Shewn  to. have
"been moft frequently induced by pains owing to defea
©f Stimulus, as the Shuddering from  cold,  and  not
                                              from 
Class III. i. 2.]    OF VOLITION.               44>
from pains from excefs of ftimulus,  which are gene*
rally  fucceeded  by inflammation.   But infanities are
on the contrary  generally induced by pains from ex-
cefs  of ftimulus, as from the too violent aaions of
our ideas, as  in common anger, which is  an infanity
of Short  duration;  for infanities generally,  though
not always, arife from pains of the  organs of fenfe;
but  convulfions generally, though not always, from
pains of the membranes or glands.  And  it has been
previoufly explained,  that though the membranes and
glands,  as  the  Stomach and  Skin, receive great pain
from want of ftimulus ; yet that the organs of fenfe,
as  the eye and ear,  receive  no pain from  defea of
 ftimulus.
   Hence it follows,  that the constitutions moft liable
 to convulfion,  are thofe  which  moft readily become
 torpid in fome  part of the fyftem, that is, which pof-
 fefs  lefs irritability ;  and that thofe moft  liable to in-
 fanity,  arc fuch  as  have excefs of fenfibility;  and
 laftly, that thefe two circumftances generally exift  is
 the fame conftitution ; as explained in Sea^XXXI.  2.
 on  Temperaments.   Thefe obfervations  explain why
 epilepfy and infanity frequently fucceed or reciprocate
 with each other, and why inirritable habits,  as fcro-
 phulous ones,  are liable  to infanity, of which I have
 known fome inftances.
    In many  cafes however there  is no appearance of
 the difpofition to epilepfy or infanity of the parent
  being tranfmitted to  the progeny.   Firft, where the
  mfanity has arifen from fome violent difappointment,
                                                 and 
 44*               DISEASES    [Class III. i. 2.
 and  not from intemperance  in  the ufe of fpirituous
 liquors.   Secondly,  where  the parent  has acquired
 the infanity or epilepfy by habits of intoxication after
 the  procreation of his children.  Which habits I fup-
 pofe to be the general caufe of the difpofition to in-
 fanity in this country.  See Clafs  III. i. i. 7.
   As  the difpofition  to  gout,  dropfy,  epilepfy, and
 infanity, appears to  be produced  by the intemperate
 ufe of fpirituous potation, and is  In all  of them here-
 ditary ; it feems probable, that this difpofition gradu-
 ally  increafes from generation to generation,  in  thofe
 families  which  continue  for many generations to be
 intemperate in this refpea ;  till at length thefe difeafes
 are  produced;  that  is, the irritability  of the fyftem
 gradually is decreafed by this powerful  Stimulus, and
 the fenfibility at the fame time  increafed, as explained
 in Seft.  XXXI.  1. and 2.   This  difpofition  is  com-
 municated to the progeny, and becomes  ftill increafed,
 if the fame ftimulus  be  continued, and fo  on by a
 third and fourth  generation; which accounts for the
 appearance  of epilepfy in the  children  of fome fami-
lies, where it was never known before to have exifted,
 and  could not be  aferibed to their own intemperance.
 A parity of reafoning fliews, that  a few  fober genera-
 tions may gradually  in the fame manner reftore a due
 degree of irritability  to the family, and decreafe the
 excefs of fenfibility.
   From hence  it  would  appear probable, that fcro-
 phula  and  dropfy  are  difeafes  from  inirritability;
but  that in epilepfy  and infanity  an excefs  of fen-
                                             fibility 
Class III. i. 2.]     OF VOLITION.              447
Ability  is  added, and  the two faulty temperaments
are thus conjoined.

                   SPECIES.
   1.  Mania  mutabilis.  Mutable  madnefs.  Where
the patients are liable  to miftake ideas of fenfation for
thofe from  irritation, that is, imaginations for reali-
ties, if cured of one fource of infanity,  they are liable
in a few months to find another  fource in fome new
miftaken or imaginary idea,  and to aa from this new
idea.  The idea belongs  to delirium, when it is an
imaginary or  miftaken  one; but  it is the voluntary
aaions exerted in  confequence of this  miftaken idea,
which conftitute infanity.
   In this difeafe the patient is liable carefully to con-
ceal the objea of his defire  or  averfion.  But a con-
ftant inordinate fufpicion of all people, and a careleiE-
nefs of cleanlinefs,  and of decency,  are generally con-
comitants of madnefs.   Their defigns cannot be coun-
teraaed, till you  can  investigate the delirious idea or
objea of  their infanity ;  but as they  are generally
timid, they are therefore lefs to be dreaded.
   Z. Z. called a young girl, one of his maid-fervants,
into  the parlour,  and,  with  cocked  piftols in  his
hands, ordered her to Strip herfelf naked;  he then
infpeaed her with fome  attention, and difmiffed her
untouched.   Then he Stripped two  of his male fer-
vants in the fame manner, to the  great terror of the
neighbourhood.  After he  was fecured,  with much
 difficulty he was perfuaded to tell me, that he had got
                                                 the 
44*              DISEASES    [Class III. i. z.
the itch, and had examined  fome of his fervants to
find out from whom he had received it; though at
the fame time there was not a fpot to be feen  on his
hands, or other parts.   The outrages in confequence
of this falfe idea were in fome meafure to be aferibed
to the  pride occafioned by  unreftrained education,
affluent wealth, and dignified family.
   Madnefs  is  fometimes produced  by bodily pain,
particularly  I believe of a difeafed liver, like convul-
fion and epilepfy ; at other times it is caufed by very
painful ideas occafioned  by external circumftances, as
of grief or  difappolntment;   but the moft frequent
caufe of infanity arifes from the pain of fome imaginary
or miftaken  idea ; which may be termed  hallucinatio
maniacalis.   This hallucination of one of the fenfes is
often produced in an inftant,  and generally becomes
gradually weakened in procefs of time, by the perpe-
tual ftimulus of external objeas,  or by the fucceffions
of other catenations of ideas,  or  by the  operations of
medicines; and when the maniacal hallucination ceafes,
or is forgotten, the  violent   exertions  ceafe, which
were in confequence  of it, and the  difeafe is cured.
   Mr.----, a clergyman, about forty years of age,
who was rather a weak  man,  happened to be drinking
wine  in jocular company,  and by accident fwallowed
a part of the feal of a letter, which  he had juft then
received;  one  of his companions feeing him alarmed,
cried out in humour, "  It will feal  your bowels up."
He became melancholy from that inftant, and in a day
or two refuted  to fwallow any kind of nourifhment.
             4                                  On 
  Class III. i. 2.]     OF VOLITION.              449
  On being preffed to give a reafon  for  this refufal, he
  anfwered, he knew  nothing  would pafs through him.
  A cathartic  was given, which produced a  great many
  evacuations,  but  he ftill perfifted,  that nothing paffed
  through him ; and though he was frightened into tak-
  ing a little broth once or twice by threats,  yet he foon
 ceafed intirely to  fwallow any thing, and died  in con-
 fequence of  this infane idea.
   Mifs-----, a fenfible  and ingenious lady,  about
 thirty, faid  flie had  feen an angel;  who told her,
 that  She need not eat, though all others were  under
 the neceffity of Supporting their earthly exiftence  by
 food.  After fruitlefs  perfuafions  to  take food,  flie
 Starved herfelf to  death.—It  was propofed to fend  an
 angel of  an  higher order ro tell  her, that now  flie
 muft begin to eat and drink again;  but  it was not
 put into execution.
   Mrs.-----, a lady between forty and fifty years  of
 age,  imagined that  fhe heard a voice  fay to her one
 day,  as She was at her toilet,  "  Repent,  or you will
 " be  damned."   From that moment fhe became me-
 lancholy,  and this hallucination affeaed her in greater
 or lefs degree for about two years ; flie then recovered
 perfeaiy, and is now a cheerful  old woman.
   Mrs.-----, a farmer's  wife, going up  flairs   to
 drefs, found  the curtains of  her bed drawn, and on
undrawing them, flie believed that  fhe  faw the corps
of her fifter, who was then ill  at the  diftance  of
twenty miles,  and became from that time infane ; and
as her fifter  died  about the  time, flie could not  be
                      G g                 produced 
450             DISEASES     [Class III. i. z.
produced  to  counteraa the infane hallucination, but
She perfeaiy recovered in a few months.
   Mrs.-----, a moft elegant, beautiful, and accom-
plished  lady,  about twenty-two* years  of  age, had
been  married about two months  to an elegant, po-
lhlied, and affluent young man, and it was well known
to be a love-march, on both  fides.  She fuddenly be-
came melancholy,  and yet not to fo great a degree,
but that flie could command herfelf to do the honours
of her table  with' grace and apparent cafe.   After-
many days  intreaty,  fhe at length told mer that flie
thought her marrying her huiband' had  made him un-
happy ; and that this  idea flic could not efface from
her mind day or  night.  I withstood her being con-
 fined, as fome had advifed, and propofed a fea-voyage
 to her, with  expeaation that the ficknefs,  as well  as
 change of objeas, might remove  the  infane halluci-
 nation,  by  introducing  other  energetic ideas; this
 was not complied  with,  but  flie  travelled about Eng-
 land with her friends and  her  huiband  for  many
 months,  and at length  perfeaiy recovered,  and is
 now I am informed in health and fpirits.
    Thefe cafes are related to Shew the utility of en-
 deavouring to investigate the maniacal idea, or hallu-
 cination ; as it may not only acquaint us with  the
 probable defigns  of the patient, from whence may
 be deduced the neceffity of confinement; but alfo may
 fome time lead to the moft effeaual plan of cure.
    I  received good information of the  truth  of the
 following cafe,  which  was  publifhed  a  few years.
                                                ago*. 
 Class III. i. 2.]    OF VOLITION.              45i
ago  in the  newfpapers.  A  young farmer  in  War-
wickshire,  finding his  hedges broke, and  the  Sticks
carried away   during  a   frofty  feafon,  determined
to watch  for  the thief.   He lay  many cold  hours
under a hay-flack, and  at length an old woman,  like
a witch in a play, approached, and began to pull up
the hedge; he waited till fhe had tied up her  bottle
of flicks, and was carrying  them off, that he  might
con via her of  the theft, and then fpringing from his
concealment, he feized his prey with violent threats.
After fome  altercation, in  which her load was  left
upon the ground, She kneeled  upon her  bottle of
Slicks,  and  raifing her] arms  to  heaven beneath the
bright moon then at the full, fpoke to the farmer al-
ready  fhivering. with  cold,  " Heaven  grant,  that
thou  never mayeft know  again  the  bleffing to be
warm."   He complained of cold all the  next  day,
and wore an upper coat, and in a few days another,
and  in a fortnight took  to his  bed, always faying
nothing  made him warm,  he covered himfelf  with
very many blankets, and had a fieve over his face, as
he lay ; and from this one infane idea  he  kept his bed
above twenty  years for fear of  the  cold air,  till at
length he died.
   M. M.  As  mania arifes from  pain either of  our
mufcles or organs  of fenfe,  the arts  of relieving pain
muft constitute the method of cure. See Sea. XXXIV.
3. 4.  Venefeaion.   Vomits of  from five  grains to
ten of emetic tartar, repeated every third morning for
three or four times ; with folution of gum-ammoniac,
                      G g  2                   and 
452             DISEASES     [Class III. i. 2.
and foluble tartar,  fo as to  purge gently every day.
Afterwards warm bath for two or three hours  a day
Opium in large dofes.   Bark.  Steel.
   Dr. Binns gave two feruples (40 grains) of folid
opium at a dofe, and  twenty grains four hours after-
wards ; which  reftored the patient.   Dr. Brandreth
gave  400 drops of laudanum to a maniac in  the great-
eft poffible furor, and in a few hours he became calm
and rational.  Med.  Comment,  for  1791, p.  384.

                     Prognoftic.
   The  temporary quick  pulfe  attending  fome ma-
niacal cafes is fimply a fymptom of debility,  and is the
confequence of too great  exertions; but a permanent
quick pulfe  fhews the pretence of fever,  and is fre-
quently  a falutary  fign ; becaufe, if the  life of the
patient be fafe, when  the fever ceafes, the  infanity
generally vanishes along with it,  as mentioned  above.
In this cafe the kind of  fever muft direa the method
of curing the infanity ; which muft confift of moderate
evacuations and diluents,  if the pulfe be ftrong; or by
nutrientia,  bark, and  fmall  dofes of opium,  if the
pulfe be weak.
   Where the caufe  is  of a temporary nature,  as in
puerperal infanity, there is reafon to hope, that the
difeafe will  ceafe,  when  the bruifes, or other painful
fenfations attending this ftate,  are removed.  In thefe
cafes the child  fliould  be brought  frequently to the
mother, and applied  to her  breaft,  if She  will fuffer
it, and  this  whether  flie at firft attends to it or not; 
Class III. i. 2.]    OF VOLITION.              45J
as by a  few trials it frequently excites the ftorge, or
maternal affeaion, and removes the infanity, as I have
witneffed.
   When the  madnefs  is occafioned  by  pain  of the
teeth, which I believe  is no  uncommon  cafe,  thefe
muft be extraaed ;  and the cure follows the extlnaion
of  the  pain.   There  is however fome difficulty in
deteaing the delinquent tooth in this cafe, as in hemi-
crania, unlets by  its apparent decay, or by fome pre-
vious information of  its pain having been complained
of; becaufe the pain  of the tooth ceafes, as foon as
the exertions of infanity commence.
   When a perfon becomes infane, who has a family
of fmall children to folicit his attention, the prognoftic
is very unfavourable ;  as it fliews the maniacal hallu-
cination  to be  more powerful than thofe ideas which
generally intereft us the moft.

   2. Studium  inane.    Reverie  coafifts of violent vo-
luntary  exertions  of  ideas  to relieve  pain, with  all
the trains or tribes conneaed with them by fenfations
or affociations.   It frequently alternates with epileptic
convulfions; with which it correfponds, in refpea to
the infenfibility of the mind  to the ftimuli  of external
objects, in the fame manner as madnefs correfponds with
common  convulfion, in the  patient's poffeffing at the
fame  time  a  fenfibility  of the  ftimuli  of external
objeas.
   Some  have  been  reported to have  been involved
in reverie fo perfeaiy, as not to have been difturbed
                       Gg3                    by 
454              DISEASES     [Class III. i. 2.
by the difcharge of a cannon ; and others to have been
infenfible to torture, as the martyrs for religious opi-
nions ; but thefe feem more properly to belong to par-
ticular infanities than to  reverie,  like  noftalgia and
erotomania.
   Reverie is distinguished from madnefs as  defcribed
above; and from  delirium,  becaufe  the   trains  of
ideas are  kept  confiftent by the power  of volition, as
the perfon reafons  and deliberates in it.  Somnambu-
lifmus  is a part of reverie, the latter confifting  in the
exertions of the locomotive mufcles,  and the  former of
the exertions of the organs of fenfe ;  fee Clafs I. 1. 1.
9. and Sea. XIX.  both  which  are mixed,  or alter-
nate with  each other, for the purpofe of relieving
pain.
   When  the patients in reverie exert their volition on
their organs of fenfe, they  can occafionally perceive
the ftimuli of external objeas, as  explained in Sea.
XIX.   And in this cafe it  refembles  fometimes  an
hallucination of the fenfes, as there is a mixture of
faa and  imagination in their difcourfe ; but may be
thus  diftinguifhed:  hallucinations of  the  fenfes  are
allied  to  delirium, and  are  attended  generally with
quick  pulfe,  and  other fymptoms of great debility ;
but reverie is without fever,  and  generally  alternates
with convulfions;  and fo much intuitive analogy (fee
Sea.  XVII.   3.   7.)  is  retained in  its paroxyfms,
as to preferve a confiftency in the trains of ideas.
   Mifs G-----, whofe  cafe is related  in Sea.  III. 5.
 8. faid, as I once fat by her,  " My head is  fallen  off,
                                                 fee 
 Class III. i. 2.]     OF VOLITION.              45-5
fee it is rolled to that corner of the room, and the
little  black  dog is nibbling the  nofe  off."  On my
walking to the place which flie looked at, and re-
turning, and affuring her  that her nofe was unhurt,
flie became  pacified,  though I  was doubtful whether
fhe attended to me.   See Clafs III.  1. 1. 9. and  Clafs
III. 1. 2. 2.
   M. M. Large  dofes of  opium given before the
expeaed paroxyfm,  as in  epilepfia  dolorifica,  Clafs
411. 1.1. 8.
   The  hallucinatio ftudiofa, or falfe ideas in reverie,
differ from  maniacal hallucinations above  defcribed,
as no infane exertions fucceed,  and  in the patients
whom I have feen they have always been totally for-
gotten, when the paroxyfm was over.
   Matter-----, a fchool-boy about twelve years old,
after  he came out of a convullion  fit and fat up in bed,
faid to me,  "  Don't you fee my  father ftanding at
the feet of the bed,  he is come a  long  way on foot to
fee me."   I anfwered,  no : " What colour  is his
coat?"  He replied,  " A drab colour."  "  And
what  buttons ?"  "  Metal ones," he  anfwered, and
added,  " how fadly his legs are  fwelled."  In a few
minutes  he  faid, with apparent furprife, " He  is
gone," and  returned to his perfea mind. Other cafes
are related in Sea. XIX. and XXXIV. 3. and in Clafs
III. 1.2. 2. with further obfervations on this kind of
hallucination ; which however is  not  the caufe of  re-
verie, but  constitutes a part  of it, the caufe being
generally fome  uneafy fenfation of the body.
                     G g  a              3.  Vigilic. 
456             DISEASES    [Class III. 1.2.
  3. Vigilia.   Watchfulnefs confifts in the  unceafmg
exertion  of  volition;   which is. generally caufed  by
fome degree of pain  either of mind  or  of body, or
from defea of the ufual quantity of pleafurable  fenfa-
tion ; hence if thofe, who are accuftomed  to  wine at
night,  take tea inftead, they cannot fleep.   The fame
happens from  want of folid food for fupper, to  thofe
who are accuftomed to ufe it;  as in  thefe cafes there
is pain or defea of pleafure  in the ftomach.
   Sometimes the anxiety  about fleeping,  that  is  the
defire  to  fleep,  prevents fleep ;  which confifts  in an
abolition  of defire or will.  This may fo far be com-
pared  to the  impediment of  fpeech defcribed in Sea.
XVII. 1.  10.  as the  inteference of  the will prevents
the effea defired.
   Another  fource of  watchfulnefs may be from  the
too great  fecretion of fenforial  power in  the brain, as
in phrenzy, and as fometimes happens  from the ex-
hibition  of  opium, and of wine ; if the exhauftion of
fenforial  power by the general aaions of the  fyftem
occafioned by the ftimulus  of thefe drugs  can be
fuppofed  to  be   lefs  than   the increafed  fecretion
of it.
  *  M. M. 1. Solid food to fupper.   Wine.  Opium.
Warm bath.  2.  The patient fliould be told  that his
want  of Sleep is of no confequence to his health.   3.
Venefeaion by cupping.   Abstinence  from wine.  4.
 A Iplifter by flimulating the  Skin,  and  rhubarb by
 ftimulating  the bowels, will  fomeimes  induce Sleep.
 Exercife.  An  uniform  found, as of a  paufing drop
                                                of 
Cluss III. i. 2.]      CF VOLITION              457
of water, or the murmur of be^s.   Other means are
defcribed in Sea. XVIII. 20.

   4.  Erotomania.   Sentimental  love.   Defcribed in
its excefs by  romance-writers and poets.   As the ob-
jea of love is beauty, and as our perception of beauty
confifts in a recognition by the fenfe of vifion  of thofe
objeas,  which have before  infpired  our love, by the
pleafure  they  have afforded to many of  our fenfes
 (Sea. XVI. 6.) ; and as brute animals have lefs accu-
racy  of their fenfe  of vifion than mankind (ib.J ; we
fee the reafon why this kind of love is not frequently
obfervable in  the  brute creation, except perhaps  in
fome married birds, or in the  aSfeaion of the mother
to her offspring.  Men, who have not had leifure to
cultivate their  tafte for  vifible objeas, and who have
 not read the works of poets and romance-writers, are
 lefs liable to fentimental love;  and  as ladies are  edu-
 cated rather with  an  idea of being chofen, than of
 choofing ; there are many men, and more  women,
 who have not much of this infanity ; and are therefore
 more eafily induced to marry  for convenience or in-
 terest,  or from the flattery of one fex to the other.
    In its fortunate  gratification fentimental love is fup-
 pofed to fupply the pureft fource of human felicity ;
 and  from the fuddennefs  with which many  of thofe
 patients, defcribed in  Species I.  of this genus, were
 feized with the maniacal hallucination,  there is reafon
 to believe,   that  the  moft violent  fentimental  love
 may be  acquired in a  moment of time,  as  reprc-
                                              SenieJ 
45-3              DISEASES     [Qlass I'll. i. 2.
fented by Shakefpear in the  beginning of  his Romeo
and  Juliet.
   Some have endeavoured to make a diftinaion be-
tween beauty and grace,  and have made  them  as it
were rivals for the poffeffion  of the human heart} but
grace may be defined beauty  in action ; for a fleeping
beauty cannot be called graceful in whatever attitude
fhe may recline; the mufcles muft be in  aaion to
produce a graceful attitude,  and the limbs to produce
a graceful motion.   But though the objea of love is
beauty,  yet  the  idea is neverthelefs much  enhanced
by the imagination of the lover ;  which appears from
this curious circumftance,  that the lady of his paSfion
feldom appears fo beautiful  to the lover  after a few
months feparation, as his  ideas had painted her in  his
abfence ; and  there is, on  that  account, always  a
little  difappointment felt  for a minute  at their next
interview from this hallucination of his ideas.
   This paffion of love produces reverie in its firft flate,
which exertion alleviates  the pain  of it,  and by the
affiftance of hope  converts  it into  pleafure.   Then the
lover feeks folitude,  left this agreeable reverie Should
be interrupted by external  ftimuli, as  defcribed by
Virgil. ^
         Tantum  inter denfas, umbrofa cacumina,  fagos
        Adidue veniebat, ibi haec incondita iblus
         Montibus et fylvis Sludio jaftabat inani.
   When the pain of love is fo great, as not  to be re-
lieved by the exertions of reverie, as above defcribed ;
as when it  is mifplaced on  an objea,  of which  the
                                               lover
y
 
Class III. i. 2.]     OF VOLITION.              459
lover cannot  poffefs himfelf; it may ftill be  counter-
aaed or  conquered by  the Stoic philofophy,  which
Strips all  things of  their  ornaments,  and inculcates
" nil admirari."   Of which leffons  may be  found in
the meditations of Marcus Antoninus.   The  maniacal
idea is faid in fome lovers to have been weakened by
the aaion of other very energetic ideas; fuch as have
been occafioned by the death of his favourite child,
or by the burning of his houfc,  or by his being Ship-
wrecked.  In thofe cafes  the violence of the  new idea
for  a while  expends  fo  much feaforial power as to
prevent the  exertion of the maniacal  one;  and new
catenations fucceed.   On this theory the  lover's leap,
fo celebrated by poets, might effea a  cure, if the pa-
tient efcaped with life.
   The third ftage of this difeafe I fuppofe is irreme-
diable ;  when a  lover has  previoufly  been  much en-
couraged, and at  length meets with negfea or difdain;
 the maniacal idea is fo painful as  not  to be for a mo-
 ment relievable   by  the  exertions of reverie, but  is
 inftantly followed by furious or melancholy infanity;
 and filicide,  or revenge, have frequently been the con-
 fequence.   As was lately exemplified in Mr. Hack-
 man, who fhot Mifs Ray in the lobby of  the  play-
 houfe.  So  the poet defcribes the paffion of Dido,
     _________----Moriamur inultse ?—
     At moriamur,  ait,—fie, fie, javat ire fub umbras !
    The  Story of Medsea feems to have been contrived
 by Ovid, who was a good judge  of the fubjea, to re-
 prefent the  favage madnefs occafioned by ill-requited
 love.   Thus the poet,
                                               Earth 
DISEASES       [Class III. r. 2.
    Earth has no rage like love to hatred turn'd,
    Nor hell a fury like a woman fcom'd.
                                     Dryden.

   5. Amorfui.   Vanity confifts of an agreeable  reve-
rie, and  is well  ridiculed in the Story of Narciffus,
who fo long contemplated his own beautiful image  in
the water, that he  died from  neglect, of taking fuf-
tenance.   I once faw a  handfomc  young  man, who
had been  fo  much flattered by his  parents,  that  his
vanity rofe fo near to infanity, that  one might difcern
by his perpetual attention to himfelf, and the difficulty
with which he arranged his conversation, that the idea
of himfelf intruded itfelf at every comma or paufe  of
his difcourfe.  In this degree vanity muft afford great
pleafure to the  polfeffor ;  and when  it  exifts  within
moderate bounds, may contribute much to the  happi-
nefs of focial life.
   My friend Mr.-----once complained to me, that
he was much troubled with baflifulnefs  in company,
and believed that it  arofe from his  want of perfonal
vanity; on this account  he  determined on a journey
to Paris, when Paris was the centre of politenefs ;  he
there learnt to drefs, to dance,  and to move his  hands
gracefully in converfation ;  and returned  a moft con-
fummate coxcomb.   But after  a very few years  he
relapfed into rufticity of drefs and manners.
   M* M. The cure  of vanity may  be attempted  by
excefs of flattery,  which will at length appear ridicu-
lous,  or  by its familiarity will ceafe to be  defired.   I
remember to have heard a ftory of  a nobleman in the
                                              court 
Class III. i. 2.]     OP VOLITION.               4S1
court of France, when France had  a court, who  was
fo difagreeably vain in converfation, that the king  was
pleated  to direa his cure, which was thus performed,
Two gentlemen were direaed always  to attend him,
one was to ftand behind his chair, and the other  at a
refpeaful diftance before him ;  whenever his  lordfhip
began to  fpeak,  one of them  always  pronounced,
" Lord Gallimaufre is going to fay the beft thing in
the world."   And, as  foon as his  lordfhip had done
Speaking,  the  other  attendant  pronounced, " Lord
Gallimaufre has fpoken the beft thing in the  world."
Till in a few  weeks  this nobie lord  was fo difgufted
with praife that he ceafed to be vain; and his majefty
difmiffed his keepers.

   6. Noftalgia.   Maladie de Pais.   Calenture.   An
unconquerable defire  of  returning to  one's native
country, frequent  in long voyages,  in which the pa-
tients become fo  infane as  to throw themfelves  into
the fea, mistaking it for green fields or meadows.  The
Swifs are  faid to  be particularly liable to this difeafe,
and when taken  into foreign fervice frequently to ce-
fert from  this caufe, and efpecially after hearing  or
finging a particular tune, which was ufed in  their vil-
lage dances, in their  native country, on which account
the playing or finging this tune was  forbid by the pu-
nifhment of death.   Zwingerus.
     Dear is that flied, to which his foul conforms,
     And ilea)  that hill, which lifts him  to the dorms.
                                      Golds m 1 t w. 
462              DISEASES      [Class III. 1.2.
   7.  Spes religiofa.  Superfluous hope.  This mania-
cal hallucination in its milder ftate produces, like fen-
timental love, an agreeable reverie ; but when joined
with  works of fupererogation, it has occafioned many
enormities.   In India devotees confign themfelves by
vows to moft painful  and unceafing  tortures, fuch as
holding up their hands, till they cannot retraa them ;
hanging up by hooks put  into the  thick  Skin  over
their Shoulders, fitting upon Sharp points, and other
felf torments.   While in our part of the globe falling
and mortification, as flagellation, has been believed to
pleafe a merciful  deity ! The  ferenity, with which
many have fuffered cruel martyrdoms, is to be aferibed
to this powerful reverie.
   Mr.-----, a clergyman, formerly of this neighbour-
hood, began to bruife and wound himfelf for the fake
of religious mortification,  and  paffed much time  in
prayer, and continued  whole  nights alone in  the
church.  As he had a wife and family of fmall  chil-
dren, I believed the cafe to be incurable ; as otherwife
the affeaion and employment in  his family conneaions
would have  oppofed the beginning of this infanity.
He was taken to a madhoufe without effea, and after
he returned home, continued to beat and bruife him-
felf, and by this kind of mortification, and  by fome-
times long faffing, he at length became emaciated and
died.   I once  told him in converfation, that " God
was a merciful being, and could not delight in cruelty,
but that I fuppofed he worshipped  the devil."   He
was ftruck  with this idea,  and promifed me not  to
                                               beat 
Class III. i. 2 ]    OF VOLITION.               465
beat himfelf for three days,  and I believe kept his
word for one day.   If this idea  had been  frequently
forced on his mind, it might probably have  been of
fervice.
   When thefe works of fupererogation have been of
a  public nature, what cruelties,  murders,  maffacres,
has not this infanity introduced  into the world!—A
commander, who had been very aaive  in leading and
encouraging the bloody deeds of St. Bartholomew^
day at Paris, on confeffing his fins to a  worthy eccle-
fiaftic on  his death-bed,  was afked, "Have  you no-
thing  to  fay about St.  Bartholomew ?"   " On that
day," he  replied, " God Almighty was  obliged to
me !"—The fear of hell  is  another  infanity,  which
will be fpoken of below.

   8. Superbia ftemmatis.    Pride of family  has fre-
quently formed a maniacal hallucination, which in its
mild ftate has  eonfifted in  agreeable reverie, but when
it  has  been fo painful  as to demand  homage from
others,  it has frequently induced  infane exertions.
This infanity feems to  have  exifted in the flourishing
ftate of Rome, as  now all over  Germany, and  is at-
tacked by Juvenal  with great feverity, a fmall part of
 which I fliall here  give as  a method of cure..   Sat. 8.
     Say, what avails the pedigree, that brings
     Thy boafted line from hemes or  from kings ;
     Though m my a mighty lord, in parchment roll'd,
     Name after name, thy coxcomb hands unfold ;
     Though wreathed patiiots crowd thy marble  hall;,
     Or fteel clad warriors frown along the walls;
                                               Wl.i'e 
 4^4              DISEASES*   [Class III. t. t

     While on broad canvas in the gilded frame
     All virtues flourilh, and all glories flame ?—
     S.iy,—if ere noon with idiot laugh you W-t
     Wallowing in wine, or cog the dubious die,
     Or act unfhamed, by each indignant bud,
     The midnight orgies of promifcuous lull !----
       Go, lead mankind to Virtue's holy fhrine,
     With morals mend them, and with arts refine,
     Or lift, with golden  characters unfurl'd,
     The flag of peace, and ftill a warring woild !—
     —So  Shall with pious hands immortal Fame
     Wreathe all her laurels round thy honour'd name,
     High o'er thy tomb, with chill'd bold engrave,
     *• The truly  noble are the good and brave."


   9. Ambitio.   Inordinate  defire  of fame.  A  care-
leflhefs about the opinions  of others is faid by Xeno-
phon to be the fource of impudence ;  certainly a pro-
per  regard  for  what  others  think of us  frequently
incites us to virtuous  aaions, and  deters us  from vici-
ous  ones;  and  increafes our happinefs by enlarging
our  fphere of fympathy, and by flattering our vanity.

     Abftract what others  feel, what others think,
     All pleafures ficken, and all glories fink.
                                         Pope.

   When  this  reverie  of ambition  excites  to conquer
nations, or to enflave  them,  it has been the fource of
innumerable wars, and the occafion of a great devasta-
tion of mankind.   Cnefar is  reported to have boafled,
that he had  deftroyed  three millions of his enemies,
and  one million of his friends.
4
The 
Class III. i. 2.3    OF VOLITION.               465

   The  works of Homer  are fuppofed to have done
great injury to mankind by  infpiring the love of mili-
tary glory.   Alexander was  faid  to fleep with them
always on his pillow.   How  like a mad butcher amid
a flock of flieep  appears the  hero of the Iliad, in the
following fine lines  of Mr. Pope, which conclude the
twentieth book.
      His fiery courfers, as the chariot rolls,
    Tread down whole ranks, and crufh out heroes' fouls 3
    DaSh'd from their hoofs, as o'er the dead they fly,
    Black bloody drops the fmoaking chariot dye ;—
    The fpiky wheels through heaps of carnage tore,
    And thick the groaning axles dropp'd with gore;
    High o'er the  fcene of death Achilles flood,
    All grim with duft, all horrible with blood ;
    Yet ftill infatiate,  ftill with rage on flame,
    Such is the lull of never dying fame !

   The cure   muft  be  taken  from  moral  writers.
 Woolafton  fays,  Caefar conquered Pompey ;  that  is,
 a man whofe name confuted of the letters C.  a?, f. a. r.
 conquered a long time ago a man, whofe name con-
 fifted of the letters P. o. m. p. e. y. and that this is
 all that remains of  either  of them.    Juvenal alfo
 attacks this mode of infanity, Sat X. 166.
    —I, demens,  et fasvas curre per alpes,
     Ut pueris placeas, et declamatio fias !

 Which is thus translated by Dr.  Johnfon,
     And left a name, at which the world grew pale,
     To point a moral, or adorn  a tale !
H h
10. Marcr. 
466             DISEASES     [Class III. i. z.
   lOr Maror*   Grief.   A  perpetual voluntary con-
templation of all the circumftances of fome great lots.*
as of a favourite child.   In general the painful ideas
gradually decreafe in energy, and at length the recol-
feaion becomes more tender and  lefs  painful.  The
letter of Sulpicius to Cicero ©n the lofs of his  daugh-
ter is ingenious.   The example  of  David on  the lofs
of his child is heroic.
   A  widow  lady  was  left in  narrow  circumftances
with a boy and a girl,  two beautiful  and lively chil-
dren, the one fix and tlie other feven years of age  ;
as her  circumftances  allowed her  to keep but  one
maid-fervant, thefe  two  children were the fole atten-
tion, employment, and confolation of her life;  She fed
them, dreffed them, Slept with them, and taught them
herfelf; they were both  fnatched  from her  by  the
gangrenous fore throat  in one wreek : fo that  flie loft
at once all that employed her, as well as all that was
dear to her.   For  the  firft three or four  days after
their death, when any friend vilited her, She  fat up-
right,  with  her eyes wide open,  without Shedding
tears,  and affeaed to  fpeak  of indifferent  things.
Afterwards flie began  to weep much,  and for fome
weeks talked  to  her friends of nothing elfe but her
dear children.   But did not for many years,  even to
her dying hour, get quite over a  gloom, which  was
left upon her countenance.
   In  violent  grief,  uhen tears flow, it is efteemed  a
good fymptom ; becaufe then the  aaions  caufed  by
U-nfitive affociation  take the place of thofe caufed  by
                                          volition  ; 
Class III. t. 2.]     OF VOLITION.                467
Volition ;  that is,  they  prevent the voluntary  exer-
tions of ideas, or  mufcular aaions,  which conftitutc
infanity.
   The  fobbing and  fighing attendant upon grief  are
not convulfive  movements, they are occafioned by  the
fenforial power being fo  expended  on  the  painful
ideas, and their conneaions, that the perfon  negfeas
to breathe for a  time, and then a violent figh or  fob
is  neceffary  to carry on the  blood,  which  oppreffes
the  pulmonary veffels,  which  is then performed  by
deep or quick infpirations, and  laborious expirations.
Sometimes neverthelefs  the breath is probably for a
while voluntarily held, as  an  effort  to  relieve  pain.
The palenefs and ill  health occafioned by long grief is
fpoken of  in Clafs  IV. 2.  1. 9.
   The melioration  of grief by time,  and its  being  at
length even attended with pleafure,  depends on our
retaining  a diftina idea of the loft objea, and, for-
getting for a time  the  idea of the lofs  of it.   This
pleafure of grief is beautifully defcribed by Akenfide*
Pleafures  of Imagination, Book II. 1.  680.
           -------------Afk the  faithful youth,
        Why the cold urn of her,  whom long he loved,
        So often fills his arms ; fo often draws
        His lonely footfteps at the filent hour
        To pay the mournful tribute of his tears ?
        Oh ! he will tell thee, that the wealth of worlds
        Should ne'er feduce his bofom to forego
        That facred  hour ; when,  ftealing from the noife
        Of care and  envy, fweet remembrance foothes
        With Virtue's kindeft looks his aching breaft,
        And turns his  tears to rapture.
                       H h 2           M. M.  Con- 
+6R              DISEASES     [Class III. x. 2.
   M. M.  Confolation is beft fupplied by the Christian
doarine of a happy immortality.  In  the  pagan re-
ligion the power of dying was, the great  confolation
in irremediable diftrefs.   Seneca fays, " no one need
be unhappy  unlets  by  his  own  fault."  And  the
author  of Tclemachus  begins his work  by  faying,
that Calypfo could not confole herfelf for  the  lofs of
Ulyffes, and found herfelf unhappy in being immortal.
In the firft hours of  grief the methods of confolation
ufed by uncle Toby, in Triftram Shandy, is probably
the beft ; "he  fat down in an arm chair by the bed
of his diftreffed friend, and faid nothing."

   11. TaJ'unn  vita.   The inanity of fubhmary things
has  afforded a theme  to philofophers,  moralists, and
 divines, from the earlieft records of antiquity ; " Vanity
 of vanities!" fays the preacher, " all is vanity !"  Nor
 is there  any  one,  I  fuppofe, who  has  paffed  the
 meridian  of life, who has  not at fome moments  felt
 the nihility of  all thing,-,.
   Wearinefs of life in its moderate degree has  been
 efteemed a  revive  to aaion  by fome philofophers.
 See  Sea. XXXIV. 2. 3.    But  in  thofe men,  who
 have run through the ufual amufements of life early
 in refpea to their age;  and  who have not  induftry
 or ability to cultivate  thofe  fcicnces, which   afford  a
 perpetual fund  of novelty,  and of  confequent enter-
 tainment, are liable  to become tired  of life,  as  they
 fuppofe there is nothing new  to be  found in  it, that
 can afford them pleafure ; like Alexander who is  faid
                                                 +0 
Class III. i. 2.]     OF VOLITION.              4$9
to have flied tears,  becaufe he had not another world
to conquer.
   Mr. —----» a gentleman about fifty,  of polifhed
manners, who in a  few months afterwards deftroyed
himfelf, faid to  me one  day, " a  ride  out in the
morning, and a warm parlour and a pack  of cards in
the afternoon, is all that life affords."   He  was per-
fuaded to  have an  iffue  on the  top of his  head, as
he complained  of a dull head-ach, which being un-
skilfully managed,  deftroyed the  pericranium to the
fize  of an  inch in  diameter; during  the time  this
took  in  healing,  he  was  indignant   about it,  and
endured life, but foon afterwards  fhot himfelf.
   Mr.----, a gentleman of Gray's Inn, fome years
ago  was prevailed  upon by his  friends to  difmifs a
miflrefs,  by whom  he  had a child, but who was fo
o-reat a termagant and feold, that flie was  believed to
ufe him very ill,  and even to beat him.    He became
melancholy in  two days  from the want of  his  ufual
ftimulus to aaion, and cut his throat on the third So
completely, that he died immediately.
   Mr. Anfon,  the  brother of the late Lord Anfon,
related to me the following anecdote of the  death of
L0rd Sc----.   His Lordfhip font to fee  Mr. Anfon
on the Monday preceding his death,  and faid, " You
are the only friend I value in the world, I determined
therefore  to  acquaint  you, that I  am tired of the
infipidity of life, and intend  to-morrow to leave it."
Mr.  Anfon faid,  after  much converfation,  that  he
was obliged to leave  town  til!  Friday,  and added,
                       H h 3                 " As 
47®              DISEASES     [Class III. i. z.
*' As you profefs a friendship for me, do me this laft
favour, I entreat you,  live  till  I return."   Lord
Sc----  believed this to be a  pious  artifice to gain
rime, but neverthelefs agreed, if he Should return by
four o'clock on that day.   Mr. Anfon did not return
till five,  and found,  by  the  countenances  of the
domeftics, that the  deed  was  done.   He  went into
his chamber and found the  corpfe of his friend leaning
over the arm of a great chair, with the piftol on the
ground by him, the ball of which had been difcharged
into the Boof of his mouth, and paffed into his brain.
   "Mr.-----and  Mr.      ■,  two  young  men,  heirs
to confiderable fortunes, Shot themfelves at  the age
of  four  or  five  and twenty,  without their  friends
being  able  to conjeaure  any  caufe for thofe rafh
aaions.  One of them I had long known  to exprefs
himfelf with diffatisfaaion of the world ;  at eighteen
years of age  he  complained, that he could not en-
tertain himfelf;  he  tried  to ftudy the  law at Cam-
bridge, and afterwards went abroad  for  a year or
two by my advice ; but returned diffatisfied with all
things.   As he had had an eruption  for  fome years
on a part of his face, which he  probably endeavoured
to remove by external applications; I was induced
to-afcribe his perpetual ennui  to  the pain  or dif-
agreeable fenfation of a difeafed liver.   The other
young gentleman Shot himfelf  in his bed-room,  and
I  was informed  that there was found written  on a
fcrap of paper on  his  table.  " I am impotent, and
therefore not  fit  to  live."   From  whence  there was
                                            reafon 
Class III. i. 2.J      OF VOLITION.              471
reafon to  conclude, that  this  was  the hallucinatio
maniacalis, the  delirious idea, which caufed  him  to
deftroy himfelf.   The cafe therefore belongs to mania
mutabilis, and not to tsedium vitae.
   M. M. Some restraint in exhaufting the ufual plea-
fures of the world early in life.  The agreeable cares
of a matrimonial life.   The  cultivation of fcience, as
of  chemiftry,  natural philofophy,  natural  hiftory,
which fupplies an inexhauftible fource of pleafurable
novelty,  and relieves ennui  by tlie  exertions it oc-
cafions.
   In many  of  thefe cafes, where  irkfomenefs of life
has been the oftenfible caufe of filicide, there has  pro-
bably  exifted a  maniacal hallucination, a painful idea,
which the patient  has concealed  even  to his dying
hour; except where the  mania has evidently arifen
from hereditary  or  acquired difeafe  of  the membra-
nous  or  glandular parts of the fyftem.

   12. Pulchritudinis defiderium.  The loij of beaut},
either by difeafe, as by the fmall-pox, or by age,  as
life advances, is fometimes  painfully felt  by ladies,
who have been  much flittered on account of it. There
is a  curious cafe of this kind  related  in Le Sage's
Bachelor of Salamanca, which  is too nicely defcribed
to be totally imaginary.
   In this fituation fome ladies  apply to  what are ter-
med cofmetics under various names,  which crowd the
newfpapers.  Of thefe the white has destroyed the
health of thoufands  ; a calx,  or magillery,  of bifmutli
 is fuppofed to be fold in  the {hope for this purpofe ;
                       II h 4                   b::' 
472             DISEASES     [Class III. i. 2.
but it is  either, I am informed, in part or entirely
white lead or ceruffa.   The  pernicious effeas of  the
external ufe of thofe faturnine applications are fpoken
of in gutta rofea, Clafs II. 1. 4. 6.  The real calx of
bifmuth would probably have the fame ill effea.   As
the red paint is prepared from cochineal, which is an
animal body,  lefs if any injury arifes from its ufe, as it
only lies on the Skin like other filth.
   The tan of the  Skin occafioned by the fun  may be
removed by lemon juice evaporated by the fire to half
its original quantity, or by diluted marine acid ; which
cleans the cuticle, by eroding its furface, but requires
much caution in the application ; the marine acid muft
be  diluted with water, and  when put upon the hand
or face, after a fecond of time, as  foon as the tan  dif-
appears, the part muft be waShed  with a wet towel
and much warm water.   Freckles lie too deep for  this
operation, nor are they in  general removable  by  a
blifter, as I once experienced.  See Clafs I. 2. 2.  9.
   It is probable,  that thofe materials which Stain Silk,
or ivory,  might be  ufed to Stain the  cuticle, or hair,
permanently ; as they are all animal fubftances.  -But
I do not know, that any trials of this  kind have been
made on the ikin.   I endeavoured in  vain to whiten
the back of my  hand by  marine acid  oxygenated by
manganefe, which fo inftantly whitens cotton.
   The cure  therefore  muft be fought  from moral
writers, and  the cultivation of the  graces of the mind,
which are frequently a  more valuable poffeffion than
celebrated beauty.
13. Pau- 
Class III. i. 2.]     OF VOLITION.              473
   13. Paupertatis tin.or.   The fear of poverty  is one
kind of avarice ; it is liable to affea people who have
i-.'ft off a profitable  and aaive  bufinefs;  as they are
thus deprived of their ufual exertions, and are liable
to obferve  the daily  expenditure  of money,  without
calculating the  fource from whence it flows.   It  is
alfo liable to occur with  a fudden and unexpeaed in-
creafe of fortune.  Mr.-----,  a furgeon, about fifty
years of age,  who was always rather of a parfimonious
difpofition, had a large houfe, with a fortune of forty
thoufand pounds, left him by a diftant relation ;  and  in
a  few weeks became infane from the fear of poverty,
lamenting  that he fhould die in a jail or  workhoufe.
He had left off a laborious country bufinefs,  and the
daily perception of profit in his books; he alfo now
faw greater expences going forwards in his new houfe,
than he had been accuftomed to obferve, and  did not
fo diftinaiy fee the fource ©f fupply;  which feems  to
have occafioned the maniacal hallucination.—This idea
of approaching  poverty is  a very frequent  and'very
painful difeafe,  fo as to have induced many to become
filicides, who were in good circumftances ; more per-
haps  than any other maniacal hallucination,  except
the fear of hell.
   The covetoufnefs  of  age is  more liable to  affea
fingle men, than thofe who have families;  though an
accumulation of wealth would feem to be more defira-
ble to the latter.  But an old man  in the former Situ-
ation, has no perfonal conneaions  to  induce him  to
open  his purfe; and  having loft the friends of hi*
                                            youth, 
474               DISEASES    [Class III. i. 2.
youth, and not eafily acquiring new ones,  feels him-
felf alone in  the world ;  feels himfelf unproteaed,  as
his ftrength declines, and is  thus  led  to depend  for
affiftance on  money, and on that account wiflies to
accumulate it.   Whereas the father of  a  family has
not only thofe conneaions,  which demand the  fre-
quent  expenditure  of money, but feels a confolation
in the friendship of  his children, when  age may ren-
der their good offices neceffary to him.
   M. M. I have been well informed of a medical per-
fon in good  circumftances  in London, who  always
carries an account of his affairs,  as  debtor and credi-
tor,  in his  pocket-book ; and looks over it frequently
in a day, when this difeafe  returns upon him ; and
thus, by counteraaing  the  maniacal  hallucination,
wifely prevents the increafe  of his infanity.  Another
medical perfon,  in London, is faid to have cured him-
felf of this  difeafe by ftudying mathematics with great
attention;  which exertions of the mind relieved  the
pain of the maniacal hallucination.
   Many  moral  writers have ftigmatifed  this infanity;
the covetous, they  fay,  commit  crimes and mortify
themfelves  without  hopes  of reward;  and thus  be-
come miferable both in this world and the next.   Thus
Juvenal :
    Cum  furor haud dubius, cum fit manifefta phrenitis,
    Ut locuples moriaris, egenti vivere fato !
   The covetous man thought  he gave good advice  to
the fpendthrift, when he faid, " Live like  me," who
well anfwered him,
                                             " Like 
Class III. i. 2.]     OF VOLITION.              475
    -----------" Like you, Sir John I
    " That I can do,  when all I have U gone !"
                                      PoPE.
   14. Lethi timor.   The  fear  of death perpetually
employs the thoughts of thefe  patients ; hence  they
are  devifing  new  medicines, and  applying  to  phy-
sicians and quacks without number.   It is confounded
with hypochondriafis, Clafs I. 2. 3. 9. in popular con-
verfation,  but is in reality an infanity.
   A  young gentleman, whom I advifed to go abroad
as a cure for this difeafe, affured me,  that during the
three years he was in Italy and France he never paffed
a quarter  of an hour  without  fearing he fliould die.
But has now for above twenty  years  experienced the
contrary.
   The  fufferers under this malady are generally at
once  difcoverable by their telling you, amidft an un-
conneaed  defcription of their  complaints, that they
are nevertheless not afraid  of dying.   They are alfo
eafily led to complain  of pains  in  almoft any part of
the body, and are thus foon difcovered.
    M. M. As the maniacal hallucination has generally
 arifen in early infancy from fome dreadful  account of
 the Struggles and pain  of*dying, I have fometimes ob-
 ferved, that  thefe patients  have  received great con-
 folation from the inftances 1 have related to them of
 people dying without pain.   Some of thefe, which I
 think curious,  I fliall concifely  relate, as a part of the
 method of cure,
 
47S               DISEASES    [Class III. i. 2.
   Mr.----,  an elderly gentleman, had fent for  me
one whole day before I could attend him;  on my ar-
rival he faid he  was glad to fee me, but that he was
now quite well, except that he  was weak,  but had
had a pain  in his bowels the day before.   He then
lay in  bed with his legs cold  up to the  knees,  his
hands and arms  cold, and his pulfe fcarcely difccrnible,
and died in about fix hours.  Mr.----, another gen-
tleman about fixty, lay in the aa of dying, with dif-
ficult refpiration like groaning, but in a kind of ftupor
or coma vigil,  and every ten or twelve minutes, while
I fat by him> lie waked, looked  up, and faid, " who
is it groans fo,  I am fore there  is fomebody  dying in
the room,"  and then funk again into a kind  of fleep.
From thefe two  cafes  there appeared to be  no pain
in the aa of dying,  which  may  afford confolation to
all, but particularly to thofe who  are affliaed  with  the
fear of death.

   15.  Orel timor.  The fear of hell.  Many theatric
preachers among the  Methodifts fuccefsfully  infpire
this  terror, and live  comfortably  upon  the  folly  of
their hearers.   In this kind of madnefs the poor  pa-
tients frequently commit filicide;  although they  be-
lieve they run  headlong into the hell, which they
dread !  Such is  the power  of oratory, and fuch  the
debility of the human understanding!
  Thofe,  who fuffer under this  infanity, are  gene-
rally the moft  innocent and harmlefs people ;  who  are
then iiabie to  accufe themfelves of the greateft ima-
                                            ginary 
Class III. i. 2.]     OF VOLITION.              477
ginary crimes, and have fo mrch intelfeaual cowardice,
that they dare  not reafon about  thofe things, which
they are direaed by their priefts  to believe,  however
contradiaory to  human  a prehenfbn, or  derogatory
to  the  great  Creator of all  things.   The  maniacal
hallucination at length becomes  fo  painful,  that the
poor infane flies from life to become free from it.
   M. M. Where the intelfeaual .cowardice is great,
the voice of reafon is ineSfeaual ; but that of ridicule
may  fave  many  from  thofe mad-making  doaors ;
though it is too  weak to cure thofe, who  are already
hallucinated.   Foot's  Farces are  recommended  for
this purpofe.

    16.  Satyriafis.   An ungovernable defire of venereal
 indulgence. The remote caufe is  probably the ftimulus
 of the  femen ; whence the  phallus becomes  diftended
 with blood by the arterial propulsion of it  being more
 Strongly excited  than the correspondent venous abforp-
 tion.   At the fame time a  new  fenfe is produced in
 the  other  termination  of the  urethra ;  which, like
 itching, requires fome exterior friaion to facilitate the
 removal of the  caufe of the  maniacal  aaions, which
 may probably be increafed  in thofe cafes by fome affo-
 ciated  hallucinations of ideas.  It differs from priapif-
 mus chronicus in the defire of its appropriated objea,
 which is not experienced in the latter, Clafs I. 1.4. 6.
 and from the priapifmus amatorius, Clafs II. 1.  7. 9.
 in the maniacal  aaions in confequence of defire.  The
 furor  uterinus,  or nymphomania, is a fimilar  difeafe.
                                      M. M. Vene- 
 4/5             DISEASES      [Class III. i. i.
   M. M.  Venefeaion. Cathartics.  Torpentia.   Mar-
 riage.

    17. Ira.  Auger is caufed by the pain  of offended
 pride.  Wre are not angry at breaking a bone, but
 become quite infane from the fmalleft ilroke of a whip
 from  an  inferior.   Ira  furor  brevis.  Anger  Is not
 only  itfelf a temporary madnefs,  but is a frequent at-
 tendant on other  infanities,  and as, whenever  it ap-
 pears, it diftinguiflies  infanity from  delirium, it  is ge-
 nerally a  good fign in fevers with debility.
   An injury voluntarily infliaed on us by others ex-
 cites our exertions of felf-defence or of revenge againft
 the perpetrator of  it; but anger does not fucceed in
 any great  degree  unlets our  pride  is offended  ; this
 idea is the  maniacal hallucination,  the pain of which
 fometimes produces fuch violent and general  exertions
 of our mufcles and ideas,  as to*difappoint the revenge
 we meditate, and vainly to  exhauft our  fenforial
 power.  Hence  angry people,  if not  further excited
 by difagreeable language, are liable in  an hour or two
 to become  humble, and forry for their violence, and
 willing to  make greater conceffions than required.
  M. M.   Be filent,  when you  feel yourfelf angry.
 Never ufe loud oaths,  violent upbraidings, or ftrong
 expreffions of countenance, or gesticulations of  the
 arms, or clenched  fills ; as thefe by  their former affo-
 ciations with anger will contribute  to increafe it.   I
have been told of a fergeant or corporal, who began
 moderately to cane his fjlilers, when they were awk-
                                              ward 
Class III. i. *.]    OF VOLITION.               4/f
ward in their exercife, but being addiaed to fwearing
and coarfe language, he ufed foon to enrage himfelf
by his own expreffions  of  anger, till toward  the end
he was liable  to beat the delinquents unmercifully.

   18. Rabies.   Rage,    A  defire of biting others,
moft  frequently attendant on canine madnefs.  Ani-
mals  in  great  pain,  as in the  colica  faturnina,  are
faid  to bite the ground they lie  upon, and even their
own  flefli.  I  have feen  patients bite the attendants,
and  even  their own  arms, in the  epilepfia dolorifica.
It feems  to  be an  exertion  to relieve pain, as ex-
plained in Sea. XXXIV.  1.  3.   The dread of water
in hydrophobia is occafioned by the repeated painful
attempts to fwallow  it, and is therefore not  an effen-
tial  or original part of the difeafe called canine mad-
nefs.  See Clafs III. 1.   1. 15.
   There is  a mania  reported to  exift  in fome parts
of the eaft, in which a man is faid to run  a muck;
and  thefe furious  maniacs are believed to   have in-
duced their calamity by  unlucky gaming, and after-
wards by taking large quantities of opium ;  whence
 the  pain of  defpair is joined  with  the energy  of
 drunkennefs; they are then faid to fully forth  into
 the moft  populous Streets, and to wound and flay  all
 they  meet,  till they receive  their own death, which
 they  defire  to procure without the greater guilt,  as
 they  fuppofe of fuicide.
   M. M. When there appears a tendency  to  bite in
 tlie  painful epilepfy,  the end of a rolled-up  towel,
                                                  or 
4-^0             DISEASES      [Class III. i. 2.
or a  wedge of foft  wood,  fhould  be  put into  the
mouth of the patient.   As a bullet is faid fometimes
to be given to a foldier,  who is  to be feverely flog-
ged,  that he  may by biting  it better bear his  pu-
nifliment.

   19. Ciita.    A defire to  fwallow indigestible fob-
fiances.   I once faw a  young lady, about  ten years
of age, who filled her ftomach with the earth out of a
flower-pot, and vomited  it up with fmall-ftones, bits of
wood, and wings of infeas amongft it.   She had the
bombycinous complexion,  and  looked like a chlorotic
patient,  though fo  young; this generally proceeds
from  an acid in the Stomach.
   M. M. A vomit.   Magnefia alba.   Armenian bole.
Rhubarb.  Bark.   Steel.  A blifter.   See Clafs I.
2. 4. 5.

   20. Cacofitia.   Averfion to food.   This  may arife,
without difeafe of the  ftomach, from  conneaing nau-
fecuj  ideas to  our ufual food, as by calling a ham a
hog's a-----.  This  madnefs is  much inculcated by
the Stoic  philofophy.   See  Antoninus' Meditations.
See two cafes of patients who refuted to take nourish-
ment.  Clafs III. 1. 2. 1.
   Aversions to peculiar kinds of food are thus formed
early  in  life by affociation of fome maniacal hallucina-
tion  with them.   I  remember a child, who on tatting
the griftle of fturgeon, alked what griftle  was ? And
feeing told ir was like the divifion of a man's nofe, re--
                     2                      reived 
Class til. i. 2.]     OF VOLITION.               4«h
ceived an  ideal hallucination ; and for  twenty years
afterwards could not be perfuaded to tafte fturgeon.
   The great fear  or averfioil, which fome people ex-
perience at the fight of fpiders, toads,  crickets,  and
the like, have generally had a fimilar origin.
   M. M. Affociate agreeable ideas with  thofe  which
difguft;  as  call a  fpider ingenious,  a frog clean and
innocent ;  and reprefs all expreffions of difguft by the
countenance,  as fuch  expreffions  contribute to pre-
ferve,  or even  to increafe, the energy of the ideas
affociated with them; as mentioned above in Species
 17,  Ira.

   21. Syphilis imaginaria.   The fear  that  they are
infeaed  with the  venereal difeafe,  when they have
only deferved it,  is a very common infanity amongft
modeft young men;  and is not to be cured without
applying  artfully  to the mind ; a little  mercury muft
be given, and hopes of a cure added weekly  and gra-
 dually by interview or correfpondence for fix or eight
weeks.  Many of thefe patients have been repeatedly
 falivated without curing the mind !

   22. Pfora imaginaria.   I have twice  feen an  ima-
 ginary itch, and twice an imaginary diabsetes,  where
 there was not the leaft veftige of  either of thofe dif-
 eafes, and  once an imaginary deafnefs, where the pa-
 tient heard perfeaiy well.  In all  thefe cafes the hal-
 lucinated  idea is  fo powerfully excited,  that it is not
 1:0 be changed fuddenly by ocular fenfation, or reafon.
                         Ii                     Yet 
 4*2             DISEASES     [Class III. 1.2.
 Yet great  perfeverance in the  frequently prefenting
 contrary ideas will fometimes flowly remove this hal-
 lucination,  or in a  great  length  of time oblivion,  or
 forgetfulnefs, performs  a cure,  by  other  means  in
 vain attempted,

    23.  Tabes imaginaria.  This imaginary difeafe,  or
 hallucination,  is  caufed by  the fuppofed  too  great
 frequency  of parting with the  femen,  and had long
 impofed upon the  phyfician  as well as the patient,
 till Mr. John  Hunter firft endeavoured to Shew, that
 in general  the morbid effeas  of this  pollution  was'in
 the imagination ; and that thofe were only liable to
 thofe effeas in  general, who had been terrified  by
1 the  villanous books, which  pretend  to prevent or to
 cure it, but which were purpofely written to vend fome
 quack  medicine.  Moft of  thofe  unhappy patients,
 whom  I have feen, had  evidently  great imprelfion of
 fear and felf-condemnation on their minds, and might
 be led to  make contradiaory complaints in almoft any
 part of the body, and  if their confeffions could be
 depended  on,  had  not ufed  this pollution to  any
 great excefs.
    M. M.  1.  Affure them if the lofs of the femen hap-
 pens but  twice a week,  it will  not  injure them.  2.
 Marry them.   The laft is a certain cure; whether the
 difeafe be  real  or  imaginary.   Cold  partial bath, and
 aftringent medicines frequently  taken, only reeal  the
 mind to  the  difeafe,  or to the delinquency; and
 thence increafe the imaginary effeas and the real caufe,
                                                  if 
Class III. i. 2.]     OF VOLITION.                4*3

if fuch exifts.   Mr.-----deftroyed himfelf to get free
from the pain of fear of the fuppofed ill confequences of
felf-pollution, without any other apparent difeafe; whofe
parents I had in vain advifed to marry him, if poffible.

   24. Sympathia alicna.   Pity.   Our fympathy with
the  pleafures  and pains of others diftinguiflies men
from other animals ;  and is probably the foundation
of what  is termed our moral fenfe ; and the fource of
all our virtues.   See Sea. XXII.  3.  3.   When our
fympathy with thofe miferies  of mankind,  which we
cannot alleviate,  rifes to excefs,  the mind becomes its
own tormenter ; and we add to  the aggregate fum of
human mifery, which we ought to labour to diminish ;
 as in the following eloquent lamentation  from Aken-
 fide's Pleafures of Imagination, Book  II.  1. 200.

         -----------------------Dark,
         As midnight ftorms, the feene of  human things
         Appear'd before me ; defer ts, burning finds,
         Where the parch'd adder dies;  the frozen fouth ;
         And  defolation blading all the weft
         With rapine and with murder.  Tyrant power
         Here fits enthroned in blood*; the baleful charms
         Of fuperftition there infect the ikies,
         And turn the fun to horror.  Gracious Heaven {
         What is the life of man ?  Or cannot thefe,
          Not  thefe portents thy awful will fuffice?
          That, propagated thus beyond their fcope,
          They rife to a.!t their cruelties anew
          In my afflicT^d bofom, thus decreed
          The univerfal fenfitive of pain,
          The wretched heir of evils not its  own !
                         Ii 2                  A pee 
4^4              DISEASES    [Cuss III. i. *.
   A poet of antiquity, whofe name I do  not recol-
fea, is  faid to have written  a book defcribing  the
miferies of the world,  and to have deftroyed himfelf
at the  conclufion of his tafk.   This fympathy, with
all fenfitive  beings, has been carried  fo  far by fome
individuals,  and even  by whole tribes, as the Gen-
reos, as not only to reftrain them from killing animals
for their fupport, but  even to induce them to permit
infeas  to prey upon  their bodies.  Such is however
the condition of mortality,  that the firft law of nature
is, "  Eat or be eaten."   We cannot  long  exift with-
out the deftruaion  of  other animal or  vegetable
beings,  either in their mature or their embryon ftate.
Unlets the fruits, which furround  the  feeds  of fome
vegetables, or the honey Stolen from them by  the bee,
may be faid to_.be an exception to this  affertion.  See
Botanic Garden, P. I. Cant. 1.1. 278. Note.   Hence,
from the neceffity of our nature, we may be fuppofed
to have a right to kill thofe creatures,  which we want
to eat,  or which want  to eat us.  But to deftroy even
infeas vmtonly Shews an unrefieaing  mind or a de-
prived  heart.
   Neverthelefs mankind may be well divided into the
feliiih  and the focial;  that is, into thofe whole plea-
fures arife from gratifying their appetites,  and thofe
whofe  pleafures arife  from  their Sympathizing with
or hers.  And according to the prevalence of thefe oppo-
sing propensities we value or diflike the poffefforof them.
   In conduaing the education of young people, it h
a nice matter to  infpire them with fo much benevolent
                                         fympathy, 
Class, III. i. 2.]     OF  VOLITION.              4Sj
fympathy,  or  compaffion,  as may render them good
and amiable ;  and yet not fo much as  to make  them
unhappy at the fight of  incurable diftrefs.  We fliould
endeavour to make them alive to Sympathize with all
remediable evils,  and at the fame time to arm them
with fortitude to bear  the  fight of fuch irremediable
evils, as the accidents of life muft frequently prefent
before their eyes.  About this I have  treated more at
large in a plan  for the condua of  a  boarding fchool
for ladies, which I intend to publifli in the  courfe  of
the next year.

   25. Educatio heroica.   From the kinds and degrees
of infanities  already enumerated,  the  reader will pro-
bably recolfea many more from his  own obfervation ;
he will perceive that all extraordinary  exertions  of vo-
luntary aaion in confequence of fome falfe idea or hal-
lucination, which Strongly affeas  us, may philosophi-
cally,  though not  popularly, be  termedv an infanity ;
he will then be liable  to divide thefe voluntary exer-
tions into difagreeable,  pernicious, deteftable, or into
meritorious, defeaable, and  even amiable,  infanities.
 And will laftly be induced to conceive, that a good
 education confifts in the art of producing fuch  happy
 hallucinations  of ideas, as  may  be followed by fuch
 voluntary exertions,  as may be termed meritorious  cl-
 aimable infanities.
    The old man of the mountain  in Syria, who ge-
 verned a fmall nation  of people called" Afiaftine.', h
 recorded thus to have educated thofe  of his nrinv who 
486             DISEASES      [Class III. i. 2.
were defigned to affaffinate the princes with  whom he
was at war.   A young  man of natural aaivity was
chofen for the purpofe,  and thrown into a deep fleep
by opium mixed with his food ;  he  was then carried
into a garden made to reprefent the paradife of Maho-
met,  with flowers  of great  beauty  and  fragrance,
fruits of delicious flavor, and beautiful houries beckon-
ing him into the fhades.   After  a while,  on being a
fecond time ftupified with opium,  the young enthufiaft
was reconveyed  to  his apartment; and on  the next
day was affured  by a prieft, that he  was defigned for
fome  great exploit,  and that by  obeying  the com-
mands of their  prince,   immortal  happinefs awaited
him.
  Hence  it is eafy to colfea how the firft ImpreSfions
made on us by accidental circumftances in our infancy
continue through life to bias our affeaions, or miflead
our judgments.  One of my acquaintance can trace the
origin of his own energies of aaion from fome fuch re-
mote  fources;  which juftifies the obfervation  of M.
Rouffeau, that the feeds of future virtues or vices are
oftener fown by the mother, than the tutor.
END "OF VOL! 1. OF PAR'fit," 
 
 
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