THE -
STUDY OF  MEDICINE,
WITH A
tfanrsaosLOfflaoAtti s^ssuse
NOSOLOGY.
BY
JOHN MASON 600D, M.D. F.R.S.
  MEM. AM. PHIL. SOC. AND F.L.S, OF PHILADELPHIA,
IN FIVE VOLUMES- ^.,.~..
vol. v.   *($//06f0f:
           if-
SECOND AMERICAN EDITION,
           »laM#ita:

BENNETT & WALTON, A. SMALL, URIAH HUNT, MAROT & WALTER,
      J. GH1GG, E. PARKER, AND T. DESILVER.
              AND
  COLLINS & HANNAY, COLLINS & Co. BLISS & WHITE, AND
         3. V. SEAMAN, NEW-YORK.
1824. 

t\mtx

   $hiladrfpftia.
Printed by William Browjt, 
A
  PHYSIOLOGICAL

     SYSTEM
        OF

NOSOLOGY;
       WITH A
  CORRECTED AND SIMPLIFIED

  NOMENCLATURE.
 
 
                  TO





           THE PRESIDENT





                  AND





              FELLOWS





                 OF THE





ROYAL COLLEGE OF PHYSICIANS OF LONDON,





         THE FOLLOWING WORK





                   19




             BY THEIR PERMISSION,




AND WITH A DUE SENSE OF THE HONOUR HEREBT CONFERRED UPON HIM,





       RESPECTFULLY DEDICATED,




                  BY




        THEIR OBLIGED AND OBEDIENT SERVANT,





                      THE AUTHOR. 
ADVERTISEMENT.
     THE following Work was  announced to the
Public, and would have appeared at the beginning of
the year, but that the Author was desirous of obtain-
ing the sanction  of the Royal College of Physicians
to dedicate it to that learned body. To the gratifica-
tion of this desire, the President, with his accustomed
politeness, afforded every facility, consistently with a
due deference to the individual judgment of the Fel-
lows of  the  College. A copy of the Work was laid
for public inspection upon the Censor's table on Feb.
3 ; an official notice of the same communicated ; and
three other copies  circulated among  the Fellows  in
rotation, and in  as many different directions, for an
examination of  it at their respective homes.   The
Court assembled on March 31,  when the question
was taken into consideration, and the  Author's re-
quest unanimously acceded to.
     April 2,  1817. 
PRELIMINARY DISSERTATION*
The following work was commenced, and its general outline laid
down, as early as the year  1S08, though the pressure of profes-
sional and  other engagements has prevented its  completion  till
now.  The interval, however, has not been entirely thrown away,
for the author has endeavoured to keep his eye open to every pub-
lication or hint that has since appeared on the subject, or has had
any connection with it, and has availed himself of whatever he has
found most valuable or interesting.
   The main object of the present attempt is not so much to in-
terfere with any existing system of nosology, as to fill up a niche
that still seems unoccupied in the great gallery of physiological
study.   It is  that, if it could be  accomplished, of connecting the
science  of diseases  more clo:?ely with the sister branches of natu-
ral knowledge ; of giving it a more assimilated and family cha-
racter ; a more obvious and intelligible classification; an arrange-
ment more simple  in its principle, but more comprehensive in its
compass; of correcting its nomenclature, where correction is call-
ed for,  and can be accomplished without coercion;  of following
its distinctive terms as well upwards to their original sources, as
downwards to their synonyms in the chief languages of the present
day; and thus, not merely of producing a manual for the student, or
a text-book for the lecturer, but a book that may stand on the same
shelf with, and form a sort of appendix to, our most popular sys-
tems of natural history ; and  may at the same time be perus-
ed by the classical scholar without disgust at that barbarous jargon,
with which the language of medicine is so perpetually tesselated;
and  which every one has complained of for ages, though no one
has hitherto endeavoured to remedy it.
   The  present, however, is but an attempt towards what is want-
ed, and  is only offered  in this view.  How far such an attempt
may be worth encouraging, and  by what means it may be con-
ducted towards a desirable degree of perfection, may perhaps be
best determined by  a brief glance at  the chief nosological  sys-
tems of the day, the nomenclature in actual use, and the general
nature of the improvement  proposed in the ensuing volume.  It
is the aim of this  introduction to offer a few hints upon each of
these subjects. 
vat
PRELIMINARY DISSERTATION.
                         SECTION I.

                      NOSOLOGICAL systems,

   I. No art or science can be acquired, for none can be clearly
 treated of or communicated, without arrangement.  All nosologi-
 cal works, therefore, possessing any value, have an arrangement,
 or method, as it is called, of some kind or other; and which it will
 answer our present purpose to consider as reducible to two, those
 of synopsis and  of system.   In the synoptic method the whole of
 the subject is seen by the writer at the time of his arranging it, as
 indeed the term imports, and radiates in loose but deverging lines
 from a point given by his own genius or inventive power.  In
 the  systematic method, the whole of the subject is, from the first,
 conjunctively  and consonantly examined, for  such is the radical
 meaning of the term system, and rigidly distributed into subordi-
 nate  divisions, agreeably to the laws of similitude and discrepan-
 cy :  so that every component part must necessarily occupy a defi-
 nite  station, as soon as the governing divisions of the system are
 laid  down.   The  first arrangement proceeds usually by parts,
 books, chapters, and sections ; of which Celsus  has furnished us
 with a  very beautiful example; the second, by a much  stricter
 device  of some  other kind ; commonly,  after the botanists, that
 of classes, orders, genera, and species; and, in consequence  of such
 greater strictness, is better calculated to assist the memory.
   Upon the synoptic method it is not the  authors intention to
 touch ;  the  systematic has so many advantages over it, as  well in
 learning as in retaining a subject,  that it has  long taken the lead
 wherever  it has  been found capable of adoption,  and especially in
 several of the  practical branches of physiological science, as zool
 ogy, botany, and mineralogy ; to which we may soon hope to add
 chemistry, though many of the facts of this last study are still too
 isolated, and the results of many of its experiments too disputable,
 to enable  us to  employ the systematic method here   with any
 great advantage at present.
   It  is under  this form, therefore, that nosology has  been
chiefly  taught for  nearly a century;  and as  the  systematic  ar-
rangement  admits  of  several  modifications, every modification
has been tried in  its turn, and  it has found its admirers.  The
simplest systematic modification, if it be in any way  worthy of
 the name, is the alphabetic,  of which, in the  present day, we
 have  many  copious examples, highly valuable  as works of easy
 reference, though  scarcely entitled  to rank  under  the  charac-
ter of  systematic arrangement.   To this classification  belongs 
                  PRELIMINARY DISSERTATION.              Jx

 the very excellent and important  work of Dr. Heberden.  An-
 °l  5  modincation which has been  had recourse to is  that of
 the duration of diseases, as divided into acute and chronic; it is
 a  modification of considerable antiquity,  and has descended to
 us  in  the works of Aretaeus, and  Caelius Aurelianus.  A third
 modification has  consisted in  taking  the anatomy of the animal
 frame  as a ground-work  for divisions; and consequently  in  as-
 sorting diseases,  as  has  been  done  by  Jonston, Sennert, and
 Morgagni, and since  been recommended  by Dr. Mead in  his
 Medical Precepts and Cautions,  into those of the head, chest,
 belly, limbs,  and  almost  every other part.  A fourth invention
 has fixed  upon the supposed causes of diseases as a basis of dis-
 tribution,  and  to  this  has been applied  the epithet  etiological,
 from the Greek term  *,tim, a  cause;  it has acquired more popu-
 larity  than any of the preceding, and was especially embraced
 by the  schools of Boerhaave, Riverius,  and  Hoffman.  Some-
 times a  mixt modification  has  been  attempted, as in the nosology
 of Doctor Macbride, who takes extent for  his first two general
 divisions of diseases, as being universal or local, sex, for his third,
 and the age of infancy for his fourth and last.  And sometimes,
 and far  more generally of late years, the  nosological system has
 been built upon the  distinctive symptoms  of diseases—the
 peculiar marks by which  they identify themselves, and so  to
 speak, become individualized:  and such is  the principle adopted
 by Sauvages, Linneus, Cullen,  and all the most celebrated nosolo-
 gists of recent times.
   This last is, in  effect, the only method  in any degree worthy
 of attention ;  for  it is the  only one  that will generally hold true
 to  itself, or on which  we can place any dependence.  Of the
 seat of  diseases we  often know but very little;  of their  causes
 far oftener still less; but there  are certain marks or characters  in
 the usual progress of  most diseases which  uniformly accompany
 and distinguish them,  and  to which, therefore, the epithet patho-
 gnomic has been correctly  applied.   It is not, indeed, to be con-
 tended that these distinctive signs are as constant and determinate
 as many of the distinctive signs that occur in zoology or botany.
 So complicated is  the animal machinery, so perpetually alterable
 and altered by habit,  climate,  idiosyncrasy, and the many acci-
 dental  circumstances by which life is diversified, that the general
 rule must admit of a variety of exceptions, and is here, perhaps,
 rather  than any where else, best established by such exceptions.
 Yet, after all, every  distinct  disease,  occur where it may, and
under what peculiarity of constitution it may, proves so generally
true to  its own course,  and is  so  generally attended by its own
  vol. v.—2 
PRELIMINARY DISSERTATION.
train of symptoms, or coincidents, which is the literal rendering
of symptoms,* that  he who steadily attends to  these,  will  not
often  be  greatly deceived,  and if he should  be, he  can  find no
other guide to set him right.
  The symptoms of a disease, indeed, have not unfrequently been
said to constitute the disease itself.  This is not perhaps  strictly
true ; they are rather an algebraical character designating an un-
known quantity, but which, in the hands of a skilful mathema-
tician, may be managed as readily in working a proposition as if
such unknown quantity were a sensible object.
  It is hence that the writings of  Hippocrates and of Sydenham
are so highly and deservedly esteemed ; and will be so as long
as medicine  shall be practised.  In their hypotheses they  are
often  erroneous:  but they seldom indulge  in hypotheses,  and
we do not look to them for their speculations, but for that which
peculiarly characterises their pages, a clear and intelligible state-
ment  of  symptoms, a valuable history of  pathognomic facts.
Celsus,  though his plan is  more general,  is also  in  this respect
highly entitled  to praise ;  it is  by attending  to the  perspicuous
description he has given us of  the  leading features  of some of
the diseases he  has  delineated,  that we  have been  best  able, as
will be shown in the progress of this work,  lo restore his text,
in various instances,   to its  original purity  arid correctness,  and
to rescue it  from the obscurity or  nonsense in  which it has been
involved  by the blunders  of  copyists, who  have  occasionally
mistaken  one name  for another,  or filled up lacunae, produced
by the devouring tooth of  time,  with their  own  erroneous con-
ceits.
  II.  Plater may be  regarded as the morning-star that first glim-
mered in  the hemisphere of symptomatology,  as Serveto  was in
that of the circulation of the blood.  The light of both was feeble
and tremulous;  but it twinkled  in the midst of darkness, and led
on to the  brightness  of day.  His  work,  entitled Praxis  Medica,
in which he gives an imperfect  sketch of a symptomatic  plan of
nosology, was published in  1602.   Sydenham, if he did not avail
himself of it, was actuated by the same quickening spirit, for his
various  treatises and  epistles, published for the  most part  miscel-
laneously,  are a practical  comment upon Plater's principle, and
seem  chiefly to have stirred up the well-stored and  comprehensive
mind of Sauvages, who was  peculiarly  attached to Sydenham's
opinions and practice, whom he is continually praising, and whom
* Jj)y.Trtu>(xaT*. from cvfjfTrrrTte, " to fall in, happen together, or coincide." 
PRELIMINARY DISSERTATION.
xi
he distinguishes by the name of Anglas Hippocrates* to that full
illustration of the symptomatic method which has given form and
being to almost  every attempt that has since appeared upon the
subject.  Sauvages first published the outlines of his plan in 1731,
in a duodecimo  volume,  under the title of Nouvelles  Classes de
Maladies,  after  having submitted his intention to the judgment of
Boerhaave.   This precursory sketch descended no lower than to
the division of genera;  but  having been encouraged to  perse-
vere,  he laboured  on the  species, and introduced  them in their
proper succession  into a new and more extensive edition  of  his
work, published in 1763, in five volumes octavo;  and  continuing
his exertions yet further in the same vineyard, he put his finishing
hand  to the  great task  he had undertaken, by  preparing a still
mor j complete and final edition, which he did not live  to publish,
but which .was given to the world shortly after his death, in 176S,
in two large volumes quarto.
   III. The Nosot.ogia Methodic a, for such is the title of M.
de Sauvages's work,  is, indeed, an Herculean labour.  It consists,
in its latest and  most perfect form, of three distinct arrangements
—a symptomatica!, an etiological, and an anatomical; so as to ac-
commodate itself to  the  taste of the old school as well as of the
new.  The s> mptomatical, to  which the  others  are  professedly
subordinate, is by far the most extensively elucidated; and com-
prises ten classes, (each  introduced  by an elaborate pathological
synopsis)  upwards of forty orders, more than three hundred
genera, and an almost innumerable host of species.   Quel nombre
prodigieux d' ennemis!  exclaims M. de  Ratte, alluding  to  this
vast  muster, in his eulogy on the  author, delivered  before the
Royal Society of Sciences in Montpellier; or rather alluding to
the somewhat smaller muster of the  preceding edition, for the last
was  not then  published.   We have yet,  however,  to  add the
varieties, which under several species are  not few ; and  to bear
in mind that to every variety, species and genus, as far as their
relative characters will allow, are allotted a definition, list of sy-
nonyms,  history, diagnosis, prognosis,  and mode of cuie; with,
frequently, an exemplification of cases, and a brief statement of the
peculiar opinions of other writers, before we can fairly appreciate
the entire mass of matter with which the volumes of  M. de Sali-
vates abound.   He  seems, indeed, to have been desirous of col-
lecting materials of every kind and quality from every quarter to
  *  Nosol. Method. Prolegom. I. 19.  See especially the closing paragraph in
his Prolegomena, in which he particularly adverts to the labours both of Plater
and Sydenham. 
Xll
PRELIMINARY DISSERTATION.
 which a market was open;  and of following up every deviation
 from health into all its possible as well  as its actual shades and
 ramifications, so that no man might have to add a syllable to  his
 work after him.
   It is not very surprising, therefore, that a work thus constituted
 and conducted  should be considerably too diffuse.  This  is its
 leading error;  yet  it is a venial one, and was by no means  desti-
 tute of advantage at the time of its commission ; for the very am-
 plitude the work evinces rendered it,  when first completed, a sort
 of  nosological  bazaar, to which every one might have  recourse
 who was in pursuit of this new branch of study, and where he
 might accommodate himself with whatever articles  he stood in
 need of.
  In reality, notwithstanding its redundancy—notwithstanding its
 occasional  want of discrimination—the  errors that are too fre-
 quently to be found in its pathology—the looseness of its primary
 divisions, and the repetition of several of its speries under different
 genera—the Nosologia Methodica is still a work of so much
 general merit and utility, that the student who neglects to read it,
 and even to read it  carefully, neglects one of the most important
 parts of his education, and which he cannot well supply from any
 other quarter.  It is, moreover, a work of considerable elegance;
 perspicuous in  its descriptions, graceful in its style,  and with the
 exception of several writers of our own country, and two or three
 of Italy, purer in its Latinity than perhaps any medical book of
 modern times written in the same tongue ; and  is one of the very
 few volumes we can still read with pleasure after a perusal of Cel-
 sus.  It is a singular circumstance, and to notice it is due to the
 female sex, that for  much of the grace  and purity of his Latin, M.
 de Sauvages was probably indebted to a learned Neapolitan lady,
 the celebrated Maria-Angela Ardingheli, one of the first scholars
 and mathematicians of her day.   He  expressly  admits his obliga-
 tions to her upon this point, in respect to his Medical Commen-
 taries, and this too  when she was not more than sixteen years of
 age.  " Styli tui gratiis, musarum floribus, meos de febre, de in-
flammatione, et de haemastica commentarios hac setate adornasti:"
—and as he selected this lady for the patroness of his Nosology,
 dedicated it  to  her, and had an  earnest  desire that she should
translate it into Italian, there  can be  little doubt that this work
also had the benefit of the same elegant assistance.
  It is not,  therefore,  to be wondered at, that the labours of M.
de  Sauvages should have made  a strong impression upon the
scientific world,  and especially upon the medical  community.
Linneus, who  was  at  this period carrying forward his system 
                  PRELIMINARY DISSERTATION.             xiii

 of botany to a perfection that leaves little to be wished for, culti-
 vated his  acquaintance from the first; and  the  new "Methodic
 Nosology  became so popular  in every  quarter, that there was
 scarcely a pathologist of any eminence for learning who  did not
 eagerly study  it, embrace its general  principles, and endeavour,
 by different modifications, to clear it of  its imperfections, and
 work it  into a more  finished  form.   And hence the successive
 attempts of Linneus at Upsala,* Vogel  at Gottingen,t Cullen  at
 Edinburgh,*  and  Sagar  at  Iglaw,§ m Moravia : and  hence the
 strong and ardent hope expressed by Gaubius, that nosology was
 now on the point of dropping its looseness and  uncertainty, and
 of entering into the list of strict sciences.   And it is highly credit-
 able to the liberality  of M. de  Sauvages,  and offers an example
 which ought never to be lost sight of, that instead of being morti-
 fied at the numerous  alterations introduced into his  system  in
 various countries, and contemplated in  many more, he  availed
 himself of several of them in the last edition of his work, and will
 be found  often  adverting to others, and especially to those  of
 Linneus, with the utmost urbanity and deference.
   Yet notwithstanding this succession of labours, the subject was
 far from acquiring the perfection of which it was supposed to be
 susceptible; and we have hence had a  still greater number of  at-
 tempts at improvement by physicians  of the first character and
 reputation in their day, of whom it may be sufficient to mention
 Selle of  Halle,  Macbride, Plouquet,  Darwin, Crichton,   Pinel,
 Parr, and Young.
   To the time of Cullen  the  general outline or classific arrange-
 ment of Sauvages was left without much disturbance; for although
 the order of succession was changed, and  changed differently in
 every new attempt, the names, in a few instances, diversified, and
 occasionally some addition made to the number, still the ten Sau-
 vagesian classes were substantially retained and adhered to.  These
 classes are as follow:

 I.  Vitia (Cutaneous Affec-      III. Phlegmasia.
     tions.)                    IV. Spasmi.
 II. Febres.                   V.  Anhelationes.

  * Genera Morborum, first published by a pupil of Linneus in 1759, and after
wards by the author in 1763.  Upsal. 16 pp.
  \ Definitiones Generum Morborum.  Gotting. 1764, 8vo.
  i Synopsis Nosologic Methodic^.   Edinb. 1769, improved by several later
editions, particularly those of 1780 and 1785, which contains, for a comparison,
the systems of Sauvages, Linneus, Vogel, Sagar and Macbride.
  § Systema Morborum Systematicum.  Vienna:, 1771 and 1776. 
XIV
PRELIMINARY DISSERTATION.
 VI. Debilitates.              Morosities of the Stomach.)
 VII.  Dolores (Local Pains.)   IX. Fluxus.
 VIII. Vesani^e    (including   X. Cachexia.

   The ten classes comprise forty-four orders, three hundred and
 fifteen genera, and about two thousand five hundred species ;  be-
 ing rather more than an average of eight to each genus.   A few
 words may suffice to point out the nature of the improvements
 which have been chiefly attempted  upon this system.
   IV. In Linneus, while the above classes remain substantially
 the same, their order of succession  is varied, the names consider-
 ably  altered, apparently from a preference of Latin  to  Greek
 terms, (as in  the use of mentales for vesania, motorii for
 sPASMi,and deformes  for cachexia,) and the list of classes is
 increased to eleven, by advancing the exanthematica of Sau-
 vages, which in him occurs as an order of phlegm \sise, to the
 rank of a distinct class; while the  class vitia, with which Sau-
 vages opens, is by Linneus thrust to the end of the series.  The
 Sauvagesian genera  are  not much  interfered with in respect  to
 number.   Upon the whole they are rather extended, and amount
 to three hundred and twenty-six.  The generic names,  however,
 are occasionally altered ;  and the definitions, which are formed by
 an almost constant reference from one genus  to another, are  ne-
 cessarily  drawn up in very different terms, in order to quadrate
 with such a change.   Some degree  of abbreviation is unquestion-
 ably hereby produced, which is always  desirable when accompa-
 nied with perspicuity.  But there  are  few cases in which the
 author has not preferred the definitions  of  Sauvages, though fre-
 quently  too diffuse ; for  the perpetual aim  at brevity in  Linneus
 leaves him too general where he has not occasion to refer to other
 diseases,  and  too perplext and  intricate  where be  has.  The
 table of Linneus's genera does  not comprise his species;  but it is
 well known that in these he adhered with  considerable closeness
 to Sauvages.
   V.  The great object of Vogel was  to  supply what  he con-
ceived to be  omssions on the part of  Sauvages : and hence he
gives a muster of not less than  Jive  hundred and sixty genera,
 being nearly  double  the number of his great prototype.   But
 to accomplish this he has been compelled  to elevate to the rank
 of genera a great multitude of affections  which ought only to
 be contemplated as  species, many of which are  merely symp-
 tomatic of other diseases, and not a few, as risus, fletus, suspi-
 rium, clamor, (some  of them,  indeed, derived from Linneus,)
 which have no  claim  to be regarded as diseases at all.   In his 
PRELIMINARY DISSERTATION.
XV
elassific arrangement, while he takes Sauvages for his guide, he
change* the line of succession  as considerably as, though  in a
difterent manner from, Linneus.   He degrades the exanthema-
tic i  of the  latter from a elassific post, and introduces them as
well as the phlegmasia of Sauvages,  as mere orders, under his
class febres.   He unites into one class the anhelationes and
debilitates of Sauvages, under the name of adynamic ; and
having thus reduced the number of the Sauvagesian classes to
nine,   he  i\iises  the.n  to eleven by the  creation  of two  new
classes. wni;h  he calls hyper^estheses, and deformitates:
the femer, properly enough, separating Sauvages's morosities of
the Stomach from genuine mental  disorders,  and the latter in-
cluding external deformities of a prominent character.  His de-
finitions are peculiarly  concise, but convey too frequently nothing
more  than general  and indistinct ideas: while his  new-created
terms are peculiarly long and cacophonous, as in the words hy-
pospadiseos, dionysiscus, and hyperartertiscus.  For his species
and varieties, or rather those he has not elevated to a higher rank,
he seems, like Linneus, to have depended, for the most part, upon
Sauvages.
   VI. The system of Sagar makes less deviation from that of
Sauvages  than  either  of the preceding: and  may  be regarded
rather as an enlargement, than a  remodification of it.   In various
respects, indeed, it alters the series of succession, but it retains the
name of every class;  though it increases the number  from ten to
thirteen,  by  advancing the Sauvagesian orders  of  plague  and
exanthematicje  to the  rank of classes, and by introducing  a
new class, denominated suppressiones, designed to correspond
with a considerable part, though not the whole," of the suppres-
sorii of  Linneus,  as  Linneus  intended this last to correspond
with a considerable part, though  not the whole, of the anhela-
tiones of Sauvages.  His definitions are mostly taken with  little
variation  from  Sauvages, but are rendered intolerably long by
confounding Sauvages's generic  characters with his  generic de-
scriptions, and  running the  two together: so that  instead of
eighteen  or twenty words, which  is,  perhaps, the  utmost  that
ought to  be allowed,  and more than the Linnean canons permit
in botany, we  have sometimes upwards of a hundred, filling an
entire page, as  in rubeola,  whose definition, if so  it  may be
called, extends to a hundred and  ten lines; and in aptha, which
employs a hundred and thirteen.  He is  less redundant in the
number of his  genera than Vogel,  though he makes a boast of
having extended them to three  hundred and fifty-one.  It would
have  been better for him,  as Cullen observes,  to have boasted of
• , 
XVI
PRELIMINARY DISSERTATION.
having exercised  in an equal degree, his power of compression.
The system of Sagar  is rendered more complete than either Vo-
gel's or Linneus's by  being filled up with his species.  These,
however, are deduced, with occasional alterations, from  Sauvages,
and exhibit the same verbosity as his genera.
   Upon the whole it does not appear that the Nosologia Me-
thodica of the Montpellier professor  royal was much benefited
either in its  arrangement or its substance, by any of  these three
attempts at improvement; while, in various respects, it was, per-
haps, rendered less commodious and useful.
   VII.  Such was unquestionably the  opinion  of Dr.  Cullen,
with respect to the two  former  of these—for that of Sagar was
not then before  the public—when he  first thought of essaying
his own powers in the  field  of symptomatic  nosology;  and
hence, notwithstanding  the  later models that  were before  him,
he resolved  upon once more taking for a basis the  original ex-
emplar.
   The first objection,  however,  to this exemplar, which he seems
to have felt, was  not the mere series, but the nature of its classi-
fication.  The main object he  proposed  to himself, and  a more
important he could not  lay'down, was that of brevity and sim-
plicity;  and  the Sauvagesian classification offended  in both re-
spects.  He determined, therefore, upon  changing it, and recast-
ing the system from its commencement.   Instead of ten classes he
conceived that four alone might  suffice,  formed, as he  proposed to
form them, of a calibre capacious enough to swallow up all the
rest.  He moulded his four classes accordingly, and distinguished
them by the names of

       I.  Pyrexia,                 III. Cachexije,
       II. Neuroses,               IV. Locales:

and, influenced throughout the  whole of  his reform by the same
spirit of simplicity and  concentration, he reduced the forty-four
orders  of  Sauvages to twenty, and his  three hundred and fifteen
genera to one hundred and fifty-one.  He next carried  his prun-
ing hook into the field  of species: some he  found to be repe-
titions  of  the  same disease occurring under  different genera,
and  others mere symptoms of other disorders, instead  of dis-
tinct or idiopathic  affections ;  all which were steadily  lopped
off;  and in this  manner  the reduction  in the species bore an
equal proportion  to that in  the genera.  The  genera  and  spe-
cies that  remained were next enlisted into his own service,
mostly with the  respective names assigned them by Sauvages, 
PRELIMINARY DISSERTATIONS.
xvu
though  the  definitions  were generally re-composed,  and appa-
rently modelled in consonance with the reformer's own practical
observations.
  Thus completed and fit for use,  the new system was first start-
ed in the largest medical  school of Europe,  its author presiding
at the head  of it.  It is not,  therefore, surprising that it should
instantly have  rushed into  popularity,  and become  a subject of
general  approbation.  Yet it  did  not  stand  in need of this ad-
ventitious support to introduce it to public  favour.   Its aim at
simplicity, as well in extent as in arrangement,  was noble, and
bespoke correct views, and a comprehensive mind;  it promised
a desirable facility to the student, and a  chaste finish to the ar-
chitecture of the  nosological  temple.   The  author  showed  evi-
dently that  he had laboured his attempt in  no ordinary degree;
and many of his definitions discovered a mastery  that had never
before been exemplified:  pictures painted to  the life, and of pro-
per dimensions.
  To this extent of praise Dr. Cullen's system is fairly entitled;
an extent which  ought ever to be borne in mind  amidst  the nu-
merous, and,  in  many instances, exaggerated  exposures of its
defects  which have lately been exhibited,  and which  it seems to
be a  growing fashion to detail both at home  and abroad ;  more
especially in Germany, where it has been  asserted,  ex cathedra,
and believed  by  extensive  audiences, that,  after all his preten-
sions, Cullen has  done little or nothing for  the  improvement of
nosology.
   That the  system,  nevertheless, has faults, and  insurmounta-
ble ones, it would be  absurd to deny; for  they meet us at the
very outset, and  run through the whole of its texture and con-
stitution.  It is sufficient to  notice the three following:   1. De-
fective arrangement.   2. Want of discrimination between genera
and  species.   3. Looseness  of distinctive character in  the last
 general division.
   1. Of the  four classes adopted by Dr. Cullen,  the first two,
 pyrexia and neuroses, have considerable merit, and this merit
 is exclusively his own.  Each term suggests to  the mind at once
 a peculiar group of diseases,  of sufficient range for a leading divi-
 sion, and occupies a province possessing a sort of natural outline,
 or arrondissement,  as the French chorographers denominate it;
 in which,  if the  boundary occasionally fail or lose itself in the
 adjoining provinces, it is easily supplied by the  hand of art.  At
 times, indeed, it seems difficult under  such a system, not  to
 overstep the natural boundary imported  by these terms in their
 common use, and, like  the late ruler of France, to give in  many
    vol.  v.—3 
xviii
PRELIMINARY DISSERTATION.
parts a broader and  an altogether artificial  outline by the inva-
sion of adjoining districts;  and,  from the paucity of his classes,
Dr.  Cullen  has frequently found  himself compelled to such  a
transgression, and has afforded us a palpable instance of it in the
very class with which he commences; for the  tribe of hemor-
rhages, which forms one of its orders, have no direct catenation
with any idea suggested by pyrexy  in the common use of the
term ; they  require coercion to bring them into a state of union ;
and, what is still worse, Dr. Cullen, with all the force he could
employ, has found  himself  incapable of coercing more than one
half of them ; and,  consequently has been obliged to leave the
other half behind,  or rather  to banish them for  contumacy to the
extreme  region of his fourth class.   So that in his system they
exhibit a wide and lamentable divorce, and afford a striking and
perpetual memorial of the tyranny which pervades it in spite of
its attractive exterior.
  Still,  however,  the  first  two  classes are substantially good:
and have in some  shape or  other been copied  by almost every
succeeding nosologist.   The third class has also a claim  to atten-
tion, though the  term cachexia, by which it is denominated,
has been used, and still continues to be  used, in senses so ex-
tremely different by  different  writers, that  it by no  means sug-
gests to the  mind a connected group  of diseases, with  the same
readiness as  pyrexia or neuroses.  As a class,  indeed,  the divi-
sion of cachexiae occurs in all the  preceding writers, with the ex-
ception of Linneus; and so  far Dr. Cullen can plead  authority;
in Linneus it is reduced to a genus, and in Vogel it is given with
singular  imprecision, both as a class and  a  genus,  distinguished
by a mere difference of number.  Under every writer, however,
the term is  employed  in a  various sense; sometimes importing
depraved external colour alone; sometimes depraved colour and
form;  sometimes  depraved  colour, form, and  size;  and some-
times,  as in  Cullen's definition, depraved habit  of the whole or a
great part of the body,  without any notice whatever of the pre-
ceding qualities.  Were we to pursue this  subject,  and it will be
necessary to do so  hereafter, we should  find that among later
writers it has been employed with a still wider difference, till at
length by several of the most intelligent it has  been banished al-
together, from the  inextricable confusion  that  has  been heaped
upon it.*
  Yet by far the most faulty and incorrigible  part of  Dr.  Cul-
len's arrangement consists in his last division or class  locales.
• See note on Dtsthexica, cl. iy. ord. ir. 
                   PRELIMINARY DISSERTATION.             xjx

  It has no scientific >elation to the preceding classes—no  parallel
  or apposition with them.  To have brought it into any such kind
  of bearing,  the  whole of the former should have been  denomi-
  nated conjunctively universales,  as has been done  by Dr.
  Macbride.   But this would have  destroyed the general casting of
  the arrangement, and have produced a division  which  was "not
  wanted,  and perhaps does not exist.*   It must be obvious to the
  slightest observer that the sole object of this class is to form an
  appendix to the  three  preceding,  for the purpose of receiving,
  like the cryptogamia of  the botanical  system, such genera as the
  foregoing classes could not be brought  to include.   Cryptoga-
  mia, however, from its  name and capacity, is altogether ade-
  quate to its intention : it is a double objection to locales that,
  while the term stands isolated and without relation to its fellow
  terms, its intrinsic and essential idea (that of particular  part or
  place) creates an insurmountable  bar to the  reception of  a great
 proportion of the genera  which  it  is directly intended to com-
 prise.   In consequence of which  the whole scheme,  as a scien-
 tific system, is rendered  nugatory ; it shuts a door upon its own
  community ; and the rejected diseases wander about from class to
  class, trying in vain for  an entrance, like  the wretched ghosts of
 the  idle and the inglorious in the Inferno of Dante,  who did
 neither good nor harm while on  earth, and who are in conse-
 quence debarred all admission both into heaven and hell, as hav-
 ing no direct character for either place;
              Cacciarli i Ciel, per non  esser men bello;
               We lo profondo inferno gli riceve.
   Of these diseases, therefore, Cullen has  been obliged to give a
 list  at the  end of his synopsis,  under the title  of  " Catologus
 Morborum a nobis omissorum, quos omississe fortassis non opor-
 tebat:"  and has thought himself called upon  to offer an apology
 in  his Prolegomena.   " These omissions," says he, " I  confess
 and regret; but various reasons operated to the omission of somo
 diseases.   In the first place it  must be acknowledged  that several
 utterly escaped our attention.   Next, there are others, sufficient-
 ly known, for which a fit place cannot be found in our system.
 And,  lastly,  there  are others  whose  history among  medical
 writers is  so imperfect,  that no fit place or character can be as-
 signed to them."t
  * See Clutterbuck's Inquiry into the Seat and Nature of Fever.   Ch. I.
 sect. iii.
  f Hujusmodi omissiones agnosco,  et quidem doleo;  sed variae rationes, ut
quidam morbi hie omitterentur, effecerunt.  Primo fieri potest, ut quidarn
observationem nostram penitus effugerint; dein sunt alii satis noti, quibus in 
XX
PRELIMINARY DISSERTATION.
   It is with the second of these apologies alone that we have any
 concern at present, for time and stricter attention may overcome
 the evils to which both the others relate.  But the utter want of
 fit places for well known  diseases in a nosological system, and
 this too in  the opinion of the author of the system, is a defect from
 which no time or labour can ever relieve it.
   Dr. Cullen, however, it must be admitted, has been as ingeni-
 ous as he  could; and contrived the  means of giving  throughout
 all his classes an entrance to diseases that have very little claim to
 admission.   But the consequence is,  that they make  a sad med-
 ley, and in many cases have not the slightest affinity or  family
 resemblance;  of which we  have a striking example in psora and
fractura,  which follow in  immediate succession  in the class of
 local  disorders.   Psora (itch) can scarcely be called a  local affec-
 tion,  unless the term  be  appropriated  to the skin  generally, as
 distinguished  from all  the  other parts of the frame; but in this
 case trichosis and lepra should have been placed in the same class,
 instead of in that of cachexies;  while fractura could have no pre-
 tensions to such a class unless when compound.   But it must cer-
 tainly puzzle the best  medical scholar in Europe, who is  not ac-
 quainted with Dr. Cullen's  arrangement,  to  discover the least
 connexion  between itch and broken bones, and  especially such a
 connexion  as  not  only to draw  them into the same class,  but to
 make them immediate neighbours in  the same order.  Dr. Cullen,
 however,  has ascertained   that they are both  local disorders,
 which entitles them to a common class,  and both dialytic disor-
 ders, or produced by a  division of  continuity, whieh entitles
 them to a common order:  and hence to the question,  "  why is
 the itch like a broken bone?" the student's  answer is, " because
 it is a dialysis :" an answer somewhat wanting perhaps in  profes-
 sional gravity,  but the only one that can be given.   And here it
 is probable we  must  stop;  for there seems no possibility  of ad-
 vancing farther, and  assigning any reason for the very close inti-
 macy allotted to psora and fractura by fixing them  in immediate
 succession. Yet there is perhaps quite as much difficulty in de-
 termining  what could be the author's motive for placing nostalgia
 in any part of the same class.
   2.   It is impossible to  take a survey, however  brief,  of Dr.
 Cullen's system, and not  to notice his very extraordinary con-
 fusion of genera and species.  And  the  author  is the  more in-
nostro systemate, locus idoneus nusquam inventus est; denique, sunt alii
quorum historia apud medicos aded sit imperfecta, ut nee locus nee character
idoneus iis assignari queat.  Prolegom. 
PRELIMINARY DISSERTATION.
XXI
duced to advert to it, because, extraordinary as such a confusion
must appear  to  all  who are acquainted with the difference, Dr.
Cullen is by  no  means the only nosologist of our own day who
has run into  the same mistake, as will easily be perceived before
the close of this dissertation.
   A genus is not a disease, any more than it is an animal, a vege-
table, or a mineral; but a group or assemblage of any of these,
possessing  certain like characters, and  associated in consequence
of such resemblance.  The consenting characters being abstracted
and  put together, constitute the generic definition, and  apply to
the whole; while the subordinate characters or coincidents, by
which one  differs from  another, constitute the  specific definition,
and distinguish  1 from 2, and 2  from 3, of the same group or
genus.   A genus, therefore, is a mere abstract term, a non-entity
in nature; highly  useful, indeed, in the  chain of  orders,—but
which  can no more  exist without species  than a regiment or a
regimental company  can exist without soldiers.  On this account
it is that no man can  ever discover a genus, though he may com-
bine generic  signs, and invent a generic name.  The usual order
is the following  : he first discovers an individual, whether a plant,
animal, or disease, possessing very peculiar marks, so as to sepa-
rate it distinctly from any known individual, or groups of indi-
viduals.   He may now, therefore, be said to have  found a new
species ; and he proceeds next to  arrange  it.  He first  separates
from it the most striking  mark by which it is distinguished; and
if this should be strictly singular,  it constitutes alone a  sufficient
character for a new genus, and will form what is called, from this
very circumstance, its essential generic character.  If it be not
strictly singular, he must look for another  striking character,—
a coincident  or  co-appearance,—or if necessary, in order to ren-
der the distinction complete, a third ;  and the generic  character
will consist in the union of these co-incidents, in the combination
of the  marks that are thus first detached from the individual, and
then brought into a state of combination.  To this combination of
detached or abstract signs he gives what name he pleases ; and he
thus obtains  a generic name as well as a generic definition.   He
then proceeds to select one, two, or more other marks, by which
the individual is peculiarly distinguished ; and these united  form
his specific definition, to which in like manner he adds a specific
name.   He  has now discovered  and identified a species,  and
formed  and  denominated a genus.  His genus, indeed, consists
at present but of a single species; and many genera never consist
of more ;  but the genus is, nevertheless, formed upon a collective 
XXII
PRELIMINARY DISSERTATION.
 principle;  it pre-supposes that other individuals may hereafter be
 detected possessing the same generic character, and consequently
 belonging to the same banner; at the same time differing in seve-
 ral of its subordinate marks from the individuals already arranged
 under such banner; and which  in consequence will produce new
 species as long as other individuals possessing such discrepancies
 shall be traced out;. unless, indeed, should the discrepancies be
 found to be casual, to depend  upon soil or food, upon  climate,
 atmosphere, position,  or some other incidental circumstance;  and
 in such case the individual is regarded as a mere variety of some
 species described already.
   The writer, therefore, who describes a genus that has no species
 belonging  or subjoined to it; or who gives a generic,  without a
 specific, name, describes a mere abstract form, a  thing that has no
 existence without the addition of other signs or qualities which do
 not enter into this definition ; and which, in relation to the indi-
 vidual, constitute the most important part.
   Now the  present charge against Dr. Cullen is, that while in some
 cases he has given genera with the proper species belonging to
 them, in others he has given genera without any species whatever ;
 and in others again that he has described species  under  the  name
 of genera.
   As instances in which he has  adhered to a regular systematic
 precision, we may take phlogosis and cynanche.   To the first are
 allotted two species, 1. phlogosis, Phlegmone:  2 p. Erythema.
 To the second are allotted five species; and it affords one of the
 most  excellent specimens in  the entire scheme of perspicuous
 description,  and accurate discrimination; though it may admit of
 a doubt whether sp. 5 might not more correctly be arranged un-
 der another genus.   The five species are as follow:  1.  cynanche
 tonsillaris: 2. c. maligna: 3. c.  trachealis: 4. c.pharyngea: 5.
 c. parotidea.
   Of a want of systematic precision the examples are  very fre-
 quent  in every class.   Thus synocha, synochus, hectica, phre-
 nitis,  hepatitis, and  many more, afford instances in the first class ;
 hypocondriasis,  chlorosis, and others in the second;  polysarcia,
 hydrometra,  hydrocele,  &c.  in  the third;  pica, adipsia,  pro-
 fusio, and nearly all that follow, in the fourth class.   Nor  can
 it  be said,  that in these cases  we  are tacitly  referred  to  the
 species of  Sauvages for adoption;  since under adipsia we are
 cautioned against using the only  one in Sauvages that has any
 relation to  Cullen's genus;   and in profusio we have a genus
for which Sauvages  has  no direct  parallel.  It  would  be  easy 
                  PRELIMINARY DISSERTATION.           xxiii

  to  prove that a very considerable number of these naked gene-
  ra are in reahty species belonging, or which a very little dexterity
  might make to belong, to another genus; but to follow up this
  Jirf.    w? a  JT      t render this dissertation too diffuse,
  work           °f examPles  will be  found  in the  body of the

    The author  has observed  that  Dr. Cullen is warmly to be
  commended for the general  example  he  has set of  banishing
  the symptomatic species of Sauvages,  and the caution he often
  evinces in  selecting  distinctive symptoms for  his definitions
 In a few instances, however, he has singularly enough retained
 the symptomatic species; and occasionally, and especially in the
 lourth  class,  has offered characters  so general as to  be  totally
 incapable of  discriminating the peculiar disease.   What sort of
 tumour  for  example,  possessing  any  distinctive features, can
 we embody to our imaginations  from  the following  character,
 which  is the whole that is communicated to  us, " extuberatio
 mollis, non dolens?"  It may  be a varix, a bronchocele, a zane-
 Jion, a sarcoma, an encystis.   In Cullen it is  intended to define
 a sarcoma.   So another  genus  in the same order,  is characterised
 by  the terms, "extuberatio durior, scabra."   But. what  is the
 meaning of durior ? we have  nothing given  us  to  compare it
 with ; and consequently, though a chief member in the sentence
 it conveys to us no adequate idea whatever.   To understand it
 we must  read it, as it is intended we should, in connexion with
 the  genus that immediately precedes it,  which genus happens to
 be sarcoma, and  then we learn that by durior is meant durior
 sarcomate.   The definition, after  all, is not very clear, and the
 reader has not yet perhaps guessed that the words are designed to
 typify a veruca or wart.                               *
   It is  not necessary to pursue  this investigation further.   There
 can  be no difficulty in conceiving why the  distinguished reputa-
 tion of Dr. Cullen should be incapable of securing to his nosologi-
 cal system the popularity with  which it  was at first greeted: n°or
 why a host  of learned rivals, few of whom have humiliated him
 by their competition, should, in different parts of Europe, have
endeavoured to offer schemes big with the fair promise of realizing
the noble  object he had in view, and free from the  defects he has
exhibited.
   These rival attempts may be summed up in a few words: for
such is the difficulty of the subject, that  none of them have been
eminently successful; while the greater part have  dropped from
the cradle into the grave. 
XXIV
PRELIMINARY DISSERTATION.
   VIII. The chief foreign  competitors are Selle, Plouquet,
 and Pinel.  The first is rather a monogram mist, to borrow a
 term from  the vocabulary  of natural history, than a writer on
 general nosology.   His first attempt was confined to the province
 of fevers alone, and appeared at  Halle in 1770, under the title of
 " Methodi febrium naturalis Rudimenta :" and it was only to
 an enlarged edition of this, published at Berlin in 1786,  that he
 subjoined a specimen of his  general classes.   They are altogether
 theoretical; and as he has not  accompanied them with  their re-
 spective genera, it would be superfluous to copy the classification.
 The cloudiness that hangs over his division of fevers  leaves us
 without regret that he did  not complete his entire  scheme.  It
 may be sufficient, perhaps, to observe, that  in  his  "Methodical
 Pyretology," rheumatism, catarrh, and exanthems are  included
 under a single  genus.
   IX. The " Outlines" of Plouquet furnish a system that wan-
 ders less into theory, but which is far too complicated, and  cer-
 tainly not without its nebulosity.   It  was published at Tubingen
 in 1791, in four volumes octavo, under the  following title, "De-
 lineatio Systematis Nosologise naturae accomodati."  It is singu-
 larly  distinguished by the  author's fondness for long  crabbed
 words.   He made a far better present to the public a few years
 afterwards in his " Hints towards a Medical and Chirurgical  Li-
 brary,"—" Initia  Bibliothecae  Medico-practicae,  et Chirurgia:
 realis,"—extending to seven volumes quarto, in the order of an
 alphabetical arrangement.
   X. To Pinel, as to Selle, we are indebted for  both  a mono-
 graphic and  a  general  attempt.   The  first is  his  well known
" Traite Mtdico-Philosophique stir VAlienation Mentale :" the
 divisions of  which are clear, and the remarks of high practical
 importance.   The  present writer will be found to have availed
 himself, as far  as possible, of the  advantages which this excel-
lent treatise affords.   He has not, however, been able to make
the same use of M. Pinel's Philosophical Nosography.   It is too
refined for  popular use, and  too  indistinct for  practical  benefit.
The classes are as follow:  1. fevers : 2. inflammations:  3. ac-
tive haemorrhages : 4. neuroses:  5. lymphatic diseases : 6. in-
determinate  class for the reception of disorders which  cannot
be received into the preceding classes, or whose  characters  yet
remain to be ascertained.  This  last  division evinces a woeful
want of skill, and is far more reprehensible than the locales of
Dr. Cullen.  M. Pinel has,  moreover, betrayed a singular  itch
for changing established  terms  which,  in many cases, require
no change whatever; and superseding  them by others  which 
                 PRELIMINARY DISSERTATION,             xxy

 are neither more true to correct theory, nor more euphonous to a
 correct ear.   As examples we may notice  that inflammatory fe-
 ver  is  here  denominated  angi-stenic; bilious fever, meningo-
 gastric;  putrid, adynamic;  malignant, ataxic.
   XI. In turning our attention to our own country, we shall per-
 ceive that the first attempt  to  improve on the Cullenian system
 was hazarded by Dr. Macbride.  It was published as early as
 1772,  and consists of  nothing  more than a nosological table, em-
 bracing indeed  the  divisions of genera and  species  (except in
 the order of  vesaniae,  which is left imperfect, from  an indeter-
 mination in the  author's mind  upon this subject)  but  totally void
 of definitions.   In the opinion of the  writer of these pages this
 unfinished sketch is well worthy of attention, and has not had
 sufficient justice rendered  to it.  Its chief  failure consists in the
 nature of its classes  or  primary divisions.  These consist of four,
 universal  diseases, local, sexual, and infantile.  The
 second, or local class, is  evidently  derived  from  Dr. Cullen,
 though the term is employed  in a stricter sense: and the forma-
 tion  of a class  of universal diseases follows  naturally,  and, in-
 deed, necessarily, from the institution of a  class of local.  A
 precise line of distinction,  however, can never be draWn by the
 most delicate hand ;  and it is obvious to  every one, that the em-
 ployment of other classes after these,  whatever be their names,
 ranges, or attributes, must be absurd ;  for the terms  universal
 and  local necessarily include every  disease in nature, and  leave
 no other  distinctive class to be added.   Yet Dr. Macbride ap-
 pears to have exhibited as  nice a  skill in the  arrangement of
 his genera and  species, as he has want  of skill in primary out-
 line.  There is  a clearness, a neatness, and simplicity, which
 the  author has  endeavoured to avail  himself of, wherever the
 structure of  his own  system  would  allow,  and which he has
 often left with  regret  where it would not.   Nothing can  more
 effectually  show the  good  taste  and liberality  of Dr. Cullen,
 than his Latin translation and introduction of the first and  most
 extensive  class  of Macbride's  table, into the  last edition of his
 synopsis,  for the  purpose of comparison  with his  own  arrange-
ment,  as well as with the systems of those to whom he was most
 indebted.
  XII.  Another table  of diseases, distributed under a  different
systematic  arrangement, was published not  many years after by
Dr.  Crichton; and,  like  the preceding,  unaccompanied  with
definitions  of any kind. Its classes are eight, consisting of Cul-
len's four,  with  the  addition of four others, for  the  purpose of
accommodating  those genera which are chiefly under  a state of
  vol. v.—4 
XXVI
PRELIMINARY DISSERTATION.
 restraint in the Cullenian method ; and to which he has given the
 names of hemorrhagic, fluxus, intumescentie, epische-
 ses.  This, assuredly, offers some improvement, but the retained
 class locales is subject to the common objections against it; and
 in the subdivisions of this class Dr. Crichton has  no reason to
 boast of being more successful than his predecessors.   He seems
 sensible,  indeed, of the diffi  ulty, and appears to shrink from it;
 for in the fourth, fifth, and sixth orders of the local  class, enti-
 tled prolapsus, luxatio, and tumores,  he has withheld his
 species; and in  the three ensuing  orders,  entitled,  vulnus, ul-
 cus, and fractura, he has equally withheld his genera.  For
 the most part his generic and specific distinctions exhibit far less
 precision than those of Dr. Macbride, whilst  he has  most unac-
 countably  restored the symptomatic species of diseases  which
 Cullen  laboured  so meritoriously to suppress.  It  is somewhat
 singular, therefore, that Dr. Crichton should have best succeeded
 where Dr. Macbride principally failed,  and  chiefly failed  where
 Macbride has been most successful.  The present writer  has been
 under far  greater obligations to Dr. Crichton  for his " Inquiry
 into  the  Nature and Origin  of Mental Derangement,"  and
 the nosological  system, in relation to  this  branch of medicine,
 which accompanies  it.  The last is a valuable improvement upon
 this division  of his general table;  yet it is not a little extraordi-
 nary that, in both, Dr. Crichton should adhere to the  vulgar dis-
 tinction between mania and melancholy, in opposition to the con-
 current  view of  the best pathologists.  This treatise, however, is,
 upon  the  whole, a truly philosophical work :  comprehensive in
 its survey, intelligible in its plan,  and richly tesselated  with il-
 lustrations and the opinions of other writers.
  XIII. There is another  system of nosology, published indeed
 some years before  Dr. Crichton's,  of which  it  will, perhaps,  be
 supposed that some  notice should be taken  in the present survey.
 —though from its being founded, not on symptoms, but on the-
 ory, it might be passed by without blame, and that is Dr. Dar-
 win's.  The author of Zoonomia  was  a  man  of  great genius.
 daring imagination,  and extensive reading.  Unfortunately for
 him, he was perpetually stung with  a desire of distinguishing him-
self by seeing things,  weighing  things, and combining them in a
manner  different from  every one  else.  All his works,  which the
present  writer has read attentively, and  some of them more than
once, give proof of this; and show evidently that,  he would at
any time rather think  wrong with himself,  than think right with
other people. And hence, while  he offers  much to gratify, he
offers also  much to offend ; and proves that if he had aimed at less 
PRELIMINARY DISSERTATION.
XXVll
 he would  have accomplished more.   His nosological system  is
 founded upon his physiological principles; which, stripped of ex-
 traneous matter, may be told  in  few words,  so far as  they are
 applicable  to the present subject.   The brain, as a collective or-
 gan,  is the fountain of life and sensation, and sends forth fibres  of
 different kinds and for different purposes;  which are excited, and
 communicate perceptions to the organ whence they originate, by
 four different classes of stimuli, those of simple irritation, of sen-
 sation, of  volition,  and of association ;  every part of the animal
 frame having a greater or less degree  of influence upon  every
 other part, and  operating this influence  by the medium of sym-
 pathy ; in  consequence of which, Dr. Darwin  was  desirous that
 his own theory  should take the name of the sympathetic. " Eve-
 ry idea" says he, " is a contraction, or motion, or configuration
 of the fibres, which constitute the immediate organ of sense ;"*
 and hence  it seems difficult for the friends of Dr. Darwin to repel
 the charge, that ideas,  under this explanation,  must be  material
 substances.  Health he contemplated  as consisting in  the natural
 correspondence, and degree of correspondence, of the various
 organs of the  body to their respective stimuli,  and disease as an
 effect  produced by any, even the slightest deviation,  from  such
 correspondence  in in any part.  Henep every  such effect, in his
 opinion, constituted a disease; and what is  commonly so deno-
 minated, and which consists of a combination of symptoms,  as
 a fever or  a colic,  he regarded as a group or bundle of diseases;
 a sort of Pandora's box. where they muster their  secret and col-
 lective strength, and whence they issue simultaneously. In form-
 ing his nosological arrangement, he made these effects,  and the
parts or organs in which they manifest themselves, constitute his
 genera and species; while he derived his classes and orders from
 their  proximate, or rather what upon  his theory are supposed  to
 be their proximate,  causes, and  the  peculiar characters  which
 these  causes exhibit; the number of the other classes being four,
 derived as may be easily conjectured  from  the four  sources  of
 stimulation just  referred to.  " I  have taken," says Dr. Darwin,
 "  the proximate cause for the classic character.  The characters
 of the orders  are taken from  the excess, or  deficiency, or retro-
 grade action, or other properties  of the proximate cause.    The
 genus is generally derived from the proximate effect.  And the
 species generally from the locality of the disease in the system."t
   By proximate cause,  however, Dr.  Darwin does  not  mean
* Zoonom.  Part I. sect. II. ii. 5.      t Preface to Zoonomia. Part II. 
XXVU1
PP.ELBUNARY DISSERTATION.
what is generally understood by this phrase,  namely, the most
striking or characteristic symptom  of a disease ;  but wh;it should
seem to be the proximate cause upon his own theory, and which
in every instance must be a different and often  a  directly  oppo-
site  thing.  Thus in nictitation,  the proximate  cause,  in  the
common sense of the term,  is a " rapid and vibrating motion of
the eye-lid," which ought, therefore, to constitute the character
of the disorder.  In  the  vocabulary of Dr. Darwin, however,
this,  instead of  being  the proximate  cause, is the proximate
effect;  while  his proximate  cause is  "increased  irritation,"
which is the remote cause, as the  phrase Is commonly explained.
We  are not now inquiring  which is the more correct use of the
terms cause  and effect,  but only  pointing out the variance  and
the  confusion  that  hence  necessarily  ensue.   The perplexity
hereby produced must have been an effectual bar, had there been
no other,  to Dr.  Darwin's system ever becoming  popular.   Un-
fortunately there are  many others, and of as formidable  an as-
pect. The entire basis is theoretical; in several parts visionary :
the whole may, therefore, prove  hereafter to  be unfounded;  a
considerable portion of it evidently is unfounded at present.   But
the direct death-warrant  of the system  consists in his  making
every single prnvlmate ©flfoet (in  common language proximate
cause, or symptom) a distinct disease;  for as the same proximate
effect or  symptom may be produced by several, or  by each of
what Darwin  calls  proximate causes,  and which constitute  his
classes,  it follows that the very same species or specific disease
must in such cases belong equally  to some order or other of se-
veral, or of all the classes of his system.   And such, to  the  stu-
dent's embarrassment and surprise, he will find upon examination
to be the real fact.  Thus while variola (small-pox)  is arranged
under cl. n. ord. i. gen.  iii. eruptio variolse (small-pox eruption)
occurs under cl. iv. ord. i gen. ii.   So hydrophobia appears first
in i. in.  i. and  afterwards  in  in.  i. i.   Diabetes in i.  in. ii.
and again in iv. in. i.  Palpitation of the heart  in i. n. i. and
again in i. in. iii. being twice in the same class : and so of many
others.
  Such perplexity sets all the ordinary laws of  method at defi-
ance ; yet it  is easily accounted for  from the nature of the pri-
mary divisions.   It  is  not,  however, so  easy to account  for
Dr. Darwin's introducing into  his  table of diseases such  natural
states or affections as the following: Healing of ulcers, i. i. iii.
Deglutition, n. i. i.   Respiration  under the same genus.  And
the life of an egg, iv.. i.  iv.  which, from some  unaccountable 
PRELIMINARY DISSERTATION.
XXIX
fancy, is thus rendered one of the diseases of  association.
While, to make the system still more defective and incapable of
practical use, its author has given  us neither his specific nor his
generic definitions,  excepting, indeed,  occasionally; confining
himself entirely to his Latin and English names: and sending us
for their descriptions to " the Nosologia Methodica of Sauvages,
and the Synopsis Nosologic of Dr. Cullen,  and the authors to
which they  refer."   But such an appeal can be of no possible ser-
vice: the diseases in Darwin's system  do not run parallel with
those referred to, and the descriptions will scarcely in  any in-
stance apply.  In some cases,  however, he has made  distinctions
that do him great credit, and are highly worthy of attention ;  and
of these the writer has endeavoured to avail himself.
   How deeply  is it to be regretted  that  so much  genius and
learning, so much valuable time and labour, and, above all, such
lofty hopes and predictions,  should have  been productive  of so
small a result.  It is in these words Dr. Darwin concludes his last,
or  supplementary, chapter, of this elaborate work, in which he
unfolds his  theory of fever.   " Thus have I given an outline of
what may be termed the sympathetic  theory of fever, to distin-
guish it from the mechanic theory of  Boerhaave, the spasmodic
theory of Hoffman and Cullen, and the putrid theory  of Pringle.
What I have thus delivered I beg to be considered rather as ob-
servations  and conjectures than as  things explained and demon-
strated ;  to  be considered as a foundation and a scaffolding, which
may enable future industry to erect a solid and  beautiful edifice,
eminent both for its  simplicity and utility  as well as for the per-
manency of its materials:—which may not moulder, like the
structures already erected, into the sand of which they were com-
posed;  but  which may stand unimpaired, like the  Newtonian
philosophy, a rock amid the waste of ages."
   No generous spirit can  read this  passage without a sigh ; nor
probably without exclaiming in the words of Mr. Pope :

             O, blindness to the future!—kindly given.

   XIV. In  the very excellent Medical Dictionary of Dr. Parr,
which has  now been about  nine  years  before  the  public, the
reader will  find, under the article nosology, a systematic ar-
rangement of diseases which ought by  no means to pass without
notice in the  course of the inquiry before  us.  Of Dr. Parr
the present  writer can only speak in terms of high consideration
and regard.   He was his colleague in conducting for some years,
two of the most extensive literary works of  the present day, 
XXX
PRELIMINARY DISSERTATION.
 though not the Dictionary in question;  and he can affirm, from
 a  full  knowledge  of his talents,  that  he  was a man of deep
 study, comprehensive  capacity,  and  extensive  learning.  His
 mind,  indeed,  was  so  widely fraught  with miscellaneous in-
 formation, that few  subjects could  come  amiss  to  him.  His
 Dictionary gives evident proof of his having been alive to every
 novelty in his own profession, and of his readiness to  allow its
 merits.  He was  far more disposed, indeed, to be satisfied  with
 the opinions  of others than with  those  of  himself; and  chiefly
 failed  in a want of deference to his own judgment.   In laying
 down  the outline of his system  of diseases, which he only at-
 tempted  upon a full  conviction that a work of this  kind was
 extremely wanted in the medical republic, he had his eye chiefly
 directed to the nosological  method  of  Selle, and the  botanical
 method of Jussieu.   It follows, therefore, that his primary divi-
 sion would consist not of classes, but of  what he intended to be,
 natural orders^ or families.  These  orders are  twelve, whose
 names  are taken from the classes or orders of Sauvages or Cullen,
 with the exception of one, suppressorii, which is borrowed from
 Linneus.
   Here again, therefore, we have a great and noble aim, what-
ever be the success of its accomplishment.  But as a natural system,
even in botany, is to the present hour, and perhaps always  will
be, a theoretical rather  than a  practical  idea,  there seems very
little expectation that  it can  ever be realized in medicine.  Lin-
neus, indeed, as We  learn from his pupil Giseke, pretended in
his lectures on botany, that nature  had at  length let  him  into
the secret upon this subject; " I know," said he, " their orders,
and  their connections,  but  these  I  will not explain:—I will
never  explain them."  He  kept his word too  faithfully; and
 the fragments of  the natural  orders which he left on his  de-
cease have been very ineffectual in  completing the system.  It
is  true  that  the outlines of the system  are before  us ; for he
named  and arranged his orders; and in many cases we can follow
up and explain the catenation; as  for instance,  in passing from
the papilionacese to the lomentacese, from  the  dumosse to the
sepiarise; but in  many of the  links  the most expert  botanists
are very much at  a loss,  and there are  others that seem to
baffle all  inquiry.   What, for example, is the nature of  the con-
nexion* between the palmse and the  piperita, with which the ar-
 rangement opens?  or by what tie is the siliquosseunited to any of
 the orders?
   On the  part, therefore, of Dr. Parr,  the  attempt was  a bold
one, and  his arrangement will  show  that, if he have  not been 
PRELIMINARY DISSERTATION.
XXXI
altogether successful, he has exhibited a very considerable decree
of ingenuity.  This arrangement is as follows:
I.	Pyrexia.	VII.	Adynamia.
II.	Phlegmasia.	VIII	Paranoia.
II!	ErtUPTIONES.	IX.	Cachexia.
IV.	Profluvia.	X.	Intumescentia
V.	Suppressorii.	XI.	Ectopia.
VI.	Spasmi.	XII.	Plaga.
  Between most of these we can trace, in the series of their de-
scent, a verbal connexion ; and  between several of them a con-
nexion of a more substantial kind.   It holds nominally in the first
three orders, but seems  to slip from us in the  three that follow;
and is  occasionally recovered in  the remaining.  Yet when we
examine the genera and  species of the  respective orders, we shall
find the connexion is too commonly nothing  more  than  verbal.
Phlegmasia has  a manifest relation  to Pyrexia ;  but in coeli-
aca, leucorrhoea, leucorrhois, (discharge of white mucus from the
anus) which are diseases of the former  order, the connexion is en-
tirely lost: nor will it, perhaps, meet with general approbation that
these, together with gonorrhoea, (used in the vulgar sense of the
term) cystirrhcea, and phthisis, should be united with coryza and
dysentery, under one common genus, to which  is given the name
of catarrhus.  This, however,  is a genus upon which Dr. Parr
peculiarly  prided  himself, and  upon which he unquestionably
bestowed  very great pains.   In like manner the order erup-
tiones seems at first to claim a near affinity with Phlegmasia ;
and in the genus exanthema it does so substantially, for here we
can trace distinctly something of that  febrile,  or to speak  more
correctly, pyrectic diathesis, which unites these two orders with
the order pyrexia.  But in the mere cutaneous eruptions, here
collected into one  genus, named  effiorescentia, the line of union
becomes so fine and filmy as to be altogether invisible.   Were
we to  pursue this prying indagation, we should soon arrive at
breaks far wider and more obvious.  It would perhaps be difficult
to find four diseases more discrepant  from each other than dys-
pepsia, amentia, amaurosis,  and  agenesia.  They seem  to have
no one common  property  with each  other.   Dr.  Parr,  how-
ever, has contrived to make them all species of a single genus, to
which he has given the  name of anepithymia, and which  he
has defined, "a diminution of power in the  different functions:"
—a character sufficiently sweeping to cover at least  half the dis-
eases that man inherits ; for excess  and diminution of power 
xxxii
PRELIMINARY DISSERTATION.
 may easily  be made to embrace  the  whole ;  and are made to
 do so under  the  Brunonian  theory.  Yet,  notwithstanding this
 licentious generalization, and aim  at a  natural  arrangement, the
 diseases of the external  senses which seem to have a pretty  close
 proximity with each other, are  partly scattered at considerable
 distances over the entire system, and partly, as in the instances
 of caligo, dysopia, paracusis, anosmia, ageustia,  anaesthesia, are in
 the unfortunate situation of Dr. Cullen's *•' Catalogus morborum a
 nobis omissorum :"—and, from forgetfulness or some other cause,
 have no place alloted them  in any section  of the system.
   There is, nevertheless, much in Dr. Parr's system that is high-
 ly  meritorious ;—the distinctions of the  different  divisions are
 scientifically  laid down ;  and, except that the genera are occasion-
 ally  too  extensive,  accurately  maintained.  He  has  certainly
 generalised too  freely :  but his example is good upon  the whole,
 well worthy  of study, and, in various cases,  of imitation.  Many
 of his specimens are  drawn with great nicety; and it is no small
 praise that his  theory is kept in due  subjection,  and is seldom
 more than a handmaid to his practice.
   XV.  Some years  after the writer had  laid down the  outlines
 of the ensuing method,  he had  the gratification of reading Dr.
 Young's Introduction to Medical Literature, including a  Sys-
 tem of  Practical Nosology.  This work, though  limited  to a
 single octavo, embraces a much  wider  field  than is proposed in
 the present attempt;  for  it ranges through an  entire course of me-
 dical education,   anatomical,  pathological,  therapeutical,  and
 chemical, as  well  as  nosological:  whilst in the  last department
 it  is drawn  up  with a  somewhat different  view,  and  is more
strictly  limited to the pale  of the medical  profession.   So far,
 however, as it  touches upon the  plan now submitted,  the author
has beheld,  with  great  pleasure, his own ideas of what ought
to  form the  basis of a nosological system  corroborated by those
of a  writer to whom the  literature of  this country and  of Europe
is under  no small  obligations.  The arrangement of Dr. Young,
 while essentially distinct from the present,  will be found  per-
haps to make  the nearest, approach to  it  of  any that have
hitherto  appeared.   In wanting  the  division of orders  to  two
of its classes,  it  is   scientifically defective ;  but its systematic
boundaries  are as clearly seen,  and  as  precisely maintained,
as  those  of Dr. Parr.  Yet  its chief merit, perhaps, consists in
offering to the  student a  masterly guidance,  through the  whole
of his professional tuition,  to the  best authorities and sources
of information ;  in this respect answering  the purpose  of Plou-
quet's seven  quarto  volumes, with a  great  saving of expense. 
                 PRELIMINARY DISSERTATION.           XXxiii
         ■                                                    *
 a prodigibus  saving of time,  and by a  far nearer and pleasanter
 pathway.
   XVI. A glance  has already been given at a few limited no-
 sological arrangements, by writers who have confined their  at-
 tention  to  a  single family or  group of diseases,  detached  for
 this  purpose  from the rest;  and  to this  description  of works
 the author has applied the name of monograms,  imported from
 the region  of natural history.   To the names  of Selle,  Pinel,
 and  Crichton, it is necessary to  add,  under this  view  of the
 subject,  those of Plenck, Willan,  Abernethy, and  Bate-
 man, to all of whom the present volume is in a greater or less
 degree indebted.
   Dr. Plenck, of Baden, is the author of two distinct treatises
 of this kind ; the one  a methodical arrangement of the " Dis-
 eases of  the Eyes ;"* and the other of  " Cutaneous Diseases."t
 In the former he follows the order of anatomy in the distribution
 of his primary divisions, beginning with the eye-brows, and de-
 scending from without inwards till  he closes with the retina.   In
 the latter, which consists of classes, genera, and species, without
 the interposition of orders, he  employs a  looser line of succes-
 sion,  though the general idea seems to be that of advancing from
 the slighter to  the more prominent elevations of the skin, com-
 mencing with macula, and proceeding to  excrescentia; the
 remaining  classes  consisting of cutaneous  ulcers,  wounds
 and insects, diseases of the nails and of the hair.   He is
 a more industrious than discriminative writer, as the reader will
 perhaps readily concede, when  informed that  he  has  arranged,
 defined,  and followed, through their progress  and mode of treat-
 ment, a  hundred and nineteen genera, comprising nearly six
 hundred species, or distinct diseases of the eyes, the genus amau-
 rosis  alone  extending to twenty species; and one  hundred and
 fifteen genera, including nearly as many  species, or distinct dis-
 eases  of the skin, as belong to the eyes!

         Hei mihi! tot mortes homini quot membra;  malisque
           Totsumus infecti, MOHs^ut medicina putetur!

   Yet compression, and a more scientific  arrangement,  would
make  either of Dr. Plenck's  attempts a valuable work;  and Dr.
Willan has the merit of having performed, this friendly office to
the latter of the two,  in his book on Cutaneous Diseases; and at
  * Doctrina de morbis Oculorum.  Edit. 2nda. Vienn. 1783.
  j Doctrina de morbis Cutaneis, qua hi morbi in suas classes, genera, et
species rediguntur.  Edit. 2nda aucta. Vienn. 1783.
   VOL. V.—5 
XXXIV
PRELIMINARY DISSERTATION.
the same time of having added  so much valuable matter of his
own,  as to entitle it to the claim of being strictly an original per-
formance.  The distinctive characters of papula, pustule, vesicle,
bleb (bulla  Germ, blasen), scale, and crust, are well given and
maintained by the former; but  the latter has expressed them
more  neatly,  and has added  many distinctions which the  former
does not afford ; whilst he has drawn  his  literary and  practical
history, and  treatment of the diseases  discussed, from  very dif-
ferent sources; and as  far as  might  be, from  his  own personal
observations.   That Dr. Willan did*not live to  finish this valuable
work  must be regretted by every one who has the welfare of me-
dicine at heart;  but the able and judicious manner in  which  it
has been brought to a  close by Dr. Bateman has served in  no
small  degree to abate the general disappointment. To the arrange-
ment  of Dr. Willan the present writer will  be found to have  paid
as much deference as the very different nature  of a general and a
limited system of nosology would allow; for  it must be clear to
every one  that had Dr. Willan  himself, after  having completed
the direct object of his pursuit,  extended his views to a  systema-
tic scheme  wide enough to embrace the whole circle of diseases,
he must have greatly modified  his first and more restricted sys-
tem before he could inweave it into 'he larger plan.   As it is, in-
deed,  it  stands  in  need of no small degree  of modification  to
clothe it with all the perfection it deserves ;  for several of his
orders would make better genera; almost all  his genera are de-
cided  species, while his species are seldom more than varieties,
and are in many cases so denominated by himself. In this respect
he might have taken a  good lesson from Dr. Young, Dr. Parr, or
Dr. Macbride; as  he might also from the two Termer in giving
the essential  character  of each disease antecedently  to the admi-
rable description with which it is followed up..
  The name of Mr. Abernethy is here mentioned  in reference
to his methodical " Classification of Tumours."   This classifi-
cation is strictly symptomatic, the characters  being  derived,  as
they ought ever to be,  as much as possible, from sensible phaeno-
mena.   The present writer has with little difficulty been able to
enlist this elegant attempt into his service ; and only laments that
he has not had an opportunity of laying himself under more ex-
tensive obligations to the same quarter. 
PRELIMINARY  DISSERTATION.
XXXV
                          SECTION II.

                  medical nomenclature.*

   I.  The perfection of a  science  depends, in no  inconsiderable
degree,  upon the perfection of  its language;  and  the perfection
of every language  upon  its simplicity and precision.   A writer
may have clear ideas in himself, but to communicate them to hi?
reader, his terms must be equally clear,  and  possess  a definite
meaning.  The  philosophy of the middle ages  was  a chaos of
darkness and perplexity;  and might have descended  with these
qualities to the present day, had not Lord  Bacon, the grand lumi-
nary  of  the sixteenth century, given life and utility to the sense-
less mass, by calling men from  the jargon of words to the  study
of things; and had not Locke and Condillac,  in the ensuing cen-
tury, set the admirable example of prefixing a determinate mean-
ing to a  host of equivocal words in common use, and scrupulously
employed them in such single signification.  " Vocabula et nomi-
nal"  says Sauvages, with admirable force  and  perspicuity, " sunt
signa idearum nostrarum, et tantum valent, quantum sonant, vel
quantum, ex definitione constanti, certa est et fixa eorum signiti-
catio.   Si itaque ob inconstantiam loquendi eodem  nomine plures
ideae  enuncientur, eo prolato, auditor  quidquid significet hoc no-
men non intelligit: ideoque qui verbis  aequivocis utitur, is ideo
loqui videtur ut  intelligi non possit. Eodem itaque  nomine, unica
tantum idea significari  debet,  si cordate loquamur."t
   In  our own  times every one  feels  the advantage which che-
mistry has derived from  the universal adoption of the  Lavoi-
sierian  nomenclature;  and though recent  discoveries have clash-
  * A considerable part of this section is drawn up from an  article upon the
same subject by the author, published in Vol. I. Part I  of the "Transactions
of the Medical Society of London," which was honoured by an award of the
Fothergillian medal.
  fNosol. Method. Prolegom. p. 26.  Several of the sections in M. Cabanis'
Revolutions et Reforme  de la Medicine are well worthy of perusal upon this
subject;  and especially sect.  viii. of  chap. iii. entitled,  Grande influence des
Langnes sur les Sciences, in which, among other things, he observes as fol-
lows :  " Ce sont l'exactitude et le bon emploi  des mots, ou plus g^neralement
des signes, qu'il faut conside>er comme le criterium de la ve>ite ; c'est a leur
caractere vague, a la manure  incertaine et confuse dont ou les emploie, qu'il
faut attribuer les notions imparfaites,  les prejug£s, les erreurs,  et toutes les
habitudes vicieuses de l'esprit."
  " Dans presque toutes les parties de la medicine, la langue est mal faite. Elle
s'est alteree de plus en plus, par la fausse application des mots emprunte's aux
autres sciences, etparun certain jargon, insignificant et ridicule, que le coupa-
ble respect des pre juges populaires a trop sou vent fait adopter aux praticiens," 
xxxvi
PRELIMINARY DISSERTATION.
ed with the etymological meaning of several of  its terms,  the
beautiful  simplicity of its principle has  proved, and  will long
continue to prove, a preserving salt;  and its vocabulary, instead
of being hereby abolished,  has  been since very largely enriched
and extended.   Botany and natural history have  also their re-
spective nomenclatures, to which  they are mainly indebted  for
the improvements they have evinced within  the last  half cen-
tury ; and  as  the nomenclature of the  first has been  more at-
tended to than that of the second,  the  science  itself has dis-
covered a proportionate  fore-leap in its  progress towards per-
fection.
  What has  been done for chemistry,  botany,  and natural his-
tory,  ought long ago  to have been done for medicine ;  whose
vocabulary is a jumble of terms derived  from almost every lan-
guage, and every system, whether dead or living, founded upon
no  common  principle, and equally  destitute  of  precision and
simplicity.   It consists of  Hebrew and  Arabic terms;  Greek
and  Latin;  French,  Italian,  Spanish, German, English, and
even Indian,  African, and Mexican ;  often barbarously and ille-
gitimately compounded, doubtful in derivation, cacophonous  to
the ear, and, for want of a determinate signification,  formed,  as
one would think, rather for the  purpose of suppressing  ideas
than of communicating them.   It  is not necessary to  detail  the
cause of this confusion.   It has manifestly arisen,  in a very con-
siderable degree,  from those political and geographical changes
that have marked the history of medicine  in its different epochs,
in  conjunction  with that  succession of theories, which, very
nearly from the  time of Hippocrates,  has  been  perpetually un-
folding to  the world ; almost every one of which, if character-
ized by nothing else,  has at least taken care to mark its existence
by a new coinage of  words.
  II.  The sources then of  the impurity and perplexity of medi-
cal  language may be contemplated under the  following  heads.
Firstly, an intermixture of different tongues that have no  family
or dialectic union.  Secondly, the want of a common principle to
regulate the origin  or appropriation of terms.   Thirdly, the in-
troduction of useless synonyms, or the adoption of different words
by different writers to express  the same  notion.   Fourthly, im-
precision in the use of the same terms.  Fifthly, an unnecessary
coinage of new terms upon a coinage of new systems.
  1. Every one knows that the languages chiefly made  use of
in the  nomenclaturet-of our  most  celebrated nosologists are  the
Greek and Latin; and it would have been well if these tongues
had  formed  the boundary  of their  vocabularies;  for unques- 
PRELIMLNARY DISSERTATION.
XXXV11
uonably they  contain a mint sufficiently large for every purpose.
Even here, however, we occasionally meet with words illegiti-
mately  compounded,  as  pellagra,*  mentagra, tonsillitis.    But
who is there that can endure,  in the midst of a Greek and Latin
vocabulary, the introduction of such barbarous words ascrampus,t
soda,J and scorbutus,§ from the German ; petechia, or more cor-
rectly petecchia,  and scarlatina, from  the Italian ; modorra, mo-
dorrilla,   and patursa, from the  Spanish;  frambsesia,  from the
French; nucha,  essera,||  (or  rather eshera) albaras,!! subeth, or
subeta,**  from Arabia; bereberi,  from  India; mordexia, from
China; bichos, from  Brazil;  mirachia,  galiancon, nambakassa,
from  Guiana, perhaps, or Guinea, or the Mountains of the Moon ;
for we cannot follow up this Babylonish dialect through the whole
of its geographical travels into

                 Words so debas'd and hard, no stone
                 Is hard enough to touch them on.

   These terms, however,  form but a small sample of the gibber-
ish that at present deforms the nomenclature of medicine.   They
are drawn from the branch of Nosology alone, and from writers
who possess,  and deservedly so, a high degree of celebrity ;—for
the examples  are  purposely confined to the works of Sauvages,
Vogel, Cullen, and Darwin.
   Had these  terms been altogether arbitrary, and had an arbitra-
ry coinage  of terms been the  principle of medical technology,
there would, perhaps, have been no  great  objection to the gene-
rality of them.  Many of them are  sufficiently  euphonous, and
each  could, in such case,  have excited only a single idea.  But
as this is not the fact, the classical  student  can  never commit
them to memory without disgust at so barbarous  an association,
nor the unclassical student without having a secret and commend-
  * Evidently from the Latin pellis, and the Greek *yp*., as Dr. Parr correctly
traces it in his Dictionary.  M. Jansens, however, and other continental wri-
ters, spell it pe/agra, and confess themselves at a loss as to the origin of the
term.  " Nomen pelagrx," says  M. J. Griece, " videtur originis,"—Immedi-
ately adding in a note,  " auctor vocis, ejus origo,  ac etymologia aeque incerta
videntur,  an a 7rt\*.e ut ipuTtmxcLs}" De Palagr. Ludg. Bat. 1788.
  •fDer krampf; whence our English cramp.
  \ Das 9od, or sodt.  Foam or scum boiling up to the surface.  The chemi-
cal term soda is from the same source.
  § Der scorbut: der scharbock; perhaps more properly, die scharf-pocke.
  H See the genus exormia, cl. vi. ord. iii. 3. 3.
  f See the genus lepidosis, cl. vi. ord. iii. 4. 2.
  ** See the genus carus, cl. v. ord. iv. 9. 4. 
xxxvm
PRELIMINARY DISSERTATION.
 able thirst to  become acquainted with their radical meaning, which
 he can only thoroughly accomplish  by  sacrificing his time  to a
 knowledge of the different languages from which they  are seve-
 rally deduced.
   2. Yet there is a more serious evil in  the want of a  common
 principle  upon  which  the  technical  terms of  medicine  have
 been  founded,  than in the want  of a common language.   And
 it is curious, and in some degree  amusing, to trace the multi-
 plicity of accidents  or fancies to  which  we  are  indebted for
 the greater number of words that enter  into the medical  vocabu-
 lary.
   Sometimes  the  nomenclator appears  to have  been  smitten
 with the love of colour;  and, in  consequence, we  have black,
 white, green, red,  scarlet, yellow, and purple  diseases, under
 the (names of  melaena,  melas, atrabilis,  leuce,  alphos, albugo,
 chlorosis, rosa,  rubedo, rubeola, scarlatina, icteritia, aurigo, and
 purpura.
   Occasionally the order of time seems  to have been the favour-
 ite principle of designation;  and hence  the  distinction of dis-
 eases into  chronic  and  acute; into  those of infancy, manhood,
 or womanhood  and old age ; into ephemeral and  quotidian;  con-
 tinent and intermittent; tertian and quartan ; or in the more tech-
 nical  terms of the nosologists, into  amphemerine,  tritaeophyte,
 and tetrartophyte fevers; into monthly fluxes,  spring rashes, and
 summer heats.   It  is  upon  different modifications of this  prin-
 ciple,  as has  been  already observed,  that  the arrangements
 of Aretsus,  Cselius Aurelianus,   and  Macbride,   are  chiefly
 founded.
   In  various  cases  Natural  History or  botany seems  to  have
 supplied a  basis; and  the  nomenclator  has  wandered  equally
 among birds,  beasts, fishes, insects,  and plants, for peculiarities
 and derivative names.  From this quarter we  derive the terms
 fames  canina, rabies canina,  (dog-hunger, dog-madness);  cy-
 nanche (dog-choak) ;*  boulimia  (ox-maw); pica  (magpie-long-
  *Cynanche (nvvxy^n) appears to have been at first a mere verbal mistake for
 synanche («*»*>%»') ; though afterwards employed  to denote a particular spe-
 cies of the synanche genus.  It is thus adverted to by Celsus, lib. iv. cap. iv.
 " Nostri amginam vocant; apud Graecos nomen, prout species est. Interdum,
 enim, neque rubor, neque tumor ullus apparet; sed corpus aridtim est, vix spiri-
 tus trahitur, membra solvuntur ;  id a-uvny^m vocant. Interdum lingua faucesque
 cum rubore intumescunt, vox nihil significat, oculi vertuntur, facies pallet, sin-
 gullusque est; id Kvva.-y%M vocatur. Ilia communia sunt; aeger non cibum devo-
 rare, non potionem, potest; spiritus ejus intercluditur. Levius est, ubi tumor
tantummodo et rubor est, cetera non sequuntur; id irotpx.<ruv3.y%>,v appellant."
 Several of the MSS. and codices for " id nuvtry%>i" give it " uti wmy^n"—others
"»« awtry%>t."  The Variorum edition is here employed, and  the  following 
PRELIMINARY DISSERTATION.
XXXIX
ing); hippus  and hippopyon (horse-twinkle  and horse-blotch);
scrofula  (swine-evil);  elephantiasis (elephant-skin);  ichthyosis
(fish-skin); vitiligo  (calf-skin);  cancer and  cancer-lupus (crab-
ulcer and wolf-ulcer); tantarismus (tarantula-dance); vampirismus
(bat-bewitchment);  roseola  (rose-rash);  urticaria (nettle-rash);
lichen (liverwort-rash).
   Sometimes  the names of persons or of places have  been re-
sorted to as a foundation for distinguishing  diseases; and  from
this source we  have  morbus  Herculeus; facies  Hippocratica;
lepra Arabum and  lepra Graecorum;  plica Polonica ; sudor An-
glicus;  morbus  Gallicus, Hungaricus, Garhamensium,  &c.  To
which may be added the names  of various  saints and preternatu-
ral agents,  some  of whom  have but  few pretensions to the  ca-
lendar, as ignis Sancti Antonii,  chorea Sancti Viti, malum Sancti
Joannis, lues  Deifica,  Daemonomania.   In  anatomy the absur-
dity produced by this cause  exists to a  still greater extent, and
has incited several  attempts  at  a reformation,  both  in  our own
country and  on  the  continent, though  hitherto  without much
success.  In our own country the plan proposed by Dr. Barclay
is well entitled to attention ;  and  in France the  exertions of  M.
M. Dumas, Chaussier, and especially of the indefatigable Vicq.
d'Azyr, are too well known to render a glance at them necessary,
were it  even consistent  with the  scope  of this dissertation.  In
the brain alone we  meet with an  assemblage of terms so ridicu-
lously diversified in their sources and primary  meanings, as fre-
quently to disturb  the  gravity of the sedatest face on  running
 them over; and at  the same  time so indelicate in many of their
references, as to render it  impossible to read  them  except in  a
dead language.
    The objection, however, in  the present instance, does not so
 much lie against any one or against  all these various  sources of
 nomenclature, as against the random and  indefinite manner in
 which each of them  is  dragged forward to furnish an occasional
 supply, and  the dull  and miserable  taste that  so largely broods
 over the whole.
passage from Galen sufficiently justifies it, torn. vi. p. 324. " Sive synanchen
dicere volueris, sive synanchem, vel altevum quidem horum synanchem, alte-
ram vero cynanchem,  sive utriimque synanchem vocaveris, duas stnanches sci-
veris esse rationes."  Both writers evidently lean in favour of synanche ,■ and
both point out the confusion resulting from the introduction of cynanche along
with it.  Aetius attempted to support the last by observing, that the patient
thrusts out his tongue like a dog; and Aretaeus says, that the name was hence
derived; but Cadius Aurelianus and Paulus used synanche as recommended
by Galen.  It is curious to observe, that the proper term is now generally ba
nished, and almost forgotten, while the corrupt term has usurped its place. 
xl
PRELIMINARY  DISSERTATION.
   3. Yet the vocabulary of medicine is  not only not founded upon
 any common basis, but perplexed by the introduction of synonyms
 or equivalent  terms derived  from different languages, in  conse-
 quence of an almost total want of agreement upon this subject be-
 tween the best and most approved writers.   A few examples will
 best explain the author's meaning.
   The more common terms among the  Greek physicians for  a
 morbid excess of appetite,  are  boulimiasis, cynorexia, and lyco-
 rexis; among the Latins, who have merely translated these terms,
 fames  bovina, canina, lupina.    Avicenna uses bolismos,  and
 many writers bulimia; while others, dissatisfied  with  the gross
 idea conveyed by all terms of this kind, have racked their genius
 for substitutes, and have at  least doubled  the number.   Hence
 Plutarch tells us that the technical term in his day was palulimos ;
 while Caelius Aurelianus employed phagedaena, several addepha-
 gia, and a few esurigo.   The Arabian writers  employed nehem,
 and sometimes jerkua.
   In like  manner depraved appetite  is  indiscriminately denomi-
 nated citta, cissa, allotriophagia, by the Greeks  ; and pica and ma-
 lacia by the Latins; though this last term is also of Greek derivation.
   Variola  and varicella,  though descending to us  from the Latin,
 through a  Spanish medium, are unobjectionable names for small-
pox and chicken-pox.*  But  as  the second  disease was formerly

  * Sauvages, indeed, does not use varicella, and objects to variola ; " variola
et patursa," says he, "ut barbara ableganda." Prolegom. p. 30. But this would
be to make sad havoc with nosological terms, many of which, as rubeola, rosa-
lia, urticaria, though of Latin origin,  have reached us through the medium of
the Spanish or Italian schools, and hence with a diminutive termination, not,
indeed, authoritatively Latin,  but allowably so, and sufficiently euphonous to
please the nicest ear.   Variola and varicella are both derived from the Latin
varus, " a pock or pimple,"  which has furnished  the  Castilian dialect with
vario andfwtmz, and hence  the diminutives variola (now altered by a change of
accent to variola) and varizella, now uniformly written varicella.  The Arabic
term for the small-pox is nebekk, the radical meaning of which is, " protrusion,
elevation, accumination ;"  and which corresponds, therefore, with the Latin
varus, and probably gave rise to the Spanish variolous its literal rendering.
  It is generally said that the Arabic name for the small-pox is chaspe: but this
is a mistake.  Chaspe is used by Rhazes and other Arabian writers to indicate
this disease, but the term itself is Syriac, and like the same term in Chaldea,
(N3D3) means directly erubescence ; the flush of red so  readily diffused over
the cheeks of the bashful and modest; and indeed the Chaldee root imports
in  its primary sense (^D^)  pudore suffundi ; whence in the conjugation aphel
^DDNj pudefacere, pudore  suffundere, confundere.  In Hebrew the same term
is employed, and  to emport the same effect, but by a different mean, for in
this last tongue *]D3 signifies " to turn pale or wan," from shame; and is ra-
ther, therefore, ignominid  affici,  than pudore affici.
  Among the Arabian writers we  meet with a  variety of Syriac terms;  for
though Arabic was the fashionable and court language of all the caliphats, 
PRELIMINARY DISSERTATION.
Xli
 conceived to be nothing more than a  species or variety of the
 first, the  student has  still  to  follow chicken-pox through many-
 nosologies,  and perhaps all the medical lexicons,  under the name
 of variola lymphatica, as well as under that of varicella.   In like
 manner rubeola, the more  common  term  for measles, and like
 the preceding a Spanish diminutive from a Latin  root, is denomi-
 nated by Sydenham and Morton, morbilli; by Sagar, febris mor-
 billosa; by  the translators  of Avicenna,  variola cholerica; by
 Castellus,  roseola.    So heart-burn is sometimes styled cardialga,
 sometimes pyrosis, from the Greek, sometimes soda from the Ger-
 man.   Wakeful, coma, commonly denominated coma vigil, is by
 Linacre called marcor; by  Sauvages typhomania; by the Spanish
 writers modorra.    St.  Vitus's dance is chorea, chorea Sancti Viti,
 and scelotyrbe; the last a very improper term, though descend-
 ing to us under the authority of Galen; since we know from Pliny
 that it was also used among the Greeks to denote  a particular spe-
 cies of scurvy.   Thus, again,  sleep-walking is denominated noc-
 tambulismus,  somnambulismus,  hypnobasia,  and   nyctobasis;
 night-mare is called incubus, succubus, ephialtes, prigalium, and
 epibole; while epilepsy has  a still greater choice of names ; and for
 syphilis they are almost innumerable.
   4. Yet we are not  only  overloaded  with terms to express  the
 same common idea, but of these  terms a very great number are
 so loose and indefinite as to convey no precise  idea whatever;
 while others, on the contrary,  cannot  fail  to express a very er-
 roneous one.  Let  us  take, as an example, some of the  names
 invented to denote  the last of the above  diseases.  Fracastorio,
 whose  muse  deserves to have been  better  employed than  in
 composing a very  excellent and classical  poem upon  so disgust-
 ing a subject, denominates  it syphilis,  Astruc, lues, both which
 Syriac was the country language of Cairo and Bagdad : many of these writers,
 moreover, were born not in Arabia, nor within the precincts of the Saracenic
 court, but in  Syria or Persia; and hence had to study Arabic as a part of
 their classical education, and on  this account we meet occasionally with Per-
 sian as well as Syriac terms.  Thus Mesne was born  and brought up in  the
 former country, and  Rhazes in the latter. The works of Mesne were first
 written in Syriac, and afterwards translated into Arabic; and it is perhaps
 from him that Rhazes derived the term.  The Persian name, indeed, for the
 small-pox is evidently of Syriac and not of the Arabic origin, for it is founded
 not upon the nature of the pimples, but upon the inflammatory redness of the
 skin which precedes their  eruption.  This term is serkhyclie from serkh " ru-
 ber, rubedo :" being,  like the Syriac chaspe, peculiarly applied to the red-
 ness or blush of modesty;'- whence serkh rui is expressly " erubescere, rubore
 suffundi."  The Greek translator of Rhazes follows the same clue; for he
 renders " chaspe" iuyhoytz, or " incendium,"  as Machelli  has given it in La-
 tin.  The common reading, indeed, is tuhoyi*, but this is evidently a mistake
of the copyist, and has been long admitted so by the interpreters.
  VOL.  V.—6 
xlii
PRELIMINARY DISSERTATION.
names are, as  to  their  origin, unexceptionable.  But  when.,
after Baglivi, it is called morbus Gallicus, and after the French
writers,"who did not choose to accept the compliment, lues Nea-
politana,  or lues Bavarica,  the disease is, at  least, loosely, per-
haps erroneously,  characterised.   By Joubert it is designated va-
riola magna; and thus,  not to mention the"absurdity of coupling
the adjective magna with  a  diminutive substantive,  we have  it
confounded with another  disease,  which  has  scarcely a  single
symptom in common  with it.   By other writers it is denominated
with equal  incorrectness, from some individual or accidental  cir-
cumstance  alone, or some particular part of the body on which it
happens to  light with  peculiar severity; and hence the unclassical
terms of ment-agra and  pudend-agra; which last,  as  though .to
increase the confusion, is introduced into the nosologies of Lin-
neus and Sagar to express a local affection of a  very different na-
ture.   Upon the same absurd principle the Spanish writers called
it bubos; the Neapolitans pellarola,  orchiarolla, and unghiarolla,
according as the eyes or skin  were chiefly affected.
  Mania is universally employed to  signify a particular species of
madness; but typhomarniaTj instead of madness, means a particu-
lar  species  of wakefulness, the ay^vTrvoi xap.cc of the Greeks,  and
the coma  vigil of  the Latins;  the  subat  asarim  or  interrupted
somnolency of  Avicenna.    'J
  Melancholia  and  atrabilis  are univocal  terms, and both were
formerly used  to denote vomiting  or dejection  of black blood,
or blood intermixed with bile.   In  later periods,  however, the
latter alone  has been  employed  to  express  this  disease, the
f*£A#/»« of  Hippocrates, while the former has been growing into
general use  to  express  madness  confined to  a  particular sub-
ject.
  What can be more  different in their commencement, or require
a more different mode of treatment, than the two species of con-
tinued fever synocha and synochus?  yet  a mere arbitrary  change
of gender,  in a common term, is all  by which  we have to discri-
minate them in the best modern  nosologies.
* Phagedena,  in  Caslius Aurelianus, and those who have fol-
lowed him, means, as already observed, canine appetite; in Ga-
len, and most  writers of  the present day, a  gangrenous ulcer.
The wind-pipe  among  the Greeks  is denominated cricos,  from
its  annular form, and trachaea,  from its  asperities.   The  anato-
mists and surgeons, as though not knowing which of the terms
to prefer, have consented to  divide them ; the  former taking the
first,  and the latter the  second.   Hence  the rings of the larynx
are denominated  cricoid cartilages,  and  all the  muscles  attach- 
PRELIMINARY DISSERTATION.
xliu
ed to them are distinguished  by words compounded of crico, as
cfcico-pharyngeus,  crico-thyroideus, &c.   The surgeons, on the
contrary, who limit themselves to the latter term, instead of crico-
cele and crico-tomy, speak only of tracheocele and tracheotomy.
The nosologists have made common cause with the surgeons; and
hence,  instead of cynanche cricalis,we have c. trachealis.  The
one is,  perhaps, as good a term as the other, but one is sufficient;
and if the nosologists and surgeons make their election of trachea,
how immethodical and, to the  unlearned, how perplexing,  is
trach oma for a disease of the eye-lids.
   Stomachus and stomachicus are-terms that apply to the stomach;
stomacace to the disease called scurvy; stomalgia to  a  particular
affeetion of the tongue.   The radical term in all these is the same;
and the Greek etymologist, though he may disapprove of one or
two of  the  compounds,  will  have no difficulty  in  tracing  them
home.    But as every medical student is not a  Greek etymologist,
many must be bewildered in  their vocabulary,  more especially
when they find  that stomacace is also employed  by several wri-
ters to  express St. Vitus's dance.
   What is the  meaning of tone ? In physiology, in pathology,
and irv the common language of the multitude,  sound and accor-
dant elasticity ;  that voluntary reaction or state of extension be-
tween antagonist muscles, as Galen has well observed from  Hip
pocrates, by which they are  removed  from a condition of rest;
and in  which the one yields to the other, not from actual debility,
but in  a precise ratio to the surplus of power  exercised over it.*
Whence that class  of medicines which contributes to this harmo-
nious play of muscular fibres in irritable or weakened organs,  is
denominated tonics; while organs that are destitute of it are said
to  be in a state of atony.  But if tone be used  to imply health,
and tonics restoratives of health, what are we  to understand by
the phrase tonic spasm ?—a phrase founded  upon  an  erroneous
pathology, too  frequently leading us astray in  our practice, and
applied to a state of muscle in which there is  no more tone, elas-
ticity,  or healthful reaction, than in the frozen strings of a violin.
To show the utter absurdity of this phrase, it is only necessary to
translate it,* and to tell the English  reader that  it is literally ex-
tensible contractility.
  . 5.  The last source of imperfection and  perplexity it  is neces-
sary to notice, is the coinage of new terms upon the coinage  of
new systems.  This has been a very ample and inveterate medium
of error; and one which has not merely run through our nomen-
• De Mot. Muscul. 1. ii 
xliv
PRELIMINARY DISSERTATION.
clature, but through our reasonings; insomuch that, through  its
prolific influence, the language of  medicine is become  a curious
mosaic  of the  chief speculations of ancient and  modern times.
The dogmatic, empiric, and methodic theories  still contribute
something towards this  general effect;  the corpuscular has added
much;  the humoral still more;  the alchemical has kept pace with
the humoral; and the geometrical has not stopt far behind.   The
spasmodic  hypothesis of Hoffman  and Cullen are by no means
unamenable to this remark.  In effect the new and unsatisfactory
character of much of its phraseology  formed no inconsiderable
source of the Brunonian opposition to  it, and laid the first foun-
dation of the Brunonian doctrine.   Yet the  followers of this last
speculation  have no great reason to triumph.  The terms  intro-
duced  by Dr. Brown are seldom strictly correct in themselves, to
say nothing of  the looseness with which they are employed, both
in his own  writings and in those of his  warmest advocates; while,
in the  more elegant display of the same opinions in the Zoonomia,
the reader is dazzled rather than enlightened, and furnished with
fine words rather than with accurate notions.
   It is almost superfluous to give examples under this general re-
mark.   Crudity and crisis ; pores and corpuscles; acute and chro-
nic ; humour and idiosyncrasy; digestion, concoction, and  disso-
lution; effervescence, fermentation,  and putrefaction; lentor  and
error loci;  choleric and nervous;  phlogistic and antiphlogistic ;
tonic and clonic spasm ; action and condition; miasm, contagion,
and infection ;  sthenic and asthenic ; excitement and excitability ;
accumulation and exhaustion;  sensitive  and irritative  motions;
decreased volitions; direct and reverse  sympathies; nature, non-
naturals, vis naturae, vis insita;  forced state of life ; procatarctic,
proegumenal, remote and proximate, continent and incontinent
causes:—these  terms are sufficient to convey an idea of  the suc-
cession of influences here referred to; and as they  are all to be
found in our lexicons, and other books of general reference, often,
indeed, in conjunction with terms  still  more clashing and contra-
dictory, they cannot fail to indicate  the discordia concors of the
medical language of the day, the embarrassment of its phraseolo-
gy, and the difficulties  which the  student has to encounter from
this source  alone, in the progress of his professional education. 
PRELIMINARY DISSERTATION.             xfv
                       SECTION III.

              SCOPE OF  THE  PRESENT DESIGN.

   I. It  is obvious then, that the healing art stands  in consider-
able need of improvement in its two important branches of noso-
logical arrangement and nomenclature :  and it is, among
other points, to  an improvement in these two branches that  the
ensuing pages are especially directed.
   In giving an outline of what the author proposes in order to ac-
complish this  purpose, it is of little  consequence which of  these
two divisions shall first pass in review before us : let us then begin
with  that  of  language  or  nomenclature,  as being,  perhaps,
freshest in the memory.
   In the hope of giving some degree of improvement to the me-
dical vocabulary, as  far as he  may  have occasion to employ it,
the author has  endeavoured  to guide himself by the following
general rules.  Firstly, a  strict adherence to Greek and Latin
terms alone.   Secondly, a use of as few technical terms as  pos-
sible, and consequently a forbearance from all synonyms.  Third-
ly, a simplification of terms, as  far as it  can be done without
violence or affectation, both in their radical structure and compo-
sition.  Fourthly, an individuality and precision of sense in their
respective use.
   1.  As the  science of medicine is open to all ages and nations,
it would be highly beneficial, if it  could  be  accomplished,  that
its technology should be  confined to one alone of the  many
tongues from which it is at present derived.   No modern tongue,
however, would be  allowed such a precedency; and were it to
be granted, there is  none so richly endowed with distinct names
for diseases as to enable it to specificate every  complaint of which
a  system of nosology is expected to  treat.   Dr. Macbride  has
made a trial of our own tongue, and  has completely failed ;  for
the generic terms, under several of his orders,  are entirely exotic,
and undermost of them very considerably so, being partly Greek,
partly Latin,  and partly English, uncouthly mixed  together for
the sake of convenience, like  foreigners from all countries at a
Hamburgh hotel.
   Our  choice, therefore, is limited to the  Greek  and Latin,
which have for ages maintained so equal a sway  in  the pro-
vince of medicine, that they must still be  allowed to exercise a
joint control.  It is a singular fact, that the Greek has furnished
us with by far the greater number of  terms  that distinguish  the 
xlvi
PRELIMINARY DISSERTATION.
 higher divisions of systematic nosology, the classes, orders,  and
 genera;  and the Latin thoie" employed to indicate the species and
 varieties.  The  systems of Liniieus and  Darwin offer, perhaps,
 the only exception to this  remark ;  for  here we meet with at-
 tempts to use the Latin tongue alone, or at least to give it a  con-
 siderable preponderancy.  These  examples, however, have not
 been followed,  and are not likely to be.   The greater flexibility,
 indeed,  and facility of combination belonigtng to the Greek,  his,
 on the contrary, induced  almost all other nosologists, as  well as
 almost all  other men  of science, to turn to  it for  assistance far
 more frequently than  to the Latin.  The author has availed him-
 self of this general taste, and by an occasional revival of terms
 which ought never to have been dropped, Was been able so far to
 simplify the nomenclature of  his classes,  orders, and genera, as
 to render them exclusively Greek;  and consequently to take his
 leave, thus far,  of all other languages whatever.   The changes
 introduced for this purpose are by no means numerous, and  will
 in no instance, as  he trusts,  betray affectation or coercion.   His
 authorities will usually be found in Celsus  or Galen,  who have so
 carefully handed  down to us  the  distinctive terms both of the
 earlier and later schools of Greece; and if at any  time he have
 had occasion to wander farther,, he  has usually supplied himself
 from Aetius, Caelius Aurelianus, Dioscorides, or Aristotle.  The
 sources,  however, from which he has drawn, are  in every case
 indicated, and, he ventures  to hope, will  be generally approved.
 Concerning the'speieific names, he has been less scrupulous;  and
 has allowed those to stand, whether Greek or Latin, that  are al-
 ready in most common use;  or has drawn from either language
 such as may most fitly express the essential character, wherever
 such character can be traced out.  Yet even here  he  has never
 wandered from the Greek farther than into the Latin.
   2. The  machinery  of every art  or  science becomes simpler,"
and its auxiliary  powers fewer and less needed, as it advances to-
 wards perfection.  It  is the  same with their technology.'  While
 we are but  loosely acquainted with the principles of an art, we
 speak of  them with circumlocution, and employ more words than
 are necessary, because we have none that will come immediately
to the point. As we  grow more expert we learn  to make a se-
lection ;  we give to many of them  a greater degree of force  and
 p*fedtsion;  and separate those that are thus rendered of real value
frott the " leather and prunello,'' the heavy outside show  of use-
less and unmeaning terms with which  they are  associated ;  and
thits gain in time as well as in power.  In unison with these ideas,
 the autbqf.  as soon as he has pitched  upon a word  that will best 
PRELIMINARY DISSERTATION.
xlvii
 answer his  purpose,  will be found, as he hopes,  to  adhere to  it
 wherever he has had  occasion to advert to the same idea, without
 indulging in any play of synonyms, or different terms possessing
 the same or nearly the same meaning.  Marisca and haemorrhoig
 have been equally employed by medical writers to distinguish the
 disease which  we call vernacularly piles.   The first  is  a  Latin
 term,  and refers to the tubercles of  the disease, and the second a
 Greek, and  refers to a discharge of blood which occasionally issues
 from theni.   As commonly used, they are direct synonyms, not-"
 withstanding this difference of radical  meaning, and either  might
 answer th6 purpose;  the  diversity of the disease being pointed
 out by distinctive  adjuncts, as  caeca, mucosa,  or  cruenta.   Sau-
 vages  and  Sagar, however, have employed'both;  but have la-
 boured to establish  a  difference, without having succeeded even
 in their own judgment.  So that in  these writers, we  have one
 and  the same disease  described  under two distinct genera in dis-
 tinct classes; the first occurring in Sauvages under class  i. ord. v.
 entitled, vitia, cystides i the other  under class  iv. ord. ii.
 entitled, fluxus, alvifluxus, and  introduced  wjth this  re-
 mark,  " h^morrhoides vero  nihil aliud sunt quam marisca,
 gazae apud  Aristotelem."   In   the  present  system, marisca* is
 alone retained ;  and the author has preferred ,jt to hjemorrhois,
 first, because hemorrhage is only a symptom that  characterizes a
 peculiar species, or rather, perhaps, a variety of the disease; and
 next, because hssmorrhois, or rather haemorrhoids,  (aJ^W*,)
 was employed among  the Greeks, as well  vulgarly as profession- *
 ally, in a much  wider sense than that of modern  times, and im-
 ported  flux of blood from the vagina, as well as from the anus j
 and, in fact, from any part of the body, when  produced by con-
 gestion  and  consequent dilatation of the mouths of the bleeding
 vessels, which were supposed in every instance to  be veins.  So
 Celsus, " Tertium vitium est, ora venarum, tanquam capitulis qui-
 busdum surgentia quae saepe  sanguinem  fundunt:  *W,W«?,
 Graeci vocant.   Idque  etiam  in  ore  vulvae fieminarum incidere
 consuevit."   To the  same effect  Hippocrates, Lib.  de Morb.


  * The term occurs in Juvenal, in its medical import, ii. 12.
                                  podice levi
           Caeduntur tumidae, medico ridente, mariscje
  In Martial it occurs frequently in the literal sense of fici, "fleshy or succu
lent figs or raisins." The spongy and succulent bulrush of the marshes or
grounds  overflowed by the sea, was  called maHscus, from  its  habitation d
mart: and hence, probably, the name of the spongy and succulent tubercles
which constitute'the piles. Our English  marsh hfs the same.origin asla- 
 Xlviii            PRELIMINARY DISSERTATION.

 Mulier.     Galen uses it in a still wider extent, De Morbis  Vul-
 garibus :* and  hence the woman with  an  issue of blood in St.
 Matthew, ch. ix. 20, is termed in the Greek text ymr, utfMppoaa-x.i
 Gaza (y«<f<«), the term used by Aristotle, would have  answered
 as well as marisca, but that it is less common in the present day,
 and  an  exotic  term  even in the Greek.   Hesychius  calls it  a
 Persian  word,  and Scaliger coincides  with him; translating it
 " thesaurus, reditus, tributus,"  " a treasury" or  place of de-
•posit or accumulation,  chiefly of tribute or taxes.  It. is rather an
 Arabic than a Persian term, though both countries  use it under
 different  inflexions.   The Arabic root  is (khazi) " a  blush or
 ruddy flush," whether from fulness, shame, or modesty ; whence
 the verb (khaza) " to  produce blushes, erubescence, or suffusion;"
 and hence {khazan) in Persian, signifies "autumn,  or  the  sea-
 son of fulness and erubescence;"  while (khazain) in Arabic is
 " a garner, treasury, or repository for the fulness of the  autum-
 nal months;" literally cella,  cellula, gaza,  or gazophylacia, as
 explained by Hesychius.
   Vogel and Plenck are overloaded with synonymous terms, or
 what may,  for common purposes, be so  regarded; and,  perpetu-
 ally aiming,  like Sauvages, in the preceding  instance, to  discover
 a distinction where none exists, they have multiplied their lisfof
 diseases, as we have already seen, almost without number.  The
 discrimination of Cullen has here been employed to the highest
 advantage, and is entitled to the thanks of every one.  Celsus is
 in this respect peculiarly correct; he adheres to the best technical
 term supplied by his own tongue;  and though he carefully gives
 us its Greek  synonym,  he never changes it  for  any  other term,
 whether Greek or Latin.
  3. In improving the technology of an  art or science, it seems
of great  importance not only that  all unnecessary terms should
be  banished, but  that  those  retained should be simplified and
abbreviated as much  as may be without  injuring their  force  or
precision.    Nothing can  be  more  repulsive  to the eye of a
learner, or more  inconvenient to the memory of an adept, than
the long cacophonous  compounds with which the science of  no-
sology has  been loaded  by several  German writers;  such  as
  * Comm. VI. cap. xxv.
  \ Sauvages, not sufficiently attending to this extensive sense of the term
among the Greek writers, represents this disease in St. Matthew as a marisca
cruenta, or case of bleeding piles, instead  of a  catamenial haemorrhage.
" Haemorrhois, a Gracce aima et rheo, est fluxus sanguinis ex mariscis : unde
mulier in Eyangelio hamorrhoissa dicta fuit."  Vol. I. p. 164. Jipud Maris*
cam. 
                 PRELIMINARY DISSERTATION.             xlix

fie pothopairidalgia of Zwinger,  for which, to the consolation
of every one's lips and ears, Nenter auspiciously invented nostal-
gia ;  the  ancyloblepharon.  hydrenterocele, and  others  already
noticed of Vogel, for which it is scarcely worth while to look for
belter to supply their place,  as they import mere shadows of real
diseases;  and such specific  epithets as spondylexarthreticus and
hydrocatarrhuphicus, employed in  the nosology of Plouquet, but
far more likely to produce than  to  remove confusion.   To this
point the  author has endeavoured to keep his eye steadily direct-
ed ; he has avoided compound terms  as  much as possible; and
when compelled to  have recourse to them,  has aimed at restrain-
ing them within compass.
  Much of the character of words  in respect to  dimensions and
euphony,  as well as to precision, depends upon the common pre-
fixes and suffixes which  it is occasional!}7 found necessary to em-
ploy ; and which in some branches  of science, and especially in
that of chemistry,  create and regulate considerably more than
half their nomenclature.
  This subject opens a wide field, though the consideration of it,
for the present,  must be confined to a very narrow  compass.  It
is altogether new, not only to medicine, but, as far as the author
is acquainted,  to Greek  philology; at  least, after an extensive in-
quiry, he has not been  able to obtain any  assistance from books
professedly devoted to it.  There seems much reason to believe
that the auxiliary parts of every compound  term, not only in me-
dical  technology, but through   the whole   range  of the Greek
tongue, had, when  first employed, distinct and definite clean-
ings, and limited the radicals, with which  they were associated,
to peculiar modifications of a common idea.  To ihrse meanings
we can still trace many  of them, though the greater  number, Jike
most of the elements  in the Chinese- characters,  have passed
through so many changes, that  it is  difficult, and  in  some  in-
stances perhaps impossible, to follow up the analysis to their ori-
ginal sources.   From the novelty of the subject the author  has,
perhaps, a fair claim upon the reader's indulgence;  the  inquiry,
however,  is worthy of  being carried  much farther than he has
tirv.e or limits to pursue it; and he hopes, and has reason to
believe, that it will be thus extended, before  long,  by a friend,
who has far more competency for the purpose than he can  pretend
to.
  The suffixes employed in  medical technology are more nume-
rous than  the prefixes, and the following is a list of those  in most
common use:
  vol. v.—7 
1                PRELIMINARY DISSERTATION.
r
Greek ^
Latin
I
Agra
algia
asma
    asmus
    esmus
    ismus
    osma
cele
copus
esis
iasis
itis
odes
odynia
osis
rhagia
rhoea
igo
ula
ilia
ularis
iliiiris
osus
dyfa
eth.yii.


   acr/uat
   iTfXOZ
    IT/LAOS


VM>M
kotto;


tart;
me



'xtric
\ttyt%
  The common prefixes arc uniformly Greek,  and are as follow :
         A                            *
         ap, ap'                       *7ro, an*
             aph'                           *<p'
         caco, cac'                     k*ho, x.ax'
         cata, cat*                      aunt, k*t'                •
         dia                           «><*
         dys                          fvt
         ec, ex                        tx., «|
         en                           w
         epi,' ep'                       uri, fit'
             eph'                         tp'
         hyper                        Ws^
         hypo                         Ws
         para, par'                     CT*/IJt, f*/»'
         peri                          mpt
         syn, sym,  sy*                  cuv, <ni/u, <rv'.

  These auxiliaries are far too numerous, and,  in the course of
the vocabulary, recur far too frequently.   Some of them however
may be suppressed, as synonyms or duplicates of others;  while
it shoufd be a rule  never to employ any one of the remainder but
when absolutely necessary to distinguish the compound into which
it enters from the root itself, or from another compound derived
from the same root, by the addition of an idea to which it is uni-
formly restricted.
  Algia, copus, and  odyne, are  direct  synonyms; to which
may also be added  agra, for though of a somewhat  different ra-
dical  meaning, it  is  commonly superadded,  like all the three 
PRELIMINARY DISSERTATION.
h
former, to  express the  general idea of  pain  or ache.  And
hence, very much  to the perplexity of the learner and the  in-
cumbrance of  the  technical  vocabulary,  we  have ctphal-algia
for head-ache,  gastr-odyne for  belly ache, chir-agra, and pod-
agra for gout-ache  in the hand or foot.  And, worse than this,
we have ost-algia,  ost-odynia, ost-agra,  and  osto-copus, to sig-
nify one and the. same affection of  the  bones   Now it may be
necessary  to retain  algia,  which  is  perhaps the most  popular  of
the whole, but we  should  as  far as  possible banish all  the rest;
and  with the exception of  agra  in  the single instance of pod-
agra, which  cannot readily be  dismissed,  none  of  the others
will be met with  in  the course of the ensuing  arrangement.
Parodynia will  indeed be found, but  in this case odynia is the root
itself.
  JEsis, osis, itis,  oma, and iasis,  have been  employed  perhaps
for  ages,  and  several  of  them  very  generally throughout the
Greek tongue, as  mere terminations,  without any direct  refer-
ence  to their origins:  and probably  without a recollection or
belief that  they have any significant origins,  or that  those ori-
gins can  be traced :  in  which  case they would become simple
terminating synonyms, and in the  ••bbreviating  aim of a tech-
nical nomenclature, ought  to follow the fate of the generality
of  the  preceding  list.    Some of  them,  indeed,  can  well be
spared ; but  accident, or a cause not  easy to be explained, has
given a peculiar and  useful  meaning  to  others,  though  very
different from  their radical sense, and these may  be  advantage-
ously retained.   The first  three are probably derived  from tu or
its different compounds,  and together  with  the Latin  term igo,
which is perhaps a corruption of ago, imply  the  common idea
of " ago,  milto," " motion, action,  or  putting forth,"  and con-
sequently,  in medical combination, of " morbid motion or  ac-
tion."  Esis (arte,) is a  direct derivative  from  tu, as is obvious in
paresis, literally  " submissio,"  " remissio,"  '* laxatio,"  " re-
straint or inability" of  " moving or putting forth;" whence  by
Aretasus, and various other Greek writers, it is used synonymous-
ly with paralysis.  We meet with  the same word  and the same
radical idea in proesis synesis, and other compounds of the same
root.   Osis (a<ri<; or  ovth)  descends in  like  manner from eipti,
"sum" itself a derivative of e«;  whence osia or ousia (an* or
ova-ia)  is  literally  " ens,  essentia,  substantia," the  thing put
forth " in being, action, or motion."   Itis (ims) is as clearly an
immediate  derivation from te^ai; itself,  like the preceding, a ra-
mification  from tu, and imports, not  merely action, but  when
strictly  true to itself,  " impetuous or violent action."   The lite- 
11
PRELIMINARY DISSERTATION.
 ral rendering of tercet is  "feror impelu," and that of irm is, " ie-
 merarius, audax,  praeceps periculorum."  While the direct  ori-
 gin of igo betrays itself in all  its compounds,  for vertigo (deriv-
 ing igo from ago) is literally  " rotatory motion or dizziness;"  ser-
 pigo, " serpentine motion or.course," peculiarly describing a par-
 ticular modification of herpetic eruption to which the term serpi-
 go is applied.
   lasis, and oma, convey different ideas as issuing from different
 radicals.  Iasis  (txnc) is literally sanatio,  from  'icto^cc, " sano,
 medeor," and hence  necessarily  imports, in composition, " me-
 dendus," or " ad  sanationem spectans."  Oma ('«,«.«) is  as obvi-
 ously an  inflection of '«^e?,  " crudus, ferus, imperfectus," as is
 its real meaning in sarc-oma> distinctly "crude, wild, imperfect
 flesh ;" atheroma, " crude,  incocted pulp or pap."  But if oma
 be preceded by the letters pt, as in ptoma (vrupupC) it is then deriv-
 ed from TrtTrra, " procido," and constantly importsprocidence or
prolapse; as  in  pro-ptoma,  "a  prolapse of any part;"  archo-
 ptomn,  " a  prolapse of the anus."   This is  sometimes  written
 ptosis, as in colpo-ptosis, " a prolapse of the vagina ;"  hystero-
 ptosis, " a prolapse of the uterus :"  but for the sake of perspicui-
 ty, and especially  to the  learner,  one mode only ought to be  ad-
 hered to, and perhaps the first is the best.
   Asma (*«><*)  is strictly " incantamentum," enchantment, in-
 cantation ; and, in a looser sense, possession,  seizure.   Osma,
 asmus, esmus,  and ismus, are  mere  varieties of asma; and that
 th^y were at  first  intended  to denote this  idea we  may judge
 from the terms phantasma, enthusiasmus, phricasmus, marasmus,
 ph< jnisnms, priapismus.   It became  long afterwards a terminal
 member of tenesmus, rheumatismus, ptyalismus, when  the ori-
 ginal sense was  nearly or altogether lost sight  of.  And  since
 this period  the  entire group have  been employed not  only  so
 generally, but in such a  multiplicity of  senses,  that  we can nei-
 ther banish  them  nor  define  them;  whence,  like esis and  osis,
 they must remain  to  be  had  recourse to as  mere  final adjuncts
 whenever necessary,  though  the  less frequently employed the
better.
   It is clear, then, as well from  actual analysis, as from  the ge-
 nius of the Greek  tongue itself, that each of these terminations
 had a distinct signification when  first introduced;  although  it
is equally clear that most of them have  for some centuries  been
 employed loosely  and indiscriminately  as mere final syllables.
In  many  instances none of  them are wanted; and  in all  such
 cases ihey ought, unquestionably,  to  be dropped as  redundant;
and, occasionally,  they have been so.   Thus  the  myopiasis  of 
PRELIMINARY DISSERTATION.              \[H
Vogel is advantageously shortened  by Plenck  to  myopia, as  at
first written  by Linneus;  and.  for the  same  reason,  mydriasis
ought to have been written mydria.   So chlorosis, if it were  to
be formed in the present day, would be chloria, and  exoneirosis,
exoneiria.  Many of the  terms introduced by Dr. Young seem
to be formed directly upon this basis, and are  highly entitled  to
attention ;  as phlysis, palmus, pneusis.
  In various instances,  again, we find,  as  already hinted  at, se-
veral of the terminations, apparently from some accidental cause,
taking  a  peculiar bearing which it would he right to encourage,
as long as they are retained, so as to give them a  direct and defi-
nite sense.   Such especially is  the  case with  itis,  which, from
the time of Boerhaave, has  been progressively employed to ex-
press organic inflammation, as in cephalitis, carditis, gastritis, and
most similar affections.   In this  sense, therefore, when employed
at all,   it ought to be employed exclusively.  And here the ety-
mological idea is directly consonant with the practical  : for, as ob-
served already, it imports increased and impetuous  action.   A few
terms only stand in our way, upon this point, even at present, as
rachitis, hydrorachitis,  ascites, and tympanites; all which, how-
ever, are of little consequence,  as they have good synonyms,  or
may be easily varied,  as the reader will perceive in  the ensuing
arrangement
  Oma has, in like  manner, from some  cause or other, a general
idea attached to its use, not easy to be explained from its primary
signification: it is that of external protuberance, and to this, there-
fore, it should  be confined.  We  meet  with this  idea in ecchy-
moma, staphyloma, atheroma, steatoma, sarcoma,  and carcinoma.
It does not easily apply to glaucoma ;  but as this was as frequent-
ly called by the Greeks  glaucosis,  and by the Romans glaucedo,
we  need  not be troubled  even with  this slight exception.   The
therioma of Celsus, though continued by Vogel, is banished from
general use,  and if it were not, this  would also admit of a ready
change to theriosis.
  Iasis is  almost as generally appropriated in the -present day
to denote  diseases of  the skin, unconnected  with fever; the
cause of which it  seems, also, as difficult to discover as in either
of  the  preceding instances:  but this  Deing the   fact,  the hint
should  be taken  and  ihe  necessary limit  applied.  We have
sufficient  exemplification of this  remark  in elephantiasis, leon-
tiasis,  psoriasis, pityriasis,  phthiriasis.  helminthiasis,  (applied
by  Plenck to cutaneous worms and larves  of all  kinds,  except
those of  the  pediculus, but  to  which malis is  preferable) and
tyriasis, importing in the same author  a peculiar variety of le- 
liv
PRELIMINARY DISSERTATION.
 pra.   To  these we may add  ichthyiasis, as in  this case  it ought;
 to be written instead of ichthyosis.   Many of these terms are
 unnecessary, and  may  be well spared, but they serve as  exam-
 ples of the general turn the final iasis has been  lately taking, and
 to which,  whenever it is made use of, it would be right to attend.
 Satyriasis,  sardiasis, and one or two other terms, form exceptions
 to the general  tendency; but  they  are  not  wanted, as will be
 readily perceived  in the ensuing  pages; while all but  the  first
 have  been  long obsolete, and are  almost forgotten.   Hypochon-
 driasis is not, strictly speaking, a Greek term.  It is comparative-
 ly of modern origin, and may he conveniently exchanged for hy-
 pochondrias.
   Cele (xviXri) retains generally,  to  the  present  hour,  its  original
 sense, which is that of " a yielding tumour," especially a yielding
 tumour produced by the protrusion of a soft part ; as in broncho-
 cele,  sarcocele,  glossocele, bubonocele.   Rhagia (pctyix) is, pro-
 perly  speaking, an elision of haemor rhagia,  from pyre-a, " rum-
 po,"  to burst or break; and  hence uniformly denotes a preter-
 natural flux of blood by the  bursting of one or more blood-ves-
 sels,  as  in  rnenorrhagia, rhinorrhagia, and enterrhagia.   While
 rhasa, (/>««*) from pea " fluo," to flow, imports, with almost equal
 uniformity, a preternatural flux of any other fluid, as in diarrhoea,
 gonorrhoea, leucorrhcea,  ottorfhoea.   In perirrhcea, as employed
 by Hippocrates in the sense  of enuresis, w have  an exception,
 as we have  also in the modern compound menorrhcea, which de-
 notes a natural flux, and in  a healthy  proportion.   But the first
 has long grown obsolete and  yielded to enuresis; and for the se-
 cond  we may employ catamenia, or menia  without  the preposi-
 tion,  which  is totally superfluous, and  omitted in  all the com-
 pounds of |t«jv, as also in the  Latin homonj'ms menses and men-
 struatio.   All these therefore may remain untouched, and are suf-
 ficiently correct in their present use.
   Odes (ahs) uniformly  imports " par,  similis," like or  akin to
the subject with which it is connected,  as in typhodes, icterodes,
 phlegmonodes : and  is probably  derived from *>&, " hoc modo."
   Ilia, ula, illaris, ularis, well known as Latin diminutive ter-
 minations,   are  perhaps  derived,   as will be  more particularly
 shown hereafter, from the Greek i)a»j, (yle  or ule)  "  materies,"
 and importing, therefore, " of the matter, make, or nature of,"
 as in papilla or pupula,  postula. fibula.  These are  opposed  by
 the suffix osus, uniformly a Latin augment, derived, perhaps, like
 osis, above,  from  in* or ovm*,  " substance,  essence,  power :"
 hence  undula is  " a litth" wave;"  undosus,  "full  of waves;"
 cellularis, " having little cells:" cellulosus,  " full of little cells." 
PRELIMINARY DISSERTATION.
IV
This distinction  has not  been sufficiently attended to by medical
writers, and  we have in consequence seen  the two suffixes occa-
sionally confounded.
  The prefixes or initial  particles or prepositions have far less
generally  departed  from  their  original sense, though  many  of
them exhibit  great looseness,  and very different  significations.
In grouping them we shall find that a, caco, dys, and para, though
separated  from  each  other  by shades of difference, are all pri-
vative or debasing; and that ec, ex. epi, hyper, though separated
in like manner, are all  augmentive  or elevating.  It  would  be
better perhaps that  a should be limited to  the idea of total pri-
vation, as in  agenesia, or aphoria: but the laxity of its use,  not
only through the whole nomenclature of medicine,  but the whole
of the Greek tongue, is an  effectual  bar to such  an attempt, as
we  may readily perceive in atonia, apucea, adipsia, asthen.a, in
which it is merely debasing or defective : and it is in this  sense
that it often becomes synonymous  with dys, para, and caco, as
in dyspnoea,  paralysis, and  cacodia (defective power  of  smell-
ing).   Dys,  indeed,  in  its strictest  sense,  should convey  the
double idea  of defect  with difficulty or distress, as in dysente-
ria,  and dysmenorrhoea;  and  caco  the double  idea  of  defect
with  corruption or depravity,  as  in   cachexia, cacophonia:  but
this distinction  has  been little  attended to.   Para occasionally
embraces  a wider range than any of the rest, and runs precise-
ly parallel  with the Latin male  or the Teutonic mes, or mis, so
frequent in compound  words of our own and  the  French tongue.
In anatomv,  however, ptlra is often  employed in the sense of
apud ovjuxta,  " bordering on, or hard by"—and in  words de-
rived from anatomy it retains this sense in the vocabulary of dis-
eases, as in parotis,  paronychia, with no small confusion  to  the
learner: and consequently gives a  sense that should be otherwise
provided for.
  It would be better still to avoid the use of all these prefixes as
much as possible, with the exception of a,  which  cannot be spar-
ed;  for, where  they convey the direct sense of a  they are  not.
wanted, and, where they, convey no  other than  that of general
morbid action, they are commonly,  though not  always,  super-
fluous expletives; since the  science in whose service they are thus
employed, necessarily  implies such an idea, as well without them
as with them.
  The opposite initials ec, or ex, epi, or eph', and hyper, denote
alike the general idea of out of, outwards, over„ above,  in their
primary sense, or when applied to  place, as  inectropium,epidemi-
cus, hyperostosis:  but that  of augmentation, or excess in their 
Ivi
PRELIMINARY DISSERTATION.
secondary  sense, or when applied  to quantity or quality, as in
ecstacis, epiphora, h} peruresis.
   En is an initial of very extensive range  as  well as  significa-
tion ; and  it has this peculiar property, that, -in different senses,
it  becomes  an  antagonist to both the  preceding  groups in the
one or other of their general meanings.  In its  primary sense,
or as  applied to place, it imports within, below; as  in  encepha-
lon, emphysema;  and  consequently opposes the  primary sense
of ec, epi,  hyper: while in its secondary sense, or as applied to
quantity or  quality,  it  exactly accords with these prepositions,
and imports superiority or  excess,  and in like manner opposes
the general idea  conveyed  by a, caco, and  dys; of which we
have  examples in enthusiasma and enuresis.   En appears there-
fore to be  as necessary an  initial particle in the medical voca-
bulary as a;  and with these two  we should  seldom  feel at a
loss for any other: for as a  is capable of supplying the place of
all the rest in  the first set, so en is capable of performing the
same  office for those  of  the second.   Hypo (J?™)  in its  significa-
tion of below or downwards, is sometimes called upon to act the
part of an  ally, as in hypogastrium,  and  hypocondrinm,  and
their  derivatives hypogastrocele, and hypocondrias,  or nypocon-
driasis; but this is seldom the case,  and at all  times obtrudes  an
assistance,  of which  en is not in want: whence  hypo might
easily share in the preceding proscription.  In  this  general view
of the subject, en seems at  first sight to be  untrue to itself:  but
it is not difficult  to explain the apparent contradiction.   En runs
precisely parallel with the  Latin  alte.  The leading idea of both
is  "power or precedency;"  and this,  whether the order of ad-
vance be from below upwards, or from  above downwards.   In
measuring rank and station,  we take the former scale, and speak
of high posts and  dignities; in  measuring  intellectual  qualities
we take the latter, and speak of profound judgment and wis lorn.
The Greek en and the Latin alte are equally applicable to both ;
and hence it is that in our own tongue, and, indeed, in  most of
the dialects of Europe, high and deep occasionally become syno-
nyms, and the same general meaning may  be  expressed by ei-
ther.  In one respect, indeed, the Greek and Latin terms differ;
the former  importing depth  in its primary, and height in its se-
condary sense; and the latter importing height in its primary, and
depth in  its secondary sense.  In all these  cases,  however,  the
difference of the two meanings is  easily understood by the con-
text,  and it would be hardly worth while to  attempt to  limit the
Greek en to either sense  if we were able.  Eti'is a short and 
                 PRELIMINARY DISSERTATION.             lyii

tractable initial, and must remain equally to form a contrast with
a, and with ex or epi; in the former case,  to import ascendancy
or superiority, as being applied to quantity or quality, and in the
latter case to import descendancy or inferiority, as being applied
to place ; with which distinction before us  its meaning can never
be mistaken.
   A word or two will suffice for the remaining  prefixes.   Cata
(kxtx) and apo (<**•«) are  two of the most frequent.  They have
been  very little  introduced  into  nosological terms of late; but
in those of early writers are  far more frequent, and exhibit  a
great  variety  of senses;  most  of  which,  however, in respect  to
either  prefix,  are capable of   being  resolved  into  the general
idea of iteration  or duplicate  action,  or  ideas  that  obviously
ramify from  this  fountain, and which   are  usually  expressed
by the Latin and English  particle  re ; as  in catapsyxis,  refri-
geration ;  cataspasma,   re-traction;  eatamenia,  re-menstruation
(importing  its regular  return); apostema, re-cession, abscession
or abscess;  apothesis, re-placement  or reduction of a  dislocated
bone.   Whence again apo is  occasionally used  in the sense  of
back  or from, as in apogeusia, apositia,  backward, tardy, defec-
tive taste or  appetite; while both are far  more  frequently used
emphatically  or  in  a  superlative sense, as importing reduplicate
action or double force ; of which  we  have  examples  in  catacau-
ma, a burn ; catagma, a  fracture ;  catalysis, for paralysis, ca-
tarrhus,  apoplexia, apocyesis (parturition.)   In this signification
both are evidently redundant;  nor are  they much wanted in any
other.
   Peri (nipt) continues  uniformly true to  the  sense of circum,
and is limited to terms derived from anatomy, as  peripneumonia
and peritonitis.  Dia (ha) is nearly  as single in its meaning;  or
rather the different significations in  which it,is used are capable
of being arranged under one  leading idea, that of separation,
which is  the only idea it should  be  allowed to convey,  if ever
employed in  the coinage of  new  terms.   We trace  this general
sense  in  diabetes and  diarrhoea,  " a  passing  off,  or flowing
through;"  diacrisis and diagnosis, " a judgment or distinction,
by the separation of one symptom  from another;"  diastole and
diastasis, " a  dilatation or  separation  of part from part."  Syn
(<rw) and its derivatives sym and  sy, are uniformly expressive  of
conjunction or association.
   Such are the significations assigned  to  these auxiliaries  when-
ever employed  in the  ensuing system; the author has,  never-
theless,  endeavoured to employ them  as seldom  as  possible,
and  always in a definite sense.  The elassific  names are given
    vol. v.—S 
lviii            PRELIMINARY DISSERTATION.
 entirely  without them, and  the  ordinal nearly so.  In this re-
 spect he  has differed from  Dr. Young, who has prefixed the pre-
 position para,  importing diseased action, to the  name of every
 class, but the  last, in which it  is exchanged for ec.  But this
 seeois a pleonasm ;  for in  a system directly nosological, para is
 necessarily implied  in every instance.  Neuroses or neurismi is
 just  as expressive as paraneurismi;  and haemorrhagise, or haema-
 siae,  as parhaemasiae.   Linneus has  been  very  particular  upon
 this point; and has never  introduced  compound terms,  but when
 he has  thought  them  strictly called for.   In  consequence  of
 which we  have mentales, quietales,  motorii, without  any  affix
 whatever.
   But though the author has felt no occasion for these auxiliaries
 in denominating his classes^ and but  little  occasion for them  in
 the names of his orders, in his generic terms  he has often found
 it necessary to have recourse to such assistance; in some instances
 because,  though evidently  redundant, the  affix could not be de-
 tached without  the appearance of affectation; but'more  frequent-
 ly for the purpose of  distinguishing the names  of different  dis-
 eases, compounded of the  same radical term : as  in phyma, ec-
 phyma, andemphyma; phlysis, ecphlysis and emphlysis;  ecpy-
 esis and empyesis, with various others  ; which, thus compounded,
 present, at the same time,  their relative points of accordance and
 of discrepancy,  and are consequently  more easily,  instead of less
 easily, distinguishable.
   4.  As the component parts of a term ought  to be restricted to
 a precise and individual meaning,  so ought the entire term, whe-
 ther compound or single.   The common signification of asphyxia
 is ''.apparent  death," whether from  suffocation,  electricity, or
 any other cause.   Plouquet, in  his  Initia, has applied this term
 to " a temporary suspension of the pulse, while all the other func-
 tions  of the system,  whether corporeal or mental, continue  with
 little  or no interruption."   The term in its original sense (et<r0v%tcc)
pulselessness,  will bear Plouquet's meaning, but it  is at the ex-
 pense  of its general  interpretation : and lience,  as the disease al-
 luded  to by Plouquet has not yet fairly found a place in nosology,
 and no other term has been devised for it, it  will be found distin-
 guished from asphyxia in the present system  by the term acro-
 tismus, of meaning precisely parallel.
   There  is  a  strange  confusion in the general  use of the terms
 hemeralopia and nyctalopia.   Most modern writers mean by the
 first,  *' vision, irksome, or painful, in the light of noon, but clear
 and  pleasant in   the dusk  of the  evening;" and by the second,
 (l vision,  dull  and confused  in the dusk, but clear and powerful 
PRELIMINARY DISSERTATION.
lix
 at noon-day."  But  this is directly to  reverse the signification,
 of both  terms,  as  employed  by  Hippocrates  and  the Greek
 schools ; and as the Greek sense  is still occasionally continued,
 there is sometimes no small difficulty, and especially to a learner,
 in understanding what  diseases are referred  to.  In the ensuing
 system  most disorders of the sight,  unconnected with inflamma-
 tory  action,  are arranged under a common genus, entitled parop-
 sia, of which hemeralopia and nyctalopia become species ; and as
 they  are here distinguished  by the names of p. lucifuga, and p.
 noctifuga, it is hoped that  the usual'  perplexity will be found
 sufficiently avoided.
   ASsthesia, among almost all the nosologists, imports sensation
 generally; and hence dysesthesia is  employed by Sauvages,
 Vogel,  Sagar, and Cullen,  as the name of an  order, comprising
 diseases of sight, smell, taste, touch, and hearing; running pa-
 rallel with the order ^esthetica, in the class neurotica of the
 present  system.  But Cullen, after having used  the term as  an
 ordinal  name in this general signification, next employs it as the
 name of a distinct genus in  the very limited signification of touch
 alone, and in contrast with  all the other senses;  anaesthesia, the
 genus referred to, being defined " tactus imminutus vel aboli-
 tus."   Linneus,  indeed, had already used it with an equal re-
 striction,  which he ought not to have done, as the term had  been
 already  adopted by Sauvages  in  its wider  and correcter sense.
 But Linneus has not  fallen  into  the self-confusion  of Cullen ;
 for he has not employed aesthesia or any of its  compounds  in
 any other import.  To  avoid this irregularity  the  anaesthesia  of
 Linneus  and Cullen is, in the  present system, exchanged for
parapsis.
   Exanthema, among the  Greeks imported  " cutaneous  erup-
 tions  generally."   Sauvages, and all the nosologists down to
 Cullen  inclusively,  together  with most  other medical writers,
 have  limited it  to express  " cutaneous  eruptions  accompanied
 with fever."  Attempts have more lately been made to fetter it
 within a  still narrower circle;  sometimes by confining it to
 "eruptive fevers produced  by specific contagion" whatever be
 the character of the efflorescence ; and sometimes by restraining
 it to the character of the " efflorescence alone,  with little atten-
 tion to its being connected or unconnected with fever."  It  is in
 this last view that the term has been employed  by Dr. Willan,
 who limits it to the import of the English term rash, and in his
 list of definitions, explains  the one term by the other.  la  this
 confined use Of the word, however, he does not always niacin
 his accustomed  precision; for after having, in his  table of defi- 
Jx
PRELIMINARY DISSERTATION.
nitions, characterised rash  or exanthem  as  distinct  from papula
and  wheal,  he employs exanthemata  as the name of  an order
embracing diseases  distinguished  by both these symptoms.  In.
Dr. Willan's very restricted use of the term there is great incon-
venience, and but little or no authority in his favour; and hence
in the ensuing system it is restored to its common nosological ac-
ceptation.
   The limits of the present  sketch will  not allow  the author to
pursue this subject much further; but it  is necessary to  observe,
before he entirely drops it, that there are various terms, in com-
mon use in nosological descriptions,  whose meaning in like man-
ner  remains in  a very unsettled  state to the present  hour; and
which it will be the object of the ensuing attempt to simplify and
define.   As examples it  may be sufficient to glance at the words
pyrexy, apyrexy, paroxysm, accession,  exacerbation, crisis.
   Fevers were called by the Greek physicians pyreti,  pyrectici
morbi, or  simply pyrectica.*  Pvrexia,  (febricitatio,  rather
than^e^m), was in  a looser se,nse applied to fever generally,  but
limited,  when more strictly employed,  to febrile  heat and  in-
creased pulsation.   The  duration of the cold  and hot stages was
called its paroxysm, and the interval between one paroxysm and
another was distinguished by the term apyrexy (airvpt^t*). What
the Greeks called paroxysm the Latins named accession, (accessus,
or accessio);  for the apyrexy of the former, the latter employed
the term intermission (intermissio), and  if the interval were only
a remission,  instead  of a perfect  intermission, the return of  the
hot fit was denominated exacerbation  (exacerbatio); which in
fact  is a direct translation of paroxysm ;t so that an exacerbation
was the same correlative to a remitting,  as an  accession was to an
intermitting,  fever.   The  duration of a single exacerbation and
its remission, or of  a single accession and  its intermission, was
denominated a febrile period.
   Sauvages  employs the  whole of these terms  with  a  pretty
strict adherence  to  their original meaning;  but  by Cullen and
still later writers they have been used with much greater laxity,
and, occasionally, in very different senses.   Like many of  the
Greek physicians, Dr. Cullen has proposed a difference between
pyrexy and pyretus or febris;  the  former of  which terms
he is well known to have taken as the  name for his first class
of diseases.   While, however, he proposes a difference between
* Ylvpiroi, irupwruiz voa-yi/uAra, ■nupw.ruut.
\ Tlxpo%u<rfjios, " incitatio, exacerbatio," from ?r*/« and if«« acutus. 
PRELIMINARY DISSERTATION.
Ixi
these terms, it is not that of the Greek  schools, but altogether
of his  own invention; Tor instead  of limiting  pyrexy, as was
done by the Greeks when they allowed a distinction, to  the mere
symptoms of increased heat and  increased pulsation, correspond-
ing in a considerable degree with what is now usually called the
second stage of a  febrile  paroxysm, he has connected shivering,
or the chief symptom of the first stage,  with it, together with
the  symptoms of "various  injured functions, and  diminished
strength  in the  limbs."*  By this addition, however, he has
considerably overshot his  own mark; for he has not only given a
new sense  to the  term,  but has  frustrated the distinction he in-
tended to establish; insomuch, that  when he  proceeds  to  define
fever by its ordinal character he  has nothing of any real import-
ance to add; for fever in  his  ordinal definition of the term  is still
pyrexy,  though pyrexy  with the comparatively trivial  appen-
dage of " previous languor, lassitude, and other signs of debi-
lity,  without primary  local disease;] and  hence, moreover^
the term  pyrexia, upon his own interpretation, applies but very
indifferently, as a elassific name to any of Dr. Cullen's remaining
orders, except exanthemata ^  for it is rarely that inflamma-
tions or hemorrhages, his other orders, are preceded by shi-
vering,  or accompanied  with  lesion of various  other  functions
than that belonging to the organ affected, although they usually are
accompanied  with " increased heat  and pulse," or  pyrexy, in
the Greek  restricted sense of the term.   It is not to be  wondered
at, therefore,  that this distinction of Dr. Cullen between pyrexy
and fever,  should have appeared to later writers as perplexed or
nugatory;  and it was probably under some such feeling that Dr.
Parr, and  still more recently Dr. Young, in  laying  down their
respective  systems, determined  upon abandoning all distinction
whatever,  and upon employing  pyrexiae  and fevers  as synony-
mous, or rather univocal terms.  It is  necessary, therefore, to
point out the discrepancy that is at  present prevailing in medical
technology upon  this subject.   In the restricted sense  in  which
the term was employed by the Greeks it seems  useful and  neces-
sary; for we have no other by which we can so well or  so shortly
indicate those peculiar febrile symptoms which connect the  family
of phlogoses or phlegmasia? with that of simple fevers; and it is
in this  sense,  therefore, as  importing  the joint idea  of febrile
heat and augmented pulse,  detached from the  ideas of shiver-

  * Post horrorem pulsus frequens, calor major,  plures functiones Ixsae, viri-
bus pracsertim artuum imminutis.
  f Praegressis languore, lassitudine, et aliis debilkatis signis, pyrexia, sine
morbo locali primario. 
lxii
PRELIMINARY DISSERTATION.
 ing,  languor, and various injured functions, that the term pyrexy
 will be employed whenever had recourse" to in the ensuing pages.
   The term accession has of late years undergone a still greater
 change in its meaning than pyrexy.   It has been just observed
 that accessio or accessus was employed by the Latin  writers in a
 sense precisely parallel  with the  Greek word paroxysm; and
 that either embraced the cold and hot  stages of a febrile seizure,
 the only stages into which such seizure was divided.* And hence
 paroxysm is a term not to be found  in Celsus, who uniformly em-
 ploys accessio  in its stead.t
   Among recent writers, however, and perhaps generally in the
 present day, while the term paroxysm  is applied  not merely  to
 fever-fits, but  to  fits  of every  violent and  intermitting  disorder
 whatever, the term accession is limited to the commencement or
 onset of a fit,  its  insultus,  as denominated  by the Latin writers;
 and hence Dr. Cullen  speaks of the "accession of paroxysms,"J
 a phraseology  which  would be  nonsense upon the original  mean-
ing of the terms;  while Dr. Turton. with  evident indecision upon
the subject, defines accessio, in his  Glossary,  " the beginning or
paroxysm of an intermitting fever,"  (allowing the reader to take
which sense he will);  and paroxysmus  " an access,  fit, or exa-
cerbation of a disease;" giving a still greater latitude, as well in
respect to the  genus, as  the stage of the morbid affection.   The'
Latin translators of Galen adhere to the original signification ; and
hence what  Cullen calls the " accession of paroxysms," is in their
language  " incrementa accessionum  :"§ and the  same import  is
given to the terms  access  or accession by Sauvages, who in de-
scribing the simple quotidian fever says,  " duratio accessus octo.
  * The paroxysm or accession embraced the whole course of a fever-fit of
whatever length, till its declination, which was not accounted a part of the
paroxysm;  and hence Celsus divides its entire range "intoaccessio and decessio.
In later times the declination has been taken into the general account;  and
the course of a fever has in consequence  been said to possess three stages,
distinguished by  the names of insultus or invasio, decvrsus, and declinatio.
The humeral pathologists who held that fever was an effort of nature to throw
off from the constitution, by a process of concoction, some peccant  matter
in the form of scum, denominated these three stages, after the  language of
Sydenham, horripilatio, ebullitio, and despumatio.  These terms, however, to-
gether with hundreds of others derived from the same mint, have long sunk
into the grave, with the hypothesis that gave rise to them.  So dangerous is
it to construct a technical vocabulary upon a basis of hypothesis.
  ■j- See especially Lib. III. cap. ii.Tii.
  i " Though the intervals of paroxysms are different in different cases,  yet
the times of the accession of paroxysms are generally fixed to one time of the
day."  First Lines, chap. III. sect. lvi.
  § Manifestissime, autem, etin hacfebrein invasionihus, atque incrementis ac.
cessionum, signum putrefactionis apparet. GaZ.de Differ. Febr. lib. II. cap. iv 
                  PRELIMINARY DISSERTATION.             J^

 decim horas non excedit ;»* and observes of the  quotidiana  sub-
 tntrans " accessus ad vigcnti quatuor horas ferme extenduntur."t
 i^ven in Cullen the term seems  sometimes to be employed  as a
 synonym for paroxysm, as in  his definition  of hectic} fever, in
 which accession  is opposed to remission  or apyrexy ; while in
 his definitions of the tertiau§  and quartan,||  in which' the words
 paroxysm and  accession are both  introduced, the latter is designed
 evidently to  import the commencement or first stage of the  for-
 mer,  or "the  accession of the paroxysm," as in the passage just
 referred to;  that which by Hoffman was elegmtly  and correctly
 denominated the  spasmus peripherics, or general spasm of the
 small  vessels diffused  over the entire surface ;  in popular lan°-ua£re
 the shivering-fit.                                         °  & '
   It is not difficult to account for this con fusion of sense : for  not-
 withstanding  the general appropriation of the  word accession
 among the Latin  writers to the whole duration of a fever-fit, or
 what is now  called a  paroxysm, its  radical  idea imports  simply
  advance, approach,  entrance, avenue;"   and in this meaning
 Celsus  himself is perpetually using the term  in its verbal form"
 and occasionally, indeed, in connexion  with accessio in its tech-
 nical  signification,  as  " donee altera  accessio  accedat,"1i
 " till another accession  accedes or conies on."
   Fordyce,  probably  from its complicate meaning, has banished
 the  term accession altogether, and introduced the phrase cold fit
 in its stead,  retaining, however, paroxysm  in its modern and po-
 pular sense:  so that,  according to him,  an ephemera  is a fever
 consisting  of one paroxysm, which paroxysm comprises  three
 stages,  "a cold fit, hot  fit, and crisis."   And here we have a new
 sense assigned to  the term crisis.  Among the Greeks it is very
 well known  to  have imported a decision or determination of  the
 disease ; and hence critical days were,  amongst them, days which
 produced  such decision or  determination.   With Dr. Fordyce,
 however, crisis imports nothing more than  the decision or deter-
 mination of a  single paroxysm of a disease, its decline or sweat-
 ing stage.  Whilst, by  many of  the humeral  pathologists, the term
 was  used in a different sense  from both these and signified  syno-

  * Class II.  ord. III. torn. ii. p. 347.
  f Class 11. ord. HI. torn. ii. p. '347.
  * Febris quotide revertens, accessionibus meridianis et vespertinis, remissione
rarius apyrexia matutina   Gen. VI.
  § Paroxysm similes, intervallo quadraginta octo  circiter horarum; acces-
sionibus meridianis. Gen.  I.
  || Paroxysmi similes, intervallo septuaginta duarum circiter horarum; acces-
sionibus pomeridianis.
  % Lib. III. cap. iii. 
lxiv            PRELIMINARY DISSERTATION.
nymously with the despumatio of Sydenham, the separation and
discharge ofthe crude and morbid material which  was the sup-
posed cause of fevers, without any reference to particular days, or
particular stages of a paroxysm.
  It is high time,  then, that an exact sense should be fixed for the
whole of this group of terms; and with a view of accomplishing
this object,  as far as he is able,  the  author will  be found in the
ensuing pages uniformly to employ, 1. paroxysm, as importing
the entire duration of  a fit of  acute  disease of any kind, whether
the interval  be perfectly or imperfectly free :  2. exacerbation,  as
signifying the paroxysm of a  disease,  whose intervals are merely
imperfect or remissive; which is the strict meaning of paroxysm
when  literally rendered:  and, 3.  accession, as  indicating the
commencement or onset of an exacerbation or  paroxysm of any
kind; which restores the term to its radical idea; whilst he has
omitted the use of  the term crisis,  as neither wanted nor convey-
ing in the present day any determinate sense.*
  II. But it is  an  object of the ensuing pages to attempt an im-
provement in the  arrangement of diseases, as well  as in the
language employed to describe them.
  A knowledge of the animal frame involves a deep  and compre-
hensive  acquaintance with  three  distinct  branches of natural
science; anatomy,  by which we   become  acquainted  with the
structure of this frame; physiology, which  teaches us its various
functions;  and nosology or pathology, which unfolds  to us the
diseases  to which  it is  subject.   Unfortunately each  of  these
branches has hitherto been taught by a different,  instead of by a
common,  method; and hence  the student, instead of proceeding
with each at one and the same time, and with a single expenditure
of labour,  is compelled to apply himself  to  every one separately,
and by a kind of new and unconnected grammar.
  The great  and comprehensive  mind  of Haller  was forcibly
struck with the expediency of uniting the whole into  one com-
mon pursuit.   In  his  " First  Lines"  he gave scope  to  his feel-
ings  upon  this subject;  and  since his, day various efforts have
  * It may not be improper to mention here, that where foreign words are fully
adopted into English, and used with an English termination or inflexion, the
author has spelt them, in the ensuing pages, agreeably to the rules that regu-
late vernacular terms:  thus preternatural is used instead of preternatural, alter
the manner of pretext and pretencje,- edematoues instead of edematous, after the
manner of economy,- gass instead of gas or gaz, after the manner of all simi-
lor monosyllables, whether verbs or substantives; as glass, grass, pass, bliss,
miss, loss, cross, dross,- and fetus, which frorn/eo, "to bring forth," is the old,
and, perhaps, the best mode of spelling it even in Latin, instead of fetus of
later date. 
PRELIMINARY DISSERTATION.             lxy
been  made to concentrate  the' studies of  physiology and ana-
tomy.   Much, however,  stifl remains to bring even  these two
branches  into that  state of  close contact  and parallel investiga-
tion for which they  are  so admirably fitted, and  which would
equally add to the perfection of both:  while  the view which
has just been given of the general history  of nosology, affords
a sufficient proof that no systematic step whatever has  hitherto
been  taken  to  incorporate the elementary study of animal dis-
eases either with that of  the animal structure or the animal eco-
nomy.
  To accomplish such  an incorporation is  the object  of the en-
suing system ; the whole edifice of which will  be  found  to  be
erected  on a physiological basis;  and to  run parallel  with the
divisions  into  which  the  science  of physiology  most usually
ramifies.  The track is new;  and difficulties  of  no ordinary
magnitude  have  been encountered in  the prosecution  of  it.
The author does  not flatter himself that  the whole of these are
by any  means removed in this first attempt: but  he  trusts that
he will be found to have pointed out a  useful  though an unex-
plored  course, and that  future pioneers  may be  able  to level
and complete, what he may thus far have left rugged and unmas-
tered.
  Having conceived the  possibility Of  a nosological  system*
Whose primary divisions should take a physiological range, and
follow up the diseases of  'the animal fabric in the order in which
the physiologist  usually develops  its organization  and its func-
tions, the author had  next to determine at which end  of the se-
ries he  should begin ;  whether,  with  Halter,  at the  first and
simplest vestige of  the living fibre, and pursue the growing ens
through all  its rising  stages of evolution  and elaboration  to  its
maturity of figure and  sensation;  or, with  the  physiologists  of
later times,  to take at once the animal frame in  its mature and
perfect state, and trace it, from some well-defined and prominent
function,  through  all the rest; which, like links in  a  circular
chain, may  be said to issue from it,  and  to  be dependent on  its
existence  and properties.
  The author was soon led to a preference of the second scheme.
It is  by  far the simpler of the  two, and  directly harmonizes
with the fundamental principle,.which runs through all the sys-
tems of zoology, botany, and  mineralogy,  of  forming  the  ar-
rangement and selecting  the characters from the most perfect
individuals as specimens   He decided, therefore,  upon taking
the more prominent functions of the human frame for his pri-
mary or elassific division, and the more  important of their re
  vol.  v.—9 
lxvi
PRELIMINARY DISSERTATION.
spective organs for his secondaryor ordinal;  and without tyeing
himself to  a particular distribution of the former in any autho-
rized or popular use at the present  moment, to follow what ap-
pears to be the order of nature in her simplest and most intelligi-
ble march.
  To repair the  exhaustion which  is  constantly taking place in
every part of the body from the common wear and tear of life,
it  is necessary that  the  alimentary  canal  should  be supplied
with a due proportion  of food,  the  procuration of which, there-
fore, constitutes in savage as well as in civil society,  the first con-
cern of mankind.  The food, thus procured  is introduced into a
set of organs admirably devised for its reception ;  and  its elabo-
ration into  a nutritive form constitutes what physiologists  have
denominated the digestive function.  The diseases then to
which this  function is subject will- be found to create the first class
of the ensuing system.
  The food thus far elaborated  has yet  to  be  conveyed  to the
lungs,  and be  still further  operated upon by the atmosphere, be-
fore it  becomes duly assimilated to the nature of the fabric it has
to support.  The function of respiration embraces this part
of the  animal economy;  and the diseases to which this  function is
subject form the second class of the arrangement.
  The blood now matured and  consummated is returned to the
heart,  and sent.forth,  in a circular  course, to every organ of
the body,  as the common pabulum  from which it  is  to secern
what it stands  in need of: the waste blood  being  carried  back
to the fountain from which it issued.   It is this circulatory track
that constitutes the sanguincous function; and the diseases by
which  it is characterised  form the  third class of  the ensuing
pages.
  But the blood does not circulate by  its  own power.   From
the brain  which it recruits and refreshes,  its vessels (perhaps
itself)  receive a perpetual influx of that sensorial energy which
gives motion,  as the blood gives food, to  the entire machine;
converts the organized into an  animal  and  intellectual system,
and forms  the important sphere of the nervous function.  This
function, also,  affords  scope for a large family of diseases; and
hence we obtain  a ground-work for  a fourth class upon the plan
before us.
   Such is  the progress towards perfection in the life  of  the  in-
dividual.   But man  is not born to  be an individual;  he is de-
signed to perpetuate his species ; and the last finish  to his frame
consists  in giving full development and activity to the  organs
which are  subservient  to this  purpose.   We now arrive at the 
PRELIMINARY DISSERTATION.
Ixvii
sexual function ; and  obtain from the diseases by which it is
marked a fifth class for our use upon the present occasion.
  As every  part is thus  receiving  new  matter from the blood,
it  is necessary  that that which is superseded  should be carried
off by proper emunctories: as it is also necessary that the an-
tagonist processes  of restoration and  detrition should  maintain
a fair balance.  And hence the minute  secretory and absorbent
vessels hold the same relation to each other as the  arteries and
veins,  and conjointly create  an excernent  function; whose
diseases lay a foundation for the sixth class of the ensuing syste-
matic attempt.
  It will yet remain to create a class for  external accidents,
and those accidental misformations which occasionally dis-
figure the fetus of the womb.  This will constitute the seventh;
and  under these  seven  classes it will  possibly be found that all
the long list of diseases may be included which man  is called to
suffer, or the art of medicine to provide  for.
  The  succession  is  here  easy and  natural:  every class, at
least  with the exception  of the last, leads  immediately to that
which follows it;  and the  student will at once  comprehend its
scope, and readily retain  its  arrangement.   The  order is  strict-
ly physiological; but it is  not exactly  the order which has hi-
therto been laid down by any of the  writers upon this subject,
as it is  more simple than  that of most of the systems, and  more
catenated than that of several.   Daubenton's, which, if not the
earliest, is one of the earliest of those entitled to the  character
of  a system, is unnecessarily extensive and complicated  for  a
medical purpose, though  highly ingenious and useful in a  zoo-
logical  view.   In this the chief  divisions are taken from the or-
gans rather than from the  functions,  which  is an inconvenient
arrangement, and  not altogether  scientific.  Dumas improved
upon this plan;  but it is to  Vicq-d'Azyr that we are indebted
for the first perspicuous attempt  upon a  basis oj*  functions; and
his attempt has been rather enlarged  than  matured, by  several
later writers,  and  particularly  by M.  M.  Richerand  and Bi-
chat.   Under Vicq-d'Azyr the  order of succession is  nearly
the  same as in  the present classification,  with  the  exception,
that it closes with sensation instead of with secretion; but the
number of general functions instead of  being limited to six is
extended to nine; the additional functions being those of nutri-
tion, ossification, and irritability;  of these, however,  the two
last have been  rejected  by Richerand  and Bichat, and the offices
they refer to, merged in the excernent  and  nervous functions:
by which means  the  system  of  the  former is reduced  to the 
Ixyi^            PRELIMINARY DISSERTATION.
present scale, with  the exception of the office of nutrition, or
the conversion of the common food of the blood into the sub-
stance of the various organs to which it  is applied; but which,
if accurately examined, is  as strictly  a part of the  excernent
function as ossification, or  the nutrition of the  bones, which
these  physiologists  have correctly  transferred  to this  division
of the animal economy.   The  process of  growth  or nutrition,
is, in  reality, that of secretion : every organ secerns  for itself;
it separates alike what  is  proper  to  be parted  with as  waste
matter, and what is proper to be received  as a  restorative  and
augmentive substance.  It  throws  off the  first, and  assimilates
to itself the second.  And  hence  the processes of secretion  and
absorption  are but parts of a common  function : conjointly they
form  a circle, and as it  has been  already observed,  hold  the
same  relation to each other as the offices of the  arteries and  the
veins.
   But though M. M. Richerand  and  Bichat have  in  these  re-
spects  simplified  the arrangement  of  M. Vicq-d'Azyr,  they
have upon the whole  considerably widened and  complicated it
by a  partition of several of his  primary divisions, which they
still  retain, into  separate  functions  :  in  consequence  of which,
while Richerand  gives us thirteen distinct  general functions of
the animal economy, together with  an appendix,  Bichat  ex-
tends the list of  functions to not  less  than twenty.   Whatever,
therefore,  be the merit of  these minuter arrangements,  it  must
be obvious that they are not adapted to the  present purpose; and
it is unnecessary  to pursue them further than to observe that some
of the additional  matter they contain is  derived from the functions
of fetal life; and that this, so far as  it relates to organic deformi-
ty, runs parallel with the seventh  class in the arrangement before
us.
   The orders in  this arrangement are  taken from what  the  au-
thor hopes will be found an easy distribution into natural groups
of the organs thaf appertain to the elassific functions, with the  ex-
ception of  the third class, in which they are derived from the  pe-
culiarity of the vascular action, and  the temperament of  the cir-
culating fluid.
   Some of the genera are  new, for the purpose of enlisting  un-
der so many common banners diseases which  have hitherto been
held  as distinct genera, but  which  ought  rather to have been  re-
garded in the light of mere  species : as adipsia, and polydipsia ;
the several diversities of morbid appetite, as  bulimia,  anorexia,
pica,  cardialgia;  the numerous family of visceral  inflammations,
as pleuritis, gastritis,  peritonitis;  the  exanthems  distinguished 
PRELIMINARY DISSERTATION.
lxix
by a rash eruption, or a vesicular eruption, with various others ;
by which the study of nosology will be found simplified, and, in
some  sort, abbreviated, rather  than perplexed  and protracted.
In proof of which it may be sufficient to remark, that on reckon-
ing up the number of the genera under which,  upon the present
system,  all the diseases of the animal frame are reducible,  and
whieh the author has never done till this  moment,  he perceives
that they do not quite  amount to a hundred and thirty.   It  is
easy indeed to make a genus too lax  and extensive, and to asso-
ciate under its name  species which have no anology with each
other; and several of our latest  nosologists, in  the  laudable en-
deavour  to  avoid the  frittered  and dislocated arrangement of
some of  the  earjier systematic writers,  have run into this ex-
treme.   The aim  of the author,  however, has  been to steer in
the midway of the two ; to generalize as far as the thread of con-
nexion will allow; but never to congregate where its continuity is
broken off.
   Every  nosologist has felt more difficulty in distinguishing be-
tween  species and varieties,  than in forming classes and genera.
And it  is here, indeed, that the  deficiency of our nosological
classifications is  chiefly conspicuous when compared with those of
plants  or animals.  Yet in many cases the line is as distinctly laid
down, and may be as accurately followed up.  Thus in Dr. Cul-
len's system, variola or small-pox is made a genus,  and the dis-
tinct and confluent kinds are termed species.  " But  as infection
from the  distinct kind  frequently produces  the  confluent  kind,
and that  of the confluent kind frequently produces the distinct,  it
would  seem  more analogous to botanical arrangement to call the
distinct and confluent small-pox varieties than species.  Because
the species of plants  in botanical systems propagate others similar
to themselves ; which does not uniformly occur in  such vegetable
productions as are termed varieties."*   And it is  equally clear that
variola should be regarded as a species, and not a genus ^ since
otherwise the classification would lose one of its most important
links,  and the varieties be without  a disease to  belong to ; for  a
genus  is no disease whatever, any more  than it  is an animal or a
vegetable.
   In many instances we  can  trace the variety  to  arise   from
some local peculiarity, as of soil or climate: and this, too, as
clearly among animals  as  among plants.   Thus  the sheep, that
in Europe produces a woolly coating, in Angora and some other
* Darwin. Zoonom. Part. IT. Pref. 
lxx
PRELIMINARY DISSERTATION.
parts of Asia Minor,  has  this coating converted  into  a glossy
silk;  and  in  the opposite coast of  Africa  into  a  coarse hair.
So the Cuba swine which were imported into that island, in  1509,
from an European stock, have nearly doubled their original size,
and have acquired the singularity of a broad solid  hoof, instead
of having a cloven foot.  These  diversities are striking: but they
are not more so than the symptoms which accompany the  erysi-
pelas in a bleak northern village, when it assumes a phlogotic or
phlegmonous character, and in  a  southern  crowded metropolis
where it must be treated with cordials and tonics : or those which
distinguish the  gout in a firm  and vigorous  constitution which
violently drives off the disease by the outlet of a  hand or  foot;
and in a delicate and atonic  frame in which it wanders from  or-
gan to organ for an indefinite term of time, assuming every day
a new disguise, and  though less violent  in  its action, far  more
mischievous in its effects.  Under the greater number of nosolo-
gical systems these diseases are ranged  as  distinct  genera, and
the diversities they thus exhibit from peculiar circumstances, form
so  many species.   Upon the common  principles,  however, of
botanical and zoological systems, the former ought only to be re-
garded as a species, and  the  latter as the varieties incidental  to
them.  The author has endeavoured to adhere to these principles
as far as possible ;  and, hence, whenever the symptoms of  a dis-
ease are merely diversified by peculiarity of constitution, of local
attack, or of any other casualty, the new features are only consi-
dered as forming a variety, and  not  a separate species.  Yet  it
must be acknowledged that the line of distinction upon this point,
is frequently less clear in the distribution  of diseases than in that
of plants and animals; though it may possibly vie with that  in
the mineral kingdom.
  It is not easy at all times, after  having defined a species,  to
determine  to what genus it  ought  to belong: for  as  the  spe-
cific character is,  in most cases, formed  from a  combination  of
symptoms, it  often happens  that several  of these symptoms
enter into the definitions of two or more genera,  and the  same
difficulty  is sometimes  felt  in  assigning  to a  genus its proper
order.   Thus yaws (frambsesia as it is commonly called) which
by Cullen is introduced into the  order impetigines of the class
cachexia, is  proscribed from this order by Sauvages, and ar-
ranged  under that of tubera of the same  class.  In effect it
has characters which  may give  it  some claim to  either order:
but its  most prominent marks, as traced by Dr.  Ludford and
other late  writers of the best authority, seem far more closely 
PRELIMINARY DISSERTATION.
Ixxi
to connect it with exanthems, in consequence of which  it will
be found under this order in  the class pyrectica  of the  pre-
sent  system. The  same  perplexity has been  felt  concerning
pestis.  Vogel inserts it in the order of febres,  Sauvages,  Cul-
len, and Parr, in that of  exanthemata; Cullen, however, pro-
fessing his  doubts as to which order it more immediately be-
longs; and  Parr distinctly declaring, in  a subsequent part of his
Dictionary,  that it is improper to arrange it  as he has  thus done
in  the part  just adverted  to;  and,  on another occasion, that
there is no foundation for regarding it as an exanthem, and that
it ought  to  be reduced  to  a variety under the asthenic  remit-
tents*  Chlorosis has symptoms which connect it with what
have hitherto been called cachexies, with morosities or wayward-
nesses of the stomach, and with sexual  orgasm.  Till the  time
of Cullen it was  generally arranged  under the  first  head; by
him, however, it has been transferred  to the class neuroses,
order adynamic, being still allowed the rank of a genus.  In
Dr. Young  it occurs  as  a mere species  of  dyspepsia,  in Dr.
Parr as a species of a  genus which  he calls anepithymia.  In
Macbride, who seems to have taken  the  most  correct view  of
its relative  bearing,  it is restored to  the rank of a genus, and
deposited in the  class and  order of " Sexual diseases proper  to
Women."
   In such difficulties as these, however, there is nothing pecu-
liar to Nosology.  In systematic Mineralogy they are more com-
mon ; as frequent perhaps in Zoology ; and  by no means  unfre-
quent in Botany.  Thus the inyxine  glutinosa,  which by Lin-
neus was regarded  as a worm,  has been  introduced  by Bloch
into the class of fishes,  and is now known  by the name  of gas-
trobranchus cascus, or hag-fish.  So the  siren  which was  at first
contemplated by Linneus  as an amphibious  animal,  was after-
wards declared  by Camper  and Gmelin  to be a  fish,  approach-
ing the nature of an eel, and was  arranged  accordingly.  It has
since, however,  been  restored, from the class of fishes,  to that
of amphibials ; and in the present day is believed by various zoo-
logists to be nothing more than a variety of the  lizard.   In like
manner the ipecacuan plant which has been successively described
as  a species of Paris, of euphorbia, of conicera, of viola, and,
by Mutis and  the younger Linneus, of psycotria, is  at  length
clearly ascertained by Schroeber to belong to the genus  callicocca.
The angustura-tree which till of late,  was commonly regarded as
a species of Brucea, has been proved  by Bonpland to have little
• See Note on the Genus Anthracia, Cl. III. Ord. III. of the present system, 
Ixxii
PRELIMINARY DISSERTATION.
 relation to this genus; in consequence of which he has formed a
 new genus, to which he has given the name of Casparia,  for the
 purpose of receiving it, referring us for a full description of the
 species to the superb work which M. Humboldt and himself  have
 been long preparing for the  press under the title of Plantes Equi-
 noxiales.  At this moment  the cascarilla plant is equally vacillat-
 ing between the two genera croton and clutia or cluytia; and, of
 the upases of Java, and especially the bohan upas  we  have re-
 ceived no specific  characters whatever; and  consequently know
 nothing of their relative places.
   In all  cases of this kind we must wait for additional  informa-
 tion, and in the mean  time  exercise our judgment upon the best
 intelligence we can obtain; correcting what is wrong, and confirm-
 ing what is doubtful, as we  have opportunity.
   It is not improbable  that some future nosologist (should the pre-
 sent work have any pretensions to futurity) may be able to assign
 more correct places to  several of the genera or species of the en-
 suing arrangement  than those they now occupy.   It should  be
 well remembered, however, that the principle of this arrange-
 ment consists in determining the proper  class Of a  disease  from
 the general function that is injured, and not from the particular
 organ, which only regulates the subordinate divisions : and  that,
 where two general functions are  injured at  the  same time,  that
 constitutes the class which appears to be most prominently affect-
 ed.  Thus strophulus, and scabies, which seldom extend deeper
 than the secretory vessels of the  skin, belong  necessarily to the
 class eccritica, or that comprising diseases of the excernent
 function; while variola and rubeola, though equally occupying
 the surface,  belong to  the  class  h^ematica,  or the diseases  of
 the  sanguineous  function ;  which, in  both  these  cases, is
 primarily and chiefly affected, as is obvious from the pyrectic ac-
 tion  of the heart and arteries.   So while  gastritis and  enteritis
belong also, as inflammatory affections, to  the hematic class,
 dyspepsy  and cholera, though  disorders  of  the  same organs,
 must necessarily be referred  to the class celiac a, or that com-
prising the diseases  of  the digestive function, this being the
part of the animal  economy which is hereby chiefly or wholly
disordered.
   It may perhaps  be  objected  that this  is to  travel  over the
 same region  a second  dr even  a third  time.   It is,  however,
 always in pursuit  of a different  object.  It  is  to follow up the
 family of diseases  that  appertain 'to a   particular  function;
 whrle,. to avoid having our attention distracted,  we leave  every 
PRELIMLNARY DISSERTATION.
lxxiii
other function and the diseases belonging to it, untouched.  We
pursue the same plan in Zoology, in Botany, in Mineralogy.   In
a common region  we discover discrepant specimens and bring them
home at different  times; exploring it on one occasion for one pur-
pose, and on other occasions  for others:  and we then separate
and  arrange the productions into different  classes  and orders  for
scientific study, notwithstanding that nature  has produced them
in a  common quarter.
   As simplicity is an object which ought never to be lost sight
of, it is always more praiseworthy, and  especially' in Nosology,
to diminish  than  to multiply genera, or even the higher divi-
sions of orders and classes,  wherever this  can  be accomplished
with an equal retention of perspicuity.  The ensuing system  has
aimed at simplification in these respects ;  and  it  is on this ground
the family of dolores, or local  pains, is entirely suppress-
ed, and the  genera  or species of which  it has  ordinarily been
composed, are distributed,  as mere symptomatic affections,  un-
der other heads.   At first sight  local  pains seem to  form  a
natural group; but when,  deceived by the comprehensiveness of
the term, we attempt to combine them under a family character,
we at once discover that they have seldom any thing in common,
whether in regard to origin, sensation, effect, or mode of treat-
ment ;  that  the  connexion is   merely verbal,  and  that they
slip  away from us insensibly into some  other divisions.   Hence
with the exception of odontalgia, and another individual or two,
Dr. Cullen  regards  the  whole  as entirely symptomatic; while
odontalgia is with him, in fact, a mere  species of rheumatism,
though advanced to the rank of a distinct genus.   Parr, while
writing the earlier part of his Dictionary,  had a strong desire to
form an order of this kind, and a full persuasion of its expedi-
ency.  " When we  explain," says he, in his article cephalal-
gia, " the arrangement of diseases? we  shall find  it difficult to
avoid an  order, at least, of dolores ; and  under  this head ce-
phalalgia must be arranged."  But when,  in the  article nosolo-
 gy he carries his arrangement into execution, we find him com-
pelled to abandon this  intention ; in consequence  of which we
have no such order  as dolores,  nor any notice whatever of ce-
phalalgia, or even of hemicrania.
   Even of those who have retained the  order, every one seems
 to have laboured  under the greatest difficulty of fixing  its  con-
 tents  and boundaries.   Sauvages, Linneus, Vogel, and  Sagar,
 make it a class;  the first allotting to  it thirty-three genera, the
 second twenty-five, the  third  forty-six,  the fourth thirty-two.
   vol.  v.—10 
lxxiv
PRELIMINARY DISSERTATION.
In  Macbride and  Crichton it  occurs  as  an order: the  former
giving only twelve, and the latter only eleven genera under it.
Dr. Young reduces it to a single  genus,  under the  name of au-
talgia, and assigns to it not more than  three species, a. dolorosa,
the subdivisions of which (they cannot  be called varieties) are
numerous, and include many of the preceding  genera; a. pruri-
ginosa ; and a. Vertigo:  the whole of which,  as observed alrea-
dy, have little analogy in  cause, effect,  mode of sensation, or
plan of treatment.   The subdivision  a. pruriginosa  was first in-
troduced by Sauvages, continued by  Linneus, Vogel, and Sagar;
thrown out by Macbride and Crichton ; and then taken up again
by Dr. Young.   In Sauvages  and Sagar,  anxietas, lassitudo and
catarrhus are regarded as dolores ;  Vogel banishes the two last,
but preserves the  first.   Linneus, and  every  other  nosologist
has banished  all three.  The four last  writers  assign to  this di-
vision rheumatism,  gout,  and  lumbago,  and  perhaps with  as
much  reason as  any other  affection.   Crichton  dismisses all
these.   Young  dismisses rheumatism and  gout,  but  retains lum-
bago and  ischias as varieties;  whilst both are again introduced
as varieties under rheumatism, which is made a species of cauma
or inflammatory fever.  It  was not merely therefore  from the
compressed nature of his classification that Cullen proscribed the
division altogether; for it  is obvious that no two nosologists have
been able to concur in the individual  diseases that should compose
it.
  III. In order to render the present work more  useful,  and to
assimilate it more closely to works of the  same kind in the colla-
teral branches of natural knowledge, to the systematic name of
every disease is subjoined its chief technical and vernacular syno-
nyms.  This is a new attempt, and occasionally accompanied with
no  small difficulty.  The vernacular  synonyms are confined  to
the three most popular languages of Europe,  English, German,
and French;  for these seem to be sufficient.  The technical  sy-
nonyms are in like manner derived  from the three most exten-
sive languages of antiquity, Greek,  Latin, and Arabic :  the last
of which are given as well in Arabic  as Roman  characters,*  in
order that the reader  who is capable  of comparing the  two cha-
racters, may see the peculiar power  which, in  the  present ren-
dering, is assigned to the  latter;  for so different is this  power
as assigned  at times  by  different individuals, and  particularly
when of different countries, that the  same word is often spelt in
such  a  variety of  ways as occasionally to defy all collation, and
* In the present edition, the Arabic characters are necessarily omitted. 
PRELIMINARY DISSERTATION.
lxxv
to render it almost  impossible to determine what  is the Arabic
term, or the Arabic characters intended to be expressed.   Occa-
sionally where the Arabic names are also Persian or Turkish, the
author has  added the initials  or other marks  of these cognate
tongues; and,  in a  few instances,  in which  they are  peculiarly
expressive, he has  also superadded the  Persian or Turkish names
even though different from  the Arabic.  At  times, indeed, the
Arabic writers themselves employ a Persian or a Syriac term, for
several of  them  were of Persian or Syrian  birth; and  in  such
cases the author has also indicated  the  proper origin : all which
has been a  labour of no  small  trouble,  from the  novelty of the
attempt,  and the  difficulty of procuring  medical  Arabic and other
eastern books that would answer the purpose.
   In Sauvages and  several  of  the  German nosologists we  have
the Arabic  synonym  given occasionally,  but  never  otherwise
than  in  Roman characters, and  these  not  unfrequently  with
great  inaccuracy.   In  Dr. Willan's   description of  cutaneous
diseases  we have a somewhat fuller  reference to the Arabic
synonyms,  still written, however, and confined to the Roman
characters,  sometimes spelt  with, and sometimes without a pre-
fix of  the  definite article,  sometimes  with  a  continental, and
sometimes  with  a  vernacular  pronunciation, from  the learned
author's  not being acquainted with the Arabic language, and hav-
ing industriously caught up  the words and descriptions  as he was
able.
   It appears high time, therefore, to give more completion to this
branch of medical synonymy than has,  hitherto, been attempted ;
and especially considering the taste which, in the present day,  is
evinced  throughout almost every kingdom in Europe for a  revi-
val of  Arabic  literature, and more particularly in  our own coun-
try and its vast oriental dependencies.   The Arabic tongue is the
oldest living language in the world : it was polished  to a  very
high  degree of classical perfection  as early at least as  the age of
Moses, (supposng,  as  is generally allowed,  the book of Job,
which  is Hebrew tissued with  Arabic,  to have  been written by
him;)  it was certainly studied and cultivated, as the language of
polite science,  at the splendid  court of Solomon; was the  chief
depository   of  learning,  and particularly of medical learning in
Europe,  as well  as in Asia and Africa, during the dark ages ; and
has descended  as a living language without any  great variation to
the present day.  The first translation of Euclid into English was
not from the  original Greek,  but  from an  Arabic version, the
work of  the monk Adelard in the twelfth century,  who, with va-
rious other ecclesiastics,  travelled abroad for the laudable purpose 
rxxvi
PRELIMINARY DISSERTATION.
of obtaining  knowledge, and studied  progressively  in  Arabia,
Egypt, and Spain; which last country alone, as it appears from
the account of the Arabic manuscripts of the Escurial, drawn up
by the learned Casiri, possessed at this era not fewer than seventy
public libraries;  evincing a wonderful patronage of literature by
the Arabian princes, when copies of books were peculiarly scarce,
and enormously expensive.  On the resurrection of science, there-
fore,  towards the fifteenth century,  it was  from Arabic sources
and the Saracenic schools,  that Europe again became acquainted
with the treasures of the medical writers of Greece.   The illus-
trious caliphats of Bagdad, Cairo, Cordova, and Fez, had  long
rivalled each other in giving encouragement to men of learning,
and especially to  physicians, whose profession,  whatever might
be their religious  tenets,  was the surest  path to  distinction and
riches.  And such was the success attendant upon this encourage-
ment,  that the colleges of  Bagdad alone are said  as early as the
eighth and ninth centuries, to have contained not  less than six
thousand students at a time.
  One of the first and most valuable writers in the extraordinary
period before us,  was Honain Ebn Isaac.  Having made himself
master of all  the  accuracies and elegancies of the Arabic  tongue
at Bassora, where it was supposed to  be spoken  in the highest
classical purity, he complied with the  munificent  invitation  of
Almansor, or rather of  his grandson Almamon,  fixed himself at
Bagdad,  and among other works, translated the Aphorisms  of
Hippocrates with the Commentaries  of Galen ; giving them  in
Arabic  instead of Syriac, which at this time was  the  ordinary
channel of translation, and that in which the works of Mesueh
were already written.  Serapion  was  contemporary with  him ;
and his  productions, many of which  are  intrinsically valuable,
were composed in the same tongue, and  enriched from the same
source.   We perceive the same vein of study running through
the writings of Avicenna, Avenzoar,  Theophail, and  Averroes.
Hence the general doctrines of the Greek pathology were every
thing,  and all diseases were resolved into the four classes of a san-
guineous, a bilious,  a  phlegmatic, and  a melancholic  tempera-
ment;  or as  they are denominated in  their own tongue, keshi
serkh, keshi zerd, keshi sepid, and keshi sijah.   It is  said, in-
deed,  that the Arabian physicians have interwoven with the doc-
trines of the Greek schools a vast mass of lumber derived from
their own religious tenets.  In  many instances the  assertion  is
true;  yet several  of the writers  were Christians,  as Mesueh and
Honain,  and  others Jews, as  Ben Maimon, or,  as  he is  often
called, Maimonides : while not a few of  them evince a very cor- 
PRELIMINARY DISSERTATION.
lxxvii
rect judgment and clear discrimination, as Avenzoar, who was
peculiarly characterised by his rejection of useless theories.   Se-
veral of them, moreover,  are well worthy of study as being the
original delineators of diseases common to our own day.  No one
ought to pretend to a scientific acquaintance with cutaneous affec-
tions, who has not studied  Serapion ;  nor with a practical history
of small-pox  or the diseases of children, who has  not read the
pages of Rhazes, and especially his Almansor, in which the for-
mer is, not indeed for the first time described,  but for  the first
time  described with accuracy:  nor ought he to  be unacquainted
with  the Maleki of  Haly  Abbas, in  which  the  writings  of
Mesueh, Serapion, and Rhazes, are critically examined and  com-
mented upon.  The direct  object of the present  attempt  will not
often allow the author an opportunity of making  those occasional
remarks on  the Arabian writers which  he would lik/ to indulge
in: but he may possibly  find such an  opportunity in  a future
work on general pathology.
   It  may not, perhaps, be absolutely necessary to learn the Ara-
bic tongue for this last purpose, as many of the productions refer-
red to may be perused in an English translation; but a knowledge
of Arabic, independently of its becoming a growing fashion, will
throw a just  and satisfactory light  on a variety of technical  terms
imported from this quarter  into our vocabularies of medicine, bo-
tany, and  chemistry,  which  we  cannot so well obtain by any
other  means.   Thus  chimia, and consequently alchimia, are
Arabic words, without the change of a letter; the original  cha-
racters being, and the radical  idea importing " incorporeal sub-
stance  or  essence;" a something that  eludes the senses; and
hence,  in a secondary sense, " cloud, mystery, deception."  Nu-
cha is from the same source, nuka or nucha,  and signifies me-
dulla spinalis, and, emphatically,  its origin or commencement, to
which part of the organ the  term  is applied in the  technical lan-
guage of the  present day.   To these  may  be added rob, the old
pharmaceutic term  for inspissated  juice, and which  is the exact
meaning of the  Arabic rob: jasmine (jasmin)  the plant of this
name, originally brought  from  the East;  and asarum  (asarun)
importing astringency,  and employed in Arabic pharmacy for this
quality; the  common, but erroneous,  derivation  of which,  how-
ever, is from  *  neg. and a-xtpa  " to adorn;" because,say  the lexi-
cographers, it was not admitted into the ancient corona! wreaths;
though from the unsatisfactory nature of this etymology, others,
nearly  as extravagant, have been  proposed, which it is unneces-
sary to quote.   So julep or julapium is the Arabic,  or juleb or
julleb,  by the Persians, into whose language it has also  been ad- 
lxxviii
PRELIMINARY DISSERTATION.
mitted, written gulab; and imports literally a sweet medicated
drink.  Kali and alkali, commonly supposed to  be  Arabic,  are
Persian terms, and kalia and alkalia, far more euphonous names
than the indeclinable nouns in general use,  and signify the ashes
of marine plants;  whence the Turks employ kal  for ashes in ge-
neral as well as their lixivium.   It is from the Persian tongue also
we obtain bezoar,  or bezoard, properly  ped-zahr and literally de-
pellens venenum, or  alexipharmacon—as also numerous  other
terms, which it would be unpardonably  digressive to enumerate
in the present dissertation.   Berberis, the Barbary tree, Enberba-
ris,  is Arabic, Persian, and Turkish; or rather an  Arabic term
that has spread through all the dialects of Asia as well as of Eu-
rope.
   It  is easy, therefore, to trace the path  by which Arabic  and
Persian terms, and even terms from other Oriental sources, have
found their way into the medical and botanical vocabularies of the
present day.   Nor is it very difficult to show  that the Greeks  and
Romans have also  been considerably indebted  to the same quarter
for many words  which enter into the common structure of their
respective  tongues ; the radical meaning of  which  can only be
explained by a knowledge of  the Oriental dialects  from  which
they have  been  borrowed.   The  Sanscrit has, perhaps,  contri-
buted most, but almost all the Asiatic languages have contributed
something.
   Thus the Latin grammarians are totally at a loss for the etymo-
logy of aeger, aegra, aegre ;  Festus gives  us  at  at;  Scaliger  *f»yoc.;
others aviypos, auttapot,  and terms still more discrepant  in  sense
and sound.   The reader will,  perhaps,  readily perceive the pro-
per origin of this  term when he finds, as he will do in the ensu-
ing pages,  that ekrah,  by the Turks pronounced egrah, is  Arabic
for  "sickness, aversion, nausea, horror, or  shuddering."
   Let us take another example.  The Latin  tongue  has two dis-
tinct terms to express  the organ of the liver, hepar and jecur.
The first is easily  referred to the Greek  ^^ap; for the second the
critics have scarcely a guess to  offer.  It is  in fact a Persian term,
jekur,  which has  been copied  into Turkish as well as into Latin ;
in the former being pronounced jegur.   It is not, however, Ara-
bic,  which gives  us  kebed,  doubtless  from  the  Hebrew,  -\22;
whence also  the Syriac (kebeda.)
   It is from the Hebrew that we obtain the common adverbial
prefix bu,  or bo,  importing magnitude or intumescence, as in bu-
limia or bolismus, as it is written  by Gordon, bubo, bubonocele.
Bu, in Hebrew ya or ny3 imports " swelling, bubbling, inflation ;"
and hence the same term, in  its  duplicate form, paya (bobo or 
PRELIMINARY DISSERTATION.
Ixxix
bubo) signifies  in Ezek. ch. ix. a large ichorous or pustulous tu-
mour or bubo, and by the Septuagint is rendered £A<*t<s which
embraces both; as does the  word Main in our vernacular version,
which might with strict propriety have retained the original word
bubo.   Bu is commonly derived from the Greek Govs, bos, as be-
ing a large animal; but  this is to  ascend one  half way to the
fountain, for Govs or  Gets, bos, boa, bubulus, and  various other
terms, of the same family,  are equally derived from the Hebrew-
root.
   Coryza,  more  literally koryza,  (xopvgx)  is a  term  of Hippo-
crates, to express gravedo,  or cold in  the  head.   The gramma-
rians have hunted in vain for its derivation,  and it is now usually
allowed  to  stand  in  the lexicons as  a Greek radix.  It is found,
however, almost all over the East in tongues and dialects of higher
antiquity-than the Greek, importing uniformly cold, or the effects
of cold.   In Hebrew it is tjnp  (koris) and signifies " constriction
or condensation ;" in Chaldea,  xpnp  (koryza,)  the Greek term
without the  alteration of a  letter, and is strictly cold,  " algor, or
frigus."   It is precisely  the same in  Syriac,  koryza,  and is em-
ployed in  this exact  sense  in the Syriac New Testament,  John
xviii.  18, and  various other passages; while  in Arabic  we meet
with  it  under the Hebrew form, koris, embracing the double
idea of cold and  condensation,  or infarction, and consequently
including both the cause and effect.
   The subject  i& interesting, and might be pursued to a great ex-
tent.   Other examples will occur in the ensuing pages; but enough
has, perhaps,  been said, to show the importance of connecting
the science of the healing art with a general study of the Ori-
ental tongues,  and of exciting the young pathologist to  a cultiva-
tion of Arabian literature, in conjunction with the medical learn-
ing of Greece  and Rome.
   IV. There is yet another, and a very prominent feature, of the
present work,  which  it is necessary to notice before we close, and
which it is  hoped will meet with the reader's  approbation.  la
order  to afford relief to the dryness of technical definitions, and
verbal criticism,  the author has digested his notes into a running
commentary,  which he has endeavoured to render replete  with
interesting cases, valuable hints or remarks, and singular physio-
logical facts, gleaned from a pretty extensive perusal of the  most
approved authorities,  collective or individual, ancient or modern;
occasionally  interwoven  with  similar illustrations, as they have
occurred to the writer in his own private walk and intercourse of
life.
   There has, of late years, been an  unnecessary degree of seep- 
Ixxx
PRELIMINARY DISSERTATION.
 ticism thrown over several of the public Journals, or Epheme-
 rides,  to which he has occasionally referred,  in  consequence of
 their containing much of the marvellous, and reposing on the
 sole authority of the individual, by whom the case  or article is
 related.   It  should be  remembered, however,  that  several of
 these  collectanea were  established for the  express purpose of
 communicating singular and extraordinary facts or occurrences in
 natural history or  physiology,  and  of confining  themselves to
 such cases.   It is true, that they are for the most part published
 upon the responsibility of the writer alone;  but it  is upon the
 same  single  credit that by far the greater number of  cases are
 given which  are published in our own day, whether by  indivi-
 duals,  or  by collective bodies.  Even the Royal  Society,  from
 whom the  ensuing pages have,  perhaps, chiefly* borrowed,  does
 not, in communicating  its transactions to  the public, assume a
 higher degree of testimony;  and thinks it prudent, by  a special
 advertisement,  prefixed  to  every half volume,  to caution  its
 readers that  its committee  do not pretend " to answer for the
 certainty of the facts, or propriety of the reasonings contained in
 the several papers, which must still rest on the  credit or judgment
 of their respective authors."  This,  indeed, ever  has been, and
 ever must be, the main ground of authority, and rational assent;
 and on this account, while the writer has  selected from a some-
 what extensive range, he has endeavoured as  far as he  has  been
 able, to weigh the characters and stations  of the different indivi-
 duals from whom he has quoted, whether as isolated reporters, or
 members of  scientific academies:  though  it is highly probable,
 after all, that the greater number of the most  curious and extra-
 ordinary aberrations from the common laws of  health and disease,
 introduced into  the ensuing commentary,  will be found  drawn
from well-established scientific miscellanies and transactions of our
 own day rather than from those of  earlier periods.
  There are a few distinguished characters from whom the author
 has quoted with peculiar freedom, for the express purpose  of
pointing out the sources to which he has been  indebted for much
of the most valuable information he has been able to acquire  upon
 the subject immediately before us,  and in order to  excite the stu-
 dent to a trial of the same path.  These, among the ancients, are
 Galen and  Celsus; and,  among the moderns, not to name the no-
 sologists who have  already passed  in  review before us,  Hewson,
 J. Hunter,  Cruikshank, Fordyce,  and Baillie.
  The student, who has made himself master  of Galen and Cel-
 sus, is enriched with all the general information he  will ever stand
 in need of from the schools of antiquity, antecedently  to the 
PRELIMINARY DISSERTATION.
IxXXi
 Arabian  caliphats.   Nothing, however, can be  more  different
 than their manner,  which, indeed, is  one cause  of the different
 extent  of their labours ; for the  field of both is  the same,  not
 only in respect to matter, but nearly so in respect  to range.   The
 Medic in a of Celsus is a close practical compendium of the  no-
 sology,  therapeutics, and surgery  of Greece and Rome during his
 own age, which was  probably that of  Augustus,* for the most
 part compared with  those of the earlier  Greek schools.  It is
 written with equal elegance and modesty, and is introduced by a
 chapter on  the  laws of health.  The works of Galen, who was
 physician to Marcus Aurelius,  are speculative as well as practical:
 they contain a  full  history of most of  the  Greek theories, and
 attack every one which is in opposition  to the doctrines  and opi-
 nions of Hippocrates; whose system he revived,  defended, and
 illustrated with  incontrovertible arguments, consummate learning,
 and  unrivalled ingenuity.  His genius was almost  universal, and
 led him  to drink deeply of every branch of science that adorned
 his age; and seems sometimes  to have tempted him to indulge in
 a redundant and unnecessary display of learning.  Vesalius, with
 a jealousy unworthy of himself, accuses him of having studied
 comparative anatomy to the neglect of human; but  the charge
 was triumphantly repelled  from  passages  in his own works  as
 soon as it was advanced.   Being a native of Pergamus, he wrote
 in the Greek tongue,  but his  style is far less elegant than that of
 Celsus.   The best edition of his works, which is  that of Venice
 of 1625, extends to seven volumes folio, including a  Latin ver-
 sion.  A more valuable present could not be made to the medical
 profession than a judicious compendium of these volumes, taking
 the terse compressed manner of Celsus  as an example upon the
 occasion.  As the joint Latin version of Linacre and  the Italian
 interpreters is in far more general use than the original  Greek, the
 author has preferred it in his quotations  for the sake of an easier
 reference,  excepting in  a few instances of verbal criticism, in
 which he has thought it right to advert to the Greek text itself.
  Upon  the distinguished  merit  and talents  of  the  illustrious
 English writers  from whom he has also drawn somewhat largely,
and whom he is chiefly anxious to  recommend to the industrious
student,  it is unnecessary to say a word.  They are not, indeed,
 the fathers of physiology; but they have furnished us,  in a regu-
 lar succession of instruction, with far  more light, and far more
 important discoveries upon the subject, than have been  developed

  * The biographers of Celsus have usually placed him under the reign of
Tiberius ; but Bianconi has employed far stronger arguments to show that
he flourished in the Augustan age.  Epist, de Celsi JEtate,
  VOL. V.—11 
Ixxxii
PRELIMINARY DISSERTATION.
by any train of writers, with the exception of Baron Haller, sines
the days of Harvey; and have taught us how we may best inter-
weave the principles of the animal economy, and  some of them
those of animal chemistry, with the practice of the  healing  art,
and  render'them subservient to the most important  purposes of
the profession.  The study is  still new,  and opens  to  us a vast
uncultivated region: and it is not surprising, therefore, that  its
earliest  labourers should occasionally have erred in beating their
way through its tangled and untrodden track, and especially when
indulging in a bolder and  more discursive imagination.  But  he
who, in following the path they have thus struck out,  is most
sensible of their errors, must have studied them with no desirable
spirit, if he be not at the same time, most  sensible  of their ex«
alted merits, and of the deep obligations  they have conferred, not
only on the world of medicine, but on the world of man. 
^.■•^■'ACULTYOV.'

CLASSES AND ORDERS.
                   CLASS L

                     CGBLIACA.

           Diseases of the Digestive Function.
                                             Page
©rder I.  Enterica.........,„;    1
            Affecting the Alimentary Canal.
    II.  Splanchnica.......^  -  - -  56
            Affecting the Collatitious Viscera.
                   CLASS II.

                   pneumatica-
           Diseases of the Respiratory Function.
 Order I.  Phonica  ..«.„......>  .  .  70
              Affecting the Vocal Avenues.
     II.  Pneumonkja  .......-  «...  81
   Affecting the Lungs, their Membranes, or Motive Power.


                   CLASS III.

                     II^MATICAc

          Diseases of the Sanguineous Function.
Order I,  Pyrectica *.*...<...,.:.&
                      Fevers, 
T.XXXiv        SERIES OF CLASSES AND ORDERS.
                                                     Page.
     II.   Phlogotica............  113
                      Inflammations.    \
    III.   EXANTHEMATICA.........A  .  157
                     Eruptive Fevers.
    IV.   Dysthetica  ............  182
                        Cachexies.
                      CLASS IV.

                        NEUROTICA.

              Diseases of the Nervous Function.
Order I.  Phrenioa.............''. .  219
                   Affecting the Intellect.
     II.  iESTHETICA............  237
                  Affecting the  Sensation.
    III.  ClNETICA .  ............  260
                   Affecting the Muscles.
    IV.  Systatjca .   ............273
  Affecting several or all the Sensorial Powers simultaneously.
                      CLASS V.

                        GENETICA.

              Diseases of the Sexual Function.
Order I.  Cenotica.............294
                   Affecting the Fluids.
     II.  Orgastica............303
                   Affecting the Orgasm.
    III. Carpotica.............318
                 Affecting the Impregnation. 
             SERIES OF CLASSES AND ORDERS,        lxxxy

                     CLASS VI.

                       ECCRITICA.

            Diseases of the Excernent Function.
                                                     Page
Order I.  Mesotica ..  ,  .  ...  .   .  -  .   .  .   .  325
                 Affecting the Parenchyma.
     II.  Catotica.............  336
                 Affecting Internal Surfaces.
     III.  Acrotica............   .  354
               Affecting the External Surface.


                     CLASS VII.

                         TYCHICA.

              Fortuitous Lesions or Deformities.
Order I.   Apalotica............395
                   Affecting the Soft Parts.
      II.  Stereotica............   407
                  Affecting the Hard Parts.
     III.  MoRPHlCA...........  .  ,   412
                   Monstrosities of Birth. 
 
TABLE
                    OF THE


     AFFIXES AND  SUFFIXES

THAT CHIEFLY OCCUR IN  THE ENSUING NOMENCIATUBE,

        With the Senses in which they are used.
AFFIXES.
A.....(«).....Diminution or loss of quality or power.
Apo, ap, aph .  (xtto, cur, tt<p)  .  . ? For the most par{ terative, duplicate^
Cata, cat  .  .  (kxta, x«t) ... 5   or augmented action : but often in-
                                   determinate.
Dia  ....  (JVa).....Separation; secernment; or secretion.
Dys  ....  (<Twf).....Morbid state or action generally; em-
                                   phatical, when  accompanied with
                                   distress or difficulty.
Ec, ex   ...(«,*!)...  .}
Epi, ep, eph  .  (mi,  «r, ep)  .  .  . C Out of; outwards; over; above.
Hyper   .   .  .  (Wi/>;   .   .  .  .j
En  ...  .  («v).....Within;  below;  applied  to places.
                                   Superiority ; excess or intensity; ap-
                                   plied to quantity or quality.
Para ....  (»*/>*)   ....  Morbid state or action generally; and
                                   hence synonymous with dys,- except
                                   in a few terms derived from anatomy^
                                   in which it imports apud, " bordering1
                                   on," as in parotitis, paronychia.
Peri .   .  •  .  (*«/>/).....Circuit; circumference.

                            SUFFLXES.

Algia  .  .   .  (axyta) .  .   »  .   .  Pain or ache.
Asmus, osmus,  (ctcr/uu, a.a-/uoc)   .   . ^ Morbid action, power,  or  possession
Esmus, ismus . (to-po?, i<r/xoc) .  .   A   generally; but mostly very indeter-
Esis, osis .   .  (trig, »«■«) .   .  .   .j   minate.
Jasis   .  .   .  («*«;) .....  Cutaneous eruption, unconnected with
                                   fever as its cause. 
Ixxxviii       TABLE OF  AFFIXES AND SUFFIXES.

Itis  ....  (/thc).....Organic inflammation.
Kele, cele   .  (x.»x»).....Covered protrusion of a soft part.
Odes  .  .  .   («/«).....Like; a-kin to.
Oma   .   . ■ .  (*>?**).....External protuberance.
Ptoma .   .  .  (map*)  ....   Naked prolapse of a soft part.
Rhoea  .  .  .   (fata)   .  .  .  .   .   Preternatural flux of any  fluid except
                                     blood.
Rhagia .   .  .  (fayi*) .  .  .  .  ' -.   Preternatural flux of blood.

                               LATIN.


Igo   ............   Diffusive or migratory action or motion"
jj,a'.ua.'.........>  Simple diminutive terminations.

Osus...........   Simple augmentive termination.
V 
NOSOLOGY.
            CLASS  I.

          CCELIACA.

DISEASES OF THE DIGESTrVE FUNCTION.
                       ORDER  I.

                   E N T E R I C A.

            AFFECTING THE ALIMENTARY CANAL.

  Disquiet, or diseased action in some part of the passage for the
reception and detrition of the food.
                       GENUS  I.

                     ODONTIA.

   Pain or derangement of the teeth or their sockets.
       Odontalgia.  Sauv.


   Class I. Csliaca.   k<wa«*x«,  ««alvina," from MtXta, " alvus,"
" venter:" and hence the terms coeliac artery, and coeiiac passion.
   Order I. Enteric a.  'Em^*«, " intestinalia;" from «m/w, "in-
testinum," " alvus," " viscus."
   Gen.  I. Odontia.  From «&«*,." dens."   This word is preferred
to odontiasis, first, because the termination iaais is now generally in-
dicative  of diseases of  the skin; and next, because odontiasis has
   vol. v»—12 
2
NOSOLOGY.
[CL. L—OR. I.
1. dentitionis.  Irritation from cutting the teeth.
     Odontiasis.  Paul.JEgin.
     Odontalgia dentitionis.  Saw.
     Odaxismus.   Vog.
     Ziras.  Arab.

been chiefly limited to a single species of the present genus, o. do-
lorosa, or tooth-ache.  In the compounds of «JWs, odontia is common
to the Greek writers, as r^tthnna, &c.
  As the jaw-bones of youth are both wider and longer than those of
infancy, it is obvious that the teeth  which are cut in the first year
must be incapable of filling up the bony arch of the fourteenth. They
might indeed have been so contrived as to grow in  proportion to the
increased range of the jaw-bones; but from their being extraneous
bodies, this must have been a very complex process, while the very
circumstance of their growth, and the internal change which must
be continually taking place, would expose them to many more dis-
eases than they are subject to at present.
  A much simpler plan has  been devised  ; and the teeth of man, as
indeed of most mammals, are composed of two distinct sets, differing
both in number and structure:  the first or smaller set consisting of
ten for each jaw, which are cut between the ninth and twenty-fourth
month after birth, shed between the seventh and  fourteenth year,
and from the period of their protrusion called milk-teeth; and the
second, or larger set, consisting of fourteen, fifteen, or sixteen for
each jaw ;  for they occasionally vary in number, which are cut pro-
gressively, upon  the shedding of  the first set, between the seventh
or eighth, and  the seventeenth  or eighteenth year, and from their
continuing till old age, except in cases of accident or disease, are de-
nominated  permanent  teeth. The  farthest grinder on each side,
however, is seldom  cut so early as the eighteenth year—generally
after the twentieth,  and sometimes not till  the thirtieth: on  which
account these teeth are  denominated denies safiientia, or teeth of
wisdom.
  The  rudiments of all the first set, and  of four belonging to each
jaw of the second set, are produced in the foetus.   These rudiments
consist of minute pulpy substances secreted in the body of the gums,
progressively elongating  to form their  respective  necks and fangs.
They are each  surrounded by a  peculiar membrane, and a bony pro-
cess which is denominated its alveolus or socket, that shoots up from
the jaw-bone as the tooth advances; it accompanies its growth, and
at first entirely  surrounds it, though it yields in its upper surface as
the tooth, in consequence of the gradual elongation of its fang or
fangs, is foreed through and cuts the gum; and when-the first set,
having answered its temporary purpose, has its fangs absorbed, and
the body of each tooth shed or cast out by the gums, the attendant
sockets are equally absorbed, and disappear at the  same time. 
OE. I.]
NOSOLOGY.
S
     Zahnen.   G.
     Dentition.  F.
     Teething.
     tt Lacte'ntium.  Cutting the milk or shedding teeth.
     G Puerilis.   Cutting the second set or permanent teeth.

   This wonderful change begins to take place, as already observed,
about the seventh year, at which time  we possess far more teeth,
including both the grown  and the growing, than at any other pe-
riod whatever: for we  have in each jaw  ten temporary teeth com-
plete, ten incomplete to succeed them, and the two permanent grind-
ers, whose stamina were formed during  fetal life, making not less
than forty-four in the whole.   The permanent teeth  have separate
sockets of their own, and in consequence  of the prolongation of the
jaw-bones, and their  augmented breadth to meet this change, do not
lie immediately under the corresponding shedding teeth, nor direct-
ly contribute to the process of shedding,  which chiefly takes place
in consequence of the absorption of the fangs and sockets of the tem-
porary set, though their ascent  contributes in some degree to the
general process.
   1. y 0. dentitionis, Adultorum. The  cutting of  these teeth is of-
ten attended with peculiar pain and inconvenience, especially when
the process  takes place very  late,  and  consequently after the  jaw-
bones have ceased to grow : for we  have in this case often a want of
sufficient room, and, in  the upper jaw, the tooth on each side i« fre-
quently obliged to  gr6w backward, in which position it sometimes
presses on the anterior  edge of the  coronoid process in shutting the
mouth, and consequently gives considerable pain.  When the same
fact takes place  in the  lower  jaw,  some part of the tooth continues
to lie hid under that process, and covered  with the soft parts, which
are always liable to be squeezed between the new tooth and the cor-
responding one in the upper jaw.   Nothing but a free opening will
ever suffice  in this case, nor even this always; for at times the evil
can only be cured by removing the  tooth itself.
   1.^0. dentitionis, Senilium.  Occasionally reproduced as late as
at the age of ninety or  a hundred.  At 92 Ysabern, Journ. de Med.
torn. xxv. p. 316.—At  100 Mtzseh, Ephem.  Erudit.  Ann. 1666, p.
175.—At 120 Efihem. Nat. Cur. Dec. ii. Ann.  iii. Obs. 15.
   For the most part, the teeth  shoot forth  irregularly, and few in
number, so as to be of  little benefit, and sometimes more  injurious
than useful,  by preventing  the approximation of the callous gums,
which till now had  been employed as a substitute for the teeth.  In
one instance, though only in one, Mr. J. Hunter informs us, that he
was witness  to the  reproduction of a complete set in both jaws; and
he supposes that in all  these cases  a new alveolar process is formed
as in the preceding sets.  "From this circumstance,"  says he, " and
another that sometimes happens to women at this  age, it would ap- 
4
NOSOLOGY
[CL. I.—OB. I-
     y Adultorum.   Cutting the adult or wise teeth.
     ^ Senilium.   Cutting teeth in advanced life, or old age.

pear that there is some effort in nature  to renew the body at that
period."
  He alludes to a return of menstruation: but there are other facts,
and of perhaps a still more singular kind, that  point to the same
conclusion.   The author once attended a lady who cut several strag-
gling teeth at the age of seventy-four, and at  the same time recov-
ered her sight so completely as to throw away  her spectacles, which
she had made use of for twenty years, and to be able to read with
ease the smallest print of the newspapers.  In another case that oc-
curred  to him, a lady of seventy-six cut two molares,  and  at  the
same time completely recovered her hearing, after having for some
years been so deaf as to be obliged to feel the  clapper of a  small
hand-bell which she always kept by her on a table in order to  know
whether she made it ring.
  One of the most singular instances on record is that given by  Dr.
Slare in the Phil. Trans, vol. xxvii.  1713, as it  occurred to his fa-
ther.   At the age of seventy-five he renewed an incisor lost twenty-
five years before ; at seventy-seven, he  renewed another incisor to
supply a similar vacancy; at  eighty, all  his teeth were hereby ren-
dered perfect; at  eighty-two, they all dropped  out  successively;
two years afterwards they were all successively renewed: so that
at eighty-five he had an entire new set.   His hair simultaneously
changed from a white to a dark hue, and his constitution seemed
somewhat more healthy and vigorous.  He died  suddenly at ninety-
nine or a hundred.
  2. Odontia dolorosa.   The  varieties are abridged from Culien, or
rather from Sauvages, from whom Cullen has copied them.  In the
earlier editions of Cullen's Nosology, odontia dolorosa  (odontalgia
as he terms it) is arranged as a  species of rheumatism, after Hoff-
man.   In the fourth and succeeding editions it is raised to the rank
of a distinct genus, and placed (xxh) between  arthrodynia and poda-
gra.   The Anglo-Saxon name for this affection was toth-ece.
  There may possibly be other varieties than are  here offered.  Ev-
ery tooth has an internal cavity, which commences at the point of
its fang, and enlarges as it ascends into its body.   This cavity is not
cellular, but  smooth in its surface; it contains no marrow, but ap-
pears to be filled with blood-vessels, which are doubtless accompa-
nied with nerves, which must necessarily be derived from  the second
and third branches of the  fifth pair, though  they have never been
distinctly traced.  In the interior of this cavity the teeth appear to
be peculiarly sensible, and  hence direct or indirect exposure to the
external air,  or in other words a carious aperture, or a current of
sharp air without such aperture, (for the air seems in many instances
to act through the substance  of a sound tooth,) will be sufficient to 
GE.L]
NOSOLOGY.
5
2. dolorosa.  Acute pain in the teeth or their sockets.
     Odontalgia.   Hoffm. Lin. Vog. Cull.

produce acute pain,and is in fact the common cause of tooth-ache:
on which account the readiest modes of cure consist in stopping up
the  aperture with  metal or  some  other  substance, defending the
tooth from the access of cold, or destroying the nerve by caustics or
cauteries through the aperture itself.
   Perhaps the pain called scorbutic may be regarded as an example
of the sympathetic variety : that from gout is for th£ most part a real
transfer of action, the organ previously affected being generally at
ease, or nearly so, during its continuation.
   For the caries of perfect teeth it is not easy to account.   Out of
the body they are indestructible, excepting by very powerful chem-
ical agents ; and yet, in the judgment of many physiologists, they
are nearly in the same state in the body as out of  it; being extra-
neous  substances  formed complete at  first, without vascularity,
growth, or internal action, and even destitute of absorbents.   Such
at least was the opinion of Mr. J. Hunter when composing his "Na-
tural History of the Human Teeth," an opinion drawn from the im-
 possibility of injecting them-—the perfection in which they are pro-
 duced  at first, and their retaining their natural colour after so long
 a use of madder as a  food, that all the other bones of the body  have
 become thoroughly tinged with it.  " But they have most certain-
 ly," says he, " a living  principle, by which means they make part of
 the body, and are capable of uniting with any part of a living body ;
 and it  is to be observed, that affections of the whole body have less
 influence  upon the teeth than upon any  other part of the body.
 Thus in children affected with the rickets, the teeth grow equally
 well as in health, though all the other bones are much affected; and
 hence  their teeth being of a larger size in  proportion to the other
 parts, their mouths are protuberant."
   Admitting the soundness of these experiments, and the accuracy
 of this reasoning, it seems impossible that the teeth,  when once
 perfectly produced in the gums, should ever decay  : for no action of
 the living principle  can  occasion a secretion of  those chemical
 agents which would alone, in  such case, be capable of destroying
 them.   It is probable therefore that this reasoning is erroneous, and
 that the teeth are vascular, though the art of injection is incapable
 of tracing the vascular structure, and  the colouring particles of
 madder-root are not  sufficiently  attenuate  to enter their vessels.
 Mr. Hunter himself, indeed, appears to speak with some degree of
 hesitation in the treatise before us;  and in  his subsequent treatise
 " On the Diseases of Teeth," offers observations that seem to show
 he  had at that time embraced a different opinion.   In the first essay,
 indeed, he allows  that "the  fangs of teeth  are liable to swellings,
 seemingly of the spina ventosa kind, like other bones;"  but he im* 
6                         NOSOLOGY.              [CL. I.—OR. I.

       Dentium dolor.  Cels. vi. 9.
       Zahn-pein.   G.
     Mai de dents.   F.
     Tooth-ache.
 mediately adds, that " there may be a deception here, for the swell-
 ing may be an original formation."  Yet in the second essay, he
 treats of this swelling as one of the diseases to which the teeth are
 perpetually liable ; he regards the teeth as subject to the common
 inflammation  of other bones, and, like other bones, evincing at times
 great sensibility through  the entire substance of the organ, as  well
 as in the central cavity itself.  Nor is it quite certain that the body
 of a tooth does not occasionally enlarge as well as its fangs ; for no-
 thing is more common  than for the space  produced by extracting
 one of  the grinders of a  healthy adult to be filled up by an approx-
 imation of the two adjoining teeth.  Mr. Hunter, indeed, endeavours
 to account for this, by supposing that each of  these teeth has been
 pressed into the vacancy by the teeth behind them, in consequence
 of their want of a proper support in this direction ;  but in such case
 there must be some  vacuity discoverable between themselves  and
 the teeth which have thus urged them forward.  In various cases,
 the author has never been able to trace any such vacuity  whatever;
 and has a decisive example to the  contrary in the state of  his own
 teeth : for having, when a boy of twelve  years old, had the second of
 the bicuspidati extracted, the vacancy thereby produced has been so
 completely filled up by the enlargement of the adjoining teeth, that
 these teeth closely touch,  and he is  only able  to introduce a fine
 probe between them  at the neck,  or lowest and  narrowest part;
 while he can  introduce  nothing  between any  of the other teeth,
 which have in no respect given way or separated from each other.
   There is  probably,  therefore,  some  internal action continually
 taking place,  though  we  are not able  to trace it very  evidently,
 And it  is probable, also, that a caries of the teeth is  occasionally
 produced by some internal  cause  operating upon and vitiating this
 action, though there can be no doubt that the chief causes are ex-
 ternal.  We have already noticed exposure to currents of cold air,
 and the medical practitioners of Germany and  the north  appeal  to
 the opposite extreme,  of the habitual use of hot aliments as a still
 more general  and mischievous source of the  same evil.  In the
 Swedish Amanitates Academic<£, Vol. VII. art. 136, we have an ela-
 borate examination of this subject by M, Ribe, who tells us, among
 other things, that " man is the only animal accustomed to hot foods,
 and almost the only anitnal  affected  with carious teeth."  Whence
 the author takes occasion to  condemn, in an especial manner, the
 custom of drinking hot tea and coffee.  And, in accordance with this
remark and recommendation, M. Tillsus, another celebrated writer
in  the same interesting journal, tells us from Kalm, in his paper en- 
GE.1.3                     NOSOLOGY.                        7
    a  Cariosa.   Carious, or from decay.
    G  Catarrhalis.   From cold.
    y  Nervorum.  Chiefly  or altogether  confined to  the  nerves
         of the sockets or  jaw-bone, and  not relieved  by  ex-
         tracting  the  suspected  teeth.  Hunter  on  Teeth,  p.
         190.
    ^  Sympathetica.   From sympathy : as  that of pregnancy, or
         irritating sordes in  the  stomach.
         Found also, occasionally,  as a symptom,  in scurvy (por-
       pbyra), erratic gout, and hysteric diathesis.
3.  stutoris.  Tingling pain in  the teeth from stridulous sounds,
               vellication, or acrid substances.
    Haemodia, (*it*u$'iu).  Aristot.
tiled Potus Thets, that the Indians of North America knew nothing
of the inconvenience of carious teeth  or debilitated stomachs, till
tea was introduced among them.   There can be no question that
the two extremes of heat and cold must "be greatly, perhaps equally
injurious  to  the teeth; and as little that  the  inhabitants of high
northern latitudes must suffer more than others from the use of hot
aliments in consequence of  the greater coldness of their atmosphe-
rical temperature.
   By whatever means, however, a decay or caries of the teeth may
be produced, it appears to operate in three different ways; some-
times commencing in  the internal cavity, and working its path out-
ward ; sometimes outward, and working its path within; and some-
times by a wasting  of the enamel, and consequent denudation of the
bony part.  The first is the least common affection, and is discover-
able  by  the  appearance of the  internal  blackness through the
external  shell; the third is more common than the first, and  the
second the most frequent of the whole; evincing, at its  commence-
ment, the appearance of an  opake white spot through the enamel,
' which gradually crumbles away about the spot, and thus  discloses
that part of  the body  of the tooth which forms  the original seat of
the  disease,  and which, by its continuance, converts the early spot
into a hole, and at  length destroys it altogether, or at least down to
its neck, unless the pain produced by its progress compel the patient
to have it extracted before the disease advances thus far.
   3.  Odontia stufioris.   Darwin Zoonom. Sect. xvi. 10, and Class iv.
i. 2. 3. has observed, that this unpleasant affection is at times pro-
duced by imagination alone.   At the time of writing this, the author
has just  left a very intelligent friend,  by whom he was consulted
 upon a case of spongy and highly irritable gums (gen. i. 7. «.), and
who observed, that just before the author saw him, he  thought he
 should have gone mad upon hearing a woman cry bullaces for sale: 
8
NOSOLOGY.
[CL.L—OR, I.
     Odontalgia haemodia.   Sauv.
     Dolor dentium a stridore.   Darw.
     Zahne-stumpf.   G.
     Agacement des dents.  F.
     Tooth-edge.
     a A stridore.  From grating sounds,
     G Ab acritudine.  From vellication or acrid substances.
4. deformis.   Deformity of the teeth from error of shape, position,
                or number.
5. edentula.   Loss or want of teeth.
     Nodosia (vwfocrta).  Auct. Grtsc.
     Nefrendis.   Vog.
     Toothlessness.  .
it gave him a tooth-edge, that, to use his own terms, convulsed all
his muscles, and seemed to run through his brain.
   4.  Odontia deformis.  This species was  called  by the Greeks
chauliodos (^aj/Afo&s), as was also the person who was thus disfigur-
ed.  Arist. (it Piirt. an. iii. f.   Ofifiian. de Venat. 1. vii.
   See Hunter, p. 115, 199, for examples of a double row of teeth :
as also Block. Medicinische Bemerkungen, p. 19. Triple row, Mean-
der, Physic, Part II.   Numerous and confused rows, Eph. Nat. Cur.
Dec. i. ann. iii. p. 566. ann. vii.  viii. obs. 101.
   5. Odontia edentula.  In the varieties of this species the affection
seldom extends  to all the teeth except in the case of old age.   In
the  first, or that from constitutional defect, a few  only in one or
both jaws are left unprovided for ;  while sometimes an effort to  this
purpose is  commenced, but not carried to perfection.   " In the head
of a young subject which I examined,"  says Mr. J. Hunter, " I
found that the two first incisor teeth in the  upper jaw had not cut
the gum ; nor had they any  root or fang, excepting so much as  was
necessary to fasten them to the gum on their upper surface ; and on
examining the jaw, I found there was no alveolar process nor  sock-
ets in that part."   Nat.  Hist, of the Human Teeth, p. 8.            '
  7. Odontia excrescens.  This  is a common symptom of the true
scurvy; but it should not be confounded with it, as it  is sometimes
an attendant upon other diseases, and sometimes an idiopathic affec-
tion.  " I have often," says Mr. J.  Hunter, "seen the same appear-
ances in children evidently of a scrofulous  habit;  and have also sus-
pected them in grown people.   They likewise frequently afifiear in
persons who are in all other respects perfectly well."   Diseases of the
Teeth, 8cc. ch. iii.
  Gen. II. Ptyalismus. irTvaXivyuts, or ■jrrvtXtvfMs, from arrtw, "  ex-
spuo," " excreo."  The sympathetic variety of this  species is so
common as to become proverbial.  It is most obvious, however, in
those animals whose  salivary  glands  are peculiarly irritable,  and 
GE. I.]
NOSOLOGY.
9
     x Peculiaris.   From constitutional defect.
     G A vi extrinseca.   From external violence.
     y a carie.  From decay.
     ^ Senilium.  From old  age.
6. incrustans.  Teeth incrusted with extraneous matter.  Tartar
     of tlie teeth.  Hunter, p.  192.
     Concreted  by   it  into  one  mass.  Eustach.  Tr. de Dent.
         cap. 2.
7. excrescens.  The substance  of the surrounding  gums  excres-
                   cent.
     Epulis («rou;u«).  Paul. Mgin. iii. 26.
     a Spongiosa.   Fungous  or spongy gums.
       Scurvy of the gums, vulgarly so  called.   /. Hunter, p. 184.
     G Extuberans.   With distinct extuberances on the surface.
       Epulis.   Heister.   Chir. torn.  i. p. ii. c.  85.
       Sarcoma epulis.   Sauv.
         Sometimes softer and  fleshy.  J.  Hunt.  p. 169 ;  and
       sometimes thicker  and  callous.   Id.  p.  188.   Produced
       by vermicles.  Act. Erudit.  Lips. 1715, p. 410. 1719, p.
consequently soon excited to increased action ; as the domestic dog,
which from this circumstance is almost always  slavering ; and  in
which this secretion seems to answer the purpose of insensible per-
spiration in other quadrupeds, for the domestic dog is not known to
have any such discharge, and never  sweats under the severest ex-
ercise.   Munro, Comp. Anat.  This curious fact has not been suffi-
ciently attended to in studying comparative physiology: for it seems
capable of giving us a glance at many of the most singular diseases
by which the dog is peculiarly characterised.
  As a critical  discharge, salivation  is for the most part  salutary,
and often terminates the disease that excites it.   This is frequently
the case in fevers, and the following instance is  perhaps worth re-
lating.   A lady  aged twenty-four, and of a  delicate constitution, was
attacked with a typhus in the spring  of 1788,  under  which she gra-
dually  drooped for  nearly three weeks.   The author thought her
in great  danger; but on  the twentieth  day a sudden and copious
ptyalism supervened, that evidently afforded her considerable relief.
This continued  for  upwards  of a  week, the  daily secretion being
never less than  a pint, and twice not  less than a pint and a quarter.
Yet, instead of  adding to her debility, it appeared to  give  fresh
vigour to the system: the digestive function resumed its  office; she
daily improved  in strength, and on its cessation at the above period
was in a state of convalescence.
  VOL. V.—13. 
10
NOSOLOGY.
[CL. L—OR. I.
                       GENUS  II.

                   PTYALISMUS.

  Involuntary flow of saliva from the moulh.
     Ptyalismus (vTvaXto-fMs.)   Hippocr. Coac.
     Anabexis (*»<*£*g<*).  Gal.
1. acutus   Increased secretion  of saliva from  increased action of
             the salivary glands.
     Salivatio callida.   Dane. i. i. 2. 6.
     Epiphora ptyalismus.  Young.
     Speicliel-fluss.    G.
     Salivation.   F.
     Salivation.
  a  Hydrargyratus.   Produced by the use of mercurial prepara-
       tions.
     Ptyalismus mercurialis.  Heins. Sauv.
  G  Sympathetica.   Produced by the sight,  smell,  or  thought of
         agreeable food.
       Saliva; fluxus cibo viso.   Darw. iv. i.  2. 6.
       Mouth-watering,
  We have numerous histories in which it has provad equally ser-
viceable about the acme of small-pox; and the fluid of  dropsies is
said to have been not unfrequently carried off by the same channel.
In the Medical Observations and Inquiries, iii. 241, there is a singu-
lar  case of an obstinate vomiting of five months standing being re-
lieved, upon  a return of  a salivation, which  for this period had
ceased.  But perhaps one of the most extraordinary instances to be
met with is related by Dr. Huxham, in Phil. Trans, for 1724, Vol.
XXXIII.   The patient was a man aged forty, of a spare, bilious ha-
bit, who had an attack of jaundice, followed by a paroxysm of colic,
this last being produced by drinking too  freely of cider.   Among
other  medicines was given a bolus,  containing a  scruple of jalap,
eight  grains of calomel, and a grain of opium.   Copious dejections
followed, and a few hours afterwards the patient complained of pain
and swelling in the fauces, spat up a little thick, brown saliva,
which was soon considerably  increased  in quantity, of a deep co-
lour,  resembling  greenish bile, though  somewhat  thinner.  This
flux of green and bilious  saliva continued  for about forty hours,
during which time the quantity discharged amounted to two sexta-
rii, or four pints.   The colour of the saliva then changed to yellow,
like a solution of gamboge, with an increase rather  than a diminu-
tion of the quantity.   It continued  of this colour  for the space of 
GE. II.]
NOSOLOGY.
11
  y Mellitus.  Accompanied with a sweet or mucilaginous taste.
     Apocenocis, ptyalismus, mellitus.   Parr.
     Sweet-spittle.
       See for examples Act. Hafn.  iv. obs. 72. Schurig, Sialo-
     graphia.   Found also, occasionally, as a symptom in dentition,
     and as a sequel or crisis of various other  affections.
2. chronicus.   Increased  secretion  of  saliva  from   debilitated
                   habit; and relaxation of the salivary glands.
     Ptyalismus a laxitate    Cheyne.  Sauv.
     Ptyalismus asthenicus.   Parr.
     Ptyalismus idiopathicus.   Cricht.
       " Si quis  ptyalismus idiopathicus sit, pro eo habere vellem."
     CuU. Nosol. gen. cxx.   See Ephem. Nat.  Cur. Dec. ii. ann.
     vii. obs. 5.
3. iners.   Involuntary flow of saliva from a sluggishness of deglu-
              tition without increased  secretion.
     Geiffern.   G.
     Bave.  F.
     Drivelling.   Slavering.
     a Infantilis.   Of infancy :  independently of dentition.
     G Senilis.    Of old age.
     y Moriae.   Of dotards or ideots.
forty hours more, after which it gradually became pellucid, and the
salivation ceased as suddenly as it came on.   During the flow of the
saliva, the teeth and fauces were as green as if they had been stain-
ed with verdigris, and the teeth retained the same cojour for a fort-
night after the ptyalism had ceased.  The patient had  a few years
before been suddenly attacked by a spontaneous salivation, so exces-
sive as to endanger his life.   In the present instance, therefore, it is
probable that  the dose of calomel co-operated with  the peculiarity
of the  constitution in exciting the discharge : but whatever was its
cause, it proved critical both of the jaundice and the colic ; for, from
the moment it took place, the pain of the bowels ceased, and the
greenish colour of the skin began to subside, the urine being at the
same time secreted more abundantly, and of a blackish hue.
  The secretion of sweet or mawkish saliva is not only for the most
part free, but accompanied with nausea,  and other symptoms of in-
digestion : and is probably what Sauvages intends by his first species,
p. nauseosus, or a saburrS. nidorosa.   It is relieved by magnesia and
other  absorbents; but  will often only yield to an emetic, followed
by warm stomachics.  The author has not found acids of more than
palliative  service, and  has sometimes thought the complaint worse
for their exhibition. 
12
NOSOLOGY.
[CL. L—OR. I
                       GENUS III.

                    DYSPHAGIA.

Pain or obstruction in swallowing, without inflammation, and mostly
                without impeded respiration.
     Dysphagia.  Sauv Cull. Sag. Plouquet.
    Ocatoposis.  Vog.
     (Esophagismus.   Vog.
1. constricta.   Difficulty of swallowing from permanent contrac-
                   tion of the oesophagus.
     Dysphagia oesophagea.   Sauv.
       The  contraction may  be produced  by  ossification, excres-
     cences, scirrhous, or calculous  concretions, about  the palate,
     &c.
2. atonica.   Difficulty of swallowing from debility of the muscles
                of deglutition.
  Gen. III. Dysphagia.  From dvsmale, and Qxyu, edo, glutio. Itis
singular that so few of the nosologists should have folluwed Sauva-
ges in making this a distinct genus ;  since dysphagia is as much en-
titled to such » distinction as dysphonia, or parafihonia, as it occurs
in Cullen.  Sauvages has unquestionably, as in several other genera,
introduced species that belong elsewhere,  and which  he is  again
obliged to notice in  otner places; but the species now  offered can,
perhaps, be no where so well arranged as in their present situation,
and the generic character is sufficiently marked.  In Parr, dyspha-
gia is arranged as a species : but It is uncertain  what he intended it
to import; for though he has placed it in his nosological catalogue,
he has  no where explained it, and has altogether forgotten the word
in his general alphabet.  In this catalogue it occurs under a genus
which he has named constrictoria, and which, with singular violence,
includes along with it obstipatio and polypus.
  1. Dysphagia constricta.   See Bonet. Sepulcr. obs.  10. Kruger
Journ.  de  Mtd  Jul. 1765.   Heister.  Anat.de (Ebophago.   Sauv. in
loc.  Mem.Med.Soc.Lond.il.  177.   See  especially, Edin.  Med.
Essays, Vol. Ii.4;h edit, in which are two interesting cases of scir-
rhus in the oesophagus ; one accompanied with a hard glandiform ex-
crescence,  extending from  the middle  of the  canal to the  upper
orifice of the stomach, and so closely filling  it that a probe could be
scarcely thrust down.
  The  causes are very numerous:  the  habit of drinking very  hot
fluids, as tea or coffee, has frequently produced it.  I has occasion-
ally been induced by the datura  stramonium.  See Eph. Nat. Cur. 
6E. III.]
NOSOLOGY.
13
     Dysphagia paralytica.   Sauv.
     Asthenia deglutitionis.   Young.
3. globosa.  Difliculty of swallowing from wind in the stomach
                 spasmodically  compressed into the feeling of a
                 ball, ascending into the oesophagus, and producing
                 a sense of strangulation.
     Dysphagia hysterica.  Sauv.
     Angone.   Vog.
     Globus hystericus.   Darw. 1. iii.  1. 7.
     Orthopnoea hysterica.   Sauv.
     Nervous Quinsey.  Heberden.
4. uvulosa.  Swallowing obstructed or troublesome from relaxa-
                 tion and enlargement of the uvula.
     Hypostaphyle.  Sauv.   Sag.
     Prolapsus uvulae.   Parr.
     (Edema uvulae.  Gorier.
     Productio uvulae a  pituita.   Heister.
     Chute de la luette.   F.
5. linguosa.   Swallowing obstructed, or  troublesome  from pro-
                 trusion or magnitude of  the tongue.
     Glossocele.   Gaubii Pathol.
     Paraglosse.   Sauv.  Vog.  Sag.
     a Exertoria.  Tongue  extended from  the  mouth, often  with
          enlargement of the  substance.
       Paraglosse exertoria.   Sauv.
       Linguae exertio.   Gorier. Syst. Pract. Med.
       Prolapsus linguae.   Parr.
       Stecker-zunge.   G.
       Sortie de la langue.   F.
       Lolling-tongue.

 Dec. III. an. ii.  More generally by ulcets, which usually take place
 at the upper or lower extremity of the oesophagus.   Sometimes by
 a hard thickening of the  coats of the  oesophagus,  similar  to  what
 constitutes a scirrhus in  a  glandular  organ.  Baillie, Morb. Anat.
 Fasc. III. PI. 3. 4.
   In one instance of indurated stricture  of the upper part of the
 oesophagus, the author knew a lady supported  for twenty year* by
 food passed through a silver canula into the stomach.
   3. Dysphagia  globosa.  This is by  no means a mere symptom of
 hysteria, as is often supposed;  for it as frequently occurs under the
 influence of various passions, as grief, fear, and anger; and is a fre-
 quent attendant upon the hypochondriacal diathesis.  It is, however,
 for  the  most part a sympathetic affection, concatenating with the
 state of  the stomach. 
14                       NOSOLOGY.             [CL. I.—OK. I.

    See  a singular case in Bonet, Sepulchr. Lib. I. Sect. xxi. obs.
    27.
  G Ranula.  Intumescence of the salivary glands or ducts.
    Emphragma salivaro.   Young.
    Frog-tongue.
      The species found also occasionally as a symptom in bron-
    chocele, enlargements of the thymus, and other causes of exter-
    nal pressure.
                       GENUS  IV.

                        DIPSOSIS.

    The desire for drinking excessive or impaired.
    Morbid  thirst.
I. avens.   Constant desire of  drinking ; with a sense of dryness
              in the mouth and throat.
    Polydipsia.   Sauv.  Linn.  Vog.  Sag. Cull.
    Sitis morbosa.  Bonet. Sepulcr. torn. ii.
    Grossen  durst.  G.
    Soif excessive.  F.
       Two hundred pints of wine, and the same quantity of water
    drunk daily.  Eph. Nat.  Cur. cent.  vii.  obs.  84.—Eighty
    measures of liquid daily.  Binninger Act. Helvet. vii. n. 16.
       Chiefly a sympathetic affection, or symptom of some other
    complaint.
2. expers.   Constant want of thirst.
    Adipsia.  Sauv. Linn.  Vog. Sag.  Cull.
  Gen. IV. Dipsosis.  From h^au-u, " sitio:" and hence the com-
pounds so common in medical nosology, adipsia, polydipsia, phobo-
dipsia, the last being a synonym of hydrophobia.   Sauvages relates
two cases of patients in whom it formed an original disease :  the one
a learned and excellent member of the  academy of Toulouse, who
never thirsted, and passed whole months  without drinking  in the
hottest part  of the summer.  The other  a woman who for forty
days abstained altogether from drinking, not having had the smallest
desire; and who was nevertheless of a warm and irascible tempera-
ment.  Tom. i. p. 770.—-See another case that continued for some
years, in the Ephem.  Nat. Cur, Cent.  V. and VI. obs. 30. 
GE. IV.]
NOSOLOGY,
  Mangel-durst.  G.
  Manquement de soif.  F.
Like the last, often symptomatic.
                     GENUS  V.

                      LIMOSIS.

The appetite for food impaired, excessive or depraved.
  Dyspepsia.  Cull.  Cricht. Young.
  Stomach disease.  Cricht.
  Morbid appetite.
  Gen. V. Limosis.   From Ai/ms, " fames," " esuries," a root as
well known to medical students as the preceding. This genus must
necessarily be of very extensive range and complication, since the
stomach, in the language of Mr. J. Hunter, may fairly be contem-
plated as the  " seat of universal sympathy," (Anim. Econ. p. 138);
or,  as he expresses it more at large in p. 132 of the same work,
"the stomach sympathizes with every part of an animal, and every
part sympathizes with the stomach."
  Nothing can more fully show the necessity of some common radi-
cal  to express the idea of hunger, and its relations in a medical
sense, than the multiplicity and even confusion of terms which have
been employed for this  purpose by  different  medical  writers.   I
have noticed this subject  at some length in the Introductory Disser-
tation, and shall here therefore only remark, that almost every pri-
mitive and compound the Greek tongue can afford has been had
recourse to for this purpose: as A*/tte$, tpayo,  «fef»s, (limus, phago,
orexis); hence bulimia, boulimus, boulimiasis, palnlimus, from limus;
phagaena, phagedaena, and addephagia, from phago; and cynorexia
and lycorexia, from orexis.  For the  sake of simplicity and ease to
the student, the author has confined himself to the first of these.
  The present genus, in the extent of its range, runs nearly parallel
with the dyspepsia of Dr. Cullen; including, however, 1. avens  or
bulimia, 1. expers  or anorexia, and pica, which the  latter does not;
though it is less comprehensive than the dyspepsia of  Dr. Young,
which not only includes all these,  but adipsia and polydipsia, and
even hypochondriasis and chlorosis.
  It is not from a  desire  of differing  from writers of such high and
deserved reputation that the author has not adopted  dyspepsia in the
present place, "but because it appears to  be more appropriate as a
specific than as a generic appellation in the sense of what is usually 
16
NOSOLOGY.
[CL. L—OR. I.
1.  avens.   Insatiable craving for food.
     Bulimia.   Sauv. Sag.  Cull.  Cricht.
     Bulimus.   Plouquet
     Addephagia. Cynorexia.   Vog.
     Phagsena. Phagedaena.   Cod. Aurel. Galen, lib. iii.   Com. in
         Lib.   Epidem.Jiph. 7.
     Nehem.  Arab.
     Fress-sucht.  Hundes-hunger.  G.
     Faim canine.  F.
     Canine appetite.
  a Syncoptica.  From a feeling of faintness and inanition.
  G Helluonum.  From habitual  indulgence in large and frequent
       meals.
understood by the term indigestion, and nearly parallel to the limited
meaning assigned to it  by Vogel, who, perhaps, first introduced it
into methodical nosology.   The reader will therefore find  it em-
ployed in this sense in spec. 7 of the present genus.
   1. a. L. avens, Syncoptica.  In the Phil. Trans. Vol. xlii. 1745, is
a singular case related by Dr. Mortimer, of a boy twelve years old,
who from a  feeling  of inanition  had  so strong  a craving,  that he
would  gnaw  his  own flesh when  not supplied  with food.  When
awake, he was constantly devouring, though whatever he swallowed
was soon afterwards  rejected.   The  food  given him  consisted  of
bread,  meat,  beer, milk, water, butter, cheese, sugar, treacle,  pud-
dings, pies, fruits, broth, potatoes ; and of these he swallowed in six
successive days, 384 lbs. 2 oz. avoirdupois, being 64 lbs. a day on an
average.   The disease continued for a year.
   Occasionally produced by worms.  See a curious case of Dr.  Bur-
roughs, Phil. Trans,  xxii. 1700; in which the  patient from  his af-
fection was rendered  capable of devouring an ordinary leg of mutton
at a meal for several days together, and fed greedily also on  sow-
thistles and other coarse plants.
   2. a. L. expers Pathematica.  This is chiefly produced by severe
grief, terror, ardent desire of obtaining an object of pursuit, or reli-
gious enthusiasm.  Of the first we have an interesting case  by Dr.
Eccles, in the Edinburgh Medical Essays for 1720, of a young lady
about sixteen years of age, who, in consequence of the sudden death of
an indulgent father, was thrown into a state of tetanus or rigidity of all
the muscles of the body, and especially of those of deglutition, accom-
panied  with a total loss of desire for food, as well as incapacity of swal-
lowing it, for two long and distinct periods of time: in the first in-
stance for thirty-four, and in the second, which occurred shortly af-
terwards, for fifty four days ; " all  which time (observes the writer)
of her first and second fastings she declared she had no sense of  hun-
ger or  thirst;  and when they were over, she had not lost  much  of 
SE. V.J
NOSOLOGY.
17
      Fress-lust.   G.
      Gourmandise.   F.
      Gluttony.
   >  Exhaustorum.   From exhaustion, as the consequence of hard
        exercise, fevers, or excessive discharges.
      Bulimia esurigo.  Sauv.
      Fressenkeit.  G.
      Voracite.   F.
      Voracity.
 %. expers.   Loss or  want of appetite without any other apparent
                affection of the stomach.
      Anorexia.   Sauv. Linn.  Vog. Sag.  Cull.
   Sauvages  has  thirteen  species,  which would here rank as varie-
 ties,  but which, as Cullen justly observes, belong rather to the genus
 (in the present system, species) of dyspepsy.  The following  have
 perhaps a fair claim to be noticed.

 her flesh."   Sauvages alludes to a similar effect  produced by reli-
 gious mania, and nymphomania.  Nosol. ii. p. 805. Asthenia absti-
 nentium.
   2.  G. L. expers Protracta.  As gluttony, or a desire to be perpe-
 tually eating, may be acquired by habit, so may fasting.   See Darw.
 Esuris i. 2. 4.  In this metropolis the idle always eat more frequent
 meals than the busy.  To what extent progressive habit might enable
 man  to protract fasting without inconvenience or disease, has never
 perhaps been fairly tried: but the appetite of hunger seems, from
 various cases, almost as capable of being triumphed over as other
 appetites, and the body of being nourished by a very trifling quantity
 of food, and  for many weeks, perhaps months, even by water alone.
 See Marcardier in Journal de Medicine, torn, xxxiii.  Schenck, lib.
 iii. obs. 39.   Waldschmid, Dissertatiode his qui diu vivunt sine ali-
 mento.  Kil. 1711.
   One of the best known and best marked examples in our own day,
 is that of Ann Moore, of Tutbury.  This  woman  has indeed been
 sufficiently ascertained to be a gross impostor, in  pretending to be
 able to live without any food whatever : but  she seems, from long
 habit, to have lost all pleasurable desire for food, and to be capable of
 subsisting upon very simple liquids alone.  She was at first induced
 to this habit by an extreme difficulty of deglutition ;  and she at length
 carried the habit  so far as, by deception, easily to excite a general
 belief that she never swallowed  any  thing  either  liquid or solid.
 The intelligent committee, who so laudably formed themselves  into
 a watch to determine the  state of the  fact, by  a constant attendance
 upon  her person  for a month,  have  sufficiently  proved that  she
 could not live for ten days without swallowing some portion of liquid.
In their report they  tell us, that  "on the eighth  day she was  ex-
   vol. V.—14 
18                        NOSOLOGY.             [CL. L—OR. I

  « Defessorum.  From too great  fatigue, or the expectation be-
       ing worn out by delay. .
  G Pathematica.  From violent passion or other absorption of the
       mind.
    Asthenia abstinentium.  Sauv.
  Y Protracta.   Enabling the system to sustain almost total absti-
       nence for a long and indefinite time without faintness.
    Anorexia mirabilis.  Sauv.
    Inedia. Jejunium   Plouquet.
    Long fasting.
 ceedingly distressed," her pulse had increased till it had amounted
 to a hundred and forty-five strokes in a minute:  and " so far was she
 reduced on the ninth day,  that she became in danger of expiring;"
 while a  few hours afterwards, when she was compelled to confess
 the imposture  she had practised, " the pulse at one wrist had en-
 tirely ceased, and the other seemed drawn to a thread."  Yet " on
 the whole," say the committee, " though this woman is a base im-
 postor with respect to her  pretence of total abstinence from  all food
 whatever, liquid or solid, yet she can, perhaps, endure the privation of
 solid food longer than any other person.   It is thought by those best
 acquainted with her, that she existed on a mere trifle, and that from
 hence came the temptation to say that she  did not take any thing.
 If, therefore, any of her friends could have conveyed a bottle of water
 to her, unseen by the watch, and she could have occasionally drunk
 out of it, little doubt is entertained that she would have gone through
 the month's trial with credit. The daughter says, that her mother'*s prin-
 cipal food is tea. and there is reason to believe this to be true."—Full
 Exposure of Ann Moore, the pretended fasting woman of Tutbury.
   Hildanas and Haller have collected numerous instances of complete
fasting, for very long periods of time, in some instances for not less
 than sixteen years, but most of them are too loosely recorded to be
 relied upon. There are other cases of this kind, however, that seem
 entitled to more attention.  See Willan, Medical Commun.  ii.  113.
 where life was supported  sixty days on water with a little orange
 juice.  Dr. Eccles's case,  as  given  above, v. 2. *: and the  case of
 Margaret  Lower (Phil. Trans. 1681), as stated in the ensuing note
 on colica stipata y, who for four months was ordered to desist from
 food of evrry kind, solid as well as  liquid, in  consequence  of the
 whole she took, and  even  the  clysters  given her,  being instantly
 vomited  up.
  Four men were preserved in a mine, from which, in consequence
 of an accident,  they were incapable  of being extricated for twenty-
 four days, without other food than water.  Phil.  Trans. 1684.—A
 boy,  fifteen years of age,  said to have  lived three  years without 
Gfi. V.]                   NOSOLOGY.                        19

3. Pica.   Appetite for improper and indigestible substances.
     Pica   Sauv. Sag. Cull.
     Citta.   Linn.
     Allotriophagia.   Vog.
     Vauket.  Arab.
     Massledigkeit.   G.
     Appetit bizarre.   F.
   » Insulsa.  From  want of taste or discrimination: as in infants
       or ideots.
     Pica infantilis.   Sauv.
   5 Perversa.  From corrupted taste or indulgence: often founded
       on empyrical or other improper advice, as the eating of chalk
       or acids to produce a  fair skin.
     Pica voluntaria.   Sauv.
either eating or drinking, with  fever occasionally, after this period
he recovered tolerable health, excepting the use of one of his limbs,
but even then took very little food.  Id. 1720,  by Patrick  Blair.—
A man, said to have lived eighteen years on water—with occasion-
ally a little clarified whey—and locked up for twenty  days  in close
confinement, with  water alone, to prove whether there were  any
imposition: meagre, and supposed to have no evacuations, but in
good  health, and pursued  husbandry.  Id  1742.—A  woman, from
epileptic fits, when a girl of fifteen, took to her bed, lost her appe-
tite, and was attacked with  lock-jaw, which, with  a few  short inter-
vals, continued for four years: was on two or  three  occasions in-
duced to take  a  little water, and her mouth was at times moistened
with wetted linen  through a cavity in her teeth, from  two of them
having  been broken  in  an  attempt to  force the mouth open :  but
swallowed nothing else.  After this period, began gradually to re-
cover from the tetanus, but had  no desire for food ;  and twelve
years from the  attack, when  able to walk upright, took  no more
food than sufficient for an infant of two years of age. Had no egesta,
but when ingesta, which  were proportioned   to  each other,  but
sometimes a dewy softness on her skin. Dr. Mackenzie, Phil. Trans.
vol. lxvii. 1777.  This case is authenticated by  numerous witnesses
of high respectability, and is entitled  to peculiar attention.—Case
of  a woman, who  lost  all desire of taking food by a  fall  from  her
horse into water during her first menstruation at  the age of eighteen:
for fifty years  scarcely ever took  solids, her chief food being whey
in the summer, and milk, milk  and water, or pure  water, in  the
winter: had frequent retchings, which were cured by smoking to-
bacco :  for the space of sixteen years had only one stool  annually,
in the month of  March, resembling a globulet of  sheep-dug : men-
struation never recurred, but occasional vomitings of blood.  Edin-.
Med. Ess. Vol. vi. p. 6. 4th edit. 
20
NOSOLOGY.
[CL. I.—OR. I.
     Malacia (paxax-ta),  Auct. Grate.   So called from the softness
       and effeminacy of character  (in  Latin  mollitks) of those,
       whether young men or young women, who addicted them-
       selves to the above practice.
         Found also, very frequently, as a symptom in chlorosis,
       pregnancy, and several species of mental affection.
4. Cardialgia.  Impaired appetite, with gnawing or burning pain
                    in the stomach or epigastrium and tendency to
                    faint.
   3. Limosis Pica. The origin of pica is doubtful. Perhaps pica and
picatio, as it is sometimes written, are corruptions ofpecca andpecca-
tio, probably from the Hebrew p£j {pec), " to err, mistake, do wrong,
offend," though its common derivation is from " pica, a magpie."
Of the two varieties  introduced into the text, the  respective causes
are in direct opposition to each other: for while the last is from a
vicious habit, the first is from a vicious want of habit; from not being
limited to what is proper, or restrained from what is improper.
   Many of the Negroes in the West Indies are fond of eating common
dirt ;  but whether from a depraved habit,  or to supply the place of
food, does not seem clear. Dirt is eaten by many animals when severe-
ly pressed with hunger—as the ant-eater (myrmecophaga Jubata), the
pangolin (manis tetradactyla), and some species of the tortoise ; and
they hereby  diminish the gnawing pain which extreme hunger is well
known to produce.—Among the most unnatural tastes evinced under
this affection, but at the same time one of the most common, is that
for swallowing  knives. In our own country it has occasionally oc-
curred; but Plouquet, Init.  Bibl. art.  Pantophagus, has collected
examples from  almost all the different states  of  Germany and the
neighbouring  principalities, Basle, Prussia,  Prague, and  different
parts of Russia.  Another curious propensity is that of swallowing
glass, of which  also the instances are numerous___Taste  for eating
hairs, Brest. Sammlung,  1719, p. 589.—For ordure, Borell.  Obs.
O.-nt. iv. 2.  Riedlin. Lin. Med. 1697.—Fourteen  hundred herrings
in pregnancy,  Tulpius. lib. iv. cap. 24.
   4. Limosis Cardialgia.  This and  the two  ensuing  species are
passed over  by Cullen, whose example has been  generally follow-
ed by succeeding nosologists;  the  affections  being regarded  as
mere symptoms of dyspepsia: while  Sauvages,Linneus, and Sagar,
have made  them distinct genera.  The present  system adopts a
middle path:  it contemplates these affections as distinct species of
one common genus.  That  they are often  associated with dyspep-
sia, or disease  of the digestive function, is unquestionable; but  it is
equally  unquestionable that they are not necessarily associated with
it, since they are frequently produced by accidental  causes, during 
GE. V.]
NOSOLOGY.
21
a Mordens.  Gnawing or burning uneasiness felt chiefly at the
     cardta, the tendency to faint being slight.
  Moisus ventriculi.  Lat.
  Soda-  Ltnn.
  Cardialgia spuria.  Aut. Var.
  Kusof.   Pers.
  Brennen im magen.   G.
  Ardeur du coeur.   F.
  Heart-burn.
     Found, also, occasionally as a symptom in dyspepsy,  flatus,
     scirrhus or inflammation of the stomach, worms, and retro
     cedent gout.
the operation of which the digestive function and the digestive organ
are unimpaired and uninfluenced.  Excitcl passions and injuries of
the head are especially capable of generating these affections in  the
soundest stomach.
  6.  Limosis Emesis.  'E/twsvs, from epciu, vomo, and hence the com-
pound " hxmatemesis" for a disease widen belongs to cl. iii.  Sau-
vages and Linnius regard nausea and vomit us as distinct diseases,
and even arrange them as distinct genera.   This  appears highly in-
correct; for, if  minutely examined, they  will be found in every
case to be nothing more  than different degrees or  modifications of
the same affection; produced  from a greater  or less inversion of
the peristaltic motion of the stomach and oesophagus, and  allayed
or overcome by the very same means.   Where the  stimulus, and
consequently the degree of inversion is slight, the effect is confined
to nausea: if beyond this, the nausea becomes retching, and  the
retching becomes vomiting.  They may, indeed, exist  separately,
for the cause may be of a kind or  strength  sufficient to throw  the
stomach at once into a state of violent inversion, and  consequently
to produce vomiting without the common intermediate changes;  as
in the case of various metallic emetics, or sympathetic stimuli from
pregnancy, irritating the fauces, or the sudden sight or smell of
some offensive material.   While, on the contrary, minute doses of
squills or ipecacuanha, or any other cause that produces but a slight
degree of action, will excite nothing more than nausea,  or the first
stage alone of the inverted action upon  which the general affection
depends.
   It is, nevertheless, curious  and of great importance, to observe
the different and opposite effects produced on the animal frame by
these two stages of one and the same disease.   Nausea lowers  the
pulse, contracts the  small vessels, occasions cold  perspiration, se-
vere rigors and trembling, and diminishes,  as long as it lasts,  the
action and even the general powers of life.  The act of vomiting, on
the contrary, rouses rather than depresses; puts to flight all the pre- 
22
NOSOLOGY.
[CL.L  OR. I
€ Syncopalis.  The pain or uneasiness exlending to the pit  of
     the stomach, with anxiety, nausea, coldness of the extremi-
     ties, failure of strength, and great tendency to faint.
  Cardialgia vera.   Aut  Var.
  Gastrodynia atterens.   Sauv.
  Aigreur d'eslomac.  F.
  Sinking Heart-burn.
y Sputatoria.  Burning pain extending over the epigastrium, and
     accompanied  with an eructation of watery fluid,  unusually
     insipid, sometimes acrid.
  Cardialgia  sputatoria.  Linn.
  Pyrosis Suecica.  Sauv.
  Pyrosis.   Cull.
  Apocenosis vomitus pyrosis.  Parr.
  Dyspepsia  pyrosis.   Young.
  Cremason.   F
  Water-brash.   Water qualm.
5.  Flatus.   Impaired appetite,  with  accumulation of wind  in
                the stomach  or  intestinal canal, and  frequent
                regurgitation
ceding symptoms, and restores the system to itself.   There are few
persons so debilitated as not to bear vomiting, but many who would
soon sink under nausea.   It is obvious, therefore, that  these two
different states of the stomach  may be employed as powerful instru-
ments in attacking a variety of general and even  of remote  local
diseases, this organ being  justly  considered as the common centre
of sympathy, and producing opposite results according as it is ex-
cited to different degrees of action.
  The Greek physicians and physiologists, like the present system,
contemplated  both these states of the stomach, as constituting one
common affection: and hence  equally employed  the derivatives of
ejke* and vxvrtau to indicate each of them, whether nausea, vomitu-
ritio or vomitus.  Thus, while the general meaning of eptia is " to
reject," Arfstotle, in Problem, uses hmtix* in the sense  of " to retch
and to nauseate," as parallel with "vomituritio and nausea:  while
wvTtvcris was in frequent use to express the action of vomiting ; and
Galen, Lex Hippocr. tells us that Hippocrates employed vxvrte/o-ets as
synonymous with haematemesis, or vomiting of blood.
  Regurgitation is sometimes found to exist without vomiting, or
even disease of any kind :  and it  then constitutes rumination, from a
peculiar constitution of the oesophagus.  A singular  case is related
by Dr. Slare*, Phil. Trans. Vol. xvii. 1690—3.  The subject was an
adult man, who always ruminated his food, or had it returned into
his mouth for a second mastication about a quarter of an hour after 
GE.V.3
NOSOLOGY.
23
    Ereuxis (t^tv^s.)  Hippocr.
    Flatulent!a.   Sauv.  Linn.
    Bombus.   Vogel.
    Blehung.   G.
    Venlosite.   F.
    Flatulency.
  a Borborygmus.  With frequent rumbling of the bowels.
  G Eructatio.   With frequent rejection upwards.
    Rugh, or Arugh.  Pers.   Whence probably the Greek-tgtvy-w%
       and the  Latin erug-o and rug o.
  y Crepitus.   With frequent rejection downwards.
    Zurat.  Arab.
       Found also, occasionally, in  one or other of these varieties,
    as a symptom in hysteria, hypocondriasis, dyspepsy, colic, and
    cholera.
6. Emesis.  Rejection of the contents of the stomach, or tendency
               to reject.
    Emesis.   Plouquet.
    iEgritudo ventriculi.  Darw. I. ii. 4. 4.
    Sickness of the stomach.

the first;  till when it seemed  to lie  heavy in the lower part of his
throat.  If he did not ruminate at the proper time, he soon became
sick.   The writer notices other cases of a similar kind.
  M.  Majendie, of Paris, has lately been  institutng a series of high-
ly curious experiments,  to determine  what are  the  parts chiefly
concerned in exciting the stomach to  vomit.  And from these  it ap-
pears, that in  nausea  the action is confined  to the organ of  the
stomach alone, or perhaps in  conjunction  with, the oesophagus;
that retching is produced by the contraction of the abdominal mus-
cles,  and  rejection by the  contraction of the  diaphragm alone, or
in conjunction with that of the abdominal muscles, and consequent-
ly that an emetic does not cause vomiting by irritating the fibres or
nerves of the  stomach,  but by means of absorption and irritation
on the nerves of  the muscles that surround the  stomach.  In one
experiment M. Majendie entirely removed the stomach, and substi-
tuted  a bladder, which he attached permanently  to the base of the
(esophagus; after sewing up the abdomen,  he injected an emetic
into the animal's veins:  it had nausea,  made  inspirations, and dis-
charged a coloured fluid which had  been previously put into the
bladder, quite  as well as it could  have done with ifs natural sto-
mach.  Rapport  a I'Institut Nat.—In many  of the present order of
diseases, however, the muscular contraction is unquestionably the
result of sympathy.
   7-  Limosis Dyspepsia,  bvtnrmcrtx, " difficultas coticoctionis," $vi,
male,  and tmttw,  coqueo.  Dyspepsia is  here used in its more com-' 
24                        NOSOLOGY-              [CL. I.—OR  t.

  «  Nausea.  Tendency to reject, but without regurgitation.
     Ekrah. Arab.   Most  of the inflections  of this word  import
       sickness, loathing, oppression, heaviness, grief, like the Latin
       aeger, aegra, of which it is probably the root.
     Eckeh  G.
     Degotit.  F.
     Loathing.
  f  Vomituritio.  Ineffectual effort to vomit.
     Dysemesia, (^Wjmo-**.)   Auct. Grec.
     Vomendi conan»en inane.  Darw.  I. Iii.  1. 8.
     Bremuhung zum brechen.   G.
     Envie de vomir.   F.
     Retching.
  y  Vomitus.   Act of vomiting, or rejecting from the stomach
     Vomitus.   Linn.
     Palmus vomitus.  Young.
     Koeji.  Arab.
     Erbrechen.   Q.
     Vomissement.   F.
     Vomiting.
       The one  or the other variety found also occasionally  as  a
         symptom in colic, colera, lithia, the accession of  fevers,
         and various affections of the head.
mon and restrained acceptation : a sense not quite so limited, in-
deed, as that of Vogel, who first copied the term  from Athtnaeus,
but considerably more so than that of Dr. Cullen and Dr. Young, as
already observed in the note on Limosis ; and  nearly parallel with
the range assigned to it by Dr. Parr, who has  also reduced it to a
species, as in the present instance, his generic term, however, being
not limosis, but anepithymia.
  In most of the nosologies there has been as great a difficulty felt
in knowing under  what  order to place this genus  or species, as in
determining what it should comprise : thus Cullen and Parr arrange
it under their order of adynamia, the latter however  sinking it, as
in the present classification, into  a species;  while in Crichton  it
occurs under the order dolores ; and in Dr. Young, under that  of
cacochymix or cachexies.
  In that entertaining and valuable  work, the Swedish Amoenitates
Academics, the reader wjll find various articles well worth consult-
ing upon the disease  before us:  particularly the four following:
" Fervidorum et Gelidorum Usus,"  by  M. C  Ribe, 1765, vol. vii.
art. 136; and the next article by M. B. C  Tiilaeus, entitled  '" Po-
tusThee  " in both which the writers  seem to ascribe most  of the 
GE. V.]
NOSOLOGY.
J85
7. Dyspepsia.  The appetite fastidious, and the food digested with
                   difficulty.
     Dyspepsia.   Vog. Parr.
     Anorexia.  Sauv. Linn. Vog. Sag.
     Memouk.  Arab.
     Unverdaulichkeit.   G.
     Indigestion.   F.
     Indigestion.
   a Sedentaria.   From a sedentary habit of life.
       Daubenton found doses of ipecacuhan, not exceeding  gr. ij.
     highly useful.   Mem. de la Soc. Med. Royale.
   G Metastatica.  From transfer of morbid action,  as  in  repelled
       gout or cutaneous eruptions.

disoruers ot the alimentary canal, and the  digestive functions, to the
perpetual ffse of tea, and attempt to show that the increase of these
diseases is referable  to the  increase of  this deleterious practice;
The third and fourth papers I  refer to,  are  still more interesting
and valuable: the first of these is by M. Suensson, entitled " Panis
Diateticus," vol. v. sec. 79, year 1757: and offers an ingenious in-
quiry into the various sorts of grain used for bread in differents parts
of the .world, whether  leavened, unleavened, or fermented ;  de-
scribes the comparative advantages and disadvantages of each, and
their effects on persons of weak habits and a sedentary life;  and
lays down various useful remarks, and points out various errors in
the process of making bread.   The  substances  chiefly examined
are rice, Turkey  wheat,  millet, and sago, with the  following sub-
stitutes for bread employed in different parts of the globe : cassava
(root of Jatropha maniot) ;  potatoes;  yams; sea-rush (root of scir-
fius maritimus) ;  drop-wort (root of spiraaflipendula) ;  clown's all-
heal (stachys  palustris);  Iceland liverwort; bark of the wild pine
{pinus sylvestris)-, still used in Dalarne ;  chesnuts;  spurrey-seeds,
{spergula arvensis) ; and the berries of the lotus  of Pliny (rhamnus
lotus,) still had recourse to by some of the African tribes.
   The fourth paper here referred to,  is  numbered 84  in the same
volume,  and entitled " Culina mutata," by M. M.  G.  Osterman.  It
may be regarded as a valuable  continuation of the  preceding:  for
the author enters into an interesting examination  of the  change that
has taken place in the choice of vegetable aliments since the time
of the ancients, and concludes altogether in favour of those of mo-
dern origin.   The nuts and acorns of the  primitive days have given
way to all the variety of the sweeter  farinaceous seeds and roots.
To the malvaceous tribes of plants, so much used  by  the Greeks
and Romans,  has succeeded the more grateful spinach; and to the
blite, the garden orach.  The acescent sorrel has taken the place of
the rough borage, and the asparagus has banished a number of roots,
recorded by the Roman writers  under the name of bulbs, though at
   VOL. v.—15 
26
NOSOLOGY.
[CL. I.—OR. I.
y Antipathiae.  The fastidiousness  or  aversion confined  to par-
     ticular foods.   Chiefly, perhaps, contracted in early infancy
     by the accidental association  of unpleasant or nauseating
     ideas with particular aliments.
  Found also, occasionally, as a symptom in icterus, parabysmus,
hypocondriasis, hysteria, chlorosis,  pregnancy, dropsy, and vari-
ous fevers.
                       GENUS VI.

                          COLICA.

     Griping pain  in  the  bowels,  chiefly about the navel, with
       vomiting and costiveness.

present it is not easy to determine the several species.   M. Oster-
man, however,  thinks that the parsnip  should not have supplanted
the skirret.   The bean of the ancients, improperly so called, (being
the root, as well as the other parts of the Indian water-lily, nymphet
nelumbo), is properly superseded by the kidney-bean.  The'garden
rocket, formerly eaten  with the lettuce to counteract its chilliness,
is banished  in favour of the more pleasant tarragon and  cresses;
the apium in favour of the meliorated celery; the pompion, and
others of the cucurbitaceous tribe, have yielded to the melon; and
the berries of the sumach to  the  fragrant nutmeg.   The silphium
{succus Cyrenaicus, which the Romans purchased  from Persia and
India at a great price, and which by Some is  supposed to be the asa-
foetida of the present day) has been proscribed in behalf of the allia-
ceous  tribe.  Among the animal  substitutes, the author observes
that the  carp has deservedly excluded a number of fishes held in
high estimation in ancient Rome.  He also points out the beneficial
change of oil for butter; of honey  for sugar; of mulsa  (liquors
made with wine, water and honey) for the  exquisite wines of mo-
dern times;  and of the zythus for our present improved malt liquors.
And he notices  also the exchange of  the calida of the Romans for
the more exhilarating tea and coffee of modern times.
  Gen. VI. Colica.  From xaXev, « colon," the chief seat of the dis-
ease.—There are four genera of diseases in Sauvages's Nosology :
gastrodynia, colica,  rachialgia, and  ileus,  whose more prominent
symptoms so closely resemble each other, as to indicate their being
a sort of  natural tribe, or family.  And Dr. Cullen has hence, with
great judgment, simplified them into  one genus under the common
name of  colica.   The  present arrangement follows  him thus far,
and only  differs  from him  in attempting a greater simplicity in its 
«E. VI.]
NOSOLOGY.
27
     Colica.   Cull.
     Koleng.   Pers.
     Grimmen.   Gf.
     Colique.   Douleur au ventre.   F.
     Colic.  Belly-ache.
1.  Ileus.  With retraction of the navel, and spasms of the muscles
              of the belly.
     IleUS (<Aee«).  HippOCT.
     Colica spasmodica.   Cull.
     Ileus spasmodicus.  Sauv.
     Chordapsus.  Cels.
     Passio iliaca. Junck.
  x  Faecosa.   The vomiting accompanied with feces or substances
       injected by the  anus.
  €  Inflammatoria.  Accompanied with symptoms of inflammation.
     Ileus inflammatorius.  Sennert.
     Colique inflammatoire.   Tissot.
species, in adding that of colica flatulenta (wind colic) from several
preceding nosologists, and in employing the established terms ileus
and rachialgia  as  specific  names, instead of adopting the new and
even  less correct  terms which Cullen has proposed in their stead.
Ileus is a word entitled to veneration, from its having descended to
us from the first Greek authorities: it is descriptive of the  com-
mon -seat of the  species, and is still in  use all  over  the continent.
Nothing is gained by exchanging colica ileus for colica spasmodica;
while the latter term is not a little tautological  and inelegant as the
name of a species in Cullen's arrangement, which has already placed
the entire genus under the order of spasmi, and hence doubly de-
nominates it « a spasmodic spasm."  In the second species perhaps,
the most essential symptom (if we may borrow  such a term from
the botanists) is the peculiar  pain that strikes  through the back;
on which  account Astruc first gave it the name of rachialgia (back-
ache), a name highly proper in itself, and which has  been, and,  on
the Continent,  still continues to be,  in more general use than any
other.   For colica rachialgia, however, Dr. Cullen  has given us co-
lica Pictonum, a term, indeed, derived from Sauvages, who at the
same time continues rachialgia, in consequence  of his making,  as
already observed, an unnecessary distinction between the two  com-
plaints.  Now while  rachialgia has the advantage  in  point of anti-
quity, it has an equal advantage in point of correctness and univer-
sality ; for it applies, in a greater or less degree, to all the  varie-
ties of this  species, while Pictonum is limited  to a single variety,
namely, that which results from the beverage of the  Pictonese,  or
inhabitants of Poitou.  On this account, therefore, the author has 
28
NOSOLOGY.
[CL. I.  OR. I.
2. Rachialgia.   The  pain at first dull  and remitting;  but pro-
                    gressively growing more violent and continued;
                    extending to the  back and  arms, and at last
                    producing paralysis.
     Colica pictonum.   Cull etAut. Var.
     Rachialgia.   Astruc. Sagar.
     Rachialgia Pictonum, spec. l.r. metallica 3.   Sauv.
     Paralysis rachialgica.  Sauv.
     Colica nervosa.  Macbride.
     Palmus plumbarius.  Young.
     Mahler-grimmen.   G.
     Colique  de Poitou. C. de peintres.   F.
     Devonshire colic.   Painter's colic.
preferred the original  to the more  modern term;  but has still ad-
hered to Cullen as closely as he has been able.
  Most of the nosologists have felt considerable difficulty in deter-
mining the place of  colica as a genus, in their respective arrange-
ments.  The most striking characters of it are the abdominal  pain.
vomiting, and costiveness, at the commencement :  the vomiting be-
ing much more violent in c. ileus than in the other species, and in
this only accompanied with stercoraceous matter.  The pain there-
fore has been generally taken as  a  directory for the  position of the
disease by those nosologists who have admitted a class of dolores, as
Sauvages, Linneus, Vogel, Sagar, and Macbride ; all of whom,  how-
ever, having followed each other in making a generic distinction
between colica  and ileus, have, in like manner, followed each other
in fixing the last under^M-rwa, or evacuations.  Dr. Cullen's system
has no such class as dolores, and he was  consequently obliged to
search out for a a local habitation of a different kind. The great, and,
in many respects, beautiful  simplicity of  his method,  however,
which contains only four classes, febrile, nervous, constitutional and
local diseases, rendered it peculiarly perplexing to determine  upon
which he  should fix.  Perhaps the last, which can  only be regarded
as an appendix  to the three preceding, might have been the  most
appropriate, especially as  it embraces anorexia  and  constipatio,
which are nearly connected, both anatomically and symptoniatically,
with colica.  Such,  however, was  not the opinion of Dr. Cullen,
who at length fixed upon the class neuroses, or nervous diseases, and
the order  spasmi, as  its proper place; and who has been followed
in this decision by most subsequent nosologists of our own country,
as Crichton, Parr, and Young.
  The  arrangement  now offered  would have allowed the author to
copy the same example, if it had  not appeared to be equally indefi-
nite and incorrect.   Colic is, properly speaking, a disease, not of the
nervous, but of the digestive function; all the digestive organs are
affected by it, and excepting by sympathy, no  other.  Spasm, which 
GE. VI.]
NOSOLOGY.
29
    *  Venenata.  From  mineral and  other poisons:  of which
         lead is the most frequent; whence the name of Painter's
         colic.
    G  Ab  acidis ingestis.  From acid  or  acidulated drinks ;  of
         which crude wines  and cider  are the  most  frequent:
         whence the name of Poilou  and Devonshire colic.
    y  A frigore.  From cold, or suppressed  perspiration, techni-
         cally denominated adiapneuslia.
    <J* A contusione dorsi. From  a blow or other injury on the back.
            These varieties, derived  from  the  remote cause, are
         copied with little alteration  from Cullen.
3 crapulosa.   The pain accompanied with nausea, headache, and
                 dizziness, before vomiting, and often terminating
                 in a griping looseness.
    Colica accidental  18.   c. meconialis  19.   c.  lactentium
         20.   Sauv.
    Colica accidentalis.—c. meconialis.  Cull.
    Colique d'indigestion.  Tissot.
     Colic  from indigestion.
       Produced by  eating  indigestible  aliments,  or  digestible
     aliments  in  too great  abundance.   In this  species the vo-
ought to be its leading character, if its proper place be under spasmi,
is no generic character of it at all.  It does not enter into the generic
definition of any writer who has thus arranged it; and if it did,  it
would  by such  definition exclude various species which are now
commonly regarded as ranging under it; as Cullen's c. callosa, (from
a scirrho-contracted rectum,) c. calculosa, and, in many of their va-
rieties,  c. stercorea and  c.  accidentalis (c. stipata  of the present
system) : for though vomiting may, in a  certain  sense, be  called
spasm, this is not the spasm  here intended.  To one species,  how-
ever, the term  is peculiarly applicable, c. rachialgia,  which, from
this circumstance, Dr. Cullen, as already observed, has  denominated
c. spasmodica ;  but then this symptom becomes a specific and not a
generic character, and consequently ought  to have no power in fix-
ing the genus.
  2 x. C. Rachialg. venenata.  This is not unfrequently produced
by merely sleeping in newly panned rooms.  Is the lead in this case
in a state of metal, oxyd, or salt ? Is  it dissolved in the air, or mere-
ly mixed with it ? The  author has met with various instances of a
most decided character  from this cause alone.  See also M. Armand
■Seguin, Annates de Chimie, lxxxviii. p 263.  The author  has met
wiih other instances of  the same variety of disease from long resi-
dence in close damp rooms filled with newly printed  or coloured pa-
per: but not from damp paper, unless newly printed or coloured. 
30
NOSOLOGY.
[CL. I.—OR. I.
     miting or looseness, or both together, frequently operate a cure.
     I'he  indigestible materials are often  fruit-stones,  or  kernels,
     which have  sometimes remained so long  as to germinate be-
     fore their rejection.—See a description of cherry-stones in this
     state, by M.  Devillaine, Journ. de Med. torn, xxxvii.—of plum-
     stones, Eph. Nat. Cur. Dec. I. iii.
4. flatulenta.   The pain acute ; extending  to the pit of the sto-
                    mach,  often impeding respiration ; accompa-
                    nied with  great fulness  and flatulency;  and
                    relieved by pressure, bending the body forward,
                    or expulsion of wind.
     Inflatio.   Aetius.
     Gastrodynia  flatulenta.   Sauv.
     Colica flatulenta.   Parr.   Art. Colica.
     Ileus physodes.   Relfinc.
     Wind-grimmen.   G.
     Colique  venteuse.   F.
     Wind-colic.
       Produced  by  crude  and  flatulent fruits,  and whatever
     lowers the tone of the  alimentary  canal ;  as too long fasting,
     fear or grief; and hence  common  among  children  and hypo-
     condriacs.
5. stipata.   The pain  severe ; the costiveness obstinate; great
                 tention, with little flatulency :  the vomiting some-
                 times accompanied with  feces ;  the  costiveness
                 with  bloody strainings:  terminating,  where not
                 fatal, in a free dejection of the infarcted matter.
  a  A vicido meconio.   From viscid meconium.
     Colica meconialis.   Sauv.  Cull.
     Tranchees des enfans.  F.
  G  A faecibus induratis.   From indurated  feces.
     Colica stercorea.   Sauv.  Cull.
     Ileus a faecibus induratis.    Sauv.
  y  Ab enterolitho.   From  bezoards and  other intestinal  concre-
       tions.
  5 y  C. stipat.  Ab enterolitho.  The Phil. Trans, contain many
extraordinary cases of this kind.  The most singular, and one of the
best related, is in No.  3, year  1681, contained in No.  181, year
1686,  by Dr. Konig, of Bern.  The patient,  Margaret Lower, a
young  woman of twenty-five, discharged continually the contents of
the intestines, and even the clysters  that were  injected, by the
mouth, and at length a  number  of stones as hard  as Rim,  some in 
GE. Vl.j
NOSOLOGY
31
     Colica calculosa.   Sauv. Cull.
     Ileus calculosus.  Sauv.
6. callosa.   With a sense of stricture in some part of the intes-
                 tinal  canal;  often  of flatulency and pain,  the
                 flatulency gradually passing off by the stricture :
                 the bowels  tardy;  at  length  discharging  small
                 liquid stools.
     Colica callosa.  Cull.
     Ileus a callosa coli stricture.   Sauv.
                  GENUS VII.

              COPROSTASIS.

Obstinate retention of the feces in the intestines.
Adstrictio.   Cels. Gal.
fragments, some of the size of peas, others of that of filberts.   A
clashing of stones against  each other was felt by pressing the hand
upon the  abdomen : there was great constipation, severe gripings,
disury ; and the urine, when voided, was often loaded with a gravelly
matter.   The aliment and-injections being  constantly returned by
the mouth, Dr. Konig  desisted for four months  from  offering her
either meat, drink, or medicine of any  kind, excepting occasionally
a spoonful of oil of almonds.  Blood was now and then vomited from
the violence of the spasmodic action of the stomach; and frequently
urine, to the amount of three or  four ounces at a time, of a strong
taste and smell.  The disease  seems to have lasted with remissions
from  January 1768 to February  1783,  at which  period the history
is abruptly dropped, though  the  patient  seems to have  been in a
state of recovery.  It was  preceded  by  the appearance of  vesicular
eruptions  in the skin, and was  probably  produced  by their  repulsion.
The chemical examination of the  calculi is loose and unsatisfactory.
  6. Colica  callosa.  The stricture here referred to is the sdrrho-
contracted rectum of surgical writers.  It lies beyond the reach of
topical remedies, and is chiefly to be alleviated by a rigid attention
to light, liquid and aperient  diets.  The disease is a lamentable,
though not a common one: yet the  writer of this work has, at the
present time, three  patients afflicted with it under his care : one a
lady of twenty-four years of age,  who has been a sufferer for about
two years; another a lady of thirty-five, who has been subject to it
for  ten years; neither of  whom   is  capable  of passing feces more 
32                         NOSOLOGY.              [CL. L—OR. I.

     Obstipatio.   Linn. Vog.  Sag. Cull.
     Stypsis.   Plouquet.
     Constipatio alvi.   Darw.
     (Kebz.)   Arab.
     Stopfung.  G.
     Constipation.   F.
     Costiveness.
1. coacta.   The  feces, when discharged, impacted and voluminous:
               the temperament firm  and rigid.
     Obstipatio rigidorum.   Cull.
     Enkebaz.  Arab.
       Probably the result of increased action of the intestinal ah*
     sorbents.
2. adstricta.   The feces, when  discharged, hard, slender,  and
                   often  scybalous ; the temperament  weakly, or
                   the habit sedentary.
     Obstipatio debilium.    Cull.
     Husr.  Arab.
       Probably the result of diminished peristaltic action.
voluminous than those of an infant; and the third, a man of forty-nine
years old, who has laboured under the disease for twenty-one years,
and can  never pass a motion  larger than a crow-quill.   Yet, by
strict attention to  diet, all three are able to exist with only occa-
sional  inconvenience  and pain; the  last, married about two years
since,  and  his  wife has lately  brought him twins.  He lives upon
liquids altogether.
  Gen. VII.   Coprostasis.   TLovrporrxtrts. from xaa-ge;, feces, and
trrxtrts, from /o-TUjtw, stagnasio,  emansio: literally  "i named feces."
Hence the-compounds coprorrhaea, " fecal metastasis," copragoga,
" gentle  purgatives;" copriemesis,  " a discharge of  feces by the
mouth,"  and various others.  Obstipatio, as usually employed to sig-
nify costiveness, is altogether   inadmissible:  it  has no authority
among classical writers ; and, if used in medicine at all, should, ra-
ther mean arthritic obliquity or contraction, the obstipitas of Sauva-
ges, contractura of Cullen, and  especially the  caput-obstipum (gen.
dxv.) of  Vogel. The common term with Celsus and the Latin writers
is adstrictio, as its opposite is solutio.  The alvus adstricta, however,
applies rather to the second species  in the present genus than to the
first; for if the feces be voluminous as well as indurated, thev are
called by Celsus coactte:  a term in like manner applied to the intes-
tinal canal itself when thus loaded, Lib. II. cap. iii. alvus coacta.  It
is on this account the author has preferred the terms coacta and ad-
stricta, as the trivial names for the  species of this genus, to Dr.
Cullen's  terms rigidorum and debilium.
> 
GE. VHI.J                  NOSOLOGY.                        33

                      GENUS  VIII.

                   DYSENTERIA.*

  Griping  and  tenesmus;  frequent, mucous,  and often bloody
  2. c. Coprostasis adstricta.   As (he cause  is widely different in
these two species, the means of relief must  be equally  so.  The
saline purgations, or nauseating doses of calomel and ipecacuhan, or
of calomel and antimonial powder, will be found chiefly useful in the
former, and  warm aromatic  purgatives in the latter.   Here, how-
ever, the disease occasionally resists purgatives of every kind ; the
accumulation is prodigious, and evacuation does not occur  for weeks
or months.  In the  case of a young  woman aged twenty-eight, the
distention of the abdomen was so general as to be mistaken for preg-
nancy, especially  a*  there was  occasional sickness, menstrual sup-
pression, and sympathetic enlargement of the breasts.  The case
terminated fatally in about three \eais from  its  commencement.
The colon, which is  preserved by Mr. Taunton, who has obligingly
shewn it to the author, as well as favoured  him with  this history,
measures in circumference more  than thirty inches, and on dissec-
tion was found to contain three gallons of fei.es.
  Tardiness  of evacuation, however,  is not always a  disease : for
some persons are accustomed to have their bowels moved not  of-
tener than twice a week, and  to such  a week's  costiveness  is attend-
ed with no inconvenience.  Chaptal  mentions  the case of a female
patient, who for four months  had no  discharge either from the bow-
els  or  kidneys, and  as little  evacuation by  sweat,, notwithstanding
that her diet was confined to milk-whey, and broths.   She was at
length cured by using  the cold bath  for eight da)S successively.
The disease was  ascribed, and perhjps rightly so, to too copious a
flow of insensible  perspiration:  in  which case rigors excited  by
nauseating medicines, as squills or small doses of ipecacuhan, might
have had a speedier  success than  the use of th<- cold bath.
  Feces retained six months.  Salmuth.  Cent. 1  obs. 24.—Two
years.  Sammlung Medic  Wahrnehmungen, band. iv. p. 294.— Three
years.   Journ. des Sfavans,  1693.—Seven years.  N. Samml. Med.
Wahrnem. band, i p. 423.
  Quadrupeds, that ruminate or possess complicated stomachs, and
use  little exercise,  are  peculiarly  subject  to  the second species,
  • [In the " Study of Medicine," Dr. Good has transferred dysenteria to the
thrid class, and second order  In that order it constitutes the tenth genus.  The
author's reasons for this change will be found in the " Study of Medicine." We
have thought it best to follow the original in both works, leaving the author's
own explanations for the very few cases in which there is a want of correspon-
dence.  Am. Publishers.]
   VOL. V.—16 
34                       NOSOLOGY.              [CL. I.—OR. I.

       dejections;  the  feces  seldom  discharged,  and in  small
       quantities.

which indeed is tne chief cause of the disease in the present system
denominated en'erolithus.  See gen. xi. of the present order.
   Gen. VIII. Dysenteria.  Avo-arigtx, from S'vs" male," and tvrtpov,
" intestinum."  By Caelius A-ir<. iiunu.., Akensioe, Richter, and Stoll,
regarded as an intestine rheumatism; by Cullen ascribed to specific
contagion ;  and by Andre, Nyander, and other followers of Linneus,
as  long before by  Kircher,  to animalculi.  Amen. Acad.  v. 82.—-
Dr. Hagstroom, embracing  this  last opinion,  employed the nux
vomica, and, as he asseits, with considerable success.  Lir»n6us de-
scribes the  supposed animalcules in his Syst. Natura, under  the
name of acarus dysenteriae.  Rolai.der, who laboured several times
under the disease, while residing  with Linneus, pretended to disco-
ver that these animalcules were conveyed  into his body in water
received from a vessel made of juniper wood.  But Buffon has long
since observed, that animalcules may be traced in all animal fluids,
and especially those  of the intestines, after rest and exposure to a
warm atmosphere.  ('See  the note on Helminthia, Gen. xii.)—In
Rolander's case the disease was probably not  contagious;  for not-
withstanding the recurrence of the complaint in  himself, there was
no other sufferer in the house.
  Dr. Cullen regards dysentery not only as always contagious,  but
as always  accompanied with fever; and,according to his nosological
arrangement,  with fever as its  leading symptom, to which all the
rest are subservient.  He has hence placed dysentery in the class
pyrexiae, order pn fluvia,and  has given has his opinion that the ge-
nus possesses but one-species, ''the epidemic dysentery with fever"
of Sydenham  (cap. iii. sect. 4) ;  which is Sauvages' species 6.  the
camp dysentery of Ramazzini  and Pringle, and the hospital dysentery
of C. Monro.  In consequence of which he  opens  his definition  by
styling it pyrexia contagiosa.
  Now, neither of these  terms are to be found in  the generic cha-
racter of perhaps any nosologist, who has not immediately copied
from Cullen.  In Sauvages, Linn6us, Vogel, Sagar, and Macbride it
occurs under the  division, not of fevers, but of fluxes, without any
notice of fever or contagion except in some of their species.  Dr.
Parr, indeed, and  Dr.  Young  place it, not exactly in the division of
pyrexia, but in that of phlegmatiae or phlogismi, which nearly answer
to each other; while the former gives us a subdivision which he ex-
pressly declares is not epidemic (dysenteria sporadica ;) and the lat-
ter makes it a part of the  definition of the genus defluxio, of which
dysenteria is rendeied a species, that it is only "often contagious,"
a limitation which is not varied, and must therefore be supposed to
hold good in the specific character itself.
  In the present arrangement, the author has chiefly taken Syden-
ham as his pole-star, whose view of the disease has best harmonized 
GE. Vni.]                  NOSOLOGY.                        35

    Dysenteria.   Hippocr. Sauv. Linn.  Vog. Sag.
    Dysenteria, an. 1669-72.   Sydenham.
    Megs.  Arab.
with whatever degree of personal knowledge, of it has fallen to his
own share.  His description, as deduced from section iv. cap. i. and
iii. appears  to be in few words  as follows: In the year 1662, cho-
lera, dry gripes, or colic without stools (immatria ventris tormina
sine dejectionibus,) and  dysentery, were very frequent.  In the fol-
lowing autumn the  last  two diseases retumed : anu in the midst of
their raging appeared a new kind of fever (novum  febris  genus)
which  accompanied both diseases, and not  only seized those that
were afflicted  either with the one or the other, but even those that
were free from  each ; resembling the  fever that not unfrequently
(non infrequenter) attended  the  two  preceding disejses, and  which
was hence distinguished by the name of the febris dysenterica.
  Omitting  the consideration of the tormina or gripes, we here meet
with a brief account of 1. simple dysentery, or without fever ; 2. dys-
entery complicated  with the fever that not unfrequently  attended it;
and 3. a new fever resembling this last.   And we also find that sim-
ple dysentery, or that without fever, may at times  be epidemic or
contagious, as well  as that with fever.
  The foregoing passage, however, forms only the  opening of the
first chapter.  It is in the third that this admirable observer and ex-
cellent writer enters fully upon the description of the epidemical
dysentery of the period  before us; in which  he tells us, that in the
course of the autumn of 1669 the dry gripes (ventris tormina sine
dejectionibus) and dysenteries raged nearly equally ; and that " some-
times a fever accompanied them, and sometimes not ;"  febris nunc iis
accessit, nunc aberrat.  u At times," says he, " the dysentery com-
mences with rigor  and shivering, su< ceeded by a heat of the whole
body, as is the case, in fevers—but frequently there is no appearance
of fever, for the host of gripings take  the lead, and  the dejections
follow."  He pursues his description of  the simple dysentery, or that
without fever, observing that in this species an excrementitious stool
is sometimes interposed without considerable pain;  and then enters
upon the species accompanied with fever.  " In the mean time," says
he, "if the  patient be in the vigour of life, or has  been  heated by
cardiacs, a fever arises, his  tongue is  covered with a thick white
mucus, and if he have been much heated, it is black and dry:  there
is great  prostration of  strength, exhaustion of spirits, and every
symptom of an ill conditioned fever."
  It is not necessary to  pursue his description of this second species
further.  It must be obvious to every one, that in the opinion of Sy-
denham, dysentery, as a genus, embraces ut  least two distinct spe-
cies, both of which, at the period of his writing, were epidemic; the
one of a  milder nature without fever, the other of a malignant nature
with it. 
3G                        NOSOLOGY.              [CL.L—OR. I.

     Tormina.   Cels.
     Rnthe ruhr.   G-
     Flux de sang.   Dyssenterie.  F.
     Bloody-flux.   Dysentery.
1. simplex.   Unaccompanied  with  fever: the feces,  when  dis-
                charged,  evacuated  without considerable pain,
                of a natural quality, and affording ease.
2. PYRECTICA.   Accompanied with fever, great loss of strength, and
                   depression  of spirits:  the feces, when discharg-
                   ed, of various colours and consistence; highly
                   fetid, and  mixed  with putrid sanies, sebaceous
                   matter, or  membranous films.
     Dysenteria.   Cull.
     Febris dysenterica.   Sydenh.
  *  Caumatodes.  The accompanying fever being a cauma.
     Dysenteria inflammatoria.   Macbr.
  G  Tiphodes   The accompanying fever being a typhus.
     Dysenteria putrida.  Macbr.
                       GENUS TX.

                     DIARRHffiA,

     Alvine evacuations crude, loose, and too frequent:  with little
         or no griping or tenesmus.

  The former of these is often met with in private practice, of spo-
radic origin, and without evincing any contagious character.  The
latter is perhaps, as Dr. Cullen asserts, at all times contagious. Since
writing the above, the  author has met with Dr. Harty's " Observa-
tions on the Simple Dysentery and its Combinations, containing a
review of the most celebrated authors who have written on this sub-
ject ;" in which much of his own opinion is confirmed, and copiously
illustrated.   The  proper place for dysentery, therefore, appears to
be that now selected:  the febrile or complicated species, might, in-
deed, be introduced under the class pyrectica, but not without con-
fusion, and  in repugnance to all the rules of correct classification, as
separating it from its fellow species.  '
  Gen. IX. Diarrhea.  Atxpjoix,  " per fluvium :"  a " flux," or
"running through :" from hxppsa !'perfluo,diffluo."  The  term is
common to all the Greek writers.
  The species are, with a slight alteration, those of Dr. Cullen; who
has judiciously introduced d. chylosa or cceliaca, and lientcria into the
number, instead of regarding them as distinct genera.  Sauvages in 
GE.IX.]
NOSOLOGV
37
     Cacatoria.   Gal.
     Defluxio.   Cozl  Aur.
     Diarrhoea.   Neoteric.
     Eshal.  Arab.
     Bauch fluss.   G.
     Cours de ventre.  Foire.   F.
     Lax.   Looseness.
1.. fusa.   Feces of common  quality, but immoderately loose, and
              copious.
     Diarrhoea stercorea.   Young.
2. biliosa.  Feces loose, copious, and peculiarly yellow.
3. mucosa.  The dejections  consisting of, or containing a'copious
                 discharge of mucus.
                   Ascribed  by Cullen to acrid ingesta, or taking
                      cold, particularly in the feet.
     Diarrhoea pituitaria.  Sauv.
     Pi'uitaria.—Leucorrhois.  Vog. 111. 112.
     Diarrhoea lactentitim.  Sauv.
       When produced by cold it forms the catarrhus intestinorum
     of various authors:  the motions are acrid, often with hut little
     bilious tinge, and the  lower part of the rectum is  excoriated,
     like the nostrils in a coryza.
4. chyi.osa   The dejections milky or chyliform.
     Cceliaca chylosa, 1.—c.  lactea.   Sauv.
     Diarrhoea chylosa.   Young.
5. lienteria.   The  dejections consisting of the  aliment  passed
                   rapidly and with little change.
6. serosa.  The dejections almost entirely liquid.
     Diarrhoea serosa.   Sauv. Young.

deed seems almost to have persuaded himself to pursue the same
simplifying plan, upon a suggestion of Paulus JEgineia: "Lienteria,"
st.>s be, "videtur diarrhaa species,rwn v ro genus distinctam, ^ut ad
summum, ut notat Paulus JLgineta, cceliaca. non  nisi gradu differt."
It is singular, that with this view of the subject he snould have allot-
ted a distinct generic  place to each of these.  Dr.  Young has  ex-
changed the term  coeliac* for chylosa; a term selected also by Sau-
vages, though under cceliaca  as a genus.   As Cieliaca is here em-
ployed as the name of a class, the  author has preferred chylosa as
the name of a species. Lienteria, lubricitas, not lesvitas uvU&uiiorum,
as usually explained)  was employed by the Greek phvsicians under
an idea that in this species the food slides rapidly along the course of
the intestines, from a peculiar lubricity or srn«.othness at such time
possessed  by them.  The idea is erroneous, but the term, as indi-
cative of fleetness of passage, may still be retained. 
38
NOSOLOGY.
[CL. I.—OB. r.
Diarrhoea aquosa.   Hoffm.ii.p.Ml.   Parr.
  Frequently metastatic, and still oftener produced by elate-
rium, or  other drastic purgatives.   Sometimes urinous; occa-
sionally tinged with blood.
Watery looseness.



                   GENUS X.

                  CHOLERA.

Anxiety, gripings,  spasms in the legs and arms; for the most
     part with bilious vomiting and purging.
Cholera (%otopa).  Auct. Graze. Sauv. CuU.
Cholera  morbus.   Auct.  var.
   6. Diarrhea serosa .   A young woman, aged twenty-four, applied
to the author in August 1806, with a disorder of this species, which
had continued for ten years, and  had never  produced fewer  than
nine or ten watery stools a day, sometimes tinged with blood.   She
was often in great spasmodic pain in the stomach or intestines ; and
had tried a long list of astringents, anodynes, and other medicines, to
little purpose.  She was much reduced, and it appeared to be a  case
of great local irritation from local debility.  Gentle stimulants were
here of essential  service, and the disease gradually yielded to cam-
phor mixture and pills of the resinous gums.
   Gen. X. Cholera.   This term nas been in use from the time of
Hippocrates ; and is supposed by Celsus is be derived from x»M, bile,
and pea, to flow, (literally bile-flux ;)  though Trallian traces it from
YfiXxs,an intestinc,nx\d piu (literally bowel-flux.)  The first two species
now offered are upon the authority  of the Greek  physicians,  con-
firmed by the experience of various modern writers, and especially
of Sydenham.  To admit the second and third, however, it has been
necessary to limit in some degree the last clause of the generic defi-
nition by the adverb plerumque, " for the most part," which is not in
Celsus,  from whom the  definition is taken generally.   Cullen has
rejected the second species, notwithstanding the preceding authori-
ties, and others have conceived it to  be more properly a species  of
colic; but as the remaining symptoms which contradistinguish cho-
lera from colic, and especially the anxiety and spasmodic contraction
of the extremities, are equally present in the  flatulent and in the
common species, we cannot separate them without confusion.  They
are both produced by various and the same causes, as surfeit, animal
and mineral poisons; both at times take place spontaneously, or 
GE. X.]
NOSOLOGY.
39
    Oben und unten purgiren.   G.
    Trousse-galant.  Tissot.
    Purging and Vomiting.
1. vulgaris.   The vomiting and purging frequent and copious.
    Cholera morbus.  Sydenh.
2. flatulenta.   The vomiting and purging rare and absent ;  great
                    and oppressive flatulence; retching ;  flatulent
                    dejections and eructations.
     Cholera sicci.   Sydenh.  Sauv.
    C   ine*i.  Hippocr.
    C. arida.  Gal.
    C  flatulenta.  Menjot.
3. spasmodica.   The  dejections watry;  ineffectual  retching ;
                    spasms  successive arid  violent,  commencing
                    in the thoracic and abdominal muscles.
without any obvious cause, especially towards the decline of sum-
mer;  and both  are  at times epidemic:  though Sydenham admits,
that in the epidemic  cholera of 1669 he met  with  but a single  in-
stance of the dry or flatulent species ;—" unicum duntaxat exemplum
me vidisse memini ineunte hujus anni autumno" cap. ii.  The third
species is now for the first time introduced into a methodic system
upon Mr. Curtis's authority.
  The species of Cullen are  derived from the diversity  of cause
alone; and are  hence improperly called species; for the disease,
and all the symptoms of the disease are  or may be ihe same.   His
species, which can only  be considered as varieties, are  c. spontanea,
and c. accidentalis:  cholera produced spontaneously and by accident.
  In Dr. Young's system,  cholera itself is made a species of diar-
rhoea ; but the vomiting and spasms of the extremities  offer marked
characters for a separate genus.  In Dr. Parr's article Nosology it
occurs as a species  of vomitus, and forms an associate  with pyrosis,
which is almost as much out of its proper place. Nor is its classical
or ordinal place in Cullen much more correct, since he makes it a
genus of nervous diseases under the order of  spasms: an  arrange-
ment  which, like both the preceding, is founded upon a single symp-
tom.
  3. Cholera spasmodica.—Mr. Curtis has well described this dis-
ease.   He regards it, and perhaps justly, as a new species, and pro-
poses to  call it  spasmodic cholera, from the violence and extent of
the cramps; though the vulgar name  given  to it in the Madras
Naval Hospital is as above.  Soon alter the attack " the spasms," he
tells us, "began to affect the muscles of the thighs, abdomen, and tho-
rax, and  lastly they  passed to tho^e of the arms, hands, and fingers:
but I never saw then or afterwards, those of the neck, face, or back,
at all affected.  The rapidity with which  these spasms succeeded the 
40                        NOSOLOGV.             [CL. I.—OR. I

     Mort de Chien-   Curtis, Account of the  Diseases of  India,
       8vo. 1807.
         Species  1  and  2 found  also  sympiomatically in gout,
       worms, enteritis, and intermitting levers.
                       GENUS XI.

                ENTEROLITHUS.

  Stony concretions in the stomach  or intestinal canal.
1.  Bezoardus.  In   concentric  layers  closely   agglutinated  or
                  crystallized ;  capable of a  fine polish ;  fre-
attack, and their severity, especially as affecting the muscles of the
thorax and abdomen, denoted in general the degree of danger in the
case. The affection is a fixed cramp in the belly of the muscle, which
is gathered into a hard knot with excruciating pain.   In a minute or
two this relaxes ; is again renewed, or the affection passes to others;
leaving the miserable sufferer hardly an interval of ease;  and lastly it
passes from one set to another, leaving the former free."  The re-
mote cause  does   ot  appear clear, nor was the mode of treatment
very effectual.  Bontius and Dr. Girdlestone have also noticed this
disease.
  Gen. XI. Enter6lithus.  From  tvrieov, "inlestinum," and Ai0«e
"lapis."  Almost all animals are endued withapftwer of separating or
secreting  lime  and other earths  from the blood for particular pur-
poses, as that of forming a shell covering in  insects and worms, and
of giving hardness to the bones in all other animals.   Under a mor-
bid action of single organs, or of the system generally, this is often
secreted in an undue quantity, and  poured forth into cavities,  where
its accumulation and crystallization must be attended with mischief.
Such at times, is the case in respect to the stomach "aind intestines.
But independently of concretions derived from this source, we often
meet with others  produced by an agglutination or crystallization of
the juices which arc contained in the  aliment, and which, not unfre-
quently, give immediate proof of their origin by the aromatic taste,
smell, or other qualities which such concretions exhibit.  There is
also a third  species of concretion  occasionally to be  traced in the
intestinal canal, of a softer structure, and cetaceous or saponaceous
feel,  which appears  to be  produced by a peculiar combination of the
materials of the feces, and constitute  proper acybala, although this
term has no? uufrequentiy been employed to signify portions of com-
mon  feces or stercoraceous matter  in an indurated state. 
GE.Xl-3
NOSOLOGY.
41
                   quently  with a metallic lustre on  the  surface
                   of each  layer; and  an accidental nucleus in
                   the centre: of a spheroidal figure;  chiefly con-
                   sisting of vegetable matter.
              Bezoar.
         "Said to be found in the human stomach, but more com*
       monly in  that of  the smaller ruminating quadrupeds, as the

   I. Enterolithus Bezoardus.  The term  bezoardus orb- zoar is de-
rives from the Persian compound Padi-zeher, or Pad-sehr, corrupt-
ed into bedzohr  and  bezoar: literally " depellens venenum," and
hence a direct synonym with the Greek term Alexipharmic.  See
for examples Sammlung Medicinischer Wahrnehmungen, Band ii.
  It is not accurately ascertained  that this  species has ever been
formed in the human stomach ; for though there are a few assertions
to this effect, tne substances to which they refer have not been an-
alyzed with  buffi'.ient attention, while the authors appear to use the
term bezoar in a very loose and  indefinite sense.  The bezoar, as
already observed, is chiefly obtained from the stomach of the smaller
ruminating animals, whose food, from the complexity of the organ,
lies for a long time in nearly a stagnant state, and is compelled to
give forth the whole of its juices under  circumstances that afford
them a much easier opportunity of agglutinating or crystallizing than
En many other animals.  In the goat kind these balls are called aega-
gropilae.  They  are of different  sizes and figures, the last being
chiefly determined by the nature of the nucleus, which in different
individuals  is marcasite,  talc, flint, gravel, straw,  glass, seeds of
plants, &c.  In colour they are white, yellow, or brownish: that of
the gazhal is greenish blue,  and when recent highly aromatic.  The
most singular circumstance belonging to them is the bronze or me-
tallic lustre  that appears on the surface of the different layers, and
does not strike deeper than the surface.  This, however, is said to
be a property peculiar to  the western bezoar, and seldom or never
to be found  in those of the east, which  are often of as beautiful a
glossy white as ivory.  Daubenton ascribes the gilt appearance to a
vegetable dye fixed by the tartaric acid of the  plants in which the
dye exists;  and  observes, that he  has remarked a  like appearance
on  the grinding teeth of  many of the ruminating tribes.   Similar
concretions  seem at times to be formed out of the animal body, and
as tubercles to the roots or other parts of certain plants:  for Four-
croy affirms, that in the cabinet of Jussieu he was shown some curi-
ous bezoars  of the oriental appearance, white or yellowish, glossy as
ivory, and of a spheroidal  figure,  which were said to be produced by
the cocoa.
   2. Enterolithus Calculus.  This is by no means unfrequently found
in the human stomach and  intestines, but  far oftener,  as observed
abov^-, in th-; digestive channel of other animals, and particularly in
   VOL. V.—17 
42
NOSOLOGY.
[CL. I.—OR. ft
     goat  and  antelope,  particularly  the beautiful  and  elegant
     species of anielope denominated gazhal  by the Arabians and
     Persians, and isebi ('jy) by the Hebrew poets ; the aim of  the
     Turks :  the antelope gazel of Linneus ; formerly employed as
     a febrifuge and alexipharmic in medicine, and worn as an amu-
     let by  the  superstitious,  who  have  sometimes  purchased a

 the larger ruminating quadrupeds, or those with the long complicat-
 ed digestive organ, where the food, as in the formation of  bezoards,
 is slowly carried forward; and in tardy draught  horses, particularly
 those of millers, which are fed largely on bum, which seems to yield
 a ready basis for these  concretions.   See Phil. Trans, xxiv.  1705,
 Thoresby.   Id. xliv. 1746, Bailey.  Id. xlviii 1754. Watson.   In the
 last case,  the disease had existed  for years: the animal died  aged
 twenty-two, nearly  foaling;—but  gave  no siym of pain or inconve-
 nience till  three months before her death.  The calculus  weighed
 15 lb. 12 oz.; average diameter 8\ inches by 8 inches.
   When chemically analyzed, they are chiefly found to consist of a
 triple or ammoniaco-magnesian phosphate, like the earthy  or white-
 sand cal< uli of the human bladder: though it is difficult to conceive
 from what  quarter the magnesia is obtained.  In the case of millers'
 horses,  some portion of this earth may perhaps be derived  from the
 bran, in which it is  always to be traced ;  but the difficulty still re-
 mains, with  respect to other animals.  The figure, whatever  be
 the size of the calculus, is usually  spheroidal, except where broken
 into separate fragments: the matter  is deposited for the most  part,
 as in the former species, upon a nucleus of some sort or other, as a
 small piece of flint, an iron  nail, a seed or  husk, a  piece  of hay  or
 straw—the structure sometimes radiating from such common cen-
 tre to the surface, and sometimes evincing distinct plates more or less
 united to each other.  In the  human subject these calculi vary from
the. size of a pea to  that of a  filbert,  chesnut, or hen's egg, and are
 often still larger.  In the case of Margaret  Lower (see note on colica
 stipata y)  they were usually of the two former sizes, and appear to
 have been formed in great abundance and  with wonderful  facility—
 for her abdomen, upon pressing it, often rattled from the quantity it
 Contained, with the sound of a bag of marbles.  Many of these were
rough and sharp-pointed at the edge, evidently fragments or nodules
 of larger concretions, and gave great  pain  to the rejection, whether
above or below, for  they were discharged both ways.  The larger
sized weighed rather more than two drams: and Dr. Konig, who
relates the case,  calculated  that the  whole that were discharged
 during the continuance of the complaint could not  amount to less
 than 5 lb.  avoirdupois.  In a  case  related  by Mr. Martineau, Phil.
 Trans. Vol. xxxii. year 1723,  five calculi, some of them much larger
 than the preceding,  were voided per anum, by a  poor woman  in
the third month of pregnancy,  after having suffered from colic about 
GE. XL]
Nosology.
4$
     single one  at  six thousand livres  when  very  fine,  and hired
     them  in  Holland and  Portugal on particular  occasions at a
     ducat a day
2. Calculus.  Radiating from a common centre, or  formed  in
                   concentric  layers ;  mostly with an  accidental^
                   nucleus ;  more  or  less porous; spheroidal  or
                   oblong:  admitting  an imperfect polish ; com-
                   posed chiefly of earths and animal matter.
four or five days : of these, the largest, 8 inches in circumference
and 6j- in  length, weighed two  ounces sixteen  pennyweights and
twelve grains.  In this case, and in various others, the calculi seem
to have been  in the intestines for a  considerable period of time with- '
out inconvenience ; for it is hardly possible to conceive that all these
should have been produced in the course of  a week.—In  another
case in the same journal, Vol.  xli. year 1740, related by M. Mackar-
ness, a calculus of 'his kind was extracted with some difficulty from
the anus by the surgeon who attended, which weighed eight ounces
and a half, and  was ten  inches and a half in circumference.  It is
described  as  " a hard, unequal,  ragged, flinty stone,"  but  was  not
examined chemically.   There is some doubt whether this  had  not
forced its way from the  bladder into the rectum ; but  there is little
doubt that it had been present in the one organ or other, and nearly of
its full size, for several years before its extraction; for the patient's
stools were always obtained with  difficulty, and  three children, which
she  had successively  borne in the three preceding years, were all
marked with a large hollow or indentation in some part of the head,
in one instance  of sufficient  extent to  hold the moiety of a smalL
orange.
   In draught-horses and oxen this species of  calculus is generally
found  single and much larger, and often of little inconvenience for
years.   They vary in size from  three  pounds  avoirdupois to ten or
twelve.  Of  this last  weight the author once met with  an instance in
a  horse belonging to Mr. Hayward, a respectable miller of Brondon
near Sudbury, in Suffolk, and Mr.  Watson Phil. Trans  V-i. xlviii.
year 1754, gives an  account of two considerably  heavier—the  one
weighing fifteen pounds, twelve ounces, with a circun:f rence of
twenty six inches; and  the other weighing nineteen pounds, exclu-
sive of the outward shell or crust which  was  broken  off in several
pieces, with  a circumference of twenty-eight inches.  Both these
were laminated,  but  "  had the  appearance of a pebble;" yet  the
specific gravity was  much lighter, the  first weighing in water not
more than six pounds.   At other  times the crystallization  is more
like that  of  gneiss or  of  grit-stone,  and almost always light and
porous.  See Phil. Trans.  Vol. xxxiv. No. 398.
   Occasionally, however, this species is found  gregarious instead of: 
4|                       NOSOLOGYtr             fCL. I.—OU. 3*

          Intestinal calculus.
       Found  in  the  human stomach and intestines ;  but more
     frequently in those of the larger ruminating animals, and slow,
     heavy draught horses, particularly those of millers.
3. Scybalum.  Soapy or unctuous ;  mostly  continuous;  some-

solitary.  Mr. Watson, in the article just quoted, mentions a  case of
several found in the intestines of a mare, and presented to the Royal
Society by the Duke of Richmond in 1746, the nucleus  of  two of
which was found to be an iron nail.   And by turning to  Vol. xliv.
year 1746, of the same journal, we find these  calculi described by
Dr. Bailey, (for the two articles appear to relate to the same case,)
as consisting of  five in number, of different sizes, some triangular,
and resembling a horse-bean, of an olive colour and finely polished ;
and one much  larger, weighing nearly  sixteen ounces troy,  and
measuring twelve  inches by eleven.
   3. Scybalum. 'Z.r.vGxMv,»' fimus;" and especially " fimus induratus.'*
This  species has not  hitherto received the degree  of attention to
■which it is entitled; and even Fourcroy and Walther seem to have
mistaken it for a biliary calculus.  The specific character is .drawn
up from  various instances  that have occurred to  the  writer, or
have been shown him by others.  A laminated scybalum, taken from
the feces of a woman who had long been suffering from costiveness
and abdominal  pain, an inch and a half in length, and nearly two
inches in circumference, of  an  oblong irregular shape, and reddish
brown colour, was lately presented to a medical meeting in this me-
tropolis as a biliary calculus, the donor expressing his astonishment
that  it could by any means be protruded through the ductus com-
munis.   It had  neither the  specific  levity, nor the  peculiar bitter,
nor the resinous stratification of gall-stones ; and there can be little
doubt that it was formed in the  intestinal canal.
  In Sir Everard Home's paper " On the Formation of Fat in  the
Intestines of living Animals," Phil. Trans, for 1813, a variety of in-
genious facts and experiments  are advanced to show the mode it>
winch scybala are formed in the  alvine passage, the component parts
of which  Sir Everard  supposes to be fat or oil, and mucus.  The
same  paper contains,  in support of  this opinion, two interesting
cases by Dr. Babington; the one that of a lady, who, upon taking
olive oil, constantly voided a number of globular concretions, «  va-
rying in  size from that of a small pea to the bulk of a moderate
grape, of a  cream colour and  slightly translucent, of a  sufficient
consistence to preserve their form and to bear being  cut by a knife,
like soft  wax;" all which, like the  scybalum above, had till this
period been regarded as gall-stones:  the second case that of a girl
four years and a half old, who appears to  have had  a power  of  se-
creting oil in the intestines,  and of discharging it per anum.  "At
three  years old her mother observed something come from her as 
GE. XII.]
NOSOLOGY,
45
times in layers;  spheroidal or oblong ; varying in
colour; consisting chiefly of mucous and oleaginous
matter.
                    GENUS  xir.

                HELMINTHIA.

Worms  or  larves  of insects inhabiting the stomach  or  intes-
       tines.
she walked across the room, which, when examined, was found to
be fat in a liquid state,  which concreted when cold.  Ever since
that time  to the present she has voided  at intervals of ten or four-
teen days the quantity of from one to three ounces, sometimes pure^
at others mixed with feces: when voided, it has an unusually yel-
low tinge, and is quite fluid like oil.  Her appetite is good, as well
as her spirits, and her flesh  firm : her belly rather tumid,  but  nut
hard ;  she is subject to occasional griping."
  The medical records furnish numerous instances of similar forma-
tions.  In the Act. Nat. Cur. Vol. iii.  obs. 51, we have a case very
similar to Dr. Babington's, of soapy or oleaginous globules excreted
in a paroxysm of colic : " excreti globuli, quasi saponacei,  cedente
dolore hypochondriorum."  So, in the Edin. Med. Comment. V. iv.
335, we have a case from the  pen of Mr. Scott, of various adipose
masses dejected in a softened state.
  Gen. XII. Helminthia. From eAu*»«-v0es,  " lumbricus  intesti-
nalis," as employed by Hippocrates.   See especially his treatise De
Morbis, Lib. IV. entitled Utet tXfuiBm  K\aTtwi.  " De lumbricis
latis."  The various kinds of  worms traced in the human stomach
and intestines  have been differently arranged  by different  writers.
Some have assorted them into round and flat worms, and others  into
indigenous and exotic, or those which they tell  us are generated in
the alvine canal, and those which  enter it from without.  The first
method is too limited ; the second hypothetical, for we yet require
proof whether every species found in  the canal does  not primarily
exist out of it.  The present system has, therefore, employed  a
different arrangement, and has comprehended  under the genus  hel-
minthia, or mvermination, three species of  diseases equally distin-
guished  from  each other by symptoms,  and by the different tribes
of animals that  form their remote cause, viz. those which are nour-
ished  aiu' find a  proper habitation throughout every part of the
alvine canal; those  whose proper habitation  is limited  to the  ex- 
46                        NOSOLOGY.             [CL. I.—OR. L

     Helminthia.  Arist.
     Vermin at io.   Auct Lat.
     Parasiiismus intestinaiis.   Young*
     Medeud    Arab.
     Wurmsucht.  G.
     Vers.  F.
     Worms.   Invermination.
1. alvi.  Worms existing and  finding a proper  nidus  in the sto-
              mach  or alvine  canal, chiefly of chi'dien and sickly
              adults; producing  emaciation, a swelled  hard belly,
              gnawing  or  pungent pain  in  the  stomach,  pule
              countenance, fetid breath, and irritation of the  nos-
              trils.
tremity of the  canal;  and those  which have no  proper habitation
in any part of it, and enter it erroneously or by accident.
   Vermination, however, is a subject that requires yet to be studi-
ed:  and if it be made, as  it often nas been, to include parasitic ani-
malcules of all sorts, it will be found very difficult to say where  it
shall end.  In the article  Dysenteria I have observed tnat that dis-
ease was by the Linnean, and various other schools, ascribed to the
larve of a peculiar insect, which the Swedish naturalist somewhat
too precipitately ventured to introduce into his catalogue, and to de-
nominate  acarus  dyseoterise.  Kircher in like manner has ascribed
the  plague to animalcules of a particular kind ; Langius the mea-
sles; various authors the  itch, though  the question is  still doubt-
ful ;  Sigler petecchiae ; Lusitanus and Poncellus small-pox ;  Haupt-
man  syphilis; Martin and Udman, both  pupils of Linneus, elephan-
tiasis ; and Nyander, another pupil of the same great  teacher, con-
tagious diseases of most, if not  of  all  kinds, in his paper in the
Amtxn. Acad, entitled Exanthemata viva.  Some, again, have attribut-
ed haemorrhoids to the same  source, and  others even tooth-ache,
which last opinion seems  at one  time to have been adopted gene-
rally, for we find Shakspeare making one of his best drawn charac-
ters  exclaim

               What! sigh for the tooth-ache!
               Which is but an humour or a -worm.

And when to these we  add the extensive use which has  in the pre-
sent  day been made of  the taenia hydatis, so that almost  every lim-
pid cyst, and, according to  D'  Adams, even cancer itself, is nothing
more than an animalcule, (a worm or an insect,) it would seem that
three quarters of the discuses ( ven  he  m st fatal ones) " to which
flesh is heir," result from a superabundance of vitality; and that 
GE. xn.]
NOSOLOGY.
41
  to Ascaridis  lumbricoidis.  Head  slightly  incurved,  with  a
       transversa contraction  beneath it : mouth triangular : body
       transparent, light y«-llow, with  a faint line down the  side :
       gr g,inous  and vivacious :  from twelve  to  fifteen  inches
       lon£   Inhabits principally  the  intestines  of  thin persons,

corruption  is no longer the triumph of  death over life, but  of life
ovei itself; of life in one form over life  in another.
  We are  at length approaching to more sobriety in our inquiries,
and it is high time that such a  period should arrive; for we were in
great danger of running into the wildest fancies of equivocal  gene-
ration, and  of equally relinquishing all  principles and all limits in
natural history.  Instead of a new succession of living beings per-
petually  but fortuitously produced by a mere bildungstreib (as the
Germans denominate it), a  simple formative effort of the vital pow-
er under  peculiar circumstances, it is more than probable that there
is no worm or insect, no animalcule of any kind, that can be proved
to exist in man or any of the  larger animals, but might be traced,
if due attention were paid to the  subject, to exist out of them, under
the form of eggs, larves, or >ome other modification, and to descend
in as regular a chain of succession as man himself.
  The common round worm (ascaris lumbricoides), though  the in-
testines  form  a proper repository for it, does not exist in the  intes-
tines alone.  Lister affirms  that he has seen them in great numbers,
in ulcers on the surface of the body, in which doubtless tne  parent
insect  or other animal had deposited her  ova.   Phil. Trans  Vol.
viii. year 1673.  In his natural history of the sheep, Palmserus haa
rendered it at least probable that the fasciolae hepaticae, or  flukes,
found so abundantly in the  liver of quadrupeds of this  kind that die
of the rot,  and the origin of which has so much puzzled she natur-
alists, are 'swallowed by the animal in marsh or stagnant waters,
Aman. Academ. iv. 58.  And  Linneus  himself pointed out that the
taenias or tape worms, the existence of which in the intestinal canal
has been an equal source of difficulty to the physiological inquirer,
exist, though much smaller,  in muddy springs; and notwithstand-*
ing that  Pallas, at first, expressed doubts upon this point, the asser-.
tion has been  adequately  confirmed by subsequent observations.
See Dubois, Amcen. Acad. De Taenia ii. 20.
   Plants are generally subject  to  the  same disease, and suffer in
the same manner;  for the usual effects are atrophy and emaciation ;
of which we have a. very striking and common example in the
blight or white wildew (albigo), rust or red mildew (rubigo), and smut
or black mildew (ustilago), whether of wheat or other grains, which
are  now well  ascertained  to be produced, not  indeed by worms,
but  by the growth of minute funguses or  other cryptogamic para-
sites on the leaves, stems, and  glumes of the  plant affected; the
chief of  which are the mucor  erisiphe, m. granulosus, secidium cor* 
48
NOSOLOGY.
[CL. I.—OR. ft
     generally about the ileum,  but sometimes ascends into  the
     stomach, and creeps out of the mouth and nostrils:  oc-
     casionally travels  to the rectum, and  passes away  at  the
     anus.
   Ascaris lumbricoides.   Linn.  Turton. Hooper.
   Lumbricus teres.  Baillie, F. iv. 9.  Auct. Var.
   Long round worm.
C  Trichocephali.   Body above slightly crenate, beneath smooth;
     finely striate  on the fore-part :  head obtuse and furnished
     with a slender retractile proboscis;  tail  or  thinner part
     twice as long as the thicker, terminating in a fine hair-like
     point: about two  inches long; in colour resembles  the
     maw-worm or  common ascaris :   gregarious,  and   found
     chiefly in the intestines of sickly children ; generally in the
     caecum.
   Trichocephalus.   Linn. Turt.
   Trichuris.  Bail.  F. iv. 9.  Hoop.
   Long thread-worm.
-y  Taeniae  .Solii.   Articulations  long and  narrow,  with mar-»
     ginal  pores  by which  it attaches itself  to the  intestines,
     one  on  each  joint, generally alternate ; ovaries  arbo-
     rescent :  head  with a  terminal mouth  surrounded with
     two  rows  of  radiate   hooks or  holders;  and a little
     below, on the  flattened  surface, four  tuberculate  orifices
nutum, uredo frumenti, and u. segetum  of Linneus.   See Sir Jo-
seph Banks's valuable essay on this subject, published in 1805, with
engravings giving various, and some of them  highly magnified re-
presentations of the wheat-straw when  infected with this disease.
Some of these parasites have  a peculiar fondness for the barberry-
tree (berberis vulgaris), where the seeds are produced in great
abundance; and it has hence  often been found, that where a large
barberry tree is  planted in the vicinity of a wheat field, the wheat
nearest to it is affected with mildew of some sort or other.
   Grasses are also subject to the same disease, and particularly the
poa aquatica.   See Sowerby's English Fungi,  Vol.  ii. tab. 139, and
for wheat, tab.  140; and compare  with Fontana's Osservazioni so-
pra la Ruggine del Grano.  Lucca, 1767. 8vo.
   Yet it is not merely by parasitic plants, but by worms themselves,
that vegetables are often infested, debilitated, and at times destroy-
ed.  Stems, leaves, and fruits, are all attacked in their turn;  and
occasionally the stem of the stoutest tree is eaten through, and death
ensues: of which we have frequent examples in the willow (salix
alba), horse chesnut (aesculus hippocastanum), as also  in the typha
tatifolia.   See H'illdcnow, Physiol. Veget. chap. vi. § 323. 
012. XII.]
NOSOLOGY.
49
        or suckers, two on  each side:  tail terminated by a semi-
        cin ilar joint  without any  aperture: from thirty to forty
        feet Jong, and  has been found sixty.   Inhabits the" intestines
        of mankind generally at the upper part, where it  feeds on
        the chyle and juices already animalized.   Is sometimes soli-
        tary, but commonly in considerable  numbers ; and adheres
        so firmly to the intestines that it is removed with great diffi-
        culty.
     Taenia solium.   Linn.  Turt.  Bail.
     Taenia osculis marginalibus.   Hoop.
     Long tape-worm.
   } Taeniae vulgaris.   Articulations short and broad,  with a pore
        in the centre of each joint, and stellate ovaries round them :
        body broader  in  the middle, and tapering towards  both
        ends; head resembling the last, but narrower  and smaller ;
        tail ending  in a rounded joint.  Like  the  last  inhabits the
        upper part of  the  intestines,  and  feeds on  the chyle ; from
        three to fifteen feet  long; usually in  families of three or
        four.
     Taenia vulgaris.   Linn.  Turt.
     Taenia lata.  Baill. F. iv. 9.
     Taenia osculis superficialibus.   Hoop.
     Broad tape-worm.
            Two other species of taenia are found in other animals,
          chiefly carnivorous quadrupeds :  t. lata and t. dentata, the
          former with a central pore, the latter with  one at each
          edge.
     x Fasciolae.   Body  flatlish,  with  an   aperture  or   pore  at
          the head,  and  generally  another  beneath:  intestines
          flexuous:  ovaries  lateral :  hermaphrodite,  and  ovipa-
          rous.
     Fluke   Gourd-worm.
2. Podicis.   Wonr>, or the larves of insects existing, and find-
                 ing a proper nidus within the  verge of the  anus,
                 extitirg a troublesome local  irritation, sometimes
                accompanied wilh  tumour;  frequently preventing
                sleep, and producing pain or faintness in  the sto-
                mach.
     x  Ascaridis  vermicuiaris.. Head subulate,   nodose, and  di-
          vided into three vesicles,  in the middle of each of which
          is an  aperture  by which  it receives nourishment ; skin
          at the  sides of  the body finely crenate or wrinkled ;
          tail  finely tajuring and terminating  in  a point;  the  fe-
          male has  a  small  punctiform aperture a little below the
  vor. v.—18 
50
NOSOLOGY:
[CL. I.—OR. I.
         head, through which it receives nourishment.  Gregari-
         ous ; vivaparous;  about  half  an inch long ; sometimes
         wanders into the intestines, and occasionally as high as the
         stomach.
       Ascaris.  Baill. F iv. 9.
       Ascaris vermicularis.  Linn.  Turt.  Hoop.
       Maw-worm.   Thread worm.
    G  Scarabaei.   Larves of several species of ihe beetle.
           These have  not  been  accurately described.   Perhaps
         the following are the chief: grey larve,  with yellowish
         legs and ferruginous head, of  s. nobilis;  and those of s.
         Scboefferi and s. volvens, which, when out of the body,
         deposit their  eggs in round balls of animal dung,  which
         they roll up and bury with their hind feet.
    y  (Estri.  Bots, or larves of the hmmorrhoidal breeze or gad-
         fly.  Round ; pale-green ; tail obtusely  truncate; bead
         tapering ; mouth horny, with two lips, and two recurved
         black claws on each side  of the mouth.  Found convoluted
         in the mucus and feces of man, but far more frequently of
         other animals, and especially of the  horse.
3. erratica.  Worms  introduced by  accident,  and  without
                  finding a proper habitation in  the stomach or
  3. G H. erratica Hirudinis.  Dr. Lister, apparently without know-
ing that the subject had been touched on before, describes the case
of a patient, who, after having " had about his stomach and right
side a most exquisite and tormenting pain for at least four months,
which many times threw him into hoirors and  dullness, ague-like,
and was the sickest  man," continues he, " I ever saw  not to die,"
vomited up a worm of  a dark green colour, like a horse-leech, and
spotted.  From the puncture of the animal, or the violence of the
retching, he brought up at the same time  two pounds of coagulated
blood: and had occasionally discharged  blood downwards.  The
man imagined he drank it in pond water during the preceding sum-
mer.  The worm  was  dead when rejected, or at least before  Dr.
Lister saw it: four inches long, and three in its largest circumfer-
ence : and is  still farther described and drawn as having three small
fins on each side near the head, with a forky, finny, transparent, and
extensile tail.  Phil. Trans. 1681-2.  No. 6.
  One of the most extraordinary cases, among those  entitled to at-
tention, is related by Mr. Paisley in the Edinburgh Medical Essays,
ii. art. 26.  In  this case there were two  worms,  whose  heads he
compares to that of the horse-leech, and which  appear to have been
tolerably quiescent in their growth, till  the general system was dis-
turbed by a wound on the breast received by  the patient in conse- 
6E. XII.]
NOSOLOGY.
51
              intestines: producing spasmodic colic with se-
              vere gripings;  and  occasionally  vomiting or
              dejection of blood.
   Of this subdivision  we know but little : yet the ensuing in-
stances may afford sufficient reason  for forming it   It  might
easily  be enlarged, but the authorities  for extending it further
are doubtful.
Gordii.  Hair-worm, or seta equina.  Found in  soft stagnant
waters :  from four  to six inches long, twisted  into various
knots and contortions  : colour pale brown, with dark extremi-
ties.
   This disease is most frequent among the  peasants of Lap-
land, and  was suspected by  Linneus,  and has been  since
proved, or thought to be  proved, by Dr. Montin, one of his
most celebrated disciples, to  be occasioned  by their drinking
the half putrid water  of stagnant marshes or ditches inhabited
by the gardius.  It is not known on the Lapland mountains.
The gripings are  often so  violent,  that the patient rolls  and
writhes on  the ground  in  severer  agony than  a woman  in
labour, and discharges bloody urine.  After many hours, some-
times an  entire day, the disorder terminates in a profuse ptyal-
ism that  continues for a quarter of an hour.   The Laplanders
call  the  disease UUen, or Hotme.   Linn.  Flor. Lap. de Ange-
lica.   Montin, Amcen. Acad.   Splachnum. ii. 26.
quence of a duel with the small sword.  The general symptoms of
this species of helminthia appeared about the third day afterwards,
and continued  with many  variations for several weeks, when the
patient discharged inferiorly one of these worms, measuring a foot
and a  half in length, and an inch and a half in  diameter, dead, but
full of blood, and accompanied by a large dejection of grumous
blood,  " to appearance  some pounds; and not many weeks after-
wards  the other still larger.—A worm, apparently similar, is stated
by Dr. Bond of  Philadelphia, 1754, to have been discharged down-
wards  by a female patient of his, who had been long subject to an
hepatic disease,  which  gradually changed to  violent  helminthic
symptoms in the stomach.   These, at length,  suddenly vanished,
and within twenty-four hours the worm was dejected, dead, and in
two parts, the whole making twenty inches in length.   The patient
died soon  after; and on  opening her,  this worm appears to have
worked its way, when small,  into the liver  by the course of the
common duct, to have committed great depredation here, and after-
wards, with considerable difficulty and dilation of the duct, to have
travelled back again.  Dr.  Bond ventures to call it an hepatic leech; 
52                        NOSOLOGY.              [CL. I.—OK. I.

  Colica Lapponica.   Sauv. ii. 103.
G Hirudinis.   Various species of the leech.   Swallowed along with
     the muddy and stagnant water they inhabit.
       Apparently both  the  medicinal and  the  horse-leech  (h.
     sanguisuga) have  been thus found ; but the exact species has
     not  been sufficiently indicated.   Sauvages, in his genus Hae-
     matemesis, quotes Galen, Schenck, and Wedel, but does  not
     describe the species.   Upon turning to Galen, iv.  411. D  the
     reader  will find that he briefly adverts  to  the disease,  and
     quotes from Asclepiades and Apollonius the remedies that were
     employed in their respective days : but he does not characterize
     the worm.
y Muscse cibariae.   Larves of the pantry-fly.   These seem chiefly
     to produce mischief while in the stomach, into which they may
     be taken with decayed cheese, as the eggs are sometimes depo-
     sited in it.   See Dr. White's case, Mem  Med.  Soc.  Lond.
     Vol. ii.  The patient, aged  thirty, was emaciated, of  a  sal-
     low  complexion ;  had gripings and tenderness  of the  abdo-
     men ;  costiveness, rigors and cold extremities.  Took columbo
     root, and occasionally calomel  and other purgatives.  In a
     month was belter, and the appetite good.   The next purgative
     brought  away  an immense  number of  pupes os chrysalid
     worms ;  some of which being preserved, were  transformed into
     four-winged insects,  the musca cibaria.
though he calculates its course as now stated.—London Med. Obs.
and Inq. i. 66.
  M;iroja, physician to Philip IV. of Spain, in his treatise De Morbis
Internis, lib. 4. cap. 16, mentions the case of  a patient who discharg-
ed a still larger dead round worm, of the same  monstrous kind, and
died in the act of discharging it:  its length was twenty fingers
breadth ; its rotundity equal to the size of a  stout  man's hand: full
of blood, and  had more than a pound and a half of  blood taken from
its inside.
  3. H. erratica Muscts cibarie___Mr. Church, to  whose entomolo-
gical skill these worms were confided, asserts in the same paper, that
he once knew a child  discharge a larve of the caddy insect (phry-
ganea grandis); and  that the phalaena pinguinalis lives and is nour-
ished in the stomach ;  and after  sustaining several metamorphoses
is thrown out, and proves its proper genus.  See  also Mr. Calder-
wood's case.   Edin. Med. Com. ix. 223. 
HE. XIII]
NOSOLOGY.
53
                     GENUS  XIII.

                       PROCTICA.

  Pain or derangement about the anus, without primary inflamma-
       tion.
     Proctica.   Linn. 59.   Vog. 167.
1. simplex.   Simple pain at the anus.
     Procnlgia.  Auct. war.
     Doulfur du fondement.   F.
2. Callosa.  Pain  produced  by, or accompanied with, a callous
                 contraction of the rectum.
       The cause  is usually, though not always,  scirrhus; and
     colica callosa  is an occasional result.   See  Colica,  spec. 6.
     The scirrhus, as in other cases, sometimes degenerates into car-
     cinoma.
3. Tenesmus.  Painful  and  perpetual urgency  to go to  stool,
                  with  dejection  of mucus  alone, and in  small
                  quantity.
     Tenesmus spontaneus.   Sauv.
     Obstipatio Tenesmus.   Young.
   Gen. XIII.   Proctica.  From irgex.Tos,podex,nates.  The term
is taken from Linneus, and employed nearly in a parallel significa-
tion.  Sagar and Macbride, from the same root, have formed proc-
talgia.
   4. Proctica Marisca.  There has been much difficulty felt among
the methodical nosologists in arranging this species, in consequence
of the diversity of its symptoms.  Sauvages and Sagar have express-
ed a desire to limit the term haemorrhois to an occasional and free
flux of blood from the anus;  and to make a distinct genus of haemor-
rhoidal tumours under the name  of tnarisca : hence the first occurs
as a separate disease in their respective systems under the class
fluxus, order alvi-fluxus ; and the second under the class vitia, order
cystides.   Cullen, contemplating piles and hemorrhoidal flux as the
same, and invariably a constitutional disease accompanied with fever.
has placed it under the  class pyrexia, order hemorrhagic.   In both
these views, however, he seems to be nearly alone; most other pa-
thologists regarding piles or  haemorrhoidal tumours  as a local affec-
tion, and perhaps no others contemplating them as necessarily con-
nected with fever.  There is, moreover, a laughable kind of sole-
cism, in applying the term hamorrhois, literally " flux of blood," to
a disease, one of whose subdivisions admits of no flux whatever, and
another of a flux of mucus without blood. 
54
NOSOLOGY.
[CL. I.—OR. L
     Stuhlzwang.   G.
     E'preinte.  F.
     Straining.
       Occasionally arising  from local acrimony or irritation: and
     then an  idiopathic affection.
       Found also as a symptom in various other complaints,  as
     dysentery, haemorrhoids, helminthia, costiveness, calculus  of
     the bladder, and pregnancy.
4. Marisca.   Livid and painful tubercles or excrescences, usually
                   with a discharge of mucus or blood.
     Marisca.  Sauv. Sag.  Plouquet.
     Haemorrhois.    Cull.
     Proctalgia haemorrhoidalis.  Macbr.
     Bnsyr.   Arab.
     Guldene ader.   G.
     Hemorrhoide.   F.
     Piles.
     x Caeca.  Pain and tubercles without discharge.
       Haemorrhois coeca.   Cull.
       Blind-piles.
     o Mucosa.   Tubercles pale and mucous.
       Haemorrhagia mucosa.   CuU.
       Leucorrhois.   Vog.
     y Cruenta.  Tubercles florid  and bleeding.
       Haemorrhagia cruenta.   Cull.
       Haemorrhois.  Linn.
       Bleeding piles.
  On these  accounts I  have followed Sauvages and Sagar, rather
than Cullen, in making a distinction  between the two affections of
anal tumours or tubercles, and anal haemorrhage :  and have trans-
ferred the latter  to the genus haemorrhagia in  Class III. Order
IV.—The position and definition of haemorrhois, as given by Linneus,
range nearly parallel  with that of Sauvages; for it occurs in  his
class evacuatorii, order abdominis, and  is expressed " dejectio san-
guinis cum proctica absque colica :" by proctica, meaning the gene-
ral anal affection to  which the term is applied in the present system.
Parr, like the preceding writers, separates haemorrhois from fevers,
but with Cullen employs the term to import anal flux of blood, and
anal tumours.   In him  it occurs in the order profluvia, genus hae-
morrhagia;  and consequently he falls into the solecism just noticed
in Cullen's use of the term.   Crichton  has omitted the disease alto-
gether, unless he intends to include it,  of which his table  gives no
notice, under haematorrhaea arteriosa,  which he  explains arterial
haemorrhage from the  intestines; but  which,  after  all, could only
comprehend a very  few of its modifications. 
GE. XIII.]
NOSOLOGY.
55
    ^ Polysosa.   Polype-like excrescences shooting from a slender
         root; bulbous; soft and compressible ; red or reddish ;
         chiefly internal.
            Found also, in some one of the varieties, occasionally, as
         a symptom or sequel of parabysma, gout, asthma, sciatica,
         rheumatism,  various affections of the bladder, hypochon-
         driasis, hysteria, ecphronia ; and occasionally giving rise
         to recent or fistulous ulcers.
5. Exania.   Inversion and  prolapse of the villous tunic of the rec-
               tum, from relaxation of the sphincter, with more or
               less tumour.
    Exania.  Sauv. Sag. Plouquet.
    Proctocele.   Pathol.  Med.
    Haemorrhois procedens.   Cull.
    Haemorrhois ab exania.   Sauv.
    Prolapsus ani.   Plater. Nenter.
    Gesassfall.   G.
    Chute du fondement.   F.
    Falling down of the fundament.
    x Simplei.   The tumour of moderate size, and the reduction
         easy.
     G Spasmodica.  The tumour large and irritated ;  and  the in-
         testine contracted by a spasm of the sphincter.
            The tumour has, in the  last case, been frequently mis-
         taken for a marisca ; and Dr. Cullen has, perhaps, given
         some countenance to the error  by describing one of his
         species of haemorrhois as  produced  by a  prolapse  of the
         anus.   The  hemorrhoidal tumour is dull  and livid ; that
         from a prolapse of the anus is flesh-coloured, sometimes
          wrinkled, at others smooth and shining.
            In some instances the  prolapse is so considerable  as to
         render visible the valvules of the colon.   Morgagn.   De
          Sed. et. Caus. Morb. Ep. xxxiii. lxv.
            Found, also, as an effect, in obstinate costiveness, stone
          in the bladder, labour, and helminthia podicis. 
56                        NOSOLOGY.             [CL. I.—OR. II.
                       ORDER  II.

                 SPLANCHNIC A.

           AFFECTING THE COLLATITIOUS VISCERA.

  Disquiet, or diseased action in the organs auxiliary to the diges-
tive process, without primary inflammation.
                   GENUS  I.

                 ICTERUS.

Yellowness of the  eyes  and skin ; white feces;  urine  saffron
     coloured, and communicating a saffron dye :  the course of
     the bile obstructed.
   Order II. Splanchnica. SwA«y^y/xa, " Viscerali  " *'ad viscera
pertinentia."  So  Dioscor. i. cap. 82. 0-irXayyyix.x (pxef*.xx.x, " visce-
rales medicinae."   Splanchna,  in its greatest  latitude in modern
times, comprises, like  the Latin viscera,  all the larger bowels or
internal organs, to whatever cavity they appertain, and consequently
includes the brain.  But, agreeably to its more exact sense, it  was
formerly limited to those of the upper and lower belly, the entrails,
as they are  colloquially denominated, those  more especially  which
were consulted by the aruspices, and constituted the chief parts of
the sacrifice!  In this  sense, it is used by Homer in describing the
sacred feast made  in behalf of Telemachus when on  the point of
quitting Ithica.  Odys. iii. 5.
       Axrxe rxtt kxtx  piye ckxtj, x.ai SIlAArXN' e^rxa-avro, &C.
   Gen. I. Icterus. " lxTegos:" among the Romans ''Morbus regius,"
or " aurigo," on account of its golden hue.  The  lexicographers
have not been  able to follow up the term to its origin.  The author
ventures therefore to suggest that it is probably derived from  the
Hebrew  *iro,  with a  formation  ' producing iw (icter), and im-
porting as a verb, '> to surround," " circumfuse," " encompass;" and
as a noun " a royal crown or golden  diadem."   Icterus was a term
also given to the golden thrush, on account of its yellow plumage;
and hence the bird was  fabled to be  connected with the disease;
and it was believed, according to Pliny, that if a person labouring 
QE. L]
NOSOLOGY,
57
     Icterus.  Auct. Grmc.
     Morbus regius.  Auct. Lot.
     Icterus.  Lin.  Vog. Boerh.  Cull.
     Aurigo.  Sauv.  Sag.
     Cachexia icterica.  Hoffm.
     Cholelithia icterus.   Young.
     Yerekaun.   Arab.
     Gelbsucht.   G.
     Jaunisse.   Mere jaune.  F.
     Jaundice.
1. cholosus.   The course of the bile obstructed  from its  own
                 viscidity :  general languor;  nausea*;  dyspepsy ;
                 and  occasional pain or uneasiness at the stomach.
     Aurigo ab obstructione.   Sauv.
     Icterus biliosus.   Parr. Diet. art. Nosol.
2. chololithicus.   The course of the bile obstructed from bilious
                     concretions in the ducts, at length protruded
                     and  discharged   with the  feces ;  frequent
                     retching; acute pain in  the hypogastric re-
                     gion, increased upon eating.
under the jaundice looks at the pheasant; the bird dies and the pa-
tient recovers.
   This complaint, from Sauvages to  Cullen, has  generally  been
ranked among the cachexies or depraved habits; " habitus deprava-
tus ;" as Dr. Cullen explains the class.  Yet one of the species ad-
mitted by both these writers is that of infants produced a few  days
after  birth,  and  ceasing almost as rapidly;  while another is the
mere result of the mechanical obstruction of the ductus choledo-
chus by local concretions.  Yet it  would be  difficult to say in  what
other part of the systems of these and various other writers this
disease should find a place.  Parr puts it more correctly under the
suppressorii; and Dr. Young under thepareccrises ;  which,in a  wide
but allowable latitude of the term, may include all  the species ex-
cept the spasmodic, perhaps the most doubtful of the whole, in which
light indeed he regards it himself.
   The pain is greatest in species 2. i.  chololithicus: the general
functions  are, perhaps, most deranged under species 1. i. cholceus,
(#>A««e«,) in which there is not only obstruction but depravation of
bile;  and  in species 4. i. hepaticus, in  which it is not only perhaps
secreted in too small a quantity, but at  the same time imperfectly.
A German physician of the present day, of  high  and  deserved re-
pute, Gothlieb Richter, (Med. and Chirurg. Observations) conceives
that this is not only the severest bqt the most common cause; and
   vol. v.—19 
58
NOSOLOGY.
[CL. I.—OR. lb
     Icterus calculosus.   Cull.
     Aurigo calculosa.   Sauv.
3. spasmodicus.  The course of the bile obstructed by spasmodic
                     contraction  of the bile-ducts ;   the disease
                     preceded  by acrimonious ingesta j hysteria,
                     or some violent pas&ion of the  mind ;  and
                     voluntarily subsiding within a few days after
                     these are removed.
     Icterus spasmodicus   Cull.
     Aurigo spasmodica.—a. a venenis.   Sauv.
4. hepaticus.   The course of the bile obstructed by the derange-
             •      ment of the  liver from scirrhus or  infarction :
                   occasional retchings and dyspepsy.
     Icterus hepaticus.  .Cull.
     Aurigo hepatica.  Sauv.
5. infantum.   The course of the bile obstructed by viscid meco-
                   nium ;   without  pain  or  dyspepsy :  easily re-
                   moved  by purgatives.
     Icterus infantum.   Cull.
     Aurigo neophytorum.   Sauv.

in proof of its depending entirely upon a morbid state of the liver,
adverts to a case in which  there was no gall-bladder to be found,
and only a skinny substance in its  stead  without cavity at all; in
which instance  he supposes the  bile, however imperfect, to have
been absorbed by the morbid  irritation of the liver as  soon as it
was formed.  Yet its presence in the blood is, perhaps, not  more
unsalutary than its absence  from  the stomach and alimentary canal.
   On what account Dr. Cullen has omitted spec. l,i. cholceus it is
not easy to say.   It is noticed by most practitioners from Hippocrates
to the  neoterics.  Parr's name of biliosus the author would have
adopted, but that this term  is usually employed in a different sense,
as importing redundancy and activity, rather than morbid change in
its combination : independently of which  the Greek term is nearly
as common as the Latin, and gives rise to all our compounds.  Dr.
Young expressly includes this species und,er his cholelithia icterus,
synonymous  with  spec.  2  of the present arrangement: but  the
symptoms are different, and the name cannot accurately cover it.
  The icterus gravidarum  of Cullen and others is here omitted, as
unquestionably not an idiopathic disease, but a symptomatic affection
only.
  Cullen has justly observed, in a note subjoined to this  genus, that
yellowness of the skin may proceed not merely from resorbed bile,
but from effused blood, or scrum of blood, as we see perpetually in
ecchyrhosis.  The saffron  dye in  the  urine is perhaps the truest
pathognomic. 
GE. II.]
NOSOLOGY.
59
  Found also symptomatically in pregnancy, colic, and fevers
of various kinds;  especially epanetus icterodes, or  yellow
fever*
                       GENUS  II.

                      MEL^NA.

     The colour of the eyes and skin fuliginous, leaden or livid ;
         black, viscid dejections,  with occasional vomitings of the
         same ; anxiety ; depression  of spirits.
     Melaena.   Sauv. Plouquet. Cull. Catal. Morb. Omiss.
     Melasicterus.   Sag.
     Cholirica.  Guarinoni  Linn.
     Melaena morbus (MeXxtvx Net/ires.)  Hippocr.
     Zeryr.  Arab.
   ^Schwartze-galle.   G.
     Maladie noire.   Ictere  noire.  F.
     Black vomit.  Black jaundice.
I.  cholcea.   The black discharge bilious ; the vomiting occasion-
                ally green and acrid  ; great languor ;  vertigo.
  Gen. II.  Meljena.   M.t\xim, from pathos, " niger."   This disease
is not in Dr. Cullen's arrangement ;>bui it occurs under the present
name, in his subjoined  " Catalogue of omitted diseases, which per-
haps ought  not to have been omitted."   Catalogus morborum a nobis
omissorum, quos omisisse fortassis  non oportebat.  Hippocrates is pe-
culiarly full in his description of this disorder, and there are few no-
sofcgists who  have not entered it into their respective systems. The
species and  definitions in the present arrangement are  taken from
Hippocrates, de Morbis, lib. ii. with little change.  The first seems
to depend upon an organic depravation of the liver, chiefly perhaps
in the case of  habitual gluttons and drunkards, who have paralyzed
or worn it out by perpetual stimulation: in consequence  of which
a pitchy and flaky bile is secreted  instead of the genuine and healthy
fluid.  The second  is  probably  the  result  of  active  or passive
haemorrhage (most likely the latter) from  the liver, the spleen, or
both in a state of  physcona.  The function of these organs appears
to be one and  the same  ; the blood in both is  peculiarly carbonated,
as the colour sufficiently indicates, and the closest alliance subsists
between them ; on which account Hippocrates calls  the spleen the
left liver, and  Aristotle the bastard liver.  The spleen has sometimes
been found adhering to  the liver. 
(JO                       NOSOLOGY.             [CL. I.—OR. H.

     Melaena atrabilis.   Sauv.
2. cruenta.  The discharge consisting  of grumous  blood  inter-
                mixed with bile:  pungent,  tensive pain in both
                hypochondria ;  compressive pain at the pit of the
                stomach and fainting.
     Melaena splenetica.  Sauv.
     The stomach and intestines full of sanguineous matter.  Columb.
         De Re Anat.  Holler. Bib.  Med. part ii. p 125.
     Has sometimes proved  salutary.  Holler, Nov. Comment.
         Goett. viii. p. 2.
     Sometimes periodical.   De Passis, in Blegny Temple d' Escu-
         lape, 1680.




                       GENUS III.

                  CHOLOLITHUS.

     Pain about the region of the liver,  catenating with pain at
         the pit of the stomach: the  pulse unchanged : sickness ;
  Gen. III. Chololithus.   From Jc«A»>, or #aA«v, bile, and  XtOos, a
stone. This disease has been confounded with icterus by most of the
nosologists, but' improperly so, for the yellow dye of the skin and
urine, which is the pathognomic symptom of jaundice, occurs often
without chololithus, and chololithus even in its passing  species or
acute state, without the yellow dye.  Dr. Young makes it indeed a
distinct genus, but regards icterus as one of its species. After Plou-
quet he spells it cholelithia, who probably took the term choledochus
as his example.   Either is allowable: chololithus is here preferred
as in unison with enterolithus, and the usual mode of forming Greek
compounds.
  The symptoms of the first species  are often not very distinct, for
when the  gall-bladder has been slowly enlarged, a concretion, as
bulky as a pullet's egg, has sometimes lodged in it, and occupied the
entire cavity, without  any very great derangement of the general
health.
  Whether the gall-bladder be a mere receptacle for superabun-
dant bile secreted by  the liver, or whether it add any new  secre-
tion to that deposited  in it, is a question which has been long agi-
tated by physiologists, and is by no means settled at the present
moment.  It is a curious fact, however, and which should  seem to be
nearly decisive of the  question, that in most, perhaps  in  all,  cases. 
GE. HI.]
NOSOLOGY.
61
         dyspepsy;  inactivity: bilious concretion in  the  gall*
         bladder or bile-ducts.
     Cholelithus.  Plouquet.
     Cholelithia.  Young.
     Gallstein.  G.
     Pierre au fiel.   F.
     Gall-stone.
1. quiescens.  Pain  about the liver and at the  pit of the sto-
the hepatic bile, or that secreted by the liver, is mild and sweet be-
fore its introduction into the cyst, and consequently becomes bitter
only from being operated upon while in this situation :  and it is
from this circumstance that the first or quiescent species discovers
itself, perhaps chiefly by a less pungent and bitter taste in the mixed
or general bile than commonly belongs to  it; for  the gall-bladder,
being nearly plugged up, or impeded in its function, is incapable of
exerting its proper activity ; and hence, too, the irregularity in the
alvine discharges, even were no considerable degree of pain is felt
about the region of the liver, and  the stomach is not very sensibly
affected.  Dr. Bush ascribes this production of  bitter taste to a
putrefactive process which takes place in the bile after its  reception
into the gall bladder: but this is no  place to pursue the subject.  Jt
is singular to observe,  that in  herbivorous animals destitute of a
gall-bladder, as the horse, elephant, manate, camel, rat, rhinoceros,
as also  in several of the cetaceous tribes, the bile is still possessed of
a  bitter principle;  and it is perhaps still more singular that we
meet with  this  secretion  and this  principle in larger abundance,
proportionably to the size  of the animal, in various insects that have
neither liver nor gall-bladder,  than in mammals  of any  kind; of
which the curculio nucum, or nut-weevil, furnishes us with a fami-
liar example;  for every one must have seen with  surprise the ex-
tent to which the larve of this curious little insect, found so frequently
in the fruit  of the hazel, is capable of embittering the taste  of the
nut, and of giving a yellowish brown tinge to its whiteness, which
alone proceeds from the bile with which its feces are loaded.
   It is possible that minute biliary concretions may occasionally be
formed in the hepatic pores; but the absorption of the more subtile
parts  of the bile  which  must necessarily take place in  the gall-
bladder, from its quiescent state, must dispose it in a much greater
degree  to assume a concrete  form, the structure  of which  varies,
though it seems to evince a general tendency to crystallized rays in
the center, with concentric laminae towards  the surface.  See Baillie
Morbid Anatomy, F. v. PI. vi. p. 109-113.
   Berzelius has lately shown that neither the resin nor the albumen,
which  have been so generally ascribed  to bile, have any  existence
in it.   The  bile becomes resinous only in the process of experi- 
62
NOSOLOGY.
[CL. L—OR. II.
                   mach obtuse and occasional: and.bile less bit-
                   ter than  usual;  the dejections irregular.
2. means.   Pain  about  the  liver acute;  frequent vomitings ; de-
              jections white ;  and  at length loaded with one or
              more bilious concretions.
     Cholelithia acuta.   Young.
     Passing of gall-stones.
       The German physicians trust chiefly to sulphuric ether and
     oil of  turpentine in  conjunction.   See Durande Observations
     sur PEfficacite du Melange, &c. 1791.



                       GENUS IV.

                    PARABYSMA.

  Knotty  or unequal intumescence  of  the  abdomen  from  an
ment, by supersaturating it with acids, while the  material hitherto
regarded as albumen, appears to be nothing more than a small por-
tion of mucus furnished it from the gall-bladder.   M. Berzelius ob-
serves, however, that it acquires an increased tendency to form re-
sin with the acids, in proportion to the length of time it has remain-
ed in this depository.   It possesses, says he,  the same  properties of
alkali and salts as the  blood; and contains a peculiar matter of a
bitter and afterwards sweet taste,  which evinces characters in com-
mon with the fibrin,  the colouring matter, and the albumen of the
blood, from which it is formed in the liver.   View of the Progress and
Present State of Animal Chemistry ; translated from the Swedish by
Gustavus Brunnmark, D. D.  In  the  hystrix cristata, or crested
porcupine,  bilious  concretions appear  to be  more common than in
any other animal:  they are for the  most  part closely  crystallized;
and have been  called bezoars  by physiologists who ought  to have
known the  difference.  They have neither the metallic lustre of the
western, nor the aroma of the eastern  bezoar, while they contain the
tinge and bitter of the bile.
  Gen. IV. Parabysma.  IIxpxGvo-ptM, " id quod magnis sarcinis infar-
citur," from -xxpxfivu,  " male coacervo, or infarcio."  The author
has adopted this tuim from the Greek writers instead of emphraxis,
hyposarca or physconia, because the two first, which, however, have
not been very generally employed, are too limited for  the purpose,
and consequently calculated to convey erroneous ideas;  while the
last has been us,ed so generally as to convey no definite idea what-
ever. 
GE. IV.]
NOSOLOGY,
63
  indurated enlargement of one or more of the viscera con-
  tributory  to the digestive  function ;  derangement  of  the
  general health.
Physconia.   Cusson. Sauv. Cull, et alior.
  Physconia  was,  perhaps, first  marie choice of by Cusson  as a
generic name to comprise a variety of organic tumours, of origins,
positions, and properties so different as to defy all generic definition
whatever.  Sauvages,  however, has followed him,  and even added
to the number of his  species;  and Cullen  has followed Sauvages.
In Sauvages it is extended to every  kind of intumescence of the
solid parts of the abdomen without pregnancy or fluctuation.  " In-
tumescentia abdominis a partibus solidis, sine graviditatc, et fluctua-
tione."   Cullen  does not essentially  deviate from  this  character;
in like manner expressly limiting it to the  abdomen.  Yet in  both
we have, among the list of affections, a physconia renalis; various
external physconies, and a physconia ab excrescent!*, while abdomi-
nal  fatness or corpulency is made another species.   Yet the scope
of physconia is carried still wider by Dr. Young, who omits all limi-
tation, extends the term to softish glandular tumours in  any part of
the body, and ranks under it simple bubo,  bronchocele, sarcocele,
and various  pulmonary enlargements; at the same time  making
physconia, thus extensive in its  range, a mere species  of  a genus
which he calls ecphyma, and which he defines " a solid tumour not
acutely painful."
  It has been found in no small degree difficult to characterize the
meaning of a physcony.  The term itself gives us little or no clue :
for Qve-Kmix  simply imports inflation, or a collection of  wind, as in
an inflated bladder.  Dr. Young, as just observed, makes it a species
of ecphyma, or solid tumour ; yet, in his specific definition, he de-
scribes it as  " a general softish tumour of a viscus or gland, com-
pletely occupying a considerable part of its substance." Sagar, on
the contrary, defines it to be a tumour u hard to the touch, resisting
without fluctuation or elasticity," sine fluctuatione, et elasi, ad factum
dura, resistens : while Turton explains it  " a hardish tumour, occu-
pying one or more of the abdominal organs, and resembling a bladder
distended with wind."
   Physconia, therefore, by importing  every thing,  imports nothing
definitely : and is made to embrace diseases that  have no analogy in
origin, situation, symptoms, or mode of cure.  Dr. Cullen, while he
retained the  term  in its general and indefinite range, was sufficiently
sensible of its looseness, and only retained it from  want  of time to
be more accurate : " species sequentes," says he, in a note subjoined
to the genus in the sixth edition of his Synopsis,  " nequaquam ad
normam Nosologic methodica recensentur; sed accuratiu* Physconiae
 species indicare difficile foret, saltern plus exegisset, quam quo nunc
 fruor otii." 
64                        NOSOLOGY.             [CL. I.—OR. II.

     Ecphyma physconia.   Young.
     Hyposarca.  Linn.
     Emphractica.  Holler. Tulp.
1. hepaticum.  Hard tumour in the right hypocondrium,  verging
                   towards, and sometimes appearing at, the pit of
                   the stomach : general languor ; pale or yellow
                   countenance ;  dyspepsy :  dejections irregular,
                   often whitish.
     Physconia hepatica.   Cuss. Sauv.  Cull.  Parr.
   In strict propiety, physconia should perhaps be confined not only
to the region of the abdomen, but to those knotty or unequal intu-
mescences which  evidently proceed from an indurated,  usually a
parenchymatous, enlargement of one or more of the viscera  contri-
buting to the digestive function, and which in a greater or less de-
gree derange its perfection,  or impair  the general health  of  the
system ; while all other swellings which have hitherto, in different
nosologies, been made to range under it, should be transferred to other
genera.  Such is the limitation aimed at in the present arrangement,
and we  hereby obtain a  family of  diseases  analogous in origin, situ-
ation, general result, and mode of treatment: and  which ought ra-
ther to be entered  in the class before us than in Class VI. Order I.
Eccritica Mesotica, which comprises a list characterized by morbid
enlargement of the parenchyma without  derangement of the general
health.  With  this limitation the author had at first intended to con-
tinue  the term physconia; but apprehending it might lead to mis-
takes, from its different use by  other  writers,  he has thought it
better, upon the whole,  to reject it altogether, and employ another
term in its stead—a term not invented for the purpose, but  in use
among the Greek  writers, and in  itself  sufficiently indicative of its
intention.
   I. } E. hepaticum, Helminthicum.—Similar animalcules, and espe-
cially  hydatids, are occasionally found in other organs,  though less
frequently: particularly the kidnies and the testicles:  but as they
can rarely be traced by any  external symptoms, they  can seldom
become a subject  of  symptomatic nosology.   See Baillie,  Morb.
Anot. Fasc. vi. pi.  7, and Fasc. viii. pi. 8.   The existence of  flukes
(fasciola hepatica)  in the human  liver is doubtful, though  asserted
by Doever, Darwin, and others.  Dr. Harrison, of Horncastle, Lin-
colnshire, in his treatise on the Rot in sheep, denies their existence
in this disease, even among these animals; and has  given proofs of
their total absence in many of the worst cases upon dissection.  He
ascribes the rot to marsh miasms.  The present writer, however, has
seen them in prodigious numbers;  and their non-existence, at parti-
cular  times, or in  particular cases, only seems to show, that, if at
any period  a  cause of this disease, rather than  an effect, they are
not the only cause. 
GE. IV.]
NOSOLOGV
65
     Hepatis tumor.   Darw. I. ii. 3.  9.
     Jekur akend.   Pers   Literally jecur coactum.  The  Latin
          term jecur is probably derived from the Persian.
     x Coactum.  From infarction.
          Found in feeble children, who secrete  less bile, and have
       the cells of the liver clogged with mucus from atony of the
       absorbents.—Found also  in  intemperate  livers;  and  in
       foreigners who reside in hot climates: an  unequal atony, and
       at times  paralysis,  being  produced in  the  organ from the
       excessive stimulus  antecedently excited by the  rays  of the
       sun or the use of spirituous potation.
         The diseased viscus often  acquires great  weight: 18 lbs.
       Bonet.  Sepulcr. lib.  i.  sect,  xviii.—20 lbs.  Bald.   N.
       Magaz. band vii. p. 275.-28 lbs. in an hydropic.   Gaoch,
       Med. and Surg. Obs.
     G  Scirrhosum.  The tumour exhibiting a  scirrhous character.
         Georg. Segeri Mis. Nat. Cur. ann. iv. obs. 142.
     y  Chololithicum.  Accompanied  with  bilious  concretions.
         Bonet.  Sepulcr. de Hypocondr. tumor.  Obs. 8.   Verduc.
         Pathol, du Rachitis.
     ^ Helminthicum.  Accompanied   with  flukes,  hydatids,  or
         other  worms.   Winker. Disp.  de  Hydat. apud  Bonet.
         Med. Septentr. ii. p. S13.—Darw. vol.  iii. 156. Svo.
I.  splenicum.   Indurated tumour below the false  ribs on the left
                  side, and towards the spine on  the same  side;
                  pale countenance ; general  debility.
    Physconia splenica.  Sauv. Cull. Parr.
    Splenis tumor.   Darw. I. ii. 3.  18.
    Ague cake.
    x Coactum.   From infarction.  Chiefly after obstinate remit-
         tents or intermittents in organs weakened by previous in-
         temperance; the  absorbents  being  hence  doubly debili-
         tated.
    Emphratica : Haller. Disp. Pathol, iv. 109.
      Sometimes continues for thirty years.   Darw. ut supra.__
    Sauv. in loco.—Tulp. Obs.  Med.  ii.  30.—Morgagn. Ep. xx.
    52. et passim—Baillie,  Morb.  Anat. Fasc. vi. pi. 2.
    G Scirrhosum.    Assuming  a  scirrhous character.    Bonet.
        Sepulcr. de  Ventris tumore.  Obs. xxxiv.  n. 3.   On
        the death  of a   woman,  found to  weigh thirty-three
        pounds,  and  to  fill nearly fhe whole of  the  abdomen.
        Complaint  lasted  seventeen  years before  the  patient
        died, during  nearly the  whole  of  which  she  pursued
        her usual  avocations.   Sauv. in  loco.—Three times its
 vol. Y.—20 
66
NOSOLOGY.
[CL. I.—OK. II
         natural  size.  Baillie, Morb.  Anat. Fasc. vi.  pi. 3.—
         Contained fifteen  pints of pus.  Histoire  de  VAcademie
         des Sciences, 1763. p. 196.  The entire viscus  has often
         been extirpated without injury.
     y Carlilagiiiosum.  The coats  of the spleen converted into a
         cartilaginous substance.   Baillie,  Morb. Anat.  Fasc. vi.
         pi.  1.
o. pancreaticum.  Hard elongated  tumour,  running transversely
                      in the epigastric region ;  dyspepsy; general
                      languor.
     Torpor pancreatis.  Darw. I. ii. 2. 7.
     Ecphyma physconia.   Young.
     x Coactum.   frrom infarction.   Baillie, Morb. Anat.  pi. vii.
         fig.  I—Torpitude produced by the  stimulus of tobacco,
         almost incessantly chewed or smoked for  many  years ;
         fatal.   Darw. utsupr.
     G Calculosum.  Accompanied  with white  calculous concre-
         tions.  Baillie ut supr. fig.  2, 3, 4.
4. mesentericum.  Indurated and  irregular  mass of tumours be-
                      low the stomach, yielding to the pressure of
                      the  hand:  pale, bloated  countenance ;
                      atrophy ; the appetite at the same  time sel-
                      dom diminished,  often  voracious.
     Physconia mesenterica.   Cuss Sauv. Cull.
     x Helminthicum.   Accompanied  with  hydatids  or  other
         worms.   Greg. Horst. lib. v.  obs. 33.—Tulp.  obs. lib.
         ii. c. 34.
     G Strumosum.  Accompanied  with scrophula.   Bonet.  ex
         Rudnieio de Ventr. turn. obs. 10.—Ambrose  Pare, 1. c.
         21—Horn. Rad. Med.
     y Scirrhosum.  Accompanied with scirrhus.   Marc. Donat.
         Hist. Med. Mir. I. vii. c. 15—Trincavell, iii.  cons. 22—
         Riolan. Anthropogr. 1 ii. c. 26—Morgagni de Sed. Ep.
         39. n. 2.
     } Sarcomaticum.  Accompanied with  sarcomatous  excres-
         cences.   Bonet. Sepulcr. de fals. gravid. Obs.  3. n. 1.
     s Steatomatosum.  Accompanied with  steatamatous  excres-
         cences.   Barthol. Cabrol. Obs. 33. 35.  Tulp. obs. ii.
         32. 33.   Joh. Lechelii apud Bonet.  Med. Sept. ii. 486.
         flterne Collect. Acad. iii. 226.
           Tumour weighed 40 lb.   Nov. Act. Nat. Cur.  Vol. i.
              obs. 92.
     £ Fungbsum.  Accompanied with fungous excrescences.  Bonet.
         Sepulcr.  de gravit. fals. obs. 3. c. 
GE. IV.]
NOSOLOGY.
67
    Sarcoma mesenterii.  Pigr.
    Suasarcosis.  Auct. Var.
    Champignon.   F.
       The  above  varieties and many of  the  references are from
    Sauvages, who has been copied in both by Cullen.   The  tu-
    mours are  often  very large, and  conglobated : and at  times
    accompanied with  cysts filled with a limpid  fluid.  In  one
    instance these  amounted to  twenty of various sizes, one as
    large as a child's  head, six as large  as the fist,  and the  rest
    resembling hens' and pigions' eggs.   Hence the  whole  abdo-
    men is  in some cases so generally tumefied as  to give a sem-
    blance of pregnancy.  This is particularly the case with the
    last variety; and as the  appetite, state of the bowels and blad-
    der are often unaffected, there  is not  unfrequently some diffi-
    culty in determining the nature of the disease.   See Sauvag.
    in loco ; as also the writings of Welsch, Trincavelli, Mor-
    gagni, and Riolani, who have  made  collections of extraordi-
    nary cases; and compare Cruicksbank on the " Anatomy of the
    absorbing Vessels," p. 115. 2d edit. 4to.
5. intestinale.   Tumour  hard  and circumscribed,  round or
                     elongated ; moveable upon the pressure of
                     both  hands;  irregular dejections  ; obstinate
                     vomiting ;  pyrexy ;  and for the  most  part
                     emaciation.
       Physconia intestinalis.   Cusson. Sauv.  Cull.
    * Conglomeratum.  Cohesive,  and   conglomerated.   Mor-
          gagn.  de sed. et caus. Morb. torn.  ii. ep.  39.    In this
          case the tumour lay sensible to sight, of a circular shape
          between the  ensiform  appendix  and  navel.  On  dis-
          section,  the ileum and  adjoining portion  of the jeju-
          num  were  retracted  upwards,  coacervated,  and  firmly
          adhesive.
     G Sarcomatosum, Sarcomatous.   Fantoni.  Obs.  Med.  select.
          ii.  In this case  the tumour, of an oblong shape,  lay
          below the left hypochondrium,  inclining to the  epigas-
          trium, prominent,  with unequal hardness.   On dissec-
          tion,  every  other  part being found healthy,  the  colon,
          under the  stomach,  and towards the left  side,  for the
          length of the palm  of the  hand, appeared closely in-
          durated,  distended,  and  loaded with a  fleshy, fibrous,
          peculiarly thickened  tumour, which contracted its  dia-
          meter.
6. omentale.   Tumour indurated and diffused; frequently spread- 
6S
NOSOLOGY.
[CL. I.—OR. It
                 ing  over the  whole  of the   abdominal  region;
                 dyspnoea ; emaciation.
       Physconia omentalis.   Cuss. Sauv.  Cull.
          This species is  usually of a mixt kind :  infarcted ; scir-
       rhous ;  glandular; and cartilaginous.   It has been found of
       various extent and  magnitude ; from a weight of five pounds
       to twenty, twenty-five,  thirty, and in  one  instance {Greg.
       Horstii. Prob. 10.  dec. vi.) fifty-six pounds, occupying  the
       whole capacity of the belly.   In one  case, the hardness was
       almost stony :  PanaroL  Pentec. iii.  obs. 10.  In another,
       osseous,  the  weight thirteen pounds:  Mongin,  Hist,  de
       1'Acad.  des Sciences, 1732.  In a third, loaded with many
       thousand glandules : Seger,  Ephem. Germ.  In  a fourth,
       accompanied with excruciating pains, the  weight  sixteen
       pounds : Huxh. Phil. Tr. Vol. vii.
7. complicatum.  The  belly  hard,  elevated, and distended as
                     though  pregnant,  and  often  supposed  to
                     be  so; yet more or  less knotty  and  une-
  7. Parabysma complicatum.  The symptoms of this species must
vary according to the organs affected, and the nature and extent of
the disease.  The enlargement is generally found  to be sarcoma-
tous, scirrhous, hydatidous, or adipose.   The liver is in  most cases
more or less concerned—sometimes in connexion with  the spleen,
sometimes with the mesentery, sometimes  with the stomach or in-
testines, and sometimes with all together. Hildanus  found the liver
so enlarged as to pass beyond the false  ribs of the left side, with
the spleen  equally enlarged, and fixed to the hepatic lobe.  Cent.
ii. Obs. 45.  Huldenreich,  in a woman  of  forty-five years  of age,
found the liver scirrhous, weighing fourteen pounds, with a fleshy
excrescence in the mesentery of the size of a child's head :  Miscel.
Nat. Cur. ann. vi. and vii.   Jaundice accompanied this case.—Bar-
tholine mentions a woman of elegant form in the flower of her age£
attacked with  another variety of this  disease,  which at length de-
stroyed her.: when all the  intestines,  liver, spleen, and every ad-
joining viscus, were found  intermixed, and  buried in fat; the liver
being at  the same time  enlarged  and scirrhous, and filling both
hypochondria; the stomach thickened, and  cartilaginous : Cent. ii.
Obs. 6.—Coiter found the whole of these organs adhering together,
and filled with cysts of different sizes distended with  a limpid fluid ;
he reckoned more than fourscore:' the organs themselves Were ex-
hausted and dry.  Obs. Anat. p. 117.
  There are instances, however, in Schcnck, Vesalius,  Helvetius,
and others, where this disease has been endured for years without
much inconvenience:  chiefly, however, in cases, where the enlarge- 
GE. IV.]
NOSOLOGY.
69
              qual:  the  breathing  seldom impeded: for
              the most part, acute pain, nausea,  obstinate
              vomiting, and thirst.
Physconia polysplanchna.   Cuss.  Sauv. Cull.
Physconia visceralis.   Auc.  Var.
ment  has been confined  to a  single viscus, forming the megah>
splanchnus {j*.tyxXovxXxywt>s) of Hippocrates. 
             CLASS  11.

       PNEUMATIC A.

DISEASES OF THE RESPIRATORY FUNCTION.
                       ORDER  I.

                     P H 0 N I C A.

             AFFECTING THE VOCAL AVENUES.

  The passage of the  voice impeded ; or  its  power suppressed or
depraved.
                 GENUS  1.

                C  0 R Y Z A.

Defluxion from the nostrils, obstructing their channel.
  Class II.   Pneumatica.  Uitvpunrtux, "ad spiritum vel respira-
tionero pertinentia," from ?m#,  » spiro:" and hence mtvptx, pulmo,
" the breathing organ."
  Order  I.  Phonica. Qmikx, " ad vocem pertinentia," from Qenq,
" vox;" and hence  aphonia (xtpmtx) Gen. IV. under the present or-
der, from *,  privation,  and <pavt); and  dysphonia (frvo-tpcmx) Gen. V.
from &v(, «' nnle," " perperam," and <pom.
  Gen. I.   Corvza.   Koevgx, Hippocr.  " gravedo,"  " distillatio :"
« cold, infarction, or stuffing in the  head,"  " defluxion."   Galen
confines the ttrm to defluxion on the nostrils alone. De Symp. Caus.
lib. iii.  c. 4.   the idea of the Greek physiologists  was that of a
condensation <|f the secreted fluids of the head by cold, so as to
distil or trickh down the passages that lead from it,  as we  see the 
GE. I.]
NOSOLOGY.
71
    Coryza.   Auct. Groic.  Sauv.  Linn. Vog.  Sag.
    Distillatio.  Auct. Lot.
    Stillicidium narium.  Bidloo.
    Phlegmatorrbagia.  Junker.
    Nuzlet.   Arab.
    Pfnufel.   G.
    Running at the nose.
1.  entonica.   The defluxion pellucid,  mucous, or  ropy, with  a
                sense of irritation or infarction.
vapours of the atmosphere,  when condensed by the same means,
trickle down glabrous conductors of any kind. The term is admira-
bly calculated  to express the whole of  this idea, though its deriva-
tion has been  sought for  in  vain by the etymologists  ; in conse-
quence of which it stands  in Scapula, and all  the  best  lexicons, as
a Greek radix.  The author begs to suggest, that it is of Asiatic
origin, and occurs in almost all  the cognate dialects of the east in
the same  signification, and  almost  without the change of  a letter,
uniformly importing cold, and the effects of cold.  Thus in Syriac
it is written korusa, and is expressly used in the Syriac New Tes-
tament in  the sense of algor,frigus ; see John  xviii. 18. Acts, xxviii.
2.  In like manner in Chaldee it  is written Ntsnip (korysa, or more
strictly korusa, as in the Greek,) and imports precisely the same.
See Jonath. on Gen. xxxi. 40.  In this tongue also it  occurs as a
verb in Job x.  10, and xxxviii.  30, tsnp {koris or korys,) and signi-
fies '• frost, constriction, condensation," (gravedo,) as  the  effect of
cold; synonymously with the Hebrew  terms "\jh and *np.   The
Hebrew, however, possesses also the very same word, though in
a remoter sense ; for enp  in Hebrew implies  " close-grained, com-
pact wood or  timber," in which signification it is used in Ezek.
xxvii. 6, and in various other places.   It is highly probable that we
should find the radical idea of the term  in Hebrew, as well as in
Syriac and Chaldee, if we had other classical Hebrew books  than
the Old  Testament to have recourse to;  for the Arabic  contains
the Hebrew term, and gives us to the present day (koris or korys)
in the sense of cold as well as of impaction  as its effect, and this too
both as a  noun and a verb : whence (leiletum zatu korysin) is nox
algida.
   Hippocrates, as we learn from Celsus, applied coryza equally to
defluxions from the head, nostrils, fauces, and  chest.   The latter
Greek physicians restrained it to the first, and distinguished the two
latter by the name of catastagmus (KXTxtrrxypMs,) which equally im-
ports distillatio or defluxion.  Among modern writers coryza is used
synonymously with  catarrh, and is consequently  regarded  as a fe-
brile affection.  It may indeed  occur, and often does so, in various 
72                        NOSOLOGY.             [CL. II.—OR. I.
* Sternutatoria.   From sternutatories.
G Lachrymosa.   From weeping or crying;   the  lachrymal
     secretion being increased by mental emotion.
  Snivelling.
y Catarrhalis.   From  sudden cold or change  in the tempera-
     ture of the atmosphere ; accompanied with a nasal voice
     and loss of smell  ; and  excoriation of the mucous  mem-
     brane of the nostrils.   Gravedo.  Auct. Var.
Coryza humida.  Nenter.
Schnupfen.   Schnuppen.   G.
Enchifrenement.  F.
Cold in 4he head.  In Old  Engl.  Pose or Mur, whence Mur-
  ren and Murrain.
£ Ozoenosa.   The defluxion more or less purulent, or ichorous
     and fetid.
fevers as a symptom, but the older nosologists are more correct in
giving it  a place distinct from fever, when strictly genuine.  De-
fluxion from the nostrils may proceed from two very different sets
of causes: increased action of the secernents,  and  diminished ac-
tion of the absorbents.  The first or stimulating set may consist of
sternutatories; of the irritation of sympathy,  as in  crying; of in-
fectious effluvia in the atmosphere (sometimes, though seldom, limit-
ing their action to the mucous membrane of the nostrils, and hence
approaching the nature of catarrh ;) and of the  local stimulus of an
ozena or nasal ulcer.
  The action of the absorbents may be  diminished by exposure to
severe cold; by the debility of old age ;  and  by  a long habit  of
sternutatories, which have a tendency, in  proportion to their  use,
to render all the vessels of the nostrils torpid ; although the absorb-
ents, as in the cases  of age and cold, and indeed in  all instances  of
debility, are sooner  operated upon than  the  secernents.  Here,
therefore,  the defluxion is produced, not from  increased secretion,
for  the secretion may even be  less than in a state of health; but
from the secretion,  whatever its quantity, not being carried  off by
its usual channel: and hence again that frequent and unsightly drip-
ping {from the nostrils of persons who addict themselves  to large
quantities  of snuff.  The author has seen the same effect produced
by an habitual use of hartshorn and powerful aromatics.
  1. ^.  C. entonica, Ozanosa.  Sauvages  makes this  variety syno-
nymous with the disease called distemper, or snuffles, as it is provin-
cially called, of dogs and horses, the morve of the French veterinary
writers.  But the distemper is evidently a contagious catarrh, with
a considerable degree of pyrexy, and usually phlogosis of the bron- 
«E. I]
NOSOLOGY.
73
     Coryza virulenta.  Sauv.
     Ozoena.  Bonnet. Sepulcr. i. 406.
2. atomca.   The defluxion limpid, and without acrimony, or sense
                of irritation.
     x Algida.  From exposure to  a keen, frosty, air.
     G Senilis.  From old age.
     y Superacta.   From long and immoderate use of strong aro-
         matics, volatile alkali, or snuff.
                   GENUS  II.

                 POLYPUS.

A  fleshy,  elongated excrescence,  shooting from  one or more
     slender roots in the cavity of the nostrils, running in dif-
     ferent directions, and affecting the speech.
Polypus.  Cels.  Heister.  Vog. B. Bell.
Sarcoma narium.  Sauv.  Cull.
Polype.  F.
Polypus.
chia.   It belongs, therefore, to Class III.  Order II. of the present
arrangement.
  Gen. II. Polypus.  TloXwovs;  so called from its general resem-
blance to the  well known woim of this name,  the hidra viridis of
Linneus. " It has lately been the custom to apply this term polypus
to a  variety of concretions and excrescences  arising in different
parts  of the body, of very different origins and  textures, as  polypi
of the heart, which are perhaps always grumous blood, or concrete
gluten ; polypi of the uterus and bladder, which are caruncles with
a slender base or peduncle; and  polypi of the  trachea, which are
also concrete gluten, occasionally  coughed up, sometimes solid and
branching, sometimes  tubular.  In the present  instance the author
has followed Celsus, and most writers from his time to that of Heis-
ter, in restoring and limiting it to the fleshy and ramifying excres-
cence of the nostrils; and will denominate those  that in other or-
gans  make an approach to its form or consistency, and which are
seldom capable of being determined by symptoms, polypous tumours,
caruncles, or  excrescences, rather than genuine  polypi.  Vogel's
definition is equally restrained, though sarcoma is not quite a correct
term ; " sarcoma intra nares praelongum, pluribus  appendicibus ad-
haerens:" Mr. B. Bell uses the term  in the same  limited significa-
  vol. y.—21 
      74                       nosology;             [cl. ii.—or. i.

      1.  plasticus.  Soft,  compressible, chiefly  pale-red;  apparently
                        originating from distention, or relaxation of the
\                        Schneiderian membrane.
          Soft, compressible Polypus.   B. Bell.
      2.  coriaceus.  Firm, cartilaginous,  chiefly deep-red ; apparently
                        originating from, or connected with a caries of
                        the ethmoid  bone.
          Firm, cartilaginous Polypus.   B. Bell.
                       GENUS  III.

                     R H 0 N C U S.

     Hoarse, sonorous breathing from stagnation  of mucus in the
         vocal canal. ,
     Rhencus, {piyxo<s.)   Hippocr.
     Stertor.   Sauv.
    Khatyt.  Arab.
1.  stertor.  The sound deep  and loud; produced  in the larynx
                and fauces.
tion.  Surg. vol. iv. ch. xxviii. sect. 5.  See also Hewson's Inquiries,
part i. p. 25.
  The grumous coagula of the heart, according to the  peculiarity
and extent of pressure they receive, are sometimes moulded into an
uncouth and serpentine form, and have occasionally been mistaken
for  real serpents; and hence a wonderful book was published in this
metropolis in 1639 by a practitioner of the name of Edward Maya-
met, entitled a " True Relation of a Strange Monster or Serpent
found in the left Ventricle of the heart of Pennant."
  Gkn  III. Rhonous.   'P«y#o?,  from  ptyy,a, " ronchisso, sterto."
Galen supposes this word to be an onomatopeia, or mere imitation of
the sound produced during the action of snoring or wheezing.  Cul-
len has omitted the genus as conceiving it to be nothing more than
a symptom of some other affection.  Vogel, and a few other nosolo-
gists, on the contrary, have raised both  the species here offered to
distinct genera.  To this they are hardly entitled; but it requires
only a narrow knowledge of the habits and  morbid  actions of the
animal system to discover instances in which both  sorts are idiopa-
thic.  Many persons have a thick or wheezy  respiration, produced
by corpulency, or by changes of the atmosphere from  hot to cold,
or from dry to moist, without any other diseased affection.   Many
persons snore habitually during sleep, and most persons have a ten. 
ge. in.]                  .nosology.                      75

     Renchus.  Vog.
     Schnarchen.   G.
     Sterteur.   Fr.
     Snoring.                                            ,  .
2. Cerchnus.  The sound dense, and impeded; produced below
                  the larynx.
     Rhochmos.   Vog.
     Heischerkeit.  G.
     Ralement'.  Fr.
     Wheezing.  Rattling in the throat.
                  GENUS  IV.

                 APHONIA.

  Inability of speech.
Mutitas.   Sauv. Cull.  Vog.
Aphonia.  Linn.  Cricht. Plouquet.
Bekym.  Arab.
Stummheit.   G.
Dumbness.  Speechlessness.
dency to do so, as they grow old.  Such affections are strictly idio-
pathic ;  they are not often indeed accompanied with much inconve-
nience'; but, as deviations from a perfect state of health, have a full
claim to their respective places in a general system of nosology.  In
botany the most insignificant  plant is  allotted  its proper station.
Cerchnus («w0  is derived from »«^«, " rauceo," or rather « ir-

  Genus  IV.  Aphonia.  AQmtx : See  note on Phonica.  There is
some disagreement among the  nosologists in arranging the diseases
that affect the power  of speech.  Linneus places the whole under
two genera, Aphonia  and Psellismus ;  Sauvages  and Cullen under
four, Mutitas, Aphonia, Psellismus, and Paraphonia; while Vogel
gives not  less than twelve, Asaphia, Clangor, Raucitas,  Aphonia,
Leptophonia, Oxyphonia, Rhenophonia, Mutitas, Traulotis, (Blscsi-
tas) Psellotis, (Balbuties) Ischnophonia, and Battansmus.  It will
easily be conjectured from  this list that Vogel has made distinct ge-
nera of many affections which ought to be nothing more than species
or varieties;  and that  Linneus  has sunk into species some  affections
that ought to rise into the rank of distinct genera.  Upon the whole,
therefore, the arrangement  of Sauvages is the best; and Dr. Cullen
has shown his usual judgment in following it. The present method 
"JfU                       NOSOLOGY.            [CL. II.—OB. I

1. elinguium.   Sheechlessness from destitution of tongue.
     Mutiias organica.   Cull.
     Mutitas  elinguium.  Sauv.—Privation of  the  tongue is  not
         always  accompanied  with dumbness:  since we have
         numerous, and apparently well-authenticated instances of
         the speech  remaining perfect after a total loss of tongue
         and of uvula.  See Phil. Trans. 1742, p. 143 ;  id. 1747,
         p. 621 ; Ephem.  Germanic, vol. iii. Eph.  Nat. Cur.
         passim.
     Byzeban.  Pers.
     «  Congenita.  The destitution coeval with the birth.
     G  Oblaesa.   The destitution produced by accident, punishment,
                  or disease
         Reunited, after being  nearly cut off.   Van  Wy, Heel-
       kondige  Mengelstossen ii.   Dec. 1.  Frank pretends a case
       of regeneration.  Satyr. Med. p. 120.
2. atomca, Speechlessness from atony of the vocal organs.
     x  Ohlaesa.   From lesion of the nerves of the tongue.
       Mutitas  atonica.   Cull.
       Mutitas  traumatica.   Sauv.
       Enduring  for ten years with paralysis, and then  suddenly
         ceasing.  Bresl. Sammlung,  1721, ii. 406—503.
     G  Pathematica.   From  sudden and  overwhelming terror,  or
         other  violent passion.   Commonly temporary ; sometimes
         permanent.
3. surdorum.  Speechlessness from deafness, congenital or  pro-
                  duced during infancy.
     Mutitas surdorum.  Sauv.  Cull.
goes between Linneus and Sauvages, and offers three genera, apho-
nia, the mutitas of Sauvages, and Cullen :  dysphonia, including the
aphonia and paraphonia of these writers; and psellismus.   Mutitas
and aphonia are direct synonyms, and equally import dumbness or
speechlessness.  The Greek term is merely preferred to the Latin
in the present system in conformity with the general rule ;  but it is
not a  little singular that in Sauvages and Cullen both these terms
should be made use of, in different senses, and as names to different
genera.  Linneus and Chrichton have restored the Greek term to its
propei' signification.
  2. a. A. atonica Oblasa.  Galen and  Sauvages advert to  cases of
dumbness produced by excision or erosion of the recurrent nerves
both in man and quadrupeds; as also to others in which they were
injured by extirpation of the glands of the neck in struma, cancer, or
bronchocele. 
°B- V.J                   NOSOLOGY.

    Mutite des sourds de naissance.   Fr.
    Deaf-dumbness.
                     GENUS  V.

                 DYSPHONIA.

  The sound of the voice imperfect or depraved.
 susurrans.  Voice weak, whispering, and scarcely audible.
  Aphonia.  Sauv.  Cull.
  x Oblaesa.   From lesion of the nerves of the larynx.
    Aphonia traumatica   Sauv.
    Aphonia atonica.   Cull.
  G PathemaUca.  From  sudden  and   overwhelming  terror or
      other violent emotion of the mind : occasionally perma-
      nent.
  y Compressoria.  From permanent  compression of the tra-
      chea.
    Aphonia trachealis.   Cull.
    Aphonia aneurismatica.—A. pulmonica.   Sauv.
  } Catarrhalis.  From neglected catarrh.
    Aphonia catarrhalis.   Sauv.
  f  Enervis.   From simple debility of the larynx without any
      obvious cause.
         The author has at this time a case under his care pro-
      duced in this manner, in which the patient, about forty
      years old, and otherwise in  good health, has never spoken,
      except in a whisper, for the  last  six years.
    Paraphonia rauca.   Cull.
    Raucedo.   Lin.
    Raucitas.   Vog.
puberum.  The voice dissonant and untrue to itself, irregularly
                alternating from harsh to  shrill;  confined to the
                age of puberty.
  Gen. V. Dysphonia.  Avo*<puvta.   See note on Phonica, as also
the preceding note.
   1. y D susurrans, Compressoria.   Sauvages refers to Morgagn:
and Bonetus for cases of severe compression from  aneurism of the
aorta, enlargement of the thymus, and various other tumours. 
78
NOSOLOGY.
[CL. II.—OR. I
     Paraphonia puberum.   Sauv.  Cull.
     Mue de la voix.   jFr.
     Change of Voice.
3. immodulata.   The voice permanently depraved, or inharmoni-
                     ous.
     x Rauca.   Naturally or habitually hoarse, harsh,  or rough.
     £ Nasalis.   Sent with a cracked and  grating sound  through
         the nostrils.
       Paraphonia nasalis.   Sauv.
       Paraphonia resonans.   Cull.
       Rhinophonia.   Vog.
       Nasitas.   Auct. Lat.
       Khemkhemet.   Arab.  Pers.  Turk.
       Parler du  nez.   F.
       Speaking through the nose.
         Produced by habit, affectation, or nasal obstruction.
     y Clangens.  Shrill and  squalling.
       Paraphonia clangens.   Cull.
       Paraphonia ulcerosa.   Sauv.
       Oxyphonia.—Leptophonia.    Vog.
     2 Sibilans.   With a whizzing or hissing sound.
       Syrigma.  Auct.  Grozc.
       Paraphonia Sibilans.   Sauv.
       Zischen.   G.
       Sifflement.  F.
         Found also sometimes  as  a symptom or sequel of various
       nervous diseases, colic, or bilious vomiting.
     s Stertens.   With a snorting,  snoring,  guttural,  or stertorous
         sound.
       Paraphonia stertens.   Sauv.
       Paraphonia comatosa.   Cull.
         Usually from relaxation of the glottis or velum palati.
     <f Palatina.   Hoarse, obscure,  indistinct;  with  a  fissure or
         other defect  in the palate.
       Paraphonia gutturalis.  Sauv.
  3. e. D. immodulata, Enervis.  A lady, of about forty-five, of easy
temper, has been subject to this variety for several years. It attacks
in paroxysms recurring at irregular periods, and usually continuing
for  five or six weeks, unless sooner relieved by stimulants and tonics.
The voice is a low whisper during the whole of the paroxysm.
  Found also occasionally  as a symptom in melancholic, paralytic,
and hysteric affections; and var. y in paristhmitis, dysphagia, and
catarrh. 
GE. VI]
NOSOLOGY.
79
Paraphonia palatina.   Cull.
Asaphia.   Vog.
  The  defect mostly congenital :  occasionally  a sequel  of
lues and some other disorders,
                       GENUS VI.

                  PSELLISMUS.

  The articulation imperfect or depraved.
    Psallismus.  Sauv.  Linn.  Sag.  Cull.
1.  Bambalia.  The flow of the articulation disturbed by irregular
                   intermissions or snatches.
    Timtamet.   Arab.  An onomatopy produced  by an iteration
         of the letters t  and  m, which  are most difficult for  the
         stammerer to articulate.
    Stammlen.   G.
    Be'gayement.   F.
    Stammering.
    « Hsesitans.   Involuntary  and tremulous retardation in articu-
         lating particular syllables.
       Psellismus ischnophonia.  Sauv.
       Ischnophonia.   Vog.
       Anstossen.   G.
       Hesitation.   F.
       Hesitation.
    o Titubans.  Involuntary  and tremulous reduplication of some
         syllables, alternating with a tremulous hurry of those that
         follow.
       Psellismus.   Linn.
       Battarismus.  Vog.
       Stottern.   G.
       Bredouillement.   F.
       Stuttering.

  Gen. VI. Psellismus, i^«aA<0-jko«, from -fycXXi^a, « balbutio."  The
Greek term  however was used in a wider sense than  the Latin,
so as to import every species  of depraved or  vitious articulation;
and in this sense it is  employed in the present  system.   The
Romans gave the name of bambaliones from GxftGxXtgv, « raptim ar-
ticulo," " to articulate by snatches."—to those who, properly speak- 
do
NOSOLOGY1.
tCL. TT.—OR. I.
         These two varieties of stammering are thus  well  de-
       scribed by Shakespear : " I  would  thou  couldst  stammer,
       that thou mightest pour out of thy mouth, a9 wine comes out
       of a narrow-mouthed bottle, either too much at once or none"
       at all."
2. Bl^sitas.  The enunciation vitious.
     Blaesitas.  Auct. Lat.
     Traulotes (t^vAot^.)  Auct.  Graze.
     Aiken.   Arab.
     x Ringens.  With a vibration or redoubling of the letter R.
       Psellismus ringens.   Cull.
     G Lallans.  The  letter L unduly liquid, or substituted for R.
         As  when delusive is pronounced deliusive, as  though the
         I possessed the power of the Spanish 11, or the Italian gl ;
         or as when parable is pronounced  pa/able.   Alcibiades is
         supposed  to  have laboured under this defect.   It is  also
         said to be common to the Jews of China, who have dwelt
         among the Chinese  so long as to  have lost the sound of
         R,   in consequence  of its  not existing in the  Chinese
         tongue;  and  who consequently pronounce in  Gen. i. 1,
         vhz n'tyxVa for x-n nwa.
     Lallatio.  Auct. Lat.
     Psellismus lallans.  Cull.
     Psellismus lambdacismus.   Sauv.
     y Emolliens.   The harsh letters exchanged for soft, as in the
         substitution of anzel for angel; capidol for capital; dat
         for that.
       Psellismus traulotes.  Sauv.
     £■ Balbutiens.   Labials, as M, B, P, too frequently introduced,
         or used instead of other letters.  So Feda is pronounced
         J5eda, Fenares,  JBenares in Bengal, the  Bengalee having
         no  V.  So impringe is often used  for in/ringe ; iftory for
         iwry ; though b  and not v is  here the radical letter, the
         Latin term being eour.
       Psellismus balbutiens.   Cull.
ing, stammered, whether  by involuntary hesitation or hurry of ut-
terance:  and hence the author has employed  bambalia for the  first
species of psellismus.
  2. s. Blesitas, Mogilalia.  The term, as given in  the text from
Sauvages, is  that used by Aetius, who denominates the subjects of
this vitious enunciation mogilali.  Dr. Cullen  does not seem to have
gained any thing by substituting acheilos. 
GE. VL]
NOSOLOGY.
81
t Mogilalia.   Labials omitted or exchanged for other letters.
       Most commonly  P for F, and F for V, as /ilfer for
     pilfer; rish for /ish,  antle  for mantle.  So the  Latin
     si6ilo is transformed by the French into siller.
  Psellismus mogilalia.  Sauv.
  Psellismus acheilos.    Cull.
  Faifait.   Arab.  An onomatopy or  imitation of the  sound
     produced by a vitious reduplication of the letter/.
f Dentiloquens.  Dentals, as C, S, T, Z, too  frequently em-
     ployed  ; producing the effect of what is called, in common
     language, speaking through the teeth.
  Asthenia vocis, Thetismus.   Young.
  Lispeln.  G.
  Grasseyement.  F.
  Lisping.
V Gutturalis.  Imperfect utterance of  the guttural letters : as
     G. J. H. K.
  Psellismus jotacismus.  Sauv.
  Psellismus Jagostomatum.   Cull.
                       ORDER II.


                 PNEUMONIC A.

AFFECTING THE LUNGS, THEIR MEMBRANES, OR MOTIVE POWER,

     Respiration irregular, impeded, or painful.
  2. (f. P. Blasitas, Dentiloquens.   Holder,  in his ♦< Elements of
Speech,"  has accounted for this depravation as follows: "Appulse
partial, giving some passage to breath, is made to the upper teeth,
and  causes a lisping sound, the breath  being strained through the
teeth."
  2. n. P. Blasitas, Gutturalis.  This, and indeed all the  varieties
of the present species, as well as many others that are connected
with it, are  most  usually the result of vitious habit,  produced  by
want of attention to  the articulation  of sounds in infancy,  or to  af-
fectation.  They are also  sometimes  dependent  upon a miscon-
struction  of the vocal organs;  of which the present  variety fur-
nishes us with an  example; for a defective  utterance of the gut-
   vol. v.—22 
82                       NOSOLOGY.            [CL. II.-OR. II.


                        GENUS  I.

                           BEX.

  Sonorous and violent expulsion of air from the lungs.
    Bex (&|.)   Auct.  Graze.
    Tussis.   Cels.  Sauv. Linn. Vog.  Sag.
    Catarrhus   Cull.
    Pneusis Tussis    Young.
1.  humida.   With expectoration of a mucous or serous fluid.
    Anaptysis {awxrvvts.)   Hippocr.
    Anacatharsis.   Gal. Sauv.
    Expectoratio.   Linn.
    Soal   Arab.
    Husten.   G.
    Toux.   F.
    Common cough.
    x Mucosa.  The  discharge   chiefly  mucous  and  excreted
         freely.
    G Anhelans.  The  cough in long paroxysms ; the discharge
tural letters  must be a necessary  consequence of a fissure in the
palate.
  Order II. Pneumonica.   TIuvimvikx :  " ad pulmonem pertinen-
tia ;" from Ybtu, " spiro."
  Gen. I. Bex.  3v\, " tussis :" £»jt7», « tussio." The Greek name
here restored for the  sake of uniformity.  Dr. Cullen's system does
not allow a place for  cough as a distinct disease : and he has hence
been obliged  to enter bex,  tussis, or common and dry cough, under
class i. pyrexia, order v. profluvia ;  and pertussis or hooping cough
under class ii. neuroses, order iii. spasmi.
,  Mr.  J.  Hunter has observed, with his  usual  accuracy, that in
coughing and vomiting,  the lungs and stomach develop an equal vis
inertia.  " It  is  not necessary that the stomach should act violently
to produce an evacuation of  its contents;  nor is it even necessary
that it should act at all: for the lungs themselves do not act in the
least when any extraneous  matter is to be thrown up ; and coughing
is to the lungs  what vomiting is to the stomach.  The  muscles of
respiration are the active parts in emptying the lungs, and can act
both naturally and preternaturally.  The action of vomiting is per-
formed entirely by the diaphragm and abdominal  muscles;  and we
know that by the same action the contents of the rectum can be ex-
pelled."   Anim. Econ. p. 199.  The late experiments of  M. Majen-
die have fully confirmed these remarks. 
GE. L]
NOSOLOGY.
83
          mucous and viscid ; excreted with difficulty, and  labori-
          ous breathing.
       Asthma catarrhale.—A. pneumodes.  Sauv.
       Dyspnoea catarrhalis.  Cull. Parr.
       Chronic cough of old age.
     v Acrida.  The discharge thin,  frothy, and saline : for the
          most part excreted with difficulty.  It is in most instances
          an atonic  affection  of the lungs  or of other organs that
          associate  in their action.  Sometimes  an attendant upon
          the  gouty,  more frequently upon inebriates  labouring
          under  a diseased  liver, to whom  it is peculiarly trouble-
          some in the morning.
     <J> Periodica.   Recurring at stated periods : partly restrainable;
          discharge thin, but not acrid.
     Tussis periodica.  Darw. IV. iii. 4. 3.
     Tussis nervosa.   Cricht.
       Most common to persons of a nervous or hypocondriacal
     temperament.
2. sicca.   Unaccompanied with expectoration.
     Khabbet.   Arab.
     Schaaf-husten.   G.
     Secheresse de poitrine.   F.
     Dry cough.
     x Ingenerata.   From  irritation produced locally,  as a scir-
          rhous or  calculous affection  of the lungs   See Borelli,
          cent. I. obs. 6.   Zacut. lib.  I. obs. 95.
     G Extranea.   From  irritating  materials inhaled from  without,
          as minute particles of glass, lime-stone, and similar bodies;
          and common to  glass-cutters, hewers of free-stone or sand-
          stone (arenarius Cos,) workers of metals, and other4ae-
          chanics.
     y Verminosa.   From worms  in  the intestines, liver, or other
          abdominal  organs.  Common to  children  with   large
          bellies, and pale emaciated countenances ; and still more
          so to sheep labouring under the  disease called  rot, and
          whose livers are usually loaded with the fasciola hepatica,
          or fluke.   See  also  M. Skragge's   Morbi  Artificum,
          Amoenit. Academ. 1764.
3. coNvulsiva.   The  cough convulsive and suffocative ; accom-
                   panied  with a  shrill reiterated hoop ;  and fre-
                   quently with vomiting:  contagious.
     Bex theriodes (f»| **«»**.)   Auct. Var,
     Tussis convulsiva.   Sauv.
     Pertussis.  Syden. Huxh.  Cull 
84
NOSOLOGY.
[CL. II.—OR. IE.
Soal-saol.  Arab.   Being the common Arabic term for cough
     reduplicated to express vehemence.
Coqueluche.   F.
Starckrr-husten.  G.
Hooping cough.—Chin-cough ;  or  more correctly Kin-cough
     or Kind- cough ; literally Child's-cough, from the German
     kind, " a child."


                   GENUS II.

                DYSPNOEA*

Permanent difficulty of  breathing,  with a sense of weight on
     the chest.
  Gen. II. Dvspncea. Ava-mttx, homS'vi, "male," and irua, "spiro."
Dyspnoea, orthopncea, and asthma, are treated of by Celsus as spe-
cies of the same genus, or rather as different degrees of the same
affection.   " Omne," says he, " in difficultate spir-ndi consistit;  sed
haec, dum modica est, neque ex toto strangulat, ^vo-motx appellatur;
curn vehementior est, ut spirare  aeger  sine sono et anhelatione  non
pobsit, xo-Optx: cum accessit id quoque, ne nisi recta cervice spiritus
trahatur, if6oinoix." Lib. IV. iv. 2—Galen, however, treats of these
afftctions as distinct genera, and discusses them in remote positions.
The same  diversity of view has occurred in modern times.  Almost
all the continental writers make each affection a  separate genus, as
dots Macbride among the writers of  our own country.  Cullen makes
a genus of dyspnoea and of asthma, and merges orthopncea in  the
former.  Dr. Parr and Dr. Young take as little notice of orthopncea,
and, with Celsus, reduce dyspnoea and asthma to the rank of species,
under a genus which they denominate anhelatio  or pneusis: a term
applied by Sauvages to an entire order.   Crichton retains asthma
alone,  appearing  to regard both  dyspnoea and  orthopncea as mere
symptoms  of other affections.  The present arrangement adheres
chiefly to that of Cullen.   It raises dyspnoea and asthma to the rank
of distinct genera, pathognomically distinguishing the  first by its be-
ing permanent, and the second by its being temporary and  recur-
rent : and it contemplates orthopncea, as a sort of asthma exhibiting
itself in a dyspnoic diathesis;  as a dyspnoea with irregular exacerba-
tions.  It coincides, therefore, with  Cullen's view, who has loosely
regarded orthopnoea as a dyspnoea,—a disease never free from  dif-
  *  In the " Study of Medicine," the author introduces between the Genera
Sex and Dyspnaa, as the second Genus, that of Laryngysmns.  See Study of
Medicine, Vol. I. p. 360. 
GE. II.]
NOSOLOGY.
85
    Dyspnoea.  Auct.  Graze. Cels.  et neoteric.
    Anhelation.
1.  chronica.  The breathing uniformly short and  heavy, mostly
                   accompanied with a cough.
    Dyspnoea.  Boerh. S'auv.  Linn. Vog.  Sag.
    Kurtzer-athem.  G.
    Behr.  Arab.
    Courte haleine.  F.
    Short breath.
    x Extranea.   From calculous or other earthy secretions in the
          substance of the lungs thrown up by coughing.
    Dyspnoea terrea.   Cull.
       Dyspnoea calculosa.   Macbr.
    G Phlegmatica.  The habit  phlegmatic  or  cachectic,  with
          scanty secretion of urine, and mostly oedematous extremi-
          ties.
       Dyspnoea pituitosa.  Sauv.
       Dyspnoea aquosa.   Cull.  Parr.
    y Pinguedinosa.   Accompanied with oppressive fatness.
       Dyspnoea pinguedinosa.   Cull.
       Engbrustigkeit.   G.
       Pousse.  F.
       Pur sines s.
    & Organica.   From deformity or organic defect, or injury.
       Dyspnoea traumatica   Sauv.
       --------thoracica.  Cull.
     e Vaporosa.   From the mischievous action of metals or other
          poisons.
       Asthma metallicum.  Sauv.
2. exacerbans.    Subject to sudden and irregular  exacerbations:
                     the breathing deep, stertorous,  acute, and suf-
                     focative ;  relieved by an erect position.
    Catarrhus suffocative.  Bagliv. et alior.
    Orthopncea.    Cels. Boerh.  Sauv. Linn.  Vog.  Sag.
    Suffocatio.  Etmuller.
    Pnigma.   Vog.
       Most of the varieties of the preceding species apply equally
    to this.
       Found, also,  under  the  one or  the  other species,  as  a
    symptom  in  aneurisms,  polypous  concretions,   and  other

ficulty of breathing; and still more so with that of Sagar,  who cha-
racterizes it expressly  as a permanent  affection, subject  to  acute
paroxysms:  "Morbus  continuus,  acutus,  subitanea,  anhelatione
sublimi, et fere suffocator&, stipatus." 
80                        NOSOLOGY.            [CL. II.—OR. II.

     affections of the heart and larger  vessels;  in  enlargements
     and other affections of the  abdominal viscera ;  in empyema,
     hydrothorax, worms,  peripneumony,  bastard peripneumony,
     small-pox, and occasionally in severe attacks of intermitting
     fevers.


                       GENUS III.

                        ASTHMA.

     Difficulty of breathing, temporary,  recurrent;  accompanied
       with a wheezing sound, and sense of constriction  in  the
       chest;  with  cough and expectoration.
     Asthma.  Auct. Graze.   Cels.  et neoteric.
     Tenk nefes.  Arab.
     Keichen.   G.
     Pousse.  Asthme.  F.
     Broken-wind.
     Asthma.
1.  siccum.   Paroxysm sudden, violent, and of short duration ;  con-
               striction  hard, dry, spasmodic ;  cough slight;  ex-
               pectoration  scanty,  and only appearing towards  the
               close of the fit.
     Asthma siccum.  Etmuller.  Cricht.
     Asthma convulsivum.   Willisii. Hqffm.
     Nervous asthma.  Convulsive asthma.
     x  Simplex.   Without any manifest cause, or combination with
         any other affection.
  Gen. III.   Asthma.  Atrdptx, " anhelatio," " spirandi difficultas:"
probably from xu, " spiro."   The species of asthma here offered are
taken rather from the practical writers than the nosologists, whose
species are, in effect, seldom more than varieties, and  are here in-
troduced  as such: being derived not from the symptoms, which
alone constitute the specific disease,  and should alone describe  it,
but from the supposed cause.   Even  Floyer, to whom we are in-
debted for the most accurate delineation of the humoral asthma that
has hitherto been given to the world, drawn from his own sufterings
through a period  of  thirty  years, has fallen  into the  same defect.
Macbride and Chrichton are the  only nosologists the author is  ac-
quainted with who have derived their species from  the natural and
proper channels which have been alone attended to in attacking the
disease, however writers may have been disposed to favour a more
speculative view in their arrangements. 
I.E. HI.]
NOSOLOGY,
87
       Asthma spontaneum.   Cull.
     G Exanthematicum.   From retropulsion of some acrid humour
         from the surface of the body.
       Asthma exanthematicum.  Sauv. Cull.
     v Phlegmaticum.  From  repelled oedema of the extremities
         in phlegmatic or cachectic  habits,  with scanty secretion
         of urine.
       Asthma cachecticum.  Sauv.
       (Edema pulmonum.  Auct.  Var.
         Possesses a considerable resemblance to dyspnoea phleg-
       matica; and both  best  relieved  by a copious secretion ojf
       urine.
     ^ Vaporosum.  From inhaled fumes  of metals, especially of
         lead and arsenic, of sulphur, charcoal, nitric acid,  and
         other deleterious or poisonous substances.
     Asthma metallicum.   Sauv.
2. humidum.  Paroxysm  gradual,  ingravescent, protracted;  the
                constriction heavy, humid,  laborious; cough se-
                vere ; expectoration commencing early ;  at  first
                scanty and viscid, afterwards copious and free.
     Asthma humidum.   River.  Cricht.  Sauv.
     Asthma humorale.  Bailie.
     Asthma flatulentum.   Floyer.
     Asthma pneumonicum.  Willisii.
     Spitting or humid asthma.  Floyer.
     Aslhme ordinaire.  F.
     Common Asthma.
     a Simplex.   Without any manifest cause, or combination with
         any other affection.
       Asthma spontaneum.   Cull.—This  term  in Cullen  ap-
         plies to the present variety, and to *  of  the preceding
         species.
     G Plethoricum.   From  plethora, or the  suppression of some
         accustomed sanguineous evacuation.
       Asthma plethoricum.   Sauv. Cull.
     y Senile.  Asthma of old age.
       Asthma senile.  Parr.
         The one or other of the species found also, occasionally,
       as  a symptom in gout,  hypocondriasis, syphilis, and  dis-
       eased viscera.
  Gen. IV. Ephialtes. 'EtptxXms, or e?t/«At«, «incubus," or " incu-
bo."  The term occuri in Macrobius—Somn. Seip. lib. i. though not 
§8                        NOSOLOGY.             [CL. II.—OR. II


                       GENUS IV.

                   EPHIALTES.

  Sighing, suffocative anhelation,  with  intercepted utterance, and
       a sense of some external substance  pressing heavily  on the
       chest : transitory.
1. Vigilantium.  Produced  during  wakefulness;  the  pressure
                     severe,  and  extending  over the abdomen ;
»                    respiration frequent, laborious, constricted;
                     eyes fixt; sighing deep and violent; intellect
                     undisturbed.
     Incubus vigilantium.   Rkod. cent. i. obs. 54.
     Ephialtes hypocondriaca.  Sauv.
in Hippocrates, Galen, or Celsus.   The author has restored this dis-
ease to the family of  anhelations;  with which it was associated by
almost every writer before the time of Dr. Cullen.  It  here finds a
natural place, and answers to its prominent character.   With sleep-
walking it has little or no connection, excepting that one of its spe-
cies occurs in the night and during sleep.  Ephialtes vigilantium is
entered on the  authority  of Rhodius and  Sauvages : it is certainly
allied to epilepsy, but seems more closely to  square  with the true
generic character of the present disease.   Sauvages gives us  three
other species as he  calls  them, but which are only symptomatic of
other affections.  Aurelianus  affirms that Ephialtes  occasionally
proves fatal from its  suffocative violence: and adds from  Selimachus,
that it was at one time as contagious and destructive at Rome as the
plague.
   Its usual exciting causes are to be found in a peculiar state of the
brain or of the stomach ; and  hence Dr. Crichton denominates the
two species, which he has introduced under it Incubus, cerebralis and
gastricus.
   The term mare,  in night-ware, is perhaps immediately imported
into our own language from the Runic or Sclavonian mythology, in
which mara signifies a frightful spectre, daemon, goblin, or night-hag,
whence the  Anglo-Saxon name of -E//-sidenne.  Yet the root of the
term is to be sought for in a still higher source, and a source which
has ramified with slight variations of meaning over most parts of the
world,  id  (mar,) in  Hebrew, imports " bitter, grievous, mischie-
vous, oppressive," " a mischievous, revengeful, oppressive spirit:"
whence vtD  (marar, in Lat. mceror,amarus) "overwhelming weight:
bitterness, or oppression," " biticr par.^s." And hence in Persian and
Arabic mar-den, «to sink under the weight of bitter pangs or afflic 
GE. IV.]
NOSOLOGY.
89
  Ephialtes tertiana.  Sauv.
nocturnus.  Produced during sleep, and interrupting it  with
                violent struggle and tremor;  the pressure on the
                chest seeming to be that of some hideous mon-
                ster or phantom.
 Ephialtes.   Sauv  Linn  Sag.  Plouquet.
 Incubus.   Vog. Junck  Cricht.
 Epilepsia nocturna.   Gal.
 Oneirodynia gravans.  Cull.
 Erethismus oneirodynia.   Young.
 Kabus.   Arab.
 Alp  Nacht-mannlein.   G.
 Cochemar.  Incube.  F.
 Night-mare.   In Anglo-Saxon, Elf-sidenne  (Elf-squatting.)
   Ihe last species found, occasionally, as a symptom in  dys-
 pepsy, and other complaints  of the  stomach, hydrocephalus,
 worms, and  hypocondriasis.  Horses  are said to  be subject
 to it.                                                  J
                   GENUS  V.

               STERNALGIA.

Violent pain about  the sternum, extending towards  the arms;
   anxiety, difficulty of breathing, and sense of suffocation.
Angina pectoris.  Heberd
Angina pectoris    Cull.  Catal. Morborum  Omissorum  quos
     omississe fortassis non oportebat.
Syncope anginosa.  Dune.  ann.  1800.   Parry.   •
Asthma dolorificim.   Darw.
Brustbraune. Eisner.   See Comm. Lips. vol.  xxxiii.
tion," « to be extinguished or die."   Hence in Greek fMtex (moir-a,)
"fate " paetxt (mor-ia,) the  "destinies or  destroying deities;" and
l**e«s, {moros) " death:" whence again, besides mar-or, tht; L*tin
ter,  s mor i, mors of the same meaning; and in German mahre, "a
goblin-tale  or ghost-tale, a tale of fictions and phantoms," of appari-
tions or fancies, or any thing unembodied or visionary.
  G,EN,.,V" Sternalgia. From o-npov, " sternum," and xXyos, " do-
lor."   There are few diseases concerning which  we  aro abl£ to
reason so little.  Dr. Heberden has the credit of having first brought
  vol. v.—23                                   5         6 
90                        NOSOLOGY.            [CL. II.—OR. It

1. ambulantium.  Supervening  suddenly  during exercise ;  with
                     tendency to syncope ;  relieved by rest.
     Asthma arthriticum.   Schmidt.
     Diaphragmatic gout.   Butler.
2. chronica.   The paroxysms less violent,  but of longer continu-
                  ance ; recurring  frequently with great palpita-
                  tion of the heart,  excited by slight, and often
                  unknown causes,  and not relieved by rest.
     Orthopnoea cardiaca.   Sauv.
     Syncope cardiaca anginosa.  Duncan.
       At limes combined with acrotismus, or cessation  of pulsa-
     tion.  See Mr. J. Hunter's case  in Entasia acrotismus.   Cl.
     IV.  Ord. iii.
                     • GENUS  VI.

                  PLEURALGIA.

     Pungent pain in the side ; difficulty  of  breathing;  without
          fever or inflammation.
     Pleurodyne.  Sauv.  Sag.  Macbr.
 mf*  ■ ■  — ■ «i ■»——^n     ■     ■■   ■ i- .■ ■■!■■■■ —   ■  ■   ■■»..... ■ —.^—   ■ ■■■
 this affection into public notice before the London College of Physi-
 cians in 1768, though possibly he was not the first that observed it;
 for the passage quoted by  Dr. Letherland in the Edinburgh Medical
 Commentaries Vol. iii. p. 180, from Poterii Opp. cent. 3. n. 22, and
 which is .-m follows, seems directly to  allude to sternalgia ambulan-
 tium : " Respirandi difficultas quae per intervalla deambulantibus in-
 cidit:—ni ut plurimum derepente moriuntur."  Ii seems also to be
referred to *y Dr. Hoffman in his Consultationes Medica, and occa-
 sionally by Morgagni.  By many writers it has been ascribed to some
 disease of the heart, as spasm, accumulation of fat, polypous concre-
 tions, ossification of the coronary arteries, or affection of the valves ;
•while some have referred it to a spasm of the diaphragm, and other
muscles  of respiration.  Probably both may be  regarded as causes
in different instances; for that the heart is not always affected is clear
from the frequent regularity of the pulse through the entire parox-
ysm. From  the cases that have occurred to the author, the respira-
tory organs seem to be the seat of spec. 1, and some affection of the
heart, of spec 2.
   Gen VI.  Pleuralgia. From irkevpx, «latus," " membrana costas
succingens," and xXyos, " dolor."  Dr. Cullen has regarded pleural-
gia, or pleurodyne, as merely symptomatic of some other disease, 
GE. VI.]
NOSOLOGY.
91
     Antalgia dolorosa. H.  Young.
     Mum.  Arab.
     Seiten-stichc.   G.
     Stitch.   Pain in the side.
1.  acuta.   Sudden  and  temporary;   supervening  on  muscular
              exercise ; relieved by  pressure.
     Pleurodyne a spasmate.   Van.  Swiet. Sauv. Macbr.
2.  chronica.  Permanent: augmented by  pressure ;  inability of
                  lying on the side affected.
     Pleurodyne parapleuritis.   Veziani  Sauv.
       The first species found also frequently as a symptom in flatu-
     lence, hysteria,  and hypocondriasis.  The  second in plethora,
     worms, syphilis, phthisis, rickets, catarrh, and rheumatism.
and tor the most part of rheumatism; and consequently  it has no
place in his system of nosology: and the example he has set has
been followed by most later writers of our own country.  The spe-
cies here offered, however, seem to have a fair claim to be regarded
as strictly idiopathic.   The second, indeed,  is frequently a conse-
quence or sequel of pleuritis, though not always so: yet even  when
it is, the disease is  altogether  distinct from  pleuritis, and must no
more be confounded with it than chronic with acute rheumatism 5
the former of which  Dr. Cullen regards as  a sequel of the  latter,
but still entitled to a separate notice and  definition.
  VanSwieten and Sauvages, in denominating pleuralgia acuta, pleu-
rodyne a spasmate, make a difference between spasma and spasmus:
" Spasma non est  spasmus, sed distractio, divulsio, qualis accidere
solet a vehementi musculi nisu, contractione,  extensione, ut inter
lucundum, onera gestanda, currendum."  Vide  Van  Swiet.  Com.
in aph. 675.  Sauv, i. 684.
  Darwin ascribes the chronic species in many cases, and  especially
among young  ladies of delicate habits, to  the use of tight  stays,
which, by their pressure, weaken the action of the vessels composing
some membranous part. I. i. 2. 14.—The common stitch in the side
(acute or transient  pleuralgia) is produced by too great and sudden
distention of  the same vessels from propulsion of blood in running
or other  violent exercise.   It is hence relieved by a tight bandage,
which equally  supports the vessels, and diminishes the current  of
•lood by its pressure; and subsides on rest, or even slackening the
pace. 
             CLASS  III.

         H  M M A  T I C A.

DISEASES OF THE SANGUINEOUS FUNCTION.
                        ORDER  I.

                   PYRECTICA.

                           FEVERS.

  Heat and number  of the  pulse  preternaturally  augmented;
usually  preceded by rigor,  and followed by  perspiration ; pains
  Class III.  H^ematica.  'AtftxriKx, « ad sanguinem pertinentia,"
fron aipuc " sanguis."
  Order I. Pyrkotica   HvftKrwa, " febrilia," from xvgnos, " ig- "
neus aesius," " febris," as this is from vv%, " ignis."
  Pyrectica is here used in its fullest collective sense, and conse-
quently as importing vomjpixTx w^cktikx, or irvgwrx,  " febres,"  or
" morbi febriles;" terms better understood perhaps by themselves
than by any definition that has ever been  offered.  In reality no
writer  seems to have been fully satisfied with  his own definition ;
and it  is not  extraordinary, therefore,  that he should seldom have
given satisfaction to others.   The  difficulty proceeds from the com-
plexity of the symptoms that  enter into  the  character  of  a fever,
the contrariety of many of them to each other in different stages of
it, and  the occasional absence of some that in other instances appear
to constitute its leading features.                               *
  That there  is a change  in  the  heat, or in the  pulsation, or  in
both, from their natural state, appears to be assented to by every
writer; hut the extent and  quality of this change has been a perpe-
tual source of controversy.  Gah-n modestly declines engaging  in
the latter question, so far as it  relates to the  heat of the body, and
merely handles it in regard to the pulse.  Fever therefore,  accord-
ing to  him,  is " a change of the natural  heat {innati caloris,) or a 
CL. III.—OR. I.]             NOSOLOGY.                       93

fixed  or  wandering ; lassitude;  debility  of mind, and  voluntary
muscles.

declination  to  a  preternatural state, with a quicker  and stronger
pulse."  Fin. Med. p. 146.  Vogel gives up the  pulse, am' fixes
pathognomicaily  upon the heat; defining  fever to be  a '.'preterna-
tural  increase of internal heat:" to which  he adds, "dryness of the
mouth and heaviness of the body."  Bunchi is afraid  of  advancing
as far as either of these.   In opposition to Vogel he abandons the
heat,  and hesitates to determine concerning the altered state of the
pulse, merely admitting that there is an alteration.   Under Bianchi's
hands therefore fever is " a change of the pulsation, with a painful,
peculiar lassitude of the whole  body, and a sudden debility of the
voluntary muscles."   His.  Hep. p. 847.
  Sennert  distinguishes fever by increased heat alone; Sylvius,  C.
Boerhaave, and Darwin, by increased  quickness of the pulse alone;
H. Boerhaave by  both these symptoms, preceded by horripilation or
shivering (Aph. 563 :)  while Cullen, in addition to the symptoms of
shivering, increased heat, and  quickness of the pulse,  subjoins," in-
jury  of various functions, especially  diminution of the strength of
the limbs."  This, however, it should be farther observed, is Cullen's
definition of pyrexy as a elassific, and  in some sort  an abstract term,
under which he has made fevers a distinct order; for  he  afterwards
defines fever as an actual disease, to  consist in preceding languor,
lassitude, and other signs of debility, with pyrexy, (or all the above
symptoms  ascribed to pyrexy,) without primary local disease.  Sau-
vages, who furnished Cullen with most of his symptoms, adds  what
Cullen has omitted—" madore in declinatione," " sweat  in  the de-
cline  of  the paroxysm."   Fordyce, who has perhaps  refined some-
what  too much, has correctly suggested, that some notice should be
taken of the state of the mental powers, these being always in some
degree weakened or disordered : a suggestion on which Dr. Clut-
terbuck has founded his  ingenious hypothesis of fever, which he
regards  as  " consisting essentially in topical inflammation of the
brain or its membranes," and consequently as being " neither more
nor less than a species of phrenitis;"  while Dr. Parr, bending also
to the authority of Fordyce, has introduced into his definition, which
is chiefly however drawn  from Cullen, the symptom of "mind un-
steady," to which he has added, " tendons of the wrist tense."
   The fullest of  these definitions is, after all, that of Cullen  ; but
it is somewhat wanting both in  elegance and precision.  Without
farther inquiring into the propriety of using pyrexy in a sense differ-
ent from most former, and many subsequent, writers, upon which
the author has already observed in the introductory Dissertation, it
must be clear that a term selected as the appellation of a class, ought
to have no place  in the definition of an order that constitutes one of
its divisions; for  whatever is contained in the class is necessarily im-
plied in every order  that occurs  under it.  In arranging fevers 
34                        NOSOLOGY.            [CL. III.—OR. I,

  The two most striking  characters  of  fever  are  heat  and in-
creased or violent  action.   In most  languages  the  name for the

therefore as an order belonging to the class pyrexies, and then enu-
merating pyrexy as one of the leading features of fevers, Dr. Cullen
evinces an inelegant  and immethodical tautology.  Yet the  same
tautology is continued through most of the other  orders of the class,
for one of the characters that enters  into the definition of hsemor-
rhagia and profluvia, and even of the genera of several of the orders,
as phlogosis, phrenitis, pneumonia, catarrhus, and various others, is
still pyrexia, while  the elassific appellation of pyrexiae is uniformly
preserved and printed as the running-title to the  whole.
  .Dr. Cullen has, moreover,  been accused of imprecision, as well
as of tautology, in introducing into his definition of pyrexies symp-
toms which do not  always occur in the different genera he has  ar-
ranged under this class, as shivering {horror.) and frequency of  pulse.
It was a frequent objection made during his life-time ; and he replies
to it as follows : "That pyrexies of this kind are sometimes, though
very  rarely,  to be  seen, I will  not deny;  but in  laying  down the
characters of classes  for the distinction of species, it does not seem
necessary that all the marks of a class should be discernible in every
one  of the species; and it is sufficient that the  greater number of
them should be present in each."
  This defence is hardly admissible ; and its introduction into prac-
tice would be a source of the greatest looseness and confusion. The
character of  a  class,  or of an order, cannot be too simple, provided
it be sufficiently discriminative ;  and if any  of the genera or species
intended to be arranged under it, do not develop such  simple and
discriminative mark,  instead of forcing them  into  a situation  to
which they do not belong, another class should  be made for their
reception; or (which however is less  advisable,) the objectionable
clause in the general  character should  be qualified by plerumque, or
some such term, to allow them an admission.
  The chief objection to the simpler of these various definitions is
its looseness; the  term change,  whether applied to the pulse or
the heat, gives no idea of the nature of the change, and consequently
no idea of the precise character  of the disease.   If with H.  Boer-
haave and Cullen we define the change in each from what occurs
most prominently;  if we provide for the occasional absence of the
introductory rigor,  or cold and  shivering, by some  qualifying ad-
verb, as " usually," or " for the most part," and  notice that debility
of the mind on which Dr. Fordyce has so justly insisted, we shall
perhaps make as near an approach to correctness as  can be accom-
plished.   It  seems unnecessary to  provide  against  the  very few
cases that  are  supposed to occur of no augmentation in the heart
or pulse; for' admitting their  existence, they are confessedly ano-
malous, and have no need therefore to be guarded against under a
general rule. 
CL. IIL—OR. I.]            NOSOLOGY.                       93

disease  is derived  from  the  former, as pyrelus in Greek,  febris
in Latin,  calentura  in  Spanish, caldezza in Italian, though both
  The division of fevers  has  proved another source of difficulty
among nosologists.   The distinctions which seem  to be most obvi-
ous for this purpose, and which have been chiefly attended to from
the time of Galen to our own day, are the duration of the disease,
and its tendency to putridity.  Sauvages, Linneus, and Sagar, have
principally adhered  to  the former;  Boerhaave, and  most of the
humoral  pathologists of recent times, as also  Macbride, to the latter.
Other physicians have  been more attentive  to the  range or locality
of fevers, as  being  epidemic, endemic, or sporadic.  This last was
a favourite view of Hippocrates;  and Sydenham, who has so closely
followed  him  in  other  respects, has had his  eye also constantly
directed  to this kind of division.   Darwin has endeavoured to ar-
range fevers according to the nature of their influence on the sensi-
tive or irritative fibres; he supposes them to  be of five kinds;  by
kinds, however, meaning species,  two of which are diseases of irri-
tation, and  three  of sensation.  Yet not quite satisfied  with this
arrangement, he immediately afterwards doubts whether the whole
ought not to be placed under another class of his system, among the
diseases  of association.  Of all arrangements therefore this is unques-
tionably the worst; it is built altogether upon  hypothesis, and scatters
a natural family of diseases over every part of the classification.
   Dr. Cullen,  whose constant and laudable object was simplicity,
and who, whenever he has  failed, has only failed from pressing this
object too far, conceived that all  fevers might  be resolved into the
two kinds of inflammatory  and nervous, objecting, however, to the
use of these terms as  entirely  theoretical.   His division therefore
is founded  upon this  view,  and  is indubitably possessed  of great
merit.  " Aliam divisionem," says he, " a differentia symptomatum,
et a natura morborum, quantum de ea judicare liceat, desumptam,
institui:  secutus simul illamapud Britannos nunc maxime usitatam
divisionem febrium continuarum in Inflammatorias, et Nervosas.
Has, autem, appellationes,  utpote quodammodo theoreticas, vitavi."
It is necessary to observe,  that the term nervous is here employed
merely in its popular sense; a sense which  seems to have been
first made use of by Willis, De Morb. Convuls. cap. viii.; for the
physiological principles of Cullen induced him to regard every fever
as strictly a disease of the nervous system; and half  tempted him
to transfer the whole  family to  his class of neuroses, or nervous
diseases.
   After  all, however, this  aim at a simplicity unknown to former
writers,  has not answered : for Dr. Cullen, instead of confining him-
self to two genera, as he seems at first to have intended, has given
us six, besides an appendix for Hectica; while he has still found it
necessary to marshal these'six under sections and subsections of in- 
 9(j                        NOSOLOGY.             [CL. III.—OR. I.

 the  Spanish  and  Italian  writers  frequently  concur  with  the
 French,  English,  and Germans  in  employing  a modification  of

 tennission, remission, and  continuity, together witn  a compitx and
 intricate machinery of minuter partitions ; by which  means he  has
 fallen into the  very scheme of distinguishing the different kinds of
 fever by the obvious sign of the ordinary duration of the disease,
 which it was his expressed object to avoid;  and at the same time
 has rendered the subject more complicated than perhaps any  other
 nosologist, with the  exception of  Darwin.  It  is hence not  to be
 wondered at  that few later writers have followed Dr. Cullen in this
 part of his method;  and that most of them  have returned to the
 general character of duration.
   Under all  the forms of fever, indeed, even those  that  are  most
 complicated,  duration seems to constitute its chief feature.   In its
 simplest shape, as that of an ephemera, or the first paroxysm of a
 quotidian, its pathognomic distinctions are few and striking, and here
 its duration may be calculated with tolerable accuracy.   However
 violent, it is here a simple disease;  consisting of a single fit of three
 distinct stages;  shivering, heat, and perspiration, each most proba-
 bly,  as  Dr. Cullen conceives,  dependant on the  other, and ceasing,
 when true to itself, after having followed  up the movements of the
 animal frame through a single diurnal revolution. In the ephemera,
 however, the cold stage is often scarcely  perceptible, and  at  times
 altogether imperceptible; and in the quotidian a predisposition or
 tendency to return is established from the first, producing a regular
 duration of intermission and of paroxysm.  This predisposition or
 tendency differs in different cases, from habit, idiosyncrasy, or cli-
mate ;  and hence the durations are different,  whether of paroxysm
 or of interval:  and  hence again the origin of the various types of
 tertians, quartans, quintans, sextans,  Sec.  as  well as of quotidians.
While in other cases the tendency is duplicated or multiplicated, and
we behold two or more sets of quotidians, tertians, or quartans run-
ning on at the same  time,  producing paroxysms daily, or oftener
 than daily; each set or type being distinguished from the rest by the
 similarity of its own paroxysms, and its diversity from those that are
intermediate.—Sometimes  the intervals  are  perfectly free  from
fever, and in this case the disease is strictly intermittent; and some-
times the paroxysm is protracted, and does not perfectly cease be-
fore  the arrival of the next in rotation.  If in the last case, there
be a decided  and regular diminution, though without a total cessa-
 tion of fever or pyrexy, the disease  becomes a remittent; but if the
remission be  less obvious and regular, it forms what is called a con-
tinued fever; a tendency to remit,  intermit, or cease at particular
periods, or after  particular durations, still running through its whole
 course, and constituting.critical terms or days.
   Admitting  duration, then, to be the  most convenient basis for the
 division of fever, we should  unquestionably commence  with the 
CL. III.-^OR. I.]            NOSOLOGY.                       97

the Latin term.   In  Anglo-saxon the  name is derived from  the

ephemera, or simple fever of Fordyce,  a disease acknowledged by
all writers, but  unaccountably omitted  by several, and huddled by
others into the  varieties or synonyms of some  other  genus.  The
author's late learned friend, Dr. Parr, in his valuable dictionary, has
written a short but good article upon this disease, under its proper
name:  and with his accustomed  acumen, has marked two species of
it;  but has strangely dropped it in his article on  Nosology. It is con-
tinued by Dr. Crichton, but omitted by Dr. Young.   Fordyce has set
a valuable example upon this subject, as well in beginning with the
ephemera, as in treating of it with  great clearness and precision,
though possibly  with too much digression.  In  a few cases of ephe-
mera, he has seen it happen, he  tells us, that the disease has con-
tinued thirty-six hours; and in one case above forty hours from the
attack to the  termination of the crisis, or perspiring stage, but this
very rarely.  On Fever, Dis. iii.  p. 59.
  The  ephemera,  moreover, has hitherto been seldom properly
defined or limited, even by those  who have employed the division.
Most of the writers have allowed it to embrace  all fevers that cease
within half a week ; in consequence of which it is ranked  by Sau-
vages under his ordinal division oifebres continue, and made to in-
clude milk-fever, the ephemera lactea of Riverius, and various others
with  which it has  as little connection; whilst Crichton has mar-
shalled under its banners vaccine fever and nettle-rash.  Avicenna
appears to have had the justest notion of its proper nature  and
limit, and the first two  species of the present system are chiefly
drawn from his description and  boundary.   Dr. Fordyce has been
equally alive to the proper range of a diary fever, and is equally
worthy of attention.  The third  species, e sudatoria, if retained at
all, must fall necessarily into the place here assigned it.  In natural
history it is not usual to continue genera or species that have ceased
to exist; but it is often difficult to  determine what have ceased
to exist: and we are not altogether free from this difficulty in the
present case. The Sweating Sickness made its first appearance in
London in 1485 ; where it took up its abode  with various intermis-
sions of activity for nearly forty years ; it then visited the continent,
overran  Holland, Germany, Belgium, Flanders, France, Denmark
and Norway, among which countries it continued  its ravages from
1525 to 1530: it then returned to England, and was last discovered
in 1551: possibly originating from inclement harvests and vitiated
grain ;  but being more probably a peculiar contagion that has long
since worn itself out, and become decomposed; though it may still be
latent, and only waiting for its proper auxiliaries once more to show
itself in the field.
   The general arrangement of Linneus, Sauvages, and Sagar, is into
continued, remittent, and intermittent fevers, each of which consti-
tutes a distinct order.  More correctly  they ought only to constitute
   vol. v.—24 
98                       NOSOLOGY.            [CL. III.—OR. I.

second  of the  above  characters,  and  is  drif, or emphatically
ge drif;  though  the former is mostly  used in Bede's Bible.   The
 so many genera; and under this more simple form we find them in
 Galen, de Diff.  Febr., who  gives them the names of intermittens,
 synocha,  and synochus:  and it is to this form the present system
 adheres, though the Galenic names are changed.
   The subject of names has,  indeed, been another difficulty of no
 small magnitude among nosologists.   The three genera of Galen
 having been transformed into  so many orders  by later writers, his
 names of synocha and synochus has been made to assume a  new
 and more limited sense, by being confined to genera under such or-
 ders, but which, in Galen's own arrangement, had it been carried to
 so much minuteness, would  have been,  and ought only to  be,  spe-
 cies.  Thus synocha ampng writers of modern times is generally
 employed to signify inflammatory fever, probably the synochus non
 putridus of Galen, and synochus, putrid fever, probably the synochus
 cum putridine ;  while the  original and more  extensive  senst s of
 synocha and synochus are expressed by febres remittentes,  and  con-
 tinentes, or febres exacerbantes. and continue, ,; remitting and conti-
 nent," or "exacerbating ar>d  continual fevers."
   The whole of this can  be  called little less than jargon.   Synecha
 and Synechus were bad names from the first; they were ban in the
 Greek, as o-vve%*is, or a-moy^s  (for it is written both ways,) and <rvvo%os't
 but they are still worse in the  Latin, being constantly liable to pro-
 duce mistake from their close resemblance  to each other;  while,
 moreover, they are  nothing more than the same words possessing
 the  same  radical meaning,  with a slight variation of termination:
 and  in their Latin form with a still slighter variation than in their
 Greek ; for synocha only differs  from synochus as being its proper
 feminine.
   But if, on these accounts, they were bad terms as employed by
 Galen, they are  altogether  absurd and  intolerable  as employed
 among recent  nosologists.   Under the  hands of Galen they had a
 radical and proper meaning,  that of continuity, from <rvny,u, to conti-
 nue, synecha importing imperfect, and synochus perfect continuity:
 and  even when first applied  to signify inflammatory and putrid fe-
 ver, they still kept  some reference  to the same idea; for the na-
 ture of their respective continuities enters  into  the definition of
 each of them as laid down by Linneus and Sauvages: but this mark
 is totally lost  sight of by Dr. Cullen, who hereby employs  terms
merely importing continuity  as the names of diseases in which con-
tinuity does not form any part of the character  which he applies to
them.   To add to the  general confusion, while Sauvages, Linneus,
 and Cullen, use synocha to signify inflammatory fever, and synochus
putrid fever, Vogel uses synochus for putrid fever, and makes no
mention of synocha.  In like  manner  the terms  intermittent  and 
E.I.j
NOSOLOGY.
99
radical idea of this term  is force, impulsion,  violent action : it is
the root of the English drive, drift.
                      GENUS  I.

                 EPHEMERA

Attack of fever sudden ; paroxysm single,  and terminating in
       about twenty-four hours.
  Febris continua simplex   Macbr.
  Febris ephemera.   Plouquet.  Fordyce, vol. ii. p. 22.
  Eintagages fieber.   G.
continent have  been used by  different writers in highly  different
senses : intermittent commonly as importing  intervals  of perfect
apyrexy. as the Greeks, or  infebricitation, as  the Latins called it;
but by Dr.  Cullen as importing intervals of mere remission, as well as
of perfect apyrexy or intermission, while  the term continent is em-
ployed sometimes in the general sense of continued fever, or fever
admitting of occasional remissions in the midst of a continued course,
which was  its more common signification; sometimes in the limited
sense of continual fever, or fever running its course without the
slightest remission  or relaxation from the beginning to the end, a
meaning given  to  it by Stahl  and  Sennert;  and sometimes, as by
Morton, in  his Pyretologia, in the sense of remitting, being precisely
synonymous with this last term as us^d by Huxham and Pringle.
   Some common understanding therefore, and consequently  some
change, is become absolutely necessary: and it seems impossible not
to approve the banishment of synocha and synochus, as has been
done  by Dr. Fordyce and various.other pathologists, as well  as by
Sagar, Macbride, Parr,  and  Young; and the limitation of intermit-
tent to its strict sense, as in the hands of Macbride, Parr, and Crich-
ton.   The  present  system follows this example, anetus, epanetus,
and enecia, being used  synonymously with the febris intermittens,
synocha and synochus of Galen, or the febres intermittentes, remit-
tentes, and  continuae of modern writers.   Dr. Young has anticipated
the author in employing anetus, but in a different sense; for he uses
it, though  as a single genus, to  embrace equally intermittent and
remittent fevers ; and hence synonymously with  the  whole section
of intermittentes, as employed by Dr. Cullen.
   Gen. 1. Ephemera. EQupttpx, " diaria," from tict, or «V,  " apud,"
and \fMfx,  " dies."  Wc  have no classical authority, however, for
using it as  a substantive, though we are justified by analogy.  Galen
writes usually tQwtoos Metros, " diaria febris." 
100
NOSOLOGY.
[CL.III—OR. I
     Courbature.   jF.
     Simple Fever.  Fordyce, passim.
     Diary Fever.
1.  mitis.   Without preceding rigor ; heat and number of the pulse
              increased slightly ; lassitude and debility inconsider-
              able ; pains obtuse, chiefly about  the head; perspi-
              ration and breathing pleasant.
     Ephemera.   Lommii.  Snuv. Cricht.
       Usually produced by excess of corporeal  exertion, study, or
     violent passion: by suppressed perspiration; sudden heat or cold.
2.  acuta.   Severe rigor ; great heat;  pulse at first small and
              contracted, afterwards quick and  strong ; perspira-
              tion copious; great languor.
       Ephemera.  Par.   It occurs in his  alphabetical article, but
     is not noticed, as it ought to have been, in his article "Noso-
     logy."
     Ephemera plethorica.   Sauv.
     Ephemera nauseativa.   Avicenn. Sauv.
     Diaria inflativa.  Auct.  Var.
     Synochus Ephemera.   Vog.
       Frequently produced by a surfeit of eating or drinking;  or
     some temporary organic obstruction : more  commonly by un-
     known causes.
3.  sudatoria.   Tense pains in the neck  and extremities; palpi-
                  tation ;  dyspnoea; pulse rapid and irregular;
                  heat intense ; intolerable thirst;  drowsiness or
                  delirium ;  excessive sweat.
     Ephemera sudatoria.   Sauv.
     Ephemera maligna.  Junck.
     Ephemera anglica pestilens.  R. Fort.
     Hydronosus.  Forest.
     Sudor Anglicus.  Sennert.
  2. Ephemera sudatoria.  Supposed  by Willan to have been the
result of  some depravity in  the  wheat made use of  in our own
country at the period of the disease, which was the beginning of the
sixteenth century.   In  proof of which he observes from other sour-
ces, that the  contemporary inhabitants of Scotland and  Wales, who
fed on oaten  or barley  instead of wheaten  bread, were not affected.
A similar disease appears to have existed soon afterwards (1525) in
Denmark, Norway, Holland, Flanders, and various parts of Germany.
Forest, de Febr. p. 157.  Senner, iv. and xvi.
  See Lord Bacon's description of the sweating sickness, Hist. Hen.
VII. p. 5.  Wedel De Sudore anglico, Jen.  1697.   Holler Bibl. Med! 
GE. II]
NOSOLOGY.
Schweyssucht.   G.
Suette.   F.
Sweating-sickness.
                       GENUS II.

                         ANETUS.

    Paroxysm intermitting, and returning during the course of the
         disease :  the intermission generally perfect and regular.
    Febris intermittens.  Gal.
    Febres intermittentes.  Sauv. Linn.  Vog.
    Intermittens.  Parr.
    Abwechselnd-fieber.  G.
    Fievre intermittente.   F.
    Ague.—Intermittent.
1.  quotidianus.   Intermission about  twenty-four  hours:  par ox-
Pract. i.   Bayer, Rathschlag der jezl regierendon Pentilens, so mar
den Englischen Sehweissnennt.  See also the note on Pyrectica.
  Gen. II. Anetus.   'A»jt«s, from xiirtpu, " intermitto," " solvo,"
" intermissio vel solutio omnis imperii," as xveros e^ova-tx t«» Tr^xrta-
rm.  Herodian.  In like manner Epanetus {rxxnros,) from sirxwiptt,
« remitto,"
  Dr. Cullen, as already observed, unites  intermittents and  remit-
tents into one section of fevers, merely distinguishing them as inter-
mittents with an interposed  apyrexy, and intermittents with remis-
sion alone ; and he makes it a part of their pathognomic character
that they are derived  from marsh miasm, miasmate paludum ortx ;
whence Dr. Young gives  to these two sorts of diseases the name of
paludal fevers.
  The present system is intended, not to support hypotheses of any
kind, however plausible, but to rest, as  far as may be, on physiolo-
gical facts. Marsh-miasm is unquestionably the grand source of both
intermitting and remitting fevers ; but it is at present too much to
say that it is the only source.  Even in  tertians Dr. Cullen himself
is obliged to admit of instances in which other agents are necessary';
but then, says he, they are  only co-agents,  and  would not operate
alone :  " has potestates excitantes pro parte principii hie admit-
timus, licet neutiquam morbum excitassent, si miasma paludum non
antea applicatum  fuisset."   But this is the very point of  contro-
versy. 
102
NOSOLOGY.
[CL. III.—OR. I.
              ysm commencing  in the morning; usual dura-
              tion under eighteen hours.
Cathemerus {Kafapepes.)  Auct. Grozc.
Quotidianus.  Auct. Lat. et Recentior.
Tagig-fieber.  G.
Fievre quotidienne.   F.
Quotidian ague.
x Partialis.   The disease confined to a particular part or or-
     gan, usually accompanied with distressing pain.
       Sometimes limited to one side. Sauv. sp.  10.  Cnoffellia
     Collect. Acad. iii. 166.  Ed. Med Ess.  i.  art. 31. ii. art.
     19.
       Sometimes limited  to  one or  both  eyes, as  in  the
     ophthalmia  febricosa.   Sauv. sp. 23.  Quotid. ophthalm.
     Mort. Pyret. exerc. i. hist. 21.   Van Swiet. in Boerh.  p.
     534.
       Sometimes, and still more  generally,  confined  to the
     whole or half the bead, embracing many cases of cepha-
     Isea,   See Cl. IV  Ord. iv  Gen. v  Cephalalgia inter-
     miitens.  Sauv. sp. 7.   Cephalaea febricosa, sp. 23.
G Comitatus.  Catenated with, or giving rise to  foreign symp-
     toms or other diseases.   Constituting the  family collected
     by Torti under the  name of febres intermittentes comitatos :
     to which belong the following :
  Ischiadic  quotidian, or intermittent ischias,  Sauv.  Quot. sp.
     i. Iscb. sp. 5.  Ed. Ess. v. art. 49.
  Nephralgic  quotidian,  or  febricose  nephralgia.   Sauv.
     Quot.  sp. 7. Nephr. sp.  13.   Mort.  Pyr. ix. hist. 28.
  If intermittent ought to be separated from continued fevers, so
ought remittent  to be separated from intermittent.  To say that in-
termittents often run into remittents is to say nothing, for remittents
as often run into continued fevers: and  it is now an established doc-
trine, that there  is no continued fever whatever without occasional
remissions.   In  effect, all fevers  have a tendency to run into each
other, and many causes are perhaps common to the whole.  The
difficulty is in drawing  the line:  yet a like difficulty is perpetually
occurring to  the physiologist in every part  of nature; and equally
calls for discrimination in zoology, botany, and mineralogy : and Dr.
Parr has correctly observed, that "  if a specific  distinction can be
established in any branch  of natural history, it must  be so in the
separation of remittents from intermittents."  Vogel unites remittent
with continued  fevers, to which  Cullen objects, and  unites  them
with intermittents.  Sauvages, Linneus, Sagar, and most modern
writers, more correctly distinguish each from the other. 
GE. II.]
NOSOLOGY.
103
       Epileptic  quotidian.  Sauv.  Quot.  sp.  4. Ed.  Ess.  ut
         supr.
    y Protractus.  Leaving the  intermission inordinately short, or
         imperfect.
       Amphemerina.   Sauv.  Embracing many of his species.
    ^ Anlicipans.  The  paroxysm  anticipating  its  antecedent
         period usually by about two  hours:  and continuing the
         same anticipation at every recurrence ;  so that the acces-
         sion may hereby be thrown into any hour of the day or
         night.
       Anticipating quotidian.  Fordyce.
    t-  Cunctans.  The paroxysm  delaying  its antecedent period,
         usually by about two  hours ; and continuing the same
         delay at every recurrence as above.
       Retarding quotidian.  Fordyce.
       The quotidian is also occasionally found, as a symptom in
         hysteria, catarrh, gout, peripneumony, ischury,  quinsy,
         and various other diseases.
2. tertianus.  Intermission about forty-eight  hours:  paroxysm
                   commencing  at noon ;  usual  duration under
                   twelve hours.
       Trilseus.  Auct. Grozc.
       Tertianus,  Auct. Recentior.
       Hemmai mushelleshe. Arab.
       Drey-tagig-fieber.   G.
       Fie'vre tierce.   F.
       Tertian ague.
       x Comitatus.   Concatenated with, or giving rise to, foreign
            symptoms or other diseases.   The chief of  which are
            the
         Choleric, or  dysenteric  tertian.   Tort.  Therap.  Spec.
            Laut. Hist. Med. cas. 6, 16, 17, 20.  Mort. App. ii.
         Atrabiliary tertian. Tort. ibid. Sauv. Tritaeoph. sp. 4, 6.
         Syncopal tertian.  Tort. Laut. Sauv.  Tritaeoph. sp. 1.
         Lethargic tertian.  Tort.  Tritaeoph. carotic. Laut. Sauv,
  4. v A. Erraticus Vagus.  It is probable that various forms of he-
micrania belong to this variety : those more especially which origi-
nate in  low, damp, or marshy districts, which  return more or less
regularly, and  are relieved by the bark alone, or in conjunction
with warmer tonics.  Several  of Sauvages' species of hemicrania
may be  properly referred to this place; and especially those which
by some writers have been denominated intermittentes larvata, or
disguised intermittents. 
104                       NOSOLOGY             [CL. III.—OR. I.

         Tertianus  apoplecticus.   Mort. T. soporos.  Werlhqf.  de
            Febr. 6.
       G Protractus.   Leaving the intermission inordinately short
            or imperfect.
         Tritaeus.   Linn.
         Tertiana (febris)  subcontinua.   Sauv.
         Tritaeophya.   Sauv. Sag. in  several of  the species.
         Tertianus remittens.  Auct.
         The species  is found also, occasionally, as a symptom in
            syphilis, sea-scurvy, worms, and scabid eruptions.
3. quartanus.   Intermission about seventy-two hours ; paroxysm
                   commencing in the  afternoon ; and  usual dura-
                   tion under nine hours.
         Tetartaeus.   Auct.  Graze.
         Quartanus.   Auct.  Recentior.
         Hemmai murbau, whence the patient is denominated mur-
            bua.
         Vier-tagig-fieber.   G.
         Quartaine.   Fievre quarte.   jF.
         Quartan ague.
         x  Comitatus.  Catenated with,  or giving rise to,  foreign
              symptoms or other diseases : of  which the chief are
              the following:
            Comatose  quartan.  Sauv.  Werlhqf. Parr.
            Cataleptic quartan.   Sauv. Bonet. Polyalth. I. 805.
            Neophralgic quartan.   Sauv. Lemer. Journ. des  Sa-
              vans.
  5. x.  Anetus complicatus.   Intermittents (chiefly tertians)  have
often proved the best remedy for chronical diseases ;  mostly in  their
simpler forms.   Menorrhagia has been cured by a tertian.  Ephem.
Nat. Cur. Dec. II. ann. vii. obs. 213.   See, for other examples, Car-
dan.  Contrad. Med. i. 1. Tr. v. n. 15.—Tertian itself carried off by
catamenia   Eph. Nat. Cur. Dec. I. ann.  vii. obs. 213.—Another in-
stance in Madai, von Wechselfieborn.  § 203.  " It has  been  often
observed," says Fordyce, " that regular  tertians clear the constitu-
tion of all other diseases, and certainly on a good foundation."   He
instances particularly the cases of chronic rheumatism ; habitual in-
digestion ; cutaneous eruptions; protracted inflammations; epilepsy;
and hysteria.  " In many of these cases such diseases are alleviated,
though  not entirely carried off."  On Fever, Diss.  ii. p. 16 —Some-
times produced by worms, and only relieved by vermifuges. Hunter
on  Blood,, p. 311___Sometimes by diseases of the liver,  spleen, or
mesenteric glands.   Id. 
GE. II.]
NOSOLOGY.
105
            Idiotic  quartan.   Sydenh. de  Morb. Acut.  V. Sauv.
          G Protractus.   Leaving  the  intermission  inordinately
              short, or imperfect.
            Tetartophya (febris.)   Sauv. Linn.  Sag. in  several of
              the species.
            Quartanus remittens.   Auct.
          y Anticipans.   The paroxysm anticipating its antecedent
              period, usually by about two  hours ;  and continuing
              the same anticipation at every recurrence ; so that
              the accession may  hereby be thrown into  any hour
              of the day or night.
            Anticipating quartan.   Fordyce.
          I Cunctans.   The  paroxysm  delaying  its  antecedent
              period, usually by about two hours ;  and continuing
              the same delay at every recurrence as  above.
          Retarding quartan.  Fordyce.
            The  species  is found  also, occasionally, as a symp-
          tom in diseases \)f the spleen, liver, and other abdominal
          organs.
4. erraticus.   Intermission and paroxysm less regular; the former
                   more than seventy-two hours.
     Febris erratica.  Sauv. Sag.
     Febris errana.  Linn.
       The varieties, as given under the form of species by Sauvages
     and Vogel, are the following:
     x Quintanus.  Tulpii. Avicen. can. iv. 1.
     G Sextan us.   Vog.
  2. Epanetus malignus.   For the origin of epanetus, see the note
on anetus.   " Malignus discitur morbus qui lmo invadit cum sponta-
nea virium prostratione : 2° cujus symptoma non respondent stadiis
morbi:  3° nee respondent signis externis, ut calori, urinae, pulsui."
Sauv. i. p. 309.
  The chief signs of putrescency are the following: the pulse quick
and tremulous; heat of the skin sharp and pungent, giving to the
finger a peculiar feel for some minutes afterwards; parched or wet
with sordid fetid sweat; smell offensive at a  distance;  breath hot
and fetid; mouth aphthous; tongue, clammy,furred,livid,greenish-
black ; urine brown or blackish, and offensive ; stools blackish, col-
liquative, very offensive, parted with profusely and insensibly; mind
wandering; twitching of the tendons; swelling and tension of the
belly;  pctecchial spots, vibices, haemorrhages.
  3. Epanetus Hectica. 'Ektikx, from £|<s,  " habitus."  Nothing can
more fully prove the complexity and  irregularity of this fever than
the different characters given of it, and the different places allotted
  vol. v.—25 
106                       NOSOLOGY            [CL. III.—OB. T,

       y Septaiius.   Etmulleri.—Hebdom. Sehenekii.
       ? Octanus.   Amati Lusitani.—Octoman. Valesii.
       e No nan us.   Zacuti Lusit.
       £ Decimanus.  %acut.
         Dichomene.   Sauv.----Ephem.  dichomene.    Deidier.
            Observ.
       7i Vagus.  Equally irregular in the violence of the parox-
            ysm, the duration of its stages, and the  period of its
            return.
         Quartana vaga.   Etmull.
5. complicatus.   Paroxysms intricate, multiplicate, or both.
     a Tertianus  duplex.   Double tertian ; the paroxysms of the
         one tertian  occurring  in the intermissions of the other;
         and the two sets evincing a  difference of duration or of
         violence.
            The  last sign determines their real' nature ; and in
         conjunction with their comparative brevity and time of
         attack, (which, like that of the genuine tertian, is at noon,)
         distinguishes them from the quotidian  intermittent ; for it
         is obvious, that from this interference  of the two sets with
         each other,  the  double tertian,  like the quotidian,  must
         have one paroxysm every day.
       Duplex tertiana.   Sauv.
       Duplicana.  Linn.
     G Tertianus triplex.  Triple tertian.  Double tertian taking
         place as  above,  but one of the sets having regularly two
         paroxysms on the day of its return ; the other, one parox-
         ysm alone.
       Tertiana triplex.   Sauv.
to it, by different authors.   Sauvages and Sagar introduce it into the
list of continued fevers.  Linneus, Crichton, and Parr, into that of
remittent or exacerbating fevers; Boerhaave regards it as of a mixt
nature, a continued intermittent: " Febris hectica," says he, " est
referenda ad febres continuatas intermittentes." Prax. Med. iii. 337,
8vo.  Vogel  and Cullen degrade it into a mere symptomatic affec-
tion.  Under this last character it is perhaps most frequently to be
found;  but it is now  generally admitted to occur at times idiopathi-
cally, or as an original  disease of the  constitution.   There are,
perhaps, few  physicians of  long or  extensive practice who have
not met  with it  under this character: and those to  whom  it has
never thus  occurred, may  consult Mr. J. Hunter's  treatise on the
Blood, p. 496. 4to: as also Dr. Heberden's very accurate description
and history j who seems, indeed, to  place it in the rank of intermit- 
GE. HI.]
NOSOLOGY.
107
  Semitertianus primi ordinis.   Gal.
y Tertianus impar.   Double tertian : the one set evincing
     a more perfect, the other a less perfect, intermission.
  Hemitritaeus.  Cels.  iii. 5.
  Amphimerinus hemitritaeus.  Sauv.
? Tertianus duplicatus.   Single  tertian,  with two  parox-
     ysms on the regular day of attack.
  Tertiana duplicata.   Sauv.
v Quartanus  duplex.   Double  quartan : the  paroxysms of
     the one set occurring in the intermissions of the other ;
     with an  intermission of the third day alone.
  Quartana duplex.   Sauv.
£ Quartanus  triplex.   Single quartan, with  regularly re-
     turning paroxysms  ; each of the intervening days being
     marked with a slighter or separate attack.
  Quartana triplex.   Vog.
n Quartanus duplicatus.   Single quartan, with two parox-
     ysms on the regular day of attack.
  Quartana duplicata.  Sauv.
0 Quartanus  triplicatus.   Single  quartan, with three parox-
     ysms on the regular day of attack.
   Quartana triplicata.  Sauv.
                       GENUS III.

                     EPANETUS.

Strikingly exacerbating, and remitting;  but without intermission :
  one paroxysm every twenty-four hours.
       Febris remittens.  Auct.
tents, but only as he employs  this term generally, so as, like Dr.
Cullen, to include a remittent action.  Cullen gives us, as a pathog-
nomic symptom,  " Urina. sedimentum furfuraceo—lateritium depo-
nente :" while Hunter tells us that " the urine is pale."  Dr. He-
berden appears to have attended to this  circumstance  very closely;
and thinks that the same irregularity which accompanies most other
symptoms of the disease attends this also:  that the urine is equally
clear or turbid in  the paroxysms and the intervals ; sometimes clear
in the first, and turbid in the second ; and sometimes  turbid in the
first, and clear in the second.  Dr. Duncan, from a long and assidu-
ous attention, has determined the character given in the text. 
108
NOSOLOGY.
[CL. HI.—OR. I.
  1.  mitis. Pulse regular,  though frequent; debility slight; remis-
             sion distinguished by sweating or a cloud  in the urine.
         Remittens mitis.   Parr.
  2.  malignus.  Pulse small,  hurried, irregular;  debility  extreme ;
                  often with signs of putrescency.
         Remittens maligna.   Parr.
      x  Autumnalis.   Often with a strong tendency to assume the
           tertian or  louble tertian type.
         Autumnal Remittent.
      G  Flavus.  With yellowness of the skin.
         Remittens icterodes.  Parr.
        Tritaeophya Americana.  Sauv.
         Typhus icterodes.   Sauv. Cull.
         American Yellow Fever.
           Said to be successfully treated by the root of the ophior-
         rhiza Mungos, Linn.—See Amoznit.  Acad. vol. ii. art. 21.
        on Lignum Colubrinum.   /. A. Darelius.
      y Ardens.   Burning remittent.
        Febris ardens.  Boerhaave.
        Febris ardens periodica.  Riv.
        Causus {Kxvtos.)   Hippocr.
        Tritaeophya causus. Sauv.
      ^ Asthenicus.  Highly debilitating remittent of the  south of
          Spain, Gombron, Breslaw, &c.
 3.  Hectica.  Pulse weak ;  stages of chilliness, heat  and sweat
                 variously  intermixed, and  sometimes single ;  the
                 cold stage exhausting ; exacerbation chiefly in the
                 eveni g:  urine with a natant, furfuraceous  sepa-
                 ration.
        Hectica.   Gal. Sydenh.  Boerh. Sauv.  Cull.
        Febris lenta.  Junk. Hoffm.
        Amphemerina hectica.   Cricht.
        Dik.   Arab.
        Schwindsucht.  G.
        Hectique.   jF.
        Hectic fever.


  In Vol. VIII. of the Amcenitates Academicae, art. 171, there is a
good paper on the  virtues  of a species of St. John's-wort hypericum
perforatum, as  an active antihectic.   The article is by C. B. Hclle-
nius; and the plant is said to  have  been successfully employed by
Linneus, under the following form: R Sumit  Hyperici  Manip. 1__
eoquc in vini Hispan. lb. iv. ad tertiae partis reman, cola. 
GE. IV.]
NOSOLOGY.
109
  Found also, occasionally, as a symptom in tabes, phthisis,
chlorosis, lues, and scirrhous diseases of various organs.
                      GENUS  IV.

                         ENECIA.

  One series of increase and decrease ; with a tendency to exacer-
      bation and  remission, for the most  part  appearing  twice
      every twenty-four hours.
      Febris continua.   Boerh. et Auct. Recentior.
      Febris continens.   Stahl. Juncker.
      Heinmai daim.  Arab.
1.  Cauma. Heal greatly  increased; pulse quick, hard, and strong;
              urine red ; disturbance of the mind slight.
       Synocha.  Sauv.  Linn.  Junck.  Cull.
       Febris continua sanguinea.   Hoffm.
       Febris continua non putris.   Boerhaave.
       Synochus.   Vog.
       Synochus imputris.   Gal.
       Febris actua.  Plouquet.
       Febris continens.   Stahl.  Plouquet.
       Continens non putrida.  Lomm.
       Febris inflammatoria.  Auct. Var.
       Hemmai mehrike.  Arab.
       General inflammation.   Fordyce.
       Inflammatory fever.
  The dose two ounces, or a half-quarter of a pint, morning and af-
ternoon.  The Swedish direction is Nwaraf ett halft quarter images
morgon och afton.
  The hypericum perforatum is a native of our own country as well
as of Sweden.
  Gen. IV. Enecia : from sjveww, " perpetuus," " continuus :" hence
Arist. Rhet.l. \,rt»tMus, " continua serie." Cauma {x.xvptx, from kxiu,
" uro"), is here  preferred to synocha,  for reasons  already stated,
and especially as forming a better distinction from synochus.  The
genus  embraces the order " febres continuae" of Suuvages,  with the
exception of ephemera and hectica ; and runs exactly parallel with
the genus " continua" of Parr.  Sauvages characterizes the three
species of cauma (synocha,) typhus, and  synochus, by a supposed 
110                       NOSOLOGY.             [CL. III.—OR. L
     * Plethoricum.   Produced by the stimulus of violent passions,
          undue muscular exercise, or heating foods upon a plethoric
          habit ;  as also by a suppression of accustomed discharges,
          as those of menstruation, habitual venesection, or perspi-
          ration.
       Synocha plethorica.   Sauv. Cull.
     G Biliosum.  Produced  by the stimulus of an undue secretion
          or absorption of bile into the sanguineous system.
       Synocha biliosa.   Cricht.
       Synocha ardens.   Sauv.
     y Pleuriticum.  'Accompanied with a violent stitch or  pain in
          the pleura.
       Synocha pieuritica.   Sauv. Cull.
     £ Cephalalgicum.   Accompanied  with  great  pain   in  the
          head ;  and  produced by  a lodgment of  worms or  the
          larves  of  insects  (perhaps  the  oestrus  ovis)  in  the
          frontal  sinus.    See  a curious  case in   Sauvages, i.
          300.
       Synocha cephalalgia.   Sauv.
          Found  also, occasionally, as a symptom  in empresma
       (organic inflammation,)  catarrh, severe local  pain,  labour,
       and sea-scurvy.
2. typhus.   Pulse small,  weak, and unequal ; usually  frequent;
               heat and urine nearly  natural ; great prostration
               of strength, and disturbance of the mental  powers.
       Typhus.  Hippocr. el vJuct. Recent.
       Typhodes.  Prosp.  Alpin.

difference of specific, or, as he would call  it, generic, duration :  the
cauma terminating in a  week at the farthest; the  typhus in two,
though sometimes protracted to three,  weeks; and the synochus,
reaching beyond the  second, and often beyond  the third, week.   In
our own country the most  frequent form  of the continued  fever is
the synochus  or mixt species.   Dr. Cullen, in his Nosology, doubts
whether this should be regarded as a distinct  genus  from typhus;
and observes, that it is difficult  to assign the synonyms  of authors if
we make it distinct.  " Inter typhum et synochum limites accuratos
ponere non possum;  et  an revera pro diversis generibus habenda,
vel positis diversis, utri eorum  synonyma  auctorum referenda, smt,
dubito."   And in his  First Lines, "I am  disposed," says  he, " to
believe that the synochus arises  from the same causes as the typhus,
and is therefore only a variety of it."  Part I. 1. i. § 69.  Yet out of
compliment to earlier writers he has continued it as a distinct genus.
Its proper place appears to be  that in which it now  stands, under
the same genus as typhus, but constituting a distinct species. 
GK. IV]
NOSOLOGY.
Ill
    x  Mitior.  With slight shiverings;  heavy vertiginous head-
         ache ;  oppression  at  the  prsecordia ; nausea ;  sighing;
         despondency ;  coma or quiet  delirium; urine whey-like.
       Typhus mitior.   Cull.  Parr.
       Typhus simplex.   Cricht.
       Typhus nervosus, sp.  2 —Comatosus, sp. 3.   Saw.
       Febris  lenta nervosa.   Huxh. on Fev. eh. viii.
       Febris  putrida nervosa.    Wintringh.
       Febris  hectica maligna nervosa.   Willis.
       Fievre nerveuse.  F.
       Nervous Fever.
    G  Gravior.  With rigor and heat  alternating with little or no
         perspiration ; pulse tense  and bard, usually quick,  but
         fluttering;  pain over the  forehead  and crown :  urine al-
         ternating from  limpid  to  turbid;  delirium succeeded by
         stupor :  signs of putrescency.
       Typhus carcerum.  Sauv. sp. 1.—Castrensis, sp. 5.
       Febris  pestilens J3gyptiorum.   Alpin.
       Febris  pestilens maligna.   Sennert. Willis, 1643.
       Febris nautica pestilentialis.   Huxh.
       Pebris carcerum  et noscomiorum.   Pringle.
       Febris putrida.   Macbr.
       MaUdie des Prisons—d'Hopital—de  Geole.   F.
       Putrid fever ; Jail, Camp, Hospital fever.
3. synochus. , Compounded of cauma and typhus: in  its com-
                  mencement resembling the former ; in its pro-
                  gress the latter.
       Synochus.  Gal.  Sauv.
       Lenta.  Linn.

  It is, however, often difficult to arrange several of the species of
what are usually called remittent and continued fevers; for the ex-
acerbations and remissions are sometimes of so dubious and obscure
a character, that we can scarcely determine concerning their exist-
ence :  and hence the yellow  fever of America and the West Indies
is regarded as of the continued kind by Sauvages and Cullen under
the name of typhus  icterodes; but as  of the remittent kind by the
greater number of more recent  writers; in  consequence of which
it occurs in  the present classification under  the name of Epanetus
malignus G, or flavus.  Enecia Synochus G, or flavus, has, however,
a very  near  resemblance to it; and  perhaps  while the yellow fever
of the  West Indies is referred to the first, that of North America
ought  rather to be referred  to the  second.  Sauvages, indeed, has
given  us a  most dangerous  American fever of the  remittent kind 
H2                       NOSOLOGY.             [CL. IU.—OR. I
        Continens putrida.  Lamm.
        Febris continua putrida.   Boerh. Wintringh.
     x  Sudatorius.  Carried off* by a  critical  sweat in an  early
          stage  of the disease ; an  effect often produced by vene-
          section.
        Synochus sudatoria.   Sauv.
     G  Flavus.   With yellowness of the skin, attended with a sense
          of burning heat.  Nearly allied to Epanetus flavus, and
          E. ardens.
        Synochus ardens.  Sauv.
     y  Puerperarum.  Occurring on the third day after child-birth ;
          rigor severe; tension  and great tenderness  of the abdo-
          men.
        Febris puerperalis.  Auct.
        Child-bed fever.—Puerperal fever.
     ? Soporosus.  Accompanied with  great drowsiness, stupor, or
          heavy sleep almost from the beginning.
        Synochus soporosa.  Sauv.
        Febris continua, ann. 1673.  Sydenh.
          Found also, occasionally, as a symptom in  dysentery,
       pleurisy, rheumatism, catarrh, and most of the exantbema-
        tous order.

with a tertian type, which he denominates Tritaeophya Americana,
and which is usually supposed  to be a variety of the epanetus ma-
lignus; yet he takes little notice of the bilious  coloar of the skin,
though  he admits there is an undue secretion of bile, and mentions
" vomitio biliosa" as one of the symptoms.
  1. Enecia,  Cauma.   On the various modifications of the  pulse in
fever, and especially in the species before us, the student should by
all mean's carefully peruse Dr Fordyce's Dissertations on the subject,
and particularly  the  first  part of his third, and the' whole  of his
fourth ;  ill both of which he lays down some very obvious distinctions
between the strength of the pulse, its hardness, softness, obstruction,
and freedom. With him the grand pathognomic symptom of cauma
is hardness of the pulse.   This accompanies it  from first to last, in
its simplest, and in its severest state.  When the disease is mild, it
is hard alone ; when more violent, it is at the same time full, strong,
and frequent.  The obstructed pulse is often confounded with the
hard, and it is  not easy  to  distinguish  them without considerable
practice.   There is a  rigidity of resistance to the finger in each,
but of a different kind. In the hard pulse it is much firmer and tenser;
and  is supposed by Fordyce to result  from such an  increase  of
arterial  contraction as to overbalance its correspondent dilation.  It
indicates,  in his opinion, a very high degree  of living power, and is
peculiarly  characterized by a tardy  coagulation of the  blood when 
CL. HI.—OR. II.]
NOSOLOGY.
US
                       ORDER  IT.

                 PHLOGOTIC A.

                       INFLAMMATIONS.

  Fixed heat and pain, or soreness; increased secretion,  lesion
of a particular part or organ ; mostly accompanied with fever.
drawn freely into an  hemispheric bason,  in consequence of which
the red particles have time to subside, and leave the surface colour-
less, or with  a buffy appearance.  In the obstructed pulse, on the
contrary, the  blood  coagulates at once ; and the red  particles not
having time to separate, the surface is of the same hue as the  cake
below.  It  has appeared to the present  writer, that while the  hard
pulse is produced by an  increased action of the muscular  tunic of
the arterial system, the obstructed results rather from decreased ac-
tion or elasticity of the cartilaginous tunic, over which  the living
power exercises as considerable a control as  over the  former, as
might be proved by innumerable illustrations if we had time.
   The German physicians describe other modifications of the pulse,
as the pulsus celer as opposed to the puhusfrequens, and the pulsus
rarus as opposed to the pulsus tardus.  But as they have not  been
able very exactly to agree upon these divisions, and especially the
rival professors at Halle, Stahl and Hoffman, it is not necessary to
dwell upon them in the present note.
   2. *.  E. Typhus, Mitior.  See Dr. Bierchen's account of the Up-
sala typhus,  in his paper  Morbi Expeditionis Classicae.   Amanit.
Academ.  Vol. v. art. 76; an article well  worth consulting.
   3. y. E.  Synochus Puerperarum.  This is regarded by many prac-
titioners as a mere variety of peritonitis;  and has  hence  been at-
tacked by a powerful  evacuant and antiphlogistic  plan;  especially
that of bleedings and purgatives.   For the  last, Dr. Armstrong has
employed calomel  to the extent of twenty  or thirty grains at a dose,
assisted with  sulphate  of magnesia ; and on the accesion of the dis-
ease, as he tells us, with success.  " Facts and Observ." &c. 1814.—
By other writers, this fever being held of  a typhous rather than of
an inflammatory  character, has been subjected to a directly opposite
treatment; and  by  Dr. Young of Edinburgh, has been affirmed to
be contagious.
   These opinions are easily reconciled,  by  recollecting  that the
disease is of a mixed character, a variety of a genuine synochus ; and
that its course and symptoms, in different individuals, must  vary
according to  the idiosyncrasy or peculiarity of the constitution, and
   vol. v.—26 
114                      NOSOLOGY.            [CL. HI.—OR. II.


                        GENUS  I.

                    APOSTEMA.

Large, suppurative  inflammation in  a  deep-seated organ ;  pus
                     copious and confined.
       Apostema.   Hippocr.  et auct. Graze.
 often, according to the state or temperament of the atmosphere, as
 loaded with moisture, marsh-miasm, or other contagious pabulum.
 These remarks are sufficient to discriminate it from peritonitis, and
 to show  that the present is its proper place.  It may possibly be pro-
 duced by  other causes than child-birth, and seems occasionally to
 have been found in males as well  as in females:  but the former is
 the usual cause.   " After labour," observes Mr. Cruickshank, "the
 cavity of the abdomen is in part debilitated, from the great change
 it has undergone in passing from a state of great tension to a state of
 great flaccidity;  and if the woman catches cold,  or receives infec-
 tion, the mischief falls on the abdomen, as the weaker part; just as
 a person liable to rheumatism, or gout, or catarrh, or diarrhoea, on
 catching cold,  is  seized with these different complaints."   Anat. of
 Absorp.  Vess. p.  119.
   Order II. Phlogotioa. Fvompxeya, "incendo, ango." Linneus
 for this  order  employs phlogistici  from the same root; but as the
 chemists have long since laid hold of phlogiston, and the term, though
 lately disused,.has a chance  of being restored, the author  has  pre-
 ferred the derivative now offered.   Cullen has phlegmasia after Ga-
 len and Sauvages : but as phlegmatia, and phlegmatic, from the same
 source, import in common medical language very different, and
 almost opposite ideas, this term is also purposely relinquished to
 prevent confusion.
  Sauvages divides inflammations  or phlogotic diseases, with  him
plegmasiae, into exanthematous, membranous, and parenchymatous :
Linneus  into membranous,  visceral,  and muscular; referring the
exanthematous  diseases to another class. Cullen has disapproved of
both these modes of division, as  conceiving it difficult to  ascertain
the seat of the affection.
  The whole of the observations of Mr. John Hunter upon this sub-
ject are worthy of being deeply studied; and will  not a  little eluci-
date the  nature of the arrangement introduced  into the present
method.  It may be sufficient to observe, that in treating on inflamma-
tion, he divides the body into two parts : 1, the circumscribed cavities,
organs, and  cellular  membrane which  connects them; and 2, the
outlets of the body, commonly called  mucous membranes, as the
ducts of  the glands, alimentary canal, &c. p. 240, 241, 254.   He 
GE-L]
NOSOLOGY.
115
Apostema.   Sauv.
Abscessus.   Cels. et auct. Lat.
Dublet.  Arab.
Eiter-geschwulst.  G.
Aposteme.
distributes inflammatory affections into three kinds, adhesive, sup-
purative, and ulcerative.  Adhesive inflammation belongs chiefly to
the former of the above two parts of the body, where they are deep-
ly seated; and appears intended to take place  in order to prevent
suppuration.  It applies therefore peculiarly to the genus empresma,
in the present order, except in  gastritis, enteritis, and cystitis ; in
all which, however, we frequently meet with striking examples of
the adhesive  inflammation, or true empresma; insomuch  that the
affected organ becomes at times so closely united with some adjoin-
ing membrane or other organ,  as to obtain a kind of artificial wall
or paries, and prevent the escape of its contents into another cavity,
when ulcerated through the whole thickness of its substance.  See
the note on empresma, species 10. x.   Suppurative inflammation be-
longs chiefly  to the same division of parts, placed near the surface,
Hunter, p. 252, and consequently applies peculiarly to the two genera
of phlegmone and phyma.   The ulcerative belongs chiefly to the
second order of  parts, p. 254, 255, as the mucous membranes and
outlets; and  hence principally applies to the genus erythema, as it
must also be  allowed to do to that of phlysis. Deep-seated  suppura-
tive inflammations and abscesses cannot well be placed in either of
these genera; and  have a claim to  be considered by themselves;
they are hence included in the genus apostema, with which the or-
der opens.
   Dr. Young, if the author understands him  rightly, unites the
phlegmone and empresma into  one and the same species of inflam-
mation,  inflammatio phlegmonica, of which he makes them  only
different varieties.  Phlegmone was, indeed, used with this latitude
among the Greeks, for it imported inflammation generally ; but it
has  long been limited to suppurative,  and by most writers to sub-
cutaneous as  well as suppurative inflammations, or those immediate-
ly under the skin, and tftose too in which the suppuration is perfect,
and  occupies the  whole cavity.  It  is  possible, however, that the
author may not  have understood Dr. Young aright: as  he after-
wards makes the different species of what is here called empresma,
species  of inflammatory fever or cauma.
   Phlegmon  then, in the present method, is used to.denote an in-
flamed subcutaneous tumour, perfectly suppurative ; phyma, an in-
flamed subcutaneous tumour, imperfectly suppurative; ionthus, a
subcutaneous tumour or tubercle slightly inflamed, hard, and insup-
purative: and phlysis, an inflamed, but low and broad tumour, ulce-
rative, exquisitely painful and running among the tendons, of which 
116                       NOSOLOGY.            [CL. HI.—OR. H.

1. commune.   Inflammation common to the  fleshy parts;  pain
                  obtuse;  tumour spreading externally; tender to
                  the  touch ;  pus  laudable ;  readily  incarning
                  when opened.
       Apostema abscessus.  Sauv.
the paronychia or whitlow is perhaps the only known species.   The
paronychia, as Galen has justly observed, has an approach to  the
erythema, or erysipelatous inflammation, which immediately follows
it, but the two must not be intermixed.
   Gen. I. Apostema. ' AiTocm/iptx :  from xQto-Ttipit, " discedo," " ab-
scedo," " absum," " deficio."  For this tern ihe Latins employed
abscessus : yet they did not, when speaking strictly, apply either ab-
scessus or apostema  to every suppurative  inflammation, but only to
those that were deep-seated, and of considerable extent, chiefly in-
deed to collections of pus consequent upon fevers,  or some  pre-
vious disorder  of particular  parts, especially abdominal diseases.
This limitation is accurately drawn  by Celsus immediately after his
description of struma, furuncle,  and phyma.  " Sed cum omnes hi
nihil nisi minuii abscessus sint, generate nomen trahit latius vitium
ad suppurationem spectans.  Idque  fere fit aut post febres, aut  post
dolores  partis alicujus, maximeque eos, qui ventrem infestarunt."
Lib. v. cap.  xxviii. § 11.  The term abscess, however, which was
colloquially used in a loose sense in the time of Celsus, is used so
much more loosely in our own day, that it is impossible to  recall it
to its precise and original meaning.   Yet apostema has not  hitherto
been thus generalized : and it is here, therefore, laid hold of, and
restrained to the  signification given it above : in doing which  tbe
author is supported by the authority of Sauvages, who has employ-
ed it with  the same limitation.
   4. Apostema Empyema.  Eftwwjftos: from e/t*, or ey, " in or intra,"
and ?rt/o», " pus."   The term is  common  to all the Greek  writers,
and the persons suffering were denominated  tptTrvw, " empyi." Cul-
len regards empyema as a mere sequel of pneumonia, which,  with
him, includes both pneumonitis and pleuritis; but as it  may take
place from inflammation of the  mediastinum, pericardium, or dia-
phragm, to say nothing of that from exterrlal injuries; and as it is
often doubtful what particular organ is directly injured, a separate
species seems decidedly called for.
   In come cases, indeed, there is no organ to which the pus can be
referred as a product of  ulceration ; and hence Mr.  Hewson con-
ceived that it is  occasionally formed out of  the coagulable lymph,
altered in  its properties by passing through inflamed vessels. "The
cavities of the pleura, pericardium, &c."  says he, " are sometimes
observed to contain considerable quantities of pus without the least
marks of  ulceration, instances of which I have  seen.   In  one pa-
tient I  found three pints of pure pus in the pericardium,  without 
GE. I.]
NOSOLOGY.
in
2. psoaticum.   Pain and tension about the loins, shooting down
                   the  spine  and thigh :  difliculty  of  standing
                   erect; fluctuating enlargement along the psoas
                   muscle ; apex of the tumour  immediately be-
                   low  the groin.
       Psoas.   Auct.  Var.
       Abscessus lumborum.   Auct. Alior.
       Psoas abscess.
         Often confounded  with scrophulous  abscess of the hip-
       joint.
3. hepaticum.   Diffuse, pulsating tumour in  the  region of the
                   liver;  preceded by pain, a yellow countenance,
                   and  shiverings.
       Hepatalgia  apostematosa.  Sauv.
any Ulcer either on that membrane or on the heart.   In another the
cavity of the pleura of the right side was distended with a pus that
smelt more Hke  whey than a putrid fluid, and the lungs were com-
pressed into a very small compass : but there was no appearance of
ulcer or erosion, either on these organs or on the pleura ; but only
under the pus was a thin crust of coagulable lymph.  In such cases
it is manifest the pus must have been formed from  the fluids: and
as the exhalant vessels at one time appear to secrete a mere water,
at another time a coagulable lymph, and in a third (when a little in-
flamed) they secrete that lymph so viscid, and change its properties
so much as to make it coagulate instantly on being secreted; so in like
manner they may sometimes, when more inflamed, have the power
of converting the lymph into pus."   Lymphat. Syst. Part ii. p. 117.
  Darwin relates  a  singular  case  of empyema, in which the pus
seems in like manner to  have  been produced  without ulceration,
though  he ascribes it  indirectly to an  abscess  in the  lungs.  "A
servant man, after a violent peripneumony, was seized with symp-
toms of empyema, and it was determined, after  some time, to per-
form the  operation.  This was explained to him, and the  usual
means were  employed by  his friends to encourage him, " by ad-
vising him not to be afraid."   By which good advice he conceived
so much fear that he ran away early next morning, and returned in
about a week quite well.  Diseas. of Sens. II. i. 6. 4.
   6. Apostema  Vomica.  From vomo, " to eject,"  especially from
the stomach, but not  always so.. The term is here used in the large
sense in which it is employed by Celsus, who applies it to a bursting
of pus  from the liver, or any other large internal organ, as well as
from the lungs.  "Si  vero jecur  vomica laborat,  eadem  facienda
sunt, quae in caeterisinterioribus suppurationibus." Lib. iv. cap. viii.
Sauvages follows him in this interpretation.  Boerhaave and Cullen
confine  vomica  to the lungs, and  that in a more  restrained  sense 
118                      NOSOLOGY.            [CL. HI.—OR. n.
       Abscess of the liver.
4. Empyema.   Fixed pain  in  the chest;  breathing laborious;
                 easiest in an erect position ;  difficult decumbi-
                 ture on the sound side ; fluctuating enlargement
                 on the side affected ;  dry, tickling cough.
       Empyema.   Auct. Graze, et neoteric.
       Lodgment of matter in the chest.
         Goekel describes a case in which the pericardium and the
       right lung were totally consumed.
       Galiicinium Medico Pract.
5. Vomica.   Deranged function of a thoracic or abdominal organ,
                succeeded by copious discharge of pus into some
                part of the alimentary channel, and its evacuation
                by the mouth or anus.
       Vomica.   Cels.
       Apostema vomica.   Sauv.
                       GENUS II.

                   PHLEGMONE.

     Suppurative, subcutaneous tumour ; tensive ; glabrous ; pain-
         ful ; at length fluctuating,  and bursting  spontaneously ;
         the pus uniform and mature.

than most writers; for they limit it to what has been called, though
with no great accuracy, occult  vomicae  {vomica  clause.)   Linneus
and  Vogel,  on  the  contrary, while they confine the term to the
lungs, explain it by open vomicae, {vomica aperta,) in which the pus
is thrown forth profusely and suddenly.
  Gen. II.   Phlegmone.  <bteypu>vv, from QXtyu, "inflammo :" "in-
flammationem quam Graeci Q\typu>vw nominant." Cels. lib. i.  The
term among the Greeks  was used for inflammation generally:  it
has long since been employed in a far more limited  sense by medi-
cal writers of perhaps every school; and its immediate meaning in
the present work has already been explained in the  note on Phlo-
gotica. the term for the order before us.
  4. Plegmone parotidea.  It is not a little singular that Dr. Cullen,
who extends phlegmone wide enough to embrace not only inflam-
mation of the ear and  of the  breast, gum-boil, and phimosis, but
also  furunculus, varus, gutta rosea, hordeolum, and even various
affections of the bones, should have banished suppurative inflamma- 
GE. II.]
NOSOLOGY.
119
    Phlegmone.  Sauv.  Vog.
    Phlogosis phlegmone.   Cull.
    Inflammatio.  Sag.
    Geschwar.   Germ.
    Zameh.   Arab.
    Phlegmon.
1. communis.  Tumour common to the surface : bright-red; hard;
                  defined ;  hemispherical ;  polarized ; gradually
                  softening and bursting at the pole.
    Eiter-beule.   G.
    Clou.   F.
    Push.
2. parulis.  Tumour seated  on the gums;  deep-red;  hardish;
                undefined; pain obtuse.
    Parulis.   Sennert.  Vogel.
    Apostema parulis.  Sauv.
    Gum-boil.
    x Simplex.   Limited to the substance of the gums.
    G Carlosa.  Connected with a caries of a tooth or socket.
3. auris.  Tumour seated within the ear; pain acute, throbbing ;
              heat and redness  spreading externally ; hearing dis-
              tressingly keen, or stunned  with imaginary sounds ;
              abscess bursting with the sense of a loud snap or ex-
              plosion.

tion of the parotid and inguinary glands not only to  another genus,
but to a very remote  part of his system, where they occur in the
class  and order of local tumours, in company with warts, corns, and
sarcomata, which have no inflammatory character.  Here too they
are conjointly described under the generic  name of bubo, with the
generic character of  " glandulae conglobatse tumor suppurans;" a
definition which does not  apply  to the parotid gland,  whose struc-
ture is not conglobate, but conglomerate.   The present appears to
be the proper place for suppurative  inflammation of the parotid,
and inguinal as well as of the mammary glands.
   5.  Phlegmone mamma, called by Dioscorides  spargano&is, from
Tjrxpyxa, " tumeo," " distendo."   This term,  however, he employ-
ed collectively to signify milk-abscess, and  a variety of tumours, in-
tumescences, and other diseases, supposed to depend upon an over-
flow,  suppression, misdirection, or depraved secretion of milk : and
especially those which have been since described under the general
term  galactirrhcea : many of these  however  have little or no rela-
tion to each other; and particularly abscess  of the  breast, and the
swelling of the lower  limb,  which occasionally takes place soon
after  child-birth, to which last the term is restrained in the present
system.                                   » 
120                      NOSOLOGY             [CL. HI.—OR. H.

     Inflammatio aurium.  Sennert.
     Otalgia inflammatoria.  Sauv.
     Imposthume in the head.
       Often a result of suddenly suppressed morbid discharges :
         sometimes a symptom of worms.
4. parotidea.  Tumour seated under  the ear :  reddish ; hard ;
                  pain obtuse ;  suppuration slow and difficult.
     Parotis.   Gal. Sauv. Vog.  Sag.
     * Benigna.   Incarnation,  and cicatrization regular and unob-
         structed.
       Parotis benigna.   Sauv.
     G Maligna.   Pus  illaudable,  profuse,  protracted; succeeded
         by foul sloughs.
       Parotis maligna.   Parr.  See Appendix  to his Diet.  art.
         Parotis.
       Usually appearing in advanced life, or about cessation of the
     catamenia.
5. mammje.   Tumour seated in the breast;  pale-red ;  hardish ;  in
                irregular clusters ; pain pricking and acute; sup-
                puration quick and copious.
     Abscessus mammarum.  Roder a Castro.
     Mastodynia apostemalosa.   Sauv.
     Phlegmone mastodynia.   Cull.
     Jema.  Arab.      ,
     Abscess of the breast.
     x Violens.  From severe pressure or blow.
     G Lactantium.   From redundancy of milk.
       Mastodynia polygala.   Sauv.
       Depot laiteux aux mammelles.   Pazos.
       Milk abscess.
  " In these cases the suppuration commonly begins in many distinct
portions of the inflamed part; so that it is not  one  large circum-
scribed abscess, but many separate  sinuses, all  of which generally
communicate.  Now it usually happens that only one of these points
externally, which  being either opened or allowed  to  break, the
whole of the  matter is  to be discharged  this way.   But it some-
times happens that the matter does  not find a ready outlet by this
opening,  and  then one or more of these different sinuses  make dis-
tinct openings for themselves."   Hunter on Blood, p. 469.
  6. Phlegmone Bubo.  Uusually derived  from GovGm (boubon), in-
guen, and hence importing a tumour not unfrequently found in this
organ.  It is  probable,  however, that the  proper root of both the
Greek and Latin terms is the Hebrew j?3#3> bobo, «« a purulent tu-
mour ;" by the Septuagint rendered ^A/*t»« (phlyctis) : which was 
GE.n/)                    NOSOLOGY.                      121

6. bubo.   Tumour seated in a conglobate gland ; reddish ; hard ;
             diffuse;  not easily  suppurating;  opening with  a
             callous edge.
       Bubo.   Sauv. Linn.  Cull.
       Phygethlon.   Vog.
       Denbel.   Arab.  The origin is Persian.
       Schlieren.   G.
       Bubon.   F.
       x Simplex.  Unconnected with any constitutional or foreign
            poison.
       G Virulentus.   Produced by a specific virus, or connected
            with constitutional affection.
         Tippel-beul.  G.
         Khyarjek.   Arab.
       The glands mostly infected  are  those of  the  inguen and
     axilla.  The  last  variety found  chiefly in lues  and pestis.
     Often cured by vomits after suppuration has advanced.  Hunter
     on Blood, p. 388.
7. phimotica.   Tumour  seated in  the prepuce ;  diffuse; obtusely
                   painful ;  imprisoning the glans, or strangling it
                   by retraction.
     x Incarcerans.   The prepuce protracted, and imprisoning the
         glans.
       Phimosis.  Heister, Chirurg.  cap. cxxx.
       Phimosis vera.  Sauv.
     G Strangulans.   The prepuce  retracted and strangling the
         glans.
       Phimosis circumligata.  Sauv.
the common term among the Greek writers for fluid tumours of
every kind, whether ichorous or purulent; and hence nyajttN, Exod.
ix. is rendered in the Alexandrian  version, ^AixriJV;, and in our
own translation  blains.  #3j?3, (bobo,) is the mere reduplicate  or
argument of jn,  (bo,) or nj?3, (boa,) (for  the n is  omissible,) and
imports " to swell or bubble,"  as water over the fire; and hence
jDya, (bobo,) is a large swelling, whether a bleb orTiubble, or more
solid tumour, as a bubo, or boil.*
  Gen. III.  Phyma.  Qvpuc, " tuberculum," from Qvu," produco,"
" erumpo."   It was used among the Greeks with great latitude, and
hence with an apparent want of precision ;  sometimes in  the mo-
dern sense of phlegmon, for tumours larger than a furuncle or boil,
but  less painful and inflammatory, and perfectly suppurative, with-
out  any core or  ventricle.  So  Celsus, lib. v. cap. xxviii. sect. 9 :
                • Qu.? Bile: see Johnson, &c.
vol. v.—27 
122
NOSOLOGY.
tCL.III—OR. II
Paraphimosis.   Auct. Grozc.
Circumligatura.   Auct. Lat.                 t
  Found frequently as a symptom in lues and blenorrhoea.
                       GENUS III.

                          PHYMA.

     Imperfectly suppurative, cutaneous,  or subcutaneous tumour;
         the abscess thickened, and indurated at the edge; often
         with a core in the middle.
     Phyma.   Willan.  Sauv. Sag.
     Eiter-blasen.   G.
2. Hordeolum.  Tumour seated in the verge of the eyelid ;  gra-
                     nular ; hard; reddish; sore  to the  touch;
                     suppuration confined to the point.
       Crithe (*?<&».)  Auct. Grozc. Vog.
       Hordeolum.   Auct. Lat. Plenck et Alior.
       Zefer.   Arab.
       Gerstenkorn.   G.
       Orgeolet.  F.
" <pv[*x nominatur tuberculum furunculo simile, sed rotundius et ple-
nius, sxpe etiam majus :—sed inflammatio, dolorque sub eo minores
sunt.   Ubi divisum est; pus eodem modo apparet;  ventriculus, qui
in furunculo, non invenitur:  verum omnis corrupta caro in pus ver-
titur."  To the same effect,  Galen De Arte Curat, lib. ii. who tells
us that the swelling and suppuration proceed  rapidly; " statim au-
getur, atque ad suppurationem festinat."  Hippocrates, on the con-
trary, applies the term to tubercles imperfectly suppurative, and in
his Praedict. lib. ii. sect. 2, as well as in various other places, speaks
of scrophulous nhymata, <pi/ft«T« £«<£»&«; and his  example is fol-
lowed by Paul 6f iEgina, lib. iii. 22.  Even  Celsus, lib. vi. cap. 18,
affirms, that  the Greeks called also by the name of phymata, a ge-
nus of tubercles that are accustomed to spring up about  the glans
penis, which they  cauterised,  and afterwards treated with aerugo
aeris, to prevent their sprouting again; and  which appear  therefore
to have been regarded as of the nature of warts, or excrescences;
while the  general body of the Galenists, as  Sauvages observes, ap-
plied the term to protuberances of every kind.   Tom. i. p. 137.
  Modern writers  have hence  been at a loss in what sense phyma
should be used.  Linneus and Cullen have  rejected it.   Sauvages 
GE. HI.]
NOSOLOGY.
123
     Stye.
       Often produced by the state of the stomach.   Plenck affirms
     that he knew a man who  uniformly had a stye after drinking
     ardent spirit.   He points out the following resemblance  be-
     tween a stye  and a boil—" est tuberculum  inflammatorium,
     parvo furunculo simile, in margine palpebrarum."
3. furunculus.   Tumour  common  to  the  surface;  deep-red  ;
                     hard  ;  circumscribed; acutely tender to the
                     touch ; suppurating with a central core.
       Furunculus.   Sauv.  Linn. Vog. Sag.
       Demmel.   Arab.  Of Persian  origin.
       Harte-beule.   G.
       Furoncle.   F.
       Boil.
4. srcosis.   Tumour excrescent; fleshy;  fig-shaped ;  darkish
               red ;  sprouting  from the hairy part  of the head or
               face:  gregarious; often coalescing; discharge par-
               tial and sanious.
       Sycosis.   Cels.  Vog. Bateman.
       x Barbae.   Tumour bard, roundish, pea-sized ; seated in the
            beard  ; commonly in clusters ; occasionally confluent,
            and spreading  from  ear  to ear;  discharge small and
            glutinous; beard matted.
          Sycosis barbae.   Cels.
          Mentagra.  Plenck.
          Kieferaussatz.  G.
          Sycosis menti.  Bateman.
       G Capilli.   Tumour soft,  unequal, clustering:  seated in
            and about the  hair of the head :  discharge ichorous,
            copious, and fetid, from a fungous surface.

and  Sagar have employed it as the name of a distinct and separate
order.  Vogel, following the example of  Hippocrates and Paulus,
has reduced it to a genus of imperfectly suppurative and glandular
tumours : and as a genus it occurs in Dr. Willan's table of arrange-
ment, including boils, carbuncles,  and  similar  inflammations as its
species.   This seems to be  the most accurate sense, and as such is
adopted in the  present system.   The resemblance between the boil
and the carbuncle is pointed out by Mr. John Hunter in his Treatise
on Blood, p. 273.
  4. Phyma Sycosis.   Zvita><ris,  from  o-vkov, " ficus."  The Greeks
gave this name to  various tubercles and excrescenses, the  shape of
which was conceived to resemble that of a fig.  By Celsus, how-
ever, De Med.  p. vi. cap. iii. it  is limited to a particular kind of in-
flammatory and imperfectly suppurative tubercle of the head and
face: Vogel has understood the term nearly in the same sense ; and 
 124                      NOSOLOGY.           [CL. HI.—OR. II

           Sycosis capilli.   Cels.
           Sycosis capillitii.   Bateman.
 5. anthrax.   Tumour common to the surface ; flat; firm ; burn-
                  ing ; penetrant;  livid  and vesicular ;  or crusty
                  above, with a sordid and gangrenous core below ;
                  imperfectly suppurative.
        Anthrax.  Auct. Grozc. Sauv. Linn.  Sag.
        Erythema, anthrax.  Cull.
        Carhunculus.  Auct. Lat.
        Jemmera ; Arab, but by Avicenna  occasionally Nar Faci.
          Ignis Persicus.
        Carfunckle.   G.
        Charbon.  jF.
        Carbuncle.
     x  Pruna.   Escar-carbuncle.   Crust black : oozing an erosive
          ichor, or sanies.
        Pruna Avicenn.   So denominated from  its  assuming  the
          color and often the oval figure  of the sloe, or fruit of the
          prunus spinosa, Linn.
     G Terminthus.   Berry, or Fungus-carbuncle.   Core or fungus
          spreaking in the shape, and assuming the figure and black-
          ish-green colour, of the fruit or berry of the pine-nut, or
          or  rifpuvBos, the  pinus  abies,  Linn,  called  by the Latins
          terebinthus;  whence terebinlhus and terminthus have been
          employed as  convertible terms in  describing the present
          disease.
Dr. Bateman has hence correctly introduced  it into his list. The
second variety, as the last writer observes, makes an approach tu
one or  two species  of porrigo, but it  has  characters  sufficiently
marked to keep it  distinct.
   5. Phyma, Anthrax.  'Avfyaf.  Gal. Paul. JEgin. « carbo."  « The
inflammation that  produces the carbuncle is of a different nature
from any of the former;  it is stationary  with respect to place, and
is  pretty much circumscribed, even forming  a broad, flat,  firm  tu-
mour.   It begins in the skin almost like a pimple, and goes deeper
and deeper, spreading with a broad base under the  skin in  the cel-
lular membrane.—It produces  a suppuration, but not an  abscess,
somewhat similar to the erysipelatous when the inflammation passes
into the cellular membrane: for as there are no adhesions,  the mat-
ter lies in the cells where  it was formed, almost like water in  an
anasarca.—This  inflammation attacks more beyond the middle age
than at it, and very few under it. It is most common in those that
have  lived  well:  I never saw  but one patient of this kind in a
hospital.  It appears to have some affinity to  the boil; but the boil
differs  in this respect,  that it has more  of the true inflammation, 
GE. HI.]
NOSOLOGY.
125
  This  variety bears  a considerable  similitude  to  the
epian of South America, and the yau of Guinea ;  terms
which signify in their respective countries rasp or straw-
berry, from the resemblance  of the fungus to these fruits,
and which  have hence been translated frambozsia by the
Latin writers of France.
                       GENUS. IV.

                     I 0 N T H U S.

     Unsuppurative, tubercular tumour: stationary; chiefly com-
         mon to the face.
     Ionthus.   fi«»ft»s.)  Auct.  Grozc.
     Varus.   Auct. Lat.
     Finnen.   G.
I.  varus.  Red ; hard ; pimply; distinct; gregarious ;  sore to the
              touch ; sometimes oozing a little fluid at the tip.
       Varus.  Linn.  Vog. Sag.
       Acna.  Aetii.
       Psydracia  Acne.  Sauv.
       Acne   Bateman.
       Rothpfinnen.   G.
       Bougeons.  JF.
       Stone-pock.
       x Simplex.  Broad-based, bright red, solid.
         Acne indurata   Bateman.
       G Punctatus.   Tipped with a black dot, discharging, on the
           pressure of the finger, a grub-like concretion of mucus.
therefore spreads less, and is more peculiar to the young  than the
old, which  may be the reason why it partakes more of the true in-
flammation."'  Hunter on Blood, pp. 272, 273.
  This species, like paronychia, has an approach to the character
of erythema, and is ranked under it by Dr. Cullen.  Yet a little at-
tention will, perhaps, show, that it belongs rather to the genus under
which  it is here placed :  it is " a phlogotic or inflammatory tumour
on the surface, imperfectly suppurative," firm, stationary, circum-
scribed, with a gangrenous core or eschar.
  Gen. IV.  Ionthus.  'Woj, literally " violet or purple eruption,
or efflorescence," from <ev, " viola;" though the etymologists differ
in deriving the term; some referring us to xvSos, " flos," from whence 
126
NOSOLOGY.
[CL. HI.—OR. II.
          Punctae mucosae.   Darw.
          Acne punctata.   Bateman.
          Maggot-pimple.
2. corymbifer.  Confluent; corymbose; rosy ;  mottled with pur-
                    ple ; often disfiguring the nostrils with  pendu-
                    lous lobes; irritated by cordials or exposure to
                    heat.
       Gutta Rosea.   Sauv.  Darw.
       Acne rosacea.  Bateman.
       Bacchia.  Linn.
       Roth-gesicht.   Roth-n'ase   G.
       Couperose:  Rougeurs.   Goutte-rose.  F.
       Carbuncled-face.
       Rosy-drop.   Welk.
          Shakspeare has alluded to the whole of these in the fol-
       lowing passage, as also in many others :—
          " His face is all bubukles, and whelks, and knobs, and
       flames  of fire."
          The first is found also occasionally as a symptom  in dis-
       eases of the stomach; and both in diseases of the liver,
       chiefly from  an habitual indulgence in spirituous potation.



                       GENUS  V.

                         PHLYSIS.

     Ulcerative,  subcutaneous  tumour :  flat;  tensive ;  glabrous.,
          diffused ;  hot; throbbing ; at  length fluctuating with an
          acrid ichor.
f. paronychia.   Seated about the nails and ends of the fingers ;
we  have exanthem;  and others to  o*6os, "fimus," " inquinatio,"
"foulness," "defilement."   Pollux, lib. iv. expressly tells us, that
the Greek ionthus is synonymous with the Latin varus ; and Diosco-
rides, lib. i. cap. 40, has united it with  morphew, freckles, and other
blemishes of the  face, PvtxpMv,}' c^tt  x.x6xprtxtjv tncthm.QxKm, toviav,
ovXw, putixvixs.
  Gen. V. Phlysis. G>At>«-*s.  Hippocr.. from Qbvu, <p*v£u, " ferveo,
bullio."  The term, with all its compounds, was used in a general
and indeterminate sense by  the Greeks to express cutaneous  erup-
tions, filled with a fluid of any kind, whether purulent or ichorous;
and hence QXvicTxivxt, (phlyctaenae) from the same, imported, as there
will be  occasion to show farther hereafter, both  pustules and vesi- 
GK.V.]
NOSOLOGY.
127
                pain acute and  pricking;  shooting up the
                hand.
Paronychia.  Auct.
Dahus.   Arab.
Nagel-geschwar.   G.
Panaris.   F.
Whitlow.
x Cutanea.   The acrid  effusion seated between  the  skin and
     parts immediately adjacent.  Heist. B.  Bell.
G Tendinis.  Effusion  seated  between the  tendons  and the
     periosteum.  Heist. B. Bell.  Garangeot.
y Periostii.   The effusion seated  between the periosteum and
     the bone, which is often rendered carious.  Heist. Wisem.
     B. Bell.
  Malignant Whitlow.
  Felon.  " The malignant paronychia is that which is com-
     monly called a felon."   Wisem.
  Similar  inflammations  are  occasionally  to  be  found  in
the  soles of  the feet and palms of  the  hands  ; they break
cles, as the terms are contradistinguished in the present day.  More
generally, however, the phlysis and its ramifications had a bearing
towards the sense of ichorous or vesicular swelling ; and hence Dr.
Willan has  correctly restrained phlyctaenae to  this meaning din his
definitions.  Phlysis, in the present work is equally restrained, as
are also its compounds  em phi) sis  and  ecphlysis,  formed after the
manner of emphyma and ecphyma  from phyma;  and of empyesis
and ecpyesis from pyesis. . Among the Anglo-saxon historians, as
Bede and Malmsbury, pustules  are called poccas; vesicular erup-
tions, blegen (blains ;)  and  boils,  or  eruptions with an imperfect
suppuration, blacam blegene.
  For the peculiar nature of this kind of inflammation, and its mode
of treatment, see Hunter on Blood, p. 469.
  Gen. VI. Erythema.   EtyHput, from eptvios, « rubor."   This is
undoubtedly a term of Hippocrates: it occurs not only in his Pra-
notiones Coaca, the genuineness of which is disputed, but in the ad-
mitted books of his Epidemics ; and is translated by Duretus suffusio
erysipelatosa;  and by Galen and Celsus erysipelas.  In  this sense
erysipelas has descended to our own day in its popular use; while the
nosologists, with a  few exceptions, have limited it to a  peculiar
species of exanthem or eruptive fever, and have revived the Hippo-
cratic term erythema, to import  a peculiar species of  local inflam-
mation, in which the febrile affection is merely symptomatic.  The
first three species here offered are taken from Mr. J. Hunter, and are
too distinctly marked, and  of too  much importance, to be omitted. 
128                      NOSOLOGY.            [CL. IH.—OR. II

    through  the cuticle with  difliculty from  its thickness,  and
    hence become diffused,  and separate the cuticle from the skin
    beneath.  The bite or poison of the gordius aquaticus, or hair-
    worm, is said to have a peculiar tendency to produce this affec-
    tion.
                       GENUS  VI.

                   ERYTHEMA.

  Red,  glabrous, tumid, fulness of the integuments; disappearing
     on  pressure ; pain  burning; inflammation ulcerative ; termi-
     nating in cuticular scales or vesicles ; occasionally in gangrene.
       Erythema.  Hippocr. et Aut.  Var.
       Hieropyr.   Vog.
       Hautrothe.  G.
       Erysepele.  F. but improperly so called.
       Inflammatory blush : improperly called Erysipelas.
1. ozdematosum.   Colour scarlet;  spreading widely  and deeply
                     through the cellular membrane, which often
                     imperfectly suppurates, sloughs, and becomes
                     gangrenous.
       Edematous Inflammation.  J.  Hunter on Blood, ch. ii. p.
         269.
2. erysipelatosum.  Colour deepish  red;  superficial ;  with  a
                        determined edge;  migrating in a ser-
  if these characteristics be kept  in view, it  will not be difficult
to draw the line between what should constitute erythema and what
erysipelas.  The first bears the same analogy to phlegmon as the last
does to small-pox.   Phlegmon is local inflammation,tending to sup-
puration ; erythema local inflammation, tending to vesication: small-
pox is an idiopathic fever producing a phlegmonous efflorescence;
erysipelas an idiopathic fever producing erythematic efflorescence.
Small-pox is always contagious ; erysipelas occasionally so : phleg-
mon and erythema have no such tendency.
  It must, nevertheless, be recollected by the learner, that erysipe-
las has been applied sometimes, even by good writers, to erythema,
as well as to the exanthem properly so called, for otherwise the two
diseases will be perpetually confounded.  Thus the first three spe-
cies of erythema here  noticed are only to be found under the term
erysipelas in Dr. Willan's arrangement, which is made to embrace 
GE. VI.]
NOSOLOGY.
129
                        pentine  direction;  the part  which  has
                        passed through  the action  healing, as the
                        part next attacked becomes affected.
       Erysipelatous Inflammation.  J. Hunter on Blood, ch. ii. p.
          269.
3. GANGRiENOsuM.   Colour dusky-red;  superficial; cuticle  sepa-
                        rated-from  the  cutis by a bloody serum :
                        the cutis, when  denuded, exhibiting dark-
                        brown  spots,  disposed  to  blister   and
                        slougb ;  occurring chiefly  in the extremi-
                        ties.
       Ignis sacer. spec. 2.  Cels.
       Gangrenous Inflammation.   J.  Hunter on Blood, ch. ii. p.
         274.
         All these species are usually to be found in debilitated or
       relaxed constitutions : the former too often appear as sequels
       of atonic fevers ; the third is common to old age, and early
       infancy.   See Underwood on the  Diseases of Children ; as
       also Willan on Erysipelas erraticum.
4. vesiculare.   Colour pale-red ; surface roughish,  and covered
                    with crowding  minute   vesicles,  filled  with
                    an  acrid, often  a  reddish  fluid ;   progres-
                    sively trailing  into  the  neighbouring sound
                    parts.
both erythema and erysipelas, as the terms have hitherto been com-
monly employed ; while  erythema is arbitrarily made use of to
characterize  another collection of cutaneous erubescences of very
different characters, and produced by very different causes ;  some of
them primary, others symptomatic, affections;  some constitutional,
others local: occasionally smooth, papulous, tubercular, or  nodose :
but all which seem to belong to different divisions.
  4. EryethSma, vesiculare.  This is  intended to delineate the ignis
sacer of the ancients, which has been  seldom understood, and never
hitherto allotted a clear methodic position.  The common error has
been in making it an exanthem or eruptive fever, an erysipelas or a
pestis, or a distinct disease approaching  to the one or the other.
There is no doubt that it has at times  been an accompanying symp-
tom in pestis, and has consequently produced a variety in this fever
which the reader will find noticed under the head pestis by the dis-
tinguished term erythematica, of which nature was  the  plague of
Athens, so excellently described by Thucydides and Lucretius. But
the ignis sacer, in its genuine and simple state, instead of  being a
typhous eruptive fever, has often very little fever of any kind, never
  vol. v.-—28 
130                       NOSOLOGY.            [CL. in.—en. n.
        Ignis sacer.  Cels. spec. 1.
      x Benignum.  The redness and  vesicles  advancing without
           a breach of the cuticle, as the part that has passed through
           the action is healing.
        Ignis sacer.   Cels. spec. 1. var. *.
      G Corrosivum.  The vesicles breaking in the part first affected,
           and the erosive fluid producing tracks of sanious ulcera*
           tion as the redness advances.
        Ignis sacer.  Thucyd. Lucret.  vi.  1165.  Cels. spec.  1.
           var. G.
        Feuerflecke.  G.
        Macula lata Plateri.    Plenck.
           It  is to this the Turkish physicians give the name of Tatlu
        ujuz, literally dulcis scabies.
          The eczema  rubrum  of Dr. Bateman, but  which,  as  he
        candidly  acknowledges, .is  incongruous  with  his  generic
        character of eczema, seems fairly (o belong to this species ;
        and,  if not one of the above, may form a  third  variety.—
        It  is  correctly denominated  an  erythema by  Dr.  Marcet.
        Medico-Chir.  Trans. II. ix. and by Dr.  Rutter.  Edin.
        Med. and Surg. Journ. IV. p. 143.
          Found  also, occasionally, as a symptom in pestis, and  as
        a sequel  on  the exhibition of mercury in  irritable habits;
        and hence denominated by some authors erythema mercuriale
        and hydrargyria.
perhaps more than  symptomatic fever;  and by Celsus is described
as being best cured by an ephemeral  or other fever that may give
increased action to the system ; hereby proving this as well as every
other variety of erythema, to be a result  of debility.
  The character and subdivisions of ignis sacer, as offered in the text
under the heads e. gangraenosum, and e. vesiculare, are taken from
Celsus, and given, as nearly as may be, in  his own words, to prevent
all doubt.   He describes it as a  genus comprising two species,  of
which the former has two varieties.  " Duae species sunt.  Alterum
est subrubicundum, aut mistum rubore atquepallore, exasperatumque
per pustulas (Q\v%txivxs)  continuas, quarum nulla altera major est,
sed pluritnae perexigute.  In his  semper fere pus, et saepe rubor cum
colore est."  Then follow the two varieties as described in the text
above :  x  " Serpitque id nonnunquam, sanescente eo, quad primum
vitiatum est: G nonnunquam  etiam exulceratio, ubi ruptis pustulis
{tyXvHTxivxts) ulcus continuatur, humorque exit."
  He then passes on to describe the second species, which answers
to the character and almost to the words of erythema gangraenosum
in the text.  " Alterum, autem, in summa cutis  exulceratione, sed
sine altitudine, latum, sublividum, inaequaliter tamen;  mediumque 
GE. VI.]
NOSOLOGY.
131
5. pernio.   Colour crimson suffused with  blue; obstinately itch-
                 ing ; chiefly affecting the extremities during win-
                 ter.
       Erythema pernio.  Sauv.
       Pernio.  Linn.  Vog.
       Erythema a frigore.   Cull.
       Kalte-geschwulst.   G.
       Engelure.   F.
       Chilblain.
       x Simplex.  The cuticle remaining unbroken.
sanescit, extremis procedentibus; ac saepe id, quod jam sanum vide-
batur,  iterum exulceratur: at circa, proxima cutis,  quae vitium
receptura  est, tumidior et durior est, coloremque habet ex rubro
subnigrum.  Atque hoc quoque malo—in cruribus maxime." Lib. V.
eap. xxviii. sect. 4.
  The author has ventured to translate  the pustula of Celsus in the
present instance <p?i.vx.Txt¥xt, vesicles, first, because  he thus explains
the term in sect. 15 of the same chapter ; and secondly, because in
the ignis sacer, which, as we learn both from  Thucydides and Lu-
cretius, was  a symptom in the  plague of  Athens, the  former has
given us this  precise term.  The following couplet is sufficient from
Lucretius.   De Rer, Nat. vi. 1164.
    Et simul, ulceribus quasi inustis, omne rubere
    Corpus,  ut est, per membra sacer  quum diditur ignis.
    Wide ting'd with purple dye, and brandish'd o'er
    With trails of caustic ulcers, like the blaze
    Strew'd  by the holy fire.
In Thucydides the same symptoms are  described thus:
  Kxt r« puv  £%*>iev xieropuva) vuput ovk xyxi Segpiov sjv, ovre %Xu(>6i, xXX*
uiri$v6{ov, irthtfooi, 4ATKTAINAIZ MIKFAI2, %at tAxee-tv e%i)v6t)*os.

  " Yet the body outwardly was not very hot to the touch, nor pale ;
but deep-red,  livid,  and efflorescing  with minute  vesicles, and
ulcers."
  In Seneca, who has closely copied from Lucretius,  the phrase
sacer  ignis is still preserved.  CEdip. 187.
        Oculique rigent, et sacer ignis
        Pascitur aftus.
        Stiff stare  the eye-balls ;  for the burning limbs
        Deep feeds the holy fire.

  5. G E. Pernio, Exulceratus.  In very cold latitudes it often affects
the nose; and the living power is destroyed  as  completely as  by
combustion.  See Biblioth. Med, Manget, iii.  p. 492.   Winkler  de 
132                      NOSOLOGY.            [CL.III.—Ofe. U.
    G Exulceratus.   Accompanied with ulceration.
     * Kibe.
intertrigo.   Colour bright red ;  cuticle eroded ; the exposed
             cutis oozing a limpid and acrimonious fluid.
    Erythema intertrigo.   Sauv.
    Intertrigo.  Linn.  Vog.
    Erythema ab acri inquilino.   Cull.
    Kereh.   Arab.
    Frat.   G.
    Ecorchure.  F.
    Fret.   Erosion of the skin.
      From  peculiar acrimony  in the matter of perspiration;
    or acrid  substances intermixing  with its natural secretion ;
    especially in folds or dimples of the skin ;  most frequently
    in the groins and  behind the  ears of infants,  whose cuticle
    is extremely delicate, and  easily eroded.   See Rhazes  ad
    Almans. , Tr. vi. cap.  17,18.
                       GENUS VII.

                     EMPRESMA.

   Deranged function  of a visceral organ, membraneous or paren-
     chymatous ; with local pain ; fever mostly  a cauma; inflam-
     mation mostly adhesive.
       Phlegmatiae membranosae et parenchymatosas.  Sauv.  Sag.
       Phlogistici.  Linn.


Frigore, 4 Leip. 2. 1737.  Belgrado Del Calore e  del Freddo. Parm,
1764.
   So, Milton, Par. Lost, ii. 294.
         ...........the parching air
         Burns frore; and cold performs th' effect off re.
   Perhaps from Virgil, Georg. I. 93.
    ....  Boreas penetrabile/rij'M* adurat.
  Gen. VII. Empresma. Presma (Vf*<rf**,) from a-giOv, " inflammo,''
is  in use  both by Hippocrates  and Gaien,  to express inflammation
generally.  Empresma, from tpvxpfiw,  " intus flammo, incendo," is
here employed to signify internal or visceral inflammation. 
GK.VIL]                   NOSOLOGY.                       133
       Febres continua? inflammatoriae.   Vog*
       Inflammatio interna.   Macbr.
       Cauma.   Young.
1.  cephalitis.  Acute pain in  the head ; intolerance of light and
                   sound ; face flushed ; eyes red ; cauma ;  watch-
                   fulness ; and delirium.
       Siriasis («fi«o-*«.)   Hippocr.  Vogel.
       Sideratio.  Auct. Lat.
       Phrenitis.  Sauv.  Sag.  Hoffm. Boerh. Cull. Macbr.
       Sphacelismus.  Etmull. Linn.
       Cephalitis.  Sauv.  Sag.
       Inflammatio phrenitis.   Parr.
       Cauma phrenitis.    Young.
       Sersam.   Of Persian origin.
       Junun.   Arab.
       Hirn-fieber.   Hirn-wuth.  G.
       Phrenesie.  Inflammation du cerveau.   F.
       Phrensy.   Brain fever.
          Found  also, as an  occasional  symptom,  in  synochus,
       worms, various exanthems, trichoma, hydrophobia,  injuries
       of the cerebrum, and severe grief.
 2. otitis.   Severe pain   in  the ear ;  tenderness upon pressure ;
              deafness or confusion of sounds.
       Otitis.   Vog. Young.
       Otalgia.   Sauv. Linn.  Vog.
       Dolor otalgicus.  Hoffm.
       Ohr-schmertz.  G.
       Douleur d'oreille.   F.
       Ear-ache.
  1. Empresma  Cephalitis.  This word is preferred to phrenitis, as
more descriptive of the organ affected.   Dr. Cullen has correctly
observed, that we are not acquainted with any pathognomic symp-
toms by which to distinguish inflammation of the brain from that of
its membranes ;  and he has hence reduced the cephalitis, phrenitis,
and sphacelismus of preceding writers, to one genus.   The present
system follows him  in this instance of generalization.  According to
Dr. Clutterbuck's hypothesis, all fevers are  mere varieties of  this
species.  Inquiry, &c. Sect. viii. p. 138.
  Sauvages, Vol I. p. 458, asserts  that the name among the Arabic
writers for this disease is sirsen.  We have here a double mistake:
sirsen should be  sersam, and the word thus used is Persian, and not
Arabic.  It  is, however,  extensively copied in  the east, and  has
found its way into the Turkish dialect.   See  the  lexicon entitled
Laghati Halimi. 
134                      NOSOLOGY.           [CL. HI.—OR. II
 3.  parotitis.   Painful, unsuppurative tumour of the parotid glands,
                  often extending to the maxillary ; conspicuous
                  externally;  often accompanied with swelling of
                  the testes in males, and of the  mammae  in fe-
                  males.
        Cynanche parotidaea.  Sauv,  Cull. Parr.
        Angina externa.  Russel. (Econ. Nat.
        Ourles.   Oreillons.   F.
        Branks.   Scottish.
        Mumps.
 4.  paristhmitis.   Redness and swelling of the fauces; with pain-
                      ful and impeded deglutition.
        Paristhmia (*•«$<e-fytiee.)  Hippocr.  Galen.
        Cauma paristhmitis.   Young.
        Cynanche.   Auct. Grozc. Sauv.  Cull. Sag. Linn.
        Angina.   Auct. Lat. Hoffm. Boerh.  Vog.
        Khenauk.   Arab.
        Kehlsucht.   G.
        Esquinancie.   F.
        Squinancy.   Squinsy.   Quinsy.
     a  Tonsillaris.   Swelling  of  the mucous membrane of  the
          fauces, and especially  of  the  tonsils:  redness florid,
          fever a cauma.
        Synanche.  Auct. Grozc.
        Cynanche tonsillaris.  Sauv. Cull.
        Cynanche faucium.  Parr.

   4. Empresma Paristhmitis :  from 7rx^x and  la-Opios, literally morbus
faucium, or throat-affection.  In Hippocrates paristhmia : •xagio4pM*—i
QXtypwixs tuvkxtxto* tG-Qpcov %a£xm.  The term was used among the
Greeks, as in the present system, generically.  The  later Greek
physicians gave different names to the different species of the genus :
and hence  we meet with cynanche,  synanche, and parasynanche;
the idea common to all  which  is that  of  angina or strangulation,
while the prefixes to the terms are of doubtful meaning   See Gal.
vi.  324. Cels. De Angina.   Aetius attempted to justify cynanche, but
Caelius Aurelianus  and Paulus used  synanche after Celsus.   The
Latins employed angina in the  same broad or generic sense as Hip-
pocrates paristhmia ;  quinsy is used in a parallel latitude among our-
selves.  Sauvages conjectures, and there  is some  ground for the
opinion, that the synanche  of the Greeks  was the common quinsy
(synanche, or paristhmitis tonsillaris)  of  the present day;  their pa-
rasynanche, the quinsy of the  pharynx (c. or p. phhringea:) and
their cynanche, the croup of modern times, bronchitis or c.  trachea-
lis.  See further upon this subject, the Preliminary  Dissertation
sect. ii. 
GE. VH.]
NOSOLOGY.
135
      Angiuae inflammatoriae.  Boerh*
       Common quinsy.
    G Maligna.   Crimson redness of the mucous membrane of the
         fauces and tonsils ;  ulcerations covered  with mucous and
         spreading sloughs, of an ash or whitish hue ; fever a typhus.
       Cynanche  maligna.   Cull.
       Cynanche  maligna.  C. ulceros. a.   C. gangraenos. 6. Sauv.
       Angina ulcerosa; maligna ;  gangrsenosa.   Auct. Var.
       Ulceros : ulcerated : malignant sore throat.
         Frequently epidemic ;  generally contagious.
       Found often as a symptom in rosalia or scarlet fever.
    y Pharyngea.  Redness florid, and especially at the lower part
         of the fauces ; deglutition extremely difficult and painful;
         fever a cauma.
       Parasynanche.   Auct. Grozc.
       Cynanche pharyngea.  Sauv.  Cull.  Eller.
       Anginse inflammatoriae, sp.  4.   Boerh.
5. bronchitis.  Breathing sonorous and  suffocative ;  voice harsh ;
                  ringing cough ; fever a cauma.
       Cynanche.   Auct.  Grozc.
       Cynanche trachealis.  Sauv. Call.
       Cynanche stridula.   Parr.
       Cynanche laryngea.   Auct. Var.
       Anginas inflammatoriae.   Boerh. sp.  1.


   Dr. Cullen is said to have prided himself upon having grouped an
extensive natural family of diseases under the term cynanche.  Parr,
art.,Angina stridula, denies that  he has done so; and  adds, that
" self-complacency had  never so baseless a  foundation.   The spe-
cies," continues Parr, " agree in no one principle but affection of the
parts connected with  the neck."  This remark is too sweeping:  it
may apply to Cullen's species of c. trachealis (croup,) and c. paro-
tidaea (mumps:)  but the rest must be exempted from its severity.
And it is not a little ludicrous to observe  Parr,  after  passing this
censure in his aiticle Angina, under which he considers the disease
in its different bearings, completely altering his  views by the time
he reaches the article Nosology : for here we find, in the first place,
the term angina banished, and that of cynanche adopted in its stead ;
and secondly, croup and mumps, which are chiefly objected to in the
preceding quotation as divisions of cynanche, not only made divisions,
but sunk from species, in which they  occur in^t^llen, into varieties.
The present arrangement follows  the Cullenian, as far as perhaps it
ought to do, and only quits it where  the latter seems  to demand a
change. 
136                       NOSOLOGY.            [CL.1U.—OR.U.
        Angina polyposa.   Mitchel.
        Expectoratio solida.  Darw.
        Cauma bronchytis.   Young.
        Angina canina.  Zacut. Lusit.
        Croup.
          In the American  states this disease usually receives the
        name  of hives, a corruption of the term heaves,  which is
        probably so called from the heaving or violent efforts of the
        muscles of the chest and  abdomen, which takes place in
        breathing during its course.   Hosack.  Amer. Med. and Phil.
        Reg. Vol. ii. p. 41.
          The aperture of the glottis is twice  as large  in  adults as
        in youth before puberty ; and  hence one cause of the great
        danger of suffocation from this  disease  in children, in whom
        the  aperture is often not more than  a Jine and a half in
        breadth.  See Richerand Elem. de Physiol, ch. xi.   See
        also Baillie's Morb. Anat. Fasc. II. pi. 2.
          The concreted  effusion,  formed in  the trachea, and  so
        profusely  coughed  up,  often  extends through  the  whole
        range  of the air-vessels as far as the eye of the anatomist can
        trace them.
6. pneumonitis.  Obtuse pain  in the chest:  constant difliculty  of
                      respiration alleviated by an  erect position ;
                      tumid, purple face  or lips;  cough generally
                      moist, often bloody :  pulse usually soft.

   Paristhmitis is here preferred to paristhmia, as used by the Greek
writers, only because it corresponds with  the general  termination
given to the species of the present genus.   But either is preferable
to angina (xy%ovt), " choak, strangle") or cynanche {x-vvxyx,*), literally
dog-choak) on account of their greater elegance, and their contain-
ing the name of the organ affected.
  Dr. Cullen,  in his remarks on cynanche maligna, seems to suppose
that  the -Spaniards distinguish this  peculiar kind of sore throat by
the name of garrotillo ; and Dr. Parr has  added, in his  article  An-
gina gangrenosa, that they have given this name to the malignant
sore  throat, from  the shrill barking sound which accompanies the
worst sort:  as though garrotillo imported barking.   The fact is, that
garrotillo is  precisely synonymous with angina and quinsy, or as the
French  write it, esquinancie, from which our term is derived.  All
denote choaking suffocation, or a sense of strangling;  the radical
Spanish verb  is garrotar, " to  choke,  bind tight, especially about
the throat, to strangle;" and all are used equally in a generic sense,
and signify suffocating sore throats of every kind.
• 
GE. VH.]
NOSOLOGY.
137
      Peripneumonia.   Sauv. Linn. Vog.  Sag. Macbr.
      Pneumonia peripneumonia.   Cull.
      Pneumonitis.  Mich.  Bourgard. Diss. 1754.
      Pulmonaria.   Auct. Var.
      Zatal-beyn.  Arab.
      Entziindung der lungen.   G.
      Peripneumonie.
      Peripneumony.   Inflammation of the lungs.
      x Vera.   The fever a cauma ; pain severe, little expectora-
           tion in the beginning.
        Peripneumonia vera.   Huxh.  Cull.
        Peripneumonia pura.  Sauv. Morgagn.
        Peripneumonia simplex.   Macbr.
      G Maligna.   Fever a synochus  or typhus.  The debility so
           extreme from  an early stage of the disease,  that the
           pulse ceases on  the pressure of the finger ;  and the
           vascular action is too weak to accomplish expectoration.
           Often epidemic.
             Said  to  be  an erysipelatous affection of the lungs,
           Sarcone, Istoria  ragionata,  &c.   Ludwig,  Adversaria.
           Baglivi, App.
         Peripneumonia putrida, sp.  3.—p.  maligna  4.—p. ty-
           phodes, 5.   Sauv.
       y Nolha.  Great secretion  and  expectoration  with a mild
           cauma   Probably  in  many   instances a catarrhal
           affection :  chiefly occurring in advanced  life, or in
           those who have  weakened  their  constitutions by ex-
           cesses.
         Peripneumonia notha.   Sydenh.  vi.  4.   Boerh. Coze.
           Journ. Med. 1790.
         Catarrhus suffocative.  Auct.  q ?
           Pneumonitis is found also, occasionally, as a symptom
         in rheumatism, phthisis, various exanthems, as small-pox,
         measles, miliaria ;  in lyssa, and rickets.   SeeMusgr. xi.
         5.  Sydenh.  passim.   Morton.   Phthisiol.  iv.  41.  de
         Variol. vii. 64.  Allion. de Morb. Mill. p. 107.   Journ.
         Encyclypedique,  torn. i.  3.   Doazam. Monspel.  Often
         terminates in vomica :  sometimes  in empyema.
7. pleuritis.   Acute pain in the chest;  increased during inspi-
                  ration ; difficulty in lying on one side ; hard
                  pulse ; short distressing cough.  .
       Pleuris.   Hippocr.  Sauv. Linn.  Vog. Sag. Cull.
       Pleuritca febris.  Hoffm.
  vol. v.—29 
 138                       NOSOLOGY,            [CL. III.—OR. II

        Passio pleuritica.   Cozl. Aur.
        Jirsam.   Arab.
        Seitenwehe.   G.
        Mai di punta.   Iial.
        Pleurisie.   F.
        Pleurisy.
        x Vera.  Fever a cauma ; pain felt chiefly on one ride.
            The inflammation, in this case, commences in that side
          of the membrane which lines the ribs ;  though often com-
          municated  to  the contiguous  portion  which covers  the
          lungs.
          Pleuritis  vera.  Sauv.
          Pleuritis  sanguinea.  Hippocr.
          Pleuritis  pura.  Bagliv. Sydenh.
        G Mediastina.   Heavy pain in  the middle of the sternum
            descending towards its  ensiform cartilage ; with great
            anxiety.   The  inflammation is seated obviously  in the
            mediastinum from the symptoms.
          Pleuritis mediastini.  Sauv.
          Pneumonia pleuritis.   Cull.
       y  Diaphragmatica.   Painful  constriction  around the  prse-
            cordia ; small, quick, laborious breathing.
              These symptoms  sufficiently decide that the inflam-
            mation  is seated chiefly in the diaphragm.
          Paraphrenias.  Boerh. aph. § 907.
          Paraphrenesis diaphragmatica.   Sauv.
            The terms paraphrenitis and paraphrenesis are derived
          from the Peripatetic philosophy, which supposed  the seat
          of the phren  ($$*») or soul to be the praecordia :  whence
          this last region was denominated phrenes ($;<»«$.)   Arist.
          De Part. Anim. 1.  iii.  Hippocrates, on the contrary, sup-
          posed its seat to be in the brain.
            This species is  found, occasionally, as a symptom  in
          typhus, catarrh, -rheumatism, worms, pregnancy, trichoma,
          miliara, and  affections of  the  liver.  Zeviani De  para-
          pleurit.  Marteau de Grandvilliers de pleuro-peripneum.
          epidem.   Bianchi, passim. Schenck. lib. ii.  De Mesery,
          torn.  ii. 314. Monton. Pyret. Hist. viii.  141.  Puzos.
          Traite des depots  laiteux.   Stabel. de Plica.  Allion.  de
          Miliaria.
3. carditis.   Pain the region of the heart, often pungent;  anxiety ;
                palpitation; irregular pulse.
       Carditis.  Sauv.  Vog. CuU.  Macbr. 
GE. VII.]
NOSOLOGY.
139
      Inflammatio wditis.  Parr.
      Cauma cardit's.   Young.
      Enziindung der hertze.   G.
      Inflammation de cceur.   F.
      Inflammation of the heart.
         See a singular case of this disease in Hewsonh Experi-
      mental Inquiries into the  Lymph. Syst. Part ii. p. 113.
      transcribed from Sir John Pringle's notes.  See also Hunter
      on Blood, p. 305,  311,339.
3. peritonitis.   Pain and tenderness of the abdomen,  especially
                  in an erect posture ; with little affection of the
                  subjacent viscera, or abdominal walls.
      Peritonitis.  Vog. Cull.
      Cauma peritonitis.  Young.
      x Propria.   The  inflammation taking the  general range of
            the peritonaeum ;  pain  extreme, often pungent,  with
            little or no relief from stools.
       G Omentalis.  With a more sensible swelling in  the region
            of the omentum.
     Omenti inflammatio.  Boerh.
     Epiploitis.   Sauv.  Sag.
     Omentitis.   Vog.
     Enteritis epiploitis.   Parr.

   8. Empresma Carditis.  The symptoms have a considerable re-
 semblance to those of pneumonitis; and Cullen affirms that he has
 often met with the disease evincing no other symptoms.  It is pro-
 bably on this account that Linneus  has taken no notice of it in his ar-
 rangement.  Vogel's definition  is founded altogether upon this view,
 " cordis inflammatio fere ut in peripneumonia."  The general con-
 nexion of the pleura with all the thoracic organs, some part of which
 seems necessarily to suffer when any one of them is affected, must
 give somethiug of a family character to the whole group of thoracic
 diseases.  It is singular that Vogel, having thus admitted the diffi-
 culty of distinguishing carditis  from pneumonitis by its symptoms,
 should  have added pericarditis as a distinct disease from  the former,
 referring us for its symptoms to those of mediastina, e. pleuritis Gof
 the present nosology.  In a strictly anatomical view it may perhaps
 be at times a separate affection; but, so far as regards the symptoms,
 we know nothing of such distinction, and it would hence be idle to
 allow it.
   9. Empresma Peritonitis. The subjacent viscera, or panetes of the
 abdomen, if affected at all, are only affected secondarily.   "If the
 peritoneum, which lines  the cavity of the abdomen, inflames, its in-
 flammation does  not affect the  parieties  of the abdomen:  or if the
 peritoneum covering  any of the viscera is  inflamed, it does not af-
 fect the viscera.  Thus the peritoneum shall be universally inflamed. 
140                       NOSOLOGY.            [CL. HI.—OR. II.

       y Mesenterica.  Pain deeper seated and more immediately
            in the mesenteric region;  external tenderness less than
            in the preceding varieties.
         Mesenteritis.  Vog.
         Enteritis mesenterica.   Sauv.  Parr.
         Puerperal fever is sometimes made another variety of this
            species : but it belongs rather to typhus.   See Enecia
            Typhus.
10. gastritis.   Burning pain at the pit of the stomach, increased
                  by swallowing ; rejection of every thing ; hic-
                  cough ; oppression and dejection of mind; fever
                  a synochus.
       Gastritis.  Sauv. Linn.   Vog.  Sag. Cull.
       Ventriculi inflammatio.   Boerh.
       Cauma gastritis.  Young.
       Inflammatio gastritis.  Macbr.  Parr.
       Entztindung der magens.    G.
       Inflammation de I'estomac.   F.
as in the pueiperui fever, yet the paritiies of the abdomen, and the
proper coats of the intestines shall not be affected :  on  the  other
hand, if the parietes of the abdomen, or the proper coats of the in-
testines, are inflamed, the peritoneum shall not be affected." Hunter,
on Blood, p. 244.
   10. Empresma Gastritis.   " If the stomach is inflamed, the patient
feels an oppression and dejection through all the stages of the in-
flammation ; simple animal life seems to be hurt and lessened, just
as sensation is lessened when the brain is injured; the pulse is gene-
rally low and quick, the pain is obtuse, strong, and oppressing, such
as a patient can hardly bear."  Hunter, on Blood, p. 234.
  10. x E. Gastritis Adhasiva. This comprises the genuine adhesive
inflammation, of which the following remarkable case, recorded by
Mr. Cruickshank, is quite in point. " A young lady died after two or
three days  illness: before this  she had been in perfect health.  I
was called in, but she was dead before I got to the house.  From
her history I was at a loss to account for her death : but on opening
the abdomen a day or two after,  I found the contents of the  sto-
mach in that cavity ; that they had  produced peritoneal  inflamma-
tion, and killed.  On examining  the  stomach,  I found a hole in it
large enough  to admit the  end  of my finger:  this hole had been
formed by absorption of part of the substance of the stomach from
scrophulous ulceration:  its edges had adhered  by  inflammation to
the under surface of the small lobe of the liver.  This  inflammation
was evidently  raised by the powers  of the body to  prevent the ac-
cident which happened ; and if no violent vomiting had taken place,
and torn this adhesion at this particular time,  she might  have  lived 
GE.VH.]                   NOSOLOGY.                      U\

       Inflammation of the Stomach.
       x Adhaesiva.   Pain very acute : fever violent.
         Gastritis phlegmonodea.   Cull.
         Gastritis legitima.  Sauv.
       S Erythematica.  With an erythematous blush extending to
            and visible in the fauces ;  pain more moderate;  fever
            less violent: pulse low and quick.
              The species, under one of  its two  varieties, found
         also as a symptom, occasionally in aphtha, measles, small-
         pox, and other exanthems ; perhaps also in repelled herpes,
         scabies, and  similar  eruptions.   Eller. de Cogn.  et Cur.
         Morb. § 11.   Hoffm. de Febr.  Stom.  Sauv. in loco.
 11. enteritis.  Griping pain in the belly, with tension, tenderness
                   and vomiting;  fever a synochus.
       Enteritis.  Sauv. Linn. Vog. Sag. Cull.
       Intestinorum inflammatio.  Boerh.
       Chordapsus.   Galen.
       Cauma enteritis.   Young.
       Entzundung der darmen.   G.
       Inflammation des boyaux.   F.
       Inflammation of the Bowels.
for years notwithstanding  the  ulcer."  Anat. of the Absorb.  Vess.
p. 122.
  It is from this common tendency of the genuine empresma, that
the author has been  induced  to distinguish the present from the
subdivision which  follows, by the name of erythematica.  Dr. Cul-
len's term is phlegmonodea, which is not quite true to his own cha-
racter of phlegmon—" in fastigium plerumque elevato, stepe in apos-
tema abeunte ; dolore  sxpe pulsatili." Cl. I. Ord. ii. Gen. vii.   Phlo-
gosis Phlegmone.
   10. G E. Gastritis Erythematica.   For a correct  distinction be-
tween the two subdivisions which occur in this and the next species,
however,  we are chiefly indebted to Dr. Cullen, but who advances
them, unnecessarily, to  the rank of species.  Mr. John Hunter has
added great strength to  Dr. Cullen's opinion concerning the second
variety.  " There  is," says he,  " an inflammation which attacks in-
ternal canals, which is classed  with the erysipelatous;  but how  far
it is the  same I do not  know :  it is certainly not the suppurative.
Whatever it is, it  may be considered in some of its effects to be in
direct opposition to the adhesive and the suppurative inflammations:
for where the adhesive most readily produces adhesions, there the
erysipelatous does not, as in the common cellular membrane; and
where the adhesive seldom takes place, excepting from extreme
violence, there this inflammation (if erysipelatous)  has a tendency 
142
NOSOLOGY.
[CL. IU.—OR. H.
        * Adhaesive.   Pain very acute ; vomiting frequent; obsti-
             nate costiveness; fever violent.
          Enteritis iliaca.   Sauv. sp. 1.
          Enteritis colica.   Sauv. sp. 2.   Boerh. 963.
          Enteritis phlegmonodea.   Cull.
        £ Erythematica.  Pain more moderate ;  fever less violent;
             little vomiting; diarrhoea.
               The species, under one of  the  two varieties, found
             also, occasionally, as a symptom in intestinal,  ventral,
             inguinal, and other hernias.
 12.  hepatitis.  Tension ;  soreness, and pain in the region of the
                   liver;  pain about the  right shoulder; difliculty
                   of lying on the left side.
        Hepatitis.   Gal. et Auct. Recent.
        Jekur fessadi.   Pers. Turk.
        Entzii ndung der leber.   G.
        Inflammation du foye.  F.
        Inflammation of the IAver.
          Properly  speaking, fessida only is Arabic, and  denotes
        malum, corruptio ; for the Arabic term for the liver is kebed,
        literally imported from the Hebrew  133, whence  also  the
        Syriac kebeda.   It has been already observed, that it is from
        the Persian term jekur, that the Latin term jecur is probably
        derived, as it is from the  Greek  term W«p  that the same
        tongue has copied hepar.

to produce adhesions, as in canals or outlets; it also opposes, in
some degree, the suppurative, in being backward  in producing sup-
puration even in those places where suppuration most readily takes
place, such as canals  and outlets; for there, as above observed, it
more readily  throws out the coagulating lymph.  Whatever the in-
flammation may be, it is certainly attended  with nearly the same
kind of constitutional affection.   The fever in both appears to be
the same: viz. accompanied with debility, languor, Sec."  On Blood,
p. 270.
   The gastritis erysipelatosa of Sauvages, sp.  4.  which  he copies
from Riverius, is improperly thus named :  for, as  Dr. Cullen has re-
marked, it clearly belongs  to the  first or  adhesive subdivision, of
which it has all or nearly all the characters.
   11. x E. Enteritis Adhasiva.  The nature of the disease depends
chiefly upon the patient's idiosyncrasy; but much also upon the sea-
son of the year and temperament of the atmosphere.  And some-
times the modifying causes are so balanced as to leave it doubtful
which variety will be established.   Master P—,  a healthy and ac-
tive boy thirteen years old,  was attacked  with marked symptoms of
enteritis in July 1805, but of so mixed a character as to produce un 
ge. vn.]
NOSOLOGY.
143
      « Acuta.  The specific character decisive ;  and the  symp-
           toms clearly marked.
        Hepatitis acuta.   Cull.
      G Chronica.  The  specific  character  obscure; and  the
           existence of the disease suspected from exposure to its
           causes ; and an occasional recurrence of the pathogno-
           mic symptoms, accompanied  with a slight degree of
           fever.
         Hepatitis chronica.   Cull.
         Hepatitis obscura.   Sauv.
13.  splenitis.  Heat, fulness, and tenderness in the region of the
                  spleen  : pain upon pressure.
      Splenitis.   Auct.
      Lienis inflammatio.  Boerh. Sennert.
      Entziindung der miltz.  G.
      Inflammation de la rate.   F.
      Inflammation of the Spleen.
         The splenalgia of authors  is usually a slight attack of
      this species with some small  degrer of fever.   Parabysma
      splenica, ague-cake, is a frequent sequel of splenalgi.
14. nephritis.  Pain  in the  region  of the kidneys and urethra ;
                  frequent micturition ; vomiting ; numbness of
                  the thigh on the affected side ; retraction of the
                  testicle.
      Nephritis.  Auct.
      Renum inflammatio.   Sennert.
       Entziindung der nieren.   G.
       Inflammation des reins.   F.
       Inflammation of the kidneys.
          Found  occasionally,  also,  as  a  symptom  in nephritic
       calculi, and  rheumatism.   Hoffri..  torn. iii. Meysery ii.
       374.
certainly for the first two  or three days.   The abdomen was tense
and tender, the intestinal canal  painful through the greater part of
its extent; the pulse was quick and moderately full; the skin very
hot and dry;—the  blood, when drawn from the  arm, without any
buffy appearance;  the sickness incessant, with great oppression and
anxiety.   The symptoms  continued  to increase—the  stomach be-
came evidently affected ; an erythematic sloughing appeared in the
throat on the fourth day from the attack;  and on the sixth the pa-
tient died.
  12.  Empresma Hepatitis.  The varieties are taken  from Cullen
Sauvages, on the authority of Amati, has given an erysipelatous 
144                      NOSOLOGY.           [CL. HI.—OR. II.
15. cystitis.   Pain and swelling in the  hypogastric region ; dis-
                 charge of urine painful or obstructed ; tenesmus.
       Cystitis.   Auct.  Recent.
       Inflammatio  vesicae.  Hoffm. Sennert.
       Cysiiphlogia.  DeMeyzerey.   Malad. des Arm.
       Entziindung der  blase.   G.
       Inflammation de la vesie.   jF.
       Inflammation of the Bladder.
         Often the result of wounds, sometimes of cantharides :
       more generally idiopathic.
16. hysteritis.   Pain,  swelling, and tenderness in the hypogastric
                   region;  heat,  pain  and tenderness  of the  os
                   uteri; vomiting ;  pulse quick and low.
       Hysteritis.   Linn.  Vog. Cull.
       Metritis.   Sauv.  Sag.
       Inflammatio  uteri.  Sennert.
       Entziindung der mutter.   G.
       Inflammation de la matrice.  F.
       Inflammation of the Womb.
       x Simplex.  The organ  being  impregnated.   Pain perma-
         manent, circumscribed, throbbing ; fever a cauma.
       G Puerperarum.   Pain less acute,  less circumscribed ; flow
         of urine difficult; fever a synochus or typhus.
17. orchitis.   Pain and swelling of the testicle; nausea or vomit-
                ing ; depression of spirits; pulse quick, somewhat
                low.
       Inflammatio testium.  Auct.  Var.
       Hernia humoralis.  Auct.  Var.
       Inflammation of the Testicle.
         The  stomach peculiarly sympathizes with this affection ;
       and it is hence often cured by vomits when all local applica-
       tions have proved ineffectual.
(erythematic) hepatitis ; as Lommius, Observ. lib. ii. has done a simi-
lar variety of pneumonitis ; but the parenchymatous viscera do not
seem to be subject to an inflammation of this description.  "  Me,
saltern, judice," says  Cullen, " erythema  non  nisi superficies  ilias
internas quas tegit epithelion et tunica villosa epidermidi externae
continua,  et  analoga,  afficere potest."  The observations of  Mr.
J. Hunter just quoted  under empresma and empresma gastritis, are
in perfect accordance  with this opinion.
  Gen. VIII. Ophthalmia.  This term is  used in  very  different
latitudes by different writers.   Sauvages, Linneus, and Sagar, make
it parallel with cephalalgia or cephalae ; and consequently expressive 
GE. VUI.]
NOSOLOGY.
145
                     GENUS  VIII.

                  OPHTHALMIA.

     Pain and redness of the eye or its appendages; intolerance of
         light ; flow of tears or other excited secretion.
       Ophthalmia.  Sauv. Linn. Plenck et Alior.
       Oculorum Inflammatio.   Vog.
       Inflammatio oculorum.  Hoffm.
       Ophthalmites.  Vog.
       Cauma ophthalmitis.   Young.
       Sahik.   Arab.
       Augenentziindung.   G.
       Ophthamie.  F.
       Ophthalmy.  Inflammation of the Eyes.
1.  taraxis.   The tunics of the eye-ball chiefly inflamed ; increas-
               ed secretion of tears.
       Ophthalmia humida.   St. Yves.
       Ophthalmia vera.  Sennert.
       Epiphora.   Gulen.
       Taraxis.   Paul. JEgin.  Aetii.
       Chemosis.   Aetii.
       Ophthalmia Chemosis.  0. Taraxis. 0. humida.  Sauv.
       Ophthalmia membranarum.   Cull.
       Lachrymose Ophthalmy.
       x Mitis.  • Limited to  the surface : pain tolerable : without
           head ache.
of any ache of the eye without reference to fever or inflammation;
among all whom it occurs as a genus under the class dolores. By
Vogel, Cullen and Macbride it is limited to inflammatory affections
of the eye: occurring  as a genus under the two former, and as a
species under the latter.  In Parr and Young  it  is  found also as a
mere species ; the second denominating it ophthalmitis, consonantly
with the common termination of the inflammatory diseases of internal
membranes and organs.  Yet it  is difficult to say what precise de-
scription of ophthalmy Dr. Young adverts to by his Cauma ophthal-
mitis,  since he merely refers us for an explanation to another genus
and species in his arrangement,  which he denominates inflammatio
specif ca; under one subdivision of which he  enters  Dr. Cullen's
ophthalmia ; as though he intended that the two  should be synony-
mous  : in  which  case,  however, there seems little or nothing left
for cauma  ophthalmitis, as Cullen's ophthalmia is purposely de-
signed to cover every inflammatory affection of the eye.
  vol. v.—30 
146                      NOSOLOGY.            [CL. HI.—OR. II.
          Taraxis.  Plenck.
        G Acuta.  Extending to the lower  part  of the eye-ball;
             sometimes commencing there ;  pain burning;  tears
             perpetual and acrid ;  intolerable head-ache.
          Chemosis.   Plenck.
 2.  purulenta.  The internal surface of the palpebrae  associating
                   in  the  inflammation of  the  eye-ball;  copious
                   secretion of a  purulent fluid.
          Purulent Ophthalmy.   Ware.
        x Epidemica.   The disease epidemic ; inflammation  rapid
          and destructive ;  head ache intolerable ; often succeeded
          by delirium ; at times remittent.
          Ophthalmia epidemica.   Wilder. Stutg. 1787. Plenck.
          Egyptian Ophthalmy.   Power. Vetch. Edmonstone.
        G Merastatica.   Apparently produced by a sudden suppres-
          sion of catarrhal,  blennorrhoic, or other morbid discharge.
          The secretion often greenish.   Swediaur.
          Scarpa. St.  Yves. Pearson. Edmonstone. Ware.
          Ophthalmia catharrhalis.  O- gonorrhoica.   Plenck.
        y Intermittens.   Marked by regular intermissions.   Nearly
          allied  to  the  epidemic variety.  Probably  produced  by
          marsh miasm.
          Ophthalmia periodica.  Plenck.
        £ Infantium.  Appearing suddenly,  and without any osten-
          sible cause, in new-born infants :  the palpebrae florid, and
          peculiarly tumid.
     Purulent Ophthalmy of new-born children.  Ware.
3. glutinosa.   The inflammation chiefly seated on the tarsus ;  its
                   sebaceous glands secreting a viscous  and acrid
                   fluid that glues and ulcerates its edges, and irri-
                   tates the eye.
       Ophthalmia tarsi.   Cull. Parr.
       Psorophthalmia.   Plenck.  Ware.
       Oculi palpebrarum scabies pruriginosa.   Caslell.
       Augenlieder fleckte.   G.   See Janin.   Uber das Auge.
4. chronica.  Eye weak  and  weeping  after  the   inflammation

  The term in the present arrangement is used in  its limited sense,
as importing inflammation accompanied with local  pain.  It might
perhaps have been placed as a species under empresma, in which
case it should have been written ophthalmitis:  but it has various cha-
racters peculiar to itself, as well in regard to its symptoms as to the
seat of the organ, which seem to entitle it to the rank of a distinct
genus, and it is thus arranged accordingly. 
.,13. VIII.]
NOSOLOGY.
147
         has  ceased;  redness  permanent,  increased  by
         slight causes.
Lippitudo.   Auct. var.
Ophthalmia chronica.   Auct. Alior.
Remed.  Arab.
Zyger-augen.  G.
Chassie.   F
Blear-eye.   Lippitude.
   Often  a  relic or sequel  of  the  preceding varieties ; and
best relieved by gentle  stimulants and  astringents,  as cold
water, solutions of camphor, zinc, alum, lead ; slight illina-
tions of French  brandy, laudanum, or the nitric oxyd  of
mercury in  the form of an ointment.
   Sometimes  the  eye  assumes a general redness without
pain,  which is the ophthalmia indolens  of Richter, Janin,
and Gendron.  See Richter, Chirargische Bibliotheck, Band
i. stuck.  4.  Gendron, Traite des maladies des Yeux, torn.
ii. p.  38. Paris,  1770.
   Ophthalmy  is also  occasionally found  as a symptom in
catarrh, scrophula, syphilis.
                  GENUS  IX.

               CATARRHUS.

Inflammation of the mucous membrane of the  fauces, of-
     ten extending to the bronchia  and frontal sinuses;  in-
  Gen. IX. Catarrhus. Kxrxppoos : " defluctio:" from xxtx and pea,
" fluo."  This term, like opnthalmia, has been used in various senses
and latitudes by different authors.  Schneider and  Hoffman show a
disposition to extend it to inflammation of mucous glands in gene-
ral:  and  Parr, enticed by such an example, has made it a genus for
including not only what is  commonly understood by catarrh, but the
cough of old age, which he admits is without febrile action, croup,
dysentery, phthisis, cystirrhcea, leucorrhcea, gonorrhoea, and one or
two others.  This is the widest acceptation of the term : the narrow-
est is that of the old pathologists, who thus distinguished between
three separate terms which are  now regarded by many  writers as
synonymous.
         Si  fluit ad pectus, dicatur rheuma Catarrhus;
          Ad fauces, Bronchus; adnaresestoCoryza. 
148                      NOSOLOGY.           [CL. HI.—OR. II.

         farction of the nostrils ; sneezing, and for the most part a
         mucous expectoration, or discharge from the nose.
       Catarrhus.   Hippocr.  Sauv.  Vog.  Sag. Cull.
       Catarrhus.   Sauv.  Linn. Vog.
       Rheuma.  Sauv. Sag.
       Catarrh.
1. communis.   Fever slight;  mucous discharge considerable.
       Catarrhus benignus.   Sauv.
       Coryza catarrhalis.  Sauv.
       Rheuma catarrhale.   Sauv.
       Gravedo.  Cels. et Auct. Lai. Linn.
       Catarrhus a frigore.   Cull.
       Febris remittens catarrhalis.   Macbr.
       Zukam.   Ar. Pers.
       Erkaltung.   G.
       Infreddatura.   Ital.
  This couplet is founded, perhaps, upon Galen's account of these
affections, De Sympt. Caus. lib. iv cap. iii. § 4 ;  but it does not fol-
low up the Greek distinction into all its ramifications;  for the Greek
physicians, as he tells  us, had also other  names for the defluxion
when it chiefly attacked other parts in the neighbourhood : as aci-
nus, when  the  uvula  was the seat of affection, antiadae, when the
tonsils, and paristhmia, when the attack was common to the fauces.
For  all these  Celsus employs  the Latin term  gravedo, between
which, however, and coryza,  he observes that there is an  evident
difference.   It is this difference which is endeavoured to be explain-
ed in the present system, in which coryza is made to import nasal
defluxion  without   pyrexy.   Celsus takes no  notice of the  term
catarrh.  In his day catarrh was  changed by the Greek writers to
catastagmus.
  Sauvages has only deviated from the rule contained in the above
Latin couplet, by omitting bronchus, and employing catarrhus in its
stead, and rheuma in the stead of catarrhus ; so that with him rheu-
ma imports a cold  or febrile defluxion of the chest;  catarrhus the
same affection of the fauces, and adjoining organs; and coryza the
same of the bead or nostrils.
  Cullen has regarded rheuma, coryza, bronchus, and catarrhus, as
synonymous terms  scarcely indicating varieties of the same  disease.
The arrangement of Dr. Cullen, however, did not allow him to place
bex, tussis, or cough any where else; and he has hence regarded
this affection also as synonymous  with  catarrh.  Here the present
system differs from him, as it does likewise in separating  coryza
from the list of phlogotic affections.  Cough is not necessarily  a
febrile or inflammatory disease, though it may  be  occasionally  a
symptom of such disease.  Cough, therefore, under the Greek term
iex, is removed with coryza, to class ii. Pneumatica, where they will 
GE. IX.]
NOSOLOGY.
149
       Rhume.  F.
       Gravedo.   Old Engl.
       Cold in the Head.
2. epidemicus.  Attack sudden ;  great heaviness  over  the eyes ;
                  fever strikingly depressive ;  epidemic.
       Catarrhus a contagio.  Cull.
       Catarrhus epidemicus.   Sauv.
       Rheuma epidemicum.   Sauv.
       Influenza.
         For an excellent chronological table of the best writers
       upon the subject, from the Cronica Meteorologica Tuscana
       of 1323, by Targioni  Tozzetti, to  Saillant, Tableau des
       Epidemies catarrhales, see Cullen's Synopsis, in loco.
         Catarrh is also found  occasionally, as a symptom in  mea-
       sles, small-pox, worms, dentition, rheumatism.
perhaps be allowed  to occupy  more correct and natural posts than
in the present place.
  Dr. Crichton and Dr. Young have sunk catarrh into a species of
inflammation or inflammatory fever; the genus of the former being
somewhat unclassically denominated phlegmasia sthenica, and of the
latter cauma.  In this view of catarrh it would find its place, under
the present arrangement, as a species of empresma.  But for the rea-
son that the author has ventured to make ophthalmia a distinct genus,
he has also ventured to do the same with respect to catarrhus.  It
has sufficiently striking characters for its present rank; and is of too
complicated  a nature for a mere species.
  2. Catarrhus Epidemicus. Dogs and horses are peculiarly subject
to a violent and frequently  fatal species of this disease; in most in-
stances highly contagious or epidemic.   This, among ourselves, is
vulgarly known by the name of distemper, snaffles or rather snuffles :
among nosologists it is  called catarrhus  caninus.   It is  a singular,
and appears to be a well ascertained fact, that dogs which have un-
dergone this catarrh never generate lyssa or canine madness, though
they are capable of receiving it by contagion.  Hence lyssa is un-
known in South  America, notwithstanding the prodigious number of
dogs kept  in many  parts of it for the express purpose of eating up
the flesh of the wild oxen and buffaloes that are shot for the value
of their hides ; and  shot too in such abundance, that the atmosphere
would otherwise be  loaded with  putrid exhalations.   In South Ame-
rica the distemper or canine catarrh is  more prevalent, and perhaps
more fatal than any where else;  half  the dogs being supposed to
die of it while puppies. 
150
NOSOLOGY.
[CL.UL—OR.H.
                        GENUS  X.


                  SPARGANOSIS.

     Pale, tense, glabrous, diffused swelling of a limb :  great ten-
         derness ; inflammation subcutaneous, unsuppuralive.
       Sparganosis.  Dioscor.
I.  puerperarum.  Occurring, for the most part, during the second
                     or  third week after  child-birth ; limited to
                     the  lower extremity, and chiefly to one side;
                     exhibiting to the touch a feeling of numerous
                     irregular  prominences under  the skin ; fever
                     a hectic.
       Phlegmatia lactea.  Sauv.  Levret.
       Phlegmatia dolens.  Hull.
   Gen. X. Sparganosis. 2;r»fy#v«<n$: from wex^yxta, " to tumefy
 and distend:" tumeo etdistentus sum, as rendered by Scapula. This
 term is taken from Dioscorides, as already observed in the note on
 Phlegmone mammae.  It is here designed, however, to distinguish
 only one of the numerous and heterogeneous diseases which Dios-
 corides has included under  it, from a notion that all are  the result
 of a suppression, miscombination, or misdirection of the milk.   Ab-
 scess in  the breast, phlegmone mammae,  is not always  connected
 with the state of the milk;  and the present species, though usually
 referred to this cause, still less frequently connected, and perhaps
 never.  The latest and best  writers  upon the subject, Mr. White,
 Mr. Trye,  Dr. Ferriar, and  Mr. Hull, concur in deriving the disease
 from lymphatic effusion,  or an inflammation of the lymphatics, or of
 the lymphatic gland of the  side affected.   Probably both  concur in
 its production, which  is Dr. Hull's  hypothesis ; at the same  time
 the fever seems to be idiopathic, and  the effused  lymph peculiarly
 thick and glutinous, constituting a critical deposit; its increased glu-
 tinosity resulting perhaps  from the  tendency  which the general
 frame at this time  possesses of producing  genuine milk,  and milk-
 like or albuminous secretions  in various parts of the body, as  for
example in  the  peritonaeum during  typhus puerperarum; and in
different parts of the hypogastrium, as described by Puzos, in  his
 Traiti des  Accouchemens,  under the name of Depot laiteux dans
1'hypogastre.
  That sparganosis is not dependent upon the state of the mammary
organ, is obvious from its  occurring in cases where there is no sup-
pression of milk ; and from  its being found equally in the  weak and
the strong, the lean and the corpulent, the sedentary and the active, 
GE. X.]                    NOSOLOGY.                      151
Anasarca serosa.   Cull.
Ecphyma cedematicum. A.   Young.
Ecchymoma lymphatica.   Parr.  Art. Lymphoeductus.
Ischias a sparganosi.  Sauv.
Depot laiteux sur la cuisse.  Puzos.
Lait repandu.   F.
Milch-streichem.   G.
Milk-spread.
                  GENUS  XI.

               ARTHROSIA.

Inflammation mostly confined to the joints ; severely painful ;
     occasionally extending to the surrounding muscles.
  Arthritis.   Auct. Grozc.
the young and the middle-aged, those who suckle, and  those  who
do not.   The  edematous affection  that takes place  in  the  ankles
afterwards is a mere sequel of the disease, dependent upon vascular
debility ; and hence Dr. Cullen seems not less improperly to  regard
sparganosis  as a species of anasarca, (anasarca serosa) than others
who have regarded it as  a species  of  milk  affection.  The author
has, at the time of writing, a lady under his care,  severely affected
with sparganosis,  of good natural constitution, and with a profuse
flow of milk ;  her age twenty-two : has lain in three  weeks.
   Gen. XL Arthrosia.  From xgOgoa,  " to articulate," whence
arthrosis, arthritis, and various other medical derivations. The usual
term for the  genus of diseases before us, among the Greek  phy-
sicians,  was arthritis, which the author would have continued, but
that, for the sake of simplicity and regularity, he  has been anxious
to restrain the termination  itis to the different species of the genus
empresma, comprising the membranous and parenchymatous inflam-
mations ; whence arthrosia is employed in its stead, and  precisely in
its original extent of meaning.
   Arthritis, among the Greeks, was used  generically to import ar-
ticular inflammations, or painful joint-tumours of every sort.   Al-
most every sort,  having, however, in recent times,  been regarded
as a distinct genus of diseases, it has frequently been a question to
which of them the Greek term should be  applied.  Hence, as will
appear  from the different synonyms  in the text, some writers have
limited it to gout, others have more or less extended it  to gout and
rheumatism;  others again have made it embrace white-swelling; 
152                       NOSOLOGY.           [cl. HI.—OR. II.

       Arthritis.   Sauv. Parr.  Art. Nosol.
       Articular Inflammation.
       Joint-ache.
 while a fourth class of writers, in order to avoid  all obscurity and
 dispute, have banished the term altogether.
   Now gout,  rheumatism,  whether acute or chronic, and  white-
 swelling, however they may differ in various points as well of symp-
 toms as of treatment,  have striking  characters that unite  them into
 one common family or genus.  Gout and rheumatism are so nearly
 allied, in their  more perfect forms, as to be distinguished with con-
 siderable difficulty ; and, in many instances, rather by the collateral
 circumstances  of temperament, period of life, obvious or unobvious
 cause, antecedent affection or health of  the digestive function, than
 from the actual symptoms themselves.  Stoll maintains that they are
 only varieties of  the same disease, Med. Rad. v. p. 465.  Bergius,
 that they are  convertible, Svanne Suar om Gikt.  White-swelling,
 in one of its varieties, is now uniformly regarded as a sequel of rheu-
 matism, or the result of a  rheumatic  diathesis:  while the  other
 variety cannot be separated from it.  All these therefore necessarily
 form one common genus, and are correctly  so arranged by Dr. Parr.
   Cullen has justly observed, after Sauvages, that properly speak-
 ing  there is but one species  of gout, the subdivisions being mere
 varieties.  This  one species, however,  he  has incorrectly made  a
 genus, and then, having entered his subdivisions under it as varieties,
 he has, in fact,  given us no species whatever.   Macbride has given
 us both genus and species as well as  varieties ;  but then  his species
 are only parallel  with  the varieties  of  Cullen, while the  genus of
 both of them should have been a species alone. The subdivisions
 of Macbride, which he calls species, are  simpler than  those  of
 Cullen; and the present arrangement, therefore, though it does not
 exactly adopt them, is in some degree guided by them.  Atonic
 gout, which is the name of Cullen's  second variety, might just as
 well include  his retrograde gout, or  third variety,  and perhaps his
aberrant, or misplaced  gout, which forms his fourth.
  The varieties of arthrosia hydarthrus, are taken from Mr. B. Bell's
treatise on white-swelling.
  From the close connexion between gout and rheumatism, Sauva-
 ges, and various other  nosologists,  distinguish some of the cases of
 disguised gout  by the name of rheumatic gout.  Mr. John Hunter
 warmly opposed  this application, for his doctrine was, that no two
distinct diseases,  or even diseased  diatheses, can exist in the same
constitution.  Yet it is singular that one of the severest illnesses that
attacked his own person,  and which ultimately proved to be dis-
 guised gout, podagra larvata, he suspected,  in its outset, to be a
rheumatic attack.   See Sir Everard  Home's Life  of  Mr. Hunter,
prefixed to his  Treatise on Blood, p. liii.  compared with p. Iv.   The 
GE. XL]
NOSOLOGY.
153
1.  acuta.   Pain and inflammation usually about the larger joints,
              and  surrounding muscles ; often wandering; urine
              depositing a lateritious sediment; fever a cauma.
       Rheumatismus.  Sauv. Linn. Vog.  Cull.
       Myositis.  Sag.  Plouquet.
       Myitis.   Cricht.
       Cauma Rheumatismus.   Young.
       Arthritis Rheumatismus.   Parr.  Art. Nosol.
       Rheumatisme chaud.  jF.
       Lauffende gicht.   G.
       Acute Rheumatism.
       x Artuum.  Pain chiefly felt in  the joints and muscles of the
            extremities.
example is highly interesting and curious, as showing the singular
forms which this morbid Proteus sometimes affects, and the various
seats it occupies : as also that a life of temperance and activity is no
certain security against its attack: for Mr. Hunter at this time had
drunk no  wine for four or five years,  and had  allowed himself but
little sleep at night.   The reader may turn to some very excellent
observations of Mr. Hunter on this disease, in his treatise on Biood,
p. 265—268.
   Gout is one of the maladies which seems to have been common to
England in its earliest ages of barbarism.  It is frequently  noticed
by the Anglo-Saxon historians, and the name assigned to it is fot-
adl, (foot-ail.)   In the Cottonian MSS. at the British Museum, Lib.
Vitell. c. 3, we have  the following prescription,  which was once re-
garded as a specific: " Take the  herb datulus ortitulosa, which we
call greata  cranleac (a species of iris or flag-flower.)   Take the
heads of  it, and dry them very much, and take  thereof a penny-
weight and an half;  and the pear-tree and roman bark, and cummin,
and a fourth part of laurel berries; and  of the other herbs half a
penny-weight  of each, and six pepper-corns, and grind all to dust;
and put two egg-shells full of wine.   This is true leech craft.  Give
it to the man to drink till he be well."
   I. Arthrosia acuta.  One of the best tracts  upon this subject is
that of Dr. Haygarth's Clinical History of the Acute Rheumatism,
contained  in his " Clinical History of Diseases," published in 1805,
It gives the fair result of a considerable extent of practice condensed
into a small compass, and arranged in a tabular form, from notes
taken by  himself  during a period of  thirty-eight years.  Of  470
patients, only  170 are stated to have had any fever, amounting to
about a third of the whole ; and hence, perhaps, the majority should
rather be regarded  as  appertaining  to  the second  species of the
present arrangement.  The tables contain a larger list of males than
of females, probably  from the former being more generally exposed
   VOL. v.—-31 
i;j4
NOSOLOGY.-
[CL. m.—OB. U.
         Veje-omefasil.   Arab.
            Said, among other curious remedies, to be relieved by
         the warmth and stimulus of an ants' nest; balneum for-
         micarum.   See Bourgeois, Hebammenbuck, part ix. cap.
         14.
       G Lumborum.  Pain chiefly f/elt in the loins ;  and shooting
            upwards rather than below.
         Lumbago rheumatica.  Nephralgia rheumat.   Sauv.
         Zulekkhet.   Arab.
         Lumbago.
       <y Coxendicis.  Pain chiefly felt in the hip-joint; producing
            emaciation of the  nates  on the  side  affected,  or  an
            elongation of the limb.                     \
         Ischias rheumaticum.  Sauv.
         Ischiadum malum.  Plouquet.
         Huft-wehe.  G.
         Sciatica.
       ■>' Thoracis.    Pain chiefly felt in the  muscles  of the dia-
            phragm ; often producing pleuritis diaphragmatica.
         Pleurodyne rheumatica.   Sauv.
         Pleuritis spuria.  Boerh.
         Kasho, Arab,  literally spurious pleurisy, as  named  by
            Boerhaave above.
2. chronica.   Pain, weakness, and  rigidity of  the  larger joints
                  and surrounding  muscles;  increased  by mo-
                  tion ;  relieved  by warmth ;   spontaneouly or
to cold : they embrace persons of all ages, but the greater number
are  between fifteen and twenty years of age.   In a considerable
majority of cases the joints were the parts principally affected ; in
some the joints and muscles ;  and  in a few  the latter alone.  The
average of  the pulse in the  above  170  patients was 100, and the
blood always exhibited  the inflammatory crust,  when drawn.  The
most successful remedy was a free use of the bark, as at first pro-
posed by Morton, and afterwards successively by Sir Edward Hulse,
and Dr. Fothergill.   It is from the accurate observation of the last
writer  that the author has added in the definition of the disease the
feature of lateritious urine.
  1. y A. acuta Coxendicis.  Said to be cured by a  decoction of the
Linnaea borealis.  Amcenit. Acad. vol. vii. art. 149.   Rariora Norwe-
giae.  Respond. H. Touning. 1768.  This plant, which  belongs to
the class didynamia, order angiospermia, is found in the woods of
our own country ;  with campanulate flowers in pairs, nodding, varies
gated with white and red.
  The decoction appears to operate as a sedative and narcotic. 
GE. XL]
NOSOLOGY.
155
                    easily growing cold ; fever and swelling slight,
                    often imperceptible.
        Rheumatismus chronicus.  Auct,
        Rheumatismus vulgaris.   Sauv.
        Arthrodynia.   Cull.
        Arthritis arthrodynia.   Parr.
        Rheumatisme chronique.   F.
        Chronic Rheumatism.
          The varieties are those of the preceding species, of which
        Cullen regards the disease  as a mere sequel.   It  appears
        however at times to be idiopathic ; but it is often difficult to
        draw the  line between the two.
 3.  podagra.   Pain and inflammation chiefly of the smaller joints;
                 returning after intervals; often preceded by,  or
                 alternating with, unusual affections of the stomach,
                 or other internal parts ; unsuppurative.
        Arthritis.   Sauv.  Linn. Sag.  Macbr.
        Podalgia.   Dioscor.
        Podagra.   Boerh.
        Arthriticus verus.   Hoffnu
        Arthritis, podagra.   Parr.
        Podagra, arthritis.   Young.
        Nikris.  Ar. Pers. Turk.
        Goutte.   F.
        Zipperlein.   G.
        Gout.
        A  Regularis.   The articular pain, swelling, and inflamma-
            tion  considerable ;  continuing for several  days,  often
            with  remissions  and  exacerbations;   then  gradually
            dispersing, and leaving  the constitution in its usual  or
            improved health.
          Podagra  regularis.   Cull. Macbr.
          Regular fit of Gout.
        G  Larvata.   Disguised and lurking in the constitution, and
            producing  derangement  in the digestive  or  other
            functions, with only slight and fugitive affection of the
            joints.
          Podagra atonica.   Cull.

  3. Podagra regularis.   Said to be produced by eating acid cher-
 ries.  Lentiluc. Miscell.  ii. 358.  Eph. Nat.  Cur.  Dec. iii.  ann. iii.
obs. 45.   Said on the contrary in the case of Linneus fc> have been
cured by his eating strawberries; and this in  five successive parox-
ysms recurring annually, each being slighter than the other; till by 
J5t>                       NOSOLOGY.            [CL. HI.—OR, II.

         Podagra irregularis.  Macbr.
         Disguised ; lurking ; atonic Gout.
       y Complicata.   The disease fixing  on some internal organ
            instead of on the joints ; or suddenly transferred from
            the joints after having fixed there ;  producing, in  the
            internal organ affected, debility or inflammation accord-
            ing to the state of the constitution.
         Podagra complicata.  Macbr.
         Podagra retrogada.   P. aberrans.   Cull.
         Retrograde ; recedent;  misplaced  Gout.
L hvdarthrus.   Tense, permanent, colourless swelling, chiefly of
                   the  larger joints ;  inflammation  slow,  and
                   deep-seated ; pain severe and fixt:  imperfectly
                   suppurative :  fever a hectic.
       Hydarthrus.   Sauv.  Cull.
       Arthritis hydarthrus.   Parr.   Art.  Nosol.
       Emmyxium articulare.  Young.
       Tumor albus.   Plouquet.
       Tumeur blanche.   F.
       Weiss-schwellen.   G..
       White-swelling.
       x Plethoricus.  Pain diffused ; swelling considerable  from
            the first; originating and chiefly seated in the cartilages
            and  ligaments of the affected  joint;  found principally
            in plethoric habits.
         Rheumatic White-swelling.   Bell on Ulcers.
       G Strumatbsus.   Pain circumscribed and shooting from a
            point ; swelling from a general thickening  of the  part;
            at first inconsiderable ; originating and chiefly seated in
            the bone.  Found principally  jn^scrophulous habits.

a perseverance in the same fruit,  the disease at length did not  show
itself for nearly twenty  years.  The story is told agreeably by  M.
Hedin, in the Amcenitates Academicae for 1772, vol. viii.; yet, ac-
cording to the general statement  of  his friends, Linneus's recovery
from the first and severest attack was  rather owing to the exhilara-
tion of his spirits  by the return of his pupil Kalm, with  a large col-
lection of rare  and  undescribed  plants  from America, than to  the
use of the strawberry.  Maton's Edit, of Pulteney's Life of Linneus,
p. 103.
   This supposed effect of the fragaria vesca on Linneus has been
often treated with pleasantry.  But if it be true that on some con-
stitutions it has occasionally acted as a poison, as is asserted in  the
work first Quoted, there is no reason why it may not have an  effect
equally salutary on others. 
CL. HI.—OR. IH.]
NOSOLOGY.
157
Scrophulous White swelling.  Bell.
  "1 conceive  all such  collections of matter to be of a
scrophulous nature : they are most common in the young
subject, and seldom found in the full-grown or old.   The
suppuration is not proper pus, nor the swelling proper in-
flammation."   Hunter on Blood, p. 391.
                      ORDER  III.

              EXANTHEMATICA.

                   ERUPTIVE FEVERS.

 CUTANEOUS ERUPTIONS ESSENTIALLY ACCOMPANIED WITH
                           FEVER.

  The term exanthemata among  the  Greeks imported cutaneous
     efflorescences or eruptions generally.   It has since been limit-

  Obder III. Exanthematica. From e|«v0s«, " effloresco," " per
summa erumpo."  It is in the last of the above  significations that
exanthema has been  employed by Dr.  Willan, in his valuable and
well-known work on Cutaneous Diseases, who uses it as merely syno-
nymous with Rash, and defines it an eruption " of red patches on the
skin, variously figured, in general confluent, and diffused irregularly
over the body, leaving interstices of a natural colour.  Portions of
the cuticle, he continues, are often elevated in rash so as to give
the sensation of an uneven surface.  The eruption is usually accom-
panied with disorder of the constitution, and terminates in a few days
by cuticular exfoliations.
  This, so far as the writer  of these  pages is acquainted, is alto-
gether a new  definition of  the term: it  applies admirably to the
English rash,  but why rash and exanthema should be regarded as
strictly parallel and synonymous, and equally limited in their mean-
ing, seems not a little difficult  to determine.   Dr. Willan admits the
term to have been used upon a much  broader scale by the Greek
physicians, whom he has  quoted  against himself,  while  he does
not always continue strictly true to his own views: for after having,
in his table of definitions, characterised rash or exanthem as distinct
from papula and wheal, he  employs  it as the  name of  an order
embracing diseases distinguished  by both these  appearances.  Ex-
anthema, till  the publication  of his work,  however  explained in
other respects, had uniformly  been regarded as indicative of a class)
order, or family of diseases, of which rash, red cutaneous irregular
patches, constituted a single division.  If rash, as suspected by Dr, 
158
NOSOLOGY,
LCL. III.—OR. Hi
ed to express cutaneous  eruptions, accompanied  with fever,
a boundary  assigned  to  it  by  Sauvages,  Linneus, Vogel,
Johnson, be a corruption of rush, it may possibly, on its first  use,
have been employed coordinately with exanthema in  the general
sense of eruption ;  but we have no  knowledge that it  was ever so
employed; while its derivation, as  thus traced, however ingenious
and  probable, is altogether a matter of conjecture.  As far back as
we can follow up the use of the term by medical writers, rash has
uniformly imported a particular species of eruption, while exanthema
has, at least for centuries, perhaps  always, expressed  eruptions in
general, or at least eruptions in general accompanied with fever.
   Dr. Pair, in the article of his  Dictionary,  Cutanei  Morbi, ap-
proves so highly of Dr. Willan's arrangement and definitions, as to
bestow much pains in  correcting what he believes to form its only
imperfection, namely, the want of a elassific division of the  pyrec-
lic and the apyrectic affections.   Yet with that singular  versatility
of opinion which, in the midst of great merit and ingenuity, so fre-
quently marks  the progress of his work, he  abandons, in  his article
Nosology, both  Dr. Willan and his own improvement of Dr. Willan;
relinquishes Dr. Willan's definitions, and in many instances his ar-
rangement; and once more employs exanthema in the general sense
of eruptive fevers, both specifically contagious and the contrary.
   In  this common  sense of the term it is  adopted in  the present
system.  Dr. Cullen in his note  on exanthemata, thinks it worth
considering  whether the word  should not be limited to eruptions
(he does not say fevers) produced alone  by specific  contagion :
" eruptiones a contagione specifica ortae."  " In which case," conti-
nues lie, " eruptions destitute of such contagion, and depending on a
particular state of fever alone, certainly cannot be ranked among
the genuine exanthemata."  He has hence omitted petechia {petec-
chia, as it should be spelt, if retained at all,)  and doubts whether he
ought not to have omitted miliaria and aphtha.  " Again," says he,
" since the exanthemata are, for the most part, contagious, and oc-
cur only once in the course of a man's life, it seems perfectly fitting
that these should be distinguished from the uncontagious eruptions
which  occur, or  may occur repeatedly  within the same term of
time:  and hence there is but little reason for arranging variola and
erysipelas in the same order.  And since, moreover, the eruptions of
certain diseases are not always of  an identic form, nor always make
their appearance, and especially on  the same day  of the disease, it.
may  be well doubted whether diseases of this sort should be ranked
among the exanthemata; and I am  hence undecided whether pestis
should be carried to the order of exanthemata or of fevers."
  There is, perhaps, somewhat too much nicety in these remarks,
and it is well  that Dr. Cullen did not attempt to regulate himself by
them in his nosological arrangement, which, in consequence  how- 
CL. HI—OR. HI.]
NOSOLOGY.
169
     Sagar,  Macbride, Cullen, and  various others :  and it  has
     still more  lately been  attempted  to  be  fettered within  a

ever, is at variance with  his definition:  for  they would have com-
pletely taken  him from that simplicity which is the characteristic
merit of his method, and involved  him in inextricable perplexity.
If all diseases produced by specific contagion were eruptive, the
term exanthemata might be properly enough applied to, and limit-
ed by, them;  but as this  is by no means the case, there is no more
ground for making specific contagion essential to exanthems, than for
making exanthems essential to specific contagion, the  absurdity of
which last idea must be obvious to every one.  In reality, fever, erup-
tion, and contagion, have no necessary or natural connexion with each
other.  Each may exist separately, or in any mode of conjunction with
the rest; and  an union of the two former, of fever and eruption, is
sufficient to characterise an order which may be correctly distinguish-
ed by the name of exanthems, whether contagion be combined with
them or not. Such combination, or the absence of it, might be a good
feature for a subdivision  of the order, if it were necessary, but it is
not called for,  in laying down the broad outline of an order itself.   Pe-
tecchia, in Dr. Cullen's system, is proscribed with great propriety
from the list of exanthems ; not because such an affection is uncon-
tagious,  but because it is a mere symptom  of diseases  of various
kinds, both febrile and infebrile ; a simple deposition of blood, from
vascular debility or a dissolved state of the sanguineous fluid, and
not a specific  eruption of any  sort.
   There seems as little reason, in laying down the character of ex-
anthemata, for considering whether the diseases the term is intend-
ed to include occur once  or more than once in the course  of a man's
life.  This  is  a part of physiology still  considerably open to inquiry,
and in which  we have hitherto made but  little progress.  We fre-
quently see in inflammations or simple cutaneous eruptions, that, a
part which  has undergone a  particular  action, as  in  the different
species of erythema, is no longer excitable by the virus that  pro-
duced such action,  and  returns  to a state of health, while the ad-
joining part, which  has hitherto remained unattacked, is  open  to its
influence.   We perceive the same common fact in a variety of dis-
eases that assault the system generally : and especially in the order
of eruptive  fevers in whatever sense we use the term.   When the
constitution has once submitted  to their influence, a change has
been made in  it, which renders it, for a considerable period of time,
far less susceptive of such  influence than antecedently ; so that, up-
on an equal exposure to the morbid cause, fresh persons always be-
come more  readily affected than the person who has lately recovered
from its operation.   So  long as  this  change or  effect  produced
upon the constitution continues, the disease is incapable of returning
the system being insusceptive of its influence.  But we know little'
of the nature  of this change, and not  much of the term  of time
to which it extends.  We see  evidently, however, that in some 
160
NOSOLOGY.
[CL. HI.—OR. HI
     narrower  circle, sometimes  by confining it to  eruptive fe-
     vers produced  by specific  contagion, whatever  be  the cha-

diseases the impression is more  fixed, and the term of time more
extensive than in others.   And  hence, while  recovery  from the
plague emancipates for only a short period, recovery from the scar-
let fever emancipates  for a much longer; and recovery  from  the
small-pox and measles for a term of time equal to the whole of life ;
so that,  generally speaking, such diseases, as well as numerous
others that produce an impression of equal duration, are only under-
gone once in the course of a man's existence.
   Such is the variation of power evinced by different diseases:  and
we see a similar variation  evinced by different constitutions.   Some
are naturally so little susceptible of a particular contagion as never
to be affected by it, though often or  continually exposed  to  its in-
fluence ; others to be but slightly susceptible  of  it, and  hence to
pass through the  disease with comparative facility, even under un-
skilful treatment,  or other unfavourable circumstances: while  a
third kind, from a strong natural susceptibility, suffer severely even
under the most judicious advice and treatment. It is on this account
that  some persons never have the small-pox, even when inoculated
for it, or directly exposed to its atmosphere; that others have a crop
of not  more than ten or twelve pustules with  little fever, during
the natural disease;  and that others again are  seamed  and scarred
with it from head to  foot.   And hence the  reason why  this and  se-
veral other diseases, that  commonly never occur oftener than once
in the course of a man's life, are  occasionally traced twice or even
three times in the same individual.  For the more  rooted  the natu-
ral propensity to a disease, the less durable the change and  immu-
nity purchased by a single attack, and the sooner the system returns
to its natural susceptibility and predisposition.  On which account
we, shall  perhaps find, without a single exception, that wherever the
small-pox has occurred a  second time, it has been in persons who
have had it with great severity in the first instance.
  There are some fevers, again, and perhaps the  greater number,
that produce no change of any kind upon the constitution in regard
to general susceptibility, leaving it in  this respect precisely as they
found it.  While there are others,  again, that, by a single  attack,
introduce a habit of repetition, and thus render it  more instead of
less susceptive of the same complaint, and open to the  same influ-
ence :  a remark which particularly applies to  intermitting  fevers,
or those produced by marsh-miasm; to which the  oftener  a patient
has been a victim, the more deeply, and especially on a recurrence
of the same season or other circumstances, he is  predisposed to their
assault again.
   This is perhaps  the whole we are  acquainted  with in  regard
to the general law of morbid  recurrence. We behold a striking
difference both in different diseases and in their influence upon dif- 
CL. in.—OR. HI.]
NOSOLOGY.
161
     racter of  the  efflorescence :  and  sometimes by restraining
     it to the character of the efflorescence alone, with  little at-
     tention  to  its   being connected  or unconnected  with fever.

ferent constitutions ; but wc know nothing of the cause of this dif-
ference in either case.   And whilst, therefore, such differences con-
tinue,  and more especially whilst we are   thus ignorant of their
causes, it seems altogether superfluous, and would perhaps be in-
correct, to limit the definition of exanthemata by a character which,
in a considerable degree, eludes all inquiry, and which is perpetu-
ally shifting its form both in different  and even in the same species
of diseases, as influenced by different idiosyncrasies.
   In the  ordinal definition of exanthematica, therefore, the author
has found it  necessary  to deviate from Dr. Cullen,  as he himself
has deviated from it  in the list of his genera; and to fall back upon
the wider latitude of Sauvages, Linneus, and Sagar.   In Cullen, the
ordinal character runs thus:  " Morbi contagiosi;  scmel tantum in
decursu  vitae  aliquem afficientes; cum  febre incipientes; definito  *"
tempore   apparent  phlogoses,  saepe  plures,  exiguae,  per cutem
sparsae :" while the order itself is made up of diseases, to some of
which  the first feature does not apply, to others the second, to others
the third; and to many of them several of these features collectively.
The definition of Sauvages is as follows: " Eruptiones cutaneae cum
pyrexia,  saepius maligna, quandoque lenta:" of this the first half is
alone sufficient; the second being superfluous, and perhaps incor-
rect.  On this account the character of Linneus is an improvement,
" Febris  cum efflorescentiS. cutis maculata."   Here maculata might
conveniently be omitted;  it is not wanted,  and the feature is some-
times not found, as in those cases of scarlet fever in which the red-
ness constitutes a diffused and universal flush.   Sagar, however, has
copied it with a  very unnecessary addition of other symptoms, some
of which do not always exist, and the whole of them never collec-
tively ; " febris cum efflorescentia cutis varia, maculosa,  pustulosa,
phlyctcenoidta et asthenia."
   The author will  only add, that under the Linnean  school there
appears  to have been a strong  and general tendency to  ascribe all
kinds  of  contagion,  whether febrile or unfebrile, and indeed a  mul-
titude  of  other disorders,  to an animalcular origin : a  tendency de-
rived  partly from the  opinions of earlier  writers, and partly  from
the remarks of contemporaries.  One of the fullest articles upon this
subject occurs in the Amcmitates Academica, Vol. V. from the pen of
M. J. C. Nyander, to which, as well as to the general subject it em-
braces, the author has already adverted in the note on Helminthia,
Class I. Ord. II. The reader, who is desirous of unfolding this theory
further,may consult Plenciz,and particularly the preface to his works,
and the second volume of Schaeffer's  Versuche. But this is to take
too  narrow a view  of the  subject,  as well  as an erroneous  one.
Without  inquiring how far contagious miasms may be possessed of
   vol. v.—32 
163
NOSOLOGY.
[CL. HI.—OR. IH.
It  is in the  second and  more popular.of these  significations
that  Exanthematica is  employed as the name for the present
order.
                      GENUS  I.

               ENANTHESIS.

Eruption  of  red,  level,  or  nearly  level patches;  variously
 vitality, we see abundant proofs that they are equally derived from an
 animal, vegetable, and chemical source; or rather that they consist
 chiefly of animal and vegetable elements decomposed by putrefac-
 tion, or other cause of disintegration, and chemically recombined in
 a new and active mode ;  obtaining by such recombination a power
 of producing disease in some instances by contact, or close approxi-
 mation ; in others by infection, or through the medium of the at-
 mosphere.
   Gen. I. Enanthesis.  From ev, in, intra, and xvBeetfloreo ; " efflo-
 rescence from internal affection;" and hence opposed to exanthesis,
 {t%x<>6i)o°is,) which in the present system constitutes a genus under
 Class VI. Ord. III., and comprises such efflorescences as are merely
 superficial or cutaneous, and not necessarily  connected with inter-
 nal or constitutional affection.  Enanthesis is  here therefore used to
 express fever accompanied with rash ;  the word rash being employ-
 ed in the broader sense in which it is adopted by Dr. Willan, in his
 third order, compared with the explanation given in his fifth defini-
 tion ; as importing red, irregular, confluent patches, whether simple,
 as in the case  of scarlet fever, or compounded of papulae or of wheals,
 as in the case of measles and nettle-rash.
  This arrangement reduces the  genera of Sauvages and Cullen to
 species, and  their species to varieties.  In Macbride they  are al-
 ready reduced in  the same manner, as are the species in  Willan;
 who, indeed,  continues the term  genera, but incorrectly, as the link
 of species is wanting in his method ;  and who for the most part ex-
 pressly calls these subdivisions, varieties.
   1. Enanthesis Rosalia.   Sauvages and Cullen,  who has  copied
 Sauvages's definition, represent the efflorescence as not appearing
 till ihe fourth day after the attack : Dr. Willan, more correctly as it
 has corresponded with the author's own practice, affirms that it ap-
 pears " usually on the second day."
  The small-pox, measles, and scarlet-fever,  seem equally to have
 been  derived  from the east; and for the earliest descriptions  of
 them we must turn to the writers of the Saracenic schools, particu-
larly those of  Cordova.  It is singular, however, that as the meaj 
GE. I.]                    NOSOLOGY.                      163

     figured ; irregularly diffused ; often confluent; terminating  in
     cuticular exfoliations.
       Rash Exanthem.
1. rosalia.  Rash a scarlet flush, appearing about the second day
                 on the face, neck, or fauces ;  progressively spread-
                 ing  over  the body;  and terminating  about the
                 seventh day : fever a typhus.
sels were for a long period  confounded with the small-pox, so the
scarlet fever was, for an equal length of time, confounded with the
measles: and hence it is difficult in one instance, to determine  what
is the precise variety of disease referred to by Avicenna, Haly Ab-
bas, and Rhazes;  all seem occasionally to allude to the scarlet fever,
but we are  not sure that they mean it.
  It is on this account that the earliest names for these diseases are of
Saracenic, or rather of Cordovan origin, as variola, rubeola, or rather
rubiola, and rosalia.  Of these the first is derived, not  as is  usually
and most absurdly supposed, from the Latin varius, but either  from
the old Spanish, vario, " a pock or pimple,"  or from  the  Spanish
diminutive viruelas, importing small-pox at the present moment, and
evidently derived from the Latin virus, first  latinized into viruola,
and afterwards changed or corrupted to variola; in Italian vajuolo
in which the u is retained;  as though virus  was  the  radix.  The
second term is a direct diminutive from the Spanish rubio, " red, or
ruddy;" and was originally  written and pronounced rubiola,  though
long since  changed to rubeola, as more consistent with the Latin.
The third  is, in like manner,  a Spanish diminutive from rosal,  the
rose-tree, so denominated from the colour of the efflorescence.  This
term in  the south-east of Italy was soon afterwards exchanged for
rossalia, from rosso, " red or blushful;" and appears still later, pro-
bably in order more accurately to  distinguish the  peculiar tint of
the  red, to have yielded to scarlatina,  " scarlet  rash  or  scarlet
fever."  While as the two diseases of measles and scarlet fever, as
just observed, were for a long time confounded  with each other,
rosalia, rossalia, and rubeola, were used  indiscriminately for  both.
Morbilli or morbillo, in like manner a Spanish diminutive, has per-
haps been  the more common name  by which  measles have been
distinguished  till within the last half century; and hence this, also,
has been equally applied to scarlet fever, and down to as late a  pe-
riod ;  for,  even in our own  country,  we not  only  find the two dis-
eases, in many of its varieties, united  by Morton, but by Sir William
Watson   So rougeole, which, among the French writers, is the com-
mon  name for measles, imported also at one  time scarlet fever;
and this so generally, that when physicians became at length  sensi-
ble of the  difference between the two maladies, and it was necessa-
ry to establish distinct terms, we learn from Cheveneau, that among
the Marseillois rougeole was at first appropriated to the scarlet  fever,
while  the measles were denominated senepion.  " Vulgus Massiliae 
164                       NOSOLOGY.           [CL. 111.-OR. HI.
        Rosalia.   Auct. Hisp.
        Rossalia.   Ingrass et Auct. Neapol..
        Purpura.   Sckulz. Junck.
        Scarlatina.  Auct. Ital. et. Angl.
        Typhus scarlatinus.   Cricht.
        Febris rubra.   Heberd.  Comment.
        Scharlachaufschlag.   G.
        Fievre rouge.   Fievre scarlatine.   F.
        Scarlet fever.
          May possibly be alluded to by Avicenna,  as suggested by
        Dr. Willan under  the name of JtViemake, but the  descrip-
        tion is too short,  and  at the same time too loose to determine.
        Hemak is applied by the Arabic writers to red efflorescences
        generally,  whether papular or  pustular ; and  is hence ren-
        dered by Meninski, from Wankulus, " varioli, vel  exanthe-
        mata iis similia.  Hemak, in gardening, signifies  the beet-
        plant (beta vulgaris,) in  physiology, mental derangement;
        and the term  may, in the  present instance,  have been used
        by Avicenna, on account of the colour of the  eruption, or the
        violence of the attack, as producing delirium.

 distingun rubinlam a* morbillis; hos vocantes senepion et iliam rouge-
 ole, in qua non sunt pustusae, sed  magnae  tantum areae, in modum
 erysipeiatis rubentes."   Obs. Med. p. 454.
   It is said by some that scarlatina was first  employed  by  English
 writers as a name for  scarlet fever: but this  can only mean that  it
 was first employed technically or generically ; for the  word, which
 is an Italian diminutive, reached us, like influenza, from  the Levant,
 where it was in vulgar use as a synonym of rosalia and rossalia long
 before it found its way into English nosology.  It is a term, how-
 ever, so barbarous and unallied to  both  Greek and Latin, as well in
 its origin as in its termination, that no good writer  of any  country
 has ever been able  to tolerate it; and it is matter of no  small won-
 der that it should hitherto never  have  given way to  the  original
 name of rosalia, of genuine Latin derivation, and with a more classic
 close.
   Morton had so mortal an aversion to the term, that  he preferred
 the error of blending scarlet  fever with measles, and of arranging
 the varieties of the two  diseases under the common generic name
 of morbilli, to employing scarlatina.   De  Haen appears  to have
 had nearly as great a dislike to it:  " Nomina morbii," says  he, " va-
 ria, erronea saepe, ineptaquc,  quibus eum medici  quondam appella-
 runt, laudatis in scriptoribus  invenire est, Scarlatina  nomine, barba-
ro satis, a colore panni vulgo sic appellati, mutuato, civitateque, ut
videtur, in arte donato."  Med. Contin. torn. i. cap. vii.  Dr. Hux-
ham for a long time eluded the term by using febris miliaria rubra, 
GE. 1.]
NOSOLOGY.
1G5
    *  Simplex.  Fever moderate, and terminating with the rash :
         little  prostration of strength ; slightly contagious.
       Scarlatina simplex.   Cull.  Willan.
       Scarlatina febris.   Sauv. Sydenh.
       Scarlatina benigna.   Macbr.
     G  Paristhmitica.   Fever severe ; throat ulcerated ; rash  later
         in its appearance and less extensive ; often changing to a
         livid  hue ; highly contagious.
       Scarlatina anginosa.  Sauv.  Withering.  Willan.
       Scarlatina cynanchica.   Cull.
       Scarlatina maligna.  Macbr.
         The s. maligna of Willan is perhaps the same variety in
       its worst degree ;  and is hence  included in it  by the  other
       nosologists quoted above.
2. rubeola.   Rash in  crimson, stigmatised dots, grouped in irre-
                gular circles  or  crescents;  appearing about the
                fourth day, and  terminating  about  the  seventh ;
                preceded by catarrh , fever a cauma.
       Rubeola.  Auct- Hisp.  Sauv. Sag.  Cull.
       Morbilli.  Sydenh. Morton. Junck. Macbr.
       Febris Morbillosa.   Hoffm.
       Typhus morbillosus.   Cricht.
       Phcenicismus.  Plouquet.
       Hasbet. Avicenn.  From (hash) " erumpere."  The Turk-
          ish  writers call it  kyzamak,  and  the Persian serukje,
          literally rubor.
       Kindsflecken.   G.
       Rougeole.   F.
       Measles.
       x Vulgaris.   Rash  slightly  prominent,  extending over  the
            mouth and fauces;  harsh, dry cough ; inflamed, watery
            eyes.  Occurring once only  in  the  course of a  man's
            life :  contagious.

or maligna, for some of  the varieties of scarlet-fever, and febris an-
ginosa miliaris  for others ; and Dr. Heberden  has still more  lately
employed febris rubra.  Willan continues  scarlatina,  but thinks it
necessary  to apologize  for  its continuance.   " The  denomination
scarlatina," says he,  " was first applied to this  disease by British
writers: however offensive the term may be to a classical  car it
cannot well be displaced,  having  found admission into all the sys-
tems of nosology.   Another age  will correct and refine the lan-
guage now used in  subjects untouched  by the fathers of physic."
Whether that  age  have yet arrived remains to be proved ;  but the
present  work shall not be without an attempt, however feeble, to 
166
NOSOLOGY.
[CL. HI.—OR. HI
        Rubeola vulgaris.  Sauv.  Cull.  Will.
        Morbilli regulares.   Sydenh.
          See Rhazes ad Almans. torn. v. cap. 28.
     G  Spuria.   The rash running  its regular course with  little
          fever or catarrhal  affection ;  affording no certain security
          against the common or regular disease.
        Rubeola sine catarrho.   Will.
     y  Nigra.   The rash about the seventh or eighth day  assuming
          suddenly a black or livid hue, interspersed with yellow ;
          prolonged in its slay ; and accompanied with  increased
          languor and quickness of pulse.
        Rubeola nigra.   Willan.
          " There  is  no  sufficient ground  or authority  for  the
        distinction  of  rubeola  variolodes  made  by  Sauvages."
        Willan.
3. urticaria.   Rash in florid, itching, nettle-sting  wheals;  ap-
                    pearing  about the second day; irregularly fad-
                    ing  and reviving, or wandering from part to
                    part:  fever a mild epanetus.
        Urticaria.   Cull. Willan.
        Uredo.   Linn.
        Scarlatina urticata.   Sauv.
        Febris urticata.   Vog.
        Purpura urticata.  Junck.
        Benat-allil (Arab.), literally " Offspring or daughters of the
          night."

hasten its appearance.  And on  this ground,  and not from  any love
of change for the sake of change alone, the  author ventures to re-
vive the more ancient and elegant  name of rosalia at  the  expense
of a term which, though in common use, is in common disappro-
bation.
   1  G.  E. Rosalia  Paristhmitica.   The  term paristhmitica is here
preferred to anginosa and eynanchica, for the reason that paristhmi-
tis is preferred to angina and cynanche in the preceding order, Gen.
VII. Spec. 4. to the note on which the reader may turn.
  2  Enanthesis  Rubiola.  Originally, as already observed, written
rubiola,  a Spanish diminutive from rubio, " red;" and afterwards
latinized to rebeola, as though derived from " rubeo, rubeus, ruber."
See  the note on Rosalia.
  2. y E. Rubeola Nigra.  Cullen, probably from complaisance, has
copied rubeola  variolodes into his list,  but with a doubt of its cor-
rectness.  It is singular, however, that he should add that this promi-
nent or  papulated variety is called in Scotland " the nirles :" a term
which, according to Willan, is also  applied both in Scotland and the 
ge. n.]                    nosology.
Brennesselausschlag.   G.
Fievre ortie'e.  De Meyzerey. Malad. des Arm
Nettle-rash.
                       GENUS  II.

                    EMPHLYSIS.

     Eruption of vesicular pimples filled progressively with an acrid
       and colourless, or nearly colourless fluid ;  terminating in
       scurf or  laminated scabs.
       Ichorous Exanthem.
1.  miliaria.   Vesicles scattered  over the body; of the  size of
                millet-seeds ;  transparent red;  afterwards milky :
                preceded by a pricking sensation, sighing, anxiety,
                and sour sweat.
       Miliaria.  Linn.  Cull.
border counties of England to herpes miliaris.   See Will. Rubeol.
p. 238 : Perhaps rather to h. exedens.
  Gen. II. Emphlysis. From tpc, pro, e»," in, intra," and (p^vrts, " a
vesicular tumour or eruption."  EkQXvu is usually employed among
Greek writers nearly  in the  same sense as QXvh ;  in  the present
system it will be found employed somewhat more strictly, and in
opposition to t^Xvu;  so  that, while emphlysis, from the latter,
imports an eruption of vesicles, whether large or small, produced
by, or accompanied with,  internal and febrile affection essentially
connected with it; ecphlysis,  from the former, imports  an eruption
of vesicles simply cutaneous or superficial:  or if, in  a few varieties
combined with internal affection, not necessarily or essentially asso-
ciated.  See, for the use of ecphlysis, the note on Cl. VI. Ord. III.
   1. Emphlysis Miliaria.  This species, from  the minuteness of its
vesicles, treads  close  upon  the general  complexion of the genus
enanthesis, and during its red appearance is often called  a rash.   By
Linneus and Parr (art. Nosol.) it is hence defined nearly in the same
terms as  rubeola, so far as relates to the eruption ;  and at Leipsic
in 1650, where it is said to  have been contagious or epidemic, was
unquestionably mistaken for rosalia or scarlet fever.  Schacher, de
Febre acuta exanthematica. Lips. 1723, in Haller. Disp. Med. torn.
v. sect. 175. Welsch, Hist. Med. in Hall. torn. v. sect. 174.  It is not
often, however, communicable; and  in  the  present  day is seldom
found in  any  form, except as a symptom of some  other  disease: 
1G8
nosology.
[CL.HI.—OR. UT.
       Miliaris.   Sauv. Sag.
       Febris miliaris.   Vog.  Webster.
       Exanthema miliaria.  Parr.
       Synochus miliaria.   Young.
       Purpura.   Hoffman. Allion. Tract.
       Friselblattern.   G.
       Miliaire.  Millot.   F.
       Miliary fever.
         The two varieties, as they have been often called, of m.
       rubra  and  m.  alba, seem to be only different stages of the
       disease. The vesicles are at firsl red from the colour of their
       under surface  or inflamed  base, being transmitted  through
       the  transparent pellicle ;  they are  afterwards opake and
       milky from  absorption  of  the more attenuate  part  of the
       fluid or from some other change.
         Found, occasionally, as  a symptom in fevers of different
       descriptions, both inflammatory and putrescent;  chiefly in
       typhus puerperarum.
2. aphtha.   Vesicles granular, roundish, pearl-coloured ; confined
               to the lips, mouth, and intestinal canal ;  terminat-
               ing in curd-like sloughs ; occasionally with succes-
               sive crops.
       Aphtha.   Sauv. Linn.  Sag.  Boerh. Cull.
       Febris aphthosa.   Vog.
       Pemphingodes.  Gal. Finit. Med.
       Pustulae oris.  Haly Abbas.
       Typhus aphthoideus.   Young.
       Mundschwamchen.   G.
       Aphthes.   F.
       Thrush.
though  the author has at this moment a clear and well-marked in-
stance of it, as an idiopathic affection, in a young gentleman of thir-
teen years of age.  The vesicles are very numerous, though dis-
tinct : they were at first red, and are now milky white: the fever
has been considerable.  The disease takes its  name  from milia,
" millet-grains,"  from the  resemblance of its vesicles to the seeds
of this plant in size, and, when matured, in colour.   The eruption
appears  at an  uncertain period after the  introductory fever has
commenced.   Darwin II. i. 3.  12, mentions a variety of  this disease
" produced by  the warmth, and  more particularly by the stimulus
of the points of the  wool in flannel or blankets applied  to the skin,
which by cool dress, and  bed-clothes  without  flannel, has  soon 
GE. II.]
NOSOLOGY.
169
     * Infantum.   Appearing  in infants  soon  after birth;  and
          often extending from  the mouth to the intestinal  canal;
          mostly with  slight  febrile  symptoms,  and white sloughs.
       Aphtha infantum.   Cull.
       Aphtha lactucimen.   Sauv.
       White-Thrush.   Sometimes  contagious.   See  Raulin Von
          Erkaltung der Kinder.
     G Maligna.  Accompanied with great debility of vascular ac-
          tion ; usually ascending from the pharynx into the mouth ;
          sloughs black ;  fever a typhus.
       Aphtha maligna.   Sauv.
       Black-Thrush.
          Found frequently in old age ; and, as  a symptom,  in  low
       fevers and cachexies.
S. vaccinia.   Vesicles few  or a single one ; confined to the part
                affected ; circular,  semitransparent, pearl-colour-
                ed ; depressed in the middle;  surrounded  with a
                red areola.
     x Nativa.  Vesicles on  the hands, or such  parts as have been
          in contact with the  affected udder of a cow ; of a  bluish
          tint ; the  fluid  at  first limpid ;  afterwards opake,  and
          purulent; often with  enlargement of the  axillary  glands,
          and  considerable fever.
       Natural Cow-pox.
            A prophylactic against the small-pox.
     G Spuria.  Vesicles less  uniformly  circular;  purulent from
          the first;  without bluish  tint;  with little or no  central
          depression.
       Spurious Cow-pox.  Jenner.
          Affords  no security  against the small-pox.
ceased;"  to which he gives the name of miliaria  sudatoria.   It is
perhaps rather a variety of intertrigo.
  2. Emphlysis Aphtha. 'AQdxt :  from avru, " accendo." This erup-
tion, like  the  preceding,  is now generally admitted to consist of
minute vesicles containing a whitish or milky fluid when  matured.
Hence Sauvages describes the disease  as  " eruptio phlyctanarum,
interiorum oris  superficiem occupantium ;" adding, that like the
last species, the efflorescence  bears a resemblance to  millet-seeds
—;' elevatio epithelidis instar grani  milii."  In like manner Sagar:
" cognoscitur aphtha phlycthtxnis linguae, faucium, oris superficium
occupantium."  To which he adds,  that in its third or mature stage,
" elevantur  papulae seu maculae in phlycthanas miliares, qua  pro-
  vol. v.—33 
170
NOSOLOGY.
[cl. ra.—or. in.
     y Inserta.  Produced  by  inoculation;  vesicle  single, con-
         fined to  the puncture ;  cellulose ;  bluish-brown  in the
         middle ;   fluid clear and  colourless to the last;  con-
         creting into a hard, dark-coloured scab  after the twelfth
         day.
       Variola vaccina.  Jenner.
       Vaccina.   Willan, et Aut. Var.
       Exanthema Vaccina.   Parr.
       Synocha Vaccini.   Young.
       Inoculated Cow-pox.
     } Degener.   Produced  by  inoculation ;  vesicle  amorphous,
         or uncertain ;  fluid often straw-coloured, or purulent;
         areola absent, indistinct,  or confused with  the  vesicle :
         scab formed prematurely.
       Degenerate Cow-pox.   Blane.   " Evidence before the House
         of Commons."
         Affords little or no security against the small-pox.
4. varicella.  Vesicles   scattered   over  the  body ;  glabrous;
                   transparent ; pea-sized ; in successive  crops ;
                   pellicle thin ; about  the  third  day  from their
                   appearance, bursting  at the tip,  and  concreting
                   into small puckered  scabs,   rarely leaving  a
                   cicatrix.
       Varicella.   Cull. Plenck. Heberden.
       Exanthema Varicella.   Parr.
       Synochus Varicella.  Young.
       Unachten kindspocken.   G.
       Verole volante.  jF.
       Chicken-pox.
       x Lentifbrmis.  Irregularly circular ; flattened at the top ;
            fluid at the first, whitish,  afterwards straw-coloured.
         Lenticular Chicken-pox.   Willan.
babiliter sunt eadem cum miliaribus cutis ;"—" the papulae or specks
are raised into miliary vesicles, and are probably the same  as in the
miliary eruption of the  skin."  These observations are sufficient to
indicate not only under what genus  aphtha should  be placed,  but
its particular station in  the arrangement of the specific scries;  and
that it should immediately follow miliaria, with which,  for reasons
already offered, the genus ought  to open.
  4. Emphlysis  Varicella.  Varicella, like variola, is of Spanish  ori-
gin ;  and derived from the  Saracen writers  of Cordova, variz, a
superficial or cutaneous tumour,  producing as its  diminutive, vari- 
GE. II.]
NOSOLOGY.
171
       Common Chicken-pox.
    £ Coniformis. Vesicles acuminated:  fluid pellucid through-
         out.
       Conoidal Chicken-pox.   Willan.
       Pemphigus  variolodes.   Frank.
       Variola lymphatica.   Sauv.
       Hydrachnis.  Cusson.
       Verolette.   F.
       Ravaglio.   Ital.
       Swine-pox.   Water-pox.
    y  Globularis.   Vesicles globular and  larger ; fluid  at  first
         whey-coloured, afterwards yellowish.
       Hives.                                        £
         The varieties are  sometimes intermixed ; and the fluid
       in a few of them occasionally approaches  to  a purulent
      appearance  : whence in various instances they,have been
       mistaken for the  small-pox.
pemphigus.  Vesicles   scattered over the  body ; transparent;
                filbert-sized ;  with a red, inflamed  edge, but
                without surrounding blush or tumefaction ; on
                breaking disposed to ulcerate  :  fluid pellucid
                or slightly covered :  fever a typhus.
    Pemphigus.    Sauv. Sag.  Cull. Macbr.
    Morta.  Linn.
    Febris bullosa.  Vog.  Selliger.
    Typhus vesicularis.  Young.
    Blasenausschlag.   G.
    Fievre vesiculaire.  F.
     Vesicular fever.  Bladdery fever.
    a  Vulgaris.   Vesicles   appearing  on the  second or third
         day, occasionally  not till  the  fifth  or sixth ;  in  suc-
         cessive  crops; often  extending  over  the  mouth and
zella, easily latinized into varicella: the Latin radical of both being
perhaps varus, or pimple.
  5. Emphlysis Pemphigus.  Fromxejtt^ig(pemphix) "flatus,bulla;"
and hence inflation, bladder, bubble.  The idea of flatulence, how-
ever, is  seldom connected  with  this disease  in modern medicine,
though very generally in ancient.  The term, in the sense in which
it is now  generally understood,  was  perhaps  first  employed by
Sauvages ; and has since passed into common use.  It is still doubted
by many whether pemphigus is entitled to be considered as a  dis-
tinct and idiopathic disease; and  whether all its varieties and modi-
fications  may  not resolve themselves  into certain  peculiarities of 
172
NOSOLOGY.
[CL. HI.—OU. III.
            intestinal canal; fluid, on  bursting, yellowish ; some
            of the vesicles livid, with a livid base.
          Pemphigus major.   Sauv,
          Pemphigus vulgaris.   Willan.
          Febris vesicularis catarrhalis.   Delii.
        G Glandularis.  Preceded by  tumefaction of the neck and
            throat:  vesicles chiefly seated on the fauces and con-
            globate   glands:  occasionally producing  abscesses :
            highly contagious.
          Pemphigus Helveticus.   Sauv.
          Pemphigus contagiosus.   Willan.
        v Infantum.  Vesicles irregularly oblong, with  livid edge,
        •   and  commonly flattened  tops ; appearing successively
            on different parts of the surface, in infants a few days
            after birth : fluid ; on breaking purplish.
          Pemphigus infantilis.   Willan.
            Found also, occasionally,  as a symptom in one or other
          of its varieties,  in erysipelas, typhus,  plague,  and other
          depressing fevers.
6. erysipelas.   Vesication diffuse;  irregularly circumscribed ;
                   appearing  on  a particular part  of  the  body,
                   chiefly the face, about the third  dry ;  with tu-
                   mefaction  and  erythematic  blush ; fever usu-
                   ally accompanied  with  sleepiness, often with
                   delirium.
erysipelas, or pompholyx, the latter of which consists of similar
vesicles  or bullae without fever,  or mere  symptoms of typhus or
plague.  Dr. Cullen seems to have  been of the last opinion at the
moment of drawing up his definition : but the fourth edition of his
synopsis contains a  subjoined note which intimates that his opinion
was altered in consequence  of his having seen  a patient,  shown
him by his excellent colleague F. Home,  and who  was labouring
unuer this disease as an idiopathic affection at the time.  And when
to this instance we add  the  authority, not merely of the earlier
writers, Bontius, Seliger,  and Langhans, but of Withers,  Dickson,
Christie, Ring, and  Braune (Uber den Pemphigus, Leips,  1795,) it
would  be unpardonable not to allow it a distinct place in a general
system of nosology.
  The varieties run parallel with those of  Dr. Willan, though not
exactly taken from  him.
  6. Emphlysis  Erysipelas.   For the distinguishing  characters of
erysipelas and erythema, see the note on Erythema.  Sauvages has
made shingles (herpes  Zoster) a species of  erysipelas, which in his 
GE.IIJ                    NOSOLOGY.                       173

       Erysipelas.   Sauv. Lim. Sag.  Cull.
       Febris erysipelatosa.  Sydenh. Macbr.
       Febris erysipelacea.   Hoffm. Vog.
       Hemret {Arab.), literally rubedo.
       Rothlauf.  G.
       Erysipele.   Feu de St. Antoine.   F.
       Erysipelas.   St. Anthonys Fire.
       x Locale.  Limited to a particular part;  the cuticle raised
            into numerous  aggregate distinct cells;  or the  cells
            running into one or more blebs or large blisters.
       G Erraticum.   Travelling  in successive  patches  from part
            to part;  the  former  patches declining  as  new  ones
            make  their appearance.
                  GENUS III.

                EMPYESIS.

Eruption of phlegmonous pimples ;  gradually filling with  a
  purulent fluid; and  terminating in thick scabs, frequently
  leaving pits or scars.
  Pustulous Exanthem.
nosology is a genus; and Dr. Cullen has followed his steps.  This
is  erroneous ; shingles  is a mere variety  of  herpes, a cutaneous
affection, unaccompanied with fever as a necessary symptom, and
consequently not an exanthem.  Its proper place is in Class VI.
Order III.
  The grammarians have usually derived igvrtTetes from, tgvu, " to
attract," and tcXxs,  " vicinity."   " The neighbouring parts," says
Dr. Turton, in  his useful Glossary,  " being affected by this  erup-
tion."   The author cannot avoid thinking that the name is derived
from  the colour; and that tgtvSos, rubor, whence fgwiGy, rubigo, is
the radical of the first part of the compound term rather than tgvet.
Egve-t-irtXxs, thus derived, will import, not an "attraction of redness,"
but a " neighbourhood  of redness," which is the most prominent
feature of the disease.
   Gen. III. Empyesis. Epvxvwts, " suppuratio," Hippocr. Aph. I. v.
from  tpuxvou, or tpvxveu, " suppuro."  The  Greek  writers also use,
and  perhaps more  generally,  ecpyesis  {stcnvtiris,) from  txirvou, of
similar meaning.  The  same distinction between the terms is made 
174
NOSOLOGY.           [CL. IU.—OR. HI.
1. variola.  Pustules appearing from the third to the fifth  day—
                 suppurating from  the eighth to the tenth : fever a
                 cauma: contagious.
       Variola.   Haly Abbas, et Auct. Neoter.
       Euphlogia.   Rhazes.
       Jedrie.   Arab.
       Kindspocken.  G.
       Petit verole.   F.
       Small-pox.
       x Discreta.   Pustules pea-sized ; distinct, distended,  circu-
           lar ;  the  intervening  spaces  red ; the fever ceasing
           when the eruption is complete.
         Variola discreta.   Cull.
         Variola discreta benigna.   Sauv.
         Variola? regulares discretae. Sydenh.
 in the present case as between emphlysis and ecphlysis: the former
 being limited to signify pustular eruptions produced by internal and
 febrile affection,  and the latter to signify those  that are  merely
 cutaneous or superficial, or with which internal affection is not neces-
 sarily associated.
   1.  Empyesis Variola.   The definition of this  disease in Linneus,
 Sauvages, and most of the earlier nosologists, contains an inelegant
 pleonasm  from the  very  loose sense which was formerly attached
 to the word pustula.  A pustule is, strictly speaking, a cuticular
 elevation or utricle containing a small  collection of pus :  but the
 term has, by most  of the earlier nosologists,  been  applied indis-
 criminately to cuticular  utricles that contain a fluid of any  kind,
 whether  opake or  transparent,  purulent  or ichorous, broken, or
 having a tendency to break at their tip; in the  definitive explana-
 tion of Sauvages, I. p. 96, « phyma parvulum apice  ruptum."  In
 like manner, in the present day, we are  constantly meeting with
 medical writers of high and deserved character, who,  still applying
 to the word the same indeterminate idea, use  the  phrase  vaccine
pustule for that of vaccine lymph, ichor, or, if its transparent cuticle
 be imported, vesicle.  It  is hence  Linneus defines variola  to con-
 sist of "pustulae suppurantes, escharoticae, &c."  Sauvages calls it
 "genus phlegmatiae exanthematicae cujus eruptio in pustulis phleg-
 monodeis,  ad suppurationem tendentious, consistit;" while Sagar
 copies the very words of Linneus as a part of his fuller description.
 —Among the Romans, pustula was used in a still wider and more
 indeterminate sense, for  Celsus  applies it to  rashes, to wheals, to
 vari or solid pimples, to  phlyctaenae or vesicular pimples, and to
 almost every kind of eruption or cutaneous  elevation of whatever
 nature or colour.  See lib. v. cap. xxviii. § 15.   And hence pustula 
GE. III.]
NOSOLOGY.
175
  Distinct Small-pox.
G Confluens.  Pustules confluent,  flaccid,  irregularly cir-
     cumscribed ;  the  intervening spaces  pale; with great
     debility.
  Variola confluens.   Cull. Sauv.
  Variola? regulares confluentes.   Sydenh.
  Confluent Small-pox.
y Inserta.  Produced  by inoculation ;  orange-coloured
     areola  about  the  puncture ; pain in  the  axilla about
     the seventh day; disease for the most part mild ; and
     the purulent discharge sometimes confined  to the punc-
     tured part.
  Inoculated Small-pox.
^ Degener.  Pimples  imperfectly suppurating ; ichorous or
     horny, and semi-transparent.
is, by Sauvages and Vogel, equally employed in their definitions of
variola and miliaria, and by the latter in that of varicella.
   For the origin of the term  Variola, see the note on Rosalia.
   It was the opinion of  Mr. J. Hunter, that when  variolous matter
is inserted into a wound, as in  the case  of inoculation, all that  it
does is to stimulate the  surrounding parts to secrete a fluid similar
to itself,  which being absorbed, infects the constitution:—so that
the patient really receives the disease  from variolous matter gene-
rated in his own body.   In consequence of which, while he allows
the inflammatory action hereby produced to be  specific, he doubts
whether  it be  critical, and extends the  same doubt  to the inflamma-
tions that take place in the chicken-pox and measles.   On Blood, p.
257.  This reasoning,  however, will  scarcely  apply  to  cases  of
natural small-pox;  for it is  here  impossible to point out any one
organ in which the  inhaled contagion is  lodged, and stimulates to
suppuration, before the  general fever makes its appearance.  And
hence Mr. Cruickshank, who quotes Mr. Hunter's opinion apparent-
ly with  approbation, feels compelled  soon afterwards to fall back
into the more  vulgar belief that the inoculating matter of smalUpox
continues dormant for  many days in the  part affected, and is then
absorbed ;  instead  of instantly commencing a  local  stimulus, and
afterwards propagating its own kind.  " Tne matter of the inocu-
lated small-pox seems to lie in the pustula  till the seventh day ; after
which, the glands in the axilla swell (the mark of absorption,) and by
the time the matter  may be supposed  to reach the heart, the erup-
tive fever commences."   Anat. of Absorb. Vess. p. 120, 125.
   For an account of the high antiquity and practice of inoculation
in India, see Mr. Schoolbred's  Dissertation " On Vaccine  Inocula-
tion," p. 69, and following. 
NOSOLOGY
[CL. EL—OR. Ill
Variola discreta siliquosa.  Mead, " Discourse  of  the
  Small-Pox."
Variola confluens crystallina.   Sauv.
Horn-pock.   Crystalline-pock.
                    GENUS  IV.

                 ANTHRACIA.

Eruption of  tumours imperfectly  suppurating, with  indurated
   Gen. IV. Anthracia.   There have long been, and still continue
 to be, great disputes among the nosologists as to the proper station
 of both the species the author has ventured to arrange under this
 generic term; many contending that plague ought not to be regard-
 ed as an exanthem, and most writers having hitherto contemplated
 yaws as an impetigo, or some other dysthectic affection.   Dr. Cul-
 len, as already observed in the note on Exanthemata, expresses a
 doubt whether the  first should not be  removed  from the order of
 exanthems into that of fevers :  Vogel  has introduced it into this
 order; Willan has rejected it: Parr arranges  it as an exanthem in
 his article Nosology, having previously,  like Willan, rejected it from
 that division in his article Cutanei Morbi. In his remarks subjoined
 to the article Nosology, he again acknowledges that " on reflection
 it appears  improper" to  introduce it  into the list of exanthems:
 and in his article Pestis, he asserts more roundly, that " there is no
 foundation  for arranging  plague  amongst the  exanthemata, and
 [that] it should be reduced to the asthenic remittents."  Sauvages,
 Linneus, Sagar, and Macbride, have entered it in the order in which
 it stands in the present work.
  In few words there appears strong  and almost incontrovertible
 reason for thus placing it.   The fever is specific, like that of all the
 exanthems ; it is contagious, like that of most of them; and although
 capable of occurring oftener than once  in a man's life, we have the
 concurrent testimony of all the  writers who have been  eye wit-
nesses of its effects, that it renders him less susceptible for a consi-
derable period afterwards. The eruption of buboes or carbuncles
is unquestionably a pathognomic symptom : the fluid they  secrete is
capable of producing  the disease  by inoculation; for the  most
 part the earlier they make their appearance  the better;  and it is
the opinion of M. Sotira,  and of most of the French medical staff
appointed to the Egyptian expedition, that, provided the bubo freely
suppurates, the patient receives an indemnity for life.  It is  true, 
GE. IV.J                   NOSOLOGY.                      177

       edges,  and for the most part a sordid and sanious  core.
       Carbuncular Exanthem.
indeed, that these tumours do not always appear in their proper or
perfect  character ; for sometimes the patient is  destroyed by the
violence of the first symptoms; and in other instances, as in small-
pox, the specific fever passes through its course with an imperfect
or trivial fructification;  but unless there be an actual germination,
or what Sauvages calls  a conatus, a  perfect or an imperfect epan-
thesis, we have no right  whatever to call the disease a' plague, and
can only regard it as a species or variety of synochus, or typhus.
  The buboes or carbuncles, jimmerat, are sometimes formed with
the first shock, or m'drop, as the Arabians call it; and, in this  case,
with a feeling of being pierced with a sharp needle, javelin, or  mus-
ket ball (lor it is differently described) in the affected thigh or arm ;
the tumour appearing within a few hours, and  enlarging, with ex-
cruciating pain for three or four days, till it often acquires, before
breaking, the size of a small orange.   Camphor,  smoking tobacco,
fumigation with gum sandrac, and the vinegar of the four thieves,
are chiefly employed as  preventives; and the principal remedies in
the present day appear to be sudorifics at the commencement of
the disease, and the bark in liberal  doses shortly afterwards.  A
very favourite remedy in Egypt, at Constantinople, and Mogodore,
is a general inunction of the body with xeit jagghy, or oil of olives,
which appears to have been first recommended by Mr. Baldwin of
Cairo, from his observing  that while the plague was ravaging all
Egypt, the dealers in  oil escaped its attack.  The coarser and  more
acrid the  oil the better.   The  application  should be accompanied
with a lon«$ continued friction, and, when successful, is followed in
about half an hour or an hour by a general and profuse perspiration
which affords relief.  The oil obstructs the pores of the skin, and
prevents the escape of the caloric, which, aided by the friction, ac-
cumulates on the surface, and  shortens or altogether prevents  the
shivering fi% which  is otherwise often very severe.   Probably  the
use of  volatile  liniment, and especially  combined with laudanum,
might be more serviceable.  During the fatal  plague which  depo-
pulated the whole of Western Barbary in 1799,  the emperor Sidi
Soloman is said to have had the disease twice, and in both cases to
have derived his cure from  a free use of the bark;  in consequence
of  which  he is never without a large supply of it.
   The  Barbary plague  of  1799 and 1800 is one  of the severest on
record.  Mr. Jackson, to whom we  are indebted for an " Account
of the Empire of Morocco," was an eye-witness to its progress; and
as  he has described it with considerable detail, and a variety of in-
dividual cases, the" author will enrich this note by a few of the more
interesting facts which  he  has communicated.
   " The symptoms of this  plague varied in different patients: the
   vol.  v.—34 
178                      NOSOLOGY.           [CL. HI.-OR. IH.

1. pestis.   Tumours bubonous, carbunculate or both; appearing
              at an  uncertain time of the disease: fever a malig-
              nant typhus, with extreme heat and debility; conta-
              gious.
       Loemus, {Aotpcos.)   Thucyd. et Auct. Grozc.
       Pestis.  Auct. Lat. et Neoter.
       Pestilentia.   Schreiber.
       Febris Pestilens.  Hoffm.
       Typhus Pestis.   Young.
       Exanthema Pestis.  Parr.  Art. Nosol.
       Vebau {Arab.), vulgarly Alamer, " the mandate, decree, or
            fate."
       Pest.   G.
       Peste.  F.
variety of age and constitution gave it a like variety of appearance
and character.  In some it manifested itself by a sudden and violent
shivering, in  others by a sudden delirium, succeeded  by  great and
unquenchable thirst.   Cold water was eagerly resorted to by the un-
wary and imprudent, and proved fatal to those  who indulged in its
momentary relief.  Some had one, two, or more buboes, which form-
ed themselves, and became often as large as a walnut in the course
of a day ; others had a similar number of carbuncles; others  had
both buboes and carbuncles, which generally appeared in the groin,
under the arm, or near the breast.  Those who were affected with
a shivering, having no bubo, carbuncle, spots (vibices,) or  any other
disfiguration, were invariably carried off in less  than twenty-four
hours; and the body of the deceased became quickly putrified, so
that it was indispensably necessary to  bury it in a few hours after dis-
solution.   The European merchants shut themselves up in their re-
spective houses, as is the practice in the Levant: I did not take this
precaution, but occasionally rode out to take exercise on horseback.
My daily observations convinced me that the epidemy was not caught
by approach,  unless that approach was accompanied by an inhaling
of the breath, or by touching the infected person."
  Yet the general atmosphere appears to have had an influence over
fresh  persons; for we are told that " families which had  retired to
the country to avoid the infection, on  returning to town, when all in-
fection had apparently ceased, were generally  attacked and died."
And what is more singular, persons who had escaped after having
resided  in one infected town, were still subject to the atmospheric
influence of another infected town.  " After the mortality had sub-
sided at Mogodore, a corps of troops arrived from the city of Tero-
dant, in the province of Suse, where the plague had been raging, and
had subsided: these troops, after remaining three days at Mogodore,
were attacked with the disease, and it raged exclusively among them 
GE. IV.]
NOSOLOGY.
179
x Fructifera.  The disease extending to about the fourteenth
    day; and relieved by the appearance of the eruption.
  Pestis vulgaris.  Sauv.
G Infructifera.  The eruption imperfect or suppressed; trans-
    ferred to some internal organ; or superseded externally by
    stigmata and vibices.
  Pestis interna.   Sauv.
  Pestis sporadica.   Sydenh. Sauv.
y Erythematica.  The  body covered over with trails of ve-
    sicular erythema, producing sleep, sanious and gangren-
    ous ulcerations as it spreads, often to the  loss of one or
    more limbs.
for about a month, though they were not confined to any particular
quarter, many of them having had apartments in the houses of the
inhabitants of the town."
  As in the plague at Athens, "the mortality was so great that the
living, not having time to bury the dead, the bodies were deposited
or thrown together, into large holes, which, when nearly full, were
covered over with earth.   Young, healthy, and robust persons, with
strong stamina, were for the most part attacked first, then  women
and  children, and lastly, thin, sickly, emaciated, and  old people."
The depressing passions of fear  and grief had also a strong pre-
disposing effect.  The  remedies were those already described.
A few suffered twice.  Morocco  lost a thousand upon an average
daily, when the infection was at its height; Old and New Fez from
twelve to fifteen hundred; Terodant about eight hundred.  The
total  loss  sustained  in these three  cities and  in  Mogodore were
estimated at one hundred  and twenty-four thousand, five hundred
souls.
   See also memoirs Medicales de l'Arm6e de l'Orient par Bruant:
Mem. sur l'Egypte, torn. iv. Samoilowitz sur  la  Peste en  Russie,
1771.  Assalini's Observations, &c.; and compare with Waldschmidt
De Peste Holsatica,  apud Halleri  Diss, pract. torn.  v. Unterricht
vors Volk gegen die Pest. Dantzig, 1770. Prosper. Alpin. de Med.
JEgypt, lib. i. M'Gregor's « Medical Sketches," written during the
passage  of the English army from  India to Egypt.  The views of
this last writer are in direct opposition to those of M. Assalini, and
in many respects concur with those of Mr. Jackson.
   \.y A. Pestis Erythematica.   For the best description of this
variety of pestis we must turn to  the pages of Thucydides,  who de-
scribes it from having been an eye-witness of its ravages, and a suf-
ferer under them ; or to those of  Lucretius, who has  copied the ac-
count with close and technical punctuality.  The following passage 
180                      NOSOLOGY.           [CL. HI.—OR. III.

       Pestis Atheniensis.   Thucyd. Lucret.
       Erysipelas pestilens.  Sauv.
       Erysipelas gangraenosum.   Will.
       Ignis sacer.  Auct. Var. but erroneously; this, which is the
           erythema vesiculare, being only a symptom.  See Ery-
           thema vesiculare.
       Mai des ardens.  F.
         See Tissofs account and all the authorities compared, in
       his letter to Sir  George Baker.   Phil. Trans, vol. Iv. year
       1765; as also Mem. de la  Societe. R. de Med. 1776.  Tis-
       sot ascribes it, in  many extensive epidemics, to the use of
       rye vitiated by a fungus somewhat of the nature of ustilago,
       or black mildew:  called by the French ergot, whence this
       disease, as also a peculiar gangrene, to which it is likewise,
       under other circumstances, said to give rise, is called Ergot
       by the French.  Tissot describes both.  See  also Sauv.  CL
       III. Erysipelas pestilens.
from the latter may serve to illustrate  this remark, De Rer. Nat.
lib. vi.  1152.
       Spiritus ore foras tetrum volvebat odorem,
       Rancida quo perolent projecta cadavera ritu:
       Atque animi prorsum vires totius, et omne
       Languebat corpus, leti  jam limine in ipso:
       Intolerabilibusque malis erat anxius angor
       Adsidue comes, et gemitu conmixta querela:
       Singultusque frequens noctem per saepe diemque,
     /  Conripere adsidue  nervos et membra coactans,
       Dissolvebat eos; defessos ante fatigans.
         Nee nimio quoiquam posses ardore tueri
       Corporis in summo summam fervescere partem;
       Sed potius tepidum manibus proponere tactum,
       Et simul, ulceribus  quasi inustis, omne rubere,
       Corpus, ut est, per membra sacer quern diditur ignis.
       Intima pars hominum vero rlagrabat ad ossa;
       Flagrabat stomacho flamma, ut fornacibus, intus:
       Nihil adeo posses quoiquam leve tenueque membris
       Vortere in utilitatem.
         Forth pour'd the breath most fetid from the mouth,
      As steams the putrid carcase; every power
      Fail'd through the soul, the body, and alike
      Lay they liquescent at the gates of death:
       While with these dread, insufferable ills,
       A restless anguish join'd, companion close,
       And sighs commixt with groans; and hiccough deep, 
GE. IV.]
NOSOLOGY.
181
2. rubula.   Tumours numerous and successive; gradually increas-
               ing from specks to the size of a raspberry; one at
               length growing larger than  the rest: core a fungous
               excrescence; fever slight; occurring only once dur-
               ing life: contagious.
       Lepra fungifera.  Cartheusen.
       Frambaesia.  Sauv. Cull. Sag. Plouquet.
       Schwammformige aussatz.   G.
       Yaws.
       x  Guineensis.   Attacking infants and young persons chiefly;
           and subsiding as soon as the eruption appears.
         Frambaesia Guineensis.  Sauv. Edinb. Essays, vol. vi.
         Yaw.   Guinea.
       /3  Americana.   Depascent; and destroying progressively both
           muscles and bones; especially  the master-yaw, which
           is called mamanpia.
         Frambaesia Americana.  Sauv.
      And keen convulsive twitchings ceaseless urg'd,
      Day after day, o'er every tortur'd limb,
      The wearied wretch still wearying with  assault.
         Yet ne'er too hot the system  couldst thou mark,
      Outwards, but  rather tepid to the touch;
      Ting'd still with purple dye, and brandish'd o*er
      With trails of  caustic  ulcers like the blaze
      Strew'd by the holy fire.  But all within
      Burn'd to the bone: the bosom  heav'd with flames
      Fierce as a furnace, nor would  once endure
      The lightest vest thrown loosely o'er the limbs.
  2. Anthracia  Rubula.  From rubus the " black-berry" or " rasp-
berry ;"  in French framboise, whence  the common  but barbarous
name of frambasia: vvhich  is here attempted to be  exchanged for
an euphonous and strictly classical term, in perfect accordance with
the  ordinary law of diminutives, which  seems to prevail through the
general nomenclature of exanthematous diseases.  Perhaps morula,
from morus, a word employed in an approximating sense by Plau-
tus, might have been  somewhat  more  appropriate, since the erup-
tion seems to bear a  nearer resemblance to diminutive mulberries
than raspberries.  But as the latter plant appears  to have  laid  a
foundation for the name both on the African and American coast, on
the former of  which  it is called  Yaw, and on the  latter Plan, or
Epian, both which, as  we are informed by Sauvages, import rasp-
berry; and as the  earliest writers have, upon this authority, denomi-
nated it framboise, or  frambasia,  the author has  not  felt himself at
liberty to deviate from the original idea. 
182                       NOSOLOGY.           [CL. HI.—OR. IV.

         Pian.  Native American.
         See Schilling De Morbo  in Europa pene ignoto, quern
       Americani vocant Yaws.  As also Sammlungfur pracktisdu
       Aerzte.  Band vii.  Stiick. 2  and  3.
                       ORDER  IV.

                   DYSTHETICA.

                          CACHEXIES.

  Morbid state of the  blood or blood-vessels; alone, or connected
with a morbid state of  other fluids, producing a diseased habit.
   There has been a still greater diversity of opinion concerning the
 proper situation of this species than of plague.  It has been gene-
 rally placed in the class of cachexies; by Sauvages and Sagar in the
 order of tubera;  by Cullen in that of impetigines.  These  writers
 take little or no notice of any kind of febrile symptoms that accom-
 pany it whether specific  or  symptomatic.  " Nulla febris  acuta,"
 says Sauvages, " hunc morbum comitatur;  verum ex  hoc neglecto
 morbo vel non  sanato, sequitur saepe macies  insignis,  phthisisque
 accidente lienteria lethalis."   Dr. Young pays as little  attention to
 the febrile symptoms by which it is said  to be distinguished, and at
 the same time transfers it from the division of cachexies {cacochy-
 mia, as he denominates them,) to the order of paramorphiae or struc-
 tural diseases.   Dr. Winterbottom and Dr. Dancer, on the contrary,
 contend, that a slight fever is its primary symptom; and Dr. Ludford,
to whom we are indebted  for, perhaps, the best history, which has
yet been given of this disease, describes it as a proper eruptive fever
totally unconnected with diet, lues, or any other taint in the  blood;
commencing with alternatives of shivering and heat, lassitude, want
of appetite, and  pains in the head  and loins so great as to prevent
sleep ; the fever and every inconvenience diminishing after the erup-
tion, and  the appetite returning.  So that like  the small pox it ap-
pears to have a  regular accession, height, and  decline ; and, as al-
ready observed, may  be propagated by  inoculation, and is never
known to occur a second time. Hence Parr, who seems for a long
time to have wavered in his opinion concerning the real nature of
this disease, regarding it in his article Cutanei Morbi as a pustu-
lous exanthem, and in his  Nosology as  a mere cuticular intumes-
cence, ord. x. sect. iii. 6, returns with a decided mind to his first opi-
nion in the article  Yaws, and asserts that " the detail of symptoms
shows that the disease is truly exanthematous." 
CL. HI.—OR. rv.]
NOSOLOGY.
183
  The words hitherto ordinarily used to import the diseases, meant
to be comprehended under this term, are, cachexia, and impetigo, or
as the Greeks express themselves hvms, lues, or lyes.  None of these,
however, exactly answer; and that on two accounts; firstly, because
dysthetica is here limited to  those depravities which seem chiefly to
originate from, or manifest themselves in, the sanguineous function,
  This view of the subject will perhaps justify the present position
of the disease; support its pretensions to the character of a carbun-
cular exanthem, and consequently develop  the nature of its connex-
ion  with  plague  under a nosological  arrangement founded on  the
principles of symptoms.
  Order IV.  Dysthetica.  From Tt6r,t*>t, whence 6iTts,6sr?is,prin-
cipium ; frvo-StTfu, male affeclus sum ; tvB-ecrtx, employed both by Hip-
pocrates and Galen as bene constituta corporis habitudo.   Cachexy,
even among the Greeks, embiaced at least two v.iy different kinds
of morbid constitution, as we learn from various parts of Celsus : the
one appertaining to old age, the other to a tabid or consumptive ha-
bit in earlier life.  Compare lib. ii. cap. i.  ver. fin. with lib. iii. cap.
xxii. ad.  init.   But in modern times the term has been used in such
a variety of ranges and significations, as to bid defiance to every at-
tempt at generalizing its meaning.  Thus in Sauvages, Vogel, Sa-
gar, and Cullen, it occurs as the name of a class;  but under each of
them is made to embrace very different diseases; the elassific cha-
racter being sometimes depraved external  colour  alone; sometimes
depraved colour and form ; sometimes  depraved colour, form, and
size; and sometimes, as in Dr.  Cullen's  definition, depraved habit
of the whole or a great part of the body, without any notice whatever
of the  three preceding qualities.  In  Macbride and Parr, Cachexy
is introduced as an order, for in  these writers the order constitutes
the primary division ; yet nothing can be more at variance than their
separate definitions of this order; for while the former makes it far
more comprehensive  than any prior nosologist, embracing polysar-
cia, emphysema,  tympanites, physconia, osteosarcosis, sarcostosis,
mortificatio, and many other diseases scattered through very  widely
separated classes of other  writers; the  latter confines it to two ge-
nera of diseases alone, impetigo and macula, (impetigo being  here
used in a very contracted sense,) and defines it " a change in  the co-
lour of the skin, generally  from  a chemical change in the nature of
the fluids."  Linneus, again, employs the term in a still more limit-
ed sense than Parr, reducing it to a mere genus of the class deformes,
order decolores, and characterising it by depraved want  of colour,
" pallor corporis oedematosus, cum  debilitate, moerore."   While
later writers, as Young  and Willan, have omitted the term  alto-
gether ;  the former substituting cachochymiae as synonymous with
its  more  general  meaning;  and the latter breaking up the entire 
184
NOSOLOGY.
[CL. III.—OR. IV.
either as it regards its vessels or its fluids; and secondly, because no
determinate sense  has  hitherto been generally assigned to either of
these three terms.
                   GENUS  I.

               PLETHORA.

Complexion florid; veins distended; undue sense of heat and ful-
     ness; oppression of the head, chest, or other internal organ.
corps of diseases usually atrintred under its banners, and scattering
them about equally, amidst r.i the eight orders which constitute his
system.
  An equal degree of vagueness has run through the use of impe-
tigo.   This, by most nosologists, constitutes  the name of an entire
order of cutaneous disuses ^according to Cullen " cachexies chiefly
deforming the skin and external frame :" according to Sauvages and
Sagar " chronic, contagious, (or for the most part contagious) mala-
dies,  which superinduce  cutaneous excrescences, gregarious tu-
mours, exulcerations  and crusts, in many instances propagable by
inoculation."  Parr reduces impetigo to a genus, though of a some-
what extensive scale, including scorbutus, syphilis, aurigo, phaenig-
mus, melasma, rubigo.   Vogel, who also renders it a genus, limits
it to a kind  of lichen, " macula, subruhra aspera, dura, sicca,  cum
ingenti prurigine ;" thus making it synonymous with the dry tetter;
while Willan, on the contrary, uses it synonymously with the running
or humid tetter; and Celsus, II. xxviii. 17, with both.   Linneus,
Macbride, Young, and various other nosologists, probably from the
uncertainty of the sense, have rejected the term entirely.
  From the same uncertainty Sauvages rejected lues, or, as it ought
rather to be written, lyes, and employed syphilis in its stead ;  and
his example has been followed  by perhaps all the later nosologists
with the exception of Macbride.  " Hie ordo," observes Sauvages,
" continet  morbos cutaneos, chronicos,  saepios contagiosos, et viru-
lentos, qui ea.  ratione  lues nominari consutvere, ut  luts syphilitica,
scorbutica : verum luis nomen tuberibus inditum est, undc lues ra-
chitica scrophulosa, cancrosa, nomen habet."
  To have employed  any one of these  terms  therefore as the name
of the present order, would have been to  add to the vagueness of
their meaning, and consequently to the imprecision  of  the order it-
self.  A new term has hence  been substituted, the direct scope of 
feE. I.]
NOSOLOGY.
185,
       Plethora.   Li'nn. Sagar.
1.  entonica.   Pulse full, strong,  rebounding;   muscular fibres
                  firm and vigorous.
       Sanguine Plethora.
2.  atonica.   Pulse  full, frequent,  feeble ;  vital  actions languid ;
                skin smooth and soft; figure plump, but inexpres-
                sive.
       Serous Plethora.
which is well calculated to embrace all those cachexiae, impetigines,
lues, or depravations, which appear chiefly to originate in a morbid
state of the blood, or the  blood-vessels without fever, whether con-
nected or not  connected  with other parts of the system;  many of
which are capable of being communicated by transfusion of blood
from a diseased to a sound constitution, and one or two of which we
have reason to believe are, in this manner, actually communicated
to the fetus in the womb.   Under the order thus  explained, sphace-
lus and necrosis, which are regarded as cachexies by Sauvages, Sa-
gar, and Macbride, have a clear title for admission;  as has also ple-
thora.   Polysarcia makes an approach to the division, but belongs
more properly to the diseases of Class VI, or those of the excernent
function.
  Gen. I.  Plethora.  nxtfaga, from wXnQu, " impleo," "inundo."
This affection, proscribed from the catalogues of Sauvages and Cul-
len, is entered, and correctly so, in the division of cachexies by Lin-
neus and Sagar.  It is equally a disease of the sanguineous and the
phlegmatic temperament; and the specific distinctions are so clear
as  seldom or never to be mistaken.   Perhaps it is in neither case,
at any time, a  mere result of redundant blood; though, in both, this
fluid seems to be formed with peculiar facility. There is commonly
moreover in both cases an undue degree of vicidity, or lentor as it
is usually called, though unquestionably resulting from very, differ-
ent causes : in the first species probably from some excess of gluten
and fibrin; and  in the second from a deficiency of the neural salts
by  which the coagulable  parts are to a certain extent held in solu-
tion.  In both  there  seems also to be very generally an excess of
oxygen, and hence the florid hue the small blood-vessels communi-
cate to  the surface.
   Gen.IL Hjemoruhagia.  Fromxtptx,"sanguis," andpv<rtra,« rum-
po."  There are few parts of Dr. Cullen's arrangement more open
to animadversion, or which in fact have been more generally ani-
madverted upon than the present.  The haemorrhages,  or fluxes of
blood, are  with him an entire order, ranking under the class pyrexia?
or  febrile diseases.   Fever, however, is  only an accidental  symptom
in idiopathic haemorrhages of any kind,  and has hence been omitted
by  all or nearly all other nosologists : while in many haemorrhages,
   vol. v.—35 
lse
NOSOLOGY.
[CL.IH— OR. IV.
                       GENUS II.

                HUMORRHAGIA.

    Flux of blood from an organ without external violence.
       Haemorrhagiae.  Hoffm  Vog.  Cull.
       Sanguifluxus.   Sauv. Sag.
       Sejli dem.  Arab.
       Bluten.   G.
       Hemorrhagic  F.
       Hemorrhage.
1.  activa.   Accompanied with  increased vascular action :  blood
              florid and tenacious.
       Haemorrhagia arteriosa.   Cricht.
       Haemorrhagia activa.  Auct. Var.
       Cauma haemorrhagicum.   Young.
    x  Narium.   Discharged from the nostrils ; preceded by local
           heat and head-ache.
       Epistaxis juniorum.   Cull.
       Epistaxis arteriosa.   Cricht.
       Ruaf.   Arab.
       Bleeding at the nose.
    G  Haemoptysis.   Trown up by coughing;  preceded by flushed
           cheeks, dyspnoea, and pain in the chest.
       Emptoe.   Gordon.
       Emptoys.  Gilbert.
       Haemoptoe.  Boerh.
       Haemoptysis.   Sauv.  Linn. Cull.
as the passive, here constituting the second species of the genus, Dr.
Cullen has himself found it absolutely impossible to introduce this
symptom ;  and he has hence been obliged to transfer all the passive
subdivisions or modifications to another part of his system, notwith-
standing their natural connexion with the active, and to distinguish
them by the feeble name of profusions, instead-of by their own pro-
per title.
  The word haemorrhage,  however, was limited  by  Hippocrates, as
we learn from Galen.  Epidem. I. comm. i. to flux  of " blood from the
nostrils," as though applid xxt' *%>x,v*; and he  has been followed,
in this restrained use of the term, by Sauvages and most of the no-
sologists.   Vogel first pointed out the inconvenience of this limita-
tion, and  exchanged  haemorrhagia for epistaxis,  thus liberating the 
"iE.IL]
NOSOLOGY.
187
Blut-speyen.   G.
Crachement du sang.   F.
Spitting of Blood.
Haemate'mesis.   Evacuated  from the  alimentary  canal, at
     either extremity; with expulsive effort;  preceded by
     tensive pain about the stomach ; and accompanied with
     anxiety and faintness.
Haematemesis.   Sauv. et Auct. Recentior.
Vomitus cruentus.   Stahl.
Vomitus sanguinis.  Auct. Var.
Vomissement de sang.   F.
Vomiting of Blood.
Haematuria.  Evacuated  at the urethra; preceded by pain
  in  the region of the bladder  or the kidneys ; and ac-
  companied with faintness.
Haematuria.  Sauv. et Auct. Recentior.
Mictus cruentus.  Sydenh.
Pissement de sang.   F.
Bloody urine.
   It  is  sometimes,  though rarely, discharged without any
mixture of urine, and  is then called  by Vogel stymatosis.
There seems no necessity for the distinction  ; though Dr.
Cullen has introduced stymaptosis into his  " Catalogus Mor-
borum a nobis omissorum."
Uterina.   Discharged  from the  uterus ;  with a sense  of
   weight in the loins, and of pressure  upon the vagina.
Uteri haemorrhagia.   Hoffm.
Haemorrhaea.   Dioscor.
Haemorrhagia uterine.  Junck.
Metrorrhagia.   Sag.
Menorrhagia.   Sauv. Linn. Vog. Cull.
Uterine hemorrhage.
Proctica.   Discharged from the  anus spontaneously ; with
former term to express flux of blood generally; and Cullen, Crich-
ton, and most later writers have followed his example.   In point of
precision, however, epistaxis, (e7no-T<*|<«,) has nothing more to boast
of than hamorrhagia : for in its radical sense it imports distillation ;
though it is employed in a  very restrained sense by Hippocrates, to
express habitual haemorrhage or distillation of blood from the nose.
Haematemesis is here used in the same latitude as vomica, (see apos-
tema  Vomica,) and imports flux of blood below as well as above.
  Plants are subject to a similar  disease ; and that too both of the
active and passive  kind.   The first is from  a plethora or  super- 
 188                      NOSOLOGY.           [CL. HI.—OR. IV.

          a sense of weight and pain within the rectum; and often
          of load in the head.
       Haemorrhois.   Sauv. Sag. Linn.
       Hasmorrhois fluens.  Cull.
2. passjva.   Accompanied with  general  laxity or debility ; and
                 weak, vascular action ;  blood attenuate,  and of a
                 Modena red.
       Haemorrhagia veno*a.   Cricht.
       Haemorrhagia passiva.   Auct. Var.
       Profusio.   Linn. Cull.
       Profusio haernorrhagica.   Young.
     a Narium.  Discharged from ihe nostrils without local heat or
          head-ache.
     G' Haemoptysis.   Thrown   up  from  the   respiratory  organ,
          usually  with  coughing ;  ofien  accompanied with  scir-
          rhous or  calculous  affection ;  countenance  pale  and
          emaciated.
     y Haema'eniesis.  Evacuated from  the alimentary  canal at
          either ex'remity  with expulsive  effort, nausea and faint-
          ness ; but without tensive pain.
     $■ Haematuria.   Evacuated at the urethra ; usually with faint-
          ness, but without previous pain.
     e  Uierina.  Discharged  from  the menstrual  organ, with  a
          sense of local  weakness.
     £ Proctica.  Discharged  from  the anus spontaneously ;  with
          little or  no pain ;  usually with varices or congestions
          of  the haemorrhoidal  veins;  occasionally producing  a
          habit.
3. vicaria.   Catenated with  a  morbid  or suppressed action of
                some other organ ;  the  outlet being usually the
                nostrils,  trachea, vagina  or rectum ; at times the
                urethra.
          The  first species found occasionally as a symptom in
       plethora; various species of fevers;   various  species of
abundance of sap, vvhich in drupous fruit-trees flows from the rup-
tured vessels, intermixed  with  a  considerable portion  of  gum:
but, in the vine, is a clear attenuate lymph, totally destitute of gum.
The latter relieves itself by the discharge, and no evil follows ; but
the former soon become  weakened, and should  have the  wound
closed by a plaister or cement of wax, or some similar material.  In
the passive  species  the sap is often  peculiarly thin  and acrimo-
nious ; the tree wastes rapidly, and no mode of treatment seems to
avail.  The  birch and oak bleed profusely upon being wounded, and
the tree often dies if the wound be not attended to. 
GE> 11.]
NOSOLOGY.
189
empresma;  melaena;   and  in  marasmus  Phthisis.   The
second  in  marasmus  Tabes  and  Atrophia,  struma  and
porphyra.
                      GENUS  III.


                   MARASMUS.

    Emaciation of the entire body.
       Macies.  Sauv. Sag.
       Marcores.  Cull.
       Kedazesh, of Persian origin, from solvo, liquifio.
       Emaciation.
1.  Atrophia.   Complexion pale,  often squalid ;   skin  dry  and
                  wrinkled ; muscles shrunk and inelastic ; little
                  or no fever.
       Atrophia.  Sauv.  Linn.  Vog. Sag.  Cull.
       Verem.  Arab.
       Atrophy.
       x Inanitorum.   The crasis of the blood vitiated by excessive
            evacuations ; as  saliva, sweat, milk, intestinal secre-
            tion, or blood itself.
         Atrophia inanitorum.   Cull.
       G Famelicorum.  The crasis of the  blood  vitiated by the
            use of  food  deficient  in  quantity,  or  innutritious in
            quality.
  Gen. III.   Marasmus.   Mxgxo-pios,  from piagxivM,  " marcesco,"
" marcescere reddo "  This term was long ago used collectively to
comprehend atrophy, tabes, and phthisis ; and in employing it there-
fore as a  generic name, the author  only restores it to its earlier
sense.   There  is a common character, by which all the diseases to
which  it applies, approach each other,  and under which they should
in the first instance be arranged: that character is a  general ema-
ciation of the frame.  Atrophia is deduced  from x,  privative, and
Tf e<pu, " nutrio."  Tabes is a Latin term, of doubtful origin, probably
from the Hebrew 3xn, (tab,) " to pine  away or consume ;" though
usually but idly, derived by the Latin lexicographers from the Greek
txkoj, rx^a, or Sxirra, with all of which  it appears to have very little
connexion either in sense or sound. 
190
NOSOLOGY.
[CL. 1H.—OR..IV>
         Atrophia famelicorum.   Cull.
       y Debilium.   The crasis of the blood vitiated by infirm
            action of the digestive faculty : as in  puny infants, and
            feeble age.
         Atrophia debilium.   Cull.  The atrophia cachochymica
            of  this author  seems  rather  to belong to  the next
            species.
:2. Tabes.   General languor; hectic fever  ; for the most  part de-
              pressed spirits.
       Tabes.  Sauv. Linn. Vog.  Sag. Cull.
       Hnlas.  Arab.
       Verzerhung.   G.
       Etisie.  F.
       Decline.
       x Purulenta.   The blood vitiated by absorption of pus from
            an external or internal ulcer, or a vomica.
         Tabes purulenta.  Cull.
       G Strumosa.   Vitiated by a scrophulous  taint;  and, for
   Marasmus is not uncommon among plants;  and this too  perhaps
in both the first and second species here offered, so far as the terms
will apply to  the  vegetable world.  The trees affected are often
found  to  droop, decline, wither, or become emaciated and perish,
sometimes suddenly,  often with a slow progress.  Frequently the
cause is unknown; yet more generally it is referable to improper
soil or planting, to invermination, or phthiriasis, malis in the present
system.
   In plantations of pine-trees this affection is sometimes epidemic,
and from  the extensive  mischief that ensues,  has  been called,  but
improperly, teredo Pinorum.  According to Wildenow  it attacks
principally the  alburnum and inner bark.   The first symptom is  a
reddish yellow hue in the acerous leaves;  then the appearance of a
great number of minute drops of resin in the middle of the  boughs,
with an offensive   terebinthinous smell  spreading  far around ;  the
bark scales off, and the liber, often the alburnum, presents a blackish-
blue appearance.  The tree is  next  covered with insects.  The
causes are long continued  dry weather ; severe and long  continued
frost, suddenly supervening upon warm  weather; and  violent gales
of wind.   The disease is incurable : and the only thing to be done in
large forests is to forbid clearing away the leaves or the moss around
the roots, as this  wiil only increase the weekness of the tree, and
render it  still tenrvrer.
   3. Marasmus Phthisis  This disease is said to be indigenous to the
Bri.ish Isles ;  anci  theie is perhaps some truth  in the report, for we
meet with various notices of it in an early part  of Anglo-Saxon his- 
GE. III.)
NOSOLOGY.
191
           the most part, connected with a scrophulous affection of
           some organ or other.
         Tabes scrophulosa.   Cull.
       y Dorsalis.  Vitiated  by excess in libidinous indulgencies.
           Accompanied with pain  in  the  back and  loins ; sal-
           low,  dejected visage ; heaviness  of the  head ;  syrig-
           mus ; sleeplessness; horror of mind ; extreme  genital
           debility.
         Tabes dorsalis.  Lomm. Sauv.
         Phthisis notias, (ptfims »«•*■<*«.)  Hippocr.   Literally Hu-
           mid tabes ; so  called from the frequent and  involun-
           tary secretion of a gleety  matter.
         Venenata.   The  blood  vitiated  by an  introduction  of
           some poisonous  or  other  deleterious  material into
           the system ; often from  the  injudicious  use of quick-
           silver;  perhaps,  at  limes,  from  small  portions  of
           arsenic.   See Sauv. in  verb.  Amati. Cent. ii. cur.
           65.
         Tabes venenata.   Cull.
         Tabes a veneno.  Sauv.
3. phthisis.   Cough: pain or uneasiness in Uie chest, chiefly on
                decumbiture :  hectic fever ; delusive hope  of re-
                covery.
       Phthisis.  Auct.  Grozc.  Sauv.  Linn.  Vog.
       Haemoptysis phthisis.   Cull.
tory, under the name oUungen adl, (lungs-ail:) and in the Cottonian
MSS. in the British Museum, Lib.  Vitell. 3, we  have the following
prescription, which appears to have  been much in vogue, and is here
copied as a curiosity.  « Take hwite hare hunan, (white-horehound,)
and ysypo, (hyssop,) and rudan, (rue,) and galluc, (sow-bread,)  and
brysewyrt, and brunwyrt, (brown wort,) and  wude merce, (parsley,)
and grundeswylian, (groundsel,) of each twenty penny-weights;  and
one sester-full of old ale,(fifteen pints;) and sethe the herbs till the
liquor  be half boiled  away.   Drink every  day  fasting a neap-full
cold, and in the evening as much warm."
  The varieties of phthisis offered in the present system, are taken
from Dr. Duncan's very valuable « Observations" on this disease ;
in which, however,  as phthisis is there introduced  as a genus, the
present varieties occur as species.   Yet as the tuberculous may run
into the apostemalous modification,  and the  catarrhal into both, ac-
cording to the peculiarity of the constitution, and other concomitant
circumstances; and more especially as the same cause may produce
each of them in  different idiosyncrasies, the present subdivision of
them may perhaps be regarded as the more correct. 
192                       NOSOLOGY.           [CL. HI.—OR. IV.
        Phthisis pulmonaris.   Mort.
        Phthisis pulmonalis.   Duncan, et auct. var.
        Soollal (Arab.)   Literally morbus  pulmonaris, from sooll,
            pulmo.
        Schwindsucht.  G.
        Ph'hisie.  Consumption.   F.
        Phthisic.   Consumption.
        x  Catarrhalis.,  Cough frequent and violent;  copious ex-
            cretion  of  a  thin, offensive, purulent mucus ; general
            soreness  in the  chest, with transitory  pains, shifting
            from side to side.  Chiefly produced by catching cold,
            or the neglect of a common catarrh.
            Catarrhal Consumption.   Duncan.
        G  Apostematosa.   Cough severe but dry ; fixt, obtuse, cir-
            cumscribed  pain  in the chest, sometimes pulsatory :
            difficult decumbiture on one side : at length sudden and
            copious  discharge  of purulent matter,  occasionally
            threatening suffocation : the other symptoms tempora-
            rily, rarely  permanently,  relieved.   Chiefly the  result
            of repeated haemoptysis.
            Apostematous Consumption.   Duncan.
       y  Tuberculosa.   Cough short  and  tickling :  excretion of
            a  watery,  whey-like sanies, sometimes tinged   with
            blood :  pain  in  the  chest  slight:  habitual  elevation
            of spirits.  Usually  the  result of  a scrophulous dia-
            thesis.
            Tubercular  Consumption.   Duncan.
              The teeth during this disease often assume a milky
            whiteness ;  the eyes a pearly lustre.
              Gun-shot   wounds  are  rarely followed with  con-


  To allay the irritation of the cough, Dr. Duncan recommends the
use of lettuce opium, or the inspissated juice of the common lettuce
of the garden,  which he  denominates  lactucarium;  and which he
has tried apparently successfully under the various modes of tinc-
ture,  pills, and  lozenges, for each of  which he offers  an elegant
formula.
  By Dr. Cullen phthisis  is contemplated as nothing more than  a
sequel of  haemoptysis, instead of being regarded as an idiopathic
disease ; and his species, vvhich are two, can only be viewed, and so
appear to  have  been by Dr. Cullen himself,as separate stages in the
progress of the complaint: his first species being denominated p.
incipiens, and characterised by an  absence  of purulent  expectora-
tion ;  and  his second p. conflrmata, distinguished by the  presence of
this last symptom. 
GE.IV.]                   NOSOLOGY.                       193

            sumption.  " I cannot say that I ever saw a case where
            such an effect took place."   Hunter on Blood.
              See  Baillie, Morb. Anat. Fasc. ii. pi. 4. 2. pi. 5.1.
            2.   Duncan's  Observ.  on Pulmonary Consumption,
            1813.



                       GENUS IV.

                     CYRTOSIS*

     Head bulky, especially anteriorly; stature short and incurvated;
         flesh flabby, tabid, and wrinkled.
  Gen. IV.  Cyrt6sis.  Kv^tutis, " curvitas, gibbositas, distortio
spinae dorsi," from xvgros, " curvus, incurvus, gibbosus."   The au-
thor has preferred this term to the compound cyrtonosus {kv^tovotos,)
morbus incurvus:  the term  morbus, or voros,  being pleonastic in a
system of nosology.  The character of the second species is chiefly
taken  from  Dr. Reeve's  very  excellent paper  in  the Phil. Trans.
for 1808,  p. Ill; which, while it establishes  the disease  to be he-
reditary, sufficiently  proves  it  to originate in a close, confined and
marshy atmosphere, with inattention to cleanliness, and wholesome
food.   It  is a singular circumstance that both these species should
have made their first appearance, or at least have been first noticed,
contemporarily. The earliest account we have of rickets is that pub-
lished  by Glisson, as it occurred in England in the middle of the se-
venteenth century: the first account of cretinism is that of Platter,
who met with it about the same time in Carinthia and the Valais.
Praxeos Medica, cap. iii. Basil, 1656.  The disease  is common  in
Navarre, and in many of the valleys of the Pyrenees, particularly
that of Luchen; and the unhappy  victims are rumoured, according
to M.  Ramond, to be descendants  of the Cagots or Capots, who, in
the eleventh century,  infected with leprosy and  other  cutaneous
maladies, were treated as a lower order of  beings;  were sold  as
slaves, disposed of by  will, obliged to  enter the church by a sepa-
rate door, and to use a particular font and seats, which were  placed
at a distance from the rest of the congregation.   Voyages dans les
Pyrenees.   But this seems  to  be  mere tradition, without a single
historic relic for its support or countenance.  Zeviani, delta  Rachi-
  • [In the' Study of Medicine,' Cyrtosis is placed in Genus IV. Order I. Class
VI.  See Study of Medicine, Vol. 4th, page 222.1
   vol. v.—36 
194                       NOSOLOGY.           [CL. Ill—OR. IV.

1. CrEtinismus.   Chiefly affecting  the  head and neck:  counte-
                      nance vacant and  stupid:  mental faculties
                      feeble or idiotic; sensibility obtuse; mostly
                      with enlargement of the thyroid gland: here-
                     ditary.
       Cretinismus.   Platter.  Prax. Med.
       Cretinism.   Reeve.   Phil. Trans. 1808.
2. Rhachia.  Chiefly affecting the limbs and  body; spine crooked;
                ribs depressed;  articular  epiphyses enlarged and
                spongy; belly tumid;  mental  faculties clear; often
                premature.
       Rachitis.   Glisson.   Sauv. et Auct. Alior.
       Riickgrat-kranckheit.   G.
       Noiiage Noiieure.   Riquets.   F.
■£     Rickets.
/         Found occasionally also as a symptom in struma, tricho-
       sis, phthisis, and elephantiasis.   Sauv. in  loco: and hence
       occasionally commencing  in  adults.  Journ. de Med. xliii.
tide, contends that rickets, if not cretinism, were known to the an-
cients, and alludes to the names of Vari, and Volgi among the Ro-
mans, and to various passages ridiculing deformity, in Thersites, the
supposed  .fisop of Greece, as well as in other authors, in  proof of
his opinion : but all such  remarks are too general; he cannot  pro-
duce a single passage from the medical writers of antiquity, clearly
characterising the peculiar deformity before us.   Hahn has attempt-
ed to do so in the works of Hippocrates, but has failed : and hence
it  is generally admitted, and has been so from  the time of Glisson
himself, supported by the concurrent opinions of Bate, Regemorter,
Van Swieten, and Trinka, that both rickets and  cretinism are of re-
cent date.
  There is some doubt about the  origin of both names.  Cretinism
was at first ascribed by different writers to two causes, with neither
of which  it appears to have  any  connexion ;  the  habitual  use of
snow water; or of water impregnated with chalk (creta) in the low
Swiss valleys in which it was first traced : and it is probable that the
term cretinism is derived from the latter opinion.   There is some
uncertainty, however, upon  this subject, but the name may stand;
the best descriptions of it that have occurred to the writer of these
pages  are that given by M. Pinel in his Traitc sur VAlienation Men-
tale, sect. iii. §  182, chiefly drawn up from M. Fodere; and that of
Dr. Reeve, in the Phil. Trans, for 1808.
   The term rickets, is usually translated in medical language rha-
ehitis,  a name  first given  to it by Glisson, as though  derived from
p»X'9 (rhachis,) the spine, in consequence of the distortion and cur-
vature of this organ, produced by its being  no  longer able to  bear 
GE. V.]
NOSOLOGY.
195
Dr. Young regards it as a regular species of scrophula; and
hence in his system it occurs under the title of scrophula Ra-
chitis.
                       GENUS  V.

                    ALPHOSIS.*

    Cuticle dead-white; pupils rosy; corporeal powers weak.
I. jethiopica.  Hair white, and woolly; irids white; sight strongest
                 in the shade.  Found among negroes.
the weight of the head and  upper extremities.  As this malady,
however, was first traced  in  England, and appears to have been
known in the western counties, and provincially denominated rickets,
before it attracted the attention of medical writers;  it is probable
that the term rachitis was employed by Dr. Glisson as much on ac-
count of its resemblance to the English term rickets, as from  its  ex-
pressing the diseased state of the spine.  Dr. Johnson, indeed, de-
rives the  English rickets and rickety  from  the Greek rhachitis,
usually but improperly  written rachitis: but this is  to commit an
anachronism, rickets and rickety being in use first, and perhaps de-
rived from the German and Teutonic r'ueken, " to rock, reel, wriggle,
or go unsteadily."  Rhachitis might, however, be a very good word,
were it not for its termination ;—itis,  in the medical technology of
modern times, implying organic inflammation, and being limited by
a sort of common consent, to the numerous species of disease, in the
present method, arranged under the genus empresma, Cl. III. Ord.
ii.:  whence the  author has  exchanged rhachitis for rhachia.   If,
however, this disease were known among th'j Greeks, it must be
sougnt for under the name here given to the genus—that of cyrto-
-.is ; for this is a term common to Greek writers, signifying  incur-
vation  generally, and incurvation  of the spine peculiarly ; in other
words, posterior  crookedness, as Ao'fJWjj (lordosis) its opposite, im-
ports anterior crookedness, or the procuration of  the head  and
shoulders.
  Gen. V.  Alphosis.   The character of the genus and species is
drawn up from  the  descriptions  of Saussures,  Maupertuis,  B zri,
and Blumenbach.  The whiteness is probably produced by a want
of the secretion of the pigment that among negroes renders the rete
  * [In the ' Study of Medicine,' Alphosis is not ranked as a genus, but is the
7th species, 10th genus, 3d order, 6th Class  See Study of Medicine, Vol. 4th,
page 466.] 
196
NOSOLOGY.
[CL. III.—OR. IV.
       iEthiops.  Plouquet.
       Albor cutis.   Plenck.
       Weissehaut.   G.
       Albino.
2. europjea.  Hair flaxen and silky:  irids rosy.  Found among
                Europeans and other white nations.
                   Trail in Nicholson's Journ. of Nat. Phil.   See
                also Blumenbach, Med. Bihl. ii. 537.   Le Cat,
                Trains de la Couleur dela Peau Humaine.   Phil.
                Trans, passim.


                      GENUS VI.

                      STRUMA.

  Indolent  glandular tumours, chiefly  in   the  neck;  suppurat-
    ing  slowly, and imperfectly, and healing  with  difficulty;
mucosum black;  and which does not usually take place till several
weeks, sometimes months, after birth; the  negro child being fair
when first born.  The Spanish and Portuguese denominate those
who are thus affected Albinos ; the French, Blafards ; the Dutch,
Kacklacken.
  As the present page is a cancel, and has consequently been work-
ed off after the rest of the volume, the author takes the opportunity
of requesting  his readers to correct  the numerals of the specific
names under the genus Phyma, p. 122, from 2, 3, 4, to 1, 2, 3: and
to give to the  names of  the  species and varieties under Ulcus, p.
216, &c. a neuter instead of a masculine termination, asvitiosum,cal-
losum,* Sec.: the author having at first employed a masculine noun
instead of ulcus; and it having escaped his attention to make the
necessary emendation on a change of the generic term.  He has also
to entreat the reader's correction of a few other errors that will oc-
casionally occur to him, chiefly typographical, and  mostly  in the
accentuation, and  the use of a  large  or small capital in  the  com-
mencement of certain specific  names: it being uniformly intended
to employ a large capital whenever a species is distinguished by the
name of an old genus, or a substantive of a similar kind in the nomi-
native case; and never otherwise.
  Gen.  VI.  Struma.  This is the name in Celsus, who well de-
scribes the disease, lib.  v. cap.  xxviii.  It is probably derived from
•f-T-hese are corrected in the American edition.] 
GE. VI.]
NOSOLOGY.
197
     upper lip thickened;  skin  smooth;  countenance,  usually
     florid.
       Struma.   Cels. Linn, et Auct. Var.
       Choiras (*«'£*«.)   Auct. Graze.
       Scrophula, or scrofula.   Sauv.  Vog. Sag.  Cull.
       Silat (Arab.), from "tumor," "tuberculum."   In Persian
          Damghul; in Turkish Aur.
       Kropff.   G.
       Ecrouelles.   F.
       King's Evil.
1. vulgaris.  Confined to the external, conglobate  glands:  tu-
                 mour pea-sized,  or chesnut-sized ; appearing in
                 infancy  or  youth ; subsiding on mature age;
                 hereditary.
       Scrophula vulgaris.  Warthon.  Sauv.  Cull.
       Cyrnl. or plurally Cyrnlu.  Anglo-Sax.   Whence  the Eng-
         lish word kernel.
2. mesenterica.  Affecting  the mesenteric glands;  countenance
                     pale ; appetite infirm ; abdomen tumid ;  ex-
                     crements usually  peculiarly fetid.
       Scrophula mesenterica.   Sauv.  Cull.
       Chartre.   Puzos.  " Maladies des Enfans."
          Found  also, occasionally, as a symptom in scalled-head,
       yaws, and other cutaneous eruptions.
          Swine  are  said to be peculiarly subject to this disease :
       on which  account it was vulgarly called choiras and scrofula,
       or sioine-evil,  among the  Greeks and  Romans.  Sauvages
       has denominated the porcine  species scrofula chalasis : it is
       named by Gilbert, De Lepra, scrofula leprosa, and by Leger,
       ladrerie des pores.
          It is to this  genus  also  that the glandular disease of

o-Tpaput, " congestion  or coacervation," as of straw in a litter, feathers
in a bed, or humours in the body : in which last sense Cicero ele-
gantly employs it as a metaphor in the phrase "struma civitatis,"
the scrofula of the state.   As struma is derived from o-Tgoftx, so is
TTpupKX from o~T£omvu or trTuovtvfu, " sterno, dejectum expando humi."
The medical dictionaries and glossaries concur in deriving  struma
from struo, but erroneously ; the terminating syllable of struma suf-
ficiently proves it to be derived from a Greek source.  The syno-
nyms arc  scrofula or scrophula, and  choiras,  or chceras :  the first
deduced  from the Latin, and the second  from the Greek, and  im-
porting the same  radical idea of swine-swellings, or morbid tumours
to which swine are subject. 
198
NOSOLOGY.           (CL. HI.—OR. IV.
horses, usually known  by the name of Farcy, is commonly
referred.  It occurs in Sauvages under the title of scrofula
Farciman : and is  unquestionably propagable by transfusion
of blood from the diseased horse,  not  only to other horses,
but to asses, as has been lately proved  by professor Coleman
at the Veterinary Institution.
                      GENUS VII.

                     CARCINUS.

Scirrhous,  livid tumour, intersected with  firm, whitish  divergent
     bands, chiefly of the secernent glands ; pains acute and lanci-
     nating :  often propagated to other parts ;  terminating in a fetid,
     and ichorous ulcer.
       Carcinus (*«^*«»s.)   Hippocr etAuct. Grozc.
       Carcinoma.   Diosc  Sauv.  Linn. Vog.  Sag.  Young.
       Cancer.  Macbr.  Cull. Parr.
       Serataun.  Arab.
       Krebs.   G.
       Cancer.  F.
       Cancer.
1. vulgaris.   Tumour burning,  knotty,  with  dark, cancriform
                  varices ; ulcer, with thick livid, retorted lips.
         " No  part exempt."  Fearon.   Treatise  on  Cancer,
       1784.
       x Pullulans.   Granulating occasionally, and giving delusive
           hopes of a cure : pains passable.
       o Spongibsus.  With fungous and  bleeding excrescences:
           heat and pain violent.
         Fungus haematodes.   Wardrop.

  Gen. VII.  CarcInus.  From kx^xivos, a crab ; on account of the
cancriform or crab-like ramifications oi the  dark, distended veins of
the cancerous tumour.  The division into occult and open, or indolent
and  ulcerative,  introduced by  Hippocrates,  and continued  to the
time of Boerhaave, is unnecessary and incorrect.   There is but one
known species, of  which these  characters constitute only different
degrees or stages.
  The question is of far  more consequence whether cancer be a 
GE. VHI-j
NOSOLOGY.
199
       Carcinoma spongiosum.   Young.
          Bierchen makes five  varieties, genuine, strumous, syphi-
            litic, fungous, noma.  Abhandlung, &c.




                      GENUS VIII.

                            LUES.

   Ulcers  on the genitals, inguinal  buboes, or both, after impure
     coition ; succeeded  by  ulcers in  the  throat, copper-coloured
     spots on the skin, bone-pains, and nodes.
       Syphilis.  Sauv.  Young.
       Venereal Disease.
1. Syphilis.   Ulcers on   the  genitals  circular,  ungranulating,
                thickened  at the edge ; those of the throat deep
                and ragged ; symptoms uniform  in their progress ;
constitutional or a local, an hereditary, or merely an occasional dis-
ease.  By its present arrangement it is obvious to  which side the
author inclines;  but the inquiry  cannot  be discussed in a note.
Much has been said,  and well said, on both sides.  Till of late, the
disease was generally regarded as  a constitutional affection, and will
for the most part, therefore, be found in the division of cachexies,
from Sauvages to Macbride.   Many of the best writers and  practi-
tioners of  the present day, however, among whom  are Dr.  Baillie
and  Mr.  Abernethy, concur in regarding  it as merely local.   Parr,
in his Dictionary, art. Cancer, has examined the subject fairly, and
given to  the arguments on both sides their due weight.  He strong-
ly contends, however, for its  being a constitutional,  and, in various
instances, an hereditary, affection.  Perhaps, like gout, it is in some
instances hereditary and  constitutional, and  in  others original and
local.  Dr. Crawford, on analysing the discharge from a cancerous
ulcer, detected in it a considerable portion of hepatised ammonia ;
and   Parr, in consequence, supposes  the cancerous  diathesis to
depend on an access  of ammonia,  and sulphur in  the blood.  Dr.
Adams is well known to  have ascribed the  disease to a  peculiar
species of hydatids.
  Gen. VIII.  Lues.  From Xvo, « solve, dissolvo," " to macerate,
dissolve, or corrupt."  Agreeably  to the  common rule of  express-
ing the power of  the Greek v  by a Roman y, this should be written
lyes ; but the contrary has obtained so long and so generally, that it
would be little else than affectation to attempt a change. 
200                       NOSOLOGY.           [CL. III.—OR. IV.

                yielding to a course  of mercury; not  known  to
                yield spontaneously.
       Syphilis.  Linn.  Vog. Sag.  Cull.
       Syphilis venerea.   Sauv.
       Syphilis maligna.   Young
       Lues venerea.  Astruc. Macbride.
       Frenk zchemeli.  Arab.
       Frantzosen.   G.
       Verole.   F.
       Pox.
   That acrimonious and poisonous materials are at times secreted
by the genitals, capable of  exciting local and perhaps constitutional
affections in those who expose themselves to such poisons by incon-
tinent sexual intercourse, appears to have been known to the world
from a very early age.  Celsus enumerates various diseases of the
genitals, most of  which are only referable to this source of impure
contact: but the hideous and alarming malady, which was first no-
ticed as proceeding from the same source towards the close of the
fifteenth century, and which has since been called almost exclusively
venereal disease, has  suppressed, till  of late, all attention to these
minor evils, in the fearful contemplation of so new and monstrous a
pestilence;  to various modifications of which most of the anterior
and slighter diseases of the same organs seem to have been  loosely
and  generally referred; as though there were but one specific
poison issuing from this fountain, and consequently but one specific
malady.
   The keen and comprehensive mind  of Mr. John Hunter first call-
ed the attention of practitioners to the idea of different poisons and
different maladies; and the subject has since been pursued by Mr.
Abernethy with a force of argument,  and illustrated by a range of
examples, that seem to have  put the  question at rest.  The latter
has sufficiently established,  that independently of the specific disease
now generally recognized by the name of syphilis, there are numer-
ous varieties of some other disease, perhaps other specific diseases,
which originate from a distinct, possibly from several distinct, poi-
sons secreted in the same region from peculiarity of constitution, or
causes  hitherto  undiscovered;  and which  are  accompanied by
primary and secondary symptoms that often vary in their mode of
origin, succession, and termination from those of genuine syphilis ;
though in many instances they make a striking approach to it: and
to which, therefore, Mr. Abernethy  has given the name  of pseudo-
syphilitic diseases.
  Whether these really constitute distinct species of disease, issuing
from distinct sorts of infection, or are mere varieties or modifica-
tions of one  common species produced by one common morbid se-
cretion, has not yet been sufficiently determined.  In this ignorance 
CL. VIII.]
NOSOLOGY.
201'
  The above Arabic is literally  Morbus Gatlicus: but the
more general name is (nar farsi,) or (ateshi Farsi,) according
as the Arabic or Persian language is made use  of; both
meaning equally  Ignis Persicus, or Persian  Fire.   By this
name it is  constantly denominated  by  the Cabirajas or
physicians of India.—The name  is  probably taken  from
Avicenna, who thus distinguished  the malignant carbuncle,
to which syphilitic eruptions  are supposed,  in the east, to
have a near resemblance.  See Phyma Anthrax.
upon the subject it is better, for the present, to regard them  in the
former, as being the  more  simple, view ;—the  author has  hence
given to this species the name of syphilodes, and has arranged it,
along with syphilis, under the generic term lues.  The sibbens or
sivvens of Scotland seems to appertain to this species.
  The origin of the term syphilis is not exactly ascertained.  Dr.
Turton spells it siphilis, and derives it  from rttytes (siphlus) " foul or
filthy ;" Sauvages, from a-w (syn,) " together,"  and QtXeu (fihileo)
"to love,"—" mutual love:" in which  case  it should be spelt ac-
cording to the common rule.  The latter, who introduced the term
into the nosological catalogue, appears to have derived it from Fra-
castoro, who was born at Padua in  1483, and died in 1553, and who
spells it in his very elegant poem De Syphilitide,  upon this very in-
elegant subject, agreeably to the usual mode.   There is an equal
uncertainty as to the quarter in which  the disease originated.  It  is
usually ascribed to  the  American  continent,  and believed to have
been imported into Europe by the crews of Columbus on  his return
home : a belief, however, which seems  to  be  altogether without
foundation.  The reader who is desirous of examining the author-
ity on which this opinion rests,  together with the various names by
which  it was at first recognized, may consult the author's article On
Medical Technology, in the Transactions of the Medical Society  of
London, series  ii. Vol. I., p. 21 and following, and the notes there
subjoined.
  Linneus stands alone in arranging syphilis as an exanthem, along
with small-pox and measles.  He thought himself justified from the
fever which occasionally accompanies the copper-coloured spots on
the skin, in an advanced stage of its secondary symptoms.
  In the Amcmitates Academica, Vol. IV. art 72, entitled " Specifica
Canadensium," by M. Von  Coelln, we have an  exact  formula for
exhibiting the lobelia syphilitica, or Indian specific  for syphilis, as
delivered to Sir William Johnson, who purchased it of the Indians
at a high  price.
  Among the Hindus, the disease is commonly known by the name
of Persian fire ; a term, however, of much earlier date than any re-
  vol. v.—37 
202
NOSOLOGY.
[CL. 111.—OR. IV.
2. Syphilodes.  Ulcers indeterminate in  their character ; symp-
                    toms irregular in  their appearance; usually
                    yielding spontaneously; variously affected by
                    a course of mercury.
cords we possess of  the existence of  syphilis, and applied by Avi-
cenna, and the writers of the Saracenic schools,  to a  particular
species of anthrax.   The Hindu specific for the cure both of syphilis
and elephas is a composition of arsenic, sane' hya, in Arabic shucc,
but which the Persians call mergi mush, or mouse-bane.   The oxyd
employed is the white arsenic, a. calciforme, and the following is the
mode in which the medicine is prepared,  as given in the Asiatic Re-
searches, Vol. II. art. viii.  "Take of sane' hya (white arsenic) fine
and fresh one tola, (equal to 105  grains)  ; of picked black pepper
six times as much ; let both be well beaten at intervals for four days
successively in an iron mortar, and then  reduced to an impalpable
powder in one  of stone with a stone pestle, and thus completely
levigated, a little water being mixed with them.  Make pills of them
as large as tares or small pulse, and keep  them dry in a shady place.
One of the pills must be swallowed morning and evening with some
beteUleaf;  or  where betel  is not at  hand,  with  cold water.   If
the body be cleansed from foulness and obstruction by gentle cathar-
tics and bleeding, before the medicine is administered, the  remedy
will  be the  speedier."  The Cabiraja, or Hindu  physician relies
implicitly on the virtues of this composition, and confidently predicts
the most certain success in both the above diseases.  The cathartic,
previously employed, is commonly manna, which is worked off with
copious draughts of  a cooling decoction of the niliifer or nymphxa
nelumbo.
  See also Sir William Jones's Works, Vol. I. p. 553, 4to. edit.
  Gen. IX. Elephantiasis.  From thtQxs, u an elephant:" so deno-
minated by the Greek physicians, because the skin of persons af-
fected with this disease resembles that of the  elephant in thickness,
ruggedness, insensibility and dark hue.  Thus applied, therefere,
the term imports elephant-skin ; in the same manner as the same
national school denominated dandriff pityriasis, bran-skin ; from the
skin under this disease resembling branny scales ; and another sort
of scaly malady ichthyiasis, or fish-skin,  from the resemblance of
the skin when thus affected to the scales of the finny tribes.
  The Greeks became first acquainied with the  elephantiasis from
their casual intercouse with Egypt.  To this quarter Lucretius,
adopting the common opinion,  ascribes its origin, lib. I. VI. 112:

       Est elephas morbus, qui propter  flumina Nili,
       Gignitur jEgypto in media, neque  praeterea usquam.
       High up the Nile, 'mid  Egypt's central plains,
      .Springs the black leprosy, and there alone 
GE. IX.]
NOSOLOGY.
203
Pseudo-syphilitic Disease.   Aberneth.
Syphilis pseudo-syphilis.   Young.
Sibbins. Sivvens.   Qu ?
  The varieties seem to be numerous; but have not, hither-
to, been sufficiently defined  for classification.
                    GENUS  IX.

             ELEPHANTIASIS.

Skin  thick, livid, rugose, tuberculate ;  insensible to feeling.
  eyes fierce and staring ; perspiration highly offensive.
  Arabia, however, seems rather  to have been the  prolific source
of this terrible scourge than Egypt;  if we may judge from what
seems highly probable, namely, that this is the disease with which
Job was  afflicted in Idumea, a part of Arabia, as described in the
sacred poem, that bears his name,  and which affords, without ques-
tion, the most ancient  record in the world, composed in a mixt lan-
guage of Arabic and  Hebrew ; and if we add to this the still more
powerful argument that the Arabic name of the disease has extend-
ed itself all over the east, and is almost the only name by which  it
is known in Egypt, Persia, and Indian, in all which regions the disor-
der is about equally common.   Yet the Arabic name  is not elphas or
elephantiasis, but juzam, literally " disjunction, amputation;"  vul-
garly indeed, and more generally pronounced and written judam, and
by the Turks judamlyk. from (judd,) a root which imports " erosion,
truncation, excision ;" evidently referring to the destructive charac-
ter of the  disease, and the  spontaneous  separation of the smaller
members, as the fingers and toes, when severe in its progress.
  In some parts of India, however, and particularly in Mysore, it is
called also, and especially by the common people who are frequent
sufferers from it, durda, a  Persian and Turkish term, applied to ele-
phantiasis emphatically ; for durd  in these languages imports sick-
ness, disease, or distress generally ; whence durda in Arabic, as well
as in the two former tongues, is a common exclamation of distress,
« vae !" " pro dolor !"
  The Arabians, however, have a malady of a very different kind
to which they give the name of elephas, elephantiasis, or elephant-
affection, in their own  language dal fil, which is literally morbus ele-
phas ; and  which they sometimes  contract  to fil or elephas alone;
so denominating the disease  from its supposed resemblance to the
dark, thick, and heavy leg of the elephant: as though elephant-leg
instead of elephant-skin.  It is the " swelled,  tumid,  or Barbadoe 
2U4                       NOSOLOGY.            [CL. HI.—OR. IV.

1. Arabica.  Tubercles chiefly on the  face and joints;  fall of the
                 hair except  from the scalp ;  voice hoarse and
                 nasal: contagious, and hereditary.
       Elephas.  Dioscor. lib. ii. Lucr. De Rer. Nat.  vi. 1102.
leg" of modern writers.   And on this account, when learning, and
especially medical learning, found an asylum, during the dark ages,
at the spiendid courts of  Bagdat,  Bassora, and  Cordova, and the
best Greek writers were translated into Arabic, or the best Greek
and Arabic into Latin, two different diseases were found to possess a
like name; for the Greeks, notwithstanding that they had already
elephantiasis to signify juzam, could only translate dal Jil by  ele-
phantiasis also.  And hence arose a considerable degree of confu-
sion, which has indeed continued to the present  moment; for  ele-
phantiasis,  (dal-fil,) or "  elephant-disease," is still applied by many
writers to both these maladies; while not  a few regard the two as
nothing more than varieties of a common species, or species of  a
common genus.  Yet the one is a tuberculate affection  of the whole
body;  while  the other is a scaly  affection of only  particular parts,
and, commonly, of not more than  a single limb.  As a mere variety
of the  proper elephantiasis, the Barbadoes or elephant-leg bucnemia
in the  present system, occurs in the Nosology of Dr. Young ; while
Dr. Parr, in his article Elephantiasis, confounds the two affections
under  one general character and history.   In his article Nosology,
indeed, he is  not guilty of the same perplexity ;  for here he confines
himself, under  the term elephantiasis, to black leprosy  alone, but at
the expense  of totally omitting the Barbadoes-leg or dal fil,  which
occurs no where in the range of his classification.
   The leprosy (lepra Graecorum,) the leuce (Xevxti) of the Greeks,
and the baras or beras of the Arabians, was by many of the Arabian
physicians, and very generally among the people, supposed in various
cases to terminate in juzam or elephantiasis,  as though these  also
were nothing more than different  stages or degrees of the same  dis-
order.   And  hence another error and perplexity in medical  study.
Alsahavarius thus unites them, and they are jumbled together, or ex-
plained alike, in nearly all  the oriental dictionaries; in which beras
or leprosy, and juzam or elephant-skin, are, almost without an ex-
ception, regarded as convertible terms; beras being sometimes ex-
plained by the name of mered or bald juzam (the term mered signi-
fying bald, i.  e. pilis carens,) and elephant-skin by that of black beras,
a name occasionally applied to it  by Avicenna.   This oriental con-
fusion  of two  different diseases was readily copied by the first Latin
translators, till at length both in the east and west, beras or lepriasis,
though literally scale skin, became a sort of family name for almost
every  foul disfigurement  of the skin, whether tuberculate  or  scaly,
cutaneous, or constitutional. And hence  the lazarettos  or hospitals
established for  elephantiasis or black leprosy during the dark ages, 
GE. IX.J                   NOSOLOGY.                       205

       Elephantiasis.  Aretozus.
       Elephantiasis.  Sag. Call.
       Elephantiasis Indica.   E. Orient.   Sauv.
       Elephantia Arabum.   Vog.
the morbus Sancti Lazari as it was also called, were filled with pa-
tients exhibiting blotches and blains of every kind; and are still de-
nominated, (judam khaneh.) or judam lazarettos.
  In the Linnean system, elephantiasis and leprosy, and perhaps se-
veral other diseases, are included under the term lepra : all which
the disciples  of the  Linnean school,  consistently with a  principle
already adverted to, ascribe to animalcules drunk in with the com-
mon beverage of water—and especially  the Gordius marinus.   The
black  leprosy is well described  as it  occurs on the  borders of the
gulf of Bothnia and  in  Finland, in an article entitled Lepra in the
Amoenitates Academicse, Vol. VII. No. 31, by M. Uddman; in the
course of which this opinion is plausibly and ingeniously supported.
It is also supported by M. Tonning in art. 149 of the same volume,
entitled Rariora Norwegian ; and was, in  fact, many years antece-
dently to this, suggested by M. Martin, also a  pupil, and a very in-
defatigable one, of Linneus, during a tour to Norway in 1758.
  At  Madeira, and in some other parts of the world, elephantiasis
does not appear to be contagious, nor  perhaps hereditary.  Yet the
testimony of  its being both, in the true elephantiasis or juzam of
Arabia and the east, is so  strong  and concurrent among the Hindu
Cabirajas, as  well as the Arabic  writers, that there can be no  doubt
upon the subject.  The distinction is sufficient to make a variety of
the former, if future observation should fully confirm the general
opinion.
  Many of  the characters here noticed  are  accurately  and ably
pointed out by Dr. Bateman in his " Practical Synopsis of Cutaneous
Diseases ;" to which the reader  may turn with great advantage for
a fuller illustration of the  subject.
  2. Elephantiasis Italica.   For a knowledge of this  species of ele-
phantiasis, as the author ventures to  denominate it,  we are almost
exclusively indebted  to Italian  physicians, by whom it is called
pellagra or pelagra—skin-affection, from pellis, and xypx, a barbarous
term, as compounded of two different languages.   The first writer
upon the disease appears to have been Francis Frapolli, a Milanese
physician, whose work, "In Morbum  vulgo  Pelagram,"  Sec.  was
published at  Milan in 1771, and  who  expresses himself doubtful
whether the  disease, though not antecedently described, is not re-
ferred  to occasionally by earlier writers, though he does not  think
that the Pilarella, as the syphilis was called, when it proved  depi-
latory to the chin and eye-brows, was the disease in question,  not-
withstanding  this seems to have  been an extensive  opinion at the
time.   The next tract, of any note upon the subject, was published 
206                       NOSOLOGY.          [CL. ffl.—OR. IV
       Lepra Arabum.  Auct. Var.
       Juzam.  Arab.
       Khora.  Hindust. Asiat. Research. Vol. II. 8.
       Elephanta-naussatz.   G.
       Black Leprosy.
2. Italica.  Tubercles chiefly on the body and limbs; sometimes
               desquammating;  great tension of the skin; vertigo;
               burning, lancinating pain in the head; melancholy;
               at first remitting, afterwards fixt, terminating  in
               alienation of mind; hereditary.
       Pelagra.   Jansen. Frapolli, Animadv. in morb. vulgo Pela-
         gram, Milan 1771.   Delia Pelagra descrizione  di Mich.
         Gherardini,  Mil. 1780.    Thierri,  Recueil  periodique
         d'Observations de Medicine: Paris, 1755.
       Pellagra.   Oleggio.
       Tuber Pellagra.  Parr.
       Mai del sole.   Mediolan.
3. Asturiensis.  Tubercles chiefly on the hands and feet; crusta-
                    ceous, desquammating; continual tremor of the
                    head and upper part of the trunk; baldness of
                    the scalp as well as of other parts: gloom and
                    terror of mind.
       Lepra  Asturiensis.   Sauv. Thierry.  Journ. de Med. Maie
         1755.
       Mai de la Rosa.  Spanish.
at Venice in  1784, by G. M.  d'Oleggio, under the title of Tr. Teo.
Prat, della Malattie dell insolato  di prima vera volgarimente dette
della Pellagra.   But the best account we have received of the dis-
ease is from  the pen of Dr. Jansen of Leyden, which  appeared in
1788.  Dr. Jansen has entered into a very full inquiry upon every
thing that relates to  it, and his description is copied, or rather con-
densed, in the present definition.   It is singular that he  could not
hit upon  the  origin of the term, and questions whether it may not
be derived from  the Greek vtXxs.  He tells us, that it was occasion-
ally called mal del  sole, as though produced by the heat of the sun.
The cause of the disease, after  all, seems uncertain; it is found in
various parts of  Italy; but especially in the  Milanese and Venetian
districts, so  widely differing  from each other in soil and situation,
that  it  can scarcely  be referred to  these sources.  Yet it is ende-
mic and hereditary ;  so that the condition of the peasantry in these
regions is truly  miserable.  Dr.  Parr  is, perhaps, the only writer
who has hitherto introduced this disease into a nosological arrange-
ment. 
GK. X.)
NOSOLOGY.
207
                        GENUS  X.

                     BUCNEMIA*
  Leg enormously tumid,  and mis-shapen ; skin thickened, livid,
     rugose ; often scaly ;  scrotum, arms, or other parts, sometimes
     participating in  the affection.
       Elephantiasis.  Auct.  Var.
       Dal fil.   Arab.
       Drusenkrankheit.   G.
       Yava skin.   Polynes Isles.
       Barbadoes-leg.   Hillary, Dis. of Barbad.
       Glandular disease of Barbadoes.  Hendy.
1.  Indica.   Bones  and  muscles of the  affected limb sound ; its
               motion little  impeded by its weight.
  Gen. X. Buonemia, from Gov,  an augmentive particle, evidently
derived from the Hebrew yi  or  rrj?3, (bo or boa.) "to swell, grow
large or intumesce," and x.v*ipui,  '' crus." or " the  leg:" literally
bulky or tumid leg.   It is, in truth, the dal fil or elephant-leg of the
Arabians, the Barbadoes-leg of modern writers, already  glanced at
in the note on  Elephantiasis, and  for which no proper technical
name has hitherto been offered:—an apology that the author trusts
will  be sufficient for  the present  attempt.  Though frequently,
as already observed, called elephantiasis,  from a  misunderstanding
of the secondary meaning  of two  univocal  terms in two  differ-
ent languages, it  is without the essential character of  tubercular
eruptions; while unlike the elephantiasis, which extends over the
whole body, it is always limited, and often confined to a single limb.
It makes, however,  an approach  to elephantiasis, and ought  there-
fore  to range near it, but it cannot be included in the same  defini-
tion.  It is very generally known both in the East and West Indies ;
in Arabia, and along the whole  range of the Polynesian Isles; in
which last it is denominated yava-skin ; as being  supposed to origi-
nate from drinking the  heating beverage  called yava;  and, like the
gout among ourselves, is regarded in a sort of honourable light.—
Instances of  it are  frequently to be met with in our own country ;
and in a case that occurred to the author about a twelvemonth agot
the patient, from an attempt to repel it, was suddenly attacked with

  * [In the " Study of Medicine?' this  geuus is transferred from this order to
the second order phlogotica, in the same class.  In that order it is placed as
the eleventh genus, and is made to comprehend two species, viz.
                    1. BUCNEMIA  SPARGANOSIS,
                    2. ——--TROPICA.
  The genus Sparganosis, which is the tenth of the second order and third
class, in this work, is suppressed in that.] 
208                       NOSOLOGY            [CL. 11L—OR. IV.


                       GENUS  XI.

                    CATACAUSIS.

              General combustibility of the body.
       Incendium spontanium.  Dupont. Plouquet.
       Catacausis.   Young.
I. ebriosa.  The combustibility occasioned by  a long and immo-
                derate use of spirituous  liquors ; and producing
                combustion spontaneously.
                  Phil.  Trans.   Bianchini.  Vol.   XL1II.   Id.
                Wilmer. LXIV. Journ. de Phisique, Pierre-Aime-
                Lair, l'An VIII.   Le Cat. Memoires.

a fit of gout in the stomaeh, which  destroyed him in three days:—
here, however, gout was a constitutional disease.
  Gkn. XI. Catacausis. Kxtxkxvt-is, " exustio,""combustio," from
xxrxfcxtu.  The only  medical writer in our own  country, so far as
the author is  acquainted with, who  has noticed  this very extraordi-
nary affection, is Dr. Young, by whom  it is referred  to under the
Greek name  here  applied  to it.   The examples of  this  singular
diathesis, leading to a spontaneous and fatal combustion, aFe so nu-
merous, so well authenticated, and press upon us from so many dif-
ferent countries and  eras, that it would be absurd to  withhold'our
assent.  In almost every instance  the combustion seems to have
taken place in females, advanced in  life, and immoderately  addicted
to spirituous liquors.  In some cases  the heat that has consumed them
appears to have originated  in themselves, in  others to have been
communicated by  a fire or candle;  but  in no case has the  flame or
fire hereby  excited in the body been so powerful  as essentially to
injure  the most combustible substances immediately adjoining, as
linen or wooden furniture.  The body in several instances  has been
found actually burning—sometimes  with a lambent flame flickering
over it—sometimes without any flame  whatever—«while the applica-
tion of water has at times seemed rather to quicken than impede the
combustion.   The event has usually taken  place at night when the
sufferer has been alone:  it has commonly  been  discovered by the
fetid penetrating smell of sooty films which have spread to a consi-
derable distance;  the unhappy subject has  in every  instance been
found dead, and more or less completely burnt up; the burnt parts
being reduced to an  oily, crumbly, sooty, and extremely offensive
matter.  " I confess," says M. Pierre-Aime-Lair, in the Journal de
Physique, Pluv. l'An. 8, " that these accounts at first appeared to me
to be  worthy of very little  credit,  but they are  presented to the
public as true by men whose veracity seems unquestionable.  Bian-
chini, Maffei, Rolli, Le Cat, Vicq-d'Azyr, and other men distinguish-
ed by their learning, have offered  certain  testimony  of the fads. 
GE. XII.]                  NOSOLOGY.                      209
                      GENUS XII.

                    PORPHYRA.

Livid spots on the skin from extravasated  blood: languor and loss
  of muscular strength: pains in the limbs.
       Purpura.  Willan. Riverii.  Prax. Med. xvii. 1.
       Scurvy.
I. simplex.  Spots  numerous,  but  small and  flea-bite  shaped;
                chiefly on the breast, arms, and legs;  paleness of
                visage.
Besides, is it more surprizing to experience such incineration than
to void saccharine urine, or to see the bones softened to such a de-
gree as to be reduced to a state of jelly ?"  The reader, who is de-
sirous of pursuing this curious subject farther, and of examining the
various hypotheses by which it has been  accounted for, may consult
the Phil. Trans. Vols. XLIII and LXIV. the first of which contains
numerous examples. Acta Medicaet Philosophica Hafniensia ; Ency-
clopedic Methodique. art. Pathologic Anat >my of man, drawn up by
Vic d'Azyr  ; Journal de Medicine, Tom. LIX. p. 140. 440 ; and Phy-
los. Magaz.  Vol. VI. p 132.  He may also turn to the description of
Merille and Muraine in  the Journal de  Medicine, Tom  LXIX. p.
140;  and Dupont's " Dissertatio de corporis humani incendiis spon-
taneis "   Lugd. Bat. 1736.
   Gen. XII.   P6rphyra.  Hogpvpx,purpura, " purple or livid dis-
ease."  Dr. Willan has used the Latin term instead of the Greek,
as indeed have most of the nosologists ; and he has used it in a sense
very nearly  parallel with its range as now offered.  " With Riverius
and some other authors," says he, « I propose to express by the
term  Purpura an efflorescence consisting of some distinct, purple
specks and  patches, attended with general debility, but not always
with fever "   Ord.  III. p. 453.  "  Cases of the Purpura seem to
have been studiously multiplied  in periodical  publications, and in
medical or surgical miscellanies —I consider it under all the forms
described, as pertaining to the Scurvy,  though it is not always at-
tended with  sponginess of the  gums, and a discharge of blood from
them, according to the definition of Scorbutus in nosology. Whe-
ther my readers agree with me or not, they will, I think, allow that
a  general view of  the  symptoms and  causes of either the  Sea-
Scurvy or Land-Scurvy, cannot properly form a part of the present
woik."   Id. p. 466.
   Certainly these cannot in precision of language be regarded  as
cutaneous diseases, and consequently a minute description of them
   vol. v.—38 
210
NOSOLOGY.
[CL. HI.—OR. IV.
Petechia? sine febre.  Auct. Var.
Phoenigmus petechialis   Sauv.
Profusio subcutanea.   Young.
Rothe punkt   G.
Petecchial Scurvy.
x Pulicosa.   Exhibiting a  pulicose, flea-bite,  or  as it  is
    commonly called, petecchial appearance, from  the first.
  Purpura simplex.  Will
(S Urticans.   The flea-bite spots  preceded by reddish, round-
    ed, and nettle-sting wheals, but without a sensation  of
    tingling or itching, fugacious  and migratory.  Chiefly
    found in the  summer and autumn.
could not properly form part  of a work possessing this title.   The
above extracts, however,  are  sufficient to prove that if Dr. Willan
could have treated of sea-scurvy, in the work in question, he would
and must have assigned it a place under the genus Purpura. Yet he
might perhaps as well have introduced purpura nautica, sea-scurvy,
as purpura contagiosa the petecchial spots of  malignant fever, which
constitutes his fourth variety ; since an efflorescence of this  kind
has at least  as little  connexion with cutaneous diseases as the for-
mer, and is, in itself, no disease whatever, but a mere symptom of
a disease.  With  respect  to land-scurvy, Dr. Willan has actually
treated of it, and at  considerable length  as well  as with great inte-
rest ; for the variety, as he calls it, though it  should be rather term-
ed species, which he  distinguishes by the name of purpura hemor-
rhagica, is in fact the land scurvy of  all medical writers, and is so re-
garded and  acknowledged by himself.   In proof of this, it is  only
necessary to  observe that in Order I, p. 51.  article Lichen lividus,
he directly translates purpura by the term land-scurvy ; and refers
us both here, and in  p. 463 of the number just quoted from, to the
■work of Ainatus Lusitanus, published  about  the year  1550, and di-
rectly relating to  this very disorder, or rather  to  all the cognate
disorders  that properly appertain  to  the present genus.   After
which  he continues  as follows :  " Engalenus is perhaps the  first
■writer who has given a clear description of this disease, (purpura )
Under the general title scurvy, he  furnishes three or four distinct
cases, wherein the purple eruption was  connected with a haemorr-
hage from the gums, from the lungs, or from  the bowels.  See Obs.
2, 33  59, 62. 68, 69, 72.  He refers the complaint  to  a putrid
diathesis  'lO'iuced by groas food, salt, or stagnant water,and a moist
cold atmosphere.  Dr. Lister, Exercitat  Med. de Scorbuto,  1680, af-
fords several cases  analogous to  those above  quoted:  the 1st,
5th, 6th, 7th, 8th, 9th. 10th, 11th, and I2th, exactly coincide with my
own observations on  the purpura hamorrhagica.  The remedies on 
GE. XU.]
NOSOLOGY.
211
          Purpura urticaria.   Will.
2. hemorrhagica.   Spots  circular,  of different  sizes; often  in
                        stripes or  patches,  irregularly scattered
                        over the  thighs, arms, and trunk;  occa-
                        sional haemorrhage  from the mouth, nos-
                        trils, or viscera; great debility, and depres-
                        sion of spirits.
       Purpura hemorrhagica.   Will.
       Sioma» ace universalis.   Sauv.
       Ileus haematites ('Ia*«s xifMinrtis.)   Hippocr.
       Haemorrhagia universalis.   Wolf. Wadel. Observ. Curieu-
          ses, Tom. III.
       Land-Scurvy.
3. nautica.  Spots of different hues intermixed with livid, princi-
                 pally  at the roots of the hair;  teeth loose; gums
                 spongy and bleeding; breath fetid; debility univer-
                 sal and extreme.
                   Occurs chiefly at sea after exposure  to a moist,
                 cold, and foul atmosphere; with long use of salted
                 food  and stagnant water.
which Dr. Lister depended for the cure of these, were, scurvy-grass,
cresses, vegetable acids, and occasionally blood letting.  Experi-
ence, however, soon  taught him, that bleeding, and likewise purg-
ing,  were highly detrimental."
  Dr. Willan has well  observed, that cases of purpura have been
unnecessarily multiplied ; and Dr. Bateman has still farther illustrat-
ed this  idea  by remarking, that " the term purpura has been em-
ployed by different writers in so many other acceptations, that some
ambiguity would  perhaps have been avoided by discarding  it alto-
gether; for some authors have used it as an appellation for measles,
others for scarlet-fever, for miliaria, strophulus, lichen, nettle-rash,
and the petechia; (petecchia)  of malignant fevers;" Synops.  of Cut.
Diseas. p. 102.   While,  as  he observes, antecedently " the term
purpura was applied to petechial spots  only by Riverius, Diemer-
broeck, Sauvages, Cusson, and some others."   It is partly  on this
account that the author has employed porphyra instead  of purpura,
as having been less hacknied in medical service; and partly, be-
cause, as remarked  in the  Preliminary  Dissertation, he has endea-
voured, for the sake of  consistency, to derive the names of all the
genera  from a common language, and  that language  the  Greek.
To scorbutus there  is every  objection; for  it is neither Greek nor
Latin, nor any  language whatever; but a term intolerably barba-
rous, derived, as is commonly supposed from the German compound
schar-bocke, or  schar-pocke, literally aggregate-pox, cluster-pox, but
more likely  from scharf-pocke,  violent or  vehement-pox,  schorf- 
£12                      NOSOLOGY.           [6L. HI.—OR. IV.

       Scorbutus.   Boerh. Hoffm. Sauv. et Auct. Recent,
       Scorbutus nauticus.  Young.
       Scharbocken.—Scorbut.   G.
       Scorbut.   F.
       Sea-Scurvy.
                   GENUS XIII.

                   E X A N G I A.

Enlargement or rupture of a blood-vessel, without external open-
  ing.
     Exangeia.  Young.
pocke, scurf or scurvy-pox, to which the inventor has endeavoured
to give a sort of Latin termination.   Independently of which scorbu-
tus, as employed  at  present, only indicates a particular species of
scurvy, and could not, therefore, without imprecision, be used in a
generic sense.
  The subject is well treated in Dr. Bierchen's paper, entitled Mor-
bi Expeditionis Classic a, in the Amanit. Academ. Vol. V. ed. 78.  Af-
ter Sir John Pringle, he strongly recommends sour-krout as one of
the most useful acids.   Of the mineral acids he chiefly extols the
sulphuric.   Dr.  Young, p. 229, observes, that in  purpura, (land-
scurvy,) " the  sulphuric acid is a powerful remedy, the citric inef-
fectual : in  true scurvy, (porphyra nautica,) the reverse."
  Gen XIII.  Exangia.  'E^xyytx, from t£xyyt£a," evacuo e vase."
Hippocr.   The spontaneous dilatation or rupture of blood-vessels is,
in most instances, the result of local or general debility in the arte-
rial or venous system; and hence this genus of diseases falls properly
within the scope of the present order.  " We know from daily ex-
perience,"  observes  Mr. B. Bell, "that  partial debility frequently
occurs in different parts of the body.  Thus there is nothing more
common than edematous swellings of the extremities, even in con-
stitutions otherwise healthy; and swellings of this nature we justly
suppose to depend most frequently on a local weakness of the parts
in which they occur.   Now why may not a debility of  a similar kind
fall upon part  of the  arterial system  ?  And if it should ever do so,
we can easily see  how, in almost every instance, it must necessarily
terminate in aneurismal swellings.—This cause of the disease may
be considered  as the most frequent origin  of aneurisms that do not
evidently depend upon external injuries."   Surg. I. p. 184.   Occa- 
GE. XIIL]                  NOSOLOGY.                      213

1.  Aneurisma.   Pulsating tumour of an artery.
       Aneurisma.   Auct.
       Abscessus spirituosus.  Amat. Lusitan.
       Aneurism.
       x Cysticum.  Tumour circumscribed; formed by a dilatation
            of the arterial coats within the  sphere of  the enlarge-
            ment.
         Encysted Aneurism.  BelVs Surg.
            Sometimes found in the heart, but less frequently than
         in the arch of the  aorta.  See Baillie Morb. Anat. F. v.
         pi. 3, fig.  1 and  2.   The  aneurismal artery is, in this
         case, usually more or less ossified.   Id. PI. 4, fig. 2.
       G Diflusum.  Tumour diffuse:  formed  by the flow of arte-
            rial  blood  into a subcutaneous  cavity, in consequence
            of a rupture of the coats of the  artery.
         Diffused Aneurism.  Bell.
       y Varicosum.  Tumour protracted:  pulsating through a su-
            perincumbent and dilated vein from an injury common
            to both.
sionally, however,  the  debility extends through the whole arterial
system, in which case the coats are  not  only unusually but irregu-
larly weak,  so as to be peculiarly liable  to  a  morbid dilatation or
rupture in every part: and it is to this predisposition that patholo-
gists have given the name of the  aneurismal diathesis.
  The same observation applies to the  veins: though it must be
observed, in respect to  both systems, that  although this peculiar
diathesis may be an adequate cause  of itself, yet, in  general, it only
lays a foundation;  and the disease owes its  immediate origin  to
some co-operating and local power, as pressure, violent concussion,
strain, or other injury.  Perhaps the varicose aneurism, as it has
been named by Dr. Hunter, is seldom produced except by  the lan-
cet.   It appears, however, to be  the least  dangerous of any, and
the most susceptive of a natural cure.   See,  for various cases of
natural cure or palliation, Lond. Med. Obs. Vol. II.  art. xxxvi. and
Vol. III. art. xiii.   See also Bell's Surg. Vol.  I. p. 217, 218.
  1. x. E. Aneurisma  Cysticum.  See two interesting cases of this
variety of aneurism in  the carotid arteries by Mr. A.  Cooper, Medico
Chir.  Trans. Vol. I.,in which the  operation was performed: unsuc-
cessfully in  the  first from  the  long standing  and size of  the sac,
which pressed with perpetual irritation on the larynx and pharynx,
exciting frequent fits of cough, and preventing deglutition; success-
fully in the second, in  which the tumour was smaller, and of  more
recent date. 
214                      NOSOLOGY.           [CL.IH—OR. IV.

          Varicose Aneurism.   W Hunter.
       } Cardiogmus.   Obtuse  intumescence and  constant  dis-
           quiet of the praecordia; with a sense of internal weight
           and pulsation increased on the smallest motion.
         Cardiogmus.   Galen. Sauv  Vog. Sag.
         Cardiogmus.   Cull. Catal. Morb. omiss.
         Aneurisma praecordiorum.  Auct.  Var.
         Polypus cordis.  Auct. Ahor.
2. Varix.  Soft, livid tumour of a vein.
       Cirsus.   (Kifo-es)  Auct.  Grozc.
       Varix.   Auct. Lat. et Neoter.
         The varix is  said at times to burst spontaneously: in
       which case this species would  afford two varieties of the
       same nature as the first two of the preceding.
                   GENUS XIV.

                 GANGRJ^NA.

The death of a portion of the  body, while the  rest continues
  alive,—often in a sound state.
    Gangraena.   Gal.  et Auct. Recentior.
    Gangrene.
  Gen. XIV. Gangraena. rxyygxtva, from y^xiva, " depascor." The
term sphacelus and gangraena have been employed, both by Greek
and Latin writers, sometimes in a similar and sometimes in a differ-
ent sense ;  and where the sense has been different, each term has
at times  expressed a  higher and  at times a lower degree  of the
same affection. Generally speaking, however, sphacelus (o-tpxKtMs,
from <r$x£a, " macto,")' has expressed the utmost range of a  gan-
grene, the total death or mortification of a gangrenous organ : and
we, hence,  see how  necrosis may be called, as  it generally is, a
gangrene, though it  has never been termed  a sphacelus.   In the
present  use of the words the  author has  adhered to this  general
view; and has hence  taken gangraena for the generic term, under
which the other two will readily range as specific  names.  Yet it is
a singular circumstance  that the most forcible word of the three,
necrosis (vHcgaa-ts, from nxgu, interimo, mortifico,)  and consequently
best adapted to express utter death or mortification, should, by an 
GE. IV.]
NOSOLOGY.
315
1. Sphacelus.  The  dead part  soft, moist, corrupt,  and highly
                    offensive.
       Sphacelus.   Sauv.  Linn.  Vog,
       Khure.   Of Persian origin.
       Ertodtung.   G.
       Gangrene humide.  F.
       Mortification.
       x Inductus.  Preceded  by fever, inflammation, local  vio-
            lence, or other exhausting power.
       G Aionicus.  The result of old age or other debility.
2. Necrosis.   The dead part dry, shrivelled, hard and dusky.
       Kribelkrankheit.   G.
       Gangrene seche.   F.
       Dry Gangrene.
       x Albida.  Retaining the  natural colour of the flesh.
         White Gangrene.
       G Discolor.   The natural  colour changed to livid or a mix-
            ture of hues.
3. Caries.  The  dead part originating in, or extending to, a por-
                tion of the subjacent bone.
       Caries.  Auct.
       Remmet.  Arab.   Hence  Ozami remime, literally  Ossa
         cariosa.
4. Ustilaginea.  Gangrene  dry,  diffuse, divergent;  commenc-
                      ing in the extremities  without fever or intu-

almost unanimous consent, be limited to denote the  lowest degree
of a  gangrenous  affection:—that mere shrivelling and withering
away of  a  limb for want  of nutriment, which we occasionally meet
with in paralytic patients, extreme old age, or after a severe wound
or an obstinate  and sinuous ulcer;  in which  the substance  of the
muscles and integuments is almost entirely absorbed and carried off,
and the bone appears to have scarcely any other covering than the
skin.  The French Medical Society have well described  it as fol-
lows : La  Gangrene seche est  caracterisee par  la mortification de
quelques unes desextremites, et quelquefois de toutes.  Le membre
s'engourdit, devient doloureux, et eprouve un sentiment  de  froid,
on plus souvent d'une ardeur insupportable.   Le vaisseux s'oblier-
ent, les  chairs se nourissent, se  durcissent, la gangrene  penetre
jusqu' aux os,  et le  malade aux prises avec la mort, est encore
heureux ;  si la partie gangre' ee  se separant  d'ellememe, il survit a
la perte de ses extremhes  Soc. de Med. 1776.
   4.  G. ustilaginea.   Grain poisoned by the introduction of vegeta-
ble funguses, or other parasitic plants, into the stems or spikelets,
has been often found,  when taken as food, productive of the  worst 
216                       NOSOLOGY.           [CL. HI.—OR. IV.
            niescence,  and  spreading till various  limbs
            drop off in succession : great hebetude of mind
            and body ;  often with violent spasms.
Necrosis ustilaginea.  Sauv.
Ergot.  F.
Mildew-Mortification.
                    GENUS XV.

                        ULCUS.

A purulent or ichorous sore produced by the separation of a dead
  part.
    Elcus («A*es.)  Auct. Grose.
    Ulcus.   Auct. Lat.
    Kerh.  Arab.
    Geschwar.   G.
    Ulcere.   F.
    Ulcer.
 and most fatal diseases.  The subject has not  been sufficiently ex-
 amined into, but there are two dreadful disorders, more especially,
 to which this cause, under different circumstances, has occasionally
 given  rise ; both which are  denominated by the  French Ergot,  in
 consequence of  this term importing blight or mildew : as they are,
 also, mat des ardens, from the burning internal heat which is often
 felt in either case.  The one of these disorders is a typhous fever,
 with the general character of pestis, or what Sauvages calls erysi-
 pelas pestilens, which is synonymous with the third variety of pestis
 under  the present arrangement.   The other is a tendency, without
 fever,  to an universal mortification, which commences in  the hands
 or feet with a sense of  numbness and external  coldness, a dusky or
 livid cuticle, great debility of mind and body, often violent spasmo-
 dic contractions;  and  spreads  rapidly over  the system, till the
 fingers, arms, nose, legs or thighs, are affected, and some of them
 drop off spontjntously.
  See  Phil.  Trans.  Vol. IV. year  1765;  Tissot's Letter to Sir
 Groige B.-ker.  Hist, de I'Acad  R. des Sciences. 1740, 1748, 1752.
 Acta Lipsia, 1708  a Langio, 1752,  p. 634. Mezerai Hist, de France,
ann. 1090.
  fifriberia is perhaps an effect of a similar cause.
  Gen. XV. Ulcus.  '£ax«$, derived by Eustathius from tixu, traho, 
OE. XV.]
NOSOLOGY.
217
1. incarnans.  Healthy, purulent, and granulating.
2. vitiosum.  With a vitiated surface and secretion.
       x Callosum.   The edges indurated and retracted.
       p Spongiosum.  With fungous or spongy excrescences.
       y Cancrosum.  With a hard, livid, lancinating, irregular,
            fetid, and frequently bleeding tumour at its base.
         Aukile.  Arab.
3. sinuosum.  Communicating with the neighbouring parts by one
                 or more winding channels.
       x Recens.   The channel fresh, and yielding.
       /3 Fistulosum.   The channel indurated, and of longer stand-
           ing.
as though distraho,  hereby producing  a  Xv<rts o-wixeixs, or in the
phrase of modern times, which is a literal rendering of the Greek,
" solution of continuity."  Ulcus is therefore, strictly  speaking, a
Greek term with  a  mere change  of  one convertible vowel for
another.  That the genus is  rightly placed in the  present order,
characterized by a " morbid  state  of  the blood  or blood-vessels,
alone or connected with a morbid state of other fluids, producing a
diseased habit," will, probably, be granted by every one who admits
the  propriety (of  which there can be  little doubt) of introducing
the preceding genus into the same division.   For so closely is ulcer
connected with gangrene, that  it cannot exist without it; it is its na-
tural effect and sequel, provided the grangrene itself  does not prove
fatal.
   Ulcers are a disease as common to the vegetable as to the animal
world.   They are sometimes  produced by  neglected  incisions  or
other wounds, and often generated by some local acrimony or other
morbid affection of the  fluids; the secretion being at times highly
virulent, and of a cancerous character;  corroding to  a considerable
extent the bark, alburnum, and even the pith of  the affected  tree.
In all these cases the dead parts and thickened edges of the ulcer
should be removed by excision, and the wound, hereby made, be co-
vered with  grafting wax, or, which  will often succeed  better,  with
Forsyth's warm cement.  The same disease sometimes attacks the
bulbs of hyacinths, and fleshy roots of other plants, which should be
carefully treated in the same manner; though, as the erosion in these
cases generally extends in a short time  to the centre, it is not often
that we can expect to be successful.
  2. y U. vitiosum Cancrosum. Much  benefit has been said to be
derived  in some cases  from the application of carbonic acid gas
kept constantly in contact with open  cancerous ulcers of the breast.
Dr. Ewart, of Bath, has  published two  interesting cases, in which
■we are told  that they  healed under this treatment like  common
ulcers.   Dr. Darwin properly ascribes this benefit rather to the
  vol. v.—39 
218
NOSOLOGY.          [CL. HI.—OR. IV
4. tuberculosum.  With tuberculous excrescences, lobed by ragged
                      and spreading ulcerations: chiefly about the
                      alae of the nostrils.
       Cancer lupus.  Sauv.
       Lupus.   Willan.
       Noli me tangere.
5. cariosum.  The ulcer extending into the substance of the subja-
                cent bone.
       Caries.   Sauv. Linn. Vog. Cull.
         If the ulceration extends to the medulla, it is often called
       " arthrocace."
         The one or the other species found also, occasionally, as a
       symptom, in lues, struma, porphyra, and other depravities of
       the constitution.
exclusion of oxygen than to any specific virtue in the carbonic acid.
As in common ulcers, the matter does not induce hectic fever till
it  has been exposed to the  air, and  then probably united  with
oxygen.   The manner of applying the fixed air is by including the
cancer in one half, or hemisphere of a large bladder; the edges
being made to adhere to the skin by adhesive plaster.  Perhaps a
mixture of one part of honey with about twenty parts of carpenter's
glue might better suit some tender skins.  The bladder is then kept
constantly filled with  carbonic acid gas by  means of a pipe in  the
neck of  it; and the  matter let out at a small aperture  beneath.
Charcoal  powder daily applied, and  perpetual exclusion of the air
by the covering of a double oiled silk, have also been advised, with
the same intention as the use of carbonic acid gas, and  in many
instances with apparent success. 
          CLASS  IV.

     NEUROTICA.

DISEASES OF THE NERVOUS FUNCTION.
                    ORDER I.

                  PHRENICA.

             AFFECTING THE INTELLECT.

Error, perversion, or debility of one or more of the mental facul-
    ties.
                     GENUS I.

                 ECPHRONIA.

Diseased perception,  with  little disturbance of the judgment.
  Cl. IV. Neurotica.  tUfv^orixx: " ad nervos pertinentia," from
*tv(ov, " nervus."  The word here employed is that in general use :
but vevgiicx would perhaps be preferable.
  Ord. I. Phrenica.  <bpatxx, " ad mentem spectantia;" from tpgw,
mens.  The order is nearly synonymous with  the  Deliria of Sau-
vages, the Mentales of Linneus, the Paranoias of Vogel, the Vesanise
of Cullen, and the Alienation mentale of Pinel.
  Gen. I. Eophr6nia.  Extpgwti, or extyorvw from ex$»»v, " extra
mentem," Suidas.  So ep^^m, is " mentis compos."   It is here used,
as among the  Greeks, generically alone, in the sense  of insanity,
and is  designed to include melancholia and mania, which by the
older  nosologists are rendered, though  very  improperly,  distinct 
220                       NOSOLOGY.            [CL. IV.—OR. I.

     occasionally shifting into  diseased judgment, with little  dis-
     turbance of the perception ; diminished sensibility ; irregular
     remissions.
       Deliria.   Sauv. Cl. VIII. Ord. III.
       Vesanias.  Cull  Class 11. Ord. IV.
       Delirium.   Cricht.
       Vesania.  Parr.
       Sufr.  Arab.
       Unsinnigkeit.  G.
       Folic.  F.
       Insanity.   Craziness.
1. Melancholia.   The discrepancy between  the perception and
                        the judgment, limited to  a  single object,
                        or train of ideas ; for  the most part with
                        taciturnity, love of solitude, gloomy  fear
                        or suspicion.
       Melancholia.   Sauv. Boerh Cull. Pinel.
       Mania melancholica.   Cricht. Synopt. Tab.
       Mania Melancholia.  Young.
       Suda.  Arab.
       Schwermuth.  G.
       Melancholic ;  ou Delire exclusif.   Pinel ii. §162.
          Edit.  2.
       Melancholy.
genera, instead of distinct species of  one common genus.  Even
Cullen has fallen into this perplexed  arrangement.  Crichton, Parr,
Young, Pinel, and  most of the recent German writers,  are  free
from it.  Parr, indeed, in his article Mania, asserts that both  con-
stitute nothing more than varieties of one common species ;  yet  with
an inconsistency which is  too frequently to be met with in  his Dic-
tionary, he changes his opinion in the article  Nosology, makes
Vesania  the  genus, and  arranges melancholia, mania, and  even
oneirodynia as separate species under it.
  The distinguishing  characters  are  clear.  In melancholy, the
alienation is restrained to a single object or train of ideas;  in mad-
ness it is general.   In this the nosologists are agreed ;  and  it hence
follows that gloom, gaiety, and mischievousness, may equally exist
under both species; according as these propensities are limited to
a single  purpose,  or are unconfined and extend  to every thing. It
is here Dr. Chrichton is incorrect; for he  distinguishes the two, not
by the limitation or generalization of the delirium,but by the raving
or incoherent clamour and violence of the one, and the dejection or
despondency of the other; which is the vulgar but erroneous line of
distinction. 
GE. I.]
NOSOLOGY.
22\
       « Attonita.  Fixt, mute, immoveable melancholy.
           Melancolia attonita.   Bellini. Sauv.
       G Errabunda.   Roving, restless melancholy: having a con-
           stant desire to change the abode.
       y Malevolens.  Morose or mischievous melancholy: occa-
           sionally terminating in suicide or the injury of others.
        } Complacens.  Self complacent and  affable  melancholy;
           occasionally rejoicing  in a visionary superiority of rank,
           station, or endowments.
         Melancholia Moria.  Nenter. Sauv.
           See,  for  examples, Hor.  Sat.  iv.  Ep. ii. 2.   But of
           this modification one of the best examples that has ever
           been  drawn,  is that  of Don  Quixote, taken unques-
           tionably  from  real life.   This variety is  connected
           with all the rest in the leading specific character of the
           discrepancy between the perception and the judgment
           being limited to a  single object or train of ideas; but it
           differs from  them by the intermixture of a certain de-
           gree of eparsis, or sentimental elevation, which destroys
           the  common  tendency to taciturnity,  solitude,  and
           gloomy apprehension.
              The more common causes of the disease  as  a spe-
           cies are false views of religion; severe disappointment;
           longing after one's native  country and  friends; conti-
           nued grief.
2. Mania.  The discrepancy between the perception and the judg-
              ment  general;  raving;  entony;  and empassioned
              emotion.
  There seems to be an equal incorrectness, though of a different
kind, in M. Pinel, whose book is nevertheless of great merit.  De-
lirium, or wandering, is a pathognomic symptom in both species; a
want of correspondence between the judgment and the perception,
which is what Dr. Cullen means by the term insania.  M. Pinel,
however, has offered instances of  what he calls mania without any
such discrepancy; and he has hence established a species which he
denominates manie sans dSlire.  These instances, however, are all
reducible to examples of rage or ungovernable passion; and ought
by no means to be confounded with mania; the judgment being in
this last, not  at variance with the perception, but  overpowered by
the predominant fury or passion of the moment.  All these belong
properly to the next  genus. 
222                       NOSOLOGY.            [CL. IV.—OR. I.

       Mania.   Boerh. Sauv. Linn.  Cull. Pinel.
       Delirium maniacum.  Hoffm.
       Delirium Mania.   Cricht.
       Mania universalis.  Young.
       Vesania Mania.   Parr.
       Jenun, Mejnunlyk.  Turk.
       Tollheit.  G.
       Manie.   F.
       Madness.
       x Ferox.  Furious and violent madness.
         Mania ferox.   Cricht.
         Manic avee  delire.   Pinel i. § 157. Edit. 2.
         Cured in  one instance by an abscess in the hand.  Act
           Nat. Cur. viii. Obs. 102.
       G Exultans.   Gay and elevated madness.
           Mania mitis.  Cricht. ii. 342.  Paraphrosyne, id. Sy-
             nopt. Tab.
       y Despondens.  Gloomy, despondent madness.
         Mania melancholica.   Cricht. Symp. Tab.
           The despondent cases are more dangerous than those
           of hilarity.
       £ Demens.  Chaotic madness.
         Dementia.   Sauv.
         Demence.   Pinel. iii. § 171.
   2. £ E. Mania Demens.  In this variety there is an utter incohe-
rence of ideas, and  evanescence of external impressions.   The un-
happy subject speaks rapidly with unmeaning babble, of daggers,
dismasted ships, green meadows, his wife, his wig, the minister or
commander in chief;  looks with a threatening aspect, which he in-
stantly exchanges for a wild and horrible laugh, and then sinks into
a momentary calm.
   Pinel has admirably characterised  it in  the following definition :
" Rapid succession,  or uninterrupted  alternation, of insulated ideas,
and  evanescent and unconnected  emotions: continually repeated
acts of extravagance:  complete forgetfulness of every previous
state:  diminished sensibility to external impressions: abolition of
the faculty of judgment: perpetual activity, without object or de-
sign, or any internal sense of its taking place."  De VAlien. Ment.
Sect. III. iii. § 176.
   Gen. II. Empathema. iixOtiput, whence tpvxxOns," cui insunt affec-
tus seu perturbationes: affectu percitus, vel commotus."  T« picv r%
r>jfr ipv%ii$ voepov xxi hoytxot to Jt xXoyo* xxt  sptTrxdfc.   Plut. adv. Col. 
GE. Ill
NOSOLOGY.
223
                       GENUS  II.


                  EMPATHEMA.

  The judgment  perverted or overpowered by the force of some
    predominant passion : the features of the countenance changed
    from their common character.
       Mania a pathemate.  Sauv.
       Manie sans delire.  Pinel. i. § 159.
       Ungovernable Passion.
1.  entonicum.  The predominant passion accompanied with in-
                  creased excitement,  ardour and activity:   eye
                  quick and  daring; countenance flushed and tu-
                  mid.
       * Iracundiae.   Wrath.
           Ira furor brevis est.   Hor. Ep. I. ii.
       0 Superbiae.  Pride.
       y Gloria? famis.   Ambition.
         Doximania (Aofypixvix.)  Auct. Grozc.
       ^ Letitias.  Joy.  Transport.
       £ Philautiae.  Self-love.   Self-conceit.
         Amor sui.  Darw.
        g Zelotypiae.  Jealousy.
2. atsnicum.  Thej predominant passion accompanied  with di-
                   minished  excitement, anxiety, and love of so-
This species has never hitherto been properly digested; and  it is
singular that Dr. Crichton, who has written so excellently on the
diseases of the passions, and  has illustrated  his observations  with
such a variety of examples, should, both  in  his " Inquiry into the
Nature of Mental Derangement," and in  his « Synoptical  Table,"
either have assigned no place to these diseases, or have transferred
them to delirium (ecphronia;) although the  perception and  the
judgment are for the most part strikingly clear, and often peculiarly
acute.   In this last  case, indeed, it is frequently perverted by the
prevailing emotion or  passion of the moment, as  where a man, un-
der the influence of despair, reasons himself into the lawfulness
and expediency of suicide; but the argument, though perverse, is
connected and well sustained, of which we have had various exam-
ples in the philosophical suicides of Germany.  In  the greater num- 
224                       NOSOLOGY.            [CL. IV.—OR. I-

                   litude; eye fixt and pensive; countenance pale
                   and furrowed.
       x Desiderii.   Longing.  Eager desire for an absent object,
            whether place or  person:  and hence equally including
            home-sickness, country-sickness, love-sickness.
         Erotomania ('Eporoptxnx )   Auct. Grozc.
         Amor insanus.   Sennerti.
         Melancholia amatoria.  Sauv.
       x Auri famis.   Avarice.
         Chrysomania (Xpvroptxvtx.)   Auct.  Grozc.
       y Anxietudinis.   Preying care.
         Melancholia phrontis.  Hippocr. Sauv.
         Curae gravis morbus.   Fozsii, p. 486.
         Maladie soucy.  Le Clerc. Hist, de Med.
       £ Mceroris.   Heart-ache.  Severe grief.
         Gasavet.  Arab.
       <? Desperationis.   Despondency.
            It would occupy too much space to fill up all the va-
         rieties  in  either species; many of which  are compound
         emotions, produced by an union of different, sometimes of
         opposite, passions.
ber of cases, however, the judgment, instead of being perverted, is
merely overpowered by the empassioned emotion; there is neither
false judgment nor false perception.
  The elegant and fanciful mind of the Greeks distinguished every
violent or  over-ruling passion by  the  name of  mania,  and hence
doximania, erotomania,  chrysomania; and the same word  is com-
monly  us^d in the same sense in the colloquial language of our own
day.  For general  or poetical use  the term is intelligible enough :
but it is  not  sufficiently correct  for medical or physiological pur-
poses, in which predominant passion must necessarily be distinguish-
ed from delirium.
  Gen. III.  Alusia.  AAt/«, x\vo*ts, xXvo-pios, " oberratio."   Galen
occasionally employs the second.   The  theme is xXvu, " errabunda
mente  afficior; inquietas oberro:"  whence  the  Latin  allucinatio,
and hullucinatio.  The Greek term  is preferred to the Latin, for the
sake of uniformity, in fixing the generic  names.  Sauvages, and af-
ter  him Sagar, have employed hallucinatio as the name of an order,
including various diseases that have little connexion with  each other.
Darwin and Crichton have used  it here as  it stands, in a  generic
sense.  In  whatever  meaning employed, hypochondrias or hypo-
chondriasis is usually placed under  it.  It is so by Sauvages, Sagar,
and Chrichton ; and it occupies the same place in Linneus, who has
merely adopted the term imaginarii instead of hallucinationes.  In 
ge. in.]
NOSOLOGY.
225
  By long  continuance, or frequent and  habitual indul-
gence, most of them have occasionally been found to ter-
minate in ecphronia or insanity.  See Eph. Nat. Cur.
passim.;  and Plater. Observ. lib. i. who  gives instances
from most of the passions.
                      GENUS  111.

                         ALUSIA.

    The judgment perverted or overpowered by the force of the
         imagination; the spirits permanently elevated or depress-
         ed; the feelings of  the mind depicted in the countenance.
       Hallucinatio.  Cricht. Darw.
         Sehu.  Arab.
         Illusion.
1. elatio.   Romantic ideas  of real life; ardent and exalted fancy;
              pleasurable feelings; frequent  pulse; great activity;
              eye  keen  and  lighted up:  countenance confident and
              animated.
Pinel the disease seems to be included under alienation mentale, and
its different varieties to be distributed, though without particular re-
mark, amidst the five species into which he has divided this affec-
tion.  But  in hypochondrias, and indeed in  alusia in general, there
is no morbid or false perception, or mistake of surrounding objects,
the judgment being only led  astray  by the imagination.  So  little
indeed has  hypochondrias to do with  real insanity, (ecphronia,) that
Vogel, Cullen, Young, and many other celebrated nosologists,  have
placed it in the list of corporeal instead of in that of mental diseases;
the first enumerating it under the order of Spasmi, the second under
that  of Adynamia;; and  the third making it a species of dyspepsia;
which, however, is to wander no  less from the mark ; for the pa-
thognomic  symptoms are of a mental character, though  corporeal
affections are perhaps always united with them.
  For the merit  or  demerit of the first species here  named  from
the rhetoricians,  elatio, the author suspects he must be alone answer-
able, and throws himself on the reader's candour for  its  introduc-
tion.   It is  however strictly derived from nature, and intended to fill
up what has hitherto been left as a vacant niche by the nosologists.
Alusia, or hallucinatio, like ecphronia, or insanity, comprises a list
  vol. v.—40 
226                       NOSOLOGY.            [CL. 1V.—OR. 1.

       Sentimentalism.
       Mental extravagance.
       x Heroica.   Chivalry.   Romantic gallantry.
           A generous and high-spirited flight of the imagination,
         but now grown obsolete, and rarely to be met with except
         in ancient tales and traditions.  Like ungovernable passion,
         (empathema,) it may lead to, and be combined with ec-
         phronia, or insanity, as in  the case of the exquisite fiction
         of the knight of La Mancha already  adverted to.
of affections that are characterised by two opposite states of ner-
vous action, entonic and atonic ; elatio is intended to include the for-
mer of these, as hypochondrias  is the latter.   They  stand in the
same relation to each other, as elevated  and dejected madness or
melancholy.  Both are united with a  peculiar modification of the
digestive  function, but  possessing opposite bearings;  being in the
former  strikingly active and energetic, and in  the  latter strikingly
sluggish and languid.   Hence under the first species the  patient is
able to endure enormous fastings, and to support life upon the  scan-
tiest and  least  nutritive diet, either of which would be destructive
under the second.   The physiologist may readily  pursue this sub-
ject, and find additional reasons for the present  collocation; but this
is not the place for physiological  speculations;  though they maybe
indulged perhaps in a future work upon pathology and physiology.
See  an elegant essay on this subject in Nicholson's Journal, vol. xv.
art. vii. p. 288.
  2. Alusia  Hypochondrias.  The specific name is taken from the
anatomical term v*o%oifytx,  in which the disease was formerly sup-
posed to be seated.  Hypochondrias is here used  instead of hypo-
chondriasis, because, as already observed  on various occasions, the
terminal iasis is, with very few exceptions, limited to a peculiar fa-
mily of cutaneous diseases.   See the Preliminary  Dissertation, and
Table of Definitions.   The author has felt the less difficulty in  mak-
ing the  present change, as hypochondriasis is of comparatively mo-
dern invention, and is not to be met with either in the Greek or Latin
writers, by whom  the complaint  is usually alluded to  or described
as a species of  melancholia, or rather a disease of the melancholic
temperament.  It constitutes the  third sort or species of this malady
as described by Galen, and which he attributes to a peculiar affec-
tion  of the stomach.   His words are these:  « Est praeterea tertium
melancholia; genus, morbi comitialis exemplo,  cum ortum a ventri-
culo habuerit: solentque medicorum aliqui banc dispositionem, hy-
po chondriacum, flatuobuin qui morbum,nominare."   De Loc. Affect.
lib. iii. cap. 6.   Diodes,  a  physician of great  reputation, had not
long before published a treatise on the diseases of the stomach, in 
ge. m.]
NOSOLOGY.
227
       G Facetosa.  High spirits; sparkling ebullient wit,  inca-
           pable  of restraining  itself;  that  often  sacrifices a
           friend at the shrine of a jest.
       y Ecstatica.   False inspiration ; visionary conceits.
           The judgment urged to mistake energetic ideas for
         realities;  to  believe  in  phantasms ;  in an  immediate
         communication with spirits, or in the  power of working
         miracles.   Examples may be found in  all ages, and  in all
         religions.   One of the  most interesting is that of  Saint
         Teresa in Butler's Lives.   In our  own  day one of the
         most striking is that of Baron Swedenborg.   This morbid
         afflatus is often aped by cunning impostors to serve their
         own interest with the multitude,
         Hallucinatio Daemonomania.  Cricht.
       ^ Fanatica.  Fanaticism.   Religious  flights of the imagi-
           nation predominant over the  natural feelings as  well
           as the judgment; urging to a voluntary and uncalled
           for submission  to  severe  privations,  mortifications,
           and torture ; or to  the  torture  and  massacre of  those
           who profess different creeds.  Examples, as in the last
           variety,  may be  found  in every age  and religion :
           among  the  prophets of Baal,  1 Kings xviii. 28 ; the
           Curetes or Phrygian priests,  Lucret.  ii.  631 ;  the
           fanatical  votaries  of the  Indian Juggernaut;  in  many
           of the convents and nunneries of Lamism, especially at
           Thibet, and still more so in many catholic countries :
           in  the  fanatical  promoters of the sufferings of  the
           Waldenses, the furies  of St. Bartholomew's day, and
           the fires of Smithfield.
         Dsemonomania fanatica.  Sauv.
         Kefijet.  Arab.
3. Hypochondrias.  Gloomy ideas of  real life ; dejected spirits;
                       anxiety ; dyspepsy ;  languid pulse  ;  in-
                       disposition to activity ;  eye  oblique and
                       scowling;  countenance  gloomy and sullen.
which this malady occurs as one of them.  Galen adverts to this
publication, thinks the disease improperly placed in such an arrange-
ment, and regards the symptoms  enumerated by Diodes as for the
most  part accidental occurrences.  " Verum  satis mihi fuerit, ea
accidentia percurrere, quae a Diocle praescripta sint in libro cui titulus
sit Affectio, Causa, Curatio," &c.
  2. a A. Hypochondrias, Autalgica.   To  this variety  belong  the 
228                       NOSOLOGY.             [CL. IV.—OB. I.

       Hypochondriasis.  Auct. Recent.
       Morbus hypochomlriacus.   Frascast.  Boerh.
       Malum hypochondriacum   Galen.  Hoffm. Junck.
       Hallucinatio Hypochondriasis.   Cricht.
       Dyspepsia Hypochondriasis.  Young.
       Gliemm.  Arab.
       Ghem.   Pers.
       Traurigkeit.   G.
       Hypochondrie.   F.
       Hypochondrism.
       Low Spirits.
       * Autalgica.  With visionary or exaggerated sense of pains,
            or  disease ;  whimsical dislike of persons,  places,  or
            things ;  groundless apprehensions of personal danger,
            or poverty.
         Melancholia aegrorum imaginariorum.   F.  Chichoineau.
         Melancholia argentis.  Sauv.
         Grillenkopfheit.   G.
         Maladie imaginaire.  F.
            See for  an  example drawn from the life,  Moliere's
         celebrated  comedy.
         Vapours.
       j3 Pertaesa.  With general listlessness, or disgust; irksome-
            ness and weariness of life.
         Melancholia Anglica.  Sauv.
         Taedium vita;.    Darw. who gives various examples, vol.
            iv.  p. 90, 8vo. ed.; as does also  Sauvages,  who  par-
            ticularly refers to Gressefs comedy,  entitled Sydney.
            See also Lucr. iii. 1074.
         Malalet.   Arab.
         Verdriisslichkeit.  G.
syphilis imaginaria, psora imaginaria, and tabes imaginaria of Darwin;
the diseases perhaps to which the hallucination is chiefly directed, and
on which it principally feeds.   The author has at this moment under
his care a singular case of the first.  Mr. S. is a man of excellent cha-
racter, aged forty-six : he has for some time been engaged to a lady,
whom he forbears to marry merely from a morbid apprehension that
he has so debilitated his frame, by having indulged in illicit amours at
an early period of life as  to be totally  unworthy of her virtues and
affection;  and that his union with her  would prove her ruin.  In
every other respect he is perfectly well; yet irresistibly impressed
with this miserable fancy, he is full of wretchedness, gets no sleep at
night, indulges in silence and  solitude, and has been often tempted to
commit suicide. 
GE. IV.]
NOSOLOGY.
229
  Ennuie.  F.
  Weariness of life.   Spleen.
y Misanthropica.  With general  malevolence, peevishness,
     and abhorrence of mankind.
  Menschen-feindschafft.   G.
  Misanthropic  F.
  Misanthropy.
                  GENUS  IV.

               ASPHELXIA.

Voluntary inactivity  of the  whole or the greater part of the
     external senses  to  the  impressions  of surrounding ob-
     jects, during wakefulness.
     Nachdenckenkeit.   G.
  Gen. IV.   Aphelxia.  'A<pex%tx, from xQtXxa, » abstraho," " re-
traho," " avoco," " abduco."  So Xenophon De Volupt. xtptteovtrx
n-fos tx Tihx.   The subject is almost, if not altogether new to noso-
logy, and has  seldom been dipt into by physiologists. Darwin occa-
sionally touches upon it in different parts of his Zoonomia, and Dr.
Crichton in his Inquiry into the nature of mental derangement; but
it yet remains to be analyzed and reduced to a nosological method.
  In order to  become acquainted with the existence of surrounding
objects, or of  an  external world, as it is called by  psychologists,
three things are necessary; sound  external senses;  a secretion of
the nervous material, whereby they are made capable of being sti-
mulated by the objects addressed to them;  and an exercise of the
faculty of attention to the impressions which  are thus  produced.
The will has the power of calling this, as it has, or ought to have,
of calling every other faculty of the mind  into a state of exertion,
or of allowing it to be indolent: and it is chiefly upon an assent  of
the will, to a relaxation of the attention, or to its concentration upon
some object unconnected with  those immediately before us, that the
phaenomenon of revery depends.  In reading books in which  we are
totally uninterested, composed in a tedious and repulsive style, we
are almost continually in a  state of revery.  The will does not ex-
ert  its  power: the attention  is suffered to wander to  something of
stronger attraction; or the imagination is left to the play of its own
capricious ideas;  and though we continue to read, we have not the
smallest knowledge of the argument before us; and if the subject
to which the  train of our thoughts is really directed be of  a strik- 
230                       NOSOLOGY            [CL. rv.—OR.I

          Reverie.   F.
          Revery.
1.  socors.  Truant attention ;  wandering fancy ; vacant  or vacil-
               ling countenance.
       Absence of mind.
          An absence  or  vacuity  too  common at schools and  at
       church; over tasks and  sermons.
ingly ludicrous character, we may possibly burst into a laugh in the
middle of a discourse of great gravity and seriousness, to the asto-
nishment of those around us.   It is of high importance therefore
that the will should obtain a perfect command over the attention ;
and it  should be one of the first efforts  of practical  education to
strengthen it in the  exercise  of this power.  Nothing indeed can
ever be learnt or seriously engaged in without it.  Yet it is often most
culpably neglected;  and an habitual inattention to every thing that
ought  to engage our notice whether in the world without us or the
world  within us,  is the necessary result,  and lays a foundation for
some of the most  awkward and  ludicrous reveries or absences of
mind that are to be met with.   It is this description of revery that
constitutes our  first species.
  There is another of a more grave and allowable kind, and which
forms  a direct counterpart to the preceding.  It occurs in cases of
intense application of all  the  powers of the mind to  a  particular
subject;  as, for example, of pure mathematics, or some overwhelm-
ing passion.  In this state, the attention, instead of being indolent,
is, with the consent and  by the direction of the will, so completely
absorbed and abstracted by the subject in question,  that it is with
great difficulty it can be roused  by any stimuli whatever to bend
itself to any thing else;  and consequently the  person who is thus
abstracted, is torpid to the world around him ;  he hears nothing, he
sees nothing, he feels nothing;  while the external senses themselves
are, perhaps, still further blunted by having the whole stock of ner-
vous or sensorial fluid exhausted, so to speak, at a single outlet  in
support of the  prevailing ecstasy.  It is this which constitutes the
second species of revery here offered.   The fall of Archimedes af-
fords us a striking example of it.   When the Roman  army had at
length taken Syracuse by stratagem, which the tactics of this won-
derful  man prevented them from taking by force : he  was shut up
rn his closet, and so intent on a geometrical demonstration, that he
was equally insensible to the shouts of the victors, and the outcries
of the vanquished. He  was calmly  drawing the lines of a diagram,
when a soldier abruptly  entered  his  room, and held  a sword  to his
throat.  " Hold friend, said Archimedes, one moment, and  my de-
monstration will be finished."  The soldier, surprised at his uncon-
cern at a time of such extreme  peril, resolved to carry him before 
GE. IV.]
NOSOLOGY.
231
2. intenta.  The attention wound up, and rivetted to a particular
                subject; with sympathetic emotion of the muscles
                and features connected with its  general drift.
       Tiessinnigkeit.   G.
       Abstraction of mind.
       x A studio.   From intense study.
       G A pathemate.  From overwhelming  passion: as rapture,
          grief, despair,
Marcellus;  but as the philosopher put under his arm a small box
full of spheres, dials, and other instruments, the soldier, conceiving
the box to be filled with gold, could not resist the temptation, and
killed him on the spot.
  There is  a  third species of revery, which differs widely from
both the preceding.  The attention is equally summoned into action,
and dismissed at the command of the will.   It is summoned in the
last species; it is dismissed when a man voluntarily surrenders him-
self to ease  and  listlessness of mind: during which period, more-
over, in consequence  of this indulgence in general indolence, the
external senses themselves unite  in the mental quiescence ; and a
smaller portion'of  nervous material is probably secreted for  the
very reason  that a smaller portion  is demanded; and hence the  ex-
ternal senses are as torpid as the  internal, and as little susceptible
to their respective stimuli.  The first playful ideas that float over
the fancy in  this case take the lead, and the mind relaxes itself with
their easy  and sportive flow.  This is denominated  brown study,
listless musing ; it forms the last  species of revery in the present
genus, and is thus admirably described by Cowper in his  Task, B.

       Laugh ye who boast your more  mercurial powers,
       That never feel a stupor, know no pause.
       Nor need one; I am conscious, and confess,
       Fearless, a soul that does not always think.
       Me, oft, has fancy, ludicrous and wild,
       Sooth'd with a waking dream of houses, towers,
       Trees, churches, and strange visages, express'd
       In the red cinders, while with poring eye
       I gaz'd, myself creating what I saw.
       Nor less amus'd have I quiescent watch'd
       The sooty films that play upon the bars
       Pendulous, and foreboding, in the view
       Of superstition, prophesying still,
       Though still deceiv'd, some stranger's near approach.
       'Tis thus the understanding takes repose
       In indolent vacuity of thought,
       And sleeps, and is refresh'd.  Meanwhile the face 
232
NOSOLOGY.
[CL. IV.—OR. I.
3. otiosa.   Leisurely listlessness; free  surrender of the judgment
              to the sportive vagaries of the fancy; quiescent mus-
              cles; idle gravity of countenance.
       Studium inane.  Darw.
       Brown study.  Listless musing.
                   GENUS  V.

                PARONIRIA.

The voluntary organs connected with the passing train of ideas
    overpowered by the force of the imagination during dream-
    ing, and involuntarily excited to their natural  or accus-
    tomed actions: while the other organs remain asleep.
       Conceals the mood lethargic with a mask
       Of deep deliberation, as the man
       Were task'd to his full strength, absorb'd and lost.
   For an elegant essay on this subject see an article in the Manches-
 ter Memoirs, Vol.  I. series ii. by the Rev. Johnson Grant, A.B. of
 St. John's College, Oxon.
   Gen. V.  Paroniria.   From ttx^x, and ovet^ot, « depraved, dis-
 turbed or morbid dreaming."  So ^vo-om^os, in Dioscor. ii. 127." tu-
 multuosis et malis somniis  molestans."
   Under the article Ephialtes, CI. II. ord. ii. gen. 4, the author has
 already pointed out his reasons for separating paroniria from this
 last disease, notwithstanding that they are united  by Dr.  Cullen
 under the  common  name of oneirodynia.  They have, in  fact,  no^
 resemblance whatever, and  scarcely  any connexion.   All the spe-
 cies arranged  under paroniria, in the present text, are so palpably
 and decidedly of the same  family, that it is not necessary to enter
 upon  the question.   They are here, however, associated for the
 first time in a genus distinct from ephialtes.   See a singular instance
 of this affection related in Sir William Forbes's Life of Dr.  Beattie.
   Gen. VI.  Moria. M«f tx, from jk.*>£«$, " stultus," " fatuus."  The
 author has limited the term to its proper signification.  Vogel em-
 ploys it, though with a differsnt termination, (morosis instead of mo-
 ria,) in the same or very nearly the same sense; but he is almost the
 only medical writer that does so.   His words are,tl mentis imminuta
 et infirmata functio, seu quaedam  ignavia, citra delirium et soporem."
 Moria is used by Nenter and Sauvages to denote melancholia com-
placens, (self-complacent melancholy,) while by others it is employ- 
GE. V.]
NOSOLOGY.
233
       Oneirodynia activa.  Cull.
       Erethismus Onirodynia.   Young.
1.  ambulans.  The muscles of locomotion excited into their ac-
                 customed action by the force of the imagination
                 during dreaming.
       Somnambulisnius   Sauv. Linn. Sag.
       Nyctobasis.   (HvxroGxo-ts.)   Auct.  Grozc.
       Noctambulatio.  Junck.
       Schlaf-spatzieren.   G.
       Sleep-walking.  Somnambulism.
2. loquens.  The muscles of speech excited  into their accustom-
                 ed action  by the force of the imagination during
                 dreaming.
       Nyctegersia.   (Hvxriyi^o-tx.)   Auct. Grozc.
       Sleep-talking.
3. salax.   The sexual organs excited  into venereal action by the
              force of the imagination during dreaming.
       Gonorrhoea oneirogonos.   Sauv.
       Gonorrhoea dormienlium.   Cull.
ed synonymously with  ancea, or idiotism.  To complete the con-
fusion, morosis, (amentia Morosis.) is the name given by Sauvages
to mental imbecility, (moria imbecillis,) though, as already observed,
he has just before used moria  in the sense of melancholy.  It is
precisely in the signification now offered  that the term is employed
by Erasmus, in his celebrated treatise, entitled "Moria Encomium,"
or " The Praise of Folly," which he dedicated to Sir Thomas More.
  Mora, moror, morosus, morositas, are  derived from this common
source, and uniformly  import  " waywardness, tardiness,  dulness,
impediment;" though the  lexicographers, not having hit upon the
right path, have wandered in different directions without being able
to satisfy themselves. In Sauvages and Sagar morositates are in Let
corporeal moria, " defects or hebetudes of the bodily functions."
  2. Moria demens.   This  term is preferred to amens, as being
somewhat more general ; though amens, or amentia, like moria, in
the preceding  note, has been used, without any authority, in a very
loose and  indeterminate signification by medical  writers; among
whom it imports equally,  insanity, stupidity, dotage, and idiotism.
The last alone is its  direct  sense, and the author  would have em-
ployed it to denote the variety y, but from its want of a fixt mean-
ing in the  present day ; on which account he  has preferred the
Greek univocal term anaa, (xvotx,) from x priv.  and  voos, or vov$,
mens : <% total destitution of mind."   Paranoea, (irxgxvovx)  is a more
general term, and is, as nearly as may be, syi.onymous with demen-
tia.   Both  import " derangement  of mind" in contradistinction to
  vol. v.—41 
234                      NOSOLOGY.             [CL. IV.—OK. I.

       Exoneirosis.   Cricht.
       Pollution involuntaire.   F.
       Night pollution.
                       GENUS  VI.

                         MORIA.

     Defect or hebetude of the understanding.
       Morosis.   Linn.  Vog.
       Amentia.   Sauv. Sag.  Cull.  Cricht.
       Matuhlik, Delilik.   Turk.
       Unversland.   G.
       Fatuile.  F.
       Fatuity.
 1. imbecilis.  The defect or hebetude partial or confined to par-
                  ticular faculties of the understanding.
       Amentia Morosis.   Sauv.
       Sthwachheit.  G.
       Imbecillite.  F.
       Imbecility.
       x  Siupiditas.   Dulness and indocility of the apprehension ;
            torpitude and poverty of the imagination.
          Yehem.   Arab.
          D'iminheit   G.
          Be ise   F.
          Stupidity.
       &  Amnesia.  Feebleness  or failure of the memory.
          Amnesia   Sauv.  Sag.  Cull.  See note of the last under
            gen Ixv.
          Oblivio.   Linn.  Vog.
          Memorise debilitas.   Junck.

u alienation of intellect," which is  ecncea,  or ecphronia, as observed
id a prior  note.
  2  /3 M. demens Lerrma, (^np*x) from tops- "ineptus," is direct-
ly synonymous with  dotage, .uxl  is rhe common technical Gieek
term.  It  is the proper root  of  de-tirus,  (among  ancient  writers
" delerus,") and delirium.
  This order ought not to close without the following note upon the
much agitated question of coercion, adr'ed  by M. Pinel to the second
edition of  his well known treatise on Mental Alienation. 
C.F.. VI.]
NOSOLOGY.
235
       Recollectionis jactura.  Darw.
       Dysesthesia interna.   Young.
       Vergesslichkeit.  G.
       Oubli.  F.
       Forgetfulness.   Oblivion.
          Sometimes   arising instantaneously, Salmuth, Cent.  II.
       obs.  41.   Forgetfulness  of the pronunciation  of  written
       words,  but with  a power of writing  them.   Ephem Nat.
       Cur.  Dec. I.  an. iii. obs. 198, and p. 603.   An.  iv.  and
       v. obs.  154.   Total as to places, or the discrimination of
       one place from another, for half an hour, in Mr. J. Hunger.
       See Sir Everard  Home's  Life of him  prefixed to his Trea-
       tise on Inflammation,  p. Iviii.
     y Credulitas.  Weakness and undue pliancy of the judgment,
          with  facility of being duped.
       Credulitas.  Darw.
       Leichtglanbigkeit.  G.
       Credulite.  F.
       Credulity.
     } Inconsiantia.   Instability  and irresolution of the will.
       Leichtsinnigkeit.   G.
       Inconsiance.   F.
       Fickleness.
          Other varieties might be added, but  it is unnecessary.
2. demens.  Defect or hebetude of all the faculties of the under-
                standing.
       Dementia.  Auct. Lat.
       Parancea (n*f*»e<* )  Auct.  Grozc.
       Beladet.  Arab.
       Unvernunfft.   G.
       Demence.  F.
       Witlessness.   Irrationality.
       x  StuI iria.   Shallow  knowledge ; feeble judgment; light,
            frivolous  fancy ;   for the most part with  good-nature ;
            sometimes with obstinacy.
       Thorheit.  G.
       Niaiserie.  F.
       Folly.  Silliness.
     p Lerema.   Impotence of body  as  well as of  mind from
          natural or premature old age :  childish desires  and pur-
  J'ai examine avec un soin scrupuleux les effets que produisoit sur
les alienes I'usage des chaines de fer, et ensuite les resultats com- 
236                       NOSOLOGY.            [CL. IV.—OR. (

         suits;  drawling  speech  or garrulous babble,  composed
         of ideas, for the  most  part  associated by previous habit.
       Lerema (Aigv>f*.a )   Auct. Gr.
       Anilitas.  Auct. Lat.
       Aberwitz.   G.
       Radoterie.  F.
       Dotage.   Superannuation.
       y Anoea.   General obliteration  of the  mental powers  and
            affections;  paucity  or destitution   of ideas ;  obtuse
            sensibility; vacant countenance; imperfect  or  broken
            articulation; with, occasionally, transient and unmean-
            ing gusts of passion.
         Wahnsinnigkeit.  G.
         Idiotism.   F.
         Idiotism.
paratifs de  leur  abolition, et je ne puis plus former des doutes en
faveur d'une repression plus  sage et  plus moderee.  Les memes
ahenes qui, reduits  aux  chaines pendant une longue suite d'annees
etoient restes dans un etat constant de fureur, se piomenoient ensuite
tranquillemcnt avec un simple gilet de force et s'entretenoient avec
tout le  monde, tandis qu'auparavant on ne pouvoit en approcher
sans le plus grand danger.  Pref. p. 1.
  Order II.  jEsthetica.  'At<r6tirixx, from xt^xio^xt " sentio, et
proprie,  sensu corporis."  The term  applies however  to all the
external  senses ; and in the language of Galen peculiarly expresses,
j)* xie-Oyrixi) S'wxpus,  "the  power or faculty of sensation."  At the
same time  it must  be admitted,  that it is occasionally applied to
mental sensation, as in  Isocr. to  Demonicus, ovra tjjv ty.iwm yvupurti
ut<r0i)tn}. " thus may  you feel their mind or inclination."
  It is hence not to be wondered at that the term  should be  used
in different senses  by different medical  writers.   It  has  seldom,
indeed, been applied to the mind, but has  strangely varied between
expressing sensation  generally and the sense of touch alone.   Dr.
Young, with his  usual correctness, has made use of the term in the
same sense in which it is adopted in the present system, to indicate
diseased sensation of  all  the  external organs; but he has deviated
from  his usual correctness in immediately afterwards applying it to
defective memory, which  he terms dysesthesia interna, and ranks in
the same list or  genus, with defect of the external senses.
  Sauvages, and after him Sagar and Cullen, have employed dyses-
thesia in  the signification of hebetude of the external senses gene-
rally ; synonymously  with the privativi  of Linneus, and partly so
with the adynamic of Vogel;  and having thus made their option of 
GE. I.]                     NOSOLOGY.                       237



                       ORDER  II.

                    ESTHETIC!

                 AFFECTING THE SENSATION.

   Dullness, depravation or abolition of one or more of the external
organs of sense.


                        GENUS I.

                      PAROPSIS.

     Sense of sight vitiated or lost.
       Dysesthesia visualis.   Young.
the meaning of the term, it became them to adhere to it; and under
such adherence, anesthesia must have imported  atony or inactivity
of the same senses generally.   But while dysasthesia extends to all
the senses, anasthesia  is by the  above writers limited to the single
sense of touch : unquestionably  with no  small  perplexity to the
young student.
   Gen. 1. Paropsis. Uxpo-^ts," diseased vision :" from nxpx," male,"
and oif/is, " visus:" as paracusis from irxpx and xxov*.   Dr. Young is
the only English nosologist, the author is acquainted with, who has
endeavoured  to  arrange all the  primary  defects of the organ  of
vision under  one head.  With him, however, this head  constitutes
a mere species, under the generic  term  dysasthesia, which, as
already observed, is  made to extend to all the senses.   And con-
sequently long-sightedness, and short-sightedness, weak  and acute
sight, double-vision, squinting  and cataract, are all contemplated as
mere varieties of the  same specific disease.  This  can never be
allowed: the error consists in  reducing to a species  what ought to
have been a genus, under which  all the varieties might have ranked
as separate species belonging to  it.   Amaurosis ought also to have
ranked  under the same banners, though  carried  by the learned
writer to another class.
   In selecting and defining the specific names much confusion has
been exhibited, in consequence of the generic term being under-
stood by some writers in a natural  or literal, and by others in a 
23S                       NOSOLOGY.            [CL. IV.—OR. II.
1. lucifuga.  Vision painfully acute  in a  strong light; but  clear
                 and pleasant in a deep shade or the dusk of the
                 evening.
       Nyctalopia.  Hippocr.  Prozdict.
       Visus nocturnus.   Boerh.
       Oxyopia.   Auct.  Var.
       Hemeralopia.   Neater.
       Amblyopia meridiana.  Sauv.
       Photophopia.  Plenck.
       Dysopia luminis.   Cull.
       Visus acrior.  Darw.
       Tagblindkeit.  G.
       Nyctalopie.  F.
       Night-sight.
         Chiefly common to those who live almost constantly in dark
       inclosures, as mines or  prisons; or who have  recently had a
       cataract depressed or  extracted.  Usually accompanied with
       perpetual  nictitation.
         Found  also, occasionally, as a symptom in  ophthalmy, ir-
       ritation of the optic nerve, and hydropscapitis.  For the last
       see  Wilt.  Von der Hirnwassersucht
2. noctifuga.  Vision dull and confused in  the dusk; but clear and
                  powerful in broad daylight.
       Hemeralopia.   Auct.  Grozc. Plenck.
       Visus diurnus.  Boerh.
       Nyctalopia.  Neoter.
       Amblyopia crepuscularis.   Sauv.
       Dysopia tenebrarum.   Cull.
       Shebkeret.  Arab.
       Nachtblindkeit.   G.
       Day sight.
         Said to be endemic in many parts of Asia; and to be a fre-
       quent affection in the Brazils, West Indies, and Poland.   See
       Hautsiierck u Recueil d'Observations de Medicine, i. 2   Weiz
       Neue Ausziige aus Dissertationen fur Wundarzte.


technical or implied sense.   Thus nyctalopia, literally night sight,
was employed by the Greeks  agreeably  to  its literal meaning, to
import that imperfection of vision under which the eye can only see
at night or  in a deep shade: while the  same term has been  used by
modern writers in the opposite sense of night-sight ache, agreeably
to the technical or implied meaning of  opia,  when employed patho-
logically ; and has hence been  made to import day-sight instead of 
GE.L]
NOSOLOGY.
239
          Plenck asserts that some men have so strong a day-sight
            as to enable them to distinguish the stars at noon.
3. longinqua.   Vision only accurate when the object  is far off.
       Amblyopia proximorum.   Sauv.
       Dysopia proximorum.  Cull.
       Presbyopia.  Plenck.
       Weitsichtigkeit.  G.
       Vue longue.   F.
       Long-sight.
       x  Vulgaris.  Common to every period of life, and  chiefly
            produced by habitual relaxation of the iris, mostly with
            somewhat too flat a  cornea.
       G Paretica.  From partial paralysis : as an  absolute incon-
            tractility of the iris, by  which  the diameter of the
            pupil is rendered unchangeable, and a paresis of several
            other  muscular powers of the eye is  superinduced ;
            while the  retina continues perfectly  sensible to the
            stimulus of light.
            Immutability of sight.   Young.  Phil.  Trans. 1793.
          1801. ^ See also Wells. Phil. Trans. 1811, art xix.
       y  Senectuns.   From old age,  in which the cornea usually
            grows less convex ; and hebetude and relaxation become
            common to all the powers of the eye.
       Presbytia.   Ltnn.
       Presbyopia.  Auct.  Var.
4. propinqi'A.   Vision only accurate when the object is near.
night-sight,  or  that imperfection of vision under which the eye can
only see in the day  or whenever there is a strong light.  And hence
hemeralopia, the opposite to nyctalopia, has been  used with the
same confusion and  contradiction of sense ; by the Greeks importing
day sight, being taken  naturally or literally; by the moderns day-
sight-ache, and  consequently night-sight,  being taken technically or
by implication ; and hence Sauvages, '• Graecis hemeralopia, neote-
ricis, nyctalopia."
  In like manner the amblyopia or  dyopia dissitorum of Sauvages
and Cullen, " morbid sight of distant objects," is the  short-sight or
near-sight of colloquial  language in all countries; whi:e their am-
blyopia, or dyopia proximorum, " morbid sight  of near objects," is
the colloquial long-sight of all countries.
  In the specific names now offered,  the author  has avoided the
embarrassment of the first two examples by selecting more appro-
priate terms; and that of the last two by endeavouring to make the 
240                       NOSOLOGY.            [CL. IV.—OR. II.

       Amblyopia dissiforum.   Sauv.
       Dysopia dissitorum.   Cull.
       Myopia.  Linn.
       Myopiasis.   Vog.
       Visus juvenum.   Plater.
       Kurzsichtigkeit.  G.
       Vtie courte.  F.
       Short sight.
5. lateralis.  Vision only accurate when  the  object  is placed
                  obliquely.
       Amblyopia luscorum.   Sauv.
       Dysopia lateralis.  Cull.
       Lusitas.   Boerh.
       Schiefen-sehen.  G.
       Vue couche.  F.
       Skue sight.   Old Engl.  (Sight askew.)
technical and colloquial terms run parallel.  Thus paropsis longin.
qua, literally " vision imperfect by being only remote,"  is the long-
sight  of  the vulgar.   Dr. Cullen, indeed,  in  his species dysopia
lateralis, " sight imperlect by  being  only askew or  oblique," has
pursued the same mode of interpretation, but then it is a mode of
interpretation at variance with all his preceding examples.
   1. Paropsis lucifuga.  This disease may be the result of at least
two causes : primary irritability of the retina ; and deficiency of the
black pigment that covers the choroid tunic.  Such deficiency is
occasionally found in persons of a fair complexion and light hair;
but more frequently in  albinos, who in consequence are more subject
to the affection.  In old persons the  same deficiency is sometimes
traced, but without painful vision ; for at this time of life the optic
nerve, like all other nerves, is become more obtuse.   In horses the
deficiency constitutes what is called a walleye.
   This acuteness of vision is natural to cats, lynxes, lions, and  per-
haps all the feline genus, which prevent the pain they would other-
wise suffer by a closer contraction of their irids  than mankind are
able to effect; while by a like  degree of expansion they are able to
see much  better than mankind in the dark.
   2. Paropsis noctifuga. The character of this disease  is precisely
the reverse of that of  the preceding ; and proceeds usually from a
want of sufficient irritability in the retina;  which, in consequence,
is only excited to action by a strong stimulus, or powerful light:
and hence does not clearly discern in the  shade or towards the close
of day.   Hens are  well known to labour  under this defect;  and
hence, they cannot see to pick up small grains in the  dusk of the
evening, and so employ this time in  going  to roost: on which ac- 
GE. I.]
NOSOLOGY.
241
6. illutoria.  Imaginary objects floating before the sight; or real
                   objects appearing with imaginary qualities.
       Suffusio.   Sauv. Sag.
       Phantasma.  Linn. Vog.
       Pseudoblepsis.   Cull.
       Falsch-sehen.   G.
       Berlue.  F.
       False-sight.
       x  Phantasmatum.  Ocular spectres: assuming various sem-
            blances.
count the disease is  sometimes  called  Hen blindness.  See Dune.
Med. Com. xix. 294.
  3. Paropsis longinqua.   In the  preceding species the  hebetude
seems chiefly to appertain to the retina :  in  the present  species it
belongs chiefly to the iris, which is habitually dilated and  not easily
stimulated to a contractile  action.  For  " it is well known," ob-
serves Dr. Wells,  " to  those who  are conversant with  the facts
relating to human vision, that the eye in  its relaxed state is  fitted
for distant objects, and that the seeing of  near objects accurately is
dependant upon muscular exertion."   Phil. Trans. 1811, art. xix.
In the paper  now referred to, Dr. Wells describes an interesting
case of a  person about thirty-five years of age, whose retina was  as
sensible to the stimulus of light as ever; yet who from a paresis, or
permanent dilatation of the pupil, saw near objects with considera-
ble confusion;  but  remote  objects with   perfect accuracy.  The
power of  moving the upper  eye-lid was  also lost.  It  was an ex-
treme case of the disease before us, complicated with partial para-
lysis of the adjoining muscles, and may be imitated by applying the
tincture of belladonna.   It was easily remedied by the use of spec-
tacles with convex glasses, by means of which the patient was able
to read without  difficulty in  a printed  book, whose letters he was
scarcely able  to distinguish from  each other before the spectacles
were applied.  This  ought only  therefore to  be  regarded as a
variety of  the present species. A third variety is that produced by
old age, constituting the presbytia, and presbyopia of medical wri-
ters (from vrgeo-Gvs,  senex.)   in which case the hebetude and  re-
laxation, while short of paralysis, extend usually through the retina,
iris, and  indeed every part  of the  complicated organ of the eye,
for the cornea becomes less  convex in its form, and less pellucid in
its transparency.
   4. Paropsis propinqua.  See the preceding note.  Mice are sup-
posed to have this kind of  vision naturally; and hence  the  name
that has been given to it of myopia, or mouse-sight.
   5.  Paropsis lateralis.   In this species the patient can  see only ob-
liquely, in consequence of some partial obfuscation of the cornea
   vol. v.—42 
242                       NOSOLOGY.            [CL. IV.—OR. II.
 1. Dark spots.   Muscae volitantes.   Auct. Var.
                Myodesopsia.   Plenck.
                Suffusio myodes.   Sauv.
 2. Net-work.  Visus reticularis.   Plenck.
                 Suffusio reticularis.   Sauv.
     This  is  sometimes permanent;  sometimes  fuga-
   cious ;  and  is probably,  as  conjectured  by Sauvages,
   produced by a morbid affection of the arteriolar of the
   retina.
 3. Sparks.  Suffusio scintillans.  Sauv.
     Generally from a blow or excess of  light.
 4. Dazzling.  Marmaryge.   Hippocr.  Vog.
     Photopsia.  Plenck.
       Usually from plethora of the vessels.
 5. Iridescence.  Suffusio colon's.   Sauv.
     From the preceding cause.
Mutationis.   Real objects changed  in their natural qua-
               lities.
 Metamorphopsia.  Plenck.
 I. Error of form.  Suffusio metamorphosis.   Sauv.
     In this respect they are  too large, too  small, cut in
  half, distorted.
 2. Error of motion.   Suffusio nutans.  Sauv.
     This consists usually in dancing, nodding, or rapid
  succession.
 (usually perhaps from scratches or slight scars,) or of the humours
 through which the light is transmitted;  or from a partial paralysis
 of the retina.  This  must not be confounded with  strabismus, or
 squinting, which proceeds from a different cause ; and is accompa-
 nied with different phenomena. In lateral vision, the  axis of the eye
 affected  usually coincides with that of the sound  eye, though it runs
 somewhat obliquely to avoid the obstruction in the tunic.  In stra-
 bismus the two  axes  do not coincide, and the judgment is formed
 from  the strongest eye alone.   If, however, in lateral  vision, the
 obstruction be such as to make the optical axis of the affected eye
 at variance with that  of the sound  eye, squinting must  be a neces-
 sary consequence of the disease.
  6. x  I. P. illusoria, Phantasmatum : Dark spots.   "These ap-
 peirances are sometimes, if not always,  occasioned  by  the opacity
 of some of  the vessels  of  the vitreous  humour, near  the retina.
 They are seen in a  full light, and cannot, therefore, as Sauvages
has justly remarked,  be caused by any thing in the anterior part of
the eye; and they may often be observed to change their form with
the motions  of the eye ; which they could not  do if they  did not 
GE. LJ
NOSOLOGY,
243
         3. Error of number.  Diplopia.   Sauv. Plenck.
              Often doubled, tripled, or  otherwise  increased, or
            multiplied.
              The chief causes are those  enumerated under x.
              Many of  these ocular illusions  are found also, as
            symptoms, in several species of dinus, syspasia, syn-
            cope, plethora cephalitis,  and  various fevers.
7. Caligo.  Dimness or abolition of sight from opacity of the cor-
               nea, or spots upon its surface.
       Caligo  corneae.   Cull.
       Obscuratio cornea.—Maculae corneas.  Plenck.
       Phtharma  caligo.   Young.
       Caligo  a nephelio.   C. a leucomate.   Sauv.
       Oma.  Arab.
       Verdunklung der hornhaut.  G.
       Nouage de la cornee.   Taye. F.
       Opake  Cornea.
       Web-eye.
         Hence,  Shakspeare, " This is the foul fiend, Flibbertigib-
       bet:  he gives the web, and the pin, squints the  eye,  and
       makes  the hare-lip."
S. Glaucosis. Dimness or abolition  of sight, from opacity of the
                  humours.
       Glaucoma.   Vog.
       Phtharma Glaucoma.   Young.
       Caligo a rhytidosi.  Sauv. Mouchart.
depend on same floating substance.   Their apparent change of po-
sition, when we attempt to follow them with the eye, is a necessary
consequence of the motion of the eye itself which contains them."
Young.
  7. Paropsis Caligo.   Caligo, Lat. " dimness, darkness, obscurity,
cloudiness."  The immediate cause is often unknown.  Baran Storck
strongly recommended an extract of the  pasque  flower, Pulsatilla
nigricans, the anemone Pulsatilla, Linn, for internal use ; and  from
the success  he  ascribes to it, the plant has found its way into the
Edinburgh pharmacopoeia.   The anemonepratensis would probably
answer as well.
  8. Paropsis Glaucosis.   Dutvxao-ti,  from yXxvxos, " blueish  or
greenish tinted," from the general colour of the obscurity.  It was
also called by the Greeks glaucoma,  and by the Romans glaucedo.
Glaucosis is here  preferred to  glaucoma, because the final oma
usually, and  for  the sake of simplicity and consistency, ought always
to import  external protuberance, as  in staphyloma,  sarcoma, &c.
See the Preliminary Dissertation. 
244
NOSOLOGY.
[GL. IV.—OR. II.
        Caligo a defectu humoris aquei.   Sennert.
        Verdunklung der glasernen feucbtigkeit.   G.
 9, Cataracta.   Dimness or abolition of sight from opacity of the
                    crystalline  lens.
        Hypochyma (ivoxv/ut.)   Auct. Grozc.
        Cataracta.   Sauv. Linn.  Vog. Sag. Plenck.
        Phtharma Cataracta.   Young.
        Caligo lentis.   Cull.
        Kafes.  Pers. Turc.
        Graue-siaar.  G.
        Cataracte.   F.
        Cataract.
        x Lenticularis.   Lenticular.   The  opacity existing  in  the
            lens  itself  and confined to it.
        G Capsularis. Capsular, or membranous.   The opacity con-
            fined to the capsule, or membrane of  the lens.
        y Complicata.   Complicated.  The opacity common to  the
            lens and its capsule.
            See Richter Von der Ausiehung des grauen Staars; and
         Hellman Von grauen Staar,  und dessen herausnehmung.
 10. Synizesis.   Dimness or abolition of sight from contraction or
                    obliteration of the pupil.
        Synizesis.   Vog. Plenck.
        Caligo a synesesi.   Sauv.
        Caligo pupillae.   Cull.
        Augensternverengerung.   G.
        x Simplex.   Simple closure of the pupil.
         The pupil becomes closed or obliterated from progressive
        contraction,  and  at length coalition, of the  muscular fibres of
       the  iris; from inflammation of the surrounding membranes;
       or from protrusion of the iris.   In all these cases it is called
       simple obliteration of the pupil.


  9. Paropsis  Cataracta.   From xxtx^xttu, " to disturb,  destroy,
abolish."   The Greeks  called this disease indifferently hypochyma,
(v7roXvpuc,)  apochysis (xiroxvo-ts,) and  hypochysis  (viro%vrtf.)   The
earlier  Latins suffusio.  See Gunzii De  Suffusionis natura et sede.
Richter Chir. Bibliothek.  St. Yves, nouveau  Traite  des  maladies
des yeux 1736.—Cataracta was, perhaps, first employed by the Ara-
bian writers.
  10. Paropsis Synezesis.   From trvnfy, « consido, coeo, coalesco;"
from the coalition of the muscular fibres  of the iris.  See Transact.
of the Swedish Academy, vol. xxxiv; and Weissenborn De Pupilla
nimis coarctata.   Erfurt, 1773. 
GL.L]
NOSOLOGY.
245
       G Complicata.   Closure  of the  pupil,  complicated  with
            cataract, or an opaque cornea.
         Plenck confines  synezesis  to  a total  contraction of the
       pupil,  making  a distinct disease of its  partial  contraction
       which he calls myosis ;  and another distinct disease of the
       variety G, which he calls synechia.   But this is  to perplex
       rather than to simplify the subject.
11. Amaurosis.   Dimness or abolition of sight, with an unalterable
                     pupil,  usually black and dilated ; but without
                     any other apparent defect.
       Immobilitas pupillse.   Plenck.
       Amaurosis.   Sauv. Linn.  Vog.  Sag.
       Gulta-serena.  Arab.
       Schwarze-staar.   G.
       Goutte-serene.   F.
       Drop  serene.—So  Milton,  in  his  address  to  Light, in
         which he also alludes to the cataract by the Latins called
         suffusio:
                            " Thee I revisit safe,
             And feel thy sovereign vital lamp ; but thou
             Revisit'st not these eyes, that roll in vain
             To find thy piercing ray, and find no dawn;
              So thick a dkop serene has quench'd their orbs,
              Or dim suffusion veil'd."
         The most common cause is a paralysis of the retina, usu-
       ally in conjunction with a paralysis  and dilatation of the
       iris.   Occasionally, however, the iris  is rigidly contracted,
       its  debility being  accompanied with great irritability : and
       hence offering two varieties ;  to which a  third  may  be
       added, from the disease  assuming at  times  an intermitting
       type.
       x Atonica.  With permanent atony and dilatation  of the
            pupil.
       0 Spasmodica.   With permanent contraction.
       y Intermittens.  With periodical cessations and returns.
            Plenck makes a distinct disease of an unalterable pupil
          with or without injury  of vision,  under the name of My-
          driasis.   In  the latter case it is  evidently a variety of

   11.  Paropsis Amaurosis.  From xptxv^os, " obscurus, caliginosus,
opacus."  " Rarissime nascitur  hie morbus sine omni pras'Iisposi-
tione."  Plenck  in loc—Warner strongly recommended Dippell's
Animal  Oil,  both externally and internally.   On the  Human Eye,
p. 22.
   12.  Paropsis  Staphyloma.  From <rrx<pv*v, " uva," a grape, from 
246                       NOSOLOGY.           [CL. IV.—OR. U.
         amaurosis ; and it is questionable whether the former case
         ever exists.
            Found also, occasionally, as a symptom  or  sequel  in
         hysteria, syspasia, and lues.
            It  is  probably to the  second of these  varieties that
         Shakspeare often alludes by the »errn pin or pin-eye, the
         pupil being contracted to nearly the diameter of a pin's
         head.  The following example is sufficient, another having
         been already quoted under P. Caligo ;

                         " Wish all eyes
                    Blind with the pin and -web."

12. Staphyloma.   Enlargement  of the ball of the eye ; protube-
                     rance of the cornea ; sight dim  or abolished.
       Staphyloma.  Sauv.  Vog.  Sag. Plenck.
       Slapbylom.   G.
       Clou.   F.
       Protuberant eye.
       * Simplex.   From  increased secretion  of  the  aqueous  or
            other humour; pupil transparent.
         Hydrophthalmia.   Vog.  Plenck.
       (Z Purulentum.  From flow of pus  from an abscess in one of
            the membranes ; pupil cloudy.
         Onyx.  Plenck.   When between the lamella? of the cor-
            nea.
         Hornhautapostem.   G.
         Hypopyum.  Plenck.  When in the aqueous humour.
         Eiteraug.   G.
       y Complicatum.   Complicated with a rupture of the iris,
            and its  protrusion upon  the cornea;  constituting  a
            grape-like tumour  : sight abolished.
         Staphyloma complicatum.   Plenck.
            The  genera  of Plenck, exophthalmia,  opthalmopto-
         sis, and  ptosisiridis, are resolvable  into the  present ;
         they  proceed  from  similar  causes,  exhibit the   same
         appearance, and, when  manageable, are to be  treated
         by the same means; one of the most useful of  which,
         in diminishing  the  protuberance, is  that of illining the
the resemlance of the tumour  to the pulpy  and  semi-transparent
appearance  of this fruit.   Richter  has the credit of having  first
pointed out  the  real  nature  of this disease.  Fascic. II. Observ*
Chirurg. p. 104 
T.E. I.)                    NOSOLOGY.                      247

         opake cornea with a minute drop of butter of antimony on
         the tip of a small  pencil-brush, at first recommended by
         Janin, and afterwards by Richter.
13. Strabismus.  Optic axes of the eyes not coinciding on an object.
       Strabismus.  Sauv. Linn. Plenck. et alior.
       Ahul.   Arab.
       Schielen.   G.
       Louchette.  F.
       Squinting.
       Goggle-eye.  Old. Engl.—This word is still retained in the
         term  goggles,  or  glasses for persons  affected  with  the
         disease : by the French called masques a couchette.
       x Habitualis.  From habit: or the custom of using one eye
            and  neglecting the  other;  whereby the latter  grows
            gradually more unsteady, and the will has no longer an
            equal command over both.
         Nystagmus.  Plenck.
         Strabismus habitualis.  Cull.
         Strabismus vulgaris.   Sauv.
   13. Paropsis Strabismus. It^xGt<rptos, from o-t^xGos," tortus oculis."
The optic axis is an imaginary right line passing from the centre of
the vitreous humour, lens, and globe of the  eye, to the object of
vision.  In perfect  vision  the optic axis of the one eye is in unison
with that of the other, and consequently they converge  or coincide
at the same point;  and the object which would  otherwise  appear
double, as being seen by each eye, is contemplated as single.  In order
to this coincidence, the muscles of each eye must constantly assume
the same direction, their  position and configuration be  precisely
alike, and  the sight be of an  equal power and focus:  a deviation
from each  of  vvhich postulates must necessarily produce squinting,
or an inaccordant action of one eye with the other.  From common
and early habit we acquire an equal command over the muscles of
both,  and  are able to give  them any direction, and  to fix them
against any object  we please :  and such is the power of habit, that
at length they involuntarily associate in the  same action, and  it is
difficult for us to give to the one eye a different direction from that
of the other, or in  other words, to make their optic  axes diverge
instead of converge.  In persons born  blind, no  benefit can be de-
rived from this  unity of  action, and hence it  is never attempted;
and the muscles  being never subjected to discipline, the eye-balls
roll at random, and wander in every direction.  And hence one of
the most difficult tasks to be acquired  by such persons after obtain-
ing sight, is that of keeping their eyes fixed, and giving the same
bearing or convergent line to  each.  And hence, again, they sec
things double  at first, and  in a state of great confusion. 
248                       NOSOLOGY.            [CL. IV.--OB. H

       G Atonicus.  From debility  of  the  affected  eye :  whence
            the sound eye possesses a different focus and power of
            vision, and  is alone trusted to :  in consequence  of
            which the weak or neglected eye insensibly wanders as
            above.
         Strabismus commodus.   Cull.
         Strabismus Buffonii.—S. spasmodicus.—S.paralyt. Sauv.
       7 Organicus.   Differently constructed  in form  or position :
            so that the situation or figure  of one eye, or of par-
            ticular parts of one eye, are inaccordant with  those of
            the  other ;  whence,  as in  the  preceding  varieties,
            one eye  is  chiefly depended  upon, and the other ne-
            glected.
  When one eye is naturally stronger, or of a more favourable focus,
or more frequently employed  than the other,  as  among  watch-
makers and jewellers, the latter from comparative neglect relapses
into an undisciplined state, and  less readily obeys the control of the
will.  Its muscles do not assume the same direction, and if they do,
in the  two former cases, the object appears double ; and  hence the
neglected or weaker eye wanders anfl stares at one or at various
objects, while the eye relied upon  is fixed upon some other.  And
it is this divergence of the optic axes, this inaccordance of direction,
or looking at different objects at the same time, that constitutes the
disease called strabismus or  squinting.
  14. Paropsis Ectropium. 'ExT^owton from zxr^tvu," averto, deflecto,
detorqueo."  The opposite  affection or inversion of one or  both
eye-lids, is denominated entropium.   It is often a very troublesome
complaint from the irritation produced by the inverted eye-lashes.
But it is, perhaps, in every instance a symptom or sequel of some other
disorder, as a tumour seated on the affected lid, or  a contraction of
its internal membrane from a cicatrix, or other cause.   See Platner
De Vulneribus superciliis illatis.   Opusc. torn. ii.  Acrel Bemur-
kungen, &c.
  Gen. II. Paracusis.   Tlx^xxvsts, irxgxxon, from xaqaxovu, " perpe-
ram, depravatc, vitiose audio."  The mechanism  of the  ear is as
complicated as that of  the eye, and as admirably adapted  in all its
parts to the perfection of the sense which constitutes its  function.
Its lobe, its entrances, its openings, its various drums, its minute and
multiplied foramina, its delicate bones, all contribute to one common
effect.   Even the surrounding  bones, and still more than this, the
teeth are, in no small degree, auxiliary to the same object; as the
experiments of M. Perolle,  given  in the fifth volume of the Turin
Transactions,  have  abundantly  established; as they have  also that
bone in general is a far better conductor of sound than air, alcohol)
or water. 
GE. II.]
NOSOLOGY.
249
14. Ectropium.  Eversion of one or both the eye-lids; and conse-
                    quent exposure of the red internal tunic.
       Ectropium.   Linn. Plenck  Vog. Ware.  Adams.
       Blepharopto.sis Ectropium.  Sauv.
       Aucwartskenrung des augen-lieds.  Plenck.
       Eraillement.   F.
       Eversion of the eye-lids.
         Found also, as a sequel, in  inflammation of the conjunc-
       tiva, purulent or chronic ophthalmy, small-pox, burns, and
       scalds.
                       GENUS  II.

                    PARACUSIS.

  Sense of hearing vitiated, or lost.
       Paracoe (*■«§«*«?>.)   Hippocr.
       Cophosis.   Linn.
       Dysesthesia auditoria.  Young.
1.  actus.   Hearing painfully acute,  and intolerant of the  lowest
             sounds.
  From the complicated organism of the ear it follows necessarily,
that, like the eye, it must be subject to a great variety of diseases j
while many of the diseases of the one sense must  bear  a striking
analogy to  those of the other.  Thus painful and  obtuse hearing,
and deafness, may be well compared with painful and obtuse vision,
and blindness.  As the eye is at times affected with  illusory objects,
so is the ear'with illusory sounds; and, as, when the optic axes do
not harmonize, as in strabismus, the same object may be seen double,
so may the same sound  be heard double where the action of the
one ear is inaccordant with that of the other.   Sauvages has given
two or three  very curious examples upon this last affection :  A
musician, while blowing his flute, heard two distinct sounds at every
note.   The sounds were in different keys, and consequently not in
harmony: and as they  were  heard simultaneously, the  one could
not be an echo of the other.  This singular affection seems to have
been  the result  of a catarrh,  and ceased on its termination.  On
another occasion  he was consulted by  a person who for  several
months antecedently had been  troubled  with a hearing of two dis-
tinct voices whenever he was spoken to  : the one at least an octave
  vol. v.—43 
250                      NOSOLOGY.            [GL. IV.—OR. II.

       Auditus acrior.  Darw.
       Paracusis Oxycoia.   Sauv.
       Ouie tendre.  F
          Sometimes  found idiopathically in nervous and highly ir-
       ritable idiosyncrasies, and bearing a striking analogy to pa-
       ropsis aeris.
          Found, more frequently, as a symptom in ear-ache, head-
       ache, epilepsy, otitis, cephalitis, and fevers of various kinds.
2. obtusa.  Hearing dull and confused; and demanding a clear and
               modulated articulation.
       Disecoia.  Auct. Grozc. Vogel.
       Dysecoea.   Sauv. Sag  Cull.
       Auditus difficilis.  Hoffm.
higher than the other, but not in unison with it, and hence produc-
ing a harsh and insupportable discordancy.  Tom. I. 756.
   The perverse paracusis, forming the third species of the present
arrangement, though perhaps more common, is not less  extraordi-
nary ; and the same attentive and indefatigable writer has collected
various examples of this  disease from  unquestionable authorities.
The first  case is that of a  woman who could never understand what
was spoken to her unless  a drum were  beating close to  her at the
same time ; and  who, on  this account, kept a drum always in the
house, which was constantly played upon while she was conversing
with her husband.  Another case is that of a bell-ringer, who could
never distinguish  speech except while the bells were ringing..   A
third  case relates to a  person who was always  deaf except when
travelling in a carriage,  during which time, from the rattling of the
wheels, he was perfectly  capable of hearing, and  in engaging  in
conversation.  Sauvages ingeniously ascribes this disease to torpi-
tude or paresis of the  organs of the enternal ear, which  require
this additional stimulus to rouse them into action, so as  to convey
the proper sounds addressed to them, beyond the  tympanum.  And
he closes  with the following  illustrations : « Sic somnolenti oculos
non aperiunt, nee   proinde aptant ad visum, nisi  magna lux oculos
eommoveat;  sic  organa genitalia ganeonum a torpore excitantur
quandoque per flagra, de quorum usu in rea venerea scripsit Mei-
bomius."   Tom.  I. 757.
   As the  organ of the  ear, however, is less  exposed than that  of
the eye, we are far less acquainted  with the immediate seat of its
diseases ;  and even with the exact bearing which every particular
part sustains in the general phenomenon of hearing.  It was at one
time supposed  that the nicest power of discriminating  sounds,
or in other words, that accuracy of distinguishing  which constitutes
what is called a musical ear, is seated in the cochlea.  Birds, how-
ever, whose perception  is  exquisite, have no cochlea.  It has since 
GE. II.]
NOSOLOGY.
251
Auditus imminutus.  Darw.
Vekr.   Arab.
Ubel-horen.   G.
Durete d'oreille.   F.
Hardness of hearing.
x  Organica.   From organic defect.
   Dyseccea organica.  Cull.
6"  Atonica.  From local debility.
   Dysecoea atonica.  Cull.
   Nervous deafness.
y  A meatu obstructo.   From obstruction in the auditory
     tube or passage: as by mucus, wax, sordes, an  insect,
     or any other extrinsic  body.
been conceived by Sir Everard Home that it is the membrana tym-
pani in which this fine feeling is peculiarly lodged. (Phil. Trans.
1800,) and that it depends upon its muscularity: yet the same feel-
ing has remained, and in its full proportion, in persons whose mem-
brana tympani has been ruptured.
   In Sauvages, hardness of hearing, perverse or depraved hearing,
and deafness, are made distinct genera under the names of dyseccea,
paracusis, and cophosis.  Cullen  throws away the last of these, as
a distinct genus, and arranges the affections that belong to it under
dyseccea; regarding hardness of hearing and  deafness as only  dif-
ferent degrees of one common malady.   Neither of these views are
correct.  First,  there ought to be but one common genus  for  the
whole, and to this the writer of these pages has given the name of
paracusis, as well out of deference to the authority of  Hippocrates,
who has employed it in the same  extensive sense, as on account of
its analogy with paropsis, the preceding genus.  In the next place,
deafness and hardness of hearing are by no means the same com-
plaint : the latter may, indeed, occasionally terminate in the former;
but it may also, and often does continue to the close of life, some-
times even from  the beginning to the close, without ever running
into deafness; and probably its seat lies generally in other  parts of
the auditory organ than that in which deafness is situated.   Dys, in
dyseccea, is by Cullen  used  as a  diminutive or negative, " auditus
imminutus vel abolitus," says he,  in his definition of the term;  per-
versity or depravity being expressed by para, as in  paracusis, which
he explains  u auditus depravatus."  Yet by dys, in his dysopia, he
intends neither a negative nor a diminutive, but a perverse or  de-
praved power; his definition of the term being « visus depravatus ;"
in which case dys is confounded with para in his own previous inter-
pretation of this preposition.  Such looseness of meaning should be
avoided as much as possible in works of science, and especially in
works for the use of students 
252                       NOSOLOGY.            [CL. IV.—OR. II.

         Dyseccea a meatu obstructo.   Sauv.
         Dyseccea a tuba obstruct a.  Id.
            Found  also,  occasionally,  as a symptom or sequel,
         in various fevers, hemiplegia, apoplexy, otitis, lues, and
         polypous caruncles  or concretions  in the passage of the
         ear.
3. perversa.   The ear  only  sensible  to articulate sounds when
                  excited by other and louder sounds intermixed
                  with them.
         Paracusis Willisiana.   Sauv.
         Paracusis imperfecta  (d.)   Cull.
         Ouie engourdie.  F.
         Perverse hearing.
            Only when  several  bells were  ringing  at the same
         time.   Birch. Hist.  Vol.  IV.—Only  in a  great noise.
         Fieliz;  Richter.   Chirurg. Bibl.  Band IX. p.  555.—
         Only during  the music of a pipe.  Stahl Colleg. p. 76.
         —Easier  in  a great  noise.  Sims. Memoirs Med. Soc.
         Lond. Vol. I. n. 5.
4. duplicata.  The action of  the one ear inaccordant with that of
                   the other; sounds heard doubly and in different
                   tones or keys.
         Paracusis duplicata.  Sauv.
         Paracusis imperfecta (c.)   Cull.
         Unrecht hbren.   G.
         Double ouie.  F.
         Double-hearing.
5. illusoria.   Internal sense of sounds, without  external causes.
         Paracusis imaginaria.   Cull.
         Syrigmus.   Sauv.
         Susurrus.   Vog.
         Nemim.  Arab.
         Imaginary sounds.
         x  Syrigmus.   Ringing or tinkling; a sharp, shrill, suc-
              cessive sound.
         ,a  Susurrus.   Whizzing.   An acute,  continuous, hissing
              sound.
         y  Bombtis.   Beating. A dull, heavy, intermitting sound.
              There are  numerous  other varieties, but it is need-
            less to detail them.
  Gen. III. Parosmis, from wxgx,«' male," and e£«, " oleo,"  " olfa-
cio;" analogously with paracusis and paropsis, and hence preferred
to parosmia.  The common term among nosologists is anosmia,but 
ge. m.]
NOSOLOGY.
253
6. Surditas.   Total inability of hearing or distinguishing sounds.
       Cophosis.  Sauv. Sag.
       Surditas.   Vog.
       Dyseccea organica.   Cull.
       Samem.  Arab.
       Taubheit.  G.
       Sourdite.  F.
       Deafness.
       x  Organica.   From organic defect.
       G  Atonica.  From local debility.
       y  Paralytica.   From local palsy.
            Found also as a symptom, occasionally as  a sequel,
          in various fevers,  hemiplegia, apoplexy, otitis,  and lues;
          and, when congenital, or occurring shortly after birth, the
          cause of aphonia surdorum, or deaf-dumbness.
                    GENUS  III.

                   PAROSMIS.

Sense of smell vitiated, or lost.
     Anosmia.   Sauv.  Linn. Vog.  Cull.
     Olfactus amissio.  Sennert.
this  only includes one species of the genus, namely, privation or
destitution of smell; which, in fact, is the only one that has hitherto
been introduced into nosological systems.   Darwin, indeed, has ol-
factus acrior, but without any  definite meaning or example:—a no-
minis umbra, to be embodied by subsequent writers.
   1. Parosmis aeris.  Generally speaking, the sense of smell in all
animals is in  proportion to the extent of the Schneiderian or olfacto-
ry membrane with which the nostrils are lined,  and over which the
branches of the olfactory nerves divaricate and ramify.  And hence
this membrane is much more extensive in quadrupeds and birds,
which  chiefly trust to the sense of  smell  in selecting their food,
than in man ; for it ascends considerably higher, and is for the most
part possessed of numerous folds or duplications.  It is hereby the
hound distinguishes the peculiar scent thrown forth from the body
of the hare, and the domestic  dog  recognizes and identifies his
master from all other individuals 
254
NOSOLOGY.
[CL. IV—OR. U.
       Dysesthesia olfactoria.   Young.
       Odoratus deperditus.  Plouquet.
I. acris.  Smell painfully acute, or sensible to odours not gene-
              rally perceived.
       Olfactus acrior.   Darw.
       Acute smell.
2. obtusa.   Smell dull and imperfectly discriminative.
       Obtuse smell.
3. expers.   Total inability of smelling or distinguishing odours
       Perte d'odorat.  F.
       Loss of smell.
       x Organica.   From  organic  defect, or  accidental  de-
            struction  of the olfactory  nerve, or its  branches; or
            of the Schneiderian membrane over which  they are
            spread.
         Anosmia organica.  Cull.
  Under peculiar circumstances, however, the ordinary apparatus
for smell possesses an  activity, and sometimes even an intolerable
keenness, which by no means belongs to it in its natural state.  M.
Virey, who has written  a  very learned treatise upon the subject of
odours, asserts that the olfactory sense exists among  savages in a
far higher degree of activity than among civilized nations, whose
power of smell is blunted  by an habitual exposure to strong odours,
or an intricate combination of odours, and by the  use of high fla-
voured foods.   And he might have added, that this sense, like every
other, is capable of cultivation, and acquiring delicacy of  discrimi-
nation by use ; that savages, many of  whom make a near  approach
to the life  of  quadrupeds, employ it, and trust to it in a  similar
manner; and that this is,  perhaps, a chief cause of the difference
he has pointed out.   It is in like manner relied upon by persons
who are deprived  of  one  or two  of the other external senses, as
those of sight or hearing, or both ; and in these cases it  often ac-
quires an  extraordinary degree  of nicety.   In the interesting ex-
ample of the boy born  blind and deaf, lately  given to the  world by
Professor  Stewart,  and  who, in  consequence, was  obliged to rely
upon the two faculties of  smell  and touch alone, in discriminating
almost all the objects that  surrounded  him, he is said, in Mr. Ward-
rop's history of the case,  to have  employed the sense of smell on
all occasions, like a  domestic dog, in distinguishing  person*, and
chiefly to have depended  on it.   By this sense  he identified his
friends and relatives;  and  conceived a sudden attachment or dislike
to strangers according to  the odour of the  effluvium that escaped
from the skin.
  The Journal des  Sfavans,  an. 1667, gives a curious history of a
monk, who pretended to be able to ascertain, by the difference of 
GB. IV.]
NOSOLOGY.
255
      Ii  Paralytica.  From local palsy.
         Anosmia paralytica.   Sauv.
         Anosmia atonica.  Cull.
           Found  also, occasionally, as a symptom  in catarrh,
         worms, lues, local ulceration, and fevers of various kinds.



                       GENUS IV.

                   PARAGEUSIA

  Sense of taste vitiated or lost.
       Apogeusis.  Vog.
       Ageustia.   Sauv. Sag. Cull.
       Dysesthesia gustatoria.  Young.
1. acris.   Taste painfully acute, or sensible to savours  not gene-
             rally perceived.
       Gustus acrior.   Darw.
       Acute taste.
odour alone, the sex and age of a person, whether he were married
or single, and the manner of life to which he was accustomed.
  This, as far as the fact extended, may possibly have been the re-
sult of observations  grafted upon a stronger natural sense than be-
longs to mankind in general; and  is scarcely to be ranked  in the
list of diseased actions.   But  among persons of a highly nervous or
irritable idiosyncrasy, the piesent writer has met with  numerous in-
stances, and doubtless other practitioners have also, of an acuteness
of smell almost intolerable and distracting to those who were labour-
ing under it: which has  fairly constituted an idiopathic affection :
and sometimes nearly realized  the  fanciful description of the poet
by making its possessors ready, at every moment, to
                   Die of a rose in aromatic pain.
  There  is a curious and ingenious paper in the Transactions of
the Swedish  Academy, Tom. I.  p. 346, from the  pen of Linneus,
entitled, "Petiveria, en Americansk v'axt," (the American Petiveria
alliacea;) containing a variety of useful observations on the peculiar
qualities given to the smell, taste, and other  properties of animals,
in consequence of  their  feeding on different foods.   The  reader
may consult it at his leisure.
  Gen. IV.  From  yevu, ilgustum prabeo," whence vxgxyeva, and
consequently vagxyev<rit.  The author has preferred, with Vogel,
the present termination to parageusia or ageusia, as  analogous to 
256                       NOSOLOGY.           [CL. IV.—OR. II.

2. obtusa.  Taste dull and imperfectly discriminative.
       Obtuse taste.
3. expers.  Total inability of tasting or distinguishing savours.
       Degout.   F.
       « Organica.   The  papilla; of the tongue destitute of gusta-
            tory nerves, or covered with a mucous, or other sheath
            which they cannot penetrate.
         Ageustia organica.   Cull.
       p Paralytica.  From local  palsy.
         Ageustia paralytica.   Sauv.
         Ageustia atonica.  Cull.
            Found  also, occasionally, as a symptom  or sequel  in
         fevers, apoplexy,  different species of ecphronia, and other
         phrenic genera, and dyspepsy.
                     GENUS V.

                   P A R A P S  I S.

Sense of touch or general feeling vitiated or lost.
    Dysesthesia contractoria.   Young.
the names of the preceding genera of the order before us.  And for
the same reason he has preferred para, to dys : the privative x would
be altogether inadmissible, as it can only apply to the second and
third species.
  The first and last species are perhaps chiefly symptomatic, though
not always so.   The second is common, and is often connected with
obtuse smell; for physiologists have remarked a striking coinci-
dence and sympathy between these two senses; and some have
conceived them  to  be  mere  modifications of  each  other.   The
writer of these pages had lately a lady of twenty-four years of age
under his care, of great mental taste and accomplishments, who had
always  possessed a considerable hebetude of both senses.   She
could distinguish the smell of a rose from that of garlic, and the
taste of port-wine from mountain or madeira; but she could not
discriminate between the  odour of  a  rose and that of a lily; or
between  the taste of beef, veal, or pork ;  and  consequently, upon
all these points, had no preference of relish.
  Gen. V.  Parapsis.   Tlxgx^ts, from xvroputt, x-J/ts, " tango, tac-
tus;" whence irxgairroptxi and irx^x^if, " perperam tango, intactus."
  The common term among the nosologists is dysasthesia ; but in-
correctly, since this word, as already observed, is also employed to 
GE. V.]
NOSOLOGY.
251
1. acris.   Touch painfully  acute, or sensible to impressions not
              generally perceived.
       Tactus acrior.   Darw.
       * Teneritudo.   Painful uneasiness or tenderness, local or
            general, on being touched with a pressure usually un-
            accompanied with troublesome feeling.
         Soreness.
            Occasionally unconnected and idiopathic, but  more
         frequently a symptom or sequel of fevers, debility, lassi*
         tude, violent exercise, catching cold,
       G Pruritus.   Painful titillation, local or general, relieved by
            rubbing.
         Pruritus.   Sauv.  Linn.  Vog. Sag. Darw.
         Autalgia pruriginosa.   Young.
         Itching.
            As an idiopathic affection chiefly local, and  easily re-
         lieved by rubbing or scratching.
            Found also, as  a symptom, in prurigo and other papulous
         affections,  purnio and  other  cutaneous  inflammations;
         urticaria, and other cutaneous eruptions.
 express morbid  sensation of any  kind,  whether  of  touch, taste,
 smell, sight, or hearing.  See the note on ^sthetica at the begin-
 ning of the present order.   But by Dr. Cullen the radical term is
 used with a peculiar want of precision: for while dysesthesia; with
 him constitutes the name of the present order, and embraces  the
 external senses at  large, anaesthesia is at the same time limited to
 that of touch.   In  this perplexity of significations he appears to be
 alone ; for though Sauvages  uses dysesthesia; as an order, and
 anaesthesia  as a genus, he uses both in the same general meaning;
 and  hence the anaesthesia of Sauvages is a different disease  from
 that of Cullen, and  imports privation of all the senses, while muscu-
 lar motion, and  a  desire for things needful remain, though with
 diminished  power.   His words are " sensus omnis privatio, super-
 stitious motu musculari, et rerum  necessariarum appetitu, sed im«
 minutis."   It constitutes the parapsis expers, var. b, of the present
 system ; and his species and examples are illustrative of it.  Sagar
 follows the  use of the term adopted by Sauvages.  Linneus  and
 Crichton employ anaesthesia  in the  import of Cullen, and limit it to
 privation of touch;  but then  they do not employ dysaesthesiae at all,
 the former substituting the term privation in its stead, and the latter
 distributing the  diseases hereby usually  embraced, under other
 divisions of his arrangement.
  Dr.  Young employs dysaesthesiae upon a wider scale than any of
the preceding writers; for he not  only allows it to reach all the
  vol. v.—44 
258                       NOSOLOGY.           [CL. IV.—OR. II,
y Algor.  Sense of temperature, local or general, below that
     of pleasant and natural warmth.
  Algor.  Sauv Sag.
  Zemherir.   Arab.
  Coldness.
     As an idiopathic affection chiefly local,  and most com*
  mon to  the head and feet.
     Found also, as a symptom, in the first stage of fever,
  syncope, hysteric syspacia, nausea, and atonic empathema;
  in all which the  affection is general.
^ Ardor.   Sense  of temperature,  local or general,  above
     that of pleasant and natural coolness.
  Ardor.   Sauv.  Sag.
  Hararet.  Arab.
  Heat.
     As an idiopathic affection occurring chiefly in plethoric
  and irritable habits.
external senses, but carries it into the mind, and makes it embrace
" want of memory, or confusion of intellect," which he denominates
dysesthesia interna:  though  he introduces the affection with a
query.
   1. y P. aeris, Algor.  " Cold, according to its degrees, produces
two very different effects ; one is  the exciting of  action without
lessening the powers, the other  is absolutely debilitating, while at
the same time it excites action  if  carried too far."  Hunter, on
Blood, p.  349.  It is observed by  Dr. Fordyce,  in his Tract on
Simple  Fever,  p.  168, and  the  observation is  quoted and  called
curious by Dr. Darwin, " that those  people who have been confined
some  time in a very warm atmosphere, as  of 120 or  130  degrees
of heal, do not feel  cold, nor are subject to paleness of their skins,
on coming into a temperature of 30 or 40  degrees; which  would
produce great paleness and painful sensation of coldness in those
who had been for some time confined in an atmosphere of only 86
or 90  degrees."   The cause  is not difficult of explanation.  The
sensorial power is exhausted by a long application to a heat of 120
or 130 degrees,  and the minute  vessels lose their power of spas-
modic constriction, or collapse: while in a heat of 86 or 90 degrees
no such effect takes place.
   1. Parapsis expers.   Some persons have an habitual numbness or
privation of the sense of feeling in particular parts of the surface,
which appears  to depend on local deficiency or  paralysis of the
nerves of touch.  And hence they  are able, in such  parts  of the
body,  to prick or cut themselves, or to  run pins  to any depth below
the skin without pain.  The author has seen several striking ex-
amples of this peculiar affection. 
GE. V.]
NOSOLOGY.
259
            Found also as a symptom in the second stage of fe-
         vers, inflammations, and entonic empathema.
2. expers.   Total insensibility to objects of touch.
       Anaesthesia.  Linn. Cull.
       x Simplex.  Confined locally or  generally to the sense of
            touch; sometimes accompanied with uneasiness.
         Stupor.  Sauv.  Linn  Sag.
         Tartus imminutus.  Darw.
         Numbness.
       (3 Complicata.   Complicated with insensibility  in  several
            or all  the other senses.
         Anaesthesia.  Sauv. Sag.
            See an  interesting  case in Collect. Acad. torn. III. p.
         184.
         Alternating with paralysis.  Heister, Wahrnehmungen I.
       p. 205.  Medico- chirurg. Trans. Vol. II. p. 216.   Case of
       Vieusseux,  communicated by Dr. Marcet.
         Found also, as a symptom,  in  apoplexy, catalepsy, epi-
       lepsy, syspasia, and syncope.
3. illusoria.   Imaginary sense of touch or  general  feeling  in
                  organs  that have  no  existence.
  Sometimes confined to  the  hands with a full power of motion.
Hist.de I'Acad, des Sciences, 1745, p. 40.—Cured by applications to
the spine.  Galen. De loc. Off. Lib. I. cap. vi. cl. 7.—Universal, or
extending over the  entire surface.  Ludovic  Op. p. 938.  Ephem.
Nat. Cur. Dec.  I. ann. iii. obs. 251—Confined to the  right arm :
the insensibility so great as  to be without pain during the progress
of a phlegmon.  On breaking  the  arm  the man felt a crash, and
only thought he had  broken the spade he was working  with.  La-
marck, Philos. Zoologique, Tom. II. p. 262.
  See  an interesting paper  upon this subject, with several  extra-
ordinary cases,  and, among others, the  above from Lamarck, by
Dr. Yelloly, Medico-chir. Trans. Vol. III. p. 90.  In the case im-
mediately described, the patient, aged 58, had  been first affected in
Jamaica about  three years  before,  and the affection  had become
permanent.  " The hands, up  to the wrists, and the feet, half way
up  the  legs, are perfectly  insenible to  any  species of injury, as
cutting, pinching, scratching, or burning.  The insensibility, how-
ever, does not suddenly terminate ;  but exists, to a certain degree,
nearly up to the elbow, and  for some distance above the  knee.   He
accidentally put one of his feet some time  ago into boiling water, but
was no  otherwise aware of  the high temperature, than by finding
the whole surface a complete  blister on  removing it.  The  extre-
mities are insensible to electrical sparks taken in every variety of
mode." 
260                      NOSOLOGY.            [CL. IV.—OR. 11

       Pseudaesthesia.   Plouquet.
         Common  to  those who have suffered amputation.  See
       Vogel. Chirurgiscke Wahrnehmungen, Samml. I. n. 9. Act,
       Med. Berol.  Dec. ii. Vol. VIII.
         Found also, occasionally as a symptom, in hypocondrias
       and other mental affections.
                 ORDER  III.

                   CINETICA.

             \FFECTING THE  MUSCLES.

Irregular action of the muscles or muscular fibres; commonly
  denominated spasm.
                   GENUS I.

                 E N T A S I A.

Irregular muscular action  producing contraction, rigidity,  or
  both.
  2. /3. P. expers complicata.  Under this variety Sauvages has given
one or two very curious examples  of general insensibility of seve-
ral or all the external senses. The most singular, for which he is in-
debted to the Academy  Collections, is that  of a delicate young man,
who was suddenly in the moining deprived of speech, and of the sense
of touch, generally without any  assignable cause  or  premonition.
Punctured and pricked in  different parts of his body, in his head,
neck, back, shoulders, breast, arms, abdomen, he felt nothing what-
ever,  and even laughed at the  singularity of the phenomenon, as
with the exception of dumbness and  cutaneous insensibility he la-
boured under no disease whatever.  It continued for two days, and
appears to have yielded to venesection.
  Gen.  1.  Entasia.  'Evtuo-is, " intentio," " vehementia," " rigor."
Scap. in loc. from evrtiw,  " intendo."   The author has  preferred
this word to tonos, tonus, or entonia, the common terms of nosolo-
gists to  express  the present  genus of diseases, because the latter 
GE. I.]                    NOSOLOGY.                      ^61
      Tonici.   Sauv. Sag.
      Convulsionis tonicae.  Garter. Etmull
      Conductiones.   Cozl. Aur.
      Spastici.  Linn.
      Tonos.   Parr.
      Entonia.  Young.
       Tonic Spasm.
1. Priapismus.  Permanent rigidity and erection of the penis, with-
                   out concupiscence.
       Priapismus.   Sauv.  Linn.  Vog. Sag.
       Tentigo  penis.  Plouquet.
       Kazech.  Arab.
       Priapisme.  jF.
       Priapism.                                     >
         Has continued after death. Ludovici Opp. p. 1056. Mar-
       cell Donat.  Lib. II. cap. 3. p. 142.  In an infant, from cal-
       losity.   Act. Nat. Cur. Vol. II. Obs. 173.
            For the most part the consequence of cold, cantharides,
          clap, or dysury.
2. Loxia.   Permanent contraction of the flexor muscles on the right
              or left of the neck, drawing the head obliquely in the
              same direction.
        Loxias (a«|i«s.)   Auct.  Grozc.
        Caput  obstipum.   Vog.
        Obstipitas lateralis.  Sauv.
        Cephaloxia.   Plouquet.
        Krumm-hals.   G.
        Stiff-neck.
        x Dispars.  From disparity in the length of the muscles op-
             posed to each other.
        G Entonica.   From excess of muscular action  on  the  con-
             tracted side.
        y Atonica.   From direct atony of the antagonist muscles.
terms are employed, in direct Opposition to such meaning, by phy-
siologists, to  import a healthy and perfect vigour or energy of the
muscles ; and by therapeutists to signify medicines capable of pro-
ducing such or similar effects.
   1. Entasia  Priapismus.  U^txjrto-pMs.  From  U^txiros, the son of
Venus and Bacchus, who is usually thus represented  in  paintings
and sculptures.   Galen applies the term also to a rigid elongation
of the clitoris without  concupiscence.
   2. Entasia Loxia.  From Aogo«, " obliquus, tortus:" whence hxar- 
262     N                NOSOLOGY.           [CL. IV.—OR. III.

       Obstipitas renuens.  Sauv.
          Found also, occasionally, as a symptom, in sprains or in-
       flammations of the neck;  in catarrh;  and in contractions of
       the skin of the neck from  severe burns.
3. articularis.  Permanent and rigid contraction of one or more
                    articular muscles or their tendons.
       Acampsia.   Plouquet.
       Contractura.   Sauv. Linn.  Sag.
       Zemam.  Arab.
       Verkiirtzung.   G.
       Contracture.   F.
       Muscular stiff-joint.
       x Entonica.  From excess of action in the muscles contract-
            ed. Articular spasm.
       /3 Atonica.   From  direct atony of the antagonist muscles.
       y Inusitata.   From long confinement or neglect of use.
            Found also occasionally,  as  a symptom, in articular
         inflammations, abscesses, and ulcers secreting an irritating
         fluid.
4. Trismus.   Permanent  and  rigid fixation of the muscles of the
                lower jaw.
       Trismus.  Sauv. Linn.  Sag. Cull.
       Capistrum.   Vog.
       Tonos Trismus.  Parr.
       Teshennuj.   Arab. Pers.
       Tic.  F.
       Locked-jaw.
         Parrots are  said  to be subject to this disorder.  Bajon,
       Memoires I. Richter, Chir. Bibl. band  V.  p. 165.
         Most  effectually  cured by large  doses  of laudanum and
       drastic purges.   A dram of tincture of opium has been given
       every hour or every two hours for two days, with strong doses
       of  calomel, jalap,  and  scammony,  and proved successful.
       See two cases by Mr. Harkness, and Mr. Parkinson, jun. in
       Trans, of the Medico-chir. Soc. II. 284. 291.
thrus in surgery, an obliquity of a joint of any kind without spasm
Dr luxation.  By  the Greeks, however, the term was specially ap-
plied to the joint or muscles of the neck.
  4. Entasia Trismus.  T^arputs.  From *£<£«, strido, " to gnash."
The Greek term, like its French  synonym tic, is said by the lexico-
graphers to be an onomatopy, or a word formed from the sound that
Ukes place in the act of gnashing. 
GE.L]
NOSOLOGY.
263
       * Nascentium.  Attacking infants during the first fortnight
            after birth.   Probably the result of acrimony in  the
            stomach.
         Trismus nascentium.   Sauv. Cull.
       G Traumaticus.   Occurring at every age as the consequence
            of a wound,  puncture, or ulcer;  chiefly in  hot  cli-
            mates.
         Trismus traumaticus.   Heister.  Sauv. Cull.
         Spasmus maxillae a vulnere.   Compend. Med.
       y Algidus.   Occurring  after exposure  to  cold  and damp,
            especially the cold of evening.
         Trismus catarrhalis.  Sauv.
            There  is little  difference in  the symptoms of any of
         the varieties ;  and they are  here chiefly entered on the
         authority of Sauvages and Cullen.
5. Tetanus.   Permanent and rigid  fixation of many or  all  the
                 voluntary muscles ; with incurvation of the body,
                 and dyspnoea.
       Tetanus.  Auct. Grozc. et Recent.
       Akhezet.  Arab.
       x Anticus.  Tetanus of the flexor  muscles: body  rigidly
            bent forward.
         Tetanus anticus.  Bontii. Med. Inq.
         Emprosthotonus (ep*,irpo<r8oTovos.)   Cozl.  Aur. Sennert. et
            Auct. Alior.
       G Dorsalis.   Tetanus of the extensor muscles : body rigidly
            bent backward.
         Tetanus dorsalis.   Journ. de Med. Oct. 1761.
         Opisthotonus (W<o-0ot«v«5.)  Aret. etAuct. Alior.
       y Lateralis.   Tetanus of the  lateral  muscles : body rigidly
            bent laterally.
         Tetanus lateralis.   Fernel.  Sauv.
   5. Entasia Tetanus. Itrxnos, "extensus:" from rata, or rtTxtva:
«tendo; extendo."   So  emprosthotonos from  tpMrgoritv,  " ante,"
and rtrrn, as above.  As also opisthotonus, from owtsfo* " pone," and
rtitv.  According to Celsus, all these terms have been used synony-
mously :  opisthotonus having been earliest employed  among the
Greeks, then emprosthotonus, and  lastly tetanus, as  the name for
the present species: while some writers  used  each of them in a
looser sense, so as to embrace various other species as well.   " Pri-
orem  Graeci  oTrirOoTovov sequentem tf,eTgoo*6oTow,  ultimum rerxvor,
appellant:  quamvis minus subtiliter quidam indiscretis his nominibus
utuntur."  Lib. iv. c. 3. 
264
NOSOLOGY.
[CL. IV.—OK. UL
       } Catochus.   Tetanus general, with little or no difficulty of
            breathing ; chronic and periodical.
          Catochus.   Sauv.  Vog. Sag  Macbr.
            Produced ordinarily from the same causes  as trismus  ;
          and found  also,  occasionally,  as  a symptom, in syphilis
          and worms.
            Catochus is commonly regarded  as a variety  of  teta-
          nus; but more  usually, perhaps, occurs  as a variety of
         carus  Ecstasis,  Gen. II. Ord.  iv.  of this class :  being
         seldom without the concurrent action or affection of other
         branches of the nervous system, besides the voluntary
         muscles.
6. Acrotismus.  Failure  or  cessation of the  pulse ; with  little or
                    no disturbance  of perception or  voluntary
                    power.
       Asphyxia, seu Defectus Pulsus.   Plouquet.
       x Universalis.   Extending over the whole arterial system.
            See Mr. J. Hunter's affection in  Sir Everard  Home's
         life of him, prefixed to his Treatise on inflammation, p.
         xlvi,  consisting  of a total  suspension  of pulsation for
         nearly an  hour,  with  cessation of involuntary breathing
         for the same time :  countenance pale and  ghastly ; facul-
         ties of the  mind, and  power over the voluntary  muscles
         perfect: internal  stimulants  useless.  Connected  with
         sternalgia.
            Similar  suspensions  of pulsation, without any other
         affection  of the system.  Anecdotes  de Medicine, p.  199.
         Marcell. Dom.  lib. VI. cap.  ii.  p. 620, ex Maltb. de
         Grado.—For seven days, without other affection. Riodlin,
         Lin.  Med. 1696,  p.  48.—Seven  days   before  death.
          Valisneri,  Opp.   III.  p. 278.—Chronic  and continuing
         through the whole term of life.   Berryat Hist, de PAcad.
         des Sciences a Paris, 1748.
  2. Entasia Acrotismus.  'AxgortrpMs,  " defectus  pulsus," from
*£«t«« « pulsus ;" whence crotophos or crotophium, " a painful pul-
sation or throbbing in the temples."  Asphyxia would have been
the term employed for this species, as it is by Plouquet, but that it
has been long appropriated to import suspended animation or appa-
rent death;—a total  cessation, not of the pulse only, but  of sense
and  voluntary motion.  The disease  has never hitherto,  that the
author knows, been  noticed by nosologists: but the cases are so
clear and numerous,  that the omission ought no longer to  continue. 
GE. II.]                   NOSOLOGY.                      265
          /3 Parlicularis.  Confined to particular parts of the arte-
              rial system.
              Over the whole system except the heart, which pul-
            sated violently.   Beggi in Pachioni opp.—Confined to
            the  arteries  of  a  single  arm.   Camerar. Memorab.
            Cent.  II. p. 54.
              Sometimes the result of aneurism or partial paraly-
            sis.
7. Systremma.   Sudden and rigid contraction and  convolution of
                    one  or more muscles  of  the  body;  mostly
                    those of the  stomach and  extremities,  vehe-
                    mently painful, but of short duration.
       Crampus.  Sauv.  Vog Sag.
       Tetanus dolorificus.   Darw.
       Taus.  Arab.
       Fekek.   Of  Persian origin.
       Crampff.  G.
       Granchio.  Ital.
       Crampe.  F.
       Cramp.
          Chiefly produced by a sudden  chill, as  that of the night
       air, or of water when swimming in it; often occasioned by
       an uneasy position, or undue distention of the muscles:  and
       hence frequently attacking  in sleep.
          Found also, as a  symptom, in  cholera;  and occasion-
       ally in pregnancy and during labour.
                        GENUS II.

                   NEURALGIA.*

      Contraction and distortion of a particular muscle  or group
          of muscles,  with partial trepidations, and acute  lanci-

   7.  Entasia Systremma.   Zvo-rgeptpix, " contortio," « convolutio,"
" coagumentum compaotile,"  "globus:" from  <rv?£t<pa,  " contor-
queo," '• convolvo in fascem." Stremma, the primary noun, is already
familiar to the medical car in  the sense of " strain, twist, wrench;"
see Cl. VII. Ord. I  Gen. ii. 3.  And  hence it is already  prepared

  [* In the " Study of Medicine," Neuralgia is the  6th genus, 2d order, 4th
class.  See " Study of  Medicine," Vol. III. p. 192.]
   vol. v.—45 
266
NOSOLOGY.
[CL. IV —OR. 1H.
          nating pains in the course of the  principal nerves: pa-
          roxysm short, recurring at irregular periods.
1. faciei.  Contraction and distortion  seated about the  ala  nasi
                and upper lip; pains shooting to the orbit:  often
                to the ear, and over the cheek, palate,  teeth, and
               fauces.
       Trismus maxillaris.—T. dolorificus.   Sauv.
       Dolor crucians faciei.   Fothergill.
       Hemicrania idiopathica.   Darw.
       Autalgia dolorosa.  E    Young.
       Tic douloureux.  Andre. Fothergill.
2. pedis.  Racking and intolerable pain seated about  the heel; tre-
              mulously shooting in irregular  directions towards the
              ancle and bones of the tarsus.
                This species is  described  from a  very  marked
               case  which has lately occurred to the author,  in  a
for systremma, in the sense of crampus, a term intolerably barbarous
and universally reprobated, though  to this hour in universal use,
notwithstanding such reprobation. The proper Latin term perhaps is
raptus nervorum; whence opisthotonia, or opisthotonus is  " raptus
supinus."
   Gen. II. Neuralgia.  From nvgov, " nervus," and «Aye?,"" dolor."
The only species that has hitherto been fully described is that which
attacks the  face—n. faciei of  the present  method, consisting  in a
morbid affection of some of the branches of the fifth pair of nerves,
constituting very generally the  sense of feeling; and for a  very ex-
cellent description of which the reader may turn  to Mr. J. Hunter
on the " Animal Economy," p. 259.
   Andre appears to be the earliest writer who remarked this painful
affection with accuracy.  He succeeded in removing it permanently
by applying a caustic to the infra-orbitary or maxillary branch in
one case, in  which a previous division of  the nerve by the scalpel,
as practised by M. Marechal,  had produced only a temporary cure.
Dr. Haighton, however, seems in one instance of a later date, to
have found the last method also radically successful.
   But perhaps the most curious and complicated example to be met
with is  that of Mr. Bosworth, a  patient of Dr. Darwin's,  and who
was operated upon successively by Mr. Cruickshank and Mr. Thomas.
In this  case the disease appears  to  have  existed  in almost every
branch of the affected nerve,  and also to  have passed into one or
two others, or to have influenced  them by sympathy.  By a dexter-
ous and repeated  use of the knife,  however, carried into  different
directions, this formidable and  intricate disease was at length radi-
cally cured, and the  patient in consequence perfectly restored to
ease.   The  account is given in  Dr. Darwin's  Zoonomia,  Part II, 
GB. ill,]
NOSOLOGY.
267
gentleman, otherwise of good health, about forty-five
years of age, who has been long a victim to it.   The
pain during the  paroxysm is so  severe as nearly to
make him faint, and is generally  compared by him to
that of scalding verjuice poured over a wound.  Here
the tibial branch of the ischiatic nerve seems to be af-
fected,  and perhaps the peroneal.
                    GENUS  III.

                       CLONUS.

Forcible agitation of one or more muscles in sudden and irregulai
     snatches.
Diseases of Irritation, Cl. I. ii. 2. 12, in two interesting letters: the
first from the author of the work to Mr. Cruickshank, and the second
from Mr. Thomas, his son-in-law, in reply.
  Darwin properly enough objects to the word trismus, under which
this genus has  commonly been arranged, " as no fixed spasm like
the locked-jaw  exists in this malady."   He adds, indeed, that in the
few cases he has witnessed there has not even been any convulsion
ef the muscles  of the face ; though this he subjoins " may possibly
occur occasionally as the consequence  of disagreeable sensation, or
to relieve it."—Almost every writer, however, besides himself, has
noticed  the existence of some kind  of nervous  contraction, distor-
tion, or  agitation, from the commencement of the disease; and in
the case of Mr. Bosworth, Dr. Darwin  expressly observes, that dur-
ing the  return of the pain " he seems to stretch and exert his  arms,
and appears to  have  a tendency  to epileptic actions,"—clearly
evincing a spasmodic diathesis.
  The word tic, of late introduced from the French writers  into our
own language,  is supposed to be an onomaptopy, or a name  fabri-
cated  for the purpose : derived, according to some, from the pun-
gent stroke with which the pain assaults, resembling the bite of an
insect;  but  according  to Sauvages and  Soleysel, from the sound
made by horses that are perpetually  biting the manger when  la-
bouring under  a variety of this disease.  We do not appear to be
acquainted with the real origin of the  term.
  Gen  HI.  Clonus.  Kaov«s, xXwitis, " agitatio," " perturbatio,"
from xXtttu, « commoveo," " concutio."   The clonic or concussiye
spasms  form two distinct orders in Sauvages, and a single genus in
Parr.   The first is unnecessarily diffuse; the second too restricted. 
268
NOSOLOGY.
[CL.IV.—OR. HI
       Clonici partiales.   Sauv.
1. Singultus.  Convulsive catch of the  respiratory muscles, with
                   sonorous inspiration; iterated  at short intervals.
       Lygmus (xvypios)   Hippocr.  et Auct. Grozc.   See Friend's
          Transl. fol. p. 181.
       Singultus.   Auct.  Lat. et JSleoter.
       Fevak.  Arab.
       Glucksen.   G.
       Hoquet.   F.
       Hiccough.
          Sometimes periodic.  Bonet, Sepulchr. lib. iii. S. V. Obs.
       4.—Sometimes  chronic; and  has  continued three months.
       Schenck, lib. iii. 49:—Four years.  Bartholin. Hist. Anat.
       Cent.  II.  hist. 4.—Twenty-four years.   Alberti, Dissert.
       Casus  singultus  chronici.  Hall, 1743.
          Occasionally idiopathic; but more frequently found, as a
       symptom, in various affections of the stomach, excess of food,
       worms, strangulated hernia,  atonic  fevers,  hypochondrias,
       and local irritation after operations.  See  Hunter on blood,
       p. 410.
2. Sternutatio.   Irritation of the membrane of  the nostrils, pro-
                     ducing sudden, violent, and sonorous expira
                     tion through their channel.
       Ptarmus (vra^pMs)   Auct. Grozc.
       Sternutatio.   Auct. Lat.
       Otas.   Arab.
       Niesen.  G.
       Eternuement.  F.
       Sneezing.
         At times periodic.  Brest. Sammlung. 1725. ii. 82.   Eph.
       Nat. Cur.  Cent.  V.  Qbs. 19.—Of long continuance.   Hor-
       stii Opp. ii. 298.—Three hundred times in a paroxysm. Eph,
       Nat. Cur.  Dec.  i. ann. iii. obs. 138.
Each order of Sauvages is reduced, in the present attempt, to a dis-
tinct  genus; to the  former the well known  and appropriate term
clonus is still applied, to the latter synclonus, which  see.
  3. Clonus Palpitatio.  The disease,  in one or two of its  varie-
ties, is accurately and ably described by  Mr.  Dundas in the  Trans-
actions of the Medico-Chirurg. Society, Vol. I.  p.  37;  who gives
many interesting cases which he regards as  having been " always
the consequence of, or connected with, rheumatic  affection."  These
cases chiefly relate to the variety y, and were  complicated with 
GE. III.]
NOSOLOGY.
269
         Found also, frequently, as a symptom in measles, catarrh,
       and worms :  and said to produce a periodical variety,
3. Palpitatio.  Irregular and vibratory  motion of the heart or ar-
                   teries.
       Palpitatio.   Auct. Lat. et Neoter.
       Palm us (TrxXptos.)   Auct. Graze.
       Khefakan.   Arab.
       Klopffen.  G.
       Palpitation.   F.
       Palpitation.
       x Cordis.  Of the  heart alone.
            The palpitation has sometimes been sonorous.   Cos-
         tell (P. V.)   Exercit. ad effect, thoracis.  Tr. IX. Tolosa
         1616.—A Vega, de arte Med.   So violent as to dislocate
         the ribs. Horsl. ii. 137. 139.—To break them. Sclienck.
         Obs.  215 ex Fernelio—Victorius, Consil.  n. 97.  In like
         manner the humerus has  been dislocated by a convulsion
         fit.   See exarthrema arid catagma Fractura, Class VII.
         Ord  I.
       G Arteriosa.   Of the arteries alone.
            A  few very decided cases of  this variety have occurred
         to the author ; and probably many more to others.   The
         anomalous  motion could be  easily felt by pressing  the
         finger on the arteries subject to it, and, in  one instance,
          distinctly seen.
            Universal.  Ephem. Nat. Cur Dec. I.  ann. vi. vii.
       y  Complicata.  Extending from  the heart more  or  less
            through the course of the arteries.
            Found, also frequently, as a  symptom in organic affec-
          tions of the heart, and violent mental emotions.
4. Nictitatio.  Rapid and vibratory motion of the eyelids.
       Nictitatio.  Auct. Lat.
       Nystagmus (wrrxyptos.)   Auct. Grc&c.
       Blinzen der augenlieder.   G.
       Souris.  F.   Diet, de Med.
       Twinkling of the eye-lids.
5. Subsultus.  Sudden and subsultory elevations of the tendons.
great  anxiety, usually with dyspnoea, with palpitation, or violent
pulsation of the carotid arteries;  and sometimes with an " action of
the heart so very strong as to be distinctly heard, and to agitate the
bed the patient was in so violently, that the pulse of the patient
could be counted by looking at the motion of the curtains of the 
270                       NOSOLOGY           (GL. IV.—OR. Ill
    Subsultus.   Linn.  Sag.
    Carphologia spasmodica.   Sauv.
    Soubresaut des tendons.  F.
    Twitching of the tendons.
      The  instances  of idiopathic affection are not common,
    though the author has sometimes met with them.  The usual
    irritation is that of debility ;  and hence it is found, far more
    frequently, as a symptom  in arthritic and hysteric affections,
    and particularly in atonic  fevers.
Pandiculatio.  Transient elongation of the extensor muscles,
                  with deep  inspiration and sense of lassitude.
    Pandiculatio.   Auct. Lat. et Neoter.
    Scordinema.   Hippocr.
    Nehva.   Arab.
    x Maxillarum.  Of the jaws.
      Oscitatio.  Auct. Var.
      Gahnen.  G.
      Baillement.   F.
      Yawning.  Gaping.
    /3 Artuum.   Of the limbs.
      Streckung.   G.
      Tiraillement.  F.
      Stretching.
        Found also, frequently, as a symptom in fatigue, hys-
      terics, restlessness, dyspepsy, and  the accession of fevers.
      As an idiopathic affection, acquired chiefly from a habit of
      idleness.
                     GENUS IV.

                 SYNCLONUS.

Tremulous, simultaneous, and chronic agitation of various mus-
  cles, especially when excited by the will.
bed."  On dissection, the heart was uniformly found enlarged in its
size, but without increase  of  muscular power:  occasionally poly-
pous concretions were  detected, and very generally adhesions to
the pericardium.  The above patients were mostly in the prime of
life. 
GE. rvj
NOSOLOGY.
271
       Clonici universales.  Sauv.
       Clonus.   Young.
1. Tremor.   Simple,  tremulous  agitation of the head, limbs, or
                 both;  most on voluntary motion.
       Tromus (r^pus)  Auct. Graze.
       Tremor.   Sauv. Linn.  Vog.  Sag. Cull.
       Raush.   Arab.
       Lerze. Pers.  It imports also the rigor that  takes place on
         the accession of an ague.   In which last sense the Turk-
         ish writers use ditreme,  as though derived from t^ims, or
         tremor.
       Zittern.   G.
       Tremblement.   F.
       Trembling.
         Found  also,  occasionally, as a symptom,  in debility,
       old  age,  surfeit, and other affections of the  stomach, pas-
       sions  of  various kinds,  paralysis, metallic poisons,   and
       worms.
2. Chorea.  Alternately tremulous and jerking motion of  the
                 face,   legs,  and arms, especially when volunta-
                 rily called into action; resembling the  grimaces
                 and gestures of buffoons; usually  appearing  be-
                 fore puberty.
       Scelotyrbe.   Galen.  Isagog. libr. fin.  Sauv.
       Chorea.   Linn. Cull.
       Chorea Sancti Viti.   Sydenh.
       Choreomania.—Ballismus.   Plouquet.
   Gen. IV. Synclonus.  From <rvyxtovt*>, " concutio," u conturbo •"
as clonus from xXoveu.  The genus, as observed  in  the preceding
note, is designed to include all the clonici universales of Sauvages,
that seem fairly to belong to the same  family.   It runs nearly paral-
lel with the clonus of Dr. Young, who has employed the term in a
sense more than commonly restricted.
   2. Synclonus Chorea. Xopos,  " chorus," " ccetus saltantium." Ac-
cording to Horst, the name of St. Vitus's dance was given to this
disease, or more probably to a  disease possessing some resemblance
to it, in consequence of the  cure produced  on certain  women of
disordered mind upon their paying a visit to the chapel of St. Vitus
near Ulm, and exercising themselves in dancing from morning to
night,  or till they became exhausted.   He adds, that the  disease re-
turned annually,  and  was annually removed  by the same  means.
Macbride has  hence given  to  it the  name of hieranosis, by other
writers applied to syspasia or convulsion-fits. 
272
NOSOLOGY.
[CL.IV.—OR. HI.
       Danse de St. Guy.   F.
       St.  Vitus's Dance.
         Sometimes   with  deep  and  continued  melancholy.
       TIdermal.  Consil.  lib  ii.  p. 14—Stoll strongly recom-
       mends the  extract of belladonna,  obtained  from  the juice
       of its roots,  every four hours, in the  proportion of from  a
       sixth  part to a  quarter  of a  grain.    Dr.  Hamilton  has
       found his purgative  system   peculiarly serviceable.   See
       his treatise  " On the Utility of Purgative Medicines,  &c."
       1805.   Cured  by the  arsenic solution,  at a medium dose
       of ten drops three times  a-day, in a girl of fourteen, after
       digitalis had  been tried  in vain.   Martin. Trans. Medico-
       chir. Soc. iv. 45.
3. Raphania.   Spastic contraction of the joints; with  trembling
                 and  periodical pains.
       Raphania.  Linn.  Vog.  Cull.
       Convulsio Raphania   Sauv.
       Kriebel-Krankheit.  G.
       Dragsiufa.   Suecic.
         Sometimes accompanied  with  cutaneous   ulcerations,
       and extensive exfoliations of  the  cuticle and cutis.   See
       Taube   Geschichte   der  Kriebel-Krankheit,   Gottingen,
       1782.
  3  Synclonus Raphania.  So called by Linneus as being supposed
by him to be produced by eating the seeds of raphania,  Raphanis-
irum.  It is chiefly found in Sweden and  the adjoining countries;
and has hence been chiefly treated of by Swedish  writers.  There
is an excellent paper upon the subject by Dr. Rothman, in the Ama-
nitates Academica,  Vol.  VI. ;  who asserts, that it is neither a new
disease, nor confined to the Baltic countries.   He  has traced it,  he
says, as  an affection common to Europe, in the works of various
writers up to the year 1596. It seems to depend upon some delete-
rious  vegetable intermixed with the  grain  employed  in  making
bread : some species of lollium, or secale (darnel or rye) have been
suspected ;  but there is more reason for ascribing it to the raphania,
Raphanistrum
  4. Synclonus  Beriberia. Bi^Ge^t,, Eustath, " concha," " ostreum ;"
a " conch or shell;" and hence figuratively incurvation in general.—-
It is unquestionably an oriental term, and is so stated by  Eustathius ;
from whom  Scapula has  copied it.  Possibly the root of the term is
the  Arabic,  beri, which signifies literally " praecido, concido," " to
cut  up or cut off,"—like  the Greek o-vyxovra, whence syncope ; and
metaphorically  " defatigo, exhaurio,"  '• to wear out, exhaust, en-
feeble."   The author has retained it as it is given  in Scapula, not 
GE. IV.]                   NOSOLOGY.                       273

4. Beriberia.   Spastic retraction of the knees on walking; trem-
                  bling and painful stupor of the limbs; sense of for-
                  mication; hoarse voice.
       Beriberi.   Bontii. Manget. Linn.
       Beriberia.   Sauv. Sag.
       Paralysis Beriberi.   Tulpius.
                       ORDER IV.

                    SYSTATICA.

AFFECTING SEVERAL OR ALL THE SENSORIAL POWERS SIMUL-
                        TANEOUSLY.

  Irritation or inertness of the mind extending to the muscles or ex-
       ternal senses; or of the muscles or external senses extending
       to the mind.
withstanding that Sauvages has introduced it into his list of " nomina
barbara, seu nee Graeca, nee Latina, relinquenda."   Tom. I.  p. 30.
Mangetus asserts that it was known to Erasistratus.
  The term is still preserved in Ceylon, but applied to a different
disease:  a peculiar sort of dropsy, commencing with stiffness and
oedema of the lower extremities,  which  shortly spread over the
whole body, producing dyspnoea, vomiting conclusive motions, and
death.   The symptoms have been given at some  length by  Mr.
Colhoun  and Mr. Christie, inspector-general of the hospitals in Cey-
lon.   The English forces established  at Ceylon are occasionally
subject to it.  See " Essay on the  Diseases incident to Indian Sea-
men or Lascars on long  Voyages."  By William Hunter, A.M.
Member of the Asiatic Society of Calcutta, &c.  In like manner
Lord Valentia, in his Travels, Vol. I. p. 318 : "a complaint, as far
as I have learnt, peculiar to the island (Ceylon) is the berri-berri.
It is in fact a dropsy that frequently destroys in a few days."
  In whatever form it conducts its attack, it appears, like the pre-
ceding, to be the result of food or drink poisoned by some minute
parasitic  plant or animalcule, as in the case of gangraena ustilaginea,
and various examples of pestis erythematica; to the notes on both
which the reader may turn.
  Order IV.  Systatica.  Zvttxtixx, " congressa," « consociata,"
» concidentia:" from vvyto-r^pci," congredior," " consocio."  Syncop-
tica might have been employed, and upon as large a scale, import
  VOL. v.—46 
274                       NOSOLOGY,           [CL. IV.—OR, IV.
                        GENUS  I.

                     AGRYPNIA.

     Difficulty or inability of obtaining sleep.
       Agrypnia.   Auct. Gaazc. Sauv. et recentior.
       Pervigilium.  Auct. Lat.
       Arek.  Arab.
       Schlaflosigkeit.   G.
       Insomnie.   F.
       Sleeplessness.
1. entonica.  Sleep retarded by an inordinate excitation of the mind
                 to a particular subject: listlessness to surrounding
                 objects.
2. chronica.   Habitual wakefulness; mind tranquil; attention alive
                 to surrounding objects.
                 See Gooch?8 Observations, App. p. 218.—Thirty-
              five days without intermission.   Grilling,  Cent. iv.
              obs. 90—Six months.  Panarol.  Pentecost. V. obs.
               4—Three years.   Plinii, lib. vii. cap. 51.
                 Mostly common  to advanced age.
                 Found also, occasionally, as a symptom,  in exces-
              sive fatigue, pain, inflammations, fevers, and various
              mental diseases.
                     GENUS  II.

                  DYSPHORIA.

Troublesome and  restless uneasiness  of the nerves and  mus-
ing as well increased as diminished action, compello, as well as con-
fido ; but that it is usually limited to the last train of ideas, and con-
sequently might have produced confusion : since the present order,
like all tke preceding, includes diseases evincing different and even
opposite states  of action.
  Gen. I.   Aorypnia.  'AygvTrvtx, " pervigilatio ;" from xygvirnet,
Wpervigilo," "  insomnem noctem duco."  The genus is not gene- 
GE. II]
NOSOLOGY.
275
       cles;  increased  sensibility; inability  of  fixing the  atten-
       tion.
       Dysphoria.   Auct. Graze.
       Inquietudo.   Sennert. Plouquet,
       Astasia.   Plouquet.
       Desasossiego.   Spanish.
       Unruhe.   G.
       Restlessness.
1. simplex.   General; and  accompanied with  a perpetual desire
                  of changing the position.
       Dysphoria nervosa.   Cricht.
       Erethismus simplex.   Young.
       Kalak. Arab.  This  term precisely answers to the English
         word fidgets, or titubatio,  as used by Cicero.
       Fretillement.   F.
       Fidgets.
2. Anxietas.  Chiefly affecting the  praecordia; with depression
                  of spirits, and perpetual desire  of  locomo-
                  tion.
       Alysmus (Axvo-ptos.)   Hippocr.
       Anxietas.  Sauv.  Vog.  Sag.
       Hemm. Arab. The Persian synonym  is tasa or laesa; nearly
          univocal with the Latin tozsa, whence pertozsa;  and pro-
          bably derived from a common source.
       Angst^  G.
       Anxiete.   F.
       Anxiety.
          Found also, occasionally, as a symptom, in acute fevers,
       affections of  the stomach, and other viscera,  hysterics, hy-
       pocondrias, and lyssa.
rally introduced into systematic nosology : but its claim is clear, as
in many instances it seems to be strictly idiopathic, and unconnected
with any other disease.
  Gen. II.  Dysphoria.  Avo-pofix, " tolerandi difficultas," from
?vr<po£eu, " difficultfr tolero," or "porto." It does not expressly en-
ter into the classification of Sauvages or that of Cullen, but is nearly
synonymous with the anxietas of the former, which, in the present
system, is  reduced to a species of dysphoria.   " Molesta sensatio,"
says Sauvages, " quae ad jectigationem cogit, sed quomodo ab affi-
iiibus morbis discrepet, dicant qui experti sunt."  This definition,
if definition it may be called, will equally apply to both the species
here offered 
276                      NOSOLOGY.           (CL. IV.—OR. IV.


                       GENUS III.

                  ANTIPATHIA.

Internal horror at the  presence of particular objects or subjects;
  with great external restlessness or deliquium.
       Antipathia.  Sauv. Linn.  Vog. Plouquet.
       Arbedet.   Arab.
       Antipathic  G. F.
       Antipathy.
1. Sensilis.   Antipathy produced through the medium of the ex-
                ternal senses.
                Sight of a drawn sword in King James I. Digby
              Theatr.  Sympathet.—Sound of music.   Eph. Nat.
              Cur. Dec. I.  ann.  i. obs. 134.—Smell of roses. Id.
              Dec. II. ann.  x.  Obs. 8.—Of strawberries.  Id.
              ann.  v.  obs. 214.—Taste of cheese.  Zacut. Lusit.
              Frax.  admir. lib. iii. obs.  103.  Eph. Nat.  Cur.
              passim.
   Gen. III.   Antipathia.  AirtirxtqsJ from xirnrxitu, " naturalem
 repugnantiam habeo." The instances advanced by physiologists are
 innumerable ; and many of them are of every-day repetition. Some
 may be accounted for from early fright, or other cause of disgust;
 but many are of very difficult solution,  and some altogether intract-
 able.  The most singular, perhaps, are those of the second species,
 instanced in the horror excited by a cat as  soon as it comes within
 the atmosphere of an unknown influence, the animal being neither
 seen nor heard, nor in any respect an object of any external sense.
 The author has met with several decided cases.  Sauvages inquires
 whether, in such  instances, the effluvium  thrown from the object
 of disgust into the atmosphere, may not,  in combining  with  the
 fluids of the influenced person, produce a tertium quid, as corrosive
 sublimate is produced by a combination of meicury  with muriatic
 acid.   The fact at present appears inexplicable:  but  it is  not more
 singular than the wonderful power so well  known to be possessed
 by the viverra noctula (common  or  great  bat,)  which renders it
 conscious of the presence and  position  of objects, when all its
senses are muffled ; and which enables it, when flying in this state,
to avoid them.  This extraordinary faculty has been called  a sixth
sense by several naturalists.
  Antipathia  does not occur in  Dr. Cullen's classification : but it
enters into his supplementary catalogue " morborum a nobis omis-
sorum, quos omississe fortassis non oportebat." 
GE. IV.]
NOSOLOGY.
277
2. Insensilis.  Antipathy produced through an unknown medium.
                   Chiefly in the case of cats, at hand, but neither
                 seen, touched, smelt, or heard.  See Smetius  Mis-
                 eel, p. 101.   Bartholin. Hist. Anat. Cent. III. 28.
                 Cent. IV. 58.   Qjuercetan, Diaet. Polyhist. p. 82.
                 Eph. Nat. Cur. Dec. II. ann. ii.  obs. 50.
                       GENUS  IV.

                         LYSSA.*

Great restlessness; anxiety;  hurry of mind; horror; and constric-
       tion of the muscles of the chest; supervening to the bite of a
       rabid animal: preceded by a return of pain and inflammation
       in the bitten part.
     Lyssa.   Auct. Graze.
     Rabies.  Auct. Lat.
     Keleb.   Arab.
     Rage.  F.
       Not always accompanied with water-dread; in dogs:  Sal-
     muth, Cent.  III. obs. 90.—In wolves: Trecourt,  Memoires et
     Observations de  Chirurgerie.  In man:—able to take fluids
     before death: Observ. Clinic. Fasc. II. p. 48.   Able to eat and
     drink: Dundas, Lond. Med. Journ. VIII.  p. 1, 1787, the case
     doubtful.  See also Fehr. Nachricht, &c. p. 44.
       The academical journals and monogrammic  writers  have
     numerous instances of the  disease after a bite of many years
     standing: sometimes twelve, eighteen, or twenty:  but the cases
     want authority.   In  Heister  is a case of lyssa produced  by
     putting into the mouth the cord  by which the rabid dog had
     been confined.  Wahrnemungen, Band II.

  Gen. IV.  Lyssa.   Ava-a-x.  « rabies," whence Xwvxtt, " furo;"
probably from  Xvu, " solvo."   The  old Greek  term is here re-
stored, as far more correct  than jhat of the present day, which is
hydrophobia or water-dread, since the last is not a pathognomic symp-
tom ; being sometimes found in other diseases; occasionally ceasing
even in canine madness, the second  species here  offered, towards
the close of the paroxysm; and though almost always found among
mankind, in numerous  instances wanting in rabid dogs and wolves.
  • [In the " Study of Medicine," Lyssa is not ranked as a genus, but is the 7th
species, 1st genus, 3d order, 4th class.  See " Study of Medicine. Vol. III. p,
228.] 
27S
NOSOLOGY.
[CL. IV .—OR. I\
       In Dr. Marcet's case, Medico-chir. Trans. I. 132,  the pa-
    tient lived  six  days  after the appearance of water-dread.
    Opium, iron,  and arsenic, were tried in large  quantities, but
    proved equally ineffectual.
       On dissection, the fauces, glottis,  larynx, oesophagus, and
    stomach, have  been commonly found more or  less inflamed ;
    sometimes abraded.
1.  felina.  The paroxysm periodical,  and returning with the full
              moon:  produced by the bite of an enraged cat.
       Anxietas a morsu.   Sauv.
       Anxietas a morsu I'elis iratas.  Morgagn. ep. lxi. 14.
       Feline madness.
         In the case here referred to, the paroxysm took place four
       days after the bite : there was great anxiety of the praecordia,
       but no water-dread.   Local and  general  bleedings were
       useless; frequent  repetition  of the tvarm bath afforded re-
       lief ; but it only yielded to an ephemera with copious  sweat.
       It returned  with the full moon for two years:  the bitten part
       first becoming highly irritable ; and the  general symptoms
       succeding,  which were now relieved by bleeding.   After
       this period it returned with  every fourth full  moon  for two
       years more.—See another case,  which terminated fatally on
       the first paroxysm, in the Trans. Med. Soc. of Lond.  Vol. I.
       p. 78.
" Constat repetita," says Sauvages, " apud Gallo-provinciales expe-
riential, canes Iuposque rabidos bibisse, manducasse, flumen tranasse,
ut olim Marologu et bis Forolivii observatum, adeoque nee cibum
nee potum aversari."  According to Meynell, the disease, among
dogs, appears from ten days to  eight months after the  bite.   In
Earl Fitzwilliam's hounds, which were bitten June 8, 1791, the in-
terval varied from six weeks to  more than  six months.   Among
mankind its accession is also very uncertain, as this seems to be re-
gulated by the time of  the year, the habit of the patient, and other
accidental circumstances.  It has  occurred a fortnight ofter the bite,
three weeks, a month, and  sometimes six weeks, and  even three
months, after which last period the patient is considered  safe.
   In two cases published by Dr. Thacher in the American Med. and
Phil. Register, Vol. I.  p. 457, the injury inflicted by the same dog,
Aug. 16, 1810, did not produce hydrophobia till nearly three months
afterwards, Nov. 3, and Nov. 14 : the first case was that of a child
under four years of age, the second that of an old man  of seventy-
three.  In the former the hydrophobia continued  for six days, and
in the latter for seven,  before death ensued.   The  remedies chiefs 
GE. V.]
NOSOLOGY.
279
2. canina.   The  constriction extending to  the muscles of deglu-
               tition ;  which  are  violently  convulsed  at the  ap-
               pearance or idea of liquids: produced by the bite of
               a rabid dog, and fatal on the  first paroxysm.
       Pantophobia.  Cozl. Aur.
       Rabies canina.   Boerhaav.
       Hydrophobia.   Sauv.  Linn. Sag.  Cull.
       Erethismus Hydrophobia.   Young.
       Clonos Hydrophobia.   Parr.
       Hund-tollheit.   G.
       Hydrophobic   F.
       Canine madness.
                     GENUS Y.

                  CEPHAL.EA.

Aching pain in  the head;  intolerable  of light  and sound; diffi-
     culty of bending the mind to mental operations.
     Sedao.  Arab.
recommended in America  are  lobelia inflata, Scutellaria latiflora,
anagallis arvensis in the form of tincture.  Dr. Hossack frankly con-
fesses he has no confidence in any of them.  Id. p. 462.
   In the Memoirs of the Manchester Society, Vol. IV. is a singular
case published by Dr. Bradsley, of an attack of lyssa twelve years
after the bite of a  dog supposed to be mad.  The patient died in
the Manchester  Infirmary with the most decided  symptoms of the
disease.  From  the long interval between  the bite and the symp-
toms, Dr. Bardsley is more inclined to ascribe the disease to several
existing  circumstances at the time of its appearance, and particu-
larly to a deep depression of spirits and strong mental agitation the
patient had for some time been labouring under, than to any canine
poison which might be lurking in the constitution.  But this would
be to suppose that lyssa is capable, under particular circumstances,
of being spontaneously generated even in the  human frame, while
Dr. Bardsley contends that it cannot exist even among dogs, except
by contact.
   Dr. Cullen, in his  definition of canine madness, which he calls
hydrophobia rabiosa, has introduced  mordendi cupiditas, " an eager
desire of biting," as a symptom.  This is incorrect, and has been
consequently omitted by most succeeding nosologists.
  Gen.  V. Cephaljea.  KeQxXxtx, from r.tQxXy, » caput," the head. 
280                      NOSOLOGY.          [CL. IV.—OR. IV.

       Hauptwehe.   G.
       Mai a la tete.  F.
       Head-ache.
1.  gravans.  Pain obtuse; with a sense of heaviness extending over
                 the whole head;  sometimes intermittent.
       Ecplexis (txTrXtfys.)  Hippocr.
       Cephalalgia.   Sauv. et Auct. Recentior.
       Etourdissement.  F.
       Stupid Head-ache.
2.  intensa.   Pain vehement, with a sense of tension over the whole
                 head; periodic:  often chronic.
       Cephalaea.  Galen. Sauv. et Auct. Recentior.
       Chronic Head-ache.
3. hemicrania.  Pain vehement: confined  to the forehead, or one
                   side of the head: often  periodic.
       Hemicrania.   Sauv. et Auct. Recentior.
       Shekykat.  Arab.
       Migraine.  F.
       Megrim.
4. pulsatilis.   Pain pulsatory, chiefly at the temples; often with
                   sleeplessness and a sense of drumming in the
                  ears.
       Crotaphus.  Cozl. Aurel.
       Cephalalgia pulsatilis.  Sauv.
5. spasmodica.   Pain partial, spasmodic; often shifting from one
                   portion of the head  to  another;  chiefly com-
                   mencing  in  the  morning;  with  sickness  and
                   faintness.
The term is applied  by Galen chiefly  to the chronic  head-ache,
whence cephalalgia has been invented,  in later times,  to express
affections of shorter duration.  The whole, however, form a natural
group, and should be included under one genus, which  is here
named after the oldest and most  authorized term.  Sauvages has
particularly noticed the symptom of disability of the mental powers
in c. gravans, and the  remark may be applied to all the other species,
" difficultas cogitandi,  distincte ratiocinandi, reminiscendi.  C. spas-
modica is possibly a variety of one  or  two of the rest; it  is intro-
duced chiefly upon the authority of Dr. Fothergill.
  Linneus is said to have cured himself of a severe  and obstinate
hemicrania, which returned at the interval of a week, and continued
for twenty-four hours, by the daily use of morning exercise, preced-
ed by a draught of cold water.  Aman. Acad. Vol. VII. Art. 125. C.
Lado. See also Maton's edition of Pulteney's Life of Linneus, p. 451. 
GE. VI.]
NOSOLOGY.
281
Cephalalgia spasmodica.   Fotherg.
Sick Head-ache.
   Most of these species found  also, at times, as symptoms
of other diseases:  chiefly  rheumatism, suppressed  catame-
nia,  dyspepsy,  and other affections of the stomach;  and
various fevers.
                       GENUS VI.

                           DINUS.

     Apparent  gyration of objects with  hebetude of the sensorial
       powers.
       Dinus (hvos.)   Aut. Grozc.
       Dizziness.
 1. Vertigo.  Dizziness;  sense of undulation in the ground; unfit-
                 ness for mental exertion.
       Vertigo.   Sauv. Linn. Vog.  Sag.
       Hullucinatio Vertigo.  Cricht.
       Autalgia Vertigo.   Young.
       Devar.   Arab.
       Schwindel.  G.
       Vertige.   Tournoyement de tete.   F.
       Swimming of the head.
 2. illusorius.   Dizziness, with dimness of sight, and imaginary
                   objects before the external senses.


   Gen. VI.  Dinus.   Atvos, «<turbo," "gyrus."   The species en-
 tered under this genus are generally regarded as  mere varieties or
 degrees of the same affection : but there are few practitioners, per-
 haps, who have not seen each of  them commence  and terminate se-
 parately ;  and consequently without running into one another, or
 having any necessary connexion.  Linneus has hence made scotoma,
 not merely a different species, but a different genus from vertigo,
 which is perhaps to carry the distinction too far.
   The vertigo of Dr. Crichton (Ment. Derangem.  11.343,) seems to
 be not essentially different from that of the present genus.  His de-
 finition is  " apparent rotatory mouon of external objects, and sense
 of undulation in  the ground, with abolished attention and thought."
By him it is  placed as a species under the genus hallucinatio.   The
present seems to be its more proper place.   It is  singular that  this
 excellent writer  should have passed by  this genus in his General
 Table.
   vol. ▼.—47 
232                      NOSOLGGY.          [CL. IV.—OR. IV-

       x Phantasmatum.   Ocular  or  auditory spectres   in  the
            semblance of net-work,  dark spots, dazzling or rain-
            bow hues  before the eyes; murmuring or whizzing in
            the ears.
       G Mutationis.   Real objects changed in  their natural quali-
            ties, by error of form, of motion,  or of number.
              This species has a near resemblance, in many of its
            symptoms,  to paropsis illusoria and paracusis illusoria,
            Cl. IV. Ord. II.  which  see.  It differs in the general
            affertion of the head, and the evanescency of the disease.
3. Scotoma.  Dizziness with  blindness  and  tendency to swoon;
                often succeeded by head-ache.
       Scotomia.   Linn.
       Serkerd.   Of Persian origin.
       Blind head-ache.
       Nervous fainting-fit.
         Most of the species found also, occasionally, as symptoms,
       in plethora, worms, and other affections of the intestinal
       canal,  hypocondrias, hysterics, and lues.
                    GENUS  VII.


                   SYNCOPE.

Motion of the heart and lungs feeble or imperceptible;  diminished
  sensibility; inability of utterance.
     Leipopsychia.   Hippocr.
     Apsychia.   Gal.
     Lipothymia.  Plouquet.
     Svncope.  Sauv.  Linn.  Sag. Vog.  Cull.
     Geshye.  Arab.
     Ohnmacht.   G.
     Evanouissement.   F.
     Svanimento.   Span.
     Swoon.
     Fainting-fit.
  Gen. VII.  Syncope. "Zvyxoirn. from Tvyxo-r*ii, *» concido," to fell
or cut down.  Dr. Cullen's definition is as follows: "Motus cordis
imminutus, vel aliquamdiu quiescens."  This is by no means suffi- 
 GE. Vm.]                 NOSOLOGY.                      283

 1. cardiaca.   Returning at irregular periods: occasional palpitation
                 of the heart during the intervals.
       » Plethorica.  From surcharge of the cardiac, or neighbour-
            ing blood-vessels.
       G Vitioso.   From  polypous concretions, or other  morbid
            affection of the cardiac or neighbouring blood-vessels.
 2. inanitionis.  Accompanied with a sense of inanition, and ex-
                    treme general debility.
       x A fame.  From hunger or long fasting.
       G A fluxu.  From sudden and immoderate flux, whether of
            blood, pus, or any other fluid.
3. doloris.  Preceded by pain or irritation  of body.
       x  Interna.  From internal pain  or irritation; produced  by
            poisons, worms, or other similar causes.
       G Externa.   From external pain or irritation; produced  by
            wounds, or other accidents or injuries.
4. pathematica.  Preceded by  the exercise of some sudden and
                    overwhelming passion.
                      See Amat. Lusit. Cent. VII. cur. 1. Plater,
                         Obs. II. 431.
ft. metastatica.  Accompanied  with retrocession or  repulsion of
                    gout, exanthems, or other diseases.
                      Found also, occasionally, as a symptom in
                    hysteria, antipathia, scurvy, and fevers of va-
                    rious kinds.
                 GENUS  VIII.

                    SYSPASIA.

Clonic spasm; diminished sensibility; inability of utterance.
ciently express:  for the heart has been sometimes totally void of
motion without syncope, as in the well-known case of Mr. John Hun-i
ter.   Sauvages's  leipothymia  is only syncope in its first attack or
mildest degree.  Its character is  " subitanea et brevis virium de-
jectio, superstite pulsus vigore, et cognoscendi facultate."  The
pulse is perhaps always affected in  some measure, but in slight cases
it  still retains  a  certain  degree of power:  the apprehension re-
mains: but the voice seems to be uniformly lost. 
284                       NOSOLOGY.           [GL. IV.—OR. IV.

1. Convulsio.  Muscular agitation violent; teeth gnashing; hands
                   forcibly clenched; transient.
       Convulsio.   Boerh. Sauv. et  Auct. Var.
       Convulsio clonica.   Etmull.
       Nezarub.  Arab.
       Convulsion.   G. F.
       Convulsion fit.
       * Erratica.   Shifting irregularly from  one part to another.
       |3 Universalis.  Attacking every part simultaneously: occa-
            sionally protracted or habitual.
         Hieranosos.   Linn. Vog.
       y Intermittens.  Reluming after intervals regular,  or irre-
            gular.
       o Ejulans.   Accompanied with shrieks or yellings, but with-
            out  pain.
       g  Infantium.  Occurring in infancy; sensibility nearly sus-
            pended; features of the face for the most part hideously
            distorted.
         Eclampsia.  Sauv.
            The varieties are altered from the species in Sauvages,
         who has given cases of each: as well  as many others which
         are only symptomatic.  See Sauv. II. 550—556.
            The  disease,  in  some  of  its  varieties,  found  also
         occasionally as  a  symptom   in  teething, worms,  and
         other intestinal irritations, in  affections of the kidneys,
  Gen. VIII.  Syspasia.  Xvo-ttxtis, o-va-rrxstx, " contractio," " con-
vulsio ;" from crvtnrxot, " contraho," " convello."  The term is evi-
dently wanted as a generic name for the three  diseases that rank
under it in the present system, the symptoms of which, and, for the
most  part, their  mode of treatment are so accordant, as to establish
the propriety of making them species of a common  genus, rather
than distinct  genera.
  In defining convulsion-Jit, the first species, most of the nosologists
represent the faculties of the intellect and external senses as not in-
terfered  with.  Sautages says, " superstite  in  paroxysmis animae
functionum exercitio:" Vogel  " cum integritate sensuum."   Dr.
Cullen is here far more correct: his words are, " musculorum con-
tractio clonica, abnormis, citra soporem ;" " an involuntary, clonic
contraction of the muscles, bordering on, but short of, lethargy."
The author believes diminished sensibility to  be a constant symptom
in all the species of syspasia here enumerated, and has hence re-
garded this incident as a generic feature. 
GE. VRI.j
NOSOLOGY.
285
          parturition, and labour, various fevers, wounds of the head,
          and other organs.
2. Hysteria.   Convulsive  struggling, alternately remitting, and
                  exacerbating;  rumbling  in the bowels;  sense
                  of suffocation;  drowsiness;  urine  copious and
                  limpid; temper fickle.
       Malum hystericum.  Hoffm  Junck.
       Hysteria.  Sauv. et Auct. Recentior.
       Mutter-beschwerung.  G.
       Mai de mere.  Passion hysterique.  F.
       Hysterics.  Hysteric-fit.
       x  Atonica.   From  debility  of constitution;  without any
            evident  proximate cause.
       G  Irritata.   From sudden emotion of the mind, or irritation
            of the stomach  or bowels.
3. Epilepsia.  General muscular agitation,  without  sensation  or
                  consciousness;  recurring at regular or irregular
                  periods.
       Comitialis.   Plin. Gal.
       Caducus.  Paracels.
       Epilepsia.   Sauv. et  Auct. Recentior.
       Clonos Epilepsia.  Parr.
       Serau; and vulgarly M'jinen, Arab,   "demon-struck."
       Fallende-sucht.  G.
       Mai caduc.  Epilepsie.   F.
       Falling-sickness.  Epilepsy.
       x  Cerehralis.  Attacking abruptly, without  evident cause,
            except  sometimes  a slight  giddiness.   The  remote

  2. Syspasia Hysteria.  ' To-Tfjtx, from vvrt^x,  uterus.  Sauvages, in
his varieties, (species  as he makes them) of this disease, seems to
have followed Rawlinson with too close a step in his " theoria sub
tilis et fallax," as Cullen seems justly to have called it: nor will the
characters he offers  to distinguish hysteria from hypocondrias, hold
in every  instance.  His advice,  however, will perhaps always  be
found equally pleasant and profitable where it  can be accomplished.
" Huic morbo sanando  prosunt quae corpus roborant, animum  re-
creant, et a morbi idea avertunt, ut exercitatio, itineratio, rusticatio,
aut cupitorum obtensio ; virgini  libidinosae matrimonium; conjugi
zelotypse  vir fidelis; post serumnas fortuna prospera, si ex his cupi-
ditas expleatur."  Vol.  II.  586.
  3.  Syspasia  Epilepsia.   'EviXe^ix : from  tiethxpiGxioputt,  fut. 1.
tTrtX^ofuci, " apprehendo,"  to seize upon.  In the  transactions of
the Swedish academy, there is a valuable paper of Linneus, i. 279,
entitled " Ron, om orsakem til Fallande gotem i Skrane ock Wern-
sharad."  " Observations on the cause of the  Falling-sickness pre- 
286                      NOSOLOGY.          [CL. IV.—OR. IV,

            cause is external violence to, or internal injury, malfor-
            mation, or disease, of the head.
       G Rigida.   The limbs fixt and rigid, with agitation of  par-
            ticular organs.
       y Sympathetica.  Catenating with  some morbid action of a
            remote part, with a sense of a cold vapour ascending
            from it to  the head.
       & Irritata.   From  sudden emotions of the mind, or irritation
            of the stomach or bowels.
            Found also occasionally as a  symptom in suppressed
         exanthems, syphilis,  fevers, and uterine affections.
            In one instance  recurring at the sight of a hare,  and
         ascribed to a fright of the mother during pregnancy from
         the sudden and unexpected approach of ihe hare.  Ephem.
         Nat. Cur. Dec. II ann. iv. App. p.  209.  Occasionally
         recovered from after frequent recurrences for twenty-five
         vears.  Rliodii.  lib. i. obs.  63.
                    GENUS IX.

                       CARUS.

Muscular  immobility ;  mental  or corporeal torpitude ;  m
    both.
    Comata.  Sauv.
    Soporosi.   Linn.
vailing at Wernsharad in the  province of Skrane."  The disease
was common to children with scalled heads, and was supposed to be
a consequence of this eruption.   Linneus seems here far more cor-
rectly to ascribe it to the ablution of the  diseased head, with  cold
water, act ng as a repellent.
  Gen.  IX.  Carus.   K«f«s, " sopor cum gravedine,"  deep heavy
sleep ; from xxgx, " the head," the organ in which the disease is
chitfly seated.
  The term Carus is here employed in a more extensive sense than
by most other writers, so as to include several of the species arranged
by Sauvages under his two orders leipopsychic and comata, nearly
synonymously with the defectivi and soporosi of Linneus, and still
more with the adynamia of Macbride.  As a characteristic symptom.
torpor, or torpitude, is preferred by the author to stupor, or sopor
on two accounts: first as being of wider signification, since it in 
GE. IX.]
NOSOLOGY.
287
       Comata vel morbi soporosi.   Sag.
       Coma.  Parr.
       Carus.   Young.
       Torpor.
1.  Asphyxia.  Total  suspension of all  the  mental and  corporeal
                 functions.
eludes the general ideas of both ;  and  secondly because neither
stupor nor sopor have been  uniformly  employed in a  determinate
sense  of any kind.  Thus stupor is often, perhaps usually, restrain-
ed to mental insensibility  or morbid sleep; while Sauvages defines
it in Class VII. Ord. I. gen 7, " hebetude of the sense of touch,"
« molestia quae sensum tacttis obscurat:" and Linneus, Cl. VI. Ord.
II. 105, " transient sleep of any part  with a  sense of formication."
« Sopor transitorius partis alicujus cum sensu formicationis."  In this
place,  and indeed generally, Linneus makes sopor combine the two
ideas of cessation of motion and of feeling,—cessation of irritability
and sensibility : while Cullen objects, and correctly, to  this strained
extent of the term, and  limits it  to  the ordinary  signification of
" sleep, or a sleep-like state:" '« pro  somno vel pro statu somno si-
mili."   Note on Gen. XLII. apoplexia.   Torpor, or torpitude in  the
above  definition, imports insensibility mental or corporeal, in a frame
still  alive, and actuated,  though often imperceptibly,  by the vital
principle : insensibility is of wider range, and is often predicated of
insentient, unorganised matter, that  never possessed the principle
of life.
  Torpitude thus explained will equally apply to asphyxia, (xrtpv^ix,
from x priv.  and <rpt>f/«, "pulsus;") ecstasis (exo-rxrts, from »|/o-t^»,
" de statu mentis dejicio ;") catalepsi* (xxrxXv^tx, from xxrxXxfiGxro-
puci, '< deprehendor ;") lethargus (xtfxgyos, from X»h ano x^yos « ob-
livio pigra;")  apoplexia  (x-xovXt^tx, horn xvo and irXio-o-a, '• percu-
tio;" and paralysis (irx^xXvrts,  from vx^xXvu, » resolvo, debilito.")
  Some of these species  are very uncommon ; and a few have been
supposed doubtful: but upon the whole the authorities are in their
favour, and  they ought  neither to be omitted, nor too generally
merged, as they seem to be by Cullen, in the   sweeping catalogue
of apoplexies, a genus, which in his arrangement,  is  made to in.
elude  a variety of distinct and often very different diseases;  but
which he found it difficult to  distinguish or arrange individually.
Asphyxy is  here used in the general sense of the term, though it
has occasionally been employed to import mere failure  or cessation
of the pulse,  which in the present classification is made a species
of entasia, under the distinctive name of acrotismus.   See present
class,  order II.
  Upon animal life in general the electric fluid,  whether discharged
from a Leyden phial, a voltaic battery, or in the form of lightning,
seems to act alike in every instance, and  only to vary in proportion 
288
NOSOLOGY.
[CL. IV.—OR. IV-
        Asphyxia.  Sauv.  Linn. Vog.  Sag.
        Mors apparens.  Lanus.
        Asphyxie.  F.
        Asphyxy
        Suspended animation.
        x Suffocationis.   From hanging or drowning; countenance
            turgid and livid.

 to its degree.   Upon plants  a stroke of lightning of the  same in-
 tensity produces  very different effects, in consequence of the varie-
 ty they exhibit as conducting  powers. Upon some it descends with-
 out mischief: in others it exhausts  itself  on  particular branches,
 which are withered as though  attacked by a  hemiplegia.   In the
 bctula alba, or common birch, it never runs  along the stem, but
 confines its stroke to the top alone, beating  off the boughs  in every
 direction.
   Ecstasy and catalepsy seem  to depend remotely upon a highly irri-
 table idiosyncrasy, perhaps  incidentally debilitated; under  which
 circumstances the usual proximate causes,  whether mental or cor-
 poreal, seem to produce the one or the other disease, according as
 the constitution  has a  greater or less tendency to entastic  spasm.
 Lethargy is Often the result of great  general exhaustion from long
 continued  labour, or severe and sudden exertion  whether of body
 or mind.  It  is  also  not  infrequently  produced  by narcotics, or
 ebriety.   The author was  once privy to a  case of catophora  that
 continued for five years : the patient was a  young lady, of  delicate
 constitution, in her eighteenth year at the time of the attack : her
 mind had been  previously in  a  state of great  anxiety:  the remis-
 sions recurred irregularly twice or three times a week, and  continu-
 ed for not more than an hour or two: during these periods the pa-
 tient sighed, ate reluctantly what was offered to her, had occasional
 egestions, and  instantly  relapsed into  sleep.   Her recovery was
 sudden,  for she  seemed to awake as though from a night's repose
 by a more perfect termination of the  paroxysm not followed by a
 relapse.   The lethargus vigil,  or apparent   sleep,  is a  frequent se-
 quel upon fevers, or other  causes of great  debility or irritability :
 in which the patient  uniformly assures the practitioner and  his
 friends in the morning that he has passed a restless and hurried night
 without a moment's sleep, while the nurse has been a witness to his
 having been asleep the whole  night long.
  Cullen, in order to include lethargy, in all its varieties, catalepsy,
 ecstasy, and asphyxy under apoplexy as a genus, is obliged to omit
 the very prominent  symptom of atertorus, or sonorous breathing,
 which is regarded as pathognomic by almost every other nosologist:
this definition is  " motus voluntarii fere omnes  imminuti, cum so-
pore plus minus  profundo, superstite motii cordis et arteriurum."
But this is to confound diseases, by simplifying without distinction.
 His definition of paralysis is equally liable to objection: it is as fol- 
GE. IX.]                   NOSOLOGY.                      289

            The cause is here evidently obstructed respiration.  Dr.
          Cullen makes this variety a species of apoplexy; but this
          is to divest apoplexy of its pathognomic character of ster-
          torous sleep.
       Khafe.  Of Persian origin.
       /3  Mephytica.  From  carbonic acid  gas, or other  irrespira-
            ble auras, by the miners called damps, from the German
            dcmpff " vapour," " exhalation."   In asphyxy from this
            cause the countenance, instead of being livid, is pallid.
          Hur.  Pers.  Literally choke-damp, " suffocatio ab exha-
            latione putei," as explained  in  ihe Constantinople edi-
            tion of the Ferhenghi Shavari, or Dictionary of Literati.
       y  Algida.  From  severe  cold.   Limbs  rigid, countenance
            pallid and  shrivelled.
lows:" motus voluntarii nonnulli tantum imminuti, sape cum sopore."
This definition  miscombines those species of palsy (if such exist,)
that are characterised by sopor or sleep, with various cases of apo-
plexy as interpreted by his own character of this last disease.   So-
por, however, in the  sense of sleep, does not, properly speaking,
constitute an essential symptom of paralysis in any case : if it at-
tend at any time it is  a mere accident; and this is  so generally un-
derstood and admitted, that some nosologists, as Sauvages and Sagar,
while they properly place apoplexy under the order of comata, re-
move palsy to  a separate order, with which  sleep or coma has no
necessary connexion.
   Some nosologists have transferred to this division the local insen-
sibilities and atonies of the external senses or parts of them.   But
as these are, in almost every instance, connected with other symp-
toms and other derangements of such organs, or their respective
functions, they rather belong  to the second order of  the present
class than to paralysis in the strict sense of  the term : they  are
iotoi "xx^xXvrtxot, rather than irxgxXwn', and in the  system before us
are arranged accordingly.
   1.  Carus Asphyxia.  Whatever be the cause of asphyxy, if it act
slowly and  progressively, or  imperfectly, the  symptoms often as-
sume an apoplectic character,  and the  disease terminates in  a para-
lytic affection more or less  general.  Thus stertorous breathing, a
swollen  projecting tongue, and suffused and prominent eyes,  are
frequently the result  of imperfect suspension by the neck;  and we
have an interesting case published by Dr. Babington in the Medico-
chir. Trans,  vol. i. 83, of a similar  effect from breathing through
the  whole of the night a diluted vapour, for so it  must  have been,
   vol. v.—48 
290                       NOSOLOGY.          [CL. IV.—OR. IV.

       ^ Electrica.   From lightning, or severe stroke of electricity.
            Limbs flexible; countenance pale; blood uncoagulable.
            In this variety the system seems to be totally exhausted
            of its irritable and contractile power.
2. Ecstasis.   Total suspension of mental power and voluntary mo-
                 tion; pulsation and breathing continuing; muscles
                 rigid;  body erect.and inflexible.
       Catochus.  Linn,  el  Auct.  Var.
       Ecstasis.  Sauv. Vog.  Sag.
      . Jezbe.  Arab.
       Entziickung.  G.
       Ecstase.  F.
       Ecstasy.
            Said to be  produced by profound contemplation or at-
          tention of mind, or overwhelming passion.   In which case
          it is reverie with a spastic diathesis.  Dr. Cullen regards
          it as a  modification of apoplexy.
            See Act. Nat. Cur. Vol. I. Obs. 250. IV. 105. VII. 40.
          Hist, de VAcad. Royale des Sciences.   Paris, 1738, p. 56.
          Eph. Nat.  Cur. passim.  In one case from  suppressed
          menstruation; Behrend's Briefe liber die wahre Beschaffen-
          heit; &c.   Fr. 1768.
3. Catalepsia.  Total suspension of mental power,  and volun-
of carbonic acid gas from burning charcoal.   Of two  persons ex-
posed to its action in the same room, the younger, a boy of thirteen,
died apparently during his sleep; the elder, a man of thirty-eight,
was found, upon being called in the morning between  six and seven,
in an apoplectic state, and labouring under the symptoms described
above.   The application of voltaic electricity surprisingly increased
the power of the muscles of respiration, but appeared rather  to
diminish the action  of the heart.   It  was hence  used alternately
with a  forcible  inhalation  of oxygen  gas,  and  various external
stimulants.  Venesection does not seem to  have been beneficial.
The man recovered in a few  days.
  3. Carus Catalepsia.  In  this species the countenance is said to
be florid, and the eyes open, and apparently fixed intently upon an
object, but without vision.  It is a disease of rare occurrence, and
varies in its duration from a few hours, or even minutes, to two  or
three days.  It returns sometimes at stated periods.   Forty grains
of  tartar  emetic have been  given without  effect.  Behrends, in
Baldingen N. Magazin, Band ix. p.  199.  In the case  of a school-
boy, aged eleven years, the paroxysms recurred ten times in twenty-
four hours, and  never exceeded three minutes  in duration.   If 
tiE. IX.]                   NOSOLOGY.                       291
                   tary motion; pulsation and breathing  continu-
                   ing; muscles flexible; body yielding to and re-
                   taining any given position.
       Catalepsis.   Sauv.  Linn  Vog. Sag. Plouquet.
       Bikhudlik.  Of Persian origin.
       Catalepsie.   F.
       Trance.
4. Lethargus.   Mental and corporeal torpitude, with deep, quiet
                   sleep.
       Carus Lethargus.   Young.
       Subat.  Arab.
       Lethargy.
         The term is applied by the Arabian physicians,  not  only
       to the  varieties enumerated  below, but  to comatose affec-
       tions generally.  The  Persian and Turkish  writers employ
       the same word, but  more usually in connexion with derd, or
       morbus; writing it,  derdus subat.
       x Absolutus.  Without intervals of sensation, waking, or
            consciousness.
         Lethargus.   Sauv.  Linn.  Vog. Sag.
       G Cataphora.   With short remissions  or intervals of imper-
            fect waking, sensation and speech.
         Cataphoro.  Sauv.  Linn. Vog. Sag.
         Comasomnolentum.  Auct.  Var.
         Assoupissement.  F.
         Sleepiness.   Somnolency.
       y Vigil.   Perfect lethargy of body, but  imperfect lethargy
            of mind;  wandering  ideas, and belief of wakefulness
            during sleep.
         Typhomania.  Auct. Grozc.  Sauv. Linn.  Vog.
         Coma vigil.  Auct.  Var.
         Apparent sleep.
            Each of the varieties found  occasionally as  a symp-
         tom in  fevers of various kinds;  concussion,  or other
the attack commenced while walking,  the  same  pace was main-
tained, though without the direction of the mind.  Stearns, Americ.
Med. and Phil. Regist. v. I.  viii.  The nosologists however mention
a variety, in which the powers of deglutition and digestion continue,
the food  being  thrust into the  mouth.  It  has been found to be
produced by the same causes as the preceding species;  and in these
cases is perhaps reverie with a spastic diathesis.   Cullen ranks this
also as a  modification of apoplexy;  but,  like the  preceding, it is
destitute of stertorous sleep. 
292                       NOSOLOGY.            [CL. IV.—OR. IV.
      injuries of the brain; and repelled gout, or other supposed
      humours or exanthems.
Apolexia.  Mental  and  corporeal  torpitude,  with  stertorous
              sleep.
    Aphronia, (x<p^ovix)   Hippocr.
    Apoplexia.  Sauv. etAuct. Recentior.
    Carus Apoplexia.  Young.
    Comus Apophxia.  Parr.
    Sektet.   Arab.
    Schlag.    G.
    Apoplexie.  F.
    Apoplexy.
    x Sanguinea.   With a hard full pulse and flushed counte-
         nance.
      Apoplexia sanguinea.   Sennert.  Sauv.  Cull.
      Coup de sang.   F.
      Sanguine Apoplexy.
    G Serosa.   With a feeble pulse and pale countenance.
      Apoplexia serosa.   Preysinger. Cull.
      Apoplexia pituitosa.  Sennert. Sauv.
      Serous Apoplexy.
         The one or other  variety  found also occasionally,
      as  a  symptom, in  ebriety, or other  affections  of  the
      stomach,  especially from  over-doses of  narcotics; sud-
      den gusts of passion;  repelled eruptions, or  suppressed
      humours; in various fevers; inflammations; hysteria and
      epilepsy.
         See an interesting case of apoplexy from  swallowing
      six ounces  of laudanum,  cured  by an  active  dose of
      sulphat of copper  given six hours after  the accident,
      and keeping the  patient in constant  motion through  the
      ensuing night: in  Dr. Marcet's  communication, Medico-
      chirurg. Trans, i.  77.
  6. Carus Paralysis.  " For many years I have been particularly
attentive to those  who have been attacked with a paralytic stroke,
forming  a hemiplegia,  I  have  watched them while alive  that I
might have an opportunity to  open them when dead ; and in all I
found an injury done to the brain in consequence of the extravasa-
tion of blood.  I have examined them at  all stages ; when  it was
recent,  some of weeks standing, others of months,  and  a few  of
years, in which  I  saw the progress  of reparation."  Hunter on
Blood, p. 213.   He regards apoplexy as merely  differing from
paralysis in  degree.  Under this  view he strenuously opposes in 
GE. IX.]                   NOSOLOGY.                      293

6. Paralysis. Corporeal torpitude, and muscular immobility more
                   or less general;  without somnolency.
       Paralysis.   Auct. Graze, et Recent.
       Zemin. Arab.   Zeminlik.   Turc.
       Gicht.  G.
       Paralysie.   F.
       Palsy.
       » Hemiplegia.  Affecting, and confined  to, one side of the
            body.
         Hemiplegia.  Auct.
       G Paraplegia.   Affecting, and confined to, the lower half of
            the body on both sides.
         Paraplegia.   Auct.
       y Particularis.  Affecting,  and  confined  to,  particular
            limbs.
         Paralysis partialis.  Cull. Parr.
            Found also, under one of these  varieties, occasionally
         as a symptom in fevers; exanthems;  colic, and other af-
         fections  of the intestinal canal; gout, rheumatism, struma,
         syphilis,  trichoma; diseases  of  the  external  organs of
         sense; wounds, and other external injuries.
both these diseases a stimulating treatment, and even objects to
blistering.   " This (the stimulating treatment) is even carried
further  than blistering:  we hardly see a man taken with all the
signs of an apoplexy, where  a paralysis in some part  takes place,
or hemiplegia, but he is  immediately attacked with  cordials, stimu-
lants, electricity, Sec.  Upon a supposition that it is nervous, debi-
lity, &c. the  poor  body is also tortured because it  cannot  act, -he
brain not being in a condition to influence the voluntary muscle,*;
we might  with  exactly  the  same propriety stimulate the fingers
when their  muscles were torn to pieces.  I must own I never saw
one of them which had  not an extravasation of blood in  the brain
when opened, excepting one who died of a gouty affection in the
brain, with symptoms similar to apoplexy.  Such a case, most pro-
bably, would require a very different mode of treatment;  therefore
when it happens  to a gouty  man, blisters to the  head,  feet, &c.
would probably be the best practice; but surely this would not be
the proper practice  in a rupture of  a vessel.   We ought to  bleed
at once very largely, especially from the temporal artery, till the
patient  begin to show signs of recovery, and to continue it till he
might begin to  become faintish.  We should give saline purges
freely to diminish  impetus, and promote absorption : then quietness
should be enjoined, and as little exercise of  body as possible,  and
especially to avoid coughing  and sneezing.   Plain  food should be
directed, and but little of it."  Hunter on Blood, p. 213. 
          CLASS  V.

       G E N E T I  C  A.

DISEASES OF THE SEXUAL FUNCTION.
                       ORDER I.

                    C E N 0 T  I C A.

                  AFFECTING THE FLUIDS.

  Morbid discharges; or excess, deficiency, or irregularity of such
as are natural.
                   GENUS  I.

               PARAMENIA.

Morbid evacuation, or deficiency of the catamenial flux.
  Mismenslruation.
  Class V.  Genetica. Ttvtrtxx, from ytttopun, " gignor," whence
ytwrts,  " origo,  ortus."  In  almost  every preceding  system  of
nosology the diseases of this function are scattered through  every
division of  the classification,  and  are rather  to  be  found by ac-
cident, an  index, or the aid  of  the  memory, than  by  any clear
methodical clue.  Dr. Macbride's classification forms the only ex-
ception the author  is acquainted with;  which, however, is rather
an attempt  at what may be accomplished than the accomplishment
itself.  He had, therefore, in a considerable degree to beat his way
through an untrodden glen, and to mark  out a path for his own use.
In this view he may be thought entitled to the indulgence of the 
GE. I.]
NOSOLOGY.
295
1. obstructions.  Catamenial secretion obstructed  in its course;
                      sense of oppression;  languor; dyspepsy.
       Arrhoea (*??W)   Hippocr.
       Amenorrhea.   CuU. Vog.
       x Emansio.  Obstructed on its accession or first appearance.
            Feet and ankles edematous at night;  eyes and face in
            the  morning; with other chlorotic symptoms.
         Amenorrhcea emansionis.   Cull.
         Retention of the menses.
       fi Suppressio.  Obstructed in its regular periods of recur-
            rence.   Head-ache, dyspnoea, palpitation of the heart.
         Amenorrhcea suppressionis.  Cull.
         Suppression of the menses.
2. difficilis.   Catamenia protruded with  great local  pain,  and
                  especially in the loins; part of the fluid coagu-
                  lable.
       Menorrhagia stillatitia.   Sauv.
       Amenorrhcea difficilis.   Cull.
       Menorrhagia difficilis.   Sauv.
       Dysmenorrhea.   Linn. Sag.
       Laborious menstruation.
medical community: yet if deficiencies or other errors exist, he has
little doubt that  the  general principle of the division will be ap-
proved, and its leading features be allowed currency.   The ordinal
term  Cenotica  (xtturtxx, from *f»«e-»«,  " evacuatio,  exinanitio;")
Orgastica (o^yxa-rtxx, from ofyx£*, " irrito, incito, and especially
libidinose;") and carpotica (xxenonxx, from xxgxos, " fructus") are
sufficiently explanatory of their intention.
  Ord. I.  Cenotica.  See the preceding note. The term is copied
from Galen, ad Glauc. lib. ii.
  Gen. I.  Paramenia.  Hx^x^nxx from irx^x, "male," and  pmv,
" mensis."   The genus is intended to comprise diseases that relate
to the menstrual  flux or vessels exclusively.  This fluid is incor-
rectly regarded as blood by Richerand aph. clxxi, and other physio-
logists :  for, in  truth, it has scarcely any common property  with
blood except that of being a liquid of a  red colour.   It is chiefly
distinguished by its not being coagulable ; and, hence, when coagula
are found in it, as in laborious and profuse menstruation, serum or
blood is intermixed with it, and extruded at the same time from
atony or entonic  action of the  menstrual vessels.  " It  is neither
similar to blood taken from a vein  of the same person, nor to that
which  is extravasated  by accident in any other part of the body; 
296                      NOSOLOGY.             [CL. V.—OU. I
3. superflua.  Catamenia  excessive,  and  accompanied  with
                  hemorrhage from the menstrual vessels.
       Excessive menstruation.
       x Crebra.  Excessive from a too frequent recurrence.
         Menses antevertentes.  Sennert.
       p Profusa.   Excessive  from too large a flow at the proper
            periods.
         Menorrhagia rubra.   Cull.
         Catameniorum fluxus immodicus.  Hippocr.  Foessii.
         Tarns.  Arab.
         Perte de sang des femmes.—Hemorrhoisse.  F.
         Profuse menstruation.
         Issue of blood,  St. Matth. ix. 20: in the Greek  original,
            the person affected is termed yvn xipu>£poove~x.
4. erroris.   Catamenia transferred  to, and excreted  at remote
                organs.
       Menorrhagia erronea.  Sauv.
       Mensium per aliena loca excretio.   Sennert.
       Vicarious menstruation.
       x Ex oculis fluens.   Dodonozi Obs. cap. xv.   Boerh.  Aph.
       /a Ex naribus.  Parozi. xxv.  12.   Brassavol. Aph. xxxiii.
            sect. v.
       y Ex alveolo dentis.   Ronssei de Horn, primord c. 28.
       ^ Ex auribus.  Brassavol.  Aph. xxv. sect. 4.
       ? Ex mammarum papillis.  Amat. Cent. ii. cur. 21. Parcsi.
            lib. xxiii. c.  52.   Cordozi Comm. in libr. Hippocr. de
            morb. Mulier.
       £ Ex vomitu,  Hipp,  de  morb.  Mul.   Aretozi, lib. ii.
            cap. 2.
but is a  species of blood, changed, separated, or thrown off from
the common mass by an action of the vessels of the uterus, similar
to that of secretion;  by which action the blood loses the principle
of coagulation, and I suppose life."  Hunter on Blood, p. 88.  Cruick-
shank supposes  it to be thrown from  the  mouths of the exhaling
arteries of the uterus, enlarged periodically for this purpose.  Anat.
of the Absorbents.   As this distinction has not been sufficiently at-
tended to either by  nosologists or physiologists, many of the  dis-
eases arranged under paramenia have been placed under  a  genus
named rnenorrhagia, which,  properly speaking, should import he-
morrhage, (or morbid flow of blood alone)  from the menstrual  ves-
sels ; and hence, we  have in this instance, not  only a wrong doc-
trine, but the formation of an improper genus ; for rnenorrhagia or 
GE. II.]
NOSOLOGY.
297
       >)  Per intestina.  Galen, in  apb. xxxv. s. v.
       6  Ex  podice.  Parozi, lib. xxiii. cap. 12.
       t  Per urinam.   Brassavol. Aph. xxx. s. v.
       *  Ex umbilico.  Nicolai Florent. Serm. ii.  c. 8.
       x  Ex digito.  Mercat. de Mulier:  affect, lib. i. c. 7.
       p* Ex cute.  Hatter, comment. 667, p. 87.
            See  also  Cruickshank  on Absorb. 4to.  p.  54,  Phil.
         Trans. Vol. XIV. 121. Richerand. Elem. de Physiol, aph.
         clxxi.
5. cessations.   Catainenial flux irregular at the term of its natu-
                   ral cessation; occasionally accompanied  with
                   symptoms of dropsy, glandular tumours, or spu-
                   rious  pregnancy.
         Has sometimes  continued to a  very late  period of life.
       To the age of 71; Holdefreund, Erzahlungen, n. 4.  To the
       age of 80; Bourgeois, Hebammenb. part. ii. cap. 6.  To the
       age  of 90; Hagendorm, cent. ii. obs.  84.  See for various
       cases Pelargus, Med. Jahr. iii. 347, and following.
                    GENUS II.

                  LEUCORRHGEA.

Mucous discharge from the vagina, commonly without infection;
  disappearing during menstruation.
uterine  hemorrhage  is,  correctly  speaking, only a species of the
genus hsemorrhagia; and will be so found in the present system.
See Cl. III. ord. iv.   This remark applies directly to Sauvages; and
more peculiarly so to Cullen, who, for the sake of simplifying, has
carried  the confusion still further.  Few diseases perhaps of the
uterus or uterine passage can be more distinct from each other than
vicarious menstruation, difficult or laborious menstruation, lochial
discharge, and  sanious  ichor;  yet all these, with several others
equally  exceptionable, are arranged by Sauvages under the  genus
rnenorrhagia, though not one of them belongs to it.  While Cullen
not only copies nearly the whole of these with the names Sauvages
has assigned  them,  but  adds to the  generic list leucorrhcea, or
whites; abortion ; and the mucous fluid  secreted in the beginning
of labour from the glandulae Nabothi at the orifice of the womb, and
hence vulgarly denominated its show or appearance.
  vol. v.—49 
298                       NOSOLOGY.             [CL. V.—OR. I
       Leucorrhoea.   Sauv. Linn.  Vog. Sag. Plouq.
       Menorrhagia alba.   Cull.
       Fluor albus.   Auct.  Var.
       Weisse flusse.   G.
       Fleurs blanches.  F.
       Whites.
1. communis.   The discharge of a yellowish-white colour, verging
                 to green.
         Has been  found occasionally contagious.  Act. Med. Be-
       rol. Dec.  I. vol. v.  p. 85.   In  Sweden endemic, Riedlin.
       Lin.  Med. 1695, p. 164.
2. Nabothi.   Slimy, and for the most part tinged with blood.
         Secreted by the  glandulse Nabothi situate on the mouth
       of the uterus; and chiefly on the beginning of labour.
       Leucorrhoea  Nabothi.  Sauv.
       Hemorrhagia Nabothi.   Cull.
       Labour-show.
3. senescentium.  Thin, acrid, frequently excoriating  and fetid.
         Secreted on the cessation of menstruation; often chronic
       and  obstinate.
         Found also, occasionally, as a symptom in cases of a scir-
       rhous or prolapsed uterus.
     GENUS  III.

BLENORRHCEA.
Muculent discharge from the urethra, or vagina: generally with
    local irritation, and dysury: not disappearing during men-
struation
  Gen. II.   Leucorrhoea.  Aevxopgotx : from Xtvxos, " white," and
pta, " to flow."  The term is comparatively of modern origin, occur-
ring in neither the Greek nor Roman writers; and appears first to
have been met with in Bonet, or Castellus.
  Gen. III. Blenorrhcea. From Gxewx,« mucus," and {let," fluo."
Sauvages, and after him  Cullen, have employed Gonorrhaa, from
yav«5, semen, and fi#, as a common term for this and  the ensuing
genus; and hence morbid secretion of mucus, venereal contagion,
and seminal flux  are all  arranged as species of the same  generic 
GE. HI.]
NOSOLOGY.
299
       Phallorrhcea.   Plouquet.
       Gonorrhoea.   Sauv. Cull.
       Catarrhus gonorrhoea.   Parr.
       Blenorrhcea urethralis.   Young.
 I. simplex.   Simple  " increased secretion from the mucous glands
                 of ihe urethra."  Fordyce.
       Gonorrhoea pura.   Sauv-  Cull.
       Gonorrhoea benigna.  Auct. Var.
 2. luodes.  Muculent discharge from  the  urethra  or  vagina in-
                termixed   with  specific  venom;   burning pain  in
                micturition:  produced  by  impure coition:  infec-
                tious.
       Gonorrhoea impura.  Cull.
       Gonorrhoea syphilitica.   Sauv.
       Gonorrhoea virulenta.  G. maligna.   Auct. Var.
       Abserdi.    Arab.
       Kalte-biss.  G.
       Chaudpisse.  F.
       Clap.
3. chronica.  Slimy  discharge  from the mucous glands  of the
                 urethra;   without  specific  venom  or  infection;
                 slightly irritating;  chronic.
       Gonorrhoea mucosa.  Cull.
       Gleet.
         Mostly a sequel of the preceding; and usually accom-
       panied with stricture or enlarged  prostate gland.   Though,
       without specific venom,  occasionally so acrimonious, as to
       produce great local inflammation  on  the person  cohabited
       wilh,  while the secreting organ which has undergone the
       morbid change, is torpid,  or nearly so, to its virulence.
disease : and this, too, under a word which imports the  last alone.
While, to  add to the confusion, this very word, in its vulgar use,
is restrained to venereal contagion, which it signifies just as much
as it does abortion or stone in the bladder.  It is high time to make
a distinction;  and to divide the list of Sauvages into two  genera.
Blenorrhcea, indeed, has already been  employed of late  by  various
writers to denote the first of these genera, and there is no necessity
for changing the term.   Gonorrhoea would answer  equally  well for
the second, were it not for the general  though absurd application of
the word to venereal virus, which has induced the author to  make a
change. 
300                       NOSOLOGY.             i.CL.V.—OK. 1.
                       GENUS  J\.

                 SPERMORRH0EA.

     Involuntary emission  of seminal fluid without copulation.
       Gonorrhoea.   Linn. Sag.
       Vedaf.  Arab.
       Saamenfluss.  G.
         Effluxus perpetuus  per foramina praeternaturalia abdomi-
       nis.   Eph. Nat. Cur.  Dec.  I. ann.  ii. obs. 185.
         See Wichman, De Pol. diurn.   Goett. 1782.  Sometimes
       intermixed with  blood.  Pelargus, Med. Jahrg. iii. 769.
1. antonica.  Involuntary emission  of a dilute and nearly pellu-
                 cid  seminal  fluid;  with  libidinous  propensity;
                 but without erection.
       Gonorrhoea libidinosa.   Sauv.
       Gonorrhoea laxorum.   Cull.
2. entonica.  Involuntary   emission  of  proper  semen  with
   Gen. IV.  Spermorrhqsa.  From  o-retpa, " sero,"  "semino:"
whence x<nreepM$, " semine carens," yvpt.voe-7regpios, " cujus semen nudum
est" a well-known term in botany ; and hence also numerous other
derivatives of the same kind.  Gonorrhoea would have been retained
in the senst intended by this genus, but from the confused significa-
tion in wnich, as already observed, it has been employed by Sauvages
and Cullen; and from  its being usually, though most  improperly,
applied in the present day to blenorrhcea luodes.
   Of the first species here enumerated, spermorrhcea atonica, Sau-
vages gives too examples ;  the  former from  Deidier, in which the
patient was  an  exemplary monk, who shrunk with  horror at the
idea of this  involuntary self-pollution, as he regarded it: the latter,
a case  in his own practice, in which  the patient, a most religious
young female, was, as  he affirms, driven almost  to madness under
the same  erroneous contemplation of the disease.   From  this last
case it should appear that Sauvages inclined  to the theory of epige-
nesis, or that which supposes the male  and female to contribute
equally a  seminal  fluid in the  act of procreation.   It  is probable
that some  local irritation is  the  usual cause.  Professor Deidier
himself suspected this in the first  of the above cases ;  and referred
it rather to a calculus  in the  bladder, sympathetically affecting the
prostate gland, than to  any idiopathic disease of the vesiculae semi-
nales.  The pious  monkjbund  himself most relieved by scourging 
GE. V.J                   NOSOLOGY.                      301

                erection; mostly from  indulgence  of  libidinous
                ideas.
       Nearly connected with paroniria salax.
                       GENUS  V.

                     GALACTIA.

    Morbid flow or deficiency of milk.
       Sparganosis.  Dioscor.
       Galactia.  Linn.  Vog.
1.  Anticipans.  Efflux of milk during pregnancy.
       Galactirrhoea mammarum.   Sauv. Sag.
       Epiphora lactea. '  Young.
         A pint and half has sometimes been poured  forth daily
       as  early as the  fifth month.   Sauv. ii. p.  412.   See  also
       Timozus Cas. p. 220.
I.  impotens.   Inability to suckle  upon child-birth.
       * Atonica.   From want of secretion.
         Aglactatio.  Linn.  Sag.
         Agalaxis.   Vog.
         Agalactia idiopathica. A.   Young.
       p Organica.  From imperfect nipple, or other organic de-
            fect.
3.  depravata.  Efflux of a  dilute or vitiated milk.
       * Serosa.  Weakened by too large a proportion  of serum.
         Galactirrhoea serosa.  Sauv.
       & Complicata.   Deteriorated  by  intermixture with  some
            foreign material.
            See Ephemr. Nat. Curios, in which we have examples
         of a flow of  black,  green,  and yellow  milk.   See also
his legs; a blister in the perinaeum would  probably have relieved
him  still more effectually.
  Gen. V.  Galactia.  TxXxxnx : from yxXx, « lac," yxXxxnxos,
" lacteus."  The author has preferred the term employed by Linneus
and  Vogel, to galactirrhoea as used by Sauvages and Sagar; since
the former is comprehensive  enough to include deficiency as well
as excess;  both which are  equally entitled  to be comprised  under
one common head as excess and  deficiency of arterial  action in fe- 
302                        NOSOLOGY.             [CL. V—OR. I.

          Sauv. ii. 412.   Probably in most instances discoloured by
          an union with effused blood.
            Occasionally  the quality  betrays  its  source.   Of
          the nature of beer.  Eph. Nat.  Cur.  Dec. I. ann. iv. v.
          obs. 15.   Vinous.  Id. ann.  iv. obs. 75.   Cent. I.  II.
          Appx. p. 194.
            Violent passion  has a peculiar influence in changing its
          natural character;  especially rage, and terror.
4.  erroris.  Transferred to, and discharged, or accumulated at,
               remote organs, often under  a different form.
       Galactirrhcea erronea.  Sauv.
       Agalactia idiopathica. B.    Young.
       x Transferred to the fauces;  and discharged in the  form of
           a ptyalism.
           Lactis effluxus ptyalismi forma.   Puzos.  Ephem. Nat.
            Curios.
       (3 Discharged from the general surface of the mammae in
           the form of sweat.   Id.
       y Discharged from the navel. Id.   Sauv.
       & Discharged from the kidneys in  the form of  urine. Journ.
           deMed. 1758.
       e Discharged from the eyes in the form of a milky  epipho-
           ra.  Sauv.
       £ Discharged from the thigh on  scarification. Id.  Weikard,
           Verm. schr. i. 47.
       » Discharged from the veins on  bleeding.   Sauv.
       9 Discharged  from the vagina.   Bourdon, Journ. des Sea-
           vans, 1684.   Paullini, Obs. cent. i. p.  27.
           Like the menstrual flux there is scarcely an  organ  to
         which  it has not  been  transferred.  See  Plouquet, art.
         Menstrua.
           The blood during  the time  of  suckling  is  often
         loaded with  milk,  and  evinces  a  milky  appearance;
         as  are  also  several of the fluids  secreted from the
ver.   Hitherto, however, these affections have been separated from
each other by nosologists, and carried to different heads, sometimes
to different orders, and occasionally to different classes ; whence the
student has had to hunt for them through every section of the noso-
logical arrangement.  It has already been necessary to make the
same remark respecting many of the species of paramenia ;  and va-
rious other instances will readily occur to the reader in the ensuing
orders. 
GE. I.]                    NOSOLOGY.                      303

         blood; and hence probably many of the above peculiari-
         ties.
5. virorum.  Secreted in males and  discharged from the proper
                emunctory.
       Galactirrhcea virorum.   Sauv.
         See Collectio Acad. III. p. 63.   A milky serum often dis-
       tils from the nipples of new-born babes of both sexes: but
       various authors, as Schbltz, P. Borelli, Lauremberg, have
       given cases of  genuine milk discharged  in like manner  by
       adult males; occasionally continuing for a long time;  and in
       some instances enabling them to perform the office of nurses.
                       ORDER  II.

                    ORGASTIC!

                  AFFECTING THE ORGASM.

  Organic or constitutional infirmity, disordering the power, or the
desire of procreating.
    GENUS  I.

CHLOROSIS.
Pale, lurid complexion; languor; listlessness; depraved appe-
  tite and  digestion; mismenstruation.
  Order II. Orgastica.  O^yxa-nxx from o^yxu " appeto impati-
enter; proprie de animantibus dicitur, quae turgent libidine." Scapul.
Orgasmus is hence used for salacity in general;  but by Linneus in
a very different sense, being restrained to subsultus artrriarum.
  Gen. I. Chlorosis. From y,xhx, or #*«;}, " herba virens ;" whence
among the Greeks ^,Xu^x<rpiut ana %Xagtxrts, " viror," " pailor." The
most common cause of this disease is menostation  or retention of
the menstrual flux.   In the definition of Dr. Cullen,  as originally 
304                       NOSOLOGY.            [CL. V.—OR. 11.
        Chlorasma (xxagxo-ptx.)   Hippocr.  Epidem. vi.
        Febris alba.  Mercat.  Rozd. a  Castro.   Sennert.
        Chlorosis.  Sauv. et Auct. Recentior.
        Dyspepsia Chlorosis.   Young.
        Anepilhymia Chlorosis.   Parr.
        Semna, of Persian origin; for  semensa, (Arab.), is literally
          " puella  albido  colore  languescens."   From " lilium,"
          " jasninum."  It is often applied to erotomania; and hence
          means  also amasia.
        Chlorose.  JP.
        Green- sickness.
 1. plethorica.   Habit plethoric; pain in the head, back or loins;
                    frequent palpitations at the heart; flushes in the
                    face; pulse full, tense, and frequent.
        Chlorosis virginea.  Sauv.  Cull.
          The orientalists,  and especially the Persians, make  a
        male variety of  this  species, which  they call  " bimariy
        kodek," or morbus puerorum, and is  designed  to include


drawn up, this system  was thus  expressed conditionally, " men-
struorum sape retentio:" in his later editions, however, he omitted
the qualification of sape, adding " nullam, chlorosis speciem veram,
praeter  illam quae retentionem, menstruorum comitatur, agnoscere
vellem."  Yet in this case he  should  not only  have  omitted  the
term  sape,  but the genus altogether; for, by such opinion  he re-
duces it to a mere symptom of obstructed menstruation, paramenia
obstructions;  and such, indeed, he acknowledges it to be, notwith-
standing that  he  continues it  as a distinct genus: " fateri cogor,"
says he, " chlorosin ideo hie minus recte pro genere recensitam esse,
ciim pro symptomate amenorrhcea semper  haberi posset."  Few,
however,  have followed  Cullen in this opinion.   Sauvages asserts
that there are daily cases of chlorosis with pica, or depraved appe-
tite and digestion among  children in their cradles; and Bonetus
affirms the same of adult males.  These were possibly cases of dys-
pepsy, or simple pica in dysthetic or cachectic habits : but the wri-
ter of these pages cannot avoid concurring with those authors who
contend that is by no means  uncommon among females who have
no interruption of the menstrual flux ; though a derangement of some
kind or  other in its quantity, quality, or constituent principles ap-
pears  to be always connected with it, and  is, for the most part, the
cause  or leading symptom : and, in the generic character, the author
has hence used the term mismenstruation (paramenia) in preference
to amenorrhcea, or obstructed menstruation.
  Dr. Young has made chlorosis a mere species of dyspepsia in his
classification : but he is  not  quite satisfied with this position :  "  I 
ge. n.]
NOSOLOGY.
305
       the affections which  often peculiarly mark the stage of pu-
       berty.
2. inops.  Habit  debilitated; great  inactivity and  love of indul-
              gence ;  dyspnoea  on  moving;  lower limbs cold
              and edematous, especially at night; pulse quick and
              feeble.
       Chlorosis a menstruatione difficili.  Astruc.
       Chlorosis a rnenorrhagia.  Sauv.
         Found also occasionally, as  a symptom, in  pregnancy,
       profuse menstruation, various dysthetic diseases, and imme-
       dicable love.
                   GENUS II.

                P R (E 0 T I A.

Premature development of sexual organization, or power.
have  followed (says he) a prevalent  opinion, but there are various
reasons for thinking it is quite as naturally connected with amenor-
rhcea."  Med. Lit. p. 282.
  One species only has hitherto been allowed by most writers.  Yet
the symptoms and mode of treatment of the disease, as it appears
in a  vigorous, florid, and full-bosomed country girl, produced by
catching cold in the feet at the catamenial period or approach; and
in a delicate, pale-faced, emaciated town-girl, debilitated by an in-
dulgence in a course of luxurious indolence from her infancy, seem
to justify and even demand a distinction.   In the former case there
is an evident redundancy of blood with powerful local spasm; and
copious venesection is loudly called for and must be beneficial.
  In  the other there may possibly be deficiency of blood, and no
spasm whatever, and copious venesection would only add to the evil.
The disease, in this case, is probably produced by a chemical im-
perfection or immaturity in  the blood itself, so as not to keep  pace
with the growth and irritability of the menstrual vessels; and  con-
sequently so as  not to afford them the proper pabulum for secretion.
Here,  therefore, in the first instance, it behoves us to employ a
strengthening and  tonic plan, and to extend it through all the de-
partments of diet, exercise, and medicine.  There can be no doubt,
however, that even the first species,  if neglected or obstinate, and
of long continuance, may, and often does, by debilitating the  con-
stitution, terminate in the  second.
  Gen II    Prce6tia.  U^mori)s, or v^oiotv>s, « praecox maturitas."
Theoph.  de Caus. pi. from n$m, "premature."   The term is pecu-
  vol. v.—50 
306
NOSOLOGY
[CL. V.—OR. H.
1. masculina.  Development of sexual precocity in males.
                   Boiset,   Journ.  des  Scavari9,   168$—Boy of
                three years old.   Leske Aus.   Abhandl.  Band.
                II.  p. 354—Various cases,  and particularly that
                of Philip Haworth in  his second year.  Medico-
                chir. Trans. I. 276.
3. feminina.   Development of sexual precocity in females.
                   Menstruation  in  infancy common.   See Plou-
                quet—Pregnancy at nine years of age.   Ephem,
                Nat. Cur.  Dec. III. ann. ii.  obs.  172—See a se-
                cond case  at the same age.   Schmid.  Act. Helvet.
                IV. 167 :  and again, in Germany, G.  E. von Hal-
                ler, in Blumenhach Bibl. I. 558—See also Eccy-
                esis ovaria. Ord. III. Gen. II. of the present class.
                Dr. Baillie^s  case.—Two  cases are given in the
                Medicochir.  Trans. Vol. II  115, by Dr. Wall;
                and Vol. IV.  204,  by Mr. Aslley Cooper.
                  See, for other instances, Hatter, Elem. Phys.
                Lib. XXVIII. sect. iii.  Kundman. Rar. Art. and
                Nat. p. 823.
liarly applied to premature semination.  It is not necessary to dwell
further upon instances or varieties of this morbid affection, as they
may be traced through the two species, into which the genus natu-
rally divides itself, in the writings of physiologists who have  been
curious upon the subject. Those who are desirous of doing so may
turn to the accounts of  Bozet in  the  Journal des Scavans or  to the
Philosophical Transactions, Vol. XLIIL, year 1745.   It  is but  a
few years ago that as striking an example of sexual precocity, as is
to be found perhaps any where, was publicly advertised in this me-
tropolis to be exhibited in the  person of Philip Haworth, the boy
whose case is referred to in the text.  In a parallel  case  recorded
in the Philos. Trans, the boy was nearly of the same age, being not
more than two years and eleven months old.
  Gen. III.  Lagnesis. Axyms,  " libidinosus," " prseceps in vene-
rem."  This is intended to include the satyriasis and nymphomania
of Sauvages, and later authors;  which chiefly, if not entirely, dif-
fer  from  each other only as  appertaining to the male or female
sex : and consequently by no means offer ground for two distinct ge-
nera. The disease is unquestionably one and the same; the diversity
of symptoms depending upon the diversity of sex alone. The second
species, lagnesis Furor,  from its violence and  affecting the entire
system, makes an approach towards  a  mental malady; and hence
Vogel has regarded satyriasis and nymphomania as species of mania. 
(SE. III.]
NOSOLOGY.
307
                       GENUS  III.


                     LAGNESIS.

  Inordinate desire of sexual commerce, with organic turgescence
     and erection.
       Nymphomania.  Sauv. et Auct. Recent.
       Satiriasis.  Sauv. et Auct. Recent.
       Shebek.   Arab.
1. Salacitas.   Appetency capable of restraint; excitation chiefly
                  confined to the  sexual system.
       Satiriasis juvenilis.    Cull.
       Salacitas.  Plouquet.
       Nymphomania salacitas.  Sennert. Sauv.
       Nauz.  Arab.
       Geilheit.   G.
       Lascivite.  F.
       Salacity.
       a Pubertatis.  Of puberty.   Excess of  stimulus produced
            by the season of adolescence.
       P% Senilium.   Of old age.  From local irritation; produced
            by debility, or topical malady; as diseased ovaries; cal-
            culus in the bladder or kidneys; leucorrhoea; or inflam-
            mation of the womb, or neck of the bladder.
But this is incorrect: the affection of the mind is merely symptom-
atic.  Parr, on the contrary, has ranked under lagnesis, love sickness,
a variety of erotomania or  empathema desiderii, which, in the pre-
sent and most systems, is regarded as chiefly a mental  malady: but
Parr's arrangement is equally incorrect.  In affections, however,
consisting of symptoms derived from  different functions, it is not
always easy to lay down their proper position.  But we  meet with
like difficulties in classing  vegetables, animals, and minerals.   The
judgment must equally direct us in all these cases, as far as it will
go-
  In the Amcmitates Academica, Vol. VI. art.  110. coffee is recom-
mended by Dr. Sparschuch as an excellent anti-aphrodisiac; who as-
serts, that it is very generally allowed  in his quarter of the  world
to possess a powerful virtue of this kind.  He supports his opinion
further by a pleasant tale from the Travels of Olearius.
  1. /8. Salacitas Senilium.  See a singular  case by Mr. Norris in
the Transactions of the Medical Society, Vol. I. p. 174, produced by 
308                       NOSOLOGY.            [CL. V.—OR. 11.

       y Plethorica.   From  plethora or entonic action; especially
            in  a sanguine temperament.
       6 Ab assuetudine.   From habit or immoderate indulgence.
            The collectors of medical curiosities give various cases
         of divorce obtained against a husband on account of ungo-
         vernable salacity.  See Eph. Nat. Cur. Dec. II. ann  ii.
         obs. 121— Plater, Obs. Lib. I. p. 257—hiedlin. Lin. Med.
         1697—p. 812— Timozus, cas. 52.
2. Furor.   Appeiency unbridled, and breaking the bounds of mo-
             dest demeanour and conversation; morbid agitation
             of body and  mind.
       Avekeb.   Arab.
       Lascivious madness.
       x Masculinus.   In males.
         Satiriasis furens.   Cull.
            Pollutiones centum per diem.   Bartholin. Epist. III. p.
         145.
       (3 Faemininus.   In females.
         Nymphomania furibunda.  Sauv.
         Furor uterinus.  Auct  Var.
            Vetulae, Riedlin,  Lin.  Med.  1697.  p. 812.   Often
         produced by local irritation, as ascarides or inflamma-
         tion.   In  one  instance  organically, by  an  enormous
 a blow received a few months before near the prostate  gland, fol-
 lowed by a  small, but nearly indolent tumour on the part affected.
 The patient was a married man of sixty seven, and during the vio-
 lence of the ertthismus, from local irritation, which had continued
 for two months, was reduced to a state  of the most wretched and
 squalid  emaciation.   The  following are  Mr.  Norris's  words :
 " Nunquam memini, inquit aegrotus. me in venerem propensiorem
 fuisse, nedum insana et insatiabili libidine permotum, ante hos duos
 menses,  quando me diro hoc et teterrimo correptum esse morbo
 sensi;  cujus  vis tanta est  et tarn effraenata, ut expleri  nequeat; et
 ad coitum cum uxore me singula nocte, quindecies saltern, imo vicies
nonnunquam, impellat. Hie vero cum aegrotantem meum priapismo
laborantem se fallere augurabar, et fortasse, nulla seminis jacturft
in venerem ruere,  paulo curiosius id ab illo quaesivi.  Affirmat au-
tem se vix in lecto decumbentem corpus uxoris contingere, cum
tanquam oestro  percitus, in repetitam venerem properat,  neque un-
quam nisi pleno coitu  res peragitur: seminis  quidem emissio potius
angere quam voluptatis afficere  visa est."  The wife, a matronly
woman of great modesty, was herself hereby  rendered extremely ill
from local inflammation.  By supporting  the system  with tonics, 
GE. IV.]                   NOSOLOGY.                       309

         clitoris, Buchner, Miscell. 1725, p. 933.   In this last we
         have an approach to the female priapism of Galen.   See
         Class IV. Ord. HI. Gen. 1.1.
                    GENUS  IV.

                  AGENESIA.

Inability to beget offspring.
     Agenesia.   Vog.
     Anaphrodisia.   Sauv. Sag. Cull.
     Sterilite male.  F.
and bringing the tumour to suppuration, the disease was effectually
cured.
  Gen. IV.  'Ayemjev*, from x neg. and ytvoptxt, " to beget."  Of the
three species offered under this genus, the division of which is en-
tirely new, the last, agenesia incongrua,  is now first attempted from
personal observations of the author,  in full  accordance  with  the
remarks of other writers and practitioners upon the same subject.
Every one must have noticed occasional instances in which a hus-
band  and wife, apparently in sound  health  and the vigor of age,
have  no increase while  together; either of  whom  nevertheless,
upon  the death of the other, and  a second marriage, becomes the
father or mother of a numerous family.  In  various instances, in-
deed, the latent cause of sterility, whatever it consist in, seems gra-
dually to diminish, and the pair   that for years  was childless, at
length becomes enriched with offspring.  In all this there seems to
be an incongruity, inaccordancy, or want of  adaptation in the con-
stituent principles of the seminal fluid  of the male  to the  sexual
organization  of the respective female;  or, upon the hypothesis of
the epigenesis, to the seminal fluid contributed by the female. Wri-
ters, strictly medical, have not often adverted to this subject, though
it is appealed  to, and, for the  most part, approved by physiologists
of all ages and countries.  Sauvages however evidently  alludes to
and admits such a cause in his definition of dysspermatismus serosus,
which is as follows : " Ejaculatio seminis aquosioris, adeoque ad gene-
sim inepti, quae species est frequentissimum sterilitatis virilis  princi-
pium."   He illustrates his definition  by a case wnich  occurred to
Haguenot and Chaptal,  who attributed  it  to the cause in question,
and refers for other examples to Etmuller.  Cullen expresses  him-
self doubtfully upon  this  species : " De dysspermatismo  seroso
SauYagesii," says he, " mihi non  satis  constat."   Yet his own go- 
310                       NOSOLOGY.             [CL. V.—OR. II.

       Male Sterility.
1. Impotentia.   Imperfection or abolition of generative power.
       Seres.   Arab.
 norrhcet' laxorum, Gen  CXXII. (in the present system spermorrhoea
 atonica) makes so near an approach  to it, that a transition from this
 to the preceding genus seems difficult to be avoided.   The two dis-
 eases appear to  be the same, or nearly so: in the one, the indivi-
 dual labouring under it, emits involuntarily, without coition, or even
 erection,  but with a  libidinous  propensity, a  pellucid  fluid  appa-
 rently of a seminal character, affirmed positively by Sauvages, from
 whom Cullen  derives his species,  and  to whom he refers, to be
 " effluxus  seminis;"  and in the other the same  dilute  and  effete
 semen, with difficult and imperfect erection, is poured fourth during
 coition.
   The opinion, however, expressed  in the species before us, offers
 a more comprehensive view of the subject; by  supposing that the
 seminal fluid may be secreted, not merely in a state of morbid dilute-
 ness, but  under various  modifications, even in a state of  health, of
 such a condition as to render it inadequate to the purposes of gene-
 ration in female idiosyncrasies of some kinds, while it may be per-
 fectly adequate in those of other kinds.   In agricultural  language
 it supposes  that the  respective seed may  not  be adapted to the
 respective soil, however sound in  itself.  In Dr. Parr's dictionary,
 article Anaphrodisia, we  meet with an approach to this view ; for he
 tells us, that " in  some instances the  semen itself seems defective in
 its essential qualities."
   Among  physiologists, the  doctrine  here  thrown forth  has  been
 very  generally held.  It necessarily follows upon the hypotheses of
 Maupertuis (Venus Physique!)  Needham (Phil.  Trans. Vol. XIV.)
 Buffon, and Lieberkuhn.  Linneus   embraced  it from the latter,
 abandoning, for this purpose, the hypothesis of Leuwenhoek.  Koel-
 reuter has applied it, with much satisfaction, to the sexual system
 of plants; and has been followed by Werner; both of whom have
 endeavoured to show, that formative  molecules exist equally in the
 generative organs of male and female, and that hybrids are hence
 alone capable of production.   They have apparently detected means
of modifying the generative or conceptive power  by culture; and
both the Hiibers have successfully applied the same process to the
bee;  distinctly proving, that by means of particular foods and regi-
men alone, they are capable of making a difference not only in the
bulk, instinct, taste, habit, and procreative power, but  even in the
sex itself of this insect, as it is vulgarly contemplated, and explained
by the name of neuters.
   The writer has said that a similar opinion has been held in all
countries.   It may be sufficient, in  the present note, to point out an 
GE.IV.]                   NOSOLOGY.                       311
Schwachmuthigkeit.  G.
Impuissance virile.   JF.
Male Impotence.
x Atonica.   From  imbecility, or want of tone.
     Chiefly produced by excess  of indulgence ;  long-con-
   tinued gleet;  or  paralytic affection of the generative or-
   gans.
example or two.  In Abdollatif 's History of Egypt,  written at the
close of  the  twelfth century, the historian, in observing that the
Egyptian mules are the largest whose dam is a  mare, offers this'
reason, " mater enim est  quae dat materiam."   See Dr. White's
Abdol. Hist. Egypt.  Compend. Arab, et Lat. The learned Arabian,
it seems, was of the same hypothesis as Sr-*?mmerda n and Harvey.
The whole of the doctrine, however, w.iich is here alluded to, the
entire theory, indeed, of epigenesis in all  its ramifications and rea-
sonings,  formed a part of the Epicurean philosophy, «nd  is so fully
unfolded by Lucretius  in his fourth book, De Rer. Nat., that later
physiologists who have embraced the same principles have had no-
thing more to do than to confirm its doctrines by additional facts and
observations, and to verify the following axiom which forms the pivot
of the entire machinery, v. 1222:
             Semper enim partus duplici de semine constat.
   For a  pretty full survey of most of the theories of generation
maintained in early eras, compared with those of modern times, the
reader is referred to the present  writer's notes on his translation of
the  above book of Lucretius, especially that on v. 1264 of the trans-
lation.   He may also  consult with  advantage  Wildenow's " Princi-
ples of Botany,"  §292, and  especially the " Generatio Ambigena"
of Dr. Ramstroom, in Vol. IV. of the Amanitates Academica."
 ■  The species here denominated impotentia is perhaps more gene-
rally called by the nosologists anaphrodisia, though this last term has
been used in very different senses;  sometimes importing want of ap-
petency ; sometimes inability; sometimes both; and sometimes only
a particular kind of inability resulting from atony alone. The dyssper-
matismus of authors is changed,  in the present nomenclature, to dys-
 spermia (2~voT7r£{pux,)  not only on account of greater simplicity, but
in conformity with the parallel Greek compoundsvxvtna^pux,iroXvo--
iregpux, yvpMoo"7ri£ptix, xa-iregpux ;  the second and third of  vvhich are
 elegantly introduced into tht Linnean vocabulary of botany,  (poly-
spermous capsule and gymnospermous seed,) and are in the mouth of
every one. Dysspermatismus is  usually spelt dy-spermatismus; and
thus made to import double-semination rather than mis-semination;
as dyoides (JWAk) means " a double form," and dy-asmus (Pvxo-ptos,)
" a  double opinion, or doubt."
   With respect  to  these two species, so  closely connected  by na-
ture, there is perhaps no artificial system of nosology under  which 
U2
NOSOLOGY.
[CL. V.—OR. II
       G Organica.  From  morbid organization, natural or  acci-
            dental ;  as  amputated, injured,  or enormous penis;
            testes impaired or destitute.
              Albinus gives a case of divorce obtained against a hus-
            band from inability to enter the vagina, ob penum enor-
            mem. Dissert, de Inspectione corporis, forensis, in causis
            matrimonialibus  fallacibus et dubiis.  Hall.  1740.—
            Plater relates another from a similar cause,  Obs. Lib.
            I. p. 250.
2. Dvsspermia.  Imperfect emission  of the seminal fluid.
       Dyspermatismus.   Sauv. Cull.
       Inepuissance d'ejaculaiion.   F.
       x Entonica.  From super-erection or priapism.
         Dyspermatismus  hypertonicus.   Sauv. Cull.   See also
            Edin. Ess.  I. 35  Cockburn,  Edinb. Essays,  I. 35.
            A case has lately occurred to the author.
       3 Epileptica.   From  incursion of an  epileptic  spasm pro-
            duced by sexual excitement during the intercourse.
         Dyspermatismus epilepticus.   Sauv.  Cull.
       y Anticipans.   The discharge  ejected hastily, prematurely,
            and without due adjustment. Schenck, Observ. Lib. IV.
            Obs. 46.
       ^ Ignavis.   The discharge  unduly retarded from hebetude
           of the genital organs.
         Dyspermatismus apractodes.   Sauv.  Cull.
         Bradyspermatismus.   Auct.  Var.
they have hitherto been introduced into the same subdivision.  In
almost every instance they have been regarded as distinct genera be-
longing to distant orders or even classes, and arranged with diseases
that have little or no relation to them.  Thus in  Sauvages, anaphro-
disia, in  the  sense of impotentia, occurs in his Class VI.  Ord. II.
" debilitates, ANEPirHYMiiE," united with  " loss of thirst," and
" desire of eating:" while dysspermatismusis carried forward toClass
IX. Ord. III. " fluxus, serifluxus."—-Cullen has felt it necessary
to deviate in both cases of arrangement from Sauvages, whom he fol-
lows almost wherever it is possible,  with a deference and  modesty-
worthy of all praise ;  and  has rt moved the two into one class, the
common aggregate division of locales, but has placed them under
different orders ; the first being arranged under Ord. II. dysorexije,
where we again find the  morbid  cravings of the  alimentary canal
united with those of the sexual organs, and even of the mind, as
in the genus nostalgia; the  second  being placed under  Ord. V.
epischeses, " suppressions," instead of « fluxes," as in Sauvages. 
GE. V.]
NOSOLOGY.
313
       e  Refluens.  The discharge thrown back into the vesiculae
            seminales or the bladder, before it reaches the extremity
            of the penis.
         Dyspermatismus refluus.   Sauv. Cull.
            Semen retrogradum in vesicam ex angustatione urethrae,
         Petit, Memoires de l'Academie de Chirurgie, I. p. 434.
       £ Organica.  The discharge obstructed by mechanical pres-
            sure; as that of stricture or hardened mucus in the ure-
            thra; indurations in the corpora cavernosa; or a prepuce
            nearly imperforate.
         Dyspermatismus urelhralis; mucosus ; nodosus ; prsepu-
            tialis.   Sauv. Cull.
2. incongrua.  The seminal fluid  inaccordant, in its constituent
                   principles, with the constitutional demand of the
                   respective female.
       Dyspermatismus serosus.  Sauv.
                  GENUS  V.

                 A P H 0 R I A.

Inability to conceive offspring.
  Sterilitas.  Linn.  Sag.
  Asthenia aphrodisiaca. B. Aphoria.  • Young.
In Parr, dysspermatismus does not appear to  have any place : he
may possibly have regarded it  as a variety of his agenesia, employed
as a  species, and  limited apparently to impotentia; but with this
limitation it would scarcely follow as a proper variety.
  Among plants we sometimes meet with an equal want of power:
occasionally from imperfectly  formed  styles or stigmas, stamens or
anthers; sometimes from suppression of  farina ; -and  sometimes
from a total destitution  of seeds:  which  last defect is common to
bromelia Ananas; musa paradisiaca, or Banyan ; artocarpus incisa,
or bread-fruit-tree ; and berberis vulgaris, or common berberry.
  Gen. V. Aphoria.   Atygix, « sterilitas ;" " infecunditas," from
<peft*, " fero," " porto." Plat. Plut.  It is singular that this disease
finds no distinct place in any of our most esteemed nosologists.  It
may possibly be intended under anaphrodisia, though this genus bas-
in none of them any species that  expressly applies to female bar-
  VOL. V.—51 
314
NOSOLOGY.
[CL. V.—OR. II.
       Atecnia.  Cricht.
       Akret.  Arab.
       Unfruchtbarkeit.   G.
       Sterilite des femmes.  F.
       Female sterility.   Barrenness.
1. impotens.  Imperfection or abolition of conceptive power.
       <* Atonica.   From imbecility or want of lone, as in the pre-
            ceding genus, sp.  1. x. Atechnia atonica.
       P Organica.  From organic defect, whether natural or acci-
            dental,  as imperforate  vagina, defective fimbriae, or
            ovaria; want of ova, &c.
            Atecnia organica.    Cricht.
              An imperforate vagina does not always preclude con-
            ception.—It has taken place where the vagina itself has
            been so narrow as not to admit the  penis. Ephem. Nat.
            Cur. Dec. III. ann. vii. viii. obs. 83—Where, with the
            same impediment,  a  rigid and unbroken hymen  has
            offered an additional obstacle. Hist, de VAcad. de Paris,
            1748.  And for similar or nearly similar circumstances,
            see Forest, xxxix. obs. 29.  Schurig.  Syllepsi). p. 131.
            Akakia, Lib. I. cap. xi.
2. paramenica.  Barrenness  from mismenstruation.
       a Obstructionis.   Produced  by menostation  or retention of
            the catamenia.
       0 Difficilis.   Produced by laborious secretion.
renness.   Dr. Young has properly placed impotence, dysspermatis-
mus, and barrenness,'together.   His genus is asthenia, and they oc-
cur, as subdivisions, under the species aphrodisiaca.   For barrenness
he employs the term aphoria, made  use of in the  present system.
Crichton,  who makes it also a distinct genus, employs atecnia as its
generic name (xrexvtx,) a word, however, that should rather import
destitution or bereavement than barrenness—" orbilas, prole carens."
Arist. Polit. ii.;  and which, independently of this, is calculated to
produce some confusion, as Linneus has  used it in the sense of *' des-
titution or deficiency of appetence"—libidinis defectus, gen. cxix.
By  Cullen and Parr this word is spelt atechnia;  and by the last de-
rived from x  neg. and t^jj, ars.   The derivation, so far as relates
to atechnia  («t«#v/<*,)  is correct; yet  it is  a misapplication of its
meaning   to  apply  atechnia  to  sterility, for its constant import,
whether employed literally or figuratively, is " unskilfulness, rude-
ness, or destitution of ari"—imperitia. But it is, perhaps, impossible
to furnish an example  of its denoting  rudeness or unskillulness,
much less want of physical power, in the fabrication of offspring. 
GE. VL]
NOSOLOGY.
315
       y Superfluitatis.  Produced by profuse discharge.
3. impercita.   Barrenness from  personal aversion or want of ap-
                  petency :  astro impercita.   So Lucr.  i.  12.
                  conversely:
-" te, Diva, tuumque
               Significant initum, perculsae corda tua vi."
                     Hollmann De la dissolution du manage pour
                   l'impuissance et froideur de l'homme et  de la
                   fern me. Paris, 1581.  Frigidity;  Fabr. Hildani.
                   Cent. V.  obs. 40.  Gaubius,  Instit.  Pathol.
                   § 820.   Lang, Epist. Med. IX.
4. incongrua.  The conceptive power irrespondent to the consti-
                   tuent principles of the  seminal fluid received.
                   See the preceding genus, sp. 3, and the note
                   upon it.
                     Hucher  De sterilitate  utriusque sexus, Lib.
                   IV. Colonn. 1688—Tugereau Sur I'impuissance
                   de l'homme et de la femme.  Paris, 1611.
5. polyposa.   The  cavity of the uterus or  vagina, or  both,  so
                 filled and obstructed by a polypous excrescence
                 as  to preclude the  entrance or  action of  the
                 seminal fluid.—See Baillie  Morb.  Anat. Fasc.
                 IX. pi. 4.
                     GENUS VI.

                 jEDOPTOSIS.

Protrusion of one or more of the genital organs or of excrescences
  issuing  from them into the genital pessage; impairing or ob-
  structing its course.
     Hysteroptosis.  Sauv.  Vog. Sag.
  Gen. VI.  jEdoptosis.   From xtfotov. " inguen," pi. xtdotx, " pu-
denda," whence xtfas, '' pudor:" ami vroxris. '' casus, lapsus."   In
like manner Sauvages and Sagar use Mdopsophia, applying the term
to the urethra as well as the uterus.  Sauvages, however, expresses
the present disease, but far less correctly, by hysteroptosis; for this,
with strict propriety, can denote only one  of the  species that fall
within its range, namely, displacement of the uterus. 
316
NOSOLOGY.
[CL. V.—OK. U.
I. uteri.   Protrusion of the uterus into the vagina.
       Prolapsus uteri.   Procidentia uteri.  Auct.
       Aftaden zihdan.   Pers.
       Chute de la matrice.  F.
       Falling down of the Womb.
       x Simplex.  The uterus retaining  its proper posture and
            figure.
            Different  names  are  frequently given to different  de-
          grees of this variety.  If the descent be only to the middle
          of the  vagina it is called relaxalio uteri; if to the labia;,
         procidentia; if  lower  than the labiae, prolapsus.
            See Baillie Morb. Anat. Fasc. IX. PI.  5.
       /3 Retroversa.  The uterus displaced, and the lower  part
            becoming the upper.
         Retroversio uteri.  Auct.
         Renversement de la matrice.  F.
         Retroverted Womb.
            Mostly limited to a state of pregnancy.
       y Inversa.  The uterus  displaced and turned  inside out,
         Inversio uteri.  Auct.
         Inversion de la  matrice.  F.
         Inverted Womb.
            Mostly produced  by unskilfully and  violently pulling
         away   the  placenta  after  delivery.  See  Baillie,   as
         above.
%. vaginae.   Protrusion of the  upper part of the  vagina into  the
                 lower.
       Hysteroptosis vaginae prolapsus.  Sauv.
       Prolapsus vagina?-  Auct. Var.
         This, like the descent of the uterus, may,  according to  the
       degree of  the disease, be relaxation, procidence, prolapse, or
       complete inversion.
L vesicjE.   Protrusion of the bladder into the urethra.
       Exocyste.  Sauv.
       Prolapsus vesica?.   Auct. Var.
       Renversement de la vessie urinaire.   Noel.  Obs.
   1. JEdoptosis uteri.   Dr. Denman alludes to an accidental retro-
flection of the uterus, the fundus being turned backwards and out-
 wards between the rectum and vagina whilst the os uteri  remains in
 its proper situation.   He never met with such a case, however, nor
 heard of more than one instance 
GE.VL]
NOSOLOGY.
317
       « Tunicis interioris.   The inner membrane being protruded.
         Exocyste Noeliana.  Sauv.
            So denominated from M. Noel, who first accurately de-
         scribed it
       /3 Colli.   The neck of the bladder being protruded.
         Exocyste Solingeniana.   Sauv.
            Denominated  after M. Solingen, who first accurately
         described it.
4. complicata.  Protrusion of different organs complicated wilh
                     each other.
       Hysteroptosis composita.  Sauv.
       a Utero-vesicalis.  Of the uterus dragging the bladder along
            with it.
         Procidentia uteri vesicam deorsum abripientis.  Sauv.
       p> Vagino-vesicalis.  Protrusion of the vagina  dragging the
            bladder along with it.
         Prolapsus vaginas vesicam deorsum abripientis.   Sauv.
5. polyposa.   Polypous  excrescence  in  the course of the genital
                 avenue: soft, compressible, red or reddish.
                    Often, though not always,  a cause of  barren-
                 ness.   See Sp. 5 of the preceding genus.
       a Uteri.  Issuing with a slender root from the fundus of the
            uterus, and more or less elongating into the vagina.
         Cercosis.   Aetii.
         Sarcoma Cercosis.   Sauv.
         Polypus uteri.   Baillie.
         Polypus  of the  Womb.
            The substantive polypus should be restrained to a fleshy
         excrescence of the nostrils.  See note on Polypus, Cl. II.
         Ord. I.
       a Vaginae.   Issuing from the sides of the vagina; broad and
            bulbous.
         Polypus  of the  Vagina. 
318                       NOSOLOGY.           [CL. V.—OK. HI.
                    ORDER  III.

                 CARPOTICA.

             AFFECTING THE IMPREGNATION.

Irregularity, difliculty or danger produced by parturition.
                        GENUS  1.

                  PARACYESIS.

   The progress of pregnancy disturbed or endangered by the super-
     vention of general or local disorder.
       Dystocia Dyscyesis.   Young.
       Morbid Pregnancy.
1. irritativa.   Pregnancy exciting distress or disturbance in other
                   organs or  functions than those primarily con-
                   cerned.
       a Syncopalis.  Accompanied with frequent fainting.
       £ Dyspeptica.  Accompanied with indigestion or  sickness.
       y Dyspnoica.  Accompanied with difficult breathing.
       ^ Alvina.  Accompanied wilh derangement of the alvine
           canal, as costiveness, diarrhoea, hemorrhoids, &c.
       t  Varicosa.  Accompanied with venous  dilatations of the
           lower extremities.
2. uterina.  Pregnancy disturbed or endangered by diseased affec-
                tion of the uterus.
       x A retroversione.  The   uterus  being  retroverted.  See
           (Edoplosis uteri /3.
       & A leucorrhoea.  The uterus secreting, or exciting in the
           vagina a secretion of leucorrhoea, so  as to produce de-
           bility.

  Ord. III. Carpotica.  From xxpiros, " fructus," xxgirao-ts, " frui-
tio."
  Gen. I.  Paracyesis.  From wx%x, " male ;" and xv^o-ts, " gravi-
ditas:" whence xva, " utero gesto."  So in Gen. III. eccyesis, from
tx " ex or extra," and xvvo-is as above: and in Gen. IV. paeudocyesis,
from -fyevSos, " mendacium," and xvyo-ts, as above. 
<;e. n.]
NOSOLOGY.
319
       y Catamenica.  The catamenia continuing to recur.
       & Hemorrhagica.  Accompanied with hemorrhage.   Cata-
            menia, unaccompanied with  hemorrhage, can scarcely
            be regarded as a disease.  Many menstruate uniformly
            for the first three or four months of pregnancy.   Some
            through the whole term, Hagedorn, Cent. II. obs. 94—
            A few have never menstruated at any other time.  Hem-
            mann, Med. Chir. Aussaze—Hopfengartner; Uber men-
            schliche Entwikelungen, p. 71.
3. Abortus.  Premature exclusion of a dead  fetus from the uterus.
       Amblosis.   Auct.  Grozc.
       Abortus.   Auct. Lat. Sauv. Linn.  Sag.
       Dystocia abortiva.   Young.
       Seket.  Arab.
       Misgeburth.   G.
         If the exclusion take place within six weeks after concep-
       tion it is called,
       Blessure.   Faux  germe.  F.
 „     Miscarriage.
         If the exclusion take  place between six weeks and seven
       months, or the term of premature labour, it is called,
       Unzeitige-geburth.   G.
       Avortement.  F.
       Abortion.
         The fetus said to have been born alive at four months, A.
       Reyes, Campus Elys. Quaest. 90.  p. 1164—To have conti-
       nued alive when born between five and six months, Brouzet,
       Sur PEducation Medicinale des Enfans, I. 37.   See, for the
       causes and treatment, " Observations on Abortions," by John
       Burns, Glasgow, 1806.
                     GENUS  II.


                  PARODYNIA.

The progress of labour disturbed or endangered by irregularity of
  symptoms, presentation, or structure.
    Dystocia.   Sauv. Sag. Vog. 
320
NOSOLOGY
[CL. V.—OK. Ill
       Partus difficilis.  Auct. Var.
       Mekhaz.   Arab.
       Accouchement laborieux.   F.
       Morbid Labour.
1. atonica.  Labour protracted by general or local debility.
       Lingering Labour.
          In the Ephemera Nat. Curios, is the case of a fetus illaps-
       ing  into the uterus after its head had been denuded, and it
       had  moaned.  Dec.  I. ann. i.  obs. 1.  Schol. obs. 62.
2. sympathetica.   Labour retarded or harassed by  sympathetic
                       derangement of some  remote organ or func-
                       tion.
       x  Syncopalis.  Accompanied  with fainting.
       G  Convulsiva.   Accompanied  with convulsions.
       7  Pathematica.   Accompanied with great terror, apprehen-
            sion, bashfulness, or other emotion of the mind.
          Dystocia a pathemate.   Mauriceau. x. 258.
3. implastica.  Labour delayed or injured  for want of  plasticity,
                   or unkindly dilatation of the soft parts.     <
       *  Rigiditatis.  The  delay  confined to a simple rigidity of
            the uterus or vagina.
       G  Haemorrbagica.  Accompanied with hemorrhage.
       y  Lacerans.  Accompanied with  laceration of the perinae-
            um, or uterus.
4. perversa.  Labour impeded by preternatural presentation of the
                 fetus,  or its membranes.
       Dystocia  perversa.   Young.
       Mausil.   Arab.
       Accouchement contre nature.   Mauriceau.
       Prozternatural Presentation.
       Cross-birth.
       x Faciei.   Presentation of the face.
       G Natium.   Presentation of the breech.
       y  Pedis.   Presentation of one or both feet.
       ^ Brachial is.  Presentation of one or both arms.
       t  Transversalis.   Presentation of the shoulder.
       i Funis prolapsi.  Prolapsed  navel-string.


  Gen. II.  Parodynia.  From itxgx, " male," and ahi, or aha <y»{,
" dolor parturientis."  So ahia, " a partu doleo."—The  term was
applied  by  the Greeks  figuratively to  severe pains of  any  kind.
The Hebrew Sn was employed  still  more generally in  the  same
figurative sense,   See Is. xxvi. 18. Jer. xxx. 6. 
GE. H.]
NOSOLOGY.
321
       7) Piacentae.  Presentation of the placenta.
5. amorphica.  Labour impeded by mis-configuration of the fetus
                   or of the maternal pelvis.
       Dystocia amorphica.   Young.
       x A fe u.  The fetus deformed by a preternatural magnitude
            of head, or some morbid protuberance.
       p Pelvica.   The maternal pelvis contracted in its diame-
           ter by natural deformity, or subsequent  disease or in-
           jury.
              Not unfrequently produced  by an  hydropic  or
           encysted  ovarium  occupying  a  position between
           the  rectum  and  vagina, and  occasioning  an  insur-
           mountable   tumour.    See  Dr.  Merriman's   case,
           Trans. Medico-chir.  Soc.   40.—Recommends  exci-
           sion.
              The German practitioners have often advised and
           performed  the Cesarean section  successfully;  and, at
           times, repeatedly on the same woman ;  in one instance
            not  fewer than seven times.   Trestan, Journ. de Medi-
            cine,  Tom. XXXVI. p. 69.
              The division of the  symphysis  has  also been fre-
            quently had recourse to with success.   See Demathus,
           Journ. de  Med VIII. 1—Fischer, in  Richter  Chir.
            Bibl.  Band. VII. p. "J70.   See also twice on the same
            subject, and successfully, Damen, Lond. Med. Journ.
            VIII. 1.
6. pluralis.   Labour  complicated by a plurality of children.
        Dystocia geminorum.  Young.
        Tezauf.   Arab.
7. secundaria.  Diseased action or disturbance succeeding deli-
                     very.
        x Retentiva.   Retention of the secundines.
          Meshim.  Arab.
          Retained, occasionally without  injury,  a  week.  Ha-
            gedorn, Cent.  III.  obs.  12—Sixty days,  Magazino
            Toscano,  II.  506—Seventy days, Journal,  fiir Ge-
            burtshelftr I. n. 8—Discharged sound  and  unoffen-
            sive  in   the  fourth   month.  Kerkring,  Specileg.
            Anatom.
        £ Dolorosa.  Violent after-pains.
        y Haemorrhagica.  Violent hemorrhage.
          Flooding.
        } Lothialis.  Profuse lochia.
            Diversified  also, occasionally,  by the  appearance  of
          fevers of various  kinds: sparganosis, or pale inflamma*
   vol. v.—52 
322
NOSOLOGY.          [CL. V.—OR. III.
tory  swelling  of  the lower  extremities ;  and  mania :
which  are rather  sequels of labour, or species  or varie-
ties  of their  respective  genera, than species of paro-
dynia.
                       GENUS III.


                     ECCYESIS.


   Imperfect  fetation  produced  in  some  organ exterior  to  the
     uterus.
       Dystocia Dyscyesis extra-uterina.   Young.
       Extra uterine Fetation.
1. ovaria.   Imperfect  fetation  occurring in the right or left ova-
               rium.
       Graviditas ovarii.  Sauv.
          Examples are common.   See Ab.  Vater Dissert, de grav.
       apparente, ex tumore  ovarii  dextri  enormi orta, per  tres
       annos cum dimidio durante.   Wirtemb.  Ed. Med.  Ess. v.
       336.  Ed. Phys. Ess. 11.273.  Forrester, 1798,379. Ed.
       Med.  Journ. II.  180.
          One of the most  singular  cases  is  that given by  Dr.
       Baillie,  Phil. Trans.  1789.   The fetation  consisted of a
       suetry substance,  hair, and  the  rudiments of four  teeth :
       the maternal subject not more than twelve or thirteen years
       of age, with an infantine uterus,  and perfect hymen.  The
       whole was evidently unconnected with  impregnation, and
       the ovarium must  have been affected with proeotia.  See
       Order II. Gen. II.  of the present  Class.
         In  the  Trans.  Medico-chir.  Soc.  V.  IV.  317.  Mr.
       Barnes of  Exeter gives  a case of a  tooth  contained  in  a
       large tumour extracted from the socket of the eye of a young
       man of seventeen.
2. tubalis.  Imperfect fetation occurring in the Fallopian tube.
       Graviditas tubalis.   Sauv.

  Gen. III.  Eccyesis. See, for its etymology, the note on Gen. I.
above.  The  diseuse is common to animals of various classes; and
may  occasionally be paralleled in the vegetable word; as  in  the
disorder common  to rose-plants, and known by  the name of bede- 
SE. III.]
NOSOLOGY.
323
         See Littre,  Mem. de 1'Acad.  R. des S<;av. 1702.   Cy-
       prian.  Dissert, de fetu ex  tuba  exciso, 1700.  Haller, in
       Boerh. v. 329.   Santorin  Obs.  Anat. c. ii.  Trans.  Soc.
       Med.-Chir. I. 215.
3. abdominahs.  Imperfect fetation occurring in the cavity of the
                     abdomen.
                       See   Krohn, Fetus  extra  uterum  hist.
                     Dentsch; De graviditate abdominali.  Mem.
                     Med. Soc. Land. III. 176. Wrisberg; Observ.
                     Anat.
                       Found in  an abdominal cyst in a male in-
                     fant about fifteen months old; Young,Medico-
                     chir. Trans. Vol.  I. 241.  " The child died
                     after a  tedious and painful illness."  The
                     body was opened, and the cyst examined: the
                     substance it contained  " had  unequivocally
                     the shape and character of a human fetus."
                       For  want of a regular  passage  opening
                     externally,  the substance  formed, often re-
                     mains for many years  in  the extra-uterine
                     nidus.   Walther gives an instance of twenty-
                     two years;  Geschichte 4, Berlin 1778. Bayle
                     a  case  of  twenty-six  years;  Phil.  Trans.
                     1677-1678, Vol.  XII.   The  Ephemera of
                     Natural Curiosities, one of forty-six  years.
                      Cent. X. Obs.  48.
                        After the death of  the  substance,  some-
                     times local  irritation  takes place,  when  a
                     part or the whole  is absorbed: or more gene-
                     rally an abscess  is produced, and it is dis-
                     charged  in  separate morsels; sometimes per
                     anum;  sometimes by  an  artificial  channel
                     formed  chiefly about the umbilicus or in the
                     groin.   In the former, see Phil. Trans.  Vol.
                     XLV. 1748, Drake.  In the latter, see Phil.
                      Trans.  Vol.  XXIV.  1704-5,  Sir  Philip
                     Sheppon, p.  2099.
guar, produced by the deposit of a number of insect eggs, in a heap,
chiefly those of the cynips rosa, in the middle of a bud.  The result
is a fleshy mass, often as large as the size of a fist, covered all over
with hair-like processes. 
324
NOSOLGG\.
[CL. V.—OR. in.
                      GENUS  IV.

                PSEUDOCYESIS.

  Symptoms of pregnancy without impregnation; chiefly occurring
       on the cessation of the catamenia.
       Spurious Pregnancy.
1. molaris.  The uterus irritated by  acoagulum of blood or other
               fluid lodged in  its cavity, often assuming a fibrous
               appearance.
       Graviditas molaris.  Mauriceau. Sauv.
       Myle (moa*i.)   Auct. Grozc.
       Mola.  Auct. Lat.
       Mesket.  Arab.
       False Conception.  Mole.
         Frequently  exhibiting  on  being discharged, hydatids or
       other vermicles.   See, for examples, Marcellus Donatus,
       Lib. IV. cap.  25.  Journ. des Spavans, passim.  Ruysch.
       Obs. 28, 29.  Thesaur. III. VI.   Evacuated  during danc-
       ing, Slevoght, Diss. Fem. mol.  labor.  Jenae, 1700.
2. inanis.   The uterus void of internal substance, and irritated by
              some unknown morbid action.
              The disease is not uncommon; one of the most noto-
           rious cases in the present day is that of the pretended
           prophetess Joanna Southcott.
  Gen. IV. Pseudocyesis.   For the etymology, see the note on
Gen. I. above.  The first species  is accounted for by Mr. Hewson
" from the blood's being without motion in the cavity of the uterus,"
and consequently coagulating.  u Hence  the  origin of those large
clots which  sometimes come  from that  cavity;  and which, when
more  condensed by the  oozing out  of the serum, and of the  red
globules, assume a fleshlike  appearance, and  have been called
moles, or false  conceptions."   Inquiries,  Part I.  p. 27.  From the
same  inaction probably the formation of  what are  called polypi of
the uterus. 
CLASS   VI.
        EC CRITIC A.

DISEASES OF THE EXCERNENT FUNCTION,
                        ORDER  I.

                    MESOTICA.

               AFFECTING THE PARENCHYMA.

  Pravity in the quantity or quality of the intermediate or connect-
ing substance of organs  :  without  inflammation,  fever,  or  other
derangement of the general health.
   Cl. VI. Eccritica.  'ExxftTixx: from exx^tm, " secerno, exhau-
rio,"  "to secern or strain off, to drain or exhaust."  The author has
preferred this derivative to any other which xgtva affords, as alike ap-
plicable  to  the  secernment and  absorbent systems.  In the view
which is here taken of these systems they bear nearly the same re-
lation to each other as the veins and arteries: the action which com-
mences with the one is carried  forward into the other.  The health
of the general function consists  in  the balance of power maintained
between the two;—its disease  in the disturbance of this  balance.
There may  be undue secretion  with healthy absorption;  undue ab-
sorption with healthy secretion ; or there may be undue  or morbid
absorption and secretion at the same time.
   Ord. I.   Mesotica.   Metros, Ionici, fteeeos, " medius," whence
furo-o6i,fiter<ro6eii,'- in medio."  This order might have been  denomi-
nated parenchymatica, but that there are two objections to the term :
the first  is, that vxpx is  used in this compound in a different sense
from its  general signification in  the present system: in the sense of
per or penitus, instead of in that of perperam ;  and consequently the
double  signification would  trench upon  that simplicity which it is
the direct object of the present nomenclature to maintain.   The se-
cond objection is, that the word  parenchyma (*"*fey#y/t«*>) is formed 
326
NOSOLOGY.
[CL. VI.—OR. I.
                         GENUS  I.


                   POLYSARCIA.

   Firm and unwieldly bulkiness of the body or its members, from
     enlargement of natural parts.
        Polysarcia.   Sauv. et Auct. Recentior.
        Empimelium Polysarcia.   Young.
        Phoenigmus plethoricus.   Sauv.
        Dicke.  G.
        Corpulence.  JF.
        Corpulency.
          Vogel makes a disease of the opposite state of body, which
        he calls ischnotis, and defines " excessiva  corporis  gracili-
        tas :"—"• excessive slenderness of body;" but this can never
        perhaps run to a morbid extreme, unless arising from some
        species of marasmus.
 1.  adiposa.  Bulkiness from superabundant  accumulation of fat.
        Polysarcia adiposa.   Sauv.
        Polysarcia faginosa.   Forest.
        Obesitas.  Darwin.
        Si men.  Arab.
        Feiste.  G.
        Grosse-panse.   F.
        Obesity.


upon a false hypothesis invented by Er sistratus, who first employ-
ed the term, and who held that the common mass or interior sub-
stance of a viscus is  produced  by concreted blood, strained off
through the pores of the bloodvessels which enter into its general
structure or membranes.  See Gal. Simpl.  Med. I. 11.
  For the reason why physconia is not allowed a place in the present
order,  as also for the abandonment of the term altogether, see  the
note on Parabysma, Cl. I. 0'd.  III.
  Gen. I. Polysarcia. TloXvo-x^xtx, "corpulentia,"  iroXva-xgxos, ucar-
nosus," " carne abundans."  " Corpulency," says Dr. Darwin, II. ii.
3. 17,  " may be called an anasarca, or dropsy of fat,  since it must
be owing to an analogous cause;  that is, to the deficient absorption of
fat compared to the quantity secreted into the cells that cantain  it."
The reasoning is correct, but the term or expression " dropsy of
fat" would  be just as proper as " fatness of dropsy" to explain 
T4E. II.]
NOSOLOGY.
327
Generalis.   Extending over the body and limbs.
   Sennert  mentions a woman,  who at thirty six years of
age weighed four hundred and eighty pounds avoirdupois ;
and a man who weighed six hundred.  Bright  of Mal-
don weighed six hundred and sixteen pounds ; and Lam-
bert of Leicester considerably more.
   In  the N. Sammlung Medic.  Wahrnehm.  III.  370, is
the case of a man  who weighed eight hundred pounds.—
Carried off by a spontaneous salivation, Eph. Nat. Cur.
Dec.  HI.  ann. v. vi. obs. 65.—By a fright,  Samml.
Medicin. Warnehmungen. Band. VI. p. 444.
Splanchnica.   Confined to the organs or integuments of
   the trunk.
Physconia ab adipe subcutaneo. 1° Sauv.
   In  these cases the abdominal  viscera are  more or less
buried in  masses of fat, and usually  accompanied with
scirrhous affections.   In the one  instance mentioned by
Sauvages,  the  limbs and visage  maintained a graceful
elegance  of shape:  in  others they  wasted with  gradual
emaciation.
                  GENUS  II.

                 EMPHYMA.

Glomeration in the substance  of organs from the production
     of new and  adscititious matter: sensation  dull; growth
     sluggish.
anasarca.   Each of tke words has a distinct meaning, and should be
restrained to that meaning alone: dropsy imports liquid  bulkiness,
fatness, solid bulkiness.
  The immediate cause of fatness is doubtful, for we are not much
acquainied with the mode by which animal oil is formed in the sys-
tem.   Dr.  Beddoes ingeniously  conjectured that one  cause of its
production is a diminution of oxygen in the animal frame.   Fat, un-
questionably, contains less oxygen than muscle, and porphyra nautica,
or sea-scurvy, in which the oxygen is perhaps reduced to its small-
est  proportion, is never  announced by meagreness, but fullness of 
328                      NOSOLOGY.             [CL. V.—OU. I.

       Excrescentiae.  Sauv.
       Ecphyma.   Young.
       Tuber.  Parr.
       Tuberculum.  Plenck.
       Sila ;  (Arab.) whence silat " ganglion, glans indurata, stru-
         ma."  The Persian term is amas, " aggregatio, glomera-
         tio, tumor, inflatio:" the verb is amasiden  " intumesco,
         aggrego;" the  participle amasa " tumescens, aggregans:
         running directly parallel  with the French  "amasser,"
         and the English verb u to amass," and  probably derived
         from a common root.
       Knote.   G.
       Tumour.  Abernethy.
1. Sarcoma.  Tumour  immoveable;  fleshy and firm to the touch.
       Lahm.   Arab.
       Sarcoma.  Sauv. Linn.  Vog. Sag.  Cull.
       Ecphyma Sarcoma.   Young.
       Sarcomatous Tumour.  Abernethy.
       x Vasculosum.   Vascular throughout:   texture  simple :
           when  bulky, mapped  on  the  surface with  abores-
           cent veins.  Found over the body  and  limbs  gene-
           rally.
habit, which is often its first symptom.  It is observed by Dr. Trot-
ter, that when a negro becomes rapidly corpulent, he never fails to
fall a prey to sea-scurvy.   According to  Saussure and Humboldt,
the atmosphere of high mountains contains less oxygen than that of
lower regions, which explains  why Condamine was attacked with
scorbutic symptoms on the summit  of Pinohina.
  Gen. II. Emphyma.  EpiQvpuc:  from eptQva, " ingenero."   Phyma
in the present system is limited to cutaneous tumours accompanied
with inflammation.  See Cl. III.  Ord. II.  Emphyma imports, in
contradistinction to phyma, a tumour originating below the integu-
ments, and unaccompanied with inflammation, at least in its com-
mencement ; while ecphyma, in Ord. III. of the present class, im-
ports, in contradistinction to both,  mere  superficial extuberances,
confined to the integuments alone.  Phyma, however, as  well as
the term tumour, has been used in a very  loose sense by  medical
writers, and even by nosologists; and made to signify a multitude of
swellings that have no  resemblance to each other,  excepting in a
preternatural hardness or prominence of the part  in vvhich they
occur: see the note on phyma, Cl. III. Ord.  II.   The inconvenience
of this generalizing diction has been forcibly  pointed out by  Mr.
Abernethy in his valuable tract on Tumours ; and Emphyma is here 
GE. II.]                    NOSOLOGY.                      329

          Common vascular, or organised Sarcoma.  Abernethy.
            Often found of an enormous size in the scrotum, consti-
          tuting the sarcocele, or hernia carnosa of authors.  Ne-
          groes are peculiarly subject to this affection, and more fre-
          quently on  the right than  the left side.   In  one  instance
          the tumour weighed 501b. Phil. Trans. 1783. Vol. LXXI1I.
          Schotte.
 intended to run nearly parallel with Tumour, as explained in his de-
 finition of  the term ;  and consequently to include, with a slight ex-
 ception or  two, the diseases which he has distributed under this head:
 the chief difference being  in exchanging carcinoma for scirrhus in
 the genus sarcoma; the former, when importing an original disease,
 being regarded  in the present system as constitutional, and conse-
 quently appertaining io Cl. III. Old. IV. where it will be found un-
 der the term Carcinus;  and when originating from  an irritated and
 ulcerated simple scirrhus, belonging to the same class and order un-
 der the genus and species Ulcus vitiosum: to which the reader may
 turn.  Carcinus, on account  of  its virulence, has been correctly
 placed last in the list by  Mr. Abernethy; but scirrhus, in its simple
 state indolent and insentient, should be placed considerably higher,
 and  hence is enumerated fifth in order under the present arrange-
 ment.  The term encystis, and indeed  the  common names for its
 varieties, are drawn from Vogel, whose subdivisions are nearly pa-
 rallel  with  those of our own  countrymen,  Dr. Aikin,  Mr.  Sharp,
 and  Mr. Abernethy.  Mr Sharp regards ganglion " as an encysted
 tumour of the meliceres kind."  The meaning is sufficiently clear,
 and the general idea sufficiently correct.  Kind, however, is a loose
 word: they are  both varieties of the same species, and are  here
 arranged as such.  The  term glomeration, or " heaping  into a ball,"
 in the generic definition, is preferred to protuberance or extuberance,
 because some tumours or emphymata  lie so deeply seated  below
 the integuments  as  to produce no prominence whatever, and are
 only discoverable by the  touch.
   The terms tuber, protuberance, and extuberance, have a primary
 reference to a similar affection in the vegetable world;  which  con-
 sists in those knobs or swellings which  are  so frequently met  with
 on the trunks, and sometimes on the  buds of trees; in the former
 case hard and fibrous; in  the latter, for the most part  fleshy and
 spongy ; and in  both  produced by the deposit of new  matter and
 the formation of new vessels; sometimes perhaps produced by lo-
 cal disease in consequence of a sudden change  of weather, and
 sometimes  by the irritating puncture of  insects.  They grow occa-
 sionally to an enormous size without the least injury to the tree on
 which they are situated  : and are technically denominated  tubera
 lignorum, or tubera gemmarum, according  to their situation.   In
frui s, and particularly apples, we often meet  with a similar affection,
   vol. v.-f-58 
330
NOSOLOGY.
[CL. VL—OR. I
/3 Adiposum.   Suetty throughout; inclosed in a thin capsule
     of condensed cellular substance; connected by minute
     vessels.
  Adipose Sarcoma.  Aberneth.
       Found chiefly in the fore and back part of the trunk.
     In one case weighing I51bs. when  extirpated.  Abern.
     p. 31.—In another 421bs.   Journ.  de Med. XX. 551.
     —In a third 191bs. dissected from the face. Leske, An-
     serl. Abhandl. I. p.  65.
y Pancreaticum.   Tumour in  irregular masses; connected
     by a loose fibrous substance, like the irregular masses
     of the  pancreas.
  Pancreatic Sarcoma.   Abernethy.
       Found in the cellular substance;  but more usually in
     lymphatic glands: chiefly in the female breast.
$■ Cellulosum.  Tumour cellulose or cystose: cells oval, cur-
     rant-sized, or  grape-sized, containing  a serous fluid;
     sometimes caseous.
  Cystic  Sarcoma.  Aberneth.
       Found generally, but mostly in  the thyroid gland,
     testis, and ovarium.   Baillie Morb. Anat. Fasc. VIIL
     pi. 8. fig.  1.   Abern. Obs.
       When in the  thyroid gland it is called Bronchocele,
     Botium, or Derbyshire-neck.  The  cells  are here nu-
     merous, the fluid  often  viscid, sometimes  gelatinous.
     See Baillie Morb. Anat. Fasc.  II. pi. l.-~Occurs, as a
     symptom,  in Cyrtosis Cretinismus, Cl. III. Ord. IV.
     Gen. IV.
■:  Scirrhosum.   Hard,  rigid, vascular infarction of  glandu-
     lar folieles; indolent,  insentient, glabrous; sometimes
     shrinking and becoming more  indurated.
  Scirrhous Sarcoma.  Aberneth.
       When  irritated tending to a cancerous ulcer.   See
     Class III. Ord. IV.  Ulcus.
       Found   in  glandular structures, chiefly those  of
     the  secernent  system.   In  one  instance,  on  the
  2. 1. a  E. Sarcoma  Vasculosum.   The term vasculosum is here
preferred to vasculare, as the suffix osus is uniformly augmentative
or intensive ; and  in  the  present  instance, therefore, imports not
only vessels, but numerous vessels.  For the same reason cellulosuv.
and tuberculosum are preferred to cellulare and tubercularf. 
GE. II.]
NOSOLOGY.
331
           breast,  which was  almost  entirely  scirrhous, and
           weighed  641bs.   Leske,  Auserlesene  Abhandlungen.
           I. Th.
       £ Mammarium.  Tumour of the colour and texture of the
           mammary gland; dense and whitish; sometimes softer
           and brownish:  often producing, on extirpation, a ma-
           lignant ulcer with indurated edges.
         Mammary,  or mastoid Sarcoma.  Abern.
           Found in various parts of the body and limbs.
       9 Tuberculosum.    Tumour  tuberculose;  tubercles  firm,
           round, and  clustering;  pea-sized  or bean-sized; yel-
           lowish, or  brownish-red;  when large, disposed to ul-
           cerate,  and produce a painful, malignant, and often
           fatal sore.
         Tuberculate Sarcoma.  Aberneth*
              Found chiefly  in the  lymphatic  glands of  the
           neck; often, simultaneously, in  other glands and or-
           gans.  Aberneth. p. 47.   Baillie, Morb.  Anat.  Fasc.
           V. pi. 2.
         • Medullare.  Tumour of a pulpy consistence, and brain-
           like  appearance;  whitish; sometimes  reddish-brown;
           when large, apt to ulcerate; and produce a sloughing,
           bleeding, and highly dangerous sore.
         Medullary Sarcoma.  Aberneth.
         See Baillie  Morb. Anat. Fasc. VIII.  pi. 7.
              Found in  different parts, chiefly in the  testes; at
           times propagating  itself along the absorbent vessels to
            adjoining organs.
2. encystis.  Tumour  moveable :  pulpy, often elastic  to  the
                 touch.
       Encystis.   Vog. Parr.
       Lupia.   Sauv, Cull.
       Encysted Tumour.   Sharp. Aikin. Abernethy.
       Wen.
       » Steatoma.   An  encysted  extuberance containing a fatty
           or suetty substance, apparently secreted from the inter-
           nal surface  of  the cyst.
       Steatoma.  Sharp.
         Found over most parts of the body; and weighing, from a
       drachm or two, to twenty or thirty pounds;—in one instance,
       described by Rbodius, sixty pounds.
       G Atheroma.  Encysted  extuberance  containing a  mealy 
332
NOSOLOGY.
[CL. VI— OR. I.
           or curd-like substance,  sometimes intermixed  with
           harder corpuscles; apparently secreted as the last.
             Found, of  different sizes, over  most parts  of the
           body.
         Molluscum.   Willan.
       y Meliceris.  Encysted extuberance, containing a  honey-
           like fluid.
             Found, of different sizes, over  most parts  of the
           body.
       ^ Ganglion.   Encysted extuberance containing a colourless
           fluid; the extiiberation fixed upon a  tendon.
         Testudo.  Encysted extuberance  containing a fluid rea-
           dily hardening  into horn or nail; and especially when
           protruded externally upon  an ulceration of  the sur-
           rounding integuments.
         Testudo.   Vogel— See also  Aberneth.  p. 90, and Sir
           Everard Home's Cases of horny excrescences from the
           human body.
1.  Exostosis.  Tumour inelastic; often immovable; hard and bony
                 to the touch.
       Exostosis.   Sauv. Sag. Linn. Cull.
         Ostea.   Immovable;  protuberant;  seated  on  the sub-
           stance of a bone.
           Sometimes  excrescent, and composed of bony  spicula
         resembling crystallizations.   Sometimes exquisitely hard
         and glabrous,  resembling ivory.   Both found chiefly in
         the bones of the cranium. See Baillie Morb. Anat. Fasc.
         X.  PI. 1. fig.  1.2.
       p Periostea.  Immovable; protuberant;  from bony enlarge-
           ment of the periosteum.
         Node.
       y Pendula. Bony tumour " hanging pendulous into a joint."
           Abernethy on Tumour, p. 102.
       & Exotica.  Bony tumour movable or immovable,  seated in
           some fleshy part of the body.  See Abernethy, ut supra.
           Perhaps only a variety of osthexia infarciens; for which
           see the next genus.
              Several of these varieties, or rather dispositions to
           an undue secretion of ossific matter, appear occasion-
            ally to depend  upon some  disorder  of the chylopoietic
           viscera.   See  Aberneth.  "On  Diseases resembling
            Syphilis," p. 85. 
ge. in.]
NOSOLOGY.
333
                       GENUS  III.

                    P A R 0 S T I A.

  Bones untempered in their substance ; and incapable of affording
    their  proper support.
       Nekes.  Arab.   Literally " os emedullatum ;" " os ener-
         vatum."
1. fragilis.  Substance  of the bones brittle and  apt to break on
                slight exertions, with little or no pain.
       Fragilitasosskim.  Auct.  Var.
       Fragile vitreum.  Auct. Var.
         Most  frequently an attendant  on advanced age.  Found
       also, at times, as a symptom in lues, struma and  porphyra:
       occasionally a  sequel of  small-pox;  Balthazaar, Chirur-
       gische Wahrnehmungen.—In one ins'ance ascribed to a more
       than usual  portion of medullary oil :  Saillant, Hist, de la
       Societe Royale  de  Medicine. Tom. VII. p. 316.
2. flexilis.  Substance of the  bones soft; and apt  to  bend, and
                 become crooked on  slight exertions  with little or
                no pain.
       Malacosteon.   Vog.
       Mollifies ossium.   Auct.  Var.
  Gen. III. Parostia.  From -xx^x, " perperam," in which sense
it is always used in the present work, and erTtov, " os, ossis."  The
genus is new, but seems called for : and the species evidently de-
pend upon an inaccordant secretion of the earth of bones compared
with their other principles : this  being redundant in the first, and
deficient in the second.  In advanced age, the secretion of animal
oil is apt to fail before that of animal  earth ; while, not unfrequently,
we  find this last existing in organs which give few or no proofs of
it in earlier life.  Hence the blood-vessels become not merely rigid,
but in some cases  ossific,  and the  bones  more  hard and fragile.
The author was once present at a church, in which a lady of nearly
seventy years  old, in good  general  health, broke both  the thigh-
bones in merely kneeling down ; and on  being taken hold of  to be
carried  away, had an os humeri also broken without any violence,
and with  little  pain.  It was  in the winter season, and  the cold
might have added to the general rigidity.  Under the influence of
a warm bed, and a  diluting regimen, the bones united in  a few
weeks. 
334
NOSOLOGY.
[CL. VI.—OR. I.
Osteosarcosis.  Macb. et Auct. Alior.
Spina ventosa.   Auct. Var.
  Found  also, occasionally,  as  a symptom  in  porphyra,
diabetes, and some species of colic.   See various  cases in
Phil. Trans, by Bevan, Pott, Hosty, Pringle ;  as also Gooch,
Surg. p. 178: and Bromfield,  Chirurgical  Observations.—
Found at times in new-born infants, more or less general-
Universal, with  perversion of  most of the  bones; Morandt
Histoire de la Maladie singuliere  et de 1'examen du  cadavre
d'une femme (Sapiot) devenue tout-a-fait contrefait  par une
ramollissement  general  des os. Paris, 1752.—In a young
man of seventeen ;  Thomason,  Jour, de Medicine, Tom.
XLIII.—In a lioness; Eph. Nat. Cur. Dec. I. ann.  ii.  6.—
In an ox (ribs;) Bircherod, Act. Maris Balthici, 1707.
                       GENUS  IV

                    0 S T H E X I A.

  Soft parts more or less  indurated by a superfluous secretion and
       deposit of ossific matter.
       Ossificatio. Plouquet.
       Lithiasis in corporis partibus.   Cull. Cat.gen. omiss.
1. infarciens.   Ossific matter deposited in nodules, or amorphous
                  masses in different parts or organs.
                     In the lungs;  Baillie,  Morb.  Anat. Fasc.
  2. Parostiaflexilis.   An analysis of the vertebrae, by Dr. Bostock,
in the case of an adult female, who died of a mollities ossium, in-
dicated that the earthy matter was oniy one-eighth part of the entire
weight of the bone, instead of amounting to more than half, which
Dr. Bostock estimates to be its common proportion in a state of
health.  Medico-chir. Trans. Vol. IV. p. 42.
  In the Transactions of the Medical Society of London, Vol. I. p.
169, is a singular case furnished  by Mr. Norris, in which the earthy
matter of nearly  half the entire scalp of a  woman aged fifty-one,
was gradually carried off  by a morbid action of the neighbouring
absorbents, operating at different points, and producing a great mul-
titude of distinct holes or foramina, so as to give the cranium, after
death,  the appearance of a sieve.   The diseased action  was, in
every part, accompanied with a superincumbent inflammation, pro- 
GE. IV.]
NOSOLOGY.
335
                  II. pi. 6.—In the substance of the heart, weigh-
                  ing 2 oz.; Burnet, Med. Pract. III. 254.—In the
                  thymus gland; Act. Med. Berol. Vol. I. Dec. iii.
                  p. 28.—In the thyroid;  Contuli, de Lapid.—In
                  the parotid; Plater, Obs. Lib. III. 707.—Sub-
                  lingual; common.—In the deltoid muscle; Russe,
                  in Blegny Zodiac, 1680.—In the trachea, con-
                  tracting  its  passage; Kirkring, Spicileg. Anat.
                  Obs. 27.—In  the dura mater; .BaiZfte,Fasc.  X.
                  Pi. 4.
3. implexa.  Ossific  matter deposited in concentric layers in  the
                tunics of vessels or  membranes,  rendering them
                rigid and unimpressible.
       » Aortae.   Ossification of  the aorta.
           With  a considerable  portion of the right ventricle and
         right  auricle of the heart.   Baillie, Fasc. V. PI. 2.
           Valves ossified without palpitation  or dyspnoea.  Mor-
         gagni, De Sed. et. Caus. ep. xxiii. 11.
           Descending trunk wholly ossified.    Genga, Anat. chi-
         rurg.  Buckner, Miscel. 1727. p. 305.
           Ascending and descending trunks wholly ossified, com-
         pelling to an erect position;  Guattani, De Aneurism.
       £ Membranea.  Ossification of membranous or connecting
            parts.
ducing tumours in the scalp which were regularly opened, and dis-
charged  the contained  pus.  The only cause that could be traced
was a fall down the cellar stairs about four months before the com-
mencement of the above symptoms, by which the patient struck her
forehead against a  heap of wood; but from which she did not at the
time appear to derive any serious mischief.
  Mr. Taunton has, among his preparations, the humerus of a man
which to a considerable extent is reduced to a mere cartilage, and
was so for a long time  during life: the whole of the earthy matter
having been absorbed,  and consequently the bone capable of being
bent in any direction.
  Gen. IV.  Osthexja.  From torsos, " osseous or bony," and ff<s,
" habitus," " habit."  Ossific diathesis, or idiosyncrasy.  T;>ij> mor-
bid affection has been seldom duly attended to in nosological ar-
rangements.  It does not occur in Dr. Cullen's classification, but  he
notices it in his catalogue of Omitted Diseases, as one of those that
ought not perhaps to have  been omitted.   Plouquet has  arranged
only a very few of the  writers on the subject under the article Os. 
336
NOSOLOGY.
[CL.  VI—OR. II-
   Of the  pleura; Baillie, Fasc. II. PI. 3.
      General ossification  of tendons, membranes, cartilages
•■   and ligaments.   Pecklin, Lib. II. Obs. 40.
 y Complicata.  Ossifica'ion of different parts simultaneously.
      Thoracic duct,  ileum, and  other  abdominal organs
   Cheston, Phil. Trans. 1780. Vol. LXX.
                       ORDER  II.

                     C A T O T IC A.

              AFFECTING INTERNAL SURFACES.

  Pravity of  the fluids, or emunctories that open  into the internal
surfaces of organs.
                     GENUS  I.

                   HYDROPS.

Pale, indolent, and inelastic distention of the  body, or its mem-
  bers, from accumulation of  a watery fluid in natural cavities.
     Hydrops.   BoerJiaave. Macbr. Young.
     Hydropes.   Cull.
  Ord. II.  CatoticA.  From xxnu," infra:" whence xxtuts^os and
xxrarxros, "inferior and infinius>."
  Gen. I.  Hybrops, "ffyai]/ and v$%os.   There is no  genus of dis-
eases which has been more awkwardly  handled by the earlier no-
sologists than the present.  The term  hydrops does not occur in
Sauvages, Linneus, or Sagar,  and only once in  Vogel in the com-
pound hydrops scroti.  Lint>eus connects anasarca and ascites, with
tympanites, polysarcia and even graviditas, into one ordinal division,
which he entitles tumidosi, and of  which these constitute distinct
genera.   Sagar arranges  all the same under the ordinal division of
cachexia.   Vogel pursues the same plan with the omission of gravi-
ditas, which he does not choose to regard as a cachexy.   Sauvages 
GE. I.]
NOSOLOGY.
337
       Phlegmatia.  Parr.
       Estiska.   Arab.
       Wassersucht.   G.
       Hydropisie.  F.
       Dropsy.
1. cellularis.   Cold, and diffusive intumescence  of the  skin,
                   pitting beneath the pressure of the finger.
       « Totius corporis.   Extending through the cellular mem-
            brane of the whole body.
         Anasarca.   Galen, et Auct. Recentior.
         Hyposarcidius ('riroe-xpKtfoos)   Hippocr.
         Lencophlegmatia.   Cozl. Aur.
         Hydropisie generate.  F.
         General Dropsy.
       G Artuum.  Limited to the cellular membrane of the limbs;
            chiefly of the  feet and ancles, and, mostly,  appearing
            in the evening.
         Phlegmatia.   Sauv.
         (Edema.  Auct.  Var.
         ffidemaiie.   F.
         Edema.
            Either species found also, occasionally, as a symp-
         tom,  in  general debility from  fever or other  causes; in
         suppressed  catamenia,  or other  habitual  evacuations;
         in pregnancy; or a suppressed eruption of exanthems.
employs the term hydropes, but only in connexion with partiales, so
as to restrain it to locai dropsies; so that with him ascites is a hy-
drops ;  but anasarca is not a hydrops, and does not even belong to
the same order; it  is an intumescentia, under which, as in the  ar-
rangement of Linneus, it is united with polysarcia and gravitidas,
while hydrops thoracis is an anhelatio, and occurs in another volume.
Dr. Cullen  has certainly, and in a  very considerable degree, im-
proved  upon his predecessors in this department.  After Sauvages,
he takes intumescentije for the name of his order : but divides it
into the four sections of adiposae, flatuosae, aquosae vel hydropes, and
solidae : while under the third section (the aquosae vel hydropes) he
introduces all the family of dropsies, whether general or local;  in-
stead of sending them,  with those who  preceded him, to different
quarters. It would, however, have  been a much greater improve-
ment, and have added to the simplicity he  aimed  at,  to have em-
ployed  hydrops as  a generic, instead of hydropes as a tribual or
family term ; and the only evil we should then have had to complain
of, would be the use of intumescentiae as an ordinal banner, for dis-
eases that have no possible  connexion wnatever, nor any kind  of re-
semblance, except  in an enlargement  of external parts.   It is to
  vol.  v.—54 
338                       NOSOLOGY.           [CL.VL—OK.1I.

       y Dyspnoica.   Edematous swelling of the feet;  stiffness
            and numbness of the joints;  the swelling rapidly  as-
            cending to the belly, with severe  and,  mostly, fatal
            dyspnoea.
         Anasarca cacotrophica.   W. Hunter,  Essay on Diseases
   ,         incident to Indian Seamen.
2. capitis.   Edematous intumescence of the  head; the sutures of
               the sculi gaping.
       Hydrops capitis.   Young.
       Hydrocephalus.   Sauv. et .duct. Recent.
       Hydroeephale.  F.
       Dropsy of the  Head.
         Contained twenty-four pounds  of  liquid,  Eph.   Nat.
       Cur. Dec.  III. ann-  i. obs. 10.—Continued  twenty four
       years,  Id. Cent. I. II. obs. 29.—Thirty years,  Van Swiet.
       ad.  § 1217.  Boerh. Aph.—Tweniy-nine years, with natu-
       ral  pupil, appetite,  and sound memory,  Michaelis,  Med.
       Communic.  I. p. 25.
         In this species-the fluid never jellies; for the lubricating
       fluid secreted naturally into the ventricles of the  brain  is
       equally destitute of this property.   " I never  saw it jelly
       even when exposed to heat."   Hewson on the Lymph. Syst.
       Part II. 193.
3. spin/E.   Soft, fluctuating  exturberance on  the spine; gaping
              vertebras.
Boerhaave that we are first indebted for the use of hydrops as em-
ployed in  the present method ; and he has  been followed by Dr.
Macbride and Dr. Young with  a just appreciation of h\& correct-
ness.
   1. Hydrops cellularis.   The fluid discharged upon tapping is often
of different kinds, not merely from different organs, but, in different
cases, from the same organ : being sometimes nearly  as thin as wa-
ter, and not coagulating when exposed to heat, which only renders
it turbid, while at other Times it flows in a viscid or ropy state, and
accords, upon exposure to heat, with the natural serum of the blood.
The causes, of dropsy must, therefore, be different in different cases.
Increased secretion, impeded absorption, or the rupture of a lym-
phatic vessel,  may each of them form a cause of itself: but in all
these instances the fluid  should be only an" accumulation of that
»fi»lch naturally moistens the cavity from  which it is  discharged.
Morbid collections of water must proceed from some other cause;
probably from the exhalant arteries being themselves so altered by
disease  as to change the  properties of  the  fluid  vvhich passes
through them; or the general mass of blood being so attentuate, or 
GE. L]
NOSOLOGY.
339
       Hydrorachitis.  Sauv.  Cull.
       Spinola.  Linn.
       Spina bifida.   Vog.
          Mostly congenital:  but sometimes produced in adults.  See
       Warner's  Cases in  Surgery.—Occasionally accompanied
       with hydrops capitis.
          Congenital  : the child alive at five  years  old,  Titsing
       apud Van Swieten, ad. § 1218.
4. thoracis.  Sense of oppression  in  the chest;  dyspnoea on
                 exercise  or  decumbiture :  livid  countenance  ;
                 urine red and spare ; pulse irregular ;  edematous
                 extremities  ; palpitation and sudden startings dur-
                 ing  sleep.
       Hydrops  pulmonis ('rfya4>  jrvevpions.)    Hippocr. II.  De
         Morb.
       Hydrops pectoris.   Auct. Var.
       Hydrothorax.   Gorier. Sauv. Cull, et Alior.
       Wassersucht des brust.  G.
       Hydropisie de poitrine.  F.
       Dropsy of the  Chest.
          Sixteen pints found lodged ;  Act. Nat. Cur.  Vol. V.  obs.
       34.
          In the  pericardium  found   four  pounds of  ichorous,
       sanguineous, and purulent fluid ;  F. Hildan. Cent. I.  obs.
       43.
          Several of  the  preceding  symptoms  are given  on the
       authority and  accurate  observation of the  author's  friend
       Sir L. Maclean of Sudbury.   See his  valuable  " Enquiry
       into the  nature of Hydrothorax,"  p. 5.   Dr. Cullen has
       rightly rejected  those species as they are  called,  but  which


in other respects vitiated, as to affect  the secretion.   In the  last
case, dropsy is not a  primary disease, but the consequence of some
other, generally perhaps of a morbid liver, spleen, or lungs.   See,
on this subject,  Mr. Hewson's valuable remarks in  his Description
of the Lympathic System, Ch. xiii.
  It is observed by Mr. J. Hunter, that  " a disease  often produces
such  weakness as to destroy  itself:" in other words, that the mor-
bid action ceases from debility.  It sometimes  happens, however,
that the strength of the system is completely worn out  at the same
time, and the  patient dies notwithstanding the  disease has given
way.  This is particularly exemplified in the first,  fourth, and  fifth
of the ensuing species: for  there  are, perhaps, few practitioners
but have seen at times a sudden cessation of these diseases, an  evi-
dent absorption of the water  existing in the affected organ, greate: 
340
NOSOLOGY.           [CL. VI.—OR- "
       ought  rather  to  be  called  varieties of Sauvages,  which,
       whether they exist or not, can  never be ascertained by the
       symptoms, as hydrops mediastini, pleurae, pericordii, hyda-
       tidosus.
         Found also, occasionally, as  a  sequel on fevers, or re-
       pelled cutaneous  eruptions.
         Cured by  tapping, Moreland,  Phil. Trans.  Vol  LVI.
       1766.—Another  successful  use of the same  operation in
       Purman.  Chirurgischen  Lorbeerkranz,  &c.—427 lb. of
       fluid evacuated  by  tapping  within ten months,  Morand,
       Vermischte  Schriften,  Band   II.—150 lb. evacuated  at
       once,  Tozzetti, Racolta  prima,  &c. n.  1.   Within twenty-
       five years, by 80 tappings, evacuated 6,631 pints ; in one
       year alone 495 pints, Aus. Jib. fur pract Aerzte, Band XI.
       p. 659.
         The fluid commonly, perhaps always, jellies upon expo-
       sure to heat.
5. abdominis.   Tense,  heavy, and equable  intumescence of the
                  whole belly, distinctly fluctuating  to the  hand
                  upon a  slight stroke being given on the opposite
                  side.
       Hpdrops abdominis.  Auct.  Var.
       Askites.   Trallian.
       Ascites.   Sauv.  Linn.  Cull, et Alior.
       Heben.   Arab
       Wessersucht des  bauches.   G.
       Ascite.   F.
       Dropsy of the belly.
       x A bnica.  Preceded  by general debility of the consti-
           tution.   Often  the result of scurvy, or fevers of vari-
           ous kinds.
       » Parabysmica.  Preceded by or accompanied with oppila-
           tion or indurated enlargement of  one  or  more of the
            abdominal viscera.
       y Metastatica.   From  repelled gout, exanthems, or  other
           cutaneous eruptions.

freedom of breathing, and even regularity of pulse; while the ge-
neral weakness has been so considerable that the vital powers have
been incapable of permanently rallying, and  the patient has died a
few days afterwards.
   l.y H. cellularis Dyspnoica.  This very severe  and singular va-
riety is taken from Mr. W. Hunter's Essay, published at Bengal, folio,
1804    The  disease  appeared with  great  frequency among the
Lascars in the Company's service in 1801.  Its attack was sudden, 
GE. I.]
NOSOLOGY.
34 i
              Gmelin informs us, that abdominal dropsy is treated
           with great success in Siberia by a decoction %of the dras-
           tic herb named by Linneus cimicifuga foztida, from its
           being offensive and poisonous to the insect from which
           it takes its name.   Flor. Sib. iv. 183.
              In the second variety the viscus  most frequently af-
           fected  is the liver; the gall-bladder of  which is often
           enormously  enlarged  and turgid.    See Phil.  Trans.
           1710-12. Vol. XXVII. Yonge, Mem. de Paris, 1701, p.
           103.   Du Verney, Act. Erud. Lips. 1718.  In the last,
           the bladder  weighed ten  pounds twelve ounces, had no
           meatus, contained various tunics, and was filled with a
           coffee-like  liquor.
              The substance of the liver is often found loaded with
           hydatids.   In one instance it weighed  twelve pounds.
           Gooch's Cases, &c. p. 170.
              The quantity evacuated by paracentesis has amount-
           ed to 68 lbs.; Ephem Nat. Cur. Dec. I. ann. ix. x. obs.
           102.—The  operation  performed forty-six times, Nov.
           Act. Cur. Vol. V.  obs. 44.—Patient cured after twelve
           operations, Commen.  Lit. Nord. 1735.
              It has often been naturally cured by some vicarious
           discharge:  the most common  are profuse perspiration
           and diarrhoea.
6. ovarii.  Heavy intumescence of the' iliac region on one or both
              sides; gradually spreading over the belly;  with ob-
              scure fluctuation.
       Hydrops ovarii.    Young.
       Ascites ovarii.   Sauv. Parr.
       Ascites saccatus.  Cull.
       Dropsy of the Ovarium.
7. tubalis.   Heavy, elongated intumescence  of the iliac region,
                spreading transversely; with obscure fluctuation.
and its course so rapid, that it frequently killed the patient in two
days.   From the description, it does  not seem to have been con-
nected with a scorbutic diathesis: and Mr. Hunter ascribes it to the
concurrent effect of breathing an impure atmosphere, suppressed
perspiration, want of exercise, and a previous life of intemperance.
All these  must, unquestionably, have  been auxiliaries, and formed
a remote cause, but the immediate cause remains still unexplained. 
342                      NOSOLOGY.            [CL. VI.—OR. II.
       Dropsy of the Fallopian tube.  Baillie, Morb. Anat. Fasc.
         IX. pi. 8. fig.  1.
8. uteri.   Heavy, circumscribed protuberance in the hypogastrium,
             with obscure fluctuation; progressively enlarging, with-
             out iscbury or pregnancy.
       Hydrops uteri.   Sennert. Young.
       Hydrometra.   Sauv. Sag. Cull.
       Wassersucht des  mutter.  G.
       Hvdropisie de matrice.   F.
       Dropsy of the  Womb.
0. scroti.   Soft, semitransparent, pyriform intumescence of the
               scrotum; progressively enlarging, without pain.
       Hydrops scroti.  Young.
       Hydrocele.  Heister. Sharp. Cull.
       Oscheocele.   Sauv.
       Oscheophyma.   Sag.
       Hernie fausse.   F.
       Dropsy  of the Scrotum.
       x Vaginalis.  The fluid contained in the tunica vaginalis, or
           surrounding sheath of the testis.
         Hydrocele.   Vog.
         Hydrocele  saccata.  Auct. Var.
       & Cellularis.   The fluid contained in  the cellular membrane
           of the scrotum.
         Hydrops scroti* 'Vog.
                  GENUS  II.

               EMPHYSEMA.

Elastic, and sonorous  distention  of the  body or its  members,
     from air accumulated in natural cavities.
  Gen  II.  Emphysema.  'EptQvrqpix, from tpvo-xu, " inflo," " flatu
distendo."  There is some doubt by what means the air is produced
in various cases in which it  is found in great abundance ; for we
cannot always trace its introduction from without, nor ascribe it to a
putrefactive process.  " In one instance (observes Mr. J. Hunter) I
have discovered air in an abscess which could not have been re-
ceived from the external air;  nor could it have arisen from putre-
faction."  Anim. Econ. p. 207. The case is singular, but too long 
GE. II.]
NOSOLOGY.
343
       Emphysema.   Gal. Dioscor.  Young. Parr.
       Windige wassersucht.   G.
       Inflation.
       Wind-dropsy.
L  cellulare. Tense, glabrous, diffusive intumescence of the skin,
                  crackling beneath the pressure of the finger.
       Emphysema cellulare.   Young.
       Emphysema pneumatosis.  Parr.
       Pneumatosis.   Sauv. Cull.
       Empneumatosis.   Cozl. Aurel.
       Sarcites flatuosus.   Smetii.
       x A vulnere.   From a wound of the thorax.
           Pneumatosis a vulnere.   Sauv.
           Pneumatosis traumatica.   Cull.
       G A veneno.   From fish-poison or other venom.
           Pneumatosis a veneno.   Sauv.
           Pneumatosis venenata.   Cull.
"3.  abdominis.  Tense,  light, and  equitable intumescence of the
                  whole belly;  distinctly resonant  to a stroke of
                  the hand.
       Hydrops  siccus et  flatulentus.  Hippocr. Fazsii.  Aph. ii

       Tympania.   Galen.
       Tympanita.   Sennert.
       Tympanites.   Sauv. et Auct. Recentior.
       Emphysema tympanites.  Parr.
       Emphysema tympaniticum.   Fotmg.
       Windige wassersucht des bauches.  G.
       Tympanite.   F.
       Tympany.
         The tympanites intestinalis of authors,  like the meteoris-
       mus of Sauvages, is a variety, sometimes only a symptom
       of dyspepsy, worms, hysteria, or some other disease affect-
       ing the intestinal canal.
         The very singular case of Margaret Dog,  related by  Dr.
to be copied.   From this and various other circumstances, Mr. H.
adopted the opinion that air is often secreted by animal organs, or
separated from the juices' which are conveyed to them : and he ap-
peals, in confirmation of this opinion, to the experiments of Dr.
Ingenhouz upon Vegetables.  The experiments  of Count de Mully
on the human body in favour of the same opinion, published in the
Berlin Transactions for 1777, are not to be depended upon ; as Dr.
Pearson  has since shown that they were made  without  sufficient
care. 
344
NOSOLOGY.
[CL. VL—Oil. II.
       A. Munro in the Edin. Med. Essays,  Vol. I. xxxi. seems to
       have been of a mixed character, a real tympany, with irregu-
       lar inflations of different parts of the alvine channel.
         Found,  also, occasionally, in the last stages of enteritis,
            and several species of hernia,  from evolution of  air in
            consequence of putrefaction.
3. uteri.  Light,  tense,  circumscribed protuberance in the  hypo-
            gastrium; obscurely sonorous; wind occasionally dis-
            charged through the mouth of  the uterus.
       Physometra.  Sauv.  Sag. Cull.
       Hysterophyse.   Vog.
       Emphysema uterinum.   Young.
       Inflatio uteri.   Sennert.
       Windige wessersucht des mutter.    G.
       Tympanite de la matrice.  jF.
       Tympany of the Womb.
                      GENUS III.

                        PARURIA.

    Morbid secretion or discharge of urine.
1.  inops.   Destitution  of urine;  without desire  to  make  wa-
            ter or sense of fulness in any part of the urinary track.
       Ischuria notha.  Sauv.
  Gen. III. Paruria. From nx^x, "perperam,"  and iv{ tu, " min-
go." The genus is intended to inciude the ischuria, dysuria, pyuria,
enuresis, and diabetes of authors;  which, like the various species
of the  preceding  genus, lie scattered,  in  most of the nosologists,
through widely different parts of the general arrangement.  Thus,
in Cullen, diabetes occurs in Cl. II. Ord. III. neuroses, spasmi : enu-
resis in Ci IV.  Ord. IV. locales, apocenoses: and ischuria, and
dysuria in Cl. IV.  Ord. V. locales  epischeses.  All these form
a natural group: and the two last  have  characters  scarcely diversi-
fied enough for distinct species, instead of forming distinct genera.
Dysuria might have served well enough as the generic term for the
whole ; but as it has been usually limited to the third species in the
present arrangement,  the author has  thought it better to  propose a
new term, than to run the risk of confusion  by retaining the old
term in a new case.
  3. *.  P. Stillatitia Helminthica.  This variety is  given  upon the
authority of Mr. Lawrence's very singular case inserted in the Me- 
GE. III.]
NOSOLOGY.
345
         Often the result of renal inflammation or paralysis; but
       sometimes  a genuine idiopathic affection.   Parr relates a
       case, that occurred in his own practice, in vvhich no urine
       was apparently secreted  for six weeks; at the end of which
       time the discharge returned spontaneously.  See  his article)
       Ischuria:  as also various similar cases in the Phil. Trans.
       particularly Mr. Richardson's of a boy who never secreted
       urine.
2. retentionis.   Urine totally obstructed in its flow; with a sense
                    of weight  or uneasiness in some part of the
                    urinary track.
       Ischuria.   Paul.  JEginet. Sauv. Cull. Plouquet.
       Esr.  Arab.   It is also applied to the next species.
       Retention d'urine.  jF.
       Stoppage of Urine.
       x Renalis.   Pain and sense of weight in the region of the
           kidneys;  without any swelling in the hypogastrium.
         Ischuria  renalis.  Sauv.  Cull.
            Sometimes accompanied  with suppurative inflammation,
         and enormous enlargement  of the organ.   Purulent,  and
         weighed 141b.   Cabrolii, Observ. n. 28.
            Sometimes accompanied with parabysma or coacerva-
         tion, and still larger.   Weighed 251b.  Commerc. Later.
         Nor.  1737, p.  326.   Another case, same weight, Hist, de
         VAcademie des Sciences, 1732, p. 45.
            The kidney sometimes emaciated, and strikingly small.
         Weighed exactly  a  drachm,  Warthon Adenographia, p.
         96.
       /3 Ureterica.  With pain or sense of weight in the  region of
            the ureters.
         Ischuria ureterica.  Sauv.  Cull.
dico-Chirurg. Trans, vol. ii. p. 382.   The patient was a female aged
24 :  had long  laboured  under a severe irritation of the bladder,
which was  ascribed to a calculus.  She at length discharged three
or four worms of a nondescript kind,  and  continued  to  discharge
more, especially when the discharge was aided by injections, or the
catheter remaining in the urethra for the night.   The evacuation of
these animals continued for  at least  a twelve-month :  Twenty-two
were once discharged at a  time; and  the whole number could not
be less than from 800 to 1000.   A smaller  kind  was also occasion-
ally evacuated.   The larger were usually from four to six inches in
length ; one of them measured eight;  slender in the middle ; fili-
form at the  extremities; thicker in the inter-spaces :  they were soft
  vol. v.—55 
34(i
NOSOLOGY.
[CL. VI.—OR. n.
       y Vesicalis.  With protuberance in the hypogastrium; fre-
            quent desire  to  make  water; and pain at the neck of
            the bladder: sometimes at the end of the penis.
         Ischuria vesicalis.   Sauv  Cull.
       ? Urethralis.   With  protuberance  in the hypogastrium;
            frequent  desire  to  make  water, and a  sense of  ob-
            struction in the urethra, resisting  the introduction of a
            catheter.
         Ischuria urethralis.   Sauv.  Cull.
            The retention has often continued from  a  week to a
         fortnight   See Eph. Nat. Cur. passim.  Cornarus Obs.
         n  21.    Paullini gives  an instance of  habitual retention,
         without injury.   Cent. ii. obs. 26.  A  protracted case in
         Haller, Bibl. Med.  Pr. ii. p. 200, of twenty-two weeks.
         In  Marcellus Donatus, lib. iv. cap. 27, 28, six months:
         but these were probably cases of paruria inops, through a
         considerable period of these  long  intervals.
            Sometimes the retained urine has regurgitated through
         the ureters:  Petit, Traite, &c.  Oeuvres Posthumes, Tom.
         iii. p. 2.
            Occasionally  the quantity retained  has  amounted to
         eight or nine pints.  Bird, Medical Observ. and Inq. vol.
         v.   In one instance to sixteen pints.  Vilde, Journ de Med.
         Tom. xlvii. p. 134.
3. stillatitia.   Painful and stillatitious emission of urine.
       Stranguria ('Zr^xfyov^tx.)  Paul. AZgin. et Auct.  Graze.
       Dysuria.   Sauv. Linn.  Vog.  Cull.
       Harnstrange.   G.
       Dysurie.    F.
       Strangury.
       x Spasmodica.    From   spasmodic   constriction  of  the
            sphincter, or some  other part of  the urinary  canal,
            catenating with  spasmodic  action  in some  adjoining
            part.
         Dysuria spasmodica.   Cull.
         Dysuria hysterica.   D. rachialgica.  D. diabetica.   D.
            nephralgica.  Sauv.
       (3 Ardens.   From spasmodic constriction  excited by the ex-
            ternal or  internal use  of  various stimulants, as acrid
when first voided, and of a yellowish hue.   For the most part they
were discharged dead. 
GE. III.]
NOSOLOGY.
347
            foods, or  cantharides; accompanied with a sense  of
            scalding as the urine is discharged.
         Dysuria ardens.  Cull.
         Dysuria arsura.  D. primaria.  Sauv.
       y Callosa.  From a callous thickening of the membrane of
            the urethra: the stricture permanent.   Baillie Morb.
            Anat. Fasc. viii.  pi. 5.
       £ Mucosa.  The urine intermixed with a secretion of acri-
            monious mucus, of a whitish or greenish hue.
            Frequently a  sequel of gout,  lues, or blenorrhcea :
         sometimes  produced  by cold, and in this case  forming
         the catarrhus vesicoz of various  authors; so denominated
         from  its being conceived that  the bladder and urethra are
         affected  in the same manner as the nostrils in a coryza.
         Where  the stricture is permanent and very  narrow, ulcer-
         ation  and fistulas in perinaeo are frequent results.
         Dysuria mucosa.    Cull.
         Pyuria mucosa.   P. viscida.  Sauv.
         GIus.   Linn.
         Catarrhus vesicae.   Auct. Var.
            The  one or other of the varieties found  also occasion-
         ally,  or  as a symptom, in  inflammation  of the urinary
         organs, several species of lithia,  and  compression from
         local  tumours, retroversion of  the  uterus in pregnancy, or
         descent of the child's head in labour.
       : Helminthica.  Accompanied  with a discharge of worms
            of  a peculiar kind.
       £ Polyposa.   The  bladder  or urethra, or both, obstructed
            by the formation of a polypous excrescence;  sometimes
            shooting to the external extremity.
     See Baillie,  Morb. Anat. Fas. vii. pi. 4.
4. mellita.   Urine discharged freely,  for the most  part profusely;
                of a sweet smell and taste; with great  thirst, and
                general debility.
  4. P. Mellita, (foxGyrys, " a  siphon," from hxGxtva, " transeo.")
Diabetes,  among the Greek and Roman, and indeed among modern
physicians till the time of Willis, imported simply immoderate flow
of urine:  the secretion of saccharine urine never having been no-
ticed till his day: and hence, in Sauvages, it signifies equally immo-
derate  flow of urine from hysteria, gout, fever, spirituous potation;
or urine combined with saccharine matter.  Now the only relation
which  the last has to the rest is that of its being usually secreted in
a preternatural quantity: but as this, though mostly, is  not always 
348
NOSOLOGY.
[CL. VI.—OR. II.
Diabetes.  Plouquet.
Diabetes Anglicus.   Sauv.
Diabetes Mellitus.  Cull. Criclit. et Auct. Alior.
 the case, it has no pretence whatever to the name of diabetes, and
 ought to form a distinct division.  Or  if the name of diabetes be
 applied to it, it should be given to it exclusively.  Dr. Young, who
 retains the name in the latter sense,  and employs it  as that of a
 genus, justly  allows but one species to  the genus, diabetes mellitus
 of Cullen ;  and describes the diabetes insipidus of Cullen under the
 genus and  species of hyperuresis aquosus.  There is great  doubt
 whether this  last ever exists  as ah  idiopathic  affection.  Cullen
 himself indeed candidly expresses the uncertainty of his mind upon
 this subject 5  almost all the cases of  diabetes of late times, he ob-
 serves, exhibit saccharine urine, " ita ut dubium sit, an alia diabetis
 idiopathicae et permanentis species revera delur."   If such should
 be found, it will probably be  nothing  more than a variety of the
 next species in the present arrangement, paruria incontinens.
   Diabetes, then, seems properly arranged as a  species of paruria,
 and the common essential name of mellita cannot well be exchanged
 for a better.   Parr has made diabetes a species  of a  genus,  which
 he calls apocenosis, including vomiting, purging, immoderate sweat,
 salivation,  matted hair, and  various other affections which have lit-
 tle natural connexion with each other :  and hence diabetis mellitus
 sinks into a mere variety of this generic and incoherent cluster.
   Concerning the cause of this extraordinary affection  we are still
 considerably in the dark.  The two principal hypotheses that have
 been started are contained in the following extract from Mr. Cruick-
 shank.  " In the diabetes it  has been supposed that the chyle  flows
 retrograde from the thoracic duct into the lymphatics of the kidney ;
 from them into the cryptae,  so  into the tubuli uriniferi, thence into
 the infundibula pelvis, ureter, and so into the bladder.   This opinion
 is mere supposition, depending on no experiments ; and, besides that
 all such opinions should be rejected, why should the chyle flow retro-
 grade in the lymphatics of the kidney, and  not in the lacteals them-
 selves?  And  why are not the  feces fraught with a similar fluid as
 well as the urine ?  The arteries of the kidneys are, on these occa-
 sions, preternaturally  enlarged, particularly those of the cryptae or
 minute glands which secrete the urine: and it  is infinitely  more
 probable that the fluid of the diabetes arises from some remarkable
 change in  the vessels usually secreting the urine, than from any
 imaginary retrograde motion of the chyle through the lymphatics of
 the kidneys."   On the Lacteals and Lymphatics, p. 69.
   See  a valuable paper on the subject of  diabetes by  Dr. Henry,
 Trans. Medico-Chirurg. Soc- Vol. II. 118, in which the affected urine
is shown to be of greater specific gravity than in its natural state ;
 exhibiting from 1028 to 1040, compared with 1000  parts of water. 
GE. HI.]
NOSOLOGY.
349
       Apocenosis Diabetes mellitus.   Parr.
       Nufas.  Arab.
5. incontinens.  Frequent or  perpetual discharge of urine, with
                     difliculty of retaining  it.
       Incontinentia urinae.  Sennert.                    '
       Perirrhoea, (vt^potx.)  Hippocr.
       Stranguria.   Gal.
       Enuresis.  Sauv.  Linn. Vog.  Sag.  Cull.
       Hyperuresis.  Young.
       Seles.   Arab.
       Harnfluss.   G.
       Incontinence d'urine.  F.
       Incontinence of Urine.
       x Aeris.  From peculiar acrimony in the fluid secreted.
       P Irritata.   From peculiar irritation  in some part of the uri-
                     nary channel.
         Enuresis irritata.   Cull.
while natural urine is  under 1020.  The saccharine matter it con-
tains appears to be of nearly, or altogether, the same nature as the
saccharine matter of vegetables.   The  urine  seems also to be to-
tally destitute, or very  sparingly possest, of urea, or the ammoniacal
secretion.  In opposition to the  two theories of  a mere morbid
state of the secreting organ, and  that of the assimilating or diges-
tive function, Dr. Henry conceives that both are in a diseased con-
dition.
  After Willis had shown that sugar existed in  a  detached state in
this kind of urine, various analysts endeavoured to ascertain its pro-
portion.   Dobson from a pound of urine collected an ounce of sac-
charine matter : Cruickshank from thirty-six  ounces troy, obtained
by evaporation not less  than  three ounces and  a quarter;  vvhich,
from the quantity discharged by the patient, would have amounted
to not less than  twenty-nine ounces every twenty-four hours.
  A similar complaint is to be traced amongst  plants,  though the
author does not  remember to have seen it  noticed as such  by  any
physiologist.  What the diabetes, honey-water, or  honey-urine is to
animals, the melligo or  honey-dew seems  to be  to  the vegetable
tribes.  In both an ordinary aqueous  secretion is for the most part
increased in quantity, and constantly combined with a production of
saccharine matter; and in both the effect is great  debility, atrophy,
and emaciation of the vital frame.  The plant usually recovers, be-
cause the coldness of the winter, that puts a stop  to its natural ac-
tions, puts a stop also  to those that are morbid :  the animal usually
dies, for in him there is no such regular sessation :  but in evergreen
plants, which suffer no winter torpitude, the disease is often as fatal
as among mankind. 
350
NOSOLOGY.
[CL. VI.—OR. 11.
     Discharge  of  hairs.    Klatt.   de  Trichias,  Alton
   1703.
y  Atonica.   From atony of the sphincter of the bladder.
   Enuresis irritata.   Cull.
£ Aquosa.  From superabundant secretion;  the fluid limpid
     and dilute.
   Hyperuresis aquosa.  Young.
     Variety  £ found occasionally, also,  as a symptom  in
   pregnancy, catamenia, sparganosis, and lithia.  y in puer-
  peral debility, paralysis, and  coma.   <? in  hysteria, hypo-
  condrias, and other nervous affections.
     The  quantity discharged has occasionally been  enor-
  mous.   Sometimes forty  pints a  day;  Dodonozus, Obs.
  Med. exempl. var. cap. 42.—3674 pints in ninety-four
  days; more than thirty-nine pints a day for the whole term:
  Barati, Casso  proposto a Ludovico Testi.—4171 pints
  within ninety-seven days; just forty-three pints  a day
  through the entire term; Comment. Bonon. Tom. I.—200
  pints  daily, time  not mentioned;  Fonseca  de  Naturae
  Artisque miraculis, p. 538.
   The honey-dew is, in general, produced suddenly, by a peculiar
haze or mist apparently loaded with a specific miasm, or other ma-
terial,  poisonous  to  certain  kinds of  plants, though innoxious to
others.   The leaves and often the stems which it affects, as it creeps
along, immediately throw forth an augmented secretion from  their
surface,  more viscid in texture, and, as just observed, considera-
bly impregnated with sugar.   Insects of various kinds are instanta-
neously attracted  by  the secretion, and particularly different species
of the aphis, or green-louse, which find in this  morbid material a
rich harvest of food, and instantly cover every part of the  plant
with viviparous or oviparous young, so minute as to be almost invi-
sible to the naked eye ;  but which are soon  traced  in the shape of
innumerable  hosts of green lice, whose voracious appetite still far-
ther exhausts the sinking plant, and extends the scene of vegetable
desolation through a wide and dreary range.  Such is the sad pic-
ture which has just  been  presented to the author's eye on visiting
various hop-plantations in the county of Essex, most of which  have
been suffering severely, and the greater number of vvhich have lost
the whole of their produce.   In  several  instances he found  it not
difficult  to trace  the course in vvhich the  pestilential  haze had
moved forward; for  while a few hop grounds lying out of its track,
or merely bordering  on it, seemed to have escaped with little com-
parative injury, a few strips of the plantations that were most affected 
GE. III.]
NOSOLOGY.
351
6. incocta.   Urine consisting of fluids taken into the stomach, and
                 excreted without  change.
          See Bartholin. Hist. Anat. Cent. I. hist. 68.   Sylvaticus,
       Consil. Cent. III. n. 41,42.   Trincavel.  De Ratione Cur.
       part. corp. hum.  Oil of almonds, without change ; Bache-
       toni, Comment.  Bonon. Tom. II. part i.   Prussiat of potass,
       and  apparently without passing  through  the  circulation;
       Wollaston  and  Marcet,  Phil.  Trans.  ,1811.   Rhubarb;
       Home, Id.
7. erratica.   Urine discharged at some  foreign outlet.
       Uroplania.  Auct. Var.
       x  Salivaris.  By the salivary glands.  Phil. Trans, passim.
       /3  Cutanea.  By the skin.   Id.
       y  Umbilicalis.   At the navel.   Act. Erudit. 1760.
       ^  Vaginalis.   By a fistulous opening into the vagina. Valis-
           nerii.  Oper. iii.
       e  Perinaetica.   By  a fistulous opening into  the perinaeum.
            Ibid.
by it, from the same  cause  escaped equally;  and, being free from
the malligo or honey-dew, were free  also from  the  assault of the
aphides, that  were attracted  by it, with a leaf nearly as clean, and a
fruit as sound as if no such disease had existed in the neighbourhood.
The mischief of this little insect is terribly augmented by the curi-
ous  faculty it possesses of  having  various ova  impregnated  by a
single copulation; so that the female is able to breed eight or nine
times in succession without  further sexual intercourse ;  and by its
breeding  oviparously in the colder part of  the  autumn, by which
the young are defended from the weather, instead of viviparously,
as in the summer.
  6. Paruria erratica. This disease has often  been described under
the name of uroplania (from  ot»£«v, and TeXx^irys, erraticus,) but seldom
introduced into nosological arrangements.  The cases, however, are
so numerous and distinct, in writers of good authority, that  it ought
not to be rejected. In most instances it is not a vicarious discharge;
in other words, a secretion of a different kind  compensating for the
absence of urine, but a discharge of an urinous fluid, apparently ab-
sorbed after its secretion by the kidneys, and conveyed to the outlet
from which it issues: of the manner of which conveyance we are as
ignorant as of the mode by which various  substances travel from the
stomach to  the  kidneys, apparently without  passing through the
general course of the circulation of the blood. 
30»2
NOSOLOGY.
[CL. VI.—OR. H.
                       GENUS  IV.

                          LITHIA.

     Morbid secretion, or accumulation of calculous matter in inter-
         nal cavities.
       Lithiasis.   Plouquet. Macbr.  Young.
       Morbi calculosi.  Sauv. Class. Morb. ^Etiol.
1.  renalis.  Pain in the loins shooting down towards the testes or
                thighs, increased on  exercise;  urine often deposit-
                ing a sabulous sediment.
       Lithiasis nephritica.  Macbr.
       Lithiasis renalis.   Young.
       x Calculosa.  Pain severe and constant; sabulous discharge
           small and seldom, or never: calculus usually large, and
           obstructing the pelvis of an ureter.
         Nephralgia calculosa.  Sauv.
           See Baillie, Morb. Anat.  Fasc. vii. pi. 5, 6.
       0 Arenosa.  Pain intermitting; free discharge of a sabulous
           sediment.
         Griess in den nieren.   G.
   Gen. IV.   Lithia : from XtOos, or rather from  XtSxa, u calculo
laboro."   The name among the old writers, and which was received
by Dr. Macbride, and  has been continued by several  since, was
lithiasis.   It is only  in the  present case altered to lithia, because
iasis is a common termination for diseases affecting the skin or cu-
ticle.
   It is singular that this disease is only indirectly glanced at by most
of the preceding nosologists, and  not  at all in its first variety, ex-
cept by Sauvages, who alludes  to it in his genus nephralgia: while
stone in the bladder, both by himself and Cullen, is  reduced to a
mere species, or rather a variety of dysuria or strangury :  as though
the peculiar symptoms and  general nature of these affections were
not sufficient to constitute a distinct genus.   The error, however,
is in both  instances rather to be ascribed to an  imperfection  in the
respective classifications, than  a  deficiency in the  judgment, of
these celebrated writers.
   The name of lithus, or lithiasis, as used by Araeteus and Aurelia-
nus, and that  of calculus or sabulum as  employed by Celsus and
Pliny, sufficiently evince the elementary  principles,  of  which the
Greeks and Romans conceived urinary calculi to consist.   The mis-
take is not to be wondered at when we reflect that it is not till about 
GE. IV.]
NOSOLOGY.
353
         Gravelle.  F.
          Gravel.
            Both varieties found in most quadrupeds.   Traced by
         Fourcroy in the horse and cat;  by the younger Morand in
         the rat.
2. vesicalis.  Frequent desire  of making water, with  difficulty
                  of discharge: penis rigid, with acute pain at the
                  glans;  sonorous resistance to the  sound  when
                  searching the bladder.
       Lithiasis cystica.   Macbr.
       Lithiasis vesicalis.  Young.
       Dysuria calculosa.  Sauv.
       Dysuria irritata.   Cull
       Calculus vesicae.   Sennert.
       Hesat.  Arab.
       Blasenstein.  G.
       Calcul de  la vessie.   F.
       Stone in the Bladder.
         Voided  of the weight of 2  oz.  by a  female;  Hanow,
       Seltenheiten der  Natur.—2\ oz. troy  by a female; Moli.
thirty years since that these  principles were detected with any de-
gree of accuracy; and that we are indebted to the minute and ela-
borate  experiments of Fourcroy and Vjuquelin for an analysis,
which not only Van Helmont, Hales, and Palucci, but even Scheele,
Bergman, Hartenkeil  and  Pearson had left  unfinished : and vvhich
still required the correcting hands of Wollaston and Berzelius to be
brought to a desirable perfection.
  Fourcroy asserts that oxen have urinary  calculi in  great abun-
dance after  dry  seasons ; which disappear in spring  and summer,
destroyed by the green  succulent food  which  is hereby afforded
them;  and  he hence reasons upon the advantage of similar food to
mankind in similar cases.   Two of the best essays upon the subject
are those of Mr. Brande on the benefit of magnesia in preventing
an increased formation of uric acid, published in the Phil.  Trans, for
1810, p. 136; and 1813, p.  213.  In the Transactions of the Acade-
my at Stockholm, a decoction of the beans of the phaseolusraefia/ws,
and the powder  of the uva  ursi are recommended by Linneus as va-
luable lithontriptics. See Tom. i. 225. Beskrifnig pa° etslag Ostin-
diskar Arter.  Also id. p. 279, Ron om  orsaken  til Fallende goten i
Skane ock Wernsharad.  A milk diet is also strongly advised, from
various cases in  which it seems to have been very successfully em-
ployed.   Genesis. Calculi. Resp J. O. Hagstrom. 1740.
  2.  Lithia vesicalis.   The shortness and expansibility of the female
urethra  not  only admits an  evacuation of large calculi  with little in-
  vol. v.—56 
354
NOSOLOGY.
[CL. VL—OR. in.
neux.—5 oz. by the penis;  Sammlung Med.  Wahrn,  Band
viii. p. 258.
   Extracted  12 oz. weight;  Cheselden,  Anat.—12 oz.;
Ephem. Nat. Cur. Dec. II. ann. v.—22 oz Fabr. Hild. de
Lith.  vesic.   Same weight, cent. iv. obs.  51 :  the patient
died during the operation.
   Found in the bladder 4§lb. weight;  Bred.  Sammlung,
1724, ii. 434  II.   In  the  bladder  of a dog Hlb .  Eph.
Nat.  Cur.  II  Dec. III. arm v. vi.  p. 99.  Nearly 51b. in
the bladder of a horse; Gattenhof, in Diss, de  Cal.  1748.
2—3  oz Phil. Tr. vol.  xv. p. 1015.
   The number of  120 of various sizes voided  in the course
of three days.   Eph. Nat.  Cur. Dec. 111. ann. v. vi.—300
large  in two  years.  Fabr. Hild. cent. i. obs.  69.—2000
wi'hin two  years.    Grtindlicher Bericht vom Blatterstein.
   Resonant; Brest. Sand. 1724.   Woolly; Bartholin. Act.
Hafn. ii. obs.  55.
   See for the chemical principles of stone in the kidney or
bladder, Phil. Trans. 1797, Wollaston. Id. 1808, Home and
Brande.
                      ORDER  III.

                    A C  R 0 T I C A.

            AFFECTING THE EXTERNAL SURFACE.

  Pravity of the  fluids or  emunctories that open on the externa]
surface:  without fever, or other internal affection, as a  necessary
accompaniment.
convenience compared with that suffered by men, but has often sug-
gested the expediency of introducing the stone forceps into the blad-
der, so as to supply the place of lithotomy.  Mr. Thomas, by gra-
dually enlarging it by means of a sponge-tent, was, in one case, able
to introduce his finger into the bladder, and succeeded in bringing
away an ivory ear pick which had been incautiously used as a cathe-
ter, and had slipped into the cavity of the bladder.   In another sin-
gular case, the same skilful operator gradually expanded the spincter
ani to a diameter large enough to admit his whole hand into the 
GE. I.]
NOSOLOGY.
355
                         GENUS I.

                  EPHIDROSIS.

     Preternatural secretion of cutaneous perspiration.
       Ephidrosis.   Hippocr. Sauv. Sag.  Cull.
I. propusa.   Cutaneous perspiration secreted profusely.
       Ephidrosis spontanea.  Sauv.
       Ephidrosis idiopathica.  Cull.
       Sudor.  Linn.
       Hydropedesis.   Vog.
       Areknak.    Pers.   Literally  " sudor  perfusus."   Turc.
         derlu, or, as vulgarly pronounced,  terlu.
2. cruenta.  Cutaneous perspiration intermixed with blood.
rectum,  and hereby succeeded in extracting a large substance that
had slipped into its channel. Medico-chirurg. Trans. Vol. i. 124.
  Order III.  Aorotica.   From xxps, " summus,"  whence xxp-
■Txrns, «' sunnnitas," " cacumen." The genera and species are taken
as i.early as  the system would allow from Dr. Willan's Cutaneous
Diseases.
  Gen. I.  Ephidrosis.  'E<ptfyatris, " sudor."  The matter of sweat
ar.d of insensible peispiration is nearly the same; the former con-
sisting of the latter with a  small intermixture of animal oil.  It is
affiimed by some writers  that there are  persons who never  per-
spire.   This is doubtful; for ali warm-blooded animals either per-
spire by the skin, or  have  some vicarious evacuation  that supplies
its place, as in the case of  the dog kind,  in which an increased dis-
charge of saliva seems to  answer  the purpose.  In  cold-blooded
animals we sometimes find partial cutaneous secretions,  as in  the
lizards, the exudation from some of which, particularly the lacerta
Geitja of the Cape of Good Hope, is highly acrid, and occasionally
proauces dangerous gangrenes. Generally speaking, however, cold-
blooded animals secrete but a small quantity of fluid on the surface,
and hence  suffer but  little  exhaustion or diminution of  weight in
long periods of time,  and can live long without nourishment.  And
it is hence  probable that, among mankind, those who throw off  but
a small portion of halitus,  may exist upon a very spare  supply of
food; which may afford a  solution to many of the wonderful cases
of fasting  persons recorded in  the scientific journals of different
countries:  for the matter of insensible perspiration  is calculated,
upon a fair average, as being daily equal  in weight to  half the food
introduced  into the stomach in the  course of the day.  Thus if a
man of good health and  middle  age and  stature, weighing about
146 pounds  avoirdupois, eats and  drinks at the rate of fifty-six 
356                      NOSOLOGY.          [CL. VI.—OR. III.

       Sudor cruentus.   Albert. Wedel.
       Sudor Sanguineus.   Jantke. Minadoi.
       Haemai idrosis.   Plouquet.
          This  species has not been very commonly noticed by no-
       sologists; but the cases of idiopathic affection  are so nume-
       rous and so clearly marked by other writers that it ought not
       to be passed over.   It has sometimes  occurred during coi-
       tion.  Paulini cent. iii. obs. 46.   Sometimes  in  new-born
       children.  Eph. Nat. Cur. Dec. ii. ann. obs. 65.   Another
       case, obs. 179.   Other cases of its secretion during coition,
       Ann vi.  Appendix, p. 4. 43. 53.  From  fear, Stahl Diss.
       de Passionibus.   Hallae,  1691.
3. partialis.  Cutaneous perspiration limited to a particular part
                 or organ.
          Ephidrosis lateralis.  Sauv.  who  quotes  from  Schmidt,
       Collect.  Acad  iii. 577, the  case of a woman who was never
       capable  (except  when  pregnant) of  being  thrown into a
       sweat in any other part than the left side.
4. tincta.  Cutaneous  perspiration   possessing   a  depraved co-
              lour.
       x Viridis.  Of a green tinge.  Sauv.  Borelli.  cent. ii. 56.
       /3  Nigra.  Of a black tinge.  Sauv. Joel. Langelot.  Collect.
            Acad. III.  255.
       y Caerulea.   Of a  blue tinge.  Sauv.   Winder.   Collect.
            Acad. III. 263.
       ^ Rubra.   Of the colour of port-wine.  Sauv. Barthol
5. olens.   Cutaneous   perspiration,   possessing   a   depraved
             smell.
       x Sulphurea.  Of a sulphurous scent.  Ephem. Nat.  Cur.
           Cent. I.  II. obs. 168.
ounces  in twenty-four hours,  he will commonly be found to lose
about twenty-eight ounces within the same period by insensible per-
spiration ; sixteen  ounces during the two-thirds of this period de-
voted to wakefulness,  and twelve ounces during the remaining third
devoted to sleep.
  It sometimes happens that this evacuation is  secreted in excess,
and  becomes' sensible, so as to render the whole,  or various parts
of the body, and  especially the  palms of the hands, covered  with
moisture, without any general  affection of the system.   And it is to
this  species that the term ephidrosis has been usually applied and
limited  by nosologists.  Sauvages, however,  has employed  it in a
wider signification,  so as to  include all the  other  species  here
enumerated;  and  perhaps correctly, though  Cullen  inclines to 
GE. II.]
NOSOLOGY.
357
       (9 Acida.   Of a sour scent.
         Ephidrosis acida.   Sauv.
       y Olida.   Of a rank or fetid scent.   Often partial, or eva-
            cuated from particular organs, as the feet  or axillae:
            sometimes from the surface generally, according  to De
            Monteaux.
         Ephidrosis a saburra.   Sauv.
       S* Moschata.   Of a musky scent.  Pecklin. lib. ii. obs. 49.
            Several of the varieties in  sp. 3 and 4 found also occa-
         sionally as symptoms in fevers of various descriptions, ex-
         anthems, syncope, porphyra; and as consequent upon va-
         rious metallurgical, and  other trades.  Suppressed natural
         secretions of other kinds are  also often combined with the
         matter of cutaneous  perspiration by metastasis, as in sup-
         pression  of milk, of urine, of catamenia, and, as has been
         said, of  feces.



                       GENUS   II.

                   EXANTHESIS.

     Simple, cutaneous, rose-coloured efflorescence, in circumscribed
       plots, with little or no  elevation.
       Cutaneous  blush.
1. roseola.  Efflorescence  in blushing patches, gradually deepen-
                ing to a rose-colour, mostly circular or oval;  often
                alternately  fading and reviving;  sometimes with a
                colourless nucleus: chiefly on the cheeks, neck, or
                arms.
       Roseola.   Severin. Willan.
       Rose-Rash.
regard the whole of them  as  merely symptomatic of some  other
affection.
  Gen II Exanthesis.  From «|, " ex, extra," and xvfaa," floreo;"
superficial, or cutaneous efflorescence, in contradistinction to " enan-
thesis" (evxiitio-vs,) in the present system a genus of Cl. III. Ord. III.
importing " efflorescence springing from within," " rash-fever:" which
see.   The author would  have  preferred  eirxi6i)(rts, for the  mere
reason that it occurs in Aristophanes, rts pmXottrtt EfiHNGEl XNOYZ :
(In Nub.) but that ex, or t%, is the preposition prefixed, and most
applicable, to  several of the other  genera in  this order, and forms
a better contrast to tv, its  opposite,  than tvt does. 
358                       NOSOLOGY.           [CL. VI.—OR. HI

         Found also, frequently, as a symptom, in dentition, dys-
       pepsy, various fevers, and other constitutional affections.
                  GENUS III.

                 E X  O R M I  A.

Small, acuminated elevations of the cuticle;  not containing a
     fluid, nor tending to suppuration; commonly terminating
     in scurf.
  Papula.   Cels. Sauv. Linn.
  Papulae.   Willan.
  Papidous skin.
  Common pimples.
  Knoten.   G.
  Boutons.  F.
   Gen.  III.  Exormia.  'Efy^pMx, exSvpuc, " papula."  So  Galen,
" apertum est ab exivttt, quo . est efeffuev, id est erumpere, derivatum
esse exivptxTt, id est  papulis, nomen, in iis quae sponie extub rant
in cute."  In lib. iii Hippocr.§5l.  " It is obvious that from exDvetv,
synonymous with £%ogputv, or «• to break out," is derived toe term ec-
thyma, or papula, in  those cases in which the eruption takes place
on the skin  spontaneously."   Ecthyma, however, has  from some
cause or  other, been generally supposed to import a species of large
pustules.  It is used expressly in this sense in our own day  by Dr.
Willan and Dr. Young; and the author Iijs, therefor  , to avoid con-
fusion, appropriated its synonym exormia or exormis  («£«?;»») to im-
port an eruption of common papulae or  pimples.
   Papula, indeed, is itself of Greek origin, being derived from pap-
pus or -rxT7r$s, " the  sprouting of down or buds," and  hence " the
sprouting of the beard."  The radical sense is " production or push-
ing forth ;" for irxvirxs means father, and nxirxos, in its primary sig-
nification, grand fatner; and hence papilla, auothei diminutive from
the same stock, imports nipple, the sprouting  channel  of  maternal
nutriment.
   The common  terminating diminutive ula or ilia is probably deriv-
ed  from  the Greek  vXt, (ule or yle) " materia, materies," " of the
matter, make, or  nature of;" thus  papula or papilla, " of the  matter
or nature of  pappus ;" lupula, " of the  matter, make, or nature  of
the lupus;" tubula or tubulus, *' of the  matter, make, or nature of
the tubus;"  pustula," of the matter, make, or  nature of  pus;" 
GE. III.]
NOSOLOGY.
359
1. Strophulus.   Eruption of red pimples in early infancy, chiefly
                    about the face, neck, and arms; surrounded by
                    a reddish halo: or interrupted by irregular plots
                    of cutaneous blush.
       Strophulus.   Willan.
       Licheniasis Strophulus.   Young.
       Exanthema Strophulus.   Parr.
       x Intertinctus.   Pimples  bright-red ;  distinct,  intermixed
            with stigmata, and  red patches: sometimes spreading
            over the body.
         Strophulus intertinctus.  Willan.
         Rothe.   G.
         Efflorescence benigne.   jF.
         Red gum.   Red gown.
tubercula or tuberculum, " of the matter, make, or nature of the
tuber:"  and so of various others.  So the Anglo-Saxon kin or kind
(rynn) is used as a diminutive in the  English lamb-kin, man-akin,
&c.   In  the cognate dialect of Germany, this last diminutive is em-
ployed still more extensively,  for  here  kind, as a single word, im-
ports child, infant; family or relative origin ; the first make or mat-
ter of kindred.
   Papula and  pustula. which  by Sauvages are degraded into mere
symptoms of diseases, and not allowed  to  constitute diseases of
themselves, are raised to the rank of genera by  Celsus, Liniieus,
and  Sagar, and, under a plural  form,  to that of orders by Willan.
In the present system exormia and ecphlysis, intended to  supply
their place, are employed as collective terms, and  run  parallel with
those papuiae and pustulae of  Willan which are not essentially con-
nected with internal disease ;  and  are  only made  use  of instead of
papula and pustula, first as being more immediately  Greek, and
next  in  order  to prevent confusion from the variety of senses as-
signed to the latter  terms by different writers.   Exormia and ec-
phlysis, therefore, as distinct genera under the present arrangement,
import eruptions of  pimples and  pustules in  their simplest state;
affecting the cuticle,  or at the utmost  the superficial integument
alone, and consequently  without  fever or other internal complaint
as a necessary or essential symptom ;  although  some part or  other
of  the system may occasionally  sympathise  or catenate with the
efflorescence.  It is difficult, indeed,  to draw a line of separation,
and  perhaps impossible to draw it exactly, between efflorescences
strictly  cutaneous  and strictly constitutional, from the numerous
examples we meet with of the one description  combining with or
passing  into  the other.  But  this is a difficulty which belongs  to
every other branch of physiology, in the widest sense of the term,
as well as to nosology j and all we can do,  in  any  division  of the 
360
NOSOLOGY.
[CL. VI.—OIL III.
 /3 Albidus.  Pimples minute, hard, whitish; surrounded by  .
     a reddish halo.
   Strophulus albidus.   Willan.
   White gum.
 y Confertus.   Pimples red, of different sizes;  crowding or
     in clusters;  the larger surrounded by a red halo; occa-
     sionally succeeded by a fresh crop.
   Strophulus confertus.   Willan.
   Tooth rash.
^  Volaticus.  Pimples deep-red, in circular patches or clus-
     ters; clusters somewhat solitary on each arm or cheek;
     more generally flying from part to part.
   Strophulus volaticus.   Willan.
   Erythema volaticum.   Sauv.
s Candidus.  Pimples large, glabrous, shining; of a lighter
     hue than the skin: without halo or blush.
   Strophulus candidus.    Willan.
 science, is to lay down the boundary with as much nicety and cau-
 tion as possible, and to correct it, as corrections may afterwards be
 called for.   Dr.  Willan's plan, which is merely monogrammic, or
 confined  to a single division of  diseases,  enabled him to unite dis-
 orders which have often very little connexion with each other, as
 exanthematous fevers, with  local diseases of the skin; small-pox,
 for example, with itch, which comes next to it, from the mere cir-
 cumstance that  both  exhibit efflorescences of some kind or other.
 But this is a plan which,  without  entering into its merit, could not
 be followed  in  any system attempted, like  the  present, upon a
 physiological basis, and taking for its range  the whole catalogue of
 diseases which flesh is heir to.   It is on this  account that variola
 and elephantiasis, by Willan introduced  under pustula, and tuber-
 culum, are  necessarily  in  the present  arrangement  removed to
 other divisions of the system ; for while Willan employs the terms
 pustulae and tubercula in  the double sense of pustules or tubercles
 with essential affection of the constitution, and without such essential
 affection, ecphlysis  and ecphyma are here limited to the last.
   Generally  speaking,  therefore, the species arranged under  the
 present order will be found simple cutaneous diseases, and  in their
 purest state perhaps always so.   There  are, however, as  already
 hinted at, certain idiosyncrasies,  or occasional conditions of the con-
 stitution, by which they are more readily  produced, or with which
they more readily associate;  such especially as a lax state of the
fibres, a languid  circulation, a  general   irritation  of  the system,
whether habitual or the result of accidental debility, or some pecu-
liar affection of the head,  stomach, or other  organ; and hence  we
occasionally meet with a few varieties or modifications of  several 
ge. in.]
NOSOLOGY.
361
2. lichen.   Erup'ion  diffuse; pimples  red;  troublesome sense of
              tinging or pricking.
       Lichen.   Willan.
       Zitterich.   G.
       x Simplex.   General  irritation,  sometimes  a few  febrile
            symptoms at the commencement; tingling aggravated
            during the night; pimples scattered over the body; fade
            and desquammate in about a week.
         Lichen simplex.   Willan.
       p Pilaris.  Pimples  limited to  the roots of the hair; des-
            quammate after ten days:  often alternating with com-
            plaints of the head or  stomach.   " Only a modification
            of the foregoing."   Will.
         Lichen pilaris.  Willan.
 species of cutaneous affection, in  which  the  system  at  large, or
 particular parts of it, appear to catenate with  the  disease,  either
 antecedently, progressively, or alternately.  This is sometimes the
 case wuh strophulus,  an.-:,  indeed, with all the species of exormia
 or papuiae ;  which, nevertheless, more generally exhibit themselves,
 and even under their severest modifications, without any apparent
 constitutional  affection  whatever;  of which  the prickly heat, or
 lichenose exormia of the West Indies, may be adduced as a striking
 example.  Lepra or lepriasis is regarded us a constitutional malady
 by many writers of recent times; but it was not so regarded  either
 by the  Greek or Arabian physicians who duly distinguished it fiom
 elephantiasis; nor is it so regarded by Dr. Willan,  who ascribes it
 chiefly to  cold, moisture, and the accumulation of sordes on  the
 skin, especially in persons of a slow  pulse, languid circulation, and
 a harsh, dry, and impermeable cuticle.  See  his Ord. II. p. 119
 120, 123.—These observations will  apply equally to the pustular
 and vesicular eruptions;  which are strictly cutaneous in their pure
 or simple state, though in a few varieties complicated, from  pecu-
 liarity of temperament or other cause, with some  internal  affec-
 tion.
   Similar to this was  the opinion of Mr. John Hunter, not only in
 regard  to these cutaneous diseases, but to various affections of the
 surface of internal canals,  of a  character decidedly inflammatory,
 and  making a near approach to erysipelas.  " This affection," says
 he, " appears to support itself by continued sympathy,  for it  com-
 monly begins at a point,  and spreads  while  it shall be getting well,
 where it first began.   This  cannot be  merely constitutional^  for if
 it was,  the part already inflamed could not recover, if its increase
in new parts  arose from  the  constitution;  but it gives the idea that
 when the parts have once gone  through this action they lose the
disposition, ™d become  healthy.  Thisjjroperty is  not peculiar  to
  vol. v.—57 
                 NOSOLOGY.           (CL. VI.—OR. HI.

 Circumscriptum.  Pimples in clusters or patches of irre-
   gular forms, appearing in succession over the trunk and
   limbs:   sometimes  coalescing:  occasionally  reviving
   in successive  crops, and  persevering  for six or eight
   weeks.
 Lichen circumscriptus.  Willan.
 Lividus.  Pimples  dark-red or  livid;  chiefly scattered
   over the extremities; desquammation at uncertain  pe-
   riods, succeeded by fresh crops, often persevering for
   several months.
 Lichen lividus.   Willan.
 Tropicus.   Pimples  bright-red, size  of a small  pin's
   head; heat, itching, and pricking as of  needles;  some-
   times suddenly disappearing,  and producing  sickness or
   other internal affection; relieved  by the return of a
   fresh crop.
     Attacks new settlers in the West Indies,  and other
   warm regions, and  leaves them in  a few weeks when
   inured to the climate.
 Eczesma.   Auct. Grozc.  SeeAet. Tetrab. IV. i. 128.
 Essera.  Plouquet.
 Sudamina.  Auct. Lat.
 Lichen tropicus.  Willan.
 Eshera, (Arab.) commonly but improperly written essera.
   It is the plural of sheri, papula, but peculiarly applied
   to this variety.
Rootvont   Belg.
Flacherothe flecke.   G.
Prickly heat.
Summer-rash.   Cleghorn.
this inflammation ; the ring-worm has this peculiarity, as also many
cutaneous ulcers.—There appear to be  two ways of accounting
for this, one is, that the whole  skin is very  susceptible of such
action, and  readily goes  on  with it by  continued sympathy ;  the
other is, that the inflammation  is such  as to contaminate  while it
spreads, but when it has once acted it is cured, as above observed.
If this last be a true bolution,  then the right practice would be  to
stop its progress by destroying  the parts beyond it."  On Blood, p.
271.  This practice  is in fact  often pursued, and  with success, in
poirigo or tinea, by a local application of a solution of lunar caustic.
   1. Exanthesis Lichen.  In the definition of the complaint the au-
thor has adhered as  closely to Willan as he has been able ;  but he
has been compelled to omit two of Willan's characters, that of the 
GE. III.]                    NOSOLOGY.                      363

       £ Ferus.   Pimples in clusters or patches, surrounded with
            a red halo;  the euticle growing gradually harsh, thick-
            ened and chappy; often preceded by general irritation.
         Lichen  agrius (*yf<««, ferus.)  Auct. Grozc.
         Papula agria.   Cels.
         Lichen agrius.   Willan.
            According to Paulus, iEgineta, and Orobasius, only a
         more violent and inveterate form of «.
       » Urticosus.  Pimples very minute, slightly  elevated, red-
            dish; intolerably itching, especially at night; irregularly
            subsiding, and re-appearing; chiefly spotting the limbs;
            occasionally spreading over the  body, with gnat-bite-
            shaped wheals:  from the violence of the irritation, at
            times, accompanied with vesicles or blisters, and sue*
            ceeded by an extensive exfoliation of the cuticle.
         Lichen urticatus.   Bateman.  Q?
         Nettle-lichen.
3. prurigo.  Eruption diffuse; pimples nearly of the colour of  the
                cuticle;  when abraded  by scratching, oozing a fluid
                that concretes into minute black scabs; intolerable
                itching,  increased by sudden exposure to heat.
       Prurigo.   Willan.
       Iklet.—Kejik.   Turc.
       x Mitis.   Pimples soft and smooth; itching, at times subsid-
            ing;  chiefly  common to the young, and in spring time;
            easily yields to a course of warm ablutions.
disease " affecting adults," and its being « connected with internal
disorder."  They are copied by Dr. Bateman, but are at variance
with the species enumerated under the  genus ;'for the livid lichen
(here marked  S) is expressly stated by Dr. Willan,  p. 50, to  be
common to " young persons  and even  children ;"  and the nettle-
lichen  (here marked Q is described  by Dr.  Bateman, p. 14,  as
" peculiar  to children," commencing  " in some cases soon after
birth, and  sometimes  later;"  while the  former observes, p.  39,
that the simple  lichen (x) "sometimes appears suddenly without
any manifest disorder of the constitution ;"  and states with respect
to the tropical  lichen (i)  from Winterbottom, Hillary, Clark, and
Cleghorn, that " it is  considered as salutary;" as " a proof that the
person affected with it is in a good state of health," p. 55 •, that " i« 
364
NOSOLOGY.           [CL. VI.—OK. III.
         Prurigo  mitis.  Willan,
       G Forrnieans.  Pimples varying from larger to more obscure
            than in the last; itching  incessant,  and accompanied
            with a sense of pricking, or stinging, or of the creeping
            of ants over the body; duration from  two months io two
            or three years, with occasional but short intermissions;
            chiefly common to adults.
         Prurigo forrnieans.   Willan.
       y Senilis.   Pimples mostly larger than in either of the above;
            sometimes indistinct, giving the surface a  shining  and
            granulated  appearance;  itching incessant; common to
            advanced years, and nearly inveterate.
         Prurigo senilis.   Willan.
            Most intractable in elderly persons who have been ad-
         dicted to spirituous drinks, whether ale, wine, or alkohol;
         and hence called by Darwin psora ebriorum, who believes,
         but without foundation, that  it may  be propagated from
         one  part of the body to another by scratching.
            Var. x occasionally terminates in contagious scabies; G
         in impetigo; y in malis pediculi.
4. milium.  Pimples very minute; tubercular;  confined to the face;
               distinct; milk-white; hard; glabrous; resembling mil-
               let-seeds.
       Grutumjsive  milium.   Plenck.
       Gries.   G.
seldom causes any sickness  or disorder, except  the troublesome
itching and  pricking," p. 59 ; that " it is not attended with any
febrile commotion, whilst  it continues out," p. 61 ; and that it "is
looked  upon  as a sign of health ; and, indeed, while it  continues
fresh on the skin no inconvenience arises from it, except a frequent
itching."—The subdivisions of Dr. Willan are denominated species;
but for the most part they are little more than modifications  of each
other, as he  candidly admits in one or  two instances, and  conse-
quently ought rather to be called varieties, as they are in the pre-
sent text.
  2. jj E. Lichen urticosus.  This variety is described from  several
strongly marked cases which have occurred to the author ; and has
a near  resemblance to the lichen urticatus of  Dr. Bateman.  The
varieties, however1, are innumerable.
  Gen. IV.  Lepidosis: from XtTts-ths, "squamma."   The Gieek
is preferred to the Latin teim, as concurrent with  the  general rule 
GE. IV.]
NOSOLOGY.
365
                     GENUS IV.

                  L E P I D O S I S.

Efflorescence of scales  over different  parts of the body,  often
  thickening into crusts.
     Lepidosis.  Young.
     Squammae.   Willan.
     Scale-skin.
     Kuba  or  Kouba. Arab.   The Arabic  term  is used  in 'a
       wide or generic sense  by most of the Arabian writers,
       and imports scaly eruptions of nearly every kind,  whe-
       ther dry or accompanied with a  purulent or other fluid.
       It is peculiarly thus employed by Avicenna and Serapion.
       Kuba is the plural  of kuveb: for the Arabians were fond
       of employing a plural noun: of which Eshera in the pre-
       ceding species  has just furnished us with an example. So
 adopted in the present system in regard to the names of the classes,
 orders, and genera.  The subdivisions are  for the most part taken
 from Dr. Willan: being pityriasis, from mrvgot, furfura, " bran or
 scurf;" lepriasis, from Xtv^s, scaber, « harsh, scabrous;" psoriasis,
 from •}»{*■ *cabies, (scabies sicca,) « scabid-scale ;" and ichthyiasis,
 from i^6vs, " a  fish."   The arrangement is a little changed  from
 that of  Willan, as pityriasis, the mildest  species, is, in Willan, im-
 properly placed between psoriasis and ichthyiasis, the two severest
 species.  In this part of the new arrangement Dr. Young has pre-
 ceded the author.  In  Willan these  subdivisions take the place of
 genera; here they are introduced as species;  and ought to  have
 been so in Willan, as they are sufficiently allied to each other for
 this purpose; and as otherwise, Dr. Willan has no species whatever
 and consequently no disease whatever;  for as  the author has fre-
 quently had occasion to observe already,  it is the species alone that
 constitutes a disease.  Dr.  Willan has indeed his subsections, but
 they are in every instance mere varieties, and are so understood and
 denominated by himself.—See his  Cutaneous Diseases, Lepra, p.
 106; Psoriasis, p. 151,  and  Pityriasis,  p.  192: in all  which  he
 passes immediately from genera to varieties, the important link of
 species- being singularly omitted.
  In Lepriasis, the last  variety (^) is added from Celsus;  and,  on
the authority of Dr. Bateman, as well as the accuracy of his dis-
tinction, the  author has  given it the synonym of  " Leprosy of the
Jews."   It exactly answers, indeed, to the Mosaic  account in Levit.
xiii. 3- 
366
NOSOLGGY.
[CL. VI.-OU. Ill
         morbilli was used instead of morbillus or morbillo, and
         we still continue to say measles, small-pox, (pocks,) aph-
         thae, &c.
            The  Persian synonym of  kuba is  perjun: which,
         like the former, is applied also to impetigo or running
         tetter.
1.  Pityriasis.   Patches of fine branny scales,  exfoliating  without
                 cuticular tenderness.
       Pityriasis.  Alex. Trail. Paul. JEgin.  Willan.
       Lepidosis Pityriasis.   Young.
       Schuppen.   G.
       Dandriff.
       x Capitis.   Scales  minute  and  delicate;  confined  to  the
            head; easily separable.  Chiefly common to  infancy,
            and advanced years.
         Pityriasis  capitis.   Willan.
         Hauptschuppen.  G.
       p Rubra.  Scaliness common  to  the body generally; pre-
            ceded by  redness,  roughness,  and  scurfiness of  the
            surface.
         Pityriasis  rubra.  Willan.
       y Versicolor.  Scaliness in diffuse maps of  irregular outline
            and divers colours, chiefly brown and yellow; for  the
            most part confined to the trunk.
         Pityriasis versicolor.    Willan.
  In the Amanitates Academica, Vol. VIII.  art. 167,  is a Disserta-
tion of Dr. Westring, in which he strongly recommends the decoc-
tion of the ledum palustre for the cure of leprosy, as well as of vari-
ous other cutaneous efflorescences, which, as already observed, the
Linnean school ascribed, in  almost every instance, to animalcules.
In Kamtschatka this plant has  long been employed  for the same
purpose, and  apparently with  a success superior to  that of the
solanum dulcamara.   Odhelius,  in the  Stockholm  Transactions for
1774, speaks in equal terms of  the  same plant; and gives us the
following form for using it.   Infuse four ounces of the ledum in a
quart of hot  water; strain it off when  cold;  and let  the  patient
drink from half a pint to a quart of it daily.
  The Indian name for leprosy is Kush'ta, and it is a frequent com-
plaint, especially in Mysore.  Among the Barbary states the use of
oil arganic as a fish sauce, and which is supposed to be of a heating
quality,  is regarded  as a very  common  cause of leprosy, (merd
jeddam) as it is here still vulgarly called,  and particularly in the
province of Haha, where this  kind of sauce is  in great repute. 
ttE. IV.]
NOSOLOGY.
367
2. Lepriasis.   Patches of smooth, laminated scales of  different
                   sizes, and a circular form*
       Vitiligo.  Cels.
       Lepra.   Willan. Young.
       Lepra Graecorum.  Auct. Var.
       Beras.—Boak. Arab.   Both terms  are  applied  to all the
          varieties of lepra by most of the Arabian physicians; but
          the first should, in strictness of language, be confined to
          lepra albida;  for it usually implies  whiteness, or splen-
          dour.   It is hence employed to signify  white  spots in
          cattle ;  while  beresa or  bersa imports,  according to
          Golius, " splendens albicante cute serpens:" Boak, in its
          radical idea, denotes vehemence and violence: it is often
          rendered  " ingens fluxus,"  " fragor," and  applied  to a
          storm.
       Aussatz.  G.
       Leprosie.  F.
       Leprosy.
       x  Vulgaris.   Scales glabrous ; whitish; size of a crown-
            piece;  preceded by smaller, reddish, and glossy eleva-
            tions of the skin, encircled  by a dry, red, and slightly
            elevated  border; often confluent;  sometimes covering
            the whole of the body except the face.
       Lepra vulgaris.   Willan.
       Common Leprosy.
       3  Albida.   Scales  whitish;  size of a silver  penny ;  de-
            pressed in the middle; chiefly confined to the extremi-
            ties.
          Alphos («x<pos.)  Auct. Grozc.  Cels.
          Lepra alphoides.   Willan.
       Beras  bejaz:  Arab, and sometimes bejaz  or white alone,
          synonymously with alphos.
The lepers of Haha are seen in parties of ten or twenty together,
and approach travellers to beg  charity.   In Morocco they are con-
fined to a separate quarter, or banished to the outside of the walls:
they are in general, however, but little  disfigured  by the disease
except in the loss of the eye-brows,  which the females endeavour
to supply by the use of alkohol  or lead ore, while they  give an ad-
ditional colour to their complexion by the assistance of al akken  or
rouge.  Preparations of arsenic are mostly relied upon  for a cure in
the east, and seem to have  been chiefly employed with advantage
in our  own country. 
368                       NOSOLOGY.           [CL. VI.—OR. III.

          Weisse-aussatz.  G.
          White Leprosy.
       y Nigricans.   Scales livid :  size  of a half-crown  piece ;
            diffused over the  body, but less widely than *.
          Melas (imXxs.)  Auct. Grozc. Cels.
          Lepra nigricans.   Willan.
          Beras asved.   Arab.
          Swarze aussalz.  G.
          Black Leprosy.
       } Canescens.  Scales white; hairs on the patches white or
            hoary; central  depression  deep; disease  more  invete-
            rate.
          Leuce (xtvxv.)  Auct. Grozc. Cels.
          Leprosy of  the Jews.   Henskr,  Von  Abendlandischen
            Aussatz, p. 341.   Bateman, p. 299.
               Several of the varieties found also occasionally as a
            symptom  or sequel,  in  lues; but distinguished by  a
            livid or chocolate hue.
               See Galeoti, Dissertazione  sopra le  malattie che si
            curano nel Regio Spedale di Sancto Eusebio.  Firenze,
            1771.
3. Psoriasis.  Patches  of rough,  amorphous scales; continuous, or
                   of indeterminate outline;  skin often chappy.
       Lepidosis Psoriasis.   Young.
       Psoriasis.  Willan.
       Impetigo.  Sennert.  Plenck et Alior.
       Scabies sicca.  Etmull. Hoffm  Plater.
       Hasef.  Arab.   Sauvages,  Vol.  I.  p.   136,  has confounded
          this with asef, or eczema.   The hasef of Avicenna is the
          present species; and is  directly translated  scabies sicca
          by Meninski and Golius.
       Kleinaussatz.   G.
       Scaly Tetter.—Dry Scale.  See Levit. xiii. 31—37.
       x  Guttata.  Drop like, but wilh irregular margin.  In chil-
            dren contagious.
         Psoriasis guttata.   Willan.
       pi Gyrata.   Scaly   patches   in  serpentine   or   tortuous
  4. Lepidosis Ichthyiasis.  The indurated incrustation exhibited in
this disease is  produced by a change in the papillae of the cutis ;
which  are elongated and enlarged into roundish cones or tubercles,
often void of sensation.   The  skin has, in  some  cases, been  found
thickened into a stout tough leather.  In a singular enlargement of 
GE. IV.]
NOSOLOGY.
369
             stripes.   Found chiefly on the back, sometimes on the
             face.
          Psoriasis gyrata.   Willan.
        y Diffusa.  Patches  diffuse,   with  a  rugged,  chapped,
             irritable surface; sense of burning and  itching when
             warm;  skin gradually thickened  and furrowed,  wilh a
             powdery scurf in the fissures;  extends over the face and
             scalp.
          Psoriasis diffusa.  Willan.
             Sometimes  preceded by  some  constitutional   affec-
          tion.
            When  limited to  the  back  of  the hand it  forms
          what  is  vulgarly called the  Baker's  Itch.    On the
          hands and arms,  sometimes  on the face  and neck,  is
          peculiarly troublesome to washerwomen; probably from
          the irritation of the soap they are continually making use
          of.
        f Inveterata.  Patches  continuous  over the whole surface;
            readily  falling off and reproducible, with painful,
            diffuse  excoriations;  extend to the  nails  and toes,
            which become convex and thickened.  Found chiefly
            in old persons.
          Psoriasis inveterata.   Willan.
        t  Localis.   Stationary; and limited  to  particular organs:
            as the lips, eye-lids, prepuce, scrotum, and inside  of
            the hands.
               In  the last form  peculiarly common to shoe makers,
            and  artificers in metallic trades, as  braziers, tinmen,
            and silversmiths: probably from filth, and  the irritation
            of the substances they make use of.
               Several of the varieties are found also occasionally  as
            symptoms  or sequels  of  lues,  particularly the first
            three: but are in every instance distinguished by the
            livid or chocolate hue of the scales.
4. Ichthyiasis.   Thick,   indurated  incrustation, encasing the
                    skin to a greater or less  extent: scaliness im-
                    perfect.}


the  lower extremity produced by  a  puerperal sparganosis, Mr.
Chevalier found the thickness of the corium in some  parts near a
quarter of an ich ; which, on  being cut into, presented   the  same
grained appearance that is observable  in a section  of the hides  of
the larger quadrupeds.  Below the coriaceous  skin,  the adipose
  vol. v.—58 
370
NOSOLOGY,
[CL.VI.—OR.HL
Lepra Ichthyosis.  Sauv.
Ichthyosis.   Willan.
Lepidosis Ichthyosis.  Young.
Fischschuppen-aussatz.   G.
Fish skin.
x Simplex.  Forming a  harsh, papulated, or warty  rind;
     hue dusky; subjacent muscles flexible.  Sometimes
     covering  the  whole body, except  the head and  face,
     palms of  the hands,  and soles of the feet.
   Icthyosis simplex.  Willan.
     In various instances  hereditary.
fi  Cornea.  Forming  a  rigid,  horny,  imbricated rind;
     hue brown or  yellow;  subjacent  muscles  inflexible.
     Sometimes covering the entire body, including the face
     and tongue.
   Icthyosis cornea.   Willan.
y  Cornigera.  With horn-like, incurvatedsproutings: some-
     times periodically shed and reproduced.
   Cornua cutanea.   Plenck.
                        GENUS  V.


                   ECPHLYSIS.

  Orbicular elevations of the cuticle containing a watery fluid.
       Wasserblattern.   G.
       Blains.

membrane exhibited an equal increase of substance, and in front of
the tibia was not less than an inch  and a half thick.   Medico-chir.
Trans. Vol. II. p. 63.
  4. y. L. Ichthyiasis  Cornigera.   The  Phil. Trans,  give various
examples, and  Willan has copied others of a curious nature.  A  few
years since a Leicestershire heifer was shown to the author, labour-
ing under the same affection.   The whole of the skin  was covered
with a thick, dry scurf; often itching; and, wherever  scratched,  a
fluid oozed out, which soon hardened, and put forth corneous, re-
curvating excrescences, often divaricating, and assuming sometimes
a leafy, sometimes a hornlike appearance.  The  back  was covered
with them ; over the  forehead, and below the  dew-lap,  they hung
in great abundance ; many as large as natural horns.   The  animal 
GE. V.]                   NOSOLOGY.                      371

1. Pompholyx.  Eruption of blebs containing a reddish, transpa-
                   rent fluid;, mostly distinct; breaking and healing
                   without scale or crust.
       Pompholyx.   Willan.
       Ahenje.  Arab.
       Wassenblasen.  G.
       x Benignus.   Blebs  pea-sized or filbert-sized ; appearing
            successively on various parts of the body; bursting in
            three or four days and healing readily.
was otherwise in good health.   A drawing and description was pre-
sented by the author to the Royal Society.
  See also Haller,  Elem. Physiol.  V. p. 30.   Journal de Med. et
Histoire de la Chirurgie,  passim.
  Gen. V. Ecphlysis.   'ExQXvtis, from txtpXvga, " ebullio," " ef-
ferveo,"  "to boil  or bubble  up or over:"  importing "vesicular
eruption confined  in  its action to  the  surface,"  as  emphlysis  is
" vesicular eruption essentially connected with internal and febrile
affection:" for vvhich see Cl. III. Ord. III. H^ematica, Exanthe-
matica.  The* term  is  intended to  include  all  those utricles or
minute bladders of the cuticle containing a watery fluid, and not ne-
cessarily connected with internal disease, whether bulla or vesicula,
between which Dr. Willan has made  but  little diffeience in his
definitions, except in respect  to size; and  which  were equally
denominated by the Greeks phlyctaenae  (QXvxrxtvxt,)  derived from
the same source.   And hence the  species that fairly appertain to
this  genus  appear to be pompholyx (irop<.QoXv%,)  il bulla," whence
yropctpoXvyva, in bullas converto, as used by Dioscorides, lib. v. cap.
75 :  herpes, from tgiea, " serpo, repo;" rhypia, from e«""?» " sordes,"
entirely copied from Dr. Bateman: and tczema (ex^eptx,) from ex£tu,
" efferveo."   In  Dr. Bateman, rhypia is written rupia ; but this  is
not quite correct: the  p is aspirated and  the Greek v  is almost
always expressed by a Roman y. So Pliny, from the very same root,
writes rhyparographus. (pwx^oyfx^os,)  "a painter of low, sordid,
contemptible subjicts:" hence, too, rhythm, from pvBpcos;  paralysis,
front  vx^xXvo-ts; and in  Dr. Bateman  himself, sycosis, from wxoi.
   2.  0 Ecphlysis Herpes Exedens.   This variety of herpes appears
to have  been much misunderstood, and to have been held of a far
severer  character  than  it really possesses, in consequence  of an
error that has  long since  crept into  the text  of Celsus,  and been
propagated in the common editions.  In his list of ulcers Celsus in-
troduces one called by the Greeks ^taput, vvhich he describes as
being of a livid or black hue, with a fetid smell,  and copious dis-
charge, insensible to the  touch, though disturbed by itching,  with
pain and inflammation around  it.   And  he then adds, according  to
the common editions, " fitque  ex  his ulcus  quod «fx»jT« toStof4.tvor
Graeci vocant."  From these proceeds the ulcer, which the Greeks 
372
NOSOLOGY.           [CL. VI.—OR. Ill,
  Pompholyx benignus.   Willan.
   Water-blebs.
P Diutinus.  Blebs  gradually growing  from small vesicles
     to  the size of  walnuis; yellowish; often spreading in
     succession  over the  whole  body, and  interior  of the
     mouth;  occasionally  reproduced, and forming an exco-
     riated surface with  ulcerations.   Often preceded  by
     languor or other general indisposition for several weeks.
     Duration from two to four or five months.
  Pompholyx diutinus.   Wdlan.
y Quotidianus.  Blebs  with a dark red base, appearing at
     night and disappearing in the morning.   Found chiefly
     on the hands and legs.
  Epinyctis.  Sauv.
call " herpes esthiomenos," or exedens.  And thus the herpes, a cu-
taneous vesicular affection, is  extravagantly converted, in one of
its species, into " a deep spreading ulcer of a cancerous character,"
as Dr. Bateman has justly described it, according  to  the general
lection, and not  being aware of the error of the  text.—In the
Variorum edition, Leonardi  Targa has  correctly restored the pas-
sage, and given us again <pxyti~aivxv, "the ulcer  called phagedaena,"
instead of tgimrx eordtopmioi, oy wnich means the whole  is rendered
simple and  inlelligiole. 4> Antea," says the subjoined note upon the
passage, "legebatur t^-jrnrx to-Botptsw, in quo nonnulli Celsum accusa-
runt, contendentes id  ulceris genus tpxyeSkuxv a Graecis appellari.
Et sanr. banc ipsam vocem ego inveni in Codicibus M.SS. ex iisque
earn reposui.  In Medico II. lacuna est. Similis lacuna erat in IV
quoque, ubi nunc herpeta esthiomenon scriptum est alia, manu :  unde
vulgaris lectio.  Infra quoque legebatur herpes, ut est alia manu in
eodem Cod. IV.  Ego ex Codicibus aliis resiitui QxyePxivx.
  For the real nature, therefore, of the peculiar species or variety
of the  herpes called esthiomenos or exedens we must turn to some
other writer than Celsus, who makes no mention of it; and we can-
not turn to a better than Galen, who has described it explicitly and
repeatedly.  Herpes, according to Galen, is an eruption of minute
and crowded vesicles of the size of millet seeds, excited on_the surface
of the skin,  filled with an acrid bilious secretion; and consists of two
species; the one containing in its vesicles a milder and  more aque-
ous fluid, called from the size of the vesicles herpes  miliaris, which
merely seems  to burn, or  corrode; the other containing a thicker
fluid of a higher heat and colour, and so  acrid as actually to corrode
the continuity of the subjacent skin,  still creeping along in a  ser-
pentine direction, as the term herpes imports, and hence denominated
by Hippocrates herpes esthiomenos. 
'^E. V.]      ,              NOSOLOGY.                       373

         Pompholygmus Epinyctis.   Young.
            Vandermonde  relates a case in  which the accessions
         were reversed; the  blebs appearing in the morning and
         disappearing at night.   1756, p. 340.
       £ Solitarius.   Solitary; but  reproductive  in an  adjoining
            part; the bleb very large, and containing a teacup-full
            of lymph.  Preceded by tingling;  often accompanied
            with languor.
         Pompholyx solitarius.   Willan.
2. Herpes.   Eruption of vesicles in small  distinct clusters; with
              a  red  margin;  at  first  pellucid, afterwards opake;
              accompanied with itching or tingling: concreting
              into  scabs.   Duration from fourteen to  twenty-one
              days.
       Herpes.   Sauv.  Linn. Cull. Willan.
       Cytisma Herpes.   Young.
       Neshr.  Arab.
       Zittermahl.   G.
       Dartre.  F.
       Tetter.
       x Miliaris.  Vesicles millet-sized;  pellucid; clusters com-
            mencing  at  an indeterminate part of the surface, and
            progressively  strewed over  the body; succeeded  by
            fresh crops.
         Herpes  miliaris.   Hippocr.  Sennert.   Hoffm.   Will
            Rubeol. p. 238.
         Herpes phlyctasnodes.   Bateman.
       0 Exedens.  Vesicles  hard; of the  size and origin of the
            last; clusters thronged; fluid dense, yellow, or reddish;
            hot,  acrid, corroding the subjacent skin and spreading
            in serpentine trails.
         Herpes esthiomenus.   Hippocr. Gal.  Sauv.
         Herpes exedens.   Turn.
  The author has put together the above description from  various
parts of Galen to make it the fuller ; chiefly from his book De Tu-
moribus prater naturam ; his Methodus Medendi, Lib. II.;  and his
treatise De Arte curativd, Lib. II.j The following are the words of
the Latin translators, which are copied rather than the Greek,  as
being more easily referable. " Cum biliosus fluor decubuerit cutem
ulcerat: qui  vero aquosa sanie sanguineve mistus, minus est acer,
magisque in tumorem attollitpartem quam ulcerat; hoc quidem Ery-
sipelas nominatur,  alterum Herpes.  Humorem vero qui fecit, et 
374                      NOSOLOGY.           [CL. VL—OR. III.
        Dartre rougeante.   F.
        Nirles.   Northern  counties.  Q. ?   See  Willan, Rubeol.
          p. 238.   Batem.; Herpes, p. 221,  note at the foot of the
          page.   The ulcerative ringworm of  Dr. Ba'eman, p. 231,
          of his Practical  Synopsis, is probably a mere  modifica-
          tion of  this variety.
            The  reader may consult with advantage  upon this va-
          riety the " Collectanea  Societatis  Medicae  Havniensis."
          Tom. II. pi.  1.   As also Block's Medicinische  Bemerk-
          ungen,  p. 37.
        y Zoster.   Vesicles pearl-sized;  the  clusters  spreading
            round the body like a girdle;  at times  confluent.   Oc-
            casionally preceded by general irritation or other con-
            stitutional affection.
          Zoster.   Plin. Nat. Hist. xxvi. 11.
          Herpes  Zoster.  Sauv.  Bateman.
          Zona.   Russel.
          Zona ignea.  Hoffm. Darw.
          Feuergurtel.   G.
          Ceinture dartreuse.   F.
          Shingles.
        £  Circinatus.  Vesicles with a  reddish base,  uniting in
            rings; the area of the rings  slightly discoloured;  often
            followed by fresh crops.
          Formica ambulatoria.   Cels.  Turner.
          Annulus repens.   Darw.
          Herpes Serpigo.   Sauv.
          Herpes circinatus.   Bateman.
          Dartre encroutee.  F.
          Ring-worm.
       e  Iris.  Vesicles uniting  in  small rings,  surrounded by
            three  concentric rings of different hues; umbo vesicular
            and prominent.  Usually found about the hands or in-
            step.
          Herpes  Iris.  Bateman.
          Iris.   Willan: who at first erroneously regarded it as an
            exanthem, and called it, in English, Rain-bow Rash.

color et calor affectionum  indicat.  Cum  autem rursus acer ipse,
alter quidem minus  talis, alter veio magis sit,  sciendum est ex
acriore  herpetum, esthiomenon constitui. Sic enim ipsum nominavit
Hippocrates.  Ab altero vero alterum cui  nonnulli  post  Hippocra-
tem miliaris  nomen posuerunt,quia miliis similes eminentias  efficit in
cute.   Mihi quidem  talis fluor pituitd  mistus videter alter  vero
exacta bilis  esse ;  hanc ob rem  cum corrosione  fit, ipsum cutis con- 
(JE. V.)
NOSOLOGY.
375
         Rain-bow Worm.
       C Localis.  Seated on a particular organ, chiefly the lip and
            prepuce, and not migratory.
         Herpes labialis.  H. praeputialis.   Bateman.
3. Rhypia.  Eruption  of broad,  flattisb, distinct vesicles; base
               slightly inflamed;  fluid  sanious;  scabs thin, and
               superficial: easily  rubbed off and reproduced.
       Rupia.  Bateman.
       x Simplex.  Scab flat; livid or blackish.
       G Prominens.   Scab elevated and conical.
       y Escharotica.  Sanious discharge erosive, producing gan-
            grenous eschars.
              The species and varieties are given on the authority
            of Dr. Bateman.
4. Eczema.  Eruption of minute,  acuminated vesicles, distinct, but
                 closely crowding  on each other, pellucid, or milky;
                 with troublesome itching or tingling; terminating
                 in thin scales  or scabs; occasionally surrounded
                 by a blushing halo.
                   Chiefly produced  by the  heat of the sun; and
                 mostly attacking the hands and other parts that are
                 principally exposed to its rays.
       Eczema.   Auct.  Grozc.  Willan.  Bateman.
       Cytisma Eczema.   Young.
       Hidroa.   Sauv. Vog.
       Asef, Arab, literally " ira, aestus,"  as signified by the French?
         and English synonyms.
       Schweis-blattern.   G.
       Echauboulure.   F.
       Heat- Eruption.


tinuum semper apprehendente  affectu ;   unde ei  nomen est.  De
Tumor. § x.—Sola vero  quando  secernitur  (bilis  videlicet,) et  in
aliquo membro consistit, herpes vocatur.   Siquidem crassa sit secun-
dum substantiam, totam exulcerat cutem usque ad came m suppositam;
atque hunc affectum Hippocrates  nominat herpetem exedentem.  Si
verb tenuior fuerit, id quod  in superflcie  est,  tantum veluti de-urit :
atque hac species generis sortitur appellationem,  cum simpliciter ct
sine additione herpes vocetur.  Nam ex duabus  speciebus,  quae
quidem nuper dictae sunt, altera herpes exedens nominatur, altera vero
miliaria, quoniam  in hoc affectu pustula parva (tpxvxrxtvxt puxgxt) et
multa per summam cutem similes miliis excitantur. Fit autem herpes
hujusmodi ex bile quidem et ipse,  sed minus  calida et  acri quam sit
prior.  De Arte curatio.  Lib. II.—Herpes non  semper ulcis  est;
quotiesque cum exulceratione  est non utique servata veteri sede 
376                       NOSOLOGY.          [CL. VL—OB. III.


                       GENUS  VI.

                     ECPYESIS.

  Eruption of small pustules, distinct or confluent; hardening into
     crustular plates.
       Ecthyma.  Hippocr.  Gal.
       Pustula.   Linn. Sag.
       Pustulae.   Cels. Wuhan.
       Eiterfinnen.   G.
       Scall  Tetter.
1.  Impetigo.  Pustules clustering, yellow, itching; terminating in
                 a yellow, scaly crust, intersected with cracks.
       Impetigo.  Cels. Will Batem.
       Phlysis Impetigo.   Young.
       Herez.   Arab.
       Running  Scall or Tetter.
       x Sparsa.  Clusters loose; irregularly  scattered;  chiefly
            over the extremities; often  succeeded by  fresh crops.
vicinas partes depascit;  sed sicuti nomen ipsum indicat, riru serpentis
bestia, r e lie to prior e loco, transit ad alterurr>."   Meth. Med. Lib. II.
   Gen. VI. Ecpyesis.  'Exirvno-ts, from tx-xvou, " supputo."  The
term  is  used  in  direct contrast to empyesis, Class III. Order III.
which see; and consequently is intended to describe pustular erup-
tions, simply cutaneous, or not necessarily connected with internal
affection, as contradistinguished from  those that essentially  result
from an internal cause.   The genus therefore  embraces the mere
superficial pustule of Dr. Willan:—a term correctly limited in his
hands to  " elevations of the cuticle with an inflamed base containing
pus."
  The author has already had occasion to observe in the note on
exormia,  a few pages  back, that pustula is the mere  diminutive of
pus (iriov, irvaTts,) probably with the  Greek oXn (ule) employed as a
diminutive termination.   In consulting Dr. Bateman,  upon the pre-
sent division of diseases, Pract. Synops. p. 143, the reader will  find
him suggesting, ingeniously enough, that the term is perhaps deriv-
ed from pus and tulit.   It is adverse  to this suggestion that pus-tula
was originally written pusula; and that pusula is still to be found in
Celsus himself according to the Codex Mediceus I.  It is also to be
recollected, that  tulit will by no means apply  to pap-ula, tub-ula,
tuberc-ula, bacc-ula, stroph-ulus, (from o-r^os,) " a small curve" or
^circlet;" together with hundreds  of  others to which ule applies
with the  utmost correctness.   In  pustula the t  is merely added ion
the sake  of euphony. 
(IE. VI.]
Nosor.onv.
377
         Impetigo sparsa.  Bateman.
       P Herpetica.   Clusters circular; crowded with pustules, in-
            termixed with vesicles;  often with  exterior concentric
            rings surrounding the interior area as it heals;  itching
            accompanied with heat  and smarting.  Chiefly on the
            hands and wrists.
         Impetigo  figurata.  Batem.
         Herpes.   Cull.
         Phlyctaena.   Vog.
       y Erythematica.   Pustules scattered, preceded, by  erythe-
            matic  blush  and intumescence; often by febrile or other
            constitutional affection.   Chiefly in the face, neck, and
            chest.
         Impetigo  erysipelatodes.   Batem.
       } Laminosa.  Pustules confluent; chiefly in the extremities;
            the aggregate scabs forming a  thick, rough, and  rigid
            casing  around the affected limb, so as to impede  its mo-
            tion; a thin ichor  exsuding from numerous cracks.
         Impetigo  scabida.  Batem.
       $ Exedens.   The purulent discharge corroding the skin and
            cellular membrane.   Chiefly on the  side of the chest
            or trunk.
       g Localis.   Confined to a particular part;  mostly the hands
            or fingers; and produced by external stimulants as sugar
            or lime.
         Grocer's Itch.   Bricklayer's Itch.
2. Porrigo.   Pustules straw-coloured; fluid viscid; concreting into
                scales or yellow  scabs.
       Porrigo.   Cels.  Willan. Batem.
       Phlysis Porrigo.   Young.
       Tinea.   Sauv. et Auct. Var.
       Teigne.  F.
       Scabby Scall or Tetter.
       x Crustacea.   Pustules commencing on the cheeks or fore-
            head in  patches; scabs often confluent, covering the
            whole  face  with  a  continuous  incrustation.   Found
            chiefly in infants  during the period of lactation.
  The  species  under  this  genus,  consisting of impetigo,  from
" impeto," to infest, porrigo, from " porrum," a leek, on account of
its laminatecf tunics, or  from " porrigo," to  upread about; ecthyma,
from  txivctt, " erumpo," to break out ;  and scabies, from " scabo,"
to scratch—have  been very loosely employed, and in very different
  vol. v.—59 
378
NOSOI.OGV.           [CL. VI.—OR. III.
Crusta lactea.   Auct.  Var. Lat.
Achor ('A#«£.)   Auct. Grozc.
Tinea lactea.   Sauv.
Porrigo larvalis.   Batem.
Milchgrind.   G.
Croute de  lait.   F.
Milky Scall or Tetter.
   The German physicians place their chief dependence
for a cure on the internal use of conium maculatum, ledum
palustre, and lapatum  acutum  in the form of decoctions.
The first is also employed externally.  See Stoerck  De
Cicuta.  StoeUeri Beobachtungen, p. 139.
Galeata.  Pustules commencing on the scalp, in distinct,
   often distant, patches; gradually spreading till the whole
   head is  covered as with a  helmet;  cuticle, below  the
   scabs, red, shining, dotted with papillous apertures, ooz-
   ing fresh matter; roots of the hair destroyed: contagious.
   Found chiefly in children, especially during dentition.
Tinea granulata.   Alison.
Tinea ficosa.   Astruc. Sauv.
Achores seu scabies capitis.   Plenck.
Porrigo scutulata.  Batem.
Shirine.  Arab.
Kel.  Pers. Ture.
Grind.   G.
Tete teigneuse.  F.
Scalled-Head.
   Sometimes a  narrow border of hair is left uninjured.
It is then called  Ringworm of the Scalp.
Favosa.  Pustules common to the head, trunk, and extre-
   mities; pea-sized; flattened at the top; in clusters, often
   uniting; discharge fetid; scabs honey-combed, the cells
   filled with the fluid.  Found both in early and adult age.
Cerion (k^ksv.)  Grozc.
significations, by most writers.   They are here,  limited to the defi-
nite senses assigned  them  by Dr.  Willan; and, with the exception
of ecthyma, by Celsus, whom Willan has followed.  Ecthyma  is
not in Celsus, though it occurs in Galen, from whose explanation it
seems probable that we are not quite using it in its proper sense;
for the latter employs it,  as already observed, in the signification 
GE. VI.]
NOSOLOGY.
379
          Favus.   Lat.
          Tinea favosa.   Astruc.  Sauv.
          Scabies capitis favosa.  Plenck.
          Porrigo favosa.  Batem.
          Honey-comb Scall or Tetter.
       }  Lupinosa.  Pustules minute in small patches, mostly com-
            mencing on  the scalp; patches terminating in dry, delv-
            ing scabs resembling  lupine-seeds; the interstices often
            covered with  a thin, whitish, exfoliating incrustation.
            Found chiefly in early life.
          Tinea lupina.   Astruc.  Sauv.
          Scabies capitis.   Plenck.
          Porrigo lupinosa.  Batem.
          Rache  seche.   Ft
       <-  Furfuracea.  Pustules very minute  with little fluid; seat-
            ed on the scalp; terminating in scurfy scales.  Chiefly
            found in adults.
          Tinea furfuracea.   Sennert.
          Tinea porriginosa.  Astruc. Sauv.
          Porrigo furfurans.   Batem.
          Rache  farinense.  F.
       £  Areata.   Clusters of  very minute  pustules  seated on the
            scalp, in circular plots of baldness, wilh a brown or
            reddish furfuraceous surface.
          Alopecia porriginosa.   Sauv.
            Makes a near approach to the area of Celsus—the tri-
          chosis Area of the present system.   The  author  has  met
          with numerous instances of this  variety; and often si-
          multaneously in the same family, as though contagious.
            Several  of  the  varieties  found  also,  occasionally,
          as  symptoms  in lues,   and  other constitutional affec-
          tions.
3. Ecthyma.  Pustules  large;  distinct;  distant; sparingly scatter-
of popula;  but  as  it is better to  adhere to one import, though  it
should not be strictly correct, than to perplex by introducing seve-
ral, the author has not thought proper to deviate from  Dr. Willan
upon this point.
   The old English  term for tetter is scall,  still preserved in the
compound Scalled-Head. The Saxon original  hsceala, which is only
a modification of the Latin  « scalae,"  scales.   The Bible translators
have properly rendered by  this term the Hebrew pro in Levit. xiii.
30—37. 
38Q
nosology.          [cl. vi.—or.  in
                   ed; seated on a hard, circular, red base; ter-
                   minating in thick,  hard,  dark-coloured scabs.
        Ecthyma.   Willan. Batem.
        Phlysis Ecthyma.   Young.
        x Vulgare.   Base  bright red;  eruption  completed  with a
            single crop.   Duration about fourteen days.
          Ecthyma vulgare.   Batem.
        /J Infantile.  Base   bright-red ;   eruption   recurrent  in
            several  successive crops,   each  more  extensive  than
            the preceding.  Found  chiefly   in  weakly  infants
            during the period of  lactation.    Duration,  two  or
            three  months.
          Ecthyma infantile.  Batem.
       y Luridnm.   Base dark-red; elevated;  pustules larger,and
            more  freely scattered,  discharging  a  bloody or curdly
            sanies.  Found  chiefly in advanced  age.   Duration
            several weeks, sometimes  months.
          Ecthyma luridum.   Batem.
          Melasma.   Plenck.  Linn. Vog.
            Found  often as  a sequel  in  debilitated  habits;  or
          constitutions broken down  by severe fevers or exan-
          thems.
4. Scabies.'  Eruption of minute pimples, pustular, vesicular, pa-'
                pular, intermixed,  or alternating;  intolerable  itch-
                ing; terminating in scabs. Found chiefly between
                the fingers or in the flexures  of  the joints.
       Scabies.   Cels. Sauv.  Vog.  Sag. Willan.  Batem.
       Psora.   Linn.  Cull. Parr.
       Phlysis Scabies.  Young.
       Nekeb.  Arab.
       Kratze.   G.
       Gale.  F.
       Itch.
       x Papularis.   Eruption  of  miliary,   aggregate pimples;
            with a  papular,  slightly-inflamed  base,  and vesicu-
  4. E. x. Scabies Papularis. In camps and prisons, where the con-
stitution has  been debilitated by confined  air and innutritious diet,
this variety is sometimes found to assume a  malignant  character;
the whole  surface of the body exhibiting a sordid tesselation of
crusts, excoriations, and broad livid spots, with an indurated base,
accompanied with fever at night, and severe headache.—See Bat-
linger Von den Krankheiten einer Armee. 
GE. VI.]
NOSOLOGY.
381
     lar  apex;  pustules scantily interspersed:  tips, when
     abraded by scratching, covered with a minute, globular,
     brown scab.
  Scabies papuliformis.   Willan. Batem.
  Rank  Itch.
s Vesicularis.   Eruption  of larger, and more  perfect vesi-
     cles filled with a transparent fluid, with an uninflamed
     base; intermixed with pustules; at times coalescing and
     forming scabby blotches.
  Scabies lymphatica.   Willan. Batem.
  Watery Itch.
y Purulenta.   Eruption of distinct, prominent, yellow pus-
     tules, with  a slightly inflamed base; occasionally coa-
     lescing, and forming irregular blotches, with a hard dry
     tenacious scab.
  Scabies purulenta.    Willan.  Batem.
  Pocky Itch.
& Complicata.   Eruption complicated of pustular, vesicular,
     and papular pimples co-existing;  spreading widely over
     the body; occasionally invading the face; sometimes con-
     fluent and blotchy.
  Scabies cachectica.   Will. Batem.
  Complicated Itch.
= Exotica.    Eruption chiefly of rank, numerous pustules,
     with a hard, inflamed base, rendering the skin rough
     and brownish: itching extreme: abrasion unlimited from
     excessive scratching.
Gratelle.   F.
Mangy Itch.
  Produced by handling mangy animals.   Several of the va-
rieties found also, occasionally, as sequels upon severe small"
pox  or other causes of constitutional debility.
  The Unguenlum  Jasseri, so celebrated  for the cure of this dis-
ease on the continent, consists of equal parts of  sulphate of zinc,
flowers of sulphur, and pulverized  laurel-berries mixed into an
unguent with linseed or olive-oil.—See, for its success, Schmucher
Vermischte Chir. Schriften, Band. III. p. 169.
  Its sudden suppression, and especially after long continuance, has
been occasionally succeeded by severe internal affection of different
kinds.   In one instance by mania : Wantner's Journ. de  Medicine,
Tom. LVI. p. 115. 
382
NOSOLOGY.
[CL. VL—OK. Ill-
                      GENUS  VII.

                          MALIS.

  The cuticle or skin infested wilh animalcules.
       Passio bovina.  Auct. Var.
       Mai is.  Sauv. Sag.
       Phthiriasis.   Sauv. Vog. Sag.
       Epizootia.   Plouquet.
       Parasitismus superficiei.    Young.
       Haut-insecten.   G.
       Clavelee.   F.
       Cutaneous vermination.
1. pediculi.   Cuticle infested with Ike, depositing their nits or eggs
                at the roots of the hair:  troublesome itching.
   Gen. VII.   Malis.  MxXts, pcaXtao-pMs, " cutaneous vermination,"
 chiefly as it exists among cattle.  The Greek word  is of doubtful
 origin.  Probably the real root is the Hebrew term uho (malit) "to
 deposit eggs," as in  Isai. xxxiv. 15.—We meet with  the  same in
 Chaldee; while  the Chaldee  noun NiTtaSD (malit-ita) imports pu-


 tredo, " corruption, putrefaction," synonymously with the Hebrew
 3p1.   In the malis Acari the author has followed the opinion of Sau-
 vages, which is now indeed the prevailing opinion of physiologists;
 and has supposed, not that the acarus scabiei is the immediate cause
 of, or a constant attendant on, scabies ;  but only,  that  wherever it is
 to be traced on the human skin, it is in or about the pustules of the
 scabies, which serve as a nidus to it; in the same manner as a dis-
 eased liver in sheep serves as  a nidus to the fluke or fasciola hepa-
 tica.
   Common as this genus of diseases is  to man, it is still more so to
 animals of perhaps  every other class and description,  from  the
 monkey to the fish-tribes, and from these to the lowest worms.   All
 of them are infested  with parasitic and  minuter  beings on their
 skins,  shells, or scales, which  afford them  an asylum, and,  for the
 most part, supply them with nutriment.
   Yet  the same affection is still more common to plants;  which arc
 not merely infested with parasitic plants, but with parasitic animals
 as well.  Of the former, the  more common are mosses, lichens,
 confervas, agarics, and boletuses ; though  they are not  always  of
the cryptogamic  or  lowest  class of plants, for the  euphorbium
Mauritanicum  is infested  with the  aphyteu  hydnora, and  various 
GE. VII.]
NOSOLOGY.
383
       Phthiriasis.  Sauv.  Vog.  Sag.
       Lausigkeit.  G.
       Maladie pediculaire.   F.
       Lousiness.
       x P. humani.  Infested  with the  common  louse;  chiefly
            inhabiting the head  of uncleanly  children,  where it
            produces a greasy scurf,  or other filth; and sometimes
            exulceration  and porrigo: occasionally migrates over
            the body.
         Phthiriasis pedicularis.   Sauv.
       f3 P. pubis.  Infested with the morpio or crab-louse;  found
            chiefly on  the groins  and eye-brows of uncleanly men:
            itching extreme, without exulceration.
         Phthiriasis inguinalis.   Sauv.
         Morpiones.  Darw.
            The excrement of this animal  stains the linen, and ap-
         pears like diluted blood.
2. pulicis.  Cuticle infested with fleas:  often penetrating the cutis
              with  their bristly  proboscis,  and exciting  pungent
              pain; eggs deposited on or under  the cuticle.
              Flea-bites.
       x P. irritantis.    Infested with the common flea,  with a pro-
            boscis shorter than  the body: eggs  deposited on  the
            roots of the hair and on flannel.
       /3 P. penetrants.  Infested with the chigoe, or West Indian
            flea, with a proboscis as long as the body:  often pene-
            trating deeply into the skin,  and lodging its eggs under
trees with some species of the viscum or missletoe.  Of the nume-
rous insects that haunt and injure plants, the more common are dif-
ferent species of the aphis, cerambix, cynips, and  curculio.  The
first genus is  vulgarly known  by  the name of puceron or  green-
louse : its species are  numerous; and some of them are found in
great abundance  on  green-house vines,  and  other  green-house
plants:  many  of these  secrete, from peculiar glands near the anus,
a whitish  slime, and others a  sweetish and  viscid  juice like the
melligo or honey-dew, and often from it, with which they smear the
leaves that afford them support.  See Class VI. Ord. II.  Gen. III.
4. Paruria mellita.  Of the cerambyx, a beautiful, and finely varie-
gated,  as  well as very extensive  family,  some  species  diffuse a
musky odour to a considerable distance ;  and  some, when taken,
utter a kind of shrill cry, produced by the friction of the thorax  on
the upper part of the abdomen and shells.   The curculio or weevil
in our own country, is perhaps chiefly found on the hazel-tree ; i' 
384
NOSOLOGY.
[CL. VL—OR. 1W
            the cuticle,  particularly of the feel:  producing malig-
            nant; occasionally fatal,  ulcers.
          Malis Americana.   Sauv.
          Chiques.  F.
          Biccho.  Brazil.
          Chiggres.
3. acari.   Cuticle infested with the tick; itching, harassing, often
             with smarting pain.
       « A. domestici.  "Observed on  the head  in  considerable
            numbers."  Young.
       p A. scabiei.   Infested with the itch-tick; burrowing under
            the cuticle,  in or near the pustules  or  vesicles of the
            scabies, in those affected.
         Scabies vermicularis.   Sauv.
         Scabies verminosa.  Plenck.
       y A. autumnalis.   Infested  with the  harvest-bug;  less in
            size than the common mite; inflicting its bite in the
            autumn, and firmly adhering to the skin: itching  into-
            lerable,  succeeded  by glossy wheals.
         Harvest-bug-bite.
4. FiLARiiE.  Skin infested with the Guinea- Worm:—winding and
                 burrowing under the cuticle,  for the most  part, of
                 the naked feet of West Indian slaves; severe  itch-
                 ing; often succeeded by  inflammation and fever.
                   Found  chiefly in both the  Indies,  most fre-
                 quently in the morning dew;  often twelve feet
pierces the tender nut when first formed, and drops an egg into the
aperture,  which in due time is transformed into the larve or mag-
got we so frequently find in this kernel.  The different species of
the cynips, or gall-fly, in piercing the stem, petiole, or leaf of a plant,
to obtain a nidus for their eggs, produce at the same time a pecu-
liar sting  or  irritation,  in  consequence of which the part affected
inflames and swells, new vessels are formed, and a fleshy tumour or
excrescence is engendered, which we denominate a gall-nut. Many
of these galls or excrescences are well known to be of great value.
They are chiefly found  on different  species of the salix, cistus,
glecboma, veronica, hieracium, salvia, and quercus, or oak.   In the
last they are most valuable, and of a peculiarly bitter taste, whence
indeed the name of g-a/Z-nuts.  Yet they  are not always bitter ; for
those of the salvia pomifera, so denominated from its excrescences,
are of a sweetish agreeable flavour, and in the east are introduced
upon the table as a luxury.  The bedeguar, or extuberance, found
on the  rose-tree,  and that on the  leaves  of the populus nigra, 
6E.VIL]
NOSOLOGY.
385
                long, not larger than a horse hair.   It  should be
                drawn  out  with  great  caution, by means of a
                piece of silk tied  round its head: for if, by being
                too much strained, the animal breaks, the part re-
                maining under the skin will grow with  redoubled
                vigour, and often occasion a fatal inflammation.
       Malis Dracunculus.   Sauv.
       Irk Medini.  Arab.  Avicenn.   Literally vermis Medinensis,
          though usually  but incorrectly translated nervus or vena
          Medinensis.
       Colebrilla.   Brazil.
       Dragonean.  Ver de Guinee.   F.
       Guinea-Worm.  See Rhazes  ad  Almans.  Tr.  VII.  cap.
          24.
5. gordii.  Skin  infested with the hair-worm : chiefly insinuating
              itself under the  cuticle of the back, or limbs of in-
              fants ;  producing pricking pains, emaciation,  at
              times, convulsions.
       Malis a crinonibus.   Etmull  Sauv. Parr.
       Commedones.   Hoffm.
       Morbus pilares.   Horstii.
       Emphragma sebacea.   Young.
          Though described  by writers  of great  credit, the  nature
       of the disease is uncertain.  By some authors the contained
       fibrils seem to be  regarded  as a preternatural production of
       hairs; but the greater number, and among the rest Ambrose
       Pare, decidedly ascribe  to  them a living  principle.   It ap-
       pears therefore to be a species of the gordius or hair-worm;
       some of which  infest other  animals  in  a  like manner ;  and
       especially  the cyprinus alburnus, or bleak,  which, at the
       time, appears to be in great agony.


 (black-poplar,) and tilia Europaa (common lime,) are the  production
 of different insects.
   Besides these, the coccus, or cochineal insect, is a very trouble-
 some little animal in several of its species, especially c. Hesperidum,
 found in  our greenhouses, and also abroad. The acarus tellarius is
 still more injurious, particularly among beans (phaseolus,) cowhage
 (dolichos,) and Syrian mallow (hibiscus.)  The larve is a small mite,
 which destroys  the  leaves of plants by spinning  over them a very
 delicate web, and thus  obstructing  the free ingress of light  and air.
   VOL. v.—60 
386
NOSOLOGY.
[CL. VL—OR. II I
                      GENUS  VJII.

                        ECPHYMA.

   Superficial, permanent,  indolent  extuberance;  mostly  circum-
        scribed.
        Phymalosis.   Young.
        Hautgewachse.   G.
        Cutaneous Excrescence.
 1.  Caruncula.  Soft, fleshy, often pendulous excrescence of the
                    common integument.   Found over the surface
                    generally.
                      Found  also, occasionally, as  a sequel  of
                    lues, about the arms and sexual organs.
        Radefet.   Arab.
        Fleisch druse.   G.
        Caroncle.  F.
        Caruncle.
          It derives,  in many instances, a particular name from its
        shape, or position, asficus, when fig or rasin-shaped, encan-
        this, when seated on the canthus or angle of the eye.
2. Verruca.  Firm, harsh, arid, insensible extuberance of  the
                common  integuments.  Found  chiefly  on  the
                hands.
       Verruca.   Auct.
       Phvinatosis verrucosa.   Young.
       Shullul.  Arab.
       Wartze.   G.
       Verriie.  F.
        Wart.
       x Simplex.  Simple and  distinct: sessile or pensile.
       /5 Lobosa.  Full of lobes and fissures.
       y Confluens.   In coalescing  clusters.


  Gen. VIII.  Ecphyma.  'E^vpun, from sx^vu.  " educo, egero,"
in contradistinction both to phyma, •' an inflammatory tumour," and
emphyma, " a tumour without inflammation, originating below the '
integuments."  See the notes on both in Cl. III. Ord. II. and  Cl.
VI. Ord.  I.  The terms are formed in parallelism  with pyesis,
empyesis, and  ecpyesis; phlysis, emphlysis, and ecphlysis, together
with various others.
  Extuberances,  similar to  those belonging to this genus, are fre-
quently found in the rinds of fruits, as of apples and oranges; and 
<GE. VIIL]
NOSOLOGY.
387
         Destroyed  in  Sweden by the gryllus verrucivorus, or
      wart-eating grasshopper, with green wings spotted with
      brown.   The common people catch it  for this  purpose;
      and it is said to operate by biting off the excrescence, and
      discharging a corrosive liquor on  the  wound.  Schoeff.
      Incon. Tab. LXII  fig. 5.
Clavus.  Roundish, horny, cutaneous extuberance; with a cen-
             tral nucleus sensible at its base.
      Found chiefly on  the  toes from the  pressure  of tight
    shoes.
    Clavus.   Auct.
    Ecphyma Clavus.  Young.
    Zekh.   Pers.
    Huneraug.   G.
    Cor des  pies.   F.
    Corn.
      Sometimes spontaneous, and gregarious,  spreading over
    the  whole head  or body; sometimes rising to a considerable
    height, and assuming a  horny appearance.  In which case
    it makes a near approach to some of the species of lepidosis,
    especially I.  Ichthyiasis cornea and cornigera.
      Our own  Phil. Trans,  and the Journals of the Foreign
    Societies are full of examples.
callus.   Callous, extuberant  thickening  of the cuticle;  insen-
            sible to the touch.
      Found chiefly on the palms of the hands and soles of the
    feet as the consequence of hard labour.
    Nasur. Arab.   Sheghe. Pers.
    Swulle.   G.
    Calus.  F.
    Callus.
form a peculiar character in some species of melon : none of which
are produced by insects, nor are we acquainted with the immediate
cause.
  4. Ecphyma Callus.  Among those who accustom themselves to
long journeys over the burning sands of Egypt, some  have had
their feet become as indurated with thick callus as an ox's hoof, so
as to bear shoeing with iron; and in Siam such persons  have been
known to walk with their naked feet on red hot iron bars.  See
Halter  Elem. Phys. torn.  V. p. 38.
  Produced also by frequent exposure of either hands or feet to hot
water or to mineral acids.  The feet have been rendered  so callous
by the  use of sulphuric acid as to endure fire without pain: Des- 
S8S                       NOSOLOGY.          [CL. VI.—OK. in.


                       GENUS  IX.

                    T R I C H  0  S I S.

     Morbid organization  or deficiency of hair.
        Haarkrankheiten.   G.
 1. setosa.   Hairs of the body thick, rigid, and bristly.
        Hystriacis.   Plenck.
          Thrown off and  renewed every autumn: six lines long, two
        or three thick, erect: five sons  affected  as the father; Phil
        Trans. Vol. V. no. 424.   See also Journ. de Med. Mar.
        1756.   Paulini, Cent. I. obs. 31.
 2. Plica.   Hairs  vascularly thickened; inextricably  harled, and
              matted, by the  secretion of a glutinous fluid from
              their roots: contagious.
        Trichoma.   Sauv. Sag. Cull.
        Plica.  Linn.  Vog.
        Plica Polonica.  Starnigcl.
        Koltek.   Polon.
        Wischtel-zopff.  G.
        Plique.   F.
        Matted Hair.   Plaited Hair.
          Usually, but not always, appearing in,  or  confined to,
        the  hairs of  the scalp.   In the beard, Eph. Nat.  Cur.
        Dec. II.  ann.  viii. 94.  Hairs of the  cnticle, Id. obs. 71.
landes Brem. Magaz. I. p. 665.  This acid is, hence, commonly em-
ploy* d by professed fire-walkers.
  Gen. IX.  Trichosis.  Tf/#«<r<s,  " pilare malum," Actuar. ire^t
Atxyv. irxO. cap. vii.  Trichiasis is the more common term, but it has
often  been used in a somewhat different and more limited sense.
Athrix and distrix, sp. 2 and 4, are evidently derived from the same
root:  and the first is here employed, instead of alopecia, which is
perhaps  the more common term, because we have the authority of
Celsus for asserting that this last imported properly a mere variety
of area. spec. 5 of the present system, under which therefore it will
be found.  Alopecia, as to its origin, is derived from xXavnjZ, " vulpes,"
a fox, from this animal being supposed to lose its hair and become
bald sooner than other quadrupeds ;  while ophiasis, the  second
variety  under the  same  species, is deduced from «p/s, a serpent;
from the serpentine direction  in vvhich  the disease trails round the
head.  Polyosis, noXiuTts, spec. 3 is derived from voXios, " canus,"
" candidus," white, hoary. 
GE. IX.]
NOSOLOGY.
389
       of the pudendum, Id.  Dec. I. ann. iii. 220.   Paullini.
       Cent. I.  obs. 77.
         Sometimes  preceded  by hemicrania,  or other constitu-
       tional affection;  and occasionally a sequel of psoriasis.  In
       Poland it appears to be endemic.
3. Hirsuties.   Growth of hairs in extraneous parts, or superflu-
                   ous growth in parts common.
       Hirsuties.   Plenck.  Linn.  Vog. Sag.
       Azeb.   Arab.
       Haarigkeit.  G.
         The most frequent variety is  that of bearded women.
4. distrix.  Hairs  of the  scalp  weak,  slender, and splitting at
              their extremities.
       Fissura capillorum.   Plenck.
       Distrix.    Vog.
       Gespaltete haarc.   G.
5. Poliosus.   Hairs prematurely  grey or hoary.
       Poliosis.   Auct. Var.
       Spilosis Poliosis.   Young.
       Shejib.   Arab.
       Graukepf.   G.
       Grison.   F.
       Gray-hairs.
6. athrix.   Decay and fall of the hair.
       Alopecia.  Sauv. Linn. Vog.  Sag.
       Gangraena Alopecia.   Young.
       Daus-saleq.  Arab,  literally " morbus vulpis."
       Chauvete.   F.
       Baldness.
       x Simplex.   Hairs of  the scalp of a natural  hue:  gradually
            dying at the bulbs, or  loosened by relaxation of the in-
            tegument.
         Defluvium capillorum.  Sennert.
         Alopecia simplex.  Sauv.
            Found, often,  as  a symptom in tabes,  phthisis, por-
         rigo and impetigo; and,  as a sequel, in fevers of various
         kinds.
       p Calvities.  Hair  grey or hoary: baldness   chiefly on the
            crown of the head and confined to it.  Mostly common
            to advanced age.
         Calvities.  Vog.
       v Barbae.  Decay and fall of the beard.   Horst. II. p. 121.
            Ephem. Nat. Cur. Dec. III. ann. v. vi.  obs. 280. 
390
NOSOLOGY.           [CL. VI.—OK. HI.
  7. Area.   Patches of baldness without  decay or  change of co-
                lour  in   the  surrounding  hair;  exposed  plots of
                the  scalp glabrous,  white,  and shining: sometimes
                spreading and coalescing, rendering the baldness ex-
                tensive.
        Area.   Celsus. Jonston.
        Alopecia areata.  Sauv.
        Porrigo decalvans.  Batem.
        x Diffluens.  Bald  plots  of an intermediate figure;  existing
             in  (he beard as well  as  in the scalp: obstinate of cure*
             Common to all ages.
          Alopecia.  Cels.  Gal. et Auct. Graze.
        £ Serpens.   Baldness commencing  at the  occiput,  and
             winding in  a  line,  not exceeding two fingers breadth,
             to each  ear, sometimes to  the forehead: often termi-
             nating spontaneously.   Chiefly limited to children.
          Ophiasis   Cels.  Gal  et Auct. Grozc.
             The characters of these varieties are given almost lite-
          rally from  Cels. Lib. vi. ch. iv  The  disease makes a
          near approach to porrigo Area of the  present system.
 8.  decolor.  Hair of the  head  of a preternatural hue.
        x Caerulea.   Of a blue colour.  Ephem. Nat.  Cur. Dec. II.
             an. iv. Appx. p 203.  An. vi  obs. 226.
        0 Denigrata.   Changed from another hue to a black.
             Paullini. Cent. III.  obs. 59 :  the sequel of a fever.
          Borelli, Cent.  III.  obs. 2, from  exsiccation.—Schenck.
          Observ. Med.  I.  4, from  terror.—Schurig, Spermatol;
          from  white to  black;  the colour of the beard changed
          also.
       y Viridis.   Of a green colour.   Paullin, Cent. I. obs. 93.
            Bartholin. Hist. Anat.
       ^ Variegeta.  Spotted like the hair of the leopard.
            Paullin.  Cent.  IV. obs. 67.  Ephem. Nat. Cur Dec.
          III. ann. iii. obs.  184.
            The  hair  occasionally grows, and has sometimes
         changed its hue  after  death.   Eph. Nat.  Cur. passim.
_________W  i                           _____,___.--------------------------------------—

  Gen. X.  Epichrosis. 'Eiciy&utrts. " superficies colorata vel ma-
culata," a coloured or spotted surface.  Theophr de Caus. pi. lib. ii.
cap. 7.  SoWi£f»£ft» « in superficie coloro,"  whence rxixgovpuis, em-
ployed by Piato, "per summam coloratus."  The genus is new, but
it seems called for.
  Leucasmus (Xivxxrpias,) is the vitiligo  of Willan.   The term  is 
GE.X.]
NOSOLOGY.
391
GENUS X.
                    EPICHROSIS.


     Simple discolouration of the surface.
       Spilosis.   Young.
       Flecke.   G.
1.  Leucasmus.   White, glabrous, shining, permanent spots, preced-
                   ed by white, transitory elevations or tubercles
                   of the same size; often coalescing, and creeping
                   in a serpentine direction; the superincumbent
                   hairs falling off and never re-sprouting.
         Common to the surface; but chiefly found about the face,
       neck, and ears.
       Vitiligo.   Willan. Batem.
2.  Spilus.   Brown, permanent, circular patch; solitary; sometimes
              slightly elevated, and crested with a tuft of hair.
       Spilus.   Auct.
       Mahl.   G.
       Tache.   F.
       Mole.
merely changed to avoid confusion, as Dr. Willan  has employed
vitiligo in a sense different from  every one  who preceded  him.
Leucasmus, the direct import of which is dealbatio, " whitening or
covering with white," is derived from Xevxos, '• albus, candidus," and
expresses with  sufficient accuracy the nature of the species.   Spilus,
from  c-7riXos, " macula," has been long in use.   Lenticula, is more
generally written  in modern  times lentigo; itis  here  given  as it
occus in  Celsus;  who also employs  ephelis  from e<p>iXts,  " vitium
faciei solis ustione;"  but in a sense far more  extended, and apply-
ing to affections which have no connexion with sun-burning.  It is
here limited  to its appropriate signification.  Aurigo is the yellow
or orange hue of infants,  so frequently occurring  shortly  after
birth; and which is occasionally to  be  met with in later periods  of
life ;  depending,  as  Dr. Cullen observes, either  on  bile,  existing
indeed in the blood vessels, though  not immediately excreted  into
them, or on a peculiar yellowness of the serum of the blood distinct
from  any  connexion with bile.   In Cullen this disease is referred to
in a note on icterus in the class cachexia, order impetigines, where
icterus is introduced along  with syphilis, scorbutus, elephantiasis, 
392
NOSOLGGY.           [CL. VL—OR. III.
3. Lenticula.  Cuticle stigmatised with yellowish-brown dots, re-
                  sembling  minute lentil  seeds; gregarious;  often
                  transitory.
          Found chiefly on the face, neck, and hands of persons pos-
       sessing delicate constitutions, and red hair.   When of a larger
       size, the Greeks called them  phaciae (<pxxtxt.)   Cels. VI. 5.
       Lenticuia.   Cels.
       Lentigo.  Linn.  Vog.
       Ephelis Lentigo.   Sauv.
       Nemesh.  Arab.
       Leberflecke.   G.
       Taches de rousseur.  F.
       Freckles.
4. Ephelis.   Cuticle  tawny by exposure to the sun;  often spotted
                with dark freckles, confluent or corymbose; disap-
                pearing in the winter.
       Ephelis a sole.   Sauv.
       Nigredo a sole.  Sennert.
       Sommersprosse.   G.
       Hale.  F.
 and a variety of other frightful and violent maladies, with which it
 has no natural or artificial connexion; and only because his method
 allowed of no other place for its reception.  Sauvages has rightly
 distinguished between this disease as  a mere cutaneous affection of
 infancy, and proper jaundice : by describing the first in Cl. I. Ord.
 I. under the name of ephelis lutea; and the second in Cl. X. Ord.
 VI. under that of aurigo neophytorum.
   In drupaceous fruits, and especially those of a fine cuticle, as ap-
 ples, we often meet with spots and discolourations of the same cha-
 racter as moles and freckles ; the causes of vvhich we do not always
 know, though we can sometimes trace them  to small punctures in
 the cutis by birds and insects.
   6. Epicrosis Pacilia.  JlotxtXtx, a term of Isocrates, from yrotxtXts,
 " versicolor,"  " pictus  diversus coloribus;"  whence Pacile,  the
 Porch or  Picture-gallery of the Stoics  at Athens.   The species is
 new to nosological classification  as well  as the genus under  which
 it  occurs; but the morbid affection has been long known to physio-
 logists ;  and  it ought to  have had a niche in the catalogue of dis-
 eases before now.
   The different  hues of black, copper-coloured, olive, and red,  by
which different nations are distinguished in different parts  of the
world cannot be regarded as diseases.   They are as natural to them
as a fair complexion  to an European, and only constitute distinct 
GE. III.]
NOSOLOGY.
393
       Sun-burn.
5. Aurigo.   Cuticle saffron-coloured, without apparent  affection
               of the liver or its appendages; colour diffused over
               the entire surface; transient: chiefly  in new-born
               infants.
       Ephelis lutea.  Sauv.
       Gelbe haut.   G.
6. P(ecilia.  Cuticle marbled generally, with alternate  plots, or
                patches of black and white.
       Cutis variegata nativa.  Plenck.
         Blumenbach gives examples from  a Tartar tribe, whose
       skin  was  naturally spotted like the leopard's, De Generis
       Humani varietate nativa.
features  in the different varieties of the human  race.  They are,
however, regarded as diseases by Plenck, who has entered them in
his class macule, under  the generic terms of rubedo cutis (rothe
haut,) nigredo cutis (schwarze haut,) and  albor cutis (weisse haut,)
by the last intending, not the inhabitants of Europe or Asia Minor,
but Albinos,  or those included under the genus Alphosis, Cl. III.
Ord. IV. of  the present system.
   Some of these natural, and many morbid discolorations have often
been found relieved by cosmetics,  as that of Homberg,  which is a
dilute solution of oxymuriate of mercury, with a  mixture of ox-
gall.   Hartmann's cosmetic was a simple distillation of arum root in
water.  If the hands be deeply discoloured, they may be  whitened
by being exposed to the fumes of sulphur.
   In the American states a  black has occasionally been known  to
have the whole of the colouring pigment absorbed and  carried off
during a severe fever, and to arise from his bed transformed into a
white man.   See the same subject treated by M. Bose,  Pr. de Mu-
tato per Morbum colore corporis humani, Lips. 1785.  Bii  .hner re-
lates  the case of a man who, on the contrary, on  recovery from a
severe fever  had  his  face tinged  with a black  hue; probably from a
morbid secretion and deposit of a black pigment along with the rete
mucosum of  the  face.   Miscel. 1729, p. 260.
   It is to the partial or variegated  secretion of the cutaneous pig-
ment that we are indebted for all the diversified and beautiful
hues  evinced by different  kinds  of animals and  vegeu.bles.   It  is
this which gives us the  fine red or violet that tinges  the nose and
hind quarters of some baboons,  and the exquisite silver that whitens
the belly of the  dolphin, and other cetaceous fishes.  In  the  toes
and tarsal membrane of ravens and turkeys, it is frequently black;
in common hens  and peacocks grey; blue in the titmouse,  green in
the water-hen, yellow in the eagle,  orange  in the stork,  and  red  in
some species of the  scolopax.   It affords that  sprightly intermix*
   vol. v.—61 
394                       NOSOLOGY.           [CL. VL—OR. III.
   Chiefly found among negroes from an irregular secretion
or distribution of the  pigment which gives the black hue to
their rete mucosum.   In Albinos, whether among  blacks or
whites, the secretion appears to be entirely suppressed from
constitutional  debility or  other defect.  See Alphosis,  CI.
III. ord. iv.
   The subjects of this disease are commonly called spotted
or pye-balled negroes.
   Plenck asserts that he once saw a man with a green face,
the right side of the body black, and  the  left yellow, pro-
duced by previous disease.
ture of colour which besprinkles the skin of the frog and salamander.
But it is for the gay and  glittering scales of fishes, the  splendid
metallic shells of beetles, the gaudy eye-spots that bedrop the wings
of the butterfly, and  the infinitely diversified  hues of the flower-
garden, that nature reserves the utmost force of this wonderful pig-
ment, and sports with it in  her happiest caprices. 
         CLASS  VII.*

            TYCHICA.

FORTUITOUS LESIONS OR DEFORMITIES,
                        ORDER  I.

                   APALOTICA.

                AFFECTING THE SOFT PARTS.

  The organization of  the  soft parts injured  or  interrupted by
violent assault or exertion.
                   GENUS  I.

                     TRESIS.

Forcible solution of continuity in a soft  part, commencing
  externally.
  Class VII. Tvchica. Tv%txx, "fortuita;" » quae forte accidunt:"
from tv%v, " eventus, seu casus fortuitus:" th. Tvy%xva.
  Ord. I. Apalotica  ' AirxXortxx,from xttxXotk, " mollities, teneri-
tudo."  Its opposite is tts^otixx, from o-Tt^tor^, « firmitas, duritas,
rigiditas, soliditas:" and hence this has  been taken as denominative
of the ensuing order.  Possibly malactica and sclerotica might have
been selected if they had been  at liberty.  But the first has been
long since laid hold of in the materia medica to signify emollients;
and the second in surgery to characterize the outermost or hardest
  * [In the " Study of Medicine," the 7th Class is not noticed at all. No doubt
because the Diseases included under it do not fall to the care of the physician.] 
■m
NOSOLOGY.
[CL. VII.—OR. I.
       Dialysis.   Parr.
1.  Vulnus.  The substance of a soft part cloven; with a spread or
                gaping mouth.
       Vulnus.   Sauv. Linn.  Sag.
       Yara.  Arab.
       Wunde.   G.
       Blessure.   jF.
       Wound.
       x Simplex.  Simple disunion by a smooth and sharp instru-
           ment.
         Vulnus simplex.   Sauv. Young.
         Playe simple.  F.
         Cut.
       (J Lacerafum.  The divided substance irregularly torn
         Laceratura.   Linn.
         Vulnus laceratum.   Young.
         Lacerated Wound.
       y Penetrans.   The wound communicating with a cavity.
         Vulnus penetrans.   Young.
         Penetrating Wound.
       ? Contdsum.   The wound effected by an obtuse instrument,
           as a  ball or splinter,  and accompanied with  contusion
           of the sourrounding parts.
         Vulnus scloppetorum.  Sauv.
         Sclopetoplagia.   Sag
         Vulnus  contusum.  Young.
         Coup d'arme a feu.   F.
tunic of the eye, the sclerotis, or tunica sclerotica ; and it is a use-
ful Linnean rule, well adapted to prevent confusion, not to  employ
a term in any branch of the same science in a new sense  that has
already been appropriated to a different.  Either set, however, will
answer equally  well,  and can plead equal authority for their use,
though the latter is more common to the medical vocabulary.
  Gen.  I.  Tresis.  Tf j»s-i«, " plaga;" " solutio continui;"  perfora-
tio:" from nrpxu. •' perforo," " terebro."   Dialysis, as employed in
a similar sense  by Dr. Parr, might perhaps have been used on the
present occasion, but that it has been generally applied by other no-
sologists to  disunions of hard as well  as of soft  parts, and might
hence prove a source of perplexity.
  1.  Tresis Vulnus.   The author has preferred the limited  sense of
vulnus as given by  the earlier nosologists, to the looser and more
general signification  of many  writers of  the present day,  who in-
clude puncture  under the term ; and some of whom include excoria-
tion.   The definitions, it is hoped) are sufficiently precise  to mark 
GE. I.]
NOSOLOGY.
•397
          Gun-shot Wound.
          Splintery Wound.
2. Punctura.   The substance of a  soft part perforated; with a
                   minute, impervious mouth.
       Punctura.   Sauv. Sag.
       Nish.   Of Persian  origin.
       Stick.  G.
       Piquure.  F.
       Punctured Wound.   Bell.
       Puncture.
       x  Simplex.   Simple  disunion  by a  sharp piercing instru-
            ment.
          Prick.
       A  Incuspidata.   The point of the instrument broken off, and
            remaining in the course of the puncture.
          Punctura a cuspidi fracta.   Sauv.
          Echarde.  F.  Tissot.  Avis au Peuple.
          Splinter,  needle,  or thorn in  the flesh.
       7  Venenata.  The  pointed instrument loaded with an acrid
            or poisonous  material; as the  arrows of barbarians,
            with the lama or  vicunas;  the  fang of the  tarantula
            and several other spiders;  the sting of the wasp, hor-
            net,  or scorpion.
          Punctura venenata.   Sauv.
          Insekten-stick.   G.
          Piquure venimeuse.   F.
          Poisoned Wound.  Bell.
the differences.  Even in free coloquial language  we seldom ven-
ture to call a puncture in the finger a wound, when made by a fine
splinter or broken needle, in which the fragment remains imbedded
in the flesh, without bleeding, and with scarcely a trace where it
entered.   Wounds, punctures,  excoriations, and  burns, however,
have a close natural relation to each other, and ought to be arrang-
ed as so many species under one genus.   In very slight cases of
burns, indeed, there is no actual  solution of the cuticle, nor even
vesication ; but these are imperfect instances, and scarcely deserve
the name of disease, or the attention of the chirurgical practitioner.
Causis (xxvtris) is here employed  to signify burn, as cauma has al-
ready been to signify inflammatory, or burning fever, the synochus
of Vogel, and Synocha of Sauvages and Cullen.   The root of both
is xxta, " uro."
  2. y T. Punctura Venenata.  In Ceylon the leaves of  the ophior-
rbiza Mungos, and in South  America the milky juice of the poly-
gala Senega (snake-root) are said to be specifics against the bite of 
393                       NOSOLOGY.            [CL. VII.—OR. I
3. Excoriatio.   The substance of a soft part abraded at its sur-
                   face.
       Ecdora.  Auct. Graze.
       Excoriatio.  Auct. Recentior.
       Attritio.   Vog
       Erythema Paratrima.   Sauv.
       Excoriaiura.   Linn.
       Er'ihash.  Arab.
       Hautschwiirung.   G.
       Ecorchure.  F.
       Excoriation.
       x Simplex.  Confined  to the skin;  chiefly  produced  by
           friction.
         The remedial power of oil of turpentine or spirit of  wine
       lately  proposed as a new discovery,  may  be  found noticed
       by Sydenham,  Opp. p. 343,  783, and Camerarius, Memo-
       rab. Cent. IV. n. 53.
       G Complicata.  Deeper than the integument, with contu-
           sion, or loss of subjacent substance.  Chiefly produced
           by severe  flagellation;  though  sometimes  accidental.
           See  Pibrac, M. Ac. Chir. IV. 63; Fabre,  74;  Louist
           106.
the coluber Naja (cobra di capello, or hooded snake,) and the crota-
lus horridus (rattle-snake.)  as well as against various other empoi-
soned punctures and lacerations.   See Amanitat. Acad. Vol. II. art.
21:  Lignum Colubrinum.  Rt sp. J. A. Darelius ; and art. 22, Ra-
dix Senega, Resp. J. Kiernander.
  Olandah, from repeated experiments of its efficacy, recommends
taking internally a mixture of rum and Cayenne  pepper.  Goeth.
Anz. 1790.
  In all these cases by far the most effectual remedy seems to be
arsenic, whether in solution or oxyd.   An  arsenic pill, somewhat
similar to that commonly given in India in cases of elephantiasis, as
already remarked in the  note on  this disease, is asserted  by Dr.
Russell,  in hid History of Indian Serpents, to  be employed with
great success in  the provinces of the Delta, under the name of the
Tanjore pill,  each of which forms a dose,  and contains a grain of
white arsenic.  Mr. Chevalier, taking advantage of this hint, strong-
ly enforced, in  his lectures, a trial of this active alterative in all
cases of wounds from venomous serpents : and Mr. Ireland, an in-
telligent pupil of his, has since carried Mr. Chevalier's recommen-
dation  into execution with wonderful success both in  St. Lucie and
Martinique.   The preparation he used  was Dr. Fowler's solution,
in the proportion of two drachms every half hour till vomiting or 
GE. II.]
NOSOLOGY.
399
4. causis.   The substance of a soft part chemically disunited or de>
              stroyed;  with  vesication or eschar.
       Eretbema Ambustio.   Sauv.
       Encausis.   Vog. Plouquet.
       Combustura.  Linn.
       Suzish, of Persian origin.
       Verbrennung.  G.
       Brulure.  F.
       Burn.
                       GENUS II.

                     THLASMA.

    Forcible derangement in the structure of a soft part, without
         disunion of the external integument.
       Thlasma.   Galen. Dioscor.
1. concussio.  The part weakened, or  interrupted in its function,
                 by  sudden concussion, without extravasation of
                 blood.
purging  ensued, the last being encouraged by cathartic injections:
but as half an ounce of lime-juice formed a part of every draught,
the arsenic was necessarily decomposed and converted into the state
of white oxyd.  See Medico-chir. Trans. Vol. Ill  p. 393.
  Gen. II  Thlasma.  GXxo-ptx, from 6xxa>," conquasso," " contun-
do, collido."   The term is sufficiently broad to cover all the species
which are  here arranged under it.  It  is taken from Galen, as is
also that which distinguishes the next genus: both which are here
employed in the exact import which Galen assigns to them.   Hav-
ing spoken of ulcers, fractures, and spasms, in relation to a solution
of continuity, he adds, " ejusdem genesis sunt et quae Grxci ^yi*x,
{rhegma) et GXxvput, (thlasma?) dicunt.—Haec in vasis,musculisque, ex-
violento  ictH vel gravi casu, vel alio quopiam valente motu excitata.
Method. Medend. torn. vi. p. 85. The root of rhegma, in Latin « rup-
tio, ruptura," is pye-o-a, "frango, rumpo:" and from the above quo-
tation we have a  proof that the Greeks applied  the term regma to
every species of laceration of the  soft parts, not  commencing exter-
nally so  as to make it a wound, by whatever kind of violence  pro-
duced, whether a blow, a fall, or any other adequate cause :  in  the
same manner as they applied  the term thlasma to every species of
conquassation, whether concussion, contusion, or strain, occurring in 
400
NOSOLOGY.
[CL. VIL—OR. I.
       Concussio.  Auct.
       Herkeshet.  Arab.
       Schiditeln.   G.
       Concussion.  jF.
       Concussion.
2. contusio.  The part weakened or disorganised in its vascularity
                by external compression;  with extravasation of
                blood, and discolouration of surface.
       Contusio.   Auct.
       Contusura.  Linn.
       Hers.  Arab.
       Zirknirschung.   G.
       Neurtrissure.  F.
       Contusion.   Bruise.
3. stremma.   The part weakened  in its motive power by sudden
                and excessive exertion; with pain and tension.
       Distensio   Auct.
       Levy.  Arab.
       Verrenckung.   G.
       Entorse.   F.
       Strain.   Wrench.
                       GENUS III.


                         RHEGMA.

     Violent snapping of a soft internal  part into two or more por-
         tions.


like parts, from the same latitude of causes.  When the lesion fell
on a ligament or cartilage, we are informed by Galen in the same
place, that  the  Greeks called it x7rocr7rx<rpM, " avulsio;" probably
from the injured part being distracted, or pulled out of its proper
site or tone.  But it does not seem necessary to continue this minute
distinction.
  Stremma, Grgepipia, " a strain, or wrench," from <rr^t<pu, «torqueo,"
has been long m medical use, and  was the colloquial term employ-
ed among the Greeks to express this peculiar injury, as we learn
from Ulpian> Dem. Olynth. ii.  The best Latin synonym is perhaps
distensio, but this is of looser  meaning, and imports other affections
as well as the present. 
GE. IV.]
NOSOLOGY.
401
       Rhegma (z*>yt*x.) Galen. Aristot.
       Ruptura. Sauv. Linn. Vog. Sag.
       Laceratio.   Young.
       Kesret.  Arab.
       Zerzerretes.  G.
       Ruptute.  F.
       Laceration.
1. ligamentare.  Laceration of a ligament.
       Laceratio ligamentaris.  Toung.
         Found also frequently, as an accompanying lesion,
       in luxations and strains.
       Apospasma (ttvroTirxo-pM.)  Auct. Grozc.
%. musculare.  Laceration of a muscle or its tendon.
       Laceratio muscularis.   Toung.
3. vasculare.  Laceration of a blood-vessel.
       Laceratio vascularis.   Toung.
4». viscerale.  Laceration of a viscus.
       Laceratio visceralis.  Toung.
                 GENUS  IV.

                   HERNIA.

Protrusion of an abdominal  organ through some inter-
    stice in its proper cavity, producing a soft and slight-
    ly elastic  tumour.
  Cele (xhXd ) Auct. Grozc.
   Gen. III. Rhegma. See the preceding note.
   Gen. IV. Hernia. 'Egvtx : from £f»es- " germen, ramus," shooting
forth,  ramification, whence  the Latins called  it ramex.  Hernia,
however,  was a name given to the  disease by the  later  Greek
writers as Galen expressly  informs us ; for by the earlier it was
simply called xtiXn. (cele,) tumour, or swelling. It was necessary, in-
deed, to make a distinction :  since from the latitude of sense afford-
ed by cele, the term  was applied, and still continues to be so, to a
variety of diseases which have no connexion whatever, except that
of a greater or less degree of intumescence: as hydro cele, sarco-
cele, broncho-cele, encephalo-cele.
   Some benefit, therefore, in point of  precision, was gained by the
introduction of the term i$vm, or ramex, however trivial the term in
   VOL. v.—o2 
402
NOSOLOGY.
[CL. VII.— OR. I.
      Hernia.   Auct. Lat. Linn. Cull.
      Demm.   Arab.
      Bruck.   G.
      Hernie.   F.
      Rupture.
i. inguinalis.  Tumour extending from the groin more or less
                 deeply  to  the  scrotum, or labia on either
                 side.—Consisting of a portion of intestine or
                 intestinal tunic,  protruded through the re-
                 spective abdominal ring, enclosed in a peri-
                 toneal sac.
      Hernia inguinalis.  Heister.  et Alior.
      Kervet.   Arab.
      Inguinal  Rupture.
      Bubonocele :  Auct. when confined to the groin.
      Oschiocele. Auct. 1  when  at the bottom  of the scro-
      Scrotal Rupture.  J    turn.
         Occasionally found ossified, Eph. Nat. Cur. Cent.  X.
      obs. 57.
      a  Intestinalis.  Descent of a portion of intestine alone:
           tumour tense, equal, roundish.
         Enterocele.   Auct.
      p  Omentalis.   Descent of a  portion of omentum alone :
           tumour soft, compressible, unequal, t>blong.
         Epiplocele.  Auct.
      y  Duplicata.  Descent of some portion of intestine and
           omentum.
         Entero-epiplocele.   Auct.
      2*  Congenita.   Sac formed of the tunica vaginalis; tu-
           mour in immediate contact with the testicle.


itself.  Yet even hernia  has been employed by many writers with
too  loose an interpretation, and been allowed to run  a race almost
as wide as cele though expressly intended to be restrained to a par-
ticular division of the diseases which the older term had been al-
lowed to  comprise.  And we have hence had hernias of the brain,
of the eye, of the uterus, of the veins; fleshy, bloody, watery, and
windy hernias, with as much confusion as was ever produced by  the
use of cele in its wildest pruriency.  Sauvages seems to have been
altogether at  a loss  what to do with  the term ; and has hence  en-
tirely dethroned it, and re-established cele upon its downfall. There
are many writers, however, who have used it in a more limited and
correct sense.  Heister perhaps led the way to this greater simpli-
city of import; and he was soon followed by Linneus, who possibly 
GE. IV.]
NOSOLOGY.
403
       Hernia congenita.  Holler, et Auct. Recentior.
       Congenital Rupture.
         As  this variety must accompany, and  consequently
       be  coeval with, the descent of the testis, it must ne*
       cessarily  take place only  a few weeks before, or at an
       early stage after, birth.
           See Baillie, Morb. Anat. Fasc. IV. PI. 7, 8.
?. femoralis.   Tumour seated on the upper and anterior part
                   of  the  thigh.—Peritoneal  sac protruded
                   through the opening for the transmission of
                   large blood-vessels.
       Hernia femoralis.  Auct.
       Hernia cruralis.   Heister et Alior.
       Femoral or Crural Rupture.
         Admits of an  intestinal, omental, and duplicate vari*
       ety, as in the preceding species.
         Is sometimes found  included in a double sac, the in-
       terior of which  has occasionally been mistaken for the
       intestine, till laid open. See Mr.  Chevalier's two cases,
       Medico-chir. Trans. Vol. IV. p. 322.
3. hmbilicalis.  Tumour protruded at the navel.  Involved in
                    a peritoneal sac, often blending itself with
                    the neighbouring parts : contents some-
                    times bursting, from magnitude, through
                    sac and skin.
       Hernia umbilicalis.   Heist, et Alior.
       Umbilical Rupture.
         Admits of an intestinal, omental, and duplicate varie-
      ty, as in the preceding species.
 carried his restraint somewhat too far, hernia being with him limit-
 ed to a protrusion of the intestinal canal alone :  and hence his defi-
 nition is as follows ; " z'nz'esz'z'nzobtecti ultra propriam sedem protru-
 sio."  Cullen has unfortunately restored the term to its larger and
 looser sense ;  and hence in the  present day it has little or no defi-
 nite meaning whatever.  Mr. B. Bell has again attempted to give it
 a  precise import by confining it, not indeed with Linneus, to pro-
 lapses of the  intestinal canal alone, but to a " protrusion of some
 part or parts from the cavity of the abdomen;" and it is in this mid-
 dle sense that hernia  is employed in the present system; being
 limited to what Harvey has forcibly called the « abdominal pene-
trans."
   Hernia is in almost every instance the result of violence or undue
exertion, either alone, or in conjunction with a local laxity of fibre- 
404
NOSOLOGY.           [CL. VII.—OK. I.
       ^ Ventriculi.   Protrosion of the stomach into the her-
            nial sac, with or without a portion of the intestinal
            materials.
         Hernia ventriculi.  Haller. et Alior.
         Gastrocele.   Auct. Var.
         Hernie de l'estomac.   La Faue sur Dionis.
         Rupture of the Stomach.
       e Hepatis.  Protrusion of the liver into the hernial sac,
            with or  without a  portion of the intestinal ma-
            terials.
         Hernia hepatis.  Bossnii et Alior.
         Hepatocele.  Auct. Var.
         Hernie du foye.   Arnaud des Hern.
         Rupture of the Liver.
       £ Splenis.  Protrusion  of the  spleen into the hernial
            sac, with or without a portion of the intestinal ma-
            terials.
         Hernia lienis.  Fabr. Hildan. Epist.
         Splenocele. Auct. Alior.
         Hernie de la rate.   Arnaud. des Hern.
         Rupture of the Spleen.
4. ventralis.   Tumour found indefinitely in the region of the
                  belly: for the most part adjoining the linea
                  alba.  Peritoneal sac often  large, and pro-
                  truded between  the interstices of the abdo-
                  minal muscles.
       Hernia ventralis.  Heister.  et Alior.
       Ventral Rupture.
It belongs therefore obviously to the present class and order.  Even
in congenital herniasis it is probable the same causes would be found
to apply if we could trace their commencement; and this more
especially in those that take place subsequently, instead of antece-
dently, to birth,  and  accompany the testicle in its retarded descent
into the scrotum.  The English name of rupture is highly improper,
being founded in a misconception that the peritoneal tunic is lacerat-
ed in every instance of the disease, instead of being merely elongat-
ed and protruded as a surrounding sac.  It is only in a few cases of
the ventral and umbilical species that an actual rupture has been
found; and in  these  instances it has occurred less from the nature
of the disease, than from the weight and magnitude of the protrud-
ing viscus.  The French, more correctly, confine the term rupture
to express the genus rhegma, which by Latin writers was indeed
usually denominated ruptura. 
GE. IV.]                 NOSOLOGY.                     405

         Varied as in the preceding species, and the varieties
       distinguished by  the  same organic names.  Chiefly
       found during infancy, or in corpulent habits.—Once in
       a woman who had submitted successfully to the Cesare-
       an section.   Saviard, Observ. Chirurg.
5. ischiatica. Tumour seated on the upper part of the male
                   perinaeum, or lower part of the female labia.
                   Peritoneal sac protruded through the great
                   foramen of the ischium; mostly filled with
                   a portion of intestine.
       Hernia foraminis magni ischii.  Auct.
       Ischiatocele.  Vog.
       Ischiocele.  Sag.
       Hernia of the Foramen Ovale.  Bell.
6. vesicalis.  Tumour seated in the groin, forepart of  the
                  thigh or perinaeum: fluctuating.—Formed by
                  a protrusion of the bladder; commonly sub-
                  siding on voiding urine.
       Hernia vesicae urinarias.  Sallzmann.
       Hernia cystica.   Auct. Var.
       Cystocele.  Platner. Ign. La  Chausse. Sauv.
       Hernie de la vessie urinaire.  Mery. Mem. de PAcad.
       Rupture of the urinary Bladder.
       *  Simplex.   The  naked bladder alone protruding.
       (3  Complicata.   Protruded bladder,  accompanied with
           a portion of intestine  or omentum, surrounded by
           the peritoneal tunic.
7. diaphragmatica.   Indefinite intumescence, or fullness of
                         chest,  with difliculty of  breathing,
                         and a sense of weight  pressing in-
                         ternally on the lungs.
                           Formed by a protrusion of a por-
                         tion  of  intestine into   the  chest
                         through  an aperture in the  dia-
                         phragm.  May be produced by vi-
                         olence or ulceration; but  is more
                         frequently the result of a misform-
                         ation of the diaphragm. See Baillie,
                         Morb. Anat. Fasc. IV. PI. 8, f. 1. 
40G                     NOSOLOGY.          [CL. VII.—OR. I"
                      GENUS  V.

                    ENTHESIS.

    Irritation or obstruction of a natural passage by the intro-
        duction of an improper material.
      Obstructio.   Toung.
1. oesophagea. Improper material obtruded into the esopha-
                  gus.
      Obstructio oesophagea.  Toung.
        The more common substances are hairs; small fea-
      thers; fish-bones; fruit-stones; various pieces of money.
        These have often remained fixed for a very long time;
      and  have occasionally been found to  migrate to very
      remote parts.  A needle has continued in the esophagus
      for nine years before it was loosened and discharged;
      Kehring, Specil. Anat. obs. 42. A fish-bone, after long
      obstruction, worked its way through  the  substance of
      the esophagus, and  was at  length thrown out  at the
      cutis; Arculari, Practica, cap. 57. The point of a sword,
      for thirty years buried  in the  eye, was at  last ejected
      by the palate; Hoechstetter,  Dec. VI. cas. 9.
        The esophagus has sometimes been large enough to
      allow a  half-crown to pass  without  injury, which has
      beejn evacuated by the rectum.   A half-crown piece of
      this kind is in Dr. Hunter's Museum.  See also Baillie,
      Morb. Anat. Fasc. III. PI.  1, for  several other curious
      examples.
2. ventricularis.   Improper material  swallowed into the
                      stomach.
      Obstructio ventricularis.  Toung.
      x Mechanica.  Hard and indigestible substances;  as a
           knife; a nail; pieces of money; a multitude of
           fruit-stones.
      /3 Venenata.  Poisonous substances, vegetable, mineral,
           or chemical.
3. intestinalis.  Improper material lodged in the intestinal
                    canal.

  Gen. V. Enthesis. 'Evfoo-ts, "insititium;" "a foreign substance
or fragment of a foreign substance introduced into a substance of  a
different kind."  And hence the term at times imports a graft or
scion. 
GE. V.]                  NOSOLOGY.                     407

       Obstructio intestinalis.   Toung.
         Occasionally discharged by an abscess at a distance;
       sometimes when pointed and slender, as pins or nee-
       dles, migrating to a remote organ.   See Phil. Trans.
       1768-9. Nichols.—Lond. Med. Journ. IV. 77, Bezv: VI.
       36, Mills:  Id. 401, Boys.
4. trachealis.  Improper material lapsed  or inhaled into
                   the trachea.
       Obstructio trachealis.   Toung.
       *  Mechanica.  Impeding the passage.
       fi  Mephitica.  Noxious to the respiration.
5. urethralis.  Foreign substance broken in the urethra, or
                   dropped from it into the  bladder.
                     Chiefly fragments of bougies, improper-
                   ly manufactured; or continued to be em-
                   ployed by the patient after being worn out.
                     The author was once consulted in a case
                   in which the operation for lithotomy had
                   been performed to recover a fragment of a
                   bougie that had been unskilfully pushed
                   into the bladder.   The operation was in
                   vain, and the man died.  Had the patient
                   been a female, the proper operation would
                   have consisted in enlarging the urethra by
                   sponge-tents, or some other elastic instru-
                   ment, so as to have admitted the fore-fin-
                   ger, or stone-forceps.  See Cl. VI. Ord.
                   II. 4.  Lithia, vesicalis.
                     ORDER II.

                    STEREOTICA.

               AFFECTING THE HARD PARTS.

  The continuity or connexion of the hard parts impaired or
interrupted by violent assault or exertion.

  Ord. II. Stereotica. 'Zreptonxx, from cregeoTn and o-regeos," du-
ritas, firmitas," and " durus,firmus." The term is applied to horns
by Aristotle: xi^xrx tt^cx ; and in the Odyssey to stones: a-regey XtOos.
See note on Order I.  Afalotica. 
 408                     NOSOLOGY.          [CL. VII.--OR. II.


                        GENUS  I.

                      CATAGMA.

   Forcible division of a bone into two or more parts.
        Catagma.   Galen, et Auct. Graec.
        Clasis.  Parr.
 1.  Fractura.  Bone broken; the divided edges more or less
                   separated from each other.
                     Pain ;  impeded function ; where movea-
                   ble, a grating sound on motion ; where im-
                   movable,  morbid depression  or  other ine-
                   quality.
       Fractura.  Auct.
       Mekser.  Arab.
       Bein-bruch.   G.
       Fracture.  F.
       Fracture.
       x Simplex.  Bone simply divided, with little injury to
            the surrounding parts.
         Simple Fracture.
            Produced occasionally,  by violent  action of  the
         proper muscles of the bone, without  other  force—
         chiefly by spasmodic action.  See Act. Nat. Cur. Vol.
         VII. obs. 127. Leske, Auserl. Abh. Band. III. p. 279,
         the shoulder.—Both  thigh-bones broken by tetanus,
         Desportes, Hist, des Maladies de St. Domingue,  II.
         171.—Another case, by convulsions, Eph.  Nat. Cur.
         Dec. I. ann. ii. obs. 225.  See Clonus, Palpitatio, *.
           The ends  of a fractured and ununiting thigh-bone,
         united by  sawing off the tips; Medico-chir. Trans.
         Griffith Rowlands, Vol. II. p. 47.
       p Comminuta.   Bone shivered at the divided part.,
         Fracture avec fracas.  F.
         Splintery Fracture.

  Gen. I. Catagma. TLxrxypua, from xxrxyu, " confringo."  So Ga-
len, " In osse fractura, Graecis xxtxypux. dicitur." Meth. Med. Tom.
VI. 85.   And this he tells us, shortly afterwards, was the colloquial
term, for that it was technically denominated apagma (xz-xypix)
" Huic proprium nomen inditum Graece est xxrxyp*.x, omnibus fere
hominibus qui Graece loqui nortint, tritum:  xiraypLx namque medi-
corum  appellatio propria est, plebi inusitatum." Meth. Med. Tom.
VI. 151. 
GE. II.]                  NOSOLOGY.                    409
       y Denudata.   Divided edge of the bone  penetrating
           the skin, and laid bare.
         Compound Fracture,
       ^ Complicata.  Combined with depression, dislocation,
           or other injury.
         Complicated Fracture.
 2. Fissura.  Bone cracked : the divided edges still in contact.
         External  violence: the internal derangement more
       than correspondent to the external injury.
       Selau.   Arab.
       Schrunden.   G.
       Felure.   F.
       Fissure.
         Chiefly affecting the cranium, though the long bones
       are occasionally subject to  it, and especially the  ribs.
       See Heister, Chir. Tom. I.  cap. vi.
       * Subjacens.  Fissure immediately below the external
           injury:  morbid symptoms confined to the same re-
           gion.
         Simple Fissure.
       0 Contra-jacens.  Fissure  and severest symptoms on
           the opposite side of the scull, to the external injury.
         Contra-fissura.—Resonitus.   Plouquet.
         Counter-fissure.
       y Complicata.  Combined with a counterstroke produc-
           ing concussion or extravasation; or with some asso-
           ciate injury on the same side.
             See a  singular case of Le Dran's in which the
           outer table of the head was fissured;  the  inner
           had a small bony  scale thrown off from it; and
           concussion with extravasation took  place on the
           opposite side of the scull.  Obs. xvii.



                      GENUS  II.

                       CAMPSIS.

     Bone or cartilage forcibly bent from its proper shape with-
       out breaking.

  Gen. II.  Campsis. Kxp*4>ts "flexio,  curvatio, inflexio:"  from
xx^ra, « flecto, inflecto, incurvo."
  vol.. v.—63 
410
NOSOLOGY.         [CL. VII.—OR. II.
1.  Depressio.   Form of the bone or cartilage flattened or
                  bent inwards.
      Thlasis.   Vog.
      Depressio.  Auct.  Var.
      Depression.                             .  .
         Found chiefly in young subjects; and principally on
      the cranium and ensiform cartilage of the chest.  Bone
      often recovering  its proper figure with the  gradual
      growth of the frame.
         Found also, occasionally, in persons predisposed  to
      parostia  fiexilis, or softness of bones : which see.
                    GENUS III.

                  EXARTHREMA.

  Extrusion of a bone from its seat of articulation.
      Exarthrema.   Auct.  Graec. Sauv. Sag.
      Luxatura.  Linn.
      Ankhyla.  Arab.
      Verrenckung.   G.
      Luxation.  F.
      Dislocation.
1. Luxatio.  Bone, easily and extensibly moveable, forced
                completely from its articulating cavity.
      Exarthrema Luxatio simplex.  Sauv.
      Exarthrema completum.  Alior.
      Luxatio.   Vog.
      Luxation complette.  F.
      Luxation.
         The  humerus has been luxated by a fit of convul-
      sions, Bilguer, Wahrnehmung. &c. p. 221.

  Gen. III.  Exarthrema. 'E%xptpyiput," exarticulatio," from xpQpoi,
"artus."   The term  is in  common use with Hippocrates, Galen,
and all the Greek writers.  Loxarthrus, by which the third species
is distinguished, is comparatively of modern date; but it has obtained
general credit,  and there is no necessity for disturbing it.  It is de-
rived from Xofyss " obliquus," and «&{•*, as above,—" twisted, oi
oblique joint." 
GE. IV.
NOSOLOGY.
411
2. Sublux atio. Bone, easily and extensively moveable, forced
                   partially from its cavity; and resting on the
                   edge of the socket.
       Exarthrema Subiuxatio simplex.  Sauv.
       Exarthrema incompletum.  Alior.
       Subiuxatio.  Vog.
       Luxation incomplette.  F.
       Subluxation.
         In the Act. Nat.  Cur. Vol. X. obs.  68, is a singular
       case of luxation, or subluxation of the vertebrae of the
       neck, without serious mischief.
3. Loxarthrus. Bone, slightly and narrowly moveable, forci-
                    bly loosened  in its articulation, and dis-
                    torted  in its relative position.
       Loxarthrus.  Sauv. Sag.
       Perversio capitis Ossium.   Duverney, Tom. ii. cap. ii.
         Chiefly occurring in the bones of the chest, with  sub-
       sequent gibbosity, especially in young persons: and in
       the bones of the carpus and tarsus, producing crooked
       wrists and splay-feet.
                     GENUS IV.

                    DIASTASIS.

  Forcible separation  of immovable bones  or  their appen-
    dages from their natural union with each other.
      Diastasis.   Auct.  Grace. Sauv. Sag.
      Ossium recessus.  Auct. Lat.
      Luxatio Diastasis.  Toung.
      Ecartement des  os.  F.
      Separation of bones.
1. epiphysica.  Separation of a bone from its epiphysis.
      Diastasis epiphysica.  Sauv.
      Diastasis epiphysium.  Duverney, Tom. II. cap. i.
         Confined to the stages of infancy and feeble adoles-
      cence : for the epiphyses of bones in a healthy constitu-
  Gen. IV.  Diastasis. Aixo-txitis, " interstitium, intervallum, di-
remptio,distractioin duas partes;" from fixrrnpu," separo,dissocio." 
412
NOSOLOGY.         [CL. VII.-—OR. III.
      tion become gradually apophyses or constituent parts of
      the bones themselves.
        Often mistaken by the unskilful for a luxation; and
      aggravated by vain and painful attempts to effect a re-
      duction.
         See, on this subject, Heister, Chirurg. Tom. I. 1.  iii.
      %  13. 19.
2. cartilaginea.  Separation of bones connected by an inter-
                     vening cartilage.
     , Diastasis synchondrosica.   Sauv.
      Diastasis synchondroseon.  Fabr. Hildan.
      Diastasis.   Parr.
         Exemplified most commonly in the separation of  the
      symphysis pubis in cases of preternatural labour: though
      other instances  are not unfrequent.
         Separation of the bones of  the pelvis by a violent fall
      from a horse, Phil. Trans. Vol. XLIV.  Cameron.—
       Leske,  Auserl.  Abhandl. III. 299.—Ileum  separated
      from the sacrum, Fabr. Hildan. Opp. p. 992.
 3. Sutoria.  Separation of connecting sutures.
       Diastasis raphica.   Sauv.
       Recessus suturarum Cranii.  Duverney.
       Diachalasis.   V'og.
         A separation of the sutures of the scull  is usually fa-
       tal.  Mr. B. Bell mentions one instance of an injury of
       this kind that terminated favourably; Surg. Vol. VI. ch.
       xl. sect. ii.
                  ORDER  III.

                 M 0 R P HI C A

              MONSTROSITIES  OF BIRTH.

Deformities anomalously produced during the generation or
  growth of the fetus.
  Ord. III.  Morphica.  Mogtptxx, " ad formam spectantia:" from
pu>e<p-o, "forma."
  Most of the genera under this order may find parallels among
plants which are perpetually affording monstrosities of every kind. 
GE. I.]
NOSOLOGY
413
                       GENUS I.


                   METROCELIS

  Congenital discolorations on the surface.
       Metroce'lis.   Auct. Var.
       Naevus.  Sauv. et Alior.
       Khal.  Arab. Pers. Bek. Ture.
       Muttermahle.  G.
       Envie.  F.
       Mother1 s-mark.
1. spilosa.  Simple, superficial, circumscribed stain; for the
               most part yellow, brown, or red.
       Naevus flammeus.  Plenck.
       Feuermahl.   G.
       a, Circularis.  With a circular or orbicular outline.
       /3 Foliacea.   Leaf-shaped.
       y Arachnoides.   With slender, claw-shaped, or spider-
            legged ramifications.
2. fructiformis.   Dark-coloured, yielding extuberance ; in
                      the form of fruit;  with a glabrous or
                       granulated surface.
                           The fruits  chiefly represented are
                         the cherry, currant, and grape, with a
                         smooth surface ;  and the mulberry,
                         raspberry,  and  strawberry, with  a
                         palpulous surface.
       « Pediculata.  Possessing a foot-stalk.
       x Sessilis.  Fixt to the surface  by a broad base.
3. turgescens.  Large, loose, sanguine,  irregular-shaped tu-
                    mour ; sensibly composed of a congeries of
                    bloated and distorted vessels.
Sometimes they occur in the stem, which is contorted, curved, or
otherwise crippled, and particularly  in cold  climates.  Sometimes
the leaves are supernumerary, frizzled, too  thick, or discoloured.
Trefoil, for example, occasionally produces four leaves; and the
beech and other trees occasionally leaves of  a permanent red.  So
fruits are frequently too large or too small, aggregate, crooked, or
offer twins of various kinds; among  the more curious of which  is
that of one involving another in its interior,  as especially occurs in
the lemon.
  Gen. I. Metrooelis. Myr^oxyXts, "materna macula:" from^T^, 
414
NOSOLOGY.          [CL. VII.—OR. III.
       Naevus cavernosus.  Plenck.—It also includes the pre-
         ceding.
4. diffusa. Discoloration spreading indeterminately over a
             limb, or a large part of the body.
                Riedlin describes a case of universal discolo-
             ration from a fright  of the  mother, making an
             approach to epichrosis Pozcilia: Lin. Med. 1696.
             p. 110.
5. Cana. Hair of the scalp hoary.  Schcnck ex Stuckio, Lib.
            I. obs. 3.
                      GENUS  II.

                    0L0PH0NIA.

  Congenital misconstruction of the vocal organs.
1. narium.  Misconstruction of the nostrils.
       * Obstruens.  Impeding the utterance, from imperfora-
           tion or other cause.
         Imperforate Nostrils.   Toung, p. 414.
      /3 Defectiva.  The organization incomplete.
2. linguyE.  Misconstruction of the tongue or its appendages.
       Paraglossa.  Vog.
       x Adhesiva.  Adhesion  to the surrounding parts.
         Adhesion of the Tongue.   Toung. p. 414.
       /3 Fraenata. Tied beneath by contraction of the fraenum,
           or its extending too  near the tip.
         Ancyloglossum.  Auct.
         Tongue-tie.
" mater," and xyXis, " macula."  See Mr. Abernethy's valuable re-
marks foi removing many of the worst cases of this deformity with-
out an operation, by merely confining the distended vessels, and di-
minishing the temperature; illustrated with several successful cases.
Observations, 1810. p. 224.
  Naevus is a more common name for this affection than metroce-
lis ; but it is a barbarous term of very doubtful origin.
  Gen. II. Olophonia.  'OXoQavtx,  for eA«a^*y««, " oblaesa  vox :"
from oXXa, flAA««, or oXXvpi, "perdo, perniciu .< infero, perimo;" and
pan, vox.  Crat. in Horis ex Athen. 1. ix.  The genus is wide, but
the term sufficiently extensive to cover it. 
»E. III.]
NOSOLOGY.
415
      y  Deglutatoria.  Fraenum loose or absent, and the tip
           of the tongue doubling back upon the fauces.
         Paraglosse deglutatoria.   Sauv.
           For examples, consult Petit'*" Observations," con-
         taining numerous cases.
3. palati.  Misconstruction of the palate.
      Hyperoum.  Auct. Var.
4. labii.  Misconstruction of the lips.
      x  Lobata.  Lip lobed  or divided in the middle ; edges
           separated and convex.
         Lagostoma.   Auct.
         Labium leporinum.  Sauv. I. 783.
         Hasen-scharte.  G.
         Bee de lievre.  F.
         Hare-lip.
           Usually, but not always, prevents suction, Brouzet,
         Sur PEducation Medic'des.  Enfans, II. p. 143.
      P%  Bilobata.  Lip bilobed, or doubly divided.
      y  Prolapsa.  One or both lips striking broad and pro-
           jecting.
                     GENUS  111.

                   PARESTHESIA

  Congenital misconstruction of the external organs of sense.
1. auditus.   Misformed organ of hearing.
       x  Flacca.  Lobe of  the ear broad, loose, and pendent.
         Proptoma auricularum.  Sauv.
           Said to be a common deformity among the natives
         of Siam.—The source of the surname  of Flaccus in
         ancient Rome.
         Flap-ear.
         " A beetle-headed, flap-ear*d knave."   Shaksp.
       $  Obstruens.  Impeding the entrance of sound, from
           imperforation or other cause.

  Gen. III. Par^esthesis.  rixpxio-ivris, "sensus,  imperfectus :"
{voxT\irx£xto-6xtoi*Mt.«\x\ sensu fallor; incompossum sensus." Theme
xtrixioftxt, " sentio," whence JLsthetica, the name for Order II. of
Class IV. 
416                      NOSOLOGY.          [CL. VIL—OR. Ill

         Imperforate Ear.   Toung, p. 414.
       y Defectiva.  The organization incomplete.
         Cophosis congenita.  Sauv.
         Surditas congenita.  Alior.
         Congenital Deafness.
2. olfactus.   Misformed organ of smell.
       x Obstruens.  Impeding the entrance of scents,  from
           imperforation or other cause.
       /3 Defectiva.  The organization incomplete.
3. visus.  Misformed  organ of sight.
       x Unoculata.  Possessing only one eye.
         Unoculus.  Auct. Lat.
         Monopia (p-Mianix) Auct.  Grace.
         Cyclops.—Monoculus.  Plouquet.
           See Nov. Act.  Cur. Vol. VIII. obs. 7—Eller, Mem.
   Gen. IV.  Perosplanchnia.  n»)goo-7rXxy%nx." viscus mancum:"
 from wajfes, " mancus, mutilus, captus parte aliqui corporis,"  and
 <r7cXxy^vov, " viscus."   The latter part of the term is in the mouth
 of every one.
   Mutilations similar to these are also perpetually occurring among
 plants.   Sometimes from unfavourable climate or unaccordant soil,
 the corol is imperfectly formed ; and the disease is then termed flos
 mutilus.  In cold seasons the corols are sometimes entirely wanting
 in viola odorata and v. canina.   Wildenow asserts that campanula
 hybrida, in some parts of Germany,  is constantly without corols,
 though it possesses them in France and Italy.  We meet with a like
 defect in various species of ipomoea, tussilago,  and  lychnis.  The
 common clove-pink (dianthus caryophillus) must often have been
 seen by most persons with the scales of its calyx so much augment-
 ed that the flower resembles  an ear of wheat, and the  corol never
 appears.   In like manner the stamens are often imperfectly formed,
 and exhibit various mutilations : or the calyx is defective, or the
 Spur, in those naturally possessing this appendage, is entirely want-
 ing.
  6. /3. P. Geniturte Defectiva. The testes commonly descend about
the seventh month of pregnancy ; and if the descent do not take
place before birth, it is usually attended with some pain and trou-
ble, and is frequently not completed  till the approach of puberty.
But there are some tribes that are said to be naturally monorchia*,
or possessed of only a single testis.  Linneus made a distinct variety
of some African tribes of the  genus homo on this account;  and the
following passage from Mr.  Barrow's " Voyage to  Cochinchina"
gives some confirmation to the  idea.  " Some of the men among
the Koras (a supposed mixed breed of Hottentots and Kaffers) were
observed to be monorchids; but whether the defect was in conse- 
GE- IV.]                 NOSOLOGY.                     417
  de l'Academie de Berlin, 1754—Gilibert, Adversar.
  Pract. Princ.—Medinisches Wochenblatt,  1785.
0 Pupillaris.  Pupil incomplete in its power of vision.
                      GENUS  IV.

                 PEROSPLANCHNIA

   Congenital misconstruction of the viscera.
 1. cranii.  Misconstruction of the head.
       x Capitosa.  Head enormously bulky:  contents solid.
         Capito.  Auct. Lat.
         Revausey.   Arab.
         Grosse-kopffg.  G.
         Jolt-head.
       $ Hydropica.   Head enormously bulky  from dropsical
           affection.
           See Med.  Com.  Ed. VI. p. 422.—Remmeth: con-
         nected with deficiency of brain. Repeated punctures
         appeared useful.
       y Cerebralis.  Brain incomplete in quantity or organi-
           zation.
           Without cranium,  and  a fleshy  mass  instead of
         brain, Vallisner, Oper. I. 330—Soemmering.   Abbil-
         dungen und Beschreibungen einiger  misgeburten.
         Mainz. 1791—Without brain or medulla  oblongata,
         Dufour. Journ. de Med. xxxv.—Acephalous; lived
         eleven hours.   Act. Med. Berol. Dec. I. viii.—Lived
         five days ; another case six days;  Plouquet.
2. cordis.  The heart misconstructed or misplaced.
       x Perforata.  The two ventricles  communicating: lips
            purple.
         Cyania.  Cricht.
            Foramen ovale and ductus arteriosus open at seven-

quence of some operation submitted to while young on superstitious
grounds, or occasioned by accident, or  the sport of nature, does not
appear to have been ascertained."  A  similar defect has been  no-
ticed among one or two of the wandering tribes on the skirts of the
Caucasus; for which see Klaproth's Travels in the Caucasus and
Georgia,  in loc.  The  author has at  this time a  healthy family
  vol. v.—64 
413                     NOSOLOGY.          [CL. VII.—or. in.
         teen years of age, Mem.  Med.  Soc. Vol. VI.   Spry.
         See also description of malformation in  the heart of
         an infant, Standert,  Phil. Trans. 1805. p.  228.  A
         still more complicated case  in Baillie''s Morb. Anat.
         PI. VI.
       ,3 Translativa.   Heart transposed to the right side.
       y Expers.  Heart totally wanting.
           See Hexvson on  the Lymph.  Syst.  Part II. p. 15.
         There were other defects besides the total absence of
         the heart.   " The circulation  had 'been carried  on
         merely by an  artery and a vein,  whose  coats  there-
         fore probably  were muscular."
       ^ Multiplicata.   Heart duplicate, or more than dupli-
           cate.
           Double: See DyAbouville, Amer. Phil. Trans. Vol.
         I. v.—In a partridge,  Tode, Annalen  V. p. 1.   In a
         dog, Paullini, Cynograph. cur. p. 43.—In a hen, Eph.
         Nat. Cur. Cent. VIII. obs.  8—Triple: found  several
         times in geese.  Eph. Nat.  Cur. passim.
3. ALVEi.   The intestinal canal or its involucres misconstrued
             ed or perverted
       x Perforans.  The intestines perforating the involucres.
           See Calder  Ed. Med. Ess. I. art. xiv.  Intestines
         appeared externally, having  fallen through a perfora-
         tion above the navel: child in health when born, but
         died four days afterwards.
       /3 Defectiva.  Some  of the  parts  wanting.  See  Din-
           more, Lond. Med. Journ.  XL p. 339.  Parietes de-
           ficient.  Similar defect, Act.  Soc.  Med. Hafn. I.
           Saxtorph.
       y Obstruens.   Obstruction in the alvine passage, from
           imperforation or other cause.
             See Calder, as above, case 2.  Fleshy tumour.—
         Pylorus imperforate from a fleshy tumour seated  on
         it, and completely blocking it up: duodenum double:
         child lived seven days after birth.   See Calder, as
         above, case 2.

under his care, in which all the sons, consisting of three, were suc-
cessively born anorchid or monorchid : in the eldest, fourteen years
of age, both  testes have  now descended;  in the  second, thirteen
years old, one has descended, the other is now passing through the
ring; in the youngest, twelve years old, there is at present no proof
of more than one testis. 
GE. V.]
NOSOLOGY.
419
         Imperforate Rectum.  Baillie.
           See Pappendorp von der verschliessung der afters.
         8.  Leipz. 1783.
4. hepatis.  Misconstruction of the liver.
                Double. Schenck, lib.  iii. sect. ii. obs. 8.
5. vesica.   Misconstruction of the bladder or urinary channel.
               Bladder deficient. Duncan, Edin. Med. Journ.
            IV. 403.
              Urethra imperfect and imperforate: urine dis-
            charged from a papilla near the navel: child other-
            wise  in health: age not  mentioned.   Mowath.
            Edin. Med. Ess. Vol. III. art. xiv.
6. genituRjE.  Misconstruction of the genital organs, or their
                 appendages.
      «  Superflua.  Organization superfluous or anomalously
           multiplied.
           Double uterus  and vagina.  Purcell, Phil.  Trans.
         1774, p. 472.
           Double penis. Schenck, Hist.  Monstror. Plouquet;
         Von der  Erbfahigkeit der kinder, p. 38.
           Penis of enormous size.   Memoires concernant les
         Arts.  1672, p. 27.  Wolf, Lect. Memorab. 1.434.
      0  Defectiva.  Organization incomplete.
           One or both testicles defective.  Generally  from
         eman-;ion.
           Prepuce or clitoris imperfect  or wanting.
         Vesiculae seminales confusedly  united, and wanting
           their  excretory ducts.  The  necessary  result of
           this  defect in an arlult must  be  dysspermia, and
           consequently agnesia.   See Baillie, Morb. Anat.
           Fasc. VIII.'pi. 1. fig-2.
      y  Obstruens.  Obstruction in  the male or female pas-
           sage from imperforation or other cause.
         Atreta.   Vog.
   GENUS  Y.

PEROMELIA.
  Congenital misconstruction or mutilation of the limbs.
1. decurtata.   Limbs curtailed of their proper length. 
420                      NOSOLOGY.         [CL. Vn.—OR. IH
       Artetiscus.   Vog.
       x Brachii.   Arms preternaturally abridged.
       j3 Cruris.  Legs preternaturally abridged.
2. truncata.   Limbs or parts of a limb totally wanting.
       * Capitis.   Head totally wanting.
       P Brachii.   Destitute of one or both arms.
       y Cruris.  Destitute of one or both legs.
       ^ Manias.  Destitute  of one or both hands.
       e Pedis.   Destitute of  one or both feet.
       " Complicata.  Destitute of various limbs.
3. contorta.   Limbs incurvated or confused in their organi-
                  zation.
         Fedaet.   Arab.
       x Colli.  Wry-necked.
         Saur.  Arab.
       ,3 Gibbosa.   Hump-backed or hump-shouldered.
         Akdab.   Arab.
       y Valga.  Bow-legged or bandy-legged.
         Akel.  Arab.
       S* Plauta.   Splay-footed or splay-handed:  having the
           foot or hand turned inwards.  Hence the name of
           Plautus, the Roman dramatic poet.
         Fedegh.   Arab.
       e Loriformis.   Club-footed or club-handed.


  Gen. V.  Peromelia.  HveopuXix: from irqgos, as above, and jueAos,
"membrum:" whence -ryeopuXns.   "mutilus, qui  mutilatus,  est
membris."
  2. v.  P. truncata Complicata.  Miss Bevan, thus preternaturally
mutilated, exhibited  herself a few years ago, in  this metropolis: a
mere head and trunk, with the rudiments only of shoulders and low-
er limbs.  She was about  thirty years of  age, of agreeable face,
form of body and manners; well educated;  worked with her needle
by means of the tongue; and painted minature portraits with great
delicacy and close resemblance, by holding her pencil between the
right cheek  and shoulder; by the same contrivance she wrote a
neat running hand.
  4. x. P. superfi.ua Digitorum. The peculiarity isoften propagated
to succeeding generations. See Mr. Carlisle's account of the family
of the Colburns of America: one of whom was lately exhibited in
this  metropolis as a boy of extraordinary  powers  in  arithmetical
calculations, Phil. Trans. 1814, p. 94.  Some of the families of the
ancient Philistines appear to have possessed the same peculiarity,
2. Sam. xxi. 20.   As also several among the Romans; for which
see Pliny, lib. xi. cap. 43. 
GE. VI.]
NOSOLOGY.
421
4. superflua.   Limbs or parts of a limb superfluous.
       Hyperartitiscus.   Vog.
       » Digitorum.  Supernumerary fingers or toes.
       P Crurum.   Lower extremities superfluous.
           Nates and lower extremities of a  second issuing
         from the abdomen of a first. Buxtorf in Aet. Helvet.
         VII. 12.
                     GENUS VI.

                     POLYPERIA.

  Congenital misconstruction of various parts or organs.
1.  promiscua.  The parts or organs  of one cavity confused
                   with those of another.
       *  Translativa.   Transposition  of  organs  from their
           proper seat.
           Abdominal  viscera in the thorax. Macaulay, Med.
         Obs. Inq. I. 25.
           Total transposition of the  abdominal and thoracic
         viscera; Sampson, Phil. Trans. 1674.
       (3  Vascularis.  Inverted distribution of the arteries.
           Baillie, PI.  21.
  Gen. VI. Polyperia.  UoXw^tx. from ToXvs, " multus," and wnpos,
"mutilus," as above: " multi-mutilatio."
  Here again we meet with similar examples in the vegetable world.
Thus, in double or treble flowers (flos multiplicatus,) the petals are
preternaturally numerous, but not so as to intefere with the semi-
nal organs.  In full flowers (flosplenus,) the petals are so multipli-
ed and crowded as to suppress the growth of the seminal organs,
and consequently to  prohibit increase; often, indeed,so crowded, as
to burst the calyx.   The first chiefly occurs in monopetalous flow-
ers, as primula, hyacinthus, polyanthes: the second in polypelatous
plants, as pyrus, fragaria, rosa, ranunculus, papaver, paeonia. Some-
times we find the spurs multiplied, and the petals completely want-
ing, in aquilegia  vulgaris, narcissus  pseudonarcissus, and various
others.  In other species of narcissus the petals sometimes remain
natural, and the nectarium is multiplied : and in other species of
aquilegia the petals  are increased, and the spurs  entirely wanting.
See Wildenow, Elem. Botan.  chap. vi. § 334, 335. 
422
NOSOLOGY.
[CL. VIL—OR. UT
  2. superflua. Superfluous organization general, or extending
                   to various  organs.
        x Biceps.  Head double.
             Double  head with single  body;  one pair of legs
          and of arms : internal organization  on many parts
          double, and  inclining to  hermaphroditism ;  Gibson.
          Phil.  Trans.  1810.  p.  123.  Fourcroy,  Medicine
          Eclairee, I. 271.   Haller  Opp. Tom.  I.—Double
          with  double heart,  Eph. Nat.  Cur. Dec.  I. ann.  i.
          obs. 7.
        G Bicorpor.   Body  double.
             Percival, Phil.  Trans. 1752. 360 ;  Twins coalescing
          at the belly ; successfully separated.  Facio,  Helve-
          tische verniinftige Wehmutter.
            Twin-sisters, coalescing at the os sacrum ; alive,
          and adults, Waldschmid, Diss, de Sororibus gemellis,
          &c.   Kinon, 1709. Another case of adults,  Walther,
          Thes. Obser.
            One head, two  bodies.  Duverney, Comment. Pe-
          tropol. III. 177.
            Two bodies ; alive, Walther, Thes. Obs. 93.
        y Convolvens.  One individual enclosed within another.
            G. W. Toung, Medico-chir. Trans. I. 234.
  .._________i-----------------------------------------------■---------------------------__
   2. G.  P. superflua.  The vegetable  world  crowded with exam-
 ples  of organic superfluity  or multiplied form.  There are few
 plants that do not occasionally exhibit  double or triple seeds : every
 kind of nut furnishes us daily with abundant examples.—So in Vol.
 I. of the Amanitates Academica,  we have an instance of a common
 yellow toad-flax (antirrhinum Linaria) producing five nectaries from
 a monopetalous pentandrous tube, instead of a single nectary from
 a ringent tetrandrous  flower, year 1744.  Dissertatio de Peloria.
 Resp. D. Rudburg.
  2. <5" P. superflua, Hermaphroditus.  Some kinds of animals, and
 especially in the lowest ranks, are natural hermaphrodites, as  the
 hirudo viridis, or garden snail, and the fasciola hepatica,  or sheep
fluke.  In animals having distinct sexes, whenever it occurs, it is
from a morbid or unnatural production of organs.  This misconfor-
mation is perhaps to be traced in most tribes, but it is more com-
mon in some than in others; and, in different instances, is to be met
with in all its gradations, from the distinct sex to the most exact
combination of male and female organs.   In the human  species,
however, the last happens very  rarely, and  perhaps  no perfect
specimen is to be found except i'i monsters exhibiting a double set
of other organs more or less completely developed, and which non- 
GE. VI.]                  NOSOLOGY.                      423

           A similar monstrosity in the vegetable world is to
         be found in the Transactions of the Stockholm Aca-
         demy, Vol. I. p. 414, under the title of Pomerantz med
         et inneslutit foster.  It consists of one orange growing
         within another.  The fruit was exhibited to the Soci-
         ety by Count Tessin.
       £ Hermaphroditus.   Genital organs  of both sexes in
           one individual.
         Hermaphroditus.   Vog.
         Khenshi.   Arab.
         Zwitter.   G.
           See Parsons, Phil. Trans. 1751.  p. 142. Ruysch,
         Observat.  Anat. n. 12.   Garfon et  Fille hermaphro-
         dites, &c.   Paris  1772.  C. Lips. Vol. XX.  p. 632.—
         Gentili, Relazione d'un individuo delle specie umana
         fino all' eta  di 13 anni creduto femmina, e poi reco-
         nosciuto per maschio, &c.  Firenze 1782.
           Baillie,  Trans.  Soc. Medico-ch. Tom. I. 189.  Gib-
         son, Phil.  Trans. 1810,  p. U'3; single body  with
         double h  ad,  the  one a  male,  the other  a female,
         double heart and  spine, and male and female genital
         organs more perfect than usual
sequently offer cases of imperfect germination, or an abortive  at-
tempt to produce twins.  In dogs and cats it is more frequent; but
far more so in the horse, ass, sheep, and  black cattle.  There is a
very striking character in the hermaphrodite of the ox kind.   When
young, its general features are an intermixture of the bull and cow-
considerably resembling  the spayed heifer or ox, properly so called :
and its flesh is usually found of a finer flavour than that of the ox.
Its generic organs  are more nearly allied to the female,  but there
is no instance in which those of  both sexes  have been found perfect
in the same individual.   This epicene production is necessarily bar-
ren ; and as the Romans applied the term taura to some cows that
were barren, hereby giving to a masculine noun a feminine termina-
tion, it has  been ingeniously conjectured  that they were  not  unac-
quainted with the  nature of the  animal before us.  In our own
country it is uniformly known by the name of a free-martin.  Its
production is also curious.  If a cow have twins both of the same
sex, or in other words, twin-bulls or twin-cows—each of the twins
is perfect in its make: but if the twins consist of a bull-calf and  a
cow-calf, the bull-calf alone is perfe' t, and the cow-calf is uniformly
a free-martin.   See Mr. J.  Hunter's treatise on the subject, in his
" Observations on animal Economy," p.  55. 
424                     NOSOLOGY.          [CL. VIL—OR. III.

3.  defectiva.  Defective organization general, or extending
                  to various organs.
      * Nanus.  The organization of the whole form distinct-
           ly developed, but inordinately diminutive.
        Zwerg. G.
        Nain. F.
        Dwaif.
           Weighing, at fifteen years old, from twelve to thir-
        teen pounds only ; and at the utmost only thirty-one
        inches high ; crooked ; Browning, Phil'  Trans. 1791.
        278.
      p Mola.   General organization imperfectly  and indis-
           tinctly developed.
        Mezghet.  Arab.
        Mole.
           Twin-mole without a heart.  Le Cat, Phil. Trans.
        167.1. 
NOSOLOGICAL  INDEX.
The Classes and Orders are distinguished by Small Capitals, and the Genera
                             by Italics.

  The letter A indicates that the term is an Arabic,- F a French,- and G a
                          German Synonym.
Aberwitz, G. 236
Abortion, 319
Abortus, ib.
Abscess, 117, 118. 120
Abscessus, 115
Absence of mind, 230
Abserdi,. /. 299
Abstraction of mind, 231
Abwechselnd-fieber, G. 101
Acampsia, 262
Acdab, A. 420
Achor, 378
Achores, 378
Accouchement contre nature, F. 320
              laborieux, F. ib.
Acna, 125
Acne, ib.
Acbotica, 354
Acrotismus, 264
Addephagia, 16
Adenophagia, 345
Adipsia, 14
Adstrictio, 31
jEgritudo, 23
JESTHEVICA, 237
JEthiops, 196
Aftaden zihdan, A. 316
Agacenent des dents, F. 8
Agalactia, 301
Agalaxis, ib.
Agenesia, 308
Ageustia.; 255
Agrypnia, 274
Ague, 101. 103,104
Ague-cake,  65
Ahenje, A. 371
Ahul, A. 247
Aigreur d' estomac, F. 22
Akel, A. 420
  vol. v.—65
Akhezet, A. 263
Akret, A. 314
Albino, 196
Albor cutis, ib.
Algor, 258
Alhemake, A. 164
Aiken, A. 80
AUotriophagia, 19
Alopecia, 379. 389, 390
Alp, G. 89
Alphos, 367             ,
Alphosis, 195
Alusia, 225
Alysmus, 275
Amas, Pers. 328
Amaurosis, 245
Ambition, 223
Amblosis, 319
Amblyopia, 237, 238, 239, 240
Amenorrhcea, 295
Amentia, 234
American yellow-fever, 108
Amnesia, 234
Amor insanus, 224
      sui, 223
Amphemerinus,  107, 108
Anabexis, 10
Anacatharsis, 82
Anaesthesia, 259
Anaphrodisia, 309
Anaptysis, 82
Anasarca, 151. 337
Ancyloglossum, 414
Anetus, 101
Aneurism, 213
Aneurisma, ib.
Anepithymia, 304
Angina, 89. 134
Angone, 13
Angst, G. 275
Anhelatio, 85 
126
INDEX.
 Anhelation, 85
 Anilitas, 236
 Ankhyla, A. 410
 Annulus repens, 374
 Anosmia, 253, 254, 255
 Ansa, 236
 Anorexia, 17. 25
 Anstossen, G. 79
 Anthrasia, 176
 Anthrax, 124
 Antipathia, 276
 Antipathie, F. ib.
 Antipathy, rb.
 Anxietas, 275
 Anxiete, F. 275
 Anxietudo, 224
 Anxiety, 275
 Apalotica, 395
 Aphelxia, 229
 Aphonia, 75. 77
 Aphoria, 313
 Aphronia, 292
 Aphtha,  168
 Aphthes, F. ib.
 Apocenosis, 22. 349
 Apoplexia, 292
 Apoplexie, F. 292
 Apoplexy, 292
 Apogeusis, 255
 Apospasma, 410
 Apostema, 114
 Aposteme, 115
 Appetit bizarre, F. 19
 Appetite canine, 16
 Appetite morbid, 15
 Apsychia, 282
 Arbedet, A. 276
 Ardeur in coeur, F. 21
 Ardor, 258
 Area, 390
 Arek, A. 274
 Areknak, A. 355
 Arrhoea, 295
 Arthritis, 151.  155
 Arthrosia, 151
 Asaphia,  79
 Asef, A. 375
 Ascarides, 46. 48, 49
 Ascites, 340
 Ascite, F. 340
 Askites, ib.
 Asphyxia, 264. 288
 Astasia, 275
 Asthenia abstinentium, 18
Asthenia  deglutitionis, 13. 81
Asthma, 86, 87. 89
Asoupissement, F. 291
Atecnia, 314
 Atheroma, 331
 Atrophia, 189
 Attritio, 398
 Augensternverengerung, G. 244
 Avarice, 224
 Auditus acrior, 250
         difficilis, ib.
         imminutus, 251
 Augenentziindung, G. 145
 Aukile, A. 217
 Auri fames, 224
 Aurigo, 56. 393
 Avekeb, A. 308
 Autalgia, 91. 257. 266
 Ausatz, G. 367
 Auswartskenrung des augemlieds, G.
   249
 Azeb,A. 389

                 B.

 Bacchia, 126
 Baillement, F. 270
 Ballismws, 271
 Bambalia, 79
 Baras, A. 367, 368
 Barrenness, 314
 Battarismus, 79
 Bauch-fluss, G. 37
 Bave, F. 11
 Bee de lievre, F. 415
 Begayement, F. 79
 Behr, A. 85
 Bein-bruch, G. 408
 Bek, Ture. 413
 Bekym, A. 75
 Beladet, A. 235
 Bemiihung zum brechen, G. 24
 Benat-allil, A. 166
 Beriberi, 273
 Berlue, F. 241
 Betise, F. 234
 Bex, 82
 Bezoar, 41
 Bezoardus, ib.
 Biccho, Portug. 384
 Bikhudlik, A 291
 Black vomit, 59
 Bladdery fever, 171
 Blxsitas, 80
 Blasenaus-schlag, G. 171
 Blasenstein, G. 353
 Blear-eye, 147
 Blebs, 372
 Bleeding at the nose, 186
 Blehung, G. 23
Blenorrhxa, 298
Blepharoptosis, 249 
INDEX.
427
Blinzen der augenlieder, G. 269
Blessure, F. 396
Bloody urine, 187
Bluten, G. 186
Blut-speyen, G. 187
Boak, A. 367
Boil, 123
Bombus, 23
Bones, flexibility of, 333
       fragility of, ib.
Borborygmus, 23
Bougeons, F. 125
Bradyspermatismus, 312
Branks, 134
Bredouillement, F. 79
Breeze-fly, 52
Brennerschlaus-schlag, G. 167
Brennen im magen, G. 21
Broken-wind, 86
Bronchitis, 134
Brown-study, 232
Bruck, G. 402
Bruise, 400
Brulure, F. 399
Briistbraune, G. 89
Bubo, 121
Bubonocele, 402
Bucnemia, 207
Bulimia, 16
Bulimos, ib.
Burn, 399
Busyr, A.  54
Boutons, F. 358
Byzeban, Pera. 76

                C.

Cacatoria, 37
Cachexia icterica, 57
Cachexies, 182
Caducus, 285
Caligo, 243, 244
Calculus (enterolithus,) 43
        intestinal, 44
        de la vessie, F. 353
        vesicx, ib.
Calus, F. 387
Callus, ib.
Calvities, 389
Campsia, 409
Cancer, 198
Canine madness, 279
Capistrum, 262
Capito, 417
Caput obstipum, 261
Carbuncle, 124
Carbuncular exanthem, 177
Carbuncled face, 126
Carbunculus, 124
Carfunckel,  G. ib.
Carcinoma, 198
Carcinus, ib.
Cardialgia, 20. 22
Cardiogmus, 214
Carditis, 138
Caries, 215.  218
Carphologia, 270
Cakpotica, 318
Caroncle, F. 386
Caruncle, ib.
Caruncula, ib.
Carus, 287, 288. 291, 292
Catacausis, 208
Catagma, 408
Catalepsia, 290
Catalepsie, F. 291
Catalepsy, 291
Catameniorum fluxus, 296
Cataphora, 291
Cataract, 244
Catarrh, 148
Catarrhus, 82.  85. 147. 347
Cathemerus, 102
Catochus, 265. 290
Catotica, 336
Cauma,  109. 133
Causis, 399
Causus,  108
Ceinture dartreuse, F. 374
Cele, 401
Cenotica, 294
Cephalaea, 279
Cephalalgia, 280
Cephalitis,  133
Cephaloxia, 261
Cerchnus, 93
Cercosis, 317
Cerion,  378
Champignon, F. 67
Change of voice, 78
Charbon, F. 124
Chartre, F.  197
Chassie, F. 147
Chaudpisse, F. 299
Chauliodus,  8
Chauvete\ 389
Chemosis, 145
Chicken-pox, 170
Chiggres, 384
Chilblain, 131
Chiques, F. 384
Chivalry, 226
Chlorasma, 304
Chlorose, F. 304
Chlorosis, 303, 304
Choiras, 197 
428
INDEX.
 Cholelithia, 61
 Cholelithus, ib.
 Cholera, 38
 Cholirica, 59
 Chololithus, 60
 Chorea, 271
 Choreomania, ib.
 Chordapsus, 27. 141
 Chrysomania, 224
 Chute du fondement, F. 55
       de la luette, F. 13
       de la matrice, F. 316
 Cinetica, 260
 Cirsus, 214
 Citta, 19
 Clap, 299
 Clasis, 408
 Clavellee, F. 382
 Clavus, 387
 Clonus, 267
 Clou, F. 119. 246
 Cochemar, F. 89
 Cceliaca, 1. 37
 Colebrilla, 385
 Cold, 72
      in the head, 14'.
 Coldness, 258
 Colic, 27
      Devonshire, 28
      painter's, 28
      Poictou, ib.
      wind, 30
 Colica, 26
       Laponica, 52
 Colique, F. 27
 Coma, 288. 291, 292
 Combustura, 399
 Comitialis, 285
 Commedones, 385
 Concussio, 400
 Concussion, 400
 Conductioives,  261
 Congenital deafness, 416
 Consumption, 192
 Constipatio, 32
 Contractura, 262
 Contracture, F. 262
 Contusio, 400
 Contusion, ib.
 Contusura, ib.
 Convulsio, 284
Convulsion, ib.
 Convulsion-fit,  ib.
 Convulsiones, 261
Cophosis, 250.  253. 416
 Coproatasis, 31
Coqueluche, F. 84
Cor de pieds, F. 387
 Corns, 387
 Cornu cutanea, 370
 Corpulence, F. 326
 Corpulency, 326
 Coryza, 70, 148
 Costiveness, 32
 Cough, chin, kin, or kind, 84
        chronic, of old age, 83
        common, 82
        dry, 83
        hooping, 84
 Coup d' arme a fen, F. 396
       de sang,  F.  292
 Couperose, F.  126
 Cours de ventre, F. 37
 Courbature, F. 100
 Courte haliene, F. 85
 Cow-pox, 169
 Crab-louse, 383
 Crachement de sang, F. 187
 Cramp, 265
 CrampfF, G. ib.
 Crampus, ib.
 Craziness, 220
 Credulitas, 235
 Credulity, ib.
 Cremason, F. 22
 Crepitus, 23
 Cretinismus, 194
 Criihe, 122
 Cross-birth, 320
 Crotaphus, 280
 Croup, 136
 Croute de lait,  37 H
 Crusta lactea, 378
 Crystalline-pock, 176
 Cura, 224
 Cut, 396
 Cutaneous blush, 357
 Cyclops, 417
 Cynanche, 134, 135
 Cynorexia, 16
 Cyrtosis, 193
 Cytisma, 373

                D.

 Dahus, A. 127
 Dal fil, A. 207
 Dandriff, 366
 Danse de St. Guy,  272
 Dark spots before the  eyes, 242
 Dartre, F. 373,  374
        encrounte"e, F.  374
 Daus ssaleb, A. 38 y
 Day-sight, 238
 Dazzling before the eyes, 242
Deafness, 253 
INDEX.
42!)
Deaf-dumbness, 77
Decline, 190
Defluvium capillorum, 389
Defluxio, 37
Degout, F. 24
Delirium, 220. 222
Delilik, Tvrc. 234
Demm, A. 402
Demmel, A. 123
Dementia, 222
Demence, F. ib.
Denbel, A. 121
Dentition, 3
Depdt laiteux, F. 120. 151
Depressio, 410
Depression, 410
Desiderium, 224
Desasossiego, Span. 275
Desperatio, 224
Desperation, ib.
Despondency, ib.
Devar, A. 281
Diabetes, 348
Diachalasis, 412
Dialysis, 396
Diaria, 100
Diarrheea, 36
Diary  fever, 100
Diastasis, 411
Dicke, G. 326
Dik,A. 108
Dinus, 281
Diplopia, 243
Dipsosis, 14
Dislocation, 410
Distensio, 400
Distillatio, 71
Distrix, 389
Dacmonomania,  227
Dotage, 236
Double hearing, 252
Double ouie, F. ib.
Douleur du fondement, F. 53
        d' oreille, F. 133
Doximania, 223
Dragoneau, F. 385
Dragsinta, Suecic, 272
Drey-tagig fieber, G. 103
Driff, Sax. 98
Drivelling, 11
Drop serene, 245
Dropsy, 337
Drusenkrankheit, G. 207
Dublet, A. 115
Dumbness, 75
Dummheit, 234
D urate" d' oreille, F. 251
Dwarf, 424
Dysaesthesia, 235. 237. 249. 255, 256
Dyseccea, 250, 251, 252
Dysecoia, 250
Dyscyesis, 437
Dysemesia, 24
Dysenteria, 32
Dysenterie, F. 36
Dysentery, 36
Dysmenorrhea, 295
Dysopia, 238, 239, 240
Dyspepsia, 15. 25
Dyspermatismus, 312
Dysphagia, 11
Dysphonia, 77
Dysphoria, 274, 275
Dyspnoea, 84
         catarrhalis, 83
Dysthetica, 182
Dystocia, 318
Dysspermia, 312
Dysuria, 347. 353

                E.

Ear-ache, 133
Ecdora, 398
Ecartement des os, F. 411
Eccyesis, 322
Eccbitica, 325
Echauboulure, F. 375
Echarde, F. 397
Eckel, G. 24
Eclampsia, 284
Ecorchure, F. 132. 398
Ecphlysis, 370
Ecphronia, 219
Ecphyma, 64. 66. 150. 328. 386
Ecplexis, 280
Ecpyesis, 376
Ecrouelles, F. 197
Ecstacy, 291
Ecstase, F. 291
Ecstasis, ib.
Ecthyma, 376. 380
Ectropium, 249
Eczema, 375
Eczesma, 362
Edema, 337
Efflorescence benigne, F. 359
Eintagages fieber, G. 99
Eiteraug, G. 246
Eiter-blassen, G. 122
Eiter-beule, G. 119
Eiter-finnen, G. 376
Eiter-geschwulst, G.  115
Ekrah, A. 24
Elatio, 225
Elephas, 204 
4S0
INDEX.
Elephantiasis, 203. 205
Elcus, 216
Elf-sidenne, Sax. 89
Elephantanaussatz, G. 206
Emesis, 23
Emaciation, 189
Emmixium, 156
Empathema, 223
Emphlysis, 167
Emphractica, 64, 65
Emphragma, 14. 385
Emphyma, 327
Emphysema, 342
Empreama, 132
Emprosthotonos, 263
Empneumatosis, 343
Emptoe, 186
Emptoys, ib.
Empyema, 118
Empyesis, 173
Enanthesis, 162
Encausis, 399
Enchefrenement, F. 72
Encystis, 331
Enecia, 109
Engbriistgkeit, G. 85
Engelure, F. 131
Enkebas, A. 32
Ennuie, F. 229
Entasia, 260
Enteritis, 141
Enterica, 1
Entero-cele, 402
Enterolithus, 40
Entero-epiplocele, 492
Enthesis, 406
Entonia, 261
Entorse, F. 400
Entziickung, G. 290
Entziindung der blase, G. 144
            darmen, 141
            hertze, 139
            lebeh, 142
            langen, 137
            magens, 140
            miltz, 143
            mutter, 144
            nieren, 143
Envie, F. 413
Envie de vomir, F. 24
Enuresis,'349
Epanetus, 107
Ephelis,  392
Ephemera, 99
Ephialtes, 88
Ephidrosis, 355, 356
Epicrosis, 391
Epilepsia, 285
 Epilepsy, 285
 Epimelium, 326
 Epinyctis, 373
 Epiphora, 10. 145
 Epiplocele, 402
 Epiploitis, 139
 Epistaxis, 186
 Epizootia, 382
 Epreinte, F. 54
 Epulis, 9
 Eraillement, F. 249
 Erbrechen,  G.  24
 Erethismus, 89. 275. 279
 Ereuxis, 23
 Ergot, F. 216
 Erkaltung, G. 148
 Erosion, 132
 Ertodung, G. 215
 Eructatio, 23
 Ertihash, A. 398
 Erysipele, F. 128. 173
 Erysipelas, 173
 Erythema, 128
 Eshera, A. 362
 Esr, A. U5
 Essera, 362
 Eterniiement, F.  268
 Etisie, F.  190
 Etiska, A. 337
Eshal, A. 37
Esquinancie, F. 134
Evanouissement, F. 282
Eversion of the eye-lids, 249
Exangeia, 212
Exangia^ ib.
Exania, 54
Exanthematica, 157
Exanthems,  157
Exanthesis, 357
Exarthrema, 410
Excoriatio, 398
Excoriation, ib.
Excoriatura, ib.
 Excrescentiae, 328
 Exoryste, 317
 Exoneirosis, 234
Exormia, 358
Exostosis, 332
Expectoratio, 82
             solida, 136
 Extra-uterine fetation, 322

                 F.

Faifait, A. 81
Faim, F. 16
Fainting-fit,  282
Fallende-sucht, G. 285 
INDEX.
431
 Falling down of the fundament, 55
                    womb, 316
 Falling-sickness, 285
 Falsch-sehen, G. 241
 False conception, 324
 False sight, 241
 Fasciola, 49
 Fatuity, F. 234
 Fatuity, 234
 Favus, 378
 Febris, 93. 99
        alba, 304
        continens, 109
        continua, ib.
        dysenterica, 36
        inflammatoria, 109
        intermittens, 101
       lenta, 108
        maligna, 111
        putrida, ib.
        puerperalis, 112
        remittens, 107
        rubra, 164
 Fedegh, A. 420
 Feiste,  G. 326
 Felon, 127
 Felure, F. 409
 Fetation, extra-uterine, 322
 Fevak, A. 268
 Fever, 92
       diary, 96
       eruptive, 157
       hectic, 108
       jail, 111
       inflammatory, 109
       intermittent, 101
       nervous, 111
       putrid, ib.
       puerperal, 112
       scarlet, 164
       simple, 100
       vesicular, 171
       Feu de St. Antoine, F. 173
Feuerflecke, G. 130
Feuergxirtel, G. 374
Feuermahl, G. 413
Fickleness, 235
Fidgets,  275
Fievre, hectique, F. 108
       intermittente, 101
        ortie, 167
       quarte, 104
       quotidienne, 102
       rouge, 164
       scarlatine, 164
       tierce, 103
       vesiculaire,  171
Fish-scuppen-aussatz, G. 370
Fish-skin, 370
Fissura, 409
Fissura capillorum, 389
Fissure, 409
Flap-ear, 415
Flatulency, 23
Flatulentia, 23
Flatus, 22
Flea-bites, 383
Flecke, G. 391
Fleckerothe flecke, ©. 362
Fleisch-driise, G. 386
Fleurs blanches, F. 298
Flooding, 312
Fluke, 49
Fluor-albus, 298
Flux, bloody, 36
Flux du sang, F.  36
Folie, F. 220
Folly, 235
Forgetfulness, 235
Formica ambulatoria, 374
Fractura, 408
Fracture, ib.
Fragile vitreum, 333
Fragilitas, ib.
Frambcesia, 181
Frantzosen, G. 200
Frat, G. 131
Freckles, 392
Frenk zehemeti, A. 200
Fress-lust, G. 17
Freaeenkeit, G. 17
Fress-sucht, G. 16
Fret, 131
Fretillement, F. 275
Frieselblattern, G. 168
Frog-tongue, 14
Fungus haematodes, 198
Furoncle, F.  123
Furunculus, 123
Furor, 308
Gadfly, 50
Gahnen, G. 270
Galactia, 301
Gale, F. 380
Galactirrhoea, 301, 302, 303
Gallstein, G.  61
Gall-stone, ib.
Ganglion, 332
Gangrena, 214
Gangrene, ib.
Gaping, 270
Gasavet, A. 224
Gastritis, 140 
432
FM)EX
Gastrocele, 4TO
Gastrodynia, 22
Gedrif, G. 98
Geiffern, G. 11
Geilkeit, G. 307
Genetica, 294
Gelbe-haut, G. 393
Gelbsucht, G. 57
Gerstenkorn, G. 122
Gesasfall,  G. 55
Geskye, A. 282
Geschwar, G. 119. 216
Gespaltete haare,  G. 339
Ghero, Pers. 228
Ghemm, A. 228
Gicht,  G. 293
Glaucoma, 243
Glaucosis, ib.
Gleet,  299
Globus hystericus, 13
Gloria, 223
Glossocele, 13
Glucksen, G. 268
Glus, 347
Gluttony, 17
Goggle-eye, 247
Gonorrhdea, 299
Gordius, 51. 385
Gourmandie,„.F. 17
Gout, 90.  155
Goutte rose, F. 126
Goutte serene, F. 245
Granchio, Ital. 265
Gratelle, 381
Graue-staar, G. 244
Graukopf, G. 389
Gravedo, 72. 149
Gravel, 353
Gravelle,  F. ib.
Graviditas molaris, 32 *
          ovarii, 322
          tubalis, ib.
Gray-hairs, 389
Green sickness, 304
Gries, G.  364
 Griess in  den nieren, G. 352
 Grillenkopfheit, G. 228
 Grimmen, G. 27
 Grind, G. 378
 Grison, F. 389
 Grossen-durst, G. 14
 Grosse-kopff,  G. 417
 Grosse-panse, G.  326
 Grutum, 364
 Guinea-worm, 385
 Guldene ader, G. 54
 Gum-boil, 119
 Gutta rosea, 126
Gutta serena, 245

                H

Haarigkeit, G. 389
Haarkrankenkeit, G. 388
Haematemesis, 187
H.KMATICA, 92
Haematidrosis, 356
Haematuria, 187
Haemodia, 7
Haemoptoe, 186
Haemoptysis, 186. 191
Hitmorrhagia, 186
             cruenta, 54
             mucosa, ib.
Haemorrhois,  54. 188
Hair-worm, 51. 385
Haia, F. 392
Hallucinatio,  225. 227
Hararet, A. 258
Hare-lip, 415
Hardness of hearing, 251
Harn-flus, G. 349
Harm strange, G. 346
Harte-rothe,  G. 123
Hasbet, A. 165
Hasef, A. 368
Hase'm-scharte, G. 415
Harvest-bug-bite, 384
Haupt-schuppen, G. 366
Hauptwehe, G. 280
Hautgewachse, G. 363
Haut-insecten, G. 382
Haut-rothe, G.  128
Hautschwurung, G. 398
Head-ache, 280
Heart-ache, 224
      burn, 199
      sinking, 22
Heat, 258
Heat-eruption, 375
Heben,A. 340
Hectic fever, 108
Hectica, ib.
Hectique, ib.
Helminthia, 45, 46
Hemeralopia, 238
Hemicrania, 208
Hemiplegia,  298
Hemitritaeus, 107
Hemm, A. 275
Hemmai mehrikeh, A. 109
         murbau, 104
         mushelleshe, 103
 Hemorrhage, 186
Hemorrhagic, F. ib.
 Hemorrhoide, F. 54 
INDEX.
 Hemret, A. 173
 Hepatitis, 142
 Hepatocele, 404
 Heres, A. 376
 Herkeshet, A. 400
 Hermaphroditus, 423
 Hernia, 401, 402
 Hernia humoralis, 144
 Hernie, F. 402
        fausse, F. 342
 Herpes, 373, 374, 375. 377
 Hers, A. 400
 Hessat, A. 353
 Hesitation, 79
 Hiccough, 268
 Hidroa, 375
 Hieranosos, 284
 Hieropyr, 127
 Hirnfieber, G. 133
 Hirnwuth, G. ib.
 Hirsuties, 389
 Hirudo, 52
 Hives, 171
 Hoquet, F. 268
 Hordeolum, 122
 Hornhautapostem, G. 246
 Horn-pock, 176
 Huft-wehe, G. 154
 Hulas, A. 190
 Hunden-hunger, G. 16
 Hund-tolleit, G. 279
 Huneraug, G. 387
 Hur, Pers. 289
 Husr, A. 32
 Husten, G. 82
 Hydarthrus, 157
 Hydrachnis, 171
 Hydrocele, 342
 Hydrocephale, F. 338
 Hydrocephalus, ib.
 Hydrometra, 342
 Hydronosus, 100
 Hydropedesis,  355
 Hydrophobia, 279
 Hydrophobic, F. ib.
 Hydrophthalmia, 246
 Hydropes, 336
Hydrops, 336. 342
Hydrops siccus, 343
Hydropisie, F. 337. 342
Hydrorachitis,  339
Hydrothorax, ib.
Hyperoum, 414
Hyperuresis, 349
Hypochondrias, 227
Hypochondriasis, 228
Hypochondrie, F. ib.
 Hypochondrism, ib.
   vol. v.—66
 Hypochyma, 244
 Hypopyum, 246
 Hyposarca, 64
 Hyposarcidius, 337
 Hypostaphyle, 13
 Hysteria, 285
 Hysteric-fit, ib.
 Hysteritis, 144
 Hysterophyse, 344
 Hystriacis, 388

                 I.

 Jaundice, 57
 Jaunisse, F. ib.
 Ichnophonia, 79
 Ichorous exanthem, 167
 Icterus, 56
 Icthyasis, 369
 Icthyiasis, 370
 Idiotism, 236
 Jealousy, 223
 Jecur akend, Pers. 65
 Jecur fessadi, Pers. 142
 Jedrie, A. 174
 Jejunium, 18
 Jema, A. 120
 Jenun, A. 222
 Jesbe, A. 291
 Ignis, sacer, 129, 130. 180
 Jimmerat, A. 177
 Jirsam, A. 138
 Iklet, A. 363
 Ileus, 27
 Ileus haematites, 211
 Illusion, 225
 Imaginary sounds, 252
 Imbecility, 234
 Imbecillite', F. ib.
 Immobilitas pupillae, 245
 Impetigo, 368. 376, 377
 Imposthume in the Ear, 119
Impotence, male, 311
Impotentia, 310
Impuissance, F. 311
Incendium spontaneum, 208
Inconstance, F. 235
Inconstantia, ib.
 Incontinence d' urine, F. 349
 Incontinence of urine, ib.
 Incontinentia urinae, ib.
 Incube, F. 89
 Incubus, 88
 Indigestion, 25
 Inedia, 18
 (nepuisance d' ejaculation, F. 312
 Inflammation edematous, 128
            erysipelatous, 129 
434
INDEX.
Inflammation gangrenous, 129
            of the bladder, 144
                  bowels, 141
                  eves, 145
                  heart, 139
                  kidney, 143
                  liver, 142
                  lungs, 137
                  spleen, 143
                  stomach, 141
                  testicles, 144
                  womb, ib.
Inflammations, 113
Inflammatory blush, 128
Inflatio, 30
Inflation, 343
Influenza, 149
Infreddatura, ltal. 148
Inquietudo, 274
Insecten-stick, G. 397
Insanity, 220
Insomnie, F. 275
Intermittens, 101
Intermittent fever, ib.
Intertrigo, 131
Joint-ache, 152
Jolt-head, 417
Ionthus, 125
Iracundia, 223
Iris, 374
Irk Medini, A. 385
Irrationality, 234
Ischiadum malum, 154
Ischias rheumaticum, ib.
       a sparganosi,  151
Ischiocele, 404
Ischuria, 345
Itch, 380
     bricklayer's, 377
     grocer's, ib.
     mangy, 381
     rank, ib.
     watery, ib.
Itching, 257
Judam, A. 203
Junum, A. 133
Juzam, A. 206

                K.

Kabus, A. 89
Kafes, A. 244
Kalak, A. 275
Kalte-biss, G. 299
Kalte-geschwulst, G. 130
Kasho, A. 154
Kazech, A. 261
Kebz, A. 32
Kedazesh, A. 189
Kefijet, A. 287
Kelilsucht, G. 134
K3ichen, A.  86
Keiik, Ture. 363
Ktl, A. 378
Keleb, A. 277
Kereli, A. 131
Kr-rk, A. 216
Kervet, A. 402
Kesret, A. 401
Khabbet, A.  83
Khafa, A.  289
Khal, A. 413
Khefakan, A. 269
Khemkhemet, A. 78
Khenauk, A. 134
Khensi, A 423
Khora, A. iC'6
Khure, A. *15
Khyarjek, A. 121
Kibe, 131
Kieferaussatz, G. 123
Kindsflecken, G. 165
Kindspocken, G. 174
King's evil, 197
Kleinaussatz, G. 368
Klopffen,  G. 269
Knote, G. 328
Knoten, G. 358
Kceji, A. 24
Koleng, A. 27
Koltek, A. 388
Kouba, A. 364
Kratze, G. 380
Krebs, G. 198
Kriebelkrankheit, G. 214. 272
Kropf, G. 197
Krum-hals, G. 261
Kurtzer-athem, G. 85
Kurtsichtigkeit, G. 240
Kusof, A. 21

                L.

Labium leporinum, 415
Labour, lingering, 320
        morbid, ib.
Labour-show, 298
Laceratio, 401
Laceration, ib.
Laetitia, 223
Lagnesis, 307
Lagostoma, 415
Lahm, A. 328
Lallatio,  80
Land-scurvy, 211
Lascivious madness, 308 
INDEX.
I.ascivite, F. 307
Lanifendegicht, G. 153
Lauslgkeit, G. 383
Lax, 37
Leberflecke, G. 392
Leichtglaublickeit, G. 235
Leichtsinnigkeit,  G. ib.
Leipopsychia, 282
Leipothymia, ib.
Lenticula, 392
Lentigo, ib.
lipidosis, 365. 370
Lepra, 206. 367, 368
Lepriasis. 367
Leprosie, F. ib.
Leprosy, 206. 367
Lerema, 235
Lerze, Pers. 271
Lethargus, 291
Lethargy, ib.
Leucasmus, 391
Leuce, 368
Leucophlegmatia, 337
Leucorrhoea, 297
Levy, A. 400
Lichen, 361, 362,  363
Licheniasis, 359
Lienteria, 37
Limosis, 15
Linguae exsertio,  13
Lippitude, 147
Lippitudo, ib.
Lispeln, G. 81
Lisping, ib.
Lithia, 352
Lithiasis, 334. 352
Loathing, 24
Locked-jaw, 262
Lodgement of matter in the
L&emus, 178
Lolling-tongue, 13
Long round worm, 48
      tape worm, 49
      thread worm, 48
Long-fasting, 18
Long-sight, 239
Longing, 224
Looseness, 37
Louchotte, F 247
Lousiness, 383
Low-spirits, 228
Loxarthrus, 411
Loxia, 261
Lues, 199
Lumbago, 154
Lumbricus, 48
Lupia, 331
Lupus, 218
Laxation, 410
Laxatura, ib.
Lygmus, 268
Lyssa, 277

                M.

Macies, 189
Macula lata Plateri, 130
Maculae corneae, 243
Madness, 222
Maggot-pimple, 126
Mehl, A 391
Mahlergrimmen, G. 28
Mai a la tete, F. 280
Mai caduc, F. 285
Mai de dents, F. 6
    de la rose, F. 206
    de mere, F. 285
    de punta, F. 138
    de sole, F. 206
    des ardens, F. 180
Malacia, 20
Malacosteon, 333
Maladie des prisons, F. Ill
        imaginaire, F. 228
        noire,  F. 59
        pediculaire, F. 383
        soucie, F. 224
Malis, 382
Malum hystericum, 285
Mangel-durst, G. 15
Mania, 220, 221, 222
Manie, F. 222
Manquement de soif, F. 15
Marasmua, 189
Marisca, 54
Marcores, 189
Massledigkeit,  G. 19
Mastodynia, 120
Matted-hair, 388
Matuhlik, A. 234
Mauzel, A. 320
Maw-worm, 50
Measles, 165
Medend, A. 46
Megraine, F. 280
Megrim, ib.
Megs, A. 36
Mekhas, A. 320
Mekser, A. 408
Meloena, 59
Melalet, A. 228
Melancholia, 220. 228
Melancholie, 220
Melancholy, ib.
Melas, 368
Melasma, 380
chest, 118 
436
INDEX.
 Melasicterus, 59
 Meliceris, 332
 Memoriae debilitas, 234
 Memouk, A. 25
 Menshen-fiendschaft, G. 229
 Menorrhagia, 187. 295, 296. 298
 Menses antevertentes, 296
        retention of, 295
        suppression of, ib.
 Menstruation, excessive, 296
             laborious, 295
             profuse, 296
             vacarious, ib.
 Mentagra, 123
 Mental extravagance, 226
 Mesenteritis, 140
 Mesket, A. 324
 Meskim, A. 321
 Mesotica, 325
 Metamorphosia, 242
 Metritis, 144
 Metrocelis, 413
 Metrorrhagia, 187
 Mictus cruentus, ib.
 Milch-streichen, G.  151
 Mildew-mortification, 216
 Miliaria, 167
 Miliaris, 168
 Miliary fever, ib.
 Milium, 364
 Milk-spread, 151
 Millot, F. 168
 Misanthropic F. 229
 Misanthropy, ib.
 Miscarriage, 319
 Misgeburth, G. ib.
 Mismenstruation, 294
 Mola, 324. 424
 Mole, 424
 Mollities ossium, 333
 Molluscum, 332
 Monoculus, 416
 Monopia, ib.
 Morbilli, 165
 Morbicalculosi, 352
 Morbus pilaris, 385
       regius, 57
 Moria, 234
 Morosis, ib.
 Morpiones, 383
 Mors apparens, 288
 Morsus ventriculi, 21
 Mort de chien, F. 40
 Morta, 171
 Mortification, 214
JMosghet, A. 424
 Mother*s-mark, 413
 Mouth-watering, 10
 Mue de la voisc, F. 78
 Mum, A. 91
 Mumps, 134
 Mundschwanchen, G. 168
 Musca cibaria, 52
 Muscae volitantes, 242
 Mutitas, 75, 76
 Mutite\ F. 77
 Mutter-beschwerung, G. 285
 Mutter-mahle, G. 413
 Myitis, 153
 Myle, 324
 Myodesopia, 242
 Myopia, 240
 Myopiasis, ib.
 Myositis, 153

                N.

 Nachtblindkeit,  G. 238
 Nacht-mannlein, G. 89
 Naevus, 413
 Nagel-geschwar, G. 127
 Nain, 424
 Nanus, ib.
 Nasitas, 78
 Nasur, A. 387
 Nausea, 24
 Nauz, A. 307
 Necrosis, 216
 Nefrendis, 8
 Nehem, A. 16
 Nehva, A. 270
 Nekeb, A. 380
 Nekes, A. 333
 Nemesh, A. 392
 Nemim, A. 252
 Nephralgia, 352
 Nephritis, 143
 Nervous deafness, 251
        fainting fit, 282
        quinsy,  13
 Neshr, A. 373
 Nettle-rash,  167
 Network before  the eyes, 242
 JVeuralgia, 265
 Neurotica, 219
 Nourtrissure, F. 409
 Nezaruk, A. 284
 Niaiserie, F. 235
 Nictitatio, 269
 Niesen, G. 268
 Night-mare, 89
 Night-pollution, 234
Night-sight, 238
Nigredo a sole, 392
Nickris, A. 155
 Nirles, 374 
INDEX.
Noctambulatio, 233
Node, 332
Nodosia, 8
Noli me tangere, 218
Nouage, -F.'l94
         de la corned, F. 243
Noueure, F. 194
Nufas, A. 349
Numbness, 259
Nyctalopia, 238
Nyctalopie, F. ib.
Nyctegersia, 233
Nyctobasis, ib.
Nymphomania, 307, 308
Nystagmus, 247. 269

                O.

Oben und unten purgiren, G.
Obesitas, 326
Obesity, ib.
Oblivio, 234
Oblivion, 235
Obscuratio corneae, 243
Obstipatio, 32
Obstipitas, 261, 262
Obstructio, 406
Ocatoposis, 12
Odaxismus, 2
Odontalgia, 1
Odontia, ib.
Odontiasis, 2
Odoratus deperditus, 254
Oedema, 13. 87. 337
Oedoptosis, 315
Oesophagismus, 12
Oestrus, 50
Ohmacht, G. 282
Ohr-schmurtz,  G.  133
Olfactus amissio, 253
Olfactus acrior,  254
Ohphonia, 414
Oma, A. 243
Omentitis, 139
Oneirodynia, 89. 233
Onirodynia, 233
Onyx, 246
Opake cornea,  243
Ophiasis, 390
Ophthalmia, 145
Ophthalmie, F. ib.
Ophthalmites, ib.
Ophthalmy, ib.
Opisthotonos, 263
Oreillons, F. 134
Oroastica, 303
Orgeolet, F. 122
Orthopnea, 13. 85. 90
Oscheophyma, 342
Oscheocele, 342. 402
Oscitatio, 270
Ossificatio, 334
Ossium recessus, 411
Osteosarcosis, 334
Osthexia, 334
Otas, A. 268
Otalgia, 120. 133
Otitis, 133
Oubll, F. 235
Ouie engourdie, F. 252
     tendre, F. 250
Oxyopia, 238
Oxyphonia, 78
Ozdena, 73

                F.

Pain in the side, 114
Palmus, 24. 28. 269
Palpitatio, 269
Palpitation, ib.
Palsy, 293
Panaris, 127
Pandiculatio, 270
Pantry-fly, 64
Pantophobia, 279
Papula, 358
Papulae, ib.
Papulous-skin, ib.
Parabysma, 62
Paracusis, 249. 252
Paracoe, 249
Paracyesis, 318
Parxstheris, 415
Parageusis, 255
Paraglossa, 414
Paraglosse, 13
Paralysis, 293
         rachialgica, 28
Paralysie, F. 293
Paramenia, 294
Paraplegia, 293
Paraphimosis, 122
Paraphonia, 77, 78
Parapsis, 256
Parasitismus intestinalis, 46
Parasynanche, 135
Paristhmia, 134
Paristhmitis, 135
Parler du nez, F. 78
Parodynia, 319
Paronoea, 235
Paronchyia, 127
Paroniria, 232
Paropsis, 237
Parosmis, 253 
438
INDEX.
Parostia, 333
Parotis, 120
Parotitis, 134
Partus difficilis, 320
Paruria, 344
Passing of gall-stones, 62
Passio b'rivina, 382
      iliaca, 27
Passion, ungovernable, 223
Parulis, 119
Pelagra, 206
Pellagra, ib.
Pemphigus, 171
Pemphingodes, 168
Peripneumonia, 137
Peripneumonie, F. ib.
Peripneumony, ib.
Perirrhoea, 349
Peritonitis, 139
Pernio, 131
Peromelia, 419
Perosphlanchnia, 417
Perte d'odorat, F. 254
      de sang de femme, F. 296
Pertussis, 83
Perverse hearing, 252
Perversio capitis ossium, 411
Pervigilium, 274
Pest, G. 178
Peste, F. ib.
Pestilentia, ib.
Pestis, ib.
Petechiae  sine febre, 210
Petecchial scurvy, 210
Petite verole, F. 174
Pfniigel, G. 71
Phagadaena, 16
Phagaena, ib.
Phallorrhcea, 299
Phantasma, 241
Philautia, 223
Phimosis, 121
Phlegmatia, 337
           lactea, 150
           dolens, ib.
Phlegmatorrhagia, 71
Phlegmone, 118
Pheogotica, 113
Phlogotice, 132
Phlyctaena, 377
Phlysis, 126. 376
Phoenigmus, 210. 326
Ph&enicismus, 165
Phonica, 70
Photophobia, 238
Photopsia, 242
Phrenesie, F. 133
Phrenica, 219
Phrenitis, 133
Phrensy, 133
Phtharma, 243, 244
Phthiriasis, 382
Phthisie, F. 192
Phthisis, 191, 192
Phygethlon, 121
Phyma, 122
Phymatosis, 386
Physconia, 63. 66. 68, 69. 327
Physometra, 344
Pian, 182
Pica, 18
Pierre au fiel, F. 61
Piles, 54
Pimple, common, 375
Pin-eye, 245
Piquure, F. 397
Pissement de sang, F. 187
Pityriasis, 366
Plague, 179
Plaited-hair, 388
Playe, F.  396
Plethora, 184
Pleuralgia, 90
Pleurisie, F. 138
Pleuritis, 138. 154
Pleurisy, 138
Pleurodyne, 90. 154
Plica, 388
Plique, F. ib.
Pneumatica, 70
Pneumatosis, 343
Pneumonic a, 81
Pneusis, 82
Pnigma, 85
Podagra, 155
Podalgia, ib.
Pcecilia, 393
Pollution involuntaire, F. 234
Polydipsia, 14
Polype, F. 73
Polyperia, 421
Polypus, 73
Polypus vaginae, 317
Polypus uteri, ib.
Polysarcia, 326
Pompholyx, 371
Porphyra, 209
Porrigo, 377, 378. 390
Pousse, F. 85
Pox, 200
Pregnancy, morbid, 318
Presbyopia, 239
Presbytia, ib.
Preying care, 224
Priapism, 261
Priapisme, F. ib. 
INDEX.
439
Priapismus, 261
Prick, 397
Prickly-heat, 362
Pride, 223
Procidentia uteri, 317
Proctalgia, 53
Proctica, ib.
Proctocele, 55
Production uvulae, 13
Fraotia, 305
Profusio, 188. 210
Prolapsus ani, 55
          vaginae, 316, 317
          vesicae, 316
          uteri, ib.
          uvulae, 13
Protuberant eye, 246
Prurigo, 363, 364
Pruritus, 257
Pneumonia, 137
Pneumonitis, ib.
Presentation, preternatural, 320
Psellismus, 79
Pseudaesthesia, 260
Pseudoblepsis, 241
Pseudocyesis, 324
Pseudo-syphilitic disease, 203
Psoas, 117
Psoas abscess, ib.
Psora, 380
Psoriasis, 368
Psorophthalmia, 146
Psydracia, 125
Ptarmus, 268
Ptyalismus, 10
Pulmonaria, 137
Punctura, 397
Puncture, ib.
Purging and vomiting, 39
Purpura,  164.  168. 209
Pursiness, 85
Push, 119
Pustula, 376
Pustulae, ib.
Pustulous exanthem, 173
Pye-balled negroes, 394
Ptrectica, 92
Pyrosis, 22
Pyuria, 347
                 Q.

Quartaine, F.  104
Quartan ague, ib.
Quotidian ague, 102
Quinsy, 134

                 R.
Rabies, 277, 278
Rache fairneuse, F. 379
      seche, F. ib.
Radafet, A. 386
Radoterie, F. 236
Rage, F. 277
Rain-bow-worm, 375
Ralement, F. 75
Ranula, 14
Raphania, 272
Rash exanthem, 163
Rattling in the throat, 75
Raucedo, 77
Raucitas, ib.
Ravaglio, Ital.  171
Raush, A. 271
Recessus ossium, 412
Recollectionis jactura, 235
Red-gown, 359
Red-gum, ib.
Remed, A. 147
Remet, A. 215
Remittent fever, 108
Renversement de la matrice, F. 316
              de la vessie urinaire, F.
                               316
Restlessness, 275
Retching, 24
Retention d'urine, F. 345
Revausey, A. 417
ReVerie, F.  230
Revery, ib.
Rhachia, 194
Rhachialgia, 28
Rhacbitib, 194
Rhegma, 400
Rhencus, 74
Rheuma, 148
Rheumatism, 153
Rheumatismus, ib.
Rheumatisme  chaud, F. ib.
Rheume, F. 149
Rhinophonia, 78
Rhochmos, 75
 Rhoncus, 74
Rhypia, 375
Rickets, 194
Ring-worm, 374
Riquets, F. 194
Rootvont, Belg. 362
Rosalia, 164
Rose-rash, 357
 Roseola, ib.
 Roth-gesicht,  G. 126
 Rothlauf, G. 173
 Roth-nase, G. 126
 Roth-pfinnen, G. 125
 Rothe, G. 359
 Rothe-punkt,  G. 210 
440
INDEX.
 Rothe-ruhr, G. 36
 Rougeurs, F. 126
 Rougeole, F. 165
 Ruaf, A. 186
 Rubeola, 165
 Rubula, 181
 Ruck-gratkrankheit, G. 194
 Rugh, A. 23
 Running at the nose, 71
 Rupia, 375
 Ruptura, 401
 Rupture, ib.

                 S.

 Saamen, A. 252
 Saamenfluss,  G. 300
 Sahik, A. 145
 St. Antony's Fire, 173
 St. Vitus's Dance, 271
 Salacitas, 307
 Salacity, ib.
 Salivatio, 10
 Salivation, ib.
 Sanguifluxus, 186
 Sarcoma, 328, 329, 330, 331
          mesenterii, 67
          Epulis,  9
          narium, 73
 Satiriasis, 307
 Saur, A. 420
 Scabies, 368.  380, 381
 Scale skin, 365
 Scall, 366. 368.  376, 377, 378
 Scalled head, 378
 Scaly tetter, 368
 Scharbocken, G. 212
 Scharlachaufschlag, 164
 Scarabaeus, 50
 Scarlatina, 164
 Scarlet Fever, ib.
 Schauf husten, G.  83
Schielen, G. 247
Schlaf-spitzieren,  G. 233
Schlieren, G. 121
Schlag, G. 292
Schullul, A. 386
Schwartze galle, G. 59
Schweys sucht, G. 101
Schwachheit, G. 234
Schwermuth, G. 220
Schwindsucht, G.  108. 192
Schwachmutigkeit, G. 311
Schiefen-sehen, G. 240
Schlaflosigkeit,  G. 274
Schnarchen, G. 75
Schrnnden, G. 409
Schupfen, G. 72
 Schuppen, G. 366
 Schutheln, G. 400
 Schwammformig aussatz, G. 181
 Schwindel, G. 281
 Schwisblattern,  G. 375
 Scelotyrbe, 271
 Sciatica, 154
 Sclopetoplaga, 396
 Scorbut, F. 212
 Scorbutus, ib.
 Scordinema, 270
 Scotoma, 282
 Scrophula, 197
 Scurvy, 209, 210, 211
 Scybalum, 44
 Sea-scurvy, 212
 Secheress de poitrine, F. 83
 Sedao, A. 279
 Sehu, A. 225
 Seiten-stiche, G. 91
 Seiten-wehe, G. 138
 Sejli-dem, A. 186
 Seklet, A. 292
 Seket, 319
 Selau, A. 409
 Seles, A. 349
 Self-love, 223
 Self-conceit, 223
 Semna, A. 304
 Sentimentalism, 226
 Separation of bones, 411
 Seram, 285
 Serataun, A. 198
 Seres, A. 310
 Serkend, A. 282
 Shebek, A. 307
 Shebkerat, A. 238
 Shekyhat, A.  280
 Shirine, A. 378
Shingles, 374
Short-breath,  85
 Short-sight, 240
Sibbens,  203
Sickness of the stomach, 2,"
Sideratio, 133
SifBement, F. 78
Singultus, 268
Silat, A. 197
 Sila, A. 328
 Silliness, 235
 Siriasis,  133
 Sitis Morbosus, 14
Sivvens, 203
Skue-sight, 240
Slavering, 11
Sleep, apparent,  291
Sleep-walking, 233
 Sleep-talking, ib. 
INDEX.
441
 Sleeplessness, 274
 Small-pox, 174
 Smell, 253, J54
       acute, 254
       obtuse, ib.
       loss of, ib.
 Sneezing, 268
 Snivelling, 72
 Snoring, 75
 Soal, A 82
 Saol, A. 84
 SoHa, 21
 Soif, excessive, F. 14
 Somnambulism, 233
 Somnambulismus, ib.
 Somnolency, 291
 Sommersprosse, G. 392
 Soubresaut des tendons, F. 270
 Soolal, A. 192
 Soporosi, 286
 Sore-throat, 135
 Soreness, 257
 Souris, F. 269
 Sortie de la langue, F. 13
 Spasm,  261
 Spastici, ib.
 Sparganosis, 150. 301
 Sparks  before the eyes, 242
 Spermorrhcea, 300
 Speaking through the nose, 78
 Speechlessness, 75
 Speichel fluss,  G. 10
 Sphacelus, 215
 Sphacelismus, 133
 Spina ventosa, 334
 Spina bifida, 339
 Spinola, ib.
 Splanchnica, 56
 Spitting of Blood, 186
 Splenitis,  143
 Spilosis, 391
 Spilus, ib.
 Squammae, 365
 Squinancy, 134
 Squinsy, ib.
 Squinting, 247
 Stamlen, G. 79
 Stammering, ib.
 Staphyloma, 246
 Starcker-husten, G. 84
 Stecker-zunge,  G. 13
Stereotica, 407
 Sterilitas, 303
 Sterility des femmes, JF. 314
Sterilite" male, F. 309
Sterility female, 314
Sternalgia, 89
Sternutatio, 268
   vol. v.—67
 Sterteur, 75
 Stertor, 74
 Stick, G 396
 Stich, 91
 Stiff-neck, 261
 Stillicidium narium, 71
 Stomacace, 211
 Stomach-disease, 15
 Stone in the bladder, 353
 Stone-pock, 125
 Stoppage of urine, 345
 Stopfung, G. 32
 Stottern, G. 79
 Strabismus, 247
 Strain, 400
 Straining, 54
 Straguria, 346. 349
 Strangury, 346
 Stremma, 400
 Stereoiica, 406
 Streckung, G. 270
 Stretching, ib.
 Strophulus, 358
 Struma, 196
 Studium inane, 232
 Stultitia, 235
 Stulzwung, G. 54
 Stummheit, G. 75
 Stupiditas, 234
 Stupidity, ib.
 Stupor, 259
 Stuttering, 79
 Stye, 123
 Stypsis, 32
 Suanimento, Span. 282
 Suasarcosis,  67
 Subat, A. 291
 Subsultus, 270
 Subiuxatio, 411
 Suda, A. 220
 Sudamina, 362
 Sudor, 355
 Sudor Anglicus, 100
 Suette, F. 101
 Suffbcatio, 85
 Suffusio, 241, 242
 Summer-rash, 362
 Sun-burn, 393
 Sup,A. 220
 Superbia, 223
 Superannuation, 236
Surditas, 253
Surdite, ib.
Suspended animation, 289
Susurrus, 252
Suzish, A. 399
Sweating sickness, 101
Sweet-spittle, 11 
443
INDEX.
Swimming of the head, 281
Swine-pox, 171
Swoon, 282
Swiille, G. 387
Sycosis, 123
Synanche, 134
Synclonus, 270
Syncope, SO. 282
Synezesis, 244
Synoca, 109
Synochus, 109. Ill
Syphilis, 199
Syrigma, 78
Syrigmus, 252
Systatica, 273
Syspasia, 283
Systremma, 265

                T.

Tabes, 190
Taches de rousseur, F. 392
Tactus acrior, 2 -7
      imminutus, 259
Taedium vitae, 228
Taenia, 48
Taesa, Pers. 275
Tag-blindkeit, G. 238
Tagig-fieber, G. 102
Tarns, A. 296
Tape-worm, 49
Taraxis, 145
Tartar of the Teeth, 9
Taste, 255
      acute, ib.
      obtuse, 256
Taus, A. 265
Taubheit, G. 253
Taye, F. 243
Teething, 3
Teigne, F. 377
Teneritudo, 257
Tenesmus, 53
Tenk nefes, A. 86
Tentigo penis, 261
Terminthus, 124
Tertian ague, 103
Tertianus, ib.
Teshennug, A. 262
Testudo, 332
Tetanus, 263. 265
Tetartaeus, 104
Tetartophya, 105
Tetter, 373. 376, 377. 379
Tezauf, A. 321
Thirst, morbid, 14
Thlasis, 410
Thlasma, 399
Thorheit, G. 235
Thrush, 168
Tic, 26'2
Tic douloureux, if. 260
Tick, 384
Tiefsinnigkeit, G. 231
Tinea, 377
Tintammet, A. 79
Tippel-beul, G. 121
Tiraillement, F. 270
Tollbeit,  G. 222
Tongue-tie, 414
Tonic spasm, 261
Tonici, ib.
Ton os, ib.
Tooth-ache,  6
Tooth-edge, 8
Tooth-rash, 360
Tormina, 36
Torpor, 287
Torpor pancreatis, 66
Tournoyement de t&e, F. 281
Toux, F. 82
Trance, 291
Tranchees des enfans, F. 30
Transport, 223
Traulotes, 80
Traurigkeit, G. 228
Tremble ment, F. 271
Trembling, ib.
Tremor, ib.
Trichoma, 388
Trichosia, ib.
Trichuris, 48
Tricocephalus, ib.
Trismus, 262, 263.  266
Tritaeophya,  104. 108
Tritaeus, 103
Tromos, 271
Trousse-galant, F. 39
Tuber, 328
Tuberculum, ib.
Tumeur blanche, F. 156
Tumor, 328
Tumour, ib.
Tussis, 82
Twinkling of the eye-lids, 269
Twitching of the tendons, 270
Tycbtca, 395
Tympania, 343
Tympanite, F. 343
Tympany, ib.
Typhodes, 110
Typhomania, 291
Typhus, 110

                V.
Vaccina, 170 
INDEX.
Vaccinia, 169
Vapours, 228
Varicella, 170
Variola, 174.
Varix, 214
Varus, 125
Vauket, A. 19
Ubel-horen, G. 251
Vedaf, A. 300
Vege-ome fasil, A. 154
Vekr, A.  251
Ventosit£, F. 23
Ventriculi inflammatio, 140
Verbrennung, G. 399
Verdriisslichkeit, G. 228
Verdunklung der glasernen  feutich-
  keit, G. 244
              der hornhaut, 243
Vergesslichkeit, G. 235
Verem, A. 189
Verminatio, 46
Verole, F. 200
Verole volante, F. 170
Verolette, F. 171
Verrenckung, G. 400
Verruca, 386
Verriie, F. ib.
Vers, F. 46
Verzerhung, G. 190
Vertige, F  281
Vertigo, ib.
Vesamia, 220. 222
Vesaniae, 220
Vesicular fever, 171
Viertagig-fieber, G. 104
Visus acrior, 238
      diurnus, ib.
      juvenum, 240
      nocturnus, 238
Vitiligo, 367. 391
Ulcer, 216
Ulcere, F. ib.
 ZTleua, 216
Unacteu kindspocken, G. 170
Unfruktbarkeit, G. 314
Ungovernable passion, 223
Unoculus, 416
Unrecht, G. 252
Unruhe, F. 275
Unsinnigkeit, F. 220
Unverdaiulichkeit, G. 25
Unvernunfft, F. 235
Unverstand, F. 234
Unzeitigc-geburth, G. 319
Vomendi conamen, 24
Vomica, 118
Vomissement, F. 24
              de sang, F. 187
Vomiting, 24
         of blood, 187
Vomituritio, 24
Vomitus, ib.
         cruentus, 187
Voracite, F. 17
Voracity, ib.
Uredo, 166
Urine, stoppage of, 345
      incontinence of, 349
Uroplania,  351
Urticaria, 166
Uteri inflatio, 344
      inversio, 316
      prolapsus, ib.
      retroversio, ib.
Vue couche, F. 240
     course, F. ib.
     longue, F. 239
Vulnus, 396

               W.

Wahnsinnigkeir, G. 236
Wart, 386
Wartze, G. ib.
Wasserblassen, G. 371
Wasserblattern, G. 370
Wassersucht,  G. 337
Water-blebs, 372
Water-brash, 22
Water pox, 171
Water-qualm, 22
Weariness  of life, 229
Web eye, 243
Weisse-flusse, G. 298
Weissehaut, G. 196
Weiss-schwellen, G. 156
Welk, 126
Wen, 331
Wheezing, 75
White-gown, 360
White gum, ib.
White-swelling, 156
Whites, 298
Whitlow, 127
Windige-wassersucht, G. 343
Wind dropsy, 340
Wind-grimmen, G. 30
Wischtel-zopff, G. 388
Witlessness, 235
Womb, falling down of, 316
        inverted, ib.
        polypus of, 317
        retroverted, 316
Worm, tape, 49
Worm, thread, 48
        round, ib 
444
INDEX.
Worms, 46
Wound, 396
Wrath, 223
Wrench, 400
Wunde, G. 396
Wurmsucht, G. 46
Yara, A. 396
Yawning, 270
Yaws, 181
Yehem, A. 234
Yerekaun, A. 57
Zahne-stumpf, G. 8
Zahn-pein, G. 6
Zahnen, G. 3
Zameh, A. 119
Zatal-bein, A. 137
Zefer, A. 12fi
Zekh, A. 387
Zelotypia, 223
Zemherir, A. 258
Zemin, A. 293
Zeminlik, Ture. 293
Zeryr, A. 59
Zerzerretes, G. 400
Zipperlein,  G.  155
Ziras, A. 2
Zirknirschung, G. 400
Zischen, G.  78
Zitterich, G. 361
Zittermahl, G.  373
Zittern, G. 271
Zona, 374
Zoster, ib.
Zukam, A- 148
Zulekkhet, A.  154
Zurat, ^. 23
Zwerg, G. 424
Zwitter, G.  423
Zyger angen, G. 147
 
 
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