Zoonomia Volume Ii Part 17

M. M. When it is exerted to excess it may be cured by snuffing starch up the nostrils. See Cla.s.s I. 1. 2. 13.

4. _Anhelitus._ Panting. The quick and laborious breathing of running people, who are not accustomed to violent exercise, is occasioned by the too great conflux of blood to the lungs. As the sanguiferous system, as well as the absorbent system, is furnished in many parts of its course with valves, which in general prevent the retrograde movement of their contained fluids; and as all these vessels, in some part of their course, lie in contact with the muscles, which are brought into action in running, it follows that the blood must be accelerated by the intermitted swelling of the bellies of the muscles moving over them.

The difficulty of breathing, with which, very fat people are immediately affected on exercise, is owing to the pressure of the acc.u.mulated fat on the veins, arteries, and lymphatics; and which, by distending the skin, occasions it to act as a tight bandage on the whole surface of the body.

Hence when the muscles are excited into quicker action, the progress of the blood in the veins, and of the lymph and chyle in the absorbent system, is urged on with much greater force, as under an artificial bandage on a limb, explained in Art. IV. 2. 10. and in Sect. x.x.xIII. 3. 2. Hence the circulation is instantly quickened to a great degree, and the difficulty of breathing is the consequence of a more rapid circulation through the lungs.

The increased secretion of the perspirable matter is another consequence of this rapid circulation; fat people, when at rest, are believed to perspire less than others, which may be gathered from their generally having more liquid stools, more and paler urine, and to their frequently taking less food than many thin people; and lastly, from the perspiration of fat people being generally more inodorous than that of lean ones; but when corpulent people are put in motion, the sweat stands in drops on their skins, and they "lard the ground" as they run. The increase of heat of corpulent people on exercise, is another consequence of their more rapid circulation, and greater secretion. See Cla.s.s I. 2. 3. 17.

Other causes of difficult or quick respiration will be treated of under Asthma, Pertussis, Peripneumony, Tonsillitis.

5. _Tussis ebriorum._ Sensitive cough is an exertion of the muscles used in expiration excited into more violent action by the sensorial power of sensation, in consequence of something which too powerfully stimulates the lungs. As the saline part of the secreted mucus, when the absorption of it is impeded; or the too great viscidity of it, when the absorption is increased; or the too great quant.i.ty of the mucus, when the secretion is increased; or the inflammation of the membranes of the lungs; it is an effort to dislodge any of these extraneous materials.

Of this kind is the cough which attends free-drinkers after a debauch; it consists of many short efforts to cough, with a frequent expuition of half a tea-spoonful of frothy mucus, and is attended with considerable thirst.

The thirst is occasioned by the previous dissipation of the aqueous parts of the blood by sensible or insensible perspiration; which was produced by the increased action of the cutaneous and pulmonary capillaries during the stimulus of the wine. In consequence of this an increased absorption commences to replace this moisture, and the skin and mouth become dry, and the pulmonary mucus becomes insp.i.s.sated; which stimulates the bronchia, and is raised into froth by the successive currents of air in evacuating it.

This production of froth is called by some free-drinkers "spitting sixpences" after a debauch. This subsequent thirst, dry mouth, and viscid expectoration in some people succeeds the slightest degree of intoxication, of which it may be esteemed a criterion. See Cla.s.s IV. 2. 1. 8.

As coughs are not always attended with pain, the muscular actions, which produce them, are sometimes excited by the sensorial faculty of irritation, as in Cla.s.s I. 1. 2. 8. I. 1. 3. 4. I. 1. 4. 3. I. 2. 3. 4. Coughs are also sometimes convulsive, as in Cla.s.s III. 1. 1. 10. and sometimes sympathetic, as Cla.s.s IV. 2. 1. 7.

M. M. Venesection, when the cough is attended with inflammation. Mucilages.

Opium. Torpentia. Blister.

6. _Singultus._ Hiccough is an exertion of the muscles used in inspiration excited into more violent action by the sensorial power of sensation, in consequence of something which too powerfully stimulates the cardia ventriculi, or upper orifice of the stomach. As when solid food is too hastily taken without sufficient dilution. And is an effort to dislodge that offensive material, and push it to some less sensible part of the stomach, or into the middle of the contained aliment.

At the end of fatal fevers it may arise from the acrimony of the undigested aliment, or from a part of the stomach being already dead, and by its weight or coldness affecting the surviving part with disagreeable sensation. The pain about the upper orifice of the stomach is the proximate cause, the too great or too little action of the fibres of this part of the stomach is the remote cause, the action of the muscles used in inspiration is the proximate effect, and the repercussion of the offending material is the remote effect.

Hiccough is sometimes sympathetic, occasioned by the pain of gravel in the kidney or ureter, as in Cla.s.s IV. 1. 1. 7. and is sometimes a symptom of epilepsy or reverie, as in Sect. XIX. 2.

M. M. Oil of cinnamon from one drop gradually increased to ten, on sugar, or on chalk. Opium. Blister. Emetic.

7. _Asthma humorale._ The humoral asthma probably consists in a temporary anasarca of the lungs, which may be owing to a temporary defect of lymphatic absorption. Its cause is nevertheless at present very obscure, since a temporary deficiency of venous absorption, at the extremities of the pulmonary or bronchial veins, might occasion a similar difficulty of respiration. See Abortio, Cla.s.s I. 2. 1. 14. Or it might be supposed, that the lymph effused into the cavity of the chest might, by some additional heat during sleep, acquire an aerial form, and thus compress the lungs; and on this circ.u.mstance the relief, which these patients receive from cold air, would be readily accounted for.

The paroxysms attack the patient in his first sleep, when the circulation through the lungs in weak people wants the a.s.sistance of the voluntary power. Cla.s.s I. 2. 1. 3. And hence the absorbents of the lungs are less able to fulfil the whole of their duty. And part of the thin mucus, which is secreted into the air-cells, remains there unabsorbed, and occasions the difficult respiration, which awakes the patient. And the violent exertions of the muscles of respiration, which succeed, are excited by the pain of suffocation, for the purpose of pus.h.i.+ng forwards the blood through the compressed capillaries, and to promote the absorption of the effused lymph.

In this the humoral differs from the convulsive asthma, treated of in Cla.s.s III. 1. 1. 10. as in that there is probably no acc.u.mulated fluid to be absorbed; and the violent respiration is only an exertion for the purpose of relieving pain, either in the lungs or in some distant part, as in other convulsions, or epilepsy; and in this respect the fits of humoral and convulsive asthma essentially differ from each other, contrary to the opinion expressed without sufficient consideration in Sect. XVIII. 15.

The patients in the paroxysms both of humoral and convulsive asthma find relief from cold air, as they generally rise out of bed, and open the window, and put out their heads; for the lungs are not sensible to cold, and the sense of suffocation is somewhat relieved by there being more oxygen contained in a given quant.i.ty of cold fresh air, than in the warm confined air of a close bed-chamber.

I have seen humoral asthma terminate in confirmed anasarca, and destroy the patient, who had been an excessive drinker of spirituous potation. And M.

Savage a.s.serts, that this disease frequently terminates in diabetes; which seems to shew, that it is a temporary dropsy relieved by a great flow of urine. Add to this, that these paroxysms of the asthma are themselves relieved by profuse sweats of the upper parts of the body, as explained in Cla.s.s I. 3. 2. 8. which would countenance the idea of their being occasioned by congestions of lymph in the lungs.

The congestion of lymph in the lungs from the defective absorption of it is probably the remote cause of humoral asthma; but the pain of suffocation is the immediate cause of the violent exertions in the paroxysms. And whether this congestion of lymph in the air-cells of the lungs increases during our sleep, as above suggested, or not; the pain of suffocation will be more and more distressing after some hours of sleep, as the sensibility to internal stimuli increases during that time, as described in Sect. XVIII. 15. For the same reason many epileptic fits, and paroxysms of the gout, occur during sleep.

In two gouty cases, complicated with jaundice, and pain, and sickness, the patients had each of them a s.h.i.+vering fit, like the commencement of an ague, to the great alarm of their friends; both which commenced in the night, I suppose during their sleep; and the consequence was a cessation of the jaundice, and pain about the stomach, and sickness; and instead of that the gout appeared in their extremities. In these cases I conjecture, that there was a metastasis not only of the diseased action from the membranes of the liver to those of the foot; but that some of the new vessels, or new fluids, which were previously produced in the inflamed liver, were translated to the feet during the cold fit, by the increased absorption of the hepatic lymphatics, and by the retrograde motions of those of the affected limbs.

This I think resembles in some respects a fit of humoral asthma, where stronger motions of the absorbent vessels of the lungs are excited, and retrograde ones of the correspondent cutaneous lymphatics; whence the violent sweats of the upper parts of the body only are produced; and for a time the patient becomes relieved by the metastasis and elimination of the offending material by sensitive exertion. For a further account of this intricate subject see Cla.s.s III. 1. 1. 10.

M. M. To relieve the paroxysm a tea-spoonful of ether may be given mixed with water, with 10 drops of laudanum, to be repeated three or four times.

Venesection. An emetic. A blister. Afterwards the Peruvian bark, with a grain of opium at night, and two or three of aloes. A flannel s.h.i.+rt in winter, but not in summer. Issues. Digitalis?

In this species of asthma, there is great reason to believe, that the respiration of an atmosphere, with an increased proportion of oxygen, will prove of great advantage; some well-observed and well-attested cases of which are published by Dr. Beddoes; as this purer air invigorates the circulation, and the whole system in consequence, perhaps not only by its stimulus, but by its supplying the material from which the sensorial power is extracted or fabricated. In spasmodic asthma, on the contrary, Dr.

Ferriar has found undoubted benefit from an atmosphere mixed with hydrogen.

See Sect. XVIII. 15. and Cla.s.s III. 1. 1. 10.

8. _Nict.i.tatio sensitiva._ Winking of the eyes is performed every minute, without our attention, for the purpose of diffusing the tears over them, which are poured into the eye a little above the external corner of it, and which are afterwards absorbed by the lacrymal points above and below the internal corner of it. When this operation is performed without our attention, it is caused by the faculty of irritation, and belongs to Cla.s.s I. 1. 4. 1. but when it is produced by a stronger stimulus of any extraneous material in the eye, so as to cause pain, the violent and frequent nict.i.tation is caused by the faculty of sensation.

This disease is sometimes produced by the introversion of the edge of the lower eyelid, which bends the points of the hairs of the eyelash upon the ball of the eye, which perpetually stimulate it into painful sensation.

This introversion of the eyelid is generally owing to a tumor of the cellular membrane below the edge of the eyelid, and though a very troublesome complaint may often be cured by the following simple means. A little common plaster spread on thin linen, about a quarter of an inch long, must be rolled up so as to be about the size of a crow-quill, this must be applied immediately below the eyelash on the outside of the eye; and must be kept on by another plaster over it. This will then act as a slight compression on the tumor under the eyelash, and will prevent the hairs from touching the eye-ball. In a week or two the compression will diminish the tumor it lies over, and cure this painful deformity.

9. _Oscitatio et pandiculatio._ Yawning and stretching of the limbs is produced either by a long inactivity of the muscles now brought into action, as sometimes happens after sleep, or after listening a long time to a dull narrative; or it is produced by a too long continued action of the antagonist muscles. In the former case there is an acc.u.mulation of sensorial power during the quiescence of the muscles now brought into action; which probably const.i.tutes the pain or wearisomeness of a continued att.i.tude. In the latter case there is an exhaustion of sensorial power in the muscles, which have lately been acting violently, and a consequent acc.u.mulation in the muscles, which are antagonists to them, and which were at rest.

These involuntary motions are often seen in paralytic limbs, which are at the same time completely disobedient to the will; and are frequently observable in very young children; and from thence we may conclude, that these motions are learnt before nativity; as puppies are seen to open their mouths before the membranes are broken. See Sect. XVI. 2.

Where these motions are observed in limbs otherwise paralytic, it is an indication that electric shocks may be employed with advantage, as the excitability of the limb by irritation is not extinct, though it be disobedient both to volition and sensation.

10. _Tenesmus_ consists in violent and frequent ineffectual efforts to discharge the contents of the r.e.c.t.u.m, owing to pain of the sphincter. The pain is produced by indurated feces, or by some acrid material, as the acidity of indigested aliment; and the efforts are attended with mucus from the pained membrane. The feces must sometimes be taken away by the end of a marrow-spoon, as cathartics and even clyster will pa.s.s without removing them. It is sometimes caused by sympathy with the urethra, when there is a stone at the neck of the bladder. See Cla.s.s II. 2. 2. 7. and IV. 1. 2. 8.

M. M. Fomentation, an enema with mucilage and laudanum.

The common exclusion of the feces from the r.e.c.t.u.m is a process similar to this, except that the muscles of the sphincter ani, and those of the abdomen, which act along with them by the combined powers of sensation and a.s.sociation, are in tenesmus excited by painful sensation, and in the latter by a sensation, which may in some instances be almost called pleasurable, as relieving us from a painful one in the exclusion of the feces.

11. _Stranguria._ Strangury consists in painful efforts to discharge the contents of the urinary bladder. It is generally owing to a stone in the sphincter of the bladder; or to the inflammation of the neck of it occasioned by cantharides. It is sometimes caused by sympathy with the piles; and then is liable in women to occasion convulsions, from the violence of the pain without inflammation. See Cla.s.s IV. 2. 2. 2. and 3.

M. M. Fomentation clyster with oil and laudanum, push the stone back with a bougie; if from cantharides give half a pint of warm water every ten minutes. Mucilage of gum arabic and tragacanth.

The natural evacuation of the urine is a process similar to this, except that the muscular fibres of the bladder, and the muscles of the abdomen, which act in concert with them by the combined powers of sensation and of a.s.sociation, are, in the former case of strangury, excited into action by painful sensation; and in the latter by a sensation, which may almost be termed pleasurable, as it relieves us from a previous uneasy one.

The ejectio feminis is another process in some respects similar to strangury, as belonging to the same sensible ca.n.a.l of the urethra, and by exciting into action the accelerator muscles; but in the strangury these muscles are excited into action by painful sensation, and in the ejection of the s.e.m.e.n by pleasureable sensation.

12. _Parturitio._ Parturition is not a disease, it is a natural process, but is more frequently unfortunate in high life than amongst the middle cla.s.s of females; which may be owing partly to fear, with which the priests of LUCINA are liable to inspire the ladies of fas.h.i.+on to induce them to lie in in town; and partly to the bad air of London, to which they purposely resort.

There are however other causes, which render parturition more dangerous to the ladies of high life; such as their greater general debility from neglect of energetic exercise, their inexperience of the variations of cold and heat, and their seclusion from fresh air. To which must be added, that great source of the destruction of female grace and beauty, as well as of female health, the tight stays, and other bandages, with which they are generally tortured in their early years by the active folly of their friends, which by displacing many of the viscera impedes their actions, and by compressing them together produces adhesions of one part to another, and affects even the form and aperture of the bones of the pelvis, through which the nascent child must be protruded.

As parturition is a natural, not a morbid process, no medicine should be given, where there is no appearance of disease. The absurd custom of giving a powerful opiate without indication to all women, as soon as they are delivered, is, I make no doubt, frequently attended with injurious, and sometimes with fatal consequences. See Cla.s.s II. 1. 2. 16.

Another thing very injurious to the child, is the tying and cutting the navel-string too soon; which should always be left till the child has not only repeatedly breathed, but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be; a part of the blood being left in the placenta, which ought to have been in the child; and at the same time the placenta does not so naturally collapse, and withdraw itself from the sides of the uterus, and is not therefore removed with so much safety and certainty. The folly of giving rue or rhubarb to new-born children, and the danger of feeding them with gruel instead of milk, is spoken of in Cla.s.s I. 1. 2. 5. and II. 1. 2. 16.

ORDO I.

_Increased Sensation._

GENUS II.

_With the Production of new Vessels by internal Membranes or Glands, with Fever._

In the first cla.s.s of diseases two kinds of fevers were described, one from excess, and the other from defect of irritation; and were in consequence termed irritative, and inirritative fevers. In this second cla.s.s of diseases another kind of fever occurs, which is caused by excess of sensation, and termed in consequence Sensitive Fever. But there is no fever from defect of sensation, because the circulation is carried on in health without our consciousness, that is, without any sensation attending it.

But as excess of sensation may exist with excess or defect of irritation, two other kinds of fever arise from a combination of sensitive fever with the irritative, and inirritative ones. Making five kinds in all.