of opthalmy, external violence and blows; sudden suppression of
perspiration; extraneous bodies or acrids admitted within the eye-lids;
acrid metallic fumes, and noxious exhalations; long exposure to
confined smoke, especially from wood fires; smoky houses and cottages;
acrid collyria; epidemick state of the air, and infection; long
continuance of wet weather; long exposure of the eyes to the rays
of strong light, to snow, or luminous objects; cold streams of air;
suppression of salutary evacuations, or cutaneous eruptions, and of
chronic ulcers; acrimony of the blood; interruption to the free return
of blood from the head; frequent intoxication: nocturnal studies; long
want of sleep, grief, tears; small tubercles within the eye-lids;
ulcerated eye-lids; variolous: morbillous; scrophulous; venereal;
erysipelatous; rheumatick; catarrhal; intermittent; herpes; cancerous.
Of fistula-lachrymalis, inflammation of the lachrymal sac, or ducts. Of
gutta-serena, plethora, distention of the vessels of the retina; palsy
of the optick nerves, general or partial; diseases of the brain, or
of the retina; profuse and suppressed evacuations; excess of venery;
chronic headach; ebriety; cachexy; venereal; intermittent; symptomatick
in the irregular gout, apoplexy, &c. Of the cataract, opacity of the
crystalline lens. The general causes of injured vision, exclusive
of opthalmy, may be briefly enumerated; and are long attention to
minute objects; weakness of the power to contract the pupil; faults
of the globe; defect of the aqueous humour, its impurity or density;
opacity of the lens, or of the vitreous humour; the retina callous or
too sensible; faults of the optic nerves; contraction, concretion,
flaccidity of the pupil; gibbous or convex lens, or too near and flat;
dropsical eye; spasm, or palsy of the ocular muscles; diseases and
ulcerations of the eye-lids and ciliary glands; ulcers and fistula,
specks and scars, in the cornea; films growing from the angle of the
eye; the eye-lids inverted, elongated, concreted; various diseases of
the brain from internal or external causes.
_Hearing_, injured by deafness; noise in the ears, inflammation. The
first is a frequent infirmity in old age. The _causes_, faults in the
original structure of this curious and complex organ; defect of the
auricle, straitness of the external auditory tube, its obstruction or
concretion: the tympanum relaxed, callous, obstructed with hardened
wax, mucus, serum, ulcers, luxuriant flesh; caries, luxation of the
small auditory bones; obstruction of the vestibule, cochlea, labrynth:
the membranes lax, dry, indurated; palsy, and spasm of the internal
auditory muscles; constriction and obstruction of the eustachian
tube; colds, catarrh, obstructed perspiration, rheumatism, plethora,
suppressed evacuations; disorders of the stomach, costiveness; nervous,
loud explosions, age, fever, soporous diseases, and diseases of the
auditory nerves, and of the brain; symptomatick in several diseases.
Inflammation of the ear excites excruciating pain, sometimes delirium.
_Smelling_ too acute, or blunt, or unnatural. The _causes_, the
membrane lining the nose rigid, dry, deficiency or excess of its mucus
tense, irritable, obstructed, scirrhous, callous, carious, stifled with
polypus, snuff; palsy of the olfactory nerves; diseases of the brain;
sordes and pus in the olfactory sinusses; and also in the mouth, gums,
teeth, tongue, larynx, fauces; foul effluvia from the stomach.
Sternutation is symptomatick in several diseases; but sometimes, is
a primary malady, it has been known to infest hours, days, or even
weeks. The _causes_, epidemick influence of the air; suppressed nasal
hemorrhage, or cutaneous eruptions; venereal; worms, or abscess in the
sinusses; disease of the brain.
_Taste._ The _causes_ affecting the principal gustatory organ, the
tongue: sordes of the tongue and mouth in various diseases; the saliva
in quantity or quality diseased, and either depraved from the blood,
or from washing over diseased parts of the mouth or palate; tension
or laxity of the gustatory organ, or papillæ; faults of the lingual
nerves; diseases of the stomach, fauces, nose, tongue, lips, &c.
_Voice and Speech._ The immense multiplicity of objects, and the
distance to the end of our literary journey, check us from expatiating
upon this prolifick topick. Under it may be included hoarse, guttural,
stridulous, deadened, stifled voice, or sound at the glottis;
stammering, lisping, defect and impediments in articulation, muteness.
The _causes_, defect or waste of mucus by exertion of the voice;
destruction of the mucus ducts of the larynx; its cartilages ossified;
injury of the recurrent nerves; laxity and palsy of the muscles of
the glottis and contiguous cartilages; venereal; changes of weather;
symptomatic in several diseases. Voice and speech may be injured in all
the various parts of their complicated organization; the larynx, the
pharynx, the tongue, uvula, fauces, nose, palate, gums, teeth, lips.
_Sterility_ of the sexes: no inconsiderable number of both sexes are
incapacitated from exercising that important and divine function of
giving creation to their own species. The _causes_ in the male sex
are, palsy, or torpidity of the penis, or its nerves, or generative
organs; the penis short, monstrous in size, its prepuce straitned;
impediments in the urethra and seminal ducts; testicles, epididymidis,
vasa deferentia; the semen inert, vapid, aqueous, scanty; weakness
of the ejecting or accelerator muscles; corpulency; too tense
erection; old age; castration, manustupration, too frequent coition,
extreme chastity, venereal disease, inebriety, broken constitution,
tabes-dorsalis. In the female sex, original structure of some part of
the generative machinery of the ovarium, fallopian tubes, womb, vagina,
labia, clitoris; straitness, concretion, obstruction of the vagina or
womb from inflammation, scirrhus, polypus; cold frigid temperament;
promiscuous coition; excess of venery, irritability; fluor albus,
obstructed menses, irregular menstruation, cachexy.
_Morbid irritability of the genitals_, including priapism, pollution,
furor uterinus. Of involuntary pollution we have treated under dorsal
tabes. In our climate the uterine mania rarely occurs in that extreme
of indecency described by authors. The woman at first is bashful and
silent; the pulse and circulation are agitated on mentioning a venereal
topick; by significant looks and gestures she betrays her passion; and
if disappointed, becomes low-spirited, anxious, and wastes in flesh.
The same has happened to some women who had the mortification to be
linked with impotent husbands. Sometimes, however, this universal
passion has burst into a flame; the woman losing all sense of shame,
soliciting, with obscenity in speech and gestures, the embraces of
the other sex; and raving on this theme with maniacal insanity. The
_causes_, acrid serum, spasm, inflammation of the urethra, vagina,
or other generative organs; irritation of the bladder, womb, rectum;
obstructed menses; fluor albus, heat, excoriation of the vagina,
venereal; stimulating, acrid, diureticks, and emmenagogues; stimulating
diet and drink, excess of venery, manustupration, libidinous books,
prints; protrusion of the vagina.
_Deglutition_ interrupted: we very rarely meet with this similitude of
tantalus, wherein food or drink is either swallowed with difficulty
and pain, or totally interrupted in its descent to the stomach, and
regurgitated by the mouth or nose. The causes spasmodick constriction
of the œsophagus, and in various parts of the tube; palsy of the
muscles of deglutition; tumors or scirrhus in the pharynx, œsophagus,
pylorus, trachea, thyroid or dorsal glands; aneurism and enlargement
of the aorta, ulcers in the œsophagus; luxation of the os hyoides;
compression of the pharyngeal nerves; cachexy, worms, crudity,
passions, extraneous substances stuck in the throat. The spasmodick
is periodical and painful; and also affects the voice: in the lower
part of the œsophagus it excites pain between the shoulders; sometimes
eructation and vomiting.
_Manducation._ Diseases of the teeth are the principal impediments
to the exercise of this function. There are few adults who cannot
describe the pangs of tooth-ach from their own feelings. It is
generally intermittent, seldom dangerous to life, except during the
first dentition of infancy. Its constant symptoms, pain, flow of
saliva, restlessness: its variable symptoms, swelled face, carious
loosened teeth; fistula, exostoses of the gums and jaws. The _causes_,
inflammation of the periosteum of the teeth, gums, or jaw; suppressed
perspiration; moist air; catarrhal defluxion; suppressed habitual
evacuations, nasal hemorrhage and venesection; plethora; intermittent,
scorbutick, arthritick; rheumatick; caries of the teeth; sugar eat;
beetle and tobacco chewed, acrimony of blood or saliva; spirituous
liquors; mercury; suppuration in the maxillary sinusses and gums;
spunginess and flaccidity of the gums and periosteum; irritation and
disorder of the fifth pair of nerves.
* * * * *
_Diseases of the Stomach and Intestinal Tube_, are very universal and
frequent maladies in both sexes, and throughout all orders and ages.
The stomach and alimentary canal are furnished with numerous nerves;
and the sensibility of the former very acute, especially at its upper
extremity. The length of the human alimentary tube, from the mouth to
the anus, is five or six times the length of the whole body: it is
folded into many convolutions, as may be daily seen at shambles, on the
opening of animals. Into this alimentary muscular and contractile sewer
are incessantly heaped food and drink, besides a variety of copious
secretions from the body, requisite in the process of digestion and
assimilation of chyle, as saliva, pancreatick fluid, bile, mucus, and
arterial exhalation from the whole of its internal surface.
Within the short space of a few weeks, the generality of mankind
consume more food and drink than amounts to the whole weight of their
bodies. This diurnal superfluity and load, together with the corrupted
and abraded animal parts of the body, and the different secreted
fluids, must again, in a few hours, be expelled through the principal
human excretories; the fecal, urinary, perspiratory. In the healthy
state, by far the smallest proportion of this diurnal superfluity is
through the intestinal excretion: the greatest part is absorbed by the
lacteals and lymphaticks, intermixed with the blood, and afterwards
filtered by urine, perspiration, and in the puerperal state, milk. In
cold climates and winters, especially if moist, the urine; in warm
climates, the perspiration preponderates. But in these prodigious
diversities ensue from exercise or rest, sleep and waking, passions
of mind, the quantity or quality of food, cleanness of the skin,
constitution, atmosphere, and the alternation with each other of these
excretions. Again, when we reflect that from the small parotid glands,
between a pint and a quart of saliva is secerned during the twenty-four
hours; and on the prodigious secretion through the kidneys, we may
easily conceive in the natural and morbid state, what a considerable
quantity may be secerned from the liver, the largest of the abdominal
viscera: making, however, some deduction for the slower circulation
through the vena porta.
The chart of London diseases demand some criticism on that inextricable
miscellany surfeits, stoppage of the stomach, vomiting, cholick and
gripes, bloody flux. In the last century, surfeits make a monstrous
article in the chronicle of deaths, amounting in some years to four
hundred; whereas, during fifteen years of the present century, they
sink down to only fifteen. Yet all are witnesses that good eating and
gormandizing are not worn out of fashion in this metropolis. Medical
men know that surfeits and intemperance are often merely predisposing
or occasional causes of diseases: they may rouse latent disorders,
or dispose the body to receive noxious impressions externally. The
searches therefore formerly, as I suspect, made many of these reports
from the ostensible cause which they imagined gave birth to the disease
and mortality. At the same time, I am not contending for the delicacy
and moderation of our forefathers appetites. They were unquestionably
in the last century, and partly indeed from the cheapness of
flesh-meat, and scarcity of vegetable nutriment, more carnivorous in
their diet than the present generation.
Stoppage of the stomach also, is a morbid centaur in the last century.
It would baffle the ingenuity of an antiquarian to decypher the true
import of this term: severe sickness, or the word Abracadabra, would
be full as intelligible. It is a vulgar name for rejection of food;
and there are few diseases in which the stomach does not sympathize.
What proportion of the mortality of infants, adults, or the sexes, are
crammed into this absurd article, I submit to the reader’s criticism.
An important circumstance, and overlooked so far as I know, by all the
calculators and criticks on the rise and fall of infant diseases in
London, and especially of convulsions, is this. In the first column of
15 years, at the beginning of the present century, colick and gripes
of the guts amount to 13668, but continue through every succeeding
column to diminish; and in the last or fifth, dwindle to 769 only. What
is meant by this complaint, colick and gripes? was it dysentery? We
observe that bloody flux makes a separate, though small group, through
all the five columns. Were these two diseases confounded in the
annual reports? or may it not be alledged, that many infant diseases
and deaths, which were formerly crowded into colick and gripes, are in
modern times transferred to the vortex of convulsions? I am aware that,
in reply, it may be suggested that drains, sewers, drier lodgings, less
damp, alteration in diet, and the more plentiful use of vegetable and
fermented liquors, have decreased dysenteric complaints in this city;
and also, that Dr. Sydenham, in 1670 and 71, describes an autumnal
dysentery as annually prevailing in London, and about two months in
duration. Turning the subject into every possible view, I continue
to suspect that numbers of infant diseases, and commonly terminating
fatally in convulsions, were formerly heaped into gripes and colick;
for during the last thirty years of the preceding century, they amount
to the enormous number of 69,799.
_Diseases of the Stomach_ are idiopathick and symptomatick. Under
the present head we shall include inappetency, indigestion, nausea,
vomiting, eructation, acidity, cardialgy, heartburn, regurgitation of
bile, pica, soda, pyrosis, hiccup, rumination. Several of these are
obvious symptoms, and are often complicated. Inappetency is generally
accompanied with nausea. Foulness or feculence in the stomach,
is indicated by weight and load in that region, anxiety, nausea,
eructation, disagreeable taste in the mouth, foul tongue: the state of
the gustatory organ is some index to that of the stomach. Acidity in
excess will excite eructation, flatulence, heartburn, gnawing pain in
that part, irregular appetite and craving, colicks, gripes, diarrhœa,
vomiting. In infants, acidity is very frequently predominant; hence
acid eructation, restlessness, gripes, green curdled feces, tumor
of the abdomen, dyspnœa, sometimes costiveness, or diarrhœa, and
sometimes dry cough, and muscular paleness and flaccidity. Of bilious
regurgitation there are various gradations: with severe sickness at the
stomach, nausea, bilious vomiting, bitter taste on the tongue, and its
surface furred; inappetency, frequently colick; sometimes temporary
jaundice. The cardialgy is a severe pain, threatening syncope. The pica
an aversion to natural aliment, and craving for unusual. The bulimy is
a monstrous appetency for food. The heartburn denotes a sensation of
uneasiness, heat, and acrimony: the soda, or water-brash, a burning
heat in the stomach and fauces, anxiety, acid eructation, exspuition of
lymph, and fretting the edge of the teeth.
The pyrosis, or cardialgia-sputatoria, is more frequent and endemic
in some countries than others; and, it is alledged, more amongst the
poor than affluent, and amongst females than males; and of the former,
the single and barren: it rarely occurs in puberty, or in old age. The
pain at the stomach and back is often very severe, and with anxiety,
until the torrent of watery fluid bursts forth, which, after continuing
one or two days, intermits: but relapses are frequent, and the disease
is contumacious. The hiccup, or sudden convulsive inspiration, is a
complicated affliction of the stomach and diaphragm. Of rumination in
the human species, there is scarce an instance in a generation.
The predisposing and occasional _causes_ of the preceding diseases of
the stomach are in general, weakness of the muscular coats; diseases
of its nerves; small omentum; the digestive menstrua as bile, saliva,
mucus, defective or depraved; frequent exspuition and waste of saliva;
slow digestion, and food corrupted in the stomach; crudities in the
stomach; vitiated chyle; excess of pituita, acidity, bile; relaxed
pylorus, large stomach, calculi in the biliary ducts; scirrhus stomach,
pancreas, liver, spleen, duodenum; mucus of the stomach abraded;
ulcers, cancer, depression of the xiphoid cartilage; frequent emeticks
and purgatives; valetudinarian regimen, too much physick, quackery, and
care about health; gluttony, epicurism, pampered indulgence of that
passion and appetite; frequent surfeits; dram-drinking; malt liquors
in excess; the aliment in quantity or quality, or in multiplicity at
one meal, injurious; ravenous ingurgitation at meals, and imperfect
manducation; fat, rancid, corrupted, salted, and indigestible
farinaceous food; tea, tobacco, watery liquids: in infancy, acid milk,
sucking to excess, curdled milk in the stomach; superfluous acid
generated in the stomach; too violent agitation in the nurse’s arms;
passions of the nurse; too tight bandages; saliva swallowed in excess
during dentition; too much vegetable diet and milk: to the catalogue
of general causes may be added various depressing and cankering
passions of mind; cares and troubles; want of sleep, intemperate study,
sedentary life, unremitting application to sedentary business; moist
cold air, foul air of cities; leaning forward on the stomach, and
improper postures of the body; costiveness; suppression of salutary
evacuations and cutaneous exanthemata; sanguineous plethora; conference
of hereditary infirmity, bad health, old age, chlorosis, worms, gout,
rheumatism, intermittent and remittent fevers, and of various other
acute and chronic diseases; poisons; extraneous substances swallowed,
contusions on the head; external injuries; blows and falls.
_Cholera Morbus_ is much more frequent in tropical and warm climates;
and in northern regions in the summer and autumnal seasons; especially
in unusually hot summers. The disease is not unfrequent in this island
and metropolis; nor is it entirely restricted to the warm season only.
The symptoms are sickness and nausea, succeeded by violent vomiting
and purging, of a bilious nature, with gripes, tenesmus, tension of
the abdomen, anxiety, great prostration of strength, intense thirst,
cardialgy, and sometimes muscular spasms in the lower extremities.
The vomiting and purging either commence about the same time, or
alternate with each other: and throughout its rapid race there is
seldom any fever. It is often a salutary effort of nature, by which a
superfluity of bile is disembogued; and in cases of ordinary violence,
may continue a day or two, and then cease. In more tremendous assaults
it sometimes proves fatal in twenty-four hours; portentous omens of
which are violent vomiting and purging, sudden prostration of strength,
quick weak pulse, hiccup, fainting, cold sweats and extremities. The
predisposing and occasional _causes_ are, hot climate and seasons;
in warm climates extreme heat and dry weather, succeeded by a fall
of rain and coolness of the atmosphere; sudden changes of weather;
increased secretion of bile and corrupted bile; surfeits, intemperance,
accumulation of feculence in the intestines and liver; excess of food
or drink without sufficient exercise; indolence, luxurious living and
sedentary life; malt liquors; passions of mind; repulsion of cutaneous
eruptions; gout; poisons; worms; symptomatick in intermittent and
remittent fevers.
_Dysentery_, bloody flux, spurious remittent. This contagious disease
has been before mentioned, under remitting and autumnal fevers. It
is called by the sagacious Morton, the Spurious Remittent turned on
the intestines; and by Sydenham also, who, perhaps undeservedly, is
panegyrized as a superior oracle, the Fever of the Season turned on
the bowels. The general symptoms are, frequent stools with severe
colick, gripes, and tenesmus, or urgency to exonerate the intestines:
these evacuations are slimy, generally with intermixture of blood,
and fragments of feces concreted into hard globules, and unusually
fetid. It is also accompanied with sickness at the stomach and pain,
inappetency, vomiting, flatulence, restlessness, foul tongue, and more
or less fever. When fatal, many are destroyed between the seventh
and twentieth days; but when moderate, it may be protracted much
longer. Relapses are frequent on any irregularity or intemperance.
The _causes_, warm climates and seasons, marshy effluvia; cold nights
followed by warm days; sudden suppression of perspiration, especially
in warm climates; exposure to cold and moist air and rains, and wet
cloaths and beds; long continuance of sultry and dry weather; excess
and corruption of bile; symptomatick; dysenterick contagion from
privies, beds, &c.——_Vid._ REMITTENT FEVERS.
_Diarrhœa_, ventris profluvium; including the different species, the
celiaca, lienteria, morbus hepaticus, niger, atrabilis. In the simple
diarrhœa, the evacuation by the anus is unnaturally frequent and
liquid. In the celiaca, or chylous diarrhœa, the aliments and chyle are
ejected: and in the lienteria, like a bucket whirling into a well, food
is no sooner taken than discharged. The morbus hepaticus is without
pain or tenesmus, with flux of blood and serum, or like ink; in colour
and consistence various. Diarrhœa is accompanied with gripes; but
not so excruciating as in the dysentery, with inappetency, dry skin,
thirst, hectic heat: but no considerable fever; nor is it contagious.
In the severity and evacuation there are varieties: and in some cases
it is salutary. The _causes_, excess of food and drink, or acrid
putrescent aliment; new fermented liquors; vegetable laxative food;
feculence in the intestines, stercorous, pituitous; vitiated digestion,
with morbid irritability of the intestinal tube; irritability of this
muscular canal, and increase of its peristaltic motion; atonia; excess
and acrimony of bile, warm climates, broken constitutions, cachexy,
chronic dysentery, immoderate flux of humours to the intestinal tube,
and exhalation by the arterial extremities of that canal; suppression
of perspiration, and of other evacuations; superfluity of serous
humours; impediments in the absorption and passages of the chyle;
obstruction in the vena portarum; laxity of the pylorus; palsy of
the sphincter ani; ulcers of the stomach, repelled gout, and rash;
sudden passions of mind; nervous irritation; erosion or rupture of the
blood-vessels on the interior surface; obstruction of the spleen; acrid
dissolution of the blood; colliquative; worms; symptomatic in fevers;
purgatives; poisons. In infancy, acidity, dentition, and saliva
swallowed to excess; corrupted milk and chyle, thin laxative vegetable
diet; errors of the nurse in diet; gravel in the kidneys.