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VOLUME XIX.

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DESCRIPTION OF THE FRONTISPIECE ILLUSTRATING

PATHOLOGY.

APOTHEOSIS OF HIPPOCRATES.

SEATED IN AN ANTIQUE CAR, DRAWN TOWARDS THE TEMPLE OF IMMORTALITY BY
CHIRON AND ANOTHER CENTAUR EQUALLY VERSED IN THE ART OF HEALING,—
HIPPOCRATES HOLDS IN HIS RIGHT HAND THE PATERA OF HEALTH, AND IN HIS LEFT
THE STAFF AND SERPENT OF jESCULAPIUS, WHOSE DAUGHTER HYGEIA IS REPRESENTED
ABOVE,— STREWING MEDICINAL FLOWERS ON THE HEAD OF THE FIRST PATHOLOGIST
IN THE WORLD ; WHILST APOLLO, SHOOTING FROM THE CLOUDS 4T THE SERPENT
PYTHON, AN EMBLEM OF PESTILENCE, SETS FREE FROM THE CAVERN OF THE MONSTER
THE VICTIMS OF DISEASE. DEATH AND THE DEMONS OF LINGERING ANGUISH AND
EXCRUCIATING PAIN ARE SEEN FLYING OFF; AND NAUSEATING SICKNESS IS
EXEMPLIFIED BY AN EMACIATED FIGURE ON THE FOREGROUND

ENCYCLOPAEDIA LONDINENSIS

OR, AN

UNIVERSAL DICTIONARY

OF

ARTS, SCIENCES, and LITERATURE.

PATHOLOGY.

PATHOL'OGY, f [from the Gr. waOo?, fufFering,
and Aoyos, a difcourfe.] The fcience or doitrine of
difeafes. — 'This tree may naturally be conceived to have
been under fome difeafe indifpofing it to fuch fruftifi-
cation. And this, in the pathology of plants, may be the
difeafe of fuperfoliation mentioned by Theophraftus. Sir
T. Browne’s M if cell.- — That part of medicine which relates
to diftempers, with their differences, caufes, and effects
incident to the human body.

As Physiology teaches the nature of the fundtions
of the living body in a Hate of health; fo Pathology
relates to the various derangements of thefe fundtions
which conftitute difeafe. Its objedts, therefore, are to
afcertain the various fymptoms which charadterife the
different diforders of each organ of the body, and efpe-
cially the diagnojlic and pathognomonic fymptoms, which
afford the means of difcrimination between difeafes that
referable each other; to determine the caufes, both pre-
difpofing and exciting, by which difeafes are induced ; to
point out the prognojis, or the tendency and probable
event of each difeafe, from the changes and combination
of the fymptoms ; and daftly, to teach the indications of
cure, and the nature and operation of the remedies adapted
to the various circumftances and periods of difeafe.

The ftudy of pathology prefuppofes an intimate ac¬
quaintance with anatomy and phyf.ology ; or, in other
words, with the ftruiture, laws, and operations, of the
animal body in a ftate of health. An obfervance of the
figns or fymptoms which denote a deviation from this
ftate, conftitutes the firft branch of medicine, or J'ympto-
matology : an acquaintance with the ufual concatenations
obferved by thofe figns, diagnofis. Nqfology regards the
arrangement of thefe figns or fymptoms; and atiology ap¬
plies to the cognizance of their caufes, whether external
or internal. The application of the properties of inani¬
mate matter to the removal of thefe caufes, or figns, is
denominated therapeutics. The fubftances ufed for this
latter purpofe are termed materia medica.

Before entering into any further examination of thefe
fubjeits, it will be neceffary to give a fiiort Iketch of the
hiftory of this art; in the courfe of which it will be feen,
that its profeffors have been employed for the moft part
in endeavouring to explain the phenomena of difeafe and
the operation of remedies according to the principles of
fome favourite or faftiionable ftudy. Thus mechanics, che-
miftry, and metaphyfics, have each in their turn formed
the bafis of celebrated medical theories : theories long
fince exploded, but of which the recollection may ferve
as beacons to warn us from the like errors. It is not,
however, for this purpofe only that the writings of the
ancients merit our regard. The perufal of them en¬
larges the field of our experience : we often find in them,
Vol. XIX, No. 1283,

remarks which ferve to explain anomalies in difeafe, and
defcriptions which their beautiful and forcible language
renders more interefting, and imprints more firmly on
our minds. They likewife furnifti hints for the further
profecution of inquiry, by fliowing the various lights in
which the fame circumftances have been viewed by diffe¬
rent men ; and the long chain of fads they difplay to
our view enables us in fome meafure to appreciate the
effeds of climate, diet, and even manners, on theconfti-
tution of our fpecies. It may be remarked moreover,
that fcarcely any fyftem of medicine has been framed,
however abfurd, which has not contributed, by the fpirit
of inveftigation it excited, and by the new flock of fads
its eftabliftiment neceffarily developed, to advance the pro-
grefs of the art.

RISE and PROGRESS of MEDICINE.

The origin of the medical art is involved in great ob-
fcurity : yet, its antiquity is undoubtedly great, fince,
from its intimate relation with the life of man, the difco-
very of it muft have been coeval with that of the moft
fimple mechanical arts.

The little we know of the earlieft hiftory of our race,
leads to the fuppofition, thatfurgery was the firft branch
of medicine cultivated. While mankind fubfifted prin¬
cipally by hunting or filhing, they muft, of neceffity,
have been fubjeded to a variety of accidents ; fradures,
luxations, &c. muft have been frequent among them, and
to cure or alleviate thofe obvious maladies muft have been
their firft care. It is impoflible to conjedure what means
were purfued for the attainment of this end, yet, it is
natural to fuppofe, they w'ere, fora long period, very in¬
efficient, and that the knowledge acquired in this ftate of
fociety was very confined. It is probable, however, that
anatomy was not wholly negleded in this barbarous age.
The frequent daughter of wild beafts, and the various
purpofes of food, raiment, &c. to which their different
parts were appropriated, muft have led to a curfory ac¬
quaintance with the ftrudure of thofe animals ; and thus
laid the foundation of comparative anatomy, an acquifi-
tion by no means ufelefs in chirurgical operations. En¬
gaged, too, in perpetual hoftility, thefavage probably re¬
garded the examination of human bodies with little or
none of that horror which has proved fo inimical to the
ftudy of anatomy in more civilized times ; and indeed,
(if we may judge from the accounts handed to us by the
ancients,) he feems to have felt a brutal pleafure in man¬
gling and deforming the perfons of his deceafed enemies.
Thus Homer relates of the Greeks over the body of
Heitor, that, OvJ’ ago. oi ti; aiwrw ys tcciq soto.

It was in times when more refined habits of life ob¬
tained, and in fituations where gentler purfuits occupied
B the

Vs a

2

PATHOLOGY.

the attention of mankind, that the application of reme¬
dies to the cure of internal maladies took its rife. The
tending of flocks and herds, which then became a very
general employment, mull have induced habits of leifure
and contemplation extremely favourable to theacquifition
of experimental knowledge : we may fuppofe that the paf-
tors obferved the effects of certain plants on their flocks ;
and by a natural and eafy tranfition were induced to admi-
nifter the fame fubftances in ailments of their own bodies :
a fuppolition which the faffs related by Herodotus and
others feem to confirm. The above-mentioned author
obferves, that Melampus difcovered the melampodium,
or black hellebore, to be poffeffed of a purgative property
from having obferved its effect on goats which had
broufed in paftures where this herb was indigenous and
frequent. Again, we are informed, that the firft ufe of
enemas was taught mankind by the Ibis, a bird which is
reported to have the power of introducing its bill into
the anus, and injefting thereby a quantity of water up
the inteftines. Pliny likewife mentions a circumftance
to which he attributed the introduflion of phlebotomy;
viz. that the Hippopotamus has a cuftom, whenever it
becomes large and unwieldy, of opening a vein in its leg
by means of a (harp reed which grows on the banks of
the Nile. The accuracy of the two latter relations may
be queftioned ; yet probably they had their origin in fads,
though tradition and the lapfe of time had altered or ex¬
aggerated them. However this may be, there can be
little doubt, but that in this branch of medicine, as in
anatomy, the phenomena difplayed in the brute creation
furniflied man with ufeful hints, and contributed, in a
few inftances, to introduce medical herbs to his notice.
The confideration of the more or lefs falubrious qualities
of his own food led to the introduction of certain regimen,
or fyftem of diet, which in thefe times, with the occafional
ufe of a few Ample cathartics, was probably fufficient for
the cure of mod internal complaints ; and thefe obferva-
tions, naturally communicated from father to fon, from
one generation to another, and eftabliflied by long and
multiplied experiments, at length laid the bafis of materia
medica and therapeutics. This empirical pradice, how¬
ever, being often found to fail in affording the expeded
relief, a minute attention was paid to the concomitant
circutnftances under which previous cures had been ef-
feded, and they were imitated accordingly. Thus one
plant was direded to be gathered in the night, another
when the moon was on the wane, See. accompanied with
abfurd and fuperflitious incantations.

With refped to the modus operandi of thefe remedies,
their firft employers mud have been totally uninformed,
in confequence of their ignorance of natural philofophy ;
to divine agency therefore they referred the effeds of
medicinal herbs, rather than to any innate virtue in the
fubftances themfelves. To this agency likewife they af-
cribed the occurrence of difeafe, or the reftoration of
health ; an idea which appears in feme meafure conneded
with that branch of heathen mythology which attributed
to every member of the body its guardian genius.

Up to this period every man was more or lefs a phy-
fleian, and contributed his individual flock of experience
to the general good ; but, when the increafing wants and
number of the human race compelled them to adopt the
forms of political government, and they eftabliflied the
military ruler or chieftain on the one hand, and the prieft,
druid, or brahmin, on the other, the pradice of medicine
fell exclufively into the hands of thofe who executed the
facerdotal fundion. They feized with avidity the exer-
cile of an art, the unknown or uncertain origin of which
favoured the illufion that it was derived immediately from
the gods : an art which, clothed in fuperftition, and ve¬
nerable from its antiquity, lent them increafed influence
over the vulgar, and was indeed hardly lefs ufeful for
that purpofe than the facred or legiflatorial offices which
they likewife affumed. They taught that peftilence or
difeafe was inflided by the angel of the enraged gods,

and eafily found means to perfuade the futferers that fuch
dire vifitations were only to be removed through the me¬
dium of prieftly interceffion, joined with lacrifices and
offerings.

From that paffage in Genefis in which it is faid, that
“ Jofeph commanded his fervunts the phyficians to em¬
balm his father,” (Gen. 1. 2.) the writer of the article
Medicine in the Encyclopaedia Britannica concludes
that the firft phyficians of the Egyptians were not priefts;
becaufe, in that age, the Egyptian priefts were in fuch
high favour, that they retained their liberty, when,
through a public calamity, all the reft of the people were
made flaves to the prince. This, however, we do not
think a valid objedion; for we cannot doubt that every
rank of perfons, priefts as well as others, might, under
an abfolute monarchy, be very properly ftyled fervants of
the prince, and alfo of his prime minifter.

The fame writer feems more founded in his conjedure
that the phyficians of the Jews were originally diftind
from their priefts ; for we read that, when king Afa was
difeafed in his feet, “ he fought not to the Lord, but to
the phyficians.” (2Chron.xvi. 12.) Now, feekingtothe
priefts, had they been the phyficians, would have been
the fame thing as feeking to the Lord; and hence it is
fuppofed, that among the Jews the medical art was
looked upon as a mere human invention ; and it was
thought that the Deity never cured difeafes by making
people acquainted with the virtues of this or that herb,
but only by his miraculous power. That the fame opi¬
nion prevailed among the nations who were neighbours
to the Jews, is alfo probable from what we read of Aha-
ziah king of Judah, who, having fent meffengers to in¬
quire of Baalzebub, god of Ekron, concerning his dif¬
eafe, did not defire any remedy from him or his priefts,
but limply to know whether he ffiould recover or not.
(2 Kings i. 2.)

We ffiall now quote a few verfes from a book of Scrip¬
ture (Apocrypha), written “ in the latter times, after the
people had been led away captive, and called home again,
and almoft after all the prophets.” In this book phy¬
ficians are fpoken of with a much greater degree of re-
fpeft, but not as if they were priefts. “My foil, in thy
ficknefs be not negligent : but pray unto the Lord, and
he will make thee whole. Leave oft" from fin, and order
thine hands aright, and cleanfe thy heart from all wick-
ednefs. Give a fweet favour, and a memorial of fine
flour; and make a fat offering. Then give place to the
phyfician, for the Lord hath created him : let him not go
from thee, for thou haft need of him. There is a time when
in their hands there is good fuccefs. For they fhall alfo pray
unto the Lord, that he would profper that which they
give for eafe and remedy to prolong life. He that finneth
before his Maker, let him fall into the hand of the phyjician.
Ecclefiafticus xxxviii. 15.

“ What feems moft probable on this fubjeft therefore
is, that religion and medicine came to be mixed together
only in confequence of that degeneracy into ignorance
and fuperftition which took place among all nations. The
Egyptians, we know, came at laft to be funk in the moft
ridiculous and abfurd fuperftition ; and then, indeed, it
is not wonderful that we fliould find theirpriefts com¬
mencing phyficians, and mingling charms, incantations,
&c. with their remedies. That this was the cafe, long
after the days of Jofeph, we are very certain ; and in¬
deed it feems as natural for ignorance and barbarifm to
combine religion with phyfic, as it is for a civilized and
enlightened people to keep them feparate. Hence we fee,
that among all modern barbarians their priefts or conju¬
rors are their only phyficians.” Ency. Brit. vol. xiii.

However this may be, the union of medicineand religion
continued for many centuries; but, whatever difeoveries
may have been made, the myftery attendant on moft fa¬
cred inflitutions has prevented communication of them
to pofterity. Neverthelefs this union was not perhaps fo
prejudical to the interefts of fcience as many have fup¬
pofed.

3

PATHOL O G Y.

pofed. Conftant facrifice and the frequent habit of in-
fpeftingthe “ /pirantwexta” of tire victims, matt have ma¬
terially advanced the progrefs of comparative anatomy ;
and the written records firlh adopted by the priefts at
lead prevented eftablilhed faffs from falling into oblivion,
even if further experience in the cure of difeafe was but
(lowly attained.

The Egyptians afcribed the invention of medicine to
Thoth, ( the Hermes Trifmegiftus of the Greeks,) to
whom divine honours were paid ; and they reported that
he was the founder of all ufeful knowledge. But there
is fome confufion in this account 5 for, on fome occafions,
this difcovery was attributed to Ifis or Ofiris, while at
other times Apis and Serapis laid claim to the merit of
it. It Ihould be recollected, however, that thefe deities
werenot like Thoth, mortals who had divine honours paid
to them after their deceafe, but embodied or perfonified
agents, by means of which the philofophers of the time en¬
deavoured to explain all the laws and operations of matter.
They were not likely therefore to be commemorated as
the inventors of medicine, although they were undoubt¬
edly invoked as prefiding over health. Athotis, one of
the Egyptian kings, left writings on anatomy, a fcience
in which the nation could hardly have been deficient, on
account of the frequent opportunities they enjoyed of
acquiring it while engaged in embalming the bodies of
the dead. But the other branches of medicine remained
a long time ftationary, fettered by abfurd regulations.
In the firft place, the chief-priefts confined themfelves
entirely to the exercife of magic rites and prophefies,
which they confidered the higher branch of the art, and
left the exhibition of remedies to th epajiophori, or image-
bearers. Secondly, the priefts of every denomination
■were compelled to follow implicitly the medical precepts
of the facred records contained in the fixhermetical books ;
for, if they deviated from thefe eftablilhed rules, or intro¬
duced new modes of pra&ice, their temerity was punifhed
with death, whether their meafures were fuccefsful or
not; thus precluding all idea of improvement. We
know very little of the details of their pradtice, as they
concealed them with myftic ceremonies ; but that they did
not interfere much with the operations of nature may be
inferred from a circumftance mentioned by Ariftotle, viz.
that they did not adopt adfive treatment till after the
fourth day of the difeafe. They had, however, a com-
prehenfive fyftem of diet ; for they excluded filh,pork, and
fuch other aliments as they confidered injurious to health.
They were alfo acquainted with a few valuable remedies,
among which may be enumerated fquills, which they ad-
miniftered to dropfical patients, and iron, which they
ufed as a tonic in cachedlic difeafes ; but they were la¬
mentably deficient in furgery, fince they were unable to
cure a common luxation of the foot, which Darius the
foil of Hyftafpes met with in hunting.

We pafs briefly over the hiftory of this fcience among
the Jews, becaufe we find little recorded on the fubjedt
except miraculous cures, which cannot properly be faid to
apply to natural medicine. Indeed the Jews feem to have
been wholly ignorant of the art of phyfic until their in¬
troduction into Egypt, when they found its principles
eftablilhed.

The alleviation of human infirmity, as recorded in Scrip¬
ture, forms a fubjedl rather to exercife the faith of the
theologian than to engage the attention of the patho-
logift. It is true, Mofes has arranged a code of medi¬
cinal and dietetic maxims, and has defcribed feveral va¬
rieties of leprofy with the minutenefs of a practical phy-
fician ; but it does not appear that he attributed much
to the virtue of medicines in thofe complaints. Indeed
the adminiftration of remedies could hardly feem necef-
fary to a people who were informed by a direCt revelation
from the Lord, that, if they would diligently hearken
unto his voice, and do that which was right in his fight,
he would put none of thofe difeafes on them with which

he had afflidfed the Egyptians. To the tribe of Levi was
appropriated the adminiftration of the facred remedies.
Solomon was celebrated for his knowledge of plants and
animals ; and he compofed a treatife on the cure of dif¬
eafes which was deltroyed by Ezekias, left it fliould caufe
the facred remedies, rendered more efficacious by the fa-
crifices of the priefts, to fall into difufe. Ifaiah the pro¬
phet was likewife famed for medical knowledge : he re-
itored Ezekias to life by applying to his wounds cata-
plafms of figs. Soon after this period the Jews were dif-
perfed in Media and Aflyria, and fubmitted to the yoke
of Babylon.

It is fuppofed that medicine was cultivated at a very
early period among the Hindoos. Of this there can be
little doubt. Whether this people were originally de¬
rived from the Egyptians, or the Egyptians from them,
the fimilitude in arts, manners, and religion, clearly in¬
dicates that the one nation arofe from the other. Ac¬
cordingly we find the art (food in former times nearly on
the fame footing in Hindooftan as it (food in Egypt. The
brahmins held the two offices of priefts and phyficians;
and, as among the Egyptians, allotted a few difeafes only
to the notice of each individual among themfelves.

In China, the progrefs of this art feems to have fol¬
lowed a retrograde courfe. For this we are at a lofs to
account : certain it is, however, that the authority of the
Chinefe'on medical fubjeCts was formerly held in much
greater eftimation than it isatprefent. Thejefuits have
informed us, that the kings of China paid particular at¬
tention to the encouragement of medicine ; and that Eu¬
ropeans were wont to put greater confidence in the phy¬
ficians of this country than in thofe of any other. More¬
over this fcience was taught in their public fchools, in
conjunction with aftronomy. Thefe fchools no longer
exift : the Chinefe phyficians implicitly follow the direc¬
tions of the medical code of Hoang-Ti, written, as they
aflert, 4000 years ago; and their knowledge is fo fmall
and inaccurate, that the emperor Cam-hi commanded
Parenhi totranflate the anatomical treatife of Dionis in¬
to the Tartarian language.

In Greece, medicine was profecuted with greater ar¬
dour, and its collateral fcience anatomy was inveftigated
more fully, than had been the cafe in any country before.
The Greeks, like the Egyptians, afcribed the introduc¬
tion of this art to divine revelation: their Apollo and
Minerva anfwered to the Ifis and Ofiris of the latter
nation ; and Orpheus, the prieft, poet, and phyfician,
ufurped the place of Thoth ; and the fable of his bringing
his wife Eurydice from Hell probably applies to his fkill in
difeafes. But the priority has been given by fome to Me-
lampus, who was a phyfician of great celebrity at Pylos. He
cured the daughters of Praetos king of Argos, who were
afflidfed with leprofy and madnefs ; and he removed like¬
wife the impotence of Iphiclus, by which cure he alfo
faved his own life.

The next on record i3 the centaur Chiron, who was
preceptor to moll of the warriors and great men of his age,
but with the greateft fuccefs to Aifculapius, or Afclepias,
a king of Theffaly (and reputed fon of Apollo), who
made fo great proficiency, that the fable fays Jupiter was
obliged to remove him from the earth to preferve his
brother Pluto’s kingdom from depopulation. His fons,
Podalirius and Machaon, received from their father the
art of healing, which they exereifed with fuccefs at the
fiege of Troy, and tranfmitted to their defcendants the
Afclepiades. At firft, the Afclepiades promulgated their
doCtrines as priefts in the temples of the god of health;
but, as fchifms arofe among the different fe&s, each tem¬
ple became in time a diftinCt medical fchool. Thus the
fchool of Ceredos and Cos were founded, in which for
fome time the defcendants of Asfculapius alone were per¬
mitted to pra&ife : but it was afterwards judged necef-
fary to admit a limited number of pupils from other fa¬
milies, who bound themfelves by oath to obferve the

rules

4 PATHOLOGY.

rules of the Afclepiades. From the fchool of Cos arofe
Hippocrates, the fourteenth in defcent from Aifculapius.

But the ftudy of medicine was not confined to this fa¬
mily ; it formed part of the education of kings and heroes.
Hercules received from Chiron, in earlier times, the ru¬
diments of medicine. Ariftasus, king of Arcadia, was
likewife a fcholar of the centaurs : to him we owe the in¬
troduction of the herb Jylphium, fuppofed by fome to be
aflafcetida. Jafon, Telamon, Thefeus and Peleus,Ulyfles,
Diomed, Hippolytus, and Achilles, were proficients in
this art. Achilles is faid indeed to have firft ufed verdi¬
gris for the purpofe of cleaning foul ulcers. But all of
them were inferior to the accomplilhed, the injured, Pa-
lamedes ; by the excellent rules of diet and exercife to
which he fubmitted the foldiers, he prevented the plague
from entering the Grecian camp after it had carried its
ravages over raoft of the cities of the Hellefpont and even
Troy itfelf.

./Efculapiusflouriftied about 50 years before the Trojan
war 5 and we have feen that his two Tons diftinguilhed
themfelves in that war both by their valour and by their
ikill in curing wounds. This indeed is the whole of the
medical Ikill attributed to them by Homer ; for, in the
plague which broke out in the Grecian camp, l.edoes not
mention their being at all confulted. Nay, what is (fill
more ftrange, though he fometimes mentions his heroes
having their bones broken, he never takes notice of their
being reduced or cured by any other than fupernatural
means; as in the cafe of ^Eneas, whofe thigh-bone was
broken by a Hone call at him by Diomed. The methods
which thefe two famous furgeons ufed in curing the
wounds of their fellow-foldiers, feems to have been the
extracting or cutting out the darts which inflicted them,
and applying emollient fomentations orftyptics to them
when neceflary : and to thefe they undoubtedly attributed
much more virtue than they could poflibly poflefs ; as
appears from the following lines, where Homer defcribes
Eurypylus as wounded and under the hands of Patroclus,
who would certainly praCtife according to the directions
of the furgeons of that time :

Patroclus cut the forky fteel away ;

Then in his hand a bitter root he bruis’d,

The wound he walh’d, the llyptic juice infus’d.

The clofing flefli that injtant ceas’d to glow;

The wound to torture, and the blood to flow. Iliad, xi.

The philofophers of Greece, by adapting their fpecula-
tions to the elucidation of this fcience, lent it material
aid. Pythagoras vifited Egypt and India, collected the
therapeutic and dietetic maxims of thofe nations, and in¬
troduced them into his own country: unfortunately, in
fo doing, he forgot the difference of climate and habits,
.and endeavoured to apply the vegetable regimen too
ftriCtly. He attended diligently to the ltudy of the ani¬
mal economy ; and he founded the fchool of Crotona,
whence arofe Alcmaeon, an anatomift of great repute.
With refpeCt to the knowledge this latter perfonage pof-
fefled of the human ftruCture, it admits of doubt ; but his
/kill in comparative anatomy is well attefted by Ariftotle,
Diogenes, and Plutarch: with him too originated the
firft theory of fleep : he fuppofed, that, when the blood
flows in the larger veflels only, fleep is induced; but,
when it returns in the finaller ones, waking occurs.
Empedocles, the diftinguiflied philofopher, was another
ornament of the Pythagorean feCt.

Befides thefe philofophers, and the Afclepiades, there
were, at this period, other perfons who devoted them¬
felves to the profeflion of phyfic, and who occafionally
were remunerated by a fixed falary. Thus Democetes of
Crotona was retained at the court of the Samian tyrant
Polycrates, with an allowance of two talents yearly :
being afterwards taken prifoner, and carried as a flave in-
do Perfia, he acquired great repute by curing Darius of a
•fprained foot, after the Egyptian phyficians had failed ;
iand alfo by his fuccefsful treatment of a tumour of the

breaft, under which Atofia, the daughter of Cyrus, and
wife of Darius, had laboured for a confiaerable time.
(Herodot. iii. 133.) Such pradlitioners, from their wan¬
dering lives, were fometimes defignated by the name of
s-Egio&vrat. Of this clafs, one of. the moll confpicuous
was Acron of Agrigentum, the contemporary and rival
of Empedocles, refpedting whom Pliny has fallen into a
ftrange error, in defcribing him as the founder of the
empiric fedt “under the fandtion of Empedocles.” Ac¬
cording to Diogenes, he was the author of fome books on
medicine and dietetics, written in the Doric dialed! ; and
he fignalized himfelf at Athens, in the time of the great
plague, by introducing the pradtice of fumigations, and
thus affording relief to many. (Plut. de Ifld. et Ofir.)
The gymnafia of ancient Greece feem alfo to have con¬
tributed to the improvement of the art. It belonged to
the gymnafiarch, or pulajlrophylux , to regulate the diet
of the youths who were trained in thefe feminaries ;_the
yt //Avaran were prefumed to be converfant with difeafes;
and it was the bufinefs of the ctXtiiflai to perform venefec-
tion, to drefs wounds, fradtures, &c. They were fome¬
times called phyficians. It was in thefe feminaries that
the gymnaftic fyftem of medicine originated, under the au-
fpices of Iccus of Tarentum, and Herodicus of Selymbria.

About this time, and contemporary with Hippocrates,
flourilhed Democritus of Abdera, who made the firft
public difledtion on record: he applied himfelf to this
talk for the purpofe of afcertaining the nature and courfe
of the bile; and difledted with fo much afliduity, that
the Abderites fufpedted him of infanity, and accordingly
fent for Hippocrates (as it is reported) to cure him : but
the latter, fo far from finding him mad, difcovered that
he was extremely wife, as he exprefles himfelf in a letter
to his friend Damagetus.

As we are now arrived at an era in which the hiftory
of pathology will afl’ume, as it were, a tangible fliape, we
fliall divide our large field of information into three fec-
tions ; the firft reaching to the decline of the art during
the dark ages ; the fecond from that time to the end of
the fixteenth century; and the third, to the prefent time.

I. From the Time of Hippocrates to the dark Ages.

Hippocrates has juftly been ftyled the Father of Me¬
dicine, fince his writings are the moft ancient exprefsly
on this fubjedt which have been preferved. His tran-
fcendent merit alone would, however, fecure to him that
title. He has left behind him uleful hints on almoft every
branch of medicine; and has inveftigated fome of them
with an exadtnefs which has left us little to defire. On
anatomy, though probably he did. not himfelf make dif-
fedtions, he has compiled all the information extant in
his time ; and his theory of medicine, though long fince
exploded, merits, in comparifon with the hypothetical
and extravagant notions that had preceded it, much en¬
comium. It was certainly more comprehenfible, and
more explanatory of known fadts, than the dodtrine of
Pythagoras, which accounted for every thing by the
fcience of numbers ; or than that of Empedocles, which
referred all phenomena to the agency of an ethereal fpi-
rit. It is, however, the practical part of medicine that
Hippocrates has fo much elucidated. We difcard his
theory of Nature, his concodtions* and infpiflations ; but
in his account of difeafes, in the accurate hiftories he has
afforded us of figns or fymptoms, their relations and ef-
fedts, he Hands unrivalled. His prognojlics, too, have
comparatively been little improved in the prefent day :
indeed he carried them to fo great a degree of perfedtion,
that he and his pupils were regarded by the vulgar as
prophets. It ftiould be likewife recorded of him, that he
endeavoured to dived the art he profefled of all that myl-
teryand fuperftition in which he found it enveloped, and
that he gave the firft outline of a fubjedt of great impor¬
tance, medical ethics. His authority has been revered for
ages, and his maxims have been received as dogmas, not
only in the fchools, but in the courts of law. We need
1 not

PATHOLOGY.

not therefore be furprifed that many men of inferior ce¬
lebrity fhould have endeavoured to render their works
popular by afcribing them to this famous phyfician. Ac¬
cordingly we find many writings extant bearing his name,
which are evidently fpurious. It fhould be remarked
however, that thefe writings are nearly of the fame date
as his genuine cOmpofitions, and contain the prevalent
doftrines of his time.

The pathology of Hippocrates was founded on the af-
fumption, that a principle exifis in the animal, tending
to the prefervation of health, and the- removal of difeafe.
To this principle, which he denominates Nature, heap-
pears to have attributed fome degree of intelligence, and
even in one place applies to it the epithet of juji. “ The
manner in which Nature adts, or commands her fubfer-
vient power to adt, is by attracting what is good and
agreeable to each fpecies, and by retaining, preparing,
and changing, it ; and on the other fide in rejedting what¬
ever is fuperfluous or hurtful, after fhe has feparated it
from the good.” This is the foundation of the dodtrine
of depuration, concoction, and criiis, in fevers, fo much
infilled upon by Hippocrates and many other phyficians.
He fuppofes alfo, that every thing has an inclination to
be joined to what agrees with it, and to remove from
every thing contrary to it ; and like wife that there is an
affinity between the feveral parts of the body, by which
they mutually fympathife with each other.

Hippocrates referred the production of mod difeafes to
diet and air ; to the former of which he attached fo much
importance, that he compofed feveral books concerning
it : yet in another part of his works he gives the judicious
maxim, that while in health we fhould by no means at¬
tach ourfelves to nice and delicate habits of living, or
live with too much regularity; becaufe thofe who have
once begun to live by rule, become difordered if they
depart in the lead from it. In the choice of fituation
with regard to the purity of air, he was particularly care¬
ful ; and noted efpecially the winds, the times of the fol-
dices and equinoxes, & c. He likewife took into con-
lideration the effects produced by deep, watching, exer-
cife, &c. and attached great importance to certain hu¬
mours, particularly blood and bile. His claffification of
difeafes was arranged according to the circumdances of
their danger, duration, or locality : thus fome difeafes
were mortal, dangerous, or curable; others acute or
chronic; and again others were divided into endemical,
epidemical, and l'poradic. Hereditary difeafes he likewife
noticed.

We are obliged to Hippocrates for the remark, that
there are certain ftages in every didemper; a point of
great practical importance. He generally noticed four;
the beginning, the augmentation, the height, and
the decline. In mortal difeafes, death took place indead
of the decline ; on which account this latter was reckoned
by Hippocrates to be worthy of particular in vedigation.
He conceived that during this dage a crifis took place ;
i. e. that the mortified matter which. produced the difeafe
was by fome means feparated from the body ; but this
feparation never occurred until the humour was fuffi-
ciently concoded ; that is to lay, brought into a fit date
for expuifion from the body, by the efforts of Nature.
Moreover, this author fuppofed, that, as every fruit has
a limited time to ripen in, fo concottion could not be ac-
complilbed unlefs within a certain period. He took much
pains to edabiilh critical day*, or the times when thefe
concoctions and crifes fnculd take place; and he deemed
them moll favourable when they occurred on odd days.

In noting the ligns and characters of difeafe, Hippo¬
crates was extremely minute, and that chiefly with a view
to foretelling the event of the malady. He obferved the
altered appearance of every feature of the face, the com¬
plexion ; the dim, fierce, fparkling, or other exprefiion,
of the eyes. He paid attention to the poflure and atti¬
tude of the fufferer •. he remarked the debility which ge¬
nerally attends the continued fupine pofition ; and he
noticed the picking of the bed-clothes, the uneafy and

Vol. XIX. No. 1283.

5

tremulous motions, and likewife the fubfultus tendinum,
which denote death in patients affected with fevers.

Hippocrates paid particular attention to the refpiration,
the different Hates of which affilled him in forming his
prognofis. He examined the urine with great care ; but,
as his remarks on it chiefly regarded his humoral hypo-
thelis, they are now of little intereft. He noticed, how¬
ever, that the crifis of fever was often brought about
when the urine became very abundant, and the thick ap¬
pearance of it denoted difeafe of the bladder ; he was in the
habit of comparing the appearance of this evacuation with
that of the tongue. The faeces too were invelligated, in re¬
lation to their odour, confluence, and colour, by this au¬
thor. But he has recorded more important fails concerning
the expectoration which arifes in pulmonary complaints:
he fays that, when it is mixed with blood (in chronic
cafes), when it is entirely wanting, or when it is fo co¬
pious as to caufe rattling in the throat, it denotes ex¬
treme danger; but that, when it is mixed with puru¬
lent matter, it indicates confumption, and terminates
in death. Concerning perfpiration, Hippocrates has re¬
corded the beneficial effects derived from its occurrence
in fevers; when it is general, it often produces the crifis :
but he has well remarked the danger of cold and partial
fweats.

It has been doubted whether this celebrated.phyfician
underltood any thing about the pulfe. It has been fup¬
pofed that the paffages found in his works apply only to
the pulfation which is feit in an inflamed part. But his
knowledge mull have extended further than this on the
fubjedt; becaufe he talks of flow and tremulous pulfes;
and in his Coucce Pranotionrs he remarks, that the feniible
pulfation of the artery in the elbow indicates delirium, or
the prelenceof violent anger.

Exercife was not neglected by Hippocrates; but he
jullly blames his preceptor Herodicus for recommending
it to thofe afflidled with fevers or inflammatory affedlions.
Indeed the latter phyfician was fo fond of gymnaftics,
that he made his patients walk from Athens to Megara,
a diftance of twenty-five miles, and return as foon as they
had touched the walls of the city. Yet Hippocrates
juflly appreciated the advantage of exercife in chronic
difeafes; and even tells 11s that “ we mull fometimes
pufh the timorous out of bed, and roufe up the lazy.”

Hippocrates gave many general rules of importance in
regard to the ellablilhment of health, among which are
the importantones of keeping up, in molt cafes, a regular
difcharge; to deplete the plethoric by low living, and to
avoid fudden expofure to increafed or diminiffied tempe¬
rature.

The therapeutical maxims of Hippocrates were few
and Ample, and all founded on his theory of Nature cu¬
ring difeafes ; infomuch that all that could be done was
to remove fuch things as were injurious to the agency
of that principle, or to affiil it in its operations when it
was deficient. He alferted, in the firft place, “That con¬
traries, or oppofltes, are the remedies for each other;”
and this maxim he explains by an aphorifm ; in which he
fays, that evacuations cure thofe dillempers which come
from repletion, and repletion thofe that are caufed by
evacuation : fo heat is deflroyed by cold, and cold by heat,
& c. In thelecond place, he alferted that phyfic is an ad¬
dition of what is wanting, and a fubtr.idlion or retrench¬
ment of what is fuperfluous : an axiom which is thus ex¬
plained, that there are fome juices or humours, which in
particular cafes ought to be evacuated, or driven out of the
body, or dried up ; and fome others which ought to be
reftored to the body, or caufed to be produced there
again. As to the method to be taken for this addition
or retrenchment, he gives this general caution, “That
you ought to be careful how you fill up, or evacuate, all
at once, or too quickly, or too much ; and that it is
equally dangerous to heat or cool again on a fudden ;
or, rather, you ought not to do it : every thing that
runs to an excels being an enemy to nature.” In the
fourth place, he allowed that we ought fometimes to
C dilate.

G

PATHOLOGY.

dilate, and fometimes to lock up ; to dilate, or
open the paftages by which the humours are voided
naturally, when they are not fufficiently opened, or when
they are clofed ; and, on the contrary, to lock up or
ilraiten the paftages that are relaxed, when the juices that
pafs there ought not to pafs, or when they pafs in too
great quantity. He adds, that we ought fometimes to
linooth, and fometimes to make rough ; fometimes to
harden, and fometimes to fatten again; fometimes to
make more fine or fupple; fometimes to thicken ; fome¬
times to roufe up, and at other times to ftupify or take
away the fenfe ; all in relation to the folid parts of the
body, or to the humours. He gives alfo this farther lef-
fon, That we ought to have regard to thecourfe the hu¬
mours take, from whence they come and whither they
go; and in confequence of that, when they go where
they ought not, that we make them take a turn-about,
or carry them another way, almoft like the turning the
courfe of a river; or, upon other occafions, that we en¬
deavour, if poffibie, to recaj, or make the fame humours
return back again ; drawing upward fuch as have a ten¬
dency downward, and drawing downward fuch as tend
upward. We ought alfo to carry off, by con venient ways,
that which is necelfary to be carried off; and not let the
humours once evacuated, enter into the veffels again.
Hippocrates giVes alfo the following inftruflion ; “ That,
when we do any thing according to reafon, though the
fuccefs be not anfwerable, we ought not eafily, or too
haftily, to alter the manner of afliug, as long as the rea-
fons for it are yet good.” But, as this maxim might
fometimes prove deceitful, he gives the following as a cor¬
rector to it : “We ought (fays he) to mind with a great
deal of attention what gives eafe, and what creates pain ;
what is eafily fupported, and what cannot be endured.
We ought not to do any thing raflily ; but ought often
to paufe, or wait, without doing any thing: by this way,
if you do the patient no good, you will at ieaft do him no
hurt.”

Thefe are the principal and moll general maxims of
the pradtice of Hippocrates, and which proceed upon
the iuppontion laid down at the beginning, viz. that
Nature cures difeafes. We next proceed to confider
particularly the remedies employed by him, which will
ferve to give us further inftruflions concerning his practice.

Diet was the firft, the principal, and often the only, re¬
medy made life of by this great phyfician to anfwer moll
of the intentions above mentioned; by means of it he
oppofed the moift to dry, hot to cold, See. and what he
looked upon to be the mod confiderable point was, that
thus he fupported Nature, and affifted her to overcome
the malady. The dietetic part of medicine was fo much
the invention of Hippocrates himfelf, that he was very de-
firous to be accounted the author of it ; and, the better
to make it appear that it was a new remedy in his days,
lie fays exprefsly, that the ancients had written almoft no¬
thing concerning the diet of the fick, having omitted
this point, though it was one of the mod ed'ential parts
of the art.

There were many difeafes for which he judged the bath
was a proper remedy ; and lie takes notice of all the cir-
cumdances that are necelfary in order to caufe t lie pa¬
tient to receive benefit from it, among which the follow¬
ing are the principal. The patient that bathes himfelf
mud remain dill and quiet in his place, without fpeaking,
while the adidants throw water over his head or are
wiping him dry; for which lad purpofe he defired them
to keep fponges, indead of that indrument called by the
ancients Jtrigil, which ferved to rub od’ from the fkin the
dirt and nadinefs left upon it by the unguents and oils
with which they anointed themfelves. He mud alfo take
care not to catch cold; and mud not bathe immediately
after eating or drinking, nor eat or drink immediately
after coming out of the bath. Regard mud alfo be had
whether the patient has been accudomed to bathe while
in health, and whether he has been benefited or hurt by it.

Ladly, he mud abdain from the bath when the body is
too open, or too codive, or when he is too weak ; or if he
has an inclination to vomit, a great lofs of appetite, or
bleeds at the nofe.

When he found that diet, exercife, and bathing, were
not fufficient to Vale nature of a burden of corrupted hu¬
mours, he was obliged to make ufe of other means ; of
which vomiting, bleeding, and purging, were the chief.

Vomits were a favourite remedy with Hippocrates. He
preferibed them to people in health, by way of preventa-
tives, direfling them to be taken once or twice a-month
in the winter and the fpring. The mod fimple of thefe
was a decoftion of hyfl'op, with the addition of a littie
vinegar and fait. With regard to the fick, he fometimes
advifed them to the fame, when his intentions were only
to cleanfe the domach. But, when he had a mind to re-
cal the humours, as lie termed it, from the in mod recedes
of tiie body, he made ufe of brifker remedies. Among
thefe was white hellebore; and this indeed he mod fre¬
quently ufed to excite vomiting. He gave this root par¬
ticularly to melancholy and mad people; and from the
great ufe made of it in thefe cafes by Hippocrates and
other ancient phyficians, the phrafe, to have need of helle¬
bore, became a proverbial exprefiion for being out of one’s
fenfes. He gave it alfo in deduxions, which come, accor¬
ding to him, from the brain, and throw themfeives on the
nodrils or ears, or fill the mouth with faliva, or that caufe
dubborn pains in the head, and a wearinefs or an extra¬
ordinary lieavinefs, or a weaknefs of the knees, or a fwel-
ling all over the body. He gave it to confumptive per-
ions in broth of lentils, to fuch as were afflicted with the
dropfy called leucnphlegmatia, and in other chronical dif-
orders. But we do not find that he made ufe of it in
acute didempers, except in the cholera morbus, where he
fays he preferibed it with benefit. Some took this medi¬
cine fading; but mod took it after fupper, as was com¬
monly praftifed with regard to vomits taken by way of
prevention. The reafon why he gave this medicine mod
commonly after eating was, that by mixing with the ali¬
ment, its acrimony might be fomewhat abated, and it
might operate with lefs violence on the membranes of
the domach.

In the didemper called empyema (ora colleftion of mat¬
ter in the bread), he made ufe of a very rough medicine.
He commanded the patient to draw in his tongue as
much as he was able; and, when that was done, he endea¬
voured to put into the hollow of the lungs a liquor that-
irritated the part, which, railing a violent cough, forced
the lungs to difeharge the purulent matter contained in
them. The materials that he ufed for this purpofe were
of different forts; fometimes he took the root of arum,
which he ordered to be boiled with a little fait in a fuffi-
cient quantity of water and oil ; difl'olving a little honey
in it. At other times, when he intended to purge more
drongly, he took the flowers of copper and hellebore;
after that he (hook the patient violently by the fhoulders,
the better to loofen the pus. This remedy, according
to Galen, he received from the Cnidian phyficians ; and it
has never been ufed by fucceeding ones, probably be-
caufe the patients could not fuller it.

Blood-letting was another method of evacuation pretty
much ufed by Hippocrates; and in inflammatory affec¬
tions he praflifed it in a large and decided manner; for
he fometimes opened the veins of both arms, and kept
them running till the patient fainted. The principal
maladies in which he had recourfe to bleeding were in¬
flammations of the liver, fpleen, lungs, or other vifeera ;
quinfy, pleurify, and pain in the head; but in fome in-
liances of chronic difeafe, as dropfy and jaundice, he
likewife performed this operation. In fevers he difap-
proved of venefeflion, becaufe he conceived thofe difeafes
were produced by certain humours which could not be
expelled by that means : it muff, however, be underftood,
that he did not extend this rule to fymptomatic fevers,
but rather to thofe which were not preceded by figns of

local

PATHOLOGY.

local inflammation. Indeed, in his writings, the term
fever is only applied to that clafs which we call idiopathic ;
and there feems good reafon to fuppofe, that, in the com¬
mencement of a fever ariling out of vilceral inflammation,
he bled very copioufly. He likewife performed cupping
■with fcarificators ; and occafionally ufed the femicupium,
which he fuppofed would draw the humours from the
affeCted part by means of aUrudiion.

As molt of the purgatives in ufe in the time of Hip¬
pocrates were very violent in their operation, often pro¬
ducing ficknefs, he prefcribed them with great caution.
He did not give them to pregnant women, old people, or
children ; nor during the dog-days. He ufed them more
frequently in chronic than acute difeafes, and chiefly with
a view to the expulfion of fome particular humour; to
each of thel'e humours he applied a leparate kind of pur¬
gative ; hence the diltinCtion of thofe fubftances into hy-
d-ragogues, cholagogues, &c. now juflly exploded. Hip¬
pocrates likewife ufed errhines, which he laid relieved
pain in the head by drawing the phlegm from the brain;
i'udoriflcs and diuretics, which were likewife for the pur-
pofe of evacuating fome peccant humour, and narcotics,
or, as he called them, hypnotics, to produce fleep. But
of thefe laft he was very lparing. To medicines which ex¬
perience had proved to be efficacious, but of which the
operation was inexplicable by this humoral pathology, he
applied the term Jpecifics. He ufed fomentations, in which
different herbs were boiled, either by direCt application or
in the form of vapour. Nor did he neglect cataplafms,
ointments, cauftics, and collyria ; all of which he pre¬
pared himfelf, or caufed to be made by his fervants un¬
der his own immediate infpeCtion. The pharmaceutical
diftinCtions of medicines into mixtures, powders, and
pills, were obferved in this time, and likewife fomething
analogous to our lozenge was ufed ; it was called a lum-
lative, was of a foft confidence, and was retained in the
patient’s mouth until flowly diffolved. The practice of
Hippocrates was beneficial to himfelf; for it is generally
underftood that he reached the age of a hundred years,
and died about 360 years before the birth of Chrift.

Soon after the death of Hippocrates, the profeffors of
medicine became divided into two feCts ; the Dogmatifts
and the Empirics.

The feed of the Dogmatists was founded by Theffalus
and Draco the fons, and Polybus the fon-in-law, of Hip¬
pocrates. Their leading tenets are recorded in the book
“On the Nature of Man,” which has falfely been attri¬
buted to Hippocrates. Ariftotle conjedtures that it was
written by Polybus. The Dogmatilts were fometimes
coiled logici, or logicians, from their ufing the rules of
logic and reafon in the fubjedts of their profeflion. They
fet out with the rule, that, “when experience fails, rea¬
fon mayfuffice.” Unfortunately, however, they took lit¬
tle pains to confult experience, but were perpetually oc¬
cupied with endeavouring to trace difeafe to its fecret
and remote caufes.

The fyftem of the Empirics, as the term imports, was
founded altogether upon experience-, and thofe who be¬
longed to this fedt have remarked, that there are three
modes by which we learn, from experience, to diltinguith
what is advantageous and what is prejudicial, in regard
to our health. 1. The firlt of thefe, and the molt Ample,
arifes from accident. A perfon, for example, having a
violent pain in the head,' happens to fall, and divides a
veffel in the forehead ; and it is obferved that, having
loll blood, his pain is relieved, Under the fame mode,
they include the experience which is acquired by obfer-
ving the fpontaneous operations of the conftitution,
where no remedy has been applied, as in the following
cafe : a perfon labouring under a fever, finds his difeafe
mitigated, after a hemorrhagy from the nofe, a profufe
perfpiration, or a diarrhoea. 2. The fecond mode of
gaining experience is, that in which fomething is done by
deftgn , with a view to afeertain what will be the fuccels
of it; as, for inftance, when a perfon, having been bitten

?

by a ferpent, or other venomous creature, applies to the
bite the firft herb that he finds ; or when a mart' attempts
to alleviate the fymptoms of an acute and burning fever,
by drinking as copioufly as he is able of cold water ; or
when a perfon tries a remedy, fuggefted tohimby a dream,
as was frequently done in heathenilh times. 3. The
third mode of experimenting is, that which the empirics
termed imitative; W'hicb is purfued in cafes, when, after
having remarked the e fleets refulting from accident, or
the fpontaneous aCtions of the fyftem, on the one hand,
or from dejign on the other, we make an attempt to ac-
complilh afimilar refult by imitating that which u!as done
on thofe occafions.

This laft fort of experience, they contend, is that which
peculiarly conftitutes the art of medicine, when it lias
been frequently repeated. They call that obj'ervation
(r'/5p7j(7K,) or autopfia, (avr ottcicc,) which each individual
fees himfelf ; and ufe the term hijlory or record, (i{Topi:t,)
for fuch obfervation, when committed to writing; that is,
the autopfia , or perfonal experience, confifts of the obfer-
vations which each perfon has made, by his attention to
the progrefs of a difeafe, whether in regard to its fymp¬
toms and changes, or to the remedies employed ; while
the record is a fort of narration or regifter of all that was
obferved by thofe individuals ; which regifter being com¬
pleted, (i. e. including all the difeafes incident to man¬
kind, and the remedies adminiftered for their alleviation, )
the art of medicine w'ould be eftabliflied with a confider-
able degree of certainty. But, as new difeafes fometimes
occur, in regard to which neither our perfonal experience,
nor the obfervations of others, can furnilh us with any
afliftance; and we meet with diforders in particular fitua-
tions, where the means of relief, fanCtioned by experience
elfewhere, are not within our reach ; we mull neceffariiy
have recourfe to fome other expedient in order to allevi¬
ate the bufferings of the patient. The empirics were pro¬
vided againfl this particular difficulty, in what they
termed a J'ubjiitution of fimilar means, ( tranjltus ad fimile ,
as the Latins have tranflated it.) This was a new experi¬
ment, which they inftituted, after having compared one
difeafe with another ; or one part of the body with ano¬
ther, of fimilar ftruCture; or, lartly, one remedy, the na¬
ture of which was afeertained by experiment, with ano¬
ther which refembled it. “ They tried, for example, in
herpetic eruptions the remedies which had relieved eryji-
pelus ; and, in the difeafes of the arms, they employed the
expedients which had been praCtifed in thofe of the /egs ;
&c. & c.” Obfervation, then, record, and the j'ubjiitution of
fimilar means, were the three fundamental refources of the
art of medicine, according to the empirics: and thefe
were denominated, by Glaucias and others, “ the tripod
of medicine.”

There is obvioufly a great deal of good fenfe and found
philofophy in this doctrine of empincifm. It points out
the true mode of invelfigating the phenomena of nature
by unwearied experiment; the mode which Bacon la¬
boured to inculcate, which Newton fuccefsfully purfued,
and which has led the philofophers of later times to the
development of that fund of natural knowledge in the
fciences of electricity, chemiltry, mechanical, and every
branch of natural, philolophy, by which modern inquiry
is diftinguifhed. Compared with this fpecies of invefti-
gation, how futile are the lpeculations, mifnamed philo-
lophy in the fchools, relative to elements and ellences,
which had no exiftence except in the imagination of the
difputants.

At firft much rancour and animofity fubfifted between
thefe two parties ; but, in procefs of time, their practice
was found to coincide in many material points; for,
though the dogmatifts were much addicted to hypothefis,
they could not fail to make clinical obfervations when en¬
gaged in practice; and the empirics did not entirely con-
tine tliemlelves to their profeffed mode of acquiring know¬
ledge, but occafionally indulged in that paflion for the¬
ory and generalization which is fo common in a philofa-

phic.

8

PATHOLOGY.

phic age. It is evident, then, that both the dogmatic and
empiric phyficians appealed to experience, and that nei¬
ther excluded altogether the dictates of reafon and re¬
flexion. The principal difference in their tenets appears
to have confided in this : that the empirics real'oned only
from the facts afcertained by obfervation, without at¬
tempting to explain their effential and infcrutable nature
by hypothefesj and that the latter fpeculated upon the
mode and nature of every phenomenon in the animal
body, and took thefe fpeculations as the bafis of their
reafoning: an error in the inveftigation of nature, which,
as we have before faid, was fo well expofed by lord
Bacon in modern times; and which was practically illuf-
trated in the triumph of Newton’s empirical doXrines,
over the dogmatical hypothefes of Des Cartes.

The empirical feX had not enjoyed great influence or
diffemination till Serapion of Alexandria, in the year be¬
fore Chrift 280, took up and defended their doXrines
with great fpirit : hence fome have called him the foun¬
der of the feX. His works are loft; hut what has been
tranfmitted of his opinion by other authors, tends to
prove that he followed the praXice of Hippocrates with
great fidelity, though he feverely criticifed his reafon-
ings.

It is chiefly to the induftry of the ancient empirics
that we are indebted for the introduction, or rather for
the full knowledge, of fedative and n'arcotic remedies;
on the liberal ufe of which probably depended the l'upe-
rior reputation acquired by fome of them over their more
cautious antagonifts. Of this fuperiority, a lingular in-
ftance occurs in the many exifting teftimonies to the fame
of Heraclides of Tarentum. Celfus Aurelianus calls him
“Empiricorum Princeps;” and Galen fpeaks of him in
very high terms. He fo far deviated from the praCiice of
the flriCt empirics, that he fearched after the caufes of
difeafe with almoft as much pertinacity as the dogmatifts;
by no means however negleCting the practical obferva-
tions which were taught in the empirical fchool. This
union of theory and praCtice led him to many ufeful refults,
more particularly in refpeCt to acute and dangerous difeafes,
his treatment of which appears to have been extremely
judicious. He feems to have made a more liberal ufe of
aCtive medicaments, efpecially of the narcotic clafs, than
his predeceflbrs, having been the firft to introduce opium
into ufe as a medicine-; and was very induftrious in his
inveftigation of animal, vegetable, and mineral, fubftances,
with a view to enrich the catalogue of the materia medica.
To the books Which he wrote upon this fubjeX, he gave
the name of the individuals to whom he dedicated them,
according to Galen; entitling one “Aftydamas,” and
another “ Antiochis.” He likewife wrote on the fubjeX
of diet, and the regimen to he obferved in difeafes, in
which abftinence feems to have been pufhed to a great
extent.

It is eafy to fee, however, that the direXion of medical
inquiry, given by the empirical phyficians, to the difeo-
Very of the qualities of medicinal fubftances, or drugs,
would in all probability lead to many abufes and evils.
Experiment of this fort being much eafier, at lealt when
careiefsly made, than that unremitting and accurate ob¬
fervation of the phenomena of difeafes which alone can
conftitute the fcientific phyfician, the ignorant and idle
would content themfelves with pharmaceutic experi¬
ments, and negleCf the talk of pathological inveftigation ;
and fejfilh craft and dilhonefty would loon learn toimpofe
on the credulity of the people, in the adminiftration of
fe£ ret remedies, when the ufe of a particular drug, and
not the general treatment of a difeafe, was fuppofed to be
the efler.ee of medicine. Hence it actually happened,
even in the early ages of phyfic, that thefe ignorant and
illiberal pretenders to panaceas, and infallible remedies,
who did not know one difeafe from another by its l'ymp-
tonis, appeared in Egypt, Greece, and Arabia, and were
much complained of by their more rational contempora¬
ries. In all fucceeding ages, the race of thefe illiterate

pretenders has been multiplied, under the abufed name
of empirics, by which we now underftand thofe perfons
who fell or adminifter a particular drug, or compound,
as a remedy for a given diforder, without any confidera-
tion as to the variations of that diforder, in its different
ftages, or degrees of violence, or as it occurs in different
conllitutions, climates, or feafons, or in perfons of dif¬
ferent age, fex, ftrength, &c. Such a practice implies
a total ignorance of the nature of the human conftitu-
tion, both in health and difeafe ; and therefore is ge¬
nerally found to be the refort of the illiterate and felfifli,
not to fay difhoneff, part of mankind.

After the death of Heraclides, the ftudy of the materia
medica took a new direXion, in confequence of the at¬
tention that was paid to the fubjeX of poifons and their
antidotes, by the kings of Pergamus and Pontus. The
antidote which was invented by the latter is well known,
though its efficacy has never been proved. Even Sere-
nus, who is in general fufnciently credulous, feems to
have had no very high opinion of its virtues :

Antidofus vero multis Mithridatica fertur
Confociata modis, fed Magnus ferinia regis
Cum caperet viXor, viiem deprehendit in illis
Synthefin, et vulgata fatis medicamina rifit.

Nicander of Colophon, who was the contemporary of
Attalus king of Pergamus, acquired great fame as a
grammarian, a poet, and a phyfician. He endeavoured
with the vvorft fuccefs to clothe medicine in flowing num¬
bers? Kis only pieces extant are the Alexipharmica and
Theriaca, which contain obfervations concerning poifon
and their antidotes, which (as we have faid) became a
very favourite purfuit about his time. See Nicander,
vol. xvii. p. 45.

■ At the time that the fons of Hippocrates founded the
dogmatic feX ; Eudoxus of Cnidos framed a lylleni of
medicine founded on the philofophy of Pythagoras, and
the praXice of the Egyptians. It was therefore princi¬
pally direXed to the dietetic part of medicine. He was
followed by his pupil Chryfippus, of wliofe praifice we
have nothing memorable to relate, but that he regarded
cabbage as a very important remedy, and was very averfe
to the operation of bleeding or the exhibition of purga¬
tives. He was the preceptor of the renowned Erafiftratus.
Diocles of Caryflus was about this period a praXitioner
of repute ; though placed by the Biographia Literaria as
low as A. D. 500. an error of 800 years ! Pie applied
himfelf to comparative anatomy with fome fuccefs, and
invented an inftrument, which was called after him Dlo-
cleus graphifeus, for the extraXion of arrow-heads. His
contemporary Praxagoras rendered important fervices to
medicine ; he firft difeovered the difference between arte¬
ries and veins, deferibed the cotyledons of the human
uterus, and explained the phenomenon of the pulfe, a
fubjeX which had been very imperfedfiy underftood by
Elippocrates himfelf. It is remarked, however, by Galen,
that his information was not fo correX, but that he in¬
volved himfelf in many difputes and contradiXionS.
This phyfician was very fond of emetics : he adminiftered
them in the iliac paflion, and in dofes fo large and fo fre¬
quently repeated, that the ftoois were ejeXed by the
mouth. His furgical treatment of the fame difeafe ihows
him to have been a bold and fkilful operator: Aurelian
fays, that he direXs an incifion to be made through the
belly and inteftines, the indurated feces to be removed,
and the bowels then fowed up.

The progrefs of this art now became advanced by the
labours of men not exaXly interefted in its praXice.
Ariftotle, who, from the unbounded liberality of his pa¬
tron Alexander, poffefled opportunities of difleXing ani¬
mals on a moft extended fcale, acquired a.mafs of infor¬
mation which we read with inftruXion and admiration
even in the prefent age. Nor were his metaphyfical doc¬
trines without their influence on the philofophy of me¬
dicine ; they continued to influence it (fometimes un¬
favourably)

4 ■

9

PATHOLOGY.

favourably) for ages. The beautiful fyftem of ethics,
likewife, to which Zeno and Epicurus gave birth, were
not developed without a fubfequent change in this fci-
ence. The tenets of Epicurus and Pyrrho were adopted
by the empirical fedft, while the dogmatifts attached
themfelves to the ftoical fyftem, particularly the dietetic
method. For, we mull remark, that, foreign as thefe
fubje&s may appear. to the pradlice of phyfic, yet its
higher branches cannot be fuccefsfully ftudied without
occafional reference to every branch of phiiofophy, whe¬
ther moral or phyfical.

The eftabliftmient of the Alexandrian School forms an
important epoch in the hiftory of medicine. But we have
to regret that the deftru&ion of its fplendid library, by
the hands of barbarous conquerors, has left us little to
relate concerning its doftrines or its practice. We have
little hefitation, however, in faying, that the advancement
of medicine muft have been very great in a fituation
where it derived aftiftance from long cultivation of its
principles in Greece, Egypt, and India, a fituation too
where fcience in general was patronifed with fo much
earneftnefs by illuftrious kings. Moreover this city of
Alexandria, on account of the connexion it held with all
the world as a commercial emporium, muft have been
frequently vilited by foreigners whole diet, clothing, ha¬
bits of life, not to mention a free communication of their
own medical rules, muft have ill uftrated the fpeculations of
the Alexandrian phyficians in a very luminous manner.
The long feries of fafts collefted by the Egyptian priefts
was here treafured up; the obfervations of the Hebrews,
who, long difperfed over the plains of Aflyria and Media,
had united their own medical doctrines with the tenets of
Zoroafter and Ham, were examined; while the Greeks,
uniting the ufeful part of this defullory and obfcure in¬
formation with the found practice of their anceftor Hip¬
pocrates, with the anatomical knowledge they were ra¬
pidly acquiring, and with their own profound phiiofophy,
advanced the progrefs of the healing art in an unexampled
manner.

Erafiftratus and Herophilus were the firft phyficians of
note in this fchool. The former flourifhed about the
time of Seleucus, B. C. 270. His attention was directed
for the inoft part to furgery and anatomy; but, that his
medical tact was of no mean defcription, we have ample
proof in the ftory told of his difcovering the love of
Antiochus for Stratonice, whom Seleucus his father had
then lately married. He made this dil'covery from ob-
ferving, that the colour of the prince changed, and his
pulfe quickened, when Stratonice entered the room, and
that no fuch effects followed the prefence of any other
woman. Erafiftratus was likewife confirmed in this
opinion, becaufe he was unable to trace elfewhere the
caufe of the prince’s extreme illnefs ; for it fhould be re¬
marked, that Erafiftratus held the lame opinion as the
dogmatifts, that a difeafe could not be cured without a
knowledge of its caufe. The fame incident likewife
Ihows the high rank which the phyficians held in thofe
days ; fince, by the influence of Erafiftratus, Seleucus was
perfuaded not only to give up his wife, but alfo part of
his kingdom, to Antiochus.

Erafiftratus fuppofed that inflammation was produced
by the coagulation of blood in the fmall arterial veflels.
In his practice he was fond of Ample remedies, more efpe-
cially of J'uccory ; and he even delcended to defcribe the
beft mode of boiling it. He taught that medicines did not
operate on the bowels by attraction, as had been fuppofed ;
and that the humours which they difcharged were not the
lame in the body as they appeared after their evacuation,
but were altered by the adtion of thofe remedies. To
purging, however, he had an objedlion, and fupplied the
want of it by clyfters. Emetics were frequently prefcribed
by him ; and he recommended abltinence in a great de¬
gree. Venefedtion he difapproved of for fome very fool-
ilh reafons ; among which, it may be fuflicient to mention,
ift. That we cannot fee the vein; 2dly. That we may

Vol. XIX. No. 1283.

cut the artery ; 3dly. That we do not knowhow much to
take. His attachment to his theory of inflammation was
the principal theory, however, why he objedted to bleed¬
ing, becaufe it did not appear to him, that the abftradtion
of blood was likely to relieve the coagulation of that
fluid in its veflels.

Some very barbarous adds are related of this phyfician ;
for inltance, that he fometimes cut open the bodies of pa¬
tients afflidted with complaints of the liver, and applied
remedies immediately to the fubftance of that organ.
Yet he objedted to the operation of parucentefis, or tap¬
ping, becaufe he conceived that, the water being evacu¬
ated, the furrounding vifcera would prefs upon the liver,
and produce fatal confequences. He had a notion, that
death changed the ftrudture of the body, as well as^the
relation of its parts. In this opinion he was ftrongly fup-
ported by Herophilus; and we turn with horror from the
contemplation of 600 victims whom thefe barbarians are
reported to have difiedted alive, and blulh that fuch a re¬
cord fhould be found in th.e annals of medicine. Yet the
refined Celfus, after enumerating the advantages which
accrued from this atrocious deed, excufes the cruelty of
it by obferving, that “It cannot be juftly deemed cruel
to put a few guilty individuals to torture, with a view to
afcertain means of relief for all the innocent among man¬
kind in all fucceeding ages.”

Herophilus added, to the anatomical refearches in
which he aflifted his contemporary, an intimate acquain¬
tance with pharmacy. He made ufe of a great number
of medicines, both Ample and compound. In his works,
we find the firft mention of a difeafe which he calls palfy of
the heart ; it produced fudden death, and it has been fup¬
pofed that this muft anfwer to what we now call angina
pedoris.

About this period, according to Celfus, the practition¬
ers of medicine w'ere formed into three divifions: 1.
Thofe who attended to diet, regimen, and domeftic ma¬
nagement, who were particularly careful to diftinguifh the
caufes and fymptoms of difeafes, and were of the firft
rank. 2dly. Thofe who adminiftered remedies, in the
preparation of which they affeCted to be particularly care¬
ful. And, laftly, thofe who performed the operations of
furgery. Anterior to this time, the preparation of medi¬
cine among the Greek phyficians was entrufted to their
or ftudents, as well as the chirurgical depart¬
ment, though the latter was often executed by the phy¬
ficians themfelves. The combination of the three branches
continued, however, for ages, in a few inftances, among
the Greeks, the Romans, and the Arabians.

The Romans, as Pliny affures us, had continued
without phyficians, if not without phyfic, during a period
of 600 years. The few manual operations which W'ere
found indifpenfably necefiary were performed by their
Haves or freedmen ; and inftances are not wanting, in
which their ficill was rewarded by the honour of citizen-
fh ip. On the occafion of a deftruClive epidemic, in the
year 463 A.U.C. however, they fent a deputation to the
temple of ZEfculapius at Epidaurus. Inftead of an oracle,
they received one of the facred ferpents ; and, following
the indication of its fpringing from the fhip upon theifland
of the Tiber, they there founded a temple to the god of
medicine, and eftablifhed his worfhip on the fame footing
as at Epidaurus. Shortly afterwards, a temple was dedi¬
cated to the Grecian Hygeia, and the worfhip-of Ifis and
Serapis was borrowed from the Egyptians : but, befides
thefe, the Romans afterwards ereCted fanes in honour of
medical deities peculiar to themfelves. A prevalent
dread of certain maladies caufed them to offer up prayers
to the deities who were fuppofed to inflict them. Hence
they worftiipped Febris on the Palatine Mount, and Mephitis
at Cremona. They had likewife a goddefs Offipaga, who
prefided over the growth of bones, and Carna, who took
care of the vifcera, and to whom they offered bacon and
bean-broth, as being nutritious articles of diet. The firft
perfon who praftifed medicine at Rome in a regular man-

D ner.

10

PATHOLOGY.

ner, was one Archagathus, a Greek, B. C. 219. The
Roman fenate at firft Teemed to give him much encou¬
ragement, and even bought a (hop Tor him, and prefented
him with the freedom of the city. But his frequent ufe
of the knife, and of the adtual cautery, Toon brought him
into difrepute. The populace were loud in their clamours
againlt his cruelty, attached to him the name of Carriifex,
Butcher, and eventually baniflied him from Rome.

Afclepiades, of Prufa in Byth.ynia, was the next phy.fi-
cian of note who appeared at Rome after Archagathus,
hut feparated from him “ longo intervallo.” He had
ftudied at Alexandriaand Athens, and came toRome,in the
654th year A.U.C. or 100 years before the Chriltian era, as
a teacher of rhetoric: but, not finding that profeflion
fufficiently lucrative, he fuddenly turned phyfician ; and,
by his confummate addrefs, in a fhort time brought him-
Telf into great notice. The prototype of all fucceeding
quacks, Afclepiades affefted to contemn every thing that
had been done before him — “ omnia abdicavit ; totamque
medicinam, ad caufam revocando, colijedturam fecit.”
He ridiculed Hippocrates for his patient obfervation of
nature, and called his fyftem “a meditation on death.”
His fame, however, would have been incomplete, if he
had not introduced a fyftem of his own. Accordingly,
taking for the bafis of it the philofophy of Epicurus and
Heraclides of Pontus, he attempted to explain all the
functions of the human body, and all the operations of
health and difeafe, by means of eorpvjcles and pores. He
aflerted, that matter confidered in itfelf was of an un¬
changeable nature; and that all perceptible bodies were
compofed of a number of final ler ones, between which
there were interfperfed an infinity of final! fpaces totally
void of all matter. He thought that the foul itfelf was
compofed of thefe fmall bodies. He laughed at the prin¬
ciple called Nature by Hippocrates, and alfo at the ima¬
ginary faculties faid by him to be fubfervient to her ; and
Hill more at what he called Attradion. This laft principle
Afclepiades denied in every inftance, even in that of the
loadftoneand fteel, imagining that this phenomenon pro¬
ceeded from a concourfe of corpufcles, and a particular
difpofition or modification of their pores. He alfo main¬
tained, that nothing happened or was produced without
fotne caufe ; and that what was called nature was in reality
no more than matter and motion. From this laft principle
he inferred that Hippocrates knew not what he faid when
he fpoke of Nature as an intelligent being, and aferibed
qualities of different kinds to her. For the fame reafon he
ridiculed thedodlrine of Hippocrates with regard to crifes;
and aflerted that the termination of difeafes might be as
well accounted for from mere matter and motion. He
maintained, that vve were deceived if we imagined that
Nature always did good ; fince it was evident that (lie often
did a great deal of harm. As for the days particularly
fixed upon by Hippocrates for crifes, or thole on which we
ufually obferve a change either for the better or the
worfe, Afclepiades denied that fuch alterations happened
on thole days rather than on others. Nay, he alferted
that the crifis did not happen at any time of its own ac¬
cord, or by the particular determination of nature for the
cure of the dilorder, but that it depended rather on the
addrefs and dexterity of >lve phyfician ; that we ought
never to wait till a diftemper terminates of its own accord,
but that the phyfician by his care and medicines mull
haften on and advance the cure. He accufed Hippocrates
and other ancient phyficians of “attending their patients
rather with a view to obferve in what manner they died
than in order to cure them;” and this under pretence
that Nature ought to do all herfelf, without any afiiftance.

The practice of Afclepiades was principally geftation,
fridtion, and the ufe of wine.' By various exercifes he
propofed to render the pores more open, and to make the
juices and fmall bodies, which caufe difeafes by their re¬
tention, pafs more freely ; and, while the former phyficians
had not recourfe to geftation till towards the end of long-
continued diforders, and when the patients, though en¬

tirely free from fever, were yet too weak to take fuffleient
exercife by walking, Afclepiades ufed geftation from the
very beginning of the moll burning fevers. He laid it
down as a maxim, that one fever was to be cured by
another; that the ftrength of the patient was to be ex-
haufted by making him watch and endure thirft to fuch a
degree, that, for the two firft days of the diforder, he
would not allow them to cool their mouths with a drop of
water. Celfus alfo obferves, that, though Afclepiades
treated his patients like a butcher during the firft days of
the diforder, he indulged them fo far afterwards as even
to give directions for making their beds in the fofteft
manner. On feveral occafions Afclepiades ufed fridlions
to open the pores. The dropfy was one of the diftempers
in which this remedy was ufed; but the moll fingular at¬
tempt was, by this means, to lull phrenetic patients
afleep. Though he enjoined exercife fomiuch to the
fick, he denied it to thofe in health ; a conduit not a little
furprifing and extraordinary. He allowed wine freely to
patients in fevers, provided the vioience of the diftemper
was fomewhat abated. Nor did he forbid it to thofe who
were afflicted with a phrenfy : nay, he ordered them to
drink it till they were intoxicated, pretending by that
means to make them deep; becaufe, he faid, wine had a
narcotic quality and procured fleep, which he thought ab-
folutely neceflary for thofe who laboured under that dif¬
order. To lethargic patients he ufed it on purpofe to
excite them, and roufe their fenfes : he alfo forced them
to fmell ftrong-feented fubftances, fuch as vinegar, caftor,
and rue, in order to make them fneeze; and applied to
their heads cataplafms of muftard made up with vinegar.

Befides thefe remedies, Afclepiades enjoined his pa¬
tients abftinence to an extreme degree. For the firll
three days, according to Celfus, he allowed them no ali¬
ment whatever; but on the fourth began to give them
victuals. According to Caslius Aurelianus, however, he
began to nourilh his patients as foon as the acceffion of
the difeafe was diminilhed, not waiting till an entire re-
mifflon ; giving to fome aliments on the firft, to fome on
the fecond, to fome on the third, and fo on to the feventh,
day. It Teems almoll incredible to us, that people Ihould
be able to fall till this laft-mentioned term; but Celfus
allures us, that abftinence till the feventh day was en¬
joined even by the predeceflors of Afclepiades.

The divifion of difeafes into acute and chronic appears
to have originated with him. The remedies which he
employed (as we have feen) were chiefly dietetical ; but
he was no enemy to phlebotomy, though he dilcouraged
vomiting and purgation: inftead of the latter he recom¬
mended clyfters. He was a great advocate for the ufe of
cold water externally as well as internally; though he
probably ingratiated himfelf with the Romans more by his
free adminillration of wine in diforders where it had not
formerly been allowed. Sprengel fuppoles him to have
been the inventor of the balnea penjilis, or Ihower-bath.

That: Afclepiades, notwithllanding his arrogance, was
a man of obfervation and difeernrnent, is evident from his
defeription of difeafes ; and from the faCl, that he always
continued to enjoy great reputation among the Roman
people, and l^iat his leClures, which, according to Pliny,
embraced the three branches of pathology, midwifery,
and pharmacy, were very numeroully attended. Galen
accufes him of humouring the caprices of his patients at
the expence of his own better reafon and judgment. The
principles of this author’s pathology gave the firft outline
of the methodic pradlice of phyfic, which was more fully
developed by Themifon and Theflalus, and afterwards by
Soranus.

The Methodics, or Methodists, endeavoured to
fleer a courfe unconnedled with the Dogmatifts or the
Empirics. They objedled to the former fedl, on account
of their hypothetical principles; and to the latter, on ac¬
count of the tedious manner in which they acquired their
knowledge. In confequence of this, they began to
claffify and generalize ; and obferved, as they conceived,

two

PATH

two dates or conditions of body which attended all forts
of complaints. To one of tliefe dates they gave the
name of fir icl urn, which implied a general conftridlion of
the whole body; to the latter, the epithet of luxum, by
which they meant a correfponding relaxation. Cafes,
however arofe, that were not referrible to either of thefe
claffes : confequently, the Methodifts were obliged to in¬
vent a third, which partook of the properties of both the
others. Hence they admitted the contradiftion of a (late
of relaxed contraction, an expreffion of which no conception
can be formed.

It has been fuppofed, however, by M. Cabanis, that this
mixed (late of laxutn and JlriClum meant an irregular dif-
tribution of vital power, or irregularity of tone. If his
idea be corredl, this clafs would comprehend all difeafes,
without the afliftance of the other two ; for we know of
no difeafe that is not marked at times by an unequal dif-
tribution of vital energies. As to the praSice of the me¬
thod ills, it may be obferved, that they wholly overlooked
the healing powers of the fyltem, and, without regard to
the peculiar circumftances of the cafe, or the nature of
the part affedled, were l'olely intent on fulfilling thofe
general indications that were conformable to their theo¬
ry. It is true, that they paid particular attention to days ;
not, however, as connedled with the dodlrine of criles,
for which the founders of this left entertained a marked
contempt ; but only as affording them a meafure of the
duration of the diforder, and a guide for the method of
treatment. In the firft days, they followed the llarving
fyftem ; afterwards they purfued the fuppofed general in¬
dications of conftri&ing, or of relaxing: during the ex¬
acerbation of the difeafe, they endeavoured to moderate
the violence of it ; during its decline, they fupported the
powers of the fyllem by nutritive diet. This was their
mode of proceeding in all acute difeafes : but, in chronic
complaints, to which it was lefs applicable, they had re-
courfe to what they termed the ^T-oco-vyr.^ait, or re-in¬
corporation, of which the profeffed object was to reltore
the proper relations between the atoms and pores, and for
which they prepared the patient by the ocvx or re-
fumplrtie circle. It was, in fadl, little elfe than their
practice in acute difeafes reverfed : they firft fought to
ftrengthen the patient by a generous diet, and then they
adminiftered a fucceffion of violent remedies, to fubdue
the original malady.

Among the difciples of Themifon, one Theflalus of
Trallis, a man of low birth and coarfe manners, made
himfelf confpicuous by the fhamelefs audacity with which
he fought to difparage the labours of others, arrogating
to himfelf the title of I&t ^ony.ri;, or Conqueror of Phy-
ficians, and that, it would appear, without the flighted:
pretenfions to either learning or talents. (Plin. xxix. i.)
He held forth, that he could qualify any one for a phy-
fician in the fpace of fix months, and aftually fucceeded
in obtaining a great number of pupiTs ; but they were from
among the lowed order of artifans, fuch as rope-makers,
weavers, cooks, butchers, fullers, and fuch like. Thefe
he took with him to vilit his patients for the ftipulated
time; and then he conferred upon them the privilege of
pradlifing for themfelves. From his time it became the
cuftom for the Roman phyficians to vifit their patients
attended by all their pupils; in allufion to which, we
have the epigram of Martial :

Languebam ; fed tu eomitatus protinus ad me
Venifii, centum , Symmache, dijcipulis.

Centum me tetigere manus aquilone gelata :

Non habuifebrem , Symmache : nunc habeo !

I’m ill. I fend for Symmachus ; he’s here.

An hundred pupils following in his rear.

All feel my pulfe with hands as cold as fnow :

I had no fever then ; I have it now.

The methodic fcliool acquired much greater repute
from the labours of Soranus and Caelius Aurelianus.
The former a native of Epliefus, who had ftudiedat Alex-

O L O G Y. 11

andria, and came to Rome during the reign of Trajan ;
the latter an African by birth. Free from the prejudices
which had difgraced his predeceffors, Soranus cultivated
the ftudy of anatomy, and wrote a book on the female
organs of generation, which is dill extant, and difplays
conftderable acquaintance with the fubjedt. Many of his
obfervations (how that he was pofleffed of great fagacity
and ftrength of judgment. To Cadius Aurelianus, on
the other hand, we are indebted for an account of his doc¬
trines and pradlice, and for one of the bed works on me¬
dicine which have come to us from ancient times ; writ¬
ten it is true, in a barbarous ftyle, but highly deferving
of perufal, on account of the accurate defcription of dif¬
eafes,. and the different methods of treatment, which it
contains.

Anatomy and the other auxiliary fciences, though they
had been fo much negledled by the Methodifts, were now
receiving important additions from other quarters.
Rufus of Ephefus, who lived in the time of the emperor
Trajan, applied himfelf zealoufly to the dilTe<5lion of ani¬
mals, particularly of apes, and defcribed from analogy
the different organs of the human body. Fie traced the
nerves from their origin in the brain, and divided them
into- thofe of fenfation and thofe of voluntary motion.
The heart he believed to be the feat of life, of animal beat,
and the caufe of pulfation ; and he (bowed the difference
of ftrudlure and capacity between the right and the left
ventricle. The fpleen he held to be an ufelefs organ.
Marinus, whom Galen calls the reftorer of anatomy, and
to whofe labours he was himfelf probably indebted for
much of his knowledge on the fubjedl, rendered dill
greater fervices to the fcience. He inveftigated the ab¬
sorbent fyftem with great care, and difcovered the me-
fenteric glands ; he diftributed the nerves into feven
pairs: the N. palatinus (then called the fourth pair) was
firft defcribed by him; and he is faid to have been the dif-
coverer alfo of the par vagum, which he termed the fixth
pair. Flis numerous writings have all perilhed.

The ftudy of the materia rnedica, and of the other
branches of natural hiftory, was profecuted with no lefs
vigour ; and we owe to the firft century of the Chriftian
era the invention of many remedies which are (till retained
in our pharmaceutical fyltems. The elder Pliny, fecond
only to Ariftotle in the univerfality of his genius, but
furpafiing even that great man in his infatiable third for
knowledge, had collected in his Hiftoria Mundi all that
the ancients knew of natural fcience. Diofcorides of
Anazarba, devoting himfelf to botany and materia rae-
dica, produced a work which ferved for a guide in thefe
fciences till a very late period. His defcriptions of fome
of the more valuable drugs, fuch as myrrh, laudanum, af-
fafoetida, ammoniac, opium, fquills, and their different
preparations, are entitled to great praife. The efficacy of
feveral remedies, which he recommends, has been ad¬
mirably confirmed by later experience, fuch as of the
elm-bark in cutaneous difeafes, of potafti as a cauftic, of
the male fern againft worms, &c. &c. Some of the con¬
temporaries of Diofcorides, as Scribonius Largus, Xeno-
crates, and Andromachus, cultivated the materia rnedica,
but with lefs fuccefs. To Menecrates, who lived in the
reign of Tiberius, and who, according to an infcription
in Montfaucon, appears to have been the author of 15s
books, we are indebted for the invention of the diachy-
lon-plafter; and Damocrates is well known as the author
of feveral complicated remedies which bear his name.
Herennius Philo, of Tarfus, is mentioned by Galen as
the inventor of an anodyne compofition, called, after
him, Philonium, and which confided of opium, euphor-
bium, and different aromatics ; and Afclepiades
Pharmacion was the introducer of numerous remedies
from the animal kingdom, which, though long honoured
with a place in our pharmacopoeias, have now defervedly
fallen into difrepute.

Before quitting this period of medical hiftory, it will
be neceflary to fay a few words refpedting two other fedls,

which

12

PATHOLOGY.

which arofe foon after the eftablilhment of the Methodic
fchool : we mean the Ecledic and Pneumatic feds. The
founder of the latter, Ariftseus of Cilicia, flourilhed as a
phyfician at Rome about the middle of the firft: century,
and diftinguilhed himfelf by his oppofition to the-tenets
of Afclepiades, and his attachment to the Stoical fyftem :
he extended the theory of pre-exiftent germs ; treated the
dodrine of the pulfe with dialedic fubtlety, referring its
varieties to the exhalation of the nvBv^a. from the heart
and arteries ; and cultivated feveral branches of patholo¬
gy ; but was more fuccefsful in his dietetic researches,
particularly with refped to the influence of the atmof-
phere.

His pupil Agathinus, endeavouring to reconcile his
principles with thofe of the Methodic and Empiric feds,
acquired the name of Epifynthetic or Ecledic; and thus
eftablilhed the Ecledic fyftem, on which, however, he
does not appear to have conferred much repute by his
own labours. That merit was referved for Archigenes
and Aretasus, who, adopting the leading tenets of the
Pneumatic theory, gave it a more fcientific form, and
enriched it by many valuable obfervations. The former
attempted to reform the language of medicine, but with¬
out much effed 5 for even Galen has occafion to complain
of the obfeurity of his phrafeology ; he was, befides, too
fond of fubtleties: but many of his practical obfervations,
which Galen has recorded, are excellent. The merits of
Aretasus, as a tkilful and attentive obferver, and as an
elegant deferiber of difeafe, are familiar to every one.
To Caflius the Iatrofophilt, another Eclectic, we are in¬
debted for many valuable pathological remarks concern¬
ing the difeafes of afi’oeiation, and the fympathies of the
nervous fyftem.

On the fubjed of Aretasus and Archigenes, Dr.
Huxham has the following note. “ It is pretty furprifing
that none fliould take notice of Aretasus Cappadox before
Aetius Amidenus, in the fifth century; (he is indeed
named in the Euporifta attributed to Diofcorid.es, but
few think that piece to be the genuine work of that au¬
thor.) Neither Galen, Caslius Aurelianus, nor Oribafius,
mention him; though fo particular in enumerating all
the phyficians of note, antecedent to, or cotemporary
with them. And yet Aretteus feems to have been a very
confiderable practitioner, and a man of great learning
and judgment : he aft'eds a very Angular ftyte, ufing many
oblolete words, Homeric and Hippocratic phrafes, and
the Ionic dialed ; which, at the time he wrote in, was
almoft entirely difufed : for, notwithftanding the conceit
of Voflius, he undoubtedly did not write till after the
time of Nero. All this one would think fliould have
made him remarkable ; efpecially if he praCtifed in or
near Rome ; which is not improbable, as he advifes
Roman wines to the lick ; particularly the Falernian,
Surrentine, Signine, and thofe of Fundi. But Galen
and Aetius quote from Archigenes feveral paffages, which
are exadly the fame, as to fenfe, dodrine, method of
cure, and manner of expreflion, with what we find in
Aretasus ; only the latter gives them the Ionic turn.
They both coincide in recommending fome particular
medicines, which are fcarce to be met with in any others,
particularly the external ufe of cantharides ; which I
think is not to be found in any preceding author, except
Celfus. Did Archigenes then borrow from Aretasus, or
the latter from the former? It is certain, Archigenes
pradifed at Rome with a very great reputation, was a
very celebrated phyfician and author, and as fucli is re¬
ferred to by Juvenal, Galen, Caslius, Oribafius, Aetius,
Sec. He is ftridly criticifed by Galen, fometintes cen-
fured, fometimes commended, but never reckoned a mere
compiler. Aretasus, on the contrary, is mentioned by
none but Aetius and Paulus Avgineta; nay, which is
not a little to be wondered at, he is not fo much as
found in Photius’s Bibliotheca. This is really ftrange,
and not eafily accounted for, and would incline one to
think that Aretasus borrowed from Archigenes ; or ra¬

ther tranferibed and new-modelled him, giving him the
Hippocratic didion and Ionic dialed. Poftibly Aretteus
might do by Archigenes fomething like what Caslius
Aureliar., not long after, did by Soranus: but, iffo, he
hath vaftly much better grascifed Archigenes than Caslius
hath latinized (as he calls it) Soranus. Upon this fuppo-
fition, we need not wonder at finding the Roman wines
recommended in Aretasus, though lie might pradife and
write in Cappadocia, or any where elfe, at the greateft
diftance from Rome. Be the matter as it will, in Aretasus
we have a molt valuable work, a moft accurate defeription
of difeafes, and in general a very proper and judicious
method of cure ; and it is greatly to be lamented, that
the work comes fo maimed to us.” Huxham on Fevers,
Pref.

During this period, furgery received confiderable im¬
provement; particularly from the labours of Heliodorus
and of Antyllus. Of the former, who was an eminent
furgeonat Rome in the time of Trajan, Nicetas has pre-
ferved feveral pradical obfervations on injuries of the head
and difeafes of the bones, which evince no mean profi¬
ciency in his art. The latter is perhaps (till more deferv-
ing of notice, as being the firft who gives any account of
the extradion of the catarad : he recommends this ope¬
ration to be performed while the catarad is final!, being
of opinion, that, when enlarged, it cannot be extraded
without bringing the humours of the eye along with if.
His diredions concerning the preparation of plafters and
ointments, and concerning the choice of veins in phle¬
botomy, are very minute. In dangerous cafes of cynunche,
he advifes bronchotomy ; and in hernia humoralis he ope¬
rated by incifion. Philagrius, who lived about the time
of Valens, appears to have been the firft who attempted
to extrad a ftone from the bladder by the high operation.
Aetius has alfo tranfmitted to us an account of the fur-
gical pradice of one Leonides of Alexandria, whofe ob¬
fervations on hernia, fcrofula, and glandular fwellings,
on hydrocele, and on inflammation of the ferotum, fhow
confiderable difeernment. In canceroqs affedions of the
bread, he reforted to amputation, and the adual cautery ;
in fiftula, his method of operation differed but little from
that recommended by Pott.

Having difpatched feveral names of fmaller eminence,
we now come to the illuftrious Celfus, who lived at Rome,
as fome think, about the reign of Tiberius. His native
place is unknown ; and many writers have fuppofed that
lie was never in pradice. Yet his minute deferiptions of
many pharmaceutical preparations could hardly have been
acquired unlefs he had compounded them with his own
hands; nor could his excellent diredtions in furgery have
been penned without fome knowledge of the manual
operations. In many parts of his works, he follows the
Father of Medicine fo clofely, that he has been called the
Latin Hippocrates ; though that name is equally appli¬
cable to him on account of the purity of his language.
(See Celsus, vol. iv.)

In his work on furgery, all the improvements from
Hippocrates to his own days are colleded ; the moft mi¬
nute and trifling difeafes are not omitted. An eminent
furgeon of the moderns emphatically exhorts every
perfon in that profeflion “ to keep Celfus in his hands by
day and by night.” He follows Hippocrates, but with
much improvement in his chirurgical diredions ; efpe¬
cially in the mode of trepanning, in applying fplints,
bandages, Sec. in the manner of extending and fixing
fradured limbs and likewife in the medical treatment of
the patient. In luxations of the fhoulder, he mentions
feveral methods of giving force to the extenfion, and of
replacing the diflocated bone. One method fimilar to that
of Hippocrates was, to fufpend the patient by the arm ;
the fore part of the fhoulder, at the fame time, refting
upon the tep of a door, or any other fuch firm fulcrum.
Another method was to lay the patient lupine, fome af-
fiftants retaining the body in a fixed pofition, and others
extending the arm in the contrary diredion ; the furgeon.

PATHOLOGY.

in the mean time, attempting, by his hands, forcibly to
reduce the bone into its former place.

He made the diltin&ion into fnnple and compound
fractures, as it exifts in the prefent day ; and his direc¬
tions in the cure of fractured ribs are extremely judicious.
The different fpecies of hernias are well defcribed by him ;
and he feems to have pfed a bandage and comprefs after
the reduction of the bowels, on the fame principle as we
now ufea trufs. In fome cafes, after the return of in-
teftitial ruptures, he diminiflied the quantity of loofe
fkin, and formed a cicatrix, fo as to contract over the
part, to render it more rigid and capable of relilting.
He defcribes various dil'eafes of the genital parts, the hy¬
drocele or dropfy of the fcrotum, a difficulty of urine,
and the manner of drawing off the water by a catheter ;
the figns of ftone in the bladder, and the method of
founding or feeling for that ftone. Lithotomy was at
that time performed by introducing two fingers into the
anus ; the done was then preffed forward to the perinteum,
and a cut made into the bladder ; and by the finger or by
a fcoop the ftone was extracted. He defcribes the manner
of performing this operation on both the fexes, of treat¬
ing the patient, and the figns of recovery and of danger.

Celfus gives excellent inltruftions with regard to in¬
flammation in general ; and mentions fome ufeful topical
applications in ophthalmia. The operations for the cata¬
ract (which confifted in depreffing the cryftalline lens),
and for fiftula, are likewife defcribed by him ; as alfo the
mode of performing the operation of paracentefis. The
external application of arfenic as a cure for cancer origi¬
nated with Celfus. In external gangrene, he cut into
the found flefli ; and, when the difeafe, in fpite of every
effort, fpread, he advifed amputation of the member.
After cutting to the bone, the fleffi was then feparated
from it, and drawn bach, in order to fave as much fleffi
as poffible to cover the extremity of the bone. He de¬
fcribes the fymptoms of that dangerous inflammation the
carbuncle, and direfls immediately to buril or corrode the
gangrened part. To promote the fuppuration of abfceffes,
he orders poultices of barley-meal, or of marffimal-
lows, or the feeds of linfeed and fenugreek. He alfo
mentions the compofitions of feveral repellent cataplafms.
In the eryjipelas, he applies cerufe, mixed with the juice
ofSolanum, or nightlhade. He is very diffufe in thofe
parts of his works which relate to pharmacy, giving for¬
mula for a great many external and internal remedies
now' defervedly aboliftied.

Though Celfus followed the praClice of Hippocrates in
many refpefts, yet he very much differed from him in
others. He particularly ridiculed his dodtrine of critical
days, which he attributed to anabfurd application of the
Pythagorean dodlrine of numbers ; and he differed from
that phyfician in regard alfo to bleeding; for he held it
dangerous to take much blood from patients at once, and
rather preferred the abllradlion of it at repeated intervals.
In regard to abflinence, he feems to have followed
Afclepiades, enjoining the fick to endure hunger and
thirft during the firft days of their illnefs, and afterwards
allowing them plenty of food. He entirely difregarded
the indications of the pulfe, from having obferved that
it was accelerated or depreffed by many adventitious cir-
cumllances, as well as from having found it very different
in complaints of a fimilar nature.

The moft confiderable of the Roman pathologifts, and
the laft of any great eminence, was Galen, who flourilhed
about a hundred and thirty years after Celfus, and was
phyfician to the emperor Marcus Aurelius. This great
man was confidered for many centuries afterwards the
moft infallible authority in all matters relating to patho¬
logy. Impreffed at an early age with the important truths
contained in the writings of Hippocrates, he viewed with
contempt and difguft the jargon and obfcurity which en¬
veloped them in the fchools of medicine. Accordingly
he became lrimfelf the expofitor of Hippocrates. He re¬
peated and extended his obfervations, prefented his opi-

Vol. XIX. No. 1283.

13

nions in new lights, and fupported his dodtrines with all
the aids which w'ere derivable from fpeculative reafoning
or the comparifon of fadls. Yet Galen in fome meafure
fell into the fame error of which he accufed his predecef-
fors and contemporaries. He obferved the naked faffs
and fimple truths related almofl without comment by the
coarle fage. He applied himfelf too much to explain,
arrange, and fyftematize, a very fmall ftock of informa¬
tion ; and, by endeavouring to illullrate a very uncertain
fcience by means of others not more exadl, he permitted
his imagination to frame hypothefes in the higheft degree
gratuitous and aflumptive. Thefe obfervations are fully
exemplified by the following Iketch of his fyftem.

He firft begins with eftablilhing four qualities in the ani¬
mal body; heat, cold, moifture, and drynefs. The pe¬
culiar combinations which thefe qualities undergo, or in
other words the changes which may be rung on them, pro¬
duce eight conftitutions, or temperaments; i. e. hot,
cold, moilt, and dry ; hot and moift, cold and moift, hot
and dry, and cold and dry. (See Galen, vol. viii.)
Idiofyncracy is that temperament which cannot be referred
to any of thefe qualities, and is therefore fuppofed to arife
from occult caules. With Hippocrates, Galen admitted
the operation of Nature ; but to this agent he added three
other faculties, or, as we thou Id call them, vital properties.
The firft and molt important, he calls the animal faculty ;
it has its feat in the brain, .performs the operations of
mind, and by means of the nerves diftributes the proper¬
ties of motion and fenfation to all parts of the body. The
fecond is called the natural faculty ; it has its feat in the
liver, and is the principal agent in giow’th, generation,
and nutrition. The third, denominated the vital facul¬
ty, is lodged in the heart, and from thence, by means of
the arteries, dilleminates heat and vitality through the
whole fyftem. Thefe three faculties were adled upon by
Nature as a primum mobile. Their production was fuppo¬
fed to be owing to the agency of certain Jpirils, or faille
vapours, which he likewife divided into three kinds, bear¬
ing the names of vital, natural, and animal. Galen ad¬
mits the exiftence of the four humours of blood, phlegm,
yellow, and black bile, firft infilled on by Hippocrates.
With that phyfician he likewife divides the body into
three component parts ; fpirits, humours, and parts, or,
as we call them ,folids. The laft-inentioned fubllances he
divides into organical and fimilar.

It were ufelels to enter into a detail of the minute diftinc-
tions of difeafesand their caufes in which Galen has in¬
dulged. Suffice it to fay, that the increafe, deficiency , or ir¬
regular diftribution,of the different humours,qualities,&c.
which we have enumerated, was regarded by him as the
eflential caufe of difeafe ; confequently the abllradlion of
redundant, the reproduction of deficient, or the correc¬
tion of peccant, humours, formed the principal indications
in his pathology. In anatomy and phyfiology, Galen dil-
covered or arranged many important fadls. His affiduous
diffedlions of animals furnifhed him with many ufeful ob¬
fervations : he likewife preferved in his writings much of
the anatomical knowledge of the Alexandrian fchool ;
and has indeed corrected by experiment the errors into
which that fchool had fallen, particularly in regard to the
circulation of the blood. Hippocrates had afierted, that
all the veffels communicated with each other, and that
the blood underwent a kind of flux and reflux to and
from the heart, like the ebbing and flowing of the lea;
and he mentions the throbbing of the temporal arteries,
as an evidence of this fail. The.anatomifls at Alexandria
had adopted a different ©pinion ; as they found the ar¬
teries empty, and the veins containing blood, in their
diffedlions, they imagined that the former were tubes for
the diftribution of air, (and gave them that name which
they have borne ever fince;) and that the veins were the
only channels for the blood. The heart of man confid¬
ing of two lets of cavities not communicating with each
other, and its connexion with the lungs, were to them
delufive circumftances, and feemed to favour their opi-
E nions.

34

PATHOLOGY.

nions. If is true they fometimes found blood in the ar¬
teries, and in the left cavities of the heart ; but then they
believed that the air or fpirit had efcaped, and that the
blood had oozed through the fides of thefe air-veflels, and
fupplied its place. Galen refuted this opinion by expe¬
riment. He laid bare one of thefe vetfels in a living ani¬
mal, and by tying it in two places, and opening it between
the ligatures, he afcertained that it contained blood and
nothing elfe. He therefore concluded, that both veins
and arteries ferved the fame purpofe-, that of diftributing
blood for the fupply of the body, but that the florid ar¬
terial blood contained more air than the purple blood of
the veins. We need hardly remark, that Galen did not
underhand the natural courfe of the blood, though he
had thus made known its containing vefl'els.

Galen did not apply himfelf much to the furgical de¬
partment of the art : however, he occafionally performed
the operation of arteriotomy, and opened the jugular
veins ; and he defcribed with accuracy the different kinds
of hernia.

In a hiftory of this kind it feems right to mention the
effect of anatomical ftudies on the mind of Galen. After
contemplating the ftrufture of the bones of a fkeleton,
and their "adaptation to their different fundiions, he
breaks out into an apoftrophe, which has been much ad¬
mired, and in which he isfaid to have exceeded any an¬
cient in pointing out the nature, attributes, and proper
worfhip, of the Deity. “In explaining thefe things,” he
fays, “I efteem myfelf as compoiing a folemn hymn to
the author of our bodily frame ; and in this I think
there is more true piety than in facrificing to him heca¬
tombs of oxen, or burnt-offerings of the moft coftly per¬
fumes : for I firffc endeavour to know him myfelf, and af¬
terwards to (how him to others, to inform them how
great is his wifdom, his virtue, his goodnefs.”

Medicine improved very flowly after the time of Galen ;
his fucceflors were more employed in compiling and com¬
menting on the works of their predeceflors, than in en¬
deavouring to extend the bounds of fcience by original
obfervation. Among the moft diftinguilhed of thefe we
may record the names of Oribaftus, Aetius, Alexander
Trallian, and PaulusAEgineta.

Oribafius flourifhed about the year 360, and was phy-
ffcian to the emperor Julian. Though commonly rec¬
koned a Sardian, he was born at Pergamus, and bred up,
together with Magnus and Ionicus, in the ichool of Zeno
the Cyprian, who taught then at Sardis, though after¬
wards he removed to Alexandria, where he became a
famous profeflbr. Eunapius reprefents Oribafius as the
greateft fcholar and phyfician of his time, and a very en¬
gaging and agreeable man in converfation. He defcribes
him as no lefs confiderable in his intereft than in his
learning : according to his account, he contributed very
much to the advancement of Julian to the empire, who
in return made him quasftor-of Conftantinople, and who,
as appears by one of his letters, had an entire confidence
in him. Ip. the fucceeding emperor’s time, through the
envy of his enemies, he fell into difgrace, had all his ef-
tates confifcated, was banifhed, and delivered into the
hands of barbarians ; amongft whom, in a little time, by
his courage and flcill, he gained fo much love and' reve¬
rence, that they, feeing what great cures he performed,
adored him as a god. At laft he was recalled by the Ro¬
man emperor, and flourithed in reputation and riches at
the very time when Eunapius wrote this account, which
muft be near the year 400.

Oribafius wrote feventy (according to Photius) or (ac¬
cording to Suidas) feventy- two books of colledtions,
which he compiled not only from Galen, but from all
the preceding phyficians, and his own experience, at the
defire of Julian; the fifteen firft of which are only remain¬
ing, and two others treating of anatomy, Afterwards he
made an epitome of this great work, and reduced it into
nine books for the ufe of his fon, Eullathius. Paulus
mentions this epitome ; but it is now loft, as are fome

other tradfs which Suidas takes notice of. Thefe works,
though chiefly compilations, are, by no means without
their ufe to the medical ftudent ; for both Oribafius and
Aetius have preferved fome fragments of antiquity, and
thofe of fome value, which are no-where elfe to be met
with ; that is, they compiled from the now-loft-vvorks of
Galen and others, and added much original matter of
their own. We will give only one inftance of what is
either omitted by Galen, or is loft together with fome
other of Galen’s works; namely, the firft defeription of
the lalivary glands, which is this : “ On each fide of the
tongue, iie the orifices of the vefl'els, which difehargethe
fpittle, and into which you may put a probe. Thefe vef-
fels take their rile from the root of the tongue, where the
glands are fituated. They rife from thefe glands, in
much fuch a manner as arteries ufually do, and convey
the falivary liquor, which moiftens the tongue, and all
the adjacent parts of the mouth.” Oribafius, lib. xxiv.
c. 8.

Oribafius, either from Apollonius or himfelf, fpeaks
very fully of the good eftedts of bleeding by way of fca-
rification, a thing little taken notice of by former writers :
and allures us, from his own experience, how fuccefsful
he had found it in a fupprelfion of the menfes, defluxions
of the eyes, headache, lfraitnefs of breathing, even when
theperfon was extremely old. He tells his own cafe par¬
ticularly, when the plague raged in Afia, and he himfelf
was taken ill, that the fecond day he fcarified his leg, and
took away two pounds of blood; by which method he en¬
tirely recovered, as did feveral others who ufed it. Here
we may obferve, that this was a different method of fca-
rifying from that performed by the help of cupping.
The Arabian phyficians feem to have'had a notion only of
the latter practice : but, from this place, as well as from
fome pafiages of Galen, it is plain, that the ancients made
deep incifions into the Ikin by the knife ; and therefore
thought, by the large quantity of blood they could draw
off, that this method was equivalent to opening. a vein.
The Egyptians make ufe of it to this very day; and
Profper Alpinus defcribes at large the apparatus : they
make, firft a ftrait ligature under the ham, then rub the
leg, and put it into warm water, and beat it with reeds
to make it fwell, and fo fcarify. A procefs in every par¬
ticular differing from cupping ; and therefore, in the cure
of giddinefs, Oribafius himfelf fpeaks of them as two
diftindt operations.

We find in this author the firft account of a ftrange and
lurprifing diftemper Avy.a.vfya'rrix, a fpecies of melancholy
and madnefs, which he defcribes thus : “The perfons af
fedied go out of their houfes in the night-time, and in
every thing imitate wolves, and wander among the fepul-
chresofthe dead till day-break. You may know them
by thefe fymptoms: their looks are pale; their eyes
heavy, hollow, dry, without the leaft moifture of a tear :
their tongue exceedingly parched and dry : no fpittle in
the mouth, extreme thirft ; their leg', from the falls and
bruifes they receive, full of incurable fores and ulcers.”
Aetius gives the very fame defeription, with fome little
variation ; only calls it K.v'jxvitjco'mx as well as Av/.xv^^ani
and obferves it prevails moft in February. Aetius takes
this paflage, as he fays, that is, makes a paraphrafe of it,
from Marcellus Sidetes, an author who lived under
Adrian and M. Antoninus; and who wrote forty-two
books concerning diftempers, in heroic verfe. Paulus
has tranforibed the fame account of this difeafe word for
word. The Greek term ufed to denote this difeafe ex-
prefles the nature of it veryjuftly; and yet Vanderlindenis
fo carelefs a writer, that lie makes it a fynonymous term
for the madnefs of the wolves themfelves. We conceive
the difeafe to have been a fpecies of mania, in which the
aflociation of the mind with deceafed relatives produced
an inclination to wander among the tombs.

Of the epilepfy, Oribafius defcribes the cure both in
the acute and the chronical fort ; that is, in the fit as well
as out of it. When the litis over, he orders bleeding;

and.

15

PATHOLOGY.

and, after four or five days, when the body is a little re- veterate afthma, after all other remedies have been tried
cruited, purging ; three days after, cupping and fcarifying. in vain. One, he fays, fiiould be made on each fide, near
He repeats thefe evacuations, and fometimes finapifms, at the middle of the joining of the clavicle, taking care
convenient diftances, and in the intervals gives proper not to touch the wind-pipe: two other little ones are
nourilhment, and ufes warm medicines, fuch as caftor, then to be made near the carotids under the chin, one on

mint, rue, and the cyrenaic juice. Whether this be
taken out of Pofidonius, as, by reading Aetius upon the
fame head, there may be fome reafon to fufpeCt, we can¬
not tell ; but the method is certainly right, and agreeable
to a rational practice. The epitome of what Galen had
faid upon the fame argument, in the next chapter, is by
no means fo full and circumflantial. Thefe few infiances
will be fufficient to (how, that even this author, though
he be chiefly a collector, may furnifii us with fome new
and ufeful reflections in phyfic; and he who reads him
with this view, may find fome other paflages of the fame
kind, not to be met with in the more ancient writers.

Aetius lived very near the end of the fifth or the be¬
ginning of the fixth century. He was a native of Amida
in Me!opo.tamia, ftudied at Alexandria, and was probably
a Chriftian, which perhaps may be the reafon why many
have confounded him with another of that name, a fa¬
mous Arian of Antioch, who lived in the time ot Julian.

In fome manufcripts he has the ftyle of Kopn; O-vJ/ixta,
Comes ObJ'equii ; i.e. the chief officer of thole who ufed
to go before the emperor, as his attendants and harbin¬
gers. We find in hint feveral particularities relating to
the Egyptian pharmacy. He has collected a great multi¬
tude of receipts, particularly thofe which had been much
celebrated, or ufed as noltrums by their inventors. Some
of thefe he feems to mention with no other defign than
to expofe them, and to let us fee the extravagant rate people
were induced to pay for them : for inftance, the colly-
riutn of Danaus, which was fold in Confiantinople for one
hundred and twenty numifmata, and with great difficulty
obtained from him ; the colical antidote of Nicofiratus,
called very prefumptuoufly Ifotheos, bought for two ta¬
lents. He feems alfo to be the firft: Greek writer among
the Chriftians who gives us any fnecimen of medicinal
fpells and charms, fo much in vogue with the old Egyp¬
tians ; fuch as that of St. Blafius, in removing a bone
which flicks in the throat ; and another in relation to
two fiftulse.

The followfing fample of a remedy for the gout is re¬
marked by Dr. Freind as being the firll ofits kind in the
hiflory of phyfic. It is an external medicine : he calls it
the grand dryer : the patient is to ufe it for a whole year,
and obferve the following diet befides in each month.
He calls the months by the Alexandrian or Egyptian
names, but in Engliffi, the direction runs thus : “ In Sep¬
tember to eat and drink milk : in October to eat garlick :
in November to abltain from bathing: in December not
to eat cabbage: in January fo take a glafs of pure wine
in the morning: in February to eat no bete : in March
to mix fweet things both in eatables and drinkables: in
April not to eat horfe-radifh : nor in May the filh called
polypus : in June to drink cold water in a morning : in
July to avoid venery : and laftly, in Augufi to eat no
mallows.” This may give us fome idea of the quackery
of thofe times.

In the works of Aetius we find many obfervations
omitted by Celfus and Galen, particularly on furgical
operations and on difficult parturition. He firft took no¬
tice of the Dracunculus, or Guinea worm, not known
to Galen. It is curious to remark the exceffive extent to
which the aCtual and potential cauteries were carried in
the time of this practitioner. In a palfy, he fays, that
he fiiould not at all hefitate to make an elchar either way,
and this in feveral places; one in the nape, where the
fpinal marrow takes its rife, two on each fide of it; three
or four on the top of the head, one juft in the middle,
and three others round it : he adds, that, in this cafe, if
the ulcers continue running a conliderable time, he fiiould
not doubt'of a perfect recovery. He is ftill more parti¬
cular when he comes to order this application for an in-

each fide, fo that the cauftic may penetrate no further
than the fkin ; two others under the breafts, between the
third and fourth ribs ; and again, two more backwards
towards the fifth and fixth ribs. Befides thefe, there
ought to be one in the middle of the thorax, near the be¬
ginning of the xiphoid cartilage, over the orifice of the
rtomach ; one on each fide between the eighth andninth
ribs; and three others in the back, one in the middle, and
the two others juft below it, on each fide of the vertebra;.
Thofe below the neck ought to be pretty large, not very
fuperficial, not very deep : and all thefe ulcers fiiould be
kept open for a very long time. »

Alexander, who flouriffied in the reign of Jultinian, is
a more original author than either of the two former.
He was furnamed Trallianus, being born at Tralles, a
famous city of Lydia, where the Greek language was fpo-
ken in great perfection : he lived in the fixth century,
fome time after Aetius. He was a man of very extend ve
praftice and of great fame, whence he was emphatically
called Alexander the phyfician. His therapeutical direc¬
tions are very full and explicit, aft d were chiefly the re-
fults of experiments made by hirnfelf. His practice was
remarkable for the judicious introduction of aperient me¬
dicines in cafes of fever, and the ufe of bleeding in fyn-
cope, adifeafe which, according to his defeription, feems
to apply to the epilepfy of our own times. But the molt
valuable part of Alexander’s writings was his book on
gout, for the cure of which he recommends purging, and
particularly with the herb hermodadlylus, which is fiip-
pofed to be the colchicum lately brought up again and ac¬
quiring great reputation in the. cure of the fame complaint.
He is the firft author who recommended the life of- rhu¬
barb, which he had recourfe to in vveaknefs of the liver
and in dyfentery. Alexander is recommended by Dr.
Freind as one of the bell practical writers among the an¬
cients, and well worthy the perufal of any modern.

Paulus, the fourth and laft of the old Greek writers,
was born in the ifland Aigina, and lived in the feventh
century, though placed by Mr. le Clerc as high as tlie
fourth. He vras a great traveller, and had opportunities
of feeing an extenfive practice in different countries.
He tranferibes a great deal from Alexander and other
phyficians. His deferiptions are fhort and accurate. He
treats particularly of women’s diforders ; and feems to
be the firft inftance upon record of a profeffed man-midzoije ,
for fo he was called by the Arabians : and accordingly he
begins his work with the diforders incident to pregnant
women. He treats alfo very fully of furgehy, and gives
fome direClions, according to J>r. Freind, not to be found
in the more ancient writers. He direCls the manner of
extruding darts, and of operating for hernia ; he deferibes
one fpecies of aneurifm ; treats of the mode of opening
the jugular veins, and alfo the arteries behind the ear.
He likewife deferibed the operation'of bronchotomy, and
ftiowed the propriety of performing it in cafes of fuffoca-
tion. This operation had been derided by Aurelianus,
and fome fevere objections were Halted againftit by Are-
taeus. It was firft; performed by Antyllus, from whom
Paulus copied it.

With Paulus clofes the period of the Greek clujjlcal
phyficians: fo we venture to call them; becaufe, if we
compare any of the Greek writers on pathology, from
the very firfi of them, Hippocrates, to the time we are
now fpeaking of, with the very bell of their contempora¬
ries in any art or profeffion whatever, they will be found
not at all inferior to them either in the difpofition of their
matter, the clearnefs of their reafoning, or the propriety
of their language. Some of them have even written
above the ftandard of the age they lived in ; an incon-
teftible inftance ®f which is Aretseus. Galen, alfo, was

not

1G

PATHOLOGY.

not the only bed phyfician, but the bed fcholar and cri¬
tic, of his time. So great an honour have thefe authors
done to their profefiion, by being verfed in other arts
and fciences as well as their own. And the great St. Bafil,
whom his own continual illnefs made a phyfician, and
who has a great many allufions and fimiles taken from
that art, was (to ufe the words of Photius) for the neat-
nefs, the propriety, the perfpicuity, and fluency, of his
ityle, one of the bed writers among the fathers ; as St.
Luke’s Greek comes nearer to the ancient Aandard than
that of the other evangelifls.

We cannot omit faying,fomething of one author more,
whom we may reckon one of the ancients, though not
properly a writer in phyfic ; Nemefius, bilhop of Emilia,
w'ho wrote a treatife concerning the nature of man, near
the end of the fourth century: becaufe his Oxford edi¬
tor afcribes two difcoveries to him, one of which was the
mod conliderable that ever was made in phyfic. The firfl
is concerning the bile, “ which is condituted (as Neme-
iius fays) not only for itfelf, but for other purpofes; for
it helps digeflion, and contributes to the expulfion of the
excrements ; and therefore it is in a manner one of the
nourifliing powers: befides, as a vital faculty, it imparts
a fort of heat to the body. And for thefe reafons it feems
to be made for itfelf ; but, becaufe it purges the blood, it
feems to be formed for the fake of the blood.” Here,
fays the editor, the fyflem of the bile is plainly and ac¬
curately delivered ; that very fydem which Sylvius de le
Boe with fo much vanity boaded he had invented himfelf in
3658. And indeed fo far is true, that here is the intire
foundation of Sylvius’s reafoning: and, if this theory be
of any ufe in phyfic, Nemefius has a very' good title to
the difcovery. But there follows a much more material
point ; and the fame editor contends, that the circulation
of the blood, an invention which tpe 17th century fo
much boafts of, was known to Nemefius, and defcribed
in very plain and iignificant terms, which are thefe :
“ The motion of the pulfe takes its rife from the heart,
and chiefly from the left ventricle of it : the artery is
with great vehemence dilated and contrafled, by a fortiof
condant harmony and order. While it is dilated, it
draws the thinner part of the blood from the next veins,
the exhalation or vapour of which blood is made the ali¬
ment for the vital fpirit. But, while it is contradled, it
exhales whatever fumes it has through the whole body,
and by fecret paflages. So that the heart throws out
whatever is fuliginous through the mouth and the nofe
by expiration.” Upon this Angle (lender proof does he
attribute this great difcovery of the circulation to Neme¬
fius ; and thefe who have infided that it was known both to
Hippocrates and Galen, have full as good arguments
on their fide. But it is evident enough, from this very
defeription, and from what the fame author fays of the
liver in the fame chapter,- that it miniders nouriflnnent
to the body by the veins, that Nemefius had no idea of
the manner in which the circulation of the blood is
really performed.

To refume the thread of our hiflory, we mud come now
to home other Greek writers of a lower rank and a later
date: but, as the greated part of thefe contain little that
is new, we lhall give a very (hort account of their works,
and only be as particular as we can in adjuding their fe-
veral ages ; concerning which all our authors have left us
in great confufion ; though indeed this is the lefs to be
wondered at, confidering that from the time of Agathias,
that is, from the year 560, to the reign of Ifaac Comnenus
in 1060, there is a chafm of five hundred years- in the
Grecian hidory; fo that we know very little of all that
interval, except what fome (lender account of the reigns
of a few emperors, chiefly Mauritius and Heraciius, fur-
nifhes us with.

Palladius, called Sophifi or Iatrafophid, was bred, as
he himfelf feems to hint, at Alexandria. We place him
firfl among the more modern Greeks, but cannot agree
with the Bibliotheca literaria, which computes that heflou-

rifned about theyear 126. Albinus better places him after
Galen, i. e. after the year 200. In fa ft, he quotes Galen
very often, and it may be proved, that he lived not only
after Galen, but after Afctius and Alexander too, whofe
words he frequently makes ufe of. His Commentaries
upon Fradlures are imperfect; however, what of them
remains is enough to let us fee that we have no great lofs
by it. In thofe upon the Epidemics, he with great per¬
spicuity and exadfnefs, illuflrates not only Hippocrates,
but feveral paflages of Galen ; and obferves particularly,
that the done increafed much in his time, and was lefs
curable; and he imputes this to the luxury of the age,
to much eating, and want of exercife. He is the firfl au¬
thor now extant who has treated profefledly of urine :
and he has very well explained the caufes of its colour
and confidence ; what didempers thefe refpedtively indi¬
cate, and what prognodics may be drawn from them.
There are feveral paflages exprefled in the fame words, as
we may read in a book upon the like fubjedl, falfely af-
cribed to Galen. He has written in much the fame man¬
ner concerning the faeces.

Stephen, the Athenian or Alexandrian, called fome-
times the one and fometimes the other, from the place ei¬
ther of his birth or his refidence, wrote a commentary
upon Galen’s Fird Book to Glauco; a book that does
not feem to want any comment to make it more intelli¬
gible. But there is reafon to think, that the chief physi¬
cal learning of his time confided in reading upon Galen ;
and Abi Olbeia, the Arabian biographer, tells us of feven
Alexandrian phyficians, among which Stephanus is one,
who digeded the works of Galen into lixteen books;
which again, according to the different matter, they di¬
vided into feven clafles : that thefe were the only books
they dudied, and that in their turn they made it their
whole buiinefs to comment upon them and explain them
to their auditors. And therefore it is not at all probable
that he lived in the third century, as Mr. le Clerc,
without any authority, fuppofes ; and, indeed, it is
plain, from this very comment of Stephen, that he was
much more modern, for he himfelf mentions very ancient
expofitors of this particular book of Galen ; and, in flec¬
tion 140, concerning a quartan, he feems to allude to a
wrong interpretation which Alexander had made of
Galen’s fenfle in this place. If this writer be the fame
with Stephen the chyrnid (as he is called), his age is ea-
fily known, for that author dedicates his work, de Chry-
fopceia, to Heraciius, and this will make his age confident
with what has already been obferved. We read of a Ste¬
phen too, and an Alexandrian likewife, in this very em¬
peror’s reign, who was a famous aflrologer, and foretold
the great power to which the Saracens fliould arrive, as
they did in fome years after. Vanderlinden calls Stephen
the lad of the old Greek authors, though, if this account
of his age be true, it will appear that feveral others wrote
in Greek after that time.

Of thefe Nonus feems to be in order next, who com-
pofed a fort of phyfic-manual, in which is contained fome
(hort account of mod didempers and their cure. He in-
feribes it to Condantine Porphyrogenitus ; who, accord-
ingto Lambecius, was the feventh emperor of that name,
the fon of Leo, and died in theyear 959, and who, as he
had fome tindlure of learning himfelf, was a great patron
of it. But Jer. Martius, who publiflied an edition of
this author in Greek and Latin, thinks the Condantine
here meant (a Porphyrogenitus as well as the other) was
the fon of Condantine Ducas, who died in 1067 ; for
this reafon, that Ducas, though unlearned enough him¬
felf, was an admirer and encourager of letters, and had
this faying often in his mouth, “ That he had rather be en¬
nobled by learning than by fovereignty;” To which of
thefe Conflantines Nonus inferibed his work, is not very
material ; I (hall only take notice, that we may collect
from Anna Comnena’s hidory, that in the interval be¬
tween thefe two emperors, learning was extremely de¬
clining, if not quite extindf.

4 This

17

PATHOLOGY.

This epitome is little elfe than a tranfcript from Aetius, medicines, fuch as caflia, manna, fenna, myrobalans ;
Alexander, and Paulus. And he is fo free with the la- the two laft he fays were brought from foreign parts to
bours of his predeceflors, that he even affumes their ex- his country, i. e. from Syria and Egypt. Senna he de-
perience to himfelf. He gives a particular defcription of fcribes as a .fruit, by which, no doubt, he means the fame
melancholy, and, with the air of a great praftitipner, is thing as Serapion does by the vagina, and Mefue by the
full of the good effects he had feen himielf from the Ar- folliculus, which contains the feed; for neither thefe au-
menian lfone, and therefore prefers it to white hellebore : thors, nor Adluarius, mention any thing of the leaves;

he talks very fenfibly about the bite of a mad dog, and
remarks, that when once a hydrophobia comes on, he
never, in all his experience, knew one recover; and yet
every word in the firft cafe is tranfcribed from Alexander,
and in the latter from Paulus.

Michael Pfellus lived not long after Nonus, and in-
fcribedthe book which he put together, Concerning the
Qualities and Virtues of Aliments, to Conftantine the
emperor. Lambecius thinks this Conftantine is he who
is called Monomachus, and who reigned from 1043 to
1055; but if, according to his account, Pfellus died in
1078, it is at lead as probable it might be Conftantine
Ducas: and what adds to the probability is, that it ap¬
pears from Zonaras, he was preceptor to Michael Ducas,
that emperor’s fon. The fame Zonaras gives this writer
the character of a perfon wholly unfit to have the tuition
of a prince, as being not at all qualified in any fort of
letters ; but Anna Comnena, who lived a few years after
him, on the contrary, extols him as one who was a perfect
mafter of philofophy, one of great natural parts, and of
profound learning both in Greek and Chaldaic. The
fame encomiums are bellowed upon him by Leo Allatius,
who (by his diflertation de Pfellis) feems to be fond of
this very name, and defcribes him as one of the firft rank
of writers. However there is nothing to be found in
his tfeatife which can do any author much credit ; for
it is only a collection from the elder Greek phyficians,
who themfelves collected this part of knowledge chiefly
from Galen, as he had done before from Diofcorides.
He was perfecuted and dripped of every thing by Nice-
phorus Botoniates, turned monk, and foon after died,
very old. There are many other trails writ by this au¬
thor, an account of which we may read at large in Leo
Allatius.

And yet, though Pfellus was fuch a compiler as has
been mentioned, Simeon of Antioch, writing upon the
fame fubjeCl, but indeed in a very impure ftyle, copied
moftly from him, which is the more extraordinary, fince
the book he tranfcribed from was then frelh in every one’s
memory: for Simeon mull have been his contemporary,
though no doubt younger, becaufe he dedicated this trea-
tife to Michael Ducas called Paripanaceus, who religned
the empire in 1078, the very year in which Pfellus, as
we are informed, died. There are many other works of
this Simeon, particularly we owe to him the tranflation
(out of Arabic into'-Greek) of a very fantaftical book.
Concerning the Wifdom of the Indians, which Perzoes,
a phyfician, collected at the defire of Chofroes, king of
Perfia.

ACtuarius, the fon of Zachary, fo called without doubt
from the employment he held as chief phyfician to the
emperor, is an author of a better character than thofe
we have juft mentioned. He wrote feveral treatifes, in
which occur many things worth our reading. He prac-
tifed at Conftantinople, and, as it appears, with fome de¬
gree of credit; his fix books concerning the method of
cure being compiled for the ufe of one of the chief offi¬
cers at court, the lord chamberlain, who was fent upon
an embafly into the North. Fabricius by miftake makes
ACtuarius himfelf the ambaflador. Tn thefe books, though
he chiefly follows Galen, and very often Aetius and Paulus,
without naming them, yet he makes ufeof whatever he finds
to his purpofe, both in the old and modern writers, as
well barbarians as Greeks ; and, to do him juftice, we may
find feveral things in him not to be met with any where
elfe. Thus, for inftance, he is the firft Greek writer who
has mentioned or defcribed the milder forts of purging
Vol. XIX. No. 1284.

and, though thefe are chiefly in ufe now, yet the pods
are fometimes made ufe of too; and, by what we can
learn from thefe writers were probably the only part of
fenna which was then adminiftered in phyfic. Another
thing which we meet with in no Greek writer before Ac-
tuarius, is the mention of diftilled liquors, as diftilled
rofe-water, See. See.

There are not proofs clear enough to point out to us
the time where we might fix the precife age of this wri¬
ter. He is commonly, but without any good authority,
reckoned to have lived in the eleventh century by fome,
and in the twelfth by others. Lambecius brings him
down as low as the beginning of the fourteenth ; but from
his ltyle we may conclude that he was more ancient ; for,
if we compare him either with Pfellus or Simeon, he will
appear to have a much greater purity in his diCtion ; and
indeed after 1200, we lhall fcarce meet with any writer
but who has fome mixture of modern Greek, or fome
barbarifms taken from other languages.

We have brought down this feCtion to a much later pe¬
riod than we intended, in order to complete the hillory,
as far as we could ground it upon any good authorities,
of the few Greek phyficians who appeared after the time
of Galen. There has been a prevailing opinion that no¬
thing was done among the ancients towards advancing
this art, but what is comprifed in the voluminous works
of that great man. What gave the firft rife to fuch a no,
tion probably might be this : that becaufe thofe who fuc-
ceeded Galen did tranferibe a great deal from him, many
were inclined to think, without giving themfelves the
trouble of examining and comparing their writings, that
they did nothing elfe but tranferibe. And no editor of
thefe authors has yet taken the leaft pains to undeceive them
in this point, what has been left us by way of comment,
being chiefly employed in grammatical or critical remarks,
without any view of explaining what relates either to the
hillory or the practice of phyfic in the time of each re-
fpedtive writer. But we have given fome inftances, and
more might be given, where the phyficians we have been
fpeaking of have defcribed diftempers which were omit¬
ted before ; where they have taught a new way of treat¬
ing old ones; where they have given an account of new
medicines, both fimple and compound, and where they
have made large additions in the practice of furgery.
And, if thefe be any real improvements of the art, it
cannot be denied but that phylic was ftill making a pro-
grefs till the year 600. As to furgery in particular, we
may, without derogation to the more ancient writers,
affirm, that whoever carefully looks into Aetius and
Paulus, will be convinced that a great many improve¬
ments have been made in that branch of pathology
which are not recited in Galen or any where elfe. And
in general it may be remarked, once for all, that the wri¬
ters mentioned in this period, till the beginning of the
7th century, and thofe whofe remains they have preferved,
were not fuch collectors (which is commonly the cafe) as
had little knowledge of the fubjedt they undertook to
treat of, but were every one of them men of experience
and pradtice. And, if the later Greek writers who fuc-
ceeded, were perfons of a lower character, and made
little advancement in the art they profelfed, it is the lefs
to be wondered at, fince, for many centuries, univerfal
ignorance prevailed over all the world; and it could not be
expedited that phyfic fliould make any progrefs, when
all other fciences and all forts of learning were almoft
quite extindl, or that it fliould be exempt from the
common calamities of thofe times.

F

II. From

18 PATHOLOGY.

II. From the Dark Ages to the end of the Sixteenth
Century.

After the downfal of the Roman empire, and when
the inundation of Goths and Vandals had almoft com¬
pletely exterminated literature of every kind in Europe,
medicine, though a practical art, (hared the fame fate with
more abftraft fciences. Learning in general, banifhed
from the feat of arms, took refuge among the eailern
nations, where the arts of peace ftili continued to be cul¬
tivated. The Arabians, from their vicinity to Alexandria,
from their intercourfe with the fed! of Neltorians and
with the Greek philofophers, who had been compelled
by the perfecution of Jultinian to take refuge in the Ma¬
hometan dates, had acquired a tafte for literature and the
fciences. The knowledge which they polTeffed of medi¬
cine is a fubjedt of curious inquiry. In the anatomical
branch, they did little more than tranflate and paraphrale
the Greek w riters. The errors which their originals had
made in anatomy became facred ; and, if the Arabs have
defcribed certain parts of the body with more exadtnefs
than Galen, thefe defcriptions were only conjedlures, or
the confequence of the ftudy of fome Greek authors who
have not defcended to us. The Mahometan laws prohibit
diffedtions, becaule, in the opinion of the Muffulmans, the
foul does not depart from the body at the moment of
death : it paffes from one member to another till it cen¬
ters in the bread, where it remains for a coniiderable
time. The examination by the angels, of the deceafed per-
fon in his tomb, could not be made on a mutilated corpfe.
The phyficians of the Arabs dudied, therefore, only
fkeletonsdn the cemeteries, and in mod furgical cafes im¬
plicitly followed the ancients.

Chemidry, with the red of the fciences, being banilhed
from the other parts of the world, alfo took refuge among
the Arabs. Geber in the feventh or eighth, and others in
the ninth, century of the Chridian asra, wrote feveral
chemical, or rather alchymical, books, in Arabic. In
thefe works of Geber are contained fuch ufeful directions
concerning the manner of conducting didillation, calci¬
nation, fublimation, and other chemical preparations,
and fuch pertinent obfervations refpedting various mine¬
rals, as judly feem to entitle him to the character which
fome have given him of being the father of chemidry, the
difcoverer of the key to the ricked treafures of nature,
though he himfelf modedly confelTes that he has done
little elfe than abridge the dodtrine of the ancients con¬
cerning the tranfmutation of metals. He mentions fe¬
veral mercurial preparations, fuch as the corrofive fubli-
mate and red precipitate, nitric acid, muriatic acid, and
many other chemical compofitions.

The Herbal of Diol'corides was enriched by the Saracens
with the addition of two thoufand plants, and their
knowledge of the vegetable world enabled them to infert
in their pharmacopoeia feveral remedies which had been
unknown to the Greeks. One great difference between
the Grecian and Saracen difpenlatories was, that the me¬
dicines in the latter were of a milder nature than thofe
in the former: another difference was the common ufeof
fugar in lieu of hopey. Diofcorides, fpeaking of the va¬
rious fpecies of honey, fays, that there is a kind of it in a
concrete date, called, Jaccliaron, which is found in reeds
in India and Arabia Felix : he alfo defcribes its medicinal
virtues. Galen writes upon it nearly in the fame man¬
ner; but the hidory of the artificial preparation of fugar,
by boiling or other means, was very imperfedtly known.
The Saracens appear, however, to have underdood the
art ; for, by a mixture of fugar with other ingredients,
they made various medicines with which the ancients
were unacquainted.

The caliphs had done much to render the Arabians
thus eminently learned. In the feventh century,
Almanfor, and his famous fuccefior Harun A1 Rafchid,
patronifed feveral medical fchools, founded hofpitals and
academies, and afiiduoufly cultivated the introduction of
Grecian learning. Unfortunately, the Arabian phyficians

mixed abfurd and myderious fuperftitions with the
knowledge they thus acquired. The popular tade for
the marvellous induced them to refort to every means of
impofing on the vulgar. Adrology was introduced, par¬
ticular pofitions and appearances of the liars were ftudied
in dangerous cafes, and amulets were in the poffellion of
every fuccefsful and popular pradtifer of medicine.

As difcoverers and inventors, the Saracens have few
claims to praife, but they formed the link which unites
ancient and modern literature; and, fince their relative
fituation with Europe fomewhat refembled the relative
fituation between Egypt and Greece, they are entitled to
a portion of our refpedt and gratitude. When the princes
of the wed began to emerge from barbarifin, they cor¬
rectly acknowledged the Moors to be the great depofitaries
of knowledge. Many ufeful treatifes, now loll in the
original, for example the fifth, fixth, and’ feventh, books
of the Conic Sections of Apollonius Pergamus, and fome
of the commentaries of Galen and Hippocrates, were pre-
ferved in the language of the Saracens, or Arabians, as
they are indifferently called.

Among the moll eminent of the Arabian phyficians,
we may reckon Rhazes, Avicenna, Albucafis, and
Avenzoar.

Rhazes, one of the olded and mod didinguifhed, was
born at Rei, in the province of Chorafan, about the year
852. There was a fchool in his native town, at which he
received his early education ; but he is laid not to have
commenced the dudy of medicine till fomewhat late in
life, having given up his time much to the cultivation of
nuific. After he was thirty years of age, he removed to
Bagdad ; and then he turned his attention to philofophy,
and afterwards to phyfic. He became, however, indefa¬
tigable in his application; and was continually occupied
in obferving, reading, and writing, until he obtained the
highed reputation ; and he was feledted out of a hundred
eminent phyficians, who were then refident at Bagdad, to
fuperintend the celebrated hofpital of that city. The hif-
torians confidered him as the Galen of the Arabians ; and,
from his long life and conftant practice, during which he
paid the moll affiduous attention to the varieties of difeafe,
he obtained the appellation of the Experimenter, or the
experienced. He was faid alfo to be profoundly fkilled in
all the fciences, efpecially in philofophy, aftronomy, and
rnufic. Fie travelled much in purfuit of knowledge, and
made frequent journeys into Periia, his native country,
and was much confulted by feveral princes, particularly by
Almanfor, the chief of Chorafan, with whom he fre¬
quently correfponded, and to whom he dedicated feveral
of his writings. Abi Ofbaia enumerated 226 treatifes
compofed by Rhazes, among which the ten books addrelfed
to his patron Almanfor are mentioned, and therefore are
doubtlefs genuine, although Haly Abbas, who has given
an account of him and his works, has not noticed them.
This work Rhazes defigned as a complete body of phyfic,
and it may be deemed the great magazine of all the Ara¬
bian medicine : the ninth book, indeed, which treats of the
cure of difeafes, was in fuch general ellimation for feveral
centuries, that it was the text-book of the public fchools,
and was commented upon by the moll learned profellbrs.
Neverthelefs, like the rell of the Arabian writings, it
contains very little more than the lubllance of the wmrks
of the Greeks, from whom the Arabians borrowed almoft
all their medical knowledge. They have, indeed, and
Rhazes in particular, given the firlt diltindl account of the
JinalL-pux, a pellilential malady which the Greeks have no¬
where accurately defcribed, and which is, therefore, gene¬
rally inferred to have been unknown among that people.
This is quellionable ; but, at all events, the firlt lpecific
account of the fmall-pox is to be found in the works of
Rhazes. He was the author, alfo, of the firlt treadle ever
compofed refpedting the difeafes of children. His book on.
the affedtions of the joints is interelling, and contains an
account of fome remarkable cures, effected chiefly by co¬
pious blood-letting. He defcribes the fymptoms of hy-
4 drophobia

PATHOLOGY. 19

drophobia very well ; and alfo Tome difeafes peculiar to
eaftern countries, as the ignis perilous, vena medinenfis,
See. and he fil'd noticed the difeafe called fpina ventofa.
Rhazes had the reputation of being a ikilful alchemift;
the art of chemiftry, in fa£t, originated with the Arabians;
and Rhazes is the firft, as Dr. Freind has fliown, who men¬
tions the ufe of chemical preparations in medicine. He
has a chapter on the qualifications of a phyfician ; and a
Angular trail on quacks and impoftors, in which he has
pourtrayed that claft of pretenders to the life ; and his
detail of their pretenfions (flows that they were at leaft as
numerous, and ingenious in their contrivances of
cheatery, as in more recent times. Rhazes lived to the
age of eighty, and loft his fight : he died in the year 932.
His works that have come down to us, through the me¬
dium of tranflations in Latin, are, 1. A fort of common¬
place book, entitled Continent, or Libri Continent es. a. A
much more perfect work, the Libri Decern, ad ' Alnutnf or em,
publifhed at Venice, 1510. 3. Six books of Aphorifms,

publiflied under the title of Liber de Secretis, gui Aphorif-
morum appellatur, Bononiae, 1489. 4. A trail on the

fmall-pox and meafles, entitled, De Pejlilentia. This laft
was tranflated by Dr. Mead in 1747, and by Mr. Chan-
ning in 17 66. As it is a fubjeil fo much in difpute, we
(flail give an extrail from the very firft chapter. “ As to
thofe phyficians who affirm, that the mod excellent Galen
lias made no mention of the fmall-pox, and therefore that
lie did not know this diftemper ; furely they have either
never read his works at all, or only very curforily; nay,
,moft of them do not know, whether what he plainly fays
of it is to be underftood of that difeafe. For Galen, in a
certain treatife, fays, this drug does good this and that
way, and alfo againft the fmall-pox. And in the beginning
of the fourteenth book, of pulfes, that the blood is putre¬
fied in an extraordinary degree, and that the inflammation
runs fo high, that it burns the fkin ; fo that the fmall-pox
and peftilent carbuncle are bred in it, and quiteconfume
it. And in the ninth treatife of the book of the Ufe of
the Parts, he obferves, that the fuperfluous parts of ali¬
ments, which are not turned into blood, and remain in the
members, putrefy, and in time increafing do ferment;
whence, at laft, are generated the peftilential carbuncle, the
fmall-pox, and confluent inflammations. Laftly, in the
fourth part of his Commentary upon the Timteus of Plato,
he fays, that the ancients gave the name cp\iyp.otrt to every
thing which produces rednefs,as the carbuncle and fmall-
pox ; and that thefe difeafes are bred in thofe in whom
bile abounds. But, as for thofe who allege; that he has
propofed no remedy or cure, nor explained the nature of
this diftemper, they indeed fay what is true : for he men¬
tions no more than what we have cited. But God knows
whether he might not have done it in fome other books,
which have not yet appeared in Arabic.”

Avicenna’s Canon Medicines, or General Syftem of Me¬
dicine and Surgery, was for many ages celebrated through
all the fchools of phyfic. It was principally compiled
from the writings of Galen and Rhazes. The latter had,
in difficult labours, recommended the fillet to aflift in
the extrafilion of the foetus 5 and, for the fame purpofe,
Avicenna recommends the forceps. He deferibes the
compofition of feveral cofmetics to polifh the fkin, and
make the hair growq or fall off. See the article Avi¬
cenna, vol. ii.

Albucafis flourifhed about a hundred years after Avi¬
cenna : the date of his birth is not known, but he died
in 1106. He is chiefly eminent as a furgeon ; and, al¬
though much of what he has left on the fubjedt of his
art is copied from Rhazes, from Paulus -Eginasta, and
other preceding writers; he has many original obferva-
tions ; and by thofe who love to fee the firft dawnings of
improvement in fcience, his works will be dill turned
over with pleafure. He infilled on the neceflity of a fur-
geon’s being fkilled in anatomy, to enable him to ope¬
rate with fuccefs; he alfo held it to be equally neceflary
that he fhould be acquainted with the materia medica, or

the properties of the medicines employed in curing dif¬
eafes ; and inveighs againft thofe who undertake for gain
the cure of difeafes, of the nature and caufes of which
they are unacquainted. It appears from his writings,
that he extracted polypi from the noftrils, performed the
operation of bronchotomy, and ufed a preparation fimilar
to the lapis infernalis, as a cauftic. He enumerates a
tremendous lift of operations, fufficient to fill us with
horror. The hot iron and cauteries v.'ere favourite re¬
medies of the Arabians ; and, in inveterate pains, they
repofed, like the F.gyptians and eaftern Aliatics, great
confidence in burning the part. He deferibes accurately
the manner of tapping in afeites; mentions feveral kinds
of jnllrunients for drawing blood ; and has left a more
ample and corredl delineation of lurgical inftruments than
any of the ancients. He gives various obftetrical direc¬
tions for extrafling the feetus in cafes of difficult labour.
He mentions the bronchocele, or prominent tumour on
the neck, which, he tells us, was mofl frequent among
the female fex. We are alfo informed by this writer,
that the delicacy of the Arabian women did noUpermit
male furgeons to perform lithotomy on females 5 but,
when neceflary, it was executed by one of their own fex.

Of Avenzoar nearly all that is known has been com¬
municated under his article. The date of his birth is
uncertain ; he is faid to have lived to the great age of
135 years ; but, as he had a fon of the fame name and pro-
feflion, it is very probable that the age of both is in¬
cluded in this term. He (or his fon) died at flforocco
in 1166, or at Seville in 1162. Avenzoar prepared his
own medicines, reduced luxated bones, and performed
other chirurgical operations. The work by; which he is
principally known is a compendium of the praflice of
medicine; in which fome difeafes are deferibed not found
in other writers. It includes a number of cafes, candidly,
it fhould feem, related, as the author does not conceal
thofe in which he was unfuccefsful. See Avenzoar,
vol. ii.

Thus we fee, that, in confequence of the general decay
of learning in the weftern parts of the w'orld, the Greek
writers were entirely neglefled, becaufe nobody could
read the language ; and the Arabians, though principally
copiers from them, enjoyed all the reputation that was
due to the others. The Arabian phyfic was introduced
into Europe very early, with the mofl extravagant ap-
plaufe : and not only this, but other branches of their
learning, came into repute in the weft ; infomuch that
in the nth century, theftudies of natural philofophy and
the liberal arts were called “ the fludies of the Saracens.”
This was owing partly to the crufades undertaken againft
them by the European princes ; and partly to the lettle-
ment of the Moors in Spain, and the intercourfe they
and other Arabians had with the Italians. For, long be¬
fore the time of the crufades, probably in the middle of
the 7th century, there were Hebrew, Arabic, and Latin,
profeffors of phyfic fettled in Italy and Spain. The uni-
verfity of Cordova, which had been founded by
Alhakem, became the molt celebrated in the world, and
maintained its repute for a long courfe of years. As
early as the tenth century, Cordova could boaft of the
largeft library in the weft; a library of 250, ooo'books,
and of which the catalogue is faid to have filled forty-four
volumes. In the twelfth century, there were no lefs than
feventy public libraries in Spain : Cordova had produced
1 50 authors, Almeria 52, and Murcia 62. At Seville, at
Toledo, and at Murcia, academies were alfo eftablifhed,
which continued to flourifh during the whole period of
the dominion of the Arabians.

In the tenth century, the rich and maritime city of
Salerno, in the Neapolitan territory, arrefted the attention
of the predatory Muflulmen. Frequently engaged either
in war or in negociation, they became mixed with the
Chriftians, and gradually communicated their literary
attainments ; and, in the year 802, Charlemagne founded
in Salerno a fchool, which in procefs of time^ became the

moll

20 PATHOLOGY.

mod celebrated in the world. About the latter end of
the nth century, Conftantine the African introduced
into the Salernian fchooi the Grecian authors, as well as
the learning which he had obtained from a long refidence
in Babylon and Bagdad. In the twelfth century, how¬
ever, this fchooi arrived at its higheft fame; and was
much frequented by the crufaders in their paftage to and
from the Holy Land. Among thefe, Robert, the ion of
William the Conqueror, had the honour of having the
well-known “ Regimen Sanitatis Salerni” dedicated to
him. In the year 1140, the emperor Frederic II. con¬
ferred particular privileges on the fchooi of Salerno, and
regulated the courfe of ltudies, and the probations which
phyficians and furgeons ihculd undergo before they were
permitted to praftife. Many of the ordinances iliow great
judgment. The Salernian fchooi continued accordingly
to flouriih till the middle of the fourteenth century, when
it appears to have begun to decline. “Fuiffe Salerni,”
fays Petrarch, “medicinas fontem fama eft ; fed nihil eft,
quod non fenio exarefcat.” Gariopontus, Nicolaus,
AEgidiu-s, Enos, and John of Milan, the author of the
Regimen Sanitatis, are the chief writers whom this fchooi
boafts. This fchooi was perhaps, the firft that eftabliftied
the form of public examination and admiftion, and pof-
fefled the power of conferring medical licenfes and de¬
grees. It recognifes molt obvioufiy the exiftence of apo¬
thecaries, and enforces the propriety of difcriminating
the three branches of the medical profeflion from each
other. The phyfician was under the neceftity of pro¬
ducing teftimonials that he had been a medical ftudent
for feven full years ; the furgeon that he had attended
to anatomy for at leaft one ; and the apothecary was pro¬
hibited from charging more than an eftabliftied ratio for
the medicaments he compounded or employed.

While the eaftern nations aftiduoufty cultivated the
knowledge of the Greek writers, and while their caliphs
and rulers encouraged fcience by a liberal patronage, a
very different part was followed by the Chriftians. The
clergy, actuated by avaricious motives, feized upon the
province of the phyfician ; and the moft ignorant priefts
and rn.onks ventured upon the practice of medicine, with¬
out any proper ftudy or preparation. At length the evil
became too crying to be any longer endured ; and the firft
Lateral! council, held in 1123, forbade the regular clergy
to vifit any longer the lick. The prohibition was re¬
peated, in other terms, by the council of Rheims in 1131,
and by the fecond general Lateran council in 1139 ; and
thofe monks and canons who applied themfelves to phy¬
fic, “ordinis fui propofitum nullatenus attendentes, pro de-
teftunda peeunia fmitalem pollicentes ,” were threatened with
fevere penalties ; and all bifhops, abbots, and priors, who
connived at their mifconduft, were ordered to be fuf-
pended from their ecclefiaftical funftions. “ But the
French priefts and monks,” fays Cabanis, “bade defiance
to thefe thundering anathemas ; and it was not till three
hundred years after, that common fenfe, and a regard to
propriety and the public good, triumphed finally over
their artifices. A fpecial bull, procured by the cardinal
d’Eftonteville, in 145a, which permitted phyficians to
marry, effected their complete feparation from the clergy ;
and, l this means alone, put a flop to a variety of fliame-
ful abufes.

To the honour of our country, however, be it men¬
tioned, that thefe abufes do not appear to have prevailed
to fuch an extent among us. The clergy did not indeed
praftife phyfic, but they were armed with great autho¬
rity over thofe who did. In the days when benefit of clergy
had a laving fignification in courts of law, the minifters
of religion were regarded with great reverence; and their
powers over the practice of medicine are not yet quite
extinft. The firft control exercifed over the practice of
phyfic in England appears to have been ecclefiaftical,
though the end and purpofe of the interference of the
church on this occafion, as in moft others in thofe times,

.as not fo much the health of the body as the welfare

of the foul, ecclefiaJUcaUy underflood. One of the confti-
tutions of Richard Wetherfhed, archbilhop of Canterbury
anno 1229, in the fourteenth year of the reign of Henry
III. runs as follows : “Under pain of anathema, we for¬
bid any phyfician to give advice for the health of the
body which may prove perilous to the foul, which is much
more precious than the body. But, when it happens that
he is called to a lick man, let him firft effeftually perfuade
him to call for the phyfician of the foul ; that, when the
fick man has taken fpiritual cure, he may, with better
effeft, proceed to the bodily medicines. Let not the
tranfgreftors of this conftitution efcape the punilhment
appointed by the council.” The punilhment here de¬
nounced againft phyficians fo offending, was a prohibi¬
tion from entrance into the church till they had made
fatisfaftion, according to chap. xxii. of the council of
Lateran, under Pope Innocent III. from whence this
conftitution is taken.

It was nearly two centuries after this, namely, in the
reign of Henry V. anno 9. that the firft ftatute was enafted
relative to praftitioners in phyfic. The preamble to this
aft, after reciting the mifchiefs arifing from illiterate
praftifers, ftates, “ that if no man praftifed therein but
all only conynge men, and approved, fufficiently ylearned
in art, filofofye, and fifyk, as it is kept in other londes
and roiaumes, therftiuld many man that dyeth for de-
faute of help lyve, and no man perilh of unconnyng.”
The petition then goes on to pray, that no perfon be
allowed to praftice phyfic, “ but he have long time yufed
the fcoles of fifyk within fome univerfitee, and be gra¬
duated in the fame.”

The next aft reftraining the praftice of phyfic in
London and its immediate vicinity, to perfons of approved
competency, was palled in the third year of the reign of
Henry VIII. feven years prior to the eftablilhment, by
charter, of the prefent College of Phyficians. Its title
was, “ An Aft for the appointing of Phyficians and Sur¬
geons.” It was enafted that no perfon within the city
of London, nor within feven miles of the fame, take upon
him to exercileand occupy as a phyfician or furgeon, except
he be firft examined, approved, and admitted, by the bilhop
of London, or by the dean of Paul’s, for the time being,
calling to him or them four doftors of phyfic, and, for
furgery, other expert perfons in that faculty. When the
Charter of the College of Phyficians was granted by the
king, it was on the petition of a prieft, the cardinal
Wolfey, chancellor of England, in conjunftion with
John Chambre, Thomas Linacre, Ferdinand de Victoria,
foreign graduates, the king’s phyficians, and Nicholas
Halfwell, John Francis, and Robert Yaxley, phyficians.
And the archbilhop of Canterbury can, and does to this
day, by his diploma, conftitutea phyfician.

To return from this digrelfion. — After Salernum, the
Univerfities of Montpellier, Paris, Boulogne, Pavia,
Padua, and Ferrara, became the moft diftinguilhed femi-
naries for medical education ; but the fervile attachment
to ancient dogmas which obtained in their fchools ma¬
terially retarded their progrefs. In 1271, the College of
Surgeons at Paris was eftabliftied by Pitard, a man who,
according to Quefnay, was born for the advancement of
his art ; and furgery was henceforth cultivated with much
fuccefs in France, as a diftinft branch of the profeflion.
Several writers on phyfic appeared in England ; among
whom Gilbert has the merit of having furnilhed the belt
defcription of the leprofy of the middle ages ; but he trod
in the footfteps of the Arabians, and gave into the fcho-
laftic ftyle. The fame remark applies to his fucceftors,
John of St. Giles, Richard of Windermere, Nicolas
of Farneham, John of Gaddefden, &c. It was in Italy
that medical fcience was revived in the trueft fpirit. In
the year 1315, Mondini de Luzzi, profeffor at Bologna,
aftoniflied the whole world, to ufe vicq d’Azyr’s expref-
fion, by the public difleftion of two human bodies. His
example was followed in other univerfities ; but the
utility of the praftice was in a great degree fruftrated by

PATH

the predilettion for ancient opinions, which made the
anatomifts of the age lefs anxious to difcover new fatts,
than to reconcile the appearances which they obferved
with the dogmas of Galen and Avicenna. An abfurd
bull of pope Boniface VIII. forbidding the maceration and
preparation of Ikeletons, alfo concurred to impede the
progrefs of anatomy; (Blumenbach, Hift. Med. Litterar.
p. 99.) but from this time forward, the Italian profeffors
maintained a high repute for anatomical fcience, and
have ranked among the inoft zealous contributors to our
knowledge of the human frame.

Though the crufades had conferred no direct benefits
on fcience, they had given a new impulfe to the human
mind, by the fpirit of commerce which they excited.
They were alfo the occafion of the rapid fpreading of
leprofy and fome other difeafes in the Weft, and of the
confequent increafe of inftitutions for the relief of the
fick, after the example of the Oriental nations. Several
orders of knighthood, as the Templars, the knights of
St. John, of St. Lazarus, the Hofpitalarii Santti Spiritus,
&c. were founded with this charitable view ; the mem¬
bers devoting themfeives to the cure of fuch pilgrims as
were afflitted with difeafe.

In the fifteenth century feveral new difeafes appear to
have invaded mankind, or, at leaft, to have attacked
them with a degree of violence that was before unknown.
The whooping-cough was epidemic in France in the year
14.14: and, according to Mezeray, it attacked all defcrip-
tions of perfons, even, the oldeft men. The fweating
ficknefs, which broke out firft in the fame country, was
brought to England by the foldiers of the duke of Rich¬
mond (afterwards king Henry VII.) upon his landing
at Milford-haven in 1485; and fpread itfelf at London
from the 21ft of September to the end of Ottober. It
returned there five times, and always in fummer; firft in
14 95, then in 1506, afterwards in 1517, when it was fo
violent that it killed many in the fpace of three hours,
fo that numbers of the nobility died, and of the com¬
monalty in feveral towns often the one-half perilhed. It
appeared the fourth time in 1528, and then proved mortal
in fix hours ; many of the courtiers died of it, and Henry
VIII, himfelf was in danger. In 1529, and only then,
it infefted the Netherlands and Germany, in which laft
country it did much mifchief. The laft return of it was
in 1551 ; and in Weftrninfter it carried off 120 in a day.

At this time alfo a new difeafe overran the world, and
threatened greater deftruttion than almoft all the old ones
put together, both by the violence of its fymptcms,and its
baffling the moft powerful remedies at that time known.
This was the venereal difeafe, which is fuppofed to have
been imported from the Weft Indies by the companions
of Chriftopher Columbus. Its firft remarkable appear¬
ance was at the fiege of Naples in 1494, from whence it
was foon after propagated through Europe, Afia, and
Africa. The fymptoms with which it made the attack
at that time were exceedingly violent, much more fo than
they are at prefent ; and confequently were utterly un¬
conquerable by the Galenifts. At this period, as fea-
voyages of confiderable duration were more frequent, the
fcurvy became a more common diftemper, and was of
courfe more accurately defcribed. But probably, from
1'uppofed analogy to the contagions which at that time
were new in Europe, very erroneous ideas were enter¬
tained with regard to its being of an infettious natures
and it is not impoflible, that, from* its being attended alfo
with ulcers, it was on fome occafions confounded with
fyphilitic complaints.

Dreadful as the inflittion of thefe maladies muft have
been on the fuffering world, we have reafon to believe
that they were not without their ufe in leading to the
improvement of medicine. The phyficians of the time,
finding the rules of their favourite authors quite inap¬
plicable to the cure of diftempers fo malignant, naturally
began to obfefve and judge for themfeives. Manardi
and Leoniceno (fee their refpedlive articles) laboured to
Vol. XIX. No. 1284.

O L O G Y. 21

expofe the errors of the Arabs, and bring back,
their followers to the ftudy of Nature and Hippocrates.
In this laudable undertaking they were feconded by the
German, French, and Englilh, profeffors ; and particu¬
larly by the labours of Dodoneus, Schenkius, Foreftus,
and Platerus.

In the early part of the fixteenth century, Briffot of
Poitou revived a fubjett which had before engaged phy¬
ficians in violent difputes. According to the Hippocratic
mode of treating inflammation, which was to take* the
blood from the inflamed part as clofely as poflible, the
Greek phyficians were wont, in pleurify, to bleed in the
arm of die fame fide as was affetted with pain. Avicenna
had objetted to this, and recommended venefettion in
the oppofite arm. This produced a great deal of alter¬
cation ; and in the end a decree of the univerfity of
Palermo iffued forth which forbade any one to bleed ex¬
cept in the contrary arm ; and the profeffors endeavoured
to perfuade the emperor Charles V. to fecond it by an
edidt. Briffot met with almoft as much opposition in
reviving the old method as the Salernitans had done in
introducing the new one : but at length the difpute was
fettled in favour of Briffot by the great anatomical dif-
coverers of that century.

The fcience of anatomy gradually became imnroved
in the hands of Zerbi, Winter, Laguna, and Sylvius ;
which laft taught anatomy at Paris in 1532. But it was
referved for the great and comprehenfive mind of
Vefalius to throw off the fhackles which had fo long
fettered the progrefs of anatomy. So far from adopting
as infallible dogmas the anatomical relations of Galen,
he attached himfelf particularly to difclofing the errors
of that author. He firft advifed anatomifts to injett co¬
loured fluids into the veffels of the body, in order to fa¬
cilitate the labour of minutely tracing them. Wliilft he
was a young man at college, he purfued anatomical in¬
quiries with great ardour and afliduity, and publilhed
fome of his difcoveries before he was twenty-five years of
age, and feven books on the anatomy of the human body
before he was twenty-nine, A. D. 1542. Thefe books
contain great difcoveries, and, in many circumftances,
correct the ancients. But, although they have entitled
their author to the gratitude of pofterity, they procured
to him fcarcely any thing but animofity from his con¬
temporaries. The authority of Galen was ftill held in
high veneration ; and, when Vefalius expofed his errors,
the hatred of all feemed turned againft him. People could
not bear to be fet right by fo young a man; and even
Sylvius denounced perpetual enmity againft him. But,
confident in the certainty with which diffettion furninied
him, he acquired a complete afcendancy over liis adver¬
saries : fo much fo, indeed, that his lettures were fome-
tiines attended by 500 pupils. He preffed Sylvius, his
mafter, fo hard, in. thefe controverfies, that the latter,
rather than admit his favourite Galen was wrong, afferted*
that “ the Jtrudiure of the human body hud become altered in
fomeparticularsjin.ee the time of Galen, and. that man’s nature
had degenerated !” Thus, for inftance, the number of the
pettoral bones occafioneda difpute, which was carried on
with great acrimony between them. Galen had adopted
feven in the human ikeleton ; but Vefalius proved that
there were only three, and that his opponent had again
been milled by the Ikeleton of a monkey. But Sylvius
objetted to this, “ that men had been larger and
taller in the time of Galen, and had feven pettoral bones,
but that, in this dwarfilh century, three only could be
found.” Vefalius afferted, that the bones of the hand
are not totally deftitute of medullary fubftance, as Galen
had maintained ; and Sylvius again endeavoured to re¬
fute his affertion, by the abfurd argument, “that the
bones in former times had been firmer and harder, and
confequently required no fuch fubftance.” Vefalius re¬
jetted the large curvature which Galen aferibed to the
os humeri, and the os ilium; while Sylvius defended
Galen, by afferting, that the bones had become more
G ftraight

22

PATHOLOGY.

ftraight by the modern mode of drefs. He vindicated, in
a fimilar manner, Galen’s neglect in defcribing the car¬
tilages of the extremities of the bones: ‘'In former
times,” faid he, “ the bones were more folid, and confe-
quently required no cartilages !”

Thefe prejudices had not paffed away from among the
French phyficians even in the following century; for we
find Moliere, in his Medecin malgri lid (Mock DoCtor),
alluding to the abfurdity we have juft mentioned, of fome
parts of the vifcera having changed their places.

“ Dodlor. Now thefe vapours of which I am fpeaking
having palled from the left fide, which is the feat of the
liver, to the right, where the heart is fituated, then the
Jungs, which we call in Latin armyan, communicating
with the brain, which in Greek we call nafrnus , by means
of the vena cava, which is cubile in Hebrew, meets in its
way with thefe vapours, which fill the ventricles of the
omoplate ; and, fince thefe vapours pofiefs a certain ma¬
lignity caufed by the acridity of the humours engendered
in the concavity of the diaphragm, it therefore happens
that thefe vapours — in fiiort, this is precifely the reafon
why your daughter is dumb.

“ Father. Nothing in the world can be clearer than
this reafoning. Only one difficulty occurs to me ;
namely the feat of the liver and of the heart. I always
thought the heart to have been on the left fide, and the
liver on the right.

e‘ Doflar. Yes ; it was fo formerly ; but we have altered
all that, and medicine is now adminijiered in a manner to¬
tally new." Mock Doftor, aft ii.

Vefalius had great advantages over his predeceffors
in being able to perpetuate his labours by means of the
beautiful reprefentations which Titian and others painted
for him. In 1561, Fallopius, in Italy, publifhed his Ob-
fervationes Anatomicte ; he was an indefatigable anato-
mift, and made great difcoveries. About the fame time,
Euftachius made himfelf confpicuoufly eminent by pro¬
moting anatomical knowledge. He feemed calculated
for fubtle inveftigations ; he drew many figures of the
human body, and engraved his own plates, the accuracy
of which cannot fail of exciting furprife in an anatomift
of the prefent day. When the labours of thefe eminent
men had, as it were, fmoothed the path, anatomy was
taught with a moderate degree of correCinefs and mi-
mitenefs in the different fchools of Europe.

But the moft important difcovery of this fcience was
that of the circulation of the blood. Berengar, who
had paid great attention to the ftruCfure of the heart,
conjeffured the right ufe of the femilunar valves. In
1547, Cannani and Amatus obferved the valve at the ter¬
mination of the vena azygos; but they did not turn the
difcovery to account; and it was referved for Fabricius
of Aquapendente to prove the prefence of valves
throughout the whole courfe of the veins. Five years
afterwards, the circulation of the blood through the lungs
was imperfeCHy defcribed by Servetus, who had availed
himfelf of the refearches of Berengar and Vefalius. In
the year 157-1, Csefalpinus had the merit of ftating it
more clearly, and even of fuggefting the firft hint of the
greater circulation ; but the full honour of the latter
difcovery muft be afcribed to our countryman, Harvey.

This improvement in anatomical knowledge was ne-
ceffarily accompanied by a ccrrefponding one in forgery.
The Italian furgeon, Maggi, corre&ed the abfurd no¬
tions that his predeceffors had inculcated, viz. that gun-
fhot wounds were conneCled with combuftion, and that
gunpowder poifoned the wound. He fhowed that, fince
the balls did not fet the wadding on fire when they came
firft from, the barrel of the gun, they could not be hot;
nor could gunpowder poifon a wound, fince it was com-
pofed of none but harmlefs materials. Maggi likewife
left fome ufefnl directions concerning amputation. Am-
brofe Pare introduced into France the treatment of gun-
fliot wounds eftablifhed by Maggi. The fame praCfice
v.as likewife adopted by John Baptift. Carcano Leone,

profeffor at Pavia. Pare was, however, unqueftionably
the moft celebrated furgeon of the 3 6th century. Be-
fides the improved treatment of gun-fhot wounds, which
he had the merit of introducing, together with many
other peculiarmethods in operative furgery, he has ren¬
dered effential fervice to different branches of that fcience.
He treated, for inftance, the hydrocele withafeton; as
the dangerous confequences of incifion were in that age
more frequently obferved than they are at prefent. He
did not apply the aCtual cautery to wounded blood-vel-
fels, according to the old practice, but fecured them by
the ligature. The fraCture of the collum offis femoris,
formerly confidered as a luxation of that bone, was firft
afcertained by him wfith accuracy ; he alfo reprobated the
frequent dreffmg of ulcers, and the application of the
trepan to the futures of the cranium and the temporal
bones. He made very judicious remarks on concuflions
of the brain, of which Henry II. died, and on fuppura-
tions of the liver arifing from injuries of the head.
Wounds of the throat, in which one of the jugular
veins, and even the trachea, was cut through, he did not
confideras mortal. He fuccefsfully treated an injury of
the nervus medianus from venefeCtion, and thereby ac¬
quired theconfidence of Charles IX. who had been fubjeCt
to that dangerous accident. A perfon who, from lofing
a great part of his tongue, had been fpeechlefs for a con-
fiderable time, accidentally recovered the power of fpaech,
by thruftiiig a table-fpoon into his mouth. Pare ingeni-
oufiy imitated this method, by contriving an appropriate
inftrument.

Amatus, or, according to fome, his mafter Aldaretti,
had invented the ufe of bougies; and thofe inftruments
now catne into very general ufe, both flmple and caufti-
cated.

The doCirine of lithotomy was confiderably improved
in this century, by the invention of two different me¬
thods of operating, namely, the great and the high opera¬
tion. Germain Colot had undertaken a fuccefsful opera¬
tion for the ftone, in the fifteenth century, and proba¬
bly by the high operation : but it does not appear that
learned furgcons had imitated this method, till an obfcure
praCiitioner at Cremona, John de Romani, in 1525, be¬
gan to adopt what is commonly called the high opera¬
tion : he taught it to Mariano Santo de Berletta, a lur-
geon at Naples, who defcribed the particulars of it in a
feparate treatife, publifhed at Venice in 3543, wherein he
profefies to have been a pupil of Romani. It is probable
that previous to this time no other method of operating
was praCtifed than that known under the name of the
J mailer apparatus, which can be employed only on children
under fourteen years of age. In fome rare inftances
which are related by Benivieni and Chrift. de Vega, par¬
ticularly in women, the ftone had been found in the ure¬
thra itlelf, in which cafes it could be more eafily ex¬
tracted. But, fince that period, the pafifage was cleared
by the application of the gorget, by means of which the
forceps could be introduced into the bladder. Mariano
Santo made ufe of the following apparatus:' he firft em¬
ployed a curved found, which he introduced into the
urethra fo as to direct the point to the left fide ; he ex-
prefsly cautioned the operator againft the incifion into
the perinaeum, and is therefore unjuftly cenfured for hav¬
ing attempted the incifion in the middle. His found was
excavated, and he performed the incifion in the direction
of the groove; then introduced the found, and along with
it the conductors, and afterwards the gorget, which, ac¬
cording to its original conftruCtion, terminated in a blunt
point; and laftly, he extracted the ftone with the forceps,
and removed the remaining particles of it, as well as the
gravel or fand, by means of the litbotomical fpoon. By
the application of the blunt dilator, the parts were ne-
ceffarily lacerated, and the wound occafioned by this la¬
ceration could not be healed without great difficulty.
Hence Le Dran endeavoured to improve upon this me¬
thod, efpecially by making an incifion through the prof-

tate

23

PATHOLOGY.

fate gland and the bladder with his guarded knife ( cou-
teuu en rondaclie); and the immortal Schmucker of Ber¬
lin was uncommonly fuccefsful in ufing the great appa¬
ratus for lithotomy in that improved ftate.

The difcovery of the high operation was the work of
necefiity and accident. Peter Franco, of Turrieres in
Provence, furgeon at Berne, Laufanne, and Orange, was
requefted in the year 1560 to perform this operation for
lithotomy, at Laufanne, on a child two years of age. He
had already begun to operate with the fmall apparatus,
when he found that the Hone was of the fize of a hen’s
egg, and confequently too large to be removed in that
manner. The child’s parents infilled that the operation
Ihould neverthelefs be finilhed; and, as the bladder very
much projefted above the ofla pubis, he determined
upon making the incifion above thefe bones. Although
he eventually fucceeded in this bold attempt, yet he pru¬
dently diffuades his brethren from imitating that practice;
and indeed the danger to be apprehended from the effu-
fion of the urine into the abdomen is fo great, that even
the improvements made by Douglas, on the high appa¬
ratus of Franco, have not much diminilhed it. In order
to remove the lione from female patients, Franco rejefts
both the large and fmaller apparatus, while he propofes
merely the dilatation of the urethra, by means of an in-
ilrument invented by himfelf; after which he extracts
the Hone with the forceps, without difiefting the parts.
He likewife invented a gorgeret, and a forceps, the arms
of which expand in the bladder; but the ufe of thefe
inftraments has been fuperfeded by others that are more
convenient.

A very painful but curious operation excited great at¬
tention during this century, although it had been pre-
vioufly performed. The reader will perhaps fmile at an
attempt to repair and reftore that prominent part of the
human face, the nofe, when mutilated by accident.
Barri, an Italian author, in his “ Italia illuftrata,” 1600,
ccmfiders Vincent Vianeo as the inventor of this lingular
pra&ice. However that may be, two Sicilian furgeons
of the name of Branca, father and fon, had, fo early as
the latter end of the fifteenth century, acquired celebrity
by the fuccefsful renovation of nofes; an art which be¬
came hereditary in the family of the Bojani. But Caf-
par Tagliacozzi, profefl'or at Bologna, railed this art to
fuch high perfe&ion, as to render it one of the principal
branches of furgery : he became fo celebrated by his ope¬
rations, that his contemporaries erefted a public monu¬
ment at Bologna, where he is reprefented with a nofe in
his hand. This operation is defcribed in an interefting
work, intitled, “ Tagliacot. de Curtor Chirurg.” fol.
Venet. 1597 ; in which he compares it to the ingrafting of
trees, expatiates on the dignity and ornament of the nofe,
and endeavours to prove that there is not the leaf! danger
in cutting out a piece from the biceps mufcle of the arm.
With refpeft to the diet to be obferved during the ope¬
ration, he gives ample and rigid inftrudlions, while he
maintains that the inoculated nofe is poflefled of a more
acute fra ell, and that it generally grows much larger and
ftrcmger than the organ which had been accidentally loft.
We may fuppofe that this operation became lefs fuccefs¬
ful in the hands of other furgeons, and fo fell into difufe
and contempt, as we find it ridiculed by Butler in the
s 7th century :

So learned Taliacotius from

The brawny part of porter’s bum

Cut fupplemental nofes, which

Would laft as long as parent-breech;

And, when the date of that vras out,

Off dropt the fympathetic fnout. Hudibras, Canto i.

It has, however, been revived in the prefent day ; and
has been praftifed with great fuccefs by Mr. Carpue, Mr.
Linn, and others.

We might here mention the names of other practitioners
who improved and illuftrated the ufeful art of furgery : as

John de Vigo, Jacob Berenger de Carpi, and Mariano Santo
de Berletta ; tile latter of whom abolifhed the aftual cau¬
tery in haemorrhages, and urged the fuperiority of a pro¬
per ligature. The anatomift Fallopius, likewife culti¬
vated furgery with fuccefs, as did moft of the anatomifts
of his age; and among them we might enumerate many
who have contributed important improvements, would
our limits permit.

The obftetric art, that important branch of furgery,
began to emerge from its barbarity during the fixteenth
century, and to excite the attention of furgeons more
than it had hitherto done. There appeared feveral in¬
troductions to midwifery, the greater number of which,
however, contained much ufelefs and abftrufe reafoning
on the generation of man, and the vitality of the em¬
bryo in certain months, while they were extremely defi¬
cient in well founded and practical rules for facilitating
delivery. See the article Parturition in the preceding
volume.

The military furgeons of ancient times are very little
mentioned in hiftory. Perhaps they were not in very
great eftimation 3 as feems probable from the perfons
with whom they are claffed in the military code made at
Mans by Henry V. where, under the head of the perfons
fubjeCt to the conftable and marfiial, the mediei are intro¬
duced in the following company : “ Whether foldiers,
flioemakers, taylors, barbers, phyficians, or ■wajher-wo-
men.” See Upton de Re Militari.

The low ftate of military furgery in France, even fo late
as the time of Francis I. (contemporary with our Henry
VIII.) may be gathered from the following extraft from
an old and fcarce book called TreuJ'ure of Ancient and
Modern Times : “In the year of our Lord 1536, the vic¬
torious king Fraunces fent a great army into Piedmont
to vitaile Thurin, &c. I was at that time but a young
chirurgion, and but little experienced in the art, becaufe
I never had as yet feen the curation of wounds made by
gun-fhot. True it is, I had read John de Vigo, his firfte
booke of wounds in general!, chap. 8. where he faith,
that thofe wounds made by fiery engines do participate
of venenofity, becaufe of the powder 5 and for their cura¬
tion he commands to cauterize them with the oile of
elders, mixed with a little treacle. Yet nevertheleffe,
becaufe I would not be deceived, before I made ufe of
the faid boyiing oile, knowing that it brought extreme
paine to the patient, I obferved the method of other chi-
rurgeons in the firft drefiinge of fuch wounds, which
was by the application and infufion of the aforefaid oile,
as hot as poflibly they could fuffer it, with tents and
fetons ; wherefore I became emboldened to do as they
did. But in the end ray oile failed me, fo that I was
conftrained to ufe, inftead thereof, a digeftive made of the
yolk of an egge, oil of rofes, and terebinth. The night
following I could hardly deep at mine eafe, fearing left
that, for want of cauterizing, I ftiould find my patients,
on whom I had not ufed the aforefaid oile, dead and em-
poyfoned; which made me rife early in the morning to
vifit them, where, beyond my expectation, I found them
on whom I had ufed the digeftive medicine, to feele but
little paine, and their wounds without inflammation or
tumour, having refted well all that night; the reft, on
whom the aforefaid oile was applied, I found them incli¬
ning to feavers, with greate paine, tumour, and inflam¬
mation, about their wounds ; then I refolved with my-
felfe, never to burne fo cruelly the wounded patients by
gun-fliot any more. A famous chirurgion at Turin,
propofed a balm for gun-lhot wounds as follows: Two
young whelps, one pound of earth-worms, two pounds
of the oil of lilies, fix ounces of the terebinth of Venice,
and one ounce of aqua vitae. In my prefence he boiled
the w'helps alive in the faid oile, untill the flelh deferted
from the bones afterwards he took the worms, having
before killed and purified them in white wine, to purge
themfelves of the earth which they have always in their
bodies ; being fo prepared, he boiled them alfo in the

3

24 PATHOLOGY,

faid oil, till they became dry; this he ftrained thorow a
napkin without any great expreffion ; that doone, hee
added thereto the terebinth ; and laftly the aqua vita; ;
and called God to witneffe that this was his balme, which
he ufed in all wounds made by gun-lhoot, and in others
which required fuppuration; withall praying me not to
divulge his fecret.”

How terrible muft have been the ftate of the military
hofpitals, and what numbers of men muft have fallen a
facrifice to ignorance, who under proper management
might have been recovered to the fervice of their country!
But, bad as the furgeons were, fome were neverthelefs
necefiary in curarmies; and, although thegeneral modeof
railing and paying them is not handed down, certainly
fome regular form of doing it muft have exifted.

In the wardrobe-account of the pay of the army raifed
againft the Scots, byHenryll. in the 15th yearof his reign,
many of the Wellh corps have an officer ftyled Medicus ;
but whether by that term a phylician or furgeon is meant,
feems doubtful, as the word medicus is foinetimes ufed
for both a furgeon and an apothecary. None of thefe
phyficians or furgeons are charged to the Englifii levies.
And to the Welch they feem to bear no regular propor¬
tion to the number of private men; a corps of 1907
men having only one, and another of 968 having two ;
the wages of all, except the two laft-named, was 6d. per
diem each ; thofe which were raifed on the king’s land in
Cardiganfhire had only 4d. each per diem.

In the lift of the troops that attended Edward III. to
the liege of Calais, only one furgeon is mentioned, who
feems to have been part of the retinue of the prince of
Wales; and, in the military eftablilhment of the 18th
df. the faid reign, as given in the accounts of Walter
Wentwayt, treafurer of the houfehold, there is one fur¬
geon for the king’s houfehold-troops ; four dodlors and
one furgeon. for the army of North Wales; two doftors
and one furgeon for that of South Wales ; a fupply by
no means competent to the number of men to which they
were appointed. Suppolingthe inferior furgeons to have
been ftyled barbers, like the field-lhaver of the Germans,
it feems reafonable to expefl they would fomewhere ap¬
pear on the mufter-roll.

Henry V. A. D. 14.15, engaged Mailer Nicholas
Colnet, a phylician, to ferve him for one whole year, in
the voyage then to be made either to the duchy of
Guyenne or France. Colnet was to bring wdth him
three archers. If the expedition went to Guyenne, he
was to have for his own wages forty marks, and twenty
marks for each of his archers, for the whole year. If
to France, for his own wages is. and to each of his
archers 6d. a day, with regards. In the fame year the
king engaged Thomas de Moreftede, a furgeon, who
contradled to bring with him twelve other furgeons and
three archers. Moreftede was to be paid as a man at
arms, iad. by the day; and his- twelve alfiftants and three
archers, each 6d. with the ufual regard. The fame con¬
ditions were covenanted, in cafe the campaign lay in
Guyenne, that were made with Colnet. Upon a peti¬
tion, the king granted Moreftede one waggon and two
fumpter-horfes, for the carriage cf the baggage and ne-
ceffaries for himfelf and the twelve other furgeons. He
likewife petitioned for money to buy necelfaries for his
office, but it was not granted. The next year the king
employed Moreftede, joining with him William Brede-
wardyn, with the title of his furgeons, in a ccmmilfion
to imprefs as many furgeons as they thought necefiary
for the expedition, with a fulficient number of artificers
for making their inftruments, to be taken wherever they
could be found.

Among the different perfons who indented in the 14th
of Edward IV. to ferve that king in Normandy and
France, for one year, are the following phyficians and fur-
geor.s : Mailer jacobus Fryle, king’s phyfician, 2s. per
diem, with twolervants at 6d. per diem; Mafter William
Hobbis, phylician and furgeon of the king’s body, iSd.

per diem; feven furgeons at i2d. and five other furgeons
every one at 6d. per diem, for their attendance in the
faid fervice beyond fea. It is remarkable, that here are
juft twelve furgeons, the fame number that appears to
have been employed on the expedition under Henry V,

In the expedition to St. Quintin’s in the reign of
Philip and Mary, 1557, an army confiding of five hun¬
dred heavy armed horfe, five hundred light horfe, four
thoufand foot, and two hundred pioneers, with officers
and a train of artillery proportionable, there were fifty-
feven furgeons, tw’o of them belonging to the fuite of
the general, one to the lieutenant-general, one to the
high marifchal, one to the general of the horfeman, one
to the general of the infantry, and one to the mafter of
the ordnance ; all thefe at the daily pay of 1 s. each. The
remainder belonged to the corps of horfe, light horfe,
and infantry, in the proportion of one furgeon to an
hundred men ; the daily pay of a furgeon of heavy
horfe was 2s. of light horfe is. 6d. and of infantry is.
No furgeon is charged for either the ordnance or pioneers.

Befides the king’s pay, it feems as if the furgeons of
former times, as well as thofe of late, received a weekly
ftoppage from the private men. This may be gathered
from the following defcription of the duties of a mili¬
tary furgeon, written in the reign of Queen Elizabeth,
“Surgeons ffioulde be men of fobrietie, of good con-
fcience, and fkillfull in that fcience, able to heal all
foares and woundes, fpecially to take oute a pellett oute
of the fame. All captaines muft have fuche furgeons,
and ought to fee them to have all their oyles, balmes,
falves, and inftruments, and necefiary ftuffe to them be-
longinge, allowinge and fparinge carriadge for the fame.
That every fouldier, at the paye daye, doe give unto the
furgeon 2d. as in tymes paji hathe bcene accujlomed, to the
augmentation of his wages ; in confideration whereof,
the furgeon oughte readilieto employ his induftrie uppon
the foare and wounded fouldiers, not intermedlinge with
any other cures to them noyfome. Regarde that the
furgeon bee truelye paid his wages, and all money due
to hym for cures, that bye the fame hee maye bee able to
provide all fuche ftuffe as to him is needfull. Such fur¬
geons mufte weare their baldricke, whereby they may be
knowen in the tyme of daughter : it is their charter in
the field.” From this paffage it Ihould feem that fur¬
geons formerly wore a diftinguilhing belt over their
ftioulders, like that now ufed by the itinerant farriers,
vulgarly ftyled fow-gelders, in order to prote6l their per¬
fons whilft adminiftering to the wounded in the field of
battle ; a precaution now rendered unneceffary by the
apparatus of bandages, &c. carried by furgeons attending
a party where fervice is expeiled, or in a field of battle.

In an eftimate made, anno 1620, for an army of twen¬
ty-five thoufand foot, five thoufand horfe, and twenty
pieces of artillery, propofed by king James to be fent to
the Palatinate, a number of furgeons is appointed, but
no allowance or provifion whatever appears in the efti¬
mate for medicines or an hofpital, although there is a
very minute detail of almclt every other necefiary (lore ;
and this feems the more extraordinary, as many of the
moft experienced officers of that time were called in to
affift in forming the eftimate. The medicinal lift appointed
for this expedition were : “ In the general’s trayne, two
phyficians, at 6s. 8d. per diem each ; two apothecarys, at
3s. 4d. and two furgeons, each at 6s. 8d. Every regU
mentof foot confifted of twelve companies of 150 men each,
and had one chief furgeon, at 4s. per diem, and another
furgeon to each company at is. per diem. Among the
general officers of horfe is one chief furgeon at 4s. a-
day, probably to fuperintend the furgeons of troops. To
every troop, which was to confift of a hundred men, one
furgeon was allotted ; his daily pay, 2S. 6d. To the ord¬
nance, pioneers, &c. there was allowed one barber-fur-
geon, at 2s. per diem ; and two under barber- furgeons,
at 6d a-day each.”

Or.e realon may be affigned for our ancient armies

being

25

PATHOLOGY.

being able to do with fo fmall a number of furgeons ; which
is, that, immediately after a battle, fuch of the meaner
fort of foldiers, whofe wounds feemed to require a con-
fiderable time for cure, were by the general difmifled,
with a fmall pecuniary provifion to carry them home :
this, according to Barnes’s Hillory of Edward III. was
done immediately after the battle of PoiSliers. Perhaps
likewife the inferior furgeons, ftyled barbers, were taken
from the ranks, and therefore paid and multered as pri¬
vate men.

The prafticeof medicine did not keep pace in improve¬
ment with anatomy and furgery. In the early part of
the i6th century the moll conspicuous name we meet
with is that of Paracelfus. This- bold and conceited che-
mill, who had been' greatly neglefted in his education,
endeavoured to combine the principles of alchemy, me¬
dicine, and altrology. He travelled much in fearch of
remedies, which he did not difdain to accept from old
women, gipfies, and conjurers. He acquired very great
reputation ; and on his return to Germany he was ap¬
pointed profeffor of furgery to the univerfity of Bade.
The pathological dodlrines of Paracelfus are very im¬
perfectly underltood. It appears, however, that he ad¬
mitted three component parts of the animal body, fait,
mercury, and fulphur. We mull not fuppofe that he
carried his notions fo far as to conceive that thefe che¬
mical fubllances were really exillent in our frame. On
the contrary, he appears to have merely ufed the above-
mentioned terms to ill ullrate his meaning by analogy.
Thus, mercury is fuppofed to mean the principle of fluid¬
ity, fulphur that of inflammability, and fait folidity. The
vital principle of Paracelfus he denominated Archaus$ it
was feated in the Itomach, and was the principal agent
in digeftion; it feparated the noxious, and prepared for
aflimilation the nutritious, parts of our aliment, with a
great deal of intelligence, and was the principal agent in
the recovery and prefervation of health. Paracelfus like¬
wife mentioned a humour as producing difeafe, though
he had abufed with fo much virulence the humoral pa¬
thology of Galen. This humour he called Turturus ; it
produced rigidity of the folids, vifcidity of the fluids,
See. but it fhould be remarked, that this author did not,
like Galen, impute difeafe to the prefence of humour,
but humour to difeafe; for the proximate caufe of this
Tartarus he contended was the irregular aCtion of the
Archsus, or prefiding fpirit. He moreover mentioned
five remote caufes of difeafe, viz. ens ujlrule, ens veneni, ens
naturale, ens fpirituule, and ens deale. Diverted of che¬
mical jargon and obfcurity, the theory of Paracelfus feems
to be this. He remarked, with many others before him,
the three principles of the animal frame ; folidity, fluidity,
and contradlility or irritability ; and he endeavoured to
trace their origin in fubllances which poflefl'ed properties
bearing to them a remote analogy. In the fecond place,
in tracing the phenomena of difeafe, he referred to the
defective or inordinate energy of the vital power the alfi-
snilation of noxious particles of food into the blood:
hence a humour which, circulating in all parts, produced
the varied phenomena of difeafe. Paracelfus in his prac¬
tice ufed the chemical remedies with fome luccefs : he
has the merit of firft introducing mercury as a cure for
the venereal difeafe, which had before his time been
treated with inert quintefcences, diet-drinks, guaiacum,
Sec. He was likewife the fit'll who prefcribed opium freely ;
and he was no friend to that abfurd practice, which had
come into vogue with the Arabian phyficians, of com¬
pounding 50 or 60 fimples together, under the miftaken
notion that all the fubllances would retain and exert their
feparate virtues, or that among fo great a number forne-
thing would be found applicable to the cafe.

Modern pharmacy may be faid to commence about the
middle of the fifteenth century, at which time it appears
to have been in a moll deplorable ftate of empirical bar¬
barity. Though it is probable that, among the earlier
pradlitioners of medicine, remedies were employed in

Vol.XIX. No. 1284.

their moll Ample forms, the art of compounding a num¬
ber of fimples together into one medicine had, by the
time of which we are now fpeaking, arrived at a pitch of
extravagance which has never been exceeded. What
carried this oftentation of compofition to thehigheft ex¬
cels, was the project of framing antidotes, which being
previoufly adminiftered, might defend againft any poifon
whatever that fliould afterwards be taken into the body.
To this fcheme is owing the multitudinous compofition
of the celebrated Mithridate and the Theriaca; for fuch
medicines muft of courfe recommend themfelves by the
number and variety of their ingredients, as they were to
contain a proper antidote for every poflible fpecies of
poifon, and more el'pecially as thefe compofitions were
to be farther wrought up into little lefs than univerfal
remedies forall difeafes to which the human body is fubjedt.

The firft of thefe antidotes was faid to be compofed
from the refult of experiments made feparately with all
kinds of Ample antidotes by the famous king whofe name
it bears 5 but, as no records are left us of any of thofe
particular experiments, we may reafonably confider this
tale as fabulous. As’ it is not likely that this medicine
or the Theriaca will ever again appear in our Pharmaco¬
poeias, we Ihall, for the amufement of our readers, de-
feribe the compofition of each, as given in the London
Pharmacopoeia publifhed in 1746.

The Mithridate is thus compofed. “ Take of
cinnamon 14 drams, of myrrh n drams ; agaric,
fpikenard, ginger, faffron, feeds of treacle muftard, or
of mithridate muftard, frankincenfe, Chio turpentine
of each 10 drams; camel’s hay, coftus, or in its Head ze-
doary, Indian leaf, or in its Head mace, French lavender,
long pepper, feeds of hartwort, juice of the rape of cif-
tus, ftrained ftorax, opoponax, (trained galbanum, balfam
of Gilead, or in its Head exprefled oil of nutmegs, Ruffian
caftor, of each an ounce ; poley-mountain, water-ger¬
mander, the fruit of the ’balfam-tree, or in its Head cu-
bebs, white pepper, feeds of the carrot of Crete, bdellium
ftrained, of each feven drams; Celtic nard, gentian-root,
leaves of dittany of Crete, red rofes, feeds of Macedonian
parfley, the lefler cardamom-feeds freed from their hulks,
fweet fennel-feeds, gum Arabic, opium ftrained, of each
five drams ; root of the fweet flag, root of wild vale¬
rian, anile-feed, fagapenum ftrained, of each three drams ;
fpignel, St. John’s wort, juice of acacia, or in its Head
Japan earth, the bellies of feinks, of each two drams and
a half; clarified honey, thrice the weight of all the reft.
Difl'olve the opium firft in a little wine, and then mix it
with the honey made hot; in the mean time melt toge¬
ther in another veffel the galbanum, ftorax, turpentine,
and the balfam of Gilead, or the exprefled oil of nutmeg,
continually ftirring them round, that they may not burn ;
and, as loon as thefe are melted, add to them the hot
honey, firft by fpoonfuls, and afterwards more freely:
laftly, when this mixture is nearly cold, add by degrees
the reft of the fpecies reduced to powder.”

The preparation of the Theriaca Andromuchi, or Venice
treacle, is thus directed. “Take of the trochesof fquills,
half a pound; long pepper, opium ftrained, dried vipers,
of each three ounces; cinnamon, balm of Gilead, or in
its Head exprefled oil of nutmeg, of each two ounces ;
agaric, the root of Florentine orris, water-germander, red
rofes, feeds of navew, extradl of liquorice, of each an
ounce and a half; fpikenard, faffron, ammomum, myrrh,
coftus, or in its Head zedoary, camel’s hay, of each an
ounce; the root of cinque-foil, rhubarb, ginger, Indian
leaf, or in its Head mace, leaves of dittany of Crete, of
horehound, and of calamint, French lavender, black
pepper, feeds of Macedonian parfley, olibanum, Chio
turpentine, root of wild valerian, of each fix drams ;
gentian-root, Celtic nard, fpignel, leaves of poley-
mountain, of St. John’s wort, of ground-pine, tops of
creeping-germander with the feed, the fruit of the
balfam-tree, or in its Head cubebs, anifefeed, fweet fen¬
nel-feed, the lefler cardamom-feeds freed from their
H hulks,

20

PATHOLOGY.

hulks, feed of bilhop’s-weed, of harttvort, of treacle-
muitardor mithridate-muftard, juice of the rape of ciftus,
acacia, or in its ftead Japan earth, gum Arabic, iforax
drained, fagapenum ftrained, Lemnian earth, or in its
Head bole-armenic or French bole, green vitriol calcined,
of each half an ounce ; root of creeping birtluvort, or in
its Head of the long birthwort, tops of the lefler centaury,
feeds of the carrot of Crete, opoponax, galbanum ftrained,
Rullia'caftor, Jews pitch, or in its Head white amber pre¬
pared, root of the fweet flag, of each two drams ; of cla¬
rified honey thrice the weight of all the reft. The ingre¬
dients are to be mixed in the fame manner as in the
Mithridate.” The Theriaca may be confidered as a
modification of the Mithridate by Andromachus, though
we are not informed what were his reafons for the varia¬
tions, except that by the addition of the viper’s fielh the
medicine was rendered more ufeful againft the bite of
that animal. The Theriaca was in fo great repute before
the decline of the Roman empire, that even the wife
Marcus Aurelius was induced to make a daily ufe of it,
to' the great prejudice of his health ; for we are told by
Galen, that his head was fo much affedted, that he dofed
in the midft of bufinefs ; and, when on this account he
omitted the opium in the coinpofition, he could not lleep
at all.

When the alchemifts had extended the bounds of their
art from the mere drudgery of manufacturing gold and
filver to the more noble and phiiofophic employment of
compoling an univerfal elixir that fhotild fecure its pof-
fefior from difeafe, and prolong his life to an indefinite
period, pharmacy derived from their labours confiderable
and folid advantages. The experiments inftituted by
thefe vifionaries with the metals, led to the accidental
difcovery of fome of the molt efficacious remedies which
we at prefent employ, efpecially the preparations of anti¬
mony and mercury, and molt of what are called the neu¬
tral or fecondary 1'alts. By calling in the aid of fire, they
’ enabled us to produce in bodies changes which, with¬
out the affiftance of this powerful agent, we fhould have
been unable to efl'eCt. Now, every thing was fubmitted
to digrjhon, calcination, fermentation, diftillation , and fitb-
limution-, but, as generally happens in cafes of innovation
or reform, thefe new methods of obtaining active reme¬
dies were carried to an abfurd and ridiculous extent.
Finding that the healing powers of many fubftances were
eliminated or increafed by the application of heat, they
feemed to imagine that the fimple medicine could in no
cafe poffefs any medical virtue till it had been
placed upon the fire or kept for fome hours in a
furnace. Hence the immenfe number of diftilled waters
and fpirits, elfential and empyreumatic oils, with which
the old pharmacopoeias are crowded, and which feem in
many cales to poliefs no other powers than what they de¬
rive from the water or the fpirit that forms the bulk of
the preparation. Not only plants and minerals, but ani¬
mals and animal matters of all kinds, were diftilled, di-
gefted, or calcined. Thus, we find a water of Jhails, a
fpirit of millepedes , an oil of earth-worms. See, See. The
abfurd and pompous names by which the preparations
were diftinguifned, are truly ridiculous. Magijierial
balfqm, Hicra picra, Ethiops mineral, Ens Veneris, Flores
Martis, Calmnclas, Aqui'tu alba, are a few which long re¬
tained their feat both in public and private difpenfatories.
As’ thefe preparations were, from their contrivers, deno¬
minated chemical, the more ancient medicines which
■were drawn almcft entirely from the animal and vege¬
table kingdoms, were denominated Galenical, becaufe
chiefly employed by the followers of Galen. Hence the
divifion of medicines into Galenical and Chemical, a divi-
fion which obtained for fome hundred years, and which
only a few years ago was prelerved in the fale-caialogues
of the London druggifts.

The chief follower of Paracelfus was Van Helmont. He
made many important chemical difcoveries ; ftrongly op-
poled the Galenical dodlrir.e ; and, though often milled in

his fpeculations by a ftrong bias to theofophifm, he ob-
ierved Nature very attentively; he pointed out more
fully than Paracelfus had done, the influence of the epi-
gaftric organs on all the other parts of the lyftem ; and he
gave fome account of the origin of urinary calculi. The
nature of inflammation was likewife explained by him,
and the pernicious confequences of exceffive bleeding
welfpointed out. Van Helmont had not, however, many
adherents at the time he lived. His theory was afterwards
taken up by Defcartes, who attempted to explain all the
phenomena of life according to chemical and mechanical
principles. Thus, the circulation of the blood and animal
heat were produced, according to him, by the ebullition
or fermentation that took place in. the heart; digeltion
was likewife performed by a fpecies of fermentation ; and
the fenfation of hunger proceeded from the acid which
was evolved during the procefs. To explain the nature'
of fecretion, Defcartes had recourfe to> the corpufcular
philofophy; comparing the fecreting organs to lieves,
which allowed only the more minute and homogeneous
particles to pafs through, while the coarfer and hetero¬
geneous bodies were rejected : the round particles were
luppofed by him to enter into cylindrical tubes ; pyrami¬
dal particles penetrated by triangular pores, and cubical
particles by fqtiare pores; and in this way each fecretion
remained diftindt, at leaft in the healthy ftate. Thefe
ideas were eagerly embraced by the Dutch phylicians of
the time, and may be confidered as forming the ground¬
work of the chemical and mechanical fyftems, which di¬
vided the medical world at the end of the fevenreeuth cen¬
tury, notwithftanding the claims to originality which le-
veral of their followers have put in.

After the revival of genuine philofophy in the fixteenth
century, it might naturally be expected that medical fci-
ence would immediately avail itfelf of its light, and par¬
take of its benefit; but this was fo far from being the
cafe, that, in the firft inftance, it proved a new fource of
error, and threw f re fin impediments in the road which was
fuppofed to be opened to the improvement of rational
medicine. The difcovery of the circulation of the blood
may, indeed, be confidered as one of the firft fruits of the
inquiries into nature begun in that age. But, though
this is a fundamental element in the economy of the
living body, it throws little or no light on the principles'
peculiar to life, being purely of a mechanical nature ; and,
abftradtedly confidered, hardly admits of any application
to the pradiice of medicine. On the contrary, this difco¬
very, by its perverted application, tended to corrupt and
millead, by a loofe adoption of the principles of mechani¬
cal philofophy, fo well laid down in that age by Galileo
and others. Boreili, in inveftigating the force of the
heart by experiment, eftimated it at 180,000 pounds;
Hales, at 51 pounds; Keil, at 1 pound. The mechanical
powers of the ftomach were, about the fame time, fub-
jedled to experimental refearch by Pitcairn, who gravely
gave out that he found this vifeus, in the human lubjedt,
exerted a force equal to 12,900 pounds, in compreifing
food in the procefs of digeftion. Others, conceiving that
chemical power had the chief lhare in this fundlion, en¬
deavoured to evince that the change in the foot! was
brought about by means of heat and fermentation.
Sounder principles have referred thefe changes to powers
which have nothing in common with the mechanical and
chemical powers which characterize inanimate nature.

From the picture that has been exhibited of the innu¬
merable doubts and difficulties which clog the attainment
of medical knowledge, and embarrafs the application of
it to pradrical purpofes, the timid, fceptical, and indolent,
may be difeouraged from ftudies apparently fo arduous in
their prol'ecution, and fo queftionable as to the efficiency
and utility of their refult. But it i§ not from charadlers
of this defeription that much good can be expedled in any
of the ufeful arts of life, If a like defpondency were to
pervade mankind in general, there would be an end to all
that enterprife and energy which alone can enable them

to

27

PATHOLOGY.

to aft up to their deftiny, and follow up thofe purfuits
upon which the perfection of their nature depends. As
the fenfes would have lain dormant for ever had there
been no external objefts to dimulate them, fo the faculties
and virtue which characterize rational nature and civilized
life could never have been developed, but through the
excitement of thofe pains, wants, difficulties, and dangers,
infeparable from human life. By no other arrangement
could our duties, our happinefs, our mental and bodily
perfections, have been bound togetherin one harmonious
and confillent fyltem. Let us compare the art of medi¬
cine, under this afpeCt, with thofe of navigation and
agriculture. Had man been furniffied by the Creator
with wings, by which he could have traverfed all feas and
oceans, fo as to fuperfede the life of ffiips, where would
have been that hardihood of character, and ail thofe inge¬
nious devices which have called forth the aCtive energies
and deep refearches of the human mind ? If, contrary to
the aCtual inltitutions of Providence, the life of man had
been fuftained by the fpontaneous productions of nature,
inftead of the products of indudry, neither the faculties of
the mind nor the powers of the body could ever have been
developed : man would have been little fuperior to the
brutes; his aCtive and inventive energies would have lain
alleep for ever ; there would have been no room for the
talents exercifed in the procuring of food, raiment, and
Ihelter, r.or in commercial intercourfe; all the mutual and
endearing ties and dependences of facial and civilized
life, all trades, profeffions, arts, and fciences, whether
miniltering to accommodation or elegance, conilituting
man's greatelt felicity, whether as objefts of purfuit or
enjoyment, would have been unknown and untafted. It
is obvious that this reafoning, being founded on a general
law of nature, mud apply equally to medicine. In a pro¬
bationary exiftence, it was neceffary that man ffiould be
tried, not only by pain and ficknefs, but by the difficul¬
ties of remedying them, as exercifes of virtue and inge¬
nuity. Why ffiould the road to medical relief lie through
fewer and (lighter druggies and dangers, than thofe of
navigation and agriculture ? But the fubjeCt is more
concifely and emphatically illudrated by the philofophical
poet, than by any amplitude of illudration, or farther
multiplicity of words which we could employ :

. - Pater ipfecolendi ( medendi),

Haud facilem efle viam voluit, primuique per artem,

Movitagros, (ggros,) curis acuens mortalia corda.

We ffiall conclude our view of the general date of pa¬
thology in the lixteenth century, with fome account of the
violent difputes which prevailed in France, on the prero¬
gatives of the medical art over thofe of furgery, but par¬
ticularly on theconteded privileges of the furgeons. Al¬
though the documents relative to this fubjeft have been
partly printed, or have at lead not been withheld from the
inlpeftion of hidorians, yet no part of medical hidory has
been condufted with more partiality, and lei's regard to
truth, by both parties. The author of the work entitled
“Recherches furl’Origine et la Progres de la Chirurgie en
France” is guilty of the grolfed mifrepreferitation, though
this book has by fome been afcribed to Franc. Quefnay.
Pafquier, in his “Recherches de la France,” fol. Paris,
1620, defervesmuch more credit; and, therefore, the mod
important points relative to that extraordinary difpute
are here briefly collefted from his more authentic
Aatement. And this alfo will remind the reader of flmilar
difputes in our own country, and about the fame time :
for, it has been already hinted, that, during great part of
the 16th century, furgery was praftifed indilcriminately
by barbers, farriers, and fow-gelders. We know that
barbers and furgeons continued for 200 years after to be
incorporated in one company, both in London and Paris.
d In Holland and fome parts of Germany, we are told, that,
even to this day, barbers exercife the razor and lancet
alternately.

The furgeons of Paris had, fince the time of Lanfranc,

(1295), formed a didinft body, called the College of St.
C6me ; and they obtained additional and refpeftable pri¬
vileges from Philip the Fair, in 1311, which entitled them
to equal rank with the members of the medical faculty;
hence they could not bear the idea that barbers ffiould
ul’urp the right of bleeding, applying pladers,and treating
external injuries and ulcers. In confequence of this en¬
croachment, the furgeons, in 14.25, obtained an aft or
arret of the parliament of Paris, by which the performance
of chirurgical operations was prohibited to the barbers,
while they were permitted to drel’s wounds, and extirpate
corns by the knife. But the phyflcians embraced the
caufe of the barbers, and indrufted them in the practice
of furgery, with a view to take revenge on the furgeons,
who, it was affirmed, had ufurped medical privileges.
The complaint of grievances which the furgeons, on this
occaflon, laid before the faculty, in the years 14.91 and
1494., were not attended with any efl'eft; and the members
of the faculty were even permitted to deliver anatomical
leftures to barbers in the French language. The furgeons
again, though in vain, reprefented to the faculty, that
they afted contrary to the laws made by themfelves, by
permitting their members to indraft barbers' in the
knowledge of anatomy, and this in their native language.
However, no other redrefs could be obtained, but that of
licenftng the furgeons to undertake public difleftions, and
of granting them a certain rank above the barbers, for
which they paid lixty folidos annually to the treafurer of
the faculty. This event took place in the year 1 502 ; and
in 1505 the furgeons renewed their application in the
charafter of fcholars or pupils to the faculty, whom they
intreated to confirm their privileges; but Helin, the
fenior of that body, fent them the difcouraging anfwer,
that their pretended rights or immunities had been ac¬
quired by furreptitious means.

In the fame year, the phylicians of Paris, as Pafquier
exprefles himfelf, “ palled the Rubicon,” and entered into
a formal contraft with the barbers, who, on account of
their implicit obedience, were patronized in preference to
the furgeons. The barbers were confequently, in con¬
tempt of the furgeons, pronounced to be “ the true fcho¬
lars of the faculty:” they were matriculated under that
name; but a promife was exafte'd from them, according
to which they were not allowed to adminider internal
medicines, without confulting, in every cafe, a member of
the medical faculty; they farther agreed to undergo an
examination, previous to their commencing bufinefs as
maders. After that period, the barbers were no longer
called Barbitovfores, the complaifmt faculty having con¬
ferred on them the more honourable title of Chiriirgici a.
Tonjtrina, or TonJ'o'res Chirurgici. A few days after this
change, the faculty proceeded to fuch extremities as to
profecute the furgeons in a court of law, becaufe they had
received information, that leveral furgeons had prefcribed
internal remedies without the previous advice of a
phyfician.

At that time, probabty, no man of genius and aftivity
prefded over the Coliege of St. Come ; for no fooner was
Stephen Barat elefted prefident of that college, than the
fituation of affairs was thoroughly changed. In the year
1515, he urged the faculty to exempt the fociety of fur¬
geons from the oppreffive tax they were obliged to pay an¬
nually, and not to compel them to attend the leftures
given by members of the faculty. As Barat addrefl'ed
himfelf to the whole univerfity, and as old Helin, the mod
zealous antagonid of the furgeons, died in the fame year,
this remondrance had the deiiredefleft. The univerfity
ilfued a decree, by which the furgeons of Paris were no¬
minated Scholu/tici, or perpetual fcholars of the faculty.
But diil greater immunities were granted to the furgeons
in 1545, by the good offices of William Vavafleur, principal
furgeon at the court of Francis I. He effefted a complete
feparaticn of the barbers from the furgeons ; and at the
fame timeobtained a decree, in conformity to which every
mafler of the chirurgical art, if he wiffied to obtain the

privilege

PATHOLOGY.

privilege of exercifing his profeflion, was obliged to ftudy
the Latin language, logic, and other elementary fciences.
By this favourable regulation, the College of Surgeons
was at once raifed to the rank of a learned fchool, and
obtained at length the right of creating Mailers, Bache¬
lors, Licentiates, and Doctors, of Surgery. In confequence
of this arrangement, Henry II. granted to the members
of the Chirurgical College of St. Louis, all the preroga¬
tives attached to a faculty ; and the patent ifl'ued on that
occafion was regiftered in the parliamentary laws, under
the name of Lettres d'Ociroi.

In the j’ear 1551, the medical faculty, under the
deanery of John du Hamel, re-commenced the difpute
againll the furgeons. Although Rudolph le Fort, dean
of the College of St. Louis, zealoufly defended the fur¬
geons, yet du Hamel found the means of procuring a re¬
peal of the decree enadled in 15155 and, contrary to the
fpirit of that law, the furgeons were again obliged to fub-
mit to an examination before the medical faculty. Under
Henry III. however, the furgeons once more obtained a
confirmation of their privileges, in 1577, by virtue of
which they were entitled to confer academical dignities ;
and, notwithftanding the newoppoiition of the faculty in
1579, the furgeons, as well as the univerfity of Paris, were in
the fame year favoured with an indult of pope Gregory
XIII. while de Thou vindicated the caufe of the former, in
a fpirited and fuccefsful manner, againft the opprelfions of
the faculty. The colleges fubfequently eitablilhed by fur¬
geons acquired fuch a degree of authority, that, in the
year 1596, they were empowered to give poll tive orders to
the barbers, in difficult chirurgical cafes always to con-
fult a fworn furgeon, and upon no account to undertake
the treatment of any other but the flighted: external inju¬
ries. Thefe privileges and prerogatives of the furgeons
of Paris were further confirmed by Henry IV. in 1602,
and by Louis XIII. in 1614.

About this time was framed the following oath, which
to this day is taken by every phyfician who takes a degree
at the univerfity of Montpelier. “ I, ■ -, be¬

fore the image of Hippocrates, in prefence of the profef-
fors of this fchool, and of my dear fellow-coilegians, do
fwear, in the name of the Supreme Being, to be faithful to
the laws of honour and probity in the exercife of medicine.
I will give my care gratuitoufiy to the indigent, and will
not exa6t a falary beyond my juft demands. Admitted
into the interior of families, my eyes fhall not fee what
they ought not to fee, nor fhall my tongue betray any
fecrets confided to me 5 nor fhall my profeflion be made
available to corrupt morals, or to favour guilt. Re-
fpeFtful and grateful to my mailers, I will endeavour to
return to their children the inltrmSlion which I have
gathered from the fathers. May men grant me their
efteem in proportion as I am faithful to this oath ; and
may I be difgraced among my colleagues when I fwerve
from it.”

III. From the Seventeenth Century to the present
Time.

The moll brilliant difcovery of the 17th century was
that of the circulation of the blood, by our countryman
Harvey, who was born in the year 1578. He firft opened
the difcovery in 1616, in his leisures in the Latin lan¬
guage, which are preferved in MS. in the Britiffi Mufeum ;
but his work, containing the details, was not publifhed
till the year 1628, when his “ Exercitatio anatomica de
Motu Cordis et Sanguinis in Animalibus” appeared at
Frankfort : and this is the only edition which bears the
ftamp of Harvey’s own authority. This treatife, which
Haller has moll appropriately flyled aurcum opufcuhm, is
conftrucled entirely upon the refult of experiment, and
contains an excellent arrangement of the fubjefit. The
author was now created phyfician to king Charles I. and
demonflrated the circulation before him in a living
animal.

The vail importance of this difcovery to the whole

fcience of phyfiology; the influence which it neceftarily
exerted on the doftrines of pathology ;■ and the general
revolution which arofe from this fource throughout the
whole circle of medical knowledge; will juftify us in
giving a flight hillorical fxetch of the fubjecl, and in
pointing out the opinions held by thofe anatomifts and
phyiiologifts who preceded- our immortal countryman
Harvey. To him, indeed, the glory of this greateft of all
phyfiological difcoveries has been affigned by the almoft
unanimous concurrence of his fucceffors. Some, however,
have endeavoured to deprive him of his well-earned fame,
by afcribing a knowledge of the circulation to various
preceding writers. Mr. Dutens, in the fecond volume of
his “ Recherches fur l’Origine des Decouvertes attributes
aux Modernes,” has brought forward paflages from
Hippocrates, Plato, Ariftotle, Julius Pollux, Apuleius,
and others, in order to prove that they knew the courfe
of the blood. After the pofitive dogmatical alfertions
with which the author fets out, we are furprifed by the
weaknefs and inadequacy of his proofs, and can only ac¬
count for the inconfiftency by fuppofing him to have been
utterly ignorant of the fubjedl. He quotes a few inf¬
lated paflages which cannot, by the moll favourable inter¬
pretation, beconftrued into the femblance of a proof, that
the writers in queftion knew the circulation of the blood.
But the only fair and unexceptionable method of deter¬
mining whether any individual was acquainted with a
particular fa 61, is to confider all that he has faid on the
iubjedl, and to draw our inferences from the refult of this
general examination. Such an inquiry will prove moll
clearly, that a knowledge of the circulation, fuch as we
pofiefs at prefent, can be afcribed to no one before
Harvey ; although a part of the fubje£t,viz. the paflage of
the blood through the lungs, had been defcribed by feve-
ral perfons before the time of that illuftrious character.

That the blood moves, has been univerfally known and
admitted, fince the fcience of medicine has aflfumed a dif-
tinfl form : how much of its courfe, and of the laws that
regulate its motion, has been afcertained at any given pe¬
riod, is another queftion. The circulation is fo generally
known in the prefent day, and the proofs on which it refts
are fo obvious and familiar to every tyro in the profeflion,
that we feel furprifed how they Ihould fo long have ef-
caped the obfervation of the numerous ingenious and
learned characters, whofe names adorn the annals of ana¬
tomy. We muft remember that the courfe of the blood,
taken altogether, forms a fubjeft of confiderable intricacy;
that the purfuit of anatomy was attended in the early
periods of the fcience with confiderable difficulty and
danger; and that the unlimited fway which the authority
of Galen held over the minds of men for fome centuries,
precluded all attempts at further inveftigation.

Hippocrates Hates that the blood meets with obftacles
in its courfe, which retard or entirely arreft its progrefs;
that it goes from the internal parts towards the furface ;
and vice-verfd, that the blood muft flow forwards from
the heart, fince the valves hinder its return, and that the
arteries are diftended when their blood is flopped. In
fpeaking of the blood’s motion, he compares it to the
courfe of rivers, to the ebbing and flowing of the fea, and
even to the revolutions of the planets. He affigns the
origin of the arteries to the heart, and that of the veins
to the liver; and fuppofes that there are two oppofite mo¬
tions in the temporal arteries, by which their pulfations
are produced. He fpeaks of four fluids in the body, the
blood, water, mucus, and bile, which come from the
heart, head, fpleen, and liver; all thofe parts are, how¬
ever, fuppiied from one principal fource, the ftomach.
Can we difcover any traces of a knowledge of the circu¬
lation in this confulion of ideas; and may we not be
jullly furprifed, to find that enlightened men Ihould be
fo led away by their prejudices, as to allow to Hippocrates
the knowledge of a difcovery, which no one had per¬
ceived in his writings for nearly three thoufand years ?
The obfervations of the founder of medicine had led

aftray

x

PATHOLOGY.

a ft ray all who followed him to the time of Harvey; but,
when the refearches of that great man had unfolded the
myftery of the circulation, his enemies dared to affirm,
that the writings of Hippocrates had furnilhed the lights
which guided him in the path of difcovery.

The philofophers who joined theftudyof medicine to
that of the other fciences, feem to have been equally ig¬
norant of the laws which regulate the blood’s motion.
Thus, Ariftotle exprefsly ftates that the blood never re¬
turns to the heart. The Alexandrian anatomifts main¬
tained that the arteries held no blood, but were filled
with air; from which circumftance they gave them the
name, which they have conftantly retained, from a»p, air,
and T'/jfsw, to hold. To explain the occurrence of blood
in thele veflels after death, they fuppofed the exiftence of
fubtle communications with the veins.

The genius of Galen difdained to follow blindly the
iteps of his predeceffors ; and he endeavoured at leaft to
difcover the truth by experiments and obfervations on
the ftrmSture of the body. By thefe means he afcertained
fome fafts, although he could not fucceed in piercing the
veil which concealed the fecret of the circulation. He
feems to have recognized the ufe of the valves at the two
orifices of the ventricles. He proved, by tying an artery
with two ligatures, that thefe veflels contain blood during
life; and ftates that they are filled by the contraction of
the heart, in confequence of which they pulfate. Thefe
circumftances feem to indicate a confiderable advance¬
ment in the knowledge of the circulation ; but we mult
mention, in the fame fpirit of impartiality, the contradic¬
tions and uncertainty which prevail in the works of
Galen on this fubjeCt, and the limits which his labours
could not exceed. He ftill referred, with Hippocrates,
the origin of the veins to the liver, and fuppofed a paflage
of the blood through thefeptum of the ventricles, while
a fmall portion entered the pulmonary artery to nourilh
the lungs : he imagined, lallly, that it might pafs recipro¬
cally between the pulmonary artery and veins.

There could be little reafon to expeCt, that in the
troubled and barbarous times which followed the age in
which Galen fiourilhed, the fecret of the circulation
fliould be difcovered ; ftill lefs that it Ihould be explained
to phyficians by men whofe purfuits were foreign to the
fcience of medicine. Yet it has been boldly afierted
that Nemefius, bifhop of Emefa, knew' the courfe of the
blood, as it has been afcertained by the fubfequent la¬
bours of Harvey. The editor of the Oxford edition of
his works, has imbibed the true fpirit of a commentator ;
who difcovers in the writings of the ancients, meanings
which never were in the contemplation of the authors;
and abufes the moderns as plagiarifts, for decorating
themfelves with the difcoveries of antiquity. But on what
grounds does Nemefius claim the honour of a difcovery,
denied to fo many great geniufes ? Becaufe, according
to Freind, the bifnop ftates, that the blood palfes from the
arteries into the veins during fleep. This reftriftion im¬
mediately overturns the claim ; which would indeed be
deftroyed by the kind of motion that he fuppofes to take
place, viz. a reciprocal alternation of undulations, like
that of the Euripus. In another paflage cited by Dutens,
he fpeaks of the arteries in their dilatation attracting the
blood from the veins; but this paflage, which we have
already quoted at p. 16, fufficiently proves that he knew
nothing of the matter; and exemplifies ftill further the
abfurdity of a perfon’s attempting to dogmatize, as
Dutens lias done, on fubjeCts of which, as being foreign
to his profeflion, and difficult of inveftigation, he cannot
reafonably be expected to be a competent judge.
“Thus,” to ufe the words of Senac, “a theologian
writes on the nature of man; a fubjedt which does not
very properly belong to fuch a writer : on no other tefti-
mony than fome vague and ridiculous expreflions, he
gains the credit of knowing the circulation, of which the
greateft phyficians and anatomifts had been hitherto com¬
pletely ignorant. Thus it is, that interpreters and com-

Vol. XIX. No. 1285.

29

mentators are milled by a blind zeal for antiquity, and
difcover hidden meanings in the moft Ample expreflions.

How would their boldnefs and aflurance have been aug¬
mented, if Nemefius had exprefled himfelf as clearly as
an ancient fcholiaft of Euripides has done, where he fays,

“ that the blood flows through the veins, and that thefe
veflels receive it from the arteries.” Should we, how'ever,
on this infulated and cafual expreflion, be juftified in be¬
llowing on a weigher of words, and meafurer of phrafes,
the honour of a difcovery, which had eluded the re¬
fearches of the greateft philofophers ?

The date of darknefs and ignorance, in which the hu¬
man mind languifhed during the fucceeding ages, does not
allow us to expeCt that any writer of that period can dif-
pute with Harvey the honour of the great difcovery.
About the fixteenth century the curiofity of mankind
was again excited to the inveftigation of this interefting
fubjeCl. Reafon, which had hitherto fubmitted to the
yoke of authority, began to aflert her rights ; and feveral
phyficians were bold enough to examine fubjeCts which
Hippocrates and Galen had not been able to develope.

Thefirft ray of light was thrown on the circulation, by
a man, whofe name cannot be mentioned without ex¬
citing feelings of compaflion for his unmerited and barba¬
rous treatment, and of indignation at the unrelenting
bigotry of. his cruel perfecutor. Gifted with an ardent
and penetrating genius, Servetus made a rapid progrefs,
at a very early age, in the fciences of natural philofophy
and divinity. Compelled to leave Spain, his native
country, he paffed into France, and ftudied medicine at
Paris, under Winter d’Andernach, who was profeflor in
the college lately fotinded by Francis I. He vifited dif¬
ferent parts of France and Germany, and, after various
perfecutions on account of his religious opinions, fettled
in Dauphiny. But Calvin, being too narrow-minded to
grant to a rival that freedom of thought and liberty of
confcience which he had fo 1'uccefsfully exerted in his '
own perfon, had him feized and condemned to the
flames. Thus, fays Portal, “ one heretic deftroyed ano¬
ther ; but the difference was, that an ambitious and de-
figning knave pronounced the condemnation, and one of
the fineft and moft enlightened geniufes of Europe was
the lamented vifitim of this iniquitous fentence.”

The paflage, which proves Servetus to have been ac¬
quainted with the pulmonary circulation, occurs in his
work de Rejiitutione Chrijlianifmi ; which, having been
carefully deftroyed on account of the herefy which it
contains, is now extremely fcarce ; fo that two or three
copies only are fuppofed to exift, and the duke de la
Valiere gave the fum of 1 32I. for one. It ftates, that the
vital fpirit is compofed of the moft fubtile parts of the
blood, and of the air, which infinuates itfelf into the
lungs ; and that the fource of this blood is in the right
ventricle. “But the communication, that is to fay, the
paflage of the blood, from the right to the left ventricle,
does not take place acrofs the middle feptum, as perfons
have generally imagined ; it depends on a more Angular
ftrufilure. In the long windings of the lung, this fubtile
blood is agitated, and prepared by the aCtion of the
vifcus, and gains a yellow colour. From the vena arteriofa
(pulmonary artery) it palfes into the arteria venofce (pul¬
monary veins) where it becomes mingled with the air
that has entered the lungs, and lofes its fuliginous excre¬
ments. Laftly, it enters the left ventricle, which attracts
it in its dialtole. Such is the preparation of the
blood, from which the vital fpirit is formed ; this prepa¬
ration, and this paflage from the arterial vein into the ve¬
nous artery, are evidently proved by the fize of the vef-
fels; which would not be fo large,' nor poflefs fo many
branches; nor carry to the lung fo great a volume of
blood, if it were deftined to the nourifhment only of the
vifcus.” He adds, that the vital fpirit is lent from the ieft
ventricle into all the arteries of the body. This repre-
fentation proves inconteftably that Servetus knew the
minor circulation. He laid the foundation of a building,

I which

PATHOLOGY.

80

which had baffled all the efforts of the great geniufes of
antiquity. In order to perfedt this defign, it was only ne-
ceffary to extend the ideas of the firft architedt. He in¬
dicated the route, through which the blood paffes from
the right to the left ventricle ; it remained to be proved
that all the blood takes this paffage, and that it returns
again to the heart from the arteries through the veins.

The obfcure Iketch of the circulation, which was fur-
niffled by Servetus, appears in a more finilhed and lu¬
minous form in the works of Realdus Columbus. He
defcribes the entrance of the blood into the heart from
the vena cava, and its fubfequent paffage through the
lungs into the left ventricle and aorta. He advanced a
ftep farther than Servetus ; for he dates that the whole
blood paffes through the lungs, and not the vital fpirit
only. But he falls into the fame error with preceding
anatomifts on the fubjedt of the liver; fuppofing that
gland to be the fource of the blood which nourilhes the
ftomach, fpleen, & c. Arantius and Caefalpinus defcribed
more perfedtly and clearly than Columbus the paffage of
the blood through the lungs ; which they confirmed by
feveral arguments drawn from the ftrudture of the parts,
and particularly from the pofition and mechanifm of the
valves. The latter indeed approached very nearly to the
grand deiideratum, the paffage of the blood from the ar¬
teries through the veins to the heart. He obferves that
a vein fwells below' the ligature; but he did not follow
this up to prove the circulation. He fays that the blood
returns to the heart through the veins during fieep; but
he fuppofed it to move backwards and forwards in the
fame veffels, like the Euripus. He was milled alfo in
the labyrinth of the liver, where fo many phyfiologifts
have loft themfelves. The arrangement of the arteries
and veins in this organ prefents fuch an intricate combi¬
nation, that we need not wonder at its proving, for fo
long a time, a fource of miftake and illufion. Paul Sarpi,
the learned hiftorian of the council of Trent, is one of
thofe to whom the circulation is faid to have been knowm;
but the want of all arguments that bear the leaft convic¬
tion on the fubjedt, will juftify us in declining any par¬
ticular consideration of his claim, as well as thofe of
Fabri a Jefuit, of Helvicus Dietericus, and others.

Notwithftanding the labours and writings of the ana¬
tomifts whofe opinions we have thus curforily examined,
the minds of men were ftill enflaved by thofe errors,
which, having prevailed for fo many centuries, had ac¬
quired the fandtion which time and authority beftow on
any opinions, however abfurd. The moft enlightened
phyficians were fatisfied with the labours of their precie-
ceffors ; and Harvey alone had fufficient courage and in¬
formation to canvafs thefe inveterate prejudices, which
length of time had confecrated as infallible truths. He
obferved and defcribed the true courfe of the blood with
a wonderful fagacity and clearnefs. None of the argu¬
ments, which prove the circulation, efcaped the refearches
of this acute obferver; fo that a modern phyfiologift, in
recounting the proofs of this phyfiological fadl, could add
little, if any thing, to what is accumulated in the ori¬
ginal work of Harvey. He was not contented with de-
monftrating the circulation in fome parts only ; but fol¬
lowed up the fubjedt in all the vifcera of the body. He
traced the courfe of the blood through the liver, where
every preceding anatomift had difcovered nothing but
perplexity and confufion. The work of Harvey is, in
(hort, one of thofe rare and precious produdtions which
embrace a fubjedt in its whole extent, and prefent it to
the mind in fo perfedt and finilhed a form, as fcarcely to
admit a tingle addition or improvement.

The merits of our countryman, whofe fame can never
perilh while medical fcience continues to be cultivated,
will be exalted to a ftill higher pitch, when we confider
the ftate of medical knowledge in England at that time.
While anatomical fchools had been long eftablilhed in
Italy, France, and Germany, and feveral teachers had
rendered their names illuftrious by the fuccefsful purfuit

of the fcience, anatomy was ftill unknown in England,
where diffedfion had hitherto hardly begun. Yet, at this
inaufpicious period, did Harvey make the difcovery,
which may be considered as a fecond and more perfedt
foundation of the fcience of medicine ; and which amply
juftifies Haller in ranking him as fecond to Hippocrates
only.

The publication of this grand difcovery roufed the
attention of all Europe. The old profeffors, accuftomed
to pay a blind and implicit deference to the authority of
Galen, which wras now utterly fubverted, and, aftiameci
of confeffing that their whole life had been fpent in teach¬
ing the groffeft errors, took up their pens in oppofition
to the author of thefe innovations. One party afferted
that the difcovery was not a new one : that it had been
known to feveral perfons, and, indeed, to all antiquity.
Such were the aflertions of Nardi, Vander Linden, Hart-
mahn, Almeloveen, Barra, Drelincourt, Patin, Falconet,
Heifter, Regnault, &c. A fufficient refutation of thefe
ftatements will be found in the hiftorical Iketch, which
we have already exhibited. Other adverfaries of Harvey
proceeded in a more rational manner; and attempted to
difprove his ftatements by experiment and reafoning.
Primerofeled the wayin this attack, and he was followed
by Emilius Parifanus, John Riolan, Cafpar Hoffman,
and others. If men of fuch acknowledged erudition as
Riolan and Hoffman were fo utterly unacquainted with
the circulation as to deny it altogether, may we not fafely
conclude that the fubjedt is not defcribed in any of the
writers who preceded Harvey ? Out of all his numerous
opponents, this illuftrious man anfwered Riolan only,
in his “Secunda et Tertia Exercitatio de Circulatione
Sanguinis.” The reply was rather extorted by the rank
and fame of Riolan, than by the ftrength of his argument.

If we feek to define exactly the precife (hare of merit
which Harvey may claim in the grand difcovery of the
circulation, it will be necteffary to hold a middle courfe
between the grofs and palpable ablurdity of thofe who
difcover a knowledge of the circulation in the writings
of Solomon, Hippocrates, Plato, Ariftotle, &c. and the
too great partiality of fuch as would deny all knowledge
of the fubjedt to every anatomift who preceded Harvey.
It feldom happens, that fo extenfive and intricate a fub¬
jedt as that which we are now confidering, is furveyed
and brought to light in all its branches by the labour
of an individual ; nor has it happened in the prefent
inftance. For Servetus, Columbus, Arantius, and Cae-
falpinus, were acquainted with the courfe of the blood
through the lungs ; and the latter writer has even an ob¬
fcure hint towards the greater circulation. But no one
attempted to prove the latter point by arguments and
experiment before the time of Harvey: the expreffions of
Caefalpinus, which are by no means clear or fatisfadiory,
had been before the public for half a century without
exciting the leaft inveftigation, and without fuggefting
to Fabricius the true office of the valves in the veins.
The entire merit of the greater circulation may, there¬
fore, be afcribed to our illuftrious countryman ; and, if
we compare the luminous method and irrefragable proofs
which are found in his expoiition of the other part of the
fubjedt, with the partial and confufed ftatements of pre¬
ceding authors, his merit will here be only fecond in de¬
gree to that of adtual difcovery.

The dodtrine of the circulation met with fome fup-
porters on its firft promulgation. Walaeus of Leyden ex¬
erted himfelf ftrenuoufly on this fide, and defended the
propofitions of Harvey in two excellent letters addreffed
to Bartholin. Des Cartes alfo, whofe authority at that
time carried vaft weight with it, took a decided part in
the controverfy in favour of Harvey, from its commence¬
ment. The dodlrine was pretty generally admitted
throughout Europe before the deceafe of its propofer.

The nature of the communication between the arte¬
ries and veins was left undetermined by Harvey, who
decided no point which he could not make the fubjedt of

experiment.

31

PATHOLOGY.

•experiment. The art of injecting the veffels of the dead
body, which has been difcovered and carried to great
perfection fince his time, has Shown a continuation of
canal joining the two fyftems of blood-veffels ; and the
employment of the microfcope has completed the proof,
by demonstrating the circulation in the tranfparent parts
o ffrogs, See. during life. The transfufion of the blood
o fone animal into the veifels of another, which has been
performed with fuccefs in many inftances, has added
another ftrong proof to the demonftration of the circu*
iation. See the Hiftoire de l’Anatomie et de la Chi-
rurgie of Portal, and the Bibliotheca Anatomica of Haller,
in the articles concerning the writers whofe names are
mentioned in this account.

Francis de le Boe, otherwife Sylvius, was born at
Hanau in 1614 ; and became profeflor of medicine at the
univerfity of Leyden in 1658. He will be therefore
readily distinguished from James du Bois, who is alfo
called Sylvius, the mailer and violent adverfary of
Vefalius, of whom we have fufficiently fpoken in the
preceding Sedition. Francis Sylvius wasamuch morediltin-
guiilied perfonage : he was alfo one of the earlieft advo¬
cates for Harvey’s doctrine of the circulation of the
blood, and was the principal caufe of its reception into
the medical ichool of Leyden. In other refpe'dts, how¬
ever, he was inilrumental in retarding the progrefs of
medical fcience, by the invention of an hypothecs re-
fpeCling the caufe of difeafes, which contributed much
to excite the attention of the medical world, and to ex¬
tend his own fame. He aferibed all the morbid a<5tions
of the vital fyftem to certain chemical operations, to
fermentations, and ebullitions, which he believed gave
origin to an excefs of acid or of alkali, to the neutraliza¬
tion of which all the efforts of the medical art were of
courfe to be directed : whence he adminiltered volatile
alkali, abforbent earths, and cordials, largely, paying
little regard to the different llages of a diiorder, or the
charafterof prevailing epidemics. The extent to which
this doctrine was received and defended in molt parts of
Europe, founded as it was upon a gratuitous hypothefis,
and therefore produftive in many cafes of much mifehief,
is furprifing, and the interruption which it occafioned to
the improvement of medicine was confiderable. In faft,
the chemical fyftem of Sylvius was admitted in almoll every
country in which chemical fcience was cultivated : it
was in Holland and in Germany however that it was
carried to the moll extravagant pitch. While one phy-
fician was earneftly employed in changing the acid Hate
of the blood, another took great pains to counteract the
alkaline properties of'the fame fluid. While Bontekoe,
deducing all morbid phenomena from the vifeidity of
fluids, eulogized the medical properties of tea, and
drenched his patients with fifty cups in fucceflion of that
liquor ; Van Ruftingh preferibed afliduoully large quan¬
tities of volatilefalts in the moll inflammatory complaints ;
believing that the two elements of fire and water compofed
the fubltance of all living bodies, and that to rellore
their balance of power or equilibrium was the only pro-
pofitum of the medical art.

In our own country the more moderate of thefe tenets,
with fome degree of modification, acquired celebrity.
Willis, Flower, and others, adopted them, and, multi¬
plying on the acid and alkaline humours of Sylvius, af-
ferted the exiftence of a great many different humours,
viz, mucilaginous, vitriolic, corroiive, See. each of which
they thought had the effeCt of producing a diforder J'ui
generis : and hence they endeavoured to trace the various
characters of difeafe. The phenomena of fever they like-
wife attempted to explain according to the chemical laws
of fermentation and ebullition. And, though Willis
probably ufed thefe terms merely in an analogical fenfe,
yet many phyficians of his time applied them to the
human frame in their llriCl and chemical fignification.

With refpeCt to the precife mode by which thefe aCiions
were thought to bring about the phenomena of health or

difeafe, the following is a brief fummary. Digellion was
fuppofed to be carried on by fermentation. If this procefs
was too aCtive, or, on the contrary, too weak, improper
or tinfermented particles of aliment remained, which,
when aflimilated and introduced into the blood, pro¬
duced the fame efteCt on that fluid as certain fubftances
called ferments do upon vinous liquors; viz. they pro¬
duced fermentation. Now, viewing the matter in this
light, thefe chemical pathologifts defined fever to be a
fermentative procefs which nature instituted. for the pur-
pofe of throwing off the aforefaid offending humours or
cacochymias. If nature fucceeded in performing this
talk, health was reflored ; if not, death enfued. Some
difeafes were however produced by external caufes; for
instance, infectious and contagious diftempers, &c. but
then each of thofe diforders was brought about by means
of humours, whether derived from the air by means of
refpiration, or from aCtual contaCt.

It is rather remarkable, that thefe phyficians admitted
a third caufe of production of cacochymite, which went
to overturn their whole fyltem. They exprefsly Hated,
that organic difeafe of any of the vifeera engendered a
peccant humour ; hence we naturally infer, that in this
cafe the folid or fibrous (IruClure was the firft caufe of
difeafe.

In Italy, where mechanical fcience had made much
progrefs, the chemical doCtrine obtained few fupporters.
Indeed, anterior to the period we are treating of, Sanc-
torius had, in his expofition of the cutaneous functions,
taught phyfiologifts the illuilration which the vital de¬
rived from the confideration of the mechanical laws. He
endeavoured to diltinguilh the different alimentary mat¬
ters according to their fpecific gravity, and referred
difeafe to an obflruCled Hate of the exhalant fyftem : an
opinion, however, which this author carried too far, and
which was by no means conducive to his fuccefsful prac¬
tice. Neverthelefs it has been of great importance to his
more enlightened fucceffors.

Sydenham was born about the year 1624. One of the
greateft benefits which he conferred upon the fcience of
medicine was that of detaching phyficians from this and
other hypothetical fyftems, and of leading them to the
only true path, obfervation and experience. He intro¬
duced a great reform into medical pradice. Though not
entirely free from the humoral hypothefes which were
fo prevalent in his time, yet he took care to lludy na¬
ture with exa&nefs, and he reported her appearances
with fidelity, even when oppofed to his own reafonings.
Indeed in many parts of his writings he takes occafion
to deprecate the practice of his predeceffors, becaufe they
not only did not fufficiently remark the minute pheno¬
mena of difeafe, but becaufe they actually mifreprefented
thofe phenomena for the purpofe of corroborating their
fanciful theories. Nor did Sydenham admit the chemi¬
cal explanation of difeafe which was fo ilrongly infilled
on by his contemporaries, and even fucceflors; for he
exprefsly ftates, that, although he has no objection to the
terms ebullition and fermentation, yet he rather ufes them
as illustrating certain morbid proceffes by analogy than
in their own commonly-received fenfe : and indeed he
quotes fome very judicious arguments tending to dis¬
prove the identity of thofe chemical procefies with dif-
eafed actions. This author followed very clofely the Heps
of Hippocrates : like him, he was principally intent on
obfervingthe minute features of difeafe, and of referring
them to their obvious and immediate caufes; like hint,
he admitted to a great extent the falutary operation of
nature, and the deleterious agency of humours ; and
like him too he paid particular attention to atmofphe-
rical changes, and the effects of them on the human
body. Indeed the chief merit of Sydenham confifted in
writing clearly, fully, and from his own individual ob¬
fervation, the hiftory of difeafes. He inveftigated the
minuteft changes which occurredin them, whether fpon-
taneoufly or from the adtion of remedies, as well as thofe

1 arifing

PATHOLOGY,

arifing from temper, age, conftitution, or other adven¬
titious circumftances.

A fyftem of therapeutics founded on fuch a bafis could
fcarcely deviate from the right path; and accordingly
the works of this author remain molt important ftudies,
whether regarded as indications to the art of diagnofis,
or to the cure of difeafe. His pradtice was in the molt
eminent degree fuccefsful ; and among the remedies he
had recourfe to we may remark many which are again
firmly eltablifhed after having long fallen into difcredit
under the inaufpicious influence of fpeculative theorifts.
Among thefe, the ufe of bleeding, and other antiphlo-
giftic methods, in the treatment of continued eruptive
fevers, has conduced very materially to the prefervation
of the lives of our fpecies. We may remark, that in this
aflumption we are borne out by the fatality which oc¬
curred during the exhibition of alexipharmics and hot
cordials by the chemifts, which the cooling fyftem has
very much obviated. The dodlrines of Sydenham, not-
withftanding the interefting ftyle in which they were
written, the fame they acquired for their author, and
their confonance with nature, were by no means gene¬
rally received ; and the chemical dodtrines continued to
be advocated by many till the commencement of the fol¬
lowing century.

In proportion as true chemical fcience advanced, the
partiality for chemical explications of the functions of
the living fyftem abated ; and phyficians feem to have
difcovered, for the firft time, that the theory of the hu¬
mours, even with all the improvements which it derived
from the corpufcular philolophy, threw no light whatever
on the adtions of the folids. A new hypothefis, there¬
fore, was projedted; and, as men in avoiding one error
are apt to run into the oppoiite extreme, phyfiologifts
now attempted to explain all the phenomena of life ac¬
cording to the mere mechanical powers of the organs, and
to reduce the laws of the animal economy to the rigid
calculations of geometry. They imagined, that they
could illuftrate every operation of the human body, by
comparing it to a fyftem of ropes, levers, and pulleys,
limited with a number of rigid tubes of different lengths
and diameters, containing fluids, which, from variations
in the impelling caufes, moved with different degrees of
velocity. When the fibres of this machine were not
fufficiently flexible ; when the pulleys and joints of the
levers were not kept in fufficient repair ; or when the
apertures of the pipes were not fufficiently free ; the
movements were neceffarily fufpended, or lefs perfedlly
performed ; and they were only to be brought into pro¬
per regulation, according to the pradtitioners who adopted
this fanciful theory, by removing the above-defcribed
impediments. The cotnpofition of the fluids was fup-
poled to be the refult of their motion in the tubes ; and
in thefe nothing was attended to but the forces of gra¬
vity and cohefion ; as in calculating the adtion of a
pump, or other hydraulic engine. “ If the chemical
fchool,” to ufe the words of Sprengel, “ had degraded
the phyfician to the rank of a brewer or diftiller, the
difciples of the iatro-mechanical fchool, on the other
hand, were glad to be efteemed as hydraulic engineers;
and feveral of them, in fadt, ferved in the double capa¬
city of engineers and profeffors of medicine.” One of
them, Dionis, a profeuor of furgery at the Jardin du
Roi, went fo far as to compare the circulatory fyftem to
the water-works at Marly, by which the water of the
Seine is raifed to confiderable height, and from thence
made to fall again upon the great wheel.

Among the caufes which conduced to the eftablifliment
of this fedt, the difcovery of the circulation of the blood
is the moft prominent. When it was found that the
blood flowed in a regular manner, through certain con¬
duits, from the heart, and returned to that organ, by
other veffels, from the extremities, phyficians fet about
calculating the mechanical force which they luppofed ne-
ceffary for enabling the heart and arteries to produce this

effedl ; and, elated with their apparent fuccefs, were led
by degrees to transfer their calculations to the other
fundtions of the body. Geometry had become the pre¬
vailing ftudy of the learned ; and focieties for the pro¬
motion of experimental philofophy were eftablifhed in
the different countries of Europe, among which the
Florentine Academy del Cimento took, in fome meafure,
the lead. It was in Italy that mathematics had been
moft afliduoufly cultivated ; and it was there that the
firft attempt was made to introduce them into medicine.
In the year 1614, Sandtorius publifhed his Medicina Sta¬
tical in which heendeavoured to (how the great influence
which the infenfible perfpiration has upon health, and
to calculate with precifion all the variations in its quan¬
tity, in the different conditions of the body. According
to Iris theory, difeafes originated from the noxious par¬
ticles of the food being retained in the fyftem, in con-
fequence of the ftoppage of the tranfpiration ; and, till
the latter fundtion was reftored to the proper ftandard,
no cure could well take place. Sandtorius diftinguiffied
the different alimentary matters according to their fpe-
cific gravities, and according as they appeared more or
lefs fitted to pafs off in the way of infenfible perfpiration.
He even ventured to apply his maxims to the paflions of
the mind ; fhowing how joy and equanimity favoured the .
excretions, while forrow and fear impeded them ; how
fevers and melancholy arofe from the obftrudted perfpi-
rable matter, where grief was long continued ; and how
they were to be removed by reftoring the fufpended ex¬
halation. Among the aphorifms of Sandtorius, there are
many found obfervations ; and medical fcience is under
confiderable obligations to him for having diredted the
attention of phyfiologifts to the fundtions of the fkin,
which, till then, had been in a great meafure overlooked ;
but his views, like thofe of moft theorilts, were far too
partial ; and there can be little doubt that, in one re-
fpect, they had a moft injurious influence, viz. by en¬
couraging phyficians in the univerfal employment of fu-
dorifics, to which they were already too prone ; and no
one will now fubfcribe to the judgment of Boerhaave, who
fays of Sandtorius and his work, “ Nullus medicorum,
qui ante eum fcripferunt; cardinem rei ita adtigit ; nec
ullus liber in re medica ad earn perfedtionem fcriptus
eft.”

The mechanical philofophers began by calculating the
force of the contradtile power of the heart neceffaVy to
produce the phenomenon of circulation : but in this cal¬
culation they proceeded on the erroneous datum, that
the refiftance oppofed by cohefion and gravity was the
fame in living veflels as in inanimate pipes. Even if this
fuppofition had been true, yet they had no means of
meafuring the numerous diameters of thefe veflels, their
curves, angles, &c. circumftances indifpenfably necef-
fary to be known before the above-mentioned calculation
could have been made. A more ingenious mode of il-
luftrating the procefs of circulation was that adopted by
Borelli. This author affumed that the power of a mufcle
was in diredl ratio to the fize of fibrous portion : - hence,
taking the deltoid mufcle for an example, and having
found the force that mufcle was capable of exerting, he
next proceeded to calculate the force which the contrac¬
tion of the heart mult exert according to its proportion -
ably larger fize. This aflumption, however, is unfounded;
for exercife increafes the power of a mufcle, without,
in every inftance, increafing its fize: nor does it appear
by what means he could precifely infulate tire adtion of
the deltoid mufcle, feeing that it is infeparably con¬
joined with feveral others which co-operate with its mo¬
tions. The experiments of Kiel and others, though
founded on different aflumptions, were not more fatis-
fadtory than thofe of Borelli. At this period, however,
geometry was fuch a favourite purfuit among the learned,
that its cultivation rendered the mind almoft diffatisfied
with every theory which did not bear the teft of mathe¬
matical demonftration. Thefe calculations therefore,

to

33

P A T II O L O G Y.

to which we muil allow the merit of ingenuity, became
generally received. Mechanical principles were applied
to every function of the body: not only the motion of
the blood, but the compofition of that fluid, and the va¬
rious and elaborate precedes of nutrition, fecretion, &c.
were referred to the fame laws. Thisabfurd application
of mathematical knowledge to vital phenomena, led thefe
philofophers into a labyrinth of error aftonifhing to com¬
mon fenfe. For inftance, while one author calculated
the contractile power of the femoral artery at upwards of
1000 pounds, he overlooked the very obvious circum-
ftance, that the pulfation of that vedel may be immedi¬
ately fufpended by the ufe of a tourniquet which fcarcely
exerts the predure of a few pounds. Indeed, the con¬
tradictory refults arrived at by thefe experimenters (howed
the abfurdity of their experiments. Thus, Borelli af-
ferted that the contraction of the heart was equal to a
refiftance of 180,000 pounds ; Keil, that it was equal to
five, or, at molt, eight ounces. Hecquet calculated the
digeltive (or, ac, cording to him, triturative) powers- of
the Itomach, in conjunction with the abdominal mufcles,
to be equal to 261,000 pounds ; Altruc ftated the amount
of that power at four pounds three ounces.

Yet was this mode of inveftigating the fcience of life
by no means ufelefs ; for, by teaching pathologifts to re¬
fort frequently to experiment in proof of their afi'ertions,
it deftroyed the attachment to fanciful and gratuitous
hypothefis which had fo long prevailed : it directed their
attention to parts and aCtions of the animal economy
which the humoral phyficians had paded over unnoticed
and undeferibed ; and, what was of ftill more impor¬
tance, it induced correCt and analytical habits of reafon-
ing. Accordingly, we find, during the 17th century,
which may be confidered as the period at which the me¬
chanical philofophers principally flourilhed, difeoveries
which have flood the teft of time, and theories, concern¬
ing the correCtnefs of which we are ftill earneftly em¬
ployed in difeuflion. Phyfiology and the minute parts
of anatomy were inveftigated with the grandeft refults ;
the circulatory fyftem was gradually and fuccefsfully il-
luftrated by many diftinguifhed phyfiologifts. Excellent
deferiptions of the ItruCture and relative pofition of the
heart were given by Steno and Lower. The microfcopi-
cai experiments of Leeuwenhoek and others ferved to
eftablifh the important faCl of the continuation of arte¬
ries and veins with each other. Ruyfch likewife, by the
great degree of nicety in the ufe of injections to w hich
he attained, was enabled to throw much light on this fub-
jeCl. Some important parts of the arterial fyftem were
difeovered by VieulTens. The necefiity of the abforption
.of oxygen gas through the lungs was firft inculcated by
Mayow. Malpighi improved the knowledge of the ftruc-
ture of thofe organs.

The mechanical part of refpiration, the compound ac¬
tions of the mufcles, See. were beautifully demonftrated
by Borelli; and Kepler applied mechanical principles to
the explanation of the functions of the eye in a manner
the moft clear and fatisfaCtory. He firft pointed out the
true ufe of the cryftalline lens, and fhowed how the
images of external objects are formed, in an inverted po¬
fition, on the retina. A public experiment with the eye
of an ox, which was made at Rome, in 1625, by the Je-
fuit Scheiner, fully confirmed Kepler’s theory: but af¬
terwards Mariotte, having found that the images of ob¬
jects difappeared when they fell on the fpot where the
optic nerve enters the eye, called in queftion the fenfibi-
lity of the retina, and maintained that the choroid coat
was better calculated to receive and rranfmit the percep¬
tions of fight; and a controverfy arofe concerning the
aCtual feat of vifion, which was carried on, with great
eagernefs, by Pecquet, Perrault, and St. Yves, and
which had the effeCt of eliciting many valuable obferva-
tions. The Newtonian difeoveries, refpeCting the pro¬
perties of light, contributed ftill more to the accurate
analyfis of the functions of the eye ; and the treatifes of
Vol. XIX. No. 1285.

Du Petit, Porterfield, and Zinn, which followed foon
after, have left little for their fuccefiors to accomplifh.

The lymphatic fyftem was likewife brought into notice
during this century. To Cafpar Afellius is due the
merit of having taken the firft ftep in the inveftigation of
this important part of the animal frame. While diffeCl-
ing a dog, for the purpofe of demonftrating the recur¬
rent nerves, the appearance of a milk-like fluid iffuing
from fome fmall white veflels arrefted his attention.
Examining them more minutely, he traced them to the
villous coat of the inteftines; and repeated difleClions
informed him, that thefe veflels -were only obfervable in
the animal which had lately fed. Hence he concluded
thefe to be the vafa chylifera. He confefled, however,
that thefe veflels had been mentioned by ancient au¬
thors, though deferibed in a very imperfeCl manner;
but he juftly claimed the honour of having firft pointed
out their ufe. Afellius, however, entertained erroneous
ideas as to the termination of the ladeals : he fup-
pofed that they united together in the pancreas, and
pafled from that gland into the liver. This error was
corroded by the rel’earches of Pugent, who, obferving on
one occafion a milky fluid in the vena cava of a dog, traced
carefully the progrefs of that veflel, and difeovered the
thoracic duCt. This difeovery was difputed however
with much acrimony ; and the character of Harvey was
tarniflied by the circumftance, that he flood forth among
the moft illiberal of its opponents. The abforbents of
the large inteftines were difeovered by Olaus Rudbeck
in the year 1651 ; he likewife refuted the received opi¬
nion, that the liver poflefled laCteals, and, by their
means, aflimilating powers : he fhowed that the only ab-
forbent veflels exifting which could have led to this
error, were the lymphatics of the hepatic glands. The
glandular fyftem in general was afterwards more fully
illuftrated by the writings of Gliifon and Wharton,
the experiments of Lower, Drelincourt, Lifter, and
Mufgrave; and the anatomical refearches of Nuck,
Pacchioni, and Duverney.

Nor were the more abftrufe and difficult queftions of
phyfiology negleCted by the philofophers of this age.
With much talent Willis fupported the hypothefis of a
nervous fluid, the vehicle of animal fpirits ; and, when
deficient or exceffive, the caufe of diforder ; and he feems
in fome refpeCts to have anticipated the fpeculations of
Spurzheim and Gall, in referring to particular parts of
the brain peculiar mental faculties. The errors of this
author on the former fubjeCl were pointed out by Mal¬
pighi, who moreover inveftigated the cerebral ftruClure
with great minutenefs, particularly in reference to tire
exiftenceof fibres in the cortical fubftance. Here too the
injections of Ruyfch and the microfcopical experiments
of Leeuwenhoek were ufefully employed to fliow the vaf-
cularity of the brain. Many improved deferiptions were
furniflied by Cafferius, Duverney, Riverius, Vieuflens,
and others, of the ftruClure of the ear. The tunica
arachnoides was deferibed by Swammerdam and Blaes.
Many interefting experiments were made on the genera¬
tion of animals ; among which the moft famous, though
certainly not the moft ufeful, was that of Leeuwenhoek
on the animalculae of the feminal fluid. See our article
Animalcule, vol. i. p. 727.

To the “ triumviate,” as they have been called, Stahl,
Hoffman, and Boerhaave, pathology and therapeutics
are indebted for many important illuftrations. The firft
of thefe phyficians has rendered himfelf famous by the in¬
troduction of an hypothefis, which, with various altera¬
tions, has maintained its ground until the prefent day.
We allude to the exiltence of an immaterial principle, or
effence, as producing the phenomena of life. The particu¬
lar tenets, however, on which this theory was founded,
had been promulgated before the time of Stahl : Rene
des Cartes had taught his followers to conlider matter as
purely paflive, and to refer all the changes to which it is
fubjeCted to a fpiritual caufe : the union of body and
K fpirit

34

PATHOLOGY,

fpirit was, in his eftimation, merely one of its modes, or
accidental conditions. Malebranche, extending the
Cartefian dodlrine, endeavoured to explain more fully
the nature of this union, and to fliow that the foul had a
more or lefs diftindl confcioufnefs of all the movements
and affedlions of the body. From thefe tenets, the tran-
fition to the fyftem developed by Stahl was very eafy ; and
an attentive review of the progrefs of the opinions in
queftion mud: convince every one that the Stahlian hypo¬
thecs, far from being entitled to the merit of originality
which its author claimed, was nothing more than an off-
fpring of the Cartefian philofophy. Educated under
Wedel, who was a devoted adherent of Sylvius, and an
affiduous teacher of his do£lrines, Stahl began very early
to queftion the fufficiency of thofe chemical explanations
which he heard applied to all the phenomena of life. It
appeared very wonderful to him, that the humours of
the body, which are, of themfelves, fo difpofed to putre¬
faction, fliould yet fo feldom fall into that ftate ; and that
the daily prefence of fo many faline fubftances, as we are
in the habit of receiving in our food, fhould produce fo
few fymptoms of acrimony. The intervention of animal
/pints he conceived to be a very unfatisfa&ory fuppofi-
tion; and all the attempts which had been made to ex¬
plain the theory of life on pure chemical and mechanical
principles he held very cheap. Taking the paffivenefs
of matter for the balls of his fyftem, he maintained, “ that
the body, as body, had no power to move itfelf, but
was put in motion only by immaterial fubftances ; that all
motion, therefore, was immaterial, and a fpiritual aCt.”
It had been alw'ays obferved, that there is a certain power
in the animal body of refilling injuries, and correcting
fome of its diforders ; and Van Helmont had afcribed
fome degree of intelligence to this power : but it w'as
referved for Stahl to refer it entirely to the rational foul,
which, he affirmed, not only originally formed the body,
but is the foie caufe of all its motions, not excepting di-
geftion, affimilation, and fecretion, in the conftant excite¬
ment of wdiich life confifts. While he referred to this
principle the actions by which health is eftablilhed, he
attributed to its irregularity the occurrence of difeafe;
admitting however, to a very great extent, the operation
of flighter caufes, among which plethora held a favoured
rank. To this ftate Stahl fuppofed the human frame was
perpetually difpofed, and that at particular periods of
life this difpofition manifefted itfelf with great precilion
in different parts of the body. Hence arofe, according to
him, in infancy complaints of the head, during adolef-
cence in the pulmonary ftruCtures, and in old age in the
digeftive organs. Fever he defcribed as an autocratic ef¬
fort of nature to conquer the morbific caufe, and to expel
it from the body ; and all the fymptoms, not excepting
rigor, were only fo many proofs of the tonic aCtion which
was thus excited. Congeftions were fuppofed, in con-
tradiftindlion to obftrudlions, to refult from an afflux of
the fluids occafioned by the fame tonic power; when ob-
ftruftion followed, or when the objeCt of the congeftion,
i. e. evacuation, w as not accompliffied, inflammation took
place; and the tendency of the violent actions which ac¬
companied it, wras to difperfe the obltrufted humour.
If this end was not attained, the obftrufted matter be¬
came vitiated, and pus was formed. Hypochondriafis,
gout, melancholy, and almoft all cachectic diforders,
were attributed to a diminution of the tonic power of the
vena portae, and the confequent ftoppage of the blood in
it ; while fpafmodic difeafes were thought to indicate an
excefs of the general tonic power of the fyftem.

Rejecting the aids derivable from anatomical refearches,
of the ufe of which in medicine Stahl entertained a very
mean opinion, he proceeded, in conformity to the general
principles we have related, to the treatment of difeafe.

It may very naturally be fuppofed that a theory which
attributed (o much to the falutary operations of nature,
was not likely to lead to very active practice : accord¬
ingly we find that Stahl adopted, to a very great extent.

the Hippocratic mode of watching thefe healing opera¬
tions, without interfering with them farther than to affift
their weaknefs or moderate their excefs: and, in fact, he
and his followers, trailing principally to the operations
of nature, zealoufiy oppofed the ufe of fome of the moil
efficacious remedies, as opium, cinchona, and mercury ;
and were extremely referved in the employment of bleed¬
ing, vomiting, See. Notwithftanding, however, the hy¬
pothetical notions of Stahl, his inert practice, and Iris con¬
tempt for anatomical refearch, yet much praife is due to
him for having directed the attention of pathologifts
to the phenomena of vitality, and firowing the fallacy of
the chemical hypothefes, a talk for which he was pre-emi¬
nently qualified by his profound inveftigations in tire
fcience of chemiftry.

Hoffman was a phyfician who obtained great celebrity
at this period, lefs however on account of his fuperior
mental faculties than for his extenfive erudition, and the
art he had of difplaying it to advantage. He was edu¬
cated under the mechanical fed of phyiicians ; and it is
rather remarkable, that Stahl, who had been taught the
chemical doctrines, fhould have difearded entirely chemi¬
cal illuftrations of difeafe, while Hoffman, who had been
taught by the mechanifts, admitted the exiftence of acid
cacochymite, and even attempted to fliow how the union
of this acid with blood produced neutral files which were
the caufe of gout, calculi, rheumatifm, and cutaneous
difeafes. Though engaged at one period of his life in
controverting the opinions of Stahl, on the fuppofed
ground of their atheiftical tendency, yet the theory of
Hoffman, as far as the vital or motive principle was con¬
cerned, fcarcely differed from that of his enlightened
colleague: for, though he applied to it the appellation of
nervous fluid, or ether, and fixed its feat in the nervous
fyftem ; yet, in attributing to it the faculties of mind,
fenfe, and intelligence, he cauled it to approach very
nearly to the anima, or foul, of Stahl. Like Stahl, too,
he allowed that morbid aCtions were frequently induced
by a plethoric ftate of the fyftem; and, in conformity
likewife with the views of that author, he referred much
to the obftrudlions of the humours, efpecially in the vena
portae. Fever and inflammation he fuppofed to arife from
fpafm, or conftridlion of the capillary veffels, particularly
of the fkin, an opinion which was illuflrated and im¬
proved in after-times, and more fully developed in the
famous theories of Cullen.

In the practical department of the art, however, Hoff¬
man left Stahl far behind him. We have to obferve in
his treatment of inflammatory diforders great decifion
and corredtnefs, and confequently a great degree of fuc-
cefs. He aboliflied too, in a great meafure, the fudorific
plan of treatment which the humoral pathologifts had
pradtifed to a very dangerous extent, and to which Stahl
was particularly attached. To him likewife we are in¬
debted for the ufe of the Liquor anodynus, an excellent
and well-known article of the materia medica. • He like¬
wife fhowed the great ufe of bark in intermittent fevers,
and of chalybeates in chronic diforders. Moreover he in-
veftigated, with great care, the -compofition of mineral
waters, and taught the a<5l of preparing them artificially.
We ought not to forget to remark that, in the work of
Hoffman, “ De Confenfu patium nervofarum,” many va¬
luable obfervations will be found, particularly thofe
which regard the influence which various organs exert
upon one another.

But the phyfician who obtained at this period the
higheft rank as a pathologill was Boerhaave. Educated
by his father with a view to the miniftry, he imbibed at
an early age a knowledge of the learned languages ; af¬
terwards applying himfelf with affiduity to the Itudy of
mathematics, and then to the profound inveftigations of
moral philofophy, he next proceeded to botany and na¬
tural hiftory, by which he laid the foundation for a very
extenfive acquaintance with the fcience of medicine,
which at length he adopted for his profeffion. See Boer-
I HAAVE,

•35

PATHOLOGY.

haave, vol.iii. Anatomy (of which his works. betray great
deficiency) was the only branch of his education which
feems to have been negie&ed ; which is neverthelefs fur-
prifing, becaufe he differed forfome time underNuck, an
anatomift of much repute. Boerhaave conceived that that
theory of medicine rauft be the belt which reconciled- the
opinions of allfefts; and, accordingly, he laboured to
unite the chemical doftrines of the day with the valuable
obfervations derived from the other fchools and from
Hippocrates. Of the father of medicine he profefi'ed to
be a great admirer, and affe&ed to return to the good
and ancient method of acquiring knowledge by obferva-
tion and experiment; but unfortunately forgot his own
rules, yielded to the influence of early ftudies and a
love of theorifing, and in many inftances obfcured the
fcience his abilities had otherwife enabled him to adorn in
a moft eminent degree. However, the plaufibiliiy of
Boerhaave’s dodtrines, the beauty of his ftyle, and the
graces of his delivery, gained for him an afcendancy
which is almoft unparalleled. We may form fonte idea
of the importance attached to his labours when vve read,
that, on his beginning a courfe of le&ures, the occur¬
rence was deemed of fo much confequence, that the
whole city was illuminated. Boerhaave adopted a notion,
of which his philofophical education (hould have taught
Jiim the abfurdity ; viz. the exiftence of an intermediate
Jubilance between matter and fpirit, a principle which
regulated or produced all the vital functions. He had
taken this idea from an ancient dogma found in one of
the writings attributed to Hippocrates; and his nephew,
Kaan Boerhaave, followed up and illuftrated this hypo¬
thecs with much fpirit, and, unfortunately, with the ad¬
miration of his contemporaries, who adopted it almoft:
univerfally, until the fplendid dilcourfes of Haller began
to wean them from opinions fo diflonant to the refults of
found reafoning.

Boerhaave died in the year 1738 ; fo that we have now
fairly got into the eighteenth century, and have arrived
at a period when phyliology, long obfcured by the mifap-
plication of the natural fciences, at length began to be
fludied according to the dictates of found reafoning and
the refults of experiment. The name of Haller (who
ftudied under Boerhaave) (lands in lofty pre-eminence
among the cultivators of medical fcience during this cen¬
tury. Panegyric has been feldom more properly applied
than to this diftinguiflied author. His biographers have
(hown how afliduoufly, at the earlieit periods of his life,
his mind was bent on the acquilition of knowledge ; and
they have reported his varied, his extenfive, accompii(h-
ments. His poem of the Alps (hows how eminently he
poflefled fublimity of imagination and the harmony of
numbers; and his refearches in our own fcience manifeft
the profundity of his reafoning; while the admirable
picture is clofed by the relation of his earned regard for
the intereds of morality and^religion. In a word, Haller
feems to have almod realized the account given of the
gods, or inventors of medicine, who individually united
the four grand fciences of- poetry, legiflature, phyfic, and
divinity. See the article Haller, vol. ix.

The irritability of the body was the point to the efta-
blifhment of which a very large proportion of Haller’s
refearches were diredted ; and in this principle he formed
a ready folution of many phenomena which had puzzled
his predeceffors and given rife to much idle and fanciful
fpeculation. We may be excufed, however, from en¬
tering into the phyfiological difcoveries of Haller, as we
(hall have cccaflon to treat of them fomewhat largely in
our article Physiology. It (hould be mentioned, how'-
ever, that the Elementa phyjiologice of Haller is a work of
thegreated merit, and which, notwithftanding the won¬
derful progrefs of phyfiology in our own time, may dill
be referred to, as containing an immenfe body of refearch
arranged in a very beautiful manner. And this book
would probably have dill remained the text-book of
every phyfiological fchool, had not the profound re¬

fearches of our countryman Hunter led mankind to de¬
tect its errors and deficiencies, and (hown how much dill
remained to be done ere the fabric of this fcience could
be confidered as reding on a ftable foundation.

It would appear that Haller was not an operating fur-
geo n ; for, in- h Js Bibliotheca Chirurgica, vol. ii. he fays,

<e Although I have pradtifed furgery feventeen years,
and exhibited the mod difficult operations on the dead
body, I have never ventured to apply a cutting indrument
to a living fubjedt, through a fear of giving too much
pain.”

Among the other phyfiologids who flouriflied' during
the early part of the eighteenth century, we may men¬
tion Porterfield, Whytt, and Borden. The two former
were diftinguiflied by their refearches on mufcular .ac¬
tion and nervous influence; and the latter has the merit
of having pointed out the importance of the cellular
tilfue, and of defcribing many properties belonging to
it which his predeceffors had overlooked.

We can fcarcely draw a ftronger contraft as to the
different methods of acquiring knowledge than by men¬
tioning the name o f John Hunter immediately after that
of Haller: the one pofie fling every advantage which col¬
lateral knowledge could procure, a man of the moft per¬
fect fkill in languages, and profoundly erudite ; the other
ignorant of the moft Ample and elementary branches of
education. Yet they (land each unrivalled in the annals *
of our art. The name of Hunter will frequently come
before us when treating the fciences of phyfiology and
zoology ; but we mud here paufe to defcribe, in fome
meafure, the fpeculation which he adopted on the fubjedt
of life, or vitality, becaufe it has probably had much in¬
fluence on pathological dodlrines. Before the time of
Hunter, many authors had remarked that a vital prin¬
ciple exilled in the body independent of organization ;
but he firft afierted, (to ufe the words of his own enlight¬
ened eulogift,) that “ life actually conftrufted the very
means by which it carried on its various procefles ; and
that it could operate in femi-fluid, and even fluid,
fubdances.”

This fpecimen of hypothetical reafoning which Hunter
has left us, forms the only exception to the unqualified
admiration with which we are difpofed to regard him.
But certainly, this notion of a vital principle is very ex¬
travagant ; and, in attributing to it fome degree of intelli¬
gence (which he has done when 'treating of the abforb-
ents,) he has rendered himfelf liable to be oppofed by the
fame conclufive arguments which had long fince refuted
the notions of Stahl. The labours, however, of Hunter,
by giving a more certain and fixed character to phyfio¬
logy, have caufed that fcience to be ufed as the bads of
medical pradtice and every modern fyflem of nofology ;
and his extenfive refearches in comparative anatomy,
opened a field of which the further cultivation has pro¬
duced, and is dill producing, great information in regard
to the fcience of life, and, hence, to the fcience of medi¬
cine. The furgical operative improvements which Hun¬
ter made, were lome new methods of treatment in rup¬
ture of the tendo achillis, and in the operations for hy-
. drocele and fiftula lacrymalis ; and likewife in the mode
of operating for popliteal aneurifm, by taking up the
femoral artery in the fore part of the thigh.

The publications for which John Hunter is moft diflin-
guiftied, are — his work on the Veneral Difeafe, 1786, and
his Treatife on the Blood, Inflammation, and Gun-(hot
Wounds, not given to the public till after his death.
Nor (hould we omit to notice the very numerous and im¬
portant papers which he prefented to the Royal Society,
in rapid fucceflion, efpecially between the years 1773 and
1 7 83, chiefly relating to comparative anatomy and phyfi¬
ology. His fame, however, will principally reft upon his
various difcoveries in this branch of fcience ; and it would
be injuftice to his charadier not to defcribe, as amply as
our limits will admit, the Anatomical Mufeum, the for¬
mation of which may be regarded as having been the main

objedf

136 PATH

objeft of his life. In its plan it was abfolutely unique,
and the perfection to which he brought it rendered it the
admiration of all who were capable of judging of its
value. It embraced the grand delign of expofing to view
the gradations of nature, from the moll limple ftate in
which life is found to exilr, to the molt perfect and com¬
plete piece of animal mechanifm, that of man. This
collection of anatomical faCts is arranged according to the
functions they are intended to illuflrate, the different
parts of animal bodies intended for fimilar ufes being
brought together in feries, fothat the various links in the
chain of perfection are readily followed, and clearly un¬
derflood, This arrangement comprehends four great or¬
ders : the firft, parts conftruCted for motion ; fecond, parts
eflentia! to animals refpeCting their own internal economy
and prefervation ; third, parts fuperadded for purpofes
connected with external objeCts ; and, fourth, parts for
the propagation of the fpecies, and the maintenance of
the young. The Firft Order exhibits the fluids of living
bodies in a feries, from the Ample colourlefs fap of fome
vegetables to the coloured and coagulating blood; the
mufcles, from the ffcraigh t Ample mufcle to the moll com¬
plicated flruCture with elaltic ligaments ; the growth of
bone, horn, fhell, Sec. and the varieties of joints. The
Second Order comprehends the organs of digeftion, be¬
ginning with the hydatid, which is itfelf a Ample pouch,
and pafling to the polypus, the leech, and more compli¬
cated animals, including a feries of flomachs, of inteftinal
canals, and of the glands connected with them, as livers,
fpleens, See. After the organs of digeftion follows the
iyftem of abforbing vefiels, from the roots of plants up to
the laCteals and lymphatics of different animals. The
next ftep is to the heart, which, in the caterpillar, is a
Ample canal, and receives various additions as we afeend
in the fcale, until we find it a double heart in man and
quadrupeds: this leads to the ItruCture of arteries and
veins. Then the lungs are fhown in all their gradations,
from the Ample vafcular lining of the egg-fhell, which
ferves as lungs for the chicken, to thofe of the more per¬
fect animals, including gills. Sec. The windpipe and
organs of voice are Aiown under their different forms.
And, lallly, the kidneys are exhibited, which feparate the
fuperfiuous fluids from the circulation. The Third
Order takes up the brain from its funplefl ftate in- the
leech, to the fnail, infeCts, fii'h, &c. upwards; the varieties
of all the organs of fenfe in the different tribes of living
things ; and, laftly, the external coverings of hair, fea¬
thers, feales, &c. the weapons of offence and defence, as
fpurs, hoofs, horns, flings, and eleCtric organs. As an
Appendix to this Order, fome peculiar ftruCtures are
added, fuch as the air-bladder in fifh, Sec. The Fourth
Order includes all the variety of parts connected with the
procefs of generation in plants and animals, from the
polypus and coral to the perfeCt animals; thofe of females
in the maiden and impregnated Hate, including the pro¬
ducts of feeds, fpawn, eggs, Sec. the pregrefs of incuba¬
tion ; the peculiarities of the fetus ; and the various or¬
gans for the nourifhment of the young. This (ketch
gives a very inadequate idea of the amazing number of
objeCts, from every department of nature, which the col¬
lection comprifed; but it contains, befides, a large feries
of whole animals, arranged according to their internal
flruCture, many of them the rareft ever brought into this
country; fuch as the camelopard, hippopotamus, &c. It
comprehends, moreover, a feries of lkulls of different ani¬
mals, and fkeletons of almoft every known genus; an
immenfe number of calculi, urinary, biliary, and intefti-
nal ; a large collection of fhells and infeCts; and a moil
complete aflortment of extraneous foflils. By his will,
Mr. Hunter directed that this Mufeum fhould be offered
to the purchafe of government ; and, after fome negocia-
tion, it was bought for the public life for the futn of
1 5,000 /. and given to the College of Surgeons, on condi¬
tion of expofing it to public view on certain days in the
week, and giving a fet of annua! leCtures explanatory of

O L O G Y.

its contents. A large building for its reception has been
completed in Portugal-flreet, connected with the College
of Surgeons, in Lincoln’s-Inn Square ; and, in the fpring
of the year 1810, the firft courfe of leCtures was delivered
by Mr. Home and Sir William Blizard,

One of the very firft furgeon9 of the prefent day, Mr.
Lawrence, in a LeCture at the College of Surgeons a few
months ago, fpeaks of John Hunter in the following
terms : “ Mr. Hunter is the glory of England in the 18th
century. In vigour and originality of genius, in compre-
henfion and depth of thought, in unwearied induftry, he
has been furpafled by none. He was one of the men who
gave a character to the age in which they live, whole
names are affociated to the great asras of fcience, and who
do honour to the country which produces them. Occu¬
pied by a laborious profeflion, and defraying from its hard
earnings the expenfes of his multifarious inquiries, he
accomplifhed what appears almoft incredible. What
might he not have done, had his time been devoted ex-
clulively to his favourite purfuits, and had they been
aided by that pecuniary afiiftance and foftering fupport,
which the rulers of mankind fo feldom and fo unwillingly
fpare from their fchemes of war and conqueft ? He fur-
veyed anatomy and phyfiology with the eye of a philofo-
pher ; proceeding conftantly , with the aid of diflection and
experiment, to afeertain the flruCture of animals, and to
determine the nature of their functions. There is
fcarcely a branch of phyfiology which he has not illuf-
trated by fome original refearches, while he has examined
each organ in every animal that he could procure. His
Mufeum is arranged on this truly philofophical principle.;
a plan followed by Arillotle, and to be completed, I hope,
by Cuvier.” This laft eminent perfon is mentioned by
the fame diftingui filed authority, as one who hasfufrered
no . corner of the wide field of zoology toefcape his pene¬
trating glance: “Equal (obferves Mr. Lawrence) to
Buffon in enlarged views and comprehenfive grafp of
mind, and much fuperior to him in patient refearch, mi¬
nute obfervation, and learned inquiry, he prefents a rare
union of all the great requifites for promoting natural
knowledge. He has been notlefs fortunate in his fitua-
tion than in his qualifications; devoting his whole time
to fcience, and furrounded by numerous able afliflants, he
could avail himfelf, to their full extent, of thofe liberal
inftitutions for the advancement of natural knowledge,
and that uniform encouragement of talent, for which fci¬
ence will ever be indebted to the late French government.
Accordingly, his progrefs has been every-where marked
by improvement and difeovery.”

Dr. William Hunter, the elder brother of John, was a
very diftinguifhed phyfician, anatomift, and accoucheur.
We have already devoted two pretty long articles in our
ninth volume to the Hunters. We need, therefore, only
add, that to William the profeflion is indebted for the
difeovery of the membrima decidua rejlexa ; and to remind
our readers how much , we have availed ourfelves of his
fplendid work, the Anatomy of the Gravid Uterus, in our
articles Anatomy and Parturition, vols. i. and xviii.
His Mufeum, which is extremely valuable, though of a
different nature from that of his brother, is now in the
univerfity of Glafgovv, having been fent there by Dr.
Bailliefome years before the time mentioned in his uncle’s
will. See JIunter, vol. ix. p. 481, 2.

Among the molt diftinguifhed anatomifls of the 18th
century, as enumerated by Haller in his Bibliothecas, we
have the names of Morgagni, Window, Chefelden, See.
which were dated in about the firft 30 years of that cen¬
tury, except Morgagni’s work, de Sedibus and Caufis
Morborum, which he publiflied at an advanced age.
Under the title of the perJ'eSt Jlate of anatomy, Halier
reviews the works of Albinus, Senac, Monros, (the father
and fon,) Nicholls, Lieutaud, Ludwig, Leiberkuyn,
Daubenton, Camper, Walther, Meckel, Zinn, Fontana,
Wriiberg, Spalanzani, Hewfon, Portal, Sabatier, Scarpa,
Blumenbach, Troja, Sec. whofe writings extend to the

time

PATHOLOGY. 37

time when he wrote, and indeed about twelve years after,
fince the two laft of the io vols. of which that noble
work confifted were publilhed, in 1788, with additions, by
the learned editors, to that time.

While fupplying the deficiencies of Haller, and extend¬
ing the enquiries to our own times, we Ihall be convinced
of the impropriety of the title of one of his chapters juft
quoted, “ the perfeftflate of anatomy,” fince anatomy and
furgery, as well as pathology and phyfiology, have been
rapidly improving ever fince. This has arif'en from the
afiiftance of governments in the different countries.
They being convinced that anatomy is one of the moft
neceflary fciences, and the groundwork of the whole heal¬
ing art, but particularly of furgery, in many great cities
academies were inftituted for the cultivation of practical
anatomy ; and fchools were alfo eftablifhed for the inftruc-
tion of the theoretical and praftical parts of furgery.

Thefe improvements in furgery have been chiefly
made in England, France, and Germany; and in all thefe
countries a number of very eminent men have appeared.

The Englifh furgeons, befides poflefling an accurate
knowledge of anatomy, and great abilities in the operative
part of their profeflion, were the firft who endeavoured to
bring the art to its prefent fimplicity. They directed alfo
their attention, in a particular manner, to the diet of pa¬
tients ; the negleft of which had caufed the unfortunate
iflue of many operations which had been dexteroufly
performed.

Among the furgeons of later times, we may firft men¬
tion the name of Sharp. He was a fcholarof Chefelden,
and one of the beft furgeons of his day. Fie wrrote a
Compendium of Surgical Operations, 1746; and alfo a
Critical Inquiry into the State of Surgery ; both of which
works are (till in high eftimation.

In the year 1719, Dr. Monro, after vifiting the fchools
of London, Paris, and Leyden, where he was a pupil of
the great Boerhaave, came to Edinburgh ; and this may
be confidered as the date of the foundation of the Edin¬
burgh medical fchool. He began by giving leisures on
anatomy and furgery, the firft which were delivered in
Edinburgh ; and in the year 1721 he was appointed pro-
feflor of anatomy and furgery to the univerfity. This
eminent anatomift and furgeon, befides filling his chair
with the greateft reputation, contributed to the advance¬
ment of our knowledge in many important parts of ana¬
tomy and furgery. His works, publilhed by his fon, be¬
fides his T reatife on Ofteology, which is certainly the beft
defcription of the bones that has ever been given, will be
found to contain many interefting and valuable obferva-
tions on various furgical difeafes.

Jofeph Warner, furgeon of Guy’s Hofpital, in London,
publifhed his Cafes and Remarks in Surgery in the year
1754, a work which contains many very important practi¬
cal remarks. He afterwards publilhed a very good work,
containing a defcription of the human eyeand its adjacent
parts, in which he particularly rejefts thefaftening of the
eye during the operation of cataraft. He alfo publifhed
An Account of the Tefticles, their Common Coverings
and Coats, &c,

Percival Pott, furgeon of St. Bartholomew’s Hofpital,
may be juftly confidered as one of the principal Englilh
furgeons of his time. He was not only a fuccefsful prac¬
titioner, but an induftrious and excellent writer. The
merits of Pott are indeed confiderable. He threw much
light on the doftrine of wounds of the head, by his accu¬
rate arrangement of the different kinds of injuries to
which the head is fubjeft. He alfo gives a good account
of hydrocele and the other difeafes of the tefticle. For
the operation of the fiftula in ano, he made material im¬
provements. He lias given many ufeful hints on fra ft 11 res
and diflocations ; and he was a great champion in favour
of the operation for cataraft by couching. He was the
firft perfon who defcribed the chimney-fweeps cancer ;
and on hernia, polypus, and curvatures of the fpine, he
Vol. XIX. No. 1283.

has made many judicious pathological and praftical cb-
fervations.

Charles White, furgeon in Manchefter, publilhed an
excellent praftical w'ork in the year 1770, in which he
recommends amputation of the foot, a little above the
ankle-joint, inftead of under the knee, as had ufually been
praftifed. He alfo ftiows the eft’eftof fawing off the ends
of bones ; and difcuffes feveral other interefting points
in furgery. In the fame year, Mr. Elfe, of St. Thomas’s
Hofpital, publilhed his treatife on the hydrocele, in which
he recommends, the ufe of cauftic in the cure of that
difeafe.

In the year 1770, Mr. Deafe, of Dublin, wrote an ex¬
cellent treatife on the wounds of the head. Mr. Brom-
field, of St, George’s Hofpital, and Mr. Hill, furgeon at
Dumfries, alfo diltinguilhed themfelves ; Mr. Bromfield
for his Chirurgical Oblervations, and Mr. flill for his
Obfervations on Cancers.

In the year 1778, Mr. Benjamin Bell publilhed the firft
volume of his Syftem of Surgery. The reputation of this
work was foon fuch, that it was tranllated into the
French and German languages ; and it has fince gone
through feveral editions in thefe, and many in Englilh.
This work prefented the moft complete fyftem of furgery
which had ever appeared ; and in every part of it there is
difplayed a talent for praftical obfervation and clearnefs
of thought which mull render it ever a ufeful and valua¬
ble prefent to furgery. Like all fuch extenfive works, it
is not without faults, and the language in which it is
written is in fome places prolix and diffufe ; but, not-
withllanding its errors, it certainly mull be confidered as
the moft ufeful body of furgery that has yet appeared in
this country.

We are aware that we have omitted the names of very
many eminent Englilh furgeons and anatomifts ; as
Douglas, Cowper, Alanfon, Hawkins, Smellie, &c. &c.
The details, however, of their refpeftive inventions and
difcoveries, would exceed our limits ; and, indeed, may
very well be fpared, for there is confefledly great difficulty
in afcribing even anatomical fafts to their right difco-
verer, much more theabftrufe and obfcure fpeculations of
phyfiologifts. Moreover, the fame fafts have been difco-
vered by different perfons, ignorant of the refearches of
each other, and each has been equally tenacious of his
prior claim. Thus, the difcovery of certain parts of the
lymphatic fyftem, was made by Dr. Wm. Hunter, and by
Monro, jun. of Edinburgh, each unconfcious of the other’s
labours. The publication of them aroufed much con-
troverfy and litigation. Numerous inllances might be
adduced of a fimilar kind.

Periodical medical works were fet on foot in Great
Britain about this time. Upon the great utility of fuch
publications, in diffufing knowledge far and wide, we
need not enlarge after what has been faid under the arti¬
cle Magazine, vol. xiv. p. 90. The Edinburgh Medical
Eflays were firlt publifned in 1732, being eleven years an¬
tecedent to the appearance of the Memoirs of the French
Academy.

Italy, during this period, lent fome aid to the improve¬
ment of furgery, by the leftures of Molinelli, Bertrandi,
and Mofcati ; while, in Holland, Albinus, Deventer, and
Camper, by their difcoveries and improvements, and ftill
more by their free communication of them, endeavoured
to remove the ftigma which the charlatanifm and fe-
crecy obferved by Ruyfcli, Roonhuyfen, and Raw, had
thrown on the furgery of that country.

In Germany, and the north of Europe, flourifhed
Heifter, the feliow-ftudent of Albinus, Blatner, Roederer,
Stein, Bilguer, Acree, Brambilia, Theden, Richter, &c.

The reign of Louis XIV. has been called, by Richerand,
the iron age of furgery in France. Yet the French, at
that time, prided themfelves on the almoft exclufive pof-
feffion of chirurgical praftitioners. “ Les progres de la
chirurgie,” obferves M. De Francheville, “furent fi

L rapides

PATHOLOGY.

88

rapides et fi celebres dans ce fi&cle, qu’on venait a Paris
des bouts de l’Europe, pour toutes les cures, et pour
toutes les operations qui demandaient une dexterite non
commune. Non feulement il n’y avait gu^res d’excellens
chirurgiens qu’en France; mais c’etoit dans ce feul pais
qu’on fabriquait parfaitement les inftrumens necelfiaires.”
It is fomewhat Angular however, that, amidft all this
boafted pofleflion of chirurgical knowledge, the fiftula in
ano (hould be a difeafe in which the French furgeons were
fearful of operating, and which had often proved fatal
beneath their attempts. Cardinal Richelieu fell a facri-
fice to the unfkilfulnefs with which the operation was
performed ; and, when the king entrufted himfelf to the
care of M. Felix, his chief furgeon, fo hazardous was
this operation deemed, that all the hofpitals were ran-
facked for thofe who had laboured under the fame
difeafe; and innumerable confultations were held with
other furgeons of known reputation, to determine on the
mode of operating that Ihould appear leaft painful and
dangerous. The churches alfo were perpetually crowded,
and prayers perpetually offered up throughout the whole
kingdom, to avert the fatal termination which was fo
generally apprehended. And, when this monarch was
attacked by the difeafe to which he fell a viftim, he be¬
came diflatisfied with his own phyficians, and employed
an empiric, who boafted of being able to cure him
fpeedily, but under whole care he expired in a few days.

We have gone back to the 17th century to fpeak of
theftate of furgery under Louis XIV. as he died at the
beginning of the 18th. Yet we cannot help attributing
the great perfection the art acquired in the laft century
to the exertions of that powerful monarch. He founded
hofpitals and colleges, eftablifhed profefforfhips, which he
required to be filled only by furgeons of acknowledged
talent : he commanded bodies to be liberally fupplied to
the anatomifts; and hence Paris became the medical and
chirurgical fchool of the greateft celebrity on the con¬
tinent.

Petit and Default are the firft and moft confpicuous au¬
thors who come under our obfervation at this time. The
eulogium on J. L. Petit, delivered in the Royal Academy
of Surgery, of which he was one of the firft and moft dif-
tinguilhed members, reprel^nts him as blending the ftudy
of anatomy with his amufements when a boy ; and ar¬
dently feeking every opportunity to increafe his know¬
ledge by obfervation. He had had experience enough to
publilh, at an early period of his life, his “ Traite fur les
Maladies des Os,” Paris, 1705, umo, a work, which for
a century was efteemed the belt upon the fubjeCt. It may
be noticed, that his fuccefs was moft virulently oppofed
by the envious. It was not till after more than thirty
years of academical labours and extenfive practice, that
he was unanimoufly elected chief of his affociates. This
acknowledged fuperiority was the more flattering, as
j. L. Petit obtained it at a period when furgery was in a
flourifliing ftate in France, and where he held no place
from which he could derive an influence foreign to his
perfonal merit. While Marefchal, La Peyronie, and La
Martiniere, allured him of the royal favour, Quefnay,
Morand, and Louis, who corrected his writings, made
him fpeak a language that does honour to the famous
colleftion to which he contributed his obfervations (fee
Memoires et Prix de l’Academie Royale de Chirurgie, 10
vols. 4to.) and in which, if we except fome theoretical
explanations, nothing has loft its value by age. In Ihort,
it will ever be confidered as one of the moft valuable col-
leftions of furgical knowledge. J. L. Petit was alfo the
author of a “Traite des Maladies Chirurgicales, et des
Operations qui leur conviennent ; Ouvrage pofthume ;” a
production that will always Hand high in the eftimation
of the judicious furgeon.

Of Default we may remark, that he is highly cele¬
brated for the exaftnefs and method which he introduced
into the ftudy of anatomy ; the ingenious apparatus
which he invented for the treatment of fraftures j a noble

ardour in his profefllon, which he knew how to infufe
into all his pupils ; and the boldnefs and fimplicity of his
modes of operating. His clinical leisures upon furgery
were the firft ever delivered. Indeed, fuch was his ge¬
nius, that, when he pra&ifed only methods already un-
derftood, lie did them with fo much adroitnefs, that he
rather appeared to be the inventor of them. He wrote
the Journal de Chirurgie, 4 vols. 8vo. and left behind him
CF.uvres Chirurgiques, 3 vols. edited by Bichat. He
likewife furnifhed many papers to the Memoirs of the
Academy of Surgery, and was a diftinguilhed member of
the Ecole de Sante which fucceeded it.

What tended principally to raife the reputation of
French furgery to fo high a pitch, was the union of indi¬
vidual labours in the Academy of Surgery juft men¬
tioned. This valuable inftitution, which gave our conti¬
nental neighbours fo great an advantage over us, was un¬
fortunately fupprefied at the time of the revolution ;
and every one interefted in the improvement of fcience
muft deeply regret the difcontinuance of a fociety, in
which emulation and talents w.ere fo long united for the
benefit of mankind. The various diflertations, publilhed
by the illuftrious members of the Academy, will ferve as
a perpetual memorial of the fpirit, ability, and fuccefs,
with which the obje£Is of the inftitution were purfued ;
and centuries hence, pra&itioners fhall reap from the
pages of its Memoirs the moft valuable kind of furgical
information. Indeed, the “Memoires et Prix de l’Aca-
demie Royale de Chirurgie” is a work which is abfo-
lutely indifpenfable for every furgeon, and the various
parts of which cannot be too often confulted. In it are
preferved the labours of Le Dran, Garengeot, De la Faye,
Louis, Verdier, Foubert, Hevin, Pibrac, Fabre, Le Cat,
Bordenave, Sabatier, Puzos, Levret, and feveral other
pra&itioners, who, though lefs famous, have contributed
by their exertions and knowledge to form this uleful
body of furgical fails. The preceding furgeons alfo dif-
tinguifhed themfelves by other productions.

Le Dran publilhed, 1. Parallele des differentes Ma-
nieres de tirer la Pierre hors de la Veflie, 1 21110. a.
Operations de Chirurgie, 2 vols. i2tno. 3. Obfervations
de Chirurgie, 2 vols. 121110. 4. Traite des Plaies d’Armes
a feu, i2ino. 5. Confultations de Chirurgie, i2mo.

Garengeot wrote: 1. Traite des Inftrumens de Chi¬
rurgie, 2 vols. 121T10. a. Traite des Operations de
Chirurgie, 3 vols. i2mo.

Fabre was the author of Recherches fur l’Art de
Guerir, 8vo.

Le Cat wrote : Recueil de Pieces fur l’Operation de la
Taille.

Sabatier publilhed the Medecine Operatoire, 3 vols. 8vo.

Puzos compofed Traite des Accouchemens ; Paris,
1759, 4to.

Levret wrote, 1. Obfervations fur les Accouchemens
laborieux ; Paris, 1747. 2. Art des Accouchemens,

demontre paries Principes de Phyfique; Paris, 1761, 8vo.
3. Eflai fur l’Abus des Regies generates, & c. Paris,
1766, 8 vo. 4. Obfervations fur la Cure radicale des
Polypes; Paris, 1749.

La Motte publilhed: 1. TraitC complet des Accouche¬
mens naturels, non-naturels,et contre Nature. 2. Traite
complet de Chirurgie.

Miutre-Jean was the author of TraitC des Maladies de
l’Oeil, 4to.

Goulard wrote : CEuvres de Chirurgie ; Liege, 1763, 2
vols. unto.

Ravaton compofed, Le Chirurgien d’Armee.

Pouteau : 1. Melanges de Chirurgie, 8vo. a. CEuvres
pofthumes, 3 vols. 8vo.

David, Obfervations fur laNecrofe ; Paris, 1782, 8vo.

The Academy of Surgery, which was overthrown
during the French revolution, had at firft a very inferior
fubftitute in the Ecole de Sante ; but, fince the reftora-
tion, has been fucceeded by the Ecole de Chirurgie, (fee
Paris, vol. xviii. p. 467.) which has brought forward

Boyer,

P A T H

B oyer, Heritier, Dubois, Manoury, Lallemand, Richerand,
Petit de Lyon, and, above all, Bichat.

To Bichat, the ingenious and enlightened Bichat, the
world is indebted for the firft truly philofophical view
of the ftrudture of the human body. The Ample divifion
of it into its component parts, which this great anato-
mift and philofopher has pointed out, mult be conlidered
as the ground-work of all future anatomical and patho¬
logical inquiries.

Bichat demonftrated, that moll of the organs of our
body are made up of a variety of elementary parts or
textures ; each of which, in whatever part of the body it
is found, uniformly has the fame phyfical properties, and
prefents the fame morbid phenomena. Thefe he confiders
as the elementary parts ; which, by the diverfitv of their
combinations, produce all the modifications of ftrudlure
and functions exhibited in the different organs of ani¬
mals, This method of confidering organized bodies,
accords with every phenomenon with which we are ac¬
quainted, and feems to arife from the eflential nature of
their conftitution. We may trace this view of the ftruc-
ture of the body in the obfervations of many of the older
anatomiffs ; and particularly it may be conlidered as the
bafis of fome of the rnoft ingenious philofophical theories
of the late ingenious Mr. John Hunter.

In order to fix the characters of the elementary tex¬
tures, Bichat employed various modes of inquiry. He
performed numerous experiments on living animals ;
perfevered in tedious and minute diffe&ions; employed
chemical re-agents to fupply the place of the knife ; and
examined with minutenefs all the varieties of morbid
ltruCture. Having by thefe means accomplilhed his ob¬
ject in tracing the character of each feparate texture, he
proceeded next to inveftigate their combinations as they
are found in the different organs.

The effeCts of this mode of inveftigating the ftruCture
of the human body when difeafed, muff be at once ob¬
vious. We learn from it, that difeafes at their com¬
mencement are generally confined to one texture of an
organ; the other textures of which the organ is com-
pofed remaining found. There is no organ of the body
from which this important truth may not be deduced.
It may be readily illuftrated from confidering the dif¬
eafes of the mucous, ferous, and mufcular, textures,
which compofe the ftomach and alimentary canal ; of the
cellular texture of the lungs ; of the mucous membrane
of the bronchi, the ferous one of the pleura, and many
others.

But difeafes are not only confined to one individual
texture of any organ, as in the cafes juft mentioned ;
the fymptoms and morbid changes are likewife uniformly
the fame in textures of a fimilar ftruCture, in whatever
parts of the body thefe textures may happen to be found.
Thus the ferous membranes which in veil the lungs, the
brain, the heart, the abdominal vifcera, have one com¬
mon character when affeCted with any fpecific difeafe;
fo alfo have the mucous membranes, whether we trace
them in the mouth, the nofe, the vagina, the urethra,
or covering the eye-ball ; and the fame may be obferved
of every individual texture which enters into the com-
pofition of our bodies.

Befides the fymptoms and morbid changes which are
common to all textures whole ftruCture is fimilar in the
natural Hate, there are others which are determined from
the particular functions of the organ in which the dif¬
eafed texture exilts. For example, when any of the fe¬
rous membranes are inflamed, the nature of the pain,
the degree of fever, and the duration of the fymptoms,
are the fame, in whichfoever one it may have taken
place. But to thefe fymptoms are added, cough, diffi¬
culty of breathing, See. when it happens to be connected
with the organs of refpiration, as in the cafe of pleuritis ;
coltivenefs, ftrangury, delirium, lofs of vifion, when
the inteftines, the bladder, the brain, or the eye, are in¬
volved in the difeafe.

O L O G Y. 39

This view of the fubjeCt naturally fuggefts a corre-
fpondent divifion of the fymptoms. The firlt clafs are ge¬
neral, and cbaraCterife a whole genus of textures; the
fecond are in a manner accefifory, and depend upon the
relative fituation or the particular functions of the or¬
gan into the compoiition of which the affeCted texture
enters. But here we mud fet bounds to this theory.
The hiftory and progrefs of difeafes Ihow, that we ought
not to confine our obfervations within l'uch narrow li¬
mits. The principles which have been Hated, indeed,
account admirably well for the propagation of fome af¬
fections ; and for fome of the fympathies which fubfift
between different parts of the body; but there are other
diforders which advance in a very different manner. In
fome difeafes which are termed chronic, for example, the
whole ftruCture of an organ becomes gradually altered,
although the primary affeCtion was confined to one of
its component textures. This is often to be obferved
in cancer, fcrofula, lues venerea, Sec. Thefe general
obfervations, however, will be fufficient to give an out¬
line of the principles of a pathological lyftem founded on
the bafis of anatomical knowledge ; but the details of
which are referved for another place.

With regard to the Jurgery of the prefent day, we may
remark, that our labours have of late been chiefly di¬
rected, by means of phyfiology and pathology, to the
treatment of furgical cafes ; and, though in that refpeCl
we may be allowed to Hand far before our anceftors, yet
even in Ample operations we are not without improve¬
ment. The bold and fuccefsful operations of Larrey
will teftify this, as well as the grand operations for
aneurifms performed by Abernethy, Lawrence, Aftley
Cooper, and others of ourEnglifh furgeons, whofe names
however we forbear to mention, convinced of our in¬
ability to do juftice to the merits of all, and unwilling to
appear invidious by the exclufion of any. •

We now haften to the confideration of thofe patholo¬
gical theories, which, perhaps more than any other
branch of medicine, form the criteria of medical prac¬
tice.

The medical theorifts, then, of the 18th century,
were chiefly Cullen, Brown, and Darwin. If we were
inclined to draw companions in regard to merit, the firft
of thefe phyficians would deferve ourgreateft encomium ;
for he obferved nature with acutenefs, and w>as conliftent
and rational in his treatment of difeafe, which cannot be
accorded to either of the latter. He likewife made an
arrangement of difeafes which had great merit, and
which nothing but the increafe of phyliological know¬
ledge, and its fuccefsful application to pathology, that
has taken place in our time, can warrant us in departing
from, and which indeed we promifed to adopt. See vol.
xvii. p. 245.

Cullen’s pathological doctrines were a modification of
the theory of Hoffman. From that author he took up
the dodtrines of l'pafm and debility, and deduced from
them all the phenomena of febrile diforders; and he en¬
deavoured to confirm his theory by proofs drawn from
the laws of the nervous fyftem, and from the confidera¬
tion of the remote caufes of the difeafes in queftion.
Rheumatifm was referred by him to a fpafm of the muf¬
cular fibres, arifing from an increafed afflux of blood;
but gout he conceived to originate in atony, efpecialiy
in atony of the digeftive organs. In thefe latter difeafes,
he rejected the idea of a peculiar morbific matter; yet in
his explanations of certain other complaints, as, for
inftance, of fcrofula, he had recourfe to the fuppofitiou
of an acrimony of the fluids. He laid much ftrefs on the
efforts of the vis medlcatrix nature, advocated the hypo-
thefisor a nervous fluid and vital principle, and aferibed
to the brain a peculiar faculty, by which it was enabled
to excite the mufcles to adlion, independently of the
mind, and to which he gave the name of irritability of
the fenj'orium. Cullen feems to have been much in the
fame fituation with Boerhaave as to anatomical and

phyliological

40

PATHOLOGY.

phyfiological learning, of which many of his fpeculations
betray a fad deficiency.

In regard to fever, Dr. Cullen’s theory was that the
firft change induced in the animal fyftem by the opera¬
tion of the exciting caufes of fever is, “ diminution of
the energy of the brain.” The powers of the body and
the mind, the functions of fenfation and motion, refpi-
ration, circulation, and fecretion, all fail, or are dimi-
niflied in the general debility ; but, after a certain time,
a morbid increafe of fome of thefe funftions, efpecially
of the circulation, takes place, with an augmentation of
the heat. The three Hates of debility, of cold, and of
heat, which regularly fucceed each other in fever, in the
order juft mentioned, are prefumed to exift in the rela¬
tion of caufe and effedt ; the firft ftate being the refult of
the fedative or debilitating influence of contagion, rnarfh-
miafmata, and cold, which are the exciting caufes. Dr.
Cullen acknowledges his inability to explain fatisfadlo-
rily, how the debility produces all the phenomena of
the cold ftage, efpecially the Jpafmodic conllridtion of the
extreme arterial veflels, which is inferred from the luf-
penfion of the fecretions, and the flirinking of parts, in
the cold ftage, as well as from the continuance of this
fufpenfion in the hot ftage, after the aftion of the heart
and large arteries is increafed. Were the conftridHon of
the cold ftage merely the refult of the weakened adfion
of the heart, it is fuppofed, that, on the return of its
ordinary or increafed adtion, the conftridfion would be
removed, and the fecretions reftored. Here Dr. Cullen
reforts to “ the vis medicatrix nature, fo famous in the
fchools of phyfic i. e. the innate preferving power of
the conftitution, which has been appealed to for the fo-
Jution of difficulties by all medical theorifts, from Hip¬
pocrates downwards. This “ fpafm of the extreme vef-
fels,” then, is confidered as “ a part of the operation of
the vis medicatrix naturae j” at the fame time, Dr. Cullen
is of opinion that, during the whole courfe of fever,
there is an atony exifting in the extreme veflels, depend¬
ing on the diminifhed energy of the brain, and that the
relaxation of the fpafm requires the reftoration of the
tone and adtion of thefe. To this atony in the veflels of
the fkin, he attributes the lofs of appetite, naufea, and
vomiting, the ftomach being affedted by fympathy. The
fpafm induced in the extreme veflels throws a load of
blood upon the central parts of the circulating fyftem,
which proves a fource of irritation to the heart and ar¬
teries, and excites them to a greater adtion, which con¬
tinues till the fpafm is relaxed or overcome. The hy-
pothefis is thus briefly recapitulated : “ Upon the whole,
our dodlrine of fever is explicitly this. The remote
caufes are certain fedative powers applied to the nervous
fyftem, which, diminiftiing the energy of the brain,
thereby produce a debility in the whole of the fundlions,
and particularly in the adtion of the extreme veflels.
Such, however, is, at the fame time, the nature of the
animal economy, that this debility proves an indiredt
ftimulus to the fanguiferous fyftem ; whence, by the in¬
tervention of the cold ftage, and fpafm connedted with
it, the adtion of the heart and large arteries is increafed,
and continues fo till it has had the effedt of reftoring the
energy of the brain, of extending this energy to the ex¬
treme veflels, of reftoring therefore their adtion, and
thereby efpecially removing the fpafm affedting them ;
upon the removing of which, the excretion of fweat, and
other marks of the relaxation of excretories, take place.”
Cullen’s Firft Lines, § 46.

To this theory it has been objedted, firftly, that it is
founded, as far as regards the vis medicatrix natures, on
the gratuitous affumption that a principle exifts of which
we have fenfible evidence ; fecondly, that, to take the
cold ftage as the proximate caufe of the after-phenomena
of fever, is difl'onant with evident fact ; for the hot ftage
of fever often comes on apparently from external caufes,
and unaccompanied by the cold ftage; and thirdly, that,
with regard to fpafm of the external veflels, 1'uch an oc¬

currence affords no explanation of febrile phenomena ;
and indeed it feems quite abfurd to fuppofe that the hot
ftage and the cold ftage can by any means be confequences
of the fame adfion ; and that, fo far from the capillaries
being contradfed, we have pretty clear evidence tha"t
they are extremely diftended with blood during all febrile
difeafes in which the fkin is affedted.

In a paflage of his “ Inftitutions of Phyfiology,” Cullen
fpeaks of a ftate of excitement, or collapfe, of the brain and
nervous fyftem, on which he fuppofes the ftrength or
debility of the other parts of the body to depend ; and
in his other writings, he is constantly labouring to prove
ill what manner thefe conditions may be occafioned by
the agency of various caufes. Brorcn, feizing upon this
idea, let about the formation of a new theory, according
to which all the adtions of life were to be referred to the
excitement of the body by Jlimuli, and all difeafes reduced
to the two general heads of diredl and indiredl debility, or
debility ariling from a deficiency, or a previous exoefs,
of excitement j or in other words into fthenic and afthe-
nic diforders.

The Brunonian fyftem might very well be compared
with the Methodic, its diftinguilhing features being the
referring of all difeafes to two oppofite conditions of the
conftitution, Jlhenia and ajlhenia, or ftrength and debility,
which might with almoft equal propriety have been called
Jlridlum and laxum, (fee p. 11.) and the confequent ex-
clufion of all particular inveftigation of the minute dif-
tindtions in the phenomena of difeafes which it encou¬
raged.

This fweeping arrangement was, however, much
lauded in many parts of the continent, and gained a very
large proportion of advocates in our country, among
thofe who had not fufficient knowledge of nature to de-
tedt its fallacy. The molt general of Brown’s principles
are thus explained.

1. To every animated being is allotted a certain portion
only of the quality or principle on which the phenomena
of life depend. This principle is denominated excit-
ability.

2. The excitability varies in different animals, and in
the fame animal at different times. As it is more in-
tenfe, the animal is more vivacious or more fufceptible
of the adfion of exciting powers.

5. Exciting powers may be referred to two clafles.
1. External; as heat, food, wine, poifons, contagions,
the blood, fecreted fluids, and air. 2. Internal; as the
functions of the body itfelf, mufcular exertion, thinking,
emotion, and paflion.

4. Life is a forced ftate ; if the exciting powers are
withdrawn, death enfues as certainly as when the excit¬
ability is gone.

5. The excitement may be too great, too fmall, or in
juft meafure.

6. By too great excitement, weaknefs is induced,
becaufe the excitability becomes defective ; this is indi¬
rect debility : when the exciting powers of ftimulants are
withheld, weaknefs is induced; and this is diredt debility.
Here the excitability is in excefs.

7. Every power that adts on the living frame is ftimulant,
or produces excitement by expendingexcitability. Thus,
although a perfon accuftomed to animal food may grow
weak if he lives upon vegetables, ftill the vegetable diet can
only be confidered as producing an effedt the fame in kind
with animal, though inferior in degree. Whatever powers,
therefore, we imagine, and however they vary from fuch
as are habitually applied to produce due excitement, they
can only weaken the fyftem by urging it into too much
motion, or fuffering it to fink into languor.

8. Excitability is feated in the medullary portion of
the nerves, and in the mufcles. As foon as it is any¬
where affedted, it is immediately affedted every-where ;
nor is the excitement ever increafed in a part, while it is
generally diminifhed in the fyftem ; in other words, dif¬
ferent parts can never be in oppofite ftates of excitement.

We

41

P A T H

We will not detain our readers by detailing all the
numerous controverfies in which this theory has engaged
the medical world, nor by repeating the various argu¬
ments which oppofed its adoption among the more en¬
lightened of our own phyficians : for an hypothecs which
fails to explain all the phenomena of difeafe cannot be
confidered worthy of our notice ; and how could it be
fuppofed that Brown, who paid little attention to the
minute fymptoms of difeafe, was capable of generalizing
fadts fo various and anomalous ? In no inftance does
the application of thefe principles form fo much a fubjeCt
for regret as in regard to the treatment of fever prac-
tifed by the followers of Brown. It may be laid, without
exaggeration, to have immolated millions of our fellow-
creatures. It inculcated methods of treatment the moll
oppofite to thofe indicated by nature and common fenfe.
Let the ftatiftical reports of mortality in every climate
teftify the truth of this painful affertion. To ftimulate
in inflammatory diforders is a mean fo repugnant to the
feelings of the patient, or the advice of every practical
author, from the time of Hippocrates downwards, that
we are aftonifhed at the extenfive prevalence of fo ablurd
a practice. We fliould remark, however, that the more
enlightened of Brown’s followers modified his doCtrines
conliderably, and in their practice often departed ef-
fentially from his dogmas. In attempting to explain the
phenomena of fever according to the doCtrine of direCl
and indirect debility, Brown has the following expref-
lions : “ The diftinCtions that phyficians have made
about the differences of fevers are all without foundation ;
they are all the fame, with no other difference but in de¬
gree ; and, unlefs in that refpeCt, they do not differ from
other difeafes of the fame form.” Elements of Medicine,
§ 662. note m. He does not, however, attempt to ex¬
plain the manner in which the various fucceffion of fymp¬
toms refults from the ftate of debility, or how the various
modifications of the pyrexiae are to be accounted for
upon this principle. The only approximation to fuch
an explanation, is merely an enumeraiion of the leading
changes in the fymptoms after the manner of Cullen, but
lefs explicit than the one given by that author. We are
told, that “ the debility during the cold ftage is the
greateft ; that of the hot lefs ; and that of the fweating
ftage, wdiich ends in health for the time, is the leaft of
all. Hence, in a mild degree of the difeafe, as cold is the
moft hurtful power, its effeCt is gradually taken oft'by the
agreeable heat of the bed or of the fun, and the ftrength
thereby gradually drawn forth. The heart and arteries,
gradually excited by the heat, acquire vigour, and, at
laft, having their perfpiratory terminations excited by the
fame ftimulus, the moft hurtful lymptom is thereby re¬
moved, the hot fit produced, and afterwards the fame
procefs carried on to the breaking out of fweat.” § 666.
We are farther told, that “ the caufe of all thefe diieafes,
(viz. fevers, from the Ample and intermittent to the
gaol-fever and the plague,) is the fame with that of dif¬
eafes not febrile, to wit, debility ; differing only in this,
that it is the greateff debility compatible with life, and
not long compatible with it.” § 670.

Such is the vague and inexplicit theory which divided
the medical world, which excited fo much intereft in
thofe who efpoufed or oppofed it, and infpired fuch a de¬
gree of enthufiafm in the debates and writings efpecially
of the pupils of the feminary which gave it birth, that it
not unfrequently burft forth with all the violence of re¬
ligious phrenzy. This indeed is little to be wondered
at, when we confider that half-educated young men, as is
the cafe with the great proportion of medical ftudents,
unaccuftomed to patient inveftigation, and fond of no¬
velty, are the moft apt to embrace fuch fpeculations as
could be fupportedand defended by ingenious and lubtle
reafonings rather than by accurate and extenfive<obferva-
tion. It was admirably well calculated to flatter the va¬
nity of the fuperficial, and to abridge the labours of thofe
difpofed to be idle, fince it was abundantly more eafy to

Vol. XIX. No. 1285.

O L O G Y.

defcant upon the fthenic and affhenic forms of difeafes,
and the excefs and deficiency of excitement, than to de-
fcribe the diftribution of the blood-veffels, or to trace
the courfe of the nerves. The knowledge of anatomy
and phyfiology was toaBrunonian perfectly ufelefs; and
the laborious foil requifite for the acquirement of thefe
branches of ftudy might well be fpared him, fince the
ftruCture of the human frame and the functions of its va¬
rious organs were by no means neceffary confiderations,
either in his eftimation of the caufes of difeafes or of the
means requifite for their removal. The beautiful Jintpli-
city of the fyftem, accordingly, recommended it chiefly to
thofe who were moft deficient in that folid knowledge
which can alone form the balls of a fuccefsful cultiva¬
tion of medical fcience; whilft its fallacy was too evident
to thofe who had opportunities of witnefling its want of
accordance with the natural operations of health and the
phenomena of difeafes.

It is, however, fully admitted, that Dr. Brown poffeffed
great vigour of mind, and feems to have been capable of
confiderable application. His talents, had they been di¬
rected to more practical and more ufeful objedts, would
have probably raifed him to eminent diftinCtion, and ren¬
dered him a valuable member of fociety. The ftyle of
his Elementa Medicines is harfli and unpolilhed, and his
meaning is often dark and ambiguous. But perhaps this
want of perfpicuity is as much owing to the fubjeCts
which he treated, the principles of which are far from
being fettled, as to the obfcurity of his expreffion. He
attempted an unbeaten path ; it is not wonderful that he
was often bewildered and loft.

A French phyfiologift and pathologift of the prefent
day, Dr. Brouffais, (Examen des DoCtrines Medicates,
1821.) has bellowed about a hundred pages on a review
of the Brunonian fyftem ; but at length he happily comes
to the conclufion, at which all the reft of the medical
world had arrived long fince, “That the claflification of
difeafes by Brown, into fthenic and althenic, general and
local, is quite arbitrary.” He then enters upon the con-
fideration of what he calls the Brownifm of the Italian
fchool. He firll (hows how readily the Italian phyficians
adopted the fyftem of the Scotch reformer in the firll in¬
ftance; and, next, how they fubfequently modified it, by
various interpolations of their own, fo as to create a new
doctrine, to which the name of contra-ftimulant has been
given. According to this fyftem, of which Rafori was
the founder, there exift but three claffes of difeafes : ill,
thofe arifing from excefs of excitement; 2dly, thofe from
want of due excitement; and sdly, thofe refulting from
local irritation, or dillurbance of the vital aCtions of the
part, differing both from inflammatory excitement and
from debility. The two former are, refpeCtively, the
fthenic and afthenic maladies of the older fchools. The
latter requires a little explanation. According to Guani,
the founder of this point of doCtrine, the animal body
is endowed with a property, inherent with its organiza¬
tion, by which it either aflimilates to itfelf thole fub-
ftances brought into contaCt with it, or enters into a re¬
action for the purpofe of rejecting them. All thofe fub-
ftances which it appropriates to itfelf, produce what is
termed animal excitement which is the agency of the affi-
milative property; whilft thofe which are not afiimilable
produce an action called irritation, which is a fort of dif-
turbance, tumult, or orgafm, of the part, and which
may extend from the part where the irritating caufe is
applied more or lefs generally over the fyftem. This ftate,
he argues, differs from the two former, becaufe it is not
relieved by either ftimulants or fedatives. It obftinately
continues as long as the caufe of it exifts ; but, when the
caufe is removed, the effeCt inftantly ceafes, and it is
never productive of real excitement, but foon, if it per-
fift, induces debility.

Guani appears to confider that animal excitement pro¬
perly, (by which he means exaltation of the vital aCtions
without abfolute change of their qualities,) only arifes
hi from

42 P A T H O

from the local application of fubftances really affimilable,
or from the prefence of fuch in the fyftem generally.

This dodtrine of irritation was adopted by Giannini,
and applied by him to the explanation of the phenomena
of fever arifing from contagion. The virus, he fays, on
being admitted into the fyftem, in proportion as it is
diffufed and applied to different parts of the body, caufes
an irritation, which is improperly called excitement, or
the effects of a Jiimulant. This irritation extending
throughout the fyftem, becaufe the irritating matter is
thus diffufed, carries every- where a local caufe of difeafe,
and thus produces a malady that is “univerfally local,”

( una malattia univerfalmente locale,) but which does not
conftitute th ejllicnic diathefis of the fchools. This fever
is only the tumultus tolo corpore diffufus of Brown ; and
is fimilar to the affedtion arifing from the irritation of a
ftone in the bladder, or the fever arifing from burns, fe-
verefurgical operations, &c. fo well treated by Dumas.

Guani, Bondoli, and Rubini, confidered this ftate of
irritation as a particular diathefis, and propofed what
they imagined to be the caufes of its exiftence and pro-
grefs. Profeffor Tommaflini alfo adopted the elementary
principles of the fame dodlrine, but modified the propo¬
rtions the phyficians already named had made refpedting
its laws. He believes that irritants may at length give
rife to real inflammation. The following are the general
axioms he endeavours to eftablilh.

ift. There exifts an order of fubftances (as well as a
partial condition of the animal ftrudture, which rela¬
tively to the reft of the organization is an extraneous
body) which, on making an impreflion on the animal
economy, produce an adtion different from thofe termed
Jiimulant, and fedutive, or more properly contra-Jlimulant ;
and which is, properly fpeaking, irritation.

adly, Some fubftances are naturally and primitively ir¬
ritative, but which may fecondarily become ftimulants
where they give rife to phlogofis ; or they may become
contra-ftimulants (fedatives ) when they produce pain or
coldnefs, or diftrefling naufea; as pain, coldnefs, and
naufea, themfelves, aft as contra-ftimulants. Others are
irritants by their quantity or concentration, or the man¬
ner of applying them, which induce either mechanical
diftenfion, or chemical decompofition, accidentally, and
may by their nature appertain to one or the other of the
two clafles of dynamics.

3dly, The ftate they produce may be diftinguifhed
from all other ftates by the following charadters: i. by
its incurability by means either of ftimulants or contra-
ftimulants : 2. by the obftinacy of its duration in fpite
of all attempts to remove it, as long as the caufe is pre-
i'ent and active: 3. by the readinefs, and as it were in-
ftantaneoufnefs, of its ceflation, as foon as the caufe is
deftroyed : 4. by the type of the difeafe, which is mani-
feftly local, even where the difturbance by fympathetic
content is univerfally difperfed.

4thly, Irritating fubftances may be either chemical
agents, which enter the organization, or mechanical agents,
which torment it, or a difordered ftate of a living part,
which becomes a centre of irritation with refpedt to the
whole fyftem.

5thly, Inaflimilability, lieterogenity, and inaffinity,
cannot be the efi'ential and diagnoftic charadters of irri¬
tants ; becaufe thofe characters do not appertain exclu-
fively to them ; nor, perhaps, to them univerfally.

6thly, In the prefent ftate of our knowledge, we are,
then, conftrained to define an irritant a pojleriori, that
■which produces the train of morbid phenomena de-
feribed under the name of the irritative tumult.

7thly, Irritation very often terminates by inducing
phlogofis in the centre of its own adtion, and then it en¬
ters into the clafs of diathefic (inflammatory) difeafes,
preferving neverthelefs, not urfrequently, the character
of irritation.

1. The difeafes of the firft clafs, thofe confifting in ex-
ceflive excitement, may then arife from all irritating and

LOGY.

exciting caufes, whether contagious virus, mechanical
or chemical injury, or excefs of the natural excitants of
the economy. Thefe produce, in the firft inftance, local
effects of the nature above indicated, which eft'edts are at
length diffufed over the fyftem to a greater or lefs extent,
according to the violence of the caufe, and the conftitu-
tional difpofition of the patient. This inflammatory ex¬
citement is of the fame nature, from whatever caufe it
arifes, and in whatever part it may be feated. It is of
importance to remark, too, that local excitement pro¬
duces only excitement as far as its influence extends, and
not debility of the reft of the fyftem by any concentration
of the vital actions, as is taught in fome other fchools.
Inflammation may occur, alfo, in an inter.fe degree, in
any certain organ, whilft the reft of the fyftem is in a
ftate of the utmoft debility ; and it is, indeed, more rea¬
dily excited in a ftate or weaknefs than in vigour, be¬
caufe the animal fibre is then more fufceptible of the in¬
fluence of ftimulants. Inflammation is, however, always
originally of a Jlhenic character; and it preferves this as
long as it exifts, even in the midft of the molt defolating
privation of vital power.

All fevers, acute and chronic, whether arifing from
the impreflion of cold, excefs of the natural excitants of
the body, animal contagion, or marfli-effluvia ; all acute
and chronic local inflammations, cutaneous ulcerative
difeafes, and phthifis ; take their place in the firft clafs.
The general caufes of this clafe of difeafes have already
been defignated as thofe of effentially excitant or irrita¬
ting qualities, but, in addition to thofe fliould be men¬
tioned, fome others which, under circumftances, are con¬
tra-ftimulants. Thus, pain, to a certain degree, is a feda-
tive ; but it becomes an excitant, when intenfe ; and
many fubftances, which are contra-ftimulant in certain
quantities, become either excitants or irritants when
given in larger quantities; this is the cafe with the tar*
tarized antimony, belladonna, digitalis, &c.

2. The fecond clafs of maladies are of the nature which
thedodtrines of Brown would term direEl debility, or that
depending on want of due excitement. The dodtrine
under confideration does not admit the exiftence of fuch
as he termed difeafes of indirect debility, or exhauftion
from previous excefs of excitement. The effedft of fti¬
mulants is confidered to be conftantly and folely excite¬
ment.

3. The charadter of the difeafes of the third clafs was
indicated when the nature of irritation was particularly
confidered.

This dodirine not only oppofes the moft favourite
dogmas of the Brunonians, that of the exiftence of what
they term indirect debility ; it alfo attacks their principle
of the effentially ftimulating quality of every fubftance
making an impreflion on the animal body. It teaches,
ift, That many fubftances adt on the animal fibre in a
mode diametrically oppofite to the ftimulant agency,
whence refult the effedts which Brown attributed only
to the negative adtion, or want of adtion, of different
fubftances; or to the diminution of the natural exci¬
tants of the fyftem. 2dly, That we may deftroy, by the
adminiftration of thefe fubftances, the effedts of exceflive
ftimulants, and that without thefe fubftances neceffarily
producing any evacuation ; and that we may, by fre¬
quent repetition of their ufe, produce difeafes which are
not fufceptible of cure by the intervention of ftimulants.
3dly, That contra-ftimulants, fuch as blood-letting and
purgatives, offer the means of cure for all maladies
which refult from excefs of ftimulation ; and that, by
the fame analogy, the effedts refulting from the abule
of contra-ftimulants are combated with efficacy by ftimu¬
lants, fuch as wine, aromatics. See. 4thly, That the
animal fibre fupports the agency of ftimulants or contra-
ftimulants in a diredt ratio, refpedtively, to the degree of
intenfity of the diathefis of excitement or of debility.
5thly, That we may difeover the degree of the diathefis
rather by the aptitude to fupport the agency of the one

or

PATHOLOGY. 43

or the other of thofe claffes of fubftances, than by the
apparent fymptoms of the malady.

This part of the new doctrine is not, however, fo ex-
tenfively adopted in Italy as the former. Many reflexive
phyficians (till maintain the opinions of Brown, and can¬
not be induced to believe that tartar emetic, digitalis, and
the like, can diredlly deprefs vital adtion in the part to
which they are applied.

Connedted with this, and bearing fome refemblance to
it, is the fyftem of Brouflais himfelf, of which the fol¬
lowing is an outline, i. That the exaggeration of the
vital adtions in one tiffue, which fubfequently re-adls on
others, conftitutes the far greater proportion of difeafes.
a. That all the tiffues'are fufceptible of experiencing this
modification, but certain ones are more expofed to it
than others. 3. That thofe in which it is ordinarily de¬
veloped, are the mucous tiffues, becaufe they are the
organs of relation, (that is to fay, organs which receive
imprefiions, and which befides develop other adtions by
the influence they exert on the nervous centres,) and be¬
caufe they are all fanguineous and fecretory organs.
4. That thefe tiffues, being formed of capillaries and
nervous fubftance, have the irritation they experience
participated both by veffels and nerves. 5. That irrita¬
tion being eftabiiflied in a tiffue, calls the fluid to it; and
that it is on this phenomenon that all the fecretions, all
the vital excretions, and, in a word, the adtions of all
the organs, depend. 6. That thefe irritations, with the
folicitation of the fluids, being carried to a certain de¬
gree by the influence of certain caufes, conftitute ltates
of difeafe. 7. That, whilft we do not diftinguifh in the
economy, the four phenomena of inflammation (tumor,
dolor, rubor, and color), we fliould not give this name to
the irritations which may be manifefted. 8. That, in cer¬
tain fubjedts, they are hardly ever raifed to the degree
which merits the name of inflammation ; but that they
then conftitute, in fome cafes, the neurofes of authors ;
in others, organic affections. 9. That, in fome perfons,
thefe irritations, confined for a long time to a certain
degree, fuddenly become exalted, and pafs to the ftate of
phiegmafla-, that is to fay, we then obferve exaggeration
of the aftion of the red capillaries, an extraordinary af¬
flux of blood, with augmentation of heat, pain, See.

10. That, in others, this exaltation takes place fuddenly.

11. That, when then thefe exaggerations of the aCtions
of organs have for the refult, not the folicitation of
blood, with heat, See. but the accumulation ofcolourlefs
fluids, and the predominance of the veffels which con¬
tain them, we then fee the phenomena of irritation in a
degree inferior to true phlegmafia, and to which, for this
reafon, the name of fub- inflammation may be given.

12. That neurofis, inflammation, and fub-inflammation,
conftitute the three varieties of irritation which furnifh
the principal and moft important divifion in pathology:
that is to fay, neurofis , when the irritation is confined to
extraordinary aCtion, without increafe of heat or immi¬
nent danger of diforganization ; inflammation, when heat,
with injection of blood, and imminent danger of difor¬
ganization, exift ; fub-inflammation, when the irritation
accumulates in the part only lymphatic fluids.

Thefe are the morbid phenomena of irritation in the
part where it originates. But, in addition to thefe, it
fhould be confidered, 1. That, as foon as the organic ac¬
tion is exaggerated in a part, it is tranfmitted to other
organs by the nervous cords, (which fliould be diftin-
guifhed from the nervous fubftance in the ftate of ex-
panfion, or in the pulpy ftate, as it exifts in the organs
of fenfe, and in the brain.) 2. That this tranfmiflion of
the exaggeration of local organic aCtion is a fympathy.
3. That it takes place, in the ftate of difeafe, according
to the fame lav/s, and by the fame means, as in the ftate
of health. 4. That the irritation, fympathetically deve¬
loped in an organ. Secondarily affeCted, is of the fame na¬
ture as the primitive irritation.

This is the mode in which M. Brouflais has himfelf

ftated the principles of his pathology of inflammatory
difeafes ; and he has fliown that, when fully developed,
they will involve the far greater part of the maladies to
which human beings are liable: but to trace thefe ex-
tenfions of them does not come within the plan of this
feCtion. It is, however, neceffary to advance fo much
refpedling this dodtrine, fince it is becoming daily more
extenfively adopted in France, and has already obtained
the confent and Support of a great proportion of the
more refleCtive part of the phyficians of that nation.

An union of the reafoning and imaginative faculties
has Seldom been poffeffed by an individual with any ad¬
vantage to the interefts of philofophy. Of the truth of
this propofition we have a melancholy example in the
writings of Darwin. The figurative expreflions and bril¬
liant didtion which fo much adorned his poems, being
applied to a ltridter Science, have equally obfeured and
tarniftied his compofitions.

We" obferve in the medical Speculations of this author
a near approach to fome of the Brunonian tenets. Edu¬
cated, however, in a fuperior manner, endued with bet¬
ter tafte, and more minute in his oblervance of nature,
Darwin faw that Brown’s two general principles were in¬
adequate to explain many forms of difeafe; and he
therefore added a third. Two general laws of the ani¬
mal economy are ftated by Darwin, as well as by Brown :
1. That all excitement or adtion of the living organs
and fundtions occafions a diminution or exhauftion of
their power, (excitability in the language of the latter,
fenforial power in that of the former,) according to the
degree of excitement. 2. That reft, inadlivity, or the
abftradtion of the ufual ftimuli, render thofe organs more
fufceptible of the adtion of the ftimuli fubfequently ap¬
plied. Thus, when a fmall part of the capillary veffels
of the fkin are expofed for a fliort time to a cold medium,
as, when the hands are immerfed in iced water for a
minute, thefe capillaries become torpid or quiefeent,
owing to the abftradtion of the ftimulus of heat. The
fkin then becomes pale, becaufe no blood paffes through
the external capillaries, and appears ftirunk, becaufe their
fides are collapfed from inadlivity, not contradled by
fpafm; the roots of the hair are left prominent from the
Seceding or fubfiding of the fkin around them ; and the
pain of coldnefs is produced. But in this fituation, if
the ufual degree of warmth be applied, thefe veffels re¬
gain their adlivity ; and, having now become more irri¬
table from an accumulation of the fenforial power du¬
ring their quiefcence, a greater adtion of them follows,
with an increafed glow of the fkin, and another kind of
pain, which is called the hot-ache, enfues.

Thus far the two theories nearly accord ; but beyond
this point the Brunonian dodtrine leaves us to a general
ftatement of debility, altogether inadequate to account
for the various forms and phenomena of fever. But Dr.
Darwin appeals to other eftabiiflied fadts in the animal
economy, upon which thefe varieties appear to depend.
From thefe he deduces a third general law ; namely.
That the fundtions of different parts of the fyftem' are
fo far catenated, or affociated with each other, as it were
in circles, either from diredt connexion in ftrudture,
from the habit of adting together, or, more frequently,
from caufes at prefent infcrutable, that an increafe or
decreafeof the adtion of one organ is followed or accom¬
panied by an increafe or decreafe of the adtion of ano¬
ther; Sometimes by a Similar change, that is, increafe
followed by increafe of adlivity, or decreafe by decreafe ;
but occafionally by the contrary change, that is, increafe
followed by decreafe of adlivity, and vice verfd in the af¬
fociated parts. The former of thefe is termed a direct
fympathy ; the latter a reverfe fympathy.

The inftances of fympathy between different parts of
the animal frame are very numerous ; as, between the
ftomach and brain, the ftomach and fkin, the ftomach and
heart, the brain and heart, the flein and lungs, the ute¬
rus and mammae, See. And this, which occasioned him

to

44

PATHOLOGY,

to call his fydem “ the fympathetic theory,” is the mod
important part of that theory; for the catenation, or af-
fociation, which takes place between various functions
when difordered, had, before his time, been very (lightly
touched on. A partial view of one circumftance of fym-
pathy had made Cullen attribute too much to the date
of the jk'm in fever; and infulated faffs of the fame na¬
ture had impreffed almod every pathological fydem with
error. Darwin embraced then the whole range of thefe
afl'ociated aCtions, and formed the defign of founding a
fydem of pathology and therapeutics on the contempla¬
tion of all the laws of animated nature. And hence this
may be confidered as the firil fydem condruCted in exaCt
conformity with phyfiology. Of this latter fubjeCt,
Darwin, however, knew little ; and hence the failure of
the fuperflruCture' which he raifed on it. Yet the con¬
ception was grand, and has been aCted upon by all patho-
logids (ince his time.

The three laws or principles of aCtion in the animal
economy, which we have mentioned before, viz. i. The
exhaudion or diminution of the fenforial powers by
exertion; 2. The recovery or accumulation of the fame
powers, during quiefcence, or impaired aCtion ; and
3. The direCt and reverfe adbciation of parts, by which
the aCtions of one part give rife to aCtions in others.;
are the grounds of Dr. Darwin’s explanation of the phe¬
nomena of fevers. He fuppofes that the cold dage ac¬
crues in confequence of the torpor of the capillary vefiels,
from the abflraCtion of the dimulus of heat, or other
caufes; the hot dage, in confequence of the renovated
activity of the capillaries, from the accumulation of
fenforial power during that torpor. Dr. Darwin, how¬
ever, remarks, that this renovated activity of the capilla¬
ries is not owing to the renewed action of the heart,
which forces them open by the mechanical impulfe of
blood; that the action of the capillaries often re-com-
mences fooner than the aCtion of the heart, thefe vefiels
having a greater mobility than the heart and large arte¬
ries, as appears in the fudden blufli of (flame ; and that,
in low fevers, the capillaries acquire increafed drength,
as is evinced by the Audi and heat of the (kin, while the
pulfations of the heart and arteries remain feeble.
Hence Ample fever is of two kinds ; in one the pulfe is
drong, in the other weak : in the fever with drong pulfe,
not only the cutaneous capillaries, but alfo the heart and
arteries, readily acquire a greater activity by the accu¬
mulation of fenforial power during the torpid date,
which lad is farther increafed by direCt fympathy with
the increafed activity of the capillaries ; this happens in
drong conditutions, and is often feen in vernal intermit-
tents : in the fever with weak pulfe, on the contrary, the
heart and arteries do not acquire much increafe of fenfo¬
rial power, but continue in fome degree in their date of
torpor, while the orgafm of the capillaries is produced ;
whence there is a hot fit, 'with feeble pulfe.

But, when the fympathies of other parts of the fydem
are called into aCtion, together with this torpor and or¬
gafm of the cutaneous vefiels, and of ,the heart and large
arteries, the fever-fit becomes more complicated and
dangerous. And again, when the torpor commences,
from the operation of other exciting caufes of fever in
other organs of the body, and extends, with the fubfe-
quent orgafm, by direct or reverfe fympathy, to the or¬
gans afl'ociated with them, other various forms and mo¬
difications of febrile difeafe are produced. Thus, if
the domach is affeCted with torpor, either primarily, as
from the aCtion of contagion fwallowed with the faliva,
or fecondarily, by its fympathy with the cutaneous capil¬
laries, or with fome internal vifcus; a total lofs of appe¬
tite occurs, followed by ficknefs and vomiting. If the
brain is affeCted, either primarily, as by the depreflive
padions, by exhaudion from watching, &c. or feconda¬
rily, as by the influence of contagious or marfli effluvia
received into the domach or the lungs, then prodration
of the general powers, head-ache, delirium, flupor, tre¬

mors, convulfions, &c. are induced. In the fame way,
the fecretions from the internal organs, as from the kid¬
neys, are diminilhed when a torpor takes place in them,
either primarily, or by fympathy with the cutaneous ca¬
pillaries, or other parts, and are redored with the reno¬
vated aCtion. Thefe phenomena take place in different
degrees in almod all fevers, and vary according to the
nature of the organs primarily affeCted, and to the date
of the conditution, or of the organs individually.
Thus, when the domach is (lightly difordered, as by in-
digedible food, or when the vafcular fydem is deranged
from expofure to cold, (when no inflammation is pro¬
duced,) the fever which enfues is mild, the brain fuffers
little by fympathy, no delirium, See. occur, and health
is foon redored. If, on the contrary, a virulent conta¬
gion aCis upon the domach, and through its medium
upon the brain, the fenforial powers are greatly exhauded,
and the complication of dangerous fymptoms, arifing
from the morbid condition of the nervous fydem, and
from the total lofs of powers in the organs of digedion,
occurs, condituting the contagious, nervous, and malig¬
nant, fever, or typhus, under its various forms and deno¬
minations.

Dr. Darwin explains the peripneumony as “generally
induced by the patient refpiring very cold air, and this
efpecially after being long confined to warm air, or after
being much fatigued or heated by exceflive labour or ex-
ercife. For we can cover the (kin with more clothes,
when we feel cold; but, the lungs not having the per¬
ception of cold, we do not think of covering them, nor
have we the power of covering them, if we defined it;
and the torpor thus produced is greater, or of longer du¬
ration, in proportion to the previous expenditure of fen¬
forial power by heat or exercife. This torpor of the
lungs affeCts the (kin with (huddering, and the domach
is alfo fecondarily affeCted ; next follows the violent ac¬
tion of the lungs from the accumulation of the power of
irritation, and an inflammation of them follows this vio¬
lent aCtion, &c.”

This author clafled difeafes according to their fuppofed
origin in didurbed dates of the vital powers ; but the
arrangement is quite fanciful, to fay the lead of it; and
the frequent repetitions of fpecies which occur under dif¬
ferent heads, (how its imperfection. Thus, he divided
difeafes into four kinds; thofe of irritation, fenfation,
volition, and affociation ; and, forming his therapeutical
doCtrines according to the fame views, he arranged the
materia medica intofeven claffes. 1. Nutrientiu, or thofe
things which preferve in their natural date the due ex¬
ertions of all the irritative motions. 2. Incitantia , or
thofe things which increafe the exertions of all the irri¬
tative motions. 3. Secernentia, or thofe things which in¬
creafe the irritative motions which conflitute fecretion.
4.. Sorbentia, or thofe things which increafe the irritative
motions which conditute abforption. 5. Invertentia ,
or thofe things which invert the natural order of the
fucceffive irritative motions. 6. lievertenliu, or thofe
things which reflore the natural order of the inverted ir¬
ritative motions. 7. Turpentiu, thofe things which di-
minifli the exertions of all the irritative motions.

This theory was never very generally received in Eng¬
land ; but, dripped of the hypothetical phrafeology and
much modified, it appears to have been taken up and il-
ludrated with much fuccefs by the celebrated Hufeland
in Germany.

We are now arrived at a period when phyficians, no
longer dazzled by brilliant hypotiiefes, required in pa¬
thology and phyfiology the clofe analogical reafoning
which had been found fo ufeful in every other depart¬
ment of fcience. Hence fyflems of medicine, incapable
of embracing all known forms of difeafe, have ceafed to
exid. Imprefi'ed with the conviction that our dock of
known faCts required much addition ere it could be ge¬
neralized, the pathologids of our time have individually
attached themfelves to the acquilition of further expe-
s ~ rience

PATHOLOG Y.

rience in particular difeafes; and, when theory has been
promulgated, it has generally had its foundation in new
difcoveries in phyfiology. Hence too it is no longer pof-
fible to enlift ourfelves under the banners of any one
pathologift, and, by quietly affuming the infallibility of
his doftrines, fave the trouble of thinking for ourfelves.
It mull not therefore be fuppofed, that, becaufe this
aera may not tranfmit to pofterity the name of an author
whofe works might contain all that we know on medical
fubjefts, we have done lefs for the fcience we profefs
than our continental neighbours. True it is, that the
fpeculations ofBroulfais and Tommafini have fomething
better to recommend them than the fyftems of Cullen,
Brown, or Darwin; yet ftill many imperfeftions exift
in them, imperfeftions necelfarily connefted with the
unfinilhed Hate of the ground-work on which pathology
is built. Neverthelefs, in real improvement, the firft
twenty years of this, the 19th, century, affords the moll:
delightful profpeft. The errors of Brown, here firft
promulgated, were here firft refuted. Currie introduced
the judicious ufe of cold bathing in the molt numerous
and formidable complaints to which human nature is
liable, viz. fevers. Abernethy and Hamilton have Ihown
the efficacy of purgatives in molt difeafes, and the inno¬
cence of their properly-regulated exhibition in all. The
bold and decided treatment praclifed by Jackfon, as
well as his found theoretical views, deferve the higheft
encomium; and we have to regret that the peculiar
ftyle and expreflion of that author has fo long oppofed
the general reception of opinions which are equally con-
fonant with reafon and the long experience of thirty
years. To Armftrong, Clutterbuck, and a hoft of others,
the infertion of whofe names would tend to render our
hiftory a mere catalogue, we owe the prefervation of
many of our fellow-creatures. Nor have our inveftiga-
tions on thefe topics been confined to our own ifiand.
The accounts we receive from our Indian poffeftions ferve
to inftruft us in the treatment of acute difeafes, by
ftiowing them in the intenfe marked forms which they
exhibit in tropical climates.

Phyfiology likewife has been by no means neglefted in
this age. That fcience, which no longer can be called
uncertain, has received auxiliaries from the improve¬
ments daily occurring in the collateral branches of
knowledge. Its more general principles have been illus¬
trated by difcufiions which the fpeculative notions of
Hunter and Abernethy on the one hand, and Lawrence
and the French phyfiologifts on the other, have given
rife to. The motive powers of the vafcular fyftem have
been illuftrated by Parry, Carfon, Bell, Philips, and
Brodie. To the two laft of whom we are moreover in¬
debted for fome ufeful information concerning the phe¬
nomena of fecretion and the dependence of that funftion
on nervous influence. The contradictory opinions, how¬
ever, which we meet with on thefe fubjefts, compel us
to acknowledge that this fcience bears little proportion
in its advancement to that of the practice of medicine.

In the early part of the prefent year, Mr. James, a
furgeon of Exeter, publilhed “ Obfervations on fome
of the General Principles, and on the Treatment, of the
different fpecies of Inflammation.” This work is an am¬
plification of the Differtation which gained the Jackfon-
ian prize on Inflammation, when the illuftration of this
fubjeft was recently propofed by the Court of Afiiftants
of the Royal College of Surgeons. This production
comprifes many interefting obfervations ; but the author
is too much the difciple of John Hunter, and he exhi¬
bits more of the manner of reafoning of that phyfiologift,
than aclofe inveftigation into the mode of production of
the phenomena he defcribes ; like him, he refts con¬
tented with a fubftitution of terms, inftead of endeavour¬
ing to explain the operations of which they are only the
expreflion : in a word, his ideas want precifion, and his
pathology depth. Mr. James adduces a new claffifica-

Vol. XIX, No. 1286.

45

tion of inflammation. His arrangement, is founded on
the difpofition which inflammatory aCtion affumes to
fpread ordiffufe itfelf, or to be limited by the adhefive
procefs or other means. In this point, too, we recognize
John Hunter. As, however, this fortuitous quality of
inflammation but feldom conllitutes a generic difference
in the form which the difeafe affumes, but depends on
feveral varying conditions of temperament and other
things in the patient, and on accidental conditions of
the atmofphere, and other external circumftances, it ap¬
pears to be objectionable, and not likely to be adopted
by the generality of pathologifts. The .author’s conli-
derations in other refpefts, efpecially thofe relating to fe-
miology and therapeutics, are judicious, and developed
with l'uflicient order and perfpicuity.

In anatomy, as far as the relative fituation of parts is
concerned, our diligent anceftors have left us little to do.
So that, if we except a few difcoveries concerning the
more minute ftrufture of membranes, the mufcularity
of veffels, &c. we have nothing new to tranfmit to our
fucceffors on this fubjeft. Far different is the refult of
our refearches on morbid anatomy. The labours of Dr.
Baillie, accompanied with defcriptions and plates of
great accuracy, are too well known to require our com¬
ment ; as likewife the excellent works of Farre, Bell,
Sec. in the fame department. And thefe examples have
been followed very generally by our moll eminent prac¬
tical phyficians.

Of courfe this brief (ketch cannot be fuppofed to em¬
brace all the names or difcoveries which dignify our
country in this enlightened sera. We lhall have occa-
lion to fpeak largely of them in the body of this article,
when we come to notice particularly the treatment of
each difeafe; and therefore may be excufed entering in
the detail of them here. In the mean time, it may not
prove uninterefting to trace a faint outline of the labours
of our foreign brethren at this moment. By fo doing,
we enlarge the fund of our experience, and thus correct
the error into which more limited obfervation might be¬
tray us.

France. — If reiterated experiment and unceafing ob¬
fervation be the means which molt forward medical fci¬
ence, the French nation have claim to high honour.
In no other country is the fcience of life illuftrated by
fo many experiments, elucidated by the application of fo
many different fciences, or examined fo ciofely in all its
varied and extenfive phenomena : yet weobferve theories
continually arifing, opinions afferted one day to be re¬
futed the next. But fome recent labours of the French
phyfiologifts, have eftablilhed fafts which ftand on the
firmed: bafis : fuch are many of the doctrines of Bichat,
of Majendie, and of Brouffais.

Of Bichat enough has been faid, in every country
where his works have been read, to ftamp him as a phi-
lofopher of the greateft merit ; and all who are interefted
in the improvement of fcience, muft deeply regret the
lofs of one whofe comprehenlive and enlarged mind,
whofe minute anatomical ftudies, and whofe brilliant pa¬
thological difcoveries, alike fitted him for re-forming and
re-cafting the fabric of medical fcience. This vail de-
fign had been formed by Bichat ; and, when a few lec¬
tures had developed his opinions, he was fuddenly car¬
ried off. In teaching mankind to ftudy the minute
ftrufture and fabric of the body, rather than to be perpe¬
tually occupied with the defeription of its relative fitna-
tions and parts, he feems, like our countryman, John
Hunter, to have followed that courfe which Lord Bacon
had fo clearly pointed out to anatomifts, and in which
much ftill remains to be done: he lays, that “ they (anato-
mifts) inquire of the parts and their fubftances, figure,
and collocations ; but they inquire not of the diverfity
of the parts, thefecrefies of the paffages, and the feats or
neftlings of the humours, nor much of the footfteps or
impreflions of difeafes ; the reafon of which omiffion I
N fuppofe

PATHOLOGY.

46

fuppofe to be, becaufe the firft may be fatisfied in the
view of one or a few anatomies, and the latter, being
comparative and cafual, mull arife from the view of many.”

The name of Majendie, already well known by his
Elements of Phyfiology, is prefented to us, in every pe¬
riodical work we receivefromFrance, as occupied in fome
interefting or ufeful experiment. Palling over his experi¬
ments in regard to the nervous fyftem, to the abforptive
power of veins, See. we may remark, that he has lately
been endeavouring to difeover fome more effectual mode
of controlling the action of rabies than has hitherto been
known. And, though it would be premature to offer
any opinion on the probable refult of his experiments,
we may remark, that he has done the public great fer-
vice by Ihowing the complete inefficacy of drugs hitherto
reputed fpecifics in the cure of this dreadful difeafe.

Of Brouffais’s phyfiological fyftem of pathology we
have given a Ihort account at p. 43. Nothing is wanting
to the full fuccefs and acceptance of that fyftem, but that
everybody Ihould think as well of it as the doftor him-
felf does. On its firft appearance, Dr. Hutchinfon, the
editor of the London Medical Journal, gave a favourable
account of it; not quite fufficiently fo, however, as en¬
tirely to fatisfy the inventor. Dr. Granville, the prefent
editor of that work, fpeaks rather contemptuoufly of it;
Rafori (the contra-ftimulant fedative Rafori) oppofes it
on the continent ; and upon the whole it feems to be
going down. Two commentaries on the doftrines of
Brouffais, of very different chara&ers, have been recently
produced at Paris. One of them, by Monf. Begin, is in¬
tended to advocate his principles, and to difplay them in
a more perfpicuousand orderly manner than has been done
by Brouffais himfelf; while the other, publifhed anony-
moufly in the Revue Medicale, a new monthly journal
of great merit, is a jeu d’efprit, full of that fine fatire
and delicate ridicule which the French fo well know how
to employ, which, while it difplays the chara&er and con¬
duct of Brouffais and the merit of his writings with great
force and fufficient eulogy, deferibes his vanities, his in¬
genious obfeurities, the nonchalance with which he cuts
the gordian knots he happens to encounter, and apolo¬
gizes for the art with which he has appropriated to him¬
felf the opinions of others, in a manner truly Rabelaic.
From this publication we fhallmake an extradl, in read¬
ing which the reader will bear in mind, that Dr. B. con¬
tends that all complaints arife from the ftomach, and that
lemonade and leeches are to cure every complaint.

“ A diftinguifhed man of letters, who is publiftiing a
new edition of Moliere, aware of the ridiculous appear¬
ance of fome modern phyficians, has determined to make
fome variations in the celebrated feene of the comedy of
that author, entitled Le Malade Imaginaire.- The fol¬
lowing is a fpecimen :

Toinettc, (drejffed as a phyfician.) Let me feel your
pulfe. Come, come, beat as you ought. Ah ! I’ll foon
make you go right. Faith ! this pulfe is mightily imper¬
tinent. I fee plainly it does not know whom it has to
deal with. Who is your attending phyfician, fir?

Argun. Monfieur Purgon.

Toin. That name is not to be found in my pocket-
book, amongft the phyficians of eminence. What did
he fay was the matter with you ?

Arg. He fays my liver is affected : others contend that
it is the fpleen.

Toin. Pooh ! pooh ! They are a pack of ignoramus. It
is your ftomach, fir, that is affected.

Arg. The ftomach ?

Toin. Yes ! the ftomach. What do you feel ?

Arg. I have occaftonally the head-ache.

Toin. Exaftly fo. The ftomach.

Arg. 1 fometimes fee double ; — I have a veil over my
eyes. v

Toin. The ftomach !

Arg. And a great difficulty in breathing.

Tom- The ftomach again !

Arg. I fuffer from great languor aud laffitude in all my
limbs.

'Toin. The ftomach!

Arg. And I now and then feel pain in my feet, in my
heels, and toes, as if I had the gout.

Toin. Exa&ly fo. It is the ftomach ! You eat with
good appetite ?

Arg. Yes, fir.

Toin. The ftomach ! You like to drink a fmall quan¬
tity of wine.

Arg. Yes, fir.

Toin. The ftomach ! You feel rather drowfy after
dinner, and delight in taking a nap ?

Arg. Oh yes, fir.

Toin. The ftomach, the ftomach, I tell you ! What
has your phyfician defired you to eat ?

Arg. He delired me to take fome foup.

Toin. Onlolugiji! [An appellation of contempt
adopted by Dr. Brouffais todefignate all thofe phyficians
who feem to have identified or perfonified the different
caufes producing difeafes, fuch as the gouty principle,
the fcrofulous humour, &c.]

.drg. And chicken.

Toin. Fatalift !

Arg. And occafionally veal.

Toin. Incendiary!

Arg. Broth.

Toin. Murderer !

Arg. Some frefb eggs.

Toin. What an aflaflin !

Arg. And ftewed prunes in an evening.

Toin. Incendiary ! the murderous diet of the ontolo-
giftic fchool.

Arg. And, above all, he defired me to put water to nay
wine.

Toin. lgnorantus, ignoranta, ignoratum ! This is not
the way of a medecin phyfiologifle . You muft drink pure
water, which is indeed too nourilhing as it is : it will
calm the gaftro-inteftinal irritation under which you la¬
bour ; and thin your blood, which is now too aenfe.
You’ll apply five hundred leeches to the pit of the fto¬
mach, which will remove the gaftro-enteriiis in the
twinkling of an eye. Don’t you fee that “irritation
is preying heavily on the mucous membrane of your
ftomach, from whence it extends its malignant power
overall the organs of y'our economy, through fympathe-
tic irradiations?” Be affured that your phyfician is an
ontologijt, who will believe only what he fees. I wiil
come again to fee you in a fortnight, if you are alive ; and,
above all, reft affured that, if I have abufed my bre¬
thren of the profeffion, it was not through envy, but
for the good of mankind. How fuperior to them all the
dodlrine phyfiologique makes me ! “ a dodtrine which is
deftined to do more good even than the immortal difeo-
very of Jenner.” [The two paragraphs in this fpeech
marked with inverted commas, are not a parody, but the
real words of Brouffais.]

The brain has of late been to the French pathologifts
what the abdominal vifeera have long been to the Eng-
lifh, the great object of intereft and the fubjedt of their
efpecial confideration. Several works of much vaiue.
have been the refults of their labours. That which pre-
fents moft evidence of a talent for original obfervation
and profound and comprehenfive reafoning, is one by
Dr. F. Lallemand, of Montpellier. The greateft merit
in the work of Dr. Lallemand confifts in the admirable
precifion and perfpicuity with which the hiftories of dif¬
eafe are given, and, for the moft part, the very judicious
reflections with which they are accompanied ; the efpe¬
cial object of which is to trace the relations between the
appearances obferved after death, and the fymptoms of
the difeafe that were manifefted during life. Dr. Lalle¬
mand differs from Dr. Roftan refpedting the nature and
origin of what the.latter has deferibed under the name
of ramollijfement du cerveau , and thinks that it is really a

confequence

47

PATHOLOGY.

confequence of inflammation of a more or lefs chro¬
nic kind. He relates fome cafes which feem to Ihow
that it has, at lead fometimes, fuch an origin. He ad¬
vances a carious propofition refpe£ling delirium, that has
much apparent probability. He fays, delirium is never
obferved in cafes of inflammation of the brain alone;
this fymptom appertains efpecially to inflammation of
the arachnoid membrane. It is not becaufe the arach¬
noid is the feat of the immediate caufes of delirium ; but
becaufe this membrane, when inflamed, irritates the fur-
face of the brain which is in contact with it; and, as
the tifl'ue of this organ is then not altered, its functions
are merely “exalted thefe functions, on the contrary,
ceafe (to an extent correfponding with the extent of the
inflammation,) when inflammation has its feat in the
proper fubftance of the brain.

A work of very conflderable value on inflammation of
the arachnoid membrane of the brain and fpinal marrow,
has been publilhed by two young phylicians of Paris,
Drs. Martinet and Parent-Duchatelet, which is the refult of
feveral years’ obfervation at the Hotel-Dieu and the Hof-
pice des Enfans Malades, under the direction, and indeed
afliflance, of Drs. Recamier and Jadelot, phyficians, ref-
pe<5tively, to thofe inftitutions. This work prefen ts'
fuch a number of cafes (not feledled, and therefore the
more valuable, as prefenting a view of what is of ordi¬
nary occurrence,) as will admit of general inferences, of
more or lefs validity, refpedling every point of moll inte-
rdl in the hiltory of the difeafe.

The charafters of arachnitis appear to vary as the dif-
eafe occurs in parts of the membrane correfponding to
different parts of the brain. Thus, the fymptoms of
arachnitis at the bale of the brain, prefent, in general,
charadlers by which the difeafe may be recognized, and
diftinguiflied from arachnitis in the convexities. There
are, however, fome varieties in thofe fymptoms, con-
nedled with dfverfities in the age of the patient., In
children, for example, who are difpofed to be afFedled
with this form of the difeafe-almolt exclufively, the ex-
cefflve irritability of their nervous fyllem occanons fpafms
in different parts, which give a particular character to
the malady. Thefe affections fometimes appear in a fud-
den manner, without any previous indications ; at other
times, the progrefs to them is more gradual ; the Hate
of the intellectual faculties prefents lefs varieties than
that of other organs. The degree of energy which the
brain pofleffes in adults, and even in adolefcents, ena¬
bles patients of this clafs to refill much longer the difpo-
fition to llupor ; fo that this fymptom is much lefs early
andcompletely manifelled in them than in children. In
both, thelefion of the intellectual faculties refults effen-
tially from the want of aCtion of the brain, from the in¬
ertia of this organ, and not from the derangement of its
functions, or delirium, which is the predominating cha-
radteriilic of arachnitis of the convexities. When in¬
flammation is feated in the portion of the arachnoid
which lines the ventricles, the fymptoms are the fame
as thofe which refult from it at the bafe of the brain ; and
in the greater number of cafes it is prefent alfo in the
latter region. Thirteen cafes of inflammation of the
arachnoid membrane of the fpinal marrow are related,
from which it appears, that the chief charadteriftic fymp¬
toms of this affedlion, areltiffnefs of the neck and trunk,
pain along the vertebral column, in addition to the com¬
mon fymptoms of irritation of the nervous fyllem, with
the abfenceof fignsof cerebral diforder when the inflam¬
mation is confined to the arachnoid of the fpine, and
their coincidence when the ferous membrane of the
brain partakes of the inflammation.

Two interelting cafes of inflammation, and confequent
dilorganization, of the fpinal marrow itfelf, have been
lately publilhed by Dr. Pinel the younger, which were
characterized by continual convulfive motions of the
whole of the trunk of the body, followed by an almoll
complete annihilation of the fundlions of the nerves of

voluntary motion, and accompanied by a febrile Hate of
the fyllem, having a paroxyfmof exacerbation every eve¬
ning.

The furgery of France, as far as operations are con¬
cerned, lcarcely appears on an equal footing with the
furgery of this country; and, if we were difpofed to cri-
ticife our Gallic neighbours, we might further remark,
that a great want of attention and refpedt is manifelled
by them for the labours of others. Thus Brouffais, juft
mentioned above, has been lately labouring to Ihow that
we know next to nothing; and very unfairly fupports
his affertions by quoting the pradlice or the reveries of
fome of the obfcurell contributors to our periodical pub-L
lications. And Boyer, a charndter of great repute in
France, and author of one of their flandard furgical
works, has the blindnefs to rejedl Mr. Hunter’s excellent
mode of operating for popliteal aneurifm, and even de¬
nies his claim to the difcovery of it. By the way, we
mayjuft extradl from a cafe lately publilhed by DeRoux,
an account of the method in which the operation for
aneurifm is performed in France : “ I performed the ope¬
ration,” he fays, “ in the place where it is now pradtifed
in England. The artery was completely infulated from
all adjacent parts, even from the crural vein, for the
fpace of an inch. I placed four ligatures at about two
lines diltant from each other. Thus there were two li¬
gatures to intercept the blood, the firfl and lall being
only left as ligatures d'uttente. I then followed the re¬
commendation of Scarpa, in applying upon the artery a
fm all cylindrical body, an inch long and two lines in
diameter, upon which I put a piece of linen, which had
been dipped in melted plalter ; on this I tied the two
middle ligatures. I took care not to let the wound
unite, and kept the lips feparated by foft lint.” An
Englifii furgeon will have little difficulty in feeing the
fcriking contrail exhibited between this operation and the
manner it is performed in the hofpitals of London. Let
us not however confound all in thiscenfure: there are
many who duly appreciate our toils and our merits; and
there are many who deferve from us the fame regard.
We might mention fcores of names in proof of this ;
but Larrey, Richerand, and Dupuytren, are fufficiently
known to our medical readers.

In parturition, we have two curious recent cafes to re¬
cord.— -A male child was born in May lall, at the Hofpi-
tal of la Maternite, at Paris, with the whole furface of
the body deeply wrinkled, like that of a very old man.
Its hands and feet are double the ordinary length, and
are equally wrinkled. It has llrong grey hair, and a
beard of the fame colour. In every other refpeCt it en¬
joys perfect health, and is nurfed in the hofpital. — The
following is not lefs interelling ; though we have already
remarked, (fee the article Parturition, in the prece¬
ding volume,) that the French are in general more fuc-
cefsful in thefe defperate cafes than ourfelves. At a
meeting of the Royal Academy of Medicine at Paris,
on the 7th of July lall, (1821.) M. Beclard, one of the
moll dillinguilhed furgeons of that capital, reported that
he had, the day before, performed the casfarian operation,
by an incifion made in the direction of the linea alba ;
and that both mother and child were doing well. The
report continues favourable down to the 10th, on which
day the account was tranfmitted.

The French pay more attention to pharmacy than per¬
haps any other nation, and confequently their attain¬
ments in that branch of the healing art are very great.
Simplicity has affumed the place of that multiplicity of
formulae which had overrun all the old pharmacopoeias ;
and the analyfis of vegetables w-hich at prefent engages
fo much the attention of the French chemilts, promifes
to afford very important information in regard to the
modus operandi of medicinal fubllances; a fubjeCt of
which very little is at prefent known.

Thefe remarks have occurred to us in perufing the lall
Paris Pharmacopoeia, or Codex, publilhed in 1818, in a
1 handfome

PATHOLOGY.

handfome 4to of 600 pages. But we muft obferve, that
the French prefcriptions continue to have more ingre¬
dients in them than our own ; for we find one of the
compound tinCtures containing 18 ingredients, another
16, and fo on. They are however, as we faid, impro¬
ving ; for their Alcoholatum vulnerarium, which, in
the former edition of the Codex, confifted of 4a ingre¬
dients, is now reduced to 13. We cannot, however,
avoid noticing the Ele&uarium opiatum polupharmacum,
theriaca dictum; and never was an epithet fo juftly ap¬
plied as the term polupharmacum to a farrago containing
upwards of 70 articles. This ne plus ultra of complex¬
ity is ufhered in by the molt folemn affurances that the
compilers have not dared to encroach on, or alter in the
flighteft degree, the directions given in the preceding
Codex (60 years fince), for the preparation of this
“ percelebris compofitio and that, although feveral of
the compound medicines, which formerly entered its
coinpofition, have lately been excluded from the pages
of the Codex, yet they have taken efpecial care to intro¬
duce every one of the conftituents of thofe compounds
in .the exaCt proportion in which they entered the prece¬
ding formula; forinftance, though the trochifi viperiniare
no longer in ufe, yet the caro viperina is carefully pre¬
ferred as an ingredient of the theriaca. In order to
give our readers fome idea of the complexity of this for¬
mula, fuffice it to obferve, that the authors have judged
it neceffary to divide it into thirteen diftinct heads, for
the purpofe of giving us fome infight into the nature and
aCtion of this monfter in pharmacy. Thefe are, 1. Acria.
2. Amara. 3. Styptica. 4. Aromatica exotica. 5. Aro-
matica ex indigenis. 6. Aromatica ex umbelliferis. 7.
Refinae et Balfami. 8. Graveolentia. 9. Virofa. 10.
Gummofa. n. Terra inert. 12. Dulcia. 13. Vinum.
The amazing complexity of this medicine, the very cir-
cumftance on which its celebrity is grounded, is a fuffi-
cient caufe of condemnation. How is it poflible to fup-
p>ofe, that the fimultaneous exhibition of agents fo oppo-
fite, is a defirable objeCl ? It will, no doubt, be always
a tEoft valuable acquifition to the quack, who, not know¬
ing what intention he fhould endeavour to fulfil, may
reckon with tolerable certainty, that fome of the articles
of this panacea are adapted to the wants of his patient.
We cannot too ftrongty reprobate the retention of this
compound, which has obvioufly arifen from timidity in
the authors, who feared to rejeft a remedy of which fo
high an opinion is entertained. B ut by whom? They
themfelves anfwe? the queftion, and confefs they have
aCted according to the willies of thofe who are totally
unqualified to form an opinion. One of the reafons
given for its introduction into the new Codex is, “ quia
a vulgo fsepius requiritur.” A parity of reafoning
would lead them to introduce into their Pharmacopoeia
all the quack-medicines of the cornpofition of which
they could attain a knowledge ; and, indeed, this inten¬
tion they have difplayed on one or two other occafions.
It appears to us, that in afligningthe above caufe for the
retention of certain remedies, they have miftaken their
duty, which is no lefs to decide what medicines ought to
be retained or rejected, than to give accurate inftructions
for the compounding and preparing of fuch as are judged
proper to compofe a part of their materia medics,. After
all the ingredients of the theriaca have -been mixed to¬
gether, fecundum artem, they are fet afide for one year,
in order to undergo a flow fermentation, as it is directed
in the Codex. That they do not undergo this procefs,
teems probable front the circumftance that anal-yfis dif-
covei's no difference between parcels of theriaca differing
much in age, the recent preparation perfectly re fern biin g
that which has been of feveral years Handing; Diafcor-
di u 1Y1 is another eleCtuary, tranfiated from the old edi¬
tion to the new Codex, in all its priftine complexity,
with the fame fcrupulous regard to its cornpofition as
that we have juft been confiderirrg. It is only to be
wondered how the Theriaca cceleftrs, and the BenediCta

laxativa, each of them confifling of at leaft twenty arti¬
cles, could have fo far degenerated as to have forfeited a
place in this new edition.

A new preparation of opium has been very recently
propofed by Mr. Robiquet of Paris. It has been afeer-
tained, that the moft aCtive properties of opium refide in
two fubftances, which may be obtained in difcinCl forms,
and which produce very different effeCts ; narcotine, and
morphine , as they have been named. The former is a
very powerful irritant to the nervous fyftem, as appears
from the experiments of Dr. Majendie ; and it feems to
be this fubftance which produces the effeCts which we fo
much wifh to avoid in the adminiftration of this medi¬
cine, and which are obviated, to a certain extent, by
giving it in the form of the black drop , or other analo¬
gous acid preparations. Morphine, according to the evi¬
dence of the fame experiments, and others made on hu¬
man beings, produces fedative effeCts without fymptoms
of the flighteft irritation. To feparate the narcotine,
then, from the other parts of opium, is a very defirable
object of pharmacy 5 and Mr. Robiquet fays it maybe
eafily effected in the following way : “ I macerate,” fays
Mr. Robiquet, “common opium, divided into fmall
pieces, in cold water, as if it were for the aqueous ex¬
tract of opium ; I filter the folution, evaporate it to the
confiftence of a thick fyrup, and treat it, in convenient
veffels, with rectified ether ; the whole is then fhaken a
great many times, before the ethereous tinCture is poured
off; this, being feparated, is then fubmitted to diftillation,
that the ether may be drawn from it. This procefs is
repeated as often as cryftals of narcotine are obtained as a
refidue of the diftillation. When the ether is without
aCtion, I evaporate the folution of opium to a confiftence
proper for pills; and I obtain, by this means, an extraCl
wholly free from narcotine.”

In the Revue medicule, before quoted, there is an arti¬
cle continued from time to time, called “ Medical Let¬
ters.” Thefe contain the medical chit-chat of Paris.
From the 2d M° of that work, we fnall make a few ex¬
tracts applicable to our prefent purpofe. Thefe letters
contain much truth, but not without a mixture of what
the French call malice, a term, however, not of fo harlh
a meaning as the fame word in our language ; and will
certainly give an idea of the ftate of medicine, and the
opinions upon it, at this time.

“ Paris has long given the ton to Europe ; and fo com¬
pletely dictates to the provinces, that whatever comes
from the capital excites the greateft curiofity ; a feeling
the more predominant in medical men, from its having
been as yet, with regard to them, lefs gratified. The
daily papers detail only events of general intereft ; and
the fcientific journals exclude all anecdote. To fill fuch
a gap will be a difficult enterprife, and the execution of
it will offend many ; but the confideration that fcience
and the public will gain by it, is a fufficient incitement to
the attempt.

“ Petitions have been prefented to both chambers, to
proteft againft the fuppreifion of the concours (examina¬
tion and competition) in the election of profeffors ; and
one of the petitioners has proved to demonftration, that
the only objeCt in this fuppreffion is to ferve the interefts
of M. Royer- Collard. If this gentleman had taken the
trouble to ftudy chemiftry, anatomy, and medicine, by
way of qualifying himfeif to deliver a courfe of medical
jurifpruder.ee, there is no doubt but he would have
faved government from all the blame which this election
has thrown upon it. John Hunter, arriving at the age
of twenty-two years from the mountains of Scotland,
where he exercifed the trade of a carpenter, became ne-
verthelefs one of the firft anatomifts of England. M.
Royer- Collard, arriving at Paris at the age of forty from
ChambCry, where he performed the duties of a commit-
fary, might have found fome better method of teaching
medical jurifprudence than by reading leCtures copied
from a printed book which is known to the whole world.

The

49

PATHOLOGY.

The fource from which the profefi’or drew thefe waters
of fcience was foon difcovered ; each ftudent, being able
to tafte them at the fountain-head for the moderate fum
of thirty francs, the price of M. Fodere’s excellent
Treatife on Medical Jurifprudence, did not hefitaie be¬
tween this expenfe and the fatigue of lifteningto tedious
lectures ; fo that the profefl'or found himfelf abandoned
by his pupils, and left alone in the vaft amphitheatre of
the fchools of the faculty. Such a milhap is certainly a
fufficient apology for M. Royer- Collard’s having given
fo few leftures in the firft year of his profefTorfhip, and
for having, during the fucceeding years, renounced all
public inftruftion. Still-we are indebted to the profelfor
for the excellent courfe of leftures which his pupils heard
in the fummer of 1819. As direftor of the Bibliotheque
Medicale, he infured the fuccefs of the work by contri¬
buting the feweft articles to it; as profelfor of medical
jurifprudence he felt it his duty to refort to limilar means
to recall his truant pupils, and accomplilhed his objeft
by employing M. Orfila to lefture for him ; and the fuc¬
cefs of the experiment did not detradl from the reputa¬
tion of the learned author of the Toxicologie.

“ Several nominations followed that of this able che-
mift. M. Beclard was called to the chair of anatomy,
M. Marjolin to that of external pathology. MM. Fou-
quier and Roux have alfo been lately appointed ; the firft
to the chair of the Clinique de Perfeftionnement, vacant
by the death of M. Bourdier; the latter to a chair of pa¬
thology, vacant by the refignation of M. Percy. A-pro-
pos of this refignation ; it is faid in the medical world of
Paris, that 60,000 francs was the price M. Percy received
for this profelforlhip ; certainly a large fura for a place,
the receipts and prefervation of which are not certain.
The cafe is not without precedent; at Montpellier in
1786, M. de Barthez fold a profeffor’s chair to M. Gri-
maud for 30,000 francs. This is great authority for the
venality of profeflorfhips ; which, however, has one little
inconvenience, i. e. that of excluding the poor man of
talent, though it prefents the inappreciable advantage of
narrowing the field of favour, a divinity more to be feared
than riches. Still we cannot complain of fimilar bar¬
gains, when they bring fuch men as M. Roux into a
more extended fphere of ufefulnefs. This excellent fur-
geon and learned profelfor muft always have appeared to
advantage in a concurrence with any rivals.

“Since the fupprellion of the concours , the faculty of
medicine prefents to the choice of the committee of pub¬
lic inftruftion four candidates. The three laft are, how¬
ever, only infcribed for form’s fake. This fort of eleftion
is not at all approved by the faculty, who accordingly,
in 1818, unanimoully demanded that the vacant profefl'or-
ftiips fhould be given by the concours. The committee
of public inftruftion refufed to accede to this requeft ;
and, to avoid all difcufiion with the faculty, refolved to
choofe the firft of the candidates named. It was there¬
fore without any chance of fuccefs, that MM. Hulfon,
R6camier, and Parifet, were joined candidates with M.
Fouquier.

“ You have not forgotten that M. Parifet left Paris,
by order of the minilter of the interior, to obferve the
yellow fever which raged at Cadiz, with great violence,
in the fummer of 1819. In Europe, as well as in the
tropics, this difeafe always difappears on the firft ap¬
proach of winter; a little trifling fa ft, of which M. De¬
cazes ought to have been aware before he put the ftate
to fuch an expenfe. As M. Parifet was ftill at Madrid
on the 23d of November, it is clear that he could not
make obfervations on a difeafe which had already difap-
peared from Cadiz. The only fubjefts for examination
would be convalefcents, who are perhaps as fit to give
an idea of the charafter of a difeafe as a few ftragglers to
convey an appropriate impreflion of the nature and
ftrength of an army. If M. Parifet had departed three
months earlier, he might have given us the refult of his

Vop. XIX No. 1286.

own obfervations ; as it is, we fhall only now have the
opinions of the Spanifti phyficians, which could have
as well been tranfmitted by the poll. As yet the fruits
of fuch an expenfive journey are confined to four co¬
loured engravings, publifhed by M. Parifet, which, an¬
nounced at a moment when all eyes were direfted to
Cadiz, excited great curiofity. We expefted at lead
portraits of Quiroga, Riego, plans of the fortifications
of La Ifla, and the redoubts of La Cortadura. It was a
cruel difappointment for the curious to find three faces
of men dying of the yellow fever, and fourteen tongues ;
not tongues of eloquence and fire, but the dirty tongues
of patients announcing to the eye and finger the ftate of
the inteftinal canal ; and which are intended by M.
Parifet to exprefs the different phafes of the yellow fever
in fuccefflon. You will be furprifed at this. Why ?
Since w'e clafs and defcribe difeafes by the fame method
which botanifts employ to clafs and defcribe plants, it
is natural that we fhould endeavour to determine the
charafters of the former, by the aid of drawings. M.
Parifet, indeed, muft view difeafes as enjoying great ad¬
vantages in this refpeft ; for Linnaeus affirms that the
colour of the corolla is too variable a quality to deter¬
mine the diftinftion of vegetables; and our learned
traveller confiders the colour of the face and tongue as
cbarafteriftic of difeafes, in which the expreflion and co¬
lour of the face change from minute to minute.

“ M. Gall has commenced his annual courfe of crn-
niology in the amphitheatre in the Rue St. Viftor. This
fcience is getting Angularly out of fafhion. Time w'as
when M. Gall made us pay high enough for his leftures,
and w'e had difficulty to fight our way to the door. Now
we enter gratis, and there is plenty of room. When M.
Decazes was minifter of police, he greatly encouraged the
fcience of craniology, by giving its inventor a penlion of
3000 francs. M. Decazes undoubtedly found the fcience
ufeful inchoofing his counfellors ; and, if this minifter’s
reign had continued, the late preventive laws would
have been founded on craniological principles.

“A fubjeft which has more reality and praftical appli¬
cation, is the excellent courfe of human anatomy which
M. Beclard gives to the faculty of medicine. M. Dumeril
had already greatly advanced the ftudy of this department
of anatomy, confidered in a philofophical point of view.
Some indeed thought that he too frequently introduced
the fubjeft of comparative anatomy. M. Beclard is more
referved on this point ; but the compofition and analogies
of textures, the forms and relations of parts, both in a
ftate of health and difeafe, fuggeft to him at every ftep a
variety of interefting general obfervations, w'hich en¬
liven the drynefs of anatomical difcufiion, and are almoft
all of praftical application. M. Beclard, before he be¬
came profefl'or, underwent the probationary trials, as
“ chef des travaux anatomiques.” MM. Dumeril and
Dupuytren occupied this honourable poft before him.
M. Brefchet now' fills it in a manner which will foon place
him on the diftinguifhed level of his predeceffors. M.
Chauffier ftill teaches phyfiology, and gives two leftures
a-week. This learned teacher always difplays the fame
profound views, and the fame originality of ideas. He
ftill preferves his prejudices again ft the acceflary lciences,
which he calls “ftrangers to medicine,” and againft che¬
mical explanations of phenomena, w'hich he ftyles chi¬
merical.

“Since Profefl'or Cuvier has become a ftatefman, and
fcience is only the amufement of his leifure hours, there
are no other leftures on comparative anatomy at Paris,
but thofe given by M. de Blainville, at the Faculte des
Sciences. They are very well attended, and would he
more fo if the theatre of the College de Pleffis were larger.
M. de Blainville, as a favant and profelfor, promifes to
be a worthy fuccefl'or of his mafter Cuvier, wffiom w'e
truft he will follow in his Linnsean zeal for the fcience
of nature 3 but we hope he will not imitate him in thofe
O pretenfions

50 PATHOLOGY.

pretenfions to nobility, which made Buflfon ridiculous
though born noble; nor that in love of office, which was
the misfortune of Pliny the elder, and of which M. Cuvier
feems to have his fhare.

“ You are acquainted with the work which M. Geoffroy
de Saint Hilaire publiffied laft year on philofophical ana¬
tomy, in which he endeavoured to bring all the types
of organization to a primitive and unique form. M.
Geoffroy continues to illuffrate his dil'coveries at the
College de Pleffis before a numerous audience, and de-
monftrates that “ infefts ire provided with a fkeleton as
complete as that of the large quadrupeds ; that the cruf-
tacese do not walk upon their claws, but upon their
ribs. It is a pity that man is not a lobffer, for then,
like ourfirft father, Adam, we might lofe our ribs with¬
out being aware of it, which would have diminifhed the
rifk which M. Richerand ran in removing thole of the
unfortunate Michelleau, in his famous operation for
cancer. For a long time M. Richerand has publiffied
nothing but new editions of his old works : it is matter
of regret; for this furgeon has great talents as a writer.
The clearnefs of his ffyle is admirable, and his works
have been univerfally popular as elementary books. But
M. Richerand as author, and M. Richerand as profelfor,
are tw'o very different perfons. It appears to be matter
of regret that M. Richerand fhould have changed his
former chair of external pathology for that of operative
medicine. In the latter he had to fucceed M. Dupuytren.
Who could ftand the comparifon ? M. Dupuytren is
perhaps the only furgeon, who with C. Bell and M.
Delpech, has made it his ftudy to teach the art of ope¬
rating by fliowing the relation of different methods with
the ftrufture of parts, and by determining the advantage
of each proceeding according to the alterations of form
produced on organs by difeale. “The leftures on che-
miftry are, of all the lectures delivered at the Faculty of
Medicine during winter, the beft attended. He who
wiffies to know chemiftry thoroughly, muff attend M.
Vauquelin. He who wiffies to fee chemical fails philo-
fophically arranged and illuftrated by experiments ffiil-
fuliy performed, muff go to the College of France, and
to the Faculty of Sciences, to hear M. Thenard ; but he
muff make hade, for it is as difficult to get a place to hear
Thenard as to fee Talma.

“A new and rival fchool has rifen by the fide of the
Faculty of Medicine. A generous oppofition is already
the refult, and it will probably fave the medical fchools
of France from the deftruftion which hovers over them.
Indeed the fchool of Val-de-Grace can only yet boaft of
one profefi’or of celebrity ; but this teacher is endowed with
real talent. He has all theenthufiafm of a reformer, and the
power of communicating it when necefiary. It is in vain
to conceal the influence which M. Brouflais already ex-
ercifes, not only on the ftudies of the pupils, but on the'
praftice of the phyflcians of the capital. As this influence
is the moft important faff I have to communicate at pre-
fent refpefting our fcience at Paris, I fiiall take an early
opportunity of detailing to you' the doftrines of M.
Brouflais. It would not be judging properly of his doc¬
trines or practice to repeat with the public, that the an¬
nual confumption of leeches in the civil hofpitals of Paris,
which conllituted only an expenfe of 2000 francs, is now
80,000. (See p. 4.6.) You will neverthelefs have heard
that M. Brouflais is not fo much in vogue as laft year,
when the minifter at war found it necefiary to clofe the
doors of the hofpital to the crowd of ftudents who be-
fleged them. As the doftrines of M. Brouflais are of a
direft praftical application, the above-mentioned circum-
ftance may have retarded their propagation. It does not
much lignify. If thele doctrines are true, reflection and
time will only ferveto eftablifn them ; if they arefalfe, it
is perhaps better that the pupils fhould defer the exami¬
nation of them until they are qualified to judge and think
for themfelves.

“ There are fome people in the world, doubtlefs, who

with to eftabliffi the amount of a falary upon any other
confideration than the fervice rendered for it ; but we
mult look to a madhoufe only to fee the falary increafein
direct proportion to the diminution of attendance. In the
hofpital of lunatics at Charenton, the following regula¬
tion appears: “The phyfician fhall refide in the efta-
bliffiment ; he fhall receive a falary of 4000 francs, and
pay five vifits a w'eek ; if he does not refide, he is to re¬
ceive 6000 francs, and pay only three vifits.” Talking
of the Charenton, I rnuft give you an account of a new
method of improving the falsifies of phyflcians in hofpi¬
tals where the patients pay for their board. This plan
conflfts in affigning to the former a certain fhare, fay two-
twelfths, of the favings which are made on the fum the
patient pays, rendering it of courl’e the intereft of the
phyflcians to make this faving as confiderable as pofiible.
The firfary of the phyfician, therefore, it is evident, can
only be limited by the bad intentions of a director too
much attached to the welfare of the patients. This may
be eafily obviated. By the affiftance of calumny, the di¬
rector is got rid of ; and, to prevent all future difputes,
the direction of the hofpital is made the marriage-portion
of the phyfician’s daughter. I need not tell you that the
Lunatic Afylum of Charenton is out of the adminiftrative
control of the hofpitals of Paris.

“When a man profefles zeal for his profeffion and love
for humanity, his ardour in difeharging his duties is
above all remuneration. At the Hotel Dieu, M.
Dupuytren receives a very moderate falary, which is
neither direftly nor inverfely proportioned to the number
of his vifits, and which does not prevent his going winter
and fu miner to the hofpital from half-paft five in the morn¬
ing to ten, and again returning in the afternoon to fee
the patients who have been recently operated upon.
Here, a Ifo, M. Dupuytren, before performing an ope¬
ration, eftablifhes, in prefence of a numerous audience,
the caufes which indicate it; he difeufles the methods of
operating employed by furgeons, and deferibes the one at
length which he is about to employ.

At the Charite, MM. Boyer and Roux alternately
take charge of the clinical department. M. Boyer ex¬
amines the houfe-pupils on the patients entrufted to their
care. The profefl’or difeufles the moft important cafes,
and difplays all that profound knowledge and practical abi¬
lity which have long ranked him amongft our firft furgeons.

At the Hofpice de la Faculte, there are only forty beds,
and the patients are feleCted with great care. M. Dubois
can therefore devote to each patient a fufficient time to
eftabliffi the diagnofis, and anfwer the queftions which
each pupil has a right to addrefs to him. In the theatre,
the profefl’or enters on the cafes which have been ope¬
rated on, or thofe which are about to take place. The
operation is then performed, after which M. Dubois fees
the out-patients. Here he applies public inftruftion to
private praftice, and prefents us in part with the advan¬
tages of thofe private eftablifhments which in Germany
are called clinica ambulatoria. M. Dubois is really inde¬
fatigable ; to the experience of age he joins the ardour of
youth. Charged with the inftruftion of female midwives
at the Hofpice de la Maternite, he has juft commenced a
public courfe of leftures on midwifery for medical ftu¬
dents. Thefe leftures will be quite an epoch, and un¬
fortunately they will be the laft which M. Dubois will
give on a lubjeft which requires more to be reduced than
extended. Who will be better able than this learned fur¬
geon to reduce to their proper value the pretenfions of
thofe furgeons, who haVe only become great accoucheurs
becaufe they were not fit for any thing elfe ?

“M. Roux has repeated wfith fuccefs the beautiful
operation of the future of the velum palati, which he was
the firft to praftife, upon an American, who had hqd a
congenital divifion of this mufculo-membraneous part.
Some months ago, at the Royal Academy of Sciences,
the fubjeft of this operation, whofe voice before was
hardly perceptible, read his own cafe very diftinftly.”

The

PATHOLOGY. 51

The following account of the funeral of the celebrated
Corvifart, well known to the Englifli faculty by his wri¬
tings, which we extradt from the Journal des Debats of
the 22(1 September, 1821, may be thought curious by the
mere Englilh reader. “The obfequies of M. le Baron de
Corvifart, phyfician, took place to-day. In purfuance
of the directions contained in his will, his body was not
taken to the church of St. Elizabeth, his parifli, but was
conveyed to his eftate at Atys, where he defired that the
religious ceremonies Ihould be performed. A deputation
from the Faculty of Medicine, in their do&or’s robes,
(en habit doSioral,) and nearly all the phyficians of Paris,
repaired this morning to his late refidence, Rue de Ven-
dome, for the purpofe of attending his funeral. Mr.
Leroux, dean of the phyficians of Paris, pronounced a
difcourfe over his body. The coffin, covered with the
mantle of a dodtor, and with the different orders which
had been conferred upon the deceafed, was afterw'ards
placed in a hearfe, to be taken to its deftination, whither
the deputation of the faculty, and a great number of
other perfons, accompanied it.”

As we have fpoken largely of the management of the
hofpitals, we ftiall conclude with a few words upon the
fubjedt of the lunatic afylums.

The Salpetriere, under Dr. EfquiroPs management, af¬
fords as fair a fpecimen of the refult of benevolent confi-
deration and exertion as any inftitution to be found in
France, or on the continent. Here the claffilication of
patients is attempted, and to a confiderable degree carried
into eftedt ; though, without doubt, there is Hill much
to be defired. The ufe of chains, and all that apparatus
of feverity which formerly obtained, are entirely done
away; and the refult has pretty clearly demonftrated that
in an inftitution of this kind, properly condudted,they are
ufelefs. Confinement and the ftrait-vvaiftcoat, we are
told, are the only reftraints now had recourfe to at La
Salpetriere. The latter of thefe, for very good reafons,
is very much abandoned in this country : it is never
ufed at Rethlem, and very feldom at St. Luke’s: its in¬
expediency is very apparent. The patient is quite in¬
capable of aflifting himfelf in a thoufand little neceffary
offices; and, when locked up by himfelf, this becomes
unufually irkfon-.e. When the wrifts are manacled to¬
gether, even the mod furious are helplefs : or a leathern
girdle may be put round the waift, and the arms may be
pinned down to this in a way to prevent any injury.

The treatment purfued here is no longer the decided
and adtive one, in the way of bleeding, purging, &c.
which ufed to be pradtifed. M. Efquirol confiders men¬
tal alienation as an acute difeafe, having its fuccelfive pe¬
riods of intenfity, decline, and convalefcence, the order
of which is not to be difturbed by officious interference,
though the fymptoms are to be moderated by gentle
means, viz. tepid baths, diluents, occafional foothing
medicines, and very flight douches. Speaking to Dr.
Clark of relapfes, he faid that he had known many
cafes where aparoxyfm had occurred after bleeding; in fome
cafes after a fmall, in others after a large, bleeding. The
treatment is made as much moral as poffible. An effort
is made to gain the confidence of the patient; and this
is generally obtained by appearing to take an intereft in
his affairs, and by fcrupuloufly preferving good faith.
As much work is given them as can be procured. The
convalefcents have a large room where they are em¬
ployed at their needle; and, by way of encouragement,
they receive a trifling remuneration for their work. M.
Pinel, as is well known, removed the regular fervants
from the inftitution, and fet the convalefcents, with
much profit to themfelves and their unhappy compa¬
nions, to attend upon the patients, and do the little me¬
nial offices.

Dr. Efquirol, from 800 diffedtions which he has made,
has come to the conclufion that “ he has never found any
conftant alteration in the ftrudture of the brain, or of any

other part. The hardnefs of the brain, infifted upon by
many, he had not generally remarked.”

The excellent regulations we have juft noticed belong
to Paris, not to the provinces. But the Report of the
Committee appointed by the Britifh parliament produced
a fenfation on the public mind which was ftrong and per¬
manent ; and, we rejoice to fay, that its good effects
have not been confined to England alone. The govern¬
ments on the continent have taken alarm, and invefti-
gation has every-where commenced. The French go¬
vernment appointed Dr. Efquirol to vilit all the recepta¬
cles for lunatics in France; and the refult of a tour which
he undertook for that purpofe, is ftated in a “ Memoire
prefenteau Miniftre de lTnterieur.” It is but juftice to
Dr. Efquirol to ftate, that this Memoir is drawn up with
much ability and feeling; and, as far as we are able to
judge, with ftridt juftice and candour. It, in fadt, does
equal credit to the head and heart of the writer.

“Thofe for whom I plead,” fays Dr. Efquirol, “ are the
moft interefting members of fociety; for they are almoft
always thevidtims of the prejudice, injuftice, and ingra¬
titude, of their fellow-creatures. Among them are to be
found fathers of families, faithful wives, Ikilful artifans,
brave warriors, and diftinguifhed literary characters,
ardent, proud, and acutely fenfible minds ; and yet thefe
individuals, who ought to attradl a peculiar degree of
fympathy and intereft; thefe unfortunate beings, fuffer-
ing under the moft fearful of human miferies, are treated
worfe than criminals, and reduced to a condition below
that of the inferior animals. I have feen them naked,
or half covered with rags, with only ftraw to protect
them from the cold, and wet pavement upon which
they lay. I have feen them badly fed, without air to
breathe, water to quench their thirft, without, in faff,
the firft necefiaries of life. I have feen them in narrow,
dirty, infedtious, cells, without air, without light,
chained in dens, where we fliould hefitate to confine the
wild animals which the luxury of our governments keeps
up at fuch expenfe in our capitals. This is a faithful
pidture of what I have feen all over France; and this is
the manner in which the infane are treated in almoft every
country of Europe.”

The infane, in France, are almoft all placed in public
eftablifinnents ; either in inftitutions fpecially devoted to
them, in hofpitals, in the depdts de mendicitS, or in boufes
of correction and prifons. They amount to 5153 in
number, and occupy 59 houfes; out of this number,
more than 2000 belong to the three great eftabliflimentsof
Paris. It is rather Angular, that in the fouthern pro¬
vinces of France, the proportion of men confiderably ex¬
ceeds that of women; while, in the north, the reverfe is
obferved. In Spain, the proportion of men is greater
than that of women.

There are only eight eftablifhments peculiarly dedi¬
cated to the reception of lunatics in France. Thefe are
at Armentieres (for men only), Avignon, Bourdeaux,
Charenton, Lille (for women only), Marfeilles, Marville,
Rennes. There are feveral glaring defeats in thefe infti-
• tutions. At Charenton, for inftance, part of the infti¬
tution is ufed as a workhoufe for the poor of the neigh¬
bourhood. Epileptic patients are mixed with the luna¬
tics, and prifoners are occafionally confined in the fame
houfe. Incurable cafes are dlfo received, and are kept
there for life. So it may be faid, that there is in France
no inftitution fpecially devoted to the treatment of infi¬
nity. In thirty-three towns of France, which M. Efqui¬
rol fpecifies, the infane are received into the general hof¬
pitals, which are alfo appropriated to the old, the infirm,
and the difeafed ; to venereal patients, and to thofe af¬
fected with cutaneous diforders, and which even admit
women of diforderly lives, and criminals. In the cities
where dep'ots de mendicity have been eftabliflied, a portion
of the building is devoted to lunatics, but only to thofe
who are furious ; thefe are kept conftantly chained in

their

52

PATHOLOGY.

their cells. The others, intermixed with paupers, are
without any of the care which their ftate requires. Dr.
Elquirol fpecifies twelve places where lunatics are received
into the depots de mendicite. In feven towns, lunatics are
even confined in prifons, and chained by the fide of the
moft abandoned criminals. The latter can work, and
the produce of their labour enables them to procure many
comforts: the infane are deprived of this refource, and
expofed to the jefts of the moft abandoned wretches.
How humiliating muft their ftate be, if a lucid interval
reveal to them their fituation; and if, in fpite of fo many
obftacles, a cure ftiould be effected, how dreadful muft
the recollection be of fuch fcenes !

Our author now proceeds to give, in a general way,
the refult of his obfervations. The buildings devoted to
the infane in France are bad: for they are always con¬
fined, damp, and generally in a ruinous ftate; and even
in the depots de mendicite, and fome hofpitals where new
buildings have been erefted for the infane, they have
been conftrudted without reference to the objedt for which
they are intended. The cells are dreadful : without air
or light, narrow and damp. They are paved like the
ftreets, are often under ground, and fometitnes in caves.
They have feldom any other aperture than the door, and
a finall fquare hole oppolite to it ; and very often, even
this aperture is wanting. There is, confequently no cir¬
culation of air, and the fmell is almoft fuffocating. Al-
moft all the inlane, not only the indigent, but thofe who
pay, are naked, or only clothed in rags. They receive
the tattered garments which have been thrown off by the
poor, or the prifoners. Straw is all they have to protedt
them from the humidity of the ground, and the coldnefs
of the air; andftraw is fometimes wanting ! “J’ai vu un
inalheureux imbecile, tout nu et fans pail le, couche fur le
pave. Exprimant mon etonnement d’un pared abandon,
le concierge me repondit que l’adminiftration ne lui paf-
fait, pour chaque individu, qu’une botte de paille tous
les quinze jours. Je fis remarquer a ce barbare que le
chien qui veillait a la porte des alienes etait loge plus
fainement, et qu’il avait de la paille fraiche et en abon-
dance ; cette remarque me valut un fourire de pitie.
Etj’etais dans une des grandes villes de France!”

In no inftitution is there room enough for the patients
to take air and exercife. The fpace allotted for that pur-
pofe is promifcuoufly devoted to both fexes ; and, in fome
houfes, the patients are brought out and “chained to the
walls of the court, by way of taking the air.”

The attendants are infufficient, and ignorant; and,
indeed, in moft houfes the patients have no fervants. In
prifons, the jailor, who has fifty or lixty criminals to look
after, has alio to attend to beings who have not the power
of expreffmg their wants.

Chains are every-where employed: i. On account of
the wretched ftate of the buildings : 2. From the infuf-
ficiency of attendance : 3. From the ignorance of the
keepers: 4. From the expenfe of waiftcoats. “J’ai
envoye des gilets pour fervir de modele dans plufieurs
villes; on ne s’en fert point par economie ; il eft certain
que les chaines coutent moins d’entretien.” The chains
employed confift of iron collars, girdles, and fetters. In
one inftitution, the patients were confined by means of
an iron collar attached to a chain, a foot and a half in
length. A whip is in the hands of the fervants, and the
bunch of keys is made a common inftrument of correc¬
tion. In all the eftablifhments of Paris, containing 2000
individuals, corporal punilhment has been long abolilhed.

The medical men in the different towns have made
many efforts to remedy thefe abufes ; but, difappointed
in their attempts, they have become difgufted, and only
vifit the infane who labour under illnefs, but never with
a view to cure the infanity. The fervants of the hofpital
order the means which they judge neceffary. At Tou-
loufe, from time immemorial, it has been the cuftom for
the medical men to vifit the indigent in the general hof¬

pital, but they never go into the quarter where the infane are
confined.

The magiftrates, deceived by falfe reports, and fright¬
ened at the tales with which interefted keepers awaken
their fears, never vifit the lunatics; reconciling their
confciences to this adt of negledl, by viewing the patients
in the light of incurables, and thinking they have done
enough when they have put them out of a ftate to do
harm, and given them bread and water fufficient to keep
them from ftarvation.

Having detailed the abufes which exift, our author
next proceeds to confider the belt method of remedying
them. The outline of his plan is fomething like what
has been propol’ed in England ; to build afylums in various
parts of the kingdom, which fhould be appropriated to
lunatics only. Dr. Efquirol is of opinion, that about
twenty of thefe buildings would be required for the whole
kingdom of France; and, as there are already three at
Paris and eight in the provinces, he would retain thefe for
the fake of economy; and, after radically reforming
them, built nine others ; all which he would place un¬
der the direction of a managing committee, to confift of
the prefects of different departments, fubfcribers, ma¬
nager, phyfician, &c. The diredtors and phyficians to be
in conftant correfpondence with a central committee, im¬
mediately under the fuperintendance of the minifter of
the interior. In conclufion, Dr. Efquirol announces his
intention to publilh an extenfive work on infanity, which
may perhaps afford us an opportunity of refuming this
intereftingfubjedl.

In Italy, the madhoufes are in a ftate equally lamen¬
table, or more fo. Dr. James Clark (Medical Notes on
the Hofpitals of France, Italy, &c. 1820.) has given us
fome fhocking inftances at Turin and Genoa; and the
temper of the Sardinian government does not lead us to
expedt any prompt amendment, as reformation is not the
order'of the day in that unhappy country. Dr. Clark fays,

“The part of the hofpital (Cafa de’Pazzi) we were firft
taken to, confifted of fmall rooms fimilar to thofe gene¬
rally met with in fuch inftitutions ; but I was difappointed
to find thefe were not for the poor patients, but for thofe
who paid a certain fum for being kept. The firft of thefe
that was opened prefented to us the wretched prifoner,
perfectly naked, and chained down to his bed by both
wrilfcs. He had raifed himfelf in his bed as far as his
chains admitted, by which movement he had call off
the fingle coverlet that had been thrown over him. He
had no Hurt; his legs (apparently red and fwollen from
cold) were drawn up under the corner of the bed-cover,
which lay over a fmall part of his body ; he was pale and
emaciated ; he uttered not a word. In Ihort, a human
being in fo wretched a ftate I had never before feen ; but
I was foon to witnefs others in a ftate ftill more horrible.
We were next condudted into a ward where thirty beds
were huddled together, on moft of which lay a poor
wretch chained by one or more limbs to the bedftead ;
for to each corner of thefe was attached a maffy iron
chain, with a clafp of the fame materials and ftrength at
the extremity, for admitting the wrift and ankle; and,
according as the keeper judged neceffary, one or more
of thefe were applied. Some were polilhed and bright as
filver, from conftant ufe. I imagined that thefe were the
moft unruly patients, but was told that this was by no
means the cafe. To thefe we were next led ; and, on
unbolting the door of a large cell, the fcene that prefented
itfelf almoft exceeds belief. The fpedlacle of the poor
wretches, naked, or covered only by fome ftraw, chained
down hand and foot to their bedfteads ; the clanking of
their chains ; the dreadful vociferation they fet up at the
fight of him who had rivetted thefe chains; the ftill
more horror excited by fuch a fpedlacle ; no terms
are ftrong enough to depidt ! I had read and heard of
chains and other means of torture for fubduing (irritat¬
ing) the unfortunate maniac; I had even feen fuch,

1 fngly

PATHOLOGY. 53

fingly chained to the wall by the neck, like an infuriated
and dangerous beaft ; but a den like this, crowded and
crammed with human beings, chained down, without a
rag of covering, ftruggling to raife their heads, and ex¬
hibiting their emaciated and galled limbs from the heap
of ftraw that had been thrown over them, was a fcene I
never expected to witnefs, and which I hope I may never
witnefs again. In this cell there were twelve men, three
of whom only were allowed any thing more than ftraw to
cover them. Some I was told had been confined there for
many months. On approaching them, they exhibited their
chained limbs with the moft earneft entreaties for libe¬
ration. One man had two chains on one arm. In this
cafe the fpace between the iron clafps was red, fwollen,
and ulcerated ; and the mortification, which in all pro¬
bability was to follow, would foon render chains unne-
ceffary for him. Others had their limbs galled, but not
in fuch a degree as that defcribed. In one inftance only,
in the whole hofpital, did I obferve any thing introduced
between the iron ring and the limb. The reft of the
men’s wards were fimilar to that I firft noticed.

“From the men’s we were led into the women’s de¬
partment, which was in the higher part of the houfe,
and which, in every refpeft, we found fimilar to that
we had juft left, the beds huddled clofely together, chains
always ready, many applied, and moft of the beds oc¬
cupied ; for, whether to fave trouble, or from the poor
creatures having no clothes but the coverlet that was
throw n over them, almoft every one wras in bed. Here,
as below, was alfo a cell where ftraw afforded the only co¬
vering, where the chains were more heavily applied, and
where the date of furious defperation to which the wret¬
ched viftims were driven, was exprelfed in terms equally
violent, and ltill more affedfing. One of thefe tortured
women held up her arm which w’as raw, and had been
bleeding, from the iron clafp having worked its way into
the fiefh i

“ Such is the dreadful ftate of this houfe, wdiich con¬
tains 180 males and 97 females, of whom one third, the
keeper told me, were kept conftantly chained. From the
fame fource I learned, that the annual number of deaths
(and this, I apprehend, is the principal way in which
this houfe gets rid of its inhabitants) fometimes amounted
to eighty (nearly one third of the whole); that it had
b$en as few as thirty ; and that the average was fifty
(nearly one fifth); a mortality, I believe, unequalled in
any inftitution of the kind in any country.” But we now
turn to a more pleafing topic, the general ftate of patho¬
logy in Italy.

We have mentioned the celebrity the Italians acquired
in the 17th century as profeffors of anatomy; and W'e
may obferve of the prefent asra, that the labours of Volta,
Scarpa, Fontana, Roffini, and Mafcagni, have much con¬
tributed to maintain that reputation. As far as the
practice of medicine is particularly concerned, until of
late, it appears to have been in a very lamentable condition
yp to the year 1812.. The Italian phylicians were divided
into Brownifts, humorifts, thofe who followed French
t rpedunte fyftem, and a few who praclifed more correblly
according to precepts originally derived from Sydenham.
To thefe are now added others who adopt what is called
the conlra-J'timvlant method, (fee p. 41.) and who boaft
among their diftinguifhed advocates Tommafini andBorda.
It was Rafori, however, who firft introduced this nuova
dcctrinu medica Italianu. During the memorable blockade
of Genoa, that phyfician obtained very great opportu¬
nities of ftudying the progrefs and charabfer of petechial
difeafes ; and the calamitous refults which followed the
application of the means recommended by Brown in al¬
moft all cafes foon led him to attempt a contrary plan of
treatment, the l'uccefs of which amply proved that thefe
fevers were of an inflammatory nature. Further invef-
tigation convinced him that fcarcely any difeafes could
be traced to diredl debility ; and he accordingly eftablifhed
that theory of fever of which the leading features corre-
Vol. XIX. No. 1286.

fpond very clofely with the obfervations of the Englifh
pathologifts. The medical fchool of Bologna, which is
in a very flourifhing condition, may be confidered “at
the head of the new doctrine;” and the profeffors, among
whom we find the name of Tommafmi, its moft zealous
and able advocates. A periodical journal, too, has been
eftablifhed at this place, to give an account of the rife
and progrefs of thefe opinions. In the mean time, thefe
opinions are warmly oppofed by many of the Italian phy-
ficians. Among the moft diftinguifhed of thefe oppo¬
nents areSpallanzani of Venice, (a nephew of the cele¬
brated Spallanzani,) and Federigo of Venice; but their ef¬
forts are not calculated to have much influence in the
medical world.

The dodtrine of this fchool in regard to the operation
of drugs merits our moft earneft confideration. The
grand axioms in Rafori’s theory, and that in which it is
moft ftrenuoufly oppofed to the dodtrines of Browne, is
that “ there exijis a clajs of fubjlances whoj'e uEtion reduces
fever ; Jlackens the circulation ; and, if pvjhed too fur, induces
diredl debility, without the intervention of any notuble dif-
charge .” Inflead of prefuming to argue upon this An¬
gular and bold affertion, we fhall avail ourfelves of the
“ State of Medicine,” appended to Lady Morgan’s Italy,
by Sir Charles Morgan, M. D. for a full expofition of
Rafori’s dodtrine, and alfo for fome very juft and per-
fpicuous remarks on the general ftate of medicine through¬
out Italy at this time.

Alluding to the axiom ftated above, Dr. Morgan pro¬
ceeds thus : “The notions formerly entertained of thefe
drugs were, that they operated by diminifhing or dilut¬
ing the mafs of circulating fluids ; in which they were
fuppofed to coincide with the operation of letting blood.
The contru-Jlimulunt dodtrine attributes their utility to
their diredt impreflion on the living folid ; to an adtion
which, when exceflive, will extinguifh life by an inftan-
taneous exhauftion. In this clafs of fubftances mull be
placed aconite, digitalis, antimonials, and in general all
mineral fubftances, cicuta, the venom of the viper, the
laurel-water and pruflic acid, camboge, tea, coffee, &c.
&c. The clafles of ftimulants and contra-ftimulants,
according to this theory, Hand oppofed to each other in
their relations to the living fibre, and ferve mutually as
counter- poifons to each other. •-Hence, fay the advo¬
cates for this dodlrine, has arifen the abundant life of
coffee among the Turks, as an antidote to the opium
they employ fo largely. Hence alfo the utility of the
vegetable acids as counter- poifons to the fame drug.
The contra-ftimulant eft’edl of lemon-juice is much
greater than is commonly luppofed. The author, when
at Naples, having experienced a flight coup de foleii, in¬
ducing a bilious vomiting and febrile paroxyfm, adopted,
under the advice of the natives, the free ufe of lemon¬
ade. Two or three quarts of this fluid, taken in the
courfe of the morning, not only removed the difeafe, but
induced a degree of debility fufficiently irkfome to re¬
quire vinous ftimulation.

One of the moft important fails attached to this doftrine
is, that the effeit of any given dofe of a contra-ftimulant
drug upon the conftitution, is inverfely as the degree of
ftimulation; and conlequently, that, in inflammatory
difeafes, the patient not only requires quantities totally
unufual in Englifh practice of thefe remedies, but bears
them without any notable eft eft upon the excretions.
In practice, therefore, the meafure of the dofe is found
in the quantity of excitement; and no dofe is deemed
exceflive which does not change the diathefis and induce
dangerous debility. Thus in fthenic maladies, the
Italians employ aconite, from a grain to a drachm ; the
kermes mineral, from eight to twenty-eight grains ; eme¬
tic tartar, from eight to feventy-eight grains; the laurel-
water, from ten to lixty drops ;<ligitaiis, from four grains
to half a drachm ; nitre, to half an ounce or an ounce.
Thefe are commonly given in divided portions through
the courfe of the twenty-four hours, largely diluted with
P anv

54

PATHOLOGY.

any Ample drink the patient prefers. It is ufual to begin
with a final 1 quantity, increafing it more or lefs rapidly-
according to the urgency of the fymptoms. However
extraordinary thefe fads may appear, there are few Eng-
!ifh praditioners who have not had opportunities of wit-
neffing fimilar refults from the adminiftration of James’s
powder. Indeed, fo great is the apparent caprice in the
adion of this drug on the ftomach, and the variety in
its evacuant effeds, that it would be almoft impoflible
not to fufped an inequality in its preparation, without
this key to explain the phenomena. Half a paper or a
paper of the real James’s powder, repeated at ffiort in¬
tervals, has, in fome cafes of fever, appeared to be per¬
fectly inert, neither inducing vomiting nor perfpiration,
though the tongue has been found moifter, and the fever
abated, on the following morning. The author’s atten¬
tion was firft attracted to the faCt by the practice of a
friend, who trufts efpecially to this remedy in the cure
of fevers, notwithftanding the abfence of all fenfible ac¬
tion from it, except the very important one of the ame¬
lioration of the patient.

The pofleffion of thefe faCts could not fail to have had
a mod beneficial effeCt on the practice of phyfic, in a
country whole climate developes inflammation with fo
much intenfity and rapidity; but it has been far more
extenfively ufeful in banilhing thofe dangerous errors of
praflice which had crept in, through the Brunonian doc¬
trine of indirect debility, or of difeafes arifing in excef-
five Itimulus being curable by ftill greater (limulation.
In inflammatory difeafe, (no matter whether chronic or
acute, no matter whether occurring in a vigorous or a
debilitated fubjeCl,) excelfive ftinmlation is the caufe
of malady ; and the contra-llimulant remedies afford
much more fuccefsful methods of cure than are to be
hoped from wine, or ether, or any other ftimulant.
Although the means employed by the contra-ftimulant
phyficians may fomewhat differ from our own, yet the
indications are generally the fame as are recommended
by our bed authorities. There is a confiderable agree¬
ment between their views and thofe of Dr. Blackall, ref-
peding the treatment of dropfy. In this fatal difeafe,
the contra-flitnulant phyficians have to boaft of much fuc-
cefs. It is a malady rendered very common in Lom¬
bardy by the prevalence of intermittents generated in
the rice-grounds, and it feldom finds its way into the
hofpitals till more or lefs extenfive disorganization has
taken place: yet the mortality in the clinical wards of
the Ofpidale Maggiore of Milan, during three years
(1812, 13, and 14) that the contra-ftimulant practice
was purfued there by profelfor Rafori, did not exceed -j^.

A confiderable comparative fuccefs has refulted alio
from the fame mode of treating confumption. The
deaths in the regifter amount indeed to ; but, if the
difeafe had been defined with any degree of accuracy
in the entries upon the hofpital-journals, even this li¬
mited fuccefs is a matter of comparative triumph.

The treatment of dyfentery is chiefly by camboge,
given as a contra-ftimulant, the dofe being gradually in-
creafed till it induces diarrhoea, which is confidered as a
fign of the refolution of inflammation.

With refped to acute difeafes, although the contra-
ftimulant practitioners pufh their remedies further than
was ufual under the other Italian fyftems, it may be
doubted whether they do not yet flop fhort of a proper
vigour. The average mortality of the clinical wards in
the Ofpidale Maggiore, during three years, was lefs than
11 percent, whereas in the other wards, where the older
pradtice was followed, it amounted to 16 per cent. The
total number of lick was 4853; that of the deaths, 520.
Of thefe cafes, 1302 were pneumonies, confumptions,
tabes, dropfy, typhus, and patients received in articuio
mortis, of whom died 428. The deaths in pneumonies
were an<^ i'1 typhus, This exceeds the deaths

in the worft epidemics that have occurred of late years
in England: That 22 per cent, in pulmonary inflamma¬

tions fliould be thought a fmall proportion, (every al¬
lowance being made for the ftimulating qualities of the
climate,) feems to indicate an inefficiency of praClice, at
lead as compared with that of England. It is not there--
fore improbable, that the employment of contra-ftitnu-
lant drugs may have led to a partial abandonment of
blood-letting, or, at leaft, to a confidence in fmaller ef-
fufions of blood than are neceflary to cure the difeafe by
a coup-de-main. The aCtion of tartar-emetic, however
powerful, is flow; and, in acute difeafes, the firft twen¬
ty-four hours are moft important. It is not therefore
impoflible, that this valuable time may be loft in the em¬
ployment of drugs, which, if given to a cure by the
abllraClion of blood, might, in fome cafes, have faved
lives, not fufceptible of refcue by the fame means when
employed at a later period. From all I could gather,
in repeated con verfations with Dr. Rafori, he feemed in¬
deed to be fufficiently alive to the importance of blood¬
letting; and I fliould make this remark with more he-
fitation, if that phyfician did not feem to me to (land
alone among his countrymen for boldnefs and decifion.
Throughout the fouth of Italy, wherever I had the op¬
portunity of dired obfervation, 1 found the blood ta¬
ken, in inflammatory difeafe, lefs in abfolute amount
than is now ufual among Englifli phyficians; and it is
taken by fmaller and more frequent bleedings. It is
not therefore improbable, that when the mind has been
pre-occupied by another idea, the fame error may have
occurred in the practice of more efficient phyficians.

Of the contra-ftimulant theory, the part which feems
the leaft perfedly developed, and concerning which there
is the leaft unanimity, is that which relates to the action
of particular drugs ; indeed, there is no branch of me¬
dical inquiry more contradictory and obfcure among the
phyficians of all feds and all countries : of this, the
endlefs difputes on the adion of digitalis, in the medi¬
cal writings of the Britiffi praditioners, afford a ftriking
inftance. Among the contra-ftimulant remedies are in¬
cluded, by fome perfons, all the mineral remedies, va¬
rious bitters, and (mirabile didu) the bliftering-fly it-
felf. Rafori totally rejeds from the materia medica the
clafs of diuretics, whofe adion heconfiders wholly con¬
tra-ftimulant : for, he fays, not only do droplies, cura¬
ble by fuch remedies, likewife get well by the ufe of
other contra-ftimulants, not diuretic ; but thefe very diu¬
retic medicines do not provoke the fame difcharges in
other difeafes; while, on the other hand, opium and
ether produce diuretic effeds in dropfies, which arife
from a real debility of the living fibre. From thefe fads,
judging empirically, we niuft come to the moft oppofite
and contradidory conclufions : but, in adopting the
contra-ftimulant dodrine, the philofophical indudion
is, that diuretics, and other fpecifics for dropfy, derive
all their efficacy, and their fuppofed fpecific adion, from
their relation to the general diathefis or conftitutional
difeafe.

One of the moft obfcure parts of the new medicine is,
that which diftinguifhes between the irritative and con¬
tra-ftimulant effeds of drugs. Several of the contra-
ftimulant drugs are, in certain dofes, of the moft acrid
and irritating adivity : (not to mention cantharides,)
nitre, the bitter purgatives, and moft mineral fubftances,
excite, when taken in over-dofes, immenfe irritation,
followed by fevere and fatal inflammation of the intefti-
nal canal. Upon the fubjed of irritation, the theorifts
have run into the niceft diftindions ; one aflerting the
exiftence of a' peculiar diathefis, produced by irritative
flimulation ; while another denies the exiftence of fuch
a diathefis. Some perfons, again, confider the irritation
as a phenomenon fui generis, removable only by the
removal of the caufe; while others hold the firft effed
of irritation and of all pain, to be purely contra-ftimu¬
lant. In all this logomachy, there feems to be more in¬
tellectual fubtilty than p radical obfervation ; and per¬
haps alfo no little precipitation in the claffification of
3 particular

PATHOLOGY.

particular drugs. It is difficult to conceive irritation in
any other light than that of di reft ftimulation, fince, when
carried to a certain point, it always induces inflamma¬
tion. That irritants therefore fliould be at the fame time
contra-ftimulants, is difficult to underftand. Whatever
gives a violent (hock to the nervous fyftem has a tempo¬
rary power of diminifhing, and in fome cafes of even
totally extingtiifhing, the vital energy. Blows on the
ftomach, ruptures of ligaments, extenlive injuries of any
important vifcus, are followed by a very marked condi¬
tion of contra-flimulus ; but this peculiar affection of the
nervous apparatus has nothing to do with the power
which a drug may hold over the circulation. In all cafes
of poifoning, where the coats of the ftomach are either
chemically or phyfiologi-cally deftroyed, this ftate of con-
tra-ftimulus precedes the acceffion of that inflammatory
fever which accompanies the effort to caft off the flough ;
but it by no means follows, that the collapfe is the di¬
vert effeft of a fpecific property in the drug adminiftered.

Dr. Clarke (in his obfervations “ On the Climate and
Difeafes of the South of France and Italy,” a work
which may be fafely confulted by tbofe invalids who are
exiled in fearch of health) has molt juftly remarked,
that the fciepces in general, and medicine in particular,
are upon a much more refpeftable footing in Upper Italy,
than on the other fide of the Apennines; and the for¬
mer is precifely the territory of the contra-ftimulant
praftitioners. To their bold adminiftration of power¬
ful remedies, the profeffion in general is largely indebted;'
more efpecially for their more philofophic ufe of digitalis
and of antimony, which, notwithftanding all that has
been written in England, had not been before refcued
from a very grofs empiricifm. The ufe of laurel-water
and the pruflic acid is another benefit derived from this
fource, though it is probable that the French will obtain
the chief merit of this application of a moft deadly poi-
fon to the purpofes of medicine. To thofe Englifti prac¬
titioners who have returned upon the traces of Sydenham,
and have difentangled themfelves from the learned er¬
rors of the laft generation, the contra-ftimulant writers
of Italy will prove highly interefting, by the confirma¬
tion they afford to views entertained at home, upon fe-
parate and independent grounds of reafoning and obfer-
vation.

When the contra-ftimulant fyftem has been noticed,
there remains but little to befaid of the ftate of medicine
i in Upper Italy, where the merits of individuals is ren¬
dered lefs available by inftitutions and by combinations
of circumftances, more or lefs fatal to all national prof-
perity. One of the principal misfortunes attendant upon
the political divifions of this ill-fated country is, the ef-
tablilhment of petty uni verfities, laden with obfcure
profeflors, v.hofe exertions meet with no adequate re¬
ward, either in fame or money. Thefe teachers educate
gratuitoufly, and confequently produce a greater fupply
of praftitioners than the demand can employ. This fa¬
cility of inftruftion and infufficiency of remuneration
operate to invite the lower clafl’es into the career; and, if
perfons of more adequate pecuniary means attach them¬
felves to the profeffion, and are defirous of feeking edu¬
cation in foreign univerfities, they are reftrained by the
reftriftive laws, which confer licenfes to praftife only on
thofe who have graduated at hom-e. Pavia, Padua, and
Bologna, which ftill preferve an aftonilhing zeal for fcience,
and which afford great facilities for the Undent, would
abundantly fuffice for the neceflities of the north of
Italy, but municipal jealoufy operates very generally to
exclude the fubjefts of other ftates from profiting by
their propinquity to thefe feats of learning. Florence,
Sienna, and Pifa, Modena, Parma, Genoa, and Turin,
have each their fchools of medicine, all cofting the pub¬
lic large fum.s, and all more or lefs unequal to maintain
profeflors of high talent or extenlive acquirements.”

The moft recent particular we have to mention in the
medical praftice of Italy, is the adminiftration of black

5$

pepper as a remedy for agues, by Dr. Louis Frank, firft
phyfician to the duchefs of Parma. A man, having ter¬
tian fever, had been treated, without benefit, by cinchona,
opium, and muriate of ammonia; when, after the lapfe
of three months, he was advifed, by fome goflip, to take,
twice a day, fix grains of whole black pepper; he rapidly
recovered his health. Dr. Ghighini, phyfician at the
court of Parma, being in a country where agues pre¬
vailed every year, more or lefs, from the influence of
ftagnant waters, tried the efficacy of the medicine, and
with the moft favourable refults. Dr. Frank has treated
about 130 patients, in the greater proportion of whom
the fever difappeared after the fecond or third paroxyfm
from the time when the remedy was firft adminiftered.
From fix to ten corns of the pepper (given to the patients
as pills) were generally adminiftered twice a-day. But
very few relapfes occurred.

Spain and Portugal. — This is a fliort and barren
feftion. The Spaniards have not lately been in a fitua-
tion to cultivate the fciences, or literature of any kind.
Long opprefled by bigoted rulers and defpotic govern¬
ments; ftruggling for liberty, and not knowing how
to ufe it; and even now torn by inteftine commo¬
tions, while employed in the moft laudable purfuits ;
we have little information to expert from fuch a
fource. Yet we begin to hope for better times ; and
it has given us great pleafure to be informed, that a
medical magazine, to be publiflied every ten days, has
been announced at Madrid, under the title of “ De-
cadas Medico Cirurgicas.” The objerts of this periodi¬
cal mifcellany are — 1. To inform the profeffion and the
public of all the difcoveries and interefting farts relating
to medicine and furgery in Spain and in foreign coun¬
tries. a. To give an impartial account of modern the¬
ories, medical dortrines, See. 3. To convey intelligence
refpertingall endemic difeafes. 4. An account of extra¬
ordinary cures. 5. Mifcellaneous queries and obferva¬
tions ; with an analyfis of medical publications appear¬
ing in Spain, and of the more important ones publiflied
in foreign nations.

A publication of this kind, tending to invite difeuffion,
will, we think, be of infinite fervice to the medical cauie
in Spain. In the mean time, a very lingular retrofpertive
decree of the Faculty of Pharmacy in Madrid has lately
been iflued, by which every perfon prartifing pharmacy,
or keeping a chemift’s fliop, who has not reached the age
of 25 years, is enjoined to attend courfes of lertures at
the Royal College up to that age, with a view to his
being re-examined previoufly to obtaining a frelh licenfe
to praftife.

The following is the account given by Mr. Broughton,
a furgeon, in his “ Letters from Portugal ,” of the mife¬
rable ftateof pathology in that country about theybar 1814.

“ In my profeffional capacity, it has fallen to my lot to
vifit the pooreft and moft diftrefted claffes ; and, miferable
as the ftate of this order of fociety appears to be upon
a cafual view of it, it is yet nothing when compared
with that which is furnifhed by a more intimate acquaint¬
ance with its evils. Often deftitute of hofpitals, and
without the aid of medical men, the unfortunate virtims
linger in the moft loathfome and deplorable ftate which
poverty and difeafe can inflirt, and are confequently
doomed to drag out their miferable exiftence a burthen
to their families and to themfelves. I found the little
affiftance I was able to afford them was eagerly fought,
and moft gratefully accepted ; and, as the intelligence
of the opportunity of relief fpread abroad, the numbers
of the afflirted, and the excefs to which their various dif¬
eafes had reached by neglert, aftonilhed me. Whenever
I met with medical men, I uniformly found this fcience
limited to a degree that almoft exceeds belief. Their
ftudy is chiefly confined to the perufal of a few old au¬
thors, whofe prartice among us has become obfolete; and
they have confequently few conceptions beyond the
dogmas of the latter. The furprife they evinced at the

furgie-al

PATHOLOGY.

56

urgical apparatus of an Englifli medical officer, and at
the commoneft operations, proved the lamentable ftate
of the whole profeffion in Portugal.

“The people in general, as well as the medical prac¬
titioner, are in perpetual terror of infeftion ; for they are
wholly ignorant of its nature, and the molt common ways
of preventing it. Even to this day the Portuguefe che~
riffian invincible prejudice againft the ufe of mercury, in
cafes where we know of no other remedy to check the pro-
grefs of difeafe. Their prejudice againft vaccination was
equally ftrong; but, by the interference of the legifla-
ture, it has been introduced; and the arrival of vaccine
matter from England is occafionally announced in the
Gazette, and inoculation performed gratuitoufly.”

In viewing the ftate of medicine in Germany, we
have much to admire ; for, w'hether we confider the
Germans as minute anatomifts, patient inveftigators of
difeafed function, or as furgical operators, they will de-
ferve high encomium. In many grand pathological
points, we difcover a great fimilarity between their opi¬
nions and our own. And this coincidence is the more
fatisfaftory, becaufe it occurred at a period when the
horrors of war prevented a free communication with the
continent. We perhaps cannot give a better account of
the German medical doftrines than by a ffiort hiftory of
the prefent ftate of their numerous univerfities, the molt
diftinguiffied profelfors attached to them, and their re-
fpeftive doctrines.

It is well obferved, by an amnfing modern writer, (An
Autumn near the Rhine, 1 8 1 S . ) that nothing can be
imagined more ftriking than the contraft between an
Engliffi and a German univerfity. “In the former, the
Gothic buildings, the magnificent colleges, the noble
libraries, the chapels, the retired walks, the fcholaltic
grace of thecoftume, are all fo many interefting indica¬
tions of the antiquity, the munificence, and the dignity,
of the inlfitution. But the conftitution of a German
univerfity has neceflarily no monument of architecture,
no appendage of dignity, fcarcely any decent building
belonging to it. The Univerfitat-Gebaude, or public
buildings, containing the library and the left ure-rooms
of the profelfors, barely come under this laft defcription.
Indeed, in moft univerfities, the leftures are delivered at
the profelfors’ houfes; the univerfity being, in faft, only
a place where there is a good library and leftures deli¬
vered to thofe who are willing to attend them.”

There were, at one time, between thirty and forty
univerfities in Germany. The events of the laft twenty
years have confiderably diminifhed that number. Viewed
as literary inftitutions, the Proteftant Univerfities, which
chiefly occupy the north of Germany, are undoubtedly
fuperior to the Catholic Schools; and, in the words of
Madame de Stael, “toute la gloire literaire de l’Alle-
magne tientaces inftitutions.” Wefhall therefore begin
with them ; and, without enumerating all, it will be
fufficient for us to ftate that the molt celebrated are
Gottingen, Halle, Berlin, Jena, Leipfic, and Heidelberg.

They are divided into four faculties; Divinity, Jurif-
prudence, Medicine, and Philofoph y. Each department
has feveral profelfors. The prince of the country in
which the univerfity is fituated, is nominally the reftor;
while a pro-reftor, chofen annually from among the pro-
feftors, exercil’es all the powers and privileges of head of
the univerfity. The profelfors are appointed by the
crown, and receive a final 1 annual falary. Their prin¬
cipal emolument is, however, derived from the ftudents
w ho attend their leftures, and from their literary labours.
Perhaps, no clafs of men concentrates within itfelf fo
much talent, indultry, and devotion to fcience, as the
German profelfors. The welfare and profp.erity of an
univerfity are generally of fo much confequence to the
ftate in which it is fituated, and that profperity depends
fo entirely on the popularity of its profelfors, that they
t.re always felefted from among thole who have by their

talents and induftry rendered themfelves confpicuous in
their refpeftive branches of ftudy.

The conftitution of the German univerfities would at
firft fight appear very favourable to the ftudents. By de¬
crees, even more ancient than the Reformation, thefe
conftitute a free body in the ftate ; and, except in criminal
cafes of great magnitude, the ordinary police of the
country has no power either of punilhment or control.
They are in faft only fubjeft, if fubjeft it can be called,
to the Univerfity Police, confiding of one or two old
men afting under the orders of the pro-reftor. There is
no gradation of rank or birth, diilinftions of country
are profeffedly abandoned, and poor and rich are on the
fame foundation, merit being the foie diftinftion. So
far all is well ; but the evils which fpring out of this fyf-
tem counteraft many of the advantages. In Germany
every one goes to the univerfity. To praftife medicine,
a regular univerfity-education is indifpenfable ; while
thofe deftined for the army or the law muft qualify them¬
felves by two years’ refidence at fome univerfity. They
generally therefore enter young, and at 16 or 17 are
transferred from the control and difcipline of the pa¬
rental houfe to a ftate of the moft unbounded licence.

No peculiarity of drefs is enjoined by the univerfity;
but a ftudent is known all over Germany by his loofe
frock, hair flowing down his flioulders, and cap bearing
the colour and emblem of the country of which he is a
native. The ftudents have a peculiar and fecret alfo-
ciation, known by the name of La ndmahfc haf ten ; that is
to fay, the natives of each country unite themfelves into
a fociety, and bind themfelves to obferve all the laws and
enaftments which may emanate from it. The particular
objefts which thefe focieties have in view are the prefer-
vation of the ftudents’ rights and privileges, the protec¬
tion of their weaker countrymen, and the regulation of
duds, one of the moft important confiderations of a
German ftudent. Thefe. focieties are prohibited by law,
but fanftioned by cuftom.

It is long lince enlightened obfervers have feen and
regretted, that in more than one refpeft thefe inftitutions
have departed from their primitive charafter, and the
fpirit in which their illuftrious founders created them.
Carried away by the torrent of the age, many academic
profelfors havemiftaken the real objeft of the univerfities,
and have given them an arbitrary and frequently per¬
nicious direction. Inftead of forming the ftudents en-
trufted to their care for the fituations they were deftined
to occupy in the ftate, they have purfued the phantom of
a cofmopolitic education, have filled with dangerous po¬
litical reveries minds equally accellible to truth and error ;
and have infpired them, if not with hoftile difpofitions,
at leaft with a decided averfion for all that they fee efta-
blifhed around them. The refult has proved as detri¬
mental to the interefts of the ftate as to thofe of the riling
generation ; it has created in the latter the pride of ima¬
ginary perfeftion, and the pretenfion of re-eftabli(hing
locial order on the bafis of fome imprafticable fyltem :
and many young men who werefent to learn have con-
ftituted themfelves the preceptors and reformers of their
country. This dangerous change did not elcape the
notice of the governments : they had long obferved and
deplored it; yet their anxiety to refpeft the freedom of
inftruftion, fo long as it did not direftly compromife pub-*
lie order, deterred them from promptly oppofing the pro-
grefs of evil by efficacious remedies. But at the prefent
time, when, under the benign influence of general peace,
and the aufpices of princes fincerely engaged in fecuring
future happinefs to their people, we were authorized in
fuppofing that the univerfities would again be placed
within thofe boundaries in which they had formerly fo
honourably ferved the caufe of their country and of hu¬
manity ; the moft hoftile attacks againft the principles on
which repofe the peace and fecurity of Germany have if-
fued from thofe very univerfities 5 for, either through

exceffive

57

PATH

excefiive blindnefs or culpable connivance on the part of
the profeffors, the nobleft faculties of youth have been
perverted in favour of extravagant projects and enterpri-
fes, which, though impotent or abfurd, are not the lefs
reprehenfible and criminal, fince thefe fatal delufions
have given rife to crimes difhonourable to the German
character. The late melancholy events at Gottingen will
fully juftify us in the above remarks.

In moft of the univerfities there are what are called
freitifche (free tables) for the poorer ftudents. Inde¬
pendently of thofe provided by the government, indi¬
viduals often leave lands or money to fup'port a certain
number of thefe freitifche. A ftudent appointed to one
of thefe, receives his dinner daily at his own houfe. By
this excellent plan, the feelings of the obliged are fpared,
and the intention of the donor fully carried into exe¬
cution, by the fupport given to merit in diftrefs. Befides
the freitifche , there are Jiipcndiem, or grants of money, ap¬
propriated to the fame purpofes ; burfaries or exhibitions.
The ftudents refide in lodgings, and dine either at a
table d’hote or have their dinner fent them from an
eating-houfe. Boarding is quite unknown.

Among the advantages which the ftudents enjoy, we
nmft particularly notice the cheapnefs and independence
of living at the univerfities, the low price of books, and
the liberality of the public libraries. The general price
of lodgings vary at different univerfities: at Gottingen,
which is by far the moft expenfive, the price of two
rooms may be quoted from three to eight louis d’ors for
iix months ; dinner from one to two louis d’ors per
month. Every thing elfe is reafonable in proportion.

No ftudent is fo poor as not to polfefs a library. The
difference in the price of books is very great, and yet
there is no clafs of men more generally opulent and re-
fpedtable than the German bookfellers. By contenting
themfelves with a moderate profit, the books bear a
price which puts them within the reach of almoft every
ftudent. In Great Britain, ftudents are obliged to con¬
tent themfelves with elementary books, and to borrow
others from public libraries. Independently of the dif¬
ficulties attending the delivery of works in thefe inftitu-
tions, it is no fmall inconvenience to the ftudents not to
have his books at all times, and to be able to ftudy at his
own time and in his own way. We are well aware of
the difference of price in paper and printing in the two
countries, but we contend that they are not fuch as to
juftify the difference in price; and, if they did, the German
bookfellers have another drawback : no fooner does a
work of merit make its appearance, than a pirated edi¬
tion is publifhed in a neighbouring ftate: and yet, with
ail this, books are one-half or two-thirds cheaper. Thus
.. Blumenbach’s Phyfiology fells- in Germany at about
5s. 6d. The tranflation of the fame volume in London,
a book of the fame fize and nature, (and, as books go
here, a cheap book,) fells at 12s. This is a favourable
inftance, for we could fliow cafes where the proportion
is as 3s. 6d. to 15s.

The public libraries in Germany are better conduced
and more ufeful than ours. They are not fo much com-
pofed of old and curious books, as of works of general
utility. They are perfectly open to the ftudents, nor
did we ever hear of a book being purloined or defaced.

There is another advantage which the fchools of Ger¬
many afford — a very conliderable facility of diffedfion.
While our prefent reftraints upon the ftudy of anatomy
exift, fo that it cannot be purfued to any ufeful extent,
or at any reafonable expenfe, nor without expofmg the
ftudent to the vengeance of the law, or the dread of vio¬
lence from popular prejudice, it is in vain for us to hope
to rival the Germans in the ftudy of elementary, much
lefs of minute, anatomy. The fmalleft fchool in Germany
is better provided with fubjedls than any of our univer¬
fities or even hofpital-fchools, and this without violating
the feelings of any one. The rooms are in general fup-
plied by the dead bodies of thofe who die in the liofpitals,
" Vol. XIX. No. 1287.

O L O G Y.

and who have no friends or relations to claim them. We
rejoice that this fubjedt has- not efcaped the notice of one
whofe eloquence can hardly fail of fuccefs when the
objedt is, as in this cafe, to benefit the caufe of huma¬
nity and improve the profeffion of which he is fo great an
ornament. See the Hunterian Oration for 1819.

In recommending the fchools of Germany to fuch of
our countrymen as may vifit the continent, we mult be
uqderftood as addrefling ourfelves only to fuch as view
the profeflion of medicine in the light of a liberal and en¬
lightened fcience : to others the appeal would be in vain.
The former we mult exhort not to be deterred by-the
manner in which Germany and her fchools are often
mentioned in this country, and that too by men whofe
reputation makes them an authority. They fpeak of the
Germans as illuminati, as proficients in animal magne-
tifm and nothing elfe, as mere book-men, &c. &c. but
negledf to obferve, that no country has adorned the pro¬
feflion of medicine with fo many eminent men, or la¬
boured more affiduoufly in her caufe, than Germany;
the land of Hoffman and Richter, Meckel and Walter,
Wrifberg and Zinn, Schmidt and Hildenbrand, the land
which ftill boafts of Franck and Soemmerring, Blumen-
bach and Beer, and Springle and Hufeland.

The German ftudent enters the profeflion much better
prepared than the generality of our ftudents. A thorough
knowledge of the claflics, and fome acquaintance with
natural philofophy, are confidered indifpenfable ; while
moft of them poffefs fufficient literary acquirements to
feel the dignity and importance of the profeflion upon
which they are entering. Their diligence is unwearied
and univerfal.

One great caufe why the produdfions of the German
fchool are fo little known or valued in this country, is
the ignorance of the German language which is fo gene¬
rally prevalent. The war haying fufpended our inter-
courfe with the Germans, our knowledge of their labours
has been derived from French tranflators, the very word
medium through which it could have been conveyed.
It cannot however be denied that, with all the zeal and
induftry which the Germans have difplayed, the benefit
derived from the application of their vait- learning to
practical purpofes (whether in our profeflion or in other
fciences) has not been equivalent to what might have
been expedted from their acknowledged talents-and un¬
wearied induftry. The fault has not lain with them,
but with the peculiar conftitution of their country.
Divided into a number of fmall and inconliderable ftates,
which were 'bound by no common union and cemented
by no common feeling, its general refource.s were weak¬
ened, and too few opportunities afforded for putting
fcientific difcoveries to the teft of practical application.
Difcoveries often lay dormant, or, in the ftruggle to
make them known, were i'eized by nations more happily
circumftanced, and their real country and author for¬
gotten. Lefling has expoled this feeling in one of his
charming fables fo happily, that we Ihall give a tranfla¬
tion of it to our readers. “ A hen, which had become
blind, continued to fcratch together her fmall heap of
corn. Little did it avail the induftrious fowl ; for another
hen, which was not blind, followed her fteps, and en¬
joyed the fruits of her labour. As foon as the blind
hen had laborioufly fcratched up a grain, the other carried
it off The induftrious German coliedls the knowledge
which the lively Frenchman puts to ufe.”

The moft celebrated of the Proteftant univerfities of
Germany is that of Gottingen. This univerfity was
founded by George II. when Eledfor of Brunfvvick and
Luneburg, on the 7th of December, 1736. The imperial
licence had been granted by the Emperor Charles VI. fo
early as January 1733, and ledfures were firft delivered in
Odtober 1734. The univerfity was folemnly opened on
the 17th of September, 1737, and named after its founder,
the “Georgia Augufta.” The celebrity which this uni¬
verfity has acquired in fo ftiort a period of time, is to be
Q afcribed

PATHOLOGY.

58

afcribed to the many eminent men it has ranked among
its teachers. Of thefe we need only mention Haller and
Richter, Zinn and Roderer, among its former, and
Blumenbach, Ofiar.der, Langenbeck, and Himly, among
its prefent, profeflors, to prove that its title to be ranked
among the firft medical fchools, is as juft as the claims
which it undoubtedly eftabliflies, on the merits of fo many
illuftr'ious charafters in other departments, to be called
the fii'ft literary and philofophical fchool in Germany.

In regard to the courfe of ftudy to be purfued to en¬
title the Undent to a diploma, there are no fixed regu¬
lations here, nor, indeed, in any of the Proteftant uni-
verfities of Germany. Ail that is required is, that the
candidate fiiould be able to undergo his examination.
No queftions are allied refpefting the duration of his
ftudies, or the univerfity where he has acquired his know¬
ledge ; but, in general, it requires three or four years
previous ftudy to be able to pais the examination, which
is drift and fair. It embraces all parts of theoretical and
prafticai medicine, including botany and chemiftry; and
a thefts in Latin is fubfequently defended before the uni-
verftty. The expenfe of graduating is about 40 louis
d’or, and the examinators are the members of the me¬
dical faculty, generally the four eldeft. Medical ftu-
dents generally fpend three or four years at Gottingen,
graduate, and then complete their ftudies in the hofpi-
tals of Vienna or Berlin. It is, in faft, chiefly a literary
medical fchool, and, the opportunities of diffiefting ex¬
cepted, bears the fame relation to Vienna and Berlin, as
Edinburgh or Glafgow does to London. The opportu¬
nities forltudy are unequalled. The freeand unfhackled
life of a raoft fplendid library; the excellent leftures of
its celebrated teachers, and thefe at a very moderate
price ; the peculiar fituation of the univerfity, in a fmall
town, from which public amufements and other temp¬
tations to idlenefs are baniflied, where there is 1 ittle or
no general fociety, and where the general tone and ha¬
bits are purely literary, are advantages which few uni-
verfities in Europe combine.

In 1815, the number of ftudepts at Gottingen was
860 ; of thefe 604 were foreigners, (i. e. not Hanove¬
rians,) and 146 medical ftudents :

In 1816, there were 1 132; of thefe, 745 were foreigners, 234 medical.

1817, 1160 710 223

1818, 1158 686 210

An unfortunate difturbance which broke out among the
ftudents in 1819, had greatly reduced the number; but
we are happy to learn, that it is rapidly regaining its
former numbers, and that the (form which threatened
its entire deftruftion, has purified it of many things
which obfcured its advantages.

The falaries of the profeflors depend on government,
and are not generally known. They vary according to
the merit and popularity of the profefl'or. Thus, a young
profefl'or may- receive only 400 or 500 dollars, perhaps
lefts ; while 1500 are given to tempt a man of eftabliflted
reputation to come and fettle in the univerfity. We
believe that no profefTor in Gottingen has more than
1500 dollars ; few fo much.

There are three hofpitals in Gottingen: 1. A medical
and furgical hofpital, under the care of profeffor Himly.
2. A furgical hofpital, under profefl'or Langenbeck. 3.
A lying-in hofpital, under profefl'or Ofiander. There
is'alfo a botanical garden, a mufeutn, chemical laboratory,
phyfical apparatus, and a public library. The leftures
of the profeflors are all delivered in German ; and here
we may obferve, that in no part of Germany is the lan¬
guage better fpoken than in Gottingen, and that to fo¬
reigners it affords the advantage of a molt excellent maf-
ter, profefl'or Benecke, profefl'or of the ancient German,
and one of the firft Teutonic fcholars now living. The
terms of ftudy are called Semeftres ; the one commences
on the 26th of April, and lafts about five months; the
other fome time in Oftober. The leftures are delivered

every day, except Sunday. The fee to each courfe is ge¬
nerally a louis d’or, and never more than two. Befides
the public leftures, the profeflors are in the habit of
giving private inftruftions to one or more pupils. Tnefe
are called privatijjima. Profeflors Himly and Langenbeck
each give privatiflima on the operations of furgery, and
on difeafes of the eye. Three or four pupils generally
unite. The profefl'or commonly receives ten louis d’or
for a privatiflimum. There are alfo feveral private lec¬
turers, but none of equal eminence with the profeflors.

Tiie -library is one of the mcft fplendid and ufeful in
the world, and occupies a large and convenient building
in the centre of the town. It confifts of upwards of
200,000 volumes. It poffeffes few manufcripts or curio-
fities ; but aims at general utility. The books occupy
nine large halls, and are arranged in a fyftematic order. -
In one department are the theological, in another the
medical, books, & c. &c. Thefe are again divided; and
under the heads of neurology, midwifery, opthalmology,
jurifprudential medicine. See. Szc. the ftudent finds every
thing which has been written on the particular fubjeft of
his ftudies. The laft alphabetical catalogue confifts of
180 volumes folio. There are generally about 3000 books
in circulation among the ftudents. To keep pace with
the progrefs of knowledge, about 5 or 6000 dollars
(ioool.) are annually expended in new works. Thefe
funds are derived from what is called the cloifter-fund ;
the produce of the cloifters and convents which were
fuppreffed at the time of the Reformation, and which in
Hanover have always been devoted to the fupport of
libraries and charitable inftitutions. This fum would
not, of courfe, be fufficient for the fupport of this noble
library, were it not to receive many donations from au¬
thors. The learned focieties are in the habit of fending
their Tranfaftions ; among thefe we obferved the name of
the Royal Society. His prefent majefty, while regent, pre-
fented a moft fplendid colleftion of books to this library.

Although the Anatomical School is profefl'edly under
the charge of the profeftor, profefl'or Hempel, it owes
its chief advantages to the diligence and celebrity of the
profefl'or of furgery, Langenbeck. A building was in¬
deed devoted to anatomical purfuits as early as 1738, but
in a literary univerfity we fteldom find that much atten¬
tion is paid to prafticai anatomy. The Surgical Hofpital
is a large and commodious building, and has been fitted
up in a very' judicious and ufeful manner. It is devoid
of architectural ornament; but is placed in an open
garden, and well ventilated. It contains two lofty wards,
adjoining each other; the one for men, the other for
women : each ward contains twelve beds. At the one
extremity are the nurtes rooms, the other leads 'to thq
operation-room, which is built in the form of an amphi-4*
theatre. Two fmall wards, attached to the bperating-
room, are devoted to difeafes of the eye, each containing
four beds. Under the Operating Theatre on the ground-
floor is the Surgical Auditorium, and adjoining it a moft
fplendid colleftion of furgical inftruments and bandages.
Patients are received into the hofpital without the pay¬
ment of any Itipend or fee. The reputation of this hof-
pital being very great, patients often come a diftance of
fifty or one hundred miles to it; but only curable and
inftruftivecafes are admitted. By thefe means no ferneftre
pafles over without affording the ftudents the opportunity
of ieeing almoft all the important operations.

The Surgical Hofpital is attended by from feventy' to
eighty ftudents, wdio are divided into praclicanten and
avjcaltanten-, i. e. praftitioners and lifteners. The former
confift of thofe who have attended a previous courfe, and
now take in rotation the charge of a patient. On doing
this they are obliged to give an account of the difeafe,
and anfwer all queftions which may be put by the pro¬
fefl'or refpefting the anatomy, pathology, and treatment,
of the patient. Profefl'or Langenbeck in his leftures on
furgery, which he delivers daily from one to three o’clock,

4 . gives

PATH

gives half his courfe in a femeftre. They might more
properly be called anatomical and furgical left u res ; for
the profefl'or firft demonftrates the anatomy of the diffe¬
rent parts in their healthy date, before he proceeds to
fpeak of them in the various forms of dil'eafe which re¬
quire furgical afliftance. The Anatomical Theatre is
annually fupplied with about eighty bodies. During the
winter thefe are ul'ed for anatomical demonftrations, and
in fumrner are devoted to the performance of furgical
operations. The anatomical demonftrations and furgical
leisures are generally attended by jzo or 130 ftudents,
of thefe about forty are praeparanten (diffeftors), and
aftift in the making of anatomical preparations.

The foundation of the Surgical Hofpital is entirely
due to profeffor Langenbeck. In 1S07, on his repre-
fentation, a certain fum was appropriated to its fupport
from the cloifter-fund. In 1808 the profeffor built the
prefent hofpital, which is Itill his own property, the
Hanoverian government paying him a yearly rent for
it. The beautiful collection of furgical inftruments alio
belongs to the profelfor. Befides thofe which he has
himfelf collected, he purchafed the collection of Heifter,
which, in an hiftorical point of view, is probably unique.
The whole as it now ttands is undoubtedly the firft in
Germany. It comprifes ail the inftruments that have
ever been ufed in furgery from the earlieft days to the
prefent time.

Profefl'or Langenbeck, as a practical furgeon, is unri¬
valled in Germany. We have feldom feen a man fo en-
thuflaftically devoted to any purfuit, or who brought to
the profeflion of furgery more capability of excelling in
it. He has been known for fome time as an excellent
anatomift, but it was his fituation in the army that brought
him into notice as a furgeon. He particularly diftin-
guiflied himfelf at Waterloo, where he held the office
of furgeon-general to the Hanoverian army, by his in¬
defatigable zeal, brilliant operations, and the excellent
arrangement of his department. He not only acquired
great diftinftion, but is faid to have enriched himfelf
during the campaign. It- is much to his credit that all
thefe circumftances have rather contributed to increafe
than flacken his zeal and exertion. Pie is unwearied in the
purfuit of his favourite ftudies. Although he has a very
confiderable praftice, and leftures five hours every day,
he is in the diflefting-room before it is light, and devotes
to it every moment which he can fpare. Hehasfounded
a mufeum, chiefly formed from the labours of himfelf and
pupils, and which contains fome very beautiful prepa¬
rations. He is alfo the author of a periodical work, and
lias written fome other books. Profefl'or Langenbeck
however, is more a praftical than a book man. His
time has been more fpent in the diflefting-room than the
library, and he is confequently not fo well verfed in the
literature of furgery as fome of his countrymen who
have probably never handled a knife, As an operator,
he is unrivalled in his own country, and we are not
aware that he is excelled in any. He is clear and deci-
fivein his judgment; rapid and elegant in his operations.

Leftures on the praftice of phyfic are delivered every
morning at ten o’clock, by profeffor Hitniy, in an au¬
ditorium connefted with his dwelling houfe, and are ge¬
nerally attended by upwards of one hundred ftudents.
Two f'emeflres are occupied by the courfe, the term of
leftures therefore correfponds very nearly with thofe
of Dr. Gregory of Edinburgh. Profeffor Plimly has
printed his “ Lehrbuch der prafticben Heilkunde” as a
text-book. This work is divided into two feftions ; the
firft contains general nofology, and the fecond treats of
materia medica. The latter feftion is really excellent,
but the firft appears, at leaft to our unphilofophical
minds, quite ufelefs. If the hearer can feparate the
praftical matter of Himly’s leftures from his theoretical
views, thefe leftures may be pronounced very good and
ufeful. He is too much attached to a fyftem; but his
leftures contain in general a full account of what is

O L O G Y. 59

known on the fubjeft, and difplay great learning and
refearch. Profeffor Himly’s clinic takes place from
eleven to twelve every day. It is connefted with a frnall
hofpital which is under his direction, founded by fome
inhabitants of Gottingen, and which derives its fupport
partly from the interelt of funds left for its maintenance,
and partly from the cloifter-f und. There are about
thirty beds in it. The principal part of the fick at this
clinic are out-patients.

Profeffor Himly has not of late publiflied anything
but his “Journal der Ophthalmologie.” His text-book is
not publiflied, being merely given to his ftudents.

Leftures on phyiiology, comparative anatomy, and
natural hiftory, are delivered, the phyfiology at eight
o’clock in the morning, comparative anatomy from three
to four, and natural hiftory at five in the afternoon, by
the celebrated Blumenbach, a name refpefted and vene¬
rated wherever it is known. Blumenbach was born in
the year 1752, at Gotha in Saxony, of parents who were
in moderate circumftances. He commenced his ftudies
at Gotha, from whence he went to Jena, where he re¬
mained two years and a half, and then came to Gottingen
to ftudy, under Haller, Richter, and Roderer. He took
liis degree as M. D. in 177 6, at Gottingen, and then pro-
pofed to return to Gotha, with the intention of purfuing
his profeflion ; but liis differtation “ De Generis Humani
Varietate,” made fo great a fenfation, from the novelty
of the fubjeft, and the excellence of the execution, that
on the fame day that lie received his degree, the Uni-
verlity named him Extraordinary Profefl'or of Natural
Hiftory. Having thus obtained a fituation which the
natural modefty of his dil’pofition rendered quite unex¬
pected, he afliduonfly devoted himfelf to the ftudy of
natural hiftory ; with what fuccefs, his numerous works,
and the fplendid benefits he has conferred on fcience,
fufficiently teftify. His cabinet of natural hiftory is one
of the molt l'plendid in the world. It is entirely col¬
lected by himfelf, and forms, perhaps, the belt monu¬
ment of the elteem in which he is held, for he has never
purchafed a Angle article in it. It is kept in his dwelling-
houfe, and occupies five rooms. Nothing can be more
inappropriate than its fituation, or more diforderly than
its arrangement. The molt valuable preparations are
feen out of their cafes lying about. There is no fyfte-
matic arrangement in any part of it; but this is not to be
wondered at, if we cenfider the progrefiive manner in
which this collection has been formed, and the age of
its pofleffor. Many would be happy to arrange it for
him, and Dr. Wernekink has done much towards re¬
ducing the chaos to order; but Blumenbach does not
like any fetting-to-rights in his mufeum.

Tfie part of his cabinet which attrafts principal at¬
tention, is his unrivalled collection of human fkulls. It
has been vifited not only by molt men of fcience, but by
all the crowned heads of Europe. On this fubjeft Blu¬
menbach lays, “ If we wifli to make great people follow
us, and not we them, it is only neceffary to make a col¬
lection of fkulls.” This collection is fufficiently known
by Blumenbach’s work “Decas Craniorum.” The molt
valuable thing in it is a Grecian fkuil, which is at leaft
2000 years old, a prefent from his pupil the Crown Prince
of Bavaria. It is in a perfeCt ftate of prefervation, and
conftitutes a molt beautiful fpecimen of the beau ideal of
the fkuil. The next in point of value are the fkuil of an
ancient Roman, and that of a cannibal (Bataku), which
he received from the prince of Neuwied. Nothing can
be more intereftingthan to view thefe three fkulls, placed
as they are by one another, and to compare their appear-
anceswwith the moral differences of charafter of the na¬
tions to which they belong. In an anatomical point of
view, the beft-preferved fkuil in the collection is that of
a negro. On the fame fhelf Hands the beautiful fkuil of
a Georgian female, and fome very rare fkulls of the in¬
habitants of Nukahiva, a prel'ent of captain Krufenftern.
There is alfo a remarkable fkuil of a Cretin, which pro¬
duces

GO

PATHOLOGY.

duces an indefcribable feeling of horror, from its clofe
refemblance to that of an ape. We have not room to
dwell upon individual parts of this co'lleftion ; but (hall
merely remark, that it derives additional value from the
care taken to authenticate the accounts given of its coh-
tents, and the fkulls are preferved in the fame date in
which they were originally found. Yet Blumenbach,
notwithftanding his collection of (kulls, is not a cranio-
logift. Spurzheim was exceflively anxious to have Blu-
lnenbach’s opinion on his craniological fyltem, and tried
many expedients to elicit it in vain. At length he at¬
tacked Blumenbach on his vulnerable fide, by bringing
him a beautiful (kull as a prelent. This was irrefiltible.
The collector ftruggled between his love of truth and his
extreme fear of wounding the feelings of the craniologift.
I-Ie looked at the (Mill, and exclaimed, “My dear doctor,
in j’our fvftem there is much which is new, and much
which is true; but the new is not true, and the true is
not new.”

Blumenbach’s collection of foflil bones is one of the
molt beautiful in Europe. Notice is particularly attrac¬
ted to the bones of the bear, which exhibit the fame
proportion in point of fize to the bear of prefent times,
as the calf of one month to the ox of two years. There
is alfo a very fine collection of minerals; and another,
no lefs valuable, of (keletons, in which that of a lionefs
is very remarkable. The preparations in this cabinet,
illuftrating the growth of the elephant’s teeth, are unique.
His wet preparations are invaluable, of which we (ball
only fay, that they are defcribed in his “ Abbildungen
Natur-Hiftorifche-Gegenftande.” We may, however,
notice as interefting, the fcetus of a porcupine, and a
crocodile efcaping from the egg. We mud not forget to
mention his beautiful collection of drawings, defcriptive
of all nations of the earth; and an invaluable aflemblage
of curiofities which have no particular relation to l'cience.

The following is a lift of his principal works: i. In¬
tro duel io in Hiftoriam Med. Litterariam ; Gottingen,
1786. z. Synopfis Syftem. ScrifKtt. quibus inde ab inaug.
Acad. G. Aug. 1737 ufque ad 1787 , difcipl. fuam augere
find. Profefs. Med. Gott. 1788. 3. Med. Bibliothek.

3 Bde. 1783 — 95. 4. Inftitutt. Phyfiol. 1787. 5. De Vi

Vitali Sahguini deneganda ; 1788. 6. Gefchichte und

Brefchreibung der Knochen ; 1786. 7. Ign. v. Born;

Zwey Abhdll. iib. d. Nutribus-kraft ; Peterfburg, 1789.
8. De oculis Leucaethiopum et iridis motu Comment ;
Gottingen, 1786. 9. De Generis Humani varietate na-

tiva 51776. 10. ColleCtio craniorum divert'. Gentium;

1790. 11. Ueber d. Bildunftrieb u. d. Zeugungfgefchaft ;

17S1.

Notwithftanding his inceflant labours in his ftudy and
..his cabinet, his three leCtures a-day, and the frequent
vilits he is receiving from (trangers, nothing can be more
affable or kind than his behaviour to ftudents. He de¬
votes to them the greater part of Sunday, and the even¬
ing of nearly every day, from fix to nine o’clock, when
he receives a certain number at tea. To the Englifti
he is particularly attached, having long been on inti¬
mate terms' with fir Jofeph Banks, and many other dif-
tinguiflied-charaCters. He fpeaks Englifti perfectly, and
polleffes all the Englifti works of great merit. He is
equally well-informed in the other departments of know¬
ledge ; his acquirements feem indeed to be univerfal.

LeCtures on midwifery are delivered by Profeifor
O (kinder, and are perhaps among the beft ever heard.
They may be entirely depended on, for they are founded
on a long courfe of accurate oblervation. His text book
"is entitled “ Ofiander’s Lehrbuch der Entbindungfkunft,”
which is perhaps the beft work on the fubjeft. Profeflor
Ofiander gives two courfes in the year, each of which
lafts about five months ; tliefe are combined with che¬
mical inftruCtion in thehofpital. The Lying-in Hofpital
is the fined building in Gottingen, and is admirably
adapted to the purpolesfor which it is intended. Befides
Hie accommodation for patients, it contains apart¬

ments for the profeffor, his beautiful cabinet, and an ap¬
propriate le£lure-room. Nothing can form a ftronger
contrail to the chaos of Blumenbach ’s collection, than
the exquifite arrangement of Ofiander’s. It contains a
mod valuable feries of preparations, chiefly illultrative of
his particular department. The room in which it is
contained is elegantly fitted up, and the preparations, ar¬
ranged in the mod beautiful order, are ail ticketed, with
a reference to the catalogue. This catalogue confifts of
feven folio volumes of MS. and to each number is af¬
fixed a complete hiftory of the cafe of the patient from
whom the preparation was taken. Profeflor Ofiander owes
this beautiful, we had almolt faid unrivalled, collection
to his own induftry. He told an Englifti gentleman,
that he had often in his younger days gone without his
dinner, to purchafe the glafs and fpirit for fome new pre¬
paration.

The leftures on botany are delivered by profeflor H.
A. Schrader, from feven to eight in the morning. The
botanical garden is one of the mod perfeCt and ufeful in
Europe, the Hanoverian government paying great atten¬
tion to its maintenance. The ledlures on chemiftry are
delivered by profeflor Stromeyer, who, fince Klaproth’s
death, may be confidered as the firft analytic chemift in
Europe. At the latter’s death, the Pruflian government
offered profeifor Stromeyer his place at Berlin ; but, the
Hanoverian government making a confiderable addition
to his falary, he preferred remaining'in his prefent poft.
He is as good a teacher as chemift, and is peculiarly at¬
tentive to his ftudents. Independent of his ledlures every
day, he exercifes the pupils twice a-week in experiments
ing in an excellent laboratory.

We may alfo here mention profeflor Haufmann, whofe
ledlures on mineralogy, and whofe coiledlion, are well
worthy the attention of the curious. The ledlures on
general fcience and literature are excellent, and every
facility is afforded, in this interefting univerfity, of culti¬
vating the higher branches of our fcience in a manner
which is almoft unequalled.

We cannot conclude without noticing the vifit of his
prefent mod gracious majefty to this town and univer¬
fity during his late tour. As the univerfity was foun¬
ded by George II. it was naturally expedted that George
IV. would not pafs through fuch a town with the fame
lialle as he would through a place of lefs confideration ;
and the public opinion was not difappointed, for he was
refolved to day as long as the very (liort time he had
prefcribed for his journey would admit. About noon,
(on the 30th of Odtober, 1821,) his majefty’s approach
was announced by a difcharge of artillery; and, when
his carriage arrived at the principal gate of the town, he
found a grand triumphal arch eredted, and a numerous
train of young females, drefled in white, and each car¬
rying in her hand a feftoon of variegated flowers, ap¬
proached, with a poem placed on a fcarlet velvet cufhion ;
which his majefty was pleafed to accept in the mod con-
defcending manner. His majefty did not immediately
proceed to the univerfity, to examine the rich (lores of
the library, the orderly cabinet of Ofiander, or the difi-
orderly one of Blumenbach. No — the firft place to
which he proceeded, on his entrance, was the riding-
fchool, where the J Indents had made all the necelfary ar¬
rangements for entertaining him with a caroufal in the.
(lyle of ancient chivalry. Here his majefty was received
by the public authorities; and the prqfejjbr of riding in
the univerfity was in waiting to exhibit before his fove-
reign fpecimens of his art, from the firft eflay up to the
acme of proficiency. His performance, we are told,
(bowed that he was without a rival in his profeflion; and
his majefty was not more pleafed than furprifed at the
exhibition. The ftudents vrere marfhalled according to
the inftrudtions contained in a printed programme, and
they aflembled in numbers not lefs than fifteen hundred.
They were placed in array by marfhals chofen from among
their body, wearing black coats, cocked hats, long tails,

61

PATH

and fcarfs of white filk tied round the waift. They
marched to the riding- fchool in files of four deep, and
formed an immenfe cavalcade. There were, befides,
about fifty ftudents on horfeback, who were to ferve
as a guard of honour to his majefty ; tliefe wore blue
coats with red collars, buff-leather fmall-clothes and
large boots, and cocked hats with white feathers. Each
of them carried a drawn fword in his hand. The riding-
fchool is in the form of an oblong fquare ; and on one
fide of it the ftudents ranged themfelves along in double
rows, the inhabitants of the town (landing immediately
oppofite to them, while his majefty was conducted to an
open pavilion that was placed at the upper end of the
room, and hung with a rich drapery of crimlon velvet
and white fat'in. To this there was an afcent of feven
fteps, and two young gentlemen of the guard of
lionour flood on the firft ftep in frout of his majefty.
In the pavilion with his majefty were the landgravine
of Heffe Hombourg, his filler, the dukes of Cam¬
bridge and Cumberland, with their ducheffes, feveral
minor princes, and the noblemen and gentlemen of
his majefly’s fuite, who took their ftation in the
rear. A large party of the ftudents now got on horfe¬
back, and went through various equeftrian exercifes,
brandifhing their lances with great agility, while they
made a profound obeifance every time they puffed
his majefty. Some Turks in effigy, who flood as their
opponents, were foon deprived of their heads : the
young cavaliers (hot them off with great adroitnefs as
they rode forward at full gallop, and dilplayed them al¬
ternately on the points of their lances and of their long
fvvords. They then rode a quadrille ; and no French
dancing mailer of the firft celebrity could have fhown
more precifion in the different figures than they evinced.
His majefty partook of fome refrefhment before he re¬
entered his carriage, and was prefented with two poe.ms,
one in German, and the other in Latin. After leaving
the viding-fchool, his majefty pafled through the princi¬
pal ftreets, and then proceeded to the hall, where the
profeffor of natural hillory gives lectures. Here his ma¬
jefty received the heads of the univerfity and the civic
authorities. He then returned to his carriage, and con¬
tinued his journey.

Catholic Univeijities. — There are two German univer-
fities in the Auftrian empire, Vienna and Prague; and
five Lyceums, Lemberg, Gratz, Olmutz, Klagenfurt,
and Linz. The difference between the univerfities and
the lyceums, fo far as concerns medical ftudy, is, that
furgery alone is taught in the latter, both medicine and
furgery in the former.

The emperor Frederic II. as appears from a work
which he compofed, and which bears for title, “ De Arte
Venandi cum Avibus,” had himfelf made numerous ob-
fervations in comparative anatomy. He is quoted as an
authority by profeffor B1 umenbach. Frederic is enti¬
tled to the everlafting gratitude of mankind, for the
exertions which he made in oppofing the fuperftitions
and the prejudices, which during the thirteenth century
prefled down into the dull knowledge of almofl every
kind, efpecially medical knowledge. He got Galen
tranflated ; gave orders that every year in Palermo a hu¬
man body fhould be diffeCted ; and commanded that no
man fhould be permitted to praCtife furgery who had not
ltudied anatomy on the human fubjebt. It was in the
year 1237, that he granted leave to the fenate pf Vi¬
enna to eftablifli a univerfity. This inllitution was con-
fiderably improved by Albert I. in 1296, Ottokar of
Bohemia added to the number of teachers, and aug¬
mented their incomes. Under Albert II. the univerfity
of Vienna flourifhed (till more : he too added to the
number of profeffors, and granted them public audito-
ria and free dwellings in the imperial caftle. Duke Ru¬
dolph IV. in 1364, removed the academical uudiloria, and
the dwellings of the profeffors, to the Minoriten-Cloiiler,

Vol.XIX. No. iily.

O L O G Y.

and to the houfes of the former knight-templars, as thefe
were more Hill and retired. In 1365, pope Urban V. if-
fued a bull of ratification for the juridical, medical, and
philofophical, faculties of the univerfity. On the folicl-
tation of duke Albert III. the theological faculty was
added by Urban VI. In 1366, this univerfity was ar¬
ranged anew, after the model of that of Paris, and ftu¬
dents were now admitted from the Auftrian, Rhenifh,
Saxon, and Bohemian, nations. Under Albert III. in
1388, the number of profeffors rofe to thirty ; and con-
fiderable additions were made to the accommodations of
the univerfity. Ferdinand II. in 1622, gave over this in-
flitution into the hands of the Jefuits, who, though they
were themfelves (hut out from the profelforfhips, yet
knew how to retain the whole government of the univer¬
fity till the year 1754, when the learned and enlightened
commentator on Boerhaave, Gerard baron Van Swieten,
fucceeded, againft much oppofition, in introducing very
important improvements. He new-modelled the whole
medical faculty, and arranged it in a manner much more
likely to anfwer its profelfed object than it had hitherto
done. He introduced profefforfhips of chemiftry and of
botany; and the eftablilhment of a botanical garden, and
of a complete collection of chemical and furgical inftru-
rnents, was wholly owing to him. He alfo brought for¬
ward a propofal for a profeflbrlhip of midwifery. He
drew the moll celebrated men of all claifes to Vienna, af-
furing them of adequate falaries. The univerfity of Vi¬
enna is at prefent the richeft in all Germany. Under
the reigns of Maria Therefa, Jofeph II. Leopold II. and
the prefent emperor, it has fo rifen in reputation amongfl
the catholic univerfities, that it now occupies, efpe¬
cially as a medical fchool, the very firft rank.

The buildings of the univerfity of Vienna are fituated
in the town, which is fmall, and is feparated by a wide
efplanade from the luburbs, in one of which is th e Allge-
meine Krunkenhuus, or General Hofpital. The hours of
lecturing in the univerfity interfere with thofe of the vi-
fits in the hofpital. Hence the lectures are but rarely
attended by thofe foreigners who vilit Vienna in purfuit
of their medical ftudies; amongfl whom are found ftu¬
dents not only from the weftern and northern countries
of Germany, but from Hungary, Swiflerland, Italy, Ruf-
fia, Denmark, Holland, and even France and England,
and with them many who have already praftifed medi¬
cine, and occafionally profeflors from diftant univerfities.
It is chiefly from the admirable arrangements of the
clinics for internal difeafes, for difeafes of the eye, and for
lying-in women, and from the celebrity of the profeffors
of thefe three clinics, that foreign ftudents are attracted
to .Vienna.

I11 order to be admitted a ftudent of medicine in an
Auftrian univerfity, it is necefl’ary that the candidate
fhould' lay before the dire&or of medical ftudy, certifi¬
cates of his having ftudied philofophy for three years in a
lyceum. Under philofophy are comprehended the Latin
and Greek languages, hillory, mathematics, natural and
moral philofophy, and religion. The fchool-year in
Vienna begins with November, and ends with Augufl.
The courfe of medical ftudy extends to five years, and
comprehends the following leCtures ;

Firft Year: 1. Introduction to medico-chirurgical
ftudy, and natural hiftory, by profeffor Von Scherer.

2. Anatomy, by profeffor Mayer. 3. Botany, by profeffor
Jofeph Von Jacquin.

Second Year: 1. Phyfiology, by profeffor Prochafka,

2. General chemiftry, by profeffor Jofeph Von Jacquin.

Third Year: 1. General pathology and therapeutics,

by profeffor Hartmann. 2. Midwifery, by profeffor Boer.

3. Materia-medica et chirurgica, by profeffor Hartmann.

4. General and fpecial pathology of external difeafes, by
profeffor Von Rudtorffer. 5. Ophthalmology, by pro¬
feffor Prochafka. 6. Demonflration of furgical inltru-
ments and bandages, by profeffor Von Rudtorffer.

R Fourth

62 PATHOLOGY.

Fourth Year: i. Special therapeutics of internal dif¬
eafes. 2. Clinic for internal difeafes. 3. Veterinary
medicine, by the direftor of the veterinary fchool.

Fifth Year: 1. Special therapeutics of internal difeafes.
*. Clinic for internal difeafes. 3. Medical jurifprudence,
by profefi'or Bernt. 4. Medical police, by the fame.

The ftudents of medicine, a clafs who in Vienna are
ftridlly diftinguifhed from the ftudents of furgery, are
not obliged to attend the following leftures : 1. Practical
furgery, by profefi'or Kern. 2. Practical ophthalmology,
by profefi'or Beer, 3. General pathology, therapeutics,
and materia medica, by profefi'or Herrman. 4. Special
therapeutics of internal difeafes, by profefi'or Raimann.

Such are the ordinary ledlures on medicine in the uni-
verfity of Vienna. Thofe indeed of Kern, Beer, and
Raimann, are delivered in the General Hofpital. For
none of the above lectures is any fee paid by thofe who
are enrolled as ftudents in the univerfity. The expenfe
of enrollment is fifteen paper-guldens half-yearly, which
is about 10s. For the lectures and clinic of profefi’or
Beer, ftrangers pay twenty-five paper-guldens yearly.
The lectures of profefl'ors Herrmann and Raimann are
defigned for candidates in furgery, and are feldom at¬
tended by ftudents of medicine.

The following are accounted extraordinary lectures:

1. Difeafes of women and children, by profefi'or Boer.

2. Philofophical and phyfical knowdedge necefiary for
furgeons, by profefi'or Piisling. 3. Duties of thofe who
attend the lick, by profefi'or Schmidt. The leftures of
Prochafka on phyfiology, and of Hartmann, are given
in Latin: the others in German.

The ftudents of pradtical anatomy carry on their dif-
fedtions in the univerfity. To foreigners, fubjedls are
ftupplied at the price ot feven paper-guldens. They are
brought from the General Hofpital, but are not fo plen¬
tiful as in the difledling-rooms of Paris. All diffedtion
in the General Hofpital is at prefent ftridtly forbidden ;
but it is not unfrequent to obtain leave to difl'edt in the
Military Hofpital, which is clofely adjoining to the ge¬
neral one, whence the dead bodies are f'urnifhed.

Befides the public ledtures, feveral of the profefl'ors in
the univerfity of Vienna give occafional privatijjima.
By the fpecial order of government, foreigners only are
allowed to take advantage of thefe private courfes. Pro-
feflor Mayer gives private demonftrations on anatomy in
this way, or in any particular part of anatomy which is
defired. Profefi'or Von Rudtorff'er gives over the priva¬
tijjima on bandages and furgical inftruments, to his affift-
ant. Profefi'or Kern ufually does the fame in regard to
furgical operations. The afliftant alfo in the obftetrical
clinic gives privatijjima. Profefi'or Beer and his afliftant,
Dr. Rofas, give limilar courfes on the operative furgery of
the eye. The number of ftudents admitted to a priva-
tijjimvm, is generally fix.

In all the public courfes of medicine and furgery, an
examination of the enrolled ftudents is held by the feve¬
ral profefl'ors every half-year, in prefence of one or more
of the other office-bearers of the univerfity. In order to
be admitted to examination fora degree in medicine, the
candidate muff: produce certificates of having acquitted
himfelf refpedlably in three femeftrai examinations, of
having completed his fifth year ot ftudy, and of having
publicly treated within the laft half-year two patients in
the clinic for internal difeafes, the cafes of which patients
he mult at the fame time prefent to the faculty, written
in Latin.

He who afpires to the degree of Magijier Chirurgia, a
rank analogous to that of memberof one of our colleges,
is obliged to follow nearly the fame courfe of ftudy as the
candidate for a degree in medicine. It is different in
regard to the common civil and country furgeons, as
they are called. Thefe ftudy Only two years, and, fo far
from being required, are fcarcely admitted to attend the
Latin ledtures of Prochafka and Hartmann. Neither in
Auftria, nor, fo far as we have feen, in any part of Ger¬

many, is this clafs of furgeons refpedlable. They are in¬
ferior to the officiers de J'anit of France, and ftill retain
the helmet of Mambrino, and execute at once the duties
of barbers and of furgeons.

One of the public examinations for the degree of mailer
in furgery confifts in the performance of two operations
on the dead body. The operations are determined by
lot. The candidate defcribes the furgical anatomy of the
parts, lays down the indications for the operations, per¬
forms them upon the dead body which is before him, and
applies the proper bandages.

Degrees are granted by the univerfity of Vienna in
ophthalmology'. Doctors in medicine, and mailers in
furgery, are conlidered as having taken this degree : -but
no one elfecan publicly pradtife as an oculift in the Au-
llrian Hates, unlefs he has attended the ledtures of Pro-
chalka, and undergone an examination by him on the
difeafes of the eye.

The marked diltindtion of ftudents of medicine from
ftudents of furgery, the fevere courfe of ftudy. to which
the former are fubjedted, the negledtful and almoft con¬
temptful education of the inferior order of furgeons, and
the uncommon opportunities for ftudying difeafes of the
eye, efpecially under men of fuch reputation as Pro¬
chafka and Beer, are prominent points in the medical'
fchool of Vienna, fo far as the univerfity is concerned.
The Hate of the profeffion throughout Auftria corre-
fponds exadlly with the provifions made by the govern- .
ment for medical and furgical education. The phyficians
are diftinguilhed for their extenfive and pradlical knowr-
ledge. Surgery, on the other hand, feems to languifb.
As for what the Germans have termed ophthalmology;
the fcience of Prochafka, the enthufiafm, the profound-
nefs, and the amazing dexterity of Beer, have contri¬
buted to render this one of their favourite itudies ; and
accordingly their pradlice in this branch is very excellent,
and their operations are performed w'ith the greateft judg¬
ment and fpirit. Indeed, a work recently publilhed in
Germany appears to give them the palm over every other
nation as oculifts ; and we mull confefs that in many
points they have outftripped the Englifh. This however
is not to be wondered at, when we confider how few in
this country make the ftudy of ophthalmic complaints
part of their education, while in Germany it forms one
of the indifpenfible qualifications of every pradlitioner.

Honour, liberty, and life, in fo far as they depend upon
medico-judiciary reports and infpedlions, are not made
the fport of ignorance and carelefinefs in Auftria. Me¬
dical jurifprudence forms an indifpenfable part of ftudy
in the univerfity of Vienna; and certain extraordinary
means of promoting an accurate knowledge of this branch
of medical fcience have been adopted by the government,
which are well worthy of imitation. - Thefe confift in the
publication of a code of regulations, by which all medi¬
co-judiciary infpedlions are to be conducted throughout
the empire, and reports to be drawn up ; and in the per¬
formance of infpedlions publicly, upon the dead bodies
which are found in fufpicious circumftances, and which,
not being at firft recognized, are carried to the dead-room
of the General Hofpital. Due notice is given to the ftu¬
dents at what hour fuch infpedlions are to take place;
and they have thus an opportunity of feeing thofe regu¬
lations put in practice which they themfelves will one
day be called to fulfil. We may here notice, that, after
every death in the Auftrian dominions, the phyfician or
furgeon who attended is required to fign a paper, certify¬
ing the difeafe, and whether it were contagious. If it
was contagious, the law obliges the relatives to have all
the bed-clothes fumigated. In Vienna there is an eftai-
blifhment for this purpofe, where, on paying a fmall fum,
the fumigation is properly performed.

There are feveral anatomical mufeums contained in
the univerfity. That of profefi’or Prochafka is the only
one which excites any peculiar intereft. As our biogra¬
phical articles cannot of courfe include any but perlons

deceafed,

PATHOLOGY.

deceafed, the prefent is one of the few opportunities
we have of noticing living chara&ers. We (hall there¬
fore prefent our readers with an account of the vifit of
an Englilh gentleman to profeffor Prochalka and his mu-
feu m.

“ There is a primitive fimplicity, a condefcenfion, and
a gentlenefs, in this old man, fo celebrated at the fame
time for his genius and his learning, which endear him
to every one. We had no fooner announced to profefl'or
Prochafka the objefl: of our vifit, than he put into our
hands a foot, which, at firft fight, had nothing of an un¬
common appearance, except that its furface was of a deep
vermilion colour. One might have fuppofed that it had
been roughly coloured, and varniftied with a brufli. He
then gave us a fmall microfcope, and defired us to exa¬
mine the foot in a good light. We had no fooner ap¬
proached to the window, and looked at the foot through
the microfcope, than we difcovered that its cutaneous
velfels were beyond conception minutely inje&ed. The
vermilion colour of the preparation arofe from the injec¬
tion filling, on every point of the furface of the cutis,
one might almoft fay a myriad of arteries. In a fecond
preparation we faw the periofteum of the_femur almolt
equally minutely injedted. This preparation feemed to
prove the non-vafcularity of cartilage; for, as foon as
the injedted veffels of the periofteum reached the border
of the articulating furface of the knee, they were moft
diftindtly feen to return upon themfelves, and not one
could be difcovered, even with the aid of the microfcope,
to be prolonged into the cartilage, which had retained its
white, or rather affumed from deficcation ayellowifh, co¬
lour. Profefl'or Prochafka has never been able to inject any
of the cartilages. He is therefore inclined to believe that
the patella which Ruyfch has defcribed, the internal car¬
tilaginous furface of which exhibited a confiderable num¬
ber of veflels* rauft have been difeafed. Profefl'or Pro-
chafiea next (flowed us a fmall box of fimilar Lieber-
kuehnian preparations, which had coft him, he faid,
nearly ten years. Thefe confided of injedted and pre¬
pared membranes, and of thin fedfions of other organs,
fixed upon plates of glafs in the fame way that other mi-
crofcopical objedts ufually are. When viewed through
the microfcope, and el’pecially thofe of the kidney, thefe
preparations difplayed a minutenefs, a beauty, and a va¬
riety, which even exceeded.our expedfations. Indeed we
can conceive nothing in this kind of preparations more
beautiful than on-2 of thofe of which we now fpeak, in
which we faw the capillaries of the cortical part of the
kidney, forming on each fide of their trunks thofe little
globules, which both Malpighi and Mafcagni fuppofed
to be hollow glands, in which the urine was depofited im¬
mediately after being fecreted.

“We accompanied profeffor Prochalka from his houfe
to his mufeum. Here we found whole heads and extre¬
mities injedfed microfcopically. He told us that he had
injedled even whole fubjedfs in that way. He (flowed us
a feries of preparations in which the periofteum, the pe¬
ritonaeum, the mucous membrane of the nofe, and that
of the inteftines, could be compared. It is from the red-
nefs which a part affumes, when well injedfed, that Pro-
cha(ka eftimates its vafcularity. Some parts, fuch as the
nails, hair, epidermis, cartilages, and arachnoid mem¬
brane, never admit injedtion. Other parts, which exhibit
fcarcely any veffels immediately after injedtion, become
extremely red on being dried ; difplaying, when viewed
through the microfcope, a tiftue of innumerable arteries.
Such is the cafe with the internal furface of the cutis,
with the nerves, and with the falivary glands.”

The Mufeum of profeffor Prochalka contains a number
of interefting preparations befides the microfcopical ones.
Ail account of fome of the moft curious of thefe has been
printed in the Quarterly Journal of Foreign Medicine,
N° I.

The Cabinet of Inteftinal Worms is a part of the Im¬
perial Mufeum of Natural Hiftory, under the particular

63

diredlion of Dr. Bremfer, and forms of itfelf an objedt of
confiderable intereft, from the great number of fpecimens
which it contains, and from the pains which have been
taken to arrange the whole, and even to difplay the in¬
dividual fpecimens. Dr. Bremfer pradtifes as a phyfician
in Vienna ; he is at the fame time a zealous cultivator of
natural hiftory, and is perfedtly enthufiaftic in this par¬
ticular purfuit, to which his office as confervator of this
cabinet diredls his attention. He has difledled no fewer
than fifty thoufand animals, with the foie view' of detedl-
ing the various fpecies of worms which fojourn in their
inteftines and in other parts of their bodies. All the
animals which die in the Menagerie at Schoenbrunn are
delivered to Dr. Bremfer for this purpofe ; and no ex-
penfe is fpared to procure dead animals of rarity, inclu¬
ding foreign birds and fifties.

The method taken by Dr. Bremfer to detedi the fmalleft
worms is extremely precife, and often aftoniftiingly fuc-
cefsful. He flits up the inteftines, and carefully colledfs
their contents, which he fets afide for examination.
Having minutely gone over the internal furface of the
inteftines which he had emptied, he proceeds to examine
the contents in fmall quantities mixed with water, and
poured into a flat glafs faucer, the bottom of which is
japanned black, furveying each quantity in fucceffion
through a microfcope. The fame kind of faucers he alfo
employs to difplay the fmaller worms, which, being moftly
white, are rendered extremely evident by the black
ground on which they are thus placed.

The preparations are arranged with much order and
neatnefs. We fee each fpecies of worpi taken from a
complete feries of animals, beginning with man, and
paffing through the different genera of quadrupeds, birds,
and fillies. Dr. Bremfer has made drawings of moft of
the fpecies, both of the natural (ize and magnified ;
they are executed with great beauty upon a black ground:
fome of them have been already engraved, and will ap¬
pear in a work upon inteftinal worms, which Dr. Bremler
is preparing for publication.

In the luburb of Vienna called the Aider Vorftadt,
are fituated the General Hofpital, the Jofephine Academy,
and the great Military Hofpital. Hence, in thisfuburb
are lodged almoft all the foreigners, as well as many of
the lfudents from the different parts of the Auftrian
dominions, who come to Vienna in purfuit of medical
ftudy.

The Allgemeine Krankenhaus, or General Hofpital,
is one of the nobleft inftitutions of the patriot-emperor
Jofeph II. It is one of the molt extensive buildings in
Vienna, and confiderably the largeft hofpital which we
have feen. Lunatic and Foundling Hoipitals are both
fituated near it ; and are, in certain economical rcfpefts,
connefted with it. The greater part of the hofpital is
of two ftories in height. It is arranged in feven large
quadrangular courts, the firft of which upon entering,
and the largeft, is laid out with grals-plots and (haded
walks; and contains, in a building feparated from the
reft of the hofpital, the houfe of the director, the medi¬
cal clinic, a lefture-room, and the mufeum of pathologi¬
cal anatomy. The phyficians, furgeons, and affiftants,
have apartments in different parts of the hofpital. Like
moft of the hofpitals in Germany, it is under the inflec¬
tion of a medical director, who muft refide within the
walls of the hofpital. This office was filled by profefl'or
Von Hildenbrand, lately deceafed ; and is looked upon as
one of great truft and high refpe&ability.

The number of ftck rooms is in ; of which 61 are for
male, and 50 for female, patients. Thefe rooms are each
twenty-fix feet long, and feventeen broad ; they are lofty
and clean. The windows are large; but are all raifed
eight feet from the floor. The advantages of being able,
by this phn, to place beds near to the windows, and of
avoiding the ftream of air which blows upon the beds
when the windows of an hofpital are low, are perhaps
over-balanced by the difadvantage of being unable rea-

3 diiy

(54

PATHOLOGY.

dily and completely to ventilate the apartments. The
beds are placed two feet and a half from each other.
The bedlleads are of wood ; and are without curtains 5
but fquare pieces of dark green cloth, hung from wooden
fupportsin the form of the letter T, are occafionally ufed
to fupply the want of curtains : for inftance, in mode¬
rating the light around a particular bed, or in conceal¬
ing a patient, during the laft moments, from the view of
thofe who are lying around him. Though long accuf-
tomed to the daily view of hofpital-wards where no fub-
ftitute was employed for curtains, we confefs ourfelves
favourable to their ufe, having feen their great advan¬
tages in thfe Hotel-Dieu of Paris, and in other hofpitals.
In beds without curtains, the patients areexpofed to the
eye of every fl ranger ; whereas, when the contrary is the
cafe, they may look upon themfelvesas in fome meafure at
home ; they can guard themfelves from the cold of a large
apartment, and are not forced to crowd around the fire¬
place ; they can procure for themfelves a certain degree
of obfcurity, favourable to repofe; and conceal them¬
felves from thofe by whom they are furrounded. The
beds of the General Hofpital are indifferent : the cover¬
ings good. A few minutes before the vifit of the phyfi-
cian or furgeon, a quantity of juniper-wood is burned on
a fhovel carried round in each ward. We never oblerved
this praiSiice prod uce any irritation even in the patients
affefled with pulmonary complaints, and it completely
removes the foetor of a lick room. The wards are
heated by a large earthen ftove placed in the centre of
each.

The patients treated in the General Hofpital, inde¬
pendently of the Lunatic and Foundling Hofpitals, are
arranged into five claffes. Of thefe, lying-in women
form one; the remaining four confift of patients aft’edted
with internal difeafes, external difeafes, difeafes of the
eye, and venereal difeafes. To each of thefe five claffes,
different parts of the hofpital are appropriated. The to¬
tal number of beds is 2000; and in the winter-feafon
this number is nearly filled. The following are the
numbers of patients treated during the years 1810, 1811,
and 1812, in the General, Lunatic, and Foundling, Hof¬
pitals :

General. Lunatic. Lying-in. Foundlings. Total.

1810 12,374 251 747 2928 16,300

1811 11,709 51 2 1 1 1 5 A843 16,179

1812 10,358 212 1489 2809 14,868

The average number yearly in the General Hofpital
alone, has, in the fucceeding years, amounted to from
15,000 to 17,000.

Three claffes of the patients of the General Hofpital
pay for their maintenance : the fourth, and, we believe,
the moll numerous clafs, are admitted gratuitoully. The
liigheft rate is eleven-pence daily. Thofe who enter
upon this rate have a feparate room, particular attentions,
and a very good bed : but they muff provide themfelves
with flieets and walhing. Forty feparate rooms are appro¬
priated for this clafs. The fecond rate is lix-pence daily :
the patients of this clafs have no feparate room; but, in
other refpefts, are treated as the former. The third rate
is, for the inhabitants of Vienna two-pence, and for
ftrangers two-pence half-penny, daily. However great
and undeniable'the advantages may be, of inftitutions in
which thofe of fmall fortune may receive medical atten¬
dance on paying a moderate ftipend, and thus the patri¬
mony of the poor be preferved to the poor, yet the mix¬
ing of thofe who pay and of thofe who are admitted
gratuitoully in one hofpital, nay, even in the fame wards,
by no means appears a proper arrangement. Neither are
we friendly to thofe immenfe palaces, we had almolt faid
little towns, which we meet with fo frequently in Italy,
and occafionally in Germany, under the name of hofpi¬
tals. Whenever the number of patients in an hofpital
exceeds a few hundreds, the public may look for abufes
and mifmanagement.

The pharmacy of the General Hofpital is an extenfive
and well-regulated eftablilhment. The Pharmacopoeia
Auftriaca, of 1814, is followed. The authors of that edi¬
tion have had efpecial regard to the cheapnefs of the ar¬
ticles admitted. They have, for this reafon, llruck out
many articles of foreign produce, fuch as, balfamus co-
paivse, balfamus peruvianus, cafcarilla; cinnamomum ori-
entale, nux mofchata, quaffia, farfaparilla, fcammonium,
fuccinum, zingiber. The medical plants, for inftance
aconite, are brought chiefly from the fubalpine parts of
Auftria. For the fake of economy, in the commence¬
ment of the cure of intermittent fever, it is almoft gene¬
ral in this hofpital to prefcribe a decotlion of the root
of the common taraxacum ; and in cafes of chancre, in
ftead of the folid nitras argenti, a folution is employed,
which is prepared by digefting for fome days, in a warm
room, a quantity of filed filver with nitric acid.

There are five clinics in the AUgemeine Krankenhaus,
two medical, a furgical, an ophthalmological, and an ob-
lletrical.

The Schola Prn&ica, or Medical Clinic, was united
with the General Hofpital in the year 1784. It confided
of twelve beds, and was under the care of Maximilian
Stoll. In the year 1787, he was fucceeded by Reinlein,
and in 1795 by John Peter Frank. It was efpecially un¬
der Frank that this inftitution flourifhed, and became
much frequented by foreigners. The number of beds
was increafed to twenty-four, and an anatomico-patholo¬
gical mufeum was ellablilhed. In 1804, Frank went to
Wilna, as a Ruffian ftate-counfellor, and thence to St. Pe-
terfburgh. He was fucceeded, fora (hort time, byBenth;
and, in 1806, by Hildebrand, who, for thirteen years, had
been profefforof medicine in Krakau and Lemberg.

There can be nothing, we think, more certain, than
that, to be really ufeful, a clinic mud confift of a fmall
number of patients. For here, the patients are not to be
merely feen, but to be obferved ; not to be obferved by a
man of experience merely, but their lymptoms and
treatment to be made the fubjefts of in veftigation by
thofe who are yet unaccuftomed to the practice of medi¬
cine. The clinical vifit ought not to furpafs the fpace
of an hour; and, in that fpace of time, it is impoflible
to vifit more than twenty-four patients. Frank had
rarely above eighteen in his clinic at Pavia.

Particular attention ought to be paid, in eredting an
hofpital, to have the clinical wards both more fpacious
and more lofty, in proportion to the number of patients
which they are to contain, than the common apart¬
ments, into which it may be fuppofed thatftudents rarely
come, and where the vifits are performed with greater
difpatch. In a clinical ward, room ought to be left
round each bed, for the accommodation of the ftudents;
and, as they are to remain three or four minutes, at
leall, by every bed-fide, there ought to be no chance of
the atmofphere of the ward becoming quickly deterio¬
rated. In thefe two particulars, the number of patients,
and the comparative fize of the wards, the medical clinic
of Vienna perfedlly correfponds with the above ideas;
but in another refpedt it llruck us as being extremely
defective, namely, in the wrant of fmall feparate rooms
for patients labouring under contagious difeafes, for
phrenitic, maniacal, and hydrophobic, patients, for young
children, and for venereal cafes.

The number of beds in each ward is twelve. Over
each bed is hung a black board, on which are written, in
Latin, the name, age, country, and profeffion, of the pa¬
tient, the name and duration of the difeafe, the remedies
in ufe, and the name of the candidatus ufjijlens, or pupil
who has the particular charge of the patient. A painted
ticket, hung up along. with this board, indicates the diet
of the patient, by the words wealf portion, quarter-por¬
tion, third-portion, half -portion, whole, portion, terms cor-
refponding with thofe of the fixed diet-table of the hof¬
pital, which is fufpended in all the wards. It feems to
be as neceflary to teach the regulation of a patient’s diet

in

65

PATHOLOGY.

in an hofpital as to teach the powers of drugs. Yet we
have feen hofpitals where no fuch thing as a diet-tabie
exifted ; or if it did exift, it w'as at lead never fubmitted
to the examination of the ftudents; and we have ob-
ferved, that it was in regulating the diet of their pa¬
tients, that young pra&itioners, iffuing from fuch a
fchool, were ever molt at a lofs.

The number of patients treated in this clinic, during
the fchool-year, is above 200. They are chofen out of a
thoufand patients; and the fele&ion made by Hilden¬
brand, as well as his w'hole manner of conduCfing the
ciinic, feemed highly judicious. He did not fearch for
extraordinary cafes, feldom ventured upon new experi¬
ments, and defpifed to raife the wonder of the unexpe¬
rienced by a fliow of boldnefs or of novelty. It wras the
great objeCt of his inftruttions to make known to his
pupils what is already approved and certain in the heal¬
ing art, and to teach them the method of obferving,
examining, and treating, every kind of internal difeafe.
He chofe from among the numerous patients who daily
entered the hofpital, fome acute cafes, and fome chronic,
fome common, and occafionally tome which were rare ;
but his choice never feemed to be made with the view of
putting to the teft any whim of the day, nor of flattering
the paflions of the young for remedies, and even for
difeafes, which are fuppofed to be newly difcovered.
Puerperal women, patients with fyphilis, and children,
were occafionally admitted.

The vifit in the medical clinic is from eight to nine in
the morning. The affiftant, who is a graduate, and is
ftyled fekundar-arzt, regularly follows the vifit, and,
along with thofe ftudents who choofe to attend, vifits
again in the evening. We have already remarked, that
no one can take the degree of doCtor in medicine in the
Univerfity of Vienna, without having attended this cli¬
nic for two years, and treated, under the eye of the pro-
feffor, two patients within the half year preceding his
offering himfelf for examination. This is abfoluteiy re¬
quired ; but we fliould fuppofe that each ftudent has the
opportunity of treating five or fix patients at the leaft,
each year of his attendance. The number of ftudents at
thebeginning of Novemberlaft w'as about fixty, including
foreigners.

The duties of the cnndiduti aflijientes, or ftudents who
have the care of patients, confilt in examining the par¬
ticular patient committed to their care, publicly on his
admiftion, and again at every vifit ; in writing out an
hjjiuria morbi ; and in keeping a careful journal of the
fymptoms and treatment. Thefe cafes are never written
in a fhort and imperfeCI manner ; they are not made up
of mere hafty notes of fymptoms, ftrung together without
order: they contain a faithful and minute account of
the ftate of the patient, at the laft morning vifit, at noon,
and at evening, with obfervations, and even occafionally
fhort arguments in regard to the diagnofis, prognofis,
and treatment. Each report is dated both by the day of
the month, and by the duration of the difeafe: they are
written in Latin ; are publicly read at the bed-fide ; and,
on the difmiflion of the patient, are delivered to the pro-
fefl'or.

ProfefTor Von Hildenbrand’s work, entitled “ Initia
Inftitutionum Clinicarum,'1’ contains exaCt rules for the
guidance of pupils in their examination of patients; in
determining the nature, form, ftage, and degree, of dif¬
eafe ; in fixing the names, treatment, and prognofis ; and
in writing the hiftory of the cafe. It has, perhaps, too
much of a fcholaftic air to be all at oncerelifhed by com¬
mon Englifh readers ; but w'e have met with no work
which could better ferve as a guide both for clinical ftu¬
dents and for clinical teachers. Nor did profeffor Von
Hildenbrand diftinguifh himfelf more by the keen-eyed
precifion with which he regarded the fymptoms, caules,
treatment, and prognofis, of a difeafe, than by the pu¬
rity and fluency of the Latin diCiion in which his obfer¬
vations at the bed-fide, as well as his le&ures, were de-

Vol. XIX. No. 1287.

livered. The whole of the converfation betw'een the pro-
feffor, affiftant, and candidate, is carried on in Latin.
ProfefTor Von Hildenbrand feemed to us to fpeak Latin
better than he did his own language ; and, though we
are more favourable to the Italian and Scottilh than to
the German manner of pronouncing Latin, we could
fometimes have fancied ourfelves in ancient Rome, and
that the perfon whom we heard was not a Galician of the
nineteenth century, but Celfus himfelf.

Hildenbrand might be regarded as an Agathseus Spar-
tanus. He was known over all Germany, a country
which is but too much overrun with hypothefes, and all
the other offspring of a futile philofophy, as being one
of the ableft fupporters of an ecleCIic fchool, in which
the doCtrines of rational medicine were combined with
thofe of empirical. That he was, in a word, a rational
empiric, appeared at once from his clinical practice, from
his prelections, and from his writings. To what are
ftyled aCtive methods of treatment, Hildenbrand was not
favourable ; and, having but fmall faith in the alleged
power of drugs, he in general adopted and recommended
fimple, mild, and indirect, means of relieving and affift-
ing nature. It feemed to be the obferving fpirit of Hip¬
pocrates, enlightened by all that phyfiology and patho--
logy have difcovered fince the days of the father of me¬
dicine, which (hone forth in Hildenbrand, guiding him
in his inquiries, and leading him to watch the moll mi¬
nute changes which nature herfelf effeCts in difeafes, but
without blinding him to the agency of any really ufeful
remedy.

We can fcarcely conceive any improvement which
could be made in the clinical education of phyficians at
Vienna. The fyftem feems to us to be perfeCt. A ftage
for dramatic and affeCted exhibitions, or for hazardous
and ill-direded experiments, is the idea which is apt to
rife in the mind upon mention of a clinic. But, in that
of Vienna, both the phyfician and the pupils feemed to
do every thing as they would have done in private prac¬
tice. It feemed as if the ftudents were led by Hildenbrand
into the private houfes of his patients ; and as if the
pupils were not learning a leffon in an hofpital, but be¬
ginning to pra&ife for themfelves, with the advantage of
having an experienced and able practitioner with whom
they might confult. The graduates of Vienna have not
idled away the feafon for practical improvement. Placed
in a fituation fuited as well for the communication of
knowledge as for the elicitation of talent, they are
fchooled in penetration, and in aClual habits of obferva-
tion ; and bring into the chambers of the tick, fomething
more than book-learning, fomething widely different
from fafhionable accomplifhments.

The Mufeum of MorbidAnatomy is attached to the me¬
dical clinic; and there is no part of the School of Vienna,
which more ftrongly marks the fincere wifh of the Au-
ftrian government to render the fyftem of medical edu¬
cation complete. A profeCtor, who aCts alfo as anatomi-
cus forenfiH, is appointed to examine with care the dead
bodies ot thofe who die in the hofpital, and to preferve
fuch parts as may prove ufeful pathological preparations.
He lives within the walls df the hofpital ; and receives
fuch a falary as may prevent him from withdrawing his
attention from this office towards other purfuits. The
Mufeum confifts of upwards of fix hundred valuable
preparations, the greater number of which are preferved
in alcohol. A Catalogue raij'omi'e has been publifhed by
Dr. Biermayer, the prefent profeCtor, in which 586 of
the preparations are deferibed, under the title of “ Mu-
fasum Anatomico-Pathologicum Nofocomii Univerfitlis
Vindobonenfis, i8if>.”

The chair of the Surgical Clinic is filled by profeffor
Vincent Kern, who gives daily leCtures upon the prac¬
tice of furgery in the operation-room adjoining to the
wards. This clinic, indeed, owes its origin to profeffor
Kern, and has exifted only fince 1806. The number of
male patients admitted is eight, and of females fix. They
S are •

PATHOLOGY.

66

are ufually chofen from among the patients of the hof-
pital who are admitted gratuitoufly ; but, when impor¬
tant operations are about to be undergone, it frequently
happens that patients who pay prefer paifing into this
clinic. This clinic is public to everyone who leaves his
name with the profefl'or. The lludents of furgery of the
fecond year are obliged to attend, and to undertake the
care of patients, as the Undents of medicine do in the
clinic for internal difeafes. From fixty to eighty lludents
follow the clinical vifit, but the operations are much
more numeroufly attended. The vifit is at ten o’clock
every morning.

With this clinic is connedled a particular inllitution,
or J Jlamfclwle, as it is ftyled, for the education of fur¬
gical operators. Profefl’or- Kern has the liberty of feledl-
ing fix individuals from among his pupils : thefe he in-
ftrudls privately for two years, exerciling them efpecially
in the various operations of furgery upon the dead fub-
jedl ; after which they are permitted publicly to operate
upon the living. Profefl'or Kern, indeeed, leaves almoft
all- the operations upon the clinical patients, except li¬
thotomy, to be performed by his pupils, while he him-
felf takes his place as their afliftant. The pupils who are
feledred for this purpof'e are notin every cafe lludents of
furgery, but are fometimes graduates in medicine, whofe
peculiar talents and inclination lead them to the practice
of furgery. They live in the hofpital, and receive from
the emperor a yearly ftipend, in consideration of which
they are afterwards obliged to ferve the Hate for a certain
period. In general they are fpeedily promoted to be
furgeons of hofpitals, regimental lurgeons, or profefiors
of furgery in fome of the lyceums.

Profefl'or Kern is diftinguiflied by his extreme attach¬
ment to flmplicity in his furgical inftruments, and me¬
thods of operating. His lithotome is a fliort and thick
knife, of a very Ample and almofl uncouth form. The
flmplicity of his external treatment of furgical difeafes is-
Hill more remarkable. His fchool may well be called
the School of Nature; for he trulls almofl as little to
art as did Maiftre Doublet, the contemporary of Ambrofe
Pare, of whom Brantome tells us ; “Et toutes fes cures
faifoit le dit Doublet par du Ample linge blanc, et belle
eau Ample, venant de la fontaine ou du puits.” - Pro¬
fefl'or Kern has baniflied from his practice almofl all the
common applications, fuel) as ointments, plafters,
lotions, lint, tow, and even bandages*; and has fubfti-
tuted in their place the application of water, and a Am¬
ple covering of linen. This plan of treatment he fol¬
lows even with his private patients; and it certainly
fliows no fmall firmnefs, to humour the prejudices of the
public fo little, as never to prel'cribe a plafter or a fldve.

In amputation, profefl'or Kern makes ufe of iced
water, which hfe applies by means of a fponge to the
l'urface of the flump, as foon as the large vefi'els are tied.
This application, fo far from being painful, appears to
give eai'e. The edges are then brought together by ad-
liefive ftraps. The flump is covered with a large flat
fponge, dipped in cold water, and wrung between the
fingers; and this is continued for forty-eight hours. In
fome cafes, this application is changed for a folded piece
of linen moiftened with warm water, and applied over
the adhefive ftraps. The fame mode of treatment is fol¬
lowed with all wounds after operation. The edges are
brought together by adhefive ftraps, and then water is
applied. No ointment, no charpie, no bandage is em¬
ployed. The fuccel's of profefl'or Kern in his operations
is very great.

The extreme flmplicity of profefl'or Kern’s practice is
a fubjedt which never fails to excite the attention of thofe
flrangers who vifit his clinic. The cafes under treat¬
ment are feen to be going on well ; and the l'uccefs is ac¬
knowledged by all to be extraordinary. Yet the ufe of
water, as almofl the only external remedy , is a pradlice which
by no means meets with a favourable reception. There
are few, even of profefl'or Kern’s pupils, who advocate

this practice'; many feem to think it unworthy of fe-
rious examination, and to feel as if fuch a Amplification
of furgery were a degradation of the art ; others blame
the pradlice with much afperity, yet without^daring to
deny the fuccefs with which they fee it attended. Thofe
who addrefs the profefl'or upon the fubjedl, he refers to
the patients before them ; or, if he enter into any de¬
fence of his opinions and practice, it is nearly in the fol¬
lowing manner : “ At the commencement of my furgical
practice, I had a patient brought to me with a large
ulcer on the leg, which had refilled all kinds of oint¬
ments and plafters. . I told the man to lie in bed, to re¬
main at reft, and to give up all applications except a
poultice, fn three weeks the ulcer was ciofed. This,
and many fimilar fadts, have convinced me of the bad
effedts of the ufual treatment, and led me to the ufe of
a more fimple plan of cure. I employ water as an indif¬
ferent matter, to cover a furface which is deprived of its
natural infulator, the external Ik in, and to protect that
furface from injurious influences. It adls favourably
upon the circumference of the lore, as well as upon the
lore itfelf. Ointments and plafters, on the other hand,
are irritating and prejudicial fubftances, when brought
into contadl with an uncovered furface, naturally unac-
cultomed to any fuch foreign imprelflons. As wounds
of bones, for inltance fradtures, are healed wfithout any
external application, fo may all wounds of the foft parts
be cured. The cure of wounds is the work of nature.
Even gangrenous, venereal, and fcrofulous, ulcers, re¬
quire only a proper, internal treatment, and the ufe of
external warmth applied by means of water. Cold, again,
applied by means of a fponge to recent wounds, leflens
in the moll effedlual manner the organic readtion, dimi-
niflies pain, moderates luppuration, and prevents ner¬
vous affedlions. Bandages may be difpenfed with, except
in a very few inftances. The journals of this clinic are
open to your infpedtion.” A farther account of profef-
for Kern’s opinions may be found in his “ Annalen der
chirurgifchen Klinik,” 2 vols. 1809 ; and in his treatife
“ Ueber die Abfetzung der Glieder. Wien, 1814.

The Opthalmological Clinic. — It is neceflary accurately
to diftinguilh thofe practitioners w>ho have of late years
applied themfelves in Germany to the difeafes of the eye,
from the clafs who are termed oculijis, whether of that or
of any other country. The latter would wilh to divide
furgery into a number of trades, of which they would
monopolize one. The former have not confined them¬
felves to the eye, but all of them have come prepared to
the ftudy of that organ by an intimate acquaintance with
medical fcience in general, and many of them have dif-
tinguilhed themfelves by their labours in anatomy, and
their improvements in the pradtice of furgery; as for
inftance, Richter, Schmidt, Barth, and Prochalka. Thefe
men have not regarded eye-difeafes as local merely.
They have rendered eye-operations lei’s frequent, by their
rational and conllitutional treatment of thofe affedlions
which give rife, under mere local and empirical manage¬
ment, to the morbid changes of the eye which afterwards
call for the interference of the operator.

Vienna is at prefent the moll celebrated fchool for the
furgery of the eye in Germany. Profefl'or Barth, who is
by birth a Maltefe, and (till lives in Vienna, as emeritus-
profeil'or of anatomy, was the firft public teacher in this
branch of furgery in Aullria. He is but little known by
his writings on this fubjedl, not having publilhed any
thing upon the difeafes of the eye, with which we are
acquainted, excepting a fmall tract, in which he deferibes
a manner of performing extradlion of the cataradl without
an afliftant. He has many pupils, however, who Hill
fpeak of his left’ons with refpecl ; and the prefent pro¬
fefl'or of pradlical opthalmology was, for a coniiderable
number of years, his afliftant. By the late John Adam
Schmidt, the fame of Vienna as a fchool for the difeafes
of the eye, was much dnereafed. He did not belong to
the general hofpital, nor to the univerllty, but to tire

jofephine

PATHOLOGY.

Jofephine Academy. He is well known by bis opthal-
mological as well as by his other writings, and efpecially
by his treatifes upon the Difeafes of the Lachrymal Or¬
gans, and upon the Inflammation of the Iris. He wrote
a confiderable part of the opthalmological Bibliothek of
Himly ; and it were to be wilhed that fome of his coun¬
trymen would treat his memory with more refpeCt, and
acknowledge what they have borrowed from his valuable
communications to that journal.

Dr. George Jofeph Beer has been for more than thirty
years employed in the practice of this department of
I'urgery. He was for many years extraordinary profeffor
only ; but in the year 1815 a chair of practical ophthal¬
mology’' was founded in the univerfity, which has flnce
been filled by this learned and enthufiaftic man. The
name of profeifor Beer is already known in England. He
is a voluminous author, but all his works are upon the
fiubjeCt of his favourite lludy.

The Clinic for the Difeafes of the Eye has undergone
various improvements within the laft ten years. It has
exifted in its prefent lituation in the General Hofpital,
and with its prefent arrangements, fince November 1816.
The clinic confifts of an auditorium, and of two wards,
on the fecond floor of the hofpital. The auditorium is
well lighted, and neatly covered in green. The windows
are fofupplied with flutters and curtains, that the light
can be in an inftant increafed or diminiflied. A large
ealtern window fupplies the light admitted during ope¬
rations. Befides feats for one hundred and fifty ftudents,
this room contains a cathedra of an oval form, raifed
about a foot and a half from the floor, and furrounded
by an iron baluftrade. From this the leflures are de¬
livered, and it is ufed alfo for the operations, being large
enough to contain a patient, along with the profeffor,
the alfiftant, and the ordinarius, or pupil to vrhofe care
the patient is intruded. A collection of inftruments and
bandages both for the ufe of the clinic, and for the il-
luffration of the hiftory of ophthalmology ; a collection of
anatomical and pathological preparations of the eye ; and
a library of printed books, manufcripts, and drawings,
illuftrative of the ftruCture and difeafes of that organ ;
are contained in the auditorium. The duff of negleft is
not allowed to gather on any of thefe collections. They
are, on the contrary, yearly increafing. The library is
open to the ftudents. The auditorium is adorned with a
buft of the prefent emperor; and portraits of Baron
Protomedicus Von Stilt, the director of medical ftudy in
the Auftrian dominions ; and of the following diftin-
guiflied furgeons ; Scarpa, Richter, Schmidt, Barth,
and Prochalka. Each ward is about the fame fize as the
auditorium, is alfo coloured green, and contains twelve
beds. The wards are feparated from the auditorium by
two fmall rooms appropriated to the ufe of the nurfes.
In the middle of each ward is a long table, which ferves
Jioth as a dining-table for the patients, and alfo for laying
out the bandages, inftruments, and medicines, made tffe
of at the vifit. The windows are fupplied with fhutters
and curtains. Each bed has three fuch fubftitutes lor
curtains as we have already defcribed at p. 64. The
wards are furniftied with every thing neceflary both for
the ftriCtnefs of clinical inftruCtion, and for the peculiar
care of patients affeCted with dileales of the eye. A fa-
laried alfiftant, refiding in the hofpital, is alfo attached to
this clinic.

The inftruCtions delivered in this inftitution, which,
as in the other clinics, are continued uninterruptedly for
ten months, are given in the following order. The lec¬
tures on Practical Ophthalmology are delivered every
morning, Saturdays and Sundays excepted, from ten to
eleven o’clock, in the German language. The ledtures
commence with a very complete account of the anatomy
and phyliology of the eye, in which conllant reference
is made to the morbid changes to which the various tex¬
tures of that organ are liable. The difleCtions of the eye
and of the neighbouring parts, which are made for this

67

part of thecourfe, are very numerous, and are executed
with great care, chiefly by profeffor Beer himfelf. Stu¬
dents can readily procure admiflion when thefe diffec-
tions are preparing; and thus have an opportunity of
becoming more intimately acquainted with the practical
anatomy of the eye, and with lome peculiarities in Pro-
feffor Beer’s mannerof demonftrating that organ. Under
the anatomy of the eye, Profeffor Beer includes the of-
teology of the orbit, and the demonftration of the muf-
cles, blood-veffels, nerves, and all other parts connected
with the organ of vilion. H§ borrows frequent illuftra-
tions from the comparative anatomy of the eye; and pof-
feffes a finer collection of original drawings in this par¬
ticular department than is perhaps in the hand of any
other anatomift. To this part of the courfe, which lafts
.about two months, follows a few leftures upon the man¬
ner in which the difeafed eye ought to be examined.
The next and principal part of the courfe continues for
nearly fix months, and is occupied with the pathology of
the eye, and the medical and furgical treatment of its
difeafes. The whole concludes with a hiftory of opthal-
mology from the mod ancient times to the prefent, and
a critical review of the moft celebrated works in this
fcience.

Daily, from eleven to twelve, Saturdays and Sundays
included, the ftriClly-praCtical inftruftions are given,
partly at the bed-fides of the patients who have been ad¬
mitted into the clinic, and partly in the review of the
ambulatory or out-patients. The plan followed by pro¬
feffor Beer is to bring every new and interefting patient,
whether he be afterwards to remain in the clinic, or to
be an out-patient only, into the auditorium, and to place
him in the cathedra. Any one of the ftudents may now
offer himfelf to be the ordinarius, or candidatus uj]ijlens ,
for this patient ; and, entering the cathedra, may exa¬
mine the fymptoms, pronounce a diagnofis and prognofis,
and propofe a plan of treatment. Ail this is done under
the correftion of profeffor Beer, whofe earned defire to
communicate inftruCtion in thefe practical exercifes merits
the moft unequivocal applaufe. It is here perhaps that
profeffor Beer moft diftinguifties himfelf. We do not
mean to leffen his fame as an eye-operator, already fo
widely and fo well eftablifhed ; but we muff confefs thafi
it was ever as a diagnoftician that he appeared to us to
rife beyond all' rivalfhip.

The number of ftudents who attended this clinic from
1814 to 1817 was as follows :

1814- 15, in. Of thefe 65 were not Auftrians.

1815- 16, 170. ... 92 .

1816- 17, 199- ... 104. .

The number of patients and of operations was as fol¬
lows :

In-Patients.

Out-Patients.

Operations.

For Cataract.

1814-15, 96

1 14

92

60

1815-16, 106

158

78

57

1816-17, 115

1 80

96

59

We have already taken notice (p. 58,62) of the method
of inftruClion by what are called privatijfima. Thole of
profeffor Beer are extremely valuable. He gives a fiiort
courfe of the operative furgery of the eye, repeats the
different operations, and explains, as hegoes along, every
ftep and minutiae in their performance ; and then direCfs
the pupil in the repetition of each of them upon the dead
fubjeCt. After attending one of thefe private courfes,
the pupil is allowed to operate upon the living fubject.
Upwards of thirty heads are employed in a courfe.

Daily, at three o’clock in the afternoon, profeffor Beer
gives advice to the poor in his own houfe; and to this
houfe- clinic, as it is called, ftudents are admitted. Many
of the lefs fevere difeafes of the eye may here be obferved,
which are not fo frequently feen at the hofpital ; and the
Undent finds in profeffor Beer a friend ever ready to ex¬
plain, and to aflift him in the examination of the cafes.

The fee for the clinic is twenty-five paper guldens

yearly.

68 P A T H O

yearly, ( 19s.) for the houfe-clinic a ducat, (10s. 6d.) for a
prixali jfimum eighty paper guldens, and for each operation
upon the living fubjedt four ducats. For Dr. Rofa’s
privatijfinmm, twenty-five paper guldens. For each head
for operations, one paper gulden.

The Gebaerhaus, or Lying-in Hofpital, was eftablifhed
by the emperor Jofeph II. in the year 1784, partly with
the view of preventing child-murder. In the courfe of
the firlt year after it was opened, 748 children were born
in this hofpital. It forms part of the General Hofpital,
and is under the fame management; but is feparated in
fonie meafure from the other buddings of the hofpital by
a fmall court.

This eftablifhment is divided into two fedtions. The
one is for thofe women who pay; to the other admiflion
is gratuitous. The former is committed to the fuper-
intendance of Dr. Pelan, and is not open to ftudents ;
the latter conftitutes the Clinical School of Midwifery,
and is under the care of profeffor Boer.

The Private Lying-in Hofpital confifts of two di'vifions.
The one contains twelve rooms on the ground floor,
which are fet apart for fecret deliveries, and the greater
number of which are occupied each by a Angle patient.
The other divifion contains fix rooms, each of from four
to fix beds. In the firlt divifion, if the room is not oc¬
cupied for a complete day, fix paper guldens are paid.
If the perfon continues longer, flie pays daily a gulden
and a half ; for which flie has board, lodging, medical
attendance, nurfing, and the baptifm of her child. If
{he gives over her child to the foundling-houfe, fire pays
forty guldens. Befides the accoucheur, midwife, and
nurfe, no perfon is allowed to enter her room. In the
fecond divifion, there are indeed feveral beds in each
apartment, yet there is fuch an arrangement, that thofe
who have been are feparated from thofe who are to be de¬
livered. A perfon who does not remain in this divifion
during an entire day, pays four guldens and a half. If
fire remains longer, (lie pays daily half a gulden. Alfo
here, none but the neceflary attendants are admitted.
If a woman of this divifion would give her child into the
foundling-houfe, flie pays twenty guldens.

This {'edition of the lying-in hofpital was intended by
the imperial patriot as an afylum for thofe who might
with to conceal their pregnancy; and here thofe indivi¬
duals find that they are fafe from difcovery. Even the
tribunals are obliged, if it be brought as a corroborative
ground of accufation againft a woman that (lie had refided
in the lying-in hofpital, to rejedl the evidence to that
eftett as not valid. On entering the hofpital, the woman
is not required to tell her real name or condition, much
lefs to declare who is the father of her child. She is re¬
quired merely to bring along with her a fealed letter
containing her real name, that in cafe of her death infor¬
mation may be communicated to her relations. Asfoon
a$ the number of her room and bed is written upon the
letter, it is returned into her own keeping. She can
enter the hofpital and leave it in difguife, or even
nialked ; and indeed continue fo during her whole reli-
xience, if flie choofe it. If (he bring a nurfe along with
her, flie need not expofe herfelf even to the nurfes of the
hofpital. She can leave the hofpital immediately after
her child is born, or remain for fome time. She can
leave her child, or remove it. Many make ufe of this
inftitution only during labour, leave it fome hours after
their delivery, and give up their child to the foundling-
houfe.

The rooms of this fedtion are neither fo fpacious nor
fo clean as thofe belonging to the fedtion for the poor,
but are more crowded. Notwithllanding, they contain
fewer lick in proportion to the number they accommodate,
and fewer die in thisfediion. This mult be attributed
in fome meafure to the greater degree of warmth, and to
the avoidance of draughts of air in fmall rooms ; in
which particulars tliefe are much preferable to fpacious
and airy wards, efpecially for lying-in women. The
average number of births in this fedtion of the lying-in

LOGY.

hofpital, has been for fome years pall from 800 to ioocr
annually, being about a third fewer than in the clinical
fchool. We fufpedt that in a confiderable proportion
of thefe births, the children are illegitimate. In the
tw'enty-four hours, there are on an average from two to
three births. Three midwives afiift at the labours, and
the accoucheur is called in only in difficult .cafes.

The Obftetrical Clinic.- — The chair of clinical midwifery
is filled by profefior Lucas John Boer. The fedtion of
the lying-in hofpital, containing all thofe women who
are admitted gratuitoufly, along with almoft all thofe
who enter on the loweft rate of twopence halfpenny
daily, is committed to his care. Every woman admitted
gratuitoufly muft afiift in the houfehold work of the hof¬
pital, and afterwards ferve for a certain time as nurfe in
the foundling-hofpital. The number of births in this
fedtion is 1200 annually. The proportion of unmarried
women delivered, is to that of the whole number deli¬
vered, as 47 to 50.

This fedlion of the lying-in hofpital is frequently ftyled
the Sc/tola Objletricia ; and it is here alone that ftudents
are admitted to the practical ftudy of midwifery. Indeed
it is chiefly in this fchool that midwifery is at all ftudied,
at leaft by foreigners, at Vienna; for profefior Boer’s
ledtures in the univerfity are for mid wives rather than
male ftudents ; and the ledtures of profefior Schmitt in
the Jofephine Academy interfere with the clinical vifit
of profeflor Boer.

Profelfor Boer vifits his clinic morning and evening.
The morning vifit is from nine to ten ; and is fo far
public, that foreign ftudents, who apply to profeiTor
Boer, are permitted to attend gratis, and to be prefent
at the deliveries which happen between thefe hours.
Thofe who follow this vifit meet in the delivery- ward,
and then attend the profeflor through the wards con¬
taining the women who have been delivered. Two wards
for this clafs of patients are conftantly in ufe, each of
fourteen beds. A third was formerly kept for the pur-
pofe of emptying either of the others at pleafure ; but
fometimes all the three are occupied.

Into one of thefe wards, thofe who are about to be
delivered are brought as foon as their labour-pains com¬
mence, and there they remain until the os uteri has di¬
lated. They then pals into the delivery-ward, which is
fituated between the two large wards for women who
have been delivered. The floors of all thefe apartments
are covered along the fides of the beds with broad pieces
of dark-coloured cloth, which are continued alfo between
the wards. This prevents thofe who have been deli¬
vered from ftepping out of bed upon a cold floor, and
hides any blood which may fall from the woman in la¬
bour, as (he pafles into the delivery- ward. The delivery-
ward contains four beds, which are furrounded by the
kind of moveable curtains formerly defcribed. No de¬
livery-chair is employed by profeflor Boer; but the bed
is arranged to anfwer the purpofe of a delivery-chair, by
means of ten- bags of ftraw, each three feet long, and
from a foot to a foot and a half thick. Thefe are laid
above the ftraw-mattrefs of the bed, and ferve to raife the
head and back of the patient. Over all are laid a woollen
coverlet and a (h.eet, and a coverlet of the fame kind is
laid over the woman.

Theaffiftant and the midwife live in the hofpital, and
are prefent at all deliveries. The profefior does not live
in the hofpital, and is called only in difficult cafes.
There are ten male ftudents, and as many female pupils,
to whofe care the patients are particularly intruded be¬
fore and after delivery, as well as during the time of
labour. Six of thefe ftudents are ftyled intra-pracikanls,
and the remaining four extra-pratihants. All the ten fe¬
male pupils are intra-pralikants, and refide in the Ge¬
baerhaus itfelf. The fix ftudents who are intra-pratikants
refide in other parts of the hofpital. The four extra-
pratikants are not Auftrians. The appointment of pra-
tikunt is given by the profeflor, and no money is taken
for it openly. The prelikants are the only perfon* called
4 upon

PATHOLOGY.

upon to be prefent at operations. A male and female
intra-pratikant daily take the office of journalifts, whole
duty it is to examine all women applying for admiffion,
to be prefent at all deliveries which take place within
the courfe of the twenty-four hours, and to enter into
a book the names of the patients who are admitted into
the clinic, and of thofe who are delivered during that
day, but without any hidoryof the cafes. The appoint¬
ment of pratilcants continues for two months.

Children’s beds are fcarcely ever employed in the cli¬
nic : the children are laid by their mothers’ fide. Swad¬
dling, a barbarity almoft unknown in England, but
which holds its ground in many parts of the continent of
Europe, is not permitted. After a few hours the bread:
is given, the mother continuing in the reclining pofture.
Many of the mothers; indeed, refufe to give the bread:
to their children, knowing that in not many hours they
are to be fent to the foundling-houfe. Small as the rate
of two-pence halfpenny a-day is, it is furprifing how
early after delivery the patients leave the hofpital, in
order to fave this expenfe. We have been allured that
frequently on the fecond day, and fometimes even on
the next day after delivery, they give up their child to
the foundling-houfe, and return home.. The greater
number leave the hofpital at the end of a week. Very
few remain two weeks.

For feveral years ' pad:, profedbr Boer has given no
clinical ledhires. Neither is there any regular lyftem of
indrubtion in the practice of midwifery followed in the
clinical fchool, nor is there any demon ftration of the
obftetrical inftruments, nor arty exercifing upon the
phantom or machine, tinder the immediate direction of
profed'or Boer. The principal part of the inftruclion to
be gained at this clinic, mud: be gathered from his oc-
cadonal remarks and converfational examinations. His
affidant, indeed, gives privalijjima , both to male and fe¬
male pupils, at ten or dfteen paper-guldens.

Profedor Boer is a pupil and a partifan of the Englidi
fchool of midwifery. His forceps are nearly thofe of Dr.
Hamilton; but he almoll feoffs at indruments, and, like
Dr. William Hunter, fums up his advice for difdcult
cafes, in the word Patience. He fays plainly, that
midwifery is better underftood i g England than in any
other country. Little, therefore, is to be learned in the
clinic of profed'or Boer of the artificial part of midwifery ;
while the bed opportunity is afforded of eftimating the
value of the ars objietriciu per expert a tionem. To a
treatife which profedbr Boer hasqmbliffied, he has given
the title of “ Elementa Medicirtae Obftetriciae Naturalis.”
This work is diftinguifhed for the claffic fade with which
it is written.

The medical treatment of the women who have been
delivered in the clinic, is in general fo extremely dmple,
that profedbr Boer is wont to fay, that they cure every
thing there with beer-foup, and require neither great
learning nor dear drugs. The number of puerperal dif-
eafes which do occur is very fmall. This is probably
owing in a confiderable meafure to a regulation, which
is drirtly followed, that no woman diould be left twenty-
fours after delivery, without having a clyder given her,
if her bowels have not been opened. In puerperal fever,
profedbr Boer is a friend neither to blood-letting nor to
drong faline purgatives ; but truds, as in many other
cafes, more to nature than to art, ordering little more
than dome powders of ipecacuanha in the commence¬
ment, clyders, fome fpoonfuls of tindture of rhubarb,
a little of Dover’s powder, and emollient cataplafms to
tjie abdomen. In the pain of the inferior extremities
atter delivery, with or without cedema, profedor Boer
has derived great advantage from a blider applied like a
garter under the knee. He maintains that abfeedes of
the mamma are never to be opened with the knife, but
are to be treated with poultices till they open of them-
felves, after which neither lint nor ointment is to be ap¬
plied. The caufe of fuch abfeedes, he confiders to be
Vol. XIX. No. 1287, *

GO

the want of timely putting the child to the bread, and of
regular fucking. To fore nipples he applies cloths
dipped in warm water, and orders the child to be con¬
tinued at the bread, its faliva being the bed remedy.

As foon as profedbr Boer fees aphthae in a child, he
concludes that it has had tea, fugar, or fyrup, or that it
has ufed a fucking-cloth. Any fuch foreign irritation,
adding upon the tender mouth of the child, caufes aphthae.
In the clinic, as the children get nothing but their mo¬
thers’ milk, aphthae are exceedingly rare, whereas that
difeafe is extremely common in the foundling-houfe. In
the ophthalmia of new-born children, profeffor Boer re-
jefls all collyria, as irritating and likely to increafe the
inflammation. He rejefts alfo the wadiing of the eyes
with milk, as it is apt to be four. He places by the bed
of the mother two cups of cold fpring- wafer. In the one
fhe dips a bit of linen, and in the other waffies out the
bit which die has removed. ’Thefe are frequently applied
over the eye-lids. Under this treatment the indamma-
tion diminifhes, the eye-lids are prevented from adhering
together, and the purulent difeharge is faid to be averted.

The Foundling-houfe is alfo under the fame diree-
tion as the General Hofpital ; but dands on the oppofite
fide of the dreet, and has its own phydeian, furgeon, and
overfeer. Of late years it has been much improved by
.the care of government, and the exertions of a fociety of
the ladies of the Audrian nobility. This is called the
“ Society of Noble Women for the Promotion of the.
Good and Ufeful.” In 1814, the following were among
the applications of their funds :

Guldens;

Care of Foundlings, and Premiums to Nurfes 9871
Inditution for the Indruidion of the Der.fand Dumb 249a
Inditution for the Indru6Iion of the Blind . . 3349

Care of Patients with Difeafes of the Eye . . , 380S

Support of poor Lying-in Women . 1250

All attempts to rear the children in the hofpital itfelf
had failed. In the mod favourable years, only 30 chil¬
dren out of the 100 lived to the age of twelve months ;
in common years, 20 out of the 100 reached that age;
and in bad years not even 10. I11 1810, 2583 out of
2789 died; in 1811, 2519 out of 2847 died. Like the
cavern of Taygetus, this hofpital feemed to open its
jaws for t'he dedrubtiori of the deferted and illegitimate
progeny of Vienna. The emperor Jofeph II. frequently
vidted this hofpital in perfon ; and upon oneoccaiion he
ordered profedbr Boer to make a feries of experiments
with all kinds of food, that it might be afeertained how
far diet had its (hare in the mortality. Twenty children
w'ere feledled, and fed with various kinds of paps and
foups ; but in a few months mod of them were dead. In
1813, the government enabled that the foundling-houfe
diould ferve merely as a depot for the children, till they
could be delivered to the care of nurfes in different parts
of the country. Already, this plan has in part anfwered
the benevolent intentions of thofe who fupported it, and
given credit to the opinion of the medical faculty, who,
in their report upon this fubjeft, attributed the mortality
in the foundling-houfe, not to the want of care, food,
or cleanlinefs, but to the crowding together of fo many
children, and the unavoidable deterioration of the at-
mofphere which hence refulted ; to the noife, and to the
contagious difeafes to which the children were expofed,
and efpecially contagious diarrhoea. This hofpital dill
continues to contain upwards of feventy nurfes, and
more than twice that number of children. Every nurfe
has her own bed, and befnle it two children’s beds. In
general, each nurfe has her own child committed to her
care, and another child.

The Inditution for Sick Children. — This inftitution
owes its origin to Dr. Madalier, a celebrated and bene¬
volent phydeian of Vienna. It is at prefent under the
care of Dr. Goelis, at whofe-houfe in the Wollzeil-ftreet
the vifit is daily held from three to five o’clock in the
T afternoon.

70

PATHOLOGY

afternoon. Students who previoufly intimate their
withes to Dr. Goelis, are permitted to attend, and
have thus an opportunity of feeing the difeafes of chil¬
dren treated with much tkill and attention. The average
number of patients is 500 monthly.

Dr. Goelis has undertaken the publication of a feries
of monographies upon the different difeafes of children,
to which difeafes his practice is nearly confined. The
vaft opportunities of obfervation, the care in conducing
this inifitution, and the numerous difl'eftions of thofe
children who die, lead us to hope much valuable infor¬
mation from thefe works, the firlt volume of which is
already publiflied.

The Jofephine Academy, confidered as a building, is
one of the molt fplendid edifices in Vienna. The empe¬
ror Jofeph II. was the founder of this inifitution, the
objeft of which is to fupply the Aullrian army with able
phyficians and furgeons. On the front of the academy
is the following infcription : “Munificentia et Aufpiciis
Imp. Ca:f. Jofephi II. P. F. Scliola Medico-chirurgica,
militum morbis et vulneribus curandis fanandifque infti-
tuta, sede et omni fupelleftile falutaris artis inftrufta,
Anno R. S. 1785.” It was opened with much ceremony
upon the 7th of November, 1785; and a gold medal of
the weight of forty ducats was (truck upon the occafion.
The firlt direftor of the academy was Brambilla, the au¬
thor of the Inlfrumentarium Chirurgicum, and other
works. To him were intruded the making of the lla-
tutes, and the arrangement of the w’hole inifitution.

The Jofephine Academy is completely feparated from
all other fchools. It is under the direftion of the mi-
nilter of war, out of whole treafury the Hilaries of the
profefl'ors and all other expenfes are defrayed. The
number of pupils is 200, of whom fifty receive a monthly
allowance from the academy. Having finilhed their at¬
tendance of two years, to which period of time the
courfe of Ifudy extends, they unde’rgo a fevere examina¬
tion, are promoted to the degree of doftor in furgery,
and appointed to a regiment ; but the academy pofl'efles
no power to grant the degree of doctor in medicine.

There are five profefl'ors and a profeftor in the acade¬
my. The profelTors belong to the army, being ltaff-phy-
ficians ; and they bear the title of imperial counfellors.
The greater number of them refide in the academy.
Their leftures are delivered in German. The Field-
phyfician-in-chief and Director is Beinel von Bienenburg.

The pupils of the Jofephine Academy have abundant
opportunities for the practical Ifudy of their profellion,
there being three clinics attached to the inifitution. The
patients are foldiers anil foldiers’ wives, chofen from the
Great Military Hofpital, which is iituated clofe to the
academy, and is fitted up for 1200 patients. The Me¬
dical Clinic is under the care of profelTor Calfellitz.
The vifit is from fix to feven in the morning. The Sur¬
gical Clinic is in the hands of profelTor Zang, a furgeon
cf very diltinguifhed merit. The vifit is from four to five
in the evening. ProfelTor Schmitt has an Oblfetrical
Clinic, in which from 70 to 80 foldiers’ wives are de¬
livered in the courfe of a year.

To all the leftures and clinics (trangers are admitted,
who previoully leave their names with the feveral pro¬
felTors, except to the oblfetrical clinic, which is par¬
ticularly deligned for the pupils of the academy. The
clinic of profelTor Zang is much frequented by (trangers.
Indeed that gentleman is looked upon as one of the firlt
furgeons in Aultria : he is at prefent engaged in a work,
two or three volumes of which have been publiflied, upon
operative furgery, which promifes to become cialfical in
medical literature.

The library' of the academy is rich in books of me¬
dicine, furgery, anatomy, botany, and natural hiltory,
and is adorned with a buff of Jofeph II. by Ceracchi. It
is open only to the profefl'ors and pupils of the academy.
The collection of natural hiltory contains fpecimens from
the three kingdoms of nature; but chiefly of fuch ob¬

jects as are interelfing from their ufe in materia medica
and practical chemiltry. The collections of all kinds of
furgical inltruments, bandages, and machines, is ex¬
tremely magnificent.

The anatomical mufeum is diltinguilhed for its col¬
lections of fkeletons and difeafed bones, and of patholo¬
gical preparations in wax ; but above all for its rich col¬
lection of wax preparations illultrative of deferiptive
anatomy and midwifery. The preparations of this col¬
lection were executed in Florence, under the direction
of Fontana and Mafcagni, and are indeed an exact copy
of the collection of the fame kind in the Mufeo di Fifico
at Florence. This collection occupies feven apartments.
Two apartments upon the fecond floor contain the pre¬
parations illultrative of midwifery. This mufeum is open '
every Thurfday, and is vilited by alidades of the people.
The Florentine collection is much admired by the crowd,
whom it is well calculated to furprife. Every preparation
lies under glafs, upon a white filk culhion fringed with
gold. The artills have not fpared ornament even to the
preparations themfelves, which are as gay as colours can
make them. It is well known that they were executed
from drawings ; but it may Itartle our readers a little to
hear,, that a feries of engravings, taken from thefe pre¬
parations, is now publilhing at a great expenfe in Vienna.
Privatilflmaare alfo given by theprofeftorof the academy,
in which thefe preparations are demonitrated. We never
could look at the collections of wax preparations in the
Mufeo di Fifico at Florence, and in the Jolephine Acade¬
my of Vienna, without acknowledging them to be ex¬
cellently fuited for teaching anatomy to grand dukes and
emperors, or for affording an hour’s amufement to any
honeft citizen whatever, curious perhaps in fuch matters.
That they are of any confiderable utility to profeflional
ftudents of anatomy, is by no means fo evident.

The Jofephine Academy is furnilhed with a botanical
garden. It has a perpetual direCfor.and fecretary; per¬
petual members or profefl'ors; aftual members, or phy¬
ficians and furgeons; foreign honorary members ; and
correl’ponding members.

A work of very confiderable value on Hofpital Gan¬
grene has been recently publiflied by Dr. Werneck,
phyfician in chief to a divifion of the Auftrian army,
who has had very extenfive opportunities of obferving
the difeafe during the late campaign in Italy, Hungary,
Poland, and the greater part of Germany. It is only
fuch points as are either of an original charafter, or fuch
as ferve to fupport doubtful points of theory, that re¬
quire notice on this occafion.- Dr. Werneck confiders
that the difeafe may appear either as affeCling primarily
the fyftem, or developing itfelf originally in an open
wound, without any fpecific aft'eCfion of the general fyf¬
tem. He thinks that it arifes from a contagious virus,
which is a modification of that producing the common
typhous fever: in fupport of which notion he cites nu¬
merous fafts, furnilhing direft and very forcible argu¬
ments in its favour. Hofpital gangrene, like typhous
fever, he alfo remarks, may occur feveral times in the
fame individual, and affeft perfons living in an infulated
manner, as well as in hoi'pitals, tranfport-lhips, or gar-
rifons, where numerous individuals are collected toge¬
ther; and it maybe cured, under either of thefe clr-
cumffances, with the ufe of no other meafures than fuch
as are proper to maintain cleanlinefs of the wound af-
fefted. Dr. Werneck has fome hypothetical opinions
about the nature of the contagious virus, that it would
not, perhaps, be right to negieft to notice; though it
fliould be utiderffood that they are not cited here becaufe
their truth is acknowledged. He fuppofes that the ef-
fence of the virus is of an alkaline nature, and is to be
correfted by acids, the moll efficacious of which, for the
implied purpofe, is the acetic acid; next to this, the
muriatic and oxy-muriatic acids; and, lalt in the lift ,
the other ftrong vegetable acids.

Similar in its general charafter to the foregoing trea-

tife,

71

P A T II O L O G Y.

fife, that of comprifing a good hiftory of its fubjeCt, with
obfervations and arguments qualified to fupport thofe of
former well-informed writers, rather than demonftrative
of any thing of remarkable originality, is the work of
Dr. Rufton the Egyptian Ophthalmy. His moft important
and interefting observations relate to the appearance of
ophthalmy in thegarrifon at Mainz in 1818. The difeafe
had been prefent in the army during the campaigns of
1813, 1814, and 1815; but it was not till the time above
mentioned that it manifefted itfelf in an alarming man¬
ner. Its prevalence occurred under the following cir-
cumffances. It affeCled only the men of one regiment,
and, for the moft part, only fome Pomeranian, Lower-
Rhenifh, and Naffau, recruits. This regiment made a
very harraffing march from the Rhine to Silefia, and back
again, in the autumn of 1817 and the Spring of 1818.
On its return, the men were crowded into a tranfport
with Several French invalids, amongft whom were many'
who had loft their fight from ophthalmy. On the arrival
of the regiment at Mainz, about a third part of the re¬
giment were found to have the itch. After this was got
rid of, Several other cutaneous difeafes appeared, as Scar¬
let fever, meafles, varioloid difeafes, and nettle- rafh ;
and, on the decline of thefe, the affeCtion of the eyes
firft appeared. It augmented in Severity from June to
September 1818, when it continued nearly ftationary, in
regard to prevalence and Severity, till March and April
1819, wdien its extent became more confined ; but its
deftruCtive agency was far from being fuppreffed until
after the moft Uriel meafures for preventing its infection
had been reformed to.

Whilft the Pruftian regiment at Mainz was Suffering
from this difeafe, the Auftrian Soldiers were entirely ex¬
empt from it, though they both lived under the fame
climate and performed Similar duty. But, whilft this
argument in favour of the propagation of the difeafe by
contagion is brought forward, we muft not negleCt to
notice thofe which favour the opinion of its primary
origin from cafual external circumitances. The whole of
the faCts related by Dr. Ruft fupport the opinion of Dr.
Vetch, that purulent ophthalmia originating from any
common caufes may become contagious; or, in other
words, that a puriform Secretion from the mucous mem¬
brane of the eye, from whatfoever caufe, is capable of
inferring, by contaCt, the mucous membrane of the eye
of another perfon, and of thus producing a difeafe Similar
to that from which it originated. It Should beconfidered
that the difeafe firft appeared in the recruits in the Pruf-
lian army ; that the military discipline of the Pruftian
army is much more Severe and harrafting than that of the
Auftrian army ; and that this Severity was further in¬
creased as the number of the Sick augmented. One part
of the military discipline to which thofe recruits were
Submitted, was that of having the hair cut very clofe
over the whole of the upper part of the head, on their
entry into the ranks, whilft they adopted the practice of
conftar.tly wetting the back part of the head with beer
and Soap, for the purpofe of' making their hair grow cn
queue-, and a very defective covering for the head was
commonly worn. Thefe circumftances may be consi¬
dered quite Sufficient to produce a difpofition to ophthal¬
mia, juft in the way in which it was manifefted. Dr.
Ruft arrived at the garrifon on the 5th of April, 1819.
He immediately put in force the moft effectual means for
preventing the progrefs of the difeafe, fuppofing it to
be communicated from one individual to another by
contagion. The numberof patients now decreafed from
month to month, till October, wdien the garrifon was
relieved, and the difeale was fuppofed-to be w holly de-
ftroyed. From June 1818, to the end of April 1819, the
numberof patients amounted to 1146; from this time to
September 1819, only 65a new cafes occurred ; fo that
the whole numberof patients was 1798, not including
one regimental phyfician, two hofpital Surgeons, and
twelve nurfes, who were affeCted with the difeafe.

The method of applying Sulphur in a gazeous form to
the Surface of the body, w’as firft introduced by Dr. Gales
of Paris. The refult of the experiments and obfervations
made on its employment, by a medical jury appointed
for the purpofe, was fo Satisfactory, that by order of go¬
vernment it was fpeedily introduced into all thehofpitals
of France, and was generally recommended in practice
by the phyficians of that country. It confifts in applying
the vapour ariiing from ignited fulphur to the naked
body of the patient, feated for that purpofe in a fort of
wooden cafe, in the upper part of wdiich thereisanaperture
for the head. To the circumference of this aperture a
leather bag is attached, which isfaftened round the neck,
and thus prevents the fumes of the fulphur from reaching
the eyes, nofe, or mouth. The effeCt of the fumigation
is to produce, in the firft inftance, increafed adlion, and
fubfequently moft profufe perfpiration; greater, indeed,
than we have ever- Seen produced by any other means.
Hence, it appears to be indicated, ift, where quick and
Ridden perfpiration is of benefit ; and zdly, where fulphur
appears to have a Specific adlion.

The Sulphureous fumigating baths were introduced
into Germany by Dr. De Carro, of Vienna, whole name
is already ennobled in the annals of humanity by the in-
trodudlion of vaccination to the continent of Afia. The
apparatus confifts of a wooden cafe, Something like a
pulpit, in which a grown perfon can fit with eafe up
to the neck. This cafe is plaftered internally. Its floor,
formed by a ftone of two or three inches in thicknefs, is
raifed fo far above the ground as to require three Heps to
get into the cafe. Underneath are the parts neceflary for
producing the fumigation. The loweft ftory is the afh-
pit, the uppertnoft the hearth for the fulphur, and the
middle contains the fire. The uppermoft divifion com-
municates'freely with the interior of the cafe, by means
of holes bored in the ftone floor of the cafe. A pipe con¬
veys the fmoke from the divifion containing the fire into
the chimney. Another pipe pafies from the cafe into
the chimney. This may be opened or Unit by means of
a valve ; and, after the operation is concluded, it con¬
veys what remains of the Sulphureous fumes into the
chimney. From this Iketch of the apparatus, the me¬
thod of ufing it is evident. The patient, perfedlly na¬
ked, Heps into the cafe, and feats himfelf on a chair,
which may be railed or lowered at pleafure. He places
his feet upon a ftool. Both the chair and (too! are
perforated with holes, to admit the free paftage of the
fumes to all parts of the body. The uppermoft board,
forming the head of the apparatus, is now let down, fo
that the patient is completely enclofed in the cafe, with
the exception of the head. Provilion is made for pre¬
venting the fumes aCting on the eyes, or entering the
mouth or nofe, as already mentioned.

There are various methods of applying the vapour to
the face, when the difeafe has its feat there, the moft
Simple of which is a. flexible pipe, which communicates
with the fulphureous vapour. The patient remains in
the bath half an hour, or at moft an hour. About five
minutes before the conclufion of the fumigation, the
valve in the fulphur-pipe is opened, and thus all unplea-
fant fmell is avoided on opening the door of the cafe.
The patient now goes to bed for an hour or two.

The cafes in which the fulphureous fumigation is
chiefly ufed, are cafes of chronic rheumatifm, pfora, le¬
pra, and other cutaneous affections, where fulphur is
ufually found of advantage. In all of thefe the benefit
derived is very ftriking, and the fhortnefs of the period
neceflary for the cure really aftonifning. Some cafes of
old chronic rheumatifm have yielded completely in a few
weeks to this remedy. One reafon of the great fuccefs
attending Dr. De Carro’s pradice, was the judicious Se¬
lection of cafes which he made, whereas many practition¬
ers have employed thefe fumigations far too indiscrimi¬
nately, and then u'ondered at the failures which took
place. The practice of fulphureous fumigation has been

made

PATHOLOGY.

72

made known to the north of Germany in a work by Dr.
Karlten of Hanover, under the title of “Ueber die
Kraetze, und deren bequemfte, fchnell-wirkendefte und
ficherfte Heilarr, durch Baden in fchwefelhaltigen Da-
empfen, und deffen vortheilhafte Anwendung zur
Behandlung chronifcher Krankeiten der Haut und
anderer Gebilde, nebft Befchreibung eines hierzu dien-
lichen Apparats, von Dr. Karlten, mit 2 Kupfern. Ha¬
nover, 1818.”

The practice is now generally adopted in moft parts of
the continent, and has extended to Rufiia and Poland.
Dr. Afialini, of the Inftitute of Sciences at Naples, has
publilhed “ Medical Refearches on Fumigations of Sul¬
phur, Mercury, &c. Naples, 1820;” one objedt of which
is, todefcribe the improvements and additions which he
has made in the ccnftrudtion of the (loves employed for
thefe purpofes. Of thefe, the principal feems to be, the
having rendered the machines more portable, and
their ufe more economical, than thofe propofed by G.ales,
Darcet, and De Carro. He has added to his work nu¬
merous examples of the beneficial erfedts which have re-
fulted from their ufe in his own practice in private life,
and in the great military hofpital Del Sagramento at
Naples. Although fo recently introduced into that
kingdom, it is at the prefent period very generally em¬
ployed and recommended by the principal profefl'ors in
the capital and provinces. The author promifes fpeedily
to produce a fecond volume, with additional obfervations
and experiments on fumigations and vapour-baths, to¬
gether with two memoirs on the ufe of thermal vapour-
baths, and on oily undtions. with artificial fumigation,
as a preventive from, and cure for, the difeafes produced
by the marlhy effluvia commonly known under the name
of malaria"

The remedies of which fignor Afialini treats, appear
to have received but little attention in this country,
although the extent of their employment in France,
particularly the fulphureous fumigations in the treat¬
ment of cutaneous difeafes, have been long known, and
their efficacy undifputed. We are not aware of the ex-
iftence of any public inftitution for this purpofe in any
part of the kingdom ; and the few private ones which
have been eftabliffled are limited in their operation, and
far from being fufficiently extended or perfedt. In addi¬
tion to this, where fuch eftablifflments exifi, the ex¬
penses neceffarily attendant upon their adminiftration
are, indeed, fo great as almoft wholly to exclude the
lower claffes of Society, for whom they are moft frequently
necefiary, from the advantages to be derived from them.

Our country has always been diftinguilhed far its cha¬
ritable inftitutions, and at no period more fo than the
prefent. Without taking from the merits of thofe
which already exift, we are convinced that few meafures
would be more humane and beneficial to the community,
than t‘he formation of fuch eftablifliments as we have
fpoken of, for the prefervation of health, and more par¬
ticularly for the prevention and removal of cutaneous
difeafes. We feel greatly allured, that fupport and af-
fiftance from the public would be readily given, and that
an effort, a commencement, only is wanting to fecure
the execution of an objedt fo necefiary and lb advanta¬
geous.

We omitted to notice, in its proper place, the Univer-
fity and the Anatomical Mufeum of Stralburg. Of the
Mufeum, an account, with a catalogue of the prepara¬
tions, was publilhed laft year (1820), by Profeffor J. F.
Lobftein.

This colledfion is divided into two principal fedtions,
one of which contains thofe of the healthy, and the
other thofe of the difeafed, ftrudture of the human fub-
jebt, and of animals. In the firft, the organs are ar¬
ranged with a view to their phyfiology, by lyftems, and
according to their different functions. The human or¬
gans, followed by the correfponding organs of animals,
are contained and cla'fied in twenty compartments, which

alfo include the preparations iifed for demonftration in
the courfes of-anatomical and phyfiological ledtures. In
the fecond, the organs, in a Hate of difeafe, occupy eigh¬
teen compartments, and are diftributed in an anatomical
order, according to general fyftems, and according to the
organs which belong to the fundlions of nutrition, rela¬
tion, and reprodudlion.

The ofifeous fyltem may be ftudied with a view to com¬
parative anatomy, by the affiftance of the entire Ikeletons
of fifty-three different animals, fifty-feven Ikulls, and a
great number of bones, of every fpecies of animals.
The colledfion of preparations which contributes to de-
monftrate the ftrudture and formation of bones, is ex¬
tremely complete. Among many of thefe, the external
and internal periofteum is beautifully injedted. The fine
injedtions of foetal bones have alfo fucceeded equally well.

The myological preparations are, at the tame time,
connedted with the fubjedt of angiology, as they have
been made from injedted fubjedts: by this means they
have been rendered doubly inftrudtive. In addition to
thefe, here are others of the foetus injedted for the pur¬
pofe of (bowing their ftrudture. Thefe preparations,
when viewed by the affiftance of the microfcope, difplay
a net-work of blood veffels fuperior perhaps to thofe in
the colledfion of Prochafka.

The preparations which relate to the fundtion of di-
geftion are various and extenfive. The alimentary canal
of the human fubjedt, from the commencement of the
oefophagus to the anus, diltended with air and dried, is
compared with that of fourteen kinds of animals, pre¬
pared in the fame way. The organs of digeftion of man
in particular, commencing with the falivary glands, are
contrafted with the correfponding organs of different
animals. The minute anatomy of thefe parts has not
been negledted. The inteltines are fo completely in¬
jedted, that the pupils can conceive a perfedt idea of their
villous coat, as it has been diltended, and the papillae
eredted by the refin of the injedtion. Portions of the
inteftines of the foetus, the veffels of which have been
injedted with ifinglafs, coloured white, are not inferior to
the preparations of Lieberkulm.

Twenty preparations of the lymphatic veffels elucidate
the receptaculum chyii and the thoracic duel, the right
lymphatic trunk, the ladteals of the mefentery well in¬
jedted, the lymphatics of the liver, the large plexufes of
the pelvis and vertebral column; the lymphatic veffels
of the lungs, thofe which pafs behind the fternum into
the anterior part of the mediaftinum, and the fuperficia!
and deep-feated lymphatics of the upper and lower ex¬
tremities. Though thefe preparations are fufficient to
give pupils an idea of the lymphatic veffels in almoft all
parts of the body, the abforbent fyftem is (fill every
year injedted in the recent fubjedt, during the anatomi¬
cal ledtures. The fame is done with the other prepara¬
tions of minute anatomy, angiological and neurological,
and thofe which relate to the organs of fenfe.

The organs of refpiration, alter being examined in
the human body, may be afterwards compared with the
fimilar organs of quadrupeds, amphibious animals, and
fifhes. The minute ftrudture of the lungs is rendered
apparent, and efpecially the difpofition of the bronchial
veficles, by preparations from the lungs of children.
The larynx difplays the fuperior arid inferior laryngeal
nerves on both (ides, traced to their moft minute
branches. The thyroid gland is completely injedted ; and
it is obferved, that this is one of thofe organs in which
the injedtion, when urged into the arteries, returns moft
readily by the veins.

With refpedt to the nervous fyftem, here are perfedt
injedtions of the pia mater, and, in fome inftances, even
the cortical fubftance of the brain has been reddened.
The injedtions of the nerves are not inferior to thole re-
prefented by Reil, in his work, entitled Exercitationum
Anatomicarum Fafciculus Primus, de Strudtura Nervo¬
rum. All the cerebral nerves, with their diftributions,

3 . are

PATHOLOGY.

are illuftrated by feveral preparations. Numerous re-
fearches have been made upon the brain itfelf, the refults
of which were publifhed in the tliird and fourth volumes
of the Journal Complementaire du Diftionnaire des Sci¬
ences Medicales, The feftions of the brain, made ac¬
cording to the views and procefs of M. Lauth, are pre-
ferved in acidulated water, which anfwers the purpofe
better than any other liquid.

The colleftion is equally rich in preparations of the
organs of fenfe. With refpeft to that of touch, we may
l'afely fay it is impoffible to carry the injeftion of the (kin
farther than is done in thefe preparations: and that none
can eafily be found lb inftruftive as thofe which relate to
the ftrufture of the negro-fkin. The nerves of the
tongue are traced to their minuted: branches. The pi-
tuary membrane, fubjeftedto maceration after injeftion,
fhows, in a very Superior manner, the net-work of rami¬
fications on this membrane. Among the preparations
of the eye, we may notice the injeftions of the veffels of
the choroid, of the retina, and of the canal of Fon¬
tana, by meVcury, &c. The organ of hearing is illuf¬
trated by a very large number of preparations, and its
moft minute parts elucidated. As early as the year 1752,
the old univerfity pofl’elTed a collection of fixteen prepa¬
rations of this organ, fo beautifully arranged by hinges,
and other mechanical means, that the various partsof the
organ may be ftudied both feparately and united, fo as
.to fhow their relation to each other. Thefe, the refult
of the great ingenuity of profeftor May, were prefented
to the Royal Academy of Sciences at Paris ; and the
Academy, in the hiftorical part of its Memoirs for the
year 1734., has mentioned it in honourable terms. Thefe
preparations, which they at prefent poffefs, have been
iince augmented by the addition of eighty-feven others,
worthy of the originals.

The preparations which relate to the fexual fyftem of
the male and female, to pregnancy, parturition, and the
produfts of conception, amount to 182 in number. In
the injections of the tefticle with mercury, the fluid in¬
troduced into the deferens has palled into the feminife-
rous fubftance. In two fpecimens they' have fucceeded in
the almolt entire development of the vas differens and
epididymis. The injeCtion of the blood-veffeis of the
tefticle with ilinglafs, coloured by cinnabar, has fuc¬
ceeded fo well, that not only the pulp of it has been
reddened, but, by the help of a magnifying-glafs, a net¬
work of vefi’els can be diftinguilhed upon the veffels
themfelves.

A feries of fifty fcetufes (hows their gradual increafe,
week by week, from the fecond month, up to the full
term of pregnancy. Six preparations lhow the difpofition
and development of the foetal organs at the different pe¬
riods of its life.

The fecond feClion of this work, containing the pa¬
thological unatomy, forms a larger part of it than the
preceding one 5 and we regret that our limits will not
allow us to give fo complete an account of its contents as
we could vvilh. We mull, therefore, confine ourfelves to
noticing a few of its moft interefting objefts.

Under the article of calculi, are mentioned fome of
very unufual fize from the maxillary duCI. The col¬
lection of horfe-bezoar (inteftinal calculi) is alfo re¬
markable; the largeft weighs nine pounds and a half.
The biliary calculi are arranged according to the
claflification of Fourcroy : no clafs eftablillied by that
chemift is wanting. The urinary calculi comprehend
thirty-eight feries, a number of which, broken, or lawn,
difplay their laminated ftrufture and the different co¬
lours of their ftrata correfponding to the three principal
elements compofing them ; viz. uric acid, pholphate of
lime, and oxalate of lime. Proftatic calculi, which are
fomewhat rare, are to be feen difpofed in regular feries,
or in a circular arrangement, in the excretory duCts of
that gland. Calculi from veins, which the author calls
phlebolithes, have been carefully collected and examined ;

Vol. XIX No. 1288.

73

and a coloured reprefentation, which the author con-
fiders unique, made of their laminated ftruflure.

Under the article caries, a cranium is mentioned, which
is perforated with apertures, in the form of a fieve, by a
venereal afteftion. The patient from whom it was
taken, was treated with mercury, and even now (as in
1758 when this preparation excited the attention of the
curious) globules of mercury are feen in the little finus,
and ulcers in the internal furface of the cranium. This
faCt, obferved by Fallopius and others, had been denied
in modern times, till fome experiments made at Tubin¬
gen in 1808, eftablilhed its truth. In a fpecimen of
caries of the pelvis, the offa pubis et ifchii are entirely
deftroyed, except the portion forming the fymphyfis of
the former, and that which contributes to the formation
of the acetabulum of the latter.

M. Lobftein obferves, that it is not yet agreed what
meaning is to be attached to the term J'pina venlofa. If
fwelling of the bone in its whole thicknefs, and a fpon-
ginefs of its texture, fuch as refults from cells of different
dimenftons, may conftitute fpina ventofa; if the cells
are filled with fluids of various kinds; if there are offeous
excrefcences, either on the external furface, or within
the above cells, the mufeurn contains fpecimens of this
diforganization; particularly i:i the os humeri, tibia, and
fibula.

The laft form of the difeafe of bone noticed, is that
in which large maffes of offeous matter entirely difappear,
and no traces of them are found, except infulated frag-,
roents floating in an abundance of mucilaginous matter.
The author firft noticed this difeafe in the ribs, and de-
fcribed it with other analogous examples in the “ Rap¬
ports fur les Travaux executes a l’Amphitheatre d’Ana-
tomie.” Since the publication of that, he has obferved
it a fecond time on the ribs and pelvis of the fame indi¬
vidual. The facrum and offa innominata were covered
with a thick periofteum, more moift than ufual ; in de¬
taching it, the compaft external table of the bones could
be at once removed : a reticular tiffue was then feen with
larger interftices, which were filled with a fubftance in
colour and confidence very like currant-jelly. This
difeafe, in the opinion of M. Lobftein, confilts in a fpon-
ginefs of the bone, accompanied by a fecretion of an
albumino-mucous matter. In the fluid of the numerous
cyfts, which fupplied the place of the offeous matter de¬
ftroyed, portions of bone, rendered thin and porous,
were feen floating like half-diffolved fugar. The conti¬
guous portions of bone had the fame fpongy appearance.

In fpeaking of the organic changes of mufcles, their
conversion into fat, to which the term Myodemie is
given, is faid to have been obferved in two inftances. In
another the femi-membranofi alone had undergone this
change. After fome remarks on the fympathetic coinci¬
dence in the deficiences and difeafes of the mufcles of
the two fides and extremities of the body, the author
relates a cafe in which the biceps of each arm, and no
other part, was found in a date of gangrene, in a woman
who died in child-bed.

The morbid changes, &c. of the vafcular fyftem, are
contained in the next chapter, from which we (hall only
mention a rare diftribulion of the aorta: its arch divides
into two branches, which, by their reunion, form a
fpace, and through this pafs the trachea and thecefopha-
gus.' The irregularity is defcribed by Hommel, in the
Commerc. Lit. Noricum. 1777.

The remaining chapters are devoted to the pathological
anatomy of the thoracic organs, thofe of digeftion, of
the urinary fyftem, nervous and generative fyftems. Like
the reft of the book, they are made up of a mafs of va¬
luable and interefting fafts, ftated with the utmoft fim-
plicity and clearnefs. Laft of all is placed a Catalogue
of the Preparations of this deleft yet extenfive Mufeum.
The whole number of them amounts at prefent to 3286,
of which 1977 relate to phyfiological, and 1309 to pa¬
thological, anatomy. The Mufeum is open to the public
U once

74

PATHOLOGY.

once every week ; ftudents have accefs to it daily ; and,
with a liberality ft ill more worthy of praife and of imi¬
tation, foreigners are admitted at all hours, and at the
firft application. It is with aftonifhment we learn, that
only fifteen years have been fpent in the accumulation
of this admirable collection : for, in 1804, there were
only 2u preparations. The very complete Mufeum of
Berlin, colt: its founder, profeffor Walter, fifty-four
years in its collection ; but it contains not more than
2268 preparations.

Three hundred bodies are annually at the difpofal of
the faculty of Stralbourg. Such noble encouragement
and opportunities of obfervation ; the co-operation of
the profeffors and the practitioners of the town, who
tranfmit, as to a common centre, the refult of their par¬
ticular pathological examinations; the rare and curious
objeCts which flock from the neighbouring country; the
intelligence and zeal of the profeCtors and ftudents ; all
thefe circumliances combined, lead us to expeCt from
this quarter ftill greater contributions to medical fcience.

Since we have travelled out of Germany; and got again
into France, vve {hall detain the reader a few minutes
while we defcribe the prefent ftate of the obftetrical art
in that kingdom ; which we are enabled to do by the
very recent publication (1821) of the “Pratique des
Accouchemens,” by a real mi dzcife, Madame Lachapelle,
chief operator at the Lying-in Hofpital at Paris.

This volume is one to which we have nothing fimilar
in this country. It is the production of a female prac¬
titioner, placed by public authority in a molt important
official fituation ; and is no lefs defervingof notice from
the rare occurrence of fuel) publications, than from the
juft views and accurate criticifms on the ftate of the
fcience on which it treats. But thefe are fubjeCts on
which it is not at prefent our intention to dwell, as we
are inclined rather to take the opportunity of pointing
out the ftate of public inftruCtion in this fcience in
France, and to contrail it with the deficiency in this
point, which all mull admit and lament as exifting in
this country.

From time immemorial, the only afylum afforded by
the city of Paris j:o puerperal women, was a miferable
ward in the Hotel-Dieu ; a principal midwife, with five
or fix pupils, whofe ftudies lafted but for three months,
ill fufficed for the number of births which occurred.
The place was ftill more inadequate; the women admit¬
ted were heaped together, and commonly feveral lay at the
fame time in one bed. Thefe inconveniences were of fo
ferious a nature as to attradl the attention of the govern¬
ment. In the year 4 of the Republic (1797), the National
Convention decided on building a houfe for theparticular
purpofe of receiving parturient women. Madame La¬
chapelle, in conjunction with her mother, the principal
midwife of the Hotel-Dieu, was charged with the direc¬
tion of the fervice of the new inftitution. The difpo-
iitions for the arrangement and order of the whole efta-
blifhment were formed in concert; and it is thus that
the plan originally laid down has been more extenfively
applied. The number of pupils as midwives has fince
pone on increafing, as well as the number of individuals
admitted. The former at prefent amount to 130 an¬
nually. This increafe, as well as the organization of the
fchool, was owing to M. Chaptal, then minifter. M.
Baudelocque was then made profeffor, and affilted to
render the work more perfedt. M. Dubois, who l'uc-
ceeded him, has preferved the order adopted by his pre-
deceffor, which we proceed to defcribe.

The pupils admitted at the School of Midwifery are
expedted to employ themfelves as well with the relief of
the patients as with their own perfonal inftruCtion : fuch,
in fadt, is the principal objedt in view. This neceffity
forces them to a practical ftudy, to which, in particular,
they are indebted for their acknowledged Juperiority
over the pupils of every other fchool. All pafs a w hole
year at the hofpital ; and about a fourth part of their

number twice this period, ferving in the fecond year to
direCt the new pupils. The newly-arrived pupils are fe-
parated into as many divifions as there remain old pupils
who double the period of their flay. Thefe laft direCt
the divifion entrufted to them, affift at funple labours,
and point out to their companions the particularities of
examination, &c. .

The patients admitted are firft examined by the prin¬
cipal midwife, wdio rejeCts or retains them according to
circumliances. The period fixed is the end of the eighth
month. Simple deliveries are all performed by the pupils,
in the prefence of the divifion, and under the direction
of the elder one, who ferves as chief. Each pupil has
the fubfequent care of the woman whom fhe has deli¬
vered. On the occurrence of the leaft difficulty, the
principal midwife is called in. If the ufe of inftruments
fhould be required, it is fhe who operates ; if the deli¬
very .be difficult, although the hand alone fuffices, fire
ftill has the charge of it; but eafy manual deli veries are
terminated, under her infpeCtion, by one of the old
pupils, fo that almoft all have, before the end of their
fecond year, performed an artificial delivery. Very com¬
plicated cafes, fuch as require the ufe of a cutting
inftrument, call for the prefence of the profeffor.

Peritonitis too often prevails in the wards : a hoft of
other difeafes may alfo attack parturient women. It is
then that, after being carried to the infirmary, they are
entrufted to the care of the experienced and learned pro¬
feffor Chauffier, principal pbyfician. Under his infpec-
tion, feveral female pupils note daily, and with 1110ft
fcrupulous exaClr.efs, the fymptoms, periods, termina¬
tion of the difeafes, and the effeCts of remedies; they
thus become accuftomed to recognize danger, to prevent
it, and, if not to remove it, at leaft to have recourfe
early to the affiftance of medicine. Three times in thg
week the profeffor explains the theory of the fcience of
midwifery. A lecture is given every day by the principal
midwife ; and a fimilar one by Mademoifelle Hucherard,
for eight years acquainted with the principles of the art,
and honoured with the title of “ principal pupil,” wdio
alfo exercifes the others on the model, in the ufe and
application of inftruments. Amongft the old pupils,
thofe who have molt facility in expreffing themfelves,
and capacity for inftrudtion, are charged with giving re¬
petitions to the new comers, of the lectures of the pro¬
feffor, the midwife, and principal pupil. Amidft all
thefe attentions to the principal objedt, the acquifition
of acceffory knowledge is not negledted. Under the di¬
rection of the principal phyfician, the apothecary lays
down to the pupils the general principles of botany, and
makes them acquainted with the molt important plants
and drugs. In the fame manner the leudent in medicine
attached to the inftitution makes fome demonftrations on
general anatomy, on that of the vifeera, on the principal
functions, on the mufcles of the abdomen, and, laftly,
on vaccination and venaefeCtion. For thefe two opera¬
tions the inftrudtions are not folely theoretical ; the pu¬
pils bleed and vaccinate as often as there is an opportu¬
nity, but alw’ays in the prefence of the ftudent in medi¬
cine. Such are the means of inftrudtion prefented to the
pupils in midwifery; the wifdom of the adminiftration
lias added ufeful encouragements. At the end of each
fcholaftic year, feveral prizes are given by competition,
on fubjedts relating to the fcience of midwifery ; the
principal is a golden medal: prizes are alfo given for
clinical vigilance, the obfervation of patients, the ftudy
of botany, and for vaccination.

It is a circumftance perhaps only to be underftood by
the confideration of the inconfiftency of human proceed¬
ings, that, while laws and regulations were early devifed
for the protedtion of the public from the pretentions of
the ignorant and unprincipled in the pradtice of medicine
and lurgery, midwifery, a fcience connedted as it is with
the tendereft feelings and belt interefts of fociety, fhould
be left in the hands of the loweft and moft uninformed

people,

PATHOLOGY.

people, at lead as far as it regards the great mafs of the
public in every country. Nor has this delufion been
confined merely to the carelefs and indifferent obferver ;
even thofe whom their abilities might have been ex¬
pected to have exempted them from the errors of common
minds, feem but too often to have thought, that infor¬
mation on difficult and complicated fubjeCts might be
acquired, as it were, intuitively; and that mechanical
unobferving experience might fupply the defeat of early
and well-grounded inftruCtion. It needs but little either
of intellect or inquiry, to fee at once the fallacy and ab-
furdity of fuch an idea.

We are aware that at the prefent period, in this
country, a confiderable portion of the male practitioners
in midwifery, are individuals whofe compulfory profeffional
education may be fairly fuppofed to render them ade¬
quate to the performance of the duties they undertake;
but it is notorious that fuch is not the cafe with the fe¬
males, on whofe care and (kill the lives or the future
comfort of women in the lower claffes of life, and in re¬
mote parts of the country, are fo completely dependent.
Nor can it be unknown, that in every part of the king¬
dom, even in the metropolis, no fecurity exifts againft
the ignorance of thofe who may choofe to enter upon the
praCtice of this molt important branch of the healing art ;
that an acquaintance with, or courfe of inllruCiion in,
its principles, forms no part of the qualifications required
by the three corporate bodies, whofe members and li¬
centiates form the greater part of private practitioners in
England. Nay, on the contrary, at leaft two of thefe
are more difpofed to difcourage than to countenance the
extenfion of this divifion of practice amongtheir members.

After an attentive confideration of the difficulties and
the inconveniences we have alluded to, it furely requires
no argument to convince every uninterelted individual,
whether profeffional or othervvife, of the neceffity for
fame regulation of this branch of the profeffion, and of
the important advantages which would accrue to the
public from the organization of a clafs oi female practi¬
tioners, well qualified for the performance of the duties
they are intended to difcharge. To the inftitution of
fuch a clafs in this country, we can fee no well-founded
or difinterefted objection ; and it mult be allowed that
nothing feems better adapted to attain the objeft in view
than the fyftem which has received fo ample a trial in
France, and of which we have given an account. Of
this at leaft we feel convinced, that a trial only is re¬
quired to exhibit its excellence, and enfure its adoption.
Should fuch a plan be ever put in execution, it would
doubtlefs be moil advantageous to combine its employ¬
ment, as has been done in France, with the internal ma¬
nagement of the lying-in inftitutions already in exiftence,
efpecially in the metropolis. But here we mull check
ourfelves, as it muft be confeffed, that it is much more
eafy to proclaim the exiftence of defeCts than to apply
appropriate remedies, and as it is far from being our in¬
tention to affume.a talk that we hope to fee in more com¬
petent hands.

Greece and Turkey. — In turning to the confidera¬
tion of Greece, the land of heroifm and claffic recollec¬
tions, we find that 3000 years have glided over without
any improvement in medicine beyond the practice of the
Father of Medicine. Indeed in many inftances we might
almoft wiffi that the practice of Hippocrates only was
followed, without variation or improvement ; but the phy-
iicians of Greece and of Turkey are much occupied in
difcuffing the theories of Brown or of Boerhaave ; and,
though occafionally a flaffi of ancient fire and of the true
philofophy of the priftine Hellenian has animated the
Greeks, yet the major part are contented with thefe
vain and fruitlefs enquiries. This ftate will not probably
laft long : the defpotic government of the Turks may be
confidered as the caufe of the long fupinenefs of the
Greeks ; and, whether the ftruggle for their indepen¬
dence be l'uccefsful or not, a fpirit of emulation and en¬

75

quiry exifts at prefent in that nation, which cannot fail
of producing much advantage to philofophy.

Of the mode of vifiting and treating patients in Turkey,
an amuling account is given by Dr. Neale, late phyfician
to the Britifh embaffy at Conftantinople.

After adverting to the belief of the Turks in predefti-
nation, Dr. N. proceeds thus. “ Still, fatalifm and
apathy have their limits; and the proud infidel, in the
hour of ficknefs, does not difdain to invoke the affiftance
of the Giaour to delay the approach of death. Of this I
had a memorable inftance within a few days after my
arrival at Terapia, when, very unexpectedly, I received
a meffage from the emperor Selim the Third, to vifit his
mother the fultana Valide. Mr. Pifani, the fenior dra¬
goman (interpreter), was the bearer of this requeft; and
the following morning I fet off by water for the feraglio,
accompanied by one of the junior dragomans. We were
put affiore at a quay near Baktchi Capouffi, where we
found a boftanji in waiting, to conduit us to the houfe
of the principal court-phyfician, who lived in a narrow
ftreet adjoining the wall of the feraglio. On arriving
there, we were informed that he had already gone to fee
his patient, having left inftruCtions that we ftiould follow
him, which w'e did, entering the gardens by the little
white gate near the chapel of St. Irene. We palled a
guard-houfe of boftanjies on our left, and then proceeded
under an avenue of lofty cyprefs-trees, towards a fecond
guard-houfe, whence we were conduced to a detached
pavilion, in which wefound theHekitn Balha, or Turkilh
phyfician, Mahmoud Eft’endi ; a Greek phyfician, named
Polychronon ; the Kiflar Agaffi, a hideous Ethiopian,
the chief of the black eunuchs; the Hazni Vekili, alio a
black eunuch, keeper of the privy purfe; and fome der-
vifes and muftis. After being introduced, and going
through the ufual routine of pipes, coffee, Iherbet, and
fweetmeats, Polychronon, converfing in Latin, entered
into a detailed ftatement of the malady with which the
fultana was afflicted, namely, an inveterate quartan ague,
of upwards of eighteen months’ ftanding. From this ffie
had recovered more than once ; but had relapfed as often,
owing, in part, to her own want of due caution, and to
the officious interference of a fet of muftis who befet her,
and forced upon her large draughts of iced water, in
which they immerfed talifmans, alluring her that they
would eftablilh her convalefcence ; but, on die contrary',
thefe draughts invariably brought back the cold fits of
her ague. Upon the laft relapfe, fome days before I faw
her, Hie had, during the cold paroxyfm, been fuddenly
bereft, in her lower extremities, of all power of motion
and fenfe cf feeling; and it was upon this point, and
fome others alfo, that my opinion was requefted. Indeed
I w'as to decide, as I found, between three of her phy-
ficians who called themfelves Boerhaavianx, and four
others who profefled themfelves firiCt Brownonians, as to
the expediency of preferibing a cathartic medicine; the
former preffing the abfolute neceffity of fuch a remedy
after five days’ conftipation, and the latter moft fooliftiiy
declaring it to be perfectly inadmiffible, according to their
interpretation of the doCtrine of Brown. This being
premifed, we all accompanied the Kiflar Agaffi to an
adjoining kiolk, in which was the fultana. After ex¬
changing my fhoes at the door fora pair of yellow flip¬
pers, we entered the royal apartments. On a mattreis,
in the middle of the floor, was extended a figure covered
with a filk quilting, richly embroidered. A female
figure veiled was kneeling at the fide of her pillows, with
her back towards the door of entrance ; and the Kiflar
Agaffi beckoned to me to kneel down by her fide, and
examine the pulfeof the fultana. Having complied with
this requeft, I expreffed a wiflnto fee her tongue and
countenance; but that I was given to underhand could
not be permitted, as I muft obtain that information from
the report of the chief phyfician. The moft profound
filence was obferved in the apartment, the eunuchs and
phyficians converfing only by figns. The Hazni Vekili

then

/

76

PATHOLOGY.

then took me by the arm, and turned me gently round,
with my face towards the door of the entrance, over
which was a gilded lattice, concealing the emperor, who
had placed himfelf there to witnefs the vifit. Our flay in
the room did not exceed fifteen or tw enty minutes. The
four large windows were fhaded externally by gilded
lattices, and the intervening pannels were covered with
mirrors and arabefque tapeltry. The divan, which en¬
circled the chamber, was veiled with crimfon cloth,
richly embroidered with gold, furrounded with culhions
of the fame defcription ; and the floor was covered with a
fuperb Perfian carpet. On our return to the firft pavilion,
I, of courfe, coincided with the Boerhaavians, and wrote
a prefcription to that effeft. Indeed, had (he been a
princefs of any other European court, it is probable that
a large bleeding would have been decided upon ; but,
from the ignorance and prejudice of her attendants, I
found it impoflible to convince them of its neceflity ; and
on confidering that the miftakes, real or imaginary, of
the Turkifh court-phyficians, are frequently vifited by
the bow-ftring, I had but little inclination to bring the
lives of my colleagues into farther jeopardy. The He-
kim-Bachi and Hazni Vekili therefore carried my pre¬
fcription, and interpreted it to the fultan, who, in re¬
turn, fent back a complimentary mefiage, and a purfe con¬
taining one hundred and fifty fequins.”

In cafe our readers fltould feel interefted in the fate of
the patient, w'e mult add, that the fultana funk under
her illnefs in the courfe of a week: but her age was fe-
venty-two ; and her Ion, far from giving way to the bar¬
barous practice of punilhing the court-phyfician, figni-
fied to him that the event; was evidently in the courfe of
nature, and fltould make no alteration in the confidence
which he enjoyed. This prince, deferving of a better
fate, was the unfortunate Selim who loft his life by an
infurreftion of the Janiflaries in 1807.

GENERAL PATHOLOGY.

In the prefent philofophic age, it appears needlefs to
difcufs the propriety and neceflity of being guided by
reafon in our pathological inveftigations. Very few pro-
feflional gentlemen will now be found ftri&ly empirical ;
and thofe few are among the leaft honoured and lead de¬
ferving in our profeflion. There is fomething in the
human mind fo prone to enquire into the caufe why, and
the reafon wherefore, that the verieft empiric in the prac¬
tice of phyfic will never be contented with attaching
himfelf to fafts, as he profefles, without regard to infe¬
rential reafoning. There is fomething fo gratifying to
one’s love of fcience, fomething which fo evidently leads
to better information, even in the vagueft explanation
of natural phenomena, that we cannot be furprifed that
it has been attempted in all ages.

Yet, in the courfe of our hiftory of medicine, we have
had frequent occalion to fhow how fatal has been the
refult of too much theory. Independently, however, of
the circumftance that what is injurious to the progrefs
of fcience in its infant ftate, may ceafe to become fo
when it is more advanced, we have found hitherto no
fyftem of medicine which has fufflciently accounted for
all morbid phenomena, or in which many huge gaps and
deficiences have not been filled up by gratuitous afler-
tions.

In the infant ftate of medicine there can be no doubt
that theory often exerted a moft decided influence on
that fcience. But the paucity of fafts, the data whence
the theories of the ancients were framed, were the caufe
©f their frequent errors. They were like labourers at¬
tempting to build a lofty palace with a few ftones. In our
own time, however, we have fo far advanced in the ac¬
cumulation of fafts, that, though much remains to be
done, we are' compelled in fome meafure to generalize
and fyftematize our knowledge, which elfe would become
too burthenfome for memory. To follow up our fimile,
we may be faid in our own time to be in pofleflion of

materials fufflcient forbuilding a liable edifice ; and hence
we may now look forward to the eftablilhment of a fyftem
which, to ule the arrogant expreflions of Darwin “may
not moulder, like the ftruffures already erected, into the
fand of which they w'ere compofed, but which may (land
unimpaired like the Newtonian Philofophy, a rock arnid
the wafte of ages.”

We (hall not paufe here to enquire into the utility of
fyftems of medicine. Our periodical medical publications
have lately raifed much uproar againft fyftems. It mull
be obvious to every one, however, that a feries of dry in-
fulated fadils, or of reafonings applicable only to a limited
number of phenomena, can never be fufflciently remem¬
bered, or indeed perfectly known. Provided, therefore,
we wander not into the mazes of hypothefis, provided
our analogies are not forced, or our claflifications likely
to lead to erroneous methods of praftice, it mull be al¬
lowed that we are advancing our knowledge, clearing
away many erroneous notions, and reconciling many
contradiilory opinions, by. taking general and extended
views of difeafe. See vol. xvii. p. 24.5.

We have faid that the knowledge of the ftru£lure and
funftions of man ftiould precede the ftudy of pathology.
Of the animal ftrufture we have given an ample account
in the firft volume of our work, under the article Ana¬
tomy; of the fecond w'e propofe to treat under the ar¬
ticle Physiology. In the mean time, the more clearly
to develope the opinions we have adopted, it will be ne-
ceflary to give a fliort flcetch of the economy of man, and
of the moll prominent fyftems and moft important ftruc-
tures which belong to his organization, the better to un-
derftand in what difeafe a deviation from this ftate con-
fifts.

In the organization of man, then, the firft fyftem to be
conlidered is the nervous. It confifts of the cranial brain,
the fpinal marrow, nerves, and ganglia. By means of
this fyftem, all mental emotions are communicated to the
other parts of the animal frame, and, through its medium,
all external impreflions are communicated to the mind.
We obferve likewife a fibrous ftrufture of different kinds
in various parts; as mufcular, offeous, See. the molt ge¬
neral and important of which are the mufcular ones. To
thefe is added a fundamental cellular ftrudture, which ap¬
pears to tonneft all parts of the other fyftems together;
and which has various appearances in regard todiverfity of
fubftance, and indeed in regard to the lecretions derived
from it. The union of thele three fyftems takes place in
various modes : in fome cafes in tubes, or on membranes,
&c. &c. and the more remarkable of thefe unifons may
be aptly divided into the digeftive, refpiratory, fanguife-
rous, fecernent, and abforbent, fyftems; and this phyfiolo-
gical divifion we have taken as the bafis of our arrange¬
ment, which agrees with the excellent one lately made
by Dr. Good, in his Phyfiological Syltem of Nolology.

Many objeftions have been made however to all the
prefent arrangements; the moft important of which is,
that, by allowing the attention of the medical praftitioner
to be exclufively direfled to one fyftem or to one organ,
it prevents that due attention being paid to morbid cate¬
nations, which the practice of phyfic imperioufly de¬
mands. There is nothing, however, in the nature of
nofology which renders this error a'venial one. It mull
be allowed that morbid impreflions are generally primarily
made on one particular tilfue or organ; and it mull be
allowed too, that a fyftem which is lecondarily affected,
often fuflers the moft feverely ; or that the fyftem fecon-
darily affedled may be the moft important to life, and
hence our attention ftiould be chiefly directed towards it.
We will venture to affert, that whoever has afliduoufly
ftudied the ftrudfureof parts and their phyfiology, cannot
fall into the error of confining his attention to one part
of the animal economy to the exclufion of the reft.

To render this more plain, we (hall proceed with fome
further account of the adlion of the different fyftems
above mentioned upon each other. If the animal frame
3 were

PATH

people, at lead as far as it regards the great mafs of the
public in every country. Nor has this delufion been
confined merely to the carelefs and indifferent obferver ;
even thofe whom their abilities might have been ex¬
pected to have exempted them from the errors of common
minds, feem but too often to have thought, that infor¬
mation on difficult and complicated fubjeCts might be
acquired, as it were, intuitively; and that mechanical
miobferving experience might fupply the defeCt of early
and well-grounded inftrudtion. It needs but little either
of intellect or inquiry, to fee at once the fallacy and ab-
furdity of fuch an idea.

We are aware that at the prefent period, in this
country, a confiderable portion of the male pradtitioners
in midwifery, are individuals whole compulfory profeffional
education may be fairly fuppofed to render them ade¬
quate to the performance of the duties they undertake ;
but it is notorious that fuch is not the cafe with the fe¬
males, on whofe care" and fkill the lives or the future
comfort of women in the lower claffes of life, and in re¬
mote parts of the country, are fo completely dependent.
Nor can it be unknown, that in every part of the king¬
dom, even in the metropolis, no fecurity exifts againft
the ignorance of thofe who may choofe to enter upon the
practice of this molt important branch of the healing art ;
that an acquaintance with, or courfe of inftrudtion in,
its principles, forms no part of the qualifications required
by the three corporate bodies, whofe members and li¬
centiates form the greater part of private pradtitioners in
England. Nay, on the contrary, at leaft two of thefe
are more difpofed to difcourage than to countenance the
extenfion of this divifion of pradtice amongtheir members.

After an attentive confideration of the difficulties and
the inconveniences we have alluded to, it furely requires
no argument to convince every uninterefted individual,
whether profeffional or otherwife, of the neceffity for
fome regulation of this branch of the profeffion, and of
the important advantages which would accrue to the
public from the organization of a clafs of female prufti-
tioners, well qualified for the performance of the duties
they are intended to discharge. To the inftitution of
fuch a clafs- in this country, we can fee no well-founded
or difinterefted objedtion ; and it mult be allowed that
nothing feems better adapted to attain the objedt in view
than the fyftem which has received fo ample a trial in
France, and of which we have given an account. Of
this at leaft we feel convinced, that a trial only is re¬
quired to exhibit its excellence, and enfure its adoption.
Should fuch a plan be ever put in execution, it would
doubtlefs be molt advantageous to combine its employ¬
ment, as has been done in France, with the internal ma¬
nagement of the lying-in inftitutions already in exiftence,
efpecially in the metropolis. But here we muft check
ourfelves, as it muft be confefi'ed, that it is much more
eafy to proclaim the exiftence of defedts than to apply
appropriate remedies, and as it is far from being our in¬
tention to afi'ume a talk that we hope to lee in more com¬
petent hands.

Greece and Turkey. — In turning to the confidera¬
tion of Greece, the land of heroifin and claffic recollec¬
tions, we find that 3000 years have glided over without
any improvement in medicine beyond the pradtice of the
Father of Medicine. Indeed in many inltances we might
almoft wiffi that the pradtice of Hippocrates only was
followed, without variation or improvement ; but the phy-
ficians of Greece and of Turkey are much occupied in
difcuffing the theories of Brown or of Boerhaave ; and,
though occafionally a flalh of ancient fire and of the true
philofophy of the priltine Hellenian has animated the
Greeks, yet the major part are contented with thefe
vain and fruitlefs enquiries. This ftate will not probably
laft long: the defpotic government of the Turks may be
confidered as the caufe of the long fupinenefs of the
Greeks ; and, whether the ftruggle for their indepen¬
dence be fuccefsful or not, a fpirit of emulation and en¬
voi.. XIX. No. 1288.

O L O G Y. 75

quiry exifts at prefent in that nation, which cannot fail
of producing much advantage to philofophy.

Of the mode of vifitingand treating patients in Turkey,
an amuling account is given by Dr. Neale, late phylician
to the Britilh embaffy at Conftantinople.

After adverting to the belief of the Turks in predefti-
nation. Dr. N. proceeds thus. “ Still, fatalifm and
apathy have their limits; and the proud infidel, in the
hour of ficknefs, does not difdain to invoke the affiftance
of the Giaour to delay the approach of death. Of this I
had a memorable inftance within a few days after my
arrival at Terapia, when, very unexpectedly, I received
a meffage from the emperor Selim the Third, to vifit his
mother the fultana Valide. Mr. Pifani, the fenior dra¬
goman (interpreter), was the bearer of this requeft ; and
the following morning I let off by water for the feraglio,
accompanied by one of the junior dragomans. We were
put affiore at a quay near Baktchi Capouffi, where we
found a boftanji in waiting, to conduCt us to the houfe
of the principal court-phyfician, who lived in a narrow
ftreet adjoining the wall of the feraglio. On arriving
there, we were informed that he had already gone to fee
his patient, having left inltruCtions that we ffiould follow
him, which we did, entering the gardens by the little
white gate near the chapel of St. Irene. We paffe.d a
guard-houfe of boftanjies on our left, and then proceeded
under an avenue of lofty cyprefs-trees, towards a fecond
guard-houfe, whence we were conducted to a detached
pavilion, in which we found theHekim Baffia, or Turk.ifti
phyfician, Mahmoud Eftendi ; a Greek phyfician, named
Polychronon; the Kiflar Agaffi, a hideous Ethiopian,
the chief of the black eunuchs; the Haz.ni Vekili, alfo a
black eunuch, keeper of the privy purfe; and fome der-
vifes and muftis. After being introduced, and going
through the ufual routine of pipes, coffee, fherbet, and
fweetmeats, Polychronon, converfing in Latin, entered
into a detailed ftatement of the malady with which the
fultana was afflicted, namely, an inveterate quartan ague,
of upwards of eighteen months’ Handing. From this (he
had recovered more than once ; but had relapfed as often,
owing, in part, to her own want of due caution, and to
the officious interference of a fet of muftis who belet her,
and forced upon her large draughts of iced water, in
which they immerfed talifmans, alluring her that they
would eftablilh her convalefcence ; but, on the contrary,
thefe draughts invariably brought back the cold fits of
her ague. Upon the laft relapfe, fome days before I faw
her, (he had, during the cold paroxyfm, been fuddenly
bereft, in her lower extremities, of all power of motion
and fenfe of feeling; and it was upon this point, and
fome others alfo, that my opinion was requefted. Indeed
I was to decide, as I found, between three of her phy-
ficians who called themfelves Boerhaavians, and four
others who profeffed themfelves drift Brownonians, as to
the expediency of prefcribing a cathartic medicine; the
former preffing the abfolute neceffity of fuch a remedy
after five days’ conftipation, and the latter moft foolifhly
declaring it to be perfectly inadmiffible, according to their
interpretation of the doCtrine of Brown. This being
premifed, we all accompanied the Kiflar Agaffi to an
adjoining kiolk, in which was the fultana. After ex¬
changing my (hoes at the door fora pair of yellow flip¬
pers, we entered the royal apartments. On a mattrefs,
in the middle of the floor, was extended a figure covered
with a filk quilting, richly embroidered. A female
figure veiled was kneeling at the fide of her pillows, with
her back towards the door of entrance; and the Kiflar
Agaffi beckoned to me to kneel down by her fide, and
examine the pulfeof the fultana. Having complied with
this requeft, I exprefled a wifli to fee her tongue and
countenance; but that I was given to underlie nd could
not be permitted, as I muft obtain that information from
the report of the chief phyfician. The moft profound
filence was obferved in the apartment, the eunuchs and
phyficians converfing only by figns. The Hazni Vekili

X then

76

PATHOLOGY.

then took me by the arm, and turned me gently round,
with my face towards the door of the entrance, over
which was a gilded lattice, concealing the emperor, who
had placed himfelf there to witnefs the vifit. Our ftay in
the room did not exceed fifteen or twenty minutes. The
four large windows were ffiaded externally by gilded
lattices, and the intervening pannels were covered with
mirrors and arabefque tapeftry. The divan, which en¬
circled the chamber, was veiled with crimfon cloth,
richly embroidered with gold, furrounded with cufhions
of the fame defcription ; and the floor was covered with a
fuperb Perfian carpet. On our return to the firft pavilion,
I, of courfe, coincided with the Boerhaavians, and wrote
a prefcription to that effect. Indeed, had ffie been a
princefs of any other European court, it is probable that
a large bleeding would have been decided upon ; but,
from the ignorance and prejudice of her attendants, I
found it impoflible to convince them of its neceflity ; and
on confulering that the miftakes, real or imaginary, of
the Turkifli court-phyficians, are frequently vifited by
the bow-Aring, I had but little inclination to bring the
lives of my colleagues into farther jeopardy. The He-
kim-Bachi and Hazni Vekili therefore carried my pre¬
fcription, and interpreted it to the fultan, who, in re¬
turn, fent back a complimentary meffage, and a purfe con¬
taining one hundred and fifty fequins.”

In cafe our readers ftiouid feel interefled in the fate of
the patient, we mull add, that the fultana funk under
her illnefs in the courfe of a week: but her age was fe-
venty-two ; and her 1'on, far from giving way to the bar¬
barous practice of punifliing the court-phyfician, figni-
fied to him that the event was evidently in the courfe of
nature, and (hould make no alteration in the confidence
which he enjoyed. This prince, dei'erving of a better
fate, was the unfortunate Selim who lofl his life by an
infurreftion of the Janiflaries in 1807.

But at length we have better news to communicate,
and fiuch as will be highly gratifying to our readers. For
we think that all who intereft themfelves in the progrefs
of fcience, and more particularly in that of medicine,
cannot but feel pleafure in learning that in Turkey, a
part of the world where knowledge has hitherto made
the molt inconfiderable advancement, where every thing
is under the dominion of prejudice, and the moft: bene¬
ficial fuggeftions are oppofed with the moft obftinate ani-
mofity, the government has lately caufed to be compofed
and printed in the vernacular language, the firft work on
anatomy and medicine which has been produced by the
prefs at Conftantinople. Whether we confider the aver-
fion entertained by the Turks for the moft ufeful know¬
ledge which does not accord with the fpirit of the Koran,
or which is derived from Chriftians ; or their implicit
obedience to the oulemas, or priefts, whofe intereft and
policy have uniformly prompted them as much as poflible
to enflave and paralyze the national mind 5 this revolu¬
tion in the opinions of Muffulmen appears in an equal
degree extraordinary.

The only ftep which the Turks have taken in civiliza¬
tion for the laft century has been the adoption of print¬
ing, (firft introduced at Conftantinople fo lately as
1726.) but this improvement was fall lofing its beneficial
effefts till the reign of the unfortunate Selim III. juft
mentioned, who fomewhat revived the declining ftate
of dawning literature. But the prejudices and religious
fcruples againft every kind of reprefentation of human
figures; the religion which forbids the contafl of blood,
as a pollution; the law* againft the opening of bodies ;
and, laftly, the belief in predeltination, which ranks im¬
providence and indifference to the accidents of life among
religious virtues ; all thefe, by their combined operation,
afforded, till the prefent time, infurmountable barriers to
the progrefs of anatomy and furgery. From all thefe ob-
ftacles then, the work of which we are about to give an
account, cannot fail to excite general attention, and to
conftitute an epoch in the hiftory of the Ottoman Empire.

This volume, printed at Conftantinople in the Turkifli
language, contains about 300 folio pages; and, what is
more particularly worthy of notice, it is accompanied by
fifty-fix indifferently-engraved plates, in which the hu¬
man figure, and the various objefrs of anatomy, are de¬
picted. The greater part of it has been copied by the
author, Chani-Zadeh Mehemmed-Ata-Oullah, from fo¬
reign productions of a fimilar nature. According to fome
communications made to M. Bianchi by a perfon lately
arrived at Paris from Conftantinople, this Muffulman
muft be the foil of an old and principal phyfician of the
government, whom his father fent to Italy for the pur-
pofe of profecuting his ltudies, and who at his return
immediately engaged himfelf in writing on anatomy and
furgery.

The principal phyfician of government, called in the
Turkifli language Hekirn Bajha, arrives at his dignity
after having filled the office of cadi, or judge; and is
chofen from the religious or judicial officers. It is only
when he has arrived at the end of his career, and at the
rank to which all his colleagues may afpire, that he is
nominated as the chief phyfician of the empire, without
having undergone any medical education which could
entitle him to the office. He has, therefore, at the fame
time to fulfil the duties of his other employment, and
to direCt his attention to the ltudy of medicine and fur¬
gery, a circumftance which will enable us to judge of his
neceflarily-limited acquaintance with the knowledge re¬
quired for the exercife of his new profeffion ; though he
is ex-officio at the head of the medical department in the
empire; as the phyficians, furgeons, and druggifts, fub-
jeCt to the Grand Signior, are nominated by the principal
phyfician of government, a fource from which he derives
a confiderable revenue.

M. Bianchi obferves that, notwithftanding the preju¬
dices, or rather the fuperftitious refpeCt, of the nation
for ancient cuftoms, many individuals are to be found
among the public officers, who have a fufficient degree of
intelligence to induce them to countenanceimprovements
calculated for the general good. He was more particularly
led to make this remark, at the time of the plague in the
year 1811-12, when he was commiflioned by the French
conful to tranfiate into Turkilh the inftruCtions con¬
tained in the work of Guyton-Morveau, on the means of
deftroying the infeClious properties of air by the aid of
chlorine. The tranflation was put into the hands of the
governor of Smyrna, and was received with equal pleafure
and gratitude. The method was not only at once adop¬
ted by him, both as an antidote againft infection, and a
means of purifying contaminated apartments and goods,
but he alfo ordered its adoption by all the members of his
family, at that time engaged in the principal adminiftra-
tions of Smyrna, as well as by the Greek and Armenian
communities of the fame city. However latisfaftory and
beneficial the plan may be, it is at prefent highly probable,
that the tragical death of the governor, which took place
in 1817, by order of the Grand Signior, and the difgrace
of all his family, will plunge into oblivion not only the
plan itfelf, but alfo the falutary effedls by which it was
followed; a refult which is inevitable in a nation, among
whom inftruflion and information are not general, and
men, difpofed to protect the interefts of fcience, have
only an ephemeral exiltence.

It is very much to be wiffied, that this firft appearance
of a tafte for medicine and furgery, by becoming more
general in the Eaft, may produce phyficians in that part
of the world, who would be better calculated than the
prefent race, to affume the guardianfhip of the public
health ; for, with the exception of fome foreigners at
Conftantinople, and the other towns of the Levant, who
acquit themfelves with reputation in their profeffion, the
whole empire is infefted with a mob of charlatans and ad¬
venturers, who are conftantly committing devaftations on
mankind by the exercife of a profeffion, of the firft ele¬
ments even of which they know nothing.

3 The

PATHOLOGY.

The work of Chani-Zadeh,in the opinion ofM.Bianchi,
is written in a ftyle which is clear, concife, and elevated :
mod of the technical expredions have been borrowed
from the Arabic, though fometimes, and efpecially in the
anatomical defcription, the author has retained the Greek
or Latin word employed in the original fource from
whence he derived his information.

The following extraCts, which M.Bianchi has tranflated
from the text of the author’s firft preface, contain fome
interefting details on the arrangement of the book, the
nature of its contents, and the motives which induced
the fultan Mahmoud to permit its publication by an ex-
prefs ediCt. The author of this notice believes that the
work of which he has given the outline may be of utility
to thofe who have an idea of praCtifing medicine or lur-
gery in any part of the Levant. The Angularity of the
Oriental expreflion, and the rhodomontade ftyle of the
following extradr, will perhaps render its perufal not
uninterefting, more particularly as the produdtion is of
very recent date ; we are, therefore, induced to give it in
its entire ftate, as a curioiity in medical literature.

“ Medicine and anatomy are elementary fciences, and
the objeCts of general ftudy. They fall within the cog¬
nizance of philofophers, literati, and the minifters of re¬
ligion. Not only learned men and people of found
judgment acknowledge that the aim of thefe fciences is
the difcovery of truth, but from the remoteft antiquity
they have always been confidered, by the higheft autho¬
rities, as conftituting a branch of valuable and honour¬
able knowledge. The advantages which refult from
their cultivation are not confined to the human race, but,
from the united tellimony of the learned, their beneficent
influence embraces all animated nature. The benefits of
modern medicine are molt obvious ; and anatomy, found¬
ed on accuracy and attention, has arrived at fuch a de¬
gree of perfection, that every thing which now concerns
the treatment of internal maladies, the drefling of wounds
and ulcers, and the cure of infirmities, is, by an admira¬
ble difpofition derived from the rules of art, diverted of
doubt and exempt from danger.

“ In conformity to thefe confiderations, Khamfei
Chani-Zadeh has depofed at the foot of the fupreme
throne the three following books, bound into one vo¬
lume.

“ The excellent Judge, he who is the regulator of the
-laws of the ftate, the Plato of the Empire and of the
Khalifat, the fovereign to whom fate has revealed fci-
ence and wifdom, the Sultan of Sultans, endowed with
the wifdom of Solomon, the monarch whole glory recals
the time of Cofroes, the King of Kings, inverted with the
power of the age of Djemchid, the Sultan, the Son of a
Sultan, the intrepid Sultan Mahmoud ; Khan, the fon of
the glorious Sultan Abdul-Hamid-Khan, (may the fun
of his power never ceafe to illuminate the courfe of his
victories and glorious enlerprifes !) his Majefty our Lord,
having at length condefcended, during many days, to
examine and to make profound obfervations, with jurtice
and difcernment, on all the truths of the above-men¬
tioned book, acknowledged that, independently of the
great benefit which would be derived from it to the Ot¬
toman empire (the duration of which is eternal), and
alfo to Mufl’ulmen, it had never yet been preceded by
any work, the advantage of which could be at all com¬
pared with it ; and that, as fuch, it was worthy of being
confidered among the precious and innumerable produc¬
tions which have rendered his fortunate reign illuftrious.
His majefty, from all thefe confiderations of general good,
attached the greateft importance to the circumftance of
the printing and publication of the work under his fu¬
preme aufpices. This determination came opportunely
to j.uftify the precept, ‘That Kings are infpired.’

“ The figures neceflary for the work having been ar¬
ranged and correfted by the author, who procured an
ediit marked with the figns of wifdom and happinefs,
from the execution of which the work w'as to be printed

77

at the imperial prefs ; from this inftant, the old and well-
attached iervant of the fultan, he who was brought up
in purity and lincerity, and under the fhadow of the
phoenix proteCtor of his highnefs, one of the guards of
the archives, and prefeCt of the imperial prefs, Efiexd
Abdul Rahim, after having recited the Bifmillah, (‘ Bif-
millah errahman errah'an; In the name of the merciful
and compaflionate God,’) immediately commenced the
work. But what was purely the refult of the miraculous
power of his majefty is, that, without the neceflity of
having recourfe to foreign means, by the afliftance of
Allah, and by uniting the numerous artifans to be found
in Conftantinople, the neceflary figures were engraved on
fifty-fix plates of copper. On the other hand, the daily
corrections of the author caufed the printing of the
work to be foon terminated. At length, thanks to God,
who knows all things, in the month of April, 1820, the
book was entirely completed and delivered to the binder.
It muft be acknowledged that, from the ufeful faCts it
contains, the other productions which have rendered the
reign of his majefty illuftrious cannot be compared to it.
Doubtlefs it has procured for his majefty’s Have, the au¬
thor, under the ftiadow of his majefty’s power, the nume¬
rous rewards with which his highnefs has condefcended
to honour him.

“ May the Deity, whole power is infinite, be, till the
day of the laft judgment, the fupport of our lord and
mailer the Emperor of Mufl’ulmen ; and may he, for their
benefit, perpetuate our fovereign’s power, and prolong
his precious life. Such are the wilhes which I form irt
honour of the Prince of Prophets.”

Immediately after this unique preface, a table of the
contents of the three volumes is given. This table is fol¬
lowed by a fecond preface, confining of little elfe than a
repetition of what had already been faid by the author.
We are there informed that the production had been be¬
fore prefented to the fultan Mahmoud in the year 1815-
16, under the title of the “Mirror of the ObjeCts in
Human Anatomy.” The author concludes by obferving,
that, among the caufes which have contributed to the
publication of the work, may be enumerated the re¬
proach, made by many perfons, of ignorance in the phy-
ficians of the empire with regard to the new doctrines in
anatomy and medicine.

As to the works of the ancients on medicine, and par¬
ticularly of the Arabians, they are perfectly known to the
Turks, fince they are to be found in all the public li¬
braries. Toderini, in his time, reckoned more than a
hundred volumes in the library of St. Sophia, indepen¬
dently of the works of Avicenna and Averoes. They
have tranflated the works of Hippocrates, Andromachus,
Rufus, Galen, Diofcorides, and the moll celebrated
matters of Greece. The works of European phyficians
are alfo not unknown to them; for, in the library of
Raguib, pacha at Conftantinople, there is a tranflation
of the works of Sydenham ; and it is well known that,
under Muftapha III. the friend and proteClorof Ottoman
literature, a tranflation of the Aphorifms of Boerhaave
was produced; but, till the prefent time, no work on
medicine or furger.y had been printed.

The firft volume of Chani-Zadeh’s book contains all
that relates to anatomy, and the explanation of the fifty-
fix plates, which, as well as all that he has written, appear
to have been taken, in part, from the Italian tranflations
of the works of Bertin and Palfin. The fecond volume
is on the corporeal and intellectual faculties of man, or
p/iyjiulogy. The third is on the nature of difeafes and the
employment of remedies, conftituting nofology and thera¬
peutics. This is preceded by two prefaces and an intro¬
duction : the firft preface contains only a feries of quota¬
tions from the Koran on the utility of medicine, eulo-
giums on the fovereign, and apologies of the author for
the errors which may have infimuated themfelves into his
production.

It is principally with the view of afiifting thofe who are

ltudying

78

PATHOLOGY.

ftudying medicine, that the author, Chani-Zadeh, re-
folved to compofe his work on the rules of fcience, the
benefit of which he confiders infinite. He therefore par¬
ticularly recommends the repeated perufal of it, in the
order in which the articles occur, as the belt means of
avoiding error and forgetfulnefs. As the dofes of medi¬
cines have been determined from the period of infancy
to that of manhood, he notices the neceflity, in their
adminiftration, of confidering the age, fex, and ftrength,
of the patient, as well as the nature of the climate. It is
ufelefs, he thinks, to collect a great variety of remedies
for the fame difeafe, in order to indulge the caprices of
patients; for moll of the complicated preparations are to
be found in “ The Provincial” and other treatifes on
Materia Medica. At the end of the work there is a lift
of various applications, with a reference to all thofe com¬
plaints for which they are necefiary. Independently of
medical men, the author folicits the attention of thofe
perfons who may perufe his work, to dedicate the fame
proportional attention to the feveral articles as he de¬
voted to their competition. As the work is intended
equally for thofe out of the medical profeftion, its techni¬
cal abbreviations may be palled over when they are not
intelligible ; but, in general, only limple phrafes have
been employed in fubjedts relating to general utility.
The author difclaims the prefumptuous thought, that the
advantages of his book will extend to the whole world;
though he, at the fame time, flatters himfelf that it will
be ufeful to feme individuals. For admitting, fays he,
that a phylician in pofl'eflion of the work had no other
merit than that of underftanding it, he would not be ca¬
pable of doing fo much good as an accomplilhed medical
man. The latter would always be fuperior to him, from
I'.is practical knowledge; but, on the other hand, prac¬
tice alone is inadequate to conftitute a learned profelfional
character; whatever may have been his difpofition or op¬
portunities, a profound lludy of books will be equally
necefiary. Of thefe afl'ertions, he confiders that the pre-
fent work furniflies numerous fatisfadlory proofs. In all
inftauces he defires, as the recompenfe of his labour, not
only the glory of having ferved his country, but alfo the
fatisfaftory convi&ion of his having contributed, by his
unremitted efforts, to the benefit of mankind.

After the fecond preface cotnes the author’s Introduc¬
tion to Therapeutics, the arrangement of which partakes
of that of other works on the fame fubjedl: the third and
laft book concludes with a Pharmacopoeia in Arabic and
Turkifh, containing 319 formula, applicable to all forts
of difeafes.

Abridgment of the General Table of Contents. — Book
I. Anatomy. Part 1. Ofteology ; Part 2. Myology;
Part 3. Splanchnology; Part 4. Angeology and Neurology.

Book II. Phyfiology ; comprehending Natural Facul¬
ties, divided into 22 articles. — Corporeal Faculties, in 21
articles.— Of InftinCl, or the Animal Faculty, 1 3 articles.
— Of Difeafes in general. — Of the Nature of Difeafes. —
The Analogy of Difeafes, divided into 8 articles. — Oil
Averfions produced by different Caufes. — On the Signs
or Characters of Difeafes.

Book III. Nofology and Therapeutics ; comprehend¬
ing 208 foiio pages, and 55 articles, on feparate Difeafes.

Vaccination is treated of, as M. Biar.chi fays, in an in-
terefting manner, confidering that the author is a Mufl'ul-
man. He dwells particularly on the importance of the
difeovery, and infills on its advantages over inoculation,
which had been long known among the Arabians! He
fays, on this occafion, that fmall-pox, though before un¬
known, penetrated into Turkey at the conqueft of
Egypt by Selim I. The hiftory of vaccination is given
from the work of Dr. Caran (De Caro), a German phy-
fician, who, according to M. Bianchi, firft introduced
vaccination into the Eall. The author notices alfo the
experiments made in vaccination, in the year 1800, at the
palace of lord Elgin, at that time the Britilh ambalfador
at Conftantinople, as’1 well as thofe inftituted at Vienna,

in the prefence of the emperor of Auftria, and the encou¬
ragements afforded by this fovereign, who caufed his own
children to be vaccinated. He quotes entire paflfages
from the different treatifes on vaccination by Drs.
Ranque, Laurens, Maudine, and Guillotin : he more
particularly recommends the work of the latter to thofe
who are willing to be convinced of the benefits of vacci¬
nation. The fubjedl is terminated with a conclufion,
which is entirely original, on the mode of performing
vaccination, and what is necefiary in the operation, of
which the principal periods and complications are de-
feribed. The vaccine lymph is obferved not to be always
peculiar to cows, and to be portable. He alfo informs
us, that which was firft obtained at Conftantinople came
from America, England, and other countries ; but that
it is alfo to be procured in the village of Ai'az Aga, in the
neighbourhood of Kiadkhaneh, in the environs of Con¬
ftantinople; and that from the laft fource many thoufand
perfons have been vaccinated.

M. Bianchi informs us, that there have long exifted, at
Conftantinople, hofpitals for fick Muflulmen, which are
called by the Turks Tab' -y-Khaneh. The greater number
of the imperial mofques have fuch eftablifhments annexed
to them, but the moll confiderable are thofe of thefultan
Bayezid Selim and fultan Suleyman. The following
temples have alfo inftitutions of the fame nature; viz.
Khafleki Djamy, Tfchinili Djamy, Mihrmahfultane,
Djamifi, and Kilidj-Aly-Pacha Djamifi ; as well as the
Selimie, at Scutari. There are alfoafylums where patients,
reclining on fof3s, are dieted in a careful manner, as in
hofpitals properly fo called ; but the afllftance of medicine
is entirely negledted. From the word Nev Idjad, or New
Creation, M. Bianchi was led to fuppofe that the author,
Chani-Zadeh, alluded to eftablifhments founded by the
late fultan : but, as Bianchi himfelf had witnefled the di¬
lapidated condition of all the hofpitals, after the death of
the above fovereign, and as he quitted the Levant in the
year 1815, he thought proper to procure the moft recent
information as to theftateof them. He was accordingly
favoured with a communication from Dr. Maugin, phyfi-
cian of the French hofpital at Pera, in the luburbs of
Conftantinople, which is chiefly devoted to the habita¬
tions of Europeans. As it contains many fatisfadtory
details of the adlual ftate of the charitable inftitutions of
Conftantinople, we fhall infert the greater part of it.

“ Sir; I fend you the information which you requefted
on the ftate of the hofpitals and druggifts’ ihops of Con¬
ftantinople, at the time of my departure; as well as of
every thing which concerns the progrels of medical fci¬
ence among Muflulmen.

“ In the reign of the fultan Selim, two fchools were
inftituted at the Arfenal, one for the inftrudtion of pupils
in mathematics and nautical fcience, another for the
teaching of medicine and furgery. The firft of them was
under the direction of M. Brun, a French engineer; the
fecond under that of M. Gripili, who is of Greek delcenr.
Both thefe inftitutions flourilhed as long as the fultan
reigned, and while his meritorious favourite, the pacha
Hufiein, lived; but the death of this admiral, and the
dethronement of the fultan, have involved in oblivion
both the noble ellablilhments.

“ Barracks were alfo conftrudled at the fame time at
Scutari, in the faubourg of Pera; thofe of the arfenal and
of Topkhana were reftored, and another was eredted at
Levent-Tchiftlik ; fo that each was provided with its
hofpital. They were all well furnifhed, but particularly
thofe of Scutari and Levanc-Tchittlik ; there being an
European phyfician, and a (hop for medicines, at each of
them. At prefent no traces of fuch places are to be leen :
the barracks and hofpitals have been burnt, from the
fpirit of iniubordination on the part of the Janiflaries, at
the time of the revolution of Muftapha Barai'ktar, in
November 1808.

“ The hofpitals of the Arfenal, of Topkhana, and the
faubourg of Pera, are now nothing more than chambers

of

PATHOLOGY.

of barracks, where the foldier who Is ill expires of the
plague, or any other complaint, unlefs nature is fuc-
cefsful in the conteft. There are two or three quackifh
practitioners, almoft dying of hunger, to whom the Miri,
or public treafury, allows forty or fifty piaftres per month,
(25 or 30s.) in order that it may be faid that there are
titled phyficians at the places. They go much lefs with
the view of treating their patients’ difeafes, than with
that of treating themfelves with wine and brandy, which
they invariably prefcribe for every diforder.

“When the Turkilh fleet is put into commiffion, the
diforderis fomewhat lefs; but there is a confiderable in-
creafe of expen fe, particularly for the medicine-chefts,
which the phyfician caufes to be prepared at fome drug-
gift’s (hop in Conftantinople. On this occafion, it is a
matter of fpeculation between the two parties, who have
a perfeCt underftanding with each other, and charge a
great price for an inconfiderable number of medicines.
But cultom demands that each veflel ftiould be provided
with its medicine-cheft, and much economy could not
with propriety be inftituted in fuch inftances. But to
what utility can all this tend, either on land, or at fea,
when well-qualified medical men are adequately recom-
penfed for their attendance on the fick on-board the ad¬
miral’s Ihip alone ?

“ At Conftantinople there are at prefent only hofpitals
for the reception of tliofe affeCted with the plague, and
for patients luffering either under external or internal
difeafes which are not of a contagious nature. The French
government has two; one at Galata, for complaints of
an ordinary kind 5 the other in the faubourg of Pera, for
fuch of their unfortunate countrymen as are attacked by
peftilential difeafes. The Greeks have three great hofpi¬
tals, of which two are devoted to the plague. The Latins
have, in the faubourg of Pera, but a Angle hofpital, which
is defined equally for the relief of tliofe fluttering with the
plague and with other difeafes. Thefe are all the hofpi¬
tals which now exift at Conftantinople : it rauft be ac¬
knowledged that, while fuch eftablifliments do honour to
humanity, the individuals entrufted with the direction of
tnofe for the plague are accuftomed to engage in fpecu-
lations, no lefs barbarous than infolent, on what each
patient is likely to leave them : for it is a well-known faCl,
that they regard themfelves as the univerfal legatees of all
the unfortunate objeCts that are brought there, and that
the death of the patients is the more certain if they are fo
unlucky as to poflefs any money or jewels. In addition
to fuch villainy, they have the audacity to fend for fale,
at the bazars of Galata and Conftantinople, the fpoils of
their ill-fated victims.

“No druggift’s ftiop in Conftantinople is directed by a
Turk : molt of them belong to Greeks, a few to Arme¬
nians, and fome to Europeans. As this profelflon re¬
quires previous ftudy, the Turks, who have no acade¬
mies nor faculties of medicine, and who never travel to
gain information, feel their incompetency to undertake
the fuperintendance of fuch eftablilhments.

“It was in the month of June 1820, that I quitted
Conftantinople; and fince faw with much pleafure, and
a lively intereft, the work which you (bowed me. The
great progrefs juft made by the Turks, in the publication
of this production, by order of the fultan Mahmoud
himfelf, at once proves that the fovereign prefers difcoun-
tenancing the prevailing prejudices, and that he is in
poflefilon of fufficient power to filence fanaticifm, which
would not have failed to advance loud remonftrances
againft the impiety of reprefenting human figures : but
fuch complaints might have been anfwered by the alfur-
ance that the plates were not executed with trifling or
futile views.

“If reafon ftiould ever gain the afcendancy among thefe
people, the fultan will eftablilh hofpitals, and cauie laza¬
rettos to be conftruCted at Proti, an ifland oppofite the
capital, in order to arreft, at the port of Conftantinople,
the fcourge which annually decimates the Ottoman em-

Vol. XIX. No. 1288.

79

pire. I have the honour to be, &c. Maugin. — Paris,
April 1821.”

GENERAL PATHOLOGY.

In the prefent philofophic age, it appears needlefs to
difcufs the propriety and neceftity of being guided by
reafon in our pathological inveftigations. Very few pro-
feffiona) gentlemen will now be found ftriCtly empirical ;
and thofe few are among the lead honoured and lead de-
ferving in our profeflion. There is fomething in the
human mind fo prone to enquire into the caufe why, and
the reafon wherefore, that the verieft empiric in the prac¬
tice of phyfic will never be contented with attaching
himfelf to faCts, as he profefles, without regard to infe¬
rential reafoning. There is- fomething fo gratifying to
one’s love of fcience, fomething which fo evidently leads
to better information, even in the vagueft explanation
of natural phenomena, that we cannot be furprifed that
it has been attempted in all ages.

Yet, in the courfe of our hiftory of medicine, we have
had frequent occafion to (how how fatal has been the
refult of too much theory. Independently, however, of
the circumftance that what is injurious to the progrefs
of fcience in its infant (late, may ceafe to become fo
when it is more advanced, we have found hitherto no
fyftem of medicine which has fufficiently accounted for
all morbid phenomena, or in which many huge gaps and
deficiencies have not been filled up by gratuitous afler-
tions.

In the infant ftate of medicine there can be no doubt
that theory often exerted a moft decided influence on
that fcience. But the paucity of faCts, the data whence
the theories of the ancients were framed, were the caufe
of their frequent errors. They were like labourers at¬
tempting to build a lofty palace with a few (tones. In our
own time, however, we have fo far advanced in the ac¬
cumulation of faCts, that, though much remains to be
done, we are compelled in fome meafure to generalize
and l'yftematize our knowledge, which elfe would become
too burthenfome for memory. To follow up our fimile,
we may be faid in our own time to be in pofleflion of
materials fufficient for building a liable edifice ; and hence
we may now look forward to the eftabliftiment of a fyftem
which, to ufe the arrogant exprefiions of Darwin “ may
not moulder, like the (truCtures already ereCted, into the
fand of which they were compofed, but which may (land
unimpaired like the Newtonian Philofophy, a rock amid
the wafte of ages.”

We (hall not paufe here to enquire into the utility of
fyftems of medicine. Our periodical medical publications
have lately railed much uproar againft fyftems. It muft
be obvious to every one, how'ever, thataferies of dry in-
fulated faCts, or of reafonings applicable only to a limited
number of phenomena, can never be fufficiently remem¬
bered, or indeed perfectly known. Provided, therefore,
we wander not into the mazes of hypothefis, provided
our analogies are not forced, or our claflifications likely
to lead to erroneous methods of practice, it muft be al¬
lowed that we are advancing our knowledge, clearing
away many erroneous notions, and reconciling many
contradictory opinions, by taking general and extended
views of difeafe. See vol. xvii. p. 245.

We have faid that the knowledge of the ftruCture and
functions of man ftiould precede the ltudy of pathology.
Of the animal ftruCture we have given an ample account
in the firft volume of our work, under the article Ana¬
tomy ; of the fecond we propofe to treat under the ar¬
ticle Physiology. In the mean time, the more clearly
to develope the opinions we have adopted, it will be ne-
ceflary to give a ftiort (ketch of the economy of man, and
of the moft prominent fyftems and moft important Itruc-
tures which belong to his organization, the better to un-
derftand in what difeafe a deviation from this ftate con-
fifts.

In the organization of man, then, the firft fyftem to be
Y confidered

80

PATHOLOGY.

confidered is the nervous. It confifts of the cranial brain,
the fpinal marrow, nerves, and ganglia. By means of
this fyftem, all mental emotions are communicated to the
other parts of the animal frame, and, through its medium,
all external impreflions are communicated to the mind.
We obferve likewife a fibrous ftruCture of different kinds
in various parts; as mufcular, offeous, &c. the moil ge¬
neral and important of which are the mufcular ones. To
thefe is added a fundamental cellular ftruCture, which ap¬
pears to conneCt all parts of the other fyftems together;
and which has various appearances in regard to diverfity of
fubftance, and indeed in regard to the fecretions derived
from it. The union of thefe three fyftems takes place in
various modes : in fome cafes in tubes, or on membranes,
See. Sec. and the more remarkable of thefe unifons may
be aptly divided into the digeftive, refpiratory, fanguife-
rous, fecernent, and abforbent, fyltems; and this phyliolo-
gical division we have taken as the bafis of our arrange¬
ment, which agrees with the excellent one lately made
by Dr. Good, in his Phyfiological Syltem of Nofology.

Many objections have been made however to all the
prefent arrangements ; the mod important of which is,
that, by allowing the attention of the medical practitioner
to be exclulively directed to one fyftem or to one organ,
it prevents that due attention being paid to morbid cate¬
nations, which the practice of phytic imperioufly de¬
mands. There is nothing, however, in the nature of
- nofology which renders this error a venial one. It mull
be allowed that morbid impreflions are generally' primarily
made on one particular tilTue or organ; and it mull be
allowed too, that a fyftem which is fecondarily affeCted,
often fuffers the moft feverely ; or that the fyftem fecon¬
darily affeCted may- be the moft important to life, and
hence our attention fhould be chiefly direCted towards it.
We will however venture to affert, that whoever has affidu-
oufly ftudied the ftruCture of parts and their phyfiology,
cannot fall into the error of confining his attention to one
part of the animal economy to the exclufion of the reft.

To render this more plain, we (hall proceed with fome
further account of the aCtion of the different fyftems
above mentioned upon each other. If the animal frame
were fo conftruCted that no inteftinal motion was necef-
fary for the continuance of its external aCtions, we could
readily fuppofe it poflible that the nerves would be unaf-
feCted by any change in the mufcular fyftem, and the
latter might produce its functions without any impreilion
from the former. But, when we fee, that the cerebral
functions can only be continued while blood, pofleffing
certain properties and component parts, circulates accor¬
ding to given- laws through its fubftance; and when we
coniider that the mufcular fyftem can be called into ac¬
tion only by the nervous fyftem, either direCtly by means
of nerves, or indirectly by fluids, deriving fome of their
properties from the nerves; then we cannot fail to have
the moft certain conviction of the aCtion of the one on
the other.

It is extremely difficult to know at what part to begin
fil'd, when fpeaking of aCtions which are thus always de¬
pendent one on the other, and which are always in a
circle. We take, however, the heart ; and, fuppofing
it of a fibrous fundamental ftruCture, and fupplied with
blood and nerves, we proceed to confider its aCtion. A
cavity of the heart called the left ventricle, having received
a certain fupply of blood, propels it by contraction into
the aorta, and from it into the fmaller arterial branches.
Thefe branches further aflift the motion of the blood by
contracting their circumference, the power of contrac¬
tion being in an inverfe ratio to the diameter of the tubes.
The terminations of arteries are further affifted in pro¬
pelling the blood by' the property of capillary attraction ;
reins reftore the fluid to the heart in a direCt ftream, al¬
tered however in its properties; for veflels called Jeccr-
nents have, by means of an affinity exifting between* their
coats and certain parts of blood, removed fome parts of
that fluid ; and other veflels, called abforbents, have re-

ftored a portion of other component parts previoufly fe-
creted from the blood, or received from without. The
moft obvious change undergone during this circulation
is a-change in the colour of the blood ; this however is
reftored by fecond circulation produced by the other ca¬
vities of the heart, and is called the pulmonary procefs.
In this circulation the blood appears to be indireCtly ap¬
plied to atmofpheric air, and hence to acquire a principle
which reftores its colour. But this procefs is under the
immediate influence of the nervous fyftem, and is difeon-
tinued when the aCtion of that fyftem is fufpended.
After this procefs has taken place, the blood is reftored
in its priftine ftate to the heart. The changes which fe-
cretion and abforption effeCt in the blood are of courfe
depravation of its elements on the one hand, and repro¬
duction on the other. Secretion has been defined “ a pro¬
cefs which feparates from the blood fubftances which are
not found in that fluid.” This propofition, as it Hands,
is fo abfurd, that we ihall take no pains to confute it.
Secretion is better explained by fuppofing that it deprives
the blood of certain of its elements, and combines them
in a manner different from that in which they previoufly
exifted in that fluid; and further, that our chemical ana-
lyfis is not fufficiently accurate to deteCt the elements
(ftriCtly fpeaking) of this re-compofition.

The number of the various fecretions is too great to
be here detailed. Some of them are re-abforbed, and fome
pafs from the body by various outlets. Previous to thefe
circumftances, however, their progrefs is retarded, and
their nature changed, by fubftances called glands. The
abforbents receive thefe fecretions from the whole funda¬
mental or cellular ftruCture ; they receive the fluid previ¬
oufly fecreted from the blood; they further receive from
certain expanfions of the fundamental or cellular ftruC¬
ture extraneous bodies. Thefe are, the (kin, the lining
of the pulmonary air-cavities, and the alimentary canal.
The abiorption from the (kin is in general probably final! ;
though, when internal abforption is deficient, cutaneous
abforption is no doubt increafed. Of the pulmonary cavi¬
ties the foreign matter abforbed is derived from the air.
The nature of this abforbed matter is not precifely known :
It is indifpenfably neceffary, however, to the performance
of life. But, the greateft portion of extraneous matter
is abforbed from the alimentary canal. The whole of this
canal is perhaps an abforbing as well as fecreting furface ;
a peculiar portion of it is however much more aClive than
the reft ; and this portion is placed fo far down, that the fo¬
reign bodies received have had time to fuffer the changes
induced by the fecretions poured into the canal, and
thereby to have its nutritive part feparated from that ex-
crementitious mafs. The great extent of this expanfion,
its numerous fecretions, the clofe relation it holds with
the nervous, its intimate relation with the vafcular, fyf¬
tem, and by their means indireCtly with every part of
the body, render it perhaps the moft frequent medium of
general difturbance in the human frame; and hence it
may with great propriety be confidered in the firft part
of our pathological difq uifitions.

The view' we have taken of the human frame clearly
indicates the iinpoffibility of ever forming a nofology in
the old and reltriCted ufe of the term ; that is, an arrange¬
ment of difeafes founded on the affumptioh that an indi¬
vidual part or a feparate, ftruCture can be difordered
without involving the reciprocal aCtion of various other
parts. When the phyfician, therefore, finds fever ar¬
ranged under the clafs Hasinatica, he is not to fuppofe
that we are difinclined to admit the important part which
the nervous fyftem has in this difeafefand foon of many
other orders, genera, and fpecies.

In this place we mult recur to our article Nosology,
in order to offer fome apology to our readers for neglect¬
ing to redeem our promile of tiling Cullen’s fyftem. We
trult this promife will be deemed better “honoured in
the breach than in the obfervance,” when it is confidered,
that many errors had been complained of in Cullen’s
3 arrangement.

81

PATHOLOGY.

arrangement, even from its firft publication ; and that,
fince that period, phyfiology and pathology have made
fo much progrefs, that they may literally be faid to be
revolutionized. Nor is the fyftem we have adopted to be
confidered as a crude fpeculation, un matured by experi¬
ence, or unfanftioned by general affent. .It is founded
on the cleared and mod comprehensive views of the ani¬
mal economy; and its projector was entirely free from
that fatal error of mod new fydem- makers, that of defpi-
fing the labours of his predeceffors in the fame path.
On the contrary, he has availed himfelf of all that had
been done before him by Sauvages, Pinel, Linnaeus, Cul¬
len, Vogel, and many others; and has added the infor¬
mation which long dudy and experience had furnilhed
him with. A dronger reafon than all thefe, which has
induced us to employ Dr. Good’s nofology, is its claffical
and correct nomenclature. Our medical technicology
abounds in the mod barbarous and abfurd appellations;
which, fo far from having any meaning, or affording
any account of the nature or appearance of difeafe, often
ferves only to perpetuate fome ancient and ridiculous
notion. Often derived from the oriental languages, half
latinifed, they have been long cenfured by claffical phy-
ffcians ; and fome alterations have accordingly been made
from time to time. But it was referved for Dr. Good
entirely to alter the medical nomenclature, and at once
to fimplify and adorn a very dry and uninviting fub-
je£t. We may further remark, that Dr. Good’s work is
patronifed by the heads of the medical profeflion in Eng-

We (hall now' give an outline of the different fydem s,
or claffifications, of difeafes, which have fucceffively pre¬
vailed ; and the few remarks we fliall make as we go on,
will, we think, furniffi additional reafon s for the courfe
we mean to adopt, of forming the great body of our ar¬
ticle upon the fyftem of Dr. Good.

Dr. Good himfelf very judicioufly obferves, that no art
or Science can be acquired, for none can be clearly treated
of or communicated, without arrangement. All nofo-
logical works, therefore, poflefling any value, have an ar¬
rangement, or method as itis called, of fome kind or other.

The Simplest arrangement, if it be in any -way worthy
of the name, is the alphabetic, of which, in the prefent
day, we have many copious examples, highly valuable as
works of eafy reference, though fcarcely entitled to rank
under the character of fydematic arrangement. To this
daffification belongs the very excellent and important
work of Dr. Heberden. — Another modification which
has been had re courfe to, is that of the duration of dij-
enfes, .as divided into acute and chronic ; it is a modifica¬
tion of confiderable antiquity, and has defcended to us
in the works of Aretasus, and of Cadi us Aurelianus.- —
A third modification has confifted in taking the anatomy
of the animal frame as a ground-work for divifions ; and
confequently in afiforting difeafes, as has been done by
Jonfton, Sennertus, and Morgagni, (and fince recom¬
mended by Dr. Mead in his Medical Precepts and Cau¬
tions,) info thofe of the head, cheft, belly, limbs, and
aim oft every other part. — A fourth invention has fixed
upon the fuppofed cauj'es of difeafes as a bafis of diftribu-
tion ; and to this has been applied the epithet etiological ,
from the Greek term aina., a caufe; it has acquired
more popularity than any of the preceding, and was es¬
pecially embraced by the fch ools of Boerhaave, Riverius,
and Hoffman. — Sometimes a mixed modification has been
attempted, as in the nofology of Dr. Macbride, who
takes extent for his firft two general divifions of difeafes,
as being univerfal or local -,J'ex for his third ; and the age
of infancy for his fourth and laft. — And fometimes, and
far more generally of late years, the nofological fyftem
has been built upon the diftinblive J'ymploms of difeafes; the
peculiar marks by which they identify themfelves, and, fo
to fpeak, become individualized: and fuch is the princi¬
ple adopted by Sauvages, Linnaeus, Cullen, and all the
Hi oft celebrated nofologifts of recent times.

This laft is, in effeft, the only method in any degree
worthy of attention ; for it is the only one that will ge¬
nerally hold true to itfelf, or on which we can place any
dependance. Of the feat of difeafes we often know but
very little $ of their caufes far oftener (till lefs ; but there
are certain marks or characters in the ufual progrefs of
moll difeafes which uniformly accompany and diftinguilh
them, and to which, therefore, the epithet pathognomic
has been correftly applied. It is not, indeed, to be con¬
tended that thefe distinctive Signs are as constant and de¬
terminate as many of the distinctive figns that occur in
zoology or botany. So complicated is the animal machi¬
nery, fo perpetually alterable and altered by habit, cli¬
mate, idiofyncrafy, and the many accidental circum-
ftances by which life is diverfified, that the general rule
mull admit of a variety of exceptions ; and is here, per¬
haps, rather than any-where elfe, bell established by fuch
exceptions. Yet, after all, every diftinCt difeafe, occur
where it may, and under what peculiarity of constitu¬
tion it may, proves fo generally true to its own courfe,
and is fo generally attended by its own train of fymp-
toms, or “ co-incidents,” (which is the literal rendering
of fymptoms,) that he who fteadily attends to thefe will
not often be greatly deceived; “ and if he ftiould be,
(fays Dr. Good,) he can find no other guide to fet him
right.”

Plater may be regarded as the morning-ftar that firft:
glimmered in the hemifphere of fymptomatology, as Ser-
vetus was in that of the circulation of the blood. The
light of both was feeble and tremulous ; but it twinkled
in the midft of darknefs, and led on to the brightnefs of
day. His work, entitled Praxis Medica, in which he
gives an imperfect Sketch of a fymptomatic plan of nofo¬
logy, was published in 1602. Sydenham, if he did not
avail himfelf of it, was actuated by the fame quickening
fpirit; for his various treatifes and epiftles, published for
the moll part mifcellaneoufly, are a practical comment
upon Plater’s principle, and feem chiefly to have Stirred
up the well-ftored and comprehenfive mind of Sauvages,
who was peculiarly attached to Sydenham’s opinions and
practice, whom he is continually praifing, and whom he
distinguishes by the name of “ Anglus Hippocrates,” to
that full illuftration of the fymptomatic method which
has given form and being to almoft every attempt that
has fince appeared upon the fubjedl.

Sauvages firft published the outlines of his plan in 1731,
in a duodecimo volume, under the title of “ Nouvelles
Clafles de Maladies,” after having fubmitted his intention
to the judgment of Boerhaave. This precurfory Sketch
defcended no lower than to the divifion of genera ; but,
having been encouraged to perfevere, he laboured on
the fpecies, and introduced them in their proper fuccef-
fion into a new and more extenfive edition of his work,
published in 1763, in five volumes oCtavo; and, conti¬
nuing his exertions yet further in the fame vineyard,
he put his finishing hand to the great talk he had under¬
taken by preparing a Still more complete and final edi¬
tion, which he did not live to publish, but which was
given to the world Shortly after his death, in 1768, in two
large volumes quarto.

The “ Nofologia Methodica,” for fuch is the title of
M. de Sauvages’s work, is, indeed, an Herculean la¬
bour. It confifts, in its lateft and mod perfect form,
of three diftinCt arrangements, a fymptomatical, an
etiological, and an anatomical, fo as to accommodate
itfelf to the tafte of the old fchool as well as of the
new. The fymptomatical, to which the others are
profefledly fubordinate, is by far the mod extenfively
elucidated; and comprifes ten clalfes, (each introduced
by an elaborate pathological fynopfis,) upwards of forty
orders, more than three hundred genera, and an almoft
innumerable holt of fpecies. “ Quel no mb re prodigieux
d’ennemis !” exclaims M. de Ratte, alluding to this valt.
mu Iter, in his eulogy on the author, delivered before the
Royal Society of Sciences in Montpellier; or rather allu¬
ding

82

PATHOLOGY.

ding to the fomewhat fmaller mufter of the preceding
edition, for the laft was not then publifhed. We have
yet, however, to add the varieties, which under feveral
fpecies are not few ; and to bear in mind, that to every
variety, fpecies, and genus, as far as their relative cha¬
racters will allow, is allotted a definition, lift of fyno-
nyms, liiftory, diagnofis, prognofis, and mode of cure;
with, frequently, an exemplification of cafes, and a brief
ftatement; of the peculiar opinions of other writers, be¬
fore we can fairly appreciate the entire mafs of matter
with which the volumes of M. de Sauvages abound. He
feems, indeed, to have been defirous of collecting mate¬
rials of every kind and quality from every quarter to
which a market was open; and of following up every
deviation from health into all its poflible as well as its
aCtual fliades and ramifications, fo that no man mighj
have to add a lyllable to his work after him. It is not
very furprifing, therefore, that a work thus conftituted
and conducted fhould be confiderably too dilfufe. This
is its leadingerror; yet it is not a.venial one, and was by no
means deftitute of advantage at the time of its commif-
fion ; for the very amplitude the work evinces rendered
it, when firlt completed, a fort of nofological bazar, to
which every one might have recourfe who was in purfuit
of this new branch of ftudy; and where he might ac¬
commodate himfelf with whatever articles he ftood in
need of.

To the time of Cullen the general outline or claftific
arrangement of Sauvages was left without much difturb-
ance; for, although the order of fucceflion was changed,
and changed differently in every new attempt, the names,
in a few inftances diverfified, and occafionally fome addi¬
tion made to the number, ftill the ten Sauvagefian claffes
were fubftantially retained and adhered to. Thefe claffes
are as follow :

VI. Debilitates, Debilities.

VII. Dolores, Local Pains.

VIII. Vefania, DefeCts of
Judgment.

IX. Fluxus, Fluxes.

X. Cachexia, General De¬
bility.

I. Vitia, Cutaneous Difeafes.

II. Febres, Fevers.

III. Phlegmufice, Inflamma¬
tory Fevers.

IV. SpaJ'mi, Convulfive Dif¬
eafes.

V. Anhelationes, Difficult Ref-
piration.

The ten claffes comprife forty-four orders, three hun¬
dred and fifteen genera, and about two thoufand five hun¬
dred fpecies; being rather more than an average of eight
to each genus.

In Linnaus, while the above claffes remain fubftantially
the fame, their order of fucceflion is varied, the names
confiderably altered, apparently from a preference of
Latin to Greek terms, (as in the ufe of MeAtales for
Vefaniae, Motorii for Spafmi, and Deformes for Ca¬
chexias;) and the lift of claffes is increafed to eleven, by
advancing the Exanthematicas of Sauvages, which in him
occurs as an order of Phlegmasia, to the rank of a
diftinfl: clafs ; while the clafs Vitia, with which Sau¬
vages opens, is by Linnaeus thruft to the end of the
feries; which at length will appear as follows :
Exanthcmatici, Eruptions, j Motorii, Involuntary Mo-

Critiei, Common Fevers.
Phlogiftici, Inflammatory
Fevers.

Dolores, Painful Difeafes.
Mentales, Lofs of Judgment.
Quietules, Lofs of Motion.

tions.

Supprefforii, Obftru&ions.
Evacuatorii, Evacuations.
Deformes, Changes in the
Solids.

Vitia, Changes in the Sur¬
face.

Some degree of abbreviation is unqueftionably hereby
produced, which is always defirable when accompanied
with perfpicuity. But there are few cafes in which the
author has not preferred the definitions of Sauvages,
though frequently too diffufe; for the perpetual aim at
brevity in Linnaeus leaves him too general where he has
not occafion to refer to other difeafes, and too perplexed
and intricate where he has.

The great objefl of Vogel was to fupply what he con¬
ceived to be omiffions on the part of Sauvages : and hence
he gives a mufter of not lefs than 560 genera, being
nearly double the number of his great prototype. But,
to accomplifh this, he has been compelled to elevate to
the rank of genera a great multitude of affections which
ought only’ to be contemplated as fpecies, many of which
are merely fymptomatic of other difeafes, and not a few,
as Rifus* Fletus, Sufpirium, Clamor, (fome of them,
indeed, derived from Linnaeus,) which have no claim to
be regarded as difeafes at all. In hisclaflific arrangement,
while he takes Sauvages for his guide, he changes the
line of fucceflion as confiderably as, though in a'different
manner from-, Linnaeus. He degrades the Exanthema-
tici of the latter from aclaflific poll, and introduces them,
as well as the Phlegmafiae of Sauvages, as mere orders
under his clafs Feeres. He unites into one clafs the
Anhelationes and Debilitates of Sauvages under the
name of Adynamia; and, having thus reduced the
number of the Sauvagefian claffes to nine, he raifes them
to eleven by the creation of two new claffes, which he
calls HYPERCASTHESES,and Deformitates; the former,
properly enough, feparating Sauvages’s “ moralities of
the llomach” from genuine “ mental d Borders, ” and the
latter including external deformities of a prominent cha-
ra6ter. We ftiall enumerate his claffes according to his
own arrangement in the year 1764, as follows:

Febres, Fevers. Cachexia, General Debility.

Profiunia, Evacuations. Paranoia, Aberrations of

EpiJ'chefes, Suppreflions. Mind.

Dolores, Pains. Vitia, Superficial Deformi-

1 Spafmi, Spafms.- ties.

Adynamia, Debilities. Deformitates , Solid Defor-

HyperaJlheJ'es, Depraved Sen- mities.

fations.

His definitions are peculiarly concife, but convey too
frequently nothing more than general and indiftimfl
ideas : while his new-created terms are peculiarly long
and cacophonous, as in the words Hypofpadiaeos, Diony-
fifeus, and Hyperartertifcus. For his fpecies and varie¬
ties, or rather thofe he has not elevated to a higher rank,
he feems, like Linnaeus, to have depended, for the moft
part, upon Sauvages.

The fyftem of Sugar makes lefs deviation from that of
Sauvages than either of the preceding; and may be
regarded rather as an enlargement than a re-modification
of it. In various refpefls, indeed, it alters the feries of
fucceflion, but it retains the name of every clafs ; though
it increafes the number from ten to thirteen, by advan¬
cing the Sauvagefian orders of Plagje and Exanthe-
matica to the rank of claffes, and by introducing a
new clafs denominated Suppressiones, defigned to
correfpond with a confiderable part, though not the
whole, of the Supprefforii of Linnaeus, as Linnaeus in¬
tended this laft to correfpond with a confiderable part,
though not the whole, of the Anhelationes of Sauvages.
Sagar’s Nolology was publifhed in 1 776. His claffes
are —

The Sauvagefian genera are not much interfered with in
refpefl to number. Upon the whole they are rather ex¬
tended, and amount to 326. The generic names, how¬
ever, are occafionally altered, and the definitions, which
are formed by an almoft conftant reference from one ge¬
nus to another, are neceffarily drawn up in very differ¬
ent terms, in order to quadrate with fuch a change.

Vitia, Cutaneous Difeafes.
Flags, Wounds.

Cachexia, General Difeafe.
Dolores, Pains.

Fluxus, Fluxes.
Supprejfiones, Suppreflions.
SpaJ'mi, Spafms.

Anhelationes, Defecti ve Ref-
piration.

Debilitates, Debilities.
Exanthemata, Eruptions.
Phlegmajia, Inflammations.
Febres, Fevers.

Vejania, Madnefs.

PATH

Sagar’s definitions are moflly taken with little variation
from Sauvages; but are rendered intolerably long by-
confounding Sauvages’s generic characters with his ge¬
neric descriptions, and running the two together: fo that,
in (lead of eighteen or twenty- words, which is, perhaps,
the utmoft that ought to be allowed, and more than the
Linnaean canons permit in botany, we have Sometimes up¬
wards of a hundred, filling an entire page, as in rubeola,
whofe definition, if fo it may be called, extends to a
hundred and ten lines ; and in aphtha, which employs a
hundred and thirteen. He is lefs redundant in the num¬
ber of his genera than Vogel, though he makes a boall
of having extended them to 351. It would have been
better for him, as Cullen obferves, to have boafted of hav¬
ing exercifed, in an equal degree, his power of compref-
fion. The fyftem of Sagar is rendered more complete
than either Vogel’s or Linnaeus’s by being filled up with
his Species. Thefe, however, are deduced, with occa-
fional alterations, from Sauvages, and exhibit the Same
verbofity as his genera.

The main objeCt which- Cullen propofed to hiinfelf,
and a more important he could not laydown, was that of
brevity and Simplicity ; and the Sauvagefian claffification
(for Sagar’s was not then before the public) offended in
both refpeCls. He determined, therefore, upon changing
it, and re-calling the fyftem from its commencement.
Inftead of ten claffes, he conceived that four might Suf¬
fice, formed, as he propofed to form them, of a caliber
capacious enough to Swallow up all the reft. He moulded
his four claffes accordingly, and diftinguiftied them by
the names of

Pyrexia, Febrile Disorders. Cachexia, General Diforder.
Neurofes, Disorders of the Locales, Local Difeafes.

Nerves.

Influenced throughout the whole of his reform by the
Same Spirit of fimplicity 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 pruning hook into the field of Spe¬
cies ; Some he found to be repetitions of the Same difeafe
occurring under different genera, and others mere Symp¬
toms of other disorders, inftead of diftin<5t or idiopathic
affections ; all which were fteadily 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 enlifted into his own Ser¬
vice, moftly with the refpeCtive names affigned them by
Sauvages, though the definitions were generally re-com-
pofed, and apparently modelled in confonance with the
reformer’s own practical observations.

Thus completed and fit for ufe, the new fyftem was
firft darted in the larged medical School of Europe, its
author prefiding at the head of it. It is not, therefore,
furprifing, that it fliould inftantly have ruftied into popu¬
larity, and become a fubjeCt of general approbation. Yet
it did not (land in need of this adventitious Support to
introduce it to public favour. Its aim at fimplicity, as
wdl in extent as in arrangement, was noble, and befpoke
correCt views and a comprehenfive mind ; it promifed a
definable facility to the (Indent, and a chafte finifti to the
architecture of the nofological temple. The author
ftiowed evidently that he had laboured his attempt in no
ordinary degree ; and many of his definitions discovered
a maftery that had never before been exemplified : pic¬
tures painted to the life, and of proper dimenfions.

To this extent of praife Dr. Cullen is fairly entitled.
That his fyftem, nevertheless, has faults, and insurmount¬
able ones, it would be abfurd to deny; for they meet us
at the very outfet, and run through the whole of its tex¬
ture and conftitution. Dr. Good notices the errors and
inconveniences of the fyftem under the three following
heads: 1. DefeClive arrangement. 2. Want of discrimi¬
nation between genera and Species. 3. LooSeneSs of dis¬
tinctive character in the laft general divifion, or clafs.

Vol. XIX No. 1289.

O L O G Y. 83

We (hall have occafion to notice only the firft and laffof
thefe heads.

Of the four claffes adopted by Dr. Cullen, the firft two,
PYREXi-ffi and Neuroses, have considerable merit, and
this merit is exclusively his own. Each term fuggefts to
the mind at once a peculiar group of difeafes, of Sufficient
range for a leading divifion, and occupies a province pof-
feffing a Sort of natural outline, or urrondiffement , as the
French chorographers denominate it; in” which, if the
boundary occasionally fail or lofe itfelf in the adjoining
provinces, it is eafily Supplied by the hand of art. At
times, indeed, it Seems difficult, under Such a fyftem, not
to overftep the natural boundary imported by thefe terms
in their common life, and, like the late ruler of France,
to give in many parts a broader and an altogether arti-
iicial outline by the invafion of adjoining diftriCls ; and,
from the paucity of his claffes, Dr. Cullen has frequently
found himfelf compelled to Such a tranfgreffion, and has
afforded us a palpable inftanceof it in the very clafs with
which he commences ; for the tribe of Hemorrhages,
which forms one of its orders, have no direCt catenation
with any idea fuggefted by pyrexy in the common ufe of
the term ; they require coercion to bring them into a
date of union; and, what is (till worfe, Dr. Cullen, with
all the force he could employ, has found himfelf incapa¬
ble of coercing more than one half of them ; and, conse¬
quently, has been obliged to leave the other half behind,
or rather to banifti them for contumacy to the extreme
region of his fourth clafs. So that in his fyftem they ex¬
hibit a wide and lamentable divorce, and afford a ftriking
and perpetual memorial of the tyranny which pervades it
in Spite of its attractive exterior.

Still, however, the firft two claffes are fubftantially
good; and have in Some fliape or other been copied by
almoff every Succeeding nofologift. The third clafs has
all'o a claim to attention, though the term Cachexije, by
which it is denominated, has been ufed, and (till con¬
tinues to beufed, in Senfes fo extremely different by dif¬
ferent writers, that it by no means fuggefts to the mind
a conneffed group of difeafes, with the Same readinefs as
Pyrexiae or Neurofes. As a clafs, indeed, the divifion of
Cachexias occurs in all the preceding writers, with the
exception of Linnaeus; and fo far Dr. Cullen can plead
-authority'; in Linnseus it is reduced to a genus; and in
Vogel it is given, with lingular itnprecifion, both as a
clals and a genus, diftinguiftied by a mere difference of
number. Under every w'riter, however, the term is em¬
ployed in a various fenfe ; Sometimes importing depraved
external colour alone; Sometimes depraved colour and
form ; Sometimes depraved colour, form, and fize ; and
Sometimes, as in Cullen’s definition, deprived habit of
the whole or a great part of the body, withoutany notice
whatever of the preceding qualities.

But by far the moll faulty and incorrigible part of Dr.
Cullen’s arrangement confifts in his laft divifion, or clafs,
Locales. It has no Scientific relation to the preceding
claffes, no parallel or appofition with them. To have
brought it into any Such kind of bearing, the w hole of
the former ffiouki have been denominated conjunctively
Universales, as has been done by Dr. Macbride. But
this would have deftroyed the general calling of the ar¬
rangement, and have produced a divifion which was not
wanted, and perhaps does not exill. It mult be obvious
to the flighted obferver, that the Sole objeCt of this clafs is
to form an appendix to the three preceding, for the pur-
pofe of receiving, like the Cryptogamia ot the botanical
fyftem, Such genera as the foregoing claffes could not be
brought to include. From its name and capacity, how¬
ever, it is altogether inadequate to its intention ; and,
while the term (lands inlulated and without relation to
its fellow-terms, its intrinfic and effential idea (that of
articular “part or place”) creates an insurmountable
ar to the reception of a great proportion of the genera
which it is direClly intended to comprife.

Of thefe difeafes, therefore, Cullen has been obliged
Z to

84 PATHOLOGY.

to give a lift at the end of his Synopfis, under the title of
“ Catalogus Morborum a nobis omifforum, quos omiffiffe
fortafiis non oportebat 5” and has thought himfelf called
upon to offer an apology in his Prolegomena. “ Thefe
©millions,” fays he, “I confefs and regret; but various
reafons operated to the omiffion of fome difeafes. 1. In
the firft place it mnft be acknowledged that feveral utterly
efcaped our attention. 2. Next, there are others, Suffi¬
ciently known, for which a fit place cannot he found in our
fyftem. 3. And, laftly, there are others whofe hiftory
-among medical w'riters is fo imperfedf, that no fit place
or character can bealfigned to them.”

It is the fecond of thefe apologies, which we have
printed in Italics, that has determined us in the courfe
we have adopted, of rejedling the fyftem altogether.
Time and ftridter attention may overcome the evils t8
which both the others relate. But the utter want of fit
places for well-known difeafes in a nofological fyftem, and
this too, in the opinion of the author of the fyftem, is a
defedf from which no time or labour can ever relieve it.

, Since, therefore, the diftinguiflied reputation of Dr.
Cullen was incapable of fecuring to his nofological fyftem
the popularity with which it was at firft greeted ; we need
not wonder if a hoft of learned rivals, few of whom how¬
ever have humiliated him by their competitions, fnould,
in different parts of Europe, have endeavoured to offer
fchemes big with the fair promife of realifing the noble
objedf he had in view, and free from the defeats he has
exhibited. Thefe rival attempts may be fummed up in
a few words : for fuch is the difficulty of the fubjedl, that
none of them have been eminently fuccefsful ; while the
greater part have dropped from the cradle into the grave.

The chief foreign competitors are Selle, Plouquet, and
pinel. — Selle is rather a monogrammift, to borrow a term
from the vocabulary of natural hiftory, than a writer on
general nofology. His firft attempt was confined to the
province of fevers alone, and appeared at Halle in 1770,
under the title of “Methodi Febrium naturalis RudL-
menta:” and it was only to an enlarged edition of this,
publifhed at Berlin in 1786, that he fubjoined a fpecimen
of his general claffes. They are altogether theoretical;
and, as he has not accompanied them with their refpedtive
genera, it would be fuperfluous to copy the claffification.
The cloudinefs that hangs over his divifion of fevers
leaves us. without regret that he did not complete his
entire fciieme. It may be fufficient, perhaps, to obferve,
that in his “ Methodical Pyretology,” rheumatifm, ca¬
tarrh, and exanthems, are included under a fingle genus.

The “ Outlines” of Plouquet furnifh a fyftem that wan¬
ders lefs into theory ; but which is far too complicated,
and certainly not without its nebulofity. It was pub-
lifned at Tubingen in 1791, in four volumes odlavo,
under the following title : “ Delineatio Syftematis Nofoio-
cise naturte accommodati.” It is fingularly diftinguiflied
by the author’s fondnefs for long crabbed words. He
made a far better prefent to the public a few years after¬
wards in his “ Initia Bibliotheca il ledico- praftica, et Chi’
rurgia realis ; or Hints towards a Medicaland Chirurgical
Library,” extending to feven volumes quarto, in the
order of an alphabetical arrangement.

To Pinel, as to Selle, we are indebted for both a mo¬
nographic and a general attempt. The firft is his well-
known “Traite Medico-Philofophique fur P Alienation
Mentale ;” the diviiions of which are clear, and the re¬
marks of high practical importance. The prefent writer
will be found to have availed himfelf, as far as poflible,
of the advantages which this excellent treatiie affords,
under the article Insanity, voi. xi. He has not, how¬
ever, been able to make the fame ufe of M. Pinel’s “ Phi-
lolophical Nofography.” It is too refined for popular
ufe, and too indiftindl for pradlical benefit. The claffes
are as follow : 1. Fevers. 2. Inflammations. 3. Adtive
Hemorrhages. 4. Neurofes. 5. Lymphatic Difeafes.
6. An indeterminate clafs for the reception of diforders
which cannot be received into the preceding claffes, or

whofe charadters yet remain to be afcertained. This laft
divifion evinces a woeful want of fkill, and is perhaps
more reprehenfible than the Locales of Dr. Cullen. M.
Pinel has, moreover, betrayed a Angular itch for changing
eftablilhed terms which, in many cafes, require no change
whatever; and fuperfeding them by others which are
neither more true to corredt theory, nor more euphonous
to a corredt ear. As examples we may notice, that in¬
flammatory fever is here denominated angi-fienic ; bilious
fever, meningo-gafiric ; putrid, adynamic ; malignant,
ataxic.

In turning our attention to our own country, w-e fhall
perceive that the firft attempt to improve on Cullen’s
fyftem was hazarded by Dr. Macbride. It was publifhed
as early .as 1772, and confifts of nothing more than a
nofological table, embracing indeed the divifions of ge¬
nera and fpecies (except in the order of Vefaniae, which
is left imperfedt, from an indetermination in the author’s
mind upon this fubjedl), but totally void of definitions.
It is the opinion of Dr. Good, that this unfinifhed Iketch
is well worthy of attention, and has not had fufficient
juftice rendered to it. Its chief failure confifts in the
nature of its claffes or primary divifions. Thefe confift
of four; Universal Diseases, Local, Sexual, and
Infantile. The fecond, or local clafs, is evidently de¬
rived from Dr. Cullen, though the term is employed in
a ftridler fenfe : and the formation of a clafs of Univerfal
Difeafes follows naturally, and indeed neceffarily, from
the inftitution of a clafs of Local. A precife line of dif-
tindlion, however, can never be drawn by the moft de¬
licate hand ; and it is obvious to every one, that the em¬
ployment of other -claffes after thefe, whatever be their
names, ranges, or attributes, muft be abfurd ; for the
terms Univerfal and Local neceffarily include every dif-
eafe in nature, and leave no other diftindtive clafs to be
added. Yet Dr. Macbride appears to have exhibited as
nice a fkill in the arrangement of his genera and fpecies,
as he has want of fkill in his primary outline. There is
a clearnefs, a neatnefs, and fimplicity, which, fays Dr.
Good, “ J have endeavoured to avail myfelf of, wherever
the ftrudture of my own fyftem w'ould allow, and which
I have often left with regret where it would not.” No¬
thing can moreeffedlually fhow the good tafte and liberality
of Dr. Cullen, than his Latin tranflation and introduc¬
tion of the firft and moft extenfive clafs of Macbride’s
Table into the laft edition of his Synopfis, for the purpofe
of comparifon with his own arrangement, as well as with
the fyftems of thofe to whom he was moft indebted.

Another Table of Difeafes, diftributed under a diffe¬
rent fyftematic arrangement, was publifhed not many
years after, by Dr. Crichton ; and, like the preceding,
unaccompanied with definitions of any kind. Its claffes
are eight, confifting of Cullen’s four, with the addition
of four others, for the purpofe of accommodating thofe
genera which are chiefly under a ftate of reftraint in the
Cullenian method ; and to which he has given the names
of H/t.morrhagijE, Fluxus, Intumescentije, and
Epischeses. This affuredly offers fome improvement ;
but the retained clafs Locales is fubjedt to the common
objedfions againlt it; and in the fubdivifions of this clafs
Dr. Crichton has no reafon to boaft of being more fuccefs¬
ful than his predeceffors. He feems fenfible, indeed, of
the difficulty, and appears to ftirink from it; for in the
fourth, fifth, and fixth, orders of the local clafs, entitled
Prolapfus, Luxatio, and Tumores, he has withheld his
fpecies; and in the three enfuing orders, entitled Vul-
nus, Ulcus, and Fradtura, he has equally withheld
his genera. For the moft part his generic and fpecific
diftindtions exhibit far lefs precifion than thofe of Dr.
Macbride, whilft he has moft unaccountably reftored the
fymptomatic fpecies of difeafes which Cullen laboured fo
meritorioufly to fupprefs. It is fomew'hat Angular, therefore,
that Dr. Crichton fliould have belt fucceeded where Dr.
Macbride principally failed, and chiefly failed where
Macbride has been moft fuccefsful.

Dr.

PATHOLOGY.

Dr. Darnin' s fyftem of nofology, publifhed indeed
fome years before Dr. Crichton’s, is founded, not on
fymptoms, but on theory. The author of Zoonomia was
a man of great genius, daring imagination, and extenfive
reading. Seep. 43. Unfortunately for him, he was per¬
petually ftung with a defire of diftinguifhing himfelf by
feeing things, weighing things, and combining them, in
a manner different from every one elfe. All his works
give proof of this; and fliow evidently that he would at
any time rather think wrong with himfelf than think
right with other people. His nofological fyftem is
founded upon his phyiiological principles ; which, ftripped
of extraneous matter, may be told in few mords, fo far
as they are applicable to the prefent fubjeCf. The brain,
as a collective organ, is the fountain of life and fenfation,
and fends forth fibres of different kinds and for different
purpofes; which are excited, and communicate percep¬
tions to the organ whence they originate, by four diffe¬
rent claffes of ftimuli, thofe of Ample irritation, of fen¬
fation, of volition, and of aflociation ; every part of the
animal frame having a greater or lefs degree of influence
upon every other part, and operating this influence by
the medium offympathy ; in confequence of which, Dr.
Darwin was defirous that his own theory fttould take the
name of the fympathetic. “ Every idea," fays he, “is a
contraction, or motion, or configuration of the fibres which
conftitute the immediate organ of fenfe;” and hence it
feems difficult for the friends of Dr. Darwin to repel the
charge, that ideas, under this explanation, mult be ma¬
terial fubftances. Health he contemplated as confifting
in the natural correfpondence, and degree of correfpon-
dence, of the various organs of the body to their respec¬
tive ftimuli, and difeafe as an effed produced by any, even
the flighted, deviation from fuch correfpondence in any
part. Hence every fuch effed, in his opinion, conftituted
a difeafe; and what is commonly fo denominated, and
which confifts of a combination of fymptoms, as a fever
or a colic, he regarded as a group or bundle of dileafes ;
a fort of Pandora’s box, where they mufter their fecret
or collective ftrength, and whence they iffue fimulta-
neoufly. In forming his nofological arrangement, he
made thefe effects, and the parts or organs in which they
manifeft themfelves, conftitute his genera and fpecies ;
while he derived his claffes and orders from their proxi¬
mate (or rather what upon his theory are fuppofed to be
their proximate) caufes, and the peculiar characters which
thefe caufes exhibit; the number of the clafles being
four, derived as may be eafily conjeCtured from the four
fpurces of ftimulation juft referred to. “ I have taken,”
fays Dr. Darwin, “ the proximate caufe for the claffic cha¬
racter. The characters of the orders are taken from the
excefs, or deficiency, or retrograde aCtion, or other pro¬
perties, of the proximate caufe. The genus is generally
derived from the proximate effed. And the fpecies gene¬
rally from the locality of the difeafe in the fyftem.”

By proximate caufe, however, Dr. Darwin does not
mean what is generally underltood by this phrafe, namely,
the molt ltriking or charaCteriftic fymptom of a difeafe ;
but what Ihould feem to be the proximate caufe upon his
own theory, and which in every inftance mufi be a differ¬
ent and often a direCtly oppofite thing. Thus in nicti¬
tation, the proximate caufe, in the common fenfe of the
term, is a “ rapid and vibrating motion of the eye-lid,”
which ought, therefore, to conftitute the character of the
diforder. In the vocabulary of Dr. Darwin, however,
this, inftead of being the proximate caufe, is the proximate
effed ; while his proximate caufe is “increafed irritation,”
which is the remote caufe, as the phrafe is commonly ex¬
plained. We are not now inquiring which is the more
correCt ufe of the terms caufe and effeCt, but only pointing
out the variance and the confufion that hence neceffarily
enfue. The perplexity hereby produced rnuft have been
an effectual bar, had there been no other, to Dr. Darwin’s
fyftem ever becoming popular. Unfortunately there are
many others, and of as formidable an afpeCt. The en¬

tire bafis is theoretical ; in feveral parts vifionary : the
whole may, therefore, prove hereafter to be unfounded ;
a confiderable portion of it evidently is unfounded at
prefent. But the direCt death-warrant of the fyftem con¬
fifts in his making every Angle proximate effed (in com¬
mon language proximate caufe, or fymptom) a diftinCl
difeafe ; for, as the fame proximate effeCt, or fymptfc>m,
may be produced by feveral, or by each, of what Darwin
calls proximate caufes, and which conftitute his claffes,
it follows that the very fame fpecies or fpecific difeafe
mu ft in fuch cafes belong equally to fome order or other
of feveral or of all the clafles of his fyftem. And fuch,
to the ftudent’s embarraffment and furprife, lie- will find
upon examination to be the real faCf. Thus while Va-
liola (fmall-pox) is arranged under cl. ii. ord. 1. gen iii.
Eruptio Variolas (fmall-pox eruption) occurs under cl.
iv. ord. 1. gen. ii. So Hydrophobia appears firft in i. 3.
i. and afterwards in iii. 1. 1. Diabetes in i. 3. ii. and again
in iv. 3, 1. Palpitation of the heart in i. a. i. and again
in i. 3. iii. being twice in the lame clafs : and fo of many
others.

Such perplexity fets all the ordinary laws of method at
defiance ; yet it is eafily accounted for from the nature of
the primary divifions. While, to make the fyftem ftill
more defective ‘and incapable of practical ufe, its author
has given us neither his fpecific nor his generic definitions,
excepting, indeed, occafionally ; confining himfelf en¬
tirely to his Latin and Engliffi names ; and fending us
for their deferiptions to “ the Nofologia Methodica of
Sauvages, and the Synopfis Nofologise of Dr. Cullen, and
the authors to which they refer.” But fuch an appeal
can be of no poffible fervice : the difeafes in Darwin’s
fyftem do not run parallel with thofe referred to, and
the deferiptions will icarcely in any inftance apply.

In the very excellent Medical Dictionary of Dr. "Parr,
which has now been about twelve years before the public,
the reader will find, under the article Nosology, a fyl-
tematic arrangement of difeafes which ought by no means
to pafs without notice.

In laying down the outline of his fyftem, Dr. Parr had
his eye chiefly directed to the nofological method of Selle,
and the botanical method of Juffieu. It follows, there¬
fore, that his primary divifion would confift not of claffes,
but of what he intended to be natural orders, or families.
Thefe orders are twelve, whofe names are taken from the
clafles or orders of Sauvages or Cullen, with the excep¬
tion of one, Suppressor.ii, which is borrowed from Lin¬
naeus.

Here again, therefore, we have a great and noble aim,
whatever be the fuccefs of its accomplifhment. But, as
a natural fyftem, even in botany, is to the prefent hour,
and perhaps always will be, a theoretical rather than a
practical idea, there feems very little expectation that it
can ever be realifed in medicine. On the part, therefore,
of Dr. Parr, the attempt was a bold one ; and his arrange¬
ment will ffiow that, if he has not been altogether fuc-
cefsful, he has exhibited a very confiderable degree of
ingenuity. This arrangement is as follows :

Pyrexia, Fevers.
Phlegmafia, Inflammations
Eruptiones, Eruptions.
Profluvia, Fluxes.
Supprejj'orii, Suppreffions.
Spajmi, Spafms.

Adynamia, Debilities.
Paranoia, Alienations.
Cachexia, General Diforder.
Intumefcentia, Tumours.
Edopia, Protrufions.

Pluga, Wounds.

Between moftof thefe we can trace, in the feries of their
defeent, a verbal connexion ; and between feveral of them
a connexion of a more fubftantial kind. It holds nomi¬
nally in the firft three orders, but feems to flip from us
in the three that follow ; and is occafionally recovered in
the remaining. Yet, when we examine the genera and
fpecies of the refpeCtive orders, we fliall find the con¬
nexion is too commonly nothing more than verbal.
Phlegmasia has a manifeft relation to Pyrexia ; but
in Caeliaca, Leucorrhcea, Leucorrhois, (difeharge of white

mucus

86

PATHOLOGY.

mucus from the anus,) which are difeafes of the former
order, the connexion is entirely loft: nor will it, per¬
haps, meet with general approbation that thefe, together
with Gonorrhoea (ufed in the vulgar fenfe of the term),
Cyftirrhcea, and Phthifis, (hould be united with Coryza
and Dyfentery, under one common genus, to which is
given the name of Catarrhus. This, however, is a genus
upon which Dr. Parr peculiarly prided himfelf, and upon
which he unqueftionably bellowed very great pains. In
like manner the order Eruptiones feems at firft to claim
a near affinity with Phlegmasia ; and in the genus Ex¬
anthema it does fo fubftantially, -for here we can trace
diftinCtly fomething of that febrile, or, to fpeak more cor¬
rectly, pyreCtic diathelis, which unites thefe two orders
with the order Pyrexia. But in the mere cutaneous
eruptions, here collected into one genus, named Efflo -.
rf/ceniia, the line of union becomes fo fine and filmy as
to be altogether invifible. Were we to purfue this prying
indagation, we fliould foon arrive at breaks far wider and
more obvious. It would perhaps be difficult to find four
difeafes more difcrepant from each other than Dyfpepfia,
Amentia, Amaurofis, and Agenefia. They feem to have
no one common property with each other. Dr. Parr,
however, has contrived to make them all fpecies of a
fingle genus, to which he has given the name of Anepi-
thi/mia, and which he has defined, “a diminution of power
in the different functions a character fufficiently (weep¬
ing to cover at leaft half the difeafes that man inherits ;
for excefs and diminution of power may eafily he made
to embrace the whole; and are made to do fo under the
Brunonian theory. Yet, notwithftanding this licentious
generalization, and aim at a natural arrangement, the
difeafes of the external fenfes, which feem to have a pretty
clofe proximity with each other, are partly fcattered at
conliderable diftances over the entire fyftem, and partly,
as in the inftances of Caligo, Dyfopia, Paracufis, Anof-
mia, Ageuftia, and Antefthefia, are in the unfortunate
fituation of Dr. Cullen’s “ Catalogus morborum a nobis
omifforum and, from forgetfulnefs orfome other caufe,
have no place allotted them in any feCtion of the fyftem.

There is, neverthelefs, much in Dr. Parr’s fyftem that
is highly meritorious. The diftinCtions of the different
divifions are fcientifically laid down ; and, except that
the genera are occafioually too extenfive, accurately
maintained. Dr. Parr gives the following fhort explana¬
tion of his own fyftem : “ In this arrangement there is
a concealed methodus, which, as it is notan objeCt of
importance, we need not explain farther than by adding,
that feverilh complaints, increafed and diminillied eva¬
cuations — increafed, diminifhed, and irregular, nervous
excitement — difeafed fluids, appearing either in increafed
or diminifhed bulk— the difplacements and folutions of
continuity — follow in order.”

Dr. Young's “ Introduction to Medical Literature, in¬
cluding a Syftem of Practical Nofology,” though limited
to a fingle oCtavo, ranges through an entire courfe of
medical education, anatomical, pathological, therapeuti¬
cal, and chemical, as well as nofological; whilft in the
laft department it is drawn up with a fomewhat different
view, and is more ft riCt ly limited to the pale of the me¬
dical profeifion. The arrangement of Dr. Young, while
effentially diftinCt from that of Dr. Good, will be found
perhaps to make the neareft approach to it of any that
lias hitherto appeared. In wanting the divifion of orders
to two of its clafles, it is fcientifically defective ; but its
fyftemntic boundaries are as clearly feen, and as precifely
maintained, as thofe of Dr. Parr. Yet its chief merit,
perhaps, confifts in offering to the ftudenta mafterly gui¬
dance, through the whole of his profefiional tuition, to
the heft authorities and fources of information ; in this
refpeCt anfweringthe purpofe of Plouquet’s feven quarto
volumes, with a great faving of expenfe, a prodigious
laving of time, and by a far nearer and pleafanter path¬
way.

A glance has already been given atafevv limited nofo¬

logical arrangements, by writers who have confined their
attention to a fingle family or group of difeafes, detached
for this purpofe from the reft; and to this defcription of
works Dr. Good has applied the name of monograms. To
the names of Selle, Pinel, and Crichton, it is neceffary to
add, under this view of the fubjeCt, thofe of Plenck,
Willan, Bateman, Abernethy, and Granville.

Dr. Plenck, of Baden, is the author of two diftinCt
treatifes of this kind; the one a methodical arrangement
of the “ Difeafes of the Eyes and the other of “ Cuta¬
neous Difeafes.” In the former he follows the order of
anatomy in the diftribution of his primary divifions, be¬
ginning with the eye-brows, and defcending from with¬
out inwards till he clofes with the retina. In the latter,
which confifts of clafles, genera, and fpecies, without the
interpofition of orders, he employs a loofer line of fuccef-
fion; though the general idea feems to be that of advanc¬
ing from the (lighter to the more prominent elevations of
the (kin, commencing with Macula, and proceeding to
Excrescentia ; the remaining clafles confiding of Cu¬
taneous Ulcers, Wounds and Insects, Diseases of
the Nails and of the Hair. He is a more induftrious
than difcriminative writer, as the reader will perhaps
readily concede, when informed that he has arranged,
defined, and followed, through their progrefs and mode
of treatment, a hundred and nineteen genera, comprifing
very nearly fix hundred fpecies, or diftinCt difeafes of the
eyes, the genus amaurofis alone extending to twenty
fpecies; and one hundred and fifteen genera, including
nearly fix hundred fpecies, or diftinCt difeafes of the
(kin.

Yet compreffion, and a more fcientific 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 Difeafes;” and at the fame time of hav¬
ing added fo much valuable matter of his own, as to
entitle it to the claim of being ftriCtly an original per¬
formance. The diftinftive characters of papula, puftule,
veficle, bleb (bulla), fcale, and cruft, are well given and
maintained by the former; but the latter has exprefled
them more neatly, and has added many diftinCtions which
the former does not afford ; whilft he has drawn his
literary and practical hiftory, and treatment of the dif¬
eafes difcuffed, from very different fources ; and, as far
as might be, from his own perfonal obfervations. That
Dr. Willan did not live to finiffi this valuable work muft
be regretted by every one who has the welfare of medi¬
cine at heart ; but the able and judicious manner in which
it has been brought to a clofe by Dr. Bateman has ferved
in no fmall degree to abate the general difappointment.
Had Dr. Willan lived to complete the direCt objeCt of his
purfuit, and then extended his views to the whole circle
of difeafes, he muft have greatly modified his firft and
more reftriited fyftem before he could have incorporated
it in the larger plan. As it is, indeed, it (lands in need
of no fmall degree of modification to clothe it with all the
perfeftion it deferves ; for feveral of his orders would
make better genera almoft all his genera are decided
fpecies, while his fpecies are feldom more than varieties,
and are in many cafes fo denominated by himfelf. In this
refpeCt he might have taken a good leffon from Dr. Young,
Dr. Parr, or Dr. Macbride ; as he might alfo from the
two former in giving the eflential character of each dif-
eafe antecedently to the admirable defcription with which
it is followed up.

The name of Mr. Abernethy is here mentioned in refe¬
rence to his methodical “ Claflification of Tumours.”
This claflification is ltriCtly fymptomatic, the characters
being derived, as they ought ever to be, as much as poffi-
ble, from fenfible phenomena.

The laft monogram we have to notice is a “ Claflification
of the Difeafes of Children,” by Dr. Granville, principal
phyfician to the Royal Infirmary for Sick Children ; and
detailed by him in the London Medical Journal for De-
3 cember

87

PATHOLOGY.

cember laft (1820), of winch work he is at prefent the
editor.

Dr. G. in his addrefs to the then editor, obferves,
“ You mud have been ftruck, in common with every
other practitioner of this or any other country, with the
fingular circumftance of no regular claffification of infan¬
tile difeafes having ever been propofed by the feveral
eminent authors who have written on that particular
branch of medicine ; and you will probably agree with
me, that no-where is the neceility of fuch a claffification
' likely to be more felt than in an extenfive inftitution di¬
rected folely to the alleviation of thofe difeafes, where
daily and numerous occafions mutt occur for its ufe. In
the Infirmary to which I have had the honour of being
appointed principal medical officer, it would fcarcely have
been poffible for the phyficians and furgeons belonging
to it to have preferved any degree of uniformity in the
medical records of that inllitution, had we relied on the
ufual routine only, of entering the names of patients
without any very precife and uniform defignation of
their complaints. It became, therefore, necefl'ary to efta-
blifh fomething like a Synopfis, by the help of which, as
if with the ufe of a common language, we might become
intelligible, not only to each other but alfo to the profel-
fion in general; the members of which may hereafter wifh
to refer, for many ufeful fubjefts of information, to the
regifters of the Royal Infirmary.

“ How far the prefent attempt to form fuch a Synopfis
may fucceed in removing the difficulties which, like
thofe experienced in general pradtice before any nofolo-
gical arrangement of difeafes had been eftablifhed, muff be
felt in the confideration of infantile complaints, I leave
my colleagues and the public to decide. I have no pre-
tenfions on the fubjeCt, and I give my prefent fpeculation
as a mere attempt; happy if it ferve to ftimulate more
competent perfons to fill upthechafm which has hitherto
exifted in nofological fcience. The names of Heberden,
Rofen, Capuron, Burns, and Underwood, not to mention
feveral others, muff be familiar to thofe who have paid
particular attention to the difeafes of children. The de-
fcriptive obfervations and pradtical remarks of thefe emi¬
nent men leave fcarcely any thing to be wiflied for; yet
it muft be admitted that, had thofe defcriptions and re¬
marks followed fome fpecific arrangement, the facilities
for their ltudy and their retention would have been greater
than they now are.

“ The plan of the prefent claffification is as follows : I
have, in the firft place, confidered all deviations front
healthy adlion or healthy ftrudturein children, as having
either begun with their fetal life and formation, or deve¬
loped themfelves at the moment, and in confequence, of
parturition. Thefe, therefore, form a firft great divifion,
very diftindl from that of any other complaint w-hich may
afflidt a child fubfequently to its birth and up to the adult
age. To this firft great divifion, I have'applied the deno¬
mination of Morbi Congenili, and I have necefi'arily been
obliged to make two -clafles of it; in the former of which
I have placed all difeafes or deviations from healthy
ftrudlure previous to, and confequently independent or,
parturition ; wdiile in thefecond thofe congenital difeafes
have been arranged which are connected with, cr depen¬
dent on, parturition. The difeafes embraced by the firft
of thefe two clafles of the firft great divifion are by far
more numerous than thofe of the fecond clafs ; and, in
order to facilitate their recollection, they have been fub-
divided into ten orders, each order containing an unequal
number of genera, in all forty-five. Two orders only
are contained in the fecond clafs : i, topical ; 2, univer-
fal ; each being fubdivided into five genera.

“ Having thus difpofed of all the difeafes which, from
their being coeval with the patient, form a well-defined
and diftindl divifion, it remained for me to arrange all
thofe deviations from health which are known to "occur
fubfequently to birth and as late as the adult age, whether
peculiar to the period of time that lies between thefe two

Vol. XIX. No, 1289.

epochs, or likely to affedl children in common with per¬
fons more advanced in years. Thefe two confiderations
gave rife to a fecond great divifion, which I have defig-
nated by the name of Morbi SubJ'eqtienles,a.% quite diftindl
from thofe which formed the fubjedl of the preceding
remarks.” This fecond great fedlion is divided into four
clafles, and each clafs into two orders ; the genera are
96, which added to 55 in the firft grand divifion, make a
fum of 1 51 genera of difeafes with which children are
afflidted. How numerous the particular fpecies may be we
are left to conjedlure, as the author fays, “ I have not
extended my confideration to either fpecies or varieties,
as this would have carried me too far.”

This Synopfis has been printed on a card, for the con¬
venience of lludents. Omitting the names of the genera,
the claffification will appear as follows :

I. Morbi congeniti.

Clafs I. Atocica. Congenital Difeafes independent
of Parturition.

Order 1. Atrefis. Natural openings imperforate.

2. Collifis. Unnatural adhefions.

3. Hiazeuxis. Unnatural feparations.

4. Elatojls. Defective organization.

5. Perifleuzis. Superfluous organization.

6. Hydrops. Unnatural accumulation of fluids.

7. Edopiee. Difplacements.

8. Affymetria. Anti-fymmetrical conformation.

9. Purcejlhefis. Defedlive adlion of fenfes.

10. Metrocehs. Marks.

Clafs II. Tocica. Congenital Difeafes dependent on
Parturition.

Order 1. Topici. Partial.

2. UniverJ'ales. General.

II. Morbi subseouentes.

Clafs I. Zotica. Morbid Alterations of the preferva-
tive Fundtions.

Order 1. Pneumalici. Affedling refpiration.

2. Hcematici. Affedting circulation.

Clafs II. Auxitica. Morbid Alterations of the augmer.-
tive Futidlions.

Order 1. Cccliaci. Affedting digeftion.

2. Lymphatici. Affedling abforption.

Clafs III. Apocritica. Morbid alterations in the fegre-
gating Fundtions.

Order 1. Eccritici. Alfedting fecretion and excretion.

2. Hermatici. Affedting exhalation.

Clafs IV. AUsthetica. Morbid Alterations of the fen-
fiti.ve F undtions.

Order 1. Ncurotici. Affedting fenfation.

2. Myolici. Affedting voluntary motion.

We hail the eftablifhment of an Infirmary for Sick
Children, as likely to form a new era in favour of the
rifing generation ; for we cannot doubt that it will havb
its effedl in improving a branch of medical pradtice, of
which it is not too much to fay, that it has hitherto been
unaccountably negledted. “ In no department of our
profeffion (fays Dr. Reid) does the pradtice of it appear
fo cruelly abfurd as in the mifmanagement of infants. I
once ventured to obferve, that, of the cafes of mortality
in the earlier months of our exiftence,nofmall proportion
confifts of thofe who have funk under the oppreifion of
pharmaceutical filth. More infantile l'ubjedts in this me¬
tropolis are perhaps diurnally deftroyed by the mortar
and peftle, than, in the ancient Bethlehem, fell vidtims
in one day to the Herodian mafiacre. I plead guilty to
the charge of rafhnefs and hyperbole, which were brought
againft this remark when firft publiffied ; but I wifh that
the years of experience, which have fince intervened, had
convinced me that the remark was altogether deftitute of
foundation. When we contemplate a church-yard, the
earth of which is compofed in great meafure of the bodies
of infants, it is natural for us to fancy, but furely it is
A a not

88 PATHOLOGY.

not reafonable for ns to believe, that t-hofe beings were
born for no other purpofe than to die; or that it is within,
the defign of nature that the pangs of production on the
part of the mother fltould, on that of her offspring, be
almoft immediately fpcceedbd by the ltruggle of diffblu-
lution. Fault mud exilt fomevvhere : it cannot be in the
providence of God; it mu ft therefore -attach to the im¬
providence and indifcretion of man. Confequences as
fatal originate from ignorance as from .crime. Infanticide,
when perpetrated under the impulfe'of maternal defpera-
tion, or in the agony of anticipated difgrace, is a fubjeft
of aftonifhment and horror ; but, if a helplefs viftim be
drugged to death, or poifoned by the forced ingurgitation
of nauleous and effentially-noxious potions, we lament
the refult merely, without thinking about the means
which inevitably led to its occurrence. Confcience feels
little concern in cafes of medicinal murder. The too-
ordinary habit of jelling upon thefe fubjefts in convivial
or familiar converfation, has an unhappy tendency to
harden the heart, and inclines us to regard, with an inhu¬
man and indecorous levity, thofe dark and horrible cataf-
trophes which too frequently arife from profeffional igno¬
rance or miftakeT Efiays on Hypochondrialis ; 2d edit.
1821.

Some other fyftems of inferior importance have appeared
in different countries, efpecially in Germany. We pafs
over them, however ; and, difmifting this uninterefting
branch of our fcience, retrace our Heps to conlider the
moll important of the modes in which difeafe, or a change
from the phenomena of healthy action, may arife.

An inquiry into the abllraft principles of difeafe is a
fubjeft of acknowledged difficulty. The very definition
of the word difeafe involves more trouble than might at
firft feem apparent, and is indeed a matter about which
there exifts much difference of opinion. We content
ourfelves, therefore, with the life of the laconic definition,
that difeafe is the abfence of health, acknowledging, how¬
ever, that this defcription involves the definition of
what health is. But the latter queftion is anfwered by
Phyfiology, a fcience with which the . pathologift is fup-
pofed to be previoully acquainted.

We do not propofe to enter into a confideration of the
minute and remote caufes of difeafe. It would not per¬
haps be difficult to lhow, that the firft changes which
take place in the various ftruftures mull operate by their
relation with the vital properties. This, of courfe, ap¬
plies principally to thole caufes which produce what is
called the predifpojition to difeafe. A predij'pofing cuvj'e is
that which renders the body liable to be attacked by dif¬
eafe, or to be afted upon by an exciting caufe ; for the
operation of an exciting caufe alone is generally not fuf-
ficient to produce difeaie. Thus feveral perfons may be
expofed at thefame time to the fame external agents, e. g.*
to cold and moifture : in forne, thefe agents will excite
difeafe ; on others they will aft with impunity. In the
former perfons, fome circumftances mull have exifted
which rendered them liable to receive thofe morbid im-
preffions; in the latter, no fuch predifpofition was pre-
fent. Again, fome of thofe, whom the exciting caufes
affefted, may fuffer one kind of difeafe, and others a dif¬
ferent one; thus, one individual may be afflifted with
rheumatifm, another with catarrh, a third with dyfentery,
and fo on ; fafts implying the exiftence of fome peculiar
condition of the body, or of the organs refpeftively at¬
tacked, w hich is juftly deemed a predifpofing caufe of the
particular malady which may have occurred. In fome
inftances, the predifpojition is obvious and well under-
ftood : thus one attack of rheumatifm, pleurify, or any
inflammatory diforder, generally renders the body more
liable to fuffer a fecond : a peculiar formation of thecheft,
combined with a fair and delicate fkin, with dark eyes,
lively fpirits, &c. implies a tendency to be affefted with
pulmonary confumption : and a plethoric habit, large
head, Ihort neck, very florid complexion, &c. threatens
the acceffion of apoplexy. In fuch circumftances the

kinds of exciting caufes, which ought to be peculiarly
avoided, are manifeft ; and by a careful attention to this
fuggeftion, the difeafes, with which the individuals are
menaced, may be often avoided.

The exciting is the next mode of remote caufation, and
is of courfe an agent which operates for the moll part by
the relation it holds with the predifpofing caufe. The ex¬
citing caufes of difeafe have given rile to many and va¬
rious hypothefes. Hippocrates fuppofed that diet and
air were the externals whence difeafe w\as principally de¬
rived ; and certainly, as thefe are the pabula vita:, as they
conllitute the repair necefiary to our exiftence, an unufual
Hate of them mull produce a correfponding change in the
fenfations and funftions of our bodies. We can only
therefore add to thefe exciting caufes, mental impre.ff.ons
and exceffive aftion, or the reverfe, of certain organs.
But there are fome exciting caufes fo very generally af-
fefting mankind as to lead us to fuppofe that they operate
independently of any ftate of predifpofition ; as the poifon
of fyphilis, fmall-pox, rabies, &c. Though even thefe
difeafes do not feem uninfluenced by the Hate of confti-
tution, as they exilt in various degrees of intenfity in
different individuals.

As thefe exciting caufes of difeafe can come only from
without, they mult operate in the firft inltance through
the medium of thofe parts by which man is related with
the external world. Thefe are the organs of fenfe, and
thofe unions of the three fundamental ftruftures which
have been denominated the alimentary canal , the pulmonary
cavity, and the cutaneous expavjion. As thefe three ftruc-
tures are all affimilation or abforption, and at the fame
time abundantly fupplied with nerves, they mult commu¬
nicate morbid impreffions, either, ill, by ailimilating fub-
llances of an improper nature ; of which we have frequent
inftances in the reception of poifons, &c. into the blood,
in thetranfmiffion of the marlh miafmata, or the contagion
of fevers, &c. or 2dly, by tranfmitting nervous impreffions
to the brain, and inducing diforder of that organ, and the
nervous fyllem generally. Each of thefe modes may, ac¬
cording as predifpofing caufes are in exiftence,' produce
local difeafe, or dilturbance of general funftions.

But it is very obvious, that, however firmly thefe no¬
tions may be eftablilhed, we advance but a very little
way in attaining a knowledge of exciting caufes. Bor,
fo various are the modes by which externals may operate,
fo many infcrutable and various properties belong to
food, and Hill more to air, and fo numerous mull be the
derangements produced by nervous excitation, that the
attempt to trace the law's of thefe caufes will for ever re¬
main inefficient.

The operation of the fenfes can of courfe only induce
diforder of the brain and nervous fyllem by exhaulling
its energies ; whether that exiiaullion be produced by
excitement of the brain generally, or of its particular
parts ; or, on the other hand, by the depreffion of them.

To illuftrate thefe principles, we will fuppofe a patient
afflifted with a ftate of the liver predijpojc.d to difeafe. Is
mental emotion by exceffive grief, that is to fay, is the
produftion and tranfmiffion of nervous energy, dillurbed
by the inordinate aftion of the brain? the procefls of
fecretion in the liver will be obftrufted ; and thus induce
firnple local plethora, perhaps the fimpleit form of difeafe.
On the other hand, difeafe may occur in the predij'pofed
liver by the immediate application of an improper mate¬
rial received into the blood, and afting as an unufu'al
Itimulus to the contraftile power of the capillary velfels
of the liver; hence, in the fame way, impeding fecretion,
&c.

Of the application, however, of thefe doftrines, we
fhall have occafion to give very frequent illuftration in
the pathology of particular difeafes. We have now to
conlider the nature of what is called the proximate caufe
of difeafe. The precife meaning attached to this term
is, that it delignates an adtion of the body, in contra-dil-
tinftion to Hates of impreffions which conllitute remote

caufes.

PATHOLOGY. 89

caufes. The proximate caufes, therefore, of difeafes,
muft be alinoft as numerous as the difeafes themfelves ;
and hence they will form part of the pathological dif-
cuflion we (hall enter into with regard- .to each different
malady. In this place, however, it will be proper to of¬
fer fome remarks concerning the local origin of difeafe.
That difeafe may, and indeed generally does, arife from
lofs of the balance of abfion between one part and the fyf-
tem at large, feems indifputably proved. How far, how¬
ever, this part may proceed in difeafed action without
influencing the general health, is another and an impor¬
tant confideration. Having lately met with fome re¬
marks on this head by Mr. Pring, we have tranfcribed
them from his “ Indications,” on account of the clofe
reafoning with which he has illuftrated the fubjedf.

“There are but few (perhaps not any) examples of
difeafe which is confined wholly to one part. There are
many inftances of difeafe of one part, in which the or¬
ganic fyftem elfewhere does not perceptibly fuffer : but
thefe are attended with pain or difordered motion, which
is fufficient to prove an extenflon of the difeafed (fate. In
the organic fyftem, however, a perfon may have an ulcer
in the leg, or a tumour upon the (boulder, or an herpe¬
tic difeafe upon fome fpot of the (kin, or a ftricfure of the
urethra, & c. without any fenfible derangement of the
fame fyftem elfewhere. But even in thefe inftances we
cannot prove that the change is entirely local, unlefs it
may be fliown, ift, that the natural condition of the feat
is not a dependent one, by which diforder might origi¬
nate in another fphere ; and, ad, fuppoflng the difeafe
fo originate in its apparent feat, that no other is fo con-
nedled with it as to participate in its modifications. But,
if it is poflible that any part (hould poflefs only an affimi-
lating life, that no other part is dependent upon it, and
that the condition of difeafe does not open any new or
preternatural relation, then it is poflible that the affimi-
iating life of fuch part may become exclufively difeafed.

“ It happens however in moft inftances of difeafe, that
this ftate prevails in more than one feat. In fuch in¬
ftances thefe two alternatives are to be difcriminated :
ift, Whether the difeafes occupying different feats are
not independent of each other? ad, Whether the pri¬
mary produces the fecondary difeafe ?

“Jf in the courfe of a fever an abfcefs fliould form in
one axilla, and a week afterwards an abfcefs (hould form
in one groin ; if the eruption of the fmall-pox (hould ap¬
pear firft in the face, and then be extended over the whole
body ; if a tubercle fliould form in the liver, and a month
afterwards a vomica fliould burft in the lungs ; if a vene¬
real ulcer (hould form in the throat, and fix weeks after¬
wards a node on the tibia; we fliould fcarcely in thefe
(and there are many fuch) cafes affert that the difeafe
occupying the firft feat was the caufe of the difeafe occu¬
pying the fecond.

“But, if one half of the body fliould be paralyzed by
the rupture of a blood-veflei ot the brain ; if vomiting
(hould fucceed to a blow on the head ; if difordered ref¬
piration fliould fucceed to the operation of a caufe of
prefi'ure on the brain ; if atrophy fliould fucceed to difeafe
of the mefenteric glands; if the fecretion of a gland
fliould be fufpended during an inflammation of it ; if
convulfions fliould fucceed the irritation of a nerve ; if
paralyfis of the fphi abler of the bladder fliould fucceed to
an injury of the (pine. See. — vve have no hefitationin thele
cafes in affirming that the primary is the caufe of the fe¬
condary affeblion, becaufe we know that the healthy ftate
of the properties engaged in the fecondary, acknowledge
the regular dependent relation with thole engaged in the
primary feat of affeblion.

“ Again, if vomiting fliould fucceed the formation (or
introdublion) of a calculus in the gall-duff, or to the
pafling of a calculus along the ureter ; or if a pain in the
fhoulder (hould fucceed an inflammation fet up in the
liver; or if hernia humoralis fnould fucceed to an affec¬
tion of the urethra, perhaps produced by an injeblion ;

or if tetanus fliould follow a punblured or lacerated
wound ; or if pain in the breads (hould fucceed concep¬
tion, &c. — we have in thefe cafes no hefitation in faying,
that the fecondary is produced by the primary change.

“ Thefe are examples of the claffes of related difeafe.
Difeafe of one part, or one ftate of difeafe, might produce
another ; ift, by difturbing an habitual dependence ; and,
2d, by the influence of an occafional caufe. The firft: is
illuftrated above; as if an injury of the brain fliould pa¬
ralyze nerves whofe functions are dependent upon the
brain, or as if refpiration fliould become laborious, or
perhaps ceafe, by the operation of any caufe of prefl'ure
upon the brain, &c. The fecond is illuftrated in thofe
other examples, in which a relation is exhibited under
circumftances of difeafe, which was not manifefted as one
of dependence for a natural office, during health.

“ The affeblion of a dependent feat in confequence of a
difordered ftate of the feat from whence its functional
properties are derived, is by no means a regular occur¬
rence. We know that there might be a violent pain in
the head, a throbbing of all its vefl'els, as if the whole
brain was violently difordered, and yet the funblion of
refpiration, which depends upon the brain, may be but
little or not at all interrupted ; at the fame time, a flight
prefl'ure upon the brain (hall impair or prevent thefe de¬
pendent functions. The reafon is, that properties are not
indifferently related with any caufe of diforder ; but their
relations are precil'e ; as, properties of the brain animate
the organs of refpiration, thefe properties related with the
agency of prefl'ure, not related with caufes merely produc¬
ing pain or even inflammation ; the dependent function,
impaired by the former, becaufe the former is related
with the properties engaged in the dependence; not re¬
lated with the latter, becaufe, although they produce a
certain affeblion of the feat of the properties which ani¬
mate the refpiratory organs, they do hoi; produce a change
in the nature and relation of thefe properties, to expebl
which would be like expebling that paralyfis of nerves
fliould not occur from prefl'ure upon a part of the brain,
becaufe it ftill retains fome properties of life.

“ It has been dated that related difeafe happens in two
ways, which may here be repeated : ift, by difturbing an
habitual relation of the regular dependent kind ; 2d, by
a new relation which is opened between parts not before
connebled by intercourfe of funblion, in confequence of
a new condition which one of them has affumed: it has
been (fated (and examples given) that difeafe might oc¬
cupy a fucceffion of feats without the exiftence of any
caufative relation between them.. It is neceffary, before
we proceed any further, to inquire after the method of
diftinguiffiing between difeafes which, though occurring
in a (eries, are independent of each other, and thole
in which the fubfequent is produced by the preceding
difeafe. ,

“ In making this diftinblion we are liable to frequent
error: the only grounds of the diftinblion, however, are
as follow. Mere fucceffion, as has before been infilled,
can never prove caufation : but it indicates caufation,
from the analogy of fuccelfion to thofe palpable in¬
ftances of caufation in which the dependence of the
effedl upon the afiigned caufe may be proved by the re-
fult of analyfis and of fynthefis; of taking away (or
withholding), and of combining, the caufes. Succeffion
then, upon this ground of analogy, which has been more
fully explained, may indicate caufation ; and yet we do
not fuffer every inftance of fuccelfion to fugged ever fo
faintly an inference of caufation.

“The fucceffion of an eft'ebt to its true caufe is invari¬
able : from analogy in this refpebt, we infer pofitively the
operation of a caufe in all inftances of invariable fucceffion;
thus, day and night invariably fucceed the prefence or
abfence of the fun. But we prefume ftill further upon
this analogy; we infer the operation of a caufe, when the
fucceffion of the fame confequence to the fame antecedent
is frequent, but not invariable; thus, an ounce and a

half

00 P A T H O

half of laudanum taken into the ftomach will commonly,
but not always, produce death ; we have no hefitation
in afiigning the laudanum as the caufe of death, in thofe
inftances in which death takes place, notwithftanding
there are other inftances where the obvious circumftances
are alike, in which it is not followed by death. Inva¬
riable fuccejfion bears fo ftrong an analogy to caufation,
that we fcarcely fufpedt the pofiibility of our being de¬
ceived in an inference grounded upon it ; and yet we do
fometimes make a falfe inference founded upon paft inva¬
riable fucceftlon, as is proved by additional, or fubfe-
quent, experience. Frequent fucceftlon of like to like,
bears an analogy to the invariable, and upon this analogy
we found an inference of caufation : the point of ana¬
logy is between the frequent and the invariable , confe-
quently the analogy mult be eftabliftied or prefumed upon,
in proportion to our experience of the frequency of the
fucceftlon of like confequences to like antecedents.
Thefe grounds of the inference of a caufe, as is juft
ftated, are imperfedt, and rnuft admit frequent error;
for we cannot define what number of fuccelftons of like
confequences to like antecedents, are an adequate num¬
ber to prove caufation. Hence then, although we in¬
fer caufation from fucceftlon, we are obliged to confefs
that we can do this only in certain cafes; before we can
admit the truth of an inference of caufation, we muft
have iiad an experience of a fufficient frequency of a
like fucceftlon. Different men will hold different opi¬
nions with regard to what conftitutes a fufficient fre¬
quency, and the want of a poftible definition in this
matter admits a great diverfity of opinion upon impor¬
tant points, and gives room for the diftindtion of clofe
and loofe reafoners. But, when once we have had expe¬
rience of what is confidered a fufficient frequency of like
fucceftlon, wejhen infer fome difference (where it is not
perceptible) in cafes in which the fame confequences do
not fucceed the fame antecedents. In fuch inftances,
we balance an account between like and diflimilar fuc-
cefilon ; and we affign a caufe only where the frequency
of the fame fucceftlon (approaching to the invariable )
exceeds that of the exceptions. Thus, (not to quit our
fubjedt,) if the exhibition of a particular medicine
fliould be followed by recovery from phthifis pulmonalis
in one inftance, this fucceftlon would, where men are
difpofed to catch at ftraws, indicate a poftible caufation ;
if the fame event fucceeded to its exhibition in ten in¬
ftances, its credit would be better fupported ; if in a
hundred, better Hill. If it fliould fucceed in five and
fail in five, we fliould hefitate perhaps tc aftign it as the
caufe of recovery in the firft five; if afterwards it fliould
fail in fifty cafes, we fliould fay that in the five in which
it W’as followed by recovery the cure was owing to oilier
caufes. If it fliould fucceed in a hundred and fail in fifty,
we fliould then perhaps judge the hundred to amount to
an adequate number to eftablifli the relation of the medi¬
cine, as a caufe of recovery ; while we fliould explain its
failure in the other fifty, by fuppofing fome diverfity of
circumftances, by which its relation as a caufe was modi¬
fied, to have prevailed. The conclufion amounts to this :
We infer that a fecondary is produced by a primary dif-
eafe, upon an experience of a frequent fucceftlon of the
one to the other, provided at the fame time that our ex¬
perience furnifhes us with no ftronger analogies to fenfi-
ble caufation, by which we are rather juftified in confi-
dering them diftinft.” Pring, ch. iv.

This fucceflion of difeafed actions in many difeafes pro¬
duces acurative effedl; and the contemplation of this fadtis
what has caufed fo many errors to be committed in practice
in regard to the operation of nature. Seeing that thecon-
ftitutional difturbance produced a reftoration of health in
local difeafes, Hippocrates, and thoufands fince his time,
liftve been led to the adoption of that inert practice em¬
phatically termed the “ Medicine expcdlante." It has
always been a popular dodtrine, and it is one that carries
a great deal of plauflbility in the face of it, that the

LOGY.

main objedt and the fum total of the powers of medi¬
cine, confift in aiding the natural efforts of the conftitu-
tion for the removal of difeafes. But this propofltion
requires confiderable qualification. If it be merely meant,
that medicine can only operate through the medium of
the powers or energies of the living body, and that, in¬
dependently of thefe vital energies, medicine has no
operation, the pofition is a truifrn which cannot be quef-
tioned. But, if it be meant that the foie power and ob¬
ject of the medical art are limited to the furthering of
all morbid excitement, and to the removal of obftacles
to the completion of the purpofes of that excitement ;
i. e. to aflifting the efforts of nature, or guarding them
from interruptions ; the affertion appears to be altoge¬
ther gratuitous, and nothing lefs than an abufe of lan¬
guage. In the firft place, it is founded on the affumption,
that all difeafed adtion is falutary; which the effedts of
numerous difeafes diredtly contradidt, and which has no
better foundation than two other gratuitous affumptions,
namely, the exiftence of a morbid ferment in the blood,
and of an archeus, or rational foul, governing all the
operations of the animal economy. But, fecondly, ad¬
mitting the falutary tendency of difeafed adtions, confi¬
dered as the efforts of nature, by what figns are we to
interpret her intentions, or to difcover when (lie requires
affiftance , and when reftraint ? On this point the greateft
practical errors are likely to be committed, and have, in
fart, been conftantly and extenfively committed, by thofe
humoral pathologifts, who have prefumed upon their
knowledge of the intentions of Nature.

Another popular and general opinion arifing from the
obfervance of this fucceftlon of difeafed adtions, and
connedted likewife with the humoral pathology, is the
dodtrine of metaftafis, or tranfpofition. It is found, that,
on the difappearance of an eruption of the fkin, inflam¬
mation of fome of the vifcera often takes place; and
again, that the cure of gout in the extremities fometimes
produces very formidable eft'edts on the brain. Hence it
was fuppofed, that there was an abfolute tranflation of
fluid to the part fecondarily affedted. On this fubjedt,
however, as we again find fome matter of an important
nature in Mr. Pring, wefliall make another extradt.

“ That certain difeafes are related with 'each other in
the way of caufe and effedt, is a remark which is contem¬
porary with the earlieft records of medical obfervation.
It is alfo a piece of information popular with all claffes,
that the cure of one difeafe, whether fpontaneous or by
art, is fometimes followed by the occurrence of another.
Thus, it is common to expedl a favourable change of
fome internal difeafe upon the occurrence of a cuta¬
neous eruption ; thus, alfo, it has fallen under the ob¬
fervation of the ignorant and unprofeflional, that a cuta¬
neous difeafe, cured by external applications, often pro¬
duces vifceral difeafe. The language of the vulgar in
the firft of thefe cafes is, that the internal difeafe is
coming out ; in the fecond, that the difeafe of the fkin is
thrown in, or fettled upon the lungs for inftance. To
all phyflcians the clafs of fadts here adverted to is well
known ; they have been made the fubjedt of exprefs
treatifes, and have been remarked upon in every age, and
explained according to the prevailing pathology of the
times. But the profeffors of medicine have of late been
rather fceptical with refpedt to the affigned agency of the
phenomena in queftion, though it is not improbable that
their exception was taken rather againft the dodirine of
humours, See. by which the phenomena were , explained,
than againft the more modeft inferences which they
might be allowed to furnifli. To all phyficians of the
prefent day the clafs of fadts, defignated as thofe of re¬
lated difeafe, is well known : by fome, thefe facts are not
fuffered to furnifli an inference of a relation, that is, they
are confidered independent of each other; others admit
the relation, and explain it in the language of the vul¬
gar ; others fay that one difeafe, inftead of falling or be¬
ing thrown upon another part, is converted into a difeafe
3 of

PATHOLOGY. 91

of another part : fome phyficians admitting the clafs of
fadts, and -admitting alfo the inference of a relation, be¬
lieve that the examples are very rare ; others are inclined
to think them univerful ; aye, and to allow them only
one tendency, although they might tend to fifty, or five
hundred, different eft'e&s. It will appear from this ac¬
count that the exiftence of related difeafe has been long
known, that the knowledge of it has become popular,
and confequently there is no novelty in the ftatement of
the fadt. If we would improve our knowledge with ret
pedt to fuch difeafes, it muff be, not by ignorantly gene¬
ralizing a fingle limited clafs, but by a juft analyfis of its
laws, by an inquiry into its nature, its frequency, and
by an accurate difcrimination of its inftances. The firft
fubdivifion which we have propofed of this clafs is that
of related fecondary difeafe, tending to cure the pri¬
mary.

“ Perhaps the moft unequivocal examples of related
fecondary difeafe, tending to cure that which occurs in a
primary feat, are thole of metaftafis. A perfon might
have pneumonia clearly characterized by its fym'ptoms :
the fymptoms of this local difeafe on a fudden lhall ceafe,
and the fubjedt become immediately a fie fled with phre-
nitis, which lhall be followed by death within eight-and-
forty hours. Thefe occurrences may be confirmed after
death by difleftion (quod vidimus teftamur). If we in¬
quire into the caufation in this example, there are thofe
to whom the whole procefs is perfectly clear, who will
reply, the inflammation left the lungs and went to the
brain; was it then the fame inflammation? and, if fo, what
was the objeft of its journey, or why did the inflamma¬
tion take it into its head to travel ? To analyze a little
more curioufly:

“ Inflammation exifts in the lungs: why does it ceafe
in the lungs ? either from that progreffive caufation
(which has been defcribed) taking place in the lungs, or
from a progreffive caufation taking place elfewhere, by
which a relation is opened between the feat of fuch pro-
grefiive change and the properties engaged in the difeafe
of the lungs, the end of which relation is, that difeafe
is eftabliflied in a feco.ndary, and ceafes in the primary
feat. The evidence in this cafe, derived from the order
of fucceflion, is, that the difeafe in the lungs, being the
antecedent, is alfo the caufe of the difeafe in the brain
which fucceeds to it; in other words, the properties con-
ftituting inflammation of the lungs leave this feat, and
are transferred to the brain. But, if the pneumonia is the
antecedent to the phrenitis, what is the antecedent to
the metaftafis ? or why does a difeafe leave a feat in which
it is eftabliflied ? The alternatives which muff form the
anfwer to this queftion are fuggefted above: either a
change takes place in the properties of the lungs, by
which they no longer admit the ftate of inflammation,
which is then affirmed by fome other vifcus, already in a
predifpofed ftate to take up inflammation upon the cefla-
tion of it in another feat; or elfe the brain (continuing
our example) afl'umes a ftate which is fo related with the
properties engaged in the inflammation of the lungs, as
to produce a ceflation of the inflammatory condition in
this feat. From this view it is obvious, that the fenfible
fucceflion is inadequate to determine the caufation; for
the brain may be the firft to afi'ume a change, by which
it cures the difeafe in the lungs; or the difeafe may
ceafe in the lungs, from caufation proceeding in this
feat, and be aflumed by the brain, or any other feat
which is predifpofed to this refult, under the relations
which obtain upon the ceflation of a difeafe in a feat
which it had hitherto occupied.

“The alternatives here fuggefted muft obtain in every
cafe in which the primary ceafes upon the occurrence of
the fecondary difeafe, but they do net neceflarily obtain
in all cafes of related difeafe : thus we fay dentition dif-
orders the bowels ; this is a cafe of Ample fucceflion,
which, by analogies before explained, we infer to be
alfo one of caufation. If, upon the occurrence of dil-

Vol. XIX. No. 1289.

order of the bowels, the procefs of dentition w-ere fuf-
pended, we fliould then have to determine whether the
change preparatory to the metaftafis took place in the
bowels or in the maxillary nerves. The progrefs of con-
fumption might be fufpended upon the occurrence of
pregnancy ; here confumption, as a related ftate, preceded
pregnancy, yet we know, as the caule in this inftance is
palpable, that the feat of that change which produced the
mataftafis was the uterus, or fecondary related feat.
Thus alfo the catamenia may be checked by an expofure
to cold, which will produce rheumatifm; the change
preparatory to, or caufative of, the metaftafis, is here
alfo in the fecondary feat. From thefe and many fimilar
examples, we may perhaps conclude very generally,
that the primary difeafe in metaftafis does not produce
the fecondary, but that the metaftafis itfelf is determined
by a change which takes place in the fecondary feat.

“ Related difeafe, according to our reduced divifiori,
is of two kinds : ift, as when a primary difeafe ceafes
upon the occurrence of a fecondary ; and, 2d, as wdien
a fecondary merely fucceeds to a primary dileafe. The
former inftances have been exprefled by the word metafld-
fis, which implies that the difeafe leaves one feat and goes
to another : this, however, is a conjefture without proof,
for an inflammation of the eye may be cured by a fponta-
neous diarrhoea ; if the identical properties of the pri¬
mary difeafe went to the leat of the fecondary, thefe
properties, being thofe of inflammation, fliould produce
inflammation of the bowels rather than a diarrhoea,
which rarely occurs in inflammation of the bowels. If
the identical difeafe of a primary is in metaftafis tranf-
ferred to a fecondary feat, as the charaEter of the fecondary
is commonly very different from that of the primary difeafe ,
it is necelfary to infer that the identical nature of the
primary difeafe is liable to be modified by peculiarities
which belong to the fecondary feat.

“ This firft clafs of related difeafe, then, viz. that in
which a primary ceafes upon theoccurrence of a fecondary
difeafe, may be called JubJlitution of difeafe ; which
merely exprefles the fadt that one difeafe has taken place,
while another has ceafed : the word ‘ vicarious,’ which is
familiar in medicine, exprefles the fame thing. The fe-
cond clafs of related dileafe, viz. that in which the pri¬
mary does not ceafe upon the occurrence of the fecondary,
may be called related extenfion of difeafe (the caufative
relation being in both cafes aflumed upon the grounds
before ftated).

“ The examples of fubftituted difeafe are very nume¬
rous; and it is upon this experience of their frequency
that the relation of caufe and eft'edt in fome or other of
its modes comes to be inferred to fubfift very generally
between them. We cannot, however, upon this point
compel belief. Although the examples of fubftituted
difeafe are very numerous, they are not fufficiently regu¬
lar to admit a claffification of thofe primary difeafes
which are likely to be cured (to beg an expreffion) by
the occurrence of fecondary ones. We can rarely,
(owing to this irregularity) perhaps we can in no cafe, an¬
ticipate. the cure of a primary difeafe by a fecondary one;
that is, we cannot pronounce that a certain fecondary
difeafe will fucceed to the primary, and that the latter
will then ceafe. We more frequently expedl the cef-
Jation of a primary difeafe, when the fymptoms of a fe¬
condary one, of the tendency of which we have had ex¬
perience, do actually appear, than we anticipate a fubfti-
tution of difeafe, while the exifting fymptoms occupy
exclufively the primary feat. There is, however, an ex¬
ception to this remark, when the fame fecondary has been
fubftituted for the fame primary dileafe, in one or more
inftances.” Pring, ch. v.

Difrnifling the confideration of thefe abftrufe and ob-
feure fubjedts, we next proceed to confider the fymptoms
of difeafes ; a fubjedl of the firft moment, and one w hich
deferves the moft unremitting obfervation; for, though
the caufe of the difeafe may be obfeure, and though its
B b laws

92

PATHOLOGY.

laws may beinfcrutable, painful fenfations and difordered
fan&ions are. but too apparent. The great difficulty,
therefore, which attends the ftudy of fymptomatology,
is not to perceive fymptoms, but their congeries or catena¬
tions j and to obferve what are really the primary fymp¬
toms, and what are fympathelic, or fecondary: for it is
on thefe obfervations that the diftinguiffiing of one dif-
eafe from another depends. It was in this branch of
pathology, in the (liagnojis, that Hippocrates and Syden¬
ham arrived at lo great a degree of perfection. Indeed,
i-n the writings of the former phylician, we find fo excel¬
lent a fyftem of diagnofis, that we may even now turn
to the ftudy of it with great advantage. We have enu¬
merated fome of the leading rules of Hippocrates’s
fymptomatology; rules which enabled him to difcrimi-
nate difeafes with great exaftnefs, ignorant as he was of
the knowledge of phyfiology, ignorant even of all that
regarded the pulfe except its molt violent actions. Of
late, a return to thefe rules has been inculcated by one of
the firll practical phyficians of the age we live in, Dr.
Marlhall Hall : he has ffiown, that, though we had fo far
deviated from the rules of Hippocrates as no longer to
mention them, yet that all fcientific phyficians had made
theminuteft obfervations on the phenomena of difeafe in
their own minds, and had even fixed the identity of many
complaints from the conviction thefe minute circum-
ftances produced, without -however attempting to ana¬
lyze the appearances on which this conviction refted. To
fupply this analyfis has been the objeCt of Dr. Hall ; and
it mult be confeffed he has done it in the completed
manner. To explain his meaning more clearly, wre ffiall
quote a few lines from him. He obferves that there is in
practical medicine a circumftance of the firft importance,
the recognition of a difeafe. The general appearance of
a patient, the peculiar modification, the particular com¬
bination, and mutual influence, of the fymptoms, give a
general character to-the wliole difeafe, which is recog¬
nized and felt by the phyfician of experience and obfer-
vation. “ Every praCtitioner of medicine is continually
engaged in the bufinefs of diagnofis as the very ground¬
work of his profeffional duties ; and I fear the founded
and mod enlightened are in the daily habit of aCting
upon views that they would be at a lofs to defcribe, and
have not time to analyze.” This paffage is quoted from
the letter of a phyfician at once learned and experienced.
It alludes diftinCtly to that general fource of diagnofis
conftituted by the combination of all the circumdances
of a difeafe. Dr. Hall adds, that he has had repeated
opportunity of oblerving an eminent phyfician, on ap¬
proaching a patient, and that even during deep, exprefs
his fentiment refpeCting the nature of the affection and
condition of the patient ; the juftice of which time and
the event have verified. This circumftance firft con¬
vinced him that there was fomething in the general af-
peCt and appearance of difeafes, on which the experi¬
enced phyfician founds a diagnofis, and which it wmuld
be of the greateft utility to analyze and defcribe.

Diagnofis, or the ftudy of fymptoms, is founded on the
obfervance of various phenomena ; the external appear¬
ance, the fenfa'tions, and the impaired funllions, of the pa¬
tient; not to fpeak of the more remote circumftances,
which ftiould never be forgotten as the probable caufe of
the difeafe ; the liability to certain difeafes from age, fex,
temperament, &c. the effeft of medicines, &c. With
regard, then, to the appearances of the patient, the firft
and moll: obvious is the countenance ; the countenance
is principally compofed and derives its expreffion from
the aftion of the mulcles ; as the mufcles are capable of
rapid contractions, are numeroufly fupplied with nerves,
are the agents wdiich particularly manifeft the ftate of
the mind, it is evidently a part in which morbid changes,
either in the circulatory, mufcular, or nervous, fyftem,
will become apparent : hence it indicates many impor¬
tant circumftances to the eye of the praCtitioner. Dr.
Hall obferves that the following particulars are to be

noticed with regard to the face. i. The colour, general
or partial, z. Tumidity or ffirinking; general or par¬
tial. 3. Fulnefs or emaciation. 4.. ACtion or inaCtion
of the mufcles; general or partial, continued or oc-
cafional, irregular or fpafmodic. 5. The circulation.
6. Drynefs or moilture; general or partial. 7. The
temperature. 8. Particular features. 9. General ex¬
preffion.

The acute author juftly direCts our attention, how¬
ever, to the previous ftudy of the natural ftate of the
countenance under various circumftances. He has di¬
rected us to confider the delicate and tumid ftate of
complexion in the infant, the fmallnefs of its features,
the abundance of cellular tiffue, the fmall development
of the facial mufcles, their unmarked degree of expreffion,
the larger and fuller llze of the eyes, the fmallnefs of
the features generally. In youth, he ffiows that their
ftates become gradually changed, and approach more
nearly to the appearance of the adult countenance. He
fays, however, that it is the nature and force of the cir¬
culation, and the condition of the cellular membrane,
which impart the character to the countenance of
youth. The circulation is ftrong and arterial ; the cel¬
lular membrane injeCted, firm, and elaftic. It is at
this period and under thefe circumftances, that the ti¬
midity and ffirinking, obferved in the different forms
and ftages of fever, and the changes from fulnefs to ema¬
ciation, in certain organic difeafes, are moft remarkable.
The adult countenance is remarked to have a greater
development of the mufcular fyftem, and the various
expreffions of pain, anxiety, & c. are extremely well de¬
fined. The diforder of the circulatory fyftem, as indica¬
ted by rednefs, lividitv, or pallor, is likewife well defined.
In old age, on the contrary, the leannefs, the flaccidity
of the face, the want of colour, &c. are to be noticed.
Sex further influences the countenance. In the female,
the mufcular fyftem is lefs developed, the cellular more
fo. In the ftates of conception, of the firft month of
pregnancy, during the flow of the catamenia, a peculiar
tumidity and enlargement of the features is obfervable.
In advanced pregnancy, on the other hand, we often fee
thinnefs, anxiety, and uneafinefs, vifible in different de¬
grees in the female vifage.

The temperament falls next under confideration, as its
principal charafteriftics are -manifefted in the face.
Mental emotion, too, ffiould not be forgotten. Its in¬
fluence is fometimes exerted on the mufcular fyf¬
tem, fometimes on the circulation, and fometimes on
particular features. Serioufnefs, gaiety, morofenefs,
are characterized by their particular effeCts on the
countenance, produced principally by means of the
mufcular fyftem. Continued and deep thought caufes
this fyftem to be afteiSted with an unufual degree of con-
tradtion. Expectation and furprife induce a relaxation
of the mufcles. Anger, fliame, fear, affeCt the circula¬
tion principally ; the firft moves the blood upwards, and
fuffufes the forehead ; (haine dift'ufes a bluffi over the
cheeks; fear renders the countenance pale and flirunk,
and induces drynefs of the tongue. Joy and grief equal¬
ly occafion a flow of tears. Enthuiiafm animates the
countenance as it does the bread ; defpondency depreffes
the expreffion, as it makes the heart beat more feebly.
External caufes often influence the countenance in a
manner that it is neceflary to be apprifed of, in order to
prevent an erroneous diagnofis. The immediate effeCt of
bodily exertion and of external heat is to fuft'ufe the
countenance; expofure to cold contrafts the features, and
frequently induces an appearance of lividity. Repletion
of the ftomach occafions an appearance of heavinefs and
of propenfity to fleep, with a degree of ftift'ufion over
the face. Want induces an oppofite eft’edt, an appear-
ence of mental and bodily depreffion. Wine fuffufes
the eyes and face, and, according to its quantity, en¬
livens or obliterates the expreffion.

The next part which falls under our contemplation in

diagnofis

93

PATHOLOGY.

diagnofis is the general surface, in which the follow¬
ing circumftances are to be attended to; viz. i. The fur-
face in general; as to colour, tumidity, or (hrinking of
the integuments; oedema or anafarca, corpulency or
emaciation, roughnefs or fmoothnefs of the Ikin, drynefs
or moifture of the Ikin, and temperature, 2. The hands
and feet in particular. 3. The elementary cutaneous
aftedtions.

And here again the circumftances of age, fex, and
temperament, are to be noticed with the fame minute-
nefs as in regard to the face. That part of the cutane¬
ous expanfion which envelopes the tongue has always been
noticed as an important indication of the exiftence of dif-
eafe. It Ihould be viewed with regard to, 1. Its moifture or
drynefs, whether general or partial. 2. Its being with
or without fur, clean or loaded, fwollen or indented.
3. The enlargement or difappearance of its papillae. 4.
Itscolour. 5. How protruded. 6. The internal mouth in
general, and the tafte and breath, fliould likewife be ex¬
amined.

The attitude in difeafe is next to be confidered. This
fubjedt comprifes a vie w of, 1. The pofition. 2. Changes
of pofition. 3. The caution obferved in moving; or
the oppofite ftate of writhing, or of jadtitation. 4. The
ftate or eft'edts of mufcular adtion ; and the ftate of muf-
cular power or debility.

The healthy pofture of infants during fleep is various.
The young infant ufually lies on its back, often with
its hands and arms raifed above its head, or laid upon its
cheft, or fpread open, and with its lower extremities
drawn upwards. When it is laid on its fide, the upper
and lower limbs are ftill placed in a ftate of complete
flexion and relaxation. The pofture ufually remains un¬
changed, unlefs the infant be difturbed by external ob-
jedts of fenfe, internal emotions, or difeafe.

In the healthy and undifturbed fleep of adult perfons,
the ufual pofture is that on one fide, the body being fre¬
quently inclined rather to the prone than to the fupine
pofition. The head and Ihoulders are generally forne-
what raifed, and, together with the thorax, bent gently
forwards. The thighs and legs are in a ftate of eafy flex¬
ion. The pofition is apt to be changed from time to
time, the perfon lying on one or other fide alternately.

The attitude, motions, and manner, are confiderably
influenced by the temperament, the degree of bodily
ftrength, by the ftate of the mental operations, and by
the paflions. In a ftate of great debility, whether from
age or difeafe, the body uniformly falls into the fupine
pofition ; and the recovery of the ufual pofition of the
fide is always a fign of returning ftrength.

Thefe, then, are the morbid appearances which are to
be regarded in fymptomatology. As to the fecond head
of morbid fymptoms, uneafy or painful fenfations, they
are the moft frequent concomitants and figns of all dif-
eafes. Few difeafes are free at leaft from uneafinefs : for,
as there is a degree of pleafurable feeling belonging to
the healthful adiion of all the organs of the body; fo,
when thefe are interrupted and difturbed, the fick man
fuffers pain, anxiety, and various difagreeable fenfations.
Befides the various modifications of pain which we de-
feribe by comparing them with the fenfations produced
by different caufes, i'uch as a burning, (tinging, (tabbing,
gnawing, pain ; a (hooting, throbbing, binding, pain,
and fo forth ; itching, tingling, a fenfe of laflitude, of
torpor, or numbnefs, of ltupor, of heat, of cold, of
weight, naufea, giddinefs, faintnefs, ringing in the ears,
and a multitude of uneafy feelings, indicate the varieties
of difeafe. Sometimes the feverity of thefe feelings
conftitutes the principal part of the difeafe ; and they
agitate and diftrefs or terrify the patient fo much, that
they become more dreadful than even the apprehenfion of
death ; indeed, in many cafes, thefe painful fenfations
are by no means deftitute of danger, from whatever
eaufe they originate, as they may wear out the powers of
life by their inceffant irritation.

The third means of diagnofis is the confideration of
impeded or deranged functions. This is a fubjedt of the
greateft ufe in pradtical medicine ; for, as the knowledge
of healthy function is the grand defideratum in all our
inveftigations of the animal frame, fo a knowledge of
their derangements may be confidered the principal part
of the ftudy of difeafe. Thefe derangements often con-
ftitute individual difeafe ; often, on the other hand, they
are indicative of general or remote difeafe. It is for the
latter purpofe that we now confider them; and it need
hardly be remarked that the two previous methods of
diagnofis which we have confidered, are, in a great mea-
fure, fubfervient to this. In regard to derangement of
the digejlive fundtion , independently of the examination
of the tongue, breath, &c. before enumerated, we have
to confider, firftly, the function of the pharynx and
cefophagus, as it affedts deglutition. Secondly, Of the
ftomach ; and herein of the appetite, third, hiccup,
erudtation, naufea, vomiting, and the matters rejected.
Thirdly, Of the bowels; as conftipation, diarrhoea, te-
nefmus, involuntary (tools, flatulency, borborigma, dif-
tention ; the ftate of the faeces; difeharges of mucus,
blood, or pus.

The fundlion of refpiration is next in order; and this
fubjedl comprifes a view of, 1. The mode of refpiration.
2. The effedl of a full infpiration. 3. The kinds of
cough and of expedtoration. 4. Sneezing, gaping, &c.
5. The ftate of the voice. 6. The phenomena mani-
fefted by the ftethofeope, and the pulfation of the heart.

In the circulatory J'yJlem, the moft important diagnoftic
appearances are to be noticed with peculiar care. That
alternate dilatation and contradtion of the arteries,
which is called the pulfe, is the chief mean by which we
are guided in afeertaining the nature of acute difeafes.
The following divifions of this phenomena have been
made. The flow pulfe, the quick pulfe, the Joft pulfe,
the hard pulfe, the intermitting pulfe, and th e full pulfe.
Many other varieties have been enumerated by different
authors, by Galen, Bordeu, Nihel, Bellini, and Maflaria ;
but they are entirely fanciful.

Before we proceed to deferibe the varieties of the pulfe,
it will be neceffary to fpeak of the many difcrepancies
it exhibits in health. Thefe anomalies had not efcaped
the penetrating eye of Celfus. He aptly obferves, “ Ve-
nis enim maxime credimus, fallaciffimae rei ; quia ftepe
iftae leniores celeriorefve funt, et astate, etfexu, et cor-
poruin natura : faepe eas concitat et refolvit fol, et bal¬
neum, et exercitatio, et metus, et ira, et quilibet alius
animi affedhis : adeo ut, cum primum medicus venit,
folicitudo, asgri dubitantis, quomodo illi fe habere vide-
atur, eas moveat. Ob quam caufam, periti medici eft,
non protinus ut venit, apprebendere manu brachium ;
fed primum refidere hilari vultu, percontarique, que-
madmodum fe habeat : et ft quis ejus metus eft, eum
probabili fermone lenire; turn deinde ejus corpori raa-
num admovere. Quas venas autem confpedtus medici
movet, quam facile mille res turbant !” Lib. iii. cap. 6.
I11 our own time, Dr. Falconer has paid much attention
to thefe circumftances ; and has fliown that, before we
can derive any information from the pulfe, it will be ne¬
ceffary to obferve the varieties which exift in its natural
ftandard, and alio the changes to which it is fubjedted by
common caufes. The ftandard natural pulfe has been
varioufly eftimated : perhaps theexadleft computation is
that which reckons 73 beats in the fpace of a minute.
The pulfe is generally, however, quicker than this in
women, in perfons of fanguineous temperament, and
in young children. The increafe of pulfe in women ap¬
peared to be in the ratio of one feventh more than in man.
As to children, according to Dr. Heberden, “the pulfe
of a healthy infant afleep on the day of its birth is be¬
tween 130 and 140 in one minute: and the mean rate
for the firft month is 120 ; for during this time the artery
often beats as frequently as it does the firft day, and I
have never found it beat flower than 108. During the

firft

94 .. P A T H O

firft year, the limits may be fixed at 108 and iao. ' For
the fecond year at 90 and 100. For the third year at 80
and 108. The fame will very nearly ferve for the fourth,
fifth, and fixth, years. In the feventh year, the pulfatiohs
will be fometimes fo few as y^, though generally more.”
From the twelfth year, then, except that the pulfatioris
are much more eafily quickened by illnefs or any other
caufe, they differ but little from thofe of a healthy adult,
the range of which Dr. Heberden ffates to be from a little
below 60 to a little above 80 in a minute. From an ave¬
rage of five-and-twenty boys, obferved by Floyer, be¬
tween the ages of twelve and fixteen, thepulfe was about
83; in all of them above 80. With regard to the dimi¬
nution of pulfe which has been faid to be obfervable in
the decline of life, Dr. Falconer is difpofed to believe,
though not very confident in his opinion, “ that the pulfe
in a healthy perfon becomes gradually flower from about
forty-five years of age to about fixty, after which period
it begins again to grow quicker, and to become, as fe-
veral other circumftances in the fyftem do alfo, more
refembling that of children. But to this,” he adds,
there are undoubtedly many exceptions.”

It has been generally fuppofed that ftature had a great
influence on the pulfe; and Senac, from obfervations
made on a hundred men in the royal guards, deduced
the following eftimate of pulfes in proportion to ftature :
namely, at two feet, pulfe 90; at four feet, pulfe 80; at
five feet, pulfe 70 ; and at lix feet, pulfe 60. Dr. Bryan
Robinfon has likewife made a computation, but it differs
from Senac’s ; and, upon the whole, this point does not
feem to be fatisfadlorily afcertained. Haller efpecially
mentions, in oppofition to this opinion, that the Swifs
people, who are generally tall, have quick pulfes ; and
further inftances the fafr, that he was himfelf fix feet
high, and that his own pulfe beat 78 in a minute.

The pulfe is moreover influenced by the time of day.
In the morning the pulfe is generally floweft, and be¬
comes accelerated towards evening. This is raoft re¬
markable in perfons in whom a high degree of nervous
fenfibility is apparent. The principal caufes which ac¬
celerate the pulfe are food, exertion of every kind, (even
fpeaking or Handing,) warmth, the paftions of hope, joy,
and anger ; and fometimes, the reaction which fupervenes
to fudden fhocks and impreffions on the nervous fyftem.
On the other hand, the pulfe is depreffed by abftinence,
fleep, fear, anxiety, and grief ; and by certain degrees of
cold. But the operation of all thefe caufes is fubjedt to
great variation, and is often countera&ed by the influence
of oppofite agents.

In feeling the pulfe, the degree of quicknefs is of courfe
eafily determined by a ftop-watch ; the degree of force
is eftimated by the refiftance which the artery op’pofes
when compreffed by the finger. In order to afcertain
this refiftance, the pulfe fliould be ftrongly comprefied by
three of the fingers until no pulfation is experienced;
after which, by gradually relaxing the fingers, we dial 1
afcertain its proportion with a tolerable accuracy. It is
to be remarked, however, that the obefity of certain per¬
fons alters this circumftance; for not only is it more
difficult to feel the degree of refiftance of the veffel when
covered with a thick layer of fat, but fat perfons have
likewife flower pulfes than lean ones. Another diftinc-
tion of the pulfe is taken from its hardnefs : this term is
ufed to imply a peculiar fudden vibration, like the fen-
fation communicated by the fenfe cord or wire of a mu-
iical inftrument. “ Some books,” Dr. Heberden remarks,
“ fpeak of intermitting pulfes as dangerous figns, but I
think without reafon ; for fuch trivial caufes will occa-
fion them, that they are not worth regarding in any
iilnefs, unlefs joined with other bad figns of more mo¬
ment. They are not uncommon in health, and are per¬
ceived by a peculiar feel at the heart by the perfons
themfelves every time the pulfe intermits.” We have
generally ■ onfidered thefe intermitting pulfes as of dyf-
peptic origin, and havefeen theni removed, in fevers, by

LOGY.

a purge. Where the pulfe intermits, and is very unequal
in its beats, and there is at the fame time palpitation of
the heart, oppreflion of the breathing, lividity of coun¬
tenance, or other ferious fymptoms, then the intermiffion
is probably one among the figns of fome affedion of the
heart ; but in ordinary cafes, occurring with fymptoms
of indigeftion, or flight feveriffinefs, it is perfedly void
of danger. It is curious, indeed, that irregularities of
the pulfe are fometimes habitual, and difappear only
with good health. Dr. Heberden fays, “ many perfons
will likewife have unequal pulfes without any other fign
of ill health. I have met with two, who, in their bell
health, always had pulfes very unequal, both in their
ftrength and the lpaces between them; and, upon their
growing ill, their pulfes conftantiy became regular;
and it was a never-failing fign of their recovery, when
their arteries began again to beat in their ufual ir¬
regular manner.” The writer of this article can add to
thefe, an inftan.ee of an old lady of his acquaintance in
whom the fame appearances as recorded by Dr. Heberden
are very ftrikingly marked.

The propriety of thefe divifions was formerly much
queftioned, as implying an unneceflary and frivolous de¬
gree of minutenefs ; but it feems fcarcely worth while to
make any remark on this fubjeft, as their neceffity is now
generally admitted, and is eafily proved by the grand
criterion of medical theory — its practice. It muft be ad¬
mitted, however, after all, that the pulfe, as Celfus fays,
is “ fallaciffima res and it is only by regarding it in
conjunction with the other modes of diagnofis that we
are enabled to make practical ufe ofits various phenomena.

The circulating fyftem prefents further points of con-
fideration in regard to morbid changes in the blood.
Thefe alterations are little underftood. It is probable
that many exift of great importance, which are neverthe-
lefs not cognizable to our fenfes. The moft obvious
change in the blood is that which conftitutes what is
called Jizy or inflammatory blood. It takes the former
name from a tough buff-coloured coat which forms on
its furface after coagulation, and which, according to
Hewfon, confifts of albumen and a portion of fibrine ;
and the latter, from its being peculiar for the moft part
to inflammatory difeafes. Changes of lefs magnitude have
been obferved in various other difeafes; as a peculiar
blacknefs in the blood of fcorbutic patients, the want of
red colour in, and the dilute quality of, the blood in
fome ftages of dropfical and chlorotic aifeCtion, &c. But
we forbear to enter into any further notice of this fubjeft
at prefent. The reader may confult, for more particular
information on this head, the works of Hewfon, Four-
croy, and Thackrah.

The ftate of the ezeernent fyjlem is principally examined
by analyfis of the excreted lubftances ; as of the urine,
fweat, uterine difeharge, &c. but in many inftances the
inveftigation of thefe lubftances is very obfeure.

The laft fyftem which remains to be noticed as afford¬
ing certain information in refpeft to diagnofis, is the
nervous. The operation of the five fenfes, the elevated
or depreffed ftate of the Ipirits, the ratiocinative and ima¬
ginative functions, afford notice of the degree of danger
of fome maladies in. a moft certain manner; and hence
deferve to be ftudied with diligence and attention.

We now proceed to fpeak of Therapeutics, that
branch of medicine to which all the other branches Hand in
relation only as auxiliaries; auxiliaries, it muft be confeffed
however, the attainment of which is ablolutely neceffary
ere we can prafitife this branch in a philofophic manner.
Unfortunately this truth has till lately been unknown.
The long, the tedious, and (to untutored minds)
the uninterefting, path of anatomical relearch, of obfer-
vation, of experiment, and of cautious deduftion,
fuits not the tafte of mankind in general. Hence they
have attempted to cure their infirmities by fhorter and
pleal'anter methods ; and hence, even now, the wonder¬
working fpecific claims unmerited attention; and the

therapeutical

05

PATHOLOGY.

therapeutical branch of medicine is purged of fewer of
its ancient errors than any other of the pathological
(ciences.

The removal of difeafe may be eftefted by various
agents. The firft, the mod obvious, and indeed the only
ones of which the modus operandi is clearly underftood,
are thofe which aft according to the common laws of
matter. Thefe agents are few in number: they confift
of the furgical operations ; of thofe fubftances which ope¬
rate chemically, as folvent^s of (tones in the bladder,
clyfters diffolving fcybala, &c. The fecond are thofe
which aft on the various parts of the animal fyftem by
means of relation with the vital properties. But, as thefe
properties are little underftood, it is very evident that
we cannot trace with any accuracy their relation with
medicinal fubftances. Hence much of the therapeutical
branch of medicine refts on inferences of a very loofe and
uncertain charafter. The aftion of moft of the articles
of the materia may be fuppofed to affeft principally the
contraftility of fibres or of veffels. Thofe which increafe
the aftion of that power are called Jiimulants ; thofe which
diminilh it ,/edatives; and medicines producing vifible
effefts on the fenlibility of the nervous fyftem are called
narcotics.

The difficulty now to be overcome is to clafs the nu¬
merous fubftances of the materia mcdica under each of
thefe heads ; a difficulty at prefent infurmountable ; for
not only we do not know but the impaired ftate of fen¬
libility may arife from altered aftion of the contraftile
forces, or that thofe forces may not be influenced origi¬
nally by the altered fenfibility ; but, further, we require
a long feries of experiments to be inftituted ere we can
admit into our claffification one half of the drugs con¬
tained in our Pharmacopoeia. For this reafon, deeming
it more confonant with true philofophy to confefs our ig¬
norance than to perpetuate erroneous doftrines, it is our
intention, when we come to that part of our article which
more particularly relates to medicines and their dofes,
to adopt the Ample order of the alphabet. And indeed,
the pompous arrangements of the materia medica into
dalles and orders, with other fubdivifions, are now de¬
rided by the faculty. Some medicines pofl’efs very diffe¬
rent powers, fo that their proper places are not eafily
afeertained. They muft therefore be repeated under dif¬
ferent heads ; and it is evident how many repetitions
fuch arrangements muft occafion; fince, when an article
is properly placed, an increafed dofe of the fame would
often carry it into another divifion, and the fame drug
will have a different effeft in different cafes or ftates of
difeafe. At p. 44, we have given the outline of Darwin’s
arrangement, which is the moft concife ; but it does not
fatisfy our minds. Kirby’s Tables contain 18 claffes,
each, of courfe, divided into at lead three feftions, to in¬
clude animal, vegetable, and foffile, fubftances; and Dr.
Cullen has 23 claffes, which are theie :

Aftringents.

Tonics.

Emollients.

Corrofives.

Stimulants.

Narcotics.

Refrigerants.

Antifpafmodics.

Diluents.

Attenuants.

Infpiflants.

Demulcents.

Antacids.

Antalkalines.

Antifeptics.

Errhines.

Sialogogues.

Expeftorants.

Emetics.

Cathartics.

Diuretics.

Diaphoretics.

Menagogues.

Of thofe who have copied Dr. Cullen’s arrangement
with fome modification, there is perhaps none that de¬
fer ves more attention than the anonymous author of the
“ Thefaurus Medicaminum,” and a “ Prafticai Synopfis
of the Materia Alimentaria and Materia Medica.” This
author diftributes the articles^of the materia medica into
12 claffes. 1. Evacuants, comprifing errhines, fiala-
gogues, expeftorants, emetics, cathartics, diuretics, dia¬
phoretics, emmenagogues. 2. Emollients, comprifing
diluents and emulcents. 3. Abforbents. 4. Refrige¬
rants. 5. Antifeptics. 6. Aftringents. 7. Tonics. 8.

Vol. XIX. No. 1289.

Stimulants. 9. Antifpafmodics. 10. Narcotics, n.
Anthelmintics; and 12. Heteroclites ; this laft being
formed to include thofe articles that could not properly
be reduced under the former heads.

Mr. Murray’s arrangement, which is very ingenious, is
founded principally on the doftrine of univerful Jiimulus ,
and he thus explains the principles on which it is efta-
blifhed. “Thofe ftimulants, which exert a general ac¬
tion on the fyftem, may firft be confidered. Of thefe
there are two well-marked fubdivifions, thediffufible and
the permanent ; the former correfponding to the ufual
claffes of narcotics and antifpafmodics ; the latter, in¬
cluding likewife two claffes, tonics and aftringents. In
thefe there is a gradual tranfition paffing into the one from
the other, from the moft diffufible and lead durable lli-
mulus, to the moft flow and permanent in its aftion.
The next general divifion is that comprifing local ftimu¬
lants ; fuch are the claffes of emetics, cathartics, expec¬
torants, fialagogues, errhines, and epifpaftics. Thefe
all occafion evacuation of one kind or other; and their
effefts are in general to be aferibed, not to any operation
exerted on the whole fyftem, but to changes of aftion
induced in particular parts. After thefe, thofe few me¬
dicines may be confidered whole aftion is merely mecha¬
nical or chemical. To the former belong diluents, de¬
mulcents, and emollients. Anthelmintics may perhaps
be referred with propriety to the fame divifion. To the
latter, or thofe which aft chemically, belong antacids or
abforbents, lithontriptics, efcharotics, and perhaps re¬
frigerants. Under thefe clafl’es may be comprehended
all thofe fubftances capable of producing falutary changes
in the human fyftem. Several claffes are indeed excluded
which have fometimes been admitted ; but thefe have
been rejefted, either as not being fufficiently precife or
comprehenfive, or as being eftablilhed only on erroneous
theory.” Murray’s Elements.

Mr. Murray’s arrangement will beft be underftood
from his own Table.

A. General Stimulants.

«. Diffufible. 5 Narcotics.

( Antilpalmodics.

l>. Permanent. \ Tonics.

( Aftringents.

B. Local Stimulants.

C. Chemical Remedies.

Emetics.

Cathartics.

Emmenagogues.

Diuretics.

Diaphoretics.

Expeftorants.

Sialagogues.

Errhines.

Epifpaftics.

Refrigerants.

Antacids.

Lithontriptics.

Efcharotics.

D. Mechanical Remedies. Anthelmintics.

Demulcents.

Diluents.

Emollients.

Dr. Parr alters the arrangement of Dr. Cullen’s claffes,
and increafes them to 26, as below:

Emetics.

Cathartics.

Diaphoretics.

Diuretics.

Expeftorants.

Errhines.

Sialagogues.

Emmenagogues.

Stimulants.

Refrigerants.

Antifpafmodics.

Tonics.

Sedatives.

Attenuants.

Infpiflants.

Alterants.

Demulcents.

Antacids.

C c

Antalkalines.

Antifeptics.

Emollients.

Corrofives.

Aftringents.

Antidotes.

Lithontriptics.

Anthelmintics.

Whilft

1

A

I

96 PATHOLOGY.

Whilft Dr. Cullen’s claffification has been thought too
diffufe, and Dr. Darwin’s much too contraftedj and
adapted merely to his own exceptionable fyftem of nofo-
logy, Dr. Kirby, in his fmall traft, entitled “ Tables of
the Materia Medica,” has inferted feventeen clafles, which
are, upon the whole, judicioufly felefted ; and his ar¬
rangement has been adopted by moft of thofe modern
■writers who are of opinion that the materia medica are
fo numerous as to require a methodus. The claflification
is as follows ; and, as hinted before, every clafs is fub-
divided, as far as poflible, into an animal, a vegetable,
and a mineral, feftion.

Clafs I. Emetics. — Emetics are fuch medicines as
are calculated to excite vomiting, and thus difcharge
the contents of the ftomach.

II. Expectorants. — Thofe medicines are called ex¬
pectorants, that are employed to promote the excretion
of pus or mucus from the windpipe and lungs. In ge¬
neral they are emetics given in fmaller doles, though
there are feveral medicines, efpecially fome of the gum-
refins, that are confidered to aft in this way, without any
tendency to excite vomiting.

III. Diaphoretics. — Diaphoretics are thofe remedies
that are intended to promote, keep up, or reftore, the ex¬
cretion of perfpirable matter from the (kin ; and of thefe
fome act but feebly, and only increafe the infenfibie per-
fpiration, while others aft more powerfully, and, under
favourable circumftances, excite fweating.

IV. Diuretics. — Thefe are fuch medicines as promote
or increafe the excretion of urine.

V. Cathartics. — Cathartics are thofe medicines
which promote or increafe the evacuation of excremen-
titious matter, or of ferous fluids, from the bowels.

VI. Emmenagogues. — Medicines which are fuppofed
to aft on the womb, and to promote the difcharge of the
menltrual flux ; but it is more than doubted if any drugs
whatever have that peculiar aftion.

VII. Errhines. — Thofe medicines are termed errhines
that are employed to promote an increafed difcharge of
mucus from the noftrils.

VIII. Sialagogues. — Thefe are employed either to
promote an increafed flow of faliva, or to produce fuch an
aftion on the gums as (hail indicate their having been re¬
ceived in fufficient quantity into the circulation. Under
the former diviiion are ranked feveral vegetable fubftan-
ces 5 under the latter are included only mercury and its
preparations.

IX. Emollients. — The medicines commonly called
emollients confift either of diluting liquors, formed of
Ample water; or certain vegetable infufions ; or mucila¬
ginous and oily matters that have the mechanical pro¬
perty of defending the parts to which they are applied,
from the aftion of acrimonious fubftances that pafs over
them, or of foftening and relaxing the fkin and other
external parts. The firft of thefe are commonly called
diluents, the fecond demulcents, and the third limply emol¬
lients.

X. Refrigerants. — Under this term are compre¬
hended thofe remedies which are employed with a view
to diminifh the preternaturally increafed heat that takes
place in the body during fevers and feveral inflammatory
affeftions.

XI. Astringents. — Aftringents are defined by Dr.
Cullen to be fuch fubftances as when applied to the hu¬
man body produce a condenfation and contraftion of the
foft folids, and thereby increafe their denlity and force of
cohefion. If they are applied to longitudinal fibres, the
contraftion is made in the length of thefe; but, if applied
to circular fibres, the diameters of the veflels, or the cavi¬
ties which thefe furround, are diminilhed.

XII. Tonics. — Tonics are thofe medicines w'hich are
fuited to counteraft debility, or to give ftrength and ener¬
gy to the moving fibres.

XIII. Stimulants. — Moll of the articles of the Ma¬
teria Medica might, in an extended fertfe, be called Jliniu-

lants ; but this term is, by the general confent of phyfi-
cians, reftriftively applied to thofe medicines which pof-
fefs the power of fuftaining or increafing the vital ener¬
gies ; of raifing and invigorating the aftion of the heart
and arteries ; and of reftoring to the mufcular fibre, when
affefted with torpor, its loft: fenfibility and power of
motion.

XIV. Antispasmodics. — Thofe medicines which have
been found by experience to put a flop to convulfive mo¬
tions, or fpafmodic contraftions of the mufcular fibres,
are called antifpafmodics. Moft of them are ftimulants,
fome narcotics, and fome are confidered as fpecific anti¬
fpafmodics.

XV. Narcotics. — This term has been ufually applied
to thofe remedies which are calculated to relieve pain and
procure lleep. They have alfo been termed anodynes and
hypnotics ; and moft of them were formerly ranked in the
clafs of fedatives.

XVI. Anthelmintics. — Thofe medicines which are
employed with a view to expel worms from the bowels,
are called anthelmintics.

XVII. Absorbents. — Medicines which are taken in¬
wardly for drying-up or abforbing any acid or redundant
humours in the ftomach or inteftines. They are likewife
applied outwardly to ulcers or fores, with the fame in¬
tention.

That each of thefe fyftems was framed by their authors
in confonance with their peculiar and erroneous theo¬
ries is a fufficient reafon for their prefent difmiflal.
Granting, however, that the effefts of the fubftances
thus claflified were correftly detailed, it is very evident
that moft of the clafles are eafily refolvable into the clafs
of Jlimulants ; for fuppofing that any medicines can pro¬
duce expeftoration, that procefs can only be accompliftted
by ftimulating the exhalent veflels of the bronchial ex-
panfion ; and the fame remark is applicable to molt of the
other clafles above mentioned. With refpeft to Simu¬
lants, the moft proper pathological divifion appears to be
according to the particular ftruftures on which they
exert their effefts. Of thefe the moft general are purga¬
tives, emetics, diuretics, and diaphoretics ; not to men¬
tion emmenagogues and a holt of others, the feparate
and independent aftion of which does not appear to be
well known.

Purgatives. — Many errors have been committed in
the adminiftration of this ufeful clafs of fubftances. The
heterogeneous mixtures which have been made of them,
and their indifcriminate application, fufficiently prove
that the phyficians of the laft century did not properly
underftand the ufe of them. To Dr. Hamilton and Mr.
Abernethy we are indebted for pointing out the general
and falutary effefts produced by the exhibition of purga¬
tives. Thofe a. thors have clearly fliown, that many
nervous affeftions, and even chronic dileafes of the fe-
creting and vafcular funftions, may be cured by thefe re¬
medies. Dr. Hamilton’s fuccefs in treating febrile and
hyfteric difeafes has been truly great; and Mr. Aberne¬
thy has demonftrated their Angular utility in local dif¬
eafes, as obftinate ulcers, See. Accordingly the benefit
of cathartics is now very generally eftirnated ; and we are
perhaps in danger of falling into an error quite oppofite
to our predeceffors, that of placing too much reliance on
their ufe.

Sufficient attention however has not been paid to the
particular aftion of different cathartics. Praftitioners
have been too much in the habit of preferibing them in-
difcriminately, without fufficiently alluding to the effefts
which each drug is capable of producing on the different
parts and ftruftures of the alimentary canal. Mr. A.
Carlifle firft diredted the attention of his profellional
brethren to this point. “ Cathartics,” he obferves, “ ap¬
pear to operate in the following ways ; viz. either by ex¬
citing the periftaltic motion of the inteftines to an unu-
fual degree, and thereby caufing them to protrude their
contents more quickly through the alimentary paffage ;

i or

PATHOLOGY.

or by increasing the fluidity of the alimentary mafs by
fubftances which are obnoxious ; or to induce thefe two
effe<5ts. The firft kind of cathartics probably aft upon
the mufcular fibres of the inteftines, and the fecond kind
feem to aft upon the vafcular parts of the inteftines.
Some cathartics induce an unufual flow of bile into the
inteftines 5 and in this refpeft they refemble, in their
modus operandi, the natural ftimulus of the bowels,
which is the bile. Other cathartics Simulate the exhUlent
veflels of the inteftinal membranes, and thereby give an
excefs of fluidity to the volume of their contents : or all
thefe feveral modes of operation may be united by a fuit-
able mixture of cathartic medicines. Again, fome ca¬
thartics aft efpecially upon the ftomach, and upon the
upper portions of the inteftinal tube ; and others feem to
ftimulate particularly the lower and larger inteftines.
Some operate by emptying the bowels only, without di-
minilhing the animal vigour ; whilft others fink the
ftrength of the patient by emptying the Sanguineous fyf-
tem at the time they hurry away the nutritious aliment.”

With refpeftto the fubftances capable of producing the
above-mentioned eftefts; the ingenious authoris inclined
to think that rhubarb afts almoft exclufively on the fto¬
mach and on the large inteftines ; on the former organ
efpecially when combined with ipecacuanha. Mercurial
falts (of which thofe in moft common ufe are the blue
pill and calomel) operate in two ways : by inducing Se¬
cretion of bile from the liver, and hence furnilhing the
bowels with their natural ftimulus to action, or by their
direft effeft on the coats of the larger inteftines induc¬
ing Secretion from the Surfaces of thofe organs. Mr.
Carlifle fuppofes that the neutral falts aft by exciting
watery discharges; but the aftion oft thefe fubftances is
modified by the quantity of fluid in which they are taken,
and by the previous condition of the alimentary canal;
for they may be decompofed by the morbid Secretions.
On this latter account Epfom falts are particularly re¬
commended by this author, becaufe, even if decompofed,
their operation is ftill enfured by the purgative quality
of their bafe. In regard to the modification produced
on the aftion of thefe falts by their dilution, it is a cu¬
rious remark, that Small quantities of falts diflolved in
large quantities of water aft with as much force, greater
certainty, and lefs fubfequent exhauftion, than much
larger quantities in Smaller menftrua. Caftor oil may be
confidered as one of thofe rare purgatives which aft ge¬
nerally on the inteftinal canal ; perhaps by its vifcid ole¬
aginous part on the Superior portion of that canal, and by
its acrimonious refin on the lower bowels. Its refinous
portion is fuppofed by this author to be particularly ob¬
noxious to abforption ; and hence we may infer arifes
the certainty of its operation. Jalap is one of thofe ca¬
thartics which Seems to ftimulate exclufively the peris¬
taltic aftion of the bowels, and is therefore of much ufe
in evacuating them in acute difeafes. Scammony, gam¬
boge, and elaterium, aft moftly on the mufcular parts of
the bowels, and perhaps the nervous; but thefe effefts,
except in combination with other medicines, are very
precarious. Aloes of Colocynth are generally fuppofed
to aft on the lower parts of the inteftines ; but that effeft
probably arifes rather from the infolution of thofe fub¬
ftances until they arrive So far, than from their Specific
aftion on thofe parts.

It Seems Scarcely neceffary to remark on the advanta¬
geous mode of ufing various forts of purgatives in con¬
junction, as that praftice has very generally obtained,
and is very Successfully applied to all kinds of medici¬
nal fubftances.

Cathartics may be adminiftered in the form of cJyJler ;
and in many inftances this method has great advantage
over the ordinary method. The French employ “ lave¬
ments" on almoft all occafions. They are chiefly ufeful
in cafes in which the ftomach is unable to retain, or would
be injured by, irritating medicines ; as in ga/irids, or
inflammation of the ftomach, and in febrile complaints

97

attended with extreme debility, efpecially in the latter
ftages ; fince by this mode the contents of the lower parts
of the inteftines are Simply evacuated, without any fti¬
mulus to the Secreting veflels, and with little or no irri¬
tation of the fyftem at large. It is alfo to be obferved,
that confiderably larger doles may be Safely employed in
this way. It is of advantage to employ fome emollient
fubftance, combined with the purgative, to defend the
inteftine in fome meafure againft the acrimony of the me¬
dicine. Thus, if the eleftuary of Senna is ufed, it may
be conveniently rubbed up with a little oil; and the
whole will then mix uniformly with milk or any other
liquid. When clyfters are employed as purgatives, it
muft be remembered that they cannot pafs higher up than
the valve of the colon, and consequently that they can
only aft direftly upon the large inteftines. Therefore,
they can Seldom entirely fupply the place of purgatives
by the mouth, which pafs through and excite the whole
inteftinal canal ; but they prove moft ufeful auxiliaries,
particularly in thofe cafes of inteftinal diforder that are
attended with much vomiting and irritability, where,
befides emptying the lower bowels, they aft as topical
fomentations, and very often induce eafe and deep when
other methods fail. In Such cafes, therefore, they ftiould
be in pretty large quantity, not very ftimulating, and as
warm as the patient can bear them. As vermifuges, alfo,
clyfters have a peculiar and local ufe, where the worms
are lodged in the lower inteftines ; particularly as very
highly ftimulating medicines are often required to dif-
lodge -thefe troublefome animals, which, if given by the
mouth, might produce a good deal of inconvenience and
irritation.

The reader will clearly perceive how insufficient thefe
observations are, and how much the inveftigation of the
remote modus operandi of various purges ftill remains a
defideratum. The fubjeft, however, is confefledly fur-
rounded with much difficulty ; yet a Series of experiments
might probably be devifed to throw further light on this
interefting fubjeft, which ftiould likewife extend to a
much larger number of cathartics than thofe we have hi¬
therto confidered.

Emetics, or thofe fubftances which operate a rejeftion
of the contents of the ftomach, are of various kinds. Moft
of the common poifons are emetics ; and many other fub¬
ftances, not deleterious in themfelves, do, when admi¬
niftered in exceffive quantities, produce ficknefs. Some
difputes have been made public concerning the ac¬
tion of thefe fubftances ; fome phyfiologifts l'uppofing
that they produced their effeft by ftimulating the fto¬
mach to contraftion, others that the abdominal and
coftal mufcles were the agents concerned, and which
produced vomiting, the ftomach performing no contrac¬
tion. Many experiments have been made on this point ;
and the reiult renders it probable that both the above-
mentioned powers are concerned in the aft of vomiting,
and that the cefophageal part of the ftomach is firft afted on.

The ufe of emetics in what may be termed a reftrained
or limited degree is frequently attended with the moft
powerful eftefts. The fenfation of naufea, that l'enfation
which occurs previous to the aft of vomiting, is in the
higheft degree debilitating: it reduces the aftion of the
heart, and is attended with very general fecretion from
the mucous expanfion of the nofe, eyes, fauces, air-cells,
and ftomach. Hence dofes of emetics capable of produc¬
ing this effeft and no more are ufed in acute difeafes : for
it is worthy of notice, that beyond the above-mentioned
point (that of naufea), when vomiting Succeeds, the fyf¬
tem appears JlimutatecL, and the cerebral circulation in-
creafed. So that to produce naufea, and to produce vo¬
miting, is a very different matter, and worthy of parti¬
cular attention.

The aftion of the urinary fyftem is increafed by increaf-
ing the natural quantity of fluids Swallowed, or by the
ufe of Diuretics. The number of fubftances which
have been praifed by different writers, as poffefl'edof diu¬
retic

PATHOLOGY.

i

$8

retie powers, or capable of ftisnulating t lie aftion of the
kidneys, is very great, efpecially from the vegetable
world. Many of them, however, are very inefficacious ;
and it is the common imperfection of the whole of this
clafs to be very uncertain in their operation : fometimes
the more feeble diuretics will fucceed, when the ftronger
have failed ; and often, after every variety of kind and
combination has been tried, the fecretion of urine remains
unaltered. Digitalis, fquill, mercury, and cryftals of
tartar, feparately or combined, are the mod efficacious of
the clafs ; but the alkalies both fixed and volatile, fome
of the neutral falts, the nitrous ether, the^terebinthates,
See. are by no means ufelefs as auxiliaries. There is per¬
haps no clafs of medicines, in which a combination of
two or more fubftances, poffeffing fimilar powers, is fo
frequently important, as in that of the diuretics. Thus
the ufe of potafs, joined with bitter vegetables, is recom¬
mended by fir John Pringle, as an efficacious medicine :
and, as the alkaline fubftances may be often prevented,
by purging, from reaching the kidneys, fo their diuretic
effeft may be often more certainly fecured by giving an
opiate at the fame time, according to the practice of Dr.
Mead. A combination of the fquill, with digitalis, and
fome of the lefs purgative preparations of mercury, as
the common blue pill, is occafionally very aflive in its
diuretic operation ; and, in children, or in old and feeble
people, the union of the fpirit of nitrous ether, or of other
diuretic fubftances, with the bark, or other vegetable to¬
nics, appears to be often very ferviceable.

Diuretics, moreover, receive great additional power
from perfeft fol'ution ; and it was remarked by Cullen,
that the union of diluents with thefe fubftances was pro-
duftive of the beft effefts. Diuretics are moll generally
had recourfe to for the purpofe of determining fluids to
the kidneys which were liable to be effufed ; and indeed
they have been fuppofed to aft an important part in re¬
moving them when that procefs had occurred. If the
latter luppofition be admitted, we muft fuppofe that a
diuretic pofl'efies immediately the power of promoting
abforption ; and of that we have no direft evidence. On
the other hand, that diuretics can prevent the further
accumulation of effufions is a faft of which we have
llrong inference, and which is accordant with the inex¬
plicable law of derivation fo generally obferved.

Diaphoretics are thofe fubftances which promote in-
fenfible perfpiration, or fweat. Their modus operandi
may be inferred to arife, either by direft application, or
by nervous confent. If diaphoretics are affimilated, pafs
into the round of the circulation, and are applied
direftly to the cutaneous veflels, they may produce
increaled contraftion, or the reverfe : or otherwife, the
powerful fympathy obferved between moft parts of the
mucous expanfions, and efpecially between the ftomach
and (kin, authorife us to believe, that the contraftion or
dilatation of the veflels of the flein may be produced by
nervous excitement, firlt im prefled on the ftomach, thence
propagated to the nervous general communication, and
iaftly to their veflels; or, in other words, the effeft may
be produced by fympathy.

The older praflitioners took great pains with thefe
medicines: the fudorific plan of treatment was the
fruitful fource of miliary eruptions, and a variety of
troublefoine complaints. The ufe of diaphoretics is at
prefent much reftrifted, particularly thofe which increafe
the general circulation.

There are two means, by which perfpiration may be
induced, and the aftion of fudorific medicines promoted ;
namely, by application to the (kin, and ingefta. When
the flein is not in a ftate unfavourable to perfpiration,
the application of heat to the furface of the body, with¬
out any affiftance from powers internally applied, is fuffi-
cient to produce fweating ; and the application of cold,
i. e. the abftraftion of the heat, canalmoft certainly pre¬
vent the fame, though confiderable powers are employed
within. Thus fweating may be obtained by the heat of

the air, applied as in what is called the dry bath, or by
increafing the heat of the furface by previous warm
bathing, or by accumulating the warm effluvia of the
body itfelf upon its furface. This laft may be done by
covering up the body very clofely with fuch coverings as
may both prevent the efcape of the warm effluvia ariling
from them, and at the fame time prevent the accefs of
external cold. But, farther to favour the diaphoretic
aftion, a quantity of warm liquid may be taken into the
ftomach, which not only excites the general circulation,
but particularly, by confent of the veflels on the furface
of the body with the ftomach, excites the aftion of thofe
veflels which pour out fweat. The ufe of warm liquids
alone, efpecially in the morning, while in bed, where
there is a general difpofition to perfpiration, is in flight
febrile cafes an ample fudorific. Thefe two means, of
covering up the body clofely, and taking warm liquids
into the ftomach, are what we call the fudorific regimen;
which will often anfwer alone the purpofe of exciting
diaphorefis ; is often neceflary to the operation of fudo¬
rific medicines ; and will always render their operation
more complete and permanent. Cullen's Mat. Med. vol. ii.

The combination of opium with fudorific medicines is
valuable in two ways : the opium aids the operation of
the fudorific, on the one hand ; and, on the other, the
fudorific, by determining to the fkin, renders the ano¬
dyne effeft of the opium more certain and complete, and
prevents fome of its unpleafant influence on the head :
for opium, given when the flein is dry, or not accompa¬
nied by perfpiration in the courfe of its operation, is very
apt to occafion reftleflnefs rather than fleep, and to pro¬
duce a flight approach to delirium, by its influence on
the brain : hence the acknowledged value of the combi¬
nation which is univerfally known by the name of Dover's
powder, as a fafe and aftive diaphoretic and anodyne ;
it confifts of opium combined with the diaphoretics, ipe¬
cacuanha, and fulphate of potafs.

Guaiacum too has been much praifed for its fudorific
properties : Dr. Cullen confidered it to be one of the
moft valuable of the ftimulant diaphoretics, becaufe it
affords a matter which paffes more entirely to the ex¬
treme veflels, and feems to ftimulate the exhalents more
in proportion than it does the heart and great arteries.
By this means it is both a more fafe and more effeftual
fudorific than thofe which ftimulate the latter almoft
only : but acute rheumatilin, or rheumatic fever, as it is
called, is almoft the only acute difeafe in which it can
be recommended ; and it is a difeafe in which the fweat¬
ing is fpontaneoufly profufe, and bears ftimulants better
than phlegmonous inflammations.

Emmenagogues. — It has not been thought neceflary
to treat particularly of emmenagogues, as they are moil
of them general ftimulants, and are fo uncertain in their
aftion that they can fcarcely be viewed as ftimulators of
the uterus in particular.

A few other minor divifions, are alfo commonly
made; as Errhines, which aft on the mucous membrane
of the nofe, &c. but thefe coniift of fo very fmall a num¬
ber of the pharmacopceal articles, that the mention of
the fubftances themfelves would be lefs tedious than their
claffification.

There are fome articles in the materia medica which
have been denominated general Jlimulants , from their
effeft on the fyftem at large. They are little ufed at
prefent in the praftice of phyfic, but were ftrongly re¬
commended by Brown, and confequently came into
very general approbation during the time that author’s
theories were triumphant. They obtained this diftinc-
tion partly becaufe Brown was praftically and individu¬
ally acquainted with the healthy feelings they excited,
but moftly becaufe their ufe naturally grew out of his
theory of debility and excitement before noticed.

Moft of thefe fubftances appear to influence the body
by means of the nervous fyftem ; for the rapidity with
which their aftion is elicited cannot allow us to fuppofe

their

PATH

their abforption, and local application to the circulating
powers. This remark will likewife apply to many of the
Sedatives ; for, though thefe latter fubftances are for
the moll part abforbed and carried into the circulation,
and thus operate immediately on the contradfile powers
of veffels, others exift of which the inftantaneous adtion
allows of no explanation except the fuppofition that they
adt on the nervous fyftem through the medium of the
ftomach. It is obvious however, that, ftridtly fpeaking,
all medicines adting on the nervous fyftem fliould be
comprehended in another divifion ; but, as we before
obferved, the modus operandi of the refpedlive articles in
the materia medica is not fufficiently eftablifned to allow
us to arrange them thus clofely according to their effedfs.

We muft obferve, in this place, that many ftimulants
attended with difcharges mayindiredlly produce fedative
effedts by removing plethora ; as purgatives, diuretics,
&c. The eftablifliment of the oppofite fadf, viz. that
fome fubftances produce diredly fedative effedts, is a
grand feature in the new Italian dodtrine, and in which
that dodtrine is oppofed to the Brtinonian theory, which,
as we have before fhown, fuppofed that all medicines
were ftimulants, and only produced debility by promoting
difcharges. This opinion is not to be difmifl'ed with
quite fo little ceremony as many parts of Brown’s doc¬
trines ; for, though not admiftible to its full extent, it is
rational to conjecture that many fubftances do produce
inadlion of particular parts or organs by exceflive ftimulus
on others, and thus that the clafs of diredt fedatives is
very limited indeed.

The moft powerful fedative agent that we ufe in me¬
dicine is Bleeding. This operation is however fcarcely
capable of being arranged under any divifion ; for, in the
firft place, if the fyftem is gorged with blood, there can
be no doubt that fuch a ftate may arife as will preclude
the rapid adtion of the heart; and in this cafe, by dimi-
niftiing the quantity of blood to be moved, the motive
power remaining the fame, the velocity will neceflarily
be increafed. Thus, bleeding is a Jlimulant, on the other
hand the rapidity of the heart’s adlion is in certain
ftates reduced, or rendered flower, by bleeding. Thus, it
is a fedative. Again, fyncopemay be induced by bleeding;
and, as this is dependent on diminiftied circulation
through the brain, the operation here holds relation
with the nervous fenfibility. And further, the emptinefs
of the fanguineous fyftem produces increafed adtion in
the ubforptive powers.

According, then, to the various ftates of difeafe, this
operation produces different effedls, which are ftill further
varied by the time and manner of its performance. With
regard to the time, this has great influence on the cura¬
tive refults. Thus in inflammations of all kinds, it i3
necefl’ary to bleed in the early ftages, left the continuance
of that difeafe fhould terminate in change of ftrudlure, or
at lead in permanent dilatation of veffels. The manner of
bleeding refpedts the abftradtion of blood from fmall or
large orifices, by frequently-repeated and fmall, or by
large and fudden, evacuations. Topical bleeding is ano¬
ther mode of abftradling blood which is ufefully employed
in a great number of inflamed or excited parts, when
previous exhauftion or other caufes preclude general
bleeding. With regard to the mode of performing ve-
nefeCtion, arteriotomy, acupunCture, & c. fee the article
Surgery.

The a£tion of the abforptive fyftem is increafed with a
view to the removal of many folid depofitions, fluid fe-
cretions, and extraneous bodies, &c. Like the circula¬
tory fyftem, it may have its contradlile phenomena in¬
creafed or diminiflied. The firft indication is attempted
by mechanical preflure, and by certain medicines called
ftimulants ; and it feems further increafed in direft pro¬
portion to the exhaufted ftate of the heart and arteries.
The fecond change, or the diminution of the aCHvity of
s^fpEbents, is not found to attend with certainty the ex
hibition of particular drugs ; but it is produced by various

Vol. XIX. No. 1290.

O L O G Y. v 09

morbid alterations, by heat, by the defeft of mechanical
preflure, and by the reduction of nervous fenfibility.

To return however to the ufe of ftimulants ; mechanical
prejfure is an agent which exerts great and general in¬
fluence over the abforbent fyftem. In their courfe
through the extremities of the body, the abforbents are
compreffed by the diftenfion of the arteries, and during
the contraction of mufcles ; within the cavities of the
abdomen and thorax, they are fubjeCted to the preflure
of the ingefta, of the diftended air-cells of the lungs, the
movements of the diaphragm, and of the refpiratory and
abdominal mufcles. Atmofpherical preflure, as well as
the weight of clothes, &c. is likewife to be taken into
eftimation. It is obvious that, as abforbents are furnifhed
with valves which prevent the return of fluids towards
their open mouths, prejfure muft accelerate the flow of
their contents towards their venous terminations,

It muft here be remarked, that the effeCt of long-con¬
tinued preflure is probably two-fold; operating on the
one hand to increafe abforption, on the other to prevent
depofition. Medicines which increafe abforption operate
for the moft part by increafing contraction. But they
may further, in fome ipftances, render folid depofi¬
tions lefs difficult of abforption, by producing folu-
tion of their conftituent parts. That an empty ftate of
the fanguineous fyftem generally renders abforption
more aCtive, is a faCt which we fliould be inclined to ad¬
mit a priori ; and it has received full confirmation from
the well-known experiments of Majendie. It explains
how purgatives, diuretics, &c. to which the older phyfi-
cians attributed abforptive powers, may really bring on
abforption, by caufing depletion ; and it further renders
plain the circumftance, that a great number of medicines
do not manifeft their falutary operation except in ex¬
haufted depleted patients.

In our therapeutical indications, one of the moft im¬
portant is the imitation of' nature in the production of
oppofite difeafes. That difeafe in one part or ftruCture
of the body often ceafes on its production in another, is,
as we have before ftiown, a general law in pathology, fub-
jeCt however to many exceptions. It is in expectation of
producing this falutary change that we ufe many of the
moft powerful ftimulants. Thus blifters, muftard-cata-
plafms, embrocations, moxa, &c. are employed with the
intention of converting difeafes, i. e. of inducing aCtion
in a part not effential to life, for the purpofeof removing
it from one in which its direefteCts are known and appa¬
rent. It is to be obferved, however, that contra-irrita¬
tion is a mean which can only be reforted to with ad¬
vantage in certain degrees of inflammation ; for it is
known that, in inflammations of the higheft magnitude,
blifters, when applied before bleeding and evacuants have
been premifed, increafe general irritation without alle¬
viating topical difturbance ; and this holds good in re¬
gard to moft other fubftances of the fame clals.

As appendices to the ufual and common remedies, we
have to mention medical eleCfricity, and the inhalation
of gazeous fluids. Each of them has received an ephe¬
meral and exceflive degree of praife ; and hence, like
many of the furprifing remedies perpetually arifing, have
fallen into undeferved contempt.

The cure of the moft violent and inveterate difeafes
has been afcribed to eledricity, All that now remains
certain with regard to it is, that it is a powerful ftimu-
lant, and one which is the more ftrongly recommended,
becaufe it can be applied to a variety of parts, when the
common methods of ftimulation cannot be employed.
The mildeft modes of ufing electricity are thofe rnoli in
vogue at prefent, as its violent application is reprobated
by the belt practical writers. Its ufe in fufpended ani¬
mation, in chronic glandular enlargements, in atony of
the organs of generation, are well known.

Animal electricity, or Gaivanifm, is in fome refpeCts
fimilar to common eleCtricitt n its effects, and in others
different ; but, in a medical view, it has not anfwered the
D d expectations

100

PATHOLOGY.

expectations which at firft were formed of its aCtion. All
thofe animals which polfefs excitability are affeCted by
Galvanifm as they would he affeCted by any other violent
ftimulus; and, if the excitable part be at all mufcular, the
fibres are vigoroufly contracted. This caufes, in a living
and confcious animal, a fenfation not unlike an eleCtric
fhock. The (hock is more like that of common electri¬
city, as the plates of the battery are fmaller and more
numerous. When the plates are of very large furface,
a fort of vibratory motion is felt through1 the part, at¬
tended with a fenfation of heat ; and this, in a powerful
battery, is felt fo longas the connection is kept up. The
bell mode of taking the fliock is firft to moiften the hands,
or the part where the effeCt is to be applied ; grafp in
each hand a 'piece of metal, fuch as two fpoons, and touch
each end of the battery with the other ends of the fpoons
at the fame time. If it is intended to be applied to any
other part, let two plates, of about two inches in diame¬
ter, be each attached to the wires coming from the bat¬
tery, and let the plates be applied to fome two parts : if
the effeCt be too fevere, let fome inferior conductor be
placed between the plate and the fkin. Sir H. Davy
found, that, when an animal fubftance was placed in the
circuit of a galvanic battery, the different compounds
contained in it were decompofed. This was more Spe¬
cially the cafe with the faline bodies contained in the
animal fluids; the acids of the falts were found on the
pofitive fide of the battery, and the bafes of the falts on
the negative. Should it be afcertained that any redun¬
dancy of faline matter is the caufe of difeafe, Galvanifm
might be employed with great fuccefs in feparating thofe
bodies from the fyftem. See the article Electricity,
vol. vi. p. 409, 445, & feq.

Pneumatic medicine, or the ufe of gafes in the cure of
various internal complaints, was very falhionable at the
time chemiftry formed one of the moll ardent purfuits of
the French nation, and when they attempted to explain
the vital properties according to the laws of oxygen, &c.
And in this country, Beddoes, Rollo, Cruikfhank, and
others, made many interefting experiments and trials on
this fubjeCt. Of late its ufe has declined. See Oxygen,
vol. xviii. p. 1 67.

The diverfified experiments of Sir H. Davy on the
refpiration of nitrous oxyde and fome other gafes, fo in-
tereftingly defcribed in his fcientific refearches in 1800,
in a great meafure diflipated the general apprehenfions of
fatality refulting from the inhalation of compound gafes,
and fatisfaClorily demonftrated that many of the aerial
fluids, before confidered as deftruCtive to vitality, might
be breathed with perfeCt fafety.

The following cafe, (howing the beneficial effeCts of
oxygen gas in reftoring fufpended animation, occurred
in the year 1814, in the laboratory of the Dublin So¬
ciety, and excited confiderable intereft. It was commu¬
nicated by Samuel Whitter, efq. who made the experi¬
ment on himfelf. He introduces the account by obferv-
ing that, when a mixture of carbonate of lime and zinc,
or iron-filings, is expofed to an intenfe heat, the peculiar
gafeous fubftance named carbonic oxyde is difengaged,
which has been ftated to bear the fame relation to car¬
bonic acid that nitrous gas does to nitric acid. But
agreeably to the ftriking obfervations of Mr. Higgins,
profeflor of chemiftry to the Dublin Society, in his work
recently puhliflied, (wherein his claim to the difcovery
of the atomic fyftem is unequivocally eftablilhed,) it
would appear that, in the combination of oxygen with
different gafes, it is the atom of oxygen only that is found
multiplied, as is beautifully exemplified in all the metal¬
lic oxydes, acids, and gafes. An apparent anomaly has
been noticed with relpeCt to nitrous oxyde, which the
experiments of Mr. Higgins on the compofition of nitrous
gas tend to obviate, and fanCtion a comparifon of the
proportions of carbon and oxygen in carbonic oxyde
with thofe of azote and oxygen in nitrous oxyde, rather
than the atomic coincidence of carbonic oxyde and nitrous

gas. Carbonic oxyde was difcovered and defcribed by
Mr. Cruikfhank in 1801 ; it is highly combuftible, burn¬
ing with a fine blue flame, but it is utterly incapable of
fupporting animal life.

“ Defirous of witnefling the progreflive effeCts of car¬
bonic oxyde when freely refpired, with a view to compa¬
rative analogy in reference to nitrous oxyde, I was
tempted a few days ago to inhale a portion of it as copi-
oufly as poflible. The confequence had very nearly
proved fatal to me. A confiderable quantity of the gas
having been carefully prepared by Mr. S. Wharmby, the
very ingenious and able afliftant to Mr. Profeflor Higgins,
a feries of experiments on its refpiration were propofed.
Mr. Wharmby firft noticed fome points of refetnblance
it bore to the nitrous oxyde, particularly the Angularly
fweetifh tafte ; and, having made two or three infpira-
tions, was feized with a degree of convulfive tremor and
giddinefs that nearly overpowered fenfibility. Thefe
violent effeCts were but tranfient, though confiderable
languor, head-ache, and debility, remained for many
hours afterwards. Anxious to purfue the experiment
ftill further, I next made three or four hearty infpirations
of the gas, having firft exhaufted my lungs of common
air as completely as poflible. The effects were an incon¬
ceivably f'udden deprivation of fenfe and volition. I
fell fupine and motionlefs on the floor, and continued in
a ftate of total infenfibility for nearly half an hour, appa¬
rently lifelefs, pulfstion being nearly extinCt. Several
medical gentlemen being prelent, various means were
employed for my reftoration, without fuccefs ; when the
introduction of oxygen gas by compreflion into the lungs
was, fuggefted, the effects of which may be fairly con-
trafted with thofe of the carbonic oxyde. A very rapid
return of animation enfued, though accompanied by
convulfive agitations, exceflive headache, and quick ir¬
regular pulfation, and, for fome time after mental reco¬
very, total blindnefs, extreme licknefs, and vertigo, with
alternations of heat and (hivering cold, were painfully
experienced. Thefe unfavourable fpafms were fucceeded
by an unconquerable propenfity to fleep, which, as might
be expefted, was broken and feverilh. An emetic of
tartarized antimony finally removed thefe alarming fymp-
toms, and the only unpleafant effeCts felt on the en-
fuing day were thofe occafioned by the fall.

“I very much regret that the confufion arifing from
the idea of my death, fo dilturbed the arrangement, that
no accurate determination could afterwards be made,
either of the quantity of gas refpired, or the change it
underwent in the procefs ; and the experiment is rather
too hazardous for repetition. Neverthelefs, the extra¬
ordinary efficacy of oxygen gas in cafes of fufpended ani¬
mation produced by carbonic acid, choke-damps, and
other fuffocating gafes, is fairly deducible, and I conceive
cannot be too forcibly recommended to the faculty, in
fuch inftances. I therefore fincerely hope that the refults
of this experiment may be of practical utility in thofe
cafes, which are fo frequently occurring, and are often
fo awfully fatal ; it being the decided opinion of the pro-
feflional gentlemen prefent on this occafion, that the free
ufe of the oxygen gas was folely inftrumental in reftoring
me to life.

“ Mr. Higgins himfelf had nearly once fallen a viCtim
to a fimilar experiment with fulphuretted hydrogen, the
effeCts of which, after recovering from a death-like infen¬
fibility, were painful and oppreflive for many days.”

This very ihort (ketch may appear fcarcely a fufficienc
account of General Pathology and Therapeutics.
The pathological reader will be immediately ftruck with
the omiflion of all notice of Spafm, of Inflammation and
its confequences, &c. But we have rather deemed it
prudent to invelligate thefe fubjeCts under their feparate
heads, and have merely inferted thefe obfervations as
being of too general a character to be reduced under
any of our divifions. We therefore at once proceed to
the

CLASSIFY

101

PATHOLOGY.

CLASSIFICATION of DISEASES,

According to the fyftem of Dr. Mason Good.

Clafs I. C celiac a, Difeafes of the Digeftive Funftion.
Order r. Entericu. Affecting the alimentary canal.

2. Splanchnica. Affefting the collatitious vifcera.
Clafs II. Pneumatica. Difeafes of the Refpiratory
Funftion.

Order i. Phonica. Affefting the vocal avenues.

2. Pneumonica. Affe&ng the lungs, their mem¬

branes, or motive power.

Clafs III. H/ematica. Difeafes of the Sanguineous
Funftion.

Order t. Pyrettica. Fevers.

a. Phlogotica. Inflammations.

3. Exanthematica. Eruptive fevers.

4. Dyjlhetica, Cachexies.

Clafs IV. Neurotica. Difeafes of the Nervous
Function.

Order 1. Phrenica. Affefting the intelleft.

2. JEJihetica. Affefting the fenfation.

3. Cinetica. Affefting the mufcles.

4. Syjlatica. Affefting feveral or all the fenfo-

rial powers fimultaneoufly.

Clafs V. Genetica. Difeafes of the Sexual Funftion.
Order 1. Cenotica. Affecting the fluids.

2. Orgujlica. Affecting the orgafm.

3. Curpotica. Affefting the impregnation.

Clafs VI. Eccritica. Difeafes of the Excernent Func¬
tion.

Order 1. Mefotica. Affedting the parenchyma.

2. Cutotica. Affedting internal furfaces.

3. Acrotica. Affedting the external furface.

Clafs VII. Tychica. Fortuitous Lefions or Deformities.
Order 1. Apalotica. Affedting the foft parts.

2. Stereotica. Affedting the hard parts.

3. Morphica. Monftroflties of birth.

Class I. C CELIAC A, [from the Gr. Koihict, the belly.]
Diseases of the Digestive Organs.

There is no clafs of difeafes which more imperioufly
demands the earned and attentive conlideration of the
patliologift than this ; and certainly there is no clafs of
difeafes which has of late received more attention from
the medical world. We have before remarked on the
connexion which the alimentary canal holds with the
reft of the fyftem ; and on the media through which
this connexion is fupported. We have fliown, that, if
the fenforial powers be difturbed, the nervous productions
which expand on the mucous membrane of the alimen¬
tary canal will have their office altered orfufpended, and
deficient fecretion will be the refult 1 that, on the other
hand, every part of the mufcular and nervous fyftems
may be. affefted by the difordered ftate of the alimentary
canal, fince the impreffions of the latter, conveyed to
the brain, may affeft, through it, all other parts. This
reciprocal dependence and relation, then, we are quite
willing to admit ; but we have here to pauie, and to con-
fider a doftrine which is founded on this relation, but
which we are unwilling to admit. It is the doftrine,
that the primary caufe of difeafe refts immediately in the
ftomach and bowels. Now it is very obvious, that, in
tracing the origin of difeafes, the order of fucceffion
obferved by its fymptoms is the only guide which we
can adopt ; and it requires little experience to prove
that the fucceffion of /ymptoms affords in many difeafes
direct contradiction to the doftrine above mentioned.
For inftance, the effect of ftudious and fedentary habits
on the human frame, by inducing long and exceffive ac¬
tion of the brain, is to exhauft fenfibility ; hence the
due tranfmiflion of nervous power will be interrupted,
and the fecernent fyltem will be deranged in various ways.

It is true, the ftomach and bowels are generally the parts
in which this derangement is principally made manifeft ;
but this does not occur invariably. The fecretion from
many glands is fometimes difturbed, while the gaftric
and enteric fluids prefent no fenfible change. Again ; a
blow on the head, though it frequently produces vomit¬
ing, yet that effeft is not uniform. And again ; in the
efteCt of temperature, whether diminiffied or increafed,
we are able to trace the order of fucceffion through the
circulating to the nervous fyftem, without meeting with
any implication of the digeftive function in dilorder ;
and fo on. That the alimentary canal is a medium
through which morbid materia and impreffions are con¬
veyed to the reft of the fyftem, we have before ftated ;
yet fuch conveyance may not derange thefe organs, but
may produce fecondary effects on other ftruftures ; effects
which' may require remedies of a nature quite different
from thofe calculated to relieve ftomachic or inteftinal
derangements. Strong objections too are in force again ft
another part of the lame doftrine, viz. that of conli-
dering the ftomach as a centre of fympathy ; that is to fay,
when thofe terms are ufed to exprefs a peculiar property
of the ftomach, a property different from what is obfer-
vable in all mucous expanfions. For aflu redly the lize
or intenfity of power in the nerves, will fufficiently ac¬
count for the ready and general fympathy obferved with
regard to that organ, and other parts of the body, with¬
out reforting to this gratuitous hypothefis.

An argument is advanced in fupport of the origin of
difeafe in. the ftomach, which we are inclined to regard
with greater refpeft than any of the reft 5 namely, that
the cure of many local and conftitutional complaints is
effeCled by means which procure copious fecretion from
the alimentary canal. We may obferve, however, that,
while we allow the faft, the hypothefis which is founded
on it need not be admitted. The alimentary canal may
be confidered (in a greater or left degree in its various
parts) as the emunStory of the fanguineous fyftem. Thus
even the bile, befides its ufe in the reparation of chyle,
is carried downwards in large quantities with the feces.
The bowels, too, pour large quantities of fluids, which
vary in their fmell, colour, and confiftence; and, to a
certain degree, without the health being affeCted. Hence
fecretion from thefe parts may aft in various ways 5 either
by removing certain Hates of plethora, or by eliciting
from the blood noxious particles. In this way, emetics
thrown into the blood, are feparated from that fluid by
the digefting fecretions, and produce vomiting. We are
aware that this feems to approach, in fome degree, to the
humoral pathology ; but it is now become admitted, that
our pathological theorifts have perhaps too clofely dis¬
carded the explanation of difeafe which this doftrine af¬
forded. The proximate caufe mull, indeed, be looked
for in the aftion of the folids ; but the medium through
which difeafe is propagated is, undoubtedly, very often
the blood. The violent effeft produced by the injeftion
of a fmall quantity of air, or of other kinds of fluids,
feems very direft confirmation of this opinion.

We muft further remark, that the promulgators of
thefe doftrines have overlooked the manner in which the
derangements of the collatitious vifcera alter the ftate of
the ftomach and bowels ; an effeft which takes place ei¬
ther by means of the application of morbid fecretion, or
by continuity of difeafed aftion. With regard to the
remote caufes of difeafe in the digeftive organs, the fol¬
lowing are ftated by Dr. Nicholls in his Elements of Pa¬
thology. “ The procefs of digeftion may be imperfeftly
performed, owing to a variety of caufes; among which
we may reckon, — Food of an improper quality, or in
improper quantities ; imperfeft performance of the pro¬
cefs of maftication, in which cafe the food will not be
fufficiently mingled with faliva, nor will it be fufficiently
broken down and divided ; diminilhed fecretion of faliva,
ordifcharge of that fluid from the mouth; increafed fe¬
cretion of faliva; difeafed ftates of the fluids which flow

into

PATHOLOGY.

102

into the fauces ; an altered ftate of the gaftric or of the
pancreatic juices ; the prefence of an increafed or dimi-
niftied quantity of thefe fluids ; an altered ftate of the
bile; an infuflicient quantity of that fluid, whether ari-
fing from diminifhed fecretion, or from fome obftrudtion
to its influx into the duodenum ; the prefence of too
great a quantity of bile ; the flow of too great a quantity
of that fluid into the ftomach ; dileafed condition of the
ftomach, whether confiding of Ample plethora, of inflam¬
mation, diminifhed capacity, inordinate diftenfion, thick¬
ening of its coats, partial rupture, ulceration, or dif-
placement; difordered conditions of the cardiac or py¬
loric orifices ; obftrudied ftates of the inteftines ; hurried
adlion of the bowels ; increafed fecretion of enteric
juice ; diminifhed or depraved fecretion of that fluid ; col¬
lections of fteces; worms ; diminifhed fenfibility of the
nerves of the ftomach, whence may enfue diminifhed fe¬
cretion of gaftric juice, and diminifhed adlion of the
mufcular fibres of that cavity; an interruption of the
communication between the cerebral and the anti-cere¬
bral extremities of thofe nerves; increafed fenfibility of
the nerves of the ftomach, whence may enfue, increafed
fecretion of gaftric fluid, pain referred to the ftomach,
and the production of vomiting; altered ftates of the
cranial and fpinal brain; deficiency of nervous power ;
longabfence offleep; an increafe ora diminution of tem¬
perature, generally or locally ; powerful fenfations ; paf-
fions, efpecially thofe of the deprefling kind; powerful
exertion of the faculties, &c. &c.

The firft caufe of difeafe, then, which we have to
treat of, is the food. On this fubjeCt we propofe to fpeak
fomewhat fully, becaufe it regards one of the princi¬
pal agents in therapeutics. The difeafed aCtions of the
alimentary canal, of the collatitious vifcera, and laltly of
the ftate of the nervous, power, will conllitute the next
fubjedls of difcuflion.

That the natural food of man is equally theprodudl of
the animal and vegetable kingdom; that his digeftive
powers accommodate themfelves, in a certain degree, to
various kinds of fuftenance; that, ceteris paribus, vege¬
tables and water are capable of nouriftiing men of the
rnoft powerful mufcular and ienforial developments ; and
that the oppofite practice is attended with equally good
effedls ; are truths fo generally admitted and firmly
founded on the hiftorical records of every country, that
they need form no part ofourprefent difcuflion. On the
other hand, that the partially-refined and half-civilized
ftate in which we now live, our frequent meals, their
quantity difproportioned to our exercife, and the various
combinations which the culinary art affords us, may be
faid fully to counteract the ufeful and accommodating
conftitution with which we are endowed, are remarks
fo trite and familiar, that nothing but their importance,
ancl the want of attention paid to them, excufes our re¬
petition of them. The diet of man requires a certain
adaptation to the varieties of climate ; and here injlind ,
(or, as fome call it, nature,) untutored by education and
refinement, feems the bell guide ; for we find moft fa-
vages preferring in hot climates the vegetable fufte¬
nance, in colder regions animal food: and this me¬
thod of life experience proves to be moft conducive to
longevity and ftrength. Not that we are very favourable
to the mode of life called natural, being fully perfuaded
that man’s natural ftate is that of the higheft civilization,
fince to that he is continually tending; and hence we
ftiould not have ufed this faft as an argument unlefs it
had been fupported by our own experience.

The fubjeCt of diet, in reference to our own climate,
and in cafes of difeafe, has occupied very general atten¬
tion ; but the difficulty with which this fubjedt is at¬
tended, precludes us from prefenting our readers with any
•philofophical view of it ; for moft writers have been occu¬
pied withdetailingthegoodorbad effedlsof particular fub-
ftances, founded, it is to be feared, in too many inftances,
on partial views or individual feelings. Thus we are

continually hearing, even from medical men, that fuch a
thing is eafy of digeftion, and another difficult, and fo
on; while our indiferiminate application of thefe rules
foon teaches their fallacy : it foon fhows that what agrees
with one perfon produces violent effedls on another, and
that different ftates of diforder in the ftomach require
regimen of very oppofite powers.

In the natural and healthy ftate of the body, we mull
regard in fome meafure the Hippocratic advice; not to
carry our dietetic arrangements to a too great degree
of refinement, becaufe any occafional irregularity will
produce the more unpleafant effedls ; but at any rate the
ftate of health is bell confulted by partaking of few
articles at a meal. The proportion of exercife, too, be¬
comes a matter of conlideration ; but inftindl points out
the true path ; for, as lefs exercife is taken, lefs appetite
is experienced. The habit of meeting our friends at
meals, the variety of provifions which kindnefs and hof-
pitality prefent to and urge on us, are perhaps the moll
frequent caufes why thele inftindlive calls are fo feldom
attended to. But, though to thofe who take frequent
exercife, this relaxation and enjoyment is productive of
fcarcely any inconvenience, yet it is feverely felt by the
fedentary and the ftudious ; and hence to the latter are
rules and regulations more generally addreffed.

It has been held of late years that drinking at meals is
an unneceffary, and indeed improper, cuftom. This opi¬
nion receives fupport from obferving the habits of ani¬
mals, few of which drink while digeftion is going on in
the ftomach. In Greece, this cuftom of dry feeding is
faid to prevail ; and Xenophon fays, that the ancients did
not drink till the repaft was finilhed. We have not fuffi-
cient proofs to enable us to engage in proving or difpro-
ving this dogma; but we may obferve, that its applica¬
tion fhould of courfe be fomewhat regulated by habit and
inclination, and by the nature of the food and the ftate
of the atmofphere. In the Didlionnaire des Sciences
Medicales, the fentiments of Halle and Nyften on this
fubjedl are thus expreffed : “ La quantite de boiffon k
prendre pendant le repas doit etre en proportion d’autant
plus grande ou moindre, que les alimens eux-memes
font plus fees ou plus humides ; qu’ils fe laiffent plus ou
moins aifement penetrer par les liquides falivaires et gaf-
triques ; qu’ils forment, par leur vifeofite, une maffe
plus ou moins tenace ; qu’ils ont plus ou moins la pro-
priete de diftendre l’eftomac et d’y fejourner uncertain
temps. Les boiffons doivent aufli etre prifes en quantite
plus ou moins grande, fuivant les conftitutions indivi-
duelles qui, en raifon de leur degre de fechereffe ou d’hu-
midite, prefentent des differences tres-grandes relative-
ment a la quantite et au degre de liquidite des fucs fali¬
vaires et gallriques. Les perfonnes feches et bilieufes,
dont les organes font tres-irritables et dont la chaleur
propre eft plus ardente, dont les evacuations inteftinales
font plus habituellement d u res et feches, qui font ordi-
nairement conftipees, ont befoin d’une plus grande quan¬
tite de liquides aqueux et frais. La proportion des boif¬
fons aux alimens doit enfin varier felon 1’influence des
faifons et de l’etat de l’atmofphere. On peut cependant
pofer en principe, i°, qu’une quantite de boiffon qui
excede trop la mefure des befoins naturels, cnerve les \
digeftions, et favorife les alterations fpontanees des ali¬
mens qui fejournent dans l’eftomac, furtout quand ce
wifeere a peu adlivite ; 20, qu’une quantite de boiffon
infuffifante prolonge le fejour des alimens dans la cavitc
galtrique, et entretient le fentiment de plenitude qui en
eft la fuite. Mais il faut furtout, a cet egard, fe mettre
en garde contre l’habitude qui outrepaffe plus fouvent
la mefure qu’elle ne refte en-de$a; connaitre, par fon
experience, quelle quantite de liquide eft ia plus favora¬
ble ; favoir que la foif que donne l’ufage des fubilances
feches, en epuifant fur-le-champ les organes falivaires,
n’eft fouvent que momentanee, et fe difiipe en peu d’in-
ftans par le renouvellement de la falive. Ces oblervr.tions
font importantes pour ceux dont les digeftions font lentes,

1 imparfaites;

103

PATHOLOGY,

imparfaites 5 pour ceux qui font fujets aux aigreurs, et
cliez qui les fonftions de l’eftomac font aifrfment trou¬
bles par la fuperfluite des liquides.” (Tom. iii. p. m.)

It is fuppofed too, that the rapid drinking of fluid is
lefs falubrious than gradually fwallowing it, as the for¬
mer practice tends to produce dijlenlion of the (lomach ;
but of this dillention we have no very unequivocal
proof.

Of the bad effects of too great a quantity of food we
have frequent inftances, both in fudden and chronic af¬
fections ; and we have every reafon to believe that man¬
kind offend in general by taking too much food rather
than by taking that of an improper quality. A negleft
of attention to the quantity of the food, proportioned to
the neceflity of each individual, is fooner or later fol¬
lowed by the molt ferious confequences. To the ftrong
and robuft inflammatory difeafes happen, and all fuch as
proceed from plenitude, as the gout, apoplexy, See. To
the more tender and delicate, it is the parent of a nume¬
rous progeny of diftempers, affefting both body and
mind ; there is fcarcely a malady that can be named
which is not increafed by excefs of food, till the difeafe
at length bids defiance even to temperance itfelf, and all
prefeription. The hozv much , indeed, mull be deter¬
mined by every individual ; but thofe who are happy
enough to abftain at the firli fenfation of fatiety, have
made great progrefs in the art of maintaining fuch a
command of appetite, as, under molt chronic indifpofi-
tions, is one of the great aids of recovery ; and, in health,
is one of thefureft prefervatives againft them.

To the delicate and valetudinary the confideration of
the quantity of the food is of frill more importance.
They do not rife from rich and varied repafls with the
fame freedom from uneafy fenfations as the robuft ; they
are affefted with uneafinefs, fome in one way, fome
in another, by the unnatural load. And we often hear
them complaining of the ill effefts of this or of that par¬
ticular kind of diet, when, perhaps, their fufferings arife
from the quantity of all, rather than from the difagree-
ment of any. What renders an attention to the quan¬
tity of food in invalids (till more necefiary, is, that they
are often fubjeft to a falfe appetite ; to a craving that does
not arife from the demands of health, but from the mor¬
bid condition of the juices in the ftomach, which
prompts them to eat more, and more frequently, than
nature requires. Hence it happens that fuch people are
often difpofed to take in much more than can be digefted,
to devour their food rather than eat it ; by which means
their fufferings are increafed, difeafe gains ground, de¬
feats every purpofe of the phyfician, and leads them into
fome permanent and incurable malady.

The time of eating is another grand confideration.
It is well afeertained that a periodical aftion exiftsin the
different fecreting parts of the body ; and that the fto¬
mach afts with different degrees of energy at different
times, and according to fixed laws, can admit of no dif-
pute; for not only does its being only required to aft at
certain times indicate this, but the hunger we feel at the
hour of repaft, and its abfence after a fliort time if not
fatisfied, afford further corroboration of it. The cuf-
toms of various countries changes too in refpeft to time ;
and, provided the fame periods are obferved each day,
this does not feem to influence our health in a great de¬
gree. Mr. Abernethy ftates the proper interval between
each meal at fix hours, which reduces the meals to three
in a day; and this feems to be the moft judicious
arrangement which can be made, and which has indeed
been generally adopted among the affluent clafles in this
country, fupper being for the moft part difearded ; or
perhaps we fhould rather fay, that the meal of dinner
has been difearded, and an early fupper fubftituted.
But two very moderate meals, at a fuitable diftance of
time, would doubtlefs be digefted with much more eafe
than one full meal, when the ftomach has been debili¬
tated by long falling, and has fuffered fatigue, together

Vol. XIX. No. 1290.

with the body at large, from the exertions of a long day.

So that, as Dr. Fothergill has obferved, “ when people
affure us they eat no fuppers, from obfervation I am led
to fufpeft, that it would be better for them if they did,
than to opprefs nature with a cumbrous load that may
be much more detrimental.” This, indeed, feems to
be pretty well underftood with refpeft to invalids and
convalefcents, who are generally fupplied with fmall
light meals at proper intervals, rather than have all their
diet crowded into one late dinner.

We fhall juft infert a general view of the more com¬
mon fubftances ufed at meals, for the purpofe of confult-
ing the health of thole perfons who, though not ill, find
the gaflric funftions eafily difturbed. The general
breakfaft of people, from the higheft to the lowed, is
tea, coffee, or chocolate. There are, of courfe, many
exceptions ; fome for one reafon, fome for others, making
choice of other fubftitutes, as their experience or opi¬
nions guide them. To thefe articles, bread of fome kind,
with more or lefs butter and fugar, is commonly joined
to make up the meal. From many inconteftible proofs
that butter in confiderable quantities is injurious to con-
ftitutions not ftrong, it is fparingly ufed in many families.

It is found by many to be very difficult of digeltion, ef-
pecially when toafted before the fire, or fried, as well as
in fauces. Many people, apparently robuft, and whole
organs of digeftion are ftrong, often find themfeives
much difordered by large quantities of butter. Nothing
more fpeedily and effeftually gives the fick head-ache,
and fometimes within a very few hours. After breakfaft,
if much toaft and butter has been ufed, it begins with a
Angular kind of glimmering in the fight, objefts fwiftly
changing their apparent pofition; giddinefs then comes
on, head-ache, and ficknefs. An emetic, and warm
water, foon walh off the offending matter, and remove
thefe diforders. Thefe are circitmllances Which very of¬
ten happen to people who are inattentive to the quantity
of butter they eat at breakfaft. A moderate quantity of
frelh butter, with bread expofed as little to the fire as
poflible, or not at all, appears to be wholefome, and is
capable of becoming, with the other aliments, as loft
and inoffenfive chyle, perhaps, as any part of our diet.

The fame thing may perhaps be faid of coffee as of tea;
the heat, the ftrength, and the quantity, make it un-
wholefome or otherwife. There are nations who alrnoft
live upon coffee, as others do on tea; and among neither
are any difeafes prevalent that can juftly be aferibeu to
thefe ingredients in the common courfe of living. There
are, however, individuals of peculiar conftitution, in
whom the Indian tea excites various unpleafant fymp-
toms, as head-ache, rellleffnefs, &c. and feveral Britilh
plants have been recommended as fubftitutes, and ufed
with advantage. But Dr. Reid, in his Effuy on Hypo-
chondriafis, fays, “ I am inclined to think that there are
many cafes in which a tafte for tea ought to be encou¬
raged rather than condemned. This tafte has a tendency
to preclude the more prevalent, and after all more mif-
chievous, propenfity for vinous ftimulation. Many per¬
fons, diftinguilhed lor their longevity, have been known
to indulge habitually in the ule of tea; which we may
account for, not from its being in itfelf a wholefome beve¬
rage, but from afondnefs for it generally implying a dif-
talte for potations of a much more decidedly pernicious
nature. Tea will produce, in fome very irritable frames,
an artificial (late refembling intoxication ; but it is a
cloudlefs inebrity. Tea removes the film from an eye
that has been obl'cured by a grofs and ftupifying intem¬
perance, and tends to improve a fufeeptibiiity to the true
relifh of focial and intelleftual enjoyment.” It (hould
be recollefted, however, that every vegetable infufion of
this fort, is but warm water, rendered more palatable by
the aroma of the herbs fo infufed ; and that there is little
or no nutriment conveyed by them to the body, except
what is contained in the fmall portion of milk and fugar
added to them. Thefe liquors, then, (hould be conii-
E e dered

104

PATHOLOGY.

dered as the mere beverage, by which the folid portion
of the breakfaft, the bread, See. is to be diluted, and its
digeftion aflifted ; and it would be advifable for the deli¬
cate and valetudinary to curtail the liquid and augment
the folid part of a tneal, which is to fupport them during
the exertions of the day, rather than to fill the ftomach
with a diluent and narcotic liquid, at once failing to
nourifh the body, and deprefiing the aftion of the ftomach,
where little is taken befides.

But the effefts of improper conduft in refpeft to thofe
things which now conftitute our breakfafts are of little
confequence, compared to thofe which arife from the
well-covered table at dinner. The indulgences of break¬
faft fupply but very few materials for deftruftion ; but
the repeated exceffes at dinner are ferious affairs. And
although, as we have before ftated, the quantity of food
is the point to be principally regarded ; yet the quality
is by no means a matter of indifference to the valetudi¬
nary. The principal admonition which the late Dr. He-
berden deemed it neceffary to imprefs on the minds of
delicate perfons and invalids, was to avoid all thofe ar¬
tificial ftimulants of the appetite, which excite the de-
fire for food beyond the fimplecall of nature, and there¬
fore beyond the natural powers of the ftomach to digeft.
Such are all made difhes, and condiments of the more
poignant qualities ; nor is variety of difhes lefs perni¬
cious, upon the fame principle. It is probable that, in
their nature, aromatic vegetable condiments, or fpices,
are lefs pernicious to the organs of digeftion, than the
various modifications of alcohol, or fpirits ; but the mif-
chief which they occafion indireftly, by leading to excefs,
is unbounded. This excefs is ftill more pernicious, now
that the hour of dinner is poftponed to the evening; for
the ftomach is enfeebled by the longabfence of ftimulus,
and by fympathizing in the fatigue of the body, fo that
its power of digefting a copious and heterogeneous mafs
is greatly diminifhed. It is loaded, and diftended, and
oppreffed ; and the body, in its turn, fuffers with the fto¬
mach. Hence, we fee the flufh of the countenance fuc-
ceeding to a late and copious dinner ; the indifpofition
to any exertion, mental and corporeal ; the general op-
preflion of the animal powers; the general fenfation of
heat; the hurried pulfe ; dry or clammy tongue; and
other fymptoms of feverifhnefs. It is moft obvious,
that the daily, or even frequent, repetition of fuch a
diforder, (for it is, in faft, a morbid condition which is
thus produced,) cannot be fuffered, without injury to
the conftitution.

Some of the common articles of diet require a little
attention. Bread, the ftaff of life, is not the ipoft eafy
of digeftion ; if taken in confiderable quantity, very
ftrong organs are requifite to convert it into nutriment,
and more efpecially when it is new, for then it is of a
glutinous and heavy nature, and extremely difficult of
folution. Cafes have been recorded, indeed, in which
an immoderate quantity of frefh-baked bread proved the
caufe of death. (See London Med. Journal, vol. i. p.
333.) In weak ftomachs a large proportion of ftale bread
is indigeftible 5 it turns four, produces the heart-burn,
flatulencies, and interrupts the perfect concoftion of
every thing elfe. On this principle, the neceftity of pay¬
ing much attention to this capital article of diet ought
to be inculcated on valetudinarians in general ; never to
abftain from it wholly, but to ufe it with moderation;
to confider it as one of thofe things which, fparingly ufed,
is extremely neceffary and beneficial ; if otherwife, the
fruitful fource of many complaints, which are little fuf-
pefted from this caufe.

In this country, animal food, of one kind or another,
conftitutes the chief part of our nourifhment. That
there are forne kinds of more eafy, fome of harder, di¬
geftion, is well known to every one; fo that it is unne-
ceflary here to particularize them. The young of animals
is generally confidered as more eafily foluble than the old;
but in ftomachs difpofed to acidity, this does'not appear

to be the cafe. Animal food is rendered more digeftible,
by approaching to a ftate of beginning putrefaftion ;
hence, the flefli of animals recently killed is lefs eafy of
digeftion than that which has been kept for fome time;
and hence, alfo, the flefh of an animal which has been
hunted, or has ufed any violent exertions before death,
is more tender and wholefome than one which has been
in confinement ; for, after fuch exertions, the mufcular
or fieftiy parts are difpofed to go fpeedily into a ftate of
putrefaction. It muft not be forgotten, however, that
this remark is applicable only to cafes where the ftomach
is quite healthy; there being every reafon to believe,
that, if any degree of gaftritis is excited, putrifying meat
would prove violently ftimuldting.

In refpeft to vegetables, the beft rule is to ufe thofe
which beft agree with each particular conftitution. All
the vegetables brought to table, which have been ren¬
dered foft by boiling, are readily digeftible. The raw ve¬
getables, ufed in falad, &c. are fomewhat lefs fo ; but,
unlefs where the ftomach is much difpofed to acefcency,
they are generally wholefome. “ On this head,” fays
Dr. Fothergill, “ I have only one ftiort caution to give.
Thofe who think it neceffary to pay any attention to
their health at table, fliould take care that the quantity
of bread, and of meat, and of puddings, and of greens,
fliould not compofe each of them a meal, as if fome were
only thrown in to make weight; but carefully to ob-
ferve, that the fum of all together do not exceed due
bounds, orincroach upon the firft feelings of fatiety.”

With refpeft to fruit, it is doubtlefs wholefome in
its ripe ftate; efpecially if taken in the forenoon, orin-
ftead of a meal. But, like other agreeable and nutri¬
tious fubftances, it muft prove injurious, when added
to the load of the ftomach, after a plentiful meal.

Much might be faid about the comparative advantages
of the different kinds of liquor ufed at table. The great
objeft of drink at our meals is to dilute the aliment ta¬
ken into the ftomach, and thus render it more capable
of digeftion. It is too often, however, ufed for a very
different purpofe; namely, to ftimulate an imperfeft ap¬
petite, and to enable the ftomach to receive with relifti
what, in its unftimulated ftate, it would loathe and re-
jeft. Inafmuch, then, as drink is conducive to excefs in
eating, it is pernicious to take large and frequent
draughts of any liquid during a meal. Dr. Fothergill
has laid down a few limple rules in refpeft to drink.
“ The lefs quantity of fermented liquors we accuftom
ourfelves to the better. Abftain from fpirits of every
kind, however diluted, as much as may be. Where mild
well-brewed beer agrees, to keep to it as a beverage.
Where water does not difagree, to value the privilege,
and continue it.”

By thofe who recommended drinking not at, but after ,
meals, the interval ufually fixed upon is about two or
three hours ; and we are moreover recommended by Mr.
Abernethy to reft for a confiderable time after a meal,
fome experiments made on dogs having proved that the
digeftion of food in the ftomach takes place moft readily
when the mufcular fyftem is in a ftate of inaftion. This
liasjbeen objefted to, however, by a Mr. Hare ; but, as
that gentleman has not tried the experiment over again,
his objeftions are not valid. It feems to us, that the
natural difinclination to move which we all feel after
partaking of food, and the frequent eruftations, &c.
which exercife produces when ufed during the fame pe¬
riod, fufficiently prove the correftnefs of Mr. Aberne-
thy’s opinions on this fubjeft, without any appeal to ex¬
periment. The day, then, according to the view taken
by the diftinguifhed gentleman juft mentioned, will be
thus divided 1 The early part of the morning is to be
devoted to exercife. Half an hour’s reft being premifed,
breakfaft is to be procured. Reft again becomes necef¬
fary for two or three hours. Exercife again Ihould then
be had recourfe to, until within half an hour before din¬
ner, the latter period being as before devoted to quief-

eence»

PATHOLOGY.

cence. The fame round of employments to be continued
until the third meal of the day, which is fuppofed toconfti-
tutethelaft. According to this arrangement, the intervals
between breakfaft and dinner, and between dinner and
Aipper, (or tea,) will be each lix hours. See Abernethy
on the Conftitutional Origin of Local Difeafes.

We have to give our fmall tribute of encomium to
this plan of life, being well allured by experience of its
i'alutary and beneficial operation. It is very remarkable,
but no lefs fatisfaddory, to find, that the habits which ex¬
perience has proved to be molt conducive to health,
coincide completely with the practice founded on reafon-
ing ; the trainers of our pugilifts having long fubmitted
their pupils to rules very fimilar to the dietetic ones juft
mentioned, and truly we can fcarcely find any-where elfe
fuch ftrong proofs of their propriety. A bloated drun¬
ken fellow, whofe hours are perpetually occupied with
debauch, and whofe frame evidently betrays the baneful
effects of intemperance, fubjefted to three months
training, that is, to the influence of regular and power¬
ful exercife, falubrious air, wholefome and fparing fup-
plies of food, reftrifted in drink to water, and perhaps a
few glaffes of wine, becomes developed in his mufcular
ftrutture to an aftonifliing fize : he affords a ftudy for the
painter which almoft equals the boafted ftatues of Italy;
his Ikin acquires a fairnefs which might add beauty to
our falhionable females ; and indeed the whofe appear¬
ance of the man is changed “ quanto ab illo Hettore.”

In recommending, however, the above, we are aware,
that they require much modification in their application
to morbid ftates, becaufe the digeftive functions are in¬
fluenced in various and in oppofite modes, according to
fex, age, habits of body, and habits of life.

Though the refults of chemical analyfis, in regard to
the nutritious parts of our diet, do not furnilh much
practical information, it may be proper to advert to
them with a view to future generalization. The food of
man conlifts of feveral unchangeable principles, foreign
to the bufinels of nutrition, combined with others in
which the nutritive power refides. The latter varies in
its characters and proportions. Mucilage, gelatine,
gluten, albumen, fecula, fibrine, fugar, and the bafe of
oxalic acid, are the general modifications under which
the nutritive fubftance prefents itfelf. Each of thefe
varies according to the nature of the heterogeneous prin¬
ciples with which it is aflociated.

In the numerous plants which do actually, or which
might, lerve for food, mucilage fometimes exifts alone,
or mingled with extractive, colouring, acrid, bitter, or
odorous, matters; or diluted with various proportions of
water. It is often united with oxalic acid and fugar ;
fometimes with a very aCtive volatile principle of a very
acrid tafte and penetrating odour. Laftly, it furnilhes
the matter of gums and vegetable jellies ; in one of which
the nutritive principle is imperfeClly formed, while in
the other it is brought into a very fmall volume. Gum
tragacanth, feneca, cherry-gum, &c. are examples of this
matter. It is no-where cultivated, nor even collected,
for food ; fo that we might be apt to confider it as inca¬
pable of affording any nourifliment, if it were not known-
that the caravans eroding the fandy deferts of Africa,
over which they have brought gum feneca, have in many
inftances loft their way, exhaufted their provifions, and
been obliged to live on this gum for many weeks, having
nothing elfe but water alone, and a very fparing fupply
of that. Mucilage is aljo contained in moft vegetable
juices, and in the Items and other parts of plants.

In the flelh of animals which we ufe for food, the ge¬
latine is united with fibrous, extractive, faline, and earthy,
particles. It is mingled with fat, and with ferous or
lymphatic fluids. It is found in various degrees of te¬
nacity and confidence; in which it determines all the
fenfible differences of the white organs, which contain an
abundance of gelatine. In a word, it forms the animal

i

105

jellies, which conftitute a mild, light, and wholefome,
food.

Vegetable gluten is always found combined with other
fubftances folublein water, without which it could not be
diffolved in, and blended with, our juices. It abounds
in the gramina, where it is united with fecula, extractive
principle, colouring matter, mucilage, and an earthy
fubftance. The albumen of animal matters refembles, in
many points, the vegetable gluten. The whole white,
and a great part of the yolk, of an egg, are a compofition
of albumen, and colouring and oily principles. The
cafeous matter of milk is a modification of albumen :
which, together with the principles of butter and fugar,
compofes that foft etnulfive liquor, fo favourable to the
conftitution of infancy. The moft nutritive plants are
thofe whofe bafe and prevailing principle is the amyla¬
ceous fecula. It exifts fometimes completely pure, and
free from extraneous admixture ; fometimes united with
mucilage, oils, or gluten ; fometimes with fugar, extrac¬
tive or colouring matters; fometimes with earthy, acid,
or faline, principles ; and very rarely with noxious or
poifonous matters. Wheat is compofed of gelatinous
matter and fecula. Thefe two principles, aCted on by the
fermentative procefs, form bread, the nutritive qualities
of which are not furpaffed by any vegetable fubftance.
It is fo much the more proper for animalization, inafmuch
as the fermentation has already brought it into a ftate fit
for decompofition.

The principle now alluded to, which conftitutes the
farinaceous matter of vegetables, is contained, perhaps,
in the largeft proportion, in rice ; and wheat is the next
to this. Other grains are only fubftitutes for thefe ; ex¬
cept maize, which is eafily cultivated, and contains much
farinaceous matter. The legumina contain much of the
fame principle ; as alfo nuts, and the feeds of the cucur-
bitaceae and poppy, although not ufed for food. It exifts,
probably, in the Items of fome plants, as thepalmse, from
the expreffed juice of which fago is formed ; in the roots
of many claffes, as the potatoe, yam, and pignut, in
which it is very abundant.

The fibrine of the mufcles and blood partakes of the
properties of gluten and fecula : it admits of a very fpeedy
aflimilation, and exerts a more marked, rapid, and exten-
five, influence on the ftrength in general, than any other
food; yet it refifts the digeftive powers, when, deprived
of gelatine or dried, it is reduced to a hard coriaceous
fubftance. It forms a clofe and firm, but delicate and
divifible, texture, in the mufcles of healthy animals, which
form a light and fucculent kind of food. An extractive
colouring matter generally adheres to the fibrous fub¬
ftance ; and the differences in its quantity or quality pro¬
bably influence the appearance and nutritive powers of
our various animal foods.

Sugar, and the oxalic bafe, which can hardly be fepa-
rated from it, are produced by both kingdoms. The ve¬
getable acids are convertible into a fugary fubftance, which
bellows on them whatever nutritive powers they may
poffefs. Other acids, befide the oxalic, are unfit for nou-
rilhment ; and they only acquire that property by an ad¬
mixture of the latter or of fugar or mucilage. The fame
principles exift in various proportions in the fruits em¬
ployed for food. The refpeCtive quantities of mucilage,
fugar, acid, and water, indicate how far they are fufeep-
tible of digeftion, and, confequently, nourilhing. Sugar
exifts in moft vegetables ; but is moft abundant in the
fugar-cane, from which alone it is furniflied to any great
amount, in the fugar-maple, and the beet-root. Except¬
ing whatisfupplied from the vegetables above mentioned,
and which hardly forms the food of any perfon, its
fources for the purpofes of food are not very general,
being confined principally to dates, grapes, figs, and fome
other fr.uits. Fruits indeed, in general, contain fugar;
many of them in fufficient quantity to afford confiderable
nourifliment. But the three fpecies juft enumerated are

thofe

106

PATHOLOGY.

thofe on which many individuals live almoft entirely ; the
fugar being nearly their only nourifhment ; this obferva-
tion holds with regard to dates in 1'ome of the African
tribes, grapes in fome parts of Portugal and Spain, and
figs in Greece and the Grecian iflands.

Exprefl'ed oils, found in vegetables, are alfo capable of
being digefted ; the feeds containing them, and especially
nuts, are in many inftances the principal food of the in¬
habitants of a country, as cocoa-nuts in America and
the Eaft. Thefe feeds indeed contain farinaceous matter,
but in too ftnall proportion to afford nourifhment of it-
felf. The oily animal fluids alfo afford nourifhment ; the
molt common fource of thefe is the fat of meat and butter,
but fome of the Ruffians and the Greenlanders drink
with avidity fpermaceti and train oil.

As rules for diet and exercife are attended to chiefly
by valetudinarians and the aged, we fhall notice a publi¬
cation which appeared in the year 1758, called “The
Old Man’s Guide to Health and longer Life.” The au¬
thor very properly divides his old men into two regi¬
ments, the thin and the grofs, to each of which he pre-
lcribes a different regimen; the following rule, however,
being common to both ; “Ufe no butter at breakfaft, if
you wifli to preferve an appetite for dinner ; and, in pro¬
portion as you ufe more or lefs (butter), fo will your
feelings be.” The author goes on ; “ The grofs old man
fhould take his exercife chiefly in the forenoon, with as
little nourifhment as poflible ; the thin old man fhould
have a light breakfaft, but take his exercife after dinner.
The thin old man cannot fleep in the morning ; the grofs
man cannot rife early, unlefs he fleeps in the day-time.”

The frequent notices in newfpapers of individual in¬
ftances of extreme old age, as well living as dead, have
led us fo think that much ufeful information might be
elicited from a narration of the molt elfential circumftan-
ces ami habits of life of thofe who have thus fo greatly
exceeded the ordinary limits of human exiftence ; fuch
particulars, for inftance, as quantity and quality of food ;
degrees of abftinence and indulgence in animal or intel¬
lectual enjoyments ; of exercife and labour, or of feden-
tary inactivity ; and laftly, the proportions of health and
ficknefs. Now, although great uncertainty may arife in
afcertaining the accurate truth of many faCts, through
the traditionary nature of the fources from whence they
muft be collected, yet, among thofe who furnifh editors
of newfpapers or other publications with cafes of long
life, enough might be obtained, by any one interefted in
the fubjeCt, to throw' great light on the at-prefent dif-
puted queftion of relative caufes, and might tend to efta-
blifli, at leaft with greater probability than yet exifts, the
quantum of influence which the moral and habitual ope¬
rations and regulations of the animal economy poffefs
over the peculiar idiofyncracy of that economy itfelf.
We are not, certainly, fo fanguine as to expeCt from any
combination of faCts, however numerous and well at-
tefted, that mankind will ever regain the art of living to
Methufelah’s age ; no, certainly not; thofe were the days
of miracle, long lince found ufelefs : but if, from a com¬
panion of a multiplicity of various and oppoling truths,
fome certain general principles could be difcovered, on
which the prefervation of human life, and, what is Hill
infinitely of more importance than mere length of life, its
healthful fecurity from the afflictions of bodily difeafe
and moral fuffering, could be proved to depend ; then,
inftead of merely exciting a momentary feeling of wonder,
like the prelent barren ftatement of the years an individual
has held his being, fuch a concentration of prominent
circumftances attendant on lengthened exiftence would
become the precurfor of a new era, both in the fcience
of medicine and in that of the happinefsand well-being
of univerfal man. We are aware that the relater of any
inftance of longevity could do little more than colleCt
the circumftances connected with it : to combine and de¬
duce muft be the work of a mind in full pofleffion of the

aggregate mafs of particulars, and qualified to draw in¬
ferences from them.

After diet and exercife, the remaining numerous caufes
of difeafe in the digeftive organs refolve themfelves for the
moft part into the effeCts of fympathy w'ith or dependance
on the aCtion of various other parts. The cerebral ftruc-
ture forms one of the leading and moft important. It
were of little importance to fpeak here of the numerous
complaints incidental to men of ftudious habits. It muft
be expefted that, feeing that mufcular contraction acts
a very important part in the human frame, and that
the force of that action is increafed (within certain limits)
in proportion to its exercife, therefore indolence muft be
productive of hindrance to the due performance of vaf-
cularand abforbent functions of the body. It is further
to be confidered that nervous influence is neceflary to
fecretion ; and on fecretion the hunger, digeftion, &c.
may be faid to depend. No w, it is well known that the
intenfe aCtion of the brain in performing mental pheno¬
mena do effentially and fometimes completely difturb the
tranfmiflion of nervous influence. Of this we have the
moft frequent examples. Every one knows how often
enthufiafts in fcien-ce are led to forget the precife hours
of refrefliment, and how much the man of literature in
this refpeCt differs from the bon vivant. It would feem
(to ufe a figurative expreflion) that the brain was fo ab-
lorbed in the fubliinity of thought, that it had no time
to perform its corporeal and coarfer funftions. But of
courfe thefe functions are requifite in the higheft degree,
and the non-performance of them fubjeCts the ftudious
man to difficult and uneafy digeftion; and fhould there¬
fore be encouraged by regular habits and by mufcular
aCtion.

On the other hand, the want of due aCtion in the ra-
tiocinative powers feems to allow increafed nervous fup-
ply to the fecreting organs. Thus many mentally-indo-
lent perfons have voracious appetites ; and indeed we
cannot help thinking that the amazing digefting powers
manifefted by our peafantry (in the generality of whom
we fee correfponding inactivity of mind) depends in a
great meafure on the unexercifed ftate of the intellect.
This propofition it would be perhaps difficult to demon-
ftrate, becaufe the faCts under confideraticn may be ex¬
plained on other grounds. It is worthy of remark, how¬
ever, that we fee none of this exceftive defire for food ma¬
nifefted by men who, engaged in occupations equally la¬
borious and healthy as the ploughman’s, are called upon
moreover by neceffity or ftimulated by education to the
exertion of their minds.

It has been aflerted more than once, that abftinence
fits the mind for increafed exertion. This notion can
only be admitted with fome reftriCtion. To a great de¬
gree it is undoubtedly true, becaufe, according to our
prefent methods of life, it may be reckoned that the ge¬
nerality of perfons are inclined to a plethoric ftate of
the vefiels of the head, and hence a low kind of living may,
to a certain point, tend to revivify the exhaufted brain.
This beneficial refult may arife too from tranquillity
being reftored to the extenfive nervous expanfions of an
irritated ftomach, which propagated their morbid con¬
dition to the brain ; or, again, it may prevent for a time
the fupply of noxious materia to the vafcular fyftem of
the brain. In the latter mode efpecially it is probable
its effeCt is very frequent; for there is ftrong ground to
conjecture that many mental diforders arife from the laft
caufe. The effeCt which the deranged liver produces on
the brain can only be accounted for on the fame fuppo-
fition ; i. e. that of abforption and local application.

This agency of the liver on the head is corroborated by
the refpeCted teftimony of Dr. James Johnfon. See his
work “ On the Dileales of Tropical Climates,” p. 189.
He fays, fpeaking of hepatic derangements, “ The whole
of the literary world, from the poet in his garret to the
learned prefident in his hail, feel more or lefs of its ef¬
fects.

PATHOLOGY.

feds. This deficiency in the fecretion of bile, the con-
Sequence of mental exertion and corporeal inadivity, is
evidently the morbus eruditorum, * which ficklies o’er, with
the pale caft of thought,’ 'the countenances of the ftu-
dious, who wafle their hours and their health by the
midnight lamp ! To them I need not defcribe the ma¬
lady ; they are too familiar with its various, fymptoms.
But few of them are aware how far material caufes can
influence intelledual ideas. If I wi(h to exert, on any
particular occafion, the whole force of my memory, ima¬
gination, perception, and judgment, I know, from re¬
peated experience, that by previoufly emulging the liver
and its duds, and carrying off all bilious colluvies from
the alimentary canal, by mercurial purgatives, which
alfo excite a brifker fecretion in the chylo-poi'etic vifcera,
I am thereby enabled to avail myfelf of thofe faculties
above mentioned, to an infinitely greater extent than I
otherwife could. This is no theoretical fpeculation -5 it
is a p radical fad. It may help to explain the great ine¬
quality which we often obferve in the brighteft effufions
of fancy 5 and fhew us why even the immortal -Homer
fometimes nods.”

The ftomach is influenced by fympathy with other
parts to a very great degree: iftly, by the (late of the
Ikin ; sdly, and mod materially, by the ftate of the lungs;
and, laftly, by the ftate of all the coliatitious vifcera.
Among thefe the moft ftriking is the liver. It is fcarcely
fair to infer, however, that affedions of the alimentary
canal are produced by the coliatitious vifcera through
the medium of the nervous fyftem ; fince the unnatural
fecretions poured into it by them may produce all the
difturbances we have occafion to witnels. From the na¬
ture of this ftrudure it is verjt evident, that each of its
fecondary procefles is dependant on the due performance
of the primary ones. Thus the faliva cannot mix with
the food in a proper manner until the teeth have
performed their office; the ftomach cannot ad if any
impediment exifts in the pharynx ; nutrition cannot
take place if the adion of the ftomach fufpended or
materially depraved ; and fo on. Hence, then, the belt
mode of considering thefe difeafes is according to their
anatomical relation to each other; fo that difeafes of the
teeth, faliva, pharynx, and fo on, will form the order of
our arrangement.

Before enteringon them, however, we have a few remarks
to make on fome grand divifions in regard to the patho¬
logy of the mucous membrane of the ftomach and bowels.
To thefe derangements the fweeping term indigeftion
has by moft writers been applied, with a view of compre¬
hending the whole of this varying and numerous clafs.
We are indebted to the continental writers for fome very
material elucidations of the nature of gaftric affedions.
We find, in the work of Brouffais efpecially, a moft able
expofition of the chronic inflammation of the ftomach ;
a difeafe which had been greatly overlooked, and perhaps
confounded with thofe inexplicable modes of adion
which have been accounted for on the unfatisfadory af*
fumptions of want of tone, laxity , weuknejs, or delicacy ,
of ftomach, &c. It is to be doubted if the ufe of thefe
vague expreffions has not induced many to adopt thefti-
mulating, the purgative, or the ftomachic, plan, to the
manifeft injury of their patients, when cooling and un¬
irritating meafures were more appropriate. Gaftritis, in
the common fignification, is certainly a difeafe of rare
occurrence, and is as dangerous as rare; but this applies
only to its moft acute and. violent form. Brouffais has
eftablifhed the fad, by repeated diffedion and obferva-
tion, that this inflammation exifts in various forms ; that
it is capable of going on to produce diforganization of
the mucous expanlion of the alimentary canal ; that, on
the other hand, it may produce iymptoms and effeds re-
fembling acute fevers. He has traced the gradual (hades
and gradations, from the violent and acute form of inflam-:
mation to which old nofologifts have applied the word
gu frit is, down to thole troublefome though flight a»-

Vol. XIX. No. 1291.

107

pearances which we have been accuftoined to call indigef-
tion. The notion of a flight modification of gaftritis had
indeed been entertained by Cullen ; for he fpeaks of ery-
thematic inflammation of the ftomach ; but it does not
appear that this idea was ever followed up by him, or
applied with any advantage to practice. With refped
to the exiftence of this affedion, we fhould, a priori,
conclude that inflammation of the. ftomach would be a
difeafe of frequent occurrence, becaufe that organ is of¬
ten oppofed to fubftances of a highly-irritating nature,
becaufe its vafcular fyftem is much developed, and be¬
caufe it poffeffes a high degree of fenfibility. Indeed we
are inclined to think that many difturbances in the ali¬
mentary canal may be traced to inflammation in the firft
in fiance, and that the ftate of atony of the digeftive appa¬
ratus is often the refult of that previous over-adion .
To generalife thus would, however, in the prefent ftate
of our knowledge, be premature; for we fhould know
precifely in what proportions the abforbent, the vafcular,
or the nervous, fyftem, of this digeftive tube, are im¬
plicated in difeafe, ere we could ftate the fweeping cou-
clufion, that inflammation is the general forerunner of
gaftric difturbance. Moreover many cafes will occuh' to
the pradical phyfician in which no inflammatory adion
was in the leaft degree apparent.

Perhaps then the moft appropriate arrangement will
be into, 1. Chronic inflammation of the alimentary canal ;
2. into difturbed fundion of that canal arifing from un¬
known modes of adion ; and, laftly, into fympathetic
propagated difeafe arifing from, or communicated to*
other parts. It is with the fecond only that we have now
to do. The firft, as being conneded with general in¬
flammation will be treated of under gafritis; and the third
will receive frequent iiluftration in almoft every difeafe
in our catalogue. It is however of the utmoft import¬
ance that the two dates of atony and excitement fhould
be well difcriminated ; and on that account we cannot
avoid giving in this place a fhort diagnofis of the two
kinds of difeafe.

Chronic gaftritis differs from the Ample fundional
difturbance of the ftomach, in that a fenfe of pain (of
various kinds however) is almoft continually prefent, and.
that the fenforial fundions and the pulmonary fyftem-
are more powerfully affeded : the (kin exhibits more of
heat ; in the early flages, the circulation is fomewhat af¬
feded ; third and evening exacerbations are frequently
prefent ; and vomiting is feldom abfent. Moreover the
fympatheticf irritations that arife from the irritation of
the ftomach, prefent more of an inflammatory charader.
It will eafily be feen, that every one of thefe fymptoms
is equally prefent in various kinds of Ample indigeftion ;
but the connexion of the whole mull be taken into con-
fideration. The excellent effeds of cool drinks, &c. in
allaying the difeafe, feems to prefent another difcrimina-
ting point, fince that effed is feldom experienced in Am¬
ple indigeftion.

The fame cautions are pradically neceffary in treating
the mere fundional difturbances of the lower parts of
the alimentary canal, and chronic enteritis, colonitis,
&c. but, as this is not the place to enter into difcuffions
on inflammation, we merely point out the fad that dif-
crimination is neceffary in thofe difeafes. The fundional
difturbances of the alimentary canal are fo numerous,
and fo anomalous in their charader, that they almoft
baffle defcription, and we (hall meet with no order of
difeafes .in which our nofological arrangement is more
itnperfe.d than in this; for not only do many of the in¬
dividual difeafes run into eacli other, but fome of the
fpecies, we ace inclined to think, are merely fymptoma-
tous. Cullen arranged thefe complaints in a very gene¬
ral way. Mr. Abernethy too, though he has written fome
of the heft hiftories of them which we have, did not at¬
tempt to claffify or arrange the different kinds, though
he expreffed a hope that fuch difcrimination might after¬
wards be made. More recently, in the interfiling work
Ff of

108 P A T H O

of Dr. Wilfon Philip on Indigeftion, we meet with want
of due arrangement. The genus Limojis of the prefent
fyftem will be made to comprehend molt of thefe difeafes,
though perhaps the fubdivilions are imperfedt. We have
not introduced any account of thofe various diforders
which arife from, and are traceable to, derangement of
thefe parts; fora dileafe cannot be much altered in its
character by remote caufes ; and hence the terms Dyf-
peptic-FhthiJis, cum multis aliis, feems mifapplied ; not
that we forget that complaints ariling from indigeftion
are mod frequently curable, but becaufe we hold it in-
difpenlible to pay particular attention to the ftate of the
laboratory of the fyftem in every clafs of complaint.

The clafs Cceliaca is divided into two orders and feven-
teen genera.

Order I. Enterica, [from the Gr. eyripov, an entrail.]
Diforders aft'edting the Alimentary Canal.

This Order contains twelve Genera.

Genus I. Odontia, [from o^ou;, a tooth.] Pain or De¬
rangement of the Teeth in their Sockets. This genus
embraces feven fpecies.

i . Odontia dentitionis, difficult or painful teething,
is further divided into four varieties: a, la&antium ; /•?,
puerilis; y, adultorum ; fenum.

a. O. dentitionis ladlantium is a difeafe well known, and
of frequent occurrence. It is caufed by the tenfe ftate
of gum covering the tooth ; or, on the other hand, by
the too-rebxed ftate, which allows the tooth to pulh it
up and prefs on the nerves, without producing abforp-
tion. It feems, too, that conftitutional dilturbance has
a great (hare, by rendering the nervous fyftem particu¬
larly fenfible, in encrealing the bad effeCts of dentition.
Children of plethoric and irritable habits are pe¬
culiarly obnoxious to this complaint, as alfo thofe in
whom coftivenefs is prefent. It is remarked alfo, that
rickety children cut their teeth at advanced periods, and
with much difficulty; and it is popularly known that
favourable dentition is indicative of future health.

The following are a few of the morbid fymptoms of
difficult teething; viz. Inflammatory fwelling of the
gums, tonfils, and parotid glands; rednefs of the eyes
and cheeks ; vomiting, griping pains, tenefmus, profufe
diarrhcea with green evacuations, and fometimes oblti-
nate coftivenefs and retention of urine. Fever, accom¬
panied with cough and other catarrhal affeCtions, hic¬
cough, univerfal or partial tetanus, convulfions, &c. are
the fymptoms by which, according to the eftimate of fe-
veral writers, nearly a third of children are deftroyed in
difficult dentition.

Thefe are the common fymptoms of difficult dentition ;
but occafionally peculiar ones arife, which not unfre-
quently fnblide as foon as the tooth is cut; as, for in-
ftance, gutta rofacea, (Lorry, Trait, de Morb. Cutaneis,
1777. p. 41 1.) deafnefs ; amaurotic blindnefs ; enlarge¬
ment of the knees ; paralyfis ; and lamenefs of one or
both legs. (Pafch, Abhandlung aus der. Wundarzney
von. den Zahnen, S. 25, 36.) Aphthae of the mouth ;
an inflamed tubercle over the tooth which is about to be
cut; fuppuration, ulceration, and even floughing of the
gums. Rachitis is alfo alleged to have its origin fome-
times from difficult dentition. But we ffiould rather
fuppofe that in the laft inftance the caufe had been tnif-
faken for the effeif. The firft fymptoms are local, and
appear to be accompanied with pain, as the child is reft-
lefs, uneafy, and rubs his gums, and carries every thing
to his mouth. There are alfo generally inflammation,
heat, and fwelling of the gums, and an increafed flow of
faliva. A general ftate of fever follows, which is fome¬
times flight and fometimes violent, and is very remark¬
able both for its fudden rife and declenfion ; fo that in
the firft hour of his illnefs the child ftiall be perfectly
cool, in the Tecond fluffied and burning hot, and in
the third temperate again. The local fymptoms which
enfue in diftant parts, are various and complicated ; for

LOGY.

the appearance they put on is in fome degree determined
by the nature of the parts which they affeCh

It is to be recollected, that the lymptoms of irritation
from teething have often very clofely refembled inflam¬
matory difeafe, efpecially of the brain, fo that practition¬
ers ffiould in ail cafes take particular notice of the ftate
of the teeth. The treatment of the difeafe is of courfe
Ample ; namely, to keep the bowels open ; in plethoric
children to apply a few' leeches behind the ears ; when
much irritability prevails, a narcotic of the leaft ftimu-
lating kind, as hyofeiamus, may be given. But the moll
advifable ftep, in addition to the above, is to divide the
gum over the tooth. The incifton is to be made with
the common inftrument, well known by the name of the
gum-lancet, which is far better for the purpofe than an
ordinary lancet, as that is apt to cut the tongue and lips,
efpecially when the child moves about much. The
grinding teeth require a crucial incifion : all the others a
Ample tranfverfe cut completely through the gum. The
wound is then to be examined with the finger, in order
to afeertain that no tenfe fibre over the tooth continues
undivided. In this country practitioners feldom apply
any thing to the incifion ; but abroad, it is not uncom¬
mon to put to it a mixture of lemon-juice and honey.
A premature incifion of the gum foon clofes again, and
therefore does little fervice ; but it is improbable that
the cicatrix, thus produced, can be any impediment
afterw’ards to dentition, as many have imagined ; for it is
an eftabliflied faCt, that cicatrices in general are more dif-
pofed to ulcerate and be abforbed, than the original parts
of the body. Mr. Hunter, indeed, informs us, that he
performed the operation above ten times upon the fame
teeth, where the difeafe had recurred as often, and every'
time with the abfolute removal of the fymptoms. No
idle apprehenfions ffiould therefore deter us from divi¬
ding the gum, where there is any chance of benefit
from the proceeding. At the fame time this is not recom¬
mended as a prophylactic meafure, but as being proper
only when illnefs, fufpedfed to arife from dentition, ac¬
tually exifts.

The life of hard applications, as biting the root of
marfli-mallow's, fmooth corals, boars’ tulks, See. render
the gums callous ; but more good might, perhaps, be de¬
rived, if fubftances with roughifti furfaces were employed.

The anomalies which w>e remark in regard to the back-
wardnefs, or on the contrary unufual forwardnefs, of den¬
tition, do not feem worthy of notice in this place, be¬
caufe they are fcarcely within the reach of medical affift-
ance : it is ufually remarked that healthy children cut
their teeth early ; while thofe who are rickety, or other-
wife affefted with chronic complaints, are equally late
in performing the fame procefs. The molt common or¬
der of the firft teething is as follows : In the fixth or fe-
venth month after birth, the firft or milk teeth make
their appearance through the gums. The two middle in-
cifores of the lower jaw are thofe which moll frequently
firft come out ; and, in the courfe of a few weeks, they
are generally followed by the two middle incifor teeth
of the upper jaw. At length, after fome months more,
the lateral incifors and the canine teeth (how themfelves.
The anterior molares, or front grinders, do not com¬
monly pafs through the gums until the child is a twelve-
month old.

(3. O. puerilis ; and y. O. adultorum. Thefe two va¬
rieties may be confidered together. It feldom happens
that much irritation is produced in thefe advanced terms
of dentition. Occafionally, indeed, the protrufion of the
dentes fupientia, or “ teeth of wifdom,” in adults,, is fo
long delayed, that, the jaw having ceafed to enlarge, and
being completely filled with the other teeth, the preflure
of the wife teeth on the coronoid procefs when they arife
from the upper, and on the fuperior teeth when from the
lower, produces a trifling inconvenience; but this is
eafily remedied by freely opening the gum, or by extract¬
ing thefe ufelefs teeth.

The

PATHOLOGY.

The fame variety, in regard to time of appearance, exifts
in the fecond dentition as in the firft. The common pe¬
riod is from eight or nine to thirteen years of age.
Many cafes of three or more dentitions have been record¬
ed on undoubted authority.

O. fenum. The reproduction of teeth in advanced
age is another curious but well-authenticated fadt. In
general the teeth which appear at this period are irregu¬
lar and ufelefs. John Hunter, however, faw one cafe in
which a complete fet arofe in both jaws. Dr. Good men¬
tions two cafes in which a few draggling teeth were cut
at a very late period of life; and which were further re¬
markable on account of the patients recovering, the one
her hearing, the other her fight; fenfes of which they
had been for years partially deprived. For further cafes
in which teeth were produced very late indeed, the reader
may confult Yfabern, Journ. de Med. tom. xxv. p. 316.
Nitzfeh, Ephem. Erudit. Ann. 1666, p. 175. Ephem.
Nat. Cur. Dec. 11. Ann.iii. Obf. 15. and the Phil. Tranf.
vol. xxvii. 1713.

2. Odontia dolorofa, acute pain in the teeth or their
fockets. Dr. Good makes four varieties of this difeafe 5
viz. a, cariofa ; /?, catarrhaiis ; y, nervorum ; fym-
pathetica.

a. It appears agreed by the mod: enlightened phyfiologifts,
that the internal part and fang of the teeth are vafcular,
while the enamel is an inorganic fecretion. Caries there¬
fore may arife from inflammation of the tooth giving rife
to abforption of the fubltance and enamel; or the fame
procefs may take place from chemical folvents applied
externally. We (hould be inclined to think that the former
caufe is the moft common. The more remote caufes of the
inflammation of the teeth are various, and many of them
infcrutable. Heatand cold, which are tranfmitted readily
through the enamel, are perhaps the moft frequent. Dif-
ordered fecretion from thefalivary glands are perhaps the
moft ufual caufe of decompofition of the enamel ; for we
cannot fuppofe that the fubftances we fwallow, hetero¬
geneous as they are, can produce much effeCt in palling
fo rapidly as they do through the mouth. It is fcarcely
neceflary to remark that inflammation of the gums will
generally communicate their morbid ftate to the teeth.
By whatever means, however, as Dr. Good fays, a decay
or caries of the teeth may be produced, it appears to ope¬
rate in three different ways : fometimes commencing in
the internal cavity, and working its path outward ; fome¬
times out ward, and working its path within; and fometimes
by a wafting of the enamel, and confequent denudation
of the bony part. The firft is the leaft common affedtion,
and is difcoverable by the appearance of the internal
blacknefs through the external Ihell ; the third is more
common than the firft, and the fecond the moft frequent
of the whole 5 evincing, at its commencement, the ap¬
pearance of an opake white fpot through the enamel,
which gradually crumbles away about the fpot, and thus
difcloles that part of the body of the tooth which forms
the original feat of the difeafe, and which, by its conti¬
nuance, converts the early fpot into a hole, and at length
deftroys it altogether, or at leaft down to its neck, unlefs
the pain produced by its progrefs compel the patient to
have it extrafted before the difeafe advances thus far.

It is of no practical ufe to infert the various remedies
by which the pain arifing from denudation of the nerves
of the teeth has been attempted to be alleviated. They
are for the moft part of that nature which, by exceflively
ftimulating the nerve, entirely deftroys its fenlibility.
Hence, perhaps, the moft efficacious are the ftrong mine¬
ral acids, carefully applied by means of a pin or probe
to the carious furface 5 but this requires that the gum,
&c. (hould not exhibit any marks of inflammation.
Small degrees of caries, or (light fiffures, may be relieved
by filing, filling up with gold, See. Of courfe, however,
the only radical cure, where much caries is prefent, is to
extradt the tooth ; for the mode of performing which fee
the article Surgery.

109

If inflammation have not produced caries (and there
is often violent and excruciating pain irreferrible to de¬
cayed teeth), lancing the gums freely, and attending to
the fympathetic adlion whence they derived their difeafes,
e. g. difordered gaftric or uterine fundtion, will often
effedt the cure. The inflammation often extends over
the whole face, and is particularly diftinguilhed by the
exafperation of the pain which warm liquids give rife to
when applied internally. This is moft effedlually com¬
bated by cooling lotions and by purges. The ill effedls of
the ufe of the ftimulating remedies in this kind of tooth¬
ache is exemplified (tronglyby the following cafe, extradled
from the London Medical Journal, vol.iii. communicated
by Mr. Fowler, of Princes-ftreet, Hanover Square. “ A
gentleman whom I attended, wasafflidfed wuth the tooth¬
ache in the firft dens ltiolaris. Being much alarmed at
the idea of extradtion, he applied to an old woman, who
at that time was efteemed famous for the cure of the
tooth-ache without drawing. She had applied her nof-
trum to the tooth twice within the fpace of three days;
and, on the fourth, he came to me, complaining of a lore
mouth, telling me where he had been to get relief, and
that the liquid which had been ufed was very cauftic.
From the appearance of the violent inflammation, which
had taken place from the difeafed tooth to the epiglottis,

I advifed him to confult fome medical gentleman of emi-'
nence immediately ; with which advice, I am forry to fay,
he did not comply. Not hearing from him on the third
day, I called (en paflant), but he w'.as too ill to be feen ;
a derangement of intellects had taken place. I called
again four days afterwards, and was informed, that he
had died raving on the preceding day. I had every rea-
fon to believe, that the fluid which had been inferred into
the tooth with a view of deftroying the nerve, had pro¬
duced this tragical end.”

y. Difeafe of the nerves of the teeth is perhaps the moft
troublefome fpecies of tooth-ache. The appearances it
exhibits are anomalous ; and the complaint is fo fre¬
quently aflbeiated with caries of the teeth, that its pre-
cife nature is often unknown until fome of the teeth have
been extradled without the leaft alleviation. This affec¬
tion arifes from the fame caufe as other morbid affedtions
of nerves; often from gaftric, inteftinal, or biliary, derange¬
ment ; pregnancy, plethora, worms, &c. and is to be com¬
bated only by removing the caufe, anti by the ufe of re¬
medies having the effedl of allaying nervous irritation.
As this affedtion feems, then, to arife from various caufes,
it is capable of comprehending the other varieties men¬
tioned by Dr. Good. We (hall have occafion to fpeak
more at large on this fubjedt when treatingof Neurotica.

3. Odontia lluporis, or tooth-edge, has two varieties :
a,, a ftridore ; /3, a acritutide. The former, which is af-
fociated in a remarkable manner with peculiar imagina¬
tions, is the fenfation we feel when the edges of two
knives are rubbed acrofs, when we cut a cork, or rub
our coat-fleeves together. Dr. Good mentions the cu¬
rious circumllance, that a friend of his experienced this
fenfation in a remarkable degree from hearing a woman
cry bullaces for fale. It is perhaps difficult to explain
this phenomenon. It is moft probably fomehow connec¬
ted with fympathetic adlion between the nerves of teeth
and ear; unlefs we could admit the notion of Hagerup,
that the nerves of the teeth are auditory, in which cafe
this operation of harffi founds might readily be accounted
for As connedled with this point, we beg the reader to
notice the conclufion of our article Dumbness, vol. vi.
p. 117.

j3. The latter variety is produced by moft chemical
fubftances that can denude or diflolve the enamel. It is
felt at the edge of the teeth, perhaps on account of the
tbinnefs of the enamel at that parr. Morbid fecretions
ejedled from theftomach into the mouth frequently caufe
this unpleafant fenfation. Mechanical injuries, as gnaffi-
ing the teeth, attrite the enamel likewife ; and it is laid
to be a fymptom in rachitis, bilious diforders, See. The

removal

3

110

PATHOLOGY.

removal of the remote caufe is of courfe the only plan of
treatment. Warm liquors, and the chewing of almonds,
have however been recommended.

4. Odontia deformis, deformity of theteeth, from
error, ftiape, pofition, or number. The teeth fometimes
grow in a very irregular manner; as from the palate,
underneath the tongue, or not upright in the gums.
The latter circumftance is a very general confequence of
neglecting to draw the firft teeth of children on the ap¬
pearance of the fecond. It may be remedied, when in a
trifling degree, by pulhing the tooth from time to time
towards its proper fltuation ; or, more permanently, by
means of fome mechanical contrivance, as lilk thread or
Bruner’s machine. A metallic plate anfwers the purpofe
very well ; its width fliould be lefs than the height of
the teeth ; its breadth equal' to three teeth; it is to be
applied to the infide of fuch teeth as incline inwards, and
to the outfldes of thofe which incline outwards; at the
ends of the plate are two holes, through which the filk-
t breads, fmeared with wax, are to be palled, and, after
eroding each other, are to be tied over the oblique tooth.

^hen the teeth are fo far removed from the gums as
to render thefe methods ineffectual, extraction is of courfe
the only refource. Albinusrecords.au example, in which
a tooth grew out of the maxillary procefs below the orbit.
It was concealed until it made its way out in this extraor¬
dinary fltuation. Annot. Acad. t. i. p. 54.

The teeth have fometimes been oblerved inverted, their
bodies being fltuated towards the jaw. Pollich, Increm.
Gjjium, p. 25. Albin. c. 9. PaIJin, c. 9.

Sometimes the teeth are placed too diftant apart, fo
that between their crowns large interfpaces are left.
Thus, in children three years of age, the crowns of the
milk-teeth are fo clofe to each other, that they are late¬
rally as it were in contact ; but, in children feven years
old, there are wide interfpaces between them. The reafon
of this is owing to the jaw increafing in fize, while the
dimeniions of the teeth undergo no alteration. The fe¬
cond or permanent teeth, on the other hand, (at lead the
firft twenty of them,) have larger bodies than the milk-fet.

Frequently the tartar infinuates itfelf between the
crowns of the teeth, and occafions a confiderable repara¬
tion of them. We need l'carcely obferve, that the cure
requires that the tartar fliould be taken off, and the teeth
reduced into their natural pofition.

The deformity of which we are now treating, is occa-
lionally afcribable in adult fubjefts to the preternatural
breadth of the jaw, in which circumftance it is abfolutely
incurable.

Theteeth may be too crowded together, fo that their
crowns are laterally in contaCf. This defeCt may extend
to fome or all the teeth. The frequent confequence is,
that the lateral margins of thefe parts become carious.
This deformity arifes from the great width of the crowns
of the teeth, and it may be afeertained by ocular examina¬
tion. In fome inftances, all the bodies of the teeth are
preternaturally wide, in others only a certain number of
them. It is caufed likewife by the uncommon fhortnefs
of the jaw. It may be known by obferving that the
crow ns of the teeth are not too large, and that the alveo-
lary arches are ftrikingly diminutive. The mode of cure
confifts in filing off a little of the lateral edges of the teeth
affedled.

Sometimes the number of the teeth exceeds what is the
ufual fliare of the human fpecies in general; and this
particularly occurs whenever the number amounts to
more than thirty-two. Columbus has feen thirty-three;
Fauchart, thirty-three and thirty-four; Bourdet, thir¬
ty-fix; and Ingraflias thirty-fix, including twenty-four
grinders.

In fome inftances, the exeeflive number is ow'ing to
there being a double row of teeth. This malformation
may happen to both jaws, or be confined to one. It has
been noticed in both jaws by Munick, p. 144. Plinius,
c. xi. p. 623. C. Bartholinus, p. 464, See. Arnold met

with a boy, fourteen years old, who had all together fe-
venty-two teeth in his mouth. There was a double fet
of the incifores, canine teeth, and three pofterior grind¬
ers ; but the anterior grinders were triple : confequently
there were counted in each jaw eight incifores, two ca¬
nine on each fide, and twelve molares. The incifores
were not arranged in an even double row' ; but each row
feemed irregular, and its order as it were promifeuous.
The arrangement of the canine and grinding teeth was
more regular. None of thefe teeth were affefted with
caries. (Jbf. Phyf. Med. p. 69. See alfo Hunter, p. 115,
199, for examples of a double row of teeth. Bloch,
Medicinifche Bemurkungen, p. 19. Triple row, Nean-
der, Phyfic, Part II. Numerous and confufed rows,
Eph. Nat. Cur. ann. iii. vii. viii.

5. Odontia edentula, or toothleflnefs. This fpecias
confifts of four varieties, ct, Peculiaris ; from conftitu-
tional defedt. S, A vi extrinfeca; from external vio¬
lence. y, A carie ; from decay. Senilium, from old
age. In all thefe varieties, the affection feldom extends
to the whole teeth, except in the cafe of old age. In
the firft, or that from conftitutional defeft, a few only in
one or both jaws, are left unprovided for ; while fome¬
times an effort to this purpofe is commenced, but not
carried to perfeiflion. “ In the head of a young fubjeft
which I examined,” fays Mr. J. Hunter, “ I found that
the two firft incifor teeth in the upper jaw had not cut
the gum; nor had they any root or fang, excepting fo
much as was neceflary to fallen them to the gum on their
upper furface ; and, on examining the jaw, I found there
was no alveolar procefs nor fockets in that part.” Nat.
Hift. of the Human Teeth, p. 8. It is obvious that the
only method of remedying this defeft is by inferting
fupplemental teeth ; as to which fee the article Surgery.

6. -Odontia incruftans, tartar of the teeth. Tartar
is an earthy cruft, which adheres to the teeth. As it
fills up the interfpaces of feveral of the teeth, and occu¬
pies their external furfaces, it is feldom obferved upon
their infides. By the Greeks it was called odontolithos,
from o^oi-s, a tooth, and Aiflo;, a ftone. By others it has
been termed tophus ve 1 calculus dentium.

With regard to the eftefts of the tartar, it difplaces
the teeth, and renders them loofe and painful ; it alfo
feparates the gums from the fangs, producing caries in
the latter, and a bad fmell in the breath. In refpeft to
colour, the tartar of the teeth is of three kinds, namely,
dark-brown, yellow, and black.

Since many perfons who never clean their teeth at all
are not disfigured with thefe depofitions of tartar, it ap¬
pears that a peculiar difpofing caufe is neceflary for the
occurrence of the complaint. It is moft likely that
morbid ftates of the faliva are the moft frequent; for
there are certain perfons, whofe teeth are conftantly in-
crufted with tartar, notwithftanding they are in the con¬
tinual habit of waffling their teeth and mouths. Berd-
more relates a furpriling example of this fort. A man,
thirty-two years of age, had the teeth of each jaw coated
with folid tartar, half an inch in thicknefs, both on the
outfide and infide of the teeth, and on the furface of the
gums, fo that the interllices of the teeth were altogether
invifible. The gums were every-where pufhed off the
teeth, and painful. The incruftations upon the incifor
teeth were fo thick, that the lower lip was rendered more
prominent. During a fortnight, Berdmore removed
every day fome of the tartar from the teeth with an in-
ftrument, and at length employed a dentifrice and brufh.
The retraced gums were fcarified, and thus made to ad¬
here to the necks of the teeth. The patient was obliged
to bruftt his gums and teeth three times a-day, partly
with a view of preventing the new formation of tartar,
and partly in order that the regeneration of the gums
might be ftill more promoted. But, although the patient
ftri&ly followed this plan, his teeth and gums, in the
courfe of half a year, became again covered with an ex-
tremely-thick coat of tartar. Berdmore was therefore

under

PATHOLOGY. Ill

under the necefiity of recommending- the ufe of a ftiffier
brufii, and a dentifrice made of (hells, for the purpofe of
removing the tartar.

With refpefit to the treatment of tartareous incruftations
of the teeth in general, it is effential to remove the
tartar, and clean the teeth well every day. It is alfo
needful to correft the ftate of the falivary l'ecretion.

Perfons who are in the habit of ufing acrid tin&ures or
powders which diffolve the enamel, and make it porous,
are frequently troubled with tartareous incruftations.
The caufe being avoided, the mode of treatment is the
fame as in the preceding cafes.

This afte&ion fometimes arrives at fuch a pitch, that
feveral of the teeth become concreted together. See
Eultachius de Dent. cap. 2.

7. Odontia excrefcens. Varieties: a, fpongiofa; 0,
extuberans.

a.. O. fpongiofa is taken to apply to the difeafe which
has been i'o well defcribed by Hunter as fcurvy in the
gums, from its identity with one of the fymptoms of fea-
Icurvy. It is not to be concluded however that the term
is exactly correft, or that this fymptom is always con¬
nected with a general fcorbutic diathefis; on the con¬
trary, the above-mentioned author has often feen fcurvy
of the gums in perfons quite healthy, in patients af¬
flicted with fcrofula, and other complaints equally re¬
mote in their nature from fcurvy. The primary fymp¬
toms of this complaint are thole of inflammation ; viz.
pain, rednefs, and turgefcence. The gums bleed on
the flighted: injury ; the tendernefs is firll obfervable on
the edges ; the fmooth fkin appears denuded on the
latter parts; and often, particularly in the interftices be¬
tween the teeth, there (hoot up irritable granulations.
To this ftate ulceration and abforption fupervene : the
former procefs is often fo extenfively prefent as to denude
all the teeth of each jaw ; more commonly, how'ever, it
is confined to one part, at moft to one jaw. It frequent¬
ly happens in this cafe that the alveolar procefs difap-
pears by abforption, in which event there is always a
very confiderable difcharge of matter from the infide of
the gum and alveolar procefs, flowing out in the direc¬
tion of the tooth. In many of thefe cafes, we find that,
while the gums are ulcerating in one part, they are
fwelling and becoming fpongy in another, and hanging
loofe upon the teeth ; and this often takes place when
there is no-where any ulceration. At length the teeth
become loofe, and in a few years drop out, one after the
other, at Ihort intervals, until the perfon is rendered
toothlefs. It is from this complaint that many perfons
lofe their teeth at a very early period of life. Indeed
moft individuals are more or lei's fubjeCt to it ; as the
gums, in fome part or another, although there be no
iymptoms of the difeafe, are likely to become preterna-
turally red, enlarged, and tender. Therefore, whenever
a tendency to this difeafe is obferved, great care fhould
be taken to apply fuch means as will arreft its pro-
grefs.

The treatment of fcurvy of the gums confifts in freely
lancing them when in the inflamed or fpongy ftate. The
ufe of aftringent lotions too is after this of effential
fervice. Thefe ftimuli to be varied according to the
feelings of the patient. The moft common are infufion
of roles with the tinfture of myrrh, decodiion of bark,
folutions of alum, arquebufade-water, &c. In fome
cafes great benefit is derived from the ufe of fea-water,
and Mr. Fox obferves, that he always recommends it
to be ufed warm if the gums be tender. When
the gums are exceedingly tender, and have any ten¬
dency to ulceration, Mr. Fox recommends wafhing the
mouth very frequently with barley- water fweetened with
honey. In two or three days, if the forenefs is diminilhed,
the lancet is to be cautioufly ufed with the diluted tinfture
of myrrh as a walh. When this treatment fails in mak¬
ing the edges of the gums heal, and they hang loofely
about the necks of the teeth, Mr. Fox obferves, that

Vox,. XIX. No. 1291.

much good will be derived from the ufe of a folution of
the argentum nitratum. He fays, that, if the difeafe be
only partial, the cauftic Ihould be applied with a camel’s-
hair pencil dipped in the folution. This remedy is de¬
fcribed as communicating a new action to the gums, and
they generally get well in a Ihort time. Indeed, when¬
ever the gums are very full, and difcharge a good deal of
offenfive matter, wafhing the mouth with a folution of
lunar cauftic is, according to Mr. Fox, a very excellent
means of rendering the mouth fweet and comfortable.
This remedy, when applied to the fore edges of the gums
with a hair-pencil, may be ufed as ftrong as in the pro¬
portion of a dram of the argentum tf> an ounce of diftilled
water ; but, if the mouth is to be rinfed with it, not more
than one grain of the cauftic fhould be put to two ounces
of water, left, by being too ftrong and getting into the
throat, it fhould occafion an unpleafant naufea.

Perfons, who are often troubled with inflammation of
the gums, ought to have them fcarified whenever they
become painful, or are more turgid than ufual. By the
lofs of a fmall quantity of blood, the affedtion is imme¬
diately relieved, and kept from committing the ravages
which have been related. In fcarifying the gums, the
lancet fhould be applied longitudinally to thofe parts
which are fituated between the teeth, becaufe, if the
gums are cut where they cover the fangs, they will
flirink in healing, and leave the hecks of the teeth ex-
pofed. On the other hand, if the gums are lanced in the
angles between the teeth, they will be drawn tighter in
healing, and the teeth be eventually ftrengthened. Fox
on the Difeafes of the Teeth.

In addition to thefe meafures, it will often be neceffary
to correct the ftate of the conftitution, when fcorbutic or
fcrofulous appearances are prefent. Frequently, too,
fecretions from the alimentary canal fhould be procured,
for the purpofe of removing irritation extending to the
gums, as part of that ftrudture. It is to be remarked alfo,
that the free fcarification we have urged above fhould be
difpenfed with in fcrofulous cafes, fince, according to
the teftimony of Hunter, they do harm in thefe cafes.
This author fpeaks favourably of fea-bathing, and
rinfing the mouth with fea-water.

The next variety, |3, O. extuberans, feems clofely allied
with the firll, as a confequence ; unlefs indeed we admit
the belief that in this the inflammation is attached to the
bony ftrudture. However this be, the tooth affedted in
gum-bile is generally found fw’elled, or in advanced
cafes abforbed at its fang, while the fubftance of it re¬
mains found. Sometimes, on the other hand, it is
fuppofed to originate from a difeafe in the focket, or
jaw, which has no connexion with the tooth, and only
affedts it fecondarily. Upon drawing fuch teeth, fays
Mr. Hunter, they are generally found difeafed at or near
the point, being there very rough and irregular, like ul¬
cerating bones. The laft kind of gum-biles may arife
altogether from fuch a caufe, the appearance on the fang
of the tooth being only an effedl.

The fame furgeon has explained, that thefe abfceffes,
whether arifing from the teeth or the fockets, always
deftroy the alveolar proceffes on that fide where the
matter is difcharged, on which account the tooth is ren¬
dered more or lefs loofe. This event may be feen in
many Ikulls, and alfo frequently in the living fubjedf ;
for, when the alveolar procefs is deftroyed on the outfide
of the tooth, if the latter part be moved, the motion may
be obferved under the gum all along the fang. When
thefe abfceffes have burft through the gums, they often
clofe up, and put on the appearance of being healed ; but
fuch as difcharge themfelves between the gums and teeth
can never heal up, becaufe the gum cannot unite to the
tooth. At certain periods, however, the difcharge from
them diminiflies, owing to a fubfidence of the fuppura-
tion ; but, either expofure to cold, or fome other acci¬
dental caufe, occafioning a frelh inflammation, an in-
creafe of the fuppuration is the confequence; and either
G g the

112

PATHOLOGY.

the old orifice in the gum becomes opened again, or the
difcharge by the fide of the tooth is augmented. In the
latter cafe, Mr. Hunter believes, that the affeCtion is lefs
fevere than in the former, in which frefh ulceration is
required for the paflage of the matter. Thus a gum-bile
goes on for years, healing and opening alternately ; the
effeCt of which is, that the alveolar procefi'es are at length
abforbed, and the tooth gets loofer and loofer, till it
either drops out, or is extracted. Mod probably, in all
fuch cafes, fays Mr. Hunter, the communication between
the cavity of the tooth and the jaw is cut off ; yet it keeps
in part its lateral attachments, efpecially when the gum
grafps the tooth ; but thefe attachments are lefs when the
matter paffes between the gum and the tooth ; though
fome of them are ftill retained, particularly on the fide
oppofite to the paflage for the matter.

With regard to the fymptoms of gum-biles, thofe which
open through the gum may be diftinguiihed by a fmall
riling between the arch of the gum and the attachment
of the lip. Upon prelfing the gum at the fide of this
point, fome matter will commonly be obferved oozing
out at the eminence. This eminence feldom fubfides
entirely ; for even when there is no difcharge, and the
opening is healed over, a fmall rifing may itill be per¬
ceived, which Ihows that the gum-bile has been there.
Such gum-biles as difcharge themfelves between the
gum and the tooth are always difcovered by prefling the
gum, whereby the matter is forced out, and is feen lying
in the angle between the gum and the tooth.

A fungus will fometimes Ihoot out of the orifice of a
gum-bile, in confequence of a luxuriant difpofition to
form granulations on the infide of the abfcefs, and the
opening being backward to heal. In this cafe, the tooth
aCls as an extraneous body ; and, by the fecretion of
matter, the abfcefs is prevented from healing. There is
no difference in the treatment of gum-biles, whether they
arife from a difeafed tooth, or a difeafe in the locket.
When an abfcefs forms round the root of a tooth, the
tooth, by lofing its connexion with the other parts, lofes
every power of union, as it is not endowed with the power
of granulating. Hence it becomes an extraneous body,
or at leaft aCts here as one, and that of the worft kind,
which, fays Mr. Hunter, it is not in the power of any
operation in the machine to get rid of. In this cafe,
therefore, the only cure is by the extraction of the tooth ;
and, as this is the laft refource, Mr. Hunter obferves, that
every thing fliould be done to make the parts as eafy
under the difeafe as polfible, fo that this operation may
be poftponed.

When the abfcefs has burft through the gum, Mr.
Hunter advifes us to keep the opening from doling, with
a view of preventing future gatherings. He recommends
enlarging the opening, and keeping it enlarged till all
the infide of the abfcels is Ikinned over, or the aperture
in the gum lofes the difpofition to dlofe up. This will
in a great meafure prevent any future formation of mat¬
ter, or at lead whatever is formed will find a ready out¬
let, fo that no accumulation can happen. The end of
the fang, indeed, will be expofed ; but, under fuch cir-
cumftances, it will not be in a worfe fituation than when
foaked in matter. Mr. Hunter next remarks, that one
method of doing this is to open the gum-biles by a cru¬
cial incifion the full width of the abfcefs, and fill it with
lint, which fliould be dipped in lime-water, or a diluted
folution of lunar cauftic, made by diflolving one drachm
of the cauftic in two ounces of diftilled water; and the
wound fliould be dreffed very frequently, as it is with
difficulty that the drefling can be kept in. If this is not
fufficient to keep the wound open, it may be touched
with the lunar cauftic, fo as to produce a flougli ; and
the application may be repeated, if found necefl'ary.
Some difficulty is experienced in keeping on the dreflings ;
but conftant attention will make up for the inconvenience
of fituation. Mr. Hunter alfo fpeaks in favour of touch¬
ing the furface of the abfcefs with the lapis fepticus, and

keeping the lip from coming into contaCf with the part
for one minute, within which fpace of time the cauftic
will penetrate to the bottom. The furface of the bile
fliould be wiped as dry as poflible, that the cauftic may
not do mifchief by fpreading.

It has been a practice to extract the tooth, then file off'
any difeafed part of it, and immediately replace it. This
method has often failed, in confequence of the tooth
being introduced into a difeafed jaw ; but occafionally it
has fucceeded.

When a gum-bile is formed on a back-tooth, the
treatment, according to Mr. Hunter, need not be fo
nice as when the abfcefs is fituated upon any of the fore¬
teeth, becaufe appearances are then of lefs confequence.
Therefore the gum may be flit down upon the fang
through its whole length, from the opening of the gum-
bile to its edge; which proceeding will preventany future
union, while the healing of all the cavity of the abfcefs
will prevent any future collection of matter. The wound
afterwards refembles the liare-lip. Hence this practice
is not advifable when the place of the cut would be much
in view, as when the abfcefs is fituated upon any of the
fore-teeth. In thefe cafes, when the granulations pro¬
trude from the fmall opening, a cure may be effected in
the manner above mentioned, or the granulations may
be cut off with a knife or lancet. However, in general,
a permanent cure cannot be thus effected, and the gra¬
nulations rife up again.

In confequence of bad teeth, excrefcences alfo arife
from the gum, near or in contaCt with the teeth which
are difeafed. In general, fuch growths may be eafily re¬
moved with a knife, or any other cutting inftrument
which may be found moft convenient. They will often
rife, in a day or two after the operation, as high as ever;
but this newly-generated matter generally foon dies, and
the difeafe terminates well. They frequently have fo
much of a cancerous appearance as to deter furgeons
from meddling with them ; but Mr. Hunter believed,
that, when they arife at once from the gum, and appear
to be the'only difeafed part, they have no malignant dif¬
pofition. However, this great furgeon had feen them
with very broad bafes when the whole could not be re¬
moved, and yet no bad confequences refulted from the
partial removal of them. In a few years they often rife
again, by which means a great deal of trouble is occa-
fioned. The writer of this article has feen a cafe of this
nature, in which the extent and rapid growth of the
fungus rendered excifion impracticable, very fuccefsfully
removed by tearing out, and the life of cauftic.

The few remarks we have made on the fubjeCt of dif-
eafes of the teeth and gums, clearly indicate the regula¬
tions which fliould be adopted for the prefervation of
thefe beautiful ltruCtures; viz. by abolifhing the ufe of
all dentifrice capable either of mechanically detriting,
or chemically diflolving, the enamel, qs well as of all ali¬
mentary fubftances which have the fame effeCts; but at
the fame time of diligently removing, at leaft once a-day,
all fordes from the mouth. Perhaps nothing conduces
to the fame purpofe more than healthy action of the fto-
mach ; for the vifcid ftate of the falivary fecretions are
well known when that organ is deranged ; and we may
further remark, that fine teeth are moft ufually obferv-
able in thofe who are free from gaftric difturbance; and
that few animals are fubjeCt to decayed teeth in an equal
proportion to our own race. As a popular notion is pre-,
valent, that the ufe of fugar is prejudicial to the teeth,
it is proper in this place to contradict it as far as regards
the circumftance of its diflolving the enamel ; for general
de Beaufort ate every day for forty years a pound of fu¬
gar, and lived to the age of feventy. After death, his
vifcera were found free from difeafe, and his teeth found.
(Anecdotes de Medecine, tom. ii. p. 35.) Plenck put a
healthy tooth into fome fyrup diluted with water, and
kept it there two months, at the end of which time it
was taken out, and found to have undergone no change.

(DoCtrina

113

PATHOLOGY.

(Doftrina de Morb. Pentium, p. 52.) How far, however,
this fubltance may indireftly hurt the teeth, by derang¬
ing the gaftric funftions, may admit of fome difcuffion.

Genus II. Ptyalifmus , [from wlow, to fpit.] Diforders
affecting the Salivary Glands. This genus contains three
fpecies.

1. Ptyalifmus acutus, or Salivation, has three varieties :
et, hydrargyratus; (3, fympatheticus ; 7, mellitus.

a. Ptyalifmus hydrargyratus. This confifts in an in¬
creased Secretion of faliva from an extreme action of the
Salivary glands. As an idiopathic diSeaSe, it is Seldom
Seen, and even then not until it hasaffumed the chronic
'form. It more ufually makes its appearance in confe-
quence of irritation from mercury. Other fubftances,
however, will produce it ; but this is the molt common,
and the only one we are acquainted with which increafes
this Secretion with certainty and precifion. Formerly the
uSe of mercury for the purpofes of Salivation was carried
to So great an extent, that frequent floughings and ul¬
cerations of the mouth were the confequence. But,
llnce it has been known that the degree of violence with
which mercury is puflied is far from increaling its curative
effefts, we have not to record So many of thofe frightful
appearances.

The production of this difeafe is generally the work of
the phyfician. With refpeft to the quantity of mercury
neceflary to produce it, the greateft variation is obferv-
able. While, on the one hand, it is carried into the
conftitution without vifible effeft for very long periods,
or is carried off by Sweat, purging, & c. on the other, the
moll trifling doSes in different conftitutions produce vio¬
lent and alarming effefts in a few days. The inftances in
which the patients have been infenflble for long periods
to large and frequently-repeated dofes of this medicine,
will be familiar to mod of our readers. The oppofite ftate
of conftitution is not perhaps So frequently met with ;
but even that is Sufficiently common. The uSual quan¬
tity of mercury required is about five grains of the blue
pill, which contain a grain of mercury, to be repeated
three times a-day ; or, if calomel is employed, a grain
night and morning at firft, or two grains at night, guarded
with a grain of opium, left it Ihould irritate the bowels,
will be a proper dofe. If the ointment is preferred, half
a dram of the ftrong mercurial ointment may be rubbed
in night and morning. In about a week or ten days, by
either plan, the mouth will be Slightly fore in the majo¬
rity of cafes; while, on the contrary, as we have before
mentioned, cafes are not uncommon in which two or
three Small dofes of mercury have produced copious fa¬
livation. In debilitated habits, three grains of calomel
given in the dofe, or one grain on three Succeeding nights,
has been found to induce the discharge. It has been
brought on by Sprinkling precipitate on a wound ( Hil¬
da n u s ) ; by a mercurial injeftion in a fiftula ; by a mer¬
curial girdle; or by the mercurial ointment employed to
kill lice. In thefe cafes, the idiofyncracy of the patient
Seems to influence the effeft ; and, therefore, this ftiouid
be, if poffible, ascertained before mercury is exhibited in
any considerable quantity.

It is uSual at prefent to produce this discharge in a
very moderate degree; but Some aftion on the gums is
neceflary, to (how that the medicine has been introduced
into the fyftem. This is particularly the cafe in lues and
chronic inflammations of the liver. In other complaints
it is lefs effential if the Symptoms disappear. The effec¬
tual relief of thefe is the only certain criterion by which
we are taught to leave off’ the medicine; and it will be
prudent to continue it for fome time after thefe have dis¬
appeared.

Of courfe this is not the proper place to difcufs the ef¬
fefts of mercury, or, generally Speaking, its adminiftra-
tion ; but, as far as regards the bringing on of ptyalifm,
we cannot help remarking, that, as its continuance is al¬
ways unpleafant, and Sometimes difficult of cure, a
greater degree of care is required in its inftitution than

the generality of praftitioners think proper to adopt.
Under this impreffion, we cannot do better than urge the
rules of Dr. Hamilton on this fubjeft ; wliofe advice,
however it may be thought by Some to favour of unne-
ceffary minutenefs, is nevertheless highly ufeful in many
cafes, and has the advantage of erring on the right fide
in all.

“ The firft precaution to be adopted in this climate du¬
ring a courfe of mercury, is confinement within doors,
with a regulated temperature of the apartment. The
utility and the neceflity of this precaution muft be So ob¬
vious, that it is unneceffary to expatiate upon the fub¬
jeft. Not that it is meant that the patient fliould be con¬
fined to an ill-ventilated room 5 for, on the contrary, a
plentiful Supply of freflr air is of effential utility. While
the boldnels with which Mr. Pearfon expoles Such pa¬
tients to cool dry open air may be well Suited to perfons
who have been immured in a crowded hofpital with a
mercurial atmofphere, it certainly would be moft preju¬
dicial to the better ranks of Society in private practice.

“ zdly. The diet ought to confilt of the mildeft poffi¬
ble food, Such as preparations of milk and farinaceous
matter, with weak animal mucilages. In ffiort, all (Simu¬
lant food or drink of every description, ought to be molt
fcrupuloufly refrained from.

“ 3dly. IS the individual be robuft. Sixteen or twenty
ounces of blood Should be drawn from the arm before
any preparation of mercury be exhibited. Where, from
the delicacy of the patient, blood-letting cannot be ad-
vifed, confinement within doors a week previous to be¬
ginning the mercury, and during that time one or more
dofes of cooling phyfic ought to be taken.

“ 4thiy. The mercury mult not be given in Such quan¬
tity, or with Such aftivity, as to produce a Sudden effeft
upon the fyftem. This is certainly one of the moft im¬
portant practical improvements, fuggefted by Mr. Aber-
nethy and others, and confirmed by the late experiments;
for irreparable mifchief was often committed by the
hurry with which the fyftem was loaded with mercury.
If the other precautions be implicitly adopted, the more
(lowly the mercury is adminiltered, the more certainly,
and perhaps Speedily, will the primary Sores heal.

“ 5thly. Although, in particular cafes, (ome of the
more aftive mercurial oxydes may be ufeful, the blue
pill or the blue ointment furnilh in general tliefafeft and
mildeft preparations of mercury.

“ 6thly. Salivation is to be guarded againft by leffening
the dole, or fulpending the medicine, whenever the brally
tafte in the mouth is perceived. The Same meafures are
to be purfued if any irritation of the bowels threatens.

“ 7thly. Some vegetable diluent ought to be drunk in
large quantities, for thepurpofe principally of preventing
the peculiar ftate of the blood, which mercury is So apt
to produce. The decoftions of farfaparilla, guaiacum,
faffafras, &c. 'anlwer this purpofe; and perhaps they are
all equally efficacious, if drank tepid, and in Sufficient
quantity.

“ Stilly. It is extremely difficult to eftablifli any gene¬
ral rule tor the duration of a mercurial courfe, as that
muft be regulated very much by the circumftances of each
particular cale. From two to three months may perhaps
be Sufficient in the majority of cafes.

“ 9thly. The daily ufe of the warm bath, where that
can be conveniently commanded, is found particularly
beneficial.

“ xothly. If any irritable feelings occur wdiile under
the influence of mercury, the ufe of the medicine fliould
be inftantly fufpended, and the moft aftive mealures for
checking the progrefs of Such complaints ought to be
carefully adopted. Preparations of camphor, of the fpi-
ritus ammonite aromaticus, of opium, of cicuta, &c. are Se¬
verally ufeful, accprding to the circumftances of each
cafe.

“ uthly. After the mercurial courfe is finilhed, the
patient ought to remain within doors for at lealt a fort¬
night, improving the diet, (though ftill abftaining from

wine

114 P A T II O

wine and ftimulating liquors,) and taking gentle exercife,
progrelTively increafing it according to the return of
itrengrh.

“ Laftly. The flannel and woollen drefs, in which thofe
under a courfe of mercury Ihould be, literally fpeaking,
encafed, is to be changed daily ; and, befides the ordinary
precautions of having thofe articles of drefs well waffied,
it is neceffary that they be expofed for at lead twenty-
four hours to the open air, and afterwards to the influence
of a large fire, before being again ufed.”

Salivation is ufed as a curative means in lues, liver-
complaints, in fome fevers, &c. in our account of which
we (hall take further notice of it. It has been recom¬
mended, moreover, as a cure for pbthifis by Dr. Ruth ;
and a cafe was publifted in the 3d volume of the London
Medical and Phyfical Journal, ftrongly corroborative of
this treatment, by Dr. Peiffer. We may here remark
that there is every reafon to fuppofe that cafe, as well as
feveral others recorded in fupport of the fame opinion,
were not genuine phthifis, but rather that form of pul¬
monary difeafe which fupervenes on difordered (fates of
the hepatic fyftem, and in which mercury undoubtedly
exerts a falutary influence.

With reganl to the treatment of mercurial ptyalifm, it
is generally remarked, that, as foon as the mercury ceafes
to be adminiftered, the fpitting ceafes of itfelf. At all
times, however, this does not fake place ; and accordingly
we have many methods recommended by various authors
for its removal. Thofe molt in repute are purgative me¬
dicines, opium, and fulphur. If any mercury remains in
the fyftem, thefe will fometimes relieve ; but thele medi¬
cines are not all of equal efficacy. Mr. Hunter thinks
purgatives ufelefs, and Dr. Parr lias not found them
highly beneficial, though he thinks they fometimes lefl'en
the difcharge. Opium is highly ufeful, particularly in
the form of Dover’s powder. Sulphur is known to lefl'en
the activity of mercury out of the body ; and, as it en¬
ters the circulation with little change, it may have the
fame effect on the circulating fyftem. But this, like
other finely-fpun theories, deceives us in praClice. Sul-
phuris by no means highly ufeful in thefe circumftances.
Diuretics, which feem to excite what appears to be a vi¬
carious difcharge, have been employed but with little ef¬
fect. We believe every praftitioner, by the means men¬
tioned, has been able to mitigate falivation ; but by no
remedies, in every inftance, to conquer it wholly. See
Hunter, Swediaur, Bell, and Howard, on the Venereal
Difeafe ; Stahl de Salivatione Mercuriali ; Alberti de Hy-
drargyrofi ; and Hamilton on the Ufe and Abufe of Mer¬
curial Medicines.

As a critical difcharge, falivation is for the moft part
falutary, and often terminates the difeafe that excites it.
This is frequently the cafe in fevers; and the following
inftance is perhaps worth relating. A lady, aged twenty-
four, and of a delicate conftitution, was attacked with
the typhus in the fpring of 1788, under which (lie gra¬
dually drooped for nearly three weeks. Dr. Good thought
her in great danger; but on the twentieth day a fudden
and copious ptyalifm fupervened that evidently afforded
her confiderable relief. “This continued for upwards of
.1 week, the daily fecretion being never lefs than a pint,
and twice not lefs than a pint and a quarter. Yet,
inftead of adding to her debility, it appeared to give
freflt vigour to the fyftem : the digeftive funftion re¬
fumed its office; (he daily improved in (L ength, and, on
its ceffation at the above period, was in a (late of conva-
lefcence.”

We have numerous hiftories in which it has proved
equally ferviceable about the acme of ftnall-pox; and
the fluid of dropfies is faid to have been frequently d i re¬
charged by this channel. An extraordinary inftance of
this is related by Dr. Huxham, in Phil. Tranf. for i7a4~
vol. xxxiii. The patient was a man aged forty, of a (pare
bilious habit, who had an attack of jaundice, followed
by a paroxyfm of colic, this laft being produced by
3

LOGY.

drinking too freely of cider. Among other medicines
was given a bolus, containing a fcruple of jalap, eight
grains of calomel, and a grain of opium. Copious de¬
jections followed, and a few hours afterwards the pa¬
tient complained of pain and fwelling in the fauces, fpat
up a little thick brown faliva, which was foon confider-
ably increafed in quantity, of a deep colour, refembling
greeniffi bile, though fomewhat thinner. This flux of
green and bilious faliva continued for about forty hours,
during which time the quantity difcharged amounted to
four pints. The colour of the faliva then changed to
yellow, like a folution of gamboge, wit., an increafe ra¬
ther than a diminution of the quantity. It continued
of this colour for the fpace of forty hours more, after
which it gradually became pellucid, and the falivation
ceafed as fuddenly as it came on. During the flow of the
faliva, the teeth and fauces were as green as if they had
been ftained with verdigris, and the teeth retained the
fame colour for a fortnight after the ptyalifm had ceafed.
The patient had a few years before been fuddenly attacked
by a fpontaneous falivation, fo exceffive as to endanger his
life. In the prefent inftance, therefore, it is probable
that the dofe of calomel co-operated with the peculiarity
of the conftitution in exciting the difcharge : but, what¬
ever was its caufe, it proved critical both of the jaun¬
dice and the colic; for, from the moment it took place,
the pain of the bowels ceafed, and the greeniffi colour of
the (kin began to fubfide, the urine being at the fame
time fecreted more abundantly, and of a blackiffi hue.

A very remarkable cafe is related in the London Med.
and Phyf. Journal, vol. xxx. p. 37, by Dr. Yeats. The
fubjeft: was a female, in whom a ptyalifm was excited for
the purpofe of improving the date of the menftrual dif¬
charge. This attempt, however, brought on very great
derangement of the digeftive organs, manifefted by im¬
mediate rejeftion of every kind of medicine or aliment,
by acid galtric fecretion, &c. The cure of this ftate re¬
filled every means fuggefted by the experience of Dr.
Yeats, until he again induced ptyalifm, when every un-
pleafant fymptom abated, and the patient gradually and
perfeftly recovered. Remarkable as this cafe appears, and
difficult as it is to trace the mode of curation eftabliffied
by the refufcitation of ptyalifm, we perfeftly coincide
with Dr. Yeats in attributing the recovery of his patient
to that procefs. The reader will meet with fome impor¬
tant remarks on this fubjeft in the Med, Obferv. and En¬
quiries, vol. iii. by Sylvefter and Dobfon, and by Bardfley
in the Med. Reports.

£. Pt. fympatheticus, or mouth-watering. A watering
of the mouth experienced by fome at the fight or fmell of
food is an inftance of its production by nervous influence.
Its occurrence in fever and other complaints, where it
feems to produce very falutary effeCts, (hows that it fome¬
times becomes fpontaneoufly the feat of tranflated or
fubftituted difeafe. Mechanical preffure, as is well
known, excites very much the aftion of the falivary
glands ; as in chewing, fucking, &c. It is on this prin¬
ciple that it has been recommended to roll a marble, or
fmall bullet, in the mouth, for the purpofe of afl'uaging
third; the mufcular motion neceffarily involved in this
aft, eliciting copious falivary fecretion, and confequent
moiftening of the fauces. Tobacco likewife, and all
other local irritants, are capable of inducing this en-
creafed fecretion.

y. Pt. mellitus, or fweet fpittle. This is generally
connefted with diforder of the ftomach : its remote
caufes are probably identical with thofe of Diabetes mel¬
litus. Dr. Good obferves of it, that the fecretion of fw'eet
or mawkiffi faliva is not only for the moft part free, but
accompanied with naufea, and other fymptoms of indi-
geftion : and is probably what Sauvages intends by his
firft fpecies, P. naufeofus, or a (aburra nidorofa. It is
relieved by magnefiaand other abforbents ; but will often
only yield to an emetic, followed by warm ftomachics.
It may be neceffary, no doubt, to vary the treatment ac¬
cording

115

PATHOLOGY.

cording to the nature of the gaftric difturbance. This
affeClion is alfo occafionally fympathetic, as in dentition
fometimes occurs, and as a f'equel or crifis to various
other afteCtions.

2. Ptyalifraus c'nronicus. When, from the caufes we
have detailed, an excited ftate of the falivary glands has
continued long, a chronic inflammation is fet up, and al¬
tered and vitiated Hates of the fecretion take place.
This naturally induces much derangement of the procefs
of digeftion, and hence demands more particular atten¬
tion. In addition to the conftitutional remedies required
in the acute ftage of ptyalifm, we are now called upon to
adopt the application of topical remedies, for the purpofe
of altering the aCtion of the fecernents. Of thefe, acid
and aftringent gargles are the moft ufeful. Blifters be¬
hind the ears have alfo been found efficacious. Dr.
Robertfon has detailed, in the LondonMedical andPhyflcal
Journal, vol. xxxiii. fome cafes fuccefsfully treated by
the oxyde of bifmuth. In the London Medical Tran-
faCtions, vol. ii. a curious cafe is mentioned, in which a
very long-continued and troublefome ptyalifm was cured
by chewing dry bread and fwallovving it.

3. Ptyalifmus iners, drivelling or Havering. This
confifts in an involuntary and diftreffing flow of faliva
from fiuggiffinefs of deglutition or other caufes, without
increafed Jecretion. It has three varieties : cc, infantilis ;
£, fenilis; 7, moriae.

This affection is diftinguiffied from the other fpecies of
ptyalifm by the circumftance, that, while in the former
increafed fecretion (arifing either from an excitement or
dilated Hate of the fecreting veflels) is prefent, in this
the redundancy of fluid owes its exiftence to diminijhed
ahjbrption, and to the want of that almoft continual deglu¬
tition by which this fecretion is removed from the mouth.

The lecond variety is particularly attendant on para¬
lytic patients. This circumftance is probably connected
with the ftate of the brain ; an idea which obtains con¬
firmation from the contemplation of the third variety,
with which debility of underftanding is thus curioufly
connected. To trace the relation which exifts between
thefe ftates would form a fubjeCl of much intereft and
difficulty. As it does not appear however, that, in the
prefent ftate of our knowledge, this affeCtion is under
the control of the medical art, we (hall wave all further
difcuffion of the lubjeCt.

Genus III. jfivfphagia, [from bad or imperfeCt, and
Qccy u, to eat orlw’allow.] Pain or obftruCtion in fwallow-
ing. This genus includes five fpecies.

1. Dyfphagia conltriCta, or difficulty of fwallowing from
permanent diminution of the calibre of the cefophagus.
This affeCtion arifes from a thickened ftate of the mucous
membrane, from induration of the fame, from its acqui¬
ring a cartilaginous ftrudlure, from offiflcations, excref-
cences, fcirrhous or calculous concretions, See. It may
be produced likewife by tumors prefling on the canal,
when thefe arife from neighbouring parts. Ulcers like¬
wife, or other folutions of continuity, by deftroying the
play of the circular fibres, prevent or impede deglutition.
Among other caufes, Dr. Parr, in his Medical DiCiion-
ary, mentions the concretion of mucus, and fupports it
by the teftimony of Hoffman. We need fcarcely obferve,
that, from the nature of the cefophageal ftrudlure, this
circumftance cannot occur, unlefs indeed the natural le-
cretions are very much altered ; an alteration which
would impiy previous difeafed action for a long period,
and hence is unlikely to be removed by diluents and ni¬
trous powders, as the above-mentioned author has re¬
commended. The cafe in queftion was probably one of
the kind deferibed by Dr. Baillie in his work on Morbid
Anatomy, in which coagulated lymph was found in great
quantity. The obftruCtion of fwallowing is moft fre¬
quently caufed by mechanical injury, as pins ,or other
iubftances accidentally introduced.

From whichever of thefe numerous caufes impeded
Vol. XIX. No. 1291.

deglutition may arife, the removal of the caufe itfelf will
be the firft indication of cure. Hence, in all cafes where
tumors in or around the pharynx exift, the removal or
diminution of thofe morbid accumulations rnuft be at¬
tempted. This is, however, no very eafy talk, becaufe,
in the firft place, the kind of tumor or excrefcence is
feldom to be diferiminated when in the canal ; and thofe
which arife externally, as bronchocele, & c. are often dif¬
ficult of cure. In thefe cafes, while we ufe every en¬
deavour to remove the difeafe according to particular in¬
dication, the patient mult be fupported with nourifhing
clyfters or with liquid aliment palled into the ftomach by
means of a flexible tube. By this contrivance, according
to the teftimony of Dr. Good, a lady was fupported for
twenty years.

Difficult as tumors of the cefophagus are to remove, w’e
ffiould not negleCt every probable means of relief ; for
fometimes the breaking of an abfeefs and the difeharge
of its contents has been of great fervice. In the Hiftory
of the Royal Medical Society in Paris for the year 1776,
we are told, that a young lady, aged fixteen years, after
being troubled for about three months with a fpafmodic
cough, began to have a difficulty of fwallowing, which
increafed fo fall, that after a very fliort time ffie was in¬
capable of taking any nourifhment by the mouth, fo that,
for the fpace of three months, life was fupported folely
by clyfters. Mercurial and other frictions were employed
without effeCt. At length M. Macquart, reflecting on
the cafe, and conjecturing that an eneyfted tumourexifted
in the cefophagus, and that it might probably be now in
a ftate of fuppuration, he refolved to adminifter fome
fubftance, which, by its weight, might occafion a rup¬
ture of the fac. For this purpofe he preferibed an ounce
of crude mercury, mixed with the yolk of eggs, to be
fwallowed every three hours. This remedy was taken,
and the patient, foon after flie had fwallowed the fecond
dofe, brought up a confiderable quantity of pus. From
this moment ffie was able to fwallow broth, and by pro¬
per care recovered. An emetic, in cafes when complete
itoppage does not happen, might be preferibed with equal
advantage. According to Dr. Parr, when fcrofulous in¬
durations happen about the cefophagus, the ungt. hy-
drargyri, rubbed on the neck over the induration, or
fmall dofes of calomel, have often been of Angular effi¬
cacy, efpecially if ufed early after the attack of the dif-
order. If the cafe is of more confiderable duration, he
thinks the mercurials ffiould be given, fo as to excite
and fupport a moderate ptyalifm for fome time.

Many are the contrivances for removing foreign bodies
flicking in the paflage to the ftomach ; but it would often
be better to leave the cafe to nature, than to irritate fo
tender a part, which muft be the effeCt of fuch attempts.
If the fubftance'can be reached with the fingers, or with
the forceps, the extraction is eafy. When pins, fiffi-
bones, or fimilar bodies, flick acrofs the gullet, fome re¬
commend a wire with its end turned up like a hook, to
be pafled below thefe bodies, and then turned fo as to
bring them up. Pins, and other (harp bodies, when
they have ftuck. in the throat, have been returned by
fwallowinga piece of tough meat tied to a ftrong thread,
and then pulled up again. If the detained body may
more fafely be pulhed down, the probang is a ufeful in-
ftrument. It hath frequently happened, that, though
indigeftible bodies have been fwallowed, no inconveni¬
ence hath arifen from them. (See Lond. Med. Tranf. vol.
iii. and Med. Mufeum, vol. ii.) If the bodies cannot be
eafily moved up or down, endeavours Ihould not be con¬
tinued long, left inflammation come on. If the patient
can fwallow, a large draught of water may be taken, a
pradfice the more neceflary if the fubftance wedged in
poflefs any great degree of folubility; or, if he cannot
fwallow, an affiftant may injeCt fome fluid into the gullet,
W'hich will fometimes loofen the impacted body. When
thefe endeavours fail, the patient muft be treated as if
labouring under an inflammatory difeafe; and the fame
H h treatment

116

PATHOLOGY.

treatment will be required if an inflammation take place
5n the part, after the obftruCting body is removed. A
proper degree of agitation has fometimes fucceeded in
removing the obftruCting body better than inftruments.
Thus a blow on the back hath often forced up a fubftance
that ftuck in the gullet or windpipe. Pins, which have
lluck in the gullet, have been difcharged by riding on a
liorfe or in a carriage.

In the London Medical Obfervations and Inquiries,
vol. iii. is an account of a finall fibre of a feather being
fwallowed, and extradited by means of a probang with a
thread or two palling from one end to the other, and
faftened to the fponges which w'ere connected with each
end of this inftrument. For fome more complicated
methods of extracting thefe fubltances, fee the article
Surgery.

Independently of the caufes juft mentioned, Dr.
Baillie has obferved, that the cefophagus is liable to ftric-
ture, produced by the contraction of its mufcular fibres
at fome particular part. This difeafe is mod common in
women whofe conftitutions are delicate, and much fub-
jeCt to nervous influence. When fuch a difeafe is exa¬
mined in the dead body, the cefophagus is found to be’
more or lefs contracted in fome part of it, and it feels
harder than ufual, as all mufcles do in a contracted ftate.
There is no appearance of difeafed ftruCture ufually com¬
bined with it ; yet this contraction might lay the founda¬
tion of a permanent and even a fatal difeafe. The muf-
cularfibres of the cefophagus might fo piefs on the inner
membrane, as to excite inflammation in it, which might
advance to fuppuration, and would molt probably termi¬
nate fatally.

A very unufual ftriCture of the cefophagus has been
noticed by the fame author. It confilted in its inner mem¬
brane being puckered together, foas to form a narrownefs
of the canal at a particular part. The canal at that part
was fo narrow, as hardly to allow a common garden-pea
to pafs. There w'as no appearance, however, of difeafed
ftruCture in the inner membrane which was fo contracted,
and the mufcular part of the cefophagus furrounding it
was perfectly found. This difeafe was very flow in its
progrefs; for the perfon in whom it took place had been
for many years affeCted with a difficulty of fwallowing,
and could only fwallow fubftances of extremely finall fize.

Thefe cafes have been much relieved by an attention to
the ftate of the ftomach and inteftines, though not fo
much fo as in the fpafmodic affeCtions we flrall have oc-
cafion prefently to notice. But we (hall fubjoin a cafe
wherein a cure was very happily performed by mechani¬
cal means. It was communicated by Dr. Stevenfon, of
Kegworth, to the Medical and Phyfical Journal, vol. viii.

“ Mrs. Wagdin, Trent Lock, Derbyfliire, the fubjeCt of
the fubfequent communication, is forty years of age, of a
thin fpare habit, and irritable temperament. She dates
the origin of her complaints from a violent attack of
cynanche maligna near twelve years ago, to the contagion
of w'hich (lie was expofed alrnoft immediately after her
recovery from a fevere parturition. The moll prominent
features of her diforderfrom that period till the expiration
of more than three years, were a flight though progreffive-
ly-increafed difficulty of fwallowing, accompanied with
fome degree of forenefs, and an augmentation of the
lalival excretion. With a view' to the palliation of thefe
fymptoms, (lie was directed to have occafional recourfe
to aperients, leeches, blifters, and gargles. By this time,
however, the difficulty of deglutition had become fo
alarmingly exafperated, that (he was no longer capable
of fwallowing folids, even of the magnitude of a pea. In
this fituation (lie put herfelf under the direction of Dr.
Smith, late of Nottingham, who prefcribed mercurials.
A moft fevere falivation was the confequence, under
which ihe laboured for the protrafted (pace of three
months. By this method the fymptoms were fo ccnfider-
ably alleviated, that (lie was capable once more of fwal¬
lowing foft and well-comminuted folids. But, though

thus refcued from her impending fate, the remedy was
productive of effeCts no lefs formidable. I allude to ex-
ceffive debility, frequent fyncope on the leaft motion,
colliquative fweats, her fyftem being greatly emaciated,
and a prey to hyfterical paroxyfms. By the aid of proper
dietetical management, as the complaint it was vainly
hoped was fubdued, her attendants flattered themfelves
(lie might (till furvive even this fevere conteft. Alas!
no fooner were her drooping fpirits reanimated by the
fenfible acquifition of renovated vigour, than the fond
expectations (he had cheriflied became deprefled by a
vilible return of her former impediment to fwallowing.

“ During the laft (even years, (he found herfelf reduced
to the fad neceftity of fupporting a miferable exiftence
by means of liquid aliment, fuch as foups, milk, &c. I
faw her for the firft time in the beginning of OCtober,
1801. She had then a dejeCted emaciated appearance, a
quick pulfe and other heCtic fymptoms, and was harraffed
by an alrnoft inceflant ptyalifm, more particularly urgent
during the earlier part of the day, at which time (he
was always hoarfe. The breathing was much incom¬
moded when (lie reclined on a fofa or bed, which con¬
curred with the other fymptoms in rendering her nights
very reftiefs. Her bowels were habitually inactive.
There was not any external tumefaCtion of the thyroid
gland, nor could the obftruCted part be obferved by in-
lpeCting the fauces.

“ Dyfphagia, in this inveterate ftage, has I believe hi¬
therto alrnoft invariably bidden defiance to the beft-direCted
medical expedients ; and the Angularity of the cafe will,
I truft, be deemed a fulficient apology for; the minutenefs
of its defcription. I propofed to her, as a dernier refort,
to have recourfe to mechanical dilatation, a practice none
of the faculty had before even fuggefted. Senfible that, if
not fpeedily relieved, (lie muft fall a victim to this relent-
lefs difeafe, (lie agreed to fubmit implicitly to any plan
from the adoption of which the fmalleft profpeCt offuccefs
might rationally be anticipated.

“ I firft cautioufly introduced a common bougie into
the lower part of the pharynx. In this place, a powerful
refiftance that occurred, and which occafioned my inftru¬
ment, on the application of fomewhat forcible preflure,
to bend in various directions, feemed to confij-m my<
theory of the nature of the difeafe. Thus foiled, I ven¬
tured to fubftitute a finall probang copioully charged with
oil. It was not without fteady and continued efforts that
this operation was made to dilate the ftriCture. After
having overcome this obftacle, the inftrument defcended
without much difficulty till it reached, I fuppofed, the
lower portion of the celophagus near the cardia, when a
fecond impediment announced the exiftence of another
ftriCture. The fame meafures however at length availed
in enabling the probang alfo to force a paflage through
this contracted part, when it fuddeniy pafi’ed into the
ftomach. The inftrument having been deliberately with¬
drawn, as foon as Mrs. W. had fomewhat recovered from
the irritation and fatigue produced by this, I gave her
fome gruel which ftood ready, in order that (he might af-
certain, by fipping leifurely a fmall quantity, whether
any benefit had accrued from the operation. Upon at¬
tempting to fwallow, (lie found the former impediment re¬
moved, and continued drinking till (lie had confumed at
leaft half a pint of the liquid with the greateft facility as
to the power of deglutition, though of courfe fome fore¬
nefs muft have exilted. Apprehending that the paflage
would not, by the fmall inftrument employed, be fufficiently
dilated to admit of the ready ingurgitation of Folids, the
operation was repeated with a larger inftrument three
fucceflive times, a few days being fuffered to intervene
between each, in order that the topical pain might be al¬
layed by the exhibition of oily linCtufes and aperients,
and by fomentations. The fourth operation enabled her
to fwallow folids without experiencing the fmalleft in¬
convenience, a faculty (lie (till continues to exercife in
its fulleft extents

“As

4

117

PATHOLOGY.

tc As a further teftimony of the efficacy of mechanical
means in the radical cure of this tremendous difeaie,
permit me (hortly to add, that the only daughter of the
above-mentioned lady, aged twelve years, had from her
earlieft infancy, indeed from her birth, laboured under
Dyfphagia conftriCta. Her conftitution partakes much
of the nervous irritability of her mother. The want of
fubftantial food (for her exiftence had been fupported
by the fuCtion of liquid aliment alone) tended obvioufiy
to retard the phyfical evolution of her fyftem. The
complete fuccefs which had crowned my efforts in the cafe
of Mrs. W. naturally created an anxious wilh in the pa¬
rents to have the fame means reforted to in the prefent
inftance ; of the abi'olute neceffity of which my intelli¬
gent little patient was fully fatisfied, and readily con¬
tented to undergo the operation, from the. fanguine ex¬
pectation of deriving equal benefit. It is with fentiments
of the greateft fatisfaClion I am authorifed to (late, that
the expedient has proved altogether falutary and effica¬
cious. The texture of her body, which previous to the
operation had ever been extremely delicate, has acquired a
wonderful degree of renovated vigour ; and her fpirits,
formerly fubjeCl to great depreffion, have obtained fuch a
healthy flow, that ihe can now engage in juvenile amufe-
ments with the greateft cheerfulnefs and vivacity.”

2. Dyfphagia atonica, or the difficulty of fwallowing
from debility of the mufcles concerned in that aCf, is
perhaps chiefly diftinguifhed from the other fpecies of
this genus by the circumftances, that the obftruCtion
f'eems continual, thus different from the fpafmodic ; and
that folids are more eafily fwallowed than liquids, which
does not obtain in the firlt fpecies noticed. It is often
fympathetic of a morbidly-diftended ftate of the mufcu-
lar coat of the llomach, dependent on the interrup¬
tion of nervous influence. If even idiopathic, it ftiould
be combated by gentle ftimulants, among which bitters
perhaps hold the inoft favoured rank. The moft inte-
refting cafe in illuftration of this difeafe with which u'e
are acquainted, was publifhed in the 3d volume of the
Medical Obfervations. The part was preferved in Dr.
Hunter’s collection. The pharynx was, in the cafe in
queftion, dilated at its lower extremity, into a pouch of
confiderable fize, which palled behind the cefophagus.
This pouch began to be formed in confequence of a
cherry-ftone having relied there forfome time, which had
made a kind of bed for itfelf. It remained in that fitu-
ation for three days, and then was brought up by a vio¬
lent fit of coughing. A part of the food always refted
afterwards in the cavity made by the cherry-ftone, by
which it was gradually enlarged. At length, in the
courfe of about five years, the cavity was enlarged into
a bag of a confiderable fize, fufficient to contain feveral
ounces of fluid. This bag paffed down a good way be¬
hind the cefophagus, and the cefophagus neceffarily ac¬
quired a valvular communication with it. In proportion
as the bag enlarged, this valvular communication would
become more and more complete, till at length every
kind of food muft have refted in the bag, and could not
, pafs into the cefophagus. In this way the perfon was de-
llroyed. The lower end of the pharynx is, perhaps, the
only part of the canal where fuch an accident could hap¬
pen. The pharynx is not contracted gradually, fo as to
lofe itfelf infenfibly in the cefophagus, but contrails itfelf
rather fuddenly at the lower end. Hence a little recefs
is formed, in which an extraneous body may occafionally
reft. This is neceffarily at the pofterior part, fo that, if
the recefs lhould be enlarged into a cavity, it muft pafs
behind the cefophagus.

Blifters have been found of ufe in the paralytic ftate of
the mufcular fibres of the cefophagus; and electricity has
been found fuccefsful, with the occaflonal ftimulus of
the probang. The latter means we ffiould ftrongly recom¬
mend.

3. Dyfphagia globofa, the globus hyftericus of Darwin,
and the nervous quinfey of Heberden, is a difficulty of

fwallowing from wind in the ftomach, fpafmodically com-
preffed into the feeling of a ball afcending into the cefo¬
phagus, and producing a fenfe of ftrangulation. Irrita¬
tion of the nerves appears to be always conceded with
it. This may be produced, in its firft origin, by the
many and various caufes acting on the nervous extremi¬
ties. In the womb and the alimentary canal, the rnajo-
rity of thefe caufes are applied ; while in many inftances
the brain itfelf is primarily and immediately aCted on by
mental emotion, and propagates through the nervous
fyftem its difturbed ftate. According, then, to the ftruc-
ture from the difeafed aCtion of which this phenomenon
is derived, it is accompanied by the fymptoms peculiar to
diforders of that ftruCture. Hence the variety of appear¬
ances conneCted with this difeafe bid defiance to arrange¬
ment, and finuilate, in their proteiform and varying cha¬
racter, many of the moft ferious maladies ; and hence our
plan of cure muft vary according as the ftomach, the
brain, or the uterine fyftem, is primarily affeCted.

As far, however, as regards the globus hyftericus itfelf,
we cannot confider it as any thing but a fymptom of the
irritation before delcribed. We give oumolologift’s own
reafon for inferting it, which it will be feen does not at
all impugn our opinion. He fays; “This (Dyfphagia
globofa) is by no means a mere fymptom of hyfteria, as
is often fuppofed ; for it as frequently occurs under the
influence of various paffions, as grief, fear, and anger;
and is a frequent attendant upon the hypochondriacal
diathefis. It is, however, for the moft part, a fympathetic
affeCtion, concatenating with the ftate of the ftomach.”
In fpeaking of Dyfpepfia and Hylteria, we (hall detail this
fubjeft in full : for the prefent we may remark, that, for
the removal of the mere fymptom, ftimulants of the fto¬
mach are the moft appropriate palliatives.

4. Dyfphagia uvulofa, or fwallowing impeded by elon¬
gation of the uvula. This may arife from Ample relax¬
ation, from inflammation, or ulceration. It is attended
with uneafinefs and difficulty in fwallowing, cough, ,nau-
fea, commonly a continual fpitting, (ometimes a difficulty
of breathing, and a Hammering or faulty articulation.
There are two varieties, differing as they arife from in¬
flammation or from relaxation. In the firft, the uvula is
fwelled, hot, acutely painful, of a red or livid colour, and
falls down in an altered form. Sometimes fuppuration
comes on, and the difficulty both of fwallowing and
breathing is more confiderable than in the fubfequent va¬
riety. When this complaint is very violent, there is ap¬
parent danger of ftrangulation. It is cured by bleeding
and purging ; gargling with fubaftringent liquids, and
fometimes lcarification. In the feconcl variety, the uvula,
preferving its natural colour, is relaxed, elongated, pale,
or cedematous.

It is remarkable that, on fome occafions, the irritation
arifing from this elongation of the uvula is only felt when
the mucous membrane of the ftomach and fauces is in an
irritable ftate. A medical man applied to an eminent
leCturer on furgery for the purpofe of having a portion of
the uvula taken off. The leCturer, who had on (ome
former cafe remarked the faCt juft noticed, eluded the
performance of the operation for fome days, and during
that time directed opening medicines, & c. to be taken ; the
confequence of which was, that the patient felt in a little
while no inconvenience from his elongated uvula, al¬
though on examination no diminution of its fize was ap¬
parent. The treatment of the relaxed uvula confifts in
the ufe of (limulating and aftringent gargles, and trie
correction of morbid Hates of the mucous membrane of
the alimentary canal. When thefe meafures are unfuc-
cefsful, the extirpation of a portion of the uvula is advif-
able ; for which, fee Surgery. -

5. Dyfphagia linguofa, fwallowing obftruCted or trou-
blefome from magnitude or protrulion of the tongue.
This fpecies has two varieties : a, exertoria ; (3, ranula.

In a. exertoria, the tongue is protruded, often with
enlargement of its fubftance. As an idiopathic and du¬
rable

PATHOLOGY.

118

rableaffeftion, it is manifefted moil frequently in children.
It happens fometimes immediately after birth ; at others
in the firft years of infancy . In both cafes this deformity,
be it from birth or accidental, degenerates gradually,
when it is not remedied in its beginning, into an habi¬
tual difeafe, which increafes with age; and many have
been afflifted with this deformity for life. An author of
the fixth century, Gafpar Peucer, is the firft who has
laid he had feen children come into the world with the
tongue out of the mouth, and “hanging on the chin,
like that of a calf recently (lain.” Such is his exprefiion.
He confidered this vicious conformation as a phenome¬
non, in fome meafure foreign to the art ; as an incurable
monfirofity. The fame cafe has been obferved, with a
little more exaftnefs, by Zacchias; this phyfician fpeaks
of having feen, in 1628, at Rome, a new-born child, very
Jtrong and well formed, who had the tongue out of the
mouth, the length at lead of three fingers breadth ; it
was a little wider and a little thicker than it ufually is at
that age; when the child moved it, and drew it in, one
could judge how much it exceeded the opening of the
mouth. Neverthelefs, it fucked pretty well, provided
the nurfe’s nipple was large and elongated ; for it could
not execute the fame fundtion with another nurfe, whofe
nipple was (hort and thin. Arrived at the age of about
fourteen months, it ate and drank pretty freely, although
it had, night and day, a portion of the tongue out of the
mouth ; it began even to pronounce fome words, when it
died, without Zacchias having known the caufeofits death.

The firft appearance of the difeafe is generally loon
after birth, though inftances (fee the Memoir of Citizen
Laflus in the firft volume of the National Inftitute of
Science and Arts in France) are not wanting to fhow
that the difeafe has exifted before birth. In either cafe,
however, the point of the tongue tumefies, is prolonged
by little and little out of the mouth, till it is found ex¬
tending even upon the chin. Suffering the child to fuck
much increafes this elongation ; and, in proportion as the
tongue extends and tumefies, it draws with it, by its
weight, the os hyoides and the fuperior part of the la¬
rynx, which contributes to render deglutition ftill more
difficult. The continual and very-abundant effufion of
faliva, which is no longer retained in the mouth, induces
third and drynefs of the throat; the incifive and canine
teeth of the lower jaw are thrown forward, and partly
quit their alveoli ; the tongue, rubbing againft thefe dif-
placed and worn teeth, excoriates and bleeds ; the lower
jaw always hangs down, and projefts a little forward ;
the under lip reverfes, and projefts ; the fuperior edge of
the lower jaw is hollowed by degrees in its middle, de¬
prived at length of teeth by the preflure and motion of
the tongue, which forms there a kind of furrow to lodge
itfelf ; in fine, this organ, at times more, at others lefs,
tumefied, hangs conftantly out of the mouth. Such are
the fymptoms which charafterife this difeafe when it is
inveterate ; at the fame time, it does not abfolutely pre¬
vent f'peech and deglutition ; but the found of the voice
is harlli, and deglutition is always more or lefs reftrifted.

The firft attempts which were made to cure this difeafe
were by amputating the protruded part of the tongue;
and the fear of haemorrhage alone reftrained the hands of
the furgeons of the fifteenth century. It feems that we
have no occafion for this violent praftice ; for it has been
Ibown by Laflus, in the Memoir above mentioned, on the
deareft grounds, that, in nine cafes out of ten, the pro¬
truded tongue is reduceable by gradual prelfure, and that
a bandage fo placed as to keep the mouth fliut will gene¬
rally be fufficient to cure the difeafe. This, however,
•can only apply to thole cafes in which fimple congeftion
or inflammation is prefent, in confequence of the return
of blood beiiig prevented by the unnatural pofition of
.the organ. Of courfe, when degenerations of ftrufture
have occurred, the morbid enlargements will require the
application of ligatures or extirpation with the knife. See
■Surgery.

|3. D. ranula, is an intumefcence under the tongue,
named from its fituation in the vense raninas, or
perhaps from its altering the voice of the patient. This
tumour is feated on either fide of the fraenutn. It is
round, of a greyifh colour like an hydatid, foft, compref-
fible, indolent, and, in the early ftage, almoft tranfparent.
At firft it is of about the fame fize as a nut or a cherry ;
but by degrees its volume becomes much more confider-
able. This alfo is very frequently met with in young
children : its occurrence in adults is more uncommon.
It confifts of a fucceffive dilatation of the excretory tube
of the fubmaxillary or elfe of the fublingual gland, the
orifice of which duft is by fome caufe or another flopped
up, or obliterated ; fo that the confined faliva accumu¬
lates, becomes vifcid, and ceafes to flow in the ufual
manner. In proportion as the ranula increafes, the inci¬
pient ftate of it having been neglefted, its enlarged fize
raifes up the tongue, and forces it backward ; the confe¬
quence of which is, that maftication, deglutition, and
refpiration, are obftrufted. The voice becomes indif-
tinft and hoarfe ; the motion of the tongue is reftrained :
it cannot be put out of the mouth. By degrees, the in-
cifor and canine teeth of the lower jaw are loofened; the
layer of mufcles, compofing the lower parietes of the
mouth, is deprefled; and the dwelling, having attained a
confiderable fize, makes a very manifeft prominence be¬
neath the chin. In this advanced ftage, that is to fay,
when it has exifted ten or twelve years, as praftitioners
occafionally fee inftances of, the appearance of the fwell-
ing is quite altered from wdiat it originally was. The
tumour is now hard, elaltic, painful, and ulcerated : it
is as large as a turkey’s egg, and not fituated at the fide
of thefrumum, but anteriorly under the tongue, to which
it is clofely adherent. The mouth emits a very fetid
fmell ; and the breathing is fo much obftrufted, that the
patient, through fear of fuffocating, is obliged to lie with
his mouth wide open, when he goes to fleep.

While a ranula is recent, the fluid which it contains is
a vifcid faliva, refembling the white of egg, but fome-
times of rather a yellow colour. In time it is gradually
changed, becoming turbid and puriform ; and, in certain
inftances, foft, friable, greyifh, concretions, from the fize
of a pea to that of an almond, commonly called falivary
calculi, are found in the kind of cylt, which is produced
by the dilatation of the falivary duft. Thefe calculi ef-
fentially conlift of a large proportion of the phofphate of
lime, united with a mucilaginous fubftance.

The tumour is often of a fcrofulous kind, and con¬
tains a thick purulent matter. It has been ftyled a hyda¬
tid, and is laid by Siebold to be an expanlion of Whar¬
ton’s duft. When it grows fuddenly, both the fpeech
and fwallowing are impeded, with much pain ; but it ge¬
nerally increafes gradually, and its effefts are not violent.
Inftances, it is laid, have occurred of thefe tumours de¬
generating into cancers; but this is highly improbable.
They are with great difficulty difperfed or brought to
fuppuration, and generally require the knife for their
removal. And indeed it has been afferted on refpeftable
authority, that a ranula, whether recent or inveterate, can¬
not be cured except by a furgical operation. SeeSuRGERY.

The fpecies is found occafionally as a fymptom in bron-
chccele and other caufes of external preflure.

Genus IV. DipJ'afis, [from to be thirfty.] Mor¬

bid thirft ; the defire for drinking exceflive or impaired.
This genus contains two fpecies.

1. Dipfofis avens, conftant thirft with acidity of the
fauces. This fpecies is generally found in fevers, fluxes,
dropfy, &c. Many cafes are on record in which this af-
feftion has reached an aftonifhing height. There are
fome authentic records which feem to fhow that it is an
idiopathic difeafe. See the London Medical Journal,
vol. iii. a cafe by Dr. Dyce; and vol. iv. of the fame
work, the cafes of Dr. Domeier and Tuaam Peaal. In
thefe, aridity of the fauces and pharynx, the probable

4. caufe

119

PATHOLOG Y.

caufe of thirft, was prefent, excepting the Jail, almoft with¬
out conftitutional difturbance.

The heft treatment appears to be to evacuate the bowels,
and the ufeof mineral acids. Of courfe, when the difeale
is traceable, and we have little doubt that it is fo in all,
to exceflive depletion by fweat, urine, &c. to nervous de¬
rangement, inflammation of the ftomach, or any other
difeafed flate, the correflion of that ftate demands our
firft confideration. For an allonifhing cafe, in which two
hundred pints of wine, and the fame of water, were drunk
daily, fee the Eph. Nat. Cur. cent. vii. and for another,
in which eighty tnealures of liquid were taken-in daily,
fee Binninger in the Adi. Helvet. vii. p. 16.

z. Dipfolis expers, or conftant want of thirft. Cullen
was of opinion, that this always indicated an aftedlion of
the fenforium commune. Sauvages, however, relates two
cafes of patients in whom it formed an original difeafe:
the one a learned and excellent member of the academy
of Touloufe, who never thirfted, and pafi'ed whole months
without drinking inlhehotteft part of the furnmer ; the
other a woman, who for forty days abftained altogether
from drinking, not having had the fmalleft defire, and
who was neverthelefs of a warm and irafcible tempera¬
ment. See another cafe that continued for fome years,
in theEphem. Nat. Cur. cent. v. and vi.

Genus V. Limofis, [from hunger.] Morbid Ap¬

petite; 5. e. exceflive or depraved. The following are the
feven fpecies, with their varieties.

i. Limofis avens, infatiable craving for food. We
have three varieties of this fpecies.

a. L. fyncoptica, from a feeling of faintnefs and inani¬
tion. This diforder, we believe, is feldom idiopathic:
it more frequently depends on very general gaftric difturb¬
ance, and is certainly connected with deficient adlion of
the abforbents. In the Phil. Tranf. vol. xliii. 1745, >s a
Angular cafe related by Dr. Mortimer, of a boy twelve
years old, who, from a feeling of inanition, had fo ftrong
a craving, that he would gnaw his own flefh when not
fupplied with food. When awake, he wasconftantly de¬
vouring, though whatever he fwallowed was foon after¬
wards reje&ed. The food given him confided of bread,
meat, beer, milk, water, butter, cheefe, fugar, treacle,
puddings, pies, fruits, broth, potatoes; and of thefe he
fwallowed in fix fucceflive days 384^. 2 oz. avoirdupois,
being 64lbs. a-day on an average. The difeafe conti¬
nued for a-year.

It is occafionally produced by worms. See a curious
cafe of Dr. Burroughs, Phil. Tranf. xxii. 1700 ; in which
the patient from this aftedlion was rendered capable of
devouring an ordinary leg of mutton at a meal for feve-
ral days .together, and fed greedily alfo on fow-thiftles
and other coarfe plants. Voracity is, however, by no
means an unfrequent fymptom in worms.

|3. L. lielluonum, from habitual indulgence in large and
frequent meals. Habit, induced by idlenefs, is undoubt¬
edly the moft frequent caufe of gluttony. The unoccu¬
pied perfon perpetually eats, unlefs difeafe impedes this
fenfual gratification. Sometimes, however, it feems that
an idiolyncracy of a peculiar nature difpofes to exceflive
appetite. In a cafe we (hall prefently quote, not only
the father, but nine fons, were remarkable for the vora-
cioufnefs of their appetite. This aftedlion can fcarcely
be called a difeafe; for, without entering into any dif-
cuflion on the caufe of hunger, we may remark that that
fenfation evidently depends on fome adlionof the ftomach.
Whatever that may be, if it is increafed without pain or
derangement of the digeftive or any other function, it is
evident that we have no more reafon for calling this a
difeafe than the great ftrength which we remark in fome
men, and which evidently depends on exceflive power of
the mufcles. Hence it appears how abfurd thofe attempts
muft be which have been made to remove this idiofyn-
cracy by acids, opium, &c. in a word by any treatment
Vo L. XIX. No. 1291.

but the moral. The unfortunate individuals afflicted
with this propenfity arefeldom fo robuftas thofe of more
moderate appetite ; and they feldom, according to the tefi-
timony of M. Perc}-, live beyond the age of forty years.
In moft of the cafes on record, the flcin appears to be the
part whence the furplus of provifion is thrown off; the
itools and urine being commonly in the ordinary propor¬
tion.

It would be improper, in a work of this fort, to pafs
over the moft remarkable cafe we are acquainted with ;
although, from its frequent quotation, it is probably
known to. moft of our medical readers.

The cafe is that of , the famous Turare, who was known
to all Paris, and who died at Verfailles about the year
1800, at the age of twenty-fix years. M. le Baron Percy,
who favv Tarare, and who made fome inveftigations re-
fpedling this Angular perfonage, has given us the hiftory
of him, in a very curious Memoir on Polyphagy. At
feventeen years of age, Tarare weighed only one hundred
pounds ; and was already able to eat, in twenty-four
hours, a quarter of a bullock of that weight. Having
left his parents when very young, (he was of the environs
of Lyons,) fometimes begging, fometimes Healing, to
obtain fubfiftence, he attached himfelf to one of the
mountebank (hows on the boulevards. One time, on the
ftage, he defied the public to fatiate him; and ate in a
few minutes a pannier-full of apples, furniftied by one of
the fpeftators ; he fwallowed flints, corks, and all that
was prelented to him. At the commencement of the war
Tarare entered into the army ; he ferved all the young
men in eafy circumftances in the company, did all their
jobs for them, and ate up the rations they left for him.
Famine neverthelefs gained upon him ; he fell fick, and
was taken to the military hofpital at Soultz. On the day
of his entry he received a quadruple allowance : he de¬
voured the food refufed by the other patients, and the
fcraps about the kitchen ; but his hunger could not thus
be appeafed. He got into the apothecary’s room, and
there ate the poultices, and every thing he could feize.
“ Let a perfon imagine,” fays M. Percy, “all that domeftic
and wild animals, the moft filthy and ravenous, are capa¬
ble of devouring; and they may form fome idea of the
appetite, as well as the wants, of Tarare.” He would eat
dogs and cats. One day, in the prefence of the chief
phyfician of the army, Dr. Lorence, he feized by the neck
and paws a large living car, tore open its belly with his
teeth, fucked its blood, and devoured it, leaving no part
of it but the bare fkeleton ; half an hour afterwards he
threw up the hairs of the cat, juft as birds of prey and
other carnivorous animals do. Tarare liked the fleflt of
ferpents ; he managed them familiarly, and ate alive the
largeft fnakes, without leaving any part of them. He
fwallowed a large eel alive, without chewing it ; but we
thought we perceived him crulh its head between his
teeth. He ate, in a few inftants, the dinner prepared for
fifteen German labourers: this repaft was ccmpofed of
four bowls of curdled milk, and two enormous hard pud¬
dings. After this, the belly of Tarare, commonly lank
and wrinkled, was diftended like a- balloon : he went
away, and flept until the next day, and was not incom¬
moded by it. M. Comville, the furgeon-major of the
hofpital where Tarare then was, made him fwallow a
wmoden cafe, enclofing a ftieet of white paper : he voided
it the following day by the anus, and the paper was un¬
injured. The general-in-chief had him brought before
him ; and, after having devoured in his prefence nearly
thirty pounds of raw liver and lights, Tarare again
fwallowed the wooden cafe, in which was placed a letter
to a French officer, who was a prifoner to the enemy.
Tarare fet out, was taken, flogged, imprifoned ; voided
the wooden cafe, which he had retained thirty hours, and
had the addrefs to fwallow it again, to conceal the know¬
ledge of its contents from the enemy.

They tried to cure him of this infatiable hunger, by the
I i ufe

120

PATHO

uie of acids, preparations of opium, and pills of tobacco;
but nothing diminifhed his appetite and his gluttony.
He went about the flaughter-houfes and bye-places, to
difpute with dogs and wolves the mod difgufting ali¬
ments. The fervants of the hofpital furprifed him drink¬
ing the blood of patients who had been bled, and in the
dead-room devouring the bodies. A child fourteen
months old difappeared fuddenly; fearful fufpicion.s fell
on Tarare ; they drove him from the hofpital. M. Percy
loll fight of him for four years : at the end of this time
he faw Tarare at the civil hofpital at Verfailles, where he
was perifhing in a tabid Hate. This difeafe had put a
If op to his gluttonous appetite. He at length died in a
Hale of confumption, and worn out by a purulent and
fetid diarrhoea, which announced a general fuppurntion of
the vifcera of the abdominal cavity. His body, as foon
as he was dead, became a prey to an horrible corruption.
The entrails were putrefied, confounded together, and
immerfed in pus : the liver was excefiively large, void of
confidence, and in a putrefcent Hate; the gall-bladder
was of confiderable magnitude; the ilomach, in a lax
ftate, and having ulcerated patches difperfed about it,
covered almoft the whole of the abdominal region. The
flerlch of the body was fo infupportable, that M. Telfier,
chief furgeon of the hofpital, could not carry his invelti-
gation to any further extent.

Tarare was of a middle-fized ftature ; his habit of body
was weak and flender ; he was not of a ferocious l'pirit;
his look was timid; the little hair he had preferved, al¬
though very young, was very fair, and extremely fine.
His cheeks were fallow, and furrowed by long and deep
wrinkles : on diftending them, lie could hold in them as
many as a dozen eggs or apples. His mouth was very
large ; he had hardly any lips ; he had all his teeth ; the
molares were much worn, and the colour of their enamel
ftreaked like marble ; the fpace between the jaws, when
they were fully feparated, meafured about four inches :
in this ftate, with the head inclined backwards, the
mouth and cefophagus formed a reCtilinear canal, into
which a cylinder of a foot in circumference could be in¬
troduced without touching the palate. Tarare, fays M.
Percy, was conftantly covered with fweat ; and from his
body, always burning hot, a vapour arofe, fenfible to the
fight, and (till more fo to the fmell. He often ftank to
fuch a degree, that he could not be endured within the
diftance of twenty paces. He was fubjeCt to a flux from
the bowels ; and his dejections were fetid beyond all con¬
ception. When he had not eaten copioufly within a fhort
time, the (kin of his belly would wrap almoft round his
bod}^. When he was well fatiated with food, the vapour
from his body increafed, his cheeks and his eyes became
of a vivid red ; a brutal fomnolence, and a fort of hebi-
tude, came over him while he digefted. He was in this
ftate troubled with noify belchings ; and made, in moving
his jaw, fome motions like thole of deglutition. M.
Percy never faw in him any figns of rumination. Tarare
was almoft devoid of force and of ideas. When he had
eaten to a moderate extent, and his hunger only ap-
peafed, he was quick and aCtive ; he was heavy and lleepy
only when he had eaten to excefs.

Another cafe, very fimilar to the above, was brought
into view about the fame time at Liverpool that the firft
was at Paris; and the lubjeCt of it was alfo a foldier in
the French fervice. This cafe is recorded in the article
Hunger, vol. ix.

I hele are our modern inftances. A few' ancient ones,
to which fome of our readers may perhaps not give full
credit, are related under the word Gluttony, vol. viii.

The writer of the article Medicine in the Ency. Brit,
has obferved, that the pylorus being too large has l'ome-
times caufed this difeafe. We need not remark on the
abfurdity of this fuppofition ; becaufe every thing we
know of thefe cafes evidently fhows that the digeftion of
food is properly performed, a fad quite incompatible with
She idea that the pylorus lets the food pafs too quickly.

LOGY.

In that cafe, indeed, the food would pafs almoft un¬
changed, and the ftools would of courfe be unnatural,
and in large quantity; appearances actually the reverfe
of thofe we have derailed. It is but juftice, however, to
ftate, that in lientery, a difeafe in which much food is
taken, this conformation has been difcovered.

7. L. exhauftorum, or voracity from exhauftion, as
in the event of long abftinence, fevers, or exceftive dif-
charge. This can only be coniidered as a natural phe¬
nomenon rendered more manifelt by its exciting caufes
being longer or more intenfely applied. It affords us an
opportunity of remarking on the danger of gratifying
the appetite to its full extent after long abftinence, from
whatever caufe it may.be produced. After long fading,
indeed, fo many have been the fatal inftances that have
occurred from a full meal, that it is now popularly
known and guarded againft. After recovery from fevers
and other exhaufting affeCtions, in which for a long pe¬
riod little or no fuftenance has been taken, the fame rule
fhould in a minor degree be retained; but this regulation
is not praCtifed even by our profeffional brethren, who
are often found to prefcribe tonics and flimulants on the
recovery of patients from febrile affections. The fame
regard to quality is perhaps equally eftential; but, as the
dietetic arrangements of convalefceuts, will be fully
treated of, and as no very great errors are commonly
committed on this bead, we ftiall pafs it over, leaving as
a general direction, the precept of Horace —

Nil nifi lene decet

Vacuis committere venis.

a. Limofis expers ; lofs or want of appetite, without any
other apparent affeCtion of the ftomach. This is the ge¬
nus Anorexia of Sauvages, Linnaeus, Vogel, Sagar, and
Cullen. Sauvages has thirteen 1'pecies, which would
here rank as varieties, but which, as Cullen juftly ob-
ferves, belong rather to the genus (in the prefent fyftem,
fpecies) of dyfpepfy. The following have perhaps a fair
claim to be noticed.

a. L. defefforum; from too great fatigue, or the ex¬
pectation being w'orn out by delay.

(3. L. pathematica ; from violent paflion or other ab-
forption of the mind. This is chiefly produced by fevere
grief, terror, ardent defire of obtaining an objeCt of pur-
fuit, or religious enthufiafm. Of the firft we have an in-
terefting cale by Dr. Eccles, in the Edinburgh Medical
Effays for 1720, of a young lady about fixteen years of
age, who, in confequence of the ludden death of an in¬
dulgent father, was thrown into a ftate of tetanus, or ri¬
gidity of all the mufcles of the body, and efpecially of
thofe of deglutition, accompanied with a total lofs of
defire for food, as well as incapacity of fwallowing it,
for two long and diftinCl periods of time : in the firft in-
ftance for thirty-four, and in the fecond, which occurred
fliortly afterwards, for fifty-four, days ; “all which time
(obferves the writer) of her firft and fecond fallings, (he
declared (he had no fenfe of hunger or thirft ; and, when
they were over, (lie had not loft much of her flelh.” Sau¬
vages alludes to a fimilar effeCt produced by religious ma¬
nia, and nymphomania. Nofol. ii. p. 805.

7. L. protraCla ; enabling the fyftem to fuftain almoft
total abftinence for a long and indefinite time without
faintnefs. As gluttony, or a defire to be perpetually
eating, may be acquired by habit, fo may falling. The
appetite of hunger feems, from various cafes, almoft as
capable of being triumphed over as other appetites, and
the body of being nourilhed by a very trifling quantity
of food, and for many weeks, perhaps months, even by
water alone. See Marcardier in Journal de Medecine,
tom. xxxiii. Schenck, lib. iii. obf. 39. Waldfchmid,
Diff. de his qui diu vivunt fine alimento.

One of the beft-known and belt-marked examples in
our own day, is that of Anne Moore of Tutbury. She
was fufficiently afcertained to be a grofs impoftor, in
pretending to be able to live without any food whatever :

but

121

PATHOLOGY.

but fhe feems, from long habit, to have loft all pleafura-
ble defire for food, and to have been capable of fubfifting
upon very fimple liquids alone. She was at firft induced to
this habit by an extreme difficulty of deglution ; and ffie
at length carried the habit fo far as, by deception, eafily
to excite a general belief that flie never fwallowed any
thing either liquid or folid. The intelligent committee,
who fo laudably formed themfelves into a watch to deter¬
mine the ftate of the faCt, by a conftant attendance upon
her perlon for a month, fufticiently proved that flie could
notlive for ten days without fwallowing fome portion of
liquid. In their report they tell us, that “ on the eighth
day (he was exceedingly diftreffed,” her pulfe had in-
creafed till it had amounted to 145 ilrokes in a minute ;
and “ fo far was (lie reduced on the ninth day, that (lie
became in danger of expiring;” while a few hours after¬
wards, when flie was compelled to confefs the iinpofture
(lie had praCtifed, “ the pulfe at one wrift had entirely
•ceafed, and the other feemed drawn to a thread.” Yet
“ on the whole,” fay the committee, “ though this wo¬
man is a bafe impollor with refpeCt to her pretence of
total abftinence from all food whatever, liquid or folid,
yet fhe cun , perhaps, endure the privation of Jolidfood longer
than any other perj'on. It is thought by thole bejl ac¬
quainted with her, that (lie exifted on a mere trifle, and
that from hence came the temptation to fay that (he did
r.ot take any thing. If, therefore, any of her friends
could have conveyed a bottle of water to her, unfeen by
the watch, and (he could have occafionally drunk of it,
little doubt is entertained that flie would have gone
through the month’s trial with credit. The daughter
fays, that her mother’s principal food is tea ; and there is
reafon to believe this to be true.” Full Expofure of Anne
Moore, the pretended faffing woman of Tutbury.

The cafe of Mary Thomas, a poor Welchwoman of
Merionethffiire, refembles in fome points that of Anne
Moore, but is (till more extraordinary, becaufe her mor¬
bid ftate was much feverer; and had been of longer dura¬
tion, comprehending the greater portion of a century.
And it occurred about the fame time ; as Mr. James
Ward, a royal academician, publiftied “ Some Account”
of both thefe extraordinary women, “accompanied with
Portraits and illuftrative Etchings,” (1813.) for he vi-
fited them as an artift. From his narrative it appears,
“that Mary Thomas has exifted between feventy and
eighty years almoft without food ; and certainly, accor¬
ding to evidence that does not appear in any way objec¬
tionable, for ten whole years, without the lead particle
of nutriment of any kind or form palling her lips, and
without Ihowing any fenfibility or knowledge of external
events; and has had, in that time, no excrementitious
difcharges from the inteftines or urinary bladder. In
1812 this woman was Hill living ; and, from the extraor¬
dinary tenacity to life which fhe evidently poflefies, un¬
der circumftances that would have abridged the days of
any other human creature, though now 80 years old, (he
may, perhaps, long enough furvive to have her hiftory
more explicitly detailed, and the faCls connected with her
peculiar ftate decidedly unfolded.” This expectation
was, however, defeated by the death of Mary Thomas
during the year in which this account was written.

On enquiring into the hiftory of this cafe, a fad has
arifen of fome importance. Mr. Pennant, whofe reputa¬
tion for every thing excellent is ftill freih in our minds,
faw Mary Thomas in the year 1770; and his relation
agrees fo much with Mr. Ward’s, that they mutually fup-
port each other, and give a degree of credibility to an
otherwife incredible cafe.

The great attention which was bellowed by the philo-
fophica) world on the above cafes, together with the
fpirit of inquiry which ftill exilts as to the poflibility of
iu butting- without food, has induced us to make the fol¬
lowing extrads from a paper in the Harleian Mifcellany
as being perhaps not without fome degree of intereft.
The title of the paper is, “ A Difcourfe upon prodigious

Abftinence; occafioned by the Twelvemonth’s Fading of
Martha Taylor, the famed Derbylhire Damfel : proving
that, without any Miracle, the Texture of Human Bo¬
dies may be fo altered, that Life may be long continued
without the fupplies of Meat and Drink. By John Rey¬
nolds. Humbly offered to the Royal Society. London:
Printed for Nevil Summons, at the fign of the Three
Crowns, near Holbourn Conduit ; and for Dorman New¬
man, at the Surgeons Arms in Little Britain. 1669.”
Quarto, containing 37 pages, befides the Title and Dedi¬
cation. Hurl. Mijcell. vol. iv. p. 43.

The exordium, confining of a collection of fimilar in-
ftances, bears ftrong teftimony of fuch occafiona! devia¬
tions from the courfe of nature; and we muft confefs,
although at a lofs to account for it, we are by no means
to difregard fuch a mafs of evidence, fince many other
fads lefs palpable to the community at large, and much
lefs fufceptible of proof, are believed, although equally
inexplicable. Credulity and incredulity are alike the
offspring of unreflecting habits. Too great a pliability
on the one fide, and too much inflexibility on the other,
are obftacles that will always interrupt the way to truth.
That pen, however, as our author fays, “ certainly drops
biafphemy, that dares to raze the facred records; and
that uncharitablenefs which prefuines to write falfehood
upon all human teftimonies : they that affent to nothing
not confirmed by authority, are unfit to converfe in hu¬
man focieties ; for how can I expeCt that anybody fhould
believe me, whillt I myfelf will believe nobody ? It is an.
argument of an empty brain, to prefume to comprehend
all things, and thereupon to rejeCt thofe things from ail
exiftence in their world that have not their fcience in its
intellectuals.

“ Molt certain it is, that Mofes faded forty days and
as many nights, whilft he abode in the burning mount ;
Elijah went as long in the ftrength of a meal ; and no
lefs was the fall of the holy Jelus. St. Auftin reports,
that, in his time, one furvived forty days falling. The
learned Fernelius faith, he faw a pregnant women that
lived two months without meat or drink. Zacutus Lufl-
tanus reports, that at Venice there lived a man that failed
forty days ; another there forty-fix days ; and from Lon-
gius and Fontius (two confiderable writers,) another full
three years ; and that with juft ftature, good habit, free
countenance, and youthful wit. The famous Sennertus
is copious in fuch ltories : he relates from Sigifmundus
and Citefius, a perfon he faith worthy of credit, that
the people of Leucomoria, inhabiting fome mountains in
Mufcovy, do every year die, in a fort, (or rather fleep or
freeze,) like frogs or fwallows, on November 27, and fo
continue in that rigid ftate ; the humour, diftilling from
their noftrils, is prefently condenfed by the ambient cold,
much like to icicles, by which thofe potent pores are pre¬
cluded, and the molt endangered brain fortified againft
the fatal aflaults of brumal extremities. The fame Sen¬
nertus rehearfes a ftory of a virgin at Padua, from Vigun-
tia, profeflbr there, who, anno 1598, was afflicted with a
fever, then a tumor, then arthritic pains, and pains in the
ventricle and whole abdomen; then with vomiting and
naufeating of food, till at laft file could take no food for
two months; then, after another fit of vomiting, purging,
and bleeding, fhefafted eight months; and, after a little ufe
of food, Ihe failed two months more. And, to be fhort,
he (lories it of three perfons that failed each two years,
one three years, another four, one feven, another fifteen,
another eighteen, and one twenty ; yea, one twenty-nine,
another thirty, another thirty- fix, and one forty years.
Famous is the ftory, perhaps fiClion, being poetical, of
Epimenides, (whole words St. Paul is thought to cite in
his Epiflle to Titus,) whom fome report to have flept fe-
venteen years, fome feventy-feven years, together. But
enough of ftory : thofe that are defirous to read more, are
referred to Marcellus Donat, lib. iv. de Med. Hift. Mi-
rab. c. 12. Schenk, lib. iv. Obferv. Guaguinus, lib. iii.
Hift. Franc. Petrarch, lib. iii. de Mirabel, c. 22. Portius

de

322 PATHOLOGY.

deHill. Puellse German. Ufpergenfis in Chron. Lentulus
in Hill. Admir. Apol. Berius, lib. de Vini Nutritione.
Bozius, lib. xi. c. 4.. de (ignis Eccl. Fulgorius, lib. i. c.6.
Lepaeus, lib. ix. Hid. Scot. Fovorinus apud Gellium,
lib. xvi. c. 3. and efpecially Licetus, who wrote a particu¬
lar tra£l to folve the phenomena of this prodigy.

“ But, further to fatisty thefe incredulous perfons, it is
affirmed that fome of thefe abftineuts have been watched
By the mod wakeful eyes and jealous ears, to detedl their
fraud, if guilty of any; as was that maid that refufed all
food, except only water, for three years, by Bucoldianus,
with whom (he abode for twelve days, at the command
of Ferdinand the emperor; fo that Apollo.nia Schreje-
rana was taken by the fenate of Bern, and put into the
hofpitai of that town, and there watched till they were
fatisfied of the truth of her total abllinence.”

Mod of thefe cafes are certainly too unnatural to at¬
tempt to refute, however gravely they may have been af-
ferted. Ufelefs, therefore, as the talk would be to dis¬
prove what nobody would believe, as well as to combat
with arguments the exidence of what has been faid to be
feen, believed, and fworn to, it would be equally unjud
to doubt the authenticity of the whole. The cafe which
the author himfelf has related, bears drong tedimony of
the poffibility of the human body fubfiding under priva¬
tions of food for a number of days, if we do not give
credit for the full time he has reprelented. This ab-
ftinent, he fays, “is one Martha Taylor, a young damfel
born of mean parentage, inhabiting not far from Bake-
well in Derbylhire ; who, receiving a blow on the back
from a miller, became a prifoner to her bed for feverai
days; which being expired, (he obtained fome enlarge¬
ment for a time, but by increafing didempers was quickly
remanded to her bed-prifon again ; where continuing fome
time, (lie found, at lad, a defeat in her gula, and
quickly after a dejeftion of appetite ; fo that, about the
zzd of December, anno 1667, die began to abdain from
all folid food, and fo hath continued, (except fomething
fo fmall, at the feldom ebbings of her didemper, as is
altogether inconfiderable,) till within a fortnight before
the date hereof, which amounts to thirteen months and
upwards ; as alfo from all other forts, both of meats and
drinks, except now and then a few drops of the fyrup
of dewed prunes, water, and fugar, or the juice of a
roaded raifin, &c. but thefe repads are ufed fo feldom
and in fuch very fmall quantities, as are prodigioufly infuf-
hcient for fudenation : die evacuates nothing by urine
or dool ; die fpits not, that I can hear of, but her lips are
often dry, for which caufe (he takes water and fugar with
a feather, or fome other liquids ; but the palms of her
hands are often moid, her countenance frefh and lively,
her voice clear and audible; in difcourfe die is free ; her
belly dapped to her back-bone, fo that it may be felt
through her intedines, whence a great cavity is ad¬
mitted from the cartilago enfiformis to the navel; and,
though her upper parts be lefs emaciated, (though much
too,) yet her lower parts are very languid, and unapt for
motion, and the (kin thereof defiled with a dry pruriginous
fcurf, for which, of late, they have wadied them with
milk ; die deeps fo fparingly, that once die continued
five W'eeks waking. Led lhe diould prove a cheat, (he
hath been diligently watched by phyficians, furgeons, and
other perfons, (for at lead a fortnight together,) by the
appointment of the noble earl of Devonfhire, as is al-
' ready publidied by Mr. Robins, B. of D. that is, ballad
maker of Derby; whofe ballad, they fay, doth much
excel his book. Likewife feverai other perfons, at other
times, have been pleafed to vyatch fortheirown fatisfaftion,
who, detefting no fraud, have given the account above
mentioned.”

It was obferved by Dr. Henderfon, from Magn. Gabr.
Block, that all examples of extraordinary fading have
been confined to the female fex. This is another confirm¬
ation of the remark. Men, however, under circumdances
,of neceffity, have been enabled to endure fevere privations,

even under confiderable bodily exertions. The crew ■of
Bligh, and thehidory of many other navigators, give full
tedimony of the powers that exid in mankind when their
natural fupport has been materially reduced, and alfo
totally taken away. The following particulars are col¬
lected from a note in Dr. Good’s Nofology, to which we
have been already fo much indebted.

Four men were preferved in a mine, from which, in eon-
fequence of an accident, they were incapable of being ex¬
tricated for twenty-four days, without other food than
water. Phil. Trunf. 1684. — A boy, fifteen years of age,
faid to have lived three years without eating or drinking,
with fever occafionally ; after this period he recovered
tolerable health, excepting the ufe of one of his limbs,
but even then took very little food. Id. 1720. by Patrick
Blair. — A man, faid to have lived eighteen years on water,
with occafionally a little clarified u'hey ; and locked up
for twenty days in clofe confinement, with wateralone, to
prove whether there were any impofition; meagre, and flip-
pofed to have no evacuations; but in good health, and pur-
fued hulbandry. Id. 1742. — A woman, from epileptic fits
when a girl of fifteen, took to her bed, loll her appetite,
and was attacked with lock-jaw, which, with a few (liort
intervals, continued for four years : was on two or three
occafions induced to take a little water, and her mouth was
at times moillened with wetted linen through a cavity in
her teeth, from two of them having been broken in an at¬
tempt to force the mouth open; but fwallowed nothing
elfe. After this period, began gradually to recover front
the tetanus, but had no defire for food ; and twelve years
from the attack, when able to walk upright, took no
more food than fufficie.nt for an infant of two years of age.
Had no egefta, but when ingella, which were propor¬
tioned to each other, but fometimes a dewy foftnefs on
her (kin. Dr. ^Mackenzie in Phil. TranJ'. vol. lxvii. 1777.
This cafe is authenticated by numerous witnelfes of
high refpeftability, and is entitled to peculiar attention.
— Cafe of a woman, who loll all defire of taking food by
a fall from her horfe into water during her firll menltrua-
tion at the age of eighteen : for fifty years fcarcely ever took
folids, her chief food being whey in the fummer, and
milk, milk and water, or pure water, in the winter : had
frequent retchings, which were cured by fmoaking to¬
bacco : for the fpace of fixteen years had only one (lool
annually, in the month of March, refembling a globulet
of (heep-dung: menfhuation never recurred, but occafional
vomitings of blood. Edin. Med. EJf. vol. vi.

3. Limofis pica, appetite for improper and indigeftible
fubltances. We have two varieties of this fpecies.

a. L. infulfa, which arifes from want of talle or difcri-
mination, as in infants and idiots.

/3. L. perverfa. This arifes from corrupted fade or in¬
dulgence. It is often founded on the ablurd notion that
eating chalk, acids, See. will produce a fair (kin. This
variety anfwers to the malacia, fiaAaxia, of the Greek
authors. When ariling from thefe caufes, chaftifement
or advice can only be had recourfe to, and medical treat¬
ment is out of the queltion. It is to be doubted, how¬
ever, whether mere mental impreffion ever induces this
complaint. It is more reafonable to fuppofe that the
morbid (late of the (lomach is the caufe ; and, in fail, we
fcarcely ever meet with a cafe of pica in which the galtric
fecretion is not much altered. Looking to more remote
caufes, uterine diforder appears often to influence the
nervous fyftem in the firll inliance, and the (lomach fecon-
darily. In the early ltages of pregnancy, and in chloro¬
tic lubjeits, the difeafe is moll generally found; and
hence fome writers have fuppofed uterine irritation to be
the foie caufe of pica. But this is certainly not the cafe j
for we fometimes meet with the complaint in boys; and
in the Well-India illands the negroes are often (ubjeft
to it. It is rendered remarkable in the latter inltance by
dirt being the (ubftance taken. It feems that regular ha¬
bits of diet have frequently cured the negroes of this
dirt-eating, without the aid of medicine. (Sec Bryan
4 Edwards’s

PATHOLOGY.

Edwards’s Hiftory of the Weft India Iflands.) It has
been fuppofed that the prevalence of an acid in the fto-
iriach occaftoned the demand for earthy and abforbent
fubftances in pica : but many of the fubftances, taken in
different inftances, are not poffeffed of any antacid quali¬
ties. The diforder is very frequently beyond the power
of medicine to relieve in a direct way. In the cafe of
pregnancy, it commonly ceafes altogether about the fourth
month, and has been relieved by blood-letting in ftrong
and plethoric women : but in chlorotic girls it is only
removed by the courfe of medicine which removes the
morbid ftate of the habit in general, and reftores the na¬
tural difcharge where that was fufpended. In inftances
where it attacks men, or women in whom the uterine
functions are healthy, it ftiould be treated on the common
principles of Dyfpepfia.

It is aftoniftiing to note the various difgufting and in-
digeftible articles fwallowed by the patients of this dif-
eaie: chalk, allies, coals, foot, pitch, cinders, &c. have
each been taken in fome cafes. But among the moft un¬
natural talles evinced under this affeCtion, though we
do not agree with Dr. Good in calling it “ one of the
moft common,” is that for fwallowing knives. In our
own country it has occafionally occurred; (fee Knife-
eater, vol. xi. p. 784.) but Plouquet, Init. Bibl. art.
Pantophagus, has collected examples from almoft all the
different ftates of Germany and the neighbouring prin¬
cipalities, Balle, Pruftia, Prague, and different parts of
Ruffia. Another curious propeniity is that of fwallow¬
ing glafs, of which alfo the inftances are numerous.
But thefe, as well as eating hair (Brefl. Sammlung, 1719.)
and ordure (Borell. Obf. cent, iv.) mu-ft rather be confi-
dered as inftances of folly and bravado, than of tafte.
Not fo, however, the

y. L. pica nali, a name given by Cohaufen to the im¬
moderate and habitual taking of fnuff, a filthy depravity
common to both fexes ; and which, after being confined
for fifty years, in this country, to the old women of the
old French fchool, has been revived by the dandies of the
prefent day. It has not yet reached the ladies; and fo
we hope it may end where it has begun, with the moft
contemptible part of the creation. Pica nafi feems a
whimfical term; but Cohaufen has chofen to treat this
habit as adifeafe, and has written an exprefs treatife con¬
cerning it. The word pica, in general, denotes an abfurd
and unnatural appetite; and the define of taking the
powder of tobacco in this manner is called a diftempered
appetite of the part into which it is taken, that is, the
nofe. The confequences of the taking fnuff immode¬
rately, are, that the fenfe of fmelling is either entirely
deftroyed, or at lead greatly impaired : for the nervous
tubercles of the noftrils, being continually' vellicated by
this powder, are by degrees clogged up, or wholly defi-
troyed ; and the fenfible membrane, which lines the nof-
trils, is rendered callous, and wholly unfit for the dif¬
charge of its office in fmelling. The voice is next af-
f'eCted by this powder; for it caufes a fort of aftriCiion
at the bottom of the nofe, which affeCts the palate, and
confequently the fpeech; this gives the perfon who takes
it a continual defire of taking more and more, to rid him-
felf of that ftoppage.

As we are treating of morbid longing, it may not be
improper to mention, that many perlons recovering from
febrile affeCtions experience a particular defire for articles
of food which we ftiould, a priori, be inclined to think
highly prejudicial, and confequently to deny them the
enjoyment of. But experience has fliovvn, that in this
cafe the inftinCt may be often fafely indulged : a rule to
be admitted, however, with much caution and reftriOion.

4. Limofis cardialgia. This and the two following
fpecies we find it impoffible to confider in any other light
than as fymptoms of indigeftion. We (hall therefore
give but a brief account of them. Cardialgia has three
varieties : a, mordens ; £, fyncopalis ; y, fputatoria.

a. L. mordens is that painful fenfation of heat and
Vol. XIX. No. ii9a.

123

acrimony about the fuperior orifice of the ftomach,
which, from the vicinity of its feat to the heart, is popu¬
larly called heart-burn. It is produced by the irritation
of acid matter in the ftomach, which rifes to the upper
orifice, fometimes by eruCtation into the cefophagus and
throat, and is fometimes completely ejected by vomiting.
That this irritating matter is of an acid nature, is evinced
by the tafte ; and it has even been feen to produce an
effervefcence on falling on a marble hearth, according to
Dr. Darwin. When vomited, or raifed by eruCtation, it
is fometimes fo intenfely four as to abrade the mouth
and throat; and, in general, it produces a fenfation in
thefe parts fimilar to that which exifts in the ftomach.

The production of this acid may arife from two fources.
If the gaftric powers are fo deficient that they cannot
within a certain time digeft the food, and propel it from
the ftomach, fermentation will take place, and acid will
be generated. Abetter explanation feems to be, that the
acid is lecreted, that it is gaftric juice changed from its
natural ftate. That this is the cafe feems probable, be-
caufe acid eruCtation is often felt fo foon after a meal,
that it is impoffible acid could be generated by fermenta¬
tion ; and moreover we have known eruCtations poffeffing
the higheft degrees of acidity to pafs from a patient whom
we had confined for many cfays to an animal diet. The
palliative remedies are alkalies. Dr. Darwin remarks,
that, as the faliva fwallowed along with our food prevents
its fermentation, according to the experiments of Pringle
and Macbride, confiderable relief is fometimes found by
chewing parched wheat or rnaftic, or a lock of wool, fre¬
quently in a day, when the pain occurs, and by fwallow¬
ing the faliva thuseffufed.

£. L. fyncopalis. This appears to differ from the laft
only in this, that the production of the acid is attended
with fo peculiar an effeCl on the nerves of the ftomach,
that feelings of extreme weaknefs and fyncope are expe¬
rienced. The pain, too, which in the firft variety is felt
in the upper extremity of the ftomach chiefly, is extended
in this to the lower part of the fame organ.

7. L. fputatoria, or water-brafh ; the pyrofis of Cul¬
len. It is a burning pain extending over the epigaftrium,
with an eruCtation of watery fluid, ufually infipid, fome¬
times acid. This difeafe comes on in paroxyfms, which
ufually happen in the morning and forenoon when the
ftomach is empty. The firft fymptom is a pain at the
pit of the ftomach, with a fenfe of conftriCtion, as if
the ftomach were drawn towards the back: the pain is
increafed by railing the body into an ereCt pofture, and
therefore the patient bends himfelf forward. This pain
is often extremely fevere, with a fenfe of burning ; and,
the fluid continues to be brought up for fome time, and
does not immediately give relief to the pain which pre¬
ceded it ; but at length it terminates the pain, and the
fit ceafes. Thefe paroxyfms come on without any evident
caufe, nor is the origin of the difeafe always to be im¬
puted to any particular fort of diet. It feldom, if ever,
attacks thofe people who ufe frefti animal food daily ; but
appears to be moft common among thofe who live almoft
entirely upon tea, milk, potatoes, and farinaceous fub¬
ftances. It is much more common in women than in
men; fometimes it attacks pregnant women, and often
thofe who labour under leucorrhcea. It feldom occurs
in any one before the age of puberty, or in thofe who
are confiderably advanced in life : when it has once taken
place, it is very prone to recur occafionally for a long
time afterwards. It is more common in Scotland than
in this country, and chiefly affects the lower claffes of
the people. The paroxyfm is moft effectually relieved by
anodynes, efpecially opium, hyofeiamus, and coniurn ;
and with lefs certainty by other ftimulants and antifpaf-
modics, as fulphuric ether, ammonia, and the tinCture of
guaiacum, Thefe remedies, however, do not materially
contribute to prevent the recurrence of the difeafe.

5. Limofis flatus, or flatulence, is the generation of
air in the inteftinal canal, which, like the production of
K k acid,

PATHOLOGY.

124

acid, C3n have only two fources ; viz. either from the
chemical changes which the food undergoes in confe-
quence of deficient fecretion, or from the altered ftate
of the fecretions themfelves ; for there is little doubt that
air may be fecreted, as Mr. Hunter firft fuggefted. There
are three varieties of this complaint : a, borborygmus;
(2, eruftatio ; y, crepitus.

a. The firft Variety of flatus is indicated by a fenfe
of uneafinefs, with a rumbling or gurgling noife in the
belly. It isfometimes very diftrefling, fince it draws the at¬
tention of by-ftanders; and is not uncommon in young
women, about the age of puberty. “ I attended a young
lady about fixteen,” fays Dr. Darwin, “ who was in other
refpefts feeble, whofe bowels almoft incefiantly made a
gurgling noife fo loud as to be heard at a conliderable dif-
tance, and to at t raft the notice of all who were near her.
As this noife never ceafed a minute together for many
hours in a day, it could not be produced by the uniform
defcent of water, and afcent of air through it ; but there
muft have been alternately a retrograde movement of a
part of the bowel, which muft again have puthed up the
water above the air ; or which might raife a part of the
bowel, in which the fluid was lodged, alternately above
and below another portion of it, as might happen in fome
of the curvatures of the fmaller inteftines, the air in which
might be moved backward and forward like the air-bubble
in a glafs level.” Dr. Darwin recommends “ ten corns of
black pepper fwallowed whole after dinner, that its
effefts may be flower and more permanent,” in the
borborygmi of young women. We have feen them fuf-
pended by any fubftance, taken into the ftomach, as a
piece of dry bifcuit, which, by the way, the late Dr. Buchan
confidered “as one of the beft carminative medicines,”
and recommends it in all complaints of the ftomach, ari-
fing from flatulence and indigeftion. Thefe diforders
are often particularly troublefome when the ftomach is
nearly empty ; and perhaps the operation of a bifcuit
taken at fuch times is merely that of relieving this tem¬
porary vacuity, which any other light aliment would
equally efteft.

0. The fecond variety, eruftatio, is of courfe pro¬
duced by the aftion of the mufcular fibres of the ftomach
on thecontained food. When this fymptom does not take
place, and wind is pent up in the ftomach, it produces all
the diftrefling confequences which are attendant on great
diftention of that organ. In fome inftances great pain
of the ftomach is excited, either by the Ample extenfion
of the fibres, or by partial fpafmodic contraftions ;
great anxiety and oppreflion are felt in the cheft; the
refpiration becomes laborious and difficult, with a fenfe
of fuffocation ; and the heart intermits in its aftion, giving
rife to intermiflion of the pulfe, or is excited to violent
palpitations. Thefe fymptoms are generally alleviated
by the difcharge of wind by eruftation : this alleviation,
however, is only temporary; for the flatus again accumu¬
lates, and re-produces the fame effefts. The generation
of air in the ftomach, in lefs degrees, is an ordinary con¬
comitant of indigeftion ; but it generally pafles off readily.
Some people, indeed, acquire a habit of voluntary
eruftation, which, Dr. Darwin fays, augments the malady.
He obferves,“ that, when people voluntarily ejeft the fixed
air from their ftomachs, the fermentation of the aliment
goes on the fafter; for flopping the veflels which contain
new wines retards their fermentation, and opening them
again accelerates it ; hence, where the digeftion is impaired,
and the ftomach fomewhat diftended with air, it is better
to reftrain than to encourage eruftations, except the
quantity makes it neceflary.” (Zoonomia, Clafs i. 3. 1.)
It has been fuggefted, but, we think, incorreftly, that, in
the repeated voluntary attempts to difpel wind from the
ftomach, which are often continued for fome length of
time, the atmofpheric air is often aftually fwalloued, and
the difagreeable fenfation of diftention thus augmented.

For the relief of flatulence, (the radical cure, as we
have already obferved, can only be effefted by curing the

dyfpepfia,) a number of medicines have been devifed,
from a very early period of time, efpecially fuch as are
comprehended under the appellation of carminatives.
Thefe are generally fubftances pofl'efling ftrong fenfible
qualities, which render them inftantaneoufly ftimulant to
the nervous fyftem ; and, by fuddenly exciting the muf¬
cular coat of the ftomach to aftion, enable it to overcome
the diftenfion, and difpel the diftending gas. The aro¬
matic vegetables, containing much eflential oil, fuch
as juniper-berries, the feeds of anife, carraway, and cori¬
ander, fhe roots of ginger and zedoary, and the waters
diftilled from thefe, are among the mod efteemed car¬
minatives. To thefe may be added other ftimulant and
antifpafmodic medicines; fuch as aflafcetida, and other
ftrong-fmelling gums ; volatile alkali ; opium, ether, &c.
Warm fomentation externally to the region of the ftomach
has been recommended by Dr. Darwin, and other ex¬
ternal remedies were employed by Dr. Whytt; efpecially
friftions on the region of the ftomach, with liniments
compofed of the warm oils ; fuch as the exprefled oil of
mace, oil of mint, See. and alfo the application of large
plafters to the belly, made with the ftimulating gums and
gum-refins.

y. L. crepitus, is a term ufed to exprefs the expulfion of
wund ab ano. We confefs ourfelves totally at a lofs to con¬
ceive why this expreffion was introduced into a fyftem of
nofology.

6. Limofis emefis, rejection of the contents of the
ftomach, or tendency to rejeft. This afteftion feems the
fimpleft form of gaftric difturbance. It is generally the
immediate confequence of diminilhed nervous influence.
Thus, blows on the head, injury of the nerves, or fym-
pathy with difenfed vifeera, readily excite it. It has
three varieties, which are only different degrees of the
fame aftion ; and that aftion is, as we have faid before,
only a fymptom of other difeafes. The firft variety,

a. L. nauftea, or loathing, is the mere fenfation of
ficknefs without vomiting. The caufes of naufea are
numerous. We (hall mention the moft frequent one,
viz. dilordered digeftion, under that head.

The brain is feldom materially aftefted by any feriotis
irritation or derangement, without deranging the ftomach
by fympathy : thus, ficknefs at the ftomach is a common
fymptom of every degree of local injury of the head, in
which preflure or concuflion of the brain is occafioned; it
accompanies inflammation of the brain and its mem¬
branes, the preflure of water in the ventricles, or ofother
morbid effufion or growth within the cranium ; as well as
the oppofite ftate or inanition of the veflels of the brain, as
in fyncope, or after great Ioffes of blood. The other or¬
gans, with which the ftomach is often fympathetically de¬
ranged, and fickened, are chiefly the kidneys and the uterus.
Thus naufea is a common concomitant of inflammation
in the kidneys, or of the irritation of gravel or of a ftone
lodged in thefe organs, and becomes one of the diagnoftic
marks by which difeafe in the kidneys is diftinguifhed
from other painful affeftions of the loins. Sympathetic
naufea is alfo a frequent concomitant of uterine irritation
or diforder ; thus it is one of the moft frequent fymptoms
of the beginning diftention of the uterus in pregnancy,
and accompanies inflammation and other painful con¬
ditions of that organ. The influence of the mind alone
is likewife capable of exciting naufea, and even its ul¬
timate degree, vomiting. The fight, or even the de-
feription or imagination, of loathfome and offenfive
objefts and aftions, will produce this effeft on the ftomach
of many individuals of refined habits, or who are unac-
cuftomed to fuch objefts.

It is not eafy to account for that variety of ficknefs,
which is produced by certain kinds of motion of the body,
fuch as fwinging, whirling, and the undulating motion
of a fhip at fea. It feems, however, to be referrible prin¬
cipally to the fympatlietic connexion between the ftomach
and brain ; i. e. to the vertigo ordizzinefs produced in the
latter, through the medium of the organs of vifion, by thefe
4. unufuai

PATHOLOGY.

unufual motions. Sicknefs and vertigo are mutually pro-
duftiveof each other, like fomeotheraffeftions of the head
and ftomach. When the ftomach is rendered Tick by wine or
naufeous drugs, a giddinefs is perceived, even with clofed
eyes, and vice verfti. Dr. Darwin mentions a ftriking fait
illuftrative of the effeft of this dizzinefs, produced through
the organs of light, in bringing on and preventing fea-
ficknefs. “ In an open boat palling from Leith to King-
horn in Scotland, a fudden change of wind fliook the
undiftended fail, and ftopt our boat ; from this unufual
movement the pafl'engers all vomited except myfelf. I
obferved, that the undulation of thelhip, and the inftabi-
lity of all vifible objects, inclined me firongly to be fick ;
and this continued or increafed when I clofed my eyes,
but, as often as I bent my attention with energy on the
management and mechanifm of the ropes and fails, the
licknefs ceafed; and recurred again as often as I relaxed
this attention.” (Zoonomia, feft. xx.) Similar naufea,
though lefs in degree, is commonly an attendant on the
vertigo produced by looking from a high tower, or at¬
tempting to crofs a narrow path, unfupported, over a
deep chafm.

As this is fo evidently a mere fymptom of difeafe, the
treatment of it embraces a large field of difcufiion, vary¬
ing according to its aetiology. As a palliative, effervef-
cing draughts, or, when acid only is prefent, alkalies are
ferviceable. It is to be obferved, that the prafticeof refort-
ing to emetics on all occafions of naufea, is injudicious ;
and probably aggravates the evil tenfold, by augmenting
the irritability and feeblenefs of the ftomach, and thus
laying the foundation for permanent imbecility in that
important organ.

£. L. vomituria, retching, or an ineffeftual effort to
vomit. In this fymptom the patient, by a voluntary aft,
endeavours to rejeft the load which opprefles him ; but,
the fympathetic aftion between the ftomach and the invo¬
luntary mufcles concerned in this aft not being fufficiently
in force, its performance is reftrained.

y. Vomitus, vomiting, or rejeftion from the ftomach.
The aft of vomiting is produced by the fame caufes
as naufea, though they exift in greater degree. The fame
palliatives are in ufe.

Among other affeftions analogous to this, muft be no¬
ticed rumination. Itis known to bea natural and voluntary
aft in animals which have a plurality of ftomachs, as the
ox, fheep, deer, goat, and camel ; (fee vol. xiv. p. 236.)
but unnatural and very rare in the human fubjeft. Yet
it is by no means a difeafe, but rather a peculiar con-
ftitution of the cefophagus ; and thofe who have this
faculty “ have declared,” fays Blumenbach, “ that they
had a real enjoyment in it; and that with them, as with
the clafs pecora, it was a voluntary aft.”

In exhibiting the hiftory of our knowledge upon this
fubjeft, it is a matter of difficulty to determine whether
it was known to the ancients, and, if known, in what
light they viewed the affeftion ; for it is evident, that
we cannot, with juftice, call it a difeafe, feeing that its pof-
felfors do not confider it fuch, from its being, on the con¬
trary, rather attended with confiderable enjoyment. If we
confider the habits and boundlefs luxury of the civilized
among the ancients, the manner in which the ftomach
was unloaded of a previous meal, in order to re-enter
upon a fecond gratification of the palate, among the
Grecian and Roman gourmands, in their refpeftive eras
of luxury, it may be eafily inferred that fuch an affeftion
as that we are now employed to defcribe, would have
been confidered a moil delightful fource of animal grati¬
fication ; and^certainly would not have been the lefs
indulged, nor would the enjoyment have been diminifhed,
had a fimilar opinion been entertained by their phyficians
as was propagated by honeft Fabricius ab Aquapendente,
that the pofleflor was endowed with a double ftomach,
and that the other beftial concomitants might, in procefs
of time, be expefted, either in themfeves or their more
beftial defcendants.

12-5

Galen, who had ample opportunities of obfervation
among the many inftances of indigertion he muft have
met with in the luxurious court of the Antonines, does
not give the hiftory of a fingle cafe ; and, amid the various
ftomach-aches and affeftions of Marcus Aurelius, which, it
would appear, both puzzled the brain and excited the anx¬
iety of this prince of phyficians, fo as to make him afraid
that a glafs of fpiced wine might be too hazardous a re¬
medy for the good emperor, the faculty of regurgitating his
meals for a fecond maftication, appears not to have en¬
tered into the number.

Fabricius ab Aquapendente furnilhes two of the earlieft
inftances of human rumination. The firft is of a noble¬
man, in whom it generally took place an hour after his
meals; which, whether folid or fluid, were always returned,
in order to undergo a fecond maftication. Fabricius
thought it proper to mention that the father of this indi¬
vidual had a horn growing from his forehead ; and, with
great good faith, adds, “ ex quo forte datur nobis intel-
ligi, parentis femen aliquam habuiffe cum cornugeris ani-
malibus, neque mirum fuifle genitutn filium fimile, quid a
parente contraxiffe :” that, although the fon did not inhe¬
rit his father’s horns, yet he poflefled the accompanying
faculty of rumination.

The fecond inftance with which Fabricius has fa¬
voured us, was in a monk, who, although poflefled of a
moft ravenous appetite, died of marafmus. This monk
was poflefled of ft ill higher beftial attributes ; for Fabricius
defcribes him as having his forehead loaded with two horns;
and Johannes Burgovverrus, who vifited this monk in the
company of Joh. Prevotiusand Thos. Minadous, wrote a
DiflTertation on this interefting individual, and afforded
Fabricius with the particulars which are inferted in hi.s
works. Burgower alfo adds, that the brother of this
monk was alfo adorned with two budding horns,
“ Duorum cornum veftigia geftafle,” as a Jlriking feature
of family-likenefs ; or, as this author will have it, “ Quod
enim fratris erat, id monacho ruminanti fimul gratis im-
petiunt.” But this illuftrious individual did not rumi¬
nate, unhappily for the argument of Thos. Bartholinus,
who, from thele two individual inftances, haftens to the
conclufion, (in his TreatiJ'e ds Unicornu, cap. 2.) from the
obvious analogy of the cornugera pecudes, that all hu¬
man ruminants are poflefled of horns; and alfo avers,
that a double ftomach will always be found on diffeftion.

Sennertus furniihes another hiftory of a man of forty ,
who poflefled this faculty from a child. He finds no
difficulty in accounting for its occurrence, when he
learnt that, when a child, this individual had loft his mo¬
therland had been fed during his non-age with the milk
warm from the cow. He accordingly foberly concludes,
that he fucked it in with his nurfe’s milk !

Philip Salnuith furnifhes us with another inftance of
human rumination. It always took place in this indivi¬
dual about a quarter of an hour after having left table.
He always ate ravenoufly, and fwallowed his food almoft
without any previous maftication.

John Faber Lynceus (in Expofitione Hiftor. Nardi An-
thonii Recchi, p. 630.) gives an inftance of moft obftinate
rumination in a highly-rel'pefta'ole German, who, even
when feated over his cups with his friends, was always
obliged to retire about half an hour after the meal
into a remote corner of the apartment, and then ruminate
the ingefta, undifturbedly and as quickly as poffible;
which having done, he enjoyed uninterruptedly the fociety
of his friends. Having been afked how he became
obliged to indulge this propenfity, he anfwered that
from a boy he had been fubjeft to acid eruftations ; that,
after having reached his thirtieth year, he found it impof-
fible to refill admitting into his mouth the food that
conftantly regurgitated from his ftomach. And, being
farther interrogated whether the fecond maftication of his
food could polfibly afford him any gratification, “ Indeed,”
he replied, “ it is fweeter than honey, and accompanied
by a more delightful relilh.”

This

PATHOLOGY.

126

This affeftion might be faid to be in the family of
this lioneft German; for he was blefl'ed with two grown
fons : the older, of twenty-four years, alfo poffefled this
delightful faculty, but had it more under control than
the father, as he could prevent it altogether when in
company. The younger could not.

G. H. Velchius adduces another example, in an inhabi¬
tant of London ; who, in the fortieth year of his age,
and of found health, always returned his food, in order
to undergo a (lower and more deliberate maftication.
Rumination moftly took place in this individual from an
hour to two hours after a meal ; but even at the remoter
period it ftill preferved a pleafant tafte, and was without
any degree of acidity.

In an inftance adduced by Daniel Ludovicus (in the
Ephemerides Nat. Cur. anno ix. and x.) that occurred in
a young woman, this aft was not performed with the ufual
pleafure, and the returned food pofleifed a more difa-
greeable tafte than that which accompanies the more
perfeft cafes of this affeftion. Bitters and ftomachic pur¬
gatives did not prevent its occurrence, which however
was not always regular in its appearance ; and, although
carthartics and emetics prevented it for a (hort period, it
foon returned.

John Conrad Pyer (Merycologia, cap. vi. ) mentions a
cafe in a fatuitous young man ; alfo its occurrence in a
ruftic in Swifferland ; and in a woman in the neighbour¬
ing town. He fagely endeavours to prove, from the cir-
cumltance of thofe individuals being rullics and cowherds,
that the frequent fight of the ruminating procefs had
imprefied their brains with a fimilar propenfity, which,
although imperceptible in its progrels, had neverthelefs
ripened into maturity.

Slare (in an early volume of the Phil. Tranf.) mentions
the cafe of a Briftol man, who appears to have pofleifed
this faculty in its perfeftion. This individual not only
ruminated the folid ingefta, but alfo fluids, as milk and
foups. There was, however, one imperfeftion con-
nefted with this cafe, as it relates to the (late of this man’s
Itomach during his meals ; that the viftuais feemed
fcarcely to defcend into tiie Itomach, but to lie in the
low'er part of the throat. However, the portion of the
meals firft taken was firlt ruminated.

In a cafe related in the 286th Number of the Journal
general de Medicine by Mr. Tarbes, as quoted by the
Editor of the London Medical and Phylical Journal, the
prominent phenomena were nearly the fame 3s the one
juft related. Rumination was firft manifefted by the
patient after his recovery from confluent fmall-pox, in
the fixth year of his age ; and it was conllantly performed
after every meal, until the period of its total ceflation.

About half an hour after having eaten, he fuffered a
flight uneafinefs in the epigaftric region ; this fenfation
was followed by the tranfmiffion of a ball of food from
the ftomach to the mouth. The aliments thus brought
up had neither a difagreeable odour nor an acid tafte, and
did not appear to have undergone any alteration in the
ftomach. The patient chewed them with as much plea¬
fure as he did on firft taking them. After this portion
was again fwallowed, another mafs, which did not appear
to have been mingled with that chewed the fecond time,
was brought into the mouth ; and fo, in fucceflion, all the
food he had taken at his laft meal was returned. On fit¬
ting down to eat his food, the patient, inftead of mafti-
cating well what he took, only divided it in a very im-
perfeft manner, as might be feen by the fpecimens re¬
turned into the mouth during rumination. If he, by
chance, happened to (leep foon after a meal, he, after
about two hours, awoke to vomit up all the food which
had not been ruminated. He went on in this way until
the time of his marriage, when his rumination ceafed,
almoft fuddenly. It was leflened on the day enfuing
from it, and was entirely difcontinued at the end of eight
days. A great thirft, which he had fuffered whilft he ru-
/ninated, difappeared at the fame time. He fuffered no

inconveniences in confequence of the change ; and, during
the fix years which have fince elapfed, he has become more
robuft and healthy than before.

Dr. Copeland has related a curious cafe of this kind in
the London Med. and Phyf. Journal, No. 267, for May
laft (1821.) The fubjeft of it was a gentleman in the
meridian of his age, of a ftrong but fpare habit, and of
the fanguineo-melancholic temperament. Owing to
caufes to which he was fubjefted through the very early
period of life, he had been obliged to take his meals in a
very hafty manner. The very few minutes allowed to his
ordinary meals led to a hafty and imperfeft maftication of
the food ; and, although his time was at his own dif-
pofal as he reached manhood, ftill the habit had been re¬
tained through the reft of the already pafled portion of
his life.

The greater part of its early period was fpent in an
aftive, varied, and pleafant, employment, generally in the
open air, and in the vicinity of the fea; and this alter¬
nation of aftive exercife, in fo healthy a fituation, pre¬
ferved the due equilibrium of the organic aftions ; the
former neutralizing the effefts produced upon the digef-
tive funftions by the co-operation of an hafty and imper¬
feft maftication of the ingefta, and by fedulous ftudy.

So long as this diverfified mode of living was enjoyed,
the regular operation of the digeftive tube was conti¬
nued, and no fymptoms of dyfpcpfia appeared, until he
took up his conftant refidence in the metropolis. For a
confiderable time, the chief and almoft only complaint
was fputatoria, or water-qualm : for two or three hours
after every confiderable meal, part of the more liquid
contents was ejefted from the ftomach, in large mouth¬
fuls, at intervals of from two to five or ten minutes, at¬
tended with a flight acidity ; fometimes with a flight fla¬
tulence and fenfe of fullnefs at the ftomach, but never
with any cardialgia, nor with the flighted fenfation of
naufea. This affeftion was generally augmented by any
of the ufual articles of defert, or by port- wine ; while it
was relieved, or entirely prevented, by a moderate quan¬
tity of white wine, and by avoiding every fpecies of ex¬
ertion that could tend to difturb the funftion of digef-
tion. This affeftion, after continuing feveral years, with
occafional interruptions, according to the care and
means taken to prevent it, pafled at laft into complete
rumination, which has been prefent after every confide¬
rable meal for fome time. But, as it was attended with
lefs inconvenience than the preceding fputatoria, and
being unaccompanied with any difagreeable fenfation,
no great importance was attached to it, until it became
complicated with a cutaneous eruption. For that I was
confulted; and, upon making inquiry into the ftate of
the digeftive organs, was readily informed of the rumi¬
nating affeftion. The profefiional intercourfe that now
took place furniflied me with the particulars already re¬
lated, which may ferve as an introduftion to a know¬
ledge of the nature of this difeafe.

The following is a ftatement of the particulars of this
cafe, when fubmitted to my care. The ruminating af¬
feftion was at that time generally prefent after all his
meals, and conftantly after breakfaft and dinner. The
appetite was always good, and the food, conftantly taken
in large mouthfuls, was mafticated haftily and imperfeftly,
and fwallowed eagerly. There was no thirft ; the bowels
were habitually coftive. Sleep was found. His meals
were taken more with a defire to fatisfy an unpleafant
fenfation or a requifite defire, than to indulge the plea-
fures of the palate, and was performed haftily, in order
that the ftudies and purfuits, to which he confidered
eating an interruption, might be immediately refumed.

Under the ufual circumftances, rumination commenced
from a quarter of an hour to an hour and a half after a
meal. Immediately upon the commencement of this aft,
a flight fenfation of fullnefs might be felt at the cardia,
when the attention was particularly direfted to it, that
led to a deeper infpiration than ulual. So foon as the

127

P A T H O

n£t of infpiration was completed, and while the mufcles
of the glottis remained fixed, a bolus of the unchanged
aliment rofe rapidly from the ftomach, with the firft effort
at refpiration, at the moment when the diaphragm had
juft relaxed, and the re-aCtion of the abdominal mufcles
commenced. But expiration did not take place until the
alimentary ball had pafled completely into the mouth, as
the glottis remained clofed until then : upon this having
taken place, expiration was immediately effected ; and
fo rapidly did expiration fucceed to the regurgitation of
the alimentary bolus, that the latter (unlefs when the
attention was clofely applied to the fubjeCt) appeared as
part of the expiratory aCt.

The ruminating procefs was never accompanied, at
any time, with the fmalleft degree of naufea, nor any pain
or difagreeable fenfation. The returned alimentary
bolus was attended with no unpleafant flavour, was in
no degree acidulous, and was equally agreeable, and was
mafticated with additional pleafure, and with much
greater deliberation than when firft taken. The whole
of the aliments received at any one meal was not re¬
turned in order to undergo this procefs, only the part
that had undergone an infufticient maftication ; but which
indeed conftituted the greater portion of folid aliment.
That taken at the commencement of a meal was the firft
difgorged ; this was afcertained by eating from a variety
of lolid difhes, or from partaking of different portions of
the fame. The more fluid portions were not always re¬
turned, unlefs along with the more folid or imperfectly
mafticated parts. When, however, the ft’omach was
diftended by a large meal, the fluid contents were fre¬
quently returned, and fubjeCted to this procefs.

This affeCtion may be confidered as having been paflive-
ly under the control of the will j and, although it fome-
times took place when nearly unconfcious of the pro¬
cefs, yet it never occurred when the mind was incapable
of being aCted on by external impreflions received by the
fenfes. Thus, if at any time, from previous fatigue, and
the concentration of the organic nervous energy towards
the digeftive organs, fleep was induced immediately after
a full meal, this affeCtion did not take place; but flatu¬
lence, acrid eruftations, &c. afterwards fupervened, and
continued for fome time, in confequence of the gaftric
j uices being inefficient to the production of the requifite
changes on the ingefta retained in a ftate of imperfeCt
divifion. Very frequently, when the ruminating procefs
was thus prevented, or voluntarily fuppreffed when cir-
cumftances required it, the ingefta, both fluid and folid,
were returned at the end of feveral hours ; but w:ere then
generally acid, frequently acrid and bitter, and fometimes
in fo large a quantity as to fill the mouth beyond its ca¬
pacity of retention. But even then no cardialgia nor
gaftrodynia was experienced, nor the fmalleft degree of
naufea ; and even thefe difgorged matters were attempted
to be mafticated, although generally thrown out on ac¬
count of the difagreeable tafte.

“ In fpeculating upon the nature of this cafe,” fays Dr.
C. “ it appears evident that the energy of the digeftive
and affimilating organs was greatly diminifhed: confe-
quently the ftomach, deriving its influence, whether that
prefiding over the mufcular aCtion or vafcular fecretion,
from the fame fource, namely, the organic fyftem of
nerves, experienced a proportionate diminution in its fe-
creted juices. This was rendered apparent by the changes
which took place in the aliments, when taken even in
very moderate quantity, and when retained without
being fubmitted to re-maftication. Connected with de¬
bility of this organ, an increafe of its animal fenfibility,
which it derives from the diftribution of the eighth pair
of nerves, appears to have been prefent. Under thefe
circumftances, the gaftric juices (being, as inferred, in
dim in idled quantity) could be fufficient only for a fmall
portion of aliment, which neverthelefs had been taken
in an abundant quantity; and, having combined with
that part whofe ftate is moft favourable to fuch an ad-
VOL.XIX. No. 1292.

LOGY.

mixture, and being, by the ufual aCtion of this organ,
conveyed to the pylorus, the imperfeClly-mafticated
portions, and that part which remains impenetrated by
the gaftric juices, tnuft either continue at the cardiac ex¬
tremity, or be propelled there by the aClion of the fto¬
mach. That the undigefted portions of the food do not
only remain in that fituation, but may, by a peculiar and
complicated aCtion of this organ, be conveyed there,
may be proved not only by reafoning upon the nature of
its organic aClion, but has even been demonftrated by
large fiftulae of this organ, fituated at its anterior con¬
vexity, and opening externally at the epigaftric region.

In a cafe in the Hopital de la Charite, under the care of
Corvilart, the complicated aClion of this organ was wit-
nefled, conveying the digefted portions of the ingefta
towards the pylorus, which pafled only in very fmall
quantity, while the bulk of the unchanged aliment was
propelled, by a contrary aCtion, to the oppofite extremity
of the organ. It cannot be fuppofed improbable that the
irritation produced in this part of the ftomach by the un¬
changed aliments in ruminating individuals, fliould ex¬
cite the animal fenfibility of this organ ; and, if the hrain
be in a ftate capable of receiving the fenfation, it is pro¬
pagated to the organs of refpiration, and their aCtion
induced through the medium of the fame let of nerves,
namely, the par vagum, that forms not only the refpira-
tory clafs, but alfo the connecting chain between the or¬
ganic and animal orders of the grand nervous fyftem ;
and, while it bellows an exquifite fenfibility on the pul¬
monary fyftem, it likewife gives a requifite, but fparing,
(hare of its influence to this important organ.

“In effecting the procefs of rumination, the organic
contractility of the ftomach can do no more than, by an
elective procefs (foon to be explained) , place the aliments
about to be returned in a fituation, in refpeCt to thecar-
dia, favourable to the excitation of the animal fenfibility
of this organ, and to its ready regurgitation and propul-
fion along the cefophagus. So loon as the demand is
made upon the fenfibility by the fituation of the alimen¬
tary bolus, the par vagal clafs of nerves is excited to
aCtion, and a full infpiration is effected, as has been de-
fcribed. The introduction of the bolus into the cardiac
extremity of the cefophagus, may be confidered as ef¬
fected by the ordinary contractility of the ftomach ; per¬
haps fympathetically heightened at the moment by the
re-aCtion of the abdominal mufcles ; while, at the fame
time, the diaphragm has juft undergone relaxation, in
which the cardia may, from intimate nervous commu¬
nication, fuffer a fimilar participation, and thus give fa¬
cility to the afcent of the alimentary ball in the cefopha¬
gus, which immediately contracts behind it from the ir¬
ritation produced by its pafl'age, and the bolus is thus
conveyed to the mouth.

“The influence of the will appears to be requifite,
fince the procefs is interrupted during fleep. But this
influence is only puffively engaged in the production of
the ruminating aCt, by bringing about the co-operation
of the refpiratory organs. The elective procefs exer-
cifed by the ftomach in this affeCtion, is fimilar to that
which it employs in periods of health, and may be con¬
fidered as relative to the degree of digeftive energy, and
to the comparative dates in which the various ingefta
may enter the ftomach.

“In the debilitated ftate of the ftomach, and confequent
deficiency of the fecretions, digeftion can be perfectly
performed only when the aliments are prefented in fmall
quantity, and in a favourable ftate, from complete com¬
minution and from intermixture with the falivary juices.
If, however, in this ftate of the organ, the food is con¬
veyed rapidly into it, poflefled of neither of thefe requi-
fites, fo as to produce fudden diftention, a re-aCtion of
this vifcUs upon its contents takes place; and, as the im-
perfeCtly-mafticated food conftitutes the greater portion
of the ingefta, there is abundance prefent to be returned
into the cardia, while there is a deficiency of aliment in
LI a fit i

128

P ATHOLOGY.

a fit ftate to combine with, or to be operated upon, by
the gallric juices ; which, when effe&ed, is rapidly con¬
veyed to the other extremity of this organ, by the re-
aftion of the mufcular coat, from the undue diftention
and the ftimulus of folid contents. Thus a double eft'efil
is produced by the healthy organic contractility of this
organ, when in a weakened ftate, and yielding a dimi-
n 5 filed quantity of the ufual fluids ; which ftate indeed
may be confidered as conftituting this peculiar affection,
namely, that part of the aliment which is diflolved by the
gaftric juices is conveyed towards the pylorus, while, at
the fame time, the tonic adtion tending to diminifh the
capacity of the organ pufh'es the lefs comminuted and
indigeftible portions of food into the unrefifting cardia ;
which is returned, as I have attempted to describe, in
order to undergo a fecond comminution and intermixture
with the falivary juices ; after which it is in a fit ftate to
be conveyed to its deftination along the mucous furfaces,
with the juices of which it combines, and thus permits a
central portion of the rnafs to return and undergo a fimi-
larprocefs.

“In the curative plan purfued during the time this
gentleman was under my care, the cutaneous eruption
was viewed as originating in the long and progrefiive de¬
rangements of thedigeftive canal; and the ruminating
affedlion, from the highly intelligent hiftory of its origin
afforded me by the patient, as well as of the fenfations
and connexions of the phenomena fo kindly accorded me
during my attendance, was confidered as the moft ad¬
vanced and peculiarly modified ftate of dyfpepfia, or gaf¬
tric debility.

“ Under the ufe of infufions made from a combination
of vegetable tonics, aperients, and aromatics, with the
addition of an alkaline carbonate ora carminative tinc¬
ture, and the frequent ufe of the warm bath, with fub-
fequent friflion ; while, at the fame time, a deliberate
maftication of the aliments, and a moderate indulgence
in light and digeftible food, was enjoined ; amendment
foon became apparent. After a fortnight’s continuance
of this plan of treatment, the cutaneous difeafe had made
conliderable progrefs towards removal, and the ruminat¬
ing affedlion, which till then had been prefent after every
conliderable meal, was now very feluom experienced ;
nor did any fymptoms of dyfpepfia take its place, unlefs
when the injunctions regarding the mode of living and
maftication of the food were not attended to, or when
fubjedted to caufes operating a diminution of the digef-
tive energy; then, dyfpeptic fymptoms, or even flight
rumination, occafionally prefented themfelves.

“ Within a few weeks, the eruption was entirely re¬
moved ; but the ruminating affedlion returned whenever
the proper precautions were not obferved. Having im-
prefled the mind of my patient with the neceflity of purT
filing corredtly the plan I had prefcribed to him, upon
the grounds that fuch an affedlion, if indulged, would
gradually undermine the energy of his fyftem, he became
more attentive to the ftate of his digeftive organs, and to
his mode of living; and now, (March 1821.) for feveral
months, he has enjoyed perfedl health, and had no re¬
turn of the ruminating adt. Having transferred, as he
fays, the gratification formerly enjoyed in the fecond
maftication to the firft, this procefs is now performed more
deliberately ; a more complete admixture of the aliments
with the falivary fluids and with the air, takes place ;
while the ftomach is lefs fuddenly, and much more mo¬
derately, diftended.”

Diflections have not been able to throw any light upon
this affedlion ; nor can it be expedted, in the prefent ftate
of our medical knowledge, that, even in the event of
a violent death taking place in a ruminating fubjedl,
any vifible alteration in ftrudlure could be detedled. Fa-
bricus ab Aquapendente and Thos. Bartholinus were
confident of finding two ftomachs, at leaft, in ruminating
individuals, from the analogy of the cornuted tribes.
Pyer and Morgagni ridiculed the idea, and fupported a

contrary opinion, upon the ground that there were ani¬
mals that ruminated without a double ftomach. The
only inftance Dr. Copland had met with in which in-
fpedtion after death took place, was in the inftance of
this affedlion occurring in a monk. This defection is
recorded both by Jo. Rhodius (Cent. ii. obf. 59.) and alfo
by Bonetus, (Sepulchretum, 1. iii.) It was made by
FancifcusPlazzonus, and is thus related by Jo. Rhodius :
“Monachus cum voluptate cibus ruminavir. Medici
brutorum more gemino ventriculo praeditum putabant.
Ipfo defundto, F. Plazzunos cefophagum reperit undi-
quaque carnofum inftar mufculi, reliquis univerfi cor¬
poris partibus fe redte habentibus.” The phyficians of
the feventeenth century were not much enlightened by
the opening of this monk, but their dreams refpedting
the exiftence of two ftomachs were henceforth diflipated.

Enthufiaftsin their arduous profeflion (which all young
medical men ought to be) are greatly indebted to fuch
learned phyficians as Dr. Copland, Dr. Cooke, &c. for
their indefatigable refearches into the early hiftories and
records of the more ambiguous difeafes ; and the utility
of fuch condenfed communications is greatly enhanced
by the practical remarks accompanying them. Mr, G.
Nefle Hill has added a cafe, and diffettion, of fimilar dif¬
eafe in a feverely-afflidted infane patient, who fell under
his care in the year 1791 : he appeared to fall a victim to
epileptic infanity, the refult of early indifcretion. That
part of the hiftory of this young man which related to his
rumination of his food, bore an exact refemblance to the
onefo ably detailed by Dr. Copland. “ I examined the
body, (fays Mr. Hill,) in the prefence of the venerable
Haygarth, who, as well as myfelf, was much ftruck with
the extreme tenuity and fmooth internal furface of the
ftomach. In order the more corretly to obferve the ru¬
minating procefs, I invited my patient to dinner feveral
times ; he ate with a ravenous appetite and wonderful
quicknefs, but never finithed a meal withoutcommencing
the ruminating procefs.” A further hiftory of this cafe
will be found in the Appendix to Hill’s Effay on the
Prevention and Cure of Infanity.

7. Limofis dyfpepfia, or indigeftion. The funtion of
digeftion in the ftomach being performed by means of
fecreting agents, which are veflels and nerves, and by
mufcular fibres which propel the food downwards, ail
caufes of indigeftion mud operate, 1. by difturbing the
tranfmiftion of nervous influence ; 2. by difturbing the
ation of fecreting veflels; or, 3. by paralyfing the play
of the mufcular fibres. Now it would require little la¬
bour to fhow, that nothing can influence the one mate¬
rially without influencing the others, both on account
of their reciprocal ation, and on account of the agency
which foreign fubftances will produce on the other ftruc-
tural elements in confequence of the deficient ation of
one. Thus, if nervous influence be difturbed, fecretion
will be wanting ; confequently the food will undergo
chemical decompofition, will fwell and evolve gales;
thus it will diftend the circular fibres of the ftomach be¬
yond their ufual fphere of relaxation, and by that means
prevent the further digeftion of food. In the fame way
the mufcular coat will be liable to diftention in the cafe
of diminilhed fecretion, when that diminution arifes
from torpor of thefecernent veflels ; and, if the circular
fibres are diftended by mere quantity, that diftention will
hurt the nervous power; for it is known that when muf-
cles are ftretched beyond a certain natural compafs, their
nerves communicate to the fenforium pain or irritation.
In this way, therefore, reafoning from our knowledge of
the quick communication of nervous power to and from
the brain, we infer, that increafed tranfmiflion of ner¬
vous influence to the affeted organ will arife. Here
fecretion will be increafed, though in early inftances
probably unaltered. By this increafed fecretion, the
food will be prevented from enlarging by chemical
changes, and cannot therefore further diftend the cir¬
cular fibres ; while thofe forces will, in confequence of

129

PATHO

the folution of the fubftance, more eafily expel it : fo
that, in early accidents of this fort, the increafe of one
power feems to relieve in fome meafure the deficiency of
the other. This, however, can obtain but fora fhort time ;
for the undue excitement of the fecreting veflels muft
foon induce altered ftates of the gaftric juices ; Hates in
which of courfe the latter will be deficient in fopie of the
diflolving qualities. It is impoflible to Hate exactly
which of, or in what proportion, tliefe powers firft under¬
go derangement. It is probable that, while in gluttons
diftention of mufcular fibres is the firft ftep to diforder, in
the drunkard the nervous expanfions may be firft injured,
while the fecreting veflels are difordered by caufes
which arife from the conftitution at large. Having ftiown,
however, that thefe powers are all eflentially deranged in
a manner almoft fimultaneoully, it is of little importance
to attempt to trace the fubjeCl further : for it does not
feem that, generally fpeaking, in the earlieft ftage of in-
digeftion, the vafcular fyftem is materially implicated.
We except of courfe the affeftion of the ftomach which
we have noticed in our introduction, chronic gaftritis. -
We have already endeavoured, on general principles,
to trace the morbid affeCtions arifing from diforders of
the alimentary canal : it remains to do fo in detail. We
have faid that this diforder injures the other parts by
nervous influence, or by the abforption and local appli¬
cation of difeafed blood. There feems every reafon to
believe, that in indigeftion, when the complaint is not
very violent or of long Handing, though nervous irri¬
tation may arife, the aflimilation of food into healthy
blood is not materially altered : fo that difeafe traceable
to indigeftion will in the firft ftages be the mere confe-
quence of nervous diforder. It is important, as a prac¬
tical diftinCtion, thus to know when derangement is
propagated to remote organs by nervous communication,
without involving the vafcular fyftem importantly, or
whether the vafcular fyftem has become deranged in con-
fequence of the local application of difeafed blood, or a
continuance of nervous irritation fo long kept up as to
alter the contractile power of the veflels. The tracing of
difeafes in this manner appears to us a matter of the ut-
moft importance ; for it is notorious that many affeCtions
arife from difturbance in the ftomach and bowels, which
mimic or refemble idiopathic difeafes of the firft magni¬
tude and danger.

Idiopathic difeafe may after a time be induced by the
long continuance of the caufe juft mentioned ; but it is
a practical faCt of the utmoft confequence, that, while in¬
flammation, (and that is the moft frequent form of difeafe
that occurs,) arifing idiopathically, is difficult of fubduc-
tion, and only to be removed by emptying the blood-vef-
fels ; the fame aCtion arifing from nervous excitement
thus propagated, foon fubfides when that excitement is
withdrawn; and this takes place, though more rarely,
even in cafes of long Handing ; in cafes where the aflimi-
lative function is deranged, and morbid ftates of the
fluids are exifting, the removal of thefe ftates being at¬
tended with the gradual fubduCtion of the propagated
difeafe;

Having detailed the caufes of indigeftion in full in
our introductory obfervations on this clafs, we (hall now
proceed to confider the fymptoms of indigeftion, dividing
it into two ftages. The firft, in which mere difturbance
of function, the digeftive, and that in flight degree, is
apparent, and in which the fympathetic difeafes are vary¬
ing and unmarked; the fecond, in which that difturbance
is manifeited in a marked and ferious form, in which the
vafcular ftruCture feems continually affeCted, and which
is generally connected with difeafed ftates of the collati-
tious vifcera. The dependant ailments attached to each
of thefe ftates will be difcufled under the fame heads.
This divifion is however merely chofen on account of its
practical utility, becaufe fome difference of treatment
both of the local and conftitutional difeafe is neceflary,
according as the digeftive difturbance is recent or of long

LOGY.

Handing ; but, in enumerating the fymptoms of this dif¬
order, it muft be confefled that no peculiar fign indi¬
cates with certainty or precifion the pafling of diforder,
or the firft ftage, into that of difeafe, or the fecond; and
that much careful and in fome meafure original obferva-
tion is required even after the fulleft defcription on the
part of the practitioner.

The fymptoms of the early ftage of indigeftion are
fuch as arife from chemical changes in the food, and the
fimpleftchangesin the gaftric fluid : thefe are the evolution
and eruCtation of various gafeous, oily, acid, or acrid, pro¬
ductions. They exift in various degrees ; butare only pre¬
fen t, however, during or after a meal ; and, when thedi-
geftion is not in aCtion, littleinconvenience is experienced.

It appears, however, that the trifling difturbance in the
function of the ftomach may, for a certain time, produce a
feeble or otherwife vitiated fecretion, without in any
other way very fenfibly affeCting the functions of the
fyftem. People frequently complain of a fenfe of diften¬
tion after eating, and flatulent and acid eruCtations, who,
notwithftanding, enjoy good general health ; and find
that even thefe fymptoms may be prevented by taking
lefs food, and that of a more digeftible quality; and, if
they are prudent in this refpeCt, and the conftitution is
otherwife found, and not expofed to the effeCts of indo¬
lence, and other caufes weakening the nervous fyftem,
the ftomach will often recover its powers without far¬
ther means. The irritating caufes are often, however,
daily and hourly applied, and leave the ftomach perma¬
nently difordered by their frequency. The gaftric juice
becomes probably fo altered or increafed, or fecreted at
improper times, as to produce unpleafant fulnefs in the
ftomach, even during its empty ftate. The bowels, whe¬
ther in confequence of the unnatural or undigefted ftate
of the materia applied to them, whether fympathetically
affeCted by continuity of ftruCture, or from want of a
natural ftimulant exifting in the fecretion of the ftomach,
become deficient or irregular in performing their office.
Their fecretions likewife fuffer deviations from the
healthy ftate, and are fcantily produced. The quantity,
colour, or confiftence, of the faeces, are changed ; they
are occafionally diftended and tenfe, efpecially lome time
after eating. Difordered fecretions are manifefted in the
mouth : a clammy tafte is experienced ; and the tongue
is more or lefs furred, efpecially in the morning. But
thefe fymptoms, the patient finds, yield to fome mild
aperient, which, at the fame time, promotes the aCtion of
the ftomach; and his feelings on the whole differ but little
from thofe of health. He is raore apt to be thirfty ; his
appetite is generally more or lefs impaired and variable ;
he complains of his feet being cold ; butftill his ftrength
and general appearance are but little affeCted ; and he
feldom thinks it neceflary to pay particular attention to
fymptoms which appear fo flight, and for the time yield
fo readily. By degrees, however, they recur more fre¬
quently, and begin to be attended with fome depreffion
of ftrength, which at firft is only occafional. This, in
general, is the firft thing which ferioufly calls his atten¬
tion to the difeafe. The mind, if the difeafe proceed,
partakes of thefe returns of languor, and the patient at
length finds it difficult at all times to command his at¬
tention, and, upon the whole, that he is not capable of
his ufual mental efforts. His fleep is difturbed by per¬
plexing dreams, and fometimes by fits of night- mare. In
a large proportion of cafes, however, he enjoys good
nights, and even thofe who are troubled with dreaming
and reftleffnefs, often feel more drowfy than ufual.
He now becomes alarmed, and occafionally feels a degree
of defpondency. Inftead of thinking too lightly of his
complaint, he often regards it in the moft ferious point
of view, and cannot be perfuaded that any thing lei's
than fome important derangement can produce the
anxiety and depreffion by which his attention gradually
becomes wholly engrofled.

The derangement of the alimentary canal now pro-

4 duces

130 PATHOLOGY

duces difordered funftion of the collatitious vifcera; and a
change takes place which marks an important Hep in the
progrefs of the malady. The alvine difcharge begins to
deviate from the healthy appearance: it fometimes con¬
tains uncombined bile, fometimes it chiefly confifts of
bile; its colour at other times is too light, more fre¬
quently too dark ; and occafionally, at length, almolfc
black. At different times it afl'umes various hues, fome-
times inclining to green, fometimes to blue; and fome¬
times it is mixed with, and now-and-then almoft wholly
confifts of, undigefted bits of food. When there is much
draining, it often contain^ mucus in diftinft maffes, and
not unfrequently fubftances refembling bits of membrane.
It frequently (eparates from the canal with more diffi¬
culty than ufual, and leaves a feeling of the bowels not
having been completely emptied. We have reafon to
believe that the above change and variety of colour arife
chiefly from the ftateof the bile, to which the alvine dif¬
charge owes its natural tinge, being quite white when no
bile flows into the bowels. It would appear that the
properties of the bile are fometimes changed without
change of colour; but this is comparatively l'o rare, that,
if the colour of the alvine difcharge be natural, we may
generally infer that the function of the liver is duly per¬
formed.

Many conceive that the changes of colour in the al¬
vine difcharge are often to be alcribed more to circum-
ftances in diet, and changes which the contents of the
bowels undergo in their paflage through this canal, than
to the ftate of toe bile ; and we have no doubt thefe
caufes operate to a greater or lefs extent. The long de¬
lay of their contents in the bowels generally darkens the
colour; a milk-diet produces a difcharge of a lighter co¬
lour than one conflfting chiefly of animal food, and fome
vegetables and medicines communicate a certain tinge
to the difcharge. With a little attention on the part of
the pradlirioner, this circumftance will feldom miflead
him. It mull always be kept in view, that the appear¬
ance of the difcharge often changes when it has remained
for fome time out of the body.

The difeafe has hitherto been what is called ftomach-
complaint. It is now, from the various appearances of
the vitiated bile, and the various fymptoms which arife
from the irritation it occafions in the alimentary canal,
what is called bilious and nervous complaint. The
former of the two laft appellations has alfo arifen from
the bile, of which there is fometimes a fuperabundant fe-
cretion, being occafionally, in confequence of the in¬
verted a£tion of the duodenum, thrown into the fto-
inach ; and there exciting naufea, headache, and bilious
vomiting.

The urine alfo deviates from the healthy ftate. In its
tnoft healthy ftate, it is perfeffly tranfparent when palled,
and remains fo after it is cool, its colour being more or
lefs deep in proportion to the degree in which its con-
tentsarediluted. But it is fometimes covered withavery
thin oily film, which appears to arife from an imperfeit
ftate of the affimilating procefs. Sometimes alfo it is lim¬
pid, and parted in unufually large quantities, more fre¬
quently fcanty and too highly coloured. It is then moll
apt, as we ftiould ft priori expert, to depofit fediment,
unlefs fome degree of fever prevail, when it often either
depofits nothing, or a little of the red fediment.

A remarkable fympathy between the ftate of the kid¬
neys and inteftines is often obferved in indigeftion ; the
urine remaining fcanty and high-coloured, when the
bowels are conftipated ; and flowing freely, and of a
paler colour, as loon as a free difcharge from them has
been obtained. Even in thofe dropfical affections which
fupervene on this difeafe, it is common for all diuretics
to fail, when the bowels are conftipated, and for the ope¬
ration of cathartics alone to be followed by a free dif¬
charge from the kidneys.

The copious flow of urine which fometimes attends
indigeftion, feems frequently to arife from a failure in the

aCtion of the Ikin, as appears from fome of the experi¬
ments juft referred to. The kidneys and Ikin feparate
the fame fluid from the blood, and a failure of fecretion
from the latter is often compenfated by an increafe of
that from the former, if they have not by fympathy par¬
taken too much of the ftate of the Ikin. Thus, in dyf-
peptics, an unufual application of cold to the furface,
when the powers of the lyftem are not able fo to re-aCt as
to fupport the due aCtion of the Ikin under it, frequently
occafions an increafed flow of urine. The fame caufe
often occafions a greater difcharge from the bowels. It
particularly demands attention in this difeafe, that, al¬
though the increafed difcharge from the bowels in the
inllance before us is of a watery nature, when the Ikin has,
from the ftate of that difeafe, become uniformly languid,
the increafe is often in the folid, as well as liquid, con¬
tents of the bowels. On the fame principle, the quantity
which paffes from the bowels of delicate children when
the Ikin has become dry and Ihrivelled, is often aftoniffi-
ing, and that even when little nourilhment is received;
as if not only what ought to have parted by the Ikin, but
a great deal of what had been inhaled by this organ, were
depofited in a folid form in the alimentary canal.

What is here faid is well illuftrated by the cafes which
we detailed of very great eaters, in whom the alvine dif¬
charge was no greater than in other people, but the fe¬
cretion by the (kin was found much more copious.

The fenfible change in the appearance of the alvine fe-
cretions in indigeftion, is generally attended with fome
change in the other fymptoms. The ftomach is more apt
to be oppreffed after eating, the patient often obferving
that he feels as if there were not room for what he had
taken. The bowels are more frequently variable, diar¬
rhoea often fupervening without any evident caufe, almoft
uniformly followed by fits of conftipation. Thefe, the
patient finds, cannot now be removed by the Ample me¬
dicines which at firft reftored due action to the bowels ;
larger dofes or more active medicines are necertary, and
their effeft correfponds with the previous ftate of the
bowels. The difcharge is generally unfatisfa&ory,
fomething feeming to be retained. It is very often wa¬
tery or iemi-fluid, mixed with mucus, and fometimes
ftreaked with blood ; and, after it has been repeated,
often chiefly confifts of mucus and a little blood, the paf-
fing of which is attended with much gripingand bearing-
down, and followed by a conftant defire of further eva¬
cuation. The patient takes more medicine with the hopes
of a freer eft'eft ; but he thus often increafes the {training
more than the difcharge.

After this ftate of irritation has continued to recur for
a great length of time, a degree of permanent fpafmodic
ftridfure fometimes appears, which gives a tape-like ap¬
pearance to the alvine difcharge. In the mean time the
patient is haraffed with a variety of other fymptoms, arif-
ing from the irritation occafioned by the morbid con¬
tents of the alimentary canal ; increafing languor, pains of
the ftomach, more frequently of the bowels, and parti¬
cularly of the lower part of the bowels, fometimes conti¬
nued, generally of the griping kind ; a fenfe of heat, or,
as the patient often calls it, burning, referred to the
ftomach, and now-and-then extending to the bowels,
(which fometimes proves the molt obftinate and diftreff-
ing fymptom of the difeafe;) or of weight in the right hy-
pochondrium or lower part of the abdomen, with unufual
diftenfion of the former, fometimes difappearing in a day
or two, particularly after freer evacuations, and return¬
ing again, at other times more ftationary ; a more foul
and clammy tongue, naufea, more rarely vomiting, a de-
preffion of llrength, which fometimes, particularly after
the unfatisfa&ory operation of cathartics, almoft amounts
to fyncope, and a defpondency that is hardly equalled in
any other difeafe.

As thefe fymptoms proceed, others, the confequence of
the fympathy which exifts between the ftomach and other
parts of the fyftem, gradually ftiow themfelves. Thefe

are

131

PATHOLOGY.

are different in different cafes ; pain of different parts,
and other complaints, of the head, affections of the fight,
the hearing, fmell, or tafte. The voice and articulation
are fometimes varioufly affeCled. The patient is diftreffed
with' fpafms of the trunk or limbs, numbnefs, and even
temporary lofs of power in the latter; and feelings of
endlefs variety are defcribed, as fometimes in one part of
the body, and fometimes in another.

By a conftant recurrence of fuch attacks without being
uniformly ill, for the rapidity with which the patient
rallies is often as great as that with which he is fubdued,
he is gradually rendered unfit for the aCtive duties of
life. This preys on his mind, increasing the defpondency
which makes a part of his difeafe, and which in its turn,
by further debilitating the digeftive organs, aggravates all
the fymptoms. Thefe organs being no longer in a proper
ftate to fupply due nourishment, the body becomes ema¬
ciated, and more permanently feeble, the ftrength by de¬
grees rallying lefs readily and lefs perfectly after the fre¬
quent returns; and what was at firft only a temporary
depreffion from a debilitating caufe affeCling the nerves
of the alimentary canal, is gradually changed into real
debility, the countenance, which is almoft always a fure
index of what is palling internally, becoming pale and
haggard.

The patient, often from an early period of indigeftion,
feels fome uneafinefs on lying on the left fide; more
rarely this is the cafe with refpeCt to the right fide. In the
progrefs of the difeafe, lying on either fide becomes un¬
comfortable, and, in its advanced ftages, the only eafy
pofition is on the back, with the (boulders a little raifed,
and generally inclined to the right fide.

The tongue and other parts of the mouth are varioufly
affeCted from the commencement. Their Secretions be¬
come more and more thick and clammy, the former being
covered with a white or brownifli mucus, which alio
more or lefs adheres to, and irritates, the fauces. Some¬
times all thefe parts are more or lefs parched and ftiff ; at
other times the faliva is morbidly thin and copious, the
tongue being cleaner, but often of a whitilh and fouden
appearance. In protra&ed cafes, when the fymptoms
have been rather obftinate than fevere, and confiderable
debility has come on, this fymptom is often very trouble-
fome, the faliva frequently running from the mouth. In
the advanced ftages of the more fevere cafes, there is often a
vifcid frothy fecretion from the fauces, while the mouth
in general is drier than ufual, which forms a very promi¬
nent feature of the difeafe. The patient isconftantly hawk¬
ing up this matter, particularly after eating, and will tell
you that all his food turns to phlegm. This difcharge
is fometimes fo great and haraffing as to prove the moft
diftrefling fymptom, and feems not a little to add to the
debility. In fome cafes the tongue, in the more ad¬
vanced ftages, becomes clean, ihining, and morbidly
frnooth, and at length affeCted with aphthae. This ftate
of it is feldom oblerved except when a confiderable de¬
gree of fever has fupervened, which is not uncommon at
thefe periods.

The Ikin, in protraCted cafes, often becomes dry, lhri-
velled, and fometimes, at length, almoft fcaly, and the
hair is parched and inclined to ftand on end; the whble
furface is cold, the patient is conftantly hanging over
the lire, and even experiences frequent fits of chillinefs
approaching to Ihivering. He bears all extremes of tem¬
perature ill, being as much oppreffed by a very high tem¬
perature as he is chilled by a low one. Wounds heal
lefs readily than ufual ; and the Ikin is not unfrequently
affeCted with a troublefome itching, which often fliifts
its leat ; or with nettle-ralh, herpes, and other fpecies of
eruptions ; and even ulceration fometimes fupervenes
without any evident caufe.

Befides the more tranfitory fymptoms in the head,
which have been mentioned, there are often marks of an
habitual undue determination of blood to the brain, pro-

yoi. XIX. No. 129s.

ducing languid inflammation of the eyelids, tinnitus au-
rium, and occafionally throbbing of the temples. Some
are oppreffed with drowfinefs, almoft approaching to ftu-
por ; others with almoft conftant pain more or lefs fevere,
fometimes in the back of the head, more frequently in
the fore part ; others are fubjeCt to giddinefs, and fome
even to fudden fits of infenfibility. The thoracic vifeera
are often particularly affeCted; not unfrequently dyfp-
ncea fupervenes, and the patient is fometimes haraffed by
a dry and irritating cough, or with fits of palpitation.
When expectoration attends the cough, it is generally
difficult, but brings confiderable temporary relief. It
deferves notice, that, in this ftage of the difeafe, he more
frequently complains of pain in the left than in the right
fide; but the feat of the pain is very various; not un-
ffequently it is -chiefly in the back, about the Ihoulders,
fometimes attended with itching, and in the limbs, more
frequently in the legs than the arms. Irregularity of
pulfe and fyncope are not unufual fymptoms; and are
much to be feared when combined with other charaCter-
iftics of angina pedoris, as they fometimes produce, in the
fecond ftage of indigeftion, organic difeafe of the heart.
Pain and tendernefs of the mufcles of the cheft is alfo
frequent; and, when this occurs, the patient feems worfe
at night, and turns in bed with difficulty and pain.

The above hiftory of the firft fymptoms of indigeftion
we have borrowed from the accurate work of Dr. Wilfon
Philip. It remains to trace the fympathetic derange¬
ments which grow out of this ftage.

It is to be premifed, that, when nerves are irritated,
and fympatheticaliy affeCt diftant parts, the latter, how¬
ever influenced, return to their natural ftate when the
nervous excitement is removed. Of cqurfe, as the altered
ftate of the nervous influence will accelerate or impede
the contraftile powers of veffels, the phenomena of in¬
flammation may occur, and the fame excitement conti¬
nued may produce the confequence of inflammation. It
follows therefore, that, if the nervous expanfion of the
ftomach be irritated, and caufe diftant diforders, we may
cure thofe by removing that irritation : but if, from its
long continuance, or from the nature of the affeCled
ftruChire, irritation degenerates into inflammation, we
have further indications to fulfil. Of this fact experience
convinces us every day. We have to correct the morbid
ftate of the fecondarily- affeCled part, as well to remove
the firft caufe.

The firft derangements are what we have to confider
at prefent. The fubjeCt has been ably treated of by Dr.
Marlhall Hall, in his Effay on the Mimoses ; a name
which, as its origin implies, defignates a ftate which mi¬
mics, or refembles, other difeafes.

The above-mentioned author has however ufed this
term in a very extended fenfe; he has included in it
many difeafes where idiopathic diforder had become efta-
blifhed. For our own part, we (hall reft riCt the term to
thofe affeClions which are propagated by nervous in¬
fluence, which do not implicate permanently the vafeu-
lar ftruCture, and which fubfide on the removal of indi¬
geftion. Ufed in this fenfe, it charaCterifes the affeCtion
in queftion with great force and faithfulnefs ; and con¬
veys a clear idea of the difference which we find in the
mere fympathetic diforder, and thofe more ferious af¬
fections which, arifing from longer-continued or feverer
forms of dyfpepfia, or from thefe and the morbid predif-
pofitions of their own feats, require mixed methods of
treatment : i. e. fuch as immediately influence the circu¬
lating as well as the digeftive funCtion. But, ere we
enter on this branch, we mull again remind our readers,
that we confider Difpr.pfia, in all its immediate as well as
remote fymptoms, as a difeafe incapable of regular ar¬
rangement. In proportion as one or other of its nume¬
rous caufes are applied, in proportion as the remedial in¬
dications are wrong or mifplaced, will it appear in the
marked and fevere characters of the fecond ftage, without
Mm exhibiting

132 P A T H O

exhibiting any traces of what we have called its firft.
And, belides this, if morbid predifpofitions are exiftent in
the remote ftruStures, idiopathic difeafes will occur in
them, as foon as the nervous excitements we have juft
fpoken of are applied to them ; and thus (how the fallacy
that will attach to the unreftriSled notion, that the fym-
pathetic diforders of the firft ftage of indigeftion are fo
purely nervous as not to produce real topical inflamma¬
tion in fome cafes. We are convinced however, that, as
the divifion we have made will be found good in the ge¬
nerality of cafes, it is better to adopt it than run the
various remote and local fymptoms of indigeftion into
one another without order. The anomalies we (hall
notice will eafily be remembered ; and, though their
confufion (if we may ufe the expreflion) muft undoubt¬
edly take from the uniformity of arrangement, we
confider that far better than that we (hould fail to repre-
fent with fidelity, and to the beft of our knowledge, the
true phenomena of nature.

To return, however, to the mimofes. The common and
diftinguiftiing fymptoms of thefe affections are, that,
while in idiopathic difeafe a peculiar and perpetual ftate
of diforder is found, or at lead a ftate which exhibits re¬
gular intermiflions and paroxyfms, thefe complaints ex¬
hibit no regularity whatever; that, while in idiopathics
one great and predominant fymptom arrefts the atten¬
tion of the patient, and often of the practitioner, in this
the difeafe is complicated, afteCts for a time one ftruCture,
then another; and indeed manifefts all thofe appearances
which we (hould expeCt in merely excited dates of the
nerves, without inflammatory aftion. As it is impoflible,
on account of the multiplied groups of fymptoms which
may occur in thefe affections, to detail all their forms, we
(hall confine ourfelves to a general review of their nature
as they occupy the nerves of the grand fyftems, or parts.

The firft we (hall confider is the brain. Here we find
many dates arifing from this caufe, very clofely refem-
bling difeafe of the vafcular fyftem ; and it muft be re¬
marked indeed, that the latter ftate is more frequently
induced by nervous excitement in the brain than in
any other part. The moft common fymptom is faintnefs.
This is the moft ordinary nervous excitement, fince it
occurs in the (impleft derangements of the nervous
power. The circle of fympathies in this cafe, fudden
and fimultaneous as it undoubtedly is, is complex. The
ftomach afteCts the head, the head the function of refpi-
ration, the latter the heart ; and, this laft failing duly to
impel the blood into the cerebral ftru&ure, /amring takes
place. A further confequence of this ftate is languor of
themufcular fyftem from torpid circulation in the brain ;
and the fame torpidity will likewife influence thefecret-
ing powers. The irritant of the ftomach being however
removed, all thefe effeCts ceafe. But, where acontinued
dyfpeptic ftate exifts, thefe effeCts become more perma¬
nent, which readily explains the fainting, languor, tre¬
mor, &c. which are attendants on the firft ftage of indi¬
geftion, and which are eafily removed with that com¬
plaint. With regard to the languor, it is to be remarked
that between languor arifing (imply from the caufe we
are fpeaking of, and between that which fupervenes in
the more advanced ftate of indigeftion, a great difference
exifts : for, while the firft merely depends on the inter¬
ruption of nervous influence, the latter probably owes
its prefence to fome alteration in the contractile power
of the mufcular fibre. However this may be, the diffe¬
rence between real and apparent debility is allowed by
the beft practical writers.

We have no knowledge why ftomachic irritation ap¬
plied to the brain caufes fometimes one, fometimes ano¬
ther, kind of diforder of that organ ; why one man feels
temporary blindnefs, another debility, anotherdelirium,
and fo on. We have certainly no means of knowing
whether this takes place becaufe the applied irritants aCl
only on particular parts of the cranial ftruCture, or whe-

L O G Y.

ther the nature of the irritants alters the nature of the
fympathetic difeafe. We have good reafon to infer both
of thefe circumftances. The firft, however, is a fpecula-
tion of no ufe in practice : the latter may be fo in a (light
degree, becaufe we (hall find that, in the inflamed ftate
of the ftomach, the inflammation will more readily arife
in the brain ; while, in the cafe of mere nervous irrita¬
tion, that ftate will be lefs frequently found. The moft
formidable appearances which are complicated with irri¬
tation of the gaftric nerves are thofe of epilepfy and apo¬
plexy. Slight degrees of hypochondriafis, too, likewife
occur ; but thefe are unfrequent in the firft ftage of dif-
pepfia. A threatened attack of apoplexy of this kind is
often obviated by the exhibition of a ftrong purge.
Where it once takes place, or where the pulfe is the
fame as we commonly find aflociated with that ftate,
bleeding, &c. will of courle be had recourfe to likewife.'
We mention this here, to remind the reader of the great
neceflity of procuring evacuations by emetics and purga¬
tives when this form of apoplexy exifts. It is this kind
of apoplexy which fo often and fo fatally attacks perfons
retiring to bed after a hearty /upper ; an occurrence la¬
mentably frequent in the daily records of our times. A
fudden attack of epilepfy has often been induced by the
fame caufes. The purgative treatment is extremely be¬
neficial, as well as in dates of infenfibility and delirium,
lofs of memory, blindnefs, &c. fuddenly fupervening to
thefe digeftive derangements.

A peculiar ftate of the brain is often induced by irri¬
tation in the alimentary canal, which has been called by
Dr. Nicholl, the firft author who has given a clear view
of it, “ Erethifm of the brain.” According to the ex¬
perience of that author, it feems that it chiefly occurs in
children. Such a (lute, however, is often met with in
patients afflicted with indigeftion at more advanced ages.
Dr. Nicholl thus deferibes it : “ There is a ftate or condi¬
tion of the cranial brain in infants, which may be called
a ftate of irritation, an irritated ftate, or, in one word,
erethifm. What this peculiar condition of the cerebral
ftructure is, I cannot explain. It is a ftate diftinCt from
that which is called inflammation of that ftruCture, for it
may exift without any perceptible increafe of the quan¬
tity of blood that flows through the cerebral blood-vel-
fels ; it is a ftate under which inordinate effeCts arife from
ordinary impreflions upon different parts of the nervous
fyftem. In its perfect form, and under a high degree of
it, it is a highly fenfitive condition of the cranial brain,
a condition the very reverfe of that under which fleep
occurs. Under fuch a condition of the cranial brain, the
child is wakeful, fcarcely ever (leeping ; it is attentive to
every found, and to every object of fight; its temper is
irritable; the retina is highly fenfible to light, fo that the
child winks if its face be turned towards the window, or
towards a candle ; the pupil is, in many inftances, more
or lefs contra£led ; but this is not always the cafe. The
limbs are much in aCtion ; the head is often moved about,
or is (haken from fide to fide; the child cries without any
apparent caufe, and it is foothed only by tofling it, by
carrying it about, by putting it to the breaft, or by letting
it fuck the cheek of the nurfe, or its own fingers ; the
fecretion of tears is, in many inftances, increafed, caufing
fuffufion of the eyes, and rednefs of the edges of the
tarfi; the fecretion of the fchneiderian membrane may
be increafed, caufing a fluffed ftate of the nafal paffages,
producing fneezing, and exhibiting the appearance of
that ftate which is popularly called a cold. The bowels
are, in many cafes, relaxed; yet no difordered ftate of
the ftools may appear. During fuch a ftate as I have de-
feribed, there may be a degree of animation, and a quick-
nefs of obfervation, much beyond what are commonly
met with in children of the fame age : fo that, although
a morbid condition of the cranial brain be prefent, the
child may be confidered as particularly healthy, on ac¬
count of its being wakeful and lively, and fenfible to the

moft;

PATHOLOGY.

molt trifling impreflions. But it frequently happens, that
an attentive obferver may detect other fymptoms : the
child may ftart in its deep ; it may be very readily awak¬
ened ; when awake, it may Hart at the flighted noife, as
at the ihutting of a door, moving a chair, palling the finger
over the wicker-work of its cradle, or on being flightly
moved, or touched gently; a fudden frown may pals
over the forehead, and may quickly difappear; the eyes
may be clofed irregularly, or alternately, or a winking of
one eye, or frequent winking of both eyes, or a firm
clofing of both eyes, may be from time to time de¬
tected ; the hand may be raided frequently to the
head ; the child may cry, without any evident caufe,
as if it were pricked with a pin ; at other times, it may
Ihriek ; the fills may be clenched, the thumb being bent
in, and laid flat acrofs the palm of the hand, the fore¬
arms being bent upwards on the arms. Should a
iimilar condition of the fpinal brain be prefent, the
child may be bent backwards, prefenting a Hate of
opijlhotonus ; its legs may be drawn up, while the head is
thrown backwards.”

There is another form of infantile erithifm characterized
by want of animation, fretfulnefs when roufed, want of
fleep, and yet “ a ftate that can hardly be called waking ;”
indifference to furrounding objeCls, pallor and chillinefs
of the body, rolling of the eyes, plaintive moaning or
Ihrieking, jactitation of the hands, and other minor fy tnp-
toms ; which our author denominates torpid erelliifm.

Scrofulous children have generally the greateft ten¬
dency to cerebral erithifm ; and, where this tendency
exilts, the flighteft irritation of the nervous fyftem will
call it into aCtion. In the milder forms and earlier ftages
of this affeCtion, the fymptoms which it produces may be
great wakefulnefs, great fenfibility to flight impreflions,
with reltlelfnefs and high animation.

It is to be remarked, that irritants applied to any of
the nervous expanfions may produce eretliifm, fo that it is
juft poflible that it may arife independent of gaftric or
intellinal diforder. It is to be noticed likewife, that this
ftate is extremely liable to run into inflammation of the
brain and hydrencephalus, wdiich it fometimes refembles in
the clofeft manner, particularly where worms are the irri¬
tants applied.

The refpiratory function is often much difordered by
dyfpepfia. Paroxyfins of oppreflive dyfpnoea come on,
which very clofely refemble afthma ; fo clofely indeed,
that it is only by attending to the increafe of the fymp¬
toms after eating, to its hiftory, and the ftate of the ali¬
mentary canal, that we can eftablifli a diagnofis. And it
is not improbable that afthma properly fo called, fre¬
quently, if not generally, originates in a complication of
this nature; but is afterwards continued, or repeated,
either from a degree of diforganization induced in the
heart or lungs, from the influence of the external caufes
of afthma, or from the caufes of indigeftion.

The affeStions of the heart which occur in confequence
of the Mimofis acuta, are fluttering, palpitation, and irre¬
gular aCtion. Fluttering and palpitation of the heart
are amongft the tnoft frequent fymptoms. To eftablilh a
correCt diagnofis in the feverer cafes it will be neceffary to
watch the effeCt of the remedies in removing this diforder.
The palpitation of the heart, if a confequence and effeCt
merely, will be mitigated or removed with the original
affeCtion. In the lefs fevere form of this.complaint, the
difcrimination mull be principally founded on a cautious
obfervation of the effeCt of bodily exercife on the aCtion
of the heart, when the fymptom of palpitation is other-
wife abfent, and when the patient is leaft indifpofed, and
on the continued hiftory of the complaint. In difeafe of
the heart, it is bodily exertion and mental agitation which
renew. and recall this dreadful difeafe; but, in the com¬
plication of dyfpepfia with palpitation, the patient, if not
prevented by weaknefs, can, at the time when the hur¬
ried movement of the heart is abfent, run pretty rapidly,
or walk up flairs, without fuftering more than is ufual ;

133

and periods occur when he has puffed feveral days, weeks,
or months perhaps, without experiencing the palpitation.
In a difeafe of the heart, thefe circumftances are by no
means obferved ; the uneafy fenfations which accompany
this difeafe, if abfent at times, are always excited on any
corporeal exertion; and, moreover, difeafe of this organ
is in general highly characterized, and diftinguifhed from
certain fymptomatic diforders of its functions, by the
permanency of the affeCtion ; by its invariable aggrava¬
tion on mufcular exertion, as well as mental emotion
and by the particular relief obtained at firft from blood¬
letting. Difeafe of the heart, although its fymptoms
may be mitigated at one period and aggravated at another,
is however permanent ; the fymptoms are never entirely
abfent ; and they may at any time be renewed, in an ag¬
gravated form, by mufcular exertion. In dubious cafes,
the patient may be made to run up fairs ; the fymptoms
of an organic difeafe of the heart are invariably aggra¬
vated by this mufcular exertion, the pulfation of the
heart becoming violent, the pulfe perhaps irregular, the
refpiration exceedingly difficult, &c. circumftances not
equally obferved in iymptomatic derangements of the
functions of this organ, unlefs when they are attended
with great debility. There is almolt always, too, great
but tranfitory relief from blood-letting, in a degree not
obferved in the fymptomatic affeCtions.

The affeCtions of the mufcular fruBurc , independent of
the debility, &c. juft noticed, are partial paralyfes, fuch
as are termed fpafmodic, among which tetanus often ap¬
pears. The belt illuftration of this ftate is afforded by
the hiftory of hyfteria, when it arifes from gaftric irrita¬
tion. The abfurdity, however, of applying the term hyf-
tcria to a difeafe which does not at all implicate the ute¬
rine fyftem, and which even affeCts men, is obvious
enough : we (hall therefore ufe the term of Dr. Hall, viz.
Mimofis urgens, and referve the term hyfteria to defignate
fymptoms of uterine irritation. The Mimofis urgens,
then, is generally denoted by combining fome coniider-
able emotion of the mind, denoted by fighing, fobbing,
tears, or laughter, with a fenfe and exprellion of fuffoca-
tion, and with fome urgent affeCtion of the head, heart,
refpiration, ftomach, or mufcular fyftem, and a peculiar
and high degree of hurry, and apparently imminent
danger.

Of the Mimofis urgens there are three forms, the mild,
the fevere, and the inveterate ; and there are molt nume¬
rous modifications.

i. The mild form of the Mimofis urgens fubfifts as a ten¬
dency to alternate high, and low fpirits, to fits of laugh¬
ter, to frequent deep fighing, and to tears. A fit of
laughter, or of crying, fometimes takes on an aggravated
character; the laughing, or the fobbing, becomes immo¬
derate, convulfive, and involuntary, and there is fre¬
quently a peculiar fpafmodic chucking in the throat.
The countenance changes, being alternately flulhed and
pale, and denoting great anxiety. There is frequently
an urgent difficulty in breathing, with much rapid hea¬
ving of the chelt. Sometimes a dry, fpafmodic, and vio¬
lent, fit of coughing occurs. There is generally a fenfe,
an appearance, and an urgent fear, of impending fuffb-
cation. In different inftances there is palpitation, hic¬
cough, retching, or borborygmus. The patient is de-
fpondent, and aggravates all her fufferings.

a. The fevere form of the Mimofis urgens confifts in a
various attack, catenation or combination of the follow¬
ing fymptoms : The commencement, courfe, or termina¬
tion, of this and indeed of every form of the Mimofis
urgens, is generally marked, and the cafe diftinguiflied,
by the figns of fome inordinate mental emotion, (joy,
grief, or other affeCtion,) which conftitute the moft cha-
raCteriftic fymptoms of this diforder. The attack is fre¬
quently ulhered in by an unufual appearance of the
countenance; a rapid change of colour, rolling of the
eyes, diftortion or fpafmodic affeCtion of the face. The
extremities are apt to become very cold. A ftate of gene-

PATHOLOGY.

134

ral or partial, of violent or of continued, convulfion, or
of fixed fpafmodic contra&ion, takes place, and difplays
every poflible variety in mode and form. The fevere form
fometimes confifts chiefly in a general or partial pain and
throbbing of the head. Occafionally this pain is confined
to one particular fpot, and is fo acute as to have ob¬
tained the appellation of clavus hyflericus. Sometimes
there is intolerance of light and noife ; fometimes a ftate
of ftupor; fometimes delirium. The refpiration is fre¬
quently much affe&ed : an oppreflive and fuft’ocative
dyfpncea takes place ; or the breathing is rapid, anxious,
and irregular; or varioufly attended with fobbing, figh-
ing, much rapid heaving of the cheft, and fometimes
with a fpafmodic a6tion of the diaphragm, inducing a pe¬
culiar elevation of the abdomen, or an equally-peculiar
fuccuflory movement of the trunk in general ; fome¬
times the refpiration appears to befufpended altogether
for fome time, the pulfe continuing to beat as before.

A crowing noife, or fcreaming, is apt to occur in this
affeftiorx. There is, occafionally, hoarfenefs, or even an
entire lofs of the voice, continued for fome time. There
is fometimes a painful, violent, dry, hoarfe cough, conti¬
nued, or recurrent in paroxyfms. There is occafionally
acute pain of the cheft or abdomen. Palpitation of the
heart, and fyncope, are alfo ufual affeftions. The pulfe
is otherwife little aft'efted. There is frequently an ur¬
gent fenfe of fuffocation, accompanied with the feeling
of a ball afcending into the throat; this fymptom is fo
peculiar as to have obtained the denomination of globus
hyjlericus, and is confidered as diagnoftic of this affe&ion.
Hiccough, and violent fingultus ; retching and vomiting ;
the fenfe of a ball rolling within the abdomen ; borbo-
rygmus ; a peculiar great and fudden tumidity of the ab¬
domen, apparently from flatus ; conftipation, & c.

3. The inveterate form of the Mimofis urgens (id enim
vitium quibufdam feminis crebro revertens perpetuum
evadit) confifts fometimes in an almoft-perpetual agita¬
tion of fome part of the body, the limbs, the refpiration,
the throat, or the ftomach ; and fometimes in a ftate of
continued contraction of the hand or foot, or of fome
other part. In different inftances too, there is a conti¬
nued ftate of nervous agitation from the flighted noife
or other caufe ; of paralytic, epileptic, or fpafmodic, dif-
eafe ; or of imbecility of the mind. In fhort, this affec¬
tion is characterized, by affeCting in the fame or in dif¬
ferent inftances, fingly or conjointly, all the feveral fyf-
tems which conftitute the human frame; the organs of
animal and of organic life ; the different fets of mufcles,
voluntary, involuntary, mixed, and fphinCter; the fa¬
culties of the mind, and the emotions of the heart; the
functions of the head, the heart, the ftomach, &c. “It
is in thus viewing the Mimofis urgens, that the diagnofis
is often formed between its different and very-various
attacks, and other affeCtions having a different origin,
but of which it is the imitator, nam nullos fere non amu-
latur ex iis affeCtibus quibus atteruntur miferi mortales.”
Hall, p. 162.

The diagnofis in Mimofis urgens is founded partly on
the peculiar and different appearance of the particular
cafes, and partly on the precurfory, concomitant, or fuc-
eefiive, occurrence of fome unequivocal fymptom, and
efpecially of the appearances of mental emotion, &c. be¬
fore noticed ; and of hurry and apparent urgency of
complaint in general. It is, in particular, in this manner
that the paroxyfm of convulfion in the Mimofis urgens
is to be diftinguiflied from epileptic or puerperal convul-
fions ; for, though the appearances are very fimilar, there
is probably fome fymptom of mental emotion, or fome
appearance peculiar to the Mimofis urgens, efpecially
the hurried and heaving refpiration, or fome circumftance
in the hiftory of the attack, which may lead to the diag¬
nofis. Otherwife the phyfician mult wait awhile, and
watch the courfe of the affection, and the fucceflion of
fymptoms; in this manner fome fymptoms decidedly pe¬
culiar to the Mimofis urgens will occur to prompt the

diferimination. In the epileptic or puerperal convulfion,
there is an abfence of thefe fymptoms of mental emotion,
as joy, grief, &c. and the patient feems to be rather a
prey to fome power which exerts a violent empire over
the fource of fenfe and mufcular motion. The Mimofis
urgens may excite alarm ; but the epileptic or puerperal
convulfion prefents a far more dreadful afpeCt; the fa<;e
perhaps becoming deeply flufhed and livid, with foaming
at the mouth, more fhocking diftortions of the counte¬
nance and of the body, and a very different and a more
ferious affeCtion of the refpiration. By iuch means thefe
affections will generally be diftinguiflied.

The occurrence of delirium is not very frequent ; but
Dr. Hall has witnefled it repeatedly. The cafe is identi¬
fied by the occurrence of fome fymptoms peculiar to the
Mimofis urgens.

The occurrence of ftupor as a form of the Mimofis
urgens is by no means unfrequent. Dr. Hall relates the
following x;afes : “Some time ago I received an urgent
call to vifit a poor woman faid to be in an alarming ftate
of infenfibility. She was without fenfe or motion, but,
in other refpeCts, unafteCted with any particular fymp¬
tom. The medical attendant had prepared his lancet to
open a vein in the arm. In a Ihort time, however, tire
patient recovered herfelf, and manifefted fymptoms which
are peculiar to the Mimofis urgens. — In another cafe
which occurred in an aged woman, a vein had been
opened, under the idea that fhe was afteCted with apo¬
plexy. Some fymptoms of an anomalous kind occurred,
and file became affeCted with an unequivocal attack of the
Mimofis urgens. — In fimilar or dubious cafes it is proper
to wait, and obferve the change of fymptoms; and parti¬
cular inquiry mull be made into the hiftory, mode of at¬
tack, &c. of the affeftion. Perhaps the patient foon
opens the eyes, fighs, is aft'eCted with dyfpncea, or burfts
into tears. In general fome unexpected and anomalous
fymptom occurs, to denote the nature of the aft'eCtion.”

In pain of the cheft in Mimofis urgens, the countenance
is expreflive of great anxiety, hurry, and agitation ; and
the noftrils are moved with rapidity. The patient com¬
plains much, manifefts great impatience, is urgent for
relief, and calls out from the pain. The pain of the
cheft is extremely acute, and the part affeCted is de-
feribed as excruciatingly tender on being touched, and
the hand applied to it is ufually puftied rudely away.
With or without the pain of cheft, there is often an ur¬
gent dyfpncea; the refpiration is rapid, hurried, with
much oharaCteriftic heaving of the cheft, fometimes with
great and rapid movements both of the cheft and abdo¬
men, and often with a peculiar hifling noife.

Cough occurring as a form of the Mimofis urgens,
comes-on in continued fits ; it is frequent, hoarfe, and
hifling; “ seger creberrime tuflit, fere fine intermiflione,
nihil prorfus expeCtorans.” Hall, 176.

The affeCtion of the diaphragm in the Mimofis urgens
is attended by the moft acute pain in the epigaftric region,
extending to each fide along the falfe ribs, and to the
back ; it is augmented occafionally by moving, or by the
aCtion of the diaphragm in refpiration, and caufes the pa¬
tient to cry out. The refpiration is irregular, perhaps
performed by the cheft alone ; the noftrils move, the face
is fometimes fluftied, and there is often ftiedding of tears.
Thefe cafes are diftinguiflied from inflammation, by the
occurrence of lymptoms peculiar to the Mimofis urgens ;
the mode of attack, which is fudden ; and the general
afpeCt of the cafe, which is hurried and urgent; con-
trafted with the ufual charaCteriftics of inflammation,

The imitation of croup by the Mimofis urgens takes
place in fuch a manner as to deceive a curfory obferver.
The refpiration and cough have precifely the character of
thefe fymptoms as occurring in inflammation of the tra¬
chea. It is by inquiry, waiting, and by cautjoufly ob-
ferving the cafe, that the diagnofis is to be inftituted.
On inquiry, the attack will probably be found to have
been marked by fome fymptom or character of the Mi-

5 mofis

PATHOLOGY.

moils urgens ; or, by waiting, Tome fuch fymptoms may
occur to develope the myftery. The cafe is fometimes
fo urgent as apparently to demand an operation to pre¬
vent an impending fuffocation. We quote the following
cafe: “ In a young woman, aged fifteen, the firft fymp-
tom which arrefted the attention was a ftridulous found
of the refpiration ; and circumftances conduced to render
an attack of an inflammatory nature probable. She had
been conveyed through the cold air, and appeared to be
livid from cold. On being feen in bed, however, the
nature of the difeafe became obvious, from the prefence,
then, of globus ; from the hiftory, by which it was alcer-
tained that other fymptoms of the Mimofis urgens had oc¬
curred; and from the abfence of any affection of the
pulfe. The patient was fpeedily relieved by the opera¬
tion of a purgative medicine.” Hall, 177.

The pain of the abdomen in the Mimofis urgens is at¬
tended with great urgency of complaint; much anxiety
and fuffering; an extreme tendernefs to the flighted:
touch, rather than under p re flu re ; an hurried and irre¬
gular ftate of breathing, &c. The countenance is ex-
prefiive of an urgent anxiety 5 the patient is reftlefs, im¬
patient, and irafcible, and pulhes the hand, although
gently applied to the abdomen, rudely away; the gene¬
ral furface, and the pulfe are, at the fame time, little af-
fefted ; there is fometimes vomiting, or a fort of retch¬
ing; the bowels are generally cGnftipated. The hic¬
cough or the retching is fometimes of the moll violent
kind, and is apt to be long continued. Dyfury, or re¬
tention of urine, is alfo common as a form of the Mimofis
urgens. Its duration is ufually (hort. But it has conti¬
nued occafionally for a long period. It is diftinguilhed
by being combined with other fymptoms of this affection.

It mu ft not be forgotten that the ftomach, when its
contents irritate the nervous expanfions, and the irrita¬
tion is propagated to the brain, that organ re-ads on the
Itomach, and produces pain and fpafm in various parts
of the alimentary canal, which are not topically difeafed :
as for inftance a flight contradion of the return, of the
oefophagus, fpafm of the gall-dud, mtelena hasmatenefis,
See. But thefe are generally fo obvioufly connected with
the prefence of dyfpeptic lymptoms, that we need not
take particular notice of them.

Of the Second Stage of Difpepjia. — The firft ftage of in-
digeftion having continued for fome time, or an erethe-
matic inflammation of the ftomach, or any of the various
caufes capable of inducing inflammation, being prefent ;
the fecond ftage of indigeftion makes its appearance.
The palling of the firft ftage into this is denoted by va¬
rious figns ; fome taken from the nature of the gaftric
or inteftinal derangements, but chiefly from the nature
of the fympathetic irritations. With refped to the
former, the ftomach betrays fymptoms of chronic in¬
flammation; and the inteftinal excretions, hitherto irre¬
gular, for the mod part affume deficiency of colour or
confidence of a more permanent kind. The ftate of ner¬
vous excitation, in which fympathizing parts have been
long retained, brings on a more permanent change in
the fanguineous ftrudure, or fecretion becomes difturbed
in the fame continued manner in particular parts. The
topical affections are lefs changeable and varying. The
mind, lofing the petulant nervoufnefs of the firft ftage,
feels all the imaginary hurry and the anxiety of hypo-
chondriafis; the fymptoms are lefs under the control of
medical treatment ; every thing, in a word, afl'umes a
more fixed and continued form. The great pathogno¬
monic fign confiftsin a permanent tendernefs, on preflure,
of the foft parts clofe to the edge of the cartilages of the
falfe ribs on the right fide, after they have turned up¬
wards to be joined to the fternum. This fpot is often
very circumfcribed, and always lies about half-way be¬
tween the end of the fternum and the place at which the
loweft of the cartilages begins to afeend ; and the carti¬
lage itfelf near the tender part often becomes very tender,
not unfrequently indeed much more fo than the foft parts.

Vol. XIX. No. 1193.

135

The patient in general is not aware of this tendernefs till
it is pointed out by the phyfician. There is often, we
have feen, a degree of fullnefs in the right hypochon-
drium at earlier periods ; but it is then more tranfitory,
being generally relieved and fometimes removed by the
effeCls of cathartics, and, not unfrequently, fpontaneoufly
difappearing and returning again. The tendernefs above
mentioned never exifts long and to any confiderable de¬
gree without the pulfe becoming hard, and it often at
the fame time becomes rather more frequent than in
health.

Sometimes the hardnefs of the pulfe is fo well marked
that it is eafily diftinguilhed, but more frequently tire
hardnefs is only to be diftinClly perceived by examining
the pulfe with the utmoft care. See our remarks on the
manner of diltinguilhing the hardnefs of the pulfe, in the
prefent article, p. 9/p. The tendernefs of the epigaftrium,
after it has lafted for fome time, generally begins to be
attended with fome degree of fulnefs in the part, and to
extend downwards along the edge of the cartilages, till
at length there is a degree of fulnefs, and fometimes ten¬
dernefs, throughout the right hypochondrium, which
feels firmer than the left ; but the tendernefs is feldom fo
great as in the part of the epigaftrium above deferibed.
Sometimes the preflure, both there and in the hypochon¬
drium, rather produces a fenfe of oppreflion, affeding
the breathing, than pain. Sometimes, particularly in
the epigaftrium, it occafions pain palling through the
body towards the back, fometimes quite to the back, at
other times a fixed pain or fenfe of oppreflion under the
fternum, and, in fome cafes, a pain extending to the left
fide.

The tendernefs of the epigaftrium, as well as the hard¬
nefs of the pulfe, are perceived molt clearly when the
patient has been taking exercife; mufcular aCtion, as
might be expeCted, increafing the phenomena of inflam¬
mation. We mull not forget to remark, with refped to
exercife, that its performance is often attended with much
uneafinefs, all motion except of thepaflive kind produc¬
ing an infupportable degree of languor. This obtains
chiefly, however, in the more fevere forms of the affec¬
tion, the flighter ones being ufually free from it.

Thefe fymptoms are generally accompanied with others
indicating fome degree of feverilhnefs. The chillinefs of
which the patient has long complained is now fometimes,
and independently of any change of temperature in the
furrounding medium, interrupted by languid and op-
preflive fits of heat; and the hands and feet, inftead of
being uniformly cold, as in the earlier ftages, often burn,
particularly during the firft part of the night, while at
other times they are more obftinately cold. The thirftalfo
often increafes ; and fometimes there is a tendency to
partial fweats in the morning, efpecially if the patient
lie longer than ufual ; and thefe fymptoms are generally
attended with an increafe in fome of thofe of the firft
ftage.

The inflammatory ftate of the ftomach proceeding un-
fubdued, organic changes are foon induced, and thick¬
ening of its coats ; ulcers, feirrhus, and a variety of
ftrudural derangements, occur. More frequently, how¬
ever, the inflamed ftate of the ftomach and bowels fub-
fides, while the organs to which its difturbance has been
propagated undergoes the ftrudural diforganization.
The liver, lungs, fpleen, pancreas, lower bowels, mefen-
teric glands, heart, and brain, are faid to be moft obnox¬
ious to this occurrence ; but it cannot be queftioned that
every part of the body is liable to . the lame changes,
and from the fame caufes. Sometimes one of thefe parts
is aft'eded, fometimes many; and it is to be remarked,
that, in eonfonance with the known laws of pathology,
when difeafe eftablilhes itfelf firmly in a fecond part, the
firft is relieved from it. Indeed there feems this further
difference between the mere nervous excitement which
fupervenes to the firft ftage of Dyfpepfia and the inflam¬
matory affedions we are now treating of, that, while tire
N n former

136

PATHOLOGY.

former tend to keep up and increafe the original difeafe,
thefe (the latter) aft on that which excites it in the
fame manner as a counter-irritant is known to do, though
tinqueftionably in a much more effeftual manner. Thus,
it is not uncommon in indigeltion for the liver to fuller
in fuch a manner, that it (hall become enlarged and ten-
deron preffure; and, when ahe difeafe' is deftroying the
texture of the lungs, having fpread from the liver to
them, for the former to recover, or nearly recover, its
healthy ftate. And thus an extenfive external difeafe,
occurring in fuch cafes, will often fave the vital organ,
even after the difeafe has made confiderable progrefs in it.

It is obvious, then, from the foregoing remarks, that
the treatment of all difeafes remotely traceable to indi¬
geftion are not to be difcuffed in this place ; nor are the
diforganizations of the ftomach to be treated of here; as
each of thefe form diftinft fpecies, and require feparate
confideration. It only remains therefore to trace the dif-
ordered Hates of the fanguineous and fecretory funftions
arifing in the fecond ftage of Dyfpepfia; and to notice
the general indications for the relief of the local, and the
particular indications for the cure of the general, difeafe.

For the reafons Hated in p. 108, we lhall forbear to
mention all the complaints traceable to the confirmed ftage
of indigeftion. Indeed it would feem from what we have
there remarked, that, as thefe propagated complaints are
literally the complaints of the fanguineous and nervous
ftrufture of the parts affefted, they are diftinft and idio¬
pathic; that ■they are inflammations, however induced,
and therefore to be met with the ufual remedies for that
aftion. But praftical conflderations (which fhould fuper-
fede all other) induce us to notice certain cafes in which
experience has ftiown that the moft marked and ferious
forms of chronic inflammation, and of difeafed fecretion,
have been cured by the medicinal treatment of dyfpepfia ;
and we think that, when the laws of fympathy are better
known, this divifion will appear no lefs philofophical than
praftical. We have before adverted to the impoflibility
of drawing an accurate diftinftion between inflammations
which, though produced by nervous irritations, are ren¬
dered permanent by their own difeafed tendencies, and
thofe which are merely fympathetic. And, in the cafes we
are about to confider, probably a ftill greater difficulty of
diagnofis exifts. The difficulty in thefe cafes is to efta-
blifti how far, when the original caufe of dyfpeptic dif¬
eafe is removed, the parts will return to their natural
.ftate.

Reafoning a priori, we (hould conclude, that the ope¬
ration of this caufe could not extend beyond inflamma¬
tion and altered fecretion ; but experience has clearly
fliown, that, nervous irritation being removed, difor-
ganized parts undergo reparative proceffes, and in an
aftoniiliing manner may refume their natural ftrufture.

In the nervous fyftem we remark, that the head is in¬
fluenced in this difeafe in a manner decidedly inflamma¬
tory. This inflamed ftate of the cerebrum, in the fecond
ftage of indigeftion, is well ffiown by head-ache, by in-
creafed hardnefs and fulnefs of pulfe, and by the in-
creafed pain which the recumbent pofture produces. As
it advances, various forms of mental difturbance become
rnanifeft. In this form of difeafe we mull be efpecially
careful not to let our notions of the dyfpeptic origin of
the difeafe weaken the vigour of our pradlice ; for local
and (when the date of the circulating powers demand it)
ievere general depletion are neceffary here, as in
idiopathic difeafes; and indeed, as this is the part where
the moft intimate connexion between the fanguineous
and nervous fyftems takes place, we Ihculd naturally ex-
peft to meet with this faft.

It fometimes happens, in this fecond ftage, that the
head-ache aflumes a chronic form, continuing for weeks,
or even months, without being very fevere. Both local
and general blood-letting then very frequently fail to
give permanent relief. The bell means are thofe which
iupport an habitually-free aftion of the bowels and Ikin,

(and moft efFeftually correft the difeafe of the digeilive
organs,) and permanent drains from ther neighbourhood
of the head.

There are two occurrences which ought ever to be pre-
fent to the mind of the praftitioner : the firft is the ten¬
dency to the tranfition of nervous into idiopathic inflam¬
mation, which is particularly obferved with regard to
the head; the fecond, the poffibility of the co-exiftence
of the two ftates.

The tranfition of the affeftion of the head in Dyfpepfia
into an idiopathic inflammation, or the co-exiftence of
the latter affeftion with the former, is to be apprehended
on the occurrence of any of the following lymptoms in a
ferious degree and continued form : A fenfe of flu'hing
or fulnefs about the head ; acute pain of the head ; un-
ufual heavinefs, dull head-ach, or vertigo ; drowfinefs,
ftupor, difturbed fleep, delirium, incubus, ftertor; for-
getfulnefs, timidity, confufion of mind; change of affec¬
tions ; tendency to laughter, and tears ; affeftion of the
fenfes, as temporary lofs of fight, flalhes of light, double
vifion, finging or loud noifes in the ears, intolerance of
light, or found ; tendern^fs of the fealp. Many of thefe
fymptoms, however, occur in the firft ftage. It is only
when they exift in an eminent degree that they denote
danger. But it is bell to take an early alarm. The
danger of compreffion of the brain is unequivocal on the
occurrence of an untifual diftortion, or an unmeaning
expreffion, of the countenance ; of a deleft in articula¬
tion ; of a temporary numbnefs or torpor, or of tranfient
and partial weaknefs of any of the limbs; efpecially if
one fide of the body alone be affefted. The occurrence of
ftupor, convulfion, paralyfis, or relaxation of thefphinc-
ters, leaves little to doubt refpefting the exiltence of this
fatal occurrence.

In fome cafes, the erethi final ftate of the brain before
noticed puts on a more marked and formidable appear¬
ance ; and it is not very unufual, when this difeafe has
continued fome time, to fee the patient, after more fe¬
vere attacks than ufual, and fometimes without this
warning, fuddenly fall down, and in a few hours, and
in fome cafes almoft immediately, expire. In fuch cafes
the aids of medicine are vain. The powers of the con-
ftitution are not oppreffed by difeafe, but worn out by
its continuance. This is what, in contradiftinftion to
apoplexy arifing chiefly from the ftate of the veflels, is
properly termed nervous apoplexy, the moft fatal of all its
forms ; and. it has been remarked, that in fome cafes no
morbid appearance prefents itfelf on diffeftion : the fatal
derangement is in the nervous fyftem alone, whole ftruc-
ture is too minute for our obfervation. If the ufual plan
of bleeding in cafes of fudden infenlibiiity be here re-
forted to, the difeafe is only the more fuddenly fatal.

The ftate of the brain in fuch cafes refembles that which
furgeons call eoncvjjion. Its mechanifm is deranged.
The difference is, that in the one this mechanifm is de¬
ranged by a fudden and violent caufe, applied while the
powers of the fyftem are entire ; and which, confequent-
ly, if the little ftrength that remains be carefully huf-
banded, may often repair the injury : the other is the
effeft of a fucceffion of flight caufes gradually changing
the mechanifm of the brain, and at the fame time ex-
haufting the powers of every other part, fo that the con-
ftitution poffeffes no means of repairing the injury. The
pure nervous apoplexy, however, as here deferibed, is an
extremely rare difeafe ; becaufe it very feldom happens
that the caufes continue long enough fo to derange the
finer mechanifm of the brain as to produce lofs of func¬
tion, without influencing the ftate of the circulation in
it in fuch a manneras to produce a fatal effeft in this way.

It more often happens, that difeafe of veflels caufing
apoplexy is produced ; and it is worthy of remark, that
in this ftate a pallid countenance is ufually met with.
This circumftance occurs occafionally in all the forms of
apoplexy ; but we think it is more particularly noticed in
this than in any other. Dr. Philip fays, “ I have repeat-

PATHOLOGY. 187

edlyfeenj in an exhaufted conftitution, the face become
fuddenly pale, and all power loft, the patient falling
down infenfible, and the countenance continuing to in-
creafe in palenefs till it a /Turned a cadaverous hue ; and
yet this patient has been immediately reftored to the ufe
of his faculties, the palenefs of his countenance at the
fame time abating, by the lofs of blood; and there is
every reafon to believe would have died without it. For
it is evident that the apoplexy we are coniidering is of a
different nature from detention of the veflels of the en¬
cephalon arifing from general fulnefs; and therefore lofs
of blood from the head, and that only to fuch an extent
as relieves the fymptoms, is alone proper; the incautious
ufe of general blood-letting in fuch a cafe being alfo fol¬
lowed by a degree of debility which further difpofes to
returns of the attack, as well as to other difeafes.”

The effeft of the gaftric irritation in debilitating the
veflels of the head, might be illuftrated by many faffs :
it is enough to mention the flufhing of the face which
occurs to dyfpeptics after dinner.

Of the nature of epilepfy fo little is known, that any
attempt to trace its connexion with indigeftion nuift be
futile ; nor indeed does there appear any real difference
in the difeafe, let it arife from what caufe it may.

The moft chronic and inveterate form in which the
brain is affeffed through the gaftric media, is that of hy-
pochondriafis. We fhall referve our fpeculations as to
the nature of this complaint till we come to the clafs
Neurotica, in which we fhall take up the fubjeft of ner¬
vous irritations arifing from indigeftion on a more ex¬
tended fcale. It will be fufficient at prefent to ftate, that
in confidering the mutual aftion of one part of the fyftem
on another, the ftate of the mind deferves particular at¬
tention in indigeftion. The difeafe itfelf w'e have feen
feldom fails to render it anxious, irritable, and apprehen-
five ; and this ftate of mind, which we have found ranked
among its caufes, cannot fail to influence its fymptoms.

The affections of the mufcular fyftem which fuperVene
on this ftage of indigeftion, are of a gouty or a rheuma¬
tic nature ; and, like other inflammatory affeCions, they
prefent lefs indication of plethora when dependent on
gaftric difturbance, than when they arife from other caufes.
It muft not be forgotten, that an ill ftate of the abdo¬
minal vifcera is always connected with chronic rheuma-
tifm ; a circumftance which induces us to defer tracing
theconnexion, or noticing the peculiarities, of that dyf-
peptic variety in this place. We fhall remark, how'ever,
that, where a tendency to gout exifts, difeafe may be
induced by any caufe that produces, and for a certain
time keeps up, indigeftion. In fome the difpofiticn to
gout is fo great, that it appears without being preceded
by fymptoms of derangement in the firft paflages ; but
in the majority of cafes it is preceded by thefe fymptoms,
and the tendency to them feems to conftitute a con/idera-
ble part of the hereditary difpofition' to gout.

The regular forms of this difeafe, not affecting a vital
part, tend lefs to derange the fyftem in general, and give
more relief to the primary difeafe, than moft of the other
fymptomatic affections which have been enumerated, the
patient often remaining well for fome time after; and,
the more cautious be is in preferving the vigour of the
digeftive organs, the longer interval he enjoys. Hence
appears the danger which attends interrupting the regu¬
lar fits of gout : the fympathetic difeafe, being prevented
from taking the courfe which the difpofition to affeclion
of the extremities gives it, feizes on the part, generally
an’ internal one, which nex.t to thefe is moft liable to
difeafe; and, on the other hand, if any thing fo aftefts
any of the vital parts during a fit of gout as to render it
confiderably the weakeft part, the fympathetic difeafe
fometimes leaves the joints and feizes on the internal
part, producing what is called retrocedent gout. It is
evident that the rifle of both thefe accidents will be
greateft, where the powers of the fyftem are moft im¬
paired.

The mufcular fyftem is likewife afFefted in fome cafes by
a permanent and gradual debility, by tremor, and by
lofs of fubftance. The latter circumftance is much
dwelt upon by Dr. Hall, who weighed feveral of his pa¬
tients, with a view to more correct information on the
fubjeft. It will be found, however, that fome dyfpeptic
patients retain their embonpoint, notwithftanding much
functional difturbance.

The patients/of indigeftion are ufually aflefled with
great tremor, obferved fometimes in a quivering of the
lip, or dimpling of the chin, but more ufually, on hold¬
ing out the hand, or in carrying a cup of tea, for iriftan.ee,
to the mouth, on attempting to Hand ereft or walk, or
on being fatigued or hurried. The tremor, in fome pro-
trafted cafes, has formed the moft remarkable feature of
the affeCtion ; in others, it has been much lefs obferved,
but it is rarely, if ever, entirely abfent.

The debility which now comes on is, as we have be¬
fore obferved, of a different nature from that merely-
nerv.ous inaCtion which happens in the early ltages of the
complaint. The latter is the mere want of nervous fti-
mulation, while the former feems to be a change in the
contractile power of the mufcular fibre, probably derived
from the morbid ftate of the blood, and indicating much
danger.

The heart is often affeCted in the fecond ftage of indi¬
geftion, in various and fevere modes. The palpitation
which in the firft ftage was merely nervous, in fome in-
ftances now becomes fo obftinate, as to affume the form
of angina peCtoris, carditis, See. and, being accompanied
with an increafed hardnefs of pulfe, can only be relieved
by lofs of blood.

Dr. Philip has noticed a connexion between rheurna-
tifm and this fort of carditis. He fays, “It is a common
obfervation, that carditis is apt to fuperverie after re¬
peated attacks of rheumatic pains of the limbs. I believe
from many cafes which have fallen under my obfervation,
that it will generally be found, in fuch inftances,.that the
rheumatic pains had been combined with, and in a
greater or lefs degree dependent on, diforder of the di¬
geftive organs.” The pain of the limbs arifing from this
caufe, often aflume the form of idiopathic rheumatifm,
and become very obftinate, if the caufe which fupports
them be overlooked; which is the more likely to happen,
as cold is very often the immediate exciting caufe. Dr.
Philip has feen fevere pains of the limbs, which had long
relilted the means ufually fuccefsful in rheumatic cafes,
wholly removed by combining with thefe means the treat¬
ment adapted to the fecond ftage of indigeftion ; and it is
well known to furgeons, that the fwelling of the knee-
joint which fometimes accompanies the rheumatic con-
ftitution, is only cured by the fame indication.

On turning our attention to the other vifcera, we fee
the fpafmodic contractions of the bowels, and their oc-
cafional difturbance of function, developed in the early
periods of indigeftion, now terminating in inflammation,
ftri/ture, adhelions, piles, &c. The figmoid flexure of the
colon appears to be a part very liable to be aftedled with
inflammation, probably from the contents lodging there
longer than in other parts of the large inteftines. It is
not uncommon in protracted cafes, to find a confiderable
degree of tendernefs in the feat of this part, which is
fometimes at length affected with ulceration. It is alfo
common to find tendernefs on preflure in the feat of the
ccecum.

The liver, too, aftumes an inflammatory appearance.
We often find, when the patient takes cold, orisexpoled
to other caufes of inflammation, or the dylpeplia is ag¬
gravated, the greater part of the right hypochondrium
becomes full and tender on preflure, with a fenfe of op-
preflion and an increafed hardnefs of pulfe, often accom¬
panied with fome degree of dylpncea, and a dry teafing
cough. He fometimes complains of pain in the right,
not unfrequently in the left, hypochondrium, or in the
pit of the ltoinach, or in the right or left fiioulder; and

experiences

4

138 PATHOLOGY.

experiences Tome uneafinefs in lying on either fide, par¬
ticularly on the left, the common derangement of the
biliary fecretion being rendered more marked with thefe
fymptoms. The hepatic inflammation thus induced is
feldom, however, of that adtive kind which requires ge¬
neral blood-letting; a fortunate circumftance, as patients
of this defcription rarely bear lofs of blood well. Thefe
attacks generally partake of the chronic nature of the
habitual difeafe, and for the mod part yields to local
blood-letting and blifters, with the aid of a mild diet and
faline and aperient medicines.

The pain is often felt in the left fide, while the ten-
dernefs on p re flu re is wholly confined to the right; but,
after the affedlion of the right fide is relieved by evacua¬
tions from the tender part, it is not uncommon for the
left fide to become both full and tender, the inflammatory
affedlion appearing to attack the fpleen as foon as the
liver is relieved from it ; and it will fometimes, on the
fulnefs and tendernefs of the left fide being relieved by
the fame means, return to the liver. This alternation
often happens more than once before the difeafe fubfides.
Sometimes, though much more rarely, the fulnefs and
tendernefs appear in the left fide alone. The pain is then
more confined to the feat of the tendernefs.

Whenever the liver becomes thus implicated in the in¬
flamed ftate of the ftomach, it leads to a train of fymp¬
toms arifing out of hepatic derangement, which demand
ferious attention. It is not the leaft of thefe, that the
re-adling difeafe aggravates the gaftric difturbance, a cir¬
cumftance which very often perplexes us in the diagnofis.
But we mull poftpone further refearches till the fubjedt
of difeafed liver comes before us.

The connexion of urinary gravel with dyfpepfia is
worthy of particular notice. We are indebted to Dr.
Philip for an ingenious fpeculation on this fubjedl. He
tiiinks that it is not by fympathy alone that indigeftion
excites urinary gravel. He (hows that in moll cafes of
dyfpepfia there is a confiderable produdlion of acid in the
fir ft paflages; and this acid, as appears from his experi¬
ments, enters the mafs of blood, and is thrown out of the
fyftem by the Ikin and kidneys. As all other acids occa-
fion a precipitation of lithic acid from the urine when
the adlion of the Ikin is impaired, the one we are fpeak-
ingof often paffes in fuch quantity by the kidneys as to
caufe a depolition of lithic acid before the urine leaves
thefe organs, which there (probably in confequence of
being agglutinated by a fecretion which its ftimulation
excites on the internal fur face of the kidney) frequently
concretes into fmall maffes occafioning fits of gravel.

A precipitation of lithic acid is often obferved in the
urine of dyfpeptic patients, after it has Hood for fome
time ; and that the gravel which afflidls them is only a
greater degree of this fymptom, appears from the obferva-
tions of the bed writers on calculous difeafes, who con-
fider the calculi formed in the kidney to be almoft always
concretions of lithic acid.

Dr. Philip feems to confider, that, in difputing that
the kidneys are affedled by fympathy with the ftomach,
lie is borne out by the fadl, that while, as we have feen,
the other inteftinal organs are peculiarly liable to a flume
the inflammatory ftate of the fecond ftage of indigeftion,
the kidneys feldom fhow any tendency of this kind. This
affertion feems, however, by no means confonant with
experience ; but Dr. Philip obviates the difficulty by
faying, that, “ it is not uncommon, in indigeftion, for
the acrid ftate of the urine, arifing from the f'uperabun-
dance of acid and its other faline contents, occafioned by
the greater generation of acid in the alimentary canal,
and the inadlivity of the fkin, fo to irritate the urinary
paflages as to occafion frequent midlurition, and a fenfe
of burning, and other painful fenfations in thefe paflages,
even when no depofition of lithic acid takes place in
them.” Without attempting to invalidate this theory,
or even to prove diredt fympathy between the ftomach and
kidneys, we cannot help thinking, that an indiredl fym¬

pathy between the ftomach and kidneys, through the me¬
dium of the fkin, would account for the circumftance we
are confidering in a manner more confonant with general
principles, and equally capable of demonftration.

In profecuting further the groups of fymptoms which
a rife from dyfpepfia, cachedic diforders will hold a promi¬
nent rank. The marafmus both of infants and adults is.
often diredlly traceable to the undigefted ftate of the pa-
bula vitae, even where no affedlion of the abforbents of
the mefentery exifts ; fo that tabes, atrophia, &c. will
(as we (hall endeavour to fhow when thefe are on the
tapis) often gain relief from the treatment of dyfpepfia.
There is, however, one fpecies of cachedlic diforder which
we mu ft notice here for want of a more, fit place in our
nomenclature : vve allude to a ftate which has been de-
feribed by Dr. Hall as a variety of ( what he calls) th«
Mimofis acuta; and which appears an analogous diftem-
per to that noticed by many authors under the terms
purpura, Jcorbutus, &c. This affedlion is indicated by all
thofe fymptoms which we fhould naturally infer from a
morbid condition of the circulating fluids; for inflance,
by deficient adtion of the mufcular fibres, manifefted in
its larger ftrudlures ; by languor, indolence, and debility ;
and, in its Irnaller ones, by various topical congeftions,
and by haemorrhage ; and thefe latter are peculiarly re¬
markable on the (kin and the nervous expanfions. The
fkin, being prefled or otherwife injured, betrays extra¬
ordinary marks of want of tone, or of the refinance to,
and recovery from, unnatural agents, which healthy
ftrudlures fo remarkably difplay ; and it is fometimes af¬
fedled with a continued though variable ftate of fallow-
nefs, of yellownefs, or idlerode hue ; of darknefs, or of
a wan, fqualid, or fordid, palenefs of complexion ; or a
ring of darknefs furrounding the eyes, and extending a
little perhaps towards the temples and cheeks, and fo mu¬
tinies encircling the mouth ; and the gums, throat, &c.
are peculiarly liable to fall into ulcerations, haemorrha¬
ges, &c. Pains in the bones are often felt. We feledl a
cafe from Dr. Hall, which, though it does not exemplify
this complaint in its word form, yet is worthy of per¬
manent record, becaufe it ferves to trace the difeafe very
conclufively to a dyfpeptic origin.

“ E. M. aged"35, a framework-knitter, tall, flout, and
healthy, was employed, in 1815, in the moll a drive and
laborious manner, in hay-making; he was expofed to
great heat, underwent much fatigue, perfpired profufely,
and drank copioufly of beer and ale. He became affedled
with weaknefs, liltleffnefs, lofs of flelh, nodturnal perfpi-
ration, head-ache and vertigo, lofs of apetite, and idlertis,
with pale-coloured (tools and deep-coloured urine. He
recovered from thefe complaints; but in the year 1816
had the misfortune to break his leg. In confequence of
this accident and the fubfequent confinement, he became
and remained indifpofed ; he gradually loft flefh, and
from i4ftone, weighed between 12 and 13 only; and ex¬
perienced, on taking cold, a lofs of apetite and flrength,
with an inability to work, not known before. In No¬
vember 1817, he underwent much bodily exertion, and
remained expofed to the cold and damp. He took cold,
and became affedled with hoarfenefs, fore throat, a net
cough, with oedema of the ankles. Thefe fymptoms
ceafed, except the oedema, which receded however gra¬
dually ; but he was ftill affedled with the following com¬
plaints, which are copied from his own account of them :
Lofs of flefh, and of flrength ; a feeling of internal weak¬
nefs ; feverifhnefs, a parched and dry Hate of the throat,
and fometimes of the tongue; fenfibility to cold, chilli-
nefs, tendency to perfpiration, efpecially in the night;
head-ache ; fleepineis ; dulnefs of fpirits ; nervoufnefs j
fluttering at the heart and about the ftomach; cough-;
dyfpncea ; a clammy tongue and mouth, and foetid
breath ; lofs of appetite, fenfe of load at the ftomach,
occafional rejedlion of food, conflipation, and pain in the
chondiliac regions. This patient became much better
from the ufe of gentle purgatives of calomel, rhubarb, and

Epfom

130

PATHOLOGY.

Epfomfalt. ButinAuguft 1818, he became affeCled with
fevere and continued diarrhoea, with a lofs of flefh from
1 1 ft. alb. to ioft. 6lb. and lofs of ftrength, and aching and
wearinefs, and pain in the fhoulders, fides, and legs. He
again recovered under fimilar remedies ; but, in Novem¬
ber 1818, was taken with feverifhnefs, attended with a
parched tongue and mouth, fome delirium in the night,
and further lofs of flefh and of ftrength 5 and, at the
fame time, there occurred an extenfive ulceration of the
back part of the pharynx, and a confiderable difcharge
of bloody mucus from the noftrils. He was reduced
from 1 oft. plb. to 9ft. alb. This ftate continued, and ic¬
terus again occurred, with the ufual appearance of the
tunica albuginea, ikin, urine, and ftools. Soon after this
time I made the following lift of appearances and affec¬
tions in this poor fufferer’s complaint : 1. Swarthinefs of
complexion; 2. feverilhnefs, with parched throat and
mouth, and heat of the forehead and legs ; 3. tendency
to perfpiration 5 4. quivering of the chin and lips in
fpeaking, fimilar to that obferved before fhedding tears ;
5. tremor ; 6. fluttering; 7. lofs of flefh ; 8. difcharge of
bloody mucus from the noftrils, with ulceration ; 9. ul¬
ceration of the throat; 10. ifterus; 11. difcharge of
much blood and mucus from the bowels, preceded and
attended by pain of the abdomen, with tenefmus and
forcing; 12. the ftools, otherwife, light coloured; 13.
fome anafarca; 14. boils ; 15. painful ulcers on the legs.”

ConneCfed with the fame morbid ftate of the body ge¬
nerally, we have to obferve thofe anomalous and diftrefling
cafes which we denominate fiphilodes. But more of this
under that term.

Another cacheCtic difeafe muft be here treated of. We
have before fhown, that nervous excitement may produce
the phenomena of hyjleriu, whether it be derived from the
ftomach or uterus; and, in confidering chlorofis, there
feetns every reafon for fuppofing that a fimilar circum-
ftance occurs ; viz. that, while chlorofis is a difeafe gene¬
rally caufed by the want of due catamenial difcharges,
the want of proper digeftion, whether from deficient fen-
fation or morbid abforption, may fimulate, if not lite¬
rally produce, the fame complaint. A fadt refting on
good authority fpares us the trouble of reafotiing in proof
of this affertion : it is, that the male fex are by no means
exempt from attacks of this kind, efipecially the young
and fedentary. Chlorofis is evidently a bad term for this
aft'edtion ; nor do we like Dr. Hall’s term, Mimofis deco¬
lor, becaufe the expreflion of mimicking difeafe is not quite
applicable to it. We however borrow from that author
the defcription of it, and therefore admit for the prefent
his nomen.

Th e incipient Jluge of the Mimofis decolor is denoted by
palenefs of the complexion, an exanguious ftate of the
prolabia, and a flight appearance of tumidity of the coun¬
tenance, and puffinefs of the eye lids, efpecially the upper
one. There is fometimes a tinge of green, yellow, or
lead-colour, and frequently darknefs of the eye-lids.
There is great palenefs of the general furface, hands,
fingers, and nails; an opaque, white, tumid, and flabby,
ftate of the flcin ; a tendency to oedema of the calves and
ankles ; and a certain lofs of flefh. The tongue is white,
and loaded ; it is fwollen, marked by preffure againft the
teeth, or varioufly formed into creafes or folds ; its papil¬
lae are very numerous, and much enlarged. The gums
and the infide of the cheeks become tumid ; and the lat¬
ter, as well as the former, are fometimes impreffed by the
teeth. The breath is tainted. The patient is generally
languid, liftlefs, indifpofed for exertion, eafily overcome
by exercife, nervous and low-fpirited, drowfy, dizzy,
fainty, or breathlefs. There is generally fevere head¬
ache or vertigo ; the memory and power of attention are
apt to be impaired ; and there is fometimes. lieavinefs for
fleep. There is alfo, in different inftances, pain of one
or both fides about the falfe ribs, or in the hypochondriac
or chondiliac regions. Sometimes there is cough, diffi-
Vol. XIX. No. 1293.

culty in breathing, palpitation or irregular action of the
heart, or imperfeCt fyncope, and almoft univerfally a fenfe
of fluttering about the prsecordia. The appetite is gene¬
rally impaired. There is frequently a morbid appetite for
acids, or for magnefia. The bowels are conftipated, a
ftate which fometimes leads to diarrhoea ; the fasces are
dark-coloured, fcetid, and fcanty. The urine is fre¬
quently loaded. The catamenia become irregular, are
preceded and attended by much pain of the back and re¬
gion of the uterus, and fometimes, but not always, be¬
come flowly defective in quantity, and pale in colour.

In the confirmed ft age of this affeCtion, the ftate of the
complexion and general furface is ftill more marked. The
countenance is more pallid ; the prolabia and the gums
exanguious; or the prolabia, efpecially the upper one,
have a flight lilac hue; and the integuments are tumid.
The flcin is fmooth, but becomes preternaturally dry;
the integuments are puffy, opaque, and pale, or yellowifh ;
and there is a tendency to cedema of the feet. The
tongue becomes clean and fmooth ; but it is pale, with a
flight but peculiar appearance of tranfparency, and of a
pale lilac hue; and it remains a little fwollen and in¬
dented. The patient is now affeCied with languor, laffi-
tude, and even ferious weaknefs, being at once reluCiant
and unable to undergo fatigue. There are often attacks
of fevere pain of the head, or of equally fevere pain of
the fide ; and repeated bleeding, leeches, and blifters, are
ufually employed, affording a temporary refpite from
thefe complaints. There are alfo, fometimes, fits of dyfp-
ncea, of palpitation of the heart, or of fainting, with
beating of the carotids. The pulfe is rather frequent,
often about 100, and eafily accelerated and rendered irre¬
gular by mental emotion. The appetite is fometimes
impaired, occafionally greater than natural, and very fre¬
quently depraved, inducing a longing or conftant defire
for fome indigeftible fubftance, as acids or pickles, mag¬
nefia, chalk, cinders, fand, coffee-grounds, tea-leaves,
flour, grits, wheat, &c. which the patient likes to have
conftantly in her mouth, or to which recourfe is had when
Ihe fuffers from agitation of mind, (like the dirt- eating
negroes, p. 122, 3.) The bowels are flow and conftipated,
a ftate which fometimes alternates with diarrhoea, and in¬
duces melrena ; the ftools are dark, foetid, and fcanty.
The catamenia are attended with pain, and become paler,
and lefs in quantity, often ceafe, and often yield to a
ftate of leucorrhoea which is more or lefs conftant.

In the inveterate fiage, all the fymptoms affume an ag¬
gravated character. There is a very flow, but progreffive,
lofs of flefh. The languor becomes a ftate of permanent
debility. The cedema increafes, and takes on the aggra¬
vated form of anafarca. The pulfe becomes frequent.
There are lefs of the appearances of mere diforder, and
more of the charaCterof difeafe ; i. e. thofe local affections,
which exifted in a lefs continued manner before, now be¬
came either permanent, or are induced by the ftighteft
caufes ; and the patient can fcarcely bear the moft ordi¬
nary occurrences of domeftic life, and perhaps remains
always in bed. Sometimes there is an almoft permanent
pain of the head, perhaps with intolerance of light or of
noife; fometimes pain of the cheft, with tendernefs, diffi¬
culty in breathing, and cough. Frequently there are pain and
tendernefs of the abdomen, with ficknefs and conftipation,
or with diarrhoea. Different fymptoms reign in different
inftances ; as fome hyfteric or fpafmodic affeCtion ; a ftate
of locked jaw, clofed hand, contracted foot, or twifted
limbs; palpitation of the heart; hurried or fufpended
refpiration ; long fits of coughing, hiccough, retention
of urine. It is worthy of notice, that this chlorotic ftate
and the cacheCtic difeafes noticed before are often alter¬
nate, or run into one another.

An important connexion feems to exift between the
pathology of the ftomach and the mucous membrane of
the lungs. In the firft ftage of indigeftion, an irregular
and fpafmodic cough is often produced by nervous irrita-
O tion,

140

PATHOLOGY.

tion, as we have before feen; and, when the inflammatory
ftate has come on, an inflammation of the mucous mem¬
brane of the bronchia is no uncommon occurrence. In
cafes where predifpofition to difeafe exifts, idiopathic dif¬
eafe. enfues ; but more commonly a dependance on the
original diforder is ftill remarked in ftru&ures fecondarily
affe&ed. Affe£tions of more feverity, and which perhaps
have their feat more immediately in the parenchyma of
the lungs, are thofe which dyfpepfia gives rife to when
implicated with difordered liver. The latter vifcus in¬
deed holds a very important relation with the pulmonary
organs, whether in health or in difeafe. When we come
to treat ofinflammation of the mucous membrane of the
bronchiae, we Ihall fpeak more fully of the fympathetic
a£tion of the mucous expanfion. Suffice it to fay at pre-
fent, that communicated difeafe is frequently obfervable
between the ffomach and lungs. Dr. Haftings, in his
Treatife on Bronchitis, has very accurately delcribed the
difeafe in queftion. It is diftinguilhed by the ufual figns
of bronchitis (which fee) ; fuch as, tightnefs of the cheft,
cough, copious expeftoration, &c. and the further pre¬
fence of various dyfpeptic fymptoms, as well as indireftly
by the effect of remedies ufed in indigeftion. But often
more fevere difturbances arife ; and the violence of the
fymptoms approaches clofely to the charafteriftics of
ftrudtural alteration. Indeed every one fees cafes appa¬
rently of phthifis which yield to the treatment for indi¬
geftion. For our own part, we wilh to confine the word
phthifis to the apoftematous or tubercular kinds. Now,
with regard to the former, we conceive nc one will aflert
that it is curable by dyfpeptic treatment ; and, with re-
fpe£t to the latter, fcarcely a bolder prognofis will be
given. It muft be conceded, however, that the latter form
of difeafes may be thus cured. Mr. Abernethy has de-
monftrated to a mathematical certainty, that the repara¬
tive procefles are beneficially influenced in thehigheft de¬
gree by the treatment in queftion ; and we have only to
extend this eftablifhed propofition from the vifible exter¬
nal parts to the internal furfaces ; yet, in fo doing, we
muft confider, that both the perpetual motion and the
aerial ftimulation of the pulmonary organs, render repa¬
ration of ftrufture a moll difficult talk in them. More¬
over it is acknowledged that we have no pathognomonic
lign of phthifis; that not even the vomiting of pus can
render the exiftence of apoftema unequivocal, fince pus
may be fecreted from the mucous membrane in certain
ftates of inflammation ; and therefore we Ihall conclude,
that ftomachic medicines can be ufed as direct agents only
where neither apoftema nor tubercle exifts. We muft be
careful, however, where ae fix the bounds between fym¬
pathetic and real difeafe. In the 43d, 44th, and 45th,
ieftions of Morgagni’s 21ft Epiftle, we find the difeafe
which he calls the pleuritis verminoja treated of at fome
length. The author mentions one cafe, in which all the
fymptoms of pleurify were well marked, that terminated
favourably by bloody vomiting which brought up a worm;
and he refers to a paper of Pedratto on the pleuritis vermi-
nofa, where the relief obtained by the expulfion of worms
from the ftomach and inteftines is unequivocally proved.
In this paper it appears, that all who vomited the worms,
or palfed them by the bowels, recovered ; while thofe who
retained them died. All the common means of treatment
in inflammation of the lungs failed; medicines which
deftroyed the worms were alone fuccefsful. While their
expulfion immediately removed the difeafe, it is impoffi-
ble for us to believe that organic alteration of the lungs
had taken place ; yet in thofe in whom the difeafe had
been allowed to take its courfe, the fame appearances
were found in the thoracic vifeera as in thofe who die of
other forms of idiopathic difeafe. Analogous cafes are
not unfrequently obferved at the prefent day.

In regarding the connexion above mentioned, we often
find that the difeafed action of the digeftive apparatus is
caufed by the pulmonic irritation, and that the action fo
induced keeps up and increafes the latter irritation.

Thefe cafes are however rare, when compared with thofe
in which dyfpepfia is firft manifefted ; and they are feldom
found till difeafe has been of long continuance. It is
generally preceded by fymptoms of indigeftion, and par¬
ticularly by thofe which indicate fome diforder in the fe-
cretion of bile. Contrary to what is ufual in other fpe-
cies of the difeafe, the fpirits from the beginning are
generally more or lefs deprefled, and the countenance is
fallow.

While the firft ftage of indigeftion remains, and ner¬
vous irritation is the only caufe of the cough, the latter
is ufually dry, or the patient brings up a little mucus
after a fevere and often long-continued fit of coughing,
which feems to be rather the eft'edl of the irritation of
coughing than any thing which had previoufly exifted in
the lungs ; for the cough in this fpecies of confumption,
particularly in its early Itages, frequently comes in violent
fits, in the intervals of which the patient is often but
little troubled with it. Thefe fits are particularly apt to
occur after he has eaten, efpecially if he has eaten a great
deal, or any thing by which the digeftion is difturbed :
and on lying down.

As the fecond ftage arifes, bronchitis is the moft ufual
form of difeafe. The cough becomes more frequent, re¬
turns lefs decidedly by fits, and is attended with a more
copious expectoration.

An expectoration at firft limpid or glairy comes on.
As the difeafe advances, this increafes, though fometimes
for a confiderable time without puruloid characters. By
degrees, however, we fee fmall portions of an opake pus¬
like fubftance mixed with the expectorated mucus, and
the proportion of it increafes as the difeafe advances. In
fome cafes the quantity expectorated is aftonifhing, often
much greater, in proportion to the feverity of the other
fymptoms, than in idiopathic bronchitis.

Blood is not unfrequently mixed with the colourlefs
matter, and fometimes pure blood is coughed up in the
early ftage of the difeafe. After the pus-like expectora¬
tion commences, if blood has not previoufly appeared, it
is much lefs apt to appear than in other forms of the dif¬
eafe. If it appear even in fmall quantity after this ftage
commences, Dr. Philip fays that the cafe generally proves
fatal. The above-mentioned author is likewife of opi¬
nion that, while the blood is mixed only with a tranfpa-
rent fluid, there may be good hopes of recovery; or, if
there be no admixture of blood, there may be alfo hopes
of recovery, if the difeafe has not lafted long. But, when
the expectorated matter affumes a fanious appearance, it
feems to indicate much danger. In thefe cafes there is of
courfe the dull pain and tendernefs in the epigaftric re¬
gion of the fecond ftage of dyfpepfia ; and in progrefs of
time, an irregular heCtic is formed, differing, however,
from the true tubercular heCtic ; for, though there is
ufually fome evening exacerbation, during which the
face is generally flufhed, and though the hands and face
are occafionally bedewed with perfpiration in the night ;
thefe go off before morning. The emaciation too, though
it becomes very perceptible, does not proceed fo rapidly
as in tubercular phthifis.

The latter circumltance feems to difplay itfelf in the
fame proportion as the fever. Anorexia, flatus, tender¬
nefs over the liver, pain in the fhoulder, or other hepatic
or dyfpeptic fymptoms, are invariably prefent; and, though
they vary at different times, the patient is never free from
fome of them. The connexion between them and the
pulmonary fymptoms is rendered evident by the latter
increafing with the former ; fo that, when the epigaftric
region is very full and tender, and the flatulence and acid¬
ity more troublefome than ufual, the cough and dyfpncea
are fo alfo; and, on the former fymptoms fubfiding, the
latter likewife abate. Even the rifing of wind from the
ftomach, often, for the time, removes the tendency to
cough.

If the progrefs of the diforder be not checked, the
fymptoms approach ftill nearer to thofe of tubercular

phthifis.

PATHOLOGY.

phthifis, or in fatt that difeafe is formed. He£Hc fever
becomes completely formed, and the patient is wafted
with profufe perfpirations, anafarca and other dropfical
fymptoms often fupervening.

As the pulmonic difeafe becomes more clearly formed,
the difeafe of the alimentary canal diminishes, as we
have before Ihown it is apt to do when idiopathic difeafe
(which operates as a derivative) is fet up ; and this occur¬
rence leads of courfe to a fearful prognofis.

The intimate connexion between gaftric and cutaneous
difeafes has been clearly pointed out by Mr. Abernethy,
and the belt practical phyficians of the day. Indeed the
natural fympathy which is perceived between the ftomach
and the lkin would lead us to expeft fuch a connexion.
It is not ftrikingly evinced, however, in moderate tempe¬
ratures, and while no extraordinary agent' is in aflion ;
but, when in a high range of atmofpherical heat, when
the veflels of the lkin are excited, and the procefs of per-
fpiration is increafed, we clearly obferve this confent be¬
tween the lkin and ftomach, as evinced by want of appe¬
tite ; an effeft which is greatly increafed, if to the exter¬
nal ltimulus of high temperature we add fatiguing ex-
ercife, whereby the perfpiration is morbidly excited, and
the indireft debility of the fub-cutaneous veflels and
ftomach (by fympathy) induced. Hence, after pedeftrian
exercife in the forenoon during the heat of fummer, and
after the perfpiratory veflels have become relaxed, we find
a fenfe of fainting at the ftomach, and anorexia ; while,
on the contrary, as the weather becomes cool, and the
veflels of the lkin contrafted thereby, we perceive the fym¬
pathy in queftion exerted in the oppofite mode ; for a fti-
mulus is quickly communicated to the ftomach and the
appetite is keen s and again, when the degree of cold is
fo great as to induce permanent debility of the veflels of
the furface, and this is not immediately counteracted by
exercife or clothing, the ftomach, as well as other organs,
inevitably fympathifes, and the important procefs of di-
geltion is interrupted.

As further inftances of this fympathy, we may adduce
the effeCts exhibited on the lkin by a glafs of water or
wine taken into the ftomach j the breaking-out of fweat
which enfues to fome as foon as acids are applied to the
cefophagus ; and, when we add to thefe faCts the nume¬
rous examples which daily occur of furfeits, and the de¬
rangements in the colour, fenfation, and function, of the
furface immediately consequent on a debauch, we fhall
have no doubt in deciding, that, in nine cafes out of ten,
cutaneous foulnefs and gaftric irritation are related to
each other as caufe and effeCh

Among the numerous painful fenfations and impeded
functions which we have had occafion to enumerate as
confequences of dyfpepfia, we believe there is not one
which, primarily occurring, will not produce, as well as
follow, that difeafe. Thefe derangements in the circu¬
lating media, all nervous irritations, all agents fufficiently
powerful to control the actions of the living powers,
impediment in any part of the refpiratory or aflimilating
apparatus or in the functions of the mind, all fortuitous
lefions, will, unlefs counter-irritations or predifpofitions
to difeafe exift in other parts, produce indigeftion. This
eftablifhed, it ferves to fhow the imperious neceffity that
there is to ftudy the caufes of dyfpepfia, and to direCf
our therapeutical maxims accordingly ; and, in fo doing,
what a large fund of observation this enquiry admits of,
when we turn back to confider the formidable though in¬
complete lift which we have already detailed.

In confidering, therefore, the treatment of dyfpepfia,
we fhall revert to what we faid, at p, 128, of its firft caufes.
The contemplation of thofe which aCt by influencing the
nervous fyftem of the ftomach, is of courfe the molt ex-
tenfive. It is by this medium that local injuries and to¬
pical inflammations, intenfe ftudy, See. produce gaftric
diforder ; and, when the complaint in queftion is thus
traced as a confequence, the treatment is obvious. There
are fome nervous imprefiions, however, which, though

141

not themfelves continued, induce a train of morbid ac¬
tions which foon exhibit the form of dyfpepfia.

Of thefe imprefiions, the moll frequent is the ftate of
the atmofphere. The influence of falubrious air in pro¬
moting healthy digeftion cannot indeed efcape the moft
fuperficial obferver. This fluid feems to operate bene¬
ficially in various ways. Thus it may promote digeftion
by the excitement to mufcular aftion which its ftimulus
produces, by the elevating and pleafurable mental emo¬
tions its purity excites, or its healthful impreffion on
the mucous membrane of the lungs may be tranfmitted
more direftly to the ftomach. Hence it follows, that, on
the other hand, the want of due materials for refpi ration
muft be feverely felt in the digeftive function. The at¬
mofphere afts on the lkin only by its temperature; but
the frequent variations in this refpeft which our own
country is fubjedt to, has been long confidered a fruitful
fource of bodily ailments. It does not feem that either
the cold or heat of our own climate is particularly inju¬
rious, lince the compenfating powers of the conftitution
foon render us equal to either extreme ; but that it is the
fuddennefs of the change which is fo obnoxious to our
health 5 for, while heat augments the cutaneous capilla¬
ries, both in fize and in frequency of aftion, (an eft’eft
which extends to fome extent along the arterious trunks,)
its abfence induces a diminution of their parietes, and
a more-permanent and lefs-frequent contraction ; and,
of courfe, a fudden change from one to the other of
their ftates tends to diforder the contradlibility of the
atonic velfels, by fympathy of thofe of the lungs and ali¬
mentary canal, and by another modus operandi of the
general circulating forces.

From thefe premifes the management of the dyfpeptic
patient, in regard to air, follows in the moft obvious
manner. The viciffitudes of the climate he cannot of
courfe control ; but he may avoid the more frequent
and feverer changes of temperature to which his own im¬
prudence expofes him. We of courfe allude to the
falhionable modes of dreffing, and the habit of being out
in the night-air. See. Thefe errors, however, have been
feverely inveighed againft by a multitude of writers, and,
as might have been expedited, with little good to the
community, few members of which have the refolution
or the inclination to conquer habitual indulgences. It
remains our duty, therefore, to point out the heft prevent-
atives of danger during the expofure of invalids to the
influence of nocturnal temperature. Thefe methods we
have extracted principally from the writings of Dr. James
Johnfon.

After adverting to the deleterious combination of cold
and moifture found in the night- air, this gentleman re¬
marks, that there are five circumftances to be attended to
when we are fubjedted to its influence ; viz. 1. The con¬
dition of the body before going out of doors. 2. The de¬
fence of the body’s furface while expofed. 3. The de¬
fence of the lungs. 4. The exercife on the way. 5. The
condudV to be obferved on getting home.

1. The condition of the body ought to be as warm as
poflible, (hort of perfpiration. Many lives are annually
loft by the ill-judged caution of lingering about the
halls and doors of the heated apartments till the body is
cool, before venturing into the air. In this ftate it is
highly fufceptible of the baneful influence of the night.
It would be better to iffue forth, even with fome per¬
fpiration on the furface, than wait till the fyftem is
chilled.

2. Upon the fecond point we need not enlarge. The
frequent fight of thick coats, cloaks, See. clearly evince
that our countrymen do not offend much againft this re¬
gulation.

3. The defence of the lungs cannot be too ftrongly en¬
forced. They fliouid be guarded from the direft influ¬
ence of the night-air by fuch mufflings about the face
as may detain a portion of the air expired from the lungs
each time, and thereby communicate a degree of warmth

to

PATHOLOGY.

142

to each inhalation of atmofpheric air. A large net, for ex¬
ample, folded loofely round the face, will receive a por¬
tion of caloric, or heat, from the breath, at each expira¬
tion, which portion will be communicated to the current
of air rufliing into the lungs at each infpiration; and
thus the frigidity of the nofturnal atmofphere will be
in fome degree obviated.

4. As we proceed into the night-air while the body is
warm, fo we lhould, by a brilk pace, endeavour to keep
up that degree of animal heat with which we fet out,
and that determination to the furface which is fo effec¬
tual in preventing affeftions of any internal organ.

5. As the fudden tranfition from a heated apartment
to a frigid atmofphere muff, in fome degree, produce a
determination to the centre, and more or lefs check the
perfpiratory procefs, fome warm and moderately-ftimu-
lating liquid may be taken before going to bed, in order
that the functions of the Ikin and the balance of the cir¬
culation may be reftored ; unlefs, as is often the cafe in
nervous fubjefts, fpirituous potations caufe reftlelfnefs
and want of fleep.

It is of confequence, moreover, that the dyfpeptic pa¬
tient lhould avoid the thick fogs and damp air which fur-
round all large towns or manufactories 5 and that he
lhould therefore remove from fuch fituations into the
open country. Or, in cafe his refidence in foreign
regions, whether northern or tropical, is the probable
caufe of his indifpofition, a return home is of courfe the
obvious remedy.

As a further method of obviating atmofpherical im-
preffions, the nature of our clothing requires fome at¬
tention. Dyfpeptic patients lhould not only endeavour
to wear a lighter and warmer clothing than is ufual, but
adopt a more uniform fyftem of attire throughout the
year ; in which cafe they will, in a great degree, obviate
the keen fufceptibility to aerial impreflions for which they
are fo remarkable. They lhould avoid likewife the
falhionable habits which exift in regard to frequent
changes of drefs. The fair fex in particular, and the lefs
robuftof our own, are obferved to wear a warm drefs in
the fore part of the day, a period when the fun is mod
powerful, and when exercife is more ufed ; while the
evening or dinner drefs confifts of garments of the thin-
neft texture, when the frame is more exhaufted, and the
air damp and cold. No words are required to point out
the injury fuch a praftice muff inflift on the patients of
indigeffion.

We have before adverted to the effeft of ftudious
habits on the procefs of digeftion. Perhaps a few
words on the management of the mind will not be
mifplaced. We do not wilh, far lefs hope, to check the
patient and abftrafted exertions of genius; but, if it
can be Ihown to the philofopher that knowledge will more
kindly open her ftores to him who has not corporeal ail¬
ment to deftroy the balmy refrelhment of fleep, and whofe
enthufiafm is not liable to be dulled by baneful hypo-
chondriafm, he will perhaps be induced to fpend fome of
his exiftence, we truff not unhappily, in the lighter difli-
pations of converfation, and in the cheering influence of
corporeal movements. It will not be loft time. Health
has always been confidered the refult of a general and
pervading harmony ; that, while one part or ftrufture
afts for the fupport of life, another refts. Even the heart,
powerful as it is, refts and afts alternately. All other
organs obey the fame law ; they have longer intervals of
exertion and relaxation, it is true; but ftill they have
them. Shall the brain only receive none ? Without en-
lifting ourfelves on the fide of the philofopher who faid
the mind always thinks, we may fafely alfert, that, ex¬
cept during fleep, the brain is perpetually occupied in re¬
ceiving impreflions, or in performing its own internal
operations. If fleep, then, be the only time it is exempt
from this toil, how impaired mull the functions of that
cerebral ftrufture be which experiences but imperfeftly
and for Ihort periods the influence of “tired Nature’s

fweet reftorer !” But it is not only by tending to deftroy
fleep that too long application weakens the faculty of
thought; the time borrowed from the due exertion of the
mufcular fyftem is certainly ill applied. That abforption
and circulation are facilitated by mufcular motion will
be admitted on all hands : and whence does the brain de¬
rive its fuftenance, but from the circulating powers ?
And further, who has not felt how at times his mental
energy in a few hours of application rapidly overtakes,
nay furprifingly outdoes, the laborious ftudy of days,
when he toils “ invita Minerva !” The ftudent, therefore,
fhould endeavour, above all others, to exercife in fome
degree all his powers, his funftions, and his faculties.
His employments naturally tend to make him abftinent;
and we are well allured, that, if he does not difdain the
ufeful lefl'ons of experience in regard to his bodily infir¬
mities, he will find no reafon to coincide in the melan¬
choly but frequent afl'ertion, that intellectual grandeur
and corporeal energies are incompatible ; nor will Ovid’s
defcription (pallor in ore fedet macies in corpore toto)
be longer applicable to him.

To apply the fubjeft of the management of the mind
more clofely to indigeftion, our prefent fubjeft. The
proper exertion of the mind is perhaps too little attended
to by dyfpeptics ; yet it is of much importance ; for men¬
tal anxiety is no unfrequent fource of the complaint in
queftion, and is always an aggravation of it. Fortunately
many of the exercifes which are good for the body aft
favourably on the mind alfo ; as for inftance, the lefs-la-
borious employments of horticulture and hufbandry ; the
driving of a gig, riding on horfeback, See. Occafional
occupations in certain games, in which fome degree of
corporeal exercife is combined with the employment of
the mental faculties, as billiards and the like, are fervice-
able. We lhould principally feleft fuch amufements as
at the fame time do not engage the feelings too deeply.
The glow which poetry infufes over the foul may be fafely
indulged in by the man of bufinefs, or by thofe who follow
profeflions in which the reafoning faculties alone are called
into play. But fuch indulgence is perhaps unfavourable
to the poet himfelf. We may admit for the occafion the
fable of old, (fee the article Music, vol. xvi.) and try
the delicious influence of fw'eet founds over the morbid
feelings of the patients in queftion. Some, on the other
hand, require the avocations of bufinefs, which lhould
be diverted however of the anxiety ufually attendant.
The variety of men’s minds requires however the contem¬
plation of objefts of different kinds, though the grand
rule is, in refpeft to the mind as in the body, to exercife
without fatiguing it. But we may be fpared entering
into any thing more than hints, as the fubjeft requires
particular application rather than general rules.

The fecond caufe of derangement of the gaftric func¬
tion, viz. by diftention of the mufcular fibre, is next to
be confidered. We purpofely omit at prefent the diften¬
tion produced by chemical change arifing from a want of
nervous power or of fecretion. It remains, therefore,
to confider diftention only as far as regards the too-great
quantity, or the gazeous or fwelling quality, of the ali¬
ment received.

The mod common caufe of diftention of the ftomach is
eating too fall ; for, the appetite only fubfiding in pro¬
portion as the food combines with and neutralizes the
gaftric fluid, this praftice inevitably tends to induce per-
fons to eat more than is requifite or natural ; and, as the
gaftric fluid is but flowly 'fecreted, the major part of the
food remains in a place favourable, on account of its tem¬
perature, to chemical change without being fubmitted to
the counterafting influence of the gaftric fluid : whereas,
when we eat flowly, fo that a proper time is given for the
combination to take place, the appetite abates before the
ftomach is overcharged : for, while digeftion goes on,
and the gaftric fluid is only fupplied in proportion as frelh
food comes in contaft with the coats of the ftomach, it
combines with the food as it is formed, and never excites

the

143

PATHOLOGY.

the appetite. The truth of this is evident to every one
who has obferved that, if his meal is interrupted for ten
or fifteen minutes, although he has not eaten half his ufual
quantity, he finds that he is fatisfied. The gaftric fluid
which had accumulated has had time to combine with,
and be neutralized by, the food he had taken. On the
fame account a few mouthfuls taken a little before dinner
will often wholly deftroy the appetite, efpecially in deli-
cate people, in whom the galtric fluid is fecreted in fin all
quantity, or of a lefs aftive quality. Moreover, when we
eat too faft, the food is not only received into the ftomach
in too great quantity, but is fwallowed without being
duly mafticated and mixed with the faliva, and therefore
without properly undergoing what may be confidered the
fir ft procefs of digeftion. It is thus prefented to the fto¬
mach in a ftate in which the gaftric fluid pervades it, and
confequently a fits upon it, with more difficulty. In this
way eating too faft is injurious, even when the patient eats
but little. For thefe reafons, “ to eat moderately and
(lowly,” is often found of greater confequence than any
other rule of diet. The dyfpeptic, in eating, (hould care¬
fully attend to the firft feeling of latiety. There is a
moment when the reliffi given by the appetite ceafes § a
Angle mouthful, taken after this,oppreffes a weak ftomach.
If he eats (lowly, and attends carefully to this feeling, he
will never overload the ftomach.

Another frequent caufe of over-diftention of the fto¬
mach is high-feafoning and great variety of food, or fuch
as particularly pleafes the palate, by which we are induced
to eat after the appetite is fatisfied ; or, by the ftimulus of
the high-feafoning, a greater fupply of gaftric fluid than
the food call's for is excited, and thus the appetite pro¬
longed. This feems in particular to be an effeft of wine
drank duringdinner; and this praftice, although it occa-
fions lefs immediate inconvenience than eating too faft,
often, if carried very far, by the preternatural excitement
of the ftomach, at length impairs its vigour. It is not
uncommon, in the diffeftion of fubjefts who have greatly
indulged in the pleafures of the table, to find the ftomach
enlarged, and its fibres fenfibly relaxed.

The degree of diftention which the ftomach undergoes
alfo depends much on the kind of aliment. All food ap¬
pears to fwell more or lefs after it is received into the fto¬
mach 5 fome kinds more than others, and of courfe that
which is moft difficult of digeftion, cct. par. fwells molt ;
both becaufe it is digefted and removed from the ftomach
moft (lowly, and becaufe that which moft refills the aftion
of the gaftric fluid is moft apt to run into fermentation.

It would take up too much time to mention all the
kinds of food which are prone, by their gazeous condi¬
ments, to produce gaftric diftention. Generally fpeaking,
vegetables have this effeft in a much greater degree than
animal food, and in a crude ftate efpecially. Bread often
produces it 5 and it is probably on the fame account that
malt-liquors, taken during meals, exert a pernicious in¬
fluence over digeftion. Diftention of the ftomach is alfo
produced by too much drink, or, as with refpeft to food,
by fwallowing it with too great rapidity.

Now, with regard to the third origin of dyfpepfia, dis¬
ordered fecretion, it arifes in moft cafes out of the two
former dates; and, the errors or accidents producing
them being removed, the effeft generally ceafes. When,
however, it becomes eftablilhed, its removal implies a
much wider indication. In the firft periods of difeafed
fecretion, this fluid is perhaps not much impaired in its
digeftive properties, though diminiflied in quantity, and
pollefled of fome additional condiments. Emulations of
various kinds, pain, &c. now occur, but with little gene¬
ral difturbance, which, as wefaid before, a little attention
todietfoon fets to rights. In this llage we agree with
Dr. Philip in thinking, that a diet compofed of a mode¬
rate portion of animal food and bread is the bell ; but of
courfe this rule will be daily excepted againft on account
ot conftitutional peculiarities.

Though the coB/fid oration of diet is again before us, af.
Vol. XIX. No, 1293.

ter the ample notice we have bellowed on this fubjeft,
(p. 102-106.) it would be fuperfluous to do more than
briefly recapitulate the rules to be adopted. Thefe are
only to be underltood, and will always be bed remembered,
by a knowledge of the digeftive procefs. The patient of
indigeftion will therefore in the firft place attend to the
due maftication of his aliment ; to its moderately (low
tranfmiffion to the ftomach 5 to its degree of moifture,
which regards the two points, that it be fufficiently moilt
to allow the pervafion of the gaftric juice without weaken*-
ing that fecretion by dilution, and without producing
fermentation by its own excefs. He will take efpecial
care, when he confiders the nature of the propulfive
power of the ftomach, that he offers no impediment to
that function by taking violent exercife during digeftion.
He will carefully note and partake of thofe fubllances
which on their reception into the ftomach produce lead
pain or irritation. He will avoid thofe, on the contrary,
which produce any ill feeling; namely, for the moft part
the tough, oily, oracefcent, particles of food. Nor (hould
various kinds of food be taken at once by the dyfpeptic.
Few patients will digell well more than one fort of ali¬
ment at a meal. Moreover, the popular notion of
taking little and often is to be regarded as a popular
error: and when it is confidered, that the maftication and
other precedes belong to digeftion, that economy in which
nothing is vain, and which are in faft indifpenfably necef-
fary, the dyfpeptic (hould not evade the neceflity of fuch
precedes by taking aliment reduced to a pultaceous con¬
fidence. We dwell on this point, becaufe it is fo common
to hear of nour'Jhing food, an expreffion which, in its
common acceptation, is meant to imply the capability of
certain fubllances to nourilh our frame rather by its own
nature than by that of the digeftive aftion. Thus a va¬
riety of jellies, rich foups, &c. are laviflily bellowed on
the emaciated fufferer, and thefe greafy llimulants fail
not to deftroy the little remaining function which the
ftomach may poffefs. Dr. Philip fays very wifely, when
fpeaking on this point, that, “ however impofing the
plans of concentrating much nutriment in a fmall com-
pafs may at firft view appear, we may be well adured, that
in fuch concentration fomething is taken away from what
nature deligned for our food, which is ufeful to us.”
Thus moft dyfpeptics find, that potatoes, for example,
finely maflied, although without any admixture, are more
difficult of digeftion than when properly mafticated. To
mention a more ftriking faft : it has been fliown by the
chemifts, that a very clofe analogy, an apparent identity
indeed, exifts between fugar and the chyle which is de¬
rived from vegetables; yet a horfe fed on fugar will not
live a month.

The relation which exifts between all the ftruftures of
the body, and the neceflity of preferving a proper corre-
fpondence of energy between the nervous, the vafcular,
and the mufcqlar, ones, fince they are all connefted in
the alimentary canal, at once (hows the propriety of cor¬
poreal exercife in indigeftion : for the exercife of the vo¬
luntary mufcles affords energy, not only to them, but to
the involuntary movements, and gives, as is well known,
much a (fi (lance to the circulatory powers. But the bodily
exercife of dyfpeptic patients is a matter of nice and dif¬
ficult diferimination ; for it is well known, that, how¬
ever falutary exercife may be to a certain extent, yet that
its excels tends to produce confequences direftly oppo-
fite. Sleep, appetite, and digeftion, which are improved
by gentle exercife, are often fufpended after violent fa¬
tigue or exertion. The weak ftate of the rnufcular fyf-
tem in fome cafes is another ftrong argument in favour
of medicating the degree of locomotion, and of caution¬
ing patients not to run into the common error of fa¬
tiguing themfeives, under the idea of ftrengthening their
frame by ftrenuous exertions.

In the firft ft age of indigeftion, and ere much debility
arifes, walking during the interval of digeftion is un-
queftionably the bell exercife. It is, in the firft place,
P p very

PATHOLOGY.

144

very agreeable, and it Teems moreover the raoli natural.
There is no other accompanied with fuch a uniform and
regular exercife of the mufcles and joints ; and, from the
valvular ftru<5lure of the veins of the extremities, it is
better fitted than any other to promote the circulation,
and confequently all the functions of the fvftem.

The effeil of riding on horfeback upon the abdominal
vifcera is peculiar and faiutary ; and the jolting of a brifk
trot Teems, without inducing fatigue, to give tone to and
promote the adtion of the bowels and liver in an eminent
degree. In the more advanced ftages of indigeftion, this
delightful exercife becomes injurious 5 and little elfe can
be borne, except the walking pace of the horfe. It is
feldom, however, advifable to ride at ail at this period,
fince at the pace juft mentioned the patient is fubjedled
to the baneful effedl of diminifhed temperature. It is
better therefore to indulge in the eafe of a carriage ; and,
as this becomes too irkfome from its vibratory motion,
failing is a gentler mode of exercife. It has the credit of
being ferviceable in almoft all cafes of debility, and has
been found particularly fo in debility of the ftomach and
bowels. But even this exercife, except in warm weather,
is unadvifeable on account of the expofure to cold air.

Whenever thefe paflive exercifes cannot be borne, the
dyfpeptic may find much relief from the ufe of fridiion,
as he likewife might experience from the refrefhing prac¬
tice of champooing ; wdiich, unfortunately however, is
unknown in this country.

Thereafter will find the fubjedl of paflive exercife well
treated of in Dr. J. Johnfon’s work on the Atmofphere
and Climate of Great Britain, p. 197, & feq. We extradl
a portion, in which however it will be feen that the
learned author differs in fome meafure from the view's we
have taken in regard to exercife after meals. He fays,
“ During geftation, for inftance on horfeback, the fto¬
mach, liver, inteftines, indeed the whole digellive appa¬
ratus, experience a fucceflion of (hocks, which develop
the tonicity of thefe organs, and favour the exercife of
their fundlions. If the ftomach be empty, geftation
awakens the digeftive powers, whets the appetite, and
induces hunger: if that organ be moderately filled with
food, the whole chylopoietic fyftem, enlivened by gefta¬
tion, executes with greater facility, promptitude, and per¬
fection, the elaboration of nutritive matter; and the
whole fabric receives, in confequence, an acceflion of
ftrength. Hence people afflidted with anorexia, or diffi¬
culty of digeftion, experience the moft marked benefit
from paflive exercife, efpecially if ufed before the hour of
repaft. When ufed by them after meals, it muft be mo¬
derate in degree, and gentle in manner. Thus we every
day fee invalids, to whom digeftion is a painful procefs,
efcape the feelings of fatiety by a gentle ride on horfe¬
back or in a carriage after dinner. In this refpedt muf-
cular or adtive exercife differs eflentiaily from geftation.
To run, to dance, to play at cricket, immediately after
eating, is to aflail the ftomach with violent fuccufiions
which derange the natural order of its movements, and
diffipate on the voluntary mufcles thofe vital forces and
energies which ought to be concentrated on the organs
of nutrition.

“ But it is not on the procefs of digeftion alone that
geftation exerts a beneficial influence. It enlivens the
whole abdominal circulation of blood, but particularly
that of the various branches of the vena portarum. It
thus affedls the hepatic fyftem, facilitating both the fe-
cretion of the bile, and its elimination from the dudts of
the liver into the duodenum. It increafes the periftaltic
motion of the inteftines ; in confequence of which, the
chyme is prefented with greater regularity and rapidity
to the mouths of the ladleals, and the chyle is poured,
in a freer current, into the blood-veflel fyftem.”

When thefe meafures fail, when exercife does not in¬
duce thofe trains of adlion which lead to health, and
when the abftradtion of noxious particles of diet fails in
the fame purpofe; it becomes neceflary to have recourfe

to medicine. It feldom happens, however, but that dyf-
pepfia alone will yield to the meafures above mentioned :
when it does not, we fhould be always fufpicious of the
extenfion of the difeafe. The bowels are, as we have be¬
fore fliown, the parts moft difpofed to participate in the
difeafes of the ftomach ; and therefore our treatment
fliould not unfrequently be direfted to them. Indepen¬
dently however of the implication of the bowels in the
common afteflion, the adlion of certain medicines on
thefe vifcera is beneficially exerted on the fecretions of the
ftomach and liver. Purgatives promote thofe fecretions
in two ways : by the mechanical ftimulus derived from
the periftaltic motions of the bowels, and through the
medium of that fympathy fo remarkably obfervable in the
continued mucous ftrudlures. The proper ufe of ape¬
rients is a fubjedl of great importance at all periods, and
in all dates, of indigeftion. In the period under conii-
deration, their objedl is merely to fupport a regular adlion
of the bowels, which, as the fecretions of the whole canal
are inclined to fail, and the ftomach and upper bowels do
not difcharge their contents fo readily as they ought to
do, fhould be rather freer than in health. Different ape¬
rients fu it different conftitutions.. For the purpofe of
fupporting a regular adlion of the bowels, we recommend
pills compofed of ipecacuanha, compound extradl of colo-
cynth, and foap, with the addition of a little gamboge
when they are not fufficiently adlive, to be taken occafion-
ally at bed-time. But we abound fo much in forms of
aperient medicines, that it were wafting time to mention
many of them in this place.

It is a common pradlice to give fome form of mercury
to patients labouring under indigeftion ; and, in confe¬
quence of the ftimulus this mineral exerts on the liver,
its ufe is generally beneficial ; but as a Ample aperient it
fhould not be reforted to, and that for two reafons : the
firft, that it exerts a prejudicial influence on the fecretion
of the gaflric juice ; and fecondly, becaufe it has the effedl
of often doing more than we require 5 as for inftance,
when it falivates (which it will fometimesdo in very fmall
quantities), or when it excites ftrudlures undifeafed, and
thus deftroys the balance of adlion to the reftoration of
which our endeavours are ofteneft diredted.

The ufe of aperients alone is not however always fuf-
ficient. The difordered fecretion of the ftomach conti¬
nuing, it becomes neceflary to excite the fecreting veffels
by artificial ftimuli, for the purpofe of altering their adlion
on the blood, and cauiing them to elicit more appropriate
fluids ; as well as of exciting the mufcular fibres and ttie
nervous expanfions to carry off their load. Among thefe,
bitters hold the firfl rank. Thofe in common ufe are —
gentian, chamomile, bitter orange-peel, wormwood, co-
lumba, and bark. We are not of opinion that much dif¬
ference exifts in the merits of thefe vaiious fubftances.
Many pradlitioners ufe one or the other of them exclu-
fiveiy, and perhaps with nearly equal fuccefs. It feems
that the chamomile, orange-peel, gentian, and worm¬
wood, are lefs inclined to promote the general circulation ;
and are therefore preferable when a plethoric ftate of fyf¬
tem is obfervable. On the other hand, the cafcarilla,
columba, and the Peruvian bark, exert a more general
influence on the fyftem; and are therefore proper when,
from the irritation of the nerves of the ftomach, the cere¬
bral mafs communicates too languid an impreffion to the
circulating fyftem.

It is generally found advifeable to combine bitters and
aperients. A formula confifting of fix drachms of com¬
pound infufion of gentian and of the fame quantity of in-
fufion of fenna is of this kind: it is generally found to
promote all the procefles of digeftion and abdominal excre¬
tion. The combination of falts with the fame bitter in¬
fufion is likewife a common and excellent formula.

It is often requifite to adminifter ftimuli derived from
the mineral kingdom. Of thefe the mineral acids, the
preparations of iron, and the fulphate of zinc, are in
common ufe. Of the mineral acids, the fulphuric is per¬
haps

PATHOLOGY.

haps the beft in indigeftion, and has this advantage over
the other forts, that it operates more diltinftly on ano¬
ther part affefted in dyfpepfia, viz. the (kin. It is pecu¬
liarly ferviceable in thofe cafes, u here fweating, which is
not unufual, is tooealily induced by exercife ; for much
tendency to fweating indicates relaxation, not vigour of
the Ikin.

There are few cafes of indigeftion in which iron is not
found more or lefs ufeful at an early period, if no ten¬
dency to the fecond ftage of the difeafe has fliown itfelf.
Its goodeffefts are increafed by combining it with bitters
and aromatics ; and, in idiopathic indigeftion, the carbo¬
nate has appeared to us its beft preparation, provided it
can be taken fcruple-dofes, without producing a feeling of
heat and oppreflion in the ftomach. In the opinion of
many, the fulphate of zinc given in very fmall dofes, alfo
holds a diftinguifhed place among thefe medicines. It
may be given at later periods than iron, but it requires
caution; and, if its good effefts do not foon appear,
fhould be laid afide. It is one of thofe powerful agents,
which mult always be employed with fome degree of fuf-
picion.

The medicines we have fpoken of hitherto feem prin¬
cipally to exert their influence on the contraftility of
the mufcular fibre, or the capillary veflels. But, as we
have before feen that, however various may be the caufes
which aft on the mufcular fibres of the ftomach, or on its
nerves; yet thefe powers are fo connefted, that whatever
impairs the one neceffarily affefts the other; fo we (hall
find that a fimilar obfervation applies to the means of re¬
lief; that thofe medicines which tend to reftore a healthy
nervous power to the ftomach, tend likewife to form the
food into that fubftance which is beft fitted to excite the
mufcular fibres of this organ ; and that whatever excites
the natural aftion of thefe fibres, tends to relieve the
nerves from uneafy impreflions, and, in the moft favour¬
able way, to bring into contaft with their extremities the
food on which they are to operate through the interven¬
tion of the fecreting veflels.

There are fome remedies which aft peculiarly on the
nervous fyftem of the ftomach. Thefe are irritants, or
thofe which increafe the production of the nervous power ;
and anodynes or narcotics, the eft'eft of which is to dull
the fenfibility. The potent nature of the firft clafs is
fliown by their exhilarating effefts on the fyftem at large.
It is thus that diftiiled fpirits and aromatic tinftures pro¬
duce fo much alleviation from the uneafy fenfations of
dyfpepfia. It is well known, however, that the meafure
of vigour which fpirituous potations afford is generally
followed by increafed debility ; and we (hould therefore
be cautious in the exhibition of them. They can be given
with fafety only under the following circumftances ; viz.
when patients have fo long indulged in their ufe, that we
have to fear the increafe of dyfpeptic fymptoms from the
fudden relinquilhment of the habitual ftimulant, or when
we have fo far correfted the date of the other vifcera and
of the fyftem in general, that the ftomach feems only to
want fome additional nervous excitement to call its na¬
tural aftion into full play. Even when exhibited with
thefe intentions, it is beft to give fpirits only in conjunc¬
tion with bitters, and in fmall dofes. This rule does not
of courfe apply to violent or fpafmodic paroxyfms of dyf¬
pepfia, in which fomewhat aftive dofes of diftiiled fpirit
are often admiftible. When combined with bitters, the
medicines of this clafs render the former medicaments
more permanent in their eft'eft ; and indeed, the aftion of
the latter feems often neceffary to enable the ftomach to
bear the former without oppreflion. The quantity of
diftiiled fpirits in fuch mixtures (hould always however be
fmall ; a twelfth, at moft an eighth, of the whole. In the
exhibition of aromatics lefs nicety is required: the pro¬
perties of all are fimilar, though fome fuit the ftomach
and the tafte of individuals better than others. Thus
ginger may be ufed when cardamoms ftimulate the fyftem

145

too much ; and cardamoms will relieve flatulence and
fpafmodic pains, when ginger fails.

Among the drugs which augment nervous fenfibility,
we have to mention ammonia. The operation of this
fubftance is by no means Ample. It accelerates the pulfe
for fome time after reception into the ftomach, while it
ftimulates the contraftile fibres of that vifcera, and is
alfo a grateful and permanent ftimulus to its nerves. It
is well calculated to relieve thofe patients in whom the
force of the circulation is below par ; provided, how¬
ever, that no tendernefs of the epigaftrium, hard pulfe, or
any lenfation of burning in the hands or feet at night, is
experienced ; for the latter fymptoms would undoubtedly
be formidably augmented by its adminiftration. Cam¬
phor poffeffes fome of the properties of ammonia in a
(lighter degree. Its property of alleviating ficknefs ren¬
ders the nuftura camphorae a good vehicle for other me¬
dicines.

We have recommended much caution in the ufe of ir¬
ritants : the ufe of anodyne remedies demands perhaps
ftill more. The only medicine of this clafs which produces *
effefts worth notice is opium. In violent fpafms this
medicine may be given fomewhat freely ; but Dr. Philip
fays, that very fmall dofes,* two or three minums of tinc¬
ture of opium for example, repeated two or three times
a-day, often prove highly ferviceable in allaying morbid
irritation ; their conftipating eft’eft is eafily counter-
afted ; and fometimes indeed they have very little of
this efteft. A better mode of exhibiting opium is under
the form of the Pulv. ipecac, comp. From two to four
grains of this preparation, given every fix or eight hours,
appears to have a peculiar efteft in allaying the irritation
attending indigeftion, which probably arifes from its
aftion on the (kin. It appears to be beft adapted to thofe
cafes in which that combination of languor and reftleff-
nefs, often fo remarkable in this difeafe, prevails. It is
better from time to time to difcontinue and renew its
ufe, than to exhibit it for a great length of time without
interruption ; which, even when the dofe is very fmall,
is apt to occafion fome confufton or other uneafinefs of the
head ; an efteft which goes far to increafe eventually all
the dyfpeptic fymptoms.

While thefe remedies are then in aftion, we ftill have
to contend with paroxyfms of pain and nervous irrita¬
tion. To thefe, opium, ether, cardamoms, and the whole
hoft of antifpafmodics, are the ufual and effeftual reme¬
dial agents. Among thefe means of temporary relief,
very-warm water holds a higher place perhaps than is ge¬
nerally fuppofed. To its frequent ufe there are the fame
objections as to other powerful ftimulants ; but occafion-
ally it relieves dyfpepfia in a very decifive manner. It de-
ferves mentioning, although it is difficult to explain it,
that a confiderabie degree of heat applied externally to
the region of the ftomach is as effeftual, provided it be
continued for a fufficient length of time, in removing
cramp, as any application of heat we can make internally.

It is alfo frequently relieved by heat applied to the feet.

It is during this ftage of dyfpepfia that galvanifm is often
advantageous ; but in the ufe of this ftimulant we muft
be careful to regulate it fo that it may not excite inflam¬
matory (ymptoms.

When the bowels become implicated in the difeafe of
the ftomach, a more briik and continued date of purging
is required. To fpafmodic affeftions of thofe parts the
fame fpirituous remedies that relate to the gaftric affec¬
tion are applicable.

When, from the fullnefs of the right hypochondrium
unattended by deficiency of bilious fecretion, we have
realbn to fuppofe tardinefs of aftion in the duodenum,
thofe purgatives which excite the periftaltic motions are
preferable to all others. Of thefe, the combination of
rhubarb and fenna may be mentioned as one of the beft.
When, on the other hand, mucous feeretions are apparent
to excefs in the faeces, the faline cathartics (hould be em¬
ployed.

2

PATHOLOGY.

146

ployed. We referve, however, further remarks on the
due regulation of the bowels till we come to the next
genus.

The functional derangement of the liver occurring as a
confequence of dyfpepfia, requires the particular treat¬
ment of the former complaints to be conjoined with that
of the latter difeafe. The medicine bell calculated to
promote the fecretion of bile is mercury. The different
preparations of this mineral may be ufed according to the
peculiar conftitution of the patient. The moft common
are Abernethy’s blue pill, Plummer’s pill, and calomel.
The firft of thefe, given in dofes of four or five grains
every fecond or third night, as recommended by Mr.
Abernethy, is particularly ferviceable in thofe cafes
where the affection of the liver has fupervened early, and
where, confequently, it is the principal caufe which fup-
ports and aggravates the dyfpepfia. This pill difagrees
however with fome conftitutions. We do not allude to
the tranfient fenfation of pain which is felt in fome fto-
rnachs for the firft half-hour after its reception ; but the
more permanent fenfations of the fame kind that are fome-
times experienced. Calomel is perhaps, after all, the belt
kind of mercurial for the firft ftage of indigeftion ; and is
chiefly applicable when irregularity of the fecretion of
bile is prefent. It alfo deferves notice that calomel ne-
ceffariJy occafions brifk purging, on which the benefit
derived from it often greatly depends ; fo that, while, by
its peculiar effedl on the firft paffages, it excites a better
action of the liver, by its purgative effedl it tends fur¬
ther to emulge the gall-du&s, and relieve the diftended
ftate of the liver. Its operation, then, is moft wanted
where this diftention is greateft, which may be known, we
have feen, by the ftate of the right hypochondrium, and
will be Jeaft injurious where the ftrength is moft able to
bear fo confiderable a call upon it. When there is little
diftention of the liver, and the ftrength is much reduced,
the operation of the blue pill, provided it agrees tolera¬
bly well with the ftomach, is preferable. The relief ob¬
tained from it may be lefs fpeedy, but it will be obtained
at lefs expenfe to the conftitution. Inftances frequently
occur of the bad effedts of not attending to this difting-
tion. What is only a falutary evacuation in one cafe,
is an overpowering caufe of debility in another.

Plummer’s pill often fits well on the ftomach when both
of the former preparations of mercury fail. The propor¬
tion of antimony in its compofition tends to caufe its in¬
fluence to be exerted on the Ikin as well as on the liver ;
and hence in the cure of cutaneous affections it is held
in merited eftimation.

As the effedl of mercury is only required to be tran¬
fient in the firft ftage of dyfpepfia, whatever form of the
mercurial remedy we employ fliould be carried off by an
aperient, either given with it or at a proper interval after¬
wards. Of thefe alternatives, we fliould (with the excep¬
tion of peculiar cafes) incline to the latter; for it can¬
not be queftioned, that much larger dofes are required to
promote the hepatic fecretion when combined with the
dry purgatives, as colocynth, aloes, &c. and we have feen
cafes where it failed entirely to produce fuch effedl. In
the milder form of difeafe we are now fpeaking of, a
draught of falts and fenna, taken in the morning after a
mercurial pill the over night, will we think be found the
leaft painful or debilitating in its operation. When mer¬
cury occafions much irritation of the bowels, its conti¬
nued ule brings on a degree of dyfentery. The patient
is tormented with griping and tenefmus, and at length
paffes little befides mucus, often mixed with a fmall
quantity of blood. In fuch cafes, we mull difcontinue
its ufe for a fliort time ; and when we find, as fometimes
happens in fuch cafes, that on returning to it the fame
fymptoms conftantly recur, and cannot be prevented by
changing the preparation, or the ufe of anodynes and
mucilages, it muff be entirely laid afide.

Given under the above regulations, mercury is a very
excellent remedy for the hepatic derangements of indi¬

geftion. Its indifcriminate ufe undoubtedly does much
harm ; and there can be little doubt that various kinds
of “ antibilious pills” (as they are foolilhly called), which
are daily vended in great quantities, do upon the whole
more harm than good. Indeed this muft always be the
cafe with patent medicines ; no medicine can be energe¬
tic, unlefs it has the property of inducing derangement
of fome part ; and therefore, if the production of a de¬
rangement from the natural ftate be not properly di¬
rected, much mifchief muft enfue. The indifcriminate
ufe of mercury in gaftric complaints has called forth thefe
remarks j and we with particularly to repeat to our me¬
dical brethren a faCl well eftablilhed by the teftimony of
the bell authors ; that mercury Ihould hold no place in
the treatment of Ample indigeftion, while the fecretion
of bile is unchanged ; and that, when that change has
occurred, its cure Ihould be effeCled by the leaft pofllble
quantity of this potent mineral. As mercury fometimes ir¬
ritates the fyftem at a rate not balanced by its beneficial
influence, it becomes neceffary to fearch for a fubftitute
which may be employed inilead of it. The combination
of the nitric and muriatic acids, taken internally or ufed
externally, as Dr. Scott firft recommended, has appeared
to us the moft fuccefsful. See Nitro-Muriatic Acid,
vol. xvii. p. 104.

With refpedl to the more diftant affedlions arifing from
dyfpepfia, we have before Ihown, that, numerous as they
are, they are for the moft part the products of nervous ir¬
ritation ; hence depletion has little effect on them.
When they are of that violent and uncontinued charafter
which we have called, after Dr. Hall, the Mimofis urgens,
antifpafmodics, as mulk, valerian, ether, emetics, &c. are
the remedies indicated in addition to the ufual dyfpeptic
treatment. The fame remark applies to the fpafrnodic
dyfpncea,palpitatio cordis, &c. When more permanent ef¬
fedts feem induced,counter-irritantsareofelfentialfervice.

The affections of the head which occur in indigeftion
require more particular notice. We fliould be par¬
ticularly careful to keep the circulation rather below
than above the ufual llandard in cerebral affedlions, be-
caufe of the formidable difpofition to inflammation which
they frequently and fuddenly affurne. On this account,
when the pulfe does not forbid it, and the cerebral is not
relieved by the excitement of fecretion in the gaftric
ftrudture, topical bleeding is the moft advifable ftep.
This fliould be followed by the fliower-bath, an agent at
once exciting the Ikin and depleting the cranial circula¬
tion. This pradtice is ufeful in the ftate of erethifm which
we before noticed as defcribed by Dr. Nicholl. That
author recommends the ufe of the pulv. ipecac, comp,
but a fpecimen of the difeafe we lately faw feemed in-
creafed in violence after each exhibition of the above me¬
dicine. On the whole, topical bleeding, a cooled ftate of
the external part of the head, the abllradlion of ftrong
light and of all irritating irnprellions from without, tole¬
rably free purging, and the ufe of diuretics, are the beft
modes of treatment. In all head-affedtions, free dif-
charges from the inteftines and bladder are ftrongly re¬
quired. In the head-ache of the firft ftage, emetics give
temporary relief; but particular care is required to note
the diagnoftics, as ftupor, or throbbing of the temples,
w’hich tend to fliow eftablilhed difeafe in the head. When
tills occurs, or indeed when inflammation is-sfet up in any
ftrudture, the ufual treatment of the phlogoticiK null be
combined with that in queltion.

The connexion between the functions of the Ikin and
alimentary canal has been often adverted to. The former
ftrudture affords an excellent mean for relieving the dif-
orders of the latter. Thus the medicated bath recom¬
mended by Scott is a more powerful agent in improving
the fecretion of the ftomach, liver, and bowels, than the
internal ufe of the acid. But the chief meafure adting on
the fkin is the bath. Cold bathing is an old remedy in
indigeftion. It is feldom fafe, however, in nervous or
debilitated lubjedls. Where its ufe can be borne, a fliort

plunge

147

PATHOLOG Y.

plunge is the beft mode of applying it; and much care
lhould be taken that perfect drynefs, and indeed re-aftion,
of thelkin, be produced, by rubbing with dry cloths. In
fome cafes fponging only, followed by the lame fri&ion,
is the furtheft attempt at cold bathing which the delicacy
of our patients’ conftitutions will allow us to make. The
warm bath does not require the lame limitation ; and it
deferves in our opinion more confideration than it
.generally obtains. A gentleman of much experience,
.Dr. J. Johnfon, is of the fame opinion ; he obferves that,
.if the general ufe of the warm bath lhould ever become
prevalent in this country, it will produce a more bene-
.licial revolution on the health and longevity of the in¬
habitants, than any change which the hand of time has
ever wrought; and that, fo far from weakening or ener¬
vating the conftitution, it has a decidedly contrary ef¬
fect ; and therefore, in debilitated fubjeffs, it is infinitely
more proper and fafe than the cold bath. Indeed the good
effe£ts of the. latter refult from the re-aftio'n of the fyf-
tem ; but, as this re-affion is entirely an effort of the con¬
ftitution itfelf, to refill as it were, or undo, what the cold
immerfion had produced, a confiderable degree of vital
.energy is necelfary ; otherwife fome internal vifcus may
fuffer. On the contrary, fays Dr. J. the warm bath elicits
the blood to the furface of the body,' with hardly any of
that re-acfion obferved after the cold bath. The whole
contaneous fyftem of velfels is thus filled with blood,
while the velfels of the interior organs are relieved, and
that without any particular exertion of the heart which
might render it liable to fubfequent exhauflion. The
fpirits too are railed, the pulfe mended, and the appetite
jncreafed; in Ihort, a general renovation is felt through¬
out the whole frame ; an effedl more remarkably ob¬
served after exhauflion or fatigue. The oriental nations
have long appreciated its virtues in this refpedl. Homer
defcribes Ulyffes, among others, as refrelhing himfelf
with the warm bath, on his return home ; and the nume¬
rous and fplendid baths, by the building of which the
Roman emperors gained fo much popularity, will fhow
that this comfort, or luxury, was no lefs elteemed in the
weft.

The warm bath will by no means be an effedlual reme¬
dy in dyfpepfra, unlefs the immerfion in it be of much
longer continuance than, is ufual in this country. Dr.
Thomas, a pra&itioner who has fpent fome time abroad,
informs us, that “ upon the continent, where fo much
good is produced by this powerful remedy, no one thinks
of recommending a patient to flay lefs than an hour in
the warm bath ; and at UfTat, where fo many cures have
been effedled by means of- the bath, and by fuch means
only, I have known many weakly delicate patients take
two baths of one hour each every day for three weeks
without intermiffion ; and I have no doubt in my mind,
and the fame conviflion pervades medical men in general
in France, that it is owing. to this manner of taking the
warm mineral baths, that fo much. good is effefted by that
remedy; and, by parity of reafoning, I may fay, that little
good is obtained from them in this country, becaufe there
is not fufficient time allowed for bathing.”

. The vapour-bath is alfo a remedy of great efficacy in
the complaint in queftion.-

„ Thedifeafes for which the warm bath may be employed,
are much more numerous than thofe where the cold bath
can be exhibited with fafety. And in faft it may be ufed
on moft occafions without premifing the accurate difcri-
mination required ere we adopt the critical meafure of
cold bathing. See the article-BATHiNG, voi. ii. p. 803.

On the; treatment of the Jccond Jioge of indigeftion, we
have feen that, after a certain period, a- change takes
place in the nature of dyfpepfia; that a difordered ftate
pf the circulating velfels of the ftomach fupervenes to
fufpenfion of nervous influence and of mufcular propul-
fion ; that this change happens at various periods, fome-
times in a few days or weeks, but that not unfrequently
it is not manifefted for many months, more rarely for
,t VOL. XIX. No. iz9i. *

years ; that this ftate is characterized by a change in the
phenomena of the circulating fyftem, indicated by a hard
pulfe; and that there is likewife pain in the ftomach.
•We confider thefe fymptoms as indicating chronic inflam¬
mation of the ftomach; and we may remark, that this
opinion is borne out by analogical reafoning on what takes
place in other parts, and by the diffeffions of the more
marked cafes which are recorded by foreign practitioners.
We have therefore to reduce inflammation ; and of courle
the flimulating meafures which we have ufed in the firft
ftage of indigeftion are to be laid alide ; but, in ad’opting
the oppofite or antiphlogiftic treatment, we inuft confider
that the ftoma'ch is the feat of complex functions; and
that, though inflammation has fupervened, nervous de¬
rangement and mufcular inaftion ftill remain. More¬
over, the periodical affioh of the ftomach, and its conftant
expofure to irritants, render general or fudden depletion
of the contents of its velfels of little avail, lince, how¬
ever the latter may be depleted, and however perfectly
they may recover their natural diameter, the frequent fti-
mulus of foreign fubftances will tend to reproduce the
morbid ftate of vafcnlar fullnefs. The impeded nutrition
which is prefent caufes a debility of the fyftem quite ob¬
noxious to vafcular depletion. The treatment of this
ftage of dyfpepfia requires therefore particular attention,
inafmuch as we have to reduce inflammation by one train
of precedes, and produce mufcular and nervous action
by another. As thefe are incompatible indications, the
lefs mult give away to the more important; that is to fay,
wemuft reduce the inflammatory adtion firft, and confider
the mufcular and nervous debility afterwards. The for¬
mer intention muft be effected by applying leeches to the
epigaftrium, by cooling applications, as effervefeing
draughts and folutions of nitre, cold water, See.' and by
a very abftemiotis vegetable diet. When thefe mea¬
fures are luccefsful, we may cautioufly return to the ufe
of bitters, &c. and thereby endeavour to remove the 'caufes,
i. e. morbid diftention and diminilhed nervous power,
which have produced the difeafe in queftion. When the
inflammatory ftate has not continued long, and has not
appeared till the nervous indigeftion has been of long
Handing, we generally prognofticate its removal by the
above-mentioned means with certainty; bur, in propor¬
tion as it becomes more thoroughly eftablithed, we lhall
find lefs marked relief from the bleeding, and a much
more aggravated and fudden return to inflammation when
we attempt to ftiipulate by bitters.

It is at this period of indigeftion that ipecacuanha is
an excellent remedy. The effect of this lubftance is to
produce fecretion from the ftomach, though, it muft be
allow'ed, not that which is commonly called the gaftrlc
juice ; the nature of that fluid, or at lead: its peculiar ef¬
fect on the nervous expanfion, being altered. That fe-
cretion is an excellent means of removing local plethora
is well known ; and hence appears the advantage we de¬
rive from this drug. In regard to its dole, we fhouid give
as much as induces fecretion without caufing naufea, a
phenomenon which tends to debilitate the mufcular fibres
of' the ftomach. A grain and a half, two, or in fome cafes
three, grains will be fufficieht. It is necelfary, however,
to produce fecretion from a more extenlive furface than
the ftomach itfelf: the bowels fhouid be kept in an open
ftate, and the hepatic fecretions lhould likewife be pro¬
moted. . In taking the firft ftep, we lhould employ thofe
purgatives which produce the leaft pain or irritation in
their operation. Vegetable diet, which we have before
fpoken in commendation of, will in many cafes relax the
bowels; but, where this effect is not produced, aperients
muft be given. They fhouid be of a mixed kind ; they
fliould comprehend many ingredients of this numerous
clafs, avoiding however fuch as produce nervous irrita¬
tion. We have commonly recommended, when it is fuf-
ficiently aitive, the Confectio fennte; but many other
formula will no doubt anfwer the purpole equally well.
Of courfe, when one part of the bowels is more fliig

Q ft gilh

148 PATHOLOGY.

gifli than another, we Should endeavour to excite it by
purgatives which aft fomewhat exclusively on it ; as, for
inftance, rather more rhubarb mult be administered when
the duodenum feems inaftive.&c. The number of mo¬
tions mud be fomewhat regulated by the Strength, &c.
but three in the courfe of the day will feldom be too many.

We have noticed, that, when the firft Stage of indigef-
tion has continued for Some time, the funftion of the
liver becomes disordered. A greater or lei's tendency to
diforder in this organ, alter it once appears, always con¬
tinues throughout the difeafe, l'o that it is a condant
attendant on the Second Stage ; and tiiofe medicines which
influence the Secretion of this organ, therefore, always
form part of its treatment. Of thefewe Still find mercury
by far the moSt efficacious. Several circumstances, how¬
ever, render caution, in the ufe of this medicine, even
more neceSTary in the Second than in the firll Stage. Not
only has the greater continuance of the difeafe occasioned
a greater lofs of Strength ; but its increafe, and the change
which has taken place in its nature, renders it neceSTary
to employ this medicine for a longer time, and often in
a way that more direftly influences the State of the con¬
stitution.

In the firft Stage, as we have Seen, we want only the
transient efFefts of this medicine on the liver. On the
other hand, we now want to induce a more permanent
change in the difeafed State of that vifcus,.and rather to
reltore the altered properties of its Secreting vefl'els than
Simply to increaSe their aftion for the fake of removing
plethora. It has been lately recommended, with this
view, to give mercury in very-minute and fomewhat-fre-
quentdofes. Dr. Philip Says that he has “generally given
a grain of the blue pill, Sometimes only half a grain,
twice or three times. in twenty-four hours, till the l'ecre-
tion of bile appeared to be healthy, repeating thefe dofes
when it was again dilordered ; and by fuch dofes, which
may appear to many little better than trifling, I have Seen
the bile gradually reftored to a healthy Slate, when larger
dofes had been employed in vain. They not only often
Succeed where larger dofes fail, but the change, in pro¬
portion as it takes place more Slowly, feems generally to
be more permanent.” We may add, that, in the Second
Stage of indigestion, violent aftion of the abdominal vif-
cera Strongly tends to deftroy their tone; and this forms
another reafon againSt employing large dofes. of mercury,
Since, by their aftion on the Secreting Surfaces, they pro¬
mote Sudden, anft debilitating evacuations; an effect very
unfavourable in the weak Hate of the constitution which
attends this Stage!

By the above praftice we avoid the occasional ill eft'efts
of mercury in a great degree, though Some practitioners
of diftinftion conceive it to be fomewhat inert. Our own
experience, however, is in favour of it ; and in Dr. Hall’s
writings cafes are mentioned in which the like diminutive
dofes of this medicine produced favourable refults.

Much latitude will be allowed, however, in the ufe of
mercury, Since the difference of climate or of constitution
renders a dofe in Some cafes too-powerful, in others per-
feftly nugatory. There can be no doubt, for inftance,
that in hot climates a much larger proportion may be
given of this medicine than in temperate ; and the various
degrees of fufeeptibiiity to its aftion, which different in¬
dividuals exhibit, are equally well known and unaccount¬
able.

When mercury disagrees with the bowels, conium, hy-
ofieiamus, or extract, papaveris, maybe conjoined with it;
or we may have recourse to the nitro-muriatic-acid bath
as a Substitute. The latter remedy is indeed Sometimes
of uSe during the intervals of ufing mercury; but it too
often happens that the cathartic tendency of the mer¬
cury is increafed by the acid. The bath muSt not be
u fed during the inflammatory State of the Stomach, but
may be very advantageoufly preferibed when local blood¬
letting has been premifed. The degree of aftion which
the nitro-muriatic-acid has to exert on the constitution is

regulated by the Strength of the health, and by the extent
of the cutaneous Surface immerfed, a hand ora foot being
firft bathed ; and, if its eifefts are borne well, by degrees
the reft of the body up to the chin. See vol. xvii. p. 106.

Dr. Philip has recommended dandelion to be tiled as a
Substitute for mercury in dyfpepfia. He fays that “ it ap¬
pears to poSfefs greater powers in this difeafe than are
ufually aferibed to it, but it requires to be taken in very
large dofes. It is belt adapted to thofe cafes, in which
the bile is deficient or much disordered, while the power
of the Stomach is Still considerable. In Such cafes, I have
Seen the patient reftored by a Strong decoftion of dande¬
lion ufed for common drink, without the aid of any
other medicine. In addition to its effeft on the liver, it
tends to cool, and consequently allay the inflammatory
diathefis, and often excites both the bowels and kidneys.
The latter effeft, which is belt counteracted by alum,
when the Stomach bears it well, is frequently fuch as to
make it neceSTary to discontinue the dandelion. The
former is feldom considerable, and can always be restrained.
It is often given with great advantage in aid of the fmall
dofes of mercury when the Stomach bears it well, and
enables us further to diminish the quantity of this medi¬
cine.”

The functional derangements which occur as remote
confequences of dyfpeplia, are to be cured only by remo¬
ving the original difeafe. The topical inflammations re¬
quire additional remedies; for we have before noticed
that, when of long Standing, they often aft as counter-ir¬
ritants to the gaftric disturbance. The liver, lungs, Spleen,
and heart, are molt liable to this affeftion ; and are all to
be treated on thefe principles ; viz. to withdraw nervous
irritation by counter- Stimulation, to bleed locally or ge¬
nerally according to the frequency and hardnefs of the
pulfe, and procure Secretions from the abdominal vifeera,
and from the Skin, by the warm bath.

The Same rules apply to the treatment of the head-
affeftions. Here the Sympathy between the external and
internal parts allows the additional ufe of cold lotions to
diminish the aftion of the velTels of the head : a Simple
meafure, but one of great efficacy. The ereft polture, or at
lead a near approach to it, Should likewise be infilled on ;
and a more aftive kind of purging than in the derange¬
ments of the abdominal vifeera. The erethifmal State of
the brain Should be treated with continued counter-irrita¬
tion, and with much alfiduity; Since, when once it has
apoplexy, this latter calamity is generally fatal, and ap¬
pears uninfluenced by bleeding or any other known means
of relief.

In the gouty and rheumatic affeftions of this Stage of
indigeftion, in addition to the ufual means, the Colchi-
cura is by no means a defpicable remedy. Indeed, where
this drug agrees, it Seems to reduce both the arthritic
and the gaftric inflammation at the Same time. The ufe
oS an anodyne liniment likewife affords temporary relief
to the rheumatic pains.

When the inflamed Slate of the mucous membrane has
been communicated to the bowels, and piles, Strifture,
or tendernefs along the courfe of the ccecum, are prefent,
the molt efficient method of relief is anal leeching. This
praftice has not obtained in our country the attention it
deferves, though the great benefit our continental neigh¬
bours derive from it, Should have taught us its common
ufe long ere this time. We find Some prejudice oppofed
to it; but, if properly condufted, it is by no means un-
pleafant or indelicate. The leeches may be applied to the
fundament by means of a glafs formed like an eye-glafs,
but of larger dimenfions ; and, after they have laid hold,
the patient Should fit over a bidet, and by the warm va¬
pour or by ablution promote the difeharge of blood. We
have found this method more fuccefsful than even leech¬
ing over the epigaftrium, where tendernefs of the part is
prefent ; and it has this further advantage, that, from the
nature of the Sanguineous distribution, it direftly depletes
the whole abdominal vifeera.

Pain

149

PATHOLOGY.

Pain in the courfe of the colon is often relieved by fric¬
tion with a liniment, by fuppofitories and clyfters. Be¬
fore leeching has been ufed, the inflammatory (late of the
bowels is rather increafed than relieved by cathartics; and,
after it, thofe only of the mildeft nature fliould be had
recourfe to.

The fubjeCfs of mtelena, diarrhoea, See. which would
naturally follow here, mult be deferred till our nofologi-
cal arrangement brings them before us.

When inflammation of the mucous membrane of the
lungs is connected with Dyfpepfia, we have a very power¬
ful agent in the hydrocyanic acid. This remedy has in¬
deed been preferibed with fuccefs by Dr. Elliotfon for
the relief of all dyfpeptic fymptoms dependent on dif-
turbed nervous power; but we have not introduced it
into our lift, as we have not been able to colleCt, from
mere general experience, the like favourable teftimony of
its virtues ; and it is fo potent a drug, that we would not
hazard its occaftonal deleterious effeCts, fince the correc¬
tion of the firft ftage of dyfpepfia may generally be ac-
compliflied by milder meafures. In the. removal, how¬
ever, of bronchitis, this acid muft be regarded as an im¬
portant agent, and one which at the fame time perhaps
relieves the original fourceof difeafe. It is given in the
dofe of half a minim at firft, and this is- gradually ex¬
tended in proportion to the efteCt obferved from it. Of
courfe this complaint requires more ftriCt attention to the
purity of air, the regulation of temperature, and the
perfpiration of the Ikin, than other forms of the dyfpeptic
Sympathies. It is generally accompanied with hepatic
derangement; and on this account is ufefully treated by
i mall dofes of calomel, perfevered in until a healthy
bilious difeharge is feen in the (tools.

The cacbeCtic difeafes of indigeftion require in general
a very remarkable change in the diet of the invalid ; nor
does itfeem that we need in thefe cafes fo particularly re¬
gard the fpecies of change, fince an alteration of whatever
kind is generally found ufeful : thus, a meat-diet will
produce a cachectic date of blood in fonie, as a vegetable
diet will in others ; and a change is in either cafe clearly
indicated, both by reafon and experience. We (hall take
up this fubjeCt under the head Dyfthetica.

The chlorotic indigeftion mentioned at p. 139, requires
in general a more generous diet and more active exercife ;
and as, in females, the uterus is often implicated in the
difeafe, fteel, aloes, See. are appropriate remedies.

The connection between urinary gravel and indigeftion
does not lead to any difference in the ufual plan of cure ;
fince, from whatever caufe gravel may arife, it will re¬
quire a peculiar treatment. It is worthy of remark, how¬
ever, that beer, efpecially if ftale, will caufe the depofition
of fabulous matter; while fpirits, efpecially alcohol, di-
minilhes this tendency in a remarkable degree. Thefe
facts are of courfe of moment in relieving the fymptoms
in queftion.

In the ufe of all thefe meafures, and in their application
to the various forms of dyfpeptic derangement, the prac¬
titioner (hould endeavour fo to conjoin them, and adopt
their ufe to the idiofyncrafy of his patient’s conftitution,
that he may not materially difturb the balance of power in
the various parts of the iyftem ; but the ufe of remedies
will feldom avail much, if the primary and fundamental
fources of the difeafes in queftion, viz. bad air, improper
orexceflive quantity of food, and lympathetic irritations,
be not removed.

Genus VI. Colica, [from tuoMv, the colon ; this part
being the chief feat of the difeafe.] Griping of the guts.

This genus contains fix fpecies. It is characterized
by griping pain in the bowels, chiefly about the navel,
with vomiting and coftivenefs. The-caufes of the com¬
plaint are local irritants, whether undigefted aliment,
poifon, or crude fecretions of the upper parts of the ali¬
mentary canal. Or it may, and indeed moll commonly
does, arife from fympathy with a remote part; perhaps

more frequently with the (kin. Seven fpecies are enume¬
rated by Dr. Good, and Cullen mentions more; but the
proximate caufe of all thefe appears to be the fame; viz.
fpafmodic contractions of the mufcular fibres of the in-
teftines.

1. Colica ileus, (Colica fpafmodica, Cullen .) Characte¬
rized by retraCtion of the navel, and fpafms of the muf-
cles of the belly. It begins with a fenfe of weight or
pain, at the pit of the (tomach, attended with lofs of ap¬
petite, yellownefs in the countenance, a (light ficknels,
and coftivenefs ; the pain gradually increafes, becomes
fixed about the navel, from whence painful dartings pro¬
ceed in various directions ; wherever pain is felt, forenefs
and tendernefs remain fome time afterwards. The fick-
nefs increafes with the pain ; and, at length, a vomiting
of bilious matter comes on, the function being of courle
deranged by the difeafe of the inteftines. The urine is
diminiflied in its ufual quantity, and a tenefmus fome-
timesadds to the diftrefs. While the pain is fpafmodic,
the pulfe remains unaffected, except concurring circum-
ftances produce a change in it. The urine is various. If
the fmaller inteftines are the feat of the pain, it is felt
more acutely; if the larger inteftines are the parts ag¬
grieved, the fenfe of pain are more dull and heavy ; fome-
times there is a bitter tafte in the mouth, and a yellow¬
nefs in the countenance. Sometimes the diforder limn-
lates a fit of the gravel ; (tones pafling through the ure¬
ters ; rheumatic pains in the mufcles of the belly; the
blind piles ; (tones pafling through the gall-duCf. Gra¬
vel in the kidney produces often colic-pains, not eafily
diftinguifhable; but, when (tones pafs through the ureters,
the tefticle on that fide is often retraCted, the leg is be¬
numbed, and a pain (hoots down the inlide of the thigh.
Rheumatic pains in the mufcles of the belly rarely affect
fo accurately the umbilical region, but dart, in various
directions, to the cheft or to the pelvis, and are attended
with forenefs, not confined to the abdomen. The pain
from the blind piles is confined to the reCtuin; and that
from a (tone in the gall-duCt is felt in the pit of the fto-
mach, occafionally (hooting through the body to the
back.

When the diforder is purely fpafmodic, the mere alle¬
viation of the fpafm is fufticiently obvious. Ether, vale¬
rian, ammonia, opium, &c. being premifed, means are to
be put in force for procuring (tools. Therefore, either
foon after or in conjunction with an opiate, fome cathar¬
tic medicine (hould be adminiftered, either by the mouth
or in a clyiter. If the conftipation has been but of ftiort
duration, the neutral falts will generally be adequate to
the purpofe of procuring evacuations ; fuch as the mag-
nefite fulphas, for ir.ftance, or the fodae ftilphas : both
have the advantage of being conveniently repeated at
ftiort intervals, in fmall quantities, until the defired ef¬
fect is produced ; and their aCiion is increafed by their
union. Caftor-oil, a mild and tolerably-certniu purgative,
is the belt medicine we know of. Indeed molt painters
who are aware of the utility of caftor-oil efcape the attack
of this malady, to which (as well as to the next fpecies) they
are very (ubjeCt, by taking a large dofe as foon as they
perceive the flighted: fymptoms of the difeafe. Where
ficknefs is prefent, if more aCtive means are required, calo¬
mel, combined with jalap and rhubarb, may be employed.
Moreover, remedies may be applied immediately to the
part affefted, by means of clyfters. Large quantities of
warm water (to the extent of fome pounds), injefted by
a proper fyringe, have frequently had the effeCf of remo¬
ving the pain and fpafmodic ftriClure of the colon, partly
by the foothing effeCts of the warmth, and partly by me¬
chanical dilatation. Opium may alfo be adminiftered in
the fame menftruum, combined with neutral falts, with
confiderable advantage. Thefe emollient clyfters act alfo
powerfully in aid of laxative medicines taken by the
mouth, particularly where the latter are impeded in then-
operation by a collection of indurated feces ; for, while
the periftaltic motion of the bowels is roufed by the

laxatives

3

ISO PATHOLOGY.

laxatives in the upper part of the canal, the obftruflion is
mechanically loofened, in the lower part, by the clyller...
A folution of aflafoetida, alfo, adminiftered in this way,
tends both to relieve the pain by its antifpafinodic qua¬
lities, and alfo to Simulate the lower bowel to evacua¬
tion. But, Where there is very obftinate conftipation, a
clyfter of more efficacy is one made of turpentine, pro¬
perly fufpended in water by means of mucilage or the
yolk of an egg. In cafes where every purgative medi¬
cine has failed, and the moll powerful clyfters have
proved ineffedlual, the aflion of the bowels may be exci¬
ted by throwing cold water on the lower extremities.
When inflammation does not feem likely to occur, and
powerful cathartics are required, the oil of croton will be
found a remedy of great avail.

It is of much importance, however, to diftinguifh
fpafm from inflammation of the colon, with which it is
Sometimes connected, and into which it is likely to run.
In faff, this always happens before a fatal termination
takes place. :i nut

The former is thus diftinguilhed from the latter
pffeffion. The fymptoms, which imply the fpafmodic
Hate, are a foft pulfe of natural or of little-increafed fre¬
quency; the pain intermitting occafionally, or moving
from pne part to another, and being, relieved, or at leaft
not increafed, by external prefl’ure, and the occurrence
of feculent evacuations, though the lattercircumftance is
ieldom to be relied cn. The fymptoms, on the contrary,
which lead to a fufpicionof inflammation, are, unremit¬
ting feverily of pain, obflinate conftipation, tenfion of
the abdomen, and an aggravation of the pain by preflure;
a very-frequent fmall and bard pulfe; the Ikin being hot
and dry, or partially moift with clammy fweats ; frequent
retching, with a dry brown tongue, hiccup; and, above
all, pain in the head, or difturbance of the cerebral func¬
tions.

Where inflammation is threatened, recourfe fhould be
immediately had to the lancet, and a free bleeding from
the arm, from a large orifice, fliould be effedled. In ple¬
thoric habits, this operation may require to be repeated,
if the pain fliould not remit,' and the pulfe fliould remain
hard and frequent, and if the blood drawn fliould exhibit
the huffy coat or contraftion of the coagulum. Where
the fymptoms of inflammation are lefs violent, leeches
to the abdomen, the warm bath, fomentations, or a blifter,
may be applied. In ftrong habits, indeed, if the pain
lias been of confiderable duration, inflammation isalways
much to be apprehended ; and a moderate venefeftion
may be beneficially employed in anticipating its aftual
attack. The tobacco-clyfter is likewife ufeful in violent
cafes ; but the dreadful effefts this agent is capable of
producing fliould render us very cautious in the ufe of it.
Of courfe, opium, an excellent remedy in the fpafmodic
colic, fliould be entirely profcribed in this.

In the aggravated form of this attack, afymptom arifes
which gives name to the difeafe; namely, the ftercora-
ceous vomiting, or iliac pajfim. In it the periftaltic mo¬
tions of the inteftines are totally inverted, and all their
contents, even clyfters, will be vomited; a circumftance
always to be accounted highly dangerous; but, if the
paflage through the inteftines be free, even though their
periftaltic motion fliould be inverted, there is much more
hope of a cure than when the belly isobftinately coftive,
and there is fome fixed obftruftion which feems to bid
defiance to cathartic remedies.

Introfufception, ulceration, mortification, See. are the
ultimate confequences of the inflammatory procefs ; oc¬
currences for the moll part fatal, or at leaft only deriving
alfiftance from furgical operations.

A very feverc kind of colic is produced by the poifon
of- lead. It is our next fpecies ; viz.

2. Colica racbialgia, (C. Piftonum, Cull.) The colic of
Poitou; otherwife called the painter’s or Devonlhire colic.
In this difeafe the pain is at firft dull and remitting; but
' progreflively growing more violent and continued ; ex¬

tending to the back and arms, and at laft producing pa-
ralyfis. We copy the following more detailed account
of its fymptoms from the Encyclopaedia Britannica.
“ The patient is generally firft feized with an acute pain
at the pit of the ftomach, which extends itfelf down with
griping pains to the bowels. Soon after there is a dif-
tenfion, as with wind ; and frequent retchings to vomit,
without bringing up any thing but fmall quantities of
bile and phlegm. . An obftinate coftivenefs follows, yet
fometimes attended with a tenefmus, and the bowels
feem to the patient as if they were drawn up towards the
back ; at other times they are drawn into hard lumps,
or hard rolls, which are plainly perceptible to the hand
on the belly. Sometimes the coats of the inteftines feem
to be drawn up from the anus, and down from the py¬
lorus, towards the navel. When a ftool is procured by
artificial means, ds clyfters, &c. the feces appear in little
hard knots like ftieep’s dung, called Jcybala, and are in
•fmall quantity. There is, however, ufually an obftinate
coftivenefs ; the urine is difeharged in fmall quantity,
frequently with pain and much difficulty. The pulfe is
generally low, though fometimes a little quickened by
the violence of the pain ; but inflammatory fymptoms
very feldom occur. . The extremities are often cold; and
fometimes the violence of the pain caufes cold clammy
fweats and fainting.. The mind is generally much af-
fedfed, and the fpirits are funk. The difeafe is often te¬
dious, efpecially if improperly treated, infomuch that the
patient will continue in this miferable ftate for twenty or
thirty days fucceffively ; nay, inftances have been known
of its continuing for fix months. In this cafe the pains
at laft become almoft intolerable : the patient’s breath
acquires a ftrong fetid fmell like excrement, from a re-
. tention of the feces, and an abforption of the putrid ef¬
fluvia from them by the lafteals. At laft, when the pain
in the bowels begins to abate, a pain comes on in the
fhoulder-joints and adjoining mufcles, with an unufual
fenfation and tingling along the fpinal marrow. This
foon extends itfelf from thence to the nerves of the arms
and legs, which become weak ; and that weaknefs in-
creafes till the extreme parts become paralytic, with a
total lofs of motion, though a benumbed fenfation often
remains. Sometimes, by a fudden metaftafis, the brain,
becomes affedled, a ftupor and delirium come on, and the
nervous fyftem is irritated to fuch a degree as to pro¬
duce general convulfions, which are frequently followed
by death. At other times,, the periftaltic motion of the
inteftines is inverted, and a true iliac paffion is produced,
which alfo proves fatal in a fliort time; Sometimes the
paralytic affedlion of the extremities goes off, and the
pain of the bowels returns with its former violence ; and,
on the ceflation of the pain in the inteftines, the extre¬
mities again become paralytic ; and thus the pain and
palfy will alternate for a very long time.”

The cure of this dreadful diforder is to be effedfed by
removing the fpafmodic conftridfion ofthe inteftinal canal.
In this form of colic there appears to be little difpofition
to inflammatory adtion ; and therefore, wherever colic
can be decidedly traced to the operation of lead, we
fliould adminifter a large dofe of opium, and repeat it at
fliort intervals, until the pain. (and of courfe the fpafmo¬
dic ftridture) is relieved. When thiseffedl has been pro¬
duced, we may proceed to excite the adlion of the bowels,
and procure proper evacuations of feces ; after which,
the cure is foon completed by tonics and cordials. This
rndlice of firft: relieving the pain and conftridlion by
piates,, before the bowels are attempted to be forced by
purgative medicines, was llrongly recommended by Dr.
Warren, (Med. Tranfadl. vol. ii.) and was alfo employed
by Dr. Darwin, (Zoonotnia, vol. ii.) As affifting the
antifpafmodic operation of opiates, the warm-bath, fo¬
mentations, &c. Ihould likewife be reforted to.

Of the palfy which fucceeds to Colica pibfonum there
feems to be a tendency in the conftitution, efpecially in
recent cafes, to recover itfelf, if the exciting caufe is

i avoided 5

PATHOLOGY.

avoided ; and this may be aided by the local ftimulus of
warm water, friction, &'c. and by mechanical fupport to
the paralyzed hands. Dr. Pemberton has recommended
that, for this latter purpofe, the patient Ihould have his
hands and fingers extended upon a fort of battledore, tied
to the fore-arm, which fhould be worn daily. He affirms
that, in feveral inftances, a perfeft cure of the paralyfis
from lead has been effeCled in the courfe of a few weeks.
(Treatife on Dif. of the abdominal Vifcera.)

Some varieties are mentioned as arifing from other
caufes than the poifon of lead ; but it does not feem that
this peculiar form of colic called rachialgia, and attended
with paralyfis, is produced by any other materia. It has
indeed been fuppofed, from its prevalence in cider-coun¬
tries, that acid ingefta might produce it ; but this oc¬
currence feems to have arifen from the frequent employ¬
ment of lend in the machinery of cider-making. The
reader will find this opinion very clearly proved by con-
fulting fir George Baker’s papers in the Medical Tranf.
vol. iii. Dr. Hunter, ibid. Dr. Fothergill, Med. Obf. and
Enq. vol..v. Indeed the pain arifing from acid ifigefta is
generally with tene firms and relaxation rather than with
conftipation.

Alum has been ftrongly recommended in rachialgia.
The modus operandi of this drug feems obfcure ; but it
deferves mentioning from the refpeftability of tliofe who
introduced it. The fame thing may be laid of the Cupri
Sulphas. Salivation, percuffion, eleClricity, See. may all
be ufed with benefit in this kind of palfy ; but they will
feldom be fuccefsful if, as is generally the cafe, the attack
of colic fhall have left behind hindrance of the gaftric
and inteftinal funClions. It is in cafes when the latter cir-
cumftance happens that the Bath water is a ufeful remedy.

It is obvious that the return of Colica pi&onutn,
and of the palfy which fucceeds it, can only be effectu¬
ally prevented by relinquiffiing thofe avocations which
neceffarily expofe the patient to the influence of the
poifonous metal which excites the difeafe ; or by re¬
fraining from thofe liquors with which any of its pre¬
parations are intermixed. When the buiinefs of the
patient precludes this, much good may be derived from
purgatives whenever conftipation has continued for a
whole day.

When colics arife from acrid poifonous matter taken
into the ftomach, the only cure is either to evacuate the
poifon itfelf by vomiting, or to fwallow fome other fub-
ftance which may decompound it, and thus render it in¬
active. The moll common and dangerous fubftances of
this kind are cprrofive mercury and arfenic. The former
is eafily decompounded by alkaline falts ; the latter by
ruagnefia in large quantities. Some kinds of fungi, when
fwallowed, are apt to produce colics attended with flupor,
delirium, and convullions ; and the fame fometimes hap¬
pens from eating a fhell-fifh known by the name of muf-
cles. The effeCi of the latter is removed by vomiting.
See the article Poison.

3. Colica crapulofa, (C. accidentalis, C. meconialis,
Cull.) Colic from indigeftion,. The pain accompanied
ivith naufea, head-ache, and dizzinefs, before vomiting,
and often terminating in a griping loolenels. It is pro¬
duced by eating indigeftible aliments, or digeftible ali¬
ments in too great abundance. In this fpecies the vo¬
miting or loolenefs, or both together, frequently operate
a cure When they do not, we may, following the natu¬
ral indications, excite ficknefs and purging.

4. Colica flatuienta, wind-colic. In this fpecies, the
pain is acute, extending to the pit of the ftomach, often
impeding refpiration ; accompanied with great fulnefs
and flatulency; and relieved by preffure, bending the
body forward, or expulfion of wind. The diforder is
produced by crude and flatulent fruits, and hence com¬
mon among children. It is, however, more generally a
fymptom of dyfpepfia, and hence- the cure is obvious.
The paroxyfm is to he relieved by antifpafmodics and
opium ; the cauffis removed if poffible, and the bowels
kept open.

Vol. XIX. No. 1294.

151

A fimilar treatment is requifite in the next fpecies, with
this reftriCHon, however, that it is lb often conneded
with general difturbnnce of the nervous and vafcular
fyftems, that opium Ihould be lefs freely given, and fup-
purations and clyfters ufed in preference to irritating
purges.

5. Colica ftipata is characterized by fevere pain, obfti-
nate coltivenefs, great tenfion, with little flatulency : the
vomiting is fometimes accompanied with faeces 5 the cof-
tivenefs, with bloody (trainings: it terminates, where
not fatal, in a free dejeftion of theinfarfted matter. Dr.
Good gives three varieties.

cc. A vifeido meconio, from vifeid meconium. Colica me¬
conialis, Sanv. Cull.

£. A facibus indurulh, from indurated fteces. C. fterco-
rea, Cull.

y. Ab enterolilho, from inteftinal concretions. C. cal-
culofa, Cull. Ileus calculofus, Snuv. — The early volumes
of the Phil.Tranf. contain fome very extraordinary cafes
of this kind. The moil Angular is in No. 3. p. 68. anno
t6Si. continued in No. 181. p. 94. anno 1686. by Dr.
Konig, of Bern. The patient, Margaret Lower, a young
woman of twenty-five, difeharged continually the con¬
tents of the inteftines, and even the clyfters that were
injefted, by the mouth, and at length a number of
(tones as hard as flint, fome in fragments, fome of the
fize of peafe, others of that of filberts. A clafliing of
Hones againft each other was felt by preffing the hand
upon the abdomen : there was great conftipation, fevere
gripings, dyfury ; and the urine, when voided, was often
loaded with a gravelly matter. The aliment and injec¬
tions being conftantly returned by the mouth, Dr. Konig
defifted /'or four months from offering her either meat, drink,
or medicine of any kind, excepting occafionally a fpoon-
ful of oil of almonds. Blood was nowand then vomited
from the violence of the fpafmodic aClion of the ftomach ;
and frequently urine, to the amount of three or four
ounces at a time, of a ftrong tafte and fmell. The dif¬
eafe feems to have lafted, with remiffions, from January
1678 to February 1683, at which period the hiftoryis ab¬
ruptly dropped, though the patient feems to have been
in a ftate of recovery. It was preceded by the appear¬
ance of veficular eruptions in the lkin, and was probably
produced by their repullion. The chemical examination
of the calculi is loofe and unfatisfaClory.

6. Colica callofa. This fpecies of colic differs mate¬
rially from all the preceding; for here th» contraction of
the mufcular fibres is limited to a fmali portion of the in-
teftine; and, analogous to what we obferve in the ure¬
thra and other membranous canals, the repetition of this
aClion often ends in a certain permanent!}' -contracted
ftate of the part affeCted. In the early Itages, however,
this feems merely a diminifhed fphere of contraction ac¬
quired by the fibres in queftion ; for they are (till capable
of dilatation, and no thickening of fubftance is at firft
perceptible. This ftate cannot however continue long;
the ftriCture becomes thickened, and fomewhat indurated,
and the paffage of faeces in a great degree interrupted.

The fituation in which we meet with this ftriCture is
more commonly about the termination of the colon, and
at the projection of the facrum, than any other part of
the inteftinal canal : and, when one ftriCture is difeovered
in this fituation, there is often another a few inches
lower in the gut. This does not, however, uniformly
happen, a ftriCture-being often met with about the termi¬
nation of the colon, where there is none in the inteftine ;
and the fame impediment has been found between three
and four inches from the anus, where there has been none
higher. But thefe contractions occur fo exclufively in
moll cafes about the figmoid flexure of the colon, and
near its termination in the reChim, that this part fhould
he carefully examined in every cafe of obftruCtion.

Although the above parts of the colon are the mod
obnoxious to ftriChires, yet it is evident the complaint
may take place in any part of it. “ I have once feen,”-
lays Dr. Baillie, “o.ne of the vulvulte canniventes much
R r longer

152

PATHOLOG Y.

longer than ufual, and paffing round on the infide of the
jejunum like a broad ring. The canal of the gut was ne-
celfarily much narrowed at this ring ; but no mifchief
had arifen from it. This malformation, however, might
have laid the foundation for future mifchief; fome fub-
llance too large to pafs might have refted on the ring, and
produced inflammation, ulceration, and untimely death.”
And, in a cafe publifhed by Dr. Combe, in the fourth
volume of the Tranfaftions of the College of Phyficians
of London, where there was an uncommon pulfation in
the aorta, dilfeftion difcovered the lower part of the
ilium, as far as the colon, contracted for the fpace of three
feet, to the flze of a turkey-quill ; the aorta was in a per¬
fectly healthy ftate.

The fymptonis indicating the prefence of ftrifture in
the reCtum, as chiefly copied from the accurate work of
Mr. W. White, are, habitual coftivenefs ; occaflonal un-
eafinefs, arifing from a fenfe of fulnefs in the courfe of
the tranfverle arch of the colon, but more efpecially to¬
wards the termination of its figmoid flexure, chiefly occa*
fioned from wind meeting with fome obftruCtion down¬
wards. The patient is often fenfible of theaggravation of
this fymptom from a variation in the quality or quantity
of his food. Sometimes the fulnefs may be felt externally,
in the courfe of the figmoid flexure of the colon. Al¬
though this fymptom frequently happens to be the firlt
to arreft the patient’s attention, and continues fome time
before any particular local inconvenience is experienced
from the palling of the feces, yet this by no means inva¬
riably occurs. Befides the fenfe of fulnefs juft noticed,
other fenfations are often excited in the courfe of the
colon ; viz. acute pain, a fenfe of p re flu re when the feces
accumulate above the It rift ure ; violent fpafmodic con¬
tractions in different parts of the inteftine, which ufually
happen after the colon has been exerted by expelling the
feces. Sometimes the patient feels as if tightly girded
with a cord. It may be proper to notice, that thefe dif¬
ferent fenfations are in general aggravated, in proportion
as the ftrifture is feated high up in the reftum. Sooner
or later the patient experiences an uneafinefs on going to
ftool, attended with difficulty in voiding the feces. As
the diforder advances, thealvine excretions become gra¬
dually more fcanty, the feces are ejefted fometimes flat,
at others of a triangular form. They are fmaller than
natural ; and are often difcharged with a fquirt, fome¬
times accompanied by a l'udden and loud explofion of
Wind.

The fame phenomena are thus concifely defcribed by
Dr. R. White in the fourth volume of the Memoirs of the
London Medical Society. “ When a perfon fomewhat
advanced in life is troubled with frequent conftipation,
complains of fulnels and weight in thertomach, with re¬
peated inclination to difcharge the contents, and uneafy
rumbling in the belly, and diftention in the lower part of
it, with a fenfation of numbnefs toward the upper part
of the facrum, extending down the reftum; repeated
fruitlefs efforts being alfo made to pafs a ftool, attended
with a fenfe of conltriftion and tenefinus high up in the
reftum, and flatus, which feemed to the patient to oc¬
cupy the intermediate fpace, burfts forth; clyfters failing
as well as medicines, and the complaint unattended with
fever or pain ; — it will be reafonable to expeft fome me¬
chanical ©bftruftion in the paffage.”

After an evacuation, a fenfation commonly continues
for fome time, as if the w'hole of the feces had not been
expelled. This by degrees goes off, and the patient feels
himfelf tolerably eafy until the next time of going to
ftool, when a fimilar fenfation recurs.

With regard to the leffened diameter of the feces juft
noticed, which mult neceffarily be the cafe whenever a
permanently-contrafted ftate of the gut takes place, there
are fome exceptions. If the ftrifture indeed fliould hap¬
pen to be fo low in the reftum as not to allow room for
the accumulation of feces, it muft appear evident that
they will be found uniform in diameter, in proportion to

the degree of ftrifture, while they continue to be dif-'
charged in a figured ftate. And alfo, when the ftrifture
is high up in the reftum, fo long as the gut below re¬
tains its natural expulfive power, an accumulation will be
prevented, and the diminifhed fize of the feces will con¬
tinue. But, as the diforder increafes, the inferior por¬
tion of the inteftine gradually lofes that power;' and,
when the contraftion becomes confiderable, a fmall quan¬
tity of feces only paffes at a time through the ftrifture,
and, not being fufficient to ftimulate the lower part of
the reftum, (which in a great rneafure is deprived of its
natural aftion,) an accumulation goes on from time to
time, until at length it becomes difficult to remove ; and,
on thofe occalions, feces of a natural fize have been
fometimes difcharged.

Pain of the back, about the facrum, is a very common
attendant on ftrifture in the reftum, and fometimes a
primary lymptom; the pain frequently (hooting down
the thighs, and in fotne inftances to the foies of the feet.
Haemorrhage is alfo a frequent occurrence, as well as a
mucous difcharge. Mr. White alfo has found pain in
the back part of the head a ufual lymptom of this
difeafe.

When the foregoing fymptoms lead us to fufpeft the
prefence of ftrifture, manual examination inuft be had
recourl'e to. Indeed the matter can only be determined
by this method. “This ought to be performed in the
nioft careful and attentive manner, feeing there is a pof-
fibiliry of miftaking the complaint either for a difeafed
proftate gland, or fora fcirrhous uterus, efpecially if the
hardnefs is attached to the cervix uteri, or back part of
the v3gina. In profecuting the examination, the firlt
ftepto be taken (after the bowels have been emptied) is
to introduce the finger (oiled) as high up the reftum as
poffible, at the fame time defiring the patient to bear'
down, as if going to ftool. For, if the examination is
firft made by introducing a bougie, it may happen that
the inftrument is pu(hed between the folds of the intef¬
tine, particularly if there (hould be particular laxity of
its internal membrane; and the practitioner may be led
to fuppofe there is a ftrifture, when in reality none ex-
ifts. If, however, on introducing the finger, neither
ftrifture nor induration can be difcovered in the reftum,
a bougie, ten or twelve inches in length and pretty thick,
muft be introduced, and paffed as high as the termination
of the colon; which will ealily be done, if ftrifture is
not likewife prefent at the lower part of the reftum.

This complaint is liable to be confounded with diar¬
rhoea, dyfentery, piles, indeed with almoft every chronic
cli(eafe of the inteftines, and, above all, with fcirrhus
uteri, and fcirrhus of the reftum. So much difficulty,
indeed, occurs in refpeft to the former, that Dr. White
fays, “ Symptoms of the contracted reftum in the female
are fo fimilar to that of a lcirrhous uterus, that I do not
know any mark whereby the one difeafe can be diftin-
guiftied from the other, excepting that in the latter the
urinary biadder is more liable to be atfefted than in the
former; though fometimes pain and difficulty in difcharg-
ing the urine attend that alfo.”

In diftinguilhing this cafe from Proftica callofa, or
fcirrhus of the reftum, we fliould notice, that, in Am¬
ple ftrifture, pain is only experienced on going to ftool ;
while, in a fcirrhous ftate of the reftum, the fufferings
are not only greater at thefe times, but there is alfo, at
other times, great pain about the facrum, often (hooting
down the thighs, as well as a fenle of burning heat and
pain in the reftum. In this laft deplorable difeafe, efpe¬
cially in its advanced ftages, the feces palled are gene¬
rally in a liquid ftate, fo that the difeafe may be con¬
founded with a chronic dyfenteric complaint. In ftric-
tures of the reftum, there is little emaciation or lofs of'
ftrength until the diforder is far advanced; the counte¬
nance then becomes fallow; and, in fome inftances, the
pulfe is quick, with other heftic fymptoms. Moreover,
as we before remarked, the Ample ftrifture is higher up

than

153

PATHOLOGY.

than the fcirrhus, and not generally of fo hard and un¬
yielding a ftruCture. The cleared: diagnofis is derived,
however, from the introduction of a canula, as recom¬
mended by Mr. Coley of Bridgnorth, in a paper read to
the Medico-Chirurgical Society. This gentleman having
a patient under his care, whom he was unable to afford
relief to by a common bougie, fince that inftrument
invariably bent upon itfelf, had recourfe to a tin canula,
for the purpofe of giving fupport to the yielding bougie.
The experiment fucceeded ; and, having occalion fome
time after to increafe the diameter of his canula, Mr.
Coley found that, by holding a lighted candle at the
end of it, he could readily diftinguifh the contracted part
of the inteftine.

In the treatment of this affeCtion, the principal part
conlifts in removing the caufes of irritation by diet of
the lead irritating kind, as jellies, fago, &c. and evacua¬
ting the bowels daily by clyders of warm u’ater. When
injections cannot be thrown up in the ordinary way,
from the contracted date of the pafl'age, a large hollow
bougie may be fadened (indead of a common pipe) to a
bladder, by which means they may be conveyed beyond
the obltruCtion.

Nervous irritation may belefl’ened byconium, hyofcia-
raus, &c. and the combination of the blue pill with them
is generally required to promote the biliary difcharge,
which is of courfemuch deranged in cafes of long ftand-
ing. If purgatives are given by the mouth, none of this
clafs fhould luperfede cador oil. It is fcarcely neceflary to
add, that aloetic cathartics tend to increafe the complaint.
In refpeCI to the regulation of the alvine excretions it
is proper to remark, that attention to this part is not only
neceflary in the camdipated date of the bowels, attendant
on the early dage of the difeafe, but alfo in its more ad¬
vanced progrefs, when diarrhoea has fupervened, becaufe
the evacuations are feldorn in fuflicient quantity to re¬
lieve the bowels, without the aid of laxatives.

The local application of the bougie is the next thing
to be confidered. This will often produce much irrita¬
tion and aggravation, unlefs nervous excitement be re¬
moved by emptying the bowels and regulating the diet
previous to its ufe. Before employing this indrument,
we diould be well allured that fcirrhus is not prefent, as
it uniformly aggravates that difeafe. The bougie fhould
be, at fil'd, of fuch a fize as to pafs the driCture without
conliderable refidance, led irritation and inflammation
be excited. The fize diould alfo be increafed very gra¬
dually till the parts become accudoined to the flimulus.
There being always more or lefs of fpafmodic aCtion ex¬
cited by the bougie, it fhould be introduced flowly and
gently, waiting a little when it touches the driCture, be¬
fore it is puflied through. At fird it diould not remain
longer than half an hour in the reCtum ; if there be
much irritation, not fo long. By degrees it may be al¬
lowed to remain eight or ten hours at a time, with little
or no inconvenience to the patient. In general, it may
be pafied daily. From four or five to eight or ten weeks
will elapfe before the flriflure admits a full-fized bougie;
even then, the indrument mud be gradually left ofl’. It
is found that the natural aCfion of the bow'els is gene¬
rally much improved by the application of the bougie.
As auxiliaries we may mention the hip-bath, and injec¬
tions with extraCt of poppy. The former may be ufed
for a few minutes before employing the bougie ; and the
anodyne injection after the bougie contributes to leflen
the morbid irritability of the part. With refpeCI to the
kind of bougie, we fhould prefer that ufed by Mr. Coley,
though perhaps, this is not a matter of the fird importance.
Mr. Coley’s bougies are compofed of lint rolled up, tied
•at the lower end with dring, which forms a loop about
three inches long, for the purpofe of being fecured to a
T bandage. They are to be immerfed in a compofition of
lead four parts, and wax one part; and then drawn
through a wooden frame, having holes of various diame¬

ters. Great advantage, our author obferves, will be de¬
rived from making the points conical. His manner of
applying them difl’ers from the common mode in this,
that they are wholly concealed within the re€tum, as will be
prefentiy deicribed ; which he confiders a great improve¬
ment, as it enables the patient to walk about, or even
ride on horfeback, during the ufe of them. He advifes
them to remain in the bowel, if poflible, all night ; which,
he thinks, has the efteCt of promoting the abforption of
difeafed ftruCture, by long-continued preflure, as well as
of refilling the tendency to contraft. At the fame time,
he obferves, that the difcharge of the cerate, produced
by the heat and moidure of the anus, is avoided; the
cerate not being melted by any portion of the inteftine above
the J'phinSter.

Mr. White mentions a variety of this difeafe, which
arifes in confequence of venereal infeCtion. “When the
diforder proceeds fronrthis caufe, it generally commences
with an appearance either of ulceration, or excrefcence
about the verge of the anus. The fphinCter ani becomes
gradually contracted ; and, the difeafe extending up¬
wards within the reCtum, a conliderable tlrickening and
induration of the coats of the intefline take place, which
produce great irregularity and contraction in the pafl'age.
Sometimes there is a continued line of contraction from
the anus, as far as the finger can reach, then terminating
in a kind of cartilaginous border, the inner membrane
having a thickened and condenfed feel. There is often
a difcharge indicating a difeafed, if not ulcerated, flute
of the inner membrane above the contracted portion of
inteftine. All the cafes which I have hitherto met with
of this nature, have occurred in females, and they have
uniformly proved incurable, when attended with the
ftruClural derangement juft deferibed.”

The reCtum is alfo liable to contraction from tubercles
fituated immediately above the fphinCter ani, very differ¬
ent from the foft bluilh hasmorrhoidal tubercles which
often furround the anus. Thefe lafl protrude when the
patient (trains ; and, when returned within the fphinCter,
no hardnefs can be perceived in the gut. It isthereverfe
with the other tubercles; they do not come below the
fphinCter, and they have an indurated feel.

The fpecies of contraction noticed as the confequence
of venereal infection, Mr. W. has found exafperated by
the bougie, even when conjoined with a regular courfe
of mercury. “ In the tuberculated ftate, however, ari-
fing from afimilar caufe, (he fays,) the bougie will be found
of great fervice.” In fcirrhus of the reCtum, the bou¬
gie would manifeftly be improper.

Sometimes ftriCture is attended by prolapfus ani, flefhy
excrefcences, or luemorrhoidal tubercles, udiich prove
a hindrance to the ufe of the bougie, and require to be
previoufly removed by ligature or the knife. But, in
doing this, he muff be careful not to include any portion
of the prolapfed inteftine, which fometimes comes down
with the excrefcence. The prolapfus ani, however,
which occurs as the confequence of ftriCture in the rec¬
tum, is very partial, and unlike the common prolapfus.
Whilft the whole of the lower portion of the reCtum pro¬
trudes from a relaxation of the fphinCter, this only occu¬
pies one fide of the anus, forming a pendulous flap. It is
neceflary to puftithis flap gently up with the fingerbeyond
the fphinCter, to make way for the bougie to pafs, which
otherwife would be apt to get entangled in the prolapfed
portion of tire inteftine. The ufe of the bougie will
fometimes overcome this impediment ; but, if it fhould
continue after the pafl’age is dilated, and prove trouble-
fome, the pendulous part may be removed with the knife,
and the patient freed from future inconvenience.

With regard to the divifion of the ftriCture, as prac¬
ticed by Wifeman and others, there can be no doubt of
the expediency of the operation in fome inftances, where
the bougie fails, and the ftriCture is of a cartilaginous
hardnefs. See the article Surgery.

Genua

154

PATHOLOGY.

GemisVII. Coprof afis, [from xoWgftC, dung, and oretait;,
ftagnation.] Retention of the Faeces. This genus has
only two fpecies.

1. Coprodnfis coafta, (Obftipatio, Cull) Coftivenefs.
This is a complaint to which fedentary perfons and bon-
vivants are much expofed, and which has long and juftly
been considered a frequent caufe of the numerous dy ft¬
p-optic cafes we daily witnefs. Its obvious cure is the ufe
of cathartics ; and for thefe medicines formulae abound
in every family. The frequent recourfe which is had to
purgatives tends, however, to impair the functions of the
intellines, by rendering the peri ftal tic powers inaflive
except under the influence of ftimulus; and further,
even this ftimulus, as is well known, gradually lofes its
effedt by repetition. On this account our therapeutical
indications fliould embrace a wider field of remedial
agency. As the mufcular fibres are the agents of the pe-
mftaltic motioit, we Should endeavour to Strengthen the
tone of the mufcular iYltem generally, fince one part is
feldom weak without all participating in the fame debi¬
lity. This purpofe is peculiarly to be effedled by exer-
cife to fuch a degree as to Strengthen mufcular contraction
without producing fatigue; by the cold bath, and by
medicines which are laid to give tone to the mufcles.
Mr. Howfhip, in his work on the inteftines, fays, that
bark internally administered for l'ome continuance will
bring on the healthy aCtion of the trowels to fuch a degree
that purgatives become unnecelTary. The belt method
of ufiog it feems to be to unite it with a moderate dofe
of cathartic medicine, and then gradually diminifli the
dofe of the latter, and increafe that of the former.

If coftivenefs continues, however, a clyfter of warm
water will produce the al vine difeharge, and without, of
ciourfe, Stimulating in any inordinate degree the entire
Secretion, fince this meafure does nothing more than dift
folve the faeces. The life of clyfters is becoming more
fashionable in this country, and there is every reafon to
believe, that, if we ufed them oftener, and applied draft
tic purges lefs frequently, the digeltive apparatus of molt
perlons would be found in a better condition. It has
been recommended by foir.e lo endeavour to inllitute re¬
gular ftools by voluntary endeavours at regular periods ;
but we believe this will feldom do good, except when an
indolent habit of neglecting the calls of nature has been
the caufe of the complaint; and, even then, draining
Should not be long perfifled in.

Codivenefs feldom occurs in young infants. When it
does, it always arifes from badnefs or deficiency of the
juirie*s milk, or from the food. If one copious evacu¬
ation take place every twenty-four hours, and the in¬
fant be thriving, there is no occafion for interference ;
but, if there be any greater torpor of the bowels than
this, fuitable remedies are to be employed. For this pur¬
pose, a brifk laxative may be given every day, for four or
five times fucceflively. The bed laxatives for infants are
manna, calcined magnefia, and cold drawn cador-oil.
Where thefe means fail, and there is reafon to attribute
the coftivenefs to the nurfe’s milk, we mud regulate the
diet, and open freely the how-els, of the latter. Rut, if it
be found that the milk dill pod’eO'es that injurious quality,
the nurfe diould, if poflible, be changed. Where this
cannot be done, four or five drops ol antimonial wine
may be given to the infant every night at bed-time.

2. Coprodafis addricla. In this fpecies the fame ge¬
neral treatment fliould be regarded. Purgatives of a
gentle kind, and gradually leflened as they are found ef¬
fectual, are the fird agents. Diet fliould be ufed of a re¬
laxing kipd, we mean fuch a# is principally compofed of
green vegetables. The fympathy which exids between
the (kin, the mucous lining on one part of the alimentary
canai and another, render medicines applied to the Sto¬
mach and (kin of efteCt on the bowels ; fo the warm
bath, naufeating doles of calomel and antimony, will,
if perfevered in, fometimes effect a cure. Constipation

often occurs without producing much inconvenience.
Some perfons are accudomed to have their bowels moved
not oftener than twice a- week ; and, to fuch, a week’s
codivenefs is attended with no particular inconvenience.
Chaptal mentions the cafe of a female patient, who, for
four months, had no difeharge either from the bowels or
kidneys, and as little evacuation by fweat, notwithdand-
ing that her diet was confined to milk-whey and broths.
And the writer of this article is acquainted with a lady
who often pades a week or a fortnight, and on one occa¬
fion pafled a month, without a faecal evacuation : her
urinary difeharge is copious, but clear ; and no extraor¬
dinary degree of perfpiration is manifed on her (kin.
But this is nothing to cafes related in old books, as in
the early volumes of the Phil. Tranf. and of the Journal
des Scavans : from thefe and fuch like authorities, Dr.
Mafon Good has quoted cafes of fasces retained for fix
months — two years — three years — feven years ! Credut
J a dans (ipellu !

Genus VIII. JDyfenteria, [from bad, and ttTcgor,
bowel.] Dyfentery. Griping and tenefmus ; frequent
mucous and bloody digedions, the fasces feldom dis¬
charged, and in (mall quantities. Bloody flux.

The word chfenteiy, as ufed by the ancients, had no
very precife fignification. Originally its import was “ an
aft’e&ion of the* bojvels” in general; and we find Hippo¬
crates ufing it, not only to Signify all ulcerations, but all
haemorrhages, of the intedines (even thofe which are
critical and falutary), and likewise every kind of dux,
with or without blood. (Prorrh. 2. et Epidem. lib. ii.)
It would feem, however, that, after his time, foir.e of the
other Greek authors, whofe works are Jod, were fenfible
of this want of precifion, and therefore redrifted the
meaning of the word to an ulceration of the bowels, at¬
tended with gripes and tenefmus, (or draining,) and with
imicousand bloody (tools. For a dileafe with thefe fymp-
toms CelSus calls tormina, and fays it is the dyfcntcria of
the Greeks ; and Ccelius Aurelianus, retaining theGreek
name, deferibes the dyfentery much in the lame manner
with Celfus. (See Celf. de Med. lib. iv. cap. xv. Cod.
Aurel. de Morb. Chron. lib. iv. cap. vi.) Yet Galen re¬
turns to the looler acceptation of the word, fometimes
defining a dyfentery “an ulceration of the bowels,” at
other times mentioning four fpecies of that didemper, all
with bloody dools ; but of which only one agrees with the
tormina of Celfus, or the dylentery of the moderns. Are-
tseus confines the term to an ulceration of the bowels ;
and this notion of theconflaiit ulceration of the bowels,
in conjunction with dyfenteric fymptoms, prevailed in all
medical writings until the time of Sydenham and Willis.
Dr. Good mentions two fpecies of this difeafe :

1. Dyfenteriu (implex; unaccompanied with fever: the
faeces, when difeharged, evacuated without confiderable
pain, of a natural quality, and adording eafe.

2. Dyfenteria pyreCtica, accompanied with fever, great
lofs of Strength, and deprefiion of fpirits : the faeces, when
discharged, of various colours and confidence; highly
fetid, and mixed with putrid fanies, Sebaceous matter, or
membranous films.

Of the fird Species of dyfentery it is unnecedary to
fay much ; its cure is effected by milder means than
the fecond, though according to the fame indica¬
tions. Nor, important and dire as the fecond form is,
will it require a long difeudion, fince its nature has been
fo clolely dudied, and its method of cure (o well efta-
blifhed of late by our colonial furgeons, that we have the
fatisfaCtion of prefen ting more general principles as guides
on this fubjeCt than we are enabled to do with regard to
mod other difeafes.

In (peculating on the nature of dyfentery, the fird
thing that requires our condderation is the increafed
difeharge from the bowels. Of the caufe of this pheno¬
menon one explanation alone p<refents itfelf; viz. a more
rapid pafiage of the fecreted fluids through their veifels ;

1 or.

PATHOLOGY.

or, in other words, excitement of thofe veflels. Whe¬
ther this excitement bedeferving of the name of inflam¬
mation has been difputed. It is, however, a queftion of
no great moment. We (hall have occafion to (how, when
the filbjeft comes before us, that the two above-mentioned
Kates are, as far as regards the mucous membranes, very
clofely allied ; and in the prefent cafe, even if inflamma¬
tion be not the mode of action primarily eftablifhed, dif-
feCtion (hows that it is almoft always unequivocally and
extenflvely prefent in fatal cafes.

It has been objected againfl confidering this difeafe as
inflammation of the bowels, or enteritis, that the latter
difeafe is uniformly accompanied with eoflivenejs and fup-
prefled fecretion. It mull; be noted, however, that a
diftinCtion (hould be made between inflammation as it
affeCls the exhalent orifices of veflels, and the fame aCtion
affeCting the blood- veflels more extenflvely. As far as
regards the bowels only, it feems very clear that diarrhoea
and dyfentery are the fame difeafe, fince increafed and
morbid fecretion are in each apparent. Dyfentery, how¬
ever, appears to affeCt a larger extent of the fyftem than
the former complaint; and indeed we cannot help coin¬
ciding with Dr. J. Johnfon in confidering that we mud
look to aferiesof caufes rather than to a proximate one
for illuftrating the nature of this difeafe. From the la¬
bours of this author and of feveral of his contempora¬
ries it is made evident, that the (kin and liver are the
parts primarily affeCted in dyfentery. jThe difeafe hap¬
pens for the mod: part in warm climates, where of courfe
thefe organs are fubjeCted, as is well known, to the influ¬
ence of debilitating agents. It happens too, mofl com¬
monly, when wet or damp weather fupervenes to that
which was airy and warm. That fuch change of tempe¬
rature (hould produce this difeafe in fome cafes, while
enteritis or other maladies are caufed by the fame agent
' at other times, can only be accounted for on the afiump-
tion of predifpofition to difeafe. Thus we (hould be in¬
clined to think, a priori, that hepatitis, cholera, and dy¬
fentery, might be brought on by the fame caufes, according
to the debility which the habits or conditutionof the indi¬
vidual affeCted might produce in a particular part of the fyf-
iem : and this accords with the experience of the bed prac¬
titioners. In faCt a little confideration (hows us, that this
opinion may be pu(hed much further. In cold climates
the lungs are the organs which undergo the greated de¬
gree of flimulation from the atmofphere; and hence, if
the cutaneous perfpiration be checked, we find a vica¬
rious difcharge take place on the bronchial membrane,
and pneumonia and phthifis become common. So, the
liver being the part mod called on for exertion in warmer
climates, and the whole of the digedive powers being
weakened in the fame ratio, we find, in thefe fituations,
that the hindrance of the cutaneous difcharge caufes
larger afflux of fluids to the abdominal vifcera, and a con-
fequent diflurbance of function.

Stimulating and indigefiible diet, which is often ufed by
the European in tropical climates, has been mentioned as
another caufe of the prevalence of dyfentery ; and Mr.
Bampfield (Practical Treatife on Dyfentery) is of opi¬
nion, that the peculiarities of clothing may be looked to
as another caufe. He fays, “ The copious perfpiration
of the newly-arrived European becomes accumulated,
when he is fitting or walking, on the lower part of the
(flirt, more especially about that part of the abdomen
where the wailtband of the fmall-clothes or pantaloons
prefles againd it, the tight or clofe application of which
occafions an increafe of heat and of perfpiration at this
particular part during the day, and intercepts the exha¬
lation as it flows down the body ; hence, if he (hould lie
down in this date, cold will be induced on a particular
part of the abdomen, by the evaporation of the exhaled
fluid from the wet linen in contaCt with it; perfpiration,
before profufe, will be now effectually fuppreffed, and its
injurious confequences be felt by the chylopo'ietic vif-
_ c'era.” -

It. is a propofition almofl proved, then, that the (kin
Voe. XIX. No. 1294.

155

is firfl affeCted in dyfentery, and that a vicarious difcharge
of mucus takes place from the bowels. The doppage of
the perfpiration induces moreover a general plethora of
the abdominal vifcera; and, as the liver commonly par¬
ticipates in the inaCtion of the veflels of the furface, this
important gland, and probably other glands, fail to un¬
load this plethora by fecretion ; fo that not only is a great
difcharge thrown on the bowels, but, the latter organs
being infufficient for its removal, a generally plethoric
and febrile date is eflablifhed. The irritation made on
the nerves of the bowels by the morbid fecretions induces
irregular and violent contractions of the mufcular fibres ;
and hence we explain the occurrence of pain, tenefmus,
and retention of faeces, as well as of thofe permanent
ftriCtures which are fometimes found in thefe parts on dil-
feCtion.

The firfi notice of this difeafe is generally a fenfation
of chillinefs and flight rigour ; to this fucceed anorexia
and uneafinefs in the bowels ; in a few hours this is fol¬
lowed by griping and purging, attended with tenefmus,
during which mucus only is evacuated ; at the fame time
febrile fymptoms make their appearance ; the (kin be¬
comes hot and dry ; and reftlefl’nefs, and fometimes deli¬
rium, occur; an indefcribable languor foon after this
pervades the mufcular fyflem, blood is poured forth
(when from the reCtum in flreaks, when from the higher
parts of the bowels perfectly mixed) with mucus. Severe
pain and inceflant purging attend the motions, emitting
little odour, and often containing membraniform lymph.
If the complaint continues uninfluenced by medicine, or
receives no relief from the exhauflion of the veflels by
their fpontaneous action, death occurs with the ufual
fymptoms of high inflammation and mortification. Or,
if the difeafe does not arrive at this termination, a chro¬
nic date of the difeafe is induced, which, lading for a
longer or (horter time, ends in Ample diarrhoea, in ulce¬
ration of the villous coats, in permanent contractions,
or more favourably and lefs frequently in recovery.

The degree of violence with which the fanguineous
and nervous fyflems are affeCted is various. Sometimes
the pulfeis little altered ; and in this cafe we feldom find
much blood in the flools, but merely mucus and ferum,
and thofe in fmall quantities. A pain in the abdomen is
felt juft before each evacuation, and at that period only.
From this (late we find every grade of fever, and increafe
of the other fymptoms in proportion, until we arrive at
a variety in which the pulfe is accelerated to an amazing
height, and delirium manifeft ; in which there is a con-
ltant fixed acute pain of fome part of the abdomen or
inteftinal canal, including the parts contained in the pel¬
vis ; obftinate retention of faeces, but very frequent and
copious dejeftions of mucus, ferum, or blood, or a mix¬
ture of thefe, together with fevere tormina and tenefmus.
The blood drawn and concreted exhibits the inflamma¬
tory buff. Sometimes the fever is of the intermittent or
remittent kind.

The cure of dyfentery is founded on the following indi¬
cations : viz. to remove the violence of morbid aCtion,
left inflammation, and its fatal confequences, (hould come
on ; to reftore the balance of the circulation ; and, laftly,
to correCt the altered (late of the fecreting veflels of the
inteftines, and allay the contraction of the mufcular coats
of the fame (truCtu res. The firft is, of courfe, done by
bleeding. Sydenham ufed this meafure, though not to
any important extent; and it was not till after the late
war on the peninfula that its ufe became general.

As to the extent which bleeding (hould be carried to
in dyfentery, no general rules can be given, fince this mult
be regulated rather by its effects on the pulfe than by
quantity; and in faCt it fometimes happens that fo little
fever attends, that bleeding is unneceffary. In violent
cafes bleeding ad deliquum (hould be had recourfe to,
fince, as in all other complaints characterized by in¬
creafed vafcular aCtion, the fuddennefs with which we
abftraCt blood is of great importance.

As the (teces are retained notwithftanding the urgency
S s for

156

PATHOLOGY,

for evacuation, purgatives may be adminiftered. They
areadmiffible only with much reftridtion. Calloroil feems
the only purgative which can be prefcribed with fafety,
lince moll: others in common ufe irritate the nervous ex-
panfion of the bowels, and in even the morbid contrac¬
tions. This oil is faid indeed to fheathe the nerves, by
its lubricity, from the irritating fecretions, while it pro¬
duces natural and general fecretion. Clyfters have been
recommended ; but the ilimulus of detention is of all
other ftimuli the moll irritating to the difeafed inteftine.
Moreover they do not reach to thofe points where the
eftabliftiment of fecretion would be a defirable matter ;
and confequently little good can be expected from them.

It has been urged by Dr. J. Johnfon, that we fhould not
be obedient to every call of nature, the ftraining which
enfues being highly detrimental, and augmenting, in
many cafes, the difcharge of blood. Every motion of the
body indeed, increafes the defire to evacuate. As little
or nothing, except mucus and blood, comes away in
four efforts out of five, we fhould therefore endeavour
to ftifle the inclination to ftool ; and we (hall often fuc-
ceed ; for the tormina go off in a few minutes, and by
thofe means we elude not only the ftraining, but the pain¬
ful tenefmus which continues fo long after every fruit-
lefs attempt at evacuation. This circumftance, though
apparently of a trifling nature, Dr. J. thinks of confider-
able importance, though it has feldom been attended to.
It has the fandlion of antiquity, however, as may be feen
in the following precept of Celfus : “ Et Cum in omni
fiuore ventris, turn in hoc precipue neceffarium eft, non
quoties libet defidere, fed quoties neceffe eft ; ut hac ipfa
mora in confuetudinem ferendi oneris inteftina deducat.”

Diaphoretics are of courfe to be ufed, and the fecre¬
tions of the fkin encouraged by the warm bath ; but this
is by no means an eafy tafk, fince, independently of the
uncertain operation of thefe remedies, the perforation is
liable to frequent checks on account of the patient’s fre¬
quently rifing from bed to evacuate his bowels. The
painful contra dlions of the bowels are beft allayed by
opium. A fmall pill may be introduced into the redlum;
or it may be given in the form of the pul v. ipecac, comp,
in which combination its effedts are alfo beneficially ex¬
erted on the fkin.

The adfion of the fecreting veflels is altered by mercu¬
rial medicines ; calomel in large and frequently- repeated
dofes being indeed our principal dependence in this com¬
plaint. The modus operand! of this medicine is by no
means generally underftood. Thofe who have ufed it
molt fuccefsfully affert indeed, that it corrects the condi¬
tion of the liver by emulging its dudls, unloading its
congefted or over-gorged veflels, removing undue deter¬
minations of blood to its yielding texture, prompting the
healthy fecretion of its peculiar fluid, and thereby re-
folves pyrexia. But all this is of courfe gratuitous af-
fumption. The medicine may certainly ftimulate the
liver; but it is too much to affert that by fo doing it
cures dyfentery, fince it is feldom fuccefsful till ptyalifm
is produced ; and every one knows that the fecretions of
the liver may be corrected by mercury in very fmall
dofes. Mercury is faid to equalize the circulation ; but
this appears an illogical propofition. If the affertors of
this imply that it produces general fecretion, and thus
brings into a <51 ion torpid fecernents ; it is a truifiu which
cannot be queftioned ; but to fpeak of equalifing circu¬
lation in any other manner implies that calomel affedts
morbid ftrudtures in one mode, and healthy ones in ano¬
ther ; a notion which does not feem to have the leaft pro¬
bability on its fide. However this may be, mercury is the
only medicine to be trufted to in dyfentery: and it mufl
be pu filed to fuch an extent as to induce falivation. It
may be given from dofes of a few grains to that of one
fcruple three times a-day ; and it is aflifted by other me¬
dicines in conjunction: thus opium, ipecacuanha, and
calomel, anfwer the defired end with lefs uncertainty
than the feparate exhibition of any fingle one.

The diet of the dyfenteric patient fhould be very fpa-

ring, and fhould confift of the leaft Irritating fubftanees,
the various preparations of the farinacea, as fago, arrow-
root, rice, See. are alone admiflible; but the lefs food of
any kind that is taken in the beginning of the difeafe,
the better. In chronic dyfentery, where our principal
effort muff be directed to keeping the biliary fecretion by
gentle dofes of calomel, and inducing regular adtion of the
fkin by diaphoretics, by flannels next the fkin, and as
much as poffible by regulated temperature; the diet fhould
confift of the fame kind of fubftanees as in the acute
ftage ; and it is fometimes advifable to ufe aftringents,
as the kino, See. A difh is recommended by Dr. J. John¬
fon, which he fays the patients relifh much : it confifts
of flour and milk boiled together, and rendered palatable
with fugar and fpice.

When the diforder is pretty well removed, gentle fti-
mulation by the bitters and the mineral acids, particu¬
larly the nitric, muft be had recourfe to. At the fame
time we mult guard again ft fuffering the patient to in¬
dulge in too much food ; for after this complaint the ap¬
petite is often greater than the powers of digeftion, and
its indulgence is fometimes followed by a relapfe into the
original difeafe, or other difeafes, equally diltrefling and
dangerous, are brought on.

The queftion concerning the contagion of dyfentery
will be difeuffed when we fpeak of the fubjedt at full
under the order Pyrectica of this arrangement.

Genus IX. Diarrhoea, [from pea, to flow.] Flux, or
Loofenefs. Generic charafters — Alvine evacuations
crude, loofe, and too frequent : with little or no griping
or tenefmus. There are fix fpecies.

1. Diarrhoea fufa. Faeces of common quality, but im¬
moderately loofe and copious.

2. Diarrhoea biliofa. Fxces loofe, copious, and pecu¬
liarly yellow.

3. Diarrhoea mucofa. Dejedlions confiding of, or con¬
taining, a copious difcharge of mucus. This is aferibed
by Cullen to acrid ingefta, or taking cold, particularly in
the feet. When produced by cold, it forms the Ca-
tarrhus inteftinorum of various authors : the motions
are acrid, often with but little bilious tinge, and the
lower part of the redtum is excoriated, like the noftrils
in a coryza.

4- Diarrhoea chylofa. The dejeftions milky or chyli-
form.

5. Diarrhoea lienteria. The dejedlions confifting of
the aliment palled rapidly and with little change.

6. Diarrhoea ferofa, the watery loofenefs, in which the
dejedlions are almoft entirely liquid. It is frequently
metaftatic, and ftill oftener produced by elaterium, or
other draftic purgatives. Sometimes urinous, occafionally
tinged with blood.

Diarrhoea is a leading and cbaradleriftic fymptom in
many diforders, both acute and chronic, general and lo¬
cal. This genus is to be diftinguilhed from the foregoing
by being generally without fever, and by the alvine eva¬
cuations confifting of the natural fxculent matter, though
in a more liquid flate ; and by the abfence of tenefmus, or
violent bearing down, which attends Dyfentery. There
is alfo in the latter diforder more fevere griping than in
Diarrhoea : but this occafionally occurs in the Diarrhoea,
and therefore is not a decifive diftindlion. There is, how-,
ever, as we faid before, a mutual alliance between the
two difeafes, which occafionally pafs into each other; a
diarrhoea, if negledled or improperly treated, fometimes
being converted into dyfentery ; and a dyfentery, when
its worft fymptoins have been fubdued, fometimes leav¬
ing a diarrhoea behind.

The effential part of this difeafe, in all the fpecies we
have enumerated, confifts in a preternatural increafe of
the periftaltic motion, and of the fecretions, in the whole
or a great part of the inteftinal canal ; and the predifpo-
fing caufe of the difeafe is a peculiar irritability of the
inteftines, and of the fecreting veflels which open upon
their internal furface.

The

157

PATHOLOGY.

The feveral exciting caufes of diarrhoea may be referred
to two different clafl'es. The firfl: comprifes diforders of
certain parts of the body, which, either from a fympathy
of the inteftines with thefe parts, or from their connec¬
tion with the fyftem at large, occafion an increafed attion
of the inteftines, without the transference of any ftimu-
lant matter from the primary difeafed part to them.
Thus, the general fympathy of the inteftines is often ma-
nifefted in perfons under the influence of certain paffions
of the mind, as anger, fear, and fome others, which oc-
cafionally excite a diarrhoea. And among the difeafes of
other parts of the body, which aftett the inteftines, the ir¬
ritation of dentition, in infants, may be mentioned as a fa¬
miliar illuftration, as it is feldom difficult and painful
without occafioning diarrhoea. The fympathy between
the (kin and the bowels is particularly great in many in¬
dividuals, fo that a chill, or the application of cold and
moifture, efpecially to the feet, will generally excite a
diarrhoea : and the fame fympathy is (ltown in others by
the occurrence of diarrhoea from the fuppreffion of cuta¬
neous eruptions, or the flopping of profufe or habitual
difcharges from fores, & c.

The fecond clafs of occafional caufes of the increafed
a&ion of the inteftines, confifts of the ftimuli which are
applied dire&ly to the inteftines themfelves : and thefe are
of various kinds. They may be fubftances introduced
by the mouth, as indigeftible aliment, purges, &c. or
poured into the inteftines by the feveral excretories open¬
ing into them, as the fecretions of the liver, &c.

Diarrhoea, when it occurs in fevers, is often a very un¬
manageable and dangerous fymptom. After the meafles
it is often falutary ; but in many inftances it has proved
more fatal than the difeafe itfelf, as is faid to have been
the cafe in the fatal epidemic meafles in the ifland of St.
Helena in the year 1807. Diarrhoea is one of the moil
common diforders attendant on difficult dentition in
children : in fatt, almoft every irritation which excites
feverilhnefs in young children, is apt to occafion it. It
is likewife a fymptom of the prefence of worms in the in¬
teftines. In the laft ltage of pulmonary conl'umption, a
colliquative diarrhoea, which is liable to alternate with
the colliquative fweats, is an almoft univerfal occur¬
rence.

The leading indications of the cure of diarrhoea will
turn upon one or other of the following circutnftances.
Whether it appear to a rife from, 1. a morbid irritability
of the inteftines ; a. a preternatural ftimulus applied to
them ; or, 3. a combination of thefe two. The firfl: in¬
dication will require the irritability to be allayed ; the fe¬
cond, that the offending matter be expelled, or its acri¬
mony corrected ; and the third will demand a mixed plan,
confiding of the other two, either jointly or alternately,
together with an attention to the ftate of other func¬
tions and organs, which may affeft that of the prima via.

The means adapted to fulfil the JirJl indication, or to
allay the morbid irritability of the inteftines, will confift
in the adminiftration of opiates. In moft of the forms
of diarrhoea, fmall dofes of rhubarb are a good altrin-
gent. In the cafes of D. mucofa or D. lienteria, efpecially
when it has arifen from acrid purgation, conftituting a
hypercatharfis, and in all inftances of colliquative diar¬
rhoea, the adminiftration of opiates is particularly requifite.
The vicarious difeharge muft be folicited to the (kin by
warm bathing and fudorifics ; and, if difofganization is
threatened, the ufe of calomel, as in dyfentery, muft be
reforted to.

The means adapted to fulfil the fecond indication, of
removing a preternatural ftimulus from the inteftines,
confift in the adminiftration of evacuants, or correctors
of acrimony. Hence the ufe of emetics, of purgatives,
of clylters, with the one view; and of mucilaginous di¬
luents, alkalies, and abforbents, with the other.

The acrimony, which excites diarrhoea, efpecially in
children, is moft commonly of an acid nature, and is ge¬
nerated in the ftomach during the impferfed digeftion of

the food. Alkaline andabforbent medicines tend to neu¬
tralize it, and therefore to remove the irritation of this
acrimonious caufe of diarrhoea. Cordials and ftimu-
lants alfo are ufeful auxiliaries in removing fuch a di¬
arrhoea.

When the third indication occurs ; when there is, at
the fame time, a morbid irritability of the inteftines, and
an unufual ftimulus applied to them, the latter muft be
removed or corrected, where that is practicable, by eva¬
cuants or other means, and the irritability moderated.
Abforbents, fuch as preparations of chalk, teftaceous
powders, lime-water taken with milk, See. will tend to
correCt any acid acrimony that may be formed in the ca¬
nal ; while gentle laxatives may be combined with them,
fuch as rhubarb. Thefe are principally indicated in cafes of
chronic diarrhoea, and in debilitated habits. A determina¬
tion of the fluids to the (kin, by diaphoretics, by warm¬
bathing, by reftoring fupprefled difcharges, or fubftitut-
ing fuch as may be equivalent, by warm clothing, friction,
and the exercifeof geftation, will aid in fulfilling this in¬
dication ; efpecially in cafes where the occurrence of di¬
arrhoea is obvioufly connected with the application of
cold, the fuppreflion of cutaneous excretions, or with a
generally debilitated habit. This purpofe is alfo more
effectually accompliftied, when a courfe of fuitable diet
is purfued at the fame time ; efpecially the ufe of milk,
rice, the amylaceous parts of vegetables, fuch as arrow-
root, tapioca, fago, &c. with animal broths and jellies.
Dr. Heberden recommends the combination of fpices
with the vegetable mucilages, as the nutmeg, cinnamon.
See. or the combination of cretaceous medicines with
fpices and opiates. He alfo advifes the ufe of a fpoonful
of mutton fuet, difl'olved in four ounces of warm milk,
twice a-day, both as medicine and nutriment to a patient
under chronic diarrhoea.

Dr. Good mentions a cafe of D. ferofa, which occurred
to himfelf in 1806. The patient <Was a young woman,
aged twenty-four; the diforder had continued for ten
years, and had never produced fewer than nine or ten'
watery ftools a-day, fometimes tinged with blood. She
was often in great fpafmodic pain in the ftomach or intef¬
tines ; and had tried a long lift of aftringents, anodynes,
and other medicines, to little purpofe. She was much
reduced; and it appeared to be a cafe of great local ir¬
ritation from local debility. Gentle ftimulants were here
of eflential fervice ; and the difeafe gradually yielded to
camphor mixture and pills of the refinous gums.

Diarrhoea is a common complaint among infants. The
natural appearance of the ftools is altered from the bright
orange colour, pulpy and curdled confidence, and inoften-
five fmell ; and they become green, (limy, and at the fame
time emit a four fmell, which arifes from the prevalence
of acidity in the firfl: paflages. The complaint is not
often dangerous ; it generally yields to a laxative com-
pofed of a little magnefia and rhubarb. But the nurfe’s
food (hould be regulated; and the infant ought to have
no other food, in addition to the milk, than arrow-root.

This complaint generally arifes from expofure to cold,
or from fome irritation or accumulation in the bowels.
The linen and ftools are ftreaked with blood ; and there
is violent pain, or fymptoms of fever. Where (limy
ftools are of the colour of clay, and emit a putrid fmell,
the infant foon becomes emaciated ; and the difeafe of¬
ten terminates fatally, though its progrefs be flow.

As the diforder proceeds, very unfavourable fymptoms
occur, fuch as emaciation and drynefs of the (kin, fwel-
ling or fhrinking of the belly, with an altered appear¬
ance of the countenance ; and there is a conftant fretting*
or peevilhnefs of temper. Swellings of the glands of
the groin, and a little uneafinefs of breathing, as if there
were a flight tendency to cough, are alfo very unfavour¬
able fymptoms. In many of thefe cafes the purging is
the effeCl of a difeafed ftate of fome of the digeftive or¬
gans, or of the mefenteric glands ; but in others it
arifes from an irregular aCtion of the former organs. The

continued.

158 P A T H O

continued ufe of alterative medicines., which maintain
a deady but gentle aftion upon the alimentary canal, and
the adjoining vifcera, feems to be the mod fuccefsful treat¬
ment. At the fame time we mudcorreft and modify their
operation according to circumftances, and palliate urgent
fymptoms. The occafional ufe of injections of thin
darch and laudanum, in the proportion of eight or ten
drops of the latter to two table-fpoonfuls of the former,
may like wife be employed.

A fevere and often fatal fpecies of diarrhoea is known
in Scotland by the name of the “ weaning brafh.” It oc¬
curs after weaning a child too fuddenly, efpecially at an
unfavourable feafon, as the autumn. It commences
fometimes two or three days after weaning, but fre¬
quently not for three or four weeks, with a purging and
griping, and green Pools. If this be negledted, the
fymptoms increafe, retching and vomiting fupervene, fol¬
lowed by a loathing of every kind of food, emaciation
and foftnefs of the flefh, reftleffnefs, third, and fever of a
heCtic charafter. But the mod charaCteridic fymptom of
this difeafe is a condant peevifhnefs, the efteCt of uncea-
fing griping pain, exprefi'ed by the whine of the child,
but efpecially by the fettled difcontent of its features.
In the progrefs of the difeafe, the evacuations from the
belly fhow very diderent aCtions of the intedines, and
great changes in the biliary fecretion ; for they are fome¬
times of a natural colour, at other times flimy and afh-
coloured, and fometimes lienteric. The difeafe feldom
proves fatal before the fixth or feventh week ; but fome¬
times an earlier termination is fuddenly produced by in-
cedant vomiting and purging, or by convulfions, from
the extreme irritation in the bowels.

On dideftion, the intedinal canal, from the domach
downward, is found abounding with fingularcontraftions,
and has in its courfe one or more intus-fufceptions ; the
liver is firm, larger than natural, and of a bright-red co¬
lour ; and the gall-bladder, which is enlarged, contains a
dark-green bile. In fome cafes the mefenteric glands
have been found fwelled and inflamed ; in others, how¬
ever, fcarcely enlarged, and having no appearance of in¬
flammation. It is probable, therefore, that this difeafe
is owing to the morbid date of the liver, and that the ex¬
tremely irritable date of the whole abdominal vifcera,
marked by the fpafmodic contractions and intus-fufcep¬
tions, See. is occafioned by fympathetic irritation.

The diet fhould confid of eggs, the finer kind of light
fhip-bifeuit, or arrow-root, cudard, the juice of lean meat,
plain animal jellies, broths freed from their oily part, and
milk. The bread-milk might perhaps be redored with
advantage. Vegetables of all forts, particularly fruits,
acids, and compofitions of which fugar or butter form a
part, and fermented liquors of every kind, fliould be
itriCtly prohibited. The feet diould be kept warm by
woollen dockings, and flannel worn next the lkin; and
the warm bath and fomentations may be frequently ufed
to alleviate the continual fpafms. Small dofes of calomel
are howeverthe mod effectual remedy againd the weaning
brafli, as againd other chronic forms of bilious diarrhoea.
We may generally give half a grain of calomel morning and
evening, or a grain every night, for a week or ten days.
After the third or fourth dole, there is generally a great
change in the colour of the alvine difeharge; it becomes
of a dark mahogany-colour, and is in general more offen-
ftve. When this change takes place, it produces a favour¬
able change in the diforder. Soon afterwards, the chil¬
dren become free from fever, more placid ; and in a day
or two more their appetite returns, with their former
complexion, and every other demondration of health.

ConneCied with diarrhoea, we have to notice a com¬
plaint of the bowels clearly deferibed of late by Dr.
Powell. Like the foregoing, it confids in a difeafed fe¬
cretion from the mucous lining of the alimentary canal ;
the matter evacuated being of a fubdantial form, and
confiding of layers of cosgulabJe lymph moulded into
the form of the ioteftina) cavities, The fame matter

LOGY.

often formed towards the termination of dyfentery, and
Villerme (Did. des Sciences Medicates) fays, “I have
had occafion to fee great quantities of thefe adventitious
membranes paffed by dool, in the colic of Madrid. They
were generally of a gelatinous confidence, and enveloped
in mucus. One of thefe exhibited an exaCl mould of the
intedine, being tubular, and fome inches in length.” In
this cafe it is eafily referred to throwing out of lymph, a
confequence of inflammation. In the complaint in quef-
tion, it does however follow inflammatory aCtion. In¬
deed we meet with the fame membraneous fubdances in
fedentary perfons, efpecially females, who have languid
and imperfeft digedion, with a torpid date of the biliary
and intedinal fecretions. Here gelatinous concretions
would appear to take place on the internal furface of the
intedines, and even the hepatic dufts themfelves, from
mere remora of the fluids and want of energy in the fe-
cretory glands and organs. Sometimes thefe flakes are
confiderable ; and, when developed in water, reprefent
entire tubes broken off irregularly at the ends j which
has led to the erroneous opinion that they were portions
of the mucous membrane of the intedines.

The fymptoms of this difeafe referable very clofely
thofe which attend the pading of gall-dones ; fo much fo,
indeed, that Dr. Powell fays, “ Whenever violent pain
takes place in the epigadric region of the abdomen, exa¬
cerbating in paroxyfms accompanied by ficknefs, yellow-
nels of the eyes and fkin, and urine, by clay-coloured
fasces, and without any proportionate increafe of aftion
in the circulation, biliary concretions are fuppofed to
be forcing through the duffs ; and, when thefe fymptoms
abate, it is inferred that their paflfage into the duodenum
has been effefted.” In the cafe of biliary concretions,
however, we naturally expeft a repetition of attacks, and
no very fpeedy termination of the patient’s fufferings :
on the contrary, the fort of attack here deferibed is more
initiated, and, when once it has paded, its recurrence is
by no means equally to be dreaded as is that of the
former.

In edablidiing his diagnofis more particularly, however.
Dr. Powell direffs the ufual large pan to be filled with
water, and the faeces to be dirred in it, after which the
water has been left to red long enough to afeertain whe¬
ther the concretions, as they often do, have rifen to the
furface. This water he pours off; and repeated fimilar
affufions are made, time being allow-ed for fubfidence be¬
tween each. The refidueis then to be examined. This
refidue, in the cafes to which the author refers, “ has
exhibited a large quantity of dakes, modly turned into
irregular diapes, and appearing to have formed parts of an
extenfive adventitious membrane of no great tenacity or
firmnefs.” In the fird cafe that came under Dr. Powell’s
notice, this membrane was paffed in perteft tubes, “fome
of them full half a yard in length, and certainly fufficient
in quantity to have lined the whole intedinal canal.” In
the others alfo, the aggregate quantity has been very
large, and continued to come away for many days, in ir¬
regular thin flakes, of but one or two inches in extent,
and not perfedlly tubular. Dr. P. has definitely exa¬
mined four fuch cafes, in all of which the leading fymp¬
toms led him to fufpedl the paflage of biliary concretions
at the time. They were all adult females. In but one
of thefe our author had been confulted for previous ill
health. “ She had frequently fuft'ered from occafional
pain in the inteftines, and derangement of her powers of
digeflion, with flatulence and a lenfe of fuffocation. She
was always relieved, at the time, by mild opening medi¬
cine, and believed herfelf able to prevent the attacks of
pain from increafing to any ferrous degree of violence,
by repeating it according to circumftances. A fimilar
hiflory of liability to frequent recurrence of pain, ac-t
companied by indigedion, was related to me in the other
indances. The more violent feizures. under which I faw
all the patients, confided in a Bidden an.d exceffive pain
in the epigadric region, increafing in paroxyfms very fre¬
quently.

159

P A T II O L O G Y.

nuently, rather relieved by prefl'ure of the patient her-
lelfat the time, but leaving great forenefs and tendernefs
during the intervals. This ftate continued under four
days; during it the ftomach was very irritable, and the
tongue coated and clammy. Jaundice came on at an
early period ; and the ftools were white, brown, or fome-
what greenilh, and ftreaked in colours, until the films
began to pafs, when they were mixed with a full fuffi-
ciency of bile, but not'at firft of a healthy colour. The
pulfe throughout was calm, moderate, and natural, in
none of the inftances amounting to 90.” There was no
indication of inflammation. In one inftance Dr. Powell
noticed a confiderable hardnefs and contraction of the
abdominal mufcles; in another cafe there was fuperadded
to the above fymptoms a difficulty in palling the urine,
with pain in the region of the bladder, requiring the ufe
of the catheter.

The practice which appeared to Dr. P. moft. advan¬
tageous, was the Heady ufe of a mixture of the infufum
gentianre compofitum and infufum fennae, with the addi¬
tion of from ntx. to fltxx. of liquor potaflae, repeated fo
as to produce four or more ftools in the twenty-four
hours. Under its ufe the flakes firft feparated, and con¬
tinued to do fo in great abundance ; the jaundice difap-
peared, and the patients recovered health and ftrength.
During tile paroxyfms, the warm bath, warm fomenta¬
tions, leeches, and blifters, are ferviceable as external re¬
medies ; and internally, we Ihouid attempt to allay the
pain and irritation, firft by pretty large dofes of opium and
hyofciamus, and then ading on the bowels pretty
brilkly by compound extrad of colocynth, calomel, and
hyofciamus, aided by purgative enemas to folicit the perif-
taltic adion. The recurrence of thefe diftrefling attacks
can only be prevented by regulating the ftate of the
bowels, and by correding the depraved fecretions them-
felves. This is to be done by Arid regimen, great atten¬
tion to the fundions of the Ikin, and by luch. remedies
as ad on the biliary fecretion. In conjundion with thole
meafures, a Heady perfeverance in the ufe of the nitro-
muriatic acid bath has been ufed in obftinate cafes with
fuccefs.

Genus X. Cholera; [fuppofed by Celfus to be derived
from bile, and pea, to flow, (literary bile-flux ;) but

Trallian traces it from p^oXac, an inteftine, and pea, (li¬
terally bowel-flux ;) a derivation which agrees better with
the phenomena of the difeafe.] Purging and Vomiting ;
•wind and cramp in the Homach and bowels.

The caufe of cholera is, as we have before hinted, re-
ferrible, in common with dyfentery, to a difturbed ftate
of circulation, induced in the .firft inftance by inadion
and conftridion of the veffels of the Ikin, and thereby
communicating a plethoric ftate to the abdominal vifcera.
In cholera, however, the difeafe afteds more feverely the
liver and fuperior part of the alimentary canal, and the
lower bowels feem influenced but in a minor degree. In
mild cafes, the plethoric ftate of the liver unloads by fe¬
cretion, and the bile is evacuated by vomiting and purg¬
ing. In cafes of extreme violence, however, no fuch
effed takes place 5 and hence the old authors feem to have
fallen into a great error in attributing cholera to increafed
fecretion of bile : for, as the colonial praditioners have
well fltown, a copious flow of this fecretion is rather to be
confidered as falutary or critical than indicative of the
difeafe in queftion. We have three fpecies of this genus.

1. Cholera vulgaris, or Cholera morbus. Specific cha-
rader — Vomiting and purging frequent and copious.
The following excellent defcription of this difeafe is
copied from Sydenham. He fays, “ Malum ipfurn facile
cognofcitur, adfunt enim vomitus enormes, ac pravorum
humorum cum maxima difficultate et anguftia per alvum
dejedio ; cardialgia, fitis. Pulfus celer ac frequens, cum
seftu et anxietate, non raro etiam parvus et inasqualis,
infuper et naufea moleftiflima, fudor interdum diaphore-
ticas, crururn et brachiorum contradura, animi deli-

Vol. XIX. No. 1294.,

quiu m, partiuin extremarum frigiditas, cum aliis notae
fymptoniatibus, quae adftantes magnopere perterrefa-
ciunt, atque etiam angufto viginti quatuor borarum fpa-
tio aegrum interimant.” The praditioners who followed
Sydenham described the difeafe as attended from the firft
by bilious vomiting; but later writers deny this. And
that clofe obferver of nature, Arelaeus, fays, “In primis
quae evomuntur, aqua; firniliu flunt ; quae anus effundit,
ltercorea, liquids, tetrique odoris fentiuntur'. Siquidetn
longa cruditas id malum excitavit, quo li per clyfterem
eluanter, primo pita ih flu, n o v bi/iofa ferunlur.'"

2. Cholera flatulenta, windy or dry cholera. The
vomiting and purging rareor abfent ; great and oppreflive
flatulence ; retching ; flatulent dejedions and erudations.
Sydenham fays, that in the epidemic cholera of 1669 lie
net with but a Angle inftance of the dry or flatulent fpe¬
cies. It feems, indeed, a difeafe of rare occurrence, and
the difcriminating fymptcm, flatulence, is probably owing
to the nature of the fwallowed food.

3. Cholera fpafmodica, Indian cholera ; emphatically
called “mort de chien.” The dejedions watery ; inef-
fedual retching; fpafms fucceffive and violent, commen¬
cing in thd thoracic and abdominal mufcles. We copy
the ample account of the fymptoms of this dreadful ma¬
lady from the authentic Reports on the Epidemic Cho¬
lera which raged throughout Kindoftan and thepeninfula
of India, in 1817, 18, and 1 9 ; publifhed under the autho¬
rity of the Bombay government.

“The attack was generally ufliered in by a fenfeof
weaknefs, trembling, giddinefs, naufea, violent retching,
vomiting, and purging, of a watery, ftarchy, whey- co¬
loured or greenifh, fluid. Thefe fymptoms were accom¬
panied or quickly followed by fevere cramps, generally
beginning in the fingers and toes, and thence extending
to the wrifts and fore-arms, calves of the legs, thighs, ab¬
domen, and lower part of the thorax. Thefe were foon
fucceeded by pain, conftriftion, and oppreffion of ftomach.
and pericardium; great fenfe of internal heat; inordi¬
nate thirft, and inceffant calls for cold water, which was
no fooner fwallowed than rejected, together with a quan¬
tity of phlegm, or wiiitifh fluid, like feethings of oatmeal.
The aftion of the heart and arteries now nearly ce'afed ;
the pulfe either became altogether imperceptible at the
wrifts and temples, or fo weak as to give- to the finger
only an indiftindl feeling of fluttering. The refpiration
was laborious and hurried, fometimes with long and fre¬
quently-broken infpirations. The fkin grew cold, clam¬
my, covered with large drops of fweat ; dank and difa-
greeable to the feel, and dilcoloured of a bluifh, purple,
or livid, hue. There was great and fudden proftration of
ftrength, anguifh, and agitation. The countenance be¬
came collapfed ; the eyes fulfilled, fixed and glafly, or
heavy and dull; funk in their fockets, and furrounded
by dark circles ; the cheeks and lips livid and bloodlefs ;
and the whole furface of the body nearly devoid of feeling.
In feeble habits, where the attack was exceedingly vio¬
lent, and unrefifted by medicine, the fcene was foon
clofed. The circulation and animal heat never returned;
the vomiting and purging continued, with thirft and
reftleflhefs ; the patient became delirious or infenlible,
with his eyes fixed in a vacant ftare, and lunk down in
the bed; the fpafms increafed, generally within four or
five hours.

“The difeafe, fometimes at once, and as if it were mo¬
mentarily, feized perfons in perfect health ; at other
times, thofe who had been debilitated by previous bodily
ailment; and individuals in the latter predicament gene¬
rally funk under the attack. Sometimes the ftomach and
bowels were difordered for fome days before the attack,
which would then, in a moment, come on in full force,
and fpeedily reduce the patients to extremities.

“Such was the general appearance of the difeafe where
it cut off the patient in its earlier ltages. The primary
fymptoms, however, in many cafes, admitted of confider¬
able variety. Sometimes the ficknefs and loofenefs were
T t preceded

t

PATHOLOGY,

160

preceded by fpafms ; fometimes the patient funk at once,
after palling off a fmall quantity of colourlefs fluid, by
vomiting and ftool. The matter vomited in the early
ftages was, in molt cafes, colourlefs or milky; fometimes
it was green. In like manner, the dejedfions were ufually
watery and muddy; fometimes red and bloody ; and, in
a few cafes, they confided of a greenifh pulp, like half-
digefted vegetables. In no inftance was feculent matter
palTed in the commencement of the difeafe. Thecramps
ufually began in the extremities, and thence gradually
crept to the trunk ; fometimes they were fimultaneous
in both ; and fometimes the order of fucceffion was re-
verfed ; the abdomen being firft affefted, and then the
hands and feet. Thefe fpalms hardly amounted to ge¬
neral convullion. They feemed rather affections of in¬
dividual mufcles, and of particular fets of fibres of thofe
mufcles, caufing thrilling and quivering in the affefted
parts, like the fleflt of crimped falmon ; and firmly ft i f -
fening and contorting the toes and fingers. The patient
always complained of pain acrofs the belly, which was
generally painful to the touch, and fometimes hard and
drawn back towards the fpine. The burning fenfation
in the llomach and bowels was always prefent ; and at
times extended along the cardia and cefophagus to the
throat. The powers of voluntary motion were, in every
inftance, impaired ; and the mind obfcured. The patient
ftaggered like a drunken man, or fell down like a helplefs
child. Head-ach over one or both eyes fometimes, but
rarely, occurred. The pulfe, when to be felt, was gene¬
rally regular, and extremely feeble, fometimes foft ; not
very quick ; ufually ranging from 80 to ioo. In a few
inftances, it rofe to 140 or 150 fhortly before death.
Then it was indiftinft, fmall, feeble, and irregular. Some¬
times very rapid, then flow for one or two beats. The
mouth was hot and dry ; the tongue parched, and deeply
furred, white, yellow, red, or brown. The urine at firft
generally limpid, and freely palled ; fometimes fcanty,
with fuch difficulty as almoft to amount to ftrangury ;
and fometimes hardly fecreted in any quantity, as if the
kidneys had ceal'ed to perform their office. In a few cafes,
the hands were tremulous; in others, the patient de¬
clared himfelf free from pain and uneafinefs, when want
of pulfe, cold fkin, and anxiety of features, portended
fpeedy death. The cramp was invariably increafed upon
moving.

“ Where the ftrength of the patient’s conftitution, or
of the curative means adminiftered, were, although ina¬
dequate wholly to fubdue the difeafe, fufficient to refill:
the violence of its onfet, nature made various efforts to
rally ; and held out ftrong, but fallacious, promifes of
returning health. In fuch cafes, the heat was fometimes
wholly, at others partially, reftored ; the cheft and abdo¬
men in the latter cafe becoming warm, whilft the limbs
kept deadly cold. The pulfe would return ; grow mo¬
derate and full ; the vomiting and cramps difappear ; the
naufea diminifh, and the ftools become green, pitchy, and
even feculent ; and with all thefe favourable appearances,
the patient would fuddenly relapfe ; chills, hiccup, want
of fleep and anxiety, would arife ; the vomiting, oppref-
ilon, and infenfibiiity, return ; and in a few hours termi¬
nate in death.

“When the diforder ran its full courfe, the following
appearances prefented thernfelves. What may be termed
the cold ftage, or the ftate of collapfe, ufually lafted from
twenty-four to forty-eight hours, and was feldom of
more than three complete days’ duration. Throughout
the firft twenty-four hours, nearly all the fymptoms of
deadly oppreflion, the cold Ikin, feeble pulfe, vomiting
and purging, cramps, thirft, and anguiffi, continued un-
diminilhed. When the fyftem Ihewed fymptoms of re¬
vival, the vital powers began to rally, the circulation and
heat to be reftored; and the fpafms and ficknefs to be
confiderably diminilhed. The warmth gradually re¬
turned ; the pulfe rofe in ftrength and fullnefs, and then
became fliarp, and fometimes hard. The tongue grew
more deeply furred 3 the thirft continued, with lefs nau-

fea. The ftools were no longer like water; they became
firft: brown and watery; then dark, black, and pitchy ;
and the bowels, during many days, continued todifcharge
immenfe loads of vitiated bile, until, with returning
health, the fecretion of the liver and other vifcera gra¬
dually put on a natural appearance. The fever, which
invariably attended this fecond ftage of the difeafe, may
be coniidered to have been rather the refult of nature’s
effort to recover herfelf from the rude fliock which fhe had
fufcained, than as forming any integrant and neceffary
part of the diforder itfelf. It partook much of the nature
of the common bilious attacks prevalent in thefelatitudes.
There was the hot dry ficin ; foul, deeply-furred, dry,
tongue ; parched mouth ; fick ftomach ; depraved fecre-
tions ; and quick variable pulfe ; fometimes with ftupor,
delirium, and other marked affe&ions of the brain. When
the diforder proved fatal after reaching this ftage, the
tongue, from being cream-coloured, grew brown, and
fometimes dark, hard, and more deeply furred ; the teeth
and lips were covered with fordes ; the ftate of the fkin
varied; chilis, alternating with fluffies of heat ; the pulfe
became weak and tremulous; catching of the breath;
great reftleffnefs, and deep moaning, fucceeded ; and the
patient foon funk, infenfible, under the debilitating ef¬
fects of frequent dark pitchy alvine difcharges.

“ Of thole who died, it was believed, perhaps rather
fancifully, that the bodies fooner underwent putrefac¬
tion than thofe of perfons dying under the ordinary cir-
cumftances of mortality. The bodies of thofe who had
funk in the earlier ftages of the malady, exhibited hardly
any unhealthy appearance. Even in them, however, it was
obferved, that the inteftines were paler, and more diften-
ded with air, than ufual ; and that the abdomen, upon
being laid open, emitted a peculiar offenfive odour, wholly
different from the ufual fmell of dead fubjefts. In the
bodies of thofe who had lived fome time after the com¬
mencement of the attack, the ftomach was generally of
natural appearance externally. The colour of the in¬
teftines varied from deep rofe to a dark hue, according as
the increafed vafcular action had been arterial or venous.
The ftomach, on being cut into, was found filled, fome¬
times with a tranfparent, a green, or dark, flaky, fluid.
On removing this, its internal coats, in fome cafes, were
perfectly healthy ; in others, and more generally, they
were crofted by ftreaks of a deep red, interfperfed with
fpots of inflammation, made up of tiffues of enlarged vef-
fels. This appearance was frequently continued to the
duodenum. In a very few cafes, the whole internal fur-
face of the ftomach was covered with coagulable lymph ;
on removing which, a bloody gelantine was found laid on
the interior coat, in ridges or elevated ftreaks. The
large inteftine was fometimes filled with muddy fluid,
fometimes livid, with dark bile, like tar; juft as the indi¬
vidual had died in the earlier or later periods of the at¬
tack. In raoft cafes, the liver was enlarged, and gorged
with blood. In a few, it was large, foft, light-coloured,
with greyilh fpots, and not very turgid. In others again,
it was collapfed and flaccid. The gall-bladder was, with¬
out exception, full of dark-green or black bile. The
fpleen and thoracic vifcera were, in general, healthy. The
great venous veflels were ufuaily gorged ; and, in one
cafe, the left ventricle of the heart w'as extremely turgid.
The brain was generally of natural appearance. In one
or two inftances, lymph was effufed between its mem¬
branes, near the coronal future, fo as to caufe extenfive
adhefions ; in other cafes, the finufes, and the veins lead¬
ing to them, were fluffed with very dark blood.”

The treatment of cholera in each fpecies will be
founded on the fame general principles ; viz. to reftore
to the llcin and external parts the balance of action by
means of very-hot baths, diaphoretics, urtication, See. to
remove the plethora of the fyftem, and efpecially of the
portal fyftem, by aCtive bleeding; and to promote fecre¬
tion by mercurial remedies. The combating of particu¬
lar fymptoms, which is an indifpenfable talk, will require
us to adminifter opium for the allaying of fpafm and

nervous

161

PATHOLOGY.

nervous irritation, and to give emetics to provoke, or
elrervefcing medicines to reftrain, vomiting; and fo on. In
ourcountry the cure of cholera may, in general, be effected
by diaphoretics, as the pulv. Doveri. comp, finall and
frequently-repeated dofes of colomel, the warm bath,
cold drinks, and abftinence ; after which, columbo and
other Simulants of the 'ftomach may be ufed to perfeft
the approaches to health.

In the Cholera fpafmodica we have however a much
moreterrible malady to contend with. In the Report we
have juft quoted, we are told that “the centre-divifion
of the army, under the commander-in-chief, exhibited
an awful fpecimen of the fatality of the difeafe. It con-
lifted of lefs- than 10,000 fighting men ; and the deaths,
within twelve days, amounted, at the very loweft efti-
mate, to 3600 ; according to others, to 5, and even 8000!”
The dread of a mortality fo great will, no doubt, ftimu-
late us to ufe the meafures commonly fuccefsful with the
utmoft care and promptnefs; and,confidering the immenfe
body of information which we have received from the lur-
geons who witnefi’ed the ravages of the difeafe in the vaft
populations of either Ind, we can have little helitation
in eftablilhing therapeutical dogmas.

A meafure which ftrikes at the fons and origo mali is
bleeding. This Ihould be at once carried ad deliquium
animi, and Ihould form the firft part of the treatment.
The alleviation of pain, the reftoration of the biliary fe-
cretion and of the perfpiration, rauft be attempted by
large dofes of calomel, varying from a few grains to a
fcruple, and combined with opium. Antimony being
fcarcely ever retained on the ftomach, the ficknefs is to
be moderated by clyfters compofed of aqueous folutions
of opium, fince even the latter fubftance, in a folid form,
is rejected when given by the mouth. Mr. J. Boyle
(Treatife on the Epidemic Cholera of India, 1821.) is of
opinion, however, that ficknefs Ihould by no means be
checked. He lays, “ The conftant naufea and irritation
of ftomach, which is oblervable in the early ftages of this
complaint, without full or violent vomiting, fimply
fpouting up, as it were, any thing fwallowed ; the ob-
ftrudiion of the biliary dudts obferved in difledtion, and a
general want of fuccefs in practice ; induced me to em¬
brace ideas perfectly new on the fubjeft. The obftruc-
tion of the biliary dudts I looked on as a fource of irri¬
tation to the nervous fyftem generally, and the naufea
and ficknefs of ftomach as an effort of nature to free ner-
felf of an unaccuftomed evil. In accounting for the
caufes of this difeafe, it has been obferved, and with
great juftice, that when, from the exertions to vomit,
bile makes its appearance, a favourable prognofis may be
formed. Now, if the appearance of bile be a falutary
one, (and it certainly is,) why not favour the progrefs of
its formation, inftead of obftrudling its paffage by the
adminiftration of fedatives ? We know of nothing which
will increafe the fecretion of bile fo quickly or fo effec¬
tually as the adt of vomiting ; we alfo know the fympa-
thy which fubfifts between the liver and ftomach, and
that derangement of either organ will more or lefs af¬
fect both. It is evident, then, that the gaftric derange¬
ment peculiar to this difeafe, is not only indicative of
the exiftence of lurking mifchief, but diredtly points to
the treatment. Further, of all the cafes of which I have
feen or heard, there was not one fatal termination after
bile had, in any way, or by any means, made its appear¬
ance.”

The diaphoretics which the Indian pradlitioners give
are often of a highly-ftimulating nature; as arrack-punch,
&c. but thefe fhould not be ufed till the plethora and
confequent cerebral difturbance, which in fome cafes is
dreadfully violent, is fubdued by venefedtion. In ufing
the bath, we fhould be careful to employ it hot ; for it
is eftablifhed on good authority, that, till the temperature
is railed to an unplealant height, no good is derived
from it.

The convalefcents of cholera fhould be fubjedted to the

influence of the nitric-acid bath ; and the acid internally
adminiftered likewife forms a cooling palatable drink,
which tends to reftore the tone. of the alimentary canal,
and improves the fecretion of the liver.

With regard to the contagious nature of this com¬
plaint, the reader is referred to Pyrectica,

Genus XI. Enterolithus, [from zirepov, bowel, and 7u0of,
ftone.] Stony concretions in the ftomach and bowels.

For the information under this head we are wholly
indebted to Dr. Mafon Good ; as no other fyftem con¬
tains a fimilar genus. We have therefore no fynonymes
to put down. Dr.Good very juftly obferves, that “ almoft
all animals are endued with a power of feparating or fe-
creting lime and other earths from the blood for particu¬
lar purpofes; as that of forming a (hell covering in infefts
and worms, and of giving hardnefs to the bones in all
other animals. Under a morbid adtion of Angle organs,
or of the fyftem generally, this is often fecreted in an un¬
due quantity, and poured forth into cavities where its
accumulation and cryftallization muft be attended with
mifchief. Such, at times, is the cafe in refpeft to the
ftomach and inteftines. But, independently of concre¬
tions derived from this fource, we often meet with others
produced by an agglutination or cryftallization of the
juices which are contained in the aliment, and which, not
unfrequently, give immediate proof of their origin by
the aromatic tafte, fmell, or other qualities, which fuch
concretions exhibit. There is alfo a third kind of con¬
cretion occafionally to be traced in the inteftinal canal,
of a fofter ftrudfure, and cetaceous or faponaceous feel,
which appears to be produced by a peculiar combination
of the materials of the feces, and conftitute proper fey bala,
although this term has not unfrequently been employed
to fignify portions of common feces or ftercoraceous
matter in an indurated ftate.” Thus, then, we have three
fpecies.

1. Enterolithus bezoardus, the inteftinal bezoar : in
concentric layers clofely agglutinated or cryftallized ; ca¬
pable of a fine polilh ; frequently with a metallic luftre
on the furface of each layer; and an accidental nucleus
in the centre: of a fpheroidal figure ; chiefly confiding
of vegetable matter. It is faid, (though not proved) to
be found in the human ftomach ; but more commonly in
that of the fmaller ruminating quadrupeds, as the goat
and antelope, particularly the beautiful and elegant fpe¬
cies of antelope denominated gazhul by the Arabians and
Perfians, and tj'eb'i by the Hebrew poets ; the ahu of the
Turks; the Antilope gazella of Linnieus. It was for¬
merly employed as a febrifuge and alexipharmic in me¬
dicine; and worn as an amulet by the fuperftitious, who
have fometimes purchafed a Angle one at fix thoufand li-
vres when very fine, and hired them in Holland and Por¬
tugal on particular occafions at a ducat a-day. See the
article Bezoar, vol. iii.

2. Enterolithus calculus, inteftinal calculus: radiating
from a common centre, or formed in concentric layers ;
moftly with an accidental nucleus; more or lefs porous;
fpheroidal or oblong ; admitting an imperfedt polifh ;
compofed chiefly of earths and animal matter. This fpe¬
cies, Dr. Good fays, is by no means unfrequently found
in the human ftomach and inteftines ; but far oftener in
the digeftive channel of other animals, and particularly in
the larger ruminating quadrupeds, or thofe with a long
complicated digeftive organ, where the food, as in the
formation of bezoars, is flowly carried forward ; and in
tardy draught-horfes, particularly thofe of millers, which
are fed largely on bran, which feems to yield a ready
balls for thefe concretions. See Phil. Tranf. xxiv. 1705.
xliv. 1746. xlviii. 1754. In the laft cafe, the difeafe had
exifted for years: the animal died aged twenty-two,
nearly foaling ; but gave no fign of pain or inconvenience
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

con fill

PATHOLOG Y.

IG2

confift of a triple or ammoniaco-magnefian phofphate,
like the earthy or white-fanci calculi of the human blad¬
der; though it is difficult to conceive from what quarter
the magnefia is obtained. In the cafe of millers’ horfes,
fome portion of this earth may be derived from the bran,
in which it is always to be traced; but theMifficulty Hill
remains with refpect to other animals. The figure, what¬
ever be the fize of the calculus, is ufuaily fpheroidal, ex¬
cept where broken into feparate fragments : the matter
is depofited for the moft part, as in the former fpecies,
upon a nucleus of fome fort or other, as a fmall piece of
Hint, an iron nail, a feed or hulk, a piece of hay or draw ;
the ftrufture fometimes radiating from fuch common
centre to the furface,' and fometimes evincing diftinft
plates more or lefs united to each other. In the human
fiubjeft, thefe calculi vary from the fize of a pea to that
of a filbert, chefnut, or lien’s egg, and are often (fill
larger. In the cafe of Margaret Lower (feep. 151.) they
were ufuaily of the two former fizes, and appear to have
been formed in great abundance and u'ith wonderful fa¬
cility; for her abdomen, upon preffing it, often rattled
from the quantity it contained, with the found of a bag(
of marbles. Many of thefe were rough and (harp-pointed
at the edge, evidently fragments or nodules of larger
concretions, and gave great pain in the rejection, whether
above or below, for they were difcharged both ways. The
larger-lized weighed rather more than two drams; and
Dr. Konig, who relates the cafe, calculated that the whole
rhat were difcharged during the continuance of the
complaint could not amount to lefs than 51b. avoirdu¬
pois. In a cale related by Mr. Martineau, (Phil. Tranf.
vol. xxxii. 1723.) five calculi, fome of them much larger
than the preceding, were voided per anum, by a poor
woman in the third month of pregnancy, after having
fuffered from colic about four or five days : of thefe, the
largeft, 8 inches in circumference and 6f in length,
weighed two ounces fixteen pennyweights and twelve
grains. In this cafe, and in various others, the calculi
deem to have been in the inteftines for a confiderabie pe¬
riod of time without inconvenience ; for it is hardly pof-
fxble to conceive that all thefe fliould have been produced
in the courfe of a week. In another cafe in the fame
journal, vol. xli. 1740, related by M. Mackarnefs, a
calculus of this kind was extracted with fome difficulty
from the anus by the furgeon who attended, which
weighed 8| oz. and was io§ inches in circumference.
It is defcribed as “ a hard unequal ragged flinty (tone,”
but was not examined chemically. There is fome
doubt whether this had not forced its way from the
bladder into the re£lu in; but there is little doubt that
it had been prefent in one organ or other, and nearly of
its full fize, for feveral years before its extraftion ; for
the patient’s (tools were obtained with difficulty; and
“ three children, which (he had fucceffively borne in the
three preceding years, were all marked with a large
hollow or indentation in fome part of the head, in one
inftance of fulficient extent to hold the moiety of a fmall
orange !”

3. Enterolithus fcybala, concretions refembling indu¬
rated fasces : foapy or unftuous ; moftly continuous ;
fometimes in layers ; fpheroidal or oblong; varying in co¬
lour; confiding chiefly of mucous and oleaginous matter.

“ This fpecies,” fays Dr. Good, “has not hitherto re¬
ceived the degree of attention to which it is entitled ; and
even Fourcroy and Walther feern to have millaken it for
a biliary calculus. The fpecific charafter is drawn up
from various inftances that have occurred to the writer,
or have been fliown him by others. A laminated fcyba-
lum, taken from the fasces of a woman who had long been
fuffering from coliivenefs and abdominal pain, an inch
and a half in length, and nearly two inches in circumfe¬
rence, of an oblong irregular lhape, and reddifli brown
colour, was lately prefented to a medical meeting in this
metropolis as a biliary, calculus, the donor exprelling his
aftoniffiment that it could by any means be protruded

through the duclus communis. It had neither the fpe¬
cific levity, nor the peculiar bitter, nor the refinous ftra-
tification, of gall-ftones ; and there can be little doubt
that it was formed in the inteftinal canal.”

In fir Everard Home’s paper On the Formation of Fat
in the Inteltines ofliving Animals, Phil. Tranf. for 1813,
a variety of ingenious fafts and experiments are advanced
to (how the mode in which fcybala are formed in the
alvine pafiage, the component parts of which fir Everard
fuppofes to be fat or oil, and mucus. The fame paper
contains, in fupport of this opinion, two interefting cafes
by Dr. Babington : the one that of a lady, who, upon
taking olive-oil, conllantly voided a number of globular
concretions, “ varying in fize from that of a fmall pea to
the bulk of a moderate grape, of a cream colour and
(lightly tranflucent, of a fufficient confidence to preferve
their form and to bear being cut by a knife, like foft
wax ;” all which, like the fcybalum above, had till this
period been regarded as gall-ftones : the fecond cafe that
of a girl four years and a half old, who appears to have
had a power of fecreting oil in the inteftines, and of dif-
charging it per anum : “At three years old her mother
obferved fomething come from her as (lie walked acrols
the room, which, when examined, was found to be fat in
a liquid (late, which concreted when cold. Ever fince
that time to the prefent (he has voided at intervals of ten
or fourteen days the quantity of from one to three ounces,
fometimes pure, at others mixed with fasces : when voided,
it has an unufually yellow tihge, and is quite fluid lilje
oil. Her appetite is good, as well as herfpirits, and her
flefti firm : her belly rather tumid, but not hard; fire is
lubjeft to occafional griping.” The medical records fur-
ni(h numerous inftances of fimilar formations. In the
Aft. Nat. Cur. vol. iii. obf. 51. we have a cafe very fimi¬
lar to Dr. Babington’s, of foapy or oleaginous globules
excreted in a paroxyfm of colic : “ excreti globuli, quad
faponacei, cedente dolore hypochondriorum.” So in the
Edinb. Med. Comment, vol. iv. p. 333, we have a cafe
from the pen of Mr. Scott, of various adipofe maftes de-
jefted in a foftened (late.

Genus XII. [Helminthic/, from an inteftinal

worm.] Worms or larvae of infefts inhabiting theftomach
or inteftines.

The exiftence of worms or parafitic animals in the in¬
teftines of other living creatures, is to the phyfiologift an
important fubjeft of contemplation, inafmuch as, the
queftion fo long agitated concerning the (pontaneons ge¬
neration or external intreduftion of worms once fettled,
we fhonld be enabled to obtain lome clearer ideas on the
nature of life. In the praftice of medicine, however,
we are not required to enter into this difficult queftion.
It is enough for the pathologift to knew that worms in
the alimentary canal are to his fellow-creatures a fourcs
of annoyance and pain, by what figns to deteft their
prefence, and to know likewife by what means they are
to be expelled. The latter view may lead him to make
fome claifification of the animals in queftion, Amply how¬
ever for the reafon that it is neceflary to vary the reme¬
dial agent according to the fpecies or genus of the offend¬
ing animal. The ufual (eat of worms is the alimentary
canal ; but they have been found in all parts of the body.
Sennertus fays, “ Praeter vermes inteftinales, funtet alii.
omnes J'tre corporis partes incolentes, uti vermes dentales,
gingivales, rhinarii, pulmonarii, cardiaci, fanguinarii, uri~
narii, urnbilicales ; vermes in hepate, in faliva, &c. Sed
hi omnes non nifi in ftatu morbido inveniuntur.” And
to this lift we might add a hundred others. The alimen¬
tary canal appears however to be the only part in which
the prefence of worms can be detefted by fymptoms, or
from which they can be expelled by medicine ; fo that we
(hall confine ourfelves to the parafitic inhabitants of this
cavity.

For an ample defeription of the various kinds of intef¬
tinal worms, with plates reprefenting their external form

and

4-

PATHOLOGY.

and internal ftrudlure, the reader is referred to the arti¬
cle Helminthology, and to each tribe under its generic
name; as Ascaris, Hirudo, Lumbricus, Taenia, &c.
We (hall therefore merely copy in this place, with a few
additions, the claffification of Dr. Good, which mud be
allowed on all hands to be fufficiently comprehenfive
for pradlical purpofes ; and which, at the fame time, com-
prefles the immenfe body of refearch from which it is com-
pofed into a very fmall fpace. The following are the
three fpecies and their varieties.

i. Helminthia alvi, or worms exifting and finding a
proper nidus in the ftomach or alvine canal, chiefly of
children and fickly adults; producing emaciation, a
fwelled hard belly, gnawing or pungent pain in the fto¬
mach, pale countenance, fetid breath, and irritation of
the noftrils. Of this fpecies of difeafe there are five va¬
rieties, occafioned by the different genera of worms whofe
names they bear.

a. H. Afcaridis lumbricoidis, commonly called the
long round worm ; by Dr. Baillie, Lumbricus teres. For
its Ipecific character, and a reprefentation of it, fee vol.
ii. p. 251. The body is tranfparent, light yellow, with
a faint line down the fide; it is gregarious and vivacious,
and, according to Brera, poffefles much fenfibility : is
from twelve to fifteen inches long. It inhabits princi¬
pally the inteftines of thin perfons, generally about the
ileum, through the parietes of which it fometimes eats its
way. It has been known to afcend into the ftomach, and
creep out of the mouth and noltrils : it occafionally tra¬
vels to the reftum, and pafies away at the anus. This
animal, being poflefled of a cutting ffiarp point, often
caufes pungent and rending pains, efpecially about the
umbilical region. Colic and borborygmi are fymptoms
peculiar to it,

(3. H. Trichocephali hominis, the long thread-worm;
(Trichurus vulgaris, Baillie.) Body above (lightly cre-
nate, beneath fmooth ; finely ftriate on the fore-part : head
obtufe, and furniflied with a (lender retractile probofcis ;
tail or thinner part twice as long as the thicker, termina¬
ting in a fine hair-like point; about two inches long; in
colour refembles the maw-worm, or common afcaris : gre¬
garious, and found chiefly in the inteftines of fickly chil¬
dren ; generally in the ccecum.

7. H. Taeniae folii, the long tape-worm : articulations
long and narrow, with marginal pores by which it at¬
taches itfelf to the inteftines, one on each joint, generally
alternate; ovaries arborefcent: head with a terminal
mouth furrounded with two rows of radiant hooks or
holders ; and a little below, on the flattened furface, four
tuberculate orifices or fuckers, two on each fide: tail
terminated by a femicircular joint without any aperture :
from thirty to forty feet long, and has been found fixty.
It inhabits the inteftines of mankind, generally at the
upper part. Is fometimes folitary, but commonly incon-
fiderable numbers. As the head of the Taenia folium is
furniflied with pointed fangs, it fometjmes attaches itfelf
with fuel) force to the mucous membrane of the inteftines,
as to produce the moft (evere, and even deadly, fymptoms,
lince the membrane is mangled, and inflammation, or
even gangrene, may be the confequence. A Angular
(ymptom of this taenia is a frequent fenfe of tenfion or
tightnefs in the nofe. See Helminthology, vol. ix.
p. 343-6.

o. H. Taeniae vulgaris, (T. lata, Baillie,) the broad
tape-worm : articulations (hort and broad, with a pore
in the centre of each joint, and ftellate ovaries round
them ; body broader in the middle, and tapering towards
both ends ; head refembling the laft, but narrower and
fimaller ; tail ending in a rounded joint. Like the laft, it
inhabits the upper part of the inteftines, from three to
fifteen feet long; ufually in families of three or four.
The fymptoms of taenia are pain in the belly, with a
turning motion and weight in the fide; occafional prick¬
ings or bitings in the region of the ftomach ; fwelling of

Vol. XIX, No. 1295.

163

the abdomen at intervals, with fenfe of coldnefs there;
appetite enormous, while emaciation continues, with
fenfe of increafing weaknefs; complexion livid; pupils
unufually dilated ; eyes fuft'ufed with tears; vertigo with
naufea; vacillation of the legs, and fometimes convulfive
tremblings of the wdiole body; occafional evacuation,
per anum, of fmall fubftances refembling the feeds of
the lemon or gourd, which are portions of the marginal
papilla; of the worms.

e. H. Fafciolas, from the fluke, or gourd-worm. Body
flattifh, with an aperture or pore at the head, and gene¬
rally another beneath : inteftines flexuous : ovaries late¬
ral : hermaphrodite, and oviparous.

2. Helminthia podicis, worms, or the larvse of infedts,
exifting, and finding a proper nidus, within the verge of
the anus, exciting a troublefome local irritation, fome¬
times accompanied with tumour; frequently preventing
deep, and producing pain or faintnefs in the ftomacli.
Here we have three varieties.

a. H. Afcaridis vermicularis, from the maw-worm, or
thread-worm : head fubulate, nodofe, and divided into
three veficles, in the middle of each of which is an aper¬
ture by which it receives nourilhment; (kin at the fides
of the body finely crenate or wrinkled; tail finely taper¬
ing, and terminating in a point; the female has a fmall
pundtiform aperture a little below the head, through
which it receives nourifhment. Gregarious ; viviparous;
about half an inch long; fometimes winders into the in¬
teftines, and occafionally as high as the ftomach.

(3. H. Scarabaei, larvae of feveral fpecies of the beetle,
as of the S. nobilis; S. Schceft’eri, S, volvens, which,
when out of the body, depofit their eggs in round balls
of animal dung, which they roll up and bury with their
hind feet.

7. H. CEftri; bots, or larva; of the hasmorrhoidal
breeze or gad-fly. Round; pale-green; tail obtufely
truncate; head tapering ; mouth horny, with two lips,
and two recurved black claws on each fide of the mouth.
Found convoluted in the mucus and fasces of man, but
far more frequently of other animals, and efpecially of
the horfe.

3. Helminthia erratica ; worms introduced by accident,
and without finding a proper habitation in the ftomach
or inteftines: producing fpafmodic colic with fevere gri-
pings; and occafionally vomiting or dejection of blood.
Of this fpecies alfo we have three varieties.

a. H. Gordii, from the hair-worm. Found in foft
ftagnant waters : from four to fix inches long, twilled
into various knots and contortions: colour pale-brown,
with dark extremities. This difeafe is moft frequent
among the peafants of Lapland ; and was fufpected by
Linnaeus, and has been fince proved, or thought to be
proved, by Dr. Montin, one of his moft celebrated difei-
ples, to be occafioned by their drinking the half-putrid,
water of ftagnant marfhes or ditches inhabited by the
gordius. It is not known on the Lapland mountains.
The gripings are often fo violent, that the patient rolls
and writhes on the ground in feverer agony than a wo¬
man in labour, and difeharges bloody urine. After
many hours, fometimes an entire day, the diforder ter¬
minates in a profufe ptyalilin that continues for a quar¬
ter of an hour. The Laplanders call the difeafe ullen, or
holme.

Q. H. Hirudinis, occafioned by various fpecies of the
leech. Swallowed along with the muddy and ftagnant
water they inhabit. Apparently both the medicinal and
the horfe leech have been thus found; hut the exadt
fpecies has not been fufficiently indicated. Sauvages, in
his genus Haematemefis, quotes Galen, Schenck, and
Wedel 5 but does not deferibe the fpecies. Upon turn¬
ing to Galen, iv. 411.D. the reader will find that he
briefly adverts to the difeafe, and quotes from Afclepi-
ades and Apollonius the remedies that were employed in
their refpediive days : but he does dot charadterife the
U u worm |

PATHOLOGY.

m

worm ; and Dr. Lifter, apparently without knowing that
the fubjedl had been touched on before, defcribes the cafe
of a patient, who, after having “ had about his ftomach
and right fide a molt exquifite and tormenting pain for
at leaft four months, which many times threw him into
horrors and chillr.efs, ague-like, and was the fickeft man,”
continues he, “ I ever faw not to die,” vomited up a
worm of a dark-green colour, like a horfe-leech, and
/ported. From the pundiure of the animal, or the vio¬
lence of the retching, he brought up at the fame time
two pounds of coagulated blood: and had occafionally
dilcharged blood downwards. The man imagined he
drank it in pond-water during the preceding fummer.
The worm was dead when rejected, or at leaft when Dr.
Lifter faw it: four inches long, and three in its largeft
circumference; and is ftill farther defcribed and drawn
as having three fmall fins on each fide near the head, with
a forky, finny, tranf'parent, and extenfile, tail. Phil. Tranf.
1681-2. No. 6.

- One of the moft extraordinary cafes, among thofe en¬
titled to attention, is related by Mr. Paifley in the Edin¬
burgh Medical Eftays, ii. art. 26. In this cafe there were
two worms, whole heads he compares to that of the
horfe-leech, and which appear to have been tolerably
quiefcent in their growth, till the general fyftem was
diiturbed by a wound on the breaft, received by the pa¬
tient in confequence of a duel, with the fmall lword.
The general fymptoms of this fpecies of Helminthia
appeared about the third day afterwards, and continued
with many variations for feveral weeks, when the pa¬
tient difcharged inferiorly one of thefe worms, meafuring
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 dejedlion of grumous blood, “ to appearance fome
pounds;” and not many weeks afterwards the other, ftill
larger. — A worm, apparently fimilar, is ftated by Dr.
Bond of Philadelphia, 1754, to have been difcharged
downwards by a female patient of his, who had been
long fubjedl to an hepatic difeafe, which gradually
changed to violent helminthic fymptoms in the ftomach.
Thele, at length, fuddenly vanifhed ; and within twenty-
four hours the worm was dejefted, dead, and in two
parts, the whole making twenty inches in length. The
patient died foon after; and, on opening her, this worm
appears to have worked its way, when fmall, into the
liver by the courfe of the common dudl, to have com¬
mitted great depredation here, and afterwards, with con-
iiderable difficulty and dilation o€-the duff, to have tra¬
velled back again. Dr. Bond ventures to call it an hepa¬
tic leech; though he calculates its courfe as now ftated.
London Med. (Jbj'erv. and Inq. i. 68. — Maroja, phyfician to
Philip IV. of Spain, in his treatife De Morhis Internist,
lib. iv. cap. 16, mentions the cafe of a patient who dif¬
charged a ftill larger dead round worm of the fame mon-
ilrous kind, and died in the aft of difeharging it : its
length was twenty fingers breadth ; its rotundity equal
to the fize of a ftout man’s hand ; full of blood, and had
more than a pound and a half of blood taken from its
infide.

y. H. Mufcas cibariae ; larvae of the pantry-fly. Thefe
feem chiefly to produce mifehief while in the ftomach,
into which they may be taken with decayed cheefe, as
the eggs are fometimes depofited in it. See Dr. White’s
cafe, Mem. Med. Soc. Lond. vol. ii. The patient, aged
thirty, was emaciated, of a fallow complexion ; had gri-
pings and tendernefs of the abdomen; coftivenefs, ri¬
gors, and cold extremities. Took columbo-root, and oc¬
cafionally calomel and other purgatives. In a month
was better, and the appetite good. The next purgative
brought away an immenfe number of pupes, or chryfalid
worms ; fome of which, being preferved, were tranf-
formc-d into four-winged infedls, the Mufca cibaria.
Mr. Church, to whofe entomological fk.il 1 thefe worms
were confided, a Herts that he once knew a child difeharge

a larva of the caddy infedl (Phryganea grandis) ; and
that the Phalsena pinguinalis lives and is nourifhed in the
ftomach; and, after fuftaining feveral metamorphofes, is
thrown out, and proves its proper genus. See alfo Mr.
Calderwood’s cafe ; Edin. Med. Com. ix. 223.

The fymptoms of worms are as various and complica¬
ted as we ftiould naturally expedt to find them, when we
take into confideration the multiform efledl of nervous
irritation on all parts of the body. When fpeaking of
the functional difturbances of the alimentary canal, we
have endeavoured to ftiow how the irritated extremities
of the nervous expanfion of the ftomach and bowels will
convey nervous irritation to every other organ, and after
a time induce more important changes. The fame rea-
foning will apply to the efredl of worms, which are to
the nerves irritants of extreme power. To deferibe,
therefore, all the fymptoms of worms, would be endlefs ;
and it would moreover be ufelefs, lince they may be fimu-
lated by every other nervous diforder. The only certain
fign of their exiftence is their being feen in the ftools ;
but in many this is not obferved till their prefence has
produced much gaftric and inteftinal difturbance. Ac¬
cording to profeffor Brera, in perfons attacked by worms,
the colour of the countenance is changed ; it is fome¬
times red, then pale, or leaden-coloured. A half circle
of azure appears under the eyes ; they lofe their vivacity,
and are fixed and motionlefs with regard to furrounding
objedts ; they are fad and dejedled ; the lower eye-lids
fwell, and the pupils are evidently dilated. At other
times the eyelids are yellowifh, and the fame tint extends
over the white of the eye. There are alfo infupportable
itchings in the noftrils, with occafional haemorrhage
from the fame parts ; headache is frequent, efpecially
after taking food ; this is fometimes fo violent as to
produce delirium and phrenitis. The mouth is full of
laliva, and exhales a fetid and verminous odour; there
is grinding of the teeth; uneafy and agitated fleep, and
great thirft. Sometimes fomnambulifm renders the pa¬
tient timid. Fainting, vertigo, and tingling of the ears,
augment the morbid ftate of the fufferer. The cough
is dry and convulfive, fometimes ftertorous, and even
fuffbeating ; refpiration is difficult, and fometimes at¬
tended with hiccough; fpeech is interrupted, and in
fome inftances entirely fuppreffed. The mouth is frothy,
and there is palpitation of the heart; the pulfe is hard,
frequent, rapid, and intermittent. The belly is tumid,
and troubled with borborygmi ; there are eradiations,
naufea, retching to vomit, and vomiting. At one time
there is no appetite; at another it is fo great, that the
patient is compelled to take more food than ordinary.
The belly fwells, and is the feat of fevere pains ; there is
a fenfe of pricking and tearing, which is not fixed, but
wanders over the whole abdominal cavity ; thefe fuffer-
ings are aggravated wdien the ftomach is empty, and im=C
mediately ceafe on taking food. The bowels are fome¬
times relaxed, fometimes coftive. The urine is crude
and turbid ; the excrements fetid ; cardiaigia afflidts the
patient, and fometimes deftroys him ; the body is ema¬
ciated, though the patient eats much ; and violent itch¬
ing of the anus fometimes occafions fainting. At other
times tenefmus aggravates the pains of thefe parts.
Languor, anxiety, liftneifnefs, and extravagance in con-
dudl, difeourfe, and the intelledlual fundlions, are ob¬
ferved in perfons harraffed with worms.

The profeffor has alfo feen pains of the joints, refem-
bling arthritic rheumatifm, resulting from worms. Wei-
kard relates the cafe of a woman who was long harafled
with headache, fpafmodic affedlion of the eyes, vertigo,
fub-apopledtic attacks, and occafionally temporary blind-
nefs. One day, feeling fomething in her nofe, flie ex-
tradled, with a hook, a living lumbricoides, and then
three more. Some anthelmintic remedies now preferibed
brought away feven worms per anum, when the woman
was perfedlly cured of her diftrefling complaints. Worms

hav®

165

PATHOLOGY.

have been known to excite apoplexy in the brain, and
nephritis, when fituated in the bladder ; in which cafe,
Piodueunt uliqunndo eredlionem molejiam penis.

Itching of the nofe, and dilatation of the pupil, are
faid to be the lead equivocal lign of worms.

Upon the whole, we may fufpedt the prelence of worms
where irregular appetite and great difturbance of the
nervous fyltem are prefent, without any other marked
caufe of irritation, and unattended with alteration in the
circulating powers. The irregularity and the complete
remiflion of certain pains, and the deranged fecretion of
the bowels, will further aflift the diagnolis. It is a good
rule, however, in all anomalous and rare difeafes, to en¬
quire whether the patient has, or has had, any fymptoms
of worms, fince even intermiffions of the pulfe, palpita¬
tions of the heart, fyncope, vertigo, lofs of fpeech,
blindnefs, buzzing in the ears, mental dejedlion, reftlefs
fieep, hiccup, convulfions, epilepfy, and many other dif¬
eafes, may be produced by thefe animals.

. The treatment of worms comprifes their expulfion in the
firft place, and fecondly the prevention of their regene¬
ration. For the former purpofe, a numerous holt of
drugs have been recommended by various authors.
We fhall infert, from Prof. Brera, a catalogue raifonee
of the molt approved anthelmintics.

Allium fativum, or garlic, Iras been proved by Rofen-
Itein and Tiffot to be capable of expelling worms, efpe-
cially the taenia.

Artemifia fantonica, or worm-feed, is well known to
have confiderable power over the lumbricoides particu¬
larly. The dofeis from two grains to a drachm.

Afclepias Curaffavica, or Curagoa fwallow-wort, (the
Apocynum eredlum, folio oblongo, &c. of Sloane,) from
its emetic quality called baftard or wild ipecacuanha,
and by the negroes red-head , is a powerful vermifuge.
See vol. ii. p. 256.

The bark of the baftard cabbage-tree (Geoffrea iner-
mis) Hands, according to Mr. Chamberlaine, among the
firft in the lift of powerful vermifuges;, (fee vol. viii. p.
339, 40.) but even this, after an extenfive trial, was
given up by that gentleman on account of its uncer¬
tainty.

Jalap, probably from its difagreeable fmell and nau-
feous tafte, is a ufeful auxiliary, at leaft, to other anthel¬
mintics.

Affafcetida has been often ufefully employed in feveral
difeafes refulting from worms, particularly in the fpaf-
modic clafs. It is fometimes combined with other medi¬
cines, as myrrh, the black oxyde of iron, calomel, &c.
Affafcetida enemata are ufeful in the afcarides.

Oil, as clofing all the fpiracula of worms, is very ini¬
mical to thefe animals. The oil of walnuts has been
particularly extolled ; but Mr. Chamberlaine afferts that
taenia will live for many hours in oil.

Camphor. Pringle long ago demonftrated the anthel¬
mintic powers of camphor. The celebrated Mofchati
generally prefers it to other vermifuges. Half a drachm
is diffolved in a pint of water; to which a drachm of gum
arabic is added, and this mixture is given in fpoonfuls ;
or injections of ftronger folutions than the above are
thrown up. The employment of camphor is alfo atten¬
ded with this advantage, that it counteracts the predif-
pofition to the further development of verminous feeds.

Tanacetum vulgare, the common tanly, has been long
celebrated. Aloes, rhubarb, the gratiola officinalis,
gamboge, _ chamomile, fulphuretted fcammony, and
other fimilar articles, are alfo remedies commonly ufed
for the expulfion of worms. They are not fpoken of
lingly, becaufe thefe draftics are ufually combined with
other vermifuge remedies, vegetable or mineral.

Murias ammonias, combined with rhubarb or jalap,
is confidered by Block as a very efficacious vermifuge.

Iron, in conl'equence perhaps of its tonic powers, is a
well-afcertained anthelmintic, tending both to deftroy

worms, and prevent their fubfequent generation. The
fulphate of iron is confidered to be the beft preparation,
as poffefiing the greateft aftringent force, and being pow¬
erful in moderating exceflive fecretion of mucus in the
bowels. To children, profeffor Brera gives it in dofes
of from two to ten grains ; and to adults, in dofes of
half a drachm to a drachm. Thefe are large dofes. Its
virtues are much enhanced by conjunction with cin¬
chona, valerian, jalap, affafcetida, See.

Mercury can have no fpecific effedt againft worms, -fince
the labourers in the quickfilver-mines of Almada, in
Spain, are peculiarly fubjedl to worms, though thefe people
abforbfuch enormous quantities of that mineral, that glo¬
bules of mercury areevacuated with the ftools. Thel'ame
thing happens in the mines of Lydria, and in the labo¬
ratories of Chemnitz in Hungary. Befides this, Rofen-
ftein has adminiftered mercury in feveral cafes, even to
falivation, wdthout being able to expel a fingle worm.
Brera fays, however, that mercury, given in the ftate of
oxyde, adts on the folids as a pow’ertul ftimulant, fince
by its ufe the pulfe acquires great force, and the fecre-
tions and excretions are augmented. In this way feve¬
ral of the oxydes of mercury have been very efficient in
expelling worms, and in curing verminous affedlions.
Among thefe, the fubmuriateof mercury is to be preferred.
Ptyalifm fhould never be produced in thefe cafes.

Petroleum is famous at Montpellier againft worms.
Rofenftein, many years ago, related the cafe of a man
who was delivered of a taenia by a dofe of petroleum and
oil of turpentine.

Tin has been confidered vermifuge ever fince the days
of Paracelfus. But, as profeffor Brera properly obferves,
this method is objedlionable on account of the danger of
lead or arfenic being mixed with the tin. He himfelf
faw the Colica pidlonum, and paralyfis of the lower ex¬
tremities, produced by taking the filings of tin.

Towards the middle of the laft century, Madame
Nouffer’s remedy againft taenia excited confiderable at¬
tention. The medicine was three drachms of the root
of the male fern (Polypodium felix mas) in powder,
mixed with four or fix ounces of the diftilled water of
male fern, or lime-tree flowers, taken in the morning.
The_dofe, of courfe, was graduated for children. Two
hours after taking the powder, the patient is to fwallow
the following bolus : Take of calomel, and dry refin of
Aleppo fcammony, of each twelve grains ; of gamboge
five grains ; form into a bolus with hyacinth confedlion.
This, by the way, was a tolerably good vermifuge of it-
felf, and doubtlefs contributed as much towards Mad.
Nouffer’s fuccefs as the fern-powder.

Dr. Bourdies, of Paris, has adminiftered the following
remedy with great fuccefs in both fpecies of taenia : Pour
a drachm of fulphuric ether into a glafs of the decodiion
of male fern, which the patient is to take falling; four
or five minutes after, an injedlion of the fame decodiion,
with two drachms of ether, is to be thrown up. One hour
after, give two ounces of oleum ricini, and one ounce of
the fyrup of peach-bloffoms. This treatment is to be
continued for three days. The worm is commonly dif-
charged but half organized. When the worm is in the
ftomach, fuccefs is certain; when in the inteftines, the
treatment, after fome time, is repeated; then Dr. Bour-
dier preferibes an enema of decodiion of fern and two
drachms of fulphuric ether, immediately after the pa¬
tient has fwallowed the etherated potion.

The remedy of the celebrated odier was no other than
caftor-oil. It both kills the worms and expels them.
Adults fhould take three ounces of the oil, and children
a tea-fpoonful, feveral times a-day. Lelle advifes that
the oil be taken at bed-time, and ten grains of gamboge
the next morning.

Dr. Coffin has known Fowler’s folution deftroy the
taenia in feveral cafes. Dr. Filher, of Maffachufetts, alfo
obferves, that the taenia may be deftroyed by Fowler’s

folution.

16G PATH

folution. . For this purpofe the patient thould take it two
or three times a-day, in as large doles as the ffomach will
bear; and continue the ufe of it till the worms are de-
ftroyed.

Dr. Girdleffone, of Yarmouth, Hates in the 15th vo¬
lume of the Medical and Phyfical Journal, that he has,
for fome time, prefcribed the folutio mineralis in cafes of
tape-worm. “ This medicine,” he fays, “with the ufe
of purgatives, brings away larger portions than any pur¬
gative medicine without it. And I have found the fo¬
lutio mineralis a molt powerful deflroyer of the afcaris
lumbricoides.”

Dr. Pollock, of Bengal, has Hated that a number of
cafes of taenia were cured by decoftion of pomegranate.
“ In fome of thefe the taenia had acquired an enormous
length ; and in fome of them it was received in tepid wa¬
ter, and lived for feveral hours after it was pafled.”

A remedy, however, of fuperior power to all thefe,
and one which feems to aft very generally on all kinds of
worms, is the oil of turpentine in doles of from 3 vi to
two ounces. It was firff recommended by Chauberf, and
Hnce tried on an extended fcale in this country, where it
has met with a very favourable reception. Many objec¬
tions are in force againH this medicine. The fi rft, an
intolerable thirfl that follows its ufe, and which it is im¬
proper to indulge by drinking: the fecond is, that its
efficacy is deflroyed by mixture, and hence it is next to
impoffible to adminifler a large dofe of turpentine to chil¬
dren, who, in faft, form the majority of worm-patients.
In conclufion, therefore, though we have thought pro¬
per to enumerate moH anthelmintics which have obtained
great repute, we tnuH give a decided preference to the
Dolichos pruriens, or cowhage, overall others. This plant
was firH introduced into this country by Mr. Chamber-
laine. The parts ufed are the fetae, or hairy contents of
the pod, (fee Dolichos, vol. vi. p. 11) which are, ac¬
cording to the above-mentioned author, to be mixed
with honey or treacle, and thus formed into an eleftuary ;
or it may be compounded in the form of lozenges, in
which Hate it becomes a very palatable remedy for re-
fraftory children. Theaftion of this medicine is ffiown
by Mr. Chamberlaine’s experiments to be entirely me¬
chanical, and exerted only on the body of the worms,
the fliarp fpiculte Hicking into the animals in queftion
and killing them, while the coats of the bowels are de¬
fended from the accident by their conHant fecretion, or
firmer Hrufture.

Of the eleftuary, made with cowhage and treacle, a
tea-fpoonful is in general found to be a fufficient dofe for
children, from infancy to the age of fix or eight : from
thence to fourteen, a defert-fpoonful is found toanfw'er
well : and, for all above that age, a table-fpoonful. For¬
merly Mr. C. thought it might be fufficient if taken once
a-day, but experience has (hown that it anfvvers better
when taken twice ; viz. at night going to bed, and in
the morning an hour before breakfaH ; and, though little
or no previous medicine is necelfary, yet it is generally
found to operate more effeftually where a gentle emetic
(provided nothing forbids it) has been premifed. The
cowhage, after being begun upon, is to be continued
for three or four days ; after which, fome brilk purga¬
tive, fuel) as jalap, or infulion of fenna, or in ffiort what¬
ever purging medicine is known to agree befi with the
patient, is to be taken ; which will in general bring away
the worms, if there be any. Afterwards the cowhage is
to be continued as long as there may feem occafion ; re¬
peating the purgative at intervals of three or four days.

This medicine, excellent as it is, feems of late to have
fallen into difufe in this country, where indeed the diffi¬
culty of procuring it genuine muH have fubjefted its
employers to frequent failures in its application. It is
remarkable, however, that Mr. Chamberlaine, after thir¬
ty-five years very extenlive trial of it, never had one cafe
of failure fent to him, though he publicly courted their
rranfiuiffion, and though it was as extenfively ufed as

O L O G Y.

highly extolled by the firH phyficians of the day. For
our own parts, when the ufe of gentle purgatives fails to
expel the worms, we flrongly recommend the immediate
exhibition of this medicine; a meafure we may adopt
without fear, fince we are allured it afts mechanically,
and cannot therefore do mifehief even if its employment
be ill-timed. Dr. Coffin, the American tranfiator of
Prof. Brera’s work on verminous difeafes, fpeaks highly
in praile of this remedy.

After all that has been faid refpefting the lafety of cow¬
hage, and however inoffenfive in general it may be, reafon
will diftate to us, that where the mucus of the ffomach
and intefiines is abraded, or leflened, from any caufe
whatfoever; or where there is a tendency towards in¬
flammation in any part of the inteflinal canal ; the exhi¬
bition of this medicine cannot be unattended with danger.

The firH edition of Mr. Chamberlaine’s “Praftical
Treatife on Dolichos pruriens” was publiflied in 1784.
A tenth edition appeared in 1S12, in which he obferves,
“I ffiall not go fo far as to fay, in praife of this my fa¬
vourite medicine, that I never knew it to fail ; but I will
fay, that I have experienced more certain good eftefts,
and fewer ill confequences, than from any other medicine
given with the fame intention ; infomuch, that I have,
fince I firH began t.o exhibit the cowhage, had no occa-
lion to look for any other vermifuge. My primary ob-
jeft continues to be, the introduftion into common prac¬
tice of an article which I have long experienced to be a
fafe and efficacious anthelmintic; nor have my endea¬
vours been unattended with fuccefs, as the Dolichos
pruriens is now for the firfl time introduced into the
Materia Medica of the London Pharmacopoeia, at the
lafl reform of that book by the college, in the year 1809.
It has been alfo received into the Pharmacopoeia of the
Dublin College of Phyficians. In that of Edinburgh, it
has Hood as an officinal for feveral years.”

When the worms have been expelled, the correftion of
the tone which has given rife to or has been produced
by them, will require the application of thofe remedies
and rules which are explicitly detailed under Dyfpepfia,
in this article.

Genus XIII. ProSliea; [from nr^y.T^, the fundament.]
Pain or derangement about the anus and reftum, with¬
out primary inflammation. There are five fpecies.

1. Proftica fimplex, fiinple pain at the. anus. The
pain which arifes occafionally in the anus is of a fevere
and fpafmodic kind; is liable to remit, and is produced
by the paflage of large and indurated faeces ; or is caufed
by fympathy with diforder of other parts, generally of
the fuperior parts of the alimentary canal, lefs frequently
of the urethra. Mild purgatives, warm fomentations,
and, in fevere cafes, anal leeching, are the moH appropri¬
ate remedies.

2. Proftica callofa, pain produced by, or accompanied
with, a callous contraftion of the reftum. The caufe is
ufually, but not always, feirrhus, which is liable more¬
over to degenerate, as in other cafes, into carcinoma.
Colica callofa is alfo, an occafional refult. When this
complaint does not arile from feirrhus, it may be con-
fidered of the fame nature as Colica callofa, under which
title we have detailed the treatment. When it arifes from
feirrhus, in which cafe it forms what is called the
fcirrho-contrafted reftum, therapeutical endeavours are
of little avail. The origin of this complaint, as indeed
of feirrhus altogether, is quite obfeure. Mr. White con-
fidered at firH that it was a confequence of Ample ffric-
ture ; but fubfequent experience has induced him to alter
his opinion. Mr. Copeland, in his excellent Treatife,
thinks it may be caufed by whatever produces inflam¬
mation or irritation of the inner membrane of the intef-
tine; but neither is that opinion by any means well fup-
ported. The feat of this difeafe (different from what we
ufually obferve in Colica callofa) is generally two or
three inches above the outer fphinfter; and there is often

3 a found

PATHOLOGY.

a found capacious portion of the bowel between the
ftriClure and this fp hinder, though in the advanced
ftages of the difeafe even this often becomes indurated.
Indeed the fcirrhus fometimes occupies nearly the whole
cavity of the reCtum ; implicates in thickening and in¬
duration all its coats, particularly the mufcular ; and,
after a time, abrafion or ulceration of its internal mem¬
brane takes place, attended by a ferous, or thin and fa¬
mous, difcharge. The fevere fuffe rings of the patient
during the progrefs of this dreadful malady, and its more
rapid advance to a fatal termination, will help to diftin-
guilh it from other fpecies of contraction, when it would
be difficult fometimes to decide from mere local invefti-
gation.

In addition to thefe remarks, and the diagnoftic figns
we have drawn between this difeafe and Ample ftriCture,
when fpeaking of the latter difeafe, we copy, from Mr.
White and Dr. Sherwin the following remarks. Along
with the great and permanent pain about the facrutn,
/hooting down the thighs as before noticed, the burning
heat and pain of the reCtum, “ the patient gradually ex¬
periences a difficulty in evacuating faeces of a thick con¬
fluence. As the paffage becomes obftruCied, the faeces
acquire a thinner confidence, and the firlt complaint
which he makes is of a loofenefs.” On this paragraph of
Dr. Sherwin, Mr. White remarks, that, “although it
may be very true, that the diforder fometimes arrives at
the above-mentioned flage before any application is made
for relief, yet it does not follow from thence, that a
diarrhoea is a primary fymptom ; becaufe the hiftory of
cafes clearly demon/trates that the complaint in general
does exift for a confiderable length of time before a diar¬
rhoea comes on; and I believe it will be commonly
found in a very advanced ftage, whenever fpontaneous
diarrhoea takes place.”

Dr. Sherwin further remarks, “He (the patient) con¬
tinues in other refpeCts apparently in good health ; his
appetite is but little impaired ; reiterated fcanty evacua¬
tions, amounting in the whole to a fufficient quantity to
keep the ftomach eafy, preferve a fort of balance in the
intellinal canal : but, by degrees, the cavity of the gut
becomes lefs permeable ; opiates and teftaceous powders
have perhaps been had recourfe to, and the frequent need¬
ing to ftool abates. The patient and his friends flatter
themfelves he is getting well ; but he foon falls off in his
appetite for food. The abfence of ftools is fometimes
attributed to this caufe, till the-lower part of the abdo¬
men by degrees acquires a remarkable prominence, at¬
tended with uncommon rumbling of wind in the belly,
like gurgling of water in a bottle. By degrees a total
fuppreffion of ftools takes place ; the tumour of the ab¬
domen increafes; the uncommon rumbling of wind be¬
comes more audible, fo as to engage the attention of the
friends and vilitants of the patient. The diftention gra¬
dually increafes, till the ftomach is opprefled, and a vo¬
miting comes on. The vomitingis not very frequent at
firft ; but, by degrees, every thing fwallowed is vomited
up. Severe pains are felt from diftention in various parts
of the abdomen ; and a true iliac paffion of the chronic
kind comes on, and continues as long as the patient
lives, unlefs he is accidentally relieved by a free dif¬
charge of thin faeces, which will fometimes unfufpefledly
give a refpite to his fufferin'gs. In confequence of which,
the appetite for food will again return ; the patient will
again appear to be getting well: but the anxious foli-
citude of his friends at this period will urge him to get
down a confiderable quantity of generous nouri/hment,
till a repetition of the fame fcene takes place, and the
unhappy man is alternately tantalized and worn out,
either with a ftoppage or a purging.

“ If affiftance is not called in till the patient arrives at
this deplorable ftate of the difeafe, the want of ftools,
the great pain, vomiting, and tenfenefs of the abdomen,
may be pronounced an inflammation of the bowels, or
an iliac paffion of the acute kind. If powerful means are

Vol. XIX. No. 1 295.

167

employed under fuch idea, it is eafy to conceive that the
laft moments of the patient muft be rendered doubly dif-
treffing.”

The conftant inclination to ftool which attends this
diforder may be diftinguilhed from a. common tenefmus
by attending to the followingcircurriftances. A common
tenefmus is generally fudden in its attack, or elfe it fol¬
lows from purging or dyfentery ; it is often the confe¬
quence of draltic cathartics, and is always attended with
confiderable pain, and moft frequently with a- mucous
difcharge tinged with blood, inftead of feces; whereas,
that which accompanies the fcirrhous reCtum is attended
with little or no pain, but with powerful ineffectual
/trainings; during which, there will be often a difcharge
of wind ; and the mucus fqueezed out is flimy, but al¬
ways more or lefs black, and the excrementitious matter
is very feldotn tinged with blood. In the common te¬
nefmus, the impetus feems entirely fpent on the fphinc-
ter ani, and there is more or lefs of a protrufion of the
gut : but in the /training from a fcirrhous reCtum, the
patient is not fenfible of that diftrefs at the fundament
which is experienced in the other; and, as foon as the
fmall portion of excrementitious mucus is voided, he is
able to rife immediately from the ftool ; but in the com¬
mon tenefmus he is under the neceffity of /training long,
even after the expulfion of all that he knows, from his
feelings, will at that effort be evacuated ; and, after he
is able to rife from the ftool, there /till continues a burn¬
ing fenfation, urging in a continual expulfion : where¬
as in the fcirrhous reCtum, after the patient has /trained
hard, whenever a fmall quantity arrives at the anus, it
is fquirted out with flight efforts, and little or no un-
eafinefs follows ; nor does the countenance /how that ex¬
treme diftrefs which generally attends a fpafmodic ftric-
ture of a common tenefmus. It may alfo be obferved,
that there is very little emaciation of the body or lofs of
ftrength until the diforder is far advanced; the counte¬
nance then becomes fallow, and in forne inltances the
pulfe is quick, and is accompanied by heCtic fymptoms.

The following defcription of the appearances on dif-
feCtion are detailed by Df. Baillie : “It (the fcirrhus)
fometimes extends over a confiderable length of the gut,
viz. feveral inches; but generally it is more circumfcribed.
The peritoneal, mufcular, and internal, coats, are much
thicker and harder than in a natural ftate. The mufcular
too is fubdivided by membranous fepta, and the internal
coat is fometimes formed into hard irregular folds. It
often happens that the furface of the inner membrane is
ulcerated, producing cancer. Every veftige of the na¬
tural ftrudure is occafionally loft, and the gut appears
changed into a griftly fubftance.”

In the advanced ftage of contracted reCtum, an abfcefs
often forms near the anus, and common fi/lula is pro¬
duced on the abfcefs burfting, which renders it liable to
be miftaken for the original complaint. If operation for
fiftula be performed under thefe unfavourable circuin-
ltances, it aggravates the fufferings of the patient. Some¬
times it happens in the female fubjeCt, that, in confe¬
quence of an abfcefs. forming, or the inteftine becoming
ulcerated, a communication is formed between the rec¬
tum and the vagina, and the liquid part of the feces pafs
through the aperture, and are difcharged by the vagina.

The prognofis of this dreadful difeafe, which Dr. Sher¬
win wrote 30 years ago, ftill remains too true: he fays,

“ The difeafe comes on in the moft gradual and imper¬
ceptible manner : flow in its progrefs, but terrible in its
confequences ; it yields not to medical a/fiftance, bu.t
muft under the belt management become ultimately fatal.

It however admits of palliation ; and, if early difcovered,
will alfo admit of the laft moments of the patient being
refcued from unavailing, miftaken, and diftrefling, at¬
tempts to cure. It is therefore an objeCt of the moft fe-
rious attention of the humane practitioner.”

Attempts at cure have not, however, been wanting.
M. Delpech, in his Precis Elementaire, tom. iii. has
X x propofed -

168

P A TaH O L O G Y.

propofed to divide the (tridtured gut, in order to fecure
the efcape'of the contents of the bowels, the confinement
of ’which muff, as he obferves, produce extreme diftrefs
and danger. He adds, that the carrying up a cutting in-
ftrument into the midft of a cancerous difeafe muff be
expedted to produce ulceration, and, in this way, haften
the deftrudtion of the patient ; but that, in cafes of this
kind, every thing that can be propofed is fubjedt to ob¬
jection. His words are ; “ On a propofe de faire alors la
fedlion de l’un de ces points intermediares, afin d’affurer
le paffage des matieres. Ce parti a de grande inconveniens
fans doute. Porter l’inftrument tranchant au milieu ou
tout presd’une affedtion cancereufe, c’eft hater l’ulcera-
tion, qui doit confommer la ruine du malade ; mais,
dans des cas de cette nature, on ne peut rien entreprendre
que de tres defedtueux.” Upon this point it has been
very properly obferved, that operative furgery fhould
rarely, if ever, be recommended, unlefs where the chances
are decidedly in favour of its fuccefs : and, if this opinion
is right, it mud unqueftionably be wrong to advife an
operatioh in a difeafe of inevitably fatal event. It can
only tend to bring difcredit upon that branch of furgical
pradtice, which, from the pofitive good that, under pro¬
per diredtion, it is capable of conferring, lays the faireft
claim to the regard and confidence of mankind.

Some pradtitioners have tried mercury in this malady,
but with little fuccefs. Should we be fuccefsful at any
future period in the treatment of fcirrhus, we may per¬
haps entertain better hopes of the complaint in queftion,
though the conflant irritation to which it mull be fub-
jedted in this part will render its cure a matter of great
difficulty. Default, in his Oeuvres Chirurgicales, men¬
tions cafes which were cured by tents ; but it is now ge¬
nerally under(tood,that thefe were merely fnnplcftridtures.

3. Prodtica tenefmus. A tenefmus is a frequent and
infatiable propenfity to ftool, without being able to pafs
any thing, notwithllanding the mod violent ed’orts. It
may be occafioned by any kind of irritation, either of the
redtum itfelf or of the neighbouring parts ; by acrid fub-
dances taken into the body ; by fome of the dronger
purges, as aloes, fcammony, elaterium, Sec. or by fympa-
thetic irritations. It is often very pernicious, both from
the exceffive uneafinefs it occafions to the patient, and
from exhauding his drength ; and by the frequent and
vain ed'orts bringing on a prolapfus ani, and communica¬
ting the violent irritation to the neighbouring parts, as the
bladder, See. When arifing from local acrimony or from
the life of cathartics, it may be deemed an idiopathic af¬
fedtion ; but more generally it is found as a fymptom of
other complaints, as dyfentery, haemorrhoids, helminthia,
codivenefs, calculus of the bladder, and pregnancy.

The treatment, when Amply diredted to the relief of
the uneafy fenfation, confilts in injedting anodyne and
mucilaginous enemata, and in exhibiting oleaginous ca¬
thartics. A clyder of darch, or of ltarch and opium,
forms the bed remedy with which we are acquainted for
the relief of tenefmus. In mod cafes, however, we have
to diredl our attention to the didant irritation of which
this complaint is fymptomatic.

4. Prodtica marifea, (Haemorrhois, Cullen.) Piles.
Specific charadter, livid and painful tubercles orexcrefcen-
ces, ufuallywith a difeharge of mucus or blood. Of piles
we have the four following varieties.

ot.r P. cceca, (H. cceca, Cull.) The blind piles : pain and
tubercles without difeharge.

(3. P. mucofa, (H. mucofa, Cull.) Tubercles pale and
mucous; they are moreover tranfparent, compreffible,
highly eladic, and often produced in the courfe of a few
hours. This variety is fuppofed to arife from a depofition
of ferum only beneath the lkin.

y. P. cruenta, (H. cruenta, Cull.) The bleeding piles.
Tubercles florid and bleeding: they confid fometimesin
didention or a varicofe date of the hemorrhoidal veins;
more frequently of blood effufed into the cellular tiffue.
They are opake, of a dark colour, the blood firming evi¬

dently through the flein ; and are of a firmer confidence,
and more flowly formed, than the preceding variety.

5. P. polypofa. Polype-like excrefcences ftioofing
from a (lender root; bulbous; foft and compreffible; red
orreddilh; chiefly internal.

Piles in general occafion only a flight degree of incon¬
venience; but fometimes they give rife to ferious .griev¬
ances, either by burfling and pouring out fuch quantities
of blood as reduce the patient to the lowed date of de¬
bility, and dangeroufly impair his health ; or by exciting
inflammation around them, and caufing abfeeffes and
fidulas; or by becoming conftridted by the fphindter ani
mufcle, fo as to produce exceedingly acute pain ; or,
ladly, by affuming a malignant character.

P. marifea arifes mod commonly from fome obdruftion
in the circulation through the haemorrhoidal veins.
Habitual negledl of the bowels favouring the accumula¬
tion of hardened faeces in the redtum ; (training to void a
confined dool ; the preffure of the gravid uterus, or of
any preternatural tumours; a fedentary life; fudden
and violent exertion; lifting heavy weights; have, in
their turn, been the means of bringing on this difeafe,
and may be confidered as fome of its mod frequent caufes.

The fird appearance of all the varieties of marifea is
generally connedted with pain and inflammation. The
patient ufually complains of an uneafy fenfe of weight
and fullnefs, as well as of heat about the parts, particu¬
larly fevere in paffing a motion. If the inflammation re¬
main unfubdued, the fundament becomes very painful ;
the patient can then neither walk, ride, nor fit, the only
tolerable date being that of abfolute red in the reclined
pofition ; and, during the continuance of this date, paffage
of a motion is followed by extreme didrefs. With thefe
fymptoms there is generally more or lefs feverilh heat and
redleffnefs, and perhaps even delirium.

The marifeae may be numerous, or otherwife. Some¬
times a Angle fwelling only exids ; more frequently there
are feveral furrounding theanus. Occafional haemorrhage
is in mod cafes connedted with marifea. Perhaps in tire
effort to pafs a motion, bleeding comes on while the
parts are inflamed ; in this cafe, the blood generally
flows from within the anus, though it may occafionally
fpring from fome part of the external fwelling. Some¬
times the bleeding will fird occur, and frequently in the
abfence of every other fymptom ; or at lead without pain,
inflammation, or external tumour.

Many refpedtable writers affirm, that hemorrhoids
which are not very troublefome, and difeharge only mo¬
derate quantities of blood, are rather falutary than hurt¬
ful to the conditution, and require no particular treat¬
ment. Among thefe, it may be fufficient to mention,
Stahl, Sabatier, and Petit. This opinion has, however,
met with fome oppofition. In Dr. Rees’s Cyclopaedia,
article Hemorrhoids, it is drongly argued againd. The
writer of that article admits the general falutary effedt of
leeching in hemorrhoids, but affirms that the relief thus
obtained arifes from its curing other difeafes in the con-
fiitution which might be as well or better relieved by
taking blood from the arm. The writer of that article
proceeds es follows : “ Entertaining, as we do, a total
difbelief of the dodtrine, that the bleeding from piles is
ever really ferviceable to the fydem, we (hall never at¬
tempt to re-produce a difeharge of blood from them,
when fuch is fuppreffed ; but, at the (ame time, fince a
perfon with piles may alfo have complaints which require
bleeding, we perceive no reafon why, in fuch cafes, any
change (liould be made in the common mode of taking
away blood, or that venefedtion in the arm (hould be
abandoned for the employment of the leeches or the lan¬
cet in another part. We know, that it is approved as a
general maxim, to take away blood as near as poffible to
the feat of a difeafe : and to this method we alfo give our
decided approbation. It is for this reafon, that we often
preferibe the application of leeches to the anus, in cafes
of inflamed protruded hemorrhoids. But, as we do not
1 credit

PATHOLOGY.

credit that the ftoppage of bleeding from piles is likely
ever to prove a caufe of any difeafes, but rather of an
improvement of the health, we are far from being an¬
xious to fee the hemorrhage renewed in any form what¬
ever. But, fuppofing fome illnefs were aftually to be the
efteft of a fuppreflion of bleeding from the tumours, fuch
illnefs could only be imputed to a conftitutional ple¬
thora, induced by the ufual evacuation of blood not
taking place. Here the redundant and hurtful quantity
of the circulating fluid might be much more conveniently
and certainly drawn from the arm, in the common way,
than by applying leeches to the tumour, or punfturing
them with a lancet. The blood, in this circumftance, is
not taken away for the relief of the piles, but of fome
other affe<5lion ; and, confequently, the principle of bleed¬
ing as near as poflible to the feat of the difeafe is not
at all obferved, as fome may fuppofe it is, in drawing
blood from the fwellings themfelves.”

With regard to this fubjeft, we may obferve, that there
can be little doubt but that, in cafes manifeftly depen¬
dent on preffure of the hemorrhoid veins, the lofs of
blood may be ufelefs, perhaps hurtful ; but it cannot be
queftioned, that piles in many inftances arife from a dif-
ordered date of the abdominal vifcera; and that they
ierve materially to relieve the local plethora of thofe or¬
gans. Hence we fee them arife often in dyfpeptic and
bilious complaints, which they then relieve in a very
effeftual manner. To fay that general bleeding would
afford equal relief to thefe complaints, is to affert what is
contrary to experience ; and it is equally abfurd to fay,
that in this cafe the blood is not taken from the part af-
fefted, fince a glance at the connexions of the hsemor-
rhoidal veins, fhows that they are literally continued from
the portal fyftem. The frequency of the above-men¬
tioned caufes of marifca compel us therefore to fay, that
in difmiffing fo unceremonioufly the obfervation of the
old praftitioners, that the bleeding from piles is often
falutary, we (hould aft very haftily. We cannot help
quoting the appropriate fentiments of Dr. Parr, who
(though he deemed the danger of flopping hemorrhoi¬
dal difcharges inexplicable) fays, however, that “ it ap-
ears rafh and prefumptuous to deny, at once, what has
een eftablifhed in the opinion of able and experienced
praftitioners; opinions not haftily taken up, and as
quickly refigned, but apparently refting on fafts, the
refult of the obfervation of many years, in different and
diftant countries.”

Dr. Parr is of opinion, that this complaint in old age
is often indicative of difeafe in the venous fyftem in ge¬
neral. “If in early age we perceive aftive hemorrhages
in the brain, in the more advanced periods we perceive
fimilar effefts from venous plethora. We then find thofe
apoplexies and palfies from a languid circulation ; in other
words, from weakened refiftance of the venous fyftem.
In the lungs we find, front the fame caufe, humoral afth-
ma and hydrothorax 5 in the epigaftric region, infarfted
liver, and the morbus niger; in the hypogaftric, hemor¬
rhoids. If we judge right, hemorrhoids are of two
kinds. It is a difeafe of youth, as well as of maturer age ;
and, in the former, is often acutely painful without eva¬
cuations, in the latter lefs commonly painful, but ufually
attended with bloody difcharges. In each it feems a fa¬
lutary determination from parts otherwife overcharged ;
and this we think is proved by many fafts. In the very
painful hemorrhoids of young perfons, faturnine and
cold applications, which relieve pain, often induce fick-
nefs and faintnefs. In fpeaking of fiftula, we have fhown
that checking the difcharge is often injurious, and that
confumptive fymptoms frequently follow the operation
and the healing of the wound. We will admit that fuch
confumptions are connefted with the ftate of the liver ;
but fo far as we have feen, and the cafes are not few, the
age is pot that of biliary congeftions, but of accumula¬
tions in the lungs, viz. the confumptive period, from
fifteen to thirty-five, generally from eighteen to thirty.

169?

It appears then highly probable that congeftions on the
thoracic vifcera are relieved by others on thefe parts ; and
we thus fee the connexion of hemorrhoids with the ge¬
neral health, independent of any venous connexion with
the liver. In thefe cafes, the parts inflamed are carun-
culas already mentioned, and the inflammation is aftive.
Yet in the hemorrhois of advanced life, fuch congeftions
evidently take place. The difeafe is the venous, and the
tumours, in the greater number of inftances, varices:
they bleed, and the patient is relieved. Congeftion and
inconvenience follow, to be again obviated by a recur¬
rence of the hemorrhage.”

The inflamed and irritable ftate of the fphinfter which
thefe complaints have a tendency to produce, often makes
it contraft fpafmodically on the hemorrhoid, and occafion
great pain and diftrefs. Mr. Howfhip mentions two cafes
in which the contraftion was fo powerful and continued,
that the ftrangulated hemorrhoid floughed off.

In fpeaking of the treatment of this complaint, we
(hall of courfe pafs over all cafes arifing from permanent
preffure on the hemorrhoidal veins, as from pregnancy,
&c. Thefe can only be relieved by the removal of the
caufe. For the treatment of all the varieties, the fame
meafures are indicated, except that, as the marifcas are
only vifiblejuft after the patient has been at ftool, in
fuch cafes the praftitioner is obliged to take this oppor¬
tunity of performing operations, or of applying reme¬
dies.

The relief of the fecond variety is eafily accomplifhed.
Abfolute reft for a few days, attention to the bowels,
and warm bathing of the parts, will comprife all that is
required.

As the P. M. cruenta, or bleeding piles, often produce
much furrounding inflammation, they will require, in ad¬
dition to abfolute reft, an aftive treatment. If the pa¬
tient is of a full habit, and the parts are very turgid and'
painful, an important ftep will be the application of cup-
ping-glafles near the parts. Leeches will occafionally
anfvverthe purpofe ; but, if it be required to takeaway
five or fix ounces of blood fpeedily, the operation of. cup¬
ping is much more certain and manageable. If necef-
fary, the bleeding may afterwards be encouraged by fo¬
menting with warm water, or a poppy-head decoftion.
Should the bowels be confined, it may be prudent to de¬
lay, for a little while, the additional difturbance incurred
by the paflage of a ftool, perhaps containing hardened
faeces, until the fymptoms are fomewhat relieved ; al¬
though the procuring a cool and gently-relaxed ftate of
the bowels is always important; andindeed, till this point
is gained, little real progrefs in improvement can be
made. Should feverifh fymptoms demand attention, fa-
line or antimonial diaphoretics may, if neceffary, be added
to aperients; and, when they have operated fatisfaftorily,
we may direft an opiate at night. A falve, made of el¬
der-ointment and the powder of oak-galls, in equal parts,
may be applied to the tumours, together with linen wet
with the lotio aquae lithargyri acetati. This latter is
more particularly neceffary in conjunftion with leeches,
when the cafe is accompanied with confiderable pain and
inflammation.

Painful fpafm of the fphinfter is to be relieved by the
continued ufe of warm fomentations, or occafionally by
gentle fteady preffure upon the tumid parts, by which
means part of the blood will be made to pafs inward by the
hemorrhoidal veins, relieving the fenfe of outward fullnefs.
When the pain and inflammatory ftate of piles is owing
to their being conllrifted by the fphinfter-ani mufcle, it
is evident that the mode of relief confifts in pufliing the
tumours with the finger a little within the reftum, where
they are not liable to fuffer from preffure. When marif-
cae materially obftruft the paflage of the fasces, or are very
painful, and fubjeft to profufe bleedings, and the means
above mentioned are ineffeftual, the removal of the tu¬
mours (hould be recommended.

Piles are removed with a knife or fciffors, the tumours

being

PATHOLOGY,

170

being {imply cut through at their bafes. In performing
this operation we are direfted to fave fome portion of {kin,
on which account the fcalpel is preferable to the fciffors.
Another mode of removing piles is by a ligature palled
round their bafe. This is an eligible plan when the fwellings
are fituated high up the reftum, where the danger of bleed¬
ing is fomewhat alarming ; but it is tedious, feveral days
often parting before the tumours drop off ; and it is alfo lefs
cleanly, and attended with much more pain than is occa-
fioned by the knife. There are very good furgeons how¬
ever, who employ the ligature in preference to the
knife, and of courfe where bleeding has produced much
debility it is the belt method. When the marifcas are
numerous, we fnall often fucceed, as Mr. Ware firft ob-
ferved, in relieving the patient, by cutting off only one of
them ; for, if an accurate enquiry be made, he believes it
will be found that the patient will point to one, or at
mo ft to two, of the tumours, from which all the pain
proceeds.

If the hemorrhage which fometimes follows the opera¬
tion of cutting off piles brings on alarming fymptoms of
exhauftion, we mud diftend the reSum with a piece of
fponge of fuch fize as will make therequifite degree of
prefl'ure upon the opening of the bleeding veffel. Some
dip the fponge in a ftyptic lotion ; but the beft way is to
introduce that fubftance quite dry into the inteftine, and
let it expand there with the blood which would be im¬
bibed by it.

When we meet with cafes of long {landing which we
have reafon to believe connected with difordered func¬
tion of the ftomach and bowels, a very ftrift attention
to diet is called for. This is at all times indeed of the
ffrft importance, lince it is quite obvious that, the irrita¬
tion of the parting of {tools being the chief fource of irri¬
tation, every mean which diminifhes their volume and
acrimony muft be a powerful agent in expediting the
cure. If, after flopping the bleeding front piles, biliary
difturbance occurs, we fhall do well to reproduce the dif-
charge by anal leeching after the manner defcribed when
fpeaking of Coproftalis. Oleaginous cathartics will alfo
be found ufeful.

5. Proftica exania, (H. procedens, Cullen.) Falling
down of the fundament. Inverfion and prolapfe of the
villous tunic of the reftum, from relaxation of the
fphinfter, with more or lefs tumour. This fpecies con-
fifts of two varieties.

a.. P. {implex, confifts in a protrufion of a part of the in¬
ternal membrane of the- re £1 urn, which, becoming in¬
verted, and parting out at the anus, forms a red foft flattifli
circular tumour. It is frequently obferved in children,
affefted with tenefmus or dyfentery, in thofe who are
fu fieri ng a fit of the ftone, or undergoing the operation
of lithotomy. Women, having internal hemorrhoids,
and in the violent efforts of labour, are alfo fubjeft to
the fame accident. Its common caufe is too-violent and
repeated exertions of the redlum itfelf, excited by fome
fource of irritation about the extremity of this inteftine.
Thus, the too-frequent employment of aloetic medicines,
the aftion of which particularly affefts the large intes¬
tines, often occafions the above complaint. The fame
thing refults from afcarides, which, lodging about the
lower part of the reft urn, occafionally caufe excertive ir¬
ritation. Habitual coftivenefs, hemorrhoids ; in a word,
everything which, by ilimulating the reftum, excites
too violent an aftion of this inteftine, may induce this
' complaint. In the early and moft fimple ftage of this
difeafe, the fwelling may be eafily reduced by compref¬
ling it with the fingers, and the reduction may be main¬
tained by the application af a bandage, which will keep
up moderate prelfure ; and, even in fevere and more ad¬
vanced cafes, the reduftion may be readily effefted by the
following procefs. The patient being in bed, lying
upon his fide, or, what is better, on the abdomen, while
his buttocks are raifed rather higher than the reft of the
body, the furgeon is to make ltrong but equal preffure,

with the palm of his hand, on the lower portion of the
prolapfed inteftine. By continuing fuch preffure, the
inteftine may, in general, be eafily reduced. But, if this
plan {hould not fuffice, the upper part of the protruded
inteftine muft be compreffed with the fingers of one hand,
(previoufly oiled,) while the lower part is preffed upward
by the palm of the other. In this way we are almoft fure
to fucceed, unlefs, from having too long delayed the re¬
duftion, the gut has become fwollen and inflamed, when
it will be impoffible to reduce the part before fuch fymp¬
toms have been fubdued. For this purpofe it may be
proper to take blood from the patient, in fuch quantity
as his ftrength will allow. The inteftine may alfo be fo¬
mented; and, when the fwelling has been diminiftied
by thefe means, there will be no difficulty in replacing
the parts in the manner juft mentioned.

After the bowel has frequently defcended, the fphinc-
ter fometimes becomes fo weakened, that it can no longer
keep the part fupported. Hence different bandages have
been devifed for fupporting the anus after its reduftion.
A oomprefs, doubled feveral times, is ufually applied to
the anus, and fupported in this pofition by means of a T
bandage ; and, in many cafes, this anfwers very well.
A machine was invented by Mr. Gooch, which has the
double advantage of fupporting the inteftine more fe-
curely than any other with which we are acquainted, and
of allowing the patient to take a great deal more exercife
than he could do without its affiftance. M. Bernard has
invented an inftrument which confifts of an oblong oval
body, rounded at one end, and terminating at the other
in a narrow, rather long, neck, with a flat border at its
extremity. The body of this inftrument, which is made
of elaftic gum, when introduced into the inteftine be¬
yond the fphinfter, dilates and fupports the gut, while
the fphinfter embraces its neck, and the border of this'
part of the inftrument hinders it from afcending too far
up the reftum. A. firing is alfo attached to the edge,
which tends to prevent the occurrence. This peffary is
very fmooth, and confequently cannot do any injury
to the parts. It is alfo very light, being only compofed
of a very thin, though tolerably folid, fubftance. As it
is pierced at its termination, it does not impede the
difcharge of air, which might otherwife incommode the
patient.

When the inteftine is protruded at the time the patient
is at {tool, the part is to be immediately replaced. This
the patient fhould accuftoin himfelf to do without affift¬
ance ; and then the bandage, or peffary, is to be applied.
In order to ftrengthen the lphinfter ani and adjacent parts,
the weaknefs of which muft, in the majority of cafes, be
regarded as the entire caufe of the difeafe, the patient
ffiould take preparations of bark and Heel, and make ufe
of the cold bath. Aftringent injeftions, particularly
fuch as are compofed of an infufion of gall-nuts, or oak-
bark, are alfo ferviceable.

With refpeft to the ulcerated, inveterate, and ir¬
reducible, cafes of exania, we may attempt the extirpa¬
tion of fuch difeafes with the knife.

(3. P. fpafmodica. The tumour large and irritated ; and
the inteftine contrafted by a fpafm of the fphinfter. This
ferious diforder has been confounded with the previous va¬
riety, in which a confiderable portion of the colon, caecum,
and even fometimes of the ilium, becomes everted and
puffied out at the anus. (Morgagni de Sed. et Cauf. Morb.
Ex. xxxiii.) The tumour has been alfo miftaken for a
marifca ; and Dr. Cullen has, perhaps, given fome coun¬
tenance to the error, by defcribing one of his fpecies of
heinorrhois as produced by a prolapfe of the anus.
The hemorrhoidal tumour is dull and livid; that
from a prolapfe of the anus is fleffi- coloured, fome¬
times wrinkled, at others fmooth and {hining. For¬
mer praftitioners confidered this occurrence in the
fame point of view as P. exanise {implex : they believed
that the whole of the reftum became everted, in
confequence of the relaxation of the fphinfter and leva-

tores

PATHOLOGY. 171

tores ani, and that it then drew after it other portions
of the inteftinal canal. But they ought to have been
undeceived by the ftrangulation which generally occurs
under fuch circumftances, and which not only throws a
great obftacle in the way of the redudtion of the difplaced
part, but even fometimes brings on mortification. Be¬
tides, the connexions of the redtum with the neighbour¬
ing parts, by means of the cellular fubftance which fur-
rounds it, and the attachment of this inteftine to the
pofterior furface of the urinary bladder, render the above
origin of the complaint impoflible. Such an explanation
could only be admitted with regard to thofe protrufions
of the redtum which come on in a very flow manner.
This account could not afford a fatisfadtory explanation
of certain cafes, in which the everted inteftine prefents
a very enormous tumour. Fabricius ab Aquapendente
mentions his having feen tumours occafioned by a pro-
lapfus of the redtum, which were as long as the fore-arm,
and as large as the fill. In the Melanges des Curieux de
la Nature, we find an account of a tumour of this fort,
which was two feet long, and occurred in a woman from
parturition. Nor is a more fatisfadtory reafon afligned
for thefe cafes, by fuppofing that they originate from a
relaxation of the villous coat of the redtum, and its fe-
paration from the mufcular one. We are not authorifed
to imagine that fuch a feparation can take place to a con-
fiderable extent, nor fo fuddenly as to give ril? to the
phenomena fometimes remarked in this difeafe. But
more accurate obfervations have removed all doubt upon
this fubjedt. In the fourth volume of the Memoires de
l’Academie de Chirurgie, we read an account of a pre¬
tended prolapfus of the redtum, which, after death, was
difcovered to be an everfion of the ccecum, the greater
part of the colon being found at the lower end of this
inteftine, and molt of the redtum at its upper part. This
everfion began at the diftance of more than eleven inches
from the anus, Snd^terminated about five or fix fron? this
opening, the tumour, formed by the difeafe, having been
reduced fome time before the child’s death. It was im¬
poflible to draw back the everted part, in confequence of
the adhefions which it had contradted. Another diftinc-
tion has evinced the fame fadt. A child, after fuffering
very acute pain in the abdomen from receiving a blow,
had a prolapfus of the inteftine through the anus, about
fix or feven inches long. This was taken for a prolapfus
of the redhim. After death, the termination of the
bowel out of the anus was found to be nothing lefs than
the ccecum, which had palled through the colon and rec¬
tum, to make a protrufion at the anus.

This difeafe occurs alfo, as an effedt, in obftinate cof-
tivenefs, ftone in the bladder, labour, and helminthia po-
dicis.

In this place we have to detail the meafures to be adop¬
ted for the removal of concretions and extraneous bodies
from the redtum. Thefe concretions may be formed in
the larger inteftines, and efpecially in the redtum, by the
mere accumulation and protradted lodgment of the fasces.
Sometimes, however, thefe mall'es of indurated matter
include no extraneous fubftance; in other inftances, their
nucleus is a biliary calculus; but in molt cafes they are
merely compoledof the fasces in a dry hardened ftate.

Whatever may be the nature of thefe fubftances, their
exiftence may be known by the conftipation, complete or
partial, which they produce; by the fenfe of weight
which the patient feels about the fundament; of touch¬
ing the indurated obftrudting body, by a finger intro¬
duced in ano. Oily emollient clyfters, and carminative
draughts, will ferve for expelling fuch concretions as are
not of too firm a-confiftence; but the extradtion of them
is abfolutely neceflary when they are particularly hard.
The operation is to be done with a fpoon, or l'uitable
forceps, properly oiled ; and, after the concretion has
been removed, an emollient clyfter is to be adminiftered,
in order to allay any irritation which may have been
Vol. XIX, No. 1295.

caufed by the introduction of the requifite inftruments.
When the fphindler ani contracts fo forcibly, that the
operation is attended with extreme pain and difficulty,
we are advifed by furgical writers to make a dilatation of
the anus, by pradtifing an incifion at its pujlerwr angle:
a wound made in this diredtion cannot injure any part of
confequence, whilft there would be a rifk of wounding
the urethra in the male, or the vagina in the female fub-
ject, if the cut were made at the anterior angle; and an
incifion carried laterally would be apt to injure the pudic
veflels. A divifion of the fibres of the fphindter ani does
not produce any material permanent weaknefs of its ac¬
tion ; and a paralyfis of this mufcle, according to Riche-
raud, can never proceed from fuch a caufe.

The hard concretions which lodge in the redtum can¬
not be reached with the finger when they are fituated
high ; and, in this circumftance, the furgeon muft ufe a
probe, or found, in order to aflTure himfelf pofitively of
their prefence.

The extraction of fubftances which madnefs or folly
have caufed to be introduced into this fituation is often
attended with a great deal of difficulty, and has even de¬
manded, on the part of the operator, more than ordinary
fagacity, in confequence of the various fhapes, the hard-
nefs, and the fragility, of thefe different bodies. Glafs
phials, inftrument-cafes, fhuttles, &c. have been intro¬
duced into the redhim by maniacs. One perfon of this
defcription put into bis redhim a flint-ftone, which did
not admit either of being extradled or broken, owing to
its hardnefs and flippery furface, and which in the end
caufed the patient to die in the greateft agony, with
fwelling and gangrene in the abdomen. Marchetti lias
recorded an inftance, in which a pig’s tail, hardened by
cold, was forcibly tliruft up the redtum of a girl of the
town. This extraneous body could not be withdrawn,
as the ftiort briftles, which all inclined outward, immedi¬
ately came in contadl with and pierced the inner part of
the bowel. It remained in the part fix days, and occa¬
fioned a train of alarming fymptoms ; fuch as fever, vo¬
miting, fwelling of the abdomen, and obftinate conftipa¬
tion. Marchetti faftened a ligature to the end of the fo¬
reign body, which protruded at the anus, and then pafled
the ligature through a long piece of reed, which he in¬
troduced up the redtum, and drew the pig’s tail through
this tube without lacerating the inteftine. In another
cafe, a piece of wood, three inches long and two in width,
was lodged in the redtum. Colic, tenfion of the abdomen,
fever, conftipation, and difficulty of making water, came
on, and lafted fix days. The impoflibility of removing
the extraneous fubftance with a pair of forceps, led to
the idea of ufing a borer, which, having been pafled up
the redtum under the guidance of the finger, was in¬
ferred deeply enough into the piece of wood to draw
it out.

Order II. Splanchnica, [Gr. appertaining to the vif-

cera.] Diforders affedting the collatitious Vifcera.

This Order contains four Genera.

Genus I. Iderus , [Gr. from the yellow or golden co¬
lour.] Yellow Jaundice. Generic charadters — Yellow-
nefs of the fkin; white faeces; urine faffron-coloured, and
communicating a faftron dye. The courfe of the bile
obfti udted. This genus has the following five fpecies.

1. Idterus cholceus. Specific charadter; the courfe of the
bile obftrudted from its own vifeidity, or from lofs of con-
tradlility in the bile-dudts ; general languor ; naufea ; dyf-
pepfia ; and occalional pain or uneafinefs at the ftomach.

2. Idterus chololithicus. (I. calculofus, Cullen.) The
courfe of the bile obftrudted by bilious concretions in
thedudls; frequent retching occurs in this complaint,
with acute pain in the hypogaftric region, increafed upon
eating.

3. Idterus fpafmodicus. The courfe of the bile ob-
ftftidted by fpalinodic contradtion of the bile-dudts : the

Y y difeafe

I7tt PATHO

difeafe preceded by acrimonious ingefta 5 hyderia, or fome
■violent paflion of the mind; and generally fubfiding
within a few days after thefe are removed.

4. Ifterus hepaticus. The courfe of the bile obflrufted
by the derangement of the liver from fchirrhus or infarc¬
tion : occafional retching and dyfpepfia.

5. Ifterus infantum. The courfe of the bile obflrufted
by vifcid meconium ; without pain or dyfpepfia. See
Parturition, p. 715.

Jaundice is found fymptomatically in pregnancy, colic,
coprodafis, and fevers of various kinds ; efpecially in the
yellow fever.

Thecaufes of jaundice are fufficiently explained by the
above claflification, which is indeed founded almoft en¬
tirely on their variety. The infpiflation of bile which
occurs in the firft fpecies is faid by Dr. Saunders to have
been found in the gall-bladder, and prefenting there a
vifcid and pitchy confidence. Dr. Powell, on the other
hand, dates, that it does not fee m to block up the large
dufts, nor their entrance into the duodenum, but rather
accumulates in the liver itfelf, the deviation from a
date of fluidity rendering its paflage through the fmaller
canals difficult. He conceives that this date of the fecre-
tion is connefted with the ufe of fpirits.

Inaftivity of the dufts is another caufe of the reten¬
tion of bile. Some authors have indeed edimated the
contraftile powers of thefe parts at a very low rate ; but
we trud that we fhall be able to fhow, in the proper
place, that their contraction, though flow, is powerful
and well marked. It cannot however be doubted, but
that other powers aflid the paflage of the bile; as for in¬
dance, the occafional didention or relaxation of the flo-
mach, the motions of the diaphragm, bowels, and abdo¬
minal mufcles. Hence a life of indolence and inactivity
feems to be a frequent fource of the malady in quedion.
Hence too literary men, and thofe who are engaged in
fedentary occupations, in which for the mod part the
body is inclined forwards, and the gall-dufts obvioufly
liable to fuft'er condant compreflion between the liver and
adjoining parts, are frequently jaundiced. But, indepen¬
dently of the deficiency of thefe aids to the propulfion of
bile, a want of contraftile power in the gall-bladder will
produce jaundice. Dr. Powell mentions a cafe in which
the powers of contraction were lodfrom over-didention ;
the accumulation of bile having become fo great, as to
produce a tumour externally, and an evident fluctuation.

Want of exercife operates powerfully in the production
of the fecond fpecies likewife. Biliary concretions are
comparatively more frequent in women than in men ;
thofe men who are engaged in literary purfuits are very
liable to them; and in either fex they are mod common
after the aCtive period of life is pad. Haller noticed the
frequency of their occurrence in criminals whofe death
had been preceded by long confinement. They are often
found in . the • gall-bladders of oxen which have been
flailed during the winter-months; and Dr. Powell believes
that they occur in a larger than common proportion of
maniacs who have been long confined.

Of the exiflenceof the third fpecies fome doubts have
been entertained : Dr. Cullen particularly mentions it,
and Dr. Powell deems it well efiablifhed. It is faid by
Sydenham to come on occafionally during hyderics ; and
it has been obferved to follow violent fits of anger, and
other emotions of the mind. But the accurate Dr. He-
berden denies the correftnefs of Sydenham’s obfervation,
in refpeft to hyderia, both from his own experience and
the authority of many other petitioners. With refpeft
to the influence of the paflions, Dr. Saunders remarks,
that anger not only augments the quantity of bile fe-
creted very confiderably, but likewife vitiates it : hence
it is, that, being carried into the duodenum in large
quantities, and regurgitated into the flomach, it produces
the fame effefts as an emetic ; and hence probably the
term choleric , as applied to paffionate people. If the
duftus communis do not tranfmit it as fad as it is fe-

LOGY.

creted, and the gall-bladder is fo full that it cannot ye»
ceive the excefs ; then it will be forcibly returned upon
the hepatic fyflem, and, by entering the blood-veflels,
produce jaundice. Some have fuppofed that, during the
general commotion of the paflions, a gall-done may have
been pufhed from the bladder into the duft, and thus
produced jaundice 5 but the whole attack has often been
too tranfitory, and too free from the general fymptoms
of the paflage of a gall-done, to allow of fuch a fuppofi-
tion. The fymptoms of fpafm, affefting the parts in
quedion, are, however, generally confidered as being
fimilar to thofe of the paflage of a concretion. So that,
on the whole, the explanation which Dr. Saunders has
given, of the influence of the paflions in producing a
temporary jaundice, appears to be the mod probable.

The fourth fpecies is generally traceable to drinking, as
is likewife a thickening of the coats of the biliary dufts, .
by which their calibre mud be diminifhed, as mentioned
by Morgagni (De Caufis et Sedibus Morborum, Epid.
xxxvii. art. 10.) who gives an indance of the total obli¬
teration of the common duft. Dr. Saunders remarks,
that this contraftion of the canal of the duft is pro¬
duced by the extenfion of difeafed flrufture, originally
produced in the flomach by the abufe of fpirituous li¬
quors, to the biliary dufts. “ In the difleftion of thofe
who have been intemperate dram-drinkers, the difeafed
flrufture may be traced,” he fays, “ from the flomach
along the courfe of the duftus communis ; and I have
frequently feen thefe dufts fo contrafted and thickened,
that they could not tranfmit bile.” A fimilar effeft,
from inflammation of the liver extending to the gall¬
bladder and dufts, which often lays the foundation of an
incurable jaundice, has been obferved by Dr. Pemberton :
the inflammation of the duft may be removed, he ob-
ferve«, but the thickening remains, a permanent evil.

In addition to the feries of caufes already detailed, ari-
fing from obdruftion to the paflage of the bile into the
duodenum, it has farther been a quedion, whether any
obdruftion to its difcharge from the bowels, after it has
cleared its appropriate dufts, may not likewife occafion
its abforption into the fydem, and therefore produce
jaundice. It would appear, from an experiment of M.
Portal, that this may happen. He palled a ligature round
the intedine of dogs, a little below the opening of the
duftus communis choledochus ; and obferved that, in
five or fix hours afterwards, their eyes acquired a yellow
tinge ; and, upon examining the lafteals, he found them
filled with bile. (Mem. deTAcad. des Sciences, 1777.)
In fome of the cafes of obdinate coflivenefs, accompa¬
nied by jaundice, that are on record, it is probable, there¬
fore, that the jaundice was a fymptom, rather than a
caufe, cf the coflivenefs. This feems to be the cafe, in
the flight jaundice of infants, which fpeedily vaniihes
when the bowels are unloaded.

It is of confequence that the fchirrhous date of the
liver fliould not be miflaken for a mere congedion of
blood or turgefcence of the veflels throughout the liver,
which may prefs upon and block up the biliary dufts,
and thus occafion the abforption of that bile to the fecre-
tion of which it miniders. Hepatitis, or inflammation of
the liver, is fometimes accompanied by jaundice; and this
would probably happen more frequently were it not in ge¬
neral confined to a fmall part of the vifcus, or to its invefl-
ing membrane. Moreover, after the intermittent fevers of
this country, and the analogous remittents of warmer
climates, a jaundice often comes on towards the con-
clufion, which has been confidered as forming no very
unfavourable prognoflic ; for there does not generally
appear to be any other difeafe of the liver, in fuch cafes,
than an increafe of its fize, with great accumulation of
blood through its fubdance. Dr. Powell mentions the
cafe of a woman who died of confumption, and whofe
lungs were found to be alinod one mafs of ulcerated tu¬
bercle; within the lad three days of her life, jaundice
had come on to a very intenfe degree. Yet, on diflec¬
tion.

PATHOLOGY. 173

rion, the duffs were found free, and the gall-bladder
empty, and no external tumour was difcovered ; but in
the liver there feemed to be a great accumulation of
blood ; it was much increafed in fize, had a loole texture,
and was in every part deeply tinged with bile.

Schirrhous tumours of the contiguous parts, as of the
head of. the pancreas, of the pylorus, fcrofulous enlarge¬
ments of the lymphatic glands in the capfule of Gliffon,
and fteatomatous fwellings of the omentum, are often fo
lituated as to obftruft mechanically the paflage of the
bile into the inteftines ; tubercles of the liver have
fometimes alfo operated as extraneous caufes, and from
their local fituation. Hopped the natural courfe of the
bile. But the liver is often much enlarged by colledlions
of large tubercles, which yet leave, in their interlaces, a
perfect freedom for the aflion of the veffels and the paf-
fage of the biliary duffs; and fcirrhus of the liver is
hot ufually a general difeafe, but is confined to particu¬
lar fpots, which are often out of the way of the biliary
paffages ; fo that it has been found, on diffe&ion,
to have made confiderable progrefs without inducing
jaundice.

Tympanites is often accompanied by jaundice, a cir¬
cumftance which is to be deemed very unfavourable. In
a cafe mentioned by Dr. Powell, the accumulation of air
was fo great, that, very fpeedily after the appearance of
jaundice, the ccecum was burft by it, and the patient de-
ftroyed.

From whatever caufe the obftruffion of bile may arife,
the abforbents carry back that fecretion into the blood
with the ferum ; and with which it becomes fo intimately
mixed, that it is received into the minuteft of the white
veffels, as in the eye and white of the nails. All the folid
parts of the body, except the medullary fubftance of the
brain, as fome have affirmed, even the bones themfelves,
the fat, and the cartilages, have been obferved to be
deeply tinged of a yellow colour. The fecreted fluids
are generally alfo deeply tinged. In cafes of fome dura¬
tion, the perfpirable matter is coloured ; fb likewife is
the faliva, which has a very bitter and bilious tafte : but
the urine is much more highly impregnated with bile,
and more fpeedily, than any other of the fecretions. In¬
deed the milk is the only exception which is made by
authors ; for the affeftion is fuppofed to extend even to
the femen.

The affirmation that the bilious tinge extends to the
humours of the eye, has not been detedled by modern in¬
quirers, and is probably without any foundation. But
Galen, Hoffman, Boerhaave, and Sydenham, all affert
that they have occafionally witneffed the circumftance ;
and Lucretius fays ;

Lurida prseterea fpeflant quaecunque tuentur
Arquati. Lib. iv. ver. 333.

On the other hand, Dr. Heberden, and other phyfi-
cians of much obfervation and experience, have never
found fuch a change of vifion in any patient ; nor have
we ever met with any living practitioner by whom it had
been detected. It is not, indeed, animpoffible cafe, parti¬
cularly where the difeafe has been of very long continuance
and great intenfity, when, fhould the cornea or humours
of the eye become impregnated with bile, the light would
pafs through a yellow medium, and objects thus be
tinged of that colour. But thefe parts are not ufually
found impregnated with bile.

To fum up more clofely the fymptoms of jaundice, we
may obferve, that it is marked by a yellow colour of the
whole furface of the body, which is fir ft feen, and is molt
corifpicuous, in the tunica eonjunttivu, or white part of
the eyes, and at the roots of the nails. The urine is
thick, of a deep yellowifli-brown colour; and tinges
linen and other white fubftances, immerfed in it, of a
yellow hue; and this indeed is confidered by many a
pathognomonic fign. The bowels are often coftive, but
fometimes loofe j and the ftools are commonly of a very

pale and clay-like appearance both in confiftence and co¬
lour, from the abfence of bile, and have not the ufual
feculent fmell. This difeafe is accompanied with a fenfe
of much lalfitude and languor, and a great inaptitude
to exertion ; with lownefs of fpirits, and a feeling of pain
and tenfion, or weight and opprefllon, about the praecor-
dia; there is alfo frequently much anxiety, and fome
degree of difficulty of breathing, as well as a trouble-
fome fenfe of itching over the fkin, unattended by any
eruption. Many fymptoms of indigeftion are generally
prefent ; fuch as naufea, vomiting, flatulency and eruc¬
tations, and lofs of appetite : folid food taftes bitter in
the mouth of fome patients ; and in fome ftates of the
difeafe hiccup occurs, and occafional paroxyfms of ri¬
gour or chillinefs. The ftate of the pulfe varies much;
in general it is fornewhat quicker than natural ; but in
fome cafes, and particularly under the circumftances juft:
mentioned, it is flower. The pain is fometimes extremely
acute in the epigaftrium, or pit of the ftomach, or in
the right hypochondrium, efpecially during the paflage
of a gall-ftone. Moreover the latter circumftance much
increafes the fymptoms.

A pain, which is often moft acute and fevere, fo as to
be hardly fupportable, but fometimes moderate, is pro¬
duced, and is often accompanied by Ihiverings, which
afterwards occafionally recur. The pain is leated at the
pit of the ftomach, and 1'eems generally to be confined
to that point of the epigaftric region which correfponds
to the fituation of the opening of the common dudt into
the duodenum, and from this part it appears to dart
through to the back ; the pulfe at the fame time conti¬
nues nearly as flow as is natural, and has none of the
hardnefs attendant on inflammation. By an attention
to the feat of the pain and this natural ftate of pulfe, Dr.
Heberden obferves, that it is not difficult to foretel the
outward yellownefs in many cafes, fome days before it
appears. The breath, during the continuance of the
pain, becomes fliort and hurried ; there is great general
anxiety and reftleffnefs, fometimes amounting to deli¬
rium, and at laft great depreflion and fainting; the fto¬
mach is affected by naufea and retching; and there are
often irregular fpafmodic twitches in various parts of the
body. There are often profufe fweats, which are, how- '
ever, fometimes ahfent ; and they do not depend at all
upon the lhiverings, for they are fometimes prefent
when no fhivering has occurred. Thefe fymptoms do
not continue long in all their violence; for although the
patient, during the paflage of a gall-ftone, is never free
from fome pain, yet it increafes, by paroxyfms, to a ftate
of acute fuftering, and fubfides again into one of com¬
parative eafe, during which there is a fenfe of deep-feated
forenefs and fulnefs of the epigaftric and right hypo¬
chondriac regions. The greateft relief from pain is ex¬
perienced by bending the body forward upon the knees,
in which pofition the relaxation of the abdominal muf-
cles leaves the affeCted parts fubje&ed to the leaft pref-
fure. Another fit, perhaps of equal or greater violence
than the firft, then comes on, and alternates with another
remiflion; this may occur feveral times in an hour; but
fometimes the duration of the paroxyfm is much longer.

At fome early period of thefe attacks, the jaundice
makes its appearance; and it continues fora confidera¬
ble time after the violent fymptoms have difappeared.
When the concretion has paffed, however, and the more
urgent fymptoms have ceafed, the yellownefs may foont
be perceived to diminilh in its intenfity; but, before it
can entirely difappear, it requires that the whole quan¬
tity of the tinged ferum be removed by a gradual opera¬
tion of the excretory glands, and a frefli fupply in a na¬
tural ftate be introduced.

The duration of the attack, including the whole time
of the paflage of the concretion, is as various as its inten¬
fity; fometimes a few hours, fometimes feveral days, or
even weeks, elapfe, before it is expelled. In the former
cafe, the paflage is often fo rapid as not to allow time for

PATHOLOGY.

m

the jaundice to take place. The number and fize of the
concretions alfo vary much : fometimes the gall-bladder
is filled with them ; at other times there are not more
than one or two: fometimes they are fmall and angular;
at others large, and have a more regular furface. They
have been fometimes feen nearly of the fize and figure of
the gall-bladder itfelf, fo as almoft to fill the whole ca¬
vity. Thefe large concretions are lefs frequently the
caufe of jaundice than fmaller ones ; for, from their bulk,
there is but little probability of their entering the dudus
cy/licus, and afterwards of obftrudling the dudus communis:
it is from calculi of fmaller dimenfions that fuch obftruc-
tions generally arife. Cafes are recorded, however, in
which calculi of immenfe bulk have paffed ; but thofe
have no doubt obtained their paffage by contracting ad-
liefion, and producing ulceration into the bowels. It is
remarkable, that while ftones remain in the gall-bladder
they are perfedlly harmlefs ; and when they are very fmall
they readily pals with the cyftic bile. The principal in¬
convenience, then, arifes upon the accident of their being
carried from the cyft into the narrow dudls. Biliary
concretions are very frequently found in the gall-bladder,
in the d'iffedlions of dead bodies, when no fymptom has
appeared during the life of the perfon to excite a fufpi-
cion of their exiftence.

It is commonly fuppofed that the biliary concretions
♦ are protruded from the dudts by the contractile power of
the duffs alone. The truth of this opinion, however.
Dr. Pemberton has queftioned ; and he maintains, that
the gall-ftone is propelled by the accumulating bile be¬
hind it, which at the lame time pulhes it forward and
diftends the duct. For, in the firft place, the duff, he af¬
firms, is always found contrafled before the gall-ftone;
whereas, if the concretion were protruded by the con-
traffile power of the duff, it ought to be contraffed be¬
hind it. In the fecond place, opium and blood-letting
are employed as relaxants and antifpafmodics, and fuc-
cefsfully : but this relaxation would rather retard than
expedite the palfage of the calculus, if its protrufion were
the refult of the contraflile power. This opinion has
unqueftionably much probability in its favour.

The ftate of the pulie and the remiffion of pain, the oc¬
currence of fhivering after and not anterior to the pain,
diftinguilh Ifferus from the Phlogotica and their confe-
quences.

The ifferodic hue which occurs in Chlorofis is diftin-
gu i tiled from the colour of jaundice by the unaltered
whitenefsof the eye, and the abfence of bile in the fecre-
tions in the former complaint.

The treatment of this complaint mull be varied accord¬
ing to the exciting caufe of the obftruffion. In Ifferus
cholceus ourobjeft will ofcourfe be to promote the adtion
of the liver; for which purpofe, brilk dofes of calomel
given at night, and worked oft’ in the morning with
falts, will be necelfary; and, in addition to this, the re¬
gulation of diet’and exercile, as noticed under Dyfpepfia,
mull be attended to; and the mufcular fylfein put into
moderate and regular adtion.

In the fecond fpecies, of courfe, no permanent cure
can take place till the biliary concretions are removed
from the bile-dudts ; and we know of no agent capable of
accelerating their palfage. If the notion of Dr. Pember¬
ton be true, fuch medicines as relax the dudts may in¬
deed be ufeful ; and there can be little doubt but that,
feeing how materially the mufcular adtion aft'edts thefe
tubes, its prelence may indiredtly aflift the palfage of the
ftones; but., as to dilfolving them by chemical agents, it
appears to be a vagary long fince given up by all enlight¬
ened pathologilfs ; and we believe that we allow to our
knowledge of the treatment of thefe complaints all the
praife it deferves, when we ftate, that it embraces nothing
more than the removal of impediment to the fpontaneous
operations of the afredted lfrudfure, and the corredfing
of fympathetic derangements. With this firft view,
large doft* of opium may be given, and fuch meafure3

may be ufed as produce general relaxation, as the warm-
batlv. The fecond will vary of courfe according to the
nature of the fympathetic difeafe. If the palfage of the
(tone excite motions in the vafcular fyftem even in a
flight degree, we Ihould fubtradl blood freely and fud-
denly, and endeavour to calm nervous excitement by
digitalis, &c. If, on the contrary, thefe motions are not
induced, opium, is unqueftionably the moft powerful re¬
medy for abating pain with which we are acquainted : it
Ihould be given firft in a large dofe, (for inftance two grs.)
and then fmaller proportions at fuch intervals that a
regular effedl be procured ; always premifing thdt the
bowels are kept open and the vafcular lyftem undifturbed.

The fame general rules are applicable to the third fpe¬
cies. We may remark, however, that in this a free courfe
of purgatives will in moft inftances be required: thefe
Ihould be of a warm and ftimulating nature. The ex¬
treme pain often felt in this fpecies requires, as in the
former, the exhibition of opium.

In all cafes, we think fome good will be derived from
the ufe of medicines which promote free difcharges of
the hepatic fecretion. Mercury is of courfe ufually pre-
fcribed ; but, when this fails or is inadmiflible, the acids
internally and externally may be ufed with advantage.
Indeed the nitric acid had obtained much reputation in
jaundice, even fo long ago as the time of Baglivi. The
ufe of alkaline medicines has alfo obtained fome counte¬
nance, which can only depend on their corredfing in fome
degree the morbid ftate of the bile ; a ftate which proba¬
bly often occafions biliary concretions.

In that ftate of the liver which produces jaundice to¬
wards the end of intermittent fevers, mercury is the bell
and only remedy; and calomel, in fmall dofes, is the
form under which, in this and fome other hepatic difeafes,
it feems to adl moft powerfully. Where fcirrhus of the
fubftance of the liver, or of the neighbouring organs, ope¬
rates mechanically by its prefl’ure upon the duffs, and
occafions jaundice, it is more likely to prove the fource
of permanent mifchief than any other caufe, and our
means of relieving it are lefs eft'eftual. In the true tu¬
bercle of the liver, which begins with induration, and
afterwards pafles on to ulceration, the efficacy of any me¬
dicine is very doubtful; even mercurials, when given in
large quantities, and under any form, have not feemed to
produce any decided advantage.

When jaundice arifes from a general congeftion of the
velfels of the liver, general blood-letting, or, if the cir-
cumftances of the conftitution and ftrength of the patient
forbid that, local bleeding by leeches, or cupping-glafles
after fcarification, or the application of blifters to the
hypochondrium, will be ufeful, together with the exhi¬
bition of purgatives; and if it be admitted, that torpor,
of the inteftinal canal, and a retention of bile or an accu¬
mulation of mucus in the duodenum, can fufficiently
obftrudt the departure of the bile, and thus occafion
jaundice, as it feems to do in young children, the em¬
ployment of any adtive purgative will be adequate to its
removal. Calomel and jalap are particularly well fuited
to this indication.

Dr. Caleb Miller, of Briftol, (U. S.) has employed with
confiderable fuccefs the phofphoric acid, internally, for
the cure of jaundice. He directs a large table-fpoonf ul
of the acid, prepared according to the diredtions con¬
tained in Murray’s Materia Medica, to be added to a
pint of balm-tea, and the mixture to be taken as fall as
the ftomach will bear it, till it operates as a diuretic.
In a very obftinate cafe of jaundice, which was ultimate¬
ly cured by this remedy, Dr. Miller ftates, that the pa¬
tient took eight pints of the mixture in four-and-twen-
ty hours.

Genus II. Melana, [from black.] Black Jaun¬

dice. Generic charadters — The colour of the eyes and
fkin fuliginous, leaden, or livid ; black vifcid dejedtions,
with occafional vomitings of the fame ; anxiety ; deprel-
fion of fpirits.

The

PATHOLOGY.

The nature of this complaint was fuppofed by the an¬
cients, among whom we may mention Hippocrates,
Beerhaave, and Van Swieten, to be occafioned by ntra
bilis. Blit Dr. Home, in his Clinical Experiments, traces
it to an effufion of blood from the ineferaic veffels,
which, by its ftagnation and corruption, afi'umes that
ft range appearance. The difeafe, he fays, frequently
follows haemorrhage ; and thofe of a fcorlnuic habit are
moft fubject to it. It is an acute difeafe, and terminates
fpon 5 yet it is not attended with any great degree of
fever. Dr. Good confiders that either of theft? caufes
rhay produce it, and accordingly he makes two fpecies.

1. Melsena cholcea: the black difcharge bilious ; the vo¬
miting occafionally green and acid ; great languor ; ver¬
tigo. It feems to depend upon an organic depravation
ot the liver, chiefly perhaps in the cafe of habitual glut¬
tons and drunkards, who have paralyzed or worn it out
by perpetual Humiliation : in confequence of which, a
pitchy and flaky bile is fecreted inltead of the genuine
and healthy fluid.

2. Melsena, cruenta : the difcharge confiding of gru-
snous blood intermixed with bile : pungent tenfive pain
in both hypochondria; comprCflive pain at the pit of the
ftomach and fainting. This is probably the refult of
aCtive or pafllve haemorrhage (mod likely the latter)
from the liver, the fpleen, the bowels, &c.

This difeafe has fometimes proved (alutary, and it has
on other occafions appeared periodically. For the cure
of this complaint, gentle purgatives and clyfters have
been recommended from the time of Hippocrates down¬
wards; and they are as beneficial in this affection as in
the hasmatemefis, to which it bears much affinity. Dr.
Home employed the diluted fulphuric acid, in addition
to laxatives ; and, as he believed, with confiderable ad¬
vantage. Emetics he juftly deems ufelefs, if not inju¬
rious ; and fhunned the ufe of opium, as tending to fliut
up the matter that nature was carrying off. Opiates,
however, combined with gentle cathartics, tend rather
to aid the operation of the latter, by removing the fpaf-
modic conftriCtion which takes place in the bowels, and
thus alfo afford material relief to the pains. It has been
fometimes cured very rapidly by fpirit of turpentine in
large purging dofes.

Genus III. Chololilhus, [from %oAvi, bile, and Ai0o;, a
ftone.] Gall-ftones. Generic characters — Pain about
the region of the liver, catenating with pain at the pit of
the ftomach : the pulfe unchanged ; ficknefs ; dyfpepfy ;
inactivity: bilious concretion in the gall-bladder or
bile-duCts.

As this difeafe differs from ICterus only in being unat¬
tended with yellow colour of the fkin, it has been con¬
founded with it by moft of the nofologifts. Dr. Good
has, however, feparated them ; for he fays the yellow dye
of the fkin and urine, which is the pathognomic fymp-
tom of jaundice, occurs often without Chololithus ; and
Chololithus, even in its parting fpecies oracute ftate, with¬
out the yellow dye. The different degreein which its fymp-
toins are manifelted,accordingas the gall-ftone is ftationary
or the reverfe, has appeared t.o our nofologifts a fufficient
reafon for feparating this genus into the two following
fpecies.

1. Chololithus quiefcens: pain about the liver and at
the pit of the ftomach obtufeand occafional ; the bile lefs
bitter than ufual ; the dejections irregular.

2. Chololithus means: pain about the liver acute;
frequent vomitings; dejections white, and at length
loaded with one or more bilious concretions.

The reader will find the treatment, &c. detailed under
ICterus ; and the compofltion of the gall-ftones will be
mentioned when fpeaking of the calculous diatheiis as
connected with calculi in the bladder.

Genus IV. Parabyfma , [from irafciGua, male coaccrvo,
to heap up, or obftruCt.] Knotty or unequal intumef-
cence of the abdomen from an indurated enlargement of

Vol. XIX. No. 1295.’

one or more of the vifcera contributory to the digcftive
function ; accompanied' with derangement of the general
health. This is the Fliyfconia of Cullen, Sauvages, and
others.

The whole of this genus, with the fmall exception of
cafes arifing from inaCtion, may be confidered beyond
the reach of medicine. Indeed, when we confider that,
in attempting to remove tumours of long Handing, we
are endeavouring to alter the aCtions of parts which have
no analogous ftruCtures in the natural ftate, and with
the laws of which we are confequently unacquainted, we
can have little hope of accomplifliing our tafk. To this
we may add, that, while moft maladies which depend on
exalted or diminiflied aCtions of the natural parts have
been found at times amenable to medical agency, expe¬
rience furnithes no unequivocal records of the like happy
termination of the diftempers in queftion. Yet do thefe
diftant difeafes claim our moft unremitting, moft intenfe,
ftudyand attention; fince what we cannot cure w>e may
perhaps prevent. To trace therefore, by dilfeCfion of
morbid parts, the various appearances which different
grades of diforganization prefent, and to combine this
information with clofe and faithful delineations of ac¬
companying external fymptoms, are purfuits which,
though we nnift confefs hitherto almoft ufelefs in regard
to the complaints in queftion, muft ultimately meet their
reward. Attempts of this nature have been made, and
are ftill profecuted with much ardour, particularly on
the continent. The knowledge at prefent obtained is
however fmall and unfatisfaftory ; fo much fo indeed,
that many of the varieties arifing out of the feven fpecies
of our author we fhall pafs over w ithout comment, merely
referring our readers to fome of the numerous hiftories
which the learned Dr. Good has noticed ; and to the
article Tumours for an account of the probable ori¬
gin and mode of growth obfervable in diforganization in
general.

1. Parabyfma hepaticum : hard tumour in the right
bypochondrium, verging towards, and fometimes appear¬
ing at, the pit of the ftomach ; general languor ; pale or
yellow countenance ; dyfpepfy ; dejections irregular,
often whitifh. There are four varieties of this fpecies.

a. P. coaCtum; from infarction. Found in feeble
children, who fecrete lefs bile, and have the cells of the
liver clogged with mucus from atony of the abforbents.
Found alfo in intemperate livers ; and in foreigners who
refide in hot climates: an unequal atony, and at times
paralyfis, being produced in the organ from the exceffive
ftimulus antecedently excited by the rays of the fun or
the ufe of fpirituous potations. (See Hepatitis in this ar¬
ticle.) In this cafe, gentle dofes of calomel, or blue
pill, ftriCt regulation of the bowels, abftemious regimen,
&c. are generally followed, after due perfeverance, by
reftoration to health. The fame remarks are applicable
to the treatment of the infarCted fpleen ; for by thefe
means a fpleen fo\enlarged as to occupy the major part
of the abdomen has been effectually removed in a few
months.

|3. P. fcirrhofum ; the tumour affuming a fcirrhous
character.

7. P. cololithicum; accompanied with bilious concre¬
tions.

(51. P. helminthicum ; accompanied with flukes, hyda¬
tids, or other worms. See Winker’s Difp. de Hydat.
apud Bonet, Med. Septentr. ii. Darwin, vol. iii.

Other morbid ftruftures of various forts and fizes are
occafionally built up in the liver; but, as there is little
evidence of their feparate origin, it is needlefs to multi¬
ply the varieties. They are fo thickly interfperfed in
our periodical journals, that all reference feems unnecef-
fary. Some varieties of them will be found in the fu-
perb wmrk of Dr. Farr, (Morbid Anat. Liver, 1812.)

2. Parabyfma fplenicum; ague-cake: an indurated
tumour below the falfe ribs on the left fide, and towards

Z z the

PATHOLOGY

176

the fpine on the lame fide; pale countenance; general
debility. Three varieties are noted.

a. P. coaflum ; from infar&ion. Chiefly after obfti-
nate remittents or intermittents in organs weakened by
previous intemperance ; the ablorbents being hence
doubly debilitated.

P. fcirrhofum ; affuming a feirrhous charafter. On
the death of a woman it was found to weigh thirty-three
pounds, and to fill nearly the whole of the abdomen.
The complaint lafted feventeen years before the patient
died, during nearly the whole of which Ihe purfued her
itfual avocations. Sauvages. — Three times its natural
fize. Buillie, Morb. Anat. Fafc. vi. pi. 3. — Contained
fifteen pints of pus. FUJI. de l' Acad, des Sciences, 1753. —
The entire vifcus has often been extirpated without in¬
jury.

7. P. cartilaginofum : the coats of the fpleen converted
into a cartilaginous fubftance. Baillie, Morb. Anat.
Fafc. vi. pi. 1.

3. Parabyfma pancreaticum : hard elongated tumour,
running tranfverfely in the epigaftric region; dyfpepfy ;
general languor. Here are two varieties.

a. P. coa&um; from infarftion. Buillie, Morb. Anat.
pi. vii. fig. 1. — Torpitude produced by the ftimulus of
tobacco, almoft inceflantly chewed or fmoked for many
years; fatal. Darwin.

(3. P. calculofum ; accompanied with white calculous
concretions. Buillie ut fup. fig. 2, 3, 4.

The pancreas occafionally aflumes a feirrhous ftrudfture.
It is delcribed as remarkable for the little general diftur-
bance of the fyftem ; the fixed and burning pain at the
pit of the flomach, exceflively increaled by the preflu re
of the diftended flomach ; fo much fo indeed, that,
though the appetite is often good, the patient is com¬
pelled to induce vomiting after eating, to lull the pain.
The bent pofture, as taking oft' compreflion, is likewife
preferred. Coflive ftate of the bowels much increales the
pain, by producing the like preffure on the difeafed vi(-
cera. The palliative treatment is therefore obvious.

4. Parabyfma melentericum : indurated and irregular
mafs of tumours below the flomach, yielding to the pref-
fure of the hand; pale bloated countenance ; atrophy;
the appetite at the fame time feldom diminilhed, often
voracious. There are fix varieties.

а. P. lielminthicum ; accompanied with hydatids or
worms.

jS. P. ftrumofum ; accompanied with fcrophula. See
Marafnius, in this article.

y. P. fcirrhofum ; accompanied with feirrhus.

б. P. fareomaticum ; accompanied with farcomatous
excrefcences.

e P. fleatomatofum ; accompanied with fteatomatous
excrefcences. In one inftance, the tumour weighed
40 lbs. Nov. Act. Nut. Cur. vol. i.

if. P. fungofum ; accompanied with fungous excref¬
cences.

The above varieties are from Sauvages, who has been
copied by Cullen. The tumours are often very large,
and conglobated : and at times accompanied with
cyfts filled with a limpid fluid. In one inftance thefe
amounted to twenty of various fixes, one as large as a
child’s head, fix as large as the fift, and the reft refem-
bling hens’ and pigeons’ eggs. Hence the whole abdo¬
men is in fame cafes fo generally tumefied as to give a
j'emblance of pregnancy. This is particularly the cafe
with the laft variety; and as the appetite, ftate of the
bowels and bladder, are often unaffected, there is not
unfrequently feme difficulty in determining the nature
of the difeafe. See Sauv. in loco ; as alfo the writings of
Welfch, Trincavelli, Morgagni, and Rioiarii, who have
made collections of extraordinary cafes ; and compare
Cruikfhank on the Anatomy of the abforbing Veffels, p.
j 1 5. 2d edit. 4to.

5. Parabyfma inteftinale: the tumour hard and circum-
fcribed ; round or elongated ; moveable upon the pref¬

fure of both hands ; irregular deje&ions 5 obftinate vo¬
miting ; pyrexy ; and for the moll part emaciation. Two
varieties.

а. P. conglomeratum ; cohefive, and conglomerated.
Morgagn. de Sed. et Cauf. Morb. tom. ii. In this cafe the
tumour lay fenfible to fight, of a circular fhape between
the enfiform appendix and navel. On diffeCtion, the
ileum and adjoining portion of thejejunum were retrac¬
ted upwards, coacervated, and firmly adhefive.

(9. P. farcomatofum. Fantoni. Obf. Med. feleCh ii.
In this cafe the tumour, of an oblong fhape, lay below
the left hypochondrium inclining to the epigaftrium,
prominent, with unequal hardnefs. On diffeClion, every
other part being found healthy, the colon, under the fto-
mach, and towards the left fide, for the length of the palm
of the hand, appeared clofely indurated, diftended, and
loaded with a flefliy fibrous peculiarly- thickened tumour,
which contracted its diameter.

б. Parabyfma omentale; the tumour indurated and
diffufed ; frequently fpreading over the whole of the ab¬
dominal region ; dyfpncea ; emaciation. This fpecies is
ufually of a mixed kind : infarCled ; feirrhous; glandu¬
lar; 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 inftance (Greg.
Hurftii. Prob. 10. dec. vi.) fifty-fix pounds, occupying
the whole capacity of the belly. In one cafe, the hard¬
nefs was almoft ftony -. Panarol. Pentec. iii. obf. 10. In
another, offeous, the weight thirteen pounds: Mongin ,
Hilt, de 1’Acad. des Sciences, 1732. In a third, loaded
with many thoufand glandules ; in a fourth, accompa¬
nied with excruciating pains, the weight fixteen pounds :
lluxh. Phil. Tranf. vol. vii.

7. Parabyfma complicatum : the belly hard, elevated,
and diftended as though pregnant, and often fuppofed to
be fo; yet more or lefs knotty and unequal ; the breath¬
ing feldom impeded ; for the moft part, acute pain, nau-
fea, obftinate vomiting, and third. (Phyfconia polyf-
planchna. Sauv. Cull. Phyfconia vifeeraiis. Auc. Far.)

The fymptoms of this fpecies, Dr. Good obferves, mull
vary according to the organs affefted, and the nature
and extent of the difeafe. The enlargement is generally
found to be farcomatous, feirrhous, hydatidous, oradi-
pofe. The liver is in moft cafes more or lefs concerned ;
fometimes in connexion w-ith the fpleen, fometimes with
the mefentery, fometimes with the ftomach orinteftines,
and fometimes with all together. Hildanus found the
liver fo enlarged as to pafs beyond the falfe ribs of the
left fide, with the fpleen equally enlarged, and fixed
to the hepatic lobe. Cent. ii. Obf. 43. — Huldenreich,
in a woman of forty-five years of age, found the liver
feirrhous, weighing fourteen pounds, with a flelhy
excrefcence in the mefentery of the fize of a child’s head ;
Mifcel. Nat. Cur. ann . vi. and vii. Jaundice accompanied
this cafe. — Bartholine mentions a woman of elegant
form, in the flower of her age, attacked with another va¬
riety of this difeafe, which at length deftroyed her : when
all the inteftines, liver, fpleen, and every adjoining vif¬
cus, w'ere found intermixed, and buried in fat ; the liver
being at the fame time enlarged and feirrhous, and filling
both hypochondria ; the ftomach thickened, and cartila¬
ginous. Cent. ii. — Coiter found the whole of thefe organs
adhering together, and filled with cyfts of different fizes
diftended with a limpid fluid; he reckoned more than,
fourfeore : the organs themfelves were exhaufted and
dry. ObJ'. Anat. p. 117. See alfo the works of De Haen
and Boerhaave for remarkable diffe&ions of the fame
kind.

Recent refearches feem to prove in a very convincing
manner, that, however different the matter contained in
abdominal tumours, they have a common origin in tu¬
bercles, or, as fome fay, in hydatids. We (hall not enter
into this fpeculation now ; but, as it is of importance to
diftinguifh the earlieft approaches of a diforder which gra¬
dually involves the whole of the liver, peritoneum, in-

teftines3

PATHOLOGY. 177

tedines, and occafionally the domach, in one dreadful
and incurable difeafe, we ftiall tranfcribe from Dr. Baron
a clear, and we believe, from our own obfervation, faith¬
ful, portrait of its primary fymptoms.

The complaint comes on in general with tendernefs
and dillention of the abdomen, accompanied with nau-
fea and vomiting. The bowels, for the mod part, are
coftive, both before and after the attack ; but they are
frequently in an oppofite date. At this period, the fymp¬
toms not being fo violent as to force the patient to feek
for proper relief, they are very apt to be negleCted : but,
unlefs the true nature of the diforder be difcovered, and
its courfe arreded at an early dage, all fubfequent efforts
will probably be ufelefs. The progrefs of the aft'eCtion is
as follows: the bowels become more and more irregular
in their aCtion ; the tendernefs and fwelling increafe ;
the appetite fails; the puife acquires greater velocity;
the features look fharp and contracted ; the countenance
becomes pale or fallow, the lips parched and fkinny; the
tongue fometimes of a bright colour, refembling what is
feen in diabetes, at other times it is covered with a thick
whitifh mucus. The flefli and drength decay rapidly :
great emaciation takes place : the fkin, except towards
the lad dage, is for the mod part dry and fealy : the
urine fmall in quantity 5 occafionally clear, more fre¬
quently otherwife. If a cough has not exided from the
beginning, it is very apt to occur about this time; but
this is by no means to be confidered asadiagnodic fymp¬
tom; its exidence depending upon the fpreading of the
difeafe to the pleura, and thoracic vifcera.

The feet fometimes fwell towards the conclufion of the
difeafe, or the fwelling is confined to one leg or thigh.
At this period, if the examination of the abdomen be
made with due care, it will be found to communicate to
the touch the feeling occafioned by a folid tumour; the
integuments and mufcles not rolling upon the contained
parts as in a date of health. But in i'ome cafes, where
the effufion is conjoined with the original and more im¬
portant difeafe, a ferife of flu&uation may be difcovered.
Very frequently the patient complains of a didreffing
feeling of a “ broiling heat” at the domach ; the dil-
charge of a tough ropy phlegm from the mouth, con-
ftant naufea, with violent retching and vomiting ; and,
in two cafes, the matter brought lip during feveral days
before death was dcrcoraceous. In the courfe of the
complaint, the appetite is for the mod part very bad;
but the defire for liquids is infatiable, even though a con-
fcioulnefs exids that a large quantity cannot be fwal-
lowed without occafioning very great didrefs. When a
feeling of finking and emptinefs prevails, the patient
eagerly thinks of many articles that might allay his un-
ealinels, but the fight of them feldom fails to excite
loathing and difgud. Should any fudenance be taken,
it is either fpeedily returned by vomiting, or it eaufes
indefcribable uneafinefs. The patient rolls about in all
directions, in vain feeking for fome point where he may
repofe. Every aCtion of the domach or intedines comes to
be performed with great pain. The paflage of flatus up¬
wards or downwards, the movements which take place
before the evacuation of the bowels, all give rife to fuf-
feFing. At times the pain is fharp and tranfient ; at
others it is heavy and obtufe ; but a fenfe of weight is
feldom abfent ; and it is more felt after vomiting or pur¬
ging than before. One patient, (an infant,) in allufion
to this fymptom, ufed to put his hand on the abdomen,
and exclaim piteoufly, “ Oh ! fo heavy !” Another faid,
that his bowels felt as if they were “ tied up in a napkin.”
At another time he faid, “ they feemed to be in a mafs;”
and at a third, he declared that, if he had “ a fhot at¬
tached to every convolution of his intedines, he could
not fufl'er more than he did.”

The above-mentioned author has not found medical
treatment of much avail even in the earlied flages of the
above complaint. The production of a continued date
of naufea has feemed to him to he attended with fome

advantage ; and Dr. Jennerhas communicated fome cafes
which were cured by a long continuance of that uneafy
fenfation. It is neceffary, moreover, to palliate the
fymptoms by bleeding occafionally; to keep the bowels
lax, and to relieve pain by narcotics. Mercury, which
might -be fuppofed an agent of fome ufe in promoting
ablorption, appears to aggravate rather than to amelio¬
rate the complaint. It is to be obferved, that a fome-
what different praCtice will be reforted to by thofe who
regard this difeafe in a different light from Dr. Baron ;
this gentleman confidering it a difeafe of the abforbents,,
while others confider the tubercles (the mod common,
and earlied appearances on difleCtion) to be produced by
effufed coagulating lymph, the confequence of inflamma¬
tion. Dr. B. oppofes this view of the cafe with much>
ingenuity ; but, upon fumming up all the faCts known
on this intereding fubjeft, and after tracing the different
gradations of difeafed flrufture with much labour, we
are forced to acknowledge our information very infuffi-
cient, and our minds far from being made up on this:
head.

Class II. PNEUMATICA, [from Tmv^a, breath.]
Diseases of the Respiratory Function.

Order I. Phonica, [from (pavn , the voice.] Diforders

aft'eCling the Vocal Avenues. This Order contains fix:

Genera. >

Genus I. Coryza, [Gr. nafal mucus.] Running at the
nofe. Galen confines the term xopvga. to defluxion from
the nodrils alone ; but Hippocrates, as we learn from
Celfus, applied it equally to defluxions from the head,
nodrils, fauces, and ched. The latter Greek phyficians
redrained it to the fird, and diflinguifhed the two latter
by the name of catadagmus (y.uzcta-Tci'yy.oq), which
equally imports dijlillutio or defluxion. Among modern
writers coryza is uled fynonymoufly with catarrh, and is
confequently regarded as a febrile aft'eCtion. It may in¬
deed occur, and often does fo, in various fevers as a
fymptom ; but the older nolologids are more correCt in
giving it a place diflindl from fever, when dridtly genuine..
Defluxion from the nodrils may proceed from two very
different fets of eaufes : increafed adiion of the fecer-
nents, and diminiffied adiion of the abforbents. The
fird or dimulatiiig fet may confid of dernutatories ; of
the irritation of fympathy, as in crying; of infedlious
effluvia in the atmofphere (fometimes, though feldom,
limiting their adtion to the mucous membrane of the nof-
trils, and hence approaching the nature of catarrh); and
of the local dimulus of an ozana, or nafal ulcer. The
adiion of the abforbents may be diminiffied by expofure
tofevere cold ; by the debility of old age ; and by a long
habit of dernutatories, which have a tendency, in pro¬
portion to their ufe, to render all the veflels of the nof-
trils torpid ; although the abforbents, as in the cafes of
age and cold, and indeed in all indances of debility, are
fooner operated upon than the fecernents. Here, there¬
fore, the defluxion is produced, not from increafed fecre-
tion, for the fecretion may even belefs than in . a date of
health; but from the fecretion, whatever its quantity,
not being carried, oft' by its ufual channel; and hence
again that frequent and unlightly dripping from the nof-
trils of perfons who addiCt thenifelves to large quantities,
of fnuff. Of this genus we have two fpecies, with their
varieties.

1. Coryza entonica: the defluxion pellucid, mucous,,
or ropy, with a fenfe of irritation or infarction. This
fpecies is divided into four varieties.

a. Sternutatoria ; from dernutatories.

(3. Lachrymofa ; from weeping or crying ; the lachry¬
mal fecretion being increafed by mental emotion.

y. Catarrhalis, cold in the head ; from fudden cold oe
change in the temperature of the atmofphere ; accompa¬
nied with a nafal voice and lofs of finell ; and excoria¬
tion of the mucous membrane of the nodrils. The ca¬
tarrhal;

PAT Ii O L, O G Y.

178

tarrhal variety of Coryza is mod frequently met with in
clamp weather ; and, as might be fuppofed, ofcenett at¬
tacks perfons of the mod delicate habits. In general the
increased fecretion induced gradually unloads the mucous
membrane, and the complaint goes off. It is frequently
connected with irritation of the bronchial lining of the
lungs, and is then cured by the fame meafures as the
latter affe&ion.

C. catarrhalis in infants is often however of a violent
nature ; fo much fo" indeed, that we fhall give a more full
account of it than of the preceding varieties. This coryza
generally attacks infants at the bread ; it is charafferized
by freezing, tumefaction of the nofe and eye-lids, and a
fhining appearance of the flcin covering thofe parts ; con-
lfant open date of the mouth-, a rather dry date of the
lips and tongue ; the refpiration is accompanied by a na-
Ihl wheezing. Sucking is impeded, though liquids put
into the mouth are fwailowed with facility; the infant
takes the nipple in his mouth, but be has hardly made
tiiree or four fuftions when his refpiration appears to
be obdruCled ; his face becomes of a violet colour; he
precipitately abandons the nipple, utters fome cries, and
is feized with a fit -of fevere coughing, which leaves him
in a date of partial dupor. Thefe accidents difappear in
a fhort time, but are renewed whenever he again attempts
to fuck. This fird dage of the difeafe lads for four or
five days, or thereabouts ; it is followed by a fecretion
from the nafal cavities, the exidence and quantity of
which, 3t lead in new-born children, it is notalways eafy
to afcertain, becaule it either dries or falls into the pha¬
rynx when the infant lies horizontally on its back. The
abfence of any appearance of malformation of the tongue
or of the mouth, the facility of deglutition, the occur¬
rence of fits of coughing every time the infant attempts
to fuck, joined with the particular fymptoms before men¬
tioned, fuch as a drilling appearance of the lkin of the
nofe, with a tumefadfion of this part and of the lower
-eye-lids, a nafal fniffling, the manner of refpiration by
the mouth, clearly fhow inflammation of the mucous
■membrane of the nafal cavities. The infant fhould be
kept warm ; and we fhould direft the attendants to fo-
urrent its nodrils with a warm decoftion, and carefully
remove the mucus colledled in them. The infant will
generally be able to fuck as foon as the date ot the nafal
cavities permit it to breathe with the mouth clofed.

S. C. ozsenofa, [from o£n, dench.] An trlcer fituated
in the nofe, difcirarging a fetid purulent matter, and
fonretimes accompanied with caries of the bones. Some
authors have dignified by the term, an ill-conditioned ul¬
cer of the antrum. The fird meaning is the original one.
The difeafe is defcribed as coming on with a trifling
tumefadfion and rednefs about the ala nafi, accom¬
panied with a difcharge of mucus, with which the nof-
ctril becomes obdrudted. The m.atter gradually affumes
the appearance of pus, is mod copious in the morning,
and is fometimes attended with lneezing and a little
bleeding. The ulceration occalionally extends round
the ala nafi to the cheek, but feldom far from the nofe,
the ala of which alfo it rarely dedroys. The ozasna is
often connected with fcrophulous and venereal complaints.
In the latter cafes, portions of the oda fpongiofa often
come away. After the complete cure of all venereal
■complaints, an exfoliating dead piece of bone will often
Iceep up fymptoms fimilar to thofe of the ozaena, until
it is detached. Mr. Pearfon remarks, that the ozatna
frequently occurs as a fymptom of the Cachexia fiphi-
loidea. It may perforate the feptum nafi, defiroy the
offa fpongiofa, and even the oda nafi. Such mifchief is
now more frequently the effedl of the Cachexia fiphiloi-
dea than of Lues venerea. The ozaena mud not be con¬
founded with abfcefles in the upper jaw-bone.

The variety we are treating of has its origin, in com¬
mon cafes, from a violent degree of catarrhalis ; and
therefore, when the former complaint is prefen t, it is ne-
ceflary to reprefs it as fad as poffible, by local bleeding

and counter-irritants, before this unpleafant and intf aff¬
able dage of the complaint be induced. When drums
orfiphilis is the caufe of the difcharge, the general treat¬
ment of thofe affedlions mud be had recourfe to. Caufes
which arife from the former of thefe complaints are the
mod traftable.

2. Coryza atonica: defluxion limpid, and without
acrimony, or fenfe of irritation. Three varieties.

a. Algida ; from expofure to a keen, frody,air.

(3. Senilis ; from old age.

y. Superadla ; from long and immoderate ufe of drong
aromatics, volatile alkali, or fn u ft.

Genus II. Polypus, [from its refemblance to the worm
of that name.] A flelhy elongated excrefcence, fhooting
from one or more Oender roots in the cavity of the nol-
trils, running in different dire&ions, and aftefling the
fpoech.

It has lately been the cudom to apply the term polypus
to a variety of concretions and excref'cences arifing 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 flender
bafe or peduncle ; and polypi of the trachea, which are
alfo concrete gluten, occalionally coughed up, fometimes
folid and branching, fometimes tubular. Dr. Good, how¬
ever, has followed Celfus, and mod writers from his time
to that of Heider, in redoring and limiting it to the
flelhy and ramifying excrefcence of the nodrils; and he
divides it into two fpecies.

1. Polypus pladicus, the foft polypus : foft, compref-
fible, chiefly pale-red ; apparently originating from dif-
tention or relaxation of the Schneiderian membrane.

2. Polypus coriaceus, the bard cartilaginous polypus :
firm, cartilaginous, chiefly deep-red ; apparently origi¬
nating from, or connected with, a caries of the ethmoid
bone.

This complaint, being modly the fubjeft of manual
operation, will be treated of under the article Surgery.

Genus III. Rhoncus, [Greek.] Hoarfe fonorous breath¬
ing from dagnation of mucus in the vocal canal. There
are two fpecies.

1. Rhoncus dertor, fnoring or fnorting : the found
deep and loud ; produced in the larynx and fauces.

2. Rhoncus eerchnus, wheezing: the found den fe, and
impeded ; produced below the larynx.

We cannot help confidering both thefe fpecies as fymp-
tomatic; though Dr. Good fays, “it requires only a
flight knowledge of the habits and morbid adlions of the
animal fyflem to difcover indances in which both forts
are idiopathic.” But his inode of proving this affertion
feems rather to favour our opinion than his own ; for he
dates, that u many perfons have a thick or wheezy refpi¬
ration, produced by corpulency, or by changes of the
atmofphere from hot to cold, or from dry to moid, with¬
out any other difeafed adedlion.”

Of the remaining three genera of this order we fiiall
merely give our author’s divifions, the fubjeft being am¬
ply treated of under the articles Deaf and Dumb, Stam¬
mering, Stuttering, &c.

Genus IV. Aphonia, [from u, priv. and (puvn, voice.]
Dumbnefs ; total inability of fpeech. (Mutitas, Cull.
and Sauv.) This, we think, fhould have been the lad
genus of the order-. It contains three fpecies.

j. Aphonia elingium, duinbnefs from the want of a
tongue. This fpecies is naturally divided into two va¬
rieties : a, congenita, where the deditution is coeval
with the birth ; and 6, where the fame is produced by
accident, punifhment, or difeafe. In either cafe we may
naturally fuppofe this to be a radical and irremediable de¬
feat. Privarion of the tongue, however, is not always
accompanied with dumbnefs ; fince we have numerous,

and

5

PATHOLOGY. 179

and apparently well-authenticated inftances of the fpeech
remaining p'erfeft after a total lofs of 'tongue and of
uvula. We (hall cite two of the mod remarkable.

The firil is of a woman who was a native of Monfaray,
in the territory of Elvas, in Portugal. The cafe was
attefted by Wilcox biffiop of Rochefter, then chaplain to
the Engliflt faftory at Liffion, in a letter dated from that
city, Sept. 3, 1707 ; and was laid before the Royal So¬
ciety in London. The following is an ext raft from the
letter: “The Conde d’Ericeyra, a nobleman of letters,
and curious in natural knowledge, brought from the
frontiers of this country a woman without a tongue, who
yet (peaks very well; (he is feventeen years of age, but
in ftature exceeds not one of (even or eight. I was with
her at the conde’s houfe, and made her pronounce every
letterof the alphabet, which (he can do diftinftly. She hath
not the lead bit of a tongue, nor any thing like it ; but
the teeth on both (ides of her under-jaw turn very much
inward, and almod meet. She finds the greateft want of
a tongue in eating; for, as others when they eat move
their meat about with their tongue, (lie is forced to ufe
Jier finger. She pretends to didinguiih tades very well,
b,u t I believe doth it imperfeftly. Her voice, though
very diftinfl, is a little hollow, and like that of old peo¬
ple who have loft half their teeth.”

The other cafe was that of a girl born in Portugal alfo,
(in 1718,) without ,a tongue. M. de Juffieu, of the
French Academy, faw her at Lilbon when (he was about
fifteen years of age. He examined her very attentively.
In the place of the tongue was a (mail flefliy fubftance,
which he found was able to contraft and dilate itfelf, of
courfe it had all the mufcles of the tongue. The places
where the tongue (hould be, remained plump and full,
as if the tongue had been in being. He examined after¬
wards how (he performed the feveral fundlions of the
tongue. Firft as to fpeech : (he pronounced (everal
words fo diftinftly, that, had he not known (he wanted
the tongue, he could not difcover by her fpeech that (he
wanted it. She, however, pronounced the letters C, F,
G, L, N, K, S, T, X, Z, with more difficulty than the
other confonants. When (he pronounces them, (he in¬
clines her head forward, drawing back the chin as it were
to the larynx, in order to raife it in a line with her teeth.
The fecond funftion of the tongue, the tafte, Are had as
exquiiite as any body. She told M. de Juffieu, that (he
found an agreeable tafte in thofe dry fweetmeats he had
given her. Maftication (lie performed with difficulty :
the above fleffiy fubftance was not long enough to ga¬
ther and keep the food under the teeth : (be was here
obliged to ufe the maxilla inferior, which through habit
flie could either approach or remove from under the fu-
perior, as (lie wanted to bring the morfel (lie would grind
under the upper jaw. She fometimes ufed her finger for
the fame purpofe. Deglutition muft needs be difficult to
her. The tongue naturally forms itfelf into a kind of a
hollow, (bmewhat like a fpoon, by which means it ga¬
thers every atom in the mouth, and protrudes them into
the pharynx; but here nature and ufe from her infancy
have in fome meafure fupplied this want of a tongue.
The mufcles attached to the above flefhy fubftance raife
themfelves up, forming at the fame time a kind of rima,
which, in fome fort afting the part of a tongue, protrudes
the aliments into the pharynx, (he obferving to incline
her head forward, which facilitates their defcent. Thofe,
together with the labial mufcles, help her by their con-
traftion to fpit out what is in her mouth.

M. Roland, furgeon at Saumur, has a cafe pretty near¬
ly the fame. A boy, nine years old, loft his tongue by a
mortification that enfued an ulcer he had after the fmall
pox. There was this difference, the root of the boy’s
tongue was bifurcated, and pretty apparent, whereas the
root of the above girl’s was round and fmall. This boy
alfo could fpeak, and perform the other functions of the
tongue, like the girl.

Vot,. XIX. No. 1396.

2. Aphonia atonica : fpeechleffnefs from atony of the
vocal organs. Here alfo we have two varieties.

a. Oblsefa ; from lefion of the nerves of the tongue;
as in paralyfis.

Q. Pathematica ; from hidden and overwhelming ter¬
ror or other violent paffion. Commonly temporary,
fometimes permanent.

3. Aphonia furdorum. Dumbnefs from deafnefs, con¬
genital or produced during infancy.

Genus V. Dyfphonia , [from bad, and (pavri, voice.]
Sound of the voice imperfeft or depraved. This is the
Aphonia of Cullen and Suuvages. There are three fpe-
cies and many varieties.

1. Dyfphonia fufurrans : the voice weak, whifpering,
and fcarcely audible. The varieties are —

«. Oblaefa ; from lefion of the nerves of the larynx,
p. Pathematica ; from fuddeiriand overwhelming ter¬
ror, or other violent emotiorf of the mind : occafionally
permanent.

y. Comprefforia ; from permanent compreffion of the
trachea.

Catarrhalis ; from neglefted catarrh,
s. Enervis ; from fimple debility of the larynx without
any obvious caufe. Dr. Good “ has at this time a cafe
under his care produced in this manner, in which the pa¬
tient, about forty years old, and otherwife in good health,
has never fpoken, except in a whifper, for the laft fix
years.”

2. Dyfphonia puberum, change of voice. The voice
diffonant and untrue to itfelf, irregularly alternating
from harffi to (brill; confined to the age of puberty.
This, we think, can hardly be considered as a difeafe.
Sauvages and Cullen call it Paraphonia puberum.

3. Dyfphonia immodulata : the voice permanently de¬
praved or inharmonious. The varieties are —

a. Rauca ; naturally or habitually hoarfe, hard), or
rough.

(3. Nafalis ; fent with a cracked and grating found
through the noftrils. Produced by habit, a deflation, or
nafal obftruftion.

y. Clangens ; Ihrill and Squalling,
j. Sibilans; with a whizzing or hiding found,
s. Stertens; with a fnorting, fnoring, guttural, or fter-
torous, found. Ufually from relaxation of the glottis or
velum palati.

Palatina ; hoarfe, obfcure, indiftinft; with a fiffure
or otiier deleft in the palate. This defeft is moftly con¬
genital ; hut occafionally a Sequel of lues and fome other
diforders.

Genus VI. Pfellifmus, [Gr. to Hammer.] Articulation
imperfeft or depraved. There are two Species.

1. Pfellifmus bambalia, ftammering. The flow of ' the
articulation difturbed by irregular intermiffions or
Snatches. Dr. Good makes two varieties.

a. Hasfitans, or hefitation : involuntary and tremu¬
lous retardation in articulating particular Syllables.

(3. Titubans, or fluttering: involuntary and tremu¬
lous reduplication of fome Syllables, alternating with a
tremulous hurry of thofe that follow.

Thefe two varieties of ftammering are thus well de¬
scribed by Shakefpeare : “ I would thou couldft Hammer,
that thou mighteft pour out of thy mouth, as wine comes
out of a narrow-mouthed bottle, either too much at
once or none at all.”

2. Pfellifmus blsefitas. The enunciation vitious. Here
we have no fewer than Seven varieties.

a. Ringens ; with a vibration or redoubling of the
letter R.

Lallans ; the letter L unduly liquid, or fubftituted
for R. As when delufive is pronounced dek'ufive, as
though the l poflefled the power of the fpanifti ll, or the
Italian gl ; or as when parable is pronounced pa/ab!e.

3 A Alcibiades

i80

PATHOLOG Y.

A'lcibiades is fuppofed to have laboured under this de¬
feat. It is alfo laid to be common to the Jews of China,
who have dwelt among the Chinefe fo long as to have loft;
the found of R, in confequence of its not exifting in the
Chinefe tongue.

y. Emolliens; the harfh letters exchanged for foft, as
in the fubftitution of ansel for angel ; capidol for capital ;
eh t for that.

Balbutiens ; labials, as B, M, P, too frequently in¬
troduced, or ufed inftead of other letters. So Feda is
pronounced Beda, Fenares Benares, in Bengal, the Ben¬
galee having no V. Soimpringeisoften ufed for in/ringe;
i&ory for itiory ; though b and not v is here the radical
letter, the Latin term being efmr.

£. Mogilalia; labials omitted or exchanged for other
letters. Moll commonly P for F, and F for V, as./ilfer
for pilfer; tiifh for/dfh. So the Latin fiiilo is transformed
by the French into filler.

Dentiloquens, lifping : dentals, as C, S, T, Z, too
frequently employed; producing the effeft of what is
called, in common language, fpeaking through the
teeth.

v>. Gutturalis; imperfect utterance of the guttural let¬
ters; as G, J, H, X. This, and indeed all the varieties
of the prefent fpecies, as well as many others that are
connected with it, are moft ufually the refult of vicious
habit, produced by want of attention to the articulation
of founds in infancy, or to affectation. They are alfo
fbmetimes dependant upon a mifconftruCtion of the vocal
organs : of which the prefent variety furnillies us with
an example; for a defective utterance of the guttural
letters mull be a neceflary confequence of a fifl'ure in the
palate.

Order II. Pneumonica, [Gr. from breath.] Dif-

orders affecting the Lungs, their membranes, or mo¬
tive power; and producing irregular, impeded, or pain¬
ful, refpiration.

The refpiratory fyftem performs the talk of prefenting
to the blood a certain aerial matter neceflary to that
fluid ere it can perform many of the moll important
functions of the animal economy. The powers in ufe
are, i. Large fponge-like mafles called lungs, which paf-
fiveiy receive and emit, and which in the remoteft termi¬
nation of their cells allow contadt (or nearly fo) between
the blood and the atmofphere. 2. Moving powers, or
mufcles of refpiration, which, alternately prefling or re¬
moving prefl'ure from the lungs, allow the weight of the
atmofphere to inflate the fponge, or on the other hand
expel the air evidently changed in its properties. Be¬
tween thefe two parts, viz. the mucous lining of the
lungs and the refpiratory mufcles, a ftrongand perpetual
fympathy exifts. No fooner have the lungs become filled
with air to a certain extent, than the ftimulus applied is
conveyed to the mufcles, which contract and empty thofe
organs, while the contraction of other mufcles occurs to
dilate the cheft again as foon as the uncharged blood,
flowing into the lungs, produces an uneafy fenfation.
This fympathy brings to our confideration the 3d agent
concerned in refpiration ; viz. the nervous fyftem.

Thefe are the agents which apply the air to the blood.
The power which applies the blood to the air, namely
the heart, is likewife to be taken into confideration, as
this organ and the lungs are generally connected in dif-
eafe and in health. Leaving out of thequeftion for the
prefent the remote injury to the brain by deficiency of
blood, and to the heart by depravation of the fame fluid,
and premifing that no impediment exifts to breathing in
the mouth, noftrils, or fauces; we remark, that the
aerial change of the blood may be imperfectly or diffi¬
cultly performed in confequence of a want of the due
expanfion of the lungs; from an altered aCtion of the
refpiratory mufcles; or from an altered ftate of the re-
fpired air.

The due expanfion of the lungs may be prevented by
an alteration of ftruCture, whether of the tubes and cells,
or of the fubftance, of the lungs; as by oflification, by
abfeefles, by hydatids, by tumours, by condenfation of
the lungs; by earthy concretions; by plethora of the
blood-veflels of the lungs generally, whether pulmonary
or bronchial. The due expanfion of the lungs may alfo
be prevented by anafarca or by emphyfema of the cellu¬
lar membrane which connects the bronchia ; perhaps by
adhefions of the pleurae; by collections of fluid in the
cavities of the pleurae ; by enlargement of the heart, or
by enlargement of any of the parts fo fituated as to offer
mechanical impediment to the enlargement of the tho¬
rax. Oflification of the cartilages of the ribs; gibbofity;
anchylofis of the joints between the ribs and the fpine;
irregular aCtion of the diaphragm ; or obftacles to its de-
feent, as diftention of the ftomach or of the inteftines, or
paralyfma, or hydrops, may likewife be enumerated as
capable of hindering the expanfion of the lungs.

The aClion of the refpiratory mufcles may be dimi-
nifhed by contractility in their fibres, or by want of ner¬
vous power. It will be increafed by every circumftance
capable of irritating the mucous membrane of the lungs,
and thus exciting fympathy, in common with other muf¬
cles, by the aCtion of the brain, or by general increafe of
contractility.

The air which is refpired, may be deficient as to quan¬
tity, or it may be too much rarified, or it may contain
noxious panicles, or it may confift of fome noxious gas ;
or, in fhort, its compofition may be altered in various
ways from the natural conftitution of the atmofphere.

The firft and moft remarkable mode in which the refpi¬
ratory fyftem is deranged is in what is called coughing.
In this aCtion a large quantity of air, furnifhed by a con-
fulerable inlpiration, is violently and fuddenly expelled,
with a confiderable noife, by a very ftrong and aimoft
convulfive exfpiration, and in its paflage clears away mu¬
cus, or any thing el fe which may happen to be in the air-
paflages. The air may be driven out at once or at feveral
exfpirations : in the latter cafe the exfpirations are con¬
tinued often as long as any air can be expelled, and the
emptied cheft is again fupplied by an infpiration accom¬
panied with noife. It is obvioufly nothing but a fudden
and exalted difplay of that fympathy which produces
refpiration, and is generally produced by nervous ex¬
citement of the bronchial membrane. We mult not for¬
get however, that, as a fympathy exifts between the ref¬
piratory mufcles and other parts as well as the lungs, fo
coughing may be induced by other caufes than the ir;i-
tation of the latter organs. Thus diforders of the vif-
cera of the abdomen, efpecially of thofe which lie in
contaft with the diaphragm, frequently bring on a cough.
A fhort dry cough is an invariable fymptom of inflam¬
mation of the liver, whether acute or chronic, and ac¬
companies the various tubercular and other obftructions
in that organ. Diforders of the ftomach are, alfo, often
accompanied with a cough of the fame dry and teazing
nature, efpecially when that organ is over-diftended with
food, or is in the oppofite condition of emptinefs. In
fhort, there is fcarcely a vifeus in the cavity <■>/ the ab¬
domen, the irritation of which, in a ftate of difeafe, has
not excited cough. Diforders of the fpleen, pancreas,
and even the kidneys, have all given rife to this fymptom ;
and external tumours, attached to them, have had the
fame effeCt. (See Morgagni Epift. xix. art. 57, 58, &c.)
Thus, in the afeites, or dropfy of the belly, the water;
in tympanites, the air; in corpulency, the fat in the
omentum; and, in pregnancy, the gravid uterus; have
all, in fome cafes, the effeCt of exciting cough.

Our readers fhould bear in mind, however, that each
of the caufes here enumerated may injure the expanfion
of the lungs permanently, and excite convulfive aCtion
of the refpiratory mufcles only as a fecondary refult. But
at prefent we are to confine ourfeWes to the difeuflion of

4 thofe

181

PATHOLOGY.

thofe caufes of cough which have their feat in the lungs.
Accordingly, in the order Pneumonica we have fix ge¬
nera.

Genus I. Be.v, [Greek.] Cough. Catarrhus, Cullen.
Generic character — Sudden and violent expulfion of air
from the lungs. There are three fpecies.

i. Bex humida, or common cough, is too well known
to require a particular defcription. There are four va¬
rieties.

x. B. mucofa, ufually comes on with flight fluffing of
the nofe, and fenle of fulnefs in the palate and contigu¬
ous parts; a flow of mucus follows, which unloads the
fecreting veflels, and a fpontaneous cure occurs. Its na¬
ture is fo generally allowed to be the fameas Catarrhus,
that to that genus we muft refer the reader for a full ac¬
count of the feverer forms.

(3. B. anhelans. (Dyfpncea catarrhalis, Cull.) The
chronic cough of old age. This alfo can be confidered
in no other light than a confequence of previous inflam¬
mation of the mucous membrane, and hence it were
perhaps better to treat of it under Catarrhus ; but, as
its very prolonged ftage may be merely the re fu It of in-
creafed exhalation, we ftiall not difturb our nofologift’s
arrangement. We take a defcription of it from the ex¬
cellent work of Dr. Haftings on Bronchitis. He fays,
“The cough generally attacks the patient in the com¬
mencement of the cold weather, and fometimes conti¬
nues throughout the whole of the winter months. The
mucous membrane is fo irritable, that the flighted change
of temperature is fenfibly felt. The refpiration is always
uneafy, and a peculiar wheezing of the breath is often
prefent. The cough is molt violent in the morning, the
patient never failing to cough fora confiderable time af¬
ter he awakes; and the fit feldom goes off till the air-
cells are unloaded of the fecretions which have collected
there during the night. Throughout the day the cough
is often quiet for feveral hours together, and only comes
on in confequence of increafed exertion, or when the
ftomach is loaded with a hearty meal. The expectora¬
tion is copious, and ufually confifts of tenacious mucus
mixed with a pus-like fluid. Sometimes, however, it is
much lefs confident, and it is white and frothy. The
patient has feldom any pain in the cheft, and if he have,
it is flight and tranfient. Some fymptoms indicative of
diforder in the digeftive organs are generally prefent.
There is a fenle of weight in the epigaftric region, and
the patient is frequently affeCled with pain in that part.
The tongue is white and loaded, and the appetite fails.
The pulfe is quicker than natural, though rarely hard.
The urine is often high-coloured, and not feldom fcanty.
The bowels are irregular. Such a combination of fymp¬
toms as that above ftated is common ; but we fometimes
meet with chronic bronchitis which has exifted for fome
time without producing much conftitutional ailment.
The patient is affe&ed with cough, copious expectora¬
tion, and uneafy refpiration ; but there is no f ever, and
the pulfe is not at all accelerated. Thefe fymptoms occa-
fionally become the foundation of hydrothorax; but
more commonly, as the warm weather comes on, the
cough fubfides, and the patient’s health is reftored.”

The chronic cough is however much modified, accor¬
ding to the degree of bronchial inflammation which pre¬
ceded it. When this has happened in an intenfe degree*
we do not obferve, fays Dr. Haftings, the flow and gra¬
dual progrefs of the firft ftage, which is fo remarkable
when this difeafe fupervenes under the forms of catarrh ;
for the acute inflammation has previoufly reduced the pa¬
tient to the loweft ftate of debility, and the powers of
life are funk. The refpiration is opprefled and laborious,
the cough is frequent and haraffing, the pulfe rapid, and
death is hourly expeCted. It however fometimes hap¬
pens, that the violence of thefe apparently-fatal fymp¬
toms is in fome meafure fubdued, and the patient gains
fome ftrength,. fo as to be enabled to lit up for a ffiort

time. The cough is mitigated, the refpiration is lefs
laborious, and the wheezing is notfo perceptible. The
expectoration, however, is increafed, though the matter
expectorated is not of the fame nature throughout :
fome part of it is tenacious, tranflucenf, and cannot be
diffufed in water; other parts are opaque and purulent.
Small quantities of blood are now alfo often intermixed
with the fputa : the pulfe lofes its hardnefs, but becomes
weaker and much quicker. We have generally com¬
bined with thefe unpromifing fymptoms increafed ema¬
ciation, and inability to make any mufcular exertion.
Irregular fweats break out, and a flufliing of the cheeks
occurs.

In fome cafes, the untoward fymptoms do not proceed
further; they gradually amend. The expectoration di¬
minishes, the cough is lefs haraffing, and the refpiration
not fo uneafy. The patient begins to gather a little
ftrength, and the appetite returns. A change of air and’
favourable feafons are particularly advantageous at this
period, and by thefe means the patient frequently reco¬
vers his health, although months fometimes elapfe be¬
fore fuch progrefs is made as enables us to fpeak with any
confidence as to ultimate recovery. But, if no fuch alte¬
ration in the charaCIer of the diforder take place, a
greater degree of general debility occurs, with a further
lofs of fleffi. The cough becomes extremely haraffing,
the refpiration more quick and laborious. The expe&o-
ration increafes, and is more purulent in its appearance.
The pulfe is rapid. During the night general perfpira-
tion breaks out, and the face in the day is often flulhed.
The patient can ftill, for the molt part, take a deep in-
fpiration without pain, and lying down does not produce
much increafe ofdyfpnoea. He feldom complains of any
ftiooting pain in the breaft. Even from this almoft hope-
lefs ftate patients occafionally recover ; but, when the
difeafe has exifted fo long as tocaufe extreme emaciation
and very copious pus-like expectoration, there is little or
no hope. It fometimes happens that dropfical fymptoms
come on before death.

In the treatment of this complaint, our firft endeavour
ffiould be directed to moderating the force of the circula¬
tion, which is fometimes, though rarely, extraordinary;
more frequently it will be merely neceflary to diminiffi
local plethora by leeches; after this, the irritable ftate of
the mucous membrane may be checked by blifters and
rubefacients, or iffues, which may be fteadily perfevered
in. It is a remarkable faCt, noticed by Dr. Haftings,
that, during the ufe of thefe counter-irritants, purulent
expectation is occafionally converted into the iecretion
of natural mucus.

Emetics have often been recommended in that variety
of chronic bronchitis which appears in old people, and is
denominated tuffis fenilis. The cough and dyfpncea are
in fuch cafes much aggravated by the accumulation of
redundant Iecretion in the trachea, bronchia, and air-
cells, which* by the adtion of vomiting, is frequently
thrown up. Whenever, therefore, the lungs appear
loaded with phlegm to any great degree, they may be re¬
lieved by an emetic : but this pradfice does not appear
to have much eft'edt in forwarding a radical cure. The
tinCre of meadow- faffron (Colchicum) poflefles very
remarkable powers in chronic cough. It allays the
cough, promotes the flow of urine, and keeps up a regu¬
lar alvine difeharge. Moreover, from the power it pol-
fefles over the fecretions, this medicine tends to relieve
fever. The dofe generally preferibed is twenty drops
three times a-day. In fomecafes this muft be diminiffied
on account of its aftion on the bowels, fevere diarrhoea
being occafionally brought on by its ufe. Sometimes
the patient is not affefted by twenty drops : if this ffiould
happen, the dofe may be gradually, increafed, until the
bowels, the Ikin, or the kidneys, are a<5ted upon. Pa¬
tients rarely bear more than thirty drops three times a-
day without being a good deal purged, which is not to
be defired in prolonged cafes of this difeafe. If there be

much.

182

PATHOLOGY.

much quickrefs of the pulfe, eight or ten drops of the
tincture of Digitalis, or foxglove, may be combined with
this medicine; a combination by which the cough is
more relieved, and the quicknefs of the pulfe more per¬
manently diininiftied, than by the fe pa rate exhibition of
either.

While we have reafon to fufpeft a congefted ftate of
the capillaries of the mucous membrane, we rnuft peril ft
in low regimen, the life of Digitalis, Colchicum, &c. as
we (hall mention when fpeaking of catarrh; but, when
the complaint prefents much irritation or relaxation of
the fecernent veffels, more ftimulating medicines are
ufeful. In having recourfe to thefe, however, we muft
be careful not to ltimulate too fuddenly or too much,
as we have to deal with a ftate of parts much difpofed to
refume inflammatory aftion. It is therefore advifable to
'pegin with the mildeft of this clafs. The powder of the
bulbs of the Scilla maritima is often ferviceable in chronic
cough. Dr. Haiti ngs exhibited this powder in conjunc¬
tion with ammoniacum, as diredted in the compound
i'quill-pill of the London Pharmocopceia ; and in old
people of phlegmatic habits, when there is not much
fever, he found it very ufeful.

Witli the fame view Dr. Haftings has exhibited Cin¬
chona chiefly in thofe inftances that fucceed to acute
bronchitis, where the debility brought on by the acute
attack is very confiderable. In fuch cafes, if the dyfp-
ncea be not increafed, the benefits arifing from its exhi¬
bition are fometimes very apparent. The profufe perfpi-
rations and other difcharges are not only reftrained by
this remedy, but it occafionally appears to alter the fe-
cretion from the mucous membrane of the lungs, and
thus brings about a more healthy condition of that mem¬
brane, by invigorating its blood-veflels and reftoring
their natural tone. In thefe cafes it may be combined
with diluted fulphuric acid, which alfo tends to reftrain
the colliquative fweats that fo often accompany this dif-
ea fe.

The ufe of mercury in fome varieties of chronic bron¬
chitis greatly aflifts the operation of other remedies; but
it muft be given in fuch a way as to produce the leaft
poflible debility of the fyftem. We have before noticed
the efficacy of this medicine in bronchitis arifing from
gaftric and fibrous difturbance. But there are cafes in
which it is advantageous in chronic bronchitis uncom¬
bined with any difeafe in the abdomen. Thefe fometimes
occur after meafles, when the fnrillnefs of the voice in¬
dicates confiderable affedtion of the mucous membrane
lining the trachea. Indeed the great advantage we de¬
rive from calomel in croup would lead us to adopt it
very conftantly in fimple inflammation of the bronchial
membrane. But the debility produced by this difeafe,
when of a chronic nature, forbids the ufe of a remedy fo
debilitating.

In the latter ftages of chronic bronchitis, where the
quantity of matter expe&orated is very large, and the
cough very troublefome, there is no remedy fo powerful
in allaying the uncomfortable irritation about the glottis
as opium. But, valuable as this remedy is, it is not
always free from inconvenience or danger, and confe-
quently other remedies of this clafs have been propofed
as fubftitutes for it. Dr. Duncan has ftrongly recom¬
mended la&ucarium when opium cannot be given. He
fays, “Of all the medicines which I have employed for
alleviating cough in phthifis, and indeed as a fedative in
many other difeafes, next to opium, I have found no
article fo beneficial as that fubftance which fome have
lately denominated lettuce-opium, and which I term
tu&ucarium."

When inflammation is not apparent, inhalation of tar-
water may be a gentle ftimulus of fome avail in altering
the morbid aftion of the veffels. The ftritleft attention
ihould be paid to the due performance of the digeftive
and excretory functions. The clothing muft of courfe
vajy according to the feafqn and fituation. The patient

fiiould endeavour to obtain moderate but not opprtfiave
warmth. In this climate, flannel next the Ikin during
the fpring and winter months, by (lightly ftimulating its
veffels, fuftains the circulation on the furface, and thus
tends to relieve chronic inflammatory difeafes of the
pulmonic fyftem. When the difeafe has feveral times
returned, and is eafily brought on by viciffitudes of tem¬
perature, a removal to a wanner and more Heady climate
is proper. Under thefe circumftances a pure and dry air
fnould be felefled, as a hot fituation conjoined with
m oi ft u re is always to be avoided. The lea-air during
the fummer-months, in thole who live in an inland fitu¬
ation in this country, fometimes invigorates the confti-
tution, and reftores the tone of the veffels on the bron¬
chial furface, fo as to prevent a return of the difeafe-,
where former attacks have left a fufceptibility to inflam¬
matory adlion.

The two following varieties are given on the authority
of Dr. Good ; but their feparate exiftence, affumed on
the different appearance of the fluid difcharged, does not
feem fupported by practical writers. They are,

y. B. acrida ; the difcharge thin, frothy, and faline ;
for the molt part excreted with difficulty. It is in mo ft
inftances an atonic affeftion of the lungs or of other or¬
gans that affociate in their adlion. Sometimes an atten¬
dant upon the gouty; more frequently upon inebriates
labouring under a difeafed liver, to whom it is peculiarly
troublefome in the morning.

B. periodica ; recurring at Hated periods : partly
reftrainable ; difcharge thin, but not acrid. Moftly
common to perfons of a nervous or hypochondriacal tem¬
perament.

2. Bex ficca, or dry cough; i.e. unaccompanied with
expe&oration. Three varieties.

«. B. ingenerata ; from irritation produced locally, as
a fcirrhous or calculous affeftion of the lungs. See Bo¬
re] li, obf. 6. arid Zacut. obf. 95.

(3. B. extranea ; from irritating materials inhaled from
without, as minute particles of glafs, lime-ftone, and
fimilar bodies; and common feo glafs-cutters, hewers of
free-ftone or fand-ftone, workers of metals, and other
mechanics.

In manufadluring towns, the preparers of yellow
leather, and thofe employed in fome parts of the china
manufactory, are often fubject to fevere attacks of this
kind. They are expofed during fome parts of the procefs
to inhale an air loaded with dull, which produces inflam¬
mation of the bronchial membrane of a chronic and pe¬
culiar nature. Dyfpncea is generally the primary fymp-
tom, which is often neglected for many months. If the
occupation, under thefe circumftances, be continued,
the difeafe is aggravated. The patientis not unfrequent-
ly feized with harmoptyfis, which is occafionally very
profufe, and is accompanied with a great increafe of
dyfpncea, and fevere cough. The pulfe too becomes ac¬
celerated, and is generally hard and ftrong. The furface
is hot, the tongue white, and there is confiderable thirft :
occafionally bluenefs of the lips and general lividity of
the countenance alfo appear. It often happens that we
can arreft the haemorrhage by blood-letting and aft rim-
gents; but in moll: cafes of this delcription, the haemop-
tyfis is followed by very untoward fymptoms. Whether
haemoptyfis have come on or not, if the bronchia be ftill
fubjeded to irritation, the cough increafes, and is atten¬
ded (for it is by no means true that extraneous fubllan-
ces always produce a dry cough,) with a copious expec¬
toration of thick mucus, which is mixed with pus-like
matter, and fometimes ftreaked with blood. “The pa¬
tient complains of an uncomfortable tightnefs acrofs the
cheft, and the dyfpncea does not abate. He lofes flefii,
the pulfe becomes quicker, the tongue continues loaded,
and there is confiderable thirft. In by far the greater
proportion of thefe cafes, if the occupation be relinquifh-
ed, thefe fymptoms, by an appropriate treatment, difap-
pear, and the patient is reftored to health. In others the

termination

PATHOLOGY.' 188

termination of the difeafe is not fo happy. The patient
emaciates; he has profufe night-fweats, and the cough
l’.arafl'es him to fuch a degree as to prevent his reding by
night. The expectoration is prodigious, and becomes
much more purulent. The dyfpncea is greatly increafed,
the pulfe is very quick, and there are regular evening
exacerbations. The patient at length dies exhaufted.”
Haftings) 275.

B. verminofa ; from worms in the intedines, liver,
or other abdominal organs. Common to children with
large bellies, and pale emaciated countenances; and dill
more fo to dieep labouring under the difeafe- called rot,
and vvhofe livers are uiually loaded with the Fafciola
hepatica, or fluke.

3. Bex convulfiva, (Pertuflis, Cull.) Whooping-
cough ; chin-cough, "or more correCtly kin-cough or
kind-cough ; literally “ child’s cough,” from the Ger¬
man kind, achild. The cough con vulfive, and fufFocative,
accompanied with a fhrill reiterated whoop, and frequent¬
ly with vomiting ; contagious.

This malady commences as an ordinary catarrh. In
the fpace however of a fortnight or three weeks, the
fymptoms undergo a change, and the difeafe exhibits a
convulfive cough, in which the expirations are made
■with fo much rapidity and violence, and are fo long and
frequently repeated, that the whole air feems to be ex¬
pelled from the lungs, and the patient appears to be in
danger of fuffocation. At length a full ajid violent in-
fpirption is necelfarily made for his relief, which, from
the iinufual velocity with which the air rufhes in, or
from the fpafmodic contra&ion of the glottis, produces
a peculiar found or whoop: thefe actions alternate until
mucus is expectorated, or the contents of the ftomach
partially ejefted. Thefe evacuations commonly put an
end to the coughing, and the patient remains free from
it for fome time after. But the duration of the paroxyfm
and the relief obtained are very different in different in-
ftances. Frequently the expeftoration or vomiting
takes place after the firft or fecond coughing; but fome-
times this happens only after feveral alternate coughings
and whoopings; and, in very fevere cafes, the paroxyfm
ends in the complete exhauftion of the patient, without
any difeharge whatever.

The fits of coughing return at various intervals, rarely
obferving any exaft period. They happen feveral times
in the courfe of the day, and more frequently in the
night. In general they come on without any obvious
caufe ; but they are alfo brought on fooner and more
•violently by various fources of irritation, as by confide-
rable bodily exertion, fuch as running, or even laughing,
turning from fide to fide in bed, diftending the ftomach
by food, or irritating it by fuch as is indigeftible or acri¬
monious. Fretting and crying commonly bring on the
fit. Though the paroxyfms come on fuddenly, the pa¬
tient has commonly fome warning, which excites his
alarm ; and, to avoid the violent and painful concufiion
which the coughing occafions to the whole body, he
fometimes throws himfelf on the ground, or clings faft
to any thing that is near him, or demands to be held
faft by any perfon that be can come at, and will even run
acrofs the room for that purpofe, with terror and fup-
piication exprefled in his countenance. In alrnoft every
cafe of the difeafe, dyfpncea is prefent. Frequently there
is a difficulty of breathing, not only immediately before
and after the •fits of coughing, but, in the more fevere
cafes, the patient pants on the leaft exertion, as if he had
run a race, or performed fome feat of bodily ftrength.

When there is little expecloration, and that of a thin
mucus only, the fits of coughing are violent, and conti¬
nue long : but, as the expefforated matter foon becomes
confiderable and very thick, as it is more readily expec¬
torated, the fits of coughing are of fhorter duration. If
the fits are violent and long continued, they necelfarily
interrupt the free tranfmiffion of the blood through the
lungs, and confequently the return of blood from the
Vjjl. XIX, No. 1256.

head. This gives rife to turgefcence and fufftifion of the
"'face, and fometimes occalions haemorrhage from the nol'e.

Sydenham fpefks of the whooping-cough as unconnec¬
ted with fever; Dr. Cullen remarks, that “It is conr
ftantly in fome degree prefent ; but with evident exa¬
cerbation towards evening, continuing till next morn¬
ing.” (Firft Lines, mccccx.) Dr. Watt alfo obferves
upon this point, “as far as tny experience goes, I am
difpofed to believe, that, even in the miideft cafes, as-
long as the kinks (paroxyfms) continue, there is always
fome part of the day when the prefence of fever can be
dete&ed. It may be fo flight as hardly to deferve no¬
tice ; but (till, to an attentive obferver, who has oppor¬
tunities of feeing the patient day and night, it is abun¬
dantly obvious. I have remarked it even in thofe fa¬
vourable cafes, where the appetite continued good, and
where the patients feemed to fuffer little or nothing in
their general health.”

Indeed the phenomena of increafed heat and aflive
pulfation have been fo generally noted, that it feems
furprifingthat they fhould haveefcaped Sydenham’s (ufu-
ally) dole obfervation.

With regard to the nature of whooping-cough, it
feems evidently a fpecies of bronchitis, or inflammation
of the mucous membrane of the lungs, which has thefe.
circumftances peculiar to it, that it elicits a fecretion
pofleffing contagious properties, and that it is connected
with fpafmodic action of the mufcles of the glottis and
of the cheft. The low degree of febrile irritation it fome¬
times produces will prevent many from according the
term inflammation to the malady. This is however of
no confequence ; the prefence of difeafed fecretion no one
will deny 5 and that the irritation this arifes from is very
prone to bring on unequivocal fymptoms of inflamma¬
tion, is equally indifputable. Dilfeflion of fatal cafes
has invariably fhown rednefsand diftentionof capillaries
on the nervous membrane, or effufion of pus or flakes
or coagulated lymph. In fome cafes diforganization has
been propagated to the fubftance of the lungs. In fopie
very young fubjedts, indeed, fuffocation has occurred
from the long irritation of the mucus having kept up
coughing till the cheft was emptied of air, and the glot¬
tis has been clofed, firft by the fpafm of its mufcles, and
afterwards by the preffure of the atmofphere ; and here
diffedtion has furniffied little evidence of inflammation..
The courfe and event of this difeafe are very uncertain.
In the miideft form in which it appears, it commonly
continues from one to three months; and, in the more,
fevere, con.fiderably longer. Even after it has nearly or
wholly ceafed, an accidental expofure to cold occafions a
relapfe.

The treatment of Bex convulfiva follows clearly out of
the views before taken of its nature. I11 the firft place,
we have to guard againft inflammation fpreading to any
alarming extent. In proportion, therefore, as the dyfp-
ncea and fever are fevere, and as the patient is ftrong
and plethoric, it becomes necelfary to employ blood-letting,
and even to repeat it according to the urgency of the
circumftances. Even in more delicate and younger chil¬
dren, fome evacuation may be neceffary by means of the
lancet, in the commencement of the difeafe; and local
bleeding, by leeches applied to the cheft, may be reforted
to, where general blood-letting is deemed inadmiflible.
The difficulty of the tranfmiffion of blood through the
lungs fhould be watched* and early attacked by this effi¬
cient remedy, or the difeafe will often baffle all the fub-
fequent efforts that can be made. Moreover the treat¬
ment of dyfpepfia fhould be kept clofely in view. The
inflammation of the membrane, and the convulfive aflion
of the refpiratory mufcles, are of courfe connected with
nervous irritation ; and hence we muft be careful that
all excitement of the nervous fyftem be withheld. Ab-
ftemioulnefs and the ufeof purgatives have the two-fold
effect of inducing a right aftion of the chylopoi’etic vif-
cera, and of diminifhing inflammation,

3 B Every

184

PATHOLOGY,

Every practitioner muft have ohferved the almoft con-
ftant derangement of the excretions of the bowels, under
any acute difeafe in children, but more efpecially under
tbofe affefting the lungs ; and the relief obtained, even
in refpeCt to the original diforder, by regulating the al-
vine difcharges. It is important, therefore, when the
difeafe affumes an inflammatory type, to keep up a con-
ftant free (fate of the bowels from the fir ft, by the repeated
ufe of laxatives, efpecially of thofe which contain a por¬
tion of calomel. According to the ftate of aCtual con-
ftipation, or of mere derangement of the excretions, the
purgatives will be ufed more actively at intervals, or more
conftantly in fmaller dofes.

Of all other remedies, emetics appear to be among the
moft ufeful in this difeafe ; for they not only determine
the fluids to the furface, and ftill more effectually relieve
the lungs by promoting its fecretions, but they alfo tend
to interrupt the recurrence of the fpafmodic affeCtions.

As a fecondary expedient, with a view to obviate or re¬
move inflammatory determination to the lungs, when it
occurs in this difeafe, the application of blifters is often
beneficially reforted to. They do not, however, appear
to aCt fo beneficially in the relief of the pain and dyfpnoea
attending this difeafe, as in ordinary cafes of catarrh; and
ought not to be relied on, where the inflammatory con-
geftion in the lungs is confiderable. They are moft be¬
neficial, when this inflammatory condition has been al¬
ready partly fubdued by the more aCtive evacuations.

The medicines generally in ufe in thefe complaints are
the fame as in the common forms of bronchitis ; viz. di¬
gitalis, colchicum, &c. The alkalies, foda and potaflt,
have alio great influence on this complaint. To allay
the nervous excitation, conium and hyofciamus may be
advantageoufly prescribed ; the warm bath Should be ufed
occasionally, and reft absolutely enjoined ; for, whether
we view' the mere Symptom of dyfpncea, or extend our
refearches to the probable caufe of its occurrence, we
Shall find ample reafon to induce us to keep the lungs
in as tranquil a ftate of action as poffible. It is in this
way indeed that bleeding in all pulmonary difeafes muft
be principally ufeful ; viz. that the diminished quantity
of blood in the fyfteni calls for lei’s activity in the refpir-
ing powers.

Thefe rules apply, however, only to Severe cafes. In the
ufual mild forms, a regulated diet, pure air, and medi¬
cines of an aperient nature, with an occafional emetic,
will accomplish all that is required in the firft ltage of the
diforder.

In the after Stages', when the operation of the conta¬
gion may be fuppofed to have ceafed, and the convulsive
cough to be continued through the influence of habit, a
different indication arifes, and different remedies are to
be employed. That the power of habit contributes to keep
up the difeafe, after the influence of contagion has de¬
clined, is to be inferred from the circumftance that the
fymptoms have disappeared, like other nervous Symp¬
toms, in confequence of the impreflion of terror, or other
Strong emotions of the mind ; which agents cannot be
fuppofed to have the power either of correcting or ex¬
pelling a morbific matter from the conftitution, but
which are evidently Suited to change the ftate and ha¬
bits of the nervous fyftem ; or, at all events, of inducing
a change in the merely habitualdiforderof the fecernents.
With this view, the inhalation of tar vapour may be re¬
forted to with advantage. Some authors have advifed a
variety of tonics ; but their mode of aftion is obfcure,
and general experience has not confirmed the original
accounts of their efficacy. A Stimulant more congenial
to the bronchial membrane is country air. Indeed
change of air has been very generally deemed the moft
effectual remedy in the advanced ftages of the difeafe.
And fo Strong has this impreflion been made upon the
public, that it has been generally believed, that any
change of air, even from a better to a v/orfe, is beneficial.

This, however, Seems improbable; and the fact perhaps
is as Dr. Watt has Stated it : “It no doubt frequently
happens,” fays that writer, “ that a child is better on
being taken from one place to another, even when the
air in the latter place. is fuppofed to be worfe than the
former. Here, however, I fnould be difpofed to attribute
the good effeCts, not to coming into a more impure at-
mofphere, but to the child’s being abroad , any atmol-
phere being better than confinement to the houfe.” This
advice is not of courfe meant to apply to any but cafes
in which the inflammatory tendency of the cough is per¬
fectly fubdued.

But we muft not forget to mention, that a refpeCtable
author has oppofed the notion that change of air is al¬
ways beneficial to patients of whooping-cough. Dr. Ro-
bertfon has Seen Some lamentable instances to the con¬
trary. He thinks the removal Should be but a Short dif-
tance from home, “and the new abode Should be choferi
in every thing refembiing the former one,” avoiding ele¬
vated and expofed Situations, as well as thofe that are
too low and damp, or within the range of exhalations
from Stagnant waters or flooded meadows. Inland Situ¬
ations are preferable to the coalts. The advantages of
change of air, he thinks, may Sometimes be obtained by
change of rooms and habits, at home. Upon the whole
we are of opinion, that, as a general meafure, change of
air, or, at any rate, being much in the air, is advisable ;
but, like other good rules, it is liable to fotne exceptions.

Dr. Archer, an American phyfician, advifes to relieve
the whooping-cough by vaccination. This, of courfe,
can be reforted to only under particular circumstances.
Dr. A. fays, “ I have vaccined fix or eight patients that
had the whooping-cough, and in every cafe it has fuc-
ceeded in curing this moft diftreffing difeafe. The
whooping-cough does not come to its height in lefs than
fix weeks from its commencement; and then, when a
favourable termination is expefted, the declenfion of the
difeafe is gradual, and it does not terminate in lefs than
fix weeks more. To arreft this afflicting diforder in its
progrefs, I would recommend vaccination in the fecond
or third week of the whooping-cough, i. e. when the
fymptoms of the whooping-cough are fully afcertained,
then to vaccinate. Should the convulfive cough be vio¬
lent, I Should immediately vaccinate ; being well allured
that the diftreffing fymptoms of the whooping cough are
checked by vaccine diS'eafe. The termination of the vac¬
cine difeafe will be the termination of the whooping-
cough.”

Genus II. Tdyfrnaa, [from Sw;, bad, and mice, to
breathe.] Anhelation. ‘Permanent difficulty of breath¬
ing, with a fenfe of weight on the cheft.

Dyfpnoea is produced by fo great a variety of caufes,
and from its very nature is fo evidently fymptomatic, as
in faff Parr and the belt fyftematic writers have always
considered it, that we Shall refer our readers to the origi¬
nal maladies which give rife to its varieties for the necef-
fary details concerning it.

It may be pradtically ufeful, however, to remark, that
an unremitting difficulty of breathing is common to fome
old perfons, in whom its long continuance, and the ab-
fence of other fymptoms, forbid us to fuppole any orga¬
nic change in the Structure of the lungs or contiguous
vifeera, or indeed any merely mechanical obstruction, to
have occurred. It differs but in a flight degree (as far
as our own opportunities of Seeing it have extended) from
afthma: the point of difference between the two com¬
plaints is merely the regular and continuous diforder of
refpiration in the former difeafe, as antagonized to the
paroxyfms or exacerbations of the latter. There are two
lpecies.

i. Dyfpncea chronica, or Short breath : breathing uni¬
formly Short and heavy, moftly accompanied with a
cough. There are five varieties.

a. D.

185

PATH OLOG Y

to. D, extran'ea, (D. terrea, Cull.) From calculous or
other earthy fecretions in the fubftance of the lungs
thrown up by coughing. See Catarrhus, in this article.

0. D. phlegmatica, (D. aquofa, Cull.) The habit
phlegmatic or cachectic, with fcanty fecretion of urine,
and moltly oedematous extremities. See Hydrops, in this
article.

y. D. pinguedinofa, or purfinefs ; accompanied with
oppreffi.ve fatnefs. See Corpulence, in this article.

o. D. organica, (D. thoracica, Cull.) From deformity
or organic defect, or injury.

e. D. vaporofa j from the mifehievous a&ion of metals
or other poifons,.

i. Dyfpncea exacerbanst SuhjeCt to fudden and irre¬
gular exacerbations: the breathing deep, ftertorous,
acute, and Suffocative; relieved by an ereCt polition.
This, when not Symptomatic, is the fame as the follow¬
ing genus, varying from it only in its acutenefs and
violence; it requires a fimilar treatment. Found, alfo,
under the one or the other fpecies, as a Tymptom in
aneurifms, polypous concretions, and other affections
of the heart and larger veflels; in enlargements and
other a (left ions of the abdominal vifeera ; in empyema,
iiydrotborax, worms, peripneumony,baftard peripneumo-
ny, fmall-pox, and occalionally in fevere attacks of inter¬
mitting fevers.

Some au thors have explained the term Catarrhus fuffo-
cativus (the name by which this fpecies is called by
Baglivi and others) as Synonymous with croup.

Genus III. Afthma, [probably from ctw, I breathe.]
Difficulty of breathing, temporary, recurrent ; accom¬
panied with a wheezing found, and fenfe of conftriCl ion
in the cheft; with cough and expectoration. Thefe ge¬
neric characters are fubjeCt to great variations. Afthma
lias of late years been traced in a very large proportion
of cafes to organic changes in the thoracic vifeera. As
there leeins good reafon, however, to believe, that the
majority of afthmatic patients (perhaps nearly all where
the complaint is not of long Handing or of peculiar vio¬
lence) Suffer from functional impediment only, we con¬
fine ourf elves to the confideration of afthma of this latter
kind.

The exaCl nature of afthma is not fettled. Among the
■old writers, Floyer paid much attention to this difeafe,
with which he was feverely aftlidted ; but his opinions as
to its caufe are fo much tainted with the humoral doc¬
trines, that it is ufelefs to difeufs them. He has left,
however, a very good description of the Symptoms of one
kind of afthma. Cullen fuppofed it to confift in a fpaf-
modic conftridiion of the mufcular fibres of the bronchia,
preventing the free ingrefs and egrefs of the air, and con¬
sequently the due expanfion of the lungs. This opi¬
nion, however, is not reconcileable with the known
ftrudhire of the bronchia, and lias accordingly been laid
afide. The fame author mentions feveral varieties of it,
as exanthematicum,fimplex, phlegmaticum, plethoricum,
&c. arifing from remote and diftindt caufes. Thefe Dr.
Good has adopted in his Nofology ; but the Amplified
arrangements of pradfical writers feem to warrant the
difmifial of Such divifions. Dr. Bree, in the belt treatife
on this Subject which we know of, confiders afthma, pro¬
perly Speaking, and as diftinguifhed from mechanical
preffure of all kinds, whether tumors, concretions, or
other confequences of inflammation, to be a material
irritant applied to the air-cells of the lungs, and exciting
the contraction of the refpiratory mufcles for its remo¬
val. To take in his juft and more extended view of the
difeafe, we quote his own words. He fays, “ If it be ne-
cefiary to define the difeafe, I would fay, agreeably to the
principles of the following inquiry, Afthma is an excef-
hve contraction of the mufcles of refpiration, without
acute lever, excited by an irritation in Some of the vifeera
whofe functions thele mufcles are intended to ferve.
Under this generic definition are comprehended all affec¬

tions not febrile, attended by an uncommon adtion of
the mufcles ufed in refpiration ; the influence on thefe
mufcles being the fame in kind, though diftindt by fitu-
ation and quantity of force, as it may exill in fome of the
lower vifeera, or in the lungs.”

Now, as far as regards the lungs, the material irritant
productive of afthma is fuppofed to be a mucous fecre¬
tion. Dr. Bree deduces, from a valt ftore of ancient and
modern authors, observations tending to (liow, that the
paroxyfm of afthma'is ahnoft invariably connedled with,
and terminated by, the expectoration of mucus or Serum :
and he infers, that the impediment to refpiration arifes
from the gradual collection of this fluid in the air-cells.
There it may exift for a certain time without producing
dilturbance ; but at length the filling up of the remote
terminations of the bronchite impedes the changes of the
blood, and calls into forcible adtion the refpiratory
mufcles; whereas the lymph accumulated in the air-cells
is rather oppreffive than acrimonious, and the fenfib'.lity
of their membrane is lefs than that of any part of the
bronchia and trachea. Moreover the veficle cannot col-
lapfe in the attempt at expiration, becaufe its cavity
is filled with lymph. Hence Dr. Bree thinks arifes the
true caufe of a paroxyfm, “ beginning with little or no
cough, and that Seemingly impeded but, after the
fluid has been leflened by abforption, Still more may be
discharged in the vapour of expiration, and, the elafticity
of the bronchia being thus reftored, the much-defired
fpitting of mucus may take place.

We copy from this author the following lucid account
of his opinion-s as to the production and -nature of this Se¬
cretion. “It is obvious, that mucus could not have been
expeCtorated without a previous Secretion of ferum. But,
as this mucus is copioully discharged, the effufion of Se¬
rum mutt have been confiderable : it may be therefore
proper to inquire in what ftate of the lungs fuch an effu¬
fion can take place. It is known that the glandules of
the trachea and bronchia are fubjedt to inflammation, and
that in catarrh an excretion of mucus is confiderable
from this condition of their veflels; but practitioners
have generally teftified, that pyrexia and Symptoms of
inflammation are not prefent in fpafmodic afthma. We
muft then look farther for the fource of this copious fe¬
cretion, and we (hail find it in the veflels with exhalent
orifices at the extremities of the air-pipes ; the conftruc-
tion of which is not complex like that of the mucous
glandules; and they have not follicles in which they may
depofit their lymph till it be excreted. There are many
reafons for believing this to be the principal, if not the
only, fource of the copious expeCforation in afthma.”

In confequence of the condition of the habit in afthma,
the matter of heat is not given out in this as in other in-
ftances of glandular Secretion. Thecapillary veflels are
paffive in this difeafe; and, not contraCfing So narrowly
as to detain the grofs part of the current, they permit
lymph to pafs inftead of exhaling only a thin vapour.

It Seems that, in the early periods of afthma, and while
ferum is not very abundantly effuled, a quicknels of ref¬
piration commonly precedes the paroxyfm, and the ex¬
pirations carry off, in vapour, that fluid from the cavi¬
ties : the aCtion of the abforbents is probably alfo quick¬
ened, fo that, by the united powers of thefe inftruments,
the balance may be reftored between abforption and ex¬
halation.

There can be little difficulty in according to Dr.
Bree, that this explanation is very plaulible and fatisfac-
tory, and that irritation of mucus on the nerves of the
bronchia is no doubt in many cafes the proximate caufe
of afthma. Every one muft allow, however, that'any cir-
cumftance inducing an irritable ftate of the nerves will as
furely produce the difeafe as the fecretion does; and it
is of little confequence what irritant is applied to thefe
nerves, Since we find cough and difficulty of breathing
produced by a variety of ailments, as in the liver, womb,
kidneys, See. We therefore confider afthma the refult of

irritation

386

PATHOLOGY.

irritation of all tliofe parts which hold a fympathy with
the refpiratory mufcles. Indeed Dr. Bree’s opinion does
not differ widely from this, as he has allowed that afthma
frequently has its origin in biiious and gaftric difturbance.
A further evidence in favour of this notion is, that fome
afthmatic patients -do not, not withllanding violent ef¬
forts, expectorate ferum or lymph.

The wheezing noife, and the ftraitnefs and anxiety,
gave Cullen reafon to fuppofe that a conftrittion of the
bronchi® took place in afthma. Dr. Bree thinks their
fymptoms may be more fatisfadtorily traced to detention
of the ftomach and cefophagus ; when in the former part,
preventing free infpiration by hindering the defcent of
the diaphragm ; when in the latter, narrowing the bron¬
chi® by preffure. But the mod dyfpeptic patients of
afthma do not invariably fuffer the above fymptoms in the
higheft degree. It feems clear therefore, that, though
contraction of the bronchia is almoft impofiible, a partial
cloftireof the glottis may occur from fpafm of its muf¬
cles, and produce the phenomena in queftion. Indeed
thefe mufcles are as intimately involved in fympathy
with the bronchial membrane as the external mufcles of
refpiration, and confequently are liable like them to have
this fympathy when kept up for too long a period by ir¬
regularity or difturbance in the times of their contrac¬
tion and relaxation. We now come to fpeak more par¬
ticularly of the two fpecies into which Afthma is divided.

1. Afthma ficcum, dry, nervous, or convulfive, afthma :
paroxyfm ludden, violent, and of ftiort duration ; con-
ItriClion hard, dry, fpafmodic; cough flight; expectora¬
tion fcanty,and only appearing towards the clofe of the fir.

We have before ftated that the convulfive efforts of the
mufcles of refpiration in this complaint may be called
into play by irritation of any part of the body the nerves
of which have influence over thofe mufcles in a ftate of
health ; fo that dyfpepfia, or difturbance in the liver or in
the bowels, or even in the uterus, may give rife to diffi¬
culty of breathing by impeding the defcent of the dia¬
phragm, or by increafing or diminifhing the fympathe-
tic motion of any of the other refpiratory mufcles ; and,
as the aClions of the former vifcera are periodical in health
and in difeafe, the periodic occurrence of nervous irrita¬
tion will influence in the fame irregular mode the dyfp-
ncea, and caufe afthma.

It is in afthma arifing from thefe abdominal irritations
that many anomalous fymptoms occur. General ner-
voufnefs, itching of the Ikin, flufhes of heat, diabetes,
hyfteria, See. are of no uncommon occurrence; but the
complaint is too ftrongly diftinguiflied from any of thofe
complaints to render us liable to miftake in our diagnofis.

From what has been before ftated, it feems that the
-caufes of afthma are, nervous irritation of the bron¬
chi®, affecting by fympathy the mufcles of the cheft and
glottis ; or the lame irritation of other nerves fitnilarly
connected. The fecond caufes are embraced in the ex-
tenfive views we have taken of dyfpepfia : the former can
arife only from the peculiar ftate of the bronchial exha-
lants already mentioned, or the bad ftate of the air in¬
haled.

It remains therefore only to fpeak of aerial irritation.
In the firft place, it nnift be remarked, that the ftate of
the bronchial membrane will much alter the nature and
force of the impreflions it receives from the air. Dr.
Bree fays, the fenfible membrane of the trachea is na¬
turally defended by its lymph from the attack of aerial
acrimony, as far as the condition of bodies varying in
fenfibility to external impreflions will admit of this de¬
fence. Other things being equal, this guard is fufficient,
and anfwers the purpofe for which it was defigned. But,
if the fecretion of lymph from this membrane be defi¬
cient, and the abforbing power be aClive, the furface of
the membrane may be irritated by a thoufand impercep¬
tible points which the air conveys in the aft of infpi-
jation.

The ftate of air moft congenial to the afthmatic patient

appears to be that of denfity, a' ftate which more than
counterbalances the ill effeCts of foreign particles with
which it is often loaded ; and hence, in the majority of
cafes, the air in low fituations is more favourable to the
lungs of afthmatic patients than that of the high lands-.
It feems moreover, that, even if impurities of the air
ought to be confidered as the aerial caufe of afthma, thefe
are more ftrongly applied to the lungs in rare than in
denfe ftates of the atmofphere, fince in the latter they are
fufpended at an altitude fuperior to that of the human
frame.

Dr. Bree accounts for the good influence of denfe air
on afthma by ftating, that a certain weight of air is ne-
ceffary to inflate the lungs fully; and that, the greater
the force of preffure thus applied, the more perfectly will
the aerial particles required for the blood be forced
through the bronchial membrane, or through the collec¬
tions of ferum which its tubes may contain. He men¬
tions experiments on animals, in which the abforption of
oxygen was effected with great fpeed when artificial pref-
fure was applied. He fays, moreover, that, “the ufual
denfity of the air being lefiened, a certain volume will
not only poffefs lefs weight, and prefs lefs againfl the
membrane, but it will alio contain lefs oxygen to enter
into the new affinity.”

So much for the ftate of the air as far as regards its
immediate tranfmiffion to the bronchial membrane. Its
temperature exerts itfelf with equal power on the Ikin.
Cold and moifture check cutaneous perfpiration, when
the body is under their influence : there is therefore ad¬
ditional fluid circulating to the pulmonary exhalents, and
there is lefs expiration of vapour in breathing ; fo that
we have, in this ftate of the atmofphere, an exciting
caufe of afthma as frequently as in that of moifture with
rarity of air. Cold alone will fometimes, but not com¬
monly, excite the paroxyfm ; for there may be ftates of
the atmofphere inducing great torpor on the pulmonary
exhalents, without the prefence of aqueous vapour, or
moifture. Thus, the eaft and north-eaft winds would
exert the beneficial influence which coldnefs, Amply
united with denfitj' of air, has on refpiration, were it
not that thefe penetrating winds check cutaneous perfpi¬
ration, and thereby induce another caufe of afthma by
this matter being turned upon the lungs. So on the
other hand, in fummer and autumn the atmofphere is
rare, and fo far hoftile to the afthmatic; but, to leffen
this inconvenience, he enjoys the grateful lenfe of a
warm Ikin, and general perfpiration, as the circulation
is determined to the furface during thefe feafons. “ If
(fays Dr. Bree) it were not for this diverfion in favour
of the lungs, the patient would perceive much more of
his complaint than he really does in the warm feafon ;
for many circumftances operate againfl him then which
do not in winter.” The exhalation from the pulmonary
veffels, decidedly increafed by exercife or other caufes,
will oftener be prdfufe in the hot months; and be more
fuddenly followed by the coldnefs, which is known to
come upon furfaces in proportion to the evaporation
made from them, than happens at cold periods of the year.

This view of the modus operandi of the atmofphere
is more confonant with legitimate deduction from fafits
than the old notion that vapours in the air were all the
offending agents to be looked to, fince it is notorious
that many afthmatic people live better in the crowded
and fmoky precin&s of a large city than in the open air
of the country. Sometimes, indeed, fumes, dull, &c.
are eafily proved to lead to, or aggravate, an afthma; but
generally we cannot well confider aerial impreflions to be
the exciting caufes of the paroxyfms of this malady, fince,
fuch impreflions being conflant, the cough and difficulty
of breathing would be equally fo. We muft therefore
conclude, that the particles of matter contained in foul
air accumulate in the bronchia, and affimilate with its fe-
cretions, until their bulk brings on the dyfpnoeic pa¬
roxyfm.

PATHOLOGY.

We (hall tranfcribe Dr. Bree's account of the fymp-
toms of this complaint. It bears a clofe refemblance to
the noted defcription given by Floyer, but is perhaps
more amply detailed. “The attack of a paroxyfm of
periodic or convnlfive afthma is preceded very generally
by dyfpepfia, and the circumftances which occur to a re¬
laxed habit. This condition of the body may have pre¬
vailed for months or years before it takes the additional
form of afthma; but, when that difeafe appears, dyfpep-
iia never fails to be aggravated, and to lhow itfelf with
violence before the lit.

“ The firft fymptoms are flatulence and diftention of the
ftomach and bowels; a heavy pain over the forehead and
eyes ; eruCtation of wind, with water which is fometimes
infipid, at others four. When the evening approaches,
this weight over the eyes becomes more oppreflive, and
the patient is very fleepy. Occafionally, if he be particu¬
larly animated by company and conversation, the drow-
finefs does not take place, but a fhortnefs of breathing is
perceived, and foon after much anxiety of the prascor-
dia, with great reftleflnefs. The prefence of company
then becomes irkfome, as it feems to increafe a certain
heat of the body, a want of free refpiration, and an irri¬
tability which repels the moll cautious attentions of
friends. Frequently at this period there is a tingling
and heat in the ears, neck, and breaft, and a motion to
expel the contents of the bowels is attempted with fome
violence, and with great uneafinefs of the abdominal
mufcles. When an afthmatic feels thefe warnings, he
may be convinced that his enemy is at hand. At fome
uncertain hour before midnight the patient becomes
Suddenly fenflble of the increafed violence of the difor-
der ; moft frequently after a dumber in bed he awakes
with:great difficulty of breathing, and he feels the ne-
ceflity of a more ereCt pofture of his body. Infpiration
is performed with great effort of the mufcles, but is never
perfe&ly deep, and the diaphragm feems to defcend with
great difficulty againft an oppofing force. There is now
a defire of free air, fpeaking becomes diftrefling, and the
irritability of the mind continues, but is not lb acute as
in the approach of the fit. There is a great ftraitnefs
of the cheft, and a wheezing found in refpiration. An
inclination to cough Ihows itfelf, but this is Small and in¬
terrupted. The pulfe is increafed in quicknefs a few
ffrokes, but without hardnefs. There is no preternatu¬
ral thirft, unlefs, as often happens, the fit be excited by
indigeftible matter in the firft paffages. There is a pro¬
pensity to make water, which is copious and pale, and
frequently discharged. After fome hours of diftrefs the
patient perceives his anxiety to be lefs, the breathing is
lefs quick and laborious, the inspirations are longer and
more full, the expirations are ftill attended with wheez¬
ing; the pulfe is not So quick, but more full; irritation
is lefs acute. The cough probably brings up a portion of
phlegm, and a very fenflble relief follows that excre¬
tion. Then the tranquil ftate of the feelings introduces
fleep, but not unaccompanied by wheezing, which con¬
tinues almoft always through the firft night, and until,
by the progrefs of the fit on the fecond or third day, a
more considerable expectoration of mucus takes place.

“The fecond day is ufhered in by a remiflion of the
fymptoms, which the patient perceives from the time of
awaking in the morning. No change of pofture is, how¬
ever, yet made with impunity; and particular diftrefs af-
feCts him, if he engage in the fatigue of drefling whilft
the ftomach is empty. The pulfe will be accelerated
more than it was in the acme of the paroxyfm ; and mo¬
tion muff: frequently be fufpended, or a vehement agony
for breath will certainly come on. During the day, if
no particular hurry occur, the breathing becomes gra¬
dually more free till the evening ; an inexperienced afth¬
matic even flatters himfelf that his difeafe is leavinghim,
but lie finds at the approach of night that he mult fuf-
tain a new attack. The par.oxyfm recommences with the
ufual fymptoms, and the night is palled nearly as the

VOL. XIX, No. izy6.

137

former; but the fleep is more perfect, and produ&ive of
more relief.

“ The third day, the remiflion is more complete; there
is fome additional expectoration ; and bodily motion is
performed with lefs diftrefs, but ftill with great incon¬
venience. After the paroxyfm has been renewed in this
manner for three nights, the expectoration generally be¬
comes free, but there is no certain termination of the
fit at a fixed period. However, except in particular
cafes, it goes off after a few days ; and, as the daily re-
mifllons become more perfeCt, the urine is higher co¬
loured, and in fmaller quantities; the expectorated mu¬
cus is more copious and digefted ; ftrength of pulfe and
vigour of aCtion increafe, and good humour again enli¬
vens the mind.

“ The expectorated mucus has been faid to be ftreaked
with black, or to have a blackilh tinge ; and this appear¬
ance certainly prevails in many inltances, but not inva¬
riably. The tafte of the expectorated mucus is alfo
equally uncertain; it is fometimes fweetilh, but more
frequently it is faline, and it is occafionally coloured mi¬
nutely with blood. There is a confiderable variation in
the periods of the accefiion of the paroxyfm, and in its
duration, in the intervals of the fits, the quantity of
mucus expectorated, and the freedom of that difcharge.
Thefe circumftances of the difeafe will be influenced by
the predifpofing caufes, and by occafional accidents.”
Dr. Bree’s Practical Inquiry into Difordered Refpiration.

Afthma may occur at any age ; but except where there
is a mal-conformation of the cheft, it feldom attacks in
early life. It ufually afflicts perfons of mature or ad¬
vanced age. People who follow certain occupations are
more liable to it than others ; fuch as millers, maltfters,
ftone-cutters, wool-combers, flax-drefl'ers, &c. Many of
thefe inltances, however, of Ihort breathing, belong rather
to Dyfpncea than to Afthma. Although the attacks are
fo fevere and diftrefling for the time, yet in the intervals
the patient commonly enjoys a tolerable fhare of health,
and is able to engage in the purfuits of bufinefs or plea-
fure, according to his ftation in life ; nor do they feem,
in numerous inltances, to have much effeCt in Ihortening
the natural period of human exiftence, many allhmatics
having been known to live to the age of feventyand up¬
wards. The difeafe, however, terminates at length in
peripneumony, confumption, dropfy, lethargy, or apo¬
plexy.

In the treatment of afthma, we have two purpofes to
effeCt ; viz. to relieve the paroxyfm on the one hand, and
to reCtify the morbid condition of the pulmonary organs
on the other.

We have feen that the paroxyfm is moft frequently
excited by diftention of the ftomach and bowels, or by
the accumulation of irritating fecretion in the bronchial
tubes. Hence we mult labour to evacuate the offending
matter from each cavity ; we mult further allay, by anti-
fpafmodic medicines, the irregular aCtion of the mufcu-
lar parts. An emetic is the firft remedy to be applied.
By gentle vomiting we may obtain fome knowledge of
the ftate of the firft paflages; and the paroxyfm will go
on with milder exacerbations, if irritating matter be re¬
moved from thfe ftomach and duodenum. Further than
this, naufea and vomiting difcharge the fubtil and Acrid
particles which have been received in infpiration, by pro¬
moting fuch a fecretion of lymph as may envelope them,
and excite expectoration ; befides which, this dilution
probably defends the membrane from further irritation.
Afterwards a draught with one ounce of diftilled vinegar,
and from one to three grains of pulv. ipecac, in pure wa¬
ter, may be taken every four hours, as a means of deter¬
mining to the furface of the body, and promoting abforp-
tion and exhalation. If coftivenefs prevail, it will be
neceflary to remove it, by the ufe of rhubarb or infufion
of fenna; but we mult avoid full purging. If acid eruc¬
tations are frequent, then, inftead of the acetous
draughts with ipecac, chalk or magnefia ufta in a draught
3 C of

188 PATHO

of mint-water, with the fame naufeating ingredient, will
anfwer better. Dr. Bree ftates, that “ it has happened
in feveral inftances, after various means intended to miti¬
gate the diftrefs of the fit had failed, that the Rubigo
ferri, or carbonate of iron, in dofes of ten grains every
four hours, appeared mod clearly to remove the pa-
roxyfm.” This effeft can only, he thinks, be accounted
for by looking to the inert condition of the ftomach and
lungs, and to the languid ftate of the circulation in the
thoracic and abdominal vifcera. He adds, “ Whatever
in fuch circumftances can haften the paflage of the blood
through the lungs, and promote a quicker return to the
heart from the lower vifcera^ mild be ufeful in the inten¬
tion of prefent relief, as well as of aftual cure.” It is
in aid of this acceleration of blood to the lungs that ih-
haling oxygen, as recomme'nded by Dr. Beddoes, is an
ufeful meafure. See 'lherapcutics in this article.

“ In the morning, the patient fhould take clear coffee
as foon as he awakes, which fhould be repeated at inter¬
vals with dry toaft; and this drink, which feems to aft
medicinally on afthrna, may be adminiftered, during the
remifiion alfo, with a few drops of tinft. opii, every three
hours, the naufeating draught being fufpended between
the exacerbations. At the beginning of the fecond exa¬
cerbation the naufeating draught fhould be repeated, at
firft with a fufficient proportion of ipecacuhan to excite
puking, and afterwards with a lefs dofe that may only oc-
cafion naufea. In the fecond remifiion, the plan purfued
in the former fhould be refumed. The third exacerba¬
tion will probably be mild, fo that the ipecacuhan
draughts may be fufpended, or they may be united with
aether and tinfture of columbo in place of the ipecacu¬
han. With this plan there will appear on the third day
a confiderable tendency to expeftorate, which fhould be
promoted by ammoniac, and vinegar of fquill with tinft.
opii, or with volatile falts. Ammoniac is called an ex-
peftorant; but the patient, before this period, too fre¬
quently takes this naufeous medicine without ufe.” Bree,
p. 283. 5th edit.

From this time we have to turn our attention to the
cure of the complaint during its remifiion; and what can
be effefted for this purpofe may be ftated in a very few
words. It is fcarcely neceffary to mention the removal
of the exciting caufe. If bad air, a removal to a better
fituation; if gaftric or inteftinal difturbance, (no doubt
the primary caufe in the major proportion of cafes,) a
rigid adoption of the treatment of Dyfpepfia (which fee)
muft be followed. We may remark here, that, having
fully entered into the coniideration of diet, &c. under
that head, we fliall feel it unneceffary to refume the fub-
jeft in our account of every one of thofe dileafes to which
fimilar regulations are applicable.

In afthrna thefe regulations fhould be fulfilled with
much diligence and attention; but they will always re¬
quire accommodation to individual cafes, particularly
to patients with nervous ailments. We may remark,
that cordial and ftimulating bitters are particularly indi¬
cated in afthrna. Thefe remedies will require a long con¬
tinuance in their ufe, and frequent change of the varie¬
ties.

With regard to the management of the fanguineous
fyftem in this complaint, it is to be borne in mind, that a
great number of cafes are on record in which it wascon-
nefted with organic changes in the thoracic vifcera. To
prevent therefore fuch occurrences, it is of importance
that we by no means negleft to moderate the force of
the circulating powers. In eftefting this purpofe, we
muft be guided by the pulfe, with little reference to the
nofological divifion of difeafe.

Unlefs from the above confideration, bleeding fhould
be cautioufly reforted to. Dr. Bree ftates, that, “ under
confiderable evacuations of blood, the fudden depletion
of the veflels may leave their coats without the ftimulus
receffary to produce a contraftion equal to the fpace

LOGY.

which the blood had occupied ; the heart will participate
in the injury, and will alfo be deficient in vigour of con¬
traftion. If, therefore, blood be taken, it fhould be
drawn from the veflels at intervals, and in fmall portions,
which would allow of a contraftiie power being exerted,
in proportion as the vefiel lofes its contents; and fo much
fluid would not finally be taken away as to leave it with¬
out the ftimulus of diftention, fo eflential to its returp
of health.” He fays alfo, that, “ before the pulmonary
veflels have relieved themfelves by their exhaling orifices,
blood may pofiibly be drawn with fome advantage; but,
when effufion has taken place, a certain debility follows,
and a lofs of contraftiie power in the veflels.”

The fame purpofe is alfo effefted by digitalis, though
the good effeft of this remedy is atterted by fome in cafes
where no extraordinary degree of pulfation was manifeft
in the arteries. The aftion of this remedy is by no means
well underftood. It is of much importance to excite the
minute parts of the circulatory fyftem, for the purpofe
of unloading the great veflels. From what we obferve
in other complaints, we fhould be inclined to ufe the
warm bath ; but Dr. Bree reports unfavourably of it : it
feemed, in this one cafe efpecially, to aggravate the ma¬
lady. Of the cold bath this author, in common with
many others, fpeaks favourably. The firft effeft of the
bath feems to be painful and injurious: but, when re-ac¬
tion follows, (and it fhould only be ufed when this does
follow,) the cutaneous capillaries are excited, and thus
unload the circulation ; independently of which, they
communicate a fympathetic vigour to the pulmonary ex-
halants.

The tendency to fpitting fhould be promoted by the
exhibition of expectorating medicines ; fuch as ipecacu¬
anha, oxymel of fquill, and ammoniacum. Of the firft
of thefe, not more than two or three grains fhould be gi ven
for a dofe, fo as to excite, in this ftage of the diforder,
merely naufea, but not vomiting; the two others fhould
be joined together in the form of a draught or mixture,
with or without the addition of tether.

A dry and pure air, but not that of an elevated fitua-
tion, is in general belt fuited to afthmatics ; there are,
however, as before ftated, frequent exceptions to this ob-
fervation. The bowels fhould be kept regular, by rhu¬
barb and aloetic aperients. Small dofes of calomel may
be given with great advantage, in many cafes; and efpe¬
cially where the afthmatic affeftion is connefted with a
difeafe of the fkin. Whenever the patient’s feelings warn.
him of an approaching attack, he fhould take an emetic,
and after its operation an opiate : and at all times he
fhould encourage expeftoration ; but oleaginous emul-
fions and fweet mixtures fhould be profcribed. Ifl’ues
have been recommended by fome praftitioners for lef-
fening the frequency and violence of the paroxyfms.
It is faid that king William continued perfeftly free
from his afthmatic complaint, during the whole of the
time that the wound he received on his fhoulder, in the
battle of the Boyne, kept open and difcharged matter.

The utility of counter-irritants feems here very equi¬
vocal, efpecially in young fubjefts. Dr. Bree fays,
“ In very old afthmatics, ifiues are fometimes necef-
fary. In younger fubjefts, when the difeafe is not yet
inveterate, they may occafionally be ufeful, by diverting
aqueous humour from the lungs, and giving a better op¬
portunity for the operation of tonic remedies.”

Diuretics have been very generally reforted to, often
perhaps becaufe in this complaint the urinary fecretion
is difordered ; but this is generally traceable to the dyf-
peptic fymptoms to which our attention fhould be prin¬
cipally direfted. There are cafes, however, in which diu¬
retics are plainly indicated. When Dyfpncea remains
after the fit, and the urine is at the fame time fmall in
quantity, and high coloured, faline diuretics fhould be
given; and mercurials are alfo then ufefully com¬
bined, as the cafe is probabiy complicated with vifceral

obftruftions.

PATHOLOGY. 189

obftruflions. Diaphoretics are of much ufe in the ear¬
lier ftages of afthma ; but, when the malady is of long
Handing, their utility is often doubtful. Whenever they
are employed, gentle perforation, not fweating, fliould
be elicited. Stimulating ludorifics are for the moll part
improper. The pulv. ipecac, comp, will be found a ufe-
ful diaphoretic in afthma. It is generally allowed to be a
very innocent form of exhibiting opium ; and the ufe of
this article is often called for by the deranged Hate of the
nerves, as much as the aftion of the fkin is required to
be promoted by its diaphoretic property. The inhalation
of fteam ariling from various herbs, as hemlock, ftramo-
nium, &c. appears to be rather hurtful. Indeed from
what has been before faid of the caufe of afthma, it is
evident, that heat and moifture conveyed into the lungs
is by no means likely to cure an afthma. A regular ufe
of oxygen between the paroxyfms, and when inflamma¬
tory tendency exifts, will be found more ufefu).

2. Afthma humidum, humoral afthma. Under this
term fome phyficians have comprehended the anafarca of
the lungs j but we defignate by it that fpecies or variety
of fhortnefs of breath or wheezing, which is accompanied
with a conllant cough, and expectoration of mucus, and
which is diftinguilhed from phthifisand catarrh by being
unattended with fever. It is diftinguilhed fromadropfy
of the cheft, by the abfence of a numbnefs of the arms,
and (after the ceflation of a temporary aggravation of the
fliort-breathing from accidental caufes) by the patient
being able to bear the horizontal pollute. It is the pi-
luitous afthma of fome writers. It generally begins un¬
der the form of the firft fpecies, or convullive afthma $
and, like it, is liable to accidental aggravations from
changes of the weather, and the other exciting caufes
before mentioned. In regard to its therapeutical treat¬
ment, we Ihould adminiller emetics anti expeflorants
joined with artherand other antifpafmodics. Bliftersand
ilfues are more ferviceable here than in the convulfive
afthma; but the employment of diuretics is more parti¬
cularly indicated ; fuch as fquill, acetated kali, and di¬
gitalis. Ten or fifteen drops of the tinClure of foxglove,
or one grain or a grain and a half of the powdered leaves,
joined with a fourth part of opium, Ihould be given at a
dofe, and repeated twice in twelve or fourteen hours,
until the fhortnefs of the breath is relieved by a flow of
urine, or until fuch an eft'efl is produced on the pulfe,
the head, or the bowels, as fliall make it neceflary to fuf-
pend the ufe of the medicine. Decoflions of feneka or
dulcamara (fee Practical Synopfis of the Materia Medica,
vol. i. p. 152, 233.) may be prefcribed in place of the
digitalis, where this laft fliall be found to difagree. The
patient fliould be direfled to wear flannel next his Ikin,
and to keep his feet warm and dry.

It is worthy of remark, that afthma is often prolonged
by the habitual ill-aflion of the refpiratory mufcles, their
nerves, or the bronchial exhalants, when the general
health is otherwife tolerably good, and the patient free
from the external agents which firft: caufed the malady.
When the difeafe affumes this form, the paroxyfm js lia¬
ble to be brought on by mental emotion, or any extraor¬
dinary impulfe on the nervous fyllem. As the aftion of
mufcles in general, by frequent repetition, produces in
them a great mobility, orpronenefs to contradl, fo thole
of the glottis and chelt equally obey this law. It is to
the mufcles therefore that Dr. Bree referred the feat of
this afthma from habit. Others deem it a want of energy
in the nerves; and this feems a very probable account of
it in fome cafes.

The complaint is to be cured by tliofe meafures likely
to break the aflociated chain of morbid adlions ; as, em¬
ployment of an interefting kind when the paroxyfm is
flightly threatened ; a complete change of air and occu¬
pation, a ufe of ftimulants of higher order than is admif-
fible in the preceding forms of afthma, tolerably good
jiving, and aflive exercife. But galvanifm is a remedy

of the firft importance. Dr. W. Philip having ufed this
meafure with great fuccefs, we quote his account of its
adminiftration.

“ I have employed galvanifm in many cafes of habit¬
ual afthma, and almoft uniformly with relief ; and have
found the aftedlion of the breathing as readily relieved
when it appeared as a primary difeafe, as when it fuc-
ceeded to indigeftion. The time, during which the galva¬
nifm was applied before the patient faid that his breathing
was eafy, has varied from five minutes to a quarter of an
hour. I fpeak of its application in as great a degree as
the patient could bear without complaint. For this ef¬
fect I latterly found from eight to fixteen four-inch plates
of zinc and copper, the fluid employed being one part of
muriatic acid, and a hundred and twenty of water, fuf-
ficient. Some require more than fixteen plates, and a few
cannot bear fo many as eight; for the fenfibility of dif¬
ferent individuals to galvanifm is very different. It is
curious, and not eafily accounted for, that a conliderable
power, that perhaps of twenty- five or thirty plates, is
often neceflary, on firll applying the galvanifm, in order
to excite any fenfation ; yet, after the fenfation is once
excited, the patient fhall not, perhaps, particularly at
firft, be able to bear more than fix or eight plates. The
ftronger the fenfation excited, the more fpeedy in gene¬
ral is the relief. I have known the breathing inftantly
relieved by a very ftrong power. It has generally been
made a rule to begin with a very weak one, and increafe
it gradually at the patient’s requeft, by moving one .of
the wires from one divifion of the trough to another,
and moving it back again when he complained of the
fenfation being too ftrong. It is convenient for this pur-
pofe to charge with the fluid about thirty plates.

“ The galvanifm was applied in the following manner.
Two thin plates of metal, about two or three inches in
diameter, dipped in water, were applied, one to the nape
of the neck, the other to the lower part of the epigaf-
tric region. The wires, from the different ends of the
trough, were brought into contact with thefe plates, and,
as obferved above, as great a galvanic power maintained
as the patient could bear without complaint. In this
way the galvanic influence was fent through the lungs, as
much as poflible, in the direction of their nerves. It is
proper, conftantly to move the wires Upon the metal
plates, particularly the negative wire, otherwife the cu¬
ticle is injured in the places on which they reft. The
relief feemed much the fame, whether the pofitive wire
was applied to the nape of the neck, or the pit of the llo-
macln The negative wire generally excites the ftrongefl
fenfation. Some patients thought thatthe relief was molt
fpeedy, when it was applied to the epigaftric region.
The galvanifm was difcontinued as foon as the patient
faid that his breathing was eafy. In the firft cafes in
which I ufed it, I fometimes prolonged its application
for a quarter of an hour or twenty minutes after the pa¬
tient faid he was perfeflly relieved, in the hope of pre¬
venting the early recurrence of the dyfpnoea ; but I did
not find that it had this eft'efl-. It is remarkable, that,
in feveral who had laboured under opprefled breathing
for from ten to twenty years, it gave relief quite as rea¬
dily as in more recent cafes; which proves, that this ha¬
bitual difficulty of breathing, even in the moll protrafled
cafes, is not (always) afcribabie to any change having
taken place in the more evident mechanifin of the lungs.”
Philip on Indigeftion, p. 372.

Genus IV. EphiaUes, [Gr. a leaper, becaufe it was
thought a demon ‘'leaped” upon the bread.] Incubus,
or Nightmare. Generic characters — Sighing fuffocative
anhelation, with intercepted utterance, and a fenie of
fome external fubftance prefling heavily on the chelt: tran-
fitory. This genus has two Ipecies, both of which are
fomewhat allied to epilepfy.

1. F.phialtes vigilantium : produced during wakeful-

nefs 5

190

PATHOLOGY.

nefs ; the preffure fevere, and extending over the abdo¬
men; refpiratioii frequent, laborious conltridted; eyes
fixed; fighing deep and violent; intellect undifturbed.

E. vigilantium is entered on the authority of Rhodius
and Sauvages. Sauvages gives us three other fpecies,
but thefe are evidently fymptomatic of other affe£tions.
It is a difeafe rarely met with, and generally arifing from
fevere irritation of the nerves of the ftomach.

a. Ephialtes nofturnus, (Oneirodynia gravans, Cullen.')
■Nightmare, or elf-fquatting : produced during deep, and
interrupting it with violent ftruggle and tremor; the
preffure on the cheft feeming to be that of fome hideous
monfter or phantom. This latter fympfom has given
rife to the various popular names, wdiich, however differ¬
ent in different countries, all agree in exprefling the pre¬
fence of fome phantom, wizard, or goblin ; and which, as
Dry den fays,

Seeks fome love- wiider’d maid with fleep opprefs’d.
Alights, and grinning fits upon her brealt.

Befides the delufion of fupernatural fpirits, the imagi¬
nation at times difplays the calamities of life. The
patient fancies himfelf to be ftruggling with flrong
men, or to be in a houfe on fire, or in danger of being
drowned; and, in attempting to run away from danger,
or climb up a hill, he fancies he falls back as much after
every ftep as he had advanced before. After he awakes,
the terror excited by thefe frightful ideas leaves often a
palpitation of the heart, with great anxiety and languor,
and fometimes a tingling of the ears, and a general tremor.
Many abfurd explanations have been given ofthe phenome¬
non of incubus, which we fhall not flop to detail. It is
now generally agreed that the feat of the nightmare is
principally in the ftomach. It is well afcertained that
fome forms of epilepfy, and of hyfterical fits, originate
from diforder in that vifcus ; and fo great a fimilarity
exifts between the difeafes, that Galen confidered the in¬
cubus as a nocturnal or flight epilepfy. People troubled
with nervous and hypochondriac affeftions, and who
have delicate or flatulent ftomachs, are more peculiarly
fubjeft to this diforder ; and it is obferved, that a heavy
or flatulent fupper greatly aggravates the nightmare in
thofe who are predifpofed to it. The fympathy of the
ftomach with the head, heart, lungs, and diaphragm, is fo
remarkable, that there can be no difficulty in referring
the feveral fymptoms of the incubus to a difagreeable ir¬
ritation of the nerves of the ftomach.

The incubus is moft apt to feize perfons when lying on
their back, becaufe, in this pofition, on account of the
ftomach and other abdominal vifcera prefling more upon
the diaphragm, we cannot infpire with the fame eafe as
when we fit up or lie on one fide. Further, in that fitua-
tion of the body the food feems to lie heavier on the fto-
mach, and wind in it does not feparate fo readily by the
cefophagus and pylorus as in an ereft pofture, when thefe
orifices are higher than the other parts of the ftomach.
The nightmare occurs in the time of fleep, becaufe the
ftrange ideas excited in the mind, in confequence ofthe
difordered feelings of the ftomach, are not then correfited
by the external fenfes as they are when w'e are awake ; nor
do we, by an increafed refpiration or other motions of
the body, endeavour to (bake off any beginning uneafy
fenfation about the ftomach or breaft. The incubus ge¬
nerally occurs in thefirft fleep, and feldom towards mor¬
ning, becaufe at the earlier period the ftomach is more
loaded with food, and thatin a more crudeand indigefted
ftate than in the morning. A lefs degree, amounting
only to frightful dreams, is almoft a conftant concomi¬
tant of overloaded ftomach in fome habits; and requires
the fame treatment as Dyfpepfia, which fee.

Genus V. Sternalgia, [from npvov, the breaft-bone, and
pain.] Violent pain about the fternum, extending
towards the arms ; anxiety, difficulty of breathing, and
fenfe of fuftocation. (Angina pe&oris, Iieberden and

Cullen.) Our nofologifts have given us two fpecies ; but
we are notfatisfied with their reafons for the diftinftion.
They are,

1. Sternalgia ambulantium, (Afthma artliriticum,
Schmidt. Diaphragmatic gout, Butler.) Supervening
fuddenly during exercife ; with tendency to fyncope ;
relieved by reft.

2. Sternalgia chronica. (Orthopnoea cardiaca, Sa ire.
Syncope anginofa, Duncan and Barry.) The paroxyfms
lefs violent, but of longer continuance; recurring fre¬
quently with great palpitation of the heart, excited by
flight, and often unknown, caufes ; and not relieved by
reft.

This dreadful diforder is found to attack men much
more frequently than women, particularly thofe who
have fliort necks, and are plethoric or corpulent. Al¬
though it is fometimes met with in perfons under the
age of twenty, it more frequently occurs in thofe who
are between forty and fifty. In flight cafes, and in the
firlt ftage of the diforder, the fit comes on by going up¬
hill, up-ftairs, or by walking at a quick pace after a
hearty meal; but as the difeafe advances, or becomes
more violent, the paroxyfms are eafily excited by paflions
of the mind ; by exercife even of the moderate kind ; by
fneezing, coughing, or {training at {tool. In fome cafes,
the patient is attacked whilft fitting or (landing, without
any previous exertion or obvious caufe. On a fudden,
he is feized with an acute pain or tightnefs at the extre¬
mity ofthe fternum, inclining to the left fide, and ex¬
tending up into the arm, as far as the infertion of the
deltoid mufcle, accompanied by a fenfe of fuftocation,
great anxiety, and a dreadful conviction of the fatal
tendency of this malady. This commonly continues for
the (pace of an hour.

In the firft ftage of the difeafe, the uneafy fenfation at
the end of the fternum, with the other unpleafant fymp¬
toms, which feemed to threaten a fufpenfion of life by a
perfeverance in exertion, ufually go off7 upon the perfon's
(landing (till, or turning from the wind. Dr. Parry
dates, that bending the body in fome cafes increafes the
pain ; and therefore the patient draws himfelf up ftraight,
with the head fomewhat bent backwards.

In a more advanced ftage, the paroxyfms do not fo
readily recede, and are much more violent. During the
fit, the pulfe finks in a greater or lefs degree, and be¬
comes irregular ; the face and extremities are pale, and
bathed in a cold fweat ; and, for a while, the patient is
perhaps deprived of the powers of fenfe and voluntary
motion. People affeCted with this complaint often die
fuddenly, but fome continue fubjeCt to it for upwards of
twenty years.

The caufe of this diftrefling malady is not clearly un-
derftood ; it was formerly fuppofed to be either a fpaf-
modic affeCtion, or a caries of the fternum; after this, Dr.
Parry dated that it was an oflification of the coronary ar¬
teries which fupply the mufcular fubftance of the heart
with blood. This change of (truCture mull certainly
render the heart unequal to the talk of circulating the
unufual quantity of blood thrown upon it by bodily ex¬
ertions or paflions of the mind; and, as the oflification
increafes, it muft at all times impede the circulation.
Dr. Parry fupports this notion by diffeCtions ; but it is
clear that Angina peCtoris often occurs and amends fpon-
taneoufly, or is removed by medicines ; a confummation
not poflible if the coronary arteries were oflified.

Dr. Reeder, in his work on the Difeafes of the Heart,
divides the caufes of Sternalgia into four claffes. i. An
oflified, or otherwife difeafed, ftate of the coronary arte¬
ries, whereby their calibre becomes much diminiflied ; or
an oflified condition of that portion of the aorta whereat
thefe veflels are given off-, fo as to.leffen the diameter of
their aortal orifices. 2. Oflification and enlargement of
the valves of the heart, and of thofe placed at the origin
of the aorta and pulmonary artery ; alfo morbid contrac¬
tion of the different apertures to which they are attached ;

3

P A T H O

and enlargement of the heart accompanying thefe morbid
Hates. 3. Aneurifm and edification of the thoracic por¬
tion of the aorta. 4. A difordered date of the chylopoietic
organs, more efpecially of the ftomach, producing indi-
gellion.

When Sternalgia arifes from organic derangement, it
admits only of palliation ; and, when fympathetic only,
the difeafe producing the fympathetic manifeftation
fhould be removed. On this account, to diftinguifh be¬
tween the two caufes is of the utmoft confequence. Dr.
Powell, in the Tranfaftions of the College of Phyficians,
thus details the diftingui filing, fymptoms : “ When a
patient complains of a flight difficulty in refpiration,
increafed by exercife, and aggravated by a recum¬
bent pofture ; if the pulfe does not beat with intermiffions,
and the feveral ftrokes are not unequal in force, although
the pulfations may be preternatural ly flow, or, on the
contrary, more than ufually quick, I know, from aftual
examination after death under thefe different circum-
ftances, that there fometimes is not any organic difeafe
in the thorax. If refpiration be uneafy, and the patient,
at firft experiencing fome difficulty in lying down, (hall
in a little while fo adjuft his pofition as to deep comfor¬
tably, I believe there cannot be any organic mifehief in
the thorax, although poflibly there may be effufion. If
the patient cannot fleep in a recumbent pofture, or, when
afleep, if, Aiding down gradually into his bed, he is fud-
denly awaked with a fenfe of fpafmodic ftri&ure and
ftrangulation, provided there hath not been previoufly
obferved an irregular and an intermittent pulfe, I fhould
fufpeft effufion within the cheft, rather than any difeafe
of ft ru flu re. And if, in addition to the above circum-
ftances, there fhould be anafarcous fwellings of the legs,
and the countenance fhould be bloated and purple-co¬
loured, the cheft is certainly labouring under an effufion
of fluid ; but even then it is not abfolutely clear that hy¬
drothorax is actually produced by mal- organization in
the thoracic vifeera.”

Dr. Hutchinfon, the late editor of the London Me¬
dical journal, has remarked the Angular and charaffer-
iftic fymptoms of fwelling of the throat, painful deglu¬
tition, and hoarfenefs, as attendant difeafes of the heart
which exhibit the form of Angina peftoris. None of the
diagnoftics are however infallible 5 and indeed the dif-
tindfion between nervous and organic difeafes of the
thorax is one of the greateft difficulties in the whole lift
of human maladies.

In the treatment of Angina, we have to confider its
palliation during the paroxyfm, and its effectual remo¬
val. Antifpafmodics are the ufual agents employed for
the former purpofe. Dr. Reeder, in his treatife quoted
before, objefts to the life of internal ftimuli, unlefs the
heart appear unable, after the lapfe of fome time, to re¬
gain its ufual adlion, when weak wine and water, a fmall
quantity of aether or fpirit of ammonia diluted, may be
given. Some patients experience immediate relief by
Itrong brandy and water. Should not thefe fucceed, we
fhould apply a blifter over the cardiac region, and im-
merfe the arm, when much affedled, in hot water, and
afterwards diredl it to be rubbed with fome ftiniulant and
anodyne liniment. Opium may be given with advantage
in a protrafted paroxyfm ; and this medicine, or the ex-
trafl of hyofeiamus, often prevents no&umal attacks,
when given at bed-time. Should the fyncope remain an
undue length of time, it will be neceffary to tranfmit elec¬
tric or galvanic ffiocks through the region of the heart,
and to inflate the lungs by proper bellows, fo as to elta-
blifti an artificial pulmonary and aortal circulation.

_ A few drops of hydrocyanic acid have been faid to re¬
lieve the paroxyfm of Sternalgia very rapidly. In the
intervals between the paroxylms, much may be effected
to prevent their acceflion, by the patient obferving pro¬
per rules with refpeft to exercife and diet, and by avoid¬
ing exciting caufes. Exercife, particularly on horfeback,
liquid not be had recourfe to when the ftomach is full.

You. XIX. No. 1297.

LOGY. 191

Dr. R. advifes his patients to drink water, and to eat
fparingly ; to keep the bowels open ; to regulate the
temperature of the body by clothing, and to avoid
heated rooms and an impure atmofphere. Occafional
plethora fhould be removed by bleeding in the recumbent
pofition, or by cupping ; and its recurrence prevented as
much as poffibie by the almoft exclufive ufe of farina¬
ceous food. I flues in the thighs or arms may be ufed,
as well as the tartrite of antimony, to excite a puftular
eruption ; but an occafional blifter will generally anfwer
every purpofe, with much lefs inconvenience to the pa¬
tient.

Genus VL Pteuralgia, [wAeup, the fide, and <*Ayo?,
pain.] Sharp pain, or ftitch, in the fide; difficulty of
breathing, without fever or inflammation j and thus dif-
tinguiflied from Pleuritis, or pleurify.

A ftitch or pain in the fide often occurs, independent¬
ly of any acute inflammation of the lungs, pleura, or con¬
tiguous organs, and it is generally increafed by the ac¬
tion of breathing. It has been often denominated a
falfe or fpurious pleurify. The pain, however, is feldom
feated in the membrane called the pleura, but often in
the mufcles of the cheft, fometimes in the other membra¬
nous parts ; and it may arife from rheumatifm affecting
thofe parts, from fpafm or cramp, from a plethoric con¬
dition, or from a nervous and hyfterical ftate, in which
the circulation is languid and irregular : it may alfo be
connected with a gouty, fiphilitic, or fcorbutic, habit.
Sauvages has diftributed the PI eurodyne (his name for
this genus) into eighteen fpecies, according to itsorigin
from one or other of thefe caufes. But Dr. Good gives
us only two fpecies.

1. Pleuralgia acuta: fudden and temporary; fuper-
vening on mufcular exercife; relieved by preffure.

2. Chronica: permanent: augmented by preffure 5 in¬
ability of lying on the tide affedted.

The firft fpecies found alio frequently as a fymptom in
flatulence, hyfteria, and hypochondriafts. The fecond in
plethora, worms, fiphilis, phthifis, rickets, catarrh, and
rheumatifm. See Pleuritis.

Class III. HAEMATIC A, [from the Gr. «-i blood.]
Diseases of the Sanguineous Function.

The chief modes in which the fanguineous fyftem is
influenced in difeafe is in regard to the ftate of the con¬
tained fluid on the one hand, or the ftate of the con¬
taining veflfels on the other. The confideration of the
firft occupied, as is well known, for a long time, the
medical world ; and the inoft famous hypothefes of the
feventeenth and early part of the eighteenth centuries
were founded on fuppofed chemical changes in the blood
during difeafed ftates. (See the hiftorical feftion of this
article, p. 13' — 16.) At prefent, though it is acknow¬
ledged that the contained fluids vary much as to their
nature in different perfons and difeafes, and that the in¬
troduction of foreign bodies in an unajfimilated ftate is
followed by. violent fymptoms, yet we have alfo afeer-
tained that the conftitution accommodates itfelf in a
great degree to thofe infeniible changes which unufual
food or indigeftion produces, and that the blood exhibits
a variety in the proportion of its conftituent parts even
in healthy individuals. There can be no doubt that a ge¬
neral bad ftate of the fluid of the body exifts in fome
difeafes ; and thefe are neceflarily accompanied with
alteration in the contraftile power of the blood-veffels.
Of the nature, however, of this morbid alteration of the
blood, we know fcarcejy any thing. We ftiall mention
the fcaqty flock of fads we are furniffied with on this
fubjefit when treating of the laft order of this clafs,
Dyjpeptica, or Cachexies.

The quantity of the blood in the animal frame varies
in moft difeafes, and often without our being able to
trace any very manifeft caufes. of this Variation. Some
3 D diftinguilhed

PATHOLOGY.

192

diftinguiflied authors have adduced the faCtof general inor¬
dinate habits of eating as an explanation of the frequency
of plethora; but as, from the fails we have noticed under
Dyfpepfm it is clear that gluttony mud lead for the moll
part to indigeftion, and that to deficient nutrition we
fhould be tempted to look for the caufe of this Hate. In
the general diminution of fecretion, and in fail in fevers
where this diminution is very apparent, a full Hate of
the blood-veli'els is the moft formidable fymptom, and
one which the moll copious abftraCtion of blood in many
cafes fcarcely abates.

The plethoric Hate may (though it rarely does) exilt
in the fame degree in the fanguineous fyftem generally ;
or it may be exceffive in all parts, but much more fo in
one or more peculiar ftruCtures ; or, which is more com¬
mon, it may be exceflive in one part, and deficient in the
reft. Under each of thefe circumllances, the blood-vef-
fels are dillurbed in their functions; which brings us
to the confideration of thefe latter parts.

At page 28, we have detailed briefly the agents of the
circulation, and have not hefitated to mention the con¬
tractility of arteries as one of them. In doing this,
however, we were perfectly aware, that we were oppofed
by the opinions and experiments of fome of our bell
pathologills ; yet, on the other handymen of equal ta¬
lent, and the authors of experiments apparently con¬
ducted with equal precifion, fcrongly corroborate our
view of the queltion. For our own parts, we pay little
deference to thefe experiments which, from their very
nature, can never be conclulive. Whoever will take the
trouble to read over with attention the numerous hifto-
ries of experiments detailed by Dr. Haltings, the lad au¬
thor who has performed experiments on this fubjeCl, will
concur with us in this opinion. They will find, that in
fome experiments the dilatation and contraction was not
manifeft at all; in others, not for fome time; and in
others immediately and unequivocally. Indeed we
fhould naturally expeCt that thefe circumllances would
occur to parts llimulated by unnatural means; and de¬
prived no doubt of much of the fluid of the vafa vacofum
by the difleCtion necefl'ary for their expolure.

We think, however, that this matter may be more fa-
tisfaCtorily fettled by analogical reafoning than by the
evidence of the fenfes, when that evidence produces
fuch various appearances. By thofe who fuppofe that
arteries aid the motion of the blood, it has been afierted,
that the heart cannot propel that fluid through the round
of the circulation ; but this afl'ertion has neither been
proved nor difproved. One party fays that the heart has
this power, for this reafon ; it is not required to drive
the blood through the whole of the arterial and venous
fyftems, fince an impreflion on the aorta by means of
the left ventricle (the column ofblood being continuous)
mult immediately, and without the hindrance of friction,
be tranfmitted to that portion which the venous fyltem
is pouring into the oppolite fide of the heart. But it is
certain that this continuous column is liable to much
variation; and hence it would feem more probable that
the arteries lent fome aflillance to the heart. That the
arteries have this power in fome animals is demonllrated,
becaufe they have no heart ; and, though Dr. Parry may
fay, that “ if the circulation is carried on by any central
force of whatever defcription, the apparatus in which
that force refides is to all intents and purpofes a heart
he mull in this cafe lhow how the ftruCture in queltion
differs from arteries in common ; and that it does differ,
the refearches of the accurate Sir Everard Home feein
to deny. It might appear, that the dependence fome
arteries have on the nervous fyftem, and that exclufively
of the heart, was a ftrong argument in favour of the con¬
tractility of thefe veflels; but thofe who difcredit the
exiltence of this property aflert, that this independent
aCtion of the artery arifes from the debility of its pa-
rietes, which gives way to the impulfe of the heart, and
admits a greater flow of blood ; this debility exprefling,

according to them, a lofs of tonicity, or that degree of
contraction which an artery is at all times exerting on
its contents.

WTe cannot help thinking that the truth of this refo-
lutely-contefted point lies between. For, upon examin¬
ing the probable aCtion of tonicity, little difference will
be feen between it and the phenomena of contractility.
We mult remark, that tonicity is uled by one party to
denominate a perpetual tendency to diminilh the calibre
of the artery: contractility is ufed by the other left to
defignate alternate contractions followed by aClive di¬
latation. ACtive dilatation is by no means probable,
fince it is unlike the phenomena we obferve in other con¬
tractile ItruCtures of the body; fo that this mult be con-
fidered the refult of the heart’s aCtion. But, with regard
to the tonicity which Parry and others allow to arteries,
they lay, that this is not the “ contraCtilite par defaut
d’extenfion” of Bichat, but a vital power. If fo, is it
too much to aflert that a vital contraCtile (truCture, which
is expanded, will recover a fmaller calibre than it had
originally ? To exemplify this, we fuppofe the fize of an
artery equal to 3, and that the impulle of blood injeCted
into it ltretches it to 4.. It may be inferred from the
known power of contracting fibres in other parts of the
body, that, the prelfure being removed, it will reduce its
circumference to (fay) 2^ : and this overcomes another
objection that has been made to fuppofing the contrac¬
tion and dilatation of arteries ; viz. that this dilatation
might impede as much as accelerate the progrefs of the
blood, fince it might exilt over the whole arterial fyftem
juft at the time the left ventricle contracted. But, if
the contraction be brought about in the manner we have
Hated, it mult of courfe obferve the lame time in its con¬
traction as the heart itfelf, and confequently may mate¬
rially aflilt the circulation.

We fhall alfume, therefore, in our (peculations on the
Haematics, the contractility of arteries, ufing this term
with the reftriCtion before Hated. We have before faid,
that at the extreme branches of the arteries a motion is
derived from a capillary attraction exilting between thefe
veflels and the blood. This of courfe is no explanation,
becaufe we do not know any thing about capillary at¬
traction. It may be ufed, however, to denote that the
firme law governs the motions of the blood in thefe
living tubes (to a degree) as in inanimate veflels. A
motive power is again to be found in the fecernent fyl¬
tem : and here the data of reafoning become fewer than
thofe on which it is founded, even with regard to the
capillary arteries ; and we can only conjecture, plaufibly,
that an attraction exifts between certain parts only of
the blood and the Tides of the veflels ; and that the ad¬
dition of a fomething from the nerves is necefl’ary to
change thefe parts of elements to the form they exhibit
on fecreting furfaces, or outlets. Thepaflage of fluids
in the larger abforbents, and in veins, we have before no¬
ticed. It was necefl'ary to recapitulate thefe circumftan-
ces, that the whole of them might be borne in mind
while treating of the difeafes of this fyftem.

With regard to difeafes from quantity of blood, it is
to be noticed, that an increafe in the mafs of blood fel-
dom exifts unaccompanied by an increafe of the aCtion
of the heart ; when this does occur, the blood, although
its quantity is increafed, will have its rate of motion di-
miniflied. In fuch a cafe, the fmaller arteries, in which,
as before ftated, the contractility is greater, in proportion
to the fize of the veflel, than it is in the larger arteries,
will, from the want of dilatation by means of the heart’s
contraction, leflen their fphere of contraction, fo that an
increafed proportion of the general mafs of blood will
be contained in the larger arterial trunks, in the veins,
and in the cavities of the heart. The whole round of
the circulation will be obftruCted. The aCtion of the
heart will confift of flow feeble contractions, or of inef¬
fectual flutterings. The pulmonic procefs will be imper¬
fectly performed: hence refpiration will be laborious and

hurried.

4

PATHOLOGY.

hurried, the colour of the blood will be changed, and
temperature diminiffed.

From the circulation of this blood of unnatural qua¬
lity, diforder of the .whole of the nervous fyftem, and
hence of every function in the body, may enfue. If the
mafs of blood be increafed, and if the aftion of the heart
be alfo increafed, fo as to propel the greater mafs with
freedom; in fuch a cafe, the contractility of the fmaller
arteries being more powerfully oppofed, thefe veflels will
yield more readily to the current of the blood; they will
therefore receive a greater quantity of that fluid, and
confequently an increafed quantity' mull pafs by their
termination. The quantity of fecreted and of exhaled
fluids will be increafed ; the blood will flow with greater
force, and in. greater quantity, throughout the whole
round of the circulation. As an increafed quantity of
blood will pafs, in a given time, through the pulmonic
circuit, refpiration mu ft be more quickly performed,
otherwife’that fluid will not duly undergo the pulmonic
procefs. The fenfibiiity of the nervous fyftem may be in¬
creafed, and the functions of that fyftem may be more
freely performed. Hence all the functions dependent on
nervous influence will be exalted.

The diminution of quantity in the blood generally
manifefts itfelf by the want of aftion in the nervous fyf¬
tem, and hence of ail the Accretions. But this ftate is
not likely to laft long; and indeed generally remedies it¬
felf, except when the affimilating organs of the body are
difeafed.

Faffing over thefe plethoric ftates, we come to the con-
fideration of an alteration in the contraftility of the
blood-veffels, or of the common malady called inflam¬
mation.

When a violent blow is given to an external part of the
body, the four following circumftances are after a time
obfervable ; viz. rednefs, tumefaftion, pain, and heat.
Prefently a- throbbing is felt in the arteries going to
the part, and a difturbance takes place in the vafcular and
nervous fyftem, concifely called fever, and a change in
the quality of the blood. To account for thefe fimple
appearances has puzzled the medical philofophers of
every age, and it puzzles them fill!. In our Introduction
we have noticed the wild fpeculations of the earlier phy-
flcians. Faffing over Boerhaave’s notion, that vifcidity
of blood was the caufe of inflammation, and that of Cullen,
which, like this theory of fever, refts on the affumption
of a fpafm of the extreme arteries, we proceed to notice
the celebrated opinions of Mr. John Hunter. According
to him, inflammation is to be conlidered only as a difturbed
ftate of parts, which requires a new but falutary mode
of aftion to reftore them to that ftate wherein a natural
mode of aftion alone is neceflary. From fuch a view of
the fubjeft, therefore, inflammation in itfelf is not to
be conlidered as a difeafe, but as a falutary operation,
confequent either to fome violence or to fome difeafe-
Effewhere the author remarks, the aft of inflammation is
to be conlidered as an increafed aftion of the veflels,
which, at fir ft, confifts limply in an increafe or diftention
beyond their natural lize. This increafe feems to depend
upon a diminution of the mufcular power of the velfels,
at the fame time that the elaftic power of the artery mult
be dilated in the fame proportion. Owing to this dilata¬
tion, there is a greater quantity of blood circulating in
the part, which is according to the common rules of the
animal economy : for, whenever a part has more to do
than Amply to lupport itfelf, the blood is there collected
in larger quantity. The /welling is produced by an ex-
travafation of coagulable lymph, with fome ferum ; but
this lymph differs from the common lymph, in confe-
quence of palling through inflamed veflels ; it is this
lymph which becomes the uniting medium of inflamed
parts ; veflels Iboot into it, and it has even the power of
becoming vafcular itfelf. The pain proceeds from fpafm.
The rednefs is produced either by the arteries being more
dilated than the veins, or becaufe the blood is not

193

changed in the veins. When, after an ibjury, a part
cannot be reftored to health by inflammation alone, or by
adhefion, then fuppuration, as a preparatory ftep to the
formation of granulations, and the confequent reftora-
tion of the part, takes place. The veflels are nearly in
the fame ftate as in inflammation ; but they are more
quiefcent, and have acquired a new mode of aftion. See
Hunter on the Blood, Inflammation, &c.

That the capillaries are diftended in inflammation is
pretty generally agreed ; and, this allowed, we clearly ex¬
plain the increafed fize of the part, without admitting
that lymph is extravafated, a faft of which we have no
proof.

We have not fpace to enter at full into the proofs of
the diftended ftate of the capillaries. There is lefs dif-
cuffion required about this diftention, however, than it
has been the falhion to enter into ; for it is vifible to the
naked eye, and is (till more clearly ihown by the micro-
fcope. The independence of this diftention on the
heart is alfo pretty clearly eftabliffied ; for we obferve
bluffing from fliame or ire, and a rednefs in various
parts of the body, without general accelerated pulfe.
But, though the diftention of the capillaries in inflam¬
mation is pretty generally allowed, pathologifts are by
no means agreed as to the rate of motion which the
blood undergoes in them ; fome, as Wilfon, aflerting
that the velocity of the blood through an inflamed part
is diminiffed ; others ftating that it is increafed. Dr.
Parry fliows very clearly, that this is of little confequence
to our fpeculations on this fubjeft; but properly remarks,
that, if the velocity be diminiffed, yet, the quantity be¬
ing increafed, the momentum mult ftiii be greater than
ordinary. Again ; a queftion arifes, whether the arte¬
ries retain during inflammation the alternately-con trail¬
ing force which we have affigned to them in health, or
whether this power is loft. The proofs of the firft alter¬
native reft on what is obferved by means of the micro-
fcope on the tranfparent parts of cold-blooded animals;
as, for inftance, on the web of a frog’s foot. It is- there
feen, that, on the application of ftimuli to a certain de¬
gree of force and for a certain time, a permanent or un¬
varying dilatation of the capillaries fupervenes, and the
blood feems to move (lowly. This obfervation is not
worth much, however, becaufe even the alternate con¬
tractions of the capillaries are not vifible in the fituation
above mentioned, on account of the fmall fize of the
veffel . We may adduce a pathological obfervation more
ftrongly corroborative of the inert dilatation of the capil¬
laries in inflammation ; which is, that, whereas the ex-
hauftion of the contents of arteries (not having been
thus aft'efted) is met with almoft invariably, inflamed ar¬
teries are not exhaufted of their blood.

The pain in inflammation is not eafily accounted for.
That the fenfibiiity of the nerves is much increafed is
evident from the extreme uneafinefs which ordinary im-
preffions produce on them when in a ftate of inflamma¬
tion ; but we are ignorant by what means this pain is
produced-; It has been attributed to the preffure of the
diftended capillaries ; and this appears plaufible at firft
view ; Lut the idea is oppofed by the fails, that many
parts fuffer diftention of their capillary veflels without
pain occurring ; and that the -pain is often mod fevere
before this diftention begins ; as for inftance, after a blow,
or in the cafe of gout, in which difeafe, as is well known,
the coming-on of rednefs and fwelling often relieves the
excruciating pain of the firft attack; fo that we are com¬
pelled to ftate increafed fenfibiiity as one of the eflential
circumftances of inflammation, but we cannot trace the
caufe of its produftion. The increafed warmth of the
part has been fuppofed to depend upon the prefence of
an increafed quantity of blood. But, as the extrication
of heat is a procefs which is dependent upon the ner¬
vous fyftem, and confequently influenced by altered con¬
ditions of that fyftem, the increafed warmth, and the in¬
creafed evolution of heat, which accompany inflamma¬
tion,

194

P A T H O

tion, may be chiefly attributed to the irritated ftate of
the nerves. And accordingly we find, as Mr. Hunter’s
well-known experiments teftify, that the heat of inter¬
nal parts (to which the office of extricating heat does not
belong) have not their temperature increafed during in¬
flammation. It is worthy of remark, that the real in-
creafe of heat in the inflamed part is not fo great as the
feelings of the fuft'erer might lead us to fuppofe, the
thermometer feldom indicating very remarkable changes
in this refpeft. To the irritated ftate of the nerves we
muff: therefore look for this fenfation of exalted tempe¬
rature.

Mr. Hunter’s account of the rednefs of the part feems
very probable, efpecially if we add to what he has (aid
on the fubjeft, that the total want of fecretion muff pre¬
vent the chemical change on which the darkened colour
depends. It appears then, that the tw'o dates of exalted
fenfibility of nerves on the one hand, and plethora of the
capillary veflels on the other, account for the four firft
phenomena of inflammation ; and it would perhaps pre-
ferve us from much obfcurity in our fpeculations, if we
afiumed the exiftence of thefe ftates without endeavour¬
ing to penetrate into the mode of their production.

The two ftates of altered nervous fenfibility and al¬
tered mufcular or vafcular contraftility, are capable of
feparate exiftence. Plethora is well known to produce
fometimes no pain ; and the mod excruciating pain, as
for inftance in tic doulereux, is often unaccompanied by
inflammation. In the majority of cafes, however, thefe
ftates feem to follow each other. The obftruftion of the
circulation in a limb caufes pain and inflammation ; and
impreflions w hich can only aft through the medium of
the nerves caufe the fame aftion.

The primary impreflions which diforder the properties
of an artery, mud occur through the medium of the
nerves, or of the contained blood. From what we
obferve of the effefts of an undue degree of nervous
influence being tranfmitted to one part, as in cafes of
fatigue, &c. we are led to infer, that the exceflive
tranfmifiion of nervous power brings on two kinds of
alteration in the contraftility of an artery. It may pro¬
duce increafed contraftion; and this will furely be fol¬
lowed by fuch a diminution of that force as accords with
this remarkable and well-known law obferved in con-
traftile fibres over the whole body; that they, having
exerted their funftion beyond a certain point, lofe their
contraftility for a given time. Again ; the nature of the
nervous impreftion may be fuch as to weaken or direftly
impair the contraftility of the veil'd, and thus diftention
of the arteries may occur without any previous contrac¬
tion.

The alterations induced by the bad quality of the
blood will be of the fame two kinds; a direft diminution
or direft increafe of the contraftility of the veil'd ; the
former being lefs uniformly followed by the latter ftate
than when it arifes from nervous influence. Thefe fafts
form the bafis of our theory.

It muft not be forgotten, that this reafoning with re¬
gard to the ftate of veflels in inflammation has been
thought to be overthrown by fome, becaufe it is inade¬
quate to explain the various appearances and produfts ;
as of inflammation, the different cutaneous phlogofes,
eryfipelas, terminations in gangrene, ulceration, &c.
And thefe authors have talked of various kinds of inflam¬
mation ; as that arifing from different morbid poifons,
See. To this we reply, that we do not take inflammation
in this wide fenfe : all we know of the funftion of the
vafcular fyftem of red blood demonftrates that this (yf-
tem is capable only of a change of the contraftility of
its veflels ; and no diminution or increafe (and diminu¬
tion or increafe are the only changes in contraftility of
which we can form any clear notion) will account for a
variety in the appearance of inflammation. We muft
therefore look to the fecernent fyftem for the various
forms of inflammation ; and, though the little we know

LOGY.

of thefe veflels keeps us ftill much in the dark on the
fubjeft, yet the phenomena in queftion admit of our
forming plaufible and general deduftions from the in¬
ferred properties of the white veflels. Indeed the effefts
of inflammation depend much upon the nature of the
fecretion carried on in particular parts. Thus, when
inflammation is feated in a mucous furface, (i. e. on a
furface poflefling veflels which fecrete and pour out mu¬
cus,) an increafed quantity of mucous fluid will be
poured out. When a furface upon which exhalants open
(or, in other words, a ferous furface) is the feat of in¬
flammation, that ftate is, in many inftances, followed by
increafed flow from thofe veflels. The irritated (fate of
the nerves alone would difpofe the exhalants to give
paflage to an increafed quantity of fluid ; and the lame
eft'eft might refult from Ample plethora. There are
other fluids which are the produfts of fuch veflels as are
fituated in an inflamed part. As the blood furnilhes the
materials for all fuch fluids, fo will the plethoric ftate of
the blood-vefi’els, during inflammation, furnifn an in¬
creafed quantity of thofe materials, while the feparation
of them from the blood is influenced, or produced, by
the ftate of the nerves. In each of thefe cafes, we have
ftrong evidence that the fecernents are the parts pecu-
liarly affefted, while the ftate of the capillaries is the
fame; fo that we may conclude, that inflammation is in
all parts and ftruftures the fame; i. e. a dilatation of
the capillaries, while its various appearances arife from
the changes which the fecernents undergo, whether that
change be in the pouring- forth of unnatural produfts,
or aflimilating and retaining thofe produfts in their cavi¬
ties. In other words, that variety of fecretions is the
concomitant, not the eflential, circumftance of inflamma¬
tion. The fame notion may be extended to furfaces in
which fecretions are not poured out, but depofited in the
cellular fubftance ; as eryfipelas, and various unbroken
cutaneous defcedations.

We have laid, that diftended capillaries and the ex¬
treme fenfibility of nerves account for the four local
phenomena of inflammation — heat, rednefs, fwelling,and
pain. We muft not forget to mention, that the diften¬
tion of the capillaries is, as Dr. Haftings has (liown, ge¬
nerally preceded by increafed aftion or excitement, in
which the veflels are fmaller, and contraft probably with
greater frequency. This is fo clearly proved by Dr. H.
that we (hall not relate his experiments or repeat his ob-
fervations, but refer the reader to the feries of experi¬
ments which he has publilhed (on bronchitis) ; the fa ft:
is of importance, lince it (hows that excitement, which
we have been wont toconfider a minor fpecies of inflam¬
mation, is really an oppofite procefs.

The difcufilon of the general phenomena of inflamma¬
tion, fever, and the huffy appearance of the blood, re¬
quires us to (how in wdiat the ftate denominated Jeter
confifts, how it is connefted with local inflammation, and
how a general change in the quality of the circulating
fluids arifes, from the local inflammation or from the
general difturbance.

With regard to the altered quality of the blood, this
fluid, taken from a patient labouring under inflammation,
exhibits peculiar appearances. The blood, when it has
efcaped out of the living veflels, fpontaneoufly feparates
into two diftinft parts, the ferum and the craffamentum.
The laft is a compound fubftance, confifting chiefly of
coagulating lymph and red globules, the molt heavy in¬
gredients in the blood. Now it is to be obferved, that
blood taken away from perfons affefted with inflamma¬
tion, is longer in coagulating, and coagulates more firm¬
ly, than when drawn from people in other circumftances :
hence the red globules, which are very heavy, not being
fo foon entangled in the lymph, defcend by their gravity’
more deeply from its furface, which, being in this man¬
ner more or lefs divefted of the red colouring matter, is,
from its appearance, termed the huffy coat , or inflammatory
cruft , The firmer and more compaft coagulation of the,

lymph

195

PATHOLOGY.

lymph comprefles out an unufu.il quantity of ferum
from it, and the furface of the Jizy blood, as it is fre¬
quently called, is often formed into a hollow, the edges
being drawn inwards. Thefe changes in the blood are,
in fome cafes, a more infallible proof of the exiftence of
inflammation than the pulfe itfelf. In peritoneal inflam¬
mation, the patient fometimes fee ms to be in the mod
feeble (late, and the pulfe, abftraftedly confidered, would
rather induce the pra&itioner to employ tonics and fti-
tnulants than evacuations ; but, ftiould the continuance
or exafperation of the diforder, or any other reafon, lead
the furgeon to ule the lancet, then the huffy coat, the con¬
cave jurfuce of the blood, and the large quantity of J'erum,
clear away all doubt concerning the exiftence of inflam¬
mation. It is important, therefore, always to infpeft the
blood after it is cooled, with a view to the detection of
this unnatural ftate. But every pra&itioner ought to
hear in mind, that, in pregnant women, and in a few
anomalous conftitutions, the blood, taken away by the
lancet, always exhibits the foregoing peculiarities, though
inflammation may not prevail.

The above alteration in the quality of the blood has
never been accounted for. As it is only obfervable in
conftitutions where fome fource of nervous irritation is
prefent, we fliould be inclined to refer its appearance to
that irritation. We fliall hereafter have occafion to (how
how important a part nervous excitement plays in deve¬
loping the phenomena of fever; and it is to be remarked,
that, while inflammation is merely local, no change
takes place in the ftate of blood in general ; but no
l'ooner has fever become eftablilhed, than the blood exhi¬
bits the buffy coat. Now, in the inftance of pregnancy,
it will be allowed on all hands, that the gravid uterus is
a perpetual fource of nervous irritation to molt females;
and it has been remarked, that thofe anomalous confti¬
tutions in whom this appearance has been always met
with have been perfons who exhibited excefllve fenfibility
in the nervous fyftem, or were, in other words, of the
nervous temperament.

' The aftion of the nervous fyftem may produce this
change in the blood by the difproportionate evacuation
of the elements of the blood, as in excefllve fecretion,
or by the undue retention of fome of thefe parts ; both
of thefe difturbances being of courfe effected by the ac¬
tion of the nerves on the l’ecreting veffels. The prefent
ftate of our knowledge does not permit us, however, to
(how in what ftruftures this conjectured deprivation or re¬
tention is effefted.

In confidering the next general fymptom of inflamma¬
tion, fever, we fliall enter into a full account of the febrile
ftate, both idiopathic and arifing from this a£tion, or, as
it is termed by furgeons, fymptomatic fever. We have
gone fo far into the fubje<5t of inflammation, becaufe it
was neceflary to the right underftanding of the febrile
phenomena we have next to explain. Thefe general
views having been taken, we fliall trace the various forms
inflammation exhibits in the different ftrudlures, and the
different changes in fecretion which accompany it, when
('peaking of Phlogotica, the fecond order of this clafs.

It is generally allowed that no general definition of
fever, capable of embracing all its varieties, has been
given. A general alteration is found in the organic,
oftentimes in the animal, funftions, the former fuffering
the firft changes. The fanguineous and mufcular fyf-
tems are aifo altered ; and, when the difeafe is eftablifhed,
all the functions feetn impeded together. This ftatement,
that fever confifts in an alteration folely of almoft all the
fun&ions of the body, is, it mull be confefled, extremely
vague; yet it is the only one which will embrace all the
varieties of fever; for cafes are recorded where the heat
was not exalted without the pulfe being fenfibly aug¬
mented, and vice-verfa ; and fo on of every other func¬
tion.

VOL. XIX. No. i*9 7.

Order I. Pyrectica, [wvpelos, Gr. from wup, fire.] Fevers.

Here we have the heat and number of the pulfe preter-
naturally augmented; ufually preceded by rigor, and
followed by perforation ; pains fixed and wandering;
laflitude, debility of mind and of the voluntary mulcles.

In our introduction we have mentioned fome of the
snoft remarkable opinions as to the effential nature of fe¬
ver. The fpeculations of Brown and Darwin were no¬
ticed 1 and many havearifen fince; but there are few which
we now deem worth detailing. The firft which, from the
ftrong faffs by which it is fupported, is deferving of no-
tice, is the theory of Dr. Clutterbuck. We fliall copy
from the article Fever of Dr. Rees’s Cyclopaedia, Dr.
Bateman’s (this gentleman being underftood to be the
writer of that article) expofition of Dr. Clutterbuck’s
theory, and his luminous objections ; referving our own
remarks for the end of it.

Dr. Clutterbuck’’ s Theory. — Fever has ufually been called
a general difeafe, affefling all the functions, in contra-
diltinCtion from local difeafes, in which fome particular
organ is the primary feat of the diforder, and the affec¬
tions of the other functions are fecondary or fymptom¬
atic. But Dr. Clutterbuck denies the exiftence of ge¬
neral difeafe, and maintains that all general or extenfive
derangement of the animal fyftem is referrible to local
derangement in fome one organ. The organ univerfally
affeCted in all the varieties of idiopathic fever; which
differ but in degree, as well as in thofe which arife from
fpecific contagion, as malignant fore throat, fcarlet fe¬
ver, fmall pox, See. is, in the author’s opinion, the brain .
This is manifeft, he contends, from the fymptoms, as
the head-ache, the depreflion of ftrength, and other de¬
rangement of the animal functions, the delirium, the
tremors, failure of vifion, See. It is manifeft from the
nature of the remote caufes which 'aft chiefly on the
brain and nervous fyftem, as intoxication, fear, grief, and
other paffions, external irritation, not to mention nmf-
mata and contagion, of the operation of which we are
ignorant; as well as from the predifpofing caufes, which
probably confift in a deficiency of fenfibility, as in idiots,
negroes, old people, and infants’, but it is more particu¬
larly manifeft from the confequences of fever, whether
after recovery, or after death, afeertained in the latter
cafe by diffeCrion. Among the confequences of fever,
which are not uncommon after recovery, are an impaired
condition of the fenfes 5 fuch as deafnefs, imperfeCt vi¬
fion, depraved tafte ; paralytic affeClions, or convulfive
complaints, as epilepfy and chorea ; derangement or lofs
of the mental powers, fuch as melancholy, great irrita¬
bility of mind, lofs of memory, or even complete fatuity.
The confequences obferved on difleflion, after death
occafioned by fever, are frequently vifible difeafe of the
brain, of which feveral examples are quoted by the au¬
thor. He then proceeds to (how, that the local affection
of the brain, thus manifeft, is in fafl inflammation of that
organ ; or that fever, therefore, “ is nothing lefs than a
fpecies of phrenitis, or topical inflammation of the
brain,” and (hould be arranged in the order of Phlegma-
fia, with pleurify, enteritis, and other fymptomatic fevers:
but, as Phrenitis has been generally applied to a particu¬
lar form of inflammation of the brain, and implies deli¬
rium, which does not always occur in fever, although
it is a frequent fymptom. Dr. Clutterbuck propofes the
term Encephalitis as the denomination for fever. The
arguments adduced in proof of the notion that the topi¬
cal affedlion of the brain, in fever, is inflammation, are,
1. The analogy between the fymptoms of fever and thofe
of inflammation, viz. pain, heat, throbbing, acute fenfi¬
bility, &c. being common to both. a. The occafional
buff of the blood in both. 3. The fimilarity of feveral
of the exciting caufes of both. 4. The occafional alter¬
nation of fever with inflammation. 5. The analogy in
regard to the cure of the two difeafes generally, as by
means of blood-letting, vomiting, fweating, purging,
bli lie ring, and the application of cold. 6. The fymptoms
3 E ©f

196 PATHOLOG Y.

V.

of fever not being diftinguifhable, on the whole, from
rbofe which belong to phrenitis, as defcribed by authors.
7. That the morbid condition of the brain, difcovered
by difledtion, is fuch as implied previous inflammation.

“ In the firft place,” fays Dr. Bateman, “ Dr. Clutter-
buck, like other theorifts enamoured of a favourite doc¬
trine, appears to have laid too great itrefs upon thofe
phenomena which fupport that dodtrine, and to have
conceded lefs to oppofing fadts than they are entitled to
claim. Hence, in retracing the delineations of fever, in
the words of the mod creditable writers, he has diftin-
guiftied by italics all thofe flgns which indicate derange¬
ment of the encephalon, by which they are made to Hand
the molt prominent features in the pidt ure. Hence, alfo,
he has afiumed the pofition, that the derangements of
the natural and vital fundtions, which are nearly, if not
altogether, as univerfal concomitants of fever as the dif-
orders of the animal fundtions, are neverthelefs, in all
cafes, fecondary fymptoms, originating from the primary
affedtion of the brain. Thus the naufea, the vomiting,
the total lofs of appetite and of the digeftive power, are
believed to be always fympathetic of the affedtion of that
organ ; fo likewife is the quickened adlion of the heart
and arteries, and of the refpiration. That this, however,
is a gratuitous afl’umption, may be fhown, 1. By attending
to the very hiftories which Dr. Clutterbuck has quoted,
in which the occurrence of the deranged condition of
the ftomach is as conftantly mentioned as that of the
diforder of the encephalon. 2. By obferving, that the
fympathy between the brain and the ftomach is perfedtly
reciprocal; fo that the brain fuffers in fympathy with
the ftomach, not lefs manifeftly than the ftomach with
the brain. 3. .Byremarking, that the fymptoms of dif-
ordered ftomach are capable of being relieved or re¬
moved, while the fnfipofed caufe (affedtion of the brain)
remains; the thirft being allayed, and the ficknefs re¬
moved, by changing theftate of thefkin only, the former
by moiftening it with water, the latter by exciting fweat,
as obferved by Sydenham. Whence Drs. Cullen and
Darwin feem to be rather j u ftified in attributing the de¬
rangement of the ftomach, when it is affedled fecondarily,
more frequently to its fympathy with the ftateof thefkin
than of the brain.

“Farther, the connexion of many of the leading fymp¬
toms with fome diforder of the brain, or common fenfo-
rium, is admitted by all, and equally favours the hypo-
thefis of the other authors, as well as that of Dr. Clutter-
buck ; fince, whether the brain is primarily or feconda¬
rily affedled, certain phenomena in the nervous fyftem
mult neceffarily enfue. We have juft ftated fome rea-
lons for believing that it is often thus fecondarily affedt-
ed ; and it now remains to offer our reafons for fuppofing
that inflammation of the brain, when it does occur in
fever, (to which we cannot confider it as efl’ential,) is
commonly fecondary likewife.

“ The firft fymptoms of the affedtion of the brain are
by no means thofe which indicate inflammation or un-
ufual excitement of the fenforium; on the contrary,
they are fuch as indicate an oppofite Hate, which Dr.
Cuilen has termed atony and collapfe, and Dr. Darwin
torpor ; the head-ache itfelf, according to the obfervation
of Dr. Fordyce, is altogether diftindt from the head-ache
of inflammatory excitement, or of the hot ftage. Any
fymptoms that can be interpreted as indications of local
inflammations, fuch as rednefs of the eyes, protrufion of
the features, fluftied countenance, throbbing of the arte¬
ries, and even delirium, are theappearances belonging to
a fubfequent period of the fever. But at this fubfequent
period, inflammatory congcftions are liable to occur in
the other vifcera, if not fo frequently, at leaft not unfre-
quently; as in the ftomach, for example, the inteftines,
the lungs, and other organs. This fadt has been noticed
by many phyficians of accurate obfervation. Riverius
long ago remarked, that acute and malignant fevers
fcarcely ever occur unaccompanied by inflammation in

fome one of the vifcera; and he has ftated in another
place in molt diftindt terms, that wfe ought aftiduoufly to
recoiled!, that all thofe fevers, with which local inflam¬
mation is conjoined, are not fymptomatic, but often idio¬
pathic, and that the inflammation fupervenes, not being
the caufe but the confequence of the fever ; quafebrem
if am non effioit, Jed illi potius fuccedanea rjl. Thus, he
adds, ‘ We frequently obferve in pradtice, that patients
labour under continued fever for a day or two before
pain of the fide and other fymptoms of pleurify appear ;
thus alfo many perfons on the third or fourth day of fe¬
ver fall into inflammation of the brain, &c. Sic nobis
Jiequenter in vfu pradico vide. re licet agrotuntes, ab initio
Jebre continua laburantes per unam out alteram diem ante~
quam dolor lateris el alia pleuritidis Jigna appurcunt : J'tc
multi tertia v el quarta febris die in piirenitidem incidunt ,
Sj-c.' (River. Prax. Med. lib. xvii. cap. i.) Dr. Donald
Monro, vvhofe teftimony on fubjedts of morbid anatomy
is of conliderable weight with Dr. Clutterbuck, remarks,
when fpeaking of malignant fever, that ‘ this fever oc-
cafions in general more or lefs rednefs (I do not know
that we can properly call it true acute inflammation) of
the membranes ; and the febrile matter is apt to fall on
particular parts, and there to create abfcefles, particu¬
larly in the brain, the lungs, and the glandular organs."
(Treatife on Military Hofp. vol. i- p. 237. and Dr.
Clutterbuck’s Treatife, p. 172.) Obfervations to this ef-
fedt might beeafily multiplied, and we have already enu¬
merated feveral in a former part of this article. It is
fomewhat Angular, that Dr. Clutterbuck, who quotes
the remark of Dr. Monro, fhould deem it favourable to
his hypothefis of excluiive inflammation of the brain ;
flnce it obvioufly proves an equal liability to inflamma¬
tion in other organs, if it proves any thing. Now, it
mult be admitted, that, if fever depends upon inflam¬
mation of the brain, and is merely fymptomatic of fuch
a ftate, this ftate mull be always prefent, when the fymp¬
toms of fever occur; one'clear negative example is lurely
fatal to the theory. Dr. Beddoes coliedted a confiderable
quantity of evidence from the hiftories of difledtions,
made during the prevalence of feveral epidemic levers on
the continent ; from which it is proved, indeed, that
congeftion, or fome other morbid appearance, was fre¬
quently oblerved in the brain or its membranes ; but it
is alfo Ihowing, that abfcefles, gangrene, or other marks
of inflammation, were not lefs frequently found in the
vifcera of the thorax and of the abdomen, especially in
the ftomach and liver. Thefe fadts we have detailed,
when fpeaking of the confequences of fatal fevers, as
difcovered by difledtion ; and it is unneceftary to repeat
them here. Dr. Beddoes is fairly led (fuppofing the fadts
accurately reprefented) to this inference, that, in idiopa¬
thic fever, the ftomach and contiguous parts have been
found more conftantly and more deeply affedted with in¬
flammation, than the brain and its membranes. (Re-
fearches, Anatomical and Pradtical, concerning Fever,
See. by T. Beddoes, M. D. publilhed in 1807.) But, left
the teftimony of authors of little note may bequeftioned,
we (hall quote that of one of the molt able and experi¬
enced of our hofpital-phyflcians. Dr. Lind of Haflar.
Speaking of a deftrudtive contagious typhus, which pre¬
vailed in the French fleet in 1757, he fays, ‘the fymp¬
toms of the fever were the fame as we have already given
in the defeription of the gaol-diftemper. On difledtion,
the brain of thofe who died was found perfectly found,
though during their ficknefs the head had always ieemed
greatly affedted : in two cafes only, out of twenty which
were infpedied, the blood-veflels of it appeared a little
enlarged. The lungs were generally found gorged with
blood, and feemed to have a gangrenous difpolition. The
abdomen more immediately luffered by the difeafe, parti¬
cularly the liver, ftomach, and inlejlines ; in the inteftiries
there was often found a green offenlive liquor, fometimes
worms." (See Lind on Fevers and Infections, chap. iv.

197

PATHOLOGY.

For thefe reafons Dr. B. concludes, “ that inflamma¬
tion occurs only occafionally in the brain ; that this or-
jan is liable to inflammation only i ri common with the
other vifcera; and that inflammation is in all the organs
a fecondary refult of fever, and not its eflential caufe.
In this view of the fubjeft, all the arguments from ana¬
logy between fever and inflammation, which Dr. Clutter-
buck has brought forward, may be (and indeed muft be)
admitted ; while, at the lame time, they add no weight
to his theory: for the analogy is equally favourable to
the notion of a fecondary as of a primary occurrence of
inflammation. And we cannot but obferve, before we
take leave of thefe doCtrines, that the analogies which
Dr. Clutterbuck has pointed out, as well as the various
faCts which we have quoted from Riverius, Monro, Bed-
does, and Lind, fend to confirm the hypothefis of Dar¬
win, under which thefe faffs, contradictory as they are,
to the opinions of Dr. Clutterbuck, are reduced to a
perfeCt coniiltency.” It may be added, that a doCtrine,
according molt accurately with that of Dr. Cl. is taught
by Dr. Ploucquet, in the univerfity of Tubingen.

Now, (peculating upon this contention between the
two molt eminent writers on the fever of this country, it
will appear, that Dr. Ciutterbuck’s hypothefis is neither
proved by himfelf nor refuted by his antagonift. For,
fuch is the fympathy between all parts of the body, that,
if inflammation of the brain be produced, a general in-
creafed adtion of the heart and arteries occurs, and thofe
parts predifpofed to inflammation will take on that ac¬
tion, or inflammation arifing on other parts will as furely
difturb the cerebral. The fucceflion of fymptoms does
not overthrow this theory, becaufe, though the firft
fymptoms denote diminilhed energy of the brain, fuch a
(fate is, according to a law before laid down, moll likely
to be followed by the oppofite Itate.

To the teltimonyof Lind and others, Dr. Clutterbuck
objeCts, that we are not acquainted with the appearance
of abrain perfectly found ; and the changes in that deli¬
cate. ItruCture muft often be infcrutable; and bethinks
that few perfons die without fome morbidity of the brain.
We are not, however, difpofed to advocate the opi¬
nion of Dr. Clutterbuck (principally for the laft objec¬
tion, which his anfw'er does not overthrow), but to ihow
that it is not much afteffed by the arguments in queftion ;
and we have no hefitation in faying, that, whetheras a caufe
or a confequence, inflammation of the brain is more gene¬
rally found in the fevers of this country than anyotherkind
of lefion, as indeed we fhould naturally expeCf to find in
civilized fociety, where the brains of the inhabitants are
for the molt part in a Itate of unnatural excitation. We
fltould therefore pay thegreateft attention (atlealt in fe¬
vers of this country) to the occurrence of inflammation
of the brain.

With refpeCt to the gojiric origin of fever, hinted at by
Dr. Bateman in the preceding extraft, and which when
firit promulgated obtained few fupporters; it is remark¬
able, that it is now believed in (with fome modification)
by many of the mod eminent continental pathologifts,
among the firftof whom is Brouflais. This author con¬
ceives that the plague, and all varieties of fever, whe¬
ther adynamic, ataxic, typhous, or yellow, are nothing
elfe than various fpecies of inflammation of the mucous
membranes of the ftomach and (mail inteftines, differing
in their degrees of violence, as well from the peculiar
conftitution of the patient, as thecaufes which may have
produced them. M. Brouflais terms thefe maladies goj-
Iro-enttrites, not becaufe he believes that, in all cafes, the
ftomach and inteftines are irritated in the fame degree, but
becaufe the affeCtion which commences almoft conftantly
in the firft of thefe organs is quickly propagated to the
fecond ; and from the curative indications being the fame,
whatever may be the part moll violently affecied. He
endeavours, to point out, from the fymptoms, the princi¬
pal feat of irritation in the different llages of the difeafe.

When it is violent, and has continued for a certain length
of time, he has conftantly obferved that it has been com¬
municated throughout the whole extent of the fuperior
portion of the digeftive canal. The large inteftines are,
however, ordinarily free from diforder; and, when they
are implicated, the particular fymptoms give notice of it
to the attentive pradl itioner. In proof of this theory,
Brouflais aflerts that all the modifications of the gnftro -
enteritis prefent the following fymptoms: lofs of appe¬
tite; more or lefs of urgent third; on the centre of the
tongue a coating, which is variable in thicknefs, denfity,
and colour; and, about the point and lateral parts of
that organ, a rednefs that varies in colour from a rofe-
tint to the moft fiery hue : appearances always noticed
by authors who have written of fever, but which M.
Brouflais confidersas moft pcfitive and conftant figns of
gaftric irritation. The heat of the Ikin being increafed,
particularly about the abdomen and the epigaftric region,
and its conveying a fenfation of roughnefs to the hand,
is generally, according to this author, the effect of irri¬
tation of the mucous membrane of the digeftive organs.
The morbid aCtions, manifelled in the nerves and the
brain, as depreffion of fpirits, morofity, cephalalgia, even
the moft profound ftuporand depreffion of the nervous
power, or, on the contrary, the moft furious delirium,
are confidered to be the refult of fympathy with the fto¬
mach and fmall inteftines ; as alfo the violent and almoft
infupportable pains in the joints which attend fome
fevers.

In examining the moft frequent caufes of febrile dif-
eales, M. Brouflais thinks we find evidence of exifting
irritation of the mucous membrane of the ftomach and
fmall inteftines, becaufe thofe caufes adt, either direCtly
or indirectly, on the digeftive lyftem. Thus, repeated
error's of regimen, tire ingeftion of acrid and irritating
fubftances, the influence of putrid miafmata, &c. appear
in the firft order ; amongft thofe of the fecond may be
counted thofe miafmata which, being received into the
fyftem through the Ikin, or by the refpiratory or digeftive
organs, always evince their influence on the latter; ex-
celfive heat of the atmofphere, which excites the Ikin,
and fympathetically the ftomach and fmall inteftines, &c.
Moreover, gaftric irritation, as all authors have obferved,
is very often the precurfor of gnjiritis, in the common
application of this term, or of gaftric, mucous, and atax¬
ic fevers, which fucceed each other in the above order
in the fame individual. The caufes that produce typhus,
yellow fever, and plague, fometimes confine their influ¬
ence to the determination of a flight degree of gaftric ir¬
ritation. In the progreffive increafe of the fymptoms
which characterize the paflage of the malady from the
moft trifling to the moft violent form, Brouflais thinks
it is abfolutely impoflible to obferve any exaCt period at
which the affeCtion precifely changes in its nature: every
thing, on the contrary, indicates that it is the fame orga¬
nic lefion, acquiring more intenfity, and producing more
alarming fympathetic affections. He therefore fees no
reafon which Ihould authorize us to divide the collection
of fymptoms into two, three, or more, feCtions, and to fay
that two or three different maladies have fucceeded to
each other.

From the efteCts of medicines, which may lead us to
recognize the nature of difeafes he (till fees further cor¬
roboration of the theory in queftion. Having Ihown that „
antiphlogiftic meafures are thofe which moft frequently
fucceed in the maladies of which we treat, anti that, the
fortunate refults he has obtained from their application
are beyond any comparifon in extent with the fuccefs that
has enfued from contrary modes of treatment; he ralhly
infers, that tonics and ftimulants increafe the febrile com¬
motion, becaule they ftimulate the inflamed furface.
But the ftrongeft evidence of the theory of Brouflais is
drawn from his numerous dhTeCtions. “ On the termi¬
nation of gaftro-enteritis, or of the numerous maladies

which

V

PATHOLOGY.

108

which reprefent the different degrees of that affe&ion,
we always find the-confequences of inflammation of the
digeftive canal ; but the afpedl and nature of thefe re¬
mains of organic irritation prefent feveral varieties, the
knowledge of which is of confiderable importance.
When the difeafe has been but of Ihort duration, we
fometimes find the tunics of the ftomach and inteftines
injected with blood, and prefenting throughout their
whole extent, even on their external furface, a rofe-co-
loured hue that is not natural to them, without difcover-
ing manifeft inflammation of any determined portion of
the mucous membrane. This Ihows that thefe organs
have been the feat of irritation that has occafioned an in¬
ordinate afflux of blood to thofe parts, but that inflam¬
mation had not developed itfelf. We may compare this
ftate to that of apoplexy, where the veffels of the brain
are found diftended with blood, without any eft'ufion
having taken place. It would not, however, be right to
reprefent to ourfelves the mucous membrane as little co¬
loured with blood during life as we may find it after
death : the tongue is very often of a bright red colour in
the patient, but becomes pale and dilcoloured in the
dead body. It feems that irritation mull have conti¬
nued for a confiderable length of time to render the co¬
lour of the parts permanent after death ; that is to fay,
to combine a certain quantity of the red fluid with their
tifl'ue.”

In general, whatever may have been the diforder ob-
ferved in the fuperior parts of the inleftinal canal, the
inferior portion (that is, the large inteftines) is unaf¬
fected. But, when gaftro-enteritis has been accompa¬
nied with diarrhoea or dyfentery, we find traces of inflam¬
mation of the latter parts alfo ; this extent and compli¬
cation of organic lefion conllitutes the epidemic dyfen¬
tery.

A theory fimilar to this has much obtained in Ame¬
rica. Dr. Chapman, profellor of medicine in the univer-
lity of Pennfylvania, (in his Elements of Therapeutics,)
Hates, that “ fever, whatever may be the caufe, is always
a difeafe of fympalhy, having the primary link of its ulti¬
mately lengthened and complex chain in the ftomach. It
is upon this organ that contagion, marlh-effluvia, and
other noxious matters; aft ; and hence, precifely as in
the cafes of poifon, a local irritation at firlt occurs,
which, if not at once arrelted, fpreads itfelf, by multi¬
plying the trains of morbid aflociation, till the difeafe
becomes general, involving more or lefs every part of the
animal economy.”

Dr. Harrifon (in the Gulftonian Lefture for the year
1820) has adopted a theory identical with that of Brouf-
I'ais. He fays, “ Fever I confider to be a derangement
of certain funftionsof the body, dependant on irritation
of fome particular part, which becomes a caufe of dif-
turbance to the reft of the fyftem by means of the fym-
pathy exifting between its feveral organs. But irritation
of any part will not give rife to fever; and it appears,
that it is irritation of one organ folely that will produce
this eft'eft, and that organ is the mucous membrane. The
funftions deranged in fever are thofe of the fecretory or¬
gans : hence the morbid ftate of the fecreted fluids, and
the alteration of the temperature of the body. From
the derangement of thefe funftions arife all the effential
phenomena of fever. The increafed frequency of the
aftion of the heart and arteries, and the dijlurbunce of the
intellects, which ordinarily accompany it, are accidental
phenomena, and are not neceflary in order to conftitute
fever. The intellefts are often not difordered ; and we
not unfrequently obferve typhous fever run its whole
courfe without any increafed frequency of the pulfe.

“ Difturbance of the funftions of the brain is a gene¬
ral attendant on all fevere febrile. diforders, and, as it is
here (hown, is an effeft of the local difeafe already de-
feribed ; the delirium being in a dire.61 ratio with the in¬
flammation of the mucous membranes ; as indicated by
4

the inflamed conjunftiva, and other evidences of tins
ftate.” Dr. H. likewife afferts, that the moft ftrongly
marked cafes of inflammation of the mucous membrane
of the ftomach often commence' in this way. The pa¬
tient at firll fuffers an inordinate craving for food, which
is not immediately removed by the introduftion of ali¬
ment into the ftomach ; it however ufually fubfides in
about half an hour or fo ; but it re-appears foon after¬
wards with increafed violence ; and in a fliort time, as a
few days, efpecially if ftimulating food is taken, it be¬
comes a fenfe of abfolute pain, attended with naufea,
vomiting, and difguft for every kind of alimentary mat¬
ter, except cool and unirritating liquids. This has often
been obferved in yellow-fever, the origin of which is one
of the moft fevere forms of inflammation of the mucous
membrane of the ftomach and duodenum. The diforder
of the ftomach above deferibed is not unfrequently the
only fign of the approaching difeafe for one or two days;
and we may often witnefs the fame circumftances in the
feveral forms of fever that occur in our own climate.

“Fever does not immediately refult from irritation of
any other part. We find extenfive and very fevere in¬
flammation of ferous and cellular membranes, and of the
fibrous and bony ftruftures, and no fever exifts : but, if
the irritation of any of thofe parts be participated by the
mucous membranes, all the phenomena of fever imme¬
diately appear.”

This theory has been by fome confounded with the lu¬
minous one of Dr. Jackfon ; but it certainly differs
widely in this point. Dr. Jackfon Ihows that the mucous
membrane of the ftomach is the part which ordinarily re¬
ceives the impreflion of contagious effluvia, and that the
fame membrane does frequently take an inflammatory ac¬
tion ; but he is far from afferting with Brouflais and Har¬
rifon, that inflammation of this membrane is the effential
caufe of fever; i. e. that without which it cannot exift.
Again, M. Brouflais is confcious that the firll impreflion
giving rife to the phenomena of fever always aftefts the
mucous membrane of the Jlomuch, either from the exciting
caufe having been immediately applied to this organ, or
from its fympathifing with fome remote part in a ftate
of irritation ; and, unlefs fuch a fympathy happens in
the latter cafe, he confiders that real fever cannot arife.
Dr. Jackfon equally inculcates the doftrine of the local
origin of contagious fever, but he does not fix this ori¬
gin in any part exclufively; and he, befides, confiders
that the Jkin itfelf, properly fpeaking, or the cutaneous'
envelopment of the exterior of the body, as well as the
mucous membrane of the lungs and alimentary canal,
may be the part firft affefted ; and that the irritation of
this organ may excite in the fyftem the whole of the phe¬
nomena to which the generic term fever has been applied,
without the mucous membrane of the ftomach being ne-
ceflarily interefted in the produftion of the feries of
fymptoms ; though he dates that fuch an implication
does take place in by far the greater proportion of in-
ftances.

The other point of difference, is the part of the ner¬
vous fyftem which forms the medium through udiich the
fymptoms are developed ;' though the reality of a differ¬
ence in this refpeft is not very evident. Dr. Jackfon de-
fignates it as the fenforium; by which it appears he means
the cerebral fyftem: though he may intend only to fig-
nify the principle of fen/ibility generally, without fpecify-
ing the particular parts in which it may be feated. M.
Brouflais confiders the ganglionic nerves as the effential
organs by which the fympathies in queftion are pro¬
duced.

The next pathologift whofe theory of fever demands
our attention is Dr. Nicholls. We quote from his ex¬
cellent “ Pathology.” A particular and methodic ana-
lyfis of the fymptoms which conftitute the feveral ftages
of the morbid condition of the fyftem which is thus
termed, leads him to conclude that the early Jlage of it

refults

PATHOLOGY.

refults from “diminifhed fenfibility of the nervous fyf¬
tem ; diminifhed adtion of the heart ; a contradted ftate
of the fmall arteries.” The height of it, from “ increafed
fenfibility of the nervous fyftem; increafed adtion of the
heart ; increafed flow of blood through the fmaller arte¬
ries, the oppolition which is made by the exertion of the
contractile power of thefe vefl'els being overcome by the
increafed adtion of the .heart.” The decline from “ di-
ininifhed fenfibility of the nervous fyftem ; enfeebled
adtion of the heart ; relaxed ftate of the fmall arte¬
ries.”

The refpedtive ftates of the feveral ftages above enume¬
rated, Dr. Nicholl confiders, may occur in either of the
three following orders : “ i. Contradtion of the fmall
arteries; diminiflied adtion of the heart; torpor of the
nervous fyftem. 2. Diminifhed adtion of the heart; tor¬
por of the nervous fyftem ; contradtion of the fmall arte¬
ries. 3. Torpor of the nervous fyftem ; contradtion of
the fmall arteries ; diminiflied adtion of the heart.”

Adverting then to the fubfequent phenomena, Dr.
Nicholl fays, that “ thefe three ftates having exifted an
uncertain time, a new order of ftates arifes. The adtion
of the heart becomes increafed, increafed fenfibility of
of the nervous fyftem takes place, and anlncreafed quan¬
tity of blood is received by the fmall arteries. Thefe
three changes may take place in varied order; for in-
ftance : the increafed adtion of the heart may firft arife :
this may produce a removal of the torpor of the nervous
fyftem; audit may, by increafing the momentum of the
blood, overcome the refiftance which is offered by the ex¬
ertion of the contractile power of the fmall arteries to
that fluid. Or, the fenfibility of the nervous fyftem may
become increafed; and to this altered ftate of that fyftem
may fucceed increafed adtion of the heart, and a more
copious flow of blood through the fmall arteries. Or, if
the contradted ftate of the fmall arteries give way, a
more free and powerful adtion of the heart may follow,
and the torpor of the nervous fyftem may be removed.”

The ftates which produce the fymptoms of the fecond
ftage of fever may, then, occur in either of the three
following orders, viz. j. Increafed adtion of the heart ;
increafed flow through fmall arteries; increafed fenfibi¬
lity of nervous fyftem. 2. Increafed fenfibility of ner¬
vous fyftem ; increafed adtion of heart ; increafed flow
through fmall arteries. 3. Diminiflied contradtion of
fmall arteries ; increafed adtion of heart ; increafed fenfi¬
bility of nervous fyftem.

“ Having arrived thus far in our inquiry, let us return
to the ftates which produce the fymptoms of the firft ftage
of fever. Let us fuppofe a cafe in which increafed con-
tradliun of the fmall arteries is the firft eftedt of the pri¬
mary caufe of fever. In fuch a cafe, the refiftance of¬
fered by thofe arteries to the current of the blood may
induce an obftrudted ftate of the general round of the
circulation, whence will enfue a turgid condition of the
larger arterial and venous trunks, and of the cavities of
the heart ; and from thefe effedts will arife an oppreffed
and an over-powered ftate of the adtion of the heart.
The obftrudted ftate of the circulation will lead to a
turgid ftate of the cerebral blood-veflels ; which eft’edt,
as well as the want of a free fupply by thofe vefl'els of
blood which has duly undergone the pulmonic procefs,
will induce torpor of the cerebral ftrudtures, and, from
the torpid ftate of thofe ftrudtures, as well as from the
diminution of the quantity of blood received by the fmall
arteries, will enfue diminiflied fenfibility of the nerves
in general. Thus will the feveral caufes of the fymp¬
toms of the early Jloge of fever be prefent.

“ The action of the heart, at firft overpowered by the
refiftance offered to the blood by the fmall arteries, and
ftill more enfeebled in confequence of the diminifhed
fenfibility of the nervous fyftem, may gradually become
increafed. It may become increafed, poffibly, from its
myn powers of contradtion having acquired an accumu¬
lation of energy during its opprefl’ed ftate, or in confe¬
quence of increafed fenfibility of the nervous fyftem ; or

VOL. XIX. No. 1297.

perhaps, in fome inftances, owing to a diminution of the
contradtion of the fmall arteries, and a confequent dimi¬
nution of oppolition to the adtion of the heart. Should
the adlion of the heart become increafed, the momentum
of the blood will be increafed, and confequently the
refiftance offered by the fmall arteries may be borne down ;
in which cafe the freedom of the circulation will be re-
flored. The removal of the obftrudled ftate of the cir¬
culation, and the diilribution of an increafed quantity
of blood throughout the nervous fyftem in general, will
remove the caufes of torpor of that fyftem. Torpor of
the cranial brain is, in many inftances, fucceeded by a
degree of fenfibility of that ftrudlure greater even than
that which immediately preceded the infenfible ftate of
it. This is conftantly the cafe after fleep. So alfo an in¬
fenfible ftate of the nerves in general is, in many in¬
ftances, fucceeded by a degree of fenfibility greater than
that which immediately preceded the infenfible ftate. In
the cafe under conlideration, then, it may happen that
the torpor which prevailed in the early ftage of fever
may, after it has exifted for fome time, gradually be re-
folved into a ftate of increafed fenfibility. The prefence
of increafed fenfibility of the nervous fyftem will be
followed by increafed adlion of the heart, and by the
flow of an increafed quantity of blood through the
fmall arteries. Thus may thofe ftates be formed which
give rife to the fymptoms attendant on the fecond Jloge
of fever.

“Suppofe that torpor of the cerebral ftrudlure is the
firft effedt of the primary caufe of fever. Such- a ftate will
give rife to general in fenfibility. The adlion of the heart
will be diminifhed, and the contradtion of the fmallarteries
will be increafed. The increafed contradtion of thefe
arteries will, as we have feen, tend to produce an en¬
feebled adtion of the heart ; and a diminution of the ac¬
tion of the heart leads, as we have alfo feen, to increafed
contradtion of the fmall arteries. Thus may the caufes
of thofe fymptoms which attend the early ftage of fever
he prefent.

“ If the torpor of the cerebral ftrudtures, after it has
exifted for an uncertain time, fubfides, and is fucceeded
by a degree of fenfibility even greater in degree than that
which preceded it, fuch new condition of the cerebral
ftrudtures will be attended by increafed fenfibility through¬
out the nervous fyftem generally : increafed quantity of
blood will flow through the fmall arteries. Thus thofe
ftates will he eftablilhed which give rife to the fymptoms
attendant on the fecond ftage of fever.

“ If diminifhed adtion of the heart be the firft
effect of the caufe of fever, diminution of the momen¬
tum of the blood will enfue, to which will fucceed
increafed contradtion of the fmall arteries and tor¬
por of the cerebral ftrudtures, and confequently, a ge¬
neral diminution of the fenfibility of the nervous fyftem.
And thus thofe ftates will be formed which produce the
fymptoms of the early ftage of fever.

“ When thefe ftates have exifted an uncertain time, if,
as we have fuppofed, the heart be enabled, from changes
which take place within itfelf during its ftate of inadti-
vity, to adl with a degree of force even greater than be¬
fore; the momentum of the blood will be increafed, and
the refiftance of the fmaller arteries will be overcome
The torpor of the cerebral ftrudtures will be removed,
and a preternatural degree of fenfibility of thofe ftruc-
tures may arife, not only as a confequence of an in¬
creafed flow of blood through their blood-veflels, but
poffibly, as we have fuppofed, as a confequence of the
previous ftate of torpor. The increafed fenfibility of the
cerebral ftrudtures will induce a general increafe of fen¬
fibility throughout the nervous fyftem, and will caufe
the action of the heart to be ftill more forcibly exerted.
Thus, in various ways, thofe feveral ftates which charac¬
terize the fecond ftage of fever will be eftablilhed. Du¬
ring the exiftence of the fecond ftage of fever, although
an increafed quantity of -blood flows through the- fmall
arteries, yet this increafed flow appears to arife, in the
3 F generality

200 PATHOLOG Y.

generality of cafes, not from ceffation or diminution of
contraiOion in thofe vefl'els, but from the increafed adfion
of the heart enabling the blood to force its way into,
and through, thefe arteries, in fpite of the oppofitiou
which is offered by their contradfile power to that fluid.
So that, in the fecond ftage of fever, there is, as it were,
a continued conteft and ftruggle between the adiion of
the heart and the contradlile power of the fmall arteries,
the balance of power being conftantly in favour of the
former.

“ We now proceed to the confideration of the laft ftage,
or the decline of fever. We obferve that, whenever a
high degree of fenfibility of the nervous fyftem has ex-
ifted for fome time, it is, fooner or later, fucceeded by a
ftate of torpor, the degree of which is proportionate to
the duration and the degree of the preceding fenfibility.
Wealfofind that, when a high degree of adtion has been
kept up for fome time by the heart, a languid adfion of
that organ fooner or later fucceeds ; the degree of lan¬
guor being proportionate to the duration and the degree
of the preceding ftrength of adfion. When a high de¬
gree of refiftanceto the momentum of the blood has been
offered, for a length of time, by the contradfile power
of the fmall arteries, the exertion of that power will,
fooner or later, become enfeebled, or will be fufpended ;
the diminution of that exertion being proportionate to
the degree and duration of its previous adtivity.

“We have traced the various ways in which thofe
ftates which characterize the fecond ftage of fever may
be formed. Let us fuppofe that, in either of thofe ways,
thefe ftates have been produced. The high degree of
fenfibility of the nervous fyftem; the high degree of ac¬
tion on the part of the heart ; the ftrong, but unavailing,
refiftance of the fmall arteries, may feverally laft an un¬
certain time. The natural confequence of each of thefe
liates will be, as we have juft feen, the formation of an
oppofite ftate. The high degree of fenfibility will give
place to torpor ; the powerful action of the heart will fub-
fide into feeble contradtion ; the ftubborn refiftance of
the fmall arteries will give way. Accordingly we find
that thefe natural confequences are precifely the occur¬
rences which are met with in the laft ftage of fever. The
fenfibility of the nervous fyftem becomes diminifhed in
proportion to the duration and degree of its previous in-
creafe. The adtion of the heart becomes feeble. Both
thefe new ftates favour the increafe of each other. The
contradtion of the fmall arteries gives way ; the ftruggle
between thefe veffels and the heart is at an end, fo that
the contradtion of the heart, although enfeebled, may {till
be able to carry on the circulation of the blood ; and
thus an obfti-adted, or a ftagnant, ftate of the round of
the circulation, which would otherwife refult from the
languid adtion of the heart, may be prevented.

“ It appears, then, that both in the firft and in the laft
ftages of fever, the fenfibility of the nervous fyftem and
the adtion of the heart are diminifhed ; while, in the
early ftage, the contradtion of the fmall arteries is in¬
creafed; whereas, in the decline of fever, it is diminifhed
or altogether fufpended. The different ftate of the con-
tradtile power of the fmall arteries, then, appears to
conftitute the leading diftindtion between thecharadter of
thefe two ftages of fever. From the refult of our invefti-
gation, it appears that the ftates which charadterize the
iecond ftage of fever are the confequences of thofe ftates
which uftier in fever ; and that the ftates which confti¬
tute the third ftage are the natural refultsof thofe which
are met with in the fecond ftage. It follows then that
the ftates attendant on the third ftage, as well as thofe
which mark the fecond ftage, are the confequences of
thofe ftates which appear in the firft ftage of fever.”

Before we proceed to examine the juftnefs of thefe
views of fever, we (hall prefent to our readers a hiftory
of thofe phenomena. It is now pretty generally acknow¬
ledged, that the divifion of the fevers of this country
into fynocha, fynochus, and typhus, is not founded in

nature, but engendered by hypothetical notions in the
brain of Cullen. On this account we (hall proceed to
fay, that, of fevers in general, the commencement is
commonly marked by fome degree of languor, laifitude,
and general uneafinefs; the patient feels himfelfill, with¬
out being able to refer his uneafy feelings to any parti¬
cular part of the body. There is alfoa liftleffnefs, or a
defire frequently to change the pofture, but at the fame
time the fenfe of wearinefs difpofes the patient to refift
this inclination ; the motions when made are fluggifh,
and frequent yawning and ftretching accompany the at¬
tempt. The mind is affeCted in a fimilar way ; it cannot
reft upon any objeCt; the attention is not under the
command of the will, but wanders from one fubjeft to
another; and, as the ability of exerting the mufcular
powers becomes diminifhed, there is likewife an inabi¬
lity of exercifing the faculties of the mind ; the patient
cannot think or reafon, even upon his ordinary affairs,
with his ufual eafe. Along with thefe fymptoms, but
more frequently after them, he feels a fenfation of cold,
commonly firft in his back, but afterwards over the
whole body ; the fame kind of fenfation that he feels
when furrounded by a colder medium than he is ac-
cuftomed to: he willies, therefore, to go near a fire, or
into the rays of the fun, or to put on warmer clothing.
At the fame time the face and extremities are obferved
to be pale, the features flirink, the bulk of every external
part is diminifhed, and the (kin over the whole body ap¬
pears conftriCted, as if cold had been applied to it. This
fenfation of cold varies much more in different inftances
of incipient fever than the languor and laflitude before
mentioned ; in fome cafes it is very flight, in others not
at all felt or noticed ; whilft in many inftances, particu-'
larly in the intermit’ent fevers, it becomes fo great as to
produce a tremoror fhaking in all the limbs, with a chat¬
tering of the teeth and frequent rigors of the trunk of
the body. In this ftate, the a&ual heat of the furface,
whether meafured by the fenfations of a by-ftander or a
thermometer, is confiderably diminifhed ; in the extre¬
mities in particular it is many degrees below the ftandard
of health. Not only on the furface, as is generally ima¬
gined, but even over the whole fyftem, the heat is pro¬
bably diminifhed ; the air expired from the lungs feels
cool to the back of the hand, held near the mouth. Dr.
Currie ftates, that he has found the heat under the
tongue, and at the axilla, as low as 94, 93, and 92, de¬
grees of Fahrenheit’s thermometer. (The healthy tem¬
perature of the human body, it may be obferved, is
about 98° of the fame thermometer.) Dr. Fordyce
affirms, that 940 was the loweft degree of heat that
he had witnefl’ed under the fame circumftances. (Firft
Diflertation on Fever, p. 40.) The fenfations of the pa¬
tient, however, do not always correfpond with the ac¬
tual degree of cold, as meafured by the thermometer, or
by the fenfations of others ; for it has been remarked,
efpecially towards the termination of the cold ftage of
the fever, that the patient feels himfelf cold, even on
thofe parts of the body which are fhown, by the applica¬
tion of a thermometer, to be of the natural heat, or even
hotter than they ufually are in health. With this ftate
of coldnefs, the fenfibility of thebody is confiderably di¬
minifhed; all the fenfations, but efpecially thofe of touch
and tafte, are lefs accurate and diftinCt than in the healthy
ftate. Dr. Fordyce remarks, that, “in the attack of fe¬
ver, fuch a degree of infenfibility, with a feel of coldnefs,
has in many cafes taken place, that even hot fubftances
have been applied in fuch manner as to coagulate, nay
perform the chemical analyfis of the part, without any
fenfation of heat having arifen in the mind of the pa¬
tient.” (Loc. Cit. p. 49.) The diminution of the fa¬
culty of fenfation is very various in different inftances of
the attack of fever.

Upon the firft approach of febrile languor the pulfe is
not always altered in refpeCt to frequency, but it always
becomes weaker than before j fometimes it is alfo flower

than

201

PATHOLOGY.

than in health for a fliort time ; but, as the fenfe of
cold increafes, it becomes fmaller, and gradually more
and more frequent, and often irregular. While the con¬
tractions of the heart and arteries are thus feeble, all the
fecretions of the fyftem are likewife diminifhed. The
tongueand mouth becomedry and clammy,in confequence
of the diminifhed fupply of faliva and of the mucus of
thofe parts ; the fkin alfo becomes dry, as well as pale
and cold, there being little or no matter of perfpiration
poured out. The changes in the urine are Itill more re¬
markable ; the impaired adfion of the fecretory veffels of
the kidneys is evinced by the diminifhed quantity of the
urine at this period of fever, as well as by the palenefs
of its colour, in confequence of its holding lefs of the
mucilaginous and faline parts in folution than in health,
and by the abfence of any cloudinefs or depolition when
it cools. There is generally alfo a fmaller quantity of
feculent matter evacuated from the inteftines at the
commencement of fever, or in other words a degree of
conftipation, which implies a deficiency of the fluids fe-
creted from the inner furface of the alimentary canal, as
well as of the bile and pancreatic liquor, by which the
fseces are rendered more liquid and moveable, and the
bowels are ftimulated to attion. Analogous to thefe
changes in the ftate of the fecretions are the fudden and
conliderable detumefcence of fwellings, which may happen
to fubfift on the furface of the body, and the drying-up
or ceffation of the difcharges from ulcers and wounds,
during the cold ftage of fever.

The refpiration alfo fuffers fome change in the attack
of fever, being often (hort and frequent, and fometimes
attended with a cough, more particularly in intermittent
fevers. There is at the fame time a great anxiety, or a
fenfe of weight, fullnefs, and great uneafinefs, in the
bread. This diftrefling feeling, which has been thought
by fome phyficians a pathognomonic fymptom of fever,
and hence denominated febrile anxiety, is totally different
from, and independent of, the general uneafinefs all over
the body, which was before mentioned, and often occurs
in a very difproportionate degree. It refembles that
anxiety which takes place from grief, fear, and other de¬
prefling paflions of the mind, and which is alfo accom¬
panied by palenefs, and diminution of iize of the veins
which are feen on the furface. The patient likewife re-
fpires irregularly, as one under the influence of the
paflions j u ft noticed, and frequently fighs deeply, as if
to free himfelf from the load that opprefles the region of
the heart.

At the beginning of the attack of fever, fometimes as
the very firft fymptom, but often later, a dull pain is felt
in the fmall of the back, which feems to occupy the
lumbar vertebra;, but is not accurately referred to any
particular point. It is very fimilar to the pain which
arifes from weaknefs or fatigue ; but, unlike that, ac¬
cording to Dr. Fordyce, it is equally felt in the hori¬
zontal as in the credit poflure of the body. The head at
the fame time is affected with pain, which is commonly
feated in the forehead over the eyes, and feels to the
patient as external; fometimes it likewife occupies the
back part of the head ; and occafionally it is felt all
round the head. It varies much in degree, but com¬
monly increafes as the attack proceeds ; it is ufually at¬
tended with a fenfe of weight, and is often augmented
by light falling upon the eyes. A fimilar pain generally
arifes all over the body, which the patient often defcribes
as feated in all his bones, without being able to parti¬
cularize in what part of the body it is felt. Sometimes
it is more particularly confined to the larger joints ; and
it is occafionally attended with great forenefs, as from
over-fatigue. Such forenefs, however, is more com¬
monly confined to the fubfequent periods of the difeafe.

From the commencement of the attack of fever the
natural funttions are always deranged. The changes in
the appearance of the tongue are among the firft indica¬
tions of this derangement. At firft the tongue appears

to be thinly covered on its upper furface with an extreme¬
ly vifcid fluid, efpecially in the middle and towards the
root, the edges and point being nearly free from it. The
under furface of the tongue, below the point, is fcarcely
ever covered with this matter. Sometimes, at the very
beginning of the diforder, the covering of the tongue is
a folid cruft of a whitifh colour, adhering fo firmly as to
be incapable of being (craped off; fometimes it verges
towards a brown colour. At the approach of the cold
ftage of fever the ftomach is commonly affected; the appe¬
tite for food ceafes, and averfion even to the fight or fmell
of meat often takes place. Dr. Fordyce remarks, that he
“ has known feveral inftances where perfons, fitting down
to the table with a ftrong appetite, an attack of fever
having fuddenly taken place, in lefs than two minutes
they have been unable to eat any thing, and have been
feized with perfedt averfion even to the fmell of food.”
(Loc. cit. p. 93.) Sicknefs at the ftomach often comes
on at the firft attack, and this is increafed occafionally
to fuch a degree as to produce vomiting. More common¬
ly, however, this does not take place at the very com¬
mencement ; but the difinclination to food increafes
gradually to naufea, then to vomiting, which in fome cafes
is very fevere, not only the contents of the ftomach being-
evacuated, but likewife thofe of the duodenum, and of the
glands, the fecretory ducts of which open into it. Bile,
therefore, and the pancreatic juice, are thrown up, together
with the contents of the ftomach, and the other fluids
fecreted into the ftomach and duodenum. Of thefe fluids,
however, the bile is the raoft confpicuous from its colour,
tafte, and fmell; and it has therefore often been obferved
by practitioners, while the gaftric and pancreatic anil
other juices fecreted into the duodenum, as they are not
very confpicuous from their fenlible qualities, have not
been taken into the account. Combined with the fick-
nefs and averfion to food, there is generally a confiderable
degree of third..

Few other fymptoms, which are obfervable at the com¬
mencement of fever, remain to be mentioned. The ftate
of the countenance is very peculiar and characteriftic,
from the moment of the attack. It not only becomes
pallid, or of a dirty hue, in common with the reft of the
furface of the body, but it affumes an expreflion of dull-
nefs or heavinefs, partly in confequence of the languid
action or relaxed condition of the mufcles of the face,
and partly from the fame condition of the mufcles of
the eye-ball, by which ifs form and motion are altered,
and its ufual brightnefs and quicknefs are impaired.
The difpofition to deep is diminiftied or loft; or, if it
occurs, the repofe is (hort and interrupted, and very im¬
perfect, fo that there is much dreaming, during which
the ideas that prefent themfelves are nioftly of an un-
pleafant kind.

When the fenfation of cold, and the attendant fymp¬
toms, have continued for fome time, (the period being-
very various in the different kinds of fever,) the cold
becomes lefs violent, and is alternated with flufhes of
heat. In the more fevere continued fevers, it frequently
happens that the cold is not permanent for any length of
time, but that this alternation of chills and heat takes
place from the beginning. By degrees the cold goes oft
entirely, and a heat greater than natural is extended, at
firft unequally in different parts, but at length generally
over the whole body ; but even when it is fo far advanced ,
that the heat, meafured at the axilla or under the tongue,
is greater than the ftandard of health, a (light acceflion
of external cold will produce a general chillinefs. There
is no regularity in the reftoration of the heat to the
furface ; in fome parts the heat is above what is natural,
while in others it remains below this ftandard ; and hence
arifes that mixed fenfation of cold and heat, which every
one acquainted with fever has experienced, in the tran-
fition from the cold to the hot ftage of the paroxyfm.
This inequality of the diltribution of the heat is lefs in
the Ampler forms of fever, and greater in thofe which

are

PATHOLOGY.

*202

are more complicated and irregular. In general the
fenfe of cold predominates, even after a morbid heat has
taken place at the axilla, under the tongue, and in diffe¬
rent parts of the thorax and abdomen. Atlength, how¬
ever, the heat of the furface becomes general and uni-
tonn, riling to 102, 103, 104, and fometimes 305, of
Fahrenheit’s thermometer. Different authors indeed
fpeak of febrile heat four or even five degrees higher than
this ; but fuch heat never occurred under the obfervation
of Dr. Fordyce or Dr. Currie, the beft authority on this
fubje£l : Dr. Bateman alfo had frequently employed the
thermometer, in cafes of continued fever, and never oB-
f'erved a higher temperature of the body than 104 in
intermittent or continued fever, the patients being in cool
apartments, with very light bed-coverings. The fenfa-
lion of heat becomes at length ftrong and Heady, and
the accefiiou of external air does not produce a return of
chillinefs as before; this ferifation is moll powerful in the
extremities, particularly on the palms of the hands and
loles of the feet.

The increafe of the circulation takes place at the fame
time as the returning heat, and often in the fame unequal
manner, being evidently greater in fome particular parts
than in others. Thus it frequently happens, that one
part lhall become red and enlarged, one arm, for inftance,
while the other is pale and contracted ; the veins of the
one being full, and the blood flowing in them more ra¬
pidly, while thofe in the other remain contracted. This
lhall continue for fome time, when the parts become af-
feCled in the oppofite way ; the arm which was florid and
diftended becoming pale and contracted, and vice verjd.
This fhifting, however, remains but a fliort time in Jimple
fever, perhaps not above half an hour ; in the paroxyfms
of intermitlents it continues longer, and (till longer in the
firft attack of continued fever. Univerfal rednefs at length
takes place; the features of the face and other parts of
the body recover their ufual fize, and become even more
turgid ; and the fuperficial veins evince the greater cir¬
culation now going on through them by their fullnefs
and increafed fize. The fkin is relaxed and fmooth, no
longer exhibiting the goofei-flein appearance by its con¬
traction round the little glands and roots of the hair;
but it continues for fome time dry. The pulle now be¬
comes f uller and ftronger, and its frequency continues
or is Hill farther increafed ; in Ample fevers, it beats oc-
cafionahy at the rate of 140 or 150 llrokes in a minute,
wjth a confiderable degree of fullnefs and hardnefs
(Fordyce) ; but in the hot llage of intermittents, and
in the heat of continued fevers, it is moll commonly from
90 to no at this early period of the difeafe ; fubjeCl,
however, tp great variation according to the conllitution
of the patient, and the type of the fever. The refpira-
tion, though more free than during the chillinefs, conti¬
nues llill frequent, and accompanied by a fenfe of load
and anxiety, which the patient endeavours to remove by
occafional laborious efforts, and deep fighing. The fe-
cretions Hill remain diininifhed; the <kin is parched, no
perfpiration breaks forth; the tongue and mouth are alfo
dry and parched, and the fur on the former becomes
thicker; the urine, though it becomes higher coloured
than in the cold Hage, remains tranfparent, and depofits
nofediment; and the bowels are coflive. The thirff is
confiderably increafed as the heat advances; the naufea
and vomiting gradually diminilh, but the averfion to food
is augmented.

The corporeal ffrength and the mental powers become
more oppreffed ; the lenfibility, however, is refiored in
general with the returning circulation and warmth of
the furface ; fometimes it becomes even more acute than
in the healthy Hate, fo that the fkin is more ealily irri¬
tated, the eyes are offended with the light, and the leaff
3ioife is heard with pain, and greatly dilturbs the feelings
of the patient. The attention becomes lefs under the
control of the will, and the faculty of recollection and
the reafoning power are exerted with difficulty, and im¬

perfectly, fo that fome confufion of thought takes place,
-which often arifes to delirium-, when the hot Itage is
completely formed : occafionally, indeed, a degree of
delirium occurs in the beginning of the cold Hage, but
more frequently in the fubfequent periods of the fever.
The numerous and dillrefling dreams, which conffantly
recur in the diffurbed and unrefrelhing fleep which takes
place in the firff ftages of fever, may be confidered as the
flightell degree of delirium. In the next degree, the pa¬
tient, when he awakes, is fome time before he can attend
to the impreffions made on the organs of fenfe: he does
not know his bed, his bed-chamber, or his attendants, for
a few minutes, but feems to awake as it were a fecond
time, and becomes perfectly fenfible. If the delirium is
in!a little greater degree, the ordinary impreffions of ex¬
ternal objedts produce no effeCl : the ideas, which float
in the mind rapidly, feem to be excited without train or
connexion ; the affociation being carried on by the in¬
ternal impreffions alone. If the attention of the patient,
however, be llrongly excited by external impreffion, he is
capable of diltinguilhing the furrounding objeCts, and of
returning correct anfwers to queffions put to him ; but,
that ffrong impreffion being withdrawn, he relapfes into
his delirious dream. As the delirium increafes, with the
advance of the fever, the faculty of diltinguilhing the
objeCls that furround him gradually diminilhes; he be¬
gins to exprefs his ideas in words, i. e. to talk incohe¬
rently; the ideas which prefent themfelves rapidly, and
without apparent connexion, are generally diffagreeable
and diftrefling. He is fometimes in a church-yard among
tombs, fometimes falling from a precipice, fometimes
purfued by wild beaffs, in the midff of conflagrations,
See. The delirium increafing, he becomes completely
infenfible to external objeCts. This is a common pro-
grefs of the alienation of mind in fever, beginning on
the fecond or third day, or later, and increafing to the
fourteenth or fifteenth, if the patient furvive fo long; at
firft being only obvious in the night, or during the im-
perfeCl (lumbers, or in the waking moments, when ex¬
ternal impreffions are fewer, or almoll entirely excluded ;
but afterwards continuing night and day without inter-
miflion.

With the beginning of the hot Hage, the head-ache is
commonly increafed, and appears to be diflimilar from
that which took place in the cold Hage. The latter pain.
Dr. Fordyce remarks, “always feels to the patient as
external ; it is clearly a pain affeClingthe integuments of
the head, perhaps the fkin alone, at moll the pericranium ;
but the pain which arifes in the fecond llage is felt by
the patient internally, and gives him the idea that there
is fomething diftending tire head or the brain, fo as to
attempt to burft the cranium.” (Firft Dill, on Fever,
pp. 85 and 228.) In the mean time the carotid and
temporal arteries beat full and ftrong, the eyes are rather
red, and the face is flulbed. Connefted with thefe fymp-
toms, which obvioufly imply an increafed quantity and
impetus of the blood carried to the brain, the organs of
fenfation, while fully capable of conveying impreffions tu>
the mind, neverthelefs produce fometimes erroneous im¬
preffions. Thus the patient can fee, but he millakes ob-
jedls ; he fancies one individual is another, or that a man
is a poft : and his organs of hearing, which are alfo more
readily affedled, do not convey the fame perceptions
which the fame founds would excite in health. The
fame thing happens with regard to his other fenfes.

All the fymptoms above enumerated increafe from the
fecond day of fever. The tongue grows more foul, and
the cruft which forms upon it thicker, until the middle
of the fecond week. Towards the end of the fecond
week this cruft often difappears more or lefs, and the
furface of the tongue looks raw when moift, and when
dry has a polilhed glaze, efpecially about the middle,
fome of the cruft remaining upon the fides towards the
edges.

Before thefe fymptoms, however, have advanced to tile

degree

203

PATHOLOGY.

degree juft defcribed, and after the general heat has con¬
tinued for an indefinite time, (in the ephemera] and in¬
termittent fevers a few hours, in continued fevers feveral
days,) it often happens, that a partial moifture begins to
appear on the fkin, generally on the forehead, which ex¬
tends gradually downwards to the neck and breaft, and
at length a free fweat takes place from the whole furface
of the body. At the fame time the fymptoms of the firft
ft age of the fever begin to abate, fometimes one giving
_ way firft, and fometimes another, fo that it cannot be faid
which has the priority : fometimes the weight and anx¬
iety about the prascordia are firft obferved to diminilh,
fometimes the change of the pulfe from hardnefs to foft-
fiefs is the firft obvious amendment, and fometimes the
relaxation of one or other fet of fecretory veffels, See.
Such a change of the fymptoms, terminating fpeedily in
a reftoration of the health, has been called, by a term
borrowed from the Greek, a erifis ; and the excreted
fluids, which are poured forth at the time of this change,
have hence been denominated critical difeharges. The
moll linking appearance, both to the patient and by-
ftander, is the perfpiration, which is frequently carried
to the extent of profufe fweating in internments and
the Ampler forms of fever, but fometimes amounts only
to gentle moifture. While the fweating continues, all
the fymptoms of the previous ftages abate s the preter¬
natural heat is gradually diminilhed ; the pulfe becomes
fofter and lefs frequent; the breathing is likewife frequent,
and more free, and is unaccompanied by fighing ; and the
anxiety and heavinefs in the cheft are greatly alleviated.
The head-ache gradually goes off, and" the pains of the
loins and extremities ceafe ; the naufea and vomiting no
longer diftrefs the patient, who now acquires a relilh for
light nourifhment; the thirft is removed ; the mouth and
tongue become moift, as the falivary and mucous glands
pour out their fluids, and the tongue becomes gradually
clean, firft upon the edges, afterwards in the middle and
®H&r the root ; the cruft, which had formed upon it,
coming off in fmall flakes, until the whole furface is in
its ordinary ftate. The fecretions of the liver, pancreas,,
and inteftinal glands, being reftored, the bowels begin to'
aft, and the evacuation from them comes to its ordinary
quantity. A loofe ftool is commonly paffed at the end of
a paroxyfm of intermittent fever ; and fometimes a diar¬
rhoea comeson in continued fever, and, being the molt ob¬
vious, is then confidered as the critical difeharge. The
urine generally undergoes fome peculiar changes in the
erifis of fever: it is not only fecreted in larger quantity,
but, although bright and tranfparent when difeharged,
if allowed to remain for fome time it is obferved to grow
turbid, as if containing a quantity of a yellowilh-red
powder, and at length to depofit flaky cryftals of a dirty
red colour, commonly termed a lateritious fediment.
Tumours, which were diminilhed during the cold, and
more painful in the hot, ftage, return to their ufual fize
during the fweat, and ulcers again begin to difeharge
matter. Theintelleftnal funftions are alfo reftored during
the erifis ; the attention of the patient is no longer ab-
forbed by his uneafy feelings, the confufion of his head
is relieved, and he is not ha raffed by the perpetual re¬
cti rre nee of diftrelfing images to the mind, efpecially in
his (lumbers ; a difpofition to calm deep returns; and
the countenance relumes its natural expreflion.

It was remarked by Hippocrates, and the majority of
the ancient phyficians, that tliefe crifes occurred more
frequently on particular days of the fever, which they,
therefore, obferved with great care, as affording both
particular indications in praftice, and the means of
prognofticating the phenomena of the fubfequent periods
of the difeafe. Hence they called thefe days critical days.
Tliefe periodical changes, happening on particular days,
are however feldom diftinftjy noticed in this country ;
they feem to occur more decidedly in warm climates,
where all fevers have a greater tendency to affume the

Vol. XIX. No. 1297.

remittent form. Dr. Cullen, who believed that even in
this country thefe critical days were obfervable, though
lefs diftinftly than in hot climates, explained their occur¬
rence upon the principle, that continued fevers were in
fome degree difpofed to take on the types of intermit¬
tent’s ; and in this principle he has been followed by Dr.
Fordyce. (See Cullen, Firft Lines, § cxix. Fordyce,
Third Differt. on Fever, p. 120.) But it mull be re¬
marked, that the doftrine of critical days, as taught by
Hippocrates, was ridiculed by Afclepiades and Celfusp
who praftifed in the fame climate with Hippocrates, and
in the fame city with Galen ; and Herophilus altogether
denied its truth.

In this country, and in cold climates in general, con¬
tinued fevers are feldom terminated by erifis. Some
praftitioners have maintained, that a erifis never takes
place, whilft others have infilled that crifes happen in all
continued fevers. Dr. Fordyce juftly remarks, that
thefe extremes of opinion are both inconfiftent with cor¬
rect obfervation. It is admitted, however, that crifes
occur much lefs frequently in this climate than in hotter
countries ; and we think that the phyfician juft men¬
tioned confiderably over-rated the proportion when lie
fays, that “ not above one-third part of the fevers which
happen in London are terminated by a erifis.” (Loc.
cit. p. 126.) We believe the proportion to be very far
below this ftatement. In the great number of inllances
of fever, no erifis takes place 5 but the difeafe terminates
in a more flow recovery, or in death.

The fymptoms before enumerated increafe gradually
to the end of the firft, or middle of the fecond, week ;
fometimes by the feventh day the fymptoms have at¬
tained their greateft feverity ; fometimes, too, the fecond
week is gone through without very fevere fymptoms, and
in other cafes fymptoms of the greateft diftrefs and
danger then occur; and there are all gradations between
thefe extremes. The appearances in the fecond week,
when the fever is not extremely fevere, are often as fol¬
lows. The pulfe is frequent, beating from 100 to 120
in the evening, and in the morning fomewhat lefs; the
Ik in continues dry and hot, in various degrees; the
tongue is covered with a brownilh fur; the appetite is
often totally loft; thirft continues, but is often com¬
plained of lefs during the fecond than during the firft
week ; and the depreffion of ftrength is confiderable.
The deep is difturbed and fiiort, and the delirium is ma-
nifefted in the intervals by the incoherence of the obfer-
vations of the patient, until he is completely roufed by
fome ftrong imprelfion on the fenfes. In the morning
the delirium is lefs than in the early part of the night,
and the deep fometimes tolerably quiet ; even during the
day there is confiderable confufion, and occafionalSy
much flownefs of intelleft. Hence perhaps the thirft, as
well as the head-ache, and pains of the back and limbs,
are lefs complained of, rather than from aftual relief or
diminution of thefe fymptoms. The eyes have a dull and
confufed appearance, and commonly fome degree of red-
nefs, from a number of fmall veffels diftended with
blood. Sometimes a degree of ftupor comes on in tire
morning, and continues till the more aftive delirium of
the night. If this ftate (hould remain. Dr. Fordyce ob-
ferves, till about the fourteenth day, the evening attacks
become by degrees lefs, but the ftupor continues, with
deafnefs, and inattention to external objefts ; and thefe
appearances remain the very laft fymptoms of the difeafe.

Very frequently about the end of the fecond week, and
often fooner, the fymptoms begin gradually to diminilh
in feverity. The firft appearance of this abatement is
not uncommonly a cleannefs and healthy look about
the edges of the tongue ; fometimes, although not very
generally, fweating takes place all over the body, and
the Ikin afterwards continues moift; more commonly the
moifture and foftnefs of the Ikin appear in a lefs marked
manner. The delirium abates altogether in the day, and
3 G returns

204

PATHOLOGY.

returns lefs feverely at night; or, if the patient be deaf
with fome ftupor, rhefe (ymptoms are little changed in
the twenty-four hours, but remain until the whole of the
difeafe has difappeared. The deprefiion of ftrength goes
oft, but leaves real weaknefs behind. 'I'he urine depofits
fometimes a copious lateritious fediment for a^day or
two, and afterwards returns to its natural appearance.
Sometimes there is a copious lateritious fediment in the
urine made in the night, and a mucous one in that made
in the dav-time. The coftivenefs goes off, and the fseces"
return to their ordinary appearance ; and all the fecre-
tions become gradually increafed, not equally, but fome¬
times one more fpeedily, fometimes another. The eyes,
unlefs when the delirium has ended in ltupor, begin to
have a more healthy appearance, are more compofed and
clearer, and exprefs a greater attention to the objefts
around them. The deep returns, but not equally; the
patient fometimes palling a quiet, at others a re file Is,
night. The appetite returns, although feldom regular¬
ly ; fometimes it is voracious, but the patient is not-
w’ithftanding fatisfied with a very fmall quantity of food;
in the other cafes it returns very flowly. Although the
deprefiion of ftrength fometimes goes off altnoft at once,
yet it leaves the patient often with a greater feeling of
weaknefs. Thus, however, the whole difeafe difappears,
and the patient recovers his ftrength very quickly.

But, although this favourable termination of fever oc¬
curs in a large majority of inftances in this country, it is
neverthelefs a difeafe frequently fatal, and, under parti¬
cular circu mftances, the caufe of great mortality. When
fever terminates fatally, the fymptoms prefent themfelves
chiefly under two different afpefts, but varioufly modi¬
fied, approaching to each other, or even partially com¬
bined. The individual varieties it is impofiible to depift;
a knowledge of them can only be attained by perfonal
obfervation of numerous cafes at the bed-fide of the lick.
One of the forms, juft alluded to, confifts principally of a
great aggravation of the fymptoms of the hot ftage. The
heat of the fkin continues great and pungent, and its fur-
face dry and parched ; the countenance is Unified, and the
eye fuftufed with rednefs, and intolerant of light; the
head-ache is fevere, little or no fleep is obtained, the de¬
lirium is augmented, and is accompanied with extreme
reitlefinefs, often with vociferation, and even great muf-
cular ftrength, fo that the patient is with difficulty con¬
fined in bed ; and the pulfe is frequent, with confiderable
jhardnefs. About the end of the fecond week thefe
fymptoms fuddenly change ; the delirium ends in an in-
diflinffnefs or confufion approaching to ftupor, the arti¬
culation becomes indiftindi, the breathing laborious, the
ftrength finks rapidly, cold l'weats and convulfive motions
enfue, and the patient is cut off in a few hours. Some¬
times fymptoms of inflammation of the lungs fupervene,
and, continuing together with the delirium, hot fkin, fre¬
quent pulfe, and brown tongue, the patient dies with
fymptoms of fuffocation ; and fometimes inflammation of
the inteftines, or other important organs, being l'uper-
added to the original fever, accelerates and modifies the
fatal termination. This has been called inflammatory
fever. The other form of the difeafe, above mentioned,
is extended more commonly to the third week, fome¬
times later, and the progrefs of the fymptoms is more
gradual. The deprefiion of the mufcular powers conti¬
nues to increafe with the difeafe : the eyes become funk,
dull, and liftlefs ; the countenance dejeffed, and of a
dufky hue ; the delirium is attended with a low mutter¬
ing, and the patient lies without the difpofition or the
power of making any exertion, or he picks the bed¬
clothes; the tongue becomes crufted with a dark-brown
or black matter, a fimilar fordes colledts upon his teeth
and lips ; the pulfe is frequent, beating from izo to 130
times in a minute, and is at the fame time fmall and
feeble; the refpiration is alfo weak, generally frequent,
and interrupted with fighing or a dry cough ; the voice

becomes indiftinft or inarticulate; and there are flight
convulfive twitches, or fubfultus tendinum. At length
the proftration of ftrength becomes extreme; the patient
lies on his back, being unable fo fupport himfelf in any
other polition, and even Aides down towards the bottom
of the bed ; he is altogether infenfible to external im-
prefflons ; the fphindters, as well as the mufcles of vo¬
luntary motion, are relaxed, and he pa fifes his ftools and
urine involuntarily in bed ; the pulfe becomes very feeble,
tremulous, and fcarcely to be felt at the wrift; partial
clammy fweats break out ; the eyes appear glazed and
fixed, and the other features fhrink ; the patient is unable
to fwaliow ; his breathing becomes irregular and labo¬
rious, attended with fome noife in the throat, as the fatal
event approaches; the extremities grow cold ; and, often
after fome. hours, the functions of life finally ceafe.
When fever affumes this form, it eonftitutes typhus , or
the nervous, malignant, Sec. fevers of authors.

There are fome other appearances, which, though not
the ordinary attendants on fever, occafionally occur, ef-
pecially when the difeafe is of a fevere kind, and which
have been confidered as evidence of malignancy, or of
putrefcence. Generally in the fecond week of the dif¬
eafe, but fometimes as early as the fourth or fifth day,
(fee Pringle on Difeafes of the Army, part iii. chap. 7.
and Huxham on Fevers, chap, vii.) an eruption of fpots,
not elevating the cuticle, of a red colour, fometimes pale,
often darker, or even of a livid or purple hue, appears on
the fkin: thefe fpots, or pelechice, are thickeit on the
breaft anil back, lefs numerous on the legs and arms, and
are feldom, if ever, feen on the face. They were firft
defcribed, among the moderns, by Ingraffia of Naples,
afterwards more particularly by Fracallorius, under the
names of lenticula, punSlicula, or peticula; whence alfo
the fame appellations were given to the fevers themfelves.
(See Fracaftorius de Morb. Contag. lib. ii. cap. 6.) Pe¬
techias appear in fever, moll frequently in clofe and
crowded fituations ; formerly they were very frequent
attendants on the fevers which occurred in the perfons
under confinement in clofe cells, or crowded apartments
in our prifons. Dr. Willan has ftated, however, upon
the authority of the furgeon of Newgate, that, fince a ge¬
neral attention to ventilation and cleanlinefs has been
adopted, petechias do not now appear in more than one
cafe of fever in thirty in that prifon. He has alfo added,
from the obfervation of Dr. Bateman, phyfician of the
Fever Inftitution in London, that the proportion of cafes,
in which petechiae occur in that inftitution, is about one
in forty-two. (See Willan on Cutaneous Difeafes, order
iii. p. 468.) Sometimes the purple fpots are of a large fize ;
in which cafe there are often alfo livid blotches, or Itripes
like the ftrokes of a whip, vibices, and haemorrhages, break
forth from the internal parts, as the bowels, lungs, fto-
mach, and wherever the furface is covered with a very
thin cuticle, as from thenoftrils, thegums and mouth, & c

A rafh of a different fpecies, which Dr. Willan has
termed rofeola, “a rofe-coloured efflorefcence, varioufly
figured, without wheals or papulae, and not contagious,”
(Loc. cit. order iii. genus 4.) fometimes makes its appear¬
ance in fever of the typhous type : fometimes it precedes
the formation of purple fpots and vibices, and in other
cafes it is feen early in the fever, but remains only for a
fliort time without any material confequences. Some
other cutaneous appearances occafionally occur, as men¬
tioned by Huxham, (Loc. cit. p. 97.)'fuch as miliary
puftules, a fcabby eruption about the lips and nofe, and
aphthae.

We have thus laid before our readers an ample account
of the phenomena of fever, in order that the relation be¬
tween tliofe phenomena and our explanation of them may
be more clearly feen. We proceed to examine the merits
of the gaftric theory of fever. In the firft place, the afler-
tion of Broufiais, that a furred tongue and other appear¬
ances of the mouth indicate inflammation, by no means

refts

205

PATHOLOGY.

r&fts on a (table foundation, becaufe thofe difordered fe-
cretions may be the refult of difturbance in the brain.
It mult be granted, however, that the red appearance of
the edges of the tongue, a fymptom this author particu¬
larly dwells upon, is a fign of inflammation ; but every
one knows that this fymptom is often wanting in fevers;
and, that all other appearances of the tongue may be
produced by nervous irritation, altering the fecretion on
the furface of that organ, is clear enough, from the ob-
ferved and well-known effefts which the artificial inter¬
ruption of nervous power to a fecreting furface invariably
occafions. Now that inflammation of the mucous mem¬
brane itfelf may produce the various appearances of the
tongue in fever, we cannot admit, becaufe local applica¬
tions, known to be capable of bringing on inflammation,
do not caufe the difplay of fimilar appearances. More¬
over, if it were allowed that inflammation of the mucous
membrane do exift, it were (till impoflible to (how by
what influence general febrile commotion is produced ;
becaufe inflammation in one part mull be the fame as in
another to a certain-degree ; and hence fever might re¬
fult from inflammation of any organ of the body without
implicating the digeflive tube, which does away with the
theory. The effeft of ftimulants and tonics in fever does
not require us to believe this theory, fince the intimate
fympatby between the ftomach and brain offers a ready
explanation of the faft. Independently of this, a few
cafes have occurred in debilitated and generally-difeafed
patients, in whom the exhibition of gentle ftimulants has
produced highly favourable confequences.

The ftrongeft faffs adduced in favour of the doftrine
of Broufl'ais, is the red appearance of the infide of the
ftomach on diffeftion, becaufe his opportunities for car¬
rying on diffeftions of that kind have been almoft un¬
limited ; but we think whoever attends to the clafs of
patients from whom thefe diffeftions were made, and the
climate they exifted under, will have no hefitation in be¬
lieving, with us, that this author has been led to form
this fweeping conclufion as to the general fources of fe¬
brile ailments from having principally had under his care
the gaftric form of fever, i. e. a complication (very fre¬
quently met with) in which the ftomach, fometimes fole-
ly, fometimes in common with other organs, is in a (late
of phlogofis. We have feen patients who have died of
fever, in whom rednefs of the mucous membranes in the
ftomach was not found ; and, though our very limited
experience would feebly indeed counterbalance that of a
Broufl'ais, we conceive that a very few unequivocal cafes
overthrow the whole theory as to the effential caufe of
fever.

We have no hefitation in contradifting Dr. Harrifon’s
affertion, that the intenfity of fever is in direft ratio to
gaftric inflammation. We deny this from diffeftions ;
and we leave this and the above affertion, which we have
made in oppofition to Broufl’ais, to be corroborated by the
experience of our medical brethren.

It muft be granted, after all, that gaftritis in various
degrees of feverity, though ufually mild, is (rnoft pro¬
bably from the fame caufe which produces heat and red¬
nefs of the external (kin) a frequent concomitant of con¬
tinued fever; and that it always exifts in the Exanthema-
ticae, or eruptive fevers.

It will be feen, that Dr. Nicholls’s rationale of febrile
phenomena is principally derived from the application of
the two laws, that diminiflied fenfibility is followed by
excefs of fenfibility, and the fame of contraftility (or, as
he ftyles it, tonicity). The extenfive and accurate man¬
ner in which he has traced their operation in the long
quotation we have given, will fave us from pointing them
out further. It will be feen, however, that this author
by no means enters into thofe queftions which the majo¬
rity of writers have contended about, and which we have
before detailed. There are moreover many conclufions
ftated of which Dr. Nicholls has adduced no proof; as
where he fays, in fpeaking of the firft ftage of fever, that

fulnefs of blood in the head will arife from want of ac¬
tion in the heart ; and it is on this affumption that many
of his reafonings turn.

Upon reviewing thefe various theories of fever, not
one of which has maintained altogether its ground, we
neverthelefs fee much to admire; and we (hall now pro¬
ceed to cull the good parts of each and exhibit them in
what appears to us to be the moll: Ample form. We (hall
firft pa fs in. review the caufes of fever. Thefe are of
three kinds: inflammations of all parts ; animal irritants,
or contagious effluvia; and vegetable irritants, or marfh
miafmata. A predifpofition of body is required to ena¬
ble thefe agents to produce the febrile ftate, fince all are
not equally liable to undergo their operation.

The ftate of body which feems to be moll: liable to be
affefted by fympathetic fever, or that from local inflam¬
mation, is plethora ; though it is to be remarked, that
this does not argue that fymptomatic fever is in plethoric
habits the molt formidable. The ftate of the body which
difpofes to the influence of contagion and miafmata, is
a weakened condition of the nervous fyftem. Thus
cold, bad living, fatigue, the depreffing paffions, Venus
nirnia,' have long been accounted predifpofing caufes.
They are alfo in conjunction, or long applied, exciting
caufes, and will produce fever without contagion.

From thefe well-known and generally-allowed ftate-
rnents it follows, that the operations of febrile commo¬
tion is carried on through the medium of the nervous
fyftem ; a faft long fince fliown by Cullen and others,
but of which we have been long in making a proper ufe
in the profecution of this fubjeft. We have feen that in
fever the capillary fyftem betrays the firft fymptoms of
derangement, principally manifelted in the (kin. Thefe
fymptoms are generally coldnefs orrigor, the confequence
of conftriftion of the capillaries. Now, to this gene¬
ral c-onftriftion (as is explained by Dr. Park in his Patho¬
logy of Fever) may be referred all the phenomena of the
firft or cold ftage of fever. For, every part having a dif¬
ferent mode of feeling, and a different funftion to per¬
form, it follows that various effefts will refult in differ¬
ent organs from the fame change of circulation. And
accordingly, that ftate of veffels which occafions a fenfe
of cold on the furface is accompanied by the fenfe of
navfed in the ftomach. The fame conftriftion in the ca¬
pillary fyftem of the brain produces diminiflied perform¬
ance of the fenforial funftions; or agents direftly debi¬
litating the brain may give rife to this conftriftion over
the whole furface. However this may be, the atonic
(fate of the brain muft be looked to as the caufe of the
languor and laflitude, the lengthened mufcles of the face,
the lofs of ftrength, fainting, &c. which are the conco¬
mitants of the firft ftage of fever. To the fame condi¬
tions of nervous torpor and capillary conftriftion, we
refer the feeble fmall pulfe, the palenefoof the (kin, and
the fhrinking and diminution of fize in the features, and
every other external part, as well as of morbid fwellings.
From the contrafted condition of the capillaries the other
lecretions are diminiflied, through wanting a due fup-
ply of blood. The mouth and tongue become dry from
the fcanty fupply of faliva ; the pancreatic juice, the
bile, the mucous and ferous excretions in the alimentary
canal, being diminiflied, as well as the mufcular aftion
of the bowels enfeebled, the faeces are not paffed for¬
wards, and coftivenefs takes place ; the urine is not
only fmall in quantity, but of pale colour. The heat of
the body is dependent on the due fupply of animalized
blood and nervous power, and always increafed when the
ratio of thefe fluids is increafed, is now diminiflied by
their diminution. The diminiflied circulation of blood
in the capillaries naturally throws a larger fupply on the
heart; and to this circumftance the anxiety, and^fenfe
of load about the region of the heart, the fighing, yawn¬
ing, and ftretching of the limbs, as well as the (hort and
dilturbed refpiration, are to be attributed.

All the fymptoms, then, of the on let of fever, con-

ftituting

PATHOLOGY.

206

ftituting the phenomena of the cold ftage, are explicable
on the fuppofition of a deprelllon or diminution of the
nervous energy, however induced ; and chiefly adding by
conftriCHng the capillaries, or by conftri&ion of thofe
capillaries which involve the brain in torpor. In like
manner, the fymptoms of the hot -ftage and the fubfe-
quent phenomena, in continued fevers, are refera¬
ble to an imperfeCt recoiling, as it were, of the ner¬
vous power, and more immediately to the increafed
aCtion of the heart and arteries, and of the capillary
veflels.'

The heat, the rednefs of Ikin, and flufhed counte¬
nance, the returning fize of the external parts, the ref-
toration or even increafe of the fenfibility of the organs,
are all the refult of the diflention of the extreme veflels
by the red blood, as the oppofite fymptoms of the cold
ftage were the confequence of an oppofite condition of
the circulation. Hence the frequent forenefs of the
body, which cannot bear its own preflure without pain ;
hence intolerance of light in the eye, and the quick fen¬
fibility to noife in the ear, both of which increafe the
head-ache, which is now more acute, and deep-feated:
hence alfo difeafed parts become more painful. The
quick and ftrong pulfe implies the greater force of the
heart, and of the arterial aCtion ; neverthelefs the dry-
nefs of the flcin, and the continued fuppreflion of the
reft of the fecretions, evince the continuance of a mor¬
bid condition of the extremities of the exhalantsand fe-
cernents by which their funftions are impeded.

This laft circumftance has been varioufly explained.
Cullen attributed it (as before ftated) to a fpafmodic
contraction of the termination of the veflels ; but, as
we before fhowed, it did not explain how this was pro¬
duced ; and it feemed curious that a fufpenfion of fecre¬
tions ftiould arife both in the hot and cold ftage from the
famecaufe. A new explanation has been promulgated by
a late author, Dr. Park. He conceives that, “ During the
hot ftage of fever, that thefe mouths are clofed can hard¬
ly admit of difpute; as it feems impoflible in any other
way to explain, when the veflels to which they belong
are gorged and diftended with fluids, what prevents thefe
fluids from tranfuding at every pore.

“ In order to explain why they are thus conftriCted in
the hot ftage, and to underftand the nature of thefe pa¬
tulous mouths which perform an important part in the
production of both fever and inflammation, we have
only to regard them in the light of fphinCters, to which
they are perfectly analogous. The office of both is to re¬
tain the contents of the organ to which they belong, or
to allow their tranfmiinon only at fuitable times, and in
proper quantity. Accordingly, the aCtion of the fphinc-
ter appears to be vicarious with that of the organ, as its
office requires it ffiould be; that is, the fphinCter relaxes
when the organ contracts, and, on the other hand, the
fphinCter contracts when the organ relaxes. Tl^us, for
example, when the ftomach is roufed to inordinate ef¬
forts of contraction by an emetic, its fphinCter, the py¬
lorus, relaxes, and bile is tranfmitted through the duo¬
denum in vomiting. When the inteftines are excited to
contraction by a ftrong purgative, the fphinCter of the
rectum relaxes, and faeces are with difficulty retained.
When the bladder contracts for the expulfion of urine,
its fphinCter relaxes, and allows the tranfmiffion of this
fluid. So likewife, when the veflels of the furface fltrink,
and palenefs is produced by fear, a cold fweat breaks
out, and the furface becomes moift. Or, when the vef-
fels collapfe from lofs of blood, the fame clamminefs of
the furface attends, and is the forerunner of fyncope.;
and thus tranfpiration is increafed, and not fufpended,
as Dr. Cullen fuppofed, by moderate contraction of the
veflels.

“ On the other hand, the fphinCters and the pores alike
become conftriCted when the organs or veflels to which
they belong are relaxed and over-diftended. Thus, when
the ftomach is diftended with food, the pylorus clofes.

and fuffers nothing to be tranfmitted till the bulk of its
contents is reduced by abforption. When the reCtum is
over-diftended by immoderate accumulation of faces, its
fphinCter contracts, and the molt obftinate conftipation
is apt toenfue. When the bladderis over-diftended with
urine, its fphinCter becomes conftriCted, and ftrangury
is the confequence. In like manner, when the veflels of
the furface are over-diftended by immoderate determina¬
tion of blood in fever or inflammation, the pores then
become conftriCted, and tranfpiration is fupprefied. And
for the fame reafon, the fecretion of bile is fupprefied in
aCtive inflammation of the liver; and that of urine in
acute inflammation of the kidneys. Thus the mouths
of theexhalent veflels, terminating on the external and
internal furface, appear to be governed by the fame laws,
and to exhibit the fame modes of aCtion, as the fphinc-
ters belonging to larger organs. In the hot ftage of fe¬
ver, then, tranfpiration is fupprefied, and morbid heat
kept up by over-diftention of the veflels exciting fpafmo¬
dic conftriCtion of their mouths ; and accordingly it is
to the removal of vafcular diflention that we mull look
for a ceflation of that conftridion, and the return of
tranfpiration.”

To us, this idea of the fphinCter-like properties of the
fecreting veflels appears as vifionary and gratuitous as
the notion before mentioned of Cullen. Moreover,
much mult, in the relaxation of fphinCters, be attributed
to the form which their antecedent mufcular parts oppofe
to them. At all events, this fuppofition is not required.
If fecretion were a procefs dependant on the mere drain¬
ing or letting-through of certain parts of the blood, we
could account well for the hindrance of fecretion on the
notion of contraction in the veflels; but the products of
fecretion depend on nervous influence; take away the
nerves going to a part, and fecretion ceafes. Can this
be becaufe fuch deprivation caufes a contraction of their
mouths ?

The alteration of the fecretion in fever is thus ex¬
plained. Secretion is diminiflied in the firft ftage, be¬
caufe the conftriCtion of the capillaries brings to the fe-
cernents fmaller quantities of blood. It is ftill more di-
miniffied, or it is altered or fufpended, in the hot ftage
of fever, becaufe, the nerves being prefled on by the dif¬
tended capillaries, or the nervous power being more ra¬
pidly expended in the blood in the generation of heat,
perhaps a more rapid motion in the fanguineous circula¬
tion is hindered from aCling on the fecernents. It mat¬
ters not whether the latter be diftended or contracted, or
in a mean ftate : they are too fmall to receive blood ; and
the ftate of its parts depends on the faculties de¬
rived from the nerves, which we fee have here loft their
power.

Cullen erred in confidering the hot to be an invariable
confequence of the cold ftage of fever. The cold ftage
may happen ; and fo great may be the debility induced,
that re-aCtion may never return ; or the hot ftage may
be manifefted at once, as in fymptomatic fevers and fome
other kinds. The fweating ftage is produced in a man¬
ner not very well underftood. It was fuppofed by the
older phyiiologifts, as Albinus, Haller, &c. that the
fweat, as well as the infenfible perfpiration, is a mere
exudation of the watery part of the blood through the
cuticle ; hence it w\as faid to arife, in fever, from a me¬
chanical relaxation of the extreme arteries, which were
fuppofedtobe fpafmodically contracted during the hot
ftage. But it has been obferved by later phyfiologifts,
that this opinion refpeCting the nature of the perfpiration
is contrary to all analogy, and founded only upon expe¬
riments made on the dead body. The opinion of Dr.
Fordyce and Mr. Crufcklhanks appears to be the true one ;
namely, that the matter of perfpiration is fecreted from
the blood by the capillary arteries, and thrown out on
the furface by organic pores in the cuticle, (however dif¬
ficult to be difcovered,) connefted with the extremities
of thefe arteries ; and that in this procefs there is not a
4 feparation

!

PATHOLOG Y. 207

Reparation merely, but a new combination, as in fimilar
inftances of fecretion.

It has been very generally held, that the coming-on
of perfpiration tends to cure fever. We do not altoge¬
ther fubfcribe to this dodtrine, though certainly fweat-
ing produces a falutary refrigeration. It feems to us,
however, that it is critical, rather becaufe it (hows that
the nerves have relumed their functions; that it is not
fo ufeful in itfelf, as in being an indication of another falu¬
tary change in the conffirution. It is to t he reftoration of
the nervous influence that we refer the re-eltablilhment
of fecretion all over the body; as the moiflure of the
mouth, the abfence of third, the return of appetite, and
the copious flow of urine. The increafe of the febrile
phenomena in the hot flage towards evening, is exp! fined
by the well-known f'adt, that the adtion of the heart
always accelerates at that period.

According to the views here taken, the actions of the
nervous fyflem are efl’ential movements of the febrile
ftate. When we confider that this is indeed the only one
through which the general fympathy between the capil¬
laries of all parts of the body can be manifefted, we (hail
readily conceive that the brain mud be the part whofe
morbid condition is efl'ential to fever. Our ignorance of
the ftrufture and functions of that organ, prevents us
from reafoning fo haftily as to affirm with Dr. Clutter-
buck, that inflammation is the condition which pro¬
duces fever. But certainly it does feem, that a perpe¬
tual fympathy being eftablifhed along nervous conti¬
nuations, a fympathy capable of cauling at their remote
parts difeafe limilar to that which gave rife to it, mud
in its courfe implicate in this fame adtion (inflamma¬
tion) a part where the vafcular and nervous fyftems are
fo clofely united as the brain.

The il 1 ult ration we have attempted feems to embrace
the fymptomatic, the idiopathic, and the intermittent,
forms of fever. The firft we (hall now difmifs the con-
ffderation of, as appertaining to Surgery, under which
article the fu bjedt will be relumed. Of the others a little
remains to be laid as to the agents which produce them.
Of the natural agents, i. e. the atmofpherical, the mental,
or the terredrial, which are daily altering the nature and
conditution ofonr bodies, we may remark, that our pre-
fent knowledge renders us quite incapable of tracing or
illudrating their effects. We fliall (peak therefore of
contagion.

An opinion has been raflily broached by fome, that,
becaufe fever is often diredtly traceable to contagion,
therefore it arifes from no other caufe. ’It has been
v/ifely and mod impugnably anfwered, that, on this fup-
pofition, the feeds of all the manifold ills which “ flefli
is heir to” mud have been latently contained in Adam,
and that many of them mud have laid in the fame dor¬
mant date for hundreds of generations ; as in the cafes
of fmall-pox, fiphilis, &c. The more general notion,
and the only one which bears the ted of reafoning, is,
that contagions are produced by natural chemical changes,
whether external or internal to the human body; in
which latter fituation they re-produce their kind. Thus
putrid decompofitions of animal fubftances, the fame
procefle3 adding on vegetables, or the adtion of the fun
on the earth itfelf; feem, in fome fituations, to have
been each followed by a diftindt contagious fever. The
contamination of the air by the breathing of many indi¬
viduals, as in clofe places of confinement or in large the¬
atres, has been followed by the fame confequences, even
when the individuals inquedion were all free from infec¬
tious fever. Often, however, the fevers which follow
exposure to the above-mentioned agents are not tranf-
terrable from one to another, but are rendered common
by the genera! influence of the exciting agent. It feems
too, that fome difeafes which are not generally conta¬
gious may, under circumftances of peculiar violence and
iptenfity, acquire t his property; for, on the teflimony
of very eminent phyficians, phthiiis and croup have been
Vot. XIX. No. 1298.

Raid to be infedtious; eryfipelas is well known to have
become fo on fome occafions ; and indeed we fhould not
be furprifed, when we confider the multiform produdts
of difeafed fecreting furfaces, that lecretions of a vola¬
tile nature fhould be generated, and that they fhould be
fo related with our frame as to produce like adtions to
thole whence they took their rife. But, whether in
the bodies of men or out of them, this product is ame¬
nable to the adtion of the common agents of matter.
We fee difeafes, which have been idly called fpecific, al¬
tering in the courfe of years their nature, — old ones loff,
new ones arifing. For the horrible leprofy of the an¬
cients we in vain fearch a prototype in the medical hif-
tory ofonr own time. The dreadful fiphilis which mu¬
tilated the foldiers at the fiege of Naples, is now fo
changed in its charadter, that we hardly recognize it in
the ancient defcriptions ; and, though fcariet fever,
meafles, &c. hold on for centuries their unchanging
courfe, this is no evidence againft the fadt, that many
dift'ufible maladies do change by the hand of time, while
ail are fubjedt (though in a minor degree) to the influ¬
ence of the fame agents which control fimilar adtions of
the body when called into play by other caufes.

The molt important part of our inquiry refpedting
contagion, relates to the mode and circumftances of its
communication from individual to individual, and of its
general fpreading, with a view to difcover the means of
fuppreffing it, or preventing its extenfion. This en¬
quiry is, of courfe, limited to the contagions which are
l’oluble or dift'ufible in atmofpheric air; Alice it is 'ob¬
vious that the indiffufible contagions may be avoided, by
Ihunning the contadf of the dileafed. And it mult be
premifed, that all the febrile contagions have been found,
by experiments, to be propagated according to the fame
laws, and to be fupprefled by fimilar means.

Whenever a contagious epidemic difeafe prevails, a
very general alarm is excited, in confeqnence of a no¬
tion, that the feeds of an evil fo generally deftrudtive
mulf be diffufed through the atmofphere at large; and
that, if we rtir abroad, we breathe contagion at every
flep. This opinion has been promulgated by phyficians
of high rank and authority ; but recent obfervations
have fhown that it is erroneous; thus at once removing
all grounds for this unnecefi’ary alarm, and diredting
our attention to thofe means of precaution and preven¬
tion which can alone efFedlually contribute to our fecu-

nty- .

Without entering into the long firing of authors
who have fupported this opinion, it is enough to ftate
Amply, that a fufficient number of fadls are now known
to eftablifh the inference that the popular opinion and
apprehenfion are groundlefs, and that the moil malig¬
nant contagions are never conveyed to any great diffance
through the atmofphere ; but that they are, in fadl, ren¬
dered inert and harsnlefs by difl’ufion in the open air,
and even in the air of a well-ventilated apartment. It
is alfo eftabiifhed on clear evidence, that an accumula¬
tion of contagious matter may occur, and may undergo,
from the warmth of the body, a change which will in¬
creafe its force ; fo that the ftridieft cleanlinefs in the
clothes and perfon of the patient ftiould always be in-
fifted on.

, Contagion is capable of being contained in unventi-
lated clothes. A nation Iras been exterminated by fome
of its people wearing a blanket tainted with contagion ;
but ventilation fo e fie dtu ally removes this, that we are
in no fear of carrying infedtion from one houfe to ano¬
ther in our clothes. It may indeed hang about furni¬
ture, or it may remain for iome time in the air of a place
where the accefs of frefii air is excluded.

In moll cafes, the contagious eflence of feve^ remains
fome days in the body before its effects are manifeft. In
others, the attack is almoft fimultaneous with the recep¬
tion of the contagion. Where a fudden infedtion takes
place, a dil'agreeable fenfation is excited at tire moment
3 H of

208 P A T II O L O G Y.

of expofure, which different perfons have defcribed dif¬
ferently. Some have felt a (harp tafte in the mouth, as
if blue vitriol were diifolving in it, but which nowafhing
or gargling could remove. Others have compared the
firft imprefiion to that of an earthy exhalation from a
newly-opened grave, the fenfation extending down to the
ftomach, fometimes exciting inftantaneous ficknefs and
fflivering. Dr. Haygarth mentions that two of his pa¬
tients, who were phyficians, were infe&ed fuddenly by a
fhort expofure. One of them thought that he caught
the fever by creeping behind, in order to affift, his pa¬
tient; the other by infpefting morbid faeces. In both
thefecales, the expofure was fuch as might probably af¬
ford a full dofe of the contagion. Dr. Lind is of opi¬
nion, that, in thefe difeafes, the dools, efpecially if very
fcetid, are mod communicative of contagion; next to
thefe, the breath; and, ladly, the effluvia from the
body.

The aftivity of contagion is not always proportionate
to the appearances of malignancy in the difeafed. Some¬
times only one man in a fhip may be feized with the pete¬
chial or with the yellow fever, fays Dr. Lind, while all
the red continue unaffefted. And on the contrary, fe¬
vers, of the milded defcription, fometimes fpread exten-
fively. The period at which different fevers begin and
ceafe to generate contagious effluvia is not abfolutely as¬
certained. It feems mod probable that in eruptive fevers
there is no contagion till the eruption appears; and that
contagion remains fo long as any fcab remains on the
fkin. This is clearly the cafe in fmall-pox.

When it is confidered, that contagion originates in ac¬
cumulated and confined animal effluvia, and is communi¬
cated either to thofe w’ho approach, or come in contaCl
with the fick, or by means of fubdances impregnated
with contagious matter, and in thefe ways only, the
means of prevention are obvious.

With refpeCt to the cafual origin of contagion, it is
Scarcely neceffary to fay, that cleanlinefs and ventilation,
as they preclude the confinement and accumulation of
the animal effluvia and Secretions, will infallibly prevent
the generation of the poifon. Where contagion exids,
its farther communication may be prevented by avoiding
contact or approach to the fick, and by confining the pa¬
tient to a Separate room, in which, if it be kept clean,
and well ventilated, it has already been fliown that the
contagion will be inert at a fhort didance from the fick ;
and therefore that the neceffary attendants, and medical
vifitors, will receive no injury from refpiring the air
within it. In this way contagion has been prevented
from Spreading in large Schools, and other places, where
a number of people live together, as in workhoufes and
liofpitals, of which Some examples have been already
given. Dr. Haygarth’s rules for the prevention of in¬
fection, Seem to comprife all the requifite means to be
adopted in houfes where contagious fever exids : they are
the following.

i. As fafety from danger entirely depends on cleanli¬
nefs and free air, the chamber-door of a patient, ill of
an infectious fever, efpecially in the habitations of the
poor, fhould never be fhut ; a window in it ought to
be generally open during the day, and frequently in the
night. Such regulations would be highly ufeful both to
the patient and nurfes; but are particularly important
previous to the arrival of any vifitor.

a. The bed-curtains fhould never be drawn clofe round
the patient ; but only on the fide next the light, fo as to
fhade the face.

3. Dirty clothes, utenfils, See. fhould be frequently
changed, immediately immerfed in cold water, and waffled
clean when taken out of it.

4. All discharges from the patient fhould be indantly
removed. The floor near the patient’s bed fhould be rubbed
clean every day vPith a wet mop or cloth.

5. The air in a fick room has, at the fame time, a more
infectious quality in Some parts of it than in others. Vi¬
fitors and attendants fhould avoid the current of the pa¬

tient’s breath ; the air which afeends from his body, ef¬
pecially if the curtains be clofe ; and the vapour arifing
from all evacuations. When medical or other duties re¬
quire a vifitor or nurfe to be placed in thefe fituations of
danger, infection may be frequently prevented by a tem¬
porary fufpenfion of refpiration.

6. Vifitors Should not go into an infeCted chamber with
an empty flomach ; and, in doubtful circumltances, on
coming out, they fflouid blow from the nofe, and fpie
from the mouth, any infectious poifon which may have
been drawn in by the breath, and may adhere to thofe
pafflages.

Befides thefe precautions, we are advifed to endeavour
by gafeous agents to deftroy the contagious pabulum.
The vapours of vinegar, and thofe of the Sulphureous
acid, have been long ufed with fome degree of fuccefs ;
but thofe of the muriatic, and ftill more perhaps thofe
of the nitrous, acid, appear to be the belt antidotes to
accumulated contagion. The evidence of the efficacy
of the nitrous-acid fume, in purifying infeCted places
and fubftances, which was a few years ago laid before the
Houfe of Commons by Dr. Carmichael Smyth, was fuch
as to induce that houfe to vote a national donation of
five thoufand pounds to him for the difeovery. This
vapour is eafily obtained, by mixing with powdered nitre
a little of the ftrong acid of vitriol or Sulphuric acid ;
the latter combines with the potafs, the bafe of the nitre,
expelling at the fame time the nitrous acid in fumes.
(See Dr. C. Smyth’s treatife on the fubjeCt.) The va¬
pour of the muriatic acid may be obtained in a Similar
manner, by ufing common fea or rock fait, inllead of
nitre. Where contagion has been long pent up in clofe
cells or rooms, it is apt even to adhere to the walls. In
fuch cafes, white- walking, with hot or newly-flaked lime,
is an efficacious aid of the acid fumigations.

We are Sorry, however, after all, to be obliged to ad¬
mit the juftice of a remark of Dr. Clutterbuck’s ;
“that thefe modes of chemically neutralizing the conta¬
gious virus, while they lead to a falfe Security, are often
quite ufelefs.” For this reafon, ventilation and cleanli¬
nefs are the chief means on which we fhould place our
dependance in guarding againlt the diffufion of fever.
Thefe are both meafures of fo much importance, that
the profoundeft phyficians have not thought it derogatory
to their dignity to enter into minute and particular di¬
rections for their perfect eftablifflment. The means re¬
quired are however obvious to the meaneft capacity.
We fliall j uft quote a fhort extraCt from Dr. Jackfon, be-
caufe the fad it contains is not generally known. He
fays, “ In cold, damp, and foggy, weather, the free
admiffion of external air might probably be injurious ;
for air of that defcription is not calculated to abforb or
diflipate the floating contagion. In this cafe, the ftrong
heat of fire in open fire-ftoves, fo placed as to diffufe its
influence into the lower layer of the atmofphere, has ap¬
peared to myfelf to be the only fubftitute for defeCt of
common ventilation, and the only fure means of recti¬
fying the air that is vitiated by emanation from the bo¬
dies of living men. Heat, as aCting on the fkin, proba¬
bly operates favourably on the conditions of contagious
fever; it evidently operates favourably, as exciting and
maintaining circulation of air within the apartment. I
here take leave to mention the circumftance that firft di¬
rected my attention to it. The wards in the barrack in
Weftmoreland Fort, on Spike Ifland, which were allot¬
ted to the reception of the fick of the St. Domingo ex¬
pedition, and which were crowded to the molt extreme
degree of crowding, were alfo in fome degree cooking-
places ; that is, employed for the preparation of the
lighter parts of diet. A large fire was neceffary : and a
long grate, being filled with coals, threw out a great heat,
fufficient to roaft a furloin of beef. This was the cafe
in the larger wards, .where there were from forty to fifty
perfons flowed on the floor as clofe as they could lie.
Thofe who lay within a certain diftance of the fire gene¬
rally did well, though thefymptomsof thedifeafewereoften
4 violentj

PATHOLOGY.

violent ; thofe who were near the end where there was no
firediedin great numbers, though the fymptoms of the dif-
eafeoften appeared to be moderate. The air near the fire
was comparatively light, and notoftenfive; near the remote
end it was heavy, unpleafant, almoft infupportable to the
tranfient vifitors. The influence of ftrong heat from fire,
in a fick apartment, appeared to be f’o ufeful, at leaft fo
agreeable, in the prefent cafe, that large fires were or¬
dered to be made in all the huts and flteds on the out-
fide of the fort which were occupied by the fick. The
air in thefe huts, though filled with fick to overflowing,
was not offenfive, the progrefs of contagion was not ac¬
tive, and mortality was comparatively moderate ; in faff,
on the lowed fcale. From that and other more recent
experience, I am difpofed to confider the action of the
heat of fire as a molt important mean of ventilation,
mainly conducive in arrefting the progrefs of contagion ;
the chief truft, in fadf, in damp, foggy, and Hill, weather,
through which we can expect to preferve the air of hofpi-
tals, as filled with febrile fick, from a dangerous vitia¬
tion.”

Feveris generally fatal from the occurrence of inflam¬
mation of fome part or texture of the body ; and diflec¬
tions fliow, according to the type of the reigning epide¬
mic, diforganizations of the mucous membranes of the
brain, the lungs, the liver, or other vifcera. In a few
cafes, however, no topical congeftions are found ; and
the patient feems to be worn out by continued exhauftion
of the fundtions of the nervous fyftem.

The treatment of fever naturally grows out of the hif-
tory already given of its caufes, adrions, and confe-
quences. We fhall confine ourfelves to a mere outline
of it, from a convidlion that the peculiar varieties in
character, and confequently in the treatment, of epide¬
mics, are only to be learnt by experience of the particu¬
lar fever which happens to be prevalent; or, in other
words, that epidemics continually vary, as was indeed
the opinion of Sydenham. For fimilar reafons we fhall
omit all notice of a vaft ftore of drugs which in particu¬
lar cafes have had the merit of curing fever; e. g. yeaft,
carbon, muftard, with many others which occur to us
even at this moment.

A diftindtionis to be made between feveras itis Ample,
and as it is complicated with inflammation of particular
organs. Firft of Ample fever. This requires fome dif¬
ference in treatment, according to the ftage it has ar¬
rived at ; the ftages being three ; viz. the cold ftage, the
hot ftage, and the declining ftage. This divifton, it is
proper to obferve, is in fome meafure arbitrary, and has
no exadt relation to time : for, as the whole duration of
the difeafe is extremely various, extending from a few
days to as many weeks ; fo the continuance of the diffe¬
rent ftages, both individually and relatively to each other,
is not lefs various ; and it becomes impoflible to aflign a
determinate extent fo any one of them ; added to which,
they often run imperceptibly into each other. A fuf-
ficient difcrimination, however, may be made between
them for the purpofes of pradtice ; which is the point of
chief importance.

The application of contagious virus is firft made, in
the majority of inftances, to the ftomach ; and there feems
good reafon to think that it remains there, and produces
local effedls before it is carried into the circulation. It
is probably on this account that an emetic often efFediti-
ally prevents the development of the febrile movements :
this remedy fhould therefore be ufed in early cafes ; and
purging fhould likewife be reforted to, becaufe it is fome-
times difficult to eftablifh thefe adlions in the hot ftage of
fever. When the hot ftage is newly formed, it is ftill
often defirable to change the order of fympathetic actions
which are eftablifhed. For this purpofe, the abftraftion
of blood till fainting eufues, followed by a brifk purge,
will often entirely prevent a fevere fever from running
its courfe.

In the more fevere forms occafionally met with in fo¬

209

reign pradlice, the meafures for arrefting the progrefs of
the malady muft be peculiarly energetic. The expe¬
rienced Dr. Jackfon, fpeaking of a fevere and complica¬
ted form of fever, which he characterizes as prefenting
itfelf with appearances of violent irregular vafcular ex¬
citement, and local determinations which threaten con-
vulfion and apoplexy, fuffocation or engorgement of in¬
ternal organs, lungs, liver, or fpleen ; fornetimes with a
ftrong, or what may be called a concentrated, general ac¬
tion, thickened and conftricled fkin,- ardent as a live coal;
a condition, which threatens to fubfide by internal con-
geftion, or to explode by local external gangrene of va¬
ried form, viz. petechise, ftreaks of ecchymofis, or exten-
five and deep blacknefles ; — gives the following judicious
directions. When a certain quantity of blood, only
meafureable by the phyfician as fuperintending the pro-
cefs, has been abftraCted from the arm, it is ad vi fable
that the patient be ftripped naked and immerfed in a
warm bath of moderate temperature, the immerAon con¬
tinued for fifteen or twenty minutes, the ikin (trongly
fcrubbed with brulbes and foap while under immerAon.
At the expiration of twenty minutes, the condition is to
be examined with care ; and, if it be then found that the
mode of adtion has not changed, that is, if the movement
has not become general and equal, it will be advifable to
re-open the vein, and to allow blood to flow, while the
patient remains in the bath, until the objedl in view be
attained : that is, until the circulation be in fome manner
equalized. When that is done, cold water is to be af-
fufed copioufiy upon the head and flroulders, while the
lower extremities remain in the warm bath. The courfe
of the difeafe will, in moll cafes, be fufpended, if not
perfeftly arrefted, by the effeCt of the proceedings now'
recommended; and when that is done, the body, being
removed from the bath, is to be wiped dry, and laid in
bed ; blifters, as means preventive of return, are to be
applied to the head, neck, back, or fides, according to the
predominance of the local fymptoms. FriCfion with warm
oil will be ufeful ; emetics and purgatives promife the
fame benefit here, after the cafe is Amplified, as in the
preceding. A bolus of camphor, nitre, tartarized anti¬
mony and fnake-root, with half a grain of opium, and
two or three grains of calomel, given every five or fix
hours, with plentiful dilution, frequent ablution, and
frequent change of bed and body linen, conduce, if the
courfe of the difeafe be not totally arrefted, to maintain
the movements in an equal tenor until the febrile cir¬
cle be completed, when healthy adtion may be expected
to re-appear. The outline of pradtice now fuggefted,
varied according to circumftances, applies to the cure of
the difeafe in all its conditions.

Thefe violent meafures are feldorn refortable to in
private practice, nor are they generally required in the
fevers of this country; fo that, if tolerably adtive bleed¬
ing and purging do not arreft the difeafe at its onfet, we
let it run its courfe, endeavouring to condudt it favour¬
ably to its termination.

It is well known that fome thirty years back the treat¬
ment of febrile difeafes confifted in ftimulating and ex¬
citing the body to the higheft poflible pitch. The folly
of this plan has been of late feverely reprobated; but a
fliadow of defence has been inftituted, on this ground ;
that, as epidemics are always changing their charadter,
what was ufeful and right formerly has ceafed to be fo.
But this is mere delufion ; for Hippocrates, Sydenham,
and Huxham, and indeed all judicious practical men, bled
in fevers; nor can the nature of fever itfelf be fo chan¬
geable, as to be cured by contrary remedies, though in¬
deed its variations in charadter may require a correspond¬
ing variety in treatment. We muft therefore refer to
the well-known hypothetical notions of debility, &c.
the fatal pradtice of our immediate predeceflors.

Bleeding is now on all hands agreed to be the chief
agent in fubduing the violence of fever, though there is
much difagreement as to its modus operandi, and as to

the

PATHOLOGY.

210

the extent to which it may be carried with fafety. Of the
various explanations which different authors have given
of the beneficial operation of bleeding we (hall not (peak,
becaufe they will naturally be underitood from the ge¬
neral fpecnlations of the pathologifts already palled in
review. According to the notions we have adopted,
that a general diftention of the capillaries of the fyltem
is thecaufe of fever, and that an increafe in the produc¬
tion of nervous power in the brain and fpinal marrow' is
the caufie which perpetuates this diftention from one
part to another, and moreover fufpends the aftions of fe-
cretir.g veffels ; — bleeding mult of courfe be advifed as a
meafure which relieves that diftention. If diftention be
the ftate of the capillary fyftetn in fever, this ftate muft be
evidently increafed by the increafed action of the heart,
the vis a tergo thence derived affing as a perpetual dila¬
tor of the aft’efled veffels. The diftention is alfo of courfe
increafed by the quantity of blood. Bleeding therefore
relieves diftended capillaries by taking from them two
caufes of their unnatural condition : firft, it takes away
the quantity; and fecondly, as the adftion of the heart
depends fomewhat on the quantity, it takes away the
diftending force of the latter vifcus. The latter effeft is
llill further increafed if bleeding be carried ad deliquium
animi, or till circulation of blood in the brain be fufpen-
ded. Now', deeming as we do, that the diftention of the
capillary lyftem occurs alfo in the brain and fpinal
marrow, and thus excites the nervous fymptoms, we con-
iider bleeding on the fame ground a great and direct af-
liftance to the revival of the nervous functions, and
hence to the reftoration of fecretion. The benefit of
bleeding is alfo to be explained on other grounds ; i. e.
on. the luppofition of the increafed contradficn and dila¬
tation of the capillaries in fever. It may in fuch cafes
operate by relieving plethora, the ftimulus to contradfi-
iity, and by diminilhing the produdlion of nervous
power, the refult of increafed circulation in the brain
and fpinal marrow. Whatever fide of the .queftion we
take, the propriety of early bleeding in fever is fhown.
It muft be remarked, however, that a low nervous fever
is often formed, in which we have no right, from the
produdfs of dilfedtion or from realoning, to infer en¬
largement of the cerebral capillaries ; in which, however,
a high degree of nervous irritation exifts, and in which
local bleeding is alone admiffible. It is in this form of
fever that counter-irritants are very ufeful.

From the above conliderations the propriety of bleed¬
ing as early as poffible in continued fever muft be confi-
dered fully eftablifhed. As to the quantity to be taken
away, no dogmata can be laid dowm on the fubjedf ; for
neither the pulfe, the fize, the age, nor the temperament,
of the patient, are unequivocal guides to our pradlice.
The confideration of thefe conjointly muft diredt us in
general. The firft bleeding ftiould be carried on til! the
patient faints. As to the propriety of repeating the ope¬
ration, the fizy appearance of the blood noticed in fever,
and a certain degree of inflammation of the lips of the
divided orifice in the arm, will indicate to us the affirm¬
ative; while the diminished produdlion of heat, and di¬
minution of the pulfe, will point out when it is time to
difcontinue the ufe of this potent meafure.

Purging at the commencement of fever is of the higheft
utility ; and will often, according to the teftimony of
Drs. Clutterbuclc and Bateman, cut fhort the difeafe.
It (hould be excited by the moil adlive means; e. g. by
cathartics of gamboge, elaterium, fubmuriateof mercury
and jalap, &c. (we have generally ufed elaterium.) The
excitement thus produced on the bowels relieves the
fever, both by emptying the fecreting veffels, and by ex¬
citing an irritation vicarious to that exifting in the brain.
As the difeafe advances, (that is, about the (ixth day,)
this ftrong purging lfiould give way to milder or laxative
yncdicines, the adminiftration of which (hould not be
puftied further than to procure two motions in the four-
znd- twenty hours. The reafon for not perfifting long in

the life of draftic cathartics is left inflammation be in¬
duced of the mucous membrane of the bowels ; a circurn-
ftance much to be dreaded.

Digitalis is a medicine of great ufe in controlling the
adlions of fever. It feems to operate in the fame way as
bleeding ; viz. by diminilhing the adtion of the heart and
larger arteries, it prevents the undue diftention or ex¬
citement of the difeafed capillaries. But it is a medicine
which requires to be carefully watched. There is no
rule to be laid down as to its ufe. We are contented, in
ordinary cafes, to give from five to ten drops of its tinc¬
ture every four or fix hours; but thefe doles may be
quintupled in ardent fevers of great intenfity, as we fee
the Italians are in the habit of doing, not only with im¬
punity, but with fuccefs. (See p. 53 of this article.)

As to the dietetic treatment of febrile patients, we have
fcarcely any thing to fay. The parched mouth and nau-
feating palate of the fufterers in queftion fo clearly an¬
nounce the painful violation of feelings which thofe muft
have undergone who were fubjedled to the difeipline of
the Brunonian fchool, that one almoft wonders that the
common fenfe and prejudices of mankind did not run
again!! the injurious regimen of wine and ftimulants.
In the majority of cafes our patients need eat nothing;
a variety of cold drinks, as barley-water, lemonade, &c.
may be provided for them, and allowed in the moft unli¬
mited quantities. Acid fruits may be taken freely; and
this is in general all that is defired. Should fuftenance
be wifhed, thin gruel is all that (hould be allowed; for of
the heating and ftimulating effects of broths, bSef-tea,
See. every one is fufficiently aware. At the fame time
the free current of air through the apartments in the
houfes of the poor, and the removal into another room
of the huddled-up and dirty furniture, are alfo indifpen-
labiy neceflary. The bed-clothes, linen, &c. of the pa¬
tient, ftiould be changed at leaf! every other day; and
fponging the body with water (when maternal or
anile prejudices do not oppofe it) (hould be ordered.
And let no one defpife one iota of thefe fimpl’e (and,
when uncombined, inefficient) meafures ; for they have
faved the lives of thoufands, and may be confidered (in-
fignificantas they are in themfelves) among the proudeft
refults which have arifen from the philofophy of the pre¬
rent age. To the cold effufion ef pecial ly we are indebted
for the prefervation of many of our moft efficient veterans
at a time when the ufe of bleeding was not eftablifhed.

Cold applications to the head are often of much avail
in the removal of the nervous fymptoms of fever. Dr.
Clutterbuck thinks “they are moft ferviceable where
the pain and throbbing are the moft violent, and the heat
of body generally much increafed.” Where, on the
contrary, the face is pale, and the extremities cold, as is
often the cafe in feeble fubjedls, and in advanced ftages
of difeafe, the ufe of warm fomentations to the head from
time to time feems more beneficial.

The laft lfage of fever is marked at once by great dif-
order in, and imperfeft performance of, all the fenforial
functions. The patient is nearly infenffble to impref-
fions ; there is extreme proftration of ftrength, indicated
by the fupine pollute, and the continual Aiding of the
body towards the .bottom of the bed; together with invo¬
luntary tremors of the hands and tongue; and laftly, early
delirium, followed by an almoft total annihilation of the
powers of mind. The pulfe is commonly fort and com-
preffible, though often with confiderable fulnefs; and
the heat of the body is generally confiderable.

It is in this ftage, that black fordes colled! about the
mouth and teeth ; that the tongue turns black on its fur-
face ; and that petechias, purple fpots, and vibices, with
dark-coloured haemorrhages, are apt to occur; Succeeded
by involuntary and foetid dilcharges by (tool and urine.
It is to fever marked by fuch fymptoms, that the terms
putrid and malignant were formerly and erroneouily
applied.

In former times, when perfons labouring under fever

were

211

P A T H C

were confined in a clofe and heated atmofphere, and when
cordials and ftimulants, under the name of alexiphar-
mics, were largely employed, fuch a train of fymptoms
was by no means uncommon. At prefent, owing to a
more judicious management of the patient, they are
rarely feen. The treatment of patients under thefe cir-
cumftances is difficult : little in fa£t can be done. It is
to be remarked, that this Hate is never met with when
proper antiphlogiftic meafures have been premifed. The
patient, after having undergone their operation, always
terminates his life in another manner; viz. either from
a general wearing-out and exhaultion of the nervous
fun&ions, or from local inflammation of a particular
organ.

With refpe£l to the period of this ltage at which
bleeding becomes inadmiffible, this is very uncertain; for
it has been often fuccefsfully performed even when the
pStient appeared near his death. Dr. Clutterbuck fays
that he has occafionally employed it with advantage at
almofl every period up to the end of three weeks. He
believes it may be fafely done at any time, as long as the
fenforial fundtions are carried on in a tolerably perfedt
manner; “ that is, while the external fenles are prefer¬
red, the intelledtual found, the voluntary powers merely
impaired, without being disordered.” This author thinks
that, contrary to what is generally fuppofed, “ the more
the fenforial fundtions are dilturbed, particularly the
greater the delirium, the lefs confidence can be placed in
this evacuation.” The pulfe does not always indicate
when it will be too late to bleed ; for in numerous cafes
Dr. Clutterbuck has found it weak and fmall, when
bleeding has proved of the mol decided advantage. As
a general rule, it may be Hated, that, while a full and
wiry pulfe authorizes us to bleed in the mol ad¬
vanced ftages of continued fever, a fmall and contradled
ftate of it fhould be a veto to fuch pradtice. Hardnefsof
pulfe fhould alfb be particularly attended to. Dr. Clut-
terbuck thinks, when it is “ foftand compreffible, blood¬
letting is altogether inadmiffible.” In the advanced
ftage of fever, bleeding fhould be had recourfe to with
much caution and referve, in regard to quantity; for the
lofs of two or three ounces will, at fuch time, be pro-
dudtive of very marked effedts. He alfo thinks that this
pradtice fhould not hinder the very moderate ufe of lti-
inulants, as wine, ammonia*, &c. Upon the whole, how¬
ever, we fhould attempt very little of the latter kind of
pradtice, and fhould content ourfelves with the negative
pradtice of abflradting all nervous irritants, as light,
found, &c. and open the bowels and excite the kidneys ;
always recolledting what Sydenham fays, “ ob nimia di-
ligentia medici.” It is to be recolledted, that we are not
now fpeaking of thofe cafes in which inflammation and
diforganization takes place in a particular organ, this
being the moll frequent mode in which continued fever
terminates.

A determination of blood to particular organs is a very
frequent occurrence in epidemic fever. Sometimes thefe
determinations happen very generally, from fome pecu¬
liarity in the nature or the caufe of the epidemic ; as
when we fee inflammation of the lungs an almofl; con-
ftant companion of the prevailing fever ; or where in¬
flammation of the mucous membrane of the inteftines,
conftituting dyfentery, prevails. Occafionally, however,
while Ample fever is prevalent, the particular predifpo-
fitions todifeafe which are prefent in theconftitution are
manifefted by oppreffion of particular organs. As to the
nature of thefe determinations of blood, we have no he-
fitation in afcribing them to inflammation. It fhould be
mentioned, however, that this is denied by a phyfician,
the excellence of whofe defcriptions and treatment of the
above difeafes forbids us to pafs over his hypothefis,
which we fhould otherwife confign to the oblivion it
muft.foon meet with, and for which nothing but the
pradlical merits of its author has procured even an ephe¬
meral reputation. The hypothefis in queftion is that of

Vol. XIX. No. 1298.

LOGY.

Dr. Armftrong, who confiders that congeftion of blood
takes place in the veins of organs gravely aft'edted in epi¬
demic fever, and without any further diforder in the ar¬
terial fyftem than fimple excitation. Now nothing can
be more bafelefs than the ftrudture of this theory. It
refts, firft, upon the refults of difledtion ; that is, upon
finding adtual congeftion of blood in the veins. Now
the verieft tyro that ever took up a fcalpel knows that
the laft adt of the arteries and the left ventricle is the
propulfion of blood in the dead fubjedt, fo that the arte¬
rial fyftem is always empty, the venous fyftem full. And
again, granting that an excitement of the fmall arteries
exifted, and caufed diftention and enlargement of the
veins; the fadl is pradtically unimportant, becaufe our
endeavours mull be directed to the relief of the excited
arteries, not to that of the veins, which are paffive tubes.
Venous congeftion cannot, however, exift without de¬
rangement in the adtion of the heart; and if fuch de¬
rangement exifted, congeftions of the veins would exift
generally ; occurrences which certainly do not happen.
Many other arguments fuggeft themfelves againft this
wild fpeculation ; but, as thofe we have adduced feem
quite conclufive, we ffiall difmifs the fubjedt. We muft
affert, however, that in no other work extant do we find
fo good a hiftory, or fuch efficient treatment, of local in¬
flammation fupervening to fever, as in the work of Dr.
Armftrong. From this gentleman’s work, and from that
of Dr. Jackfon, we fhall principally derive the fymptoms
of the following complaints.

We (hall not enter into any difcuffion as to whether all
fevers be of one kind ; and the .yellow fever, epidemic,
dyfentery, &c. the fame difeafe, varying in intenfity,
and deriving the peculiar charadter of thofe forms of dif¬
eafe from the predifpofitions which climate and other ex¬
ternal agents produce, though this feems a very probable
view of the fubjedt ; but we (hall confine ourfelves for
the prefent to an account of thofe complications which
are met with in the epidemic fevers of this country. The
molt common complication is that of fever with inflam¬
mation in the lungs and its inveftments. In this cafe, in
addition to the ordinary fymptoms of fever, a permanent
pain is felt in fome part of the cheft, generally acute,
though occafionally obtufe ; but, in either cafe, much in-
creafed by deep infpiration. There is a fenfe of weight
or conftridtion acrofs the breaft. The refpiration is al¬
ways laborious ; the thorax heaves, as if under fome op-
preffive load ; and the alae nafi are thrown into ftrong
motion. The patient is extremely reftlefs, and has a
frequent and troublefome cough, which augment's both
the pain in the fide and the difficulty of refpiration,
Moft frequently he cannot breathe with any degree of
eafe when incumbent, but is obliged to have the trunk
confiderably elevated. The features altogether indicate
furprife, alarm, or anxiety ; the eyes feem prominent ;
the cheeks and lips are generally of a deeper colour than
natural, yet in fome cafes the face has a pale bloated ap¬
pearance. The tongue is commonly foul in the middle,
and of a dark red round the edges; the pulfe is fome-
times flow', full, and ftrong ; and in other inftances,
quick, fmall, and weak. As in almofl: all local inflam¬
mations, the temperature of the Ikin varies a great deal
in the day, and partial perfpiration are not uncommon,
efpecially wdien the pain of the fide is acute. A milder
form of inflammation attacks the pleura, which is often
infidious and unfufpedted. If the breathing be narrowly-
watched, it is obferved to become quicker and more anx¬
ious, efpecially in the horizontal pofture; and cough and
uneafinefs are almofl: always excited on a full infpiration.
There is alio, for the moft part, pain or forenefs in the
left fide, or under the fternum, with a feeling of weight
or tightnefs in the breaft, often with little pain. The
progrefs of the inflammation is, however, involved in
confiderable obfcurity : but it may, neverthelefs.be traced
by the continuance of uneafinefs in the cheft ; by the in-
creafe of the cough, dyfpncea, and reftleflnefs; by the pa>
3 1 tient's

PATHOLOGY.

m2

tient’s panting or breathing fliort whenever he fpeaks ;
by the number of refpirations exceeding the natural
amount in a given time; by the colour of the face, indi¬
cating fome impediment to the common changes of the
blood in the lungs; and by the gradual increafe of the
pulfe, and of the fever. When the inflammation ends in
an abfcefs, the uneafinefs in the brealt abates, but the
breathing becomes more laborious, and there are chilly
and hot fits, with copious fweats, and great lofs of
ftrength. The moll common termination, however, of
inftances of this kind, is by an effufion of ferum into the
cavities of the pleura. This calamity is not neceffarily
fatal at once, fome patients lingering for fome time afterit.

In this form of difeafe, the treatment of fever in gene¬
ral mull be conjoined with the ufual means for alleviat¬
ing local inflammation. It is feldom an accurate diag-
nofis can be eftablilhed between inflammation as it affeCts
the fubftance of the lungs, or as it affe&s the pleura. In
either cafe bliftering may be confidered a meafure of
great effeCt ; and, if there feems Itrong evidence of the
exiftence of inflammation in the pleura, we may have
recourfe more freely to the lancet than under ordinary
circumftances. It is to be remembered that cold affulion
is by no means to be allowed when the lungs are affedled
in fever. The warm bath is often, however, of great ul'e
when the temperature of the Ikin is unequal; and at the
fame time diaphoretics are of much importance. Of
this kind of medicine, large dofes of calomel, with as
much opium as will counteract the purging property of
the latter drug, are the molt advantageous.

Another complication fomewhat analogous to the pre¬
ceding, is that of fever with bronchitis. The fever in
this cafe is attended with a cough, at firft dry, but after¬
wards moift. In recent cafes the expedforated matter re-
fembles the white of an egg, but in a more advanced
ftage it appears vilcid and opake. The pulfe through¬
out is feeble and quick, the tongue foul, the heat
variable, the bowels irregular, and the llomach prone to
rejeft its contents ; and, although the patient frequently
appears drowfy, for the molt part he obtains very little
fleep. In fome perfons thus affeCted, thecomplaint con¬
tinues many weeks, and often acquires a confumptive
character before death. When it ends favourably, the
convalefcents remain long in an emaciated and enfeebled
(late. An abatement of the vomiting, fome defire for
light food, and a tendency to quiet fleep, are the appear¬
ances which augur recovery.

The treatment of this complaint rnuft differ principally
from that of Ample fever in that a minor degree of bleed¬
ing will fuffice, and in the exhibition of naufearing
medicines, which are of very great ufe, notwithllanding
the gaftric irritability which prevails. In a word, the
treatment is that of Catarrhus, (to which the reader is
therefore referred for more explicit details,) conjoined
with the more aCtive and general treatment of fever.

Abdominal inflammation is frequently complicated
with the fever in queltion; and it is often difficult to
diftinguifh the precife fituation of this occurrence; for
the funClions are fo generally difordered, that their dif-
turbance affords no diagnoltic, as in cafes of common in¬
flammation. It is not, however, of the utmoll import¬
ance to afcertain the precife feat of the inflammation, as
the treatment does not vary eflentially. The inflamma¬
tion of the mucous membrane of the ftomach which ac¬
companies fever is fo common in fome countries abroad,
that it has induced Biouflais and others, as we have be¬
fore feen, to infer its invariable prefence in febrile dif-
eafes. In the works of the above author are to be found
a variety of excellently-written cafes of the complication
in queftion. J. P. Franck (De Curandis Hominum Mor-
bis Epitome PraeieCt.onibus Academicis dicata, Ven.
1805.) more properly confines the term gujb ic fever to
thole cafes in which the fever is accompanied and exaf-
peraved, though nor caufed, by phlegm, bile, inteftinal
worms, or other irritating matter capable of inducing an

z

inflamed ftate of the ftomach. We consequently generally
meet with this difeafe in dyfpeptic patients when they
become the fubjedts of fever. We copy from a tranfla-
tion of Frank’s work the fymptoms of the gallric fever.

“It begins, like other fevers, with alternate cold, fhi-
vering, and heat, accompanied with laffitude, head-ache,
and pains fimilar to rheumatifm in the back, the loins,
and the joints. The face becomes pale, and the eyes yel-
lowifh ; but the ftomach is chiefly affeCfed with inflation,
tenfion, and a fenfe of weight, joined with anorexia,
loathing of food, naufea, retching, and erudtation of
difagreeable flatus, and of bilious, tenacious, acid, or
acrid, matter. The ftate of the mouth is the belt indi¬
cation of the ftate of the ftomach, which is obfervable in
the fcetid breath, the tongue loaded with tenacious white,
or yellow mucus, fometimes talielefs, and at others bitter
and difagreeable. Diforders in the abdomen fucceed,
fuch as borborigmus, gripes, wandering pains, fenfe of.
weight and fulnefs, with either conftipation, or bilious,
fetid, or frothy, dejedtions. In this ftage of the affedtion
the patient may not be fo ill as to be confined to bed ;
but in a fhort time, though the cold fit be neither great,
nor conftant, and fometimes may be abfent; the heat,
thirft, giddinefs, and head -ache, increafe, the pulfe be¬
comes more frequent and often intermittent, the fymp¬
toms of the ftomach, naufea and retching, and of the ab¬
domen, are aggravated ; the flufhing of the face is greater,
with greenifh palenefs towards the fides of the nofe ; the
under lip quivers, the eyes are fuffufed with tears, the
refpiration becomes hurried and difficult, often accompa¬
nied with a cough, either with or without expedloration;
pain fimilar to that of rheumatil'in is felt in the thorax,
lcapuiae, and fauces; there is often great apparent prof-
tration of ftrength, with delirium, drowfinefs, or vigilia.

“ After three or more days, remiffions occur in the
morning, with a gentle fweat breaking on the forehead
and breaft. The tongue is fometimes more loaded with
yellow mucus, and fometimes dry in the middle, and of
a brown colour; the urine is made with ardent pain, is,
deeper yellow, or appears like that of cattle, or with a
pink or furfuraceous fediment. Towards night, fome¬
times with a flight chillinefs, or (hivering, all thefe fymp¬
toms are aggravated ; the fkin becomes dry, harfh, and
burning, and is fometimes fuffufed with a yellow tinge;
blood often drops from the noftrils, mixed with yellowifh
ferum; and the vigilia, reftleflnels, and delirum, are ex¬
ceedingly dift refling.

“ As the difeafe advances, the morning remiffion al-
moft difappears: the region of the liver and ftomach is
more tenfe and painful ; the anxiety, heat, thirft, and
head ache, become much aggravated ; the delirium is
almolt conftant; the fauces are parched; the tongue,
brown, livid, approaching to black, and covered with a
vifcid mucous, is almolf of a fragile hardnefs and chopped;
and the fpeech is impaired and fluttering. The eyes are
very red, the hearing is obtufe, and the temples throb.
The circulation is quickened, while the blood- veflels are
contracted ; the urine, fcanty, thicker, fetid, and voided
unconl'cioufly ; and the ftools, liquid, brown, or greenifh,
and extremely fetid : the abdomen is inflated and founds
to the touch, and the Ikin is parched or bathed in a vifcid
fweat.

“ If the fever in this ftage is either negleCfed or badly
treated, or the patient is otherwife in unfavourable cir¬
cumftances, it will foon terminate fatally. On the other
hand, if the force of the difeafe is fubdued either fponta-
neoufly or by art, then the offending matters are thrown
off by the bowels and fkin, the remiffions become longer
and more diftind, the tongue more moift, and the mucus
which covered it either floughs oft, or, as the tip of the
tongue becomes redder, comes away from the edges in
foftfcales. Sometimes a very fudden change now takes
place: the vifcid matter almoft of a ligneous hardnefs,
which was adhering to the palate, quickly foftens, and is
bedewed with a bland moifture. At this period, the fe¬
ver

218

P A T H

ver fometimes pafles by almoft imperceptible gradations
into a periodic intermittent 5 or the exacerbation, be¬
coming in its returns more tardy and mild, terminates in
an equable and moift tranfpiration ; the ftools become
copious, pultaceous, and natural; and the urine depo-
fites a copious reddifh- white precipitate.

“ In the more mild and (low forms of the fever, the
patient, on riling from deep, feels little refrefhed, is lift-
Jefs and morofe, and his mouth and fauces are loaded
with phlegm ; he has fetid eruftations, and copious mu¬
cous expectoration, with naufea 5 has little relifli for
food, but does not altogether loathe it, though after eat¬
ing he complains of weight, fulnefs, drowfinefs, flatus, and
obftruftion of the bowels. He has a flow, weak, and
fometimes a full and rather-hard, pulfe, with little third.
Cold (hivering is fucceeded with wandering flufhes, and
dry fqualid (kin, or (light fweating; leaden heavinefs of
head, and murmuring and ringing in the ears, caufing a
degree of (lupidity. The vifcidity, in fuch cafes, of the
mucus in the ftomach and inteftines is often fo great as
to obltruft the orifice of the biliary dutt, and give rife
to jaundice. The abdomen fwells, and feels painful to
the touch in confequence of flatus, and of the inertia of
the bowels. Singultus and difficult deglutition fucceed
to great anxiety and oppreflion of the ftomach; but in
a few days numerous aphthae are obferved to fpread from
the fauces over the whole cavity of the mouth, which
foon (lough off, and are replaced with a frefh crop. Some
patients are alfo diftrefled with difficulty of breathing
and cough, which is firft dry, and afterwards acco'mpa-
nied with abundant and vifcid expe&oration. In this
(late of things we can fcarcely call the difeafe fever, un-
lefs there is greater proftration of ftrength, pains in the
joints, increafing towards night, burning of the (kin, or
eruptions frequently breaking out immaturely ; and
more particularly if there are diftinft evening exacerba¬
tions, fucceeded by lefs diftinft remiflions, vertigo, vigi-
lia, flupor, delirium, frequent fyncope, with recurrent
diarrhoea, rapidly undermining the powers of the fyftem.
In other cafes, great quantities of worms, fometimes liv¬
ing and fometimes dead, or nearly putrid, are ejefted
both from the mouth and anus, accompanied with pecu¬
liar fcetor of the breath, and the ufual fymptoms of ver-
minofe irritation ; fuch as wandering pains, lancinating
pains of the joints, itching of the nofe, tremor, fainting,
naufea , tenefinus, and copious dejections of putrid mucus.

“When the attack of the fever is more fudden, we
generally, though not always, obferve the cold (hivering
to extend beyond an hour, and to recur by turns, being
followed by heat, which is for the molt part parching,
andincreafed towards night, often accompanied with fu¬
rious delirium. In fome cafes a flight remiflion occurs in
the morning ; in others none. The pulfe is weak and
indiftinCt, collapfing after it has at firft been full and
fomewhat hard. There is much naufea and birternefs of
the mouth, and fo great tumefaftion and oppreflion of
the ftomach, that the very touch or weight of the bed¬
clothes is painful. Towards evening there is again an
exacerbation, correfponding fometimes to femi- tertian
intermittent; and the yellownefs of the eyes, fiuftiing,
head-ache, vigilia, anxiety, fcetor of the breath, and
delirium, are increafed ; and the third:, and longing for
acids, is fometimes intenfe, but occafionally is flight.
The urine, at the accefs of the paroxyfm, is brown, thick,
turbid, and foetid ; during the remiflion, it is watery
and crude. The ftools are exceedingly offenfive. Abun¬
dant but vifcid perforation gives no relief. The tongue
is tremulous, and, with the teeth, is loaded with a brown
vifcid matter; or it is fcabrous, almoft black, very dry,
and can fcarcely be extended beyond the teeth. The
flupor and vigilia increafe ; blood ru(hes copioufly from
the noftrils, or is paffed with the urine and faeces ; fluid,
grumous, and preceded by pain extending to the pubis.
Now large quantities of aeruginous and vifcid bile are
®je£ted from the ftomach, agreeing in this almoft with

O LOG It.

the yellow fever of America and Siam. The ftools be¬
come more liquid, green, brown, frothy, and very
offenfive; and there is feldom power remaining either to
void or to retain the natural difcharges. The patient,
notwithftanding, fays he is very well, and attempts to go
to his friends, whom he imagines are abfent. He picks
the bed-clothes, or mutters to himfelf 5 and fometimes
burfts out into fits of furious delirium. This is fucceed¬
ed by fubfultus tendinum, comatofe flupor, violent pul-
fation of the carotids, great difficulty of refpiration, col¬
liquative diarrhoea, cadaverous breath, hiccup, cold ex¬
tremities; cold, prof ufe, and vifcid, fweat ; very rapid,
and fcarcely perceptible, intermittent pulfe; lethargic
deep, convulfion, and death.”

In our climate, though occafionally the gaftric fever
arrives at the fame violence as above, upon the whole
gaftric irritation is more (low in its prog refs. It gene¬
rally happens that the ftomach and inteftines fuffer toge¬
ther, and that the inflammation implicates the whole
ltrufture of thofe parts, while in the accounts juft ren¬
dered we often perceive a phlogofts of the mucous mem¬
brane only. In this cafe the complaint is generally at¬
tended with deep continued pain, and forenefs of the
integuments, increafed on preflu re ; retching, vomiting,
or anorexia, defire for cold acidulous drinks; (hort quick
refpiration, fulnefs as well as flatulence of the bowels,
great proftration of ftrength, reftleffnefs, and anxiety.
The patient almoft invariably lies upon his back, fre¬
quently tolling his arms about, moving his feet, or
changing the pofition of his head. If de fired to turn
upon his fide, it gives him confiderable uneafinefs in the
abdomen; and, if fuddenly raifed into the upright pof-
ture, he generally begins to erufl, retch, or vomit.

The pulfe is fmall and (harp, and in fome cafes very
quick, but in others below an hundred in a minute ; the
tongue foul in the centre ; the mouth clammy ; the tafte
vitiated; the bowels are, for the molt part, bound; the
lips parched and pale, or fomewhat livid ; and the coun¬
tenance exprefles much did refs. The pain of the belly
is augmented by yawning, by coughing, or by drawing
the breath deeply down, and fometimes even by the
blandelt liquids, which are ufually rejected, unlefs taken
in fmall quantities at once. If the pain be acute, the
(kin is often of a pungent heat about the bread and
abdomen ; While the forehead and face, expofed to the
atmofphere, are fometimes damp and even cold.

During the advancement of the abdominal affe&ion,
the pulfe grows fmaller and quicker, the vomiting more
urgent, the belly tumid; the third, fenfe of internal
heat, and reftleffnefs, being all aggravated. Upon the
approach of fuppuration, of effufion, or of gangrene,
there are rigors or flight chilly fits, with much abate¬
ment of pain ; but cold copious and clammy perfpira-
tions come on, attended with (hort agitated breathing,
with an hurried undulating pulfe, frequent dark lax
ftools, and inceffant vomiting. Soon after this, the pa¬
tient dies. For the mod part, however, inflammation of
the ftomach or bowels terminates fatally before it has
advanced into aftuai gangrene ; the patient finally finking
under the accumulated force of exhauftion and of irrita¬
tion.

It has been mentioned, that in mod fevere cafes of
gaftric fever a great derangement of the functions of the
liver is found. Sometimes, however, the latter circum-
ftance exifts alone. But we are not always to infer that
morbid adfion of the liver exifts becaufe we meet with
copious vomitings of bile ; for the act of vomiting it-
felf will induce copious difcharge of bile from the health-
ieft individual. We again quote, chiefly from Arm-
ftrong, the hiftory of the fymptoms of this complication.

“ If the liver be attacked with inflammation, giddi-
nefs, load about the bread, ficknefs, and vomiting, are
often among the primary fymptoms; and the patient,
complaining of pain and forenefs, with weight about the
right hypochondrium, can neither bear preffure in that

place,.

214

PATHOLOGY.

place, nor lie upon the left fide, without an increafe of
pain. When the convex furface of the liver is the feat
of the inflammation, it is fometimes not very eafy todif-
tinguifh the hepatic aflfeftion from pleuritis: but in the
former uneafinefs is excited by prefling the hand under
and above the falfe ribs, and there is generally fome pain
at the top of the flioulder; circumftances not commonly
obfervable in inflammation of the pleura : and further,
the cough and dyfpnoea are not fo diftrefling as in the
latter, while the abdominal fecretions, efpecially thofe
of the liver, are much more vitiated.”

The cough is for the moll part dry, but fometimes hu¬
mid, and frequently excites a pungent pain in the part
affefted, with a tendency to naufea, retching, or vomit¬
ing. The fpirits and ftrength, particularly the former,
are much deprefled ; the mind is apprehenlive, confufed,
or flightly delirious, the pulfe quick and hard ; or low,
intermitting, or opprefled ; the breathing anxious and
variable; the tongue covered with a dirty white, or yel-
lowilh, more frequently with a brown fur; the urine
fcanty and deep-coloured ; the bowels are generally irre¬
gular; and the fasces dark, flimy, varied, and mixed
with morbid bile. The heat of the Ikin, though fome¬
times only a little, is at other times much, above the
ltandard of health ; it is fometimes jaundiced. Dr. Arm-
ftrong Hates, however, that this fymptom often occurs
without inflammation of the liver.

It is to be remarked, that there is often much obfcurity
in tracing the prefence of gaftric fever or inflammation
in any part of the abdominal fever, when it aflumes a
flow and mild form. But the exiftence of this Hate in
any part of the belly may be inferred in continued fever,
when, after the fupervention of the ftage of excitement,
the ftomach remains uncommonly irritable; when there
are conftant feelings, however trifling, of weight or un¬
eafinefs about the fcrobiculus cordis, when there is
quickened or anxious refpiration ; a change always ob-
fervable in abdominal, feldom in cerebral, irritations.
We fliould alfo note the fmall and rapid pulfe, the in-
diftinfl chills and heats, the dry or foul tongue, with
thirlt, reftleflnefs, frequent erudlations, fenfe of internal
heat, forenefs, or pain, in fome particular part ; and an
unufual quantity of dark, thick, fluid matter in the
ftoois on the operation of a purgative. The progrefs,
indeed, of fuch affedlions mull be traced by the above
fymptoms ; /or pain is not very confpicuous. But the
bell method of finding out obfcure abdominal inflamma¬
tion is to prefs forcibly on the bowels at a time when the
patient’s mind is occupied with fome other objeft. It is
proper tofelefl this opportunity; for oftentimes patients
complain of pain in reply to the queftion “ Does preflure
hurt you ?” becaufe they expect that fuch will be the cafe.

The mod important feature in the treatment of the
gaftric complication of fever is its inertnefs. This is a
fail not fufflciently dwelt upon in this country; and,
though the too great dependance which our Gallic
neighbours place upon medicated broths, eau fucre, &c.
may be worthy of cenfure when fuch remedies are ap¬
plied to inflammatory complaints in general, yet, when
the inflammation is confined to the mucous lining of the
alimentary canal, the mere omiflion of irritating medi¬
cines, whether cathartics or Simulants, will do much for
the cure of the difeafe. The nature of our treatment
in abdominal inflammation will depend therefore upon
whether the inflammation be confined to the above tube,
or whether it more generally implicates the furrounding
vifcera. In the firlt cafe, free general bleeding feems by
no means called for, though leeching the abdomen is
highly neceflary. As in this cafe a large quantity of ir¬
ritating fecretions have been colledted, to the great ag¬
gravation of the gaftric difturbance, it fliould be our firft
care to evacuate them from the fyftem. In doing this,
we fliould life fuch remedies as are mod likely to bring
about the defired effefl without, by their own properties,
irritating the inflamed membrane. In the firft place, am¬

ple dilution with acidulated drinks is to be had recourfe
to ; an emetic is the next thing to be prefcribed, and its ef-
fedl is often miraculous ; but, after the firft time of giving
it, its repetition feems by no means admiflible. The
evacuation of the bowels is to be effected by a dofe of
caftor oil, if the ftomach does not rejeft it, and by ene¬
mas : by the latter remedies, compofed of oleaginous
(or in cafes of fevere pain of anodyne) decodtions, the
alvine difcharge is to be regularly kept up. The medi¬
cines are to be fuch as at once diminifti the temperature
of the ftomach ; as, the common faline draughts, nitre
largely diluted, &c. occafionally fmall dofes of antimony
may be ufed. Nofolid food or animal broths Ihould be
allowed ; but cooling drinks may be taken in large quan¬
tities, together with fweet mucilaginous decoctions.

Now, if the collatitious vifcera feems more deeply im¬
plicated, much will depend upon the Hate of the general
fever. If the latter be highly manifefted, if the tempera¬
ture be high, and the pulfe ftrong, bleeding and after¬
wards cupping over the aflrefled part mull be had recourfe
to without lofs of time. If, on the other hand, a vio¬
lent and intenfe inflammation fupervenes, while the ex¬
citement of fever is not marked, (and this is no uncom¬
mon occurrence,) we fliould endeavour to excite thofe
parts of the body which difplay a diminution in the
quantity of their circulating fluids. To this end a hot
bath mud be premifed before we bleed ; and, in perform¬
ing the latter operation, we fliould carefully watch the
riling of the pulfe ; an occurrence fo important, that we
may occafionally endeavour to promote it by cordials and
ftimuli. After this, finapifms to the feet, and other
counter-irritants, will be found ufeful agents. It will
be neceflary alfo to excite the fecernent fyftem generally
by large dofes of calomel and opium.

When inflammation of the liver is clearly manifefted,
or when the mucous membrane of the bowels is threat¬
ened with ulceration, in additipn to the ufual revulfive
meafures we fliould exhibit calomel in five-grain dofes,
combined with half a grain of opium, every fix hours,
till ptyalifm is induced. We may remark, that no gene¬
ral rules can be laid down as to the ufe of blifters : they
are for the inoft part of the utmoft efficacy in relieving
the local complications attendant on continued fevers ;
but they require to be applied with much care, as to
the ftate of the fkin generally; for, when inflammation
of the mucous membrane of the alimentary canal is at¬
tended with much heat and rednefs of the fkin, it is ge¬
nerally found that blifters increafe rather than alleviate
the complaint: they alfo aft in a detrimental man¬
ner in cafes where exceffive nervous irritability is
prefent.

Befides the complications before mentioned, we fome¬
times find rheumatifm or angina united with fever. De¬
pletion may be pufhed to the utmoft extent in the for¬
mer; in the latter, quite the reverfe.

In taking leave of the treatment of continued fever,
we have to fay a few words on the management of conva-
lefcents. It is too much the pra&ice even in this coun¬
try, and it is carried to a much greater extent abroad,
to give bark and other ftrengthening medicines, as they
are improperly called, to thofe who have efcaped from fe¬
vere attacks of fever. We have no liefitation in ftrongly
reprobating this practice. We fliould anxioufly incul¬
cate, that ftrength is only to be attained through the me¬
dium of healthy digeftive organs ; and that, when thefe
are ftrong, a very fmall ^quantity of fuftenance will pro¬
duce a high degree of nutrition, hjpw, as fudden ple¬
thora is proverbially “ a bad fign” when it fupervenes to
fevers, we fliould be cautious of producing it by exciting
in an unnatural manner the energies of the digeftive or¬
gans, and we fliould rather fuffer them to recover their
tone (which they will generally do) in a gradual manner,
and by means of their own powers.

We now proceed to the confideration of Yellow Fe¬
ver; a difeafe at the prefent moment committing dread¬
ful

PATHOLOGY.

Ful ravages on mankind, and concerning the origin of
which the medical world is much divided. The conflift-
ing opinions of medical men on this fubjeft are indeed
well known to the public ; the grand quelfion to decide
being whether yellow fever is contagious or not. It is by
no means eafy however to trace the operation of the in-
fcrutable agents which give rife to this difeafe : and hence,
while one phyfician attributes its diffufion to exhalations
from the body of the human fpecies, another finds per¬
haps in the fame cafe evidence of its origin from miaf-
mata. In a late number of the Medical Repofitory we
find the names of numerous and refpeflable authors mar-
fhalled in regular array againft each other as taking oppo-
fite fides in this important queftion, We copy the chief
of thefe, that thofe who want to examine cloftly the evi¬
dence on each fide may have recourfe to it.

Among thofe who confider yellow fever to be an im¬
ported and contagious difeafe, are ranked Arejula, Batt,
Berthe, Dalmas, fir J. Fellowes, Moreau de Jonnes, B.
Progetto, Salgado, &c. who found their opinions on the
yellow fever of Spain; and more recently Parifet holds
the fame opinion. Alfo Bally, fir Gilbert Blane, Cai-
zerques, Chifholm, W. Currie, Des Portes, D’Oyarvide,
Lind, Ried, &c. who derive their fatlfts from the Weft
Indies and America.

Among thofe who deny that yellow fever is conta¬
gious, and afl'ert its origin to be entirely local, or depen¬
dent upon fome myfterious and inappreciable change in
the atmofphere, are ranked Amiel, Burnett, Caftan,
Doughty, Keutfch, Lacofte, Langerman, O’Hallaran,
See. who draw their obfervations chiefly from the fever of
Spain ; and Bancroft, Barker, Browne, Comftock, Clarke,
Coventry, Davidge, Denmark, Deveze, Dickfon, Fer-
gufon, Gilbert, Hillary, J. Hunter, R. Jackfon, Jeft'er-
fon, M'Artlnir, M‘Lean, E. Millar, Moore, Mofeiy. Muf-
grave, Mnttlebury, Ramfay, A. Robertfon, B. Rndi, Sa-
varefi, Selden, Sheppard* Trotter, Valentin, Vanel, Veitch,
Whitehead, &c. in the Weft Indies and America ; and
in Africa, Drs. Copland and Winterbottom.

Among thofe who hold a middle courfe, allowing the
local origin of the fever, but afferting that it may be¬
come contagious, we find Eytnann, Hofack, Humbolt,
J. Johnfon, Le Blond, Nicol, Palloni, Pugnet, Romans,
‘ Sec .

To thefe we mull add the Angular opinions of Baron
Larrey. This author divides virus into two kinds ; the
one fluid, as in fiphilis, fmall-pox, and vaccina; the
other gafeous, or miafmatici of this laft fort is (he fays)
the virus of the yellow fever. Each virus has a particu¬
lar influence on certain parts. That of the yellow fever
adds particularly on the nervous fyftem of animal and or¬
ganic life. It is connedded with the lymphatic fyftem ;
and, according to him, it is the moft fubtle and fuga¬
cious of all. It lafts but a moment at the higheft point
of difeafe; and then lofes the power of tranfmitting it-
l’elf. It is principally feated in the exanthema when this
exifts, and in the cutaneous tranfpiration. It is in this
manner that M. Larrey endeavours to reconcile the con-
tradi&ory opinion of phyfleians on this fubjeft. He is,
however, an advocate for meafures of precaution ; for if,
lays he, one patient only out of a hundred lie capable of
tranfmitting the difeafe, prudence requires that the whole
Ihould be fequeftered, as it is impoflible to afeertain the
individual by whom the difeafemay be perpetuated.

For our own parts, we can only give the ccnclulions
we have arrived at from an attentive perufal of moft of
the above w'orks. It would far exceed our limits to de¬
tail, even in the moft comprefted form, the arguments of
thefe numerous and confliffing authorities. But, taking
up thofe opinions which feem to have been moft carefully
induced from fadis, and which in fome manner explain
ffte diftonant evidences of various authors, the follow¬
ing circumftances appear to us tolerably well eftablifhed.
Firftthat the yellow fever, the bilious remittent, the
Bengal fever, the liulam fever, See. are all one and the
VOL. XIX. No. 1258.

215

fame difeafe modified by varieties in climate, conftitution,
and predifpofing caufes ; that is to fay, that they are fo
far the fame difeafe, that their fundamental therapeuti¬
cal indications are fimilar, and that they are apt, when
external circumftances ferve, to run into each other.
Secondly, that this fever is for the moft part caufed by
certain miafmata from marfhy foils, which miafmata are
fuppofed to be the prodmft of putrefying vegetable fub-
ftances, it being urged that animal putrefaction is not
found to produce yellow fever. This, however, is by no
means clearly afeertained. It is afferted that the mial-
mata in queftion are generated for the moft part in fixa¬
tions where the water has receded or been partially dried
up, and where confequently the muddy bottom is ex¬
posed to the fun’s rays. It is afterted alfo, that an high
temperature is an indifpenfible condition to the produc¬
tion of thefe miafmata, or at leaftto their morbid aftion
on the human body ; whether fuch heat be in aftual ex-
iftence,or whether it has immediately preceded a fudden
acceftion of cool weather.

Though thefe miafmata from marfliy foils are undoubt¬
edly in many inftances the foie caufe of the yellow fever,
yet fomething mull be often attributed to the influence
of defeending dews from the atmofphere. Indeed Dr.
James Johnfon mentions having himfelf experienced the
ienfible eft’edl of this dew on-board of a (hip; and it
feems very probable that jt was only by the preventive
treatment he employed, that he warded off an attack ot
this fever. This author likewife informs us, that a fever
which broke out in the Leopard’s crew followed upon
a defeent of dew which took place every night, and
was perfectly Jalt and litter to the tojle. The above-men¬
tioned fad, according to Dr. J. Johnfon, leads to a
“ praftical inference of confiderable utility; viz. that,
when neceftity compels us to penetrate through thofe in-
falubrious woods, jungles, or marlhes, we fhould feleCt
that point of time at which ive are lead likely to meet
thofe miafrns, whether in their afeending or defeending
ftate. This period feems to extend from three to fix
o’clock in the afternoon ; that is, after the greateft heat
of the earth and air, and, confequently, the greateft eva¬
poration ; and before the condenfation and return of
fuch exhalations as rofe during the day, and which
combine with thofe ftill iffuing from the heated foil
for fome time after fun-fet. Independently of this cir-
cumftance, the body feems to be pofleffed of greater
energy at this period of the day than at any other, it
being that time when the principal meal is nearly di-
gefted, and confequently the animal vigour at its higheft
pitch. The deprefling paflions, intemperate or bad liv¬
ing, and the other predifpofing caufes of the fever of this
country, aCt with equal or greater force in aflifting the
baneful operation of the mialms of yellow fever.

Thirdly, it is inferred as a probability, (for we have
no evidence of our own to offer,) that yellow fever ari-
fing from miafmata may in fome conftitutions generate
the volatile material which other fevers do, and produce
contagion. Independently of the evidence derived from
the authors before mentioned, the principles we have
laid down when treating of contagion lead to the fame
conciufion. Indeed, when we confider the nature of
contagion itfelf, we cannot refufe ouraffent to the propo-
fition in queftion. We fee that a fever, clearly traced
in the firft inftance to local injury, will, under the con¬
comitant circumftances of foul wards in an hofpital,
deficient ventilation, & c. engender contagious fever
through large bodies of men ; fo that we infer that any
fever, however induced, may be contagious, feeing that
its local origin does not hinder the contagions effluvia
from being produced. Moreover, let us confider the
manner in which contagion is produced. Itmuftbearo-
lalilefecretion ; and this can only arife from the mucous
membrane. Now, when we fee the great variety of ap¬
pearances- which the vifible produdfts of this membrane
exhibit when inflamed, can we doubt that in almoft ail
3 K violent

21G

PATHOLOGY.

violent inflammations contagious effluvia may be fecreted.
In common ftates of the atmofphere, this is probably
mixed, diffufed, and decompofed ; but in peculiar con¬
ditions of the air a fufpenfion may take place, and thus
contagious fever may be rendered general. Now that
the morbid fecretions of the mucous membrane are con¬
tagious effluvia, and that thef'e are modified by nervous
impreflions in the fame way as all fecretions are, feems
rendered (till more probable by the circumftances, that in
thofe fevers which are molt contagious, viz. the exanthe¬
mata, a phlogofed ftate of the mucous membrane is uni¬
formly prefent, and that an emetic exhibited early in
thofe maladies often prevents the attack; a faft which
we can only explain on the fuppofition that this remedy
actually removes a depofited fecretion, or, in other words,
contagious effluvia from the furface of the ftomach. In
faff, there feems good evidence in fupport of the opinion,
that all inflammation of, or difordered fecretion in, the
mucous membrane may elicit contagious effluvium.
Thus dyfentery, cholera, eryfipelas, the influenza, (a
fpecies of catarrh,) have all been fometimes contagious,
though it is well known that all thefe difeafes occur
without fucli an effect being produced. Nor, can we,
on the fame account, difmifs with the abfoiute denial
which molt authors have thought proper to do, the well-
fupported aflertion, that croup and phthifis are occafion-
ally catching.

To return to the yellow fever; it is to be remarked,
that a confideration of the medical topography of the
countries where this fever has appeared mult difclofe
grand and important circumftances relative to the ma¬
nagement of our fleets and armies. As this fubjeft,
however, embraces a wide field in a branch of medical
fcience hitherto not cultivated fyftematicaliy, we regret
that our limits will not permit us to difcufs it fully ;
but we can, with the utmoft confidence, refer our read¬
ers to a work by Dr. James Johnfon on Tropical Cli¬
mates; which contains all that is at prefent known on
the fubjeft.

As to the nature of yellow fever, its immediate
caufes operate of courfe, as in other fevers, through the
medium of the mucous membranes; and the irritation
which is communicated to the brain and fpinal marrow
forms the grand connefting and eflential link to the de¬
velopment of the general febrile phenomena. The ac¬
tion of the predifpoling caufes, as climate, fatigue, &c.
is however to render the mucous membranes particularly
liable to inflammation ; while the fame influence, by af-
fefting the circulation of the furface, as was (liown when
treating of Cholera, throws unnatural quantities of blood
into the portal fyftem, and produces congejlion there,
this being the only part of the venous fyftem where
fucli a ftagnation can take place. The eft’eft of this is
particularly felt in the liver, the ftoinach, and indeed
the whole abdominal vifcera.

The charafteriftic fymptom of this fever, viz. the yel¬
low colour of the fkin, is varioufly accounted for by dif¬
ferent authors. Dr. Bancroft fuppofes it is induced by
the preflure to which the aft of vomiting fubjefts the li¬
ver and gall-bladder. But to this it is replied, that
there is no proportion between the intenfity of colour
and the feverity of the vomiting ; and moreover, that
it often occurs before the vomiting takes place. Brouf-
fais is of opinion, that the yellow colour depends on
violent irritation of the duodenum propagated to the fe-
cretory organ of the bile. The moft plaufible opinion,
however, though it has been much ridiculed, feems to be,
that the fufpenfion of the aftion of the liver prevents the
elimination from the blood of the bilious elements, and
that thefe, exifting in the blood from the want of fecre¬
tion, and not from abforption, produce the phenomena
in queftion. We have fome reafon to believe, that a
morbid ftate of blood might caufe the fame appearance
without the liver being materially implicated. This
indeed, as far as regards certain yellow dingy patches

which occafionally appear on the (kin in this fever, is al¬
lowed by Dr. Bancroft.

The black vomit, a moft formidable fymptom in yellow
fever, was for a long time attributed to a fuperabundant
and altered fecretion of bile ; but certainly without foun¬
dation, as is evident from the faft, that in a great number
of difleftions the liver has been found in a healthy ftate ;
and, where it has differed from its natural appearance, it
has frequently been of a paler colour; the gall-bladder
has alfo at the fame time been found in a healthy ftate,
containing its ufual quantity of bile, not at all altered in
its appearance or properties. Moreover, at a time when
the ftomach has been diftended with black vomit, the paf-
fage from the duodenum into the ftomach has been com¬
pletely obftrufted by the pylorus valve, fo that no portion
of the matter could have been derived from the hepatic fyf¬
tem, in every part of which fyftem the bile was quite natu¬
ral in colour, tafte, and confiftence. The matter of black
vomit, compared with bile, differs materially from it in
all its phyfical qualities. It differs from it in colour; for,
however dark the bile may appear in its moft concen¬
trated ftate, it always difplays a yellowifh or greenifh-
yellow tinge, when fpread on a white furface, or when
diluted ; and this is never obferved with the matter of
black vomit. Indeed Dr. Bancroft has found that an
addition of bile to the latter, altered its nature fo much
as to give it an appearance different from what it had be¬
fore ; nor could the black vomit be imitated by any mix¬
ture of various proportions of dark-coloured bile with
the fluids found in the ftomach. It differs moft deci¬
dedly in tafte; the black vomit being always infipid,
when freed from other foreign matters; whereas the bile
can never, by any means, be deprived of intenfe bitter-
nefs.

A natural conclufion therefore is, that the black vo¬
mit proceeds from the ftomach itfelf, and is a confequence
of inflammation of that vifcus; whether this be a par¬
ticular morbid fecretion by the inflamed veffels or glands
of the ftomach ; or, as Dr. Bancroft thinks, “ merely
blood which has been effufed from fome of the fmall ar¬
teries, ruptured in confequence of the feparation of cer¬
tain portions of the villous coat-, and which has coagu¬
lated within the general cavity of the ftomach, or on the
furface over which it was effufed ; and, having been af¬
terwards detached and triturated by the violent and fre¬
quent contraftions of that organ in the efforts to vomit,
has had its appearance as a coagulum of blood altered,
and its colour darkened by the gaftric juice, or by fome
chemical decompofition, either fpontaneous, or produced
by the aftion of the air, or other matters contained in
the ftomach.”

It remains to give a defcription of the fymptoms of
this fever, which we believe will be found to agree accu¬
rately with the above fhort pathological lketch. The
defcriptions, not being drawn from our own obfervation,
are felefted from the moft accredited authors, whofe
names we fhall fubjoin. The chief diftinftions between
the different forms this fever exhibits are drawn from its
violence, or, what amounts to nearly the fame, its con¬
tinued, its remittent, or its intermittent, form.

The firft defcription is that of Dr. Bancroft, derived
from the contemplation of this fever in the weftern he-
mifphere. “ The progrefs and violence of the yellow
fever differ greatly, according to the force of its caufe,
the vigour and excitability of the patient, and the feafon
of the year. When it prevails epidemically in hot cli¬
mates, and attacks young and robuft men, lately arrived
from temperate regions, the diforder commonly appears
in its moft aggravated form. In this, the patient firft
complains of laflitude, reftleffnefs, flight fenfations of
cold and naufea, which fymptoms are foon fucceeded by
ftrong arterial aftion, intenfe heat, flufhing of the face,
rednefs of the eyes, great pain and throbbing in the head
and in the eye-balls, uneafinefs and pain in the ftomach,
opprefflon of the praecordia, a white fur on the tongue.

PATH

and a dry parched (kin, with a quick, full, tenfe, and
generally ftrong, pulfe, though it is fometimes oppreffed
and irregular. Thefe fymptoms are fpeedily accompanied
by frequent efforts to vomit, efpecially after fwallowing
food or drink, with difcharges, firft of fuch matters as
the ftomach happens to contain, and afterwards of con-
fiderable quantities of bile, appearing firft yellow and
then green, fometimes tinged with blood, but in the
progrefs of the diforder with matters of darker colours :
an increafe of pain, heat, and forenefs of the prsecordia,
alfo occurs, with conftant wakefulnefs, and frequently
with delirium more or lefs violent. This paroxyfm, or
exacerbation, which has been called the inflammatory or
the febrile itage, generally lafts thirty-fix hours, but is
fometimes protratted for feventy-two hours, and even
longer, probably in confequence of either general or
local inflammation, (particularly in the brain or llomach,)
or of irregularity in the circulation, which are known to
prolong the paroxyfms in fevers of type.

“A remiflion then occurs, in which many of the fymp¬
toms fubfide, fo as often to induce a belief that the fever
is at an end, and recovery about to take place. Fre¬
quently, however the foundations of irreparable injury
to the brain or ftomach have already been laid in the
former paroxyfm ; and in fuch cafes the remiflion is fliort
and imperfedt. During thefe remiflions, the pulfe often
returns apparently to the condition of health ; the flcin
feels cool and nioift, and the intelledt, if previoufly dis¬
turbed, Fometimes becomes clear; fometimes, however,
the patient remains in a quiet and ftupid ftate, a fymptom
generally denoting great danger. Another fign of dan¬
ger, as denoting a very morbid condition of the ftomach,
is the renewal of the efforts to vomit, when preffure is
made on that organ, or food is fwallowed. After a certain
interval, this remitting ftage is fucceeded by another,
which may be called a lecond paroxyfm, and which, pro¬
bably, would appear as a renewed exacerbation, if the
violent effefts of the firft had not almeft exhaufted the
patient’s excitability, and in conjunction with the ex¬
treme depreflion of ftrength which ufually attends in¬
flammation of the brain or ftomach, rendered him nearly
unfufceptible of thofe morbid addons which are neceffary
for that purpofe. In this latter ftage, then, inftead of
great febrile heat,' and ftrong arterial aCtion, the warmth
of the body, and the frequency and ftrength of the pulfe,
are often lefs than when the patient was in health; but
frequently the pain and heat in the ftomach become ex¬
cruciating, with inceffant (trainings to vomit, which, in
moft of the fatal cafes, are followed by hiccough, and re¬
peated difcharges of matters refembling turbid coffee
more or lefs diluted, or the grounds of coffee, and alfo by
evacuations of fimilar dark matters from the bowels.
Here it is to be obferved, that, when thefe fymptoms oc¬
cur, (indicating a violent affeCtion of the ftomach and
bowds,) the patient is, in general, fufficiently in poffeflion
of his intellects to know thofe about him, and to give
diftinCt anfwers to queftions made to him, although his
exceflive weaknefs often renders him incapable of mental
exertion, and his inability even to raife his head may
induce the appearance of coma. In thofe cafes, however,
in which the brain has fuffered greater injury than the
ftomach, the retching and black vomit, juft defcribed,
do not fo commonly occur ; but, inftead of them, low
muttering, or coma, with convulsions of the mufcles of
the face, and other parts of the body, fupervene. About
this time, alfo the tongue and teeth are covered with a
dark-brown fur ; yellownefs of the (kin and petechias
make their appearance ; the urine has a putrid ftnell and
dark colour; the feces likewife become moft offenfively
putrid; haemorrhages fometimes take place from the nof-
trils, gums, and various other internal furfaces. There
is in fome patients, a fuppreflion of urine ; in others, an
involuntary difcharge of it, and of the feces: the pulfe
becomes feeble and intermits ; the breathing is laborious;

O L O G Y. 217

portions of the (kin affume a livid colour; the extremi¬
ties grow cold ; and life is gradually extinguifhed.”

On the above defcription Dr. J. Johnfon remarks, that
the propriety of characlerifing the fubfidence of great
heat and vafcular adion at the clofe of the firft ftage as a
remiflion, is very queftionable. It is, in fact, (fays he,)
the tranfition from inordinate adion to exhauftion; to
that almoft hopelefs ftate which (the foundation of almoft
irreparable mifchief having been already laid in the moft:
important vifcera) is fpeedily to terminate in diforgani-
zation and death, and has nothing in it of the falutary
tendency of a remiflion. As Dr. Gillefpie obferves, “it
is proper to caution young praditioners againfta miftake
very common with regard to the yellow, or ardent fever;
that is, of taking the fatal ftage which follows the ceffa-
tion of ardent heat and great excitement, and which ac¬
companies a fphacelus of the vifcera, for a falutary crifis
of the difeafe.” Difeafes of Seamen. — “ Cette diminution
des fymptomes en impofe quelquefois au malade, et memo
aux medecins inexperimentes.” Did. des Sciences Me-
dicales, tome xv. p. 336.

This declenfion of fever at the clofe of the firft ftage
excited early attention, and is often fo marked as to have
been frequently miftaken for a proof of returning health.
It is noticed by Dr. Hume, who had the charge of the
naval liofpital at Jamaica between the year 1739 and
1749, and was afterwards a commiflioner of the Sick and
Hurt Board, in the following terms : “The pulfe is at
firft full, quick, and ftrong ; but in forty-eight hours
after feizure, or thereabouts, it fometimes becomes calm
and regular, fcarcely to be diftinguiftied from the pulie
of a perfon in health.” See Dr. Hume’s Account of the
Yellow Fever, publiflied by Dr. Donald Munro.

Now, that we may more firmly eftablifh the accuracy
of the above defcription, as well as fliow the corrednels
of Dr. Johnfon’s remark, that the partial diminution of
pain and uneafinefs is not properly a remiflion, we fub-
join the following account of the fame fever as it oc¬
curs in another part of the weft. It is detailed by Dr.
M'Arthur. According to that author, this fever is ufually
ufttered in by the fenfations which precede other fevers ;
fuch as lailitude, ftiffnefs, and pain of the back, loins,
and extremities; generally accompanied by fome degree
of coldnefs. Tilde are foon fucceeded by a fevere pain
of the head ; a fenfe of fullnefs of the eye-balls ; into¬
lerance of light ; ikin dry, and imparting a burning heat
to the hand; pulfe full and quick ; tongue covered with,
a whitifli mucus, but often not materially altered from
the ftate of health ; bowels bound. “ I may here remark,
that the adual degree of heat, as indicated by the ther¬
mometer, is not proportionate to the intenfity commu¬
nicated to the touch. It generally varied between 990
and ioa°, very feldom exceeding 1030. yet the Ikin im¬
parted a burning cauftic fenfation to the hand at thefe
times. If the patient has been attacked in the night, he
awakes with oppreflive heat, head-ache, and the other
fymptoms of fever, the fenfation of cold having pafled
unnoticed. At other times, after fatiguing exercife in
the fun, and fometimes after a hearty meal, the violent
head-ache, and other fymptoms of the fever, are ulhered
in by an inftant lofs of mufcular power, and immediate
depreflion of nervous energy. The patient, as if he were
ftunned by a blow, falls down, his eyes fwimming in
tears. In thofe cafes, delirium is an early fymptom.
In a few hours, the pain of the loins increales, and, in
aggravated cafes, llretches forward towards the umbili¬
cus ; the countenance is flufhed ; the white of the eye as
if finely injeded by blood veffels, the albuginea appear¬
ing through the interftices of the network of veffels, of a
peculiar blue (hining cartilaginous whitenefs.

“ During the firft twelve hours, the patient is not par¬
ticularly reftlefs, enjoys fome fleep, and, when covered
by the bed-clothes, has partial perfpirations on his face,
neck, and breaft. About the end of this period, there is

tVgreat

4

218 V A T H O

a great exacerbation of the fever ; he becomes reftlefs ;
the heat and drynefs of the (kin increafe ; there is much
pain of the eyes and frontal finufes ; the pain of the thighs
and legs is augmented ; third is increased, with a fenfa-
tion of preffure about the region of the domach. Naufea
and vomiting occur towards the end of the fird twenty-
four hours. If the fever has not been arretted within
thirty-fix hours from its commencement, the patient is
in imminent danger, and all the fymptoms are aggrava¬
ted ; the pulfe is ftrong and full, and pulfation of the
carotids appears diftindl on each fide of the neck. The
(kin continues hot and dry ; the third is increafed ; there
is much anxiety, the patient continually (hifting his pof-
ture ; the urine becomes high coloured ; all his uneafinefs
is referred to his head and ioins. A fenfation of pain is
felt about the umbilicus, when prelfed upon ; the white
o( the eye now appears of a dirty concentrated yellow
colour, and apparently thickened, fo as to form a ring
round the margin of the cornea. The blood-velfels of the
eye appear more enlarged and tortuous ; knees drawn up¬
wards to the abdomen ; frequent vomiting, with much
ftraining;mucus,and hiscommon drink only, beingejefled.

“Delirium comes on about the end of the fecond day.
There is now a drynefs, or (light fenfation of forenefs,
of the throat when fwallowing ; and about this time an
urgent fenfation of hunger frequently comes on, and a
remarkable want of power in the lower extremities, re-
fembling partial paralyfis of the limbs. About this time,
alfo, the pain of the loins is fo fevere, that the patient
exptefl'es himfelf as if his back was broken. The third
day, or dage, begins by apparent amelioration of all the
bad fymptoms, the vomiting and third excepted. The
matter ejefted has fmall membranaceous-looking flocculi
floating in it, refembling the crufl wadted from a port-
wine bottle- The third is now urgent, and there is an
inceffant demand for cold water, which is almofl imme¬
diately reje&ed by the domach. The heat of the (kin is
reduced; the pulfe finks to, or below, its natural flan-
dard ; the patient, for an hour or two, exprefi'es himfelf
to be greatly relieved ; and, at this time, a perfon unac¬
quainted with the nature of the difeafe would have hopes
of his recovery. This date, however, is of fiiort dura¬
tion, and the delufion foon vaniflies. The delirium in-
creafes ; the matter ejected from the domach becomes
black as coffee-grounds, and is fiomewhat vifeid. Diar¬
rhoea comes on ; firfl green, then black, like the matter
vomited. The patient often complains of being unable
to pafs his flools, from a want of power i n the abdominal
mulcles. There is an acrid burning fenfation of the do¬
mach, and forenefs of the throat, extending along the
whole courfe of the oefophagus, in attempting tofwallow;
eyes, as if fuffufed with blood ; (kin a dirty yellow ; parts
round the neck, and places preffed upon in bed, of a
livid colour. More or lefs haemorrhage takes place
from the nofe, mouth, and anus; and a depofition of
blood from the urine. The delirium becomes violent ;
the body as if it were writhed with pain, the knees in-
celfantly drawn up to the belly. The patient feizes, with
convulfive grafp, his cradle, or any thing within his
reach, and prefers the hard floor to his bed. The pulfe
now finks; refpiration becomes laborious; the counte¬
nance collapfed ; the ludre of the eye gone. For fome
hours, he lies in a date of infenfibility before death ; at
other times, expires after fame convulfive exertion, or
ineffectual effort to vomit. The tongue is fometimes
but little altered during the courfe of the fever; and, if
loaded in the early dages, it often becomes clean and of
a vivid red before death.

“Such is the regular fucceffion of fymptoms which
characterize this fever, but of longer or (horter duration,
according to the violence of the difeafe, or drength of
the powers of life to refid it. In weakly habits, the vaf-
cular aCtion at the beginning is lefs marked ; and, in
thefe cafes, the fever is generally more protracted, and

LOGY,

the patient expires unaffeCted by the laborious refpira¬
tion, and convulfive motions, which attend the lad drug¬
gies of life in the more violent degrees of this endemic.
Very often the patient retains his fenfes till within a few
minutes of his death; and fometimes will predict, with
confiderable precifion, the hour of his didolution.

“ In the early dages of the word cafes of this fever,
there is much anxiety in the countenance of the patient,
who expreffes a defpair of recovery ; and I have never
noticed a remijfwn during the whole courfe of the fever. Se¬
veral cafes of remittent fever under my care terminated
in the endemic fever.

“A certain number of thofe attacked by this fever, if
prompt meafures to fubdue it had been employed, reco¬
vered from its fird dage. They exhibited evident figns
of amendment within the firll twenty-four, or at far-
thed thirty-fix, hours, from its fird attack. Alfo, a
confiderable proportion recovered from the fecond dage;
that is to fay, previoudy to black vomiting unequivocally
appearing. But I have only known thirteen cafes, in
above five years, to have recovered from the lad dage.
Some of thefe were afterwards invalided, in confequence
of dyfpeptic complaints, and generally-difordered dare
of the domach and other abdominal vifeera. In thefa
cafes, the domach gradually became retentive ; the eyes
and (kin became of a more vivid yellow; they had re-
frelhing deep, but continued extremely weak and languid
for a longtime. The oozing of blood from the fauces
and gums alfo continued for fome days ; and the depo¬
fition of blood in the urine remained longed ; this ex¬
cretion being always the lad to return to its natural
healthy condition.

“ Pain of the back, early dretching round to the na¬
vel ; forenefs in the throat and cefophagus ; heat and
acrid fenfation in the domach; urgent third ; hunger;
want of power, refembling paralyfis of the limbs ; violent
delirium ; defpondency ; enlargement of the blood vef-
fels, and a red-yellow colour of the white of the eye,
either fingly or colledlively, indicate extreme danger ;
and, when the black vomit has appeared, fcarcely a hope
remains.'”

The next form of yellow fever, is the inflammatory en¬
demic which attacks new comers, (efpecially when they
live intemperately,) on their arrival in the Wed Indies.
The reader will fee the precife fimilarity between this
fever (which is allowed to arife from the united influence
of plethoric conditution, intemperate habits, and changes
in the temperature of the air) and yellow fever. Its
fymptoms are thus deferibed by Nodes Dickinfon : “ In
its feverer afpeft, and when negledted at the attack, this
fever confids of two dages. In the fird, there is increafed
excitement, refulting from an unufual dimulus applied
in an excefiive degree to a fydem peculiarly fenlible to
its impreflion : it produces a derangement in the func¬
tions of fome or many vifeera. If this goes on, the fe¬
cond dage appears, in which the drufture of thefe vifeera
is altered to a degree incompatible with the living date.
Thus the difeafe proceeds from high excitement to ir¬
reparable exhaudion, as we (hall perceive by attending
to the hidory of its fymptoms,. In the lefs fevere ex¬
ample there is chillinefs at the onlet, foon followed by a
permanent and univerfal fenfe of heat, fluflted face, in¬
flamed eyes, head-ache, increafed fufeeptibility to tbs
imprefiions of light anti found, vertigo, drawfinefs, figh-
ing, white tongue, arid fauces, third, wandering pains,
lofs of appetite, codivenefs, high-coloured urine, dry
(kin, naufea, with full and frequent pulfe; — (hould thefi*
fymptoms in a fevere degree remain without control,
the difeafe is foon increafed to its mod aggravated form.
The patient is extremely refllefs, with a continual defire
to alter his poiition, but without relief. The heat and
head-ache are intenfe ; the carotids throb with unufual
violence. There is fometimes a furious delirium; tin¬
nitus aurium, and even lofs of fight. There is. occa-

fionaily,

219

PATHOLOGY.

fionally, a dry cough with pain in the fide, and almoft
invariably a fenfe of heat, oppreffion, and pain on prel-
fure at the prsecordia, accompanied by eonftant fighing.-
Vomiting- fometimes comes on very early in the attack.
There is often great drowfinefs, but no refrelhing deep.
In 1'orne cafes an acute pain is felt in the right fide ; and
a yellow colour of the Ikin often fupervenes. This yel-
lownefs is occafioned by the prefence of bile, which is
alfo detected in the urine and ferum difcharged from
the blifters. Should the paffage of bile into the intef-
tines fpontaneoufiy take place, or be procured by the
aftion of purgatives, this jaundiced appearance will ge¬
nerally be prevented : neverthelefs, in feme cafes it may
ofiibly a rife from a redundant fecretion, even when the
ilious canals are free ; and a bilious vomiting and purg¬
ing may . occur with the yellownefs of the fkin, and carry
off the attack. Thefe fymptoms proceed with various
degrees of violence, and they occupy an uncertain period.
Within twelve, twenty-four, or thirty-fix, hours, or
perhaps after a longer but indefinite time, an important
change takes place. It marks the commencement of the
fiecond ftage. Many of the molt urgent fymptoms de¬
cline. The pain and heat of furface fubfide. There is
a fenfe of cold with dampnefs of the Ikin. This change
at fir ft fo much aflumes the appearance of febrile remif-
fion as to give great hope to the inexperienced pra&i-
tioner; but it fpeaks a ftate of the utmoft danger. In
fome cafes the patient finks, at once, after the fubfidence
of excitement, apparently deftroyed by the general affec¬
tion, without any previoufly-fevere determination of
blood to particular organs; and he dies at the moment
of hope in his amendment. But, more commonly, the
cataftrophe is not fo fudden. With the diminution of
heat and pain, the pulfe falls; the countenance exhibits
great diftrefs ; the eye is funk ; the pupil dilated ; fome¬
times delirium continues ; at others, there is great in-
fenfibility witli tendency to coma. Vomiting, occafion-
ally, continues without intermiffion : at times, however,
the ftomach remains tranquil; and this, when there is
much cerebral difturbance.

“ As the difeafe advances, a difcolouration of the fkin
often takes place. It appears in yellow, brown, and
livid, patches. This difcolouration never comes on un¬
til the fubfidence of the fymptoms of excitement, how¬
ever early in point of time. It occurs within the paftive
haemorrhage from various parts : from the nofe, corners
of the eyes, ears, &c. and at the fame time with the black
vomiting. This change of colour appears to arife from
ecchymofis proceeding from exhauftion of the vis vitae in
the capillary veflels of the furface in confequence of pre¬
vious inordinate excitement. It is very diffimilar from
the bilious yellownefs already noticed as an incidental
fymptom of the firlt ftage of the difeafe.

“ The firft difeharges from the ftomach are merely the
ingefta; afterwards a large quantity of ferous fluid is
ejected, when little has been drunk. In a more advan¬
ced ftage of the complaint, the material' thrown up is
ropy, and mixed with numerous fmall ffreds, flocculi,
or membranaceous films, which float in the ejefiied liquid.
Thefe loon acquire a dark-brown, purple, or black, co¬
lour ; but do not, at firft, communicate much general
tint to the fluid in which they are fufpended. After¬
wards, the matters vomited are more intimately mixed
together ; and, with the addition of dark-coloured blood
which is effufed into the ftomach, vitiated bile, and other
morbid fecretions, give an appearance in the aggregate of
coffee-grounds. There is at this period, ufually, a purg¬
ing of dark-coloured matter refembling tar mixed with
black blood,

“ Sometimes within the firft forty hours, at others af¬
ter a more protrafled period, the feene draws towards a
clofe with the ordinary phenomena of approaching di Ab¬
lution which accompany the laft ftages of acute difeafe
in general. There. are dilated pupil, ftrabifmus, ftngul-
tus. fubfultus teadinum, conxsudeliquium, hemorrhage

VOL, XIX. No. 1*99, ' 0

from various channels, fupprefiion of urine, low mutter¬
ing delirium, total infenfibility, occaflonally violent
raving, and an inceflant difpofition to rife in bed. Thefe
are among the laft fymptoms of an unfubdued attack;
and they mark the near approach of death.”

To eftablifh our aflertion of the identity of the various
forms of yellow fever, we Ihall now give a defeription
of this fever as it occurs in the eaft and other parts. In
many parts of the eaft, the comforts and habits of the
people are far from proving fuch powerful predifpofing
caufes of yellow fever as in the weft ; but, as this is by no
means general, we often meet with the precife fymptoms of
continued fever, as exemplified in the following excel¬
lent defeription of the endemic of Batavia, drawn up by
Wade Shields. “The patient, without much previous
notice (of the firft attack), is fuddenly feized with gid-
dinefs and cold chills, a fenfe of debility, and vomiting,
with pain over the orbits, and in the epigaftric region.
He frequently falls down, and is infenfible during the pa-
roxyfm ; his body covered with cold clammy fweats,
except at the pit of the ftomach, zvhich always feels hot to the
palm of the hand ; the pulfe is fmall and quick. On re¬
covering a little, this train of fymptoms is fucceeded by
flulhings of heat, increafed pain over the orbits and in
the linciput, pain and a fenfe of internal heat about the
ftomach and prsecordia, oppreffed breathing; the lower
extremities, at this time, not unfrequently covered with
cold fweats. The eyes now become, as it were, protru¬
ded, and the countenance fluffed. Retching, and, at
length, vomiting of difcoloured bilious matter, comes
on ; the tongue white and furred, the abdomen tenfe
and full, with pain in the loins and lower extremities.
The length of this paroxyfm varied from fix to eighteen
hours, and was generally fucceeded by cold rigors ; very
often low delirium, preparatory to the next ftage or pa¬
roxyfm of the fever. The intellectual functions now be¬
come much impaired, the patient not being at all fenfible
of his fituation, or of any particular ailment. If alked,
how he is ? he commonly anfvvers, “Very well;” and
feems furprifed at the queftion. This was a very dan¬
gerous fymptom, few recovering in whom it appeared.
In this ftage all the fymptoms become gradually, often
rapidly, aggravated; particularly, the head-ache, pain
and tenfion in the epigaftric region, and vomiting. Some
patients, on-ffore, were carried off in eighteen, twenty-
four, thirty, or forty, hours, and others not till as many
days after the attack, efpecially when removed on-board,
from the more noxious air of the ifland. A great pro¬
portion changed, in a few days, to a bright yellow ; fome
to a leaden colour: other cafes terminated fatally, in a
very rapid manner too, without the flighted: alteration in
that refpeCh Generally, however, the change of colour
indicated great danger. Vomiting of black bilious Huff,
refembling the grounds of coffee, trequently commenced
early, and continued a raoft diftrefling fymptom 5 too
often baffling all our attempts to relieve it. In fome, a
purging of vitiated bile, or matter refembling that which
was vomited, occurred ; in a great many, a torpor pre¬
vailed throughout the inteftinal canal ; rarely did any
natural fseces appear fpontaneoufiy. The pupil of the eye
was often dilated, and would not contraft on expofure
to a ftrong light 5 in others there was great intolerance
of light: both indicated danger. Low delirium was a
pretty eonftant attendant on this fever, from firft to laft;
fometimes, though more rarely, raging-high delirium.
The latter cafe is attended with red, inflamed, and pro¬
truded, eyes; great inquietude, hot dry Ikin, and fmall
quick pulfe. The patient’s mind is aftively employed
about his ufual occupations. During the violence of
the paroxyfms, he is quite infenfible to every thing that
goes on around him, conftantly grafping at, or wrench¬
ing, objefls within his reach. In the low delirium, alfo,
the mind is much occupied on avocational fubjefts : if a
feaman, about the fhip’s duty ; if a foldier, about hk re¬
giment, marching, &c. Some patients were comatofe
3 & from

2.20 , \ PATHOLOG Y.

from the fi r A attack ; in others, the fever was uthered
in with convulsions, delirium, and cold fweats, without
any intervening heat of the furface, except at the pit of
the 1 to macli, which, in mod cafes, was burning-hot to
the touch, and accompanied internally by a fimilar fen-
fation according to the patient’s own feelings.

‘'Haemorrhage from the mouth or nofe feldotn occurred;
in two cafes, which terminated fatally, the blood did
not coagdlate, but tinged the linen yellow. Aphthae
appeared in a few cafes, and indicated danger. Subfultus
tendinum often attended both on the low and high de¬
lirium. The pulfe never could be depended on. In the
very laft ffage it has been regular ; but in general it is
finall, quick, and either hard or ftringy and tremulous ;
fometimes, during the reaction of the fyftem, full and
hard. Deafnefs was very common, and an unfavourable
fymptom. Two kinds of eruption appeared about the
lips : one fuch as we often fee at the decline of common
fevers; the other, confided of fmall black or brown
fpots round the lips, and w’as likewife a dangerous, in¬
deed a fatal, fymptom. With this eruption, the teeth,
tongue, and fauces, generally become covered with a
brown or black cruft, and the breath intolerably fetid.
Locked jaw took place in two cafes at Onruftffiofpital,
but the patients were infenfible of it: both died. The
brain appeared the organ chiefly affe&ed at firft — the
ftomach and liver in fucceflion. In thofe cafes which
occurred on-board, and where the patient had not flept
on-fliore at Edam, the fymptoms were much milder, and
the fever refembled more the bilious remittent of other
parts of the Eaft. A great torpor prevails generally
throughout the fyftem, with the low delirium ; blifters,
medicines, &c. having little effefl on the patient, who
appears as if intoxicated. When roufed, he recollects
the perfon who is fpeaking to him, for a moment, and
anfwers in a hurried incoherent manner: then lies on
his back, his mouth and eyes half open ; both feces and
urine often parting involuntarily. I have feentpatients
remain in this ltate for hours, nay,' for days together,
fcarcely moving a Angle voluntary mufcle all that time.
Never was there a difeafe fo deceitful as this fever: I
have frequently feen inftances where every fymptom was
fo favourable, that I could almoft have pronounced my
patient out of danger: when all at once he would be
leized with reftleffnefs, black vomiting, delirium, and
convulflons, which, in a few hours, would hurry him
out of exiftence ! The fatal terminations generally
happened on the third, fifth, feventh, ninth, and not
unfrequently the eleventh and thirteenth, day; if they
parted this period, they ufually lingered out twenty or
thirty days. But very few indeed ever ultimately reco¬
vered, who had flept on-fhore, and were attacked at that
dreadful ifland, Edam ! No conrtitution was exempted
from the aflault of this fever. It feized with equal or
nearly equal violence on thofe who had been many years
in India, and on the mod robuft and plethoric, or newly-
arrived, European. Even the Dutch officers and Malays,
who had been drawn from different parts of Java, and
whom we had prifoners at Edam, fell viftims as fall, or
nearly fo, as the Englifh. Several officers, feamen, and
foldiers, were fent on-board from this ifland, in hopes
that the change of air might mitigate the difeafe. Many
» of even the worft cafes of thefe would promife fair for a
few hours in the forenoon ; but night always difpelled
our hopes, for then the patient relapfed as bad as ever:
they almoft all died. But their fate was confiderably pro-
craftinated by the change ; many of them lingering out
a great length of time on-board, finking at laft from the
confequences of the fever, rather than from the fever
itfelf. Several of them changed into obftinate intermit-
tents at fea, with great derangement of the liver, fpleen,
and bowels. Indeed the liver, in moft cafes, feemed af-
fefted from firft to laft in this fever ; but, in all protradled
ftates of it, this affeftion became the prominent fymptom.
In thofe that were cut off during the firft eighteen, twen¬

ty-four, or thirty, hours, the bra'm appeared to be the
organ opprefled.”

The remittent form of yellow fever is that moft fre¬
quently met with in the Eaft. We (hall accordingly pro¬
ceed to defcribe the marfh remittent, or endemic fever of
Bengal, in the words of Dr. Clark. “This fever at¬
tacked in various ways, but commonly began with ri¬
gors, pain and ficknefs at ftomacii ; vomiting, head-ache,
oppreffion on the praecordia, and great dejection of fpi-
rits. Sometimes, without any previous indifpofition, the
patients fell down in a deliquium, during the continu¬
ance of which the countenance was very pale and gloomy;
as they began to recover from the fit, they exprefied the
pain they fuffered by applying their hands to the fto-
mach and head ;” fo great indeed, that delirium often
came on at once; but, “after vomiting a conliderable
quantity of bile, they foon returned to their fenfes.
Sometimes the attack was fo fudden and attended with
fuch excruciating pain in the ftomach, that I have been
obliged to give an opiate immediately.

“In whatever form the difeafe appeared at firft, the
pulfe was fmall, feeble, and quick : the pain at the fto¬
mach increafed, and the vomiting continued. As the
paroXyfm advanced, the countenance became flufhed,the
pulfe quick and full, the eyes red, tongue furred, thirft
intenfe, head-ache violent; delirium fucceeded ; and the
patient became unmanageable ; but a profufe fvveat
breaking out in twelve or fourteen hours, generally mi¬
tigated all the fymptoms. In the retniffions, the pulfe,
which before was frequently 130, fell to 90. The patient
returned to his fenfes, but complained of great debility,
ficknefs at ftomach, and bitter tafte in the mouth. This
interval, which was very fliort, was fucceeded by another
psroxyfm, in which ali the former fymptoms were ag¬
gravated, particularly the thirft, delirium, pain at the
ftomach, and vomiting of bile. If the difeafe was neg-
ledfted in the beginning, the remiffions totally difappeared,
and the (kin now became moift and clammy ; the pulfe
was fmall and irregular, the tongue black and crufted,
and the pain at the ftomach and vomiting of bile became
more violent.” It is needlefs to fay, that from this period
till death clofed the fcene, the features of this fever were
fuch as charafterife the laft moments of all violent and
fatal fevers.

The unfavourable terminations are generally between
the third and feventh day, though in fome cafes the fever
goes on to the fifteenth or twentieth day: but vifceral
obftrudtions are almoft always the confequence ; and he¬
patitis and dyferitery complete what the fever fails to
accotnplifh. Dr. Johnfon adds, that feveral cafes oc¬
curred under his infpeftion where there was a yellowifli
fufFufion on the fkin, as in the endemic of the Weft,
with vomiting of matter bearing a conliderable fimilarity
to the grounds of coffee. This however is by no means
an uncommon fymptom in the fevers of the Eaft.

Occafionally, in the advanced feafon of the year, or
when cold weather fets in, this fever aflumes an inter¬
mittent form. The fimilarity in the nature of the two
forms of difeafe is well fupported by a Report drawn up
by Drs. Ainflie, Smith, and Chriftie, on the epidemic
fever of Coimbatore. The Report ftates, that it was
either remittent or intermittent, according to theconfti-
tution, treatment, and feafon of the year. People by
nature delicate and irritable, or rendered fo by irregula¬
rities or want of care, were fometimes attacked by the
difeafe in the remittent form, proving bilious or nervous,
as the conftitution inclined. “The fame happens to
the more robuft, when improperly treated, as where bark
is given early and before proper evacuations have been
premifed. As the feafon becomes hotter too, the remit¬
tent form prevails overthe intermittent. Males fuffered
more than females, and young people and thofe of mid¬
dle-age more than old people and children. The remit¬
tent form fometimes makes its approach very infidioufly.
The patient feels himfelf out of forts for a few days ; his

appetite

P A T II O L O G Y. 221

appetite fails him; he has fqueamiftinefs, efpe.cially at the
light of animal food ; univerfal laflitude; alternate heats
and chills ; ftupid heavinefs, if not pain in the head.
The eyes are clouded ; the ears ring ; the bowels are in¬
variably coftive. In other cafes, the enemy approaches
rapidly ; and rigors, great proftration of ftrength, verti¬
go, naufea, or vomiting, ufher in the difeafe.

“The fii'lt paroxyfm, which is often attended with de¬
lirium and epiftaxis, after continuing an indefinite pe¬
riod with varying fymptoms, terminates in a fweat ;
not profufe and fluent, as after a regular hot fit of ague,
but clammy and partial, with the effeft, however, of
lowering the pulfe and cooling the body, but not to the
natural Itandard. The latter ftill feels dry and uncom¬
fortable ; the pulfe continuing fmaller and quicker than
it ought. This remiflion will not be of long Handing,
without proper remedial meafures. A more fevere parox¬
yfm fconenfues, ufliered in by vomiting (fometimes of
bile), and quickly followed by exceflive heat ; delirium ;
great thirlt ; difficult refpiration; febrile anxiety;
parched and brownifh tongue. The next remiflion (if
it do take place) is lefs perfect than the firft, and brings
ftill lefs relief. In this way, if medicine or a fponta-
necus purging do not check the difeafe, it will run its
fatal courfe, each fucceeding attack proving worfe than
its predecefibr, till exhaufted nature begins to give way.
The pulfe declines; the countenance fhrinks, and looks
fallow ; the eyes become dim, the abdomen fwells from vif-
ceral congeftion ; the ftomach loathes all food, when hic¬
cup, ftupor, and low delirium, ufher in death. Such fe¬
vere cafes, the committee think, were, -in general, owing
to neglect or blunders at the beginning of the difeafe.”

Between the bilious fever and the continued form of the
weftern endemic we obferve little difference. In eacii,
gaftric irritability, inflammation or fullnefs of the abdo¬
minal vifcera, oppreflion of the head, are for the mod part
prefent. The other febrile fymptoms are by no means
conftant and regular. Thus the pulfe is frequently re¬
gular, and fometimes up to 120 or 130 in the minute.
It is the fame with the temperature of the fkin. Often,
when mad delirium is prefent, the pulfe will be 86, and
the thermometer in the axilla at 96° of Fahrenheit. The
"bowels are almoft always conftipated, or in a ftate of dy-
fenteric irritation. No fuch thing as natural flools in
this fever are ever to be feen, unlefs procured by art.
Frequently, but not always, yellownefs of the eyes, and
even of the fkin, takes place ; and the mental functions
are very generally affefted, which indeed is charafteriftic
of all bilious difeafes.

The following is the tnoft general order in which the
febrile phenomena prefent themfelves. Severe pain in
the head, arms, loins, and lower extremities; ftridture
acrofs the bread, with great pain under the fcrobiculus
cordis ; retching and griping. In fome cafes the pulfe
intermits, and the temperature of the fkin is increafed ;
in others, cold chills come on, attended with partial
clammy fweats ; but all patients complain of pain under
the frontal bone ; molt have white furred tongues, and
third. An increafe rapidly takes place in the leverity of
the pain in the head, limbs, loins, and acrofs the epigaf-
tric region ; condant vomiting of vifcid bile comes on ;
intermiffion of pulfe goes off. In fome, the fkin is cold ;
in others hot, with infatiable third. Tongue, in mod
cafes, covered with a thick white crud. Great irritabi¬
lity of the ffomach, and averfion to food. Bowels con¬
ftipated ; but a few patients have a fcetid bilious purging.
The third or fourth days bring an increafe of pains
acrofs the epigaftric region, and in the head, with fre¬
quent vomiting of bile ; tongue fwelled and furred, but
no great heat or acceleration of pulfe. An increafe of
all thefe fymptoms, efpecially the violent pain in the
head under the frontal bone, takes place; delirium, and
yellownefs of the fkin, come on ; and the fatal progrefs
of the difeafe is precifely flmilar to that of the continued

fever before detailed. Throughout the whole of the dif¬
eafe, the liver appears to be feverely affected.

The difeafe does not always proceed, however, in the
manner here mentioned. Sometimes violent madnefs is
the firft decided lymptom : the patient endeavours to
commit fuicide, and lias been known to attack with fury
thofe who have endeavoured to prevent his throwing
liimfelf over-board, or committing fimilar acts of violence.
The patient often falls fuddenly down, with fuffufed
eyes and infenfibie limbs ; and awakes after fome time
to undergo the molt violent inflammation of the brain.

The appearances found on dijfcdling thofe to whom
yellow fever has proved fatal, are fuch as commonly fol¬
low inflammatory aflion ; and, according as this aftion
has been violent or otherwife, we obferve the various gra¬
dations of mortification or (laughing, of abfcefs or ulce¬
ration, of adhefion or effufion, or (rarely) of Ample red-
nefs and dilatation of veffeis.

The parts principally affected are, the brain, the mem¬
branes of which are often found adhering together, and
the ventricles containing watery or bloody fluids,; the
liver, the ftruftureof which is varioufly affected, from a
flight hardnefs and darkened colour of its edge, to a ftate
fo completely diflblved and broken down, that with the
flighted preffure the finger runs into if. The gall-blad¬
der is almoft always turgid with bile; the ftomach and
fmaller inteftines inflamed in various degrees, the fto¬
mach being frequently ulcerated or fphacelated, and the
inteftines exhibiting various difeafed products : it rarely
happens that the inflammation extends to the colon.
The thoracic vifcera are not generally much aflefted,
though occafionally polypi arefound forming in the heart,
or the pericardium is unufually diftended. But ulce¬
ration or abfcefs of the lungs is perhaps the- lead fre¬
quent organic lefion of the vifcera. The fkin is often
affefted with inflammatory aftion, as exemplified by its
frequent termination in (pots and ecchymofes. It is to
be remarked, that fometimes the abdominal vifcera are
very much difeafed, while the brain is tolerably found :
but much variety exifts as to the organs affefted.

We pafs over numerous hiftories of the forms of yel¬
low fever. We have dated what appear to us the princi¬
pal divifions. To attempt to detail the perpetually-
changing varieties in febrile difeafe is equally beyond our
limits or our power ; fora hiftory, fo far complete, that
it embraces all the forms of yellow fever that have hi¬
therto appeared, we again refer our readers to the work
of Dr. J. Johnlon, before quoted, and to which we have
been much indebted in our compilation of the hiftory of
this difeafe.

The courfe of few maladies fo ftrongly exemplifies the
danger of following with unvarying meafures difeafes
fimilarly named as that of the yellow fever. The treat¬
ment of this difeafe muft change according to the pre¬
valence of particular fymptoms, according to the mode
of attack, and according to the efteifls it produces.
It cannot uniformly be grounded on the divilion of
ftages, fo ufeful in moll ailments ; for we have before
feen, that it fets in in various and oppofite ways ; being
fometimes attended with coldnefs and diminution of all
the phenomena of life ; fometimes, on the contrary,
with raving delirium, and great exaltation of ftrength,
heat, &c. It cannot altogether be founded on the exci¬
ting caufe; for the intenfer and the milder forms equally
arife from the aftion of the fame agent, if the conftitu-
tion be different; nor can an obfervance of the conftitu-
tion of the patient always lead us to difcrimination, fine*
the weakeft patients have borne depletory meafures un¬
der which the robuft have funk, and of courfe vice verfa.

The firft acceflion of the fever being the period at
which alone remedial agents can be depended on, it be¬
hoves us to meet it with the utmoft promptitude and de-
cilion. If the cold ftage be firft manifelted, we (hould
lofe no time in putting in force thofe meafures of bleed¬
ing/.

222

PATHOLOGY.

ing en the one hand, and reftoring the balance of cir¬
culation on the other, as detailed in the quotation from
Dr. Jackfon in our 209th page. If the raving delirium
and increafed circulation be firft manifeft, our bleeding
nudt .be ftill more free; and here let us caution our pro-
feffional brethren againft thofe futile half-meafures which
fyftematic writers in this country have been accuftomed
to recommend. We repeat the opinion of the beft-in-
formed practical writers on Indian maladies, when we
quote Dr. J. Johnfon’s exprefiion “ Bleed boldly and de-
cilively'till the head and prtecordia are relieved, or draw
110 blood whatever.” Indeed it is effedr we muft look to.
Thepulfe is fo changeable, that it is a bad guide; and,
as to quantity, this is fo various in different perfons of
the fame appearance, that the meafurement of ounces is
ftill mors fallacious. Ninety ounces of blood have been
drawn during the early ftage of this fever; and not
until that quantity was extradled did the fymptoms
abate. This meafure frequently relieves not only
the head and abdominal congeftion and inflammation,
but alfo the diftrefling and perpetual vomiting. In pro-
iecuting it we muft let nothing deter us from our pur-
pofe. Should mental impreflion caufe faintnefs, the pa-
rientis to be fupported with a little wine and water; the
bleeding reftrained ; and, as foon as animation is reftored,
we muft again open the vein. When the head is vio¬
lently affedled, cold lotions are to be applied to it ; and,
if there is general and high excitement, water fhould be
dallied over the whole body. Againft emetics ftrong tef-
timony exifts ; and indeed, when the great irritability
of the ftomach is confidered, we fliould naturally fup-
pofe fuch remedies muft do harm. The only cafe in
which an emetic feems at all allowable, is when a full
meal of folid food has been taken foon after the accef-
fion of the fever, and the ftomach has not rejedted it.
Here it appears highly probable that the undigefted ali¬
ment mult excite more ferious inflammation than the
tranuent ftimulus of the emetic.

Purgatives in a condenfed form, as calomel with rhu¬
barb and jalap, may be next exhibited ; and thefe
Ihould be aflifted in their operation by oleaginous or fa-
line enemata. When the irritability of the ftomach is
fo great that we fear the rejection of purgatives, a fcru-
ple dofe of calomel combined with a grain of opium, is
laid to reduce the difpolition to vomit in a rapid and afto-
nilhing manner; after which the purgatives may again be
perfevered in. When the bowels have been freely eva¬
cuated by purges, we muft have recourfe to calomel, a
remedy which writers on this fever have floridly called
their “ flieet-anchor.” This medicine, exhibited in large
dcfes and combined with opium, has been found to be a
remedy of univerfal application. Many have trufted to
it alone ; but though with thefe practitioners fome pa¬
tients were cured, and the lives of others confiderably
prolonged, yet the rate of mortality which occurred du¬
ring the exclufive ufe of mercury fo far exceeded that
which attended the practice of conjoining its exhibition
with bleeding, that the latter pradtice is now reforted to
in all violent cafes. This fadt may be explained on the
ground that abforption does not readily take place when
the blood-veffels are full, or on the ground that the ge-
nerally-increafed momentum of blood keeps up inflam¬
mation in the capillary fyftem of the difeafed vifcera,
notvvithftanaing the favourable adlion of mercury on the
fecernents. At all events, it is almoft impoflible to im¬
pregnate the fyftem with mercury till ample depletion
lias been ufed. Of the mode of adlion of mercury we
have before regretted our ignorance, when fpeaking of
cholera and dyfentery. In the fever in queftion, it feems
to be chiefly effedtive by eftablifhing general fecretion ;
and we find that, when this happy occurrence has taken
place, (which is denoted by ptyafifm coming on,) then,
and not till then, is the patient in a fair way of recover¬
ing. If the ftomach rejedts the calomel, mercurial in-
undiion may be fubftituted.

4

The above-urged meafures ofcourfe require fome mo¬
dification. If the head be more exclufively affedled, and
the liver in a trifling degree only, we need not always
pufh the mercury to the extent of ptyalifm ; but we
fliould carry the bleeding to the higheft pitch, and parti¬
cularly attend to the cold affulion. When the difeafe
aftumes the mild remittent or intermittent form, the pa-
roxyfm may becondudied by the fame means as before
mentioned. During the intermiflion, calomel may be
conjoined with bark, and the latter injedled per ano ;
but, ever keeping in mind to reftore the adlion of thofe
parts which are deficient, and diminifh thofe motions
which are exceflive, we fliould endeavour by blifters, by
baths, and by local bleeding, to relieve topical inflam¬
mation, and reftore the balance of power of wdiich all the
phenomena of this fever indicate a fevere derangement.
It is fcarcely neceflary to add, that it is of importance to
avoid the exciting caufes of the complaint, fince thefe
invariably aggravate it. Thus the removal of loldiers
into barracks at a diftance from peftilential effluvia, of
tailors from on-board of foul or crowded veflels, &c.
fliould, when pradlicable, be ftrongly urged. It is to be
remarked, that fome have fuppofed the yellow fever fo
be a difeafe which cannot occur twice in the fame indi¬
vidual ; but this is contradidled by the bell authorities.

We muft now return to our nofological arrangement,
which, for the obvious reafon that it entirely difagrees
with the opinions we have adopted as to the identity of
feveral fevers diftindtly named, we have thus far aban¬
doned. Dr. Good gives in the prefent order of Pyrexia;
four genera.

Genus I. Ephemera, [from the Gr. '^utpa, a day.]
Ephemeral, diary, or Ample, fever. Generic charadters
— Attack fudden ; paroxyfm fingle, and terminating in
about twenty-four hours. There are three fpecies.

1. Ephemera niitis, or mild ephemera : without prece¬
ding rigor; heat and number of the pulfe increafed
flightly; laffitude and debility inconfiderable ; pains ob-
tufe, chiefly about the head ; perfpiration and breathing
pleafant. This fpecies is ufually produced by excefs of
corporeal exertion, ftudy, or violent paffion ; by fup-
prelfed perfpiration ; fudden heat or cold.

2. Ephemera acuta, or acute ephemera : fevere rigor;
great heat ; pulfe at firft fniall and contradled, after¬
wards quick and ftrong ; perfpiration copious ; great
languor. It is frequently produced by a furfeit of eat¬
ing or drinking; or fome temporary organic obftruc-
tion. Thefe two fpecies of Ephemera generally go off
fpontaneoufly ; or, at nidi, by the help of reft and ab-
ftinence.

3. Ephemera fudatoria, the fweating ficknefs : tenfe
pains in the neck and extremities ; palpitation ; dyfpncea,
pulfe rapid and irregular; heat intenfe ; intolerable thirft ;
drowfinefs or delirium ; exceflive fweat.

The hiftory of the rife and progrefs of this Angular
and formidable difeafe conftitutes one of the moft cu¬
rious articles in the annals of medicine. Its origin is
involved in a good deal of obfeurity; and much vague
and inconclufive reafoning, concerning the mode in
which it was propagated, is to be met with even among
the moft authentic authors who deferibe its ravages.
It feems, however, to be generally admitted, that it firft
appeared in the army of the earl of Richmond, after¬
wards king Henry VII. upon his landing at Milford
Haven, in 1485 ; and that it foon fpread to London,
where it raged from the beginning of Auguft to the end
of Odtober. Whether the troops, which were foreign
foldiers, levied by the earl of Richmond, brought the
difeafe with them from the continent, or whether the
contagion was generated in the crowded tranfport-yef-
fels on-board of which they were embarked, it is irn-
pofflble, amidft the deficiency of evidence, to determine.
It may readily be fuppofed, however, that a highly ma¬
lignant and contagious difeafe might have been generated

under

PATHOLOGY.

under thefe circumftances, efpecially as this body of
troops is defcribed by a contemporary hiftorian (Philip
de Comines) as the moft wretched he had ever beheld ; col-
ledred, it is probable, from jails and hofpitals, and bu¬
ried in filth. The mod general opinion at the time, how¬
ever, certainly appears to have been, that it arofe from
i'ome peculiar ftate of the atmofphere, and was propaga¬
ted by contagion ; but no writer has diltinftly pointed
out the connexion of this or of any other epidemic
with a fpecific condition of the air, nor detedfed any pe¬
culiarity in the circumftances attending its fil'd appear¬
ance, or fubfequent returns.

The fweating-ficknefs broke out in England four dif¬
ferent times after this, but at unequal intervals. The
fummer feafon was always the period of its commence¬
ment, and it continued rife from three to five months.
It appeared during the fummer of 1506; and again in
7517, from July to the middle of December; when it
raged with peculiar violence, proving fatal in the courfe
of three hours ; extending its havock to many of the no¬
bility, and carrying off, in many towns, half the inha¬
bitants. Its next recurrence was in 1528; at which
time, though it was fomewhat lefs fatal, many ot the
courtiers of Henry VIII. fell viftims to it, and that mo¬
narch himfelf was in danger. Eellay, bifhop of Bayonne,
then ambaflador in England, who was affedled with it,
reports, that of 40,000 perfons attacked with it in Lon¬
don, only 2000 died. The lad time that it vifited Eng¬
land was in 1551, when its fatality was fo great, that in
Wedminder 120 died of it in a day, and among others,
the two fons of Charles Brandon, both dukes of Suffolk.
In Shrewfbury, particularly, according to the tedimony
of Dr. Caius, who refided in that city, 960 died within
a few days. The diforder had alfo, in the mean time, been
defolating many parts of the continent. "In 1 529 it fird
fltowed itfelf in Holland, and thence fpread to the Nether¬
lands, and to Germany, dedroying a great number of
lives. It is dated to have interrupted a conference at
Marpurg between Luther and Zuinglius, about the eu-
charid. From the defcription which Wierus has given us
of this epidemic, as it appeared in Germany, it leems to
have commenced with a violent cold dage and fiiivering,
which continued half an hour or more, accompanied with
great pains in the region of the diaphragm and groin,
and the other fymptoms already mentioned as charafler-
izing the difeafe, when obferved in England. Swelling
and diffnefs of the hands at the beginning of the attack,
and vomiting of black blood or bile, are alfo noticed by
this author in particular. Erafmus, an eye-witnefs of its
devaluations, defcribesit in very forcible terms, v vifum
ed ax amne Phlegetoneo emifi'um hoc malum.”

Thisdifeafe has been defcribed by various writers under
the names of fudor Avglicus, ephemera Brit.annica, ephe¬
mera fudatoria, RydronoJ'ns, and hydropyrctos. It appears
from their accounts to have fpared no age or condition,
but to have attacked more efpecially perfons in high
health, of middle age, and of better rank and condition.
The invafion of the difeafe was exceedingly fudden, and
was marked by the affection offome particular part, pro¬
ducing thefenfation of intenfe heat, extending through
the limb, atid afterwards diffufing itfelf over the whole
body. This was immediately followed by profufe fweat-
ing, which generally continued more or lei's through the
whole courfe of the difeafe, and was attended with infa-
tiable thirft. Extreme reltleflhefs, head-ache, delirium,
naufea, cardialgia, and an irrefiftible properifity to jleep,
chara&erized itsprogrefs; together with great proftration
of ftrength, producing frequent fainting, and irregula¬
rity in the aflion of the heart, which fometimes palpi¬
tated violently, while at other times the pulfe was weak
and fluttering. In this way the patient was carried off
frequently in two, three, or four, hours from the erup¬
tion of the fweat. Thofe more efpecially who bore their
Jufterings with impatience, and who fought relief from
the fen fe of heat, by which they were tormented, by ex-

Vql. XIX. No. 1299.

223

pofing their bodies to the air, or even by putting their
arms out of bed, were often fuddenly ftruck with death.
The fweat, when promoted, is represented as being un-
ufually clammy, as well as abundant, and as having a
very ftrong and peculiarly fetid odour. The violence of
the attack generally fubfided in fifteen hours, yet the pa¬
tient was not out of danger till the expiration of twenty-
four hours.

For a long time phyficians were at a lofs how to treat
this new and Angular malady. The fatal effedfs of expo-
fure to cold, however, fuggefted the propriety of accumu¬
lating heat round the patient, with a view of promoting
the fweat, which appeared fo manifeftly to be a critical
difcharge. The moment a perfon was feized with the
fymptoms of the difeafe, he was to lie down immedi¬
ately in bed, without taking off his clothes, and to be
completely covered, all but the face, with bed-clothes;
in which fituation he was to remain perfectly ftili, not
ftirring a limb, if pofiible, nor putting a hand out of bed,
He was enjoined abltinence from food during the whole
twenty-four hours, and even from drink the firft five
hours : then a little ale or beer, or wine and water, was
to be given in fmall portions, and fucked through a
fpout, the patient ftili lying in the fame pofture. At the
expiration of about fourteen hours, the bed-clothes were
gradually to be removed, and the fweating reftrained ;
and, after it was quite over, proper food was to be given
to recruit the exhaufted ftrength. This was the procefs
when the fweat flowed fpontaneoufly : when this was not
the cafe, attempts were made to excite it, fuch as by dry
and warm frictions, wine, aromatics, vinegar - whey,
China-root, and other fudorific medicines. By this me¬
thod of 'praftice, actively purfued, and properly adapted
to the circumftances, we are told that the difeafe, though
fo fatal when neglefted or mifmanaged, was got over
with a tolerable certainty of fuccefs; fo that, according
to the obfervations of lord Bacon, who has given us a
lltort account of it in his Hiftory of Henry VII. it might
be looked upon “ rather as a furprife of nature, than
obftinate to remedies.” Great ftrefs is laid by fome phy¬
ficians on the danger of indulging the propenfity to deep
which accompanies the paroxyfin. “If they were fuf-
fered to fleep,” fays Cogan, “ commonly they fwooned,
and fo departed, or elfe immediately upon their waking.”
(Haven of Health, p. 262.) It appeared, however, from
the teftimony of the continental phyficians efpecially,
that much harm, and frequently fatal confequences,
arofe from the extremes to which the hot regimen was
carried.

Dr. Willan, in his publication on cutaneous difeafes,
has thrown out a fuggeftion concerning the origin of this
affection, which he fuppofes might have been owing to
fome difeafe or depravation in wheat, or to fome noxious
vegetable growing with it in particular fituations. This
idea feems to have been fuggefted by fome analogy to be
traced between the fatal epidemic, called feu facre, feu
St. Antoine, mal des ardens, See. which is fuppofed to have
originated from eating rye damaged by a parafitic plant,
conftituting the diforder in corn termed by the French
ergot ; and it was alleged, that the inhabitants of Wales
and Scotland who fed on barley or oat bread, were not
attacked. This opinion appears, however, to be unte¬
nable, and has been ably combated in a paper in the
Edinburgh Medical Journal, vol. iv. p. 464.

In a curious and fcarce book, called the Touchftone of
Complexions, firft printed in 1633, we have the opinion
of Dr. Ltevinus Lemnius, the famous German philofo-
pher, who vifited this country at the beginning of tire
16th century, as to. why the fweating-ficknefs fliould
prevail here more than elfewhere. It will be feen by the
following extradl, that we have been long and commonly
regarded by foreigners as a gluttonous nation. “ The
ephemera, or diaria, is the fweating-ficknefs, which, be-
caufe it began in England, is called the Englijh fweat.
Why this difeafe is termed by the name of the Englilh

224

PATHOLOGY.

fweat, I fuppofe grew hereupon, for that the people of
that country be often therewith attacked, partly through
their curious and dainty fare, and great abundance of
meats, wherewith they crarnme themfelves very inglu-
vioufly, which I noted at my late being in that realme,
(about the time of midfummer,) by reafon that the ayre
with them is troubled, cloudy, and many times with
foggy dampes overcaft, whereby is engendred the caufe
and originall, both inwardly and outv/ardly, of this dif-
eafe ; the vehemency whereof' bringeth them into a bloody
fweating, wherewith they muft wreftle and drive as with
a molt fierce and ftrong enemy, ..and which they muft en¬
deavour with all might to fupplant : hereupon happen
trannces and fwounings, through feeblenefle of body
and minde, fainting and drooping of the fpirits, decay
of powers, flopping of the pipes and voyce, and life
almoft thereby cleane yeelded up, and the party even
brought unto death’s doore.”

Other books from which original information may be
collefted on the fubjeft of this article are the following :
A Boke or Confeill againft the Difeafe commonly called
the Sweat or Sweating-Sicknefs, made by John Caius,
Doftor in Phyfic, 1552, nmo. which was afterwards re¬
viled, enlarged, and put into a more fcientific form, by
the author, and publiflied in Latin, in 1556, under the
title of De Ephemera Eritannicu. Joh. Wierus, De Su-
dore Anglico. C. V. Dubourghdieu, De Pefte. Forref-
fus, Schol. Obferv. vi. B. Sennertus, iv. 15. Thomas
Cogan’s Haven of Health. Lord Bacon’s Relation of
the Sweating-ficknefs examined, &c. by Henry Stubbe,
Phyfician at Warwick, 4to. Lond. 1671. R. Fortis,
Ephemera Anglica Peftilens.

Genus II. Anelus, [from aviy/xi, I intermit.] Intermit¬
tent ague, or fever. Generic characters' — Paroxyfm in¬
termitting, and returning during the courfe of the dif-
eafe : the intermiffion generally perfect and regular.

There cannot perhaps be ftronger evidence againft the
notion that local inflammation is the invariable accompa¬
niment of fever, than that derived from the occurrence
of intermittents. In thefe difeafes, a cold paroxyfm fol¬
lowed by a hot one, each more fevere than in continued
fever, leaves the patient perfeftly free for fome time from
pain, or indeed lofs of ftrength or derangement of func¬
tion. Neverthelefs, according to Brouflais, thefe fevers
are, equally with thofe of the continued form, gafiro-
enterites. But any one not blinded by a favourite hypo-
thefis, cannot fail to view intermittents rather in the
light of irritative than inflammatory affections ; that is to
fay, as difeafes in which the nervous fyftem is primarily
affefted, and the capillary fyftem fecondarily and as a
confequence. But the reafon why intermifllons take
place is the difficult point to be decided. Darwin endea¬
voured to refer thefe periodical changes to the influence
of our diurnal habits, in regard to aftivity and fleep,
exhauftion of fenforial power and invigoration, and to
the diurnal periods of heat and cold, light and darknefs,
& c. upon all the actions of our frame. That thefe cir-
cumftances greatly influence the operations of the animal
body, cannot be doubted : and, were all the periods of
aftion and intern\iflion diurnal only, we might admit the
generalization as correct. But we cannot reconcile the
very frequent intermiffions of difeafe, which continue for
tertian periods, that is, during an interval of forty-eight
hours, and ftill more thofe which continue for quartan
periods, of feventy-two hours, with this general law.
See Zoonomia , vol. ii. feft. 36.

The French writers (among whom the names Begin
and Mongellaz occur to us at prefent) have fpeculated
of late as to the caufe of intermittents. But, though
thefe gentlemen have detailed fome remarkable obferva-
tions concerning the laws of intermittents, we do not
find any rational attempt at inveftigating the reafon of
the intermiflion. Dr. Park, in his Gulftonian Lecture,
dated very properly, that irritation was the caufe of the

4

fevers in queftion ; and he founded his explanation of the
caufe of intermiffion on this aflumption ; viz. that the
effects of irritation vary according to the mode in which
it is applied ; “that which is internal to the organs ex¬
citing increafed contraction ; while that which is external
diminifties or fufpends it.”

“ Beginning with internal irritation, its immediate ef-
feft is to excite the organs to increafed contraction, as
the following examples may (how. Thus, emetics ex¬
cite increafed contraction in the ftomach; purgatives in-
creafe contraction in the inteftines ; fudorifics ftimulate
the exhalent veflels to contract,” &c.

On the other hand, our author infers that the influence
of external irritation is to fufpend or diminifti contrac¬
tion, becaufe, “in afteCtions of the ftomach or inteftines,
rubefacients or blifters, externally applied, are ufed for
this purpofe. In morbid irritability of the womb, fric¬
tions and fomentations have that effeft. In the vafcular
fyftem, the influence of external irritation is obvious
and vifible on the furface, in the relaxation and increafed
fulnefs of veflels produced by it, in whatever mode it is
applied; whether mechanically, as by rubbing, lcratch-
ing, or bruifing ; or phyfically, as by the application of
finapifms, increafed fulnefs and diftention of the veflels
being invariably the effeft that refults. And in the fame
way relaxation and increafed fulnefs of the veflels is pro¬
duced by ftrong ftimulants applied to the internal fur-
face of the ftomach, where they aft externally to the veL
fels ramified on that furface ; hence the general glow and
fenfe of warmth that arife from taking wine or ardent
fpirits.”

The application of the above-mentioned propofition to
the phenomena of intermittent fever is as follows. The
firft caufe, whether marfti-miafma or any thing elfe being
admitted to the mucous membranes, aCts as a ftimulant
(according to Dr. Park caufing relaxation) externally to
thefe veflels; and hence the unufual flow of fpirits which
often precedes a febrile attack. As foon, however as this
agent is abforbed, and carried into the circulation, it ex¬
cites increafed contraction, (according to Dr. Park with
diminilhed circulation ;) and hence the cold fit. “The
duration of this cold ftage (fays Dr. Park) is limited,
becaufe the powers of aftion are limited ; and, the more
violent the contraction, the fooner thofe powers will be
exhaufted. The duration of the hot ftage is limited, be¬
caufe the relaxation of veflels which occafions it arifes
folely from their previous over-aftion, and not from any
perfonal debility.”

The fweat ing-Jlage is referred by our author, accord-
ing-to an hypothefis before mentioned, when fpeaking of
continued fever, to the relaxation of the fph in diet'- like
extremities of the capillaries, thefe veflels having reco¬
vered their natural dimenfions after the expiration of the
hot ftage. The beneficial operation of the fweating-ftage
is dependant, in the firft place, on a reduction of irritabi¬
lity attendant upon a copious depletion of the veflels ;
and, fecondly, on the partial expulfion of the irritating
caufe : “the quantity of which muft be diminilhed with
every paroxyfm ; one portion being thrown off- by tranf-
piration, while another is returned back into the primae
viae, where it no longer afts internally to the veflels, and
therefore no longer excites them to contraftion.” The
paroxyfm, however, recurs after a certain period; “ be-
cauf^ the portion that remains will be again taken up by
abforption, and be internally applied to the veflels;
where its ftrength will gradually accumulate, until it ac¬
quires force enough to excite another paroxyfm ; and
thus the fever affumes the intermittent form.”

Now it is obvious, that, according to the rapidity of
this accumulation of the agent of the fever, fo will the
difeafe be quotidian, tertian, quartan, &c. Dr. Park
likewife attributes fomewhat of the fecond and follow¬
ing attacks of ague to an accumulation of excitability,
which he fays predifpofes the body to be more ftrongiy
afted on by flighter caufes ; for, if this accumulation did

not

225

PATHOLOGY.

not take place, the miafmatal irritant being thrown off
gradually by perfpiration and other fecretions, the pa-
roxyfms would always become milder as the difeafe ad¬
vanced. But this is not the cafe.

This liypothefis, though far from being correft, ap¬
pears to us the beft yet promulgated ; and the hint de¬
rived from it fee ms to us to ferve as the foundation for
a theory more confonant with acknowledged faffs. We
mean, that the idea of accumulation of material agents
maybe explained without the affumptiou (an affumption
which a thoufand fafts deny) that internal irritants ex¬
cite, while external irritants diminifli, contra flility. We
•Ihould rather fuppofe the following circumftances take
place: that the miafma, or other caufe of ague, operates
exclufively on the mucous membrane, it may be, of the
Itomach or lungs, but we know not where : it may be
conjeftured, however, on the Itomach ; that the irritation
it excites is direftly tranffnitted to the brain and nervous
fyftem in general, through the medium of which, as in
continued fever, the capillaries are fo affefted as to pro¬
duce fever. Abforption of the miafma taking place, this
irritation is no longer kept up on the nerves of the mu¬
cous expanfion 5 and, in unifon with the law often urged,
a re-aftion takes place over the whole body, merely in
confequence of the nervous diminution of motion.
Without inferring an aftual accumulation of the miafm,
fince that would be difturbed by the paffage of food, &c.
we Ihould fay, that a number of imprejfions from the now
fecreted miafms were neceffary to develop the fympathetic
aflion of fever; and of courfe, as the conftitution was
more or lefs irritable, fo would the febrile movements
take place in a larger or Ihorter period. There is no ne-
ceflity to infer that the quantity of miafm gets lefs, be-
caufe we know that fecreting veffels often fecrete the
fame irritant as that which caufed their morbid ad ion ;
as is exemplified in morbific pains. Left it be faid, how-
ever, this is only eftablifhed with regard to animal irri¬
tants, we Ihould account for the unaltered degree of fe¬
ver obferved in fucceeding paroxyfms on the well-known
law of habit ; viz. that fympathetic movements are more
eafily called into aftion in proportion to the frequency
of their previous occurrence. It will be feen that much
of this theory belongs in fad to Dr. Park; to whom
moreover this much is due, that its ftrudure is entirely
owing to the train of thought into which his reafoning
has call us. And we fliall endeavour to conned thefe
views with an explanation of tic douloureux and other
periodical nervous affedions, when we come to the clafs
Neurotica.

The adions which give rife to the paroxyfms of inter-
mittents, though kept up folely by irritation, being ne-
verthelefs fimilar in their nature to thofe of continued
fevers, it follows, as in other difeafes, that, if the con-
tradility of the blood-veffels is impaired, adual inflam¬
mation will arife ; and hence that continued fever will
come on, or that a ftate nearly bordering on this, but
at the lame time capable of increafe from the periodical
adion of the exciting caufe, will occur ; in which cafe
we witnefs what is called a remittent fever.

Each paroxyfm of an intermittent fever is divided into
three different ftages, which are called the cold , the hot,
and the fweutivg, Jlages, or jits-

1. The cold Stage commences with languor, a fenfe of
debility and lluggilhnefs in motion, frequent yawning and
ft retching, and an averfion to food. The face and extremi¬
ties become pale, the features Ihrink, the bulk of every ex¬
ternal part is diminilhed, and the Ikin over the whole
body appears conltrided, as if cold had been applied to
it. At length the patient feels very cold, and univerfal
rigors come on, with pains in the head, back, loins, and
joints, naufea and vomiting of bilious matter; the refpi-
ration is fmall, frequent, and anxious ; the urine is almoft
colourlefs ; fenfibility is greatly impaired ; the thoughts
are fomewhat confufed 5 and the pulfe is fmall, frequent.

and often irregular. In a few inftances, drowfinefs and
ftupor have prevailed in fo high a degree as to referable
coma or apoplexy ; but this is by no means ufual.

2. Thefe fymptoms abating after a fhort time, the fe-
cond ftage commences with an increafe of heat over the
whole body, red n el's of the face, drynefs of the Ikin,
thirft, pain in the head, throbbing in the temples, anx¬
iety and reftleffnefs ; the refpiration is fuller and more
free, but ftill frequent; the tongue is furred, and the
pulfe has become regular, bard, and full. If the at¬
tack has been very fevere, then perhaps delirium will
arife.

3. When thefe fymptoms have continued for fome time,
a moifture breaks out on the forehead, and by degrees
becomes a /meat.; and this, at length, extends over the
whole body. As this fweat continues to flow, the heat
of the body abates, the thirft ceafes, and molt of the
fundtions are reftored to their ordinary ftate. This con-
ftitutes the third ftage. It mult, however, be obferved,
that in different cafes thefe phenomena may prevail in
different degrees, and their mode of fucceffion vary;
that the feries of them may be more or lefs complete ;
and that the feveral ftages, in the time they occupy, may
be in different proportions to one another.

Such a depreftion of ftrength has been known to take
place on the attack of an intermittent, as to cut off the
patient at once ; but an occurrence of this kind is very
uncommon. Patients are feldom deftroyed in intermit-
tents from general inflammation, or from a fulnefs of the
veffels either of the brain or of the thoracic vifeera, as
happens fometimes in a continued fever; but, when they
continue for any length of time, they are apt to induce
other complaints, fuch as dyfpepfia, difeafe of the liver,
dropfy, &c. which now and then prove fatal. In warm
climates, particularly, intermittents are very apt to ter¬
minate in a fatal manner. When the paroxyfms are of
fhort duration, and leave the intervals quite free from fe¬
ver, we may expeft a fpeedy recovery 5 but, when they
are long, violent, and attended with much anxiety and
delirium, the event will be doubtful.

Diffeftions of thofe who have died of an intermittent,
fhow a morbid ftate of many of the vifeera of the thorax
and abdomen ; but the liver, and organs concerned in the
formation of bile, as likewife the mefentery, are thole
which are ufually moft affefted.

The treatment of an intermittent fever refolves itfelf
into thofe means which may be employed during a pa¬
roxyfm to arreft its progrefs, or to mitigate its violence ;
and thofe which may prevent any return, and effeft a per¬
manent cure. This forms of courfe the more important
part of the plan ; but it is fometimes neceffary to pal¬
liate urgent fymptoms ; and it is always definable to fuf-
pend a paroxyfm, if poffible, not only to prevent mil-
chief, but alfo that there may be more time for the ule
of the moft effeft ual remedies. When therefore a fit is
commencing, or (hortly expefted, we may try to obviate
it by fome of thofe means which excite movements of an
oppofite defeription in the fyftem : an emetic will gene¬
rally anfwer the purpofe, determining the blood power¬
fully to the furface of the body. Should the paroxyfm
have already come on, and the cold ftage be very fevere,
the warm bath, and cordial diaphoretics in repeated
moderate dofes, may aflllt in bringing warmth to the
furface : when, on the contrary, great heat prevails, the
antiphlogiftic plan is to be purfued; and it is highly ne¬
ceffary, if any organ of importance be much inflamed,
to take blood, efpecially if the patient is plethoric and
rebuft : acidulated drink may be exhibited, with purges,
keeping the furface cool at the fame time. In the inter-
millions, ftimuli of various kinds are recommended; at
the head of which we place cinchona and arfenic, the
former of which is to be taken largely in fubftance,
where the difeafe is not complicated with vifceral affec¬
tion 5 in a quotidian an ounce at leaft Ihould be given

between

PATHOLOGY.

22C,

between the fits, in a tertian half as much more, and in
a quartan two ounces. It will be generally better to
dear out the primre viae before this remedy is begun
with; and various additions may often be required, to
make it agree better with the ftomach and bowels, parti¬
cularly aromatics and other ftimulants, aperients or fmall
dofes of opium, according' to circumftances. In thefe
dofes, however, it generally oppreffes the ftomach ; and
it may reafonably be doubted whether the application of
bark has not often produced the vifceral difeafes which
have happened in this complaint. The French ufe a pre¬
paration of this drug- called quinine. It has this advan¬
tage over the cinchona in powder, that it contains all the
remedial portion of that fubftance, without difturbing
the digeliive procefs by its large quantity of tough
woody fibre. The dofe is two grains, to be given every
two hours during the intermiftion. The fulphuric acid
has been ftated to have proved very fuccefsful in the re¬
moval of this difeafe. But the mod efficacious prepa¬
ration we know of is the liquor arfenicalis : it muft be
given in dofes of io or 12 drops two or three times a-d.iy,
and it^ effeCts watched.

Our readers will bear in mind (fee p. 55 of this arti¬
cle), that the black pepper (in dofes of 6 to 10 grains
twice a-day) has been fuccelsfully given by Drs. Frank
and Ghighini. Since that paragraph was written, many
refpedable teftimonials have appeared in favour of the
ufe of this drug. It is remarkable that this is merely an
old medicine revived, Diofcorides and Cafimir Medicus
having both ufed it in the treatment of intermittents.

This complaint often feems kept up by an habitual
operation of a&ion after the exciting caufe has ceafed
to exift. It is in thefe cafes that fo much has been done
by mental impreflions. We might fill a page with an
enumeration of the various inert remedies which have,
•through the medium of imagination, cured the ague.
It will be fufticient to extraCt two fentences from the
works of two of the firft philofophers of this country.
“ I myfelf,” fays Mr. Boyle, “ was cured of a violent
quotidian by applying to my wrifts a pafte made of bay-
falt, new’ hops, and blue currants; which has alfo re¬
lieved many others both of quotidians and tertians.”
(Philof. Works abr. tom. i. p. 80.) And Lord Bacon
lays, that “juices of ftock-gilly flowers, rofe-campion,
garlic, and other things, applied to the wrifts, and re¬
newed, have cured long agues.” His lordfliip likewife
recommends, in the heats of agues, to hold eggs of ala-
bafter and balls of cryftal in the hands.

The genus Anetus is divided by Dr. Good into five
fpecies, and thole fpecies into many varieties, as will ap¬
pear from the following enumeration.

1. Anetus quotidianus, the quotidian ague : intermif-
fion about twenty-four hours; paroxyfm commencing
in the morning ; ufual duration under eighteen hours.

< This fpecies is fubdivided into the following varie¬
ties.

a.. Partialis : confined to a particular part or organ,
ufually accompanied with diftrefiing pain. Sometimes
limited to one fide. Sometimes, and ftill more generally,
confined to the whole or half the head, embracing many
cafes of cephalaea.

(3. Comitatus : catenated with, or giving rife to, fo¬
reign lymptoms or other difeafes.

7. P rot raQus : leaving the intermiftion inordinately
fnort, or imperfeCL

8. Anticipans, the anticipating quotidian of Fordyce :
the paroxyfm anticipating its antecedent period ufually
by about two hours ; and continuing the fame antici¬
pation at every recurrence ; fo that the accefiion may
hereby be thrown into any hour of the day or night.

e. Cunftans, the retarding quotidian : the paroxyfm
delaying its antecedent period, ufually by about two
hours ; and continuing the fame delay at every recur¬
rence as above.

3. Anetus tertianus, the tertian ague: intermiflion

about forty-eight hours ; paroxyfm commencing at noon ;
ufual duration under twelve hours. Divided into,

a. Comitatus : catenated with other difeafes ; and,

13. Protradlus: leaving the intermiftion inordinately
ftiort or imperfedh

3. Anetus quartanus, the quartan ague : intermiftion
about feventy-twro hours ; paroxyfm commencing in the
afternoon ; ufual duration under nine hours.

This, like the former, has a., Comitatus ; and /•?, Pro¬
tradlus. Alfo,

7. Anticipans, or anticipating quartan : the paroxyfm
anticipating its antecedent period.

8. Cunclans, or retarding quartan : delaying its ante¬
cedent period.

4. Anetus erraticus, the irregular intermittent : inter¬
miftion and paroxyfm lefs regular ; the former more than
feveuty-two hour's.

This is divided into, cl, Quintanus ; /?, Sextanus; 7,
Septanus ; 0, Odtanus; e, Nonanus; £, Decimanus ; and
laftly, -/}, Vagus, which is equally irregular in the vio¬
lence of the paroxyfm, the duration of its ftages, and the
period of its return.

5. Anetus complicatus, the complicated intermittent :
paroxyfms intricate, multiplicate, or both. Here we
have no fewer than eight varieties.

a. Tertianus duplex, or double tertian.

C. Tertianus triplex, or triple tertian.

7. Tertianus impar, unequal double tertian.

8. Tertianus duplicatus, fitigle tertian with two parox¬
yfms on the regular day of attack.

£. Quartanus duplex, or double quartan.

£. Quartanus triplex, or ftngle quartan with regularly-
returning paroxyfms, each of the intervening days being
marked with a /lighter attack.

n . Quartanus duplicatus, or Angle quartan with two
paroxyfms on the regular day of attack.

0. Quartanus triplicatus, or lingle quartan with three
paroxyfms on the regular day.

Genus III. Epanetus, [from I remit.] Re¬

mittent fever. Generic characters — Strikingly exacer¬
bating, and remitting, but without intermiftion ; one pa¬
roxyfm every twenty-four hours.

It is quite unneceSary to defcribe minutely the fymp-
toms of the remittent fever, after the ample detail which
we have given of thofe of fever in general. We may
juft obferve, however, that it varies extremely in its cha-
rafter, according to the feafon, climate, and other cir-
cumftances under which it appears. In its milder forms,
the remittent begins with chillinefs, laflitude, pains in
the bones, head-ache, and a difordered condition of the
ftomach, lofs of appetite, ficknefs, and even vomiting.
At night the febrile lymptoms run high ; the heat and
thirft are great, the tongue and mouth are parched, the
pain of the head is violent, the patient is totally unable
to deep, and is continually tolling and tumbling about,
and often becomes delirious. But generally in the morn¬
ing, an imperfe& fweat brings on a remiftion of all the
fymptoms. In the evening, the paroxyfm returns, but
is not preceded by any cold fit or fhivering; yet it is
commonly more fevere than the former. Next morning
it remits as before; and thefe periodical changes recur
daily, becoming however lefts marked, if the difeafe he
negleCled, until the fever infenlibly aftumes a continued
form. The pulfe is full and quick during the remifllons
to indicate fever ; but rigors feldom precede the fits after
the. firft attack. Many patients difcharge a bilious mat¬
ter from their ftomachs by vomiting, and all are difor-
dered in that organ. The more violent form of this com¬
plaint, as exemplified in the yellow fever, has already
been tlefcribed. The milder form is to be treated accor¬
ding to the fame indications as the fevere ; but, of courfe,
by much lefts powerful meafures. Here we have three
fpecies, with their. varieties.

1. Epanetus rnitis, the mild remittent: pulfe regular,

though

F A T 1 1 O

though frequent; debility flight; remiffion diftinguifhed
by fweating or a cloud in the urine.

3. Epanetus malignus, the malignant remittent ; pulfe
/mail, hurried, irregular; debility extreme; often with
flgns of putrefcency. Of this there are four varieties.

а. Autumnalis, the autumnal remittent: often with
a ftrong tendency to affume the tertian or double tertian
type.

б. Flavus, the American yellow fever.

y. Ardens, the burning, remittent, the Caufus (Kauc-of)
of Hippocrates.

S. Afthenicus, the highly-debilitating remittent of the
fouth of Spain, Gombron, Breflaw, &c.

3. Epanetus hedlica, hedlic fever: pulfe weak ; ftages
of chillinefs, heat, and fweat, varioufly intermixed, and
fometimes Angle ; tire cold ftage exhaufting ; exacerba¬
tion chiefly in the evening : urine with a natant furfu-
raceous feparation; countenance flightly fluflied or pale,
funk, fallow, flirunk, and tremulous ; debility, but not
decided proftration of ftrength ; tongue whitifli ; ema¬
ciation great, but not fudden ; vertigo, or pain in the
head ; pofition often fupine ; anorexia, fometimes naufea
and diarrhoea.

Some writers have detailed accounts of an idiopathic
Febris hedlica; but we believe it will generally be found
that this is merely fymptomatic of a grave attack of Dyf.
pepfia, under which article it has already been mentioned.
It is for the molt part found as a fymptom in tabes ; and
fometimes in phthifis, chlorofis, lues, and fcirrhous dif-'
eafes of various organs.

Genus IV. Enecia, [from y,h uvs, perpetual.] Conti¬
nued fever. Generic charadiers — One feries of increafe
and decreafe ; with a tendency to exacerbation and re¬
in iflion, for the molt part appearing twice every twenty-
four hours. There are three fpecies, befldes varieties.

1. Enecia cauma, inflammatory fever; the Synoche of
Sauvages and Cullen. Heat greatly increafed ; pulfe
quick, hard, and ftrong; urine red ; difturbance of the
mind flight. Dr. Good has four varieties.

a. Plethoricum. “Produced (fays Dr. Good) by the
ftimulus of violent paflions, undue mufcular exercile, or
heating foods, upon a plethoric habit ; as alfo by a fup-
preflion of accuftomed difcharges, as thofe of menftrua-
ticn, habitual venefedtion, or perfpiration.”

/3. Biliofum : produced by the ftimulus of an undue
fecretion or abforption of bile into the fanguineous
fyftem.

7. Pleuriticum : accompanied with a violent ftitch or
pain in the pleura.

S. Cephalalgicum : accompanied with great pain in the
head,

2. Enecia typhus: pulfe fmall, weak, and unequal;
ufually frequent ; great proftration of ftrength, and dif¬
turbance of the mental powers. Two varieties.

a. Mitior, the nervous fever : with flight Ihiverings ;
heavy vertiginous head-ach ; oppreflion at the praecor-
dia ; naufea ; fighing; defpondency ; coma or quiet de¬
lirium ; urine whey-like.

(3. Gravior, putrid fever s countenance flirunk; eyes
vague, fuffufed, and with a film of mucus; tongue chap¬
ped, dry, and very fordid ; complexion brownilh or flight
pink; lips tremulous, fometimes muttering 5 pofition
fupine, limbs extended ; refpiration frequent and tremu¬
lous ; little increafe of heat ; bowels irregularly aftedled;
relaxation of the fphindter redlum, £tc. ufual duration
from fix to forty days.

3. Enecia fynochus : compounded of cauma and ty¬
phus: in its commencement refembling the former; in
its progrefs the latter. Here are four varieties.

d. Sudatorius : carried off by a critical fweat in an
early ftage of the difeafe.

(3. Flavus: with yellownefs of the fkin, attended with
a lenfe of burning heat. Nearly allied to Epanetus flavus,
and E. ardens, varieties of E. malignus.

VOL. XIX. No. 1299.

LOGY. 227

7. Puerperarum, child-bed fever. See the article
Parturition, vol. xviii. p. 674.

S. Soporofus: accompanied with great drowfinefs, or
ftupor.

Order II. Plogotica, [from (pfcyo, I fet fire to, or
burn.] Inflammations.

Having already (fated in what mode the primary phe¬
nomena of inflammation were induced, and that the va¬
rieties of appearance this adtion exhibits were the refult
of changes in the fecernent fyftem rather than in the red-
blood veflels ; we (hall now proceed to confider the latter
part of the pofition in queftion, i. e. what changes the
fyftem of the white veflels undergoes in order to produce
the varieties of inflammation.

The principal varieties inflammation exhibits on its
firft occurrence, are thofe of phlegmon, eryfipelas,
and a mixture of both. In each, heat, pain, rednefs,
and fwelling, are apparent ; but eryfipelas differs from
phlegmon in this, that, while in the latter the degree
of pain, rednefs, &c. gradually decreafing, clearly
indicates, that the morbid change in the properties
of veflels is moll intenfe in the middle of the injured
part, and that the natural adtion is gradually reffored
towards its circumference ; in the former, heat, red¬
nefs, See. prefent an abrupt difcontinuance, one line
having all the charadiers of inflammalion, but the next
being perfectly pure from difeafe. The pain alfo is not
of the fame kind, nor the fwelling fo great, in eryfipelas
as in phlegmon.

The remarks made while treating on inflammation in
general, as to its mode of produdiion and its general ef-
tedts on the conftitution, are molt particularly applicable
to phlegmon. It remains, therefore, that we fliould now
fpeak more particularly of eryfipelatous inflammation.
From various circumftances it feems pretty clear, that
eryfipelas is inflammation of the fkin ; but how it happens
that the veflels of the fkin fhould differ fo materially
from other parts in the phenomena they exhibit under
the fame adtion, is one of the unfolved problems of our
fcience ; nor, as far as we know, has its folution been
ever attempted. According to Cullen, indeed, eryfipelas
depends “ on a matter generated within the body, and
thrown out, in confequence of fever, upon the furface of
the body.” Mr. Pearfon reprefents it as the “ critical
termination of another difeafe, fuch as obftrudted men-
ftruation, quartan ague, fuppreffed fuppuration, fpa Ano¬
dic and convulfive difeafes.” But thefe are merely vague
conjedtures as to remote caufes, and have nothing to do
with the queftion, why does inflammation in the cuta¬
neous ftrudture exhibit irregularity of fwelling, and burn¬
ing pain, &c. and why does inflammation in other parts
manifeft the phenomena of phlegmon ? If it be faid,
that this depends on the peculiar ftrudlure of the fkin,
we mull fhow that thofe authors have been deceived who
have fpoken of phlegmon attacking the fkin, and of ery¬
fipelas attacking deep-feated parts. It is a remarkable
fadt, that thofe authors who have endeavoured to explain
the phenomena of inflammation have for the raoft part
confined their attention to phlegmon. It does not ac¬
cord wdth the purpofe of the prefent effay to fpeculate on
this difficult lubjedt ; but we (hall juft lay the fadts before
our readers, whence they may draw their own concluiions.

In the firft place, if eryfipelas be not folely confined to
the fkin, it is in this ftrudlure that it is moft frequently
met with, and moft fuddenly, extenfively, and clearly,
manifefted. It is much influenced by and dependent on
the Hate of the nervous fyftem, and of the primee vice, at¬
tacking for the moft part intemperate livers; and, when
it attacks that part of the fkin in which the nervous fyf-
tem is moft acute, it is developed with aflonifhing force
and celerity. It is liable to be connedled with phlegmon,
in which cafe we fhould fuppofe phlegmon to be the af-
fedlion of deep-feated eryfipelas of the fuperficial parts of
the body. It is intimately connedled with the ftate of
3 N the

228

PATHOLOGY,

thefecernent veflels; and one peculiar connexion between
eryfipelas and thofe veflels is (hown in what is called
cedematous eryfipelas. It is alfo connedted with a vaft
majority of that difeafed action of the fecernents which
are called cutaneous difeafes. It is unattended with the
throbbing which is experienced in the arteries of phleg¬
monous limbs. The following charadteriltics may be alfo
added. When eryfipelas is of an unmixed kind, it has
not the dark red colour which common inflammations
have, but a lighter red, with a yellow tinge, which is par¬
ticularly obfervable towards the termination of the dis¬
order. The fwelling which occurs is unattended with
any remarkable induration, and forms a very inconsider¬
able prominence. The Ikin of the inflamed part has a
Shining appearance, and, on being touched with the finger,
turns white at the fpot where the preffure is made ; but
the bright red colour immediately afterwards returns.
The pain is ufually of a burning Shooting defcription ;
and the patient frequently complains of a fort of itching,
which is found to be particularly annoying. The fwelling,
which happens in cafes of eryfipelas, is not only lefs hard
and elevated than that of phlegmonous inflammation,
but it is, at the fame time, quite irregular. Another re¬
markable feature of eryfipelas, is the manner in which
this inflammation often changes its Situation, by getting
well on one fide, while it is Spreading in fome other di-
redtion. The alteration which the Skin undergoes in
eryfipelas confifts in its feeling at the part affedted lefs
pliable than in the natural State, and a little thickened.

It will be recolledted that we have objedted to all fur¬
ther divifion of inflammation than this, into phlegmo¬
nous and eryfipelatous ; but many divifions have been
founded on the terminations of inflammation. Thefe
we confider as dependent on the adtion of Secreting vef-
iels; and the latter adtion dependent on the plethoric
Slate of the blood-veffels in inflammation, and the altered
condition of their own nerves. We proceed therefore to
Speak of the terminations of inflammation.

The firfi: termination is that in which, the capillaries
recovering their powers, and the nerves lofing their in-
creafed fenfibility, the phenomena of inflammation ceafes
to exift, and the natural functions of the parts affedted
continue. This is the molt favourable event that can
happen; but, according to Dr. Parry, the leaft: frequent.
This is true of phlegmon, but by no means of eryfipelas.
Even in phlegmon, refolution often takes place before
the fwelling of the injured part has come on. ^

Now as to the connexion between inflammation and
its products, it is to be noted, that the latter are pro¬
duced in two ways : firft, by Simple increafe of alteration
in the adtion of the fecernents, as in extravafation of
fluids on the nervous and ferous membranes; the Se¬
cond, by the abfolute acceflion of new properties in fome
of the inflamed veffels, or, by the adtual growth of new
veSTels, as in adhefion, fuppuration, and ulceration.

It was a favourite opinion of the late John Hunter,
and one which has been very generally adopted, that not
only inflammation, but each of the above-mentioned
terminations, w'ere instituted for the determinate purpofe
of curing difeafe; that, if the powers of a part were not
competent to produce one adtion, they Set up another,
which required lefs power, and which might attain the
objedt in view, though more Slowly and lefs efficiently.
There is Something hypothetical in all this ; yet whoever
attentively considers the reparative procefles of the body,
cannot fail to conclude, that the laws to which they are
fubjedted are framed in fuch a manner that their opera¬
tion tends under ordinary circumstances to the fanity
of our frame. As, however, the immediate agents con¬
cerned in their laws can have no choice of adtion or
adaptation of means to ends ; as they cannot vary with
uncommon circumstances ; fo we frequently witnefs
from their operation baneful effedts ; and hence it be¬
comes our province to control their operations under

many circumstances, though upon the whole we muft
view them among the molt beautiful phenomena which
the animal economy prefents.

The firft divifion of the produdts of inflammation em¬
braces the hiftory of thofe arising from the Simple increafe
of, and alteration in, the adtion of fecernent veSTels. It
is obvious that thefe produdts of inflammation can only,
be manifested in particular ftrudtures. Various divifions
of thefe ftrudtures have been made by Bichat ; but it is
pretty generally allowed, that the divifions of membra¬
nous parts made by this author are too minute. The
production of the firft terminations of inflammation re¬
quires the prefence of an apparatus furnished with exha-
lants or fecretory veflels from the arterial or capillary
fyftem of the refpedtive parts. This apparatus confifts.
either of fome Ample furface, as the lkin and various parts
of the mucous membrane ; of fome natural cavity, the
internal furface of which is lined with Similar membrane
as the Stomach, bowels, bladder, &c. or of lome difconti-
nuity of fubftance, forming a virtual, though often not a
real, cavity ; into which either exhalants open imme¬
diately, as in the cellular fyftem; or which is lined with
membrane, capable, by means of Similar exhalants, of
furnishing its appropriate fluid, as the ventricles of the
brain, medulla oblongata, and nerves; the intervals be¬
tween the coverings or Sheaths of the fame parts, the
duplicatures of the pleura and peritonaeum, the pericar¬
dium, the fynovial receptacles, & c. Or, laftly, this appa¬
ratus confifts of fome excretory dudt or dudls communi¬
cating with the part, if glandular, as in the mamma;,
liver, kidneys, falivary glands, &c. in which cafes the
duel anfwers the double purpofe of providing during
health a falutary fluid, and of evacuating the part, when
affedted with exceffive momentum of blood.

It is obfervable alfo, that the feveral organs fo fupplied
have, ufually, the combination of two of thefe circum¬
stances of Structure, fo as to acquire a double power of
evacuation, either immediately from themfelves, or from
neighbouring portions of the fame arterial branches.
Thus the lungs have pleura without, and mucous mem¬
brane within ; the liver, peritonaeum without, and pori
biliarii from within, &c. To thefe may be added the cel¬
lular, parenchymatous, and other, fubitances, forming a
proportion of the mafs of various parts, and affording a
third emundtory for the fuperfluous contents of blood-
vefiels, by means of exhalants and fecretory capillaries,
every where opening into them, as through the mem¬
branes before defcribed. This is the cafe in the medulla
of the brain, and in various other organs ; in which we
often find exhaled fluids, as well as between the mem¬
branes and in the ventricles of the former, and on the
feveral furfaces of the latter.

The nature of the fluids effufed in inflammation, and
their effedts on the feveral parts, vary confiderably, ac¬
cording to the nature of the texture from which they
originate, and to the degree of the malady which gives
them birth. From each of thefe ftrudtures fimilar produdts
are derived. In all of them the firft operation of inflamma¬
tion is generally to increafe the natural fecretions. Hence
mucus is more copioufly fecreted in the alimentary and
pulmonary expanfions of the mucous membrane, in the
uterus, and in the vagina. Serum is copioufly effufed in
the cellular tiflue, on the ferous membranes ; and the Se¬
cretion of tears is increafed from the eyes, &c. As the
inflammation advances, or as it is more intenfe, the pro¬
dudts vary: the mucous membrane pours forth coagu¬
lating ferum, fibrine, pus, or blood ; and the ferous mem¬
brane fimilar produdts. Neither chemical analyfis nor
the known properties of thefe fubftances allow us to in¬
fer any material difference in them, whether they arife
from the ferous or mucous membranes.

All thofe parts which are fecreting furfaces, and at the
fame time have outlets, as the mucous membranes, are
not commonly fubjedt to that procefs called adhefion. ; for

the

PATH

the natural fecretions of the part a£t perpetually fo as to
throw off the firmer accumulations, and to evacuate them
from the body: while, on the other hand, increafed fe-
cretion on the ferous furfaces, when it becomes indurat¬
ed, agglutinates the correfponding parts together, be¬
comes organized, and thus are adhefions contracted. It is
1 y this procefs occurring in artificial cavities, as wounds,
&c. that reparation takes place. The fame procefs may
be confidered as the origin of that cream-like fubftance
depofited in the cavities of joints, in capfular ligaments,
in the (heaths of tendons, See. which, by the abforption
of the thinner parts, becomes what is called chalk-Jlune, a
well-known effect of highly-inflammatory gout, and con¬
fiding of urat of foda. The fame is depofited in the cel¬
lular fpace between the inner and fibrous coats of the
larger arteries, becoming true bone, or phofphate of lime,
and producing fuch diftreffing effeCfs, refulting, according
to fome late obfervations, from an inflammatory affeCtion
of the va.fa vaforum 5 and when on the coronary arteries
of the heart, according to Parry, the proximate caufe of
fyncope angens.

Though thefe various products are for the moft part
the refult of inflammation, yet it is by no means clear
that they are not fometimes prefent without the occur¬
rence of this action. Copious mucous excretions are
often habitual to old perfons in whom we cannot infer
increafed vafcular a&ion ; and the various depofitions
of the fcrofulous diathefis feem generally to be caufes
rather than confequences of inflammation. On the other
hand, as increafed fecretion may exift without inflamma¬
tion, fo the latter may occur without the former; nor
does the peculiar modification which gives rife to this
circumftance feem clearly afeertained. It would feem
indeed, that the violence of the inflammation had fome
influence over the fufpenfion of fecretion ; but this does
not uniformly happen, fince the violent inflammation we
have mentioned as incidental to fevers of hot climates
are often accompanied from the firft with copious though
morbid fecretion. In the generality of cafes, however,
in which fecretion is flopped, we believe it will be found,
that the capillary fyftem is lefs fuperficially and more
violently inflamed than when this aftion is increafed.

It is alfo to be noted, that on fome occafions increafed
fecretion brings on inflammation, though by no means
fo frequently as inflammation induces fecretion. In
thefe cafes we obferve flight and unimportant exceffes in
the fecreting powers, after having continued fome time,
fuddenly exhibit the regular phenomena of inflammation.

When inflammation terminates by the procefles of ad-
hefion, fuppuration, or ulceration, we infer, that either
new fecreting veflels are formed, or that the fanguineous
capillaries acquire the fecreting faculty. Of adhefion
we have before fpoken. It is generally allowed to be
produced by the formation of new veflels. We infer that
fuppuration and ulceration are procefles which depend on
the capillaries acquiring new faculties, becaufe there is
in each a lofs of fubftance which could only be thus ac¬
counted for. The capillaries having acquired the above-
mentioned property, and loft that of tranfmitting blood
to the affe&ed ftrufture, muftdiminifti from the deficiency
of fanguineous fupply, abforption being l'uppofed to con¬
tinue. Moreover, pus, the fluid fecreted, is, according
to recent experiments, but (lightly removed in its nature
from the blood itfelf. Hence it would naturally be the
production of veflels which poflefled the fecreting power
in the lead perfeft manner. We infer it alfo from the
fuppofed inadequacy of the common fecernents of thofe
parts in which fuppuration is often eftabliflied to pour
forth fuch copious fupplies of pus ; and laftly we infer it,
becaufe how, other wife than on the fuppofition that a
change takes place in the terminations. of the capillaries,
could we explain the fad, that healthy ulcers do not
bleed ?

The laft and moft fatal termination of inflammation is
gangrene. This alfo exhibits fomewhat different appear-

O L O G Y. 220

ances, as it affefts the bones or flefli, or as it is produced
from the furface of an ulcer, in which latter cafe the
gangrened portion is called a Jlcrugh. Gangrene is termed
the death of a part; and is generally fuppofed to be the
aftual abolition of all vital powers and motions, and that
the part actually returns to inert matter. The fad that
gangrened parts look different from dead parts is
readily explained by the fuppofition, that the former
have entirely loft their contractility and elafticity, while
the latter, as is u'ell known, do not lofe the firft pro¬
perty for fome hours, nor the fecond for fome days,
after what is commonly called death. See Gangrene in
this article.

The natural connexions of philofophy would lead us
in this place to an examination and hiftory of local inju¬
ries followed by inflammation and the conftitutional or
febrile difturbances arifing therefrom. As however the
arbitrary difeafes of Medicine and Surgery have feparated
the practical application of thefe rules, we inultdefer thefe
fubjeCts till we arrive at the article Surgery. To that
article we (hall alfo refer the reader for an account of
external injuries, or fuch as belong to manual treatment.

It may not be amifs, however, to obferve, that the fe¬
brile (late which fupervenes on local injury does not dif¬
fer from common fever, except that, being kept up by a
certain irritating caufe, it can only be cured by the re¬
moval of fuch caufe; and hence that all treatment muff:
be direCled to the cure of the local difeafe. And farther,
as the local injuries are intenfe, or the conftitution mor¬
bid, the fever will affume inflammatory or heflic charac¬
ter, or a mixture of both.

This Order contains eleven Genera. To explain Dr.
Good’s arrangement of Inflammation, we (hall copy part
of a note fubjoined to this order. He therein remarks,
that “ The whole of the obfervations of Mr. John Hunter
upon this fubjeft are worthy of being deeply ftudied; and
will not a little elucidate the nature of the arrangement
introduced into the prefent method. It may be fuffi-
cient to obferve, that in treating on inflammation, he di¬
vides the body into two parts : 1, the circumfcribed ca¬
vities, organs, and cellular membrane which connects
them ; and 2, the outlets of the body, commonly called
mucous membranes, as the dufls of the glands, alimentary
canal, & c. He diftributes inflammatory affections into
three kinds, ad'hefive, fuppurative, and ulcerative. Ad-
hefive inflammation belongs chiefly to the former of the
above two parts of the body, where they are deeply feated;
and appears intended to take place in order to prevent
fuppuration. It applies therefore peculiarly to the ge¬
nus Emprefma in the prefent order, except in gaftritis,
enteritis, and cyftifis; in all which, however, we fre¬
quently meet with ftriking examples of the adhefive in¬
flammation, or true Emprefma ; infomuch that the af-
fefted organ becomes at times fo clofely united with
fome adjoining membrane or other organ, as to obtain a
kind of artificial wall, or paries, and prevent the efcape
of its contents into another cavity, when ulcerated
through the whole thicknefs of its fubftance. Suppura¬
tive inflammation belongs chiefly to the famedivifion of
parts, placed near the furface ; and confequently applies
peculiarly to the two genera of Phlegmone and Phyma.
The ulcerative belongs chiefly to the fecond order of
parts, as the mucous membranes and outlets ; and hence
principally applies to the genus Erythema, as it muff
alfo be allowed to do to that of Phlyfis. Deep-feated
fuppurative inflammations and abfeefles cannot well be
placed in either of thefe genera ; and have a claim to be
confidered by themfelves ; they are hence included in
the genus Apoftema, with which the order opens.

Genus I. Apojlema, [ctnoftb ipu, to recede from.] Deep-
feated abfeefs. Generic charadlers — Large fuppurative
inflammation in a deep-feated organ; pus copious and
confined. This genus contains five fpecies.

1. Apoftema commune, or fimple abfeefs: inflamma¬
tion

PATHOLOGY.

230

tion common to the fiefhy parts; pain obtufe; tumour
fpreading externally; tender to the touch; pus laud¬
able ; readily incarning when opened. See Surgery.

2. Apodema pfoaticum, pfoas abfcefs: pain and tenfion
about the loins, (hooting down the (pine and thigh; dif¬
ficulty of (landing ereft ; fiudluating enlargement along
the pfoas tnufcle; apex of the tumour immediately be¬
low the groin. See Surgery.

3. Apoftema hepaticum, abfcefs of the liver: diffufe
pulfating tumour in the region of the liver ; preceded by
pain, a yellow countenance, and fhiverings.

This is by no means a common complaint in this
country; but it is met with in hot climates, where in¬
deed the medical practitioners are faid to be remarkably
expert in performing an external operation for its relief.
We fhould take efpecial care to prevent fuppuration from
happening in this important organ, by aftive treatment
during the inflammatory period of the complaint. Sup¬
puration is prognofticated if inflammation continues in
the liver feveral days ; if the pain remits, and is followed
by a pulfation in the fame place, and if fhiverings come
on, with a countenance of a yellowifh colour ; foon after
which a tumour and a fenfe of weight are perceived in
the region of the liver: a heftic fever follows, with third,
and extreme feeblenefs. Aretasus obferves, that pain
generally extends to the throat, and to the extremity of
the (houlder ; and a dry, but not very frequent, cough
afflidls the patient. He further remarks, that this dif-
order is fotnetimes miflaken fora tumour of the perito¬
naeum ; but that the latter is more irregular, and is not
circumfcribed by the limits of the hypochondrium.

The favourable termination of this complaint depends
on the manner in which the abfcefs burfls. If externally,
we may entertain fome hope ; if internally, at the cavity
of the abdomen, it is for the mod part fatal. See Hepa¬
titis.

4. Apodema empyema, lodgment of matter in the
ched: fixed pain in the chefl ; breathing laborious, but
eafiell in an ereft pofition ; difficult decumbiture on the
found fide ; fiudluating enlargement on the fide ad'edled;
dry tickling cough. It is often brought on by difeafed
adlion in the pleura without ulceration. There is reafon
for believing that matter is contained in the cavity of
the chefl, when, after a pleurify, or inflammation in the
thorax, the patient has a difficulty of breathing, parti¬
cularly on lying on the fide oppofite the affedted one ;
and when an cedematous fwelling is externally percep¬
tible. The malady is fometimes relieved by the opera¬
tion of paracentefis thoracis, (fee Surgery;) and cafes
are related in which the matter is faid to have been ab-
lorbed.

5. Apodema vomica: deranged fundlion of a thoracic
or abdominal organ, fucceeded by copious difchargeof pus
into fome part of the alimentary channel, and its evacu¬
ation by the mouth or anus.

The term is here ufed in the large fenfe in which it is
employed by Celfus, who applies it to a burding of pus
from the liver, or any other large internal organ, as well
as from the lungs. “ Si vero jecur vomica laborat, eadem
facienda funt, quse in ca^teris interioribus fuppurationi-
bus.” Lib. iv. cap. 8. Sauvages follows him in this in¬
terpretation. Boerhaave and Cullen confine vomica to
the lungs, and that in a more reftrained fenfe than mod
writers ; for they limit it to what has been called, though
with no great accuracy, occult vomicae (vomica clauja).
Linnteus and Vogel, on the contrary, while they confine
the term to the lungs, explain it by open vomicae ( vo¬
mica aperta ), in which the pus is thrown forth profufely
and fuddenly

Genus II. Plilegmone, [from (pXiyu, to inflame.] Phleg¬
mon ; abfcefs or tumour near the furface. Generic cha-
raflers — Suppurative fubcutaneous tumour ; tenfive;
glabrous ; painful ; at length fiudluating, and burding
fpontaneoufly ; the pus uniform and mature.

+

The treatment of phlegmon is to be conducted, as far
as local treatment is regarded, by topical applications,
which are generally either cold or warm lotions. Heat
is well known to promote and increafe all animal aflions,
and mud therefore tend to keep up and augment the
procefs of inflammation. Hence arifes the indication
to diminifh the heat of the part affedled, by making ufe
of cold topical applications, and maintaining a continual
evaporation from the inflamed furface. The common
plan is to dip linen in the faturnine lotion, and, after
folding it once or twice, lay it all over the part affedted,
taking care afterwards to keep it condantly wet with
the application. In mod indances cold water will anfwer
every purpofe ; in others the aqua ammonias acetatx, or
lotions of the fulphateof zinc, alum, &c. may be employ¬
ed. Poultices made with linfeed-meal and water, or with
bread and water, are the ordinary applications of this
kind ; and fo great is the importance which ought to be
attached to the circumdance of making them foft and
unirritating, that a furgeon of the firfl eminence has not
difdained to make their compofition the fubjedt of partof
a ledture before the College of Surgeons. With poultices,
fomentations are alfo frequently proper, as having in all
fevere cafes a great effedl in leflening the pain. Like-
wife, when fuppuration is unavoidable, they accelerate
the cure by promoting the formation of matter, and
hadening its approach to the furface of the body. The
common method is to dip flannels in a decodlion of
chamomile-flowers, or white poppy heads, wring them,
and apply them very warm to the inflamed part ; but
warm water anfwers the purpofe as well. In difcriminat-
ing the cafes which require cold applications from others
to which warm ones are mod ferviceable, the pradlitioner
fhould always bear in mind, that, when fuppuration is
inevitable, it is invariably mod advantageous to difcon-
tinue cold allringents without delay. In general where
the chance of the phlegmon being refolved is great, cold
applications are bed ; but for the mod part the choice of
the topical remedies mud be regulated by the patient’s
feelings. There are fome patients who feem to derive
mod eafe from hot applications ; there are others who
appear to experience mod comfort from cold ones. The
latter remedies ought perhaps rather to have the prefe¬
rence, when the profpedl of preventing fuppuration is
fair and rational, and when at the fame time they afford
as much eafe as poultices. There are feven fpecies.

1. Phlegmon communis : tumour common to the fur¬
face ; bright-red; hard; defined; hemifpherical ; pola¬
rized ; gradually foftening and burding at the pole.

2. Plilegmone parulis, gum-boil : tumour feated on
the gums; deep red ; liardifh ; undefined; pain obtufe.
Divided into two varieties.

as. Simplex : limited to the fubflance of the gums. (2.
Cariofa : connedled with a caries of a tooth or focket.
When the former variety happens, the part may be freely
opened with the lancet, and the gum fomented. When
the latter variety comes on, the offending tooth mull be
drawn.

3. Plilegmone auris, impoflhumein the head : tumour
feated within the ear ; pain acute, throbbing; heat and
rednefs fpreading externally ; hearing diftreffingly keen,
or dunned with imaginary founds; abfcefs burding with
the fenfe of a loud fnap or explofion. In this complaint
we fhould iyringe the infide of the ear with foap and wa¬
ter, and apply a blifter behind it. A roafled onion, though
an anile prefcription, will alfo be found ufeful: it is ap¬
plied in the helix of the ear as a poultice.

4. Phlegmon parotidea, phlegmon of the parotids :
tumour feated under the ear: reddifli ; hard; pain ob¬
tufe; fuppuration flow and difficult. Two varieties.

a. Benigna : incarnation and cicatrization regular and
obflrudled.

|3. Maligna : pus illaudable, profufe, protradled ; fuc¬
ceeded by foul Houghs. Dr. Parr gives the following
account of this fecond variety. The malignant parotid

(wells

J

cs / /

o '//// '//.

> ofm

Zngrav&t./cr die. EruJ/dap ouka. Zondmjtns is. stizs..

PATHOLOGY.

Plate 1 .

PATHOLOGY. 23L

fwells like the milder kind, and is at firft fcarcely diftin-
guilhable from it, but by its attacking in advanced life,
and in females about the periodical change. It is not
painful, and advances flowly to fuppuration. If the
latter can be prevented by leeches, cooling applications,
& c. the inconvenience, for many years, is not confider-
able; but, when it fuppurates, the pus is feldom lauda¬
ble, and the patient loon finks from the difcharge. In
this cafe, bark, hemlock, and the whole tribe of poifons,
have been tried in vain. The wound enlarges, the Houghs
become deeper, till the conftitution is completely under¬
mined, and gradually finks. The fcirrhous parotids may
be extirpated, (though this is one of the mod difficult
operations in furgery;) but the malignant fink deeper,
and will not admit of the operation, which is always
dangerous from the numerous large veffels in the neigh¬
bourhood.

5. Phlegmone mammae, abfcefs of the breaft : tumour
feated in the breaft; pale-red; hardilh; in irregular
clufters; pain pricking and acute; fuppuration quick
and copious. Here alio we have two varieties.

a. Violens : from fevere prefl'ure or blow.

(3. La&antium, milk-abfcefs : from redundancy of
milk. Both varieties are charafterifed by tumefaction,
tenfion, heat, rednefs, and pain ; fometimes in both
breafts, but molt commonly in one. Pyrexia generally
attends the difeafe. It is fometimes very quickly formed,
and in general without any thing preceding to Ihow it;
but now and then a flight Ihivering is the forerunner.
This difeafe terminates either in refolution or fuppura¬
tion. If left to itfelf, it generally terminates in i'uppu-
ration. But it is often of long continuance; it is very
painful, but feldom fatal, unlefs when abfolutely neg¬
lected. The termination of the difeale by gangrene is
feldom to be apprehended ; at leaft few, if any', have feen
the difeafe terminate in this way.

As to the firft variety, during the inflammatory ftage,
cold lotions, purging, See. may be had recourfe to. In
the fuppurating ftage, the fame treatment is required as
in the var. (3, or milk-abfcefs. This latter may in ge¬
neral be prevented by an immediate application of the
infant to the breafts after delivery, or at leaft before they
are turgid with milk. When pus is actually formed, a
foft warm poultice, compofed of bread and water, or of
a decoCtion of poppies and linfeed meal, ftiould be con-
ftantly kept upon the part, and renewed every three or
four hours; at the fame time carefully fufpending the
enlarged breaft, with an handkerchief fpread under it,
and tied behind the neck. It is very rarely proper to
make any artificial opening in thefe abfeeffes : they ftiould
be permitted to burft of themfelves, and be poulticed as
long as the hardnefs or inflammation continues. During
this painful period, the child muft be fuckled by the
healthy breaft; for it rarely happens that the milk is
pure during a ftate of inflammation, or that the mother
can bear her child’s attempt to draw the nipple.

During the fuppurating procefs, the dietetic regulations
laid down under Dyfpepfia muft be rigoroufly enforced.
The local application muft vary with the appearance of
the ulcer when it heals ; and the adminiftration of
remedies will alfo be regulated by the fame criterion. See
Parturition, vpl. xviii. p. 71a, 13.

6. Phlegmone bubo : tumour feated in a conglobate
gland ; reddifii ; hard ; diffufe ; not eafily fuppurating ;
opening with a callous edge. Divided into,

a. Simplex : unconnected with any conftitutional or
foreign poifon.

|3. Virulentus : produced by fpecific virus, or con¬
nected with conftitutional affeCtion. The glands moltly
infeCted are thofe of the inguen and axilla. This laft va¬
riety is found chiefly in lues and peftis. Often cured by
vomits after fuppuration has advanced.

The firft variety will require the fame treatment dur¬
ing its inflammatory ftage as phlegmon in other parts,
and the fame during the fuppurating ftage as common

Yol. XIX. No. 1299.

abfcefs. The fecond variety, being fymptomatic of other
difeafes, will properly be treated under thofe heads.

7. Phlegmone .phimotica, phimofis and paraphimofis :
tumour feated in the prepuce; diffufe; obtufely pain¬
ful; imprifoning the glans, or ftrangling it by retraCfion.

a. Tncarcerans: the prepuce protraCfed, and imprifon¬
ing the glans. Numerous fubjeCls are born with a con¬
traction of the aperture of the prepuce; and the cafe is
then called a natural or congenital phimofis. Sometimes,
in adults, and particularly in old perfons, the prepuce
contracts fo much, without any evident caufe, that its
cavity becomes filled with urine during the aCt of mak¬
ing water, and great pain is the confequence. In cafes
where the opening is exceedingly fmall, and the diforder
is either congenital, or has occurred without obvious in¬
flammation, it is by no means an uncommon circum-
ftance for calculi to be formed under the prepi ce.
Thefe fometimes refemble in fliape the glans, on which,
as it were, they are moulded. When the phymofis is
congenital, and has exifted a long while, it frequently
happens that, in confequence of inflammation, adhelions
have taken place between the glans and the prepuce; and,
in this event, it may not always be in the power of the
furgeon to effeCt a cure. The poflibility of doing fo
muft depend, in a great meafure, upon the extent and
firmnefs of the adhelions. According to Richerand, it
is feldom practicable to deftroy them after the patient has
attained the age of puberty.

No operation ought to be praCtifed on children for the
natural phimofis, unlefs prefling inconvenience ftiould
immediately arife from the malformation. The conftric-
tion generally goes off, as fuch fubje&s approach the
adult ftate. For the mode of performing the operation
when neceffary, fee Surgery. For the treatment of the
difeafe, and alfo the other variety, (3, ftrangulans, or
paraphimofisy in which the prepuce is retraCled and
ftrangling the glans, fee Lues of this article.

Genus III. Phyma, [Gr. a tubercle, from (pvu , to
break or gulh out.] Boil, carbuncle, &c. Generic cha¬
racters — ImperfeClly-fuppurative, cutaneous or fubcu-
taneous tumour ; the abfcefs thickened, and indurated
at the edge; often with a core in the middle. There are
fourfpecies, though Dr. Good has numbered them as if
one were omitted.

1. Phyma hordeolum, the ftye : tumour feated in the
verge of the eye-lid; granular, hard, reddifli, fore to
the touch ; fuppuration confined to the point. This is
generally produced by indigeftion. Ple.nck affirms that
he knew' a man who uniformly had a ftye after drinking
ardent fpirit. He points out the following refemblance
between a ftye and a boil : “ Eft tuberculum inflamma-
torium, parvo furunculo Jimile,m margine palpebrarum.”
See Surgery.

2. Phyma farunculus, the boil: tumour common to
the furface ; deep-red ; hard, circumfcribed, acutely
tender to the touch ; fuppurating with a central core.
See Surgery.

3. Phyma fycofis : tumour excrefcent, flelhy, fig-
fliaped, darkifh-red, fprouting from the hairy part of the
head or face; gregarious; often coalefcing; difcharge
partial and fanious.

Dr- Bateman has deferibed the Sycofis to confift of “ an
eruption of inflamed but not very hard tubercles, oc¬
curring on the- bearded portion of the face and on the
fcalp, in adults, and ufually cluftering together in irre¬
gular patches.” Some difference takes place in the ap¬
pearance and progrefs of the eruption, when it is feated
in the chin and in the fcalp. Hence it is divided into
two varieties.

ce. Sycofis barbae, (S. menti, Bateman.) The turnout-
hard, roundifti, pea-lized ; feated in the beard; com¬
monly in clufters ; occafionally confluent, and fpreading
from ear to ear ; difcharge fmall and gelatinous, beard
matted. See Plate I. fig. 1.

3 & According

232

PATH G

According to Dr. Bateman, in this complaint the tu¬
bercles arife firft on the under-lip, or on the prominent
part of the chin, in an irregularly-circular clutter ; but
this is fpeedily followed by other clutters, and by diftimft
tubercles, which appear in fucceflion along the lower
part of the cheeks up to the ears, and under the jaw to¬
wards the neck, as far as the beard grows. The tuber¬
cles are red and finooth, and of a conoidal form, and
nearly equal to a pea in magnitude. Many of them con¬
tinue in this condition for three or four weeks, or even
longer, having attained their full fize in feven or eight
days; but others fuppurate very tlowly and partially,
discharging a fmall quantity of thick matter, by which
the hairs of the beard are matted together, fo that (ha¬
ving becomes impracticable from the tender and irregu¬
lar furface of the (kin. This condition of the face, ren¬
dered rugged by tubercles from both ears round to the
point of the chin, together with the partial ulceration,
and (cabbing, and the matting together of the unfhaven
beard, occafions a confiderable degree of deformity;
and it is accompanied alfo with a very troublefome
itching. -

Though this complaint occurs, of courfe, chiefly in
men, women are not altogether exempt from it. But in
them it is commonly flight, fince it is not expofed to the
lame irritation as when it occurs in the male fex. Its
duration is very uncertain ; being fometimes removed in
a fortnight; fometimes the fuppuration goes on for
many weeks ; and fometimes the fuppurating tubercles
heal, and again begin to difcharge. Occafionally the dif-
eafe difappears for a feafon, and then recurs.

6. Sycoiis capilli, (S. capillitii, Bateman.) Tumour
foft, unequal, cluttering : (bated in and about the hair
of the head ; difcharge ichorous, copious, and fetid,
from a fungous furface. See Plate I. fig. a.

The Sycofis capilli is feated chiefly about the margin
of the hairy fcalp, in the occiput, or round the fore¬
head, and temples, and near the external ear, which is
alfo liable to be included in the eruption. The tuber¬
cles rife in cl niters, which aft'ebt the circular form; they
are fofter, and more acuminated, than thofe on the chin ;
and they all pafs into fuppuration in the courfe of eight
orten days, becoming confluent, and producing an ele¬
vated, unequal, ulcerated furface, which often appears
granulated, fo as to afford fome refemblance to the in¬
ternal pulp of a fig. The ulceration, as Celfus dates, is
generally humid ; for there is a confiderable discharge of
a thin ichorous fluid, which emits an unpleafant rancid
odour.

Dr. Bateman informs us that “the Sycofis, under its
firfl-mentioned form, may be diftinguifhed from Acne
indurata, by its feat being exclufively on the bearded
part of the face; by the fofter, more numerous, and
cluftered, tubercles ; and by the ulceration which they
tend to produce. And, under its fecond form, in which
it is fomewhat affimilated to the eruption of favous puf-
tules, or Porrigo favofa, affecting the face and the bor¬
ders of the capillitium, it may be difcriminated by the
tuberculated and elevated bate of the fuppurating tu¬
mours ; not to mention the adult age of the patient, and
the abfence of contagion.”

As to the treatment of Sycofis, when the tubercles are
numerous, inflamed, and confluent, and efpecially w hen
the fuppuration is either beginning or confiderably ad¬
vanced, the molt fpeedy benefit is derived from the ap¬
plication of poultices, at night, of linfeed powder,
bread and milk, or other Ample ingredients. In the
lefs fevere forms, warm ablutions or fomentations may
be fubftituted. When the inflammatory fymptoms are
reduced, and in cafes where they are from the firft mo¬
derate, the healing procefs is much promoted, and the
difcharge moderated and reftrained, by the application of
the unguentum hydrargyri nitrati, diluted with three
or four parts of Ample ointment, or by the ung. hydrarg.
prascipitat. united with an equal portion of the zinc

LOGY.

ointment, or the cerate of acetate of lead. At the fame
time it is ufeful to prefcribe antimonials, with alterative
dofes of mercury, followed by cinchona, or ferpentarJa,
and the fixed alkalis ; or fuch other meafures as may be
required to re-eftablilh the functions of the chylopoietic
vifcera, which arealmoft always difordered in Sycofis.

4. Phyma anthrax, (Erythema anthrax, Cullen.) Car¬
buncle: tumour common to the furface; flat; firm;
burning ; penetrant ; livid and veficular; orcrufty above,
with a fordid and gangrenous core below; imperfectly
fuppurative. There are two varieties.

a. Pruna, the efcar carbuncle: cruft black; oozing
an erofive ichor,, or fanies.

Q. Terminthus, the berry or fungus carbuncle. See
the article Surgery.

Genus IV. Ionthus, [Gr. a violet or purple eruption ;
from ion, purple; or from onSo?, filth.] Tubercles in the
face. Generic characters — Unfuppurative tubercular
tumour; ftationary, and chiefly common to the face.

This genus (the Acne of Dr. Bateman) is charaCter-
ifed by an eruption of diftinCt, hard, inflamed, tubercles,
which are fometimes permanent for a confiderable length
of time, and fometimes fuppurate very llowly and par¬
tially. They ufually appear on the face, efpecially on
the forehead, temples, and chin, and fometimes alfo on
the neck, (houlders, and upper part of the breaft ; but
never defcend to the lower parts of the trunk, or to the
extremities. As the progrefs of each tubercle is (low,
and they appear in fucceflion, they are generally feen at
the fame time in the various ftages of growth and de¬
cline; and, in the more violent cafes, are intermixed
likewife with the marks or veftiges of thofe which have
fubfided. There are two fpecies.

1. Ionthus varus, the ftone-pock : red, hard, pimply,
diftinCt, gregarious ; fore to the touch ; fometimes oozing
a little fluid at the tip. This fpecies has two varieties.

a. Simplex, (Acne indurata, Bateman.) Broad-bafedj
bright red, and folid. This variety is defcribed as an
eruption of fmall tubercles, which appear fingly, and
are not very numerous, nor accompanied by much inflam¬
mation, nor by any intermediate affeCtion of the (kin.
When it has continued fome time indeed, a little rough-
nefs of the face is produced, where the larger tubercles
have difappeared, in confequence of a flight cracking or
difpofition to exfoliate in the new cuticle; but thefe
marks are not permanent. Many of the tubercles do not
proceed to fuppuration ; but gradually rife, become mo¬
derately inflamed, and again ilowly fubfide in the courfe
of eight or ten days, leaving a tranfient purplifh-red
mark behind. But others go on to a partial fuppuration,
the whole procefs of which occupies from a fortnight to
three wreeks. The tubercles are firft felt in the (kin, like
a fmall hard feed, about the fize of a pin’s head, and en¬
large for three or four days, when they begin to inflame :
about the fixth or feventh day they attain their greateft
magnitude, and are then prominent, red, finooth, and
(liining, and hard and painful to the touch. After two
or three days more, a final 1 fpeck of yellow matter ap¬
pears on the apices of fome of the tubercles; and, when
thefe afterwards break, a thinner humour is fecreted,
which foon dries into a yellowifli fcab. The inflamma¬
tion now gradually declines, the fize and hardnefs of the
tubercles diminifti, and the fmall fcab becomes loofened
at the edges, and at length falls oft’ about the third week.
The individual tubercles, which rife and fuppurate in
fucceflion, pafs through a fimilar courfe.

This eruption recurs frequently, at fliort intervals, in
fome individuals, who have it partially; but in others,
who are ftrongly predifpofed to it, it is more ex-
ten five, and never Wholly difappears, but is, at uncer¬
tain periods, more or lefs troublefome. It is generally
worft after eating heartily, or drinking an unufual por¬
tion of wine, or after the occurrence of any other caufe
of indigeftion ; as well as after any inordinate excitement

PATHOLOGY.

of the cutaneous circulation from violent exercife in hot
weather or in heated rooms, efpecially when followed by
a copious draught of cold liquor. This difeafe occafion-
ally puts on a much fevererafpeCh In the form to which
the term in dura fa is more ftriCHy applied by Bateman,
hardnefs is a remarkable feature in the appearance of the
tubercle, which is at the fame time more permanent, and
more apt to fpread from the face to the neck and (hould-
ers, than in the preceding form. The tubercles are oc-
cafionally acuminated, as if tending to immediate fup-
puration, being at the fame time of a bright rofeate hue :
yet many of them continue in a hard and elevated ftate
for a great length of time, without any difpofition to
fuppurate- Others, however, pafs on very (lowly tofup-
puration, the matter not being completely formed in them
for feveral weeks, and then only a final 1 part of the tu¬
bercles are removed by that procefs. Sometimes two or
three coalefce, forming a large irregular tubercle, which
occafionally fuppurates at the feparate apices, and fome-
tiines only at the largeft. In whatever mode they pro¬
ceed, their vivid hue gradually becomes more purple, or
even livid ; and their tendernefs is then extreme.
Slight crufts form upon the fuppurating tubercles, which
after fome time fall off, leaving fmall fears furrounded
by hard tumours of the fame dark red colour ; and thefe
fometimes fuppurate again at uncertain periods, and
fometimes (lowly fubfide and difappear, leaving a purple
or livid difcoloration, and occafionally a (light depreflion,
which is long in wearing off.

The general treatment of this diforder will be con¬
duced on the fame principles as (light inflammatory com¬
plaints in all parts of the body, when thefe a rife from
internal irritation. The mod frequent caufe of this
difeafe, as the fagacious Darwin remarked, is found in
deranged aCtion of the chylopoi'etic vifeera. Dr. Bateman
indeed does not feem to allow this ; for he fays that the
patients of this complaint often enjoy good health, and
that it is generally a local difeafe. But whoever confi-
ders the caufes which, according to this author’s account,
aggravate varus, will have little hefitation in concluding
that the fame caufes may often produce the complaint.
According to the teftimony of Dr. B. himfelf, the treat¬
ment of this complaint by repellent lotions often gives
rife to vicarious difeafe in other parts; an occurrence
which will never happen, we believe, if, previous to the
life of thofe applications, we regulate by gentle purga¬
tive and abftinent diet the ftate of the ftomach and
bowels. . The local applications to be ufed are weak fti-
muli of various kinds ; as lotions of water with a fmall
proportion of fpirits of wine, or a few grains of oxy mu¬
riate of mercury, the ftrength of the latter being gra¬
dually increafed (to a great degree when the tubercles
are indurated) as the difeafed part lofes its inflammatory
character.

£. Pun&atus, the maggot-pimple : tipped with a black
dot, difeharging, on the preflu re of the finger, a grub¬
like concretion of mucus. In other refpe&s this is fimi-
lar to the former variety. The indurated mucus may be
extracted by the fingers, or by means of a fmall blunt
curved forceps, and the little tumour treated as the firft
variety. In Plate II. fig. i, we have given a re prefen ta-
tion of Ionthus varus ; and at A are depicted a few of
the black punftas which give character to the fecond va¬
riety.

2, Ionthus corymbifer, (Acne rofacea, Bateman.)
Rofy drop, or whelk : confluent ; corymbofe ; rofy mot¬
tled with purple ; often disfiguring the noftrils with pen¬
dulous lobes ; irritated by cordials or expofure to heat.
See Plate II. fig. a.

This complaint occurs from a greater intenfity of the
fame caufe that gives rife to the firft fpecies ; being
chiefly found in thofe that ftimulate the mucous expan¬
sion of the ftomach with fpirits, and whofe livers are de¬
ranged in confequence of the fame habit. Its appear¬
ance differs in the following particulars from the prece¬

233

ding fpecies. In addition to an eruption of fmall fuppu¬
rating tubercles, there is alfo a (hilling rednefs, and an
irregular granulated appearance of the (kin of that part
of the face which is affeCted. The rednefs commonly
appears firft at the end of the nofe, and afterwards
fpreads from both fides of the nofe to the cheeks, the
whole of which, however, it very feldom covers. In
the commencement it is not uniformly vivid ; but is pa¬
ler in the morning, and readily increafed to an intenfe
red after dinner, or at any time if a glafs of wine or fpi¬
rits be taken, or the patient be heated by exercife, or by
fitting near a fire. After fome continuance in this ftate,
the texture of the cuticle becomes gradually thickened,
and its furface uneven or granulated, and variegated by
reticulations of enlarged cutaneous veins, with fmaller
red lines ftretching acrofs the cheeks, and fometimes by
the intermixture of fmall fuppurating vari, or pimples,
which fucceflively arife on different parts of the face.

This fpecies of Ionthus feldom occurs in early life,
except where there is an hereditary predifpofition to it ;
in general it does not appear before the age of forty ;
but it may be produced in any perfon by the conftant
immoderate ufe of wine and fpirituous liquors. The
greater part of the face, even the forehead and chin, are
often affeCted in thele cafes ; but the nofe efpecially be¬
comes tumid, and of a fiery red colour; and, in ad¬
vanced life, it fometimes enlarges to an enormous fize,
the noftrils being diftended and patulous, or the alse fif-
fured, as it were, and divided into feveral feparate lobes.
At that period of life too, the colour of the pimples be¬
comes darker and more livid ; and, if fuppuration take
place in any of them, they ulcerate unfavourably, and
do not readily a (Tu me a healing difpofition. In young
perfons, however, who are hereditarily predifpofed to
this complaint, irregular red patches not unfrequently
appearin the face, which are often fmooth and free from
tubercles, and fometimes throw off (light exfoliations at
intervals. Thefe patches may be gradually extended, if
great temperance both in food and drink be not obferved,
until the whole face afl'ume a preternatural rednefs.

As this eruption is chiefly fympathetic of fome de¬
rangement of the chylopoi'etic vifeera, or of a peculiar
irritability of the ftomach, little advantage can be ex¬
pected from local applications : and, in fad, the ftimu-
lants, which are beneficial under proper regulations, in
the other forms of Ionthus, are generally prejudicial
in this, and aggravate the complaint. We (hall not enter
into any particular directions for the treatment of this
complaint. Since this is fo obvious, the firft objeCt to
be attained is to induce the patient toabftain from drink¬
ing, feldom an Cafy talk ; and, this being accomplilhed,
an abftemious diet and mercurial alteratives will be the
principal remedies to be depended on. Dr. Bateman
fays the fymptoms may be fometimes palliated by the li¬
quor potaffas, or other antacids, which feem alfo to have
fome influence in leffening inflammatory aCtion in the
(kin. If the inflammation fubfides, the gentled reftrin-
gents (hould be ufed externally to the patches of reticu¬
lated veins ; -fuch as very dilute fpirituous or acetous
lotions, with or without a fmall proportion of the ace¬
tate of lead, or Ample ointments combined with alum,
acetate of lead, &c. in fmall quantities.

Genus V. Phlyfis, [from (p\vu, to boil up, to bubble.]
Whitlow. Generic characters — Ulcerative fubcutaneous
tumour; flat, tenfive, glabrous, dift'ufed, hot, throbbing ;
at length fluctuating with an acrid ichor. There is but
one fpecies.

Phlyfis paronychia : feated about the nails and ends
of the fingers: pain acute and pricking; (hooting up
the hand. Three varieties.

a. Cutanea : the acrid eftufion feated between the (kin
and parts immediately fubjacent.

(?. Tendinis : eft'ufion feated between the tendons and
the periofteum.

y. Perioftii,

PATHOLOGY.

y. Perioftii, the malignant whitlow, or felon : effufion
feated between the periofteum and the bone, which is of¬
ten rendered carious.

Similar inflammations are occafionally to be found in
the foies of the feet and palms of the hands ; they break
through the cuticle with difficulty from its thicknefs,
and hence become diffufed, and feparate the cuticle from
the flcin beneath. The bite or poifon of the Gordius
aquaticus, or hair-worm, is laid to have a pecular ten¬
dency to produce this affedion.

Genus VI. Erythema, [Gr. from spsv&oq, rednefs.] In¬
flammatory fluff), improperly called Eryfipelas. Generic
characters — Red, glabrous, tumid, fulnefs of the inte¬
guments; difappearing on preflure ; pain burning ; in¬
flammation ulcerative ; terminating in cuticular fcales
or veficles, occafionally in gangrene. There are fix
fpecies.

1. Erythema adematofum, cedematous inflammation :
colour fcarlet ; threading widely and deeply through the
cellular membrane, which often imperfedly fuppurates,
fioughs, and becomes gangrenous.

2. Erythema eryfipelatofum, eryfipelatous inflamma¬
tion : colour deepi(h-red ; fuperficial ; with a determined
edge; migrating in a Terpentine direction; the part
which has pafled through the aCtion healing, as the part
next attacked becomes aflfeded.

3. Erythema gangraenofum, gangrenous inflammation :
colour dulky-red ; fuperficial ; cuticle feparated from
the cutis by a bloody ferutn ; the cutis, when denuded,
exhibiting dark-brown fpots, difpofed to bliffer and
flough ; occurring chieflyr in the extremities.

Thefe three fpecies are ufually to be found in debili¬
tated or relaxed conftitutions : the former two often ap¬
pear as fequels of atonic fevers ; the third is common
to old age, and early infancy. For the treatment, fee the
article Surgery.

4. Erythema veficulare, fiery inflammation : colour
pale-red ; furface roughilh, and covered with crowding
minute veficles, filled with an acrid, often a reddifti,
fluid ; progreflively trailing into the neighbouring found
parts.

This is intended, as Dr. Good informs us, to deline¬
ate the ignisfiacer of the ancients, which has been feldom
underftood, and never hitherto allotted a clear methodic
pofition. The common error has been in making it an
exanthem, or eruptive fever, an Eryfipelas or a Peffis,
or a diftind difeafe approaching to the one or the other.
There is no doubt that it has at times been an accompa¬
nying fymptom in Pettis, and has confequently produced
a variety in this fever which the reader will find noticed
under the head Pettis by the diltinguiffiing term erythe-
Kiatica, of which nature was the plague of Athens, fo
excellently defcribed by Thucydides and Lucretius.
But the ignis facer, in its genuine and fimple ltate, in-
ltead of being a typhous eruptive fever, has often very
little fever of any kind, never perhaps more than fymp-
tomatic fever ; and by Celfus is defcribed as being bed
cured by an ephemeral or other fever that may give in-
creafed adion to the fyttem. The varieties are,

a.. Benignum : the rednefs and veficles advancing
without a breach of the cuticle, as the part that has
pafled through the adion is healing.

/3. Corrofivum : the veficles breaking in the part firft
aft’eded, and theerofive fluid producing tracks of fanious
ulceration as the rednefs advances.

Thefe fubdiviiions of ignis facer are taken from Cel¬
ias, and given, as nearly as may be, in his own words,
to prevent all doubt. Fie defcribes it as a genus compri-
iing two fpecies, of which the former has two varieties.
“ Dus fpecies funt. Alterum eft fubrubicundum, aut
mijlv.ni ruborc atque pallore, exafperatumque ' per pvfiulas
(OAvxT Kim?) continuas , quarum nulla altera major eft,
fed plurimee perexigutx, In his feinper fere pus, et ftepe
rubor cum calure eft.” Then follow the two varieties as

defcribed above : “ a, Scrpilque id nonnunquum fanefeente
eo, quod primum vitiatum eft ; Q, nonnunquam etiam ex-
ulcerato, ubi ruptis pujlulis (<p\vy,’ru,ivu.iC) ulcus continu-
atur, humorque exit." Fie then pafl'es on to deferibe the
fecond fpecies, which anfwers to the character and al-
moft to the words of our third fpecies, Erythema gan-
grtenofum. “ Alterum, autem, in fiumvus cutis exulcera-
tione, fed fine alliludine, latum, fiublividum, inasqualiter
tainen 5 mediumque fanefeit, extremis procedentibus ;
ac ftepe id, quod jam fanum videbatur, iterum exulcera-
tur : at circa, proxima cutis, quae vitium receptura eft,
tumidior et durior eft, coloremque habet ex rubro fub-
nigrum. Atque hoc quoque malo — in cruribus maxime."
Lib. V. cap. xxviii. fed. 4.

Dr. Good has ventured to tranfiate the pvfiula of Cel¬
fus in the prefent inftance tp^oy.xa.ivxi, veficles ; firft, be-
caufe he thus explains the term in fed. 15 of the fame
chapter ; and fecondly, becaufe in the ignis facer, which,
as we learn both from Thucydides and Lucretius, was a
fymptom in the plague of Athens, the former has given
us this precife term. The following couplet is fufficient
from Lucretius. De Rer. Nat. vi. 1164.

Et jimul , ulceribus quafii invjlis, omne rubere
Corpus, ut ejl, per membra facer quum diditur ignis.

Wide ting’d with purple dye, and brandifli’d o’er
With trails of caultic ulcers, like the blaze
Strew’d by the holy fire.

In Thucydides the fame fymptoms are defcribed ; and in
Seneca, who has clofely copied from Lucretius, the phrafe
facer ignis is ftill preferved. See CEdip. 187.

The Eczema rubrum of Dr. Bateman feems to belong
to this fpecies, and may form a third variety. It is com¬
monly denominated Erythema mercuriale or hydrargy¬
ria. This difeafe is preceded by a fenfe of ftiftnefs,
burning heat, and itching, on the part where it com¬
mences, Which is moft frequently the upper and inner
furface of the thighs, and about the ferotum in men ; but
fometimes it appears firft in the groins, axillae, or in the
bend of the arms, or about the wrifts and hands, or in
the neck. Thefe fenfations are foon followed by an ap¬
pearance of rednefs, and the furface is fomewhat rough
to the touch. This, however, is not a fimple effloref-
cence; for, on examining it minutely between the light
and the eye, or with a convex glafs, the roughnefs is
found to be occafioned by innumerable minute and pel¬
lucid veficles, which have been miftaken for papula:. In
two or three days, thefe veficles, if they are not rup¬
tured, attain the fize of a pin’s head; and, the included
ferum then becoming fomewhat opake and milky, the
charader of the eruption is obvious. It foon extends
itfelf over the body and limbs in fuccefiive large patches ;
and is accompanied by a confiderable fw'elling of the in¬
teguments, fuch as is feen in fmallpox and other erup¬
tive fevers, and by great tendernefs of the Ikin, and
much itching. When the veficles begin to lofe their
tranfparency, they generally burft, and difeharge, from
numerous points, a thin acrid fluid, which feems to irri¬
tate the furface over which it pafles, and leaves it in a
painful, inflamed, and excoriated, condition. The quan¬
tity of this ichorous difeharge is very confiderable ; and
it gradually becomes thicker and more adhefive, ftif-
fening the linen which abforbs it, and which thus be¬
comes a new fource of irritation; it emits alfo a very
fetid odour. This procefs takes place in the fuccefiive
patches of the eruption, until the whole furface of the
body, from head to foot, is fometimes in a ftate of pain¬
ful excoriation, with deep fllfures in the bends of the
joints, and in the folds of the Ikin of the trunk ; and
with partial fcaly incruftations, of a yellowilh hue, pro¬
duced by the drying of the humour, by which alfo the
irritation is augmented. The extreme pain arifing from
the preflure of the weight of the body upon an exten-
five portion of fuch a raw furface, is fufficient to give
rife to an acceleration of the pulfe, and white tongue ;

3

235

PATHOLOGY.

but the funftions of the ftomach and of the fenforium
commune are not evidently dilturbed by this difeafe.
The duration of this excoriation and difcharge is un¬
certain and irregular: when only a fmall part of the
body is affefted, it may terminate in ten days; but, when
the diforderhas been univerfal, the patient feldom com¬
pletely recovers in lefs than fix weeks, and is often afflifted
to the end of eight or ten weeks. By fo fevere an inflam¬
mation the whole epidermis is deftroyed in its organiza¬
tion ; and, when the difcharge ceafes, it lies loofe, affu-
raing a pale brown colour, which changes almoft to black
before it falls off in large flakes. As in other fuperficial
inflammations, however, the new red cuticle that is left
is liable to defquamate again, even to the third or fourth
time, but in fmaller branny fcales, of a white colour;
and a roughnefs fonietimes remains for a confiderable
period, like a flight degree of Pforiafis. In fome in-
flances, not only the cuticle, but the hair and nails, are
alfo obferved to fall off; and the latter, when renewed,
are incurvated, thickened, and furrowed.

In fome cafes this difeafe is limited to a fmall fpace ;
and then the difcharge is flight, and its whole duration
ffiort. Similar local attacks of it occur in irritable con-
ftitutions, efpecially in hot weather, affe6ting the hands
and wrifts, the neck and external ear, and other parts,
but without any conftitutional diforder. Succeflive crops
of the veficles arife in irregular patches, with a red blulh
around them, which produce partial incruftations, as
the ichor that iffues is dried : and by thefe vefications
and deficcations of the matter the affection is kept up for
fome weeks.

The treatment of this fpecies of Erythema may be
comprifed in few words; for it is principally palliative.
But, although medicine may not poflefs the power of
(hortening the period of its duration; yet the omiflion
of the palliative meafures will allow an extreme aggrava¬
tion of the fufferings of the patient to take place, and
probably prolong it beyond its natural courfe, as well as
contribute to wear out the vigour of his conftitution.
The mifery and exhauftion, refulting from the excellively
tender and irritated ftate of the {kin, may be greatly al¬
leviated by frequent ablution or fomentation with warm
gruel, or (trained bran and water ; or by the frequent
ufe of the warm bath, which has the advantage of clean¬
ing the furface without occafioning any abrafion by
friction. A conftant application of poultices has pro¬
duced confiderable eafe to the patient, when the affection
was confined to the extremities. Where the cuticle has
exfoliated, Mr. Pearfon recommends the application of
a tnild cerate, confiding of litharge plafter, wax, and oil,
fpread thickly on linen rollers, and renewed twice a-day.
With the fame view of diminifliing the irritation of the
furface, the bed and body linen of the patient, which
becomes hard and ftiff as the difcharge dries upon it,
(hould be frequently changed. Every additional irrita¬
tion from flimulating food and drink (hould be avoided ;
the bowels (hould be kept open by the adminiftration of
occafional laxatives ; and opiates may be given for the
purpofe of foothing the fenfations of the patient. The
fulphuric acid is grateful and refrefiiing ; and, in the de¬
cline of the fwelling and difcharge, it may be combined
advantageoufly with the exhibition of farfaparilla.

5. Erythema pernio, chilblain: colour crimfon fuf-
fuied with blue; obftinately itching; chiefly affefting
the extremities during winter. Two varieties.

a. Simplex: the cuticle remaining unbroken.

6. Exulceratus; accompanied with ulceration.

Intenfe cold produces the fame efteft, in exciting in¬
flammation, as intenfe heat. Hence chilblains are bed
treated on the fame principles as burns or fcalds. In the
firft variety, cold fpirituous applications are to be ufed ;
and the patient (hould avoid the extremes and alterna¬
tions of heat and cold ; confequently Ihould not put his
feet near the fire on coming out of the cold. The fecond
variety is to be treated by poultices. Terrible examples

Vol. XIX. No. 1300.

of this chilblain occurred among the French foldiers on
their retreat from Mofcow. On this occafion Baron
Larrey, in his circular to the French furgeons, fpeaking
of the effefts of intenfe cold, obferves, that, in general,
froft-bitten fores (plaies de congelation) prefent the
fame phenomena as burns. In both cafes a gangrenous
efchar, more or lefs extenfive, is formed, the feparation
of which mult be promoted by topical applications which
excite the furrounding found parts. The molt fimple
and effectual drefling was unguentum de fiyrace, fpread
on linen or lint. Alcoholic embrocations and decoc¬
tions of cinchona counterafted the procefs employed by
nature in the cure. The efchars feparated, the wounds
are to be confidered as fimple, and treated accordingly.
When chilblains fphacelate, they are to be treated as
gangrene in general.

6. Erythema intertrigo, erofion of the (kin : colour
bright red ; cuticle eroded; the expofed cutis oozing a
limpid and acrimonious fluid. This arifesfrom peculiar
acrimony in the matter of perfpiration, or acrid fub-
ftances intermixing with its natural fecretion ; it occurs
moftly in children, in the folds or duplications of the
(kin, as the groins, armpits, and behind the ears. Tepid
ablution, and certain abforbent powders well known to
mothers and nurfes, e. g. fuller’s earth, comprehend all
that is required for the cure of this erofion. The bowels
(hould be opened if coltivenefs is prefent.

Genus VII. Emprefma, [from I flame or burn

within.] Internal Inflammations. Generic characters —
Deranged function of a vilceral organ, membraneous or
parenchymatous, with local pain; fever moftly a cauma;
inflammation moftly adhefive.

Hitherto we have fpoken only of thofe inflammations
which, obvious to the fight and touch, cannot be milla-
ken for complaints of a different kind. But the genus
upon which we are now entering prefents a vaft number
of the mod ferious difeafes which we are afflifted with ;
and which are difficult torecognife, not only from their
hidden fituation, not only from the fimilarity which the
fymptoms of each fpecies hold to thofe of another, and
from the occafional refemblance which they all bear to
irritative or fympathetic diforders. It is in every cafe a
matter of great moment to diftinguifh whether a difeafe
be inflammatory or otherwife ; fince, this grand diftinc-
tion once eftablifhed, we know whether it is abfolutely
neceffary to aft decifively and at once, or whether we may
be allow’ed to wait and watch the full development of
the difeafe. We may reft more fully contented when we
have made this diftinftion, becaufe the firft treatment of
all internal inflammation is nearly fimilar. So ftrongly
was this truth impreffed on the mind of the accurate
Celfus, that, before he difcriminates any difeafes by name,
he marks certain fymptoms orfigns which require or au¬
thorize blood-letting, purging, and fimilar aftive mea¬
fures. In urging the importance of this general diftinc-
tion, we are by no means unconfcious how neceffary it
often is to diftinguifh at an early period the precife fitua¬
tion of Phlogofis; and in many inftances it is prafticable
to do fo. But that it is not fo in all is one of the moll
firmly eftablifhed fafts in medical fcience. Cafes have
occurred even in the brain, an organ above all others dif-
pofed to take on inflammation from irritation, which fo
clofely imitated Phrenitis, that the molt accurate prafti-
tioners have been deceived by it ; yet, on difleftion, no
inflammatory aftion has been difcovered. This circum-
ftance is the more lamentable, becaufe irritation and in¬
flammatory difeafe require to be differently treated. It
may be borne in mind, however, that the wrong treat¬
ment of irritation is feldom fo fatal as the wrong treat¬
ment of inflammation.

The marks whichdiftinguifti inflammation from violent
fpafm are too obvious to be miftaken by the mod fuper-
ficial obferver. In the prefent inftance, therefore, we
(hall confine our diagnofis to thofe infidious approaches
3 P of

236 PATHOLOGY.

of inflammation which fimulate the aCtions in which fuf-
penfion of the functions of a part takes place with fome
uneafy fenfations, but without actual difeafe. The more
obvious marks of inflammation are derived from its ap¬
proach, which is generally flow, except indeed in violent
cafes ; but in thefe no danger or miftake can arife ; the
other phenomena of inflammation being moll ftrongly
marked : by its progrejjion , which is generally conftant
and unremitting, except indeed that the difeafe is great¬
er towards evening: by the increafed fenjibility in the
aft'eCted part, preflure being invariably found to aggra¬
vate inflammation, and common ftimuli, which in health
were unfelt, producing the fame effect : by the derange¬
ment of the functions of the inflamed organ, particularly
of its fecreting function : by its effeCt on the nervous J'yf-
tem of the brain, which is to induce in the firft ftage ex¬
altation, in the fecond diminution or irregularity in the
manifeftations of the intellect by its eft'eCts on the ner¬
vous fyltem, as Ihown in the voice, the patient exprefling
his diltrefs by low or gentle moanings (except the brain
be much aft'eCted), and not by thofe hafty, clamorous,
and impatient, expreflions, fo common in thofe' who fuf-
fer from difeafes of irritation : by the fympathetic aCtion
it excites in the capillary fyftem, inducing an increafe of
the general temperature : by its aCtion on the heart and
arteries, which is characterized by an increafe in the ful-
nefs and frequency of the pulfe, but more efpecially by
its hardnefs, a condition which mull be particularly at¬
tended to ; (fee our directions for afcertaining thefe par¬
ticulars at p. 93, 4.) for, in all infidious inflammations,
though the pulfe be not fuller nor more frequent than
common, it will invariably be found harder. Each of
thefe marks of dilturbance, taken feparately, would fail
in guiding us with accuracy in recognifing inflammation :
it is by the conjunction of feveral or all of them that we
mult be directed.

To prevent the frequent repetition of the fame direc¬
tion, we fliall now give a general account of the thera¬
peutical indications belonging to Emprefma. Of the
mode of aCtion by which bleeding reduces inflammation,
we have already fpoken at p. 209, 10. and here we mull
repeat our conviction that much error arifes from meafu-
ring the degree to which it is proper to carry this evacu¬
ation by the mere number of ounces. If we have clearly
afcertained that the difeafe is inflammatory, and that
the fymptoms before us are kept up by inflammation, we
mult bleed till relief is obtained : we mull be guided
folely by the effeds of our practice.

Next to the agency of bleeding in reducing inflamma¬
tion are to be mentioned that clafs of medicines which
(fomewhat differently from the common acceptation of
the term) we have named Sedatives. Of thefe the molt
eftablifhed is the Digitalis. Many drugs are known how¬
ever which poflefs the faculty of diminilhing the con¬
tractility of the arteries in an eminent degree ; but thefe,
from their uncertainty or accidental ill eifeCts, we for¬
bear to notice, not doubting, however, that a few years
will fee the remedies in queltion in full ul’e in the medi¬
cal world ; among which the Pruflic acid will, under
fo^ne form or preparation, probably hold a diltinguilhed
rank. It will be in vain attempted to exercife the ope¬
ration of fedatives in intenfe Phlogofes, unlefs evacua¬
tions have been premifed. Thus we fee the Italians, as
before reverted to, giving medicines of this clafs in the
moll exceflive dofes, without lowering the pulfe, becaufe
they had negleCted to bleed their patients freely before
their exhibition : hence in acute difeafes we Ihould al¬
ways ufe bleedjng firlt. In the clafs of fedatives we
Ihould not forget naufeating medicines, though thefe
aCt through the medium of the nerves. Antimony is
the molt common drug adapted to this purpofe : it
Ihould be fo managed as to procure naufea without vo¬
miting, efpecially in cephalitis.

Stimulation is reforted to in inflammation two ways.
In the firlt, which is conftituted for the purpofes of pro¬

moting the fecretions of the difeafed part, we exhibit
medicines which poflefs an exclufive aCtion on it; as
purgatives in bowel-complaints, expectorants in bron¬
chitis, See. The ufe however of thefe remedies is fel-
dom admiflible in the early ftage of inflammation ; and
they are upon the whole very limited in their application.
The next and more important mode of ftimulation is
inllituted on the aflumption that a lofs of balance ex-
ilts between inflamed parts and the reft of the fyftem ;
and confifts therefore in irritating found ItruClures for
the purpofe of relieving the difeafed ones. Many of the
medicines having this effeCt operate alfo by inducing
fecretion, and thereby relieving plethora. In this double
manner do purgatives aCt.

We alfo may make ufe of our knowledge of fympathy
to relieve inflammation. We throw cold water on the
head in Cephalitis, becaufe, on account of the fympathy
between the external and internal parts of the head, by
conftringing the vefleis of the Ikin we alfo conltringe the
vefl’els of the brain, the dilatation of whiqh is the chief
condition of the inflammation. The great difficulty con¬
fifts in properly timing and diferiminating the neceflity
for each of thefe meafures. For one practitioner throws
cold water on the head, and his patient recovers of Ce¬
phalitis : another blitters the fcalp on one fuffering un¬
der the fame malady, and a like happy refult enfues :
yet thefe remedies are direCtly oppolite, and the time or
the attendant phenomena will explain why different
treatment was neceflary in difeafes nominally the fame.
The genus Emprefma contains feventeen fpecies.

1. Emprefma cephalitis, phrenfy, or brain-fever : acute
pain in the head ; intolerance of light and found; face
flufhed; eyes red ; cauma ; watchfulnefs and delirium.

For a long period medical practitioners have been
ltruc’k with the remarkable anomalies which exift in the
fymptoms of cranial inflammation. It has been attempt¬
ed to account for the principal appearances that inflam¬
mation exhibits by the fuppofition that fymptoms wrnuld
vary as the brain itfelf or its invefting membranes were
attacked. Many practical authors, on the other hand,
have denied that the diftinction in queftion can be made.
Among thefe it may be fufficient to mention Cullen and
Frank, and more recently the iliuftrious Portal; and in¬
deed it muft be confeffed, that, till the prefent time, the
diftinCtions were by no means clear, and even now it is
well afcertained that in all fevere membranous inflamma¬
tion the inverted parts will fuffer the like difeafe. This
is particularly remarkable in inflammation of the inveft-
ments of the brain, in which few cafes are feen without
derangement of the intellect, an occurrence which can
only be explained on the fuppofition that the brain is
inflamed. The French fay that it is only in inflammation,
of the brain that the faculties are deranged ; but that, in
inflammation of the membranes, they are merely exalted;
yet will they fay that the mere membrane can have any
thing to do with the elevation of thought, except as the
blood flows falter through the brain ? and will they fay
that the excitement which follows drinking is membra¬
nous not cerebral excitement ? certainly not.

In our introduction we have mentioned the impor¬
tant addition Drs. Martinet and Parent-Duchatelet had
made to the progrefs of pathological fcience by their
excellent deferiptions of inflammation of the arachnoid
membrane, (fee p. 47.) This complaint is commonly
called arachnitis , but more properly arachnoiditis, which
term we fliall ufe. It may not be amifs toc.obferve, that
the arachnoid is a delicate tranfparent membrane, clofely
in contact with the pia mater, and reflected over the in¬
ternal furface of the dura mater. It forms a lining for
all the ventricles of the cerebrum and cerebellum. It is
conftantly lubricated by a fine rofy exhalation ; and is
decidedly a ferous membrane, performing the fame func¬
tions in the head as the membranes invefting the heart,
lungs, and abdominal vifeera, perform in their refpec-
tive fituations. Like them, it is infenfible to touch or

torture

PATHOLOGY. 237

torture when in a healthy ftate ; and, like them, when
inflamed, it acquires a high degree of morbid fenfibility.
To this we attribute the head-ache, more or lefs violent,
which invariably attends on arachnoiditis. This mem¬
brane is inflamed by the fame caufes which inflame other
ferous membranes ; and, like them, frequently throws
out aqueous collections, or forms adhefions where the
furfaces were before free ; or, like thofe fubftances, it
forces out a whitifli or jero-albuminous fluid, fome-
times forming layers of falfe membrane.

The primary and moll frequent caufes of the difeafe,
are percufllons of the head, expofure to the fun, organic
iefions of the brain itfelf, apopleCtic difpofition, and de¬
prefling paflions. Among the fecondary caufes, in point
of frequency or importance, are metaftafes of different
kinds, fuppreflion of habitual difcharges, the ufe of
ftrong drinks, and the common caufes of other internal
phlegmafiae, as of pleuritis, gaftritis, &c.

The firft ftage of arachnoiditis is marked by an increafe
of the fenfibility, and by head-ache, one of the moll con¬
ftant characters of the difeafe. A tendency to fopor is
fometimes manifefted, efpecially when the difeafe is
Yeated at the bafe of the brain. The ftomach alfo is
fym pathetically affeCted with naufea or vomiting. A
febrile movement is generally elfabliflted in the fyftem,
varying according to the age of the fubjeCt, the fenfibi¬
lity of the conftitution, and the degree of the inflam¬
mation. In fome rare cafes, efpecially of metaftafis,
coma fets in from the beginning, and all the fymptoms
of the third period or ftage (defcribed hereafter) com¬
mence at once, and are quickly followed by death. The
duration of this firft ftage is ufually from a few hours to
three or four days.

The fecond ftage or period, which is that of re-aCtion,
is accompanied with difturbance in the locomotive
powers, correfponding with that of the brain itfelf. It
is in this ftage that we obferve convulfions, delirium, reft-
lefliiefs, ofcillations or commencing dilatation, of the pu¬
pils, and other phenomena of cerebral inflammation.
In this ftage the pain in the head is lefs conftant than in
the firft ftage, thefenforium appearing lefs fenfible ofim-
preflions, as well internal as external. This ftage varies
in duration, from two, three, or four, days, to one or
even two weeks. It exhibits fome difference in fymp¬
toms according to the principal feat of the difeafe. When
the latter is at the bafe of the brain or in the ventricles,
coma is almoft effential, and is combined with convul¬
fions, agitation, affeCtion of the eyes, &c. whereas, if
the arachnitis be on the convexity of the hemifpheres,
delirium is the early and regular and charaCteriftic phe¬
nomenon.

The third ftage is that of the fhorteft duration, vary¬
ing from a few hours to three or four days, and rarely
palling that period. This is the ftage of collapfe ; the
abolition of fenfe, lofs of motive power, paralyfis, local
or general, and coma, being the charaCteriftic fymptoms.
In this ftage, however, the features of various cerebral
affections are combined, and confequently all diftinCtions
between arachnoiditis and inflammations of other parts
of the brain confounded.

The collapfe fo charaCteriftic of the third period or
ftage, and the excitement which diftinguifhes the fecond,
have this peculiarity, that, while one part of the body
fhall prefen t the phenomena of one of thefe ftages, ano¬
ther part fhall prefent thofe of the other. For ex¬
ample, in the face, we fhall often fee the mufcles of
the eye-lids paralytic, while thofe about the mouth are
convulfed. It is principally when the arachnoiditis ex-
ifts about the bafe of the brain, near the decuffation of
the optic nerves, that this medley of fymptoms belong¬
ing to two different ftages is obferved. It is almoft need-
lefs to fay, that a return to health from any of thefe
ftages (this is rarely the cafe from the third) is marked
by a diminution of intenfity in the fymptoms, and a

final ceflation of them. At the fame time it is often dif¬
ficult to diftinguifh the tranfition from one ftage into
another, efpecially of the firft into the fecond, and the
fecond into the third. No fingle fymptom can be de¬
pended on for this difcrimination j the whole mull be
taken in connexion.

The fymptom of the greateft importance in the inva-
fion of this difeafe is head-ache. It is often intenfe, but
varies confiderably according to its feat. Cephalalgia
then, occurring fuddenly, and efpecially when violent,
fliould always excite fufpicion of arachnoiditis, whether
it takes place in a perfon previoufly well, or labouring
under fome other difeafe.

As far as regards the expreflion of the countenance in
arachnoiditis, a general character of furprife and ftupor
is obferved, which it is impoflible to defcribe, but which
cannot eafily be miftaken, after being once feen. More¬
over the pupils are dilated or contracted, or alternately
in each ftate. The globe of the eye prefents a greater
or lefs degree of rednefs in the conjunCtiva ; fquinting
on one or both fides; conftant rolling of the organ, its
reverfion upwards, and finally paralyfis of the upper eye¬
lid. Few cafes occur without fome affeCtion of the
pupils.

The mufcular aCtions of the face are fometimes de¬
ranged ; and trifmus is by no means a very unfrequent
attendant on this complaint. It feldom occurs till after
the firft ftage is pall. Grinding of the teeth, and foam¬
ing at the mouth, are generally feen only among child¬
ren ; and in the fecond and third ftages of the difeafe.
Spafmodic or convulfive movements of the facial muf¬
cles are not very frequent, and never feen but in the ad¬
vanced ftages. Generally fpeaking, the face is coloured
and animated in arachnoiditis $ fometimes, however, it is
pale and void of expreflion.

Delirium frequently aft'eCts adults, who are moft dif-
pofed to arachnoiditis of the convexity of the brain. It
is generally of the tranquil kind, or a muttering of hair-
articulated words between the teeth. It is feldom fo in¬
tenfe but that the patient can be roufed to anfwer dif-
tinCtly at times. Thefe remarks appertain to the firft and
fecond ftages. In the third, there is generally an anni¬
hilation of the intellectual faculties. The commence¬
ment of delirium may, for the moft part, be confidered
as the fign of tranfition from the firft to the fecond ftage,
and forms the moft charaCteriftic feature of arachnoiditis
of the convexity of the hemifpheres. Where there is no
delirium, there is generally either dulnefs. morofenefs,
irafcibility, or preternatural excitement, and unufual ex¬
hilaration. In almoft all cafes, however, we fee a marked
diminution of the cerebral faculties, or an itnpoflibility,
as it were, of bringing them into action $ fo much fo,
that many patients can only be induced to utter mono-
fyllables.

Somnolency is one of the moft frequent of all the phe¬
nomena of arachnoiditis. When the difeafe purfues its
ordinary courfe, this fymptom does not appear till the
end of the firft or beginning of the fecond ftage. In a
very few cafes it has been obferved from the very com¬
mencement. Head-ache is almoft infeparable from the
firft and part of the fecond ftage of the difeafe. It is
highly probable that it continues to the laft, though not
complained of by the patients, who are overwhelmed by
the force of the difeafe, and incapable of diftinguiftiing
any particular fymptom. They generally characterize
the pain as heavy, numb, or (hooting, ufually occupying
the whole, but fometimes only half, of the head. The
apparent feat of the pain is not always the feat of the
difeafe. Stupor, characterized by a kind of felf aban¬
donment, lofs of all energy, and countenance of furprife,
is common to every ftage of the difeafe, but efpecially
the two firft. In a very few cafes there has been obfti-
nate pervigilium, inftead of fomnolency ; and in a ftili
fewer ((howing that there is no rule without exception),

238 PATHOLOGY.

the patients have retained their intelleftual faculties un¬
til the laft.

The mufcular fyftem exhibits various deviations from
the healthy ftate, viz. general or local rigidity, or con¬
traction, local or general palfy, local or general convul-
fions ; to which we may add a third ftate, that of agita¬
tion. This laft fymptom is feldom feen except in the
firft and fecond ftages. It is not of much importance as
an aid in the diagnofis ; but not fo convuljions. Thefe,
with paralyfis, are one of the moll charadteriftic figns of
arachnoiditis. General convulfions are moft common in
children ; and are principally feen in the fecond and be¬
ginning of the third ftage ; more in the upper than in
the lower extremities. Rigid contraftions of the muf-
cles are feen (in order of frequency) in thofe of the lower
jaw, pofterior of the neck, fuperior and inferior extre¬
mities. They belong to the fecond ftage, and early part
of the third ; fometimes conftant, but generally fhowing
intervals of relaxation.

The temperature of the Ikin is generally elevated, and
equally diffufed over the whole furface of the body,
being higheft in the fecond ftage of the difeafe, diminifli-
ing and greatly varying towards the termination of the
third ftage. The Ikin is generally dry during the firft
ftage; in the fecond, fometimes moift, or even covered
with an abundant perfpiration, efpecially about the face.
Drs. Martinet and Parent-Duchatelet take notice of a
difagreeable odour which patients labouring under this
difeafe exale about the end of the fecond ftage, and
which they can compare to nothing but the fmell of
mice. They aflert that it always proved a very unfa¬
vourable fymptom. We have met with this fymptom in
other complaints, where indeed no trace of arachnoiditis
could be found.

The organic lefions difcoverable on the necrotomy (a
new and exprefiive word, as confining difleCtion to the
dead fubjedt) of patients who have died of arachnoiditis
are — a fimple blulh or rednefs of the arachnoid mem-
. brane ; thickening, and lofs of tranfparency, in the faid
membrane; a purulent, fero-purulent, or fero-gelatinous,
exudation on its furface; the formation of falfe mem¬
branes ; and aferous effufion into the ventricles, between
the laminae of the arachnoid, or into the cellular tifiue
which unites the faid membrane to the pia mater.

The treatment of this complaint is fimilar to that of
Cephalitis in general, as far as regards bleeding, purg¬
ing, and the exhibition of fedatives. Bleeding, however,
does not do fo much good in the advanced ftages of
Arachnoiditis as in the advanced ftages of Cephalitis.
It ftiould therefore be ufed early in this complaint :
local bleeding is alfo highly beneficial : the French
furgeons, in addition to thefe meafures, order counter-
irritants, by means of finapifms and blifters to the
feet and legs. A blifter on the head has occafionally
been productive of the moft ftriking relief. General cold
affufion is particularly recommended, as alfo the applica¬
tion of cold water to the head alone. Compreflion of
the carotid arteries may alfo be ufed to reprefs the too
great momentum of blood to the head. Thefe remedies,
according to Martinet and his colleague, will often de¬
ceive the praftitioner ; and upon the whole they give a
lamentable account of the ufual termination of this ma¬
lady. The practice of the Englifli in this complaint,
though few of them make any diftinCtion between Arach¬
nitis and Cephalitis, is tolerably fuccefsful ; and for this
reafon, that the fyftem of bleeding in inflammation is
carried to a greater extent in this country, and purging
with draftic cathartics is more in vogue. But we fliould
obferve, that the, arachnoiditis of this country is not
often fo violent as in France.

This account has been introduced here from a firm
conviClion in the mind of the writer of this article, that
the divifion of cerebral and arachnoid inflammation has
a foundation in nature. Before he read the work of
Martinet, or even a review of it, his note-book con¬

tained a hiftory of certain anomalous cafes of head-affec¬
tions which he by no means underftood the nature of.
Their hiftory perfectly coincided, at lead in all effential
points, with the details given by the authors before
mentioned. Since reading the work in queftion, and
during the late hot weather, (June 1822.) feveral cafes
have occurred to him. It may be worth while to notice,
that, in one of the belt marked of thefe, the fubjeCt of
which was a child four years old, after the moft aCtive
bleeding and purging, and after the cold affufion of the
head had been ufed with mere mitigation of the fymp-
toms, at the end of the third day the exhibition of a
fcruple of calomel combined with two grains of opium
in four dofes completely and moft rapidly cured the pa¬
tient. For excellent details of cafes and dilfeCtions we
refer to the work itfelf, or to a very good analyfis of it
in the eighth number of Johnfon’s Journal, which we
have made fome ufe of in our hiftory of arachnoiditis.

In the above hiftory of the fymptoms of Arachnoiditis,
the following are the moft remarkable variations which
occur from the fymptoms of fimple Cephalitis. The
contracted ftate of the features, the extreme irritability
of fome of the mufcles, fometimes the integrity of the
reafoning powers, the eafinefs of refpiration ; the fymp-
toms obferving certain changes as the pain is fituated on
the top or bafe of the brain ; the peculiar rotation, gritty
fenfation, or turning-up, of the eyes; and laftly, the difi-
polition of the difeafe to affeft the fpine. We cannot
help in this place remarking, that, in the work of Ducha-
telet and his colleague, the diftinCtion of fpinal and ce¬
rebral arachnitis is by no means fo unfounded as fome
of our countrymen have fuppofed. A cafe occurred
fome time fince to the writer of this article in which the
attending practitioner cured a patient (as he thought) of
Peritonitis by a fmall bleeding and a purge. The pa¬
tient fuddenly became affeCted with the primary fymp¬
toms of fpinal arachnoiditis with little cerebral difturb-
ance. The latter however increafed ; and the patient,
without exhibiting any very violent derangement of the
pulfe or mental faculties, died in the courfe of ten days.
On difleCtion of the head at the bafe of the cranium,
the arachnoid tunic was found thickened, ftudded with
depofitions, and adherent to the furrounding parts.
The fame wasftill more remarkable in the fmall portion
of the fpine which was cut up through the foramen ovale.
A flight effufion was found in the ventricles. A fpecies
of arachnoiditis very common in this country is Hydro¬
cephalus, which fee.

The following account of Cephalitis will probably re¬
quire much alteration when the precife difference which
charaCterifes the inflammation of the inverting or the in¬
verted parts of the cranium fhall be known.

Cephalitis often makes its attack with a fenfe of full-
nefs in the head, flufhing of the countenance, and rednefs
of the eyes; the pulfe being full, but in other refpedls
natural. As thefe fymptoms increafe, the patient be¬
comes reftlefs; his fleep is difturbed, or wholly forfakes
him. Sometimes it comes on with tremors of the limbs,
and intolerable pains of the hands, feet, and legs ; fome¬
times with ftupor and rigidity of the whole body ; and
fometimes with anxiety, and a fenfe of tenfion in the
breaft, which is often accompanied with palpitation of
the heart. Sometimes, again, the ftomach is affefted ; and
naufea, and a painful fenfe of weight in that vifeus,
fometimes heart-burn and vomiting, are among the
earlieft fymptoms. The pain in the head foon becomes
confiderable, and fometimes very acute. The feat of it
is various : it generally feems to occupy the whole head;
it is deep-feated and ill defined ; and, in other cafes, it is
felt principally in the forehead or occiput. The rednefs
of the face and eyes generally increafes with the pain,
and there is often a fenfe of heat and throbbing in the
head, the countenance acquiring a peculiar fiercenefs.
Thefe fymptoms, for the moft part, do not laft long be¬
fore the patient begins to talk incoherently, and to (how
2 ' other

239

PATHOLOGY.

other marks of delirium : fometimes, however, delirium
does not come on till the fifth, fixth, or feventh, day. It
gradually incr.eafes till it often arrives at a ftate of phren-
fy. The face becomes turgid, the eyes ftare, and feem as-
if starting from their fockets ; tears, and (according to
fome) even blood, flowing from them; and the patient
fometimes refembles a furious maniac, from whom he is
principally diftinguilhed by the ftiorter duration of his
complaint.

We fliould, d priori, expert in phrenitis confiderable de¬
rangement in the different organs of fenfe, which fo im¬
mediately depend upon the ftate of the brain ; and fuch
is the fadl. The eyes are incapable of bearing the light ;
and falfe vifion, particularly that termed mufca volitantes,
or floating motes and flafhes of light feeming to dart be¬
fore the eyes, are frequent fymptoms. The hearing is
often fo acute, that the leaft noife is intolerable: fome¬
times, on the other hand, the patient becomes deaf; and
it has been even obferved, that the deafnefs and morbid
acutenefs of hearing fometimes alternate. Affections of
the fmell, tafte, and touch, are lefs obfervable.

The rejpiration is generally deep and flow, fometimes
difficult, now and then interrupted with hiccup, feldom
humid and frequent, which Iaft is a very unfavourable
fymptom. The deglutition is often difficult, fometimes
convulfive. The liver is often affefted ; and complete,
jaundice, the urine and fkin being tinged yellow, fome¬
times fupervenes. Inftead of a fuperabundance of bile,
however, there is fometimes a deficiency of it, which af¬
fords a bad prognofis. The feces being of a white co¬
lour, and a black cloud in the urine, have been regarded
as fatal fymptoms. The black cloud in the urine is owing
to an admixture of blood; when unmixed with blood, the
urine is generally pale.

Among the moft unfavourable fymptoms of cephalitis
the following may be enumerated ; namely, tremors of
the joints, convulfions of the mufcles of the face, grind¬
ing of the teeth, fudden changes of the colour of the
face from florid to pale, involuntary tears, a mucous
dil’charge from the nofe, the urine being of a dark-red
colour, or yellow^, or black, or covered, with a pellicle;
the feces being either bilious or white, and very fetid ;
protule fw'eat of the head, neck, and (houlders ; paralyfis
of the tongue, general convulfions, much derangement
of the internal funCIions, and the fupervention of the
fymptoms of other vifceral inflammations, particularly of
peripneumony. If the delirium changes to coma, and
the pulfe at the fame time becomes weak and the deglu¬
tition difficult, the approach of death may be generally
expeffed.

With refpeCt to the c«i/« of cephalitis, we have already
obferved that it is a rare difeafe in our temperate climate,
but is more frequently obferved in warm latitudes. The
predifpofition feems to confift in the irritability of youth
and of the fanguine temperament, as u'ell as in a paffionate
temper of mind. The exciting caufes are fuch circurn-'
fiances, internal and external, as tend to produce an ac¬
cumulation of blood in the head ; among which are the
direfif influence of a vertical fun in tropical climates, or
long expolure to it in hot weather in more moderate
heats, eipecially under great bodily exertions; violent
fits of anger; intoxication; conculfion, fraCture of the
flcull, or other mechanical violence ; long and intenfe
exertion of the mind ; certain narcotic poifons, miafmata,
and perhaps contagion.

The cure of cephalitis muft be conducted upon the
fame general principles as that of other- acute vifceral in¬
flammations; and, from the particular importance of the
organ inflamed, the antiphlogiftic and evacuant plan
muft be purfued with the utmoft vigour and expedition.
Blood-letting is to be confidered as the principal depen¬
dence of the practitioner, and the more early it is em¬
ployed, the more efficacious in general it will prove. It
fortunately happens, that in this complaint, the advan¬
tages of general and local blood-letting may be combined ;

Vol. XIX, No. 1300.

inafmuch as a large quantity of blood can ufually be pro¬
duced from the veflels immediately connected with the
inflamed organ. When this advantage can be obtained,
it fliould never be overlooked. It is advifable, therefore,
to open the temporal artery, or the jugular vein, and to
take a large quantity of blood, according to the violence
of the fymptoms, and to the age and ftrength of the pa¬
tient. The blood-letting fliould be carried to the ex¬
tent of producing fyncope or fainting 5 and, when that
effeCt follows, the relief is more often complete.

We need pay very little attention to the admeafured
quantity of blood we take. We muft bleed till the vio¬
lence of the delirium is much abated, and till the pulfe
is materially lowered. The eftefts of the blood-letting,
in diminifliing the morbid determination of blood to the
head, Ihould be feconded by all other means in our
power. The application of cold to the fcalp, fuch as waffl¬
ing it, after (having, with cold water, vinegar;and water,
or fpirits, is often exceedingly beneficial. To affift in
leflening the flow of blood to the head, the patient
ihould be kept as near the ereCt pollure as can be borne.
At the fame time he muft be kept in bed, becaufe the
mufcular exertion required to fit or ftand accelerates the
pulfe; but the head and clieft muft be fupported by
pillows, or by othercontrivances. And at this time, every
irritation, efpecially thofe of light and noife, of which
the inflamed fenforium becomes peculiarly fufceptible,
fliould be carefully withdrawn.

When the aftion of the heart is fomewhat diminiftied,
and the brain (till continues opprefled, we (hall find
great benefit from bliftering the lower extremities; but
this fliould not be done on the firft invafion of the ma¬
lady. I11 addition to thefe direCt means of diminilhing
the inflammatory aCtion in the head, the indirect efteCt,
which is produced by copious evacuations from the
bowels, obtained by the life of purgatives, is of great im¬
portance, and fliould be carefully attended to. Even
fyncope itl'elf has been produced by profufe evacuations
from the inteftines, which implies the complete influence
over the circulation in the brain, which Inch operations
produce. The free ufeof elaterium, fcammony, gamboge,
&c. therefore, fliould be reforted to in all cafes of phre¬
nitis ; and, if a fpontaneous diarrhoea fliould fupervene,
the pradlitioner will be-careful not to check it. As in
all other cafes of inflammatory fever, every external
fource of excitement Ihould be carefully excluded ; the
apartment ihould be cool and well ventilated ; the bed¬
clothes light ; the drink aqueous, cold, and acidulated.

It feems fcarcely neceflary to add, that naufeating dofes
of antimony, and the frequent exhibition of infulion of
digitalis, are very appropriate auxiliaries to the treat¬
ment of Cephalitis.

2. Emprefma otitis, (Otalgia, Cullen.) Ear-ache fe-
vere pain in the ear; tendernefs upon prefiure ; deafnefs
or confufion of founds. This complaint is accompanied
by a fenfe of weight or teniion in the internal ear, with
fome flight degree of fever. The treatment is the fame as
Phlegmon auris, (which fee p.. 230.) except that, when
it is accompanied with much fever, we Ihould bleed, left
the violence of the inflammation fliould diforganize the
ear. Otitis is often a confequence of inflammation affeft-
ing the throat and euftachian tube; in which cafe we
muft ufe meafures which might be confidered fomewhat
aflive as compared with the fmall extent of the difeafe,
that we may prevent the clofure of the euftachian tube ;
an accident productive of ferious inconvenience.

3. Emprefma parotidis, (Cynanche parotidea, Cull.
Branks, Scotlice. Mumps, Anglice.) Painful unfuppura-
tive tumour of the parotid glands, often extending to
the maxillary ; confpicuous externally ; often accompa¬
nied with fwelling of the teftes in males, and of the
mammae in females. This complaint, which is (aid to
have proved both epidemic and contagious, comes on
with the ufual fymptoms of fever, which are foon after
attended with a confiderable tumour of the external

3 Q fauces

240

PATHOLOGY.

fauces and neck. This appears firft as a glandular move-
able tumour at the corner of the lower jaw ; but the
fwelling foon becomes uniformly diffufed over a great
part of the neck, fometimes on one fide only, but more
commonly on both. The fwelling continues to increafe
till the fourth day ; but, from that period it declines,
and in a few days more paffes off entirely. As the fwell¬
ing of the fauces recedes, fome tumour affeft s the tefti-
cles in the male fex, or the breafts in the female. Thefe
tumours are fometimes large, hard, and fomewhat pain¬
ful ; but, in this climate, are feldom either very painful
or of long continuance. The fever attending this dif-
eafe is commonly flight, and recedes with the fwelling
of the fauces 5 but fometimes, when the fwelling of the
teflicle does not fucceed to that of the fauces, or when the
one or the other has been fuddenly repreffed, the fever
becomes more confiderable, is often attended with deli¬
rium, and has fometimes proved fatal. As this difeafe
commonly runs its courfe without either dangerous or
troublefome fymptoms, fo it hardly requires any remedies.
An antiphlogiftic regimen, and avoiding cold, are all
that will be Commonly neceffary. But when, upon the
receding of the fwelling of the teflicles in males, or of
the breafts in females, the fever comes to be confiderable
and threatens an affeftion of the brain, it will be pro¬
per, by warm fomentations, to bring back the fwelling;
and, by vomiting, bleeding, or bliftering, to obviate the
confequences of its abfence.

4. Emprefma parifthmitis, (Cynanche, Cull. Angina,
Au6l. Lat .) Squinancy, or quinfy. Rednefs and fwelling
of the fauces with painful and impeded deglutition.
This fpecies contains three varieties.

a. P. tonfillaris, or common quinfy. It is an inflam¬
mation of the mucous membrane lining the throat, and
affefting efpecially the tonfils, and fpreading from thence
along the velum and uvula. The difeafe is marked by a
rednefs of the parts, accompanied by fwelling, which is
fometimes confiderable, fo as to render the aft of fwal¬
lowing painful and difficult, or even to impede it almoft
entirely. There is alfo a troublefome clamminefs of the
mouth and throat, with a frequent but difficult excre¬
tion of mucus ; there is often a pain (hooting into the
ear: the voice is altered, and articulation rendered in-
diftinft. A degree of fever is generally prefent. This
kind of quinfy is not contagious. It terminates fre¬
quently by refolution, fometimes by fuppuration, but
hardly ever by gangrene. The progrefs of the inflamma¬
tion to fuppuration, is fometimes, indeed, very rapid ; at
other times there are feveral fmall abfceffes, which break
one after another, and the difeafe is tedious. Occafionally
the tonfils become enlarged and hard after this inflam¬
mation, and remain fo for years. When a large impof-
thume breaks, there is generally fudden relief from the
pain, difficulty of breathing, fwallowing, and fpeaking ;
although often no matter is thrown up, but paffes down
the oefophagus.

The difeafe is commonly traced to expofure to cold.
It affefts the young and fanguine, and is very liable to
return, in fome conftitutions, upon the application of
cold to any part of the body, fo as to become. almoft ha¬
bitual. It occurs, efpecially in fpringand autumn, when
viciffitudes of heat and cold frequently take place. The
inflammation and fwelling often begin mod violently in
one tonfil, and afterwards, abating in that, increafe in
the other. The remedies for inflammation, and the an¬
tiphlogiftic regimen, are to be employed for the cure of
this complaint. It is greatly aggravated by heating diet
and ftimulating medicines. General blood-letting is
feldom neceflary ; but leeches to the neck and external
fauces are very ufeful. Blifters, when early applied to the
fame parts, are alfo highly beneficial, and have often had
the effeft of curing by refolution a violent inflammation
of the throat. When fuppuration is begun, they can be
of little ufe. Purgatives, repeated occafionally, are of ef-
fential benefit. The inflammation is often relieved by

topical refrigerants, particularly acids ; hence the ufe of
gargles containing vinegar, lemon-juice, or the mineral
acids, and rendered palatable by means of honey or fy-
rup. Thefe acids moreover coagulate the mucus w’hich
adheres about the parts, and cleanfe the paffages. In
many cafes, however, no application has afforded more
relief than the vapour of warm water received into the
fauces by means of Mudge’s inhaler.

P. maligna ; crimfon rednefs of the mucous mem¬
brane of the fauces and tonfils ; ulcerations covered with
mucous and fpreading floughs, of an affi or whitifti hue;
fever a typhus. This difeafe is of great danger and im¬
portance. We give the following account of its nature
on the authority of Dr. Parr. It attacks like a flight in¬
flammatory fore throat, though fometimes only a languor
infidioufly creeps on, with a little difficulty of fwallow¬
ing; and, in the worft cafes, even this is abfent. The
ftrength, however, rapidly finks, the features fall, aghaft-
ly palenefs comes on, and death quickly follows. In
(lighter kinds, the courfe is not very different from that
of the inflammatory fpecies, though feemingly flight,
with alternate chills and heats, pain in the head, 82c. till
the debility appears, when every other bad fymptom im¬
mediately follows. Every fore throat ffiould, therefore,
be carefully examined.

In the moft aftive inflammations of the throat, white
fpecks will fometimes appear on the velum pendulum or
tonfils. If the inflammation is florid, the conftitution
robuft, and the pulfe firm, thefe fpots may be difregard-
ed. On the contrary, in fome inftances of the molt ma¬
lignant kind, no floughs can be obferved. The diftinc-
tion muft be taken from the colour of the inflammation.
In the true malignant fore throat, the colour approaches
rather to the crimfon and the pink than the red ; and
fometimes a (hade of brown, not far diftant from the cin¬
namon, is mixed. The pain in fwallowing is flight in
proportion to the degree of inflammation ; languor, lift-
leffnefs, and indifference, are very confpicuous ; and the
features difplay the fame want of fulnefs and tone : the
eyes are red and watery. At this time the pulfe will be
fometimes apparently ltrong, but a flight attention (hows
that the ftrength of the ftroke is apparent only : it throbs
with a kind of convulfive weaknefs, rather than beats
with a fteady firmnefs. The tongue grows brown, the
breath offenfive ; and delirium, at night, comes on ; by
day, a wandering is only obfervable. When there are
floughs on the throat, the edges are of a dark pink red;
they are obferved to cover, and fometimes they conceal,
a confiderable lofs of fubftance : they enlarge, become
deeper, and the edges black. An ichor, or a thin acrid
matter, is difcharged from the nofe or ears ; the (tools
are thin and highly offenfive. The fever is faid to remit
in the morning, but the remiffion is inconsiderable, and
will never affilt in the diftinftion, though it will fome*
times lead to an infidious fecurity. Sometimes, from the
beginning, exanthemata appear ; and the putrid fore
throat is frequently, if not conftantly, an attendant on
Scarlatina: thefe foon affume a darker hue, and appear
livid. The breath in the earlier periods is not aftefte.d,
but a wheezing noife fupervenes if neglefted; and this,
in the worft kinds, is fucceeded by a (hrill barking found.
It evidently arifes from the eryfipelatous inflammation
extending to the larynx, and is generally a fatal fymp¬
tom. The eruptions have been erroneoufly defcribed as
favourable and critical, In a difeafe which runs -its
courfe generally in lefs than five, always in feven days, no
prognoftic is to be depended on but a more florid appear¬
ance in the throat, and a more healthy afpeft of the edges
of the fores.

The difeafe is epidemic, and attacks the aftive and
robuft as well as the infirm. The treatment muft in its
early ftages be ft rift ly antiphlogiftic; but it is faid that,
when the floughs are formed, fuch meafures are injurious.
It feems to us, however, that in this refpeft we lhould
be guided by the ftate of the pulfe, &c. rather than adopt

a line

241

PATHOLOGY.

a line of practice founded on the name of the difeafe.
In fadt, as we (hall (how when (peaking of Gangrene in
general, we mud fometimes ftimulate by bark and wine,
and fometimes a& thereverfe by bleeding and purgatives,
when we want to produce the expulfion of (loughs.
Towards the latter end of the malady, when ftimulation
is required, we certainly meet with much fuccels by fol¬
lowing the pradtice thus detailed by Parr. After laxatives,
the bark is to be given in adtive dofes, with aromatics.
Half a dram of the bark, with ten grains of aromatic
(pices, (hould be exhibited every two hours. If it feems
to produce ftridtures on the (kin, and rigour, five or fix
grains of camphor, and three or four of James’s powder,
combined with a little opium, (hould be added to each
dofe. Thefe may be waihed down with a ftrong decoc¬
tion of bark, (harply acidulated with either of the mine¬
ral acids. Dr. Parr how-ever remarks, that in this dif¬
eafe the bark feldom difagrees. The adtion of thefe re¬
medies is greatly aflifted by diet and gargles. Port-wine
(hould be given freely ; it (hould indeed enter into every
part of the food, and be drunk alone, cold. Even deep
is lefs lieceflary than bark and port- wine; and, (hould it
continue above three hours, the patient muft be awak¬
ened, for the lofs of time cannot be regained. The
quantity of the medicine and the wine muft be regulated
by the eftedt. If we gain nothing in the firft thirty-fix
hours, we may depend on a fatal event : if we lofe ground
in twenty-four, our hopes will be inconfiderable. We
have known women unaccuftomed to wine drink two
bottles within twenty-four hours, for more than a fort¬
night. The gargles (hould be of a ftrong decodtion of
bark, very (harply acidulated with mineral acids or with
the ftrongeft Cayenne vinegar, or fome Cayenne in fub-
ftance (hould be added ; and they (hould be frequently
iifed, or, as the patient is languid, injedted with a fy-
ringe. Pepper-corns conftantly bitten, and the faliva
fwallowed, we have often found highly ufeful.

“ Thefe are the appearances, and fuch the pradtice, in
the more violent attacks of the complaint ; and we have
never feen an inftance of it, when taken early and treated
in this manner, in a conftitution moderately ftrong, prov¬
ing fatal. The fame plan, lefs adtively purfued, is adap¬
ted to the milder kinds. But even the mildeft (hould
not be treated with indifference.”

y. P. pharyngea : rednefs florid, and efpecially at the
lower part of the fauces ; deglutition extremely difficult
and painful ; fever a cauma. This appears to be the fame
difeafe as the firft variety, except that it is feated lower
down in the throat.

5. Emprefma bronchitis, (Cynanche trachealis, Cull.)
Croup. Breathing fonorous and fuffocative, voice harlh;
ringing cough ; fever a cauma. The term bronchitis is by
Dr. Good confined to that peculiar and violent inflam¬
mation which is mod appropriately termed by medical
men in general laryngitis, as the latter term exprefles
the feat of the aftedtion much better than bronchitis;
and, as bronchitis is now properly u(ed to defignate
thofe complaints which will be detailed under the genus
Catarrh, we (hall ufe the term laryngitis in the following
defcription.

Laryngitis, then, is an inflammation of the fuperior
part of the trachea or larynx, to which parts, however,
it is feldom confined, but extends downwards through
the ramifications of the bronchiee. It affedts perfons of
all ages, but is moft formidable when it occurs to chil¬
dren, in whom it is faid, from thenarrownefs of the aerial
aperture, the internal thickening of the parietes of the
tube foon produces fuffocation. It feems however, from
the firmnefs of the coagulum thrown out, that the in¬
flammation in croup is of the moft exceflive kind, fo that
death might be accounted for independently of the
fmallnefs of the glottis.

The complaint fometimes runs its courfe in twenty-
four, thirty-fix, or forty-eight, hours 5 more commonly
it continues a few days, Occafionally the peculiar noife

2

which is the pathognomonic fign of croup, attends on
flight inflammations of the bronchise and larynx, but
the complaint is then of a fomewhat prolonged duration.

Laryngitis is often a confequence of the fpreading of
true bronchial inflammation ; and fometimes the one al¬
ternates with the other. The croup generally begins
with a (hort dry cough, wheezing, and other catarrhal
fymptoms. Soon the wheezing becomes more obferva-
ble, the cough more troublefome, and marked by a pe¬
culiar (hrill found ; the refpiration is performed with a
wheezing or croaking noife, and at length grows very
diftrefling and laborious. At the beginning, or in (lighter
cafes, the found of infpiration refembled the palling of
air through a piece of muflin ; afterwards it was as if the
noife came from a brazen tube. The cough was attended
with a peculiar (hrill found, even at an early period of
the difeafe, as well as the voice, where there was not
a perfedt hoarfenefs. Dr. Home defcribes it “ vox inftar
cantus galli.” It has been compared to the noife which
a fowl makes when caught in the hand. This peculiar¬
ity, however, is not eafily expreffed by words, but a
knowledge of it is readily acquired by obfervation.

By the end of the lecond, or on the third day, fome¬
times fooner, fymptoms of affedtion of the fyftem take
place, as white tongue, third, increafed heat, and fre¬
quent pulfe: and the difeafe advances rapidly, not
merely from violent general affection, but from the in¬
fluence which it has upon the organs of refpiration; the
difficulty of breathing becoming now very diftrefling, the
countenance being often flufhed, and great inquietude
and a continual inclination to change from place to
place fupervening. The child at the fame time eagerly
puts its fingers into its mouth, as if to pull away fome-
thing which flicks in the paflage. All the fymptoms are
increafed during the night, throughout the difeafe.

A change now takes place; and, the inflammation
terminating in effufion, the paflage of the air becomes
obftrudted by vifcid matter in the trachea, fome of which
is occafionally thrown up by coughing or retching.
Occafionally alfo, portions of a film or membrane, of a
whitifti colour, are thrown up by the fame painful
exertions ; and the efforts made to diflodge it are often
fo diftrefling, that the child appears to be almoft in a
date of ftrangulation. This is fucceeded by an abate¬
ment of all the fymptoms, until a frelh quantity of the
fame fubftance is formed, when the diftrels recurs as be¬
fore. In many cafes, the difficulty of breathing and ap¬
pearance of fuffocation are increafed by paroxyfms, fo as
to occafion extreme anxiety and inquietude. And in
other cafes the difeafe, after continuing fome time, ap¬
pears fuddenly alleviated : the breathing is free ; cheer,
fulnefs, appetite, and a difpofition to amufement, take
place. But a change for the worfe comes on as fuddenly,
and death enfues; the livid and fwelled face, and con-
vulfive ftruggles, giving the little patient every appear¬
ance of one actually ftrangled. When the internal fau¬
ces are viewed, as Dr. Cullen has obferved, they are
fometimes without any appearance of inflammation ; but
frequently a rednefs and fwelling appear. But it i?
commonly remarked that moft of the cafes which occur
-in the winter are attended with inflammation and fwell-
ing of the tonfils, uvula, and velum pendulum palati ;
and frequently large films of a white fubftance are
formed on the tonfils.

Croup moft commonly attacks children during the
three firft years after weaning. It rarely occurs before
three months, or after ten years. It is often infidious
in its approach; the child having only a flight cough or
hoarfenefs, with little fever or ill feeling.

The treatment of croup is that of inflammation in its
moft acute and violent form, and in a fituation where its
continuance threatens fpeedy death. On this account,
the inflammation muft be fubdued at all ri(ks; and no
fear of the confequences (hould arreft the vigour of the
practitioner. A very large general bleeding, followed

242

PATHOLOGY

by the application of a great number of leeches to the
edges of the lower jaw and to the fides of the neck,
carefully avoiding the trachea, are the firft means to be
ufed. The knowledge of the powerful efficacy which
mercury poflefles of checking in fome cafes the deposi¬
tion of coagulating lymph (though we cannot explain
its modus operandi), furnilhes us with another remedy
of fcarcely lefs importance. Calomel may be given in
dofes of four or five grains every hour, combined with
jullfo much opium as will prevent it from pafling off by
the bowels. Thefe dofes are applied to children of three
or four years of age ; they may be greatly increafed when
required. Along with thefe meafures the common means
of counter-irritation may be _ advantageoufly ufed, as
for inftance the hot-bath and buffering remote parts.
Blifters on the neck feem to 11s to be attended with very
bad effedts in the early period of the difeafe.

When fuffocation is threatened, or perhaps in fome
remarkable cafes after it has occurred, we may perform
the operation of tracheotomy.

6. Emprefma pneumonitis, (Pneumonia perineumo-
nia, Cull.) Peripneumony, or inflammation of the lungs :
obtufe pain in the cheft ; conftant difficulty of refpira-
tion, alleviated by an eredt pofition ; tumid purple face
or lips ; cough, generally moift, often bloody ; pulfe
ufually foft. Dr. Good makes three varieties of Pneu¬
monitis.

a. Pn. vera : the fever a cauma ; pain fevere, little
expedtoration in the beginning.

£. Pn. maligna : fever a fynochus or typhus. The de¬
bility fo extreme from an early ftage of the difeafe, that
the pulfe ceafes on the preflure of the finger ; and the
vafcular action is too weak to accomplifli expedtoration.
Often epidemic.

y. Pn. notha : great fecretion and expedtoration, with
a mild cauma. Probably in many inftances a catarrhal
affedtion : chiefly occurring in advanced life, or in thofe
who have weakened their conftitutions by exceffes.

We Shall treat the firft two varieties together, as the
latter appears to be merely a confequence of the former,
and to Stand to it in the fame relation as typhus does to
inflammatory fever ; i. e. merely as the effedt of previous
inflammatory action. The third variety, which is pro¬
perly bronchitis, is referred to Catarrhus.

Inflammation of the parenchyma of the lungs, to
which for the prefent we confirm our attention, is Seldom
a folitary affection, the pleura being in general affedted
along with it : and it is occasionally accompanied with
catarrhus.

Pneumonitis comes on with an obtufe pain in the cheft
or fide, great difficulty of breathing, particularly in a
recumbent pofition, or when lying on the fide affedted,)
together with a cough, drynefs of the Skin, heat, anxiety,
and thirft. At the firft commencement of the difeafe the
pull'e is ufually full, Strong, hard, and frequent ; but in
a more advanced ftage it is commonly weak, foft, and
often irregular. In the beginning, the cough is frequent¬
ly dry and without expedtoration ; but in fome cafes it
is moift even from the firft, and the matter fpit up is va¬
rious both in colour and confiftence, and is often Streaked
with blood. The countenance is generally flufhed; the
noftrils are much dilated before each refpiration ; the
patient ufually breathes with the diaphragm principally,
but not So exclufively as in Pleuritis. In the more Se¬
vere Pneumonites, the difficulty of breathing, at all times
the molt dangerous fymptom, becomes increafed, and is
often attended with more or lefs general, deep, livid, or
even dark, fuffufion of the countenance, with fome de¬
gree of tumidity, but little heat. There is alfo great
anxiety in the expreflion. The noftrils are widely dila¬
ted, and Sharply deprefled above their lobes, juft before
and during infpiration. The patient is often obliged to
fit up in bed. There are vertigo and pain of the head.
The refpiration is attended with great labour, oppreflion,
and generally with a rattling noife : on infpiration, the

bottom part of the fternum is often drawn forcibly and
quickly towards the fpine, the upper ribs raifed, and the
abdomen protruded ; on expiration, thefe movements
are reverfed. Sometimes the pomum adami defcends on
infpiration ; fometimes the Shoulders are much elevated.
Speaking is very difficult. The cough occurs in painful
oppreSfive fits, and raifes various expedtoration ; this is
however generally copious and mucous, fometimes
tinged with blood. The hands are cool, and livid, and
the pulfe frequent.

If the adtual inflammation or engorgement of the
lungs does not caufe death, a favourable termination is
effedted by the occurrence of copious fecretion, both
from the nervous lining and the ferous investment of the
lungs; though it muft be confeffed that inflammation of
the lungs often fubfides by mere refolution, where bleed¬
ing is actually employed. And moreover the establish¬
ment of each of thefe Secretions, when in excefs, pro¬
duces other and fatal difeafes, as empyema and chronic
catarrh. Another termination of Pneumonitis, is fup-
puration of its fubftance, or Apoftema vomica.

Before we fpeak of the treatment of pneumonitis, we
Shall detail thefymptoms of the next fpecies.

7. Emprefma pleuritis, or pleurify : acute pain in the
cheft; increal'ed during infpiration; difficulty of lying
on one fide; hard pulfe; Short dittrefling cough. Dr.
Good gives three varieties.

cl. PI. vera: fever a cauma ; pain felt chiefly on one
fide. The inflammation, in this cafe, commences in that
fide of the membrane which lines the ribs; though of¬
ten communicated to the contiguous portion which co¬
vers the lungs.

G. PI. mediaftina : heavy pain in the middle of the
fternum, defcending towards its enfiform cartilage 5 with
great anxiety.

y. PI. diaphragmatic.! : painful conftridtion around
the prsecordia ; Small, quick, and laborious, breathing.

Pleurify comes on with an acute pain in the fide, which
is much increafed by making a full infpiration, and is ac¬
companied by flushing in the face, increafed heat over
the whole body, rigors, difficulty of lying on the fide
affedted, together with a cough and naul'ea; and the
pull’e is hard, Strong, and frequent, and vibrates under
the finger when prelfed upon, not unlike the tenfe firing
of a mufical instrument. The blood exhibits the thick
fizy or huffy coat on its furface in a high degree.

We lee in this complaint an expreffion of Suffering on
the countenance, and a State of general contraction of
the features. The noSlrils are acute and drawn a little
upwards, and are furrounded by a ring of a pearly white.
They are moved rapidly by the alternate adts of refpira¬
tion, being dilated quickly j uft before each inspiration.
There is often a circumfcribed or partial flufli of the
cheeks, which generally terminates abruptly, efpecially
towards the note. The patient cannot, in general, lie
on the pained fide or part; and he choofes a particular
pofition, which is preferved unchanged ; any motion o"f
the body Seems to aggravate the pain of the cheft. The
relpiration is frequent, quick, and Short, and often per¬
formed exclufively by the diaphragm, the chef being motion-
lej's. If a deep infpiration be attempted, it induces Sharp
pain, and is, with the calling out from this pain, imme¬
diately checked and fupprefled by the patient. The
cough is alfo checked, and is, at firSf, fhort and dry, and
attended with Sharp pain. The patient fpeaks in a low
tone, and in Short Sentences. The pulfe is rather fre¬
quent and (harp, fometimes lefs affedied than might be
expedted. The pain is Situated in various parts of the
cheft ; generally on one fide, or under the fternum ;
fometimes under the fcapula, or at the back.

Pleuritis terminates fatally by implicating in in¬
flammatory adtion the vifcera it invests, by fpreading to
other ferous membranes, or by effufion, adhefion, See.
the confequence of inflammation when it attacks ferous
membranes. Adhefions are very frequently formed with¬
out

PATHOLOGY.

out material inconvenience to the patient ; and no
doubt increafed effufion fometimes occurs without any
ill eifeft. The lungs, the pericardium, and heart, com¬
monly become involved in the morbid action, when death
occurs in pleuritic complaints.

The treatment of inflammation, whether feated in the

pnrcnchymo r\f thp lunge tko iq uiml'a*® TIip

remedy chiefly to be depended upon is blood-letting,
freely and early employed. The quantity of blood drawn
nuift of courfe be regulated by the violence of the dif-
eafe, and the ftrength of the patient’s conftitution, and
ought generally to be as large as this laft circumftance
will allow. The remiflion of the pain and the relief of
the refpiration, during the flowing of the blood, may
limit the quantity to be then drawn; but, if thele fymp-
toms of relief do not appear, the bleeding (hould be con¬
tinued until fome degree of licknefs and faintnefs, the
figns of approaching fyncope, come on. This direction is
as old as the writings of Hippocrates. It will often hap¬
pen, that one bleeding, however copious, will not prove
a cure for the difeafe : for, although the pain and diffi-
culty of breathing may be much relieved by the firft
bleeding, thefe fymptoms very frequently recur after a
(liort interval, and often with as much violence as before.
In the event of fuch recurrence, the bleeding mull be
repeated, even in the courfe of the fame day, and perhaps
to the fame quantity as before. Sometimes the fecond
bleeding may be larger than the firft. There are perfons
who are conftitutionally liable to faint even upon a fmall
bleeding; and, in fuch perfons, this may prevent the
drawing of fo much blood at firft as a pneumonic in¬
flammation may require; but, as the fame perfons are
frequently found to bear fubfequent bleedings better
than the firft, thefe may be carried to the extent which
the fymptoms of the difeafe feem to demand. For it is
according to the ftate of the fymptoms, that the bleed¬
ings muft be determined to be repeated; and they will
be more effe&ual, when employed in the courfe of the
firft three days, than afterwards: but they are not to be
omitted, although four or five days may have elapfed
before the phyfician is called in ; nay, if there be a re¬
currence of the urgent fymptoms, as defcribed above,
the bleeding fhould be repeated at any period of the dif¬
eafe, efpecially within the firft fortnight, and even after¬
wards, if a tendency to fuppuration be not evident, or
if, after an apparent folution, the difeafe (hall have again
returned.

There is in peripneumony, as in fome other acute in¬
flammations, a ftate of pulfeoccafionally recurring, which,
to an inexperienced praflitioner, appears to contra-indi¬
cate the ufe of the lancet ; it is foft, and fmall, or what
has been called an opprefled pulfe ; but it rifes, and be¬
comes fuller and larger, after blood-letting. Under fuch
circumftances, the propriety of the blood-letting is to
be determined by the urgency of the other fymptoms,
efpecially of the difficulty of breathing. In a fimilar man¬
ner, a pulfe that is irregular, and beats with confiderable
intermiflions, in peripneumony, will become regular
after the relief of blood-letting ; and fuch a ftate of pulfe,
therefore, when the pneumonic fymptoms are urgent, is
not to be confidered as contra-indicating, but as more
ftrongly demanding, the ufe of the lancet.

When a large quantity of blood has been taken from
the arm, fome blood may be ftill taken locally, by means
of cupping. This local blood-letting will be particu¬
larly proper, when the continuance or recurrence of
pain, rather than the difficulty of breathing, becomes
the urgent fymptom. After this, a large blilter (hould
be applied over the thorax or fide, according to the feat
of the pain, and the abftinent and cooling regimen rigo-
roufly enforced.

Some practitioners, apparentlylipon theoretical grounds,
have objected to the ufe of purgatives , upon the fuppoii-
tion that the evacuation which they occaiion may tend
to fupprefs the expectoration ; but, in the vigour of the

Vol. XIX. No. j3oo.

243

patient and of the difeafe, fuch an apprehenfion is abfo-
lutely groundlefs. On the contrary, the free evacuation
of the bowels, by cooling purgatives, conduces, like
the blood-letting, to diminifli the local and general in¬
flammatory aCtion. In the turgid and loaded ftate of the
lungs, the (training of vomiting is likely to be productive
nf rntfrhief, and cart anfwer no ufeful pa.rl'''r° .■ pbr»

practice of exhibiting naujealing medicines is highly
proper. Of thefe, antimony and ipecacuanha, combined
with digitalis, are the nioft common. The laft medicine
is alfo ufed with advantage in the earlielt ftages of the
difeafe, to reprefs the frequency of the pulfe.

Though it has not been our cultom, in the compila¬
tion of this article, to enter particularly into necrotomy,
becaufe we wifhed to be the more full on the aCtions and
diforders which lead to fatal difeafes, rather than to detail
irremediable conditions; yet we cannot avoid tranfcri-
bing from the judicious Laennec, his account of the ap¬
pearance on difleCtion which the inflamed pleura exhibits.
The minutiae of pathological anatomy are fufficiently
important in regard to the obfcure difeafes of the cheft,
to warrant this deviation from the general tenor of our
labours.

The anatomical chara&er of acute pleurify, like that
of the inflammation of all ferous membranes, is rednefs
of the part affeCted. This rednefs is in fome fort punc¬
tuated, and looks as if one had traced with a pencil upon
the pleura an infinity of fmall bloody fpots of very irre¬
gular figure, and very clofe to one another. Thefe red
points occupy the whole thicknefs of the membrane, and
leave fmall intermediate portions retaining the natural
white colour. This punctuated appearance is unquef-
tionably a character of the inflammation, and not at all
attributable, as fome have fuppofed, to the partial difap-
pearance of the rednefs after death. Befides this parti¬
cular rednefs, and even in thofe inftances where it is very
inconfiderable, we always find the fuperficial blood-vef-
fels of the pleura redder, more diftinCt, and more diften-
ded, than in the natural ftate.

M. Laennec never could clearly make out a diftinCt
thickening of the pleura in thefe cafes. Such fuppofed
thickening, he thinks, has been either an extenfive con¬
geries of miliary tubercles on the outer or inner furface
of the pleura ; or a cartilaginous incruftation on the
parts covered by it; or, laftly, falfe membranes, more or
lefs denfe, adherent to its internal furface.

Inflammation of the pleura is always accompanied by
an extravafation on its internal furface, and which may
be confidered as the fpecies of fuppuration proper to fe¬
rous membranes. This extravafation appears to com¬
mence with the inflammation itfelf. It confifts of two very
different matters. The one, of a firmer femi-concrete
confidence, is ufually tec meAfu If e membrane, orcoagulable
lymph; the other, very thin and watery, is called, ferojity,
or fero-purulent effufion. Both of thefe exhibit great va¬
riation of character. The falfe membrane confifts of a
yellowilh-white, opake, dr femi-tranfparent, matter, va¬
rying from the confidence of thick pus to that of boiled
white of egg, or of the buffy coat of the blood. This,
fubftance forms a complete incruftation (where the in¬
flammation is general) over the pleura coftalis and pleura-
pulmonalis. Thefe two (fleets of pleura are fometimes
united by bands of the fame membrane, extending from
the one to the other, through the ferous fluid effuled into
the cavity. Thefe membranous exudations vary in thick¬
nefs, from half a line to two lines ; fometimes exhibiting
a kind of reticulated ftruCture ; at others, appearing
ftudded or granulated with fmall irregular tubercles.
Thefe membranes are fometimes detached and found
floating in the ferofity. Th e ferous effufion is commonly
of a lemon, or light-yellow, colour, t ran ('parent or (light¬
ly flocculent, refembling unftrained whey ; an effufion
common to all the ferous menjbranes in the body. In
fome cafes, this effufion is of a very deep tawny colour,,
ruddy, and evidently mixed with blood ; fometimes, in-
3 R deedj

214

PATHOLQG Y.

deed, quite bloody. The portions of pleura fituated be¬
neath falfe membranes, when this is the cafe, are much
redder than in the moll acute recent inflammation, owing,
as Laennec thinks, to a fecondary inflammation fuper-
vening at a later period than the formation of the falfe
membranes. The effufed fluid is generally without-taffe

or fmell, in apute pleurify. The relative proportions be¬
tween the erruieci imnn anti albuminous concretions, is

not at all fixed. Generally Speaking, the more violent
the inflammation, the more extenfive and thick is the
membranous exudation. In weak leuco-phlegmatic fub-
jeds, on the contrary, we find a great quantity of lim¬
pid ferum, with a finall portion of thin membrane often
floating in it. In fuch cafes, the pleurify feems to pafs
infenfibly into hydrothorax, as we (hall fee more parti¬
cularly hereafter. It is an exceedingly rare cafe, M.
Laennec obferves, to find the contiguous furfaces of the
pleura united, without previous effufion of fluid, fince
the abforption of the fluid is the firft ftep in the fanative
procefs. We may therefore conclude, on finding thofe
old adhefions of the lungs to the fides, that there exift-
ed, in the acute flage of the difeafe, an effufed fluid ; for,
when patients happen todie in that flage, we almoft inva¬
riably find an effufion. The following paflage will con¬
vey a clear idea of the fanative procefs in pleurify, and
the organization of the extravaf'ated fubftances-

It is the character of th efolje membranes produced in
pleurify to be changed into cellular fubltance, or rather
into a true ferous tifl'ue like that of the pleura ; and this
is tire natural progrefs of the procefs when left quite un-
difturbed. This change is produced in the following
manner : The farms effufion which accompanied the
membranous exudation is abforbed, the comprefled lung
expands, and the falfe membranes inverting it and the
coital pleura become united into one fubftance. By and
by, this fubltance becomes divided into layers pretty
thick and opaque, which are feparated by a very fmall
portion of ferofity. About this time blood-veflels begin
to make their appearance in it, the firft rudiments of
which have the afped of irregular lines of blood, much
larger than the veflels which are to take their place.
The blood feems as if it had been forced into the fub-
ftance of the falfe membrane by a ftrong injection ; and
we find the correfponding portions of the pleura redder
than elfewhere, and as it were fpotted with blood. After
a time, the pfeudo-membranous layers become thinner
and lefs opaque ; the lines of blood afl’ume a cylindrical
fhape, and ramify in the manner of blood-veflels, but Hill
preferving their augmented diameter. On minutely ex¬
amining thefe at this flage, we find their external coat
conlifling of blood fcarcely yet concrete, and very red ;
within this there is a fort of mould, or rounded fubftance,
whitifh and fibrous, and formed evidently of concreted
fibrine, perforated in its centre, already permeable to the
blood, and evidently containing it. Eventually, the
layers of the falfe membrane become quite tranfparenr,
and nearly as thin as thofe of the ordinary cellular tifl'ue,
and the blood-veflels refemble in every refped thofe
which ramify on the inner furface of the pleura. It
wants, however, the firmhefs of the natural cellular fub-
ilance, being eafily torn in our attempts to examine it,
and its veflels ftili retain the large diameter indicative of
their recent formation : and it requires fome considerable
time for them to attain the perfed charader of the ori¬
ginal tiflues of the body.” Thefe organizations having
taken place, the health remains unaffeded, and the rel-
piration, except in fome particular cafes, does not fuffer
from their prefence.

In Ample pleurify, we find no fign whatever of inflam¬
mation of the pulmonary parenchyma, even in the vici¬
nity of the molt inflamed portions of pleura. We find
the fubftance of the lungs in fuch cafes more denfe and
lefs crepitous, owing to the comprefiion of the effufed
fluids. If the extravafation has been very great, the
lung becomes flattened, ceafes to contain air, and con-

4

fequently to crepitate ; its veflels are comprefled and con¬
tain little blood, and the bronchia, witli the exception
of the larger trunks, are evidently rendered fmaller.
Sometimes, however, we obferve certain portions of the
lungs polTefling a rednefs like that of mufcle ; and a corn-
pad homogeneous texture, in which no trace of air-cell
can be detected. This has been termed carnification nr
hepatization ot the lungs. Laennec confiders it a pro-
dud of inflammation. For fome further interefting par¬
ticulars as to Empyema, and the produds of chronic
pleuritis, we refer the reader to Laennec’s work “ De
1’Aufcultation mediate, &c.”

Some authors have aflerted the exiflence of chronic
pleurify as giving rife to Empyema, and a variety of
morbid products within the bags of the pleura. Thefe
fymptoms are very infidious ; and we do not find them
altogether clearly detailed in any author. A flight pain
in the fide with dry cough (which latter brings on a
flitch in the fide), together with a pulfe rather hard, are
the only circumftances which occur to our recollection.
The difeafe is feldom recognized till effufion or adhefion
has taken place, when, according to Laennec, fome in¬
formation may be derived from the ufe of th s jtethofcope,
of which inftrument we fhall prefently have occafion to
fpeak.

8. Emprefma carditis, inflammation of the heart: pain
in the region of the heart, often pungent ; anxiety ;
palpitation; irregular pulfe.

The difeafes of the heart are confefledly the mod dif¬
ficult to recognize in the whole range of human maladies.
When we consider the complicated adions which the
heart is the agent of, and the irregularities thofe actions
are fubjeded to by alterations in the furrounding organs
which are affociated in its movements, it will be fuffi-
ciently obvious, that the fame difeafe of the ftrudure of
the heart will, as it aft'eds one or other of its parts, give
rife to various and diffimilar phenomena. To illuflrate
this by a very Ample fad: if the capillaries of the lungs be
obftruded, increafed propulfive power muft be exerted
by the right ventricle ; and, the ftrudure of this portion
obeying the general laws of all mufcular parts, its in¬
creafed exercife will be followed by correfpondent dimi¬
nution of power, and debility will enfue. To trace the
effed of the above irregular impulle on the powers and
fundions of the heart would lead to a wide and unde¬
fined department of medical fcience ; to wit, an account
of the mode of produdion of the various morbid growths
found in the cavities of the heart. The circumstance is
merely mentioned to Show, that, becaufe the heart is
compofed of four cavities, each fubjedto Similar altera¬
tion from different caufes, and vice verfa, we cannot but
exped to find very anomalous fymptoms in its difeafes.
Thus, in carditis, the moll unfat, isfadory accounts have
been given, becaufe, till the prefent time, authors over¬
looked the fad, the palpable fad, that inflammation
muff be different as it was fituated in one or another
portion of the heart; and that in a violent degree it
might adually be diredly oppofite in its fymptoms to its
milder forms.

The Symptoms ufualiy aferibed to carditis were fever,
pain in the Situation of the heart, palpitations, an irregu¬
lar pulfe, cough, difficulty of breathing, and often Syn¬
cope. It is obvious that the fymptoms here enumerated
are merely the common fymptoms of peripneumony, or
pleurify, with the addition of palpitation, irregularity of
pulfe, and fyncope, or fainting. But it is obferved by
Senac, that thefe fymptoms are extremely uncertain ; and
with regard to palpitation, although its prefence may lead
us to fufped that the heart is affeded, yet it is probably
an hypothetical opinion, fince, in that inflammation
which arifes from wounds of the heart, palpitation doss
not occur. (Traite du Cceur, tom. ii. chap. 7.) With
refped to the other two fymptoms, it has been remarked,
that the prefence of an irregular pulfe, and the occur¬
rence of Syncope, together with the fymptoms of pneu¬
monia

'245

PATHO

monia (or inflammation of the lungs), can only lead to a
probable fufpicion of an afreCtion of the heart; iince they
are by no means conftant attendants on carditis ; and the
former very frequently attends other cafes of pneumonia.
(Wjlfon on Febrile Difeafes, vol, iv.) Upon the fame
grounds Dr. Cullen accords with the observations of
Vogel, that “ the fymptoms of carditis are nearly the fame
with thofe of peripneu mony, but in general more fevere.”

In this perplexity as to the melt: important of cardiac
difeafes, it mull be highly gratifying to have an addition
to our ufual modes of diagnofis. This has been at¬
tempted, as our readers are probably aware, by Laennec.
This author perceived that many of the movements of
the thoracic vifeera were audible , and conceived the de-
fign of rendering this circumftance ufeful to his profef-
flon. Finding the application of the ear to the cheft inef¬
ficient to give very accurate information on the fubjeCt,
and a&ing on the eftablifned knowledge of the increafe
of found when palling through tubes, the author invented
an inftrument which he called, from its life, a ftethofeope.

It is merely a cylindrical piece of denfe wood, about one
foot in length and four inches in circumference, having
a hole drilled longitudinally through it of about three
lines in diameter. The lower end of the inftrument is
placed on the thorax of the patient, the upper to the ear
of the phylician ; and through this perforation the ruffl¬
ing of the air into the air-cells in infpiration, See. is heard.
We pafs over this however for the fame reafon that we did
when fpeaking of pulmonary complaints, becaufe we
cannot ourfelves difeover the phenomena Laennec de-
feribes, though we are willing to admit this may be the
refuit of want of tad. As far as regards the motions of
the heart, the ftetholcope feems entitled to more credit ;
and by its life, and by means of the important difeufiion
now going on, we may hope foon to fix the diagnofis of
difeales of the heart on the firmed grounds.

. Before entering on Carditis, it will be neceflary to
fpeak of the motions which are heard through the me¬
dium of this cylinder during health. We fpeak firft of
the extent at which the beating of the heart is heard.
The beating of the heart is heard mod diftindly when
the cylinder is applied to the left fide, between the fifth
and feventh ribs, or to the lower part of the fternum, the
aClion of the left fide of the heart being bell heard in
the firft: lituation, the adion of the right in the fecond.
It is alfo heard in a lefs degree ever the right fide. It is
more diftinCt during exertion, &c. and in thin people,
the beating being lefs perceptible and lefs diffufed in fat
perfons. In the former, indeed, we fometimes hear the
beating of the heart all over the fternum, on the left fide
as far as the clavicle, and fometimes in the fame lituation
on the right fide. When the beating of the heart is
heard beyond thefe limits, or even within them, if the
patient has flight dyfpnoea, is unable to take much ex-
ercife on account of fliortnefs of breath, palpitation fu-
pervening to flight emotions, See. we may fufpeCt difeafe
of the heart, though thefe fymptoms may continue for
years without any further changes. It feems that, when
the parietes of the heart are thin, and confequently weak,
the beating of the heart is heard over the greater part of
the thorax ; and that the reverie happens when thofe
parts are thickened. It fliould be remarked, however,
that the increafe in the general fize of the heart eaufes
its beating to be externally heard.

The next point to be attended to in the ufe of the
ftethofeope, is the degree of impulfe which the beating of
the heart gives to the cheft. Laennec calls this the
Jhock. It nuift not however be confounded with the
movements of refpiration, which, when Ihort and fre¬
quent, as in fevers, &c. may be miltaken for it. It feems
that this (hock is audible through the cylinder when it
cannot be felt by the hand. It is rather indiftinCl in
healthy and fat perfons ; and is generally in a direct ra¬
tio to the thicknefs of the walls of the ventricle, conl'e-

L O G Y.

quently in an inverfe ratio to the extent of the beating
of the heart. It is only heard during the contradion of
the ventricles ; or at lead the contraction of the auricles,
when audible, produces a more diftant and indiftinCl
found. The Jhock is fcarcely heard at all when the
parietes of the ventricles are morbidly thin. The in-
creafed force of this thock is viewed, therefore, as pre-
fumptive evidence of thickening of the parietes of the
ventricles, while its abfence feems to indicate dilatation,
of the ventricles. Laennec endeavours to point out the
phenomena developed by the ftethofeope when both
the latter dates of difeafe are prefent ; but thefe are by
no means fatisfaCtory. The Jhock is heard over the fifth,
and feventh ribs on the left fide, over the lower half of
the fternum, or, when that bone is fhort, over the epi-
gaftrium. Coinciding with the (hock above-mentioned,
and coinciding alfo with the pulfe, we hear, by means of
the cylinder, an obtufe found which lafts about two fe-
conds : this is produced by the contraction of the ven¬
tricles. Immediately afterwards we hear the contraction
of the auricles announced by a Ihort acute noils, which
Laennec has compared to the found produced by the
lapping of a dog or from the valve of a bellows. He de¬
nominates it claquement, a word well tranflated by. our
Englifh clacking. This clacking, the fign of the con¬
traction of the auricles, is followed by the perfeCt in¬
action of the heart for a fhort fpace of time. Then the
obtufe noife, and riling or yAoc/c of the ventricles, is again
heard ; which is inftantly followed by the clacking ; and
fo on. The proportion of thefe motions is nearly as
follows: of the time occupied by all the motions of the
heart, one fourth is taken up. by the clacking, or con¬
traction of the auricles ; one fourth by abfolute reft ; and
one half by the contraction of the ventricles. Having
thus explained, in a certain degree, the application of this
new inftrument, we return to Carditis.

As between inflammation of the brain and arachnoid
membrane, as between that of the pleura and of the
lungs, the fymptoms vary, fo alfo do we find them vary¬
ing as the nnifcular fubftance of the heart, or its inveft-
ment, the pericardium, is the feat of this adion. This
opinion is of courfe to be received with fome dillruft, be¬
caufe our knowledge of the difeafes of the heart is very-
limited. We reft it chiefly on the authority of Laennec,
than whom no one has performed more important fer-
vice in elucidating the nature of the difeafe we are
treating of.

The principal divifions of difeafes of the heart are
made with reference to the morbid products or altera¬
tions of ftruCture found on difiedion. Though we pro-
pofe to mention curforily the chief of thefe, it is by no
means our intention to treat of them fully. We fliall
rather confine ourfelves to a minute and laboured de¬
tail of the forms and diagnoftics of inflammation as it
alfeCts the various parts or ftruCtures of the prime mover
of animal life. We do this, becaufe it feems to us, that
morbid anatomy is of no life unlefs it leads to a difeo-
very of the mode of aCtion by which difeafed ftruCtures
are built lip ; for that, in the majority of cafes, when
once formed, all endeavours to remove them by medical
ikill are unavailing, is a truth but too well known.

Inflammation of the inverting membrane of the heart,
or pericarditis, has been ufually held to be uncliftinguifti-
able from inflammation of the heart itfelf; and, when
acute, this mull necelfarily be true of all but the firft
periods of the difeafe, becaufe its connection with its
inclofed vefiels will of courfe bring on aCtual Carditis.
The fymptoms of acute pericarditis are Ample accelera¬
tion of the movements of the heart ; viz. quick and hard
pulfe, rednefs of the capillary fyftem as tnanifefted in the
ikin, added to the ufual fymptoms of phlogofis of ferous
membranes. The acceleration alluded to is evidently- an
efFeCt of irritation of the mufcular fibres of the heart ;
and, this being uniformly exerted over the whole of the

heart,

24G

PATHOLOGY.

heart, we fhonlcl naturally expe£l to find more increafe
In the quicknefs and force of its motions : for, to more
rapid circulation through the pulmonary circles we refer
rednefs of the fkin ; to the fame increafe through the
aortal fyftem, arifing from quickened aflion of the ven¬
tricles, we refer the quick pulfe; and tothefe united, the
increafed heat. The tame fymptoms belong alfo to that
early ftage of carditis which has not pafled the bound
named excitement, and to inflammation of the mem¬
brane which lines the heart and arteries. From this it
follows, that the primary fymptoms of inflammation, in
whatever ftruiShire of the heart it may be fituated, pro¬
duces the fame fymptoms while it is within certain li¬
mits as to violence; but this is by no means true of
thofe grave phlogofes which attack particular fpots of
the heart, or attack it generally in a violent manner.
Nor is it true of the fevered forms of pericarditis or ar¬
teritis, (the term by which wedefignate phlogofis of the
inner membrane of the heart and arteries.) In thefe, the
fymptoms betray the following variations. Molt authors
have afierted, that between acute pericarditis and actual
carditis there is no difference. Indeed Dr. Baillie and
others have fated that they are never found feparate on
diflection. Laennec, however, denies this. In carditis, in
common with other thoracic inflammations, we have
difficulty of breathing, febrile heat, and third. From
the peculiar fenfibility of the nerves with which the heart
is connedled, extreme anxiety and oppreflion are met
with, the countenance betraying the deeped didrefs.
From the increafed fenfibility of the nerves, the motions
of the heart are felt by the patient : this confitutes what
is termed palpitation. Palpitation is more generally felt,
however, from arterial increafe in the motions of the
heart. It is fometimes fo great, that it is felt even in
the carotids and the head. One fide or cavity of the
heart, afling more rapidly than its correfpondent one,
naturally induces irregularity of pulfe ; it likewife in¬
duces an accumulation of blood in one cavity to fo
great a degree, as to fufpend its aftion : hence arifes
fyncope. Pain is likewife prefent : it is ufually de¬
scribed as of a fharp and gnawing kind, fituated under
the dernum, and is highly aggravated by mufcular mo¬
tion. The recumbent podure is often uneafy, the pa¬
tient feeling eafied when the body is bent forwards.

That inflammation of the heart has exided without all
thefe fymptoms is no objection to the account here of¬
fered, for pain is often abfent in other phlogofes com¬
monly charadlerifed by it. It may happen that irregular
aft ion of the mufcular fibres of the heart may not occur,
in the fame way that fpafmodic contraction of the muf¬
cular coats of the bowels does not always attend phlogo¬
fis of the internal membrane, though it does fo com¬
monly. And, if the latter propofition be admitted, we
fhall have no difficulty in accounting for the abfence of
fyncope and irregularity of pulfe. It is to be noticed,
that inflammation of the mufcular fubdance of the heart
is a difeafe of rare occurrence. Laennec doubts if a
cafe has appeared in which inflammation occupied the
whole of the druCture in quedion. Phlogofis of parti¬
cular portions, ending in abfeefs or ulceration, are more
common ; but dill the majority of cardites feem to be
membranous affections.

The following are the fymptoms of acute pericarditis,
as deferibed by Laennec. “ Les contractions des ventri-
cules du coeur donnent une itnpulfion forte, et quel-
quefois un bruit plus marque que dans 1’etat naturel ; a
des intervalles plusou moins longs furviennent des pul-
fations plus faibles et plus courtes, qui correfpondent a
des intermittences du pouls, dont la petitede contrade
extraordinairement avec la force des battemens du
eceur; quelquefois il peut a peine etre fenti. Lorfque
ces figne-s furviennent tout-a-coup chez un hornme qui
n’avait jamais Cprouve de fymptomes de maladie du
creur, il y a une grande probabiiite qu’il ed attaque de
pericardite. Aflez ordinairement le malade eprouve une

dyfpnee plus ou moins grande, des angoiiles, une anx-
iete inexprimable ; il ne peut faire quelques pas, ou fe
remuerun peu brufquement dans fon lit, fans epronver
des fyncopes. Le fentiment de douleur, de chaleur, ou
de poids a la region du cceur, ed un fymptome beaucoup'
plus rare, mais qui fe rencontre cependent quelquefois.
Dans quelques cas, la region du cceur rend un fon mat;
mais le plus fouvent ce figne n’ed pas bien evident.”

When the membrane which lines the cavities of the
heart and large arteries-is inflamed, condituting arteritis,
we obferve the following circumflunces. The complaint
fometimes arifes fpontaneoufly, but more frequently as
a confequence of fevere febrile adeCtions, fmall-pox,
meafles, or rheumatifm. When it comes on vicarioufly
with the latter difeafe, all the phenomena of carditis are
uncommonly fevere except fyncope, which is often not
prefent.

This difeafe has alfo fupervened on extenfive furgical
operations. It fometimes begins as phlebitis, or inflam¬
mation of the vifeus ; fometimes as arteritis, or inflam¬
mation of the arteries ; occafionally it produces death,
while confined to one or other of thefe vefiels, but more
frequently the lining of the heart becomes implicated
before the fatal event. The fymptoms of the complaint
are— general rednefs of the lkin; increafed pulfation of
the arteries, fo great as to be viiible at the didance of
fome paces from the patient ; and the ufual fymptoms
of carditis foon follow'. Early in the difeafe, if its de¬
velopment is not fudden, the patient is redlefs, impa¬
tient, watchful, irritable: lie experiences partial flufli-
ings, which gradually increafe both in frequency and
extent : his bowels are inactive, but his pull'e is imper¬
ceptibly aftefted. By and bye, he complains of a deep-
feated pain in fome part of the abdominal or thoracic
regions, and feldom fails to deferibe it as being hot, lan¬
cinating, fpafmodic, and increafed by flight exertion.
Difturbance-of the vafcular fyflem now comes on : refpi-
ration is accelerated, and the breath feels offenfive from
its heat. The mouth, however, remains humid, the
tongue red, the lips moid and natural. Rigors at lad
are felt ; and, as the difeafe advances, the internal pain
becomes more did’ufed. The original flufliings give
place to a true febrile date of the cutaneous furface; and
the difquietude is fucceeded by head-ache, naufea, lan¬
guor, and depreffion. Inappetency and quenclilefs third
prevail. The bowels are more obdinate ; the mouth
tades bitter. The pulfe, in fome indances, is hard,drong,
and tumultuous ; in others, wiry and irregular. If tran-
fient deep is obtained, it is unrefreihing and interrupted
by dartings and frightful dreams. About this time
cough begins. This fometimes is dry, frequent, teaz-
ing; fometimes it recurs in violent and tedious parox-
yfms, and is accompanied with expectoration of fetid
mucus, the clots'of which are occafionally dreaked with
florid blood. When the difeafe has, at length, acquired a
formidable afcendancy, all its previous fymptoms, and
the fymptomatic fever (which is generally the inflamma¬
tory), are greatly aggravated. The patient’s counte¬
nance fuddenly ffirinks, becomes pallid, haggard, cada¬
verous. His Arength finks ; his emaciation is extreme.
His lips are crimfon or livid ; his tongue red, fmooth,
moid. At the fame time his breathing is rapid, difficult,
irregular; the head-ache intenfe ; ..the pulfe hard, la¬
bouring, intermittent, accelerated to iio — 130. Confe-
cutive to the former deep internal pain, a didrefsful
fenfe of condriftion, mod frequently in the cardiac, prae-
cordial, or epigadric, region, is edabliflied. Spafms not
unlike thofe of tetanus, in many cafes, occur under the
xyphoid cartilage, and in the line of the diaphragm.
The countenance and extremities grow cedematous.
Forcible palpitations of the heart, and, in fome indances,
of the abdominal aorta, fo as to be diflinftly felt
through the integuments, now predominate. The arte¬
ries pulfate with alarming and painful violence, and the
aCtion of the more fuperficial is quite vifible : that of

PATHOLOGY.

the carotids is audible by the patient himfelf, often by
his attendants. Syncope is frequent ; the paroxyfms of
dyfpncea protracted and agonizing. The anafarcous ef-
fufion extends and becomes general. In many cafes
afcites fupervenes ; in others, hydrothorax : in fome, the
extravafation of ferum is univerfal and profufe. Dyfp¬
ncea fucceeds, and the patient is confined to a fitting
pofture. The lead motion excites cough, and a fenfe of
indant fuffocation. Wheals and ecchymofed patches
arife in different parts of the body. Violent convulfions
enfue; and, in one of thefe, exhauded already and mo¬
ribund, he druggies and expires.

The appearances on diffeCtion are a general and deep
rednefs of the internal coats of the arteries, veins, and
heart : fometimes this lad prefents a fpotted appearance :
it is to be obferved, however, that both purple and fear-
let rednefs of the internal membrane of the heart and
large arteries, has been noticed by Hodgfon and Laen-
nec in fubjefts who had not fufFered indammation. We
fhall not detain our readers long on the necrotomy of this
difeafe further than to obferve, that indammation of the
arteries, whether chronic or acute, renders the veffels
liable to the depofition of organizable lymph on their in¬
ternal furface ; to obliteration, dilatation, and aneuryfm ;
to a cartilaginous and deatomatous thickening of their
inner coat; to the depodtion of ofleous and other mat¬
ters in any part of their druClure ; and to become feir-
rhous, cancerous, fungous, ulcerated, or fphacelated.

The reader will perceive the difficulty of didinguifliing
arteritis from fimpie inflammatory fever ; but the midake
is not of much confequence, fincethe treatment is in each
difeafe the fame. A very clofe analogy is alfo perceptible
between the fymptoms of this complaint and the form of
inflammation deferibed before it. As to the duration of
thefe difeafes, they are various. What we have hitherto
dated with regard to carditis applies to its mod violent
form, to that form indeed which runs its courfe in from
two to feven days. Another form of carditis is now and
then found which is called the fubacute : this variety is
charasff erized by fymptoms analogous to thofe of the acute,
only fomewhat more moderate. There is lefs fevere
pain and fenfation of burning in the fituation of the
heart ; but which are generally preceded by fhivering,
and attended with great heat and third, and a quick,
hard, and fometimes irregular, pulfe. The countenance
of the patient, at the commencement of the attack, is
ufually fuffufed, but after a lapfe of a few days becomes
hollow and dejefled, and has a peculiar irritable look.
There is a condant date of agitation and great anxiety.
The palpitations of the heart are not fo vehement ; and
the faintings, if they occur, are ufually of an incomplete
defeription. If the difeafe run on to a fatal termination,
the hippocratic look of the face, an abatement of pain,
flight rigors, extreme anxiety, fenfe of fuffocation, flight
faintings, and occafionally cedematous fwellings, take
place a fhort time prior to that event.

Sub-acute inflammation of the heart is fometimes com¬
plicated with Pneumonia, Pleuritis diaphragmitis, and
organic obdruftions in the great veffels. It has alfo been
connedted with the fymptoms of Catarrhus fuffocativus
and croup, though the ufual feat of thofe affections be¬
trayed no inflamed appearance on diffedlion.

The treatment of carditis undereach of thefe forms is
Ample, but too often ineffedlual. Bleeding is every thing
in it. We have urged the neceffity of very adtive blood¬
letting in mod of the fpecies of this genus we have at
prefent pafled through. It will be fufficient therefore to
obferve, that carditis calls for more adlive depletion
than any other of-the Phlogotica ; for, not only mud we
bleed to reduce inflammatory adfion, as in other Aruc-
tures, but we mud alfo bleed with the view of letting the
heart at red ; this operation being the only one by which
rejl can be procured. In addition to thefe meafures, it
is proper to excite the capillaries by all forts of irritants ;
as by dradic purges, brifk diuretics, diaphoretics, blif-

Vol. XIX. No. 1301.

247

ters, or fridlions with tartarJzed antimony on the chefl,
or, if in a rheumatic patient, on the legs. It mud not
be concealed, however, that, except the bleeding and
purging, little dependance can be placed on thefe mea¬
fures. Should they be fo fortunate as to produce a re-
miflion of fymptoms, we fhould Adivate the patients with¬
out lofs of time by mercurial inundlion, and by fcruple-
dofes of calomel combined with opium. Local bleeding
feems next to ufelefs in Carditis. In Arteritis, verylarge
dofes of digitalis may be given with advantage.

A no-lefs formidable difeafe, and one dill more difficult
to recognife, is chronic carditis. It proceeds fo infidi-
oufly, that it often becomes incurably eflablifhed before
a fufpicion of its true nature has occurred. It fre¬
quently fubfids unattended by any pain in the region of
the heart itfelf. On the contrary, it is apt to induce
pain, and to refemble affections, in dijlant parts, as the
epigadrium, the liypogadrium, &c. It is at length af-
certained to have exided, by the fymptoms of deranged
circulation, the effeCts of organic change fuperinduced ;
or perhaps its exidence is not fufpefted during life. The
fymptoms which have been mod frequently obferved are
— fome degree of febrile ad'eCtion ; a fmall, quick, and
irregular, pulfe ; and a peculiar jarring fenfation commu¬
nicated to the hand when placed over the fituation of the
heart. Palpitation of this organ is generally abfent ; but,
when it does occur, it is inconfiderable in point of ex¬
tent. There is ufually no pain, though we fometimes
meet with a little uneafinefs in the region of the heart :
at other times a flight degree of obtufe fugitive pain may
be prefent. When pain is feated in the hypogaflric re¬
gion, it is oftentimes attended with fuppreffion of urine.
Sometimes there is a fenfe of beating in the head. The
pulfation frequently takes place in the epigadric region,
which has, in fome degree, the appearance as if it arofe
from a throbbing tumour. Obdinate vomiting is occa¬
fionally prefent. At length dropfical affections fupervene,
as oedema of the face and extremities, and effuflon into
the cavity of the thorax ; the breathing then becomes
more difficult and laborious; the countenance affumes
an anxious and bloated afpeCt ; delirium not infrequent¬
ly comes on ; and the patient after much differing, of
longer or ffiorter duration, finks into diffolution. Chro¬
nic inflammation is not uncommonly fuperadded to di¬
latation or enlargement, and alfo to other organic affec¬
tions, of the heart.

M. Corvifart deferibes a variety of Pericarditis, which
he denominates fub-acute. It is lefs rapid in its courfe,
and lefs obfeurely marked, than acute inflammation of
this organ, but neverthelefs more marked and rapid than
the form of difeafe jud detailed. “ L’invafion de la
peracardite fub-aigue, ed bien rarement marquee par des
fymptomes vifs qui puiflent fairs regarder la malaaie
comme devant etre promptement funefle. La pleurefie
ed la phlegmafie avec laquelle cette pericardite commen-
$ante a le plus de traits de relfemblance. Comme dans
cette affeCtion, le malade eprouve d’abord un fentiment
de chaleur generate dans tout le cote malade de la poi-
trine ; peu apres, cette chaleur fe concentre vers la region
du cceur; la fe fait fentir une douleur vive et brulante.
La refpiration devient promptement haute et genee ; le
pouls ed frequent, dur, et rarement irregulier; les deux
pommettes, et particulierement la gauche, font colorees
d’un rouge vif ; tels font les phenomenes de l’invafion :
mais au troifieme ou quatrieme jour, l’alteration parti-
culiere des traits, la figure grippee, fur laquelle on voit
Pexpreffion d’un abattement profond et pourtant d’une
forte d’irritation, une anxiete condante et exprimable,
une agitation continuelle, la refpiration haute, penible,
entrecoupee, les palpitations legeres, les defaillances 5n-
completes, d’autant plus eloignees l’une de l’autre que
la marche de la maladie ed plus lente ; enfin, le pouls

fietit, frequent, dur, ferre, concentre, fouvent irregu-
ier, lie laifl'ent que peu de doutes fur le fiege pofitif de
rinflammation. Les fymptomes plus graves, qui, vers
3 S ie

248

P A T H O

le troifieme jour, remplacent eeux de l’invafion, ne reft-
ent les memes que pendant peu de temps, apres lequel le
vifage s’altere davantage, la face prend tous les traits de
celle fi bien depeinte par Hippocrate ; la douleur cefie
en tout ou en partie ; il y a des friffons fugaces, des de-
faillances longues et incompletes, des fuffocations, une
anxiete infupportable ; une infiltration generale furvient :
Je malade meurt enfin, le plus fouvent a I’improvifte, foit
en voulant fe lever, fqit en buvant, foit en changeant de
pofition.”

The treatment of chronic carditis, and the above-
mentioned form of pericarditis, confifts in keeping the
heart in a ftate of comparative reft by occafional bleeding,
and a diet of the molt fparing kind ; in counter-irritating
the Ikin by bliftering, or by a feton, and by the gradual
introduction of mercurial remedies. In the mean time
the adtion of the bowels, of the Ikin, of the kidneys, and
indeed of all parts of the fecernent fyftem over which
medicine has any controul, fliould be gently excited.

Acute carditis, i. e. of the mufcuiar fubftance, termi¬
nates in abfcefs, ulceration, gangrene, or rupture. Gan¬
grene inuft be of rare occurrence, fince the rupture
would molt probably take place before the former acci¬
dent could occur. We have no means of knowing, du¬
ring life, that abfcefs or ulceration exifts. The former
may exift without fymptoms ; for Benivenius gives a
cale of a criminal, who, before his execution, feemed
perfectly well, in wdiofe heart, however, an abfcefs was
difcovered on difleCtion.

From the cafes hitherto recorded, it feems that abfcefs
is more rare on the internal than on the external furface
of the heart. On the contrary, ulcers are molt common
on the infide of the heart. Ruptures are the frequent
mode of termination of ulcers in the heart. Rupture
may occur, however, from violent and fudden exertion ;
but thefe cafes are few in number. It is remarkable that
ruptures of the right ventricle are lefs frequent than
ruptures of the left ; and that, in the latter cafe, the rup¬
ture feldom happens at the thinneft part of the mufcu¬
iar fubftance. It is needlefs to add, that thefe ruptures
muft.be followed by inftant death. A rupture of the
cardae tendinse may occur, however, without this fudden
fatality. • On difleCtion of rupture of the heart, the peri¬
cardium is invariably found full of coagulated blood.

Increafe of fubftance of the heart, or hypertrophy, and
diminution, or atrophy, morbid dilatation, and contrac¬
tion, are all affediions which may arife from chronic irri¬
tation of the mufcuiar fubftance of the heart. This is
only, however, a furmife : it is certain that the above-
mentioned ftate may come on without any afteCtion of
the heart’s fubftance, but from obftrudtion or difeafe in
contiguous vifcera. The caufe of morbid hardnefs or
foftnefs of the heart is fuppofed to be poffibly chronic in¬
flammation ; but nothing is known precisely on that
head.

Pericarditis terminates in an effufion of water, in tu¬
bercles, granulation of various kinds, and more common¬
ly in adhefions. When effufion takes place in the peri¬
cardium, and the cafe is unattended with organic dif-
eafes of the heart, we have, in addition to the fymptom
of deranged function exhibited in carditis, a deep livid
colour of the lips ; fometimes a cough ; a conftant fenfe
of weight in the region of the heart; frightful dreams,
the fubjeCl of which is generally impending fuffocation.
The weight at the cheft is generally aggravated by the
recumbent pofition ; the eafieft pofture being a gentle in¬
clination forwards, the hands refting on the knees.

Thefe are all the fymptoms obfervable in hydrops pe¬
ricardii of I'm a 1 1 dimensions ; that is to fay, when one
pound or fo of water is eft'ufed : but, when the com¬
plaint is more exceflive, (for the effufion is faid to have
reached the extent of eight pounds,) we have, as fome
authors fay, much more marked fymptoms. Senac avers,
that he has feen the fluctuation of the fluid contained

LOGY.

within the pericardium, between the third, fourth, and
fifth, ribs ; and Corvifarc mentions that he once felt it.
Pulfations, moreover, are fometimes felt a little on the
right of the fternum, and alfo a little higher or lower on
the left fide than where the heart’s pulfation is commonly
recognized; thefe arife from the water being impelled, by
the aftion of the heart, with fome degree of force, againft
the parieties of the thorax at different points.

It is reafonable to fuppofe, that with the fiethofcope
we (hould-experience a found of fludhiation ; and that, if
the pleura contained fluid, we fliould meet with this at
fome diftance from the heart, and ifochronous with its
pulfations. Laenr.ec heard a very diftinCt fluctuation in
a cafe in which air was contained in the pericardium.

We fliould not pronounce, on difleCtion, that a patient
had laboured under this difeafe merely becaufe we found
a fmall quantity of water in the pericardium, fince a few
ounces may be poured forthafter death. The effufed fluid
is generally limpid, and tinged with yellow or red. It
has been propofed to cure this malady by pundluring the
pericardium, fome advifing this to be done through the
ribs, others by trephining the fternum.

We have not Ipace to detail the other various products
found in the pericardium : they are indeed the fame as
in all other ferous membranes. We have a few words,
however, to fay on adhefion of the pericardium to the
heart. Many authors have defcribed formidable fymp¬
toms as attached to this malady: but it is remarkable
that more recent inveftigation has fhown, that the fymp¬
toms defcribed are as uncertain as in any other difeafe of
the heart. We quote from Laennec the following re¬
markable account. He fays, “ Avant que la converfiou
des fau lies membranes en tilfu cellulaire fut bien connue,
1’adherence du pericarde aucceur a eteregardee par divers
auteurs comme la caufe de plufieurs accidens graves.
Lancifi et Vieuffens penfent qu'elle produit conftamment
des palpitations; Meckel, qu’elle rend le pouls habitu-
ellement petit ; Senac, qu’elle determine des fyncopes
frequentes. M. Corvifart lui-meme eft tombe a cet egard
dans plufieurs erreurs. Had met trois efpeces d’adherences:
dans la premiere, I’adhefion du pericarde au cceura lieu au
moyen d’une matiere albumineufe demi-concrete ; et c’eit
la feule qu’il reconnaiffe comme unefuite de la pericardite.
La fecondeelt l’adherence intime ou par un tifl'u cellulaire
tres-court : il penfe qu’elle eft l’eftet d’une aftedlion rhu-
matifante ou goutteufe. La troifieme eft celle qui a lieu
au moyen d’un tifl'u cellulaire plus ou moins long: la
caufe de celle-ci lui eft inconnue. Il ne penfe pas, au
refte, qu’on puilfe vivre et vivre fain avec une adherence
complice et immediate du coeur au pericarde ou des pou-
mons a la plevre. Je puis affurer que j’ai ouvert un
grand nombre de fujets qui ne s’etaient jamais plaint
d’aucun trouble dans la refpiration ou la circulation, et
qui n’en avaient prefen te aucun ligne dans leur maladie
mortelle, quoiqu’il y eut adherence intime et totale des
poumons ou du cceur ; et, pour ce qui regarde ce dernier
organe en particulier, je fuis tres-porte a croire, d’apres
le nombre de cas de ce genre que j’ai rencontres, que
l’adherence du coeur au pericarde ne trouble fouvent en
rien l’exercice de fes fondlions. Il m’a paru feulemenc
que la contraction des oreillettes devenait beaucoup plus
obfcure quand dies font adherentes au feuillet fibreux
du pericarde.”

The membrane which lines the heart and larger arte¬
ries is fubjeCl, independently of the two kinds of red-
nefs before mentioned, to oifification and cartilaginous
indurations of certain parts of it ; and to many other
anomalous products, varying from Ample coagulation of
blood to polypi, tubercles, cyfts, and even hydatids.
We mull: refer the reader, who wifties to be familiarly ac¬
quainted with their appearances when he meets with
them on difleCtion, to Laennec’s work, in which he will
find a moft ample account of them. But we fliall quote
his account of the fymptoms of the oifification and carti¬
laginous

PATHOLOGY. 249

Jnginous incruftations which affefl: the valves of the heart,
becaufe thofe fymptoms differ as they are iituated on one
or other of thefe parts.

The fymptoms of the edification of the mitral valve
will be found to vary in fome degree from thofe which
betoken odification in the figmoid valves. The chief
token of odification in the mitral valve is, according to
M. Corvifart, “ a peculiar refilling, difficult to defcribe,
felt by the hand when applied on the precordial region.”
But, though hard to defcribe, itis (as Laennec obferves)
eafy to recognize after it has once been obferved, and
Laennec compares it to the trembling of a cat when ftroked.
Corvifart adds, that the pulfe is alio very peculiarly flut¬
tering ; it is moreover weak, without hardnels 'or fulnefs.
and lefs irregular than in odification of the aortic fig-
moids, but more fo than in the ftraitening of the orifices
of the right cavities.” To thefe fymptoms are often
added thofe which announce hypertrophy and dilatation
of the left auricle and right cavities, becaufe the obftacle
which the blood meets with in pafljng from the auricle
to the left ventricle muff; neceflarily, after a certain time,
produce thefe effe&s.

Laennec, however, was never able to dete£l this pecu¬
liar character of the pulfe, even in thofe cafes where the
ruffling or trembling in the precordial region was moll evi¬
dent ; neither was the latter fymptom evident to the touch
except where the narrowing of the affe&ed orifice was
very confiderable; for Laennec had often niet with cafes
of extenfive odifications of the aortic and mitral valves,
in which none of that ruffling could be perceived.

In the edification of the figmoid valves, the pulfe, fays
M. Corvifart, “may preferve a certain degree of hard-
nefs and ftiffrnefs, but never much of fulnefs nor of regu¬
larity.” There will be ftrotig and frequent palpitations ;
befides “that peculiar fpecies of undulation, ruffling, or
purring,” which has been already noticed in odification
of the mitral valve. We fee, then, fays Laennec, that
“thefe fymptoms are at length reduced to that peculiar
fenfation which is felt by the hand applied over the re¬
gion of the heart, and which I call J'remiJJement cataire ;
for the greater or lefs irregularity of the pulfe cannot
be confidered as a pathognomonic fymptom, fuch
irregularity being met with, in every poflible degree, in
pericarditis, in the paroxyfmsof all difeafes of the heart,
even when no odification is prefent, and alfo in difeafes
of the lungs where the heart is not aftefted.

“ Since I began my obfervations with ftethofcope, I have
met with but three cafes wherein the odification of the
mitral valve was fo confiderable as to conftridl the orifice
of the left ventricle to a degree fufiicient to produce the
frenriffemenl cataire; and, as thefe patients did not die, I
had not an opportunity of verifying the diagnoftic by
infpeftion. Nor have I met with that affection above
three or four times, and that in a flight degree, in the
aortic figmoids. The ruffling could not be difcerned in
thefe cafes, which however were decided cafes of oflifica-
tion, and all verified by necrotomy. On a comparifon of
the few obfervations juft given with thofe which I had
previouflyjnade without the help of the ftethofcope, I
think I may prefent the following refults as exadf, or
very nearly fo.

“ The odification of the mitral and figmoid valves does
not produce irregularity in the circulation, nor can it be
difcovered by examination of the pulfe or by applying
the hand over the region of the heart, until it has
reached fuch a degree as to have confiderably nar¬
rowed the orifices of the left ventricle. The odification
of the mitral valve does not produce the ruffling noife
unlefs it is very confiderable ; and I never obferved it in
odification of the figmoids, though I have often found
them fo oflified as to have reduced the orifice of the
aorta to one half or even one third of its natural fize.

“A moderate degree of odification in the mitral valve
may be detected by the cylinder (the ftethofcope), by the
following fymptoms s the found which accompanies the

contraction of the auricle is more prolonged, more dull,
yet fomewhat rough like the itroke of a file upon wood ;
fometimes the found refembles a blow or flap, but this
when the induration is rather cartilaginous than bony.
This peculiar found, of a file or of a blow, is very evi¬
dent even in thofe cafes where the fremijfemenl is not fen-
fible to the touch ; but it is more fo when the latter is
prefent, and has a degree of ftrength in proportion with
it. The ofiification of the aortic figmoids may be de¬
tected by a fimilar found during the contraction of the
ventricle.

“ A flight degree of odification in the figmoid and mi¬
tral Valves produces neither of the founds we have men¬
tioned ; but it may be detected, or fufpeCted, from a fen¬
fation of hardnefs, roughnefs, or hardinefs, in the con¬
traction of the ventricle or the auricle; and this fenfa¬
tion is clearly independent of the force of impulfion in
thefe organs. The fame fymptoms would probably oc¬
cur in flight odification of the tricufpid valve and the
pulmonary figmoids. In thefe cafes, as in dilatation-
and hypertrophy of the heart, an examination made
(with the cylinder) alternately under the lower part of
the fternum and between the cartilages of the iixth and
feventh ribs, noticing alfo the ftate of the external jugu¬
lar veins, will be always fufiicient to decide in what part
of the heart the difeafe is forming.”

The arrangement of Dr. Good not giving us an oppor¬
tunity of fixing the remaining difeafes of the heart with
nofological accuracy in theirproper places, we ffiall treat
of them here, even though they do not exaCtly tally with
the generic characters of Emprefma.

Like all other mufcles, the heart increafes, in regard
both to the number and force of its fibres, during un-
ufual exertion. It is thus that thickening and general
enlargement of the heart follows extraordinary and Jong-
continued exercife. We may remark, however, that an
unufual volume of the heart is fometimes congenital.
Exercife operates in a fimilar manneron one cavity of the
heart : thus, if obftruCtion exift in the lungs, the increafe
of power acquired by the right ventricle requires alfo
increafed fize of its contractile ftruCture; and the fame
arifes in the left ventricle from obftruCtion in the aorta.
This increafe of fubftance may be connected with parti¬
cular circumftances which may alter its fymptoms ; that
is to fay, there is a difference in hypertrophy of one or
that of both cavities. The fymptoms of this difeafe are
taken chiefly from Laennec. There isa difference between
hypertrophy with diminution of the cavity, and hyper¬
trophy with increafed calibre, and fo on. The varieties
and fymptoms of hypertrophy which follow are chiefly
extracted from the work of Laennec, wherein he conti¬
nually examines, the opinions and definitions of Corvi¬
fart.

By hypertrophy, or “increafe of nourifliment,” of the
heart, we are to underftand an increafe of thicknefs in its
mufcular fubftance, and confequently of the fidesofits
ventricles, at the fame time that thefe cavities are not in¬
creafed in the fame proportion ; moft commonly, indeed
the cavities are diminiffied. This difeafe, which is not
very common, feerns to have eluded the refearches of
Monf. Corvifart ; for he conftantly fuppofes a thickening
of the fides of the heart to be accompanied with a pro¬
portionate dilatation of its cavities. The thickening, in
this cafe, is always accompanied by confiderable increafe
in the confidence of thie fubftance of that organ, unlefs
the hypertrophy is combined with an affeCtion defcribed
under the defignation of“foftening of the heart.”

Hypertrophy may exift in one of the ventricles only,
or in both at the fame time. Theauricles may beaffeCted
at the fame time and in a fimilar manner; but moft fre¬
quently they remain as thin as in their natural ftate, even
when the correfponding ventricle has acquired an enor¬
mous thicknefs. In fome few cafes, the auricles alone
may be aft’eCted with hypertrophy.

When the left ventricle is attacked with hypertrophy,
4 the

PATHOLOGY,

250

the Tides of tl is ventricle become thicker than in the na¬
tural or healthy ftate. “I have fometimes,” fays Laen-
r.ec, “found the thicknefs to be full an inch at the bafe
of the ventricle, which is double that of the healthy
Hate : this thicknefs in general diminilhes infenfibly from
the bafe to the apex of the ventricle, where it becomes
almoft nothing; but in other cafes the apex partakes in
the affeftion, and I have fometimes found it from two
to four lines in thicknefs, which may be eftimated at
twice or four times its natural thicknefs.” The fleffiy
columns and fupporters of the valves acquire a thicknefs
proportioned to the degree of hypertrophy. The inter¬
ventricular partition, which in the prefent cafe feems to
appertain to the left ventricle much more than to the
right, participates greatly in the difeafe, though it never
acquires a thicknefs equal to that of the reft of the lides
of the ventricle. The mufcular fubftance of the difeafed
ventricle becomes fometimes twice as hard as in the na¬
tural ftate, and of a more intenfe red colour. The ca¬
vity of the ventricle appears to have loft in capacity what
the fides have gained in thicknefs. In a heart twice as
large as the patient’s fill, this cavity has been fo fmall,
that an almond with its fhell could fcarcely be fqueezed
into it. The right ventricle, now diminifhecl in propor¬
tion as the left is enlarged, lies flat along the interven¬
tricular partition, and does not reach fo low as the point
of the heart: in thefe fevere cafes, it feems as it were
imbedded in the fubftance of the Tides of the left ventricle.

The following' are the anatomical chara&ers of hyper¬
trophy of the right ventricle. The Tides of this ventricle
are thicker and harder than in the natural ftate : they
fink or give way but little under the knife ; their thick¬
nefs is more uniform than that of the left ventricle, being
indeed nearly the fame throughout the whole length of
the ventricle ; it is, however, always rather more marked
about the triglochin valve, and in that portion of the
ventricle which forms the origin of the pulmonary ar¬
tery. The flefliy columns and pillars are confiderably
increafed in dimenfions ; and this circumftance, which is
more evident than in hypertrophy of the left ventricle,
is, together with the extraordinary hardnefs of the fub¬
ftance of the heart, moft remarkable and decifive of an
hypertrophy of the right ventricle, and moft eafy to de¬
tect on a firft examination ; for the abfolute thicknefs of
the Tides of this ventricle is never very confiderable;
never, fays Laennec, more than four or five lines.

Hypertrophy of the Left Ventricle. — This is the affec¬
tion which appears to be defcribed by M. Corvifart under
the name of “active aneurifm of the heart.” The fymp-
toms arifing from a thickening of the left ventricle, be-
fides thofe of difeafes of the heart in general, are — a
ftrong pulfe, the beats being very perceptible to the pa¬
tient, as well as to phyfician, by applying his hand over
the region of the heart; the abfence or diminution of the
found arifing from percuflion on the region of the heart;
and the red, rather than blue, colour in the face. But
thefe fymptoms are not conftant ; and it is not uncom¬
mon for a confiderable hypertrophy of the left ventricle
to exift where fcarcely any of them are prefent. The
pulfe, in particular, is a very deceitful guide; and it is
perhaps as common to find it weak as ftrong, even in pa¬
tients affli&ed with a high degree of hypertrophy. Per-
cuffion, and the application of the hand over the region
of the heart, are alfo fruitlefs modes of examination if
the patient happens to be fat or dropfical. The ufe of
the ftethofcope, however, is here of more decided import¬
ance. The inftrument being fixed between the cartilages
of the fifth and fixth ribs of the fternum, the contraction
of the left ventricle will produce a ftrong impulfe, and a
found duller than ordinary ; and the more confiderable
the difeafe, the more this found is prolonged. The con¬
traction of the auricle is very Ihort, little fonorous, and
therefore fcarcely fenfible in fevere cafes. The beatings
of the heart are heard through a fmall extent only ; moft
frequently they are fcarcely audible under the left cla¬

vicle and the top of the fternum; fometimes they are
heard only where they may be felt, namely, between the
cartilages of the fifth and feventh ribs. In this diforder,
more than any other, the patient feels the beating of the
heart almoft continually; but he is not very fubjeCI to
violent attacks of palpitation, unlefs from fome extrinfic
caufes, as difturbance of the mind or violent exercife.
Irregularities and intermittences of the palpitation are
not common ; and they are characterized by an increafe
in the impulfe of the ventricles rather than by the noife
they make.

Hypertrophy of the Right Ventricle.- — The fymptoms in
this cafe, according to M. Corvifart, differ from thofe of
the preceding feCtion chiefly by a greater difficulty of
breathing and a darker colour of the face. He adds,
“the beating of the heart being more evident on the
right fide of the bread may be confidered as a fymptom
of the dilatation of the right ventricle ; but this fymp¬
tom, unlefs accompanied by others, is not much to be
depended upon.”

Lancifi had noted as a fymptom of the aneurifm of
the right ventricle, the fwelling of the external jugular
veins, accompanied with pulfations analogous and ifo-
chronous to thofe of an artery. M. Corvifart rejeCts this
fymptom, relying upon what has, he fays, “ been ob-
ferved in cafes where the left cavities have been found
dilated ;” and moreover, “ becaufe fuch pulfation may
be confounded with that of the carotids.” But the
obfervation of M. Laennec gave him a refult which
does not agree with the opinion of M. Corvifart.
He fays, “ I conftantly found this fymptom in all the
cafes of hypertrophy of the right ventricle which came
under my notice; and I never obferved it in perfons at¬
tacked with hypertrophy of the left ventricle, unlefs the
fame perfons had a fimilar affedfion in the right alfo ; and
I think that perfon mult have been a carelefs obferver,
or one who had never met with thefe jugular pulfations,
who could confound them with the rifing produced by
the beatings of the carotids. Thefe pulfations, more¬
over, are confined to the lower part of the jugular veins ;
and are fcarcely fenfible, or much lefs fo, towards the
middle of the neck, where the external jugular vein ap¬
proaches the carotid, from which indeed it is feparated
only by the fterno-maftoid mufcle. Sometimes, however,
the reflux of the blood extends farther, and even beyond
the jugular veins: Hunaldus had found it to extend,
moft decidedly, to the fuperficial veins of the arm. We
may therefore confider this fymptom, whenever it is pre¬
fent, as a good reafon to fufpedt at leaft an hypertrophy
of the right ventricle.”

The contractions of the heart in hypertrophy of the
right, as heard through the ftethofcope, are of the fame
kind as in hypertrophy of the left ventricle, except that
the found from the contractions of the affeCted ventricle
is lefs dull. But in hypertrophy of the right ventricle,
the heart gives a ftronger impulfion under the lower
part of the fternum than between the cartilages of the
fifth and feventh ribs ; while the contrary takes place,
as we have feen, when the left ventricle is affeCted. In
the generality of perfons, the pulfations of the heart are
equally audible in each of thofe places ; but in others,
who however have no appearance of difeafe of the heart,
they are heard more clearly under the fternum than be¬
tween the cartilages of the ribs ; “ and it has appeared to
me,” fays Laennec, “ that fuch a fymptom has always co¬
incided with, or denoted, a decided predifpofition to hy¬
pertrophy or dilatation of the right ventricle.”

Hypertrophy of both Ventricles. — When both ventricles
are at once attacked with hypertrophy, they both defcend
to the point of the heart ; and the fymptoms confift of an
union of thofe proper to the hypertrophy of each ven¬
tricle, but with almoft-conftant predominance of thofe
which indicate the hypertrophy of the right ventricle.

Dilatation of the Ventricles. — A dilatation of the ven¬
tricles of the heart, which M. Corvifart denominates

“paffive

251

PATHOLOGY.

"paffive aneurifm,” is diftinguifhed by the following
anatomical characters— enlargement of the cavities of
the ventricles, the fides becoming thinner. Thefe marks
are commonly attended with a foftening of their muf-
cular fubftance, a colour fometimes bluer than natural,
at other times more pale, inclining to yellow. The fides
are fometimes faftened to fuch a degree, efpecially thofe
of the left ventricle, as to yield to the preffure of the
fingers; and they become fo thin as not to exceed (in
the left ventricle) two lines in the thickeft part, and at
the extremity fcarcely half a line. The extremity of the
right ventricle is fometimes thinner ftill, appearing to
confift only of a little fat and a (trip of the internal or
ferous membrane of the pericardium which covers the
heart. The flefhy columns, particularly thofe of the
left ventricle, are manifeftly more diftant from each other
th.an in the natural Urate. The interventricular partition
lofes lefs of its thicknefs and confidence from the effeft
of the dilatation than the reft of the parietes of the heart.

The dilatation may affeCt one ventricle only ; but it is
more common to find them both affeCied at the fame
rime; which is the more remarkable, as in hypertrophy
the contrary takes place. When one ventricle only is
affeCled, its extremity reaches lower than the other,
but this difproportion is not fo great as in hypertrophy;
and the enlargement of the dilated cavity appears rather
to be in its diameter than longitudinally; infomuch that
a heart which has both its ventricles dilated, becomes
rounded, and very near as large at the apex as at the
bafe ; and in Ihape it will appear like a pouch, rather
than of the conic form which is natural to it.

As to the caufe of dilatation of the heart, fome differ¬
ence of opinion is found amongft the belt authors.
Corvifart conceived, that, when the fyftem was in a ftate
of plethora, or the heart, from other caufes, kept much
in a ftate of congeftion, it had a tendency to dilate in
one or more of its cavities. With the dilatation of the
auricles he almoft invariably found a correfponding iti-
creafed tenuity of the parietes. In the right ventricle
too, the walls generally became thinner as its capacity
increafed ; but in the left ventricle, the contrary. He
confidered the caufe to be preffure on the parietes from
the fulnefs of the cavities, which in their dilatation be¬
came attenuated or thickened, not from fuperadded dif-
eafe, but from the inherent and original diverfity cf
ftruCture. He conceived the fymptoms would be found
to correfpond with this explanation : That in aClive
aneurifm the powers of the heart would be found to be
increafed ; its concufiion on the cheft great, and the
pulfe proportionably ftrong.

M. Roftan arrived, after a very laborious inveftigation
cf the fubjeCV, at fomewhat different concluiions. He
convinced himfelf that dilatations, with increafed thick-
iiefs, were not to be afcribed fimply to the effeCt of in¬
ternal impulfe, modified by the original charadler of the
cavity, but that invariably fome extrinfic caufes could be
found; that the current of the circulation was oppol'ed
either at the valves, or at fome remoter diftance ; that
the heart endeavoured to overcome this refiftance; that
in this effort its parietes were often increafed in thick¬
nefs, and its powers in ftrength. Patient examination
declared the obftru&ion fometimes to exift at a diftance
from the centre of circulation, which had not previoufly
been contemplated, deep in the fubftance of the lungs,
or far in the courfe of the aoita. He conceived the dif-
eafe to occur more frequently in the right ventricle than
M. Corvifart had done. Claiming then the merit of af-
ferting for this caufe the confequence it bore, one which
feemed fo fatisfa&orily to account for the appearances,
he upon the whole agreed with his fellow-labourer in the
fame field, that where there was increafed thicknefs there
was increafed power. He very clearly, however, demon-
ftrated how all this might exift without its manifefting
itfelf by thofe fymptoms of increafed ftrength and power
on which M. Corvifart had dwelt. The heart was mak-

Vol. XIX. No. 1301.

ing its effort to overcome fome refiftance, and the full ef¬
fect of its impulfe could be felt only to the point of ob-
ftru&ion. Hence you could no longer depend on mere
ftrength of pulfe as a diftinguilhed fign of dilatation with
increafed thicknefs of parietes. Imagining that he had
thus afcertained, more fatisfaCtorily than had previoufly
been done, the key-ftone on which much learned
lore had been built, the caufe of that clafs of difeafe ge¬
nerally denominated attive dilatation, M. Roftan’s invef-
tigations difclofed another truth. The caufe of obftruc-
tion fometimes aCted fo long, and the thickening in¬
creafed to fuch an extent, that it encroached upon the
capacity of the cavity. Seeing how this could be readily
explained, that it was but a further effefl of the fame
caufe, he very naturally allowed it to remain in the clafs
to which it was moft allied. In feveral cafes he found
the cavity fo fmall, that it would hardly contain a wal¬
nut.

But the conclufions both of Corvifart and Roftan betray
too ready a tendency to draw general conclufions; for
it now feems pretty clearly afcertained, that the difeafe
which M. Roftan attributes uniformly to fome obltruc-
tion in the courfe of the circulation, may fometimes arife
independently of this or any other very apparent caufe.
M. Laennec properly confiders, that it is occafionally an
idiopathic affection of the heart, though not of frequent
occurrence.

The figns of a dilatation of the left ventricle, according
to M. Corvifart, are — “ pulfe foft and feeble ; palpita¬
tions weak, dull, finking; the hand feems to feel a foft
fubftance which raifes the ribs, not ftriking them brifk-
ly ; and preffure feems to render the beats more feeble.
Very little found proceeds from the region of the heart.”
But the only certain evidence of a dilatation of the left
ventricle, according to Laennec, is that produced by the
ftethofcope; namely, the ruftling roaring found of the
contractions of the heart heard between the cartilages of
the fifth and feventh ribs of the fternum. The loudnefs
of the found, an4d its extent, (how the extent of the dila¬
tation. Thus, if the found of the contraction of the
ventricle is as loud as that of the contraction of the au¬
ricle, and the beatings of the heart are at the fame time
evident on the right fide of the back, the dilatation is
very confiderable.

Dilatation of the right ventricle, according to M. Cor¬
vifart, is accompanied with nearly the fame fymptoms, as
to the ftate of the pulfe and the beating of the heart,
which however are rather more evident, of courfe, on the
right fide, that is, near the fternum and towards the epi-
gaftrium, than in the region of the heart properly fo
called. He, however, places not much reliance on this
fymptom, nor on that of Lnncifi, namely, the fwelling
or puffing-up of the external jugular veins. The fymp¬
toms he thinks moft to be depended upon are — greater
difficulty of breathing than in the affeCtions of the left
ventricle; a more decided ferous diathefis; more fre¬
quent hemoptyfis ; a more dark lividity in the counte¬
nance, fometimes even the darkeft blue.

“Thefe obfervations,” fays Laennec, “are in general
correCl; but I cannot entirely concur with my celebrat¬
ed mafter (Corvifart) as to the importance of two of
thefe fymptoms — the fwelling of the jugulars, and the
extent of the abfence of found in the region of the heart.
An habitual puffing-up of the external jugular veins, but
without fenfible pulfations, lias appeared to me the moft
conftant (doubtful) fymptom of dilatation of the right
cavities of the heart. As to the abfence of found, I have
often found the right cavities much dilated in cafes where
the breaft emitted a confiderable found in the precordial
region and under the fternum ; and in general it has ap¬
peared to me, that the difeafe of the heart which produced
moft frequently the fuppreffion of found was not this,
but “ hypertrophy combined with dilatation,” of which
we fliall prefently fpeak. As to M. Corvifart’s remark
of the more intenfe lividity of the countenance in dila-
3 T tatioa

PATHOLOGY.

252

tation of the heart, it may perhaps be more dark, in dila¬
tation of the right than of the left cavities, and the fame
thing may be faid of the lividity of the extremities; but
I have often feen the countenance very pale and yellow-
iffi, and even the lips difcoloured, in patients attacked
with dilatation of the heart; and, on the other hand,
hypertrophy with dilatation of the right cavities, has ap¬
peared to me to be the difeafe molt frequently attended
by intenfe lividity of the face and of the extremities,
great (luffing, frequent or confiderable hasmoptyfis, and
a very confiderable pouring-out of ferous matter.”

The only conftant pathognomonic fymptom of dilata¬
tion of the right ventricle, is the ruffiing noife of the
heart to be heard under the lower part of the fternum,
or in the fpace between the cartilages of the fifth and
feventh ribs on the right fide. The degree of dilatation
is meafured by the extent of the heart along which the
found can be heard, and according to a kind of progref-
five fcale for which we mull refer to Laennec, § 599.

The palpitations, in dilatation of the heart, confift
chiefly in the frequency and noife of the contractions,
not in the increafe of their force, which indeed is often
lefs than when the patient is in health. The irregulari¬
ties of llrength and of frequency, and the intermittences
of the pulfe, are not very common, though perhaps ra¬
ther more fo in thefe cafes than in hypertrophy.

Dilatation combined with Hypertrophy of the Ventricles of
the Heart. — The union of thefe affections is very com¬
mon. It may exift in one of the ventricles, or in both
together. In the latter cafe, the heart may become pro-
digioufly enlarged, even to thrice the fize of the patient’s
fid. This increafe of fize arifes from the thickening of
the parietes of the ventricles* together with a propor¬
tionable increafe of their cavities; their mufcular fub-
llance alfo becomes harder.

Thefymptoms of this affeCtion are, of courfe, a com¬
bination of thofe of hypertrophy and of dilatation. The
contractions of the ventricles are attended with great
force, and a confiderable noife ; thofe of the auricles are
fonorous alfo. The pulfations may be heard through a
great extent; and fometimes, efpecially in thin people
and in children, the impulfion is felt equally under the
clavicles, in the ribs, and even a little in the left part of
the back. “I once (fays Laennec) heard and felt the
contraction of the ventricles in the lower and polterior
right part of the bread of a woman attacked with this
malady ; and, though the was a little woman, and not
flrong, the impulfe and the found were more intenfe in
that place than I have met with them in the precordial
region of a 'flout man.”

The contractions of the ventricles, in this difeafe,
may be readily felt on applying the hand over the region
of the heart ; for here, particularly during the moments
of palpitation, the beats will be found quick, dry, flrong,
and fenfibly refifling the hand. If we attentively notice
the patient when he is mod calm and undiflurbed, it will
be feen that his head, his limbs, and even the bed¬
clothes, are really fliaken at every contraction of the
heart. The beatings of the carotids^of the radials, and
other fuperficial arteries, are often vifible. If we prefs
the region of the heart, that organ, according to the ex-
preffion of M. Corvifart, “ feems to be angry at the pref-
fure, and to re-aCt more violently.” Thefe violent
beatings, fays he, when the diforder affeCts the left ven¬
tricle, are accompanied with a pulfe which is frequent,
ftrong, hard, vibrating, and hard to be flopped. “ This
character of the pulfe is obferved, indeed,” fays M.
Laennec, “very frequently in hypertrophy with dilata¬
tion, as well as in Ample hypertrophy of the left ven¬
tricle : but I cannot agree with M. Corvifart in regard¬
ing it as a fymptom of aCtive aneurifm of the left ventri¬
cle ; for, as I have elfewhere obferved, we find very often
a pulfe fmail and weak, though otherwife regular, in men
wliofe heart is very large and habitually beats with great
violence, and vice verfa.

“The palpitations which take place in the difeafe we are
treating of, when examined by the help of the ftethof-
cope, prefent the fame characters with the habitual con¬
tractions defcribed above, but with greater intenfify;
and they are feldom accompanied with irregularities, un-
lefs when death is near, and they become weaker. In
thefe palpitations we fometimes obferve, befides the im¬
pulfe which the heart feems to give through a large fur-
face, a ftroke more dry, more fonorous, ffiorfer though
ifochronous, and which appears to (trike the parietes of
the bread along a much (mailer furface: this ftroke is
evidently produced by a quick and flrong rifing of the
apex of the heart.”

If the beatings of the heart are examined alternately
right and left, i. e. under the lower part of the fternum
and between the cartilages of the fifth and feventh ribs,
on the left fide, we may exaClly know which is the af-
feCted ventricle, if only one, or whether both are affec¬
ted, as molt commonly happens. It will be ufelefs to
repeat the fymptoms which have already been fufficiently
detailed. Dilatation with hypertrophy of the ventricles
of the heart being, of all affeCtions of the heart, that in
which it attains the larged fize, it is alfo that wherein
the abfence of found in the region of the heart is ob¬
ferved mod frequently and to the greateft extent.

Dilatation of one ventricle with hypertrophy of the
other, is a fpecies of complication not very uncommon,
though more fo than the preceding. The fymptoms are
(till a mixture of thofe of hypertrophy with thofe of di¬
latation, the one fet predominating over the other ac¬
cording as the former affeCtion is more or lefs intenfe
than the latter.

Dilatation of the Auricles of the Henri.— This variety of
difeafe very rarely occurs, and we (hall therefore be
brief in detailing the fymptoms. Laennec fays, that,
whenever the auricles were confiderably enlarged, whe¬
ther from a&ual dilatation or from diftention arifing in
extreme pain, he found that their contradlions, inftead of
the brifk found they produce in the natural (late, which *
has been compared to opening and (hutting of a valve,
give out only a dull obtufe found like a bad pair of
bellows. He never could clearly difcover that the con¬
tractions of the auricles gave any impulfe, even when
the thicknefs of their parietes was greatly increafed.

Here Laennec recalls our attention to a negative fymp¬
tom which he had already noticed in analyfing the beat¬
ings of the heart ; namely, that, “in many cafes of hy¬
pertrophy of the ventricles, the contraction of the au¬
ricles can fcarcely be diftinguiffied by examination over
the region of the heart ; but if, inftead of this, the cy¬
linder be applied over the fternum or under the clavicles,
the contractions may then be clearly diftinguiffied, and
often the found is very confiderable. This fymptom, as
I have before obferved, feems to point out, that the af¬
feCtions of the auricles and thofe of the ventricles are to¬
tally diftinCt from each other; i. e. that the auricles are
not affeCted by the maladies of the ventricles.”

Softening of the heart, fatty coverfions, atrophy, and
cartilaginous and bony indurations, do not betray clear
fymptoms of their exiftence during life; or at lead we are
not fufficiently acquainted with thefe fymptoms. A ge¬
neral cacheCtic habit is ufually obferved in mod of thele
morbid dates, which of courfe require the long continu¬
ance of diforder before they are ellabliffied.

The treatment of hypertrophy or dilatation is feldom at¬
tended with fuccefs. The little that is to be done is com-
prifed in a few words. The circulation mull be kept below
par, by repeated fmail bleedings, when the fubftance of the
heart is any-where thickened ; by a very low diet, when it
is diminilhed or morbid. Wefiiould fomewhat modify the
latter rule, becaufe it is often an objeCt to nouriffi and
fupport the body in a (late of aCtual deprivation of fome
of the fanguineous elements. Occafionally counter-irri¬
tants, and a regular ufe of medicines aCting mildly on
the capillary fyftem, are alfo proper. Perhaps much of

the

P A T H O

the ill fuccefs which has attended this plan may be re¬
ferred to the difficulty we have to make patients perfevere
in this very abftemious regimen, and the prejudice's we
hdve to encounter againll the innumerable bleedings
which it is neceflary to perform.

We cannot difrnifs the fubjeft of cardiac difeafe with¬
out reminding the praftitioner of the occafional fimilar-
ity Which nervoits irritations difplay to organic difeafes
Of the heart. We refer the reader, for one fource of this
irritation, to Dyfpepfia; but nervous excitement in other
organs befides the ftomach gives rife to fyncope and
palpitation ; as for inftance, in hyfteria, pregnancy, pul-
fation in the epigaftrium, See. The diagnofis is founded
on the permanency of organic malady, in contradiftinc-
tion to the paroxyfmal attack of irritative palpitation ;
for though, in the former cafe, the patient is better and
worfe, he is feldom wholly free from difeafe. The in¬
creafe in-the fymptomsof organic difeafe when mufCular
exercife (particularly running up ftairs) is uled, furniflies
another point of difference between this and nervous
diforder. Some further and obvious indications of diag¬
nofis are drawn from the appearance of the tongue, fkin,
general date of the pulfe, &c.

9. Emprefma peritonitis, inflammation of the perito¬
neum: pain and tendernefs of the abdomen, efpecially
in an ereft pofture ; with little affeftion of the fubjacent
vifcera, or abdominal walls. Dr. Good gives three va¬
rieties.

' a.. P. propria: the inflammation taking the general
range of the peritoneum; pain extreme, often pungent,
with little or no relief from ftools.

|3. P. omentalis : with a more fenfible fwelling in the
region of the omentum.

7. P. mefenterica: pain deeper feated, and more im¬
mediately in the mefenteric region ; external tendernefs
lefs than in the preceding varieties.

Inftead of thefe diftinftions, we ffiail adopt the more
Cornrhon ones' of acute and chronic peritonitis.

Acute Peritonitis generally commences, like other vif-
ce’ral inflammations, with chills and fliiverings, though
thefe are forrietimes flight, and occafionally abfent alto¬
gether. This cold ftage has been known to continue
two or three days before the re-aftion took place. After
this, the pulfe becomes quick and frequent ; there is
confiderable third ; and the general affedfion, called
fever, enfues. Thefe fymptoms are attended from the
very beginning witli a fenfe of heat and pain in the ab¬
domen, at firft generally confined to fomeone part, though
fometimes diffufed over the whole of its furface. This
pain is much increafed by preffure ; or, in other words,
there is a great tendernefs or forenefs of the belly, and
moft invincible coftivenefs. The pulfe is at leaff one
hundred in a minute, and fmall ; yet the tongue is not
much altered at firft from its natural appearance.

As it is of much importance to diftinguiflr the tender¬
nefs on preffure, we flrould carefully watch the counte¬
nance of the patient while we prefs on the belly. In
doing this, we ihould put both hands on the fides of the
beliy, and draw them as it were to the centre ; this mode
of preffure producing more pain than that which is made
direftly downwards. In the courfe of twenty-four
hours the pain and tendernefs on preffure increafe, fo
that even the weight of the bed-clothes fometimes be¬
comes intolerable, and the pulfe riies to a hundred and
twenty or thirty in a minute : at this time the tongue be¬
gins to be covered with a cream-coloured mucus, and,
though it is moift, there is great thirft. A confiderable
degree of tenfion and fwelling now takes place over the
■whole abdomen ; and the patient finds moft relief from
ain by remaining motionlefs upon the back, with the
nees in a fmall degree elevated. This pofition, while
it throws the weight of the inteftines to the fpine, and
therefore removes the preffure of them from the inflamed
membrane, at the fame time relaxes the abdominal muf¬
cles, and prevents any ftrifture over the outer furface of

L O G Ye 253

the inflamed part. As thefe mufcles are called into ac¬
tion by any attempt to rife or even to turn, fo fuch a
motion neceffarily aggravates the acute pain ; whence
abfolute reft, as juft ftated, is moft eafy to the patient.
The patient, for the fame reafon, generally breathes by
the intercoftals, and very littie by the diaphragm. The
tenfion of the belly continues to increafe to the fixth,
feventh, or tenth, day ; on one of which days, unldfs
proper meafures have been taken to remove the difeafe,
the patient moft commonly expires. Previous to death,
the pain often fuddenly ceafes, and the inexperienced
may conceive that this is an indication of amendment in
the difeafe: but, if the fymptoms be minutely examined,
it is found that, at the fame time, the pulfe is finking
in ftrength and increafing in rapidity, that the ftrength
of the patient is alfo fenfibly diminiftted ; the counte¬
nance collapfes, cold clammy fweats break out, the ex¬
tremities lofe their vital warmth, and at length a labo¬
rious refpiration manifefts the concluding llruggle of
life.

But the fymptoms above enumerated are often modi¬
fied by age, conftitution, feafon, and other circumftances.
Thus, in fome fubjefts, of feeble conftitution and advan¬
ced age, peritonitis will creep on without fever, or even
local pain — and yet the diforder will go on to complete
diforganization of the peritonaeum, or fuch an effufion
of ferous fluid as gives the complaint the character of af-
cites. In fome fubjefts, the thicknefs of the mufcles and
parietes of the abdomen renders the pain of preffure
icarcely perceptible. A favourable prognofis, however,
is to be deduced from a gradual ceffation of the pain, ef¬
pecially when it is accompanied by a diminution of ten¬
fion and forenefs, and when at the fame time the pulfe
becomes fuller and lefs frequent, the fkin lefs parched,
foft, and moift, the refpiration lefs laborious, and the
countenance more open and expreffive of eafe.

Inflammation of the peritoneum may be diftinguifhed
from colic by the permanency of the pain, and the frei
quency of the pulfe, as well as by the tendernefs on
preffure, even before any tenfion of the abdomen has
taken place ; and by the abfence of any inclination to go
to ftool when the pain is fevere, as well as by the undi-
miniftied fuffering when an evacuation of the bowels is
eft'efted, either fpontaneoufly or by medicine. It is not
fo eafily diftinguifhed from inflammation of the bowels,
or .enteritis. In this latter difeafe, however, there is ob-
ftinate conftipation, and the pain is more acute, and not
fo much aggravated by external preffure ; the ftomach is
alfo commonly affefted with vomiting.

But thefe diftinftions are by no means to be depended
on; for, though we have the authority of Hunter for
confideringperitonitis a diftinft affeftion, (Hunter on the
Blood, 244.) yet it cannot be difputed that many cafes
do occur in which the organs in veiled by the peritonaeum
become implicated in its inflammatory difeafe ; and, ac¬
cording as the peritonaeum is inflamed, over the ftomach
or over the bowels, fo enteritis or gaftritis will enfue.

The predifpofing caufes of peritoneal inflammation are
involved in obfeurity. The exciting caufes are various :
compreffion of the abdominal vifcera ; blows or falls on
that region ; internal friftion or preffure, as of the gra¬
vid uterus, extra- uterine conceptions, enlarged ovaries,
or other morbid growths within the abdomen ; violent
and long-continued corporeal exertions, violent and re¬
peated contraftions of the abdominal mufcles in vomit¬
ing ; irregular circulations of the blood in the cold ftages
of intermittents, and ftriftures of the colon or reftum
producing unnatural contortions and friftion of the in¬
teftines on one another, are all caufes of peritoneal in¬
flammation.

But the grand caufes are to be fought in the aftion of
a cold atmofphere on the furface of the body ; the appli¬
cation of wet or cold, efpecially to the feet, when the
perfon is in a ftate of corporeal inaftion ; the negleft of
changing wet clothes, the drinking of cold liquids when
1 the

254

PATHOLOCY.

the body is heated, and whatever fuddenly interrupts
certain functions of the fyftem, as the fuppreffion of per-
fpiration, the iochia, and the menftrual difcharge.

Over the caufes which produce epidemic difpenfations
of this difeafe, the fame veil of myftery hangs, that con¬
ceals from our view the etiology of other epidemics.
M. Broulfais faw the difeafe epidemic, and apparently
contagious, among the Prench armies, in various
psrts of the continent ; in Germany, Holland, and
Italy. We have all feen puerperal peritonitis epidemic
in our own country. The tranflation of rheumatic, ar¬
thritic, or eryfipelatous, inflammations, from the joints
or furface of the body to the interior tiffues, is not to
be overlooked.

Bayle, Broulfais, and others, have noted the following
morbid appearances after acute peritonitis, i. Rednefs,
thickenings,, and even efchars, which penetrated to the
mucous membrane of the peritoneum. 2. Solid exuda¬
tions, in form of falfe membranes, lining the ferous fur-
face of the peritoneum, but without organization. 3. A
liquid exudation, fometimes turbid, fometimes limpid
or reddifh : more or lefs of ferous and purulent fluid was
always found in the abdominal cavity, bathing the fur-
face of the inteftines. 4. M. Brouffais alfo found red
clots, fometimes thin, fometimes thick, fpread over,
in form of membrane, the peritoneum, which was red¬
dened and thickened underneath. Blood itfelf has been
found effufed from the peritoneal lining of the abdomen,
without any apparent breach of velfel or fubltance.
Sphacelations were fometimes found.

In molt cafes where acute peritonitis has been cured,
and the patient foon afterwards died of other difeafes,
adhefior.s were found, fimilar to tliofe occafioned by
pleurify.

The nature of the difeafe being once afcertained, the
method of cure will be obvious. As in all other acute
inflammations, blood-letling from the fyftem at large is
the remedy to be principally depended upon, and fhould
be referred to at as early a period as poflible. And this
evacuation fhould be large, frequent, and early ; for, if
the inflammation be not mitigated in the fpace of twen¬
ty-four hours of adtive treatment, the event wdll gene¬
rally be fatal. The chief guide in directing this opera¬
tion mult be the degree of pain expreffed by the patient,
particularly under the adtion of preffure : and even if
this be much diminiflied, it may ftill be right to apply
from ten to fifty leeches to the abdomen ; and, as i’oon
as thefe have done their office, its whole furface fhould
be covered with a blifter. It is to be diftindtly under¬
stood, however, that neither leeches nor bliftering ffiould
be trufted to, until fome diminution of pain has ac¬
tually been produced by the general bleeding. And far¬
ther, if it fhould happen that the pain is not dimfnifhed
after the Second bleeding, this operation muff be re¬
peated even to the fourth or fifth time, after intervals of
three or four hours each. If it fhould be unequivocally
manifeft at any one of thefe bleedings, that the ftrength
of the patient is inadequate to the lofs of Sixteen ounces,
a Smaller quantity may be taken away, and we may re-
Sort, at the Same time, to the topical application of leeches
and biifters. It Seems, however, preferable to delay the
application of a blifter till the constitutional eff'edts oc-
calioned by the local inflammation are partly removed
by the general bleeding, and till the diforder is thus re¬
duced to a State more nearly approaching to a Simple to¬
pical affedtion. For, by proceeding thus, the double ad¬
vantage will be obtained, of applying the topical reme¬
dies at a period when their influence will be exerted
with the greateft effedt, and the pradtitioner moreover
wiil r.ot be deprived of the only means of ascertaining
the variations of the diforder; namely, by preffure on
the abdomen. The firft Symptom on which we may pro¬
nounce the recovery of the patient, is the ability of re¬
maining in a Sitting pofture, after he had previoufly been
confined to the back : this pofition of the body proves

that the inflamed peritoneum is now able to bear the
weight of the bowels, which perhaps never takes place
where the patient does not recover.

With refpedt to internal medicine, it is of Secondary
importance. Nevertheless it is neceffary that the bowels
fhould be kept open, and this fhould be effedted with as
little irritation as poflible. For this pu.rpofe, caftor-oil,
or Small doSes of the Sulphate of magnefia, may be admi-
niftered with advantage ; and emollient ciyfters may be
injected, which, at the Same time that they procure
ftools, will adt as internal fomentations. Fomentations
may be alfo applied externally to the abdomen, when
the tendernefs is Sufficiently removed to admit of the
preffure. It is Scarcely neceffary to add, that the ftridteft
antiphlogiftic fyftem muft be adopted, both in refpedt to
diet and medicine.

It may be right to mention an irregularity in the com¬
plaint, which is apt to miflead the pradtitioner, and to
deter him from reforting to thofe vigorous meafures fo
effential to counteract the magnitude of the danger.
There is now and then, at the very firft attack, fo great
a degree of proftration of ftrength, accompanied likewife
by a pulfe Scarcely perceptible at the wrift, as might in¬
duce us to confider the patient at the point of death, and
unequal to undergo the treatment above recommended.
There is alfo a fpafmodic attack of pain, which remits.
Thefe appearances, however, feem to arife wholly from
the inflammation extending to the peritoneal coat of the
ftomach and inteftines. Here, as in different circumftan-
ces, the pain on preffure muft be the criterion to deter¬
mine our pradtice; and, if the pain fhould be found ex-
quifite, no accidental Symptom fhould lead us from truft-
ing for relief chiefly to the lancet. Such a decifion will
foon be juftified by a freedom in the adtionof the arterial
fyftem, the pulfe becoming fuller and ftronger, by an
abatement of the languor and proftration of ftrength, and
by a diminution of pain.

Among other powerful but uneftabliffied meafures we
have to mention the injedtion of tobacco per ano, cold
lotions to the belly, and the exhibition of oil of turpen¬
tine. Whether any further good can be attributed to
the laft medicine than what refults from its purgative
operation is not yet known.

The attack of the chronic inflammation of the perito¬
neum is very different from that of the acute Species. It
advances by degrees, manifefting itfelf only by occasional
Superficial pricking pains over the abdomen, without
producing any inclination to go to ftool : the pulfe is
Somewhat accelerated, and the tongue (particularly in
the morning) is Slightly covered with white fur. There
is alfo considerable thirft ; yet there is no exacerbation
of fever in the evening, nor any hedtic fluflies on the
cheeks : on the contrary, the countenance is full of lan¬
guor, and the face is pale and doughy.

In the early ftages of the difeafe, the patient is capable
of performing his ordinary avocations, and only com¬
plains, after fatigue, of a certain degree of tightnefs and
pricking forenefs acrofs the abdomen, from one os ilium
to the other. This ftate will continue, with little varia¬
tion, for many months, during w'hich the operations of
the bowels will fometimes proceed naturally, though
more commonly the patient is coftive. There is no ten¬
sion of the fkin of the abdomen, as in the acute Species ;
on the contrary, the fkin and abdominal mufcles are
fometimes obferved to fit loofely upon the peritonaeum,
which gives a fenfation to the touch, as of a tight band¬
age underneath, over which the fkin and mufcles may be
Said (as it were) to play. The patient always complains
more of the tightnejs than of th epain-, and, as this tight¬
nefs is much increased by any congeftion in the inteftines,
the relief which he experiences from evacuating their
contents, leads hifn to attribute his fenfations to an ha¬
bitual coftivenefs, for the removal ol which evil all his
endeavours are uiually diredted.

The progrefs of the aftection is as follows : The bow¬
els

PATHOLOGY.

255

els become more and more irregular in their aCtion ;
the tendernefs and fwelling increafe; the appetite fails ;
the pulfe acquires greater velocity; the features look
fharp and contracted; the countenance becomes pale or
fallow; the lips parched and ikinny ; the tongue, fome-
times of a bright colour, refembling what is feen in dia¬
betes, at other times it is covered with a thick whitilh
mucus. The flefli and ftrength decay rapidly ; and great
emaciation takes place. The {kin, except towards the
Jail ttage, is for the mod part dry and fcaly ; the urine
fmall in quantity, occafionally clear, more frequently
otherwife. If a cough has not exifted from the begin¬
ning, it is very apt to occur about this time ; but this is
by no means to be confidered as a diagnoftic fymptom ; its
evidence depending upon the fpreading of the difeafe to
the pleura, and the thoracic vifcera. The feet foinetimes
1'well towards the conclufion of the difeafe, but the fwel¬
ling is often confined to one leg and thigh. At this pe¬
riod, if the examination of the abdomen be made with
due care, it will he found to communicate to the touch
the feeling occafioned by a folid tumour ; the integu¬
ments and mufcles not rolling upon the contained parts
as in the fird dage. Butin fome cafes, where ed’ufion is
conjoined with the original and more important difeafe,
a fenfe of fluctuation may be difcovered. Very frequent¬
ly the patients complain of a didreding feel of what they
call a “ broiling heat” at the domach, the difcharge of a
tough ropy phlegm from the mouth, condant naufea,
with violent retching and vomiting; and, in two cafes,
the matter brought up during feveral days before death
was dercoraceous.

In the courfe of the complaint, the appetite is for the
mod part very bad ; but the defire for liquids is infatiable,
even though a confcioufnefs exids that a large quantity
cannot be Iwallowed without occafioning very great dif-
trefs. When a feeling of finking and emptinefs prevails,
the patient eagerly thinks of many articles that might
allay his uneafinefs; but the fight of them feldom fails
to excite loathing and dilgud. Should any fudenance be
taken, it is either fpeedily rejected by vomiting, or it
caufes indefcribable uneafinefs. The patient rolls about
in all directions, in vain feeking for fome point where
he may repofe. Every aCtion of the domach or intef-
tines comes to be performed with great pain. The paf-
fage of flatus upwards or downwards, the movements
which take place before the evacuation of the bowels,
all give rife to fufFering. At times the pain is (harp and
tranfient ; at others heavy and obtufe. But a fenfe of
weight is feldom abfent; and it is more felt after vomit¬
ing or purging than before. One patient, (an infant,)
in allufion to this fymptom, ufed to put its hand on the
abdomen, and exclaim piteoufly, “ Oh ! fo heavy.” Ano¬
ther faid, that his bowels felt as if they were “ tied up
in a napkin.” At another time he faid, “ they feemed
to be in a mafs :” and at a third, he declared, that if he
bad “a (hot attached to every convolution of his intef-
tines, he could not differ more than he did.”

The above defcription, which is chiefly taken from
Drs. Pemberton and Baron, is not applicable to all cafes.
Chronic peritonitis fometimes comes on fo infidioufly,
that not the flighted fufpicion could be entertained of its
exidence. We fliould therefore be careful, fince this dif¬
eafe is often the fequel of acute peritonitis, not to remit
too foon in our endeavours for the cure of the latter
difeafe.

Exceptions to the fymptom of condipation are more
frequent in chronic than in acute peritonitis. In fome
cafes, too, the appetite is preferved, and the digedion but
little deranged ; in which cafes we may conclude, that
the peritoneum reflected over the domach is not very
deeply involved in the difeafe. At other times, however,
there is vomiting; hut this is not to be confidered a pa¬
thognomonic fymptom of chronic peritonitis. Brouffais
mentions a fenfation, as though a ball were rolling about
in the abdomen, and fometimes approaching the throat ;

Vol. XIX. No. 1301.

this he attributes to the agglutination of the infedines,
which form, with the gorged mefenteric glands, around
and mobile mafs in the belly, often without any effufed
fluid.

In chronic peritonitis, the peritoneum acquires a great¬
er degree of morbid thickening, and the inflammation
appears to have penetrated to the different ItruCtures of
the fubjacent organs. The efl’ufion is ferous, limpicj, or
greenifli, or reddilh, with white purulent-looking fila¬
ments floating about. Occafionally we find fpread over
the whole extent of the peritoneum, or over fome of the
envelopes which it lends to various organs, a crop of gra¬
nulations, pifiform, white, and not unlike certain mili¬
ary eruptions of the {kin. Bayle, who examined thefe
granulations very minutely, obferves that, in a fubjeCt who
prefented them to a great extent, he could fcrape them
off very eafily with the fcalpel in many places, and that
there the peritoneum underneath appeared perfectly found.
In other parts, however, they could not be railed from
the membrane without tearing it. Brouflais has alfo re¬
lated numerous cafes where the peritoneum was larded,
and immenfely thickened, with crops of tubercles. “ I
have alfo (fays the fame author) feen afpecies of veficles,
fimilarto hydatids, formed of the mod limpid ferutn, un¬
der a tranfparent flieet of membrane which had been ele¬
vated thereby.”

Brouflais obferved, that thin men, of a lymphatic tem¬
perament, and who had been weakened by any difeafe,
particularly by protracted intermittents, were the molt
iubjeCr to thefe tuberculated diforganizations of the pe¬
ritoneum. ThefubjeCts opened by M. Laennec prefent¬
ed the following morbid appearances in the abdomen.
On perforating the peritoneum, a quantity of gas rufhed
out, which had the odour of fulphurated hydrogen. The
inteftinal canal was found Angularly conglomerated, and
agglutinated into one mafs, and partly covered by thick¬
ened and adherent epiploon. In fome cafes the intef-
tines were entangled and twilled upon each other, and
glued together by falfe membranes. The peritoneum it-
felf was thickened, diforganized, and tuberculated, in
the maimer already delcribed, with effufions of va¬
rious kinds in the cavity of the abdomen. It is evident
that thefe chronic diforganizations of the peritoneum
cannot long exilt without affeCting the ftruCture, and con-
fequently the functions, of the various abdominal Vifcera.
Hence the digeltion, chylification, biliary fecretion, See.
all become deranged, and prefent a complication of dif-
trefllng phenomena. But not only is the difeafe propa¬
gated to the organs over which the peritoneum is fpread ;
it is not feldom extended to the ferous tillues of other
cavities than t hat of the abdomen.

Before we proceed further, it will be right to inform
our readers, that in following the common notion, that
all the above-mentioned morbid products are therefult
of inflammation, we are oppofed by fome very refpeCta-
ble pathologifts. Dr. Baron, in his clever work on the
“Tuberculated Accretions of Serous Membranes,” pro¬
mulgates the idea, that morbid productions on the peri¬
toneum are not always the confequence, but rather the
caufe, of inflammation of that membrane. He fuppofes
that tubercles are formed from hydatids, (a notion enter¬
tained by Morgagni;) and that thefe fubltances owe their
production to a difeafed {fate of the abforbent rather
than the vafcular fyltem. He details many faCts drawn
from the obfervance of the fcrophulous diathefis of the
patients of chronic peritonitis, from the abfence of
fymptoms of inflammation, till in all probability the
morbid products were formed. He traces up the forma¬
tion of large tumours and general agglutination of the
inteftines, from the fmallelt millet-fized hydatid; and he
{hows that the fymptoms of derangement of the vafcu¬
lar fyftem, when they exilt, may eafily be referred to the
local llimulation of the tubercle or other morbid pro¬
duct. We are not able to decide the queflion, whether
morbid accretions of the peritoneum never arife but from
3 U inflammation 5

PATHOLOGY

258

inflammation; but we will venture to fay, that in the
majority of cafes they do ; and whoever reads Dr. Baron’s
cafes attentively cannot fail to fee ftrong evidence in fa¬
vour of-this notion. In that of Sarah Tandy, “ the com¬
plaint is reported to have come on only four weeks ago,
with tendernefs and fwelling of the belly, naufea, andvo-
miting.” This patient did not, die for a year, fo that the
appearances on difieftion could furnifli no evidence as to
when the tuberculous affe&ion had begun. In the cafe
of the female, p. 36, the “affeflion began in the pleura;”
and we do not generally obferve metaftalis in difeafes of
the abforbent fyftem. Sarah Aldridge (p. 28.) is made
to ftate, that (he recollefts the pain was “ more fevere at
the commencement than it has been fince;” her blood
t oo !< fhowed a flrong buffy coat.” The cafe of Browning
(p. 41.) affords any thing but evidence of the origin of
the difeafe from difeafed abforbents ; it came on after an
operation for ftrangulated hernia, and was clearly con-
tiefted with the fphacelation of the inteftine which took
place.

This difeafe is full of danger, as well from the flow
infidious progrefs which it makes to undermine of itfelf
the cpnftitution, as from the accidents to which it ex-
pofes the patient during the long courfe of management
required in its treatment. As another caufe of danger,
alfo, may be added, the want of refolution which we
have fo often to regret in patients during the cure of a
chronic difeafe, where the ad vantages of the plan, from
its gradual operation, are not fo obvious to the fenfes.
The fymptoms which indicate recovery are, an abatement
of the pricking pains of the abdomen, and a diminution
of the frequency of the pulfe to eighty in a minute : but
even under thefe appearances, however favourable, a re-
lapfe is always to be dreaded.

■We have little, and that little unfatisfaftory, to fay
concerning the treatment of this difeafe. In the firil
place, bleeding mull be fo far had recourfe to as to keep
the circulation as much as pofiible below the ftandard of
health. The bowels mull: be kept open by none but the
mildeft laxatives. The moll perfect quietude ; cauteriza¬
tion by means of continued bliftering on the abdominal
regions; naufeating medicines fo carefully watched that
they never may produce a<5tual vomiting ; are alfo to be
refo'rted to. Under thefe meafure we may cure this com¬
plaint, when it hasexifted two or three weeks only, if we
are fortunate enough to be called in fo Toon. After that
period our tneafures will fomewhat change. We mult
endeavour to excite the abforbent fyftem to remove the
morbid productions ; and for this purpofe we fhould
chiefly trull: to rigid abftinence. We fhould alfo endea¬
vour to increafe the fenfations of the fkin, kidneys, See.
Mercurial medicines feem fuccefsful in advanced ftages
of the complaint. We fhould try them, however, in the
early ftage of the difeafe; in the latter, as there is little
hope of promoting the abforption of a tubercle, we fhould
naturally be averfe to excite the irritation of fever which
follows the introduction of mercury.

10. Eruprefma gaftritis, (Gaftritis, Cullen, fyc.) inflam¬
mation of the ftomach : burning pain at the pit of the
ftomach, increafed by fwallowing; rejection of every
thing; hiccough ; oppreflion and dejeCtion of mind ; fe¬
ver a fynochus. There are two varieties.

a. Adhsefiva: pain very acute ; fever violent.

£. Erythematica : with an erythematous blufli extend¬
ing to and viflble in the fauces; pain more moderate;
fever lefs violent : pulfe low and quick.

This fpecies, under one of its two varieties, is found
alfo as a fymptom, occafionally, in aphtha, mealies, fmall-
pox, and other exanthems.

Thefe terms which defignate the varieties we ufe per¬
haps fomewhat differently from Dr. Good, in the follow¬
ing fenfe. The firft variety will defignate that violent
form of inflammation in which all the coats of the fto¬
mach, and probably its peritoneal covering, are affefted.
The fecond variety is gaftritis affeCting the mucous mem¬

brane only. The firft is alrnoft always acute and violent*
and is very rarely met with; the latter exhibits both an
acute and chronic character, and is frequently obferved.
The firft variety, which has long been known to medical
authors, is thus deferibed.

Gaftritis adhefiva is charaClerized by an acute burning
pain in the region of the ftomach, which is fuddenly in¬
creafed, and vomiting at the fame time excited by any
thing whatever that is fwallowed; it is alfo aggravated
by external prefture. Thefe fymptoms are accompanied
by a great degree of general fever ; the pulfe is extremely
quick and fmall, and commonly hard. There is alfo ex¬
treme anxiety, and a greater deprefflon of ftrength, and
lofs of power in all the functions of the body, than in
the cafe of alrnoft any other inflammation. In many in-
fiances there is a remarkable tendency to fyncope ; and
there is frequent retching, and often hiccup, indepen¬
dently of any thing fwallowed. In fome inftances, other
fymptoms are fuperadded to thefe. Thus, very early in
the difeafe, a high delirium has fometimes come on, with
great giddinefs and lofs of fight, from the fympathetic af¬
fection of the brain ; confiderable difficulty of breathing
has alfo occurred, probably from the impoffibility of de¬
pressing the diaphragm without compreffing the ftomach;
convulfions of the mufcles, and in fome cafes, although
intenfe third: was prefent, aCtual inability to drink has
'alfo taken place.

From the, great fenfibility of the ftomach, and its fym¬
pathetic connexion with the other important organs of
life, it mull be obvious that inflammation of this vifeus,
by whatever caufes produced, muft occafion a great and
often fatal derangement of the fyftem. If the difeafe lafts
long enough to follow the ordinary courfe of other in¬
flammations, it may terminate like them by refolution,
gangrene, or fuppuration. Some writers have mentioned
feirrhus and cancer of the ftomach as among the lequelae
of gaftritis ; but Dr. Cullen has correctly ftated that the
feirrhofities, which are often difeovered afteCting the ftc-
mach, are feldom known to be the confequences of in¬
flammation.

The prognrjis, as to the tendency of the difeafe to one
or other of thefe terminations, may be deduced from the
following appearances and conflderations. The difpofi-
tion of the inflammation to ceafe, or to terminate by re¬
folution, as it is called, may be known by the mild or mo¬
derate ftate of the fymptoms ; and by a gradual remiffion
of them, in confequence of the aftion of the remedies
employed in the courfe of the firft few days of the .dif¬
eafe. For in violent cafes, where the remedies have not
been applied fuflicientiy early or with fufficient vigour,
gangrene comes on very rapidly. That a gangrene has
begun, may be known from the fudden remiffion or cef-
fation of the pain, while the pulfe continues frequent,
and at the fame time becomes weaker; while other marks
of the finking of the powers of life in the whole fyftem
come on ; fuch as frequent fainting, flatting of the ten¬
dons, hiccup, a cadaverous appearance of the counte¬
nance, &c. Suppuration is a lefs frequent termination of
gaftritis, but dtcafionally occurs, and may be expected to
take place, when the fymptoms have continued, in a mo¬
derate degree, for more than one or two weeks ; and el-
pecially when there is a confiderable remiffion of the
pain, while a fenfe of weight and anxiety ft ill remain.
When an abfeefs is formed, the frequency of the pulfe is
at firft abated; but it foon again increafes, and frequent
cold ftiiverings, and marked exacerbations of heat and
feverifhnefs in the afternoon and evening, followed by
night-fweats, come on ; in other words, a heCtic fever
enfues. At length the difeafe commonly proves fatal,
unlefs the abfeefs open into the cavity of the ftomach, the
pus be difeharged by vomiting, and the ulcer foon heals.
There are, indeed, fome rare inftances on record, in which
the impofthume has burft externally, and not only the
pus, but the alimentary matters fwallowed, have pafled
out at the opening during the remainder of life. In fuch

cafesj

257

P A T H O L O G Y.

cafes, a previous adhefion of'the ftomach with the perito¬
neum had taken place by means of the inflammatory
procefs.-

We are not acquainted with any particular predifpofi-
tion to gaftritis in the firft inftance ; but, when the dii-
eafe lias once occurred, like mod: other inflammations, it
leaves a tendency in the part affedled to be more eafily
excited to inflammation again ; and therefore, fora long
time fubfequent to recovery, the utmoft caution, in re¬
gard to the ufe of irritating food and drink, is required.
The exciting caufes are, inch matters applied to the fto-
mach, as, from their fenfible, chemical, or mechanical,
properties, occafion violent irritation to the ftomach, or
injure its texture 5 or the inflammation is produced by
the extenfion of the difeafe from the neighbouring organs,
or from diftant parts; or frequently it follows luddenly
on the fecond variety.

When inflammation of the ftomach induces death, in¬
dependently of fuppuration or gangrene (which are not
the moll frequent terminations of the difeafe), lometimes
the inflammation is found, upon diffcclion , to havelpread
over a confiderable part, or perhaps the whole, of the in¬
ner membrane ; but moll commonly it occupies a fmaller
portion. The ftomach upon theoutfide, at the inflamed
part, ftiows a greater number of fmall veflels than ufu-al,
but is commonly not much crowded with them. On
opening the ftomach, it is found to be a little thicker at
the inflamed part, the inner membrane is very red from
the number of fmall florid veflels, and there are frequently
f'pots of extravafated blood. Portions of the inner mem¬
brane are fometimes deftroyed ; and fometimes a thin
layer of coagulable lymph is found thrown out upon a
portion of the inner furface of the ftomach. See Baillie’s
Morbid Anat. p. 138.

The treatment of acute gaftritis will neceffarily vary,
according to the nature of the exciting cauff, and to the
degree and duration of the difeafe, and to the circum-
. fiance of its being Ample or complicated. The leading
indication however, and the general plan, muft be the
fame as in all phlegmonic inflammations in their com¬
mencement; namely, to attempt the refolution of the
difeafe by depletion, together with the ftrift obfervance
of the antiphlogiftic regimen. Large bleedings inuft be
fpeedily employed, and repeated, if the urgency of the
fymptoms continue to require it, notwithftanding the
fmallnefs of the pulfe, the general debility, and even
difpofition to fainting. For, after bleeding, it is ob-
ferved that the pulfe commonly becomes fuller, and the
tendency to fyncope is diminiflied. In an inftance re¬
corded in the Edinburgh Medical Effays, the patient was
bled five times within feven hours, and was each 'time
fuddenly relieved from the acute pain ; the pulfe, before
irregular, became regular; and the cold extremities be¬
came warm. In delicate conftitutions, when the violence
of the inflammation has been reduced, but not altoge¬
ther removed, by bleeding, the application of leeches,
or of cupping-glafles, after ffarification, to the region of
the ftomach, may be occaflonally reforted to with advan¬
tage. A large blifter, applied to the pit of the ftomach,
after venefedtion, is likewile advantageous. In cafes
where a confiderable irritability of the ftomach, with
little or no adlual inflammation, exifts, and gives rife to
naufea and vomiting, the external agency of a blifter is
often the moll effectual remedy. It is perhaps advifable
to abltain altogether from taking any thing whatever
into the ftomach, Whether by way of medicine or ali¬
ment, until the violence of the inflammation be fome-
what fubdued, Ance thefe matters at flrft will produce vo¬
miting. In other cafes, where any thing can be borne
by the ftomach, liquids of the very mildelt kind, fuch as
milk arid water, thin gruel, See. muft be given, and in
very fmall quantities at a time.

Opiates, in whatever manner exhibited, are very hurt¬
ful during the flrft days of inflammation of the ftomach ;
but, when its violence has greatly abated, or the pain

and Acknefsrecur at intervals only, opiates may be cau-
tioufly adminiftered in clyfters. It is remarkable, that,
notwithftanding the ufually nau fearing effedt of antimony,
this fubftance may be given with advantage in gaftritis,
when combined with enough opium to reftrain its ac¬
tion. Adtive purges fnould be exhibited in clyfters till
the bowels are fully opened.

We are particularly cautioned in this complaint to
avoid a fudden return to full living, on account ot the
tendency of the difeafe to relapfe.

The fecond variety differs in its fymptoms, as it is
chronic or acute. Its acute form is ufually connected
with general inflammation of all the coats of the ftomach,
and hence its fymptoms are often the fame; yet it un¬
doubtedly may exift feparately, Ance fuppuration and
gangrene of the ftomach, leftons not very uncommon in
the flrft variety, are fcarcely ever met with in the acute
gaftric inflammations which are found in exanthems.
Its caufes are nearly flmilar to thofe of the other variety.

The firft fymptoin of Gaftritis erythematica is fome¬
times a violent vomiting refembling cholera morbus.
The patient throws up every thing that he fwallows ;
then bilious, mucous, or even fanguineous-looking, mat¬
ters; going very frequently to (tool at the fame time.
Fever is a neceflary accompaniment of this form of the
difeafe. Sometimes gaftritis declares itfelf without vomit¬
ing ; but always with violent pyrexia, often unpreceded
by a cold ftage or (hivering. The patient complains of a
burning internal heat, and generally of a forenefs in the
pharynx. The tongue appears red and clean, and the
thirft is confiderable ; the defire for cold acidulated drink
is as great as the averficn for every other kind of liquid.
If the phlogofis does not extend to the inteftinal tube,
there is conllipation. If it reach the colon, there is di¬
arrhoea with tenefmus. There is deep-feated pain in the
epigaftric, and efpecially in the right hypochondriac, re¬
gion, but not exafperated without a certain degree of
preffure. This pain isfometimes lancinating, and accom¬
panied by a fenfe of conllridtion. It manifeftly dimi-
nifties after the patient has fwallowed cold aqueous drink,
efpecially if acidulated. Very often the vomiting ceafes
in a few days, although the other fymptoms perfift. At
other times it continues, o^ fupervenes in the courfe of
the difeafe; and the patietit is haraffed with conftant
naufea, which appears to him to be occafioned by fome
globular body rifing upwards, aiul painfully com'prefting
the lower part of the cheft. Each fit of vomiting is fol¬
lowed by a temporary eafe of very ftiort duration, the
patient inceffantly demanding emetics ; a fymptom ft i H
more common in peritoneal inflammation than in acute
gaftritis. The abfolute impoflibility, which the patient
l'uppofes, of ('wallowing any thing, appears referrible to
the contradled and highly-irritabJe ftate of the upper
orifice of the ftomach. Such are the principal fymp¬
toms of uculq gajlrilis ; but feveral of them may beabfent;
even pain itfelf does not exift, in fome cafes, where
the inflammation is molt intenfe. Our diagnofis muff
therefore be aflifted by a rigid obfervance of the fympri-
thetic troubles produced by this phlogofed ftateof the
mucous membranes of the digeftive organs. The Jir/i
clafs of thefe appertains to the head, affedling the func¬
tions of the fenfes, and the movements of the voluntary
muffles. Head-ache may or may not exift. Aberrations
of the intellect, correfponding with the moments of
greateft buffering, are more Heady in their appearance.
“ I have feen,” fays Brouffais, “ men as completely
delirious as in fevers the moft malignant, or phrenitis it¬
felf.” In fuch cafes too, we often fee the conjundtiva
red, the eye inflamed, and the features altered. In pro¬
portion as the difeafe advances, and the bufferings in-
creafe, the attention becomes eftranged, till coma en-
fues. In the mean time we obferve irregular con tradf ions
of the facial muffles, grinding of the teeth, fubfultus
tendinum, and various convullive movements. The pa¬
tients throw off the bed-clothes when they are fenfible,

complaining

PATHOLOG Y.

258

complaining that the internal heat which devours them
is ten times more infupportable when the cheSl is covered.
They try all kinds of pofitions in bed 5 ligh deeply ; and
Show in their countenances the expreffion of intenfe
agony. If they are queftior.ed refpe&ing the nature and
feat of their pains, they apply the hand to the epigaftric
region, but cannot clearly defcribe their Sufferings ; the
fenfe of internal burning is the only one which is distinct
to them. We muft therefore ground our diagnolis on
the tout enfemble of the fymptoms, and efpecially on
the instantaneous relief produced by cooling drink.

In refpeCt to the refpiratory fyftem, we obfer/e fome-
times a cough, with teazing pain ; a glairy or mucous
expectoration Streaked with blood, or white, like that of
peripneumony, at the period of refolution ; a general
pain in the cheft 5 a laborious refpiration in fanguineous
fubjeCts. 1 The voice is often loft from a fympathetic pa-
ralyfis of the laryngeal muffles. During the firft days of
acute gaftritis, the pulfe is full, hard, and often as ftrong
as in pneumonia, particularly if the peCtoral fymptoms
above mentioned are prefent; a proof of fanguineous
plethora in the pulmonary parenchyma. In lighter
ihades of gaftritis, and when the vital powers have been
reduced by pain, the pulfe is Sharp, irregular, or even
intermittent ; towards the clofe of life, imperceptible.
Heat of lkin is confiderable, during the violence of the
acute ftage. M. Brouffais has always found it dry and harfti.
The lkin is cold when the difeafe is on the decline, and
cannot be brought to a natural warmth when the difeafe
is verging to a chronic Hate. The cutaneous fecretions
are fuppreffed ; and the breath is fetid in a few days
after the circulation becomes much increafed.

Chronic Gaftritis cry them atica. — This may be a primi¬
tive affeCtion, or the lequela of an acute attack. It is
produced by the fame caufes as the above-mentioned form
of the difeafe ; but, from peculiarity of constitution, or
force of caufe, it is unaccompanied by thofe violent com¬
motions in the fyftem which arrelfc the attention of the
other kind. The patient complains of pain acrofs the
bafe of the cheft, deep-feated in the epigaftric and hypo¬
chondriac regions ; generally more confiderable in the
right fide, and fometimes fo high up as to be thought in
the cheft. This pain is conftant and very troublefome;
fometimes burning, lancinating, pricking, and confined
to a very circumfcribed fpot, efpecially when the ftomach
contains any acrid or irritating fubftances. It is very
frequently accompanied by a fenfe of conltriCtion. Some
patients complain of feeling as though a ball of large fize
were prefling againft the diaphragm ; others as if a bar
were fixed acrofs the ftomach, preventing their fwallow-
ing food or drink. Gf all thefe fenfations, the lancina¬
ting and Hinging pains are thofe which acquire the great-
eft degree of iutenfity. The others are fo faint, that the
patient feldom demands relief from them till the ftrength
becomes conliderably reduced.

The appetite always fails; and, when the difeafe exifts
in its greateft degree, there is a general abhorrence of
food. When there is any remains of appetite, the digef-
tion is quite imperfeCt. Aliments are ufually thrown up
foon after eating ; efpecially if too much food, or food of
a ftimulating nature, have been fvvallowed. Thofe who,
from a milder degree of the difeafe, or idiofyncrafy of
ftomach, do not vomit, are opprefied, during the gaftric
digeftion, with a fenfe of load at the ftomach, naufea,
acid, corrolive, or fetid, eruCtations, rumination, and
exafperation of the ufual pain. There are fome patients
who only experience eruCtations, inquietude, and mental
perturbation. The pulfe rifes a little, and the fkin warms,
during gaftric digeftion ; but fink to their ufual level
when the digeftive procefs is finished. For a confidera¬
ble time the bowels are as coftive as though a fcirrhus of
the pylorus exifted ; but ultimately, in the majority &f
cafes, there is diarrheea, with colic, tenefmus, and ftools
mixed with blood-- a proof of the extenfion of the diff

eafe. Then the breath, and even the perfpiration, exhale
an odour manifeftly fteroraceous.

Thefe fufferings, even when not very fevere, are badly
borne by the fick, who become dejeCted, impatient, taci¬
turn, difcontented, and not difpofed to enter into the
details of their feelings. They have an air of fuffering
in their countenance ; the conjunctiva, lips, and cheeks,
being of a deep red colour, verging towards that of tinc¬
ture of logwood ; as are alfo the tongue and whole inte¬
rior of the mouth, excepting along the centre of the
former, where a thin mucous lift may be feen. In a few
fubjeCts the tongue is very much loaded, the breath of¬
fensive, and a bitter tafte is experienced in the mouth;
but thefe are exceptions, and the diagnofis muft be drawn
from the whole of the fymptoms, not from any one ex-
clufively.

As foon as this difeafe is completely eftabliftted, the
cellular and adipofe membrane becomes nearly abforbed,
with but little diminution of the muffles ; when thefe
laft are much extenuated, the difeafe is without hope.
At all times, however, the fkin is drawn tight over the
muffles, finking in in their interftices, fo that it cannot
be pinched up but with difficulty, even in thofe places
where it is ufually very relaxed. In no other fpecies of
maraffnus has M. Brouflais feen this degree of adhefion
fo ftrongly marked. This character of the lkin, toge¬
ther with its colour, being a brown, inclining to yellow,
offer two of the moll conftant diagnoftic Signs of chronic
gaftritis.

The pulmonary fyftem fuffers very little in this fpecies
of the difeafe, with the exception of a flight ftomach-
cough occafionally. Nor is the circulation fo much in¬
fluenced, at the beginning, as to evince any appreciable
febrile movement. When the difeafe has made progrefs,
then the pulfe becomes hard and frequent ; the lkin, at
the fame time, being hot, and dry to the touch. There
is always an evening exacerbation, with agitation and
reftleffnefs. If this train continues unchecked, proftra-
tion of ftrength foon enfues, and the gaftritis, in fa£t,
paffes info the acute form. If, however, the febrile
movement is only marked by frequency of pulfe, with¬
out heat of fkin ; or if the patient only experiences a few
hours of heat towards the evening, or during digeftion ;
the malady may continue chronic. In all cafes, if long
protraCted, the febrile fymptoms fubfide, and the evening
exacerbation ceafes to be fenuble. Then the fkin becomes
cold, and of the colour before deffribed, with percepti¬
ble wafting of the body. When diarrhoea is added, the
ceflation of pyrexial phenomena is ftill more fudden and
complete.

The treatment of the acute form of this variety is fimi-
lar to that of Gaftritis adhasfiva, except that cold lotions
at firft, and afterwards warm fomentations, are to be ap¬
plied to the epigaftrium inftead of blitters ; and local is
to fuperfede in a great meafure the general bleeding.
Cooling acidulated drinks and efferveffing draughts af¬
ford much gratification to the patient. Strong purges,
even when naufea is not prefent, are extremely hurtful ;
and, upon the whole, the practitioner is to be careful
not to give too much medicine.

As to the treatment of chronic gaftritis of the mucous
membrane, this mult be regulated by fomewhat fimilar
indications. The patient muft abftain from all animal
food and all indigestible vegetable fubftances ; thin gruel
and cold drinks, as weak folutions of nitre, the occa-
fional application of leeches and warm fomentation, with
laxative clyfters, forming the molt approved remedies.
This applies to chronic gaftritis when itaffumes the cha¬
racter of local pain and irritaffon, manifesting generally
a fenfe of burning at the pit 0/ the ftomach , redntfs of the
fauces, and factor of the breath. Another form of chronic
gaftritis, which Supervenes to long-continued nervous
irritation, has been mentioned under Dyfpepfia, where
it is deffribed as constituting the fecond ftage of that
4 complaint.

PATHOLOGY.

complaint. Chronic erythemata, or inflammation of the
ftomach, is no uncommon difeafe in this country, where
the common pradlice of purging dyfpeptic patients is
frequently adopted in it, and tends materially to increafe
its violence.

ii. Emprefma enteritis, inflammation of the bowels :
griping pain in the belly, with tenfion, tendernefs, and
vomiting ; fever a fynochus. This alfo has two varieties
diftinguifhed thus ; that one afteils all the coats of the
bowels, and the other only its mucous membrane.

a. E. adhsefiva. Pain very acute ; vomiting frequent;
obftinate coftivenefs ; fever violent.

When this difeafe attacks the fmall inteftines, it is at¬
tended with many of the fymptoms of inflammation of
the ftomach. There is acute pain fituated in different
parts of the abdomen, but generally about the umbilical
region ; it is conftant, but liable to exacerbations from
time to time, generally defcribed as of a twilling kind.
There is, in a marked degree, a painful expreffion of
countenance and manner, and difficulty of refpiration.
The general furface is at firfl fomewhat hot, but at length
the countenance and extremities become fhrunk, cold,
and perhaps affedled with cold perfpiration, and lividity.
The pulfe is frequent and fmall. The tongue is moift,
but not always free from load. The ftomach ufually
rejedts every article of food or of medicine. The bowels
are moved with great difficulty, but generally with
much relief. The abdomen in general becomes tumid
and tenfe, and exceedingly tender under prefl'ure.

An inflammation attacking the large inteftines isdif-
tinguifhed by pain ufually fituated in the hypogaftric and
iliac regions, or on one or other fide of the abdomen,
and gradually becoming more general : this pain is at
firft, perhaps, of a violent or fpafmodic charadler ; after¬
wards it is fixed, conftant, increafed under prefl'ure, re-
llrains the movements of the body, and, in fome degree,
cf refpiration ; and induces a ftate of continued and pain¬
ful contraction of the features. 4Tlie patient becomes
reftlefs, and throws the arms about. The furface is af¬
fedled as in inflammation of the fmall inteftines. The
pulfe is fometimes little accelerated, until the affedlion is
advanced. The tongue is moift, and whitifh or loaded.
There is often little or no vomiting. The operation of
purgative medicine is effective, but attended by an ex¬
cruciating pain, charadleriftic of this difeafe. Sometimes
the bladder feems to participate in this affedlion; and there
is a conftant defire, with ineffedlual efforts, to void urine.

Enteritis is much difpofed to terminate in gangrene,
an occurrence indicated by a fudden remiflion of the
pain, while, at the fame time, the ftrength fails, the
pulfe finks, the voice grows feeble, the countenance
fhrinks, and aflumes even a cadaverous afpeCt ; yet the
difler.tion of the belly is not diminifhed, but often in¬
creafed. This tendency to terminate fpeedily in morti¬
fication conllitutes the great danger of inflammation of
the inteftines. Sometimes the difeafe terminates in fup-
puration, which, though lefs rapidly fatal, mod common¬
ly wears out the patient’s ftrength and life in a lingering
manner ; but fometimes this condition ends in recovery.
The formation of pus is indicated in this difeafe, as in
other internal inflammations, by the remiflion, but not
total ceflation, of the pain, and by the occurrence of
frequent fits of rigor, and fometimes by a purulent dif-
charge by ftool. But the difeafe, efpecially when the aid
of medicine is early and adlively obtained, frequently
terminates favourably, by refolution, as it is called ; i. e.
by a gradual diminution and ceflation of the fymptoms.
If the pains abate gradually, and the tendernefs and dif-
tention of the abdomen leflen, while the pulfe becomes
fofter and fuller, natural evacuations of fasculent matters
are pafled, and a free general perfpiration breaks out,
this favourable termination may be anticipated. Where¬
as, the continuance of the conftipation and of the fixed
pain, the increafe of the ficknefs and vomiting, the oc¬
currence of the fymptoms juft defcribed as indicative of

Vol. XIX. No. 1301.

259

gangrene, efpecially if accompanied with hiccup and
cold fweats, are among the unfavourable prognoftics.

The principal fource of miftake into which the pradli-
tioner is likely to fall in treating this difeafe, is in con¬
founding it with colic ; a fpafmodic diforder, which re¬
quires a treatment efl'entially different, but which never-
thelefs occafionally terminates in enteritis. The diag-
noftic fymptoms of the two complaints have been already
Hated at length. See Coliea, p. 14.9.

The exciting caufes of enteritis are obftruCtions in the
bowels, which neceflarily retain the fasces, until thefe,
by their quantity or quality, become extremely irritat¬
ing, and excite inflammation ; or irritating fubllances
conveyed into the inteftine, which, by their bulk, fhape,
or indigeftibility, or by their chemical or fpecific acri¬
mony, produce excitement there. Thus, the fwallowing
of hard kernels, feeds, or ftones of fruit, of pieces of
metal, &c. has often induced the difeafe ; and the pre¬
fence of fcybala, or hardened faeces, and of calculous con¬
cretions, operates partly, by the immediate irritation
which they occafion. Thus alfo, llrong concentrated
acids or alkalis, fpirituous liquors, high-feafoned food in
large quantities, draftic purgatives, worms, &c. in the in-
teftinal canal, have excited inflammation in it in different
inftances. Hence the difeafe has fometimes been the im¬
mediate efteCl of repletion, or of a fit of intoxication -.
and even a mild cathartic, when the bowels were loaded
with much hardened faeces, which the medicine was in¬
capable of removing, has, in fome rare cafes, produced
inverted motion and intus-fufception , terminating in ente¬
ritis. A very common caufe of inflammation in the
bowels is the application of cold to the legs and feet, or
to the abdomen itfelf, efpecially if fudden or long con¬
tinued. Gout, rheumatifm, eryfipelas, or chronic erup¬
tions, are fometimes followed by inteftinal inflammation.
It is alfo a fymptom in hernia.

In the cure of enteritis, as in all other acute inflamma¬
tory difeafes, the leading objeCt is to remove the inflam¬
mation, from which all the other fymptoms of the dif¬
eafe originate. This, though apparently an identical
propofition, cannot be too llrongly inculcated, in the
treatment of enteritis; becaufe the exceflive conftipation
of the bowela, which, ifo common with the reft of the
fymptoms, is in general merely an efteCl of the inflam¬
matory condition of the bowels in fome part, is often at¬
tacked by the inattentive practitioner with aCtive purga¬
tive medicines, as if it were the primary objeCl, and the
fource of all the mifchief. The inflammation is to be
fubdued by blood-letting, from a large orifice, to an ex¬
tent which mull be various according to the conftitution
of the patient, and the violence of the fymptoms. This
depletion may be aided in its efteCts by tiie application
of leeches, and afterwards of a blifter, to the abdomen ;
and by the ftriCteft abftinence from all ftimularing ali¬
ment. The blood-letting mull be repeated in a ftiort
time, if the fymptoms do not abate, and the ftrength
of the patient is fufficient to fupport the evacuation;
which can only be determined by the obfervation and
experience of the practitioner. If the pulfe fliou'ld be¬
come fuller and lefs wiry after the operation, it will af¬
ford a ftrong reafon for the repetition of it, fiiould the
continuance of other fymptoms appear to require it. The
warm bath may be reforted to with advantage.

It mull be obvious, that before the inflammation of
the inteftines is leflened or removed by thefe meafures,
any additional irritation to the membranes, already in an
acute ftate of fenfibility, whether by the immediate fti-
mulus of a cathartic medicine, or by the contents of the
bowels being forced forwards to the inflamed part, muft
tend to aggravate the diforder, rather than to relieve it.
In faCt it is ufually found, that purgatives, given by the
mouth, are not fuccefsful, where this previous diminu¬
tion of the inflammation has not been effected. And,
when this has been accompiiflied, fome of the milder pur¬
gatives, as the neutral falts, fhould firft be admiuiftered,

3 X the

260 P A T H O

the action of the inieftines downwards being at the fame
time folicited by emollient clyfters, which alfo contribute
to the fame relaxant purpofes as the external fomenta¬
tions. A purgative medicine has often been known to
operate as foon as a blifter, applied to the belly, began to
rife, though it had not acted previoully : and this obfer-
vation is (till more commonly verified, after a free evacu¬
ation by blood-letting.

Though it is not advifable to irritate the bowels by
draftic purges, it is improper to allow conftipation to
continue in this complaint. Clyfters therefore, and the
following mode of purging, will be found ufeful. Five
grains of calomel may be given with one of opium ; and,
an hour afterwards, a large dofe of caftor-oil. This will
be retained on the ftomach in confequence of the feda-
tive operation of the calomel and opium ; and the bowels
will be opened without pain or irritation.

|3. E. erythematica, exhibits various gradations of fe-
verity of danger. It has already been amply treated of
under the heads of Diarrhoea and Dyfentery.

i2. Emprefma hepatitis, inflammation of the liver.
Tenfion, forenefs, and pain, in the region of the liver;
pain about the right fnoulder ; difficulty of lying on the
left fide. This fpecies has two varieties.

a. Hepatitis acuta : the fpecific character decifive, and
the fymptoms clearly marked.

(3. H. chronica : the fpecific character obfcure, and the
exiftence of the difeafe only to be fufpefted from an ex-
pofure to its caufes, and an occafional recurrence of the
pathognomonic fymptoms accompanied with a flight de¬
gree of fever.

The caufes of this difeafe are often obfcure. Befides
the ufual ones of Emprefma, we find hepatitis frequent
and fevere in fituations where extreme heat, or extraor¬
dinary viciffititdes of heat and cold, are met with. The
difeafe comes on with a fenfeof chillinefs preceding pain
in the right hypochondrium, fometimes dull, fometimes
fliarp, extending up to the clavicle and fhoulder of that
lide molt ufually, which is much increafed by preffing
upon the part; and is accompanied with a cough, opprel-
ii'on of breathing, and difficulty of lying, except on the
tide afrefted ; together with naufea and ficknefs. The
inteftines are generally inaftive, and the llools ffiovv a
deficiency of biliary lecretion, or at lealt of any inter¬
mixture of it with them ; the urine is of a deep faffron
colour, and fmall in quantity; there is lofs of appetite,
great third, and coftivenefs, with a ftrong, hard, and fre¬
quent, pulfe, of from 90 to 100 in a minute, and fome¬
times intermitting ; the Ikin is hot and dry at the fame
time, and the tongue covered with a white, and fome¬
times a yellowifti, fur; and, when the difeafe has conti¬
nued for forne days, the Ikin and eyes often become
tinged of a deep yellow.

The appearance of the blood is fomewhat remarkable
juft before it coagulates, when, the red part falling to the
bottom, and the buffy coat not yet being formed, it ap¬
pears of a dull green colour. This it owing to the mix¬
ture of the yellow-coloured bile with the purple-co¬
loured venous blood, as yellow' and purple form green :
the coagulable lymph contains none of the purple colour;
therefore the buffy coat is not green, but yellow. The
lame appearances are obferved in the blood of a perfon
labouring under jaundice.

In hepatitis, as well as in other fpecies of Emprefma,
we do not always find the fymptoms of the fame degree
of violence as they are defcribed in the definition : thus
in fome cafes the fever is fevere, in others it is fcarcely
perceptible : in fome inftances, the pain is very acute and
violent; in others, collections of pus have been found
after death, when no pain had been felt. When the
pain is feated deep in the fubftance of the liver, as that
poffeffes little fenfibility, the pain is ufually obtufe ; but,
when the furface is affeCted, it is acute, and apt to fpread
to the diaphragm and lungs, producing cough.

Many authors have made a diftinCtion between the

LOGY.

fymptoms that occurwffien the inflammation occupies the
convex furface of the liver, and thofe that are prefent
when the difeafe affefts the concave. It is faid, when
great difficulty of breathing, and cough, accompany the
pain in the region of the liver, that thefe fymptoms in¬
dicate the inflammation to be feated in the fuperior or
convex part ; but, where the inflammation occupies the
concave or inferior furface, which lies contiguous to the
ftomach and duodenum, there is more ficknefs and vomit¬
ing ; and moreover, the pain is not fo violent in that re¬
gion of the organ as in the other inftance. But thefe
fymptoms are not unequivocal.

Hepatitis, when it occurs in India, exhibits many ano¬
malies which are very unufual in this climate. Dr.
Johnfon, in his well-known work on Tropical Climates,
ftates, that in many cafes, if we expert to find the pa¬
thognomonic fymptoms of acute hepatitis, as it appears
or is defcribed in Europe, we (hall be greatly deceived.
“ In comparatively few inftances have I feen the violent
rigors, high fever, hard, quick, and full, pulfe, acute
pain, See. which we would naturally look for as preced¬
ing the deftruCtion of fuch a large and important vifcus.’*'

It accords, however, with Dr. Johnfon’s experience,
that fuch cafes do occur during the firft twelve or eigh¬
teen months after arriving in the country. He men¬
tions the cafe of a young gentleman, who, defpifingall
rules of temperance or precaution, ran about in the fun
for fome days at Malacca, indulging in all forts of li-
centioufnefs or inebriety ; and was feized, in a day or
two afterwards, with rigors and heat alternating ; fuc-
ceeded in a few hours by pain in the right fide, extend¬
ing acrofs the pit of the ftomach, accompanied with fome
difficulty in refpiration. He did not fend lor Dr. J. till
twelve or fourteen hours after the attack. He had then
high fever, hard quick pulfe, great dyfpncea, a (hort
cough, and the moft excruciating pain in the region of
the liver; and a flux foon terminated his life. But our
author met with few cafes in India fo exquilitely marked
with acute European fymptoms as this. In general, he
fays, the difeafe makes its approach in a much more quef-
tionable fliape, though equally pregnant with danger as
the foregoing, and not feldom more rapid in its courfe.
“A man comes to us, complaining of having a flux. He
fays he is frequently going to ftool ; that he is griped,
but paffes nothing but flime ; that his ftools are like wa¬
ter, or fome fuch remark. It is ten to one if he men¬
tions any other fymptom at this time. But, if we come
to interrogate him more clofely, he will confefs that he
has had fome forenefs at the pit of the Jlomach, or perhaps
in the right fide. If we examine the part, a fulnefs will
fometimes appear; if we prefs upon it, he Harts back, or
Ihrinks at leaft from the preflure. If we look into his
countenance, befides a certain anxiety we fliall obferve a
dark kind of fallownefs in his cheeks, and a yellowifti hue
in his eyes. The latter is feldom abfent in hepatic dif-
eafes, both in India and Europe. The temperature of
the furface will probably not be much increafed ; but the
Ikin will have a dry feel ; his mouth will be clammy, and
his tongue have a whitifh or yellow fur towards the back
part. His pulfe, though neither diard nor very quick,
will have an irritable throb, indicative of fome internal
affe&ion. His urine, if infpedted, which it always flsould,
will be found to tinge the bottom and fides of the pot
with a pink fediment, or turn very turbid a few hours
after it is voided ; and he will generally complain of
fome heat and fealdingin making water. Thefe are all
the external marks we can perceive ; and the few fymp¬
toms at the head of the lift are all that the heedlefs fol-
dier or failor has noticed, or at leaft recorded. Happily
for the patient, as well as his phyfician, the degree of
violence in the bowel-cornplaint, where other fymptoms
are not confpicuous, will be almoft always a fure index
to the rapidity or danger of that in the liver. Whereas
in thofe cafes where the fymptoms are of the violent or
European caft, particularly pain, fever, and dyfpncea.

PATHOLOGY.

the bowels are very frequently coftive for the firft few
days of the complaint. If it is not early checked, it will
frequently run on to fuppuration, and then the chance of
its pointing, or of the matter finding its way through
dufts or adhefions, with ultimate recovery, is faint indeed.
Other fymptoms will occafionally arife in this difeafe, or
accompany it from the beginning. Thus the fever is
fometimes fmart; the enlargement, hardnefs, or tender-
nefs, of the part, more violent; the inability of lying on
a particular fide may be complained of ; a (hort cough
may attend; or that particular fenfation in the acromion
fcapulte may be noticed, though it is not very often that
this lad is prefent, Thefe fymptoms, and the duration
of the complaint, will vary much. Indeed, the latter is
very uncertain ; as its continuance may be protrafted to
feveral weeks, without fuppuration or organic derange¬
ment of vital importance following. This, then, is the
hepatitis of India; and certainly there is no fmall diffi-
milarity in fymptoms between it and the acute hepatitis
of Europe. The flux, which may be termed the pathog¬
nomonic of the former is almoft always wanting in the
latter. The one (Indian) partakes more of inflamma¬
tory congeftion and obftruftion ; the other of aftive in¬
flammation, like that of the lungs, kidneys, &c.”

The cure of the acute hepatitis, as it occurs in this
country, may generally be effefted by the ufual cooling
and depleting plan. Bleeding local and general, blifters
over the region of the liver, brifk cathartics, and, when
the violence of the difeafe abates, the exhibition of mer¬
cury in full dofes, complete the lift of meafures this dif¬
eafe requires. In hot climates it will be necefi'ary to pufli
the mercury further, to begin with it earlier, and conti¬
nue it longer, than is requifite in the hepatitis of this
country. In the former lituation, indeed, it is often ne-
ceflary to adminifter calomel in fcruple dofes in the very
onfet of the difeafe; and bleeding need only be had re-
courfe to as an auxiliary. This, however, we by no
means intend to deny, that very extreme bleedings are
fometimes required in Indian dyfentery ; but mercury is
the chief dependance : this medicine muft be pulhed till
it produces falivation, and its aftion kept up till all vef-
tige of difeafe is extinft.

Acute hepatitis terminates when not cured, in fuppu¬
ration or gangrene. In this country, however, more
patients die of the inflammation itfelf than of its feque-
lae. Suppuration is moft common in hot climates. See
Apcjlema hepaticum, p. 230. But few cafes are known of
the occurrence of gangrene in the liver.

The fecond variety, or chronic inflammation of the
liver, is a difeafe which is more common in this country
than the acute; and is fo infidious in its progrefs as to
have fometimes advanced to complete diforganization,
before its exiftence was fufpefted. In fome meafure, in¬
deed, a fimilar obfervation applies to all the chronic de¬
rangements of the fubftanceof the liver, which often ex¬
cite no alarm, by the fymptoms which might be expedited
to accompany them, until they are fully formed. The
flightindifpofition that occurs is attributed to indigeftion,
flatulence, or fome other affeftion of the ftomach ; the
pain of which the patient occafionally complains is falfely
referred to that organ ; and its continuance is fo (hort,
and the degree of it frequently fo inconfiderable, as to
demand but a flight attention. The relief obtained by
eruftation and the difcharge of air alfo tends to confirm
the opinion, that the feat of the difeafe is in the Jiomach :
but this relief may be explained on the principle of re¬
moving the diftention of the ftomach, and fo taking off
the preflure of this organ from the liver.

While this flow inflammation and gradual obftruftion
is going on in the liver, the patient is fubjeft to occa-
fional pain in the right hypochondrium, extending to the
feapulae, or to the top of the ffioulder ; a quick pulfe, an
increafe of heat alternating with chilly fenfations, diffi¬
cult breathing on quick motion, fome difficulty of lying
on the left fide, flatulence, indigeftion, acidity, coftive-

261

nefs; and, together with a gradual diminution of ftrength
and fleffi, he has a pale or fallow complexion. The com¬
plexion, indeed, of a perfan—mTefted with chronic ob¬
ftruftion in the liver, although often not wearing the ap¬
pearance of jaundice, yet has frequently a peculiar fal¬
low n e Ts , or a dirty-greeniffi hue, which Dr. Darwin, from
its refemblance to the colour of a full-grown filk-worm,
has aptiy, though pedantically, denominated bombycinous.
The extent and duration of pains, Dr. Saunders obferves,
arifing from difeafe of the liver, are fo various, as fre¬
quently to deceive both the phylician and patient; they
extend to the flioulder, fcapulae, mufcles of the neck,
along the arm, even to the joints of the wrift. Every
change of pofture either relieves an old pain, or induces
a new one, as does the mere bending of the body in any
direftion, or even extending the arms. The pains are
greater in a fupine than in an ereft pofture.

Thefe fymptoms, and fome others which make their
appearance in the more advanced ftages, are fufficient to
point out the exiftence of chronic difeafe in the liver :
but it is to be regretted, that they are not peculiar to
chronic inflammation of that organ. ProfelTor Portal
points out fome difficulties in forming an accurate diag-
nofis between difeafes of the liver and of fome of the
neighbouring organs, efpecially of the lungs. He fays
that, on the one hand, obftruftions and congeftions in the
right lobe of the lungs, and the right cavity of the cheft,
fometimes occafion fuel) an alteration in the fituation of
the liver, by prefling down the diaphragm, as to produce
a fufpicion of difeafe in it, by occafioning the appearance
of a tumour in the right hypochondrium. He relates a
cafe of this fort, in which he was deceived by this apparent
tumour, in a patient who died of pulmonary confump-
tion, where little or no expeftoration took place: and
he cautions practitioners not to be milled by fuch an ap¬
pearance, which is common in all congeftions of the cheft.
He affirms, too, that a degree of jaundice is occafionally
produced, where the bile has free paffage into the intef-
tines, but is there detained, in confequence of mechani¬
cal impediments, as volvulus, ftrangulated hernia, accu¬
mulations of hardened faeces, &c. when it is taken up
by the lafteals, and enters the blood-vefi'els. On the
other hand, he remarks, if we fometimes attribute dif¬
eafes to the liver which have their feat elfewhere, there
are other maladies, aftually feated in the liver, which are
frequently aferibed to other organs. Thus the contigu¬
ous vifeera, fuch as the right kidney, the diaphragm, the
lungs, the ftomach, and the colon, are fometimes fup-
pofed to be affefted with difeafe, which is feated exclu-
fively in the liver. Many examples of this are to be found
in the writings of Morgagni and Lieutaud. Mr. Portal
relates two cafes of fevere and continued vomiting, con-
nefted with difeafed liver, the firft of which proved fatal ;
and the other was cured, in confequence of the leflfon
taught by the previous dilfeftion. An enlargement of
the liver was felt externally, with great tendernefs in
the epigaftrium. See Mem. de l’Acad. des Sciences,
Ann. 17775 or Mem. fur plufieurs Maladies, par Ant.
Portal.

It would take up much fpace to detail the immenfe
variety of organic lefions which are met with in the liver.
Some of thefe have been clearly accompanied or preceded
by chronic inflammation ; in others, the coincidence of
this aftion is doubtful. We ffiall not enter into any ac¬
count of them,fince we do not find that diagnoftic fymp¬
toms, diftinguifhing one particular degeneration of ftruc-
ture from another, can be laid down; and, moreover,
becaufe no curative indications can be founded even on
the flight hiftory of fymptoms with which pathologifts
have furniftied us. Indeed hydatids, various kinds of
tubercles, feirrhus, foftening of the fubftance of the or¬
gan, adhefion of its furface with contiguous parts, and
effufion from its invefting membrane, often produced over
the whole of the peritoneum, and giving rife to dropfy,
are more rarely followed by death than the former lefions,

which

262

PATHOLOGY

which are in fa£l almoft always fatal. We (hould except,
however, foftening of the liver, which is often unattend¬
ed with danger, or indeed indifpofition.

The caufes of this complaint are various, but the moll
frequent is indigeftion. It is remarkable that organic
alterations in the ftru£lure of the liver happen more fre¬
quently in drunkards than in thofe whofe hepatic func¬
tions are deranged from other caufes. The treatment of
this has in fome fort pre-occupied our pen while treating
of Dyfpepfia ; it may be fummed up in a few words. The
adoption of meafures which will enfure daily but mode¬
rate alvine difcharges; a ftridl regulation of diet, which
mull be very fparing ; otherwife, as the febrile fymptoms
are more clearly or more oblcurely marked, leeching to
the region of the liver or to the anus, or even general
bleeding if the hardnefs of the pulfe calls for it; and the
cautious introduction of mercurial medicines, which may
on fome occafions be puftied to the extent of falivation ;
form the whole of the treatment. If mercury is expell¬
ed to difagree with the conllitution, or if, after being
tried, it is found ufelefs, the nitro-muriatic acid both
offers a means of correcting hepatic derangement, plea-
fant in its modes of application, and often fuccefsful in
its effeCt. We have anticipated a full account of the
mode of applying it under the article Nitro-Muriatic
Acid, vol. xvii. p. 104.

In organic derangements of the liver, a regular and
ItriCt attention to what we call, for the fake of brevity,
the dyfpeptic treatment, with abllinent living, and, if no
great nervoufnefs be prefent, counter-irritation by means
of an iflue, offer the only means of palliation. The ad-
miniftration of mercury, fo commonly reforted to, often
aggravates the difeafe ; that is, if the alteration of ftruc-
ture be of long Handing; for, while nothing but coagu-
lable lymph is effufed in the interftices of the ftruClure
of the liver, falivation will undoubtedly be of much fer-
vice.

13. Emprefma fplenitis, inflammation of the fpleen :
heat, fulnefs, and tendernefs, in the region of the fpleen;
pain upon preflu re.

The fpleen is an organ which from its ftruClure is lia¬
ble to congeftion, or accumulation of blood, before aClual
inflammation occurs. Thus in the earlieft ftage of the
diforder, the organ is fwelled from the paflive ftate of its
veflels, which receive a greater proportion of blood than
they can return. No fever or pain accompanies this ftate,
but leads to inflammation by the tenfion and irritation
of the membranes that inveft the fpleen, a fenfe of ful¬
nefs in the left epigaftrium being the chief fymptom.

In the fecond ftage, the pulfe becomes quicker, and
it is long in convalefcence before it is reduced to its na¬
tural ftandard. The increafed pulfe is produced by pain¬
ful irritation at firft, and next by the aClual tenfion of
the membranes, proceeding to inflammation and adhe-
fion of the adjoining parts. The quicknefs of the pulfe
will aflift in diftinguiftiing the degree of progrefs of this
difeafe; for it will be found, by reference to hiftories,
that in a great proportion of cafes there was no warning
of the growing mifchief in the earlieft ftage; and that
painful affeClion of the left fide exifted in many other
cafes long before fever was induced, though thefe ended
fatally. In the firft ftage the patient can lie upon the
left fide, but not upon the right. In the fecond ftage it
is impoftible to lie on the fide afteCted. The fpafmodic
aClion of the diaphragm is more likely to come on in the
fecond ftage, and may be much aggravated by ftimulant
treatment. There is no emaciation in the firft ftage of
a morbid kind ; nor any confiderable emaciation in the
fecond ftage, notwithftanding the large and continued
evacuations.

In the third and lalt ftage of fplenitis, emaciation is
always an attending fymptom, combined with heCtic or
flow fever, particularly in middle-aged and elderly people.
In this third ftage diarrhoea fupervenes, as well as dylen-
tery, and difcharges of grumous and dark blood take

place, by vomiting and by ftools : thefe difcharges give
temporary relief in many cafes, and occur long before
the final event.

The treatment of this complaint is fimilar to that of
the other fpecies of this genus. Bleeding mud generally
be the firft ftep, to relieve the congeftion of the portal
fyftem, and draftic cathartics for the fame purpofes. A
derivation to the capillary fyftem of the fkin and mufcu-
lar fyftem muft be attempted by antimonials a^id the
warm bath ; but, after the bleeding, our chief dependance
muft be on draftic cathartics. Mercurial remedies are of
ufe if the fpleen becomes permanently enlarged.

The Splenalgia of authors is ufually a flight attack of
this fpecies with fome fmall degree of fever. Parabyfma
fplenica, or ague-cake, is a frequent fequel of Splenalgia.

14. Emprefma nephritis, inflammation of the kidneys ;
pain in the region of the kidneys and ureters ; frequent
mi&urition; vomiting; numbnefs of the thigh on the
afteCted fide; retraction of the tefticie.

The chief difficulty, in this complant, is to difcover
whether the inflammation be idiopathic, or whether it
arife from the irritation of calculi. The following
fymptoms, drawn chiefly from Dr. Hall’s work On Diag-
nofis, may afford fome information as to this dittinCtion.

Inflammation of the kidney is accompanied with a
pain in the lumbar region, and often along the courfe of
the ureter; a feeling of numbnefs of the thigh: retrac¬
tion and pain of the teftis ; there is a frequent defire
to void urine, which is ufually high-coloured. There
are generally naufea and vomiting; pain, and conftipa-
tion of the bowels. There is more or lefs of an expref-
fion of pain in the countenance. The motions of the
body are fomewhat impeded ; and certain motions are
particularly painful ; as bending to one fide, or lifting
up the thigh, efpecially if the hand be prefi'ed forci¬
bly on the knee at the lame moment. Preflure between
the fhort ribs and ilium, and fometimes along the courfe
of the ureter, induces an aggravation of the pain. The
general furface is foft, warm, but moift. The pulfe is
accelerated. Sometimes the pain and other fymptoms af-
feCt one fide only; fometimes both fides are affeCted.

Now, in calculus in the kidney or ureter, we find, at
fi rft, paroxi/fms of excruciating pain in thefituation of the
kidney or ureter, attended by great mufcularcontra&ion
of the countenance; dillortion of the body; holding
and forcing of the breath; copious perfpiration ; a fre¬
quent defire of micturition, or retention of urine ; the
urine itfelf is fometimes mixed with a mucous, puriform,
or bloody, fluid. The tongue and pulfe are little affeCt-
ed. Thefe paroxyfms are apt to be induced by the vio¬
lent motions of running, jumping, riding, See. Some¬
times the fymptoms of calculus are more infidious and
continued, and lefs violent. They are apt to afl'ume the
character of inflammation, or of chronic difeafe of. the
kidney.

When the kidney is chronically inflamed, it is attended
with fome of the fymptoms juft detailed, though in a
minor degree. At length perhaps a tumor is perceptible
on examination of the region of the kidney and of the
fpace between the falfe ribs and the ilium. Difeafe of
the kidney is diftinguiflied from organic difeafe of moll
of the other abdominal vifeera, by obferving that the de¬
gree of emaciation is much lefs, or its progrefs much
flower ; efpecially when the latter affections are attended
by an equal degree of fuffering. There is generally pale-
nefs of the countenance and general furface. The pulfe
is accelerated.

The terminations of nephritis are the fame as thofe
of other inflammations. In flight cafes, refolution
may be obtained ; but, where the difeafe has con¬
tinued with confiderable violence for upwards of a
week, fuppuration may be apprehended. It may hap¬
pen however, that, when the difeafe has been kept down
by proper remedies, refolution may take place as late
as the fourteenth day. It is marked by the difap-

pearance

PATHOLOGY. 2G3

psarance of the fever, and all the fymptoms. Suppura¬
tion is marked by a remiffion of the pain, with rigors,
throbbings, and lieftic fever: in fome cafes, pus is dif-
charged with the urine.

On the firft coming-on of this complaint, a quantity
of blood, proportionable to the feverity of the pain,
ought immediately to be taken away; and, if the firft
bleeding does not afford conliderable relief, the ope¬
ration fhould be repeated on the fame day, or on the next
at fartheft. Topical bleeding with feveral leeches will
alfo be proper.

After bleeding, fomentations and clyfters may be ufed.
The patient is at the fame time to be directed to drink
plentifully of barley-water, thin gruel, whey, or linleed
or marfh-mallow tea. The inteftines are to be emptied
by gentle purgatives, as frequently as the occafion may
require, in addition to emollient clyfters. The warm
bath, and diaphoretics, fuch as the faline medicine com¬
bined with naufeating dofes of tartarifed antimony, will
at the fame time be proper. When the febrile fymptoms
do not run high, and the inflammation has been fub-
dued by a vigorous adoption of antiphlogiftic remedies,
opiates may be ufed occaftonally to foothe pain, and may
be added to the clyfters. In nephralgia, they are very
important remedies, but not in pure nephritis.

In nephritis, the application of blifters is fometimes
pfoper. The cantharides ufed in them fhould be infil¬
led in boiling water, a mode of proceeding which de-
ftroys their irritating operation on the kidneys. If this
be not done, abforption of the bliftering-fluid will do
more harm than the local ftimulus will do good. To¬
wards the termination of the complaint, foda is a ufeful
remedy. The reader will find fome further ufeful re¬
marks on this complaint under the articles Nephritis
and Nephralgia, vol. xvi. p. 721.

15. Emprefma cyftitis, inflammation of the bladder:
pain and fweHing in the hypogaftric region ; difcharge of
urine painful or obftrudted ; tenefmus. It is often the
refult of wounds, fometimes of cantharides ; more gene¬
rally idiopathic.

The treatment of thisdifeafe is the fame as that of ne¬
phritis, except that drinking large quantities of fluid
muft be forbidden. Purging clyfters, containing opium,
fliould be injefted very freely in this complaint.

16. Emprefma hyfteritis, inflammation of the womb:
pain, fwelling, and tendernefs, in the hypogaftric region;
heat, pain, and tendernefs, of the os uteri; vomiting;
pulfe quick and low. It has two varieties.

a. H. fimplex, the organ being unimpregnated : pain
permanent, circumfcribed, throbbing; feveracauma.

B. H. puerperarum : pain lefs acute, lefs circumfcribed ;
flow of urine difficult ; fever a fynochus or typhus.

The uterus is obvioufly liable to fuffer inflammation,
like the other vifcera of the body, from the common
caufes of inflammatory difeafe. In the unimpregnated
date, however, it is lefs frequently attacked by this dif-
order than mod of the neighbouring organs ; and feldom,
if ever, is thus affedfted, except about the periods when
its veffels are in a Hate of increafed adfion, in confequence
of the occurrence of the menftrual difcharge. At thefe
periods, when not only the uterine fyftem, but the con-
ftitution in general, undergoes a flight erethifm, or ten¬
dency to febrile excitement, fudden expofure to cold,
violent exercife, great heats, or very high feeding, occa-
fionally bring on inflammation in the womb ; more efpe-
cially in females of plethoric habit.

The moll frequent caufe of inflammation of the womb,
however, is the irritation or injury which it is liable to
fuffer during the procefs of parturition or abortion ; oc¬
currences which arife from the preflure different parts of
this organ neceffarily undergo, during thefe procefl'es.
Perhaps the free difcharge of the lochia, which is a ne-
ceflary confequence of the feparation of the placenta,
anfwers the fecondary purpofe of local depletion, and
thus, like a copious blood-letting inftituted by art, pre-
Vol. XIX. No. 1302.

vents the evils which would otherwife be very likely to
enfue. This fuppofition is rendered farther probable,
from the circumftance that inflammation of the uterus,
when it comes on a few days after child-birth, is con¬
nected with a fuppreffion of the lochial difcharge.

Inflammation of the fubftance of the uterus ufually be¬
gins about the fecond or third day after deli very ; and is
firft known to exill by a fenfation of pain felt at the lower
part of the abdomen, which gradually increafes in vio¬
lence, and is diftinguilhable from after-pains by its con-
ftancy. After-pains are intermittent, like the pains of
labour, depending, like them, upon contractions of the
uterus ; but the pain of inflammation, arifing from the
uninterrupted adiion of the veffels, is neceffarily unre¬
mitting. The patient complains much of any preflure
applied externally to the region of the uterus ; and this
organ feels larger than common under the hand, as well
as much harder, refembling almoft a ftone in firmnefs.
Marks of conftitutional affeCtion foon appear in the ini
creale of heat over the whole body, a white and dry
tongue, third, head-ache, a hard, full, and ftrong, pulfe,
(when the difeafe occurs in full habits,) and in all cafes
a frequency of pulfe, from 100 to 120 ftrokes in a minute.
Very foon after the attack, theftomach is ufually affedted
with ficknefs and vomiting ; but this fymptom is not in¬
variable. There is commonly a confiderabie degree of
pain in the back, fhooting round the pelvis to the groins,
and down the thighs. Not only the lochial difcharge,
but alfo the fecretion of milk, is for the moft part in¬
terrupted. The bowels are varioufly affedted ; often
coftive in the commencement of the difeafe, but frequent¬
ly very loofe as it advances. The urine is commonly
high-coloured, depofiting fometimes a pink-coloured fe-
diment, when it can be feen unmixed with the uterine
difcharges. It will fometimes be found, when the dif¬
eafe has communicated with the neck of the bladder, or
when the uterus and bladder have fullered, that fuppref¬
fion of urine will take place, fo that the catheter muft be
employed two or three times a-day to draw it eft’. On
the other hand, we have feen the inflammation apparent¬
ly extend to the kidneys, in which cafe no urine was fe-
creted for two or three days ; yet the patient experienced
the fenfation of an urgent defire to make water, probably
from the inflammation being likewife communicated to
the neck of the bladder. If the inflammation is very
great, it may fpread to the peritoneum, covering the
lundus of the uterus, and lining the cavity of the belly ;
in which cafe there is great fwelling, tendon, and forenefs
of the belly; and other new fymptoms arife, fuch as cha¬
racterize the child-bed fever, defcribed under Parturi¬
tion, vol. xviii, p. 674.

In the progrefsof the difeafe, flight fliiverings frequent¬
ly take place at different times in the day, while the
acutenefs of the pain is diminilhed, and the face of the
patient becomes occafionally fluflied. Thefe fymptoms,
together with the increafed frequency and weaknefs of
the pulfe, mark the tendency of the difeafe either to
fuppuration, or to a dangerous failure of the vital
powers. The tongue puts on a fiery red orfcarlet ap¬
pearance, which is often followed by aphthae : fymptoms
of great general irritation l'ucceed ; and the patient is
often cut oft' in a ffiort time. Now and then, however, a
flow of fetid lochia relieves thefe fymptoms : the pulfe
becomes lefs frequent; the flufliings more rarely appear ;
the tongue grows paler, and the fkin, which before had
been hot and dry, now relaxes and is cooler; a fponta-
neous diarrhoea comes on, and the patient recovers.
The cafe is more favourable, and the profpeCt of recovery
greater, where thefe Ihiverings and flufliings have never
occurred; but where the uterus gradually becomes
fofter, and lefs tender on preffure, the lochial difcharge
returns in its ufual quality and quantity, and the fecre¬
tion of milk begins again.

As the difeafe is often extended to different organs at
the fame time, and the fymptoms muft neceffarily be
3 Y rather

PATHOLOGY.

264

rather complicated, the functions of all the fuffering or¬
gans being in, fome" meafurfe deranged, an accurate dif-
tinftion of the feat of the diforder is often difficult.
This, however, is the lefs important, as the fame reme¬
dies will remove the inflammation, in whichfoever vifcus
it may occur. Of thefe, blood-letting is the moll effica¬
cious ; and, even in the puerperal fate, in ftrong confti-
tutions, it fhould be early and liberally employed. In
the dil'eafe happening independent of parturition, it can¬
not be omitted with fafety, perhaps, under any circum-
ftances ; but the repetition of it mud be determined by
the conliitution of the patient, the violence of the fymp¬
toms, and the effeft of the previous bleeding on the dif-
eafe. It may frequently be found neceffary a fecond and
a third time. A blifter may be alfo applied to the belly,
as near the feat of the pain as may be. Gentle cathartics,
efpecially of the faline clafs, are evidently ufeful in the
cafe of hyfteritis unconnected with child-birth ; but, in that
which follows delivery, a courfe of purging is not to be
recommended. It is always right, indeed, in the firft in-
ftance, to procure two or three evacuations from the intef-
tines j but, afterwards, it will generally be enough to pre-
ferve the regular motions of the bowels, by giving, from
time to time, final! quantities of caftor-oil, ora little rhu¬
barb mixed with fome faline purgative. vVith a view of
producing a determination to the {kin, fmall dofes of an¬
timony and opium, or the compound powder of ipecacu¬
anha, with the addition of a little rhubarb, and an occa-
fional faline draught, may be ufefully adminiftered. In cafe
a fpontaneous diarrhoea ffiould come on, it fhould not be
interfered with, farther than taking care that the ftrength
of the patient be not too much reduced by it. Except
where there is reafon to fufpetl the exiftence of undi-
gefted or indigeftible aliment in the ftomach, the aftion
of vomiting fhould always be avoided; inafmuch as it
conflantly increafes the pain by the agitation which it
occafions, and the p refill re made by the mufcles of the
abdomen on the inflamed uterus.

It is fcarcely neceffary to add, that, during the whole
courfe of the difeafe, every thing heating and ftimulating
fhould be cautioufly avoided ; that the food of the patient
fhould be of a mild and digeltible nature, confifting of
liquid and vegetable fubftances, and her drink watery and
diluent, every fort of animal food, and of fermented and
lpirituous liquors, being abflained from.

As hyfteria occurs, both connected with and inde¬
pendent of parturition, particularly in thofe who indulge
in full diet, and in the ufe of heating food and liquors ;
fo the prevention of the difeafe mu ft depend principally
upon temperance and regularity in this refpefh In the
former cafe, this end may be obtained by attention to the
proper management of the woman both before and during
labour. See Clarke’s E flays on the Management of Preg¬
nancy and Labour.

The terminations of this complaint are fimilar to thofe
of the other fpecies of this genus.

17. Emprefma orchitis, (Hernia humoralis, and Inflam-
jnatio tefiium, of various authors.) Inflammation of
the teflicle. Pain and fwelling of the tefticle ; naufea
or vomiting; depreflion of fpirits 5 pulfe quick, feme what
low.

Subjefl: to the fame caufes of inflammmation as other
organs of the body, the teflicle is alfo extremely liable
to an inflammation vicarious with the urethra. Hence
its frequency in blenorrhcea. The firft appearance of
fwelling is generally a foft pulpy fulnefs of the body of
the tefticle, which is tender to the touch ; this increafes
to a hard fwelling, accompanied with confiderable pain.
The epididymis, towards the lower end of the tefticle,
is generally the hardeft part. The hardnefs and fwell¬
ing, however, often pervade the whole of the epididymis.
The fpermatic cord, and efpecially the vas deferens,
are often thickened, and fore to the touch. The fper¬
matic veins fometimes become varicofe. A pain in the
loins, and fenfe of weaknefs there, and in the pelvis, are

other cafual fymptoms. Colicky pains; uneafinefs in
the ftomach and bowels; flatulency; llcknefs, and even
vomiting ; are not unfrequenr. The whole tefticle is
Dwelled, and not merely the epididymis, as has been af-
ferted.

The treatment of orchitis, whether local or conftitu-
tional, does not differ eftentially from that of phlegmon
in general. The great fympathy between the ftomach
and the aftefled organ indicate the propriety of adminif-
tering naufeating medicines ; indeed the difeafe has been
cured by vomiting when other means have failed.

Genus VIII. Ophthalmia , [from oipSafyAo;, Gr. the eyr.]
Inflammation of the Eye. Generic charaiters — Pain and
rednefs 0/ the eye or its appendages ; intolerance of
light ; flow of tears, or other excited fecretion.

This Genus naturally follows the preceding, where
inflammations of various parts are treated of; “and might
perhaps,” Dr. Good obferves, “ have been placed as a
fpecies under Emprefma, in which cafe it fhould have
been written opthalmitis: but it has various characters
peculiar to itfelf, as well in regard to its fymptoms as to
the feat of the organ, which f'eems to entitle it to the
rank of a diftinft genus;” and accordingly he has divi¬
ded it into the following fpecies and varieties.

1. Ophthalmia taraxis, (Oph. membranarum, Cullen.)
Lachrymofe ophthalmy. The tunics of the eye-ball
chiefly inflamed : increafed fecretion of tears. Divided
into,

a. Mitis: limited to the furface ; pain paflable, with¬
out head-ache.

Acuta : extending to the lower part of the eye¬
ball ; fometimes commencing there; pain burning;
tears perpetual and acrid ; intolerable head-ache.

*. Ophthalmia purulenta, purulent cpthalmy ; the in¬
ternal furface of the palpebras afl’ociating in the inflam¬
mation of the eye-ball ; copious fecretions of a purulent
fluid. Four varieties.

«. Epidemica, Egyptian ophthalmy : epidemic ; in¬
flammation rapid and definitive ; head-ache intolerable ;
often fucceeded by delirium; at times remittent.

(3. Metaftatica : apparently produced by a fudden fup-
preflion of catarrhal, blenorrhoic, or other morbid dif-
charge. The fecretion often greenifh.

y. Intermittens : marked by regular intermifiions.
Nearly allied to the epidemic variety. Probably produ¬
ced by marfli miafmata.

S'. Infantum, purulent ophthalmy of new-born chil¬
dren : appearing fuddenly, and without any often Able
caufe in new-born infants: the palpebras florid, and pe¬
culiarly tumid.

3. Ophthalmia glutinofa, (Ophthalmia tarfi, Cull. Pfo-
rophthaltnia, Ware.) The inflammation chiefly feated on
the tarfus ; its febaceous glands fecreting a vifcous and
acrid fluid that glues and ulcerates its edges, and irri¬
tates the eye.

4. Ophthalmia chronica, blear-eye, or lippitude : eye
weak and weeping after the inflammation has cea fed ;
rednefs permanent, increafed by flight caufes. Often a
relic or fequel of the preceding fpecies ; and beft re¬
lieved by gentle ftimulants and aftringents, as cold wa¬
ter, folutions of camphor, zinc, alum, lead 5 flight ill j na¬
tions of French brandy, laudanum, or the nitric oxyd of
mercury in the form of an ointment.

Sometimes the eye a flumes a general rednefs without
pain, which is the Ophthalmia indolens of certain writers,

For the caufes and treatment of moft of the above fpe¬
cies and varieties, fee the article Ophthalmia, vol. xvii.
p. 528.

Genus IX. Calarrhu s, [Gr. from xctlet, and jut, to
flow.] Catarrh. This term, like Ophthalmia, has been
ufed in various fenfes and latitudes by different authors.
Schneider and Hoffman fhow a difpofition to extend it to
inflammation of mucous glands in general : and Parr,
enticed by fuch an example, has made it a genus for in¬
cluding

PATHOLOGY. 2G5

eluding not only what is commonly underftood by Ca¬
tarrh, but the cough ot‘ old age, (which he' admits is
without febriie aftion,) croup, dyfentery, phthifis, cyf-
tirrhcea, leucorrhcea, gonorrhoea, and one or two others.
This is the wideft acceptation of' the term: the narrow¬
ed is that of the old pathologifts, who thus diftinguiflied
between three feparate terms which are now regarded by
many writers as fynonymous :

Si fluit ad peffus, dicatur rheurna Catarrhns,

Ad fauces, Bronchus; ad nares, efto Coryza.

In the prefent fyftem, the following are the Generic
characters — Inflammation of the mucous membranes of
the fauces, often extending to the bronchia and frontal
fmufes ; infar&ion of the noftrils ; fneezing, and for the
moil part a mucous expectoration or difeharge from the
nofe. There are two fpedes.

i.Catarrhus communis, common catarrh, or cold in the
head ; in which the fever is flight, and the mucous dif¬
eharge confiderable.

Of thofe flight inflammatory affeCtions of the branchiae
which are familiarly termed colds , and which fpontane-
ottfly amend, we have already fpoken of under Bex
humida, p. 181. There are two remarkable varieties in
adute catarrh.

The firfl, which commonly appears during fudden
changes of fhe weather, generally attacks old people,
and thofe of phlegmatic habits. This difeafe often
deceives by the apparent mildnefs of its attack.
The febrile fymptoms are for the mod part not fevere
at firfl, when compared with thofe which ufually
attend pneumonia. The patient does not complain of
any fixed pain in the cheft, but of confiderable uneafinefs
and fenfe of flraitnefs there. He is affeCted with oppref-
fion about the pnecordia, and the countenance is expref-
iive of anguifh. To thefe fymptoms are added laflitude
over the whole body, and a general fenfe of weight and
tenfion over the bread. The refpiration is quick and la¬
borious. By degrees, from the accumulation of the fe-
cretions, the air-cells are more and more filled up, and a
wheezing noife comes on. Hoarfenefs, though not con-
ftantly, very frequently attends. The patient cannot
take a deep infpiration with the accuftomed freedom ;
and the attempt to do fo often brings on confiderable
cough, or increafes the pain, if any exifts. Early in the
difeafe, the dyfpnoea is not aggravated by lying down,
and no inconvenience arifes from turning on either
fide; but, as it advances, the refpiration is more free
in the ereCt pofture. In addition to this conftant dyfp-
ncea, there are cafes in which the patient is fubjeCt three
or four times in the day to an aggravation of the diffi¬
culty in breathing; a fudden conftri&ion acrofs the
thorax is complained of, which fometimes, extending to
the larynx, prevails to fo great a degree as to prevent
the voice from being articulate. In a flrort time, how¬
ever, fuch exacerbations remit, and the complaint re¬
lumes its continued form.

A cough is one of the firfl: fymptoms, and from the
commencement is ufually accompanied with flight ex¬
pectoration ; though in fome cafes, in the firfl ftage,
there is an unnatural drynefs of the parts. The expec¬
toration is always fcanty early in the difeafe, and does
not at all relieve the cough : but in a few days, if the
diforder begin to fubfide, a copious fecretion takes place
from the inflamed membrane, and a large quantity of
thick vifeid opaque mucus is fpit up : after which the
violence of the cough is ufually diminiflied. The cough
more frequently in this than in pneumonia excites vo¬
miting : this ufually relieves the bronchia of very confi¬
derable portions of denfe white mucus, which are fome¬
times moulded into the fliape of their ramifications.
The patient is frequently feized with fits of coughing,
which aggravate the dyfpncea ; and, after their violence „
lias fubflded, he is left almoft breathlefs, with a painful
I'enfation of flraitnefs acrofs the cheft. The urgency of

thefe fymptoms, however, gradually abates if another fit
of coughing do not difturb the refpiration. Yet the
dyfpncea, in many cafes of this difeafe, is by no means
proportional to the cough ; the latter being often flight
when the former is very fevere. The cough and dyfp¬
ncea are generally relieved by a copious expectoration,
and more efpecially in thofe who are in the decline of
life, and have been frequently the fubject of catarrhal
affeCtions.

In almoft every inftance the cough is accompanied
with intolerable pain acrofs the forehead, which may be
fympathetic, or it may be an aCtual extenfion of the in¬
flammation. In many cafes drowfinefs and vertigo at¬
tend. The tongue is often dry, and the whole mouth
feels clammy from vifeid mucus. The ftomach refufe.s
all fuftenance, and the third is urgent. The urine is
fometimes red and-turbid, depofiting no fediment; and
fometimes it is fcarcely changed from the natural ftate.
The frequency of the pulfe in the commencement
of the difeafe is often not much increafed; but during
its progrefs fome fulnefs and hardnefs are perceptible,
though, in the more ordinary examples, fulnefs is
more charafteriftic of this affeCtion than hardnefs ;
and in thofe whole conftitutions are impaired by hard
drinking, wdio are frequently attacked with this diforder,
the ftrength of the pulfe is often rather diminiflied than
increafed. The temperature of the body is feldom much
raifed, although the face is often fluflied, and evening
paroxyfms of heat and reftleffnefs come on. The furface
is generally dry, unlefs aCted upon by diaphoretic reme¬
dies. The blood drawn is, for the moil parr, buffed.

The duration of this difeafe is uncertain. It is often
difficult indeed to determine the precife time of its com¬
mencement, fo infidious is the attack. In fome cafes it
terminates in a few days, whilft in others it runs on to a
much longer period. In the more violent cafes, when the
remedies employed do not check the progrefs of the
fymptoms, the pulfe towards the feventii or eighth day
becomes very quick and much weaker; occafional per-
fpirations breakout, the nails and lips aft'ume a flightly
livid hue, and the countenance is diftreffed, anxious,
and pallid, with fomewhat of a purple tinge. In faCt,
every fymptom befpeaks obftruCtion in the air-paflages.
Soon afterwards the extremities grow cold, and the pa¬
tient dies from fuffocation.

In cafes of a lefs dangerous nature than above alluded
to, the more diftreffing fymptoms begin in fix or feven
days to fubfide. The dyfpnoea becomes lefs urgent, the
cough is relieved, and a copious expectoration of a thick
white matter takes place. But the recovery is always
flow', the expectoration continuing for fome time, and ge¬
nerally preventing the patient from recovering his ftrength
for feveral weeks. Moreover, in this ftate of the difeafe
the bronchial membrane is particularly liable to be af-
feCted by atmofpheric changes; and thus, not unfrequent-
ly, a chronic affeCtion of a very obftinate nature occurs.
If, however, the weather be favourable, after the worff
fymptoms have been removed, the difeafe often gradually
dilappears ; but not without leaving the mucous mem¬
brane much difpofed to take on inflammatory aftion,
which will almoft inevitably occur when the exciting
caufes again operate in any confiderable degree.

Inflammation of the bronchia, when it takes place in
the ltrong and plethoric, ufually produces fymptoms of
much greater feverity. The pulfe, the furface, and the
tongue, all ufually indicate violent reaction ; but the
countenance is often peculiarly pallid. The progrefs of
this variety of catarrh is more rapid than that of the one
before fpoken of. Even in this, however, there is rarely
a fixed pain in any part of the cheft, but a diftreffing
fenfe of Jlraitnefs is conftantly felt. The breathing is
hurried and laborious, the patient only experiencing to¬
lerable eafe in an ereCt pofture. A cough almoft con¬
ftantly attends, but it feldom bears any proportion to
the dyfpncea; the former being often trifling when the
/ latter

266 PATHOLOGY*

latter is very opprefiive. Some ex peroration is generally on immediately after the difappearance of any affe&ion

prefent in the early ftage of this difeafe; and its ceflation,
if the dyfpncea continue, is one of the word figns, as it
(hows that there is not ftrength enough remaining to
enable the patient to relieve the cheft from the matter
which is poured out into the bronchia; it muft confe-
quently accumulate, and at length entirely fill them and
the air-cells. The {kin, lays Dr. Badham, is dr}', the
tongue foul, and the urine high-coloured and fcarce ;
the pulfe, however, varies in other refpefts, always hard,
the neceffity of immediate venefeftion for the mod part
obvious. Wheezing is not fo confiant an attendant on
this as on the firlt variety. It is chiefly noticed towards
the clofe of the difeafe.

The ftage of excitement, if not met by appropriate re¬
medies, almoft invariably terminates in a corretponding
finking. of all the powers of the fyftem : dyfpncea takes
place; the lips become purple ; the pulfe finks, and is
much increafed in frequency ; the heat of the furface is
greatly diminifhed ; the {kin is generally damp, and the
forehead and chin are bedewed with cold perfpi ration.
Expe&cration, from being copious, becomes fcanty, or
altogether ceafes ; and the patient dies from the accu¬
mulation of the fecreted fluids in the air-cells. The vio¬
lence of the dyfpncea, and the tendency of this difeafe to
terminate fatally as early as the fifth or fixth day, form
its moll flriking features.

When vigorous meafures are early employed, fo as to
make an impreflion on the conftitution, thefe dangerous
fymptoms occafionally give way. The dyfpncea abates;
the conftriftion acrofs the cheft fubfides ; the cough is
relieved, being attended with a more copious and thicker
expectoration, which affords much relief. The pulfe,
the furface, and the tongue, become more natural, and
by degrees the patient is free from prefent danger. The
great debility which has been induced, however, necef-
i'arily renders recovery very flow; and frequently a te¬
dious chronic difeafe enfues, which is charadterifed by a
frequent and violent cough, and a very copious expec¬
toration of a pus-like matter. The pulfe is greatly
quickened, the face is often flufhed, particularly towards
evening, and in the night partial perfpirations break
out. To thefe fymptoms is fometiines added extreme
emaciation : indeed almoft all the fymptoms of a fuper-
vening phthifis appear, and the death of the patient feems
inevitable.

The difcrimination of acute catarrhus from pneumo¬
nitis is difficult ; and thefe difeafes cannot be always dif-
tinguifhed from each other. The countenance is fre¬
quently pallid in catarrhus ; it is not fo in pneumonitis.
The dyfpncea and anxiety are more diftrefling in the for¬
mer difeafe than in the latter. Pain is feldom com¬
plained of in catarrhus, a diffufed forenefs of, or a pe-
cuW&r Jhaitnefs acrofs, the cheft being alone felt; whilft
pain almoft conftantly attends pneumonia. When the
expectoration commences, it is much more copious in
inflammation of the bronchial membrane than in inflam¬
mation of the fubftance of the lungs or pleura. The
wheezing noife which almoft conftantly attends fome of
the varieties of inflammation of the bronchia is feldom
heard in that of the lungs. There is fomething alfo pe¬
culiar in the refpiration in almoft every inftance of acute
catarrhus ; it is hurried and anxious ; and, as Dr. Bad¬
ham obferves, the efforts of all the voluntary mufcles
that can be called into adtion render the opprefled ftate
of the lungs fufficiently evident. The anxiety of coun¬
tenance is much greater in catarrhus than in pneumoni¬
tis. The pulfe is alfo different in bronchial inflamma¬
tion ; it is frequent, but it wants the hardnefs and vibra¬
tion of the pleuritic pulfe.

We may likewife be aided in forming our djagnofis
by attending to the origin of the difeafe. If the pedto-
ral attack fucceed to rubeola, it is more than probable
that it is feated in the bronchial membrane. In the
fame manner, if difficulty of breathing and cough come

4

of the fkin, there is good ground to fufpedt that the
mucous membrane lining the air-paflages may be in a
ftate of difeafed adtion. In variola, when much difficulty
of breathing occurs,' it is probable that inflammation of
the bronchial membrane may have taken place. In
chronic ulceration of the trachea, when any fudden at¬
tacks of difficult breathing happen, and continue for
fome time, it is likely that the more minute air-paffages
are inflamed.

The danger from acute catarrh is different in the dif¬
ferent varieties ; but it is true of both, that, when the
breathing is not very difficult, the cough not fevere, the
expedtoration copious and free, and affording relief, the
pulfe regular and firm, and not very frequent or hard,
and the ftrength not much reduced, the prognofis is not
unfavourable. When the breathing is very high and la¬
borious, a degree of coma fupervenes, the nails become
livid, and the voice is hoarfe and indiftindt : when the
anxiety and fenfe of oppreflion are very great, and the
pulfe weak, quick, and fluttering, the fatal event will
almoft inevitably occur. There are few difeafes, how¬
ever, in which the prognofis is more uncertain than in
the firft variety of bronchitis. Our chief dependence
may be placed on the ftate of the expedtoration. When¬
ever the difeafe terminates favourably, the expedtoration
is free and copious ; and, in proportion as the danger
increafes, the lungs become more opprefled, the expedto-
ration fcanty, and the debility great.

When bronchitis attacks the ftrong and plethoric, the
danger is feldom equivocal. No inflammatory affedtion
of the pulmonary organs is more frequently fatal than
this. There is much to dread, even if vigorous meafures
be employed at an early period. The fenfe of conftridtion
acrofs the cheft ; the hurried, anxious, and laborious,
breathing; the cough without much expectoration, the
dry and hot fkin, the foul tongue, the high-coloured
urine, and the quick pulfe, indicate the feverity of the
inflammation. The prognofis is more favourable if the
breathing be relieved, and the cough be attended with a
free expectoration. But it is much worfe if we obferve
the fiighteft purple tinge on the cheeks, or if the expec¬
toration diminifli, and the breathing beeome more diffi¬
cult; or, finally, if the eyes be rather prominent, and
the patient alternately reftlefs and lethargic. The cafe is
altogether hopelefs when the pulfe becomes quite feeble
and frequent ; or when partial fweats break out, and the
expectoration ceafes. In young children, the prognofis
is more unfavourable than at any other age.

Catarrhus arifing from cutaneous difeafes is more dan¬
gerous than that proceeding from cold.

The following is a concife view of the means we have
recourfe to for removing thefe inflammatory affedtions.
To moderate the excitement of the fanguiferous fyftem,
general blood-letting, and abltinence from all ftimulat-
ing food. To promote expedtoration and perfpiration,
antimonial and faline medicines. To direCt the fluids
towards the furface, and relieve the congeftion of the
debilitated capillaries, local blood-letting, blifters, and
rubefacients. The above means are general and local.
Of thofe which are general, blood-letting is by far the
molt powerful for diminiftiing the excitement of the fyf¬
tem ; but it is not equally called for in all the varieties
of bronchitis. In the firft variety, where the difeafe oc¬
curs in phlegmatic habits, venefedtion is generally proper;
but, on account of the peculiar habit of body, blood¬
letting fliould be employed with caution ; for Sydenham
obferves, (and all fucceeding writers have admitted the
accuracy of his obfervation,) that patients of this de-
fcription do not bear bleeding well. The abftradtion of
ten ounces of blood from the arm early in the difeafe,
fometimes mitigates the fymptoms ; after which it is ge¬
nerally more fafe to depend upon an attention to diet,
proper expectorants, and local evacuations. The pecu¬
liar tendency to effufion often renders the treatment of

PATHOLOGY. 2G7

this affedtion difficult, as we are fometimes deterred by
that caufe from purfuing the blood-letting when the in¬
flammatory fymptoms indicate its employment. In this
event we mull fubdue the inflammation by thofe means
which are lead: likely to bring on effufion.

Catarrhus, however, as has been noticed in the hiftory
of the fecond variety, fometimes occurs in robuft habits,
and occafions violent fymptoms. The flage of excite¬
ment in thefe cafes is not of very long continuance; it
foon terminates in irremediable debility. The flrort
fpace of time that is allotted for the employment of an-
tiphlogiftic meafures fltould not, therefore, be allowed to
pafs without an attempt to make a decided impreffion on
the difeafe. With this view, blood-letting fltould be
holdly employed. From twenty to thirty ounces of
blood may be taken from the arm in fevere cafes, at the
firft blood-letting. It is difficult, however, to diredl the
precife quantity of blood. If the patient be of a ftrong
habit, and the pulmonary fymptoms urgent, and the fe¬
brile excitement confiderable,we fhould allow it to flow till
the pulfe becomes weak, or the pulmonary fymptoms are
relieved. There are few cafes which yield to one blood-let¬
ting. The propriety of its repetition fhould be determined
by the degree of benefit obtained, the date of the fymptoms,
and the ltrength of the patient. Several blood-lettings
are fometimes required. When the difeafe attacks chil¬
dren, general blood-letting fhould be employed as far as
the ftrength will admit. In young children we cannot
always obtain blood from the arm, but we may generally
fucceed in taking it from the jugular vein. This prac¬
tice, indeed, is attended with forne advantage, as the
blood is taken from a vefiel which pours its contents in¬
to the thorax. For the moll part, however, children do
not bear the lofs of blood well; but in an attack which
is menacing life there is no alternative: we mull adopt
powerful meafures, for without them the difeafe will al-
moft certainly prove fatal ; but fuch is its dangerous
charadlei^ that even by them its progrefs is often not
arrefted. When bronchitis is complicated with chronic
difeafe of the trachea, blood letting to any great extent
cannot be always employed ; for, if ulceration of the
trachea have come on, the ftrength is often fo much ex-
liaufted by it, that the lofs of any confiderable quantity
of blood is not admiffible. Even if relief be obtained by
thefe means, it can only be temporary, unlefs the ulcer¬
ation can be removed. Bronchitis arifing from the irri¬
tation of external tumours requires venefedfion ; but this
remedy cannot give efteblual relief, unlefs the caufe pro¬
ducing the inflammation can be taken away.

Vomiting is fometimes productive of relief. Several
writers have fpoken very lv.ghly of the ufe of emetics in
the fecond variety. The aqueous folution of tartarized
antimony is in general, perhaps, the bell remedy for pro¬
ducing it, although in young children it is not fo fafe as
ipecacuanha, which, in them, fliould be confequently
preferred. Independently of the adlion of the former as
an emetic, it feldom fails to excite diaphorefis, which if
general, and not too profufe, nor brought out by heating
meafures, is ufually beneficial. But the good effedts of
antimonials are not confined to thofe cafes in which we
wifh to produce vomiting. In every variety of acute ca¬
tarrh, when there is much fever prefent, the greateft ad¬
vantage is derived from the fteady ufe of antimonials.
They are indeed the mod valuable of all medicines; for
they not only, by exciting naufea and opening the pores
of the fkin, confiderably leffen the febrile excitement,
but, by their adlion on the exhalant vefiels of the lungs,
they promote expectoration, and thus leffen the inflam¬
mation of the mucous membrane. They may be given
in combination with faline draughts and nitrate of potafs.
In the advanced ftage, when the inflammation is nearly
fubdued, and the bronchia are clogged, ipecacuanha
combined with fquills is often of great fervice ; but in
all cafes of this difeafe, as long as the excitement is con-

Vol. XIX. No. 1302.

fiderable, if antimonial remedies be excepted, no expec¬
torants are fo ufeful as mucilaginous mixtures.

In every variety of bronchitis, we fltould keep the body
lax ; and, in the commencement of the difeafe, fhould
adminifter an adlive purgative, fo as to clear the alimen¬
tary canal, and fliould afterwards fo employ it as to keep
up a due adlion of the bowels. Opium is prejudicial as
long as there is much fever; but, when that declines,
and irritability of the fyftem and air-paffages Hill prevails,
it not unfrequently allays the cough, and calms the pa¬
tient. But opiates mull be employed with great caution,
efpecially in the fecond variety ; for when the fecretion
is copious, and the ftrength much reduced, they inter¬
rupt, for a time, the efforts to expedlorate, and may thus
prove fatal. In combination with fmall dofes of calomel,
opium may fometimes be exhibited at an earlier period
of the difeafe. When conjoined, thefe remedies not only
diminifh the cough and aflill expectoration, but feem
likewife to regulate the fecretions throughout the fyf¬
tem. Diuretics have been advifed by fome writers of au¬
thority ; and, when the difpofition to effufion fiiow's it-
felf, the milder kinds may be of confiderable fervice.

Local blood-letting fhould be ufed under the fame re-
ftridfions as in other inflammations. Blifters are pro¬
ductive of great benefit after the excitement has been
confiderably relieved by blood-letting. But when ca¬
tarrh occurs in phlegmatic habits, and affumes the form
of peripneumonia notha, bliftering may then be employed
from the commencement, and is one of the remedies to
be chiefly relied on in the cure of that variety. If the
difeafe be obftinate, we fhould not be content with a
fmall blifter to the chell; one of fufficient fize to cover
the whole of its anterior part fliould be applied ; and, if
the fymptoms do not readily yield, the difcharge from
the bliftered part fliould be fupported, or a fucceffion oj|
blifters employed. ”

The tepid bath often relieves this as well as other in¬
ternal inflammations, by removing the tenfion of the
furface, and exciting diaphorefis. Local fomentations
and cataplafms may be alfo ufed : they bring a larger
quantity of blood into the vefiels of the integuments co¬
vering the thorax, and encourage a more copious effufion
of blood from the leech-bites. When the difeafe be¬
comes chronic, thofe remedies are to be had recourfe to
which we have mentioned when treating of chronic ca¬
tarrh. See p. 183 of this article.

The diffedlions of catarrhal fubjedls manifeft morbid
appearances in the following order: Rednefs of the
bronchial membrane'; w'ant of elafticity in the lungs ;
mucous, fanguineous, or purulent, exhalation; ulcera¬
tion of the bronchias ; a rednefs or other morbid ap¬
pearance of the fubftance of the lungs, fhowing the exig¬
ence of pneumonia and bronchitis.

Dropfy and a variety of dyfpeptic ailments are fome¬
times aflociated with Catarrhus; the dropfy as a con-
fequence, the dyfpepfia a caufe, of the pulmonary 'dif¬
eafe. Of the dyfpeptic bronchitis we have fpoken under
Dyfpepfia ; and the latter does not require a diftindt
treatment. The fame remark is applicable to the ca¬
tarrhus attending meafles and other exanthems.

2. Catarrhus epidemicus, the epidemic catarrh, or in¬
fluenza : attack fudden ; great heavinefs over the eyes ;
fever ftrikingly depreffive; epidemic.

For an excellent Chronological Table of the bell
writers upon the fubjedl, from the Cronica Meteorologica'
Tufcana of 1323, by Targioni Tozzetti, to Saillant’s
Tableau des Epidemies catarrhales, fee Cullen’s Synop-
fis, in loco. It appears, from what can be gathered from
thefe fources, that the influenza was a calarrh which was
no otherwife diftinguiffied from the firft fpecies than by its
feverity and its being contagious. Dogs and horfes are
fubjedl to a violent and frequently fatal variety of this
difeafe ; in molt inftances highly contagious or epidemic.
This, among ourfelves, is vulgarly known by the name
3 Z of

PATHOLOGY.

268

of dijiemper, or fnuffles : among nofologifts it is called
Catarrhus caninus. Dr. Good mentions it as a fingular
well-afcertained faft, that dogs which have undergone
this catarrh never generate lyfla, or canine madnefs,
though they are capable of receiving it by contagion.

Genus X. Sparganojis , [Gr. from o-wapyaw, to tumefy
and diftend ; tumeo et dijlentus fum, as rendered by Sca¬
pula.] Generic characters — Pale, tenfe, glabrous, diffufed
fwelling of a limb; great tendernefs ; inflammation fub-
cutaneous, unfuppurative. There is only one fpecies.

Sparganofis puerperarum, milk-fpread, or Phlegmafla
dolens : occurring, for the moft part, during the fecond
or third week after child-birth ; limited to the lower ex¬
tremity, and chiefly to one fide ; exhibiting to the touch
a feeling of numerous irregular prominences under the
fkin: fever a heCtic.

This complaint is not always confined to the puerperal
ftate, but it is fo in moft cafes. In about twelve or fif¬
teen days after delivery, the patient is feized with great
pain in the groin of one fide, accompanied with a confi-
derable degree of fever, which however is feldom prece¬
ded by rigor or fhivering. This part foon becomes af¬
fected with fwelling and tenfion, which extend to the
labium pudendi of the fame fide only, and down the in-
fide of the thigh, to the ham, the leg, the foot, and the
whole limb: the progrefs of the fwelling isfo quick, that
in a day or two the limb becomes twice the fize of the
other, is moved with great difficulty, and is hot and
exquifitely tender, but without any external appearances
of inflammation. The pain in the groin is generally
preceded by a pain in the fmall of the back, and fome-
times by a pain at the bottom of the belly on the fame
fide; the parts which fuffer the moft pain are the groin,
the ham, and the back part of the leg about its middle.
The pain indeed extends over the whole limb, in confe-
quence of the fudden diftention ; but in a day or two it
becomes lefs fevere. The fwelling is general and equal
over the whole limb ; it is much harder and firmer than
in anafarca, in every ftage of the diforder ; it is not fo
cold, in any ftate of the difeafe, as the dropfical fwelling,
nor fo much diminifhed by a horizontal pofition, neither
does it pit when prefled upon by the finger, nor does any
water ifl'ue from it when it is punCtured by means of a
lancet. The furface is very fmooth, fhining, and pale ;
and is even and equal to the touch in every part, except
where the conglobated glands are fituated, which in fome
cafes are knotty and hard, as in the groin, the ham, and
about the middle of the leg at its back part.

This diforder generally comes on in the fecond or early
in the third week after parturition. But Mr. White
mentions one inftance in which it commenced as early as
twenty-four hours after delivery, and another as late as
five weeks: but thefe are rare and extreme occurrences.
The difeafe fubfides in the following order: firft the
pain and fwelling of the groin and labium pudendi, be¬
gin to remit, next thofe of the thigh, and laftly thofe of
the leg.

The fever in fome patients fubfides in two or three
weeks, in others it continues fix or eight weeks, attend¬
ed with quick pulfe and heCtic fymptoms. The difeafe
fometimes attacks both extremities ; but this rarely hap¬
pens, perhaps not in one cafe in ten. After the diforder
lias exifted a week or two, it is not uncommon for the
found leg to fwell towards evening, and become cedema-
tous ; but then the groin and thigh are not affeCled on
that fide, and the leg is much fofterto the touch than the
other, and pits when prefled upon by the finger. Mr.
White (Inquiry into the Nature and Caufe of that Swel¬
ling in one or both of the Lower Extremities, which
fometimes happens to Lying-in Women, 1784), affirms,
that he has never known it to fuppurate or prove fatal,
or to be followed by any material inconvenience, after a
few months were elapfed, except a little fwelling of the
leg after fatigue, particularly after walking.

The caufes of this difeafe are not very obvious. It
attacks women who are in full llrength, and thofe who are
reduced by flooding; thofe who have a moderate dif-
charge of the lochia, and thofe who have a fmall or a large
quantity; thofe who give fuck and thofe who do not,
whether their breafts be drawn or not, and whether they
have a great deal or little milk. It attacks women in
whatever pofition they have been delivered ; but of thofe
who were delivered on the fide, it appears that th'e great¬
er number were affeCted on that fide in which they lay
at the time of delivery. It attacks women of all ranks
and of different habits, both the rich and the poor; the
moft healthful, as well as thofe who have laboured under
chronic difeafes : the ftrong and the weak, the lean and
the corpulent; the fedentary and the aCtive; the young
and the middle-aged ; after the firft or any other labour,
and whether the labour be natural or preternatural. It
happens at all feafons of the year indiferiminately ; and
in the country as well as in large towns. It never attacks
either of the arms, or other parts of the body; and,
though it fometimes occurs in both the lower extremi¬
ties, in the fame or in different lyings-in, it never at¬
tacks the fame limb more than once.

The complaint feems to confift of an inflammation
feated in the mufcles, cellular membrane, and interior
furface of the fkin, which produces a rapid effufion of
ferum and coagulable lymph from the exhalants into the
cellular membrane of the limb. Dr. Hull, in his learned
treatife on Phlegmatia dolens, divides the difeafe into
three ftages ; and treats the firft, or inflammatory, ftage,
upon antiphlogiftic principles, applying leeches and blif-
ters to moderate the local aCfion ; and emollient fomen¬
tations, liniments, and ointments, to relieve the tenfion
of the fkin. The fecond ftage does not require or bear
evacuations ; but the other parts of the antiphlogiftic
treatment, fuch as reft, the removal of irritations, gentle
diaphoretics and fedatives, the warm bath, &c. mult be
continued ; and the topical affection is to be remedied by
gently ftimulating liniments. The third, or afthenic,
period, requires the adminiftration of tonics and ftimu-
lants, and exercife, efpecially in a carriage ; while at the
fame time the topical affection mult be treated by the
application of a tight bandage, by the cold bath, or cold
water dafhed on the limb, and by remedies which may
increafe the aCtion of the abforbents, fuch as blifters,
friction, heat, ele&ricity, See. and by the internal medi¬
cines which excite abforption, fuch as mercury, digi¬
talis, alkalies, Sec. Thefe remedies, particularly the
evacuants, will of courfe be regulated according to the
vigour and habit of the patient.

Genus XI. Arthrofia, [Gr. from uffyov, a joint.] Arti¬
cular Inflammation, or Joint-ache. Generic characters
— Inflammation moftly confined to the joints, feverely
painful ; occafionally extending to the furrounding muf¬
cles. This genus contains four fpecies, including gout,
rheumatifm, Sec.

The nature of neither gout nor rheumatifm is precifely
known. The capfules of joints, the fheaths of tendonr,
and indeed of the tunica propria mufculorum, appear to
be the parts chiefly affeCted ; and it feems alio, that in¬
flammation is the affeCtion in queftion. The difeafes,
however, of rheumatifm and gout vary in their antece¬
dent and concomitant fymptoms, and alfo in regard to
the morbid depofitions to which they give rife. It does
not feem clear, however, that either of thefe difeafes is
unconnected with conftitutional malady; becaufe arte¬
rial inflammation of the membranes of the joints is not
always attended with the fymptoms of gout and rheuma¬
tifm. The connexion of gout and indigeftion has been
long obferved ; and, from all we have been able to ga¬
ther, this connexion has been almoft invariable. The
difeafe has, in the majority of cafes, attacked ple¬
thoric and intemperate perfons ; and even the exceptions
which have happened have always prefented patients,

who

2G9

PATHOLOGY,

who from mental exertions, from hereditary predifpofi-
tion, or from tome other of the numerous caufes of indi-
geftion, have had the abdominal vifcera difordered. In
fpeaking of Dyfpepfia, we have before dated, that it was
capable of producing nervous irritation in many parts of
the body, and that, if it continued very long, was very
violent in degree, or if the fanguineous fyltem was debi¬
litated, it would produce inflammation. This it feems
to do in gout. We infer that it does fo, becaufe dyfpep¬
fia always precedes gout. It does not indeed appear that
it is the long continuance or the violence of the nervous
excitement which is the caufe of the inflammation, fince
neither the one nor the other is often prefent. We mull
look, therefore, to the fanguineous fyltem, which w’e
believe will in all gouty cafes fie unufually full, and its
contained blood will be unnatural.

We are quite unable, in the prefent (late of our know¬
ledge, to fhow why the inflammation attacks the limbs
and joints rather than other parts; but we are equally ig-
norantof thecaufes which determine other inflammations
to particular parts of the body. We conclude, then,
that gout is a difeafe of irritation, in which the inflam¬
matory a&ion is brought on by diftant diforder. It is
no argument againft the theory in queftion, that many
patients are quite free from fymptoms of indigejlion during
an attack of gout ; becaufe, as we have before Ihown un¬
der Dyfpepfia, inflammation being eftabliflied in a diftant
part, it a&s as a counter-irritant to the original difeafe,
as when long-continued indigeftion brings on inflamma¬
tion of the lungs, and the dyfpepfia goes off. Rheumatifm,
on the other hand, feems lefs conne&ed with indigeftion.

Having indulged in thefe few remarks, and being on
the whole quite difi’atisfied with our progrefs in the
aetiology of either gout or rheumatifm, we lhall proceed
to detail their fymptoms and cure.

i. Arthrofia acuta, acute rheumatifm : pain and in¬
flammation, ufually about the larger joints and furround¬
ing mufcles, often wandering; urine depofiting a lateri-
tious fediment ; fever a cauma. Four varieties.

a. A. artuum : pain chiefly felt in the joints and muf¬
cles of the extremities.

(3. A. lumborum, lumbago: pain chiefly felt in the
loins ; and (hooting upwards rather than below.

y. A. coxendicis, fciatica pain chiefly felt in the
hip-joint ; producing emaciation of the nates on the fide
affeCted, or an elongation of the limb.

<?. A. thoracis, fpurious pleurify: pain chiefly felt in
the mufcles of the diaphragm; often producing Pleuritis
diaphragmatica.

This divilion into varieties is rather nominal than real ;
and all the diftinclions of rheumatifm required by prac¬
tical men is that of acute or chronic, or combined with
gout.

Acute rheumatifm begins, like moll other febrile dif-
eafes, with fits of chillinefs, which are fucceeded by in-
creafed heat, frequent pulfe, third, lofs of appetite, and
proftration of ftrength. Not unfrequently, however, the
peculiar fymptoms appear before any febrile fymptom is
obferved ; namely, pain and inflammation in the joints.
The pain fometimes affefts the joints alone ; but often it
afteCts alfo the mufcular parts, fhooting along the courfe
of the mufcles from one joint to another; and it is al¬
ways increafed by the aCtion of the mufcles, that is, by
any attempt to move the joints that are difeafed. Its ufual
feat is in the larger joints, fuch as the hips, knees, (hould-
ers,and elbows: the ankles and wrifts are alfo frequently
attacked ; but the fmaller joints, fuch as thofe of the toe-s
and fingers, fuffer confiderably lefs. Two, three, or more,
of thefe joints, are commonly affe&ed at the fame time ;
but the pain is conftantly fliifting its place, leaving fome
joint and going to another, and frequently returning
again to each of them feveral times during the courfe of
the difeafe; and in this manner the difeafe is often pro-
traded for a confiderable length of time. Soon after,

and fometimes at the fame moment with the commence¬
ment of the pain, the joint feized becomes fwelled and
foinewhat red, and is extremely painful to the touch. The
pain is fometimes relieved by the occurrence of fwelling,
but not always ; neither is the joint thus rendered more
fecure from a return of the attack. The patient, thus
unable to move the joints affeded, which are irritated
and acutely pained by external contad, fometimes even
by the weight of the bed-clothes, and in a ftate of fe-
vere internal pain, unable to find any pofition of eafe,
lies fleeplefs and reftlefs for feveral days and nights toge¬
ther. The fever accompanying the difeafe is molt confider¬
able during the night, at which time the pains alfo are moll
violent. The pulfe is commonly from ninety to a hun¬
dred in a minute, and occafionally more frequent ; often
full, and fometimes hard and (harp, but molt frequently
foft. The heat of the fkin is confiderable, and the dif¬
eafe is commonly attended with fweating, even from an
early period, which is often profufe and con Hunt, but
never either relieves the pains permanently or proves a
crifis to the fever. The urine, in acute rheumatifm, is
remarkably high-coloured from the beginning, and after¬
wards depofits moft copioufly a brownifh-red fediment,
like brick-duft. This fediment, however, is probably
the refult rather of the profufe fweating than of any pe¬
culiarity belonging to the difeafe ; fince it is commonly
feen after a dole of fudorific medicine, or any other va¬
riety of perfpiration. Like the fweating, it does not oc-
cafion or betoken any favourable change in the fever.
The blood exhibits, in a high degree, the buffy coat.

With the fymptoms above detailed, the rheumatic fe¬
ver often continues for feveral weeks: it feldom, howe¬
ver, proves fatal, and perhaps never while the joints
alone are the feat of the difeafe ; the fever, indeed,
ufually becomes lefs violent after two or three weeks,
and the pains lefs fevere, and lefs difpofed to change
their place. But occafionally the inflammation of the
joints has difappeared, and fome vital organ, as the brain,
lungs, or ftomach, has been feized with inflammation,
by which the patient has been carried off ; or thefe organs
have become fimultaneoufly affe&ed, and the fame fatal
event has enfued.

It has been remarked by Dr. Cullen, as indicative of
the peculiar nature of rheumatic inflammation, that the
acute rheumatifm, though it has fo much of the nature
of the other phlegmafiae, differs from all thofe hitherto
mentioned in this, that it is not apt to terminate in fuppu-
ration. Indeed this hardly ever happens in rheumatifm :
but the difeafe fometimes produces effufions of a tranf-
parent gelatinous fluid into the (heaths of the tendons.
He fays, “ if we may be allowed to fuppofe that fuch ef¬
fufions are frequent, it muftalfo happen that the effufed
fluid is commonly re-abforbed ; for it has feldom hap¬
pened, and never indeed to my obfervation, that confi¬
derable or permanent tumours have been produced, or
fuch as required to be opened, and to have the contained
fluid evacuated. Such tumours, however, have occurred
to others, and the opening made in them has produced
ulcers difficult to heal. (Firft Lines, par. 448.) The non¬
occurence of fuppuration in thefe violent rheumatic in¬
flammations is of itfelf a ftriking charaCteriftic of the dif¬
eafe ; and the circumftance, that it is not productive, on
the other hand, of what are called chulk-Jlones, or of
that cretaceous-like fecretion which is the refult of the
inflammation of gout,' diftinguifhes it from the latter
malady. In addition to this circumftance, however,
there are other points of diftindtion between the gouty
and rheumatic inflammation ; namely, that the latter
ufually attacks the large joints; that it is not preceded
by fymptoms of indigeftion ; that it does not recur in
regular paroxyfms ; and that it attacks younger people,
and thofe not liable to gout from their modes of life ;
and that is ufually the effeCt of a fpecific caufe, cold.

The predifpofing caufes of rheumatifm, are plethora

and

270

PATHOLOGY.

and the other caufes of inflammation in general. Males,
and thofe between the time of puberty and thirty years
of age, are the moll liable to acute rheumatifm.

2. Arthrofia chronica, chronic rheumatifm : pain,
weaknefs, and rigidity, of the larger joints and furround¬
ing mufcles; increaled by motion; relieved by warmth ;
fpontaneoufly or eafily growing cold ; fever and fwelling
flight, often imperceptible.

The varieties are the fame as thofe of the preceding
fpecies, of which Cullen regards the difeafe as a mere fe-
quel. It appears however at times to be idiopathic ; but
it is often difficult to draw the line between the two;
and indeed a variety of links conne6l acute and chronic
rheumatifm together. In moll inftances, chronic rheu-
matifm is the direct confequence of an attack of the
acute form of the difeafe. The febrile fymptoms, the
fwelling, and particularly the rednefsof the joints, have
difappeared, and the general functions have refumed their
healthy condition ; but Hill certain joints continue to be
affefled with pains and ftiflhefs, which are particularly
felt on motion, and are often accompanied by a fponta-
neous coldnefs, and a torpor fometimes almoft amounting
to paralytic. Thefe affe&ions are much influenced by
the changes in the temperature and humidity of the at-
mofphere; and are diltindtly aggravated by external cold,
and relieved by external warmth. The parts affefted are
not eafily made to perfpire; fo that, when the other
parts of the body are brought into a Hate of free and
warm perforation, that on the pained joints is only cold
and clammy. The pains are alio, like thofe of acute
rheumatifm, moll fevere in the night.

This chronic affeftion of the joints, however, is very
often altogether independent of any previous inflamma¬
tion and fwelling, and occurs in many perfons who have
never been fubjeft to an attack of acute rheumatifm. It
occurs, indeed, very frequently in perfons fomewhat ad¬
vanced in life, and beyond the period when the acute form
of the malady is ufually feen. In thefe cafes it is commonly
afcribed totheadion ofcoldjvery often to partial expofures
of the particular parts of the body in which it takes its feat ;
and it is apt to be produced again and again in thofe parts
which have oncefulfered from expofure of other parts of
the body to cold. Thus, getting the feet wet will in¬
duce an attack of lumbago, fciatica, or a crick in the
neck, according to the predifpofition induced in thefe
relpe£live regions by former attacks. Many cafes of
chronic rheumatifm, are afcribed, however, to violent
ltrains of the mufcles of particular parts, occurring on
fudden and fomewhat violent exertions, and even to
fatigue from long-continued exertions of particular
mulcles.

As to the treatment of rheumatifm, this is different
according to the ftage of the malady. In the firft llage
of rheumatifm, free general bleeding mud be had recourfe
to, followed by purgatives and local bleeding. When
the difeafe is mitigated by thefe meafures, our endeavours
may be direfted to the abatement of pain by means of
opiates ; and alfo to the cure of the difeafe by certain
remedies empirically adminiftered ; of thefe cinchona and
opium have the greateft reputation. Indeed fome prafti-
tioners have recommended thefe drugs at the onfet of
the difeafe. This feems to us highly improper. The ob-
je£l of cinchona can only be to ftimulate the veflels of
the inflamed membrane, with a view to the recovery of
their na'tural powers ; nor can opium be any further ad-
vantageoufly exhibited than as it affuages pain, and thus
removes one of the conditions of inflammation. Seeing
the difpofition of rheumatifm to fuffer metaftafis, we
(hould be very careful not to remove, by any other than
conftitutional remedies, the local affeftion. Cold lotions
may be ufed however to abate the violence of the inflam¬
mation.

When the rheumatifm has become chronic , the curative
meafures mull be changed. We fliould remove occafion-
ally general plethora ; but our attention lliould for the

moll part be dire6led to the nervous fyftem ; and we IhalS
find topical remedies by no means ufelefs. In addition
to the rigid adoption of the dyfpeptic treatment, a free
ufe of guaiacum Ihould be relorted to ; or in fome cafes
fmall dofes of antimony, calomel, and opium, w'ith warm
fomentations to the affedled joints.

When the fymptoms are mitigated, counter-irritants
may be ufed with advantage. Some other fubllances
have been employed, with occafional fuccefs, in the cure
of different cafes of chronic rheumatifm, which do not
appear to poffefs any quality in common, and the opera¬
tion of which, therefore, cannot be fatisfadlorily ex¬
plained. Among thefe we may mention Jutphur, which
has long poffeffed a fort of popular reputation for the
cure of lumbago, and fome other varieties of the difeafe.
Taken nightly in a confiderable dofe, fo as to afl gently
upon the bowels, it has fucceeded, in fome inftances, in
affording a very fpeedy and marked alleviation of the
fymptoms; but, on the other hand, it has very often
failed to produce any effedt whatever; and under what
circumftances thefe refpe£live variations in its operation
occur, no one has been able to afcertain.

As another expedient for the cure of chronic rheuma¬
tifm, the arfenical folulion of Dr. Fowler has been recom¬
mended ; and, if plethora and dyfpepfia be removed, it
may be employed with fafety, and, as it feems to us, with
fuccefs.

The warm or tepid bath, from the temperature of 85°
to 950 of Fahrenheit’s thermometer, has been much ufed,
but feems to be fomewhat fuperfeded by the application
of the vapour of hot water to the furface. Dr. Bardfley
fays, “ whenever the joints were found fo rigid as to be
nearly immoveable, and the pains upon motion exquilitely
fevere, or when the mufcles had become contracted and
almoft paralytic, and indeed in every protradled cafe of
the difeafe of the hip-joint, lumbago, or fciatica, the va¬
pour of hot water, locally and properly applied, afforded
(efpecially in conjunction with other topical applications)
a fa fie and often fuccefsful remedy.”

As counter-irritants in chronic rheumatifm, bliftering,
iffues, or the ointment of emetic tartar, have been em¬
ployed with highly-beneficial effeCts. In flight cafes,
rubefacients, or thofe fubllances which ftimulate the cuta¬
neous veflels, and excite a rednefs of the furface by cau-
fing them to be diftended with blood, will be found ufe-
ful, efpecially when their operation is aided by friction.

Among other llimulants which have been employed
for the cure of chronic rheumatifm, efpecially in thofe
cafes which are obftinate and of long duration, or are ac¬
companied by confiderable torpor and rigidity, and a di¬
minution of the vital heat, the influence of the elcflric
and galvanic fluids has been reforted to ; and many tefti-
monies might be adduced in proof of the beneficial ope¬
rations of both thefe agents. Dr. Bardfley affirms, that
the application of eledlricity by fparksand Ihocks, elpe-
cially the former, was manifeftly advantageous; at the
fame time he acknowledges, that it was chiefly in con-
jundlion with the local application of vapour, and with
tonics and anodynes adminiftered internally, that the
moll marked advantages were produced.

3. Arthrofis podagra, the gout : pain and inflamma¬
tion chiefly of the fmaller joints, returning after i ntervals ;
often preceded by, oralternating with, unulual affections
of the llomach, or other internal parts; unfuppurative.
Three varieties.

a.. P. regularis : the articular pain, fwelling, and in¬
flammation, confiderable; continuing for feveral days,
often with remiffions and exacerbations; then gradually
difperfing, and leaving the conftitution in its ufual or
improved health.

/3. P. larvata ; difguifed and lurking in the conftitution,
and producing derangement in the digeftive or other
funftions, with only flight and fugitive affe&ion of the
joints. •

y. P. complicata : the difeafe fixing on fome internal
2 organ,

PATHOLOGY.

organ, inftead of on the joints ; or fuddenly transferred
from the joints after having fixed there; producing, in
the internal organ affedted, debility or inflammation ac¬
cording to the ftate of the conftitution.

The gout fometimes comes on fuddenly, without any
warning of its approach ; but it is generally preceded by
feveral fymptoms, efpecially by thofe of indigeftion, as
heart-burn, flatulence, and heavinefs after meals, with
erudlations of acid or bitter matters, and fome degree o
languor and torpor of the body; but immediately before
the fit the appetite is fometimes unufually fliarp. There
is alfo often an unufual coldnefs of the feet and legs for
a few days preceding the fit, with the ceffation of the
perfpiration about the former ; a frequent numbnefs, al¬
ternating with a fenfe of prickling, along the whole of
the lower extremities ; occafional cramps of the mufcles
of the legs, and an unufual turgefcence of the veins,
are occafionally obferved.

The attack is fometimes felt in the evening, but more
commonly about two or three o’clock in the morning;
when the patient is awakened from a quiet fleep by a
pain affecting one foot, generally the ball or firft joint of
the great toe, but fometimes the other parts of the foot,
or the ankle. This pain is accompanied with more or
lefs of chillinefs and (hivering, which, as the pain in-
creafes, gradually ceafe, and are fucceeded by a hot ftage
of pyrexia, or fymptomatic fever, which continues du¬
ring the fame time as the pain. The pain becomes by
degrees more and more violent : at firft it is attended
with a fenfation as if warm water were poured upon the
membranes affedted, and is faid to refemble the pain of
a diflocated joint ; as it becomes fevere, it is fometimes
defcribed as refembling the pain of a tenfion or lacera¬
tion of the ligaments, fometimes as like that from the
gnawing of a dog, and fometimes as a feeling of weight
and conftridtion of the membranes of the part, which be¬
comes fo exquifitely tender, as not to endure the weight
of the bed-clothes, nor even the (baking of the room
from a perfon walking brifldy in it. Hence, great reft-
leffnefs of the whole body, and efpecially of the part af¬
fected, always accompanies the fit ; the patient conftantly
changing his pofture, with a view to eafe the pain, which,
neverthelefs, continues fevere all the following day, un¬
til midnight, after which it gradually remits : and about
two or three in the morning, that is, after twenty-four
hours from the firft attack, it commonly c'eafes almoft
entirely; and this freedom, with the breaking out of a
free perfpiration, allows the patient to fall afleep. On
waking, he finds the pain (light, and the part affedted
with fome rednefs and fwelling.

When a paroxyfm has thus come on, although the
violent pain, after the period of twenty-four hours, be
confiderably diminifhed, yet the patient is not entirely
without pain. For fome days he has a return every eve¬
ning of pain and fever, which continue, with more or
lefs violence, till morning. After continuing in this
manner for feveral days, the difeafe fometimes goes off
entirely, not to return till after a long interval ; and in
fuch cafes it generally leaves the perfon in very perfedt
health, enjoying greater eafe and alacrity in the functions
both of body and mind than he had for a long time be¬
fore experienced.

It often happens, however, that the difeafe does not
thus fpeedily quit the patient, efpecially when he has pre-
vioufly fuffered confiderably from its attacks. For, in-
ftead of ceafing altogether after a few days, it feizes the
other foot in the fame manner as it did the former, both
in refpedt to the vehemence and duration of the pain.
Mod commonly the foot firft affedted becomes quite eafy,
in fuch a cafe, and even as ftrong and healthy as if it had
not been difeafed ; but fometimes both feet are affedted
together, and with equal violence. When this happens,
the fucceeding exacerbations, as Sydenham remarks, are
lefs regular, both as to the time of coming on, and as
to their continuance; but the pain always increafes in

Vol. XIX. No. 1302.

27 L

the evening and remits in the morning; and what is
called a Jit of the gout, which goes off fooner or later,
according to the age and conftitution of the patient, is
made up of a number of tliefe little fits. For, when this
difeafe lafts two or three months, it is not to be efteetned
one continued fit, but rather a feries or affemblage of
fmall fits, the laft of which proves milder and (horter,
until the whole is terminated. In ftrong conftitutions,
and fuch as have the gout feldom, the attack is common¬
ly finilhed in fourteen days ; but in thofe of advanced
life, or who have frequent returns of the difeafe, thefe
feries of fits will continue for two months ; and in fuch
perfons as are more debilitated, either by ag® or the
long continuance of the diforder, it will not go off till
the fummer advances, (beginning, as is mod common,
in January, or early in February,) which feems to drive
it away.

When the fit is going off, a violent itching feizes the
foot, efpecially between the toes ; and the cuticle peels
off. The appetite and ftrength return fooner or later,
according to the greater or lefs feverity of the preceding
fit, and the-interval of health between the paroxyfms is
generally nearly in the fame ratio ; i. e. longer in propor¬
tion to the greater violence of the laft fit. At the begin¬
ning of the difeafe, Dr. Cullen obferves, the returns of
it are fometimes only once in three or four years ; but af¬
ter fome time the intervals become (horter, and the at¬
tacks become annual ; afterwards they come twice each
year, and at length recur feveral times during the whole
courfeof autumn, winter, and fpring ; and as it happens
that, when the fits are frequent, the paroxyfms become
alfo longer, fo, in the advanced ftate of the difeafe, the
patient is hardly ever tolerably free from it, except, per¬
haps, for two or three months in fummer.

Before the difeafe becomes thus inveterate, however,
it has gradually aftumed other appearances, and attacked
other parts of the body. At firft it commonly affedts
one foot only ; but afterwards every paroxyfm affedts
both feet, the one after the other, and then both toge¬
ther ; and its changes of place as it continues to recur,
are not only from one foot to the other, but alfo from
the feet into other joints, as the hands, wrifts, elbows,
knees, &c. fo that there is fcarcely a joint in the body
that is not, on one occafion or other, affedted. It fome¬
times feizes on two different joints at the fame time; but
more commonly it is fevere in a (ingle joint only, and
paffes fucceflively from one joint to another; fo that the
patient’s affliction is often protradted for a long time.
The pains, indeed, are commonly lefs violent, in this
ftate of the difeafe, than they were at firft ; but, in addi¬
tion to them, lofs of appetite, (icknefs, and other fymp¬
toms of the atonic gout, now alflidt him. Befides, in the
intervals between the firft paroxyfms of the diforder, the
joints which had been affedted were entirely reftored to
their former fupplenefs and ftrength, and were free from
pain or uneafinefs, and all thefundtions of life were well
performed. But in this protradted condition of the dif¬
eafe, the joints remain not only weak and (tiff after the
termination of the fit, but they become at length fo con¬
tracted and difabled, that, although the patient can (land,
and perhaps walk a little, yet it is very (lowly, and
with great lamenefs and difficulty, fo that he is fcarcely
able to move from room to room; and fometimes the
joints lofe their motion altogether.

In many perfons, though not in all, when the difeafe
has frequently recurred, this immobility of the joints is
farther increafed by the formation of concretions, of a
chalky appearance, upon the outfide of them, and for
the moft part immediately under the (kin. The fecretion
or depofition of this matter is charadteriftic of the difeafe,
being the confequence of gouty inflammation alone. It
feems to be depofited at firft in a fluid form, but after¬
wards becomes dry and firm ; in which ftate the concre¬
tions have the appearance of a friable earthy fubftance,
and have been called chalk-Jlones, which fee, vol. iv. p. 75,.

4 A From

272 PATHOLOGY,

From the inveftigations of Dr. Wollafton, however, and
other modern chemifts, it has been afcertained that they
contain no calcareous or earthy matter, but confilt of a
neutral fait, formed by the combination of the lithic
or uric acid, with the fixed alkali, foda ; conftituting a
lithate or urate of foda. Thefe concretions form princi¬
pally about the joints of the toes and fingers, in little
nodules; but fometimes they appear about the larger
joints, as the elbow and knee, occafioning a whitifh
fwelling almoft as large as an egg, which becomes gra¬
dually inflamed and red.

The attack of the regular gout is readily diftinguifhable
from the only difeafe which refembles it, viz. acute rheu-
matifm, if all the fymptoms are taken into confideration.
In the firfl place, gout is commonly a difeafe of advanced
life ; acute rheumatifm is moft frequent from the age of
eighteen to thirty. Nor does rheumatifm, like the gout,
-feize the feet in preference to the other joints, or remain
for a confiderable time in the fame joint ; but at the firfl
attack it often feizes every joint of the body in fucceflion,
and fometimes continues for feveral months. The colour
of the fkin of the part affeCted in rheumatifm, if it. be
changed, is only flightly red, whereas it becomes of a
deep bright red in the gout. The pain in the rheuma¬
tifm is not extremely acute while the part is at reft, but
becomes violent when it is moved only; which is not
the cafe in the gout. And the fymptoms of indigeftion
and difordered ftomach, which precede the paroxyfm of
the gout, together with the marks of diftinCtion juft men¬
tioned, will ferve particularly to determine the nature of
the paroxyfm. It mull be admitted, however, there are
inftances of the combination of the fymptoms of the two
difeafes, which renders it difficult to decide to which of
them the individual examples belong.

When the gout is cured in the limbs, inflammation of
other organs of the body is often obferved ; and many
practitioners have concluded that the tranfiated difeafe
differed from common inflammation. There appears no
juft reafon for fuppofing this. The fymptoms of thefe
inflammations are fimilar, and the cure precifely the fame.
Our knowledge of the previous condition of the patient
might induce us to rely more fully on counter-irritation,
feeing that this procefs had a curative effeCt on the ori¬
ginal malady; but further no difference fhould be made
between the treatment of gout and that of inflammation,
\v hen vital organs are attacked. Simple irritations alfo
alternate with gout, and require the ufual treatment:
fevere fpafms of the belly by hot and ftimulating medi¬
cines ; and fo on.

The cure of gout is no eafy talk. It is one, however,
which well repays the praCtitioner for his labour, whether
he confiders the alleviation of human fuffering, or the
pecuniary emoluments he derives from his profeffion; for
no difeafe is productive of more pain, or more exclulive-
ly attaches itfelf to the higher orders of fociety.

The connexion between gout and indigeftion having
been pointed out, it remains merely to apply the know¬
ledge of this connexion to the cure of the difeafe. In
the firfl place, we have ftated fulnefs of veffels to be one
of the conditions of gout : this therefore nnift be removed.
In fome cafes, a very large bleeding may be neCeflary; in
others, a very ftnall one will fufficiently diminilh the
plethora. The treatment of the local plethora is com-
prifed in cold lotions, leeching, or cupping; but thefe
fhould not be ventured on till general plethora has been
removed by bleeding, and the derangements of the di-
geftive organs, which firfl give rife to the fymptoms in
the extremities, fet to rights. For the latter purpofe,
temperance and aClivity are the chief meafures in which
we can place confidence. By temperance, however, we
do not mean a fudden relinquifhment of the nutritious
food and ftimulating liquors in which the patient has
indulged; neither, in recommending exercife, is it our
intention to caufe exceffive exertions to fuperfede a life
of flothful eafe. The diet mull retain many of the pro¬

perties to which the gouty fubjedl has long been aecuf-
tomed ; and the change which we make fbduld be gra¬
dually brought about.

_ We cannot give any very precife rules as to the fort of
diet which it fhould be our ultimate aim to eftablifh. It
may be fufficient to remark, that in plethoric patients
this fhould gradually be deprived of thofe fubftances
which are rich and eafy of affimilation, while the quan¬
tity is at the fame time diminifhed. In patients who are
not plethoric, but in whom nervous irritations, whether
mental or otherwife, have deranged the digeftive organs,
this plan mull be modified ; and the diet of a nutritious
though eafily-digellible quality, as jellies, foups, & c. muft
fuperfede the more abftinent diet.

As to the medical treatment of the gouty, this will
in fome meafure vary according to the nature of the at¬
tending dyfpepfia. The acid fecretions of the ftomach
require carbonate of foda, a medicine which alfo aCts on
the kidneys. Derangement in the hepatic fecretion re¬
quires calomel ; and the inaction of the bowels, purga¬
tives, &c. But, upon the whole, it feems generally un-
derftood, that little medicine is required in the dyfpepfia
of gouty patients. The derangement in the fecretion
of the kidneys in gout has made many phyficians turn
their attention to a probable connexion between thefe
two afteCtions. In fpeaking of Dyfpepfia, we have al¬
ready ftated the opinion of a diftinguifhed pathologift,
that in that complaint an acid is actually affimulated
into the blood, and that it gives rife to gravel ; and, as
is well known, an acid humour in the blood was once
confidered the proximate caufe of gout. We have alrea¬
dy mentioned objections to Dr. Phillip’s views on t.he
fubjeCt of calculi. It is certain, notwithftanding, that
promoting the fecretion of the kidneys is attended with
falutary effects in the complaint under confideration.
The aCtion of the fkin and of the capillary fyllem in
general ftiould be excited, in gout, by bathing, and
by exercifing the found limbs. The fame treatment, which
cures the gout once eftablifhed, prevents alfo its recur¬
rence ; and indeed, if temperance and exercife were ftritdly
ufed during convalefcence, it is probable that few would ff-
fer from repeated attacks of gout.

Having then gone through the treatment of gout on
principles of pathology, it remains to mention a powerful
remedy, of the falutary efteCl of which moft medical men
can bear teftimony, though they know nothing of its
modus operandi. This is the Colchicum, or meadow-
faffron. It has long been ufed in quack- medicines as a
fpecific for the gout ; and was preferibed by the ancients;
and lately it has become extremely popular. It is faid to
ail on the fkin, the kidneys, and the bowels; but it
fometimes does much good without producing any vi-
fible efteCl of this kind. It is not, however, a fpecific for
gout: it is a highly dangerous remedy to tamper with ;
and it labours under the opprobrium, that patients cured
by it are very apt to fuffer attacks of gout at a (horter
period than when cured by the ordinary plan of treat¬
ment. It may be ufed in conjunction with other medi¬
cines with great advantage. A variety of formula are
advocated by different practitioners ; but it does not
feem that any one of them is preferable to another. We
have generally ufed the wine. It is worthy of remark,
that if the fediment be feparated from the preparation of
Colchicum, its effeCls are lefs likely to be injurious than
if this portion is taken into the body. We repeat, that
few patients who are cured by Colchicum, or by any
other medicine, will fuffer a relapfe if they ftriClly ob-
ferve temperance and exercife.

4. Arthrofis hydarthrus, white fwelling : tenfe, per¬
manent, colourlefs fwelling, chiefly of the larger joints ;
inflammation flow, and deep-feated ; pain fevere and
fixed ; imperfeftly fuppurative ; fever a heftic. Two va¬
rieties are noted.

u. Plethoricus, rheumatic white fwelling: pain dif-
fufed; fwelling confiderable from the firft 5 originating
z and

Plate 111

PATHOLOG Y .

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PATH

and chiefly feated in the cartilages and ligaments of the
affedfed joint ; found principally in plethoric habits.

/3. Strumatofus, fcrofulous white fwelling : pain cir-
cumfcribed and (hooting from a point; fwelling from a
general thickening of the part; at firft inconftderable ;
originating and chiefly feated in the bone. Found prin¬
cipally in fcrofulous habits.

Tliefe varieties are upon the authority of Bell on
Ulcers ; but Hunter fays, “ I conceive all fuch collec¬
tions of matter to be of a fcrofulous nature : they are
moll common in the young fubjedt, and feldom found
in the full-grown or old. The fuppuration is not proper
pus, nor the fwelling proper inflammation.” Hunter on
Blood, p. 391. See the article Surgery.

Order III. Exanthematica, [from e fanOsw, to fpring
forth, to bud.] Eruptive Fevers ; or, cutaneous erup¬
tions effentially accompanied with fever. This order
contains four genera.

Genus I. Enanthe/ls, [from m, within, and cti9 ea, to
fpring, or flower.] Ralh, or efflorefcence from internal
affection. Generic characters — Eruption of red, level,
or nearly level, patches; varioufly figured; irregularly
dift'ufed; often confluent ; terminating in cuticular ex¬
foliations. There are three fpecies.

1. Enanthefis rofalia, (Scarlatina of various authors.)
Scarlet fever: rafh a fcarlet flufh, appearing about the
fecond day on the face, neck, or fauces; progreflively
i'preading over the body ; and terminating about the
feventh day; fever a typhus. Of this genus there are two
varieties.

a.. R. fimplex : fever moderate, and terminating with
the ralh; little proftration of ftrength ; (lightly conta¬
gious.

As no authors have written on cutaneous difeafes fo
ably and fo fully as Drs. Willan and Bateman, we (hall
extrafl all our accounts of cutaneous difeafes from the
works of the latter.

The Rofalia fimplex confifts merely of the ralh, with a
moderate degree of fever. The day after the flight fe¬
brile fymptoms have appeared, the efflorefcence begins
to (how itfelf, about the neck and face, in innumerable
red points, which, within the fpace of twenty-four hours,
are feen ever the whole furface of the body. Thefe, as
they multiply, coalefce into ftnall patches, but on the
following day (the third) form a diffufe and continuous
efflorefcence over the limbs, efpecially round the fingers.
On the trunk, however, the rafh is feldom univerfal, but
is diftributed in diffufe irregular patches, the fcarlet hue
being moll vivid about the flexures of the joints and the
loins. On the breaft and extremities, in confequence of
the great determination of blood to the miliary glands
and papillae of the ikin, the furface is fomewhat rough,
like the cutis anferina, and feveral papulae are fcattered on
thefe parts. See Plate III. fig. 2. On the following (the
fourth) day the eruption remains at its acme; and on
the fifth it begins to decline, difappearing by interftices,
and leaving the fmall patches as at firft. At this period,
and on the evening of the fecond day, fome attention is
requifite to diftinguilh the fcarlet ralh from mealies : the
oblervation of the crefcent-like form of the patches of
the latter, and the more diffufe and irregular fhape of the
former, will be a material guide. (Compare Plate III.
fig. 1, with Plate IV.) On the fixth day it is indiftinCl,
and is wholly gone before the end of the feventh. On
the eighth and ninth days a fcurfy defquamation of the
cuticle takes place. The efflorefcence fpreads over the
furface of the mouth and fauces, and even into the nof-
trils, and is occafionally vifible over the tunica albuginea
of the eye : the papillae of the tongue too, which are
conflderably elongated, extend their fcarlet points
through the white fur which covers it. The face is of¬
ten conflderably fwelled. There is ufually great reft-
leffnefs, and fometimes flight delirium, which appears to
be much connected with the great heat of the furface,

OLOGY. 273

and continues in various degrees of feverity, together
with the fever, from three to feven days. A few pa¬
tients efcape without any fever, almoft without indif-
pofition.

13. R. parifthmitica, (Scarlatina cynanchica, Cullen;
S. anginofa, Bateman.) In this variety, the precurfory
febrile fymptoms are more violent, and an inflammation
of the fauces appears, together with the cutaneous ef¬
florefcence, and goes through its progrefs of increafe and
decline with it. Occafionally, however, the affedtion of
the throat commences with the fever, and fometimes not
until the eruption is at its height. With the firft febrile
fymptoms, a fenfation of lliffnefs and a dull pain on
moving are felt in the mufcles of the neck ; and on the
fecond day the throat is rough and ftraitened, the voice
thick, and deglutition painful. On this and the two fol¬
lowing days, the fymptoms of fever are often fevere ; the
breathing is oppreffed ; the heat of the lkin is more in-
tenfe than in any other fever of this climate, rifing to
1060, 1080, or even nz°, of Fahrenheit’s thermometer.
There is ficknefs, with headach, great reftleffnefs, and
delirium ; and the pulfe is frequent, but feeble : there is
alfo an extreme languor and faintnefs. The tongue, as
well as the whole interior of the mouth and fauces, is of
a high red colour, efpecially at the fides and extremity,
and the papillae protrude their elongated and inflamed
points over its whole furface. The ralh does not always
appear on the fecond day, as in R. fimplex, but not un-
frequently on the third ; nor does it fo conftantly extend
over the whole furface, but comes out in fcattered
patches, which feldom fail to appear about the elbow's.
See the Plate, fig. 3. Sometimes too it vanilhes the day
after its appearance, and re-appears partially at uncer¬
tain times, but without any correfponding changes in
the general diforder : the whole duration of the com¬
plaint is thus lengthened, and the defquamation is lefs
regular. When the ralh is flight, indeed, or fpeedily dif-
appears, no defquamation often enfues; while, in other
inftances, exfoliations continue to feparate to the end of
the third week, or even later, and large pieces of the
entire cuticle fall off, efpecially from the hands and feet.
The tumour and inflammation of the throat often difap-
pear, with the declining efflorefcence of the lkin, on the
fifth and fixth day of the fever, without having exhibited
any tendency to ulceration. Slight fuperficial ulcera¬
tions, how'ever, not unfrequently form on the tonfils,
velum pendulum, or at the back of the pharynx, fome¬
times early and fometimes later. Little whitifh (loughs
are feen, intermixed with the mottled rednefs ; and, when
they are numerous, the throat is much clogged up with
a tough vifcid phlegm, which is fecreted among them.
When thefe are removed, after the decline of the fever,
fome excoriations remain, which foon heal.

R. parifthmitica fometimes puts on, towards its termi¬
nation, much more formidable charadlers. From its
commencement fome difference is indeed obfervable,
though not dillindlly. The efflorefcence is ufually faint,
excepting in a few irregular patches, and the whole of it
foon affumes a dark or livid red colour. It appears late,
and is very uncertain in its duration; in fome inftances,
it fuddenly difappears a few hours after it is feen, and
comes out again at the end of a week, continuing two
or three days. The lkin is of a lefs fteady and intenfe
heat : the pulfe is fmall, feeble, and irregular : the func¬
tions of the fenforium are much difordered; fometimes
there is early delirium, and fometimes coma, alternating
with fretfulnefs and violence. The eyes are dull and
fuffufed with rednefs, the cheeks exhibit a dark-red
flulh, and the mouth is incrufted with a black or brown
fur. The ulcers in the throat are covered with dark
floughs, and furrounded by a livid bafe ; and a large
quantity of vifcid phlegm clogs up the fauces, impeding
the refpiration, and occafioning a rattling noife, as well
as increafing the difficulty and pain of deglutition. An
acrid difcharge alfo diftiis from the noftrils, producing

fo renefs.

274 PATHOLOGY.

forenefs, chops, and even blifters. Thefe fymptoms are
often accompanied by fevere diarrhoea, and by petechiae
and vibices on the {kin, with haemorrhage from the
mouth, throat, bowels, or other parts, which, of courfe,
but too often lead to a fatal termination. This generally
takes place in the fecond or third week ; but, in a few
inftances, the patients have fuddenly funk as early as the
fecond, third, or fourth, day, probably from the occur¬
rence of gangrene in the fauces, oefophagus, or other
portions of the alimentary canal ; and fometimes at a
later period of the difeafe, when the fymptoms had been
previoufly moderate, the malignant changes have fud¬
denly commenced, and proved rapidly fatal. Even thofe
who efcape through thefe dangers, have often to ftruggle
againft many diftreffing fymptoms, for a confiderable
length of time; fuch as ulcerations fpreading from the
throat to the contiguous parts, fuppuration of the glands,
tedious cough and dyfpnoea, excoriations about the nates,
&c. with hedic fever.

This difeafe is not unfrequently followed by a date of
great debility, under which children are affeded with
various troublefome diforders. But there is one affec¬
tion peculiar to the decline of Rofalia, which occurs ef-
pecially when the eruption has been extenfive ; namely,
anafarca of the face and extremities. This dropfical ef-
fufion is commonly confined to thefe parts, and there¬
fore unattended with danger: it ufually appears in the
fecond week after the declenfion of the raffi, and conti¬
nues for a fortnight or longer. But in a fmall number
of cafes, when the anafarca had become pretty general,
a fudden effufion has taken place into the cavity of the
cheft, or into the ventricles of the brain, and occafioned
the death of the patient.

In tracing the fcarlet fever in its mildeft form, the
interference of medicine is unneceffary, and in fad hurt¬
ful. If the bowels are much confined, a laxative may be
given, and faline medicines may ferve to increafe the fe-
curity of the patient ; but, further than this, medicine
does harm. In the fecond variety, however, we have
reafon to adopt more efficient meafures. Although
blood-letting has been recommended by Morton, De
Haen, and others, the experience of our later writers on
this fubjed coincides in deeming it injurious. Dr.
Willan fays, wherever it had been employed great de-
preffion and faintnefs were the immediate confequences,
the pulfe becoming more weak and frequent, and often
irregular. And Dr. Withering difcountenances even
local bleeding. “ Sometimes, where the fiery rednefs of
the eyes and the ftate of delirium feemed to demand the
application of leeches to the temples,” he obferves, “I
have feen them applied, but never with any good effed.”
Upon the whole, it is beft to confine bleeding in fcarlet
fever to cafes in which the head or other vital part is
gravely affeded, or in which the fymptoms lead us to
infer that the difeafe will terminate in a malignant form.
We have found leeches to the pit of the ftomach of effen-
tial benefit when the attendant gaftritis has been ex¬
treme.

Emetics have been much recommended ; and in the
early ftage of the difeafe, probably while the contagious
materia is ftill in contad with the ftomach, they fome¬
times prevent the development of the exanthem : and
many have advifed vomits to be continued, and in large
and frequent dofes, during the continuance of the ma¬
lady, and under all its forms. The propriety of this prac¬
tice may reafonably be doubted. Naufeating medicines
are neverthelefs ufeful ; and fox-glove may be given in
the early ftages of the difeafe. Gentle purgatives ffiould
be regularly adminiftered ; but draftic cathartics ffiould
be entirely proferibed.

The application of cold is a remedy of the greateft
avail in Rofalia, the fimple obfervation that the {kin is
hot and dry being enough to guide us in its ufe. If the
fooliffi prejudices of patients prevent us from ufing this
important meafure, fponging the body, and efpecially the

epigaftrium, may be reforted to. In the latter end of the
difeafe, i. e. when it puts on the malignant form before
deferibed, cold aft'ufion is improper. Leeches to the in¬
flamed throat, blifters in the vicinity of an inflamed organ,
and gargles, are local applications of much ufe ; but of
which plenty of formulae abound. Plate III. fig. 3, dif-
plays the appearance of Rofalia parifthmitica in its moft
advanced or malignant ftate.

2. Enanthefis rubeola, meafles : raffi in c rim foil ftig-
matifed dots, grouped in irregular circles or crefcents ;
appearing about the fourth day, and terminating about
the feventh ; preceded by catarrh ; fever a cauma. Three
varieties.

«■ R. vulgaris : raffi {lightly prominent, extending over
the mouth and fauces ; harffi dry cough; inflamed
watery eyes. Occurring only once in the courfe of a
man’s life : contagious. See Plate IV. fig. 1 .

R. fpuria : the raffi running its regular courfe with
little fever or catarrhal affe&ion ; affording no certain
fecurity againft the common or regular difeafe.

y. R. nigra: the raffi about the feventh or eighth day
affuming fuddenly a black or livid hue, interfperfed with
yellow ; prolonged in its ftay ; and accompanied with in-
creafed languor and quicknefs of pulfe. See fig. 2.

The two laft varieties are fufficiently deferibed in the
above definition. It remains, however, to give a more
detailed account of the fymptoms of meafles in general.

R. vulgaris begins with fymptoms of fever; fluffiing
of the cheeks; a fenlation of pain or weight acrofs the
forehead and eyes, with difpofition to fleep ; flight fore¬
nefs of the throat, a white fur on the tongue, a frequent
and fomewhat irregular pulfe. On the third and fourth
days, the eyes become tender and inflamed, the eye-lids
and tarfi a little turgid ; there are difeharges from the
eyes and noftrils, and repeated fneezing; and afterwards
a frequent dry cough, hoarfenefs, difficulty of breathing,
and a fenfe of conftridtion acrofs the cheft. Thefe fymp¬
toms decline with the efflorefcence on the feventh day.
A harffi founding cough often precedes the attack, in
infants, feven, ten, fifteen, or twenty, days. The raffi
appears in patients having a delicate Ikin, partially on
the third day ; in thofe having a dark or thickened {kin
about the fifth ; but moft ufually on the fourth. It is
firft vifible on the forehead, under the chin, about the
throat, nofe, cheeks, and mouth ; it is formed on the
neck and breaft, early on the fifth day, and is diffufed,
towards night, round the trunk, and on the extremities ;
during this day it is moft full and vivid on the face, as
reprelented on Plate IV. On the fixth day the effloref¬
cence on the face begins to decline ; that on the body is
moft red and extended, and declines on the fucceeding
day, leaving a roughnefs and itching of the Ikin, with the
formation of feurf. The colour of the raffi is lefs vivid
than in Rofeola 5 and, on its decline, affumes a yellow-
iffi hue. It commences with diftintt red and nearly-cir-
cular dots ; larger patches appear afterwards, approach
to the form of a crefcent or femicircle, and are gently
raifed under the finger. They confift of a number of
the dots juft mentioned, with which they are alfo inter¬
fperfed, leaving, however, large interftices of the natural
colour. Diftinft papulae are apt to appear on the face
and hands in infants, and on the w rifts and hands in
adults : miliary veficles alfo appear on the neck, breaft,
and arms. On the fourth day, fmall dark- red patches,
of the form deferibed, appear on the palate, uvula, tonfils,
and velum pendulum palati ; during the fucceeding day,
they pafs into a general ftreaky rednefs. If the eruption
be repelled by cold, delirium, dyfpncea, or diarrhoea, oc¬
curs, attended with confiderable danger.

Dr. Willan thus recapitulates the diagnoftic chara&ers
of Rubeola and Scarlatina, (our Rofalia.) “ 1. The
efflorefcence in Scarlatina generally appears on the Jecond
day of fever; in the meafles it is feldom vifible till the
fourth. 2. It is much more full and fpreading in the
former difeafe than in the latter, and confifts of innume-

, rable

PAT H O LOGY

Plate IV.

275

PATHOLOGY,

fable points and fpecks under the cuticle, intermixed with
minute papulae, in fome cafes forming irregular patches,
in others coalefcing into an uniform flulh over a confi-
derable extent of furface. In the Meafles the rafli is
compofed of circular dots, partly diftindf, partly fet in
fmall clufters or patches, and a little elevated, fo as to
give the fenfation of roughnefs when a finger is paifed
over them. Thefe patches are feldom confluent, but
form a number of crefcents or fegments of circles, with
large intervening portions of cuticle, which retain their
ufual appearance. In Scarlatina, when any part of the
rafli has a tendency to circular forms, the circles are
ufually completed; fometimes their circumferences inter-
feft each other varioufly. The colour of the rafli is alfo
different in the two difeafes, being a vivid red in Scarla¬
tina, like that of a boiled lobfter’s fhell ; but in the
Meafles a dark red, with nearly the hue of a rafpberry.
3. During the febrile ftage, the Meafles are diftinguifhed
by an obftinate hoarfe cough, forcing up, in repeated
paroxyfms, a tough acrimonious phlegm; by an inflam¬
mation of the eyes and eye-lids; by an increafed dif-
charge from the lachrymal gland, fneezing, &c. The
Scarlatina is frequently attended with a cough, alfo with
rednefs of the eyes from an extenfion of the rafli to the
tunica albuginea, circumftances which render the diftinc-
tion between this complaint and Meafles particularly dif¬
ficult, if other fymptoms be not clear and deciflve. On
minute obfervation, however, it will be generally, per¬
haps always, found, that the cough in Scarlatina is fliort
and irritating, without expectoration ; that the rednefs
of the eye is not attended with intolerance of light ; that
the ciliary glands are not affeCted ; and that, although the
eyes appear fhiningand watery, they never overflow. 4.
Mod writers, in diftinguifliing Scarlatina from Meafles,
obferve that there is a peculiar fenfation of anxiety, de-
prefiion, and faintnefs, in all cafes of it which are atten¬
ded with fever. 5. When the rafli appears on the third
or fourth day, being fcattered, and of a dark fliade of
colour, as frequently happens in the two laft varieties of
Scarlatina, the difeafe may be diftinguiflied from Meafles,
by the appearances in the throat, by the rigidity of the
mufcles of the neck, &c.”

In the treatment of themildeft cafes of Rubeola, as lit¬
tle medical practice is neceflary as in the milder cafes of
Rofalia; and, in cafes of more feverity, bleeding is to be
confined by the fame reftridions as we have endeavoured
to eftablilh in its ufe in the latter complaint. That is to
fay, when pain or forenefs in the chefi, opprefled breath¬
ing, general anxiety, and reftleflhefs, are abfent in the
eruptive ftage of the meafles, w’e fhall have no occafion
to bleed ; and, where thefe are prefent, venefedion,
either general or local, will almoft always be neceflary.
But fometimes it happens, that the breathing is very
hurried, the cough frequent, and the pulfe much quick¬
ened, about the firft coming out of the rafli; and yet, if
we wait a day or fo, we lhall find the refpiration gradu¬
ally improve. In irritable children, and efpecially in in¬
fants, the refpiration often becomes extremely anxious
on an attack even of Ample fever, wholly unconnected
with pectoral inflammation ; and this is more particularly
the cafe when the bowels are difordered. We muft be
jnoft careful to difcriminate fuch a ftate of breathing from
that which commonly attends pulmonic inflammation :
nor, indeed, is this difficult, becaufe the former is feldom
permanently the fame, but varies fo much, at different
times, that the patient will feem now much opprefled,
and again eafy ; whereas, in the latter, there are no
changes of this fort in the refpiration, for it is fo confi-
derably opprefled, as never to be entirely eafy. Befides,
the anxious breathing, which arifes from irritation, is
generally increafed by the ereCt pofition, and that which
arifes from inflammation more or lefs diminiflied : in the
firft, the child now and then obtains pretty tranquil (lum¬
bers, with little motion of the cheft ; but, in the laft, the
fleep is always very difturbed, and the cheft may be feen

Vol. XIX. No. 1 303.

heavingupand down with an unnatural labour. When
any part of the pulmonary fyftem is inflamed in children,
both the diaphragm and the abdominal mufcles are ge¬
nerally thrown into an inordinate aClion ; fo that, if the
belly and bread be expofed, one cannot fail of being
ftruck with their forcible movements.

What is here faid of pulmonic inflammation is alfo
applicable to cephalitis, when it comes on during meafles :
the latter complaint is, however, of very rare occur¬
rence. The reduction of pulmonic inflammation is the
chief objefl in the treatment of meafles. Cupping or
bliftering to the cheft are occafionally required after the
general bleeding. For the reft, the adminiftration of fa-
line medicines, gentle laxitives, and occafional fopori-
fics, fills up our catalogue of remedies for meafles. Both
meafles and fcarlet fever are contagious, and aft'edt a per-
fon once only during life, fubjedt however to the fame
exception as fmall pox or other fimilar maladies.

3. Enanthefis urticaria, nettle-ralh : ralh in florid, itch¬
ing, nettle-fting, wheals ; appearing about the fecond
day; irregularly fading and reviving, or wandering from
part to part : fever a mild epanetus.

The urticaria begins with pain and flcknefs at the fto-
mach, head-ache, great languor or faintnefs, a difpofition
to deep, a fenfe of anxiety, an increafed quicknefs of
the pulfe, and a white fur on the tongue. In two days,
or fometimes later, wheals appear, with an efflorefcence
in patches of a vivid red, or fometimes nearly of a crim-
fon colour. They are preceded by fits of coldnefs and
fliivering, and are attended with a mod troublefome itch¬
ing or tingling, which is greatly aggravated on uncover¬
ing the body, or during the night, and which prevents
reft for many hours. The patches often coaiefce fo as
to produce a continuous rednefs ; they appear on moft
parts of the furface, but particularly on the fhoulders,
loins, nates, thighs, and about the knees. They alfo
extend to the face; and there is fometimes a red circle
round the palm of the hand, accompanied with a fenfation
of violent heat. They appear and difappear irregularly,
firft on one part, and then on another ; and may be excited
on any part of the flcin by ftrong fridfion or fcratching.
During the day the efflorefcence fades, and the wheals
in general fubiide ; but both return with a flight febrile
paroxyfm in the evening. The red patches are often
elevated above the adjoining cuticle, and formdenfe tu¬
mours with a hard diftindl border; the interftices are' of
a dull white colour. When the patches are numerous,
the face or limb chiefly covered with them appears tenfe
and enlarged. At the latter end of the diforder the eye¬
lids are red and tumefied, and there is often a fwelling
and inflammation on the fides of the feet. On the ap¬
pearance of the eruption, the pain and ficknefs at the
ftomach are in general relieved; but, when it difappears,
thefe fymptoms return. The whole duration of the a f-
feSion is feven or eight days. On its decline the ralh
exhibits a light purple or pink colour, gradually difap¬
pears, and is fucceeded by flight exfoliation of the cu¬
ticle.

This diforder occurs principally in fummer, in perfons
of a plethoric and fanguine habit, efpecially from indul¬
gence in eating and drinking. It is often connedled
with teething and bowel-complaints in infants, w’hom it
aft’edls at one and at two years old. It appears to aft’edt
men more than women. A fimilar affedlion is induced
from eating almonds, muftirooms, herrings, crab-filh,
mufcles, lobfters, &c. The Urticaria is liable, from the
form of the ralh, to be miftaken for Rubeola, and, from
the ftate of the general furface, forRolalia, efpecially on
a partial examination. Several parts of the furface, and
all the limbs, fliould be infpedted, as the rafh is often dif-
tindlly marked in one place, although obfcure in others.
The charadter of the eruption; the mode of attack ; the
abfence of catarrh ; and fore throat ; the prefence of tin¬
gling and itching, &c. will fufficientiy diftinguilh the af-
fedlion. An emetic of ipecacuanha, followed by a gen-
4 B tie

276

PATHOLOGY.

tie laxative, with light and cooling diet, (with total ab-
ftinence from fermented liquors, and from fudorific me¬
dicines,) conftitute the foie treatment which appears to
be requisite for the fafe condudt of thefe diforders to
their period of decline ; at which time the cinchona, with
fulphuric acid, is beneficial.

Genus II. Emphlyfis, [from tp for sv, within, and
$>Avcr»;, a veficular tumour or eruption.] Ichorous erup¬
tion from internal fever. Generic characters — Eruption
of veficular pimples filled progreflively with an acrid and
colourlefs, or nearly colourlefs, fluid} terminating in
fcurf or laminated fcabs. There are fix fpecies.

i. Emphlyfis miliaria, the miliary fever: veficles
fcattered over the body ; of the fize of millet-feeds }
tranfparent red, afterwards milky; preceded by a prick¬
ing fenfation, fighing, anxiety, and four fweat.

The veficles are at firft red, from the colour of their
under furface, or inflamed bafe, being tranfmitted
through the tranfparent pellicle; they are afterwards
opaite and milky, from abforption of the more attenuate
part of the fluid, or from fome other change. This af¬
fection, which is a mere fymptom of inflammatory fever,
generally owes its exiftence entirely to the hot and ftimu-
lating practice of our forefathers. In the prefent im¬
proved practice, it is fcarcely ever feen ; and it requires
no particular treatment.

i. Emphlyfis aphtha, the thrufh : veficles granular,
roundifh, pearl-coloured; confined to the lips, mouth,
and inteftinal canal; terminating in curd-like floughs ;
occafionally with fucceflive crops. Two varieties.

a. Aphtha infantum, white thrufh : appearing in in¬
fants foon after birth ; and often extending from the
mouth to the inteftinal canal ; moftly with flight febrile
fymptoms, and white floughs.

£. Aphtha maligna, black thrufh : accompanied with
great debility of vafcular aCtion ; ufually afcending from
the pharynx into the mouth ; floughs black; fever a ty¬
phus.

To forbid improper diet, prefcribe gentle laxatives,
and occafionally the warm bath, and to caufe a weak fo-
lution of borax to be applied to the fauces, conftitutes
all that is neceflary for the treatment of Aphtha in¬
fantum.

The fecond variety (hows itfelf at firft by an uneafy
fenfation or burning heat in the ftomach, which comes
on by flow degrees, and increafes gradually in violence.
After fome time, fmall pimples, of about the fize of a
pin’s head, appear on the tip and edges of the tongue ;
and thefe at length fpread over the whole infide of the
mouth, and occafion fuch a tendernefs and rawnefs of
the parts, that the patient cannot take any food of a folid
nature; neither can he receive any vinous or fpirituous
liquor into his mouth, without great pungency and pain
being excited. Little febrile heat attends, but the fkin
is always remarkably dry and without the leaft moifture
on it; the countenance is pale, the pulfe is fmaller and
more languid than in health, and a general coldnefs is
felt over the whole body, but more particularly in the
extremities.

This complaint is always combined with chronic gaf-
tritis, of which it is probably a mere fymptom ; and it re¬
quires the fame treatment, with the addition however of
gargles.

3. Emphlyfis vaccinia, cow-pox : veficles few, or a An¬
gle one, confined to the part affe&ed ; circular, femitranf-
parent, pearl-coloured ; depreffed in the middle, fur-
rounded with a red areola. Four varieties.

a. V. nativa, natural cow-pox : veficles on the hands,
or fuch parts as have been in contact with the affefted ud¬
der of a cow; of abluifhtint; the fluid at firft limpid ;
afterwards opake, and purulent; often with enlargement
of the axillary glands, and confiderable fever. A pro¬
phylactic againlt the fmall-pox.

£. V. fpuria, fpurious cow-pox : veficles lefs uniformly

circular; purulent from the firft; without bluifti tint},
with little or no central depreflion. Affords no fecurity
againft the fmall-pox.

y. Inferta, inoculated cow-pox: produced by inocula-,
tion; veficle Angle, confined to the punCture; cellulofe;,
bluifh-brown in the middle ; fluid clear and colourlefs to
the laft; concreting into a hard dark-cloured fcab after
the twelfth day.

3. V. degener, degenerate cow-pox: produced by
inoculation ; veficle amorphous, or uncertain ; fluid
often ftraw-coloured, or purulent ; areola abfent, in-
diftinCt, or confufed with the veficle; fcab formed pre¬
maturely. Affords little or no fecurity againft the fmall-
pox. See the article Inoculation, vol. xi.

Since the time at which that article was compofed, much,
very much, has been written on the fubjeCt of vaccina¬
tion. But, though fome interefting circumftances of its
origin, and the vaft extent of the world to which it has
travelled, have been made known, yet we look in vain
through the long lift of reports, from the molt illuftrious
bodies of the profeflion, of cafes, with which our perio¬
dicals have fo long teemed, and even through entire trea¬
ties on vaccination, for one new practical faCt. In a
work of this kind it may be neceflary, however, that we
fliould give our teftimony in favour of vaccination; left,
if it fliould fall into the hands of fome whofe prejudices
are in oppofition to the ufe of Jenner’s difcovery, our
filence fliould be conftrued into difapprobation of it.
And this is the more neceflary, becaufe, in fome of the
early articles of this work, vaccination has been fpoken
of in a flight manner. Its value was not then known, as
its efficacy was not eftablilhed. But we can no longer
withhold our conviction of its great benefit in the majo¬
rity of cafes. We have now the fupport of the higheft
authorities in ftating, 1. That vaccine matter, duly in-
ferted under the fkin, is capable of preventing the fu¬
ture occurrence of the fmall-pox. 2. That this matter
requires a very fmall degree of concentration, but that
it is liable to degeneration from chemical changes when
removed from the body, and alfo while in the fore if it,
be taken at an improper time.

Many exceptions exift to the firft rule. If the patient
be afflicted with any cutaneous defaedation, the vaccina¬
tion will be generally ineffedfual. In many cafes fmall-
pox will come on after cow-pox, notwithftanding the ut-
nioft precaution, from peculiar idiopathy of habit or
conftitution ; and this happens in a far greater proportion
of cafes than the occurrence of fmall-pox twice ever happened ,
But fo mild is it under thefe circumftances, that vacci¬
nation might be confidered one of the kindeft grants
ever conferred by Providence on man, did it never effect
any tiling more than this modifying operation ; for, even
in that cafe, we fliould poflefs in the vaccine procefs all
the advantages without any of the evils that are confefif-
edly appended to variolous inoculation ; and the writer
muft indulge the hope that neither the apprehenfions of
the timid, nor the wrong-headednefs of the obftinate,
will operate to any confiderable extent, in encouraging
the re-introduCtion of the latter practice. The fword for
ages fufpended over us has been blunted to the extent of
almoft entire liarmleffnefs ; and it were fully amounting
toinfanity, to polifli it ourfelves into its priftine power.
And, when it is confidered that by far the majority of
vaccinated perfons do not take fmall-pox under any cir¬
cumftances of expofure or even of inoculation ; when it
is confidered, alfo, that in thofe countries where vacci¬
nation is enforced, fmall-pox no longer exifts ; we cannot
but view the prejudices againft it as a great ftigma on
our national character.

4. Emphlyfis varicella, the chicken-pox : veficles fcat¬
tered over the body ; glabrous, tranfparent, pea-fized ;
in fucceflive crops 5 pellicle thin ; about the third day
from their appearance, burfting at the tip, and concreting
into fmall puckered fcabs, rarely leaving a cicatrix.
There are four varieties of this fpecies noted by Dr. Good.

PATHOLOGY.

*. V. lenfc'iformis, common chicken-pox : eruption
appearing the fecond or third day, and confiding of fmall
red protuberances, not exaCtly circular, and having a flat
(hining furface, in the centre of which a minute veficle
is foon formed : this, on the fecond day of its appear¬
ance, is generally feen fir A on the bread and back, af¬
terwards on the face and extremities ; difappears about
the tenth day, leaving red marks on the lkin, without de-
preflion.

(3. V. coniformis, conoidal chicken-pox, or fwine-pox :
veficles acuminated : fluid pellucid throughout.

y. V. globularis, the hives : veficles globular and
larger 5 fluid at firfl whey-coloured, afterwards yellowifli.

The varieties are fometimes intermixed ; and the fluid
in a few of them occafionally approaches to a purulent
appearance ; whence in various indances they may have
been miflaken for the fmall-pox. It mud be recoil eCted,
however, that the pudules and veficles do fometimes rife
into one another, or that pus and ferum may be pro¬
duced by different degrees of the dime aftion ; fo that
the diftinCtion in quedion is not to be depended on. Our
readers are well aware, that fome have inferred that
varicella is a modification of the fmall-pox ; and Dr.
Bateman has thought proper to give fome credit to this
opinion. In a note on Varicella, p. 208 of his Synopfis,
he fays, “Since the introduction of vaccination, confi-
derable differences of opinion have exided among medi¬
cal practitioners, refpeCting the character of the eruption,
which has occafionally appeared, after expofure to vari¬
olous infeCtion, in perfons previoufly vaccinated, fome
denominating it chicken-pox and others fmall-pox. The
mod careful obfervers mud have admitted the difficulty
of edablifhinga decifive didinCtion in many of thefe cafes.
A feries of intereding obfervations which have lately
been made at Edinburgh, have led the ingenious Prof.
Thomfon to believe that the chicken-pox itfelf is in faCt
a fecond and modified fmall-pox. While the quedion is
ftill fub judice, I leave Varicella in its nofological feat ;
but many faCts crowd upon my own recollection, which
incline me to believe that this fuggedion will ultimately
prove to be correCt.”

The information that has been obtained on this head
fince Dr. B. wrote, has been highly corroborative of
Prof. Thomfon’s views; but, as the queftion is by no
means at reft, we fhall follow the above great authority
in leaving Varicella in its “ nofological feat.” The rea¬
der may confult on this head the Edinburgh Med. and
Surgical Journal, 1818. and a variety of papers of recent
dates in the London Medical Journal. The following
are the ufual diagnoftic marks laid down between thefe
difeafes.

Varicella may be diftinguifhed from fmall-pox by, 1.
The appearance, on the fecond or third day from the
eruption, of the veficles full of ferum at the top of the
pock. The pudules which are fulled of the yellow li¬
quor referable what the genuine fmall-pox are on the fifth
or fixth day, efpecially when there happens to be a larger
fpace than ufual occupied by the extravafated ferum. It
happens to mod: of them, either on the firft day the little
veficle arifes, or on the following, that its tender cuticle
is burft: a thin fcab is then formed on the top of the
pock, and the fwelling of the other part abates without
the formation of pus as in fmall-pox. 2. Slight fcabs
cover the chicken-pox on the fifth day, at which time the
fmall-pox are not at their height. 3. The inflammation
round the chicken-pox is very fmall, and the contents
of them do not feem to be owing to fuppuration as in the
fmall-pox, but rather to what is extravafated immedi¬
ately under the cuticle by the ferous veffels of the fkin
over a common blifter. No wonder, therefore, that this
liquor appears fo foon as on the fecond day ; and that,
upon the cuticle being broken, it is prefently fucceeded
by a thin fcab. Hence, too, no fear is left.

Varicella is a difeafe which is by no means dangerous,
and which affeCts a perfon but once in his life. No other

277

treatment is required than the cooling regimen, mild
aperients, and faline draughts.

5. Emphlyfis pemphigus, veficular or bladdery fever :
veficles fcattered over the body; tranfparent, filbert-
fized; with a red inflamed edge, but without furround¬
ing blufli or tumefaction ; on breaking, difpofed to ulcer¬
ate ; fluid pellucid or (lightly coloured; fever a typhus.
Three varieties.

а. P. vulgaris: veficles appearing on the fecond pr
third day, occafionally not till the fifth or fixth ; in fuc-
ceflive crops ; often extending over the mouth and intef-
tinal canal ; fluid, on burfting, yellowifli ; fome of the
veficles livid, with a livid bafe.

/?. P. glandularis, (P. contagiofus, Willan :) preceded
by tumefaCtion of the neck and throat 5 veficles chiefly
feated on the fauces and conglobate glands; occafionally
producing abfeefles ; highly contagious.

y. P. infantum: veficles irregularly oblong, with livid
edge, and commonly flattened tops; appearing fucceflively
on different parts of the furface, in infants a few days
after birth ; fluid; on breaking, purplifli.

Pemphigus is found, for the moil part, as a fymptom
only in eryfipelas, typhus, plague, and other deprefling
fevers. Dr. Good doubts whether Pemphigus is enti¬
tled to be confidered as a diftinCt and idiopathic difeafe ;
and whether all its varieties and modifications may not
refolve themfelves into certain peculiarities of eryfipelas,
or pompholyx, the latterof which confifts of fimilar vefi¬
cles or bulla; without fever, or mere fymptoms of typhus
or plague. Dr. Cullen feems to have been of the laft
opinion at the moment of drawing up his definition : but
the fourth edition of his Synopfis contains a note which
intimates that his opinion was altered in confequence
of his having feen a patient, fhown him by his excellent
colleague F. Home, and who was labouring under this
difeafe as an idiopathic affeCtion at the time. And when
to this inftance (fays Good) “ we add the authority, not
merely of the earlier writers, Bontius, Seliger,- and
Langhans, but of Withers, Dickfon, Chriftie, Ring, and
Braune, (Uber den Pemphigus, Leipf. 1795.) it would be
unpardonable not to allow it a diftinCt place in a general
fyftem of nofology.”

Notwithftanding this firing of authorities, it may rea-
fonably be doubted that idiopathic Pemphigus ever ex-
iffed. In Dr. Bateman’s Synopfis this opinion is adopted
from a review' of all the authors above quoted ; and in
this it is fhown that the accounts they have given are
highly vague and unfatisfaCtory.

6. Emphlyfis eryfipelas, St. Anthony’s fire : vefication
diffufe; irregularly circumfcribed ; appearing on a parti¬
cular part of the body, chiefly the face, about the third
day; with tumefaction and erythematic blufh; fever
ufually accompanied with fleepinefs, often with delirium.
This admits of two varieties.

ot,. Locale: limited to a particular part; the cuticle
railed into numerous aggregate diftinCt cells ; or the cells
running into one or more blebs, or large blitters.

б. Erraticum : travelling in fucceflive patches from
part to part; the former patches declining as new ones
make their appearance.

Eryfipelas, which feems to occur twice over in Dr.
Good’s arrangement, has been already referred to another
divifion of this work.

Genus III. Empyefis , [i. e. fuppuration.] Puftulous
eruption. Generic characters — Eruption of phlegmo¬
nous pimples; gradually filling with a purulent fluid;
and terminating in thick fcabs, frequently leaving pits or
fears. But one fpecies.

Empyefis variola, fmall-pox : puftules appearing from
the third to the fifth day, fuppurating from the eighth to
the tenth ; fever a cauma ; contagious. The fmall-pox
confifts of the following four varieties.

a. V. difereta, diftinCt or natural fmall-pox : puftules
pea-fized ; diftinCt, diftended, circular; the intervening

fpaces

278

PATHOLOGY.

naces red ; the fever ceafing when' the eruption is com¬
plete.

Fhe natural fmall-pox begins with fenfibility to cold,
fhivering, languor, feverifhnefs, difturbed deep, pain of
the head and of the back, vomiting, and tendernefs of
r lie epigaftrium under prell'ure. In adults, there is a
ftrong tendency to perfpiration ; in infants, ftupor, and
fits fmilar to thofe of epilepfy, fometimes occur about
fhe third day, but there is no tendency to perfpiration.
On the fourth day, the eruption generally appears on the
face, and perhaps on the neck andbreaft; it extends
gradually during the enfuing day, and becomes general
over the furface of the body. The febrile fymptoms
abate on the appearance of the eruption. On the fourth
and fifth days, the puftules are fmall, hard, and globu¬
lar, red and painful, feparate anddiftinft from each other,
with nearly colourlefs interftices. They enlarge gradu¬
ally until the eighth day, when they contain a little yel-
lowifh fiiiid, and the interftices become red. From this
day the puftules increafe in breadth, and have a fmall pit
in their centre, until the eleventh, when they become
mere rounded, and are encircled by rings of rofe-co-
loured inflammation, which coalefce when the eruption
is numerous. About the eighth day, there is frequently
a flow of faliva, the integuments of the face are apt to
become fwollen, the eyes are often clofed, and the eye¬
lids diftended like a bladder. This tumefa&ion gradual¬
ly declines ; it is much abated, and the puftules are fully
diftended, about the eleventh day, when a degree of fwel-
ling is fometimes obferved about the hands and feet,
which, in its turn, fubfides gradually; about the fame
time too, the tendency to perfpiration diminifhes, or
ceafes, fpontaneoufly. The puftules break, the fluid
partly ifiues, and at length dries and forms a fcab, the
cuticle becoming fhrivelled ; a procefs which is completed
on the face about the fifteenth day. In a few days more,
the fcabs feparate, leaving the fubjacent part of a brown-
ifh-red colour, and often pitted. The fluid in the puf¬
tules fituated on the arms and hands, is fometimes ab-
ferbed, and the cuticle falls down in a flaccid ftate.

£. V. confluens, confluent fmall-pox, is attended with
febrile fymptoms of a more ferious kind, refembling thofe
of Emprefma maligna, and exacerbating towards even¬
ing. There are frequently coma, delirium; vomiting,
and fometimes diarrhoea; a frequent, feeble, pulfe; there
is lefs tendency to perfpiration; the appearance of the
eruption induces lefs, and lefs permanent, relief; and
the fever refumes its violence about the ftxth day. The
eruption appears early, on the third day. It is preceded,
or attended, in many inftances, by exanthema. The
puftules are more numerous on the face; fmaller, and
lefs hard and eminent ; during a flouer and lefs marked
progrefs, their diameters enlarge; they do not retain
the circular and orbicular form, but aflfume an irregular
figure, remain flat, and coalefce, fo that frequently the
face feems covered with one extended and continuous
puftule. The interftices are pale and flaccid, and with¬
out the rofe-coloured inflammation obferved in V. dif-
creta. The contained fluid becomes opaque and brown-
iftt, but does not afl'ume the yellow, confiftent, and pu¬
rulent, appearance. The puftules at length break, the
Cuticle flirivels up, the enclofed fluid ifiues ; dark brown
fcabs' are formed, feparate flowly, and leave deep
pits. The tumefa&ion of the face, and the falivation,
t ake place earlier, and are more conliderable, than in V. .
difereta ; they abate, and the hands tumefy, about the
feventh day. In infants, diarrhoea fometimes occurs ;
and there is no falivation. On the general furface the
puftules are more diftinft ; but they are lefs prominent,
and the enclofed matter lefs confiftent, than in the former
variety. The febrile fymptoms are mitigated on the ap¬
pearance of the eruption, but again become more vio¬
lent, and conftitute what is termed the fecondary fever
in this difeafe.

y. V. inferta, inoculated fmall-pox : produced by ino¬

culation ; orange-coloured areola: about the punfture;
pain in the axilla about the feventh day ; difeafe for the
mod part mild ; and the purulent difeharge fometimes
confined to the punctured part.

• S. Degener, horn-pock, or cryftalline pock : pimples
imperfectly fuppurating; ichorous or horny, and femi-
tranfparent.

- Now as to the treatment of fmall-pox. Since it ap¬
pears very evident, that the danger and violence of the
fymptoms are nearly in proportion to the quantity of the
eruption ; which is again much connected with the de¬
gree of fever that accompanies and precedes it ; the firft:
indication is, to moderate the eruptive fever.

In the cafe of inoculated fmall-pox, this procefs may be
commenced in the interval between the infertion of the
matter and the beginning of the diforder, that is, feveral
days previous to the origin of the fever; when, by a
light and cooling diet, and by the ufe of laxative medi¬
cines if the habit be full, the body may be brought into
a lefs inflammatory ftate, and thus rendered lefs fufeep-
tible of violent inflammatory difeafe. But, in the cafual
fmall-pox, we have commonly no warning of the malady,
until the eruptive fever actually commences; nor, when
it has already begun, can we be certain, from any pecu¬
liar fymptoms, that it is any thing but an ordinary fe¬
ver; uniefs it occurs in perfons who, not having pre-
vioufly undergone the difeafe, have been notorioufly ex-
pofed to the infeftion. It is fortunate, however, that
our inability to diftinguifh the fever which is about to
uftier in the fmall-pox from common inflammatory fever,
is of no moment; fince the fame remedies are the moft
appropriate in both cafes. According to the degree of
violence with which the fever commences, the activity of
the meafures for moderating it will be various. If the
fymptoms are not fevere, the patient may be recommend¬
ed not to keep his bed, but to remain, according to the
advice of Sydenham, in a cool apartment, having the
benefit of cool air; and at the fame time to difeard ani¬
mal food, and adopt that of a cooling nature, vegetable
"decodfions, acidulous fruits, and diluent drinks, fuch as
plain cold water, lemonade, whey, &c. All his drinks
fhould be given cold ; and the bo'ivels fhould be freely
opened by fome cooling purgative, as by the neutral
falts, with a little calomel. If thefe meafures are adequate
to keep down the fever, ar.d if, at the fame time, the
eruption appears early, and in fmall numbers, the fafety
of the patient may be confidered as afeertained ; and no
farther treatment, except a continuance of the antiphlo-
giftic fyftem, is neceflary.

Where the fever comes on, however, with great vio¬
lence, manifefted by a quick hard pulfe, intenfe heat,
and thirft, a flufhed countenance, inflamed eyes, fevere
head-ache, quick and opprefled refpiration, with deli¬
rium, very active meafures fhould be immediately adopt¬
ed, especially in plethoric habits. In perfons of this de-
feription, the firft objefl would be to let fome blood, the
quantity of which mull be determined by a confideration
of the violence of the fymptoms. At the fame time, the
cooling plan muft be adopted to the fulleft extent in re-
fpeft to the apartment, which fhould be freely ventilated
by the admiflion of the external air, through open win¬
dows and doors, and to the bed, which fhould be a
mattrafs, and as lightly covered as the feafon and the
feelings w ill permit. If the fkin is intenfely hot and dry,
much benefit will be obtained, in the moil: expeditious
manner, by fponging the furface occafionally with cold
water, or even by the ufe of the cold affufion. An active
purgative will alfo contribute to relieve inflammatory ac¬
tion, and fhould be fpeedily adminiftered, and repeated
according to circumftances.

If, however, thefe falutary meafures have been omitted,
or have proved inadequate to prevent a numerous erup¬
tion, efpecially upon the face; if the puftules are not
diftinft ; and particularly, if, on the fifth day, the fever
does not fuffer a confiderable remiflion ; the difeafe will
a ftill

PATHOLOGY.

ftill require a great deal of attention. It will ftill be ne-
ceffary to avoid heat and a heating regimen, and to con¬
tinue to admit the free accefs of cool air, although the
more aCtive applications of cold, by fponging or affufion
with water, need not be continued. At this period of
the difeafe, it may alfo be neceflary, in adult and pletho- .
ric fubjeCts, to take away fome blood. This, however,
feldom requires to be repeated. But a cooling purgative
fhould be adminiftered and repeated, or aided by a fre¬
quent repetition of laxative clyfters ; and the free ufe of
diluent drinks fhould be permitted.

Opium, which has been very much ufed in fmall-pox,
does harm in its early ftages. In the later periods of the
difeafe, however, when the febrile excitement is low, and
much irritation is kept up by the hardening crufts, the
moderate ufe of opiates is to be recommended.

The fecondary fever, as it is called, occurs about the
eleventh day, upon the complete fuppuration of the pul-
tules, or at leaft when thefeare perfectly full and ftretched
to their utmoft extent. The bowels fhould be treated by
gentle purgatives provided no diarrhoea has occurred.
According to the ftate of the pulfe, and the appearance
of the matter in the eruptions, the ftrength of the pa¬
tient, and other fymptoms, more or lefs of a cordial plan
of treatment mult, however, be combined with the lax¬
atives. Light liquid nourifhment, with a little wine
and water as drink, fhould be frequently adminiftered ;
and an infufion of cinchona, with the mineral acids, will
be given with advantage. If the difeafe put on a more
malignant character, with petechias and hsemorrhages, the
fame treatment mull be continued. Under this cordial
plan, the petechiae will fometimes difappear; the empty
veficles will become filled with matter ; and the ichorous
fluid of others be changed into white thick pus ; the
other fymptoms of courfe improving in a fimilar degree.

If the fever becomes complicated with inflammation
of the head, cheft, bladder, or indeed of any other part,
the ufual meafures for its removal are to be ufed. To
prevent as much as poflible the deformity of pitting,
which fucceeds fmall-pox, about the tenth day of the
difeafe we fhould fpread over the face a mafk of fine old
cambric, thinly fmeared with a mild liniment compofed
of oil, fpermaceti, and a little wax. This mafk may be
renewed three or four times in twenty-four hours, and
fometimes oftener. An agreeable and refrefliing cool-
nefs is felt for fome time after each application ; and, the
apices of the puftules not being fuffered to dry and
harden, pitting is prevented in a great meafure.

Small-pox very rarely attacks the fame individual
twice. For inftances, however, fee the article Small¬
pox.

Genus IV. Anthracia, [from an 9p«|, a hot coal.] Car¬
buncle, or Plague-fore. Generic characters — Eruption
of tumours imperfectly fuppurating, with indurated
edges, and for the mot part a fordid and fanious core.
There are two fpecies.

i. Anthracia peftis, (Lcemus, Greek Authors.) Plague :
tumours bubonous, carbunculate, or both ; appearing
at an uncertain time of the difeafe $ fever a malignant
typhus, with extreme internal heat and debility ; conta¬
gious.

The precife fituation which Peftis fhould occupy in
the nofological fcale is a matter about which authors have
been divided. Dr. Good gives it a place among the ex¬
anthems, becaufe “ the fever is fpecific, like that of all
the exanthems ; it is contagious, like that of molt of
them ; and, although capable of occurring oftener than
once in a man’s life, we have the concurrent teftimony
of all the writers who have been eye-witnefles of its ef¬
fects, that it renders him lefs fufceptible for a confiderable
period afterwards. The eruption of buboes or carbun¬
cles is unqueftionably a pathognomonic fymptom : the
fluid they fecrete is capable of producing the difeafe by
inoculation ; for the moft part, the earlier they make

Vol. XIX. No. 1303.

279

their appearance the better ; and it is the opinion of M.
Sotira, and moft of the French medical ftaff appointed
to the Egyptian expedition, that, provided the bubo
freely fuppurates, the patient receives an indemnity for
life- It is true, indeed, that thefe tumours do not always
appear in their proper or perfeCt character ; for fometimes
the patient is deftroyed by the violence of the firft fymp¬
toms ; and in other inftances, as in fmall-pox, the fpe¬
cific fever pafles through its courfe with an imperfeCt or
trivial fructification ■, but, unlefs there be an aCtual ger¬
mination, or what Sauvages calls a conatus, a perfeCt or
an imperfeCt epanthefis, we have no right whatever to
call the difeafe a plague, and can only regard it as a
fpecies or variety of fynochus, or typhus. It has three
varieties.

a. P. fruCtifera : the difeafe extending to about the
fourteenth day ; and relieved by the appearance of the
eruption.

j3. P. infruCtifera : eruption imperfeCt or fuppreffed
transferred to fome internal organ ; or fuperfeded exter¬
nally by ftigmata and vibices.

y. P. erythematica : the body covered over with
trails of veficular erythema, producing deep fanious and
gangrenous ulcerations as it fpreads, often to the lofs of
one or more limbs.

For the beft defcription of this variety of Peftis, Dr.
Good refers us to the pages of Thucydides, who de-
fcribes it from having been an eye-witnefs of its ravages,
and a fufferer under them j or to thofe of Lucretius,
who has copied the account with clofe and technical
punctuality. The following paflage from the latter may
ferve to illuftrate this remark. De Rer. Nut. lib. vi,
1152. But we give it in the tranflation :

Forth pour’d the breath moft fetid from the mouth.

As fleams the putrid carcafe : every power
Fail’d through the foul, the body, and alike
Lay they liquefcent at the gates of death :

While with thefe dread, infufferable ills,

A reftlefs anguifli join’d, companion clofe.

And fighs commixt with groans ; and hiccough deep.
And keen convulfive twitchings ceafelefs urg’d,

Day after day, o’er every tortur’d limb.

The wearied wretch ftill wearying with aflault.

Yet ne’er too hot the fyftem couldft thou mark
Outwards, but rather tepid to the touch ;

Ting’d ftill with purple dye, and brandifh’d o’er
With trails of cauftic ulcers like the blaze
Strew’d by the holy fire. But all within
Burn’d to the bone : the bofom heav’d with flames
Fierce as a furnace, nor would once endure
The lighted veil thrown loofely o’er the limbs.

The extraordinary length of this article, and the va¬
rious and affeCting, though not ftriCtly pathological, de¬
tails which the hiftory of Plague exhibits, induces us to
defer our account of the malady in queftion till we come
to the article Plague.

1. Anthracia rubula, the yaws: tumours numerous
and fucceffive j gradually increafing from fp'ecks to the
fize of a rafpberry j one at length growing larger than the
reft: core a fungotis excrefcence ; fever flight ; occurring
only once during life $ contagious. Two diftinCt va¬
rieties.

a. R. Guineenfis, Guinea yaw: attacking infants and
young perfons chiefly ; and fubfiding as foon as the
eruption appears.

(3. R. Americana, American yaw: depafcent ■, and
deftroying progreflively both mufcles and bones ; efpe-
cially the mafter-yaw, which is called mamanpia. See
Yaws.

Order IV. Dysthetica, [from I am ill.]

Cachexies. “Morbid ftate of blood or blood-veffels
alone or connected with a morbid ftate of other fluids
producing a difeafed habit.”

4c

This

280

P A T H O

This definition of Dr. Good’s is extremely vague. It
is very difficult, however, to make any arrangement of
cachexies in our prefent ftate of knowledge without ma¬
ny faults j but, at all events, fome of the difeafes already
mentioned might be referred to morbidity of the blood-
veffels ; and certainly dropfy has little to do with depra¬
vity of the blood as a primary caufe. We muft confefs,
however, that this is not the cafe of Plethora, Haemor-
rhagies, Paffiva, Cyrtofis, Porphyra, and fome others.
We have already exprefied our opinion that many dif¬
eafes are referrible to morbidity in the blood : and, after
long and unwarrantable difregard of this important faff,
our contemporaries are now returning to the inveftiga-
tion of the nature of the blood in difeafe. Their labours
have hitherto been little fuccefsful ; and indeed fcarcely
any thing can be ftated with certainty as to the ftate of
the blood in the majority of difeafes, nor in any of them
are we able to trace tbofe minute changes on which the¬
rapeutical agents would be fafely fet in adKon. It feems
pretty clear that all material changes in the blood muft
be a work of time. The changes which a fudden altera¬
tion in the blood would induce in the conlradtility of the
vafcular and fenfibility of the nervous fyftems would be
fuch, that death, or at all events extreme febrile com¬
motion, muft occur. Moreover, all unnatural matters
in the blood would, under fuch circumftances, be carried
off by the fecretions; and thus the fanguineous fluid
would return to its natural condition. Blood being
folely derived from food and air, it is to thefe agents we
muft look for its alterations. As the former can operate
only by producing a greater or lefs degree of oxygenation
in the blood, and as cachedfic difeafes are not extraor¬
dinarily manifefted in fituations where bad air is prefent,
we fhould probably be right in referring cachexis to the
ill effedts of particular food? Indeed deficiency or bad
quality of food and drink is evidently the caufe of a very
large proportion of cachedtic maladies, and a ferious
fource of aggravation to them all. In the natural or
healthy ftate, indeed, we have very clear evidence, that
unhealthy chyle is not formed in confequence of one or
two improper meals; but when, from a long-continued
ufe of fubftances irritating to the alimentary canal, from
a reftridtion to one particular kind of food, or from pre¬
vious difeafe in the abforbent or aifimulating veflels,
blood is flowly and imperceptibly produced of an unna¬
tural quality, we fhould be prepared to meet with a cor-
refponding change in the contractility of the containing
veflels ; we ftiould expeCt alfo to find the fecretion flowly
deranged, and, as the difeafe advanced, the nervous fyf-
tem debilitated. The changes which the blood under¬
goes is perhaps very various in different difeafes ; but
we know little of them. We may remark, however, that
in all cachedtic difeafes (properly fo named), the change
in the blood diminifties the contractile power of the fan¬
guineous fyftem. Now', it having been proved by expe¬
riment, that the quantity of fibrine, and confequently the
degree of coagulation, is in direCt ratio to the force of
the arterial contractions, we fhould naturally expeCt to
find the blood containing an unufual proportion of fe-
rum, and more flow in its concretion, in cacheCtic dif¬
eafes, fince in them fymptoms of arterial debility are for
the moll part unequivocal. It is only in this view of the
fubjeCl that the firft genus o£ this order, viz. Plethora,
can be allowed to exift ; for, from what has been before
ftated with regard to the dependance of the blood-veflels
on the nerves, of the nerves on the veflels, and of the
veflels on the blood, plethora, exifting while thefe par¬
ticular ftrudtures retained their natural properties, muft
inevitably terminate in local inflammation. This order
contains fifteen genera.

Genus I. Plethora, [from to fill.] Fulnefs of

blood. Generic characters — Complexion florid ; veins
diftended ; undue fenfe of heat and fulnefs; oppreffion

LOGY.

of the head, cheft, or other internal organ. There are
two very diftinCt fpecies.

i . Plethora entonica, fanguine- plethora. This firft
fpecies is rarely feen as a difeafe. It is probably a fre¬
quent forerunner of all the fpecies of PyreCtica and Phlo-
gotica, but exifts in various degrees in different habits,
and in many perfons without manifefting fcarcely any
fymptoms of indifpofition. The change ufually obferved
in the blood is an increafe of coagulation, and in the
rednefs of its colour.

a. Plethora atonica, or ferous plethora, is a difeafe in
which much change is induced in the ftate of blood.
This change confifts in an undue proportion of ferum,
and a deeper hue than ordinary. The pulfe is full, fre¬
quent, and feeble ; the mental adtions languid ; dullnefs
and lownefs of fpirits being often met with. The figure
is often plump, but inexprelfive, fuch as is vulgarly called
dead fat; and the urine coagulates on the application of
heat.

The treatment of plethora is fufficiently obvious. The
firft fpecies, being the forerunner of inflammation or in¬
flammatory dropfy, will require brifk purging and bleed¬
ing, and a fpare and vegetable diet. In the fecond fpe¬
cies, the fame indication of reducing the bulk of the
blood is to be kept in view ; but, as free bleeding dimi¬
nifties rapidly the tone of the fyftem, and as the vital
powers are evidently in a very low ftate, we muft proceed
with the utmoft caution ; and, contrary to what is prac-
tifed in inflammations, (where our objeCt is to diminifh
the exceflive adtion of the heart rather than the quantity
of blood,) we ftiould in ferous plethora bleed very fre¬
quently, but in fmall quantities at a time. An altera¬
tion ftiould be made in the diet, which, in the majority
of cafes, fhould gradually become fparing. The treat¬
ment of dyfpepfia united with the chronic hepatitis (dif¬
eafes ufually combined with the ferous plethora) fhould
be purfued, and the kidneys excited by means of diure¬
tics.

Plethora, in one or other of its fpecies, is ufually
found as an almoft-univerfal fymptom in hemorrhage
and dropfy.

Genus II. Harnorrhagia, [from a:/xa, blood, and ptu,
to flow.] Hemorrage ; flux of blood from an organ with¬
out external violence. There are three fpecies, befides
varieties.

i. Haemorragia adtiva, adtive hemorrhage: accompa¬
nied with increafed vafcular action ; blood florid and te¬
nacious.

Active hemorrhages are caufed by all circumftances
capable of inducing an increafed momentum in the af-
fedted part, or in the fyftem generally.

The immediate or proximate caule of an adtive hae¬
morrhage is the rupture of a blood-veflel, where the blood
flows till, by the permanent contradtion of the broken
artery, or a coagulum, it is mechanically reftrained.
This retention is much more readily effedted if the heart
is quiefeent.

Adtive hemorrhages we muft confider as febrile dif¬
eafes of an inflammatory kind. They are defined by
Dr. Cullen, Pyrexia, with an effufion of blood indepen¬
dent of external violence ; and the blood drawn having
an inflammatory appearance. Adtive hemorrhages
chiefly occur in full plethoric habits, moft frequently in
the fpringand in the early months of fummer. Previous
to the fever which uftiers in the difeharge, fome general
fulnefs and uneafinefs is felt, with a load on the parts
from whence the hemorrhage will flow. The topical
heat, fwelling, or itching, is fometimes confiderable. A
fliort rigor which follows is relieved by the ufual heat,
and the hemorrhage foon comes on during this hot fir.
After fome time the difeharge and the fever both ceafe y
but every fpontaneous hemorrhage has a tendency to re¬
cur; and, if this recurrence happens more than once,

after

PATHOLOGY. 281

after a dated time, a habit is formed which is with diffi¬
culty overcome. Thefe very marked appearances do not
always occur; but traces of fuch fymptoins may be of¬
ten diftinguifhed even in the moft debilitated dates. This
fpecies has fix varieties.

a.. H. a. nariurn, (Epifiaxis juniorum, Cull.) Bleeding
at the nofe. In this variety the blood is difcharged
from the nodrils, ufually preceded by a pain and heavi-
nefs in the head, fiufhing in the face, heat and itching in
the nodrils, a throbbing of the temporal arteries, and a
quicknefs of the pulfe. In other hemorrhages, a coldnefs
of the feet, and fhivering over the whole body, together
■with a codive belly, are obferved to precede the attack.
The intenfity of the head-aft'e£lion is often very great.

(3. II. a. haemoptyfis, fpitting of blood. In this com¬
plaint, with the common fymptoins of fever and in-
creafed arterial adtion, a Hurtling of the cheeks comes
on, attended with dyfpncea and pain in the ched ; a
cough follows, by means of which blood is copioufly
ejedled.

y. H. a. haematemefis, vomiting of blood. In this va¬
riety, dark-coloured clotted blood is thrown up from the
domach, ufually mixed with much phlegm. The dif-
charge is often preceded by a tenfive pricking pain in
the domach, or the left hypochondrium ; and almod al¬
ways attended with a naufea, anxiety of the praecordia, a
comprefiing pain on the fame fide, and faintnefs.

It is. of much confequence to afcertain whether the
blood comes from the fauces, the nofe, the domach, or
the lungs. If from the fauces, either diredlly or dropping
from the nofe, it is inconfiderable in quantity, and not
alzcays attended with any hawking; and, though this is
fometimes the cafe, the fymptorns of Haemorrhagia na-
rium, or infpedlion of the fauces, will adid the diflinc-
tion. Blood, however, feldom comes from the fauces,
but in palfive hemorrhage. When a difcharge of blood
is from the domach, it is brought up by vomiting; but
patients can feldom didinguilh between thefe two opera¬
tions. In general, when from the domach, the quantity
difcharged at once is more confiderable; it is alfo mixed
with the contents of the domach, and not the mucus of
the lungs; and faintnefs and naufea have generally pre¬
ceded. The pulmonary blood is ufually fiorid ; that of
the domach of a darker colour. Complaints of the lungs,
preceding the difcharge, will diow that a doubtful he¬
morrhage probably proceeds from thofe organs.

The treatment of thefe hemorrhages is very fimple.
The adtion of the heart being one of the caufes of the
hemorrhage, this is if podible to be redrained. Blood
fliould be taken with almod as much freedom as in Em-
prefma ; i. e. if the pulfe and conditution of the patient
warrant fuch a meafure. We have dated that it is ne¬
ceflary to take blood very quickly in inflammation, and
this is dill more neceflary in afftive hemorrhage : a large
orifice, or fometimes both arms, fliould be opened for this
purpole ; for it is not fo much required to deplete blood
as to exhauft the force of the heart. This being done,
if the hemorrhage does not dop, the next dep is to af-
tringe the extremities of the bleeding veflels. This objedt
is a defied in the H. nariurn by injections of fulphate of
zinc, fulphate of copper, See. in haematemefis by dilutions
of fulphate of zinc, but in very moderate dofes; or by the
Tindtura Ferri muriatis, in large draughts of cold water.
The fame treatment is applicable to the paroxyfm both
of haemoptyfis and that of haematemefis. In the bleeding
of the nofe, the auxiliary meafure of dalhing cold water
over the face, head, and neck, or even the general cold
bath, may be reforted to. We may remark, that the af-
fufion of cold water has been ufed in haemoptyfis ; but,
for obvious reafons, it is a dangerous expedient. Plug¬
ging the nafal finufes with lint may be adopted as a der¬
nier refort in violent hemorrhage from the nofe.

The above remarks apply principally to the treatment
of a fudden eruption of blood. When this is flopped,

the treatment fliould be condudled dill with the fame
view of leflening the momentum of the blood by vene-
fedlion and abflinent diet. We fliould avoid all circum-
ftances capable of dimulating the heart, or increafing the
impetus of blood in the aifedted organ. Animal food
fliould therefore be withheld, quietude enjoined, cool
drinks and purgatives adminidered. In haematemefis,
and dill more in haemoptyfis, digitalis and the fuperace-
tate of lead are very ufeful medicines. The former is
given in various dofes (ufually from five to -twenty
drops), according to its effedls ; and the latter in a quan¬
tity varying from one to three or more grains. The fu-
garof lead is ufually combined with opium.; but we have
found it more fuccefsful when given alone. The fears
of fome pradlitioners as to this fubdance producing colic
fliould not arrefl its exhibition, its conflipating effedts
being eafily corredled by purgatives.

H. a. haematuria, bloody urine: evacuated at the
urethra ; preceded by pain in the region of the bladder
or kidneys ; and accompanied with faintnefs.

A difcharge of blood by urine, when proceeding from
the kidneys or ureter, is commonly attended with an
acute pain in the back, and fome difficulty of making
water, the urine which comes away firfl being muddy
and high coloured, but towards the clofe of its flowing
becoming tranfparent and of a natural appearance.
When the blood proceeds immediately from the bladder,
it is ufually accompanied with a fenfe of heat and pain at
the bottom of the belly. The voiding of bloody urine
is always attended with fome danger, particularly when
mixed with purulent matter. When it arifes in the
courfe of any malignant difeafe, it indicates a fatal ter¬
mination.

When the difeafe occurs in a plethoric habit, it may
be proper to take blood, and purfue the general anti-
phlogiflic plan, opening the bowels occafionally with
caftor-oil, &c. When owing to calculi which cannot be
removed, we mud be chiefly content with palliative
meafures, giving alkalies or acids according to the qua¬
lity of the urine; likewife mucilaginous drinks and
clyders; and opium, fomentations, &c. to relieve pain ;‘
uva urfi alfo has been found ufeful under thefe circum-
ftances ; but more decidedly where the hemorrhage is
purely palfive ; in which cafe alfo fome of the terebinthate
remedies may be cautioufly tried ; and means of flrength-
ening the conditution mud not be negiedted.

£. H. a. uterina, uterine hemorrhage: blood difcharged
from the uterus ; with a fenfe of weight in the loins, and
of preflu re upon the vagina. See Paramenia, and the ar¬
ticle Parturition, vol. xviii. p. 706-9.

£. II. a. prodtica, (Hemorrhois, Cull.) blood difchar¬
ged from the anus fpontaneoufly ; with a fenfe of weight
and pain within the reef urn ; and often of load in the
head. See the genus Prodica, p. 166.

z. Haemorragia pafliva, palfive haemorrhage : accom¬
panied with general laxity or debility ; and weak vaf'eu-
lar adlion ; blood attenuate, and of a Modena red.

Palfive hemorrhages are much more difficult to cure
than the adlive fpecies before detailed. Their chief
fymptom, as in the active hemorrhages, is a dilcharge of
blood, which however is faid to be of a darker colour,
longer in coagulating, and the coagulum when formed
lefs firm, than in adlive hemorrhages. The fymptorns of
fever are alfo abfent ; and, above all, the pulfe is foft and
fmall. The palfive hemorrhages refult fometimes from
ruptured arteries ; but fometimes the blood is actually
fecreted. They are not neceflarily accompanied with
plethora, but they are fo very generally. They are al¬
ways connected with alteration in the blood ; and are
confequently never met with except in old perfons, in
dyfpeptics or debilitated habits, or in thofe who have
fuftered from bad modes of living. The fame local treat¬
ment is neceflary in both fpecies; but bleeding, fo im¬
portant in the firfl, is of no avail towards relieving the

fanguine

282

ATHOLOGY

(anguine eruption in the fecond. Between the paroxyfms,
however, it is neceflary, for the mod part, to take blood,
and that frequently; but in fmall quantities, as directed
in ferous plethora. The dyfpeptic treatment mud be put
in force. Very great benefit is alfo derivable from coun.
ter-irritants, as bliders, &c. and, except in hasmaturia,
by diuretics. The treatment of paflive hemorrhage em¬
braces a wider field of dietetic treatment than probably
any other malady. It may be confidered as the fame dif¬
eafe with Porphyra, afl’eCting however another druCture.
The varieties are fimilar to thof'e of the fil’d fpecies; viz.

a. Nnrium : difcharged from the nodrils without local
heat or head-ache.

Haemoptyfis : thrown up from the refpiratory or¬
gan, ufually with coughing; often accompanied with
fcirrhous or calculous aft'e&ion : countenance pale and
emaciated.

y. Hsematemefis : evacuated from the alimentary canal
at either extremity with expulfive effort, naufea, and
faintnefs; but without tenfive pain.

S. Hsematuria : evacuated at the urethra; ufually with
faintnefs, but without previous pain.

e. Uterina : difcharge from the inendrual organ, with
a fenfe of local weaknefs.

£. ProCtica : difcharged from the anus fpontaneoudy,
with little or no pain ; ufually with varices or congef-
tions of the hsemorrhoidal veins; occafionally producing
a habit. See ProCtica marifca, p. 168, 9.

A remarkable hidory is contained in the 33d volume
of the London Medical Journal, of a whole family who
died at different periods from hemorrhage fupervening to
trifling wounds or fcratches. But, as the relator made no
further remarks as to the conditution or fymptoms of
the patients, we know not whether thefe were cafes of
aCtive or paflive hemorrhage. We fhould be inclined to
fuppofe the latter.

3. Hasmorragia vicaria, vicarious hemorrhage : cate¬
nated with a morbid or fuppreffed action of fome other
organ ; the outlet being ufually the nodrils, trachea,
vagina, or reClum ; at times the urethra. This fpecies
has the fame fymptoms and treatment as idiopathic he¬
morrhage. It may be aCtive or paflive.

Genus III. Marafrnus, [from p.oi^a. tvw, to grow lean.]
Emaciation of the entire body. It has three fpecies.

Emaciation is a fymptom of many complaints, and one
which often ferves us to diltinguifli idiopathic from
nervous or irritative difeafes : it being ufually found,
that, while in the latter this is often abfent, in mod
chronic inflammations or degeneration of internal flruc-
tures, early emaciation is met with. A marafrnus from
mere exhaudion, a very unimportant difeafe, difl'ers
from that which depends on vifceral diforder in the
greater tightnefs of the fkin which the latter exhibits,
while in the former its texture is loofe and natural.

1. Marafrnus atrophia, atrophy : complexion pale,
often fqualid ; fkin dry and wrinkled ; mufcles fhrunk
and ineladic : little or no fever. Three fpecies.

a. A. inanitorum : the crafis of the blood vitiated by
exceflive evacuations; as faliva, fweat, milk, intedinal
fecretion, or blood itfelf.

(3. A. famelicorum : the crafis of the blood vitiated
by the ufe of food deficient in quantity, and innutritious
in quality.

y. A. debilium : the crafis of the blood vitiated by
infirm aCtion of the digedive faculty ; as in puny infants,
and feeble age.

The fird and fecond varieties are cured by the gradual
exhibition of natural food ; the third by the treatment
for Dyfep/ia, which fee.

2. Marafrnus tabes, decline: general languor; heCtic
fever; for the mod part deprefled fpirits. Four varieties.

a. T. purulenta : the blood vitiated by abforption of
pus from an external or internal ulcer, or a vomica.

That heCtic fever is a common attendant on the forma¬

2

tion of pus is unquedionable ; but whether this arifes
from abforption is doubtful. Indeed it has rather Teemed
to us to be the particular irritation going on in the fup-
purating part which didurbs, through the medium of the
nervous fydem, the general health. If this were an ad¬
mitted explanation, it would alfo lead us to fuppofe that
the beneficial effedl of bark was owing to the oppofite
impreflion it induced on the fydem.

(3. T. drumofa, (T. fcrophulofa, Cull.') Blood vitiated
by afcrofulous taint; and, for the mod part, connected
with a fcrofulous aft’eCtion of fome organ or other. See
Struma mefenterica.

y. T. dorfalis : vitiated by excefs in libidinous indul¬
gences. Accompanied with pain in the back and loins;
fallow, dejeCted vifage ; heavinefs of the head ; fyrigmus;
fleepleflnefs ; horror of mind ; extreme genital debility.

We believe this dreadful malady is not to be alleviated
by any but moral treatment.

S. T. venenata: the blood vitiated by an introduction
of fome poifonous or other deleterious material into the
fydem; often from the injudicious ufe of quickfilver;
perhaps, at times, from fmall portions of arfenic.

2. Marafrnus phthifis, confumption. To attain a know¬
ledge of the caufesand cureof confumption, may judlybe
confidered the highed point of ambition to the Englifh pa-
thologid. For, whether we confider the extraordinary in-
roadsitmakes on thepopulation of this country ingeneral,
the youth, the beauty, and often the mental endowments,
of its victims; or, ladly, the opprobium its fatality cads
upon our profeflion ; it cannot fail to be an objeCt of the in-
tenfed fludy and contemplation. Much has been written
on confumption by Englifh writers ; the whole materia
medica has been ranfacked for fpecifics againd it ; yet
very little has been done. It feems to us, that the pa¬
thology of this difeafe has not been dudied with the accu¬
racy that has been lately applied to almod all others.
This want of a theoretical view of phthifis does not in¬
deed arife from the deficiency of high ratiocinative
powers in the writers of our time. It is that we want
aCtual data on which to found our reafoning. We want
a few edabliflied faCts for our premifes. Mod men can
reafon accurately on allowed premifes ; but in phthifis
the premifes are fo far from being allowed or fettled, that
there is much reafon to believe that grofs errors are to be
found in thofe mod commonly received. To trace the
operation of air on the lungs, as far as its temperature,
its weight, its humidity, its foreign mixtures, and its
electrical properties, are concerned, is a talk which can
only be accomplidied by the united labours of many.
And, though numerous defultory obfervations have
been made on thefe points, yet, not being made with the
fpecific objeCl of tracing the caufe of confumption, but
being generally confined to one only of thefe particulars,
our information is very confined. Advancing another
link in the chain of the caufes of phthifis, the abfence
of fymptoms, and the unfrequency of deaths at an early
Itage of this difeafe, have prevented the medical obferver
from accurately tracing the formation of the confumptive
diforganization to its fird fource, and through its fepa-
rate dages.

But, if thefe invefligations, condu&ed with fomewhat
of a philofophic fpirit, have failed, what have we to ex-
peCt from the mere experimenter, who, throwing afide
the laborious toil of comparing the climate and fituation
of diflant countries with the mortality of phthifis, or the
dill more difagreeable office of numerous and minute
difleCtions, has been employed merely in praCtifing on
human life by potent drugs, in the vain hope of difco-
vering a fpecific ? We will venture to predict that it is
not from this tribe of pathologids that confumption will
meet with a cure. Yet how many boaded fpecifics have
been fafhionable for a time, to fall into merited oblivion !
In this fpecies Dr. Good reckons three varieties.

a. Pht. catarrhalis, catarrhal confumption : cough fre¬
quent and violent ; copious excretion of a thin, odenfive,

purulent.

PATHOLOGY.

purulent, mucus ; general fo reliefs of the cheft,. with
tranfitofy pains fhifting from fide to fide. Chiefly pro¬
duced by catching cold, or the neglect of a common ca¬
tarrh.

$. Pht. apoftematofa, apoftematous confumption :
Cough fevere but dry ; fixed, obtufe, circumfcribed, pain
in the cheft, fometimes pulfatory ; difficult decumbiture
on one fide; at length fudden and copious difcharge of
purulent matter, occafionally threatening fuffocation ; the
other fymptoms temporarily, ^rarely permanently, relieved.
Chiefly the refult of repeated htemoptyfis.

y. Pht. tuberculofa, tuberculous confumption: cough
ftiort and tickling ; excretion of a watery whey-like fa¬
iries, fometimes tinged with blood; pain in the cheft
flight; habitual elevation of fpirits. Ufually the refult
of a fcrofulous diathefis. .

We cannot, however, minutely follow the. above divi-
iTon of confumption, becaufe, in common with many
other divifions, they are becoming generally abandoned
in confequence of the advance of pathological knowledge.
It mull be granted that catarrh is often accompanied by
tubercles, and that thefe formations often precede apof-
tema ; but the peculiar fymptoms and the fatality of
phthifis belong only to the third variety ; the two former
varieties being confidered as fevere forms of Bronchitis,
or Apcftema vomica, which fee. The word Phthifis is
therefore reftrifted in this treatife to thofe diforganiza-
tions of the lungs known by the name of tubercles, and
to the fubfequent alteration in ftrufture thefe tubercles
undergo. The only diftinftion that can be made out, as
far as we conceive, will depend on whether the patient be
ftrumous or not.

• Now, as to the formation of tubercles in the lungs,
this is a point little known. We have before had occa-
iion to notice, that two explanations had been afforded
of the appearance of tubercles ; that one theory affirmed
them to be organizations of lymph previoufly effufed by
an inflammatory procefs ; that, on the other hand, ffome
referred the production of tubercles to an undefined dif-
eafe in the abforbent fyftem; and, as a coincident opinion,
that the firft germ of the tubercle was an hydatid. We
are not prepared to decide between the oppofite parties;
but we incline to fuppofe that tubercles may originate in
both ways. And firft, of the formation of tubercles
from inflammation, we conceive fome evidence is to be
found in viewing their remote caufes. Variable weather,
more efpecially if in a cold and humid climate, has the ef¬
fect of preventing the due aftion of the whole of the cu¬
taneous vefiels; confequently internal circulation is in-
creafed. This increafe in the circulatory fluids is parti¬
cularly felt in the lungs. This fact is evident to every
one ; for the mod common obferver has not failed to no¬
tice the extreme feeling of diftention in the lungs which
follows the application of cold to the furface of the body.
Now, if it be admitted that plethora can be induced in
the lungs by cold and moifture applied to the Ikin ; if it
be admitted alfo, that confumption is molt prevalent in
thofe liruations where, from the degree of cold and moif¬
ture, or from their variability, thefe conditions can aft
moll forcibly on the Ikin ; then, knowing as we do that
impediment in the cutaneous increafes the pulmonary
circulation, and that plethora is the chief condition of in¬
flamed parts, we cannot hefitate to aferibe the production
of tubercles to an inflammatory origin in lb me cafes.
Further proof of their origin in this lource might be ad¬
duced from the frequency of phthifis after the pneu¬
monia.

With refpeft to the origin of the tubercles in difeafed
abforbents, this, though capable of lefs direft proof, is
Hill probable. It refts greatly on the fuppofed locality of
fcrofula, the latter dileafe being ufually confidered an
affeftion of the lymphatic fyftem ; and, as fcrofula and
phthifis are frequently complicated, as in fcrofulous pa¬
tients tubercles even in other vifeera are the moft com¬
mon degenerations, the origin of phthifis being the fame

Vo l. XIX. No. 1303.

28-3

as fcrofula has been juftiy contended for. It refts alfo-
on the grounds, that many people expofed to the vicif-
fitudes of climate, and who are fubjeft to frequent pneu-
monites and catarrhs after fever, enjoy neverthelefs im¬
munity from confumption. Moreover, tubercles have
been found in the lungs of the foetus. Indeed fo evident
is the faft that phthifis and drama are often the fame dif-
eafes, that we believe it has never been difputed. The
only queftion to be decided, is whether chronic pneumo¬
nitis will not end in phthifis, even in conftitutio'ns not
ftrumous. The very general fuffering of the French
army in Holland, and the teftimony of Brouflais, who
fays that all the tuberculous cafes he diflefted there
were preceded by catarrh or pheumonia, go to prove the
affirmation.

Leaving, however, thefe fpeculations, on which we can¬
not throw' fo much light as we wifli, we proceed to con-
fider thefe tubercles when formed, their progrefs, and ac¬
companying fymptoms.

Laennec, in his excellent work on “Mediate Aufcul-
tation,” ftates that the earlieft ftage of tubercles he lias
met with is when they form final! femi-tranfparent grains
of a grey hue, but fometimes diaphanous and almoft co-
lourlefs. Their fize, in the firft inftance, varies from
that of a millet to that of a hemp-feed; they at length
become larger, opake or yellowifh, at firft in the centre,
and fuccefiively throughout their extent. Thofe molt
adjacent unite as they develope themfelves,and form then
more or lefs voluminous manes, of a pale yellowifn co¬
lour, opake, and of a denfity fimilar to that of the hardeft
fort of cheefe ; they are then termed crude tubercles. It
is ordinarily towards this epoch of the difeafe, that the
tifiue of the lungs, hitherto healthy, begins to become
hard, greyifti, and femi-tranfparent, around the tuber¬
cles, from a new production of tuberculous matter in
the firft ftage of its formation, which infiltrates the pul¬
monary ftrufture : the latter is fometimes found without:
tubercles. The pulmonary tifiue, thus engorged, is denfe,
humid, and wholly impenetrable to the air. Numerous
fmaller opake yellow fpots then become difperfed in it,
and at length extend throughout it.

In whatever way tubercles are formed, they terminate,
after a period of various duration, by becoming foft, and
at length liquid. This foftening begins in the centre of
each mafs, and gradually extends to the circumference.
Tuberculous matter at this ftage is in two different
ffates : it either refembles a thick inodorous pus of a
deeper yellow colour than the tubercles, or it is fepa-
rated in two parts, one of which is very liquid, more or
lefs tranfparent or colourlefs, unlefs it be tinftured by-
blood ; the other opake, and of the confidence of loft
and friable cheefe. The latter, M. Laennec fays, is par¬
ticularly found in fcrofulous fubjefts. When the tuber¬
culous matter is completely foftened, it opens a pafiage
into fome one of the adjacent bronchial tubes ; this open¬
ing is fmaller than the diameter of the cavity left after
the evacuation of the matter, and remains fiftulous.
Many excavations of the above kind generally co-exift ;
and cavities fuccefiively formed often open into each
other, forming anfraftuous excavations of various forms
and extent. Bands or columns of condenfed pulmonary
tiffue, often infiltrated alfo by tuberculous matter, fre¬
quently traverfe thefe excavations. Baylehas Hated that
thefe hands were traverfed by blood-vefl’els ; but M.
Laennec has hardly ever found a veflel of any conlider-
able fize in them. The vefiels naturally exifting in the
pulmonary -ftrufture are obliterated in thofe bands. The
tuberculous matter, on being developed, prelles afide the
proper ftrufture of the lungs, and its blood-vefiels are
found often very large in fize, winding about the parie-
tes of the cavities foon after the foftening of the tubercu¬
lous matter, and forming even part of thofe parietes.
Thefe vefiels are ordinarily flattened ; they are rarely ob¬
literated ; but thofe of their ramifications which are di-
refted towards the excavation or towards the tuberculous
4- D malfes,

2M PATHOLOG Y.

maflfes, are evidently fo 5 and liquids injected into thofe
veflels will not pafs into the cavities, as Dr. Baillie long
fince obferved.

The ramifications of the branchiae appear to be rather
enveloped in, than prefied a fide by, tuberculous matter;
and the compreflion excited on them, apparently, prompt¬
ly deftroys them, for they can hardly ever be diilinguifhed
in the tuberculous mafies 5 and yet it is very rare to find
an excavation, however fmall, in which one or more
bronchial tubes of different diameters do not open, and
in a direction which makes it evident that thofe tubes
were originally extended through the tuberculous mat¬
ter. The parietes of thofe excavations, in proportion as
they are formed, become lined with a fort of thin, fmooth,
foft, and almoft friable, falfe membrane, of nearly an opake
white hue, and which is eafily removed by fcraping it
with a fcalpel. Sometimes a finer membrane of the fame
kind is formed in fpots on the fides of the cavities; or
fuch a membrane will exift beneath the former, but not
adherent to it, and which is attached more intimately
than the former to the texture which it lines. It feems
to be the firft degree of development of the former.
Sometimes neither of thefe membranes is prefen t, and
the fides of the excavations are formed by the pulmonary
texture, ordinarily hard, red, and infiltrated by tuber¬
culous matter, in different degrees of development.

From this falfe membrane, as well as from the bron¬
chial lining, (a very large portion of which becomes in¬
volved in the fame aftion,) pus is fecreted. At times
alfo blood is poured forth, giving rife to the fanguineous
fputa fo common in the latter ftages of confumption.

If the difeafe now remain ftationary, there is deve¬
loped, here and there, beneath this falfe membrane, flakes
of greyifh-white and femi-diaphanous matter, of a tex¬
ture analogous to cartilage, but a little fofter, and which
adheres intimately to the pulmonary tiflue. Thefe
flakes at length increafe fo as to unite, completely line
the ulcerous excavation, and terminate, as by continuity
of fubftance, in the internal membrane of the bronchial
tubes which open into thofe cavities. Sometimes this
cartilaginous fubftance is of a light-red colour, appa¬
rently from a development of very fine blood-veflels ;
fometimes this formation is as ancient as the tubercles
themfelves, an affe&ion which conftitutes the encyjied tu-
lercle. It adheres ftrongly to the furrounding ftrufture
of the lungs, but the tubercles it envelopes can be fe pa-
rated from it, although alfo firmly adherent; and the in¬
ternal furface of the cyft is then found fmooth and po-
liflied, although unequal in its furface.

In cafes of recovery, the above cartilaginous cyft,
forming a communication with the bronchial air-cells,
and lined with the polilhed membrane before mentioned,
which has the fame character as mucous membrane in
general, becomes no longer a fource of irritation, and, the
unnatural cavity alone remaining, the confumption is
arrefted. A ftili more perfeft cure is effefted if the car¬
tilaginous cyfts cicatrize in confequence of an approxi¬
mation of their fides.

By the above-mentioned procefles, then, phthifis is
fometimes cured. In almoft all cafes, however, other
terminations enfue. The tubercles coalefce, and form
enlarged tubica; and then preflure on the branchiae ex¬
cites a fevere bronchitis, which terminates in death, or,
if life be more prolonged, the cyfts degenerate into foul
ulcerations.

The following, then, is the procefs of pulmonary tu¬
bercles •. Firftly, diaphanous miliary granulations ; fe-
cpndly, grey tubercles, more voluminous, and yellow
and opake in the centre; thirdly, tubercles entirely opake,
but ftili of firm confidence ; fourthly, foftened tubercles,
efpecially in the centre ; fifthly, excavations, more or
Jefs completely empty; fixthly, the excavations lined by
a mucous membrane, and their external covering formed
of cartilage; or, on the other hand, an ulcerous cavity
fecreting pus and blood 5 laftly, the cartilage cicatrized,

or, fatally and more generally, the fubftance of the lungs-
deftroyed. It is to be remarked alfo, that, as in other
parts of the body, the tubercular cyft in the lungs fome¬
times contains varieties of morbid matter, as a medul¬
lary or cerebriform matter, a melanofe or black matter, a
cancerous matter, &c. It is needlefs to fay that thefe are
hopelefs cafes, and moft diftinguifiiable from each other,
or from Ample tubercles, during the life of the fufterer.
They are fortunately rare.

Our talk is now to trace the fyrnptoms which accom¬
pany the above-mentioned morbid changes. We have no
fear of being contradicted when we fay, that, notwith-
ftanding all that has been written on phthifis, the early
fyrnptoms of the tubercular formations have never been
correCtly defcribed. This has arifen partly from the con-
fufion of terms ; for, till lately, moft authors have treated
of chronic catarrh, apoftema, vomica, and other infidi-
ous difeafes of the lungs, under the title of confumption ;
while, in more recent accounts, the fame deficiency ftili
exilts from the paucity of examples the phyfician has had
an opportunity of witnefling. Not indeed that there is a
fcarcity of phthifical patients, but becaufe the abfence of
pain or uneafy fenfation prevents them from applying to
medical men in the beginning of the difeafe.

From what we have been able to colled by perfonal
obfervation and from contemporary authors, we conceive,
that a remarkable pallor of the ficin, a diminution of
perfpiration, and a removal of all thofe trifling cutaneous
roughnefles or defcedations from which fcarcely any one
is entirely free, are among the earlieft iigns of confump¬
tion. To thefe alfo is added a feeling of tightnefs in the
cheft on unufual exertion, as running or the like. Some¬
times this tightnefs is abfolutely a pain ; fometimes it is ab~
fent, and a mere quicknefs of breathing follows flight ex¬
ertions. A peculiar placidity of manner is ufually obferved
in patients at this period, and fomewhat of fulnefs in the
face. The next fymptom is a cough, which feems to the pa¬
tient to arife from irritation in the glottis, like that pro¬
duced by the accidental prefence of a hulk of corn, or
other dry fubftance. It is familiarly known by the name
of an bulky or tickling cough. This, which is ufually
worfe towards night, is not however always prefenr.
Thefe fugacious fyrnptoms are of courfe little to be de¬
pended on, fince they are met with in trifling gaftric irri¬
tations ; but they may ferve to direft our attention to the
accelfion of phthifis at an earlier period than it would
otherwife have been done.

The l’ufpicion that thefe fyrnptoms denote phthifis will
be confirmed, if hereditary predifpofition, or if external
fyrnptoms of ftruma, fliould alfo be prefen t. The above-
mentioned appearances do not always produce more formi¬
dable fyrnptoms. They do fo, however, in fo large a pro¬
portion of cafes, that the following defcription may juftly
be called the fecond Jlage. We believe that when it is
the firft ftage, or, to fpeak more plainly, when phthifis is
fuddenly manifefted, and is rapid in its courfe, a chro¬
nic pneumonitis is always very evident, pain and fever
being for the moft part met with.

In the progrefs of this affe<5lion, the pallor of the coun¬
tenance is interrupted by partial flu-ftiing of the cheek.
This is attended with a fenfation of burning heat in the
part flufhed : it is not confined to the cheek ; a fenfe of
burning and rednefs being often feen and felt round the
palms of the hands or foies of the feet. The pulfe be¬
comes frequent 5 a difficulty of lying on one fide comes
on, attended with pain in fome particular pflrts of the
cheft, which is increafed by fudden changes of pofition.
One portion is generally preferred during the whole dif¬
eafe. The irritation being now communicated to the;
mucous membrane of the branchiae, or the irritability
of that membrane being now fo far increafed that flight
variations of temperature aft'eft it with inflammation, the
cough, before dry, becomes attended with copious expec¬
toration. The refpiration is quick and eafily accelerated,
and the noftrils are forcibly moved by it. As this dif-

PATHOLOGY.

cafe advances another grade, and as the tubercles begin
to foften and ulcerate, thefe fymptoms become more
marked ; heClic fever is more tnanifeft, and fuffers even¬
ing exacerbations. Sweats general or partial, but always
debilitating, break out ; the blood becomes more highly
oxygenated, either in confequence of its more rapid
circulation through the pulmonary organs, or from its
more extenfive and c'.ofe application to the air through
the medium of the ulcerated cavities. Hence the phthifi-
cal patient acquires, to a great extent, the high roman¬
tic and imaginative fpirit which has been fo often re¬
marked to attend the paffage over lofty mountains, lltua-
tions in which the air is extraordinarily rarefied. Hence
the never-dying hope, the abfence of all that defponding
q ueruloufnefs which excites our pity, not unmingled
with contempt, in viewing the viftim of hypochondriac
malady. It has been faid, indeed, that the amicability,
ferenity, and gaiety of temper, of the confumptive pa¬
tient, is rather the refult of the temperament that dif-
pofes to phthifis than of the phthifis itfelf; but we be¬
lieve there are few practitioners who have not obferved
that the very firft approaches of confumption are marked
by much lefs hopefulnefs than the latter ltages ; and,
even at times when the conftitutional dilturbance fuffers
an exacerbation, the fpirits are higher than ufual.

To proceed with this picture. Cafes of recovery are too
rare to allow us much to fay as to the appearances of
amendment. We need hardly caution the practitioner
not to be deceived by the cheerfulnefs of the patient,
and by the occafional abfence of all ill feeling which
fometimes 1 alts for a day or fo. The fymptoms which
foretel the fatal termination of the malady are well known.
All the fymptoms are diftreffingly increafed: the quick
pulfe, the evening exacerbations, the colliquative fweats,
the giofly eye, the hurried and difficult refpiration, the
diftended noftrils, and the general emaciation, are all mod:
ftrongly manifefted. To thefe may be added, diarrhoea
and flight delirium. Thefe arrived at the higheft pitch
endurable by the human frame, the patient calls on the
by-ftanders for breath, fnaps with horrid energy at the
air, and expires. This afflicting termination only occurs,
however, when the patient actually dies from dyfpncea,
while the reft of the frame retains to a high degree the
powers of life. More commonly, gradual wafting and
decay entirely exhauftsthe fufferer, and he finks into the
grave without a groan.

According to I.aennec, the formation of the ulcerated
cavities in the lungs may be known by applying the Jie-
thnfcope (fo often mentioned) to the cheft, in which cafe
the ro/ce of the patient ferns to come through the cylinder.
This phenomenon Laennec calls pedoriloquifm. The ftu-
dent may make himfelf acquainted with it by applying
the ftethofcope to the trachea of any individual, or in¬
lean perfons over the infurcation of the bronchia;. The
parts of the cheft over which the ftethofcope is to be ap¬
plied to afcertain an ulceration in the lungs are the an¬
terior and fuperior portion, the axilla, the fpace between
the clavicle and the trapezius mufcle, and the folia above
and below the fpinous procefs of the fcapula. It may be
perfect, imperfeCV, or doubtful. When it is perfect, it
is a certain fign of the exiftence of a preternatural ca¬
vity in the lungs. It is more clearly evident in propor¬
tion to the acutenefs of the voice of the patient ; when
the voice is grave or hoarfe, the peCtoriloquifm is like
the voice coming through a fpeaking-trumpet or roll of
paper. Accidental circumitances fometimes operate to
prevent pe&oriloquiftn from being clearly evident : La¬
ennec finds it proper, therefore, to examine a patient
feveral times ; and in no cafe where peCtoriloquifm was
manifeft did he fail to recognife, by dilTeCtion or by fymp¬
toms, ulceration in the lungs.

The above circuinftances will diftinguilh the latter
flages of phthifis from chronic bronchitis ; but the diag¬
nosis of its firft ftages is more difficult. In chronic
bronchitis the abfence of pain during infpiration, the ca«

285

pability of refting on either fide in bed, (when there is
no abdominal difeafe,) the wheezing noife in refpiration,
the leaden colour of the lips, and the pallidity of the
countenance, the appearance of the fputa, confiding al-
raoft entirely of mucus, are fymptoms which diftinguilh
it from tubercular phthifis. Moreover, the dyfpncea
is greater on exertion in tubercular phthifis, and the
patient cannot take fo large a volume of air into the
lungs as he can in bronchitis. The dyfpncea too is lefs
relieved by expectoration ; and there is a peculiar fenfa-
tion of ftufling complained of in catarrh, which does not
occur in phthifis. The expectoration is various, but
there is always a confiderable quantity of mucus mixed
with the pus-like matter. The quantity of matter ex¬
pectorated in the former difeafe is much greater than in
tubercular confumption. The cough alio in bronchitis
is deep and fonorous. The paroxyfms of heCtic fever
are much lefs regular in chronic bronchitis than in tuber¬
cular phthifis. The perfpirations are more, and the ema¬
ciation lefs, in inflammation of the mucous membrane,
than in tubercular phthifis, though we do meet with
cafes in which the emaciation is as great in the former as
in the latter affeCtion. When the pulmonic fymptoms
have arifen from a difeafed liver, it is a ftrong prefump-
tion that the feat of the difeafe is in the bronchial mem¬
brane ; for in almoft all cafes of this defcription the mu¬
cous membrane is the part affeCied. When this combi¬
nation occurs, the fpirits are always depreffed ; and, in
addition to the ufual pulmonic fymptoms, we have in
this form of the difeafe a painful and diftended epigaf-
trium, unnatural ftools, and difordered digeftion. The
mouth is dry in a morning, and the tongue loaded. The
fits of coughing are conftantly excited when the ftomach
is overloaded, and are apt to come on when the patient
is lying on either fide in bed. If chronic have fucceeded
to acute bronchitis, the emaciation is fometimes fo great,
the heClic fever fo complete, and the matter expectorated
fo purulent, that a perfon feeing the difeafe after it is
formed will often be inclined to believe that he has to
treat an ordinary phthifis ; but an attention to the hiftory
of fuch cafes will frequently lead him to diftinguilh the
former affeCtion from the latter; and the event will
ufually juftify his diftinCtion.

The greateft advantage arifes from tracing thefe. affec¬
tions to their origin. We fometimes find that the fymp¬
toms have come on foon after the difappearance of a cu¬
taneous affeCtion, which ibould always lead us to fufpecl
that the bronchial membrane is difeafed. Notwithftand-
ing all our attention to the occafional caufe by which the
difeafe is induced, to the habit of the patient, and to the
modification of the fymptoms, in the latter llage of the
difeafe it often becomes impoffible to diftinguilh catarrh
from phthifis.

An ignorance of the precife caufes of phthifis we have
before lamented. We lhall put down what is ufually
faid in medical works on this fubjeCt. The predifpofition
is frequently hereditary, defcending from parents whom
the difeafe had attacked, or who had, at fome period of
their lives, been affeCted with fome form of fcrofula. It
is diftinguifhed by external peculiarities of form and ap¬
pearance. Perfons poffeffing fine fkin, with large veins,
foft hair, light eyes, a florid complexion, tall and thin
perfon, long llender neck, narrow cheft, and projecting
fhoulders, may be confidered as having the phthifical pre¬
difpofition. The fine Ikin and complexion, and llender
form, are however much furer emblems of confumptive
predifpofition than the colour of the hair and eyes ; for
the difeafe often attacks dark-haired perfons. Brouffais
refers the confumptive conftitution to an extraordi¬
nary development in the lymphatic fyftem. Frequent
attacks of pneumonitis feem to become caufes of con¬
fumption. The fame may be faid of catarrh, of hsemop-
tylis, or any other difeafes which caufe increafed afflux of
blood into the lungs. But as many perfons, and even
whole nations, fuffer pulmonary difeafe without the fub-

fequeut

PATHOLOGY.

2S6

fequent formation of tubercles, we cut only confider
the above difeafes as a (lifting the production of, rather
than entirely producing, phthilis.

The caufe of the frequency of confumption in Eng¬
land has been varioufly accounted for. It evidently can¬
not be the coldnefs of the climate; for in fofne of the
more northern regions of the globe phthiiis is fcarcely
known: nor, when we confider the fudden hurricanes
and chilling blafts which occafionally alternate with ex-
cefiive heat in hot climates, where the difeafe is equally
unknown, are we jullifiedin referring it to the viciflitudes
of our clime. Some have endeavoured to prove that the
ciampnefs of our atmofphere is the caufe of confumption ;
but in Holland, and other humid fituations, the mortal¬
ity of confumptive patients does not equal that of our
own country. It Will not therefore feem improbable,
that we muft look for the caufe of confumption in a mor¬
bid ftate of the blood; and that the adlion of cold and
moifture merely determines, byincreafing the circulation
through the lungs, the elimination of its morbid mate¬
rial to thofe latter organs. What feems to bear out this
explanation is, that the fame fort of temperaments moft
difpofed to phthilis are alfo difpofed to tubercular depo-
fitions in other parts of the body, if circumftances ope¬
rate to increafe the afflux of blood to thofe parts. The
fame propofition receives further proof from the known
connexion betwxen long-continued impediment to the
fundlions of the liver and phthilis ; and no one can
doubt, that inaction of the largeft gland in the body
muft deteriorate the blood. Still further proof is derived
from the well-known circumftance, that the abforption
of venereal virus does, under certain circumftances, pro¬
duce confumption : an inftance of this we have now un¬
der our care.

We confider, therefore, deterioration of the blood one
caufe of phthilis; debility of the fundlions of the lkin
another. That the functions of the lkin are injured by
cold and moifture, and ftill more by changes of tempera¬
ture; that coldnefs, moifture, and frequency of change,
are the adlual conditions of the Englilh atmofphere ; and
that the determination of blood to the lungs is in direct
ratio to the inaction of the lkin; are propofitions which
no one will be inclined to doubt. Whoever views,
therefore, the exanguious lkin of the perfon difpofed to
dbnfumption, and contrails it with the rough rednrfs of
thofe who, through fullering the viciflitudes of climate
and the privation of wholefome diet, are neverthelefs
wholly exempt from its attacks, cannot fail to learn a
wholefome leifon as to a mode of preventing confump¬
tion. This is, to increafe the adlion of the cutaneous
veflels until a permanent vigour of the lkin is acquired.
As to the means of doing this, much care will be requi-
lite. It will fometimes be neceflary to ufe the warm bath
or fridlion : but, where fymptotns approaching phthilis
are entirely abfent, the cold bath, followed by fuch fric¬
tion as will enfure powerful re-adlion, would be moft
lifeful. In doing this, however, we muft be careful that
the bather does not flop long in the water; and that it
be never ufed except rednefs and heat of lkin follow the
immerfion. Regular mufcular exercife is alfo indifpenfi-
ble, always taking care that expofure to wet be avoided.
The clothing fliould be warm, but not heavy ; and fliould
be fo regulated, that, while the lkin is prevented from
fullering the evil influence of moifture, it is not rendered
morbidly fenfible by extreme heat. The filthinefs of the
cuftom would ever prevent its ufe in a civilized ftate ;
elfe, conlidering the ftimulating influence of oil on the
lkin, we fhould conceive that inundlion muft be a very
powerful agent in ftrengthening this important covering.
To this practice, however, many northern lavages pro¬
bably owe their ability to refill the rigour of their climate.
To return to the fubjedt. The above meafures fhould
of courfe be aflifted by an attention to the food of the
phthifical patient. The reader will obferve, that the
iibove remarks apply merely to the bringing up of chil¬

dren born of a confumptive ftock, or difplaying the
marks of the confumptive diathefis at an early age.

The treatment of phthilis is now to be difeuffed ; and
it naturally arifes out of the above defeription of caufes
and fymptoms. In altnoft all deteriorations of the blood,
fome excels of it will, we believe, be generally found;
and indeed moft authors have feemed to confider bleeding
neceflary to the treatment of phthilis. Even if plethora
did not exift generally, the inaction of the lkin would of
courfe throw a greater proportion of blood than ordi¬
nary into the larger veflels, and confequently into the
lungs. At all events, the propriety of bleeding is pret¬
ty generally allowed. This evacuation Ihould therefore
be made in fmall quantities at a time, and according to
the degree of pain, the rapidity of the attack, and the
hardnefs of the pulfe. In the earlieft periods of the
dileafe, the bleeding will require to be regulated rather
by the fulnefs of the pulfe than by any other fign. If
we are called in atthis period of the difeafe, ourattention
fliould be carefully diredled to the removal of all diftant
irritation ; for often the difeafe of other parts of the
body, efpecia’ily of the liver, is the caufe of phthilis. If
this be not the cafe, and the malady we have to treat be
ftridtly idiopathic phthilis, the lkin muft be excited, the
regulation of diet very clofely attended to, and the pa¬
tient placed in a fituation in which the debilitating in¬
fluence of cold and moifture is carefully excluded. The
warm bath, the flefli-brulli, and a regular ufe of antimony
in fuch dofesas not tonauleateor produce fweating, are
all the means we are poflefled of for fulfilling the nrft
indication. The fecond muft be the bufinefs of the pa¬
tient. It is impoflible today down any exadl rules as to
what food, or what proportion of it, fliould be ufed by
the confumptive patient. There is no doubt in our
mind, that much, very much, may be effected by what
we have before called the dyfpeptic treatment, in curing
phthilis. Not indeed that we are fanguine enough to
fuppofe that this will bring about the abforption of the
tubercles ; but certainly, if it improves the morbid con¬
dition of the blood, it will prevent their increafe, and it
will exert a very beneficial influence on the curative pre¬
cedes which the tubercles undergo in their progrefs to
excavation and cicatrization. A concentrated form of
diet, as jellies, milk, and mucilaginous preparations, has
obtained a popular fame as a regimen for confumptive
patients, but probably without deferving it. Indeed,
conlidering that in phthifis the adlien of the ftomach
does not feem much impaired, we fliould rather ad vife
fparing quantities of meat or vegetables, fince with them
the natural juices of the ftomach and bowels would be
mixed, and confequently the quality of the blood moft
probably improved. We are doubtful whether abfti-
nence fliould he carried merely to the extent of improv¬
ing the digeftivd and aflimilative powers, or whether it
fliould be fo far enforced as to produce emptynefs of the
fyftem. The latter pradlice, lleadily perfevered in, has
certainly fucceeded in removing a variety of morbid
growths on the outfide of the body ; and, from the re-
lult of foine few cafes which have come to our knowledge,
we are inclined to favour its adoption in phthilis. The
excellent Broufi’ais alfo fpeaks well of it. Dry feeding
has alfo been recommended by fome ; and, as it is pretty
well afeertained that nutrition goes on but (lowly, even
from large quantities of food, unlefs a certain proportion
of'drink be taken, this may have operated in the fame
way as rigid abftinence, but it is by no means fo effedlual
as adlual abftinence. It is needlels to add, that ftimula-
ting drinks fliould be forbidden in confumptive cafes.

The third indication, i. e. that of placing the patient
in a favourably-conftituted climate, is next to be attended
to. A variety of places have been recommended for
confumptive patients: thefe have generally been feledted in
warmer climates, on the fuppofition that the caufe of
confumption was the coldnefs of our atmofphere. But
an high temperature is by no means enough to enfure
i alleviation

PATHOLOGY.

alleviation to the phthifical patient. Many places in hot
climates are expofed to bleak winds : often the w inter is
as bleak as our own. The mod: proper fituation is one
in which equability of temperature throughout the year,
protedlion from wind, and denfity of air, are continued.
The occafional cold induced by blalls of wind renders the
fituation of Rome, of Pifa, and even of Nice, objection¬
able. A place called Villa Franca, a fliort diftance from
Nice, has been recommended as a fpot in which the
temperature is uniform, the fite low, and the foil
fertile. But, where pecuniary refources are wanting,
or where the comforts of the native country are relin-
quifned with regret, a fituation may be found at home,
fcarcely if at all inferior to the boafled climes of Italy.
The lower parts of the well-fheltered Devonfiiire have
long been held in repute for the phthifical patient ; and
Dr. Fofter, in a recent work on the “ Climate of Pen¬
zance and Land’s End,” has fbown that the latter places
are fuperior even to that. The contrail of Penzance
with the famous places of refort in Italy, is much in its
favour, as will be feen by the following Table.

Fahrenheit's Thermometer.

Time of Ob¬
servation.

Dec,

Jan.

Feb.

Alar.

Nice, 3 years, (1815-1817)

fun -rife

44

44

47

45

Pifa,

(1814- l8l6)

fun -rife

42

40

43

41

Rome,

(1815-1817)

7 A.M.

42

41

43

42

Penzance,

(1815-1817)

7&8A.M.

42

41

44

42

The benefit confumptive patients derive from a fea-
voyage has induced many to fuppofe that the fea-coafl
mud be an advantageous fituation. This notion has
been confuted, however, by recent obfervation. Mr.
Mansford efpecially (fee Mansford on Pulmonary Con-
fumption) is of opinion, that the vicinity of the fea
fhould be feduloufly avoided. This author confiders
that low inland fituations which enjoy a tolerably equa¬
ble and fomewhat warmer temperature, with a feclufion
from the keen blads of the north and ead, are the fitu¬
ations to be felecled from thofe who are fu fieri ng under
pulmonary confumption. On reviewing various points
in our own ifland, Mr. M. thinks no place prefents fo
many requifites for the refidence of confumptive patients
as the low ground which extends fouthward from the
Mendip Hills ; of which he thus depidls the leading
features : “ Its geographical pofitien is in the fouth-
weftern part of the ifland. The fhelter ad'orded by the
range of hills towards the north, and the lownefs.of its
level, while fpots may be chofen jull fufficiently raifed
above the mailhy lands to efcape the prejudicial and
chilling influence of concentrated moifture, without
being fo high as to defeat the object in view', point it
out as one of the mod eligible. To thefe advantages of
a phyfical nature may be added others of a more obvious
and inviting charadter. The varied and romantic fce-
nery of the neighbourhood does not fail to charm thofe
who poflefs a relifli for the beauties of nature ; while the
tades and habits of individuals may be gratified in the
fociety of a city, or the feclufion of a village.”

Now with regard to the drugs which have procured a
name in the cure of confumption, we fhall pafs over the
lichen, dramonium, tar-vapour, with a hod of others,
becaufe the fliortnefs of their reputation has too clearly
indicated their inutility; and pafs to the confideration of
two medicines which are now much in vogue; viz. the di¬
gitalis and the pruflic acid. Thofe who give the former
drug very properly confine its adminidration to cafes in
which it has the effedl of abating the arterial adlion.
This however is only to be found by its exhibition ; for
we are not acquainted with the external appearances
which defignate the conflitution in which digitalis acce¬
lerates rather than deprefles thepulfe; it fliould be given
in very fmall dofes, and gradually increafed. Though
unable to explain its modus operandi, we may remark,
that a combination of very minute dofes of this drug, as

Vol. XIX. No. 1303.

287

a quarter of a grain given every night with half a grain
of calomel, has done much good, and this in cafes
where no hepatic diforder w'as apparent. We make this
remark becaufe it is well known, that, in phthifis accom¬
panied by difordered liver, a cure is often eftedled by the
gradual ufe of mercury ; and hence many pathologids
confine its exhibition to liver-cafes.

The utility of digitalis, when exhibited w'ith the
above-mentioned reftridt ions, in conjunction with other
meafures, and not as a fpecific, no one will doubt. Of
the pruflic acid we cannot fay fo much. Indeed, the
diftinguifhed authors who have introduced it not having
Hated the peculiar effedls of the drug, and having de-
fcribed it as a fpecific capable of curing phthifis in an
early flage, and alleviating it when advanced, we can
only fay, that it appears to us very extraordinary, that
the fame medicine ihould promote the removal of a tu¬
bercle and the cicatrization of an ulcer, fince thefe ope¬
rations appear efientially different. Moreover, in the
cafes in which we have tried the pruflic acid, a few have
been made worfe, and none have recovered. Neverthe-
lefs it is very probable, that, if w’e knew more of the
precife operation of this medicine, and the time at which
it fhould be ufed, it might prove a ufeful auxiliary to
the treatment of phthifis.

Exercife, by various modes of geftation, has been fre¬
quently employed as a remedy for confumption. Syden¬
ham indeed afferted, that riding on horfeback is as effec¬
tual in the cure of phthifis pulmonalis, as the bark in
agues, or mercury in the venereal difeafe, provided the
journeys be long enough. An example is related in Dr.
Darwin’s Zoonomia, vol. ii. (the cafe of the late inge¬
nious Dr. Currie of Liverpool,) in which an hereditary
phthifis was removed, by perfevering in a daily journey ;
at firll in an eafy carriage, and fubfequently, as the
ftrength increafed, alternately in the carriage and on
horfeback. Some phyficians, however, are of opinion,
that exercife on horfeback is rather pernicious, than
otherwife, in phthifis. Sailing feems to be confidered at
prefent as the mod efficacious mode of geftation, efpecially
if a long voyage is taken, with the double recommenda¬
tion of removal to a warmer climate. As a fort of fub-
flitute for this kind of gentle motion, Ringing has been
recommended as a remedy for phthifis ; and Dr. Carmi¬
chael Smith has written a treatife in its favour. In the
ufe of any or all thefe modes of gentle exercife, however,
the fame precept muft be purfued ; they muft be reforted
to early in the difeafe, and varied with the feelings of the
patient.

When the difeafe proceeds favourably, the fame treat¬
ment as to regular exercife, pure air, and nourifhing
diet, is to be perfevered in ; and the digitalis and other
powerful drugs difcontinued. When the ulceration of
the tubercles is attended with bad fymptoms, we can
only alleviate the fuffering of the patient. It will be too
late to fend him to a foreign clime, or perhaps to allow
exercife. The keeping-up of a regular degree of tempe¬
rature in fpacious apartments, the occafional ufe of nar¬
cotics, among which opium combined with fulphuric
acid, poppies, and ladtucarium, hold the chief rank,
comprifes all that can be done for the palliation of fymp¬
toms, and the prolongation of a wretched exiftence.

Genus IV. Cyrtofis, [from xrplo;, curved.] Rickets, or
curved fpine. Generic charadters — Head bulky, efpe¬
cially anteriorly ; ftature fliort and incurvated ; flefli
flabby, tabid, and wrinkled. There are two fpecies,.

1. Cyrtofis cretinifmus, Cretinifm: chiefly affedting the
head and neck : countenance vacant and ftupid : mental
faculties feeble or idiotic; fenfibility obtufe ; moftiy
with enlargement of the thyroid gland : hereditary.

The term Cretinifm is ufually applied to the idiotic
and incurvated patients ; bronchocele to the fame dif¬
eafe connedted with enlargement of the thyroid gland.
In this fyftem Cretinifmus embraces both. Cretins are
4 E never

PATHOLOGY.

238

never found but where goitres exift, though the latter
are often found without cretins. This feems to (how
that only a more powerful application of the common
caufe is necefl'ary to produce cretinifm.

The precife nature of cretinifm is unknown. It is
fuppofed to be a malady clofely allied to_ fcrofula. The
fame may be faid of the next fpecies. It is well efta-
blifhed that cretinifm is a difeafe of low and moift re¬
gions. Profeffor Fodere, in his Voyage to the Maritime
Alps, had occafion to make numerous obfervations tend¬
ing to prove the truth of this opinion. Bronchocele, or
goitre, and cretinifm, accompany each other in the ma¬
ritime Alps as they do in the Swifs mountains. Here, as
well as in the valley of Aorta, Maurienne, and the Va¬
lais, they are not found in elevated regions; they are not
feen at Saint Dahlias le Sauvage, nor at Molinet, nor at
Tende and Briga ; the maritime places, as well as cold
and dry, or hot and dry, elevated regions, are exempt
from them : but they are commonly met with in the hu¬
mid parts of both the northern and fouthern regions, at
the foot of the fecondary Alps. They are mod frequent
in the valley of Vifubia; and at Saint Martin de Lantof-
ca the greateft part of the population has goitres; there
are here, alfo, fifty cretins from birth : from hence we
rife to Val de Blora, and thofe infirmities are no longer
feen ; but, on defcending again into the valley Tinee,
they are conftantly obferved until we arrive at Saint
Etienne, where not a cretin was to be found. In general,
in the valley Tinee, the inhabitants of the hamlets on the
borders of the river which runs through it, are fubjedl to
goitre and cretinifm, whilft thofe of the hamlets fituate
on the more elevated parts are free from them. The
Valley la Roja prefents alfo ftriking examples of the fame
kind : there is not a cretin or goitre to be feen in the
chief village in it, which is fituate on high ground, whilft
they are numerous in the immediately furrounding re¬
gion, which is comparatively low. The w'hole of the
author’s obfervations ferve to confirm his former remark,
that goitre and cretinifm exift and take their courfe with
the degree of the humidity of valleys, in all temperatures and
climates.

In the United States, Dr. Gibfon informs us, broncho¬
cele prevails as an endemic. It is very frequent in many
parts of Lower Canada, efpecially near the marfhes be¬
tween St. John’s and Montreal. At Detroit, Lake On¬
tario, Oneida, Erie, Huron, and among the Tufcorora,
Seneca, Oneida, and Brothertown, Indians, it is very
common. In many parts of the date of Vermont, efpe¬
cially Bennington and Chittenden, bronchocele is well
known. It is alfo found at Camden, Sandgate, and
Chefter, in the fame ftate. Sandgate, fome years ago,
contained ioao inhabitants, and out of that number one
fourth of the females were affefted with the difeafe. Ac¬
cording to Dr. Trade, bronchocele is fo common a dif-
order at Windfor in Vermont, that hardly any female is
exempt from it. In the ftate of New York goitre prevails
principally in the neighbourhood of Old Fort Schuyler,
the Oneida-village, the German Flats, Fort Herkimer,
Fort Dayton, Henderfon-town, Onondago-valley, Ca-
nafaraga, Brothertown, the townfhip of Manlius, and the
whole of the military diftridh At Angelica, in Alleg-
hany-county, ftate of New York, goitre is a very fre¬
quent complaint. In Pennfylvania, where bronchocele
is very common, it is found chiefly at Pittfburgh, on the
waters of the Alleghany, Sandufky, Monongahela, French
Creek, Cannonfburgh, Brownfville, and throughout the
county of Somerfet. In fome parts of Virginia, efpecially
at Morgantown and'on the banks of Cheat-river, it is by
no means unfrequent. In certain fituations on the
weftern fhore of Maryland, and in North and South Ca¬
rolina, the difeafe is occafionally met with. It is pro¬
bable, indeed, that goitre may be found as an endemic
difeafe in almoft all the mountainous and marfliy diftrisSts
throughout the United States. All writers on the com¬
plaint agree that it generally prevails in valleys at the
bottom of the higheft mountains, which are particularly

expofed to the influence of eafterly and foutherly winds.
In thofe fituations, moreover, where the temperature is
mild and uniform, where the atmofphere is moift, in the
neighbourhood of rivers, of falls or lakes, or of the fea,
where the foil is rich and the habitations furrounded by
fruit-trees, goitres are commonly found.

We (hall now fpeak of the Englifh, or curable broncho¬
cele. The feat o( this difeafe is the thyroid gland, which
lies juft below the larynx, round the trachea. The tu¬
mour appears in the fore-part of the neck, between the
(kin and the wind-pipe. Women are the moft frequent
fubjedts of it ; and in them it ufually appears early. Dr.
Hunter met with one cafe of this kind in a young fur-
geon ; but it is rarely happens in males.

The cretinifmal bronchocele is a tumour arifing on
the fore-part of the neck; it generally firlfc appears fome
time betwixt the age of eight and twelve years, and con¬
tinues gradually to increafe for three, four, or five, years;
and fometimes the Lift half-year, we are told, it grows
more than for a year or two before. It generally occu¬
pies all the front of the neck, for the whole thyroid
gland is enlarged ; and it is of a pendulous form, not
unlike, as Albucafis fays, the flap or dewlap of a tur¬
key cock, the bottom being the larger part of the tu¬
mour. In figure, it varies confiderably in different cafes.
It is foft, or rather flabby, to the touch, and fornewhat
moveable; but, when it has continued fome years after
it hai' ceafed to increafe, it becomes more firm or con¬
fined. By the fituation and nature of the complaint, it
generally occafions a difficulty of breathing, which is in-
creafed on the patient’s taking cold, or attempting to
run. In fome the tumour is fo large, and fo much af-
fefts the breathing, as to occafion a loud wheezing.
Patients, however, fometimes fuffer but little from a
large tumour, while others fuffer much from an inconfi-
derable one : in general, however, it occafions little incon¬
venience. Dr. Hunter obferved, that the tumour now
and then fuppurates.

The bronchocele fhould be diftingnifhed from a fchir-
rhus, from an aneurifm, and from thofe fwellingsin the
neck that arife from drains or ruptured veflels. The
diftin&ion however is not difficult.

An iffue, or a perpetual blifter, applied on fome other
occafions, has apparently prevented the growth of the
bronchocele, though the effect continued only during
the irritation. It cannot be extirpated, as it is entangled
with the recurrent neryes, and the firft branch of the
external carotid artery; and, if by chance a fuppuration
is formed, an ill-conditioned ulcer, difficultly cured, is
the confequence. In addition to the above direflions,
attention to the ftate of the general health, and the re¬
gular exhibition of large dofes of uva urfi, or foda, com¬
prehends all the treatment. If not cured before the age
of puberty, at which time it fometimes amends fponta-
neoufly, little fuccefs can be anticipated.

This applies to the common bronchocele of this coun¬
try. Occurring under the form of cretinifm, as feen in
the alpine regions, we are not aware that any treatment
has been very fuccefsful. Dr. Wylie, of Peterfburg, is
faid to ufe, with good effeft, fridtion with an ointment
compofed of § fs of litharge ointment, 3j of calomel,
and gr. x. of tartrite of antimony. And we learn in the
Appendix to Dr. Clark’s “ Notes on France, Italy, &c.”
that M. Quadri thinks highly of the treatment by feton.
“ I find,” fays he, “that all goitres of a foft confidence,
and not arterial, were cured quickly and fafely by the
feton. Of twelve individuals on w'horn the operation
was performed, eight were perfectly cured.” Probably
removing to a higher fituation, and living in the belt
manner, might in the courfe of a few generations exhauft
the difeafe. See Cretins, vol. v.

2. Cyrtofis rachia, the rickets : chiefly affedting the
limbs and body; fpine crooked ; ribs deprefled ; articu¬
lar epiphyfes enlarged and fpongy ; belly tumid ; mental
faculties clear, often premature.

Ufually the firft appearance of rickets is in the eighth

or

PATHOLOGY. 2 89-

or ninth month of the child’s age. The feveral parts of and imperfectly, and healing with difficulty; upper lip
the body by degrees become difproportioned ; the fkin thickened ; fkin fmooth ; countenance ufually florid,
grows lax, the belly flaccid ; the mufcles are extenuated, The belt divilion of Strumais derived from its external
particularly thofe of the neck ; the joints of the hands, or internal appearance. Dr. Good’s claffification accords
arms, knees, and feet, are enlarged, fo that there feem with this principle. It is long flnce Mr. Abernethy re-
to be excrefcences on the bones of the wriftsand ankles ; ferred to diforder of the digeltive organs fcrofulous dif-
the bones and the f'pine, too weak to fupport the body, eafe; and the fame opinion has been taken up by Dr.
are at length incurvated ; the child walks with more Carmichael Smyth, and more recently by Mr. Lloyd,
difficulty, until this exercife becomes too troublefome to Neither of thefe authors, however, has advanced the
be continued ; the carotids and jugulars fwell, but the etiology of the difeafe one ilep. Its connexion with
other blood-veflels difappear; the head grows large ; the diforderof the digeftive organs no one can fail to fee ;
futures are more vifible ; the fontanel is often membra- but the mode by which the latter aft on the former is by

nous; the neck too weak to fupport the head fteadily.
The countenance is, however, lively, and the child is
more fenfible than ufual at the fame age ; the breaft is
ftraif, and compreffed on its fides; the Tternum riles up
in a point, and the extremities of the ribs are enlarged
and crooked ; the hypochondria fwell ; fever, with fymp-
toins of conlumption, comes on, and the patient finks
from debility. In children predifpofed to rickets the
teeth come forward llowly, and foon decay. The appe¬
tite, however, feldom fails; but digeflion is moftly im-
perfeft.

The rickets chiefly prove fatal from the attending
heftic, confumptive fymptoms, or afthma. If the dif¬
order continues after the fifth year of the child’s age,
the body ufually continues weakly hnd deformed for the
whole life. The bones of the legs, though very crooked,
will become nearly, often perfeftly, ftraight during the
growth of the child, if it becomes ftrong and healthy.
On diffeftion, the mufcles are found pale and flaccid, the
liver indurated, the mefenteric glands enlarged and
hardened, the bones fpongy. Its ufual period of attack
is from fix months to two years; but it has attacked
adults. The top of the fpinal marrow is faid to have been
uncommonly hard and obftrufted ; water is fometimes
found between the dura and pia mater ; and the brain is
enlarged.

The immediate caufe of rickets is the want of a due
proportion of phofphate of lime in the bones. The re¬
mote caufes of this deficiency are difordered ftate of the
digeftive organs, in confequence of which bad blood is
prepared, and inaftion in the veflels which fecrete the
healthy part of bone. The means employed in the treat¬
ment are the fame as in that of dyfpepfia ; viz. regular
pajfive exercife, bathing, medicines which flightly ftimu-
late the ftomach, thofe which open the bowels, and thofe
which promote the fecretion of bile ; nutritive diet, and
country air. Months and years will often elapfe before
a cure is eft’efted ; it is in all cafes a tedious affair.

Genus V. Alphofis, [from ahtpo;, white.] White lepro-
fy. Generic characters — Cuticle, among negroes, white
and colourlefs ; hair white and woolly; irids white; pu¬
pils rofy; fight ftrongeft in the fliade; corporeal faculties
feeble ; mind unimpaired.

There is but one fpecies, which is the Albino, or
White Moor. See the article Albinos, vol. i. p. 240.

A variety is found among Europeans with fair cuticle;
flaxen hair; irids blue; pupils rofy; corporeal powers
weak; mind unimpaired. Trail, in Nicholfon’s Journal,
Feb. 1808.

“ The whitenefs is probably produced by a want of the
fecretion of the pigment that renders the rete mucofum
black ; and which does not ufually take place till feveral
weeks, fometimes months, after birth ; the negro-child
being fair when firft born.” The Spaniards and Portu-
guefe denominate thofe who are thus affefted Albinos;
the French, Blafards ; the Dutch, Kacklacken.

Genus VI. Struma, [from cflpupet, Gr. coacervation ;
not, lays Good, from Jiruo, Lat. to heap up.] Scrofula,
or King’s Evil. Generic charafters — Indolent glandu¬
lar tumours, chiefly in the neck 5 fuppurating flowly,

no means apparent. We are very well able to afcertain
how dyfpepfia difturbs the nervous and vafcular fyftems
of remote parts ; but, when we come to confider it in
relation to fcrofulous difeafe, we afk why every intenle
dyfpepfia does not produce fcrofula in fituations and ex¬
ternal circumftances favourable to its development. If
it be anfwered, that dyfpepfia produces fcrofula only in
conftitutions predifpofed to the latter malady, we aik in
what this predifpofition confilts. We have already fliovvn,
that a predifpofition to inflammation confifts in a want or
an excefs of contraftile power in the vafcular fyftem ;
and that a predifpofition to nervous difeafe confifts in an
habitually higher degree of fenfibility in particular nerves.
But the predifpofition to fcrofula is by no means clearly
made out. Brouffais indeed refers the fcrofulous confti-
tution to a preponderance of the lymphatic fyftem over
the nervous and vafcular fyftems. Upon the whole, it
muft be allowed by all, that the nature of the difeafe
called fcrofula is at prefent unknown.

Some recent authors have comprifed under the term,
fcrofula a very large proportion of the chronic phlogoti-
ca ; but, it feems to us, without juft caufe. We ffiaU
confine ourfelves in this article to the term in its oider
and more reftrifted fenfe. There are two fpecies.

1. Struma vulgaris : confined to the external conglobate
glands: tumour pea-fized, or chefnut-fized ; appearingin
infancy or-youth ; fubfiding on mature age ; hereditary.

Two conditions of the body are to be defcribed in
treating of fcrofula. The firft, the appearance of the
perfon predifpofed to fcrofula ; and the fecond, the ap¬
pearance of the difeafe when formed. The fcrofulous
conftitution is obferved to be, in many inftances, denoted
by particular fymptoms. It has been faid that the com¬
plexion is fair, and the colour of the hair either reddifti
or of fome other light tint ; but people with dark com¬
plexions and black hair are equally i'ubjeft to fcrofulous
complaints. The fkin is remarkably foft and white, and
the face often has a fhining polifhed fmoothnefs. The
cheeks are in general florid ; and the tunica albuginea is
frequently of a dead white colour, and more pale than
ufual. The edges of the eye-lids are affefted with a de¬
gree of tendernefs which eafily degenerates into a trouble-
lome inflammation, that diftreftes the patient by its con¬
tinuance, and produces a difagreeable degree of deformi¬
ty. This rednefs is very common and remarkable. There
is likewife very frequently a fwelling of the upper lip,
with fome thickening of the noftrils and point of the note,-

One of the moft frequent fymptoms of fcrofula is a
fwelling in the fuperficial lymphatic glands, efpecially in
thofe of the neck. Such glands fwell without any pre¬
vious complaint, and often attain a large fize before the
fwelling attrafts notice. The fwellings are frequently
unaccompanied with pain or difcolouration. The fame
indolence and abfence of inflammatory fymptoms, which
charafterize fcrofulous fwellings of their glands, likewife
diftinguifh fimilar affeftions in other parts of the body.
The commencement of the attack is, in general, unper¬
ceived, and the progrefs flow; though the tumefaftion
which follows is frequently very conliderable.

The greater number of fcrofulous affeftions are accom¬
panied with a preternatural fwelling of the parts attacked.
The tumour is of two kinds ; one remarkable for its foft-

:oefs,

1

290 P A T H O

nefs, the other of a more firm confiftence. Soft fcrofu-
lous tumours are always formed by the effufion of a fluid j
and it may be remarked that they are fomewhat variable
in their fize, being one day more prominent and tenfe,
the next more funk and flaccid. When they are opened
in the early ftate, they are found to contain nothing but
a ferous fluid, which lies in the cells of the cellular mem¬
brane. As the fluid is not contained in one common
cavity, the tumour has a foft flabby feel, and imparts to
the fingers of a furgical examiner no diftindt fenfation,
either of elafticity or fluctuation. But, when the fluid
has been for home time eft'ufed, a finking difference oc-
curs, a fluid lodged in a particular cavity now being
evidently perceptible. This change feems to proceed
from the deftrudtion of the partitions which are between
the ceils of the cellular fubftance. As thefe collec¬
tions, however, are not accompanied with any fen Able
degree of inflammation, they are not furrounded with a
firm, folid, circumfcribed bafe ; and they do not betray
any great tendency to ulcerate the flcin, and burft of their
own accord. Hence they fometitr.es become very promi¬
nent, and the flcin is gradually diftended to a furprifing
degree.

The matter contained in fuch tumours alfo undergoes
a change. After a time, the more folid parts are depo-
fited in the form of little maffes, refembling coagulated
milk. The remaining portion of the fluid is rendered
thinner, and refembles whey. A quantity of purulent
matter is alfo formed on the internal furface of the cavity,
which feems to he attacked with a flow kind of inflam¬
mation. The admixture of this purulent matter greatly
changes the appearance of the contents of the tumour,
and they now bear more refemblance to thofe of a com¬
mon abfcefs. They never acquire, however, exadtly
the properties of healthy purulent matter, being always
thinner, more tranfparent, and more of a greenilh co¬
lour.

Although the tendency to ulceration is not confidera-
ble, the lkin at length gives way, and allows the matter
to efcape through a narrow opening. After the contents
are evacuated, the tumour fubfides; but, there being in
general little difpofition in the parts to heal, a fcrofulous
lore is ufually formed, which difcharges unhealthy mat¬
ter, and continues open for an indefinite length of time.

The other more firm kind of fcrofulous fwelling al¬
ways increafes flowly, and mofl commonly attacks the
neighbourhood of joints. The affedted part enlarges,
without acquiring any circumfcribed determinate form.
By degrees the tumour becomes fofter; and at laft parti¬
cular portions near the furface become more prominent,
inflame, fuppurate, burft, and difcharge matter. But,
as the fuppuration is only partial, and the difcharge in-
confiderable, they have little effect in diminUhing the fize
of the fwelling, or in producing any other change of
importance. The only difference occafioned is the addi¬
tion of little ulcerations, which lead to iinufes, and emit
matter.

A common abfcefs, in a perfcn of a fcrofulous condi¬
tion, often exhibits appearances which betray the dif-
eafed ftate of the fyftem. The matter firft fecreted is
formed with extraordinary rapidity; the fwelling is fome¬
what more tranfparent, the furface more (hining, and the
colour of the tumour more blue, than is obfervable in a
cafe of healthy abfcefs. Scrofulous abfceffes alfo con¬
tain, before they burft, a larger quantity of purulent
matter, in relation to their fize, than common phlegmo¬
nic abfceffes. When abfceffes in fcrofulous patients burft,
an empty cavity is not left; but there is feen a mafs of
cellular membrane apparently deprived of life. It refem¬
bles wet cotton, and often feparates in the form of a fo¬
lid mafs. The reparation is effected without pain. This
ftate of the cellular membrane bears fome remote analogy
to the death of the central parts in a carbuncle ; but it
differs from the latter difeafe by there being no malignity,
pain, nor danger.

LOGY.

The bones of fcrofulous people partake of the general
difeafe in the conftitution ; they feem to contain a fmall-
er proportion of the phofphate of lime, and a larger one
of gelatinous matter, than what exifts in the compofition
of a healthy bone. They are alfo exceedingly fuicepti-
ble of morbid adtion. The particular changes, however,
induced in the bones by fcrofula, are not to be treated of
in this place.

With regard to fcrofulous juicers, their margin is com¬
monly of a pale red or purplifti call, with a (hining fur¬
face; the edges in general thin ; and the furface of the
fore funk fomewhat below the level of the furrounding
parts. Thefe fores are moftly attended hut with a fmali
degree of inflammation, and little pain ; they are not very
fenfible, and have no great difpofition to fpread. The
matter difcharged from them is vifcid, having very little
colour, and often an offenfive fmell. In confequence of
its vifcidity it adheres to the furface of the fore, and co¬
vers the granulations. It is to be obferved, however,
that fcrofulous ulcers fometimes affume a more malignant
afpedt, having elevated indurated edges, and fungous
central granulations, accompanied with pain and an icho¬
rous difcharge. In thefe cafes, they may counterfeit the
appearance of cancerous ulcers; but, though the refem¬
blance may be very impofing, we are in general able to
afcertain the real nature of the cafe, by tracing its hif-
tory from the commencement, and by infpecting the reft
of the patient’s body with accuracy ; when the veftiges
of former fcrofulous fores, or other proofs of a fcrofu¬
lous conftitution, often manifeft themfelves.

Scrofulous fores often continue to difcharge for a long
while, with very little change of appearance. In time,
however, they begin to heal, and, for the moil part,
dry up altogether at laft, leaving a very ugly red irre¬
gular cicatrix, upon which the flcin feldbm recovers its
natural look. In general, fcrofulous complaints are moft
troublefome in the fpring, and get better towards the
end of the fummer.

Scrofula is an hereditary difeafe. It is doubtful whe¬
ther it can be communicated by contadt, or even inocu¬
lation. Kortum tried to transfer fcrofula from one per-
fon to another by inoculation ; but, although he took
great pains to infert the matter completely, and repeated
the experiment frequently, yet all his attempts failed, as
no difeafe was communicated to the perfon inoculated,
nor even any very evident irritation excited at the pk.e
where the matter was inferred. Yet it is unqueftionably
propagable by transfufion of blood from the difeafed
horfe, not only to other horfes, but to affes, as has been
lately proved by profeffor Coleman at the Veterinary In-
ftitution.

The remote caufes of fcrofula are Well eftabliftied.
Every circumftance capable of prolonging for a certain
fpace of time irritation of the bowels ; an alteration in
the quality of the blood from injuries of the nervous fyf¬
tem ; and, above all, a cold and humid atmofphere ; will
produce fcrofula. The laft caufe is perhaps the moft
frequent of all. The means of cure are therefore ob¬
vious. The fame regulations that we haveadvifed under
phthilis, for exciting and ftrengthening the flcin, are to
be put in force. The diet fhould be regulated ; the fe-
cretions of the mucous membranes gently excited. In
performing the firft indication, much ft refs has been laid
by Mr. Lloyd upon the necefiity of warm clothing. This
is a very important matter. Flannel fliould be worn next
the flcin ; and the patient fhould ufe every means in his
power to keep up a regular temperature of the body.
For this purpofe, rhe drefs fhould be as heavy at one pe¬
riod of the day as another; and the pradtice of fleeping
under too many bed-clothes avoided; there being good
reafon to believe that a great majority of perl'on s err in
this latter refpedl. Cold bathing, whenfoUozved by re-aCtion,
fhould alfo be enjoined; and the patient fhould remove
toa lefs humid air than that in which he has been accuf-
tomed to live. The regulation of the digeftive organs

embraces

PATHOLOGY.

embraces modifications of dyfpeptic treatment obvious
enough. The bowels are to be kept regular; and the
hepatic fecretion excited, if depraved in quality or defi¬
cient in quantity. For opening the bowels, the mildeft
purgatives only mull be ufed, irritation of the mucous
membrane being feduloufly avoided; for irritating ca¬
thartics aggravate the difeafe. According to the condi¬
tion it happens to be in, the ftomach will require to be
excited by gentian, fteel, and aromatics ; or, on the con¬
trary, to have its morbid fecretions corredled by fedatives
and alkalies. The diet will be regulated by the fame cri¬
terion. In moft cafes folid animal food may be allowed ;
but this of courfe will depend on the powers of digeftion,
fince, if the food be not properly digelted, little mull be
taken, and that reduced to a pulpy confidence. If mor¬
bid growths are large, and their continuance dangerous,
much may be effected towards their difcuflion by extreme
abltinence, and the exhibition of finall dofes of antirno-
nials daily. The external treatment of fcrofulous tu¬
mours, ulcers, &c. is obvious. Little, in the majority
of cafes, need be done. If they put on an inflammatory
appearance, the ufual means for the reduction of inflam¬
mation is to be put in force ; if they are indolent, flight
irritants, or, as the cafe demands, counter-irritants, mull
be reforted to. The treatment of fcrophulous ulcers
and abfcefles will receive further notice under the article
Surgery.

2. Struma mefenferica : afFedling the mefenteric glands;
countenance pale; appetite infirm ; abdomen tumid ; ex¬
crements ufually peculiarly fetid.

The nature of this fpecies of fcrofula is pretty evident.
The application of irritating matter to the termination
of the mefenteric abl'orbents is the primary caufe. This
irritant is either improper food, or food undigefted in con-
fequence of dyfpepfia. The irritation on the oral extre¬
mities of the abforbents caufes an inflammation of their
vefl'els, which is communicated to their glands ; the in¬
flammation deftroys in a great nleafure the abforbing pro¬
perty of the vefl'els ; and, when the inflammation termi¬
nates in depofition of morbid matter, as tubercles, &c.
thofe properties are entirely loll; confequently the fup-
ply of chyle to the blood is flopped, emaciation and de¬
bility follow, and the patient dies. The detail of fymp-
toms is fufficiently full in Dr. Good’s definition. As to
the treatment of the malady, this is to remove the exci¬
ting caufes ; under which plan, during its early ftages,
the difeafe may be removed. Gentle dofes of calomel,
althelmintics, wholefome diet, and the other meafures
ufed in the treatment of difeafes arifing from gaftric,
bilious, or inteflinal, irritation, are to he adopted. In the
latter flages of the difeafe, extreme abltinence appears to
be the only means capable of arrefting the depofition of
tuberculous matter. Dr. Uwins has related a cafe, in
which very minute dofes of digitalis, we believe one
drop, gradually increafed, effedled a cure. Moft pradli-
tioners trull to fmall dofes of calomel and opium.

The fymptoms of this complaint are very fimilar to
what Dr. Gregory has called u fcrofulous inflammation
of the peritoneum.” It is very nearly the fame com¬
plaint, except that the irritation does not feem to be de¬
rived from the inteftines. The treatment of this latter
difeafe, with the addition of occafional bliftering, is the

fame as in the Struma mefenterica.

' ^

Genus VII. Carcinus, [from y.apy.mo;, cancer, a crab ;
on account of the cancriformor crab-like ramifications of
the dark diftended veins of the tumour.] Cancer. Ge¬
neric charafters — A fcirrhous livid tumour, interfered
with firm wliitifli divergent bands, chiefly of the fecer-
nent glands ; pains acute and lancinating, often propa¬
gated to other parts ; terminating in a fetid and ichorous
ulcer. Dr. Good makes but one fpecies.

Carcinus vulgaris : tumour burning, knotty, with dark
cancrifortn varices ; ulcer, with thick livid retorted lips.
^ A hard unequal tumour that is indolent, and with-
Yol. XIX. No. 1304.

291

out an y difcoloration in the Ikin, is called' a fcirrhus ; but,
when an itching is perceived in it, which is follow'ed by
a pricking, (hooting, or lancinating^ pain, and a change
of colour in the fkin, it is ufually denominated a cancer.
It generally is fmall in the beginning, and increafes gra¬
dually; but, though the Ikin changes to a red or livid
appearance, and the ftate of the tumour from an indo¬
lent to a painful one, it is fometimes very difficult to fay
when the fcirrhus really becomes a cancer, the progrefs
being quick or flow according to concurring caufes.
When the tumour is attended with a peculiar kind of
burning fnooting pains, and the ikin hath acquired the
duikv purple or livid hue, it may then be deemed the ma¬
lignant fcirrhus, or confirmed cancer. Mr. Pearfon fur¬
ther adds, when thus far advanced in women’s breafts,
the tumour fometimes increafes fpeedily to a great fize,
having a knotty unequal furface, more glands becoming
obftrufted, the nipple finks in, turgid vefl'els are confpi-
cuous, ramifying around, and refembling a crab’s
clav.'s. Thefe are the character: flics of an occult cancer
on the external parts; and we may fufpedl the exiftence
of one internally, when fuch pain and heat as hath been
defcribed fucceedin parts where the patient hath before
been fenfible of weight and preffure, attended with obtufe
pain. A cancerous tumour never melts down in fuppu-
ration like an inflammatory one ; but, when it is ready to
break open, efpecially in the breaft, it generally becomes
prominent in fome minute point, attended with an increafe
of the peculiar kind of burning fliooting pain, felt be¬
fore at intervals in a lefs degree, and deeper in the body
of the gland. In the prominent part of the tumour, in
this ftate, a corroding ichor fometimes tranfudes through
the fkin, foon forming an ulcer ; at other times a confi-
derable quantity of a thin lymphatic fluid, tinged with
blood from eroded vefl'els, is found in it. Ulcers of the
cancerous nature difcharge a thin fetid acrid fanies, which
corrodes the parts, having thick dark-coloured retorted
lips; and fungous excrefcences frequently rife from thefe
ulcers, notwithftanding the corrofivenefs of the difcharge.
In this ftate they are often attended with excruciating,
ungent, lancinating, burning, pains ; and fometimes with
leeding.

Though a fcirrhus may truly be deemed a cancer as
foon as pain is perceived in it, yet every painful tumour
is not a cancer ; nor is it always eafy to fay whether a
cancer is the diforder or not ; irregular hard lumps may
be perceived in the breaft ; but on examining the other
breaft, where no uneafinefs is perceived, the fame kind
of tumours are fometimes found, which renders the di-
agnoftic uncertain. Yet, in every cafe after the ceflTa-
tion of catamenia, hard unequal tumours in the bread
are fufpicious ; nor, though without pain, are they to be
fuppofed indolent or innoxious. Barren women, old
maids, and thofe who mifmenftruate, are chiefly the fub-
jedls of cancer.

The nature of cancer is unknown. It has long been
difputed, whether it was . a general difeafe, a portion of
the fluids determined by different caufes to the aftedled
part, or whether any accident to the organ difeafed altered
its former habits, fo as to produce a poifonous corrofive
fluid inftead of the ufual falutary one. We regard it as
local; and in this opinion many of the bell practitioners
of the prefent day, among whom are Mr. Abernethy and
Dr. Baillie, concur. All its fymptoms imprefs the notion
that it is a local inflammation, as far as regards the vaf-
cularfyftem, in which the feceryients, from hereditary
predifpofition (which we cannot admit to exift in the
blood), or from other at prefen t unknown caufes, lofe their
natural functions, and acquire a faculty of fecreting a
new and peculiar poifon. This a 61 ion of the fecernents
is fo exceflive, that no known agents are capable of con¬
trolling it. The arguments adduced in favour 'of the
general origin of the difeafe are thefe ; that it is heredi¬
tary, and often met with in the fame family. This can
be no argument in favor of it, were it not prefumed that
4 F hereditary

292

PATHOLOGY,

hereditary predifpofition confifts in a peculiar crafts of the
blood. But this is fo far from proved, that the opinion
that the ftate of the nervous fyften: conftitutes predifpo-
fttion has the molt fupporters. Thus it is faid by Dr.
Parr (fee his article Cancer), that in fix cafes in which
he found cancer heal, the famedifeafe broke out in other
parts; or apoplexy, enteritis, & c. fupervened. This
proves nothing ; or, if any thing, rather againlt the pro-
pofition of the cacheCtic origin of the malady. For, as
to the occurrence of cancer in another part when an old
cancer is healed, does this prove the blood difeafed ? does
not the fame thing follow the healing of Ample ulcers,
and the reduction of common phlegmon ? yet no one will
refer thefe maladies to difeafed blood. Arid again ; how
does it happen that apoplexy and enteritis follow the cure
of cancer? according to this mode of argument, cancer of
the brain or bowels lhould enfue !

At prefent no remedy for cancer is known ; nor has
any plan of treatment been laid down for its early ftages
which fhould warrant us in negleCting to urge, with all
the eloquence we are matters of, the extirpation of the
difeafed part. Previous to amputation of the breaft,
however, much care will be requifite to regulate the di-
geftive organs, the ftate of fulnefs of the fanguineous
fyftem, and, in women, above all, that of the catamenial
flux. Dr. Good makes two varieties of this l'pecies.

ct.-C. pullulans : granulating occafionally, and giving
delufive.hopes of a cure ; pains paffable.

(3. C. fpongiofus, (Fungus hasmatodes, Wardrop :)
■with fungous and bleeding excrefcences ; heat and pain
violent.

The latter difeafe was firft defcribed by Mr. Hey, in
his Practical Obfervations in Surgery. “ ft is a bloody
tumour, which forms in every part of the body : painful
when feated in the mufcles ; but producing little incon¬
venience when in the cellular fubftance. It diltends the
integuments ; but does nor, like an abfcefs, render them
thinner. When prefi'ed with the hands, one part will
give the fenfation of a deep-feated fluid ; in another the
tumouris hard and uneven. When the integuments burft,
the appearances are fometimes thofe of an excoriation
only ; fometimes a dark bloody mafs protrudes through
the aperture. Where the fungus comes into contaCt
with the mufcles, they lofe their natural rednefs and their
fibrous appearance, becoming brown, and like the adi-
pofe membrane. When the fungus appears through the
fkin, it bleeds copioufly, and the hemorrhage is frequent¬
ly repeated till the patient finks; neither the hydrargyris
nitratus ruber, the hydrargyris muriatus, antimonium
muriatum, or undiluted vitriolic acid, can reprefs its
growth. Amputation is the only remedy; and if the
tumour has begun at the lower part of a limb, and the
flighted portion is left at the upper, the difeafe returns.
It appears to be an organifed, and has been fancifully
conjeCtured to be a living, parifitic animal, nourilhed by
the vital fluid of the patient, and capable of abforbing
from the fubjacent veflels what is eft'ufed from its own.”

-Genus VIII. Lues, [from Xvia, to diflolve, or corrupt.]
The Venereal difeafe. Generic characters — Ulcers on the
genitals, inguinal buboes, or both, after impure coition ;
fucceeded by ulcers in the throat, copper-coloured fpots
on the fkin, bone-pains, and nodes. It is now confidered
as divided into two fpecies.

1. Lues fiphilis, the common fiphilis, or pox : ulcers
on the genitals circular, ungranulating, thickened at the
edge; thofe of the throat deep and ragged; fymptoms
uniform in their progrefs; yielding to a courfe of mer¬
cury, not known to yield fpontaneoufly.

2. Lues fiphilodes, pfeudo-fiphilis, fibbens, orfivvens:
ulcers undeterminate in their character ; fymptoms irre¬
gular in their appearance ; ufually yielding fpontaneoufly;
varioufly aft'eCted by a courfe of mercury.

This is perhaps only a variety of the preceding; and
many other varieties might be noted, but they have not
hitherto been fufficiently defined for claffification , for

which reafon, and becaufe a full account of the various
conflicting opinions upon the nature and various forms
of this difeafe would increase this article to an enor¬
mous fize, we mud (having given the early and popular
hiftory under Lues, vol. xiii.) refer for farther parti¬
culars to the article Siphilis.

GCnus IX. Elephantiafis, [fo denominated by the
Greek phyficians, becaufe the fkin of perfons affeCted
with this difeafe refembles that of the elephant in thick-
nefs, ruggednefs, infenfibility, and dark- hue.] Elephant-
fkin. Generic characters — “Skin thick, livid, rugofe,
tuberculate; infenfible to feeling; eyes fierce and flaring ;
perfpiration highly offenfive ;” tefticles wafted. Seethe
article Leprosy, in this work. There are three diftinCl
fpecies.

1. Elephantiafis ArabSca, the black leprofy. (This is
the Elephantiafis of Aretaus, Sauvqges, and Cullen .) Tu¬
bercles chiefly on the face and joints; fall of the hair
except from the fcalp ; voice hoarfe and nafal ; diforder
contagious, and hereditary.

2. Elephantiafis Italica, fo called by Dr. Good, becaufe
“ for a knowledge of it we are almoft exclufively indebted
to Italian phyficians, by whom it is called Pellagra, ficen-
affedinn from pellis and aypa ; a barbarous term, as com¬
pounded of two different languages.” It is otherwife
called Mai del Sole, as if brought on by the heat of the
fun. In this fpecies, the tubercles are chiefly on the
body and limbs; fometimes defquamating : great tenfion
of the fkin ; vertigo ; burning lancinating pain in the
head; melancholy; at firft remitting, afterwards fixed,
terminating in alienation of mind : hereditary.

3. Elephantiafis Afturienfis : (Mai de la Rofa, Spnnijh .
Lepra Aftiirienfis, Sauvages.) Tubercles chiefly on the
hands and feet; cruftaceous, defquammating ; continual
tremor of the head and upper part of the trunk ; bald-
nefs of the fcalp as well as of other parts : gloom and
terror of mind.

Genus X. Bucneniia. [from£ov, an augmentive particle,
and Kt'ij/avj, the leg.] Tumid leg. Generic characters —
Leg enormoufly tumid and mif-fhapen ; fkin thickened,
livid, rugofe ; often fcaly ; fcrotum, arms, or other parts,
fometimes participating in the afFeCtion. Only one fpe¬
cies, called

Bucnemia Indica, or Barbadoes-leg ; bones and muf¬
cles of the affeCted limb found ; its motion little impeded
by its weight.

This difeafe, fays Dr. Good, “ is, in truth, the dal fil,
or elephant-leg of the Arabians, the Barbadoes-leg of
modern writers, and for which no proper technical name
has hitherto been offered. Though frequently called
elephantiafis, from a mifunderftanding of the fecondary
meaning of two unequivocal terms in two different lan¬
guages, it is without the eflential character of tubercular
eruptions ; while unlike the Elephantiafis, which extends
over the whole body, it is always limited, and often con¬
fined to a fingle limb. It makes, however, an approach
to Elephantiafis, and ought therefore to range near it,
but it cannot be included in the fame genus. It is very
generally known both in the Eaft and Weft Indies, in
Arabia, and along the whole range of the Polynefian
Ifles ; in which laft it is denominated yava-Jltin ; as being
fuppofed to originate from drinking the heating beverage
called yava ; and, like the gout among ourfelves, is re¬
garded in a fort of honourable light. Inftances of it
are frequently to be met with in our own country ; and,
in a cafe that occurred to the author about a twelve-
month ago, the patient, from an attempt to repel it, was
fuddenly attacked with a fit of gout in the ftornach,
which deftroyed him in three days. Here, however, gout
was a conftitutional difeafe.”

Genus XI. Catacaufis, [Gr. burning.] General com-
buftibility of the body. No generic characters are given,
and only one fpecies noted by Dr. Good, which is

Catacaufis

t

PAT H O L O G Y,

Catacaufis ebriofa : the combuftibility occaiioned by a
Jong and immoderate ufe of fpirituous liquors; and pro¬
ducing combuftion fpontaneouily. For inftances, fee
Phil. Tran f. vol. xliii. and lxiv. Journal de Phyflque,
Pan viii. Le Cat’s Memoires; and the article Burning
in this work, vol. iii. p. 533. Since thatarticle was print¬
ed, we have met with fome cafes more recent and more
extraordinary than any there related.

In thevear 1S1 1, John Heinrich Kopr>, M. D. profeffor
of cliemiftry at Hanau, pub'ilhed at Frankfort a little
treatife with the laudable view of exciting attention to
fpontaneous combuftions of the human body; and espe¬
cially as being neceflarily fubjeff to juridical inveftigation.
Seventeen authenticated cafes of this kind of combuftion
are related. Sixteen of thefe occurred to females, and
the feventeenth to a man. This laft has the peculiarity
of the perfon furviving the accident three days, and of
his being able to give fome account of the circumftances
and fenfations by which it was accompanied. The Angu¬
larity of this cafe induces us to give a tranflation of it ;
but we regret that it did not come under the immediate
obfervation of Dr. Kopp ; it is cited by him from a Flo¬
rentine journal, in which it was inferted by Jofeph Bat¬
taglia, a furgeon at Porte Bafto, who attended the pa¬
tient. “ Don G. Maria Bertholi, a prieft, who lived on
Mount Volere, in the neighbourhood of Fivizzani, went
on bufinefs to a fair at Filetto. After having walked
about the whole day, he went, toward evening, to Fenile,
and put up at a relation’s. Immediately after his arrival,
he retired into his bed-room, and defired to have a hand¬
kerchief placed on his back, under his fliirt. In a few'
minutes after this, being left by himfelf, a Angular noife,
mingled with cries, was heard from his bed-room. The
people of the houfe ruftied in, .and found the prieft
llretched on the floor, furrounded by a fmall lambent
flame, which retired as the perfons approached, and at
length entirely vanilhed. He was immediately put to bed,
and the next morning (fays Battaglia) I vifited him.
On a careful examination, the integuments on the right
arm were found loofened from the mufcles, and hanging
down. Between the ftioulders and thighs the integu¬
ments were equally injured. An incipient mortiflcation
appeared on that part of the right hand which had been
moft injured. On the fecond day, this part was in a com¬
plete ftate of gangrene. On the third day, the mortiflca¬
tion had extended to all the injured parts. The patient
now had excefiive thirft and fever, violent convulflons,
putrid evacuations from the bowels, conftant vomiting,
and delirium. On the fourth day, after lying tw'o
hours in a ftate of torpid fleep, he expired. At my laft
viflt, during this courfe, I (Battaglia) faw with aftonifti-
ment that the putrefcence had already made rapid ad¬
vances ; the body of the patient emitted a moft infupport-
able ftench ; worms were feen crawling from him ; and
the nails fell from his Angers. To the queftion how this
accident had happened, the patient atifwered, that heflrft
felt a blow, as with a club, on his right arm ; and had
obferved, at the fame time, a fpark hanging to his fliirt ;
and that the latter had in a moment been converted into
allies. The handkerchief, which had been placed on the
bare Ikin of the Ihoulders, was found entire, and not
even fcorclied. The drawers he had on were alfo left un¬
touched, but the night-cap was quite confumed, though
not a hair of the head was burned. That this dift’uled
fire had confumed the Ikin, the fliirt, and the whole night¬
cap, without touching the liair, is a faft I (Battaglia)
can fully warrant. The night, on which this phenome¬
non happened, was calm, and the air clear. Not the leaft
empyreumatic fmell, nor the leaft trace of Are or frnoke,
was perceived in the room. The lamp, previoufly Ailed
with oil, was dry, and its cotton incinerated. No exter¬
nal caufe can, with probability, be afligned for this de¬
plorable accident : if Maffei had ftill been alive, he would
have availed himfelf of it as a plain proof that a lightning
proceeds from within and deftroys us ; as noticed in the

29S

article Burning, quoted above. This is the only in-
ftance upon record of the calamity having happened to a
man.

The laft cafe we (hall mention is one in which two
perfons were involved in deftruCtion at the fame time.

It was read to the Medical Society at Paris, by Dr. Char-
pentier, phyflcian to the royal forces of the marine, at
Guerigny, near Nevers. “ On the 12th of January, 1820,
at ten o’clock in the4vening, feveral neighbours.of Mrs.

P. of Nevers, perceived a peculiar odour, which they
thought flmilar to that of broiled animal matter and
burning wool, only more difagreeable and naufeous. They
faw neither frnoke nor vapour iflue from any of the adja¬
cent houfes; and at laft, agreeing among themfelves
that this odour was produced by the burning of the re¬
mains of an old Carmelite nun, who had died in the
neighbourhood that day, they retired to bed withoutma-
king any further inquiries. On the 1 3th, in the morning,
a woman, living near the place, who had a fecond key to
the door of the houfe. becaufe flie was in the habit of
going there daily to aftift thefervant in attending on her
iniftrefs, opened the door to go and perform her ordi¬
nary duties. On entering the room, a denfe vapour if-
fued out, accompanied with an infupportable ftench, that
almoft fuftocated her. She retreated from the houfe,
crying out in the moft violent manner for help. The
neighbours came about her ; and, after waiting a few
moments to let the vapour efcape, they proceeded io exa¬
mine the ftate of the room, they found neither Mrs. P.
nor her fervant. At flrft they faw no appearance of dead
bodies, but they immediately recognized that Mrs. P.'s
bed was entirely burned. Its different parts, however,
preferved their form ; but, on the flighted: touch, it all
funk away, and the bedftead, mattrefs, feather-bed,
fheets, blankets, and woollen curtains, were reduced to
a cinder. Before they ftirred thefe cinders they examined
the Are-place, in which they found no wmod, nor any
charcoal, in combuftion : the Are had not been covered,
and it had probably gone out for want of wood. A can-
dleftick flood in the Are-place, and another, on the
ground, in the middlqof the room; there was no candle
in either of them.

“ On proceeding to examine the allies, or remains of
the combuftion, there was found, in front of the fpot
which had been occupied by the bed, the extremity of a
leg covered by a flocking, with a (hoe on the foot, and
which was recognized to be part of the right leg of the
fervant. It was the only portion of the body of this
woman that had not been reduced to allies. The cra¬
nium of the miftrefs, devoid of thefcalp, v.'hich had been
burned, was found in a fltuation correfponding with that
in which the head would be as the woman lay in bed.
This was the only portion of her body that had not been
utterly deftroyed by combuftion, excepting a fmall frag¬
ment of the neck, or rather the Ikin of the neck, that
had been enveloped in a red kerchief, and of which there
were yet fome remains immediately attached to the pre¬
ferved portion of the neck.

“Although the room had no ceiling, the beams and
rafters, which were very near to the top of the bed were
not burned ; but they were black, and felt very hot. All
the tilings about: the room, efpecially fuch as were clofe
to the bed, were extremely humid; which was owing,
without doubt, to condenfation of the denfe vapours
with which the room was Ailed on being flrft entered. A
wooden clock, hung up againft the wall beflde the bed,
fell into afltes on the flrft movement.

“There were no other perfons in the houfe but thefe
two women. The miftrefs was ninety years old, the fer¬
vant Axty-Ax ; they were both of a weak constitution,
thin and meagre ; their food was bad, although the mif¬
trefs had an income of 6000 francs. She, for fome time
paft, had drunk eau de Cologne to great excefs; and had
eaten hardly any thing flnce this habitual abufe of
fpirits. The fervant alio ate but little ; (lie now and then

took

294

PATHOLOGY.

took a little brandy; but her nourifhment confifted
chiefly in good old wine, hot and well fugared. She of¬
ten took this in fufficient quantities to make her tipfy.
It is believed that the exceflive cold of the night (140
Fahrenheit) had led her to drink to excels.”

Genus XII. Porphyra, [Gr. purple, or livid .] Scurvy.
Generic chradters — Livid fpots on the (kin from extra-
vafated blood; languor, and lofs of mufcular ftrength;
pains in the limbs.

The term fcurvy has been moft erroneoufly and abfurd-
ly ufed in popular language; having been applied, in fait,
to all difeafes of the Jk'in , of a flow and chronic nature,
however various in their eflential character, and pofl'efting
nothing in common with the true fcurvy. The fkin, in
fcurvy, is not the feat of the difeafe, but is only deranged,
like other organs of the body, in the progrefs of the
malady; and that derangement is totally different from
the«inflammatofy, pimply, puftular, or fcaly, conditions
of the fkin, which occur in leprofy, tetters, and other
cutaneous diforders, ufually mifcalled fcorbutic. This
miftake requires correction, not merely as a matter of
nomenclature, but becaufe a great practical error refults
from it; namely, the administration of antifcorbutic re¬
medies in thefe cutaneous diforders, which cannot be
cured, and are often aggravated, by them. The late
Dr. Willan conferred a benefit on the profeftion, by his
definite difcriminatio.n of thefe lad-mentioned diforders.

The fcurvy, properly fo called, was firft accurately de-
fcribed, and received its name, in modern times; and it
is the fubjeCt of difpute, as in the cafe of fome other
difeafes, whether it was known to the ancient phyficians,
or is a malady of more recent origin. The firft fpecific
accounts of the difeafe appeared in the early part of the
fixteenth century, when the name of the malady feems to
have been familiar among the vulgar : but the fymptoms
were noticed by the early voyagers in the preceding
century; for confiderably more than half the crew who
accompanied Vafco de Gama in his voyage round the
Cape of Good Hope, in the year 1497, were deitroyed
by this difeafe. Olaus Magnus, in his Hiftory of the
Northern Nations, publifhed in 1555, has defcribed it at
confiderable length, and dates that it was known to the
inhabitants of Saxony by the name of fchorluk, or Jcorbuc ;
whence the Latin term fcorbutus, and our appellation
fcurvy. The term fignified “fore-mouth; and was pro¬
bably applied to the difeafe in confequence of the fpongy
ulcerations of the gums, with haemorrhages, and loofen-
ing of the teeth, which are among the more fevere fymp¬
toms of the complaint. Dr. Lind, however, fuggefts,
with Hill more probability, that the name was derived
from a Sclavonic word, Jcorb, dignifying “difeafe;” the
fcurvy being endemic in the northern countries of Eu¬
rope, from whence we borrowed the appellation.

Moft of the continental writers have maintained, that
although the ancients have not defcribed the fymptoms
of fcurvy, as a fingle diftindt difeafe, they have, howe¬
ver, mentioned feveral concurring fymptoms, which can
fcarcely be fuppofed to belong to any other malady ;
while Drs. Freind, Lind, Trotter, and fome other authors
of this country, contend, that the Greeks, Romans, and
Arabians, refuting in fouthern climates, and unpradtifed
in long voyages, probably never witnefled the fcurvy, and
thence have no-where accurately defcribed it. The ra¬
rity of the difeafe, under fuch circumftances, will proba¬
bly account for the imperfedt defcriptions which they have
left : but fieges and feafons of great dearth were not un¬
common in thofe times, and gave rife at leaft to the ignis
facer, which appears to have been nearly allied to fcurvy ;
and the following obfervations relate to no other known
difeafe. Hippocrates, when defcribing the difeafes of
the fpleen, mentions fome fymptoms which accompany
the enlargement of that organ : “ The colour of the
body,” he fays, “ is changed, and becomes black and
pallid, like the rind of a pomegranate ; the breath is fe-

1

tid, and the gums .alfo emit a bad fin ell, and fall away
from the teeth ; ulcerations breakout in the legs, refem-
bling epinydlides ; the limbs are emaciated, and the bow¬
els do not difcharge their contents. (Lib. de Internis
Affedl.) And again, in his fecond book of Prognoftics,
Hippocrates obferves, “ In thofe who have tumid fpleens,.
the gums are difeafed, and the mouth emits a fetid odour ;
but thofe whofe fpleens are enlarged without any confe*
quent hemorrhages, fuch perfons are attacked with ill-
conditioned ulcers in the legs, and black fears.” Here
we have an additional fymptom of fcurvy, viz. the he¬
morrhages, which were omitted in the former defeription.
Thofe, however, who expedt to find only the utmoft accu¬
racy in the works of Llippocrates, will perhaps be fur-
prifed to find that he has again defcribed, ft i 11. more dif-
tinftljq the fymptoms of fcurvy under another appella¬
tion. For in the fame book (refpedting Internal Difeafes)
in which he has noticed the enlarged fpleens, he men¬
tions the fymptoms of the ileus hematites (cAeo;
or “ bloody iliac difeafe,” in nearly the fame terms :
“This difeafe begins in the autumn, and exhibits the
following fymptoms. The mouth and teeth emit a fetid
fmell, and the gums feparate from the latter, and blood
flows from the nofe ; fometimes alfo ulcers break out in
the legs, and, while fome of thefe heal, others break out
afrefh ; and the fkin about them is of a black colour, thin,
and tender.” This may be deemed a good brief deferip¬
tion of fcurvy ; and, if the commentators are right in their
corredtion, the concluding fymptom is equally charadler-
ittic: “ the patient is indifpofed to walk, or to ufe any
exertion.” The paflage, as it ftands in Hippocrates, how¬
ever, aflerts the affirmative, that the patient is dilpofed to
exertion; a circumftance fo inconfiftent with ulcerations
of the legs, hemorrhages, and the other fymptoms, that
the commentators agree that the negative particle a mull
have been omitted. Van Swieten remarks, that the epi¬
thet of “ th.in or tender fkinned,” Aetttgoe^oi, which Hip¬
pocrates applies to thofe patients, is particularly charac-
teriftic of the fcorbutic ftate ; fince we obferve in the
fcurvy, that the flighted injuries break into the fkin, and
leave ftubborn ulcerations in it ; and this more remark¬
ably happens in the legs, where only fcratching them with
the finger-nails will bften raifean excoriation, that is fol¬
lowed by an ulcer of long continuance.” (Comment, in
Eoerh. Aph. 1 148.) Celfus, when treating of the affec¬
tions of the fpleen, mentions this indifpofttion of ulcers
to heal : “ Ulcera aut omnino non fanefeunt, ant certe
cicatricem vix recipiunt.” And we may add, that the
opinions of the commentators, refpedting. the fentence
above mentioned, is confirmed by the ftatement of Cel¬
fus, who diftindtly afierts, that exertion is painful and
difficult.

A difeafe is alfo mentioned by Strabo and Pliny, as oc¬
curring in the Roman armies in particular fituations.
wdiich can only be referred to fcurvy. In this difeafe,
which Pliny aferibed to drinking the water of a certain
-well, when it occurred in the army of Germanicus while
encamped near the Rhine, an affedtion of the gums, with
a falling-out of the teeth, is faid to have been combined
with a lofs of mufcular power in the lower extremities;
the former affedlion being called Jtomacace, (quafi crropiciris
x-eiKiu., forenefs of mouth,) and the latter fccletyrbe. (Nat.
Hill. lib. xxv. cap. 3.) Similar affedlions, to which the
fame appellations are given by Strabo, are faid to have
prevailed in the army of Ailius Gallus, when in Arabia.
(Geograph, lib. xvi.) Some authors, however, have de¬
nied that this fceletyrbe could be a fcorbutic fymptom;
becaufe Galen has ftated Jcelelyrbe to be a kind of para-
lyfis, in which the patient is unable to walk ftraight : but
fuch a term might be fufficiently appropriate to that ri¬
gidity of the joints .which often occurs in fcurvy.

On the whole, therefore, we are difpofed to believe,
with the early writers upon this fubjedt, that the fcurvy
was known to the Greek, Roman, and Arabian, phyfi¬
cians; although, from its comparative rarity in fouthern

climates.

PA T H O I. O G Y.

Plate V

a

* a « s

■ :«--A *; ;. *A. ... *t .V

A:-''? A ' .

§8118

• */■. ,1.; •• v. v ,. ■, ... .

3.-2?/

Engraved, for tfi&* Ena/ clop azdza Zoruknensis.

6

/Toss sc

6. Y '.W ////// ,/ ',j

293

PATHOLOGY.

climates, it did not occur fo often or fo extenfively as
to claim their attention very ftrongly. In our prelent
ftate of knowledge, 'it is divided into three very dillindl
fpecies.

i. Porphyra fimplex, petechial fcurvy : fpots numerous,
but fniall and flea-bite fhaped ; chiefly on the bread, arms,
abdomen, and legs j palenefs of vifage. There are two
varieties.

a.. P. pulicofa, (Purpura fimplex, Willan and Bateman -)
In this variety, which is exhibited on the annexed
Plate V. fig. i. there is an appearance of petechias, or ex-
travafations under the cuticle, without much diforder of
the conftitution, except languor, and lol's of the mu feu -
lar drength, with a pale or fallow complexion, and often
with pain in the limbs. The petechias are mod nume¬
rous on the bread, and on the infide of the arms and
legs ; and are of various fizes, from the mod minute point
to that of a flea-bite, and commonly circular. They
may be didinguilhed from recent flea-bites, partly by
their more livid or purple colour, and partly becaufe, in
the latter, there is a diitindt central punCture, the rednefs
around which difappears on preffure. There is no itch¬
ing, or other fenfation attending the petechias.

/3. P. urticans (fee the fame Plate, fig. 2.) is diftin-
guilhed by this peculiarity, that it commences in the
form of rounded and reddifh elevations of the cuticle,
refembling wheals, but which are not accompanied, like
the wheals of urticaria, by any fenfation of tingling or
itching. Thefe little tumours gradually dilate, but,
within one or two days, they fubfide to the level of the
furrounding cuticle, and at the fame time their hue be¬
comes darker, and at length livid.. As thefe fpots are
not permanent, but appear in fucceflion in different
places, they are commonly feen of different hues; the
ire fh and elevated ones being of a brighter red, while
the level fpots exhibit different degrees of lividity, and
become brown as they difappear. They are moll com¬
mon on the legs, where they are frequently mixed with
petechise; but they fometimes appear a!fo on the arms,
thighs, breaft, & c. The duration of the complaint is
various, from three to five weeks. It ufually occurs in
fummer and autumn ; and attacks thofe who are liable to
fatigue, and live on poor diet; or, on the contrary, deli¬
cate young women, who live luxurioufly, and take little
exercife. Some oedema of the extremities ufually accom¬
panies it, and it is occafionally preceded by a ftiffnefs and
weight of the limbs.

The cure of the above-mentioned varieties is often
difficult. Viewing the difeafes as arifing from dyfpepfia,
we fhould direct an alteration to be made in the diet of
the patient, and the bowels to be kept regular. Indeed
active purging has been recommended by the beft autho¬
rities, The ftate of the fkin, as far as regards its itching
or other unpleafant fenfation, will alfo require palliative
mealures, as the warm bath, See. The debility of the
lyftem may be in fome meafure obviated (when the diet
and bowels are regulated) by mineral acids and bark,
or by gentian.

2. Porphyra haemorrhagica, land-fcurvy : fpots circu¬
lar, of different fizes ; often in ftripes or patches, irregu¬
larly fcattered over the thighs, arms, and trunk ; occa-
fional haemorrhage from the mouth, noftrils, or vifeera ;
great debility, and depreffion of fpirits. See the Plate,
%• 3*

We often fee perfons in whom the very (lighteft bruifes
or impreflions turn black. This is moft generally the
cafe in old perfons ; and is indeed commonly o'oferved in
an inverfe ratio to the vigour of the mufcular ft ruff ure.
It is evidently the refill t of want of contraff ile powers
in the capillary veffels, which confequently give way, and
allow extravafation 5 or in which, from the fame caufe,
the blood ftagnates. An extreme fufeeptibility to this
lividity is feen in the patients of P. haemorrhagica, except
in cafes comparatively fudden in their acceffion, and at¬
tended from the firft with high inflammatory fymptoms.

VOL. XIX. No. 1304.

This fpecies, like the former, is alfo remarkable for the ,
appearance of petechias; but thefe, as Dr. Bateman fays,
are “ often of a larger iize, and are interfperfed with vibi-
ces and eccliymofes, or livid ftripes and patches, refem¬
bling the marks left by the ftrokes of a whip, or by vio¬
lent bruifes. They commonly appear firft on the legs,
and, at uncertain periods afterwards, on the thighs, arms,
and trunk of the body; the hands being more rarely
fpotted with them, and the face generally free. They
are ufually of a bright red colour when they firft appear,
but foon become purple or livid ; and, when about to dif¬
appear, they change to a brown or yellowifh hue; fo that,
as new eruptions a rife, and the abforption of the old
ones flowly proceeds, this variety of colour is commonly
feen in the different fpots at the fame time. The cuticle
over them appears finooth and fhining, but is not fenftbly
elevated : in a few cafes, however, the cuticle has been
feen raifed into a fort of veficles, containing black blood.
This more frequently happens in the fpots which appear
on the tongue, gums, palate, and infide of the cheeks
and lips, where the cuticle is extremely thin, and breaks
from the (lighteft force, difeharging the effufed blood.
The gentleft preffure on the fkin, even fuch as is applied
in feeling the pulfe, will often produce a purple blotch,
like that which is left after a fevere bruife.

“The fame ftate of the habit which gives rife to thefe
effufions under the cuticle, produces likewife copious
difeharges of blood, efpecially from the internal parts,
which are defended by more delicate coverings. Thefe
haemorrhages are often very profufe, and not eafily re-
ftrained, and therefore fometimes prove fuddenly fatal.
But in other cafes they are lefs copious ; fometimes re*
turning every day at ftated periods, and fometimes lefs
frequently and at irregular intervals $ and fometimes
there is a flow and almoft inceffant oozing of blood. The
bleeding occurs from the gums, noltriis, throat, infide
of the cheeks, tongue, and lips, and fometimes from the
lining membrane of the eyelids, the urethra, and the ex¬
ternal ear ; and alfo from the internal cavities of the lungs,
ftomach, bowels, uterus, kidneys, and bladder. There
is the utmoft variety, however, in different inftances, as
to the period of the difeafe in which the haemorrhages
commence and ceafe, and as to the proportion which they
bear to the cutaneous efflorefcence.

“ This lingular difeafe is often preceded for fome weeks
by great laflitude, faintnefs, and pains in the limbs, which
render the patient incapable of ar.y exertion ; but, not
unfrequently, it appears fuddenly, in the mid ft of appa¬
rent good health. It is always accompanied with extreme
debility and depreffion of fpirits : the pulfe is commonly
feeble, and fometimes quickened; and heat, flufhing,
perfpiration, and other fymptoms of flight febrile irrita¬
tion, recurring like the paroxy fms of hedtic, occafionally
attend. In fome patients, deep-feated pains have been
felt about the prascordia, and in the cheft, loins, or abdo¬
men ; and in others a confiderable cough has accompa¬
nied the complaint, or a tumour and tenfion of the epi-
gaftrium and hypochondria, with tendernefs on preffure,
and a conftipated or irregular ftate of bowels. But in
many cafes, no febrile appearances have been noticed ;
and the functions of the inteftir.es are often natural. In
a few inftances frequent fyncope has occurred. When
the difeafe has continued for fome time, the patient be¬
comes fallow, or of a dirty complexion, and much ema¬
ciated; and fome degree of oedema appears in the lower
extremities, which afterwards extends to other parts.
The difeafe is extremely uncertain in its duration: in
fome inftances it has terminated in a few days; while in
others it has continued not only for many months, but
even for years.”

Though the indications for the treatment of this diff
eafe are perhaps as clear as any in medicine, we are ufu¬
ally difappointed in our expectations of cure. The firft
thing to be done is of courfe to diminifh the quantity of
the circulating fluid. This practice is obvioufly cor-
+ G reCt;

2U6 PATH

re£l : it immediately fubtrafls a portion of the irritant
which keeps up the difeafe of the vafcular fyftem. The
taking of blood, however, feems only u.feful in reducing
the inflammatory a£lion to which its morbid quality has
given rife. The amelioration of the quality of the blood
is to be attempted by ftridt attention to the aliment
from which the chyle is formed, and the ftate of the
organs which aflimilate it. It would take much time to
expatiate here upon the peculiar regimen which would
be neceffary for particular patients. It is clear enough
that no one plan of diet will cure the difeafe. If the
patient has lived long on vegetables, animal food would
of courfe be allowed in moderate quantities; if the ac¬
tion of the ftomach feemed particularly debilitated, it
might be proper to have the food fo prepared by culi¬
nary procefles as to excite and ftrengthen the aflimilating
function ; and fo on of other (fates.

Since the fecernent fyftem a<5!s as an emunftory to the
blood, its greater excitation (hould be enforced ; always
taking care, however, that the excitation be not fo great
as to diredt the difeafed adfion to the excited ftru&ure.
Thus the bowels and kidneys fliould be excited, but
only by the mildeft purgatives and diuretics.

In reftraining the local hemorrhage, the tindfura ferri
muriatis, the fulphate of zinc, and the fulphuric acid,
are the raoft efficacious fubftances that we know of.
They may be ufed fometimes in a very ftrong form.
Dr. Struve mentions a cafe in which he applied concen¬
trated fulphuric by means of a pencil to bleeding pete-
chiae, and the hemorrhage ceafed.

3. Porphyra nautica, fea-feurvy: fpots of different
hues intermixed with livid, principally at the roots of
the hair; teeth loofe; gums fpongy and bleeding;
breath fetid ; debility univerfal and extreme.

The very frequent connexion between long-continued
ufe of folid meat and feurvy, has led to the fuppofition,
that eating of much fait is the caufe of feurvy ; but this
idea is now confidered erroneous: The ufe of fait feems
to produce feurvy only in confequence of its extreme
quantity irritating and impairing the digeftive organs ;
and moreover the lofs of nutritious juices which falted
meats undergo, may operate to retard aflimilation : at
all events, feurvy may be brought on by the ufe of fub-
flances in which fait forms a very fmall part; and it is
raoft evidently increafed or diminifhed in proportion to
the degree of fpirits or defpondence which the mind of
the patient undergoes. See a very remarkable inftance
of the ftate of mind in this difeafe, vol. xi. p. 500.

Thefe two laft and moft important fpecies were for a
long period confounded together, confidered to be dif-
eafes of debility, and confequently to be cured only by
ftimulating means. We are indebted to Dr. Parry for
firft (howing the error of this idea. He firft pointed out
the important faft, that plethora was the ftate of body
which attended the Purpura hasmorrhagica, or land-
feurvy ; and that the dreadful phenomena of this ma¬
lady arofe from morbid action of the blood-vefl'els ;
though it is allowed that this morbid a6lion muff: refult
from morbidity of the blood itfelf in the firft inftance.
'The only fimilarity which is traceable between the land
and fea feurvy is that in each the primary caufe is dif-
order of the aflimilating funftion. In moft cafes this
arifes from bad food, whether it be improper in quality,
deficient or otherwife in quantity. The aflimilating
function is fubje£t likewife to be influenced by caufes
foreign to the aliment itfelf. Thus we find falted meat
produces the fea-feurvy, excefs and irregularity of eat¬
ing the land-fcurvy and its peculiar varieties.

In the land-fcurvy, the gaftric or inteftinal diforder
exerts itfelf moft efpecially on the capillary fyftem, and
that in a flow and gradual manner; while the condition
of plethora is extreme, and worthy of particular atten¬
tion in the cure. On the other hand, in the fea-feurvy,
the mufcular fubftance, in confequence of the depriva¬
tion of the fibrine of the blood, is firft affected, and the

O L O G Y.

contractility of the capillary fyftem fecondarily ; nor is
plethora generally very apparent, nor the inflammation
fo violent as to require depletory meafures. We have
thought proper to introduce thefe curfory remarks for
the fake of (howing the jullnefs of the prefent arrange¬
ment.

The following remarks apply, more or lefs, to the
fymptoms and treatment of all the fpecies. The firft in¬
dication of the approach of feurvy is an averfion to any
fort of mufcular exertion ; a lazinefs, or ftrong inclina¬
tion to fit ftill or lie in bed ; which is accompanied with
a fpontaneous laffitude, or a fenfe of heavinefs and pain
throughout the body, and efpecially in the mufcles of
the limbs and loins, like that which arifes from great fa¬
tigue, which foon becomes aClual feeblenefs, fo that the
lead exercife, efpecially in afeending or defeending a de¬
clivity, induces fatigue and (hortnefs of breath. With
this averfion to motion and diminiffied power of exertion,
there is alfo very early a change of the complexion, which
becomes pale and bloated, or fallow, efpecially about the
lips and corners of the eyes, where there is a greenifh
tinge. Thefe two fymptoms, indeed, the difinclination
to exertion, and the fallow countenance, often portend
the approach of feurvy, while the patient eats and drinks
heartily, and feems otherwife in good health : and the
fpeedy laffitude and difficulty of breathing upon motion,
are among the moft conftant concomitants of the diftem-
per throughout its courfe.

As the difeafe advances, other fymptoms appear.
Among thefe the Jlomacace, or morbid condition of the
mouth, is one of the firft that prefents itfelf. The gums
become hot and painful, and foon fwell, growing foft
and fpongy, and of a livid hue, and afterwards extreme¬
ly putrid and fungous, conftituting one of the moft dif-
tinguifliing features of the difeafe. This occafions great
fetor of the breath, and the loofening of the teeth, which
become moveable in their fockets, and may be taken out
without force or pain, and even fall out fpontaneoufly.
Haemorrhages alfo take place from the (lighted preffure
on the gums, or even without any apparent caufe, as
well as from the nofe ; and ultimately from other parts
of the body, where the cuticle is delicate, or the furface
broken, in confequence of the apparent lofs of cohefion
in the (olids, and efpecially in the vafcular fyftem.

From this caufe thejkin alfo exhibits fome of the moft
drifting charafferiftics of feurvy. It becomes dry, and
fpotted over with difcolourations of a red, bluiffi, purple,
and black, hue, of various fizes, from the petechia , or
fpots like flea-bites, to the moft extenfive ecchymofes, of
the fize of a hand-breadth, or larger, fuch as are produ¬
ced by the fevered bruifes. Thefe appear chiefly on the
legs and thighs ; but often alfo on the arms, bread, and
trunk of the body; and fometimes, though more rarely,
on the head and face. They confift, in faft, of effufions
of blood under the cuticle, from the rupture of the fmall
veflels. As the difeafe advances, this laxity and lofs of
cohefion in all the folids becomes ftill more manifeft, by
the frequent and profufe bleedings which are liable to
occur from different parts of the body; efpecially from
the nofe, gums, ftomach, bowels, lungs, kidneys, and
bladder, and from the ulcers and fungous excrefcences
which arife on the furface. In fome patients, the hae¬
morrhages from the bowels are accompanied by fevere
pains and diarrhoea ; while others, without either purg¬
ing or gripes, difeharge great quantities of pure blood
by the anus. Other marks of laxity appear in the cede-
matous fwelling which takes place in the legs, beginning
firft about the feet and ankles ; which, however, is more
painful than common anafarca, and retains longer the
impreffion of the finger. They appear remarkably alfo,
in the great facility with which the flighted bruifes and
wounds degenerate into foul fungous ulcers, as well as
in the fpontaneous appearance of fuch ulcers, and the
breaking-out of long-healed fores, and even the difunion
of old fraftures in bones. “ Whatever former com-

plaints,*

297

PATHOLOGY.

plaints,” Dr. Lind obferves, “the patient has had, es¬
pecially bruifes, wounds, &c. or whatever prefent dis¬
orders he labours under, upon being afflicted with the
Scurvy, his old complaints are renewed, and his preSent
rendered worSe.” Indeed the Scurvy often firft (hows
itSelf by the changes in diSeaSed parts. “Thus, when a
perSon has had a preceding fever, or a tedious ficknefs,
by which he has been much exhausted, the gums for the
mod: part are firft affefled, and a laflitude conftantly at¬
tends} whereas, when one has been confined from ex-
ercife by having a fraCtured bone, or from a bruife or
hurt, thefe weak and debilitated parts become almoft al¬
ways firft Scorbutic. As for example, if a patient labours
under a ftrain of the ankle, the leg, by becoming Swelled
.and painful, and Soon after covered with livid Spots,
gives the firft indication of the difeafe. And, as old ul¬
cers on the legs are very frequent among Seamen, in this
cafe likewiSe the legs are always firft affeCled, and thefe
ulcers put on a Scorbutic appearance, although the pa¬
tient Seems otherwise perfectly healthy, and preferves a
Srefti good colour in his face.” The effeCt of the difeafe
upon former maladies is ftrongly depicted by the elegant
writer of Lord Anfon’s Voyage. “But a 1110ft extraor¬
dinary circumftance,” Says that gentleman, “and what
would be Scarcely credible upon any fingle evidence, is,
that the Scars of wounds which had been for many years
healed, were forced open again by this virulent diftern-
per. Of this there was a remarkable inftance in one of
the invalids on-board the Centurion, who had been
wounded above fifty years before at the battle of the
Boyne; for though he was cured Soon after, and had
continued well for a great number of years paft, yet, on
his being attacked by the Scurvy, his wounds, in the pro¬
gress of his difeafe, broke out afrefti, and appeared as if
they had never been healed. Nay, what is Still more afto-
niftiing, the callus of a broken bone, which had been
completely formed for a long time, was found to be
hereby diffolved, and the fraCture Seemed as if it had ne¬
ver been consolidated.” (Voyage round the World in
1740 — 4, by Lord Anfon, compiled by the Rev. R. Wal¬
ter, Chaplain to the Centurion, p. 102.) The ulcers,
which occurred in the legs of the Scorbutic patients on
this occafion, are Said to have been “ of the worft kind,
attended with rotten bones, and Such a luxuriancy of
fungous fleSh as yielded to no remedy.” The edges of
thefe Scorbutic ulcers are of a livid colour, and puffed up
with the fungous excrefcences, which are not inaptly
called by the Sailors bullock's liver , Since to this fubftance,
when boiled, Dr. Lind Says, they bear a near refemblance,
both in confiftence and colour. They often arife in the
courfe of a night to a monftrous fize; and, although de¬
stroyed by cauftics or the knife, (in which laftcafe, a co¬
pious bleeding commonly enfues,) are found at the next
drefiing as large as ever. Dr. Lind affirms, however, that
“ they continue in this condition a considerable time
without tainting the bone.” (Lind on Scurvy, pt. ii.
ch. 2.) Thefe Scorbutic ulcers, which are lingular and
uniform in their character, are diftinguifhed from all
others by being So remarkably offenfive, bloody, and fun¬
gous.

In addition to thefe affeCtions of the lower extremities,
(to which however they are not exclusively confined,) in
the advanced ftage of the Scurvy, the patients moft com¬
monly lofe the ufe of their limbs, having a contraction
of the tendons in the ham, with a fwelling and pain in
the joint of the knee. Indeed, a ftiffnefs in thefe ten¬
dons, and a weaknefs of the knees, appear pretty early
in this difeafe, generally terminating in a contrasted and
■Swelled joint.

In the progrefs of the Scurvy, the patients commonly
complain of pains, which are often moving from part to
part. Some complain of a general pain in their bones,
which is moft violent in the limbs and loins, and espe¬
cially in the joints and legs 5 and a pain, with tightnefs
and oppreffion, in the breaft, is very common. The head

is Seldom or never affeCted, unlefs the patient is feverifh,
which is unufual ; for, as Dr. Lind well obferves, the
difeafe is altogether of a chronic nature, and fever may
be juftly reckoned among its adventitious Symptoms.
It is remarkable, indeed, that in the worft ftages of the
Scurvy, with all the Severe Symptoms above deferibed,
with painful Spreading ulcers of the Surface, with con¬
tracted limbs, hemorrhages, Spongy, putrid, Stinking,
gums, over-run with Sprouting fleSh, and often deeply
ulcerated, with inability to make the lead mufcular ex¬
ertion, without fainting, or perhaps dying ; yet the pa¬
tients, even in this ftage, have a good appetite with
their Senfes entire; and, though eafily dejected and made
low-fpirited, yet, when in bed, they make no complaint
of pain or Sicknefs, and appear to be in tolerable health.
This Singular characteristic of the difeafe is well depicted
by the reverend author before quoted. “ Indeed, the
effeCts of this difeafe,” he fays, “ were in almoft every
inftance wonderful; for many of our people, though
confined to their hammocks, appeared to have no incon-
fiderable Share of health ; for they ate and drank hearti¬
ly, were cheerful, and talked with much Seeming vigour,
and with a loud Strong tone of voice; and yet on their
being the leaft moved, though it was. only from one part
of the Ship to the other, and that in their hammocks,
they have immediately expired ; and others, who have
confided in their Seeming Strength, and have refolved to
get out of their hammocks, have died before they could
well reach the deck. And it was no uncommon thing
for thofe who were able to walk the deck, and to do
Some kind of duty, to drop down dead in an inStant, on
any endeavours to aCt with their utmoft vigour ; many
of our people having perished in this manner during the
courfe of this voyage.”

The principal phenomena deferibed in the necrotomy
of Scorbutics, are the general extravafation of blood,
and the dissolution and Separation of parts naturally
united. Thus the bodies of the mufcles are often found
Swelled and hard, from the blood fixed among their fibres,
So that the limbs remain bent or contraCIed ; and the
epiphyfes of the bones are found Separated, the cartilages
of the Sternum loofened from their union with the bony
part of the ribs, or the ligaments of the joints are corro¬
ded and loofe. The mefenteric glands are generally ob¬
structed and enlarged, and the Spleen bigger than natural,
often falling to pieces as if it confided of coagulated blood.

It is now generally understood that no medicines are
of avail in the cure of Scurvy unlefs the diet be impro¬
ved ; and that, if this be done, medicines are Scarcely
ever required. It has been found, that in the worft cafes
the administration of frefli vegetables has restored the
Sufferer to health. Among thefe vegetable productions,
lemons hold the firft rank. Indeed So univerfal has been
the Succefs which has attended the treatment of Scurvy
by the vegetable acids, that Some have inferred that a
want of oxygen in the blood is the proximate caufe of
this difeafe ; an hypothefis however which is unsupported
by faCts. When lemons cannot be preferved, as in long
voyages, citric acid is a very ufeful Substitute. The
Scurvy, which was once So formidable in our navy as to
deftroy whole fleets, is now So far got under by the regu¬
lations introduced into our navy (chiefly through the ex¬
ertions of Dr. Trotter), that it is Scarcely more frequent
than other difeafes.

Genus XIII. Exangia, [from to pour out

from a veffel.] Enlargement or rupture of a blood-veffel,
without external opening. There are two Species.

1. Exangia aneurifma, aneurifm : pulfating tumour of
an artery. Three varieties.

a. A. cyfticum, eneyfted aneurifm: tumour circum-
feribed; formed by a dilation of the arterial coats with¬
in the fphere of the enlargement.

/3. A. diffufum, diffufed aneurifm : tumour diffufe :
formed by the flow of arterial blood into a Subcutaneous

cavity.

298 PATHOLOGY.

cavity, in confequence of a rupture of the coats of the the found parts, and the progrefs of the difeafe arretted,
artery. „ And in fome cafes, where the ulceration was very flow,

y. A. varicofum, varicofe aneurifm : tumour protrafl- and unaccompanied by much. inflammation, the internal
ed : pulfating through a fuperincumbent and dilated ufe ot arfenic has been found beneficial ; a circumftance,
vein from an injury common to both. For the treatment which has probably given rife to the opinion, that can-
of thefe three varieties, fee Surgery. cer has been cured by that mineral. In three or four

S. A. cardiogmus : obtufe intumefcence and conftant lefs fevere cafes of lupous tubercles in the face, which
difquiet of the prtecordia; with a fenfe of internal weight had made no progrefs towards ulceration, I have leen the
and puliation increafed on the fmalleft motion. See folution of muriate of barytes, taken internally, mata-
Curditis of this article. rially amend the complaint. Bateman, p. 299. Thedif-

2. Exangia varix : foft livid tumour of a vein. See eafe is faid to have been cured in fome inftances (vide
Surgery. Med. Journal, vol. xv.) by carbonate of iron.

Genus XIV. Gangrana, [from ypouvu, to feed upon.]
Gangrene; the death of a portion of the body, while the
relt continues alive, and oftpi in a found ftate. There
are four fpecies.

1. Gangrsena fphacelus, mortification : the dead part
foft, moift, corrupt, and highly offenlive. Divided into,

cl. G. induftus, which is preceded by fever, inflamma¬
tion, local violence, or other exhaufting power.

(3. G. atonicus ; the refult of old age or other debility.

2. Gangrsena necrofis, dry gangrene: the dead part
dry, flirivelled, hard, and dulky. Two varieties here alfo.

cl. G. albida, white gangrene: retaining the natural
colour of the flelh.

@. Difcolor: the natural colour changed to livid, or a
mixture of hues.

3. Gangrsena caries : the dead part originating in, or
extending to, a portion of the fubjacent bone.

4. Gangrsena uftilaginea, mildew-mortification, or er¬
got : gangrene dry, diffufe, divergent; commencing in
the extremities without fever or intumefcence, and
fpreading till various limbs drop off in fucceflion : great
hebetude of mind and body ; often with violent fpafms.
See the article Surgery.

Genus XV. Ulcus, [ehxo;, derived by Euftathius from
s\y.u, traho , as though dijtraho, hereby producing a Auau;
o-vi/svsi a?, or in the phrafe of modern times, which is a
literal rendering of the Greek, “ folution of continuity.”]
Ulcer; a purulent or ichorous fore produced by the re¬
paration of a dead part. There are five fpecies.

1. Ulcus incarnans : healthy, purulent, and granulat-
ing.

2. Ulcus vitiofum : with a vitiated furface and fecre-
tion. Three varieties.

a. Callofum: the edges indurated and retraced.

|3. Spongiofum ; with fungous or fpongy excrefcences.
y. Cancrofum : with a hard, livid, lancinating, irregu¬
lar, fetid, and frequently bleeding, tumour at its bafe.

3. Ulcus finuofum : communicating with the neigh¬
bouring parts by one or more wunding channels. Di¬
vided into,

a.. Recens: the channel frelh, and yielding.

P. Fiftulofum : channel indurated, and of longer Hand¬
ing* For the treatment of thefe three fpecies, and their
varieties, we mutt refer to the article Surgery.

4. Ulcus tuberculofum, lupus, or noli me tangere: with
tuberculous excrefcences, lobed by ragged and fpreading
ulcerations : chiefly about the alas of the noftrils.

This is a very rare but formidable difeafe. Very little
is known as to its nature or treatment. It is a flow tu¬
bercular affeffion, affeiRing the nofe, lips, or other parts
of the face, or trunk of the body. It commonly ends in
ragged ulcerations, which gradually deftroy the fkin and
niulcular parts to a confiderable depth. Sometimes the
difeafe appears in the cheek circularly, or in the form of
a fort of ring- worm, deftroying the fubftance, and leaving
a deep and deformed cicatrix : and Dr. Bateman has Teen
a fimilar circular patch of the difeafe, dilating itfelf at
length to the extent of a hand-breadth or more, upon the
pectoral mufcle.

“ By furgical means, i. e. by the knife or the cauftic,
a reparation has fometimes been made of the morbid from

5. Ulcus cariofus, (Caries, Sauv, Linn. Cullen, See.)
Ulcer extending into the fubftance of the fubjacent bone.
If the ulceration extends to the medulla, it is often called
“arthrocace.”

Class IV. NEUROTICA, [from nv(pov, a nerve.]
Diseases of the Nervous Function.

Order I. Phrenica, [from the mind.] Affefling
the Intelledf. Error, perverfion, or debility, of one or
more of the mental faculties. This order contains fix
genera.

Genus I. Ecphronia, [from ex, out of, and (ppnv, the
mind.] Infanity. Generic characters — Difeafed percep¬
tion, with little difturbance of the judgment, occafion-
ally (hifting into difeafed judgment, with little diftur¬
bance of the perception; diminiftied fenfibility; irregu¬
lar remiflions. There are two very diftimSt fpecies.

1. Ecphronia melancholia, melancholy: the difcrepancy
between the perception and the judgment limited to a
Angle objeft, or train of ideas; for the moft part with ta¬
citurnity, love of folitude, gloomy fear, or fufpicion.
Four varieties.

a.. M. attonita : fixed, mute, immoveable, melancholy.

(3. M. errabunda : roving, reftlefs, melancholy; having
a conftant defire to change the abode.

y. M. malevolens : morofe or mifehievous melancholy ;
occafionally terminating in fuicide, or the injury of
others.

S. M. complacens : felf-complacent and affable melan¬
choly; occafionally rejoicing in a vifionary fuperiority
of rank, ftation, or endowments.

See, for examples of this laft variety, Ilor. Sat. iv. Ep.
ii. 2. But of this modification one of the beft examples
that has ever been drawn, fays Dr. Mafon, “is that of
Don Quixote, taken unqueftionably from real life. This
variety is connected with all the reft in the leading fpe-
cific character of the difcrepancy between the perception
and the judgment being limited to a Angle objeft or
train of ideas ; but it differs from them by the intermix¬
ture of a certain degree of eparfis, or fentimental eleva¬
tion, which deftroys the common tendency to tacitur¬
nity, folitude, and gloomy apprehenfion.”

The more common caufes of the difeafe as a fpecies
are falfe views of religion 5 fevere difappointment ; long¬
ing after one’s native country and friends; and conti¬
nued grief.

2. Ecphronia mania, madnefs : the difcrepancy be¬
tween the perception and the judgment general ; raving;
entony; and empafiioped emotion. Four varieties.

cl. M. ferox : furious and violent madnefs.

(3. M. exultans : gay and elevated madnefs.

y. M. defpondens: gloomy defpondent madnefs. The
defpondent cafes- are more dangerous than thofe of hila¬
rity.

S. M. demens: chaotic madnefs.

We fhall now proceed to give Dr. Good’s arrangement
of the remainder of this order; without any intention,
however, of following our nofologift into an account of
the nature or treatment of mental difeafes. Indeed
much as we refpedt the talents of Dr. Good, we cannot
help fmiling at his love of nofology when we find that
mufing, joy, jealoufy, and even love, are ftyled difeafes.

PATHOLOGY.

of which we may fay, as Ovid did long fince of the laft,
that they are nuttis medicabilis herbis.

Genus II. Ewpnthema, [from eh and 7 raO^as, of
to fuffer.] Ungovernable pafllon. Generic characters —
The judgment perverted or overpowered by the force of
fome predominant paffion-: the features of the counte¬
nance changed from their common character. Twofpecies.
• r. Empathema entonicum : the predominant pafllon
accompanied with increafed excitement, ardour, and ac¬
tivity : eye quick and daring; countenance flufhed and
tumid. Divided by Dr. Good into,

«. Iracundiae, wrath.

(3. Superbiae, pride.

7. Glorias famis, ambition.

o\ Letitise, joy.

e. Philautias, felf-love, or felf-conceit. .

£. Zelotypiae, jealoufy.

2. Empathema atonicum : the predominant paffion
accompanied with diminifhed excitement, anxiety, and
love of folitude; eye fixed and penfive; countenance pale
and furrowed. Six varieties.

a. Defiderii, longing : eager defire for an abfent ob¬
ject, whether place or perfon : and hence equally in¬
cluding home-ficknefs, country-ficknefs, love-ficknefs.

/3. Auri famis, avarice.

7. Anxietudinis, preying care.

8. Mceroris, heart-ache.

e. Defperationitis, defpondency.

Genus III. Alufia , [from a.\v;, o.\vg 1;, ccXva’u.oi, oberra-
tio. Galen occafionally employs the fecond. The theme
is a.\vu , “errabunda mente afficior; inquietus oberro
whence the Latin allucinatio, and hallucinatio.'] Ulufion.
Generic chambers — The judgment perverted or overpow¬
ered by the force of the imagination ; the fpirits perma¬
nently elevated or deprefled; the feelings of the mind de¬
picted in the countenance. Twofpecies.

1. Alufia- elafio, mental extravagance : romantic ideas
of real life; ardent and exalted fancy; pleafurable feel¬
ings ; frequent pu-lfe ; great activity ; eye keen and
lighted up : countenance confident and animated. Di¬
vided into,

ct. E. heroica, chivalry or romantic gallantry. A ge¬
nerous and high -fpiri ted flight of the imagination, but
now grown obfolete, "and rarely to be met with except
in ancient tales and traditions.

(3. E, facetofa, high fpirits; fparkling ebullient wit,
incapable of reltraining itfelf; that often facrifices a
friend at the fhrine of a jeft.

7. E. ecftatica, falfe infpiration ; vifionary conceits.
The judgment urged to miftake energetic ideas for real¬
ities; to believe in phantafms ; in an immediate commu¬
nication with fpirits, or in the power of working mira¬
cles. Examples may be found in all ages and in all re¬
ligions. One of the moll interefling is that of Saint Te-
refa-in Butler’s Lives. In our own day one of the molt
ltriking is that of Baron Sw'edenborg.

E. fanatica, fanaticifm.

z. Alufia hypochondrias, hypochondrifm : gloomy
ideas of real life ; dejeCted fpirits ; anxiety; dyfpepfy ;
languid pulfe; indifpofition to activity; eye oblique and
fcowling; countenance gloomy and fullen. Three va¬
rieties, all perhaps proceeding from Dyfpepfia, which fee.

«. H. autalgica, vapours: with vifionary or exagge¬
rated fen fe of pains, or difeafe ; whimfical diflike of
perfons, places, or things; groundlefs apprehenlions of
perfonal danger, or poverty.

/3. II. pentsefa, fpleen : with general liftleflnefs, or dif-
g.ult ; irkfomenefs and wearinefs of life.

7. H. mifanthropica, mifanthropy : with general ma¬
levolence, peevilhnefs, and abhorrence of mankind.

Genus IV. Aphelxia, [from otip^y.to, to draw away.]
Reverie. Generic characters — Voluntary inactivity of
the whole or the greater part of the external fenfes to

Vol.XIX. No. 1304.

299

the impreflions of furrounding objeCts, during wakeful-
nefs. Of this difeafe, which, as Dr. Good juftly obferves,
is almoft, if not altogether, new to nofology, and has
feldom been dipt into by phyfiologills, the doCtor gives
us three fpecies.

1. Aphelxia focors, abfence of mind : truant attention;
wandering fancy; vacant or vacillating countenance.

2. Aphelxia intenta, abftraCtion of mind : the atten¬
tion wound up, and rivetted to a particular fubjeCl; with
fympathetic emotion of the mufcles and features connect¬
ed with its general drift.

3. Aphelxia otiofa, brown ftudy, or liltlefs mufing :
leifurely liftlelfnefs; free furrenderof the judgment to the
fportive vagaries of the fancy ; quiefcent mufcles ; idle
gravity of countenance.

Genus V. Paroniria, [from wocfx, and ompor, dreaming.]
Depraved, diiturbed, or morbid, dreaming. Generic
characters — The voluntary organs connected with the
palling train of ideas overpowered by the force of the
imagination during dreaming, and involuntarily excited
to their natural or accuftomed aCtions, while the other
organs remain afleep. Three fpecies.

1. Paroniria ambulans, fleep- walking, or fomnambu-
lifm : the mufcles of locomotion excited into their ac¬
cuftomed aCtion by the force of the imagination during
dreaming.

2. Paroniria loquens, fleep-talking : the mufcles of
fpeech excited into their accuftomed aCtion by the force
of the imagination during dreaming.

3. Paroniria falax, night-pollution; (Gonorrhoea dor-
mientum, Cull.) The fexual organs excited into venereal
aCtion by the force of the imagination during dreaming.

The reader will obferve, that the term Paroniria falax
is reftriCled to night-pollution from dreaming, and does
not therefore embrace that kind of night-pollution which
requires the aid of medicine.

Genus VI. Moria, [from p.vp> i;, filly, foolilh.] Fatuity;
defeCt or hebetude of the underltanding. Two fpecies,
fubdivided into varieties.

1. Moria imbecilis, imbecility: defeCt or hebetude
partial or confined to particular faculties of the under-
ftanding. Four varieties.

ct. Stupiditas, ftupidity : dulnefs and indocility of the
apprehenfion ; torpitude and poverty of the imagination.

/3. Amnefin, forgetfulnefs : feeblenefs or failure of the
memory.

7. Credulifas, credulity: weaknefs and undue pliancy
of the judgment, with facility of being duped.

o. Inconftantia, ficklenefs : inftability and irrefolution
of the will.

2. Moria demens, irrationality: defeCf or hebetude of
all the faculties of the underltanding. Three varieties.

a. Stultitia, fillinefs : (hallow knowledge ; feeble judg¬
ment; light frivolous fancy ; for the molt part with good
nature, fometimes with obltinacy.

(3. Lerema, dotage: impotence of body as well as of
mind from natural or premature old age; childilh defires
and purfuits ; drawling fpeech or garrulous babble,
compofed of ideas for the molt part aflbciated by previous
habit.

7. Ancea, idiotifm s general obliteration of the men¬
tal powers and afteCtions ; paucity or deftitution of ideas;
obtufe fenfibility; vacant countenance; imperfeCt or
broken articulation ; with, occafionally, tranfient and
unmeaning gufts of palfion.

Order II. Aisthetica, [from xia-Qy ert;, perception, of
tx.u7Quvop1.x1, to perceive.] Difeafes affeCting the Senfation.
Dullnefs, depravation, or abolition, of one or more of
the external organs of fenfe. This order contains five
genera.

Genus I. Paropfis, [from orapa, bad, and oij/t?, fight.]
Difeafed vifion ; the fenfe of fight being vitiated or loft.

4 H Under

800

PATHOLOGY.

Under this genus, Dr. Good includes all difeafes of the
eye, except Ample ophthalmia. We regret that we can¬
not in this place enter into an account of thefe maladies.
When, however, it is confidered, that the anatomical de¬
tails, as to the ftriidture, into which we mud firft enter,
would be long, and that moreover the mod comprefled
accounts of ocular maladies occupy a fpace much greater
than could be introduced into this article, we are com¬
pelled to podpone the fubjedt until we arrive at the arti¬
cle Surgery. In the mean time we have much fatisfac-
tion in referring our readers to two works of the fird ex¬
cellence for all necedary information upon the difeafes in
quedion. We allude to the works of Mr. Travers and
Dr. Vetch. Dr. Good’s cladification of thefe difeafes, in
which there appears no fault except that catarrh, glauco-
fis, &c. cannot be confidered as nervous difeafes, is as
follows.

r. Paropfis lucifuga, night-fight : vidon painfully acute
in a drong light; but clear and pleafant in a deep diade
or the dude of the evening. Chiedy common to thofe
who live almod condantly in dark inclofures, as mines
or prifons ; or who have recently had a cataraft depred'ed
or extraCIed ; and to fhort-fighted perfons. Found alfo,
cccadonally, as a fymptom in ophthalmy, irritation of
the optic nerve, and Hydrops capitis.

a. Paropds no&ifuga, day-fight: vidon dull and con¬
fided in the dude ; but clear and powerful in broad day¬
light. It proceeds ufually from a want of futficient irri¬
tability in the retina; which, in confequence, is only ex¬
cited to adlion by a ftrong ftimulus, or ppwerful light ;
and hence does not clearly difeern in the diade or to¬
wards the clofe of day. Hens are well known to labour
under this defeft ; and hence they cannot fee to pick up
fmall grain in the dude of the evening, and fo employ
this time in going to rood: on which account the dif¬
eafe is fometimes called hen-blindnefs.

3. Paropfis longinqua, long-fight: vidon only accu¬
rate when the objeCl is far off.

In the preceding fpecies the hebetude deems chiedy to
appertain to th 0 retina : in the prefent fpecies it belongs
chiefly to the iris, which is habitually dilated, and
not eadly ftimulated to a contractile aClion. For “it is
well known,” obferves Dr. Wells, “ to thofe who are con-
verfant with the faCts relating to human vidon, that the
eye in its relaxed Hate is fltted for diftant objects, and that
the feeing of near objects accurately is dependant upon
mufcularexertion.” (Phil. Tranf. 181 1, art. xix.) There
are three varieties,

a. Vulgaris : common to every period of life, and
chiefly produced by habitual relaxation of the iris, moft-
jy with fomewhat too flat a cornea.

/3. Paretica : from partial paralyds : as an abfolute in-
con tra&ility of the iris, by which the diameter of the pu¬
pil is rendered unchangeable, and a pareds of feveral
other mufcular powers of the eye is fuperinduced ; while
the retina continues perfeftly fendble to tire ftimulus of
light. For cafes, fee Phil. Tranf. 1793 and 1811.

7. Sene&utis : from old age, in which the cornea ufu¬
ally grows lefs convex ; and hebetude and relaxation be¬
come common to all the powers of the eye.

4. Paropds propinqua, lhort-fight: vidon only accu¬
rate when the objeCt is near. Mice are fuppofed to have
this kind of vidon naturally ; and hence the name that
has been given to it of myopia, or moufe-dght.

5. Paropfis lateralis, fkew-fight. In this fpecies the
patient can only fee obliquely, in confequence of fome
partial obfufeation of the cornea (ufually perhaps from
fcratches or flight fears), or of the humours through
which the light is tranfmitted; or from a partial paralyds
of the retina. This mull not be confounded with ftra-
bifrnus, or fquinting, which proceeds from a different
caufe, and is accompanied with different phenomena.
In lateral vifion, the axis of the eye affeCted ufually coin¬
cides with that of the found eye, though it runs fome¬
what obliquely to avoid the obftruCtion in the tunic. In

Jlrabifmus, the two axes do not coincide, and the judg¬
ment is formed from the ftrongeft eye alone. If, however,
in lateral vidon, the obftruftion be fuch as to make the
optical axis of the affefled eye at variance with that of
the found eye, fquinting muftbe a neceffary confequence
of the difeafe.

6. Paropfis illuforia," falfe dght : imaginary obje&s
floating before the dght ; or real objeCts appearing with
imaginary qualities. Dr. Good notes two varieties, and
feveral fub-varieties.

a. Phantafmatum : ocular fpeftres, affuming various
femblances; as, dark fpots, the rnufdae volitantes of va¬
rious authors; net-work, fparks, dazzling, iridefcence,
&c. “ Thefe appearances (fays Dr. Young) are fome¬
times, if not always, occadoned by an opacity of fome of
the veflelsof the vitreous humour, near the retina. They
are feen in a full light; and cannot, therefore, as Sauva-
ges has juftly remarked, be caufed by any thing in the
anterior part of the eye ; and they may often be obferved
to change their form with the motions of the eye ; which
they could not do if they did not depend on fome float¬
ing fubftance. Their apparent change of podtion, when
we attempt to follow them with the eye, is a necedary
confequence of the motion of the eye itfelf which contains
them.

/3. Mutationitis : real objeCts changed in their natural
qualities : hence proceed, error of form, when objefts
appear too large, too fmall, cut in half, diftorted ; error
of motion, which condfts ufually in dancing, nodding,
or rapid fucceflion ; and error of number, when objeCts
are doubled, tripled, or othervvife increafed or multiplied.

7. Paropds caligo, opake cornea, or web-eye : dimnefs
or abolition of dght from opacity of the cornea, or fpots
upon its furface. “ This is the foul flend, Flibbertigib¬
bet : he gives the web, and the pin, fquints the eye, and
makes the hare-lip.” Shukefpeare.

8. Paropds glaucods : dimnefs or abolition of dght
from opacity of the humours.

9. Paropfis catarafta, cataraCf : dimnefs or abolition
of fight from opacity of the cryftalline lens. Three kinds.

a. C. lenticularis, lenticular : the opacity exifting in
the lens itfelf, and confined to it.

/3. C. capfularis, capfular or membraneous: the opa¬
city confined to the capfule, or membrane of the lens.

7. C. complicata, complicated : the opacity common
to the lens and its capfule.

10. Paropfis fynizefis : dimnefs or abolition of fight*
from contraction or obliteration of the pupil. Two va¬
rieties.

a. S. flmplex, dimple clofure of the pupil. The pupil
becomes clofed or obliterated from progreflive contrac¬
tion, and at length coalition, of the mufcular fibres of
the iris ; from inflammation of the furrounding mem¬
branes ; or from protrufion of the iris. In all thefe cafes
it is called “ dimple obliteration of the pupil.”

(3. S. complicata ; clofure of the pupil complicated with
cataraft or an opake cornea.

11. Paropfis amaurofis, gutta ferena, or drop ferene:
dimnefs or abolition of fight, with an unalterable immo¬
vable pupil, ufually black and dilated ; but without any
other apparent defect. Three varieties.

a. A.atonica; with permanent atony and dilatation
of the pupil.

|3. A. fpafmodica ; with permanent contraction.

7. A. intermittens ; with periodical ceflations and re¬
turns.

is. Paropfis ftaphyloma, protuberant eye : enlargement
of the ball of the eye; protuberance of the cornea; dght
dim or abolilhed. Staphylo7im is from oTatpvX-n, a grape,
on account of tla,e refemblance of the tumour to the pul¬
py and femi-tranfparent appearance of this fruit. Rich¬
ter has the credit of having firft pointed cut the real na¬
ture of this difeafe, of which there are three varieties.

a. St. fimplex ; from increafed fecretion of the aqueous
or other humour: pupil tranfparent.

j3. St.

PATHOLOGY.

St. purulentum: from flow of pus from an abfcefs
in one of the membranes ; pupil cloudy. By Plenck
called onyx, when between the lamellse of the cornea j
and hypopyum, when in the aqueous humour.

y. St. complicatum; complicated with a rupture of
the iris, and its protrufion upon the cornea ; conftituting
a grape-like tumour; light aboliflied.

13. Paroplis ftrabifmus, fquinting : optic axes of the
eyes not coinciding on an objeCt.

The optic axis is an imaginary right line palling from
the centre of the vitreous humour, lens, and globe, of
the eye, to the object of vifion. In perfeft vilion, the
optic axis of the one eye is in unifon with thaf of the
other, qnd confequently they converge or coincide at the
fame point ; and the object, which would otherwife ap¬
pear double, as being feen by each eye, is contemplated
as Angle. In order to this coincidence, the mufcles of
each eye mull conllantly affume the fame direction, their
pofition and configuration be precifely alike, and the
fight be of an equal power and focus : a deviation from
each of which poltulates mull: neceffarily produce fquint¬
ing, or an inaccordant aCtion of one eye with the other.
From common and early habit we acquire an equal com¬
mand over the mufcles of both, and are able to give them
any direction, and to fix them againft any objeCt we
pleafe : and fuch is the power of habit, that at length they
involuntarily aflbciate in the fame aCtion, and it is diffi¬
cult 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 inftead of converge. In perfons born
blind, no benefit can be derived from this unity of ac¬
tion ; hence it is never attempted; and, the mufcles
being never fubjeCted to difcipline, the eye-balls roll at
random, and wander in every direction. And hence one
of the moll difficult talks to be acquired by fuch perfons
after obtaining fight, is that of keeping their eyes fixed,
and giving the fame bearing or convergent line to each ;
and hence, again, they fee things double at firll, and in a
Hate of great confulion. When one eye is naturally
ltronger, or of a more favourable focus, or more fre¬
quently employed than the other, as among watchmakers
and jewellers, the latter from comparative negleCl re-
lapfes into an undifciplined Hate, and lefs readily obeys
the control of the will. Its mufcles do not affume the
fame direction, and if they do, in the two former cafes,
the objeCl appears double ; and hence the negleCted or
weaker eye wanders and flares at one or at various ob¬
jects, while the eye relied upon is fixed upon fome other.
And it is this divergence of the optic axes, this inaccor¬
dance of direction, or looking at different objeCts at the
lame time, that conftitures the difeafe called ftrabifmus,
or fquinting. From the above-mentioned caufes, we
divide the fpecies into three varieties.

a. Str, habitualis, from habit, or the cuftom of ufing
one eye and neglecting the other ; whereby the latter
grows gradually more unfteady, and the will has no
longer an equal command over both.

(3. Str. atonicus, from debility of the affeCted eye ;
whence the found eye poffeffes a different focus and power
of vifion, and is alone trufted to : in confequence of
which the w’eak or negleCted eye infenflbly wanders as
above.

y. Str. organicus, differently conftruCted in form or
pofition : fo that the fituation or figure of one eye, or of
particular parts of one eye, are inaccordant with thofe of
the other ; whence, as in the preceding varieties, one eye
is chiefly depended upon, and the other negleCted.

14. Paropfis eCtropium, everfion of the eye-lids : ever-
fion of one or both the eye-lids ; and confequent expofure
of the red internal tunic.

The oppofite affeCtion, or inverfion of one or both eye¬
lids, is denominated entropium. It is often a very trou-
blefome complaint, from the irritation produced by the
inverted eye-lafhes. But it is, perhaps, in every inftance
3 fymptom or fequel of fome other diforder, as a tumour

.*501

feated on the affeCted lid, or a contraction of its inter¬
nal membrane from a cicatrix, or other caufe.

Genus II. Paracufis, [wapa>tcn? of Hippocrates, from
mapa,, bad, and axaiv, to hear.] Senfe of hearing vitiated
or loft. There are fix fpecies.

1. Paracufis acris : hearing painfully acute, and into¬
lerant of the lowed founds. A fymptom of increafed
nervous excitement, as in cephalitis, epilepfy, &c. When
idiopathic, i.e. when a merC nervous difeafe of the part,
and unconnected with general plethora or general exalta¬
tion of the cerebral fundion, it will require the fame
treatment as in other local irritations ; that is, the fub-
duCtion of noife, opening medicine, and, in violent and
diftrefiing cafes, the belladonna may be ufed.

2. Paracufis obtufa : hearing dull and confufed, and
demanding a clear and modulated articulation. Hard-
nefs of hearing is divided into,

as. Organica; from organic defeCl.

|3. Atonica, or nervous deafnefs ; from local debility.
This, which arifes from deficient energy of the auditory
nerves, is much relieved by eleClricity.

y. A meatu obftruCto ; from obftruftion in the au¬
ditory tube or paffage ; as by mucus, wax, forties,
an infeCt, or any other extrinfic body. When any
fubftance is lodged in the part, it muff: be extracted
by fyringing; and in fome cafes, as where the Euftachian
tube was clofed in confequence of inflammation, tire tym¬
panum has been fuccefsfully punCtured by Sir A. Cooper.
For the mode of performing this operation, fee the arti¬
cle Surgery.

3. Paracufis perverfa, perverfe hearing: the ear only
fenlible to articulate founds when excited by other and
louder founds intermixed with them.

Of this extraordinary difeafe, Sauvages has collected
various examples from unqueftionable authorities. The
firft cafe is that of a woman who could never underftand
what was fpoken to her unlefs a drum were beating clofe
to her at the fame time ; and who, on this account, kept
a drum always in the houfe, which was conllantly played
upon while ftie was converfing with her hulband. Ano¬
ther cafe is that of a bell-ringer, who could never diftin-
guilh fpeech except while the bells were ringing. A
third cafe relates to a perfon 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 engaging in converfation. Sauvages inge-
nioufly afcribes this difeafe to torpitude or parefis of the
organs of the external ear, which require this additional
ltimulus to route them into aCtion, fo as to convey the
proper' founds addreffed to them beyond the tympanum.
And he clofes with the following illuftrations : “ Sic
fomnolenti oculos non aperiunt, nec proinde aptant ad
vifum, nifi magna lux oculos commoveat; lie organa ge¬
nitalia ganeonum a torpore excitantur quandoque per
flagra, de quorum ufu in rea venerea fcriplit Meibomius.”
Tom. I. 757.

4. Paracufis duplicata, double hearing: the aCtion of
the one ear inaccordant with that of the other: founds
heard doubly and in different tones or keys.

Sauvages has given two or three very curious exam¬
ples upon this laft affeClion : A mufician, while blow¬
ing his flute, heard two diftinCt founds at every note.
The founds were in different keys, and confequently not
in harmony; and, as they were heard fimultaneoufly, the
one could not be an echo of the other. This Angular
affeClion feems to have been the refult of a catarrh, and
ceafed on its termination. On another occafion he was
confulted by a perfon who for feveral months antecedent¬
ly had been troubled with a hearing of two diftinCl
voices whenever he was fpoken to : tire one at leaft an
oCtave higher than the other, but not in unifon with it,
and hence producing a harlh and infupportable difeor-
dancy. Tom. I. 7 56.

5. Paracufis illuforia, imaginary founds : internal

fenfe

1

302 PATHOLOGY.

fenfe of founds, without external caufes. Three varie¬
ties are given.

“• Syrigmus, ringing or tinkling 5 a (harp, thrill, fuc-
cufiive, found.

/?. Sufurrus, whizzing 5 an acute, continuous, hilling,
found.

y. Bombus, beating; a dull heavy intermitting found.
This appears to be very nearly of the fame nature as the
firft fpecies.

6. Paracufis furditas, deafnefs : total inability of hear¬
ing or diftinguifhing founds. Three varieties are noted.

a. S. organica ; from organic defeCt.

p. S. atonica ; from local debility.

y. S. paralytica; from local palfy.

Genus III. Parofnnn, [from Trapa, and o£a, to fmell.]
The fenfe of (Yneli vitiated, or lolt. (Anofmia, Sauv.
Linn. Vog. Call.) There are three fpecies.

1. Parofmis acris, acute fmell: fmell painfully acute,
or fenfible to odours not generally perceived.

Generally fpeaking, the fenfe of fmell in all animals is
in proportion to the extent of the Schneiderian or olfac¬
tory membrane with which the noftrils are lined, and
over which the branches of the olfaftory nerves divari¬
cate and ramify. And hence this membrane is much
more extenfive in quadrupeds and birds, which chiefly
trull; to the fenfe of fmell in felefting their food, than in
man; foritafcends confiderably higher, and is for the
molt part poflefled of numerous folds or duplications. It
is hereby the hound diltinguilhes the peculiar fcent
thrown forth from the body of the hare, and the domef-
tic dog recognizes and identifies his matter from all other
individuals. Under peculiar circumftances, however,
the ordinary apparatus for fmell poflefies an activity, and
fometimes even an intolerable keennefs, which by no
means belongs to it in its natural ftate. M. Virey, who
has written a very learned treatife upon the fubjeft of
odours, aflerts that the olfaftory fenfe exifts among fa-
vages in a far higher degree of activity than among civi¬
lized nations, whole power of fmell is blunted by an ha¬
bitual expofure to ftrong odours, or an intricate combi¬
nation of them, and by the ufe of high-flavoured foods.
And he might have added, that this fenfe, like every
other, is capable of cultivation, and acquiring delicacy
of difcrimination by ufe; that lavages, many of whom
make a near approach to the life of quadrupeds, employ
it, and trull: to it, in a fimilar manner; and that this is,
perhaps, a chief caufe of the difference he has pointed
out. It is in like manner relied upon by perfons who are
deprived of one or two of the other external fenfes, as
thofe of fight or hearing, or both ; and in thefe cafes it
often acquires an extraordinary degree of nicety. In
the interefling example of the boy born blind and deaf,
lately given to the world by Profellor Stewart, and who,
in confequence was obliged to rely upon the two faculties
of fmell and touch alone, in difcriminating almolt all
the objects that furrounded him, he is faid, in Mr. War-
drop's hiftory of the cafe, to have employed the fenfe of
fmell on all occafions, like a domeflic dog, in diftinguilh-
ing perfons, and chiefly to have depended on it. By this
fenfe he identified his friends and relatives; and con¬
ceived a fudden attachment or diflike to Arrangers ac¬
cording to the odour of the effluvium that efcaped from
the (kin.

The journal des Scavans, anno 1667, gives a curious
hiftory of a monk, who pretended to be able to afcer-
tain, by the difference of odour alone, the fex and age
of a perfon, whether he were married or Angle, and the
manner of life to which he was accuftomed. This, as
far as the faft extended, may poflibly have been the re-
fultof obfervations grafted upon a ttronger natural fenfe
than belongs to mankind in general ; and is fcarcely to
be ranked in the lift of difeafed actions. But among per¬
fons of a highly nervous or irritable idiofyncrafy, Dr.
Good had met with numerous inftances, and doubtlefs

other practitioners have alfo, of an acutenefs of fmell
almoft intolerable and diftrafting to thofe who were la¬
bouring under it, which has fairly conftituted an idio¬
pathic affeftion ; and fometimes nearly realized the fan¬
ciful defcription of the poet, by making its pofleffors
ready, at every moment, to “die of a role in aromatic
pain.”

There is a curious and ingenious paper in the Tranf-
aCtions of the Swedifh Academy, tom. i. from the pen,
of Linnaeus, containing a variety of ufeful obfervations
on the peculiar qualities given to the fmell, tafte, and
other properties, of animals, in confequence of their feed¬
ing on different foods.

2. Parofmis obtufa, ohtufe fmell : fmell dull and im¬
perfectly difcriminative.

3. Parofmis expers, want of fmell : total inability of
fmelling or diftinguifhing odours. This may be,

a.. Organica; from organic defeCt, or accidental de-
ftruCtion of the olfaftory nerve, or its branches ; or of
the Schneiderian membrane over which they are fpread.
Or,

£. Paralytica ; from local palfy.

Genus IV. Parageufis, [from yeva-u;, tafte.] The fenfe
of tafte vitiated or loft. (Ageuftia, Sauv. and Cull.)
There are three fpecies.

1. Parageufis acris, acute tafte: tafte painfully acute,
or fenfible to favours not generally perceived.

2. Parageufis obtufa, obtufe tafte : tafte dull and im¬
perfectly difcriminative.

3. Parageufis expers, total inability of tailing or dif¬
tinguifhing favours. The papillae of the tongue deftitute
of guftatory nerves, or covered with a mucous or other
Iheath which they cannot penetrate.

The firft and laft fpecies are perhaps chiefly fymptom-
atic, though not always fo. The fecond is common,
and is often connected with obtuD fmell ; for phyfiolo-
gifts have remarked a ftriking coincidence and fympathy
between thefe two fenfes ; and fome have conceived them
to be mere modifications of each other. Dr. Good had
a lady of twenty-four years of age under his care, of great
mental tafte and accomplifhments, who had always pof-
fefled a confiderable hebetude of both fenfes. She could
diftinguilh the fmell of a rofe from that of garlic, and
the tafte of port wine from mountain or madeira ; but
Ihe could not difcriminate between the odour of a rofe
and that of a lily ; or between the tafte of beef, veal, and
pork ; and confequently, upon all thefe points, had no
preference of relilh.

The lofs of tafte, and the peculiar changes of the fame
faculty, in fevers and molt inflammatory difeafes, are well
known.

Genus V. Parapjis, [from wapos, and a.-^ »j, touch.]
Senfeof touch, or general feeling, vitiated or loft. Three
fpecies.

1. Parapfis acris : touch painfully acute, or fenfible to
impreflions not generally perceived. Four varieties.

a. P. teneritudo, forenefs : painful uneafinefs or ten-
dernefs, local or general, on being touched, with a pref-
fure iifually unaccompanied with troublefome feeling.
Occafionally unconnected and idiopathic, but more fre¬
quently a fymptom or fequel of fevers, debility, laffitude,
violent exercife, or catching cold.

|3. P. pruritus, itching : painful titillation, local or ge¬
neral, relieved by rubbing.

y. P. algor, coldnefs: fenfe of temperature, local or
general, below that of pleafant and natural warmth. As
an idiopathic afteftion chiefly local, and molt common
to the head and feet.

31. P. ardor, heat : fenfe of temperature, local or gene¬
ral, above that of pleafant and natural coolnefs. As an
idiopathic afteftion occurring chiefly in plethoric and ir¬
ritable habits. Found alfo as a fymptom in the fecond
ftageof fevers, inflammations, and entonic empathema.

2. Parapfis

PATHOLOGY. 303

2. Parapfis expers; total infenfibility toobje&s of touch.
Divided into,

a.. Simplex, numbnefs : confined locally or generally
to the fenfe of touch ; fometimes accompanied with un-
eafinefs.

C. Complicata : complicated with infenfibility in feve-
ral or all the other fenfes.

3. Parapfis illuforia : imaginary fenfe of touch or ge¬
neral feeling in organs that have no exiftence. Common
to thofe who have fuffered amputation. Found alfo, oc-
cafionally as a fymptom, in hypochondriafis and other
mental affeftions.

Order III. Cinetica, from xinv, to move.]

Diforders affe&ing the Mufcles. Irregular aftion of the
mufcles or mufcular fibres; commonly denominated
fpafm. This order contains four genera.

Genus I. Entafia, [from eneiw, to ftretch.] Tonic
fpafm. Irregular mulcular aftion, producing contrac¬
tion, rigidity, or both. There are feven fpecies.

1. Entafia priapifmus, priapifm ; fo called from Pria-
pus, the fon of Venus and Bacchus, who is ufually thus
reprefented in paintings and fculptures. Permanent
rigidity and ereftion of the penis, without concupifcence.
For the moft part the confequence of cold, cantharides,
clap, or dyfury. It feems to arife from a fpafmodic con¬
traction of the ereftores penis, wholly unconnected with
the Hate of fulnefs of the veficulae feminales. It is a dif-
eafe of advanced life. Priapifmus affords a ftriking in-
ftance of fpafm arifing from debility. Camphor and
opium at night, with purgatives and diluents in the day¬
time, are the belt remedies ; but we can in general only
palliate ; the difeafe is feldom removed.

2. Entafia loxia, ftiff-neck: permanent contraction of
the flexor mufcles on the right or left of the neck, draw¬
ing the head obliquely in the fame direction. Three
varieties.

a. L. difpars; from difparity in the length of the
mufcles oppofed to each other.

0. L. entonica ; from excefs of mufcular aCtion on the
contracted fide.

7. L. ato.nica ; from direCt atony of the antagonifl
mufcles. Found alfo, occafionally, as a fymptom, in
fprains or inflammations of the neck; in catarrh ; and in
contractions of the fkin of the neck from fevere burns.

This and the following fpecies will require to have their
treatment varied according to the exciting caufe ; and,
when not arifing from inflammation or injury, may be
fubjeCt to the fame treatment as that which applies to
atony of the mufcles in general. Thefe indications we
fhall more particularly develope under our defeription of
Tetanus.

3. Entafia articularis, mufcular ftiff-joint : permanent
and rigid contraction of one or more articular mufcles or
their tendons. Three varieties,

a. Entonica, articular fpafm ; from excefs of aCtion in
the mufcles contracted.

0. Atonica ; from direCt atony of the antagonifl: muf¬
cles.

7. Inufitata ; from long confinement or negleCt of ufe.
Found alfo occafionally, as a fymptom, in articular inflam¬
mations, abfeefles, and ulcers fecreting an irritating fluid.

4. Entafia trifmus, locked jaw : permanent and rigid
fixation of the mufcles of the lower jaw. This has alfo
three varieties.

a. Tr. nafeentium ; attacking infants during the firfl
fortnight after birth. Probably the refult of acrimony in
the ftomach. This is principally found in hot climates ;
and refults occafionally from irritation in the digeftive
organs, and in other cafes from the irritable ftate of the
divided funis. As it is feldom cured when once formed,
praClitioners in hot climates fliould be careful to keep the
bowels open, and infpeCt occafionally the ftate of the fu¬
nis.

0. Tr. trauniaticus ; occurring at every age as the con-
Vol. XIX. No. 1305.

fequence of a w'ound, punCture, or ulcer; chiefly in hot
climates.

The following varieties of this, and of all the next fpe¬
cies, will be treated of together, as being of the fame
nature, and differing in appearance merely from the pe¬
culiar mufcles affeCted.

7. Tr. algidus ; occurring after expofure to cold and
damp, efpecially the dew of evening.

5. Entafia tetanus : permanent and rigid fixation cf
many or all the voluntary mufcles ; with incurvation of
the body, and dyfpncea. Four varieties.

«. T. anticus, (Emprofthotonus, Aucl. var.) tetanus
of the flexor mufcles : body rigidly bent backward.

0. T. dorfalis, (Opifthotonus, Au6i. var.) tetanus of
the extenfor mufcles : body rigidly bent forward.

7. T. lateralis: tetanus of the lateral mufcles: body
rigidly bent laterally.

$. T. catochus : tetanus general, with little or no dif¬
ficulty of breathing ; chronic and periodical.

Tetanus is very ltriddy a nervous malady. It follows
mechanical or chemical irritations, under circumftances
of high temperature or irritable habit of body, and fome¬
times without thefe circumftances. The irritations are
of various kinds. The moft common is a wound, punc¬
ture, or bruife, particularly if a large nerve be wounded.
Next in order come gaftric and internal irritations; and
thefe are fo generally met with even when external in¬
jury exifts, that one might almoft infer that they always
form a link in the chain of morbid aftion. Another
caufe is put down in medical fyftems ; viz. the fudden
application of cold to the heated body. From whatever
caufe, however, the irritation arifes, its effefts are exerted
in fuch a manner on the mufcular fyftem, as to produce
a rigid and permanent degree of contraction. Unlike
what is obferved in nervous difeafes in general, this dif-
order does not abate when its original caufe is removed.
If the limb be amputated on which the irritating wound
has been inflicted, no relief follows. Hence it feems that
the violence of the irritation in the firft inftance caufes an
aCtual difeafeof the nervous fyftem capable of exciting con¬
tinually mufcular aCtion. What this ftate may be we know
not. It has been afferted, that it is inflammation of the
fpinal marrow. The ftate of the vafcular fyftem does not
bear out this affertion ; neither is it borne out by the
mode of attack, which generally comes on firft in the
jaw, a part not depending on the fpinal marrow for its
nervous fupply. Moreover the effeCt of remedies does
not bear out the above propofition ; the moft extravagant
bleedings have often failed to procure relief ; while fti-
mulants have been fometimes fuccefsful. We (hould
conclude, therefore, that tetanus is a difeafe which arifes
from irritation of the extremities of nerves, which con-
fifts in fuch a change of the nervous centres of motion,
that they continually and exceflively maintain their fti-
mulation on the mufcular powers ; and that, when this
ftate of difeafe (when it may be) is induced, it goes on
independently of the caufes which produced it. This
explanation by no means involves the queftion, whether
or not tetanus be fpinal inflammation : it only refufes to
adopt the affirmative, on account of the paucity of dif-
feCtions on which it is founded.

The firft fymptom the attentive praflitioner remarks in
tetanus, is a tranfient ftiffening of the limbs during fleep,
and fometimes fpafmodic twitches. Another fymptom,
which is only ufeful as indicating that tetanus is likely
to occur, is fufpenfion of the alvine difeharges. The next
fymptom is flight ftiffnefs in theback part of the neck and
about the fhoulders, which, gradually increafing, impedes
the rotatory motions of the head, and alfo its flexion for¬
wards : fo that the patient cannot look downwards, or to
either fide, without turning his whole body. This un-
eafy feeling, being chiefly felt on motion, very much re¬
sembles what occurs from rheumatifm, but it is accom¬
panied with a fenfe of general laflitude and debility. The
rigidity now extends from the back of the neck to the
4 I mufcles

304

PATHOLOGY.

mufcles of the jaw, and of the root of the tongue, fo that
both maftication and fwallowing become difficult and
painful; and at length impoffible. The attempt at
deglutition is attended with convulfive efforts ; efpe-
cially when liquids are endeavoured to be fwallowed.
So great is the diftrefs which accompanies thefe convul-
fions, that the patient becomes very reluctant to renew
the trials, and refufes all nouriffiment; and it fometimes
infpires him with even a dread of the fight of water.

As the difeafe advances, another fet of fymptoms ap¬
pears, bringing with them a confiderable increafe to the
fufferings of the patient. A fudden and violent pain is
felt (hooting from the lower extremity of the fternum to
the fpine, in the fituation of the diaphragm. Thefe fpafms
recur from time to time, at ihort intervals ; and at each
recurrence, give the fignal for an immediate aggravation
of all the other fpafms. The mufcles of the neck and
jaw are immediately called into violent action ; the head
is pulled ftrongly backwards ; and the jaw becomes firm¬
ly clenched. Thefe periodical acceffions of fpafm become
more fevere, and their effects more durable; fo that the
head continues to be in a (late of retradtion, and. the jaw
is permanently clofed, the teeth being fo firmly fet toge¬
ther, as not to admit of the ftnalleft opening. Such con-
ftitutes what may be regarded as the firft ftage of the dif¬
eafe; which fometimes takes up three or four days. At
other times the difeafe eftablifhes itfelf, with its whole
train of dreadful fymptoms, in a few hours; in which
cafe the danger is imminent ; as death generally takes
place in from twenty-four to forty-eight hours, and the
patient very rarely paffes over the third day.

The continuance of the difeafe, if the patient furvive
the immediate attack, is marked by the increafing fpafm
of the diaphragm, which now returns every ten or fifteen
minutes, and is inftantly fucceeded by a ftronger retrac¬
tion of the head, and rigidity of the mufcles extending
down the back, along the fpine, and aft'edting even thofe
of the lower extremities. Their .contradtions increafing
in force, the body is frequently raifed in the form of a
bow, relting upon the head and feet alone : a (late which
is more particularly denominated opijlholomos. The
countenance is pale and contradted ; the maftoid, cora-
co-hyoid, and lterno-hyoid, mufcles, together with the
others concerned in deglutition, and the deltoid and
pedtoral mufcles, are mod violently contradfed, fo that
the (houlders are ftrongly raifed forwards, and the arms
are ftretched out, .or drawn acrofs the body; but the
wrifts and fingers feem not to be affedted. In a few fe-
conds a remiffion takes place ; the (houlders and arms re¬
cline, and the inferior extremities relax; yet not fo en¬
tirely, but that generally fuch a degree of rigidity con¬
tinues as to prevent their being bent, even when this is
attempted by another perfon. The mufcles on the (ides
and fore part of the neck continue (fill contradted, al¬
though not fo ftrongly; but their adtion is overcome by
the number and ftrength of the pofterior ones; fo that the
contradlion of the head conftantly remains. The patient
breathes quick for fome minutes, as if he had been excef-
fively exercifed, and the pulfe is fmall, fluttering, and
irregular; but both become more calm and (low. The
face is fometimes pale in the intervals, but oftenerfluffied;
and the whole countenance expreffes ftrong appearances
of the mod melancholy diftrefs ; as well on account of
the terror the patient feels at the approaching paroxyfm,
as from the torture he has differed from the iaft, of which
the painful contractions he (till feels perpetually remind
him. He, for the inoft part, defires to lie (till as much as
poffible, and to avoid all attempts at drinking, fpeaking,
or any kind of motion ; all of which are apt to occafion a
return of the fpafm in all its horrors. Some, indeed, are
felicitous to try a change of pofition, in hopes of obtain¬
ing one of greater eafe ; but the adt of turning the pa¬
tient never fails to bring on an attack of the convulfion,
by which the head is drawn back to the fpine : and it is
at length found, that the beft means of avoiding this is
for him to lie perfedtly (till on the back.

It may, in general, be obferved, that the extender mud
cles are affedted with fpafm before the flexors. In the
lower extremities, indeed, both the flexor and extenfor
mufcles are commonly at the fame time affedted, and keep
the limbs rigidly extended. The flexors of the head, and
the mufcles that pull down the lower jaw, become affedted
in the progrefs of the difeafe, together with the abdomi¬
nal mufcles; fo that the belly is ftrongly retradted, and
feels hard, like a piece of board. The fpafm of thefe and
the other flexor mufcles, becoming fo powerful as to ba¬
lance the adtion of the extenfors, is a circumftance that
marks the advance of the difeafe, and may be regarded as
conftituting the commencement of a third jlage. In this
fituation the body and limbs are perfedtly ftraight and
rigid, and incapable of being moved in any way ; and it
is to this condition that the term tetanus has been more
efpecially applied. It is a (fate of the mod exquifite ftif-
fering : the patient is on the rack from the continual
recurrence of the fpafm, which has fcarcely any remiffion.
The redti mufcles of the abdomen often contradt un¬
equally, producing the appearance of hard balls in parti¬
cular parts. The whole belly is drawn inwards, and does
not yield in the leaft to the defeent of the diaphragm in
infpiration. Although the lower extremities are always
rigid at this period, yet their adtion is fo violent during
the height of the paroxyfms, that, were it not for the
ftanders-by, the patient would be projedted feet-foremoft
off' the bed ; or would, at other times, be puffied upwards
with fuch an impetus as to ftrike the head with great
force againft whatever might happen to be in the why.
Occafionally, the flexor mufcles acquire the preponder¬
ance over the extenfors, and the trunk of the body is
bent forwards, the chin being fixed to the breaft. This is
what has been called emprojlhotonos, and occurs only in
the mod violent, and of courfe the leaft frequent, form
of the difeafe. It would appear from fome cafes reported
by Sauvages, that thefe oppofite dates are difpofed to al-
ternate with one another.

In extreme cafes, there are hardly any of the voluntary
mufcles that remain in their natural (late. The face and
eyes are diftorted ; the tongue is fuddenly darted out
between the teeth, and often miferably lacerated from
their doling at the fame moment. Even the fmall muf¬
cles of the ear partake of the fpafmodic adtion, which fo
univerfally prevails in the fyftem. While the tongue is
thruft out, the mufcular (left, which is fituated between
the arch of the lower jaw and the upper part of the tra¬
chea, is drawn upwards within the throat. The counte¬
nance is much contradted ; a general fweat breaks out;
the eyes are watery and languid; and a pale or bloody
froth bubbles out from between the lips. Tetanus, in
thefe violent forms, is perhaps the moft painful difeafe
that can affedt the human frame. So exquifite a degree
of pain would fcarcely be compatible with life, were it
not occafionally afl'uaged by the fliort and imperfedt re-
miffions of fpafm which occur. A more continued and
fevere fpafm, or a general convulfion, generally finifhes
the tragedy, and releafes the unhappy vidtim from all his
mifery : or, if already too exhaufted by the feverity of
pain to admit of this mode of termination, delirium of¬
ten enfues, protects the patient by a happy infenfibility
to further fuffering, and fmooths the avenue to death,
which is then preceded by a general relaxation of the
fpafms.

Such are the fymptoms which peculiarly belong to te¬
tanus : and it is, perhaps, the moft remarkable circum¬
ftance attending the difeafe, that hardly any fundtion is
primarily affedted, except that of mufcular adtion. The
fenfes and appetites are perfedt and entire; the intellec¬
tual fundtions are undifturbed ; and the natural fundtions
proceed in their ulual courfe. Fever is neither an ef-
fential nor a common attendant on the difeafe. In the
firft ftage, when the fpafm is confined to a few mufcles,
the pulfe is not affedted : it becomes accelerated only
when the fpafmodic adtions are general; and this merely
in confequence, as it would appear, of the mechanical

eftedt

PATH

effeCl produced on the blood-veffels by the contractions
of the mufcles, which will hurry on the circulations and
throw the blood upon the heart in larger quantity than
ufual, rendering the pulfe contracted, frequent, and ir¬
regular. The refpiration is hurried from the fame
caufe, and the temperature of the body, as might be ex¬
pected, is increafed in the fame proportion. That thefe
fymptoms are not the eft’eCt of fever, appears from the
ftate of the blood, which is found to be of a loofer texture
than natural, and never exhibits the buffy coat, as in
inflammatory difeafes. On fome occafions, indeed, when
the diforder is very violent, the arterial actions are in¬
creafed, and a febrile ftate prevails ; and this appears to
take place more frequently when the difeafe has origi¬
nated from cold, than when it has been excited by
wounds. The flcin is at firft natural, but, as the difeafe
advances, is covered with a cold fweat. The tongue is
always moift. Vomiting fometimes takes" place early in
the complaint, but it commonly fubfides in the progrefs of
it : it is even ufual for the appetite of hunger to remain
through the whole courfe of the difeafe ; and what food
can be got down appears to be fufficiently well digefted.
Some local effeCls feem to be attributable to the con¬
tractions of the abdominal mufcles. The fphinCter of
the bladder is occafionally affeCted with fpafm, fo as to
impede the difcharge of urine, which is voided with pain
and difficulty : at other times, its fecretion is fuppreffed.
When it can be obferved, it is ftated as being high-co¬
loured, and fomewhat turbid. The bowels are found to
be, in every in fiance, obftinately coftive, a ftate which
may partly be accounted for by the effeCt of opiates,
which are fo generally adminiftered for the cure ; but
which, independently of this caufe, appears to be inhe¬
rent in the difeafe itfelf. The bowels require the mod
draftic purgatives; and there is a great fenfe of uneafinefs
about the precordia. In the latter ftages of this dif¬
order, indeed, when the powers of life begin to decline
from the vaft expenditure of energy occafioned by the
violent mufcular aClions, every function in the fyftem
partakes of the general diforder ; the intellect gives way,
and the patient finks from exhauftion alone, if a general
convulfion does not occur to haften his end. It is men¬
tioned by Dr. Cullen, that, in feveral cafes, a miliary
■eruption has appeared upon the fisin , but he expreffes a
doubt whether this was a fymptom of the difeafe, or the
effeCt of a certain treatment of it. It has not been ob¬
ferved, he adds, to denote either fafety or danger, or to
have any effeCt in changing the courfe of the diftemper.

Tetanus arifing from wounds is in general flower in
its progrefe than that which proceeds from cold : but is
attended with more danger to life. It is often eight or
ten days, and fometimes much longer, after the inflic¬
tion of a wound, before the firft fymptoms of tetanus
make their appearance : and this frequently happens
when the effeCls of the injury on the part itfelf appear
tojiave fubfided ; when the wound has healed, and no
pain or uneafinefs has remained.

Sometimes the difeafe is very fudden in its acceflion,
when it is alfo more fevere. Generally, however,' it
.makes its attack in the gradual manner before defcribed.
The moft rapidly fatal cafe that has ever been recorded,
is one that we have on the authority of the late profeffor
.Robifon of Edinburgh. It occurred in a negro, who was
a waiter -at a tavern, and who happened to fcratch his
thumb with the broken edge of a china plate, and who
d ied of tetanus a quarter of an hour after this apparently
flight accident.

In the late campaigns of our armies in the peninfuia
of Spain and Portugal, according to the report of fir
Janies Macgrigor, tetanus occurred in every defcription,
and in every ftage of wounds, from the flighteft to the
moft formidable, from the healthy and the Houghing,
front the incifed and lacerated, from the moft fimple and
moft complicated. It occurred at uncertain periods ;
but it was remarked, that, if it did not commence before

4

O L O G Y. 305

twenty-two days from the date of the wound, the patient
was fafe.

As to the appearance of afore which gives rife to teta¬
nus, this is by no means peculiar. Some have ftated that
the fore is generally in an irritable and morbid ftate, and
by no means difpofed to fuppuratiom M. Farrey ftates
that the wound is generally dry, or affords only a Icanty
ferous exudation. Certain it is, however, that tetanus,
as before noticed, is no uncommon attendant on wounds
completely healed.

It has been fuppofed by many, that tetanus arofe from
the partial divifion of fome nervous fibres, in confequence
of which the undivided filaments were unequally and
violently ftretched : a ftate which would be remedied by
their complete divifion. Experience, however, the ft u In¬
born enemy to fo many hypothefes, has by no means
proved favourable to this opinion. From the more vio¬
lent forms of the difeafe hardly any inftance of recovery
has been known to take place. On the other hand, the
mere protraCtion of the fymptoms is an indication of the
comparative mildnefs of the difeafe. Indeed it is a re¬
mark as old as Hippocrates, that, if a patient furvives
the fourth day without fuffering an exacerbation of his
complaint, he is fafe. Dr. Parry has adduced the velo¬
city of the circulation as an ufeful criterion of the dan¬
ger of the difeafe ; and obferves, that, if the pulfe be not
above 100 or iio by the fourth or fifth day, the patient
al moft always recovers; but, if it be quickened early, that
it proves fatal ; and yet there are a few inftances of reco¬
very where the pulfe has rifen to 120 on the firft day.
We muft remark however, that, in upwards of twenty
cafes of this difeafe which Dr. Morrifon witneffed among
negroes, the pulfe was in no inftance accelerated in the
manner related by Dr. Parry. This author never knew
it above 98, whether the termination was favourable or
fatal. The following prognoftic paffage we (hall tranfcribe.
“When the difeafe comes on gradually; when for the
firft three or four days the mufcles of the jaws~are folely
affeCted, and that perhaps not in any alarming degree ;
when the abdomen is not preternaturally hard, or the
bowels obftinately coftive; when the fkin is moift and
moderately warm, and above all when the patient enjoys
fleep ; we may (by the means hereafter to be fpoken of)
entertain ftrong hopes of an eventual recovery. An in¬
creafed flow of faliva, where mercury has or has not been
ufed, is always to be regarded as favourable; the lefs the
general air of the countenance is changed, the better.
On the other hand, when the attack is violent and Rid¬
den ; when the mufcles of the neck, back, and abdomen,
are rigidly contracted; when the patient complains of a
fhooting pain from the fternum towards the fpine ; when
the belly feels hard like a board, and the leaft preffure
thereon produces fpafmodic twitchings or contractions of
the mufcles of the neck, jaws, &c. or when the fame ef¬
fect is brought about by the prefentation of any fubftance
(folid or fluid) near the mouth, we have much reafon to
fear a fatal termination. Spafmodic ftartings of the muf¬
cles fet in fometimes early in the difeafe, and, recurring
every eight or ten minutes, are to be regarded as very
unfavourable.”

The only difeafe which tetanus can be confounded
with, is rabies contagiofa. In the latter, however, there
is generally fever ; frequently increafed heat of the body.
In rabies, vomiting is common at the commencement;
not fo in tetanus. The delirium, too, of hydrophobia,
is abfent in tetanus. The (hooting pain from the fter¬
num to the fpine is feldom wanting in tetanus or prelent
in the other.

Few patients fall a facrifice after the ninth or tenth
days, which period they never could have attained, un-
refs the violence of the complaint had in a great meaftire
fubfided. In this milder form, however, it may be pro¬
longed. feveral weeks; and fometimes the fpafmodic dif-
pofition remains even for months, before health is com¬
pletely. reftored. The pulfe, in. thefe cafes, continues

flow.

306 P A T H O

flow and hard, and the belly bound: but, if blood be
drawn, it does not exhibit any difference from its ufual
irate. Under every circumftance of recovery, indeed,
the convalefcent labours long under general debility, and
cannot, for months, raife liimfelf from a fupine or recum¬
bent pofture without affiflance, nor without pain.

Occaiional deviations from the courfe above defcribed
are met with in different cafes. The moll lingular of
thefe anomalies is the one recorded by fir Gilbert Blane,
in which tetanus prevailed to a very confiderable extent,
without affed'ting the patient with the lead degree of
pain. The fpafms were, in this inftance, accompanied
with a tingling fenfation, which was even rather agreea¬
ble than diftreffmg. The cafe, however, terminated fa¬
tally j but, to the laff, no pain was experienced. In two
cafes mentioned by the fame author, the fpafms affe&ed
only the fide of the body in which the wound was fituated.

The refult of diffeCtions of patients who have died of
tetanus throws little light on the nature of this terrible
affeCHon. Sometimes there are found flight effufions
within the cranium ; but, in general, no morbid appear¬
ance whatever can be detected in the head. There ap¬
pears to be always more or lefs of an inflammatory ap¬
pearance in the villous coat about the cefophagus and
ftomach in the neighbourhood of the cardia. Befides
the rednefsand increafed vafcularity of thefe parts, M.
Larrey dates that he found the pharynx and cefophagus
much contracted, and covered with a vifcid reddifh mu¬
cus. Dr. M‘Arthur found, in feveral cafes, the intef-
tines much inflamed; and in two of them a yellow waxy
fluid, of a peculiar offenfive fmell, covering their inter¬
nal fnrface : but whether the inflammation was primary,
or only a confequence of the preffure of the abdominal
mufcles, which contract fo violently in this difeafe, he is
unable to decide. More recent difledtions have difplayed
inflammation and its confequencesin the fpinal marrow;
but the cafes hitherto publiflied are too few in number
to allow us to draw general conqlufions from them.

The obfcurity which involves both the ratio fymptoma-
tuin and the proximate caufe of tetanic affections, has oc¬
casioned the practice in thefe diforders to-be moflly empi¬
rical. The indication of cure which is generally appli¬
cable in all difeafes, namely the removal of the exciting
caufes, has but little place in a morbid condition, which
is the confequence of caufes that in general have ceafed
toaCt, or which it is notin our power either to remove
or control. In tbofe cafes where we could fuppofe local
irritation to be dill operating, the mod effectual method
of counteracting its effeCts on the fyflem, would obvi-
oufly be to intercept all communication between the feat
of the irritation and the fenforium. If, however, the
difeafe has already eftablifhed itfelf, and thefevere fymp-
toras have come on, it does not appear that this would
fucceed in arreding the courfe of the diforder. Experi¬
ence has but too fully fliown, that amputation of the
limb from the injury of which the tetanus had arifen,
will very feldom procure even a mitigation of the fymp-
toms, if performed after a certain period from their firfl
appearance. This plan was fully tried in our army at
Tculoufe, and totally failed. In fome indances, how¬
ever, it is faid that a favourable change has enfued, and
that patients have even recovered by the facrifice of the
-wounded limb : and it has been remarked, that the
ipalins relaxed immediately on the divifion of the foft
parts by the knife, and before the faw was applied to the
bone, in order to complete the operation. It is, there¬
fore, highly probable, that the free divifion of the parts
above the zcound, or dill more certainly the amputation of
the limb, would, at a certain flage of the afl'eCtion, fecure
the patient from the approach of tetanus. But the diffi¬
culty is here to eflimate the probability of the patient’s
having the difeafe, as nothing fliort of the certainty of
its being at hand could well juflify the operation.

. As it is matter of experience, that an early and highly
irritable and painful condition of -the wound has a ten-

L O G Y,

dency to excite tetanus, as well as a date in which the
difcharge is of a peculiar unhealthy character, or is fup-
preffed altogether, our immediate objeCt fliould be to al¬
lay as much as poffible the local irritation, and to re-efla-
blifii a healthy fecretion of pus. Mechanical caufes of
irritation fliould as much as poffible be obviated, by early
attention to remove fplinters of bone, balls, or other fo¬
reign bodies that may be lodged in the wound. Poul¬
tices and foothing applications will anfwer the double
purpofe of quieting local inflammation, and bringing on
healthy fuppuration : the irritability of the furface may
fometimes be mod effectually deflroyed by lunar caudic ;
after which, an emollient poultice may be applied. An
oppoflte plan of treatment has been recommended by Dr.
Rufh ; namely, that of exciting confiderable inflammation
in the wounded part, by epithems of turpentine, and
other highly-dimulating applications; which, though it
may in certain cafes have fucceeded in preventing teta¬
nus, does not appear to be generally applicable, and feems
accordingly to have been abandoned. On the contrary,'
it has of late been the univerfal practice in the navy, to
add tinfture of opium to the dreffings applied to wounds,
with a view of preventing tetanus. With the intention
of re-exciting fuppuration where there is no difcharge,
M. Larrey recommends the application of bliders as near
as poffible to the wound, and adduces indances of fuc-
cefs from this mode of treatment.

But the cure of tetanus, when once it has commenced,
is to be fought for more by the ufe of general than of to¬
pical remedies. The feat of the diforder has been trans¬
ferred to the cranial and fpinal nervous fyflem, and our
efforts mud be directed to allay their inordinate aCtion.
Bleeding has received the fulled trials in tetanus. Occa-
fionally this has cured the difeafe; occafionally it has
mitigated the fufferings of the patient, and fmoothed the
way towards death ; and fo perfectly innoxious does it
feem in all cafes, that it may be fearlefsly tried in all.
A cafe has been related in which the application
of leeches to the fpine was attended with a good effeCt.
It is given, however, on the authority of one who con¬
ceived that fpinal inflammation and tetanus were the
fame.

The affufion of cold water has in general been attended
with great benefit. It is a praCtice particularly recom¬
mended by Dr. Wright, in the London Medical Obferva-
tions, and is functioned by the concurring teftimonies of
Dr. Cochrane in the Medical Commentaries, and of Dr.
Currie in his Medical Reports, as well as by many other
practitioners. A large pailful of cold water fliould be
thrown upon the patient every two or three hours ; he is
to be immediately wiped dry, and laid in bed after each
affufion, and an opiate draught adminiflered. Some re-
miffion of the fpafms will in this way be generally ob¬
tained; and many inflances are upon record, of complete
cures being effected by perfeverance in this plan. Be¬
fore the introduction of this praCtice, the warm bath \6as
very commonly employed; the patient, after ufing it,
being placed in bed, without being dried, between two
blankets, with a view to bring out a fweat. It does not
appear, however, that this plan was attended with any
general or permanent advantage; and is certainly infe¬
rior in efficacy to the cold affufion.

But neither bleeding nor cold affufion offers fo much
to depend on in the cure of tetanus as aftive purging.
The difordered date of the alvine difcharges in this dif¬
eafe firff led Mr. Abernethy to adopt the praftipe of pur¬
ging for its cure ; and of late the mod unequivocal tef-
timonials of its efficacy have arifen from all quarters.
Mr. Abernethy afked what was the date of the bowels
between the infliCfion of external injury and the coming
on of tetanus ? and the anfwer to this is pretty well
known, the bowels are generally in a codive or otherwife
morbid condition. And fince this faCt has been known,
the proportion of tetanic cafes from wounds has been
much lefs than formerly. Under thefe circumflances, it

is

807

PATHOLOGY.

is therefore highly neceflary to purge the patient as foon
as the difeafe has made its attack. Should tri firms be fo
great that the opening of the jaws is prevented, one or
more teeth mull be drawn, arid purges conveyed by means
of the eladic catheter and fyringe into the ftomach in
large and repeated quantities; at the fame time clyfters
mull be given. Men of the bed experience recommend
falivating the fyftera, as early as poflible, with mercury ;
and confequently direft us to give calomel by the
mouth, and rub mercury-ointment along the courfe of
the fpine and other parts, with a view to induce falivation ;
and this has often had a good effeft. Opium is a very
ufeful remedy ; it allays the irritation of the nervous
fyllem in an extraordinary degree; and, though we have
beard much of the Jiimulating effeft of opium, we cannot
but view it as direftly fcdative as far as regards the fpinal
marrow and medulla oblongata, notwithstanding it may
have a ftimulating influence on thofe fuperior por¬
tions which are confidered by mod philofophers to be
the indruments of the mental operations. At all
events, experience decidedly favours the u'fe of opium
ia alleviating, if not in curing, tetanus. It mud be
given in large dofes : from one drachm to half an ounce
of laudanum may be prefcribed according to circum-
ftances; always providing that its operation be clofely
watched, and its repetition regulated by its effefts.

We pa fs over a variety of drugs which have obtained
a name for the cure of tetanus, becaufe the cafes related
of their efficacy are fo few as to warrant us in fuppofing
them fpontaneoully cured. Reafoning from the fedative
effeft which the rubbing of belladonna on the forehead
Ins upon the eye, we would fugged that this ineafure
might be tried with advantage along the courfe of the
fpine for the relief of tetanus. Its internal exhibition
might likewife be ufefully reforted to.

The ufe of bliders has not been attended with much *
fuccefis in this difeafe. They are ufeful adjunfts applied
along the fpine. As fliowing in a drong light the good
effefts of counter-irritation in this difeafe, we dial! pro¬
bably be pardoned by our readers for prefen ting the fol¬
lowing account of a barbarous remedy ufed in the Tonga
i (lands. The inhabitants of thefe places adopt a remedy
which they borrowed of thofe of the Fiji i (lands. It con-
fids in the operation of toculbji, or paffing a reed fird wet¬
ted with faliva into the urethra, fo as to occafion a con-
fiderable irritation and difcharge of blood; and, if the
general fpafm is very violent, they make a feton of this
paffage, by paffing down a double thread, looped over
the end of the reed ; and, when it is felt in the peri nasu in,
they cut down upon it, feize hold of the thread, and
■withdraw the reed, fo that the two ends of the thread
Jiang from the orifice of the urethra, and the doubled
part from the artificial opening in the perintcuin ; the
thread is occafionaliy drawn backwards and forwards,
which excites very great pain and abundant difcharge of
blood. The latteroperation Me, Mariner faw performed
ieveral times ; but only twice for tetanus, arifing in both
Inftances from wounds in the foot ; in thefe cafes the
fpafms, but particularly the convulfive paroxyfms, were
exceedingly violent, extending to the whole body, neck,
face, trunk, and extremities ; but in neither cafe was the
jaw permanently locked, though on every cafe it was vio¬
lently clofed fora few feconds. In both cafes the difeafe
came on fuddenly, three or four days after the wound was
received, which was from an arrow not barbed. The
moment the fymptoms became evident, tocolofi was per¬
formed, In the (hort fpace of two hours, one of them
was greatly relieved, and the other in about fix or eight
hours. The following day, the one was quite well, and
afterwards had no other attack ; confequently the thread
was withdrawn : but the other, on the fecond day,- was
not quite free from fpafmodic fymptoms; and, a parox-
_yfm coming on, the feton was moved frequently, which
in two or three hours gave him great relief, and he after¬
wards had no other attack; it was thought prudent,
however, to keep in the feton till the fourth or fifth day,

ypL.xrx, No. 1305.

when it was withdrawn. The effeft of this operation
was a confiderable pain fend tumefaction of the penis, but
which gradually Cubfided in about five or fix days. The
artificial openings in both cafes healed fpontaneoully,
without any difficulty. (Mariner’s Account of the Tonga
I (lands.)

6. Entafia acrotifinus ; failure or ceflation of the pulfe;
with iittle or no di/turbance of perception or voluntary
power. Two varieties.

a. A. univerfalis ; extending over the whole arterial
fyfteni ; and connedied with fternalgia. The inftances on
record of this affeftion are few. The following lift we
copy from Dr. Good. “ Sufpenfions of pulfation, without
any other affection of the fyftem. Anecdotes de Medec'tne,
p. 199. Marcell. Dom. lib. vi. cap. 2. — For feven days,
without other aft'eftion. Riodlin, Lin. Med. 1696. — Seven
days before death. Valifneri , Opp. iii. p. 278. — Chronic,
and continuing through the -whole term of life. Berry at
Hift, de 1’Acad. des Sciences a Paris, 1748.” See alfo Mr.
J. Hunter’s ad'eftion in Sir Everard Home’s Life of him,
prefixed to his Treatife on Inflammation, p. xlvi.
confiding of a total fufpenfion of pulfation for nearly
an hour, with ceflation of involuntary breathing for the
fame time 5 countenance pale and ghaftly ; faculties of
the mind, and power over the voluntary mufcles, perfeft ;
internal ftimulants ufelefs. Notwithftanding the high
authority laft quoted, it does feem a circmnftance con¬
tradictory to all the phenomena of life that have been
obferved, that the faculties of the mind, and the power
of the voluntary mufcles, could continue perfeft while
the circulation was fufpended. It feems more reafonable
to fuppofe (and indeed fome warm advocates of Mr. Hun¬
ter’s doftrines do fuppofe), that the aftion of the heart
was not in his cafe entirely fufpended, but at the fame
time fo far leflened that no pulfation was conveyed to the
hand. The ceflation of pulfation might aftually take
place in the wrift from the feeble aftion of the heart.
The cafe of Mr. J. Hunter is however one of much in-
tereft, and worthy of attentive confideration.

Dr. Cheyne, in one of his medical treatifes, relates
a cafe, the accuracy of which is eftabliihed by an ir¬
refragable combination of evidence, of a man who could
die, to all appearance, at any time that he chofe, and,
after having lain for a confiderable period exaftly as a
corpfe, was able, as it fhould feem, by a voluntary drug¬
gie, to re (to re to himfelf the appearance and all the various
funftions of animation and intellect. It is to be inferred
from the latter part of the (lory, that the unnatural and
painful exertion by which this perfon aflumed the fenw
blance of difeafe, produced at length a really fatal refult.
Death would be no longer mocked with impunity. The
counterfeit corpfe, a few hours after its revival, relapfed
into a date which was capable of no fubfequent refufei-
tation. But the cafe is fo interefting and remarkable as ’
to deferve our giving it in all the detail with which Dr.
Cheyne prefents it to his readers. “He could die or ex¬
pire when he pleafed ; and yet, by an effort, or fomehow,
he could come to life again. He infilled fo much upon
our feeing the trial made, that we were at laft forced to
comply. We all three felt his pulfe fir ft ; it was diftinft,
though fmall and thready ; and his heart had its ufual
beating. He compofed himfelf on his back, and lay in a
(till poll ure for fome time; while I held his right hand,
Dr. Barnard laid his hand on his heart, and Mr. Skrine
held a clear looking-glafs to his mouth. I found his
pulfe fink gradually, till at laft I could not feel any by
the mod exaft and nice touch. Dr. Baynard could not
feel the lead motion in his heart, nor Mr. Skrine perceive
the lead fort of breath on the bright mirror he held to his
mouth. Then each of us, by turns, examined his arm,
heart, breath ; but could not, by the niced fcrutlny, dif-
cover the lead fymptoms of life in him. We reafoned a
long time about this odd appearance as wellas we could ;
and, finding he dill continued in that condition, we be¬
gan to conclude that he had indeed carried the experi¬
ment too far; and at laft we were fatisfied that he was
, 4 K aftually

P'ATHO LOGY.

308

aflually dead, and were juft ready to leave him. This
continued about half an hour. By nine o’clock in the
morning, in autumn, as we were going away, we obferved
fome motion about the body, and upon examination
found his pulfe and the motion of his heart gradually re¬
turning; he began to breathe gently and l’peak foftly.
We were all aftonilhed to the laftdegree at this unexpe&ed
change ; and, after fome further con verfation with him and
with ourfelves, went away fully fatisfied as to all the parti¬
culars of this fa£t, but not being able to form any rational
fcheme how to account for it. He afterwards called for
his attorney, added a codicil to his will, and calmly and
compofedly died about five or fix o’clock that evening.”

/3. A. particulars ; confined to particular parts of the
arterial fyftem. “Over the whole fyftem except the heart,
which pulfated violently. Beggi in Pachioniopp. — Con¬
fined to the arteries of a fingle arm. Camerar. Memorab.
Cent. ii. p. 54.” It is fometimes the refult of aneurifm
or partial paralyfis. This is by no means rare, certain ir¬
regularities with regard to particular arteries being often
remarked.

7. Entafia fyftremma, cramp. (Tetanus dolorificus,
Darzvin.) Sudden and rigid contraction and convolution
of one or more mufcles of the body ; moftly thofe of the
ftomach and extremities, vehemently painful, but of
fhort duration. Chiefly produced by a Hidden chill, as
that of the night-air, or of water when fwimming in it;
often occafioned by an uneafy pofition, or undue dilten-
tion of the mufcles ; and hence frequently attacking in
fleep. Found alfo, as a fymptom, in cholera; and occa-
fionally in pregnancy and during labour.

Cramp, or fpafm, is one of the moft painful difeafes we
are liable to ; at the fame time it is the leaft dangerous.
Change of temperature, and agents which increafe the
tranfmiffion of nervous impulfe to the cramped part,
readily effeft a cure. Of courfe this does not apply to
fpafms arifing from diftant irritations (for thefe latter
mult then be removed), or to the fpafms of the partu¬
rient ftate, which are induced by preffure on nerves or
blood-veflels.

Genus II. Neuralgia, [from nvpov, a nerve, and aAyo?,
pain.] Contraction and diflortion of a particular mulcle
or group of mufcles, with partial trepidations, and
acute lancinating pains in the courfe of the principal
nerves ; paroxyfm fhort, recurring at irregular periods.
There are two fpecies defcribed by Dr. Good, which
however are perfectly analogous.

1. Neuralgia faciei, tic douloureux : contraction and
diftortion feated about the ala nafi and upper lip; pains
fliooting to the orbit; often to the ear, and over the
cheek, palate, teeth, and fauces.

a. Neuralgia pedis : racking and intolerable pain feat¬
ed about the heel ; tremuloufly fhooting in irregular di¬
rections towards the ancle and bones of the tarfus. This
fpecies is defcribed from a very marked cafe which oc¬
curred to Dr. Good in a gentleman, otherwife of good
health, about forty-five years of age, who had been long
a victim to it. The pain during the paroxyfm was fo fe-
vere as nearly to make him faint, and was generally com¬
pared by him to that of fcalding verjuice poured over a
wound. Here the tibial branch of the ifchiatic nerve
feemed to be affeCted, and perhaps the peroneal.

In this difeafe (we fpeak chiefly of the firft fpecies),
the pains vary in their degree of intenfity; at one time
exciting the moft piercing cries, and diftraCted writhings
and motions, in the miferable patient ; while at another
they are more bearable. When at the acme of their
violence, the parts affeCled are often convulfed, and fome¬
times various contortions and grimaces are obfervable.
Thefe are to be diftinguifhed from the convulfive twitch-
ings of the mufcles with which the difeafed nerves com¬
municate, and which are occafioned by irritation from
the excefllve pain ; while the contortions and grimaces
are voluntary, being caufed by the patient’s writhing and
willing from the agony of his torture, and may be pre¬

vented by a firm refolution to refill any impulfe of ftirink-
ing from the attack.

The pain does not always confine itfelf to the feat of
the difeafe, but darts with the rapidity of lightning to
the neighbouring parts, fliooting in different directions
like radii from a centre. It rarely gives warning of its
approach, and often the firft fign of an attack, is the
patient’s llarting up in a ftate little fhort of phrenfy.
In this condition, fome patients beat the part with
violence, or forcibly rub it wnth fome rough fubftance till
excoriation takes place ; and, in fome inltances, they
have fucceeded in thus diminilhing the intenfity of the
pain.

The pains are more frequent during the day than in
the night, probably from there being fewer caufes of ir¬
ritation during the latter feafon ; and they are more fre¬
quent during converfation than in filence; and Hill more
lo at the time of maftication, when the attacks often fuc-
ceed each other with fuch rapidity as to appear like one
continued paroxyfm, with fcarcely an interval of cefla-
tion. The eye at times is red, inflamed, and watery, as
we fometimes obferve in fevere tooth-ache ; in other
cafes it is particularly dry; and in fome patients a co¬
pious flow of faliva fucceeds a paroxyfm. In general,
only one fide of the face is affeCted with this dreadful
malady ; but, as there are cafes recorded in which both
fides fuffered at the fame time, we cannot lay it down as
a certain charaCteriftic of the difeafe. Fouquet obferved
at Montpellier two women who had both cheeks affeCted
at the fame- time ; and Pujol knew a lady, who, for feveral
months, had the pain in one cheek, which after a while
was free from pain; but the other cheek was immedi¬
ately attacked in the correfponding place, the pain con¬
tinuing for two months, and then refuming its former
pofition.

When the difeafe continues for a great length of time
with increafing violence, the patient can neither obtain
reft by night nor by day, and his appetite fails. The
complaint ufually terminates without any apparent caufe,
leaving the patient for a time to enjoy the comforts of
life. But whoever has had one attack may with confi-
derable certainty anticipate another ; and, though he is
to-day well, and free from all pain, to-morrow’s dawn
may ufher in a renewal of his torment. So varied is the
duration of this affeCtion, and fo limited is our knowledge
of it, that we can aftign no determinate or even probable
period for its continuance ; and, unlefs a cure iseft'eCled,
it returns at intervals more or lefs frequent, and with
increafed violence, till the great final cataftrophe, which,
however, it does not feem to accelerate. For, though
Dr. Banfch is faid to have died of it, we can place little
reliance on the report; and fubfequent cafes and obfer-
vations do not corroborate fuch a fuppofition.

This malady is confined to the nervous fyftem, the pa¬
tient feldom difplaying fever or acceleration of the pulfe.
It is moft generally remarked in perfons who have an
unufual degree of nervous irritability in general, and more
efpecially when this nervous temperament is joined to
bilious and gaftric difturbance. It is increafed by all cir-
cumftances which impair the tone of the digeftive organs,
or by any local irritation ; in fome cafes even by the tri¬
fling one of {having.

A variety of fpecifics for neuralgia have come in and
gone out of fafhion. They have generally been medi¬
cines of the narcotic and fedative clafs; as cicuta, bella¬
donna, See. and might have deceived their employers lefs
often than has been the cafe, had their exhibition been
preceded by medicines which aft on the alimentary canal,
and its collatitious vifeera. Indeed the ftate of_ the di-
geltive organs is the firft thing to be attended to in neu¬
ralgia, as in fo many other difeafes. Mr. Abernethy is
faid to have cured many patients by this alone ; and,
when it does fail to cure, it never we believe fails to mi¬
tigate. We fliould therefore urge moft ftrongly the ftridl
regulation of the digeftive organs in tic douloureux.
As the local detra&ion has a fedative operation on excited

nerves

PATHOLOGY.

nerves, even when plethora is not the caufe of the exci¬
tation, leeching or cupping (liould be alfo reforted to in
all fevere cafes. If the pain continues unabated, bella¬
donna orconium may often be prefcribed with advantage;
and we give preference to the former, as being more pow¬
erful.

Many cafes of Neuralgia have been cured by dividing
the difeafed nerve. Neverthelefs it has fo often failed
entirely, in confequence of the intenfity of fome nervous
fibril which has caufed the irritation ; its effects have
been fo little permanent, and the operation itfelf fo
painful ; that it is of all others the laft furgical operation
we tliould undertake. It feems that in neuralgia, as in
nervous irritation in general, the irritant being re¬
moved, the difeafe ftill continues from fome internal
change having taken place in the nerve itfelf. It is in
fuch cafes that arfenic is a ufeful remedy. The life of
this powerful mineral has however lately been fuperfeded
by the carbonate of iron introduced by Mr. Hutchinfon:
it is given in dofes of a half drachm or a drachm twice or
three times a-day. It is in this advanced and habit.ual
Huge of the difeafe that electricity fometimes performs a
cure.

Genus III. Clonus, [i. e. agitation, perturbation ; from
xXov w, to (hake.] Convullive fpafm. Generic characters
— Forcible agitation of one or more mufcles in fudden
and irregular fnatches. There are fix fpecies.

1. Clonus fingultus, hiccough : convulfive catch of
the refpiratory mufcles, with l'onorous infpiration; ite¬
rated at lliort intervals.

This difeafe is merely fympathetic of diftant irritation.
Flatulence of the Itomach, difeafe of the liver, or indeed
of any of the vifcera contiguous to or fituated near the
diaphragm, will caufe the fymptom. It is often found
to attend fevere operations ; and is well known as a fa¬
tal indication in mortifications. Otherwife it may fome¬
times exilt for days without injury to the patient. — It is
fometimes periodic. Bonet, Sepulchr. lib. iii. Obf. 4. —
Sometimes chronic ; and has continued three months.
Schenck, lib. iii: — Four years. Bartholin. Hilt. Anat.
Cent. ii. hilt. 4. — Twenty-four years. Alberti, Differt.
Cafus fingultus chronici. Hall, 1743. See alfo Hunter
on Blood, p. 410.

2. Clonus (ternutatio, fneezing: irritation of the mem¬
brane of the noltrils, producing fudden, violent, and fo-
norous, expiration through theirchannel.- — At times peri¬
odic. Brejl. Snmmlung. 1725. ii. 82. Eph. Nat. Cur. Cent. V.
Obf. 19. — Of long continuance. Horftii Opp. ii. 298. —
Three hundred times in a paroxyfm. Eph. Nut. Cur.
ann. iii. obf. 138. It is particularly induced by phlogo-
fis of the mucous expanfion of the air-paffages. Hence
its frequency in mealies, catarrh, &c.

3. Clonus palpitatio, palpitation : irregular and vibra¬
tory motion of the heart or arteries. There are three
varieties; the moft frequent of which is,

os. P. cordis, or palpitation of the heart alone. — The
palpitation has fometimes been fonorous. Cajiell (P. V.)
Exercit. et eftedt. thoracis. Tr. IX. Tolofa, 1616. A
Vega, de Arte Med. So violent as to dillocate the ribs.
Horjl. ii. 137. *39* — To break them. Schenck. Obf.215.
ex Fernelio. Vidorius, Confil. n. 97. In like manner
the humerus has been diflocated by a convulfion-fit.

The moft important circumftance to be underftood in
regard to palpitation of the heart, is whether it depends
on nervous irritation or organic alterations. Its nature,
when arifing from the former caufe, the reader will find
difeuffed under Dyjpepfu ; and, when from the latter,
under Carditis. The two following varieties appear to
anfwer to the difeafe we have deferibed under the title of
Arteritis, p. 246.

/3. P. arteriofa ; of the arteries alone.

y. P. complicata ; extending from the heart more or
lefs through the courfe of the arteries.

4. Clonus nidfitatio, twinkling of the eye-lids : rapid
arid vibratory motion of the eye-lids.

309

5. Clonus fubfultus, twitching of the tendons : fudden
and fubfultory elevations of the tendons. This feems to
arife from a deficient fupply of nervous powers to the
mufcles, or at leaft a fupply fuddenly applied and ex-
haufted. It is found in moft cafes when the nerves have
been much weakened, as after long fatigue, fevers, and
towards the approach of death.

6. Clonus pandiculatio : tranfient elongation of the
extenfor mufcles, with deep infpiration and fenfe of laf-
fitude. Two varieties.

a.. P. maxiilarum, yawning or gaping.

(3. P. artuum, ftretching of the limbs, frequently
noted as a fymptom in fatigue, hyfterics, reftlelfnels,
dyfpepfy, and the acceftion of fevers. As an idiopathic
affedtion, acquired chiefly from a habit of idlenefs.

Genus IV. Synclonus, [from a-w, together, and clonus.]
General fpafm. Generic characters — Tremulous, fimul-
taneous, and chronic, agitation of various mufcles, ef-
pecially when excited by the will. There are four fpe¬
cies.

1. Synclonus tremor, trembling : Ample, tremulous
agitation of the head, limbs, or both; moftly on volun¬
tary motion.

2. Synclonus chorea, St. Vitus’s dance: alternately
tremulous and jerking motion of the face, legs, and
arms, efpecially when voluntarily called into adtion ;
refembling the grimaces and geftures of buffoons; ufu-
ally appearing before puberty.

According to Horftius, the name of St. Vitus’s dance
was given to this difeafe, or more probably to a difeafe
pofleffing fome refemblance to it, in confequence of the
cure produced on certain women of difordered mind upon
their paying a vifit to the chapel of St. Vitus near Uim,
and exerciling themfelves in dancing from morning to
night, or till they became exhaufted. He adds, that the
difeafe returned annually, and was annually removed by
the fame means. But the French give to another faint
the honour of exciting or of curing this difeafe: they
call it Dance de Saint Guy.

Dr. Hamilton, in his work on Purgative Medicines,
gives the following excellent hiltory of this difeafe.
“ Chorea Sandti Viti attacks boys and girls indiferimi-
nately 5 and thofe chiefly who are of a weak conftitution,
or whole natural good health and vigour have been im¬
paired by confinement, or by the ufe of fcanty or im¬
proper nouriffiment. It appears moft commonly from
the eighth to the fourteenth year. I faw it in two young
women, who were from fixteen to eighteen years of age.
The approaches of chorea are flow. A variable and of¬
ten a ravenous appetite, lofs of ufual vivacity and play-
fulnefs, a fwelling and hardnefs of the lower belly in
moft cafes, in fome a lank and foft belly, and, in general,
a conftipated ftate of the bowels, aggravated as the dif-
tafe advances, and flight irregular involuntary motions
of different mufcles, particularly of thofe of the face,
which are thought to be the effedt of irritation, precede
the more violent convulfive motions, which now attrail
the attention of the friends of the patient. Thefe con¬
vulfive motions vary. The mufcles of the extremities
and of the face, thofe moving the lower jaw, the head,
and the trunk of the body, are at different times, and in
different inftances, affedted by it. In this ftate the pa¬
tient does not walk lteadily ; his gait refembles a j ump-
ing or ftarting; he fometimes cannot walk, and feems
palfied ; he cannot perform the common and neceffary
motions with the affedted arms. This convulfive motion
is more or lefs violent, and is conftant, except during
fleep, when, in moft inftances, it ceafes altogether. Al¬
though different mufcles are fometimes fucceflively con-
vulfed, yet, in general, the mufcles affedted in the early'
part of the difeafe remain fo during the courfe of it.
Articulation is now impeded, and is frequently com¬
pletely fufpended. Deglutition is alfo occafionally per¬
formed with difficulty. The eye lofes its luftre and in¬
telligence ; the countenance is pale, and expreffive of

vacancy

\

PATHOLOGY.

310

vacancy and languor. Thefe circumftances give the pa¬
tient a fatuous appearance. Indeed there is every reafon
to believe, that, when the complaint has fubfifted for
fome time, fatuity to a certain extent interrupts the ex-
ercife of the mental faculties. Fever, fuch as arifes in
snarafmus, is not a necefl'ary attendant on chorea; ne-
verthelefs, in the advanced periods of the difeafe, flncci-
dity and wafting of the ntufcular flefh take place, the
confequence of conftant irritation, of abating appetite,
and impaired digeftion, the common attendants of pro-
traced chorea; and which, I doubt not, may, in fOme
inftances, although contrary to the opinion that chorea
is not fatal, have been the forerunners of death.”

In the old pra&ice of antifpafmodics and cordials,
little good was done for chorea. Since the general pro¬
mulgation of the grand faft, that, in nine cafes out of
ten, nervous difeafes of all kinds arife from diforders of
the abdominal7 vifcera, this difeafe has been more fuc-
cefsfully treated. Full purging is the chief remedy at
prefent. The purges ufed ftiould be rough and draftic,
and ftiould be continued forfome time, even when their
efficacy is not at firft apparent. In chorea, as in neural¬
gia, where habit only keeps up the malady, medicines
capable of powerfully influencing the nervous functions
may be ufed ; as, for inftance, the arfenical folution.

3. Synclonus raphania: fpaftic contraCion of the
joints; with trembling and periodical pains. So called
by Linnaeus as being fuppofed by him to be produced by
eating the feeds of Raphania raphaniftrum, the wild rad-
difti, or jointed charlock. It is chiefly found in Sweden
and the adjoining countries ; and has hence been chiefly
treated of by Swedifh writers. There is a paper upon
the fubjeC by Dr. Rothman, in the Amoenitates Acade¬
mics, vol. vi. who aflerts that it is neither a new difeafe,
nor confined to the Baltic countries. He has traced it,
he fays, as an affe&ion common to Europe, in the works
of various writers up to the year 1596. It feems to de¬
pend upon fome deleterious vegetable intermixed with
the grain employed in making bread : fome fpecies of
Loliurn or Secale (darnel or rye) have been fufpedted ;
but there is more reafon (he fays) for afcribing it to the
Raphania raphaniftrum. It is fometimes accompanied
with cutaneous ulcerations, and extenfive exfoliations of
the cuticle and cutis.

4. Synclonus beriberia : fpaftic retraction of the knees
on walking : trembling and painful ftupor of the limbs ;
fenfe of formication ; hoarfe voice.

The beriberia has been found chiefly in the Eaft Indies,
and is a fpecies of palfy, in which, according to Bon-
tius, patients feem to imitate ftieep in lifting their legs
■when they walk. This palfy confifts in a partial depri¬
vation of the motion and fenfation of the hands and feet,
and fometimes of the body. Sagar once faw fome fheep,
-obierving a wolf, feized with this fpafmodic affec¬
tion ; and they, whether ftanding ftill or walking, mo-
mentaneoufly retracted their knees, which immediately
returned to their natural fituation. The caufe is gene¬
rally thought to be expofure to the cold vapours of the
night too loon after exercife. Dr. Good fuppofes that
the fwallowing of fome parafitic plant, or animalcule,
in the food or drink, is the caufe of it.

The difeafe is not mortal, except by feizing the mufcles
of the breaft, fo as to obftruCl refpiration and the voice.
In the cure, moderate exercife and friftions are ufeful :
the Indians ufe a femicupium made of water, in which is
boiled an aromatic herb called lagondi; or, in want of it,
camomile and melilot. The affefted parts are rubbed
well with a mixture of the oils of mace and rofes. Bleed¬
ing is not required ; but, on the contrary, ftimulants and
tonics are to be ufed, with an occafional gentle purge.
Decoctions of farfapariila and guaiacum are alfo of fer-
vice.

The term beriberi is ftill preferved in Ceylon, but ap¬
plied to a different difeafe ; a peculiar fort of dropfy,
commencing with ftiffnefs and cedema of the lower ex¬
tremities, which ftiortly fpread over the whole body,

producing dyfpnoea, vomiting, cohtulfve motions, and
death. The fymptoms have been given at fome length
by Mr. Colhoun, and Mr. Chriftie, infpedtor-general of
the hofpitals in Ceylon. The Englifh forces eltablifhed
at Ceylon are occaiionally fubjedt to it. See “ Effay on
the Difeafes incident to Indian Seamen or Lafcars on long
Voyages, by William Hunter, A. M. Member of the
Afiatic 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 ifland (Ceylon) is the
berri-berri. It is in faft a dropfy that frequently deftroys
in a few days.”

Order IV. Systatica, [from c-tmofa/xi, I colledl to¬
gether.] Difeafes aft'edling feveral or all the fenforial
powers fimultaneoufly. Irritation or inertnefs of the
mind extending to the mufcles or external fenfes ; or of
the mufcles or external fenfes extending to the mind.
It contains nine genera.

Genus I. Agrypnia, [front «, priv. and vrtvo ?, fleep.]
Sleepiefl'nefs. There are two fpecies.

1. Agrypnia entonica: fleep retarded by an inordinate
excitation of the mind to a particular fubjefl ; liltleflhels
to furrounding objedls.

2. Agrypnia chronica : habitual wakefulnefs ; mind
tranquil; attention alive to furrounding objedls. Moft-
ly common to advanced age.

Genus II. DyJ'phork, [from $v;, difficulty, and (pofiu,
to bear, or endure.] Reftlefliiefs. Generic charadle'rs —
Troublefome and reftlefs uneafinefs of the nerves and
mufcles; increafed fenfibility ; inability of fixing the at¬
tention. There are two fpecies.

1. Dyfphoria fimplex, fidgets: general; and accom¬
panied with a perpetual defire of changing the polition.

2. Dyfphoria anxietas, anxiety: chiefly aft’edting the
praecordia; with depreflion of fpirits, and perpetual de¬
fire of locomotion.

All the above fymptoms, when not accompanied by the
derangement of the fyftem denominated fever, may be
referred to fome of the numerous forms of dyfpeptic
malady. Anxiety is more particularly referrible to ex-
ceflive eating, or weaknefs of the mufcular coat of the
ftomach. The fidgets are frequently obferved in thofe
who have nothing to do, and feem to be the refult of
want of exercife for the brain ; in confequence of which,
its energies are exerted on trifling fubjedfs. On the
other h.and, JleepleffneJ's is a common attendant on the
literary character, the over exertion of the mind keeping
up a continual ftate of irritation in the brain. Hence the
fleep is broken, light, and troubled with dreams. For the
cure, &c. fee Dyfpepfia , under which head this fubjedl is
fomevvhat copioufly difcufled.

Genus III. Antipalhia, [from etrli, againft, and rraOoj,
feeling.] Antipathy. Internal and unaccountable horror
at the prefence of particular objedls or fubjedls ; with
great external reftleflnefs, or deliquium. Two fpecies
are noted by Dr. Good.

1. Antipathia fenfilis : antipathy produced through the
medium of the external fenfes. As, at the fight of a
drawn fword in king James I. Digby Theatr. Sympathet.
— Sound of mufic. Kph. Nat. Cur. Dec. I. obf. 134. —
Smell of rofes. Id. Dec. II. ann. x. obf. 8. — Of ftrawber-
ries. Id. ann. v. obf. 214. — Tafte or fmell of cheefe.
Zacut. Lvfit. Frax. admir. lib. iii. Obf. 103. Eph. Nat.
Cur. paflim. — Erafmus, though a native of Rotterdam,
had fuch an averlion to fi/h, that the fmell of it gave him
a fever. — Ambrofe Pare mentions a gentleman who never
could fee an eel without fainting. — Jofeph Scaliger and
Peter Abono never could drink milk. — Cardan was par¬
ticularly difgufted at the fight of eggs. — Uladiflaus, king
of Poland, could not bear to fee apples. — Henry III. of
France, could never fit in the room with a cat.

2. Antipathia infenfilis : produced through an un¬
known medium. Chiefly in the cafe of cats, at hand,
but neither feen, touched, fmelt, nor heard.

Genus

311

PATHOLOGY.

Genus IV. Lyffa, [that is, madnefs; probably from
to diffolve, becaufe the fenfes are impaired or melted
away.] Madnefs from the bite of a rabid animal, com¬
monly called hydrophobia. Generic characters— - Great
reftlelfnefs ; anxiety; hurry of mind; horror; and con-
ffriclion of the mufcles of the cheft ; fupervening to the
bite of a rabid animal : preceded by a return of pain and
inflammation in the bitten part. There are two fpecies.

1. Lyffa felina, feline madnefs : the paroxyfm periodi¬
cal, and returning with the full moon ; produced by the
bite of an enraged cat. Anxietas a morlu felis iratre.
Morgagn. Ep. lxi. 14.

In the cafe here referred to, the paroxyfm took place
four days after the bite : there was great anxiety of the
praecordia, but no water- dread. Local and general
bleedings were ufelefs ; frequent repetition of the warm-
bath afforded relief ; but it only yielded to an ephemera
with copious fweat. It returned with the full moon for
two years : the bitten part fil'd becoming highly irrita¬
ble ; and the general fymptoms fucCeeding, which were
r.ow relieved by bleeding. After this period it returned
with every' fourth full moon for two years more. See
another cafe, which terminated fatally on the fird pa¬
roxyfm, in the Tranf. Med. Soc. of London, vol. i. p. 78.

2. Lyffa canina, canine madnefs : (Pantophobia, Cal.
Aur. Rabies canina, Boerhaave. Hydrophobia, Sauv.
Linn. Sag. Cull. See.) The condridflion extending to the
mufcles of deglutition, which are. violently convulfed at
the appearance or idea of liquids ; produced by the bite
of a rabid dog, and fatal on the fird paroxyfm.

The term hydrophobia, which has been fo generally ap¬
plied to the Lylfa canina, has been defervedly reprobated,
becaufe the “ dread of water,” the literal meaning of the
word, is not a pathognomonic mark of the difeafe. The
older writers ufed the terms aerophobia, or a “dread of
air,” and pantophobia, or a “ fear of all things,” as ap¬
propriate names for the difeafe, becaufe the imprefiion of
cold air fometimes excites terror, and the diforder is
marked by a Angular degree of general timidity and
didrud. The term hydrophobia, being erroneoufly applied
to the rabies of the dog, has induced a fuppofition that
no dog is rabid while he continues to drink ; w'hereas he
is conllantly endeavouring to quench his third in that
difeafe. And again, the appellation of madnefs has led to
a belief that violence and fury are charafteriliic of rabies
in the dog ; but, though he is irritable and peevilh, there
is nothing of wildnefs in his difpofition. In confequence
of this midake, dogs have been allowed to go about,
fondled, and even flept with (fee Mem. of Swedilh Acad.
1777), in a rabid date.

Ariltotle is the fird writer whoexprefsly mentions this
difeafe. He fays that all animals, except man, are infefted
by the bite of a mad dog, and dedroyed by it. This
imperfedl date of knowledge refpedling the malady, is a
proof that it was a matter of recent obfervation ; for,
although feveral perfons might be bitten without fullering
the dileafe, and, . from the length of time which com¬
monly elapfes between the inflidlion of the bite and the
appearance of the fymptoms, feveral cafes might occur
before it was referred to its true fource ; yet no very long
time would be requifite to clear up thele doubtful points.
Accordingly, we find fubfequent writers treating of the
difeafe in a familiar manner. Plutarch affirms that the
hydrophobia was fird feen at Rome in the days of Afcle-
piades; after whofe time, we meet with frequent notices
of this difeafe in the works of the ancients.

The fymptoms of Lylfa, as they appear in the dog, have
been inferted under the article Hydrophobia, in our
10th volume. We proceed, therefore, to difeufs the na¬
ture and origin of the difeafe. It is known, that animals
of the dog-kind, including the wolf and the fox, are mod
frequently the fubje&s of Lylfa ; and mod writers have
maintained that, although it may be received and propa¬
gated by other animals, yet it always originates with
lome of the canine race. It is likewife faid, that the ge-

Vol. XIX. No. 1305.

neration of Lyffa is confined to male dogs. Like the
origin of many difeales emphatically called fpecific, as
fmall-pox, fipliilis, and itch, the origin of this in the
fimple inflammatory or irritative procelfes is unknown ;
yet we cannot but believe, that to fitch procelfes all
fpecifics owe their fird produftion. However this may
be, it is a faff, that, at certain periods of the year, dogs
are more prone to Lylfa than at others. The difeafe,
however, has by no means the chara&er of an endemic.
It feents to require a very rare and peculiar combination
of circumdar.cesfor its fpontaneous development, though,
when once formed, it fpreads with the mod alarming ra¬
pidity, in confequence of its infectious nature. Various
meafures have been dated for the prevention of hydro¬
phobia in dogs ; as vaccination, worming, See. but, we
believe, with no fuccels. Of the exciting caufes of this
difeafe we know nothing. Great heat has been alferted
as one caufe; though it mud be recollected, that the
difeafe is lefs frequent in the tropical climates than with
us. Boerhaave alfo enumerates “a very hot climate, or
one expofed to the extremes of heat and cold ; feeding
upon putrid flinking maggotty flefli ; want of water;
worms bred in the kidneys, intedines, brain, or cavities
of the nofe.” But the influence of thefe circumdances
in producing the difeafe is not edabliffied by a fufficient
number of obfervations.

All domedic animals, birds as well as beads, are fufeep-
tible of the poifon of the rabid dog. We do not find that
there is any race of animals exempted from its effefts.
But whether every animal labouring under the difeafe is
capable of infefting others, or whether this power is con¬
fined to a few only, we are yet to learn. Boerhaave affirms
that the difeafe has been communicated by infeCiion to
others by dogs, cats, wolves, foxes, horfes, affes, mules,
fwine, apes, cocks of the poultry breed, and men, when
afteCted with rabies, (Aph. 1 1 32.) and the cow has alfo
been faid to propagate it. Van Swieten has dated fome
indances, from old authors, of hydrophobia occafioned
by the beak of an enraged cock wounding the hand and
arm. But there is little doubt that, in fuch cafes, the
fpafmodic and fatal difeafe, which enfued, was tetanus.
It is certain, however, that not only animals of the canine
fpecies, but cats, have produced hydrophobia in the hu¬
man fpecies by their bite; and a fuppofed difference of
fymptoms has led Dr. Good, as we have feen, to feparate
Lyffa into two fpecies.

It feems very natural to fuppofe, that every animal fuf-
ceptible of the difeafe had the power of communicating
it, provided their natural habits led them to bite and tear
with their teeth fuch animals as came in their way, while
in an enraged ftate. With refpeCt to men under the in¬
fluence of hydrophobia, although the popular notion of
their general difpofition to bite thofe around them is
erroneous, yet there are inftances on record in which
hydrophobic patients did bite fome of their attendants,
but no ill confequences have been known to follow'.
From this, however, as Dr. John Hunter juftly remarks,
we can draw no pofitive inference; for it is but a fmall
proportion (about one in fixteen), of fuch perfons as are
bit by dogs undoubtedly mad, who are infe&ed with the
poifon. The experiments, however, of Mr. Cline, throw-
great doubt on the infe&ious qualities of the faliva of the
human fubjeCh He took particular pains in inferting
this fecretion, while frelli, into a dog, three rabbits, and
feveral fowls : “ but in none of thefe inltances was there
the leaft appearance of the diforder at the expiration of
three months.” Mr. Aftley Cooper, on the other hand,
inoculated a dog, a pig, a fowl, and a rabbit, with the
faliva of a dog, which had recently died of rabies, by in¬
ferting, from the point of a lancet, between two and three
drops under the Ikin of the inner part of the thigh of each.
The dog and fowl were kept confined for nine weeks, and
the pig feven, but without any appearances of hydro
phobia. The dog afterwards became the property of a
gentleman, who kept him nearly twelve months, and he
4 L had

312

PATHOLOGY.

had never any marks of the difeafe. The rabbit was acci>
dentally killed on the fourth day from the experiment.
But the experiments of Majendie led to a refult precifely
oppofite.

With regard to the aftivity of the poifon of the rabid
dog, the fafts which have been collected have been
fo vaguely dated, that the inferences are quite inconclu-
five. Among the older writers, indeed, there was much
credulity, and they have tranfmitted to us many fabulous
liiffories in regard to the operation of the rabid virus.
“Scarce any poifon known (fays Hillary, relying upon
the truth of thofe tales) is fo infectious, or fo eafily and
readily communicated by fo many and various ways, as
this of a mad dog is : for the flighted bite, only tearing
the fkin, without drawing blood ; or the fmalled quantity
of the Haver of the mad animal, either frefh or dried for
fome time, taken upon the tongue or lips ; or rending a
perfon’s clothes and leaving the llaver on them to dry,
has produced this difeafe ; as a woman had her coat torn
by a mad dog, which die a confiderable time after fewed
up, and bit od' the thread with her teeth, and fome time
after died rabid from biting od’ that thread. (Hildanus
Obf. Chir.) Alfo a man only kiffing his children to take
his leave of them when he had the rabies upon him, they
all foon after died rabid. (Palmarius de Morb. Contag.)
Killing a favourite dog that was mad had the fame
effeCf, &c. and produced this mod fatal difeafe.” See
Hamilton, vol. i. p. 98.

In the London Medical Repofitory for April 18 14., are
two cafes, from which (if we could be certain that the
difeafe was Lyfia) it would appear probable that a dog,
free from any charafteridic mark of hydrophobia, and
apparently in the highed date of health, may communi¬
cate by its bite this mod dreadful malady. One of the
cafes was that of a dog, apparently ailing nothing, who
liad repeatedly licked a woman’s chopped hands. The
other of a dog, who afterwards continued in health, and
remained in the family it belonged to, having bitten a
boy feverely in order to efcape, when it was tealed by that
and other boys. This lad cafe is fo very remarkable, that
we cannot refrain from giving it at length. It is related
by Mr. Parkinfon, furgeon, of Hoxton-fquare.

“The fubjeft of this cafe was a boy, about ten years of
age. He came to me, accompanied by four other boys
older than himfelf, he having been bitten by a dog. The
canine teeth had pafl'ed quite through between the
metacarpal bones of the firft and middle finger, and of
the ring and little finger ; the fkin of the back of the hand
and of the fingers was alfo torn in feveral places. By in¬
quiry of the boy himfelf, apart from his companions, I
learnt, that, as they were going along a rather narrow-
walk, one of the boys cried out, ‘ There he is !’ meaning
a dog which they had been in the habit of teafing ; that,
as they were between him and his home, they ranged
themfelves acrofs the walk to dop him ; and that the dog,
after making one unfuccefsful attempt, made a pufh be¬
tween him and the wall ; which he endeavouring to pre¬
vent by putting out his hand, the dog feized it, and then
ran by and gained his home. As obtaining correct infor¬
mation was here of fo much importance, I examined all
the other boys feparately, who all confirmed the account
of the unfortunate boy, and were all fatisfied that it was
the fame dog that they had been accuffomed to teafe.
Difcovering no circumdance whatever which would war¬
rant a fufpicion of the bite having been inflifted other-
wife than defenfively, I walked the wounds with fpirics of
turpentine, and drefled them with a terebinthinate
liniment. Still anxious as to the date of the dog, I made
additional inquiry refpefting it ; when I obtained every
affurance of the dog being in perfect health.

“ The wounds were drefled with red precipitate and a
terebinthinate ointment, and healed in about five days.
But, at nearly three weeks from the infiiftion of the bite,
I was fent for to the boy, he having had fome flight
feveriflmefs the night before, which was rather increaled.

My fon accompanied me, and we foon difcovered that the
dreadful malady was edablifhed. Ignorant of any mea-
fures that could be relied on, and as Pyrexia, with evi¬
dent inflammation of the tonfils, exifled, we agreed on the
experiment of taking away blood, which was done to the
quantity of fix or feven ounces, by which a flight degree
of faintnefs was produced, without any apparent amend¬
ment. The afliffance of Dr. Yeiiowly was now requefted,
and immediately obtained ; when, it being confidered that
no medicine had manifefted any remedial powers in this
difeafe, it was agreed to make trial of the effefts of lead,
and to endeavour to moderate the more urgent fpafms
by the employment of henbane. The experiment was
fully made, the fuperacetate of lead and the extract of
hyofciamus were had recourfe to, but without the leaft
advantage; the child, after fuffering from every decided
fymptom of hydrophobia, being feized with convulfions
fo violent as to require two men to retain him in the bed ;
to which fucceeded a Hate of quiet infenfibility, lading
about half an hour, and terminating in his death, which
took place on the third day from the attack.

“ After this fatal termination, the dog, which had
inflifted the bite, again became the fubjeft of inquiry.
Dr. Yeiiowly and myfelf immediately, therefore, went to
its tuafter, who regretted very feelingly the fad cataf-
trophe, but at the fame time faid that he doubted how it
could be attributed to his dog; fince, although he had
reafon to believe, from the provocation the boys were
perpetually employing, that he might have inflifted the
bite ; yet, as we fliould fee, he did not appear to be in a
ftate which W'ould have enabled him to communicate fo
dreadful a malady. The dog, a fine healthy fpaniel, now
rufned in, and flew on his matter's knees, licking his face
and mouth with much fondnefs ; his malter permitting
him thus to manifeft his affeftion for feveral minutes, for
the purpofe of evincing his reliance on the healthinefs of
the dog. I then again queftioned the other boys in the
molt particular manner, and found them all agreeing in
the dog which we had juft feen, and the dog which had
inflifted the bite, being the fame. Not fatisfied even with
this, I watched the dog during its continuance in the
neighbourhood, which was for at lead two years, without
feeing reafon to fufpeft it of a difpofition to injure any
one. Within thefe laft five days I have repeated my in¬
quiries, and have learnt that the dog was well a few
months ago. — J. P. Feb. 1814.”

According to the relater of a cafe quoted by Dr.
Hamilton, the difeafe, which took place on the eighth
day, and was fatal on the eleventh, arofe from contaft
only of the rabid faliva, without any injury done to the
perfon. The fame author fays, “ A young woman had
her apron torn and Havered by a mad dog leaping on her,
and attempting to bite. Fortunately lhe received no
other injury from him, by the timely afliftance offered,
and by the loofe part of her clothing which he laid hold
of. But imprudently, and without proper refleftion, Ihe
began to mend the rent in her apron before the part was
either waffled or well dried ; and as imprudently, or
through habit, inftead of cutting the thread with fciffars,
bit it off with her teeth. Lo, what followed ! In a few
weeks fhe was feized with hydrophobia, which proved
fatal.” There is good reafon to believe, however, that
there muff have been fome flight fcratch, unperceived by
the patient, in the firft of Hamilton’s cafes, through
which the virus made its entrance; and, in the feconcl,
it of courfe found its way into the conftitution through
the abforbenls of the mouth. After all, thefe aftonilhing
accounts are perhaps for the molt part falfe ; for an excel-
five fearof a difeafe often leads toextravagantaffumptions
as to its aftivity ; as we know, from the caution which
fome old popular writers evinced, that we fliould not
drink out of the fame cup, ufe the lame towel, &c. as that
which has been uled by a patient of Lues.

The part of the body which is bitten feems to have fome
influence on the probability of the attacks A bite in

the

PATHOLOGY. 313

the face is faid to be moll generally followed by the
difeafe ; which might leem to imply, that parts much
fupplied with veins molt rapidly propagated Lyfla. A
bite on the hands, however, is equally formidable ; fo that
we naturally conclude, that the expofed parts of the
body fuffer more readily from the bite than the covered
parts; becaufe, in the latter, the clothes rub off part of
the virus from the teeth before they penetrate the lkin.
Some have fuppofed, that, if a gulh of blood follows im¬
mediately on the bite, the chances of exemption are in
favour of the patient; but, in Brera’s Memoria per la
Cura dell’ Idrofobia, four cafes are related in which this
occurrence happened, and neverthelefs the patients
died.

It is a fortunate circumftance, that men are lefs dif-
pofed to lyfla than dogs : and of the latter fcarcely one
efcaping, while, of the former, it is computed that only
one in fixteen, who have been bitten, contracts the
difeafe.

The wound inflicted by the bite of a rabid animal has
nothing peculiar in its appearance, and heals as readily
as the bite of an animal that is not rabid. F rom the time
of the bite until the period when the fytnptoms appear,
there is no derangement of health, nor any perceptible
change in the conftitution, provided the perl'on bitten be
not under the influence of fear. The interval between
the inflexion and the commencement of the difeafe varies
confiderably in different inftances: the mod common
period appears to be about forty days or fix weeks. Dr.
Hamilton draws the following conclufions, as to the in¬
terval between the bite and the occurrence of the difeafe,
from a table of 1 31 cafes. Only three took the difeafe
before the 1 8th day, none before the nth — from the 18th
to the 30th, feventeen were feized : fixty-three began to
be ill from 30 to 59 days after the bite ; twenty-three
were attacked from two to three months inclufive ; nine
from three to four months ; two at five months; one at
five months and eleven days ; one at fix months 5 one at
feven months; two at eight months; one between eight
and nine months; two at nine months ; one at eleven
months; one at fourteen months ; two at eighteen
months; and one at nineteen months. TheJaft-tnen-
tioned interval is, he thinks, the longeft to which any
credit can be given. On the other hand, a cafe is re¬
lated by Dr. Bardfley of Manchefter, which proved fatal,
as is ufual ; and every inquiry refpeCting w'hich corrobo¬
rated the patient’s repeated affertion, “ that he had never
fuffered the leaft injury from any animal, except the bite,
inflicted twelve years Jince, by an apparently-mad dog.”
(Memoirs of the Lit. and Phil. Soc. of Manchefter, vol.
iv. p. 431.) In this inftance, the nature of the difeafe was
perfectly clear, and the evidence as to the bite not lefs
fatisfaClory.

At an uncertain time, then, after the infliction of the
bite, the patient feels a degree of pain, or uneafy fenfa-
tion, in the bitten part, tohich is fometimes compared to
a fcorchingbyheat,isfometimesattended with itching, and
fometimes fuppofed to be rheumatic. This pain, when the
bite, as is molt frequent, is in the hand, fpreads up the
outfide of the arm to the fhoulder (not affecting the
axilla) and the neck. In foine cafes the cicatrix left by
the bite is faid to become inflamed, and even to difcharge.
Thefe pains are foon fucceeded by a general depreflion of
fpirits, and efpecially a fenfe of undefcribable liltleffnefs
and anxiety. Sometimes a general rigour or chill occurs,
a$ in the commencement of a fever. The night is palled
in the fame reftlefs ftate, without lleep. The appetite
begins to fail, and feme thirft is prefent. And now the
peculiar fymptom which gives the difeafe its name, the
dread of liquids, is difeovered, often accidentally, on
attempting to take drink ; as the liquid approaches the
lips, a fudden convulfive fob, or catch in the breath, with
a momentary fenfation of choking, takes place, which is
renewed at every attempt. As the difeafe advances, this
attempt is not thought of without horror, and the very

idea excites thefe fpafmodic fits of choking in the throat,
and catching of the breath.

This dread of liquids is, as we have before dated, not
always prefent, nor is its prefence a certain fign of the
difeafe ; and in dogs and other animals is fo far from be¬
ing general, that they often fwim through rivers, and
drink copioufly. The caufe of this fymptom, in man,
has engaged the attention of many pathologilts. It can
only be referred to two caufes : firft, an actual experience
of difficulty of fwallowing, which renders the patient »
fearful to attempt an aCtion which gives him lb much
pain ; or, on the other hand, a dread of the water itfelf
from fome fearful aftbeiation connected with it, an affo-
ciation, as it would feem, quite unconnected with the
will. For our own parts, we cannot conceive the hydro¬
phobia to arife from experience of the difficulty of fwal¬
lowing, becaufe in the moll violent cafes no difficulty of
fwallowing food attends ; becaufe alfo the fymptom often
comes on fuddenly, on the fight of water, before any
difficulty has been experienced ; confequently before the
patient can have had any experience on the matter.
Moreover, a ftream of air, a flafti of light, nay the reflec¬
tion of light from a looking-glafs, has fometimes filled
the patient with an equally fevere emotion of horror as
water has ; and often again, when the fight of water was
painful, wine has been freely drank. It is not, Jiowever,
an eafy talk to explain how the hallucination of mind in
lyfla fliould be particularly directed to water. It may
be that the nervous fyftem, excited to the higheft degree,
acknowledges, with a quicknefs and intenfity amounting
to pain, tho fe undulating motions which are lo peculiarly
manifefted in almoft all the natural phenomena which
imprefs our nerves. Hence the undulating motion of a
candle excites uneafinefs ; the fight of water excites the
recollection (unacknowledged by the will) of the roar¬
ing of the fea,the dizzy whirl of the current, or perhaps
of the danger to which we are often expofed on this ele¬
ment. That on fome occafions wine has been Iwallovved
when water could not, may arife from the different recol¬
lections to which wine gives rife. That it is the fight
of water, and not the difficulty of fwallowing it, that
produces hydrophobia, is corroborated by this; that a
child requefted his father to put fome tea in a tea-pot, fo
that he might be able to drink it out of the fpout, with-
out the pain of looking at it.

But the dread of lwallowing liquids, although the moll
Angular fymptom of the difeafe, conftitutes but a fmall
part of this diftrefling malady. The ftate of diforder
into which the nervous fyftem is thrown, is evinced by
the extreme irritability of the whole frame, mind and
body, and the exceffive fufeeptibility to all impreffions.
Hence the conftant watching and inquietude; and the
fudden fits of anger and impatience, arifing from the
moll trifling caufes, as the patient himfelf readily allows,
and even wonders at, and apologizes for, in the fucceed-
ing moments of compofure. Hence alfo the diftrefs,and
even the recurrence of his fpafms, occafioned often by the
flighteft motion of the air, as from opening the door,
from the approach of any perfon, or even of a perfon s
hand, in front of him ; or even by the buzzing of a fly.
This morbid excitability of the nervous fyftem is far¬
ther manifefted in the extreme timidity and fufpicion of
the patient, in the imaginary objects of terror and unea¬
finefs which the fenfes frequently reprefent to him, and
in the occafional delirium and incoherence of ideas, from
which, however, he eafily collects himfelf.

There are fome other circumftances belonging to the
difeafe, of lefs note, which remain to be mentioned. One
of thefe isa conftant collection of a thick ropy tenacious
faliva in the fauces, which is often productive of extreme
diftrefs ; for, as the miferable fufferer is unable to make
the fmalleft attempt to fwallow it, without exciting the
convulfive choking, he fpits it out inceflantly, and with
great vehemence and difficulty, often cautioning the by-
ftanders to keep out of the way. The pulle in the be¬
ginning

314

PATHOLOGY.

ginning is not quick, nor is the ficin hot ; and there is
none of the mufcular debility fo remarkable in fever;
but, as the difeafe proceeds, there is fome feverifh heat,
and the pulfe becomes quick ; varying, however, exceed¬
ingly as flight caufes of irritation influence the patient:
as death approaches, it ufually becomes very quick and
tremulous. Sicknefs and vomiting often occur, when a
little phlegm, tinged with brown or yellow bile, is brought
up. There is often a fenfe of great oppreflion and ftric-
ture about the bread, or what has been called anxiety
about the prtecordia ; and which is probably an affeXion
of the . heart ; for it is accompanied with fighingand deep
irregfilar infpirations, and the patients find fome relief
from motion, as running and walking, which thow the
lungs not to be the feat of the oppreflion. The counte¬
nance is generally forrowful, and often exprefllve of a
great degree of horror and diltrefs.

There is a confiderable variety in the fymptoms in dif¬
ferent conftitutions : even the hydrophobia, or dread of
fwallowing liquids, occurs in very different degrees.
But there is no part of the difeafe that admits of greater
variation than the degree of mental derangement, which
in fome does not amount to more than extreme irritabi¬
lity and impatience ; in others to muttering and incohe¬
rent talking, yet giving rational anfwers when queftions
are afked ; and in a few it rifes into fhort fits of the moft
violent rage and fury, in which the patients bite and tear
themfelves and every thing near them. In general they
manifelt no difpofition to mifchief; yet popular prejudice
is ftill on the watch for the “ barking and biting like a
dog,” as the difeafe advances. In a cafe related by Dr.
Marcet, the byftanders confidently expeXed the fyntp-
tom of barking , which they “ thought at laft to have
clearly difcoveredin the peculiar noif'e which he made in
breathing.” Dr. YVavell, fpeaking of this fort of refpi-
ration, fays, “the noife he made in drawing air into his
lungs was undoubtedly peculiar; but neither in my opi¬
nion, nor in that of any other, medical gentlemen who
attended him, did it bear the leaft refemblance to the
barking of a dog,” (Med. Records and Refearches, p.
1 51.) Were this notion of the canine metamorphofis,
•which the difeafe has been fuppofed to effeX in man,
merely fpeculative, it would be lefs important to confute
it ; but it is to be lamented, that the praXical refult of
It, in the cruel and murderous plan of fuffocating the
patient, has been followed, both in France and in this
country, within the laft twenty years of the eighteenth
century. See Hamilton on Hydrophobia, vol. ii. p. 140.
and App. p. xxviii.

The duration of life, after the commencement of the
fymptoms of hydrophobia, has been on an average about
Jour days; it varies from thirty-fix hours to five, fix, or
many more, days. The termination of life is likewife va¬
rious in different inffances: death is often very fudden,
being produced by one of the convulfive attacks, fuch as
occur on the attempts to drink; at other times, more
general convulfions carry off the patient; while in other
inffances, again, the ftrength finks gradually, and the pa¬
tient dies comatofe.

Difl'eXion of hydrophobic cafes difplays inflammation
of the fpinal marrovr, and, in a flight degree, of the
membranes of the brain. The ftomach, efpecially at its
cardial extremity, and alfo at the cefophagus, is ufually
found in the fame ftate. The obfervance of rednefs and
other marks of phlogofis on the mucous membrane of
the bronchia: has induced Trollet to infer, that this mem¬
brane is the feat of hydrophobia, and that the infeXious
matter is a morbid fecretion from it: but this opinion,
like every other on the etiology of Lyffa, refts on very
flight grounds. Some other inconfiderable changes have
been obferved ; but they feern to have been moftly adven¬
titious,.

From the peculiar nature of the fymptoms above de¬
tailed, it might be conceived that no difficulty could
occur, in diffinguifliing rabies canina from every other

difeafe to which the human body is liable. But this is
very far from being the cafe ; for many hiftories are re¬
lated, in which, although the difeafe was the confequence
of a bite, it partook more of the nature of tetanus ; and
others are detailed, in which no bite had preceded the
difeafe, or had occurred at fo diftant a period as to render
its influence in exciting the difeafe extremely queftiona-
ble. It muff be obferved, however, that the tetanic fpafins
generally commence within a few days after the injury,
or in a much ffiorter period than thofe of rabies ; that the
jaw is commonly rigidly locked in tetanus, and the muf-
cles of the neck and back moft particularly affeXed ; that
the fpafmsare of a more fixed or “tonic” fpecies, (in
the language of Cullen,) confiding of rigid and long-
continued contraXion, rather than of fliort convulfive
aXion, and are relieved rather by remiffion of their
violence than by a complete folution of the fpafm ; that
there is lefs feveriffinefs, quicknefs of pulfe, and third, in
tetanus; and, above all, that there is little of that ex¬
treme mobility of feeling, and anxious, impatient, and
apprehenfive, date of mind, which marks the hydropho¬
bic condition.

It mud be obferved, that many inffances are recorded
of patients who have aXually frightened themfelves into
a ftate very clofely refembling hydrophobia. Indeed, Dr.
Percival has remarked, that it has fometimes been brought
on by the imagination alone; and Dr. Ferriar fays, “I
met with an inftance of this kind lately, in which it was
very difficult to prevent a perfon from rendering himfelf
completely hydrophobic. Himfelf and his wife had been
bitten by a dog which they fuppofed to be triad. The
woman thought herfelf well; but the man, a meagre hy¬
pochondriacal fubjeX, fancied that.he had uneafinefs in
his throat, and that he could hardly fwallow any thing.
When he fil’d applied to me, a medical friend who was
prefent, aiked him whether he had any fenfation of heat
at the pit of the ftomach. He anfwered in the negative,
doubtfully; but, next day I found him in bed, com¬
plaining of heat in the pit of the ftomach, difficulty of
fwallowing, tremors, and confufion in the head. He
continued to perfuade himfelf he was ill of rabies, and
confined himfelf to bed, expeXing death for near a fort¬
night. At laft I remarked to him, that perfons who
were attacked by rabies never furvived more than fix days ;
this drew him out of bed, and he began to walkabout.
By a little indulgence of his fears, this might have been
converted into a very clear cafe of fpontaneous hydro¬
phobia, ana the patient would probably have died.” We
are inclined to doubt the fatality of this fpontaneous hy¬
drophobia, which is, in faX, nothing more than a nervous
diforder.

As to the treatment of lyffa, we have but one remark
to make; viz. that the bitten part rnuft be cut out as
foon as poffible; for on that practice only can we rely.
As to the time at which it is expedient to perform this
operation, little can be faid with certainty. Of courfe it
is of no ufe when hydrophobic fymptoms are manifeft.
Often it is of ufe before that period; and fo irregular
are the cafes of the abforption of animal poifons, that we
are juftified in cutting out the part at any period before
the coming-on of the fymptoms. With regard to the
operation itfelf, we fliould firft afcertain the extent of
the wound, and the direXion it has taken; and, as a
precautionary meafure, the punXmre may be duffed full
of lint. The part is to be dried from blood ; and the in-
cifion carried completely under the punXured or lace¬
rated wound. The excided piece muft then be examined,
left the knife ffiould not have completely taken away the
whole of the lacerated cavity. Should more than one
wound be made, they can be cut out feparately, ufing the
precaution to take a clean knife foreach cut, left that be¬
fore ufed, having touched the part imbued with the ca¬
nine virus, fliould again inoculate the fufferer with the
difeafe. As to prophylaxies for hydrophobia, we en¬
tirely dilbelieve their exiftence; and of remedies notone
1 is

J

PATHOLOGY.

is yet known that has been a'lile to arreft the progrefs of
this terrible difeafe, Majendie has made numerous ex¬
periments, even by injecting the inoft famous drugs into
the veins, (a much furer means than giving them by the
mouth :) and the refill t of thefe experiments (hows con¬
vincingly, that no known fubftance has the lead control
over the difeafe ; and that the difcovery of a fpecific is
fcarcely even to be expefted. But the fame diftinguifhed
pathologift has made one experiment, which feems to
fhovv that there may yet be di/covered a more diredl me¬
thod of relieving hydrophobia than any yet adopted.
The experiment confided in emptying a dog of a large
portion of his blood, and throwing in warm water in-
itead of it. The dog was effectually rendered quiet by
it ; but, in confequeiree of the proportion of water be¬
ing over great, effufion took place in the lungs, and
the animal died.

It may be a Iked, Are we then to give up to certain de-
ffrufrion every patient who is feized with fymptoms of
hydrophobia ? We reply, No; but the hope of cure is fo
fm all, that no one bitten by a mad dog fliould be allowed
to refufe the excifion of the bitten part : the mod urgent
remondrances, nay, when it can be done, force Ihould be
employed, to prevent this fatal procraftination. When
the difeafe is once formed, the exhibition of mercury till
falivation is induced, with the belladonna in dofes fo
large and fo often repeated as to produce the mod alarm¬
ing effects on the fydem, feems to afford the bed chance
of fuccefs. Four patients thus treated by Dr. Brera
recovered. Bleeding, the warm and cold bath, mercury,
blidering, belladonna, opium, the fcutellaria, the Alifina
plantago, chlorine, cantharides, arfenic, with a hod of
drugs fo inert that they could under no circumdances
have influenced the human frame in the (lighted degree,
have been lauded, from the recovery of individual cafes,
as cures for Lyffa. The lad remedy which has reached
us is the oxygenated muriatic acid, which Dr. Previfali
of Pavia has prefcribed with fuccefs, (as he fays,) where
the fymptoms were advanced, in a liquid form, from a
drachm to a drachm and a half daily, in citron water, or
fyrup of citron. Thefe trials were made fo recently as
the month of January, 1822.

Genus V. Cephalaa, [from xitpato, the head.] Head¬
ache. Generic characters — Aching pain in the head ;
intolerance of light and found 5 difficulty of bending the
mind to mental operations. There, are five fpecies, be-
fides varieties.

1. Cephalaea gravans, ftupid head-ache: pain obtufe ;
with a fenfe of heavinefs extending over the whole head ;
fometimes intermittent.

2. Cephalaea intenfa, chronic head-ache: pain vehe¬
ment, with a fenfe of tenfion over the whole head; peri¬
odic 3 often chronic,

3. Cephalaea hemicrania, megrim : pain vehement 3
confined to the forehead, or one fide of the head 5 often
periodic.

4. Cephalaea pulfatilis : pain pulfatory, chiefly at the
temples 3 often with fleepleffnefs and a fenfe of drumming
in the ears.

5. Cephalaea fpafmodica, fick head-ache : pain partial,
fpafmodic 5 often Drifting from one portion of the head
to another; chiefly commencing in the mornings with
ficknefs and faintnefs.

All thefe fpecies are mere fymptoms of other difeafes :
chiefly plethora and indigeftion.

Genus VI. Dinus , [i. e. whirling round.] Dizzinefs.
Generic characters — Apparent giration of objects, with
hebetude of the fenforial powers. Three fpecies.

1. Dinus vertigo, fwimming of the head : dizzinefs 5
fenfe of undulation in the ground 5 unfitnefs for mental
exertion.

2. Dinus illuforius : dizzinefs, with dimnefs of fight,
Vol. XIX. No. 1305.

315

and imaginary objefts before the external fenfes. Two
varieties.

a. Phantafmatum : ocular fpeflres in the femblance of
net-work, dark fpots, dazzling or rainbow hues before
the eyes 5 murmuring or whizzing in the ears.

(3. Mutationis : real objedts changed in their natural
qualities, by error of form, of motion, or of number.

3. Dinus fcotoma, nervous head-ache : dizzinefs with
blindnefs and tendency to fwoon 5 often fucceeded by
head-ache.

Thefe fpecies are mere fymptoms of plethora or dyl-
pepfia.

Genus VII. Syncope, [from arvvM’ri la, to cut down.]
Fainting. Generic characters — Motion of the heart and
lungs feeble or imperceptible 3 diminiffied fenfibility, in¬
ability of utterance. Five fpecies.

1. Syncope cardiaca : returning at irregular periods :
occafional palpitation of the heart during the intervals.
Divided into,

a. Plethorica: from fare ha rge of the cardiac or. neigh¬
bouring blood-veflels.

J3. Vitiofa: from polypous concretions, or other mor¬
bid affedtion of the cardiac or neighbouring blood -vel-
fels. See Carditis.

2. Syncope inanitionis : accompanied with a fenfe of
inanition, and extreme general debility. Two varie¬
ties.

«. A fame ; from hunger or long fading.

(3. A flux u ; from bidden and immoderate flux, whether
of blood, pus, or any other fluid.

3. Syncope doloris : preceded by pain or irritation of
body.

a. Interna; from internal pain or irritation ; produced
by poifons, worms, or other fimilar caufes.

(3. Externa; from external pain or irritation ; produced
by wounds, or other accidents or injuries.

4. Syncope pathematica ; preceded by the exercife of
feme fudden and overwhelming paflion.

5. Syncope metaftatica : accompanied with retroceffion.
or repulfion of gout, exanthems, or other difeafes.

Fainting, or (wooning, is a fymptom in fo many difor-
ders that it cannot be neceffary to treat it as a Separate
difeafe.

Genus VIII. Syfpcijia , [from avurraa, to draw or con¬
tra 61.] Convulfions. Generic characters — Clonic fpafm ;
diminiflied fenfibility; inability of utterance. Three
fpecies, and many varieties.

1. Syfpafia convulfio, convulfion-fit : mufcular agita¬
tion violent ; teeth gnafliing 3 hands forcibly clenched 5
tranfient.

In affigning convulfions a place in nofology, we are
evidently and confeffedly defcribipga fymptom of a great
many other difeafes, and a mere fymptom in all ; fince
the mufcular agitation which conftitutes convulfion
forms no part of the difeafe, and indeed feems to be one
of thofe falutary proceffes, which, though depending on
diforder, tend neverthelefs to remove it. The difeafes in
which this fymptom is mod found are teething, worms,
and other inteftinal irritations 5 afteflions of the kidneys,
arturition, and labour 3 various fevers, wounds of the
ead and other organs. Dr. Good makes five varieties.

a. C. erratica ; fhifting irregularly from one part to
another.

6. C. univerfalis ; attacking every part fimultaneoufly 5
occafionally protrafted or habitual.

7. C. intermittens 5 returning after intervals, regular
or irregular.

C. ejulans ; accompanied with ftirieks or yellings,
but without pain.

s. C. infantium 3 occurring in infancy 3 fenfibility near¬
ly fufpended ; features of the face for the molt part hide-
oufly diftorted.

1 4M

In.

PATHOLOGY.

316

In nii thefe cafes we mud endeavour to difcover the
Irritated nerves, and excite them to a new kind of ac¬
tion. In the laft variety, the infantile convulfion, we
fhould look chiefly to the teeth and bowels. If any ir¬
ritation feems likely to exill about the former parts, they
mull be freely lanced ; if about the latter, purgatives
mull be given. If, on the other hand, pain and dizzinefs
of the head be very fevere, leeches may be applied. The
warm-bath is the firft thing to be had recourfe to when
a child has a convulfion-fit ; and the attendants fhould
be cautious not to forcibly open the clenched hands, or
in any other way attempt- to counteract the mufcular
motions, lince refinance merely increafes their ex¬
ertion.

2. Syfpafia hyfteria, hyfterics : convulflve ftruggling,
alternately remitting and exacerbating ; rumbling in
the bowels; fenfe of fuffocation ; drowfinefs ; urine co¬
pious and limpid ; temper fickle. Two varieties.

ci. H. atonica ; from debility of conftitution; without
any evident proximate caufe.

(3. H. irritata ; from Hidden emotion of the mind, or
irritation of the Itomach or bowels.

In tracing the nervous difeafes which grow out of dyf-
peptic ailments, w'e have been very full and explicit on
that form of hyfteria which has its origin in gaftric irri¬
tation, and efpecially that which is generally called the
irregular forms of hyfteria. Hyfteria, as it arifes from
uterine irritation, will now be difcufled ; and this for
the purpofe of introducing the fymptoms of an hyfteric
fit. The treatment will in no means deviate from that
before laid down. The ftate of the uterine fyftem will
be’of courfe looked to ; but fo great is the fympathy be¬
tween the uterine and aflimilating organs, that irritation
in the former generally impairs the functions of the latter;
confequently the general plan of treatment cannot be
different.

The paroxyfm or fit of hyfteria is commonly preceded
by a fenfe of laflitude, coldnefe of the feet, and a co¬
pious difcharge of pale limpid urine: often by pain in
the head, loins, or Itomach ; which latter organ, as the
fits commence, is fometimes affeCted with vomiting.
The paroxyfms commonly begin by fome pain and ful-
nefs felt in the left fide of the belly. From this a ball
feems to move, with a grumbling noife, into the other
parts of the belly ; and, making as it were various con¬
volutions there, feems to move into the itomach, and
more diftinCtly itill rifes up to the top of the gullet,
where it remains for fome time, and by its preflure upon
the larynx gives a fenfe of fuffocation. There is occa-
fionally much difficulty of breathing, and a palpitation
of the heart at the onfet. By the time the difeafe has
proceeded thus far, the patient is affeCted with a ftupor
and infenfibility, while at the fame time the body is agi¬
tated with various convulfions : the trunk of the body
is writhed to and fro, and the limbs are varioufly agi¬
tated ; commonly the convulflve motion of one arm and
hand is that of beating with the clofed flit upon the
breaft very violently and repeatedly. The whole of the
belly, and particularly the navel, is often drawn ftrongly
inwards ; fometimes there is a violent working, or alter¬
nate riling and falling, of the belly', attended with con-
fiderable noife. The fphinCter ani, during the fit, is
fometimes fo firmly conftriCted as not to admit a fmall
clyfter-pipe ; and there is at the fame time an entire fup-
preffion of urine. This ftate continues for fome time,
with fome remiflions and renewals of the convulfive mo¬
tions; but they at length ceafe, leaving the patient in
a ftupid and feemingly fleeping ftate. More or lefs fud-
denly, and frequently with repeated fighing and fobbing,
together with a murmuring noife in the belly, the pa¬
tient returns to the exercileof fenfe and motion, but ge¬
nerally without any recollection of the feveral circum-
Itances that had taken place during the fit.

Such fits are very liable to recur from time to time,
and during the intervals the patients are fubjeCt to in¬

voluntary motions, to fits of laughing and crying, with
fudden tranfitions from one to the other; while fome¬
times falfe perceptions and fome degree of delirium alfo
occur, as well as all the various incongruities of the dif¬
eafe to which we alluded above. The preceding account
is that of the molt common form of the hyjieric paroxyfm;
but this is confiderably varied in different perfons, and
even in the fame perfon at different times. It differs
chiefly by having more or fewer of the circumftances
above mentioned, by the greater or iefs degree of vio¬
lence of thefe, and by the different duration of the whole
fit. See Cullen, Firft Lines, par. i 5x4.

The hyfteric paroxyfm fcarcely refembles any other af-
feCtion of the bod)', except occalionally the paroxyfm of
epilepfy ; but in epilepfy, the convulfive motions are ge¬
nerally much more violent, and the infenfibility more
complete ; there is foaming at the mouth, and a ftate of
coma, or profound fleep, follows the fit ; on the contra¬
ry, there is no globus rifing into the throat, no agitation
of the abdomen, no fcreaming, laughing, or crying, nor
any copious difcharge of limpid urine, as is common in
the commencement of the hyfteric fit.

For the relief of hyfteric fits, our means will vary ac¬
cording as the peculiar mobility of the nervous fyftem,
on which the diforder chiefly depends, is connedted with
a plethoric habit, and a purely fanguine temperament,
or with an habit the reverfe of plethoric, in which a con-
fiderable degree of debility, and a pale and phlegmatic
temperament, prevail. If the patient be of a robuftand
plethoric conftitution, blood-letting is the moft effedlual
antifpafmodic that can be employed ; and, when the
convulfions are fevere, or long continued, with a flufliijig
or fulnefs of the vefiels of the face and external parts, it
is the only antifpafmodic that can be adminiltered with
fafety. At the fame time, the turgefcence and adtivity
of the blood-veflels, and the confequent over-irritation
of the nervous fyftem, may be diminilhed by the applica¬
tion of cold to the head and abdomen, or to the body in
general. The ufe of naufeating emetics has alfo been
recommended for this purpofe. Where the plethora is
not fo confiderable as to warrant general blood-letting,
cupping from the neck, or from any part in pain, may be
fubftituted.

But in thofe habits which exhibit no marks of plethora
or of confiderable ftrength, evacuations of blood, fo far
from being beneficial, are extremely detrimental, and
are abfolutely enumerated among the caufes which in¬
duce the difeafe. In fuch conftitutions, the hyfteric pa¬
roxyfm is to be diminilhed or cut (hort by ftimulant and
antifpafmodic medicines. Of thefe, opium, in its va¬
rious preparations, is one of the moft effectual ; and its
efficacy is confiderably aided by a combination with the
more diffufible ftimulants, efpecially with aether and am¬
monia, or the volatile alkali. It is moft commonly not
difficult to force the patient to fvvallow twenty or thirty
drops of fulphuric aether and of tindture of opium, in
any liquid, at the commencement or during the conti¬
nuance of the fit; and this is frequently followed by a
fpeedy ceftation of the fpafmodic motions. Various other
ftimulant medicines, efpecially thole of ftrong and pun¬
gent odour, may be adminiltered with good effect under
the fame circumftances; fuch are the preparations of va¬
lerian, mulk, caftor, camphor, afia-fcetida, oil of amber,
oleum animale, &c. At the fame time, any ftrong im-
preffion made upon the nervous fyftem will frequently
arreft the progrels of the paroxyfm ; as the application
of any ftrong- fmelling fubftance to the noftrils, luch as
burning feathers and volatile falts. The ltimulus of
heat may likewife be reforted to for the relief of the pa¬
roxyfm, when it is obftinate; and it may be applied to
the whole body, by means of the warm bath 5 or to the
lower extremities, in the way of pediluvium.

After the paroxyfm is over, the complaint requires a
fteady regulation of the circulating and digeftive fyftem,
of the mufcular motions, &c. in the manner before ad¬
verted

1

PATHOLOGY.

verted to. This difeafe is without clanger, except when
it terminates in epilepfy, a termination by no means un¬
common to this and other nervous maladies. This re¬
mark naturally leads us to,

3. Syfpafia epilepfia, the epilepfy, or falling ficknefs :
general mufcular agitation, without fenfation or con-
i'cioufnefs ; recurring at regular or irregular periods.

Of the two firft: proportions contained in the above
definition, we have to remark, that they are liable to
much uncertainty. The mufcular agitation is. of va¬
rious kinds. In the more common form, in which the
attack of the difeafe is l'udden, it confifts in a convulfive
or twitching agitation ; in another form of the difeafe,
the mufcles are in a Hate of fixed rigidity, like tetanus.
The limbs are ftretched, and the whole trunk extended
and fixed by a rigid fpafm ; the eyes are widely open ;
not reverted, but flaring frightfully; the pupils con¬
tracted, and quite infenfible to theflimulus of thellrong-
ell light: “Erigitur quoque penis in infantilnis ; in
adolelcentibus femen ejicitur, et ftepiusurina ad magnam
diftantiam prorumpit.” In other cafes, again, the muf¬
cular fyflem is perfedlly relaxed throughout the epi¬
leptic fit. Sometimes one fide of the body is more con-
vulfed than the other; fometimes irregularity is obferved.
Some of the mufcles of the face being more affedled than
others, exhibit various and violent difcortions of the
countenance. The tongue is often affedled, and thruft
out of the mouth, while the mufcles of the lower jaw
are alfo affedled, and, (hutting the mouth with violence,
often wound the tongue grievoufly. A fymptom much
lefs variable than the mufcular agitation before adverted
to, is the date of ftupor or infenlibility during the pa-
roxyfm. In a very great majority of cafes this amounts
to complete coma ; but, in others, a flight degree of
f'enfibility or confcioufnefs remains during the paroxyfm.
This ftupor generally comes on fuddenly, and without
any premonitory fymptoms. Sometimes dizzinefs and
pain in the head, and vifual deceptions, are felt before
the attack. Sometimes the remarkable fenfation called
aura epileplica precedes the attack : this is a fenfation of
fomething moving in fome part of the limbs or trunk of
the body, and from thence creeping upwards to the head ;
and, when it arrives there, the perfon is immediately de¬
prived of fenfe, and falls into a fit. It is defcribed fome¬
times as refenibling that of a cold vapour, fometimes
as like a fluid gliding, and fometimes like the fenfation
of a frnall infedt creeping, along the body ; and very of¬
ten the patients can give no other diftindl idea of their
fenfation, than as in genera! of fomething moving along.
It might be fuppofed that this fenfation arofe from fome
afteCtion of the extremity or other part of a nerve, aCted
upon by fome irritating caufe ; and that the fenfation,
therefore, followed the courfe of fuch nerve. But it
is not found to follow the courfe of any nerve diftinCily,
and it generally feems to pafs along the integuments.

During the epileptic convulfions, the face becomes
red, then livid and fwelled, from the interruption to
the circulation through the head ; and there is common¬
ly at the fame time a frothy moifture ifluing from the
mouth ; and in the moll fevere cafes the urine and al-
vine excrements are involuntarily difcharged. In fome
inftances a hiding or ftertorous noife is emitted. The
■convulfions have for a few moments fome remiflions, but-
are fuddenly again renewed with great violence. Gene¬
rally, after no long time, this terrible ftruggle ceales al¬
together, and the patient remains for fome time without
motion, in a (late of abfolute infenfibiiity, and under
the appearance of a profound deep. After fome conti¬
nuance of this feeming deep, he fometimes fuddenly,
but for the mod part by degrees only, recovers his fenfes
and power of motion, but without any memory of what
had palled from the firft feizure of the fit; and complain¬
ing of head-ache, and exceflive pain in all the limbs, as
if from fevere fatigue. During the convulfions, the pulfe
and refpiration are hurried and irregular; but, when they

317

ceafe, thefe return to their ufual regularity and healthy
date.

It is a remarkable and diflreffing faCl, that epileptic
attacks happen much more frequently during deep than
in waking hours. The difeafe pretty equally affefts
males and females ; nor are there any temperaments,
habits, or conftitutions, exempt from its attacks. There
are periods of life at which epilepfy is more prone to oc¬
cur than at others. Infants are fubjeCt to the difeafe ;
but in them it generally arifes from irritation in the
bowels, and difappears with the exciting caufe. The fil'd
dentition alfo is a critical period ; but, if the difeafe ap¬
pear then, it generally goes off when the dentition is
completed. Epilepfy often appears, for the fil'd time,
about the eighth, tenth, or twelfth, year ; in which cafe
there is danger of its becoming habitual. Still there is a
profpedl of its fubfiding at puberty ; but, if this period
pafs without amendment, there is little hope afterwards.
In females, the coming forth of the catamenia fome¬
times affids the conffitution in getting rid of the difor-
der; but it much more frequently gives rife to it ; at
lead there is no period of life in which females are fo fre¬
quently attacked with epilepfy as the period of fird men-
ffruation. The intimate connexion between epilepfy
and other nervous diforders we have before adverted to.

The pathology of this difeafe is obfcure. Many emi¬
nent writers have contended that epilepfy confids in an
unufual fulnefs of the veffels ; and they indance the
flufliingand turgidity of the countenance, the puliation
of the carotids, the dilatation of the pupils, the relief
afforded by blood-letting, the appearances on difl'edtion,
&c. in proof of their opinion. We may remark, how¬
ever, that while we admit that plethora of the head is a
very frequent condition of epilepfy, and that it is alrnod
always the foie caufe of its fatal termination, we cannot
allow that epilepfy arifes from plethora of the brain. If
that date were indeed the caufe of epilepfy, how happens
it that epilepfy is not a frequent occurrence in fever,
where there is evident cranial plethora ? How happens
it that it is not more obfervable in cafes in which a me¬
chanical hindrance is oppofed to the return of blood from
the head ? How happens it that the fymptoms of epi¬
lepfy vary from thofe of apoplexy, which is evidently a
difeafe of fulnefs of the head ?

To the appearances on diffedlion we fay, that thefe ap¬
pearances are not uniform ; that frequently no turgef-
cence of veflels is found on necrotomy, efpecially if the
fubjedl be young. If, on the contrary, plethora were the
caufe of epilepfy, (hould we not always find it on dif-
fedlion ? Granting that fome part only of the brain was
affedled with vufcular fulnefs, fliould we not find that
part always and undeviatingly the feat of turgefcence on
difledlion ? But we do not find this. We find a fulnels
of blood in the head; but we do not perceive it more re¬
markable on the bafe than on the top of the brain, nor do
we find it in all cafes any-where. The fact that bleed¬
ing does good in epilepfy, is no proof of the inflamma¬
tory origin of the difeafe, becaufe bleeding may do good
by diminishing nervous excitability generally, or by di-
minilhing the adtion of the fecernents; in which cafe
they may fecrete lefs of the fluid ; which, it may be pre¬
fumed, irritates fome part of the nervous fyltem. In a
word, fo many are the effects of bleeding on the fyftem,
that we cannot found any theory on its effedls ; and if
we were to do fo, the event wouid not bear us out in it.
Bleeding often fails in epilepfy, efpecially in protradled
cafes ; and we fcarcely have heard of a cafe in which
bleeding alone was fuccefsful.

For our own part, w'e (hall attempt no theory of this
difeafe. We believe that the (late called irritation (a
Hate we are ignorant of the nature of, but which is ma-
nifefted to us by exaltation of the cerebral fundlions) is
the firft dileafe of the brain ; that the intenfity of this
gives rife to cerebral plethora, a (late which, by over-dif-
tending the capillaries, paralyzes the movements of the

fuperior

318 PATH

fuperior parts of the brain, which are already debilitated
by the over-excitement of that part of the brain (the
bafe and fpine) from which the nerves of voluntary
motion are derived ; the phenomena of epilepfy evi¬
dently difplaying exaltation of one fet of nervous func¬
tions, with diminution or complete lofs of others. The
appearances of diifeftion, as we have before hinted, are
generally thofe of inflammation; rednefs of the mem¬
branes or fubftance of the brain, flight adhefions and af-
fuflons in the fame part, are the moft remarkable. Irre¬
gularity in the bones of the cranium, fome of their pro¬
jecting parts prefling on the brain, tubercles and oflifl-
cation of the inverting membranes, are fometimes met
with.

In the treatment of epilepfy, we have two objefts irt
view. The firft to diminiflt the fanguineous plethora
which is the immediate caufe of the fit: hence bleeding
may be praftifed during the fit, or as foon after as may
be, efpecially if fulnefs of pulfe be felt, if vertigo or
mufcae volitantes have preceded, or if pain in the head
lias followed it. The degree to which this evacuation is
to be carried muft be regulated by circumftances. Cafes
which arife from idiopathic cerebral irritation, will gene¬
rally allow of more copious abftraftions of blood than
thofe which arife from fympathetic or dirtant irritations.
Thefe cafes, of what may be called idiopathic cerebral
irritation, are comparatively rare. The more frequent
forms arife from irritation in the liver, bowels, or fto-
inach. In thefe cafes, local plethora will ftill require to
be obviated. But our attention muft chiefly be directed
to the treatment of the malady during the remiflion, by
means of regular and fparing diet. Free purging may
at firft be ufed in all cafes ; but, in thofe under immediate
confideration, this muft fhortly give way to milder lax¬
atives, left the over-aftion of the bowels become a freflt
caufe of irritation. When uterine irritation occafions
the epilepfy, (and when we confider the high importance
of this fyftem in the female Economy, we (hall not be
furprifed at the frequency of this caufe;) emmenagogues
if the catamenia are fupprefled, or fedatives and tonics
according to other circumftances, muft be reforted to.
The main indication being ftill, as in all other cafes, to
keep a certain balance of excitement; by diminilhing
local plethora, and exciting the fecreting and motive
organs.

The infufficiency of this plan alone fuggefts the adop¬
tion of other meafures in addition to them. Thefe mea-
fures, however, we have no faith iq, unlefs the digeftive
organs and the ftate of the cerebral circulation be at the
fame time attended to. The firft meafure is counter-ir¬
ritation. This may be done by fetons in the nape of the
neck; perhaps more favourably by iflues or fetons on the
facrum, or above the knees. If thefe applications are
too troublefome, an iffue in one or in each arm will have
a fimilar effeft, in a certain degree. If there are any con-
ftitutional diforders which may aft as drains or diverfions,
they fliould be encouraged. A feton in the fcalp has
been found uleful.

Among the medicines which feem to alter the aftion
of the nervous fyftem, and which confequently do good
in protrafted epilepfies, arfenic and the nitrate of filver
hold the firft reputation. The former drug has often
cured this difeafe : it is given in the ufual moderate dofe
of ten drops of Fowler’s folution, to be gradually in-
creafed. It is certainly not fo much to be depended on
as the nitrate of filver, but is free from an unpleafant
effeft which we fhall prefently note as belonging to the
latter medicine. The nitrate of filver is a medicine of
great power; and, given when the conftitutional treat¬
ment has been llriftly purfued for fome time, will, we
believe, rarely fail. The unpleafant effeft above alluded
to confifts in a remarkable blacknefs or difcolouration of
the fkin which has in fome cafes followed its ufe, and
which, when once formed, lafts for life. It is faid, how¬
ever, that this may be obviated by keeping out the rays

O L O G Y.

of the fun during the exhibition of the medicine. It is
alfo ftated, that a period of from three to fix months’
continuance in the ufe of the argenti nitras has always
preceded this difcolouration : it is therefore advifed that
we fliould never continue the medicine for many weeks
together ; and in faft, if its good effefts are not apparent
in a month or fix weeks, we believe it will be found quite
ufelefs.

Dr. Good makes four varieties of this difeafe.

a. E. cerebralis : attacking abruptly, without evident
caufe, except fometimes a flight giddinefs. The remote
caufe is external violence to, or internal injury, malfor¬
mation, or difeafe, of the head.

£?. E. rigida: the limbs fixed and rigid, with agitation
of particular organs.

y. E. fympathetica : catenating with fome morbid ac¬
tion of a remote part, with a fenfe of a cold vapour af-
cending from it to the head.

A remarkable but authenticated faft is, that the tour¬
niquet applied round the limb before this auru has af-
cended, often flops its progrefs, and wards off the dif¬
eafe ; but, as mental emotion has great effeft in keeping
off epilepfy, (as the well-known ftory of Boerhaave, who
threatened his patient out of it, teftifies,) we fhould be
inclined to attribute this effeft to the influence of the
imagination.

E. irritata; from fudden emotion of the mind, or ir¬
ritation of the ftomach or bowels.

Genus IX. Carus, [x«po?, deep heavy fleep; from xapas,
the head.] Torpor. Generic charafters — Mufcular im¬
mobility ; mental or corporeal torpitude ; or both. There
are fix fpecies.

i. Carus afphyxia, fufpended animation : total fuf-
penfion of all the mental and corporeal functions. Four
varieties.

a. A. fuffocationis ; from hanging or drowning ; coun¬
tenance turgid and livid.

/3. A. mephytica; from carbonic acid gas, or other ir-
refpirable auras, by the miners called damps, (from the
German dumpff, vapour, exhalation.) In afphyxy from
this caufe, the countenance, inftead of being livid, is
pallid.

7. A.algida; from fevere cold : limb^rigid, counte¬
nance pallid and flirivelled.

The three grand organs, the brain, lungs, and heart,
fupport motion and fecretion by their aftion and re-ac-
tion on each other; and the funftions of any one of them
cannot be fufpended without the fufpenfion of the other
two. If the aftion of the heart ceafes, the brain ceafes to
tranfmit the nervous energies neceflary to the aftion of
the refpiratory mufcles, neceflary perhaps alfo to the ox¬
ygenation of the blood. If the aftion of the nervous
pow'er be fufpended, the heart retains its powers a fiiort
time; but, the refpiratory procefs being fufpended, the
exertion of thofe powers is prevented ; and fo on.

From thefe premifes it follows, that all cafes of death
are traceable to the fufpenfion of the ufe of thefe func¬
tions. In moft cafes this fufpenfion depends on aftual
deJlruSlion of the powers or properties of the part; and
confequently revival is impoflible. In many cafes the
powers remain unimpaired, but latent ; and are quiet only
becaufe the ftimulus to them is abfent. The wheel of
motion, kept up by the aftion of the heart, lungs, and
brain, on each other, has been flopped ; but, the powers
of aftion ftill remaining in thofe parts, if it is once fet
going, their reciprocity of aftion will keep it up. We
confequently find fudden death ufually from fufpenfion
of the funftion of breathing, as from hanging, drowning,
or the like ; or from rupture or ftoppage, or from mecha¬
nical impediment, of the heart ; or, laftly, from fome un¬
known change in the brain ; preemptively, and indeed
certainly in many cafes, from rupture of biood-veflels, or
general preffure from diftention of veffels. To the firft of
thefe clafles we fhall confine ourfelves; the fecond is of

courfe

PATHOLOGY.

courfe remedilefs ; and the third clafs will be treated of
under apoplexy, with the exception of a brief notice in
this place.

In the refufcitation of perfons drowned or hanged, or
rendered infenfible by mephitic vapours, the firft object
will be to place the fyftem in that ftate of temperature
molt favourable to the development of the nervous func¬
tion ; viz. that of warmth. The fame remark is applica¬
ble to cafes of fufpenfion of life from cold. It is to be
ftridtly obferved, however, that the reftoration of heat to
the body be not fuddenly effedled ; for, if Jlimulation be
dif proportionate to excitability, excitation will not be ma-
nifelled, confequently the increafe of temperature fliould
in all cafes be at firft very fmall, and gradually augmented.
With refpedf to the quicknefs with which the increafe of
heat is to go on, this muft vary according to circumftances.
We may go on much quicker when fufpended anima¬
tion arifes from hanging, drowning, or breathing foul
air, than when the body has been frozen. We alfo be¬
gin with a higher temperature at once ; for, in the latter
cafe, the fridtion of the body with water, or even fnovv,
muft be the prelude to higher degrees of temperature,
while in the former we may at once put the patient into
a warm bed, or immerfe him in warm grains or water, or
whatever may be at hand.

A flexible pipe being introduced through the pharynx
into the ftomach, a little warm wine and water, with a
very minute dofe of ammonia, may be injected ; fome
advife alfo injeftion per ano. While this is doing, the
lungs are to be inflated : this is belt done by cutting a
hole in the front of the trachea, and introducing a tube
affixed to Hunter’s bellow's ; or, if they are not at hand,
a common bellows may fuffice; the lungs being alter¬
nately filled with air, and then exhaufted of it by pref-
fure on the cheft. Oxygen may be ufefnlly employed
when procurable, efpecially in cafes of A. mephytica.
If a figh beat at the heart, if the flighted: change in the
colour of the (kin, fliould indicate an effort on the part
of the heart to refume its fundtions, a little blood fliould
be drawn from the arm, and a (hock of eledlricity of the
moft infignificant degree paffed through this organ. The
force of the electricity may gradually be increased.

The above rules embrace all that is requifite for the
refufcitation of life. With refpedl to the time at which
they are admiffible, no rule can be laid down. We may
realonably hope for fuccefs when the patient has not
l>een more than a quarter of an hour deprived of air.
Seldom do they recover after twenty minutes. Yet fo
many aftonifliing cafes of refufcitation, after the moft ex¬
traordinary laple of time, are oii record, (e. g. fixteen
or eighteen hours, three days, fifteen days, fee Parr’s
Medical Dictionary, p. 627.) that we fliould ufe fome
meafures even in any cafe within the bounds of pro¬
bable reftoration. But, after twenty minutes’ hanging,
or three or four hours of fubmerfion, w’e fliould be
careful not to revive the hopes of the fufferer’s relatives
merely to plunge them into deeper affliction, by com¬
mencing any plans of refufcitation. We cannot pals over,
on this fubjeCt, a negleCt very common among practition¬
ers in general; viz. the defertion of perfons fuddenly falling
(apparently) dead in a fit. It is ufual to open a vein or
artery ; and, if no blood flow, the patient is given up for
loft. This practice, defervedly reprobated by the higher
orders of the profeflion, and by no means trufted to in
our hofpitals, chiefly belongs to the general practitioner.
It is acknowledged that thefe fudden vifitations are of¬
ten irremediably fatal ; but neverthelefs we are wrong
in fuppofing them to be always fo. Often when the
veins do not bleed, and the heart remains perfectly qui-
efcent, both thefe phenomena will appear if ftimulating
inflations be thrown into the ftomach and inteftines, and
a (hock of eleCtricity paffed through the heart. On this
account, thefe falutary meafures, as well as inflating the
lungs, fliould never be negleCted.

This grofs abandonment of our fellow-creatures has
VOL.XIX. No. 1306.

813

been feelingly and forcibly dwelt upon by Mr. White in
his work on the “ Diforder of Death.” This author in¬
culcates the adoption of refufcitative meafure in all cafes
of fudden death. We fliould, for obvious reafons, not
have recourfe to it, however, in any but doubtful cafes.
Dr. Good gives us another variety of Carus, quite be¬
yond the reach of the art of medicine.

A. eleflrica; from lightning, or fevere ftroke of
eleCtricity: limbs flexible; countenance pale; blood
uncoagulable. In this variety the fyftem feems to be
totally exhaufted of its irritable and contraClile power.

2. Carus ecftafis, ecftacy: total fufpenfion of mental
power and voluntary motion ; pulfation and breathing
continuing; mufcles rigid; body ereCt and inflexible.
Said to be produced by profound contemplation or at¬
tention of mind, or overwhelming paffion ; in which cafe
it is reverie with a fpaftic diathefis. Dr. Cullen regards
it as a modification of apoplexy.

3. Carus catalepfia, trance: total fufpenfion of men¬
tal power and voluntary motion ; pulfation and breath¬
ing continuing ; mufcles flexible ; body yielding to and
retaining any given pofition.

In this fpecies the countenance is faid to be florid, and
the eyes open, and apparently fixed intently upon an
objeCl, but without vifion. It is a difeafe of rare occur¬
rence ; and varies in its duration from a few hours, 01-
even minutes, to two or three days. It returns fome-
tirnes at ftated periods. Forty grains of tartar emetic
have been given without effeCt. (Behrends, in Baldin-
gen N. Magazin, Band ix. p. 199.) In the cafe of a
lchool-boy, aged eleven years, the paroxyfms recurred
ten times in twenty-four hours, and never exceeded three
minutes in duration. If the attack commenced while
walking, the fame pace was maintained, though without
the diredfion of the mind. (Stearns, Americ. Med. and
Phil. Regift. v. i. viii.) The nofologifts, however, men¬
tion a variety, in which the powers of deglutition and
digeftion continue, the food being thruft into the mouth.
It has been found to be produced by the fame caufes as
the preceding fpecies ; and in thefe cafes is perhaps re¬
verie with a fpaftic diathefis. Cullen ranks this alfo as
a modification of apoplexy ; but, like the preceding, it
is dellitute of ftertorous deep. The exiftence of cata-
lepfy may however be reafonably doubted. It has been
o(ten feigned by impoftors.

4. Carus lethargus, lethargy: mental and corporeal
torpitude, with deep quiet deep. The term is applied
by the Arabian phyficians, not only to the varieties enu¬
merated below, but to comatofe affedtions generally.

«. L. abfolutus : without intervals of fenfation, wak¬
ing, or confcioufnefs.

/3. L. cataphora, fomnolency : with (hort remiflions or
intervals of imperfedt waking, fenfation, and fpeech.

7. L. vigil, apparent deep : perfedt lethargy of body,
but imperfedt lethargy of mind; wandering ideas, and
belief of wakefulnefs during deep.

Each of thefe varieties is found asafymptomin fevers
of various kinds; concuffion or other injuries of the
brain ; and repelled gout, or other fuppofed humours or
exanthems.

5. Carus apoplexia, apoplexy : mental and corporeal
torpitude, with ftertorous deep. Dr. Good notes two
varieties.

a.. A. fanguinea, fanguine apoplexy ; with a hard full
pulfe and fluffed countenance.

(3. A. ferofa, ferous apoplexy ; with a feeble pulfe and
pale countenance.

The varieties of Dr. Good we (hall not adopt. The
recent light which the continental phyficians have
thrown on the fubjedt of apoplexy by their diffedtions,
and the experience of our own pradlical authors, unite
in overturning the above diftindtion. A number of ar¬
rangements have been made from the few fadts known,
which will as inevitably be difcarded. In the mean time
we may remark, that the dividing a difeafe into many
4 N varieties

350 PATH

varieties anfwersno good purpofe. It makes the patho¬
logical ftudent expe<ft to find difeafes exa&ly to corref-
pond with the varieties laid down by his nofologift, while
every one knows that will never be the cafe; confequent-
ly it feems better to us to defcribe the various forms of
apoplexy under one head, when the ftudent eafily per¬
ceives their connexion, and the probability of his meet¬
ing with many intermediate forms.

We ufually find the apople£tic patient in a ftate in
which, as Dr. Cooke accurately fays, “ the animal func¬
tions are fufpended, while the vital and natural func¬
tions continue; refpiration being generally laborious,
an,d frequently attended with ftertor.” According to
Serres, the ftertorous refpiration is often fioweft when the
pulfe is quickeft ; and this want of correfpondence be¬
tween the two functions of circulation and refpiration
this author considers to be a pathognomonic fign of apo¬
plexy.

Although the attack is often fudden, yet, where pa¬
tients have paid attention to their own fenfations, there
have ufually been fome of the following premonitory
lymptoms ; as, pain in the head, ringing in the ears, ver¬
tigo, difpolition to fomnolency, numbnefs of the limbs,
orfenfe of formication ; dimnefs of fight; flalhes of light
before the eyes, with fuelling and watering of thofe or¬
gans ; fiufhing of the face; turgidity of the jugular
veins ; trembling and faultering of the voice ; failure of
the memory ; deep breathing, &c. After more' or lefs
of the foregoing premonitions, the attack is ufhered in,
according to Dr. Abercrombie, in one of the three fol¬
lowing forms.

“In the firft form, the patient falls down fuddenly,
deprived of fenfe and motion, and lies like a perfon in a
deep deep ; his face generally flufhed ; his breathing
ftertorous; his pulfe full, and not frequent, fometimes
below the natural ftandard ; in fome cafes, convulfions
occur. In this ftate of profound ftupor, the patient may
die after various intervals, from a few minutes to feveral
days, or he may recover perfectly without any bad con-
fequences of the attack remaining, or he may recover
with paralyfis of one fide. This paralyfis may difappear
in a few days, or it may fubfide very gradually, or it may
be permanent; other functions, as the fpeech, may be af-
fefted in the fame manner; and, fometimes, recovery
from the apople&ic ftate is accompanied by lofs of fight.

“ The fecond form of the difeafe begins with a fudden
attack of violent pain in the head; the patient becomes
pale, fick, and faint, generally vomits, and frequently,
though not always, falls down in a ftate refembling fyn-
cope; the face very pale, the pulfe very fmall. This is
fometimes accompanied by flight convulfion. In other
cafes, he does not fall down, the fudden attack of pain
being only accompanied by flight and tranfient lofs of
recollection. In both cafes, he recovers in a few mi¬
nutes ; is quite fenfible, and able to walk ; continues to
complain ofintenfe head-ache; after a confiderable time,
perhaps fome hours, becomes oppreffed, forgetful, and in¬
coherent, and thus gradually finks into coma, from
which he never recovers. In fome cafes, paralyfis of
one fide occurs; but in others, and I think the greater
proportion of this clafs, there is no paralyfis.

“ In the third form, the patient is fuddenly deprived
of the power of one fide of the body, and of fpeech, with¬
out ftupor ; or, if the firft attack is accompanied by a
degree of ftupor, this foon goes oft'; he appears fenfible
of his fituation, and endeavours to exprefs his feelings by
figns. In the farther progrefs of this form of the difeafe,
great variety occurs ; in fome cafes, it paffes gradually
into apoplexy, perhaps after a few hours; in others,
under the proper treatment, the patient recovers per¬
fectly in a few days. In many cafes, the recovery is
gradual, and it is only at the end of feveral weeks or
months that the complaint is removed. In another va¬
riety, the patient recovers fo far as to be able to fpeak
indiftinCtly, and to walk, dragging his leg by the molt

O L O G Y.

painful effort, and after this makes no further improve¬
ment. He may continue in this ftate for years, and die
of fome other difeafe, or he may be cut off' by a frefti at¬
tack. In a fifth variety, the patient neither recovers nor
paffes into apoplexy ; he is confined to bed, fpeechlefs
and paralytic, but in poffeflion of his other faculties, and
dies gradually exhaufted, without apoplexy, feveral weeks
or months after the attack.” Thefe two laft varieties
belong to palfy, properly fpeaking.

In the feverer degrees of this difeafe, the function of
refpiration is generally much embarraffed ; flow and la¬
borious at the beginning of the paroxyfrn ; frequent,
weak, and irregular, towards the fatal termination.
Stertor, though not always, is very commonly prefent;
and fome of our ableft phyficians meafure the violence
and danger of the difeafe by the degree of the ftertor.
This laft remark is equally applicable to the frothy fa-
liva, or foam, excreted from the mouth, and fometimes
blown away from the lips with confiderable force. In
refpeCt to the pulfe, it is obferved by Dr. Cooke, that it
is “at firft regular, ftrong, full, and flow, beating from
fifty-five to lixty-five times in a* minute; but, as the
difeafe advances, it becomes weaker, and more frequent;
and, in the end, irregular or intermitting.” Dr. Gre¬
gory, in his LeCtures, obferves, that “it is a fatal fign when
the pulfe is firft fmall, and afterwards becomes very full.”
Whenapoplexy terminates fatally, as thedifeafe proceeds,
the abolition of fenfe and voluntary motion feems to be¬
come more complete ; the refpiration and pulfe more
weak and irregular; cold clammy fweats affeCt the face
and whole body; the features fhrink, and convulfions
fupervene, which terminate in death.

The predifpolingcaufesare, age, (few patients fuffering
apoplexy before the age of 40,) cold and moifture,
plethora, and intenfe thinking. Any circumftance in¬
deed which fills the blood-veffels inordinately, prevents
their due activity in the general circulation of the body,
or caufes extraordinary aCtion in the brain, may predif-
pofe to or actually cau-fe apoplexy. We ftiould alfo men¬
tion, among the caufes of apoplexy, difeafe of the heart,
whether this arife from exceflive aCtion of this organ gene¬
rally or from difproportionate aCtion of one of its cavities.
The connexion between cardiac and apoplectic difeafe,
■which has recently been much dwelt on by the French,
is worthy of particular attention. The pathology of
apoplexy ufually laid down, is that it arifes from concuf-
fion of the brain, its fatality being caufed by acoagulum
of blood or an effufion of ferum, forming the comprefling
body. Many diffeCtions, however, difcovered no kind of
lefion of the above-mentioned fort ; and M. Serres, in his
experiments on animals, found that compreflion did not
produce apoplexy ; and in his diffeCtions of the human
body, he fometimes found coagula of blood in the brain
without the antecedence of this difeafe. Hence it be¬
came allowable to doubt the correCtnefs of the eftablifhed
doCtrine. M. Serres, from numerous diffeCtions, infers,
that apoplexy, in all inftances except thofe attended with
paralyfis, is a difeafe of the membranes of the brain ;
hence he calls it meningeal apoplexy. That the inflamed,
and confequently thickened, and generally effufing, ftate
of the membrane may produce apoplexy by its uniform
and extenlive preffure over the furface of the cranium,
cannot be denied; but it may reafonably be queftioned
whether apoplexy is membranous inflammation, when
we confider the extreme pain ufually attendant on that
fort of difeafe ; nor do we find that the appearances repre-
fented by M. Serres are corroborated by the teftimony of
other authors. It fliould be recolleCted alfo, that we are
not obliged to admit, that, becaufe preffure from a clot
of blood does not produce apoplexy, (as ftated in the
experiments and diffeCtions of M. Serres,) therefore pref¬
fure is not the caufe of the difeafe. For the diftention of
the blood-veffels mutt induce a very great preffure, and
one which is uniformly exerted through the whole fub-
ftance of the brain. Of courfe, when we confider the

compaCi

321

PATHOLOGY.

compact and unyielding ftruflure of the cranium, and the
incompreflibility of the fubftance of the brain, we (hall per¬
ceive, that a very (light increafe in the momentum of the
blood mu ft exercife a powerful p re (1'ure on fome part or
other; and it feems to us, that this part will be thee.rfmtte
terminations of the arterial branches. Thefe terminations,
having a ftrong tendency to diminifh theircaliberin a ratio
increasing with the diminution of their Size, naturally
exert this power in a much greater degree than the larger
arteries, which po fiefs not only lefs of this power, but
are fo much nearer the heart as to Suffer in a greater de¬
gree from its impulfes : consequently they will be emp¬
tied by the preil'ure of the larger arteries to a degree that
will counterbalance all vis a tergo ; fo that the circula¬
tion of the brain 'will be kept up Solely by the middle-
fized arteries and veins. That this is the cafe does not
admit of direft proof ; yet it is Supported by ftrong infe¬
rences, for it is allowed by all, that the brain cannot be
diminiftied in its volume by preffure, except by the emp-
tir.efs of its veflels. It is alfo allowed, that the pulfa-
tions of the arteries going to the head manifeft vigour
and fulnefs; and it is alfo pretty generally believed, that
the blood comes back freely enough through the jugulars ;
and hence we have the llrongeft reafon to believe, that
the capillary fyftem, and that only, -is emptied of its blood
in apoplexy.

This hypothefis explains the phenomena of apoplexy
in a very clear manner. It explains the lofs of confeiouf-
nefs that attends this difeafe ; a phenomenon always de¬
pending on want of due Supply to the arterial termina¬
tions of the cerebrum, as we fee in Syncope from bleed¬
ing. It explains how apoplexy is cured by venefeflion,
which, by reftraining the aftion of the heart and the ple¬
thora, diminifties the preffure. It (hows how, when effu-
fion of blood takes place, and paralyfis comes on, there
is Some amelioration of the apopledfic Symptoms; i. e.
becaufe the general preffure is removed, and one merely
local remains; consequently affetfting only particular
nerves and their dependant functions. That there are
■exceptions tothelaft fa<St only (hows, that the effufion of
blood may not always be followed by the dilatation of the
capillaries; a faft not more Surprising than that emptied
arteries do not always contract on their contents, as we
have reafon to believe happens in phlogofis unreftrained
by bleeding.

The appearances on diffeftion are various. M. Serres
dates, as vve before hinted, that in all Simple apoplexies
(i. e. unaccompanied by paralyfis) the membranes of the
brain are alone affedfted. The difeafe of membranes is
Sometimes attended with effufion, which is Serous, San¬
guineous, or fero-fanguineous. Sometimes it confifts
only of rednefs, diftention of the veflels, of the pia ma¬
ter, flirinking of the dura mater, and opacity, Sometimes
accompanied wfith whitifh granulations, of the tunica
arachnoides. Moft authors ftate, that the blood-veffels
in the fubftance of the brain are always found much dif-
tended. It is in the fubftance of the brain that Sangui¬
neous extravafation from rupture of the veflels is ufually
met with ; the corpus ftriatum and the thalamus nervorum
opticorum being the precife Situations of this lefion.

When apoplexy terminates by paralyfis, and the latter
in convaleicence, the changes which the difeafed ftruflure
undergoes are very numerous. In the firft place, the
apoplexy terminates in paralyfis, in confequence of the
rupture of an artery or vein, which renders the preffure,
before general, merely local ; and consequently, when
death does not Speedily follow, allows the cerebrum to
reSume its funftions in fome part. The extravafated
blood after a time becomes Surrounded with a cavernous
pouch, Somewhat like an aneurifmal Sac, and which fre¬
quently opens by a rent into the ventricles, or on the Sur¬
face of the cerebrum. The parietes of this cavern is
very Soft, tinged ftrongly by the blood, about aline or
two in thicknefs, unequal, anfractuous, and evidently

lacerated on its internal Surface, and prefenting flaky fila¬
ments when agitated in water. It is furrounded by a
layer of cerebral fubftance, about three lines in thicknefs,
of a pale yellow colour, and the confidence of thick cream,
Scarcely mifcible with water: this layerbecomes gradually
blended with, and loft in, the Surrounding healthy brain.

From this cyft, abforption of the effufed blood gradually
takes place; or at leaft the brain graduallyaccommodates it-
felf to the imprefling body. “ After the abforption of the
blood, (Says M. Rochoux,) the parietes of the cavern, or
pouch, above deferibed, approximate, and in Some mea¬
sure cicatrize, by the intervention of a cellular and vaf-
cular connexion, forming various areolae, between which
is found a reddifh ichorous fluid, more or lefs abundant,
and Sometimes glutinous. Thefe parietes are much
denfer than the reft of the brain, about a line or two in
thicknefs, and of a yellowifh-brown colour. I affirm
that thefe caverns are conftantly found after apoplexy
terminating in-paralyfis ; and their number always cor-
refpondswith the number of attacks.” This laft remark
of Rochoux’s agrees with that long fince made by our
illuftrious countryman Hunter. See Hunter on the
Blood, p. 213.

The treatment of apoplexy varies as it is accompanied
with Symptoms of paralyfis or as thefe are wanting. In
the firft attack of the difeafe, however, the treatment is
the fame in each variety. The objedt is to deplete the
cerebral veflels. For this purpofe the jugular vein
fliould be opened, the patient fixed in an eredt pofture,
and blood drawn until Some return of fenfation is mani-
fefted. Frequently, however, this relief is expedted in
vain. Seeing the difficulty, therefore, of removing apo¬
plexy, when once formed, it fliould be the care of the
pradlitioner to notice its premonitory Symptoms with pe¬
culiar attention. The occurrence of vifual deception,
the moft trifling aberration of the cerebral fundfions, if
attended with Sanguineous fulnefs, or if occurring in
patients predifpofed to apoplexy from age or formation,
will warrant us in taking a large quantity of blood from
the arm, and exhibiting a ftrong draftic purge. The lat¬
ter being repeated from time to time, and low diet en¬
joined, by thefe means an attack of this formidable ma¬
lady may in almoft all inltances be warded off.

To return to the treatment of the difeafe when formed.
Inftead of the jugular vein, Some pradlitioners have
ftrongly recommended arteriotomy, and have feledled
the temporal artery for this purpofe. It does not Seem
of much confequence whether the temporal artery or the
jugular vein be opened, provided a Sufficient quantity of
blood be drawn, and that quickly. The fmallnefs of the
temporal artery, however, often prevents a Sufficient flow
of the blood; and no Such objedtion is in force againlt
the jugular vein. When from one of thefe Sources a Suf¬
ficient quantity of blood has been drawn, our attention
mull be diredled to the ftate of the alimentary canal. If
a large meal has been taken within five or fix hours of
the attack, or if the patient has been known to Suffer
under dyfpepfia for fome time previous to the occurrence
of apoplexy, a full dofe of ipecacuanha, with copious
draughts of warm water, may be adminiftered. In the
nervous apoplexy deferibed under Dyfpepfia, this mea¬
sure might precede or fuperfede blood-letting. Unfortu¬
nately, however, the diagnofis between nervous and San¬
guineous apoplexy is very obfeure. When the emetic
has operated, aperient clyfters are to be given ; and
thefe may be followed by draftic purges. The peculiar
kinds it is Scarcely worth while to Specify, as they are
Sufficiently known. We may remark, however, that the
oil of croton, from its intenfe and Sudden adtion, pro¬
mises much benefit in apoplexies. If under thefe cir-
cumftances the difeafe in Some meafure goes off, refto-
ring confcioufnefs and feeling to the patient, it will be
right to prevent the recurrence of the fit by counter-ir¬
ritating diftant parts ; as bliftering the legs, giving draft-

322

PATHOLOGY

tic purges, and exciting the kidneys by turpentine or
fmall dofes of tindtura lyttas. As to the time it may be
right to perfevere in thefe meafures, or in bleeding, when
little apparent amendment is produced, no general rule
can be given. The termination of apoplexy is generally
rapid : but, as we have before noticed, exceptions occur
fufficiently often tojuftify the adoption of every meafure
till the lateft period. When the difeafe terminates in
paralyfis, it will be neceflary to bear in mind the manner
in which a cure is effected. But we fliall not enlarge on
this fubjedt, becaufe it has received full confideration in
another part of this w'ork. See Palsy, vol. xviii. It
may be right, however, to remark, that we (Irould keep
up a brilkadlion of the bowels, and take every means to
obviate fanguineous fnlnefs and gaftric irritation, as
meafures moll likely to procure abforption. In palfy
itridtly local, or in cafes of fuch old Handing that we have
reafon to confider the morbid depofition no longer the
caufe of the difeafe, and that the paralyfis depends on in-
ertnefs of nerves from mere habit, electricity will be found
ufeful.

6. Carus paralyfis : corporeal torpitude, and mufcular
immobility, more or lefs general ; without fomnolency.
Three varieties.

a. P. hemiplegia ; affedting, and confined to, one fide
of the body.

/•?. P. paraplegia ; affedting, and confined to, the lower
half of the body on both fides.

y. P. particularis ; affedting, and confined to, particu¬
lar limbs.

Palfy is found alfo, under one of thefe varieties, occa-
fionally as a fymptom in fevers; exanthems ; colic, and
other affeCtions of the inteftinal canal ; gout, rheuma-
tifm, ftruma, fiphilis, trichoma ; difeafes of the external
organs of fenfe; wounds, and other external injuries.
We do not find that we have any thing material to add
to what has been Hated in the recent article Palsy, vol.
xviii. p. 301-3.

Class V. GENETICA, [from yetim^xi, to beget.]
Diseases of the Sexual Function.

Order I. Cenotica, [from xewo-n;, an evacuation.]
AffeCting the Fluids. Morbid difcharges ; or excefs, de¬
ficiency, or irregularity, of fuch as are natural. This
order contains five genera.

Genus I. Paramenia, [from vrxpx, bad, and prii, the
menfes.] Morbid evacuation, or deficiency of the cata¬
menial flux.

The catamenial flux is a fecretion from the mucous
membrane which lines the uterus and fupericr part of the
vagina. It differs from the ordinary mucus fecreted in
thefe parts, in coagulating, in occurring periodically (for
it appears in health only once a-month), and in its pof-
fefling the colour of blood. Its red colour is however
the only property which it has in common with blood,
it being in every other refpeCt totally different from that
fluid, as Hunter has very clearly fliown. See Hunter on
the Blood, p. 88. In warm climates, women begin and
leave off menfiruating at a much earlier period. of life
than in cold ones. The quantum of catamenial dif-
charge, allowing for great varieties dependant on cli¬
mate and conflitution, may be fixed at a mean ratio of
five or eight ounces, and the time of its flowing at from
four to fix days. Nothing is known as to the intimate
proceffes of the human economy by which this monthly
action occurs in the female; but it is known that the
menflrual flux is in ordinary cafes neceflary to fit the
uterus for conception, and that its interruption or irre¬
gularity exerts a very unpleafant influence over many of
the fundtions of the body. The immediate fituation of
Paramenia is of courfe, as before Hated, the uterus and
fuperior part of the vagina. But thefe parts are often
affedied by diftindt maladies, which we muH remove be¬

fore remedies adting on the fecernents of the uterus will
avail. This genus contains five fpecies, befides varie¬
ties.

1. Paramenia obftrudtionis. In this complaint the ca¬
tamenial fecretion is obftruded in its courfe ; fometimes
altogether, fometimes only to a certain degree. From
the retention of a large quantity of fluid in the blood,
fymptoms of plethora are often prefent; and, from the
ftrong fympathy between the flomach and uterus, the
former organ becomes difordered, and draws into difor-
der the refl of the chylopoietic vifcera : confequently the
ufual dyfpeptic fymptoms of acid and rancid erudlation,
load at the pit of the flomach, coflivenefs, low fpirits,
&c. are hardly ever entirely abfent. There are two va¬
rieties.

x. Emanfio, retention of the menfes : obftrudted on
their acceflion, or firfl appearance. Feet and ancles ede¬
matous at night ; eyes and face in the morning 5 with
other chlorotic fymptoms.

(3. Suppreflio, fuppreflion of the menfes : obftrudted in
their regular periods of recurrence. Head-ache, dyfp-
ncea, palpitation of the heart.

From thefe fymptoms it is fufflcientlv obvious, that
fupprejjhn of the menfes is attended with flronger marks
of plethora than retention of the menfes, while in the
latter difeafe the dyfpeptic fymptoms are more predomi¬
nant.

Retention of the menfes arifes from an inactive Hate
of the uterine fecernents; (excepting, of courfe, cafes
of imperforate hymen.) This inadlion may be the refult
of an infufficient flow of blood to the uterine fyflem,
or from a debility which the fecernents in general always
fuffer when thofe of the fkin and alimentary canal are de¬
bilitated. Some have faid that the difeafe arifes “ from
a w'ant of power in the fyflem to propel blood into the
uterine veffels with a force fufficient to open their extre¬
mities;” but furely this pathology is overturned by the
fadt, that vigour of pulfe is fometimes met with in reten¬
tion of the menfes. We mufl therefore look to the dif¬
ordered Hate of the fecernents for the cure of this difeafe.
It is to be remarked, that, while fome women begin men-
Hruation without any unpleafant feelings, others fuffer
much pain and illnefs previous to theiracceflion. More¬
over the difcharge is often irregular, both in quantity
and time of occurrence. The firfl appearance of them
is generally at the age of fifteen or fixteen, fometimes not
till eighteen or nineteen. Thefe fadts are mentioned in
this place to guard againft the ufe of medicine for the
relief of thefe natural irregularities, (if we may be allowed
the expreflion,) while general ill feelings are abfent.
They do not of courfe arreft the adoption of remedial
meafures when unpleafant fymptoms arife in confequence
of the retention.

The treatment of the firfl variety is fufficiently Ample.
It confifts in exciting the fecernent fyflem generally, and
that of the uterus in particular. In the firfl place, the
treatment of dyfpepfia mufl be put in force. The ufual
palliatives, alkalies and opiates, mufl correct the difeafed
fecretion of the flomach ; flight mercurials mufl be made
to operate on the liver; the bowels mufl be kept in a
regular and healthful ftate by means of laxatives and
appropriate diet; and exercife mufl be regularly taken.
After this, the ikin is to be excited by means of the
cold bath, followed by fridlion to produce re-adtion ; and
moderate dofes of ftimulating medicines, as gentian, and
more particularly fteel, may be given.- .The indica¬
tions of exciting the uterus is to be effedted by the
ufual popular means of the warm bath applied to the
feet or over the hips; and the milder laxatives may
give way to purges fome what draltic. To thefe mea¬
fures may be added, in obftinate cafes, mild emmena-
gogues, as the mifturte myrrhae comp, or decodt. aloes
conf. in the ufual dofes. The addition ot ten or
twelve drops of tindture of bliitering-fly, or , of the
r black

PATHOLOGY. 323

black hellebore, to each dofe of the above mixture, will
aid their effeft. Emmenagogues may be done without
in molt cafes ; and they are of little ufe, unltfs the dyf-
peptic treatment precedes or accompanies their adminif-
tration.

The two following fpecies of mif-menftruation, and
the treatment of fupprefiion of the menfes, we fnall dif-
cufs together, becaufe, as we (hall prefently (how, a few
fimple principles will better accord with our praftical
information as to their treatment, than any artificial de¬
tails drawn from external appearance.

2. Paramenia- difficilis, laborious menftruation : cata¬
menia protruded with great local pain, and efpecially in
the loins ; part of the fluid coaguiable.

3. Paramenia fuperflun, excefiive menftruation : cata¬
menia excefiive, and accompanied with hemorrhage from
the menftrual vefl'els. Two varieties.

a. Crebra; excefiive from a too frequent recurrence.

(3. Profufa, profufe menftruation ; (JJJue. of blood, Matth.
ix. 20.) Exceffive from too large a flow at the proper pe¬
riods.

Of that fpecies of mifmenftruation which is charaffer-
ized by a more frequent return of the complaint than
natural, we can afford no fatisfa£fory pathology, becaufe
we are unacquainted with the caufe which brings on the
catamenia even during health, and confequently cannot
be fuppofed to know thecaufe of its more frequent occur¬
rence. The improvement of the general health will be
generally attended with the cure of this malady. As to
fupprefled, painful, and profufe, menftruation ; the firftis
fometimes, and the two laft frequently, attended with
fymptoms which characterize a certain degree of periodi¬
cal inflammation in the parts affeCled. This is peculi¬
arly the cafe in thefe coagulating difcharges which are
met with in painful menftruation, and which for the mod
part are of lymphatic conftruftion, and accurately coin¬
cide with the furface from which they are exuded. The
latter fad is not however perceived, unlefs the coagula
are placed in water, where they gradually difplay a pla¬
cental ora tubular form, evidently correfponding with
fome portion of the uterus. Again ; profufe menftrua¬
tion is fometimes attended with a quick and full pulfe,
and more efpecially when an aClual hemorrhage takes
place. In each of thefe cafes it will be neceflary to de¬
plete the fyftem in a moderate degree ; in fupprefiion of
the menfes, by leeching, ajid to excite the relaxation by
a warm hip-bath and briflc cathartics ; in painful men-
llruation, it may in fome cafes be allowed to take blood
more generally; and, in addition to the warm bath, & c.
opiates fhould be given in fomewhat ample dofes. When
the uterine difcharges become profufe, the very nature of
the complaint itfelf forbids the ufe of bleeding; but ne-
verthelefs, by low living and by the exhibition of digi¬
talis or plumbi fuperacetatis, we mull in fome meafure
imitate the praflice laid down with reference to phlogofis
of the mucous membrane, or aftive hemorrhage.

In the greater proportion of cafes, .the profufe and the
impeded action of the menftruating organs will be found
connected with debility of the uterine fecernents, and of
the body generally; and will require a ftimulating treat¬
ment. The diet mull be regulated fo as toenfure gene¬
ral vigour of the conftitution, and the bowels and chy-
lopoietic vifcera in general excited to fecretion. At the
time proper for the menfes to come on, the ufual means
of warm bathing of the lower extremities, emmenagogues,
and, laltly, electricity pafled through the womb, will
enfure the accefiion of the flux; while narcotics and af-
tringents, as opium and fulphuric acid, &c. with reft,
will generally be fuccefsful in reftraining an excefiive
puffwe difeharge.

4. Paramenia erroris, vicarious menftruation : catame¬
nia transferred to, and excreted at, remote organs.

Vicarious menftruation is curable only by iiich reme¬
dies as excite and irritate the uterine fecernents. This

Vol. XIX. No. 1306.

difeafe offers curious examples of that procefs called
metaftalis. Dr. Good enumerates many varieties; viz.

a. Ex oculis fluens. Dodonai Obf. cap. xv. Boerh.
Aph.

p. Ex naribus. Parai. xxv. 12. Braffavol. Aph.
xxxiii.

y. Ex alveolo dentis. It onffei de Horn, primord. c. 2S.

S. Ex auribus. Braffavol. Aph. xxv. feft. 4.

£. Ex mammarum papillis. Amat. Cent. ii. cur. 21.

£. Ex vomitu. Jlipp. de Morb. Mul. Aretai, lib. ii.

». Per inteftina. Galen, in Aph. xxxv. f. v.

S. Ex podice. Parai, lib. xxiii. cap. 12.

1. Per urinam. Braffavol. Aph. xxx. f. v.

x. Ex umbilico. Nicolai Florent. Serm. ii. c. 8.

A. Ex digito. Me.rcat. de mulier affeft, lib. i. c. 7.

(x. Ex cute. Iluller. comment. 667. p. 87. See alfo
Cruikfhank on Abforb. 4.10. p. 54.. Phil.Tranf. vol. xiv.
121. Richerand’s Elem. de Phyliol. Aph. clxxi.

5. Paramenia ceffationis : catamenial flux irregular at
the term of its natural ceffation ; occalionally accompa¬
nied with fymptoms of dropfy, glandular tumours, or
fpurious pregnancy.

The ceffation of the menfes is, from the unufual quan¬
tity of fluids thrown into the general circulation, often at¬
tended with a variety of acute and chronic inflammations.
Thefe are bell: obviated by occafional bleedings and pur¬
gatives. When they make their appearance, counter-
irritants, as fetons, See. are highly ufeful. On this ac¬
count we are diretted not to heal ulcers and breakings-
out in the lower limbs at this period of life. The ute¬
rine difeharge generally flops at about the forty-fifth year;
but it has fometimes continued to a very late period of
life. To the age of 71; Holde/reund, Erzahlungen, n. 4.
To the age of 80 ; Bourgeois, Hebammenb. part. ii. cap.

6. To the age of 90 ; Hagendorm, cent. ii. obf. 84. See,
for various cafes, Pelargus, Med. Jarh. iii. 347, and fol¬
lowing.

Genus II. Leucorrhaa, [from Xvjy. 0;, white, and
to flow.] Fluor albus, or whites. Generic charadlers —
Mucous difeharge from the vagina, commonly wuthout
infedfion ; difappearing during menftruation.

The difcharges from the female organs of women have
been for the molt p.art indiferiminately treated of under
the term rohites. The impropriety of this fweeping defig-
nation is evident from the variety of difeafes of which a
difeharge of this kind may be a fymptom. The common
caufes of difcharges from the vagina are the fame as thofe
of mucous phlogofes in general ; viz. cold debilitating the
fundiions of the (kin, mechanical irritation (hence the oc¬
currence of leucorrhcea from excefiive copulation), difeafed
fecretions poured over the furface of the vagina, as when
the uterus is difeafed, or diftant irritation. The vagina
is alfo expofed to increafe of its mucous difeharge from
relaxation of its mufcular coat ; for this, of courfe, allows
a greater afflux of blood to pafs to the mucous membrane,
and hence more copious fecretion follows. The difeharge
has in fo many inftances been traced to this laft fource,
that mod people confider whites as the refult of weaknefs,
and preferibe ftimulating medicines without caution.
It fflould be remembered, however, that all mucous mem¬
branes are liable to fimilar kinds of difeafed aflion ; and
that inflammation is perhaps of all others the mod com¬
mon affedtion they are fubjedt to.

The diftindlion which has been made by Dr. Clarke of
the different varieties of this difeafe are taken from the
appearance of the difeharge. It appears that a tranfpa-
rent or a white mucous difeharge is the refult of inflam¬
mation of the mucous membrane in the vagina, uterus,
meatus urinarium, or bladder; and that a more purulent
difeharge has its origin from the fame fource in more
violent cafes. On the other hand, we find the purulent
difeharge, efpecially when mixed with blood, a fymptom
of the corroding or the carcinomatous ulcers of the cer-
4 0 vix

324

PATHOLOGY.

vix uteri, of abfcefs of the womb, or abfcefs in fome part
of the vagina. Lnftly a watery difcharge, according to
Dr. Clarke, accompanies the cauliflower excrefcence of
the os uteri, hydatids of the womb, and the oozing ex¬
crefcence of the labia. There are three fpecies.

i. Leucorrhcea communis, Ample inflammation of the
mucous membrane of the vagina, is charafterifed by a dif¬
charge of a tranfparent mucus of a gelatinous nature,
which does not render water turbid, and which, when it
arrives at the external labia, acquires from friftion with
the air a white colour. This difcharge may be pro¬
duced by two different kinds of affion in the mucous
membrane, which bear a clofe analogy to two difeafes of
a flmilar but diftant drudfure ; viz. acute and chronic
bronchitis. Thus in one inftance this difcharge is caufed
by cold, full living, and idlenefs ; attacks robufland above
all corpulent peri'ons, u'ho for the mod part menftruate
in great quantities ; is attended with much diforder of
the hepatic functions ; with vertigo, mufci-volitantes, and
other fymptoms of undue circulation in the head, and
with a full pulfe. In a word, all the fymptoms of ple¬
thora are fufficiently manifeft. The treatment is in this
cafe fufficiently obvious. It conflftsin removing the ge¬
neral plethora by bleeding from the arm, and .the local
fulnefs by leeches orcupping. The bilious diforder is to
be remedied by regular doles of calomel ; the bowels kept
open by brifk faline, but not dradic, cathartics ; and a
low diet enjoined. At the fame time, the difcharge, as
it is a confequence of plethora, and as it tends to cure
more violent maladies, as haemorrhage and apoplexy (to
which the patients under confideration are very liable),
mull not be fuddenly redrained. At fird indeed the
•warm bath and the frequent injeftion of warm water
into the vagina will be proper, not only to cleanfe the
acrimonious difcharge, but to make it flow more freely ;
and it will not be till iome time after the plethoric, bili¬
ary, and indeed all unpleafant fymptoms except the dif¬
charge, are gone, that we may venture to order an adrin-
gent application. This may be a weak folution of ful-
.phate of zinc, or of fuper-acetate of lead.

But the other form of the complaint which, as we be¬
fore dated, depends on the relaxation of the mufcular
drudlure of the vagina, and fo connedled with adtual de¬
bility, attacks weak and dyfpeptic patients, thofe who
live in a moid atmofphere (hence its frequency in Hol¬
land), thofe who keep bad hours, inhabit hot rooms, and
lie long and late in bed, or u’ho fuclcle their children for
too long a time. Pallor, and a yellowifli exanguious date
of the lkin, with a doughy feel, and in the feet and legs
flight cedematous fwellings of the integuments, mark the
patients of this malady. The pulfe, final] and fometimes
quick, is liable to acceleration from occafional nervous
palpitations. Anorexia, flatulence, coflivenefs, and irre¬
gularity in the fecretion of bile, pave the way to a more
or lefs marked degree of hedtic fever, which eventually
leads tootherand more eventful maladies.

The treatment of thefe fort of cafes mud of courfe be
different from that before defcribed. The removal to a
drier atmofphere, the interdidfion of late hours, the fub-
ditution of a daily nap on the fofa for late indulgence
in bed, are the fird and mod obvious meafures. Paf-
Ave exercife mud be ufed in the early dages of the ma¬
lady; and aftive mufcular motion mud be referved for
cafes in which the fydem has recovered, or has not lod, a
certain degree of vigour. The food mud be at fird light,
and requiring little power in the domach to diged it; as
foups, jellies, &c. but thefe mud be fucceeded by folid
animal food before the vigour of conditution will be
quite redored. The bowels mud be kept open by mild
laxatives ; the liver, if inactive, mud be operated on by a
few grains of blue pill every other night. Gentian and
carbonate of ammonia will tend, in conjunction with
proper diet and a free date of the bowels, to excite the
powers of the fydem in a very falutary manner. As foon
as fome material amendment has taken place in the gene¬

ral health, and not till then, fhould we turn our atten¬
tion to the redraining of the difcharge. For this pur-
pofe the gentian and ammonia may be advantageoufly
changed for the exhibition of fome preparation of iron,
combined with an alkali, and occaflonally with myrrh.
Cold bathing and adringent injections may now be ufed.
For the latter, folution of alum or fulphate of zinc are
the mod proper, their drength being, as in other cafes,
gradually increafed.

2. Leucorrhcea nabothi, labour-fhow' : flimy, and for
the mod part tinged with blood. Secreted by the glan¬
dular nabothi fituate on the mouth of the uterus ; and
chiefly on the beginning of labour.

The fame parts are how'ever liable to another difcharge,
coming at a different time, and poffeffing characters quite
different from the above defcription. In fome cafes of
of vaginal difcharge, the fluid feems to come from the
fuperior parts; and hence, though probably mixed with
the common mucus of the vagina itfelf, exhibits charac¬
ters fomewhat different. It is defcribed by Mr. Clarke,
who calls it the white mucous difcharge, as being “ opake,
of a perfeCt white colour, and refembling in confidence a
mixture of darch and water made without heat, or thin
cream.” This difcharge is eafily walked from the finger
after an examination ; and it is capable of being difrufed
through water, rendering it turbid. Mr. Clarke is of
opinion, that “ a morbid date of the glands in the cer¬
vix of the uterus probably gives rife to this difcharge;
at lead, the cafes in which it comes away are thofe in
which the fymptoms are referred to this part; and, when
preffure is made upon the cervix uteri under fuch circutn-
dances, the woman complains of confiderable pain.”

It feems from the caufgs and fymptoms of thefe dif¬
eafes, and from the nature of the curative agents found
mod ufeful in its treatment, that the above morbid date
of the cervix uteri is chronic inflammation. Witlf re¬
gard to the pathognomonic fign, tendernefs of the os ute¬
ri, this of courfe is only known by introducing the finger
into the vagina. In doing this, little irritation is excited
in the vagina itfelf; but, as foon as the os uteri is
touched, a great degree of uneafinefs is felt. The feme
fenfation is alfo felt during the paffage of an evacuation*
along the reClum. The cervix uteri feels poliflied and
fmooth ; and this didinguifhes the difeafe from carcico-
ma, in which hardnefs is felt; and from ulceration, in
which of courfe fome breach of furface is felt. In this
afredtion few' fymptoms are prefent. The patient com¬
plains of uneafinefs in the back, and lower part of the
abdomen, which gradually becomes adfual pain. Riding,
or other motion tending to induce preffure, increafe this
pain in fome degree ; but the draining required to evacu¬
ate indurated faeces renders it very acute. The fame at¬
tempt often fqueezes from the vagina the mucous fecre¬
tion, which is always accumulated there in a greater or
lefs quantity in this difeafe; and, as it falls down on tlie
motion, is apt to lead perfons to fufpedl that fome difeafe
in the redlum has given rife to the difcharge. A certain
degree of dranguryalfo is generally prefent; and fome¬
times cydic tumors in the vagina have been met with,
when they have probably been caufed by the fame inflam¬
matory adtion which gives rife to the tendernefs of the os
uteri. The prefence of a mucous difcharge, the abfence
of pain when the lower part of the belly is prefled on, and
the abfence alfo of periodical exacerbations of pain, dif-
tinguilh this difeafe from hyfleritis, or inflammation of
the fubdance of the womb.

The treatment differs little from thatlaid down for leu¬
corrhcea dependant on inflammatory adtion. Local blood¬
letting, by cupping or leeching the back or groins, re¬
peated according to circumdances, forms the balls of the
treatment; and, where fymptomatic fever prefents itfelf,
venefedtion is proper, though feldom neceflary. The
hip-bath is a ufeful remedy, and the patient may fit in it
twice a-day, at the temperature of 90°. Where this lad
cannot be procured, fomentations to the back or abdo-
i men

PATHOLOGY.

men are ferviceable. Tepid water thrown into the va¬
gina, conditutes a direft fomentation to the part aft’e£led.
Mild laxatives, and, at bed-time, five grains of Dover’s
powder, and three of camphor, may be reforted to with
advantage. If drangury be confiderable in degree, a
large dole of opium will be neceffary, fueh as 6 o or 80
drops of laudanum, and fmaller dofes frequently repeat¬
ed, afterwards, with mucilaginous drinks. Whenever the
bladder is unequal to the expulfion of its contents, the
catheter fhould be ufed ; for it will be in vain to trull to
diuretics. Although it is not often neceffary to keep
the patient in bed, yet the horizontal pofition fiiould be
perfilled in for fome time, and all nevvcaufes of irritation
(efpecially copulation) avoided.

The next appearance to be noticed in vaginal difcharges
is that of pus. This fluid is fometimes J'rcreted from the
mucous membrane of the uterus and vagina in confe-
quence of inflammatory atfion. It is diftingnilhed from
the fluid which flows from an ulcer or abfcefs by this cir-
cumllance ; that the pus poured from an ulcerated cavity
in the uterus is frequently mixed with blood, while that
fecreted from the unaltered membrane during the inflam¬
matory procefs is rarely difcoloured by the fanguineous
fluid: it is in fa£l a muco-purulent difcharge. Now the
fymptoms of this complaint are, generally fpeaking, not
very different from thofe which attend the mucous dif¬
charge which inflammation induces in the parts in quef-
tion. When the vagina is particularly affedled, itching
of the external parts, and a fenfation of burning, exten¬
ded from the labia “ up the body” (as it is expreffed by
patients), are experienced ; and, when the os uteri is
open, little difference is found between this and common
phlogofes of its lining, except perhaps that the pain in
the laft is more violent. Add to this, that in all cafes
of purulent difcharge, even when this is in fmall quan¬
tity, hedlic fever and weaknefs and emaciation are feldom
abfent.

It is to be remembered, however, that the drudlure of
the vagina and of the uterus renders them liable to fome
peculiar fymptoms from the difeafe in queftion. Thus
the cellular fubftance of the vagina, being much furnifhed
■with veffels,,and liable to many fources of irritation, is
liable alfo to have abfceffes formed, when the mucous
membrane has been fo much difeafed as to produce pus.
Thefe abfceffes are of courfe only to be detedled by ma¬
nual examination ; and to be treated by the practice
ufually followed in other abfceffes. It is fdrffc difcovered
on the part of the patient by a fudden breaking of fome
internal part, followed by a copious difcharge.

When pus is fecreted in the womb, and the os uteri,
from its clofure by means of coagulable lymph or from
the firmnefs of its contradlion, denies an exit to this
fluid, a peculiar fet of fymptoms arife. Theuterus fwells
in a rapid manner ; fo rapidly indeed, that it might be
taken for pregnancy, if the tendernefs of the belly, the
acute pain in the back, the general difeafe of the patient,
and the occafional palling of menltrual mixed with puru¬
lent difcharge, did not forbid fuch a fuppofition. Some¬
times the os uteri opens in confequence of the didending
form of the enclofed fluid ; but on fome occafions this has
been here fo far from taking place, that the pus has only
found exit by an ulcerated paffage through the ftridlure
of the difeafed organ into the redtum. It is fcarcely ne¬
ceffary to add, that the ufual means of moderating vaf-
cular adlion, foothing the nervous irritability of the part
by fomentations, and of the fyftem by narcotics, and in¬
ducing an healthy Hate of blood by proper diet and me¬
dicine ; are required in this difeafe to be condudled in the
fame manner as in abfcefs, or in inflammation of the
mucous membranes.

3. Leucorrhoea fenefcentium : thin, acrid, frequently
excoriating and fetid.

Under this term we (hall include thofe difeafes which,
according to Mr. Clarke’s arrangement, are attended with
a watery difcharge. In doing this, we fear we pay too

•325

little refpedl to the nofological arrangement of Dr. Good ;
but the fadt is, that we find no evidence of this kind of
difcharge as an idiopathic difeale ; and moreover, we do
not find that all the difeafes of which it is a fymptom are
fpecified in our fyftem. To leave them out on this ac¬
count would be unpardonable.

1. A difcharge refembling clearwater, containing very
little or no glutinous matter, refultsfrom cauliflower ex-
crefcence of the os uteri, hydatids of the uterus, or
oozing excrefcence of the labia.

The cauliflower excrefcence is fo named from its ftri-
king refemblance to the upper furface of a cauliflower,
or a head of brocoli. The furface is granulated, and con-
fifts of a great number of fmall projedtions, which may
be picked off from the furface, as the granules may be de¬
tached from the vegetable. The firmnefs of the tumour
agrees alfo with that of the plant : here the granules will
be large and irregular, there fmall and equal. From a
very fine membrane fpread over the furface of this tu¬
mour is poured out the aqueous fecretion. As the ru¬
mour occupies the upper part of the vagina, it is con¬
cealed from view ; but in fome cafes, where it attained
a confiderable fize, Mr. Clarke harl feen it, and afferts
that it had a bright flelh colour. It pours out arterial-
lookingblood very plentifully, if injured during examina¬
tion, and fometimes fponraneoufly in plethoric habits.
This excrefcence has little or no fenfibility ; can never be
traced into the cavity of the uterus ; is fometimes rapid
in its growth, but much influenced by the contradlile
power of the vagina, being more rapidly developed in
married women who have borne children than in Angle
women. It is highly vafcular, and is of a ftrudlure ana¬
logous to the placenth.

A perception of moifture, and then gradually an incon¬
venient difcharge, are the firll fymptoms. The difcharge
increafes ; but, being unattended by pain or fcetor, the
complaint is negledted, until a tinge of blood is per¬
ceived, or the colour of the cheek begins to change,
with a correfponding lofs of ftrength. Then the alarm
is taken. A difcharge of blood almoft always fucceeds
fexual intercourfe; the digeftion begins to be impaired ,
hyfterical fymptoms are produced, and all that boll of in¬
explicable phenomena confequent on derangement of the
chylopoietic vifcera, increafing the patient’s flock of bo¬
dily and mental mifery. Increafe of debility is accom¬
panied with decreafe of abforption, and, of courfe, with
depolitions of fluid in different parts of the body, pro¬
ducing cedema of the feet at night, and puffinefs of the
face and eyelids in the morning. On this account, hy¬
drothorax may deftroy the patient long before flie would
have been exhausted by the difeafe itfelf. An alarming
hatmorrhage fometimes induces a fatal fyncope. No
great degree of emaciation, in general, attends the com¬
plaint. On the contrary, in feveral diffedlions, a layer
of fat, of confiderable thicknefs, has been found cover¬
ing the abdominal iriufcles. This fat Ante of the fubjeft
of fuch an excrefcence, forms a remarkable contrail to
the extreme emaciation which attends carcinomatous tu¬
mours. The feel of this tumour by the finger diltin-
guifhes it from the hardened cervix uteri of the incipient
carcinoma, and from the irregularity of furface met with
in the ulcerated flate of the fame organ. The difcharge
alfo differs; yet, as in this complaint a difcharge is pre-
fent, as now and then it is fcetid, as a tumour is found
upon examination, and as the difeafe has always, fooner
or later, a fatal tendency, it has been too frequently con¬
founded with carcinoma. The prognoftic, as to the ulti¬
mate event, it is true, mud be nearly the fame ; but there
is reafon to believe that the fize of the tumour may be
dimini/hed by judicious management, particularly by di-
minilhing the adlion and fulnefs of the blood-veffels of
the neighbouring parts. At all events, enlargement of
the tumour will be greatly retarded.

With this view, local blood-letting from the region of
the facrum and hips is a mod valuable remedy. The

quantity

PATHOLOGY.

quantity of blood to be taken away mull be regulated by
the fize and degree of refiftance in the tumour, and by
t he quantity of watery difcharge (always a meafure of the
extent of difeafe), regard being paid to the ftrength of
the patient. At the fame time it muft be recolledted,
that if, by the lofs of eight or ten ounces of blood by
cupping, the quantity of the watery difcharge can bedi-
ininifhed from four ounces to two ounces daily, the pa¬
tient will, at the end of a fortnight, poffefs more power
than if flie had loft four ounces of blood by cupping, and
the quantity of the watery difcharge had been diininilhed
to three ounces daily.

Local bleeding, however, when intemperately em¬
ployed, may haften the patient’s diflolution. It ftiould
not be prefcribed when much cedema of the feet is pre-
fent, nor during the prevalence of much debility ; in
faff, it ftiould not, at any time, be carried farther than
juft to produce the intended effeCt, as there are many
other auxiliary arts in referve. If the patient ftiould be
a ftrong woman, and if the difeafe has not been of long
duration, twelve or fourteen ounces of blood may be
taken away: if ftie ftiould poffefs lei's ftrength of confti-
tution, it may be fufficient to order the removal of fix or
eight ounces only ; and to repeat this once in three weeks
or a month. The application of leeches to the pudendum
4s alfo ferviceable. All general and local ftitnuli are of
courfe to be avoided ; the diet to be of the mildeft kind,
as puddings, white fifti, and vegetables. Wine and fex-
ual connexion to be entirely profcribed. The bowels
ftiould be (o managed, that one eafy motion be daily pro¬
cured ; all draining efforts in evacuating the redhim
being as injurious in this as in other uterine complaints.
The fulphate of magnefia in infufion of rofes will be
found a mild laxative. ,

The enlargement of the tumour may be greatly dimi-
nifned, and the difcharge confequently leffened, by the
■ application of cold to the outfide of the pelvis, and by
the injeflion of cold fluids into the cavity of the vagina.
Cold water may be applied to the external parts of gene¬
ration, to the pubis, and to the loins, by means of a
fponge ; and this may be done, not once or twice only
in the twenty-four hours, but feveral times : by keeping
the parts in this way conftantly chilled, the blood vef-
fels will be contracted, and the advantages refulting
from fuch a mode of treatment will foon be made evident,
in the diminution of the quantity of the difcharge, and
in the improvement of the conftitutional health. The
recumbent pofture ought to be infilled upon 5 and, in
injecting fluids, care ftiould be taken that the fyringe
does not touch the excrefcence, otherwife blood will
flow'. A cylindrical fyringe, the diameter of which
is about three quarters of an inch, the extremity being
rounded off, may be ufed for this purpofe ; and the pa¬
tient ftiould be cautioned not to introduce it farther than
an inch, or an inch and a half.

In that aggravated form of the difeafe, where the tu¬
mour nearly protrudes, the patient ftiould lie down upon
the bed with her hips raifed, and a fmall quantity of the
alfringent fluid ftiould be poured in between the labia,
with a common butter-boat. When the tumour has ac¬
tually protruded, compreffes dipped in an aftringent
fluid may be applied, or a fponge wetted with it may
be lightly drawn over the furface. The aftringent injec¬
tions recommended, confift of fulphate of zinc and water
■in various proportions, or alum and water. Solutions
jof the mineral aftringents in decoClions of aftringent ve¬
getables, conftitute applications poffefled of great power:
fuch as, cort. granat. contuf. gfs. aq. diftillat. -xiij.
coque per fextam partem horse et cola, dein adde liquori
colato aluminis 3'j- Galls, or oak-bark may be fubfti-
tured for the pomegranate. The efficacy of the latter
formulas in a great meafure depends upon the tannin.
As tii is principle lias the power of coagulating albumen,
io as to form an infoluble precipitate, it becomes necef-
flary to prepare the patient for a circumftance which may

otherwife occafion great alarm in her mind, the appear¬
ance of thin, whitiffi, or afti-coloured, flakes, which w ill
come away from time to time. Thefe are frequently
thought to be portions of the body, and the agitation of
the patient’s mind has been very confiderable, until it
has been quieted by fome explanation. Where irritable
vagina exifts, a mixture of decoCtion of oak-bark and
linfeed tea, forms a lefs irritating lotion.

In many cafes, where the conftitution has fuffered,
the powers of nature require to be recruited, and we
muft employ fome light tonic. The muriatic and ful-
phuric acids are appropriate medicines. Sulphate of
zinc, in fuch dofes as do not excite vomiting, and com¬
bined with an effential oil to reconcile the ftomach to
its ufe, is recommended as occafionally ufeful. Say as
follows : Sulphate of zinc, gr. xv. extrafl of hop, gj.
oil of cinnamon, gt. iij. Iff. in pi 1. xv. one to be taken
every night.

In fome inftances the refources of the medical art fail,
and then the ligature holds out a profpeCt of relief, which
has naw and then been realized. True it is, that the
fungus may, and probably will, he regenerated 5 but a
confiderable time, may elapfe before a tumour of large
fize forms ; and in the interim, by the removal of the fe-
creting furface, the difcharge will be reftrained, and
time will be afforded for the powers of the patient to re¬
cruit.

2. Hydatids of the uterus are connected with the ute¬
rus and with each other by fmall filaments and by por¬
tions of fubftances partly bloody and partly gelatinous.
A fnnilar fubftance is attached to the internal part of the
uterus, from which the footftalks of the hydatids grow.
The number of thefe hydatids increafing, the cavity of
the uterus enlarges ; and, when the organ has attained
a large fize, it contracts upon its contents. When the
pelvis can no longer contain the enlarged uterus, that
vifcus rifes into the cavity of the abdomen, and may be
felt as a circumfcribed tumour through the parietes.
The function of menftruation is ufually interrupted.

In the examination of a patient labouring under hy¬
datids of the uterus, the body of this vifcus will be
found enlarged, and fuddenly bulging out from the
upper part of the cervix. All thefe fymptoms attend
other enlarged (fates of the uterus ; but there remains to
be mentioned one other fymptom which ferves to diltin-
guifti this difeafe from all others, and from pregnancy,
— and this fymptom is the difcharge of an almoft-colour-
lefs watery fluid. This watery difcharge is to be diftin-
guift'.ed from that which attends the cauliflower-excref-
cence, by the irregularity and fuddennefs of its appear¬
ance and ceflation ; being produced by a rupture of one
or more of the coats of thefe hydatids, in confequence of
the occalional contraction of the uterus upon them, or of
any fudden violence, as in the act of coughing or l'neez-
ing ; whereas the difcharge from the cauliflower-excref-
cence, being a fecretion from its furface, is conftantly
efcaping. The fluid watery difcharge may be diftinguilh-
ed from thofe fplafhes of urine which fometimes come
away from pregnant women, by being wholly inodorous.

Sooner or later a parturient nifus takes place : the os
uteri opens ; the hydatids are expelled by periodical
pains j and then, for the firft time, danger prefents itfeif
in the form of a frightful haemorrhage. The reafon of
this laft is obvious. The placenta covers only a limited
fpace of the internal furface of the uterus, whereas the
hydatids fpring from every portion of the cavity. No
means of curing or arrefling the progrefs of this difeafe
have hitherto been difcovered. The patient is to be ap-
prifed of the nature of the complaint, and the event is to
be patiently waited for, treating occafional fymptoms as
they arife. When the time arrives at which the uterus
ftruggles to unload itfeif of its contents, then all the (kill
and energy of the practitioner will be neceffary to control
the haemorrhage, and fultain the powers of the conftitution.
Perfect quietude in the horizontal pofture (hould be en¬
joined,

327

PATHOLOGY,

Joined, and all fthmflating food and drink denied. Cold
applications are to be ufed to the loins, abdomen, and
external organs j and portions of ice (their acute edges
being rounded off by being held in the hand) may be
introduced into the vagina, or into the uterus. “Let it
not, however, be forgotten, (fays Mr. Clarke,) that the
great remedy for uterine haemorrhage is uterine contrac¬
tion ; and every poflible mode of exciting this is to be
put in pra&ice. The application of a bandage round the
abdomen has fometimes the power of exciting this con¬
traction : but, if the haemorrhage fhould continue pro-
f'ufe, and if any portion of the hydatids fhould remain
in the uterus, an attempt fhould be made to remove
thefe, in order to produce complete contraction of the
rnufcular fibres. Two or three fingers, or the whole
hand, covered with pomatum, fhould be carefully intro¬
duced into the uterus, and carried up between the fides
of the uterus and the hydatids, which are to be detached
from the part to which they adhere by the mofl gentle
means. The mafs, being now included in the hand of
the operator, is to be brought out of the uterus, the bur¬
geon recollecting always, in the performance of this ope¬
ration, that the degree to which the os uteri is dilatable
without laceration, is in proportion to the fize of the
whole uterus, both in pregnancy as well as in this dif-
eafe. So that, fuppofing the uterus in this difeafe to be
enlarged to the fize of that vifcus in the fixth or feventh
month of pregnancy, the whole hand of the operator may
he, if necefl’ary, introduced through the cervix; where¬
as, in fmaller dimenfions of the uterus, if any attempt is
made to introduce the wdiole hand through the cervix,
however carefully it may be attempted, a laceration of
it may enfue, and thus the patient may be involved in a
new danger. The expulfion over, and haemorrhage re-
lirained, the conftitution mull be invigorated by fuitable
means, particularly by the cinchona and mineral acids.

3. Oosing Tumour of the Labium. In this, the difcharge
arifes from the furface, or rather from the interftices of
the tumour. The fluid is of a watery nature, and fome¬
times very abundant in quantity, being renewed almoft
immediately after the furface has been dried by a napkin.
Blood never ifl’ues from the tumour, fo that it has no
analogy with cauliflower excrefcence. The tumour is
fometimes fo large as to occupy the whole of the labia,
extending even to the raons veneris. It feldom projects
more than a line or two above the plane of the furround¬
ing tkin. The colour of the tumour varies little from
that of the cuticle of the neighbouring parts. In the
immediate neighbourhood of the tumour cedema is oc-
caiionally met with, but the tumour is not cedematous ;
foon after the furface of the tumour has been wdped
quite dry, a watery fluid begins to ooze from it, and to
form drops, which, having become large, at length run
off, and keep the furrounding parts in a ftate of conftant
humidity; fometimes forenefs and excoriation take place,
as upon the upper lip when the fecretion from the nof-
trils is increafed, but the tumour itfelf is feldom ren¬
dered more fenfible.

The fecretion from this tumour correfponds, in appear¬
ance, with that from the cauliflower excrefcence. The
difeafe having begun, it continues to enlarge ; and infu-
lated patches of it appear in the neighbouring parts, at
•length running into each other. The complain t feldom
attacks young women. The principal inconveniences of
this difeafe are, an itching, fometimes'preternatural fenfe
•of heat, and a watery difcharge. When excoriations of
the neighbouring parts are prefent, or an eryfipelatous
-blufli appears upon them, more advantage will be de¬
rived from the internal exhibition of the cinchona in
Tubftance than from any other medicine; but noimpref-
flon will be made upon the difeafe itfelf by this valuable
remedy; and even the fymptoms above mentioned will
•frequently recur, and call for the employment of other
remedies.

A nutritious diet, and a moderate allowance of wine,
'■Vox.. XIX. No. 1306.

fhould be prefcribed. External applications may miti¬
gate, but never cure, the complaint. Common ftarch-
powder, repeatedly fprinkled over the parts till it cakes
upon them, is a very efficient remedy ; but it will be ne-
ceffary to keep the patient in the horizontal pofture dur¬
ing its life ; a pofition indeed which has a beneficial in¬
fluence in itfelf. A mixture of ftarch-powder and cupri
fulphas, very finely levigated, has been found ferviceable;
or a folution of cupri fulphas, or of argentum nitratum,
may be ufed. A folution of gum arabic in decoCtum
quercus may be tried. Cold water is alfo a valuable re¬
medy, and there are no cafes in which it will not afford
much temporary comfort. Perhaps the raoll effectual
applications are of a fpirituous nature. Strong new
port-wine has afforded great relief ; and, when this has
failed, brandy or arquebufade may be employed, or even
alcohol. The complaint, upon the whole, is very rare.

Genus III. Blenorrhcea, [from (STiEH'a, mucus, and psw,
to flow.] Muculent difcharge from the urethra or vagina;
generally with local irritation, and dyfury; not difap-
pearing during menftruation. (Gonorrhoea, Sauv. and
Cullen.) Three fpecies.

t. Blenorrhcea fimplex, (Gonorrhoea pura, Sauv. and
Cull.) Simple increafed fecretion from the mucous glands
of the urethra.

That a mucous fecretion may arife from the meatus
urinatus of the female without fpecific venom, is well
known ; and hence, were not cafes on record to prove
the faff, we fhould dill infer the jaoffibility of a gonor¬
rhoea exifting without copulation. We may remark,
however, that this is perhaps one of the rareft difeafes
we are fubjeCt to. It would of courfe require the very
Ample means of plentiful dilution and mild purgatives.

2. Blenorrhcea luodes, (Gonorrhoea impura, Cull.)
Clap. Muculer.t difcharge from the -urethra or vagina
intermixed with fpecific venom; burning pain in mictu¬
rition; produced by impure coition ; infectious.

We (hall enter into no fpeculatior.s as to the nature of
clap, whether it be lues, owing its character to the pe¬
culiar ItruCture it occupies, or whether it be a diltinCt
difeafe. At all events, its appearance and its cure are
quite different ; and, whether the mucous membrane is
unfavourable to the abforption of the virus, or whether
the virus of clap is not capable of affeCting'the conftitu¬
tion at large, fecondary fymptoms do not follow this dif¬
eafe. It conies on from forty-eight hours to four days
after copulation ; and is ufually preceded by tingling and
itching of the penis. The above definition embraces
all the characters of Blenorrhcea in men. In wo¬
men the difeafe is apt to be confounded with fome forms
of I.eucorrhoea communis. We nuift diftinguifh the dif¬
eafes chiefly by confidering the life and habits of the
patient, and whether any caufe has been prefent which
was likely to bring on Leucorrhcea. The Leucorrhcea,
*as Dr. Good obferves in his definition, flops during men-
•ftruation, which is not the cafe in Blenorrhcea. It is alfo
faid, that in women the early ftage of Blenorrhcea luodes
is marked by an unufual defire for fexual intercourfe,
and an itching of the labia. Pain in micturition, fo
common in clap, is feldom felt in Leucorrhcea. The
nature of Blenorrhcea is this. A peculiar ltimulus, act¬
ing on the fecernents of the mucous membrane of the
vagina or urethra, excites them to an aCtion which eli¬
cits from the blood the fame material as this ftimulus it¬
felf confifted of. This difeafed ftate of the fecernents
induces an inflammatory affeCtion of the blood-vefl'els of
the fame part, which inflammation teems to be actually
neceflary to keep up the difeafed fecretion. Gonorrhoea
therefore is cured in two ways. Firft, by reducing the
inflammation, when we thall merely have fecretion from
laxity of veflels to contend with. Secondly, by inducing
a ftimulus of fo oppofite a kind in the difeafed fecernents,
that they at once lofe the property of fecreting morbid
matter. With the firft view, cold applications to theexter-
4- P nal

32S

PATHOLOGY.

nal furface of the penis, orraons veneris, aft by fympathy
in reftraining internal inflammation: lowlivingand keep¬
ing the penis tied up towards the belly aft in the fame
manner. Large quantities of water or tea, and diure¬
tics, by diluting the falts of the urine, render them lefs
irritating, and confequently aft as a fedative on the in¬
flamed membrane when this fluid pafles through it. The
aftion of foda, in neutralizing any free acid in the urine,
operates alfo in the fame way. Under this plan, the in¬
flammatory ftage of Blenorrhoea generally goes off ; the
pain in making water (which is always a fign of inflam¬
mation) fubfides ; and a mere chronic di (charge, from
laxity of vefiels, remains. This is curable by the ufe of
injections, as folutions of fulphate of zinc or alum, and
by the exhibition internally of copaiba. In very obfti-
nate cafes the copaiba may be applied locally, by means
of a bougie. In this ftage the malady is called a gleet , is
often very troublefome, and requires frequently to have
a variety of ftimulants tried before any one will fucceed
in altering the aftion of the fecernents.

We have before faid, that certain ftimulants applied
even in the earlieft ftages of Blenorrhcea had the pro¬
perty of fo affedting the fecernents as to flop their fecre-
tion, and confequently the inflammation which arofe out
of them. Thus fome patients have ufed aftringent in¬
jections as foon as the tingling fenfation at the end of the
penis (the firft fymptom) made its appearance, and with
fuccefs. This, however, is a very hazardous experiment;
tor, if the tendency to inflammation be, from conftitu-
tional or other caufes, very ftrong, orchitis is apt to en-
fue, and prove a troublefome malady.

A more foft and efficient ftimulus is the cubeba, a drug
taken internally in dofes of from one to three drachms
three times a-day. This medicine fometimes indeed to¬
tally fails; but at all events never has appeared injurious,
and in the majority of cafes cures the Blenorrhcea with¬
out leaving behind it any gleet or other unplealant fymp¬
tom. If its good effeCts are not apparent in about a
week, it is proper to leave it off, and commence the an-
tiphlogiftic plan before laid down. The tinCture of cu-
bebs, combined with equal parts of the balfam of copaiba,
is a very excellent medicine in old-ftanding gleets.
From the above ftatement it very clearly appears, that
Blenorrhcea is in itfelf a difeafe of no great danger or
importance, and one which iseafily cured; but it is occa-
ftonally accompanied by difeafes which are the effeCt of
an inflammatory character, and are troublefome both to
the patient and the. practitioner. Thefe are, inflamma¬
tion of the tefticle, Ample bubo, cliordee, and ftriCture.

The inflammation of the tefticle generally comes on
when the difeharge from the urethra is (topped, and fub¬
fides as the latter returns. It is treated in the fame
manner as Emprefma orchitis in general, which fee, p.
■2.6 4. The bubo which accompanies Blenorrhcea, does
not feem, like the true venereal bubo, to depend on the
abforption of matter, but rather to owe its origin to an
irritation conveyed along the abforbents. This alfo
requires the fame treatment as Ample bubo, which fee.

Cliordee is ufed to exprefs an afteftion in which the pe¬
nis is curved downwards at the time of ereftion, the
under furface of this organ having a hard line running
along, and being attended with the moft excruciating
pain. This fymptom arifes from an unufual degree of
inflammation affefting the corpus fpongiofum of the in¬
ferior part of the penis, which confequently is permanently
contracted, and cannot follow the dilatation of the cor¬
pora cavernofa, or fuperior parts. Lee.ches to the penis
or perinseum are proper, with cold bathing of the affeft-
ed part when the irritation comes on. If nothing be
done, the patient, after fullering the moft intolerable tor¬
ment for fome days, is relieved by the fpontaneous refo-
lution of the inflammation, or by a rupture of veflels,
from which copious bleeding and ultimate relief fol¬
low.

Stritture of the urethra is the moft ferious diforder

which is liable to attend on Blenorrhoea. It come3 on,
however, from other irritation befides clap ; but is treated
in the fame way, whatever may have been its firft caufe.
There is fome difficulty in explaining what a ftrifture is.
It has been generally luppofed to be a contraction of
certain mufcular fibres furrounding the mucous mem¬
brane ol the urethra. Mr. Shaw, in a paper in the tenth
volume of the Medico Chirurgical TranfaCtions, has
(hown, however, that the mufcular ftruCture of the ure¬
thra cannot be demonftrated in man or in the larger ani¬
mals. Yet we cannot infer that contraCtile fibres do not
exift becaufe red mufcular fibres are not found ; neither
can we allow, that, becaufe they are fo diminutive, they
mu ft have no power, when we confider the favourable
polition in which circular mufcles aft. Moreover it feems
to us, that the complete expulfion of both femen and
of urine indicates a contraftile power in the urethra 5
and it feems alfo, that no other afl'umption explains the
form of a ftrifture; for if, as Mr. Shaw feems to infer, it
is merely an inflammatory procefs of the mucous mem¬
brane, we ihould naturally expeft to find the morbid
thickening on one fide, and a fomewhat extended furface
of the membrane, and not in this peculiar round form.
As far, however, as practical fafts are concerned, we are
quite ready to agree, that our treatment (hould never be
direfted to the dilatation of a contracted mufcle, for
that no ftrifture can arife from this caufe alone. It
feems probable that the irritation which exifts in the
mucous membrane of the urethra calls forth a fpafmodic
contraction of fome filament of contraftile fibre. It
muft be granted, indeed, that at firft this contraction will
not, on account of the weaknefs of the fibre concerned,
impede the flow of urine. It feems to us, that this latter
effeft will not take place till inflammation and thicken¬
ing of the mucous membrane enfue ; this inflammation
being viewed as a confequence of the contraction of the
contraftile fibre on the one hand, and the irritation the
contracted portion is fubjefted to by the dilating force
of the urine on the other. This thickening of the mu¬
cous membrane will of courfe be liable to fome varia¬
tions; it may undergo fpafmodic aftion, in confequence
of a contraction of the arteries which enter in the com-
pofition of the thickened ftruCture ; but it is in that part
of the urinary canal (viz. the neck of the bladder) which
is evidently furnifhed with mufcle, that fpafmodic ftric-
ture is moft commonly found. The precife nature of the
irritation that brings on ftriCture is not very apparent.
Stricture is certainly more common in hot climates, and
with intemperate perfons, than under other circumftan-
ces. It is alfo more frequently a confequence of clap
than of any other kind of urinary ftimulus ; but it does
not feem to have any proportion to the violence of the
clap. Strictures are often produced by the incautious
ufe of injections, and are aggravated by copulation. A
ftrifture of the urethra often produces other difeafes, as
a paraphimofis, or a fwelled tefticle.

The fymptoms of a ftrifture are rather obfeure. There
is a flight diminution in the fize of the flow of urine, oftep
with a degree of twifting or bifurcation of it ; and on
fome occafions the ftream is fcattered in various direc¬
tions ; on others it is completely flopped, or at lead with
the exception of a little dribbling. A difeharge of thin
mucus alfo attends, which is liable to be miftaken for a
gleet. The impediment to making water is always in-
creafed by the patient’s catching cold, or indulging in a
debauch. A pain at the end of the glans penis is often
found in ftriftured perfons; and in old cafes a variety of
dilorders are engendered. Thefe are at firft merely irri¬
tative difeafes, as unufual irritability of the bladder, noc¬
turnal emiffions, pricking and (hooting fenfations about
the fundament, &c. but in fome cafes aftual inflamma¬
tion of the bladder and its inverting peritoneum has
come on. In almolt all cafes, the refiftance caufed by a
long-ftanding ftrifture caufes the bladder to acquire a
great increafe of thicknefs and mufcular power.

1 Much

PATHOLOGY.

Much may be learnt of the precife fituatiop of a ftric-
ture by means of the bougie. This inftrument parted
down to the ftridture (hows its (filiation. The impreflion
it receives from the ftrifture, when it has parted through,
(hows the fize and form of the latter ; and the refiftance
it meets with in parting (hows the degree of the ftricture.
A (tridture is, casteris paribus, more dilatable when the
body is in a (fate of general relaxation than at other times:
this arifes from the lofs of contractile power which all the
contractile fibres undergo; for, though it may be doubted
■whether a ftrifture dilates or contracts in itfelf, (till it is
certain, that, when irritated, a fpafmodic refiftance is af¬
forded to the partage of an inftrument. But we (hould
rather refer this circumftance to the fympathetic contrac¬
tion of the healthy fibres of the canal.

From the ftatements we have made concerning the pro¬
bable ItruCture and mode of formation of a ftridture, its
treatment clearly follows. Viewing the mere contraction
of fome contraCtile fibre as an aCtion which is always an¬
tecedent to and coexiftent with that refiftance to the
dilcliarge of urine which we call ftfiCture, it is obviou's,
that local and mechanical means of removing that con¬
traction mult be put in force, in moft cafes, before a cure
can be effected. At the fame time, the removal of the
morbid thickening of the mucous membrane of the ure¬
thra by abforption (hould be chiefly attended to. For the
former purpofe, bougies are generally ufed. Of thefe in-
ftruments we (hall fpeak prefently. The latter is to be
effected by conftitutional remedies ; and, when we con-
fider the very fmall portion of membrane affeCted, and
the little fympathy this membrane altogether feems
to hold with the general fyftem, we cannot fail to be
furprifed at the great benefit thefe remedies afford to the
malady in queftion. Attention to the bowels, and to
the ftate of the fecretions in general, with mild diet and
copious dilution, will often cure recent ftriCtures without
local application ; and, wdienever it does become necef-
fary to ufe the latter, their efficacy will be diminirtied or
increafed in proportion as the general health is deranged
or the reverfe. Now the advantageous employment of a
bougie will depend much on the manner of its introduc¬
tion. The bougie (hould be of a fufficient diameter to
refill entanglement in the lacunae of the urethra; and
the grand principle which fliould direCt its introduction,
fhould be to pafs it through the ftriCture fo as to dilate
it, and thereby caufe abforption of its membranous fub-
ftance; and alfo relaxation of the contraCtile fibre, if indeed
we can bring our minds to believe that that fibre has any
thing to do with the continuance of a llriCture once
formed. If much force be ufed, we (hall (land a chance of
injuring other parts of the membrane befidesthe ftriClured
one, and thereby caufe much mifchief. At the fame
time, much preflure is fometimes required to dilate a
ftriCture. But on this head we (lull not enlarge. A
great deal of taCt, and an attention to many minutiae, are
requifite to the fafe introduction of inftruments through
the urinary partage ; and we (hall defer further notice of
the parting of bougie, the Ample and cauftic or armed, the
catheter, &c. till we come to the article Surgery.

It mult be remembered, that, when the Ample bougie
has failed, cauftic has been applied to the urethra with
fuccefs. Ufed as an agent which is to eat through a
ftriCture, and confequently employed of great ftrength,
it has no doubt often done harm. Viewed as a local fti-
mulus which excites the injured part to ulceration and
abforption, and confequently ufed in weak proportion ,
and infuch a manner as to enfure its exaCt application to
the ftriClured furface, and to that only, we will venture
to afiert, that it is a valuable auxiliary to the treatment
of this troublefome difeafe.

3. Blenorrhcea chronica, gleet : (limy difcharge from
the mucous glands of the urethra, without fpecific venom
or infection; (lightly irritating; chronic. (Gonorrhoea
mucofa. Cull.)

Moftly a fequel of the preceding 3 and ufually accom¬

329

panied wdth ftriCture or enlarged proftate gland. Though
without fpecific venom, occafionally fo acrimonious, as
to produce great local inflammation on the perfon coha¬
bited with, while the fecreting organ which has un¬
dergone the morbid change is torpid, or nearly fo, to its
virulence. Its treatment has already received due notice
under the preceding fpecies.

Genus IV. Spermorrhaa, [from crne^ot, feed, and |e u,
to flow.] Involuntary emiflion of feminal fluid without
copulation. There are two fpecies.

1. Spermorrhoea atonica, (Gonorrhoea libidinofa, Sauv.
G. laxorum, Cull.) Involuntary emiflion of a dilute and
nearly-pellucid feminal fluid ; with libidinous propen-
fity, but without ereCtion. The iaft fymptom is, how¬
ever, not always obfervable.

This difeafe is generally accompanied with much men¬
tal difturbance ; lownefs of fpirits, in a remarkable de¬
gree, generally attending it. It feems moft commonly to
owe its origin to the indulgence of folitary vice, and is
extremely difficult of cure. This may however be ef¬
fected, in lefs fevere cafes, by dating to the patient the
dangerous confequences of his vicious propenfity, and
cautioning him to refill at all times the fir ft approaches of
fenfual ideas. In violent cafes it is abfolutely necefiary
to combat the difpofition for folitude by every kind of
diflipation; and indeed it may be a queftion whether it
might not be allowable to lead the fufferer into the
haunts o( libidinous females rather than fuffer this much
more dangerous difeafe- to gain ground. The writer of
this article once attended a young man, over whole
mental energies this horrible propenfity acquired fo ex¬
treme an influence, as to induce, on repeated occafions,
attempts at fuicide. Advice was thrown away upon one
in whofe bofom religious feeling was ftrong, and who
neverthelefs abandoned himfelf to this vice in utter de-
fpair of overcoming it. Nor could the lefs-excufable
meafure of inculcating natural fin be ufed with one whofe
copulative defires failed on the approach of a female.
Two or three furious attempts at felf-deftruCtion induced
the writer to adopt bleeding ; and for the bad ftate of the
bilious fecretion he was obliged to prefcribe calomel. The
fuccefs of the depletory plan caufed it to be continued
frequently; and, the calomel being perfiited in, the
mouth became affeCted with violent ptyalifm. After
this, the patient returned to his profefllon (the law)
with renewed health and fpirits, and has never fince
been afflicted with this malady. The above cafe is nar¬
rated as a curious one ; but the practice is by no means
held out to general example.

When this difeafe is merely local, it probably is in¬
flammation of the epididymis. Counter-irritation by blit¬
ters to the perineum, with occafional bleeding, generally
cure it.

2. Spermorrhoea entonica : involuntary emiflion of
proper fernen, with erection ; moftly from indulgence of
libidinous ideas.

This fpecies is not worthy of particular confideration 5
it feems rather an effort of nature to relieve glandular ful-
nefs than a difeafe, and is not of frequent occurrence or
of dangerous confequence. Indeed a famous phyfiologiit
has afierted that it is a perfectly natural and falutaty
procefs.

Genus V. GalaSlia, [from yu'hx, milk.] Morbid flow
or deficiency of milk. Five fpecies.

1. GalaCtia anticipans: efflux of milk during preg¬
nancy. A pint and a half has fometimes been poured
forth daily as early as the fifth month. Sauv. ii. p. 412.
See alfo Timaeus Caf. p. 220.

2. GalaCtia impotens : inability to fuckle upon child¬
birth. Two varieties.

a. Atonica; from want of fecretion.

(3. Organica; from imperfeCt nipple, or other organic
defeat.

3. GalaCtia

330 P A T H O

3. Gala&ia depravata ; efflux of a dilute or vitiated
milk. Two varieties.

a. Serofa ; weakened by too large a proportion of ferum.

(3. Complicata ; deteriorated by intermixture with fome
foreign material.

See Ephemer. Nat. Curiof. in which we have examples
of a flow of black, green, and yellow, milk. Probably in
inoft inftances difcoloured by an union with effufed blood.
Occafionally the quality betrays its fource. Of the na¬
ture of beer, or of wine. See Eph. Nat. Cur. Dec. i.
ann. iv..

4. Galadlia erroris : transferred to, and difcharged or
accumulated at, remote organs, often under a different
form., Here we have eight varieties.

a,. Transferred to the fauces ; and difcharged in the
form of a ptyalifm. Puzos. Ephem. Nat. Curiof.

(3. Difchafged from the general furrace of the mammae
iii the form offweat. Idem.

y. Difcharged from the navel. Sauvages.

5. Difcharged from the kidneys in the form of urine.
Jouni. de Med. 1758.

s Difcharged from the eyes in the form of a milky
epiphora. Sauvages.

£. Difcharged from the thigh on fcarification. Weikard,
Verm. fchr. i. 47.

y. Difcharged from the veins on bleeding. Sauvages.

6. Difcharged from the vagina. Journ. des Sgavuns, 1684.
Pctullini Obf. cent. i.

Like the menftrual flux, there is fcarcely an organ to
which it has not been transferred. “ The blood during
the time of fuckling is often loaded with milk, and
evinces a milky appearance; as are alfo feveral of the
fluids fecreted from the blood ; and hence probably many
of the above peculiarities.” Good’s Nofology, p. 387.

5. Galadfia virorum : fecreted in males, and difcharged
from the proper emunflory. See Colledlio Acad. iii. p. 63.

“ A milky ferum often diftils from the nipples of new¬
born babes of both fexes : but various authors, as Scholtz,
P. Borelli, Lauremberg, have given cafes of genuine
milk difcharged in like manner by adult males ; occafion¬
ally continuing for a long time; and in fome inftances
enabling them to perform the office of nurfes.” Good ut
iiupra.

Order II. Orgastica, [from orgafm.~\ Difeafes afteflr-
ing the Orgafm. Organic or conftitutional infirmity, dif-
ordering the power or the defire of procreating. This
order contains fix genera. ✓

Genus I. Chlorofis, [from green.] Green Sick-

nefs. Generic characters — Pale lurid complexion ; lan¬
guor ; liftleffnefs ; depraved appetite and digeftion ; mif-
menftruation.

1. Chlorofis plethorica: habit plethoric; pain in the
head, back, or loins; frequent palpitations at the heart ;
flulhes in the face ; pulfe full, tenfe, and frequent.

The orientalifts, and efpecially the Perfians, make a
male variety of this fpecies, which they call bimariy
kodek, or morbus puerorum , and is defigned to include
the affections which often peculiarly mark the ftage of
puberty.

2. Chlorofis inops : habit debilitated ; great inactivity
and love of indulgence ; dyfpncea on moving; low-er
limbs cold and edematous, efpecially at night ; pulfe
quick and feeble.

Both thefe fpecies of Chlorofis have already received
due notice. The former under retention of the menfes ;
the latter under Limofis dyfpepfia, p. 139.

Genus II. J’ra'otia, [from wpat, premature.] Premature
development of fexual organization or power. Two fpe¬
cies, of courfe.

1. Prceotia mafculina : development of fexual precocity
in males. See Journ. des S^avans, 1688. Lefke Auf.
Abhandl. Band. ii. p. 354. Various cafes, and particu¬
larly that of Philip Haworth in his fecond year, in the Me-

L O G Y.

dico-Chir. Tranf. vol. i. p. 276. A boy has been for fome
time paft (hown in the neighbourhood of Leicefter-fquare,
who is a furprifing example of Prceotia. At fix months old
figns of puberty appeared, and at three years of age (when
the writer faw him) the parts had attained both in mag¬
nitude and in external appearance the form of manhood.

2. Prceotia feminina : development of fexual precocity
in females.

Cafes. — Menftruation in infancy common. See Pfou-
quet. — Pregnancy at nine years of age. Ephem. Nat. Cur-.
Dec. iii. ann. ii. obf. 172. — See a fecond cafe at the fame
age; Schmid. E61. Helvet. iv. 167. and again, in Germany,
G. E. von Haller, in Blumenbach Bibl. i. 558. — See alfo
Eccyefis ovaria, Old. iii. Gen. ii. of the prefent clafs,
Dr. Baillie’s cafe. — Two cafes are given in the Medico-
Chir. Tranf. vol. ii. 115, by Dr. Wall ; and vol.iv. 204,
by Mr. Aftley Cooper. See, for other inftances, Haller's
Elem. Phyf. lib. xxviii. fed. iii. Eundman, Rar. Art &
Nat. p. 823, & c. &c.

Genus III. Lagnefis, [from lafcivious.] Inor¬

dinate defire of fexual commerce, with organic turgei-
cenceand erection. (Nymphomania, Satiriafis, Saice. et
Aucl. recent .) Two fpecies.

1. Lagnefis falacitas, falacity : appetency capable of
reftraint ; excitation chiefly confined to the fexual fyftem.
Four varieties.

a,. S. pubertatis, of puberty. Excefs of ftimulus pro¬
duced by the feafon of adolefcence.

S. fenilium, of old age. From local irritation, pro¬
duced by debility, or topical malady ; as difeafed ovaries ;
calculus in the bladder or kidneys ; lencorrheea ; or in¬
flammation of the womb, or neck of the bladder.

See a Angular cafe by Mr. Norris in the Tranf. of the
Medical Society, vol. i. produced by a blow received a
few months before near the proftate gland, followed by a
fmall, but nearly-indolent, tumour on the part aftedfed.
The patient was a married man of fixty-feven ; and du¬
ring the violence of the erethifmus, from local irritation,
which had continued for two months, was reduced to a
ftate of the moft wretched and fqualid emaciation. The
following are Mr. Norris’s words: “Nunquam memini,
inquit asgrotus, me in venerem propenfiorem fuifle, ne-
dum infana et infatiabili libidine permotum, ante hos
duos menfes, quando mediro hoc et teterrimo correptum
effe morbo fenfi ; cujus vis tanta eft et tarn effrsenata, ut
expleri nequeat; et ad coitum cum uxore me fingula
no6te, quindecies faltem, imo vicies nonnunquam, im-
pellat. Hie verocutn sgrotantem meum priapifmo labo-
rantem fe fallere augurabar, et fortalFe, nulla feminis jac-
tura in venerem ruere, paulo curiofius id ab illo quaefivi.
Affirmat autem fe vix in le£Io decumbentem corpus uxo-
ris contingere, cum tanquam ceftro percitus, in repetitam
venerem properat, neque unquam nifi pleno coitu res pe-
ragitur: feminis quidem emiffio potius angere quam vo-
luptatis afficere vifa eft.” The wife, a matronly woman
of great modefty, was herfelf hereby rendered extremely
ill from local inflammation. By fupporting the fyftem
with tonics, and bringing the tumour to fuppuration, the
difeafe was effedlually cured.

y. S. plethorica, from plethora, or entonic affion ; efpe¬
cially in a fanguine temperament.

S. S. ad affuetudine; from habit or immoderate indul¬
gence. The collectors of medical curiofities give vari¬
ous cafes of divorce obtained againft a hulband on ac¬
count of ungovernable falacity. See Eph. Nat. Cur. Dec.
ii. ann. ii. obf. 121. Plater Obf. lib. i. p. 257. Riedlin.
Lin. Med. 1697. Timams, 52.

2. Lagnefis furor: appetency unbridled, and breaking
the bounds of modeft demeanour and converfation ; mor¬
bid agitation of body and mind. Two varieties, of courfe.

«. Mafculinus; in males. Pollutiones centum per
diem. Bartholin JZpiJl. iii. p. 145.

|3. Fsemininus, in females. (Nymphomania furibunda.
Furor uterinus, Audi. Var.)

The

33 i

PATHOLOGY.

The fymptoms of this dreadful difeafe are too apparent
to require us to enter into its difgufting hiftory. From
the flight lafcivious manifeftations of leering and fighing,
the female ultimately paries to a Hate of the mod diftref-
ling and fhocking intemperance of voice and manner, fo
much fo, indeed, as to lofe all modefty, to expofe the
naked body, and plainly folicit from ftrangers the aft of
copulation. Nothing that we are acquainted with has
been done for the cure of this malady ; but every circum-
ftance of difleftion tends to lliow, that it is the effeift of
a morbid fecretion on the vaginal nerves. We fhould
therefore ufe every means to change the aftion of thefe
fecernents. With this view, injeftions of belladonna and
the falivation of the fyftem with mercury, hold out fome
profpeCt of relief. Thofe to whom this fubjeft is inte-
refting, will find much information, delivered in a very
florid ftyle, in Dr. S. Wilmot’s tranflation of Bienville’s
work on Furor Uterinus. In this treatife the fuperace-
tate of lead in the ufual dofesis ftrongly recommended.

Genus IV. Agenefia , [from «, priv. and to be¬

get.] Impotence, or male fterility. (Anaphrodifia, Suuv.
and Cull.) Three fpecies are noted.

x. Agenefia impotentia : imperfection or abolition of
generative power. Two varieties.

ex. I. atonica ; from imbecility or want of tone. Chief¬
ly produced by excefs of indulgence ; long-continued
gleet ; or paralytic afteftion of the generative organs.

13. 1. organica ; from morbid organization, natural or
accidental; as amputated, injured, or enormous, penis;
teftes impaired or deftitute.

Albinus gives a cafe of divorce obtained againft a huf-
hand from inability to enter the vagina, ob penem enormem.
Plater relates another from a fimilar caufe.

2. Agenefia dys-fpermia : imperfeCt emifiion of the fe-
minal fluid. (Dyfpermatifmus, Suuv. and Cullen.) Six
varieties.

a.. D. entonica; from fuper-ereftion, or priapifm.

(3. D. epileptica ; from incurfion of an epileptic fpafm
produced by fexual excitement during the intercourfe.

y. D.anticipans ; difcharge ejected haftily, prematurely,
and without due adjuftment.

S'. D. ignavis; difcharge unduly retarded from hebe¬
tude of the genital organs.

s . D. refluens ; the difcharge thrown back into the ve-
ficulae feminales or the bladder before it reaches the ex¬
tremity of the penis. — Semen retrogradum in veficam ex
auguftatione urethras. Petit Mem. de l’Acad. de Chirur-
gie, tom. i. p. 434. See a curious cafe by Mr. Home in
the Phil. Tranf. 1795.

£. D. organica; the difcharge obftru&ed by mechani¬
cal preffure ; as that of ftriCture or hardened mucus in
the urethra; indurations in the corpora cavernofa } or a
prepuce nearly imperforate. This is, of courfe, the only
variety capable of cure. The indications for this pur-
pofe are obvious enough.

3. Agenefia incongrua, doubtful impotence: the fe-
rninal fluid inaccordant, in its conftituent principles,
with the conftitutional demand of the particular female.

Genus V. Aphoria , [of ci, priv. and <ptp a, to bear.] Bar-
rennefs, or female fterility ; i. e. inability to conceive off-
fpring. Five fpecies.

1. Aphoria impotens : imperfection orabolition of con-
ceptive power. Of two kinds, or varieties.

ex.. Atonica ; from imbecility or want of tone, as in the
preceding genus, fp. 1.

(3. Organica ; from organic defeCt, whether natural or
accidental, as imperforate vagina, defective fimbriae, or
ovaria; want of ova, See.

An imperforate vagina does not always preclude con¬
ception. It has taken place where the vagina itfelf has
been fo narrow as not to admit the penis. Ephem. Nat.
Cur. Dee. iii. ann. vii. viii. obf. 83. — Where, with the
fame impediment, a rigid and unbroken hymen has of-

Vol. XIX. No. 1307.

fered an additional obftacle. Hijl. de I’Acad. de Paris,
1748. An imperforate hymen does, however, in the ma¬
jority of cafes, preclude conception. For the mode of
perforating 'this membrane, fee Surgery.

a. Aphoria paramenica, barrennefs from mif-menftrua-
tion, Three varieties.

a. ObftruCtionis ; produced by menoftation, or reten¬
tion of the catamenia.

(3. Difficilis ; produced by laborious fecretion.

y. Superfluitatis ; produced by profufe difcharge.

The means before laid down for the treatment of ob-
ftruCted, painful, or profufe, menftruation, muft of courfe
be ufed when we with to remove barrennefs produced by
thefe maladies.

3. Aphoria impercita ; barrennefs from perfonal aver-
fion or want of appetency.

4. Aphoria incongrua : the conceptive power irrefpon-
dent to the conftituent principles of the feminal fluid re¬
ceived ; as in the preceding genus, fp. 3.

5. Aphoria polypofa : the cavity of the uterus or va¬
gina, or both, fo rilled and obftru&ed by a polypous ex-
crefcence as to preclude the action of the feminal fluid.
See Ba'illie’s Morb. Anat. Fafc. ix. pi. 4. See alfo the
next genus, fp. 5.

Genus VI. (Edoptcfis , [from c/aSoiov, the genitals, and
wWtj, fall.] Protrufion of one or more of the genital or¬
gans, or of excrefcences iffuing from them, into the ge¬
nital paflage ; impairing or obftrufting its courfe. (Hyf-
teroptofis, Sauv. Vog.Sug.) Five fpecies.

1. Gvdoptofis uteri, protrufion of the uterus into the
vagina. (Prolapfus uteri. Procidentia uteri, Audi. Var.)
Three varieties.

ex,. Simplex ; the uterus retaining its proper pofture
and figure. Different names are frequently given to dif¬
ferent degrees of this variety. If the defeent be only to
the middle of the vagina, it is called relaxutio uteri; if
to the labiss, procidentia; if lower than the labiae, pro-
lapfus.

This diflocation of the uterus may take place from tw'o
caufes. The firft, relaxation of the broad and round li¬
gaments of the womb; the fecond, relaxation of the
mufcular coat of the vagina. Thefe two caufes are com¬
monly united. Whatever debilitates the body generally,
or more particularly the vaginal ftruCture, may caufe re¬
laxation of the vagina. Hence, among general difeafes,
we may reckon fevere lnemorrhages, and long-continued
dyfpeptic ailments ; and, among particular ones, leucor-
rhcea and exceflive vomiting. It is pretty obvious, how¬
ever, that relaxation of the vagina would not be fufficient
to bring on procidentia uteri, except in the moft trifling
degree, unlefs the ligamentous connexions of the uterus
were alfo weakened. Now, as to the caufes of this latter
affeftion, it feems, when we confider how little the liga¬
ments feem to fuffer in-general debility of the conftitution,
that conftitutional malady cannot very fuddenly or gene¬
rally induce it. It is to mechanical injury, therefore, that
procidentia is commonly traceable. Thus blows may
lbmetimes bringit on : more generally, how'ever, it follows
parturition, when the ligaments, in aftretched and wea¬
kened condition, are prevented from recovering their na¬
tural dimenfions in confequence of the imprudent prac¬
tice of rifing from bed early after confinement ; a practice
the more prejudicial, not only becaufe at the period in
queftion the uterus is more loofely conne<5fed and of
much greater weight than ufual, but becaufe the vagina
is more relaxed, and confequently offers lefs refinance to
the defeent of this vifeus.

In the beginning of this difeafe, the falling of the
womb is often very flight. The natural projection of the
cervix uteri into the vagina is about one inch; the dif-
tance between the os externum and os uteri is about
four inches ; and, W'hen the os uteri has approached but
one inch lower, we meet with very troubiefome fymp¬
toms. Among the earlieft of thefe is a pain in the back,
4 Q a fymptom

PATHOLOGY.

332

a fymptom which often continues a long time without any
other. In more advanced dages, this pain is defcribed
as of a hearing-down or dragging kind, afenfation as of a
weight dropping into the top of the vagina ; pain in the
groins extending towards the labia is alfo felt, with a
tranfparent vaginal difcharge, and a fenfation of fulnefs in
all the parts of generation. Strangury likewife is occafion-
ally prefent; and a reparation of the bones of the pelvis
lias been met with by Mr. Clarke in one cafe. The fym-
patliy between the uterus and domach alfo gives rile to
much abdominal irritation. Anorexia, borborygmus, low-
nefs of 1'pirits, and languor, are very remarkable. The
bowels are irregular in their aCiion ; and this date of dif-
order, re-aCting on the uterine fecernents, fo far impairs
their powers, that they admit red blood, and hemorrhage
fometimes takes place. Hiccough alfo fometimes attends
this malady.

As mod of the above-mentioned fymptcms may be
fnnulated by other maladies, it is indifpeniably neceffary,
when procidentia uteri is fufpe&ed, that we fliould make
a manual examination. As the uterus goes up to its na¬
tural dtuation, in early cafes, when the patient lies down,
it is obvious that the only podure in which we can place
her, to gain any information from examination, is the
ereCt one. We need fcarcely advert to the delicacy of
touch which even in thefe circurndances will be required
on the part of the practitioner ; a taCtus eruditus only to
be learnt, however, by very accurate information con¬
cerning the druCture of the parts, and dill more by mid¬
wifery practice. When the cervix uteri has fallen down
as low as the external labia, it often reds on the perine¬
um, and the difeafe remains dationary. In making this
defcent however, and dill more as the uterus begins to
form an external tumour, the dragging of this organ on
the peritoneum exerts a very injurious induence on the
abdominal vifcera; and from the fame caufe chronic and
fometimes acute inflammation, ending in adhefion, has
been known to attend this difeafe.

Befides impairing the functions, it alfo very materially
alters the druCture, of the inteflines and of the bladder:
the reCtum, indead of taking the fweep of the facrum,
fird dips down into the tumour, and afterwards afcends
into the pelvis; the fallopian tubes and ovaria are dragged
down with the uterus, as are alfo the fmall intedines and
omentum ; the former of which fill up part of the tu¬
mour when it becomes external to the body. Under the
fame circurndances, the bladder, falling into the tumour,
drags down the meatus urinarius, and fo far alters the
direction of this paflage, that, in order to introduce a
catheter, it will be neceffary to hold the indrurnent almod
horizontally. Months and even years often elapfe whild
the uterus is making its defcent. While the procidentia
is internal, a very profufe mucous difcharge fometimes
conies from the vagina. When this happens, the patient
luffers great debility. When, however, the uterus has
fallen out of the body, the mucous membrane of the
vagina lofes its fecreting difpofition, and from expofure
to air, and from the dretching it differs from the tumour,
takes on the appearance of external fkin, lofes its rugte
and its nervous irritability, fenfible indeed to preffure,
but not to fexual defire. After a time, the prolapfed part,
efpecially the cervix uteri, becomes affeCted with fpots or
patches of ulceration. Thefe, however, are not deep,
and feldom of an unhealthy character: they readily heal
on the replacement of the tumour in its natural fitua-
tion.

Other tumours are met with in the fame Situation as
prolapfus uteri; but the latter difeafe is didinguifhed
from all others by the horizontal opening of the cervix
uteri; a mark which, contraded with the ■perpendicular
opening of the urethra in the male fubjeCt, has ferved to
detect the impodure of thofe who, having a prolapfus
uteri unufually oblong, have endeavoured to impofe on
credulity by the affumption of an hermaphrodite forma¬
tion.

In the treatment of this difeafe, we have two indica¬
tions to perforin. The fird is, to get the uterus back
into its natural fituation ; and thefecond to keep it there.
In early cafes, the fird indication is effected by merely
putting the patient in a recumbent podtion, this being
attended with a remidion of all painful fymptoms. In
the early dages of this difeafe, all therefore that will be
neceffary for the fird indication will be to keep the pa¬
tient generally lying on a mattrefs (in the day-time on
a fofa), and obviating all mufcular movements likely to
prefs on the uterus; as coughing or draining at doo!.
The indications of drengther.ing the relaxed date of the
vagina embrace a wider field. It is obvious to every one,
that, if the mufcular fyltem be in a weak date generally,
it is quite impofllble to render any one mufcle drong by
local applications. Now, as it is the mufcular druCture
of the vagina which we here wifh to operate upon, we
mud attend to the date of the mufcular fydem through¬
out the body. The diet mud be regulated in fuch a man¬
ner as to have the mod perfect adimilation : warm drinks,
as tea, &c. forbidden ; the bowels kept open by the
rnilded laxatives, and the cold bath ufed regularly. We
need not dwell upon the concomitant diforders which
will prevent the ufe of the cold bath ; thefe having been
fo often adverted to. We have before dated as a genera!
rule, that this meafure is never to be perfided in unlefs
followed by re-aCtion. A fhower-bath impregnated with
fait is ufeful forperfons of good damina, when the Ample
bath lofes fome of its influence. Medicines of the tonic
kind, as improving the digedive powers of the domach,
are alfo recommended ; as bark, gentian, See. It is de-
iirable to join with thefe, medicines which have a power
of adringing the veffels of the mucous membranes. We
are rather fceptical as to the control of any particular
medicine over local diforders, except when applied direCt-
ly to the druCture affeCted ; but it is dated on refpeCtable
authority, that certain medicines taken into the domach
do relieve relaxation of the vagina, a circumdance refer¬
able, of courfe, to the known fympathy which exids
between the domach and the mucous expanfion in gene¬
ral. Cinchona and fulphuric acid is a formula much em¬
ployed. Inperfons much debilitated it will not be found
late to ufe the cold bath fo frequently, or to give fuch
powerful adringents as we have recommended above;
but of courfe all rules of this kind mud vary with parti¬
cular circurndances.

In early dages of procidentia, the fponging or dafiiing
of cold fprmg or fait water on the loins and pudenda,
and the injection of adringent lotions, are the local
means to be chiefly relied on. The adringent applica¬
tions are to be applied to the interior of the vagina by
means of a fyringe, to the condruCtion of which it be¬
hoves the practitioner to pay fome attention. The pew¬
ter indruments in common ufe are many of them next to
ufelefs; it is indifpenfible that the pipe prefent a fuffi-
cient curve to allow to life the indrurnent with eafe ; that
the pidon is perfectly adapted to the barrel, and moves
with celerity; and that the holes at the extremity of the
pipe are fmall, and dtuated at the point, and not laterally.
The adringents bed recommended are, a mixture of dilu¬
tions of alum and fulphate of zinc, or one or both of
thefe falts difi'olved in a decoCtion of oak-bark. Thefe
applications fliould be thrown up twice or three times
a-day.

When procidentia uteri is fo far advanced as to render
the attempt at reduction by the above-mentioned mea-
fures ufelefs, we mud endeavour to give mechanical fup-
port to the difplaced uterus. For this purpofe an indru-
ment called a pefj'dry is ufed. It is various in form and
fubdance. The form mud vary with the dage or peculi¬
arity of the complaint. The mod proper fubdance at pre¬
fent ufed for the formation of a pedary is box-wood. The
circular pedary is adapted to thofe cafes in which the dif¬
eafe has not made great progrefs, and where the relaxa¬
tion of the vagina is not confiderable. Its adaptation to

the

PATHOLOGY.

the exaft fize of the vagina is a matter of great moment.
We have before Ihown, that the contraction of the vagi¬
na is one of the means by which the difeafe is cured. It
is therefore obvious, that any fubdance which would pre¬
vent this contraction, or would in the flighted: degree di¬
late the canal, mud be improper. At the fame time the
peflary mud be large enough to Jill the canal, or it will
Aide out of it. Dr. Clarke dates, that it is feldom proper
to ufe a peflary of more than two inches and a half in
diameter, on account of the preffure it would exert on
the meatus urinarius and reftum. When, therefore, the
calibre of the vagina is larger than thefe proportions, it is
proper to ufe the oval peflary, which, as its long diameter
reds tranfverfely in the vagina, may receive fupport from
the fides of this canal, without prefling on the urinary
paffage before, or the reftum behind. Should the vagi¬
na be fo dilated that a fmaller one cannot be retained,
we may ufe an oval peflary nearly as large as four inches
in its long diameter. The chief objection to this inltru-
ment is, that it is didurbed by fexual intercourfe. This
objection is of themore force, becaufe pregnancy is a de-
flderatum in procidentia uteri, inaftnuch as the afcent
of the womb during that date cures the difeafe.

The following are the directions for pafling thefe in-
flruments, given by Mr. Clarke in his Obfervations on
the Difeafes of Females. The woman fliould be placed
upon her left fide, and clofe to the edge of the bed ; and
her knees fliould be drawn up towards the abdomen.
The praftitioner is then (having previoufly examined the
fize of the vagina) to deleft a peflary, according to his
judgment, of a proper fize. This indrument is then to
be covered with fome fimple unftuous matter; and, if
its form be circular, it is to be placed between the labia,
fo that one edge will be turned towards the os pubis and
the other to the reftum : it is then to be moved in a cir¬
cular direftion on its own axis, prefling it at the fame
time towards the perineum, till it has fairly entered the
vagina. As the indrument pafles the edge of the exter¬
nal parts, fome little uneafinefs is always felt by the wo¬
man ; but this ceafes asfoon as it has reached the vagina,
to the upper part of which it is to be carried, and it is to
be fo placed that the uterus may red upon one of the
broad furfaces of it. The indrument is now to be left
in the vagina, and a fyringe full of fome cold adringent
injeftion fliould be thrown into the parts, to give tone
and contraftion to the dilated os externum, as, in cafes
where the vagina is very much relaxed, it may make a
fmaller peflary anfwerthe purpofe of fupport than would
be required if no fuch means were reforted to. What¬
ever may be the ihape of the peflary introduced, the wo¬
man fliould continue for fome minutes in the recumbent
podure.

An oval peflary requires great care in the mode of in-
troduftion, and is either a very good or a very bad indru¬
ment, according asfft is well or ill applied. In the choice
of it, the fize of the vagina is to be firft compared with
that of the indrument, the extremities of which fliould
not be too acutely pointed, led they fliould injure the
parts. The indrument being covered with fome unftuous
fubdance, one end of it is to be placed between the la¬
bia, with the fliort diameter ru lining from before to be¬
hind ; and in this direftion it is to be carried up into
the vagina. The praftitioner is then to infert the
point of his fore-finger into the opening in the centre of
the indrument, and to place it acrofs the vagina fo that
the extremities may be turned towards the fpinous pro-
cefles of the os ifchium : if the direftion of the opening
in the peflary is made to correfpond with that of the long
diameter itfelf, this will be eafily accompliflied. The
peflary is now to be paffed as high into the vagina as it
can be without giving pain, and to be left there.

Procidentia uteri iometimes occurs in women whofe
perinaeum has been lacerated to a great extent in labour ;
in fuch a cafe, neither the circular nor the oval peflary can

333

be retained; but thefacrofciatic ligaments and the os coc-
cygis will fuflicientlycontraft the lower aperture of the pel¬
vis toenable aglobular peflary to be retained. Thispeffary,
prefling equally in all direftions, is very conveniently
borne ; and it may be ufed for widows who have lod the
catamenia with great advantage. The fize of the indru¬
ment being adapted to the capacity of the parts, its fur-
face is to be covered with unftuous matter as before, and
it is to be placed between the labia ; by a gentle preffure
it is to be carried into the vagina, giving a degree of ro¬
tatory motion to it as it pafles along, which greatly faci¬
litates the introduction.

In thofe cafes in which the tumour protrudes out of
the body, it is obvious that this mud be reduced before
the peflary can be made ufe of. Previous to attempting
the reduction of a completely-prolapfed womb, we mud
enquire whether at any period of the difeafe inflammatory
l'ymptoms have been manifed; as for infiance, lading and
acute pain, with third, heat, ftnall pulfe, abdominal ten-
dernefs, vomiting, &c. becaufe, if thefe fymptoms have
been prefent, there will be much reafon to fear that the
peritoneum has contrafted adhelions which it would en¬
danger the life of the patient to break through by any
forcible attempt at reduftion.

When tumours on or above the uterus are the caufe of
this difplacement, it will feldom be advifable to reduce
the womb. In faft, all prolapfes in which the effort at
reduftion is attended with much pain, fliould be aban¬
doned. When it is determined, however, to reduce a
prolapfus uteri, the bladder and reftum mud be emptied
of their contents : the patient mud then be laid on a bed
with her hips much raifed, that the abdominal vifcera,
which are dragged down into the cavity of the pelvis,
may not oppofe, by their weight, the return of the womb.
The patient being now direfted not to drain, or in any
way to aft with her abdominal mufcles, the praftitioner
is to apply his finger and thumb to the lower part of the tu¬
mour, where the os uteri is fituated ; and, by a gentle pref¬
fure, this is to be carried up into the centre of the tu¬
mour itfelf. This done, the fame preffure is to be conti¬
nued, and the parts are to be returned into their proper
place in the pelvis. A peflary is then to be introduced
into the vagina ; and the patient fnould continue to lie
upon an inclined plane, with the hips elevated, for feve-
ral hours. In almod all cafes in which the degree of the
difeafe is confiderable, every peflary which can be intro¬
duced will be forced away by the (lighted efforts of the
woman: even the globular peflary (which is the bed)
will not be retained, neither can it be kept in the vagina
by any common bandage. But by the following contri¬
vance the globular peflary may be kept in the vagina.
In the firfl place, a peflary is to be chofen of the fize
which the cafe requires, and a fmall flip of brafs is to be
attached to it by its two ends, leaving a fpace between
the indrument and the centre of this piece of brafs : a
belt of leather, long enough to go round the patient’s
body, is alfo to be prepared ; to the centre of which, be¬
hind, a brafs wire, as thick as a common quill, is to be
attached by a fcrew. This wire is now to be properly
bent ; and, the peflary being introduced into the vagina,
the wire is to be paffed between the peflary and the piece
of brafs attached to it ; and, being brought up between
the thighs, it is to be attached to the fore part of the cir¬
cular flrap. The reduced parts are by this means fup-
ported by a peflary, and this is kept in its place by the
unyielding piece of metal.

When a feparation of the ligaments of the pelvic bones
has taken place in conjunftion with a prolapfed uterus,
the patient mud wear, in addition to the meafures before
noticed, a broad circular belt paffed pretty firmly round
the hips : this of courfe anfwers the fame purpofe as an
artificial ligament, and moreover facilitates the re-union
of the lacerated or lengthened flrifture. Strangury re¬
quires the ufual treatment.

(3. Retroverfa,

334

PATHOLOGY.

(3. Retroverfa, retroverted womb : the uterus difplaced,
the lower part becoming the upper. Moftly limited to a
Hate of pregnancy.

y. Inverfa, inverted womb: the uterus difplaced, and
turned infide out.

This complaint confifts, as the name imports, in an
inverfion of the cavity of the uterus, fo that the fundus
comes through the os uteri ; confequently that part
which formerly was the infide of a cavity is converted
into the outfide of a tumour, either contained in the va-
ina or projecting from it. In the prefent improved
ate of the art of midwifery, this difeafe is very feldom
met with, becaufe it is generally a confequence of vio¬
lently pulling the funis for the purpofe of extracting the
placenta. The weight of a large polypus has been faid to
have inverted the womb; but this is a very rare cafe.

As inverfion of the uterus is (ftriCtly fpeaking) to be
confidered as one of the immediate confequences of de¬
livery, (fee Parturition;) no admifiion would have
been given to it in this article, if it were not that it is
occafionally met with in the chronical ftate attended by
a mucous difcharge. It may be necefiary to remind the
reader, that the removal of the placenta (if adherent),
and the immediate replacement of the uterus, are to be
effeCfed as foon as pofiible when this accident has occurred
during labour. The fymptoms of the chronic lfate of
inveriio uteri referable thofe of procidentia uteri ; and,
an examination beingmade, a tumouris found either in the
vagina, or hangingoutof theexternal parts. Such atumour
may be millaken forpolypus; but, in the latter difeafe, the
os uteri encircles the neck of the tumour; in inverfion of
the uterus, the os uteri forms a part of the tumour itfelf.
Moreover, the inverted uterus is fenfible : polypi of the
uterus, on the contrary, are void of feeling. The tu¬
mour may be miftaken for procidentia of the uterus ; but
the difference may be detected by obferving that there is
no opening at its lower part, and by its furface fecreting
the catamenia at the regular periods. It is diftinguiflied
from procidentia of the bladder by being much more re¬
filling, by its fize continuing always the fame, and by the
impoflibility of finding the uterus behind it. Whilftthe
inverted uterus remains in the vagina, the difcharge (ex¬
cepting at the period of menftruation) will be of a mu¬
cous kind ; but, if the uterus falls lower, fo as to pro¬
trude beyond the external parts, the expofure of that
furface, which in a natural ftate lined the cavity, to air,
as well as to occafional injuries, may induce inflammation
and ulceration over a part or the whole of its furface ; and
the mucous difcharge may be changed to one of a puru¬
lent kind, fo conliderable in quantity as to debilitate the
conftitution, and to caufe all the common fymptoms of
weaknefs. If there are any ulcerations upon the furface
of the upper part of the tumour formed by the inverfion
of the vagina, they will be circumfcribed, and rarely cover
its whole furface. In a cafe where the uterus has been
long inverted, and lies in the vagina (the latter cavity
having undergone no change except from diftention), it
will not be advifable to recommend any other remedy
than the injeCtion of fome very mild aftringent fluid, three
or four times a-day, into the vagina. Some rellraint will
be thus placed upon the quantity of the difcharge, and
the parts will be kept clean by it. There is an extreme
degree of difeafe where the uterus (previoufly inverted)
falls out of the body, drawing down with it the vagina,
and where the woman is becoming every day more and
more weak from the quantity of the difcharge. Cafes of
this kind can receive very little benefit from external ap¬
plication, and indeed are only to be treated by palliative
medicines, as.narcotics and anodyne applications, unlefs
indeed the patient ftiould have palled the menllruating
age ; in which cafe, feeing that her comfort is deftroyed
by the difeafe, and that the profufenefs of the difcharge
perhaps threatens'her with death from the debility which
it produces, it may be advifable to recommend the per¬
formance of an operation, which has in many cafes been

attended with fuccefs, even in aged perfons. This ope¬
ration is the removal of the inverted uterus itfelf. See
Surgery.

2. CEdoptofis vaginae: protrufion of the upper part of
the vagina into the lower. This, like the defcent of the
uterus, may, according to the degree of the difeafe, be
relaxation, procidence, prolapfe, or complete inverfion.

The moll common caufe of this difeafe is an habitually
collive ftate of the reClum, in confequence of falfe deli¬
cacy poltponing the period of natural evacuation. Thus
the reClum acquires fo inordinate a capacity as to prefs in
a very great meafure on the furrounding parts. As this
preflure cannot difplace the bones of the facrum, its ef¬
fects are exerted on the part where there is leail refinance;
viz. the back of the vagina ; and hence an aCtual pouch is
formed at this part, which of courfe drives the membrane
out of its natural fite. The falling-down of cylts of dif-
eafed ovaries between the reClum and back of the vagina,
operate in the fame manner in producing this difeafe. A
tumour flightly external, a trifling degree of pain in the
back, a flight diminution of the tumour when, the pa¬
tient lies down, with a difcharge of tranfparent mucus
from the vagina, are the fymptoms of the malady. By
the introduction of the finger in ano, the pouch above
defcribed may alfo be felt.

The treatment of the difeafe follows fo obvioufly, that
little need be faid. To evacuate the reClum by fapona-
ceous clyllers, or, if thefe do not fucceed (which isfome-
times the cafe), by the introduction of the finger and a*
fcoop in ano, is the firll thing to be done. The bowels
mull be kept always open by mild cathartics, and a glo¬
bular pefl'ary introduced into the vagina, for the purpofe
of fupporting the vagina and relloring the natural diame¬
ter of the reClum. Cold aftringents fliould be thrown
into the vagina ; and cold bathing, efpecially of the loins,
ufed externally.

3. CEdoptofis veficae, protrufion of the bladder into
the urethra.

This difeafe, which has often been confounded with
procidence of the uterus or the vagina, and confequently
miftreated, confifts of a falling-down of that part of the
bladder which lies pollerior to the entrance of the uri¬
nary palfage. In making this defcent, the bladder carries
the vagina along with it, and, in very bad cafes, the an¬
terior lip of the cervix uteri ; the latter indeed to fuch a
degree, that the os uteri has been found to open direCtly
backwards, and lying in contaCt with the pollerior part
of the vagina. As in procidentia uteri, the bladder may
defcend a little only from its natural fite, or it may form
a large external tumour projecting from the labia. Pro¬
cidentia veficae is attended with a flight degree of pain,
defcribed by the patient as a bearing-down. This is ag¬
gravated by the recumbent pofture : hence the patient
is much afteCted with it during the night, at which time
alfo flie experiences frequent calls to pafs her urine. A
fenfe of tightnefs and pain is alfo referred to the navel;
and both this pain and the bearing-down are increafed by
fulnefs of the bladder and relieved by its emptinefs,
though perhaps the latter is never complete ; for it feems
that the prolapfed bladder lofes its contractile power, and
hence that portion of this vifcera which forms the tu¬
mor generally contains fome water. A mucous difcharge,
fometimes fmall and fometisnes very profufe, attends this
difeafe.

On examination with the finger, a tumor will be found
in the vagina, diftinguiflied from procidentia uteri by the
abfence of the mouth of the uterus, the anterior lip of.
which, as we before faid, is often found ftretched down
with the bladder. It is diftinguiflied from that and from
all other difeafes of the parts in queftion, by the evident
fluctuation of contained fluid, unlefs indeed we except
encyfted tumours, which are diftinguiftiable however by
their uniformity ; for, of courfe, thefe are not lefiened in„
fize by the expulfion of the contents of the bladder, as is
the cafe in procidentia velicse. The difplacement of the

4. bladder

-335

P A T HO LOG Y.

Madder is rarely attended with the gaftric difturbance fo
common and fo feverein procidentia uteri. It is only when
theexpefed ftate of the bladder has induced difeafe of its
ftruffure, that conftitutional difturbance becomes feverely
manif'efted. Relaxation of the vagina and prefl'ure on the
bladder caufe this difeafe; hence it occurs after labour,
and efpecially in thofe women who have borne many
children : hence likewife violent coughing and the lilt¬
ing of heavy weights have frequently brought it on.

Little need be done in the way of conftitutional treat¬
ment. The re&um fhould of courfe be kept empty ; and
moft particular attention fhould be paid to keep the blad¬
der a-s empty as poffible by frequent endeavours on the
part of the patient. Of courfe all coughing and ftraining
mull be prevented. The treatment further than this con-
fills in removing the relaxed condition of the vagina by
aftringent injeftions and the cold bath, and in keeping
the bladder in its place by means of a peflary. This in-
ftrument may be either of the oval or globular form, ac¬
cording as the one or the other gives lead inconvenience.
Whichever is worn fhould be perforated by four holes for
the purpofe of introducing ft lk, by means of which the
inftrument rnay be difplaced when necelfary. Dr. Good
makes two varieties of this difeafe.

cc. Tunicis interiors; the inner membrane being pro¬
truded.

(3. Colli ; the neck of the bladder being protruded.

4.. Oedoptofis complicata : protrufion of different or¬
gans complicated with each other.

a. Utero-veffcalis ; of the uterus dragging the bladder
along with it.

/3. Vagino-veficalis ; protrufton of the vagina dragging
the bladder along with it.

In thefe cafes, the reduflion of the feparate vifeera being
effected, they are to be retained in litu by means of the
peflary.

5. Oedoptofis polypofa : polypous excrefcence in the
courfe of the genital avenue ; foft, cornprefllble, red or
reddifh. Two varieties.

a. P. uteri; bluing with a flender root from the fundus
of the uterus, and more or lels elongating into the vagina.

(3. P. vaginte, polypus of the vagina ; iffuing from the
Tides of the vagina 5 broad and bulbous.

Of thefe two fpecies the former is an infenfible tumour
attached to the uterus by a fmall neck ; various as to its
fize, form, and confiftence ; being fometimes white, at
other times brown ; fometimes hard and tough, at others
foft and eafiiy broken. The foft ftate is the lead; fre¬
quently met with. The fymptoms which attend this dif¬
eafe are a copious mucous or muco-fanguineous difeharge.
Sometimes adual coagula of blood are emitted, which
often corr.efpond with the former polypous ftrudure on
which they have accumulated. . The retention of thefe
coagula fometimes induces putrefaftion, in confequence
of which an highly-offenfive difeharge takes place; to fo
great a degree, in faff, as to fimulate the fetid fmell of
the cavernous exudations from the carcinoma uteri. Pain
in the back and groins, with a fenfe of prefiure and bear¬
ing-down, are met with in this complaint ; all which
fymptoms are proportioned to the fize of the tumour.
Frequent vomiting, the confequence of the ftomach’s
lympathizing in uterine irritatio'11, is common to this dif¬
eafe; and, when the bladder alfo is thus fympathetically
affe&ed, ftrangury is no uncommon occurrence. The
latter diforder, however, as well as retention of fasces in
the reffum, is often brought on by the prefiure of the
enlarged polypus on the refpeflive canals of the urine
and ftools. In protruded cafes, dropfy may accompany
this difeafe. On manual examination, we find a tumour
of little feeling projeding through the os uteri, by which
its neck is fo completely encircled, that we can pafs the
finger round it. This polypus is diftinguifhed from in¬
verted uterus by the hiltory of its commencement, and
by its infenfibility. It might be confounded with the
cauliflower excrelcence, had not the latter an irregula¬
rity of furface, an origin by a broad bafe from the os
Vo L. XIX. No. 1307.

uteri itfelf, inftead of coming through it with a thin pe¬
duncle, and were it not attended by a watery difeharge.
Thefe circumftances are fufficiently apparent to prevent
this miftake. The polypus of the uterus affecls both
fingle and married perfons ; thofe who are cachedic, and
thofe apparently healthy, and who have fuffered no injury
of the womb. The only mode of cure confifts in tying
the neck of the polypus by means of a canula and liga¬
tures, and afterwards extracting the tumour by the fingers
or a pair of forceps ; (for the mode of doing which, fee
Surgery.) The vagina is then to be vvallied with a te¬
pid lotion for the purpofe of keeping the parts clean, and
aftringent lotions thrown up if any remains of the com¬
plaint are apparent.

The polypoid tumour which fprings from the vagina
or from the uterus by a broad bafe, is generally different
in its anatomical characters from true polypus, and is
very difficult of cure. It may be removed by a ligature ;
and, if the parts are kept clean and the ftate of the con-
ftitution (which is oftentimes in fault) amended, the pa¬
tient will experience a long period of relief ; but the tu¬
mour will almoft inevitably return.

Order III. CARrOTiCA, [from xxp7?o<;, fruit.] Diforders
affeding the Impregnation. Irregularity, difficulty, or
danger, produced by parturition.

This order contains four genera ; of which, and their
fpecies, we (hall merely give Dr. Good’s arrangement and
enumeration, as the fubjeds have been fully difeuffed
under the articles Abortion, vol. i. and Parturition,
vol. xviii.

Genus I. Parucyejis, [from rrxpx, bad, and y.v/ia k, im¬
pregnation.] Morbid Pregnancy. Generic characters —
The progrefs of pregnancy difturbed or endangered by
the fupervention of general or local diforder. There are
three fpecies, befides varieties.

1. Paracyefis irritativa : pregnancy exciting diftrefs or
difturbance in other organs or functions than thofe pri¬
marily concerned. Five varieties.

a. Syncopalis ; accompanied with frequent fainting.

3. Dyfpeptica ; accompanied with indigeftion or fick-
nefs.

y. Dyfpnoica ; accompanied with difficult breathing.

<3. Alvina; accompanied with derangement of the al-
vine canal, as coftivenefs, diarrhoea, hemorrhoids, &c.

1. Varicofa ; accompanied with venous dilatations of
the lower extremities.

2. Paracyefis uterina : pregnancy difturbed or endan¬
gered by difeafed affection of the uterus. Four varieties.

a. A. retroverfione 5 the uterus being retroverted. See
CEdoptofis uteri, (3.

3. A. leucorrhcea ; the uterus fecreting, or exciting in
the vagina a fecretion of leu-corrhcea, fo as to produce de¬
bility.

y. Catamenica; the catamenia continuing to recur.

8. Hasmorrhagica ; accompanied with hemorrhage.

Catamenia, unaccompanied with hemorrhage, can
fcarcely be regarded as a difeafe. Many menftruate uni¬
formly for the firft three or four months. of pregnancy.
Some through the whole term. A few have never men-
ftruated at any other time ; of which feme curious cafes
are related by Hagedorn, Hopfengartner, and other
Dutch writers.

3. Paracyefis abortus: premature exclufion of a dead
fetus from the uterus. If the exclufion take place within
fix weeks after conception it is called mifearriage. If be¬
tween fix weeks and ieven months, or the term of pre¬
mature labour, it is called abortion.

Genus II. Parodynia, [from irxpx, bad, and cvJ tv, or
worn mo?, labour-pain.] Morbid Labour. — Generic charac¬
ters — The progrefs of labour difturbed or endangered by
irregularity of fymptoms, prefentation, or Itrudure.
There are feven fpecies.

1. Parodynia atonica, lingering labour: labour pro-
4 R traded

33(5

PATHOLOGY.

trailed by general or local debility. In the Ephemera
Nat. Curiof. is the cafe of a fetus illapfing into the uterus
after its head had been denuded, and it had moaned.

2. Parodynia fympathetica : labour retarded or harafled
by fympathetic derangement of fome remote organ or
function. Three varieties.

ci, Syncopalis; accompanied with fainting.

/3. Convulfiva ; accompanied with convuliions.

y. Pathematica ; accompanied with great terror, ap-
prehenfion, bafhfulnefs, or other emotion of the mind.
See vol. xviii. p. 710.

3. Parodynia implaftica : labour delayed or injured for
want of plalticity, or unkindly dilatation of the foft parts.
Three varieties.

ci. Rigiditatis ; the delay confined to a fimple rigidity
of the uterus or vagina.

13. Haemorrhagica ; accompanied with hemorrhage.

y. Lacerans ; accompanied with laceration of the peri-
nteum, or uterus.

4. Parodynia perverfa, crofs birth: labour impeded by
preternatural prefentation of the fetus, or its membranes.

This fpecies is divided into feven varieties, according
as the prefentation may be that of the face ; of the breech;
of one or both feet; of one or both arms ; of the fhoulder;
prolapfed navel-ftring; or, laftly, prefentation of the pla¬
centa.

5. Amorphica : labour impeded by mif-configuration of
the fetus or of the maternal pelvis. Two varieties.

a. A. fetu ; the fetus deformed by a preternatural mag¬
nitude of head, or fome morbid protuberance.

/3. Pelvica; the maternal pelvis contradled in its dia¬
meter by natural deformity, or fubfequent difeafe or in¬
jury. Not unfrequently produced by an hydropic or en-
cyfted ovarium occupying a pofition between the redlum
and vagina. The deformed pelvis is the moll frequent
and obllinate impediment to parturition ; but it has al¬
ready been amply treated of in vol. xviii. p. 690 & feq.

6. Parodynia pluralis : labour complicated by a plu¬
rality of children.

7. Parodynia fecundaria : difeafed aiSlion or difturb-
ance fucceeding delivery. Four varieties.

ci. Retentiva ; retention of the fecundines.

13. Doloroftt ; violent after-pains.

y. Haemorrhagica ; violent hemorrhage, commonly
called flooding.,

S. Lochialis ; profufe lochia.

Genus III. Eccyefis, [from s k, out of, and *v»ok, im¬
pregnation.] Extra-uterine fetation; i. e. imperfect fe¬
tation produced in fome organ exterior to the uterus.
There are three fpecies.

1. Eccyefis ovaria : iinperfeft fetation occurring in the
right or left ovarium. (Graviditas ovarii, Sauv.) Exam¬
ples are common. See Ab. Vater Diflert. de Grav. appa-
rente, ex tumore ovarii dextri enormii orta, per tres an-
nos cum dimidio durante. Ed. Med. Eff. v. 336. Ed.
PhyJ. Eff. ii. 273. Forrefler, 179B, 379. Ed. Med. Journ.
ii. j8o. "Dr. Baiilie in Phil. Tranf. 1789. Barnes in Tranf.
Medico- chir. iv. 317.

2. Eccyefis tubalis: imperfedl fetation occurring in the
Fallopian tube. (Graviditas tubalis. Sauv.) See Littre,
Mem. de 1’Acad. R. des Sgav. 1702. Cyprian. Diflert.
de Fetu ex Tuba excifo, 1700. Haller, in Boerh. v. 329.
Santorin, Obf. Anat. c. ii. Tranf. Soc. Med. -chir. i. 215.
Seealfo a cafe by Mr. Stanley, in the Tranf. College Phy-
ficians, vol. vi.

3. Eccyefis abdominalis : imperfeft fetation occurring
in the cavity of the abdomen. See Krohn, Fetus extra
uterum hid. Dentfch de graviditate abdominali. Mem.
Med. Soc. Lond. iii. 176. Wrifberg Obferv. Anat. Young,
Medico-chir. Tranf. i. 241. “For want of a regular pai-
1'age opening externally, the fubftance formed often re¬
mains for many years in the extra-uterine nidus. Wal-
ther gives an inftance of twenty-two years; Bayle a cafe
of twenty-fix years; Phil. Tranf. 1677-1678, vol. xii.

The Ephemera of Natural Curiofities, one of forty-fix
years. Cent. x. Obf. 48.”

Genus IV. Pfeudocyefis, [from tto- sv3o, falfe, and xvr, cn;,
impregnation.] Spurious pregnancy. Generic charac¬
ters — Symptoms of pregnancy without impregnation;
chiefly occurring on the ceffation of the catamenia. Two
fpecies.

1. Pfeudocyefis molaris, falfe conception, or mole : the
uterus irritated by a coagulum of blood or other fluid
lodged in its cavity, often afluming a fibrous appearance.
Frequently exhibiting, on being difcharged, hydatids or
other vermicles. See, for examples, Marcellus Dor.atus,
lib. iv. cap. 25. Journ. des Sgavans, pafiim. Ruyfch.
Obf. 28, 29. Evacuated during dancing; Slevoght, Diff.
Fern. mol. labor. Jenae, 1700.”

2. Pfeudocyefis inanis : the uterus void of internal
fubftance, and irritated by fome unknown morbid aflion.

Class VI. ECCRITICA, [from iv.v.ywu, to ftrain off,
drain, or exhauft.] Diseases of the Excernent Func¬
tion.

Order I. Mesotica, [from /xecj-o?, the middle.] Dif-
orders afFefting the Parenchyma. “ Pravity in the quan¬
tity orquality of the intermediate or connecting fubftance
of organs; without inflammation, fever, or other de¬
rangement of the general health.” It is very clear that
this definition of Dr. Good’s by no means applies to all
difeafes of the excernent function of the parenchyma.
Indeed we are much furprifed that the very frequent
connexion between fome of the difeafes and “inflamma¬
tion” and “ fever” Ihould have efcaped any one. This
order contains four genera.

Genus I. Polyfurcia, [from woXvcnzpxoj, flefliy, abound¬
ing in flelh.] Corpulency, or obefity. Generic charac¬
ters — Firm and unwieldy bulkinefs of the body or its
members, from enlargement of natural parts.

Confidering the derivation of the word, we are rather
furprifed that Dr. Good has ufed the term Polyfurcia for
this genus, fince much flelh or mufcle is not a difeafe : it
is when th efat is fuperabundant that inconvenience is felt.

Polyfarcia adipofa ; a Angle fpecies. Bulkinefs from
fuperabundant accumlation of fat. Two varieties.

u. A. generalis ; extending over the body and limbs.
Sennertus mentions a woman, who at thirty-fix years of
age weighed four hundred and eighty pounds avoirdupois;
and a man who weighed fix hundred. Bright of Maldon
weighed fix hundred and fixteen pounds ; and Lambert of
Leicefterconfiderably more. In the N. Sammlung Medic.
Wahrnehm. iii. 370, is the cafe of a man who weighed
eight hundred pounds. — Carried off by a fpontaneous fa-
livation. Epk. Nat. Cur. Dec. iii. ann. v. vi. obf. 65. —
By a fright. Samml. Medicin. Wahrneltmungen , vi. 444.

/3. A. fplanchnica ; confined to the organs or integu¬
ments of the trunk, the limbs retaining their gracile
form.

Fatnefs feems to be owing to an inordinate degree of
power in the aflimilative organs. It has been generally
attributed to over-eating; but this is not borne out by
fails ; neither, when we confiderhow much intemperance
difturbs digeftion, Ihould we expeCt to find this the cafe.
Indeed, in many inftances, fat perfons are remarkably ab-
ftinent in regard to aliment; and it is therefore the ac¬
tive ftateofthe digeftive organs, which, undifturbed by
mental irritation to which thefe kind of people are fo
little fubjeCl, affimilates almoft every portion of food
.they take into the blood, that we mull in a great meafure
look for the caufe of corpulence. We muft confefs how¬
ever, that, even under this hypothefis, we Ihould rather
expeCt to find general plethora than an extraordinary de¬
velopment of adipofe ftriilure. Corpulence is only a dif¬
eafe when, by its preffure on the heart or any of the
vifcera, it difturbs in an unufual degree the breathing,
the circulation, or any other of the functions.

Many plans have been laid down for the reduction of
1 corpulence.

337

PATHOLOGY.

corpulence, but with little fuccefs. The mod: exceflive
and fatiguing exercife has been taken, the moft rigid ab¬
stinence adopted, without any benefit. Thefe meafures
fhould form, however, part of the treatment of molt
cafes; but we believe that a gradual diminution in the
periods of deep, and the regular ufe of dry feeding, the
quantity of fluid being brought down to the fmallelt pof-
fible degree, will do more for the cure of corpulence than
any other meafure. Of courfe, if the fat opprefl'es the
a£tion of the heart, or if plethora be manifeft in combina¬
tion with Polyfarcia, bleeding may be tiled ; but other-
wife the relief it gives feems only temporary.

Genus II. Empkyma, [from eytyvu, to engender, to
produce.] Tumour. Generic characters — Glomeration
in the fubltance of organs from the production of new
and adicititious matter; fenfation dull; growth fluggifh.

The reader has already been referred to the article Tu¬
mour in this work for an account of Phyma. To the
lame article we fltall be obliged to defer the conlideration
of the genus Emphyma, which indeed belongs more par¬
ticularly to Surgery than to Pathology in the prefent ac¬
ceptation of thofe terms.

A complete description of thefe productions has been
long before the public ; viz. Mr. Abernethy’s work on
Tumours, in which all that is known of their treatment
is comprifed ; and indeed Dr. Good’s arrangement of the
genus is entirely formed upon that excellent work. The
Species are three, with many varieties.

i. Emphyma Sarcoma, Sarcomatous tumour, (Aberne-
nethy.) Tumour immoveable ; flefhy and firm to the
touch. Of this there are eight varieties.

a. S. vafculorum, common vafcular or organized Sar¬
coma, (Abernethy.) Vafcular throughout : texture
Ample: when bulky, mapped on the Surface with arbo-
refeent veins. Found over the body and limbs gene¬
rally. Often found of an enormous Size in the Scrotum,
conftituting the farcocele, or hernia carnofa, of authors.

|3. S. adipofum, adipofe Sarcoma: Suety throughout:
inclofed in a thin capfule of condenfed cellular l'ubftance;
connected by minute veffels. Found chiefly in the fore
and back part of the trunk. Abernethy.

y. S. pancreaticum, pancreatic farcoma : tumour in
irregular mall'es ; connected by a loofe fibrous fubltance,
like the irregular mafies of the pancreas. Found in the
cellular fubltance ; but more ufually in lymphatic glands ;
chiefly in the female brealt.

S. S. cellulofum, cyftic farcoma : tumour cellulofe or
cyltofe ; cells oval, currant-fized, or grape-fized, contain¬
ing a ferous fluid ; Sometimes cafeous. Found generally,
but moftly in the thyroid gland, teftis, and ovarium.
When in the thyroid gland, it is called bronchocele, bo-
tium, or Derbyfhire-neck. The cells are here numerous,
the fluid often vifeid. Sometimes gelatinous. See Cyrto-
fis Cretinifmus, p. 288.

i. S. feirrhofum, feirrhous farcoma : hard, rigid, vaf¬
cular, infarCtion of glandular follicles ; indolent, infen-
tient, glabrous ; Sometimes Ihrinking and becoming more
indurated. When irritated, tending to a cancerous ul¬
cer; and found only in glandular ItruCtures.

£. S. mammarium, mammary or maftoid Sarcoma : tu¬
mour of the colour and texture of the mammary gland ;
denfe, and whitifh ; Sometimes Softer, and brownifh ; often
producing, on extirpation, a malignant ulcer with indu¬
rated edges. Found in various parts of the body and
limbs.

7i. S. tuberculofum, tuberculate farcoma: tumour tu-
berculofe; tubercles firm, round, and cluftering ; pea-
fized or bean-fized ; yellowifli, or brownifli- red; when
large, difpofed to ulcerate, and produce a painful, malig¬
nant, and often fatal, fore. Found chiefly in the lym¬
phatic glands of the neck ; often, fimultaneoufly, in
other glands and organs. Abernethy, p. 47.

0. S. medullare, medullary farcoma : tumour of a pul¬
py confiftence, and brain-like appearance ; whitifh. Some¬

times reddilh-brown ; when large, apt to ulcerate; and
produce a Sloughing, bleeding, and highly dangerous.
Sore. Found in different parts, chiefly in the teftes ; at
times propagating itfelf along the abforbent vefl'els to ad¬
joining organs.

2. Emphyma enciftis, eneyfted tumour, or wen:' tumour
moveable : pulpy, often elaftic to the touch. (Lupia,
Sauv. Cull.) Five varieties.

a. E. fteatoma : an eneyfted extuberance containing a
fatty or fuety fubftance, apparently fecreted from the in¬
ternal Surface of the cyft. Found over moft parts of the
body ; and weighing from a drachm or two, to twenty or
thirty pounds.

(3. E. atheroma : eneyfted extuberance containing a
mealy or curd-like fubftance, fometimes intermixed with
harder corpufcles ; apparently fecreted as the laft. Found,
of different fizes, over moft parts of the body. (Moiluf-
cum, Wit lan.)

y. E. meliceris : eneyfted extuberance, containing a
honey-like fluid. Found, of different fizes, over moft
parts of the body.

$. E. ganglion : eneyfted extuberance containing a
colourlefs fluid ; the extuberation fixed upon a tendon.

e. E. teftudo : eneyfted extuberance containing a fluid
readily hardening into horn or nail ; and especially when
protruded externally upon an ulceration of the Surround¬
ing integuments. See Abernethy, p. 90.

3. Emphyma exoftofis : tumour inelaftic ; often im¬
moveable ; hard and bony to the touch. Four varieties.

a. E. oftea ; immoveable 5 protuberant; feated on the
fubftance of a bone. Sometimes excrefcent, and compofed
of bony fpicula refembling cryftallizations. Sometimes
exquifitely hard and glabrous, refembling ivory. Both
found chiefly in the bones of the cranium.

@. E. perioftea, node : immoveable 5 protuberant ; from
bony enlargement of the periofteum.

y. E. pendula : bony tumour hanging pendulous into
a joint.

E. exotica : bony tumour moveable or immoveable,
feated in Some flefliy part of the body. See Abernethy on
Tumour, p. 102. and On DiSeaSes refembling Syphilis,
p. 85.

Genus III. Paroftia , [from irxfct, bad, and ocritov, bone.]
Bones untempered in their fubftance; and incapable of
affording their proper Support. Two Species.

1. Paroftia fragilis : fubftance of the bones brittle and
apt to break on flight exertions, with little or no pain.
Moft frequently an attendant on advanced age. Found
alfo, at times, as a Symptom in lues, ltruma, and porphy ra.

2. Paroftia flexilis, (Mollites oftium, Aucl. Var.) fub¬
ftance of the bones Soft ; and apt to bend, and become
crooked, on flight exertions, with little or no pain. Found
alfo as a Symptom in porphyra and other cacheftic mala¬
dies. See various cafes in the Phil. Tranf. by Bevan,
Pott, Hofty, Pringle; as alfo Gooch, Surg. p. 178. and
Bromfield’s Chirurgical Obfervations. — Found at times in
new-born infants, more or lefs general. — Univerfal, with
perverfion of moft of the bones. Morand, Hiftoire de la
Maladie finguliere et de l’examen du cadavre d’une femme
(Sapiot) devenue tout-a-fait contrefaite par uneramol-
liflement general des os, Paris, 1752. We have an en¬
graving lying before us, at the prefent time, representing
this extraordinary Specimen of difeafe. The foftnefs of
the bones is represented So extreme as to allow the feet to
be placed on each fide of the head, the femoral bones
forming a perfect curve.

Genus IV. Ojlhexia, [from ooIeo;, bony, and e£oj, ha¬
bit.] Soft parts more or lefs indurated by a Superfluous
Secretion and depofit of oflific matter. Two fpecies.

1. Ofthexia infarciens: oflific matter depofited in no¬
dules, or amorphous mafles, in different parts or organs.
In the lungs ; Buillie, Morb. Anat. Fafc. II. PI. 6. — In
the fubftance of the heart, weighing 2 oz. Burnet , Med.

Praft.

838

PATHOLOGY.

Praft. iii. 254. — In the thymus gland; A3. Med. Bcrol.
vol. i. p. 28. — In the thyroid ; Con/uli de Lapid. — In the
parotid; Plater Obf. lib. iii. 707. — In the deltoid muf-
cle ; Ruffe, in Blegny Zodiac, 1680. — In the trachea,
contracting its paffage ; Kirkring, Obf. 27. — In the dura
mater; Rnillie, Fafc. X. Pi. 4.

2. Ofthexia implexa: offific matter depofited in con¬
centric layers in the tunics of veflels or membranes, ren¬
dering them rigid and unimpreffible. Three varieties.

a. I. aortae; offification of the aorta. — With a confi-
derable portion of the right ventricle and right auricle of
the heart. Baillie, Fafc. V. PI. 2. Valves offified without
palpitation or dyfpr.cea. Morgagni de Sed. et Cauf. Ep.
xxiii.n. — Defending trunk wholly offified. Genga Anat.
chirurg. Buckner Mifcel. 1727. — Afcending and defend¬
ing trunks wholly odified, compelling to an ereft pofition.
Gvattani de Aneurifm.

13. I. tnembranea ; offification of membranous or con-
nefting parts. — Of the pleura ; Baillie, Fafc. II. PI. 3. —
General offification of tendons, membranes, cartilages,
and ligaments. Pccklin, lib. ii. Obf. 40.

y. I. complicata; offification of different parts fimulta-
neoufly; as of the thoracic duft, ileum, and other abdo¬
minal organs. Phil. Tranf. 1780.

Order II. CatqjTCa, [from v.a.'ro], within.] Diforders
affefting Internal Surfaces. Pravity of the fluids, or
emunftories tha/open into the internal furfaces of or¬
gans. There are three genera. .

Genus I. Hydrops, [from v<iuo, water,] Dropfy. Ge¬
neric characters — Pale, indolent, and inelaflic, diflention
of the body or its members from accumulation of a wa¬
tery fluid in natural cavities.

It has been afeertained by phyfiologifls, that, in the
healthy condition, a ferous or watery fluid is conftantly
poured out, or exhaled, from what are termed the exha-
lent extremities of the arteries, into every cavity and in-
rerftice in the body, by which the parts are conllantly
thoiftened, and their adhefion, or painful attrition, is pre¬
vented. But upon the furfaces of the fame cavities and
interftices the mouths of another fet of veflels, the ab-
forbents or lymphatics, open, and take up or abforb this
eft'ufed fluid before it has remained long, or been accu¬
mulated in thofe fpaces, and carry it back into the cir¬
culating blood, through the thoracic duft, or general
trunk of the abforbents. From this view of the animal
economy, it at fi rfb feemed obvious that a perfeft balance
between thefe oppofite funftions of exhalation and abforp-
tion mil ft exift, in order to maintain the health of the
fyfiem ; and that a dropfical accumulation muft be the
confequence of the lofs of fuch balance, and mull; be oc-
cafioned in one or other of the two following ways : 1.
If the quantity of fluid poured out into any fpace be
greater than the abforbent veflels can at the fame time take
up, it muft neceffarily accumulate in fuch parts ; or, 2.
Although the quantity poured out be not greater than
ufual, yet, if the abforption be any-how interrupted or di-
miniflied, an unufual accumulation will from this caufe
alfo enfue. Dropfy was in general therefore imputed to
an increafed exhalation or a diminifhed abforption, in
the cavities in which it occurs. It will be found, how-
ever, upon an inveftigation of the various caufes which
are capable of producing thefe morbid conditions, that
the exhalent veflels are commonly in fault, and that a
plethoric flate of the blood-veflels of the dropfical part is
the next link in the chain of caufes. This plethoric con¬
dition may or may not be accompanied w’ith inflammation
of the red veflels ; but, if fuch aftion do exift, the effufion
of ferum will be more rapid, and will be of a tenacious
and gelatinous, or otlierwife thickened, confiftence or
Iftrufture.

Of all other parts of the body, the ferous -membranes
are moft fubjeft to effufions of water. Thus in the peri¬
toneum we meet with afeites, in the pleura with hydro-
thorax, and in the flgmoidal capfules with fimilar effufions.

They are, however, by no means confined to thefe parts.
The fitfin, irritated by ablifter or by fpecific difeafe, gives
examples of aqueous effufion under various appearances
of veiicles, blebs, & c. The efi'ufed fluid exhibits differ¬
ent appearances; being fometimes aperfeftly aqueous
fecretion, like the natural ferum of the blood, and at
other times quite different. Moreover, the fame veflels
which, under a trifling excitation, fecrete undue quanti¬
ties of ferum, when more morbidly ftimulated pour forth
pus and coagulating lymph. Every thing that throws
an inordinate flow of blood to the ferous niembranes
may occafion dropfy ; and in faft peritonitis,, pleuritis,
afeites, and hydrothorax, may often be traced to the
fame caufes.

Of all other caufes of afeites, an accumulation of
blood in the peritoneal veflels h the moft frequfent. Thus
we find, that, if the liver be difeafed in fuch a manner as
to obftruft the blood which flows from the inteftines
through the vena portae to the heart, the afeites is an
almoft invariable confequence. Now in the cafe of tu¬
bercles or hydatids in the liver, the impediment being of
courfe gradual in its formation, we do not often find
inflammatory fymptoms accompanying the difeafe; but,
if cold be taken, we frequently find that inflammation
dees come on. Again ; obftruftion to the flow of blood
through the lungs, as in afthma, brings on various forms
of dropfy, but efpecinlly hydrothorax. Moreover the
prefence of the gravid uterus, or of any tumour in the
abdomen, by preffing on the great veflels which retain
the blood from the lower extremities, give rife to cede-
matous fwellings under the integuments. Dropfy ‘is alfo
a fequel of fevers, efpecially of Rofalia. Befides in¬
creafed aftion of the fecernent veflels, dropfy feems to
owe its origin to a preponderance of ferum in the blood ;
and in this cafe paffive plethora is generally found in a
remarkable degree. General plethora alfo brings on
dropfy ; and we find it a very common fequel of repreffed
difeharges, as piles, ulcers, or the like.

Of the mode in which abforption may be difttirbed or
accelerated we have before fpoken at large in another part
of this article. The connexion of diminifhed abforp¬
tion with dropfical effufion is obvious enough, either as
a caufe or an effeft. Diminution in the quantity of urine
is always met with in dropfy; and a diftinftion has been
made by Dr. Blackall between inflammatory and chronic
dropfy, according to the degree of coagulability of this
fluid. In inflammatory dropfy this author ftates that the
urine is eafily coagulable on the application of heat ; while
in chronic dropfy this coagulation is abfent altogether,
or at leaft is very trifling in degree. This diftinftion has
been contradifted; and we are enabled to ftate, from
fome experiments of our own, that it is not tenable. By
this ftatement we do not mean to detraft from the merits
of Dr. Blackall, who muft be acknowledged to have done
much to improve the treatment of dropfy.

The fymptoms vary as this difeafe affefts different parts,
as appears from the following details of the fpecies.

1. Hydrops cellularis : cold and diffufive intumefcence
of the fkin, pitting beneath the preffure of the finger.
Three varieties.

a. Totius corporis, -anafarca, or general dropfy: ex¬
tending through the cellular membrane of the whole
body.

(3. Artuum, edema, limited to the cellular membrane
of the limbs ; chiefly of the feet and ancles, and moftly
appearing in the evening.

y. Dyfpnoica ; edematous fwelling of the feet; ftiff-
nefs and numbnefs of the joints ; the fwelling rapidly
afcending to the belly, with fevere and, moftly, fatal
dyfpncea. This very fevere and Angular variety is taken
from Mr. W. Hunter’s Effay, publifhedat Bengal, folio,
1804. The difeafe appeared with great frequency among
the Lafcars in the Company’s fervicein 1801. Its attack
was fudden ; and its courfe fo rapid, that it frequently
killed the patient in two days. Mr. Hunter aferibes it

to

PATH

to the concurrent effect of breathing an impure atmo-
■fphere, fuppreffed perfpiration, want of exercife, and a
‘previous life of intemperance. Hence probably a very
■violent kind of -inflammatory dropfy.

4. Hydrops thoracis, dropfy of the chert ; (Hydro¬
thorax, Sauv. Cullen, 4'C-) Senfe of oppre(iion in the
-chert ; dyfpncea, increafed by exercife or dedumbiture :
livid and puffy countenance ; purple lips; urine red and
/pare; pulfe irregular; edematous extremities; palpita¬
tion and fudden rtartings during fleep.

The flu&uation of water in the ribs may fometimes be
felt. According to Laennec, mediate aufcullation fee p,
■244, 5.) furnifhes certain indications of the exiftence of
fluid in the. chert, and even difcovers its extent. A great
diminution, or indeed a total abfence, of the found of
refpiration ; the appearance, difap pea ranee, . and return,
of egophony, are the rtgns here manifefted by the ufe of
the ftethofeope. Whetf the pleuritic effufion is very
abundant on its firrt formation, the abfence of refpira¬
tion is then totally uniform, and fo complete that no
found whatever can be heard, however forcibly the refpi-
ratory efforts may elevate the thorax. The only part in
which there is an exception to this, is an extent about
three fingers breadth from the vertebral column. This
■exception feems to depend on the lungs being in contaff
with the parietes of the chert at the part above men¬
tioned ; and therefore the interpofition of fluid between
thofe parts, with its p re flu re on the lungs, which are the
ca.ufe of the abfence of the found of refpiration, do not
liereexift. In cafes where the lungs are attached to the
fides of the chert in other points, from adhefions of an¬
cient date, the fame exception may however exift in the
parts thus affe&ed. Sometimes, although the quantity
of fluid effufed is not diminifhed, the found of refpira¬
tion will return at the end of a few days; but it is with¬
out any mixture of rattles, unlefs pulmonary catarrh ex¬
ift at the fame time, which may help to make its diftinc-
tion from pneumonia. When the effufion is not confi-
derable, the found of refpiration commonly refembles
what it is in children. When the fluid is difappearing,
this found returns from above downwards, as the furface
of the fluid defeends ; except in cafes when this order is
interrupted by adhefions of the lungs to the thoracic
parietes. To the above figns muft be joined egophony,
which is charafteriftic of it, and conftantly indicates a
colleftion of fluid when it is moderate in quantity ; but
it difappears when the quantity of fluid is very confider-
able. It ismoft evident when the fluid has leaft confid¬
ence; and therefore is generally moll diftinft in the
fituation of the upper part of the collection. Egophony
may be fufpended fome minutes, or even hours ; but it
reappears when the patient expectorates. Many authors
have noticed an increafe in the volume of the fide in
which the collection of fluid exifts in a great degree.
This fometimes exifts in a very remarkable manner. It
difappears as the cure advances, and the fide occafionally
becomes at length fmaller than in the natural Hate.

5. Hydrops abdominis, afeites, or dropfy of the belly:
tenfe, heavy, and equable, inturnefcence of the whole
belly ; diftinCtly fluctuating to the hand upon a flight
ftroke being given on the oppofite fide.

It is this fluctuation which in ordinary cafes diftin-
guifhes dropfy from pregnancy. Antonia Scarpa has
however related cafes tending to fhow, that, either
from excefs of liquor amriii, (in which cafe third
is abfent, and the natural form of a belly containing
a gravid uterus is retained.,) or from effufion from the
peritoneum, (in .which cafe third is prefent, and the re¬
gular form of the fundus uteri is not found,) dropfy and
pregnancy may co-exift. Thefe cafes are of courfe very
rare, and are to be relieved only from the extreme dan¬
ger and dyfpncea which attend them by punCture.
Scarpa direCls this to be done (when vve wifh to avoid
wounding the uterus) in the hypochondriac region, be¬
tween the edge of the reCtus mufcle and the edge of the

V.ol. XIX. No. 1307.

O L O G Y. 339

falfe ribs. As to puncturing the womb itfelf, this is of
courfe a very dangerous experiment. Scarpa thinks,
however, that it may be tried in cafes of imminent dan¬
ger; and he quotes inftances in which it has been done
without ill effeCts. See “ Sulla Gravidanza fuflequita da
Afcite, Memoriae del Cav. Ant. Scarpa, 1817.”

Dr. Good makes three varieties of this fpecies, the laft
of which feems to 11s quite out of place, fince the difeafe
is the fame as inflammatory dropfy, though differently
produced.

cc. Atonica; preceded by general debility of the con-
flitution. Often the refult of feurvy, or fevers of various
kinds.

£. Parabyfmica ; preceded by or accompanied with op-
pilation, or indurated enlargement of one or more of
the abdominal vifeera, ufually the liver; the gall-bladder
of which is often enormoufly enlarged and turgid. See
Phil. Tranf. 1710-ia. vol. xxvii. Yonge, Mem. de Paris-,
1701. Du Verney, ACt. Erud. Lipf. 1713. In the laft, the
bladder weighed ten pounds twelve ounces, bad no mea¬
tus, contained various tunics, and was filled with a cof¬
fee-like liquor. The fubftance of-the liver is often found
loaded with hydatids. In one inftance it weighed
twelve pounds. Gooch's Cafes, 4c- p. 170.

y. Metaftatica j from repelled gout, exanthems, or other
cutaneous eruptions.

6. Hydrops ovarii, dropfy of the ovarium : heavy and
painful inturnefcence of the iliac region on one or both
fides, with a fenfe of dragging; gradually fpreading over
the belly; with obfeure fluctuation.

7. Hydrops tubalis, dropfy of the fallopian tube: heavy
elongated inturnefcence of the iliac region, fpreading
tranfverfely ; with obfeure fluctuation.

8. Hydrops uteri, dropfy of the womb ; heavy circum-
feribed protuberance in the hypogaftrium, with obfeure
fluctuation ; progreflively enlarging, without ifehury or
pregnancy.

In the treatment of no other kind of difeafe has the
prefent age more reafon to exult in its improvement in
the therapeutic art, than in that of dropfy. No longer
trammelled by that fatal devotion to fyllem which led the
older praditioners to preferibe in the fame manner for all
difeafes in which the prominent fymptom of watery efr
fufion caufed them to be ranged under the fame title ; we
look to the ctmfe of dropfy entirely for the rule of treat¬
ment. It is true, we are often puzzled to find this caufe;
but at all events, our knowledge is in the generality of
cafes fufliciently accurate to lead to beneficial treatment.
Thus, if it feems that local pain has preceded or ftill
accompanies a dropfical effufion, efpecially if this pain has
its feat in the pleura or peritoneum, vve do not hefitate to
treat it as fimple inflammation. In doing this, however,
we are of courfe as much regulated by the ftate of the
pulfe, the appearance of the blood (generally buffy and
th ejirum eufily couguluble), and the febrile commotion of
the conftitution, as the local pain. The meafure of free
bleeding is to be followed by counter-irritation (efpe¬
cially if the difeafe owes its origin to fuppreffion of fome
accuftomed morbid aCtion), and by the excitement of
the fecretion of the mucous membrane, efpecially of the
urinary paflages, by diuretics, and of the bowels by draf-
tic cathartics. The difeafe continuing obdurate, full
dofes of mercury will be well calculated to remove it.

Ifdropfy feems to arife from mechanical obftrudlion, ftill
local bleeding may occafionally be proper to reftrain the
inflammatory action which all morbid produfts tend to
produce by the ftimulus ; but our chief attention muft be
directed to the removal of the mechanical impediment.
Thus, when a fluggifli ftate of the liver exifts, the excite¬
ment of the fecernents of this organ by mercury affords
great relief to the dropfical fymptoms ; but, if tubercles,
hydatids, or other arterial morbid tumour, exift in the
liver, mercury muft be interdi/led ; and the only chance
we can afford the patient is to keep up a very frequent
naufea by tartar emetic, and cut off the fupplies from the
4 S tumour

PATHOLOGY,

340

tumour by the mod rigid abftinence. For the fame pur-
pofe, fmall bleedings are occafionally proper. Such
means will palliate the difeafe, and poftpone its termina¬
tion, though they will feldom cure it.

When dropfy owes its origin to adecreafe in the quantity
of the blood, or in the alteration of its quality, both
which are commonly connected, our endeavour muft be
diredled to reftore this fluid to its natural Hate. Fre¬
quent and fmall bleedings of courfe effect a diminution
of its quantity; and a regular attention to the ftate of
the digeftive organs is the only method of improving its
quality. With refpefit to the diet, this fttould not be too
low ; and fmall quantities of wine may be allowed. The
bowels mull be kept open, and the mucous fecretions in
general excited. Exercife alfo, either active or paflive,
mull be ufed regularly. Catarrh and afthma occurring
with dropfy require no difference in their treatment on
that account.

When either from the effefils of idiopathic inflamma¬
tion, or from general plethora, or from difeafed blood, a
Hate is induced which may be properly called the chronic
ftate of dropfy, which is frequently met with ab aborigine
in old and debilitated perfons, and in which the difeafe
feems nearly ftationary, the water very flowly collefiling,
the fanguineous functions tardy, and the digeftive organs
weak ; when, in fa£l, a diminution of abforption feems
the caufe of the diforder’s continuance, two alternatives
prefent themfelves, which muft be adopted chiefly as the
conftitution of the patient is good or bad, and as the
quantity of effufed liquid is great or fmall. Thefe are —
the removal of the water by furgical means, as by fcari-
fying the Ikin in Hydrops cellularis, by paracentefis tho¬
racis or paracentefis abdominis in hydrothorax and afcites.
(See Surgery for thefe operations.) A morbid ftate of
the conftitution, or very old age, would prevent us from
fcarifying the Ikin, left gangrene of the wounded parts
fhould enfue ; and the punfture of the abdomen lhould
never be ufed unlefs the quantity of fluid contained is
very great. It Ihould be remarked alfo, that, if the waters
feem to be contained in cyfts, no very favourable prog-
nofis fhouldbe given of the ultimate fuccefs of the ope¬
ration ; and the praftitioner fttould be aware, that in thefe
cafes he is apt to meet with fo gelatinous a ferum, that
it will not always flow through his canula. Paracentefis
thoracis is at all times a dangerous operation ; and,
though it has on fome occafions been found ufeful, yet
the danger of wounding the lungs, and the uncertainty
of the figns of hydrothorax, caufe it to be very feldom
ufed.

The means of exciting the abforbents are few and un¬
certain ; nor will they have any effedl, except in the par¬
ticular cafes under immediate confideration. Of the
medicines which promote the afilion of the abforbents,
mercury holds a very high rank, but its operation on
thefe veflels is uncertain ; neverthelefs it is found ufeful
in practice during the chronic ftate of dropfy. It Ihould
be given in fmall dofes ; and may be advantageoufly com¬
bined with diuretics. As a more direfil mode of pro¬
moting abforption, preflure has been tried in many cafes.
Thus in H. cellularis artuum, bandaging the limbs, and
in H. cellularis totius corporis and H. abdominis, fric¬
tions with the hand and flefli-brufti are advantageoufly
employed. The good effects of preflure in thefe cafes
probably induced a phyfician of eminence, SirG.Blane,
to try the fame praftice in chronic hydrocephalus ; and,
it is faid with fuccefs. When however we confider the
notorious ill effedls preflure exerts on the brain, we Ihould
not be inclined to expert much from this practice ; but
the high authority on which it refts obliges us to men¬
tion it.

As medicines which have exerted a happy influence on
dropfy under all circumftances wherein they could be
made to aft, we muft mention diuretics. Thefe medicines
are however very uncertain in their operation ; and it is
a curious anomaly, that the weakeft fometimes anfwer

where the moil powerful fail. Their exhibition is of
courfe likely to be fruitlefs in cafes where tumours or
difeafed liver occafion dropfy ; but, in inflammatory and
in chronic idiopathic dropfies, they are generally ufeful.
The digitalis, in dofes of five to tw-elve drops thrice a-
day in a folution of cream of tartar, is perhaps the moil
ufeful diuretic for inflammatory dropfy that w’e know of.
In chronic cafes, fquill combined with calomel is more
potent. But a variety of diuretics are in the Pharmaco¬
poeia, as cantharides, turpentine, See. which may be ufed
when thefe common articles fail. On the fame plan of
counter-irritation, draftic cathartics, as elaterium, fcam-
mony, and oil of croton, have been ufed : their ufe fttould
(generally fpeaking) be confined to cafes of inflammatory
dropfy.

We muft now retrace our Heps to deferibe two difeafes
which we palled over in Dr. Good’s claffification of this
genus, where they occurred as the fecond and third fpe-
cies, under the titles of Hydrops capitis (water in the
head), and Hydrops fpinse (fpina bifida). We palled
thefe over becaufe they each of them require a diftinft
elucidation; for they by no means agree in the general
charaders of dropfy. Hydrops capitis is defined by Dr.
Good as an “edematous intumefcence of the head, the
futures of the Ikull gaping.” This, however, is merely
the charadter of a very rare difeafe, and has no reference
to the fyinptoms of hydrocephalus in the common ac¬
ceptance of the term.

The term Hydrocephalus, or Hydrops capitis, does not
apply to this difeafe in any of its ftages except the laft ;
for, in its firft ftage, this malady is actually Cephalitis ;
Cephalitis, however, varying in intenfity, and traceable
to a variety of caufes. The children who are predifpofed
to hydrocephalus, are thofe who have large brains, or
unufual activity of the cerebral functions. But the ab-
fence of thefe phenomena by no means enfures a child
from liability to the difeafe in queftion. Generally, for
fome time before more marked fymptoms come on, un¬
ufual quicknefs of apprehenfion, vivacity of manner, and
reftleflhefs, are apparent. In fome children this increafe
of fenfibility reaches to an aftonilhing height, and indeed
forms completely that erethifmal ftate of brain before
defcribed under dyfpepfia, p. 136.

But a more formidable fet of fymptoms than the above
are thofe which difplay ditninijhed cerebral energy. The
children begin to be indifferent to every thing : their ac¬
tivity, vivacity, and good temper, vanilh ; they diflike
light and notice; the lively colour of their countenance
and brightnefs of their eyes begin to fade; and their
fprightlinefs paffes into dulnefs. Their bowels are con¬
fined, their urine fcantyq their reft difturbed. The larger
children, on fitting up in bed, complain of giddinels ;
they are alfo fubjeft to rheumatic pains in the limbs, but
particularly in the nape of the neck, calves of the legs,
and foies of the feet. The fmaller children exprefs the
fame feelings by a certain rocking of the head, by fud-
denly becoming filent in the midft of a cry, by whining,
and moving their hands towards their heads. The pulle
is irregular, and fometimes intermits altogether: it is
commonly the feventh, ninth, fixteenth, feventeenth, or
thirty-firft, pulfation which is weaker or deficient. From
a ftate of reverie they are roufed with a deep figh, and
begin again to notice thofe about them, of whofe pre¬
fence they had been apparently unconfcious ; the colour
of the face changes, and they are alternately fiulhed and
chilly. When afked if any thing ails them, they anfwer
with an indifferent “No.” They walk without firmnefs,
and, in ftepping forward, they often raife the foot as if
they were ftepping over a threfliold ; they totter and flag¬
ger as if drunk.

Sometimes in this ftage, the infant, though in a ftate of
health, frequently vomits, wakes fuddenly with a cry,
becomes foporofe from an overloaded ftomach, and has
an irregular pulfe. Sleepleffnefs, unufually continued
fereaming, without any other complaint; hanging the

head

341

PATHOLOGY,

head after fuch attacks ; alarm on the gentleft touch;
an exceffive quicknefs of hearing, fo as to be awakened
terrified by the flighteft noife; diminiflied appetite; an
entire abfence or excefs of thirji ; aery denoting pain, on
flight movements of the body, but fuddenly becoming
filent by quick ones; conftant pulling the nape of the
neck with the hand; increafed warmth of the head, par¬
ticularly of the forehead and nape of the neck ; are the
chief guides for the diagnofis.

A moil uncommon mode of approach is that, where
the healthieft children are all at once feized with violent
fever or convulfions, after a fudden attack of languor,
•giddinefs, and head-ache, ftiff neck, inclination to vomit,
full hard and flow pulfe, fenfibility to light, and iinging
in the ears. If the practitioner is called to this mani-
feftly inflammatory affection, and employs the neceffary
remedies with activity, effufion may be arrefted much
eafier than in the former cafes, and a greater number of
fuch fufferers may be fnatched from death. But ifa clear
view of the difeafe is not taken, and remedies are not
applied with overwhelming power, there follows moft
commonly in a few hours the moment of effufion, which
may be recognized by its charafteriftie fymptoms, and is
foon fucceeded by paralyfis and death. This firft ftage
often lafts only for a few hours; the latter frequently
eight, ten, fourteen, and even more, days.

In the fecond ftage, the fymptoms of the phrenitic
flare fhow themfelves : the patients complain of fevere
pains in the forehead, affecting the eyes, fometimes alter¬
nating with colicky pains ; alio pains in the limbs, and a
fhooting fenfation in the nape of the neck. There is no
place where they can lie ftill, and no perfon who can
foothe them : the eye opens perfectly in the dark only,
being very fenfible to light, and (h rinks above the upper
eye-lid. The head is hot to the hand ; but neither it nor
any other part of the furface of the body is red, nor
turgid with blood. In the tumultuous acceffion of the
inflammatory period there is, however, an exception
in this point 5 for the tunica albuginea is ftreaked with
blood-veffels, and the inner furface of the eye-lid is in¬
flamed. In fuch cafes only there are convulfive move¬
ments of the eyes ; the pulfations of the carotids are
ftrong ; the pale countenance fhrinks, and rarely becomes
cedematous and diftorted.

Among the pathognomonic fymptoms of acute hydro¬
cephalus, Dr. Golis enumerates drynefs of the nofe, pale-
nefs, ceffation of appetite and thirft ; furred tongue ; vo¬
miting, which becomes lefs frequent as patients advance
to the ftate of effufion ; the digeftion of food is moft com¬
monly altogether fufpended ; the belly a!fo, before tumid,
falls away. At this period, there is tendernefs on pref-
fure on the region of the ftomach and liver ; there is often
obftinate conftipation ; the urine is frequently fcanty,
paffed with pain, and has a charadieriftic white flimy de-
pofit ; the hearing now becomes acute, and even painful ;
pains in the belly, nape of the neck, and particularly the
head, are conftantly complained of by moaning ; the deep
is difturbed often by dreams, in which they cry out ; they
grind therr teeth alfo. Preffing queftions only obtain
anfwers, and thofe are fhort 5 their movements are languid
and compulfatory; they cannot fit up without naufea
and vomiting ; the pulfe is flow, unequal, and intermit¬
ting, .but eafily accelerated in a moment by pain : the
latter fymptom is alfo confidered by Dr. Golis as pathog¬
nomonic of this ftage. The fkin becomes flaccid, dry,
and difcoloured, and an eruption fometimes appears
about the lips, neck, and flioulders. They are reftlefs,
and defire to be moved from place to place. Thofe with
a very flow pulfe, complain of as much pain as thofe with
whom it is accelerated.

In the third, or ftage of effufion, the above fymptoms,
after a few hours or days, grow worfe. The patients can
no longer fit up ; the reftleffnefs ceafes; they moft com¬
monly lie on the back, and conftantly kick up the bed¬

clothes ; they carry their hands to their head, mouth, and
noftrils, into which as well as into their ears, they often
bore fo as to make them bleed ; they half forget the
words they would fay. All the external fenfes become
dull or annihilated, except that of hearing, which is of¬
ten quick; the eyes are directed obliquely downwards;
the pupils are dilated and ofcillating, but unaffedled by
ftrong light; they often fee double, or falfely ; and open
and clofe their eyes repeatedly in a few minutes. A
gloomy earneftnefs is painted in their flulhed countenance,
with a threatening expreffion : it is a curious contraft of
fiercenefs and patience, which often excites the aftonilh-
ment of by-ftanders. They wafte to a fkeleton ; their
dry flabby fkin hangs on their emaciated legs; partial
fweats break out. The urine is paffed unconfcioufly ;
there is conftipation. The debility of the pulfe, fighing,
offenfivenefs of the breath, and general weaknefs, in-
creafe ; coma comes on ; and, before the laft tragic feene,
they fometimes become confcious, fo as to fit up to eat
and drink. They fometimes even fwallow with eager-
nefs, long for their play-things, and deceive the attend¬
ant with momentary hopes, which are followed by more
fevere fuffe rings than before.

When the patient furvives this ftate, from ten to thirty
days after, more frightful fymptoms fucceed : convulfions,
followed by paralyfis, moft commonly of the right fide,
and often cramp, which draws the head backwards and
downwards. The features are thus frightfully diftorted ;
a violent fever follows; a perfpiration trickles from the
head ; a hedlic rednefs alternates with a deadly palenefs on
the disfigured countenance of the patient. The fight is
loft ; the pupil of the convulfed eye extremely dilated,
and infenfible to light, the tunica albuginea is blood-fliot,
The hearing, from being quick, gradually becomes dull;
fwallowing becomes impoffible, though there are often,
moments in which they can take fluids 5 the urine is
fcanty, and paffed unconfcioufly; it continues of a deep
yellow colour, with a white fediment ; the ftools are ftill
lefs frequent, but never feetid, as in the former ftages. In
many, the tips of the fingers become blood-red, and af¬
terwards, on the approach of death, pale. The pulfe is
ftill weaker, and more intermitting than before; the
head, however, remains warmer than the reft of the body ;
the fpafms, which draw the head backwards, and the arms
again ft the fides, ceafe only with life. For the above de¬
tail of fymptoms we are chiefly indebted to Dr. Gooch’s
tranflation of the work of Dr. Golis on Acute Hydroce¬
phalus.

Hydrocephalus is evidently inflammation of the mem¬
branes of the brain ; and it is from the arachnoid mem¬
brane efpecially that the effufion is derived. The cere¬
bral inflammation which precedes this effufion is of courfe
traceable in different inftances to different caufes. Among
the children of this country, and of the large towns ei-
pecially, it is very generally found, that irritation of the
digeftive organs is the precurfor of Hydrops capitis ;
while in other fituations the adlion of the fun’s rays is
the moft common caufe of the difeafe. It is to be re¬
marked, however, that the adlion of the folar rays on the
head generally induces thofe fudden and violent attacks
in which ftupor or raving delirium precede the way to a
fpeedy death 5 but that the more common precurlors of
hydrocephalus caufe fymptoms of cerebral excitation to
appear long before thofe of cerebral plethora. In the
firft ftage, or that in which mere irritation is manifefted
by liftleffnefs and exaltation of the mental emotions, the
treatment confifts chiefly in improving the adlion of. the
chylopoi'etic vifeera, which are fo generally impaired.
The bowels may be freely opened, to a degree in fadt
fufficient to excite counter-irritation ; the liver may be
a died upon by dofes of calomel, and low diet ordered.
When ftupor or much vifual deception is remarked, we
may bleed in this ftage of the difeafe, becaufe thefe fymp¬
toms are figns of fulnefs of the veffels of the brain 5 but,

342

PATHOLOGY.

if thefe fymptoms are not prefent, the ftate of the alimen¬
tary uanal is to be firft attended to. As foon as the
fymptoms of cephalitis become in the flighted degree ap¬
parent, whether it has been preceded by the above ftage,
or makes its attack in a fudden and unexpected manner,
bleeding muft be had recourfe to. As all that can be
done in this difeafe muft be done early, the practitioner
muft at once decide, not only from the conftitutional ap¬
pearance, but from the ftate of the pulfeand of the men¬
tal faculties of the patient, the degree to which venefec-
tion may be carried. He will be chiefly guided in his
opinion as to this point, by the mode of attack ; for,
when the difeafe comes on fuddenly, it will, caeteris pa¬
ribus, require much more ample bleeding than when in-
difpofitior. has long preceded it. Moft praCf itioners truft
to leeches to the head ; and in milder cafes thefe may do
very well ; but we are quite fure that in the majority of
patients the difeafe will be more fuddenly arrelted by the
ufe of the lancet. Even in the youngeft children, this
meafureffiould, when the difeafe is violent, always precede
local bleeding; for, as we have before fliown in this ar¬
ticle, the efficacy of bleeding depends much on its aCtion
on the heart ; and this effeCt is notincreafed unlefs by a
fudden abftraCtion of blood. After the general bleeding,
the application of leeches will be found of the greateft
benefit; and, in violent cafes, cold water to the head,
and counter-irritants, as blifters, &c. to the feet, may alfo
be ufed with advantage. The bowels are to be freely
purged by draftic cathartics. We are cautioned by fome
authors (e. g. by Dr. Golis) not to carry the ufe of thefe
fubftances too far, left we transfer the inflammation
from the brain to the inteftines. Of courfe this effeCl
muft be watched ; but in few cafes of violent Cephalitis
will it be found to occur ; and, even ffiould it take place,
it will feldom prove of an obftinate character, if the irri¬
tating medicines be wfithheld, and local bleedings and
anodyne injections reforted to.

When the third ftage, or that in which effufion has
taken place, comes on, our treatment muft be in a great
meafure directed by the hiltory of the cafe. If the pa¬
tient has been fo far negleCted, that no bleeding, or even
if not enough of this evacuation has been made, we muft
(always keeping in view the faCt that aqueous effufion is
in moft inftances a confequence of vafcular fulnefs) bleed
until the pulfe is reduced to a fomewhat natural time.
We may then purge, and counter-irritate. Lowering of
the pulfe may be produced alfo by the regular exhibition
of digitalis in minute dofes. In that ftate of aqueous ef¬
fufion manifefted by partial paralyfis, large doles of this
drug afford the only means we know of for palliating the
fufterings of the patient, and relieving the convulfive
agonies which attend death. And in thofe cafes in which
all inflammatory fymptoms have gone off, and the patient
has become quiet and idiotic, this drug will be found by
no means ufelefs. We know not whether this medicine
relieves the malady in queltion by its vicarious a&ion on
the kidneys, or whether it repreffes the irritative inflam¬
mation which all morbid depofits tend to excite in the
ftruCfure they inhabit, whenever the fyftem happens to
be fubjeCled to the influence of inflaming caufes, as cold,
&c. but we have lately feen two very marked cafes of
chronic hydrocephalus cured by the exhibition of fmall
defies of digitalis in conjunction w ith a very clofe atten¬
tion to the digeftive fyftem, and change of air. It is this
chronic ftate of hydrocephalus in which fir G. Blane pro-
pefed to bandage the cranium.

3. Hydrops fipinte, hydro-rachitis or fpina bifida, is a
difeafe moftly congenital, though occafionally met with
in adults. It confifts of a “ foft fluctuating extuberance
W the fpine, with gaping of the vertebra;.” This gaping
of the vertebras is lateral to the tumour, and arifes from
the want of the fpinous proceffes of thefe bones. The
preffure of the tumour of courfe paralyfes thofe parts
which have their nerves fupplied from the lower portion

1

of the fpinal marrow'. The difeafe is, with a very few ex¬
ceptions, incurable ; the patient oftentimes dying in a
few days after the tumour has begun to make rapid ad¬
vances. In the few cafes which have been met with in
adults, it would appear that the preffure of the water
caufed abforption of the bone; but this is merely fpecula-
tion. The little that can be done for Hydrops fpinae
confifts in applying gentle preffure on the tumour from
its commencement. If this fails, we muft punCture the
tumour with a fine inftrument, (as a needle,) evacuate the
contents, and, clofing it carefully to prevent the admif-
fion of air and consequent inflammation, re-apply the
preffure for the purpofe of preventing the return of the
fluid depofit. It is to be remarked, that, when imperfeCt
offification of the bones of the head, and hydrocephalus,
exift, then the cafe is nearly hopelefs; for the preffure
on the tumour moftly caufes the greater proportion of
water to prels on the brain. When preffure on the tu¬
mour feems to do harm, we may prevent its further en¬
largement by a concave trufs.

9. Hydrops feroti, hydrocele, or dropfy of the ferotum:
foft femi-tranfparent pyriform intnmelcence of the fero¬
tum; progreffively enlarging, without pain. Two varie¬
ties.

a. Vaginalis ; the fluid contained in the tunica vagina¬
lis, or furrounding (heath of the teftis.

0. Cell u laris ; the fluid contained in the cellular mem¬
brane of the ferotum.

Genus II. Emphyfema, [from <pvca.u, to inflate, to dif-
tend with air.] Inflation; Wind-dropfy. Generic cha¬
racters — Elaftic and fonorous diftention of the body or
its members, from air accumulated in natural cavities.

We have before fpoken, under Borborygmus, of the
fuppofition that air may be generated in the human body
by fecreting veffels. As far as this relates to the prefent
genus, it derives lupport from thofe cafes in which, upon
the authority of John Hunter and other accurate obfervers,
we are informed, that air has been found in cavities where
neither its admiffion from without nor its generation from
the putrefaCHve procefs could have been fufpefted. We
have three fpecies of this kind of Spontaneous generation
of air to enumerate.

1. Emphyfema cellulare : tenfe, glabrous, diffufive in-
tumefcence of the (kin, crackling beneath the preffure of
the finger. Two varieties, as proceeding,

a. A vulnere; from a wound of the thorax.

Though the form of Emphyfema which affeCts the tho¬
rax commonly arifes from a wound, inftan£§£ are not
wanting to (how, that this difeafe may arife from other
caufes. Thus violent fits of coughing, or other fudden
exertions, may rupture the air-cells of the lungs, and give
the air free accefs into the cellular membrane. This ef¬
fect more certainly follows if inflammation exifts in the
ftruCture of the lungs at the time the exciting caufe is ap¬
plied. In addition to the fymptoms above mentioned in
the definition of Cellular emphyfema in general, a fenfe
of fuftocation, great dyfpncea coming on in fits, and ex¬
pectoration of blood, are met with in Emphyfema from
wounds of the thorax. In the treatment of the difeafe,
the practitioner is rather occupied with removing the
inflammation of the lungs which the wound occafions,
than with the Emphyfema, which in faCt, if not exceffive
in quantity, will generally fubfide as the pulmonary
phlogofis goes off. It is to be recolleCted, however, that
a large collection of air in the cellular membrane fpreads
very faft, and threatens that ftruCture with mortification.
Hence it is femetimes neceffary to evacuate the air by
punCture, and to prevent as much as poffible its reproduc¬
tion by preffure. For the mode of operation, fee Surgery'.

(3. E. cellulare a veneno, “ from fiffi-poifon, or other
venom.” It feems to us a mere popular error to fuppofe
that the bodies of poifoned perlons fwell before death.
That this happens afterwards we have no doubt in cafes

of

PATHOLOGY.

of fifh-poifon, and that it refults from the fudden putre¬
faction which follows death produced by caufes of an
intenfe and fudden operation, and happening to perfons
in full habit of body.

z. Emphyfema abdominis, tympany: tenfe, light, and
equable, intumefcence of the whole body ; diftinCtly refo-
nant to a ftroke of the hand.

So few are the cafes on record of this curious diforder,
that it may reafonably be doubted whether it ever ex-
ifted ; that is to fay, as a diftinCt and idiopathic difeafe ;
for that it follows, a putrefactive ftate of the abdomen af¬
ter enteritis, or operation for hernia, does not admit of
a doubt. Should a cafe of idiopathic tympanitis occur,
it might be advifable to tap the abdomen. When arifing
from putrefaction, it is almoll unneceffary to fay, that
nothing need be done.

The Tympanites intejlinalis of authors, like the me-
teorifmus of Sauvages, is a variety, fometimes only a
fymptom, of dyfpepfy, worms, hyfteria, or fome other
difeafe affeCling the inteftinal canal.

3. Emphyfema uteri, tympany of the womb : light
tenfe circumfcribed protuberance in the hypogaltrium ;
obfcurely fonorous; wind occafionally difcharged through
the mouth of the uterus. This difeafe, about which as
little is known as of the former fpecies, is, according to
Parr, to be cured by rendering the mouth of the womb
pervious.

Genus III. Paruria, [from wapas, bad, and «pt«, to
make water.] Morbid fecretion or difcharge of urine.
Four fpecies.

i. Paruria inops, deftitution of urine ; without delire
to make water, or fenfe of fulnefs in any part of the uri¬
nary track. Often the refult of renal inflammation or
paralyfis ; but fometimes a genuine idiopathic affeCtion.
Dr. Parr relates a cafe, that occurred in his own praCHce,
in which no urine was apparently fecreted for fix weeks ;
at the end of which time the difcharge returned fponta-
neoufly. A very curious cafe may be found in the Phil.
Tranf. by Mr. Richardfon, of a boy who never fecreted
urine.

z. Paruria retentionis, (Ifchuria, Cullen, See. See.) urine
totally obftruCted in its flow ; with a fenfe of weight or
uneafinefs in fome part of the urinary track. Four va¬
rieties.

a. Renalis 5 pain and fenfe of weight in the region of
the kidneys, without any fwelling in the hypogaftrium.

The retention of urine, when it has its feat in the kid¬
neys, is generally caufed by inflammation, either idiopa¬
thic, or arifing from a Itone lodged in the gland or ureter,
or, on the other hand, from fome morbid growth in con¬
tiguous parts. The two former cafes are of courfe to be
relieved by bleeding, and fedatives, as opium. See. The
latter are nearly hopelefs cafes, and are only to be pal¬
liated by the fame means, in fiighter degrees of force.
This gland, when it fuppurates, or is accompanied by tu-
berculated accretions of the peritoneum, acquires, on
fome occafions, an enormous fize ; on others, it is much
diminilhed.

.0. Ureterica; with pain or fenfe of weight in the re¬
gion of the ureters.

y. Veficalis ; with protuberance in the hypogaftrium 5
frequent defire to make water ; pain at the neck of the
bladder; fometimes at the end of the penis.

§. Urethralis ; with protuberance in the hypogaftrium;
frequent defire to make water ; and a fenfe of obftruc-
tion in the urethra, refilling the introduction of a cathe¬
ter.

The treatment of the firft variety confifts merely in
relieving pain by anodynes, and promoting relaxation
by warm bathing. In the two latter varieties, we have
to confider the caufe of the ifchuria, or ltoppage of urine.
This is chiefly in the bladder : atony of the fibres of the
fundus, or fpafmodic action of the fibres of the neck of

Vol. XIX. No. 1307.

34 3

this cavity. This contraction is to be overcome by fuch
means as llimulate the contractile powers of the fundus,
or dirninilh thofe of the neck ; fo that, on many occa¬
fions, diuretics, as turpentine and nitre, remove a flight
degree of the diforder. Again, the warm bath fometimes
relaxes the mufcular fibres of the neck, and thus allows
the evolution of urine 5 but, fince each of thefe agents
mull more or lefs operate upon the antagonift mufcles, it
may fo happen that they may do no good, as indeed is
often fufficiently evident. A compoiition of equal parts
of tinfture of opium and tinCture of muriated iron added
to ten times their quantity of water, and given every
half-hour in dofes of a tea-fpoonful, is perhaps the belt
remedy for ifchuria that is known ; but it often fails.
It then becomes an objeCt to introduce an inftrument.
The bougie, the filver or the flexible catheter, may be in¬
troduced as occafion ferves ; but their introduction can
feldom be effected, unlefs fome degree of relaxation is
brought about ; for this purpofe free bleeding and the
warm bath may be had recouri’e to. If the patient faints,
this favourable opportunity of introducing the inftru¬
ment is not to be loft. Much will depend, in the treat¬
ment of this complaint, on the ta6l of the furgeon ; the
introduction of the catheter being an operation only to
be acquired by experience ; and it is well known that
fome furgeons have introduced a catheter inftantly, when
others have failed after long and repeated trials.

If the introduction of this inftrument is impoflible, it
then becomes a matter of confultation how long it may
be fafe to defer a more ferious and infallible operation,
the punCture of the bladder. No exaCt time can be fpe-
cified at which the poftponcment of this operation will
be fajral. Cafes are related in which the fuppreffion has
continued for weeks ; but of courfe no furgeon would
rely on thefe cafes for practice. As a general rule it may
be ftated, that, when the bladder is felt diftending the
belly an inch or two above the umbilicus, if the accu¬
mulation has been rapid, and the pain is very excruciat¬
ing, the bladder Ihould be punCtured. See Surgery.

3. Paruria llillatitia, ftrangury. (Dyfuria, Suuv. Cull.
&c.) Painful and ftillatitious emiflion of urine. Six va¬
rieties.

a. Spafmodica ; from fpafmodic conftriCtion of the
fphinCter, or fome other part of the urinary canal, cate¬
nating with fpafmodic aCtion in fome adjoining part.
The fame means may be ufed as advifedfor the relaxation
of the bladder in complete obftruCtion.

/3. Ardens ; from fpafmodic conftriCtion excited by the
external or internal ufe of various ftimulants, as acrid
foods, or cantharides ; accompanied with a fenfe of fcald-
ing as the urine is difcharged. Copious and mucilagi¬
nous drinks are all that are required to allay this irri¬
tation. Opium may be occafionally requifite.

y. Callofa ; from a callous thickening of the membrane
of the urethra : the ftriCture permanent. Buillie, Morb.
Anat. Fafc. viii. pi. 5. See Striflure, p. 167.

Mucofa ; the urine intermixed with a fecretion of
acrimonious mucus, of a whitilh or greenilh hue.

This difeafe may be confidered as an inflammation of the
mucous membrane of the bladder, fimilar in its nature to
phlogofis of any other mucous membrane. In fome cafes,
general bleeding, but often local depletion by means of
leeches, with copious diluents, having fmall proportions
of foda diflolved in them, will generally effeCl a cure.
When conftriCtion of the bladder has been caufed by the
long Handing of this complaint, a ftate which is marked
by conllant pain over the region of the bladder, with in¬
ability to retain the urine for a long fpace of time, it has
been propofed by Mr. Jefle Foot to wafti out and diftend
the bladder with warm folution of uva urfi, introduced by
means of a fyringe.

The one or other of thefe varieties is found alfo occa¬
fionally, or as a fymptom, in inflammation of the urinary
organs, feveral fpecies of lithia, and compreflion from
4 T local

344

PATHOLOGY.

local tumours, retroverfion of the uterus in pregnancy,
or defcent of the child’s head in labour.

e. Helminthica ; accompanied with a difcliarge of
worms of a peculiar kind. This variety is given by Dr.
Good upon the authority of Mr. Lawrence’s very Angu¬
lar cafe inferted in the Medico Chirurg. Tranf. vol. ii. p.
382. The patient was a female aged 24: had long la¬
boured under a fevere irritation of the bladder, which was
afcribed to a calculus. She at length difcharged three or
four worms of a non-defcript kind, and continued to dif-
charge more, efpecially when the difcharge was aided by
injections, or the catheter remaining in the urethra for
the night. The evacuation of thefe animals continued
for at lead a twelvemonth. Twenty-twm were once dif¬
charged at a time ; and the whole number could not be
lefs than from 800 to 1000. A fmaller kind was alfo oc-
caitonally evacuated. The larger were ufually from four
to fix inches in length; one of them meafured eight ;
(lender in the middle ; filiform at the extremities ; thicker
in the inter-fpaces : they were foft when firft voided, and
of a yellowifii hue. For the mod part they were dif¬
charged dead.

Polypofa ; the bladder or urethra, or both, obftrudfted
by the formation of a polypous excrefcence ; fometimes
(hooting to the external extremity.

4. Paruria mellita, diabetes.

The derangements which the kidneys are fubje£t to,
in regard to the quantity and quality of their fecretions,
are very numerous. In a (late of comparative health, the
urine is liable to many (light changes in the relative pro¬
portions of its conftituent parts, and fometimes indeed
acquires additional conftituents. In faft, fo much va¬
riation is obferved in the quality of the urine, that we
fee every reafon to concur in the ftrongly-expreffed opi¬
nion of a late phyfiologift, that the kidneys are the com¬
mon fewers of the conftitution. Yet, notwithftanding
the various produ£ts derived by the kidneys from the
blood, Berzelius has accurately remarked, that acidifica¬
tion is the chief employment of thefe glands. Thus the
fulphur and phofphate of the blood is converted by the
kidneys into phofphoric and fulphuric acids, and a new
acid, the lithic, is formed. The analyfis of difeafed urine
(hows, that this acidifying procefs is fometimes carried to
excefs ; and nitric, oxalic, and other acids, are produced;
while, on the other hand, it is fometimes diminiftied, or
totally fufpended, and neutral or alkaline fubftances, or
even pure blood, are predominant in the urine.' Some
authors, keeping in view this diftindtion as to the pro-
dudts of the difordered glands, and probably led alfo by
the general principle, that inflammation is marked by ex¬
cefs of the fundtions of the affedted ftrudture, have en¬
deavoured to (how, that in mod cafes “when acids are ge¬
nerated in excefs, the urine is commonly fmall in quan¬
tity, and high-coloured, and the difeafe inflammatory;
when neutral or alkaline fubftances, the urine, on the
contrary, is generally pale-coloured, and larger in quan¬
tity ; and the difeafes are thofe of irritation and debili¬
ty.” Prout on the Nature and Treatment of Gravel,
P- 31-

It feems to us that this generalization is not borne out
by experience ; or that, at all events, the exceptions to
the rule are very numerous. The matter is (till, how¬
ever, fub judice. Animal chemiftry is now very ufefully
employed in analyzing the compofition of morbid urine;
and, if the connexion between a particular (late of the
fecreted fluid and a particular (late of the fecreting vef-
fel (hould ever be pointed out, it will no doubt be very
ufeful. We are much inclined to doubt, however, whe¬
ther this happy confummation will ever be attained. We
find in other fecretions great differences, yet all dependant
on one caufe, (viz. inflammation, and more or lefs energy
in the nervous fyftemofthe difeafed part;) and we find that
the ordinary methods which relieve cafes fecreting one
kind of fcab are equally ufeful in thofe fecreting a differ¬
ent one. We are not endeavouring to undervalue the ufe

of chemiftry as applied to the analyfis of difeafed urine 5
but we wiih to (how, that, in the prefent date of our
knowledge, more fuccefs will attend that pradtice which
is diredted to the adtion of difeafed veffels, nerves, and
fecernents, than to the corredtion of chemical errors in
the fluids fecreted. Indeed we find as much contradic¬
tory evidence in the works of different authors as to the
connexion between certain difeafes and their chemical
analyfis, and we have fo many recolledtions of oppofite
appearances of this fluid in common febrile and inflam¬
matory diforders, that we look with very little confidence
to the mode of inveftigation before alluded to.

Before any analyfis of urine is attempted, it feems to us,
that the (late of the blood (hould be firft afcertained ;
fince, this known, we (hould clearly fee whether the dif¬
eafe had its origin in local difeafe of the fecernents, or in
adtual depravation in the quality of the fluid when its fe-
cretion is to be made. Now it is pretty obvious that it
muft be in one or both of thefe two modes that alteration
in the quality of the urine can be produced. And firftly,
that difeafed blood often produces difeafed urine no one
can doubt, when they fee the frequent, nay almoft inva¬
riable, precurrence of dyfpeptic ailment to thofe of
the urinary organs, and efpecially the clofe relation that
is traced between lithic difpofitions and peculiar regimen.
That difeafed fecretion may refult from local difeafe of
the kidneys, even when the blood is healthy, is not only
fufficiently probable, from its coinciding with the known
laws of the fecretory fundtion all over the body, but is
borne out by the fadts. Simple nephritis, or a blow on
the back, or even mental uneafinefs, nervous maladies,
efpecially hyfteria, fuddenly derange the fecretion in
queftion.

To return, however, to the hiftory of the prefent fpe-
cies. Diabetes is thus defined by Dr. Good : “ Urine
difcharged freely, for the moft part profufely; of a fweet
fmell and tafte ; with great thirft, and general debility.”
The fymptom of profufion of urine is one of fome varia¬
tion ; but it is fo generally met with, that it mayjuftly be
confidered as one of the chief fymptomsof the complaint.
The faccharine tafte of the urine is however the grand
pathognomonic fign of the difeafe. This charadteriftic is
always prefent, though it is fometimes obfcured by the
faline matters of the urine, and requires therefore that
the urine be fomewhat concentrated by evaporation be¬
fore it is apparent. As to other changes in diabetic
urine, it feems that the neutral falts of the urine bear
the fame relative proportion to each other asunder ordi¬
nary circumftances, but that the aggregate of them is di-
miniftied. A like diminution, and fometimes indeed
total abfence, of the urea, is alfo met with. The fpecific
gravity of the urine is alfo increafed in the complaint
under confideration. It increafes on that of healthy
urine, which ranges from 1010 to 1020, till it rpns as
high as 1038 or 1040, or in fome rare inftances as 1045.

Diabetes fometimes comes on (lowly and imperceptibly,
without any previous diforder ; and it now and then
arifes to a confiderable degree, and fubfifts long, without
being accompanied with evident diforder in any particu¬
lar part of the fyftem, the great thirft which always, and
the voracious appetite which frequently, occur in it, be¬
ing often the only remarkable fymptoms ; but it now and
then happens, that a confiderable affedlion of the fto-
mach precedes the coming-on of the difeafe, and that in
its progrefs, befides the fymptoms already mentioned,
there is great drynefs of the (kin, with a fenfe of weight
in the kidneys, and a pain in the ureters, and the other
urinary paffages. The temperature of the body is
ufually below the (tandard of health. The fpirits are
depreffed, the difpofition is equally indifferent to ftudy
or amufement, and there is evidently a decline of mental
energy, with a lofs of the power of virility. Ulceration
of the tongue and gums are of frequent occurrence in
diabetes, owing probably to the derangement of the di¬
gestive functions, Some morbid change in the alvine

excretion

PATHOLOGY. 345

excretion always accompanies the diabetic habit, and cof-
tivenefs is perhaps the mod common of thefe 5 for, in
fome inftances, the bowels have been fo remarkably tor¬
pid, that even the moft powerful medicines, in large
dcfes, produced but a trifling effeft. Watt remarks that
inflammation and fwelling are very common about the
external orifice of the urethra in diabetes.

This difeafe is often attended with fome pulmonic dif¬
order; Dr. Bardfley fays invariably, but this does not
accord with general experience. It is to be remarked,
however, that diabetes feldom terminates in death until
a fecondary caufe of the fatal event has arifen in the lungs.
Under a long continuance of the difeafe, the patient be¬
comes much emaciated, the feet cedematous; great debi¬
lity arifes, and an obfcure fever, with all the appearances
of hectic, prevail. In point of number, the pulfe is very
much diverfified : in moft cafes, it is quicker than natu¬
ral, but fometimes it is below the common ftandard. In
fome cafes vilion becomes very indiftindft, and the pa¬
tient is troubled with vertigo.

In fome inftances, the quantity of urine is much greater
than that of the ingefta. , Cafes are recorded, in which
from twenty-five to thirty pints were difcharged in the
fpace of a natural day, for many fucceflive weeks, and
even months ; and in which the whole ingefta, as was
faid, did not amount to half the weight of the urine ; and
even the folid matter which this fluid contains often
reaches an aftonifhing proportion. The furplus of the
excrement over the increment in this cafe is explained
by the want of cutaneous fecretion, (the fkin being
generally dry and harlh,) and an extraordinary imbibi¬
tion of water in the lungs. DifieCtions of diabetes have
fhown the kidneys, in fome inftances, in a loofe flabby
ftate, much enlarged in fize, and of a pale alh-colour 5 in
others, on the contrary, they have been found turgid and
red, and containing in their infundibula, a quantity of
pus, though without any fign of ulceration. At the
fame time that thefe appearances have been obferved in
the interior, the fuperficial veins on their furface were
found to be much fuller of blood than ufual. In many
cafes, the whole of the mefentery has been difcovered to
be much difeafed, and its glands remarkably enlarged ;
fome of them being very large and of an irregular Jex-
ture ; others fofter, and of an uniform fpherical Ihape.
Many of the laCteals have likewife been found confidera-
bly enlarged. The liver, pancreas, fpleen, and ftomach,
are in general in a natural ftate ; when they are not fo,
the occurrence is to be confidered as accidental. The
bladder is now and then found to contain a quantity of
muddy urine ; in fome cafes its coats are much thickened,
and its fize lefs than natural.

The hypothefes which have been framed to account
for diabetes refolve themfelves into thefe. The firft,
for which we are indebted to the fanciful genius of Dar¬
win, fuppofes a retrograde motion of the abforbents ; an
idea of which the abfurdity has been pointed out in a
previous divifion of this work, p. 43. Secondly, that of
Cullen and Rollo, which fuppofes difeafe of the aifimila-
ting agents, and eflentially confifts in the fuppofition that
blood is difeafed in diabetes, and that the kidneys are only
deranged in their affion in confequence of- the morbid
ftate of the blood fupplied to them. The third hypothe-
fis fuppofes that difeafed adtion exifts in the fecernents of
the kidneys, and that confequently the faccharine matter is
derivable from healthy blood.

The fecond hypothefis refts moreover on the ftrong fadl,
- that, if fugar be introduced into the veins of an animal,
efpecially if that animal be weak, fugar is firft found in
the blood, and fecondly in the urine. But, though this
fliows the poflibility of diabetes arifing from faccharine
blood, it does not prove that this is the invariable caufe
of that difeafe and in fadl fugar is not found in the
blood in diabetic patients in general. The advocates of
the dodtrine of the cachedtic origin of the difeafe get
over this objedtion by aflerting, that the elements of fugar

exiftin the blood. Now this means nothing ; for, accor¬
ding to this reafoning, the elements of hydrophobic and
fyphilitic virus exift in the blood ; for the fupplies out
of which thefe morbid matters are formed are drawn from
the blood by the fecernents, however incognizable the
original fluid may be when it has undergone the adlion
of thefe latter veflels.

The connection between diabetes and dyfpepfia appears
to us very evident; but we cannot fee that this proves
any thing in favour of the opinion that the blood is dif¬
eafed in diabetes, when we have fo many inftances of dif-
eafes of the fecernent fyftem arifing frorngaftric diforder.
And, moreover, the general diforder of the nervous fyf¬
tem and of the Ikin which has been obferved to precede
diabetes in fo many inftances fufficiently accounts for the
production of the difeafe without our having recourfe to
more far-fetched modes of explanation.

As there is much of uncertainty in our fpeculations
concerning the nature of diabetes, it is impoflible to at¬
tempt any philofophical view of the modus operandi of
thofe medicines which have been found ufeful in its
treatment. Our practice in this difeafe mull therefore be
ftriCtly empirical. In the firft place, bleeding has been
tried in many cafes of diabetes, and with much fuccefs
Practical writers aflert.that this evacuation is particu¬
larly called for when the difcharge of urine is profufe as
well as faccharine; but it feetns to have been of much
ufe in cafes which did not prefent this fymptom in an
eminent degree. The blood, when abftraCted, appears
of a darker hue than ordinary, and the craflamentum
large and eafily broken. After a few bleedings, however,
the craflamentum acquires firmnefs, and begins to exhi¬
bit the buft’y coat. By fome authors it is laid that this
plan of depletion has completely cured the difeafe under
confideration ; but more extended experience has not al¬
together affirmed this to be the truth ; though it is
almoft univerfally agreed that bleeding does rpaterially
diminilh the quantity, if it does not alter the quality, of
diabetic urine. Animal diet has alfo been very generally
reforted to, and with occalional fuccefs. It has been
chiefly recommended on the fuppofition, that, as fugar
w'as the principal conftituent of chyle prepared from ve¬
getables, therefore the adoption of diet of a different
kind muft effectually cure the difeafe by fubtraCting it:
but, as we have before fhown that fugar does not ac¬
tually exift, we fliould rather incline to fuppofe that ani¬
mal diet has cured diabetes rather by its falutary influ¬
ence on certain gaftric derangements arifing from excefs
of vegetable food, than from any fpecific change it in¬
duces in the blood ; and hence, that cafes of diabetes
might arife, in which animal food, by oppreffing the di-
geftive organs, would do harm. In no cafe fliould we
expeCt much from diet alone, unlefs thofe important af-
fiftants to its healthy ufe, viz. pure air and regular exer-
cife were alfo attended to. In all cafes the moft clofe
attention muft be paid to the alvine fecretions and their
regular excretion enforced by appropriate medicines, when
not fpontaneous; for, whether the difeafe be of cacheCtic
origin, whether it arifes from inflammation or from
mucous irritation of the urinary veflels, the belt effeCts
will naturally be expeCted from medicines which have
the triple advantage over all others, that they reduce in¬
flammation, calm nervous irritation, and eliminate mor¬
bid matters from the blood. As in the difeafes of the fe¬
cernents in general, fo in thofe of the kidneys in particu¬
lar, we often find that, though the caufe of the difeafe be
effectually removed, the habitual morbid aCtions of the
veflels remain. In diabetes efpecially, we often find that,
when the general plethora and the dyfpeptic diforder are
in a great meafure removed, the urinary difeafe remains
protraCted and harrafling. In thefe cafes, a fpecific or
peculiar ftimulus may be made to exert an influence on the
fecernents fufficiently powerful to induce their healthy
aCtion. Thus we have found much benefit, in a very
fevere cafe of diabetes, from the exhibition of full dofes

of

348

PAT HO

of the tin&ure of the muriate of iron. It is in thefe
cafes that the ufe of opium in fmall doles, of hepatized
ammonia, and of the magnefia calcinata, (fo ftrongly
recommended by Dr. Trotter,) feem to be ufeful.

The common modes by which diabetes terminates when
the patient dies, are by dropfy, pulmonic difeafe, and
he6lic fever, or fuddenly, and apparently from nervous
exhauftion.

5. Paruria incontinens : incontinence of urine: fre¬
quent or perpetual difcharge of urine, with difficulty of
retaining it. Four varieties.

a. Acris ; from peculiar acrimony in the fluid fe-
creted.

/ 3 . Irritata ; from peculiar irritation in fome part of
the urinary channel. — Difcharge of hairs. Klatt. de Tri-
chias, Alton. 1703.

y. Atonica ; from atony of the fphindter of the blad¬
der.

<5\ Aquofa ; from fuperabundant fecretion ; the fluid
limpid and dilute. This variety, which was formerly
confidered of the fame nature as diabetes, is now properly
feparated from the complaint, as having nothing in com¬
mon with it but an increafe in the quantity of the urine.
The change which the urine undergoes in this malady
feems to confift chiefly in the prefence of a great deal of
albuminous matter. The difeafe is rare ; but, from what
we can collefl, feems to be clearly one of the nervous; ma¬
ladies. Attention to the gaftric and cutaneous fundlions,
and the relief of the urinal irritability by opium and ful-
phuric acid, or by hyofcianus, may be for the moll part
trufted to.

A peculiar and troublefome difeafe of the urinary paf-
fage in females is fometimes met with, which, from un-
willingnefs on the part of the patient to confult medical
men on the fubjefl, often proves a fource of great dif-
trefs. It is an inflammatory affection of meatus urina-
rius. This is firft difcovered by a fevere pain, which ex¬
tends upwards during coition, the penis preffing on the
tender part. As the difeafe advances, the pain is felt on
making water; and, the paflage fuffering a partial dila¬
tation, fome part of the urine is retained in it, and ex¬
cites a conftant irritation and defire to make water. The
difeafe proceeding, fulnefs of the parts is felt, aggravated
by long continuance in the ereft pofture. If we are
called in at either of thefe periods of the complaint, we
lhall afford much relief to the patient by applying
leeches to the pudenda, and by dire£ling the bowels to
be kept open, .and a folution of fuper-acetate of lead to
be ufed as a walh. It is to the above inflammatory Hate
of this ftrufture that we have to refer the warty and
fleffiy excrefcences occafionally found at the orifice of
the meatus. Thefe are to be removed by a ligature, and
their reproduction prevented by cauftication.

6. Paruria incofta: urine confiding of fluids taken
into the llomach, and excreted without change.

7. Paruria erratica : urine difcharged at fome foreign
outlet. Five varieties.

a. Salivaris ; by the falivary glands. Phil. Tranf. 1811.

Cutanea ; by the Ikin. Idem.

y. Umbilicalis ; at the navel. Ad. Erudit. 1760.

S. Vaginalis ; by a fiftulous opening into the vagina.
Vulifnerii. Oper. iii.

e. Perintetica ; by a fiftulous opening into the peri-
nseum- Ibid. ■

Genus IV. Lithia, [from XtSo?, a done.] Morbid fe¬
cretion or accumulation of calculous matter in internal
cavities.

The formation of concretions in the urinary pafl'ages
being occafioned by the precipitation andconfolidation of
particular ingredients in the urine, calculi muft of courfe
be liable to occur in any of the cavities to which the
urine has accefs. In fad, experience proves that they are
frequently met with in the kidneys, ureters, bladder,
and urethra. It is commonly believed, that moft of

LOGY.

them are originally formed in the kidneys, from which
organs they afterwards defcend with the urine into the
other mentioned parts. We muft however regard as ex¬
ceptions to this obfervation, the cafes in which calculi
are formed round foreign bodies introduced into the
bladder through the urethra, the digeftive organs, or fome
accidental wound. In the centre of urinary calculi, bur¬
geons have often met with bullets, fplinters of bone, bits
of wood, pins, See. Nor is it neceffary for fuch foreign
bodies to be large, in order to produce this effefl : a clot
of blood, or a little bit of chaff, if not very foon voided,
will caufe a precipitation of the urinary falts.

1. Lithia renalis : pain in the loins (hooting down
towards the teftesor thighs, increafed on exercife ; urine
often depofiting a fabulous fediment.

Thefe fymptoms, and the fa£t that Hones have been
often found ondifleflion in the kidneys when thefe fymp¬
toms had preceded death, clearly convince us that it is
in the kidney that the firft nucleus of the calculi are com¬
monly produced. There are two varieties.

a. Calculofa ; pain fevere and conftant; fabulous dif¬
charge fmall and feldom, or never ; calculus ufually large,
and obftrudting the pelvis of an ureter.

(3. Arenofa, gravel ; pain intermitting ; free difcharge
of a fabulous fediment.

Renal concretions vary confiderably in their number,
fize, and ffiape. In fome cafes, a Angle fmall calculus
has been found occupying one of the foregoing fixa¬
tions; while, in other inftances, an innumerable collec¬
tion of calculous fubftances are obferved filling the
whole of the cavity of the pelvis and infundibula of the
kidney, diftending its parietes, and even obftrufling the
paflage of the urine out of thisvifeus, which is converted
into a fort of membranous cyft. Laltly, a Angle ftone in
the kidney may acquire a very large fize there ; or a great
number of fmall calculi, in the fame fixation, may be¬
come cemented together by the depofition of frefh con¬
creting matter between them, fo as to form one mafs of
enormous dimenfions, and the fhape of which invariably
correfponds to the fpace in which it is, as it were, mould¬
ed. Hence it is, that renal calculi often prefent a variety
of odd irregular figures, refembling thofe commonly ob¬
ferved in fpecimens of coral.

Urinary concretions of large fize very often exift in the
kidney, without their prefence being indicated by any
external circumftances, or attended with any fymptoms,
fufficiently unequivocal to conftitute a ground for fuf-
pedling the importance of their caufe. On the other
hand, it is very ufual for renal calculi of middling di¬
menfions to excite ferious and alarming complaints.
The reafon of this difference becomes obvious, when it
is recolle&ed that fmall concretions are readily carried
with the urine into the ureter, and become fixed in the
narrow portion of the tube ; but very large calculi can be
contained only in the upper part of this canal, where its
parietes are more yielding, and the fpace in them more
capacious. Calculi of middling fize, in their paflage
through the ureter, caufe at firft a feeling of heavinefs,
or an indeterminate fenfe of uneafinefs, and an obtufe
pain in the region of the correfponding kidney. Thefe
complaints occur at intervals of greater or lefs duration.
At length, the pain grows more urgent and annoying,
attended with flatulence, heart-burn, frequent vomiting,
painful retraftion of the tefticle, and fometimes acute
fever. The patient makes water frequently, and in fmall
quantities at a time ; and the urine is high-coloured and
bloody. The patient cannot fit upright, his body being
bent forwards towards the affected fide. Thefe fymptoms
may have more or lefs duration, and then fuddenly ceafe.
They may alfo fubfide and recur feveral times fucceffively,
with intervals of fome days. In the latter cafe, the pain
is felt at each attack to be fixated lower in the track of
the ureter. Laftly, when the fymptoms have entirely
difappeared, the urine is more abundant, not fo high co¬
loured, and eafily difcharged, the ftream fometimes bring¬
ing

2

PATHOLOGY. 347

ing out with it the urinary concretion, which has now
entered the bladder.

Suppuration of the kidney, and an abfcefs in the lum¬
bar region, in confequence of renal calculi, are not very
common events. This, however, is the only cafe of the
kind, in which the interpolition of furgery can be ufeful.
By adverting to previous circumftances, and the irregu¬
larity of the pain about the kidney, the pradlitioner may
fufpedl the nature of a phlegmonous tumour in the fitu-
ation of this vifcus. Whatever may be his conjedlures,
however, he mull carefully abftain from the ufe of his
lancet, until purulent matter is obvioully under the inte¬
guments. He may then fafely make an opening, from
which urine and pus will be difcharged, and through
which the calculi themfelves may fometimes be felt and
extracted. But it is quite clear, that no operation for
the extradlion of calculi, by means of incifion or other
violent methods, can be fafely attempted on fo vafcular a
part as the kidney. Tt is only, therefore, when (on
opening the abfcefs) calculi can be felt with a probe,
that an attempt may be made for their extraction.

Calculi are fometimes found in the ureters, efpecially
at their upper part ; but it is not fupp'ofed that they are
in general originally formed in that fituation ; an event
not likely to happen, unlefs there be fome caufe obftruft-
ing or retarding the defcent of the urine through thofe
tubes. The common belief is, that all calculi found in
the ureters are firft produced in the kidneys, from which
they afterwards defcend in the courfe of the urine. The
generality of calculi, however, which leave the kidney,
are of fmall fixe; and confequently, after a time, and
exciting fome pain and inconvenience, they ufualiy get
into the cavity of the bladder.

z, Lithia veficalis, ftone in the bladder : frequent de¬
fire of making water, with difficulty of difcharge : penis
rigid, with acute pain at the glans ; fonorous refiftance
to the found when fearching the bladder.

The form of calculi is various. Commonly they are
fpheroidal, egg-fhaped, or oval flattened at the Tides.
They alfo receive fome variety of form from the iinpref-
fion of other calculi. In a few inftances, they have been
found of an angular or entire figure, or of a fliape corre.
fponding with the pear-fliaped form of the bladder, a
circular protrufion anfwering to the neck of that cavity.
The number and fize of calculi are alfo liable to fome
variation, as may be feen by referring to the following
inftances which we are indebted to Dr. Good for pointing
put. — Voided of the weight of z oz. by a female; Hanow,
Seltenheiten der Natur. — z\ oz. troy by a female; Moll -
neux. — 5 oz. by the penis; Samwlung Med. Wahrn, Band
viii. p. 238. — Extracted, 12 oz. weight ; Chefelden, Anat.
Ephem. Nat. Cur. Dec. II. ann.v. — zz oz. Fair. Hi/d. de
Li th. vefic. Cent. iv. obf. 51 : the patient died during
the operation — Found in the bladder, 4flb. weight; Brtjl.
Summtung, 1 724, ii. 434- 1 1.— In the bladder of a dog if lb.
Eph. Nat. Cur. II. Dec. III. ann. v. vi. p. 99. — Nearly
jib. in the bladder of a horfe; Gattenhof, in Diffi de
Cal. 1748. — 2 to 3 oz. Phil. Tr. vol. xv. p. 1015. — The
number of 120 of various fizes voided in the courfe of
three days. Eph. Nat. Cur. Dec. III. ann. v. vi. — 300
large in two years. Fabr. Hild. cent. i. obf. 69. — 2000
within two years. Gr'undlicher Bcricht. vom Blatterftein.

The fymptoms of ftone in the bladder are very obfcure.
They are often fimulated by irritative maladies, and
moll efpecially by the nervous excitement confequent on
indigeftion. So marked and eftabliflied is the fimilarity
between dyfpeptic nervous affedlions and the particular
fenfations of the bladder, that on many occafions not the
flighte.fi queftion could be entertained by the inexperi¬
enced pradlitioner of the prefence of calculi, were it not
that the found gives no indication of it. Scirrhus of the
reflurn, and diieafed proftate, are difeafes which refemble
the complaint in queftion in fome refpedls.

The following is the hiftory of the ordinary fymptoms
of Lithia veficalis. The pain produced by the prefence
Vox. XIX. No. 1308.

of a calculus in the bladder, has the particularity of
always affedling, in a very remarkable manner, the ex¬
tremity of the penis. The glans becomes the feat of an
itching fenfation, which daily increafes in violence ; and
patients, efpecially children, often get into the habit of
pulling forwards the prepuce, in order to obtain relief.
Hence, this part is frequently elongated in an extraor¬
dinary degree. This lympathetic fort of pain is more
acute the larger the ftone is, and the greater the irregu¬
larity of its lurface. When the bladder is full of urine,
the pain is not infupportable; but, juft at the period
when the difcharge of that fluid is finiftied, the fuft’ering
becomes intolerable, becaufe, at this inftant the bladder
contradls, and embraces the foreign body with confider-
able force. All rough exercife augments the pain; but
walking over an uneven country, riding on horfeback,
and the jolting of a carriage particularly, have fuch an
effedl. When the patient is fubjedled to thefe exercifes,
he not unfrequently difcharges a few drops of blood from
the urethra. The defire to make water comes on very
often ; and the urine, as it flows, is attended w'ith a fen¬
fation of heat, which changes into a burning kind of pain
at the extremity of the penis. The ftream of water is
fometimes interrupted all on a fudden. The patient
v.finly endeavours to continue the evacuation ; he ap¬
plies his hand to the perineum ; he moves about, lies
down, or, in fome way or another, alters his pofture, and
the urine then begins to run again. The moveablenefs
of the ftone makes it every now and then fall againft the
orifice of the neck of the bladder, and thus prevent, for
a time, the exit of the urine. The inceflant irritation,
produced by the prefence of the calculus, extends to the
redlum ; the patient is continually teazed with an incli¬
nation to go to (tool, and the efforts, which his imagi¬
nary want caufes him to make, bring on, in many in¬
ftances, hemorrhoidal complaints, or even a prolapfus ani.
But, as we before remarked that all thefe fymptoms are
equivocal, the pradlitioner fhould always introduce a
found into the bladder before he gives an opinion on the
nature of the cafe. For the mode of founding, fee Sur¬
gery.

Having thus detailed the fymptoms which calculous
depofitions are accompanied with, and defcribed the va¬
rious fituations they occupy, and the extreme magni¬
tude or number they may acquire, we proceed to confi-
der their eompnfition, with reference to their removal by
medical fkill. In this talk we fhall make no diftindlion
as to the fituation the calculi occupy, or their fize; fince,
whether they exhibit the form of gravel or of ftone, their
compofition is analogous.

We fhall clafs urinary depofitions in the following or¬
der. 1. The lithic or uric acid depofition, being an ex-
cefs of the natural free acid of the urine. 2. The de¬
pofitions of which phofphoric acid forms a part; viz.
the phofphate of lime or bone-earth calculus ; the ain-
moniaco-magnefian phofphate : and a mixture of the
two latter, called the fufible calculus. 3. The oxalate
of lime. 4. The cyftic oxyd. 5. Compound varieties.

As to the formation of all thefe various matters, fome
of which are proper to urine in its healthy Hate, and fome
of which are peculiar to its morbid ftate, little can with
certainty be faid. Chemical philofophers have endea¬
voured to fhow, that a diet which contains a large por¬
tion of azote, as animal food, produces excefs of alkali
in the urine ; and fimilar fpeculations have been founded
on the effects of vegetable food. Further than the fad t
that an exclufive fpecies of diet tends to derange the gaf-
tric fundlions, and that a change quite oppofite muft ne-
ceflariiy change many of the operations of the fyftem,
we cannot admit the corredlnefs of any obfervations of
this kind. In fadl, contrary to what wefhoulda priori
expedt, and contrary to thefe obfervations, we do not find
that people who drink plentifully of waters ftrongly im¬
pregnated with falts are more difpofed than others to
calculous complaints. We are much pleafed to find, that
4 U the

PATHOLOGY.

348

the views we have entertained of calculous diforders, (fee
Diabetes,) viz. that they all confift in a peculiar change
in the fecernents of the kidneys, probably independent
of the ftate of the blood, and confequently under
the control of the nervous fyftem, has received much
fupport from the teftimony of a recent diftinguifhed au¬
thor, Dr. Prout, who (in his Inquiry into the Nature
and Treatment of Gravel) in every page refers to the dif-
ordered date of the nervous fyftem as a caufe of morbid
depofitions. We do not conceive that this opinion is at
all impugned by the relief afforded in fome cafes by the
exhibition of remedies oppofite in their chemical proper¬
ties to thofe of the calculi, becaufe fuch medicines may
aft by caufing a different aftion in the kidneys. The
afl’umption of this idea explains how it happens, that it
is only in fome cafes that the above remedies do good ;
fince, that fuch failure fhould occur in medicines which
aft on difordered veffels, no one can be furprifed at; but,
that the uniform and invariable operation of chemiftry
fhould be fo often difturbed muft be a matter of the
greateft wonder to thofe who conceive that thefe opera¬
tions are the caufe of calculi. To return to our hiftory
of the fpecies of calculi.

i. Lit hie Acid Depofitions. — Lithic acid is feparated
from the urine in two forms, as fediment or as calculus.
In the firft form it is in combination with ammonia; in
the fecond, pure. In the former ftate it is precipitated
llowly, and acquires a reddifh hue ; in the latter the li¬
thic acid forms a hard inodorous concretion, of ayellow-
ifli or brown colour, fimilar to that of wood, of various
lliades. According to profeffor Murray, calculi of this
kind are in fine clofe layers, fibrous or radiated, and ge¬
nerally fmooth on their furface, though fometimes a lit¬
tle rough. They are rather brittle, and have a fpecific
gravity varying from i-276 to i'786, but ufually above
1-500. One part of lithic acid is faid to diffolve in 1720
parts of cold water, and 1150 parts of boiling water ;
(Marcet, p. 65.) and this folution turns vegetable blues
to a red colour. When it has been diflolved in boiling
water, fmall yellowilh cryftals are depofited as the fluid
becomes cold. Lithic acid calculi blacken, but are not
melted by the blow-pipe, emitting a peculiar animal fmell,
and gradually evaporating until a fmall quantity of
white alh remains, which is alkaline. By diftillation,
they yield ammonia and pruflic acid. They are foluble
in the cold, in a folution of pure potafl'a, or foda ; and
from the folution, a precipitate of a fine white powder is
thrown down by theacids. Lime-water likewife diflolves
them, but more fparingly. In folutions of the alkaline
carbonates, they remain, according to Scheele, unchanged:
according to the experiments of Dr. Egan, however, they
are diflolved even by a weak folution, and alfo when the
acid is fuperfaturated by carbonic acid. (Tranf. of Iriflt
Acad. 3805.) They are not much afted upon by ammo¬
nia. They are not foluble either in the muriatic or ful-
phuric acid; though they are fo in the nitric, when af-
iifted by heat ; and the refidue of this folution, when
evaporated to drynefs, a flumes a remarkably-bright pink
colour, which difappears on adding either an acid or an
alkali. In many of thefe calculi, the lithic acid is nearly
pure; in others, there is an intermixture of other ingre¬
dients, particularly of phofphate of lime, and phofphate
of ammonia and magnefia ; and, in almoft all of them,
there is a portion of animal matter, which occafions the
fmell when they are burnt, and the lofs in their analyfis.
The depofition of lithic acid, either in the form of
fediment, gravel, or calculus, is almoft always connefted
with indigeftion. According to fome, the dyfpepfia is
the confequence of an excefs of acid being generated in
the ftomach, from the morbidity of that organ fuft'ering
chemical changes to take place in it. But, as the pre-
fence of this free acid has not been detefted in the blood
ingravelly cafes, we muft infer that the gaftric irritation
caufed (by means of fympathy) in the urinary fecernents is
the fame aftion as is excited in thofe of the ftomach ; an

opinion which, though it aflumes a. fympathy not in ge¬
neral very apparent, is neverthelefs poflible. Dr. Prout
gives another very plaufible account of this matter; one
which, while it aflumes the exiftence of difeafed blood in
thefe cafes, clearly Ihows why we do not find any free
acid in the blood, and confequently that the difeafe de¬
pends on morbid aftion of the kidneys/ induced by the
morbidity of their fanguineous fupply. This important
principle is, that, if imperfectly ajjimilated or unnaturally
albuminous matter is brought to the kidney, it does, and
muft, in virtue of its natural aftion, convert fuch imper-
feft albumen into lithate of ammonia.

The treatment of perfons labouring under the above
form of difeafe will not be difficult, whichever of the
above theories we adopt ; except that, under the influ¬
ence of the former, our exhibition of alkaline remedies
will of courfe be more free. We are bound in juftice to
declare, however, that the fuccefs which attends thefe
remedies rather militates againft than argues for, the the¬
ory in queftion ; for they are very often quite ufelefs.
The molt fuccefsful praftice feems to be, to alter the diet
in fome eflential points ; but at the fame time to attend
rather to its quantity than to its quality; to excite the
biliary and inteftinal fecretions by blue pill and gentle
purges, and thofe of the fkin by means of antimonials.

In thofe yellow depofitions (confifting of lithate of
ammonia), indicative of dyfpepfia, the fame treatment
is to be followed. Thofe pink depofitions from urine,
which are compofed, according to Prout, of the purpu-
rates of foda and ammonia, and which are ufually met
with in chronic phlogofis and heftic fever, and almoft
always in acute inflammations, do not of courfe require
that any change fhould be made in the ordinary courfe
of treatment on their account.

Thofe fudden acceflions of pain and inflammation
which are called fits of gravel are more efpecially treated
by low living, copious dilution, and full doles of hyo-
feiamus.

2. Depofitions of which Phofphoric Acid forms a part. —
Phofphoric acid and lime, magnefia and ammonia, are
all natural conftituents of urine. A depofition of one
or more of thefe alkalies, in combination with phofpho¬
ric acid, conftitutes a very common form of difeafe. It
is prefumed that the phofphoric depofition may occur in¬
dependently of any morbid change in the kidney, as when
foreign bodies get by chance into the bladder, and form
a point of adheiion for thefe falts ; a change we fhould
not be furprifed at, when we obferve the very common
occurrence of urinary cryftallizations in fituations exter¬
nal to the body. It has been doubted, however, by fome,
whether even foreign bodies do not operate by exciting
irritation, and conlequently morbid fecretion of urine.
At all events, the derangement of the aftion of the kid¬
ney is the commoneft fource of the phofphatic depofi¬
tion. This latter feems to confift in a fufpended or di-
miniflied aftion of the ufual acidifying powers of the
kidney, whereby, inftead of lithic acid, a greater quan¬
tity of urea (equivalent to ammonia), lime, and magne¬
fia, is generated. This condition of the urine is very
commonly dependent upon a deranged ftate of the chy-
lopoi'etic vifeera ; frequently, too, it is connefted with a
great degree of irritability and debility of the fyftem.
Hence it is that children are fo liable to this form of de-
pofite, from their extreme irritability, and great ten¬
dency to diforders of the ftomach and bowels.

The depofition of the phofphates is attended with un-
eafinefs about the loins, a fallow haggard countenance,
black, clay-coloured, or yeafty, ftools, and fubfequentiy
great languor and debility, as in diabetes. The urine
too here, as in the difeafes already treated of, is pale,
and fecreted in larger quantity than natural ; but it is
commonly of very low fpecific gravity, fuch as i'ooz.
When the fpecific gravity is greater than this, the phof¬
phatic fediment is proportionally more copious. In this
ftate of difeafe the urine is very prone to decompofitiori;

1 and

PATHOLOGY.

and Speedily emits a naufeous fmell from the evolution of
ammonia.

Moft authors have confidered a long-continued ufe of
alkalies as the caufe of the phofphatic calculi ; but, when
we conlider the unfrequency of this caufe,. vve fhould
be inclined to put little ftrefs on its coincidence. This
alfo is the opinion of Dr. Prout. This author allows
that in a few cafes it may occur, but, as a general prin¬
ciple in the pathology of earthy depofitions from the
urine, he considers it of no importance whatever. The
real caufes of this ftate of difeafe are, he fays, either local
or general. A large proportion of the cafes are owing to
fome injury of the back. It is an old obfervation, that
fuch injuries produce alkaline urine. Exceffive fatigue,
Severe and protrafled debilitating palfions, are among the
other general caufes of the affection, Its principal local
caufes are irritations about the bladder or urethra , efpccially
when operating for a conjider able length of time. This appears
to be the leading feature in Dr. Prout’s views of the phof¬
phatic diathefis. It is certainly deferving of remark, that
the fame view of the fubjefl had long ago been taken by
Mr. Murray Forbes, who exprefsly dates, that, “when a
foreign body gets into the bladder, it would operate bp ir¬
ritation, foas to occafion a redundancy of the phofphates.”

The tranfition from the formation of lithic acid to the
depofition of the phofphates is very curious. It takes
place gradually through the lithate of ammonia, and is
accompanied by the dil'appearance of the ufual colouring
principle from the urine. The tranfition from the mul¬
berry-calculus to the phofphates takes place through a
mixture of oxalate and carbonate of lime. The next
layers are found to confift of the carbonate and phofphate
of lime; and, ftill farther from the centre, the carbonate
of lime difappears. Dr. Prout believes that wherever the
change takes place ex abrupto, it is prefumable that fome
time mull have elapfed between the depofition of the dif¬
ferent matters. It is a curious and important feature in
the pathology of the urinary fyltem, that a decided depo¬
sition of the phofphates is never followed by a different
depofite.

When the depofition of the phofphates arrives at
the magnitude of calculi, we have the three following
kinds, as defcribed by chemical writers.

Bone-earth, or phofphate of lime calculus. — This is of a
pale brown colour, and fo fmooth as to appear polifhed.
When fawn through, it is found very regularly lami¬
nated ; and the laminae, in general, adhere fo fl ightly to
each other, as to Separate with eafe into concentric crufts.
It diffolves entirely, though flowly, in muriatic or nitric
acid. Expofed to the flame of the blow-pipe, it is at firft
flightly charred, but foon becomes perfeftly white, re¬
taining its form, until urged with the utmoft heat from
a common blow-pipe, when it may be completely fufed.
It appears to be more fufible than the phofphate of lime,
which forms the balls of bone ; a circumftance afcribed
to the latter containing a larger quantity of lime. Cal¬
culi, altogether compofed of phofphate of lime, are rather
uncommon.

Triple calculus, or ammoniuco-magnefian phofphate. —
Calculous maffes, confining folely of this fubftance, are
perhaps never met with ; but concretions often occur,
in which it obvioufly prevails; and, as Dr. Marcet ob-
ferves, “this triple fait frequently appears alfo in the
form of minute Sparkling cryftals, dift’ufed over the Sur¬
face, or between the interftices of other calculous laminse.
Calculi, in which this triple fait prevails, are generally
whiter and lefs compaft than thofe of the former clafs.
When the blow-pipe is applied, an ammoniacal fmell is
perceived, the fragment diminifhes in Size; and, if the
heat be ftrongly urged, it ultimately undergoes an im¬
perfect fufion, being reduced to the ftate of phofphate of
magnefia.” _ Dr. Wollafton defcribes the form of the
cryftals of this fait, as beingd fhort trilateral prifm, having
one angle a right angle, and the other two equal, termi¬
nated by a pyramid of three or fix Sides. Thefe cryftals

349

are but Sparingly Soluble in water, but very readily
in moft, if not all, the acids; and on precipitation, they
reaffume the cryftalline form. From the Solutions of thefe
cryftals in muriatic acid, Sal ammoniac may be obtained
by Sublimation. Solutions of cauftic alkalies difengage
ammonia from the triple fait, the alkali combining with
a portion of the phofphoric acid.

Fufible calculus. — This is commonly whiter and more
friable than any other Species. It Sometimes refembles a
mafs of chalk, leaving a white duft on the fingers; and
Separates ealily into layers or laminae, the interftices of
which are often ftudded with Sparkling cryftals of the
triple phofphate. At other times, it appears in the form
of a Spongy and very-friable whitilh mafs, in which the
laminated ftruflure is not obvious. Calculi of this kind
often acquire a very large Size, and mould themfelves in
the contracted cavity of the bladder, affuming that pear-
fhaped form before alluded to, which Dr. Marcet has
never obferved in any of the other Species of calculi, and
which confifts in the ftone terminating, at its broader
end, in a kind of peduncle, corresponding to the neck of
the bladder. The chemical compofition of the fufible
calculus is a mixture of the triple phofphate and phof¬
phate of lime. Thefe two Salts, which, when Separate,
are infufible, or nearly lb, when mixed together and
urged by the blow-pipe eafily run into a vitreous globule.
•The compofition of this fubftance, fays Dr. Marcet, may
be ftiown in various ways. Thus, if it be pul verized, and
acetic acid poured upon it, the triple cryftals will be
readily dift'olved, while the phofphate of lime will Scarcely
be aCted upon ; after which the muriatic acid will readily
difl'olve the latter phofphate, leaving a Small refidue,
confifting of lithic acid, a portion of which is always
found mixed with the fufible calculus.

The tendency to phofphatic depofition is cured with
difficulty, especially in advanced cafes, when the aftual
prefence of a ftone in the bladder forms a mechanical
caufe of continued renal irritation. Even the French
practitioners, fo Sanguine in their hopes of curing the
lithic-acid depofitions by a vegetable diet and copious
dilution, confefs their defpair in cafes of this kind. It
may be remarked, however, that palliatives are particu¬
larly indicated. Large and frequent doles of opium may
be given ; and it will be Some confolation to reflefl, that
thefe medicines have Sometimes proved more than pal¬
liative; for that under a ftriCl attention to the ftate of
the primae vise (and without this attention no medicine
can do good), they have fufpended the depofition, and
have reftored the patient, even though afflidled with ac¬
tual ftone, to a ftate of good health, by preventing the
further morbid Secretion of the kidneys, and the conse¬
quent increafe of Size in the gravel or calculus. Befides
this drug, Dr. Prout has prefcribed with good effeft a
combination of uva urfi, muriatic acid, and hyofciamus,
in the phofphatic diathefis.

3. Mulberry Calculus, or Oxalate of Lime. — This is moft-
ly of a dark-brown colour, and frequently its interior is
grey. Its Surface is ufually uneven, presenting tubercles
more or lefs prominent, frequently rounded, Sometimes
pointed, and either rough or polifhed. It is very hard,
difficult to Saw, and appears to confift of fucceffive une¬
qual layers. Excepting the few ftones which contain a
proportion of Silica, it is the heavieft of the urinary con¬
cretions. The pure alkaline Solutions have no effeft upon
this calculus, and the acids diffolve it with great difficulty.
When it is reduced, however, to fine powder, both mu¬
riatic and nitric acids difl'olve it flowly. The Solutions
of the alkaline carbonates decompofe it, as Fourcroy
and Vauquelin have obferved; and this affords us the
eafieft method of analyfing it. The calculus in powder
being digefted in thfe Solution, carbonate of lime is Soon
formed, which remains infoluble, and is eafily diftin-
guifhed by the effervefcence produced by the addition of
weak acetic acid, while there is obtained in Solution the
compound of oxalic acid with the alkali of the alkaline

carbonate.

350 PATHOLOGY

carbonate. From this, the oxalic acid may be precipi¬
tated by the acetate of lead, or of barytes ; and this ox¬
alate, thus formed, may be afterwards decompofed by
fulphuric acid. Another method of analyfing this cal¬
culus is by expofureto heat: its acid is decompofed, and,
by railing the heat diffidently, pure lime is obtained,
amounting to about a third of the weight of the calculus.
According to Fourcroy and Vauquelin, the oxalate of
limecalculuscontains moreanimal matter than any other.
This animal matter appeared to them to be a mixture of
albumen and uree. The compofition of a calculus of this
fpecies, analyfed by Mr. Brande, was — Oxalate of lime
65 grains, uric acid 16 grains, phofphate of lime 15
grains, animal matter 4. grains. We know no¬
thing of the Hate of the body which induces this cal¬
culus.

4. The Ci/Jiic Oxyd. — Dr. Majendie Hates that it very
rarely enters into the formation of gravel and urinary
calculi ; but, as the nature of this animal matter is not
generally known, it may be proper to mention its general
properties. Calculi formed of cyflic oxyd, are femi-tranf-
parent, of a yellowilh colour, and have a luftre (imilar to
that of bodies of a denfity powerfully refradive. F.x-
pofed to heat in a retort, they furnilh carbonate of am¬
monia of a fetid odour 5 there paffes alfo an heavy fetid
oil, fuch as is obtained frpm animal matter, but in a
much lefs proportion than that which refults from a dif-
tillation of uric acid. Thefe properties (how that, like
uric acid, it is principally compofed of azote; it is there¬
fore probable, that it is produced by the fame caufes
which determine the formation of uric acid. This fub-
ftance is but very (lightly foluble in water, not at all in
alcohol, or the acetic, tartaric, and citric, acids ; it is, on
the contrary, foluble in the muriatic, nitric, fulphuric,
phofphoric, and oxalic, acids, as well as in potafh, Coda,
lime-water, and the carbonates of potafli and foda. The
greater number of its properties approach to thofe of
uric acid.

5. Of the Compound or Irregular Calculi — the greater
proportion are thofe which difpiay alternate layers. Thus,
lithic ftrata frequently alternate with layers of oxalate of
lime, or with the phofphates. Sometimes alfo the mul¬
berry alternates with the phofphates; and, in a few in-
Itances, three or even four fpecies of calculi occur in the
fame (lone, difpofed in diltind concentric laminae.

Some compound calculi have their ingredients intimately
mixed. They have no charaderiflic feature ; but may
fometimes be recognized by their more or lefs irregular
figure, and their lefs determined colour, by their being
lefs dillindly if at all ftratified, and by their often pof-
fefling a coqfiderable hardnefs. By chemical analylis,
confufed refults are obtained.

The remarks we have hitherto made on the treatment
of calculous diforders, relates folely to the removal of
that fate of the confitut ion uhich caufes the depnftion or
formation of Jlonp mutter ; and confequently applies only to
the prevention of its further formation. In another part of
this work, (fee Lithontriptic, vol. xii.) we have ex-
preffed our conviction of the perfed futility of exhibit¬
ing any medicine with the view of diffolving Hone in the
bladder. It is the higheff llretch of our prefent power in
the treatment of calculi, to prevent their further progrefs;
and if we can do this, and delay, for a certain fpace of
time, the irritability of the fyflem, the bladder will accom¬
modate itfelf to the prefence of the (lone (while it no
longer grows), and much comfort may be enjoyed by the
patient of this dreadful malady. When thefe meafures
are unfuccefsful, or when the youth or good conffitution
of the patient forbid us to fear the future regeneration
of the (lone, the removal of it will be advifable ; which
if to be effeded in two ways : in men by the ufual prac¬
tice of lithotomy ; but, with regard to women, the fhort-
nefs and expanfibility of the female urethra not only ad¬
mits an evacuation of large calculi with little inconve¬
nience compared with that fuffered by men, but has often

fuggefled the expediency of introducing the (lone-for¬
ceps into the bladder, fo as to fupply the place of litho¬
tomy. Mr. Thomas, by gradually enlarging it by means
of a fponge-tent, was, in one cafe, able to introduce his
finger into the bladder, and fucceeded in bringing away
an ivory ear-pick which had been incautioufly ufed as a
catheter, and had (lipped into the cavity. In another
lingular cafe, the fame Ikilful operator gradually ex¬
panded the fphimfter ani to a diameter large enough to
admit his whole hand into the redum, and hereby fuc¬
ceeded in extrading a large fubftance which had flipped
into its channel. More recently, fir A. Cooper has fuc¬
ceeded in removing fmall Hones from the bladder of an
old patient, a clergyman, by means of a peculiar inffru-
ment of his own invention, which dilates the urethra,
and draws the Hones through the natural opening. For
the common method (and the only one capable of ap¬
plication when the calculus is large) of removing Hones
in the bladder by the operation of lithotomy, and alio for
fome further obfervations on the dilating fyfiem above
alluded to, fee the article Surgery.

Order III. Acrotica, [axpo?, extreme; hence ccy.f 'Icfi-n;,
the top or highefi point of any thing.] Diforders affect¬
ing the Surface of the Skin. Pravity of the fluids or
emundories that open on the external furface: without
fever, or other internal affedion, as a neceffary accompa¬
niment. There are ten genera, which, as well as the fpe¬
cies, are chiefly taken from Dr. Bateman’s improved
edition of Willan on Cutaneous Difeafes.

Genus I. Ephidrofs, [i. e. fweat.] Preternatural fecre-
tion of cutaneous perfpiration. There are four fpecies,
befides varieties.

1. Ephidrofis profufa: cutaneous perfpiration fecreted
profulely.

2. Ephidrofis cruenta : cutaneous perfpiration inter¬
mixed with blood.

3. Ephidrofis partialis.: cutaneous perfpiration limited
to a particular part or organ. Ephidrofis lateralis, Suhv.
who quotes from Schmidt (Colled. Acad iii. 577) the
cafe of a woman who was never capable (except when
pregnant) of being thrown into a fweat in any other
part than the left fide.

4.. Ephidrofis tinda: cutaneous perfpiration poffefling
a depraved colour. Four varieties of colour.

a. E. viridis; of a green tinge. Borelli. cent. ii. 56.

£?. E. nigra ; of a black tinge. Joel. Langelot. Coiled.
Acad. iii. 255.

y. E. caerulae; of a blue tinge. Winder. Colled. Acad.
iii. 263.

& E. rubra ; of the colour of port-wine. Sauv. and
Bart hoi.

5. Ephidrofis olens : cutaneous perfpiration poffelflng
a depraved (mell. Four varieties of odour.

a,. E. fulphurea; of a fulphureous fcent. Ephem. Nat.
Cur. cent. i. ii. obf. 168.

(3. E. acida ; of a four fcent.

y. E. olida ; of a rank or fetid fcent. Often partial, or
evacuated from particular organs, as the feet or axillae :
fometimes from the furface generally, according to De
Monteaux.

E. mofchata ; of a mulky fcent. Pecklin, lib. ii.
obf. 4-9.

The majority of thefe rare difeafes are involved in much
obfcurity, and many of them are probably conneded
with other maladies. This is the cafe efpecially with
profufe and partial perfpiration, very common fymptoms
of dyfpepfia; and may very fairly be prefumed to be the
cafe with ffinking and bloody perfpiration. Metaffalis
from the retention of milk, urine, the catamenial flux,
and faeces, may alfo produce the fame aberrations.

Genus II. Exanthefs, [from ef, outward, and
to fpring or flower; fuperficial or cutaneous effloref-
cence 5 in contradillindion to Emnlhefis, or efflorefcence

fpringing

PATH

fpringing from within. See p. 273.] Cutaneous blufh.
Generic characters — Simple cutaneous rofe-coloured ef-
fiorefcence, in circumfcribed plots, with little or no ele¬
vation.

On coming to the confideration of cutaneous difeafes
ftriftly fo called, it will be necefiary to make a few pre¬
liminary remarks. It will be recollected, that in p. 141
of this article, we have expreffed our concurrence in the
opinion which attributes the majority of cutaneous de-
faedations to gaftric or inteftinal irritation. In that place
alfo fufficient evidence of this frequent connexion has
been adduced. An objection, however, is in force
againft this mode of confidering the difeafes in queftion;
.that, while gaftric or inteftinal irritations are but few in
number, cutaneous maladies are extremely multiform ;
and hence it may be inquired, Can fo many and fucli
oppofite appearances refult from one caufe ?

Let us examine the matter a little clofely. Cutaneous
difeafe is evidently a difeafe of the fecernents of the (kin;
fometimes this dileafe is accompanied, either as a caufe
or confequence, with inflammation : i. e. turgefcence and
-heat of the fubjacent red veffels ; but fometimes this is
wholly abfent, and the difeafe of the fecernents is the
only malady. Now this difeafe of the fecernents is fup-
pofed to vary according to the produCt which is fecreted ;
and on this variation have the claflifications of cutaneous
difeafes'by Willan and Bateman been folely founded.
Thus, when inflammation of the fubjacent red veffels
takes place, the papula, or pimple, (“a very fmall and acu¬
minated elevation of the cuticle, with an inflamed bafe,
very feldom containing a fluid, or fuppurating, and
commonly terminating in fcurf,”) is found. When the
inflammation goes on to fuch a degree as to diforganize
the (kin, fquama, or fcales, (“laminae of morbid cuticle,
hard, thickened, whitifli, and opaque,” and irregular
layers of fkin called crujls, or over ulcers J'cabs,) are ob-
ferved. The flmpleft difeafe of the lkin is that in which
.the fecernents admit red blood, and fecretion is at once
fufpended. This forms the exanthema, or rafh ; (“ fuper-
ficial red patches, varioufly figured, and diffufed irregu¬
larly over the body, leaving interftices of a natural co¬
lour, and terminating in cuticular exfoliations.”) When
the above veffels fecrete iri fmall quantities, water, which
becomes opaque, and is fucceeded by fcUrf or crufts,
they are named veficles; when in large quantities like a
blifter, bulla, or bleb. Laftly, when pus is fecreted in
the cutaneous elevation, it is called a puflulu, or puftule.
The puftule has in all cafes an inflamed bafe. Dr. Bate¬
man gives four varieties of it.

a. Phlyzacium ; a puftule commonly of a large fize,
raifed on a hard circular bafe, of a vivid red colour, and
fucceeded by a thick, hard, dark-coloured fcab.

b. PJydracium ; a fmall puftule, often irregularly cir-
cutnfcribed, producing but a flight elevation of the cu¬
ticle, and terminating in a laminated fcab. Many of the
pfydracia ufually appear together, and become confluent;
and, after the difcharge of pus, they pour out a thin
watery humour, which frequently forms an irregular in-
cruftation.

<•. Achor ; a fmall acuminated puftule, containing a
ftraw-coloured matter, which has the appearance and
nearly the confidence of drained honey, and fucceeded by
a thin brown or yellowifh fcab.

d. Faviis, is larger than the achor, flatter, and not acu¬
minated, and contains a more vifcid matter; its bafe,
which is often irregular, is flightly inflamed ; and it is
fucceeded by a yellow, femitranfparent, and fometimes
cellular, fcab, like a honey-comb; whence i£ has obtained
its name.

To thefe we may add the tubercle and the wheal. The
firft is a fmall hard fuperficial tumour, circumfcribed and
permanent, or fuppurating partially; and the wheal is
the fame appearance as is produced by a (mart ftroke
with a whip on the naked fkin, Itfeems a fudden accu-

Vol.XIX. No. 1308.

OLOGY. 351

mulation of the fluids of the part, which goes off as the
veffels regain their natural powers.

To return to the fubjeft we were reafoning upon. We
perceive, therefore, two agents concerned in cuta¬
neous difeafes : the fecernents of the fkin, and the red
blood-veflels of the fubjacent tiflue. We obferve, that,
according to the peculiar irritation which affefts them,
both thefe veffels put on different appearances. Now on
the one hand, the circular form of one eruption is con-
trafted with the irregular form of another, and the mor¬
bid produff of this is quite different from the difeafed
fecretion of another. The difeafes of the ikin in which
the fanguineous ftrufture is implicated are few in number,
and for the moft part eafily traced to the caufe of morbid
blood on the one hand, or atmofpherical changes on the
other. But the difeafes which have their feat moft ftriftly
in the fecernents of the fkin, and which are by far the
moft numerous, cannot be fuppofed to fuffer from atmol-
pheric changes, fince thefe could merely operate to reduce
or increafe the quantity of blood in the blood-veflels of
the fkin; and in fa ft are not more frequent in hot or cold
climates than in temperate ones, though we allow that
they are more violent in hot ones when once formed, by
reafon of the conlequent inflammation which heat fo
naturally excites. And, even were thefe impreflions al¬
lowed to have much force, wefhould be furprifed to find
that fo many kinds of difeafe follow the very Ample
caufes of heat or cold.

It is to that portion of the cutaneous expanfion which
lines the alimentary canal, which is expofed to a thoufand
different impreflions from foreign bodies, from excels or
alteration in its own fecretions, or of thofe fecretions
poured fo plentifully into it, which moreover is fo clofely
connefted by nervous fympathy with the external fkin,
that the moft trifling ailments of the one alter the fecre¬
tion and aftions of the other, that we muft look for the
common caufe of diftention of the lkin. Befides the con¬
nexion between the gaftric and cutaneous irritation by
means of nervous fympathy, the alteration which im¬
paired digeftioaeffefts in the quality of the blood, may
bring on cutaneous defaedations ; but it feems that the
maladies produced by this caufe as deeply implicate the
fubjacent tiflue as the fkin, and therefore are not properly
to be claffed with cutaneous diforders. Thus, Porphyra
is very properly feparated by Dr. Good from this clafs.
A great number of cutaneous difeafes are infeftious.

The cure, therefore, of all cutaneous maladies may be
attempted with the following indications. The firft is to
reftrain the aftion of the fanguiferous fyftem, in thofe
maladies or in thofe ftages of maladies in which their ac¬
tion is exceflive. This is chiefly effefted by bleeding,
by cooling and fedative lotions. The fecond is, to re¬
move the morbid fecretions which are applied to the ali¬
mentary canal, and which caufe the difeafe. The cor-
reftion of bile has been followed by the cure of trouble-
fome cutaneous diforders ; and there is fcarcely a medi¬
cine capable of producing a powerful change in the fecre¬
tions of the digeftive organs but what has, on a few oc-
cafions, performed furprifing cures. But the moft pliilo-
fophical and fure method of proceeding is to reftore the
funftion of the alimentary canal by proper regulations
as to diet and exercife, and the ftate of the alvine fecre¬
tions. In many cafes this is all that is necefiary; but in
forne, notwithftanding the digeftive and fanguineous
organs are in a very tolerable ftate of health, the difeafe of
the lkin will remain unabated. Under thefe circumftan-
ces, it will be necefiary to apply fome medicine that will
ftimulate the fecernents in a different mode to that fti-
mulation imparted by their nerves. In different difeafes
different ftimuli will be necefiary; but this can only be
known by experiment. In fome, the ftimulating agent
required is almoft invariable in its fuccefsful operation ;
as fulphur for the cure of itch ; in others, the greateft un¬
certainty is met with, as in fome forms of impetigo.

4 X Another

352

PATHO

Another mode of curing cutaneous difeafes is by exciting
a function vicarious to that of the fkin, as the urine by
means of diuretics. As an adjunCt, the foothing of the
irritable feelings of the affeCted ftrudture by anodynes
and baths is on many occafions required. This genus
has only one fpecies, namely

Exanthefis rofeola, rofe-ralh : efflorefcence in blufli-
ing patches, gradually deepening to a rofe-colour, moftly
circular or oval ; often alternately fading and reviving;
fometimes with a colourlefs nucleus : chiefly on the
cheeks, neck, or arms.

This difeafe is merely fymptomatic of a little feverifti-
nefs of the fyftem ; and goes off fpontaneoufly, oratleaft
eafily difappears under the ufe of a few gentle purges.
It is mentioned in this place, lefs on account of its im¬
portance, than becaufe it is liable, in fome of its forms,
to be confounded with fome of the Exanthemata. Fig.
4, 5, and 6, on the Plate V. difplay the varieties of this
eruption. Fig. 4 is th efummer rofe-rtjh, a ralh attended
with much itching and tingling, chiefly occupying the
neck and Ihoulders, and of a rofeate hue : it goes off on
the fifth day. Fig. 5. the autumnal rofe-rcjh, occurs
chiefly in autumn ; is of damalk-rofe-colour, appears
chiefly on the arms, defquamates in about a week,
and is attended with little itching or general diforder.
Fig. 6 the Rofeola annulata of Bateman, fo called from
its ring-like form, and appearing occafionally in every
part of the body, is attended with fever when its dura¬
tion is fhort, but with none when it lalts a long time.
In the chronic form, the rednefs is not very marked till
the evening, when a good deal of itching and tingling
come on.

Genus III. Exorniia, [from sfop/zaw, to break out.] Pa¬
pulae, or pimples. Generic characters — Small acuminated
elevations of the cuticle; not containing a fluid, nor
tending to fuppuration ; commonly terminating in fcurf.
There are four fpecies.

■ 1. Exormia ftrophulus : eruption of red pimples in
early infancy, chiefly about the face, neck, and arms ;
furrounded by a reddilh halo ; or interrupted by irregu¬
lar plots of cutaneous blufli. Five varieties.

oc. Strophulus intertinCius, red gum: pimples bright-red;
diftinCt, intermixed with lligmata, and red patches; ufually
on the cheeks, fore-arms, and backs of the hands, but
fometimes fpreading over the body. The repulfion of
this eruption is dangerous ; but, fliould this happen, it
may be counteracted by warm bathing; a meafure gene¬
rally ufeful.

(3. S. albidus, white gum : pimples minute, hard,
whitifh; furrounded by a reddilh halo.

7. S. confertus, tooth-ralh, or rank red gum: pimples
red, of different lizes ; crowding or in clufters; the larger
furrounded by a red halo; occafionally fucceeded by a
frelh crop.

S. volaticus: pimples deep-red, in circular patches
or clutters ; clufters lometimes folitary on each arm or
cheek ; more generally flying from part to part.

£ . S. Candidas : pimples large, glabrous, thining; of a
lighter hue than the Ik in : without halo or blufli.

The three laft varieties are fliovvn on Plate VI. fig. 1.
as they appear on the face, on the fore-arm, and on the
arm. The fpecies, indeed, like the preceding, is not
confidered of much confequence in praCtice; but is de-
fcribed and delineated on account of its occafional fimi-
larity to fome of the Exanthems.

2. Exormia lichen: eruption dift'ufe ; pimples red;
troublefome fenfe of tingling or pricking. Seven varie¬
ties ; of which a, 7, and |, are the fubjeCts of the remain¬
ing figures of Plate VL

a. Lichen fimplex, (fee fig. 2. Plate VI.) General irri¬
tation, fometimes a few febrile fymptoms at the com¬
mencement ; tingling aggravated during the night;
pimples beginning on the face and arms ; afterwards
Scattered over the whole body; thefe fade and defqua-

L O G Y.

mate in about a week, except ip the flexures of the
joints.

(3. L. pilaris : pimples limited to the roots of the hair;
defquamate after ten days : often alternating with com¬
plaints of the head or ltomach. Only a modification of
the foregoing.

7. L. circumfcriptus, (fig. 3.) pimples in clufters or
patches of irregular forms, appearing in fucceffion over
the trunk and limbs; fometimes coalefcing ; occafionally
reviving in fuccefiive crops, the old ones decaying as the
new ones arife; and perfevering for fix or eight weeks.

Little medicinal treatment is neceffary for thefe varie¬
ties of Lichen. It is fufiicient that patients avoid heating
themfelves by much exercifeor by ftimulants, and take a
light diet, with diluent drinks, and a gentle laxative oc¬
cafionally. The diluted fulphuric acid is a grateful
tonic to the ftomach during the period of exfoliation ; or
a light chalybeate may be taken with advantage at the
fame period. All ftrong external applications are impro¬
per, efpecially preparations of mercury and of.fulphur,
which produce fevere irritation. The ancients recom¬
mended that the parts fliould be fmeared every morn¬
ing with faliva; and fome demulcent lotion, as a fubfti-
tute for this uncleanly expedient, prepared with the
white of egg, or emulfion of almonds, will relieve the
painful fenfations of the patient. Lotions of lime-water,
or of liquor ammoniae acetatis much diluted, occafionally
alfo afford relief.

L. lividus : pimples dark-red or livid ; chiefly fcat-
tered over the extremities ; defquammation at uncertain
periods, fucceeded by frefli crops, often perfevering for
feveral months. Its affinity with the Purpura is evinced
by the intermixture of petechias with the papulae; and
by the fimilarity of the origin and requifite treatment of
the two difeafes.

a. L. tropicus, prickly heat : pimples bright-red, fize
of a fmall pin’s head ; heat, itching, and pricking as of
needles; fometimes fuddenly difappearing, and producing
ficknefs or other internal affeCtion; relieved, by the re¬
turn of a frefli crop. It attacks newfettlers in the Weft
Indies, and other warm regions, and leaves them in a few
weeks when inured to the climate.

Many authors have cautioned us againft the repulfion
of the eruptidn by cold. The experienced Johnfon ob-
ferves, however, that he never found it poffible to repel
it by even cold bathing ; and feems to think that the
idea is vilionary. The fame author obferves as to its
treatment, that he found no benefit from external appli¬
cations, though he ufed many kinds. “ In ihort, (fays he,)
the only means which I ever faw productive of any good
effedt in mitigating its violence, till the conftitution got
aftimilated to the climate, were, light clothing, temper¬
ance in eating and drinking, avoiding all exercife in the
heat of the day, open bowels, and laft, not leaft, a deter¬
mined refolution to refill with ftoical apathy its firft at¬
tacks. To fit quiet and unmoved under its prefl'ure is
undoubtedly no eafy talk; but, if we can only mufterup
fortitude enough to bear with patience the firft few mi¬
nutes of the affault, without being routed into motion,
the enemy, like the foiled tiger, will generally fneak off,
and leave us victorious for the time.”

£. L. ferus, (fig. 4.) pimples in clufters or patches of a
high red colour, and furrounded with a red halo ; the
cuticle growing gradually harfh, thickened and chappy;
often preceded by general irritation and fever ; coldnefs,
fhivering, and cephalalgia, being ufually the firft fymp¬
toms oblervable. Tingling and itching are troublefome
fymptoms in this complaint : they undergo daily remif-
fions, and are much increafed by exercife, wafliing, &c.
This variety is apt to terminate in Impetigo.

The treatment of this lichen confifts in adminiftering,
at firft, fome moderate laxatives, mercurial orfaline, and
afterwards, for fome time, the diluted fulphuric acid,
three times a-day, in the infuflon of roles, or decoCtion
1 of

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PATHOLOG Y

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PATHOLOGY.

of cinchona. A fimple cooling unguent, as the rofe po¬
matum, or litharge plafter foftened with oil of almonds,
allays the troublefome heat or itching. All ftirnulating
applications are both painful and injurious.

tj. L. urticofus, nettle-ra(h : pimples very minute,
(lightly elevated, reddilh; intolerable itching, efpecially
at night ; irregularly fubfiding, and re-appearing; chiefly
fpotting the limbs ; occafionally fpreading over the body,
with gnat-bite fliaped wheals; from the violence of the
irritation at times, accompanied with veficles or blifters,
and fucceeded by an extenfive exfoliation of the cuticle.
It chiefly attacks children or young adult perfons. Fre¬
quent tepid bathing, light covering, efpecially in bed,
with the ufe of fmall dofes of fulphur, or the hydrar-
gyrus fulphuratus niger, internally, appear to relieve
the fymptoms. The Ikin will not bear ftimujation,
and is irritated even by a bath of too high temperature.
When it has occurred in feeble and emaciated children,
it may often be relieved by chalybeate medicines, as the
vinum ferri. This combination of inflamed papulae, with
intenfe itching, feems to unite the characters of the li¬
chen with thofe of the next fpecies.

3. Exormia prurigo : eruption diffufe ; pimples nearly
of the colour of the cuticle ; when abraded by fcratching,
oozing a fluid that concretes into minute black fcabs ;
intolerable itching, increafed by fudden expofure to heat.
Three varieties.

a. P. mitis : pimples foft and fmooth ; itching, at times
fubfiding; chiefly common to the young, and in fpring
time. Eafily yields to a courfe of warm ablutions, and
the internal ufe of fulphur.

(3. P. fonnicans : pimples varying from larger to more
obfcure than in the laft ; itching inceffant, and accompa¬
nied with a fenfe of pricking, or flinging, or of the creep¬
ing of ants over the body, (whence the name ;) duration
from two months to two or three years, with occafional
but fliort intermiflions ; chiefly common to adults.

y. P. fenilis; pimples moftly larger than in either of
the above; fometimes indiftinCf, giving the furface a
fliining and granulated appearance; itching inceflant;
common to advanced years, and nearly inveterate.

Plate VII. fig. 1. exhibits the varieties of this fpecies.
A points out the (lighter eruption of the Prurigo mitis ;
B the deeper and more marked appearance of P. formi-
cans and P. fenilis. Each of thefe varieties is apparently
the refult of gaftric and inteftinal irritations, and the laft
of much nervous debility likewife. The firft is more
eafily cured than the two latter; cold fpirituous lotions,
a drift attention to diet, gentle laxatives (avoiding
purges), and, according to the (late of the ftomacb, ful¬
phur and the carbonate of foda, or ftomachic medicines,
as farfaparilla, bark, & c. with mineral acids (efpecially
the oxygenated muriatic acid), are the meafures chiefly
to be depended on. In the Prurigo fenilis, pediculi are
commonly generated. Oil of turpentine much diluted
■with oil of almonds appears to exterminate thefe infeCFs
very effectually.

4. Exormia milium : pimples very minute ; tubercular;
confined to the face ; diftinCt ; milk-white ; hard ; gla¬
brous; refembling millet- feeds.

Dr. Good feems to have inferted this fpecies on the
authority of Plenck alone ; for we find no mention of it
in any other author.

Genus IV. Lcpidojls, [from Aettk, a fcale.] Scale-lkin.
Efflorefcence of fcales over different parts of the body,
often thickening into crufts. (Squammas, Willun.) There
are four fpecies, with numerous varieties.

1. Lepidofis pityriafis, dandrifF : patches of fine branny
fcales, exfoliating without cuticular tendernefs. The fu-
perficial ftate of the fcales, and the abfence of all ulcera¬
tive procefs, diftinguifhes the varieties of pityriafis from
other maladies. Without thefe diftinCtive marks we
might miftake dandrifF for fcalled-head (into which it
snuft be confeffed it degenerates if negleCted), and P. ver-

353'

ficolor for fecondary fymptoms of fiphilis. The follow¬
ing are the three varieties.

cc. Pityriafis capitis: fcales minute and delicate; confined
to the head ; eafily feparable. Chiefly common to infancy
and advanced years. Cutting off the hair, and waffling
the head frequently with foap and water, are all the means
neceflary for the cure of dandrifF on the head.

(3. P. rubra : fcalinefs common to the body generally ;
preceded by rednefs, roughnefs, and fcurfinefs of the
l'urface. To give gentle purges, and apply cooling lo¬
tions, in the ftage of roughnefs and rednefs, and to ufe
gentle diaphoretics and the warm falt-water bath when
the fcales appear, is all that is required in the treatment
of this complaint.

y. P. verficolor : fcalinefs in diffufe maps of irregular
outline and divers colours, chiefly brown and yellow :
for the mod part confined to the trunk, though occa¬
fionally fpreading over the limbs. This diforder, from its
flow progrefs, morbid colour, and ufual caufes, (de¬
bauchery, bad food, and atmofpherical viciffitudes) feems
to be much connected with a difeafed ftate of the blood.
Dr. Willan found internal medicine of little ufe ; but Dr.
Bateman recommends the oxygenated muriatic acid and
ftirnulating lotions. He alfo recommends a trial to be
made of pitch in large dofes.

2,. Lepidofis lepriafis, leprofy : patches of fmooth la¬
minated fcales of different fizes, and a circular form.
Four varieties.

a. Lepriafis vulgaris, common leprofy : fcales gla¬
brous ; whitifti ; fize of a crown-piece; preceded by
fmaller, reddifh, and glofly, elevations of the (kin, encir¬
cled by a dry, red, and (lightly-elevated, border ; often
confluent. Beneath the fcales the (kin is found red, and
in early ftages fmooth. Sometimes covering the whole
of the body except the face ; but moft commonly com¬
mencing on the extremities, where the bones lie neared
to the furface; efpecially below the elbow and the knee,
and ufually on both arms, or both legs, at the fame time.
From thefe points it gradually extends, by the formation
of new and diftinCt patches, along the arms or thighs, to
the bread and (boulders, and to the loins and fides of the
abdomen. In feveral cafes, Dr. Bateman has obferved
the eruption moft copious and moft permanent round the
whole lower belly. The hands alfo become afteCted, and
in many cafes the hairy fcalp. Though the face is not
the feat of large patches, Come fcalinefs occafionally ap¬
pears about the outer angles of the eyes, and on the
forehead and temples, extending from the roots of the
hair. In the more fevere cafes, the nails of the fingers
and toes are often much thickened, and become opaque
and of a dirty yellowilh hue, and are incurvated at the
extremities : their furface is alfo irregular, from deep lon¬
gitudinal furrows, or elevated ridges.

When the eruption of Lepriafis is moderate in degree
and extent, it is not attended with any uneafy fenfations,
except a (light degree of itching when the patient is
heated by exercife, or becomes warm in bed ; and a lit¬
tle occafional tingling in certain dates of the atmofphere.
When it is generally diffufed, however, and there is a
confiderable degree of inflammation in the (kin, it is ac¬
companied with extreme forenefs, pain, and (liffnefs ;
fometimes indeed fo great, as to render the motions of
the joints impracticable, and to confine the patient to
bed. Yet even under thefe circumftances, there is no
conftitutional difturbance : and, if no medicine be em¬
ployed, the difeafe of the. (kin may continue for months,
or even years, without any material derangement of the
fyftem.

Nothing is known of the immediate caufe of this dif¬
eafe. It has been obferved to follow the taking of cer¬
tain improper articles of diet. It has been attributed to
dirtinefs, to over-exertion, and to fudden changes of
temperature. It is faid to be hereditary, but not conta¬
gious. Dr. Bateman aflerts that it is a very common
difeafe in this metropolis ; but we are inclined to think

he

354 PATHO

lie is almoft lingular in his opinion. On Plate VII. fig.
2. we have given a delineation of this variety ; the let¬
ters A, B, C, See. Ihowing the progreflive ftages of the
malady,

(3. L. albida, white leprofy : feales whitifh ; fize of a
fflver penny; deprefi'ed in the middle; chiefly confined
to the extremities. See fig. 3 of the fame Plate.

Th is difeafe is milder than the firft variety, from which
it is diftinguilhed by the indolence of the eruption, the
fmallnefs of the feales, and their little difpofition to be¬
come confluent. Both varieties pf Lepriafis are difficult
of cure, and have acquired characters for being more ob-
ftinate than they really are, in confequence of the empiri¬
cal praftice which has been commonly applied to them.

Tire practice, to be effectual, mud depend entirely on
the ftate of the vafcular fyftem of the fkin ; for, as Dr.
Bateman has clearly fhown, if we give the fame medi¬
cines to an inflammatory variety or ftage of Lepriafis that
are found ufeful in one of tardy progrefs, we fliall of
courfe do mifehief. Therefore, whenever much rednefs
furrounds the fcale, when pain, forenefs, or ftiffnefs of
the joints, is prefent, our firfl: care fhould be to mitigate
the feverity of the cutaneous phlogofis which accompa¬
nies the eruption. Ablution with tepid water, or with
thin gruel, is the only application that it is allowable to
life. Gentle purgatives, a fo.mewhat low diet, with the
occafional exhibition of nitre, or fmall dofes of fulphur,
a few drops of the liquor potnffae, in conjunClion with
equally fparing quantities of tinClure of hellebore, are
meafures generally fufficient to remove the irritable ftate
of the fkin. But, when this ftate has degenerated into
the indolent form fo remarkable in the fecond variety,
and in the ad vanced ftages of the firft, ftimulating medi¬
cines and applications may be tried. The warm Talt- wa¬
ter bath, with a moderate degree offridion to loofen the
feales, may be firft ufed as the raoll proper local means;
and, if not found fuccefsful, may be fucceeded by the
ufe of more aCtive ftimuli, gradually increasing their
ftrength. A variety of thefe will be fucceflively required.
Spirituous lotions, or thofe containing thecauftic potafs,
the muriatic acid, or the oxymuriate of mercury, the
unguentum picis, ortheung. hydrargyri nitratis, are the
moft approved local ftimuli we know of. The internal fti-
muli which muft be reforted to when dietetic regulations
do not operate on the malady, are the arfenical folution,
pitch, and fteel. Of thefe the firft is the moft powerful.
They are all given in the ufuai dofes. Dr. Bateman re¬
commends alfo a decoftion of the Solanum dulcamara
in gradnally-increafing proportions, both as an internal
and an external application.

7. L. nigricans, or black leprofy, is a more rare variety
of the difeafe, differing externally from the L. vulgaris
chiefly in the dark and livid hue of its patches, w'hich is
moft obvious in the margin, but even appears through
the thin feales in the area of each patch. See fig. 4.
The feales are more eafily detached in this form of lepra,
and the furface remains longer tender, and is often ex¬
coriated, difeharging bloody ferum, till a new incrufta-
tion is formed. This variety of lepriafis occurs in per-
fons whofe occupations expofe them to the viciffitudes of
the weather, and to a precarious diet, with fatigue and
watching, and feems of a cachectic nature. It is cured
by nutritive food, with moderate exercife, followed by
the ufe of the bark, mineral acids, and fea-bathing.

£. L. canefcens, the leprofy of the Jews : feales white ;
hairs on the patches white or hoary ; central depreffion
deep ; difeafe more inveterate. See Leprosy, vol. xiv.

“ Several of the varieties are found alfo occafionally,
as a fymptom or fequel, in lues ; but diftinguilhed by a
livid or chocolate hue.” Good, 473.

3. Lepidofis pforialis, fcaly tetter, or dry fcale: patches
of rough amorphous feales ; continuous, or of indeter¬
minate outline ; fkin often chappy.

This irregularity of figure diftinguilhes Pforiafis from
the round feales of Lepriafis ; and the five different varie-

L O G Y.

ties of this irregularity are the fubjeft of Plate VIII.
Moreover it is without the elevated border, the inflamed
margin, and the oval or circular outline, of the leprous
patches; the furface under the feales is likewife much
more tender and irritable in general than in lepriafis ;
and the fkin is often divided by rhagades, or deep fiffures.
It is commonly accompanied by fome conftitutional dis¬
order, and is liable to ceafe and return at certain feafons.

Thecaufes of pforiafis are nearly as obfeure as thofe
of lepriafis. It is not contagious; with the exception
perhaps of the firft variety; and this exception is doubt¬
ful. Of the following varieties, the firft two are fome-
times the fequel of lichen.

a. P. guttata, (fee fig. t. Plate VIII.) “is a fort of
connecting link between this fpecies and lepra, the little
patches being diftinCt, and fmall, (feldom exceeding two
or three lines in diameter,) but with an irregular cir¬
cumference, and the other peculiar characters juft de-
fcribed. They appear on almoft every part of the body,
and even on the face ; but in the latter fituation they ex¬
hibit only a rednefs and roughnefs, without feales. This
eruption is moft common in the fpring, at which feafon
it is liable to recur for feveral years. It is preceded by
general pains, and flight feverilhnefs. In children it of¬
ten fpreads rapidly over the body in two or three days ;
but in adults its progrefs is gradual and flow.” Bate¬
man, 39.

/3. P. gyrata, (fig. 5.) fcaly patches in ferper.tine or
tortuous ltripes; found chiefly on the back, fometimes
on the face.

7. P. diffufa, (fig. 2 and 3.) patches diffufe, with a
rugged, chapped, irritable, furface ; fenfe of burning and
intenfe itching, increafed by warmth and mitigated by
cold ; fkin gradually thickened and furrowed, with a
powdery feurf in the fiffures ; moft common over the
face, ears, and fealp. Sometimes thefe extenfive erup¬
tions appear at once ; but, in other inftances, they are the
refult of numerous minute elevations of the cuticle,
upon which fmall diftindt feales, adhering by a central
point, are foon formed, and which become gradually
united by the inflammation of the intervening cuticle.
In either cafe, as the diforder proceeds, a powdery fnb-
ftance, or very minute feurf, is ieen. The heat and pain¬
ful fenfations are much aggravated by the leaft fridlion,
which alfo produces excoriation, and multiplies the fore
and painful rhagades. This form of the difeafe is moft:
frequent about the face and ears, and the back of the
hands ; the fingers are fometimes nearly furrounded with
a loofe fcaly incruftation, and the nails crack and exfo¬
liate : but it occafionally occurs in other parts ot the
body, either at the fame time or in fucceffion. It com¬
monly begins with fome general indifpofition ; and a de¬
gree of erethifm, with occafional Iharp pains in the fto-
mach, is fometimes kept up, during feveral weeks, by
the conftant irritation which it excites. Its duration is
from one to four. months, and fometimes much longer;
and it is liable to return, in fucceffive years, in the fpring
or autumn, and fometimes in both feafons.

When limited to the back of the hand, it forms what
is vulgarly called the baker's itch. On the hands and
arms, fometimes on the face and neck, it is peculiarly
troublefome to walherwomen ; probably from the irrita¬
tion of the foap they are continually making ufe of.

P. inveterata, (fig. 4.) is the moft fevere modifica¬
tion of the complaint, beginning in feparate irregular
patches, which extend and become confluent, until at
length they cover the whole furface of the body, except
apart of the face, or fometimes the palms of the hands
and foies of the feet, with an univerfal fealinefs, inter-
fperfed with deep furrows, andaharfh, ftiff, and thick¬
ened, ftate of the Ikin. The production of feales is fo
rapid, that large quantities are found every morning in
the patient’s bed. The nails become convex, thickened,
and opake, and are frequently renewed; and, at an ad¬
vanced period, efpecially in old people, extenfive excori¬
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PATHOL O G Y.

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PATHOLOGY.

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855

PATHOLOG Y.

ations fometimes occur, with a difchnrge of their lymph,
followed by a hard dry cuticle, which feparates in large
pieces. In jhis extreme degree, it approaches very
clofely to the inveterate degree of Lepriafis vulgaris in all
refpefts ; the only difference being in the form of the
patches before they coalefce. It is fometimes the ulti¬
mate (late of the Pforiafis diffufa ; .and occafionally a fe-
quel of the Prurigo fenilis.

e. P. localis: ftationary; and limited to particular or¬
gans ; as the lips, eye-lids, prepuce, fcrotum, and infide
of the hands. In the lad form it is peculiarly common
to (hoe-makers, and artificers in metallic trades, as bra¬
ziers, tinmen, and filverfmiths : probably from filth, and
the irritation of the lubftances they make ufe of.

“ Several of the varieties are found alfo occafionally as
fymptoms or fequels of lues, particularly the firft three ;
but are in every inftance diftinguilhed by the livid or
chocolate hue of the fcales.” Good, 4.75.

The fame general plan of treatment is applicable to all
the different modifications of Pforiafis, the period of its
duration, and the degree of accompanying pldogofis, be¬
ing carefully attended to. In the commencement of the
eruption, when it appears fuddenly, and the conftitution
isobvioufly difordered, a moderate antiphlogiftic treat¬
ment niuft be purfued. A gentle purgative fhould be
adminiftered, and the diet made light by abftrafting every
thing ftimulant. This regimen, indeed, is requifite
throughout the courfe of the difeafe, which is immedi¬
ately aggravated in fympathy with irritation of the fto-
mach, whether by fpices, fermented liquors, pickles, or
vegetable acids ; whence the difufe of thefe articles con¬
tributes materially to its cure. But, if the conftitution-
al difturbance has fubfided, the ufe of the fixed alkali,
combined with fulphur lotum,or with an infufion of cin¬
chona, together with tepid wa filing' with fimple water, or
milk and water, will gradually remove the complaint.
If the fcaly patches have extended over a confiderable
part of the body, and have affumed a more inert and
chronic charafter, it muft be viewed in a fimiiar light
with the Lepriafis, and the remedies recommended for
the firfi: and fecond varieties of that difeafe muft be re-
forted to.

The (hooting and burning pain and itching, in the
early and more inflammatory ftages of Pforiafis, induce
the patient to feek anxioufly for relief from local exter¬
nal applications ; but he is mortified to find that even
the mildeft fubftances prove Irritants, and aggravate his
diftrefs. A decoftion of bran; a little cream, or oil of
almonds, fometimes produce eafe ; but any admixture,
even of the oxyd of zinc, or preparations of lead, with
thefe liniments, is commonly detrimental. But the more
local, and lefs inflammatory, eruptions of Pforiafis are
confiderably alleviated by local expedients. The pfo¬
riafis affefting the hands, the fcrotum, or the eye, are re¬
lieved by the ung. hydrargyri praecipitati albi, or ung.
hyd. nitrat. diluted according to the irritability of the
(kin ; but great care is requifite to keep the parts clean
by frequent ablution, and to prevent attrition. When
the difeafe affefts the lips, nothing acrid can be borne 5
and much of the cure depends upon fee 11 ring the parts
from irritation, even from heat and cold, by a conftant
covering of fome mild ointment or plafter. In all thefe
cafes, fome of the internal remedies above mentioned
muft be at the fame time employed, according to the
period and other circumftances of the difeafe.

4. Lepidofis ichthyofis, or fi(h-fkin : thick indurated
incruftation, encafing the (kin to a greater or lefs extent.
It has fome tendency to fealinefs, but without the deci¬
duous exfoliations, the diftinft and partial patches, or the
conftitutional diforder, which belong to lepra and pforia¬
fis. There are three varieties.

a. I. fimplex : in its commencement this difeafe exhi¬
bits merely a thickened, harfli, and difcoloured, date of
the cuticle, which appears, at a little diftance, as if it
were foiled with mud. When further advanced, the

Vol. XIX. No. 1308..

thicknefs, hardnefs, and roughnefs, become much great¬
er, and of a warty character, and the colour is nearly
black. The roughnefs, which is fo great as to give a
fenfation, to the finger palling over it, like the furface of
a file, or the roughed fliagreen, is occafioned by innume¬
rable rugged lines and points, into which the furface is
divided. Thefe hard prominences, being apparently
elevations of the common lozenges of the cuticle, ne-
cefiarily differ in their form and arrangement in different
parts of the body, according to the variations of the c-u-
ticular lines, as well as in different ftages and cafes of the
complaint. Some of them appear to be of uniform thick¬
nefs from their roots upwards ; while others have a fhort
narrow neck, and broad irregular tops. The former oc¬
cur where the (kin, when healthy, is loft and thin ; the
latter where it is coarfer, as about the olecranon and pa¬
tella, and thence along the outfide of the arifis and
thighs. On fome parts of the extremities, however, ef-
pecially about the ankles, and fometimes on the trunk
of the body, thefe excrefcences are fcaly, flat, and large,
and occafionally imbricated like the fcales of carp.. In
other cafes, they have appeared feparate, being interfered
by whitifh furrows.” The above defeription, and the
delineation on Plate IX. fig. 1. are from Dr. Bateman’s
fplendid work.

This unfightly difeafe appears in large continuous
patches, which (ometimes cover the greater part of the
body, except the flexures of the joints, the inner and up¬
per part of the thighs, and the furrow along the fpine.
The face is feldom affefted, but the whole (kin is in an
extremely dry and unperfpirable condition, and in the
palms of the hands and foies of the feet it is much
thickened and brittle. The difeafe often commences in
childhood, and even in early infancy ; and is in various
inftances hereditary. The only medicines which feem
ufeful are pitch and arfenic : the former, however, muft be
taken in immoderate quantities- Dr. Bateman had a pa¬
tient who took half an ounce daily, with much amend¬
ment. Sulphureous baths, and rubbing with a rough
cloth afterwards, will often bring off the fcales ; and, as
thefe are not foon reproduced, it is a very important pal¬
liative meafure. Impreffed with this faft, Dr. Willan re¬
commends us to pick them off carefully with the nails
from any part of the body, while it is immerfed in hot
water. He fays, “The layer of cuticle, which remains
after this operation, is harfli and dry ; and the (kin did
not, in the cafes I have noted, recover its ufual texture
and foftnefs; but the formation of the fcales was pre¬
vented by a frequent ufe of the warm bath, with mode¬
rate friftion.”

(3. I. cornea. Several cafes of a rigid and horny (late
of the integuments, fometimes partial, but fometimes ex¬
tending nearly over the whole body, have been recorded by
authors; fee Phil.Tranf. N° 176. N° 297. and vol. xlviii.
pt. ii. p. 580. Alfo Zacut. Lufitan. Prax. Hift. obf. i3S.
Ephem. Acad. Nat. Cur. dec. i. p. 89. and occafionally
fuch a condition of the cuticle has been accompanied
with the aft ual produftion of excrefcences of a horny
texture. Thefe, how'ever, are rare occurrences.

y. I.cornigera: with horn-like incurvaied fproutings;
fometimes periodically (lied and reproduced. This dif¬
eafe appears to have nothing to do with Ichthyofis; the
horn ufually grows from a wart or tumour; and, if cut
off, is reproduced. Hence the only mode of cure is to
extirpate it from its roots.

Genus V. Ecphfyjis, [from extphvfy, to boil or bubble
up or over; importing veficular eruption confined in its
aftion to the furface.] Blains. Orbicular elevations of
the cuticle containing a watery fluid. There are four
fpecies, and many varieties.

1. Ecphlyfis pompholyx, blebs : eruption of blebs con¬
taining a reddifii, tranfparent, fluid ; moftly diftinft ;
breaking and healing without fcale or cruft. They are
diftinguifhed from Pemphigus by the abfence of fever,
4 Y and

356

PATHOLOGY.

and-of inflammation round their bafes. There are three
varieties.

a. P. benignus, water-blebs : blebs pea-fized or fil-
1 ert-fized ; appearing fucceffively on various parts of
ti.e body; burfting in three or four days, and healing

readily.

|3. P. diutinus, (fig. 2. Plate IX.) Blebs gradually
growing from fmali veficles to the fize of walnuts; yel-
lov.ifh ; often fpreading in fuccefiion over the whole body,
and interior of the mouth ; occafionally reproduced, and
forming an excoriated furface with ulcerations. Often
preceded by languor or other general indifpofition for
feveral weeks. Duration from two to four or five months.

This difeafe chiefly affefts perfons of debilitated ha¬
bits ; and is very fevere in the aged. It feerns to origin¬
ate under different conditions of the body, but often
after continued fatigue and anxiety, with low diet ; fome-
times from intemperance; and not unfrequently it is
connected with anafarca, or general dropfy, with fcurvy,
and other dates of the conftitution, in which the powers
of the cutaneous circulation are impaired. It is mod
troublefome and obftinate in old perfons, in whom the
tranfparent bullae fometimes equal the fize of a turkey’s
egg, while others of a ftnaller fize are intermixed with
them, which appear dark and. livid. When broken, they
leave a black excoriated furface, which fometimes ulcer¬
ates. The warm bath, ufed every fecond day, was confi-
dered by Dr. Willan as the mod active palliative, and tire
bed remedy. Bateman has feen the decodtion of cin¬
chona, with cordials and diuretics, of coniiderable ad¬
vantage in thefe cafes, efpecially when the eruption was
combined with anafarca. In young perfons in whom
the pompholyx is feldom fevere, thefe remedies are af¬
firmed by Dr. Willan to be fuccefsful within two or
three weeks; but the warm bath feerns to increafe both
the tingling in the fkin, and the numbers of the vefica-
tions, in thefe patients.

•y. P. quotidianus : blebs with a dark red bafe, appear¬
ing at night and dilappearing in the morning. Found
chiefly in the hands and legs. Vandermonde relates a
cafe in which the acceflions were reverfed ; the blebs ap¬
pearing in the morning, and difappearing at night.

P. folitarius : folitary ; but reproductive in an ad¬
joining part ; the bleb very large, and containing a tea¬
cup full of lymph. Preceded by tingling, often accom¬
panied with languor. This is a rare form of the difeafe,
and feerns to affedt only women. Cinchona internally,
and linfeed poultices, followed by light drefiings to the
fores externally, were employed with advantage in three
cafes feen by Dr- Willan.

2. Ecphlyfis herpes, tetter: eruption of veficles in
fmali diftindl clufters ; with a red margin ; at firft pellu¬
cid ; afterwards opake ; accompanied with itching or
tingling ; concreting into fcabs. Duration from four¬
teen to twenty-one days. Here we have fix varieties.

a. H. miliaris, (Plate IX. fig. 3.) Veficles millet-fized :
pellucid ; clufters commencing at an indeterminate part
of the furface, and progreflively ftrewed over the body ;
fucceeded by frefli crops. It is commonly preceded by a
flight febrile attack for two or three days. The fmali
tranfparent veficles then appear, in irregular clufters,
fometimes containing colourlefs, and fometimes a brown-
i(b, lymph; and for two or three days more, other cluf¬
ters fucceffively arife near the former. When very mi¬
nute, they fpread extenfively; but, if at maturity they
attain a conftderable fize and an oval form, we feldom
lee more than two or three clufters together ; and fome¬
times there is only a fingle chiller. The included lymph
fometimes becomes milky or opake in the courfe of ten
or twelve hours ; and about the fourth day the inflam¬
mation round the veficles affumes a duller red hue, while
the veficles themfelves break, and difcharge their fluid,
or begin to dry and flatten, and dark or yellovvifti fcabs
concrete upon them. Thefe fall off about the eighth or
tenth day, leaving a red-dened and irritable furface,

which flowly regains its healthy appearance. As the
fucceffive clufters go through a firnilar courfe, the termi¬
nation of the whole is not complete before the thirteenth
or fourteenth day.

(3. H. exedens, nirles: veficles hard ; of the fize and
origin of the laft ; clufters thronged ; fluid denfe, yellow,
or reddifh ; hot, acrid, corroding the fubjacent lkin, and
fpreading in Terpentine trails.

This difeafe is rare ; and we know not on what autho¬
rity Dr. Good lias ftated that the nirles is the fame dif¬
eafe as that defcribed by Galen, from whom his defini¬
tion is derived. We fubjoin Dr. G.’s abftradt of Galen’s
opinion : “ Herpes, according to Galen, is an eruption
of minute and crowded veficl es, of thejizeof millet-feeds,
excited on the furface of the lkin, filled with an acrid bi¬
lious fecretion ; and conlifts of two fpecies; the one con¬
taining in its veficles a milder and more aqueous fluid,
called from the fize of the veficles Herpes miliaris, which
merely fcems to burn, or corrode ; the other containing
a thicker fluid of a higher heat and colour, and fo acrid as
actually to corrode the continuity of the fubjacent lkin,
ftill creeping along in a ferpentine direction, as the term
herpes imports, "and hence denominated by Hippocrates
Herpes ejlhiomenos .”

y. H. zofter : fhingles : veficles pearl-fized ; the cluf¬
ters fpreading round the body like a girdle: at times
confluent. Occafionally with general irritation or other
conftitutional affedtion ; being ufually preceded for two
or three days by languor and lofs of appetite, rigors,
liead-ache, ficknefs, and a frequent pulfe, together with a
fcalding heat and tingling in the fkin, and fliooting pains
through tiie cheft and epigaftrium. Sometimes, however,
the precurfory febrile fymptoms are flight, and fcarcely no¬
ticed ; and the attention of the patient is firft attracted by a
fenfe of heat, itching, and tingling, in fome part of the
trunk, where he finds feveral red patches of an irregular
form, at a little diftance from each other, upon each of
which numerous fmali elevations appear, cluftered toge¬
ther. Thefe, if examined minutely, are found to be dif-
tindfly veficular; and, in the courfe of twenty-four
hours, they enlarge to the fize of fmali pearls, and are
perfectly tranfparent, being filled with a limpid fluid.
The clufters are of various diameter, from one to two,
or even three, inches, and are furrounded by a narrow
red margin, in confequence of the extenfion of the in¬
flamed bafe a little beyond the congregated veficles.
During three or four days, other clufters continue to
arife in fuccefiion, and with confiderable regularity ; that
is, nearly in a line with the firft, extending always to¬
wards the fpine at one extremity, and towards the fter-
num, or linea alba of the abdomen, at the other, moft
commonly round the waift like half a fafh, but fometimes
like a fword-belt acrofs the fhoulder.

While the new clufters are appearing, the veficles of
the firft begin to lofe their tranfparency, and on the
fourth day acquire a milky or yellowifh hue, which is
foon followed by a bluifh or livid colour of the bafes
of the veficles, and of the contained fluid. They now
become fomewhat confluent, and flatten 5r fubfide, fo
that the outlines of many of them are nearly obliterated.
About this time they are often broken, and for three or
four days difcharge a fmali quantity of a ferous fluid ;
which at length concretes into thin dark fcabs, at firft
lying loofely over the contained matter, but foon be¬
coming harder, and adhering more firmly, until they fall
off about the twelfth or fourteenth day. The furface of
■the (kin is left in a red and tender ftate; and, where the
ulceration and difcharge have been confiderable, nume¬
rous cicatrices or pits are left. As all the clufters go
through a firnilar feries of changes, thofe which ap¬
pear lsteft arrive at their termination feveral days later
than the firft 5 whence the difeafe is fometimes protradfed
to twenty or even twenty-four days, before the crufts
exfoliate. In one or two inftancesthe veficles have been
known to terminate in numerous fmali .ulcers, or fuppu-

rating

PATHOLOGY.

Plate 1 .

Ery raw. i far c/it Encgdapxdui Zondirunsis. 20iz,

35?

PATHOLOGY.

rating foramina, which continued to difcharge for many
days, and were not all healed before the end of the fourth
week. The febrile fymptoms commonly fubfide when
the eruption is completed; but fometimes they continue
during the whole courfe of the difeafe, probably from
the incefl'ant irritation of the itching and fmarting con-
nefled with it. In many inftances, the moll diftrefllng
part of the complaint is an intenfe darting pain, not fu-
perficial, but deep-feated in the cheft, which continues
to the latter ftages of the difeafe, and is not eafily al¬
layed by anodynes : fometimes this pain precedes the
eruption.

Herpes zofter is not contagious. Its caufes are not
very obvious : it is moft frequently traced to pulmonic,
gaftric, or inteftinal, irritation, and is commoneft in fpring
and autumn. As it pafles through its regular ftages
fpontaneoufly and invariably, it never requires any thing
to be done, except to adopt a cooling regimen.

S. H. circinatus, ring- worm ; (fig. 4.) velicles with a
reddifii bafe, uniting in rings ; the area of the rings
(lightly difcoloured ; often followed by frefh crops.

This is a very flight affedlion, being unaccompanied
with any diforder of the conftitution. It appears in fmall
circular patches, in which the veficles arife only round
the circumference : thefe are fmall, with moderately red
bales, and contain a tranfparent fluid, which is dif-
charged in three or four days, when little prominent
dark fcabs form over them. The central area, in each
veficular ring, is at firft free from any eruption; but the
furface becomes fomevvhat rough, and of a dull red co¬
lour, and throws off an exfoliation, as the veficular erup¬
tion declines, which terminates in about a week with
the falling off of the fcabs, leaving the cuticle red for a
fhort time. The whole difeafe, however, does not con¬
clude fo foon: for there is commonly a fucceflion of the
veficular circles, on the upper parts of the body, as the
face and neck, and the arms and flioulders, which have
occasionally extended to the lower extremities, protradl-
ing the duration of the whole to the end of the fecond
or third week. No inconvenience, however, attends the
eruption, except a difagreeable itching and tingling in
the patches.

The herpetic ringworm is moft commonly feen in chil¬
dren, and is deemed contagious. Another form of H.
circinatus fometimes occurs, in which the area of the
circles is covered with clofe-let veficles, and the whole is
furrounded by a circular inflamed 'border. The veficles
are of a conliderable fize, and filled with tranfparent
lymph. The pain, heat, and irritation, in the part, are
very diftrefling ; and there is often a confiderable confti-
tutional difturbance accompanying the eruption. One
duller forms after another in rapid fucceflion on the face,
arms, and neck, and fometimes on the day following on
the trunk and lower limbs. The pain, feverilhnefs, and
inquietude, do not abate till the fixth day of the eruption,
when the veficles flatten, and the inflammation fubfides.
On the ninth and tenth days a fcabby cruft begins to form
on fome, while others dry and exfoliate ; the whole
difeafe terminating about the fifteenth day.

£. H. iris, (fig. 5.) occurs in fmall circular patches,
each of which is compofed of concentric rings of differ¬
ent colours. Its ufual feat is on the back of the hands,
or the palms and fingers, fometimes on the inftep. Its
firft appearance is like an efflorefcence ; but, when it is
fully formed, not only the central umbo, but the fur¬
rounding rings, become diftindtly veficular. The patches
are at firft fmall, and gradually attain their full fize,
which is nearly that of a fixpence, in the courfe of a week
or nine days, at the end of which time, the central part
is prominent and diftended, and the veficular circles are
aifo turgid with lymph ; and, after remaining nearly fta-
tionary a couple of days, they gradually decline, and en¬
tirely difappear in about a week more. The central ve-
ficie is of a yellowifh white colour; the firft ring fur¬
rounding it is of a dark or brownifli red ; the fecond is

nearly of the fame colour as the centre; and the third,
which -is narrower than the reft, is of a dark red colour;
the fourth and outer ring, or areola, does not appear un¬
til the feventh, eighth, or ninth, day, and is of a light
red hue, which is gradually loft in the ordinary colour
of the fkin.

£. H. localis, (Herpes labial i s, H. prteputialis, &c.
Bateman.) Seated on a particular organ, chiefly the lip
and prepuce, and not migratory. Very little attendance
is required in herpetic difeafes. They generally run their
career without being either fliortened or delayed by it.
There is often, however, fome conftitutionaldifturbar.ee
accompanying the various forms, which it may be of con-
fequence to attend to, according to the appearance of
the eruption and the feelings of the patient. Aftr-in-
gents and anodyne lotions may be ufed ; but they muft
be regulated by the general principles already laid down
at the head of this order.

3. Ecphlyfis rhypia ; (Rupia, Bateman.) Eruption of
broad, flattifh, diilindl veficles; bafe (lightly inflamed ;
fluid fanious; fcabs thin, and fuperficial; eafily rubbed
off and reproduced. Three varieties.

a. R. fimplex ; fcab flat; livid or blackilh : the fubja-
cent fkin of the fame hue.

(3. R. prominens ; fcab elevated and conical like a lim¬
pet’s (hell; rapid in its progrefs, and fucceeded by an ulcer.

Thefe varieties of Rupia are to be combated by lup-
porting the fyftem, by means of good, light, nutritious,
diet, and by the ufe of alterative and tonic medicines ;
fuch as Plummer’s pill, cinchona, and farfaparilla. The
firft is reprefented by fig. 1. Plate X. the fecond by fig.
2. of the fame engraving.

y. R. efcharotica : fanious difcharge erofive, produ¬
cing gangrenous efehars.

4. Ecphlyfis eczema, heat-eruption : eruption of mi¬
nute acuminated veficles, diftinft, but clofely crowding-
on each other, pellucid or milky ; with troublefome itch¬
ing or tingling; terminating in thin fcales or fcabs ; oc¬
cafionally furrounded by a bluftiing halo. Chiefly pro¬
duced by the heat of the fun; and moftly attacks the
hands and other parts that are principally expofed to its
rays.

The eruption is fucceflive, and has no regular period
of duration or decline : it commonly continues for two
or three weeks, without any particular internal diforder.
The included lymph becomes more milky, and is gradu¬
ally abforbed, or dried into browmifti fcales, which exfo¬
liate, or into brownifli yellow fcabs, of the fize of a fmall
pin’s head, efpecially when the veficles are broken. But
fucceflive eruptions of the veficles are apt to appear,
which terminate in a fimilar manner by exfoliation or
(cabbing; and in thofe perfons who, by the peculiar irri¬
tability of their Ikin, are much predifpofed to the difor¬
der, it is thus continued many weeks, to the end of au¬
tumn, or even prolonged to the winter. When this
happens, the veficles generally pour out an acrid ferum,
by which the furface is inflamed, rendered tender, and
even flightly ulcerated, and the difeafe afl'umes the form
of Impetigo.

The courfe of this diforder does not appear to be ma¬
terially fliortened by the operation of medicine. The
mineral acids, with adecoflion of cinchona, or other ve¬
getable tonic, and alight but nutritious diet, feem to be
moft eftedlual in diminifliing the eruption. When it has
occurred after long-continued travelling, or any other (e-
vere fatigue, and appears to be accompanied with fome
degree of exhauftion of the powers of the conftitution,
a courfe of ferpentaria, or farfaparilla, is exceedingly
beneficial. Adtive and repeated purgation is adverfe'fto
the complaint. Simple ablution with tepid water, con¬
tributes to relieve the fmarting and tingling of the parts
affedted ; but they do not bear unguents, or any ilimu-
lant application.

Genus

PATHOLOGY.

S5S

Genus VI. Ecpyrjia, [skttvco, to fuppurate, of wvov, pus.]
Kunning Tetter. Generic charadlers — Eruption of final l
puftules, diftinfi or confluent ; hardening into cruftular
plates. There are four fpecies, with numerous varieties.

i. Ecpyefis impetigo, the common running fcald, or
tetter: puftules cluttering, yellow, itching ; terminating
in a yellow fcaly cruft, interfered with cracks.

Impetigenous eruptions are diftinguiftied from thofe of
an herpetic nature by their being preceded by fmall
pvjiules, while the latter are always preceded by veficles.
The difcharge, too, from the Impetigo is, generally
fpeaking, more profufe than that from Herpes. Not-
withftanding this diftindlion, it may be doubted whether
the two fpecies do not fometimes run into one another.
It is no uncommon thing to fee both veficles and puftules
on the fame perfon. This combination, which is very
painful and difficult of cure, appears chiefly on the
hand, the veficles of which feem to contain a very acri-
moneous fluid, fince, whenever this runs, the fkin is
gradually denuded. The veficles are flower in their pro-
grefs than the puftules; and, when broken, have a mor¬
bid fore, fecreting a thin ichor. There are fix varieties.

«. I. fparfa, (fee fig. 3, Plate X.) Clutters loofe;
irregularly fcattered ; chiefly over the extremities ; often
fucceeded by freffi crops, and forming in old and debili¬
tated perfons troublefome ulcers.

£. I. herpetica, (fig. 4.) (Impetigo figurata, Bate¬
man. Herpes, Cullen.) Clutters circular ; crowded with
puftules, intermixed with veficles; often with exte¬
rior concentric rings furrounding the interior area as
it heals ; itching accompanied with heat and fmarting.
Chiefly on the hands and wrifts.

This is the molt common variety of the nroitt tetter.
It appears in circumfcribed patches, of various figure
and magnitude, which are ufually fmaller and more
circular on the upper, and larger, oval, and irregular, on
the lower, extremities. The patches coniiftvat firft of
ciufters of the yellow plydracious puftules,' fet clofe
together, and furrounded by a flight inflammatory bor¬
der ; the whole being fomewhat raifed, but the puftules
not very prominent or acuminated. In a few days the
puftules break, and difcharge their fluid ; the furface
becomes red and excoriated, fliining as if it were ftretched,
but exhibiting numerous minute pores, from which a
confiderable ichorous difcharge is poured out, accompa¬
nied with much troublefome itching, heat, and fmarting.
The difcharge foon concretes partially into thin yellowifti
or greenilh fcabs ; but ftill continues to ooze from under
the fcab, which it forms. In the courfe of three or four
weeks, as the quantity of the difcharge diminiffies, the
fcabs dry and fall off, leaving the furface of the cuticle
red, rough, and fomewhat thickened, and at the fame
time extremely brittle, and liable to crack and to be ex¬
coriated ; fo that the ichorous difcharge and fcabbing are
eafily reproduced, and the difeafe is often thus much
prolonged in its duration. Occafionally frefn crops of
the pfydracious puftules re-nppear, as at the commence¬
ment; and the whole courfe of the eruption is repeated.

When the Impetigo herpetica is beginning to heal,
the patches undergo a procefs fomewhat fimilar to that
which takes place in the Lepriafis vulgare. The amend¬
ment commences at the centre of the patch, which firft:
fubfides, leaving the border elevated : at length this alfo
ciifappears; but the cuticle, which was the feat of the
patch, remains for.fome weeks red, fliining, and tender.

The Impetigo herpetica and fparfa are fometimes con¬
founded with two contagious difeafes, of the puftular
order-) Porrigo and Scabies. The appellation of ring-
norm, which is popularly given to the oval or circular
patch of the firft, has partly contributed to occafion this
miftake. They differ, however, from the contagious cir¬
cles of Porrigo, inafmuch as the I. figurata feldom afrefls
children, occurs principally on the extremities, and they
do not continue to difcharge a purulent and glutinous,
but, after the firft eruption, an ichorous humour; nor

do they form the thick, foft, and copious, fcabs of Porrigo :
not to mention the abfence of contagion.

The prevalence of tranfparent veficles in the patches
of Impetigo, may miftead an incautious or inexperienced
obferver into a fufpicion that the difeafe is Scabies: but
the diftribution of the eruption in patches, the copious
exudation of ichor, the rough, reddened, and fiflured,
cuticle, the magnitude and flow' progrefs of the veficles,
and the heat and fmarting, which accompany the itching,
in Impetigo, will ferve, in general, to determine the
diagnofis. In the ftriftly purulent form of Scabies, the
puftules about the hands arife to a much greater magni¬
tude and elevation than the pfydracia ; they are filled
with a thick yellow pus, and are more confiderably in¬
flamed round their bafe. The Impetigo, in its advanced
ltage is, however, more liable to be miltaken by common
oblervers, and is in faff daily miftaken, for Pforiafis or
Lepra ; as a fufficient difcrimination is not made between
the laminated and fcale-like concretions of the ichorous
matter, and the exfoliations of morbid cuticle, which
conftitute the true fcab. But the fcaly clifeafes emit no
fluid ; and the very exiftence of a difcharge, however flight,
is fufficient to determine the diagnofis of the eruption.

In the incipient ftate of thefe two forms of Impetigo,
it is ufeful to adminifter fulphur internally, in fuch
quantities as not to induce purging; and, if there is
much irritability or inflammation of the cuticle, a por¬
tion of foda, nitre, or cryftals of tartar, may be advanta-
geoufly combined with it. The Impetigo fparfa com¬
monly yields to thefe medicines, if diligent ablution
with tepid water be at the fame time employed. But,
when the difeafe is of long (landing, it requires a treat¬
ment fomewhat fimilar to that recommended for invete¬
rate Pforiafis ; namely, the diet-drinks, decoflions of
farfaparilla and cinchona, with the fixed alkalis, and
antimonials. The mercurial alteratives, however, in
this affection, are of effential affiftance to this plan of
cure; fuch as fmall dofes of cinnabar, the hydrargyrus
cum creta, or the pill of Dr. Plummer.

The external applications adapted to thefe forms of
Impetigo, are the mild deficcative unguents; for, in the
majority of cafes, the irritable furface of the tetter will
not bear ftimulants with impunity. When the difcharge
is confiderable, the ointments prepared with the oxyd
of zinc, alone, or united with faturnine ointment, or
with the white precipitated oxyd of mercury, are the
moll efficacious, in allaying the inflammatory condition
of the excoriated furface, and in reducing the quantity
of the difcharge. When there is lefs of this irritability
and exudation, the tar-ointment, or the ointment of the
nitrate of mercury, much diluted, will be found benefi¬
cial. But the too adive employment of this or any other
llimulating unguent, often does harm.

In thefe irritable forms of Impetigo, in which veficles
abound, the zinc, and faturnine applications, and even
Ample lard, occafion an aggravation of the fymptoms.
In thefe cafes it is particularly neceflary to keep the parts
covered, with a view to avoid the effects of friftion from
the clothes, as well as of heat and of cold ; to waffi the
furface daily with fome emollient fluid, fuch as milk and
water, or an infufion of bran ; to interdict the ufe of
foap ; and to befmear the parts with cream, or an emulfion
of almonds. A lotion prepared by boiling mallow,
digitalis, and poppy-heads, has been found ferviceable,
where the parts were very painful. In many cafes, how¬
ever, the ftiffnefs, which enfues upon the fpeedy drying
of thefe lotions, renders it impoflible to ufe them, and it
is neceflary to cover the part lightly with dry lint only,
or to interpofe between it and the difeafed furface a
fprinkling of the oxyd of zinc : fometimes, however, the
application of linen dipped in melted fuet, affords relief,
when no other greafy lubftance can be ufed.

In the drier and lefs irritable forms of the Impetigo,
the ufe of the waters of Harrowgate is the moll effeflual
remedy, and likewife the be.ft preventive of its return. :

3 under

PATHOLOGY

Hate XI

359

PATHOLOGY.

under the fame circumftances, the warm fea-water bath,
followed by a courfe of bathing in the open fea, is pro¬
ductive of great benefit. But, during the exiftence of any
aCtual inflammation, the irritation of fait water is de¬
cidedly injurious.

y. I. erythematica : puftules fcattered, preceded by
erythematic blufli and intumefcence ; often by febrile or
other conftitutional affeCtion. Chiefly in the face, neck,
and chell.

This variety Ihould be treated in the fame manner as
eryfipelas. As the erythema goes off, the Ikin may be
gently ftimulated by fulphureous orfalt-water baths, and
bark and the acids exhibited internally.

I. laminofa : puftules confluent; chiefly in the
extremities ; the aggregate fcabs forming a thick, .rough,
and rigid, cafing round the affeCled limb, fo as to impede
its motion; a thin ichor exfudingfrom numerous cracks.

This variety requires the fame internal medicines
w'hich have been recommended for the inveterate forms
of the preceding varieties, efpecially the fulphureous
waters. The chief peculiarity of its treatment confifts
in clearing the furface of its incruftation, and correcting
the morbid aCtion of the fuperficial vefl’els. The thick
fcab can only be foftened, and gradually removed, by
perfeverance in the application of the fleam of warm
water to it, for a ftiort time, daily. Thofe parts of the
furface, which are thus cleared, muft be covered with
foft linen, after tepid ablution, twice a-day ; and fome-
times the unguentum zinci, or a much-diluted ointment
of nitrate of mercury, may be ufed.

£. I. exedens : the purulent difcharge corroding the
ikin and cellular membrane. Chiefly on the fide of the
cheft or trunk.

This rare and intraftable difeafe is at prefent fcarcely
known. Dr. Bateman fays he had never feen an inftance
of it. The few inftances which have been recorded have
terminated fatally.

£ I. localis : confined to a particular part, moftly the
hands or fingers; and produced by external ftimulants,
as fugar or lime.

This variety includes thofe common forms of tetter
excited by peculiar ftimuli : hence it comprehends the
baker’s itch, grocer’s itch, bricklayer’s itch, and the
the eruption arifing from fri&ion with tartarized anti¬
mony, &c.

2. Ecpyefis porrigo, puftules ftraw-coloured ; fluid
vifcid ; concreting into fcales or yellow fcabs.

There are fix varieties of this fpecies. Their claflification
is adopted from Bateman ; but many circumftances feem
to fliow that they are not naturally united. Mr. Plumbe
efpecially objedts to our confidering the crufta-ladlea
(P. cruftacea) as a variety of porrigo. Of the others it
may be remarked, that the opinion of Willan, that each
of thefe varieties might be produced by one another, is
not confonant with the refults of more extended obferva-
tion, or of diredt experiment: Small dofes of mercury
are highly ufeful in this difeafe : the hydrargyri cum
creta is perhaps the beft form for very young patients.
The health of the perfon who fuckles the child fhould
likewife be attended to. As local applications in the
beginning of the malady, tepid ablution or the faturnine
ointment, and afterwards, for the purpofe of flight ftitnu-
lation, the Ung. hyd. nitrati, are all that are required.

a. P. cruftacea, milky fcall, or tetter ; (Plate XI.
fig. i.) Puftules commencing on the cheeks or forehead
in patches ; fcabs often confluent, covering the whole
face with a continuous incruftation. Found chiefly in
infants during the period of ladlation.

It is liable to confiderable variation in its courfe; the
difcharge being fometimes profufe, and the furface red
and excoriated ; and at other times fcarcely perceptible,
fo that the furface remains covered with a dry and brown
fcab. When the fcab ultimately falls off, and ceafes to
be renewed, a red, elevated, and tender, cuticle, marked
with deep lines, and exfoliating feveral times, is left

Vol. XIX. No. 1309,

behind ; differing from that which fucceeds to Impetigo,
inafmuch as it does not crack into deep fiffures. Molt
commonly, however, the difeafe terminates favourably,
though its duration is often long and uncertain. It
fometimes fuddenly puts on the appearance of ceffation,
arid afterwards returns with feverity. Sometimes it
difappears fpontaneoufly foon after weaning, or after
the cutting of the firft teeth ; and fometimes it will con¬
tinue from two or three months to a year and a half, or
even longer. It is remarkable however, that, whatever
excoriation may be produced, no permanent deformity
enfues.

Q. P. galeata, (called head : puftules commencing on the
fcalp, in diftindt, often diftant, patches; gradually
fpreading till the whole head is covered as with a hdmet ;
cuticle, below the fcabs, red, filming, dotted with
papillous apertures, oozing frefti matter; roots of the
hair deftroyed : contagious. Found chiefly in children,
efpecially during dentition. (Tinea, Alibert, Sauv. &c.)

Sometimes a narrow border of hair is left uninjured.
It is then called ringworm of the J'culp ; but has no affinity
with ringworm, properly fo called.

The firft fymptoms of the (called head are a falling of
fome of the hair, and an unpleafant itching of the fcalp ;
then arife diftindt and diftant clufters of fmall yellow
puftules, which foon break, or are broken by the child’s
fcratching them, and form fcabs, which become thick and
hard by accumulation. If the fcabs are removed, how¬
ever, the furface of the patches is left red and fhining,
but ftudded with flight elevated points, or papula, in
fome of which minute globules of pus again appear in a
few days. By thefe repetitions of the eruption of achores,
the incruftations become thicker, and the areas of the
patches extend, often becoming confluent, if the progrefs
of the difeafe be unimpeded, fo as to afFedt the whole
head. As the patches extend, the hair covering them
becomes lighter in its colour, and fometimes breaks off
fhort; and, as the procefs of puftulation and fcabbing is
repeated, the roots of the hair are deftroyed, and at length
there remains uninjured only a narrow border of hair
round the head.

Such is the defcription of (called head as it occurs in
this country. In France we fee much more violent
fymptoms ; as the following defcription, taken from
Alibert, fufficiently indicates. “ The individuals affedted
with tinea, generally feel, at firft, a pruritus, more or
lefs violent, on the head. The fcalp, on certain points
of its furface, next becomes red, chaps, or even becomes
a little tumefied. A fwelling of the cervical glands
fometimes accompanies the complaint, more rarely a
head-ache. The itching daily increafes; and puftules or
veficles are feen furrounded by an inflamed areola. In
fome cafes no trace of ulceration can be perceived, a
reddifh vifcid humour appearing to exude from the
dilated mouths of the glandular follicles. Prefently the
hair becomes agglutinated by this vifcid humour, which
iffues, flow after flow, refembling melted rofin, forming
cruft upon cruft of fcabby or fcaly layers, horrible and
difgufting to behold ! Meantime a putrid fanies beneath
corrodes the hairs even to their bulbs, deftroys the
neighbouring cellular tiflue, and threatens the cranium
itfelf. Some of thofe afflidled fall a prey to violent noc¬
turnal pains ; others into a ftate of emaciation which
entirely arrefts their growth. It is more efpecially when
tinea is congenital, or its treatment neglected, that it
commits fuch dreadful ravages. It is then that we fed
abfcefles form in the fcalp; glandular fwellings in the
occiput, neck, flioulders, and armpits; immenfe- en¬
largements of the ears ; rednefs, lacrymation, irritation
of the eye-lids; difgufting odour from the confluent
puftules ; falling of the hair; torpor and inaptitude of
the intelledls; defeat of phyfical power; even of the
generative procefs.”

The difeafe feems to originate fpontaneoufly in children
of feeble and flabby habit, or in a ftate approaching to
4 Z marafinus,

PATHOLOGY.

300

marafmus, who are ill-fed, uncleanly, and not fufficiently
exercifed; but it is generally allowed, at leaft in this
country, to arife chiefly from infection. The phyficians
of the Hopital St. Louis, a very well filled depot for
cutaneous difeafes, aflert that the contagious power of
tinea have been much over-rated ; and that it is often
impoflible to communicate by inoculation. The fame
authorities aflert, that it is invariably hereditary. Porrigo
galeata is confefledly a very difficult difeafe to cure.

With regard to the confiitutional treatment, this is of
the utmoft confequence. It has appeared to us, that to
the negled of this circumftance in the treatment of the
early ftage of Porrigo moll of thofe old and inveterate
cafes which are fo often met with, are to be attributed.
A recent author (Plumbe’s Pradical Treatife on Ring¬
worm of the Scalp, 1821,) indeed, aflerts the contrary ;
but we have had too many inflances handed down to us
of the moll dangerous phlogofes caufed by the repulfion,
and cured by the appearance, of this eruption, to enter¬
tain the leaft concurrence in this opinion. The firft ftage
of porrigo is evidently inflammation. It is, in moft cafes,
that irritative kind of inflammation almoft always con-
neded with a bad ftate of general health. In the majo¬
rity of cafes, a ftrid attention to the diet and alvine dif-
charges is all that is required. We have feen cafes, (iow-
ever, in which it was alfo necefiary to remove general
plethora by fmall bleedings, a ftate of body which natu¬
rally increafes in a great degree all inflammatory fores.
The fecretions of the kidneys fhould be moft efpecially
excited in P. galeata. The fympathy between the fecre-
tion of urine and of fweat is obvious enough : hence
terebinthinates have been found ufeful in porrigo. In
the fame ftage much will depend on the local meafures
which are ufed. Thefe fhould be (in the inflammatory
ltage) confined to the following : 1. The head fhould be
frequently waflied and well fomented with tepid water ;
the hair in fome parts fhaved ; but, when fores are plen¬
tiful, carefully cut the loofe hairs, and thofe which are
quite loofe may be taken out with a pair of pincers. 2.
After the ablution; the head fhould be well dried with
a foft cloth. 3. A mild ointment of fpermaceti and fuet
to be fpread on lint, and applied over the fore parts ; a
cap being placed over this, which muft fit pretty tight ;
for preflure will do fome good in this complaint. Thefe
little attentions, unimportant as they appear, are of the
higheft confequence in the treatment of Porrigo. As to
how long thefe meafures are to be perfifted in, muft be a
matter entirely at the difcretion of the praditioner.
Certain it is, that moft men err by ftimulating too foon ;
hence, if no very great amendment took place, we fhould
not depart from this plan too liaftiiy, and, at all events,
not while rednefs and extreme tendernefs remained, nor
until a dry and indolent ftate of the fcab is fufficiently
apparent. It is in this ftage that ftimuli are requifite :
and of thefe the records of medicine fnrnifh a large
number. Moft of thefe have in fome cafes cured Porrigo;
but, like all medicines of this clafs, they are very uncer¬
tain in their operation. They muft be ufed at firft in
fmall proportions, and may be gradually augmented to
fuch an excefs, that even a blifter may ultimately be
borne. The ftimuli moft in requefl are the mercurial
ointments, as the ung. liydrargyri prscipitati, hyd.
nitrico-oxydi,and efpecially of the hydrargyrus nitratus ;
thofe prepared with fulphur, tar, hellebore, and turpen¬
tine, and the unguentum elemi. To thefe may be added,
on more , dubious authority, preparations of muftard,
ftaves-acre, black pepper, capficum, galls, rue, and other
acrid vegetable fubftances. Lotions containing the ful-
phates of zinc and copper, or the oxymuriate of mercury,
in folution, are occafionally beneficial. The more cauftic
fubftances are often extremely fuccefsful. A lotion
containing from three to fix grains of the nitrate of
filver in an ounce of diftilled water, has removed the
difeafe. Touching the patches with themuriated tincture
of iron, or with any of the mineral acids, flightly diluted.

in fome cafes removes the morbid cuticle, and the new
one aflumes a healthy adion. The application of a blifter,
in like manner, fometimes effedually accomplifhes the
fame end. Alibert recommends a mixture of equal parts
of fulphur and charcoal incorporated with various pro¬
portions of cerate.

y. P. favofa, honey-comb fcall or tetter, (fig. 3.) Puf-
tules common to the head, trunk, and extremities; pea-
fized ; flattened at the top; in clufters, often uniting;
difcharge fetid; fcabs honey-combed, the cells filled with
the fluid.

This difeafe begins with an eruption of large foft ftraw-
coloured puftules. Thefe are not in general globular,
with a regularly-circular margin ; but fomewhat flattened,
with an. irregular edge, and furrounded by a flight in¬
flammation. They occur on all parts of the body ; fome¬
times on the fcalp alone, and fometimes on the face, or
on the trunk and extremities only ; but moft commonly,
they fpread from the fcalp, efpecially from behind the
ears, to the face, or from the lips and chin to the fcalp,
and occafionally from the extremities to the trunk and
head. They are ufually accompanied with confiderable
itching. Children from fix months to four years of age
are moft liable to this eruption ; but adults are not un-
frequently affeded with it.

The puftules, efpecially on the fcalp, appear at firft
diftind, though near together ; but on the face and ex¬
tremities they generally rife in irregular clufters, be¬
coming confluent when broken, and difcharging a vifcid
matter, w^hich gradually concretes into greenifh or yei-
lowifti femi-tranfparent fcabs. The difeafe extends, by
the fucceflive formation of new blotches, which fome¬
times cover the chin, or furround the mouth, and fpread
to the cheeks and nofe ; and on the fcalp the ulceration
ultimately extends, in a fimilar manner, over the whole
head, with a conftant difcharge, by which the hair and
moift fcabs are matted together. Under the laft-mentioned
circumftances, pediculi are often generated in great num¬
bers, and aggravate the itching and irritation of the dif¬
eafe. On the face, too, a fimilar aggravation of the
fymptoms is occafioned, in children, by an inceflant
picking and fcratching about the edges of the fcabs, which
the itching demands, and by which thefkin is kept fore,
and the ulceration extended; while the fcabs are thick¬
ened into irregular mafles, not unlike a honey-comb, by
the accumulating and concreting difcharge. On the
lower extremities confiderable ulcerations fometimes
form, efpecially about the heels, and roots of the toes ;
and the ends of the toes are fometimes ulcerated, the
puftules arifing at their fides, and even under the nails.

The ulcerating blotches feldom continue long, or
extend far, before the lymphatic fyftem exhibits marks
of irritation, probably from the acrimony of the abforbed
matter. When the fcalp or the face is the feat of the
difeafe, the glands on the fides of the neck enlarge and
harden, being at firft perceived like a chain of little tu¬
mours, lying loofe under the Ikin ; and the fubmaxillary
and parotid glands are often affeded in a fimilar manner.
At length fome of them inflame, the ficin becomes dis¬
coloured, and they fuppurate fiowly, and with much
pain and irritation. The eruption, in thefe fituations, is
likewife often accompanied by a difcharge from behind
the ears, or from the ears themfelves, with a tumid upper
lip, and inflammation of the eyes, orobftinate ulcerations
of the edges of the eyelids. When the eruption appears
on the trunk, although the puftules there are fmaller and
lefs confluent, and the fcabs thinner and lefs permanent,
the axillary glands are liable to be affeded in the fame
way.

The difcharge from the ulcerated furfaces, efpecially
on the fcalp, when the crufts and coverings are removed,
exhales an offenfive rancid vapour, not only affedingthe
organs of fmell and tafte, but the eyes, of thofe who
examine the difeafed parts. The acrimony of the dif¬
charge is alfo manifefted by the appearance of inflamma¬
tion,

PATHOLOGY.

tion, followed by puftules, ulceration, and fcabbing, on
any portion of the found (kin, which comes into frequent
contact with the parts difeafed : thus, in young children,
the bread is inoculated by the chin, and the hands and
arms by contaft with the face. The arms and bread of
the nurfe are alfo liable to receive the eruption in the
fame manner; but it is not fo readily communicated to
adults as to children.

The P. favofa requires the exhibition of the fame al¬
teratives, internally, as have been recommended for the
cure of the P. cruftacea, in dofes proportioned to the
age and drength of the patient. The diet and exercife
fhould alfo be regulated with care : all crude vegetables
and fruits on the one hand, and dimulating fubdances,
whether folid or fluid, on the other, fhould be avoided ;
and milk, puddings, and a little plain animal food or
hroths, fhould be alone recommended. If the patient
be of a fqualid habit, or fuffers under any flrumous af¬
fection, the bark and chalybeates, or the folution of mu¬
riate of barytes united with the former, will contribute
materially to the redoration of health. There is com¬
monly fome degree of inflammation prefent, which con¬
tra-indicates the ufe of aCtive flimulants externally. The
unguentum zinci, or the ung. hydrargyri prscipitati
albi, mixed with the former, or with a faturnine oint¬
ment, will be preferred as external applications, efpe-
dally where the difchargeis copious: and the ointment
of the nitrate of mercury, diluted with about equal parts
of Ample cerate and of the ceratum plumbi fuperacetatis,
is generally beneficial ; but the proportion of the un¬
guentum ceraa mud be varied according to the degree of
inflammation. A poultice is often ufefui for the larger
ulcerations.

A fevere modification of this malady fometimes attacks
the face of adults, but is eafily removed by a courfe of
purges and by emollient poultices.

£. P. lupinofa, dry tetter: puflules minute, in fmall
patches, moflly commencing on the fcalp ; patches ter¬
minating in dry delving fcabs, refembling lupine- feeds ;
the interdices often covered with a thin whitifli exfolia¬
ting incrudation. Found chiefly in early life.

This requires the fame conflitutional treatment as
the preceding varieties. Its local treatment mud alfo
be the fame, varying however the form of tfiefe to a due
relation with the intenfity of the difeafe.

s. P. furfuracea, fcurfy tetter, (fee fig. 2. Plate XI.)
Pudules very minute, with little fluid ; feated on the
fcalp ; terminating in fcurfy fcales. Chiefly found in
adults.

This variety differs from the others in the greater dry-
nefs of its exfoliation. This aridity is often fo great a3
to render the complaint likely to be midaken for Lepri-
afis, or fome other of the fcaly cutaneous deffedations.
From them it may be diftinguilhed by this circumdance ;
viz. that fcaly difeafes are not preceded, by moifl or puitular
eruption ; there is no moidure except what arifes from
rupture of veffels, produced by fcratching ; the hair is
not detached ; neither are they infectious.

The Porrigo furfuracea is often accompanied by en¬
largement of the glands of the throat. The treatment is
the fame as the other varieties of Porrigo ; viz, to re-
prefs vafcular aCtion in the inflammatory ftage, and ex¬
cite the fecernents in the latter; which latter plan may
be fooner put in force in this than in another variety of
Porrigo. Dr. Good gives, as a lad variety,

£. P. areata. This difeafe, which he fuppofes bears fome
affinity to the Area of Celfus, the Trichofis area of this
fyflem, or the Porrigo decalvans of Bateman, is inferted
becaufe “the author had feen numerous indances of it,
and often fimultaneoufly in the fame family, as though
contagious.” It is thus defined : “ Cluders of very mi¬
nute puflules feated on the fcalp, in circular plots of
baldnefs, with a brown or reddifh furfuraceous furface.”

3; Ecpyefis efthyma: puftules large; diftinCt; diftant;
fparingly fcattered ; feated on a hard circular red bafe 5

361

terminating in thick, hard, dark-coloured, fcabs. There
are three varieties ; all invariably connected with confti-
tutional difturbance.-

a. E. vulgare (Plate XI. fig. 4.) is the flighted form
of the diforder, and confifts of a partial eruption of fmall
hard puftules, on fome part of the extrerpities, or on the
neck and Ihoulders, which is completed in three or four
days. In the courfe of a fimilar period, the puftules fuc-
cefiively enlarge, and inflame highly at the bafe, while
pus is formed at the apex ; and in a day or two more they
break, pour out their pus, and afterwards a thinner fluid,
which fpeedily concretes into brown fcabs. In a week
more, the forenefs and inflammation fubfide, and the
fcabs foon afterwards fall off", leaving no mark behind.

(3. E. infantile occurs in weakly infants, during
the period of laClation, when an infufficient nutri¬
ment is afforded them. The puftules are, in appearance,
the fame as thofe of the preceding variety, and go through
fimilar ftages of progrefs in the fame time. But the dif¬
order does not terminate here : frefli eruptions of phly-
zacia continue to rife in fucceffion, and to a much greater
extent than in the E. vulgare, appearing not only over
the extremities and trunk, but on the fcalp, and even
on the face. Hence the duration of the eruption is much
greater than in the preceding variety, being fometimes
protraCted for feveral months. Yet the patients ufually
remain free from fever, and the pain and irritation feem
to be inconfiderable, except when a few of the puftules
become very large and hard, with a livid bafe, and ul¬
cerate to fome depth : in this cafe, alfo, a flight whitifli
depreflion is permanently left on the feat of the puftule.

y. E. luridum, (fig. 5.) This differs from thepreceding
varieties in the dark red colour of the bafe of the puftules,
and their hard and elevated condition. Thefe puflules
are moreover of a larger fize. The eruptions, both in
the growth of the puftules and in the fubfequent ulcer¬
ation, fcabbing, and healing, is very flow in its progrefs.
This variety is chiefly confined to advanced age. All
the varieties of ECthyma are cured by conflitutional
treatment. In the two firft varieties, improvement in
the diet of the patient and gentle purges and alteratives,
will in a fliort time effeCl a cure. In the E. luridum, a
more comprehenfive fyflem of praftiee mud be embraced;
and, viewing the difeafe as fymptomatic of a broken-up
conftitution, our endeavours mud be directed to the ge¬
neral ftate of health,, and the removal of the cacheCtic
diathefis. We have already fufficiently treated of this
under jyyfpepfia.

E. cacheCticum. Mod authors deferibe ano¬
ther variety of EClhyma. It is omitted by Dr. Good,
probably becaufe it may be doubted whether it be not a
confequence of fiphilitic or other morbid poifon. We
are inclined to think it is ; but, according to Dr. Bate¬
man, this is not invariably the cafe. It is thus deferibed
by that author. “ The diforder ufually commences with
a febrile paroxyfm, which is fometimes confiderable. In
the courfe of two or three days, numerous fcattered puf¬
tules appear, with a hard inflamed bafe, fometimes firft
on the bread, but mod commonly on the extremities :
and thefe are multiplied day after day by a fucceffion of
fimilar puftules, which continue to rife and decline for
thefpace of feveral weeks, until the Ikin is thickly ftudded
with the eruption, under various phafes. For, as the
fucceflive puftules go through their ftages of inflamma¬
tion, fuppuration, fcabbing, and defquamation, at fimilar
periods after their rife, they are neceffarily feen under all
thefe conditions at the fame time ; the riling puftules ex¬
hibiting a bright red hue at the bafe, which changes to
a purple or chocolate tinge, as the inflammation declines,
and the little laminated fcabs are formed upon their tops:
when thefe fall oft’, a dark ftain is left upon the fite of the
puftules. In different cafes the eruption varies in its
diftribution : it is fometimes confined to the extremities,
where it is either generally diffufed, or cluftered in irre¬
gular patches; but it frequently extends alfo over the
2 trunk,

362

PATHOLOGY.

trunk, face, and fcalp. The puftules which occupy the
breaft and abdomen are generally lefs prominent than
thofe on the face and arms, contain lefs matter, and ter¬
minate rather in fcales than in fcabs. The febrile fymp-
toms are diminilhed, but not removed, on the appear¬
ance of the eruption ; for a conftant erethifm or heftic
continues during the progrefs of the difeafe. It is ac¬
companied by great languor, and by much depreflion
both- of the l'pirits and mufcular ftrength ; by headach
and pains of the limbs, which are defcribed as rheumatic;
and by reftleflnefs and impaired digeftion, with irregu¬
larity of the bowds. There is commonly alfo fome de¬
gree of ophthalmia, affeding both the conjundiva and
the tarfi ; and the fauces are the feat of a flow inflam¬
mation, which is commonly accompanied by fuperficial
ulcerations.” The only effedual treatment feems to be
to fupport the conftitution by Arid dietetic regulations,
exercife, &c. and by gentle ftimulants ; as bark, farfapa-
riila, and the mineral acids, &c. and fo on till the dif¬
eafe is worn out. It fometimes lafts for feveral months.
We prefent our readers, in fig. 1. and 2. Plate XII. with
a reprefentation of its mod common forms.

4. Ecpyefis fcabies, the itch: eruption of minute pim¬
ples, puftular, veficular, and papular; intermixed or al¬
ternating; intolerable itching; terminating in fcabs.
Found chiefly between the fingers or in the flexures of
the joints. (Scabies, Cel. Sauv. Vog. Sag. Bateman. Pfora,
Linn. Cull. Parr.) There are five varieties of this dif¬
eafe.

a. Sc. papularis, the rank itch : eruption of miliary ag¬
gregate pimples ; with a papular (lightly-inflamed bafe,
and veficular apex ; puftules fcantily interfperfed ; tips,
when abraded by (cratching, covered with a minute, glo¬
bular, brown fcab.

This form of itch is liable to be confounded with Li¬
chen or Prurigo. It may be diftinguiffied from the former
by the eruption itfelf ; for the unbroken elevations in
Sc. papularis, when carefully examined, are found to be
veficular, and not papular ; they are often intermixed,
in particular fituations, with puftules ; and, when they
break, are fucceeded by fcabs ; whereas in Lichen, the
papulae terminate fpontaneoufly in fcurfy exfoliations.
In Scabies, the eruption is unconnected with any con-
ftitutional or internal diforder, and the itching is fevere :
but in Lichen, there is commonly fome conftitutional af¬
fection, and a tingling fenfation, as well as itching. The
bighly-contagious nature of Scabies will, in many cafes,
have already manifefted itfelf, and remove all doubt ; for
the Lichen is not thus communicable. In Prurigo, the
papulae, where no friction has been applied, retain the
ufual colour of the Ikin, are commonly flatter, or lefs
acuminated, and prefent no moifture or fcab, except
when their tops have been forcibly abraded ; they are
not particularly numerous in the parts above mentioned ;
and they remain long diftin&ly papular, without (flowing
any contagious property.

j3. Sc. veiicularis, (Sc. lymphatica, Bateman.) Watery
itch : eruptions of larger and more perfect veficles, filled
with atranfparent fluid, with an uninflamed bafe; inter¬
mixed with puftules ; at times coalefcing and forming
fcabby blotches. The veficles arife with intenfe itching,
chiefly round the wrifts, between the fingers, on the
back of the hands, and on the feet and toes : they often
occur alfo about the axillae, the hams, the bend of the
elbows, and fofla of the nates, where they are intermixed
with puftules ; but they do not frequently appear, like
the papular fpecies, over the breaft and epigaftrium, nor
on the thighs and upper parts of the arms. In a day or
two the veficles break ; and fome of them heal under the
little fcab that concretes upon them. But others in¬
flame, and become puftules, which difcharge at length a
yellow matter, and extend into fmall ulcerated blotches,
over which a dark fcab is ultimately formed. So that,
during the progrefs of the eruption, all thefe appearances
are intermixed with each other: the veficles, and puftules.

the excoriated blotches difcharging pu3, the minute dry
fcabs, and the larger ones fucceeding the ulceration, may
be obferved at the fame time. This circumftance confti-
tutes one of the points of diagnofis between this and
other veficular difeafes. Of thefe, however, the Herpes
and Eczema, efpecially the latter, are alone liable to be
confounded with Scabies veficularis. The Herpes dif¬
fers from Scabies in the irregularity of its courfe and ter¬
mination, and in the arrangement of its veficles in cluf-
ters, which are commonly not numerous, and appear on
thofe parts which Scabies is not very apt to attack. The
moft difficult diagnofis relates to fome of the varieties of
Eczema, which clofely refemble this, and fometimes the
former variety of Scabies; fo that it is not fo much from
the mere appearances of the eruption, as from the confi-
deration of the collateral circumftances, that a decifion
is to be obtained. The Eczema can often be traced to
diftinft fources of irritation afteCting the (kin, fuch as
expofure to the folar rays, or to great heat, and to the
application of acrid fubitances, fuch as lime, fugar, mer¬
cury, cantharides, See. It fometimes becomes inflamed
after the veficles have difeharged their lymph, but it
does not produce the large phtyzacious puftules ; and,
although the itching is fometimes intenfe, yet there is
commonly a tingling and fmarting pain with Eczema,
that does not belong to Scabies nor is it ever, like the
latter, communicated by contagion.

y. Sc. purulenta, the pocky itch, (fee fig. 3. Plate XII.)
This eruption confifts of diftinft prominent yellow puf¬
tules, which have a moderate inflammation round their
bafes, and which maturate and break in two or three days,
and then ulcerate, with increafing pain and inflammation.
Thefe puftules commonly appear firll, and attain the
largeft (ize, on the hands and feet, efpecially about the
knuckles and roots of the toes, between the fingers, and
particularly between the forefinger and thumb, and round
the wrifts. In thefe fituations, the puftules often exceed
two lines in diameter, and aflume a prominent globular
form. If thedifeafe continue a few weeks, the puftules begin
to appear on the other parts of the body which Scabies ufu-
ally attacks, efpecially about the axillae, on the back and
(houlders, and on the arms and thighs near the joints of
the knee and elbow, in the fofla of the nates, and fome¬
times, though of a fmaller fize, even about the epigaf¬
trium. In feveral of thefe fituations, where the puftules
are largeft and numerous, they coalefce, and form irregu¬
lar blotches, which ulcerate to fome extent, with hard-
nefs and elevation of the furface ; but at length hard
and dry fcabs are formed, which adhere tenacioully for a
confiderable time.

The majority of the cafes of Scabies purulenta occur
between the age of feven years and the period of puberty.
It cannot be ealily miftaken for Impetigo, when it oc¬
curs in patches, in confequence of the large fize, the
greater prominence, and comparatively fmall number, of
its puftules ; not to mention the abfence of the intenfe
itching, and of contagion, in the former. From the Por-
rigo favofa affeCting the extreituties, it will be diftin-
guiflied chiefly by its fituations about the fingers, axillae,
fofla natum, and flexures of the joints, antLby the total
abfence of the eruption from the face, ears, and fcalp ; by
the nature of the difcharge ; and by the thin, hard, and
more-permanent, fcab, which fucceeds, inftead of the
foft, elevated, femi-tranfparent, fcab, formed by the vif-
cous humour of the favi. The only other difeafe, with
which the Scabies purulenta has any affinity, is the Ec¬
thyma : but the hard, elevated, vivid red or livid bafe,
which furrounds the puftules of Ecthyma, their flow pro¬
grefs both towards maturity and in the courfe of fuppu-
ration, the deep ulceration, with a hard raifed border,
and the rounded imbedded fcab, which fucceed, as well
as the diftinCt and feparate diftribution of them, will af¬
ford the means of diferimination ; to which the inceflant
itching and the contagious property of Scabies, may be
added.

& Sc.

Plate XR

■■MM

PATHOLOGY. 363

S. Sc. complicata ; (Sc. cache&ica, Bateman .) Compli¬
cated itch : eruption complicated of puflular, veficular,
and papular, pimples co-exifting ; fpreading widely over
the body ; occafionally invading the face ; fometimes con¬
fluent and blotchy.

e. Sc. exotica, mangy itch ; (fee fig. 4.) eruption chiefly
of numerous rank puftules, with a hard inflamed bafe,
rendering the fkin rough and brownilh: itching extreme :
abrafion unlimited from exceflive fcratching. This is
produced by handling mangy animals. Several of the
varieties found alfo, occafionally, as fequels upon fevere
fmall-pox, or other caufes of conftitutional debility.

It was formerly fuppofed that the prefence of a minute
infeCt under the fkin was the caufe of Scabies ; it is now
generally underdood, that, though this infeCt is fome¬
times feen, it is fo often wanting that it can merely be
adventitious. We have given a defcription and figure of
it under the article Acarus, vol. i. p. 51.

Sulphur is a fpecific for the cure of itch. There is
good reafon to believe* however, that it is not the only
fpecific. Be this as it may, it is the mod effectual and
innocent fubdance we know of. It is ufually given in
milk internally, and ufed externally as an ointment. The
bed mode of applying the fulphur appears to be, to make
an ointment of three parts of lard to one of fulphur, which
may be fcented by any thing that is mod agreeable.
This is to be mod diligently rubbed in before the fire
at night ; and the patient, having a linen drefs prepared
which mud fit clofe to the fkin, is to put it on, get into
bed, and remain there till the following night, when the
friCtion is to be refumed. Another night being fpent in
bed, the patient is faid to arife, in mod cafes, perfectly
free. from the Scabies. If however the eruption is not
much improved in its appearance, the fame procefs mud
be repeated. The above plan is given on the authority
of one of the fird practitioners in this city.

In the feverer and more complicated forms of itch, it
may fometimes be neceffary to premife conditutional
treatment, and fedative applications to the fore furface,
before the adtninidration of fulphur is begun upon ; and,
even then, this precaution fliould be taken fome time prior
to its external ufe.

Genus VII. Malis, [Gr. from the Heb. to lay

eggs.] Cutaneous Vermination ; the cuticle, or fkin, in-
feded with animalcules. There are five fpecies, and nu¬
merous varieties.

1. Malis pediculi, loufinefs : cuticle infeded with lice,
depofiting their nits or eggs at the roots of the hair:
troublefome itching. Two varieties.

a. P. humani : infeded with the common loufe; chiefly
inhabiting the head of uncleanly children, where it pro¬
duces a greafy fcurf, or other filth ; and fometimes exul¬
ceration and porrigo: occafionally migrates over the
bod}'.

IS. P. pubis. “ Infeded with the morpio, or crab-loufe ;
found chiefly on the groins and eye-brows of uncleanly
men : itching extreme, without ulceration.” Dedroyed
by mercurial ointments.

2. Malis pulicis, flea-bites : cuticle infeded with fleas ;
often penetrating the cutis with their brifily probofcis,
and exciting pungent pain ; eggs depofited on or under
the cuticle. Two varieties.

a. P. irritantis ; infeded with the common flea, with a
probofcis fhort.er than the body : eggs depofitc-d on the
roots of the hair and on flannel.

(2. P. penetrantis, chiggers: infeded with the chigoe,
or Wed-Indian flea, with a probofcis as long as the body:
often penetrating deeply into the fkin, and lodging its
eggs under the cuticle, particularly of the feet: produc¬
ing malignant, occafionally fatal, ulcers. The chigoe re¬
quires careful extraftion.

3. Malis acari : cuticle infeded with the tick; itching
ha raffing, often with fmarting pain. Three varieties.

Vol. XIX. No. 1309.

a. A. domedici. “ Obferved on the head in confider-
able numbers." Young.

/3. A. fcabiei. Infeded with the itch-tick: burrowing
under the cuticle, in or near the pudules or veficles of
the fcabies, in thofe affeCted.

y. A. autumnalis, harved-bug-bite : infeded with the
harved-bug; lefs in fize than the common mite; inflict¬
ing its bite in the autumn, and firmly adhering to the
fkin : itching intolerable, fucceeded by gloffy wheals.

4. Malis filariae : fkin infeded with the guinea-worm ;
winding and burrowing under the cuticle, for the mod
part, of the naked feet of Wed-Indian (laves ; fevere itch¬
ing; often fucceeded by inflammation and fever. See
Filaria, vol. vii.

5. Malis' gordii : fkin infeded with the hair-worm ;
chiefly infinuating itfelf under the cuticle of the back or
limbs of infants ; producing pricking pains, emaciation,
at times convulfions. See Gordius, vol. viii.

“Though defcribed by writers of great credit, the na¬
ture of the difeafe is uncertain. By fome authors the
contained fibrils feem to be regarded as a preternatural
production of hairs ; but the greater number, and among
the red Ambrofe Pare, decidedly afcribe to them a living
principle. It appears therefore to be a fpecies of the
Gordius, or hair-worm ; fome of which infed other ani¬
mals in a like manner; and efpecially the Cyprinus al-
burnus, or bleak, which, at the time, appears to be in
great agony." Good’s Nofology, p. 496.

Genus VIII. Eephyma, [from extpva, to draw out;
in contradidinCtion both to Phyma, an inflammatory tu¬
mour, and Emphyma, a tumour without inflammation,
originating below the integuments.] Cutaneous excrel-
cence ; fuperficial, permanent, indolent, extuberance ;
moflly circumfcribed. (Phymatofis, Young.) Four fpe¬
cies.

1. Eephyma caruncula, caruncle: foft, flefhy, often
pendulous excrefcence of the common integument.
Found over the furface generally. Found alfo, occa¬
fionally, as a fequel of lues, about the arms and fex-
ual organs. It derives, in many indances, a particular
name from its fliape, or pofition ; as ficus, when fig or
raifin fhaped ; cncanthis, when feated on the cantluis 01-
angle of the eye.

2. Eephyma verruca, wart: firm, harfli, arid, infenfible
extuberanceof the common integuments. Found chiefly
on the hands. Three varieties.

&. V. fimplex; Ample and difiinCt : feffile or penfile.

(3. V. lobofa; full of lobes and fiffures.

y. V. confluens; in coalefcing cluders.

Warts may, according as they are large or fmall, be
dedroyed by cauflic, ligature, or the knife. When the
latter is ufed, candic mud be applied for fome time after,
to dedroy the roots of the morbid growth. Warts, as
Dr. Good tells us, are dedroyed in Sweden by the Gryllus
verrucivorus, or wart-eating grafshopper, which has
green wings fpotted with brown. The common people
catch it for this purpofe ; and it is faid to operate by bit¬
ing off the excrefcence, and difeharginga corrofive liquor
on the wound.

3. Eephyma clavus, corn : roundifh, horny, cutaneous,
extuberance; with a central nucleus fenfible at its bafe.
Found chiefly on the feet and toes from the prefiure of
ill-formed (hoes.

The mod efficient way to dedroy a corn is to remove
the exciting caufe ; viz. prefiure. This, however, is no
eafy matter; becaufe all fhoes at prefent made are quite
of an oppofite form to the natural figure of the human
foot ; and, if large fhoes be worn for a time, they only
aggravate the didrefs that enfues when a tight one is put
on. Frequent bathing with warm water affords great re¬
lief to the tineafy fenfations of a corn; and, when well
foaked, the top of the corn, which, from its projection,
of courfe renders the prefiure on it greater, may be cut
5 A off.

364

PATHOLOGY.

off. Moreover, when fufficiently foftened by warm¬
bathing, corns may be removed by gently picking them
round their circumference with a needle till they can be
pulled out without giving pain. Sometimes a little dia¬
chylon plafter laid on a corn keeps it foft, and promotes
its diffolution. Cutting, as commonly pra6lifed, does
harm. Thefe growths are fometimes connedled with the
periofteum, and hence arife thofe deep-feated pains in
the bones which often attend them.

4. Ecphyma callus : callous extuberant thickening
of the cuticle ; infenfible to the touch. Found chiefly
on the palms of the hands and foies of the feet as the
confequence of hard labour.

Genus IX. Trichofis, [from the hair.] Morbid

organization or deficiency of hair. Eight fpecies.

1. Trichofis fetofa : hairs of the body thick, rigid,
and briftly. — Thrown off and renewed every autumn :
fix lines long, two or three thick, ereft : five Tons affedled
as the father; Phil. Tranf. vol. v. No. 424. See alfo
Journ. de Med. Mar. 1756. Paullini, Cent. I. Obf. 31.

2. Trichofis plica, matted or plaited-hair : hairs vaf-
cularly thickened ; inextricably harled, and matted, by
the fecretion of a glutinous fluid from their roots; con¬
tagious. Ufually, but not always, appearing in, or con¬
fined to, the hairs of the fcalp. — In the beard, Epli. Nat.
Cur. Dec. II. ann. viii. 94. — Hairs of the cuticle, Id. Obf.
71. — Of the pudendum, Id. Dec. I. ann. iii. 220. Paullini,
Cent. I. Obf. 77.

Sometimes preceded by hemicrania, or other conftitu-
tional affection ; and occafionally a fequel of pforiafis.
In Poland it appears to be endemic; but it is not pecu¬
liar to that country. Notwithftanding the popular error
fcy which this pradlice is oppofed, the bell way of getting
rid of this dirty difeafe, is to fliave off the hair, and walk
the head regularly and repeatedly. The fame means may
be ufed for the cure of the local ulceration which fcratch-
ing is apt to induce in this difeafe, as thofe recommended
for Porrigo.

3. Trichofis hirfuties : growth of hairs in extraneous
parts, or fuperfluous growth in parts common. The
moll frequent variety is that of bearded women.

4. Trichofis diftrix : hairs of the fcalp weak, flender,
and fplitting at their extremities.

5. Trichofis poliolis : hairs prematurely grey, or hoary.

6. Trichofis athrix, baldnefs : decay and fall of the
hair. Three varieties.

a. A. fimplex : hairs of the fcalp of a natural hue ; but
gradually dying at the bulbs, or loolened by relaxation of
the integument.

|3. A. calvities; hair gray or hoary; baldnefs chiefly
on the crown of the head and confined to it. Mollly
common to advanced age.

7. A. barbae ; decay and fall of the beard.

7. Trichofis area ; (Porrigo decalvans, Bateman.)
Patches of baldnefs without decay or change of colour
in the furrounding hair; expofed plots of the fcalp gla¬
brous, white, and Ihining; lometimes fpreading and coa-
lefcing, rendering the baldnefs extenfive. The hair will
often be reproduced under the regular and continued ufe
of ftimulating embrocations. Dr. Good gives two va¬
rieties, taken from Celfus.

a. Diffluens; bald plots of an indeterminate figure;
exifting in the beard as well as in the fcalp: obllinate of
cure. Common to all ages.

/3. Serpens ; baldnefs commencing at the occiput, and
winding in a line, not exceeding two fingers breadth, to
each ear, fometimes to the forehead : often terminating
fpontaneoufly. Chiefly limited to children.

8. Trichofis decolor : hair of the head of a preternatural
hue.

a. Caerulea ; of a blue colour. Ephem. Nat. Cur. Dec.
II. an. iv. App. p. 203. An. vi. obfi 226.

(3. Denigrata; changed from another hue to a black.
Paullini, Cent. III. Obf. 59: the fequel of a fever. Bo-

relli, Cent. III. Obf. 2 ; from exficcation. — Schenk. Ob-
ferv. Med. i. 4 ; from terror. — Schurig. Spermatol : from
white to black; the colour of the beard changed alfo.

7. Viridis. Of a green colour. Paullini, Cent. I. Obf.
93. Bartholin. Hill. Anat.

8. Variegata. Spotted, like the hair of the leopard.
Paullini, Cent. IV. obf. 67. Ephem. Nat. Cur. Dec. III.
ann. iii. Obf. 184.

The hair occafionally grows, and has fometimes changed
its hue, after death. Eph. Nat. Cur. paflim.

Genus X. Epiehrofis, [i. e. a fpotted or coloured fur-
face.] Simple difcoloration of the furface. (Spilofis,
Young.) Six fpecies.

1. Epiehrofis leucafmus, (Vitiligo, Bateman.) White,
glabrous, Ihining, permanent fpots, preceded by white
tranfitory elevations or tubercles of the fame fize ; often
coalefcing, and creeping in a ferpentine direftion; the
fuperincumbent hairs falling off, and never re-fprouting.
Common to the furface; but chiefly found about the
face, neck, and ears.

There is no confiderable conflitutional diforder com¬
bined with this affedlion ; but it has proved exceedingly
unmanageable under the ufe of both internal and ex¬
ternal medicines. The mineral acids internally, and the
application of diluted cauftic and fpirituous fubftances
externally, have been chiefly employed, but with little
obvious eft'efl.

2. Epiehrofis fpilus, mole : brown permanent circular
patch ; folitary ; fometimes flightly elevated, and crefted
with a tuft of hair.

3. Epiehrofis lenticula, freckles : cuticle ftigmatized
with yellowifh-brown dots, refembling minute lentil-
feeds ; gregarious ; often tranfitory. Found chiefly on
the face, neck, and hands, of perfons poffefling delicate
conftitutions, and red hair. When of a larger fize, the
Greeks called them phacise (tpctx. i«i). CcIf.Vl. 5.

4. Epiehrofis ephelis, fun-burn : cuticle tawmy by ex¬
po lure to the fun ; often fpotted with dark freckles, con¬
fluent or corymbofe ; difappearing in the winter.

5. Epiehrofis aurigo : cuticle faffron-coloured, without
apparent affection of the liver or its appendages ; colour
diffufed over the entire furface; tranfient : chiefly in
new-born infants.

6. Epiehrofis pcecilia : cuticle marbled generally, with
alternate plots or patches of black and white. Blumen-
bach gives examples from a Tartar tribe, whofe fkin was
naturally fpotted like the leopard’s, lie Generis Ilumuni
varietale nativa.

Chiefly found among Negroes, from an irregular fecre¬
tion or diftribution of the pigment which gives the black
hue to their rete mucofum. In Albinos, whether among
blacks or whites, the fecretion appears to be entirely
fupprefl'ed from conflitutional debility or other defe6l.
The fubjeils of this difeafe are commonly called fpotted
or pye-balled negroes.

The different hues of black, copper-coloured, olive,
and red, by which different nations are diftinguifhed in
different parts of the world, cannot be regarded as dif-
eafes. They are as natural to them as a fair complexion
to an European, and only conllitute diftimfl features in
the different varieties of the human race. They are,
however, regarded as difeafes by Plenck, who has entered
them in his clafs Macula, under the generic terms of
rubedo cutis, nigredo cutis, and albor cutis ; by the laff
intending, not the inhabitants of Europe or Afia Minor,
but Albinos, or thofe included under the genus Alpho-
iis of the prefent fyftem.

Some of thefe natural, and many morbid, difcolour-
ations have often been found relieved by cofmetics; as
that of Homberg, which is a dilute folution of oxymuriate
of mercury, with a mixture of ox-gall. Hartmann’s
cofmetic was a Ample diftillation of arum-root in water.
If the hands be deeply difcoloured, they may be whitened
by being expofed to the fumes of fulphur. In the Ame¬
rican

1

PATH

rican ftates, a black has occasionally been known to have
the whole of the colouring pigment abforbed and carried off
during a fever, and to rife from his bed transformed into
a white man. See the fame fubjeft treated by M. Bofe,
Pr. de Mutato per Morbum colore corporis humani, Lipf.
1785. Buchner relates the cafe of a man who, on the
contrary, on recovery from a fevere fever had his face
tinged with a black hue; probably from a morbid fee re -
tion and depofit of a black pigment along with the rete
mucofum of the face. Plenck afferts that he once faw a
man with a green face, the right fide of the body black,
and the left yellow, produced by previous difeafe.

Class VII. TYCHICA, [i. e. accidental ; from t vx?)>
a fortuitous event, a cafe that rarely happens.]
Fortuitous Lesions or Deformities.

The whole of this Clafs is contained under the articles
Monster and Surgery; fortuitous lefions under the
latter, and deformities under the former. We have only
therefore, in this place, in order to render our Claflifica-
tion complete, to give Dr. Good’s enumeration of the
orders, genera, and fpecies.

Order I. Apalotica, [from aw-ator n?, foftnefs.] Dif-
orders affefting the Soft Parts. The organization of the
foft parts injured or interrupted by violence or by over¬
exertion. This order contains five genera.

Genus I. Trefis, [i.e. a wound, or perforation.] Forci¬
ble folution of continuity in a foft part, commencing ex¬
ternally. There are four fpecies.

1. Trefis vulnus, a wound. Of this there are four va¬
rieties ; as the wound may be either a fimple cut, or la¬
cerated, or deep, orcontufed, as a gunlhot or fplintery
wound.

2. Trefis punftura, a punfture. Three varieties.

a. P. fimplex ; fimple difunion by a lharp piercing in¬
ftrument.

£. P. incufpidata ; the point of the inftrument broken
off, and remaining in the courfe of the punfture.

y. P. venenata; the pointed inftrument loaded with an
acrid or poifonous material; as the arrows of barbarians
with the lama or ticunas ; the fang of the tarantula and
feveral other fpiders ; the fting of the wafp, hornet, or
fcorpion.

3. Trefis excoriatio : the fubftance of a foft part abraded
at its furface. Two varieties.

a.. E. fimplex ; confined to the ikin; chiefly produced
by friftion.

f3. E. complicata ; deeper than the integument, with
contufion, or lofs of fubjacent fubftance.

4. Trefis caufis, a burn.

Genus II. Thlafma, [from 0A&iy, to bruife.] Forcible
derangement in the ftrufture of a foft part, without dif¬
union of the external integument. Three fpecies.

t. Thlafma concuflio, concuflion, without extravafa-
tion of blood.

2. Thlafma contufio ; external compreflion; with ex-
travafation of blood, and difcolouration of furface.

3. Thlafma ftremma, a ftrain, or wrench.

Genus III. Rhegma, [from peyw^i, to break.] Lacera¬
tion. Four fpecies.

1. Rhegma ligamentare; laceration of a ligament.

2. Rhegma mufculare; of a mufcle or its tendon.

3. Rhegma vafculare ; of a blood-vefiel.

4. Rhegma vifeerale ; of a vifeus.

Genus IV, Hernia , [from Igvo?, a branch.] Rupture.
Seven fpecies.

1 , Hernia inguinalis, rupture from the groin. Four
varieties, a. Inteftinalis ; Omentalis ; y. Duplicata ;
and Congenita.

2. Hernia femoralis, femoral or crural rupture. This

O L O G Y. 365

admits of an inteftinal, omental, or duplicate, -variety, as
in the preceding fpecies.

3. Hernia umbilicalis, umbilical rupture. Admits of
three varieties, as the protrufion may be of the ftomach,
liver, or fpleen.

4. Hernia ventralis, ventral rupture. Varied as in the
preceding fpecies, and the varieties diftinguiftied by the
fame names.

5. Hernia ifchiatica, hernia of the foramen ovale.

6. Hernia veficalis, rupture of the urinary bladder. Two
varieties.

a. Simplex; the naked bladder alone protruding.

/?. Complicata; accompanied with a portion of intef-
tine or omentum.

7. Hernia diaphragmatica, protrufion of a portion of
inteftine into the cheft through an aperture in the dia¬
phragm.

Genus V. Enthejis, [from eh9>;/*», to put in.] Irritation
or obftruftion of a natural paflage by the introduftion of
an improper material. Five fpecies.

1. Enthefis cefophagea : improper material obtruded
into the cefophagus.

The more common fubftances are hairs, fmall feathers,
filh-bones, fruit-ftones, and various pieces of money.
Thefe have often remained fixed for a very longtime;
and have occafionally been found to migrate to very
remote parts. A needle has continued in the cefophagus
for nine years before it was loofened and difeharged ;
Kehring, Specif Anat. obf. 4a. A fifti-bone, after long
obftruftion, worked its way through the fubftance of the
cefophagus, and was at length thrown out at the cutis ;
Areulari, Rradica, cap. 57. The point of a fword, for
thirty years buried in the eye, was at laft ejefted by the
palate; Hoeehjletter, Dec. VI. caf. 9. The cefophagus
lias fometimes been large enough to allow a half-crown
to pafs without injury, which has been evacuated by the
reftum. A half-crown piece of this kind is in Dr. Hun¬
ter’s mufeum. See alfo Baillie’s Morb. Anat. for feveral
othercurious examples.

2. Enthefis ventricularis ; improper material fwallowed
into the ftomach. Two varieties.

a. Mechanica; hard and indigeftible fubftances; as
a knife, a nail, pieces of money, a multitude of fruit-
ftones.

1 3 . Venenata; poifonous fubftances, vegetable, mineral,
or chemical. See Poison.

3. Enthefis inteftinalis ; improper material lodged in
the inteftinal canal. Occafionally difeharged by an ab-
feefs at a diftance ; fometimes, when pointed and flender,
as pins or needles, migrating to a remote organ. See
Phil. Tranf. 1768-9. Lond. Med. Journ. iv. 77. vi, 36, 401.
and xlviii. 389.

4. Enthefis trachealis: improper material lapfed or in¬
haled into the trachea. Two varieties.

a. Mechanica ; impeding the paflage.

/3. Mephitica; noxious to the refpiration.

5. Enthefis urethralis : foreign fubftance broken in the
urethra, or dropped from it into the bladder. Chiefly
fragments of bougies, improperly manufaftured, or con¬
tinued to be employed by the patient after being worn out.

Order II. Stereotica, [from creptoq, hard, firm.]
Diforders aft’efting the Hard Parts. The continuity or
connexion of the hard parts impaired or interrupted by
violence or over-exertion. This order has four ge¬
nera.

Genus I. Catagma, [i. e. a frafture.] Forcible divifion
of a bone into two or more parts. (Clafis, Parr.) Two
fpecies.

1. Catagma fraftura, a broken bone. The varieties
are four, as the frafture may be fimple, fplintery, com¬
pound, or complicated with other injury.

2. Catagma fiflu ra : bone cracked; the divided edges
ftill in contaft. Chiefly affefting the cranium, though

the

3C6 PATHOLOGY.

the long bones are occafionally fubjeft to it, and efpe-
cially the ribs. Three varieties.

«. F. fubjacens; filTure immediately below the exter¬
nal injury.

£. F. contra-jacens, counter-fifture ; fiffure and feve¬
red fymptoms on the oppofite fide of the fkull to the ex¬
ternal injury.

y. F. complicata; combined with a counter-ftroke
producing concuflion or extravafation. See a lingular
cafe of Le Dran’s, in which the outer table of the head
was fifiured ; the inner had a fmall bony fcale thrown off
from it ; and concuflion with extravafation took place on
the oppofite fide of the fkull. ObJ". xvii.

Genus II. Campfis, [from r.ctp.ir'ru, to bend.] A bone
or cartilage forcibly bent from its proper lhape without
breaking.

Campfis depreffio, a fingle fpecies. The bone or carti¬
lage flattened or bent inwards. Found chiefly in young
fubjefls ; and principally on the cranium and enfiform
cartilage of the cheft ; the bone often recovering its pro¬
per figure with the gradual growth of the frame.

Genus III. Exarthrema, [from igctfQpvo, to put out of
joint.} Diflocation ; extrufion of a bone from its feat of
orticulation. Three fpecies.

1. Exarthrema luxatio, a luxation: the bone, eafily
and extenfibly moveable, forced completely from its arti¬
culating cavity.

2. Exarthrema fubluxatio, fubluxation : the bone
forced partially from its cavity, and refling on the edge
of the focket.

3. Exarthrema loxarthrus, twilled, or oblique joint:
the bone, flightlyand narrowly moveable, forcibly loofen-
ed in its articulation, and diftorted in its relative peti¬
tion. Chiefly occurring in the bones of the cheft, with
fubfequent gibbofity, efpecially in young perfons ; and
in the bones of the carpus and tarfus, producing crooked
-wrifts and fplay-feet.

Genus IV. Diaflafa, [from ciacP^ua, to feparate.] Sepa¬
ration of bones. Three fpecies.

1. Diaftafis epiphyfica : feparation of a bone from its
epiphyfis. Confined to the ftages of infancy and feeble
adolefcente; for the epiphyfes of bones in a healthy con-
ftitution become gradually apophyfes, or conftituent
parts of the bones themfelves. Often miftaken by the
unficilful for a luxation ; and aggravated by vain and
painful attempts to effeft a reduction.

2. Diaftafis cartilaginea : feparation of bones connected
by an intervening cartilage. Exemplified moft common¬
ly in the feparation of the fymphylis pubis in cafes of
preternatural labour; though other inftances are not un¬
frequent.

3. Diaftafis futoria : feparation of connefling futures.
A feparation of the futures of the fkull is ufually fatal.
Mr. B. Bell mentions one inftance of an injury of this
kind that terminated favourably. Surg. vol. vi.

Order III. Morphica, [from p.o%(py, form.] Monftro-
fities of Birth. Six genera.

Genus I. Metrocelis, [from y-yxyp, mother, and xyXis,
a fpot.] Mother’s marks. Congenital difcolourations on
the furface. (Naevus, Sauv. See.) Five fpecies.

1. Metrocelis fpilofa : Ample, fuperficial, circumfcribed
ftain ; for the moft part yellow, brown, or red. Three
varieties.

a. Circulars ; with a circular or orbicular outline.

13. Foliacea; leaf-lhaped.

y. Arachnoides ; with flender claw-lhaped or fpider-
legged ramification's.

'a. Metrocelis frufliformis ; dark-coloured, in the form
of fruit. The fruits chiefly reprefented are the cherry,
currant, and grape, with a fmooth furface ; and the- mul¬

berry, rafpberry, and ftrawberry, with a papulous furface.
Two varieties.

a. Pediculata; poflefling a footftalk.

(3. Seflilis; fixed to the furface by a broad bafe.

3. Metrocelis turgefeens : large, loofe, fanguine, irre-
gular-lhaped tumour ; fenfibly compofed of a congeries
of bloated and diftorted veflels. (Naevus cavernofus,
Plenck.

4. Metrocelis diffufa: difcoloration fpreading indeter¬
minately over a limb, or a large part of the body. Ried-
lin deferibes a cafe of univerfal difcoloration from a
fright of the mother, making an approach to Epichrofis
pcecilia.

5. Metrocelis cana : hair of the fcalp hoary at birth.

Genus II. Oloplionia , [from oAAvy.i, I lofe, and tpavy,
voice.] Congenital mifeonftruflion of the vocal organs.
Four fpecies.

1. Olophonia narium 5 mifconftru&ion of the noftrils.
Two varieties.

«. Obftruens ; impeding the utterance, from imperfo-
ration or other caufe.

|3. Defedliva ; the organization incomplete.

2. Olophonia linguae : mifconftru&ion of the tongue or
its appendages. Three varieties.

a. L. adhefiva ; adhefion of the tongue to the furround¬
ing parts.

£. L. fraenata ; tongue tied beneath by contra6lion of
the frienum, or its extending too near the tip.

y. L. deglutatoria, frasnum loofe or abfent, and the tip
of the tongue doubling back upon the fauces.

3. Olophonia palati : mifconllrudtion of the palate.

4. Olophonia labii : mifconftru£tion of the lips. Three
varieties.

a. L. lobata, hare-lip ; lobed or divided in the middle;
edges, feparated and convex.

£. L. bilobata; lip bilobed, or doubly divided.

y. L. prolapfa ; one or both lips ftrikingly broad and
projetSling,

Genus III. Paraflheflu, [i. e. imperfect fenfe.] Conge¬
nital mifconftruclion of the external organs of fenfe.
Here we have only three fpecies noted.

x . Parsefthefis auditus : misformed organ of hearing.
Three varieties.

a. A. fiacca, flap- ear : lobe of the ear broad, loofe, and
pendent. Said to be a common deformity among the na¬
tives of Siam. The fource of the furname of Flaccus in
ancient Rome. — A beetle-headed flap- ear'd knave. Shuke-
flpeare.

£. A. obftruens, imperforate ear.

y. A. defefliva, congenital deafnefs.

2. Parrefthefis olfaftus: misformed organ of fmell.
Two varieties,

a. O. obftruens ; impeding the entrance of feents from
imperforation or other caufe.

£. O. defeftiva; the organization incomplete.

3. Paraefthefis vifus : misformed organ of fight. Two
varieties.

a. V. unoculata ; poflefling only one eye.

£. V. pupillaris ; pupil incomplete in its power of vi-
fion.

Genus IV. Pernfplanchnia, [from Tnjpoj, defective, and
crwhciyxyov, vifeus.] Congenital mifconftrudlion of the
vifcera. Six fpecies.

1. Perofplanchnia cranii : mifconftruclion of the head.
Three varieties.

a. C. capitofa, jolt-head : head enormoufly bulky ; con¬
tents folid.

£. C. hydropica ; head enormoufly bulky, from drop-
fical atfedftion ; hydfocephalus.

y. C. cerebralis ; brain incomplete in quantity or orga¬
nization. Some have been born without a cranium, and

a flefiiy

PATHOLOGY. ‘307

a fleffiy mafs inftead of brain. Vallifneri, 330. Soemmer¬
ing ■. — Without brain or medulla oblongata ; Dufour.
Journ. de Med. xxxv.- — Acephalous ; lived eleven hours.
A61. Med. Berol. Dec. I. viii. — Lived five days ; another
cafe fix days. Plouquct.

2. Perofplanchnia cordis s the heart mifconftrufted or
mifplaced. Four varieties.

a. C, perforata ; the two ventricles communicating.

S. C. tranfiativa ; heart tranfpofed to the right fide.

y. C. expers; heart totally wanting. — See Hewfon on
the Lymph. Syft. Part. II. p. 15. There were other de¬
fers befides the total abfence of the heart. “ The circu¬
lation had been carried on merely by an artery and a
vein, whole coats therefore probably were mufcular.”

k. C. multiplicata; heart duplicate, or more than du¬
plicate.- — Double; fee d’Abouville, Atner. Phil. Tranf.
vol. i. — In a partridge; Tode, Annalen v. — In a dog;
Pauli ini, p. 43. — In a hen ; Eph. Nut . Cur. Cent. VIII.
Obf. 8.-— Triple : found ieveral times in geefe. Eph. Nat.
Cur. paffim.

3. Perofplanchnia alvei : the inteftinal canal or its in¬
volucres mifconftrufted or perverted. Three varieties.

a. A, perforans ; the inteftines perforating the invo¬
lucres. See Calder Ed. Med. Ell'. I. art xiv. Inteftines
appeared externally, having fallen through a perforation
above the navel : child in health when born, but died
four days afterwards.

(3. A. defeftiva; fome of the parts wanting. See Din-
more, Lond. Med. Journ. XI. 339. Parietes deficient.
AS. Soc. Med. Hafn.

y. A. obftruens ; obftrufticn in the al vine palfage, from
imperforation or other caufe.

4. Perofplanchnia hepatis : mifconftruftion of the
liver.

5. Perofplanchnia veficae : mifconftruftion of the blad¬
der or urinary channel. — Bladder deficient. Duncan,
Edin. Med. Journ. iv. 403. Urethra imperfeft and im¬
perforate : urine difcharged from. a papilla near the na¬
vel : child other wife in health : age not mentioned.
Mowathi Edin. Med. Elf. vol. iii. art. xiv.

6. Perofplanchnia geniturse: mifconftruftion of the
genital organs, or their appendages. Three varieties.

as. G. fuperflua ; organization fuperfluous or anoma-
loufly multiplied. Double uterus and vagina. Phil.
Tranf. 1774, p. 472. — Double penis. Schenck. Plouquet.-—
Penis of enormous fize. Memoires concernant les Arts.
1672. p. 27. Wolff, Left. Memorab. I. 434.

£. G. defeftiva ; organization incomplete. One or
both tefticles defeftive ; generally from emafculation.
Prepuce or clitoris imperfeft or wanting. Veficula? femi-
nales confufedly united, and wanting their excretory
dufts. The neceflary refult of this defeft in an adult
muft be dyfpermia, and confequently agnefia. See Buillie,
Morb. Anat. Fafc. viii. PI. I. fig. 2.

y. G. obftruens; obftruftion in the male or female
palfage from imperforation or other caufe.

Genus V. Peromelia, [from TT/jpo;, defeftive, and p.i\o<;,
a member.] Congenital mifconftruftion or mutilation of
the limbs. Four fpecies.

l. Peromelia decurtata s limbs curtailed of their pro¬
per length ; as the arms or legs preternaturally abridged.

2. Peromelia truncata : limbs or parts of a limb totally
wanting. Six varieties.

os. Capitis j head totally wanting.

£. Brachii ; y. Cruris; deftitute of one or both arms
or legs.

o. Manus; e. Pedis; deftitute of one or both hands or
feet.

5). Complicata ; deftitute of various limbs. Mifs
Sevan, thus preternaturally mutilated, exhibited herfelf
a few years ago in this metropolis: a mere head and
trunk, with the rudiments only of flioulders and lower
limbs. She was about thirty years of age, of agreeable
face, form of body, and manners ; well educated ; worked

Vol. XIX. No. 1 309.

with her needle by means of the tongue; and painted
miniature portraits with great delicacy and clofe refem-
blance, by holding her pencil between the right cheek
and fho'ulder ; by the fame contrivance file wrote a neat
running hand.

3. Peromelia contorta : limbs incurvated or confufed
in their organization. Five varieties.

as. Colli ; wry- necked.

£. Gibbofa; hump-backed or hump-lhouldered.

y. Valga ; bow-legged or bandy-legged.'

k. Plauta ; fplay-footed or fplay-handed ; having the
foot or hand turned inwards. Hence the name of Plau¬
tus, the Roman dramatic poet.

£» Loriformis ; club-footed or club-handed.

4. Peromelia fuperflua : limbs or parts of a limb fuper¬
fluous. Two varieties.

<*. Digitorum ; fupernumerary fingers or toes. This pe¬
culiarity is often propagated to fucceeding generations.
See the account of the fix-fingered family mentioned
by Maupertuis ; and Mr. Carlifle’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. Tranf. 1814,
p. 94. and our article London, vol. xiii. p. 314. Some of
the families of the ancient Philiftines appear to have pof-
fefled the fame peculiarity ; (2 Sam. xxi. 20.) As alfo feve-
ral among the Romans; for which fee Pliny, lib. xi. cap. 43.

£. Crurum ; lower extremities fuperfluous.

Genus VI. Polyperia. [from rro’kvt;, many, and Tnjpo?,
defeftive.] Congenital mifconftruftion of various parts
or organs. Three fpecies.

l. Polyperia promifcua: the parts or organs of one ca¬
vity confufed with thofe of another. Two varieties.

a. Tranfiativa; tranfpofition of organs from their pro¬
per feat ; as the abdominal vilcera in the thorax. Macau¬
lay, Med, Obf. i, 25. — Total tranfpofition of the abdomi¬
nal and thoracic vifcera ; Phil. Tranf. 1674.

£. Vafcularis; inverted diftribution of the arteries.
Buillie, PI. 21.

2. Polyperia fuperflua : fuperfluous organization gene¬
ral, or extending to various organs. Four varieties.

as. Biceps ; head double.

Q. Bicorpor ; body double.

y. Convolvens ; one individual enclofed within ano¬
ther. G. TP. Young, Medico-chir. Tranf. i. 234.

A fimilar monftrofity in the vegetable world is to be
found in the Tranfaftions of the Stockholm Academy,
vol. 5. p. 414, under the title of Pomerantz med et innejlutit
fojler. It conflfts of one orange growing within another.
The fruit was exhibited to the Society by Count Tefiin.

k. Hermaphroditus ; genital organs of both fexes in
one individual. See Anatomy, vol. i. p. 623. and
Plate VI.

3. Polyperia defeftiva : defeftive organization general,
or extending to various organs. Two varieties.

as. Nanus, dwarf; the organization of the whole form
diftinftly developed, but inordinately diminutive.

Q. Mola, mole; general organization imperfeftly and
indiftinftly developed. A twin-mole without a heart, is
mentioned by Le Cat in Phil. Tranf. 167. 1.

To the general principles of therapeutics laid down at
pages 96 & feq. and to the praftical details of the fame fci-
ence fo largely dwelt upon under every fpecies of our
numerous catalogue of difeafes, we have nothing further
to add. Diftnilfing, therefore, the fubjeft of the action
of material agents on the human frame, we come to the
confideration of the mode in which thefe agents are to be
prepared, combined, and modified, to enfure their moll
efficient operation. This embraces that branch of the
healing art called Pharmacy or more properly Pharmaco-
pology. Materia Medica is the term which is now ufed
in- the Pharmacopoeia to defignate the raw materials. In
a more extended feries, it might be made to comprehend afl
5 B the

068

PATHOLOGY.

the fubftances, however prepared, ready for the ufe of the
phyfician. The Materia Medica conlifts of three kinds of
fubftances; thofe derived from animals, thofe derived
from vegetables, and thofe taken from the mineral king¬
dom. Thefe divifions, as far as regards the fubftances
themfelves, when fubjedled to the operation of chemiftry,
run into each other. From the animal kingdom, how¬
ever, very few medicines are derived : the moft import¬
ant that occurs to us is the Lytta, or bli lie ring-fly. The
vegetable kingdom furnifties a vaft number; and from
every part of plants, trees, and flirubs, peculiar fubftances
are occafionaily derivable. Our pharmacopoeias abound
with many vegetable fubftances which are never ufed by
practitioners in general. This fuperabundance of materi¬
als was owing, in the firft inftance, to an abfurd notion,
that every individual plant in exiftencewas endowed with
curative powers over fome particular malady; and, in
the fecond, to that want of difcrimination which leads
men to miftake partial coincidence for invariable or ge¬
neral law. The chief thing which the pharmaceutift
has to attend to in the preparation of vegetables, is their
prefervation. The manner of drying, therefore, whether
in regard to its fuddennefs or tardinefs, the time of ga¬
thering, the mixing with other, herbs, &c. are all points
to be intimately attended to : for fome plants, as the
colchicum and fquill efpecially, lofe their eftefts entirely
if not pulled at a particular feafon, or if dried in an im¬
proper manner.

For the convenience of exhibition, the virtues of plants
are extracted (for immediate ufe) by infufwn-, i. e. the
power of cold or boiling water on a plant fora certain
length of time ; and by decoClion, or the aClual boiling
of the fubftance. More permanently, the virtues of
plants are preferved in tindures, i. e. fluids containing a
large proportion of fpirits of wine; and by exlruCls, pro¬
cured by means of folution and evaporation. By the
laft procefs the effential oil is feparated from the more
unftable conftituents of the plant. The common oils
are feparated by exprefiion. The fubftances derived from
the mineral kingdom are prepared by the common opera¬
tions of chemiftry, as precipitation, cryftallization, See.
Hence the necefllty that the pharmacopolift Ihould be well
verfed in the details of praClical chemiftry. The magni¬
ficent progrefsof this art has purged our Pharmacopoeia of
many of its ufelefs or incongruous fubftances, and like-
wife corrected that evil habit of preferibing which
caufed the praftitioner to combine falts which decom-
pofed each other. At the fame time chemiftry caufed vege¬
table fubftances to go very much out of ufe, at leaft
among thofe at all influenced by the fafhion of the day.
For, prefuming on their accurate knowledge of our fei-
ence to interfere with the practitioner of the more diffi¬
cult one of medicine, fome chemilts endeavoured to ridi¬
cule thefe auguft bodies who had compiled the modern
Pharmacopoeia, becaufethey had not paid fufficient atten¬
tion to chemical laws. In this impertinent attempt, they
were entirely unfuccefsful, becaufe all fcientific prafti-
tioners knew how mhch depended on thofe minute ope¬
rations of mineral or vegetable fubftances which elude
the prefent knowledge of the chemift ; and they faw the
folly of trufting to theory, and difearding a medicine
which experience fhow'ed could cure a difeafe, merely be¬
caufe it was unfcientifically compounded.

But, from whatever fource medicines are derived, much
of theirefteft depends on their judicious combination. In
the firft place, the practitioner muft be careful not to com¬
bine any minerals in a prefeription which are capable of de-
compoling each ether ; for, though we have defended the
uccaiional inattention to this rule in learned bodies and on
general experience of its utility, it neverthelefs ought to be
rigoroufly attended to in forming a prefeription. The pe¬
culiar affinities of the various falts are eafily learnt and
remembered. Of the effeCi of minerals on vegetables we
do not know much. We may remark that, generally
fpeaking, alkalies extract more efficiently the properties

of vegetables ; on fome occafions, acids feem to have a
flmilar effeCt ; but this is uncertain. In the cafe of opium
and fome other narcotics, the mineral acids feem to re-
ftrain the deleterious effeCt of the drug. The analyfis of
vegetables, as purfued by the French cheinifts, promifes to
furnilh us at fome future period with more certain infor¬
mation in regard to the operation of minerals over vegeta¬
bles ; but at prefent we do not know enough to form any
important general information on this head. In the com¬
bination of various vegetable products in the fame pre¬
feription, we have only to look to the medical operation of
thefe fubftances, becaufe they have rarely any chemical
effeCt on each other. Generally fpeaking, it is wrong to
combine in the fame formula medicines which do not
operate on the fame organs : thus we ffiould not combine
diuretics and purges, nor emmenagogues and fudorifics.
On the other hand, medicines which do aCt on the fame
ftruCture may be combined with the utmoft advantage :
Thus a fmall dofe of epfom falts, of fenna, and buck¬
thorn-juice, in combination, operates much more active¬
ly and certainly then a large dofe of any one of thefe
drugs. Again; two or three diuretics mixed together
will often operate when they have feparately failed to pro¬
duce any effeCt. But this combination of drugs, fo ufe-
ful to the practitioner, does not fucceed effectually if
puffied beyond the extent of three or four articles ; and
it ffiould alfo be recolleCted, that, if a Ample drug does
perform its office, it is wrong to mix it with others, be¬
caufe we thereby fail to improve that part of medicine we
know fo little of; viz. the particular effeCt of particular
drugs.

Befides combining medicines for the fake of increafing
their force, we fometimes combine them to reftrain
any contingent operation of a drug, which operation is
not effential to the cure, and is injurious to the fyftem ;
as when we combine fulphuric acid with opium, a com¬
bination which does not hinder the narcotic effeCl of the
opium, but prevents its ftimulating effeCt, which may do
hurt; or when we give opium with calomel, and thusen-
fure falivation while we reftrain diarrhoea. A medicine
added to another in the above manner, for the preven¬
tion of any unpleafant effeCt, is called a corrective. A
medicine which increafes the operation of anotlieris called
an adjunCt.

A lefs important point of confideration in preferibing
is to render a medicine more pleafant to the palate of the
patient, by fyrups, by acids, &c. but, in doing this, we
muft be careful not to interfere with the operation of the
aftive ingredients, and thus facrifice an important to a
trifling matter. At the fame time, fo numerous are the
formula in common ufe, that we ffiall feldom find it necef-
fary to preferibe medicines which cannot abfolutely be
taken; and at all events we muft avoid preferibing medicines
which cannot be mechanically united, as acids with olea¬
ginous fubftances; and fo on.

Prefcriptions are generally written in the Latin lan¬
guage, which of all others is the moft proper, becaufe it
is more or lefs known to the whole world, and becaufe,
being lefs familiar with it than with our own, we both
read and write it with peculiar care. The quantities of
medicine are not written in Latin, however, but are ex-
preffed by figns. Some have ftrongly urged the propriety
of writing the quantities as well as the names of the t
drugs at full length; but we cannot fee that this would
be attended with fewer miftakes than the prefent mode;
fince the tedium of writing a long word might induce
careleffnefs, and the figns in ufe are fumciently clear, and
may be rapidly written in the moft correCl: manner. We
muft except, however, the too clofe refemblance of the
drachm and ounce figns, which cannot be defended. The
firft fign ufed in medicine is the R, which is commonly
fuppoled to be an abbreviation of Recipe, Take, (which
word it is now underftood to mean in all prefcriptions ;)
but by others is ftated to have defeended to us from thofe
of the ancients who believed much in fidereal influence,

and

369

PATHOLOGY.

and who u fed it as a fign of fome planet, probably Jupi¬
ter. The next mark is for the ounce, 5 ; for the drachm,
0; for the fcruple, 3; but, having no mark for grains,
we ufe gr. To thefe we append the number of ounces,
drachms, &c. required, (dill adhering to old forms,) not
in figures, but in Roman numerals ; as 51, one ounce 5
5ij, two drachms ; 9iij, three fcruples, &c. We have
alfo this mark, orys, for half j and, more recently,
?11 for minim, or drop, ft is the mark for pound, though
feldom ufed ; O for a pint ; and a, or ana, for equal quan¬
tities of two or more articles previoufly mentioned.

Into the mode of preparing drugs we lliall not enter,
as being generally known to the medical profeflion
through the medium of the firfl: elementary works, and
as being of no ufe to the general reader. The London
Pharmacopoeia of 1809 contains all that is necefl’ary to
be known with regard to the preparation of the drugs
therein mentioned ; and the mode of preparing thofe of
more recent introduction may be found in Thompfon’s
Confpeflus , or in Gray's Supplement. To thofe who willi'
to liudy the fcience of pharmacy in a more fcientific
manner, we ftrongly recommend the work of Dr. Paris ,
entitled “ Pharmacologia.”

Alphabetical List of the Materia Medica,
With the ufual Dofes.

The dofes given by different practitioners vary fo much,
that any general table of them mult neceffarily be imper-
feCt, and can only be expeCted to guard the young prac¬
titioner from error. The quantities are meant for adults ;
and either of the two quantities here fet down, or any
intermediate one, may be ufed as adofe, except when the
word to is inferted between them, which means, “ that
the quantity fiiould be gradually raifed from the former
to the latter,” and fometimes it may be carried much be¬
yond it. Some articles, as far as their effeCts are con¬
cerned, may be given at once in much larger quantities,
and their dofe is rather therefore eftimated by conveni¬
ence, on account of bulk : fuch, however, it does not
appear neceffary to diftinguilh particularly. The fame
article is often ufed in different quantities, to produce
different effeCts : fuch fecond effeCts, when they are
emetic or cathartic, are in marked inftances accord¬
ingly given under the former, with E or C prefixed,
as may be inftanced in the article Antimonium tartari-
zatum.

Abietis Refina
Abfinthium
Acacias Gnmmi
Acetum Colchici

• - — Scillae

Acidum aceticum

- benzoicutn

— — citricum

— muriaticum

— nitricum dilutum

- fulphuricum dilutum

Aconiti Folia
/Ether reClificatus
/Erugo

Allii Radicis SuccuS
Aloee fpicatae ExtraCtum

- - vulgaris ExtraCtum

Alumen
Ammoniacum
Ammonias Murias

- - Carbonas

Anethi' Semina
Anifi Semina
Anthemidis Flores
Antimonii Oxydum

— - Sulphuretum

- Sulphuretum praecipitatum

Antimonium tartarizatum

gr. x

9j

3fs
3fs
3fs

3j

gr. x
gr. x
Tffx
IRx to
tt]x to 111x1
gr. j to gr. v
3fs 3ij

gr. § to gr. j

3j 3^

gr. v

3fs

3j

3ij

3ifs

3ifs

S^

3fs

5fs

ntxi

Iffxl

gr. v
gr. x
gr. x
gr. x
gr. v
gr. x
gr. x
gr. x

gr- j

gr. x

gr- j
gr- k
gr-j

Aqua Anethi

- - Carui

j

- Cinnamomi

f

- - Fceniculi

\

_ .

- Menthas piperitse

(

5‘j

5>v

- viridis

- Pimentas

- Pulegii

J

Argenti Nitras

•

gr. fs to gr. v

Armoraciae Radix

3i

3j

Arfenici Oxydum prasparatum

gr.Jgtogr.i

Afari Folia

gr.-x

3]

Affafcetidas Gummi-refina

gr. x

5fs

Balfamum Peruvianum

gr. x

3fs

- - Tolutanum .

gr. x

3fs

Belladonnas Folia

gr. fs to gr. v

Benzoinum

gr. x

3fs

Biftortas Radix

gr. x

3j

Cajuputi Oleum

mi

Idv

Calami Radix

gr. x

3j

Calamina prasparata

gr. x

3j

Calumbae Radix

gr. x

3]

Cambogia

gr- ij

gr.xij

Camphora ,

gr. iij

9j

Canellae Cortex

gr. x

3fs

Capfici Baccae

gr. v

gr. x

Cardamines Flores

9j

3j

Cardamoini Semina

gr. v

3fs

Carui Semina

gr. x

3j

Caryophylli

gr. v

3fs

- Oleum

IRij

IRv

Cafcarillas Cortex

gr- x

3j

Cafiias Pulpa . -

Sis

Sj

Caftoreum

gr- v

9j

Catechu Extratlum

gr. x

3ij

Centaurii Cacumina

gr. xv

3j

Cetaceum .

Cinchonas cordifoliae Cortex

- lancifolias Cortex

— - - — oblongifoliae Cortex

Cinnamomi Cortex

- — — Oleum

Coccus

Colchici Radix
Colocynthidis Pulpa
Confeftio Amygdalae

- Aromatica

- Aurantii

————— Caflias
Confe&io Opii .

— — - - Rofae caninae

- - - Gallicae .

Scammoneae

Sennae

gr. xv
gr. xv
5fs
3fs
3fs

9j

3j

3j

3]

gr. x
5fs
gr. v
gr. fs

gr- iij

Conii Folia
Contrajervae Radix
Copaiba

Coriandri Semina
Cornu uftum
Creta prasparata
Croci Stigmata
Cumini Semina
Cupri Sulphas
Cuprum ammoniatum
Cufpariae Cortex .

Dauci Semina

Decoftum Aloes compofitum

- - Cinchonas

- Cydoniae

■ ■ Dulcamaras

- — Hordei

— compofitum

— Lichenis
Sarfaparillas

compofitum

3j

gr. x
gr. x
gr- x
gr- v

*nj

gr. v

gr-j
gr-j
3j

gr. x

3j
3j

gr. x
3j
3j
9j

3fs
gr. ij to 9j
gr. x 3fs

5jfs

3jfs

3jfs

3jfs

9j

m>U

9j

gr. v
gr. v

S3

Sj

Si

Si

3fs

Sj

Si

3j

Si's

-5J

3j

3ij

3ij

3j

3j

9j
9j.

3fs
3fs
gr- x

9j

gr. j to gr. v
gr. Is to gr. v
gr. x 3j

3j
S'j
S»V
Siv
S'j

O. fs
O. fs

Siv

O. fs
O.fs
Deco&um

yj

Si's

Sj

Sj

Si's

Siv

Siv

Sj

Siv

Siv

4

370

PATHOLOGY.

Deco&um Senegae

- - Ulmi

Digitalis Folia
Dolichi Pubes
Dulcamara; Caulis
Elemi
Extraclum

Aconiti

Aloes

Anthemidis

Belladonnas

Cinchonae

refi

Colocynthidis

Conii

Elaterii

• Gentianae
Glycyrrhizae
Haematoxyli

■ Humuli
Hyofcyami

■Jalapae

• Opii

■ Papaveris

• Rhei

Sarfaparillae

Taraxaci

ofum
compofiti

Ferri Sulphas

- Carbonas

Ferrum amtnoniatuni

• - tartarizatum

Filicis Radix
Fceniculi Semina
Galbani Gummi-refina
Gentianae Radix
Glycyrrhizae Radix
Granati Cortex
Guaiaci Refina
Haematoxyli Lignum
Hellebori fcetidi Folia

- - nigri Radix

Humuli Strobili
Hydrargyri Nitrico-oxydum

- Oxydum cinereum

■ - - rubrum

- Oxymurias

- ; - Submurias

- : - Submurias

- Sulphuretum rubrum

Hydrargyrus cum Creta

- prsecipitatus albus

■ — - purificatus

Hyofcyami Folia ,

Jalapae Radix
Infufum Anthemidis

■ - - Armoracias compofitum

3ils

giv

- Aurantii compofitum

3>(s

giv

- Calumbffi

3'fs ,

giv

- - - Caryophyllorum

,

3iis

giv

- Cafcarillas

3ifi>

giv

- - Catechu

3ifs

giv

- Cinchonae

3ifs

giv

- - Cufpariae

Sift

giv

- Digitalis .

Sl

S'J

- - Gentianae compofitum

gifs

giv

- - Lini

gifs

O. fs

- Quaflias

gifs

giv

- Rhei

gifs

giv

- - Rofae

gifs

O. fs

- Sennae

gifs

giv

— — - - Simaroubae

gifs

giv

Ipecacuanhas Radix

gr. fs

gr. ij

E

gr. v

3fs

juniperi Baccae

Sfs

Sj

Kino . *

»

gr. x

Sfs

.5^

3 iv

gr. fs to
gr. v

gr. x
gr-j to
gr. v
gr. x
gr. j to
gr. x
gr. x

ST. V

gr. v
gr. v
gr. fs
gr. x
Sj

gr. x
gr. v
gr. v to
gr. x
gr. fs to
gr. ij to
gr. x
gr. x
gr. x
gr. j to
gr. ij to
gr. iij
gr. x
Sj
3j

gr. x
gr. x
Sfs

9j

gr. x

9j

gr. x
gr. x
gr. x
gr. fs

gr- ij

S'J

O. fs
gr.iij
gr. x
3i
Sfs
gr. v
gr.xv

3j

gr. v
Sfs
Sfs
Sfs
Sfs

9j

gr-nj

Sfs
3 fs
Sfs

9j
3j
9j

gr. v

3j

Sfs
Sj
Sj

gr. v
gr. x
gr. xv

Sfs

3 is
3j

Sfs

Sj
Sj
3j
Sfs
Sj
Sj
Sj
9j

gt- ij
gr. x

gr. ij

gr. a to gr. fs

gr- ij

gr.xv
Sfs
Sfs
gr. x
3iv
gr. xv
Sfs

gr. fs

gr. fs
gr. v
gr. x
gr. x
gr. v

3 is

gr. v
gr. x
gifs

Lavandulae Fiores ,
Lauri Baccae et Folia
Lichen .. .

Linum catharticum
Liquor Ammoniae

- Ammoniae Acetatis

- Ammonias Carbonatis

- - Antimonii tartarizati

E

Arfenicalis

- Calcis

- Ferri alkalini

Hydrargyri oxymuriatis

— Potaflae

— Potaflae Subcarbonatis

Lytta

Magnefia ,

- - Carbonas

- - Sulphas

Malva

Manna . .

Maftiche . .

Marrubium , ,

Mel Boracis .

_ - defpumatum

- Rofas ,

Mentha piperita .

- viridis

Menyanthes

Mezerei Cortex ,

Miftura Ammoniaci

■ - Amygdalae .

• - Aflafcetidae .

• - Camphorae ,

■ - Cornu ufti

- Cretae

- Ferri Compofita

- - Guaiaci .

- Mofchi

Mofchus ,

Mucilago Acacia;

— - Amyli

Myrifticae Nuclei
Myrrha

Oleum Amygdalae

- Anifi

- Anthemidis

- -Carui

- Caryophylli

- - Cinnamoni .

- Juniperi

■ - Lavandulae

. - Lini ufitatifiimi

- - Menthae piperitae

- viridis

■ - Origani

- Pimentae .

- Pulegii

- Ricini

- Rofmarini

• - Succini

- - -fulphuratum

- Terebinthinae reflificatum

Olibanum

Olivas Oleum

Opium

Opoponax

Origanum

Oxymel

- - Scillas

Petroleum

Pilulae Aloes compofitae

-cum Myrrha

-Cambogias compofitae
-Ferri cum Myrrha

3j

3j

gr. x

Sfs

9j

3j

Sfs

Sj ■

rijx

nl .

Sij

Svi

Sfs

Sifs

njx

ITjxX

Sj

Sij ■

njv

mx'j

gij

O. fs

Sfs

3j

3j

gfs

nix

Sfs

Sis

Sifs

gr. fs

to gr. iij

Sfs

■Sj

3fs

3ij

3j

gi

3j

Sj

gfs

g'j

gr. x

3fs

9j

Sr

3j

Sij

3j

gi

3j

gfs

gr. x

sj

gr. x

Sj

3fs

Sj

gr* j

gr. x

gj

gj

O.fs

gfs

gi

gfs

gij

giv

O.fs

gj

g'j

gj to glj

gj

glj

Sfs

Sij

gr- ij

3j

3j

gj

3j

gj

gr. v

gr.x

gr. x

Sj

gfs

gj

TT1 v

771 x

n\v

1)\ X

mj

m v

m»j

mvj

mj

m iij

mu

ITlx

mi

mv

gfs

gj

mj

miij

mU

mv

mj

miij

mu

mv

mj

ni't

3ij

gj

mU

mv

mx

Sfs

Sfs

mx

Sfs

gr- x

Sfs

gfs

gj

gr.fs

gr. v

gr. x

Sfs

gr. v.

3j

3j

sj

Sfs

Sij

nix

Sfs

gr. x

gr.xxv

gr. x

3j

gr. x

3}

gr. x

3j

Pilulae

371

/

Piluls Galbani compofits

- Hydrargyri

- Submuriatis

- Saponis cum Opio

■ - Scillse compofits

Piments Baccs
Piperis longi Fruftus

— - migri Baccs

Plumbi acetas
Porri Radicis Succus
Potafl's Acetas

- . Carbonas

- - Nitras

- Subcarbonas

- Sulphas

- Sulphuretum

— ■ Superfulphas <

— - • - Supertartras
— — - Tartras
Pulegium

Pulvis Aloes compofitus

- .Antimonialis

- — Cinnamomi compofitus

- — Contrajervs compofitus

- —Cornu ulti cum Opio

— — Crets compofitus

- —Gretas compofitus cum Opio

- ^Ipecacuanhas compofitus

- -Kino compofitus

- •Scammones compofitus

- Sennas compofitus

■ - Tragacanthse compofitus

- -Pyrethri Radix

Quafiite Lignum

Quercus Cortex
Rhamni Baccs
Rhei Radix
Rofs caninas Pulpa
— - — centifolias Petala

- - Gallicas Petala

Rofmarini Cacumina
Rubis Radix
Ruts Folia
Sabinas Folia
Sagapenum
Salicis Cortex
Sapo durus
Sarfaparillas Radix
Saflafras Lignum
Scammoniae Gummi-refina
Scillse Radix recens
- — exficcata

Senegas Radix .

Sennae Folia
Serpentarias Radix
Simaroubae Cortex
Sinapis Semina
Soda tartarizata

- Carbonas

Sodas Boras

- Subcarbonas

- - - - exficcata

- Sulphas

Spartii Cacumina

Spigelise Radix

Spiritus ZEtheris aromaticus

■ - - compofitus

- - - - nitrici

- - 1 fulphurici

— — — ■ . Ammonias

• 1 1 - - compofitus

- - - fcetidus

— - - - ■ fuccinatus

- -Anifi

— — — — Armoracias compofitus
Vol. XIX. No. 1309.

P A T H O

gr. x

3fs

gr. v

9j

gr. v

gr. x

gr. nj

gr. x

gr. x

3j

gr. v.

9j

gr. v.

9j

gr. v

9j

gr. is to gr. ij

3]

3fs

9j

3fs

gr. x

3fs

gr. x

3fs

gr. x

3fs

3j

3^s

gr. v

gr.xv

9j

3ij

3j

3J

3j

l)

gr. x

3j

gr. x

3j

gr. v

gr. x

gr. v

gr. x

gr. xv

3fs

gr. xv

3fs

3fs

3]

9j

9ij

gr. v

9j

gr. v

9j

gr. x

9j

yj

3j

gr. x

3j

gr- 1]J

gr. x

gr. v

5fs

gr. x

3fs

■>J

3ij

gr. x

3fs

3j

oJ

9.)

3j

9j

3j

gr. x

3 Is

3fs

3j

gr. xv

9ij

gr. x

3fs

gr. x

3fs

gr. x

3fs

gr. v

3fs

9j

3j

9j

gr. v

9j

gr. v

gr.xv

gr- j

gr. nj

9j

9ij

9j

gr. x

3fs

gr. x

3fs

3.)

3^3

3j

3J

gr. x

5fs

gr. x

3fs

gr. x

3 is

gr. v

gr.xv

3j

-oj

9j

3]

gr. x

9fs

3fs

3j

5fs

3j

3fs

3j

3fs

3j

3fs

3j

3fs

5j

3fs

3j

lljx

31s

31s

ors

5fs

Jfs

LOGY.

Spiritus Carui

- Cinnamomi

- - Juniperi compofitus

- Lavandulae

— compofitus

Menthas piperitas
-viridis

-Myriftics

-Piments

-Pulegii

-Rofmarini

Spongia ufta
Stannum

Staphifagriae Semina
Styracis Balfamum
Succinum
Sulphur lotum

- prscipitatum

Syrupi
Tabaci Folia
Tamarindi Pulpa
Taraxaci Radix
Terebinthina Canadenfis

■ - - - 'Cilia

- vulgaris

■ - Oleum

Teftas prasparatae
Tindtura Aloes

-compofita

Affafcetida
Aurantii

Benzoini compofita
Calumbas

Camphorae compofita

Capfici

Cardamomi

compofita

— Cafcarillas
— Caftorei
—Catechu
— Cinchonas

-Cinnamomi

compofita

- compofita

-Digitalis

-Ferri ammoniacalis

- Muriatis

-Gentians compofita
-Guaiaci-

ammoniata

-Hellebori nigri

-Humuli

-Hyofcyami

-Jalaps

-Kino

- Lytts

-Myrrhs

-Opii

-Rhei

- compofits

-Scills

-Senns

-Serpentaris

-Valerians

ammoniats

- • ■ - Zingiberis

Tormentills Radix
Toxicodendri Folia
Tragacantha
Tuflilago
Valerians Radix
Veratri Radix
Vinum Aloes

- Ferri

- Ipecacuanhs

5C

3j

3^

3j

36

3j

36

3j

56

3j

56

3j

36

3j

36

3j

06

3j

36

3 j

56

3j

56

3j

56

3J ..

56

gr. nj

gr. x

gr. x

3fs

5fs

3j

3fs

5ij

3fs

3 nj

3j

3ij

gr. is

gr. v

3fs

5'j

5fs

3j

9j

3j

Bj

3j

9j

3j

Ttjx

3fs

Si's

3 ij

3k

Sj

5fs

3 jj

3fs

3ij

3fs

3 ij

3fs

3ij

3fs

3ij

3fs

56

5fs

56

3j

56

3fs

56

3fs

3ij

3fs

3ij

3fs

3 ij

3j

56

3j

56

3j

Snj

3fs

3 ij

lljx ad

nixl

31s

3ij

Mix

3fs

3j

5ij

5j

3">j

3j

3ij

3fs

3j

3fs

3j

Rlx to 3j

3j 56

5fs 5ij

ofs 3ij

3fs 3j

lljx 3fs

56 5>6

3fs 5>6

n tx 3j

3ij 3)

31s

3ij

3fs

3 ij

3fs

5j

3iij

gr. x

5fs

gr. ij

gr.xv

gr. x

3j

36

3j

9j

3ij

gr- ij

gr. v

56

3j

56

711 xx

lllxl

Vinum

4

372

PATH<

Vinum Ipecacuanha;

E

3ij

*fs

- Opii

.

m x

3fs

Uimi Cortex

♦ \

9j

Uva Urfi

,

• gr. x

3j

Zinci Oxydum

. gr- iij

gr. x

- Sulphas

•

gr- j

gr. v

- E

gr. xv

Sfs

Zingiberis Radix

•

gr. v

3fs.

—

1 e. g.

3j

14

—

f

9ij

7

—

1

2

3fs

4

—

1

3

3j

—

x

A

gr. xv

—

i

9fs

—

1

• 8

gr. viij

—

1

T 2

gr. v.

As the foregoing dofes are intended for the adult pa¬
tient, we (hall here fubjoin Gaubius’s Table of the pro¬
portionate dofes for children; though it will immediately
occur to the judicious practitioner, that the quantities
mud vary, not with age only, but with fex, conftitution,
and (till more with the intensity of the difeafe.

For an Adult

14

7

4

3

2

In making our acknowledgments to the authors from
whole works we have derived the large body of infor¬
mation compreffed into this article, we mult be excufed
for omitting the names of a multitude of writers who
have merely, furniflied a few infulated fa£is or curfory
obfervations. We mud be excufed alfo from inferting
the names of fome whofe labours have ad'orded us infor¬
mation, led we (hould attribute to an^ one opinions
which he does not hold, but which our own error may
have caufed us to attribute to him. Ladly, we hope to
da.nd excufed for fome whom we have inadvertently for¬
gotten.

The hidorical part of this Treatife has been chiedy
compiled from the works of Sprengel, Freind, Haller,
Miller, Le Clerc, Blumenbach, Schultze, & c. and from
Good’s Hidory of Medicine.

In the hidory of the prefent date of medicine, we have
employed Sir Charles Morgan’s Appendix to Lady Mor¬
gan’s “ Italy.” Broughton’s Letters from Portugal.
Clarke’s Notes on the Hofpitals of Italy, France, &c.
The Revue Medicale. Journal des Dcbats; and feveral
excellent treatifes and extracts in the Quarterly Journal
of Foreign Medicine, 1820,21. M. Efquirol’s Memoire
prefente au Minidre de l’lnterieur. Clarke on the Cli¬
mate and Difeafes of the South of France and Italy.
Bianchi’s trandation of Chani Zadek Mehemmed Ata-
Oullah, a work lately publidted in Turkey on Surgery
and Anatomy.

For the hidory of Nofology we are entirely indebted
to Dr. Good, as well as for the Cladidcation itfelf. And
“we here again beg leave to tender to this gentleman our
admiration of his philological knowledge. It cannot be
fuppofed, from the general tenor of our views, but that
we look forward to afydem of medicine which (hould be
very much releafed from the trammels of a never-ending
lid of names; but, at the fame time, as far as grand di-
vidons and an accurately-condruCled nomenclature are
regarded, we humbly offer our opinion, that Dr. Good
has left little to be wifhed. As a piece of medical infor¬
mation, w'e cannot avoid mentioning that when nine-
tenths of this article were publifhed, Dr. Good gave to
the world a large work, entitled the Study of Medicine,
which is intended to render complete his labours in this
fcience. We have not yet feen it ; but report fpeaks
very favourably of its merits.

LOGY,

The general principles or Diagnofis have been for the
mod part taken from Dr. Marfhall Hall’s work “On
Diagnofis.”

The (hort (ketch of General Pathology is drawn from
the well-known works of Parry, Nicholl, and Brouffais.

The Pathological Anatomy interfperfed over a large
portion of the article, we have taken from the fydematic
works of Baillie, Farre, Laennec, and Brouffais ; or from
practical monographs.

The authors whom we have confulted in the clafa
Cceliaca, or difeafes of the digedive function, are —
Daubenton, Abernethy, Philip, Hall, Brouffais, Parry,
Hunter, Hamilton, and J. Johnfon ; Baillie, White,
Coley, Sherwin, and Arnott, on changes of dru6ture in
the intedinal tube ; J. Johnfon, Bayle, Farre, and He-
berden, on hepatic and dyfenteric maladies ; Brera,
Baillie, Hooper, and Chamberlaine, on worms.

In the dais Pneumatics, or difeafes of the refpiratory
function, we have borrowed much from Badhatn,
Hadings, Bree, and Alcock.

For the order Pyredica, we are indebted to Cullen,
Darwin, Bateman, Clutterbuck, Armdrong, Jackfon,
Frank, Nicholls, Park, Fordyce, J. Johnfon, ami Bancroft.

The nature and treatment of Emprefma, or internal in¬
flammations, have been difeuffed at full, but from too
many fources to admit of enumeration. With regard to
inflammation of the ferous membrane, we cannot avoid
directing the reader’s attention to the extracts from
Brouffais, Pemberton, Baron, and Laennec. And, as to
the numerous difeafes of the heart, the labours of Corvi-
fart, Laennec, and Portal, have mainly affifled our de-
feriptions.

Among Dydhetica, or difeafes from general mordid
habit of body, the difeafe Phthifis, or confumption, is
enriched by the obfervations of Scot, Beddoes, Southey,
Mansford, and Duncan, among practical writers ; and the
dill-more valuable ones of Baillie, Bayle, and Laennec, in
relation to necrotomy.

The clafs Genetica is compofed of a very compreffed
analyfis of the whole of Dr. Mansfield Clarke’s excellent
work “On the Difeafes of Females;” and by various re¬
marks from Rowley and others of the old fchool, in which
thefe difeafes were fo much confidered.

The genus Hydrops, or dropfy, is deduced from the
writings of Cullen, Parry, Blackall, Laennec, and Scarpa.
This difeafe, as it affeds the head under the form of Hy¬
drops capitis, is treated of conformably with the opinions
and obfervations of Yeats, Cheyne, and Golis.

Ouraccount of Calculous Difeafes is taken from Marcet,
Henry, Wolladon, Majendie, and Prout.

The whole defeription of Cutaneous Difeafes is taken
almod literally from the works of Wiilan and Bateman,
with the exception of the therapeutical part, which has
received fome fmall improvements fince the writings of
thofe accurate and judicious writers.

Among the more compendious fydems from which we
have derived aflidance, we have to mention the contem¬
porary Cyclopaedia of Dr. Rees, and the Encycloptedia
Britannica ; the French “ Di£t. des Sciences Medicales;”
the Medical Didionary of James, and the more recent and
excellent one of Dr. Parr.

Ladly, we mud not forget to mention our obligations
to the Medico-chirurgicaL Review', to the Quarterly
Journal of Foreign Medicine, the Edinburgh Medical Re¬
view, and the London Medical and Phyfical Journal, for
feveral excellent analyfes, and for fome recent and cu¬
rious cafes.

J. and C. Adlard, Printers,
23, Bartholomew Close.

PAT

373

PAT

PATHOPOI'EA,/. [from the Greek n-stfloc, paflion,
and tronu, to caufe.] The aCl of moving the paflions ; the
method made ufe of to move the paflions ; an addrefs to
the paflions.

PA'THOS, f. [Greek.] Paflion; vehemence; warmth;
affeCtion of mind ; energy; that which excites the paf-
fions : long fince introduced into our language, but parted
over by Dr. Johnfon. — “Lord, if thou wilt pardon this
people !” It was a vehement ■pathos ; “If thou wilt pardon
it !” He faith no more, but, “ If thou wilt not, put me
out of the book of life.” Here is a vehement prayer ; and
with this he flacks the wrath of God, and quencheth it.
Dr. Wejifeild's Difc. 1646. — By the fimplicity of its con-
duCl, it diminifhes the pathos of the fable. Mafon's Pref.
to Elfrida. — Before thefe books became common, affeCling
fituations, the combination of incident, and the pathos of
cataftrophe, were almoft unknown. Wharton's Hiji. of
E. P.

PA'THROS, [Heb. the fpread of ruin.] A city and
canton of Egypt, of which the prophets Jeremiah and
Ezekiel make mention ; Jerem. xliv. 1. 15. Ezek. xxix.
14. xxx. 14. We do not very well know its fituation,
though Pliny and Ptolemy the geographer fpeak of it by
the name of Phaturis; and it appears to have been in
Upper Egypt. Ifaiah (xii. 2.) calls it Pathros; and it is
the country of the Pathrufim, the pofterity of Mizraim,
of whom Mofes fpeaks, Gen. x. 14. Ezekiel threatens
them with an entire ruin. The Jews retired thither not-
withftanding the remonftrances of Jeremiah ; and the
Lord fays by Ifaiah, that he will bring them back from
thence to their own land. Ifaiah, xi. 11.

PA'TI. See Patta.

PA'TIA, a river of South-America, which rifes near
Popayan, and runs into the Pacific Ocean in lat. 2. 1 5.N.

PATIA'LA, a town of Hindooltan, in the circar of
Sirhind : twelve miles fouth-weft of Sirhind, 130 north-
weft of Delhi. Lat. 30. iB. N. Ion. 76. 5. E.

PAT'IBLE, adj. [from potior, Lat. to fuffer.] Suffer¬
able; tolerable; to be borne.

PATIB'ULARY, adj. [from patihulum, Lat.] Belong¬
ing to the gallows.

PATIB'ULATED, adj. Hung on a gibbet. Cole.

P A'TIENCE, J'. [Fr. from patientia, Lat.] The power
of fuffering; calm endurance of pain or labour. — Chrif-
tian fortitude and patience have their opportunity in times
of affliction and perfecution. Sprat’s Sermons.

The king-becoming graces,

Devotion, patience, courage, fortitude;

I have no reliffl of them. Shakefpcare’s Macleth.

The quality of expediting long without rage or difcon-
tent ; long-fuffering. — Neceffary patience in feeking the
Lord, is better than he that leadeth his life without a
guide. Ecdus. xx. 32. — Have patience with me, and I will
pay thee all. St. Matthew. — Perfeverance; continuance
of labour :

He learnt with patience, and with meeknefs taught ;

His life was but the comment of his thought. Harte.
The quality of bearing offences without revenge or anger:
The hermit then affum’d a bolder tone,

Kis rage was kindled, and his patience gone. Harte.

Sufferance: permiffion. — By their patience be it fpoken,
the apoftles preached as well when they wrote, as when
they fpake the gofpel. Hooker. — A fpecies of Rumex. —
Patience, an herb, makes a good boiled fallad. Mortimer.

Patience is thatcalm and unruffled temper with which
a good man bears the evils of life, from a conviCHon that
they are at leaft permitted, if not fent, by the beft of
Beings, who makes all things work together for good to
thofe who love and fear him.

The evils by which life is embittered may be reduced
to thefe four : 1. Natural evils, or thofe to which we are
by nature fubjeCl as men, and as perifhable animals. The
greateft of thefe are, the death of thofe whom we love,

and of ourfelves. 2. Thofe from which we might be ex¬
empted by a virtuous and prudent conduCl, but which
are the infeparable confequences of imprudence or vice,
which we call punifhments ; as infamy proceeding from
fraud, poverty from prodigality, debility and difeafe
from intemperance. 3. Thofe by which the fortitude of
the good are exercifed ; fuch as the perfecutions raifed
againft them by the wicked. To thefe may be added,. 4.
Theoppofition againft which we muft perpetually ftfuggle,
arifing from the diverfity of fentiments, manners, and
characters, of the perfons among whom we live.

Under all thefe evils patience is not only neceffary but
ufeful : it is neceffary, becaufe the laws of nature have
made it a duty, and to murmur againft natural events is
to affront providence ; it is ufeful, becaufe it renders our
fufferings lighter, fhorter, and lefs dangerous.

The man, therefore, who poflefles this virtue (patience),
in this ample fenfe of it, (lands upon an eminence, and
fees human things below him : the tempeft indeed may
reach him ; but he (lands fecure and collected againft it
upon the bafis of confcious virtue, which the fevereft
florms can feldom (hake, and never overthrow.

Men will have the fame veneration for a perfon who
fuffers adverfity without dejection, as for demolifhed
temples, the very ruins of which are reverenced and
adored.

Patience, however, is by no means incompatible with
fenfibility, which, with all its inconveniences, is to be
cherifhed by thofe who underftand and wifli to maintain
the dignity of their nature. To feel our own mifery
with full force is not to be deprecated. Affliction foftens
and improves the heart. Tears, to fpeak in the ftyle of
figure, fertilize the foil in which the virtues grow. And
it is the remark of one who underflood human nature,
that the faculties of the mind, as well as the feelings of
the heart, are ameliorated by adverfity. But, in order to
promote thefe ends, our fufferings muft not be permitted
to overwhelm us. We muft oppofe them with the arms
of reafon and religion; and to exprefs the idea in the
language of the philofopher, as well as the poet, of Nature,
every one, while he is compelled to feel- his misfortunes
like a man, fliould refolve alfo to bear them like a man :

Refign’d in ev’ry (late,

With patience bear, with prudence pufh, your fate;

By fuffering well our fortune we fubdue,

Fly when fhe frowns, and when fhe calls purfue.

PA'TIENCE, a fmall iftand near the coaft of America,
in Naraganfett Bay, belonging to the Hate of Rhode
Ifland.

PA'TIENT, adj. [Fr. patiens, Lat.] Having the qua¬
lity of enduring : with of before the thing endured. — To
this outward ftruCture was joined flrength of conflitution,
patient of fevered toil and hardfhip. Fell. — Wheat, which
is the beft fort of grain, of which the pureft bread is made,
is patient of beat and cold. 1 lay. Calm under pain or af¬
fliction. — Be patient, and I will ttay. Shahejpeare’s Hen. VI .
Griev’d, but unmov’d, and patient of your fcorn,

I die. Drydcn’s Theocritus .

Not revengeful againft injuries. Not eafily provoked..
— Warn them that are unruly, fupport the weak, be pa-
tient toward all men. 1 The]]', v. 14. — Perfevering; calmly
diligent. — Whatever I have done is due to patient
thought. Neivton. — Not hafty ; not vicioufly eager or im¬
petuous :

Too induftrious to be great,

Nor patient to expeCt the turns of fate. Prior..

PA'TIENT, J\ That which receives imprefflons from
external agents. — Malice is a paflion fo impetuous and
precipitate, that it often involves the agent and the pa¬
tient. Gov. of the Tongue. — AClion and paflion are modes
which belong to fubltances: when a fmith with a hammer
ftrikes a piece of iron, the hammerand the fmith are both
agents or fubjeCls of aClion ; the one fupreme, and the

other

374

'P A T

other fubordinate ; the iron is the patient, or the fubjefit
of paflion, in a philofophical fenfe, becaufe it receives the
operation of the agent. Watts's Logick.

To proper patients he kind agents brings,

In various leagues binds difagreeing things. Creech.

A perfon difeafed. It is commonly ufed of the relation
between the fick and the phyiician. — Through ignorance
of the difeafe, through unreafonablenefs of the time, in-
ftead of good he worketh hurt, and out of one evil throvv-
eth the patient into many miferies. Spenfer. — It is fome-
times, but rarely, ufed abfolutely for a lick perfon. — It is
wonderful to obferve, how inapprehenfive thefe patients
are of their difeafe, and backward to believe their cafe is
dangerous. Blackmcre.

Nor will the raging fever’s fire abate
With golden canopies or beds of ftate ;

But the poor patient will as foon be found

On the hard matrefs or the mother ground. Dryden.

To PA'TIENT, v. a. [ patienter , Fr."j To compofe one’s
felf; to behave with patience. Olfolete. — Patient your-
felf, good maker friar, quoth he, and be not angry. 1 ?o-
hinfon's Tr. of Move's Utopia, 1551. — Patient yourfelf,
madam, and pardon me. Titus Anclronicus.

PATIEN'TIA, f in botany. See Rumex patienta.

PATIEN'TIA, (Straits of,) a channel of the Eaftern
Indian Sea, between the ifland of Bachian and the fouth
coaft of Gilolo.

PA'TIENTLY, adv. Without rage under pain or af¬
fliction. — Patiently refign what juftly thou haft loft.
Milton's P. L.

Ned in the gout

Lies rack’d with pain, and you without,

How patiently you hear him groan !

How glad the cafe is not your own. Swift.

Without vicious impetuofity ; with calm diligence. —
Could men but once be perfuaded patiently to attend to
the dictates of their own minds, religion w'ould gain more
prolelytes. Calamy's Sermons.

PA'TIENTNESS,^/! The ftate or quality of being pa¬
tient.

PATIGU'MO, f. [a corruption of the French words
pate dc gtiimauve .] The name of a fort of palte or cakes
much ufed on the continent as an agreeable and ufeful re¬
medy for catarrhal defiuxions ; and fuppofed by Dr. Per-
cival to confift: of gum-arabic combined with fugar, the
whites of eggs, and the powdered fubftance of the marfli-
mailow, guimanve.

PATI'MA,_/i [fo named by Aublet from its Caribean
name, Patima-rana.'] In botany, a genus of the clafs
pentandria, order monogynia, natural order of rubi-
aceoe, Jujf. Generic characters — Calyx : perianthium fu-
perior, of one leaf, the limb with about five incifions.
Corolla and ftamina unknohvn. Piftillum: germen infe¬
rior, firmly united to the bottom of the calyx ; ftyle and
ftigma wanting. Pericarpium : berry green, roundifh,
crowned with the margin of the calyx, of four, five, or
fix, cells. Seeds numerous, very fmall, imbedded in foft
pulp. — j Ejfential Character. Calyx fuperior, almoft entire,
of fix obtufe angles ; berry crowned by the calyx, moftly
five-celled, many feeded.

Patima Guianenfis, the only fpecies known, is a native
of low marftiy places in Guiana, bearing fruit in May.
Root perennial. Stems numerous, fltrubby, ereCt, three
feet high, tubular, cylindrical. Leaves oppofite, on long
ftaiks, very large, ovate-oblong, acute, fmooth, entire.
Fruit axillary, confining of green berries, on longilh foli-
tary ftaiks. Aublet's Guiana, vol. i. p. 197.

PAT'I^. See Paten.

PA'TIN (Guy), a French phyfician diftinguiflied for
his wit and learning, was born in 1601 of refpeClable pa¬
rents in humble life, at-Hodenc in Bray, near Beauvais,
He was for fome time a corrector of the prefs at Paris,
where he obtained the efteem and friendfliip of Riolan, a

P, A T

celebrated phyfician. It was probably through his en¬
couragement that he turned his ftudies to medicine, in
which he graduated in 1627, and was admitted among the
faculty of Paris. He praCtiled during his life in that city,
rmich efteemed by many perfonsofdiftinCtion forhislearn-
ing, and for the cauftip vivacity of his converfation, but
too much attached to his liberty to puth his way at court,
or among the great. Zealous in maintaining the privi¬
leges and honour of the faculty, he was eleCted to the poft
of dean in 1650, and was appointed fucceflor to Riolan
the younger, in the chair of phyfic at the College-royal.
He delivered himfelf in Latin with fo much fluency and
choice of expreflion, that it became quite a falhion at
Paris to attend upon his thefes. In his medical opinions
he was a molt orthodox follower of the ancients, and a
determined oppofer of innovations, both in theory and
praClice. In the difputes concerning the ufe of chemical
remedies, efpecially antimonials, which then divided the
faculty, he diftinguiflied himfelf as their bittereft adver-
fary; nor was he in the leaft fparingof perfor.alities again!!:
thofe who employed medicines of that clafs. All unfor¬
tunate cafes in which they had been exhibited he fet down
as fo many murders, and he kept a particular regifter
which he termed the Antimoniul Martyrology. In his
own praftice he was a greater lhedder of blood than al¬
moft any other of the Parifian fchool, which was noted for
phlebotomy; and he generally imputed the death of a pa¬
tient to the want of fufficient perfeverance in the ufe of
the lancet. With this inftrument and a few Ample re¬
medies, particularly of the purgative clafs, he thought
that every thing might be effected, within the power of
the healing art. He, juftly perhaps, derided the coftly
compounds.and pretended fpecifics with which the apothe¬
caries’ fhops at that time abounded ; and had rational
notions of the general operation of medicines, though un¬
der the influence of falfe theories and ftrong prejudices
with refpeCt to particular articles.

In other matters Patin was one w’ho fpeculated freely.
Without joining the Proteftants, hecultivated a friendfliip
with many of that communion, and was not behind any of
them in his keen ftriCtures on the bigotry and fuperftition
of the Roman-catholic church. He feems, indeed, in his.
private opinions to have concurred with the philofophers of
the time: and it has been noted as a very uncliriftian fenti-
ment, that he confoled himfelf for the idea of quitting this
world, with the hope of meeting Ariftotle, Plato, Virgil,
Galen, and Cicero, in theother. He read muchand upon a
variety of fubjeCts, and was eager in the purchafe of new
and valuable books, of which he pofiefled a copious col¬
lection. This learned and Angular man died in 1672, in
his feventy-firft year. He wrote few works in his own
profeflion, and thofe of little importance. After his
death a great number of his Letters were given to the pub¬
lic, which have been the chief means of preferving his
memory. Of thefe there are two collections ; one ad-
drefled to various friends, printed in 1685 and 1692, two
volumes, imio. the other all written to his friend Charles
Spoil, of Geneva, and pubiifned by that family in 1718,
two volumes, i2ino. Patin’s Letters are an amufing mif-
cellany of political and literary intelligence, biographical
anecdotes, free opinions, medical hiftory and criticifm,
with a plentiful mixture of fpleen and farcafm. It is dif¬
ficult to fay whether he laflies moft feverely the court and
miniftry, the clergy, or the chemical doftors. Fie has
been accufed of giving credit to idle reports, efpecially in
difparagement of thole whom he hated ; and it would
not be lafe to rely upon the authority of his narratives,
which are often only the lie of the day ; (fee Curiofities of
Literature, vol.i. p. 200.) Neverthelefs, the pictures which
he gives of the manners and fentiments of the time are in
moft refpeCls equally juft and lively. Moft of his medi¬
cal opinions are to be found in thefe letters, with fome
extraordinary inftances of praftice. They are copioufly
interlarded with Latin, in which language his phrafe-
ology is much more cultivated than in his mother-

tongue.

PAT

tongue. All his letters have been publilhed together
in five or fix volumes. Halleri Bibl. Med.

PA'TIN (Charles), fecond Ton of the preceding, a phy-
fician and eminent antiquary, was born at Paris in 1633.
He made an extraordinary progrefs in learning, and at
the age of fourteen fultained thefes in Greek and Latin
before a large and fplendid audience. He was defigned
for the bar, and became a licentiate in law at Poitiers,
and afterwards an advocate in the parliament of Paris.
He abandoned however this profefilon for that of pliyfic,
in which he took the degree of do6tor in 1656. He had
begun to practice with great reputation, when a circum-
ltance occurred which obliged him to quit France for
fear of imprifonment. The caufe of his difgrace is in¬
volved in fome obfcurity ; but it is faid, that having been
fent into Holland by a great prince in order to buy up all
the copies of a work of court-fcandal, and burn them on
the fpot, he faved a number of them and difperfed them
among his friends. His father, in his letters, lamenting
his Ton’s misfortune, gives no hint of fuch a fa6t, but
mentions the difcovery of fome obnoxious books in his
library. Charles Patin, after palling fome time in tra¬
velling into Holland, England, Germany, and Swifferland,
finally fettled with his family in Italy, and in 1676 was
made profefl'or extraordinary of medicine at Padua : he
had the chair of furgery in 1681, and of the practice of
medicine in 1683, which polls he filled with fo much dif-
timftion, that the republic of Venice conferred on him the
order of St. Mark. He was aggregated to the Academiae
Naturae Curioforum, and was for many years chief and
director of the Academy of Ricovrati. He died at Padua
in 1693. This learned perfon was the author of nume¬
rous works in the Latin, French, and Italian, languages.
Thofe by which he is bell known relate to the medallic
fcience, in which he was a great proficient. The follow¬
ing are upon that fubjedt : 1. Familiae Romanae ex anti-
quis Numifmatibus, 1663, folio; this is chiefly founded
on the work of Fulvius Urfinus. 2. Introduction a l’Hif-
toire par la Connoiffance des Medailles, 1665, nmo. 3.
Imperatorum Romanorum Numifmata, 1671, folio. 4.
Thefaurus Numifmatum, 1672, 4to. 5. Prattica delle
Medaglie, 1673, 121110. 6. Suetonius ex Numifmatibus

illuftratus, 1675, 410. He likewife publilhed feveral Ora¬
tions and other pieces relative to medicine; an Account
of his Travels; Lycaum Patavinum, or Lives of theProfef-
fors of Padua ; and fome traCls relative to antiquities.

The wife and two daughters of Charles Patin were
learned, and were all members of the Academy of Rico¬
vrati, at Padua. — The wife wrote A Collection of Moral
and Chriltian Reflections. — Charlotte Catharine, the eldeft
daughter, pronounced a Latin oration on the raifing of
the fiege of Vienna, which was printed. She alfo pub¬
lilhed “ Tabellae feleCLe,” being an explanation of forty-
one engravings from the moll celebrated painters. —
Guhrielle-Charlotle, the youngell daughter, publilhed a
Latin differtation on the phcenix on a medal of Caracalla,
and a panegyrical oration on Louis XIV. Gen. Biog.

PATI'NA, or Patine, f. A name given to the rull
of medals. This rull, which, when genuine, gives value
to medals, is fometimes counterfeited, and a falfe patina
is fubllituted for that which is true. For detecting thefe
forgeries, fee the article Medal, vol. xiv. p. 828, 9.

PATI'NO, an ifland in the Grecian Archipelago, which
was the ancient Patmos. See Patmos.

PATINOO'N, a town of Hindooltan, in Marawar :
twenty-feven miles north-well of Ramanadporum.

PATIO'QUA, a town of Mexico, in the province of
Guaxaca : fixty-five miles fouth of St. Yago de los Valles.

PATIVIL'CA, a town of Peru, in the jurifdiCtion of
Santa, remarkable for the remains of a large Indian build¬
ing, fuppofed to have been the palace of a cacique ; litu-
ated on the coall of the Pacific Ocean. Lat. 10. 25. S.

PATIX'A, or Grand River, a river of Brafil which
runs into the Atlantic in lat. 15. 50, S.

Vol. XIX. No. 1310.

PAT 375

PAT'KUL (John Reinhold), was bom of a nobleffa-
mily in Livonia, a northern province belonging to the
crown of Sweden. The Livonians having been llript of
their privileges, and great part of their ellates, by Charles
XI. Patkul was deputed to make their complaint ; which
he did with fuch eloquence and courage, that the king,
laying his hand upon his Ihoulder, faid “You have
fpoken for your country as a brave man Ihould, and I
elleem you for it.” Charles, however, who added the
bafenefs of liypocrify to the ferocity of a tyrant, was de¬
termined to punilh the Zealand honefty which he thought
fit to commend ; and a few days afterwards caufed Pat¬
kul to be declared guilty of high treafon, and condemned
to die. Patkul, however, found means to efcape into Po¬
land, where he continued till Charles was dead. He
hoped that his fentence would have been then reverfed ;
but, being difappointed in this expedlation, he applied
to Augultus king of Poland, and folicited him to attempt
the conqueftof Livonia from the Swedes; which, he faid,
might be eafily effedted, as the people were ready to
fiiake off their yoke, and the king of Sweden was a
child incapable of compelling their fubjedlion.

Augultus took the hint, and poffefled himfelf of Livo¬
nia. Afterwards, when Charles XII. entered the pro¬
vince to recover it, Patkul commanded in the Saxon
army againlt him. Charles was victorious ; and Patkul,
fome time afterwards, being difgulted at the haughty be¬
haviour of Gen. Fleming, Augultus’s favourite, entered
into the fervice of the czar of Mufcovy, with whom Au¬
gultus was in llridt alliance, and a little before Charles
compelled Augultus to abdicate the throne of Poland.
The czar fent Patkul with the title of his ambaflador,
into Saxony, to prevail with Augultus to meet him at
Grodno, that they might confer on the Hate of their af¬
fairs. This conference took place ; and immediately af¬
terwards the czar went from Grodno to quell a rebellion
in Altracan. As foon as the czar was gone, Augultus,
to the furprife of all Europe, ordered Patkul, who was
then at Drefden, to be feized as a Hate-criminal. By this
injurious and unprecedented adtion, Augultus at once
violated the law of nations, and weakened his own inte-
relt ; for Patkul was not only an ambaflador, but an am¬
baflador from the only power that could afford him pro¬
tection. The caufe, however, was this : Patkul had dis¬
covered that Augullus’s minillers were to propofe a
peace to Charles upon any terms; and had therefore
formed a defign to be beforehand with them, and pro¬
cure a feparate peace between Charles and his new mailer
the czar. The defign of Patkul was difcovered ; and,
to prevent its fuccefs, Augultus ventured to feize his
perfon, alluring the czar that he was a traitor, and had be¬
trayed them both.

Augultus was foon after reduced to heg a peace of
Charles at any rate ; and Charles granted it upon certain
conditions, one of w’hich was, that he Ihould deliver up
Patkul. This condition reduced Augultus to a very dil-
trefsful dilemma: the czar, at this very time, reclaimed
Patkul as his ambaflador; and Charles demanded, with
threats, that he Ihould be put into his hands. Augultus
therefore contrived an expedient by which he hoped to
fatisfy both : he fent fome guards to deliver Patkul, who
was prifoner in the caltle of Konigltein, to the Swedilh
troops ; but by fecret orders, privately difpatched, he
commanded the governor to let him efcape. The gover¬
nor, though he received this order in time, yet difap¬
pointed its intention by his villany and his avarice. He
knew Patkul to be very rich ; and, having it now in his
power to fuffer him to efcape with impunity, he de¬
manded a large fum for the favour : Patkul refuted to
buy that liberty which he made no doubt would be gra-
tuitoufly reltored, in confequence of the czar’s requiii-
tion and remonltrance ; and, in the mean time, the Swe¬
dilh guards arrived with the order for his being delivered
up to them. By this party he was firlt carried to Charles’s
5 D head __

W6

PAT

head quarters at Albrandadt, where he continued three
months, bound to a flake with a heavy chain of iron.
Ke was then conducted to Cafimir, where Charles or¬
dered him to be tried; and he was by his judges found
guilty. His fentence depended upon the king ; and, af¬
ter having been kept a prifoner fome months uncertain of
h.is fate, he was, on the 28th of September, 1707, towards
the evening, delivered into the cuftody of a regiment of
dragoons; next day, the colonel took the chaplain of his
regiment afide, and, telling him that Patkul was to die
the following day, ordered him to acquaint him with his
fate and prepare him for it. About this very time he
was to have been married to a Saxon lady of great qua¬
lity, virtue, and beauty ; a circutndance which renders
his cafe flill more affe&ing.

On the 30th of September, he was put into a coach,
guarded by one hundred horfeman. Being arrived at
the place of execution, he found it furrounded by three
hundred foot-foldiers. At the fight of the flakes and
wheels, his horror is not to be defcribed ; for of the
manner of his death he had not been informed. After
praying mofl fervently, he bade the executioner do his
duty well, and put into his hands fome money which he
got ready for that purpofe. He then flretched himfelf
out upon the wheel; and while they were flripping him
naked, he begged the chaplain to pray that God would
have mercy on him, and bear up his foul in agony. He
did fo ; and turning to all the fpeClators, faid to them,
“ Brethren, join with me in prayer for this unhappy man.”
“ Yes (cried he), aflid me all of you with your fupplica-
tions to heaven.” Here the executioner gave him the
firll flroke. His cries were terrible : “ O Jefus ! Jefus !
have mercy upon me.” This cruel fcene was much
lengthened out, and of the utmoll horror; for as the
headfman had no fkill in his bufinefs, the unhappy vic¬
tim received fifteen feveral blows, with each of which
were intermixed the mod piteous groans and invoca¬
tions of the name of God. At length, after two flrokes
given on the bread, his drength and voice failed him.
In a faltering dying tone, he was jud heard to fay,
“Cutoff my head;” and, the executioner dill linger¬
ing, he himfelf placed his head on the fcaffold : after
four drokes with an hatchet, the head was feparated from
the body, and the body quartered. Such was the end of
the renowned Patkul.

Charles XII. has been very generally and feverely cen-
fured for not pardoning him, and we are not inclined to
vindicate the fovereign. Yet it mull be remembered,
that Patkul was guilty of a much greater crime than
that which drew upon him the difpleafure of Charles XI.
Ke incited foreign powers to attack his country when
under the government of a boy, hoping, as he faid him¬
felf, that it would in fuch circumdances become an eafy
conqued. He was therefore a rebel of the word kind ;
and where is the abfolute monarch that is ready to par¬
don fuch unnatural rebellion? Nothing, however, can
palliate the unfeeling barbarity of putting the veteran to
the rack. The monarch was one of the credulous phi-
lofophers of the time, who believed in the poffibility of
difcovering the methods of tranfmuting the bafer metals
into gold. Patkul, while under fentence of death, con¬
trived fo far to impofe on the fenate at Stockholm, as to
perfuade them that he had, in their prefence, converted
to gold a quantity of lefs precious metal. An account of
the" experiment was tranfmitted to the king, accompanied
with a petition for the life of fo valuable a fubjeCt; but
Charles, blending magnanimity with feverity, replied,
that he would not do that for intered which he had re¬
filled at the call of humanity and the intreaties of friend-
Ihip.

PATLADAH', a circar of Bengal : bounded on the
north.-ead by Carribarry, on the fouth and fouth-ead by
Dacca, and on the wed by Goragotand Illamabad; about
thirty miles long, and fixteen broad. The chief towns
are Chilmary and Dewangunge.

PAT

PAT'LY, adv. [from pat.'] Commodioufly ; fitly.—
Which words how patly, how livelily, do they fet out
our Saviour’s being nailed to the crofs. Barrow.

, PAT'MOS, in ancient geography, an ifland in the Gre¬
cian archipelago, now denominated by navigators St.
Jean de Patino, celebrated in ecclefiadical liidory, on ac¬
count of its being the place of St. John’s exile, and dill
more from the revelations and vifions w’hich he received
there, and which form the fubjeCls of the Apocalypfe, or
Revelation. At prefent it exhibits little more than
arid rocks. A grotto in the rock, now converted into a
church, is pointed out as the fpot where that apodle wrote
the Apocalypfe. This church belongs to a convent, the
abbot of which is prince of the illand, and pays annually
1000 crowms.to the grand fignior, befides prefents to the
capitan pacha. This prince-abbot was vifited by Dr.
Clarke, who informs us, (Travels, vol. vi.) that the li¬
brary of the convent is a fmall oblong chamber, with a
vaulted done roof ; he found it to be nearly filled with
books of all fizes in a mod negleCted date; fome lying
upon the floor, a prey to the damp and worms ; others
flanding confufedly on the (helves, which were printed
volumes, fome of which were well bound, and in good
condition ; but neither of the fuperiors of this college was
able to read. At the extremity of the chamber he found
a heap of Greek MSS. fome of which were of the highed
antiquity ; amongd other fpecimens of Grecian calli¬
graphy, he found a copy of the twenty-four fird Dialogues
of Plato, written upon vellum, in the fame exquifite cha¬
racter, which remained in the hands of his friend profef-
for Porfon until his death. But it is now, with the
other MSS. from Patinos, See. in the Bodleian library at
Oxford.

This ifland is little more than fix leagues in circuit;
confiderably longer than broad, its direction being from
north to fouth, and its form very irregular. Its coads
are interfered by a variety of gulfs and coves, and are
remarkable for the number of good harbours which they
prefent to navigators, among which that of Scala is one
of the fined in the Archipelago. But, notwithdanding
the advantages which thefe harbours might afford it as a
place of trade, it prefents to the view of the obferver a
very wretched appearance. Valleys, which might infure
abundance, are uncultivated; and, from their date of
abandonment and nakednefs, offer, with the hills that
furround them, only the fame alpeCl of ruggednefs and
misfortune. Population, which follows in the train of
agriculture and indudry, is here Angularly diminifhed ;
and, while- the monaderies fwarm v/ith lluggards, the
fields become deferts. Such is the account given of this
defolate fpot by Sonnini. Although it is deditute of
wood and rivers, and almod without gardens, its fpring-
water is pure and its air healthy. The inhabitants are
chiefly Greek Chridians, failors or fhip-builders, who
fail as far as Venice, whither they carry cotton and dock¬
ings of their own manufacture. The ifland abounds
with rabbits, pigeons, partridges, and quails. It is fix-
teen miles fouth-wed of Samos. Lat. 37. 24. N. Ion. 26.
24. E.

PAT'MOUR, a town of Hindoodan, in Golconda:
twenty-five miles north- north-eafl of Rachore.

PAT'NA, a city of Hindoodan, and capital of the
country of Bahar, and refidence of a governor. This
is a very extenlive and populous city, built along the
fouth fide of the Ganges, on an eminence. By this it is
fecured from the inundations of the river, which would
otherwife, at particular feafons, be highly prejudicial and
dangerous. Having often been the feat of war,, (fee the
article Hindoostan,) it is fortified in the Indian man¬
ner, with a wall and a fmall citadel. It is a place of very
coniiderable trade. Mod of the faltpetre imported by
the Ead-India Company is manufactured within the pro¬
vince of Bahar. It is a very ancient city; and probably
its modern name may be derived from Paliputra, or Pa-
telpoother, which we fuppofe to be the ancient Pali-

bothra.

PAT

bothra. It is 250 miles north-weft of Calcutta. Lat.
25. 37. N. Ion. 85. 21. E.

PAT'NA, a town of the province of Bukovina : thirty
miles weft of Sucfava.

PAT'NA, or Putna, a river ofMoldavia, which runs
into the Milcow at Focfani.

PAT'NESS, /'. [from pat.'] Convenience: propriety;
fuitablenefs. — This the Holy Spirit wiftied, in an age fo
refembling ours, that, I fear, the defcription with equal
patnefs may fuit both. Barrow.

PATNOU'RA, a town of Hindooftan, in the circar of
Kerleh : fifty-five miles north-weft of Maltoy.

PATO'KAH, a town of Hindooftan, in Dowlatabad :
thirty miles north- weft of Darore.

PAT'OMA, a river of Ruflia, which runs into the
Lena in lat. 59. 53. N. Ion. 116. 24. E.

PATOMACK/ or Patovvmack. See Potomack.

PATOMAT*. See Patamat, vol. xviii.

PATON'CE, adj. in heraldry. See vol. ix. p.423.

PATONG', a town of China, of the third rank, in Hou-
quang, on the Yang-tfe river: fifteen miles weft-north-
weft of Koue.

PATOO'K, or Put'tock, a river of Honduras, which
runs into the bay in lat. 15. 55. N. Ion. 84. 25. W.

PA'TOS, a river of Brafil, which runs into the Atlan¬
tic in lat. 28. 28, S.

PA'TOS, a town of Mexico, in the province of Zaca¬
tecas : eighty miles north of Zacatecas.

PATOU', a town of Hindooftan in the circar of Au¬
rangabad : forty-five miles eaft of Aurangabad.

PATOUAL', a town of Plindooftan, in Baglana:
eighteen miles fouth-eaft of Bahbelgong.

PATQUASHAGA'MA LA'KE, a lake of Canada:
450 miles weft of Quebec. Lat. 48. 20. N. Ion. 82. 5. W.

PA'TR A, a town of Hindooftan, in Guzerat ; eighteen
miles north-north-eaft of Amoud.

PA'TRA. See Patera, vol. xviii. p. 782.

PA'TRAE, or Patras, in ancient geography, a town
of Achaia, on a promontory, north of Mount Panachai-
chus. It was more anciently called AroS, derived, as it
isfaid, from ago u, I labour, and applied to it, probably
from its being the firft place of Achaia in which the inha¬
bitants occupied themfelves in labour. Patrseus, one of
the chiefs of the Acbaeans who were driven from Lace¬
daemon on the arrival of the Heraclidae, enlarged and for¬
tified Aroe, and gave it his own name. . Of all the
Achasans, the inhabitants of Patras were the only per-
fions who defended the AEtolians when they were attacked
by the Gauls. This incurfion was probably that of the
year 278 B. C. and which followed the irruption of this
people into Macedonia, in the preceding year, when they
were defeated. Auguftus, allured by the fituation of Pa¬
tras, collefted the fcattered inhabitants, and re-eftablilhed
them. He alfo united feveral towns under its dominion,
and conferred on the inhabitants all the advantages en¬
joyed by Roman colonies. In the time of Paufanias this
town was adorned with a ftatue of Diana Laphria; an
odeum which, next to that of Athens, was the moft beau¬
tiful in Greece ; and a fountain near the temple of Ceres,
where oracles were iffued for the relief of bodily mala¬
dies.

PATRA'NA, or Pastrana, a town of New Caftile in
Spain, with the title of a duchy. It is feated between
the rivers Tajo and Tajuna, in lat. 40. 2 6. N. Ion. 2.
45- W.

PA'TRAS, a fea-port town of the Morea, fituated on
the fouth coaft of the entrance into the gulf of Lepanto.
(See the preceding article.) This town is the fee of a
Greek archbifhop, and contains 10,000 inhabitants, ac¬
cording to Dr. Holland. Confuls from England, Hol¬
land, and Venice, have been accuftomed to refide here.
The principal articles of trade are coarfe oil, .filk, honey,
wheat, manna, See. In the year 1447 this place made a
brave defence againft fultan Murat, and held out till
peace was concluded, when the Morea was furrendered

PAT 377

to the Turks. The port is choked with mud, and the
road for veflels is very indifferent ; the Turks repair no¬
thing. This place is twenty-eight miles north-eaft of
Chiarenza. Lat. 38. 33. N. Ion. 21.43. E.

PATRE'E, a town of Hindooftan, in Guzerat : feventy
miles weft of Amedabad.

PA'TRES, f. [Latin.] Fathers; the name generally
given in catholic countries to the monks of the great
orders of tnonachifm, as Benedidtines, Auguftines, and
Bernardines; while the itnmenfe progeny of St. Francis
were commonly ftyled Fratres, Brothers. In any legal
inftrument, however, they were all ftyled Fratres ; and
they fubferibed themfelves fo in their correfpondence ;
but, when a gentleman or lady add refled any monk or
friar, he or fhe always ufed the name of Paler , Father,
by courtefy. There feems to be no peculiar rule on the
lubjedl.

Patres Conscripti, a denomination given to the
fenators of Rome. The firft hundred fenators, appointed
by Romulus, were called limply Patres, Fathers : another
hundred being added by Romulus and Tatius, upon the
union of the two people, thefe latter were called Patres
Minorum gentium , and the former Majorum gentium. At
length, Tarquinius Prifcus making up the number three
hundred, the two latter clafles were called Patres Con-
feripti, becaufe “ written down” to the former.

Livy, however, gives a different account of their ori¬
gin. He tells us, that, when Brutus filled up the places
of the fenators cut off by Tarquin with others chofen
out of the equeftrian order, thofe new fenators only had
the appellation given them of Patres Confcripti. Lib. i. c. 1,

PA'TRIA, a town of Naples, in Lavora, near a lake to
which it gives name : thirteen miles north-weft of Naples.

PA'TRIA, [Lat. the country.] The men of a neigh¬
bourhood. Thus, when it is faid inrjuiratur per patriam,
a jury of the neighbourhood is meant. Jacob.

PA'TRIARCH, f. [formed of the Gr. srolpt at, family,
and chief.] One of thofe firft fathers who lived

towards the beginning of the world 5 and who became
famous by a long line of defendants. Abraham, Ifanc,
and Jacob, and his twelve fons, are the patriarchs of the
Old Teftament. Seth, Enoch, &c. were antediluvian pa¬
triarchs. Long life and a number of children were the
bleffings of the patriarchs.

The patriarchal government confided in the fathers of
families, and their firft-born after them, exercifing all
kinds of ecclefiaftical and civil authority in their refpec-
tive houfeholds ; and to this government, which conti¬
nued till the time of the Ifraelites dwelling in Egypt,
fome have aferibed an abfolute and defpotic power, ex¬
tending even to the puniftiment by death. In proof of
this they allege, among other inftances, the fentence of
Judah with regard to Tamar, Gen. xxxviii. 24. con¬
cerning which it is obferved, that Jacob, the father of
Judah, w’as ftill living; that Tamar was not one of his
own family; and that fhe had been guilty of adultery,
the puniftiment of which was death by burning, and that
Judah on this occafion might fpeak only as a profecutor.
See Jennings’s Jewifli Antiq. vol.i. Sydney’s Difcourfes
concerning Government, chap. i. fe£t. 7.

Patriarch is alfo ufed in Chriftendom, for the bifhops
in poffeflion of fome of the grand fees independent of
the papal jurifdiftion ; or for the chief bifliop over feve¬
ral countries or provinces, as an archbifhop is of feveral
diocefes; who hath feveral archbifhops under him. See
Patriarchate.

The patriarchate has been always efteemed the fupreme
dignity in the church; fo that, to rife by degrees, the
bijhop had only under him the territory of the city of
which he was bifliop ; the metropolitan commanded a pro¬
vince, and had for fuftragans the bifhops of his province ;
the primate was the chief of a diocefe, and had feveral
metropolitans under him ; and the patriarch had under
him feveral diocefes, and the primates themlelves were
under him. But this order was not always obferved.

Uflier,

378

PAT

Uffier, Pagi, De Marca, and Morinus, attribute the ef-
tabiifliment of the grand patriarchates to the apoftles.
They fuppofe that the apoftles, according to the defcrip-
tion of the world then given by geographers, pitched on
the three principal cities in the three parts of the known
•world; viz. Rome, in Europe; Antioch, in Afia ; and
Alexandria, in Africa: and thus formed a trinity of pa¬
triarchs.

Others, far from attributing this inftitution to the
apoftles, maintain that the name patriarch was unknown
at the time of the council of Nice; and that, for a long
time afterwards, patriarchs and primates were confounded
together, as being all equally chiefs of diocefes, and
equally fuperior to metropolitans, who were only chiefs
of provinces. Hence it is that Socrates gives the title
patriarch to all the chiefs of diocefes, and reckons ten of

them. In effeft, it does not appear, that the dignity of
patriarch was appropriated to the five grand fees of Rome,
Conftantinople, Alexandria, Antioch, and Jerufalem, till
after the council of Chalcedon, in 451. For, when the
council of Nice regulated the limits and prerogatives of
the three patriarchs of Rome, Antioch, and Alexandria,
it did not give them the title of patriarchs, though it al¬
lowed them the pre-eminence and privileges thereof.
Thus, when the council of Conftantinople adjudged the
fecond place to the biffiop of Conftantinople, who, till

then, was only a fuft'ragan of Heraclea, it faid nothing of
the patriarchate. Nor is the term patriarch found in the
decree of the council of Chalcedon, whereby the fifth
place is afligned to the bifliop of Jerufalem ; nor did thefe
five patriarchs govern all the churches. There wereftill
many independent chiefs of diocefes, who, far from own¬
ing the jurifdi&ion of the grand patriarchs, called them-
felves patriarchs : fuch as that of Aquileia ; nor was Car¬
thage ever fubjedft to the patriarch of Alexandria.
Mofheim fuppofes, that thofe prelates who enjoyed a cer¬
tain degree of pre-eminence over the reft of the epifco-
pal order, were diftinguilhed by the Jewilh title of patri¬
archs in the fourth century. Eccl. Hift. vol. i.

The authority of the patriarchs grew by infenfible de¬
grees, till at length we find, that, about the clofe of the
fifth century, all affairs of moment, within the compafs
of their patriarchate, came before them ; either at firft
hand, or by appeals from the metropolitans. They con-
fecrated bifliops; aflembled yearly in council the clergy of
their refpe&ive diftritts ; pronounced a decifive judg¬
ment in thofe cafes where accufations were brought
agair.ft biftiops ; and appointed vicars or deputies,
clothed with their authority, for the prefervation of or¬
der and tranquillity in the remoter provinces. Nothing,
in ftiort, was done without confulting them ; and their
decrees w'ere executed with the fame regularity and re-
fpe£l as thofe of the princes. It mull, however, be ob-
ferved, that the authority of the patriarchs was not ac¬
knowledged through all the provinces without exception.
Several diftrifls, both in the eaftern and weftern empires,
were exempted from their jurifdidtion.

Patriarch is alfo applied to the chief of feveral
churches in the Eaft, who live out of communion with
the Roman church; fuch are the patriarch of the Arme¬
nians, refiding in the monaftery of St. Gregory ; the pa¬
triarch of the Abyflinians, called Aliena ; the patriarchs
of the Cophti, the Jacobites, &c. See Greek Church,
Vol. viii. p. 969.

PATRIAR'CHAL, or Patriarchical, adj. Belong¬
ing to patriarchs ; fuch as was poffefled or enjoyed by
patriarchs. — Nimrod enjoyed his patriarchal power; but
he againlt right enlarged his empire, by feizing violently
on the rights of other lords. Locke. — By difeovering the
vanity of our author’s whimfical patriarchical kingdom, I
am led to a certain conclufion. A. Sidney.

Such drowfy fedentary fouls have they,

Who would to patriarchal years live on.

Fix’d to hereditary clay,

And know no climate but their own. Norris.

PAT

Belonging to hierarchical patriarchs. — Archbifhops or
metropolitans in France, are immediately fubjedt to the
pope’s jurifdidfion ; and, in other places, they are im¬
mediately fubjedt to the patriarchal fees. Ayliffe.

Patriarchal Cross, in heraldry, is that where the
ffiaft is twice crofted; the lower arms or traverfes being
longer, and the upper fliorter. Such a crofs is faid to be¬
long to patriarchs, as the triple crofs does to the pope.

PATRIARCHATE, or Patriarchship, /. A bilh-
oprick fuperior to archbifliopricks. — The queftions are
as ancient as the differences between Rome and any
other of the old patriarchats. Selden.— Prelacies may be
termed the greater benefices ; as that of the pontificiate,
a patriarch/hip and archbifhoprick. Ayliffe.

PATRIARCHY, J'. Jurifdidfion of a patriarch; pa¬
triarchate. — Calabria pertained to the patriarch of Con¬
ftantinople, as appeareth in the novel of Leo Sophus,
touching the precedence of metropolitans belonging to
that patriarchy. Brereivood.

PATRI'CA, a town of the popedom, in the Cam-
pagna di Roma : thirteen miles fouth of Rome.

PATRI'CIAN, adj. [palricien, Fr. patricius, Lat.] Se¬
natorial; noble; not plebeian:

The infulting tyrant prancing o’er the field,

His horfe’s hoofs wet with patrician blood. Addifon.

PATRI'CIAN, J'. A nobleman. — Your daughters are
all married to weal thy patricians. Swift.

Nobl e patricians, patrons of my right,

Defend thejuftice of my caufe with arms. Sluikefpeare.

Patrician was a title given, among the ancient Ro¬
mans, to the defcendants of the hundred, or, as fome
will have it, of the tw'o hundred, firft fenators chofen by
Romulus ; and by him called patres, “ fathers.” Ro¬
mulus eftablifiied this order after the example of the
Athenians ; who were divided into two claffes, viz. the
EvwaTgi £«;, patricios, and J^oTfxov?, populares. Patri¬
cians, therefore, were originally the nobility, in opposi¬
tion to the plebeians. They w’ere the only perfons whom
Romulus allowed to afpire to the magiftracy ; and they
exercifed all the fundtions of the priefthood till the year of
Rome 495.

At length, the cognizance and chara&er of thefe an¬
cient families being almoft loft and extinguilhed by a
longcourfe of years, and frequent changes in the empire,
a new kind of patricians was afterwards fet on foot, who
had no pretenfions from birth, but whofe title depended
entirely on the emperor’s favour. This new patriciate,
Zozimus tells us, was eredled by Conftantine, who con¬
ferred the quality on his counlellors, not becaufe they
were defeended from the ancient fathers of the fenate,
but becaufe they were the fathers of the republic, or of
the empire. This dignity in time became the higheft of
the empire. Juftinian calls it fummam dignitatem. In
effedf, the patricians feem to have had the precedence of
the confulares, and to have taken place before them in the
fenate; though F. Faber afferts the contrary. What
confounds the queftion is, that the two dignities often
met in the fame perfon ; becaufe the patriciate was only
conferred on thofe who had gone through the firft offices
of the empire, or had been confuls. Pope Adrian made
Charlemagne take the title of patrician before heaffumed
the quality of emperor; and other popes have given the
title to other kings and princes by reafon of its emi¬
nence.

Patrician Deities, in mythology, were Janus, Sa¬
turn, the Genius, Pluto, Bacchus, the Sun, the Moon,
and the Earth.

PATRI'CI ANS, in ecclefiaftical writers, an ancient
fedl of heretics, who difturbed the peace of the church
in the beginning of the third century; thus called from
their founder Patricias, preceptor of a Marcionite called
Symmachus. His diftinguifhing tenet was, that the fub-
fiance of the flefti is not the work of God, but that of the
devil : on which account his adherents bore an impla¬
cable

PAT

879

PAT

cable hatred to their own flefti ; which fometimes car¬
ried them fo far as to kill themfelves. They were alfo
called Tatianites, and made a branch of the E«-

CRATIT J£.

PATRI'CIATE, /. The order or dignity of patri¬
cians.

PAT'RICIDE, /. [patricidium, Lat.] The fame with
Parricide, which fee, vol. xviii.

PA'TRICK, a county of Virginia, containing 4.699
whites, and 74a blacks.

PA'TRICK, a Chriftian and furname of men.

PA'TRICK (St.), from the eminent fervices he ren¬
dered to the Irifh in converting them from idolatry, is
called the archbilhop, apoftle, and father, of the Hiber¬
nian Church ; and he has alfo the honour of being fe-
ledted as the patron or tutelar faint of that ifland. The
name this faint received at his baptifm was Suceath,
formed from the Britilh language, and exprefiing “ Valour
in War.” His parents, who were Britons by birth, were
of great refpeftability and repute, and relided at the fpot
now called Kirk-Patrick, near Dunbarton, where it is
generally acknowledged this eminent charadler was born.
But the Irifli affert him to have been a Genoefe friar, who
travelled on foot through Italy, France, and England, to
t he coaltof Scotland, from whence he embarked and landed
at Donaghadee in Ireland.

He received the firft rudiments of his education at the
place of his nativity, and was early confpicuous for an
ingenuous and amiable difpofition, and for fuperiority of
mental powers. Scarcely arrived at the age of fixteen,
he was taken prifoner by certain Irifh exiles, and con¬
veyed to that kingdom, where he continued fix years in
captivity under Milcho, who purchafed him as a Have,
and bellowed upon him the name of Cothraig, fignifying
“ Four Families,” and defigned to convey the c ire u al¬
liance of his having been purchafed from the fervice of
three perfons, his mailers by capture, to be employed
under the fourth, who fo named him. During this fervi-
tude, from which St. Patrick contrived to efcape, he had
made himfelf a perfedl mailer of the Irifh language ; and
he is confidered, very early after his return to his native
fpot, to have conceived the with of converting the Irifn
from Paganifm to Chriliianity. The qualifications ne-
ceffary for this purpofe, could not however be attained
in Britain, where few only were then remarkable for any
particular mental acquirement : paffing, therefore, over to
the continent, he ftudied the Scriptures for thirty-five
years, firft under St. Martin, the bifliop of Tours, his
mother’s uncle, who ordained him deacon 5 and next un¬
der the no lefs celebrated St. German, bifhop of Arles,
who advanced him to prieft’s orders, and, for reafons un¬
known, gave the third name by which hiilory fpeaks of
him, of Mawn, or Maginim. By St. German he was re-'
commended to the particular confideration of Celeftine,
the fovereign pontiff, who confecrated him a bifhop, and
again changed his name to Patricias, or Patrick, not
only in allufion to the refpeclability of his defeent, but
to give luftre and weight to the important million with
which he intended to in trull him, of converting the Irifh:
and his receiving this fourth name is confidered as form¬
ing a remarkable coincidence with the fa 61 of his having
been called Cothraig, in, allufion to the four families, or
four mailers, whom he ferved ! Celeftine had before de¬
puted Palladius to preach the dodlrines of Chriftianity
to the Irifh 5 but that learned doctor had returned un-
fuccelsful from his million ; and hence arofe the favour¬
ite adage in the filler country of “ Not to Palladius, but
to Patrick, did the Lord vouchfafe the converfion of Hi¬
bernia.”

In the year 441, as afferted by moll authors, though fo
early as 432 by others, St. Patrick landed at Wicklow,
from whence he proceeded to Dublin and Ulfter, at which
latter place he founded a church 5 and, after labouring
with confiderable fuccefs for about feven years, he again

Vol. XIX. No. 1310.

vifited Britain, which he delivered from the then preva¬
lent herefies of Pelagius and Arius 5 eftabllfhed the great
church of St. Andrew at Menevia, afterwards called Sr.
David’s ; and fettled the bilhopric of the Ifle of Man.
Thefe important duties executed, St. Patrick returned to
Ireland, nearly the whole of which ifland he brought to
the Chriftian faith, after the mofl indefatigable and
zealous efforts of about the further period of thirteen
years. He then once more vifited Rome, to render an
account of the happy fuccefs of his million, which he had
executed with fo much diferetion as not to occafion the
martyrdom of even one of his companions, nor of any of
thofe for whofe falyation he had fo ftrenuoufly exerted
his noble faculties. About the year 472, lie founded the
archbifhopric of Armagh, between which place and his
church at Ulfter, afterwards the famous abbey of Saul, he
palfed the remainder of his long and well-fpent life, dying
at the latter place on the 17th March, 493, in the 120th
year of his age. The moll current belief favours his
having been buried in the abbey of Saul, in the county
of Down; but there have been arguments adduced in
proof of his having been interred at Glaltonbury, in Eng¬
land, and many more that his remains were depofited at
Glafgow, in Scotland. Cambrenfis pofitively affirms, that
“the bodies of St. Patrick, St. Bridget, and St. Columb,
were not only buried at Down, but were alfo there taken up
andtranflatedintofhrinesby John de Courfey about 1185.”

The miracles attributed to St. Patrick are numerous 5
fome of a nature too much out of the line of modern
belief to be repeated ; others too clofely bordering on
the efforts of other faints to create much intereft,
fuch as having fwam acrofs the Shannon with his
head under his arm; &c. &c. Nor fliould we have
noticed them at all, but from the circum (lance that Jo-
celin’s “ A6ts of St. Patrick” have been deemed of fuffi-
cient authenticity to be introduced to notice in the vulgar
tongue, fo recently as 1809, after having been left undif-
turbed in the Latin in which it was originally penned, in
the early part of the twelfth century, when fuperftition
and ignorance were at the greateft height in Europe.
From this legend we fliall therefore fele6l the hiilory of
one miracle, performed not by St. Patrick, but on St.
Patrick. It will fiiow, moreover, with what ingenuity the
Irifh Papifts have contrived to eat meat on the anniverfary
of their tutelar faint. “ A defire of eating meat once
came on St. Patrick, until, being enfnared and carried
away by his delire, he obtained (wine’s flefli, and con¬
cealed it in a certain veffel ; thinking that he might thus
fatisfy his appetite privily, which fhould he openly do, he
would become to his brethren a Hone of offence, and a
ftumbling-block of reproach. He had not long quitted
the place, when lo ! one Hood before him, having eyes
before and behind; whom, when Patrick beheld, he
marvelled who he was, and what meant his eyes fixed
before and behind did earneftly alk ; and h6 anfwered ‘ I
am the fervant of God ; with the eyes fixed in my fore¬
head I behold the things that are open to view, and with
the eyes that are fixed in the hinder part of my head I
behold a monk hiding flefti-meat in a veffel, that he may
fatisfy his appetite privily.’ This he faid, and imme¬
diately difappeared. Then Patrick, ftriking his bread
with many llrokes, call himfelf to the earth, and watered
it with fuch a Ihower of tears as if he had been guilty of
all crimes ; and, while he thus lay on the ground, mourn¬
ing and weeping, the angel Vidlor, fo often before men¬
tioned, appeared to him in his wonted form, faying,
‘ Arife, let thine heart be comforted, for the Lord hath
put away thine offence; and hence-forward avoid back-
fliding.’ Then Patrick, riling from the earth, utterly re¬
nounced and abjured the eating of fle(h-meat,even through
the reft of his life ; and he humbly befought the Lord
that he would manifeft unto him his pardon by fome evi¬
dent fign. Then the angel bade Patrick bring forth the
hidden meats, and put them into water; and he did as
5 E the

380

PATRICK.

the angel bade ; and the fieKh-meats, being plunged into
the water, and taken thereout, immediately became
fifties. This miracle did St. Patrick often relate to his
difciples, that they might reftrain the delire of their appe¬
tites. But many of the Irifli, wrongfully underftanding
this miracle, are wont on St. Patrick’s day, which always
falls, in the time of Lent, to plunge flefn-meats into water,
when plunged in to take out, when taken out to drefs,
when drefled to eat, and call them ‘ Fifties of St. Patrick.’
But hereby every religious man will learn to reftrain his
appetite, and not to eat meat at forbidden feafons, little
regarding what ignorant and foolifh men are wont to do.”
Life and Acis of St. Patrick, &c. now fir ft tranflated from
the original Latin of Jocelin, the Ciftercian Monk of
Furnes, who flouriftied in the early part of the twelfth
century. By E. L. Swift, Efq. 1809.

Mr. Swift has apologized for introducing the work of
Jocelin to a Britifti public in the following terms : —
“ Many and extraordinary are the miracles recorded of
St. Patrick by Jocelin ; but, without requiring the reader’s
affent to all thefe, the work ought not to be call afide
with contempt or ridicule. It tends to eftablifh a point
which the patriot feeling of every Irifhman would gladly
fUpport; The exijlence of St. Patrick, and the conveifion of
oar country by his apojlolic labours: nor can the improba¬
bility or the impoffibility of its recorded wonders invali¬
date the prefumption. Philofophy may difdain, and
Pyrrhonifm may deride, the legendary page of old Jocelin;
but, as miracles of a much higher rank have too often
met no higher refpeft, let us, before we pity the monk of
Furnes and gratulate our own fuperior wifdom, confider
whether implicit belief be not at lead: as fa fe as abfolute
fcepticifm. The occafion, however, of thefe may not
feldom be traced; the effedfts of natural caufes, operating
on enthufiaftic minds, were gradually (haded by allegory
and heightened by tradition, until the original adt was
exalted into a miracle.”

The marvellous blefiing which St. Patrick is faid to
have beftovved upon Ireland of never breeding venomous
creatures, is currently credited in that ifland, but merits
■not ferious refutation. Several eminent writers, not
doubting the fadt of reptiles, &c. not being found in
Ireland, have attempted to account for it, from the pe¬
culiar falubrity of the air and foil, to the manifeft injury
of the fame of St. Patrick; and they even adduce in-
ltances of places being alike free from reptiles, in this
country : fuch as the parifti of Dorchefter, in Oxford-
ihire, Weft of Watlington ; the manor of Bindley, near
Bofworth, Leicefterfiiire, &c. &c. Innumerable are the
other advantages imputed by the Irifli to the partiality
of St. Patrick for their ifland ; among which may be no¬
ticed the Introduction of the Latin Letters, and with them
the Reman Language, as actually poffeffmg evidences of
truth.

The wearing of Shamrock on the Feaft of St. Patrick,
is attributed- by fome to the following circumftance:
When he firft endeavoured to plant the feeds of Chriftian-
ity in Hibernia, he found great difficulty in inculcating
the doctrine of the Trinity in. the minds of his rude and
barbarous auditors ; and therefore had recourfe to a vi¬
sible image to illuftrate his difeourfe. Thus when ex¬
pounding that tritheiftical myftery, he held in his hand
a leaf of the fhamrock, or trefoil, as not only reprefenting
the' divifibility of the Divinity into three diftinct and
equal parts, but alfo its junftion or union in one ftemor
original. This ingenious mode of accounting for the
wearing of the ftiamrock may poffibly have truth for its
balls ; although it is more probable, that, as the fhamrock
had been, long before the time of St. Patrick, confidered
the national badge or emblem, it was originally worn on
his anniverfary, to mark him as their patron, or tutelar
faint. His anniverfary in our almanac is marked for the
17th of March. See that word, vol. xiv. p. 341.

In the year 1470, being the eleventh of Edward the

Fourth, an order of Knights of the Garter was inftituted
in Ireland: though, for reafons which have eluded re-
fearch, this order was abolifhed fo early as twenty-four
years’ after its eftablifhment. On the nth March, 1783,
a new order was inftituted, denominated “ Knights of the
Illuftrious Order of St. Patrick,” of which his majefty,
his heirs, and fucceffors, were ordained perpetual fo-
vereigns, and to which feveral of the molt eminent cha¬
racters under the united monarchy of Great Britain and
Ireland, have been eleCted knights. See the article
Knighthood, vol. xi. p. 822. and Heraldry, vol. ix.
P- 77 3-

PA'TRICK (Simon), a learned Englifti prelate, was
the fon of a mercer at Gainfborough in Lincolnfnire,
where he was born in the year 1626. After being well
grounded in grammar-learning by an excellent claflical
mailer, in 1644(16 was fent to the univerfity of Cambridge,
where he was admitted a fizar of Queen’s College. He
took his degree of B. A. in 1647, and in the following
year was chofen fellow of his college. In 1641, he pro¬
ceeded M. A. and about the fame time received holy
orders from Dr. Jofeph Hall, the ejeCled biftiop of Nor¬
wich. Soon afterwards he became domeftic chaplain to
fir Walter St. John of Batterfea, who prefented him to
that living towards the beginning of the year 1658.
About this time he commenced author, by publifning
his “ Mehfa myftica ; or a Difeourfe concerning the Sa¬
crament of the Lord’s Supper : to which is added, a Dif¬
eourfe concerning Baptifm,” 8vo. This piece was fol¬
lowed, in 1659, by another, entitled “The Heart’s Eafe ;
or, a Remedy againft all Troubles ; with a confolatory
Difeourfe, particularly directed to thofe who have loft
their Friends and dear Relations,” i2tno. which has un¬
dergone numerous impreffions. In 1661, Mr. Patrick
was eleCted mafter of Queen’s College, notwithftanding
the king’s recommendation of Mr. Anthony Sparrow :
but, the affair being brought before the king and council,
judgment was foon given againft Patrick 3. and fome, if
not all, of the fellows who had voted for him were ejeCted.
Upon the ejection of Dr. Manton from the reCtory of St.
Paul’s, Covent Garden, under the aCt of uniformity in
1662, Mr. Patrick was prefented to that benefice by the
earl of Bedford; and he endeared himfelf very much to
the pariftiioners, not only by his excellent preaching and
exemplary manners, but particularly by his conftant re-
fider.ee with them during the dreadful time of the plague
in 1665. In the year 1666, being defirous of proceeding
in divinity, his difguftat what had taken place in his old
college determined him againft keeping his afts at Cam¬
bridge, and he therefore entered of Chrift-Church-col-
lege, Oxford ; where he was at firft incorporated B. D.
and foon afterwards admitted D. D. About the fame
time he was appointed chaplain in ordinary to the king.
In the year 1672, he was made a prebendary of Weftmin-
lfer ; and was for fome time fub-dean of that church.
His next promotion was to the deanery of Peterborough,
in 1679; where he completed and publiftied, but not be¬
fore the year 1686, “The Hiftory of the Church at Peter¬
borough,” folio, from the manufeript of Simon Gunton,
formerly a prebendary of that church. This work was
conliderably enlarged by the editor, who added a fupple-
ment containing a fuller account of the abbots and biinops
of Peterborough than had been given by Mr. Gunton.

During the reign of king James II. Dr. Patrick, at the
hazard of all that was dear to him, fliowed his zealous at¬
tachment to iheproteftant religion, by writing and preach¬
ing againft the errors of the church o( Rome. In the
year 1686, he ably fuftained his part in a conference with
two Romifh priefts in the king’s prefence, of which the
following account is given by biftiop Kennet in the third
volume of his Complete Hiftory of England. “The Pro-
teftant champions were, Dr. Simon Patrick, and Dr.
William Jane, profeffor of divinity in Oxford. Thofe
on the Popifli fide were one Gifford, a doftor of the

Sorbonne,

P A T

P A T

381

Sorbonne, and Mr. Tilden, who, having turned Roman-
catholic at Lifbon, went under the name of Dr. Godden ;
and the Ai bj e<St of their difpute was, the rule of faith,
and the proper judge in controverfies. This conference
was very long ; and at lalf the Romifh doftors were preffed
with fo much ftrength of reafon and authority againrt
them, that they were really put to filence. Whereupon,
his majelty, going off abruptly, was heard .to fay, he never
law a bad caufe fo well, nor a good one lo ill, maintained.”
Our author's zeal for the Proteftant religion led him to
oppo.le, to the utmoft of his power, the reading of James’s
Declaration for Liberty of Commence, which was pub-
lifh&d in order to favour the papilts ; and he alfo affifted
Dr. Tenifon in eftablifhing a fchool at St. Martin’s, in
order to ccunteraft the influence of the popifn one opened
at the Savoy, for the purpofe of making converts of the
children of poor Proteftants.

At the revolution, that attention and refpeft were paid
to Dr. Patrick which his fervices and abilities merited,
and he was called upon to preach before the prince and
princefs of Orange. Soon afterwards he was appointed
one of the commiflioners for reviewing the Liturgy ; and,
as he had an excellent talent at devotional compofltion,
he revifed the Collects throughout the whole courfe of
the year : drawing up moll of them anew, and rendering
them more fuitable to the Epiflles and Gofpels of the
day. In the year 1689, he was nominated to fill the va¬
cant fee of Chichefter ; and immediately after his confe-
cration he viflted his new diocefe, in which he difcharged
in all refpefts the duties of a faithful and vigilant pallor.
He was employed, with others of the epifcopal bench, in
fettling the affairs of the church of Ireland ; with which
view they fent back to that country all the clergy who
bad fled into England for refuge from the tyranny and
perfecution of the late reign, and recommended to their
majefties feveral- worthy perfons to fill the vacant bifliop-
rics. In the year 1691, our prelate was tranflated/to the
lee of Ely, which was vacant by the deprivation of Dr.
Francis Turner for refilling to take the oaths to the new
government. In this fituation he fulfilled the duties of
the epifcopal funftion with the utmoft application, zeal,
find integrity, while he continued to profecute his ftudies
with great afiiduity. He eftablifned lectures in two
churches in Cambridge, .with a falary to each of 30I. a-
year, for afternoon-fermons every Sunday. He alfo
ihowed himfelf a benefactor to his fee by the improve-
' ments which, at a confiderable expenfe, he introduced
into its temporalities. At the fame time he Ihowed him¬
felf a benefaCtor in the nobleft fenfe to the public at
large, by the valuable writings, confecrated to the inte-
refts of piety and virtue, which he was continually com¬
mitting to the prefs. He died at Ely in 1707, in the
eighty-firft year of his age.

Bilhop Patrick was a man of extenfive learning and
eminent abilities, and pofleffed great merit as a writer.
Of the excellence of his public character we have already
made mention ; and in private life he was exemplary for
the ardour of his piety, the fanCtity of his manners, his
integrity, candour, and charity, and the other virtues
which conftitute the good man and the Chriftian. Bilhop
Burnet ranks him among thofe who were indeed an ho¬
nour to the church, and to the age in which they lived.
Among his publications are numerous devotional, prac¬
tical, and mifcellaneous, pieces, traCts againft popery,
fermons, & c. But the molt valuable of his works are
his “ Commentaries” upon the hiftorical books of the Old
Teftament, and “ Paraphrafes” on the books of Job,
Pfalms, Proverbs, Eccleliaftes, and the Song of Solomon,
which made their appearance at various times from the
year 1679, and, afteV having been frequently reprinted
in oCtavo and quarto, were collected into three volumes
folio. The Paraphrafes were firft in the order of publi¬
cation. Thefe volumes, with Lowth’s Commentaries
upon the Prophets, Arnald’s upon the Apocrypha, and
Whitby’s on the New Teftament, form a collection of

Englifh exegetical works which is held In high eftiina-
tion, and, when complete, now fells' for an exorbitant
price. IVcu/'s Hijl. Purit. vol. iv. Gen. Biop;.

PA'TRICK’s (St.), a final! illand in the Irifh Sea, near
the eaft coaft of Ireland. Lat. 53. 36. N. Ion. 6. 5. W

PA'TRICK’s (St.), a final! town, the chief of Camden
county, Georgia; fituated on Great Satilla river, about
thirty- two miles from its mouth.

PATRICK’S PURGATORY, the name of one of the
fmall iflands in Lough Derg, a lake in the fouthern part
of the county of Donegal, Ireland. This ifland itlelf is
but ia6 yards long by forty-four broad; and the cave,
which is called the Purgatory, is iixteen feet and a* half
by two wide, and fo low that a tall man cannot Hand
ereCt in it. It holds exaftly nine perfons; and a tenth
could not remain in it without great inconvenience. The
floor is the natural rock, and the whole is covered with
large ftones and fods. It was imagined in the dark ages,
that “ whoever repented and was armed with true faith,
and entering that pit continued there a night and a day,
fnould. be purged from all his fins, and alfo, during. his
abode there, fiiould not only fee the pains of the damned,
but the joys of the blefled.” There were alfo in the
ifland a monaftery for regular canons of St. Auftin, fevtn
chapels, and fix churches dedicated to St. Patrick and other
faints. The cell was demolifhed in 1497, by order of
pope Alexander VI. and in 1630 the lords juftices ordered
it to be broken open ; the monks were driven away; and
it was left in ruins. The place, however, (till continues
to be frequented in the month of May, June, and July.
This ifland, the lake, and river, are all fuppofed by fame
antiquaries to have derived their name from dearg or dirg,
“a cave,” and the cave to be fpoken of in the Puranas of
the Indian Bramins. Mr. Wilford confiders Ireland as
the Suvarneya of the Puranas. Suvarneya was from the
earlieft periods confidered as the abode of the Pitris, (i.e.
fathers or manes.) A place where the pitris could be feen
is pofitively declared to be a narrow cave in a fmall
ifland in a lake the waters of which were bitter. In it
was the entrance of the Dirghe, or long paffage into the
infernal regions, which is often mentioned in the Puranas.
The name Dirghe, and the defcription of the cave, cer¬
tainly much refemble that in Ireland, whilft the change
of Pitris to Patricius is lefs difficult than many changes
which have occurred in proper names. Still it feems in¬
credible that Ireland fiiould have been known to the
Indians, and connected in any way with their fables.
Ware and other antiquarians maintain the pagan origin of
the ceremony, and Dr. Ledwich, who denies that fucli a
perfon as St. Patrick ever exifted, fuppofes the ftory of the
cave to be “ a pagan tale of purgatory, trumped up with
every circumftance that could work on the hopes and
fears” of the Irifh, fo as to render them more obedient to
papal authority. Here then the learned doctor and his
refpeftable antagor.ift (general Vallancey) are not much
at variance, could the former admit the oriental origin of
what both confider as a relift of paganifm. The molt
d: fee u raging circumftance attending difeuflions of this
kind, is, that as on one hand, after much labour employed
in inveftigation, certainty cannot be attained, fo on the
other, if it could, it would be attended with no practical
benefit. For, of what confequence is it, whether the
purgatory were an eaftern or weftern fable; whether it
originated with a real St. Patrick, or was a fiftion of a
later age? See Ledwiche’s Antiquities of Ireland, and
Vallancey’s Profpeftus of a Dift, of the Irifh Language.

PATRICK TOWN, a town of America, in the diftridt
of Maine, and county of Lincoln, having 138 inhabitants.

PA'TRICKSBOURNE, a village in Kent, about four
miles eaft of Canterbury. It is noted by fome for the
antiquity of its church, and a curious Saxon door- way,
carved with a variety of figures ; a few paces further is
Bifrons, built by Robert Bargrave, efq. or by his lady, if
one may judge by this motto, which was placed upon it •,
Diruta edificat uxor bona, cedificata dirv.it mala. — Not far

from

332

PAT

from the laft-mentioned village is that of Bekefbourn,
■where feveral of the archbifhops of Canterbury formerly
had a fmall but elegant palace ; the gateway of which ftill
remains. In this parilh is Howletts, formerly the feat
of Sir Philip Hales. Wilkes's Briti/h Diredory.

PATRIMO'NIA, a town of the illand of Corfica : four
miles weft of Baftia.

PATRIMO'NIAL, adj. [Fr. from patrimony .] Pof-
fefied by inheritance. — The expence of the duke of Or¬
mond’s own great patrimonial eftate, that came over at
that time, is of no fmall confideration in the ftock of
this kingdom. Temple.

Their patrimonial doth the Spaniards keep,

And Philip firft taught Philip how to fleep. Dryden,
Claimed by right of birth j hereditary.— I pant for pa¬
trimonial fkies. Young.

No longer doubting, all prepare to fly,

And repoflefs their patrimonial ficy. Dryden.

PATRIMO'NIALLY, adv. By inheritance. — Good
princes have not only made a diftinclion between what
was their own patrimonially, as the civil-law books term
it, and what the ftate had an intereft in. Davenant.

PATRIMO'NIO, or Patrimony of St. Peter, a
province of the Popedom, or the eccleiiaftical ftates; fo
called, as it is faid, becaufe it was granted by the emperor
Conftantine, to fupport a church which he had built in
honour of St. Peter, and the ufe of the pope. This
country is bounded on the north by the Orvietan and
part of Umbria, on the eaft by the Safina and Campagna
di Roma, on the fouth-w’eft by the Mediterranean, and
on the north-weft by the duchy of Caftro ; about forty-
three miles in length, and thirty-two in breadth. The
country is fertile in corn and fruit, and produces a con-
fiderable quantity of alum. The principal places are
Viterbo, Monte Fiafcone, Bolfena, Civita Caftellana, and
Civita Vecchia.

PAT'RIMONY, /. [ patrimonium , Lat.] An eftate pof-
fefted by inheritance. — Inclofures they would not forbid,
for that had been to forbid the improvement of the pa¬
trimony of the kingdom. Bacon.

So might the heir, whofe father hath, in play.

Wafted a thoufand pounds of ancient rent.

By painful earning of one groat a-day,

Hope to reftore the patrimony fpent. Davies.

Their fhips like wafted patrimonies fhow ;

Where the thin fcattering trees admit the light,

And fhun each other’s fhadows as they grow. Dryden .

PATRINGTON, a town of England, in the North
Riding of the county of York, fituated on a river which
runs into the Humber; of confiderable antiquity, and
faid to have been called Prcetorium. It has a weekly
market on Saturday ; and three fairs, March 28, July 18,
and December 6, for fnoes, linen and woollen drapery,
copper and tin ware, toys, &c. The parilh-church is a
large and fpacious edifice ; its tower is furmounted by a
lofty fpire. Patrington ftands within lefs than a mile of
the eftuary of the Humber, which forms here a fmall
creek, capable of affording fheiter and anchorage to veffels
of fmall burden. According to the parliamentary re¬
turns of.i8n,the town and parilh contained 190 houfes,
and a population of 1016 inhabitants. It is eighteen
miles eaft-fouth-eaft of Hull, 192 north of London : lat.
53. 50. N. Ion. o. 10. E.

About a mile and a half to the north-weft of Patring¬
ton is the pleafant village of Wineftead, which is adorned
with two elegant villas, the feats of the late fir Robert
d’Arcy Hildyard, bart. and of Henry Maifters, efq. The
former feat is denominated Wineftead-hall ; and both,
being fituated upon gently-riling ground, command a
beautiful profpect of the town of Patrington, the Humber,
and Sunk-Ifiand. This illand has its name from the cir-
cumftance of its having been entirely under water till
the reign of Charles I. when it began to appear by the

PAT

receding of the ocean. At firft, only a few acres were left
dry at low water ; but, as it increafed in extent every
year, it was at length embanked, and laid down as paf-
ture land. Other embankments, however, were made at
fubfequent periods, in proportion as the waters retired ;
fo that the illand is now of confiderable extent, and only
feparated from the Holdernefs marlhes by a ditch a few
feet in breadth. The laft embankment was effefted in
1808, and inclofed an area of 4570 acres. Sunk illand is
divided into feveral farms; and a church has lately been
built upon it, for the accommodation of the inhabitants.
The foil is peculiarly fertile.

Spurn-head, or Spurn-point, fituated about ten miles
to the fouth-eaft of Patrington, conftitutes the extremity
of the noted Ocellum Promontoriurn of Ptolemy, which
projects nearly half-way acrofs the entrance into the
Humber. Its prefent name of Spurn-head is of Saxon
origin; the verb ypujuen, fignifying to explore or fpy
out. A light-noufe is placed here, as a guide to vefiels
navigating the eftuary. Somewhere in this vicinity was
anciently the celebrated fea-port Ravenfpur, or Ravenfer,
remarkable in the annals of England as the landing-place
of Henry IV. in 1399, and of Edward IV. in 1471, when
thefe princes came to contend for the pofleffion of the
Englilh feeptre. This town has long fince been fwallowed
up, either by the ocean or by the Humber; fo that the
fpot on w'hich it flood is uncertain. Several other towns
and villages hereabouts have experienced a fimilar fate :
among them are mentioned Hide, Frifmerk, Tharlethorpe,
Redmayr, Pennyfmerk, Upfal, and Potter.fleet ; all of
which Dr. Gibfon fuppofes were overflowed in the 30th
or 38th year of Edward III. when the tides are recorded
to have rifen to a moft extraordinary height. The inun¬
dation of Ravenfpur, however, mult have taken place at
a much later period.

Near the village of Halfham, about three miles and a
half beyond Wineftead, is a fuperb maufoleum, ere&ed
by the late William Conftable, efq. as a burying-place
for that family. The architecture of this building dif-
plays an union of elegance and fimplicity, which at once
captivates the eye, and is appropriate to the nature of
the ftrudture. The pofition of this maufoleum is lofty,
and the furrounding grounds are covered with trees.
Near this is (the remains of) the village of Hornfey, al-
moft furrounded by an arm of the fea. North-weft of
Hornfey, at fome diftance from the fea, ftands Kilham,
which lee, vol»xi. Beauties of England, \ ol. xvi. Wilkes's
Britijh Diredory, vol. iv.

PATRIOT, f. [Fr. from the Latin patria , country.]
One whofe ruling paffion is the love of his country.
This word is old in our language. Cotgrave calls a “pa¬
triot, one’s countryman.” The French patriot he renders
“ a father or protedftor of the country.” — Jofeph merited
the name of the faviour of Egypt. And if any worthy
patriot, out of a like providence, fhall before-hand gather
up the commodities into a publick magazine, for the
common benefit and relief of the people, upon the pinch
of an enfuing necefiity, he is fo far out of the reach of
cenfure, as that he well delerves a ftatue with the in-
feription of a public benefadlor. Bp. Hall's Cafes of Confe.
Here tears fhall flow from a more generous caufe.

Such tears as patriots fhed for dying laws. Pope.

It is fometimes ufed ironically for a fa&ious difturber of
the government.

Gull’d with a patriot's name, whofe modern fenfe
Is one that would by law fupplant his prince ;

The people’s brave, the politician’s tool:

Never was patriot yet, but was a fool. Dryden.

PAT'RIOT, aelj. Actuated by the care of one’s coun¬
try ; wifhing and endeavouring to promote the public
good, — That his [Swift’s] patriot fpirit was reftrained fo
long, is not to be wondered at. Delamfs Obf on Orrery's
Life of Swift.

4

PAT

Ah ! let not Britons doubt their focial aim,

Whofe ardent bofoms catch this ancient fire !

Gold intereft melts before the vivid flame,

And patriot ardours, but with life, expire. Shenjlone.

PATRIOT'IC, adj. Full of patriotifm. Dr. Johnfon
has repeatedly ufed this word in an ironical way. — Dennis
declares with great patriotic vehemence, that he who al¬
lows Shakefpeare learning, and a learningwith the ancients,
ought to be looked upon as a detradfor from the glory of
Great Britain. Farmer's Effay on the Learning of Shahe-
fpeare. — During the protedforfhip of Cromwell, a time of
which the patriotic tribes (till more ardently defire the
return, the Spanifli dominions were again attempted,
Johnfon's Falkland's Iflands.

PAT'RIOTISM,^/; Love of one’s country; zeal for
one’s country. — Being loud and vehement either againft
a court, or for a court, is no proof of patriotifm. Bp.
Berkeley' s Maxims, 1 750. — It is the quality of patriotifm
to be jealous and watchful, to obferve all fecret machi¬
nations, and to fee public dangers at a diftance. Johnfon's
Patriot.

Patriotism, or the love of our country, is one of
the nobleft paflions that can warm and animate the hu¬
man bread. It includes all the limited and particular af¬
fections to parents, children, friends, neighbours, fellow-
citizens, and countrymen. It ought to diredl and limit
their more confined and partial aCtions within their
proper and natural bounds, and never let them encroach
on thofe facred and firfl regards we owe to the great
public to which we belong. Were wefolitary creatures,
detached from the red of mankind, and without any ca¬
pacity of comprehending a public intered, or without af-
fedtions leading us to defire and purfue it, it would not
be our duty to mind it, nor criminal to negledl it : but,
as we are parts of the public fydern, and are not only ca¬
pable of taking in large views of its intereds, but by the
Itronged afFedtions connedfed with it, and prompted to
take a fliare of its concerns, we are under the mod facred
ties to profecute its fecurity and welfare with the utmod
ardour, efpecially in times of public trial.

“Zeal for the public good (fays Mr. Addifon) is the
charafteridic of a man of honour and a gentleman ; and
mud take place of pleafures, profits, and all other private
gratifications: and whofoever wants this motive, is an
open enemy, or an inglorious neuter, to mankind, in pro¬
portion to the mifapplied advantages with which nature
and fortune have blefled him.” Wherever love of our
country prevails in its genuine vigour and extent, it
fwallows up all fordid and felfidi regards ; it conquers
the love of eafe, power, pleafure, and wealth ; nay, when
the amiable partialities of friendfhip, gratitude, private
affedlion, or regards to a family, come in competition
with it, it will teach us to facrifice all, in order to main¬
tain the rights, and promote and defend the honour and
happinefs, of our country. To purfue therefore our pri¬
vate intereds in fubordination to the good of our coun¬
try; to be examples in it of virtue, and obedient to the
laws ; to choofe fuch reprefentatives as we apprehend to
be the bed friends to its conditution and liberties ; and,
if we have the power, to promote fuch laws as may im¬
prove and perfedt it; readily to embrace every opportu¬
nity for advancing its profperity ; cheerfully to contri¬
bute to its defence and fupport; and, if need be, to die
for it: — thefe are among the duties which every man,
who has the happinefs to be a member of our free and
excellent conditution, owes to his country.

This powerful and fublime paflion, by depriving man,
in fome meafure, of his natural feelings, prompts him to
love his country independently of himfelf. It was owing
to it that Decius facrificed his life ; Fabius his honour ;
Camillus his refentment; Brutus and Manlius their chil¬
dren.

A Spartan lady had five fons in the army, and was in
momentary expectation of receiving news from the field
of battle. At length a meflenger arrives from the camp ;

Vol. XIX. No. 1 310.

PAT 083

and, with trembling agitation, fhe applies to him for in¬
formation, “Your five fons,” fait! he, “ are flain.” —
“ Bafe Have ! did I afk thee that ?” — “ Yet we have gained
the victory,” replied the meflenger. — “Thanks to the
gods!” exclaimed the mother; and die indantly flew to
the temple to offer up her thanks.

The love of their country, and of the public good,
feems to have been the predominant paflion of the Spar¬
tans. Pedaretus, having miffed the honour of being
chofen one of the three hundred who had a certain rank
of diftindtion in the city, went home extremely pleafed
and fatisfied ; faying, “He was overjoyed there were
three hundred men in Sparta more honourable than him¬
felf.”

The patriotifm of the Romans is alfo well known, and
has been j uftly admired. But examples would be mif-
placed here, and muff be referved for the article Rome.
In more modern times, the French may be proud of the
patriotifm and devotion difplayed at the fiege of Calais in
1347; and the Swifs will never forget Arnold de Win-
kelried, that hero whofe aClions deferve to be tranfmitted
to pofterity by the pen of a Livy. He truly devoted
himfelf to his country as a captain and a foldier ; and, as
this inftance of devotion is lefs known than thofe we
have already alluded to, we fliall relate it in few words.
Winkelried, who was of the country of Underwald,
feeing, at the fiege of Sampach, that his fellow-country¬
men could not break through the Auftrians, becaufe,
being armed from head to foot, they had difmounted,
and, forming a clofe battalion, prefented a front covered
with iron, and briftling with pikes and lances ; formed
the generous defign of facrificing himfelf to the fafety of
his country. “ My friends, (faid he to the Swifs, who
began to be difpirited,) I this day devote my life to pro¬
cure you the viftory : I only recommend to you my fa¬
mily ; follow' me, and aft in confequence of what you
fee me do.” At thefe words he ranged them in that form
which the Romans called cuneus, or wedge, and, forming
himfelf the point of the triangle, marched to the centre
of the enemy, and, feizing as many of the pikes as he
could grafp in his arms, turned them afide, and opened
for thofe who followed him a paflage whereby they pe¬
netrated into the centre of this thick battalion. Himfelf
and thofe who were clofe to him were prefently killed ;
but the Auftrians, once, broken, were conquered : the
weight of their armour became fatal to them, and the
Swifs obtained a complete viftory.

PA'TRIOTSHIP, f. The office or dignity of a patriot.
Scott.

PATRIPASS'IANS, in church-hiftory, a name given
to the fedt of the Sabellians, becaufe they did not believe
it was the Son, but the Father himfelf, that fuffered and
was crucified. The council of Antioch, held by the
Eufebians in 345, fays, that thofe whom the Romans
called Patripaflians, the Eaftern people called Sabellians :
it adds the reafon of the name Patripaflians in their con¬
demnation : viz. that, by the incarnation of fhe Father,
they rendered him comprehenfibie and paflible.

The Patripaflian herefy was firft broached by Praxeas,
who was feconded by Vidrorinus, at the beginning of the
third century. They confelfed Chrift to be God, and
that God fuffered and died for us ; but they confounded
thedivineperfons, and denied in effedt theTrinity; mean¬
ing by Father, Son, and Spirit, not three perfons but one
perfon under three names. So that he who fuffered for
us was, according to him, as much Father as Son. Ter-
tullian wrote exprefsly againft Praxeas. Hermogenes ef-
poufed the error of the Patripaflians, whence they came
to be denominated alfo Hermogenians. Afterwards
Noetius gave into it, which occafioned them the name of
Noetians. His difciple Sabellius 4he Libyan followed,
about the year 250, whence they are called Sabellians.
Laftly, becaufe Sabellius was of Pentapolis, and the he¬
refy fpread much there, it was called the Pentapolituu
dottrine. See the article Sabellians.

5F

PA'TRIS,

384

PAT

PA'TRIS, a town of Hindooftan, in the circar of Au¬
rangabad : lix miles fouth-eaft of Aurungabad.

PATRI'ZI, or Patricius (Francefco), a philofopher
and man of letters, was born in 1529 in the ifland of
Cherfo on the coaftof Dalmatia ; but he derived his ori¬
gin from the family of Patrizi in Sienna. At an early
age he was fent for education to Padua, where he ftudied
under fome of the mod eminent matters of the time. In
1553 he began to'appear as an author in fome mifcella-
neous Italian trafts. He finifhed his ftudies in the fol¬
lowing year ; and, after fome excurfions, returned to his
own country. In 1557, with the view of obtaining the
patronage of the duke of Ferrara, he publifhed a panegy¬
rical poem on the houfe of Efte, entitled, “ L’Eridano,”
in a novel kind of heroic verfe of thirteen fyllables, not
however of his own invention. For feveral fucceflive
years he puffed an unfettled life, in which he twice vi-
fited the ifle of Cyprus, which was his abode for feven
years, and which he finally quitted on its reduftion by the
Turks in 1570 or 1571. He alfo travelled into France
and Spain, and fpent three years in the latter country,
collefting a treafure of ancient Greek MSS. which he
loft on his return to Italy. In 1578 he was invited to
Ferrara by duke Alphonfo II. to teach philofophy in the
univerfity of that city. He had remained there fourteen
years, when, upon the acceflion of Clement VIII. to the
popedom, he was appointed public profeffor of the Plato¬
nic philofophy at Rome, which office he filled with great
applaufe till his death in 1 597.

Of the various branches of fcience and literature cul¬
tivated by this learned man, ancient philofophy was that
by which he moft diftinguifhed himfelf. His work, enti¬
tled, “ Difcuffiones Peripatetics,” of which the firft part
was printed at Venice in 1571, and was reprinted with
three others at Bafil in 1581, is charafterifed asa learned,
perfpicuous, and elegant, performance. After having
commenced with a very particular account of the Arifto-
telic philofophy and its author, coinpofed with lingular
erudition, he becomes a violent oppugner of it, and un¬
dertakes entirely to fubvert it. In a fecond work, en¬
titled, “ Nova de Univerfis Philofophia,” he propofes a
new fyftein, founded upon the Platonic philofophy, but
with fucli additions and alterations as feemed requifite.
It is, however, in reality, a compound of ufelefs fubtleties
and chimaeras; and, like many other philofophers, he
has fhown himfelf more happy in refuting error than in
eftablifhing truth. Yet he deferves praifefor having been
one of the firft moderns who attentively obferved the
phenomena of nature ; and he made good ufe of the op¬
portunities afforded by his travels to colleft remarks
concerning various points of aftronomy, meteorology,
and natural hiftory. He was fuperior to vulgar preju¬
dices, and rejected the vain fcience of judicial aftrology,
then fo much in vogue. It is remarkable that in one of
his “ Dialogues on Rhetoric” he advances, under the
fiftion of an Ethiopic tradition, a theory of the earth
perfeftly fimilar to that afterwards propofed with fo
much fancy and eloquence by Dr. Thomas Burnet. His
propenfity to new ideas alfo appeared in what he wrote
refpefting the mathematical fciences. In his “ Nova
Geometria,” publifhed in 1587, he attempted to eftablifh
certain rules better than thofe which had been hitherto
adopted in geometrical proceffes ; but he appears to have
made no converts to his fyftem. His “ Parelleli Mili-
tari,” publifhed in 1594., though a work of ingenuity
and erudition, drew upon him fome ridicule for his pro-
jefts and {’peculations in an art of which he was fo prac¬
tically ignorant as that of military engineering. In his
“ Dieci Dialoghi della Storia,” in which he treats at large
on the art of writing hiftory, the fame fpirit has led him
into frequent digreflions upon fpeculative topics, which
are neither inftruftive nor amufing. Befides his original
writings, he appeared as a learned editor in the following
publication: “ Oracula Zoroaftris, Hermetis Trifmegifti,
et aliorum ex fcriptis Platonicorum collegia, Greece et

PAT

Latine, praefixa Diflertatione Hiftorica Ferrara, 1 car.
Gen. Biog.

To PATRO'CINATE, v.a. [patrocinor, Lat. patroci-
ner, old French.] Topatronife; to proteft ; to defend,

PATROCINA'TION, f. Countenance; fupport — -
Thofe fhameful libels, thofe patrocinations of treafon.
Bp. Hall.

PATROCLEI'A, or Patroclea, one of the Grecian,
iflands, called by various other names, as Gaitharonefe,
AfTes’ Ifle, the ifland of Ebony, Gaidromefa, Gardiner’s,
& c. which difference of names has caufed it to be multi¬
plied and reprefented as a clufter of iflands rather than
as one ifland. It has been faid, that ebony grows upon
this ifland ; but Dr. Clarke and his companions could
not find a fingle fpecimen of the Ebenus.

PATRO'CLUS, a Grecia'n chief at the Trojan war.
He was the fon of Menoetius, by Sthenele, whom fome
call Philomela or Polymela. The murder of Clyfonymus,
the fon of Amphidamas, by accident, in the time of his
youth, made him fly from Opus, where his father reigned.
He went to the court of Peleus king of Phthia. He was
cordially received, and contrafted the moft intimate
friendfhip with Achilles, the king’s fon. When the
Greeks went to the Trojan war, Patroclus went with
them at the exprefs defire of his father, who had vifited
the court of Peleus, and he accordingly embarked with
ten fhips from Phthia. He was the conftant companion
of Achilles ; lodged in the fame tent ; and, when he re¬
filled to appear in the field of battle, becaufe he had been
offended by Agamemnon, Patroclus imitated his example,
and by his abfence was the caufe of much evil to the
Greeks. At laft, however, Neftor prevailed upon him
to return to the war, and Achilles permitted him to ap¬
pear in his armour. The bravery of Patroclus, together
with the terror which the fight of the arms of Achilles
infpired, foon routed the victorious armies of the Tro¬
jans, and obliged them to fly to the city for fafety. He
would have broken down the walls; but Apollo, who
interefted himfelf for the Trojans, oppofed him; and
Heftor, at the inftigation of that god, difmounted from
his chariot to attack him as he attempted to flrip one
of the Trojans whom he had flain. This engagement was
obftinate ; but Patroclus was at length overpowered by
the valour of Heftor, and the interpofition of Apollo.
His arms became the property of the conqueror, and
Heftor would have fevered his head from his body had
not Ajax and Menelaus prevented it. His body was at
laft recovered, and carried to the Grecian camp, where
Achilles received it with the loudeft lamentations. His
funeral rites were obferved with the greateft folemnity.
Achilles facrificed near the burning pile twelve young
Trojans, four of his horfes, and two of his dogs ; and
the whole was concluded by the exhibition of funeral
games, in which the conquerors were liberally rewarded
by Achilles. The death of Patroclus, as defcribed by
Homer, (Iliad ix.) gave rife to new events. Achilles
forgot his refentment againft Agamemnon, and entered
the field to avenge the fall of his friend ; and his anger
was gratified only by the flaughter of Heftor, Who had
more powerfully kindled his wrath by appearing at the
head of the Trojan armies in the armour which had
been taken from the body of Patroclus. The patronymic
of ASlorides is often applied to Patroclus, becaufe Aftor
was father to Mencetius.

PATRO'L, / [ patrouille , patouille, old Fr.] The aft
of going the rounds in agarrifon, to obfertfe that orders
are kept. Thofe that go the rounds :

O thou ! by whofe almighty nod the fcale
Of empire rifes, or alternate falls,

Send forth the faving virtues round the land
In bright patrol. Thonifon's Summer.

To PATRO'L, v. n. [ patrouiller , Fr.] To go the rounds
in a camp or garrifon ;

Thefe

PAT

385

Thefe outguards of the mind are fent abroad
And Hill patrolling beat the neighbouring road,

Or to the parts remote obedient fly.

Keep ports advanc’d, and on the frontier lie. Blachmore.

PAT'RON,/ [patron, Fr. patronus, Lat.] One who
countenances, fupports, or protects. Dr. Johnfon adds,
“Commonly a wretch who fupports with infolence, and
is paid with flattery.” — I’ll plead for you as my patron.
Shaliefpeare.

Ne’er let me pafs in filence Dorfet’s name;

Ne’er ceafe to mention the continu’d debt,

Which the great patron only would forget. Prior.

A guardian faint. — St. Michael is mentioned as the pa¬
tron of the Jews, and is now taken by the Chriftians as
the proteCtor general of our religion. Dryden.

Thou amongft thofe faints whom thou doft fee
Shall be a faint, and thine own nation’s friend
And patron. Spcnfer.

Advocate; defender; vindicator. — We are no patrons of
thofe things; the bell defence whereof is fpeedy redrefs
and amendment. Hooker. — Whether the minds of men
have naturally imprinted on them the ideas of extenfion
and number, I leave to thofe who are the patrons of in¬
nate principles. Locke. — One who has donation of ecclefi-
aftical preferment:

Patrons of fenfe afraid, but not of vice;

Or fwoln with pride, or funk in avarice. Wcjley.

Patron, among the Romans, was an appellation given
to a mailer who had freed his Have. As loon as the rela¬
tion of majler expired, that of patron began: for the
Romans, in giving their Haves their freedom, did not de-
fpoil themfelves of all rights and privileges in them ; the
law llill fuhjeCted them to confiderable fervices and du¬
ties towards their patrons, the negleCt of which was very
feverely punilhed.

Patron was alfo a name which the people of Rome gave
to fome great man,, under whofe protection they ufually
put themfelves ; paying him all kinds of honour and re-
fpeCl, and denominating themfelves his clients ; while the
patron, on his fide, granted them his credit and protec¬
tion. They were therefore mutually attached and mu¬
tually obliged to each other ; and by this means, in con-
fequence of reciprocal ties, all thofe feditions, jealoufies,
and animofities, which are fometimes the effeCt of a dif¬
ference of rank, were prudently avoided : for it was the
duty of the patron to advife his clients in points of law,
to manage their fuits, to take care of them as of his own
children, and fecure their peace and happinefs. The cli¬
ents were to affirt their patrons with money on feveral
occafions ; to ranfom them or their children when taken
in war ; to contribute to the portions of their daughters ;
and to defray, in part, the charges of their public em¬
ployments. They were never to accufe each other, or
take contrary fides ; and, if either of them was conviCfed
of having violated this law, the crime was equal to that
of treafon, and any one was allowed to kill the offender
with impunity. This patronage was a tie as efFe&ual as
any confanguinity or alliance, and had a wonderful effeCt
towards maintaining union and concord among the
people for the fpace of 600 years ; during which time
we find no diflenfions or jealoufies between the patrons
and their clients, even- in the times of the republic,
when the populace frequently mutinied againft thofe who
were moft powerful in the city.

PATRO'NA, or Padro'n, a town of Syria, near the
fea-coaft, (aid to have been founded by Itobalus, contem¬
porary and ally of Ahab king of Ifrael ; the ancient name
was Botrys, or Botryum. Mr. Maundrel found here the
remains of an old church and monaftery; but thefe, as
well as the town, perfectly ruined and defolate : twenty
miles fouth-weft of Tripoli. Lat. 44. 12. N. Ion. 35. 35. E.

PAT'RONAGE, /. Support; protection. — Lady, moft

P A T

worthy of all duty, how falls it out, that you, in whom
all virtue fliines, will take the patronage of fortune, the
only rebellious handmaid againft virtue. Sidney.

Here’s patronage ; and here our heart defcries
What breaks its bonds, what draws the clofer ties ;
Shows what rewards our fervices may gain,

And how too often we may court in vain. Creech.

Guardianfhip of faints. — From certain paflages of the
poets, feveral (hips made choice of fome god or other for
their guardians, as among the Roman Catholicks every
veflel is recommended to the patronage of fome particu¬
lar faint. Addifon. — Donation of a benefice ; right of
conferring a benefice. — Ad vowfon fignifies the taking
into protection, and therefore is fynonymous with patron¬
age. Blackjlone. — See the article Advowson, vol. i.
P- 133-

Arms of Patronage, in heraldry, are thofe on the top
of which are fome marks of fubjeCtion and dependence :
thus the city of Paris lately bore the fleurs-de-lis in chief,
to (how her fubjeClion to the king; and the cardinals,
on the top of their arms, bear thofe of the pope, who
gave them the hat, to (how that they are his creatures.
Ency. Brit.

To PAT'RONAGE v.a.l To patronize; to proteCl.
A bad word. — Fie ufes it to patronage his theft. Shake-
fp'eare.

Dar’ft thou maintain the former words thou fpak’ft ?

Yes, fir, as well as you dare patronage

The envious barking of your faucy tongue. Shakefpeare.

PAT'RONAL, adj. Protecting; fupporting; guard¬
ing ; defending ; doing the office of a patron. — The name
of the city being difcovered unto their enemies, their
penates and patronal gods might be called forth by charms.
Brown's Vulg. Err.

PAT'RONESS, f. [patrona, Lat.] A female that de¬
fends, countenances, or fupports. — All things fhould be
guided by her direction, as the fovereign patronefs and
proteClrefs of the enterprife. Bacon.

Befriend me, night, bell patronefs of grief.

Over the pole thy thickefl mantle throw. Milton.

A female guardian faint. — They took her for their pa¬
tronefs, and confequently for their fhe-god. Brevir.t's
Saul and Sam. at Endor.

With wandering fleps to fearch the citadel,

Ar.d from the priefts their patronefs to fteal. Dryden.

A woman that hath the gift of a benefice. ,

PAT'RONLESS, adj. Without a patron. — The arts
and fciences mult not be left patronlefs. Ld. Shaftefbury.

To PAT'RONISE, v. a. To proteCt; to fupport; to
defend, to countenance. — Churchmen are to be had in
due refpeft for their work fake, and protected from fcorn ;
but, if a clergyman be loofe and fcandalous, he mull not
be patronized nor winked at. Bacon. — All tendernefs of
confcience againft good laws is hypocrify, and patronized
by none but men of defign, who look upon it as the fitted
engine to get into power. South.

PAT'RONISER, f. One who countenances or fupports
— That vain-glorious patronizer of diflenfions and erro¬
neous doCtrines. Skelton's Deifm rev.

PAT'RONSHIP, J'. The office of a patron. Scott.
PATRONYM'IC, adj . [from the Greek a fa¬

ther, and ovop.cn,, a name.] Derived as a name from an-
ceftors,

PATRONYMIC, f. Name expreffing the name of the
father or ancellors — It ought to be rendered “ the fon,”
TeCtonides being a patronymic. Broome.

Patronymicsare derived, 1. From the father; as Pe-
lides, i. e. Achilles the fon of Peleus. 2. From the mo¬
ther; as Philyrides, i. e. Chiron the fon of Phiiyra. 3.
From the grandfather on the father’s fide ; as ADacides,
i. e. Achilles the grandfon of Aiacus; ACtorides ; i. e.
Patroclus, the grandfon of ACtor. 4. From the grand-

2 father

386

PAT

PAT

father by the mother’s fide; as Atlantiades, i.e. Mer¬
cury, the grandfon of Atlas. 5. From the kings and
founders of nations; as Romulidae, i.e. the Romans,
from their founder, king Romulus.

The terminations of Greek and Latin patronymics are
chiefly four, viz. des, of which we have examples above ;
as, as Thaumantias, i. e. Iris, the daughter of Thaumas ;
is, as Atlantis, i.e. Eleftra, the daughter of Atlas ; and
ne, as Nerine, the daughter of Nereus. Of thefe termi¬
nations, des is mafculine ; and as, is, and ne, feminine ;
des and ne are of the firft declenfion, as and is of the
third.

The Ruffians, in their ufual mode of addrefs, never
prefix any title or appellation of refpeft to their names;
but perfons of all ranks, even thofe of the firft diftinftion,
call each other by their Chriftian names, to which they
add a patronymic. Thefe patronymics are formed in
fome cafes by adding Vitch (the fame as our Fitz) to
the Chriftian name of the father; in others by Of or Ef;
the former is applied only to perfons of condition, the
latter to thofe of inferior rank. Thus, Ivan Ivanovitch,
Ivan Ivanof, is Ivan the fon of Ivan ; Peter Alexievitch,
Peter Alexeof, Peter the fon of Alexy. The female pa¬
tronymic is Efna or Ofna : as Sophia Alexefna, or Sophia
the daughter of Alexy ; Maria Ivanofna, or Maria the
daughter of Ivan.

PATRO'US, a furname of Jupiter among the Greeks,
reprefented by his ftatues as having three eyes, which
fome fuppofe to fignify that he reigned in three different
places, in heaven, on earth, and in hell.

PATRO W'R A, a town of Hindooftan, in Boggilcund :
twenty-five miles fouth-eaft of Makoonda.

PATRU' (Oliver), a diftinguiffied French pleader, and
man of letters, was born at Paris in 1604. His father,
who was a procureur in the parliament, brought him up
to the bar. After having vilited Rome, he returned to
Paris, and frequented the courts of law, cultivating with
great affiduity the talent of fpeaking and writing with
purity. His reputation procured him admiffion to the
French Academy in 1640 ; and at his reception he deli-'
vered an oration of thanks, which pleafed that body fo
well, that it became thenceforth the rule for every new
member to pronounce a fimilar harangue. Patru was
connefted with moll of the eminent literary charaflers in
France of that period, and was confulted as an oracle
upon every queftion relative to language. Vaugelas de¬
rived great affiftance from him in his remarks on the
French language, for which he has made a proper ac¬
knowledgment. Boileau, Racine, and other wits, read
their works to him, and profited by his remarks. Ra¬
cine, indeed, fometimes fhrunk from the feverity of his
anitnadverfions ; but the correft Boileau feems to have
been fully fenfible of their value. As Patru, from what
caufe we are not informed, fell into a ftate of indigence,
Boileau purchafed his library, and generoufiy permitted
him to retain it during his life. That a poet ffiould be
the pecuniary benefadtor of a celebrated pleader, feems
contrary to the ufual order of things ; but Patru was
probably more engaged in polifhing his ftyle than in
turning over law-books and hunting, for clients : he was
a man of a philofophical fpirit, generous, cornpaffionate,
and not deprefled by the frowns of fortune. His opi¬
nions were of the fceptical caft, on which account he
was vifited by Boffuet in his laft illnefs, for the purpofe
of exhorting him to edify' the public by fome' demor.-
ftrations of religious convidlion. “ It will more become
me (faid Patru) to be filent, for men in their laft mo¬
ments talk only through weaknefs or vanity.” On his
death-bed he received a vifit from the minifter Colbert,
who brought him a late donation of five hundred crowns.
He expired in January 1681, in his feventy-feventh
year.

As an author, Patru was principally known by his
“ Plaidoyers,” which have the merit of being free from

the former barbarifms of the bar, butare without warmth
or imagination. He alfo wrote harangues, letters, and
the lives of fome of his friends, which have a fimilar cha¬
racter of cold corredtnefs, and have loft their former re¬
putation. The belt edition of his works is that of 1732,
in two volumes quarto. Moreri.

PATSAA'RI, a fmall ifiand on the eaft fide of the
gulf of Bothnia. Lat. 60. 48. N. Ion. 20. 58. E.

PAT'SAH, a town of Hindooftan, in the circar of
Surgooja: twenty-five miles north-north-eaft of Sur-
gooja.

PAT'SCHKAU, a town of Silefia, in the principality
of Neiffe : thirteen miles weft of Neiffe, and five fouth of
Munfterberg. Lat. 50. 18. N. Ion. 16. 50. E.

PATSHIKAMIS'TICK, a river of Canada, which
runs into the Sable in lat- 49. 45. N. Ion. 72. 36. W.

PAT'TA, or Pati, an ifland in the Indian Sea, near
the coaft of Africa, about ten miles in circumference;
chiefly inhabited by Arabians, with whom the Englifh,
Portuguefe, and Indians, trade for ivory and flaves : it
is fituated near the coaft, at the mouth of a river of the
fame name. Lat. 1. 56. S. Ion. 43. 20. E.

PAT'TALA, in ancient geography, a town of India,
that has been commonly referred to the Delta of the In¬
dus. Alexander arrived at this place about the middle
of Auguft, 326 years B. C. and, having made proper ar¬
rangements for the fafety and convenience of his fleet
and army, and having viewed alfo the two principal
mouths of the Indus, on which he experienced fome de¬
gree of furprife, if not of terror, from the “bore,” or
fudden influx of the tide, he departed by land for Sufa,
leaving Nearchus with the fleet to follow as foon as the
Etefian winds fliould ceafe. Nearchus failed in Odlober
with the north-eaft monfoon, conducing, according to
Dr. Gillies, in his elegant Hiftory of Greece, “ the firft
European fleet which navigated the Indian feas.” Pat-
tala is fuppofed to have been the fcite of the modern city
of Tatta, which fee. According to a tradition among
the people of Sindy, Pattala ftood in the fuperior delta,
whereas Tatta is placed in the inferior delta. Rernell.

PATTA'LIA, f. in natural hiftory, a word u fed by7
Ariftotle and the reft of the old Greek writers, to exprefs
a flag or deer of two years old.

PATTAL'LY, a town of Hindooftan, in Bahar : thir¬
ty-three miles eaft- north-eaft of Hajypour.

PATTAN', a town of Hindooftan, in Mewat : fixteen
miles fouth-weft of Corputly.

PATTAN', a town of Hindooftan, in Vifiapour ;
twenty miles north-weft of Sattarah.

PATTAN', or Lelit Pattan, a city of Afia, in the
kingdom of Nepaul, containing feveral temples, and
about 24,000 houfes : ten miles eaft of Catmandu. Lat.
28. 5. N. Ion. 85. 10. E.

PATTANCHERU', a town of Hindooftan, in Gol-
conda : twenty miles weft-north-weft of Hydrabad.

PATTAPOO'W-WINEPE'O, a lake of North Ame¬
rica. Lat. 54. 50. N. Ion. 96. W.

PATTEE'RAH, a river of Thibet, which runs into
the Ganges on the borders of Hindooftan.

PAT'TELB ACKERS, one of the fmalleft Molucca
iflands. Lat. o. 3. N. Ion. 127. 21. E.

PAT'TEN, f. [patin, Fr. from pate, or patte , a broad
foot, which Cotgrave renders alfo “ a plate or band of
iron.”] A clog of wood with an iron ring, worn under
the common ffioe by women, to keep them from the dirt.
— Their flioes and pattens are fnouted and piked more than
a finger long, crooking upwards, which they call crac-
kowes, which were faftened to the knees with chains of
gold and filver. Canulerds Remains.

Houfewives beneath the umbrella’s oily ftied

Safe through the wet on clinking pattens tread. Gay.

PATTEN’s CREE'K, a river of Kentucky, which
runs into the Ohio in lat. 38, 22. N. Ion. 85. 50. W.

PAT'TEN-

PAT

PATTEN-MAKER,/ One that makes pattens.

PAT'TENSBERG, a town of Virginia, on James
River: 156 miles weft of Richmond.

PAT'TENSEN, a town of Weftphalia, in the princi¬
pality of Calenberg, formerly furrounded with walls,
moats, and ramparts : fix miles fouth of Hanover.

To PATTER, v. n. [from patte, Fr. the foot.] To
make a noife like the quick fteps of many feet :

The pat t' ring hail comes pouring on the main,

When Jupiter defcends in harden’d rain. Dryden.

The dealing fhower is fcarce to patter heard

By fucli as wander through the foreft walks. Thomfon.

To PAT'TER, v. a. [derived by Mr. Tyrwhitt from
pater-nnjier, fuppofing that the word originally meant to
repeat the Lord’s prayer ; but rather perhaps in ridicule
of the Latin prayers of the Romanifts ; as we have made
hocus pocus out of hoc eft corpus. The word is ufed in
Scotland; and in fome places of England, Dr. Jamiefon
obferves, they yet fay, in derifory language, “ to patter
out prayers.”] To recite or repeat haftily. — The people
pattre and prai. Chaucer's Rom. R.

PAT'TERGAUT, a town of Hindooftan, in the fu-
bah of Delhi : twenty miles weft of Coel.

PATTERGOT'TA, a town of Hindooftan, in Ben¬
gal : ten miles eaft of Pucculoe.

PATTERGOT'TA, a town of AlTam : fifteen miles
eaft of Gentiah.

PATTERGOT'TA, a town of Bengal : twenty-two
miles fouth-weft of Dinagepour.

PATTERGOT'TA, a town of Bengal : eighteen
miles eaft of Boglipour.

PATTERGUR', a town of Hindoofton, in the dr¬
ear of Sumbul : four miles north-eaft of Nidjibabad.

PAT'TERN, f. \palron, Fr. patroon, Dutch.] The
original propofed to imitation; the archetype; that
which is to be copied ; an exemplar. — Patterns to rule
by are to be fought for out of good, not loofe, reigns.
Duvenant.— Chriitianity commands us to aft after a no¬
bler pattern than the virtues even of the raoft perfeft men.
Rogers.

Take pattern by our fifter ftar,

Delude at once and blefs our fight ;

When you are feen, be feen from far,

And chiefly chufe to fhine by night. Swift.

A fpecimen ; a part fliown as a fample of the reft. — A
gentleman fends to my fhop for a patte)n of fluff ; if he
like it, he compares the pattern with the whole piece, and
probably we bargain. Swift. — An inftance ; an example.
— What God did command touching Canaan, the fame
concerneth not us otherwife than only as a fearful pat¬
tern of his juft difpleafure againft finful nations. Hooker.
— Any thing cut out in paper to direft the cutting of
cloth.

To PAT'TERN, v.a. To make an imitation of fome-
thing ; to copy. — The fbape [of the temple] they fay
was revealed to Abraham out of heaven,- patterned from
that which Adam reared in paradife. Sir T. Herbert's
Travels.

Ay, fuch a place there is, where we did hunt,

Pattern'd by that the poet here deferibes. Shaliefpeare .
To ferve as an example to be followed. Neither fenfe is
now much in ufe. — That way of patterning a common¬
wealth, was mod abfolute ; though he [fir Thomas More]
hath not fo abfolutely performed it. Sidney's Def. of
Poefy.

When I that cenfure him do fo offend,

Let mine own judgment pattern out my death,

And nothing come in partial. Sliakefpeare.

PATTERPUR'RA, a town of Bengal : forty-feven
miles fouth-weft of Burdwan.

Vol. XIX. No. 1311.

PAT 387

PATTER'RA, a town of Bengal: five miles eaft of
Midnapour.

PATTERSON, a town of New Jerfey, on the Paflaic :
fifteen miles north-north-weft of New York.

PAT'TERSORT, a town of Pruflia, in the circle of
Natangen : lix miles fouth-weft of Brandenburg.

PAT'TER WALDT, a town of Pruflia, in the circle
of Natangen : twenty-four miles eaft-fouth-eaft of Ko-
nigfberg.

PATTI, Pati, or Piatti, a feaport town of Sicily,
in the valley of Demona, fituated on the north coaft, in
a bay or gulf to which it gives name, built on the ruins
of Tindaro, It is the fee of a bifhop, fuffragan of Mef-
fina: thirty-two miles weft of Medina, and forty north
of Catania. Lat. 38. 10. N. Ion. 15. a. E.

PATTI, a river of Sicily, which runs into the fea
one mile eaft of Patu.

PATTIAD', atownof Hindooftan, in Guzerat: thir¬
ty-five miles north-weft of Gogo.

PATTIA'RY, a town of Hindooftan, in Oude: fifty-
five miles eaft-north-eaft of Agra, and fifty-five north-weft
of Canoge. Lat. 27. 35. N. Ion. 79. 26. E.

PATTICAU'T, a town of Hindooftan, in Cochin :
thirty-eight miles eaft-north-eaft Cranganore.

PATTIGAM', a town of Hindooftan, in Orifla : thir¬
ty miles north of Orifla, and thirty fouth-eaft of Jaypoui .

PAT'TINGHAM, a village in Staftordf’nire, to the
weft of Wolverhampton; w'here, in the year 1700, was
found a large torques of fine gold, two feet long, three
pounds two ounces weight, in fliape of a bow of a tea¬
kettle, and fo flexible that it could be wrapped round the
arm, and be eafily extended again to its own form.
Thefe torquefes were worn by the ancient Britons, as
well as the Romans. Wilkes'' s Briti/h Directory.

PAT'TISON (William), an Englilh poet of genius,
but whofe imprudence made his life miferable, and his
deceafe premature, dying of want and the fmall-pox at
twenty years of age, 1726. He was born at Peafmarfh in
Stiflex, 1706. Jones's Biog. Did.

PATTISON’s CREE'K, a river of Virginia, which
runs into the Potomack in lat. 39. 32. N. Ion. 78. 46. W.

PATT'MES, a town of Bavaria : ten miles eaft-fouth-
eaft of Rain, and eight north of Aicha.

PATTON, a townfhip of Centre-county, in Pennfyl-
vania, having 297 perfons.

PAT'TSCHOW, or Patzow, a town of Bohemia, in
the circle of Bechin : twenty-three miles eaft-north-eaft
of Bechin, and thirty-eight fouth of Prague. Lat. 49.
30. N, Ion. 14. 50. E.

PAT'TUN. See Puttan.

PATTUNGA'H, a town of Hindooftan, in Orifla :
eighteen miles north of Sonnepour.

PATTY,/. [phti, Fr.] A little pie; as, a veal patty.
It fhould b epaty, but it is ufually pronounced patty.

PATTY- PAN, J\ A pan to bake a little pie in.

PATTYA'H, a town of Hindooftan, in Oude : twen¬
ty-two miles fouth-fouth-weft of Canoge.

PATTYPOU'R, a town of Hindooftan in Bahar: fifty-
two miles fouth-fouth-weft of Patna.

PATUCK'ET, a village of North America, about four
miles north-eaft of Providence, in Rhode-ifland; a place
of confiderable trade and manufactures. Through this
village runs Patucket or Pawtucket river, which empties
into Seekhonk river at this place. The river Patucket,
called in its more northerly courfe Blackllone’s River,
has a beautiful fall of water, diredtly over which has
been built a bridge on the line, which divides the com¬
monwealth of Maflacluifetts from the (late of Rhode
Ifland ; diftant about forty miles fouth by weft from
Bolton.

PATUL'CIUS, a furname of Janus, which he received
a pateo, becaufe the doors of his temple were always
“open” in the time of war. Some fup-pofe that he re¬
ceived it becaufe he prefided over gates, or becaufe the
5 G year

3S8 P A U

year began by the celebration of his feftivals. Ovid.
Fa/1. 129.

To PATU'LICATE, v. n. [from the Lat. patulus,
open.] To expand; to become open. Cole.

PAT'ULOUS, adj. [from the Lat. pateo, to lie open.]
Having an expanded flower, blowing open.

PATURA'GES, a town of Auftria, in the diftri£l of
Mons. The place contains 3208 inhabitants.

PATUX'EN, a river of America, which runs into the
Chefapeak thirty miles fouth of Annapolis, in lat. 38.
21. N. Ion. 76. 32. W.

PATUX'ET, a river of America, which runs into the
Providence River five miles below the town of Provi¬
dence.

PATZ'LAWITZ, a town of Moravia, in the circle of
Olmutz : eighteen miles fouth of Olmutz.

PAU, a town of France, and principal place of a dif-
tridl, in the department of the Lower Pyrenees;, before
the revolution the capital of Bearn ; fituated on a river
called the Gave of Pau. It was the feat of a parliament,
a governor, a fenefchal, &c. and contained an univerfity,
an academy of fciences, two hofpitals, a college, and fe-
veral convents. Here are manufa£tures of cloth, linen,
&c. The hams cured here are highly efteemed. It was
the ancient refidence of the kings of Navarre; and will
be for ever memorable in hiftory, fince it was the birth¬
place of Henry IV. That immortal prince was born in
the caltle, then the ufual refidence of the kings of Na¬
varre. “ It ftands on one of the molt romantic and
lingular fpots (fays Wraxall) I have ever feen, at the weft:
end of the town, upon the brow of a rock which termi¬
nates perpendicularly. Below runs the Gave, a river or
rather a torrent which rifes in the Pyrenees, and empties
itfelf into the Adour. On the other fide, about two miles
off, is a ridge of hills covered with vineyards, which pro¬
duce the famous Vin de Jorengon, fo much admired ; and
beyond all, at the diftance of nine leagues, appear the
Pyrenees themfelves, covering the horizon from eaft to
weft) and bounding the profpecl. The caftle, though
now in a ftate of decay, is ftill habitable ; and the apart¬
ments are hung with tapeftry, faid to be the work of Jane
queen of Navarre, the mother of Henry IV. Gallon IV.
count de Foix, who married Leonora heirefs of the
crown of Navarre, began the edifice in 1464 ; but his fuc-
ceflor Henry d’Albret, grandfather of Henry IV. com¬
pleted and enlarged it about the year 1519, when he
made choice of the city of Pau for his refidence, and
where, during the remainder of his reign, he held his
little court. In a chamber, which by its lize was formerly
a room of ftate, is a fine whole-length portrait of that Jane
queen of Navarre whom I have juft mentioned. Her drels
is very fplendid, and refembles thofe in which our Eliza¬
beth is ufually painted. Her head-drefs is adorned with
pearls; round her neck fir e wears a ruff; and her arms,
which are like wife covered with pearls, are concealed by
her habit quite down to the wrift. At her waift hangs
by a chain a miniature portrait. The fingers of her right
hand play on the firings of a guitar; and in her left Ihe
holds an embroidered handkerchief. The painter has
drawn her as young, yet not in the firft bloom of youth.
Her features are regular, her countenance thin, and rather
inclining to long ; the eyes hazel, and the eyebrows finely
arched. Her nofe is well formed though large, and her
mouth pretty. She was a great princefs, of high fpirit,
and undaunted magnanimity. Her memory is not re¬
vered by the French hiftorians, becaufe fhe was the pro-
tedlrefs of the Huguenots and the friend of Coligni ; but
the adlions of her life evince her diftinguilhed merit.” In
one of the adjoining chambers, is another portrait of
Henry IV. himfelf when a boy ; and on the fecond floor
is the apartment in which he was born.

The towm, or rather city, is divided into the Eaft and
Weft parts : the former contains 5800 inhabitants, and
the latter 2785. Nothing can be more delightful than the

P A V

environs of this place, enlivened as they are by vineyards,
by undulating grounds, and by the meanderings of the
river Gave. Pau is i2§ polls eaft of Bayonne, 21^ Weft-
fouth-weft of Touloufe. Lat. 43. 17. N. Ion. o. 18. W.
Wraxall' s Tour through France . Ramond's Travels in the
Pyrenees, 1813.

PAU (St.), a town of Spain, in the province of Cata¬
lonia ; twelve miles north-weft of Gerona.

PA'VAGE,J. [pavagium, Lat.] in our old law-books,
money paid towards the paving of ftreets, or highways.

PAV'AIS, or Pavache,/. in ancient armour, was a
large fliield, or rather a portable mantlet, capable of co¬
vering a man from head to foot, and probably of fufficient
thicknefs to refill the miflive weapons then in ufe. Thefe
were, in lieges, carried by fervants whole bufinefs it was
to cover their mailers with them, whilft they with their
bows and arrows ftiot at the enemy on the ramparts. In
theJift of the army that accompanied king Edw'ard III.
to Calais, we find many “Pavifors:” thefe were probably
men trained to the ufe of the pavais, which mull have
required dexterity as well as courage. The pavaches
were fometimes fupported by props : they were alfo ufed
at fea to defend the fides of the veflels, like the prefent
netting of our fliips of war : this defence w'as called a “pa-
vifade,” and may be feen in the reprefentation of ancient
Ihips. The pavais was rectangular at top, the fides being
confequently parallel, but the angle is rounded off at the
bottom. Under the protection of the pavaches, workmen
alfo approached to the foot of the wall in order to lap it.

PAVA'KA, or Agni, in Hindoo mythology, is the
regent of fire, and is a deity frequently invoked in the
variety of facrificial ceremonies obferved by that fuper-
ftitious race. The element of fire being of fiuch vital im¬
portance in all the operations of nature, and in its evi¬
dent and hidden phenomena lb ftriking and myfterious,
it has, of courfe, excited the wonder and invited the re-
fearch of the vulgar and the wife of all ages and nations.
The Sun, the fuppofed fource of heat, is naturally joined
with his offspring in the awe and adoration with which
each is contemplated ; and among the Hindoos, as with
other polytheifts, we find the attributes and charadters
of the regents of light and heat often coalefcing. The
Hindoos have, however, depidted their fire-king in co¬
lours and forms not common to others. He is painted
of a deep red ; with two faces, three legs, and feven arms,
riding on a ram, and bearing a flag with that animal on
its field. Few, if any, of the numerous ceremonies of
the Brahmans are complete without invocatory oblations
to the all-pervading element of fire, or to its perfoniflca-
tion, under the name of Pavaka or Agni; the latter is in¬
deed his moil popular and common name. (See Hin-
doostan, vol.x. p. 1 1 9.) In facrificial ceremonies, as
ordained by Menu, Agni is generally the deity primarily
invoked. A Brahman is diredted, in his domeftic fire for
drafting the food that he daily offers to the gods, to make
an oblation, “ Firft, to Agni, god of fire, and to the lunar
god, feverally ; then to both of them at once.” (C. iii.
v. 85.) Again, in offering to the Dii Manes: “The di¬
vine manes are always pleafed with an oblation in empty
glafles, naturally clean, on the banks of rivers, and in
iolitary fpots. Firft, as it is.ordained, having fatisfied
Agni, Soma, and Yama, with clarified butter, let him
proceed to latisfy the manes of his progenitors.” C. iii.
v. 207, 21 1.

The Brahmans fubdivide the igneous element, firft,
into two, the folar and terreftrial, or creative and de-
ltrudtive fire. Here Agni, as its general perfonification,
coalefces with Brahma and Siva; and hence, it has been
furmifed, his two faces. Terreftrial fire is again fub-
divided into three, viz. the nuptial, the ceremonial or
funeral, and the facrificial. Agni’s three feet nt3y allude
to thefe, or to the influence of fire over the three regions
of the univerfe. The fun is preceded by a feven-headed
horfe, or by feven horfes yoked to his car; allufive, it is

fuppofedj

P A V

fuppofed, to the prifmatic variety of a ray of light: and
fire, like the fun, is fuppofed by the Hindoo philofophers
to emit feven rays. This number is myfterioufly re¬
peated in invocations to Agni and Surya, the latter their
Phoebus or Apollo. Hence the number of arrtis bellowed
on Agni.

Like other Hindoo deities, Pavaka has a wife, or fakti,
(fee Swaha,) who appears to have been a form of Le-
chemi, the goddefs of beauty. (See that article, vol. xii.)
In one of the tales of the Puranas, it is related how
Lechemi performed tapafya for 100,000 years, in the
flower of the padina, or lotos, Handing on one foot, in
order to obtain Vifhnu. She then faw Sri Krilhna, or
Vifhnu, who faid, “Thou lhaltbemy wife when I affume
the lhape of Varaha ; but in the mean time be the fakti
of Agni, which fakti, or energy, burns every thing:
Vahni, Agni, or Fire, for an hundred years of the gods,
will have no other wilh but to pleafe thee.” She con¬
ceived by him : the gellation lafted twelve years, and three
beautiful foils were born unto her; Daklhinagni, Gar-
hapatya, and Ahavanya, three facred fires. (Af. Ref.
vol. xi. art. 2.) In this manner the theogonical legends
of the Puranas run into each other; very confufedly as
W'ould feem on partial examination, but conneCtedly as
it is faid will appear whenever that mafs of romantic
fables lhall have been competently infpeCted. SeePuRANA.

The number feven, we have feen, is that of the arms
of Agni, and of many allufions to him in his form of fire.
In the ceremony called vifwacleva, a comprehenfive one
to “ all the gods,” which is the meaning of the word, in¬
cluding the effentials of the whole detail of daily facri-
fice, and praClifed therefore chiefly by Brahmans not ex¬
ecutively engaged in the priefthood, the myftical number
frequently occurs in this invocation ; for inltance, to
Pavaka, or Agni. “Fire ! feven are thy fuels; feven thy
tongues; feven thy holy fages ; feven thy beloved abodes;
feven ways do feven facrifices worlhip thee; thy fources
are feven ; may this oblation be efficacious.” An ex¬
planation of this myfterious palfage is given by Mr.
Colebrooke, in his Efiay on the Religious Ceremonies of
the Hindoos, in the feventh volume of the Af. Ref.

We have noticed three of the fons of Agni, or Pavaka,
in the three facred fires, by Lechemi, in her form of his
fakti. He had three other fons, perhaps by a different
wife, named Uttama, Tamafa, and Riavata, whofe names
occur in the lift of feven Menus, or fages. Their names
have probably fome allufions, direCl or inverfe, to fire, or
heat, or light. By another wife he had nine fons. He
had alfo feven brothers, whofe names are varied fignifi-
cations of flame.

The three fons of Agni above named, are on other oc-
cafions called fons of Brahma. Between Agni or Brahma
we fee here fome identity: both are alfo painted red.
It is in reference to hi's creative heat that he is connedled
with Brahma. He is alfo called Vahni, a name likewife
of Sarafwati, the confort of Brahma. A palfage above
quoted has ffiown that the fpoufeof Agni coalelces with
thofe of the other two perfons of the Hindoo head ; as
doth Agni : his igneous property concentrated, connedts
him with the deflrudlive Siva, who is alfo fire ; and his
light, fo intimately related to fire, with Vifhnu the con-
fervator. This triple connexion between the deity of
heat and the three great powers, is fimilar to what is re¬
marked of the Sun under the article Surya.

Sir W. Jones, in his Differtation on the Gods of Greece,
Italy, and India, has the following palfage, applicable to
the fubjedt of our prefent article. “ The worfhip of folar
or veftal fire may be aferibed, like that of Ofiris and Ifis,
to the fecond fourceof mythology, or an enthufiaftic ad¬
miration of nature’s wonderful powers; and it feems, as
far as I can yet underiland the Vedas, to be the principal
worfhip recommended in them. We have feen that Ma-
hadeva himfelf is perfonified by fire ; but fubordinate to
him is the god Agni, often called Pavaha, or the Puri¬
fier, who anlwers to the Vulcan of Egypt, wdiere he was

p a v im

a deity of high rank ; and Agni’s wife, Swaha, refembles
the younger Vella.”

To this deity a portion of the Vedas is aferibed, as
having been revealed or promulgated by him. Seven
books of the Yajurveda he is the reputed author of : and
one of the Puranas, which details his hiflory, is called the
Agni Purani. He is therein alfo named Agnidhra,
Aanala, and Jivani : to the latter appellation it is added,
“he, who does good to all ; front whom fprung the
Vedas.” Under the article Marut it is noticed, that
the Hindoos have guardians over the cardinal and inter¬
mediate points of the heavens. Among thefe is Pavaka;
and he rules or governs the fouth-eafl. In the Gita,
when Krifhna deferibes his own pre-eminence among all
things and creatures, he fays to Arjun, “ Among the
Vafus, I am Pavaka.”

PAV'AN, or Pavin, /. [pavane, Fr. from the Lat .pavo$
a peacock, as fome have fuppofed ; but there is good
reafon, Mr. Douce believes, for thinking the term is
Italian, and derived from the city of Padua, where the
dance is faid to have been invented : yet it was formerly
called a Spanijh dance.] A grave kind of dance: not a
light tripping dance, as Dr. Johnfon, following Ainfworth,
has afierted. The method of performing it, Sir John
Hawkins fays, was anciently by gentlemen dreffed with a
cap and fword ; by thofe of the long robe in their gowns ;
by princes in their mantles ; and by ladies in gowns with
long trains, the motion of which in the dance refembled
that of a peacock’s tail. — Your Spanifh ruffs are the bell
wear, your Spanifh pavin the bell dance. Ji. Jonfon's Al-
chemijl.—lw all fets of leflons for the virginal, from the
time of queen Elizabeth to the reign of Charles I. there
was a pavan, which ferved as an adagio or flow movement
to the galiard, as the faraband did afterwards to the cou-
rant. Burney.

Who doth not fee the meafure of the moon,

Which thirteen times (lie danceth ev’ry year ;

And ends her pavin thirteen times as foon

As doth her brother ? Davies's Orchejlra.

PAVA'NA, in Hindoo mythology, is the regent of the
winds, and of the north-welt quarter of the heavens ; the
Hindoos having, as noticed under the article Marut, a
feparate ruler or guardian for each cardinal and interme¬
diate point. The name of this deity is ufually pro¬
nounced Pavan; and we may herein recognize the Faun-
us of ancient Italy, a contraction of Favon- ius, the
north-wreft wind of the Mediterranean mythology, derived
probably from a faun, or antelope, apt emblem of its ce¬
lerity, and allotted, therefore, in India, as a vehicle for
Pavana, udio, in pictures, ufually appears fo mounted.
The Puranas contain particular directions to artills in
refpeCt to their delineating the gods. In the Matfya
Purana, the following point out the attributes of the one
in queftion : “ Let Pavana be painted young, clothed in
robes of many colours, mounted on a fleet antelope, and
with a ftandard in his hand, which the wind waves behind
him as he cleaves the air.”

PAUCA'RA, a town of Peru, in the diocefe of Gua-
manga : twenty miles eaft of Guanca Velica.

PAUCARCOL'LA, a town of Peru, which gives name
to a jurifdiClion, in the diocefe of La Paz : thirty-two
miles north of Puna.

PAUCARCOL'LA, a jurifdiClion of Peru, in the
diocefe of La Paz. The inhabitants feed a great number
of flieep, and manufacture the wool, which is coarfe.
There are fome mines of filver, but they are in general
filled with water. Puna is the principal town.

PAUCARTAM'BA, a jurifdiClion of Peru, fituated
to the eaft of Cufco, about feventy-four miles in length.'
It is fertile in corn and fruit.

PAUCARTAM'BA, a river of South-America, which
rifes about fifty miles fouth-well of Cufco, and after a
northerly courle of about 200 miles through' a jurifdic-
tion to which it gives name; it joins the Apurimac.

PAUCIL'OQUENT.,

800

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P A V

PAUCIL'OQUENT, adj. [from the Lat. paucus, few,
and loquor, to fpeak.] Ufing few words. Cole.

PAUCIL'OQUY, J\ A fpeech in few words, a fparing
fpeech. Johvfon.

PAU'CITY, f \paucitas, from paucus, Lat.] Fewnefs ;
fmalinefs of number. — The multitude of pariflies, and
paucity of fchools. Hooker. — In fuch (lender corpufcles
as thofe of colour, may eafily be conceived a greater
paucity, of protuberant corpufcles. Boyle. — Socrates well
underflood what he faid touching the rarity and paucity
of friends. L' Eflrange. — Smallnefs of quantity. — This
paucity of blood is agreeable to many other animals ; as,
lizards, frogs, and other fillies. Brown's Vu/g. Err.

PAU'CTON (Alexis), a French mathematician, was
horn near Lafiay, in Mayenne, in 173 z. He received his
education in the mathematical and naval academy at
Nantes; after which he went to Paris, where his inte¬
grity and ‘talents obtained for him a confulerable (hare
of patronage. He died in the year 1799. His works
are; x. Theory of the Force of Archimedes. 2. A.
Treatife on the Weights, Meafures, and Moneys, of all
Countries, ancient and modern. 3. Theory of the Laws
of Nature; with a DilTertation on the Pyramids of Egypt.

To PAVE, v. a. [pavio, Lat. paver, Fr.] To lay with
brick or (tone ; to floor with ftone. — Let not the court
he paved ; for that ftriketh up a great heat in fummer,
and much cold in winter. Bacon.

Should (he kneel down,

Her brother’s ghofl his paved bed would break,

And take her hence in horrour. Shahejpeare.

I fee a city of more precious mold,

With filver pav'd, and all divine with gold. Dryden.

To make a paflage eafy. — It might open and pave a pre¬
pared way to his own title. Bacon.

PAVEFAC'TION, J'. [from pavefy.'] The a£t of terri¬
fying. Cole.

To PA'VEFY, v. a. [from the Lat. paveo, to be in fear,
and facia, to make.] To affright. Cole.

PAV'EL, f. in botany. See Momordica.

PA'VEMENT, f. [pavimentum, Lat.] Stones or bricks
laid on the ground; (tone floor ; floor is u fed of (tone,
but pavement never of wood. Joknjbn. — The foundation
of Roman ways was made of rough (tone joined together
with cement ; upon this was laid another layer, confiding
of fmall ltones and cement, to plane the inequalities of
the lower llratum in which the (tones of the upper pave¬
ment were fixed : for there can be no very durable pave¬
ment but a double one. Arbuthiot on Coins.

The marble pavement clofes ; lie is enter’d

Into his radiant roof. Shahejpeare' s Cymbeline.

A broad and ample road, whole dud is gold.

And pavement ftars, as dars to thee appear.

Seen in the galaxy. Milton, P. L.

In England, the pavements of the grand dreets, See.
are ufually of flint or rubble-done ; courts, ltables,
kitchens, halls, churches, See. are paved with tiles, bricks,
flags, or fire dones; fometimes with a kind of free-done,
and rag-done- In fome cities, as in Venice for indance,
the dreets, &c.are paved with brick ; churches fometimes
are paved with marble, and fometimes with mofaic work,
as the church of St, Mark, at Venice. In France, the
public roads, dreets, courts, & c. are paved with gres or
grit, a kind of free-done. In Amfierdam, and the chief
cities of Holland, they call their brick pavement the
lurgher-mafier' s pavement, to didinguifli it from the done
or flint pavement, which ufually takes up the middle of
the fireet, and which ferves for carriages ; the brick wdiich
borders it being dedined for the paflage of people on
foot.

Pavements of free -done, flint, and flags, in dreets, See.
are laid dry; i. e. in a bed of fand ; thofe of courts,
fiables, ground-rooms, See. are laid in a mortar of lime
and fand ; or in lime and cement, efpecially if there be

vaults or cellars underneath. Some mafons, after laying
a floor dry, efpecially of brick, fpread a thin mortar over
it; fweeping it backwards and forwards to fill up the
joints. The feveral kinds of pavement are as various as
the materials of wdiich they are compofed, and whence
they derive the name by which they are didinguidied: as,

1. Pebble-paving, which is done with dones collected
from the fea-beach, modly brought from the ifiands of
Guernfey and Jerfey ; they are very durable, indeed the
mod fo of any done ufed for this purpofe. They are
ufed of various fizes, but thofe which are from fix to nine
inches deep, are edeemed the mod ferviceable. When
they are about three inches deep, they are denominated
holders, or bowders ; thefe are ufed for paving court¬
yards, and other places not accudomed to receive car¬
riages with heavy weights ; when laid in geometrical
figures, they have a very pleading appearance.

2. Rag-paving was formerly much ufed in London, but
is very inferior to the pebbles ; it is dug in the vicinity
of Maiddone, in Kent, from wdience it has the name of
Kentilh rag-done ; there are fquared dones of this mate¬
rial for paving coach-tracks and footways.

3. Purbeck-pitchens, fquared dones ufed in foot-ways;
they are brought from the ifland of Purbeck, and alfo
frequently ufed in court-yards; they are in general from
fix to ten inches fquare, and about five inches deep.

4. Squared paving, for didinftion by fome called Scotch
paving, becaufe the fird of the kind paved in the manner
that has been and continues to be paved, came from
Scotland; the fird was a clear clofe done, called blue
wynn, which is now difufed, becaufe it has been found
inferior to others fince introduced in the order they are
hereafter placed.

5. Granite, a hard material, brought alfo from Scotland,
of a reddifh colour, very fuperior to the blue wynn
quarry.

6. Guernfey, which is the bed, and now almod the only
done in ufe ; it is the fame done with the pebble before
fpoken of, but broken with iron hammers, and fquared to
any dimenfions required of a prifmoidical figure, fet with
its fmalled bafe downwards. The whole of the foregoing
paving fliould be bedded and paved in fmall gravel.

7. Purbeck paving, for footways, is in general got in
large furfaces, about two inches and a half thick; the
blue fort is the harded and the bed of this kind of paving.

8. Yorlijhire paving, is an exceeding good material for
the fame purpofe, and is got of almod any dimenfions of
the fame thicknefs of the Purbeck ; this done will not
admit the wet to pafs through it, nor is itafrefted by the
frod.

9. Ryegute, or fire-fione paving, is ufed for hearths,
doves, ovens, and fuch places as are liable to great heat,
which does not affeft this done, if kept dry.

10. Neivcaflle flags, are dones about two feet fquare,
and one and a half or two inches thick; they anfwer
very well for paving out-ofiices, they are fomewhat like
the Yorkfhire.

11. Portland paving, wdtb done from the ifland of Port¬
land ; this is fometimes ornamented with black marble
dots.

12. Swced/and paving, is a black (late dug in Leicefler-
fhire, and looks w'ell for paving halls, or in parti-coloured
paving.

13. Marble paving, is modly variegated with different
marbles, fometimes inlaid in mofaic.

14. Flat brick paving, done with brick laid in farrd,
mortar, or groute, as when liquid lime is poured into the
joints.

15. Brick-on-edge paving, done with brick laid edge¬
ways in the fame manner.

16. Bricks are alfo laid flat or edgeways in herring¬
bone.

1 7. Bricks are alfo fometimes fet endways in fand,
mortar, or groute.

18. Paving is alfo performed with paving-bricks.

3 19. With

PAY

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391

19. With ten-inch tiles.

ao. With foot-tiles.

21. With clinkers for (fables and out-offices.

22. With the bones of animals, for gardens, &c. And,

23. We have knob-paving, with large gravel-ftones for
porticoes, garden-feats, &c.

Pavers’ work is done by the fquare yard ; and the con¬
tent is found by multiplying the length by the breadth.

Pavements of churches, &c. frequently confift of (tones
of feveral colours ; chiefly black and white, and of feveral
forms, but chiefly fquare, and lozenges, artfully difpofed.
Indeed, there needs no great variety of colours to make
a furprifing diverfity of figures and arrangements. M.
Truchet, in the Memoirs of the French Academy, has
fhown by the rules of combination, that two fquare (tones,
divided diagonally into two colours, may be joined toge¬
ther chequerwife fixty-four different ways : which appears
furprifing enough; fince two letters, or figures, can only
be combined two ways. The reafon is, that letters only
change their fituation with regard to the firff and fecond ;
the top and bottom remaining the fame : but in the ar¬
rangement of thefe (tones, each admits of four feveral
fituations, in each of which the other fquare may be
changed fixteen times, which gives fixty- four combina¬
tions. Indeed, from a further examination of thefe fixty-
four combinations, he found there were only thirty-two
different figures; each figure being repeated twice in the
fame fituation, though in a different combination; fo
that the two only differed from each other by the tranfpo-
fition of the dark and light parts.

The paving of ftreets is one of the moft beneficial regu¬
lations of police that have been tranfmitted to us from our
anceftors. Several cities had paved ffreets before the com¬
mencement of the Chriftian era ; neverthelefs thofe which
are at prefent the ornament of Europe, Rome excepted,
were deftitute of thisgreat advantage till al moll: the 12th or
13th century. It is probable that thofe people who firff car¬
ried on the greateft trade, were the firff who paid attention
to have good ffreets and highways, in order to facilitate
that intercourfe which is fo necelfary to keep upthefpirit
of commerce. Accordingly we are told by Ifidorus (Origin.

1. xv. c. 16.) that the Carthaginians had the firff paved
ftreets, and that their example was foon copied by the
Romans. Long before that period, however, Semiramis
paved highways, as appears by the vain-glorious infcrip-
tion w'hicli (lie herfelf caufed to be put up. (Strabo, xvi.
Diod. ii. 13. Polyreni Stratagem, viii. 26.) The ftreets
of Thebes, and probably thofe of Jerufalem, were paved.
But neither the ftreets of Rome, nor the roads around it,
were paved during the time ofits kings. In the year 188,
after theabolition of the monarchical form of government,
Appius Claudius, being then cenfor, conffrufled the firff
real highway, called after him the Appian Way, and, on
account of its excellence, the Queen of Roads. The
time when the ftreets were firff paved cannot be precifely
afcertained ; fome have referred this improvement to the
year 578 after the building of the city; others to 584;
and others to 439 ; at w hich" feveral periods fome parts of
the city and fuburbs might have been paved. That ftreets
paved with lava, having deep ruts made by the wheels of
carriages, and railed banks on each fide, for the accom¬
modation of foot-paflengers, were found both at Hercu¬
laneum and Pompeii, is well known.

Of modern cities, the oldeft pavement is commonly af-
cribed to that of Paris ; (fee vol. xviii. p. 445.) but it is
certain that Cordova in Spain was paved fo early as the
middle of the 9th century, or about the year 830. That
the ftreets of London were not paved at the end of the
eleventh century, is afferted by all hiftorians. It does
not appear when paving was firff introduced ; but it was
gradually extended as trade and opulence increafed. Se¬
veral of the. principal ftreets, fuch as Holborn, which are
at prefent in the middle of the city, were paved for the
firff time by royal command in the year 1417 ; others

Vol. XIX. No. 1311.

were paved under Henry VIII. fome in the fuburbs in
J544, others in 1571 and 1605, and the great market of
Smithfield, in 1614. But the firff really-effeftive paving-
a£t was pafled in the year 1771. See the article London,
vol. xiii. p. 1 10.

To PA'VEMENT, v. a. To floor ; to pave. Not in nfc.
— Thou God of elements pafledft through the air, w'alk-
edft upon the waters ! Whether thou meanteft to termi¬
nate this miracle in thy body, or in the waves which thou
troddeft upon; whether fo lightening the one that it
(liould make no impreffion in the liquid waters, or whe¬
ther fo confolidating the other that the pavemeuted waves
yielded a firm caufey to thy facred feet to walk on, I
neither determine r.or inquire : thy filence ruleth mine ;
thy power was in either miraculous ; neither know I in
whether to adore it more. Bp. Hall's Contempt.

PAVEN'TIA, in mythology, the tutelary goddefs of
children. Among the Romans this goddefs was invoked
to avert frightful objefts from them.

PA'VER, or Pa vie r, J. One who lays with (tones :
For thee the fturdy paver thumps the ground,

Whilft every ftroke his labouring lungs refound. Gay.

PAVET'TA, /! [the Malabar name, retained by Rheede
and adopted by Linnseus and others.] In botany, a genus
of the clafs tetrandria, order monogynia, natural order
of ftellatae, (rubiaceae, Jujjf.) Generic characters — Ca¬
lyx : perianthium bell-fhaped, very fmall, obfoletely
four-toothed, furrounding the germ. Corolla : one-pe-
talled, funnel-form ; tube long, (lender, cylindric ; border
five-parted, fpreading, (horter by half than the tube ;
fegments lanceolate. Stamina : filaments four, very
(horr, above the throat of the corolla. Anthers awl-
(haped, fpreading, the length of the border. Piftillum:
germen inferior, turbinate. Style filiform, twice as long
as the corolla; ftigma thickifh, oblong, oblique. Peri-
carpium : berry roundifti, one-celled. Seeds two, convex
on one fide, cartilaginous. Gaertner fays, the berry is
two-celled ; and the feeds folitary, one often abortive,
fo that the fruit feems to be one-feeded. There are fre¬
quently two coadunate berries, crowned with a double
calyx. — Ejfential Character. Corolla one-petalied, fun¬
nel-form, fuperior; ftigma curved; berry two-feeded,
(one often abortive.) There are nine fpecies.

1. Pavetta indica: fmootli ; leaves lanceolate-elliptic,
ftipules fmooth within, calyxes obfoletely four-toothed,
flowers in bundles. Native of the Eaft Indies. Gasrtner
fufpeCls that the natural number of flowers is two to¬
gether, as in fome fpecies of Lonicera.

2. Pavetta tomentofa : leaves elliptical, downy, as well
as the flower-ftalks ; calyx cloven half way down ; ftyle
twice as long as the corolla. Sent from India by Dr.
Roxburgh, along with the former, from which it feems
to differ chiefly in its broader leaves, which, like the
flower-ftalks and calyx, are downy, efpecially when young.
The teeth of the calyx are much more conlpicuous than
in P. indica, and this chara&er appears of confequence,
from the confideration of other fpecies.

3. Pavetta villofa : branches and calyxes villofe hoary;
leaves lanceolate-elliptic ; flowers in bundles. Branches
oppofite, four-cornered, jointed, denfely villofe, hoary ;
the laft joints more comprefied. Leaves on (hort petioles,
oppofite, two or three inches in length, acuminate, atte¬
nuated at the bafe, quite entire : the younger ones villofe
on both (ides, hoary; the older almoff fmooth above,
nerved, veinlefs.

4. Pavetta longiflora, (Ixora occidentalis, Forjk. Aral.
io 5.) Branches fmooth, leaves lanceolate-elliptic, ftipules
hairy within, calyxes four-cleft, flowers in bundles. It
may be doubted whether it is any thing more than a va¬
riety of the preceding. The branches and leaves are
quite fmooth ; the calyx has a few fmall hairs fcattered
over it, not vifible without a magnifier. It differs from
the firff fpecies in having the ftipules hairy on the inner

5 H fide.

392

P A V

fide, the flowers twice as large, the calyxes four-cleft,
not obfcurely four-toothed. Thefe were both found in
Arabia Felix by Forfkahl.

5. Pavetta caffra : leaves obovate, flowers fubumbellate,
calyxes briftle-awned. This is a fmooth tree with round
branches. Head of flowers feffile, terminating the fliorter
branchlets. Flowers in the dried plant black. Native
of the Cape of Good Hope.

6. Pavetta barbata : leaves lanceolate-oblong, pointed,
fmooth; panicles forked, divaricated, fmooth; tube of
the corolla but half the length of the five-cleft limb,
briftly at the mouth. Gathered by the late Mr. Chrifto-
pher Smith, at Honimoa, one of the Moluccas, in 1797.
He fufpeCted it to be a Pavetta, and we can only prefume
it to be fo. The whole appearance agrees with the figure
of the next; and the flowers, as in that, are five-cleft ;
but their fliort tube diftinguiflies them from every other
fpecies.

7. Pavetta pentandra, (Pfychotria Pavetta, Swartz.
Ceftrum nervofum, Mill. Dift. Lonicera foliis lanceolato-
ovatis. Plum.') Leaves oblong-lanceolate acuminate,
panicle trichotomous axillary, flowers five ftamened.
This is a fhrub, with a flem the height of a man, upright,
branched, even. Branches ft iff, round, fmooth. Leaves
petioled, oppofite, acuminate, entire, nerved, thin.
Flowers white, very fweet-f'cented. It flowers in the
fpring; and is commonly called in Jamaica wild coffee.
It is as it were a middle fpecies between Pfychotria,
Coffiasa, and Pavetta, which are very nearly allied: but it
feems to approach neareft to the laft in its inflorefcence,
and the form of the flowers, although they have five fta-
mens. Sideroxyloides ferreum of Jacquin, Amer. .19.
which is Siderodendrum of Schreber, No. 169. is allied to
this. - Native of the Weft Indies. See Mr. Miller’s de-
fcription in Cestrum nervofum, vol. iv.

8. Pavetta arenofa : branches brachiate, leaves tubercled
oppofite. This alfo is a fhrub, unarmed, upright, four
feet high, with many brachiate reclining branches.
I.eaves lanceolate, quite entire, fhining, with many pro¬
minent tubercles on each fide, which make them appear
as if they had fand fprinkled on them ; whence it is called
in Chinefe the fand-plant. Flowers white. Native of
China, near Canton.

9. Pavetta paralitica: ftem paralitica], leaves in whorls,
flowers in little axillary balls. Stem perennial, woody,
a foot high, very much branched. Leaves ovate, tomen-
tofe, quite entire. Flowers dufky-yellow, final], villofe.
Frequent on trees in the gardens of Cochin-china.

To avoid confufion, Loureiro would place fuch of thefe
plants as have a one-feeded berry in this genus ; fuch as
have a two-feeded berry in that of Ixqra ; and thofe
which have a one-celled two-feeded berry in a new genus
which he names Polyozus. See alfo Coff^a and Psy-

CHOTRIA.

PAUGANA'RY, a town of Hindooftan, in Marawar:
ten miles fouth of Tripatore,

PA'VIA, a city of Italy, on the Teffino, fituated in a
beautiful plain. The citadel was once ftrong, but the
fortifications have been neglefited; the ftreets are broad
and ftraight, with fome good buildings, but nothing at
prelent appears to announce that it was once the capital
of Lombafdy. It is the fee of a biftiop, immediately de¬
pendent on the Pope; and,befides the cathedral, contains
eighteen parifh-churches, and thirty-eight convents.
The univerfity was founded by Charlemagne, and re-efta-
bliflied by Charles IV. Pavia was founded by the Gauls,
who were driven out by the Romans, and they in their
turn by the Goths, about the middle of the fifth century.
In the year 476 or 4.77, the town being completely
ruined, Odoacer granted the inhabitants an exemption
for five years, with permiflion to rebuild the town, which
till then had borne the name of Tifinum ; when rebuilt it
was called Prtpia, or Pavia-, and in the year 568, being
taken by the Lombards, it became the capital of their
kingdom, which ended with Didier, who was made pri*

"P A V

foner by Charlemagne in the year 774 ; after that it fuf-
fered feveral calamities between the inhabitants and the
Milanefe. It afterwards became the prey' of feveral ty¬
rants, before it fell under the dominion of the dukes of
Milan. In the year 1525, Francis I. kingof France, while
he was befieging this town, was taken prifoner by the Im-
perialifts. In the year 1 527, the French, under the com¬
mand of Lautreck, returned and lacked this unfortunate
city, fo that it has never recovered itfelf. In the year
1733, it was taken by the allies, and with its territory
followed the fortune of Milan.

The French republicans took the city of Pavia, without
firing a Ihot, on the 14th May, 1796: here they found
200 pieces of artillery, 8000 mulkets, 2000 barrels of
powder, a million of cartridges, and immenfe ftores of all
kinds, belonging to the Auftrians. After the treaty of
Campo Formio, 1797, it became the capital of the de¬
partment of the Teffino, in the Cifalpine Republic ;
and of courfe has, fince that time, followed the changes
which the fineft parts of Italy have inceffimtly undergone,
till its fate was fettled, for the prelent, by the general
Treaty of Vienna, June 1S15. Lady Morgan fpeaks of
its prefent ftate as follows :

“ At the diftance of four Italian miles from the Certofa,
at the extremity of a noble avenue of trees, and in a plain,
called for its fertility il Giardino MilaneJe, the Milanefe
Garden, rifes the imperial city of Pavia. At the entrance
of this Citta di Cento Torre (City of an Hundred Towers)
Hands the ancient caftle of the Vifconti, magnificent in
ruin. One among its well-preferved ftone-belted windows
was pointed out to us as belonging to Petrarch’s cham¬
ber. It was covered with wild plants, which hung in
flaunting feftoons for many feet down. While we gazed
on it, a foldier’s wife (for all that is habitable in this ve¬
nerable fabric is an Auftrian barrack) hung a fhirt to dry
over the foliage. The windows of the gallery, where Pe¬
trarch undertook to arrange thofe precious MSS. which
the clever defpot had collected, were covered with leather
belts, and other articles of the military toilet, from which
the fun was drawing exhalations of pipe-clay. Oppofite
to this exquifite fpecimen of the domeftic architecture of
the middle ages, Hands a modern building of nearly equal
extent and importance. This edifice was railed by the
French, for the purpofes of a foundry for cannon and for
an arfenal. Here immenfe machines were ereCted, and
moft ingenious water-works conftruCted. Here were
fchools for the artillery officers and engineers. The num¬
ber of hands employed in the fabrication of fire-arms and
cannon, difrufed induftry and fubfiftence among the poorer
part of the population. This building now lies wafte ;
and the workmen, of courfe, are thrown upon mendicity,
or other fources of exiftence. From the main ftreet ot
Pavia, others of greater antiquity branch off at right an¬
gles, where all is fad, defolate, and filent; fome terminate
in piasse, or fquares, opening before vaft and cumbrous
palaces, with windows half-fafhed, doors hanging from
their hinges, balconies mouldering over beautiful but
falling porticos, and the grafs fhooting up every where
between the pavement. In one of thefe by-ftreets is
fhown the fite of the imperial palace, when Pavia was a
royal capital. This was a palace of Theodoric, often
cited in the ftory of various barbarous invafions. It was
ftanding in all its Gothic grandeur in the eleventh cen¬
tury, when a popular infurreCtion againft the tyranny of
the emperor Henry II. levelled it to the ground.”

The Medical School at Pavia, under the direction of
the celebrated Scarpa, is an admirable inftitution. The
medical profeffors are ten in number; the profefforfhips
are thirteen. They are as follow : the inftitutes ot for¬
gery ; clinical medicine; botany; clinical furgery, by
Scarpa ; human anatomy, by Fattori ; operative furgery,
by Scarpa ; pathology and legal medicine; chemiftry, by
Brugnatelli ; materia medica ; phyfiology and compara¬
tive anatomy; pharmaceutic chemiftry, by Marabelli;
midwifery. In addition to thefe are profeflors in the fol¬
lowing

PAY

393

P A V

lowing departments : agriculture ; experimental pliilo-
fophy, by Volta and Configliachi ; natural hiftory ; gene¬
ral phyfics. An extenfive library belongs to the fchool,
and a fplendid mufeum of anatomy and the various
branches of natural hiftory. Thefe are contained in a
building much like the medical fchool in Paris, but twice
as large. The hofpital is an excellent one, and under re¬
markably good management. Theinduftry and fuperior
advantages of the head of the inftitution, M. Scarpa,
have contributed greatly to the benefit and improvement
of the fchool. Scarpa was the pupil of Morgagni, and col¬
league with Fontana. At the early age of eighteen he
was profelfor of anatomy at Modena. After this he was
a pupil of William Hunter in London, and then came
to fettle in Pavia. He has recently finiflied an improved
gorget for the operation for the (tone, one advantage of
which is that it enters the bladder with very little force
on the part of the operator. For the general ftate of me¬
dicine and furgery in Italy, at the prefent moment, fee
the article Pathology, p. 53 of this volume.

Pavia is feventeen miles fouth of Milan, and feventy-
two weft of Mantua. Lat. 45. 10. N. Ion. 9. 9. E.

PA'VIA,/. in botany, fo called by Boerhaave in ho¬
nour of Peter Pavius, who was profelfor of phyfic at
Leyden, and to whom the care of the Botanic Garden
there was confided in May 1592. The botanical profef-
forlhip being conferred upon Clufius two months after¬
wards, Bontius and Pavius were afl'ociated with him in
this charge for feveral years. In 1609 the whole de¬
volved upon Pavius, and he continued to enrich and im¬
prove the garden till his death in 1617. He does not ap¬
pear to have publilhed any thing, not even a catalogue
of the garden. The prefent plant is now referred by bo-
tanifts to another genus, fee ASsculus, in which it
bears the fpecific name of Pavia, and is well known in
our gardens as the fcarlet horfe-chefnut.

PAV'ID, adj. [pavidus, Lat.] Timorous; fearful. Cole.

P AVIDITY, f. Timorous. Cole.

PAVI'E, a town of France, in the department of the
Gers : three miles fouth of Auch.

PAVIGNA'NO, a town of Italy : ten miles eaft-north-
eaft of Brefcia.

PAVIL'ION, f. [ pavilion , Fr.] A tent; a temporary
or movable houfe. — -Flowers being under the trees, the
trees were to them a pavilion, and the flowers to the trees
a mofaical floor. Sidney.- — It was ufual for the enemy,
when there was a king in the field, to demand in what
part of the camp he refided, that, they might avoid firing
upon the royal pavilion. Addifon.

He, only he, heav’n’s b]ew pavilion fpreads,

And on the ocean’s dancing billows treads. Sandys.

To PAVIL'ION, v. a. To furnilh with tents :

Jacob in Mahanaim faw

The field pavilion'd with his guardians bright. Milton.

To be (heltered by a tent :

With his batt’ning flocks the careful fwain

Abides pavilion'd on the grafiy plain. Pope.

PAUILLAC', a town of France, in the department of
the Gironde: ten miles fouth-eaft of Lefparre, and twen¬
ty-four north of Bourdeaux.

PAVILLON' (Nicholas), a pious and celebrated
French prelate, was a fon of an advocate of the parlia¬
ment of Paris, in which city he was born in the year
1597. Being deftined to the church, he was placed un¬
der the direction of the famous Vincent de Paul, founder
of the Congregation of the Priefts of the Millions, who,
finding him well qualified for the purpofesof the fociety,
employed him in the work of preaching and inftruflion
in different parts of the kingdom. He alfo appointed
him director of the order of the Daughters of Charity,
and of the conferences for the inftruCtion of young eccle-
fiaftics. So high was the reputation which he acquired
by his virtues, his zeal, and particularly by. his pulpit-

talents, that cardinal Richelieu was induced to recom¬
mend him to king Louis XIII. who nominated him
bilhopof Alet in Lotver Languedoc. This diocefe need¬
ed the indefatigable zeal and exertion of fuch a perfon as
our prelate, to reclaim it from the ftate of ignorance and
vice into which it had been funk, owing to the licen-
tioufnefs introduced during the civil wars, as well as the
negleCt and diffipation of the ecclefiaftics. To this work
he applied with fteady and unceafing ardour, and had the
fatisfaCtion of being witnefs to a wonderful reformation,
both among the clergy and the people of the diocefe in
general. During the reign of Louis XIV. he fell under the
royal difpleafure, by uniting with thofe of his epifcopal
brethren who defended the writings of Janfenius. He died
in difgrace in 1677, when upwards of eighty years of age.
He was the author of “ A Ritual for the Ufe of the Dio¬
cefe of Alet,” with inftruCtions and rubrics in French,
1667, quarto. This work was complained againft before
the inquifition at Rome, and, after a fevere examination,
was placed among profcribed books in the Index , and
condemned by a decree of pope Clement IX. That de¬
cree, however was not received in France, where the Ri¬
tual had an extenfive circulation ; and the biftiop of Alet,
in defiance of the papal prohibition, continued the ufe of
it in his diocefe. He alfo publiftied an efteemed collection
of “ Ordinances, and Synodal Statutes,” from the year
1640 to 1647, which were printed in 1655, 12010.
Moreri.

PAVILLON' (Stephen), a man of letters, nephew to
the preceding, was born at Paris in 1632. He was edu¬
cated partly under his uncle, with whom he acquired a
great knowledge of divinity and ecclefiaftical hiftory.
His proper profeflion, however, was that of the law, and
he obtained the poll of advocate-general at Metz; but a
delicate conftitution, and a love of ftudy and retirement,
caufed him to refign that office, and devote himfelf to a
life of leifure. The amenity of his manners, and the
charms of his converfation, procured him many diftin-
guifhed friends ; and, during the fits of the gout to
which he was a martyr, his eafy chair was furrounded by
perfons of rank and eminence. His indolence or his phi-
lofophy caufed him to refufe the office of preceptor to a
young prince, though it would have made his fortune.
Louis XIV. gave him a penfion of two thoufand livres,
and madame de Pontchartrain, on fending him the bre¬
vet, told him that it was only till fomething better of¬
fered. Pavilion, who was then very ill, fent for anfwer,
that if the lady meant to be his benefactor, fhemuft make
liafte. He died in 1705, at the age of feventy-three. He
was a member both of the French Academy and of that
of Infcriptions, without having folicited a feat in either.
His literary reputation was chiefly founded on his poems,
which for the moft part were of the light kind, and were
charaCterifed by eafe, delicacy, and gaiety. He alfo
wrote letters on the manner of Voiture, with a mixture of
verfe and profe. The moft complete edition of his works
was printed at Paris in two fmall volumes, 121710. 1747.
Moreri.

PAVILLY', a town of France, in the department of
the Lower Seine : nine miles eaft-north-eaft of Caudebec,
and nine north-weft of Rouen.

PAYING, /. Pavement of ftone, brick, or tile. See
Pavement.

PAVISA'DO, /. [Spanifh.] A kind of defence to co¬
ver the towers in a galley. See Pavais.

PAUKATUCK', a river of Rhode Ifland, which runs
into thefea in lat. 41. 1 5. N. Ion. 71. 50. W. In the latter
part of its courfe it divides Rhode Ifland from Connec¬
ticut.

PAUL (St.) the great apoftle of the Gentiles, was of
pure Hebrew defcent, of the tribe of Benjamin, and born
at Tarfus, the metropolis of Cilicia, about three years
after the birth of Chrift, according to the moft probable-
computations of the learned. In his early life he was-
known by the Hebrew name of Saul; but, after the com¬
mencement

PAUL.

894

mencement of his preaching in Gentile countries, he was
generally called Paul , either, as fome think, out of com¬
pliment to Sergius Paulus, proconful of Cyprus, whom
he converted to Chriftianity, or becaufe it was more fa¬
miliar to the Greeks and Romans. He inherited from
his anceftors the privileges of a Roman citizen ; and it is
probable that he was initiated' in the knowledge which
he afterwards difcovered of the learning, religion, man¬
ners, and cuftoms,of the Greeks, in his native place, wdiich
was at that time diftinguifhed by eminent feminaries of
education. From Tarfus, his father, who was a Pharifee,
lent him to Jerufalem, where he was placed under the
tuition of Gamaliel, a celebrated rabbi of that feet, in
whofe fchool he made a great proficiency in the ftudy of
the law, and of the traditions pretended to be handed
down from Mofes and the prophets. In compliance,
likewife, with the Jewifh ctiftom of teaching the youth,
even of the higheft birth, fome mechanical employment,
that they might be enabled, in cafes of neceffity, to main¬
tain themfelves without being obliged to depend upon
the liberality of others, he was inftru6ted in the art of
“ a maker of mechanical instruments ;” for that fuch is
the true meaning of the word which has been commonly
rendered atent-maker, is fatisfaftorily Ihovvn by Michaelis.
He poffefied excellent natural abilities, quicknefs of ap-
prehenfion, Itrong paflions, and firm refolution. He ap¬
pears. alfo, from his early years, to have been remarkable
for an unblemifhed life ; faithful to the didates of his
confcience, according to the knowledge which he had
acquired j and zealous for the interelts of truth and vir¬
tue. It is true that, in the exercife of his zeal, he w'as
led by the prejudices of his education, and the example
of his brethren of the fed of the Pharifees, to unwarrant¬
able lengths in oppofing Chriftianity on its firft appear¬
ance in the world. Believing Jefus to be an impoftor, he
became the bitter enemy of all who made a profeffion of
his faith, and even thought himfelf bound in duty to per-
fecute and put them to death. Hence he was led to be
prefent at the cruel murder of the protomartyr Stephen,
and to fliow his approbation of it by taking care of the
upper garments of the falfe witneffes who took the lead
in ftoning him to death. Hence he became an active in-
ftrument of the malice of the Jewifti rulers againft the
believers in Chrift, after Stephen’s death; and, having re¬
ceived a commifiion from the chief priefts, “ made havock
of the church,” entering into the houfes where the difci-
pies met for the worfliip of God, and dragging men and
women to prifon that they might be punilhed. In confe-
quence of the feverity with which he thus harafted them,
many of the believing brethren fled from Jerufalem, and
were difperfed throughout Judea and Samaria, while
others took flielter in foreign cities.

So far was Paul carried by his falfe zeal againft the fol¬
lowers of Jefus of Nazareth, that, not contented with
perfecuting them in Judea, he obtained letters from the
high prieft to the fynagogues at Damafcus, with which,
accompanied by afiiftants equally bigotted with himfelf,
hefetout for that city, with the defign of bringing pri -
loners to Jerufalem fuch of the Jewifh inhabitants as were
profelytes to the new faith. When they arrived near to
Damafcus, a miraculous occurrence took place, which
defeated their intention, and converted Paul into a
preacher of that very faith wdiich he had been fo zealous
rodeftroy. At mid-day, a fupernatural light fuddenly
fhone around them, inexpreflibly more refplendent than
the brightnefs of the fun, which filled Paul and his com¬
panions with fuch furprife and terror, that they all fell
proftrate on the earth. While they were in this pofture,
Paul heard a voice, calling him by name, and mildly re¬
proaching him with the enmity which he difcovered to
his caufe. Upon Paul’s humbly alking wdio it was that
thus addrefled him ? he received foranfwer, <e I am Jefus,
whom thou perfecuteft,” At the fame time Paul was or¬
dered to ftand up on his feet, that he might have ocular
demonftration of the actual prefence of him whom the

chief priefts had crucified at Jerufalem, and of his having
really rifen from the dead, as his difciples affirmed. This
direction Paul obeyed, and diftinftly faw Jefus Handing
before him; but was fo unable to bear the dazzling
fplendour of his appearance, that he fell to the earth a
fecond time. Fully convinced that the high pretenf.ons
claimed for Jefus were fupported by divine power and au¬
thority, Paul now yielded himfelf up implicitly to his
will, declaring his readinefs to do whatfoever he fhould
command him. He was then informed that Jefus had
felefted him for one of his apoftles, and commiffioned
him to preach to the Gentiles in his name, and to turn
them from darknefs to light; and then direfted him to
go into the city of Damafcus, where he fhould be in-
ftrufited what he was to do. Such w'as the effect of the
fupernatural brightnefs which accompanied this appear¬
ance of Jefus, that it had ftruck Paul blind, fo that he
was obliged to be led by his companions to the houfe of
a perfon with whom they appear to have been acquainted ;
and in this condition he remained three days, which he
fpent in continual faffing, as a proper expreffion of his
bitter grief for having perfecuted the difciples of Jefus,
and in offering up fervent prayers to God for the pardon
of that fin. During this time, among other vifions and
revelations for his information refpefling what he was to
do, he faw a man named Ananias coming in, and by put¬
ting his hand on him restoring his fight. On the third
day of his faffing, this Ananias, who was highly efteemed
by all the Jews at Damafcus for his piety and virtues,
and had become a difciple of Chrift, being directed by a
vifion, came to the houfe wdiere Paul was, whofe fight
wras reftored in the manner which had been fhown to him ;
after which he immediately fubmitted to the rite of bap-
tifm, in token of his faith, repentance, and pardon. This
ceremony was followed by his reception of the fame ex¬
traordinary and miraculous powers which diftinguifhed
the other apoftles, and was a neceffary qualification for
the great employment to which he was appointed.

The converfion of St. Paul, according to the moil pro¬
bable evidence which has been collected by the learned,
took place in the year of Chrift 36, or the beginning of
37, when he was in the thirty-fourth year of his age.
After this event he continued only a fhort time with the
difciples at Damafcus, and then went into Arabia. In
this country he was inftrudfed by immediate revelation
in the duties of his office, and the doftrines of the gof-
pel ; which, fince the afcenfton of Chrift, was the only
proper method of training an apoftle. He alfo received,
in the fame mode of communication, a complete know¬
ledge of whatever took place during the miniftry of
Chrift on earth ; of his fayings, miracles, fuftermgs, cru¬
cifixion, refurreftion, and afcenfion ; ot the defign both
of the law' and the gofpel, and of the confirmation which
the latter derives from the writings of Mofes and the pro¬
phets ; by which means he was qualified to preach the
gofpel, to teftiry the refurreftion of Jefus, and to prove
him to be the Chrift, without receiving either inftruftion
or gifts through the medium of the other apoftles. Af¬
ter continuing in Arabia more than two years, Paul re¬
turned to Damafcus, where he preached in the fynagogues,
proving that Jefus was the Chrift, or promifed Meffiah,
with fuch eloquence, force, and cogency of argument,
that the Jews in that place were confounded and lilenced.
Provoked at their defeat, they formed a defign againft his
life ; and prevailed upon the governor to guard the city
fo Itriftly, in order to prevent his efcape, that the difci¬
ples were obliged to let him down by the wall, through
a window, in a baflcet. Having by this means eluded the
vigilance of his enemies, Paul fet out for Jerufalem,
whence he had been abfent more than three years,
preaching that Jefus was the Chrift in the different towns
through which he parted, as he had done at Damafcus.
When he came to Jerufalem, he endeavoured to unite
himfelf with the difciples; but, as it was a time of per¬
fection, they were afraid of him, not having received

3 any

395

P A

any intelligence about what had parted at Damafcus, and
in the way thither, and being fufpicious that he afl'umed
the charafter of a: believer for the purpofe of betraying
them. However, he met with Barnabas, who, when he
heard of what had befallen Jiim, was fatisfied of the
reality of his converfion, and introduced him to James
and Peter. After this he was willingly received by the
other difciples, whom he alfo convinced of his fincerity,
by the boldnefs with which he defended the caufe of
Chrift, particularly againfl the Jewilh profelytes from
the Grecian provinces, whofe zeal for the inftitutions of
Mofes had brought them to Jerufalem. Thefe perfons,
as is not uncommonly the cate with new' converts to any
caufe, were fo warmly attached to the fyftem, which they
had recently adopted, that they were filled with the tu¬
rn oft rage againfl: Paul for preaching Jefus 5 and, being
alfo inlligated by the rulers, who could not forgive him
for going over to the perfecuted party, they formed a
plan for putting him to death. Intimation of their de¬
sign having been conveyed to the brethren, they prevent¬
ed it from being carried into execution by conducing
him in fafety to Caelarea, whence they advifed that he
fhould go to Tarfus, thinking that he might preach the
gofpel to the Jews in his native city^with more fuccefs
and lefs hazard, than in Judea. Accordingly Paul came
to Tarfus, where he appears to have continued three or
four years. Though the facred hiftory does not give
any particulars of his proceedings during that period,
yet we cannot doubt but that he was bufied in the work
of the miniftry, preaching in the name of Chrift to native
Jews and profelytes to the Jewifti religion. It is proba¬
ble alfo, that, though Tarfus was his home, yet, as it was
fituated upon the fea-coalt, he vifited from thence many
other places, for the purpofe of preaching the gofpel;
and that in his travels by land, or fliort voyages to neigh¬
bouring countries, he met with fome of thofe difafters
and fhipwrecks to which there is a reference in the recital
of his fufferings which he made to the Corinthians.

In the mean time, the perfecution of the churches in
Judea having ceafed, Peter vifited the difciples in differ¬
ent parts of that country 1 and, in obedience to the di¬
vine command communicated in a vifion, went to the
houfe of the centurion Cornelius at Caefarea, where he
preached to Gentiles ; and gave fuch an account of the
reafons for that proceeding to the apoftles and brethren
at Jerufalem upon his return, as led them to acquiefce in
it, and to glorify God for “granting unto the Gentiles
alfo repentance unto life.” During the time of perfecu¬
tion, fome Jews of Cyprus and Gyrene who were driven
from Jerufalem, travelled to Phenice, and Cyprus, and
Antioch, in which places they preached the gofpel to
Jews, and the profelytes to Judaifm. Some time after
their arrival at Antioch, hearing of Peter’s having deli¬
vered the truths of the kingdom of God to the Gentiles
at Csefarea, they alfo extended their miniftry to the
Gentile inhabitants of the city where they refided, fome
few of whom might portibly be devout men like Corne¬
lius, but the greateft part of them mu ft have been heathen
idolaters. So abundant was the fuccefs which attended
their labours, that when information of it was brought to
the church at Jerufalem, they fent Barnabas to confirm
the new converts ; and fo great was the fpeedy increafe
of their numbers under his miniftry, that, finding the
work too heavy for himfelf alone, and wifliing to have
the a Alliance of an able fellow-labourer, he went to Tar¬
fus, whence he brought Paul to Antioch, in the year 43.
Here they continued their joint labours for a whole year,
and made fuch conliderable additions to the number of
believers, that they attracted the particular notice of the
heathens, and were for the firft time diftinguilhed by the
denomination of Chrijlians.

While Paul continued at Antioch, he appears to have
had thofe vifion s and revelations mentioned by him to
the Corinthians, in which he fpeaks of himfelf as hav¬
ing been caught up into Paradife, where he heard and

Vol. XIX. No. 1 3 1 1.

U L,

faw things of which he was not permitted to fpeak 5 but
which were made known to him in this extraordinary
manner, to encourage him in the arduous and dangerous
undertaking of preaching the gofpel to the Gentiles.
During the fame time, a prophet called Agabus having
predicted that the whole land of Judea was about to he
vifited by a great famine; the new converts at Antioch
made liberal contributions for their relief in proportion
to their refpeftive abilities, and fent them to the elders of
the church at Jerufalem by the hands of Paul and Bar¬
nabas. It appears to have been during this vifit to that
city, which was in the year 44, that Paul, while praying
in the temple, was thrown into a trance or extacy, in
which he had a vifion of Chrift, who commanded him to
haften his departure, that he might proceed on that mil¬
lion into Gentile regions, for which he was particularly
defignated when called to the office of an apoltle. In
obedience to this command, Paul and Barnabas left Jeru¬
falem and returned to Antioch, accompanied by John,
whofe furname was Mark, whom they took with them as
their afliftant in the miniftry. From Antioch, after be¬
ing folemnly recommended to the divine blefling by
prayer and the imposition of the brethren’s hands, accor¬
ding to the cuftom of thofe countries, they proceeded to
Cilicia; and from thence they failed to Cyprus, where
they preached with great fuccefs both in the Jewilh fyna-
gogues, and before the idolatrous Gentiles, and converted
the proconful, Sergius Paulas, by the excellence of their
doSrine, and the miraculous punilhment of Barjefus, or
Elymas, the pretended magician, for his infidious opposi¬
tion to it. Departing from Cyprus, they landed at Perga,
in Pamphilia, where John Mark deferted them, as we
have related in vol. xiv. p. 371. and from thence they
travelled to Antioch, the capital of Pifidia, Icon! urn in
Lycaonia, Lyftra, Derbe, and other cities and diflrifts in
Alia Minor, in which they made multitudes of profelytes,
and wrought many miracles in fupport of their doilrine.
The account of this progrefs, which lafted two or three
years, though given, upon the whole, with great concife-
nefs in the hiftory of the A els of the Apoftles, contains,
neverthelcfs, two remarkable fpeeches of St. Paul, and
Sufficiently circumftantial relations of the principal inci¬
dents which befel them.

After their return from this journey, it is faid of our
apoftles, that “ they abode long time with the difciples in
Antioch.” While they continued in this city, a circum¬
stance occurred which gave rife to a conliderable difeuf-
fion among the primitive believers, and occafioned a me¬
morable decree of the apoftles and elders refpefting the
obfervances of the Mofaic ritual. Some mistaken profe¬
lytes, who came to Antioch from Judea, zealoufly
taught the brethren, in public and private, that unlefs
they were circumcifed, according to the' manner pre¬
scribed in the law of Mofes, and obferved the whole fyf-
tem of his precepts, they could not portibly be Saved by
the Gofpel, which was intended to make all that are con¬
verted to it Jews : and that they could not other wife be
true and genuine Chriltians. This dofirine, which could
not but be difagreeable to the converts from among the
Gentiles, was ftrenuoufly oppofed by Paul and Barnabas,
who maintained, that Chriftians converted from other
nations were as free from the Mofaic law, as if it had
never been given at all. In order to obtain fatisfaftion
on a point which affe£led the liberties and confciences of
a vaft number of believers, the church at Antioch re-
folved, that Paul and Barnabas, accompanied by Titus,
who was a Gentile convert, and fome others of. their
number, fhould go up to Jerufalem, and he governed by
the decifion of the apoftles and elders in that city on this
grand queftion. Accordingly, they repaired thither,
where, on an appointed day, an aflembly or council was
held, which, after much debate, occafioned by fome be¬
lievers of the fe6l of the Pharifees who were ftill zealous
for the ohfervance of the ceremonial law, determined that
the Gfintiles ought not to be fubjecled to the burthens
5 I of

598 P A

of the Mofaic ihftitution, and that by the Oofpel they
were called to a perfect law of liberty. That their deci-
fion might have the more weight with the Chriftians at
Antioch, they deputed Judas and Silas to accompany
Paul and Barnabas on their return to that place, that
they might attell by word of mouth what was the unani¬
mous judgment of theaffembly. This council was held
in the year of Chrift 49 or 50.

Not long after their return to Antioch, Paul made a
propofal to Bacnabas, that they ffiould vifit the brethren
in every city where they had made converts to the caufe
of Chrift, and examine what was the ftate of religion
amongft them. On this occafion Barnabas determined to
take with them John Mark; to which meaftire Paul
would not confent, on account of his former defertion of
them. To fuch a length was the difference carried be¬
tween the two apoftles on this head, that they feparated
from each other, and Paul chofe Silas for the companion
of his travels. Having departed from Antioch, they
went through Syria and Cilicia, confirming the churches
and making new converts; and afterwards they went
into Lycaonia, where Paul found Timothy at Lyftra, and
took him for one of his affiftants in preaching the gofpel.
From this country they palled into Phrygia and Galatia,
where they confirmed and founded many churches; and
then came to Troas, a noted fea-port, where travellers
from the upper coafts of Afia commonly embarked to
pals into Europe. At this place they were joined by
Luke ; and Paul had a vifion, in which he was directed to
proceed to Macedonia, and to commence profelyting the
Greek nations of Europe to the Chriltian faith. In obe¬
dience to the heavenly admonition, he took fiiipping
with his three affiftants, and landed at Neapolis on the
Thracian (liore, whence they proceeded to Philippi, the
chief city of that part of Macedonia, and a Roman co¬
lony. Here they continued fome time, preaching the gof¬
pel with great fuccefs both to Jews and Gentiles, and lay¬
ing the foundations of a numerous church, to which Paul
afterwards directed one of his Epiftles. Among other
proofs by which that apoftle eltablilhed his claim to a di¬
vine commiffiion, was the reftoration to her right mind of
an infane female Have, who, from the incoherent rhapfo-
dies which lhe uttered, was fuppofed to pofl'efs a fpirit of
infpiration, and brought much profit to her mailers from
the credulous multitude, who believed hercapableof pre-
diiffiins; good or ill fortune and of refolving difficult quef-
tions. Exafperated that by this cure their hopes of fu-
ture gain were at an end, thefe men feized Paul and Silas,
dragged them before the praetors of the city, and accufed
them of introducing a new religion, in oppofition to the
laws. This accufation excited the cry of the affembled
populace againft them; and the magiftrates were fo regard-
lei's of juftice, that, without any trial, they commanded
that they ffiould be ftripped, and feverely beaten with
rods ; after which they were put into the flocks, in the
moll fecure room of the common prifon. This injurious
treatment the apoftle and his fellow-prifoner fuftained
with fortitude and joy ; for in the middle of the night
they were diftiniftly heard praying and finging praifes to
God. While they were thus engaged, on a fudden a
miraculous earthquake took place, which burll open all
the doors of the prifon, and loofened the fetters from off
all the prifoners. This fnock awakened the jailor, who,
upon finding the prifon-doors open, drew his fword, and
would have killed himfelf, fuppofing that the prifoners
had all made their efcape, and that lie fhould be accufed
of connivance and treachery ; but Paul prevented the
defperate deed, by calling out to him with a loud voice
not to do himfelf any harm, fince all the prifoners re¬
mained quiet in their rooms. Upon this the jailor called
for a light, and came trembling and fell down before Paul
and Silas, whom he immediately brought out from their
place of confinement, earnellly enquiring how he might
fecure that falvation which was the fubjedt of their preach¬
ing. So powerfully convincing was the difeourfe which

U L.

they then held concerning the charafler and doctrine of
Chrift, that the jailor and all his family profeffed theru-
felves believers, and were baptized that very night. On
the next day the praetors, who had moft probably been'
terrified by the earthquake, and had doubtlefs heard of
the miraculous opening of the prifon-doors, fent their
lffitors with an order for fetting Paul and Silas at liberty.
But Paul thought it now proper that he and his fellow-
fulferer fhould announce their civil rights as Roman citi¬
zens, and take the opportunity of animadverting on the
illegal proceedings of which they were the victims.
They therefore refufed to be difmiffed privately like cri¬
minals who had received mercy, but infilled on the magif¬
trates conducing them refpe&fully out of the prifon, as
the lealt reparation for the arbitrary violation of their
privileges. No fooner were the praetors informed thaS
Paul and Silas were Roman citizens, than they became
alarmed for the confequences of their own illegal con-
ducl, well knowing that they had expofed themfelves to
very high penalties, fhould the injured parties carry on a
procefs againft them. With thefe impreffions they re¬
paired to the prifon; and, after entreating the fufferers not
to refent the wrongs which they had received, publicly re¬
leafed them in an honourable manner, requefting at the
fame time that they would depart peaceably from the
city, to prevent any popular tumults, and that they
might not be expofed to the difappointed rage of their
accufers. Having, therefore, comforted and taken his
leave of the brethren, with whom Luke remained behind,
Paul departed From Philippi, accompanied by Silas and
Timothy.

The next place where Paul founded a Chriftian church,
was at Theflalonica, a large commercial city in Macedo¬
nia, where there was a Jewilh fynagogue. Here Paul
reafoned three fabbath-days with the people of his own
nation, proving from their feriptures the claims of Jefus
to the charafler of the Meffiah ; and, though the num¬
ber of converts from amongft them was but fmali, five
apoftle bad much better fuccefs with the profelytes to
Judaifm, and even with the idolatrous Gentiles, great
numbers of whom were convinced, both by his preaching
and by the miracles which he wrought. This fuccels
excited the envy and indignation of the unbelieving
Jews, who inftigated a riotous and profligate mob to col¬
lect together, which threw the whole city into confuficn.
With thele inftruments they attacked the houfe of Jafon,
with whom Paul and his companions lodged, hoping to
make them the viftiins of popular fury; and, when they
could not find them, they feized Jafon, and fome others
of the brethren, and dragged them before the rulers of
the city, accufing them of receiving and giving ffielter to
men who created diftnrbances wherever they came, and
who promoted rebellion againft Caefar, by preaching up
obedience to “another king, one Jefus.” But the ma-
gillrates, after examining into the formidable charge,
finding that it relied on a mifconception or defigned per-
verfion of the apoftles’ language, contented themfelves
with taking fecurity of Jafon and the others for their
good behaviour, and then difmiffed them.

The brethren, however, fearing fome new tumult
might arile, fent away Paul and Silas by night to Bercea,
a populous city in the neighbourhood, where they met
with great fuccefsin gaining profelytes, both from among
the Jews and Gentiles, till fome unbelieving Jews from
Theflalonica found means to excite the popular clamour,
particularly againft Paul, whom it was thought proper
to conduct privately to Athens, where he waited for his
brethren. His arrival at this city appears to have bedn
either towards the clofe of the year 51, or at the com¬
mencement of 52. Athens, though now pad the zenith
of its political fplendour, was thegreatell feat of learning
and politenefs in all the Roman empire, where almoft all
the Roman youth of family and fortune were fent to
ftudy philofophy, polite literature, and the liberal arts,
under the ablelt profeflbrs of the age. It was at the

fame

397

P A

fame time equally diftinguiflied for t'ne multitude of its
temples and altars, and for the attachment of the people
to the fuperltitious rites an'd ceremonies of poly theiltic
worfhip, which had been handed down to them from
their anceftors. The abjeft idolatry in which they were
funk, notwithftanding their advantages for acquiring
knowledge, induced Paul, not only to preach to the
Jews and their profelytes in the fynagogues, and to dis¬
pute with them on the diftinguifhing tenets of Chriftian-
ity, but to feize every opportunity of difcourfing on them
with thofe Athenians wjiom he met with in the public
edifices in the great forum or market-place. Here lie had
for opponents forne of the Epicureans and Stoics, which
were the moll diftinguifiied lefts of philofopiiers at that
time, who brought him to the Areopagus, where the il-
lultrious court fat which took cognizance of all matters
relating to religion, that he might give thofe judges a
particular account of the doftrine which he advanced.
In the feventeenth chapter of the Afts of the Apoftles,
we have an interefting account of the addrefs and elo¬
quence which Paul difplayed on this occafion, fo as to
avoid giving offence to his audience, while he enforced
the great principles of natural and revealed religion, and
fliowed the abfurdity of the commonly-received idolatry.
But, when he fpoke of the refurreftion of the dead,
fome made a jefl of the doftrine, while others promifed
to hear him again on that fubjeft; and, having thus
fpoken, they put an end to the apoflle’s difcourfe and to
the affembly. Finding but little profpeft of fuccefs with
men whofe minds were barred by prejudice and the pride
of worldly wifdom againft the reception of the fimple
truths of the Gofpel, the apoftle foon took his leave of
Athens, and proceeded to vifit other parts of Greece.

In the year 52, Paul came to the populous and wealthy
city of Corinth, where he chiefly redded during a year
and fix months, and made numerous converts from the
Jews and Gentiles in that place and the neighbouring
country of Achaia. Provoked to rage at his fuccefs, the
unbelieving Jews concerted a plot againft Paul, on whom
they made a violent aflault, and carried him before the tri¬
bunal of Gallio, the proconful of Achaia, tumultuoufly
accufing him of perfuading the people to follow a mode
of worfhip which was not fanftioned by the laws ; but
Gallio, wifely and equitably regarding the alleged charge
to be no offence againft the peace and good order of fo-
ciety, and not to call for his interference as a civil magif-
trate, ordered the accufers of Paul to be driven away
from his tribunal. He was alfo fo fully convinced of the
bigoted malignity which had prompted the Jews to this
proceeding, that he overlooked the irregular conduft of
the Greeks, who violently beat Softhenes the ruler of the
fynagogue, even under the eye of the magiftrate, by way
of punifhment for the confufion of which he had been
an aftive promoter. After fome further ftay in Corinth,
Paul embarked for Syria at the port of Cenchrea, accom¬
panied by Aquila and his wife Prifcilla, converts to the
Chriftian faith, having fhaved his head, according to the
cuftom of the Jews, in confequence of a vow into which
he had entered to exprefs his gratitude to God for his
deliverance from the dangers to which he bad been ex-
pofed. As the veflel in which they failed had occafion
to touch at Ephefus, Paul would not negleft the oppor¬
tunity which offered of preaching Chrift, but entered the
Jewifli fynagogue, and argued fo powerfully in favour of
nis pretenfions, that he made no little impreffion on his
auditors, who expreffed a defire that he would continue
fome time with them ; with which his vow would not
permit him for the prefent to comply. Refuming his
voyage, therefore, he failed to Caefarea, whence he went
to Jerufalem, where he completed his vow, and kept the
feaft of Pentecoft. When the feaft was over, and he had
enjoyed a fhort friendly intercourfe with the church in
that city, he went to Antioch ; and, after fpending fome
time there, commenced a progrefs through all Galatia
and Phrygia, vifiting and confirming the churches which

U L.

he had before eftabliflied in thofe countries. In this
journey Paul had feveral adiiiants, and, among others,
Timothy, Titus, and Softhenes, his former enemy at
Corinth, who had become a convert to the Gofpel. With
thefe companions he came to Ephefus towards the dole
of the year 53 ; and to that city, including tnoft probably
the contiguous diftrifts, he confined his perfonal labours
till the year 56.

The firlt perfons to whom Paul preached Chriftianity
at Ephefus, were his countrymen the Jews, in whofe fy-
nagogue “ he fpake boldly for the fpace of three months,”
veafoning in defence of the truth of the gofpel-difpenfa-
tion. And, when he found that the greater number of
them were hardened by their prejudices againft conviftion,
he withdrew with the difciples whom he had made to the
fchool of one Tyrannus, who was probably an orator
or philofopher, where he preached and maintained the
Chriftian doftrine againft all opponents; by which means
it was widely difleminated among the Jews and Greeks,
who flocked to that city from the neighbouring province
of Alia. At the fame time Paul confirmed this doftrine
by the numerous extraordinary miracles which he
wrought, and the fupernatural gifts which he communi¬
cated to fome of the believers, who had been prepared
for the reception of Chriftianity by the preaching of John
the Baptift. But this fuccefs which attended his labours
excited againft Paul the enmity of the bigoted worfhip-
pers of Diana, whofe temple at Ephefus was, on account
of its magnificence, reckoned one of the wonders of the
world; and it particularly alarmed the jealoufy of one
Demetrius and his fellow-craftfmen, who procured great
profit by making filver fhrines, or fmall models of the
temple and image of the goddefs, which were fold to the
crowds who came from diftant parts to worfhip her.
Thefe men perceiving that, if the doftrine of Paul pre¬
vailed, their trade would foon be at an end, collefted to¬
gether their workmen, and, by an inflammatory addrefs
to their fuperftition and avarice, roufed them to the high-
eft pitch of fury againft Paul and his afiociates, and led
them to unite in the common cry of Great is Diana of the
Ephejians ! With this cry they ran about the ftreets,
giving the alarm to the populace, till the whole city was
thrown into confufion ; and having feized upon Gaius
and Ariftarchus, two of Paul’s companions, they dragged
them to the theatre, probably with the defign of throw¬
ing them to the wild beads which were ufually kept
there. In this critical fituation of his friends, Paul
would have ventured to go into the theatre, that he
might endeavour to bring the multitude into a better
temper, had he not been diffuaded by other friends,
among whom were fome of the principal people in the
province. At length, after the uproar and confufion of
the affembled crowd had lafted about two hours, the
town-clerk, or proconful’s fecretary, to whom the direc¬
tion of affairs in the city was committed, by his autho¬
rity obtained filence ; when, after fecuring their atten¬
tion by an addrefs in which he availed himfelf of their
prejudices, he reproved them for the irregularity of their
proceedings, by which they had rendered themfelves
amenable to the higher powers. He added, that if De¬
metrius and ids fellow-craftfmen had juft ca ufe of com¬
plaint againft the men in cuftody, or any other perfons,
the way to obtain redrefs and the punifhment of the of¬
fending party, was by an appeal to the courts of law
and magiftracy, which were always open for the adminif-
tration.of juftice. Having thus fpoken, he dif’miffed the
affembly, and fet the prifoners at liberty.

Some time after this riot, Paul took his leave of the
church at Ephefus, and travelled into Macedonia ; whence
he went to vifit the churches which he had planted‘in
Achaia, Corinth, the Peloponnefus, and other countries.
Of thefe journeys, which employed the apoftle during
two years, we have no regularly-digefted account ; but it
is probable that in that interval he went into Illyricum,
and alfo to Crete, where it is certain that he perfonally
4 laboured

338 P A

laboured in propagating the Gofpel. Having received
very large contributions from the Greek churches, for
the relief of the poor Chriftians in Judea, at Paul’s parti¬
cular requeft deputies were chofen to accompany him to
Jerufalem, that they might be witnefles of their beingap-
plied to the objedls intended. With thefe deputies, and
accompanied by Luke, Paul came from Corinth to Phi¬
lippi, where they embarked for Troas. Here Paul (laid
fome days, in order to confirm in the faith the numerous
Chriftian converts in that city and neighbourhood: and
in this interval he miraculoufly reftored to life a young
man who was accidentally killed by falling from the third
ftory of the houfe where the apoftle was-preaching. In
the twentieth and twenty-firft chapters of the A6ts, we
are prefented with the particulars of Paul’s progrefs from
Troas to Jerufalem, which it is not neceflary to detail ; a
record of his very important and pathetic difcourfe upon
his taking final leave of the elders of Ephefus at Miletus;
and an account of his courageous refolution in perfifting
to proceed on his journey, notwithftanding repeated pre-
didlions of the troubles in which he would be involved
by his unbelieving countryman.

Paul arrived at Jerufalem in the year 58, in time to ob-
ferve the feaft of Pentecoft. On. the next day after his
arrival, he had a meeting with the apoftle James, and
the elders of the church, to whom he introduced the com¬
panions of his journey, in whofe prefence, no doubt, he
delivered up the charitable contributions which he had
brought with him for the relief of the poor Chriftians in
Tuden. He then gave them a particular account of his great
fuccefs in planting the Gofpel among the Gentiles ; which
was received by them with the higheft fatifaftion. As,
however, a falfe report had been propagated at Jerufalem
and in Judea concerning Paul, that he taught the Jews
in Gentile countries to forbear circumcifing their chil¬
dren, and entirely to renounce the law of Mofes, the
apoftle James and the elders advifed him ontheprefent oc-
cafion, when there was fuch a confluence of the Jews from
all parts at the feaft, to fatisfy them that it was udthout
foundation, by aflifting four of the brethren who were
under a vow, while discharging the fame in conformity
to the Jewifti ritual. To this advice Paul readily afiented;
and on the next day, after purifying himfelf with thefe
Nazarites, he entered with them into the temple, to fig-
nify to the priefts their refolution to accomplifh the days
of purification, as the law required, till an offering fliould
be offered for each of them. Before the days of purifica¬
tion were completed, fome Jews, who had violently op-
pofed Paul while he was propagating the Gofpel in the
province of Afia, perceiving him and his companions in
the temple, raifed a loud outcry againft the apoftle, ac-
cufing him of teaching every-W'here principles fubverfive
of the law of Mofes, and even of polluting the temple by
bringing uncircumcifed Greeks into it. Thefe charges
having highly enraged the affembled multitude, they laid
hold on Paul, and dragged him tuinultuoufly out of the
temple, with the defign of beating or ftoning him to
death. In the mean time intelligence of the tumult had
been brought to Lyfias, the commander of the Roman
garrifon in the adjoining caftle of Antonia, who, know-
j,no- well the importance of checking fuch commotions at
their firft appearance, came to the place with a band of
foldiers, and, having refcued Paul from the fury of the
crowd, commanded that he fliould be kept in chains at
the caftle, till he had made enquiry into his character
and behaviour. He was pleafed, however, at Paul’s re¬
queft, to permit him to fpeak to the people from the flairs
leading to the caftle, before he was placed in confine¬
ment A Of this indulgence Paul availed himfelf to refute
the accufations of his enemies, and to lay before them a
Ihort account of his life and converfion. This he did in
the Hebrew tongue, which procured him filence and at¬
tention, till he mentioned the commiflion which he had
received from Chrift to preach to the Gentiles; when the
Jews broke out into a frefh tranfport of rage againft him,

U L.

and united in the loud cry, “Away with fuch a fellow
from the earth, for it is not fit that he fhould live.”

When Lyfias perceived that Paul’s fpeecli, which was
to him unintelligible, had rather exafperated than np»
peafed the multitude, he gave orders that he fhould be
brought into the caftle, and put to thequeftion by fcoung-
ing, that he might know the real caufe of their hatred to
him. This cruel treatment, however, the apoftle efcaped,
by declaring himfelf a Roman citizen, and claiming the
privileges of his birthright. On the following day Lyfias
releafed Paul from his fetters, and brought him before
the Jewifti council, that lie might learn with certainty
what the crimes were of which he was accufed. In this
council, which confifted of members belonging to both
the fe£ls of Pharifees and Sadducees, the apoftle, after
boldly infilling on the unimpeachable innocence of his
life, avowed himfelf to be a Pliarifee, the fon of a Pha-
rifee, and maintained that the perfecution which he fuf-
fered was partly to be attributed to his zeal in propagat¬
ing the dodlrine of the refurreftion of the dead. Upon
this, a warm conteft arofe in the council between the
parties of the Pharifees and Sadducees : the former, with
whom the dodlrine of the refurreftion was a fundamental
tenet, being difpofed to come to a refolution that all
further proceedings againft the prifoner Ihould be relin-
quifhed ; while the Sadducees, who denied that dodtrine,
ftrenuoufly oppofed fuch a meafure. At length they be¬
came fo violent in their diftenfion and clamour, that
Lyfias, fearing left Paul fliould be torn to pieces amidll
the tumult, fent foldiers to take him by force from the
midft of them, and to bring him back into the caftle.

During the fucceeding night Chrift appeared to Paul in
a vifion, encouraging him with hisapplaufe for the forti¬
tude and fidelity which he had difplayed in his fervice,
and informing him, that as he had maintained his caufe
at Jerufalem, he was alfo deftined to fupport it at Rome.
On the following day, more than forty of Paul’s enemies
entered into a plot to aflaflinate him ; but Lyfias, having-
been made acquainted with their defign, difappointed
their malice by fending him away in the night, under
the fafeguard of a ftrong body of troops, to be condufted
to Crefarea, the refidence of Felix the governor of Judea,
to whofe tribunal lie referred the apoftle’s accufers. So
intent were the enemies of Paul on his ruin, that five
days after his arrival at Csefarea, Ananias the high-pried
came to that place, accompanied by fome of the elders
who were members of the fanhedrim, and an orator, or
profefied pleader, named Tertullus, in order to profecute
the prifoner. Accordingly, at a fixed time they appeared
before the governor ; wheb Tertullus, after an adulatory
encomium on the adminiftration of Felix, (which it was
very -far from meriting,) accufed Paul of fedition, of being
a fedlary, and of profaning the temple; and to thefe charges
the Jewifti dignitaries gave theiraifent. So ably, however,
did Paul acquit himfelf in his defence, that he proved the
accufations of fedition and profaning the Temple to be
wholly unfupported by evidence. As to the charge of
his being a feftary, he acknowledged that, after the way
which they called herefy, he worfliipped the God of his
fathers ; but maintained that by fo doing he was not
guilty of any crime, fince he believed all things that were
written in the Law and the Prophets. Upon this, Felix
deferred giving his judgment upon the matter till he
fliould have an opportunity of learning further particulars
from Lyfias; but fo fully convinced was he of Paul’s in¬
nocence, that he ordered the centurion who had the care
of him to allow him every indulgence which was confid¬
ent with his fituation as a prifoner, and to admit his
friends to vifit him without reftridtion.

Some time after this, Paul was fent for to give a parti¬
cular account of his principles as a Chriftian before Felix,
and his wife DrufiUa who was a Jewefs ; 011 which occa-
fion he took the opportunity of expatiating with fo much
energy on the fubjedls of juftice, temperance, and the
judgment to come, that Felix, who was notorious for his

oppreftton

PAUL.

309

oppreflion and licentioufnefs, was unable to conceal the
emotions which agitated his bread. He therefore dif-
rnifled the apodle for the prefent ; but he afterwards fre¬
quently fent for him, hoping to receive offers of money
for releafing him. In this fituation Paul remained two
years, at the expiration of which Porcius Fedus fuperfeded
Felix in the government ; when the latter, in order to
ingratiate himfelf with the Jews, that they might not pur-
fue him to the court of Rome with complaints againfl
his injuflice and extortion, left Paul a prifoner.

Not many days after Fedus had entered upon his new
office, he fat in judgment on the cafe of Paul ; and, after
hearing his accufers, and his defence, afked him if he
was willing to be tried before his tribunal in Jerufalem,
where the requifite evidence on both fides could be mod
eafily procured. But Patil,w>ho knew that the Jews dill
retained their defign of aflaffinating himr refuled to be
acceffory to his own dedruftion by placing himfelf with¬
in the reach of his enemies ; and therefore availed him¬
felf of his privilege as a Roman citizen, by appealing
from all fubordinate judges unto Caefar ; upon which
Fedus, after confulting with his council, declared, that
fince he had appealed unto Ctefar, to Caelar he (hould go.

Not long after this, king Agrippa, who was a Jew, and
his fider Bernice, came to Csefarea, to compliment the new
governor, who, by the mention which he made to them
of Paul’s extraordinary cafe, excited their curiolity to fee
and hear him. In compliance with their wifhes, the
apodle was brought before them in an afi'embly of the of¬
ficers of the Roman army and the principal perfons of
note and eminence in Caefarea, and had full liberty given
him to enter into a defence of his own character and the
tenets which he promulgated. On this occafion Paul
gave” a concife and impreffive account of his life and con-
verfion, and afterwards reafoned fo ably in defence of
the doblrine which he taught concerning Jefus of Naza¬
reth, confirming what he faid by an appeal to the pre¬
dictions of the Old Teflament, that Agrippa was dag¬
gered by his arguments, and frankly confefled that Paul
had almod perfuaded him to be a Chridian. And the
impreflion which he made upon the red of his audience
was fo greatly in his favour, that they acquitted him of
all crimes deferving either of death or imprifonment, and
agreed that he might have been fet at liberty if he had
not appealed unto Caefar.

Fedus now determined to fend Paul without delay to
Italy 5 and for that purpofe delivered him, together with
other flate-prifoners, into the cudody of one Julius, a
centurion of the Augudan cohort, and a man of fingular
humanity, who embarked with his charge on-board a
fhip at Ciefarea, in the end of autumn, or towards the
beginning of winter, in the year 60. On this occafion
Paul was not deferred by his Chridian friends ; for we
find that at lead two of them, namely Luke, and Ariflar-
chus who had accompanied him in fome of his former
journeys, took flipping on-board the fame veflel, deter¬
mined to attend him during his voyage to Rome. The
day after they departed from Caefarea, having occafion to
touch at Sidon, Julius kindly permitted Paul to go on-
fhore, and vifit his Chridian brethren in that city. From
Sidon they failed to Myra in Lycia, where the centurion
embarked with them on-board a fliip from Alexandria in
Egypt, bound to Italy with a lading of wheat. Arriving
afterwards at a port in the ifland of Crete, Paul advifed
that they ffiould winter there, fince, with the imperfeft
knowledge of navigation in that age, failing was now
become dangerous, owing to the length of the dark
nights, and the tempeduous weather ufual at that feal’on
of the year. The mader of the ftiip, however, defirous of
reaching a more commodious harbour, with the approba¬
tion of the centurion again put to fea ; but they had not
proceeded far before a violent dorm arofe, which laded
feveral days, and reduced the fliip to fuch didrefs, that
all hope of fafety feemed to be lofl. In thefe circumdan-
ces of defpair Paul encouraged them by declaring that he

Vol. XIX. No. 13-11.

had feen an angel of God, who informed him that the
fliip would be wrecked on the coad of a certain ifland,
but that all on-board ftiould efcape fafe to land. At
length, on the fourteenth night after their departure
from Crete, the failors perceived by their foundings that
they were near fome fhore, and at break of day the fliip
was dranded on an ifland named Melita, which is gene¬
rally believed to be the fame with what is now called
Malta, though fome are of opinion that it was the ifland
of Melita in the Adriatic fea. In this critical juncture,
the foldiers who guarded the prifoners propofed that they
/hould be put to death, led they fhould feize the oppor¬
tunity of fwiniming away and efcaping out of their hands;
but Julius, being defirous of faving Paul, prevented them
from executing their purpofe, and commanded that thofe
who could fwim fliould fird throw themfelves into the
fea and mdke for the fliore, and the remainder on planks
and broken pieces of the fliip. Having all efcaped to
land, according to the apoflle’s prediction, though they
were 276 in number, they met with an hofpitable recep¬
tion from the iflanders, who kindled a fire for their relief
in their cold and wet condition. Now, as Paul was plac¬
ing a bundle of flicks upon the fire, a viper which was
concealed among them fadened upon his hand. When
the iflanders perceived this, they concluded he was a
murderer, whom the anger of the gods would not per¬
mit to live, though he had furvived the dangers of fliip-
wreck ; and, knowing how quickly the bite of thofe
venomous creatures generally proved fatal, they expelled
that he would have fwollen, or fuddenly fallen down
dead : but, when they faw that he calmly fliook ofl' the
reptile into the fire without receiving the lead harm, they
changed their opinion concerning him, and faid that he
mud be a deity in human form. (See Malta, vol. xiv.
p. 223.) O11 that part of the coad where the fliip was

dranded, was an eflate belonging to the chief man, or
governor, of the ifland, whofe name was Publius, who
kindly received the fhipwrecked voyagers into his houfe,
and hofpitably provided for them during three days, till
proper accommodations were prepared for them; and it
mud have given no little fatisfaftion to Paul that he had
it in his power to make a return for this generous treat¬
ment, by performing a miraculous cure on the father of
Publius, who was fick of a fever and bloody flux. The
fame of this miracle being foon fpread abroad, thofe who
had diforders of any kind were brought to the apodle
from every part of the ifland, who healed them all; and
he, doubtlefs, embraced the opportunity which the refort
to him of fuch numbers of people afl'orded, of inculcating
on them the religion of the gofpel, to the truth of which
fuch exercifes of a fupernatural power bare irrefragable
tedimony.

After continuing three months at Melita, during which
the inhabitants /bowed them every kind office in their
power, out of gratitude for the extraordinary benefits
conferred on them by Paul, Julius embarked with his
charge on-board a fliip of Alexandria, which had wintered
in the ifland, and failed to Syracufe the capital of Sicily.
From this celebrated place, after touching at Rhegium in
the fouthernmofl part of Italy, they failed to Puteoli, a
port not far from Naples, where they quitted the fliip,
Julius intending to proceed from thence to Rome by land.
At this place Paul met with fome Chridian brethren,
who exprefl'ed a drong defire to enjoy the benefit of his
inflrudlions and advice ; and the good centurion was fo
indulgent, that he permitted him to continue /'even days
amongfl them. During this interval, intelligence having
been brought to Rome of the apoflle’s arrival in Italy,
feveral of the Chridian brethren came from thence to meet
him; fome proceeding as far as Appii Forum, at the dif-
tance of fifty- one miles, and others to a place called
Tres Tabenue, or the Three Taverns, about thirty miles
from that city. This tedimony of refpeft and attach¬
ment to him when a prifoner, made a drong impreflion
upon the apodle’s mind, and enabled him tofinifh the re-
5 K mainder

400

PAUL,

mainder of his journey with frefh fpirit and alacrity, fince
it afforded him ground to hope for the fupport and con-
folation of their friendfhip during his ftate of confinement.

Paul arrived at Rome, according to the mod probable
fuppofition, in the early part of the year 61 ; and was
delivered over by Julius to Afranius Burrhus, the praeto¬
rian prasfeft under the emperor Nero, with fuch power¬
ful reprefentations in favour of his character and extra¬
ordinary endowments, that the apoftle was not laid under
the fame reftraint with the other ftate-prifoners, but was
permitted to live in his own hired houfe, probably chained
by his right . wri ft to the left arm of a foldier w ho was his
keeper, according to the Roman cnftora in fuch cafes.
The precife time when he was brought to a hearing before
the emperor, cannot be ascertained with any certainty;
but their opinion feems to be the moll reafonable, who
conclude that it took place foon after his arrival at Rome.
On that occafion, fo univerfal and powerful was the dread
of the tyranny and cruelty of Nero, that none of the
Chriftians at Rome would venture to attend Paul into
his prefence, as we learn from his complaint, “ No man
flood by me, but all men forfook me. Notwithftanding,”
added he “the Lord flood with me, and llrengthened
me; and I was delivered out of the mouth of the lion.”
The defence which he made, together with the favourable
reprefentations of his conduft which were mod probably
given in the difpatches of the governor Feltus, and the
report of Julius the centurion, had fo much weight with
Nero, that, though he did not fet the apoftle at liberty,
he only remanded him to that eafy confinement in which
he had been placed by Burrhus, with permifiion to re¬
ceive freely all perfons with whom he chofe to maintain
any intercourfe.

Scon after this decifion, Paul requefted the principal
people among the unbelieving Jews at Rome to meet at
his houfe, with whom he had a long and interefting con¬
ference, in which he laboured to convince them from the
Scriptures that Jefus was the Chrift. Nor was his reafon-
ing without fuccefs, fince fome of them became converts
to his doftrine, though the prejudices of others prevented
them from receiving the Gofpel. The principal accef-
fions, however, which he gained to the Chriftian caufe,
were from among the Gentiles, many of whom were pro-
felyted by him during the time that he continued a pri¬
soner, and among them perfons of high rank and influence
in Nero’s family. During the fame time Paul wrote
Epiftles to fome of the churches, and Cent forth fellow-
labourers into different countries, to propagate the re¬
ligion of his mailer. At length, after he had been con¬
fined about two years, he procured his releafe ; to which
it is not unlikely that the intereft of his friends at court
greatly contributed.

Of St. Paul’s travels and preaching, from the time of
obtaining his liberty till his death, no authentic con¬
nected records have been tranfmitted from the apoftolic
age. However, from intimations which he has given of
his purpofes in the Epiftles which he wrote from Rome
during his imprifoh'ment, we may form a probable con¬
jecture of the different places which he vifited during
that period. Some are of opinion that he went from
Rome into Spain : but the ableft critics, catholic and
proteftant, have concurred in rejefting that hypothefis.
Soon after his releafe, he appears to have embarked in
fome part of Italy, for the Eail, accompanied by Timothy,
and perhaps alfo by Titus; and in the courfe of his
voyage lie may have flopped fora fliort time at Crete, as
fome imagine, confirming the churches in that ifland,
and leaving Titus to continue his labours amongft them.
Our apoftle now feems to have proceeded by the mod di-
reft courfe for Jerufalem ; and Lardner’s conjefture is
very reafonable, when he obferves, “ I could almoft think'
that Paul was defirous to go thither, to praife God in his
temple for the favourable circnmftances of his imprifon-
ment at Rome, and for his deliverance from it. Paul’s
cafe at Rome very much refembled what had happened

to him at Corinth. After which, we find, he had a vow,
and went from Corinth to Ephefus, and haftened to Je¬
rufalem. In like manner, I imagine, that now Paul went
again to Jerufalem as foon as he could. But he made no
long ftay there.” After a fliort friendly converfe with
the Chriftians in Judea, he travelled through Syria and
Cilicia, accompanied by Timothy, vifiting the churches in
thofe countries, as he did afterwards thofe in Alia Minor.
He then left Timothy at Ephefus, and paffed by Troas
into Macedonia, where he ftaid fome time at Philippi;
and from thence he went to Nicopolis in Epirus,
where he fpent the winter. In this city he was joined by-
Titus from Crete, and was induced by the account W'hich
he gave him of the ftate of the church in that ifland, to
accompany him thither in the following fpring, taking
Corinth in his way. From Crete, Paul came again to
Rome; but it is not certain w'hether his arrival was be¬
fore or after the commencement of the cruel perfecution
under Nero. In the fummer of the year 64, a dreadful
fire broke out in Rome, w'hich continued fix or feven
days, and laid a confiderable part of the city in alhes.
This calamity was attributed to incendiaries who afted
under the orders of the emperor ; on which account he
became in a high degree the objeft of popular hatred.
That he might vindicate himfelf from the imputation of
fo odious a crime, this monfter pretended that the
Chriftians were the caufe of the conflagration ; and to¬
wards the end of the year began a moft cruel perfe¬
cution of them, in which prodigious numbers were de-
ftroyed. Of the tortures which were inflifted on them,
Tacitus has given a horrid defcription, in the forty-fourth
chapter of the fifteenth book of his Annals. In this ftate
of things, Paul, who continued his zeal and aftivity in
promoting the Chriftian caufe, and alfo Peter, who was
now at Rome, were apprehended as chief perfons among
the accufed left, and condemned to be put to death.
This fentenceappears to have been carried into execution
in the year 65, when Paul fuffered martyrdom by being-
beheaded, according to the teftimony of all the ancient
writers who mention that event, at a place called the
Salvian Waters. They add alfo, what there is the
greateft reafon to believe, that he fubmitted to the fatal
ltroke with a cheerfulnefs worthy of the noble caufe for
which he was a fufferer. He was buried on the Via Oftii;
and a magnificent church was built over his tomb, which,
fays Calmet, “is in being to this day.”

St. Peter fuffered martyrdom the fame day with St.
Paul. The latter, entitled to the privileges of a Roman
citizen, was beheaded, as already noticed ; but St. Peter,
as an alien, was doomed to the more ignominious death
by the crofs. In the Greek and Latin churches, both
of thefe feftivals are kept on the fame day, June 29 ; while
in the Proteftant church, St. Paulis merely commemorated
by his Ccnverfion, Jan. 25 ; though it is to be remarked,
that all the ancient homilies join thefe two faints toge¬
ther, not only on account of their having fuffered at the
fame time, though by different methods and at different
places, but becaufe they were co-operators in the con-
veriion of the world, the one as apoftle of the Jews, the
•other as the apoftle of the Gentiles. Several of our pa-
rifh-churches, founded before the Reformation, are dedi¬
cated to thefe apoftles conjointly, and their feveral wakes
and fairs are annually celebrated accordingly.

In all piftures and ftatues, St. Paul is known by bear¬
ing a fword, indicative of the manner of his death ; and
in the convent of La Lifla, near Toledo in Spain, is lhown
what is afferted to be the identical fword-blade with
which this eminent apoftle was decollated ; it is thought
to be compofed of copper; its length is 25 inches, its
greateft breadth about 3^ inches ; on one fide are veftiges
in Roman capitals of “ Paulus — Capite,” and on the other
“ Mucro.”

The writings attributed to St. Paul, which form a con¬
fiderable part of the Canon of Scripture, confift of Epiftles
to particular nations, churches, or individuals, arranged

in

P A

in the New Teftament, not in chronological order, but ac¬
cording to the fuppofed rank and importance of the com¬
munities or perfons to whom they were addrelfed. Hence
the Epiftles which were fent to whole bodies of Chriftians
are placed before thofe which were fent to individuals.
Thefe Epitlles are fourteen in number; and are replete
with argumentative doctrinal learning, pradtical inftruc-
tion, and invaluable information to the ftudents of facred
hiltory. The firft of the feries, for the reafons we have
affigned, is the Epiltle to the Romans, as Rome was then
the miftrefs of the world ; the Epiltle to the Corinthians
has the next (tation, Corinth having been the capital ot
Greece; the one to the Galatians the third, becaufe ad-
dreffed to the ftveral churches eftablilhed among that
people; the Epiltle to the Ephelians immediately follows,
Ephefus having been the capital of pro-confular Afia ;
that to the Philippians next, out of compliment to Rome,
to which Philippi was a colony ; and thofe to the Coiof-
fians and Theffalonians complete the number. The
Epiftles to Timothy ftand firft among thofe to individuals,
from the circumftance of Timothy having been of high
rank, and the particular friend and difcipleof the apoltle;
and the one to Titus before that to Philemon, becaufe
Titus was a preacher, and Philemon only a private perfon.
The Epiftle to the Hebrews, although always acknow¬
ledged as apoftolical, was not at firlt attributed to St.
Paul; but, when the church was fatisfied as to that fa 61,
it was added to his ineftimable writings ; and, not to dif-
turb the order in which the other Epiftles had been
placed, it was made of neceftity the laft in the feries, in-
ftead of being placed before thofe to individuals, and in
the pre-eminent ftation it otherwife would have been en¬
titled to.

But a queftion has been agitated, whether thofe now
extant are the only Epiftles which St. Paul ever wrote?
Among the learned men who have maintained the affirm¬
ative, Lardner has produced the moft fubftantial argu¬
ments for his hypothefis ; but we muft confefs that the
replies to them by Michaelis are of no little weight in
favour of the oppofite fide of the queftion. Should it be
fuppofed that his opinion is well founded, we fee no evil
that could poffibly arife from admitting it ; fince, however
gratifying it might be to poffefs more remains of this great
apoftle, we have every reafon to be fatisfied, that whatever
was of real importance, relative either to dodtrine or in-
ftrudtion, has been tranfmitted to us. And we think,
with that critic, that “it was no more neceffary that all
the epiftles of the apoftles Ihould be preferved, than that
all the difcourfes of Chrift, which were certainly of not
lefs importance, Ihould be recorded by the evangelifts,
who have thought proper to deliver only a deleft part of
them.” Among the fpurious pieces which were circu¬
lated under Paul’s name in the early age of the church,
w'ere, The Travels of Paul and Theda, The Ads of Paul,
and Paul’s Revelation ; but the forgery of their authors
was detected and expofed by the ancients. Lar duet's
Supp. to Cred. vol. ii. chap, u, 12. Michaelis' s Iutrod.
to New Tefi. vol. vi. ch. 10 — 24. Machnight's Life of
Paul. Calmct's Did. Gen. Biog.

PAUL of Samosata, fo denominated from the place
ofhis birth, was a celebrated Unitarian prelate in the third
century, after whom fuch Chriftians as entertained the
fame opinions were generally called Paulians, or Paulia-
nijls, till the council of Nice. In the year 260 he was
chofen biffiop of Antioch, and by his talents and charac¬
ter recommended himfelf to the favour of Zenobia, the
famous confort of Odenatus ; which refleds on him no
little honour, if fhe was fo excellent a princefs as hiftorians
report. Having had fome difference with his preffiyter
Malchion, the latter procured a council to be affembled
at Antioch in the year 264, before which he accufed Paul
of dangerous herefy, and of a life and converfion un.
w’orthy of the epifcopal charader. That thefe charges
were not eftablilhed to the convidion of the affembly,

may be concluded from their not paffing a fentence of

U L. . 401

condemnation upon Paul, but only direding that he
Ihould be admoniffied. For this eafy judgment he was
greatly indebted to the prudence and moderation of the
excellent Firmilian, • bilhop of Ctefarea, who appears to
have prefided in the council, and prevented them by his
influence from adopting any harffi meafures. From this
time we do not read of Paul’s meeting with any molefta-
tion before the year 269, or 270, when a fecond council
was alfembled at Antioch, in order to take into confidera-
tion the principles and condud of the biffiop. Firmilian
was fummoned to this council, but died on his journey
towards Antioch. To this event it was probably owing
that Paul’s enemies fucceeded in their defign againft him,
and procured a fentence which condemned him to be de¬
puted from his epifcopal dignity. Paul, however, refufed
iubmilfion to the decree of the council, and retained pof-
feffion of the “houfe of the church,” by which we are to
underftand either the biffiop’s d welling-houfe, or the-
houfe in which the Chriftians held their affemblies ; and
in this ftep he appears to have met with fupport both in
the protection of Zenobia and the good will of the people.
But, when that princefs was driven from Antioch, Paul’s
enemies petitioned the Pagan emperor Aurelian to expel
a Chriftian bilhop who had been favoured by his rival ;
with whole requeft he complied in the year 272 or 273.
What became of Paul after this event is not known.
That he was the author of fome publications appears from
an obfervation made by his adverfaries, that “ there was
fcarcely a page in his works without citations out of the
Old or New Teftament;” but no remains of them have
defcer.ded to modern times.

His doftrine leems to have amounted to this : that the
Son and the Holy Ghoft exift in Godin the fame manner
as the faculties of reafon and aflivity do in man ; that
Chrift was born a mere man ; but that the reafon or vvif-
dom of the Father defcended into him, and by him
wrought miracles upon earth, and inftrudted the nations;
and, finally, that on account of this union of the Divine
Word with the man Jefus, Chrift might, though impro¬
perly, be called God. It is alfo faid, that he did not bap¬
tize in the name of the Father and the Son, &c. for which,
reafon the council of Nice ordered thofe baptized by him
to be re-baptized. He may be confidered as the father
of the modern Socinians ; and his errors are feverely con¬
demned by the council of Nice, whole creed differs a little
from that now ufed, under the fame name, in the church
of England. The creed agreed upon by the Nicene
fathers, with a view to the errors of Paul of Samofata,
concludes thus : Toes ch ^eyotrca; »3V ttote ovx yiv xca
yzvvri S-/)Va.l, ovx. yv, ScC. rot/lov? n xaDoAiKij xat

a.7roo-loXix.y v/.x7w<nci. “But thofe who fay there was a time
when he was not, and that he was not before he was born,
the catholic and apoftolic church anathematizes.”

PAUL Warnefrid, or, as he is often called, Paul the
Deacon, an eminent hiftorian of the middle ages, was
born of Lombard origin, in the eighth century, at Cuidad
del Friuli. He was educated in the court of Rachis,
king of the Lombards, and afterwards ordained deacon
of Aquileia. Defiderius, the laft: king'.of the Lombards,
invited him to his court, employed him as a notary or
fecretary, and railed him to the polts of counfellor and
chancellor. After the kingdom of Defiderius was over¬
thrown, and the monarch made prifoner by Charlemagne
in 774, the private hiltory of Paul becomes obfcure, and
is very differently related by different biographers. It is
generally fuppofed that he firft retired to his native coun¬
try of Friuli, and that, after the overthrow and death of
Rodgaufo, duke of that province in 776, he took the mo¬
nadic habit. By fome means his literary merit became
known to Charlemagne, who took him into France, and
perhaps employed him in his plans of promoting learning
in his dominions. He was well acquainted with the
Greek and Latin languages, and inftrufted in the former
thofe clergymen who were felefted to accompany the
emperor’s daughter, Rotrude, to Conftantinople, where

fhe

402

PAUL.

flie was united to the fon of the emprefs Irene. A re¬
maining attachment to his fovereign Defiderius fubjefled
Paul to the fufpicions of fotne deligns in his behalf, on
which account he was banifhed ; and he would probably
have undergone the lofs of his hands, or of his eyes, had
not Charlemagne been unwilling to difable fo eloquent a
writer. It is farther fuppofed that he efcaped from his
baniffiment, and took refuge in the court of Arigifo,
prince of Benevento ; and that, on the death of that
prince in 787, he retired to the celebrated monaftery of
Monte Cafino, where he ended his days, but at whaFtime
is not known, though it is thought about the year 799.
He was a confiderable writer: his Latin poetry may rank
with the belt of that period: it confifts chiefly of hymns,
of panegyrics of faints and eminent perfonages, and other
fhort pieces. One of the molt interefting is an elegy ad-
dreffied to Charlemagne, in order to obtain the liberty of
a brother who was brought prifoner into France after the
defeat of Defiderius. Of his profe writings the molt
valuable is entitled “ De Geftis Longobardorum,” in fix
books, being the only hiftory of that nation which we
poffefs ; and it contains fa<5ts that can no where elfe be
found, and affords fome curious views of rude fociety.
Several editions of it have been publifhed, and Muratori
has inferted it in his great collection of the Italian hifto-
rians. Paul likewife contributed to the Roman hiftory
entitled “ Mifcella,” in which he was the continuator of
Eutropius. He alio wrote an abridged hiftory of the firft
bifhops of Metz, and other pieces of ecclefiaftical biogra- '
phy, and made a colle&ion of homilies by the order of
Charlemagne. Gen. Biog\

PAUL of Burgos, or of Sancta Maria, a learned
Spanifli prelate, wras of Jewifli defeent, and born at Bur¬
gos in the year 1353. He was brought up in the religion
of his forefathers ; and, as his family was refpeCtable and
wealthy, he enjoyed the advantages of a liberal and learned
education. After he had been fome years married and
fettled in the world, by reading the Summa of Aquinas he
became a convert to Chriftianity ; and at the time of his
baptifm he affumed the name of Paul of Sancla Maria.
After the death of his wife, he embraced the ecclefiaftical
profeffion, and by his merits rofe to confiderable employ¬
ments and high dignities in the church. He was made
archdeacon of Trevignoj whence he was preferred to
the bifliopric of Carthagena ; and afterwards he was
tranflated to that of Burgos. The fame of his merits in¬
duced Henry king of Caftille to appoint him preceptor
to his Ion John, the fecond monarch of that name, by
whom he was entrufted with the important office of chan¬
cellor of the kingdom. He is faid to have died patriarch
of Aquileia in 14-35, at tbe age °f eighty- two. His prin¬
cipal work confifts of additions to the Poftills of Nicholas
de Lyra on the whole Bible, which are printed with that
commentary. He was alfo the author of, 2. Scrutinium
Scripturarum, folio, printed at Mantua in 14-74, and at
Burgos in 1591. 3. A Treatife on the Name of God,

which was printed with the notes of Drufius, at Franeker,
in 1604. Dupin fays, that his performances abound in
Hebrew learning, and will afford much affiftance to the
biblical ftudent in making himfelf acquainted with the
true fenfe of the Scriptures.

Our prelate had three fons, who were baptized at the
fame time with himfelf, and acquired diftinCfion by their
rank Or literary productions, — The eldeft, named Al-
phonsus, fucceeded his father in the bifliopric of Bur¬
gos, and compofed a concife hiftory of Spain, entitled
“ Anacephalaeolis Regum Hifpaniae,” which may be feen
in the Hifpania Illuftrata, in four volumes folio. — The
fecond, named Gonsalvo, was promoted to the fee of
Placentia in Spain. — The third, called Alvarez-Garcia,
publifhed the hiftory of John II. king of Caftille, under
the title of “ Memoirs or Commentaries.” Dupin. Moreri.

PAUL (Vincent de), a faint in the Roman calendar,
and founder of the Congregation of the Priefts of the
Millions in the feventeenth century, was of humble ori¬

gin, and born at Poui, or Poy, in the diocefe of Acqs, in
the year 1576. He was firft employed in tending fneepj
but, as he foon difeovered talents which deferved en¬
couragement, his parents were enabled to fend him for
education to Acqs and Touloufe. -Having finifhed his
academical courfe of ftudies, he was ordained prieft in the
year 1600. Some time afterwards, being called to Mar-
feilles to receive a fmall property of which he was the
heir, on his return by fea to Narbonne, the veffel on¬
board of which he had embarked fell into the hands of
fome Barbary corfairs, who fold him for a flave at Tunis.
Here he fucceflively ferved three different mafters, and
was fuccefsful in reclaiming the laft, who was a Savoyard
renegado, to the faith which he had renounced. Deter¬
mined on attempting their efcape to a Chriftian country,
they ventured to fea in a fmall boat, and happily reached
Aigues-Mortes in 1607. After his return to his native
country, Peter Montorio, vice-legate of Avignon, who
knew his merits, fent him on bufinefs to the court of
Rome. Here he became acquainted with the minifter of
Henry IV. who employed him on a commiffion of import¬
ance to that monarch, in the year 1608. Afterwards
Louis XIII. recompenfed him for his fervices on this oc-
cafion, with the abbey of St. Leonard de Chaulme. For
fome time he officiated as almoner to queen Margaret de
Valois, and then retired to the inftitution of his friend
cardinal de Berulle at the Oratory. On the recommen¬
dation of M. de Berulle, he accepted of the poll of tutor
in the family of M. de Goudy, general of the galleys,
whofe lady, eminent for her piety and charity, firft in-
fpired him with that defign of founding a congregation of
priefts for miffions into the country, which he afterwards
carried into execution. In the mean time, he was de-
firous of rendering himfelf ufeful to the miferable objeCts
under the care of his patron ; and, upon application to
court, obtained the appointment of almoner-general of
the galleys, in the year 1619. The extraordinary zeal
and charity which he exercifed in that employment, and
numerous other inftances of his piety and benevolence,
were long the fubjeCts of pleafing recollection to the in¬
habitants of Marfeilles. In the year 1620, St. Francis de
Sales confided to him the direct ion and government of the
order of the Daughters of Charity, whofe office it was to
adminifter affiftance and relief to indigent perfons, con¬
fined to their beds by ficknefs and infirmity.

After the death of madame de Goudy, he commenced
the eftabliftiment of the community which he had pro¬
jected, at the college of the Bons Enfans in Paris, where
fome priefts. who approved of his defign, aflociated them-
felves under him as their principal. Hence they W’ent
by turns into different parts of the kingdom, where their
labours foon met with an aftonithing degree of fuccefs
and encouragement. Some yearsafterwards, the increaf-
ing number of his fociety induced Vincent de Paul to
accept of the great houfe of St. Lazarus in the fuburb of
St. Dennis, which became the principal houfe of his order ;
and in the year 1632, pope Urban VIII. fatisfied of its
utility, and alfo of its policy as a powerful inftrument for
preferving the attachment of the lower daffies to the ca¬
tholic faith, formed it into a regular congregation, of
which the founder was declared the firft fuperior-general.
So aCtive was the fuperior in purfuing the objeCts of the
inftitution, and fo powerfully was he feconded by the
zeal and encouragement of others, that he was enabled to
fupport miffions, not only in all parts of France, but alfo
in Italy, Scotland, Barbary, Madagafcar, &c. But his
pious and charitable exertions were not confined to the
Congregation of the Miffions. To him the Hofpital for
Foundlings owed its origin, and an annual income of
forty thoufand livres, which his appeals to the humane
and benevolent procured for it. He, likewife, was the
means of obtaining liberal benefactions towards the fup-
port of the hofpital of Bicetre, of the Salpetriere, of that
for galley-flaves at Marfeilles, and various other charit¬
able inftitutions. He eftablifticd and endowed feminaries

for

1

403

P A

for ecclefiaftics ; and in times of fcarcity and peftilence
which laid wade Lorraine, Picardy, and Champagne, he
remitted nearly four millions of livres, in money and
goods, for the relief of thofe provinces. So high was
the eftimation in which he was held as a fpiritual advifer,
that he was engaged in regular attendance on Louis XIII.
during his laft ficknefs; and under the regency of Anne
of Auftria, mother of Louis XIV. his counfel was chiefly
followed in the management of the eccleflaftical affairs of
the kingdom. Yet, during the fpace of ten years in
which he poflefied this influence, he always made a con¬
fluence of recommending the mod deferving candidates
for vacant benefices, and his whole conduct was go¬
verned by exemplary prudence and humility. He died
in 1660, when nearly eighty-five years of age. He was
beatified by pope Benedift XIII. in 1729, and canonized
by Clement XII. in 1737. Mo/heim Hiji. Ecclef. Saec,
xvii. par. ii.

PAUL I. (Pope), was a native of Rome, and brother to
his predecefior Stephen II. He became deacon of the
Roman church; and in the year 752, Stephen fent him
with rich prefents to Aiftulphus, king of the Lombards,
in order to obtain a confirmation of the treaty of peace
into which that prince had entered with his predecefl'or
pope Zachary. In this objeft he fucceeded without dif¬
ficulty ; and Aiftulphus granted an extenfion of the term
agreed upon for forty years longer, that he might divert
the pope from interfering with the defign which he had
then formed, and foon afterwards carried into execution,
of fubjugating the exarchate of Ravenna. Upon the
death of Stephen in 757, the Roman people were divided
about the choice of afucceflor; fome declaring for the
deacon Paul, and others for the archdeacon TheophylaiSf.
At length, after a vacancy of more than a month, the no¬
bility, clergy, and magiftrates, all zealoufly promoting
the interefts of Paul, the election was carried in his fa¬
vour 5 and this is the only inftance which occurs in the
whole hiftory of the popes, of two brothers being railed
fucceffively to the papal chair.

No fooner had Paul fecured his eleflion, than he dif-
patched a meflenger to Pepin, king of France, to acquaint
him with his promotion, and to entreat his protection,
and that of the French nation in general, for the tempo¬
ral dominions of the church. It lhould be mentioned
that, during the pontificate of Stephen II. Pepin had
conquered from the Lombards the exarchate of Ravenna,
and the Pentapolis, or marche of Ancona, which he be¬
llowed on the Roman fee by an inftrument of donation,
and compelled Aiftulphus to confirm the grant. This
donation railed the bilhop of Rome to the rank of a
prince, and may, be properly confidered as the foun¬
dation of the temporal grandeur of the popes. The
ftrength of the papal fee, however, was inadequate to
maintain the pofleflion of thefe new dominions, without
foreign aid, fhould the king of the Lombards, or the em¬
peror of the Greeks, prove hoftile neighbours : for which
reafon Paul embraced the earlieft opportunity of fuppli-
cating the powerful protection of Pepin. He had the
fatisfaClion of receiving from that prince, in anfwer to
the letters by his meflenger, the moft friendly congratula¬
tions on his exaltation to the papacy, and the ltrongeft
affurances of his refolution to maintain St.'Peter and his
fuccefibrs in the full pofleflion and quiet enjoyment of
what he had given them, and to employ for that purpofe,
if neceflary, the whole force of his kingdom.

As the places which were to be yielded up to the Ro¬
man fee had not been all evacuated by the Lombards be¬
fore the death of Aiftulphus, Paul, as foon as he was or¬
dained, made a demand of them from his fucceflor Defi-
derius. This prince profeffed the utmoft readinefs to
fatisfy the pope; but, alleging that the affairs of his new
kingdom engrofl’ed all his attention, he requefted that,
till thefe fhould be fettled, his holinefs would excufe him
for not complying with his demand. Of this delay the
pope complained in a long letter to Pepin. Indeed,

Vol. XIX. No. 1312.

U L.

much of his time, during the whole of his pontificate,
was occupied in writing to Pepin, or his two Tons, letters
of complaint againft the king of the Lombards, oragainft
the emperor; and in endeavouring, by frequent legations,
as well as by letters, to keep the French, the Greeks, and
the Lombards, ever at variance. To counteract this po¬
licy, the emperor and the king of the Lombards made
every effort to gain Pepin, and to perfuade him to with¬
draw his protection from the pope; reprefenting him to
be a public incendiary, who, inftead of ftriving to unite
the Chriftian princes amongft themfelves and againft
their common enemies, made it his ftudy to create divi-
fions among them, with no other view than that he might
aggrandize himfelf at their expence. All their efforts,
however, proved unfuccefsful ; as did, likewife, a folemir
embafiy which the emperor lent to France in the year
764, to obtain that objeCl by propofing an alliance be¬
tween the emperor and Pepin, which fhould be cemented
by the marriage of the emperor’s eldeft fon Leo to a
daughter of Pepin. Pepin declined the propofed alli-
ence with the emperor, becaufe he was unwilling to dis¬
oblige the pope.

Befides the events already noticed, little more is re¬
corded concerning the tranfaClions of Paul’s pontificate,
excepting the evidence which he afforded of his piety by
founding or repairing numerous churches ; and of his fu-
perftition, by countenancing the ridiculous farce dis¬
played at the tranflation of the body of St. Petronella,
the pretended daughter of St. Peter, from the cemetery
where it was difcovered, to the Vatican. Paul died in 767,
after he had prefided over the Roman church ten years
and one month. Thirty-one of his “ Letters” have
reached our time, and the whole of them may be feen in
the “ Caroline Code,” fo called from Charlemagne, who
himfelf formed the colledtion, which was publilhed by
James Gretzer, in the year 1613. Platince et Anajlajii
Vit. Pont. Cave’s Hi/i. Lit. vol. i.

PAUL II. (Pope), originally known by the name of
Peter Barbo, was defcended from an ancient family, and
born at Venice in the year 1417. He was educated in the
mercantile line, which the Venetians very wifely did not
confider to be degrading to men of noble blood. He had
fent property on-board a fliip, and was on the point of
embarking with it, when he received intelligence that
his maternal uncle had been promoted to the papacy,
under the name of Eugenius IV. This news engaged
him to change his defign, and flattered him with the pro-
fpe<5t of greater fuccefs in the ecclefiaftical profeflion than
in commercial purfuits. He therefore quitted bufinefs
for ftudy ; and, though he made but very little progrefs
in literature and the fciences, he was in the courfe of a
few years preferred by his uncle to the archdeaconry of
Bologna, the bifhopric'of Cervia in the Romagna, the
office of apoftolical prothonotary, and in the year 1440
to the dignity of cardinal. By his addrefs and obliging
behaviour, he recommended himfelf, after the death of
Eugenius, to the fucceeding popes, Nicholas V. Calixtus
III. and Pius II. Calixtus gave him the appointment of
legate in Campania. Upon the death of Pius II. in 1464,
Barbo was chofen pope by a great majority. As he was
a very handfome man, fo he was exceeding proud of his
perfon, and intimated his intention of taking at his co¬
ronation the name of FortnoJ'us, iignifying Comely, or
Beautiful; but from this defign he was difluaded by the
cardinals, who made him fenfible of the ridicule to which
he would expofe himfelf by fuch a difplay of his vanity ;
and he chofe the name of Paul II.

One of the firll public meafures of Paul’s government,
was a declaration in favour of Ferdinand king of Naples,
againft the family of Anjou ; and, as the party of the
latter had begun to revive in the kingdom, many of the
barons being diflatisfied with the arbitrary government
of Ferdinand, he fent a conliderable body of troops to
the afliftance of that prince, who was thus enabled fpee-
dily to quell the infurgents, and to reftore peace to the
5 L kingdom.

404

PAUL.

kingdom. At this jun&ure, when a fenfe of his obliga¬
tions to his holinefs was yet frefli in the king’s memory,
Paul applied to him for the arrears of the tribute due
from the kings of Naples to the papal fee, which had
never yet been paid either by himfelf or his father Al-
phonfo. In anfwer, Ferdinand complained of the un-
feafonablenefs offuch an application, when the exhaufted
Hate of his treafury, owing to the expeniive war in which
he bad been engaged ever fince he came to the crown,
rendered hint unable to comply with it: and he point¬
edly added, that he would, neverthelefs, difcharge the
arrears, as foon as his holinefs reftored to him the city of
Benevento, and all the other places held by the church
within the limits of the kingdom of Naples, which, he
maintained, belonged to that crown. Exafperated at
this reply, Paul threatened the king with excommunica¬
tion, and the kingdom, with a general interdict; Upon
this Ferdinand, to lliow how little he dreaded the pontiff’s
menace, fent a body of troops to lay fiege to Benevento ;
which fiep compelled Paul, unable to repel force by force,
to fend cardinal Rovarella to the king, that matters might
be accommodated. With this view the cardinal had fe-
veral conferences with Ferdinand, and was at laft
obliged to acquiefce in the king’s promife to pay what
was in juftice due to the apoftolic chamber, whenever he
conveniently could. •>

The next circumftance which engages our notice in the
hiftory of Paul’s adminiftration, exhibits his temper and
condudf, after he had obtained the higheft objedft of his
ambition, in a very unfavourable point of view. Among
the departments of the Roman government, one was filled
by perfons called abbreviators, whofe bufinefs it was to
abridge the bulls and letters of the pope. This employ¬
ment the pope confidered to be unneceffary and ufelefs,
and not long after his election difcharged the perfons
who filled it, though mod: of them were men of great
learning and abilities. In this number was the hiftorian
Platina, who, having with much difficulty obtained an
audience of his holinefs, reprefented the injuftice of dif-
miffing them from offices, when not chargeable with any
negleft of duty, without returningthe money with which
they had been purchafed. This remonflrance offended
the pope; but Platina went farther; for, having in vain
endeavoured to obtain another audience, he wrote a letter
to Paul, in which he intimated his refolution to apply for
redrefs to the kings and princes of Chriftendom, exhort¬
ing them to call a General Council, which would do juf¬
tice to the oppreffed, and take cognizance of his holinefs’s
conduft. This letter Paul pronounced to be high trea-
fon, commanding that Platina fhould be arrelted and
thrown into fetters. The prifoner was afterwards con¬
fined in a high tower, expofed to all the winds, without
fire, though in the depth of winter. When he had fuf-
fered the miferiesof this fituation for four whole months,
he with great difficulty obtained his releafe. The pope,
however, did not forgive him for the boldnefs with
which he dared to refill injuftice; but, in the year 1467,
gave orders for arrefting him a fecond time, under the
pretence of being engaged in a dangerous confpiracy
againft his perfon and government. Upon his being ex¬
amined by Paul himfelf, and vindicating his own inno¬
cence, without betraying any fymptom of fear or guilt,
the mercilefs pontiff ordered him to be put to the rack,
and he was accordingly tortured with the utmoft barba¬
rity, but without fubduing his fortitude. Among his
friends who were alfo arrefted, were fome of the molt
eminent literary charadlers in Rome. Thefe perfons met
with the fame inhuman treatment, which proved fatal to
feveral of them. We ffiall prefent our readers with Mr,
Rofcoe’s concife and elegant account of the pope’s ini¬
quitous conduct on this occafion. “ During the pontifi¬
cate of Paul II. letters and fcience experienced at Rome
a cruel and unrelenting perfecution, and their profefi'ors
exhibited in their fufferings a degree of conftancy and re¬
folution, which in another caule might have advanced

them to the rank of martyrs. The imprifonment of the
hiftorian Platina, who, on being arbitrarily deprived of a
refpeflable office to which he was appointed by Pius II.
had dared to thunder in the ears of the pope the dreaded
name of a General Council, might perhaps admit of fome
juftification ; but this was only a prelude to the devafta-
tion which Paul made amongft the men of learning, who,
during his pontificate, had chofen the city of Rome as
their refidence. A number of thefe, uniting together,
had formed a fociety for the refearch of antiquities,
chiefly with a view to elucidate the works of the ancient
authors, from medals, infcriptions, and other remains of
art. As an incitement to, or as charadteriftic of, their
lludies, they had affumed claffic names, and thereby gave
the firft inftance of a practice which has fince become ge¬
neral among the academicians of Italy. Whilft thefe
men were employing themfelves in a manner that did
honour to their age and country, Paul was indulging
his folly and his vanity in ridiculous and contemptible
exhibitions; and happy had it been if lie had confined his
attention to thefe amufements ; but, on the pretext of a
confpiracy againft his perfon, he feized upon many mem¬
bers of the academy, which he was pleafed toconfider as a
dangerous and feditious aflembly, accufing them of hav¬
ing, by the adoption of heathen names, marked their
averfion to the Chriftian religion. Not being able to ob¬
tain any evidence of their guilt, and finding that they
had refolution to fuffer the laft extremity rather than ac-
cufe themfelves, Paul thought proper at length to acqtiit
them of the charge ; but at the fame time, by a wanton
ab.ufe of power, he ordered that they fiiould be detained
in prifon during a complete year from the time of their
commitment, alleging that he did it to fulfil a vow which
he had made when he firft imprifoned them.”

I11 the year laft mentioned, Paul fent a legate intc-
France to procure a decree from the parliament of Paris,
confirming the abrogation of the Pragmatic Sanction ;
but in this defign he failed of fuccefs, notwithftanding
that he obtained a royal edidt to that purpofe, fince the
parliament fteadily oppofed it, and the univerfity of Paris
appealed from the legate and the edift to a General
Council. During the following year he was more fuc-
cefsful in a better caufe, having brought about a recon¬
ciliation between feveral ftates of Italy, which had taken
up arms as auxiliaries to the oppofite factions in Florence.
Soon after this event, the emperor Frederic arrived at
Rome, in confequence of a vow, and was entertained
with great magnificence by the pope. .As a proper expe¬
dient to engage the Chriftian princes in a league againft
the Turks, it was agreed that letters fliould be written,
in the emperor’s name and his own, to the princes and
ftates in Chriftendom, inviting them to fend their atnbaf-
fadors to Rome, in order to treat about the means of de¬
fending the faith. About the fame time, Paul was.infti-
gated by his ambition to obtain pofleffion of the city of
Rimini, and prevailed upon his countrymen the Vene¬
tians to afford him their affiftance. The Roman and Ve¬
netian troops were fpeedily oppofed in the field by a for¬
midable army, led by the duke of Urbino, and fupported
by the duke of Calabria. An engagement took place,
which terminated in the total rout of the army of the
pope, who found himfelf compelled to accede to fuch
terms of peace as the conquerors thought proper to dic¬
tate. In the year 1471, Paul publifhed a bull, by which
he reduced the jubilee circle to twenty-five years, and
thus accelerated the return of that moft abfurd and fu-
perftitious ceremony. To him, however, it was of little
moment, as he died fuddenlv of an apoplexy, in July
of the fame year, after a pontificate of almoft feven
years, in the fifty-fourth year of his age.

The hiftorian Platina, who could fcarcely be deemed
an impartial judge, charges him with avarice and fimony ;
with felling even bifhoprics to the higheft bidders. With
refpeft to the former of thefe charges, that there was no
folid foundation for it, is quite clear from Platina’s own

account3

405

PAUL.

account, who fpeaks of him as profufe in his expences in
buildings; in entertaining diftinguiflied perfonages; in
relieving the poor and decayed nobility; in purchafing,
at any price, jewels and precious ftones to adorn the pa¬
pal crown, and in exhibiting public fliows for the enter¬
tainment of the Roman people. Paul fee ms to have been
more accurately characterized by another contemporary
writer, Mathieu, the hiftorian of Louis XI. who fays of
him that he was greedy of money, and little cared by
what means he acquired it; but was too fond of pomp
and fliow to hoard it up in his coffers. To make a more
auguft appearance, fays Platina, he loaded the papal
crown with fuch quantities of precious ftones, that one
would rather have taken him for the Phrygian goddefs
Cybele with turrets on her head, than for the vicar of
Chrift, who fliould teach, by his example, the contempt
of all worldly .grandeur. That he might reconcile the
cardinals to this oftentation, he granted them the exclu-
five privilege of wearing purple habits, with red fdk hats,
and ill k mitres of the fame fafhion with thofe formerly
worn only by the fovereign pontiffs. Of his enmity to
learning, if there needed any other proof befides his
perfecution of the moft eminent literary characters, al¬
ready mentioned, it would be afforded by his exhortation
to the Romans to content themfelves with having their
children taught to read and write. He created eleven
cardinals during the time of his pontificate, and among
them his two nephews, although he had, previoufly to
his election, taken a folemn oath not toincreafe the num¬
ber of cardinals, or introduce more than one relation to
that high dignity. Two of the letters of this pontiff are
in the thirteenth volume of the ColleCt. Concil. and fe-
veral others in the fourth volume of d’Achery’s Speci-
legium, and in Cherubini’s Bullarium Magnum. This
pope met with a zealous apologift in one of the moft
learned men of the laft century, (Cardinal Luirini,) who
publifhed a work entitled “Pauli II. Vita ex Codice
Anglicae Bibliothecre defumpta, prtemiflis ipfius Vindi-
ciis adverfus Platinam, aliofque Qbtreftatores,” 1740,
Rofcoe's Life of Lorenzo tie Medici. Cave, vol. ii.

PAUL III. (Pope), originally called Alexandria Farnefe,
was of Roman defcent, from an ancient and noble family,
and born about the year 1467, at Carino in Tufcany.
He purfued his ftudies under the celebrated profeffors
whom the Medici family had invited to Florence, where
he was, at a very early age, diftinguiflied by his applica¬
tion to, and proficiency in, the different branches of li¬
terature. By pope Innocent VIII. he was appointed
, apoftolical prothonotary, and by Alexander VI, he was
advanced to the bifhopric of Monte Fiafcone, and in
1493 raifed to the dignity of cardinal, when he was but
twenty-fix years of age. He was warmly patronized
likewife by Julius II. Leo X. and Clement VII. By the
latter he was fucceffively nominated to the bifhoprics of
Paleftrina, Sabina, Porto, and Oftia. The fame pope
appointed him to the legation of Viterbo, and received
importantfervices from him during the time of his im-
prifonment. So highly did Clement eftimate the cha¬
racter of Alexander, that, when he was fenfible that his
end was approaching, he recommended him to the cardi¬
nals as the moft worthy of the whole college to be his
fuoceffor. The death of Clement happened on the 25th
of September, 1534; hnd on the 13th of October follow¬
ing, the thirty-fourcardinals prefent in the conclave con¬
curred unanimoufly in voting for the cardinal Farnefe.
To this unanimity two circumftances contributed : one
was his having arrived to the advanced age of fixty-feven ;
and the other, a report of the weaknefs and decay of his
conftitution, which he is faid to have countenanced with
confiderable art.

At his coronation the new pope affumed the name of Paul
III. The firft objefts to which he directed his attention,
were the progrefs of the Reformation, and the means of
crufhing a re volution pregnant with ruin to the authority
and interefts of the papal fee. He wasnolefs enraged than

his predeceffor at the innovations in Germany, and no
lefs averfe to any fcheme for reforming either the doc¬
trines of the church or the abufes in the court of Rome.
But, having been a witnefs of the univerfal cenfure
which Clement had incurred by his obftinacy on thefe
points, and knowing how much the meeting of a Gene¬
ral Council was deiired by all Chriftendom, he hoped to
avoid all reproach by a feeming alacrity in complying
with the univerfal wifh. So early as the third day after
his election, therefore, his intention was announced by
the nomination of commifiioners to deliberate about the
time, the place, and the manner of proceeding; while he
had no doubt but that from thedifcuftion of thofe points
circumftances might arife, which would either prevent
fuch a council from meeting at all, or place the fecret ma¬
nagement of it in his hands. In the article Luther, vol.
xiii. p. 795, we have given an account of the fteps which
were taken to convene this council, and of its indefinite
prorogation ; as we likewife have of the partial and ina¬
dequate reformation of abufes in the court of Rome,
which Paul pretended to fet on foot. •

In the mean time, the pope had concluded an alliance
with the emperor Charles V. and the Venetians againft
the Turks; and is faid to have entertained fuch confi¬
dence of ultimate fuccefs, that he even made a partition
of theTurkifh empire with hisallies. This objeft, as well
as the extirpation of the Lutheran herefy, he had much at
heart; but he confidered peace between the emperor and
the king of France, who werethen at war, to be an effential
preliminary to both. Nor was he without hopes that, if he
ihould prove the inftrument of promoting it, he might fe-
cure important advantages to his own family. Influenced
by thefe confiderations, he propofed an interview between
the two monarchs at Nice, and offered to repair thither
in perfon, that he might aft as a mediator in compofing
all their differences. Such apropofal could not decently
be declined by either of the contending princes ; and he
prevailed upon them to fign a truce for ten years, and in
the mean time to fend ambalfadors to Rome, tp difcufs
their pretenfions at leifure. During the private confe¬
rences of the pope with the emperor at this interview, a
marriage-treaty, which had been fome time negociating,
was at Taft concluded between Oftavio Farnefe, the pope’s
grandfon,and Margaret, the emperor’s natural daughter,
and the widow of Alexander de Medici, who had been
lately murdered by one of his own family. Soon after
Paul’s return to Italy, he difpatched cardinal de Medici
with a grand retinue to Florence, who condufted the
princefs to Rome, where fhe was received by the pope,
the cardinals, and the Roman nobility; and the nuptials
u'ere celebrated with extraordinary pomp and magnifi¬
cence.

In the year 1538, the pope, finding from the proceed¬
ings of king Henry VIII. of England, in diflolving the
monafteries, and compelling the monks to refume the
lay-habit, that all hopes of coming to an agreement with
him were defperate, thundered out his bull of excommu¬
nication againft that prince. By this bull Henry was
pronounced deprived of his kingdom; his fubjefts were
not only abfolved from their oaths of allegiance, but
commanded to take up arms againft him, and drive him*
from the throne; the whole kingdom was laid under an
interdift ; all treaties of commerce or friendfhip with him
or his fubjefts were declared null ; his kingdom was grant¬
ed to any one who fliould invade it ; and all were allowed
to feize the effects of fuch of his fubjefts as adhered to
him, and enflave their perfons, &c. But Henry’s power
W3S not to be Ihaken by fuch an inftrument; and the in-
folence of the pope only fthnulated the king to imitate
his tyranny, by perfecuting with more feverity than ever
all without diftinftion who refufed to renounce the papal
fupremacy, and acknowledge his own.

The year 1 540 was rendered memorable by the eftablilh-
ment of the order of the Jesuits ; (fee that article, and
Loyola.) During the fame year different diets were

held

406 P A

held in Germany, for the purpofe of terminating the re¬
ligious difputes, and tire divifions arifing from them
among the members of the empire; the refult of which,
r.otwithftanding the oppofition of the papal legates, were
various conceffions to the Proteftants, equivalent to a
kind of truce, which fufpended all profecutions carried
on a gain ft them in the imperial chamber, and left them in
the full poffeffion of all the privileges which they had
ever enjoyed. To thefe conceffions the emperor had been
induced to accede, in order to obtain their confent to li¬
beral fupplies towards carrying on the war with the
Turks, Thefe proceedings, however, gave great offence
to the pope, who complained of them during a fhort in¬
terview which he had with the emperor at Lucca, in
1541, when he fuggefted various things relating to the
proper method of putting an end to the difputes about
religion, and to the extinguifhing of thofe mutual ani-
mofities between that prince and the king of France,
which threatened to break out again into open hoftility.

In the year 1542, Paul, finding it impoflible to avoid
any longer calling a General Council, fent John Morone,
biffiop of Modena, to announce to the diet of the em¬
pire at Spires his determination of affembling fuch a
council without delay, and to propofe that Trent fhould
be the place of its meeting. This propofal, after fome
difcuifion, met with the approbation of the catholic
princes in the diet; but the Proteftants unanimoufly ex-
preffed their diffatisfaftion, protefting that they would
pay no regard to a council held beyond the precinfts of
the empire, called by the pope’s authority, and in which
l;e affumed the right of prefiding. Without taking any
notice of their remonftrances, Paul immediately publifhed
the bull of intimation, nominated three cardinals to pre-
fide as his legates, and fixed the day for opening the
council on the firft of the following November. His le¬
gates repaired to Trent at the time appointed, where they
remained feveral months; but as no perfons appeared
there, except a few prelates from the ecclefiaftical ftate,
the pope, in order to avoid the ridicule and contempt
which this drew upon him from the enemies of the church,
recalled them and prorogued the council. Being about
this time informed, that the principles of Luther met
with a favourable reception in many parts of Italy, he
appointed a congregation of fix cardinals, with full power
to aft as inquifitors of the faith at Pome.

During the fummer of this year, the pope, hearing
that the emperor intended paffing into Flanders by the
way of Italy, with great difficulty obtained an interview
with him at Bufetto, a frnall town between Parma and
Placentia. His profeffed objeft in taking fo long and
fatiguing a journey was, that he might mediate between
the emperor and the king of France. When, however,
he found Charles fo inveterate againft Francis that he
would not liften to any terms of accommodation, Paul
fhowed that he was alfo powerfully influenced by a re¬
gard to his own intereft, and to the aggrandizement of
his family. The former motive prompted him to en¬
treat of the emperor the reftoration of Parma and Placen¬
tia to the holy fee, but without fuccefs. With a view to
the aggrandizement of his family, knowing the empe¬
ror’s great want of money to carry on his war againft;
France, he offered him a hundred and fifty thoufand du¬
cats if he would bellow the duchy of Milan on his grand-
fon Oftavio Farnefe ; which propofal the emperor re-
jefted. Difappointed in what he had much at heart,
Paul returned to Rome, mortified and foured ; and his
ill humour was not a little inflamed by the intelligence
which he received from Germany, in the year 1 544. This
informed him, that the emperor had courted the Proteft¬
ants, and granted them extraordinary indulgences at the
diet at Spires, in order to fecure, as he by that means
did, their concurrence with the other members of the
diet, in declaring war againft France, in the name of the
empire, and granting extraordinary aids in troops and mo¬
ney. He alfo learnt from it, that Charles had confented

U L.

to call a council, and to admit of public deputations in
Germany, with a view to determining the doftrines in
controverfy between the Proteftants and Catholics ; and
that he had even contracted a profane alliance with an
excommunicated heretic and rebel againft St. Peter,
Henry of England. To fo high a degree was Paul offend¬
ed with thefe proceedings, that he addrefied to the empe¬
ror a long letter on the occafion, written with fuch acri¬
mony of language, and in a ftyle of fuch high authority,
as feemed to intimate a defign of drawing on a quarrel
with that prince. To this letter Charles made no reply,
knowing that he had been governed in what he had done
only by motives of temporary policy, and being defirous
of concealing the fchemes which he had formed for hum¬
bling the proteftant party in Germany, and for reftoring
the catholic religion wherever it had been aboliffied.

In the year 1 545, the popefummoned the Council of Trent
to aflemble anew in the month of November; but before
the time fixed for the meeting, Paul took a ftep which the
Proteftants hoped would have produced a rupture between
him and the emperor. Finding that he could not bring
Charles to approve of his ambitious fchemes for the ag¬
grandizement of his family, he ventured to give his fon
Peter Louis the inveftiture of Parma and Placentia,
though at the rifle of incurring the difpleafure of the em-
peror. This indecent grant of fuch a principality to a
fon of whofe illegitimate birth he ought to have been
aftamed, and whofe licentious morals all good men de-
tefted, gave general offence, and the emperor perempto¬
rily refufed to confirm the deed of inveftiture, upon the
pretext that Parma and Placentia were part of the
Milanefe ftate: but at length, the emperor and the
pope being now intent upon one common objeft in
Germany, they mutually facrificed to it their emotions
of jealoufy or refentment, that they might the more ef-
feftually purfue what each deemed to be of greater im¬
portance. On the 13th of December, 1545, the General
Council was opened at Trent with the accuftomed fo-
lemnities, though no more than twenty-five bifhops had
yet arrived, who were either Italians or Spaniards ; nor
were they more than forty in number, when, in oppofi¬
tion to a motion that their attention fiiould in the firft
place be direfted to the reformation of abufes, it was
agreed, that the forming a Confeffion of Faith, in which
fhould be contained all the articles that the church re¬
quired its members to believe, ought to be the firft and
principal bufinefs of the council; but that, at the fame
time, due attention fhould be given to what was necef-
fary towards the reformation of manners and difeipline.

In the fourth feffion, having begun with examining the
firft and chief point in controverfy between the Church
of Rome and the Reformers, concerning the rule which
fhould be held as fupreme and decifive in matters of faith,
the council, by its infallible authority, determined,
“ that the books to which the deiignation of Apocryphal
has been given, are of equal authority with thofe which
have been received by the Jews and primitive Chriftians
into the facred canon ; that the traditions handed down
from the apoftolic age, and preferved in the church, are
entitled to as much regard as the doftrines and precepts
which the infpired authors have committed to writing;
that the Latin tranflation of the Scriptures, made or re-
vifed by St. Jerome, and known by the name of the Vul¬
gate tranflation, fhould be read in churches, and ap¬
pealed to in the fchools as authentic and canonical.”
Againft all who difclaimed the truth of thefe tenets, ana¬
themas were pronounced in the name and by the autho¬
rity of the Holy Ghoft. The decifion of thefe points,
which undermined the main foundation of the Lutheran
fyftem, was a plain warning to the Proteftants what judg¬
ment they might expeft, when the council fhould have
leifure to take into confideration the particular and fubor-
dinate articles of their creed.

By the increafing apprehenfions of the Proteftants,
Charles faw, that he would be foon obliged to declare

openly

407

P A

openly what part he was determined to aft. At the fame
time he was ftrongly urged to commence operations
againft them by the pope, who promifed to fecond him
with fuch vigour as could not well fail of fecuring fuc-
cefs. In thefe circumftances the emperor entered pri¬
vately into negociations with his holinefs ; who, when
he found that Charles was bent in earned on extirpating,
by force of arms, the herefies which abounded in Ger¬
many, and of compelling all who had renounced the re¬
ligion of their forefathers to return to the obedience of
the holy fee, aflented with eagernefs to every article
which was propofed to him. Among other ftiptilations
on his part, the pope engaged to depofit a large fum in
the bank of Venice, towards defraying the expenfe of the
war: to maintain, at his own charge, during the fpace
of fix months, twelve thoufand foot and five hundred
horfe ; to grant the emperor, for one year, half of the ec-
clefiaftical revenues throughout Spain ; and to authorize
him, by a bull, to alienate as much of the lands belonging
to religious houfes in that country as would raife a con-
fiderable pecuniary fupply. This war of religion broke
out in the year 15+6; and the papal troops, amounting
fully to the number which Paul had dipulated to furnifti,
commanded by Oftavio Farnefe, the pope’s grandfon,
abided by able officers formed in the long wars between
Charles and Francis, feafonably joined the imperial army.
The tranfaftions of this war, till the confederacy of the
Protedants was broken up, and almod all the members
of it had been compelled to fubmit to the emperor, be¬
long to the hidory of Germany.

No fooner was information brought to Paul of the ra¬
pid fuccefs of the imperial arms, than he began to recol-
left the prudent and cautious maxims of the papal fee,
with regard to the danger of extending the imperial au¬
thority beyond bounds, which in the tranfport of his zeal
againft lierefy he had entirely forgotten. He now became
alarmed for the impolicy of his conduft, in having con¬
tributed towards acquiring for Charles fuch an immenfe
increafe of power, as would enable him, after oppreding
the liberties of Germany, to give law with abfolute au¬
thority to all the dates of Italy. He refolved, therefore,
to lofe no time in correfting his error; and, without giv¬
ing the emperorany warning of his intention, he ordered
his grandfon to return indantly to Italy with all the
troops under his command, while he recalled, at the fame
time, the licence which he had granted for the appropri¬
ation of church-lands in Spain to Charles’s ufe. Of Paul’s
treachery in thus abandoning him the emperor loudly
complained, and to his complaintsT.e added threats and
, expoftulations ; but his holinefs remained inflexible, and
his troops marched towards the ecclefiaflical date. In a
memorial which the pope publiflied on this occafion, be-
fides afligning various reafons to judify his conduft, he
difcovered manifed fymptoms of alienation from the em¬
peror, together with a deep-rooted dread of his power.
It urns not long before he began to confider him as an
enemy, the weight of whofe power he mud foon feel, and
againd whom he could not be too early in taking pre¬
cautions, He forefaw that, if the emperor acquired abfo¬
lute power in Germany, he would foon become mader of
all the decifions of the council, fltould it continue to meet
in Trent. For this reafon he determined to remove it to
fomecity more immediately under his own jurifdiftion ;
and an incident occurred which gave to this meafure the
appearance of being neceflary. One or two of the fa¬
thers, together with fome of their domedics, happening
to die fuddenly, their diforder was pronounced to be in¬
fectious and pedilential ; upon which fome of the pre¬
lates withdrew from Trent panic-druck, and after a fliort
confultation the council was tranflated to Bologna, in
the year 154.7. This dep was warmly oppofed by the
prelates in the imperial intered, mod of whom remained
at Trent, by which means a fchifm commenced in that
aflembly, the. fathers at Bologna and Trent refpeftively
inveighing with acrimony againd each other. The em»

Vcl. XIX. No, 131a.

U L.

peror ufed all his intered to procure the return of the
council to the latter place; but Paul invariably refufed
the applications which were made to him on that head.

By this time, drong fymptoms of difgud between the
pope and the emperor were very difcernible; and an
event foon happened, which produced an irreparable
breach in their connexion. Peter Louis Farnefe, the
pope’s fon, by the profligacy of his life, and by enormi¬
ties of every kind, equal to thole committed by the
word tyrants who have difgraced human nature, had ren¬
dered himfelf fo odious to all clafles of his fubjefts, that
it was thought that any violence whatever might be law¬
fully attempted againd him. In thefe circumdances,
five noblemen of the greated didinftion in Placentia,
with the privity of Gonzaga, the imperial governor of
Milan, combined in a plan for aflaflinating him. They
condufted their intrigues with fuch fecrecy, and difplayed
fuch courage in the execution of their defign, that, at
mid-day, one party of them furprifed the citadel of Pla¬
centia, where Farnefe refided, overpowered the guards,
and murdered him; while others of their body made
themfelves maders of the town. The exultation at the
fuccefs of the confpiracy was general ; and all applauded
the aftors in it, as the deliverers of their country. Be¬
fore the next morning, a body of troops from the Mila-
nefe took pofleflion of the city in the emperor’s native,
and redored the inhabitants to their ancient privileges.
The ignominious death of a fon whom, notwithdanding
his infamous vices, Paul loved with an excefs of parental
tendernefs, overwhelmed him with the deeped affliction ;
and the lofs of a city of fuch confequence as Placentia,
greatly embittered his forrow. He accufed Gonzaga, in
open confidory, of having committed a murder, in order
to prepare the way for an unjud ufurpation ; and he im¬
mediately demanded fatisfaftion of the emperor for both
injuries, by the punifhment of Gonzaga, and by the ref-
titution of Placentia to his grandfon Oftavio. But
Charles eluded all his demands, and determined to keep
pofleflion of the city, together with its territories.

While Paul felt the full force of the paflions which his
lodes and the defire of vengeance excited in his mind, the
Diet of Augfburg, by the emperor’s command, peti¬
tioned him, in the name of the Germanic body, that he
would enjoin the prelates who had retired to Bologna,
to return again to Trent, and to renew their deliberations
in that place. But the pope, from the fatisfaftion which
he felt in mortifying the emperor, as well as front his
own averfion to what was requefted, without hefitation
refolved that this petition fltould not be granted. He
had the addrefs, however, to throw the refufal on the fa¬
thers at Bologna, to whom he referred the petition, who
declared that the council could not return to Trent, con¬
fidently with its dignity, unlefs the prelates who re¬
mained there firft repaired to Bologna, and by joining
their brethren, as well as fubmitting to the decrees
which had been palled, difavowed their fchifmatical fpirit.

Charles juftly confidered their reply as a full difcovery
of the pope’s intentions, and proceeded to take the necef-
fary fleps to prevent Paul from having it in his power to
turn againft him the authority or fuch an aflembly.
With this view, he fent two Spanifh lawyers to Bologna
in January 154.8, who protefted before the papal legates,
that the tranllation of the council to that place was
founded on falfe pretexts, and that it was confequentiy
an unlawful and fchifmatical conventicle ; that all its
decifions ought of courfe to be held null and invalid ;
and that, fince the pope and his ecclellaftics had aban¬
doned the care of the church, the emperor would em¬
ploy the power which God had committed to him, to
prevent thofe calamities with which it was threatened.
A few days afterwards, the imperial ambaflador at Rome
protefted to the fame purport, and in equally harfh terms,
at an audience which he demanded of the pope, and
in the prefence of all the cardinals, as well as foreign
minifters.

SM

It

408

P A

It was not long before Charles, refolved to terminate
all differences with refpefl to religious opinions without
the intervention of any foreign jurifdiftion, laid before
the diet his famous fyilem of doftrine known by the
name of the Interim, from its being defigned to continue
no longer in force than until a free general council could
be convoked. This fyilem, which contained all the ef-
fential doflrines of popery, though artfully foftened or
difguifed, was equally difapproved of both by Papifts
and Proteftants ; but no member of the diet had the
courage openly to oppofe it, and the emperor was deter¬
mined to employ all his power in enforcing the obferv-
ance of it as a decree of the empire. As foon as the pro¬
ceedings of the diet and the contents of the Interim came
to be known at Rome, the indignation of' the courtiers
and ecclefiaftics rofe to the greateff height; and they all
warmly contended, that as the emperor had been fo daring
as to ufurp the jurifdi<2ion of the head of the church,
and had attempted to overturn the foundations of eccle-
ftaftical authority, it was neceffary to proceed immediately
to extremities againft him, before he grew too formidable
to be oppofed. But Paul, though he was highly offended
with the emperor, for affuming an authority to regulate
the doftrine and difeipline of the church, and condemned
the Interim in the ftrongeft terms, viewed the matter
vyith more temper and judgment. The experience which
he had dearly purchafed by his quarrel with Henry VIII.
taught him a leffon of caution and prudence; and his
x difeernment alfo led him to foretel, that a fyftem which
ail attacked, and none defended, could not be of long
duration, but muff fink and be forgotten when the power¬
ful hand which now upheld it was withdrawn; and that,
for this reafon, there was no need of his interpofing in
order to liaften its fall. In the mean time, the feceffion
of thofe prelates who had voted againft the tranflation of
the council to Bologna, was foon followed by the de¬
parture of others, who grew weary of continuing in a
place where they were not fuffered to proceed to bufinefs,
till at length fo few remained, that the appellation of Ge¬
neral Council could not, with decency, be bellowed any
longer upon them. Paul, therefore, had no choice left
but to diflblve an affembly which had become the objeft
of contempt to all Chriftendom; and he directed his le¬
gates to difmifs it by an indefinite prorogation.

As Paul advanc -J in years, he became more ftrongly
attached to his family, and more jealous of his authority.
Urged on by thefe paffions, he could not forget the lofs
of Placentia ; and in the year 1549, he made a fecond in¬
effectual effort to gratify his enmity to the emperor, by
an attempt to draw the French king into an alliance
againft that prince. Finding himfelf unfuccefsful in this
defign, he turned his thoughts towards the moll likely
means of preventing the future encroachments of the
emperor. With this view, he determined to recal his
grant of Parma and Placentia, and, after declaring them
to be reannexed to the holy fee, to indemnify his grand-
fon OClavio by fome other ellablilhment in the ecclefiafti-
cal Hate. This device, he flattered himfelf, would ren¬
der his poffeflion of Parma more fecure, as the emperor
lpight be cautious of invading the patrimony of St. Peter;
and he thought it would afford him a better chance of
recovering Placentia, when, in urging his folicitations to
that effeCt, he was confidered not as pleading the caufe of
his own family, but as an advocate for the interell of the
church. While he was priding himfelf in this device,
Octavio, a high-fpirited young man, having refolved not
to accept of any other territory, took meafures in order
to prevent the execution of a plan fo fatal to his ambition.
In purfuance of thefe, he fet out fecretly from Rome,
and, after having made an unfuccefsful attempt tofurprife
Parma, wrote a letter to his grandfather, intimating his
refolution of throwing himfelf into the arms of the em¬
peror. This defedion of one of Paul’s own family to an
enemy whom he hated, irritated him almoll to madnefs;
and there was no degree of feverity to which he might

U L,

not have proceeded againft a grandfon whom he reproached
as an unnatural apoftate. He was prevented, however,
from carrying his harlh refolutions into execution by his
death, which took place in 1349, when he was in the
eighty-fecond year of his age, and had held the Roman
fee upwards of fifteen years. Almoll all the hiftorians of
the fifteenth century affirm, that his death was occafioned
by a fever brought on by the violent paffions which the
behaviour of his grandfon excited ; but in Dr. Robertfon,
as referred to at the end of this article, the reader may
meet with a more authentic account of this event, which
attributes it to a defluxion on the lungs, attended with
fuch dangerous fymptoms, that his life was immediately
defpaired of. ..

The charaCler of this pope gave rife to much debate,
even in the laffc century, between cardinal Quirini, and
Schelhorn, Thieling, and other writers. The cardinal
has ufed his utmoft efforts to defend his probity and me¬
rit, his prudence and moderation ; while the two learned
men above mentioned, reprefent him as a perfidious po¬
litician, whofe predominant qualities were diflimulation
and fraud; who was wholly intent upon raifing his fa¬
mily, and ever ready to facrifice the good of the church or
Hate, to the grandeurand interefts of his numerous ille¬
gitimate offspring. Maclaine, in a note to his tranflation
of Mofheim, mentions fome Ihocking inftances of licen¬
tious and criminal exploits, with which Paul was re¬
proached in a book publilhed before his death, under the
name of Ochino. Befides his natural fon Peter-Louis, he
had a natural daughter named" Conllantia, who was
married into the Sforza family; and their children, Alex¬
ander Farnefe, and Guido Afcanio Sforza, he created
cardinals foon after his eleClion, when they were fcarcely
arrived at the years of diferetion. At different promo¬
tions, he created no fewer than feventy-one cardinals, a
far greater number than had ever yet been preferred to
that dignity by any pope. Onuphrius fays, that he was
well verfed in moft branches of literature, and a generous
encourager of learned men. He wrote a Comment upon
Cicero’s Epiftles to Atticus, before his promotion to the
pontificate, and, after it, fome “ Letters,” in a polite
Latin ftyle, to his particular friend cardinal Sadolet, and
to Erafmus. Robertfon’s Hijl. of Charles V. vol. iii..
Mojk. Hijl. Eccl. free. xvi.

PAUL IV. (Pope), whofe former name was John Peter
Caraffa , was the fon of count Montorio, a nobleman of an
illufirious family in the kingdom of Naples, and born in
the year 1476. Being dellined for the church, he from
his early years applied to ftudy with the greateff affiduity :
he not only acquired profound fkill infcholaflic theology,
but a confiderable knowledge of the learned languages
and of polite literature, the ftudy of which had lately
been revived in Italy. His mind, however, naturally
gloomy and fevere, was more formed to imbibe the four
fpirit of the former, than to receive any tinflure of ele¬
gance or liberality of fentiment from the latter; fo that
he acquired rather the qualities and paffions of a monk
than the talents requifite for the condudl of the affairs
of the world. When he was only eighteen years of age,
pope Alexander VI. made him his chamberlain ; and, in
the year 1504, Julius II. created him archbiftiop of
Theate, in the Neapolitan dominions. By the fame
pontiff he was fent in the capacity of his nuncio to Fer¬
dinand king of Arragon, when that prince took pof¬
feflion of the kingdom of Naples; and in the year 1513,
pope Leo X. fent" him in the fame charafter to Henry
VIII. king of England, at whofe court he continued three
years. Upon his return from this miflion he was ap¬
pointed nuncio to Spain, where he was made privy-coun-
fellor to king Ferdinand, and afterwards confirmed in the
fame poft by his grandfon Charles V. But, becoming
difgufted with public life, he languifhed to be in a fitu-
ation more fuited to his tafte and temper. . Having,
therefore, obtained his recall, he relinquifhed the
paths of ambition, refufed the archbilhopric of Brin-

3

PAUL.

did, which was offered him by Charles V. and even re-
figned all his eccleliaftical preferments, in the year 15x4.
He then retired to Mount Pincio, where he inftituted a
new order of regular priefts, whom he denominated
Theatines, from the archbilhopric which he had held ;
and, becoming a member of their fraternity, he conformed
to all the rigorous rules to which he had fubjefted them,
preferring the folitude of a monadic life, with the ho¬
nour of being the founder of a new order, to the higheft
dignities and greateft grandeur which the court of Rome
could offer him. In this retreat he continued many
years, until pope Paul III. induced by the fame of his
fanflity, called him toRome,in order to confult with him
concerning the moll proper and effeftual meafures for
fuppreffing herefy, and re-eftablifhing the ancient autho¬
rity of the church. Having thus enticed him from his
retirement, the pope, partly by his entreaties, and partly
by his authority, perfuaded him tore-affume the benefices
which he had refigned, and to accept of a cardinal’s hat,
in the year 1536,

After having been thus promoted to the purple, Ca-
raffa retained his monadic auderity, both under the art¬
ful and intereded pontificate of Paul, and the diffolute
government of Julius III. He was a bitter enemy of all
innovation in opinion, and had ever fliown the mod fu¬
rious zeal againll Lutheranifm. He appeared on every
occafion a violent advocate for the jurifdi&ion and difi-
cipline of the church, and was the chief indrument in
edablilhing the formidable and odious tribunal of the
Inquifition in the papal territories. Upon the death of
pope Marcellus II. in 1555, the conclave foon united in
the choice of cardinal Caraffa for his fucceffor, who was
then at the advanced age of feventy-nine ; and this cir-
cumdance had no little weight in promoting his election,
as itdattered the other competitors with the profpeft of
feeing, ere long, another vacancy in the papal chair. At
his coronation, out of grateful refpeft to the memory of
Paul III. he took the name of Paul IV. When the
Roman courtiers were informed of his eleftion, from the
auderity of his character they anticipated a fevere and
violent pontificate; while the people of Rome were ap-
prehenfive of feeing the rigour of monadic manners fub-
dituted in the room of the gaiety or magnificence to
Which they had been fo long accudomed in the papal
court. However, Paul commenced his government by
ordering his coronation to be conducted with greater
pomp and ceremony than ufual ; and, when the mader
of his houfehold enquired in what manner he chofe to
live, he haughtily replied, “ as becomes a great prince.’'
He alfo ufed great date and pomp in his fird confidory,
when he gave audience to the ambafladors of Mary queen
of England, who came to tender her obedience to the
papal lee ; on which occafion he gave the title of a king¬
dom to Ireland. Afterwards, at a private conference, he
infided that all the ecclefialtical poflefflons which had
been feized by Henry VIII. fliould be redored to the
church, and that the Peter-pence Ihould be immediately
collected for the ufe of the Roman fee. Having thus at¬
tained to the highed dignity to which he could afpire,
the principal objeil which he appears to have had at
heart was the aggrandizing of his nephews, to whom he
gave himfelf up with unbounded confidence and attach¬
ment. On count Montorio, the elded, he bedowed the
dukedom of Palliano, of which he had violently difpof-
feffed Mark-Antony Colonna ; on the fecond he con¬
ferred the government of Rome, with the county of
Bagno, and the title of marquis of Montebello; and the
younged, w'ho had hitherto ferved as a foldier of fortune
in the armies of Spain or France, he created a cardinal,
and nominated him to the important legation of Bologna.

Unhappily for the peace of Europe, the ambition of
Paul’s nephews was too afpiring to be fatisfied with the
dignities to which they had been appointed. Their
aims were direfted to fome fovereign and independent
edablilhments, fuch as had been procured by Leo and

409

Clement for the Medici, and by Paul III. for the family
of Farnefe. This defign they faw no profpefl whatever
of accomplilhing, but by difpofleding the emperor of
fome of his Italian dominions; and to attempt fuch an
undertaking, both Paul and his nephews were incited by
motives of refentment as well as of intereft. Cardinal
Caraffa, while he ferved in the emperor’s army in Ger¬
many, had been put under arrelt for challenging a Spanilh
officer; and afterwards he was prevented by the empe¬
ror’s orders from taking poffeflion of a priory in Naples,
which the pope had conferred on him. Difgufted by this
treatment, and moreover difpofed to receive imprefiions
unfavourable ro the emperor, owing to the oppolition
which his election to the papacy had met with from the
cardinals of the imperial faftion, he refolved, in confor¬
mity with the advice of his nephews, to endeavour to
enter into a treaty of alliance with the French king
Henry II. againll; the emperor Charles V. According to
the articles of this alliance, they were to attack the duchy
of Tufcany and the kingdom of Naples with their united
forces ; and, in cafe their arms fliould prove fuccefsful,
its ancient republican form of government was to be re-
eftablifhed in the former, and the inveftiture of the latter
granted to one of the French king’s fons; referving a
certain territory for the ecclefiafticai ftate, and independ¬
ent eftablifliments for each of Paul’s nephews.

The propofal of fuch a treaty proved very acceptable to
Henry himfelf, who was allured by the profpeH which it
opened to him of acquiring thofe Italian dominions for
which his predeceflors had fo often contended ; and it
was determined that the cardinal of Lorraine fliould be
fent to Rome, with full powers to bring it to a conclufion.
In the mean time the pope, having had leifure to reflect
on the danger and uncertain iffue of a war with fo power¬
ful a prince as the emperor, and probably yielding to
theaddrefs with which the imperial ambaflador had la¬
boured to foothe him, began to lofe much of his ardour
for continuing the negotiation with France; when intel¬
ligence which he received from Germany rekindled all
his former rage againft the emperor, and made him de-
firous of putting the laft hand to the treaty. It brought
him advice of the Recefs of the diet of Augfburg, and of
the toleration which was thereby granted to the Proteft-
ants in Germany. This information excited in him moil
violent tranfports of paffion. Full of high ideas with re-
fpedt to the papal prerogative, and animated with the
fierce!! zeal againft herefy, he confidered the affembly’s
decifion concerning religious matters, to be a prefump-
tuous and unpardonable encroachment on that jurifdic-
tion which belonged to him alone, and regarded the in¬
dulgence which had been given to the Proteftants as an
impious aft of that power which the diet had ufurped.
He infilled that the Recefs fliould be immediately de¬
clared illegal and void ; threatening the emperor and
king of the Romans, fliould they either refufe or delay
to gratify him in this refpeft, with the fevered effects of
his vengeance. Such a tone of authority and command
might have been affumed by a pontiff of the twelfth cen¬
tury ; but in the age of Charles V. it was impotent and
contemptible extravagance. In this difpofition the car¬
dinal of Lorraine found the pope, and foon obtained his
fignature to a treaty, which had for its objeft the ruin of
a prince againft whom he was fo highly exafperated ; and
afterwards both parties began privately to prepare for
putting it in execution.

Scarcely had the treaty between the pope and the king
of France been figned two months, before Henry forgot
the obligations under which it laid him, and agreed to a
truce with the emperor, who was upon the point of re-
figning all his hereditary dominions (Spain, &c.) to his
fon Philip, and of retiring from the world. When the
news reached Rome that this truce was aftually con¬
cluded, and fworn to by Henry as well as Charles and
Philip, in February 1556, it excited in the pope and his
nephews the utmoft altonifhment and terror. They were

confcious

410

P A

confcious that, by their engagements with the French
king, which were no longer fecret, they had highly irri¬
tated the emperor and his fon; and, finding that the duke
of 'Alva had begun to affemble troops on the frontiers of
the ecclefiaftical ftate, they dreaded that they fhould feel
the full weight of that vengance which they merited.
Under thefe circumftances, Paul determined to have re-
courfe to the arts of negociation and intrigue. He af-
fefted, as being the father of the Chriftian church, to ap¬
prove highly of the truce, confidering it to be a happy
expedient for putting a flop to the effufion of Chriftian
blood ; and he exhorted the rival princes to embrace this
favourable opportunity of fetting on-foot a negociation
for a definitive peace, offering himfelf to be mediator be¬
tween them. Under this pretext he nominated cardinal
Rebiba his nuncio to the court of Bruflels, and his ne¬
phew cardinal Caraffa to that of Paris. But the real de-
fign of Caraffa’s embaffy, was to folicit the French king to
renounce the treaty of truce, and to renew his engage¬
ments with the holy fee; and he was commanded to fpare
neither entreaties, nor promifes, nor bribes, in order to
gain that point. In purfuance of his inftruftions, Caraffa
fet out inftantly for Paris, and travelled with the utmoft
expedition ; while Rebiba was purpofely detained at
Rome for feveral weeks, and, when it became neceffary
for him to begin his journey, he was ordered to protraf! it
as much as pofiible, that the iflue of Caraffa’s negociation
might be known before he could arrive at Bruifels. In
the mean time Caraffa arrived at Paris, where he pre-
fented a conlecrated fword to the king, and by his re-
monftrances and promifes, which w'ere fupported not
only by the perfuafions of the duke of Guife and his
brother the cardinal of Lorrain, but by the addrefs of the
queen, and the more powerful arts of Diana of Poitiers,
w hom he had gained over to his party, he completely
fucceeded in the object of his million. All the prudent
remonftrances of Montmorency and the other wife ad-
vifers of the king were difregarded ; the nuncio abfolved
Henry from his oath ; and he figned a new treaty with the
pope, which rekindled the flames of war both in Italy
and the Lowr Countries. Upon this a meflenger was dif-
patched to meet cardinal Rebiba, with information of
what had palled, and inftrudtions for him to return to
Rome.

As foon as Paul was informed by his nephew that there
was a fair profpedt of his fucceeding in this negociation,
he threw off the malic ; put under arreft the Spanilh en¬
voy at his court; treated with much feverity and injuf-
tice all thofe whom he fufpefted of being attached to the
Spanilh intereft ; and ordered a legal information to be
prefented in a confiftory of cardinals again!! Philip, on
pretence that, as his liege-lord, he had a right to deprive
him of the kingdom of Naples, on account of his having
failed in the payment of the annual tribute due to the
pope from the polfelfor of it, as well as of various adts of
treafon again!! the holy fee. But, while Paul was weakly
difplaying fuch proofs of his pride and refentment, the
duke of Alva took the field, and entered the ecclefiaftical
territories. As none of the French forces which by the
treaty with Henry were to be fent to the pope’s afiiftar.ee
were yet arrived, Alva foon became mailer of the Cam-
pagna Romana, taking pofleffion of the cities in the name
of the facred college and the future pope ; and he con¬
tinued to advance, till his troops, by making excurfions
even to the gates of Rome, filled that city with confter-
nation. In this fituation Caraffa found his uncle’s af¬
fairs upon his return from France; and, knowing the
importance of obtaining time for the arrival of the ex¬
pelled fuccours, he prevailed on Paul, who, from pride
and obftinacy, was extremely reluflant, to apply to Alva
for a celfation of arms. That commander was the more
difpofed to clofe with the overture, as he found it necef¬
fary to recruit his forces, that he might be in a condition
to meet the approaching French army. A truce was ac¬
cordingly concluded for ten, and afterwards for forty,

U L.

days, during which various fchemes of peace were pro-
pofed, without any fincerity on the part of the pope.
This he fhowed fufficiently on the arrival of one body of
French troops, and the receipt of a confiderable fum re¬
mitted by the king of France ; when he became more
arrogant than ever, and banilhed all thoughts from his
mind but thofe of war and revenge. Hollilities were
again renewed; but with fo much fticcefs again!! the
caufe of the church, that Paul, proud and obftinate as
he was, found it neceffary to accommodate himfelf to the
exigency of his fituation. He accordingly employed the
mediation of the Venetians, and of Cofmo de Medici, in
order to obtain peace; and fo reafonable was Philip II.
of Spain in his expectations, that, though he had the pope
at his feet, yet he allowed him to finilh the war without
any detriment to the papal fee. The conqueror, owing
to his fuperftitious attachment to the church, appeared
in the abjeCt character of a humble fuppliant, and ac¬
knowledged his error; while he who had been the moll
arrogant hypocrite, though completely vanquilhed, re¬
tained his ufual haughtinefs, and was treated with every
mark of fuperiority.

Paul now had leifure, and he applied that leifure to
render his favourite tribunal of the Inquifition a more
efficient inftrument fOr the eradication of herefy. With
this view, he directed the inquifitors to draw up a cata¬
logue of fuch books as were thought proper to be con¬
demned, as impious and heretical. This Index Expur-
gatorius was publilhed two years afterwards ; and all were
prohibited, under pain of excommunication, perpetual
infamy, and other arbitrary puniffiments, from polfeffing
any of the books mentioned in that catalogue. The
pope likewife ordered the tribunal of the Inquifition to
take cognizance of feveral crimes which before had been
under the jurifdiCtion of the other courts ; and he de-
fervedly incurred univerfal odium, by being fo aCtive and
diligent in his inquiry after criminals, that he quickly
filled all the prilons of the inquifition. In the year 1558,
the college of the electors of the empire having been af-
fembled at Frankfort, the prince of Orange laid before
them the inftrument with which he had been entrufted
by Charles V. containing his refignation of the imperial
crown, and the transfer of it to Ferdinand king of the
Romans, which the college accepted and approved, and
put Ferdinand in pofleffion of all the enfigns of imperial
dignity. When the new emperor fent his chancellor to
acquaint the pope with this tranfaCtion, Paul declared all
the proceedingsat Frankfort illegal and invalid, as tranf-
aCted without his authority, and refufed to acknowledge
Ferdinand as emperor fo long as he lived. The fame
pretenfions were maintained by him in the inftance of
queen Elizabeth of England, who announced to him by
her ambafiador that lhe had acceded to the throne : lie
haughtily declared that the kingdom was a fief of the holy
fee, and that lhe had no right to aflume the crown with¬
out his leave. She nobly defpifed his claims, threw off
the papal yoke, and, after the example of her father and
brother, affumed, with the concurrence of parliament,
the fupremacy in all matters, ecclefiaftical as w’ell as tem¬
poral, within her dominions. The mortification which
this event occafioned to Paul was increafed by the intel¬
ligence which he received from his nuncio in Germany,
that at the diet of Auglburg, in 1558, Ferdinand had
confirmed the treaty of Paflau, which eftablilhed the
peace of religion, and alfo the decrees of the fubfequent
diets. He was equally difpleafed with the peace con¬
cluded between France and Spain, fince, by one of the
articles, the refpeftive fovereigns bound themfelves to
labour in concert for procuring the convocation of a ge¬
neral council, in order to promote the reformation of the
church, and to devife expedients for eftablilhing unity
and concord in the religious world. Shortly after this,
the pope was very defirous of convincing the world, that
he had iincerely at heart a correction of abufes in the
church ; and, with this view, he ordered all bilhops to

proceed

P A

proceed to their own diocefes, and all who had embraced
a monaftic life to return to their monafteries, admitting
of no excufe whatever with regard to the lad; and he ex¬
ecuted his mandate with fuch feverity, that many of the
vagrant monks were imprifoned, and fome of them fent
to the galleys. Towards the clofe of life he exhibited
his impartiality in the punifhment of crimes, by direft-
ing his feverity againd his nephews, who had, in many
indances, abufed the truds repoled in them. He alfo
fuppreffed fome new and very unpopular taxes, which he
pretended had been impofed without his knowledge. It
was now almod too late to aft upon a new courfe of
practice; he was unable to remedy the evils of his ad-
minidration, as he died in Augud 1 559, in the 84th year
of his age, and after a pontificate of little more than four
years. Such had been his arrogance, tyranny, and op-
predions, and he had rendered himfelf fo univerfally the
objeft of hatred, that, when he was upon his death-bed,
the Romans rofe tumultuoudy, curfed his name and fa¬
mily, and then, flying to the capitol, druck off the head
of a datue erefted to him but three months before, which
they dragged through the public dreets of the city, and
at lad threw it into the Tiber. The populace then
crowded to the prifon of the Inquifition, forced open the
doors, releafed feveral hundred prifoners, then fet fire to
the building, which was foon reduced to afhes, with all
the papers and records of that court. An edift was then
publifhed for abolifhing the arms of the Carad’a family,
and in a fingle day there was not an all the city a memo¬
rial of them left. Paul was the author of a treatife De
Symbolo; another, De Emendanda Ecclefia ad Paulum
III. befides the rules by which his monadery was go¬
verned, entitled Regulae Theatinorum. Bower. Robert-
Jbn's Hijl. of Charles V. vol. iv. Watfon's Hiji. of Phil. II.

PAUL V. (Pope), formerly called Camillo Borghefe,
was defcended from a family of fome didinftion at Sienna,
and born at Rome in the year 1552. He principally at¬
tached himfelf to the dudy of the civil law, in which fa¬
culty he took the degree of doftor, and acquired high re¬
putation for his knowledge of it. In the year 1588, he was
condituted vice-legate of Bologna; and pope Gregory
XIV. appointed him to fill the important office of auditor
of the chamber. By pope Clement VIII. he was pro¬
moted to the college of cardinals, and fent nuncio into
Spain ; and, after his return from that million, the fame
pontiff nominated him his vicar, which is one of the four
principal dignities in the Roman church. Upon the
death of Leo XI. in 1605, various candidates for the va¬
cant throne were unfuccefsfully propofed by their re-
Ipeftive friends in the conclave, and among others, car¬
dinals Bellarmine and Baronius. At length the nomi¬
nation of cardinal Borghefe met with the concurrence
of all parties, his vigorous age of fifty-three being the
only objeftion againlt him. At his coronation he took
the name of Paul V. and almoft immediately afterwards
difcovered his fpirit of nepotifm, by bellowing the car¬
dinal’s hat on Scipio Caffarelli, his fifter’s fon ; and by
appointing his two brothers, Francis and John Baptift, to
the important offices of governor of the Vatican, and go¬
vernor of St. Angelo. No one of his predeceffors ex¬
ceeded this pontiff in zeal for advancing the ecclefiaffical
authority and jurifdiftion of the papal fee, or fhowed
himfelf more violent in endeavouring to execute his ven¬
geance on fuch as enqroached upon his pretended
prerogatives. His zeal in defence of the pretended rights
and powers of his fee was particularly difplayed in the
rafh and unfuccefsful conteft into which he entered with
the republic of Venice, in the year i6o5. The Venetians
had publifhed feveral laws for reftraining the licentiouf-
- nefs of the clergy, and for other purpofes neceffary for
the well-being of their ftate, which the pope ordered to
be refcinded. This they refufed, and juftifled their con-
duft with. great fpirit. When Paul found that they op-
pofed his .demands, his fury was inflamed to the higheft
pitch. Having fuffered himfelf to be publicly ftyled
Vol. XIX. No. 1312.

U L. 411

“Vice-God upon earth, the Monarch of Chriftendom,
and the Supporter of Papal Omnipotence,” he was re-
folved to keep up his charafter, by pouring down upon
the republic the full weight of his vengeance. It was,
however, to no purpofe : the Venetians refilled, and car¬
ried their point; and, at the fame time, they banifhed
the Jefuits and Capuchins, who had thought proper
openly to break the laws of the ftate, by obeying the
pope. In this conteft they employed their ableft pens,
particularly that of the learned and ingenious Father
Paul, (fee the next article,) to demonftrate, on the one
hand, the juftice of their caufe, and to determine, on the
other, after an accurate and impartial enquiry, the true
limits of the Roman pontiff’s jurifdiftion and authority.
The arguments of thefe writers were fo ftrong and ur¬
gent, that Baronius, and the other learned advocates
whom the pope employed in fupporting his pretenfions
and defending his meafures, ftruggled in vain againft.
their irreliftible evidence.

In the mean time, the Congregation de Auxiliis, which:
was firffc affembled by pope Clement VIII. in order to
terminate the controverfy between the Jefuits and Do¬
minicans on the fubjeft of Grace, had held fixteen feffions
under the pontificate of Paul. In thefe feffions, it was
not fo much their objeft to enter into the merits of the
caufe, as to confider about the moft prudent and proper
method of finifhing the conteft. At length, the refult
of their long and ferious deliberations refembled the de¬
livery of the mountain in the fable, being nothing more
than a refolution that the whole controverfy, inftead of
being decided, fhould be fuppreffed; and that each of the
contending parties fhould have the liberty of following
their refpeftive opinions. The Dominicans affert, that
Paul had exprefsly ordered a folemn condemnation of
the doftrine of the Jefuits to be drawn up; but was pre¬
vented from finifhing and publifhing it by his quarrel
with the Venetians. The Jefuits, on the other hand, re-
prefent this account of the Dominicans to be entirely
fiftitious. What the truth might be, we do not deem it
of any importance to inquire.

About this time, the form of the oath of allegiance
required to be taken by popifft recufants in England
having been fubmitted to the confideration of the college
of cardinals, they were unanimoufty of opinion that no
true catholic could take it with a Life confcience; upon
which the pope difpatched a brief to this kingdom, pro¬
hibiting all papifts from fubmitting to it, and exhorting
them patiently to endure all manner of perfecution rather
than comply. During the year 1609, an ambaffador ar¬
rived at Rome from the king of Congo in Africa, to re-
queft that the pope would fend with him, on his return,
learned miffionaries to propagate Chriftanity in that
country ; but the death of the ambaffador foon after his
arrival, occafioned that defign to be poftponed to fome
future time. In the fame year, the pope received letters
from the king of Perfia, which had been procured by the
archbifhop of Goa, and were foon afterwards followed by
an ambaffador from the fame prince. Thefe letters and
this minifter were moft probably fent at the inftigation
of fome of the king’s Armenian fubjefts who had em¬
braced the catholic creed, with a view to procure fome
arrangements for their benefit. That they were not fent
to yield fpiritual obedience to the Roman pontiff, as was
at one time pretended, it would now be a neediefs talk
to prove. To the Perfian embaffy fucceeded another
private one from Elias, the Neftorian patriarch at Babylon,
who, having received a confefflon of the Roman faith
from Paul towards the commencement of his pontificate,
now fent an archdeacon to Rome with a new confeftion,
drawn up in different terms from the Roman, but in¬
tended tofatisfy the pope that the faith of the orientals
differed only in words from that of Rome. But even fuch
a difference could not be tolerated by papal pride ; and
the archdeacon was obliged to fubmit, not only to the
doftrines, but to the words, of the Roman church.

5N

In

412 P A

' In the year 1610, Paul was earneftly folicited to enter
into a defenfive alliance with the king of France and the
princes of Italy: but he declined acceding to their pro-
pofals, out of an apprehenfion that they intended a rup¬
ture with Spain, and an invafion. of the Milanefe ; in
which cafe he was determined to obferve the ftridleft neu¬
trality. While this fubjeft was in agitation, intelligence
arrived at Rome of theaflaflination of Henry IV. at which
the pope exprefled great forrow ; and, as a teltimony of
liis regard for that monarch, he afiifted perfonally at his
obfequies, which were celebrated with great folemnity at
Rome. Hearing that fome young Frenchmen in the city
exprefl’ed their fatisfa&ion at that event, and ftyled the
nfiaflin the deliverer of their country, he ordered them to
be arrefted, and condemned them to the galleys. -It is
fair to conclude, however, that his profecution of them
originated in other motives than an abhorrence of the
a&ion which they applauded, fince, as we Ihall prefently
fee, he could give his approbation to the doctrine of
Suarez the jefuit, in defence of the murder of kings.

When, in the year 1614., the pope received information
that a treaty was negociating between the king of Great
Britain and the queen-regent of France, for a marriage
between the prince of Wales and her fecond daughter
Chriftina, he ordered his nuncio at the French court to
remonftrate againft the propofed alliance, as prejudicial
to the church. Another fubjedt on which he diredled
fiis nuncio to remonftrate, was a decree of the parliament
of Paris, condemning the treatife of Suarez, of which the
pope had declared his approbation, to be burnt by the
hands of the common hangman, as containing pernicious
and damnable doftrine. He demanded fatisfadlion by
the formal annulling of the decree ; but all he could ob¬
tain, was only the fufpenfion of its execution. He met
with a fimilar mortification in an unfuccefsful endeavour
which he made to prevail with the ltates of France to
order the publication of the decrees of theCouncil ofT rent.

In the courfe of the following year, Paul’s attention
was chiefly engaged by the old controverfy between the
Francifcans and Dominicans, concerning the immaculate
conception of the Virgin Mary, which was maintained by
the former, and denied by the latter. On this very im¬
portant queftion, both parties were tranfported with fuch
animofity and furious zeal, particularly in Spain, that the
kingdom was almoft engaged in a religious civil war
through their diflenfions. The catholic king, to prevent
the fatal effects of this blind conteft, prefled the pope, by
repeated embaflies, to give an authoritative decifion on
the queftion in difpute. All that could be obtained from
the pontiff, however, was a renovation of the Conftitu-
tions of Sixtus IV. and Pius V. on that fubjeft ; together
with a declaration, intimating, that the opinion of the
Francifcans had a high degree of probability on its fide,
and forbidding the Dominicans to oppofe it in a public
manner ; but this declaration was accompanied with
another, by which the Francifcans were prohibited, in
t-heir turn, from treating as erroneous the dodflrine of
the Dominicans.

Shortly afterwards, the pope was involved in a difpute
with the court of France, which demanded the eftate of
the marfhal d’Ancre at Rome, for the ufe of the French
king. This demand was at firft treated with contempt
by the pope ; but at length he found it prudent to agree
to a treaty of partition, by which, though confiderably
more than a moiety was yielded up to Louis. XIII. he
was allowed to appropriate the remainder towards the
building of St. Peter’s church. In the year 16x9, Paul
publifhed an univerfal jubilee, in order to implore the
afliftance of God for the defence of the church, which
was endangered by a general infurreftion of the Proteft-
ants in Bohemia, and the other countries under the
Auftrian dominions, who had been provoked to fly to
arms by the oppreflion with which they were harafled.
Alarmed at this powerful confederacy, the popeTent af-

U L.

fiftance in money to the emperor; who, in the courfe of
the following year, gained a decifive victory which fe-
cured to him the pofl'eflion of Bohemia, and obliged the
other infurgents to fubmit. Paul furvived the news of
this viftory only a few months, and died at Rome in Ja¬
nuary 1621, in the fixty-ninth year of his age, after a
pontificate of nearly fixteen years.

Paul V. was diftinguiflied for talents and learning;
and would have appeared to great advantage in the page
of hiftory, had he not fuftered his ambition and furious
zeal for the authority of the holy fee to lead him into
meafures which he could not fupport, and had he not fa-
crificed the wealth of the ftate to the aggrandizement of
his nephew, cardinal Borghefe. As a friend to literature,
he publifhed a bull, commanding all the religious orders
to maintain profeffors in the Hebrew, Arabic, Greek,
and Latin, languages. In adorning and beautifying the
city with magnificent buildings, he is faid to have rivalled
Sixtus V. He extended and improved the Vatican palace
and library. He built two magnificent palaces for his
relations, one in the city, and the other wuthout the walls;
and in both he collected the mod valuable works in
fculpture and painting, and the fineft monuments of an¬
tiquity that he could purchafe. He brought water to
feveral parts of the city, by aquedufts and fubterraneous
channels, fome from places at nearly forty miles diftance;
and he embellifhed the ftreets with a great number of
fountains. He was likewife liberal in his charitable do¬
nations, and in his alms to the poor. During his ponti¬
ficate, no few-er than fixty cardinals were created, many
of wdiom are faid to have been kept by him in dependent
circumftances, in order to ftrengthen the intereft of his
nephew Borghefe in the facred college, and to enable
him to carry the election after his own death. Rycaut's
Contin. of Platina. Bower's Hijl. of the Popes. Modern
Univ. Hijl, vol. xxiii.

PAUL (Father), whole name, before he entered into
the monaftic life, was Peter Sarpi , was born at Venice,
Auguft 14, 1552. He was contemporary with pope Paul
V. being born in the fame year. His father followed
trade, but with fo little fuccefs, that on his death his fa¬
mily were extremely ill provided for. Peter was taken
under the care of a maternal uncle, who, being himfelf
a fchoolmafter, cultivated the talents of his nephew' with
unwearied application. He foon fhowed, by the turn of
his mind, that he had a capacity adequate to the moft
difficult departments in literature; and, having, at the
age of thirteen, made himfelf mailer of fchool-learning,
he turned his ftudies to philofophy and the mathematics.
He entered alfo on the ftudy of logic under Capella of
Cremona, who was of the order of the Servites ; and in
this order Peter Sarpi, notwithftanding the remonftrances
of his friends, determined to enter himfelf. In 1566 he
took the habit of the order, though at that time only
fourteen years of age; a period of life in moft perfons very
improper for engagements of this nature, but in him at¬
tended with fuch maturity of thought, and fuch a
fettled temper, that he never feemed to regret the choice
he then made, and which he confirmed by a folemn public
profeflion in 1 572. At a general chapter of the Servites,
heid at Mantua, Paul, for he had nowaffumed that name,
being but twenty years of age, diftinguiflied himfelf fo
much in a public deputation by his genius and learning,
that Wiliiam duke of Mantua, a great patron of letters,
folicited the confent of his fuperiors to retain him at
his court; and not only made him public profelfor of di¬
vinity in the cathedral, and reader of divinity and the
canon law in that city, but honoured him with many
proofs of his effeem. The buftle of a court did not ac¬
cord with his temper and difpofition ; he quitted it two
years afterwards, ar.d retired to his beloved privacy. He
was at this period but twenty-two years of age ; and was
intimately acquainted not only with the Latin, Greek,
Hebrew, and Chaldee, languages, but with philofophy,

fat heir Paul.

£ngraved ior the Uncyclop&Aia ZonAmmsis April 2#2j.

413

P A

the mathematics, canon and civil law, and all parts of
natural philofophy and chemiftry that were then purfued
by men of fcience. He now took prieft’s orders ; and was
diftinguilhed by the illuftrious cardinal Borromeo with
his confidence, and employed by him on many occafions,
which excited the enmity of his contemporaries, who,
jealous of his celebrity, and having nothing to urge
again ft his conduct, charged him with denying that the
Trinity could be proved from the firft chapter of Genefis:
the Inquifition, however, before whom the accufation
was brought, thought the charge too ridiculous to be
attended to for a moment. After this he palled fuccef-
fively through the dignities of his order, of which he was
chofen provincial for the province of Venice at the age
of twenty-fix years ; and he difcliarged this poll with
fuch honour, that in 1579 he was appointed, with two
others, to draw up new regulations and ftatutes for his
order. He performed this bufinefs with much fuccefs ;
and, when his office of provincial was expired, he retired
for three years to the ftudy of natural and experimental
philofophy and anatomy, in which he made many import¬
ant difcoveries. Aquapendente, the famous anatomift,
fays that he was indebted to father Paul for his know¬
ledge of the principles of vifion ; and there are pretty
good proofs that he Was not unacquainted with the cir¬
culation of the blood. He was now chofen procurator-
general of his order, and during his refidence at Rome
was greatly efteemed by pope Sixtus V. and contracted
an intimacy with cardinal Bellarmine and other eminent
perfons.

His enemies were ftill on the alert, and accufed him of
having written a letter in ciphers, which they explained,
and faid the true meaning was, that “he hated the court
of Rome, in which preferment was not to be obtained
but by dilhoneft and corrupt means.” This accufation
was palled over, but not forgotten ; and it made fuch
imprelfion on that court, that he was afterwards denied a
bifhopric by Clement VIII. He now retired from public
life, and fpent much of his time in ftudies devoted to
practical piety. The molt aCtive fcene of his life began
about the year 1615, when pope Paul V. exafperated by
lome decrees of the fenate of Venice, that appeared to him
to interfere with the rights of the church, laid the whole
ftate under an interdict. (See the preceding article.) This
quarrel with the pope foon called into the field a holt of
writers, on both fides of the queftion. Among others
Father Paul, who had been appointed theologian and one
of the counfellors of the republic, finding that not only
many of the people, but even fome of the fenators, were
filled with confternation by the papal interdict, thought
it his duty to dilfipate their groundlefs terror, by drawing
a comparifon between the pontifical authority and the
rights of fovereigns in their own Hates. With this view
he drew up a treatife, entitled, “ Confolation of Mind to
tranquillize the Confidences of good Men, and to pre¬
vent their entertaining any dread of the Interdict pub-
lifhed by Paul V.” As this work was defigned for the
foie ufe of government, it was not publilhed by the au¬
thor, but locked up in the archives of the republic ;
whence a copy having fome years afterwards been clan-
deftinely obtained, it tvas publilhed at the Hague in 1725,
in the Italian and French languages. In the lame year an
Englilh verfion of it appeared at London, under the title
of “ The Rights of Sovereigns and Subjects, argued from
the civil, canon, and common, Law, under the feveral
Heads of Excommunications, Interdicts, Perfecution,
Councils, Appeals, Infallibility, defcribing the Bounda¬
ries of that Power which is claimed throughout Chriften-
dom by the Crown and the Mitre ; and of the Privileges
which appertain to Subjects, both Clergy and Laity, ac¬
cording to the Laws of God and Man.”

But on this occafion Father Paul did not confine him¬
felf to the compofition of the work above mentioned,
which was for the ufe of the fenate. As a means of con¬
tributing towards the public tranquillity, he thought it

U L.

alfo necelfary to encourage and enlighten the general
mafs of citizens ; and for this purpofe he publilhed a
tranllation of “A Treatife on Excommunication,” by
Gerfon, both in Latin and Italian, with an anonymous
letter prefixed to it, in which he exhorted the priefts regu¬
larly to perform their functions, without any apprehen-
fion that by fo doing they Ihould violate their duty. No
fooner had this work made its appearance than it was
condemned by the Inquifition ; wiiofe judgment cardinal
Bellarmine undertook to fupport, in a ftrain of reafon-
ing adapted to make imprelfion only on timid and fuper-
ftitious minds, prejudiced in favour of the paramount
authority of the popes. The fallacy of this reafoning
our author ably detected in “ An Apology for Gerfon,”
which fully juftified that writer’s doCtrine, and the pro¬
ceedings of the Venetians in the prefent conteft. To the
fucceeding champions for the papal fee, among whom
wereBaronius and Bzovius, Father Paul made an unan-
fwerable reply, in a piece, entitled, “ Confiderationson
the Cenfures of Paul V.” in which the author’s argumen¬
tative talents, erudition, and moderation, are eminently
difplayed. Father Paul had alfo a fnare in fome other
treadles in this memorable controverfy; particularly in
“A Treatife on the Interdict,” publilhed in the names
of feven divines of the republic.

At length the court of Rome, perceiving that its caufe
was daily loling ground, while the credit of the writings
which oppofed its claims was proportionably increafing,
thought it advifable to diminilh their circulation and in¬
fluence, by preferring the charge of herefy againft their
authors. Accordingly, after the Inquifition had con¬
demned the Confiderations on the Cenfures of Paul V
as containing ralh, calumnious, fcandalous, feditious,
fchifmatical, erroneous, and heretical, proportions, Fa¬
ther Paul was cited by a decree. Oft. 30, 1606, under
penalty of excommunication, to appear in perfon at
Rome, and juftify himfelf from the excelfies and herefies
of which he was accufed. Defpifing, however, the thun¬
ders of the Vatican, he refufed to iubmit to the citation,
the invalidity of which he proclaimed in a manifefto ad-
drefled to the ir.quifitors 5 and he offered to maintain
the caufe which he had avowed, as well as to defend
himfelf againft the articles laid to his charge, in oppofi-
tion to the advocates for the papal claims, in any place
where he could be alfured of perfonal fafety. This no¬
ble intrepidity, while it rendered him the objeft of the
raoft bitter hatred at Rome, defervedly fecured to him.
the increafing relpecl and efteem of the republic whofe
caufe he fo ably defended, and was highly applauded in
molt foreign countries, Catholic as well as Proteftant.
The pope, finding that his menaces had not the efteft of
bringing the republic to fubmiflion, was defirous of an
accommodation, left, in imitation of the Proteftant
ftates, it Ihould break off all connexion with his fee j
but he wms not willing to make the firft advances, for
fear of appearing to condemn his own condudt and to
difavow his pretenfions. The republic was likewife de¬
firous of peace 5 but would take no fteps to fecure it,
which might feem to facrifice its honour cr its rights.
In thefe circumltances different foreign princes offered
their mediation ; and Henry IV. of France, by employ¬
ing Cardinal Joyeufe in negociations with both parties,
brought about a reconciliation between them, in the
year 1607.

Had the divifion between the pope and fenate conti¬
nued much longer, it is nor improbable but fhat the Ve¬
netians, by the advice and boldnefs of Father Paul,
would have been encouraged to feparate themfelves from
the Romilli communion. Such a refult was expected,
and might have taken place, according to Welvvood, had
the negociations of James I. of England with the repub¬
lic been wifely condudted. This author informs us, in
his Memoirs, p. 34, See. that “ there appeared at that
time a wonderful difpofition in that ftate to work a re¬
formation in the church, and throw off the papal yoke.

In

3

414

PAUL.

In order to advance it, king James difpatched fir Henry
Wotton his ambaffador to Venice; and, hearing that
Spain had declared for the pope, he declared for the Ve¬
netians; and acquainted Juftiniani, their ambaffador in
England, that he would not only a (Tift them with all the
forces of his kingdom, but engage all his allies in their
defence. At Wotton’s arrival, the breach between the
pope and the republic was brought very near a crifis; fo
that a total feparation was expeCted not only from the
court, but the church of Rome; which was fet on by the
learned Padre Paolo, and the feven divines of the ftate,
with much zeal, and conduced with much prudence.
The ambaffador at his audience offered all poffible aflift-
ance in his matter's name, .and accufed the pope and pa¬
pacy of being the chief authors of all the mifchiefs in
Chriftendom. This was received with great deference
and refpeCt to king James : and when the pope’s nuncio
objected, that king James was not a Catholic, and fo
was not to be relied upon, the doge took him up brifkly,
and told him, “ that the king of England believed in
Jefus Chrift, but he did not know in wdiom fome others
believed.” King James had fent with Wotton his “Pre¬
monition to all Chriftian Princes and States,” tranttated
into Latin, to be prefented to thefenate; which Padre
Paulo and the other divines preffed might be done at the
firft audience, telling him they were confident it would
have a very good effect. The ambaffador could not be
prevailed with, alleging that he had pofitive orders to
wait till St. James’s day, which was not far off. This
conceit of prefenting king James’s book upon St. James’s
day fpoiled all ; for, before that day came, the difference
was made up, and that happy opportunity loft.”

But, notwithftanding this reconciliation, in which
Father Paul was comprehended, the court of Rome did
not forget who were employed by the fenate in defending
he authority and rights of the republic, and loft no op¬
portunity of wreaking its vengeance upon them, under
various pretexts. Above all, it could not forgive our au¬
thor’s attacks on the pope’s authority ; and fome of its fa¬
natical adherents were perfuaded, that it would be a highly
meritorious aCtion to make away with a man who had been
accufed and condemned for herefy and a revolt againft
the church. Father Paul received intimations from va¬
rious quarters, that defigns were formed either on his
liberty or his life, and was ftrongly urged to be upon his
guard againft them. Trufting, however, to the accom¬
modation which had taken place, and the reCtitude of
liis own conduCt, he lived in a ftate of fecurity which
gave his enemies favourable opportunities of carrying
their plans into execution. Returning to his monaftery
on the evening of the 5th of October, 1607, he was at¬
tacked by five affaflins armed with ftilettoes, who wound¬
ed him in fifteen places, and left him for dead upon the
fpot. Very providentially, not one of thefe wounds
proved mortal, though three of them were exceedingly
dangerous: two of them through his neck; and the
third made by the ftiletto’s entering his right ear and
coining out between the nofe and right cheek, after
being driven in with fuch force, that the affaffm W'as
obliged to leave his w’eapon in the wound. As his efcape
feemed almoft miraculous, it was thought proper to pre-
ferve the bloody inftrument which was left in the cheek
as a public monument; and it was therefore hung up at
the foot of a crucifix in the church of the Servites, with
this infcription, Deo Filio Liberatori.

This defign againft Father Paul’s life was not the only
one attempted by his enemies. One plot was laid by
fome monks of his own order, to murder him at night
in his apartment, to which they had procured falfekeys ;
but it was accidentally difcovered, and the reality of it
confirmed by the feizure of letters. Various other
fchemes were alfo laid for cutting him off; and he was
even cautioned to be upon the watch againft them by car-
dinal Bellarmine himfelf, whofe efteem for fo great a man
was not diminifhed by their difpute on the fubjeCt of the

interdict, and who condemned the criminal intrigues
againft his perfon. Thefe intrigues engaged the fenate to
take all imaginable precautions for his fafety, and to pro¬
hibit all unknown perfons from having any admiftion to-
him for the future ; and he himfelf was now aware of the
neceffity of living more privately in his monaftery. In
this retirement, the firft compofition on which he em¬
ployed his pen, was his “ Account of the Quarrel be¬
tween Paul V. and the Republic of Venice,” publifhed
in 1608, and containing a relation of all the circumftances
connected with that memorable affair, drawn up with
equal ability and impartiality. His attention was di¬
rected in the next place, to the arrangement and comple¬
tion of his celebrated “ Hiftory of the Council of Trent,”
for which he had long before collected ample materials.
It was firft publilhed at London, in 1619, in folio, under
the feigned name of Pietro Soave Polano which is an ana¬
gram of Paolo Sarpi, Venetiano, and dedicated to James
I. by Anthony de Dominis, archbifhop of Spalatro, then
a refident in England. It was afterwards publifhed in
the original Italian, the French, and other languages ;
and, in 1736, Father Courayer publifhed at London a new
French tranflation of it in 2 vols. folio, illuftrated with
valuable critical, hiftorical, and theological, notes. Be¬
fore the appearance of this hiftory, the public in general
poffeffed no knowledge of ’the proceedings of that fa¬
mous council, which for many fucceffive years had en¬
gaged the attention of all the courts in Europe, excepting
what could be collected from its decrees. But Father
Paul’s work is rendered highly interefting, by laying,
open to view the fecret intrigues, the main fprings
which directed all its movements. Such a publication
could not but create the moft unfavourable impreffions
of the policy of the papal court; and on this account it
produced more bitter enmity againft the author at Rome,
than even his mafterly defences of the rights of the re¬
public of Venice. Father Paul alfo, in the retirement of
his monaftery, wrote “ A Treatife on Ecclefiaftical Bene¬
fices,” pointing out the means by which the church had
acquired its immenfe revenues, and theabufes which had
taken place in the difpofal of them ; “ A Treatife on the
Inquifition,” containing a brief hiftory of the eftablifh-
ment of that tribunal, and of the manner in which it
had been introduced into Venice in the year 1289, toge¬
ther with a, comparative view of its reception in that re¬
public and other countries; “ De Jure Afylorum ;” a
treatife “On the Manner of conducting the Government
of a Republic, fo as to infure its Duration ;” and a con¬
tinuation of the Archbifhop of Zara’s Hiftory of the
Ufcocchi, from the year 1602 to 1616. The articles al¬
ready enumerated, together with a volume of Letters,
are all the productions of Father Paul’s pen which have
been given to the public. The firft collection of them
was publifhed at Venice, 1677, in 6 vols. umo.

Father Paul’s conftitution, which, as we have feen,
was always tender and delicate, became worn out at
length by his inceflant labours ; and in the winter of
1622, his growing weaknefs, occafioned by the attack
of a violent flux accompanied with fever, convinced him
that his end was approaching. To this event he looked
forward with firmnefs and tranquillity, arifing from a
confcioufnefs of the innocence of his life, and the purity
of his intentions; and he fpent his laft days, with the
exception of thofe hours which he could not refufe to
the fervice of his country, in meditation and prayer, and
pious difcourfe with his friends. On the evening of
Jan. 14, 1623, being told by his phyfician that he would
not furvive the night, he difcovered the moft placid fub-
miflion to the will of God, and wiflied his friends to
withdraw, that they might not have the pain of witnef-
fing his laft ftruggle ; but they would not quit his dying-
bed, and heard him, as his powers of fpeech were failing,
pronounce the words, EJio perpetua, which they inter¬
preted to be a prayer for the prefervation of the republic.
He had reached the 72d year of his age. When the news

PAUL.

of his death arrived at Rome, the corrupt and fervile
courtiers exprefled great joy, and the pope himfelf could
not refrain from fpeakingof it as an event in which the
hand of God was vifible : “as if,” fays Father Fulgentio,
“ it had been a miracle for a man to die at the age of 71.”
Many of the exalted members of the Romifh hierarchy,
however, fpoke of his memory with the greateft refpedt ;
and alfo exprefled their regret that his merits had not
been duly eftimated by the fovereign pontiffs, who, they
faid, fhould have fecured fuch an extraordinary man in
the interefts of the church, by promoting him to its
dignities and honours. At Venice his lofs was deeply
lamented by all ranks, who jultly regarded him as the
brightelt ornament of their country, for knowledge,
wifdom, and virtue. His funeral obfequies were cele¬
brated with all poflible public magnificence, and attend¬
ed by a vaft concourfe of the nobles, and the other
claffes in the republic. To exprefs their grateful fenfe
of the fervices which he had rendered to his country, the
fenate erected a monument to him, on which an appro¬
priate epitaph was infcribed, drawn up by John Anthony
Venerio, a noble Venetian. Vita de P. Paolo, by Fulgen-
tius. Courayer's Vie abrtgle de Fra. Paolo. Gen. Biog.

PAUL (St.), a province in the territory or kingdom
of Brafil, in South America, fituated to the weft of Rio
Janeiro: the principal productions are grain and cotton.
The population is computed at 11,100 whites, 32,170
Indians, and 9000 blacks or mulattoes. More recently
we have heard the whole population eftimated at 300,000
fouls.

PAUL (St.), a town of Brafil, in the captainfhip of
St. Vincent. It is a kind of independent republic, com-
pofed of the banditti of feveral nations, who pay a tri¬
bute of gold to the king of Portugal. Thefe thieves are
called Paulijis. Their town of St. Paul ftands on a hill
about 150 paces in height, whence iflue two rivulets, one
to the fouth the other to the weft, which afterwards join,
and fall into the Harcambu, that pafles at a diftance of a
league to the north, a river full of fifli, and capable of
receiving large barks, but liable to inundation in the
rainy feafon. On the north of this river the mountains
extend eaft and weft for more than forty leagues, while on
the fouth-weft the chain feems to wind towards the
mountains of Chiquitos in the Spanifh pofleffions ; the
Parana palling with ftupendous rapids of twelve leagues,
the general breadth of the chain being from twelve to
twenty. In the vicinity of St. Paul, the mountains pre-
fent mines of gold of the purity of twenty-tv.'o carats,
which is found in irregular maffes, and in dull. The cli¬
mate is benign, owing to the frelh air from the moun¬
tains, but the winter is cold and frofty. United by equal
want of religion and morals, the firft inhabitants of this
town formed a republic, like that of robbers in a cavern.
Malefactors of all nations and colours, Portuguese, Spa¬
niards, Negroes, Indians, and all poflible mixtures of
mankind, formed about 100 families, which gradually
rofe to 1000, The Paulifts declared themfelves a free
people; and they feein to have merited the title in the
word fenfe of it, as they were completely free from all
laws, morals, fentiments, and virtues : but they confent-
ed to pay the Portuguefe a fifth part of the gold which
they drew from the mines or fcours (lavaderos). All
ftrangers who did not bring certificates of having been
regular thieves, were refuted admittance into this hopeful
Colony ; and there was a marked averfion from any mul¬
tiplication of profeflions, as they rejeCled any robber who
was at the fame time a fpy. The firft trial of a new citi¬
zen, was to make an excurfion, and bring in two Indians
prifoners, to be employed in the mines, or in digging the
grounds. Virtuous aCtions were puniihed with death ;
and no citizen was permitted to retire from the Society.
Supplied with fire-arms from unknown quarters, they
often defcended the large rivers, carrying terror and de-
ftruftion into the Spanifh pofleffions in Paraguay; and
an army would have been neceflary ever to reduce them

Vol. XIX. No. 1313.

415

to the Portuguefe domination. Where they fufpeCted
that force would not avail, they affumed the black gowns
of the Jefuits, and preached with great fervour to the In¬
dians, on the advantages of religion and civilization, and
the heinous offences of robbery and murder, efpecially
warning them againft thofe devils the Paulifts, who were
accuftomed to breakfaft on nuns and little children.
When they had catechifed a Sufficient number, they per-
Suaded them to follow their teachers to a convenient Spot,
where they would find abundance of all the neceffaries of
life. The poor Indians, accuftomed to the Same proce¬
dure on the part of the Jefuits, allowed themfelves to be
conducted by thefe wolves in wool, who, when they had
led them to the trap, Seized and carried them off captives.
This new mode of preaching began to difguft the Savages ;
and the Jefuits found it difficult to avoid the total lofs of
their charafter, by the artifices of thefe new brethren, as
the Indians could not poflibly diftinguifh between a Je-
fuit and a Paulift. To the Sword of the faith they were
found to join that of the flefli, and to arm all their con¬
verts, not with patience but with fufils. The Paulifts
at length began to lofe their advantages, both as preach¬
ers and as pirates ; and, the bonds of their fociety having
begun to be broken by the introduction of Some virtues,
the city was yielded to the Portuguefe monarchy, which
is ftill contented to receive a fifth part of the mines.
Population, 20,000 fouls. Lat. 23. 25. S. Ion. 45. 52. V/.
Pinkerton s Geography , vol. iii.

It was during the prince-regent’s vifit to this city, in
Auguft, 1822, that the firft decifive indication of a Separa¬
tion from the mother-country, and the total independence
of the Brafilians upon Portugal, took place. Before the
prince quitted St. Paul’s to return to Rio, the governor
and people infilled upon his declaring the independence
of Brazil, to which he acceded, and was Solemnly Sworn
in its Support. After the ceremony, he took the confti-
tutional cockade from his hat, and affixed a green badge
to his left arm, with the motto on a yellow ftripe, “ In¬
dependence or Death.” The prince returned to Rio on
the 14th of September ; on the 15th (Sunday), he ap¬
peared at the opera with this badge ; and on Monday
morning there was not a conftitutional cockade to be
Seen in the city. The military and others under govern¬
ment received orders to take off the Portuguefe cockades,
and to adopt the green badge. It appears that the Paul¬
ifts were fo indignant at the laft intelligence from Lifbon,
that the conftitutional cockade was thrown away as Soon
as the meafure of placing the provincial government of
St. Paul’s under a criminal procefs was ascertained to be
in contemplation. It is probable, that before this article
meets the public eye, the prince will have been crowned
King of Brafil. Of courfe, we Shall have an opportunity
of refuming the fubjefl under the article Portugal.

PAUL’S (St.), an ifland in the Southern Indian Sea,
to the north of the ifland of Amiterdam. It rifes ab¬
ruptly from the Sea, a confpicuous cone-fhaped mountain,
apparently Solid when viewed from the weftern fide; bur,
on coming round to the eaftern, presenting an immenfe
cavity, Scooped out of the higheft part of the ifland, and
the Sides toward the Sea broken down to the water’s edge,
thus affording a complete view of the interior. It is evi¬
dently the crater of an extindl volcano ; but whether
fhot up from the bed of the ocean, or the neighbouring
level land by which it may have been encircled being
Submerged, or how long it has ceafed to aft, muff: remain
uncertain. It is So different from any thing like the co-
ral-iflands of the Pacific or Indian oceans, and fo high
withal, that nothing of this kind can be fuppofed ; while
its diftance from any of the continents leaves no proba¬
bility of having ever belonged to either. The fhores are
lteep and rocky: a furious Surf continually waflies the
bafe ; and off the crater, at the diftance of a mile and a
half, there is anchorage in fine weather, when the wind
blows from the weftward. The breadth of the entrance
is about forty yards. When over the bar, and within the
5 O bafin,

416

P A U

bafin, the water becomes as fmooth as a pond, forming a
ilrong contrail to the continual turbulence of the lea
without. This balin occupies a confiderable portion of
the bottom of the crater ; and lince its firft difcovery, has
much increafed in lize, being now more than a mile in
circumference. Its depth in the deepeft place is thirty
fathoms, varying to feven or eight clofe to the (bore.
The latter, around it, is in general level to fome little
diftance, where the a (cent to the fummit becomes more
perpendicular. Near the water the grafs is Ihort ; farther
off it is long, coarfe, and in fuch denfe tufts, as to render
it difficult to penetrate through them.

To the Dutch navigator Flaming we owe the difcovery
of this illand in 1697, when he found the bafin, now fo
fpacious, fcarcely a piftol-lhot long, and the rocks form¬
ing the bar fo much higher than at prefent, that the
boat could with much difficulty be dragged over them.
Should the fame changes go on equally rapid in decompo-
iing the rock, the balin may in thirty years more be ac-
ceffible to the fmalier fealing-veffels. The illand is about
four miles long and three broad, the furface prefenting
nothing but a brown coarfe grafs intermixed with abun¬
dance of Hones, and near the balin fome reeds, but nei¬
ther tree nor Ihrub. To gain the furface, there being no
other landing-place, it is neceffary to enter the balin, and
afcer.d, by a very difficult and fatiguing path, the fide of
the crater. The height of the latter, reckoning the
depth of water, is eftimated at more than ninety feet ;
the circumference at the bottom a mile and a half ; at the
fummit or mouth about two miles. The fummit of the
crater is the higheft part of the illand, which (helves to¬
wards the north.

Around the bafin are feveral hot-fprings, (another
proof, if any were wanting, of the volcanic nature of the
illand,) faid to be within twenty or twenty-live degrees
of the boiling point. And as the balin abounds with
line fifn, eafily caught, it has been reprefented that they
might be thrown from the cold water to the hot, for
boiling, without being difengaged from the hook ;
though this is an exaggeration. Filh are equally plenti¬
ful in the fea without the bafin ; fo numerous and vo¬
racious, indeed, as to be caught with little trouble: they
are principally of a fpecies refembling the bream and
perch, averaging three or four pounds weight each, and
excellent eating. Veffels that touch here, wilhing to add
to their fea-ftore, fhould cure them immediately ; expo-
lure to rain, previous to fairing, is found by experience
to render them of little value. Whales frequent the vi¬
cinity of this illand at certain periods ; but its chief vi-
fitors are feals, who twenty years ago were to be feen on
the rocks, and balking in the grafs, in many thoufands.
Inftances have occurred of three thoufand having been
killed in a few days ; the principal inftrument for this
purpofe is a good cudgel, which by a fmart blow over the
fnout accomplilhes the objecl. At prefent their numbers
are much diminilhed, by the great demand for the Ikin in
commerce, and having become of late years a falhionable
article of drefs. Numbers likewife are carried to Ame¬
rica.

Theftratum of earth is thin, and little, therefore, can
be accomplilhed here by cultivation 5 but at the bottom
of the crater, around the balin, there is little doubt that
gardens might be formed, were any of the temporary
fojourners indullrious enougl) to make the attempt, and
inclofe them from the depredations of the feals. Sea¬
birds are particularly numerous, as the petere), penguin,
comihon gull, and albatrofs. Freffi umter is fmall in
quantity, and difficult to be procured. This place is
fifty miles north from Amfterdam Illand. Lat. 38. 42. S.
Ion. 77. 53. E. Monthly Mag. Nov. 1822.

PAUL (St.), a town of New Mexico, fituated at the
confluence of the two main head branches of the Rio
Bravo. — Alfo, the moll foutherly of the Pearl iflands, in
the gulf of Panama. In a fate channel on the north fide
there is a place for careening of ffiips. — Alfo, an illand

P A U

in the gulf of St. Lawrance : nine miies north-eall from

the north cape of the illand of Cape Breton _ Alfo, a

river of Guinea, which runs into the Atlantic five
miles north of Cape Mefurada.

PAUL (St.), a town of France, in the department of
the Tarn, and chief place of a canton, in the di Uriel of
Lavaur. The place contains 906, and the canton 6070,
inhabitants. — A town of France, and principal place of
a dillridl, in the department of the Var : feven miles welt
of Nice. _ Lat. 43. 41. N. Ion. 7. 11. E.— Alfo, a town of
France, in the department of the Upper Vienne: nine
miles fouth-eall of Limoges. — Alfo, a town of France, in
the department of the Leman lake, on the lake of Ge¬
neva : ten miles ealt ofThonon.' — Alfo, a town of
France, in the department of the Gard : ten miles north-
eall of Uzes.

PAUL’S (St.), a bay on the north-weft coall of New¬
foundland. Lat. 49. 50. N. Ion. 57. 35. W. — A bay on
the weft coall of Newfoundland : ten miles north-eall of
Bonne Bay. — A bay on the north-well fhore of the river
St. Lawrence, about fix leagues below Cape Torment,
where a chain of mountains, 400 leagues in length, termi¬
nates from the weftward.

PAUL’S BET'ONY. See Veronica.

PAUL DE FENOUILLE'T, a town of France, in the
department of the eall Pyrenees, and chief place of a can¬
ton, in the diflrict of Perpignan: twenty-eight miles
well-north-well of Perpignan.

PAUL DE OMAGU'AS, a town of Brafil, in the go¬
vernment of Para, on the river Amazons. Lat. 3. 33. S.

PAUL’S POI'NT, a cape on the eall coall of Barbadoes :
one mile fouth of Cuckold’s Point.

PAUL TROIS CHATEAU'X, a town of France,
in the department of the Drome, before the revolution
the fee of a bilhop : twelve miles fouth of Montelimart.

PAU'LA, a faint in the Roman calendar, was adefeen-
dant, on the maternal fide, from the noble families of
the Scipios, and Paulus iEmilius, and born at Rome
about the year 348. Becoming a widow, (he renounced
the world, and accompanied St. Jerome to Paleftine,
where Ihe was made fuperior of a monallery at Bethlehem.
She lludied the Hebrew language, that (lie might better
underltand the Scriptures ; and, after fpending feveral
years in the fuperltitious pra&ice of exceffive mortifica¬
tions and aullerities, which, Jerome fays, he frequently
attempted to moderate, died in 404, about the age of
fifty -fix. Further particulars concerning her may be
found in Hieron. Epift. lxxxvi. and under our article
Jerome, vol. x. p. 775.

PAU'LA, a town of Naples, in Calabria Citra, fituated
at a fmall diftance from the fea: twelve miles north-well
of Cofenza.

PAU'LA, a' fort of Ruffia, in the government of
Caucafus : twenty miies well of Ekaterinograd.

PAU'LA (St.), a fmall illand of Ruffia, in the Frozen
ocean. Lat. 76. 54. N. Ion. 103. 14. E.

PAU'LAR (Elj, a town of Spain, in Old Gaftiie :
eleven miles eall-fouth-eall of Segovia.

PAULARA'H, a town of Hindooftan, in Berar:
twenty-five miles north-weft Chanda.

PAULASTY'A, in Hindoo mythology, is one of “ ten
lords of created beings,” frequently alluded to in their
facred books under the name of Brahmadikas, orchildren
of Brahma. Their names are enumerated under the ar¬
ticle Muni of this work, where alfo fome particulars will
be found refpefting them. — Paulallya, orPulallya, is alfo
a name of Ravana, the ten-headed tyrant of Lanka, or
Ceylon, againll whom the wars detailed in the Ramayana
we're waged. See Ravana.

PAU'LEYS, a town of South Carolina : eight miles
fouth of Kingdom

PAU'LHAC, a town of France, in the department of
the Cants] : ten miles well of St. Flour.

PAU'LHAN, a town of France, in the department of
the Herault : nine miles north of Pezenas.

PAULHIACf,

P A U

P A U

PAULHIAC7, a town of France, jn the department
- of the Lot and Garonne: fix miles fouth-fouth-eaft of
Villereai, and three north-eaft of Montflanquin.

PAU'LI (Gregory), a learned Polifii divine of the
proteftant perfualion, was appointed minifter of the
church of Wolanear Cracow, in the year 1555. After¬
wards he became paftorand fenior minifter of the church
of Cracow. He was one of the earlieft opponents of the
do&rine of the Trinity in Poland, though he did not
advance further than the Arian hypothefis. For the
freedom with which he avowed and defended his opi¬
nions in the pulpit, he was expelled from Cracow ; when
he retired to Racow, where he died at a great age about
the year 1 591. He was the author of “ An Explanation
of difficult Paflages in the Sacred Scriptures;” different
treatifes againft the lawfulnefs of a Chriftian’s underta¬
king offices of civil magiftracy, or bearing arms ; the firft
impreffion of “ The Catechifm of Racow,” which was
afterwards altered by Laelius Socinus and Peter Stato-
rius; and various pieces in the Trinitarian controverfy,
which are enumerated in Sandii Bibliotli. Antitrinitar .

PAULIAGUET', a town of France, in the depart¬
ment of the Upper Loire : nine miles fouth-eaft of Bri-
otide, and eighteen north-weft of Le Puy.

PAU'LIAN (Father), an ex-Jefuit, was born at
Nifmes in France, of a proteftant family ; and died there,
in the year 1800, having never been ill in the courfe of
his life. His works are : 1. DiClionnaire de Phyfique,
which went through feven editions in nine years, and
which was long the only one ufed in the public fchools
of France: it is a compilation not deftitute of merit,
though inferior to that of Briflon. 2. Traite de Paix
entre Defcartes et Newton, 3 vol. 3. Commentaire fur
De la Caille et l’Hofpital. 4. Le veritable Syfteme de la
Nature oppofe au faux Syfteme de la Nature. 5. La Phy¬
fique mile a la Portee de tout le Monde : two volumes
only of this work were printed. 6. DiClionnaire Philofo-
pho-Theologique. This work, deftined for the defence of
the Chriftian religion, brought upon the author the hatred
and farcafms of Voltaire. Father Paulian was a man of a
mild difpofition : during the revolution he always behaved
with great circumfpe&ion in the exercife of the prieft-
h.ood, to which he devoted himfelf. He was a member of
the academies of Nifmes and Lyons. He has left fome
unpubli.ffied works ; among which are, 7. Memoire furle
Poids des Montagnes. 8. On Monfters. Phil. Mag. vol . ix.

PAU'LIANISTS. See Paul of Samofata.

PAULI'CIANS, a branch of the ancient Manichees,
fo called from their founder, onePaulus, an Armenian;
though others are of opinion, that they were thus called
from another Paul, alfo an Armenian by birth, who lived
under the reign of Juftinian II. In thefeventh century
a zealot called Conftantine revived this drooping feCt,
which had fuffered much from the violence of its adver-
faries, and was ready to expire under the feverity of the
imperial edicts, and that zeal with which they were car¬
ried into execution. The Paulicians, however, by their
number, and the countenance of the emperor Nicepho-
rus, became formidable to all the Eaft. But the cruel
rage of perfecution, which had for fome years been fuf-
pendea,. broke forth with redoubled violence under the
reigns of Michael Curopalates and Leo the Armenian,
‘ who inflicted capital punifhment on fuch of the Pauli¬
cians as refufed to return inta the bofom of the church.
The emprefs Theodora, tutorefs of the emperor Mi¬
chael, in 845, would oblige them either to be converted
or to quit the empire : upon which feveral of them were
put to death, and more retired among the Saracens ; but
they were neither all exterminated nor banifhed.

Upon this they entered into a league with the Saracens ;
'and, choofing for their chief an officer of the greateft re-
lolution and valour, whofe name was Carbeus, they de¬
clared againft the Greeks a war which was carried on for
fifty years with the greateft vehemence and fury. Du¬
ring thefe commotions, fome Paulicians, towards the

417

conclufion of this century, fpread abroad their do&rines
among the Bulgarians; many of them, either from a
principle of zeal for the propagation of their opinions,
or from a natural defire of flying from the perfecution
which they fuffered under the Grecian yoke, retired about
the dole of the eleventh century, from Bulgaria and
Thrace, and formed fettlements in other countries.
Their firft migration was into Italy; whence, in procefs
of time, they fent colonies into almoft all the other
provinces of Europe, and formed gradually a confiderable
number of religious affemblies, who adhered to their doc¬
trine, and who were afterwards perfecuted with theutmoft
vehemence by the Roman pontiffs. In Italy they were
called Patarini, from a certain place called Pataria, being
a part of the city of Milan, where they held their aflem-
blies ; and Gathari or Gazari, from Gazaria, or Little
Tartary. In France they were called Albigenfes, though
their faith differed widely from that of the Albigenfes
whom Proteftant writers generally vindicate. See Al-

BIGENSES.

The firft religious aflembly the Paulicians had formed
in Europe, is faid to have been difcovered at Orleans in
1017, under the reign of Robert, when many of them
were condemned to be burnt alive. The ancient Pauli¬
cians, according to Photius, exprefied the utmoft abhor¬
rence of Manes and his doCtrine. The Greek writers
comprife their errors under the fix following particulars :
1. They denied that this inferior and vifible world is the
production of the Supreme Being ; and they diftinguiffied
the Creator of the world and of human bodies from the
moft high God who dwells in the heavens; and hence
fome have been led to conceive that they were a branch
of the Gnoftics rather than the Manichaeans. 2. They
treated contemptuoufly the Virgin Mary 5 or, accordingto
the ufual manner of fpeaking among the Greeks, they re¬
futed to adore and worffiip her. 3. They refufed to cele¬
brate the inftitution of the Lord’s Supper. 4. They loaded
thecrofsof Chrift with contempt and reproach ; by which
we are only to underftand, that they refufed to follow
the abfurd and fuperftitious praCtice of the Greeks, who
paid to the pretended wood of the crofs a certain fort of
religious homage. 5. They rejected, after the example
of the greateft part of the Gnoftics, the books of the
Old Teftament; and looked upon the writers of that fa-
cred hiftoryas infpired by the Creator of this world, and
not by the fupreme God. 6. They excluded prefbyters
and elders from all part in the adminiftration of the
church. Mojheim, vol. ii.

PAU'LIEN (St.), a town of France, in the department
of the Upper Loire, and chief place of a canton, in the
diftriCt of Le Puy. The place contains 2292, and the
canton 5712, inhabitants.

PAU'LIN, a town of France, in the department of
the Tarn : twelve miles eaft of Alby.

PAU'LINGSTOWN, or Pawling, a townfliip of
North America, in Duchefs-county, New York, lying on
the weftern boundary of Connecticut 5 containing 4269
inhabitants, of whom 34 are flaves.

PAU'LINSKILL, a river of New Jerfey, which runs
into the Delaware in lat. 40. 54. N. Ion. 75. 9. E.

PAULI'NUS (Pontius Meropius), or Paulinus No-
lanus, a celebrated prelate and ecclefiaftical writer, was
defcended from a Roman patrician family, and born at
Burdegala in Gaul, now Bourdeaux, in the year 353.
He was a pupil of the famous Decius Aufonius, under
whom he made a confiderable progrels in literature, and
cultivated the ftudy of rhetoric and poetry with fuccefs.
Aufonius being afterwards called to Rome, that he
might be preceptor to the fon of the emperor Gratian,
Paulinus quitted his native place, and followed him to
that city, where he acquired much reputation as a pleader
in the forum. So refpeCtable was the character which he
eftabliffied, that he was raifed to the confular dignity
while very young; and he acquitted himfelf in hisfena-
torial capacity, in a manner that gave univerfal fatisfac-
3 ‘ tion

418

P A U

tion to the Roman citizens. Having married a Spanilh
lady, named Therafia, with whom he obtained a very
large fortune, he took his leave of public affairs, and in¬
dulged his inclination for feeing foreign countries, vifit-
ing almoft all the weftern provinces of the Roman
empire. In the courfe of his travels he formed an inti¬
macy with St. Martin of Tours, St. Ambrofe of Milan,
and other eminent ecclefiaftical characters ; his conver-
fation with whom appears to have produced fuch ftrong
religious impreflions upon his mind, that he determined
to be baptifed. His wife, likewife, who, it feems, had
before fubmitted to the fame rite, contributed not a lit¬
tle to confirm that refolution. Accordingly, he received
the facrament of baptifm from Delphinus, bilhop of
Bourdeaux, in the year 391. Afterwards, he w:ent into
Spain, and took up his refidence at Barcelona; where he
and his wife, having loft their only child, and being
without any profpett of other iffue, f'pent their time
in devout contemplation and afcetic exercifes, applying
the greatefl part of their property to benevolent and cha¬
ritable ufes.

To divert Paulinus from this change of life, and to
recall him again to the purfuit of fecular concerns, Au-
foniusand his other friends had recourfe in vain both to
perfuaiion and raillery. At Barcelona fo high was the
veneration which all clalfes of people entertained for him,
that, in the year 393, he was in a manner compelled by
their urgent intreaties to be ordained prefbyter; but not
before he had obtained theirpromife that helhould be at li¬
berty to remove, as he had intended, into Italy. During
thefollowingyearhearrivedatRome, where he was treated
with the utmoft refpeCt by all ranks; till, perceiving that
pope Siriciusand the clergy were growing jealous of him,
he withdrew to a country-houfe in the vicinity of Nola
in Campania. Having palled about fifteen years in this
place, together with his wife, in that manner of living
w hich they adopted in Spain, Paulinus was chofenand or¬
dained bilhop of Nola, in the year 409, as fome think;
or,,, as Pagi argues with great appearance of probability,
10403. The early part of his epifcopate was difturbed
by the incurfions of the Goths, who conquered and plun¬
dered the city of Nola; but he fpent the remainder of
his life in tranquillity, a bright example of piety, benevo¬
lence, and charity, and the object not only of veneration
but of delight to perfons of all ranks and parties. He
died in 431, in the feventy-eighth year of his age. His
genuine works confift of Letters and Poems, which are
partly inltruflive, but chiefly lively and entertaining.
They are correct, perfpicuous, and elegant; but the
high praife which Aufor.ius has bellowed upon the poems,
is greater than they merit. The firlt edition of all the
pieces attributed to our author was published at Paris in
1516, 8vo. and they were afterwards inferted in the fe-
cond volume of the Orthodoxographa, as well as thefixth
volume of the Bibl. Patr. * The belt feparate edition of
them, is that publilhed at Paris, in 1684, in two volumes
quarto; the firft of which contains the genuine pieces,
and the fecond fuch as are doubtful. Cave's Hijl . Lit.
vol. i. Pagi Crit. in Anal. Baronii An. 403.

PAULI'NUS, a bilhop who flourilhed in the early part
of the 7th century. He was the apoltle of Yorklhire,
having been the firft archbifnop of York: this dignity
ieems to have been conferred on him about the year 626.
He built a church at Almonbury, and dedicated it to St.
Alban, where he preached to and converted the Brigan¬
tines. Camden mentions a crofs at Dewlborough, which
had been erefled to him, with this infcription, Paulinus
lie prccdicavit el celebravit. York was fo fmall about this
time, that there was not fo much as a church in it in
which king Edwin could be baptized. Conftantius is
faid -to have made it a bilhopric. Pope Honorius made
it a metropolitan fee. We are told that Paulinus
baptized in the river Swale, in one day, 10,000 men, be-
fides women and children, on the firft converfion of the
Saxons to Chriftianity, befides many at Halyftone. At

P A U

Walftone, in Northumberland, he baptized Segbert king
of the Eaft Saxons. Bede fays, “ Paulinus, coming with
the king and queen to the royal manor called Ad Gebrin
(now Yeverin), ftaid there thirty-fix days with them, em¬
ployed in the duties of catechizing and baptizing. In
all this time he did nothing from morning to night but
inftrudl the people, who flocked to him from all the vil¬
lages and places, in the doftrine of Chriftand falvation ;
and, after they were inftru£led, baptizing them in the
neighbouring river Glen.” According to the fame Bede,
“ he preached the word in the province of Lindifli ; and
firft converted the governor of the city of Lindocollina,
(Lincoln,) whofe name was Blecca, with all his family.
I11 this city lie built a (tone church of exquifite workman-
fhip, whofe roof being ruined by long neglefit or the vio¬
lence of the enemy, only the walls are now Handing.”
He is alfo faid to have founded a collegiate church of pre¬
bends near Southwell, in Nottinghamfhire, dedicated to
the Virgin Mary.

PAULI'NUS, patriarch of Aquileia in the eighth cen¬
tury, and who is honoured by the Catholics with the ti¬
tle of faint, on account of his zealous defences of the
orthodox doflrine of the Trinity, was born in fome part
of the Auftrian dominions. He diftinguilhed himfelf by
his laborious application, and zeal for the advancement
of learning and fcience. His proficiency, coniidering
the age in which he lived, was very confiderable, and
entitles him to a high rank among his Latin contempo-
raries. By his erudition he recommended himfelf to the
patronage of the emperor Charlemagne, who bellowed
on him various fubftantial marks of his favour, and, to¬
wards the clofe of the year 776, promoted him to the pa¬
triarchate of Aquileia. In the year 793, he publifned a
little treatife in defence of the Trinity, againft Elipand
archbilhop of Toledo, entitled, “ Sacro-Syllabus,” which
is inferted in the feventh volume of the Colledl. Concii.
During the following year, he diftinguilhed himfelf by
his oppofition to the opinions of Elipand, and of Felix
bilhop of Urgela, at the council of Frankfort; and, hav¬
ing convened a fynod at Aquileia, procured the condem¬
nation of them as heretical, in 795. Two years after¬
wards, on the application of the famous Alcuinus to
Charlemagne, Paulinus received the commands of the
emperor to enter more fully into the defence of the or¬
thodox doflrine againft the bilhop of Urgela; in confe-
quence of which he produced, in 798, his “ Lib. III.
adverfus Felicem Orgelitanum,” which were firft pub¬
lilhed by Duchefne, together with the author’s fmaller
treatife, at the end of Alcuini Opera, printed at Paris
in 1617. It is proper to obferve in this place, that the
“ Lib. VII. adverfus Felicem,” which were formerly
attributed to Paulinus, have been reftored by the learned
world to Alcuinus, as their real author. Similar juftice
has likewife been rendered to Paulinus himfelf, by the
Parifian editors of the l.aft edition of St. Auguftine’s
Works : who, upon the credit of ancient MSS. have af-
figned to the patriarch of Aquileia the treatife “ De Sa-
lutaribus Documentis,” which ufed to pafs under the
name of the African bifliop. Befides the articles already
mentioned, fragments of “ A Letter to Heiftulphus,”
from our author, feverely reproving that lord for. putting
his wife to death, on the charge of adultery preferred
againlt her by a fingle witr.efs, and alfo an entire “ Let¬
ter to the Emperor Charlemagne,” are inferted in the fe¬
venth volume of the Collefl. Concii. In the firft volume
of Baluze’s Mifcellan. fome other fragments of pieces by
him may likewife be found. A complete edition of all
his works, with learned notes and illullrations, was
publilhed at Venice in 1737, by John Francis Madrid, a
prieft of the congregation of the Oratory. Paulinus died
in the year 804. Gen. Biog.

PAULINZEL'LE, a town of Germany, in the county
of Schwartzburg Rudolftadt : eight miles weftofRudol-
ftadt, and twenty north of Coburg.

PAU'LLI (Simon), a medical and botanical writer,

was

P A U

419

P A U

was born in 1603 at Roftock. He loft in his childhood
his father, who had been phyfician to the queen of Den¬
mark, but received a royal penfion to enable him to pur-
fue his ftudies. He travelled into the Low Countries,
England, France, and Germany 5 and took the degree of
M. D. at Witremberg in 1630. After praftifing fome
years at Roftock, he removed to Copenhagen, where he
occupied the chairs of anatomy, furgery, and botany, in
the medical college. In 1648 he was nominated court-
phylician ; and he rofe, in 1656, to the poll of firft phy-
lician of king Frederic III. He held the fame office under
Chriftiern V. and died in 1680, at the age of feventy-
feven. His fervices had been rewarded, in 16 66, with the
prelature of Arhufen, which remained in his family.
This phyfician publiftied various profeffional works, of
which thofe relative to botany and the materia medica
are beft known. His “ Quadripartitum de fimplicium
Medicamentorum Facultatibus,” firft printed at Roftock
in 1640, and feveral times reprinted with augmentations,
is an agreeably-written account of what the ancients have
recorded concerning the powers of vegetable fimples, to¬
gether with the refults of his own experience. It is ar¬
ranged according to the four feafons of the year ; and has
little of botanical or phyfical fcience, but is chiefly de¬
voted to pradtice. To the laft edition, the characters of
plants from Tournefort are added. His “Libellum de
Ufu et Abufu Tabaci et Herbas These,” 1661, is chiefly
a fevere cenfure on the ufe of tobacco and tea. In 1648,
he publilhed “ Flora Danica,” 4to. with figures, chiefly
from Lobel and other authors. It contains the defcrip-
tions, fynonyms, and medical virtues, of native Daniffi
plants, arranged according to the feafons. His “ Viridaria
Regia varia et academica,” 1653, is a catalogue of plants
in the botanical gardens of Copenhagen, Paris, Warfaw,
Oxford, 'Padua, Leyden, and Groningen. Paulli was
likewife a ftudious cultivator of anatomy, and the firft
who difleCted human bodies in the theatre at Copenhagen.
He publiftied feveral orations relative to this fcience, and
gave the defcription of a method of preparing fkeletons.

James Henry , fon of the preceding, was brought up to
phylic, and for fome time filled the anatomical chair at
Copenhagen. He was afterwards made profeflor of hif-
tory and royal hiftoriographer ; and at length was em¬
ployed in affairs of ftate, and ennobled by Chriftiern V.
on which occafion he took the name of RoJenfchild. He
publiftied fome anatomical works. Haller i Bibl. Anat.
et Botan.

PAULLI'NI (Chriftian-Francis), a phyfician and na-
turalift, was born in 1643 at Eifenach in Thuringia. He
ftudied at various univerfities, was crowned poet at Ham¬
burgh, made M.A. at Wittemberg, and took the degree
of M. D. at Leyden. He travelled into feveral of the
northern countries, and praftifed in his profeflion at
Hamburgh, Altona, and in Holftein. He received the
title of Count Palatine for his fervices, and was appointed
by the prince-biffiop of Munfter to the offices of his firft
phyfician and hiftoriographer. In 1689, he returned to
his native place, where he died in 1712. He was a mem¬
ber of the academies of the Naturae Curioforum and Ri-
covrati. This phyfician made himfelf known by feveral
monographs, or feparate diflertations, on fubjefts in the
animal and vegetable kingdoms ; fuch as his “ Cynogra-
phia curiofa ; Bufo brevitur defcriptus; Tradlatus de
Anguilla ; Talpa defcripta; Lagographia curiofa ; Lyco-
graphia ; Onographia; De Lumbrico terreftri ; Sacra
Herba,feu Salvia Defcripta ; De Jalappa; Nucis Mofcha-
tae Defcriptio.” In thefe, as well as in fome papers com¬
municated to the Acad. Naturae Curiof. there is more
matter of curiofity than exadt obfervation, and a tendency
is difplayed to fabulous and w’onderful narration. The
fame may be faid ot his “ Obfervationes Phyfico-Medicae,”
which, however, contain fome things worthy of obferva¬
tion. Rewrote likewife, “ Theatrum Illuftr. Viroruin
Corbeias Saxonicae,” and fome other works. Halleri Bibl.
Med. et Anat.

Vox. XIX. No. 1313.

PAULLIN'IA, f. [named by Linnaeus in honour of
Simon Paulli.] In botany, a genus of the clafs oftandria,
order trigynia, natural order of trihilatae, (fapindi,
Jiiff.) Generic characters— Calyx : perianthium five¬
leaved ; leaflets ovate, concave, fpreading, permanent ;
the two outer oppofite, one of the inner larger. Corolla:
petals four, obovate, oblong, twice as large as the calyx,
clawed; two more diftant. NeCtaries two; one four-
petalled inferted into the claws ot the corolla ; the other
four glands at the bale of the petals. Stamina : filaments
eight, Ample, ftiort, united at the bafe. Antherse fmall.
Piftillum: germen turbinate, three-fided, blunt; ftyles
three, filiform, ftiort ; ftigmas fimple, fpreading. Peri-
carpium: capfule large, three-fided, three-celled, three-
valved. Seeds folitary, obovate. EJJential Character —
Calyx five-leaved; petals four; neftary four-leaved,
unequal ; capfules three, comprefled, membranaceous,
connate.

Thefe are climbing ffirubs, throwing out long ftioots
annually like the vine. Leaves ternate (1 to 4), biter-
nate (5 to 10), triternate (11, 12), unequally pinnate
(13 to 16), or fuperdecompound (17). Peduncles foli¬
tary, axillary, having two tendrils in the middle, and be¬
yond many-flowered in racemes. The chief of what we
know on this genus is derived from Jacquin and Plunder.
There are feventeen fpecies.

i.. Paullinia Afiatica, Afiatic paullinia, or toddaiia :
leaves ternate, petioles and Item prickly. Stem round,
covered with prickles. Leaves alternate, on a long flout
petiole, on which alfo is fometimes a prickle; leaflets
oval-lanceolate, entire, fmooth, bright-green above, paler
and almoft alh-coloured underneath. Peduncles very
long and flout, prickly. Fruit commonly tricoccous, but
fometimes quadricoccous and even pentacoccous,faffron-
coloured with black fpots, of an acrid tafte with fome
fweetnefs. Seed kidney-form, grey or afli-coloured.
Flowers white, fmelling ftrongly.

Although the confumption of cinchona bark at the
prefent period is very fmall in proportion to what it was
half a century fince, yet, as MM. Humboldt, Bonpland,
and other travellers, aflert that it appears pr'obable that
the forefts of Peru and the Andes will, before a century
is paft, be exhaufted of that valuable remedy, every fub-
ftance apparently refembling it in its properties merits
attentive confideration. Many phyficians think that the
bark of the willow, oak, horfe-chefnut, &c. in our coun¬
try, is no mean fubftitute ; but it is probable that it is to
wanner climates we mull look for the mod efficacious
remedies of this clafs. Dr. Virey, in a Memoir in the
Journal de Pharmacie, ftates, that M. Bofc has received
from M. Hubert, a botanift of the Ifle of Bourbon, fome
fpecimens of the bark of this fpecies, and that it is ge¬
nerally employed in the Eaft-Indies, the iflands of Mada-
gafcar, France, Bourbon, &c. as a febrifuge in place of
cinchona, with the moll fatisfadlory refults. We are not,
however, of opinion, that more general experiment will
report fo favourably of the powers of this plant ; for the
quinine and cinchonine, the two principles in which the
efficacy of bark refides, do not form any portion of
this plant. The bark is indeed rolled fomewhat like the
cinchona, covered with an epidermis of a brown or grey-
iih colour, interfperfed with yellowifti fpots. The epi¬
dermis is about a line in thicknefs, granular in its tiflue,
and of a bright yellowifit-brown colour: its tafte is
flightly bitter and aromatic. The interior bark, which
conftitutes the liber, is thin ; of a reddiffi-brown colour;
of a Angularly bitter and poignant tafte, fomewhat re¬
fembling pepper in warmth, with a mixture of fweetnefs:
its fradlure does not prefent a refinous appearance. This
Ihrub is very common in Afia and fome of the African
iflands : it is defcribed by Rheede, in his Hortus Mala-
baricus (tom. v.) under the name of kaka-toddali. Schre-
ber makes it the genus Crantzia ; which has been
changed into that of Scopolia by Smith and Wildenow,
under the name of Scopolia aculeata 5 and arranged
5 P with

420

P A U

with the Adelia by Lamarck. Juflieu preferved the name
of Toddalia, by which it is known on the coaft of Ma¬
labar.

2. Paullinia feriana ; (Seriana fcanda triphylla et ra-
cemofa, Plum. Gen. 34. Ic. 113.) Leaves ternate, pe¬
tioles naked, leaflets ovate-oblong. 3. Paullinia nodofa:
leaves ternate, petioles naked, middle leaflet obovate.

4. Paullinia cururu, (Cururu fcandens triphylla,
Plum. Gen. 34. Ic. 111.) Leaves ternate, petioles mar¬
gined. Natives of South America.

5. Paullinia Mexicana, (Seriana fcandens enneaphylla
et racemofa, Plum. Gen. 34. Ic. 113.) Leaves biternate,
all the petioles margined, Hera prickly. Native of Mexico.

6. Paullinia Carthaginenfis ; leaves biternate, all the
petioles margined, Hem unarmed. This has the leaves
more cut than the other fpecies ; and they are very thin,
whereas in the reft they are more or lefs coriaceous and
thick. It is entirely void of prickles. Found by Plu-
mier ; and afterwards by Jacquin about Carthagena in
New Spain, in coppices.

7. Paullinia Caribtea : leaves biternate, all the petioles
margined, branches prickly. The branches and common
petioles are armed with numerous recurved prickles.
Native of the Caribees.

8. Paullinia Curaffavica, or fliining-leaved paullinia:
leaves biternate, all the petioles margined, branches un¬
armed. Jacquin remarks that in Plunder's figure the pe¬
tioles appear to be naked ; they are all, however, except
the common one, margined, or winged at the edge, but fo
flightly, that it can hardly be exprelfed in a figure. Native
of Curafoa.

According to Swartz, this is the Paulinia, or fouple-
jack, of Browne, which lie fays is very common in the
woods of Jamaica, with its flender woody flexile ftalk,
railing itfelf frequently to a very confiderable height
among the bullies : it is fo tough and yielding, that it is
commonly cut into junks, barked, and ufed for riding
and walking flicks. See Paullinia polyphylla. It was
cultivated by Mr. Miller in 1739.

9. Paullinia Barbadenfis: leaves biternate, middle
petiole margined, the reft naked. This differs from the
preceding principally in the form of the leaves, and in
the flighter and lefs frequent inciiion of them. Native
of the Weft Indies. Introduced in 1786, by Mr. Alex¬
ander Anderfon.

10. Paullinia divaricata : leaves biternate, leaflets ovate
acute, moftly entire; petioles naked, panicles divaricating,
wings of the capfules ovate. Native of Jamaica.

11. Paullinia polyphylla, parfley-leaved paullinia, or
fupplejack; (Seriana frutefcens polyphylla et racemofa.
Plum. Gen. 34. Ic. 112.) Leaves triternate, petioles
naked. Native of the Weft Indies. Cultivated in 1739
by Mr. Miller, but not mentioned in the Didlionary.
According to the Kew Catalogue, this is the Jupple-Jaclr,
and if Browne, by foliis ternato-ternatis, means triternate
leaves, his Paulinia is this fpecies; but his fynonymsare
confuted.

12. Paullinia triternata : leaves triternate, petioles
margined. This climbs trees to the height of twenty
feet. Branches round, fmooth, grooved, long, flexible.
Leaves fhining, alternate, numerous : racemes axillary,
four inches long, having about fifty flowers in them,
naked for about two inches, and then divided into three
parts, and putting out two tendrils, two inches long,
fmooth and flat ; calyx and corolla white ; leaves of the
firft ne&ary white with yeliow tips, at firft fight refembling
ftamens. Native of St. Domingo, in woods.

13. Paullinia Japonica : leaves quinate-pinnate, petio-
letted margined, Item herbaceous unarmed. Stem her¬
baceous, angular, climbing, fmooth, fcarcely the thick-
nefs of a draw. Native of Japan.

14. Paullinia vefpertilio : leaves pinnate, leaflets ovate
acuminate gaftied, petioles naked, capfules pedicelled,
with horizontal lanceolate wings. Native of the Weft
Indies.

P A U

15. Paullinia pinnata, or winged-leaved paullinia:
leaves pinnate, petioles margined, leaves fhining. Native
of Brafil, Jamaica, and Domingo, in dry fandy places.
The infertion of the feeds is the fame in Cururu as in
Seriana; but there is a remarkable difference between
them in the fituation of the partitions.

16. Paullinia tomentofa, or downy-leaved paullinia:
leaves pinnate, petioles margined, leaflets tomentofe.

17. Paullinia diverfifolia, or different-leaved paullinia:
leaves fuperdecompound, petioles margined, the loweft
pinnate, the reft ternate. Natives of South America.

Propagation and Culture. Procure the feeds from the
countries where they naturally grow. As foon as they
arrive, fow them in fmall pots filled with light earth, and
plunge them into a moderate tan-bed. If the feeds ar¬
rive in autumn, plunge the pots in the bark-bed in the
ftove, and probably the plants may come up the follow¬
ing fpring : but, if they arrive in fpring, plunge the pots
in a moderate hot-bed under a frame, where they may be
continued all the fummer ; in autumn remove them into
the ftove for the winter, watering them now and then
fparingly. The following fpring plunge the pots into a
new hot-bed under a frame, which will bring up the
plants in about fix weeks, if the feeds are good. When
the plants are fit to remove, plant each in a fmall pot
filled with light earth, and plunge them into a hot-bed of
tanner’s bark, obferving to (hade them till they have
taken new root; after which they fhould have free air
admitted to them daily, in proportion to the warmth of
the feafon. In the autumn they muft be removed into
the bark-ftove, where they muft conftantly remain. As
they require much room, and their flowers have little
beauty, they are feldom propagated in Europe.

PAULMIE'R de GRENTEMESNIL', (Jacques le), a
man of letters, fon of a learned phyfician, Julien le Paul-
mier, was born in the diftrift of Auge in 1587. He was
brought up in the proteftant religion, which was that of
his parents, and puffed fome years in the houfe of Du-
moulin at Paris, where he attended the leffures of Ca-
faubon and other learned men. At fixteen he was fent
to Sedan, where he perfected himfelf in claffical ftudies,
and went through a courfe of philofophy. He afterwards
ftudied the law at Orleans, and employed feveral fubfe-
quent years in travelling, and adding to the copious
ftore of his literary acquifitions. At the age of thirty-
three he entered into the army, and ferved with repu¬
tation in Holland againft the Spaniards under the princes
Maurice and Henry of Naffau. After the peace he paffed
fome time upon the paternal eftate in Normandy, and
then again ferved in Lorraine at the head of a company
of cavalry given him by the duke of Longueville. Re¬
turning with honour, he finally fettled at Caen, where,
at an advanced age, he married an Englifh lady of fortune.
He devoted himfelf to literature, and to the fociety of
the men of erudition with which Caen at that time
abounded, among whom it is fufficient to mention Huet
and Bochart. He was the firft planner of the academy
there eftablifhed, and fupported it againft the efforts of
malice and ignorance. With irreproachable manners, he
preferved the high fpirit of a military man ; and Huet
relates, that w hen he was alinoft in a ftate of decrepitude,
being inlulted by a rude and inlblent young man, he fent
him a challenge, and obliged him to deliver his fword
and beg his life. He was greatly afflidled with the ftone,
for which he twice underwent the operation of lithotomy.
After many fevere fufferings, which he bore with great
refignation, he died in 1670, at the age of eighty-three.
M. de Grentemefnil was a man of extraordinary quick-
nefs of parts, and compofed with great facility poems in
the Greek, Latin, French, Italian, and Spanifh, languages;
but his moft valuable performances were of the critical
clafs. At the perfualion of Huet, he publilhed a collec¬
tion of obfervations made in the perufal of various au¬
thors, under the title of “Exercitationes in optimos
Auitores Gnecos,” 1668, 4to. The great labour of his
. latter

P A U

421

P A U

latter years was a “ Defcription of ancient Greece,” in
Latin, publilhed after his death at Leyden in 1678, 4-to.
A diflertation which he wrote in 1629, concerning the
comparative merits of Lucan and Virgil, was printed at
Leyden in 1704., in the Difiertationes feleftae et criticce
de Poetis of J. Berkel. Huetius de Rebus, §-c.

PAU'LMO W, a town of Bengal : five miles north-weft
of Curruckdeah,

PAU'LMY, a town of France, in the department of
the Indre and Loire: twelve miles fouth-weftot Loches.

PAU'LO, a town of South- America, in New Grenada :
twenty-five miles eaft-north-eaft ofTunja.

PAU'LO (Marco). See Polo.

PAV'LOGRAD, a town of Ruftia, in the government
of Ekaterinofiav : thirty-two miles eaft of Ekaterinoflav.
Lat. 4.7. 10. N. Ion. 35. 54. E.

PAV'LOSK, a fortrefs of Rufiia, in the province of
Tauris, to defend the Straits of Taman, between the
Black Sea and the fea of Azof : fix miles fouth of Kerch.

PAVLOV, a town of Rufiia, on the north coaft of the
Tchudlkoe Lake : twenty miles fouth of Narva.

PAVLO'VA, a town of Ruifia, in the government of
Irtufk, on the Lena: fixteen miles north of Olenga.

PAVLOV'SK, a town of Rufiia, in the government of
Voronez, on the Don : fixty-eight miles fouth -fouth-eaft
of Voronez. Lat. jo. 24. N. Ion. 40. 14. E.

PAVLOVSKAI'A, a town of Rufiia, in the govern¬
ment of Ekaterinoflav, on the Dnieper : thirty-two miles
eaft of Ekaterinoflav.

PAU'LSBURGH, a townfhip of Coos, in New Hamp-
fhire, having fourteen inhabitants.

PAU'LUN, a town of Hindooftan, in the circar of
Kitchwara : fix miles fouth-eaft of Raajegur.

PAU'LUS zEGINE'TA. See .CEgineta, vol. i.

PAU'LUS ^EMIL'IUS, the name of two celebrated
Roman generals, father and fon. See the article Rome.

PAU'LUS (Cyrus Florus), called Paul the Silentiari/,
becaufe he was at the head of the royal filentiaries, offi¬
cers whofe bufinefs it was to prevent noifes in the palace,
flourifhed in the fixth century under the emperor Jufti-
nian. He is faid to have been of an illuftrious family,
and pofiefied of hereditary opulence, but to have been
ftill more diftinguifhed for learning and eloquence. He
was the author of poems in the Greek language, among
which was one giving the hiftory and defcription of the
church of St. Sophia in Conftantinople in more than a
thoufand hexameter lines. This has come down to our
times, and w'as publifhed in the collection of Byzantine
hiftorians, with a tranflation and notes by Ducange. He
alfo compofed a poem on the Pythian Thermic, and fome
epigrams in the Anthology. See Gibbon, vol. vii. in
which is a fine defcription of St. Sophia, taken partly
from the work of Paulus.

PAU'LUS HOOK', a fortified poft of United America,
in the ftate of Jerfey, on the North River, which is here
above 2000 yards acrofs, oppofite New York. In 1780,
this river was fo much frozen, that carriages with heavy
burdens palled over.

To PAUM, v. a. [from palm, the hand ; a very ancient
corruption, Wicliffe and Chaucer both ufing paum, or
paivm, for the palm of the hand.] To impofe by fraud.
See To Palm. — A rogue that locked up his drink, turned
away our wives, cheated us of our fortunes, paumed his
crufts upon us for mutton, and at laft kicked us out of
doors. Swift's Tide of a 7 ub, ed. 1704. ,

PAU'NACH. See Baunach, vol. ii.

PAUNCE, f A panfy :

The pretie paunce,

And the chevifaunce,.

Shall match with the fayre flower delice. Spenfer.

The ftiining meads

Do boaft the paunce, the lily, and the rofe;

And every flower doth laugh as Zephyr blows. B. Jonfon.

PAUNCH,/ [ panfe , Fr. panga, Span, pantex, Lat.]
The belly ; the region of the guts. — Demades, the orator,
was talkative, and would eat hard; Antipater would fay
of him, that he was like a facrifice, that nothing was left
of it but the tongue and the paunch. Bacon.

Pleading Matho, borne abroad for air,

With his fat paunch fills his new-fafhion’d chair. Dry den.

Tv PAUNCH, v. a. To pierce or rip the belly; to
exenterate ; to take out the paunch; to evifcerate. —
Batter his ficull, or paunch him with a (lake. ShakeJpectre.

Chiron attack’d Talthibius with fuch might,

One pafs had paunch' d the huge hydropick knight. Garth.

PAU'NCHWAY, f A fmall boat ufed in Bengal,
being merely an attendant on the budgcrotv, or barge.

The boats, or barges, chiefly in ufe at Bengal, are — the
bur for commerce, and the budgerow and inoorpunkay
for pleafure. As the two former were not noticed in
their proper place, we fhal 1 fpeak of them here.

The bur is ufed for inland navigation on the Ganges,
and very lightly built of thin deals, without either keel
or fide-timbers. The edges of the planks are faftened
together with ftaples, and the feams are flopped up with
mofs, and payed with greafe. Its largeft breadth is about
one-third of the whole length from the ftern, where it
runs up with a bend : it is very fharp forwards, and not
very high above the water. Although they are of dif¬
ferent fizes, they are all of the fame fhape and conftruc-
tion ; and fome of them can load fifty thoufand pounds
weight of merchandife, and more. They are provided
with a Angle maft, which has a large fquare fail ; and, as
they take in a great quantity of water from the fides and
bottoms, the crew' are compelled to employ fome perfons
continually in baling. They are ufed for the carriage of
cotton, and other bulky materials, the weight of which
cannot bear any proportion to their fize. In common
with all the other boats of the country, their bottoms are
nearly fiat ; and indeed, it would be impracticable on
the Ganges to employ veflels formed for drawing any
confiderable quantity of water, as the navigation is ren¬
dered extremely dangerous from the continual fliifting
of the fands.

Budgerow is the denomination given to travelling-
boats, or pleafure-barges, ufed by the Europeans, as well
as by the principal natives, in Bengal. On the outfide,
they are conftruCted like the burs ; but, within, they are
much better adapted for convenience. The fpace from
the middle to the ftern is occupied by one or two apart¬
ments, having windows on the tides, and from fix to feven
feet high ; and fome of them fourteen feet wide : the
lternmoft of them is the bed-room. Thefe budgerows
are of various fizes ; from twenty-five to fixty feet in
length, and longer. They are rowed by a n umber of men,
from fix to twenty, with oars, w'hich are long poles, at
the end of which a little oval board is nailed, in lieu of a
leaf, and which do not ftrike the water crofs-ways, but
obliquely backwards. They are fleered by a large paddle
or oar, extending ten feet from the ftern; and forwards
(lands a maft, upon which is hoifted a fquare fail, when
they go before the wind; and they have likewife a top-
mall with a fquare top-fail for fine weather. When they
have a fide-wind, they drive down athwart the ftream,
not having a keel or timber enough under water, as they
are flat-bottomed, and draw fcarcely a foot and a half of
water. The Englilh gentlemen in Bengal have much im¬
proved the budgerows by introducing a broad flat floor,
fquare fterns, and broad bows. They are thus rendered
much fafer, fail near, and keep their wind ; and there is
no danger attending their taking the ground. Befides,
they are adapted for carrying more fail. The motion
acquired by the oars of a large budgerow hardly exceeds
eight miles a-day, at ordinary times.

The paunchway moves more expeditioufly than the
budgerow ; but it is nearly of the fame conftruClion,

with

422

P A

with this difference, that the greateft breadth is fome-
what further aft and the ftern lower. Its ufe is to convey
the company either on-fhore or on-board, as it often
happens that the budgerow cannot come clofe to the
place where the party wifhes to land, or to embark. 4

The muorpimkay has already been defcribed under that
word, vol. xv.

PAUNDU'RA, a town of Hindooftan, in Oude : twelve
miles fouth-weft of Gazypour.

PAUNGAR'TENBERG, a town of Auftria: fix miles
fouth-weft of Grein.

PAUNRAN', a town of Hindooftan, in Bengal : thirty
miles fouth-weft of Nagore.

PAUNRAN', a town of Hindooftan, in Mohurbunge:
twenty miles north of Harriopour.

PAU'NTON, or Great Paunton, a village in the
county of Lincoln, anciently a Roman town, called Ad
Pontem; it having formerly had a bridge over the river.
Its church is one of the fineft old ftruilures in the county.
Paunton is about four miles fouth of Grantham.

PAU'NTON (Little), lies to the north of Great
Paunton, on the fame river.

PA'VO, f. [called in Greek, rau;, or tkup, perhaps
from ntva, to ftretch, on account of the amplitude of its
tail : in the vEolian dialeft it was pronounced n eta* ; and
lienee the Latin pavo, and its names in the modern lan¬
guages : in Italian, pavone ; in Spanifh pavon ; in French,
paon ; in German, pfau ; in Polifh, paw ; and in Swedilh,
pao-fogel. But a modern “Etymological Gleaner” de¬
rives both the Latin and Englifh name merely from the
c\3.ngpeu-hoo which the peacocks repeat in rainy weather.]
The Peacock; a genus of birds of the order gallinae.
Generic characters — Head crefted ; bill convex, ftrong ;
noftrils broad ; quills of the rump elongated, broad,
expanfible, and fpangled with eyes. There are four fpe-
cies.

x. Pavo criftatus, the common peacock; head crefted,
fpurs fingle.

Dignity of appearance, noblenefs of demeanour, ele¬
gance of form, fweetnefs and delicacy of proportions,
whatever marks diftindtion and commands refpedt, nature
feems to have bellowed on the peacock. A light waving
tuft, painted with the richeft colours, adorns its head,
and raifes without opprefting it. Its matchlefs plumage
feems to combine all that delights the eye in the delicate
tints of the fineft flowers ; all that dazzles in the fpark-
lir.g luftre of the gems; and all that aftonilhes in the
grand difplay of the rainbow'. But n,ot only has nature
united, in the plumage of the peacock, to form a mafter-
piece of magnificence, all the colours of heaven and earth;
the has felefled, mingled, lhaded, melted them with her
inimitable hand, and formed an unrivalled pi<5ture ; in-
fomuch that the feathers derive from their mixture and
their contrail new brilliancy, and effedls of light fo fub-
lime, that our art can neither imitate nor deferibe them,
but in a very faint and imperfeft manner. Such appears
the plumage of the peacock, even when at eafe and alone
in a fine vernal day. But if a female is prefented fud-
denly to his view' ; if the fires of love, joined to the fecret
influence of the feafon, rcufe him from his tranquillity,
and infpire him wdth ardour and new defines ; his beauties
open and expand, his eyes become animated and expref-
five, his tuft flutters on his head, and expreffes the
warmth that ftirs within ; the long feathers of the tail,
riling, difplay their dazzling richnefs ; the head and neck,
bending nobly backwards, trace their lhadow gracefully
on that Ihining ground, u'here the fun-beams play in a
thoufand ways, continually extinguilhed and renewed,
and feem to lend new luftre, more delicious and more
enchanting; new colours, more variegated and more
harmonious ; each movement of the bird produces new
ihades, numberlefs clufters of waving fugitive reflections,
which ever vary and ever pleafe. It is then that the pea¬
cock feems to fpreaa out all his beauties, only to delight
■his female, who, though denied the rich attire, is capti-

V o,

vated with its difplay; the livelinefs which the ardour
of the feafon mingles with his geftures, adds new grace
to his movements, which are naturally noble and dig¬
nified, and which, at this time, are accompanied with a
ftrong hollow murmur, exprefiive of defire. But this
brilliant plumage, which furpaffes the glow of the richeft
flowers, like them alfo is fubjeft to decay ; and, each
year, the peacock Iheds his honours. Then, as if
afhamed at the lofs of his attire, he avoids being feen in
this humiliating condition, and conceals himfelf in the
darkeft retreats, till a new fpring reftores his wonted or¬
naments, and again introduces him to receive the homage
paid to beauty; for he lofes his feathers with the firft fall
of the leaves, and recovers them again when the buds
burft forth. It is pretended that the peacock is fenfible
to admiration, and that a foothing and attentive gaze is
the moft certain means to engage him to difplay his de¬
corations ; but that a look of indifference chills his viva¬
city, and makes him clofe his treafures.

Aftonilhed at the unparalleled beauty of this bird, the
ancients could not help indulging their lively and
creative fancy, in accounting for the magnificence of his
plumage. They made him the favourite of imperial
Juno, After and wife to Jupiter, and not lefs than the
hundred eyes of Argus were pulled out to ornament his
tail ; indeed there is fcarcely any thing in nature that
can vie with the tranfeendent luftre of the peacock’s
feathers. The changing glory of his neck eclipfes the
deep azure of ultramarine, and, at the lead evolution, it
affumes the green tint of the emerald and the purple hue
of the amethyft. His head, which is fmall and finely
fhaped, offers feveral curious ftripes of white and black
round the eyes, and is furmounted by an elegant panache,
or tuft of feathers, each of which is corhpofed of a flender
Item and a fmall fiow'er at the top. The female does not
fhare thefe great honours with the cock, and is generally
of a light brown ; her creft is very fmall, and fhe has no
lpur. It has been faid- that both are afhamed of the
hoarfenefs of their voice and ill-fhapednefs of their feet ;
and indeed they may, for here we ought again to ac¬
knowledge the great fyftem of equity and compenfation
which pervades the whole of nature. The loud feream-
ings of the peacock are worfe than the liarfh croakings
of the raven, and a prognoftic for bad weather; and his
feet, more clumfy than thofe of the turkey, make a fad
contraft with the elegance of his plumage. The fpread-
ing of the tail, the fwelling of the throat, neck, and breaft,
and the puffing noife which they emit, at certain times,
are proofs that the turkey and the peacock Hand nearly
allied in the family-chain of animated beings.

Though the peacock has been long naturalized in
Europe, it is not a native of this quarter of the globe,
but feems to have been originally produced in the rnildeft
parts of the Afiatic and African continents. The Eaft
Indies, Buffon fays, muft be confidered as the true native
country of the peacock, whence it palled into the weftern
parts of Alia. JElian informs us, that Greece received
this beautiful bird from the Barbarians; who, Buffon
thinks, were the people of India, fince Alexander, who
traverfed Afia, firft met with the peacock in that country :
and befides, in no region of the globe is the tribe fo nu¬
merous or fo large as in that oriental clime. Mandeflo
and Thevenot faw them in profufion in the province of
Guzerat : Tavernier, in every part of India, but parti¬
cularly in the territories of Baroche, Cambaya, and
Broudra ; Francis Pyrard, in the vicinity of Calicut;
the Dutch, on the Malabar coaft ; Lintfcot, in-the ifland
of Ceylon ; the author of the Second Voyage to Siam, in
the forelts on the frontiers of that kingdom, on the fide
of Cambogia, and near the banks of the river Meinam ;
Gentil, at Iva; Gemelli Careri, in the Calamian iflands,
lying between the Philippines and Borneo. Indeed this
beautiful bird muft owe its birth to the luxurious climate
where nature lavifhly pours her riches ; where gold, and
pearls, and gems, and precious ftones, and all the beauty
i and

F A V O.

Plate I .

P A

and brilliancy of colours, are flattered with profufion.
This opinion is countenanced by Holy Writ : peacocks
are enumerated among the valuable and rare commodi¬
ties that were every three years- imported by Solomon’s
fleet; which being fitted out in the Red Sea, and not
being able to venture at a diftance from the fhore, mud:
obvioufly have drawn its riches either from India, or the
eafter'n coaft of Africa.

From Afia, it is moll probable, they were tranfported
into Greece, where at firft they were fo rare as to be ex¬
hibited in Athens for thirty years, at the monthly fefti-
vals, as an object of curiofity, which drew crouds of
fpeftators from the neighbouring towhs. We cannot fix
the date of this event ; but it was after the return of
Alexander from India, who firft flopped at the ifland of
Samos. Here the conqueror was fo delighted with the
rich plumage of the peacocks, that he enafted fevere pe¬
nalties again!! killing them. But it is very probable that
foon after this time, and even before the clofe of his
reign, they were become common ; for we learn from the
poet Ariftophanes, who was contemporary with that
hero and furvived him, that a fingle pair brought into
Greece had multiplied fo rapidly, that they were as nu¬
merous as quails ; and befides, Ariftotle, who outlived
his pupil only two years, fpeaks in feveral parts of his
Work of peacocks as well-known birds. That the ifle of
Samos was the firft ftation of Alexander on his return
from India, is probable from its proximity to Afia ; and
is befides proved by the exprefs teftimony of Menodotus.
Some indeed have given a forced interpretation of this
pafl’age, and refting on the authority of fome very ancient
medals of Samos, in which Juno is reprefented with a
peacock at her feet, have pretended that Samos was the
primitive abode of that bird, from whence it has been
difperfed to the eaft and the weft. “ There,” fays Athe-
naeus, “ are the peacocks facred to Juno, they being firft
reared at Samos, and thence carried into other countries,
as the cocks from Perfis, and the meleagrides from
iEolia.” But the truth is, that Samos was the firft part
in Europe where the peacocks were bred ; in the fame
manner as the pintadoes, which were well known to
be African birds, were feen in Aiolia or .ZEtolia, before
they were introduced into the reft of Greece; and efpe-
cially as the climate of Samos is particularly fuited to
them, and they lived there in the ftate of nature. Thefe
reafons are fufficient to account for the epithet of Samian
bird, which fome authors have beftowed on the peacock ;
but the term can be only figurative, fince Tournefort
never mentions the peacock in his defcription of that
ifland, but fays that it is full of partridges, woodcocks,
thrnfhes, wild pigeons, turtles, &c.

After the peacock was tranfplanted from Afia into
Greece, it found its way into the fouth of Europe, and
was gradually introduced into England, Trance, Spain,
Germany, Switzerland, and as far as Sweden, where in¬
deed they are rare, and require great attention, and even
fuffer an alteration in their plumage. Laftly, the Euro¬
peans, who by the extent of their commerce and naviga¬
tion connect the whole inhabited world, have fpread them
along the American coafts, and introduced them into
Mexico, Peru, and fome of the Antilles, as St. Domingo
and Jamaica, where they now are numerous, though there
were none prior to the difcovery of America. The pea¬
cock is a heavy bird, as the ancients well remarked ; the
fhortnefs of its wings, and the length of its tail, check its
aerial courfe ; and, as it with difficulty fubfifts in a north¬
ern climate, it could never migrate into the new world.

The peacock has fcarcely lefs ardour for the female, or
contends with lefs obftinacy, than the common cock.
The pea-hens are alfo of an amorous mould; and, when
deprived of the males, they toy with each other, and wel¬
ter in the duft ; but the eggs which they lay are then
void of the principle of life. Wind- eggs is their common
name in Englifh, becaufe they want their outer fhell, and

Vol. XIX. No. 1313.

V o. 423

are flaccid, as if inflated with air. Perhaps this was alfo
the reafon of the ancient epithet zep/njrian.

Thefe birds, according to Ariftotle, attain their full
vigour in three years. Columella is of the fame opinion ;
and Pliny repeats the word^ of Ariftotle with fome flight
alterations. Varro fixes the period at two years ; and
people who are well acquainted with thefe birds fay, that
in our climate the female begins to lay at the end of the
year, though the eggs are then certainly addled. But almoft
all agree that the age of three years is the term when the
peacock has acquired his full growth, and is fit to per¬
form the office of the male : and that the power of pro¬
creating is announced by a new and fplendid production :
this is the long and beautiful feathers of the tail, which
they difplay, as they ftrut and expand their fan.

The female lays her eggs foon after fecundation ; flie
does not exclude one every day, but only once in three
or four days; and according to Ariftotle the has but one
hatch in the year, which confifts in the firft of eight eggs,
and in the following years of twelve. But this mult be
underftood of thofe pea-hens that both lay their eggs and
rear their young; for, if the eggs be removed as faft as
they are laid, and placed under a common hen, they
will, according to Columella, have three hatches in the
courfe of the year ; the firft of five eggs, the fecond of
four, and the third of two or three. It would feem that
in this country they are not fo prolific, fince they lay
fcarcely more than four or five eggs in the year. On the
other hand, they appear to be far more prolific in India,
where, according to Peter Martyr, they lay from twenty
to thirty. The temperature of a climate has great influ¬
ence on whatever relates to generation, and this is the
key to thofe apparent contradictions which are found
between the ancients and our own obfervations. In a
warm country, the males are more ardent, fight with
each other, require more females, and thefe lay a greater
number of eggs ; but in a cold country the latter are not
fo prolific, and the former are calm and indifferent.

If the pea-hen be fuffered to follow the bent of inftinfl,
flie will lay her eggs in a fecret retired fpot ; the eggs are
white, and fpeckled like thofe of the turkey-hen, and
nearly of the fame fize. During the whole time of incu- -
bation, flie anxioufly ftiuns the male, and is particularly
careful to conceal her track, when flie returns from the
neft : for in this fpecies, as in the gallinaceous tribe, and
many others, the male, burning with luft, and faithlefs to
the intentions of nature, is moreearneft in the purfuit of
pleafure, than felicitous about the multiplication of the
race. If he difeovers his mate fitting on her eggs, he
breaks them ; probably to remove an obftacle to the gra¬
tification of his paflions. The pea-hen fits from twenty-
feven to thirty days, more or lefs, according to the tem¬
perature of the climate, and the warmth of the feafon.
During that time, a fuffiefi nt fupply of food ought to be
fet within her reach, that flie may not be obliged to ftray
in fearch of fubfiftence, and allow her eggs to cool ; and
care muft be taken not to teaze or difturb her in her neft ;
for, if (he perceives that they are difeovered, (he will be
filled with difquietude, abandon her eggs, and begin to
make a fecond hatch, which is not likely to fucceed, be¬
caufe of the latenefs of the feafon. It is faid that the
pea-lien never hatches all her eggs at once ; but, as foon
as a few chickens emerge, flie leaves the neft to lead them
about. In this cafe, the eggs that are left fliould be fet
under another hen, or placed in a ftove for incubation.
After the young are hatched, they ought to be left under
the mother for twenty-four hours, and then removed to
the coop ; Frifch advifes them not to be reftored to their
dam till fome days after.

Their firft food may be barley-meal, wheat fteeped in
water, or bread boiled, and allowed to cool. Afterwards
they may have frefli curd, from which the whey is well
preffed, mixed with chopped leeks, and even grafshop-
pers, of which they are very fond. When they are fix
5 Q months

424

P A V O.

months old, they will eat wheat, barley, the dregs of
cyder and perry, and crop the tender grafs. It is ob-
ferved, that on the firft days after hatching, the mother
never leads her young to the ordinary neft, or even fits
with them twice in the fame place ; and as they are deli¬
cate, and cannot mount on the trees, they are expofed to
many accidents. At this time therefore we ought to
watch them clofely, and difcover where the mother re¬
forts, and put the brood in a coop, or in the field in a
patch inclofed with hurdles. Till they grow flout, the
young peacocks trail their wings, and make no ufe of
them. In their early eflays to fly, the mother takes them
every evening one after another on her back, and carries
them to the branch on which they are to pafs the night.
In the morning, (he defcends before them from the tree,
and encourages them by her example to truft themfelves
to their (lender pinions. A pea-hen, or even a common
hen, can breed twenty-five young peacocks, according to
Columella ; but only fifteen, according to Palladius :
and this laft number is even too great for cold countries,
where they muft be warmed from time to time, and (hel-
tered under the mother’s wing.

When the brood are a month old, or a little more, the
creft begins to (hoot, and then they are fubjeX to ficknefs,
like young turkeys in fimilar circumftances. At this
time the parent cock adopts them as his offspring; for,
before the growth of the creft, he drives them away as
fuppofititious. The creft confilts of twenty-four fmall
feathers, of which the (haft is not furniflied with webs,
but befet with little (lender detached threads ; the top
is formed by a bunch of ordinary feathers united toge¬
ther, and painted with the richeft colours. The creft is
not an inverted cone, as might be fuppofed : its bafe,
which is uppermoft, forms a very extenfive ellipfe, whofe
greater axis is in the direction of the head ; all the feathers
that compofe it have a particular and perceptible motion,
by which they approach each other, or recede, at will,
and alfo a general motion, by which the whole creft is
fometimes ereXed, fometimes reclined. The tail-feathers,
or rather thofe long coverts that are inferted in the back
near the rump, are on a great fcale what thofe of the creft
are on a Imall one. The (haft is equally furniflied, from
its origin to its extremity, with parted filaments of a va¬
rying colour, and it ends in a flat vane, decorated with
what is called the eye, or the mirror. This is a brilliant
fpot, enamelled with the mod enchanting colours ; yellow
gilded with many (hades, green running into blue and
bright violet, according to the different pofitions ; and
the whole receives additional luftre from the colours of
the centre, which is a fine velvet black. The two feathers
in the middle are each four feet and a half long, and ex¬
tend beyond the reft, the others gradually diminilhing
as they approach the fides. The creft is permanent ; but
the tail is call every year, either entirely or in part, about
the end of July, and (hoots again in the fpring; during
which interval the bird is difpirited and feeks retirement,
as before noticed. This beautiful train, or, more cor-
reXly fpeaking, falfe tail, may be expanded quite to a
perpendicular upwards, at the will of the bird. The true
tail is hid beneath this group of brilliant feathers, and
confifts of eighteen grey-brown feathers, one foot and a
half long, marked on the fides with rufous grey : the fca-
pulars and fmaller wing-coverts are reddifti cream-colour,
variegated with black: the middle coverts deep blue,
glofled with green gold. The predominant colour of the
head, throat, neck, and bread, is blue, with different re¬
flexions of violet, yellow, andducid green ; and by means
of thefe waving (hades, nature can fpread a greater va¬
riety of colouring on the fame fpace. On each fide of the
head, there is a protuberance formed by fmall feathers,
which cover the perforation of the external ear. The
common peacock is reprefented on the annexed Plate.

The female is lefs than the male. The train is very
fhort, much more fo than the tail 5 fcarcely longer than

its coverts, and the feathers not furniflied with eyes; the
creft on the head the fame ; the fides of the head have a
greater portion of white ; the throat and neck green ; the
reft of the body and wings cinereous brown ; the bread
fringed with white ; the bill the fame ; irides lead-colour;
the legs, in both male and female, are (lout, cluinfy, and
of a dirty grey colour ; that of the male is furniflied with
a fpur near an inch long ; but the fpur is wanting in the
females ; though in fome a rudiment of one is feen. In
fome male birds the whole of the wing-coverts and fca-
pulars are of a fine deep blue green, very gloffy ; but the
outer edge of the wing and quills are of the ufual co¬
lour.

Though peacocks cannot fly much, they are fond of
climbing. They generally pafs the night on the roofs of
lioufes, where they do a great deal of mifchief, and on the
loftieft trees. From thefe elevated ftations, they often
fcream ; and their cry is univerfally allowed to be difa-
greeable. It is faid that the female has only one note,
which (he feldom utters except in the fpring, while the
male has three. Theophraftus fays, that their cry, if
often reiterated, forebodes rain ; others, that they fora-
tel it when they fcramble higher than ordinary; while
others allege, that thefe cries forebode the death of a
neighbour. The term of the life of a peacock is generally
allowed to be twenty-five years ; but Willoughby ima¬
gines, on the authority of Aiiian, that the peacock lives
a complete century.

As in India the peacocks live in a (late of nature, it is
ufual in that country to hunt them. They can hardly
be approached in the day-time, though they are fcattered
over the fields in numerous flocks; becaufe, as foon as
they defcry a fportfman, they fly away and conceal them¬
felves in the thickets, where they cannot be purfued.
The night therefore is the only proper time for the chafe,
which, in the vicinity of Cambaya, is conduced in the
following manner : The fportfmen get clofe to the tree
where the peacocks are perched, and prefent a kind of
banner, which fupports two burning candles; and is
painted with the figures of peacocks. The peacock daz¬
zled by the glare, or engaged in noticing the painted
birds, ftretches out his neck repeatedly, and again draws
it back ; and, when the head is obferved to be entangled
in a running knot or noofe, placed for the purpofe, the
hunters immediately draw the cord and fecure the bird.

We have feen that the Greeks much admired the pea¬
cock, but this was only for the beauty of their plumage.
The Romans, who carried every luxury to excels,
aXually feafted on peacock’s flefti. The orator Horten-
fius was the firft who ordered it to be ferved up at his
table ; and, his example being followed, this bird came to
be fold at a very high price in Rome. The emperors re¬
fined on the luxury of their fubjeXs ; and Vitellius and
Heliogabalus gloried in filling enormous chargers with
the brains of peacocks, the tongues of the phoenicopterus,
and the livers of the fcarus, forming infipid dilhes, whofe
whole merit confided in their deltruXive expence. In
modern times, that is, in the 16th century, the peacock
was (till confidered a princely di(h, and the whole bird
ufed to be ferved on the table with the feathers of the
neck and tail preferved; but few people could now re-
lifli fuch food, as it is much coarferthan the flefti of the
turkey. We are told, however, that Leo X. who was
very curious in his food, ufed to have faufages made of
peacocks ; and we are told, moreover, that the peacock is
valuable as food in the warmer climates, becaufe it keeps
fweet longer than any other fowl. The Italians have
given this laconic defcription of the peacock : “ He has
the plumage of an angel, the voice of a devil, and the
ftomach of a thief.” Let us obferve that this bird may
be a true moral emblem of thofe who, with moft alluring
outward qualities, do not poflefs the much more valua¬
ble ones of the heart and mind ; for the peacock is both
cruel and ftupid. We have feen inftances of the pea-hen

tolling

P V o

Plate II

?ngravt£ forth* Zna/clopitAalm,jui*noi!.lSlJ.

P A

tolling up her chicks with unnatural barbarity, till they
were dead; and, out of the number which fhe hatches,
The feldom rears more than one or two.

Peacocks’ feathers were formerly ufed to make a fort
of fans ; and they were formed into crowns, like thofe of
laurel, for the Troubadour poets. Gefner law a web
whofe woof was iilk and gold thread, and the warp pea¬
cocks’ feathers. Such no doubt was the robe woven with
thefe feathers which pope Paul III. fent to king Pepin.
The Indians ufe them in many of their ornamental
lirefies; and in China they are given by the emperor to
f'uch of his courtiers and chiefs of his army, as merit
spplaufe ; who then wear them in their hats, as diftin-
gnilhed marks of their mailer’s favour. The princelfes
of China alfo wear them in their caps. According to
Aldrovandus, peacocks’ eggs are reckoned by the mo¬
derns as improper food ; whereas the ancients put them
in the firft clafs, and even before thofe of the goofe and
common hen. This contradiction he explains by faying,
that they are pleafant to the talle, but pernicious to the
health. It remains to be inquired whether the tempera¬
ture of the climate affeXs their quality. There are two
other varieties.

£. P. varius, the variegated peacock : cheeks, throat,
belly, and wing-coverts, white. This is no other than a
mixed breed between the white variety and the common
peacock ; confequently they are to be feen in every pro¬
portion of colour between thofe two birds.

y. P. albus, the white peacock: body entirely white.
Climate feems to have no lefs influence on the plumage
of birds than on the fur of animals. We have feen, in
lame previous articles, that the hare, the ermine, and
molt other animals, are fubjeX to grow white in cold
countries, particularly in the winter feafon. There is a.
variety of the peacock, which feems to have received
iimilar imprefiions from the fame caufe : and the effeXs
are even greater, fince the race is permanent ; for the
whitenefs of hares and ermines is merely temporary, and
happens only in the winter. The colour of the white
peacock, on the other hand, is no longer affeXed by the
ieafon or climate ; and the eggs hatched even in Italy pro¬
duce a white brood. The one which Aldrovandus
caufed to be engraved was reared at Bologna; and this
circumltance has made him fufpeX that this variety did
not belong peculiarly to cold countries. Yet moft natu-
ralifls agree in afligning Norway and other northern
countries for its native region. It would feem that it
is there. wild ; for in the winter it travels into Germany,
where it is commonly caught in that feafon. They are
indeed found in countries much farther fouth, as in Eng¬
land, France, and Italy; but there they are in thedomef-
tic ftate.

It required a long period of time, and a Angular con¬
currence, of circumftances, to reconcile a bird bred in
the delicious climates of Afia and India, to the rigours
of the northern trails. If it had not been carried thi¬
ther, it could have migrated to thofe colder climates,
either by the north of Afia, or by the north of Europe.
It is not long -fince white peacocks were efteemed as
rarities, which proves their recent introduXion ; and, on
the other hand, the Greeks were unacquainted with
them, fince Ariflotle, having fpoken in his Treatife on
the Generation of Animals of the variegated colours of
the peacock, and afterwards of white partridges, white
ravens, and white fparrows, takes no notice of white
peacocks.

2- Pavo bicalcaratus, the Chinefe peacock ; (Peacock
pheafant, Edw. Iris peacock, Lath. Petit paon de Ma¬
lacca, Sonnerat.) Brown ; head fubcrefted ; fpurs two.
This magnificent bird is jultly confidered as one of the
greatefi beauties in nature. In fize, it is between that of
the common peacock and the pheafant; but fu peri or to
both in elegance and luftre. The bill is blackilh; but
from the noftrils to the tip of the upper mandible red ;
if ides yellow ; the feathers on the crown of the head form

*

V O. 425

a longitudinal crefi, of a dark brown colour, growing
upright, with the tips a little refleXed forward; be¬
tween the bill and eyes the fpace is naked, with a
few fcattered hairs : Tides of the head white : neck
bright reddifh brown, ftriated acrofs with dufky brown.
The rell of the plumage is unfpeakably rich and or¬
namental: the tail is fprinkled with oval fpangles, on
a fine purplifli ground, with reflexions of blue, green,
and burnifiied gold. The efieX of thefe fpangles, or mir¬
rors is the more ftriking, as they are defined and diftin-
guilhed from the ground by a double circle, the one
black and the other orange. Each quill of the tail has
two of thefe lucid mirrors cluftered together in pairs,
the fliaft palling between them. However, as the train or
falfe tail contains fewer quills than that of the common
peacock, it is much lefs loaded with fpangles; but to
compenfate for this, it has a very great number on its
back and wings, where the-peacGck has none : thofe on
the wings are rounder, in proportion as they approach
the neck; and, as the ground-colour of the plumage is a
beautiful brown, it refembles a fable richly ftrewed with
fapphires, opals, emeralds, topazes, and other precious
Hones. The greater quills of the wing are not decorated
with fpangles; all the reft have each only one ; and their
colours, whether in the wings or in the tail, do not pene¬
trate to the inner furface, which is of an uniform brown
call. We have endeavoured to give a lively reprefenta-
tion of this bird on Plate II. but, with all its beauties, it
is far inferior to the original.

The female is a third fmaller than the male, and ap¬
pears lively and aXive. As in the male, its iris is yellow ;
but there is no red on its bill, and its tail is much fmaller.
And, though in the female of this bird the colours are
more like thofe of the male than in the other peacocks,
they are more faint and dull, and have not that luftre
and thofe luminous undulations which produce fo charm¬
ing an effeX in the fpangles of the male. It is a remark¬
able circumftance, that the male of this fpecies has two
fpurs, fet one above the other on each leg, while the fe¬
male does not appear to have even the rudiments of any.

3. Pavo Tibetanus, the Thibet peacock: cinereous,
ftriated with black ; head fubcrefted ; fpurs two. This
is about the fize of the pintado ; length two feet one inch
and a half. Bill above one inch and a half long, and ci¬
nereous; irides yellow. The head, neck, and under
parts, afli-colour, marked with blackifti lines; the wing-
coverts, back, and rump, grey, with fmall white dots;
befides which, on the wing-coverts and back are large
round fpots of a fine blue, changing in different lights to
violet and green gold ; the quills and upper tail-coverts
are alfo grey; marked with blackifti lines; the quills
have two round blue fpots on each, like thofe of the co¬
verts : on the outer webs, and on each tail feather, there
are four of the fame, two on each fide the web; the mid¬
coverts are the longeft, the others fhorten by degrees :
the legs are grey, furnilhed with two fpurs behind, like
the Chinefe fpecies : claws blackifti. This inhabits the
kingdom of Thibet; and the Chinefe give it the name of
chi n- tchien-lihi.

4. Pavo muticus, the Japan peacock: crefi: merely
Tubulate; fpurs none. This is nearly the fize of the
common peacock ; but the bill is larger, and afh-coloured;
the fpace round the eyes is red; irides yellow; on the
top of the head is an elegant upright creft, four inches
in length, and in ftiape not much unlike an ear of corn ;
the colour mixed green and blue. The top of the head
and neck are greenifti, marked with fpots of blue, which
have a ftreak of white down the middle of each : the back
is greenifli blue : the breaft blue and green gold mixed ;
the belly, fides, and thighs, alh-colour, marked with
black fpots, ftreaked with white on the belly : wing-co¬
verts and fecondaries not unlike the back; the greater
quills green, tranfverfely barred with black lines, but
growing yellowilh towards the ends, where they are
black; the upper tail-coverts are fewer than thofe of the

common

428 P A U

common peacock, but much longer than the tail; they
are of a chefnut brown, with white (hafts, and have at
tiie end of each a large fpot or fpangle gilded in the mid¬
dle, then blue, and furrounded with green : the legs are
afh-colour, and not fu'rniftied with fpurs. The female is
fmalier; and differs in having the belly quite black, and
the upper tail-coverts much (hotter ; the tail green, edged
with blue, and white fhafts. This inhabits Japan, and
is only known to Europe by means of a painting, fent
by the emperor of Japan as a prefen t to the pope.

Pavo, in aftronomy, a conftellation of the fouthern
hemifphere, unknown to the ancients, and not vifible
in our northern parts of the world ; containing fourteen
ftars. ,

PAVOAS'SAN, a town of Africa, and capital of the
ifland of St. Thomas, with a good harbour, the refidence
of the governor and the bifhop.

PAV'ONE, J'. [Italian.] A peacock:

And wings it had with fondry colours dight,

More fondry colours than the proud pavune

Bears in his boafted fan. Spenfer.

PAVO'NIA, f in botany. See Hibiscus.

PAV'ONINE, adj. Belonging to the peacock-kind.

PAVOO'R, a town of Hindooftan : fifteen miles north-
welt of Tinevelly.

PA'VOR, Fear ; a Roman goddefs whofe worlhip was
introduced by Tillius Hoftilius, who, in a panic, vowed
a (brine to her, and one to Pallor, Palenefs; and there¬
fore they are found on the coins of that family.

PAUPAKEL'LY, a town of Hindooftan, in Golcon-
da : twenty miles fouth of Byarem.

PAUPANAS'SUM, a town of Hindooftan : twenty
miles weft-fouth-weft of Tinevelly.

PAUPANASS'Y, a town of Hindooftan, in the Car¬
natic.- twelve miles north-eaft of Tanjore.

PAUTER, f. [Latin.] A poor perfon ; one who re¬
ceives alms. — Pauper fignifies properly a poor man ; ac¬
cording to which w'e have a term in our law, to fue “ in
forma pauperis ;” that is, if a man or woman having
caufeof action, and not having ability to fue, the caufe
of adlion being certified under counfel’s hand, with a
petition of the party fetting forth their cafe and poverty,
the judge of the court, whether in common law' or equity,
will admit the party to fue in forma pauperis; that is,
afiign them an attorney or clerk, and counfel to defend
their caufe, and plead for them without fees. See farther
tin^r the article Costs, vol. v. p. 258.

No court allows thofe partial interlopers
Of Law and Equity, twofingle paupers,

T’ encounter hand to hand at bars, and trounce
Each other gratis in a fuit at once. Butler's Remains.

PAU'PERISM, f. The ftate of poverty.

PAU'REY, a town of Africa, on the Slave Coaft.
Lat. 6. 10. N. Ion. o. 15. E.

PAU'RWITZ. See Bauerwitz, vol, ii.

PAU'SA, a town of Saxony, in the Vogtland: thirteen
miles north-north-w'eft of Plauen, and feventy-two weft-
fouth-weft of Drefden. Lat. 50. 31. N. Ion. 1 1. 58. E.

PAUSA'NIAS, an eminent Lacedemonian commander,
was the fon of Cleombrotus, and nephew of Leonidas,
who fell at Thermopylae. He was appointed guardian
of his minor coufin, Pliftarchus, fon of that king; in
right of which office, during the abfence of the other
king he polTefled the chief magistracy. When Mardo-
nius, the Perfian general, invaded Greece with a mighty
boft, Paufanias was appointed commander in chief of the
allied army railed to oppofe him. After fomefkilful ma¬
noeuvres, in which he appears, by a feigned retreat, to
have throwm thePerfians into diforder, Paufanias brought
on a general engagement at Plataea, B. C. 479, in which
Mardonius was entirely defeated with great (laughter,
and killed in the field. With the affiftance of the Athe¬
nians, who, during the battle, had been engaged againft

P A U

fome Greeks in the Perfian intereft, the camp of Mardo¬
nius was taken, with a vaft booty. Paufanias (howed a
noblenefs of mind in rejefliiig the propofal of one of the
leaders, that the body of the Perfian general fhould be
fought for, in order to be treated with the fame indignity
thathad been offered tothat of Leonidas. Healfogave a ftri-
kingleflon to jhe Greeks,, by ordering the Perfian cooks
to prepare fuch a banquet as their mafter was wont to
partake of, whilft his own fervants were to drefs a fimple
Spartan meal, and then pointing out to his officers the
folly of a luxurious people coming to conquer a poor and
hardy one. He next proceeded to puni(h the traitors to
the caufe of Greece ; and, marching to Thebes, obliged
that city to deliver up the heads of the Perfian party,
whom he put to death.

The effect of fuccefs upon his own mind, however,
was to nourifti a fpirit of pride and arrogance, and
infpire ambitious defigns. He afiumed to liimfelf
all the honour of the battle ofPlatasa; and upon a
golden tripod, w-hich he prefented to the temple of
Delphi, he put an infcription, recording only his own
name as author of the victory. The command of the
united fleet being given him for the purpofe of freeing
the Grecian cities from the Perfian garrifons, he behaved
with great partiality to his own countrymen, and treated
the other officers with haughtinefs, and the common
men with feverity ; whilft the juftice of Ariftides, and the
affability of Cimon, gained all hearts, and reftored to
the Athenians the naval fupremacy of Greece. Paufa¬
nias performed what was enjoined him at Cyprus and
Byzantium; and, having at the latter place taken cap¬
tive feveral noble Perfians, among whom w'ere fome of
the royal kindred, he fent them to Xerxes with a letter,
propoiing a private alliance with that king, on the con¬
dition of being made ruler of Greece under his autho¬
rity. Some fufpicions of this negociation getting abroad,
he was recalled to Sparta, and underwent a trial for his
life; but, no fufficient evidence being brought againft him,
he was fined and liberated.

Returning to the army, inftead of afting with more
caution, he openly adopted the Perfian habit and man¬
ners, and went into all the exceffes of that luxury which
he had decried. It would appear that his mind was fome-
what difordered in conlequence of the following tragical
incident. Having been captivated with the charms of
Cleonice, a young woman of good family at Byzantium,
her parents, not daring to refufe his folicitations, obliged
her to comply with his defires. In order to fave her
blufhes,. (lie requefted that the lights might be extin-
guifhed when (he (hould enter his chamber. It unfortu¬
nately happened that in the dark (he (tumbled over one
of the lamps; the noife of which fuddenly awakening
Paufanias, he fancied an affaffin was coming to murder-
him, and, darting up, plunged a dagger into her bread.
When he difcovered the fatal error, he was almoft dif-
trafted, and from that time imagined that the blood of
his Cleonice perpetually demanded vengeance. He left
Byzantium, and repaired to Heraclea, where he found
perfons who pretended to evoke and pacify the fpirits of
the deceafed. Thatof Cleonice w\as called up before him,
and made to fay to him, “When you come to Sparta,
you will find a termination to your fufferings.” He went
thither, (bill occupied with his plot of betraying his coun¬
try to the Perfians. For this purpofe, he carried on a
correfpondence with Artabazus, a fatrap ; and all the
meflengers he fent were put to death, that they might
not betray him on their return. It is faid that he in vain
attempted to engage Themiftocles, then an exile, to con¬
cur in his meafures. Becoming at length impatient, he
wrote a peremptory letter to Artabazus, which he com¬
mitted to one Argilius, his particular favourite. The
young man, alarmed by the non-appearance of any former
meflengers, unfealed the packet; and, finding a direction
to put him to death, immediately difclofed the matter to the
ephori. In order to obtain a fuller proof againft Paufanias,

P A U

the magiftrates dire&ed Argilius, as if" In fear of his life, to
take refuge in the temple of Neptune at Taenarus, cau-
fing at the fame time a cavity to be dug^near the altar, in
which fome of them lay concealed. Paufanias, hearing
of his having taken fandtuary, repaired thither, much
difturbed, and afked him the reafon of his proceeding.
A converfation enfued, which fully allured the ephori of
his guilt, and they refolved to apprehend him. Be¬
coming apprized of their intention, he fled to the temple of
Minerva, called Chalcioecus, the inviolable fandlity of
which threw them into fome perplexity. While they
were in doubt what to do, the truly Spartan mother of
Paufanias brought a brick, and fet it againft the door of
the temple ; her example was followed, till he was com¬
pletely immured. When he was dead with hunger, his
body was brought out, and interred by his friends. In
fuch a wretched manner did this great but vicious man
terminate his days, B. C. 474.

After his death there w'as a feftival and folemn games in-
ftituted to his honour, in which only free-born Spartans
contended. There was alfo an oration fpoken in his
praife, in which his adtions were celebrated, parti¬
cularly the battle of Plattea, and the defeat of Mar-
donius.

PAUSA'NIAS, a Greek topographical writer, flou-
rilhed in the fecond century, under Adrian and the An-
tonines. If he was the fame orator or grammarian whom
Phiioftratus records under that name, he was a native
of Crefarea in Cappadocia, and ftudied under the cele¬
brated Herodes Atticus. His provincial pronunciation
impeded his fuccefs as a fpeaker; but he obtained repu¬
tation by his compofitions. He declaimed both at Athens
and Rome, in which laft capital he died at an advanced
age. From the writings of Paufanias himfelf we derive
very little information concerning his life. He feems to
have travelled extenfively, and, befides his extant work on
Greece, he compofed defcriptions of Syria and Phoenicia.

The “ Defcription of Greece” by Paufanias, though
not a very well-written performance, is highly valuable
to the antiquary, and contains much, information no
where elfe to be met with. It is a kind of itinerary
through Greece, in ten books, in which the author
notes every thing remarkable that fell under his obferva-
tion, fuch as temples, theatres, fepulchres, ftatues, paint¬
ings, public monuments of all kinds, the lites and di-
menfions of ruined cities, and the fcenes of important
tranfadtions. In fome parts he gives hiftorical details,
and in thofe, his ftyle, which is ordinarily common and
negligent, rifes to a degree of dignity. His work abounds
with fabulous narrations, but fuch as were traditionally
connected with the places defcribed ; whence he does not
feem to deferve Julius Scaliger’s fevere epithet of “ Grse-
culorum omnium mendaciflimus.” What he himfelf
faw, there is no reafon tofuppofe that he mifreprefented.
Paufanias was firft publifhed from the prefs of Aldus in
1 516 by the care of Marcus Mufurus. The beft edition
has been reckoned that of Joach. Kuhnius, Gr. and Lat.
folio, Lipf. 1696 ; but it is probably excelled by the mo¬
dern one of J. F. Facius, Lipf. 1794-97, 4 vols. 8vo. Vof-
fii Hifi. Grac.

PAU'SARY, /. [ paufarius , Lat.] An officer among
the Romans, who, in the folemn pomps or procefiions of
thegoddefs Ifis, diredted the flops or paufes. In thefe
ceremonies, there were frequent ftands, at places pre¬
pared for the purpofe, wherein the ftatues of Ifis and
Anubis were fet down ; much after the manner of refting-
places in the proceflion of the holy facrament in the
Romifh church. From an iufcription quoted by Salma-
fius it appears that the Romans had a kind of college or
corporation of paufaries.

Pausary was alfo a name given to an officer in the
Roman galleys, who gave the lignal to the rowers, and
marked the times and paufes ; to the end they might act
in concert, and row all together. This was always done

Vol. XIX. No. 1314.

P A U 427

with a mufical inftrument. Hyginus fays, that in the
fhip Argo, Orpheus did the office with his lyre.

PAUSE, J'. [paufe, F r. paufa, low Lat. ttcoicj, Gr.] A
flop ; a place or time of intermiflion. — Our difcourfe is
not kept up in converfation, but falls into more paufes
and intervals than in our neighbouring countries. Addi-
fon’s Sp.ediator.

What paufe from woe, what hopes of comfort, bring
The names of wife or great? Prior .

Sufpenfe ; doubt :

Like a man to double bufinefs bound,

I ftand in paufe where I fhall firft begin,

And both neglect. Shakefpeare's1 Hamlet.

Break; paragraph ; apparent feparation of the parts of a
difcourfe. — He writes with warmth, which ufually ne¬
glects method, and thofe partitions and paufes which men,
educated in the fchools, obferve. Loclie.

To PAUSE, v. n. To wait ; to flop ; not to proceed ; to
forbear for a time, ufed both of fpeech and adtion. —
Tarry ; paufe a day or two, before you hazard. Shake-
fpeare.

As one who on his journey baits at noon,

Though bent on fpeed, fo here the archangel paus'd
Between a world deftroy’d and world reftor’d. Milton.

To deliberate. — Solyman paufing a little upon the matter,
the heat of his fury being over, fiuffered himfelf to be in-
treated. Knolles.

Bear Worcefter to death, and Vernon too ;

Other offenders we will paufe upon. Shakfpearc.

To be intermitted :

What awe did the flow folemn knell infpire,

The pealing organ, and the paufing choir,

And the laft words, that dufl to duft convey’d! Tickell.

PAU'SER, f He who paufes ; he who deliberates :
The expedition of my violent love
Outruns the paufer, reafon. Sliakefpeare's Macbeth.

PAU'SIAS, an eminent painter of antiquity, flourifhed
about 350 B. C. He was a native of Sicyon. He was in-
ftrudted in the branch of painting called encauftic by
Pamphilus, and was the firft who became famous in if.
He was likewife the firft who adorned chambers with
painted ceilings. He underftood the art of fore-fhorten-
ing, which Pliny defcribes by faying that, when he wiflied
to give an idea of the length of an ox, he did not, as was
the former pradtice, place it tranfverfely to the eye, but
vertically, yet produced the full effedt by the difpofition
of the lights and fliades. He feems, alfo, to have been
the firft flower-painter ; for, having in his youth been
enamoured of Glycera, a maker of garlands, he attempt¬
ed by his art to imitate the beauties of nature which (he
had afforted, and copied a great variety of flowers. At
length he made a portrait of Glycera fitting with a gar¬
land, which was one of his moll famous performances,
and was known by the name of Stcphanep'locos. He
chiefly painted fmall pieces; one of which, reprefenting a
boy, was called Hemerefios, as being finifhed in a Angle
day. He alfo executed fome large works, among which
was a facrifice, in Pompey’s portico, containing the
figure of the ox above alluded to. He palfed his life at
Sicyon, which was long regarded as the proper country
of painting. The debts of the ftate having obliged the
Sicyonians to fell their pictures, thofe of Paufias were
brought to Rome in the edilefhip of Scaurus, where, as
we learn from a line in the Satires of Horace, they were
a great objedt of admiration to the connoilfeurs. Plinii
Hijl. Nat. xxxv.

PAUSIL'IPO, a celebrated mountain and grotto,
near the city of Naples. It took its name from a viiLa
of Vedius Pollio, eredted in the time of Auguftus, and
called Paulilypam , from the effect which its beauty was
5 R fuppofed

428

P A U

fuppofed to produce in “ fufpending forrow and anxiety.”
This mountain is faid to be beautiful in the extreme,
and to be juftly honoured with its appellation, as no
fcene is better calculated to banith melancholy and exhi¬
larate the mind. The grotto is nearly a mile in length,
ar.d is made through the mountain, twenty feet in breadth
and thirty in height. On the mountain, Vedius Pollio
had not only a villa, but a refervoiror pond, in which he
kept a number of lampreys, to which he ufed to throw
luch of his flaves as had committed a fault. When he
died, he bequeathed, among other parts of his pofleffions,
his villa to Auguftus; but this monarch, abhorring a
place where fo many ill-fated creatures had loll their
lives for very flight faults, caufed the pond to be filled
up, the houfe to be demolilhed, and the fineft materials
in it to be brought to Rome, and with them railed Julia’s
portico.

Virgil’s tomb is faid to be above the entrance of the
grotto of Paufilipo. A vaulted cell and two modern
windows above prefent themfelves to view : the poet’s
name is the only ornament of the place. No farcopha-
gus, no urn, and even no infcription, ferve to feed the
devotion of the claflical pilgrim. The epitaph, though,
not genuine, is yet ancient; it was infcribed by order of
the duke of Pefcolangiano, the proprietor of the place,
on a marble flab placed in the fide of the rock oppofite
to the entrance of the tomb, where it Hill remains. It is
as follows :

Mantua me genuif, Calabri rapuere, tenet nunc

Parthenope, cecini pafcua, rura, duces.

An Italian author, fuppofed to be Pietro de Steffano,
allures us that he himfelf had feen, about the year 1526,
the urn fuppofed to contain the poet’s allies, Handing in
the middle of the fepulchre, fupported by nine little
marble pillars, with the infcription juft quoted on the
frieze. He adds, that Robert of Anjou, apprehenlive
left fuch a precious relic fliould be carried off or deftroyed
during the wars then raging in the kingdom, took the urn
and pillars from the tomb, and depolited them in the
Caltel Nuovo. This extreme precaution eventually oc-
cafioned the lofs which it was meant to prevent : for, not-
withftanding the moft laborious fearch and frequent in¬
quiries made by theordersof Alphonfoof Arragon, they
were never more difcovered. Some, indeed, have afferted
that the tomb juft mentioned is not the fepulchre of
Virgil : among thefe we may reckon Cluverius and Ad-
difon. The reader will learn with regret that Virgil’s
tomb, confecrated as it ought to have been to genius and
meditation, is fometimes converted into the retreat of
afl'affms, or the lurking-place of fbirri. Few places, how¬
ever, are in themfelves more pifturefque; and, from the
recolleftion infeparably interwoven with it, no fpot is
more interefting. The whole hill of Paufilipo is covered
with country-feats and gardens, for fummer refort, being
protected from the hot louth and weft. In the middle of
the paffage is a church or chapel ; but the dull raifed by
the horfes and carriages is very offenfive.

PAU'SINGLY, adv. Afterapaufe; by breaks. — This
paujhigly enfued. Shake Jp care’s Hen. VIII.

PAU'SUS, j. in entomology, a genus of infefts of the
order coleoptera. Generic characters — Antennae two-
jointed, the upper joint very large, infleCted, hooked, pe-
dicillate ; head pointing forwards, with a convex, jugu¬
lar, triangle; thorax narrow, unequal, fcutellate ; fhells
flexile, deflefted, truncate; fore-feet placed at the fore¬
part of the breaft, thighs with minute appendages, the
tarfi four-jointed.

This genus does not exift in the twelfth edition of the
Syftema Naturae, but made its firft appearance in a Differ-
tation publilhed at Upfal by Linnceus in the year 1775.
At that period only one fpecies was known. In the year
1796, Dr. Adam Afzelius, then refiding at the Britiflt
fettlement at Sierra Leone, difcovered a fecond, and has
defcribed both with elaborate exaCtnefs in a paper on this

P A U

genus publiflied in the fourth volume of the Tranfac-
tionsofthe Linnaean Society of London. The etymo¬
logy of the name Dr. Afzelius imagines to be from the
Greek Tratio-i;, fignifying “ paufe, ceflhtion, or reft;” for
Linnaeus, now old and infirm, and finking under the
weight of age and labour, faw no probability of conti¬
nuing any longer his career of glory ; and lo it in reality
proved, at leaft with regard to infeCts, Paufus being the
iaft he ever defcribed. There are now five fpecies.

x. Paufus microcephalus, the fmall-headed paufus:
the head is uncommonly fmall, and without horns ; the
thorax broader than the head, and very uneven, the two
parts being entirely feparated by a tranfverfe furrow' ; the
foremoft divifion is elevated into a ftiarp ridge refembling
a collar, and the hindmoft is depreffed or cut out in the
middle into a cavity, which is obtufe behind, dilated and
deepened before, and encompaffed on the fides with diver¬
ging and outwardly-declining lobes, being rounded at
the top, and provided with fliining hairs of a fulvous co¬
lour and bent inwards. The elytra are without dots,
and rather longer than the abdomen ; the under or real
wings are footy, and without the leaft gloflinefs. The
abdomen has the terminal fegment very retufe, and the
margin of the next before it is vifibly raifed. The pivots
of the antennae are black, very bright, and at firft fight
might be eafily taken for eyes; the under joint is fur-
niflied with a wart on the inner margin of the top, co¬
vered with papillary or cartilaginous hairs ; the upper
joint, or clava, is dotted, much larger than the head, and
of the fhape of an oblong fpheroid, being rounded in.
front and compreffed, with the carina raifed into a ftiarp
edge, provided on the vertex with four tubercles fet in a
row and tipped with hairs, and elongated behind into an
obtufe tube, laterally compreffed, above depreffed, and
underneath having a knob, which, in moving, touches a
bundle of hairs on the top of the under joint: the pedi¬
cle is long and crooked, its upper being broader, com-
prefled, and keeled in front. The interior palpi are of a
lanceolate-oblong fhape, and furniftied with very minute
hinges. The mandibles have fmall hinges, and the infe¬
rior flieath is much larger than the fuperior. The hind¬
legs are a little fliorter than the others : the joints of the
tarfi are difficultly diftinguiffied. This rare infedt is a
native of Banana ifland, and Sierra Leone in Africa. Its
colour is a blackiffi brown. It is reprefented on the an¬
nexed Plate, of the natural fize, at fig. 1. magnified at
fig. 2. and the head magnified at fig. 3.

2. Paufus fphaerocerus, the horned paufus. Thus de¬
fcribed by Dr. Afzelius. “ I had been in Africa almoft
three years before I happened to meet with this remark¬
able little infect ; and then it was quite accidentally.
There was a houfe building for the governor, on an emi¬
nence called Thornton Hill at the fouth endofFree-
Town in Sierra Leone; and in the beginning of the year
1795, feveral apartments having been got ready fo as to
be habitable, one of them was allotted to me, and I re¬
moved into it in the end of the month of January. I
had not refided there many days, when one evening, hav¬
ing juft lighted my candle and begun to write, I obferved
fotnething dropping down from the ceiling before me
upon the table; which, from its Angular appearance, at-
tradled my particular attention. It remained for a little
while quite immoveable, as if ftunned or frightened, but
began foon to crawl very flowly and fteadily. I then
caught it, and, from the remembrance I had of the Lin¬
naean fpecies, I direftly took it for a non-defcript of this
genus. Some few days after, coming into my room from
fupper, with alight in my hand, and having put it upon
the table, there inftantly fell another down from the ceil¬
ing. The third I was favoured with by the then gover¬
nor, Mr. Dawes, who informed me that it had dropped
down before him on the table, juft when he had entered
his room, and was going to write. The other three,
which I afterwards colledted, were alfo got upon fimilar
occafions; and from thence I thought I had fome reafon

to

PATJSUS and PEDICELLARIA.

JTnfrjvtd fir efi£ Ena/dcpa/ha. Zondinensis. 7023.

P A U

429

P A U

to conclude that it is a noCturnal animal, that it becomes
benumbed by candle-light, that it lives in wood, and
prefers new-built houfes, See. After the end of February,
I never faw any more. The laft which I caught I put
into a box, and left confined there for a day or two. One
evening, going to look at it, and happening to (land be¬
tween the light and the box, fo that my fliadow fell upon
the infeCl, I obferved to my great aftoniftiment the globes
of the antennae, like two lanterns, fpreading a dim phof-
phoric light. This Angular phenomenon railed my cu-
riofity ; and, after having examined it feveral times that
night, I refolved to repeat my refearches the following
day; but the animal, being exhaufted, died before the
morning, and the light dilappeared. And afterwards,
not being able to find any more fpecimens, I was pre¬
vented from afeertaining the faCt by reiterated experi¬
ments at different times; which I therefore mull recom¬
mend to other naturalifts who may have an opportunity
ofvifiting Sierra Leone, requelling that they would par¬
ticularly inquire into this curious circumftance.

“I fnall now only add fome few remarks, fiiowing in
what manner this new fpecies differs from the old one.
Not being quite fo broad, it looks as if it were longer,
and more Cylindrical ; it is alfo of a lighter or chefnut
colour, afld all over very gloffy. The head is larger, but
its annular bale part fmaller, and contracted : it is fur-
nilhed with a little horn in the middle, between the eyes,
which is ftraight, conic, and tipped with a tuft of carti¬
laginous hairs : the clypeus is only depreffed, and the ju¬
gular triangle wider : the eyes are large, and very evi¬
dent ; thofe of the male black, though in a certain light
appearing greenilh ; but thofe of the female are like
pearls, or as if they were covered with a cryltalline mem¬
brane : the angles of the brim of the focket are fmall and
rounded at the top, and the hinder one lower than the
eye. The pivots of the antennae are not fo difcernible as
in the former fpecies, being like the furrounding parts in
colour: the under joint is without any hairy papilla, or
wart : the upper joint or clava is of the fize of the head,
quite globular, and refembles an inflated bladder, being
almoft pellucid, and of a light flelh-colour : the keel is
nothing more than a railed line, finilhing on the vertex in
only one chefnut-brown tubercle, covered with cartila¬
ginous hairs : behind there is a little conical (Lining hook,
of the fame colour and with the fame fort of hairs bend¬
ing outwardly, being of equal length with the horn on
the head, but narrower : the pedicle is Ihort, ftraight,
and cylindrical. The interior palpi, furnilhed with very
vifible hinges, are a little thicker towards the top, but
look in fome directions as if they were filiform : the man¬
dibles have large hinges, and the fuperior flieath almolt
as long as the inferior one, and nearly cylindrical. The
thorax is of the fame breadth with the head, and not very
uneven, the two parts being feparated by a furrow only
on the iides and underneath, the foremoll above and on
the fides refembling an annular fegment, and the hinder
one impreffed in the middle with a mark fomewhat like
two fmall diverging wings of a blackilh filvery colour.
The elytra are (horter than the abdomen, and minutely
punftated : the under wings are of a Alining and change¬
able violaceous colour, and not very'dark : the abdomen
has the terminal fegment a little convex, and in the fe¬
male more fo than in the male : underneath, the third
and laft fegments are darker than the others, the legs are
all of equal length ; the tarfi longer than thofe of the
Paulus microcephalus, and have both the joints and the
claws much more diftinCl.” Linn. Tranf. iv. 243. — This
fpecies is Ihown of the natural fize at fig. 4. 'magnified at
fig. 5. the head magnified at fig. 6.

3. Paufus ruber, the red paufus : reddilh ; thorax jagged
before. This and the next fpecies inhabit the Cape of
Good Hope.

4. Paufus lineatus, the lineated paufus : reddilh ; (hells
with a brown line. This is fuppofed to be the Cerocoma
Jineata ofFabricius.

5. Paufus ruficollis, the red-necked paufus : black ;
thorax and ftreak on the flieils ferruginous. Suppofed to
be the C. ruficollis of Fabricius.

PAUTE', a town of South America, in the audience
of Quito : twenty-three miles eaft of Cuenga.

PAUTE', or St. Yago, a river of Peru, which runs
into the Maragnon five miles weft of St. Francifco de
Borja.

PAU'TO, a town of New Grenada : twenty-five miles
eaft of Tunja.

PAU'TRE (Antony le), an eminent French architect,
was born at Paris in 1614. He diftinguiflied himfeifby his
talte in the decoration of buildings, which, though
fomewhat heavy, was grand and majeftic. Several edi¬
fices from his defigns were ereCled in the capital and its
environs, of which the mod noted were the wings and
cafcade of St. Cloud, the church of the nunnery of Port-
royal, and the hotels of Gevres and Beauvais. He was
appointed architect to monfieur, the king’s brother, and
finally firft architect to the king. He was a member of
the Academy of Architecture from its firft inftitution ;
and publilhed a w’ork on that art, entitled, “ Les Oeuvres
d’ArchiteClure d’Antoine lePautre,”of which the firft
edition appeared in 1652. He died in 1691.

John le Pautre, the elder brother of the preceding,
was an eminent defigner and engraver, and underftood the
decoration of pleafure-houfes. His engraved plates
amount to 1000, and ferved for lludies to the ablell artills
in France. His compofitions are overcharged with
fculptures and architectural ornaments, which prove
that his fertility was fuperior to his tafte. He died in
168a.

Peter le Pautre, born in 1660, was fon to the ar¬
chitect. His genius led him to (culpture, which he ftu-
died during fourteen years at Rome. On his return he
was employed in feveral public works, of which the molt
celebrated is a group of Eneas bearing Anchifes on his
flroulders, and holding Afcanius in his hand, which was
placed in the garden of the Tuileries. His performances
difplay much fire and imagination, but are fometimes in-
correCt. He died in 1744, at the age of eighty-four.
D’Argenville, Vies (les Arc/iit. et (les Sculpteurs.

PAUTUCK'E, a town of the (late of Maffachufetts :
thirty-three miles fouth-fouth-weft of Bolton.

PAUTUCK'ET FA'LLS, a cataraCl on the river Mer¬
rimack.

PAUTUX'ET, a town of Rhode Ifland: four miles
north-eaft of Providence.

PAUW (N. de), a German canon, diftinguilhed hin.felf
by his phiiofophical writings, of wdiich the principal
were “ Recherches Philofophiques fur les Americains,
les Egyptiens, et les Chinois,” in two vols. 1768; and.
“ Recherches Philofophiques fur les Grecs,” two vols.
1787, reprinted at Paris in feven volumes, 8vo. “ In
thefe works,” fays his biographer, “ there are much
learning and ingenuity, but joined with a bold fpirit of
conjecture, and a difpofition to contradict all received
notions.” They were very popular at the time of their
appearance, but have loft a great part of their original re¬
putation. The author was in high reputation with Fre¬
derick the Great, as one of the free (peculators of the
time, and was, of courfe, obnoxious to the clergy. His
private character was excellent. He died at Xanton,
near Aix-la-Chapelle, in 1799. Anacharfis Cloots, fa¬
mous at the commencement of the French revolution,
was his nephew.

PAU'XIS, a fortrefs of Brafil, in the government of
Para, on the north fide of the river Amazon. Lat. 1. 56.
S. Ion. 58. to. W.

PAU'ZEN, a town of Bohemia, in the circle of Boleflau:
ten miles eaft of Jung Buntzel.

PAUZK, Pautzk, or Putzig, a town of Pruflian
Pomerelia : twenty-four miles north-weft of Dantzic.
Lat. 54. 30. N. Ion. 18. 8. E.

PAW, / [paxven, Welfti.] The foot of a bead of prey.

—If

3

P A W

430 PAW

— If lions had been brought up to painting, where you
have one lion under the feet of a man, you fhould have
had twenty men under the paw of a lion. L’EJlrange.
Each claims pofieflion,

For both their paws are faftened on the prey. Dryclen.
Hand. In contempt:

Be civil to the w'retch imploring,

And lay your paws upon him without roaring. Dryclen.

To PAW, v.n. To draw the fore-footalongthe ground.
— Fie [ihe horfe] paweth in the valley. Job. xxxix. 21.
The fiery courier, when he hears from far,

The fprightly trumpets and the fhouts of war,

Pricks up his ears, and, trembling with delight
Shifts place, and paws, and hopes the promifed fight.

Dryclen.

To PAW, v. a. To ftrike with a drawn ftrokeof the
fore-foot :

His hot courier paw'd th’ Hungarian plain,

And adverfe legions flood the fhock in vain. Tickell.

To handle roughly. To fawn ; to flatter. Ainfworth.

PAW'AH, a town of Hindooftan, in Bahar: forty
miles louth-weft of Bahar.

PAWA'RAH, a town of Hindooflan : forty-three
miles fouth-weft of Benares.

PAW'ED, adj. Having paws. Broad orlarge footed.
Sherwood.

PAW'EN, afmall ifland in the bay of Gunong Tellu,
on the eaft coaft of the ifland of Celebes. Lat. o. 18. S,
Ion. 122. 2. E.

PAW'ING,/. Handling clumfily ; fometimes fondly.
PAW'ING, or Pogum, atown of Eaft Friefland, near
the Ems : thirty-two miles fouth of Emden.

PAW'KY, adj. [from the Sax. pascan, to deceive, ac¬
cording to Dr. Jamiefon.l Arch ; cunning; artful. North.
Grofe,

PAW'LET, a townfhipof America, in Rutland-county,
Vermont, containing 1938 inhabitants. It is watered by
Pawlet-river, which joins Wood-creek, and the confluent
ftream falls into South Bay at Fiddler’s Elbow.

PAW'LOCZ, a town of Ruffian Poland, in the pala¬
tinate of Kiev : fixty miles fouth-weft of Kiev, fixty-two
north-north-eaft of Braclaw.

PAWN, f. [panel, Teut. pignus, Lat.] Something
given to pledge as a fecurity for money borrowed or pro-
mife made. — Her oath for love, her honour’s/iaww. Shakef-
peare. — As for mortgaging and pawning, men will not
take pawns without ufe ; or they will look for the for¬
feiture. Bacon. — He retains much of his primitive efteem,
that abroad his very word will countervail the bond or
pawn of another. Howell. — Here’s the very heart and
foul, and life-blood, of Gomez ; pawns in abundance, till
the next bribe helps their hufbands to redeem them.
Dryden's Span. Friar. — The ftate of being pledged. — As
the morning dew is a. pawn of the evening fatnefs, fo, O
Lord, let this day’s comfort be the earned: of to-morrow’s.
Donne.

Sweet wife, my honour is at pawn,

And, but my going, nothing can redeem it. ShaheJ'peare.
Redeem from broking paxvn the blemifli’d crown,

Wipe off the duff that hides our feeptre’s gilt. Shahefp.

The party that pawns goods hath a general property in
them ; they cannot be forfeited by the party that hath
them in pawn, for any offence of his, nor be taken in
execution for his debt; neither may they otherwife be
put in execution till the debt for which they are pawned
is fatisfied.

If the paw’ii is laid up, and the pawnee robbed, he is
not anlwerable ; though if the pawmee ufe the thing, as
a jewel, watch, &c. that will not be the worfe for wear¬
ing, which he may do, it is at his peril ; and, if he is
robbed, he is anlwerable to the owner, as the uling occa-

fioned the lofs, &c. If the pawn is of fuch a nature that
the keeping is a charge to the pawnee, as a cow, a horfe,
&c. he may milk the one, and ride the other, and this
fhall go in recpmpence for his keeping.

Things which will grow the worfe by ufing, as apparel.
Sec. he may not ufe.

PAWN, f. A common man at chefs; [peon, piem,
French ; fuppofed to be from peon, w'hich in India fig-
nifies a common foldier. Tocld. — Rather an abbreviation
of efpion, Fr. a fpy ; the pawn being lent forward to af-
certain thepofition of the adverfary. Thus pioneer means,
as nearly as poffible, efpion, efpiouneur, being fent before
to fpy out what obftacles may retard the progrefs of the
main body, and to remove them.]

Here I a pawn admire,

That ftill advancing higher,

At top of all became

Another thing and name. Cowley.

To PAWN, v.a. To pledgte ; to give in pledge. It is
now feldorn ufed but of pledges given for money. — One
part of the nation is pawned to the other, with hardly a
poflibility of being ever redeemed. Swift.

She w'ho before had mortgag’d her eftate,

And pawn'd the laft remaining piece of plate. Dryclen.

PAW'N-BROKER, f. One who lends money upon
pledge. — The ufurers or money-changers were a fort of a
fcandalous employment at Rome ; thole money-feriveners
feem to have been little better than our pawn-brokers.
Arbuthnot.

Pawn-brokers are a kind of bankers, who advance
money at a peculiar rate of intereft, on goods impledged
for fecurity of the capital ; and, in cafe of failure to re¬
deem the goods within a limited time, they may be fold
to indemnify the lender.

A part of the population of every flourifhing country
confifts of neceflitous people, thofe frequently belonging
to a clafs whole lkill contributes to its prolperity ; but
whofe income, often flender and precarious, cannot keep
pace with the times, or lupport the demands of an in-
creafing family. Expofed alfo to fudden difappointments
and Ioffes, they are forced, from the want of pecuniary
capital, to feek a temporary relief, by pledging their pro¬
perty for a certain fum, while they pay intereft on the ad¬
vance. But this advance, in general, bears a very incon-
fiderable proportion to the value of the property, whence
its confifcation, by the increafing difficulties of the owner,
or of not being claimed on account of death or removal,
proves molt advantageous to the holder; for, in the one
cafe, he may become the abfolute proprietor himfelf, and,
in the other, he fecures a high rate of intereft originally
ftipuiated. In this point of view, a pawn-broker has an
infinite fuperiority over an ordinary banker, or money¬
lender: the latter calculates only on the credit of his
debtor, which is frequently nominal; the former never
makes an advance without being put in pofieflion of what
exceeds it in value ; his rate of intereft is much greater,
and the credit of his debtor is of no importance. Nay, it
is rather better that his circumftances fliould be defperate.
It thence refults, that, like other trades, the number of
pawn- brokers will increafe with the neceflities of the
people requiring their aid, and, on that account, giving
them employment ; juft as bankers, whofe iffues increafe
when the calls of the public require a more ample fupply
of a circulating medium. Thus a ftrong inducement is
continually held out to commence the profeflion of a
pawn-broker; for the fecurities increafe in a much
greater ratio than the debts, while the latter are void of
any rifle. We find, in the city of London, that the number
of pawn-brokers lately amounted to no lefs than about
240 ; and it was calculated, that the property of necefli¬
tous perfons in their pofieflion, probably amounted to a
million fterling. Their numbers alfo had fuddenly aug¬
mented, and they are ftill increafing. In Edinburgh,
on the contrary, which is not above a tenth part of the

431

PAWN- BROKER.

fee of tlie metropolis, there was fcarcely one a few years
ago, and now the number does not exceed a dozen.
Therefore the number is not one half in proportion to
the population of the two different places, which indicates
fewer neceflitous people by a half in Edinburgh ; arguing,
either that the inhabitants are more induftrious and more
esfily maintained,orlefsexpofed to Ioffes and fluftuations.

But the temptations held out to thofe who, in this
manner, obtain pofl'effion of the property of others to
fuch an amount, and with fo little reference to its value,
combined with the natural propenfity of mankind to
take advantage of the neceflities of their neighbours, long
ago rendered legiflative interference neceffary in regulat¬
ing the duties and interefts of pawnbrokers. Befides, it
was of great confequence to check the facilities with which
ftolen goods might be pledged with, and fold by, them.
Omitting, however,, the older enactments on thefe
branches, we fliall limit ourfelves to thofe of more recent
date.

In the firft place, it is provided by the ftamp-afts, that
every pawn-broker is to take out a licenfe on a 10I. ftamp,
to be annually renewed 5 and a feparate licenfe for deal¬
ing in plate.

The principal ftatute relating to pawn-brokers, thus
licenfed, is the 39, 40, Geo. III. c. 99. by which the fol¬
lowing rates of profit are allowed, while regulations are
made to prevent opprefiion. For every pledge upon
which there fhall have been lent not exceeding 2s. 6d.
one halfpenny is allowed as intereft, See. for any time
during which the faid pledge fhall remain in pawn not
exceeding one calendar month ; and the fame for every
month afterwards. For 5s. one penny; 7s. 6d. one
penny halfpenny; 10s. two-pence; 12s. 6d. two-pence
halfpenny; 15s. threepence; 17s. 6d. three-pence half¬
penny; il. four-pence; and fo on progreflively and in
proportion for any fum not exceeding 40s. and for any
intermediate fum between 2s. 6d. and 40s. at the rate of
four-pence for 20s. And for every fum exceeding 40s.
and not exceeding 42s. eight-pence ; and for every fum
exceeding 42s. and not exceeding 10I. at the rate of
three-pence, and no more, for the loan of every 20s. of
fuch money lent by the calendar month; and fo in
proportion for any fractional fum. § 1 — 3. Now thefe
fums, though apparently inconfiderable, are in faft high
per centages, and far furpaffing the legal rate of intereft ;
being 20 per cent, when the fum lent does not exceed
40s. and 15 per cent, when it does.

Entries to be made and duplicates given. § 6, 7. Any
perfon fraudulently pawning the goods of another, and
convicted before a jultice, fhall forfeit from 5I. to 20s.
and alfo the value of the goods pawned, See. to be afeer-
tained by the jultice ; and, on failure of payment, may be
committed to the houfe of correction, for not mere than
three months, and be publicly whipped; the forfeitures,
when paid, to be applied towards making fatisfaClion to
the party injured, and defraying the colts : the overplus,
if any, to the poor of the parilli. §8. Any perfon, coun¬
terfeiting or altering a duplicate, may be leized and taken
before a juftice ; who is to commit the party to the houfe
of correction, for not more than three months, nor lei's
than one. § 9.

If any perfon fhall offer to pawn any goods, refufing
to give a fatisfaCtory account of himfelf and the goods;
or if there lhall be reafon to fufpeCt that fuch goods are
ftolen ; or if any perfon, not entitled, fliall attempt to re¬
deem goods pawned ; they may be taken before a juftice,
who fliall commit them for further examination ; and, if
it appears that the goods were ftolen, or illegally obtained,
or that the perfon offering to redeem the fame has no
title or pretence to them ; the juftice is to commit him to
be dealt with according to law, where the nature of the
offence fliall authorize fuch commitment by any other
law ; or otherwife, for not more than three months.
§ I0*

Perfons buying or taking in pledge unfinillied goods,

VMu Xix. No. 1314.

or any linen, See. entrufted to be wallied, fliall forfeit
double the fum lent, and reftore the goods. §11. A
juftice may grant a fearch-warrant ; in executing which,
a peace-officer may break open doors, and the goods, it
found, fliall be reltored to the owner. § 12, 13.

Pawn-brokers, refufing to deliver up goods pledged
within one year, on tender of the money lent, and inte-
reft, on conviction, a juftice is empowered to commit the
offender till the goods be delivered up, or reafonable fa-
tisfaCtion made. § 14.

Perfons producing duplicates, are to be deemed owners,
unlefs on notice to the contrary from the real owner.
§ 15. Duplicates being loft, the owners, on oath before
a juftice, fliall be entitled to another from the pawn¬
broker. § 1 6.

By § 17. it is declared, that all goods and chattels
which are pawned or pledged, fliall be deemed to be for¬
feited, and may be fold, at the expiration of a year from
the date of pawning. But the pledger is, to a certain
degree, protected by another claufe, prohibiting pawn¬
brokers from purchafing goods in their own cuftody. If
any fum above' ten fliillings, and not exceeding ten
pounds, has been lent, the goods fliall be fold by public
auCtion after expiration of the year, under ftriCt regula¬
tions in refpeCt to previous ad vertifement, and publica¬
tion of catalogues, fpecifying, in addition to their de-
feription, the month in which they were pledged, as alfo
the name and place of abode of the pawnbroker. But it
is provided that pictures, prints, books, bronzes, ftatues,
buffs, carvings in ivory and marble, cameos, intaglios,
mufical, mathematical, and philofophical, inftruments, and
china, fliall be fold only at four times in the year ; name¬
ly, the firft Monday of January, April, July, and OCtober,
and on the following day if the number of articles render
it neceffary. Thus the pledger may redeem his goods at
any time within a year, on payment of the ftatutory pro¬
fits on the money lent ; but, on his failure, they may be
fold. Should he give notice to the pawn-broker before
the year clofes, of his intention to redeem, the fale muff:
be poftponed until three months fubfequent to its termi¬
nation. When the fale has aCiually taken place, the
pawn-broker is entitled to appropriate only fo much of
the price received as fliall cover his own advances, the
ftatutory profits, and cofts, and muff pay the refidue to
the owner on demand, within three years, under high
penalties in event of refufal.

It was decided on Jan. 23, 1822. II. T. in the court of
King’s Bench, that in the event of an article pawned not
being redeemed within twelve months and a day, the
pawm-broker is bound to account, if called upon by the
owner, for the difference in its produce, dedufting only
the fum advanced, the intereft, and expenfes ; and that,
if not actually fold, it may he redeemed after the time men¬
tioned. Carter v. Smith.

Pawn-brokers fliall not purchafe goods whilft in their
cuftody, or fuffer them to be redeemed for that purpofe ;
nor lend money to any perfon appearing to be under
twelve years of age, or intoxicated, or purchafe duplicates
of other pawnbrokers, or buy any goods before eight in
the forenoon, and after feven in the evening; nor receive
any goods in pawn before eight in the forenoon, or after
eight at night, between Michaelmas and Lady-day; and
before feven o’clock in the forenoon, and after nine at
night, during the remainder of the year; except till
eleven o’clock on the evenings of Saturday, and that
preceding Good Friday and Chriftmas-day ; nor carry on
the trade on any Sunday, Good Friday, or Chriftmas-
day, or any faft or thankfgiving day. § 20.

Pawn-brokers are to place in their fliops a table of rates
allowed by this aft. § 21. Pawn-broker’s chriftian and
fir name, and bufinefs, to be written over the door ; under
a penalty of iol. half to the informer, and half to the
poor. § 23.

Pawn-brokers having fold goods illegally, or having
embezzled or injured goods, j offices may award reafonable
5 S fatisfaftion

432 P A W

fatisfaftion to the owners, in cafe the fame fhall not
amount to the principal and profit; or, if it does, the
goods fhall be delivered to the owner, without paying any
thing, under a penalty of iol. §24. Pawn-brokers to
produce their books before any juftice, if required, on a
penalty of iol. to 5I. § 25.

Penalty on pawn-brokers neglecting to make entry,
iol. and for every offence againlt this aft, where no pe¬
nalty is provided, 40s. to iol. half to the informer, the
remainder to the poor. § 26. Complaint fhall, in all
cafes, be made within twelve months. § 2 7.

No perfon convifted of a fraud or felony may be an
informer under this aft. §29. Churchwardens to prole-
cute for every offence at the expenfe of the parifli, on
notice from a juftice. § 28.

This aft does not extend to perfons lending money
tipon goods at 5 per cent, intereft.

This aft to extend to the executors, &c. of pawn¬
brokers and pawners. § 31.

The form of conviftion is fettled by § 33. and an ap¬
peal given to the quarter-feflions by § 35.

However lucrative the bufinefs of pawn-brokers may
be to thofe who follow it, doubts are entertained whether
the toleration of them be not an evil to the public.
They are, indeed, temporarily ufeful, to perfons in the
nioft neceflitous circumftances ; but, as it is impoffible,
by any legillative interference, to bring them under that
control which would be defirable, as their interefts are
always at variance with the interefts of their employers,
and as mankind, under the preffure of necefiity, are re-
ftrained by no facrifice in feeking momentary relief, ulti¬
mate confiderations are too often overlooked. Hence the
firft rel'ort for aid frequently leads to a fecond, and then
to others fucceflively, while the property originally
pledged remains unredeemed, and all the reft belonging
to the owner gradually diminiflies, till he is left deftitute.
It is the poor and neceffitous only who avail themfelves
of railing fupplies on their goods, to ward off fome im¬
pending evil, and it is furprifing how low fucli tranfac-
tions are carried. Nay, the ftatute itfelf illuftrates the
nature of this miferable traffic more forcibly than could
be done in other terms. It is enafted, that if, at the pe¬
riod of redeeming the goods impledged, there fhall be a
certain fum due of intereft and profit, of which the
loweft denomination fhall be a farthing, and the redeemer
“ lhall not be able to produce and pay to the pawn-broker
a current farthing, which fhall be to the fatisfaftion and
liking of fuch perfon or perfons as are to receive the fame,
but fhall, in lieu thereof, tender to fuch perfon or perfons
to receive the fame, one halfpenny, in order to dif-
charge the faid remaining farthing fo due, as aforefaid,
the laid pawn-broker or pawn-brokers, his, her, or their,
fervant or agent, to whom fuch tender of a halfpenny fhall
be made, fliall, in exchange thereof, deliver unto fuch
perfon or perfons, fo redeeming goods as aforefaid, one
good and lawful farthing of the current coin of this king¬
dom, or, in default thereof, fhall wholly abate the faid
remaining farthing from the total fum to be received”
from the redeemer. But it is not only in the view of the
indigent yielding to the preffure of necefiity, in parting
with their property for an inconfiderable value, that fo-
° ciety fuffers an injury. The thoughtlefs and depraved
here find ready means of gratifying their propenfities, by
theaffiftance of the pawn-broker’s fliop; and thoufands part
with their apparel and furniture for what is, the next
moment, wafted in intoxication. Befides, the facility of
obtaining the reception of ftolen goods, is attended with
the molt pernicious confequences, and themoft powerful
encouragement to theft. Notwithftanding the law anx-
ioufly endeavours tofecure property to its owners by irn-
poling penalties on thofe who offer it in pawn, and in or¬
daining it to be reftored by the pawn-broker, cafes innu¬
merable may be figured, where the pawn-broker cannot
difcriminate what is the genuine property of any indi¬
vidual in particular ; and where it is not only difficult,

PAX

but may prove impoffibie, to bring an offender to juftice.
In theyear 1817, an afi'ociation was formed in Edinburgh,
for the purpofe of aiding thofe with advice and informa¬
tion who have dealings with pawn-brokers. Its fpecial
objeft is, to warn the ignorant of the laws under which
their property is protefted.

The banks called Savings Banhs may probably prove a
beneficial fubftitute for refort to the pawn-broker. Sums
amounting to a fhilling and upwards are received, and bear
intereft at 4 per cent, when accumulated to twelve fhillings;
thus enabling the labourer, or mechanic, or artifan, to
preferve the remnant of his weekly wages, and convert it
to advantage. Banks of this defcription are, at the pre-
fent moment, rapidly diffeminating throughout the dif¬
ferent parifhes and towns of England and Scotland; and
their outlet has been attended with one decided benefit,
in diminifhing the refort to alehoufes, where the earnings
of labour, too fmall to form an objeft for prefervation,
quickly difappeared. In fome towns of Italy we have
underftood there are charitable inftitutions of a mixed
nature between pawn-broking and banking. There, an
advance feems to be made on goods impledged at a cer¬
tain rate of intereft by fome, and by others money is re¬
ceived and returned, with 7 per cent, at the termination
of a year. The tranfaftions of thefe inftitutions, how¬
ever, are not completely explained, either as to the fecu-
rity given or the advantage derived. Ency. Brit. Suppl.
Jacob's Laic Diet.

PAWNE'E, /. One to whom fomething is entrufted as
a fecurity for money borrowed. — If the pawn be-laid up,
and the pawnee robbed, he is not anfwerable. Littleton's
Rep. 332.

PAWNE'ES, the name of an Indian nation, inhabiting
a part of Louifiana, confifting of three villages. The
number of warriors is 1993, of women 2170, and of
children 2060, according to the ftatenrent made in the
“ Exploratory Travels in North America.”

PAWNGAW', a town of Hindooftan, in Dowlatabad:
twenty miles egft of Perinda.

PAX, Peace, an allegorical divinity among the an¬
cients. The Athenians raifed her a ftatue, which repre-
fented her as holding Plutus the god of wealth in her lap,
to intimate that peace gives rife to profperity and to
opulence ; and they were the firft who erefted an altar
to her honour after the viftories obtained by Timotheus
over the Lacedaemonian' power, though Plutarch af-
ferts it had been done after the conquefts of Cimon over
thePeriians. Among the Romans, fhe was worfhipped
in a variety of magnificent temples. That which was
begun by Claudius, and finifhed by Vefpafian, was not
inferior to any in Rome. If we may believe Suetonius,
Jofephus, and St. Jerome, the emperor depofited there the
precious and rich fpoils of the temple of Jerufalem. In
this temple thofe w’ho profeffed the fine arts affembled,
in order to difpute about their prerogatives, that in the
prefence of the goddefs of peace all heats might be ba-
nilhed from their debates. This goddefs had alfo in the
fame city an altar, which was very much frequented.
Monuments reprefent to us Peace under the figure of a
woman crowned with laurel,, olive, or chaplets of rofes,
holding in one hand the caduceus, and in the other ears
of corn, the fymbol of plenty, which file procures. Arif-
tophanes gives her Venus and the Graces for her compa¬
nions.

PAX, f. [Lat. peace.] A fmall metallic plate, com¬
monly of filver, with the reprefentation of the crucifixion
engraved upon it, which was kiffed by the prieft at a
certain part of the mafs, he repeating at the fame time
Pax tecum, “ Peace be with you,” and afterwards by the
affiftants in token of fraternal charity. The word has
been often confounded with pix. — Innocent the Firft in¬
vented the killing of the paxe at maffe. Crowley's Delibe¬
rate Anfw, 1588. — Kifs the pax, and be quiet like your
neighbours. Chapman's Com. of May-Day, 16x1.

PAX'-WAX. See Pack-wax, vol. xviii.

x PAXA’ROS,

433

PAY

PAXA'ROS, or Bird Island, a fmp.ll ifland near the
fouth coaft of Cuba. Lat. 19. 56. N. Ion. 78.24. W.— -
Alfo, an ifland on the coaft of California, in the North
Pacific Qcean. Lat. 30. 18. N. Ion. 120.45. W. — Alio,
fmall iflands or rocks in the Pacific ocean, near the coaft
of Chili. Lat, 29. 40. S.

PAXIMA'DES, an ifland in the Mediterranean, near
the fouth coaft of the ifland of Candia. Lat. 34. 54. N.
Ion. 24. 43. E.

PAX'O, an ifland in the Mediterranean, about feven
miles long, and three broad, with a good harbour. Its
furface is highly beautiful, much inclofed, and nearly
covered with olive-trees. It is one of the Seven Ionian
Iflands under the protection of Great Britain. See St.
Maura, vol.xiv. p. 5 56.

Thefe iflands appear to flourifh, though great com¬
plaints have been made of mif-government and negleCt ;
for fir Thomas Maitland, the governor, is governor of
Malta alfo. Paxo, we are told, has fifty-fix trading vef-
fels, and exported goods to the value of 96,000 dollars in
the year 1815; which included 8500 barrels, or 2125
hogfheads, of oil. The value of the annual produdt of
the ifland was 23,000k the produce of the taxes was 695 7
dollars, the expenditure 6107. There are thirty-fix
churches, and 3968 inhabitants, the greater part of
which are in St. Gago, the capital. It is eight miles
fouth-eaft of Corfu, the feat of government, and twelve
miles well of the coaft of Albania. Lat. 39. 21. N. Ion.
20. 21. E. — Antipaxo, an inlet five or fix miles in circum¬
ference, and inhabited by a few fifliermen, lies near it.

Goodifon’s “Hiftorical Eflay on the Ionian Iflands,”
juft publifhed (Nov. 1822.) ftates the population of the
whole of the iflands of this Ionian Republic at 200,000
fouls; viz. Corfu and Cephalonia, each about 60,000;
Zante, about 35,000 ; Leucadia, or Santa Maura, 17,000 ;
and the remainder in Paxo, Ithaca, and Cerigo. See alfo
Gen. Vaudoncourt’s Mem. of the Ionian Iflands, and Dr.
Holland’s and Mr. Williams’s Travels in Greece.

PAX'TON (Upper, Lower, and Middle), three town-
fliips in Dauphin county, Pennfylvania : the firft contains
2232, the fecond 2180, and the third, including Swatara,
2998, inhabitants. — Alfo, a townfhip of Worcefter county,
Maffachufetts ; eight miles weft of Worcefter, incorpo¬
rated in 1765, and containing 619 inhabitants. — Alfo, a
townfhip of Ohio, in Rofs-county, with 661 inhabitants.

To PAY, v. a. f paier, Fr. apao-ar, Span, png-are, Ital.]
To difcharge a debt. It is applied to debts of duty, as
well as debts of commerce. — She does what fhe will, fay
what fhe will, take all, pap all. Shahefpeare, M. W. of
Windfor. — An hundred talents of filver did the children
of Ammon pap. 2 C/iron. xxvii. 5. — I have peace-offerings
with me; this day have I paid my vows. Prov. vii. 14.
Your fon has paid a foldier’s debt ;

He only liv’d but till he was a man. Shahefpeare.

It is oppofed to borrow. — The wicked borroweth, and
papeth not again. Pj’alms. — To difmifs one to whom any
thing is due with his money: as. He had paid his la¬
bourers. — To atone ; to make amends by fuffering : with
for before the caufe of payment. — Men of parts, who were
to aft according to the refult of their debates, and often
pap for their miftakes with their heads, found thofe fcho-
laftic forms of little ufe to difcover truth. Loclie.

Bold Prometheus, whofe untam’d defire
Rivall’d the fun with his own heav’nly fire,

Now doom’d the Scythian vulture’s endlefs prey,
Severely paps for animating clay. RoJ'common.

To beat. — I follow’d me clofe, and, with a thought,
feven of the eleven I paid. Shahefpeare’' s Henrp IV.

Forty things more, my friends, which you know true,
For which, or pay me quick, or I’ll pay you. B. Jovfon.

To reward j to recompenfe:

PAY

She I love, or. laughs at all my pain,

Or knows her worth too well, and pays me with difdain.

Drpden, Kn. Tale.

To give the equivalent for any thing bought. — Riches
are got by confirming lefs of foreign commodities than
what by commodities or labour is paid for. Locke. — It is
very pofliblefora man that lives by cheating, to be very
punctual in paying- for wdiat he buys ; but then every
one is allured that he does not do fo out of any principle
of true honefty. Law. — [In naval language.] To fmear
the furfaces of any thing with pitch, refin, turpentine,
tallow, and the like.

PAY,/’. Wages; hire; money given in return for
fervice. — The foldier is willing to be converted, for there
is neither pay nor plunder to be got. V Eftrange.

Come on, brave foldiers, doubt not of the day ;

And, that once gotten, doubt not of large pay. ShaheJ'p.

PAY'-DAY, f. Day on which debts are to be dif-
charged or wages paid. — Labourers pay away all their
wages, and live upon truft till next pay-day. Locke.

PAY-HO', or Pei-ho, a river of China, which rifes in
the north part of the province of Pe-che-li, and runs into
the gulf of Leao-tong in lat. 39. 3. N.

PAY-HOU', a lake of China, in Pe-tche-li : 140 miles
fouth of Peking.

PAY'-MASTER, f. One who is to pay; one from
whom wages or reward is received. If we defire that God
fhould approve us, it is a fign we do his work, and expert
him our pay-mufter. Bp. Taylor.

PA'YA, a town of South-America, in the province
of Darien : thirty miles eaft of St. Marie de Darien.

PAYABLE, adj. Due; to be paid. — The marriage-
money, the princefs brought, was payable ten days after
the folemnization. Bacon's Henry VII. — Such as there is
power to pay. — To repay, by a return equivalent, is not
in every one’s power; but thanks are a tribute payable
by the pooreft. South.

PAYASAI4 See Remedios.

PAY'AS. See Paias.

PAYE'E, /. in commerce, the perfon to whom a bill is
made payable.

PAY'ER, /’. One that pays. — Ingrateful payer of my
induftries. Beaum. and FI. Kn. of Malta.

PAYER'NE, a town of Swiflerland, in the canton of
Berne, formerly an imperial town under the protection
of the dukes of Savoy. It fubmitted to Berne in the year
1536, and is governed by its own magiftrates : twenty-
two miles fouth-weft of Berne. Lat. 46. 51. N. Ion. 6.
44. E. ■

P AY'ERSDORFF, a town of Germany, in the marg-
gravate of Bayreuth. Near it is a caftle, built of ftone, in
a llate of decay. This town and caftle were taken by the
Swedes under GuftavuS Adolphus.

PAYJAN', a town of Peru, in the diocefe of Truxillo:
fifteen miles north of Truxillo.

PAY'ING,/. TheaCl of difcharging a debt ; the aCl
or procefs of daubing any thing with fome unCluous
matter in order to preferve it ; a levere chaftifement.

PAY'MENT, J'. TheaCl of paying. — Perfons of emi¬
nent virtue, when advanced, are lefs envied, for their for¬
tune feemeth but due unto them ; and no man envieth
the payment of a debt. Bacon. — The thing given in dif¬
charge of debt or promife :

Commits his body

To painful labour both by fea and land,

And craves no other tribute at thy hands
But love, fair looks, and true obedience;

Too little payment for fo great a debt. Shahefpeare.

A reward. — The wages that fin bargains with thefinner,
are life, pleafure, and profit; but the wages it pays him
with, are death, torment, and deftruCtion: he that would
underftand the falfehood and deceit of fin thoroughly,

mu ft.

434 PAY

rmift compare its promifes and its payments together.
South.

Give her an hundred marks.

— An hundred marks! by this light I’ll ha’ more.

An ordinary groom is for fuch payment. Shakefpeare.

Chaftifement ; found beating. Ainfworth.

PAYMO'GO, a fort of Portugal in Eftramadura, on
the fea-coaft : four miles fouth-fouth-eaft of Peniche.

PAYMO'GO, a town of Spain, in the province of
Seville, on the frontiers of Portugal : thirty-five miles
north of Ayamonte.

PAYNE (John), an Englifh engraver of merit, the
pupil of Simon Pafle, born in London about the year
1607. Mr. Landfeer fays, that “ Payne had caught the
mantle of the Pafles.” Strutt fays of him that he was a
man of genius ; and, though his works are not very nu¬
merous, they neverthelefs manifeft his fuperior abilities.
He was recommended to Charles I. and had a fair pro-
fpeftof making his fortune ; but, carelefs of that as he
was of his fame, he negle&ed his bufinefs, and died in in¬
digence, anno 1647 or 48, before he had reached his 40th
year. His chief engravings confift of frontifpieces and
other book-plates, and portraits ; but he aifo engraved
a variety of other fubje&s, fuch as landfcapes, flowers,
&c. His portraits, however, are his belt works. Thofe
he executed entirely with the graver in a free open ftyle,
fo managed as to produce a very pleating effeft. Mr.
Evelyn) fpeaking of this artifl commends him alfo for a
/hip which he engraved. This fitip, as Vertue informs us,
was the Royal Sovereign, built by Phineas Pett. The
print was of a prodigious fize, and engraved on two plates,
being, when joined, three feet long by two feet two
inches wide.

PAYNE (Roger), a very eminent book-binder, was
born in London, but in what year we are not informed.
This ingenious man introduced a ftyle of binding, uni¬
ting elegance with durability, fuch as no perfon has ever
been able to imitate. He may be ranked, indeed, among
artifts of the greateft merit. The ornaments he employed
were chofen with a claflical tafte, and, in many inftances,
appropriated to the fubjedl of the work, or the age and
time of the author ; and each book of his binding was
accompanied by a written defeription of the ornaments,
in a 1110ft precife and curious ftyle. His chef d’ceuvre is
his AEfchylus, in the pefieflion of earl Spencer, the orna¬
ments and decorations of which are molt fplendid and
claflical. The binding of the book coft the noble earl
fifteen guineas. Thofe who are not accuftomed to fee
book-binding executed in any other than the common
manner, can have no idea of the merits of the deceafed,
who lived without a rival, and, we fear, has died with¬
out a fucceflor. He died, in great poverty, in Duke’s
court, St. Martin’s lane, 061. 20, 1797; and was buried
at the expenfe of his namefake Payne the bookfeller at
the Mews-gate ; and to whom, in a great meafure, the
admirers of this ingenious man’s performances may feel
themfelves indebted for the prolongation of his life ;
having for the laft eight years provided him with a regu¬
lar pecuniary afliftance, both for the fupport of his body
and the performance of his work. For this ingenious
artift had no command of himfelf : when in pofieflion of
a few pounds, he would live jovially 5 when that was ex-
haufted, almoft famifliing. Gent. Mag. Dec. 1797.

PAYNE (Thomas). See Paine, vol. xviii.

PAY'NESVILLE, a town of the ftate of Ohio, on
Lake Erie.

PAY'NIM. See Painim, vol. xviii.

PA'YO (St.), a town of Portugal, in the province of
Tras los Montes : eighteen miles weft of Mirand-de-
Duero.

PAY'RA, a town of South America, in the province
of Quito : twelve miles north-weft of Macas.

PAYRAC', a town of France, in the department of
the Lot, and chief place of a canton, in the diftridt of

P A Y

Gourdon. The place contains 902, and the canton 5171 ,
inhabitants.

PAYRE', a town of France, in the department of the
Gers : three miles fouth of Auch.

PAYRO'LA, J'. [contrafted by Juflieu from Paypay -
rola of Aublet, its Caribbean name.] In botany, a ge¬
nus of the clafs pentandria, order monogynia. Generic
characters — Calyx: perianthium inferior, of one leaf,
cloven into five roundifli acute fegments. Corolla: pe¬
tals five, oblong, narrow, ere£l, united together, fo as to
refemble a tube, their tops reflexed ; one larger, emargi-
11 ate, inferted into the diik beneath the germen. Sta¬
mina : filaments five, eredf, inferted into the dilk ; an-
therae oblong, combined, two-celled. Piftillum: germen
fuperior, placed on the dilk ; ftyle elongated, ftigma two-
lobed. Aublet remarks that he never faw the fruit of
this plant in its perfect ftate; but from an imperfeft one,
which he cut in halves, it appeared to have two cells. —
Ejfential Chara£ler. Calyx inferior, five cleft; petals five,
forming a tube, reflexed at their fummit. Stigrna two-
lobed.

; Payrola guianenfis, the only fpecies. Native of woods
in Guiana, about Sinemari, upwards of twenty miles from
the fea. It flowers in OCtober. This is a ftirub from
twelve to fifteen feet in height; ftem upright and branched;
leaves alternate, ftalked, large, ovate, acute, finooth, en¬
tire. Flowers fpiked, axillary terminal, yellow, each
furnilhed with three glands at its bafe. Aublet's Gui¬
ana, i. 249.

PAYS (Rene le), a writer of celebrity, born at Nantz
in 1636, was brought up to bufinefs, and obtained the
poll: of direCtor-general of the gabelles in Dauphine and
Provence. He was firlt known in the literary world in
1685, by a little production in verfe and profe, entitled,
“ Amities, Amours, et Amourettes,” which was read
with great avidity at Paris. It is faid that, in anfwer to
fome enquiries made by ladies as to his perfon, he ad-
drefied to the duchefs of Nemours a Portrait” of him¬
felf, written in the fame ftyle. He profefled to imitate
Voiture, but was feverely criricifed by Boileau as a very
inferior writer. Le Pays, however, inftead of being of¬
fended with the fatire, paid a vifit to the poet, and ob¬
tained his friendfhip. He publilhed letters, which prove
that he had vifited England and Holland. He was
honoured by the duke of Savoy with the knighthood
of St. Michael, and was an aflociate of the academy of
Arles. Fie died in 1690, at the age of fifty-four.

ToPAYSE, v.n. [ufed by Spenfer for poife. Fr .pefer.
See To Peise.J To balance :

Ne was itifland then, ne was it pays'd

Amid the ocean waves. Fairy Queen.

PAY'SER, f. [for poifer.~\ One that weighs. — To ma¬
nage this coinage, porters bear the tin, payzers weigh
it, a fteward, comptroller, and receiver, keep the account.
Carew.

PAY'TA, or St. Michel de Payta, a town of Peru,
in the diocefe of Truxillo, founded by Francis Pizarro
in the year 1 531. It is fmall, confifting of houfes which
are only ground-floors, the walls of fplit canes and mud,
and covered with leaves. Thefe edifices, though ex¬
tremely flight, are abundantly fufficient for a climate
where rain is confidered as a prodigy, and is not feen in
many years ; fo that, a fmall quantity falling here in
1728, great part of the buildings were ruined ; the walls
as it were melting away before it. The only houfe built
of ftone in the whole place, is that of the governor. It
has a parilh-church and chapel, dedicated to Our Lady of
Mercy, and ferved by a religious of that order.

The inhabitants of Payta are Spaniards, Mulattoes, and
Meftizoes, who live chiefly by paflengers going or re¬
turning from Panama to Lima, the number of whites
being inconfiderable; all of them conftituting but one
ftreet, and about 172 houfes. The port, though little
more than a bay, is efteemed the belt on the coaft, and

affordy

PAZ

affords a fecure anchoring-place. This is the only place
where (hips from Acapulco, Sonfonate, Panama, &c. can
touch in their pafl'age to Callao. The voyage is long and
tedious, on account of contrary winds, rains, and fliifting
currents : fo that, though the diftance, according to the
latitude of thefe parts, is only 140 leagues, a (hip is very
fortunate in performing it in forty or fifty days, and in
not being obliged to return to Payta. Southward of
the town is a mountain, called from its figure Silla de
Payta, or the Saddle of Payta. The foil round the town
is wholly fandy, and very barren : for, befides the to¬
tal want of rain, it has not a fingle river for the convey¬
ance of water, of which it would be entirely deftitute, if
it were not fupplied every day with great fatigue from
Colan, a town on the fame bay, four leagues north, near
which runs the river Chera, which waters Amotape.
The Indians of Colan are obliged to fend daily to Payta
one or two baizes, or floats, loaded with water, which
is dillributed in ftated proportions among the inhabit¬
ants. Payta has alfo the greateft part of its provifions
from the fame town. The nature of the foil, and the
fituation of the place, render it extremely hot. The town
owes its whole fupport to the harbour, which is the place,
as we have already intimated, where the cargoes of goods
lent from Panama are landed, together with thofe coming
from Callao to the jurifdidlions of Piara and Loja. In
the bay of Payta, and alfo that of Sechura, little farther
to the fouth, there is an ample fifliery, in which the In¬
dians of Colan, Sechura, and the fmall hamlets near the
coaft, are conffantly employed. The whole defence of
the town confifts in a fmall fort encompaffed by a brick
wall, and mounted by about eight pieces of cannon ;
but it has neither ditch nor outwork. It has been
often taken by the Englifh ; and particularly in 1741 by
the fquadron of commodore Anfon, when it was pillaged
and burnt. Lat. 5. 10. S. Ion. 81. 6. W.

PAYTOLLE'E, a town of Hindooftan, inRohilcund:
feven miles eaft of Bifiowie.

PAZ (La), a province and diocefe of Peru, belonging
however to the vice-royalty of Buenos Ayres. This
diocefe contains fix jurifdiflions ; viz. La Paz, Omafuyos,
Pacajas, Laricaxas, Chicuito, and Paucar-colla ; which
fee refpe&ively. The jurifdi&ion of La Paz is of no
great extent 5 and the city is almoft the only place in it
that is worthy of any notice. In the adjacent cordillera
is a high mountain, called Illimani, which is fuppofed
to contain immenfe riches; but, its fummit being perpe¬
tually covered with ice and fnow, no mine has been
opened in this mountain. The province was formerly
known by the name of Chuquiyapu , which in the idiom
of that country, is commonly thought to fignify “ an in¬
heritance of gold.”

PAZ (La), a confiderable city, and capital of the
above province, having, according to Helms, more than
4000 hearths, or 20,000 inhabitants. It is an elegant and
clean town, chiefly trading in the noted tea of Paraguay.
The province was firft conquered by Mayta-Capac, the
fourth inca ; and, the Spaniards having afterwards taken
poffeffion of it, this city was founded by Pedro de la
Gafca, in order to fecure a fettlement of Spaniards, in
the extenfive interval of 170 leagues between Arequipa
and Plata, for the improvement of commerce, and the
convenience and fafety of the traders. Its fituation was
feledled in a valley called Las Pacafas, in O&ober 1548,
as a place abounding in grain and cattle, and full of In¬
dians. Along the valley of La Paz flows a pretty large
river, occafionaily much increafed by torrents from the
Cordillera, about twelve leagues diftant from the city ;
but, from its vicinity, a great part of the country is ex-
pofed to fo cold an air, that hard frofts, fnow, and hail,
are not uncommon; but the city itfelf is fecured from
them by its happy fituation. Other parts are fo well
fheltered, that they produce all the vegetables of a hot
climate, as fugar-canes, cocoa, maize, and the like. In the
mountainous parts are large woods of valuable timber,

Vol. XIX. No. 1314.

PAZ 435

but infefted with bears, tigers, and leopards, with a few
deer; while on the heaths are found guanacos, vicunas,
and glamas, with a great number of cattle of the Euro¬
pean fpecies. The city Hands on unequal ground,
among the branches of the Cordillera, and is furrounded
by mountains. When the riverin its vicinity is increafed,
either by rains or by the melting of the fnow on the
mountain, its current forces along large maffes of rocks,
with fome grains of gold, which are found after the flood,
has fubfided, and from which fome idea may be formed
of the riches inclofed in the bowels of thefe mountains.
In the year 1730, an Indian accidentally difcovered a
lump of gold of fo large a fize, that the marquis de Caffel
Fuerte gave 12,000 pieces of eight for it, and fent it to
Spain as a prefent worthy of his fovereign. Befides
the cathedral and the parifli-church, there are three
others; and alfo religious fraternities of Francifcans,
Dominicans, Auguffines, the Fathers of Mercy, a col¬
lege of Jefuits, and a convent and hofpital, together with
two nunneries. Here is alfo a college of St. Jerome, for
the education of youth, whether defigned for civil or ec-
clefiallical employments. It is 120 miles eaft-fouth-eaft
of Arequipa. Lat. 17. 15. S. Ion. 68. 36, W.

PAZ (James-Alvarez de), a Spanifli Jefuit, was born
at Toledo in the year 1560. After having been taught
the claffics and philofophy, at the age of eighteen he
commenced his noviciate among the Jefuits, and foon
diftinguifbed himfelf by the compofition of pious medi¬
tations, on which his tutors bellowed warm approbation.
He went through his theological courfe at Alcala, and
was afterwards fent by his luperiors to Peru. Here he
occupied fucceffively the chairs of philofophy and divi¬
nity at Lima, with the higheft applause, feduloufly de¬
voting the hours not demanded by his profelfional du¬
ties to divine contemplation, and the compofition of
thofe works which w'ere from time to time given to the
public. From Lima he was fent to prefide as re6tor of
the fociety’s college at Quito ; whence he was tranf-
ferred to the fame poll at Cufco. Afterwards he filled
the high office of provincial of Peru during fix years.
While he was vifiting the different eftablifhments be¬
longing to the order in this capacity, he was feized with
a mortal illnefs at Potoli, which carried him off in 1620,
when about fixty years of age. He is highly panegy¬
rized by his biographers, as having exhibited an illuf-
trious example of all the Chrillian virtues, and uni¬
formly praftifed that rigid mortification and felf-denial
to which the Catholics aferibe exalted merit. His works
are written in Latin ; but they have been tranllated into
many of the European languages, and are held in high
ellimation. Their titles are, 1. De Vita Spirituali,
ejufque Perfedlione, lib. ix. 1608, folio; a Compendium
of which was digefted by a prieffc of Bois-le-duc, and
printed in 1620, 8vo. 2. De Exterminatione Mali, et
Promotione Boni, Lib. v. 1,614, folio. 3. De Inquifi-
tione Pads, five Studio Orationis, Lib. v. 1617, folio.
And the following, prefixed to pieces extradled and con-
denfed from the author’s larger works : 4. De Vita reli-
giole ir.ftituenda, five de quotidiana Virtutum Exercita-
tione, 1613, i2mo. afterwards revifed, and enlarged by
the author into two volumes, 8vo. 5. Meditationes tri-
partitae, 1620, 4to. 6. De Humilitate, Virtutum om¬
nium Fundamento. 7. De Virtutum Adeptione. Sot-
velli's Bill. Script. Soc. Jefu.

PAZA'RO, a cape of North America, on the weft fide
of the peninfula of California, near to the fouth end of
it; in about lat. 24. N. and Ion. 113. W.

PAZMA'NI (Peter), a celebrated Hungarian cardi¬
nal, was defeended from a noble Tranfylvanian family, •
and born at Great- Waradin in Hungary, but in what
year we are not informed. He entered the order of Je-
iuits in the year 1587, and diftinguifhed himfelf by the
progrefs which he made in the different branches of lite¬
rature, facred and profane. In the year 1607, he was
feledled, on account of his fuperior acquirements, to be
5 T profeffor

436 PEA

profeffor of philofophy, and afterwards of divinity, at the
college of Gratz, in Styria, in which polls he acquitted
himfelf with univerfal fatisfaiSlion and applaufe. After¬
wards he devoted himfelf to millions in different parts of
the kingdom, and is faid to have had great fuccefs in op-
poling the progrefs of the reformed opinions, and in
bringing back many wanderers to the fold . of the catho¬
lic church. By his zeal and a£livity he fo powerfully re¬
commended himfelf to the emperor Matthias, and the
principal Hungarian nobility, that, upon a vacancy ta¬
king place in the archiepifcopal fee of Gran, or Strigo-
nia, he was nominated to that ftation, and by the com¬
mand of the pope, againft his own inclination, obliged to
accept it. Being by this appointment primate of the
kingdom, he afiiduoufly exerted himfelf in eftablilhing a
ftriift difcipline, and correcting the relaxed manners of
the Hungarian clergy. For the encouragement of litera¬
ture, he alfo founded colleges at Prefburg, Pofen, and
other places. In the year 1629, at the folicitation of the
emperor Ferdinand II. pope Urban VIII. promoted him
to the purple: by the fame prince he was afterwards
fent ambalfador to the court of Rome. He died at Pofen
in 1637, when on his journey towards Vienna, to attend
the councils of the emperor Ferdinand III. Hepublilhed,
1. ACta et Decreta Synodi Dicecefanae Strygonienlis, cele-
bratas Tyrnauiae, 1629, 4to. which will be ufeful to the
ecclefiaftical hiltorian. 2. Sermons on the Gofpels for
all the Sundays, and feveral of the Feftivals, throughout
the Year, 1636, folio, in the Hungarian language. 3. A
Collection of Prayers, 8vo. in the fame language, which
has undergone numerous impreilions ; and a multitude
of doctrinal, practical, and controverlial, treatifes, in
Hungarian and Latin, of which a long lift is given in Sot-
velli Bib!. Script. Soc. Jefu. Gen. Biog.

PAZZA'NO, a town of Naples, in Calabria Ultra :
nineteen miles north-north-eaft of Gierace.

PE-CHOU'I, a town of China, of the third rank, in
Chen-fi : twenty-live miles north-weft of Tong.

PE-HING', a town of China, of the third rank, in
Chan-tong : twenty miles eaft-fouth-eaft of Pin.

PE-HO', a town of China, of the third rank, in Chen-fi,
on the Han river : thirty-feven miles eaft of Hing-ngan.

PE-KIANGV, a river of China, which rifes near Nan-
yang, in the north part of the province of Quantong,
and runs into the river of Canton thirty miles below
Canton.

PEA, / [pifum, Lat. pifo, Ital. pifa, Sax. pois, Fr.]
See Pisum. — A pea hath a papilionaceous flower, and
out of his empalement rifes the pointal, which becomes
a long pod full of roundilh feeds ; the ftalks are fiftulous
and weak, and feetn to perforate the leaves by which they
are embraced ; the other leaves grow by pairs along the
midrib, ending in a tendril. Miller. — The plural is peafe,
formerly peafon, which however is ftill fpoken in feveral
parts of England. — Peafe, deprived of any aromatic parts,
are mild and demulcent; but, being full of aerial parti¬
cles, are flatulent. Arbutlinot.

Sowe peafon and beans in the u’ane of the moon ;

Who foweth them fooner, he fow'eth too foone. Tuffer.
Peafe was formerly ufed as the lingular number. — The
vaunting poets found nought worth a peafe. Spenfer's
Shcp. Cal. 061. — A bit of marmalade, no bigger than a
peafe. Beaum. and FI. Doub. Marriage.

Pea, Everlafting. See Lathyrus.

- , Heart. See Cardiospermum.

- , Pigeon. See Cytisus.

- , Sweet. See Lathyrus.

- , Wing. See Lotus.

PE'A-STONE, in mineralogy. See PisoLithus.

PEACE,/ [paix, Fr. pax, Lat.] Refpite from war. —
Preferve us in peace; fo preferve us in pence, that war
may be always more odious to us than neceflity. Holyday.

The Dane and Swede, rouz’d up to fierce alarms,

Blefs the wife conduct of her pious arms ;

PEA

Soon as her fleets appear, their terrours ceafe,

And all the northern world lies hulh’d in peace. Addifon.

Quiet from fuits or difturbances. — The king gave judg¬
ment againft Warren, and commanded that Sherborn
Ihould hold his land in peace. Davies. — Reft from any
commotion. Stillnefs from riots or tumults. — All aflem-
bled here in arms againft God’s peace and the king’s, we
charge you to repair to your dwelling-places. Shakefpeare.
— Shallow, you have yourfelf been a great lighter, though
now a man of peace. Shakefpeare' s M. W. of Windfor. —
Reconciliation of differences. — Let him make peace with
me. lfaiah, xxvii. 5. — State not hoftile. — If I have re¬
warded evil unto him that was at peace with me, let the
enemy perfecute my foul. Pfalm vii. 4. — Seldom ufed
in the plural. — There be two falfe peaces or unities : the
one grounded upon an implicit ignorance. Bacon. — Reft ;
quiet ; content ; freedom from terror ; heavenly reft. —
Peace be unto thee ; fear not, thou lhalt not die. Judges
vi. 23. — The God of hope fill you with all joy and peace
in believing, that you may abound in hope. Rom.xv. 13.
— Religion directs us rather to fecure inward peace than
outward eafe, to be more careful to avoid everlafting tor¬
ment than light afflictions. Tillotfon. — Silence ; fuppref-
flon of the thoughts. — In an examination, a freed fer-
vant, who had much power with Claudius, very faucily
had almoft all the words; and, amongft other things, he
alked in fcorn one of the examinates, who was a freed
fervant of Scribonianus ; I pray, fir, if Scribonianus had
been emperor, what would you have done ? he anfwered,
I would have flood behind his chair and held my peace.
Bacon.

’Twill out. I peace!

No, I will fpeak as liberal as the air. Shakefpeare.

She faid; and held her peace: ZEneas went

Sad from the cave. Dryden.

Peace, in its general lignification, Hands in oppofition.
to war. The right of making war and peace is one of
the prerogatives of the king. In order to make a war
completely effectual, it is neceftary with us in England,
that it be publicly declared, and duly proclaimed by
the king’s authority; and then all parts of both the con¬
tending nations, from the higheft to the lowed, are bound
by it. And, wherever the right refides of beginning a
national war, there alfo mull refide the right of ending
it, or the power of making peace.

Peace is that defirable ftate, in which every one quietly
enjoys his rights, or, if controverted, they are difcuffed
with mildnels and argument. Hobbes has dared to fay
that war is the natural ftate of man. But furely, if, by
natural ftate of man, we underftand that to which he is
deftined and called by his nature, peace Ihould much ra¬
ther be termed his natural ftate ; for a rational being
fliould terminate his differences by rational methods
whereas to decide them by force is proper to beafts.
Man alone, and deftitute or fuccour, would neceffarily
be very miferable ; without commerce and the aflillance
of his fpecies, he could have no enjoyment of his life ; he
could neither difplay his faculties, nor live in a manner
fuitable to his nature : thefe particulars are only to be
found in peace. It is therefore only in this defirable
ftate that men regard, fuccour, and love, each other: this
is fo happy a condition, that they would never quit it
were they not blinded by the impetuofity of paflion, and
the grofs deceptions of felf-love. The various calami-
ties attending war are at prefent too well known, from
fad experience, in many parts of Europe; and it is a me¬
lancholy confideration, that the injuftice of the wicked
ihould fo often render it inevitable.

Nations, truly humane, who have a proper fenfe of
their duty, and underftand their true and fubftantial in-
terefts, will never purfue their advantage to the detri¬
ment of another. However intent they may be on their
own happinefs, they will take care to unite it with that

of

PEACE.

of others, and to found it on judice and equity. Thus
difpofed, they will neceflarily cultivate peace; for, if
they do not live peaceably together, how can they per¬
form thofe mutual and facred duties which nature en¬
joins them ? And this date is found to be no lefs neceflary
to their happinefs, than the difcharge of their duties. So
that the law of nature every way obliges them to feek
and cultivate peace.

This obligation of cultivating peace is a double tie.
A king owes this care to his.people, on whom war draws
a multitude of evils ; and this care is due to them in the
mod drift and indifpenfible manner ; government being
committed to him only for the advantage of the nation.
This peace, fo propitious to mankind, a nation or a fo-
vereign Ihould not only avoid didurbing; they fliould
alfo promote it to the utmod of their power, difluade
others from breaking it without neceflity, exhort them to
a love of judice, equity, and public tranquillity, to a love
of peace. It is one of the bed offices poffible to be per¬
formed to nations, nay to the whole world. What a
glorious appellation is that of peace-maker ! Were a
powerful prince rightly acquainted with the advantages
of it ; did he reprefent to himfelf the fplendid glory this
endearing charafter offers him, with the gratitude, the
love, the veneration, the confidence, of nations enjoying
happinefs under his aufpices ; did he know what it is to
reign over hearts, he would become the benefaftor, the
friend, the father, of mankind ; and in being fo he would
experience infinitely more delight than in the greated
conqueds.

The mod glorious period in the life of Augudus, was,
when he fhut the temple of Janus, adjuded the difputes
of kings and nations, and gave peace to the world. Here
he appears the greated of mortals, almod divine.

But thofe didurbers of the public peace, thofe fcourges
of the earth, who, fwayed by a lawlefs third of power,
or a haughty and favage difpofition, take up arms with¬
out judice or reafon, who fport with the quiet of man¬
kind, and the blood of their fubjefts ; thofe falfe he¬
roes, however deified by the injudicious admiration of
the vulgar, are in effeft the word of enemies to their fpe-
cies, and deferve to be treated as foes to the happinefs
and repofe of mankind. Experience, that unerring
touchdone of truth, fliows how very calamitous war is,
even among nations not immediately engaged in it.
War didurbs commerce, dedroys the properties of men,
raifes the value of the necefiaries of life, fpreads frightful
alarms, obliges all nations to be upon theirguard, and to
keep up, at a great expenfe, an armed force. He, there¬
fore, that breaks a peace without caufe, or merely to fa-
tisfy his pride and boundlefs ambition, neceflarily in¬
jures thofe kingdoms which are the objefts of his arms;
and by this pernicious example eflentially attacks the
happinefs and fafety of every nation on the earth. He
gives them a right to join in repreffing, chadifing, and
depriving him of a power, which he has fo diamefully
abufed. What evils does he not bring on his own nation,
laviffiing its blood to gratify his exorbitant paflions, and
expofing it to the refentment of confederate enemies!
A famous warrior at the end of the lad and beginning of
the prefent century has rendered his memory odious
by involving the nation he governed in continual
wars, without either judice or neceffity : if by his abilities
and indefatigable application he procured didinguiffied
fuccefles in the field of battle, he drew on himfelf the
execration of all Europe, and at length his own downfal.

Peace Societies. — The United States of America enjoy
the honour of having been the fird of the nations of the
earth who founded an organized Society for the propa¬
gation of pacific principles. There are now, at lead, five
of fuch inditutions in that country, mod of them having
their affiliated branches : of thefe the mod important are
the New York (which takes precedence of all others,
with regard to priority of formation, having been efla-
blifhed in Augud 1815), the Ohio, and the Mafiachufetts,

437

Peace Societies. The lad named one confids of upwards
of 400 members, among whom are one of the former pre-
fidents of the United States, feveral members of the
legiflature, and refpeftable judges of their courts, the
chief judice of their fupreme court, two of the former
governors, and about ninety miniders of religion ; the
lieutenant-governor of the date is prefident of their fo-
ciety. Indeed on the American continent the caufe of
peace has been fuccefsfully advocated, both from the
pulpit and the prefs ; and the friends of peace-focieties
are in confequence rapidly multiplying there.

Turn we now from America to our own country. “A
Society for the Promotion of permanent and univerfal
Peace” was edabliilied in London in the year 1816. The
objeft of it is to print and circulate trafts, and to diffufe
information tending to diow that war is inconfident with
the fpirit of Chridianity, and the true intereds of man¬
kind, and to point out the means bed calculated to main¬
tain permanent and univerfal peace upon the balls of
Chridian principles. The Society confids of perfons of
every denomination, who are defirous of uniting in the
promotion of “Peace on earth, and good-will towards
men.” Subfcribers are entitled to receive half the amount
of their fubferiptions in Trafts. The committee confids
of individuals whofe principles on the fubjeft of war are
in drift accordance with thofe on which the Society is
founded. Among thefe we need only mention that emi¬
nent philanthropid Thomas Clarkfon, the zealous co-
operator with Mr. Wilberforce in the abolition of the
dave-trade. A confiderable number of cheap but neatly-
printed trafts have been circulated, expreffive of the
opinions of the fociety, on the momentous fubjeft of the
unlawfulnefs of war, upon Chridian principles, and to
point out the means bed calculated to maintain perma¬
nent and univerfal peace.

Ten auxiliary focieties had been reported at the clofe
of 1820. The number of trafts printed in the fird year
was 48,000, in the fecond 128,000.

Confidently with that refpeft which is at all times due
to the condituted authorities of the country, the Com¬
mittee, in 1818, prefented an Addrefs with a Set of the
Society’s publications to his majedy, during his late re¬
gency, through the hands of lord Sidmouth, minider for
the home department. Addrefles were likewife prefented,
through the means of Mr. Clarkfon, at Aix la Chapelle,
to the allied fovereigns in congrefs, and alfo to his ma¬
jedy Alexander emperor of Ruffia. It does not appear
that the fociety received any anfwer from the prince re¬
gent ; but the anfwer from the emperor was fo much in
unifon with the views of the Society, that we cannot for¬
bear tranferibing it in this place.

Aix la Chapelle , the 6th — 18 til 061. 1818.

“ I received, fir, with fatisfaftion, the communications
of a fociety edabliffied upon principles conducive to per¬
manent and univerfal peace. The mixture of good and
evil obfervable in recent events, has exemplified in a fig-
nal manner the diferiminating difpenfation of Divine
Providence in mercy and judgment. As a Chridian, I
cannot but defire the edabliffiment of peace on earth by
every lawful and practicable means. As a Chridian fo-
vereign, I mud anticipate a time when nation /hall not lift
up J'wortl agaivjl nation, neither Jhall they learn war any
more. The unanimity of other Chridian powers is yet
uninterrupted, and, founded on the principle of our holy
faith, has the faired profpect of dability. Permanent and
univerfal peace is not altogether at man’s difpofal. It is
encouraging to obferve the growth of pacific difpofitions
in the world ; and focieties conducted in a temperate and
Chridian fpirit may contribute to their extenfion and
maintenance. With thefe views, the objeft of your fo¬
ciety cannot fail of my cordial approbation, without in¬
volving an implied concurrence in rneafures adopted for
its attainment, over which I have no controul.

Alexander.”

Peace,

43S

PEA

PEA

Peace, in our law-books, &c. is reftrained to a quiet and
inoffenfive carriage towards the king and his people.
Offences again ft the public peace are either fuch as are
an actual breach of the peace ; or conftru&ively fo, by-
tending to make others break it. Both of thefe fpecies
are either felonious or not felonious. The felonious
breaches of the peace, are ftrained up to that degree
of malignity by virtue of feveral modern ftatutes ; and,
particularly, the “ riotous affembling” of twelve perl'ons
or more, and not difperfmg upon proclamation : “ un¬
lawful hunting” in any legal foreft, park, or warren, not
being the king’s property, by night, or with painted
faces, (i Hen. VII. c. 7.) or appearing with the face
blacked, or with other difguife, and being armed with
offenfive weapons, to the breach of the public peace, and
the terror of his majefty’s fubjefts. 9 Geo. I. c. 22.
Sending any letter without a name, or with a fiftitious
name, demanding money, See. or threatening to kill any
of his majefty’s fubjedfs, or to fire their houfes, &c. 9 Geo.
I. c. 22. 27 Geo. II. c. 15. Deftroying any lock, fluice,

or fiood-gate, & c. turnpike gate, &c. The above-men¬
tioned offences are felonies. Thofe that remain to be
enumerated are merely mifdemeanours ; viz. affrays,
riots, routs, and unlawful affemblies, confiding of at
leaft three perfons; tumultuous petitioning; forcible
entry or detainer; riding or going armed with dangerous
or unufual weapons ; fpreading falfe news ; falfe and pre¬
tended prophecies.

Befides adtual breaches of the peace, any thing that
tends to provoke or excite others to break it, is an of¬
fence of the fame denomination ; fuch are challenges to
fight, either by word or letter, or bearing fuch challenge ;
and libels. The Englifli laws have provided various
means for preventing offences againft the public peace.
Where any man Hands in danger of harm from another,
and makes oath thereof before a juftice of the peace, he
muft be fecured by good bond, which is called binding to
the peace. Any juftice of the peace may, ex officio, bind
all thofe to keep the peace, who, in his prefence, make any
affray; or threaten to kill or beat another ; or contend
together with hot and angry words; or go about with
unufual weapons or attendance, to the terror of the
people; and all fuch as he knows to be common barre-
tors ; and fuch as are brought before him by the con-
ilable for a breach of the peace in his prefence ; and all
fuch perfons, as, having been before bound to the peace,
have broken it and forfeited their recognizances. Alfo,
wherever any private man hath juft caufe to fear that
another will burn his houfe, or do him a corporal injury,
by killing, imprifoning, or beating, him ; or that he will
procure others fo to do ; he may demand furety of the
peace againft fuch perfon ; and every juftice of the peace
is bound to grant it, if he who demands it will make
oath that he is actually under fear of death or bodily
harm ; and will fhow that he has juft caufe to be fo, by
reafon of the other’s menaces, attempts, or having lain
in wait for him ; and will alfo farther fwear that he does
not require fuch furety out of malice or mere vexation.
This is called /wearing the peace againft another ; and
if the party does not find fuch fureties, as the juftice*
in his diferetion ihall require, he may immediately
be committed till he does. A recognizance for keeping
the peace, when given, may be forfeited by any aftual
violence, or even an affault, or menace, to the perfon of
him who demanded it, if it be a fpecial recognizance ; or,
if the recognizance be general, by any unlawful a<5lion
whatfoever, that either is or tends to a breach of the
peace. Blaclijl. Com. b. iv. 1 Hawk. P. C. 126, 7, S.

PEACE, interj. A word commanding filence. — Peace !
Fear, thou Cornell too late, when already the arm is taken .
Sidney.-

Silence, ye troubled waves, and thou deep, peace!

Said then the Omnifick Word. Milton's P. L.

PEACE, an ifland on the coaft of Nova Scotia, fouth
of Mirachi point.

PEACE, a large river of North America, which runs
north-eafterly into the Lake of the Hills. In the dried
feafon, it is a quarter of a mile wide. The lands on this
river are inhabited by the Beaver and Rocky-Mountain
Indians, who are an uninformed and barbarous race of
beings. Polygamy is praftifed among them, and the
women are in the loweli ftate of debafement. At their
funerals, among other extravagant tokens of forrow, the
women, if the deceafed be a favourite fon or hulband,
cut oft' a finger at the firft joint. Some of the old women
have not a whole finger left ; but the men think it below
their dignity to lhow any mark of grief. Thefe perfons
are great gamefters, and purfue this as their employment
for feveral days and nights. Their habitations are formed
by fetting up a number of poles, united at the top, and
expanded at the bottom in a circle of twelve or fifteen
feet diameter; thefe are covered with dreffed Ikinsfewed
together. This bufinefs, and other drudgeries, are per¬
formed by the women, while the men fit fmoking at their
eafe.

PEACE-BREAKER,/. One who difturbs the peace
of the public. — They were of power to difturb their
kings, to raife war, to do mifehief, that is, to be peace-
breakers with extreme devotion. Holyday againjl Dijloy-
alty.

PE' ACE-MAKER, f. One who reconciles differences:

Peace, good queen ;

And whet not on thefe too too furious peers ;

For bleffed are the peace-makers. Shakefpeare.

PEACE-OFFERING, /. Among the Jews, a facrifice
or gift offered to God for atonement and reconciliation
for a crime or offence. — A facrifice of peace-offering offer
without blemi/h. Lev. iii. 1.

PE'ACE-OFFICER,/. An officer to keep the peace;
a conftable.

PEACE-PARTED, adj. Difmiffed from the world in
peace :

We ftrould profane the fervice of the dead

To fing a requiem, and fuch reft to her

As to peace-parted fouls. Shakefpeare' s Hamlet.

PEACE-SPEAKING, ar//. Commanding peace, giving
peace.

PEACEABLE, adj. Free from war; free from tumult.
— The reformation of England was introduced in a. peace¬
able manner, by the fupreme power in parliament. Swift.
— Quiet; undifturbed. — The laws were firft intended for
the reformation of abufes, and peaceable continuance of
the fubjeft. Spenfer.

Lie, Philo, untouch’d on my peaceable ftielf,

Nor take it amifs, that fo little I heed thee ;

I’ve no envy to thee, and fome love to myfelf :

Then why flrould I anfwer ? fince firft I muft read thee.

Prior.

Not violent; not bloody.— The Chaldeans flattered both
Caefar and Pompey with long life and a happy and peace¬
able death ; both which fell out extremely contrary. Hale's
Orig. of Mankind. — Not quarrelfome ; not turbulent. —
Thefe men are peaceable, therefore let them dwell in the
land and trade. Gen. xxxiv. 21.

PEACEABLENESS, /. Quietnefs ; difpofition to
peace. — Plant in us all thofe precious fruits of piety, juf¬
tice, and charity, and peaceablenefs, and bowels of mercy
toward all others. Hammond on Fundamentals.

PEACEABLY, adv. Without war; wdthout tymult :

To his crown, fhe him reftor’d,

In which he dy’d, made ripe for death by eld.

And after will’d it ftrould to her remain,

Who peaceably the fame long time did weld. Spenfer.

Without tumults or commotion. — The balance of power
was provided for, elfe Pififtratus could never have go¬
verned fo peaceably, without changing any of Solon’s
laws. Swift. — Without difturbance :

7 The

PEA

PEA

The pangs of death do make him grin;

Difturb him not, let him pafs peaceably. Shakefpeare.

PEACE'E, a town of Hindooftan, in Oude: forty
miles fouth of Goorackpour.

PEACEFUL, adj. Quiet ; not in war ; a poetical word:
That rous’d the Tyrrhene realms with loud alarms,

And peaceful Italy involved in arms. Dryden.

Pacific ; mild :

The peaceful power that governs love repairs
To feaft upon foft vows and lilent pray’rs. Dryden.
Undifturbed ; Hill ; fecure :

Succeeding monarchs heard the fubjedls’ cries,

Nor faw difpleas’d the peaceful cottage rife. Pope.

PEACEFULLY, adv. Without war. Quietly ; with¬
out difturbance :

Our lov’d earth ; where peacefully we flept,

And far from heaven quiet pofieflion kept. Dryden.

Mildly ; gently.

PE'ACEFULNESS, f Quiet ; freedom from war or
difturbance,

PE'ACELESS, adj. Wanting peace ; difturbed :
Terrours, which with nature war, affright
Our peacslefs fouls : the world hath loft its light :
Heaven, and the deep below, our guilt purfue. Sandys.

PEACH, f. [ peche , Fr. a contradlion of Perficum
( malum underftood), or Perfica (arbor). A tree and
fruit originally brought from Perfia into Italy. See
Amygdalus.] — September is drawn with a chearful
countenance : in his left hand a handful of millet, withal
carrying a cornucopia of ripe peaches, pears, and pome¬
granates. Peachatn.

The funny wall,

Prefents the downy peach. Thomfon's Autumn.

To PEACH, v. n. [corrupted from impeach .] To accufe
of fome crime. — When man and wife fall to peaching,
what foul loathes it not ? Whateley's Bride-Bujh, 1617. —
If you talk of peaching, I’ll peach- fit ft, and fee whofe oath
will be believed. Dryden.

To PEACH, v. a. To accufe. — Peche men of treafon
prevyly T can. Old Mor.of II y eke Scorner.

PE'ACH-COLOURED, adj. Of a colour like a peach.
— One Mr. Caper comes to jail at the fuit of Mr. Three-
pile the mercer, for fome four fnits of peach-coloured
fattin, which now peaches him a beggar. Shakefpeare' s
Mens, for Meas.

PEACH-I'SLAND, an ifland of Canada, in Lake St.
Clair, containing about 100 acres of land fit for tillage;
the reft meadow and marfli. ' ■

PE'ACHAM, a poft-town of America, in Caledonia
county, Vermont, weft of Barnet, on Connecticut river;
containing 1301 inhabitants.

PE'ACHAM (Henry), author of a book, entitled
“The Complete Gentleman,” publilhed in the reign of
James I. It treats of “ nobilitie in generall ; of dignitie
and neceflitie of learning in princes and nobilitie; the
time of learning ; the duties of parents in their children’s
education; of a gentleman’s carriage in the univerfitie ;
of ftile in fpeaking, writing, and reading hiftory ; of
cofmography ; of memorable obfervation in the furvey
of the earth ; of geometry; of poetry; of muficke; of
ftatuesand medalls; of drawing and painting in oyle ; of
lundry blazonnes both ancient and modern ; of armory
or blazing armes ; of exercife of body; of reputation and
carriage; of travaile ; of warre; of filhing.” He was
certainly a man of general knowledge, good tafte, and
acute obfervation. He refided a confiderable time in
Italy, where he learnt raulic of Orazio Vecchi. He was
intimate with all the great mailers of the time at home;
has characterized their feveral ftyles, as well as thofe of

Vol. XIX. No. 1315.

439

many on the continent. His opinions concerning their
works are very accurate, and manifeft great knowledge
of all that was underftood at the time relpefting practical
raulic. He feems to have been a travelling tutor, for
which he appears to have been particularly well qualified.
But with all his accomplilhments, he is faid to have been
reduced to poverty in his old age, and chiefly to have
fubfifted by writing little penny books, which are the
common amnfement of children.

PEACHER, /’. An accufer.— Certain thieves that were
named “ appellatores,” accufers or peacliers of others that
were guiltlefle. Fox's Acts and Mon.

PE'ACHICK, J'. The chick of a peacock. — Does the
fnivelling peachich think to make a cuckold of me ?
Southern.

PEACOCK, J'. [Of this word the etymology is not
known : perhaps it is peak- cock, from the tuft of feathers
on its head ; the peak of women being an ancient orna¬
ment : if it be not rather a corruption of beau-coy, Fr.
from the more linking luftre of its fpangled train. See
Pavo.] A fowl eminent for the beauty of his feathers,
and particularly of his tail. — The birds that are hardeft to
be drawn, are the tame birds ; as cock, turky-cock, and
peacock. Peacham.

Let frantick Talbot triumph for a while ;

And, like a peacock, fweep along his tail. Shahejpcare.

PEACOCK (Reginald), a worthy prelate, was fuc-
ceflively bilhopof St. Afaph and of Chichefter, by favour
of Humphrey, the good duke of Gloucefter; but he was
depofed for refilling the papal authority, and denying the
doftrine of tranfubftantiation, with other articles of the
Roman-catholic faith. He was not equal to fuffering in
a righteous caufe, but recanted his notions, and his books
were publicly burnt. He then retired to an abbey, pro¬
bably mortified and afhamed of his timidity, where he
died about the year 1+86.

PEA'GE DE PIZAN^ON', a town of France, in the
department of the Drome, on the fouth fide of the Ifere,
oppofite Romans.

PEAHEN, f. The female of the peacock.

PEAK,yi [Sax. pique, pic, Fr.) The top of a hill or
eminence :

Thy lifter feek

Or on Meander’s bank or Latrnus’ peak. Prior.

Any thing acuminated :

He has mew’d your head, has rubb’d the fnow oft’,

And run your beard into apeak of twenty. Beaum. and FI.
The rifing forepart of a head-drefs.

To PEAK, v. 71. [ pequaio , Span, little.] To look
fickly :

Weary fe’nnights, nine times nine,

Shall he dwindle, peak, and pine. Shahefpeare's Macbeth.

To make a mean figure ; to fneak. — The peaking cornufo
her hulband, dwelling in a continual larum of jealoufy,
comes me in the inftant of our encounter. Shakefpeare.

Why Hand’ll thou here,

Sneaking, and peaking, as thou would’ft Heal linen ?

Beaum. and FI. Wild Gooje Chafe.
PEAK, a mountain of England, which gives name to
a diftrift, in the county of Derby, between the Derwent
and the Dove, which laft river feparates it from Stafford-
Ihire. It is mountainous, rocky, and barren ; but abounds
in mines of lead, iron, coal, and antimony ; mill-ftones
and grind-ftones are likevvife dug here. The Wonders
of the Peak, as they are ftyled, have been deferibed fuc-
ceflively under the articles Bakeyvell, Buxton, and
Derbyshire.

PEAKE BA'Y, a bay on the fouth coaft of Jamaica.
Lat. 17. 59. N. Ion. 76. 58. W.

PE'AKIRK, a village of England, in the county of
Northampton, between Pafton and Market Deeping in
5 U Lincolnllvire ;

440

PEA

Lincolnlliire ; fo called from' Pcga, a devout woman,
who founded a cell in 714., which was converted into a
inonaftery by Edmund Atheling, and afterwards deftroyed
by the Danes : fix miles north of Peterborough.

PEAKS OF OTTER, the higlieft part of the moun¬
tain, called Blue Ridge, in the weft part of Virginia,
about 4.000 feet above the level of the fea.

PEAL, f. [perhaps from pcllo, pellere tympana, Lat.]
A lucceftion of loud founds : as, of bells, thunder, cannon,
or loud inftruments. — They were faluted by the way with
a fair peal of artillery from the tower. Hayward. — The
breach of faith cannot be fo highly exprefted, as in that
it fhall be the laftpecr/ to call the judgments of God upon
men. Bacon.

A peal fhall roufe their deep ;

Then, all thy faints aflembled, thou flialt judge
Bad men and angels. Milton's P. R.

Oh ! for 3. peal of thunder that would make
Earth, fea, and air, and heaven, and Cato, tremble !

Addifon.

It is once ufed by Shakefpeare for a low dull noife, but
improperly :

Ere to black Hecat’s fummons
The fhard-born beetle, with his drowfy hums,

Hath rung night’s yawning peal, there fhall be done
A deed of dreadful note. S/iakeJ'peare's Macbeth.

To PEAL, v. n. To play folemnly and loud:

The pealing organ, and the paufing choir;

And the laft words, that dull to duft convey’d. Tickell.

To PEAL, v. a. To aflail with noife :

Nor was his ear lefs peal'd

With noifes loud and ruinous, than when Bellonaftorms,

With all her battering engines bent to rafe

Some capital city. Milton's P. L.

To ftirwith fome agitation : as, to peal the pot, is when
it boils to ftir the liquor therein with a ladle. Ainjworth.
— Mr. Malone confiders this as a corruption of heel. So
Grofe fays, that/ie«Zmeans to cool; and cites, as a northern
expreftion, peal the pot.

PEANJE'E, a town of Pegu, on the Irawaddy : fifteen
miles fouth of Prone. 1

PEAR, a town of South-Carolina, on the Santee :
eighteen miles north-weft of St. James.

PEAR , f. [pejia, Saxon ; poire, French; pynan, Lat.]
A well-known fruit. — Auguft fhall bear the form of a
young man, of a choleric afpeCt, upon his arm a bafket of
pears, plums, and apples. Peacliam.

The juicy pear

Lies in a foft profufion fcatter’d round. T/iomfon.

PEAR-TREE, J. The tree that bears pears. See
Pyrus. — The pear-tree criticks will have to borrow his
name of mvg, fire. Bacon.

PEARCE (Zachary), a learned and worthy prelate of
the church of England, was born in London in the year
1690. He was the fon of a diftiller in High-Holborn,
who, having acquired a competent fortune, retired to an
eftate which he had purchased at Little Ealing, in Mid-
dlefex. Zachary received the firft part of his education
in a private fchool at Great Ealing; whence, in the year
1704, he was removed to Weftminfter-fchool, then under
Dr. Bufby. In this feminary he fpent fix years, during
which he fo diftinguifhed himfelf by his merit, that he
was elected one of the king’s fcholars. In 1710, when
he was in his twentieth year, he was eleCted to Trinity-
college, Cambridge. Mr. Pearce profecuted his academic
ftudies with great diligence and fuccefs, and was ad¬
mitted to his degrees in arts at the ftatuteable periods.
During the firft years of his refidence at Cambridge, he
occafionally amufed himfelfwith tlielighterfpeciesofcom-
pofition, andfentfpecimensof his talent in this line, fome

PEA

of which difcover humour and gaiety, to the Guardian
and Spectator. In the year 1716, he publifhed, from the
Univerfity prefs, an edition of Cicero de Oratore, in 8vo.
with notes and emendations; which, at the defire of a
friend, he dedicated to lord chief juftice Parker, and by
fo doing laid the foundation of his future fortune; for,
foon after the book had been prefented, Dr. Bentley, the
mafter of Trinity-college, being on a vifit to lord Parker,
his lord fhi p exprefted his approbation of Mr. Pearce’s
performance, and his hope that, as the editor was then a
candidate for a fellowlhip in his college, the doCtor would
fecure his election. This Dr. Bentley engaged to do,
upon receiving a promife that, if he made Mr. Pearce a
fellow, his lordftiip would unmake him again, as foon as
it ftiould be in his power to prefent him to a living; and
Mr. Pearce was defied accordingly. Immediately after¬
wards he waited on lord Parker, who received him in a very
obliging manner, putting into his hands a purfe of fifty
guineas ; and from that time, whenever he renewed his
vifits to his lordlhip, he always met with a kind reception.

In the year 1717, Mr. Pearce entered into deacon’s
orders ; and in the following year he was ordained prieft.
In the year 1718, Parker having been appointed lord
chancellor, Mr. Pearce was invited to live with his lord¬
ftiip, in the capacity of domeftic chaplain ; which invi¬
tation he gratefully accepted, and retained that poll three
years. In 1719, he was prefented to the reCtory of Sta-
pleford-Abbots, in Eflex ; to which preferment the lord
chancellor added, in the following year, that of the rec¬
tory of St. Bartholomew, behind the Royal Exchange,
London. Not long after this, Mr. Pearce had the honour
of being appointed chaplain to his majefty. In the year
1721-22, he married a lady poflefted of a confiderable for¬
tune, with whom he lived more than half a century in
the higheft ftate of connubial felicity, and had feveral
children, all of whom died young. About a year after
his marriage, he was prefented by the chancellor to the
valuable vicarage of St. Martin’s-in-the-fields, Weftmin-
fter. Being now incumbent of the parifh which was ho¬
noured with the refidence of the royal family, his lordftiip
fuggefted to him the propriety of his taking the degree of
DoCtor ofDivinity ; and, as he was not of fufficient Hand¬
ing at the Univerfity, application was made to Dr. Wake,
archbifliop of Canterbury, who granted him that title by
his diploma.

In 1724, Dr. Pearce dedicated to his patron, now Earl
of Macclesfield, his edition of Longinus on the Sublime,
with a new Latin verfion, and notes ; which, by the maf-
terly manner of its execution, contributed greatly to the
increafe of his reputation as a fcholar and critic. To the
ruin of the earl of Macclesfield, which took place in 1725,
it was in fome meafure owing that feveral years elapfed
from this time before our author received any additional
preferment; and for his next he was indebted to the re¬
commendation of queen Caroline, though Ihe was dead
before it was bellowed upon him. Among his parilh-
ioners at St. Martin’s w’as lord Sundon, w'hofe lady was
a great favourite with the queen. As Dr. Pearce Hood
high in this lady’s good graces, the frequent mention of
her good opinion of him induced her majefty frequently
to honour the doCtor with her converfation at her draw¬
ing-room, and to recommend him to fir Robert Walpole
fora deanery, whenever fuch a dignity, worthy of his ac¬
ceptance, ftiould become vacant. This recommendation
fir Robert recollected in the year 1739, and Dr. Pearce
was appointed dean of Winchefter.

In the year 1744, the dean was eleCted prolocutor of
the lower houfe of convocation for the province of Can¬
terbury; and in 1748, he was promoted to the fee of
Bangor. It appears that he did not accept of the epif-
copal dignity without great reluCtance ; and it was Hill
more in oppofition to his earneft willies that, in the
year 1756, lie was promoted to the bilhopric of Rochefter,
together with the deanery of Weftminller. For at this
period he acquainted archbilhop Potter with his intention

PEA

441

PEA

of aiking the king’s leave to refign his high flation in
the church 5 which the primate difcouraged, intimating
a doubt whether his majefty had it in his power to grant
fuch a requeft. However, having arrived at the age of
feventy-three, and believing himlelf to be unfit for dif-
charging the duties of his ftation, he informed lord Bath
of his intention to refign both his bilhopric and his dean¬
ery, and to live retired upon his own private fortune 3 at
the fame time foliciting his lordlhip to requeft for him the
honour of a private audience from his majefty for that
purpofe. Accordingly, the king fixed a day for his at¬
tendance in the clofet, when he entreated for permiffion
to refign both of his dignities; alluring his majefty that
he was only influenced by a confcioufnefs that his grow¬
ing infirmities rendered him incapable of fuftaining the
burthen of thofe appointments, and by a defire of fpend-
ing more time in his devotions and ftudies. He was of
the fame way of thinking, he faid, with a general oflicer
of the emperor Charles V. who, when he defired a dif-
miflion from that monarch’s fervice, and the emperor
a Iked the reafon for his requeft, anfwered, “ Sir, every
wife man would, at the latter end of life,, wiffi to have
an interval between the fatigues of bufinefs, and eter¬
nity !” After taking fome time to deliberate, and re¬
ceive the opinions of his legal advifers on the fubjedt,
his majefty fignified his content, and the bifhop adtually
killed hands on the occafion.

No fooner was lord Bath informed that the king had
confented to yield to our prelate’s wilhes, than he requeu¬
ed his majefty to bellow the bilhopric and deanery on
Dr. Newton, bifhop of Briftol. This application alarmed
the jealoufy of the miniftry, who thought that no digni¬
ties in the church Ihould be obtained but through their
hands. They therefore refolved to oppofe the bifhop’s
refignation, as the Ihorteft method of preventing, in this
inftance, an encroachment on their patronage; and they
informed his majefty, that the defign was generally dis¬
approved of by the epifcopal bench. Upon this, the
king fent for Dr. Pearce, and told him, that he mull think
no more about refigning his bilhopric. However, in the
year 1768, he obtained the king’s confent to refign his
deanery of Weftminfter 5 and from that time he difcharged
his epifcopal functions, and profecuted his private ftudies,
with all his remaining vigour, till the year 1773, when,
by too great exertion, he exhaufted his llrength beyond
recovery. Having confirmed feven hundred perfons at
Greenwich, he found himfelf, on the following day un¬
able to fpeak, and never regained his former readinefs of
utterance. His complaint, which was paralytic, conti¬
nued to increafe, till, after feveral months of lingering
decay, he died at Little-Ealing, on the 19th of June 1774,
in the 84th year of his age.

Befides the articles already mentioned, bifhop Pearce
publilhed, 3. An Account of Trinity-college, Cambridge,
1720, 8 vo. 4. Epiftolss dute ad cereberrimum doftiili-
raumque virum, F. V. Profeflbrem Amftelodamemfem
fcriptse : quarum in altera agitur de editione Novi Tefta-
menti a clariflimo Bentleio fulcepta, &c. 1721, 8vo. 5.
A Letter to the Clergy of the Church of England, on
occafion of the Bifhop of Rochefter’s commitment to the
Tower, 1722, 8vo. 6. The Miracles of Jefus vindicated,
in 4 parts, 1727, 1728, 8vo. in anfwer to fome of the
principal parts of Mr- Woolfton’s Six Difcourfes on the
Miracles of our Saviour, &c. 7. Two Letters in contro-

verfy with Dr, Middleton, on the fubjedt of his attack
upon Dr. Waterland, 1730 and 1731, 8vo. 8. Two
Letters to the Rev. Dr. Waterland, upon the Eucharift.
9. Nine occafional Sermons ; &c. By his will, he be¬
queathed his library to the dean and chapter of Weft¬
minfter, excepting fuch books as they already poflefTed ;
which books, together with his manuferipts, he gave to
his chaplain, the Rev. John Derby. To that gentleman
was bequeathed the care of publifhing the author’s great
work, the refult of many years’ ftudious application, and
which refledts lading honour upon his learning, critical

talents, and intimate knowledge of the fenfe and fpi-
rit of the facred writings. It made its appearance in the
year 1777, under the title of, 10. A Commentary, with
Notes, on the Four Evangelifts, and the Adis of the
Apoftles 3 together with a new Tranflation of St. Paul’s
Firft Epiftle to the Corinthians, with a Paraphrafe and
Notes, See. 2 vols. 4to. To the Commentary, See. are
added fome of the author’s earlier theological pieces.
Mr. Derby alfo gave to the public, from the author’s ma¬
nuferipts, 11. Sermons on feveral Subjects, 1778, 4 vols.
8 vo. Account of the Life of the Author, prefixed to his
Commentary . Monthly Review, vol. Ixi.

PEARCH. See Perch.

PEARL, f. [ perle , Fr. per/a, Span, fuppofed by Sal-
mafius to come from fpherula, Lat. Mr. Bryant fays, it
is “ the pared of the Antonians and Cutliites. Paralia is
the Land of Pearls.” Analyf. of Anc. Myth. iii. 205.
Todd. — A different etymology is propofed in a work
which is expedled Ihortly to ilfue from the prefs. “ The
Latin corresponding word is unio, union, from unire , to
join 3 becaufe pearls generally draw their value from be¬
ing many of the fame lize, and united together : this leads
me naturally to fuppofe, that the Englifti pearl and the
French perle are a contradfion o {'pareil, par ei lie, Fr. alike,
fimilar.”] Pearls, though efteemed of the number of
gems by our jewellers are but a diftemper in the fifti that
produces them. Some pearls have been known of the
lize of a pigeon’s egg ; as they increafe in fize they are lefs
frequent and more valued ; the true ffiape of the pearl is
a perfect round ; but fome of a confiderable fize are of
the lhape of a pear, and ferve for ear-rings. Hill.

Flowers purfied, blue and white,

Like faphire, pearl, in rich embroidery

Buckled below fair knighthood’s bending knee. Shahefp.

See the articles Manar, Mya, and Mytilus. — Pearls
have been lately difeovered in the mufl'els of the little
rivers Onune and Ouille, in the province of Luxembourg,
belonging to the king of the Netherlands : they are va¬
rious lizes, fome as large as a pea, all of a very pure wa¬
ter, and perfedtly round.

Artificial Pearls, popularly called beads, were anciently
only made of glafs, intruded on the in fide with a pearl-
coloured varnilh, a method firft purfued by fome artifts
at Murano; or with a kind of amalgam or coating of
quickfilver withinfide ; afterwards they ufed fmall balls
of wax or gum, covered with a pearl-coloured enamel.
Thefe were praifed on account of their 1 u ft re ; but, as
their beauty was deftroyed by moifture, they did not con¬
tinue long in ufe.

There has fince been invented in France another man¬
ner of making them, fo near the natural ones in lu lire
and water that they deceive a good eye. Thefe are what
the ladies now generally wear in defedl of true pearl.
Take of thrice diftilled vinegar two pounds; Venice tur¬
pentine, one pound ; mix them together into a mafs, and
put them into a cucurbit ; fit a head and receiver to it,
and, after you have luted the joints, fet it, when dry,
on a fand-furnace, to diftil the vinegar from it ; do not
give it too much heat, left the fluff fwell up : after this,
put the vinegar into another glafs cucurbit, in which
there is a quantity of feed-pearl wrapped in a piece of
thin filk, but fo as not to touch the vinegar ; put a cover
or head upon the cucurbit, lute it well, and put it into
bal. mariae, where you may let it remain a fortnight. The
heat of the balneum will raife the fumes of the vinegar,
and they will foften the pearls in the filk, and bring
them to the confiftence of a pafte ; which being done,
take them out, and mould them to what bignefs, form,
and ftiape, you pleafe. Your mould mull be of fine fil-
ver, the infide gilt ; you mull alfo refrain from touching
the pafte with your fingers, but ufe filver-gilt utenlils,
with which fill your moulds. When they are moulded,
bore them through with a hog’s briftle or gold wire, and
let them dry a little; then thread them again on gold

wire,

3

PEARL,

442

wire, and put them into a glafs ; clofe it up, and fet them
in the fun'to dry. After they are thoroughly dry, put
them in a glafs matrafs into a ftream of running water,
and leave them there twenty days 5 by that time they
will contract the natural hardnefs and folidity of pearls :
then take them out, and hang them in mercurial water,
where they will moiften, fwell, and affume their
oriental beauty ; after which, fhift them into a ma¬
trafs hermetically doled, to prevent any water coming
to them, and let it down into a well, to continue there
about eight days: then draw the matrafs up, and, in
opening it, you will find pearls exadly refembling ori¬
ental ones.

The mercurial water is thus prepared : Take plate-tin
of Cornwall ; calcine it, and let the calx be pure and fine;
then, with one ounce of the calx and two ounces of pre¬
pared mercury, make an amalgam; wafh it with fair w'a-
ter, till the water remains infipid and clear; then dry the
amalgam thoroughly, put it into a matrafs over the fur¬
nace, giving it fuch a heat as is requifite for fublimation.
When the matter is well fublimated, take off the matrafs,
and let it cool. Take out that fublimate, add one ounce
of Venice fublimate to it, and grind them together on a
marble ; put this into another matrafs, dole it well, and
fet it upfide-down in a pail of water, and the whole mafs
will diffolve itfelf, in a little time, into mercurial water:
this done, filter it into a glafs receiver, fet it on a gentle
afh-fire to coagulate, and it will turn into a cryftalline
fubftance : beat this in a glafs mortar, with a glafs peftle,
to a fine powder ; fcrain it through a fine fieve, and put
it into a matrafs, flop it clofe up, and place it in balneo
marise ; there let it remain till it refolves again into wa¬
ter, which will be fit for the above-mentioned ufe. Pojll.
Diet. Com.

The fieur Janin, or Jaquin, having obferved, that the
feales of a little fifti called the bleak, found plentifully in
the river Marne, had not only all the luftre of the real
pearl, but that, after beating them to powder in water,
they returned to their former brilliance upon drying; be¬
thought himfelf of fetting a piece or little mafs thereof
in the cavity of a bead or grain ofgirofol, which is a kind
of counterfeit opal made of glafs, and bordering much on
the colour of pearl. The difficulty was to get it there, and
when it was within to fpread it equally throughout the
bead. A little glafs tube, fix or feven inches long, and a
line and half in diameter, but very fiiarp at one end, and
a little crooked, ferved for the introducing of the mat¬
ter, by blowing it with the mouth, after having taken up
a drop of this mixture with the pointed extremity of the
tube ; and, to fpread it throughout the inner circumfer¬
ence, he contented himfelf to (hake it gently a long time,
in a little ofier bafket lined with paper. The pulverized
feales, fattened by this motion in the infide of the bead,
refume their luftre as they dry. To increafe this luftre,
in winter, they lay the beads in a hair fieve, or a bolting-
cloth, which they lufpend to the ceiling, and under it, at
fix feet diftance, they lay heaps of hot allies. In fummer
fthey fufpend them in the fame manner, but without any
fire. The pearls, thus well dried, become very brilliant,
and nothing remains but to ftop up the aperture, which
is done by melting wax, conveyed into it with a tube like
that ufed in introducing the powdered feales. After
clearing off the fuperfiuous w'ax, the)'’ perforate the pearls
with a needle, and firing them, and thus they form neck¬
laces.

To blanch and cleanfe Pearls. Firft foak and rub them
gently in bran-water, then in milk-warm w'ater, and laft
of all fteep them in mercurial water; then firing and hang
them in a glafs, clofe it well, and fet them in the fun to
dry. The bran-water is made thus : Boil two good hand¬
fuls of wheaten bran in a quart of water, till all the
ftrength of the bran is drawn out ; which ufe thus : take
anew glazed earthen pan, in which put your pearls on a
firing, and pour the third part of the bran- water upon it:
when they have foaked, and the water is juft warm, rub

your pearls gently with your hands, to clean them the
better, and continue this till the water is cold ; throw off
that, and pour on another third part of the bran-water
that is boiling ; proceed with this as you did before, and
when cold throw it away, and pour on the remainder of
the water, ftill proceeding as before. After this, heat
fair water, and pour it on your pearls to refrefh them,
and to wa(h away the remains of the bran by fhifting
them, and pouring on frefh warm water; this do thrice,
without handling your pearls ; then lay them on a fheet
of clean white paper, and dry them in a fhade ; after
which, dip them into mercurial water, to bring them to
perfection. Pojll. Did. Com.

Or, pound alabafter to an impalpable powder, and rub
the pearls therewith, very gently : this will not only
cleanfe them, but, if you let them remain in this pow¬
der twenty-four hours afterwards, they will ftill be the
better for it. White coral has the fame effect, ufed in
the like manner. White tartar, calcined and divefted of
all its moifture, is very good for the fame purpofe. Sait
diffolved, filtered, coagulated, well dried, and ground, is
as effe&ual as any of the former things for cleanfing of
pearls, by rubbing them therewith ; and, if afterwards you
lay them up in foine coarfe ground millet, it will contri¬
bute to their brightnefs.

PEARL, /. A white fpeck or film growing on the eye.
Any thing round and clear, as a drop:

Dropping liquid pearl,

Before the cruel queen, the lady and the girl

Upon their tender knees begg’d mercy. Drayton.

PEARL, /« The name of the fmalleft regular printing-type* of which the prefent
lines are a fpecimen.

To PEARL, v. n. To referable pearls :

She let to fall

Few perling drops from her fair lamps of light. Spenfer.

PEART- ASH, /. A fixed alkaline fait, prepared chief¬
ly in Germany, Ruftia, and Poland, by melting the (alts
out of the allies of burnt wood ; and, having reduced
them again to drynefs, evaporating the moifture, and
calcining them for a confiderable time in a furnace mo¬
derately hot. The goodnefs of pearl-alhes mud be dif-
tinguilhed by a uniform and white appearance : they are
neverthelefs fubjeft to a common adulteration, not eafy
to be diftinguilhed by the mere appearance, which is done
by the addition of common fait. In order to find out
this fraud, take a frnall quantity of the fufpeffed fait ;
and, after it has been foftened by lying in the air, put it
over the fire in a (hovel : if it contains any common fait,
a crackling and flight explofion will take place as the fait
grows hot.

Pearl-allies are much ufed in the manufacture of glafs ;
and require no preparation, except where very great
tranfparency is required, as in the cafe of looking- glafs,
and the belt kind of window-glafs. For this purpofe
diffolve them in four times their weight of boiling water :
when they are diffolved, let the folution be put into a
clean tub, and fuffered to remain there twenty-four hours
or more. Let the clear part of the fluid be then decanted
off from the fediment, and put back in the iron pot in
which the folution was made; in this let the water be
evaporated till the falts are left perfeftly dry. Keep
thofe that are not defigned for immediate ufe in (tone
jars, well fecured from moifture and air.

Mr. Kirwaii, who inftituted a fet of experiments on the
alkaline fubftances ufed in bleaching, &c. (fee Irifli Tranfi
for 1789.) tells us, that in 100 parts of the Dantzick
pearl-afh, the vegetable alkali amounted to fomewhat
above 63. He has alfo given tables of the quantities of
afltes and fait obtained from different vegetables ; and he
concludes from them, 1. That in general weeds yield
much more allies, and their allies much more fait, than
woods ; and that, confequently, as to falts of the vegeta¬
ble alkali kind, neither America, Triefte, nor the north¬
ern countries, poffefs any advantage over us. 2. That of
all weeds fumitory produces molt fait, and next to it

wormwood:

443

PEA

wormwood ; but, if we attend only to the quantity of
fait in a given weight of allies, the allies of wormwood
contain moll. Trifolium fbrinum alfo produces more
alhes and fait than fern. See Potash.

PEAR'L-EYED, udj. Having a fpeck in the eye,

PEAR'L-GRASS, Pearl-plant,, or Pearl-wort.
See Sagina.

PEARL I'SLAND, afmall ifland in the gulf of Mex¬
ico, at the mouth of the MIffiflippL

PEARL I'SLAND, a ftnall ifland in the Weft Indies.
Lat. 14.. 53. N. Ion. 73. 1 3. W.

PEARL I'SLAND, or King’s Island, a fmall ifland
in the bay of Panama, Lat. 7, 1a. N.

PEARL I'SLANDS, a clufter of fmall iflands in the
Atlantic, near the coaft of Nicaragua. Lat. 12. 35. N.
Ion. 83. 50. W.

PEARL KEY LAGOO'N, a bay on the Mofquito
fliore. Lat. 11. is. N. Ion. 83. 12. W.

PEARL KE'YS, iflets or rocks in the Spanilh main,
on the Mofquito fliore. Lat. 12. 26. N. Ion. 82. 45. W.

PEAR'L RIV'ER, a river of America, which rifes in
the Chaftaw country, in the weft part of the Miffiflippi-
territory, and, purfuing a foutherly courfe to the gulf of
Mexico, is navigable upwards of 150 miles. Its princi¬
pal mouths are near the entrance at the ealt end of the
iRegulets, through which is the paflage to lake Pont-
chartrain ; it has feven feet at its entrance, and deep
water afterwards. 1111769 there were fome fettlements
on this river, where were raifed tabacco, indigo, cotton,
rice, Indian corn, and all forts of vegetables. The land
produces a variety of timber, fit for pipe and hogfliead
ftaves, mads, yards, and all kinds of planks for ftrip-
building. This is the largeft river between Mifliflippi and
Mobile. Before it enters the Regulets or Rigolets, it
divides into federal channels.

PEARL RIV'ER, a river of Chiampa, which runs into
the Chinefe fea in lat. 10. 54. N. Ion. 107. 33. E.

PEARL ROC'KS, a clufter of low and dangerous
rocks in the north Pacific Ocean 5 near the fouth extre¬
mity of Calvert’s Ifland,. Lat. 51. 54. N. Ion. 231. 59. E.

PEARL-SPAR'. See Spatum cubicum.

PEAR'L-STONE,/. (Lave vitreufe perlee, Haiti/.) This
mineral is regarded by many mineralogills as a volcanic
production 5 it is frequently intermixed with Obfldian,
and hence is clafled by them as a variety of the latter mi¬
neral. It occurs in bafaltic and porphyritic rocks, in
large and fotnewhat angular concretions, which are com-
poled of fmaller roundilh concretions and thofe of others
ftill fmaller. The furface of the concretions is fmooth,
fhining, and pearly. The colour is grey, pafling into
pearl -grey and greyifli-black. It is tranflucent on the
edges 5 it fcarcely fcratches glafs, is eafily frangible, and
is fufible with intumefcence before the blow-pipe, into a
white fpongy glafs. This mineral has been found near
Sandy Brae, in Ireland, in the ifland of Iceland, and in
Mexico ; it was firft difcovered in Hungary, where it
occurs in large beds. It is claffed by Mr. jamefon and
Werner with obfldian, pitch-ftone, and pumice, as form¬
ing a member of the pitch-ftone family. According to
Klaproth, it is competed of

75.25 Silex. _

12. Alumine.

1.6 Oxydofiron.

4.5 Potafli.

2.5 Lime.

2. j Water.

98.35

PEAR'LED, aelj. Adorned or fet with pearls ; made
of pearls 1

You goodly nymphs

That, when you lift, in pearled boats of fhell
Glide on the dancing wave. P. Fletcher's Fife, Ed.
Vol. XIX. No. 1315.

PEA

The water-nymphs

Held up their pearled wrifts, and took her in,

Bearing her ftraight to aged Nereus’ hall. Milton's Comics.

Refembling pearls. — Her weeping eyes in pearled dew
flie fteeps. P. Fletcher.

PEAR'LY, adj. Abounding with pearls; containing
pearls;

Some in their pearly (hells at eafe, attend

Moift nutriment. Milton's P. L.

Refembling pearls. — Another was inverted with a pearly
(hell, having the futures finely difplayed upon its furface.
Woodward.

For what the day devours, the nightly dew

Shall to the morn in pearly drops renew. Dryden.

PEA'RMAIN, f. [ parmain , French.] An apple. —
Pearmain is an excellent and well-known fruit. Mor¬
timer.

The pearmain , which to France long ere to us was known;
Which careful fruiterers now have denizen’d our own.

Drayton .

PEARN’S POI'NT, a cape on the weft coaft of the
ifland of Antigua.

PE'ARSON (John), a very learned prelate of the
church of England, was the fon of a clergyman, re6tor
of Creake and Snoring, in Norfolk, at one of which places
he was born in the year 1612-13. In the eleventh year
of his age he was fent to Eton Ichool, where he laid an
excellent foundation of grammar-learning; and in the
year 1631, or 1632, he was elected from that feminary to
King’s College, Cambridge. Here he was admitted to
the degree of B. A. in 1635 ; after which he was chofen
a fellow of his college. In 1639, he proceeded M.A. and
not long afterwards refigned his fellowfliip, but continued
to refid e in college as a fellow-commoner. Having en¬
tered into holy orders during the lame year, bifliop Da-
venant collated him to a prebend in the church of Sarum;
and, in 1640, he was appointed chaplain to the lord-keep¬
er Finch, who is Paid to have prefented him to a living
in Suffolk. When the civil war commenced between
Charles I. and the parliament, Mr. Pearfon was made
chaplain to George lord Goring, and attended him when
he went in the king’s fervice into the weft of England.
About the year 1643, he obtained the living of St. Cle¬
ment’s Eaftcheap, in London. Here he preached a feries
of fermons, which he afterwards call into a different form,
and publiflied under the title of “ An Expofition on- the
Creed, &c.” 1659, 4to. This learned and well-known
performance has juftly been pronounced an accompliflied
work for ftyle and method, and free from thofe defects
which are too generally found in theological fyftems. It
was afterwards reprinted, with improvements, in folio;
and has been held in fuch eftimation, that twelve or thir¬
teen imprefllons of it have been called for. Before the
appearance of this work, in the year 1657, he and Mr.
Peter (afterwards bilhop) Gunning held a difpute with
two papifts, on the fubjeft of fchifm ; of which a falfe
account was publiflied at Paris, in 1658, which was dif-
claimed by both the proteftant difputants, and even by
one of their. popifli opponents.

Soon after the reiteration, preferments and honours
flowed in rapidly upon our author. Before the clofe of
the year 1660, he was collated, by Juxon bifliop of Lon¬
don, to the reftory of St. Chriftopher’s, in that city;
created D. D. at Cambridge, by a mandamus from the
king ; in flailed a prebend in the cathedral of Ely ; nomi¬
nated archdeacon of Surrey ; and appointed mailer of
Jefus-college, in Cambridge. In the year 1661, he was
one of the affiftant managers on the fide of the Eftablilh-
ment at the Savoy conference; on which occafion he ac¬
quitted himfelf in a manner that was reputable to his
learning and abilities, as Mr. Baxter did him the juftice
to acknowledge, “ Dr. Pearfon,” fays he, “ was their
5 X true

444

PEA P E B

true logician and difputant, without whom, as far as I
could difcern, we fliould have had nothing from them
but Dr. Gunning’s paffionate inveftives, mixed with fome
argumentations. He difputed accurately, foberly, and
calmly, (being but once in any pafiion,) breeding in us
a great refpefl for him, and a perfuafion that, if he had
been independent, he would have been for peace, and
that, if it were in his power, it would have gone well.
He was the ftrength and honour of that caufe which we
doubted whether he heartily maintained.”

In June 1661, he was appointed lady Margaret’s Pro-
feffor of Divinity at Cambridge, and he filled that chair
with diftinguifhed merit and applaufe. Upon a vacancy
taking place in the mafterfhip of Trinity-college, in 1662,
he was defied to that honourable ftation ; foon after
which he re'figned his prebends of Ely and Sarum, as
well as his reftory of St. Chriftopher’s. Dr. Pearfon con-
dufled hiinfelf in this pod with great reputation till the
year 1672, when he was defervedly advanced to the epis¬
copal rank, by being nominated fucceffor to the learned
Dr. Wilkins, in the fee of Chefter; with which he was
permitted to hold, in commcnclam, the archdeaconry of
Surrey, and the reftory of Wigan in Lancafhire. Be¬
fore he was railed above the rank of a prefbyter, he had
prepared for publication a learned work, which made its
appearance in 1672, entitled, “ Vindiciae Epiftolarum S.
Ignatii — Accefierunt Ifaaci Voffii Epiftolae duae adverfus
David Blondellum,” 4to. This work owed its origin to
the difpute then agitating concerning epifcopacy, and
was intended to fupport the arguments in its favour
drawn from the epiftles attributed to Ignatius, in oppo-
fition to fuch anti-epifcopalians as preferred the charge
of fpurioufnefs againft thofe remains of antiquity. Dr.
Pearfon held the bifhopric of Chefter upwards of thir¬
teen years, but was difqualified from all public fervice by
his infirmities for fome years before his death. That
event took place in 1686, when he was in the 75th year
of his age.

Bifhop Pearfon w’as a man of profound and general
learning, an exaft chronologift, and intimately acquaint¬
ed with the writings of the fathers, and with ecclefiafti-
cal hiftory. Bifhop Burnet fays of him, that he “ was
in all refpefls the greateft divine of the age: a man of
great learning, ftrong reafon, and of a clear judgment.
He was a judicious and grave preacher, more inftru&ive
than affe&ive; and a man of a fpotlefs life, and of an
excellent temper. His Book of the Creed is among the
belt that our church has produced.” Dr. Pearfon had
been admitted a Fellow of the Royal Society in 1667.
He was the author of, 3. A Preface to the Golden Re¬
mains of the ever-memorable Mr. John Hales of Eton-
college, 1660, 8vo. 4. No Neceflity of Reformation of
the public Doctrine of the Church of England, &c. fame
date, 4to. 5. A Sermon, preached before the king, and
publirtied by his majelty’s command, 1671, 4to. 6. The
Preface, Prafatio Paranetica, to J. Field’s edition of the
Septuagint, 1665, nmo. 7. Annales Cyprianici, five
tredecim annorum quibus S. Cyprianus inter Chriftianos
verfatus eft, Hiftoria Chronologica, printed with bifhop
Fell’s beautiful edition of the works of that father, 1682,
folio. He u'as alfo one of the editors of the Critici Sacri,
or Colledtion of Critics and Commentators upon the
Bible, in 9 vols. folio. And from his manufcripts were
publirtied, after his death, 8. V. Cl. Joannis Pearfonii,
S. T. P. Ceftrienfis nuper Epifcopi, Opera Polthuma
Chronologica, See. Singula prado tradidit; edenda cu-
ravit, et Difl'ertationis novis additionibus auxit H.
Dodwellus, &c. 1688, 4to. Reliquice Baxterianee. Burnet's
own Time, vol. ii. Gen. Biog.

PEASANT, / [paifan, Fr.] A hind; one whofe bu-
finefs is rural labour. — He holdeth liimfelf a gentleman,
and fcorneth to work, which, he faith, is the life of the
peafant or churl. Spenfer.

I had rather coin my heart, than wring

From the hard hands of peafants their vile trafli. S/iakefp.

PEASANT, aelj. Ruftic ; country. — This have I ru¬
mour’d through thepeafant towns. ShaheJ pear e's Hen. IV.
Lik e peafant foot-boys do they keep the walls,

And dare not take up arms like gentlemen.

Shakefpeare's Hen. VI. P. 1.

PEAS'ANTLIKE, or Peasantly, adj. Rude; un¬
taught ; clownifh ; refembling the behaviour of peafants.
— He is not efteemed to deferve the name of a complete
architeCl, an excellent painter, or the like, that bears not
a generous mind above the peafanllj regard of wages and
hire. Milton's Animad. Rem. Defence.- — We frame to our-
felves a peafantlij notion of good and evil. Spenfer on
Prod. — Learning is thought pedantic, agriculture pea-
fantlike. Gov. of the Tongue.

PEASANTRY,/. Peafants; ruftics; country people.
— The peafantrj in France, under a much heavier pref-
fure of want and poverty than the day-labourers of
England of the reformed religion, underftood it much
better than thofe of the higher condition among us.
Locke.

How many then fhould cover, that ftand bare :

How much low peafantrj would then be gleaned
From the true feed of honour ? how much honour
Pickt from the chaff? Shahef pears' s Merck, of Ven.

Behaviour of peafants ; rufticity ; coarfenefs. — As a gen¬
tleman you could never have defeended to fuch peafantrj
of language. Butler's Remains.

PEASCOD, or Peashell, / The hufk that contains
peafe. — Thou art a (heal’d peafeod. Shakef peare' s K. Lear.
— I faw a green caterpillar as big as a fmall peafeod.
Walton.

As peafeods once I pluck’d, I chanc’d to fee
One that was clofely fill’d with three times three.

I o’er the door the fpell in fecret laid. Gaj.

PEASHAWM,/ The draw of peafe.

PEASE, a townlhip of Belmont county, in Ohio, hav¬
ing 1379 inhabitants.

PEAT,/ A fpecies of earth ufed for fuel. — Turf and
peat, and cowfheards, are cheap fuels, and lalt long. Ba¬
con's Nat. Hif.— See Turfa paluftris.

PEAT-EARTH,/ Earth mixed with vegetable fub-
ftances forming or producing peat. — Carew, in his Survey
of Cornwall, mentions nuts found in peat-earth two miles
eaft of St. Michael’s Mount. Woodward.

PEAT-LAND, / Land producing peat. — It is per¬
haps owing to an antifeptic quality in fome of thefe
plants, that there happens fuch an accumulation of their
fpoils, conftantly penetrated with water, without their
undergoing any putrefaction ; a circumftance that elfen-
tially diftinguifties our peat-lands from marfhes, for the
air is always falubrious. Be Luc's Geol. Letters to Prof.
Blumenbach.

PEAT LAW, a hill of Scotland, in the county of Sel¬
kirk : two miles north- weft of Selkirk.

PEA'TRA, a town of European T urkey, in Moldavia :
fixteen miles fouth-fouth- weft of-Niemecz.

PEAULE, a town of France, in the department of the
Morbihan : four miles north- weft of Roche Bernard, and
fix fouth of Rochefort.

PEB'BLE, or Pebble-stone,/ [paebolycana, Sax.]
A fmall (tone. — Suddenly a file of boys delivered fuch a
(hower of pebbles loofe (hor, that I was fain to draw mine
honour in. Shakefpcare — You may fee pebbles gathered
together, and a cruft of cement between them, as hard as
the pebbles. Bacon. — Through the midft of it ran a fweet
brook, which did both hold the eye open with her azure
ftreams, and yet feek to clofe the eye with the purling
noife it made upon the pebble-fones it ran over. Sidney.

Winds murmur’d through the leaves your long delay ;
And fountains o’er the pebbles chid your (lay. Drjden.
The bifhop and the duke of Glo’fter’s men,

Forbidden late to carry any weapon,

Have fill’d their pockets full of pebble fones. Shakefpeare.

Pebbles

P E B

445

Pebbles are diftinguiflied from the flints and homo-
chroa, by their having a variety of colours. They are
defined to be ftones, compofed of a cryftalline matter, de-
bafed by earths of various kinds in the fame fpecies, and
then fubjeft to veins, clouds, and other variegations 5
ufually formed by incruftations round a central nucleus,
but fometimes the effeft of a Ample concretion, and veined
like the agates, by the difpofition which the motion of
the fluid they were formed in gave their differently-co¬
loured fubllances.

The variety of pebbles, of England alone, is fo great,
that a hafty defcriber would be apt to make almoft as
many fpecies as he faw fpecimens. A careful examination
will teach us, however, to diftingulfh them into a certain
number of efl'entially different fpecies, to which all the
reft may be referred, as accidental variations. When we
find the fame fubftances and the fame colours, or thofe
refulting from a mixture of the fame, fuch as nature fre¬
quently makes in a number of ftones, we dial! eafily be
able to determine that thefe are all of the fame fpecies,
though in different appearances 5 and that, whether the
matter be difpofed in one or two, or in twenty, crufts laid
regularly round a central nucleus, or thrown without a
nucleus into irregular lines, or finally blended into a fort
of uniform mafs. Thefe are the three ftates in which we
are liable to find every fpecies of pebble ; for, if it hath
been moft naturally and regularly formed by incruftation
round a central nucleus, we find that ever the fame in
the fame fpecies, and the crufts not lefs regular and cer¬
tain. If the whole has been more haftily formed, and has
been the refult only of one fimple concretion, if that has
happened while its different fubftances were all moift and
thin, they have blended together and made a mixed mafs
of the joint colour of them all; but if they have been
fomething harder when this has happened, and too far
concreted to diffufe wholly among one another, they are
found thrown together into irregular veins. Thefe are
the natural differences of all the pebbles. Hilts Hijl.
Faff. p. 512.

The term pebble-Jlone is applicable to a numerous clafs
of rocks, &c. confiding of pebbles of various fixes and
colours 5 which are irregularly connected together, either
with or without an intermediate fubftance: and it is pre¬
fumed that the cemented particles are pebbles, or have
acquired their rounded form by attrition, from their uni¬
form fmoothnefs.

One of the moft drifting varieties of pebble-ftone very
commonly occurs fcattered in large maffes over the coun¬
ty of Hereford. The whole appearance of the mafs has
given rife to the term plum-pudding j lone in this coun¬
try 5 and the refemblance that gave rife to the term is fo
remarkable, that it cannot fail to ftrike the mind upon
the firft view. The term has been very generally adopted
by foreign mineralogifts ; who, however, commonly call
it Amply pudding -Jlone, or Engli/k pudding-Jlone ; (pou-
dinge, of Brochant; poudding Anglais, of Haiiy.) See
Breccia filicena, under the article Mineralogy, vol. xv.
P- 47°> .

The ufe of thefe ftones, and their difpofition in the
earth, is a fubjeft of great admiration; and may ferve as
one of the numerous proofs of an over-ruling Providence
in the difpofition of all natural bodies. The furface of
the earth is compofed of vegetable mould, made up of
different earth mixed with the putrid remains of animal
and vegetable bodies; and is of the proper texture and
compages for conducting the moifture to the roots of
trees and plants s and under this are laid the fands and
pebbles which ferve as a fort of drain to carry off the re¬
dundant moifture deeper into the earth, where it may be
ready to fupply the place of what is conftantly rifing in
exhalations ; and left the ftrata of fand Ihould be too
thick, it is, common to find thin ones of clay between,
which ferve to put a flop to the defcent of the moifture,
and keep it from palling off too foon ; and left thefe thin
ftrata of clay Ihould yield and give way, and by their foft-
nefs, when wetted, give leave to the particles of fand to

PEC

blend themfelves with, and even force their way through,
them, there are found in many places thin coats of a poor
iron-ore, placed regularly above and below the clay; and
by that means not only ftrengthening and fupporting the
clay, but effectually keeping the fand from making its
way into it. Phil. Tranf. No. 483.

PEB'BLE-CRYSTAL, f The cryftal, in form of no¬
dules, is found lodged in the earthy ftrata left in a train
by the water departing at the conclufion of the deluge :
this fort, called by the lapidaries pebble-cryjlal, is in dupe
irregular. Woodward.

PEB'BLED, adj. Sprinkled or abounding with pebbles
-—This bank fair fpreading in a pebbled (ho re, T/iomfon.

PEB'BLY, adj. Full of pebbles. — We palled many
rivers and rivulets, which commonly ran with a clear
(hallow ftream over a hard pebbly bottom. Dr. Johnfon's
Journ Weft. Ijlands.

Strow’d bibulous above I fee the fands,

The pebbly gravel next. T/iomfon.

PEC (La), a town of France, in the department of
Paris : ten miles weft of Paris.

PECA'QUE (St.), a town of Mexico, in the province
of Xalifca : forty-five miles north of Compoftella.
Lat. 23. N. Ion. 101. 30 W.

PECCABIL'ITY, f. [from peccable .] State of being
fubjeft to fin. — Where the common peccability of man¬
kind is urged to induce commiferation towards the of¬
fenders; if this be of force in fin, where the concurrence
of the will renders the perfon more inexcufable, it will
furely hold much more in bare error, which is purely in¬
voluntary. Decay of Chr. Piety.

PEC'CABLE, adj. [from pecco, Lat. to fin.] Liable to
fin. — As creatures they are peccable. Waterhoufe on For-
tefcue. — Both he and they were originally created pure
and innocent, though fallible and peccable at the fame
time. Berrow's LapJ’e of Hum. Souls.

PECCADIL'LO, f. [Spanilh ; peccadille, French.
This word had been introduced into our language long
before the time of Dryden, from whofe writings Dr.
John Ton’s earlieft example is cited. Todd.] A petty fault;
a flight crime ; a venial offence.. — We pay no Peter-pence;
we run not to Rome- market to buy trafh. I hope his
Holinefs difpenfeth with us for thefe peccadillos. Bp.
Hall’s Hon. of the Mar. Clergy, 1620. — He means thofe
little vices, which we call follies and the defeats of the
human underftanding, or at moft the peccadillos of life,
rather than the tragical vices to which men are hurried
by their unruly paffions. Dryden. — ’Tis low ebb with his
accufers, when fuch peccadilos as thefe are put in to fwell
the charge. Atterbury.

PECCATS, a town of France, in the department of
the Gard, built for the defence of the falt-works in the
neighbourhood : three miles fouth-eaft of Aigues Mortes.

PECCAM'INOUS, adj. [ peccamen , Lat.] Full of fin.
Cole.

PEC'CANCY, f [from peccant.] Bad quality.— Apply
refrigerants without any preceding evacuation, becaufe
the difeafe took its original merely from the difaffe&ion
of the part, and not from the peccancy of the humours.
Wifeman. — Offence. — This diftorting of equivocal words,
which pafleth commonly fora trivial peccancy, if it be well
examined, will be found a very dangerous admiflion. W.
Montague's Dev. EJf. 1648.

PEC'CANT, adj. [Fr. from peccans, Lat.] Guilty ;
criminal. — That fuch a peccant creature (liould difapprove
and repent of every violation of the rules of juft and
honeft, this right reafon could not but infer. South.

From them I will not hide
My judgements, how with mankind I proceed;

As how with peccant angels late they faw. Milton.

Ill difpofed ; corrupt ; bad ; offenfive to the body ; inju¬
rious to health. It is chiefly ufed in medical writers. —
Such as have the bile peccant or deficient are relieved by
hitters, which are a fort of fubfidiary gall. Arbuthnot.

With

446

PEC

Wit!) laxatives preferve your body found,

And purge the peccant humours that abound. Dryden.
Wrong; bad; deficient; unformal. — Nor is the party
cited bound to appear, if the citation be peccant in form
or matter. Ayliffe's Parergon.

PEC'CANT, f. An offender. Not in life. — This con--
ceitednefs, and itch of being taken for a counfellor,
inaketh more reprovers than peccants in the world. Whit¬
lock's Mann, of the Eng. 1654.

PECCA'VI. [Latin. A colloquial expreflion ftill in
ufe : as, He cried peccavi .] I have offended. — In queen
Mary’s time, upon the return of the Catholique religion,
the nunnes came again to Wilton abbey ; and this Wil¬
liam earl of Pembroke, came to the gate with his cappe
in his hand, and fell upon his knee to the lady abbeffe
and the nunnes, crying peccavi! Upon queen Mary’s
death, the earl came to Wilton, like a tygre, and turned
them out, crying, Out ye whores, to worke, to worke !
A ubrey's Anecd.

PECE'TA,/. A Spanifti filver coin. The old Mexican
peceta of two Mexican reals (1736) is in weight 4 dwt.
73 gr.; its content in pure filver grains 9 3’6 ; and its value
j s. id. fterling. The peceta of two reals of new plate
(1775) is in weight 3 dwt. 18 gr. content -]z'z ; and value
iod. fterling.

PECE'TO, a town of France, in the department of the
Po : three miles fouth-weft of Chieri.

PECHAN'TRE (Nicholas de), a French poet, was
born at Touloufe in 1638. He gained the poetical prize
from the academy des Jeux Floraux three times. His
tragedy of Geta was performed at Paris in 1687, with
great applaufe. This was followed by Jugurtha, the
Death of Nero, and home others. Pechantre died in the
year 1708.

PECHARE'E, a town of Hindooftan, in the circar of
Chanderee: thirty-five miles weft-fouth-weft of Chanderee.

PECH'BLENDE, f in mineralogy. See Uranium
fulphuratum.

PE'CHIA, a town of Servia, on the Drino : thirty-five
miles north-eaft ofRagufa, 130 weft-fouth-weft of Niffa.
Lat. 43. 14. N. Ion. 19. 15. E.

PECH'LARN, or Pochlarn, a town of Auftria, on the
right bank of the Danube. The river is very wide, and
the Romans had here a harbour for their navy: they
called it Prceclara, and it was considered one of the
ftrongeft places in the country : forty-two miles eaft of
Lintz, forty-five miles weft of Vienna. Lat. 48. 14. N.
Ion. 1 5. 20. E.

PECH'LIN (John Nicholas), an eminent phyfician,
was born at Leyden in 1646. He took the degree of
M. D. in the univerfity of that city in 1667, and after¬
wards travelled into Italy for further improvement. He
was placed in the medical chair at Kiel in Holftein in
1673, and rendered himfelf celebrated by many ingenious
2nd learned publications. He was received into the Aca¬
demy Naturae Curioforum in 1678, and into the Royal
Society of London in 1691. The duke of Holftein
Gottorp appointed him to the poft of his .firft phyfician
in 1680, and afterwards to thofe of his librarian and
counfellor. In 1704, he accompanied the hereditary
prince of Holftein to Stockholm as his preceptor. He
died in that capital in 1706, and left a family, which rofe
to high diftin&ion in Sweden. The firft work attributed
to Pechlin, was an attack on the fyftems of Sylvius de la
Boe and Graaf, entitled, “Metamorphis iiEfculapii et
Apollonis Pancreatici,” under the name.of Janus Leoni-
cenus. His other works are, a. De Apoplexia, 1667.

3. De Purgantium Medicamentorum facultatibus, 1672.

4. De Vulneribus Sclopetarum, 1674. 5. De Fabrica et

Ufu Cordis, 1676. 6. De Aeris et Alimenti defeclu,

1676. This contains fome relations partaking of the
marvellous, refpedfing the retention of life under water,
which he attributes to the nitrous quality of the air and
water. 7. De Habitu et Colore Aithiopum, 1677. He
attributes the colour of negroes to the bile tinging the

PEC

cellular membrane, and not to the folar heat. 8. Theo-
philus Bibaculus, fivede potu These,” 1684; a panegyric
on tea, in a poetical and exaggerated ftyle. 9. Obferva-
tionum Phyfico-medicarum, lib. iii. 1691,410. This is
the author's principal work, the refult of much practice
and obfervation. It contains many curious and valuable
remarks, related in a perfpicuous and elegant ftyle, but
exhibits fome marks of credulity. He alfo has fome
papers in the Ephem. Naturae Curioforum. Halleri Bill.
Med.

PECHME'JA (John), a French writer, was born at
Villa Franca in 1741. He became profeffor of elocution
in the college of La Fleche, and died in 1785. His
eulogy on the celebrated Colbert was crowned with the
approbation of the academy in 1773 j’but he is principally
known by a work in poetic profe, called Telephe, 2 vols.

PE'CHOR, a town of Hindooftan, in the circar of
Gohud : twenty-five miles fouth-fouth-eaft of Gwalior.

PECHOW'LY, a town of Hindooftan, in the circar of
Chanderee: forty miles north-weft of Chanderee.

PECK, f. [from the Sax. pocca, or perhaps from pat,
a veffel. Skinner and Dr. Johnfon. — Sereniuslikewife gives
the Sax. pocca, and the Icel .poke, a pouch, a fack,as the
etymon. Poke is a northern word for all meafires. See
Rijy’s Colleft. 2d edit. p. 55. Todd.'] The fourth part of
a bufnel. — To every hill of allies, fome put a. peck of un-
flacked lime, which they cover with the allies till rain
Hacks the lime, and then they fpread them. Mortimer's
Hujb.

Burn our veffels, like a new-

Seal’d peck or bulhel, for being true. Hudibras.

He drove about his turnips in a cart ;

And from the fame machine fold pecks of peafe. King.
Proverbially ; a great deal :

Her finger w'as fo fmall, the ring
Would not ftay on which they did bring ;

It was too wdde a peck ;

It look’d like the great collar juft
About our young colt’s neck. Suckling.

To PECK, v. a. [bccquer, Fr. picken, Dutch.] To ftrike
with the beak as a bird :

As a hooded hawk, or owl,

She in vain doth roufe, and peck
This and that way with her beak.

Thy baiting does no good,

Nor thy pecking through thy hood,

Nor thy ftretching out thy claws. Fanjhaw's Paft. Fido.

To pick up food w'ith the beak. — Can any thing be more
furprifing, than to confider Cicero obferving, with a re¬
ligious attention, after what manner the chickens peck'd
the grains of corn thrown them. Addifon.

She was his only joy, and he her pride :

She, when he W'alk’d, went pecking by his fide. Dryden.

To ftrike with any pointed inftrument. — With a pick-ax
of iron about fixteen inches long, lharpened at the one
end to peck, and flat-headed at the other to drive little
iron wedges to cleave rocks. Carew's Surv. of Cornwall.
— To ftrike ; to make blows. — They will make head
againft a common enemy, whereas mankind lie pecking at
one another, till they are torn to pieces. L'Ejlrange. —
The following paflage is perhaps more properly written
to pick, to throw. — Get up o’ th’ rail, I’ll peck you o’er the
pales elfe. Shakefpeare.

PECK (Francis), an induftrious antiquary, was born
in 1692 at Stamford in Lincolnlhire. He was educated
at Cambridge, where he took thexjegree of M. A. He
entered into holy orders, and became curate of King’s
Clifton in Northamptonftiire, and afterwards obtained the
redfory of Godeby in Leicefterfhire, which was his foie
preferment. Having in 1721 publiftied propofals for
printing the hiftory and antiquities of his native town,
his work appeared in 1727, under the title of ‘‘ Academia

terlia

447

PEC

tertia AngUccma, or the Antiquarian Annals of Stamford
in Lincoln, Rutland, and Northamptonfhires,” folio.
His inquiries relative to this objeft led him to extend liis
refearches 5 and in 1729 lie printed a fheet of “Queries
concerning the Natural Hiftory and Antiquities of Leicef-
terfhire and Rutland,” which were reprinted, in 17405
but, though he made a great progrefs in collecting. mate-
rials for a work on thole fubjeCts, it never made its ap¬
pearance. In 1732 he publilhed the firft volume of the
work by which he is molt known, entitled “ Defiderata
Curiofa, or a ColleStion of divers fcarce and curious
Pieces, relating chiefly to Matters of Englilh Hiftory ;
conlifting of choice Trafts, Memoirs, Letters, Wills,
Epitaphs, & c.” A fecond volume followed in 1735 ; and
the whole was reprinted in one 4-to. volume in 1779, by
Mr. Thomas Evans. This collection has been quoted
by later biographers and antiquaries. In 1735 he dif-
played his induftry in “A complete Catalogue of all the
Difcourfes written both for and againlt Popery in the
Time of King James the Second and in 1739 l,e edited
“ Nineteen Letters of the truly reverend and learned
Henry Hammond, D.D.” Two volumes in 4to. came
from his fertile pen in 1740 : one entitled “Memoirs of
the Life and ACtions of Oliver Cromwell, as delivered in
three Panegyrics of him written in Latin ; with a Col¬
lection of divers curious hiftorical Pieces, relating to
Oliver Cromwell and a great Number of other remark¬
able Perfons;” the other, “New Memoirs of the Life
and Poetical Works of Mr. John Milton,” with a great
variety of critical illuftrations and other additions. This
was the lalt of his publications. Plis life and labours
terminated together in 1743. He left behind him a great
number of materials for nine different works which he
had in contemplation. Of his MSS. the greater part
came into the poffeffion of fir Thomas Cave, of which
the mod valuable were five vols. in 4to. fairly written
out for the prefs, under the title of “ Monafticon Angfli-
canum, Supplements novis adauCtum,” and particularly
relating to the Prasmonftratenfian order in England.
Thefe were prefented to the Britifh Mufeum in 1779, by
the laft fir Thomas Cave. Nichols's Anecd. of Bowyer.
New Biogr. Di€t.

PECK'ELSHEIM, a town of Weftphalia, in the bifliop-
ric of Paderborn : fifteen milCs fouth-eaft of Paderborn.
Lat. 51/ 34. N. Ion. 9. 15. E.

PDCK'ER, f. One that pecks.— -A kind of bird : as,
the wood-pecher.

The titmoufe and the pecker's hungry brood,

And Progne with her bofom ftain’d in blood. Dryden.

PECK'HAM, a hamlet in the parifli of Camberwell,
hundred of Brixton,and county of Surrey, is fituated at
the diftance of 4^ miles fouth-fouth-eaft from St. Paul’s
cathedral. In Domefday book, the manor is mentioned
as belonging to Batterfea, and being the property of Odo
bifhop of Bayeux, haif-brother to the Conqueror. At a
later period it appears to have been divided into two
manors, called Bredinghurft and Bafynges, from perfons
of that name who poflefled them in the reigns of king John
and Edward I. The manor of Bredinghurft is novv
vetted in the widow of William Shard, efq. but the ma-
nor-houfe has been lately demoliflied, and the fcite let on
buiiding-leafes. At Peckham are meeting-houfes for
the Anabaptifts.and Prefbyterians. Here is annually held
a large fhow-fair during the fummer feafon : hence the
common faying, “ All holiday at Peckham.” It is held
on the 2 ill, 22d, and 23d, days of Auguft ; and fucceeds
that of Camberwell, which concludes on the 20th. Peck¬
ham. has recently been embellifhed by many gentlemen’s
feats ; and a new and neat chapel has been ereCted. The
houfes have been greatly augmented of late years. Here
is a whimfical building, called the Folly, which, at Lome
diftance, forms a confpicuous object. The number of
inhabitants in 1821 was 6419.

The parifli of Camberwell is bounded by the parifli of
Newington-Butts, St. George’s Southwark, and Rother-
' Vol. XIX. No. 1315.

PEC

hitlie, on the eaft; by Deptford and Beckenham, in Kent,
on the fouth; by Croydon, and a detached part of Bat¬
terfea, on the weft ; and by Lambeth on the north. At
the time of the Domefday furvey it comprehended one
manor only, which was held of the Conqueror by Haimo,
the fheriff; but it was foon afterwards 1 divided, and
eventually became feveral diftinCt manors, called Cam-
berwell-Buckingham, Milkwell, Camberwell-Frerne or
Fryen, Dowdale or Uredale, and Deptford Strand. There
were alfo two inferior manors, Camberwell and Cold-
Abbey, both of them held of Camberwell-Buckingham.
The land iji this parifli is moflly poffeffed of great ferti¬
lity, and, exclufive of the fcites of the houfes, is laid out
in nearly an equal proportion between arable, pafture,
and gardens.

The village of Camberwell is difiant about three miles
and a quarter from St. Paul’s cathedral. The church
here was ereCted about the commencement of the reign
of Henry VIII. and confifts of a nave, chancel, and two
aides, with a fmall embattled tower at the weft end ; the
whole compofed of flints and rough done, except the
fouth-weft part, which is of brick. The chancel is of a
very fingular fliape, being the feCtion of a hexagon. In
the eaft window of the north aide are feveral full-length
figures painted upon glafs : thefe are now much muti¬
lated, as well as the infcription beneath, which however is
fufficiently entire to inform us, that they were intended
to reprefent fome members of the Mufcamp family, who
had their burying-place in this aide. There are befides,
in the fame window, two imperfeCt reprefentations of fe¬
male faints. This church contains many monuments of
the Scotts, Bowyers, and others who have been interred
within its walls. In the parifh-regifter here are feveral
very curious entries : one of which records an inftance
of a woman bearing a child at the age of fixty-three. In
this parifhare feveral charity- fchools, which are fupported
chiefly by fubfcription, except the free grammar-fchool.
This was founded and endowed by the Rev. Edward
Wilfon, in the reign of James I. and now affords educa¬
tion to twelve boys. But the chief charitable foundation
of which it has to boaft is Dulwich-College, fituated in the
hamlet whence it derives its name. Camberwell parifli
contains, according to the population returns, 2060
houfes, and 11,309 inhabitants. See Dulwich, vol. vi.

PECK'LED, adj. [corrupted from fpecltled.'] Spotted ;
varied with fpots. — Some are pechled, tome greenilli. Wal¬
ton's Angler.

PECK'WACKET. See Pigwacket.

PECK'WELL (Dr. Henry), a very eminent Englidi
divine, and popular preacher among the Calviniftic Me-
thodifts, born 1747, died 1787, having palled an aCtive life
in the exercife and promotion of charity. He was founder
ofacharitable inftitution called“The Sick Man’s Friend,”
whofe objeCt is, to relieve the bodily^ wants of the fick
poor of every denomination, and to convey knowledge
and inftruCtion to the mind. Jones's Biog.

PEC'ORA,/. [from pecus, Lat. cattle.] In zoology,
the fifth order of the clafs Mammalia, which fee, vol.
xiv. p. 236.

PEC'ORGUS, adj. Abounding in cattle. Cole.

PEC'QUENCOURT, a town of France, in the depart¬
ment of the North, on the Scarpe : five miles eaft of
Douay.

PEC'QUET (John), a diftinguifhed anatomift, was a
native of Dieppe. He ftudied phyfic at Montpellier, at
which place, in 1647, he made accidentally the difeovery
of the receptacle of the chyle and the thoracic duCt,
which has rendered him famous. He took the degree of
M. D. at Montpellier; and afterwards came to Paris, where
he employed himfelf in anatomical refearches, with
Mattel and other able men. It was in 1651 that he firft
made known his difeovery, which may rank among the
molt brilliant acceffions to fcience of that age. It was
publifhed in a work entitled, “ Experimenta nova Ana-
tomica, quibus incognitum Chyli Receptaculum, et ab eo
per thoracem in ramos ufque fiibclavios Vafa LaCtea de-
5 Y teguntur.”

448

PEC

teguntur.” Although Euftachius had given fome hints
of the exiftence of a thoracic dud, yet Pecquet deferves
the credit of having clearly traced the whole courfe of
the ladeal fyftem to its termination in the fubclavian
veins. There was fubjoined a valuable “ Diflertatio de
Circulatione Sanguinis et Chyli Motu in which he de-
monftrated the courfe of the venous blood even in the
vena portarum and the pulmonary veins, and made fome
other important obfervations on the motion of the blood
and chyle. His work was reprinted at Paris in 1654,
with the addition of a “ Differtatio nova de Thoracicis
Ladeis,” in which he refuted the theoretical objedions
of Riolan by new and decifive experiments. Pecquet alfo
wrote fome papers on anatomical fubjeds in the Memoirs
of the Academy of Sciences, (of which fociety he was ad¬
mitted a member in 1666,) and in the Journal des Sa-
vans. He was phyfician to the famous financier Fouquet,
who ufed to confer with him in his leifure hours on fci-
entific topics. A theory which this ingenious phyfiolo-
gift had unfortunately adopted concerning the alimentary
nature of vinous fpirit, made him not onlyadvife the li¬
beral ufe of brandy to others, but indulge in it fo freely
himfelf, that it fnortened his days; and he died, under the
age of fifty, in 1674. llalleri Bibl. Anatom.

PEC'QUET (Anthony), a French writer, was born in
3704. He attained the rank of grand mailer of the wa¬
ter-works and forefts of Rouen, and fuperintendant of the
military fchool. The works by which he is principally
known are, 1. An Analyfis of the Spirit of Laws, and the
Spirit of Political Maxims, 3 vols. 2. The Foreft Laws
of France, a vols. 3. Thoughts on Man. He alfo tranf-
lated the Paftor Fido of Guarini, and other Italian works,
into French. He died in 1762.

PEC'TEN, /. [Lat. from its longitudinal ftriaelike the
teeth of a comb.J The Scallop. See the article Ostrea,
vol.xviii. p. 27, and the accompanying Plate.

PEC'TEN VEN'ERIS, in botany. See Scandix.

PEC'TINAL, aclj. [peReti, Lat. a comb.] Refembling
a comb, or the teeth of a comb.

PEC'TINAL, f. — There are fiflies vvhofe eyes regard
the heavens, as plain and cartilaginous fifties, as peRinals,
or fuch as have their bones made laterally like a comb.
Brown.

PEC'TINATED, adj. Standing from each other like
the teeth of a comb. — To lit crofs-legg’d or with our
fingers peRinuted, is accounted bad. Brown's Vu/g. Err.

PECTINA'TION, J. The ftate of being pedinated. —
The complication or peRination of the fingers was an
hieroglyphic of impediment. Brown's Vulg. Err. — Comb¬
ing of the head. — Frequent peRination is recommended
by many phyficians to women, and men who wear their
hair, as an exercife; and, at the fame time, a kind of
fridion. Chambers.

PEC'FIS, J'. [might be fo called perhaps, by Linnaeus,
the author of the name, from pcRen, Lat. a comb, as ap¬
plicable to the fringed bafes of the leaves.] In botany, a
genus of the clafs iyngenefia, order polygamia fuperflua;
natural order of compofitae oppofitifolite, (corymbiferae,
Ju/f.) Generic charaffers — Calyx: common five-leaved,
cyiindric : leaflets lanceolate, blunt, almoft equal. Co¬
rolla: compound rayed. Corollets hermaphrodite, four
to fix, in the difk. Females five, fet in the ray. Proper
of the hermaphrodite funnel-form, five-cleft ; of the fe¬
male, ligulate ovate, ftiorter than the calyx. Stamina:
in the hermaphrodites ; filaments five, ihort. Antherae
cyiindric tubular. Piftillum : in the hermaphrodites ;
germen linear; ftyle filiform; ftigma bifid. In the fe¬
males ; germen linear; ftyle filiform; ftigmas two, re¬
volute. Pericarpium: none. Calyx unchanged, fpread-
ing. Seeds: in the hermaphrodites, folitary, linear;
down with two or three fpreading awns. In the females,
very like the other. Receptacle: naked. — Ejfential Clia-
r abler. Calyx five-leaved, cyiindric; florets in the ray
five; down awnedj receptacle naked. There are fix
fpecies.

PEC

_i. Pedis ciliaris : leaves linear ciliate. Root branched,
with filiform radicles. Stem herbaceous, halfa foot high,
branched, dichotomous, diffufed, round, fmooth. Branch-
lets fcattered, diffufed, round, fpreading, red. Leaves
feffile, half embracing at the bafe, linear, acuminate;
tooth-ciliate at the bafe, perforated at the edge, membra¬
naceous-ferrate when examined with a glafs, nervelefs,
fmooth. Flowers fmall, yellow. The leaves, when
bruifed, have a fweet fmell, like favory. Native of Hif-
paniola : flowering there in June.

2. Pedis pundata : leaves linear quite entire, dotted
underneath. Stem herbaceous, a foot high and more,
angular, branched, fmooth. Native of Hifpaniola, on
fandy coafts. Jacquin deferibes it as a tender upright
plant, from two to three feet in height, with fmooth ftri-
ated dichotomous branches. Leaves attenuated to both
ends, acuminate, quite entire, fmooth above, dotted at
the back, fubfeflile, an inch and a half long. Flowers
fmall, dirty yellow', inodorous. Found every-where
about Carthagenain New Spain, on the borders of woods;
flowering in September and Odober.

3. Pedlis linifolia : leaves linear quite entire, even on
both fides. This plant is fpreading and flender, and
feldom rifes above eighteen or twenty inches in height.
It is a native of the Weft Indies; and common in all
fugar-iflands.

4. Pedis humifufa : leaves ovate dotted underneath,
ciliate on both fides at the bafe, ftems procumbent. Na¬
tive of Guadaloupe and Santa Cruz.

5. Pedis proftrata : leaves oblong, fringed at the bafe ;
flowers feflile ; calyx-leaves elliptic-oblong ; ftem procum¬
bent. Native of New Spain. It flowered at Madrid in
the autumn of 1795. This feems, as Willdenow remarks,
very near the former, from which it differs in having
longer leaves, but efpecially in the want of (talks to the
flowers, which are quite feflile, either at the ends of the
branches, or in the fork between them. The leaves are
an inch or more in length ; glaucous and dotted, as in
the foregoing, underneath.

6. Pedis pinnata: leaves deeply pinnatifid, thread-fhaped;
ftem panicled ; feed-down of feveral jagged feales as long
as the florets. Frequent in New Spain. It has been cul¬
tivated for twenty-five years paft in the gardens of Spain
and France. Roth fays the root is annual, which w'e be¬
lieve to be the cafe ; Lamarck makes it perennial. Stem
ered, two feet high, leafy, angular, deeply furrowed,
fmooth, alternately branched, panicled, many-flowered.
Leaves alternate, almoft capillary, and obtufe, like fome
of the finer kinds of Artemifia; one inch and a half or
two inches long ; fmooth, very bitter, befprinkled all
overwith minute glandular dots. Flower-ftalks fcattered
and terminal, angular, roundifti, flender, fingle-flowered,
with one linear brade ; calyx turbinate ; its leaves obo-
vate, befprinkled with minute fiiining dots, and beauti¬
fully tinged with violet ; corolla yeilow ; the radiant flo¬
rets but one or two, ovate; thole of the difk about fix.
Seeds fquare, with briftly angles. Down of five or more
very beautiful, rather unequal, lanceolate, acute, mem¬
branous, glittering feales, all ftreaked with purple, their
edges more or lefs deeply jagged or fringed ; thele feales
are about as long as the corolla of each floret, and we do
not find them ever accompanied with any briftles.

PEC'TIS, /'. An ancient mufical inftrument, of the
form or ufe of which we are not very certain. Athenteus
fays, that the pedis, magadis, and barbiton, were the
fame inftrument. It has been fuppofed to have been a
dicord, a fmall inftrument of two firings, with a neck, or
finger-board, by which they were fliortened with the
prefliire of the fingers, and a complete fcale produced.

PEC'TORAL, adj. [from pcRoralis, Lat.] Belonging
to the breaft. — Take your fpedacles, fir; it flicks in the
paper, and was a peRoral roll we prepared for you to (wal¬
low down to your heart. Milton's Anim. Rem. Defence. —
Tar-water is extremely peRoral and reftorative. Bp.
Berkeley's Siris. — PeRoral medicines, in the language of

P E D

PEC

the older phyficians, were all thofe medicines which were
appropriated to the relief of the diforders of the bread: or
lungs. The epithet, however, was indefinite, inafmuch
as it included demulcents, attenuants, aftringents, and
even anodynes, or whatever contributed to eafe the
breathing and cough,. It has, therefore, been difcarded.
The more limited term, expectorants, is preferable. Cyclo¬
pedia.

PEC'TORAL,/! A medicine intended againft difeafes
of the breaft. — Being troubled with a. cough, peftorals were
prefcribed; and he was thereby relieved. Wifeman. — A
breaft-plate. — The twelve Hones in the pettoral of the
high prieft. Hammond.

PEC'TORALLY, adv. In the habit of ufing peftorals.
— Be regular, and live peflorally. Chejlerfield.

PEC'TOREL, J'. In our old writers, armour for the
breaft ; a breaft-plate, or petral, for a horfe. It is men¬
tioned ftat. 14 Car. II. cap. 3.

PE'CUL, or Picul, f. A weight ufed in fome parts of
the Eaft Indies. The bahar of three peculs, or 300
catties, in Bantam weighs 3961b. avoirdupois. The
pecul of 100 catties at Cheriboti weighs 1251b. Dutch
troy- weight, or 1 32 lb. avoirdupois. What is called the
China pecul at Malacca weighs only 125 lb. avoirdupois.
Rice is fold by the coyang of 40 peculs, or 5400 lb. avoir¬
dupois. The Siam pecul weighs 1291b. avoirdupois.

To PEC'ULATE, v. n. To rob or defraud the public.
— An oppreftive, irregular, capricious, unfteady, rapa¬
cious, and peculating, defpotifm. Burke.

PEC'ULATE, or Peculation, f. [peculatus, Lat. pe-
culat, Fr.] Robbery of the public ; theft of public money.
— The popular clamours of corruption and peculate, with
which the nation had been fo much polfelfed, were in a
great meafure diflipated. Burnet's Hijl. of his own Times.
— One of thefe gentlemen was accufed of the grofieft pe¬
culations. Burke.

PEC'ULATOR, f. [Latin.] A robber of the public.

PECULIAR, adj. [ peculiar! s , from peculium, Laf.]
Appropriate; belonging to any one with exclufion of
others. — I agree with fir William Temple, that the word
humour is peculiar to our Engliili tongue; but not that
the thing itfelf is peculiar to the Englilh, becaufe the
contrary may be found in many Spanilh, Italian, and
French, prod u6tions.6V//if. — Not common toother things.
— The only facred hymns they are that Chriftianity hath
peculiar unto itfelf, the other being fongs too of praife
and of thankfgiving, but fongs wherewith as we ferve
God, fo the Jews likewife. Hooker. — Particular; fingle.
To join moft with peculiar, though found in Dryden, is
improper. — Space and duration being ideas that have
fomething very abftrufe and peculiar in their nature, the
comparing them one with another may be of ufe for their
illuftration. Locke.

One peculiar nation to felefl

From all the reft, of whom to be invok’d. Milton.

I neither fear, nor will provoke, the war;

My fate is Juno’s moft peculiar care. Dryden.

PECU'LIAR, f. The property ; the exclufive pro¬
perty. — Revenge is fo abfolutely the peculiar of heaven,
that no confideration whatever can empower even the belt
men to alfume the execution of it. South.

By tincture or refledtion, they augment

Their finall peculiar. Milton's P. L.

Something abfeinded from the ordinary jurifdidlion. — A
particular parilh or church, that hath jurifdidtion within
itfelf, and power to grant adminiftration or probate of
wills, &c. exempt from the ordinary. Jacob. — See vol. v.
p. 300.

PECULIARITY, f. Particularity; fomething found
only in one. — If an author pqffefted any diftinguiflung
marks of ftyle or peculiaiity of thinking, there would re¬
main in his lealt fucceisful writings fome few tokens
whereby todifeover him. Swift.

To PECU'LIARIZE, v. a. To appropriate; to make

449

peculiar. — There was to be no more diftindlion betwixt
the children of Abraham and other people, and no one
land more peculiarized than another. Nelfon's Fejl.

PECU'LIARLY, adv. Particularly ; fingly. — That is
peculiarly the effedl of the fun’s variation. Woodward. —
In a manner not common to others. — When his danger
encreafed, he then thought fit to pray peculiarly for him.
Fell.

PECU'LIARNESS, f. Appropriation. — Mankind by
tradition had learned to accommodate the worlhip of their
God, by appropriating fome place to that ufe ; nature
teaching them, that the work was honoured and digni¬
fied by th e peculiarnej's of the place appointed for the fame.
Me dels Rev. of God's Houfe, 1638.

PECU'LIUM, J’. [Latin.] The ftock which-a perfon in
the power or property of another, as a Have, minor, or
the like, might acquire by his own induftry, without any
advance or afliftance from his father or mailer ; but mere¬
ly by their permiflion. The flaves among the Romans
frequently amaffed confiderable fums in this way. The
word is generally taken to fignify the advanced price
which a Have could get for his mailer’s cattle ( pecus ) or
other goods, beyond the price fixed upon them by the
mailer : this became the Have’s own property.

In the Romilh church, peculium denotes the property
which each monk or religious referves, and poffeffes to
liimfelf.

PECU'NIA,^ [Latin.] Money. But pecunia, in our
old law-books, is fometimes ufed for cattle, and fome-
times for other goods as well as money. In the emen¬
dation of the laws of Edward the Confelfor, by William I.
it is ordered, that no viva pecunia “living money,”
i. e. cattle, be bought or fold, except within cities, and
that before three fufficient witnelfes. So in Domefday
book, pecunia is frequently ufed, pro pecude ; as, pafture
ad pecuniam villa.

PECU'NIA, a goddefs among the Romans, whom they
invoked with a view of procuring money in abundance.
But, as the fpecie was coined of different metals, efpe-
cially of gold, filver, and brafs, and as one divinity would
have too much occupation in taking care of the different
coinages, a particular one was appointed for each. The
three goddeffes reprefented upon fome medals of the em¬
peror Commodus and his fucceffors, with a pair of feales,
the cornucopia, and a heap of money, by them, prove
that there was at lead that number, and the antiquaries
agree that they prefided over the coinage of three metals.
Beiides thefe three divinities, there was alfoZEs or ABfcu-
lanus, for the brafs coin.

PECU'NIARY, adj. [ preuniarius , from pecunia, Lat.
pecuniare, Fr.] Relating to money. — Their impollures
delude not only unto pecuniary defraudations, but the
irreparable deceit of death. Brown. — Confining of mo¬
ney. — Pain of infamy is a feverer punilhment upon in¬
genuous natures than a pecuniary mulct. Bacon.

PECU'NIOUS, adj. [ pecunieux , Fr.] Full of money.
Not in life.

PECU'NIUS, a deity of the ancient Pruffians, in ho¬
nour of whom they kept a fire lighted with oak perpe¬
tually burning. A prieft conftantly attended ; and, if
the fire happened to go out by his neglect, he was in-
llantly put to death. When it thundered, they ima¬
gined that their grand prieft converled with their god,
and for that realon they fell proftrate on the earth, pray¬
ing for feafonable weather. James's Mil. Diet.

FED, f. [properly pad, from pay a. Span, ftraw; See
Pad.] A final 1 packfaddie. — A ped is much fhorter than
a pannel, and is railed before and behind, and ferves for
(mail burdens. JoknJ'on. — A pannel and wanty, packfad¬
die and ped. Tuffer. — A balket ; a hamper. — A lia Ik is a
wicker ped, wherein they ufed to carry filh. E. K. Notes
on Spenjir's Skep. Cal.

PED'ACE, a town of Naples, in Calabria Citra : fix
miles fouth of Cofenza.

PED'AGE,yi [pedagiitm, from pes, Lat. foot.] Toll,
ora local due, exacted on perfons, goods, and carriages,

palling

450

P E D

painng through certain places. Pedage is ufually levied
tor the repairing of roads, bridges, and, caufeways, the
paving of ftreets, &c. — Anciently, thofe who had the
right of pedage, were to keep the roads fecure, and anfwer
for all robberies committed on the paffengers between
fun and fun; which is ftill obfervedin fome parts of Eng¬
land and in Italy. Chambers.

PEDAGOG'IC, or Pedagogical, adj. [from peda¬
gogue.'] Suiting or belonging to a fchool matter. — In the
pedagogic character he alfo publifhed Holcot’s [Huloet’s]
diftionary. War ton' s Hifi. E. P. — Thofe pedagogical
Jehu’s, thofe furious fchool-drivers. South's i Serm. on
Education.

PED'AGOGISM, f [from pedagogue.] Office or cha-
rafter of a pedagogue. — Now the worm of criticifm works
in him, he will tell us the derivation of “ German rutters,
of meat, and of ink which doubtlefs, rightly applied
with fome gall in it, may prove good to heal this tetter
of pedagogifm that befpreads them. Miltons Apol.for
Stneilymn.

PEDAGOGUE, f. [pedagagus, Lat. zra.t^ix.yuyog, Gr.
of won;, a boy, and a-yu, to guide.] One who teaches boys ;
a fchoolmafter ; a pedant. — If thou halt fons, in the firft
place be careful of their pedagogue, that he be modeft, fo-
ber, learned. Sir M. Sandy s' s Eff. 1634.. — Fleury ob-
ferves, that the Greeks gave the name pedagogues to
(laves appointed to tend their children, lead them, teach
them to walk, condudf them to fchool, &c. The Ro¬
mans alfo give the fame denomination to the tlaves who
were entrufted with the care and inftrudtion of their chil¬
dren. Chambers.

Few pedagogues but curfe the barren chair,

Like him who hang’d himfelf for mere defpair
And poverty. Dryden.

To PED'AGOGUE, v. a. To teach with fuperciliouf-
nefs :

This may confine their younger ftiles,

Whom Dryden pedagogues at Will’s ;

But never cou’d be meant to tie

Authentic wits like you and I. Prior.

PEDAGOGY, f Preparatory difeipline. — The old
fabbath appertained to the pedagogy and rudiments of
the law; and therefore, when the great Matter came and
fulfilled all that was prefigured by it, it then ceafed.
White. — In time, the reafon of men ripening to fuch a
pitch as to be above the pedagogy of Mofes’s rod and
the difeipline of types, God thought fit to difplay the
fublta nee without the fliadovv. South.

PEDAH'ZAR, [Heb. a powerful deliverer.] A man’s
name.

PEDAI'AH, [Heb. the redemption of the Lord.] A
man’s name.

PE'DAL, adj. [ pedalis , Lat.] Belonging to a foot.

PED'AL, f One of thofe large pipes of fome organs,
which are fo called becaufe played upon and llopt with
the foot.

PEDA'LIUM, f. [a Greek name, chofen for this plant
by profefior David van Royen, in allufion, as it feems, to
the fhape of the fruit. n-ecia^ov is, as profefior Martyn
fays, the “ rudder of a fliip,” which each dilated angle,
or wing, of the part-in queftion, fomewhat refembles ;
but the Greek W'ord alfo means “a ftud, button, or
head of a nail,” and the regular or artificial figure of the
whole fruit, reticulated like filagree, might well fugged
fuch an application of it here.] In botany a genus of
the clafs didynamia, order angiofpermia, natural order
of luridse, (bignonise, Jaff.) Generic characters — Ca¬
lyx : perianthium five-parted, fmall, permanent ; the
upper fegment very (hort; the lowed longer. Corolla:
one-petalled, fubringent ; tube three-cornered, with the
belly flat: border five-cleft, wide, oblique: fegments
rounded; upper ones fmaller, lowed wider. Stamina:
filaments four, glandular-hairy at the bafe, fliorter than

P E D

the tube: two fliorter than the other two. Anthers
cordate, twin, terminated by a gland : rudiment of a fifth
filament between the fliorter flamens, with a very fmall
anther. Piflillum : germ conical; flyle the length of the
damens. Stigma bifid ; the upper fegment reflex, the
lower revolute. Pericarpium : drupe juicelefs, ovate-
pyramidal, four-cornered, the corners thorny towards
the bafe. Seed: nut covered with bony fibres varioufly
interwoven, four-winged, two-celled. Nucleufes two,
oblong, covered with an aril ; one lower. There is a
void cell, below the fertile ones. — Effential CharaSer.
Calyx five-parted; corolla fubringent, with a five-cleft
border; nut tuberous, four-cornered, thorny at the cor¬
ners, two-celled ; feeds two.

Pedalium murex, or prickly-fruited pedalium, a tingle
fpecies. Stem fimple. Leaves oppofite, obovate, blunt,
toothed, truncated, naked, with the petioles glandular dn
each fide. Flowersaxillary, folitary, fmall. Fruit nod¬
ding. According to Jufiieu, it is a trichotomous herb,
with oppofite leaves. (Burman deferibes them as alter¬
nate, but perhaps his is a different fpecies.) Flowers ax¬
illary, fubfolitary. It has nearly the fame fruit with
Tropa; and the habit of Martynia. Of the fame genus
with this, or of a genus nearly allied to it is Planta Eu-
phrafise affinis, Pluk. t. 373, f. z. referred by Linnaeus to
Torenia. This plant, whilft it is in flower, fmells very
ftrong of malk. Native of the Eaft Indies. Introduced
in 1 778, by the late fir Jofeph Banks, bart. It flowers in
Auguft and September; and is an annual plant.

PEDA'NEOUS, adj. Going on foot.

PEDA'NEUS, J\ in the Roman civil law, a petty judge
who had no formal feat of juflice, but heard caufes Hand¬
ing and without any tribunal. The word feems formed
from Jlans in pedibus : and is ufed among the ancients by
wav of oppofition to thofe magiflrates who were feated
in the curule chair, in fella curuli, or had a tribunal or
bench raifed on high. The Roman pedanei, therefore,
were fuch as had no tribunal nor pretorium; but rendered
juflice de piano, or piano pede. From the eighty-fecond
Novel, it appears that the emperor Zeno eftablithed thefe
pedanei in the fee of every province; and that Juftinian
erefted feven of them at Conftantinople, in manner of an
office : granting them power to judge in any fum as high
as three hundred crowns.

PED'ANT, f. [French.] A fchoolmafter. — A pedant
that keeps a fchool i’the church. Shakejpeare.

The boy, who fcarce has paid his entrance dowm
To his proud pedant, or declin’d a noun. Dryden.

A man vain of low knowledge ; a man awkwardly often-
tatious of his literature. — The preface has fo much of
th e pedant, and fo little of the converfation of men in it,
that I (hall pafs it over. Addifon,

In learning let a nymph delight,

The pedant gets a miftrefs by’t. Swift.

Purfuit of fame with pedants fills our fchools,

And into coxcombs burnifhes our fools. Young.

PEDAN'TIC, or Pedantic al, adj. Awkwardly often -
tatious of learning. — Mr. Cheeke had eloquence in the
Latin and Greek tongues; but, for other fufficiencies,
pedantic enough. Hayward. — When we fee any thing in
an old fatirilt that looks forced and pedantic, we ought
to confider how it appeared in the time the poet writ.
AddiJ'on. — A fpirit of contradiction is fo pedantic and
hateful, that a man ffiould watch againft every inftance
of it. Watts. — We now believe the Copernican fyftem ;
yet we fliall ftill ufe the popular terms of fun-rife and fun-
fet, and not introduce a new pedantic defeription of them
from the motion of the earth. Bentley. — The obfeurity
is brought over them by ignorance and age, made yet
more obfeure by their pedantical elucidators. Felton.

PEDAN'TIC ALLY, or Pedanticly, adv. With
awkward oftentation of literature. — The earl of Rofcom-
mon has excellently rendered it; too faithfully is, indeed,

pedantically ;

3

451

P E D

pedantically; ’tis a faith like that which proceeds from
fuperftition. Dryden.

And what thou doll: pedanticly objeft

Concerning my rude, rugged, uncouth, ftyle.

As childifli toy I manfully negleft,

And at thy hidden fnares do inly fmile.

Move's Poems, 1647.

PED'ANTISM, f. The practice or profeffion of a pe¬
dant; pedantry. Phillips.

To PED'ANTIZE, v. n. To play the pedant; to do¬
mineer over lads ; to ufe pedantical expreffions. Not now
in life.

PED'ANTRY, f. Awkward oftentation of needlefs
learning. — From the univerlities the young nobility are
fent for fear of contracting any airs of pedantry by a
college education. Suift. — An obftinate addiction to the
forms of fome private life, and not regarding general
things enough. — There is a pedantry in manners, as in all
arts and fciences ; and fometitnes in trades. Pedantry is
properly the overrating any kind of knowledge we pre¬
tend to ; and, if that kind of knowledge be a trifle in
itfelf, the pedantry is the greater. For which reafon I
look upon fiddlers, dancing-mailers, heralds, mailers of
ceremony, See. to be greater pedants than Lipfius or the
elder Scaliger. Swift on Good Manners.

PEDA'RIAN, /. in antiquity, thofe fenators who fig-
nified their votes by their feet, not their tongues ; that
is, fuch as walked over to the fide of thofe whofe opinion
they approved of, in divifions of the fenate.

The origin of the word Dr. Middleton thinks owing
to this, that, though the magillrates of Rome had a
right to a place and vote in the fenate, as well during
their office as after it, and before they were put upon the
roll by the cenfors, yet they had not probably a right to
fpeak or debate there on any quellion, at lea ft in the
earlier times of the republic. For this feems to have
been the original diltinClion between them and the an¬
cient fenators, as it is plainly intimated in the formule
of the confular ediCl, fent abroad to fummon the fenate,
which was addreffed to all fenators, as thofe wdio had a
right to vote in the fenate. From which dillinCtion,
thefe laft, who had only a right to vote, were called, by
way of ridicule, pedarians ; becaufe they fignified then-
votes by their feet, not their tongues, and upon every
divifion of the fenate, went over to the fide of thofe whofe
opinions they approved. It was in allufion to this old
cultom, which feems, however, to have been wholly
dropped in the later ages of the republic, that the mute
part of the fenate continued Hill to be called by the name
of pedarians, as we learn from Cicero, who, in giving an
account to Atticus of a certain debate and decree of the
fenate upon it, fays, that “ it w'as made with the eager
and general concurrence of the pedarians, though againfl
the authority of all the confulars.” See Aulus Gellius,
lib. iii. c. 18. Cicero ad Attic, i. 19. Middleton of the
Rom. S'en. p. 86.

PE'DATE. adj. in botany, deeply cut into fegments
connected with the petiole on the inner fide on-ly, like a
bird’s foot.

PEDDAGU'DAMY, a town of Hindoollan, in the
circar of Ellore : ten miles north-well of Ellore.

PEDDAPOU'R, a town of Iiindooftan, in the circar
of Rajamundry: twenty-two miles eafi-north-eaft of Ra-
jamundry.

PED'DI-BALABA'RUM, a town of Hindoollan, in
Myfore: fixteen miles north of Bangalore.

To PED'DLE, v. n. [perhaps from petty."] To bebufy
about trifles. It is commonly written piddle : as, What
piddling work is here. — To aft as a pedlar. — Peddling
women cry Scotch cloth of a groat a yard. Crown's Sir
Courtly Nice.

PED'DLING, adj. Petty; triflings unimportant. —
Unneceflary rigours and peddling feverities. Bp. Taylor's
Artif. Handfom. — So flight a pleafure I may part with,

Vol. XIX. No. 1316.

P E D

and find no mifs ; this peddling profit I may refign, and
’twill be no breach of my ellate. Decay of Chr, Piety.

PEDE'E, f. A footboy ; a lackey. Phillips.

PEDE'E (Great), a river of America, which rifes in
North Carolina, on the borders of Virginia, in feveral
fmall rivers which unite together, and afterwards take
the name. of Pedee. Its courfe is fouth, a little inclining
to the ealt, and it runs into the Atlantic Ocean, fix miles
below George Town, in lat. 33. 17. N. Ion. 5. W.

PEDE'E (Little), a river of South Carolina, which
runs into the Great Pedee fixteen miles below Queenbo-
rough in South Carolina.

PEDEMON'TE n’ALI'SI, a town of Naples, in La-
vora : twenty miles north-north-eaft of Capua.

PEDE'NA, or Bi'ben, a town of Iltria, the fee of a
bilhop: twenty-five miles fouth-fouth-eall of Triefte,
and lixty-four north-eall of Rovigno. Lat. 45. ai. N.
Ion. 14. 16. E.

PED'ENSAC, a town of France, in the department
of the Gironde: fifteen miles fouth of Bourdeaux.

PED'ERAST, J\ [from the Gr. Trait;, a boy, and epxm;,
a lover.] One who has a criminal paffion for boys.

PED'ERASTY, f A criminal paffion for boys.

PEDERE'RO, f. [pedrero, Span, from piedra, a done.]
A fmall fort of cannon, which is particularly ufed on the
quarter-deck of fliips, to fire, or throw' forth Hones, bro¬
ken iron, or partridge-lhot, on an enemy attempting to
board. They are generally open at the breach, having
their chamber made to take out, to be loaded that way,
inftead of at the muzzle.

PEDERNEE', a town of France, in the department
of the North Coafts : four miles north-well of Guin-
gamp, and ten fouth-well of Lannion.

PEDERNEI'RA, a leaport town on the well coall of
Portugal, in the province of Eftremadura, containing
1 300 inhabitants : eighteen miles fouth-well of Leyria,
and eighteen north-eall of Peniche. Lat. 39. 31. N. Ion.
8. 56. W.

PED'ERSORE, a town of Sweden, in the government
of Wafa: three miles fouth of Jacoblladt.

PED'ESTAL, f. [ piedeftal , Fr.] The lower member of
a pillar ; the bails of a ftatue. See Architecture.— In
the centre of it was a grim idol ; the fore-part of the pe-
deftal w'as curioufly emboffed with a triumph. Addifon.

So HilF, fo mute ! fome ftatue you would fwear
Stept from its pedefial to take the air. Pope.

PEDES'TRIAL, adj. [ pedejlris , from pcs, the foot,
Lat.] Employing the foot; belonging to the foot. A
modern word.— Of the different methods that have been
deferibed in hiftory, by which archery has been praftifed,
that in ufe among-the Ethiopians, and a few other na¬
tions, is undoubtedly the moll extraordinary. We read
that thefe people, inftead of holding their bow in the left
hand, as is the ufual cuftom, drew it by the affiftance of
their feet. The faft is recorded by Diodorus Siculus and
Strabo; the latter of whom informs us of a curious ex¬
pedient of this pedeftrial archery, ufed by the Ethiopians
in hunting elephants. Mofely on Archery .

PEDES'TRIAN, adj. On foot.

PEDES'TRI AN, f. One who makes a journey on foot ;
one diftinguilhed for his powers of walking. A modern
word. Hence,

PEDES'TRI ANISM, f. Feats of walking.- Curiofity
is a prevailing foible in almoll every country ; and the
perfon who is capable of performing any wonderful ex¬
ploit feldom fails to excite the attention of the admiring,
multitude. The inhabitants of this kingdom have for
fome years pall been endeavouring to raifethis paffion by
the fwiftnefs of their horfes ; and, while fome hate la-
viflied away their fortunes in purfuit of this pleafure,
others have more prudently employed thefe noble ani¬
mals, and rendered their fpeed of general fervice, by
ufing them in bufinefs where difpatch is neceflary. Hence
it has become ah univerfal praftice to have recourfe to
5 Z them

452

PEDESTRIANISM.

them in matters of hafte and expedition, and men have
therefore had few opportunities of fhowing their alert’
nefs. In England, indeed, from the goodnefs of the roads,
the opportunities of changing horfes, and their extraor¬
dinary fpeed for fingle ftages, fwiftnefs in man is of lefs
confequence to us than it was to our anceftors, who kept
in their fervice men of prodigious fwiftnefs called run¬
ning footmen, and ufed in all meffages and affairs of dif-
patch.

Foot-races formed one fpecies of the games among
the ancients; but we do not find any inftances of walking
a confiderable diftance for a wager. However, the exer¬
tions of men muff have been often called into ufe for the
purpofe of delivering meffages, and of carrying difpatches
and other intelligence.

Philippides, who was fent by the Athenians to implore
the afliftance of the Spartans in the Perfian war, in the
fpace of two days ran 170 Roman miles. Euchides was
fent from Athens to get fome of the holy fire from Del-
phos ; he went and returned the fame day, which is 125
Roman miles.

Henry V. king of England, was fo fwift in running,
that he, with two of his lords, without bow or other en¬
gine, would take a wild buck or doe in a large park.

There was a fort of footmen, called pieclii, who attended
upon the Turkilh emperors, and were occafionally dif-
patched with orders and expreffes. They ran fo admira¬
bly fwift, that with a little pole-axe and a phial of fweet
waters in their hands, they have gone from Conftantino-
ple to Adrianople in a day and a night, which is about
160 Roman miles.

Among the moderns we have however numerous and
curious inftances of pedeftrianifm.

On the 4th of January, 1759, Geo. Gueft, of Birming¬
ham, who had laid a W'ager that he could walk 1000 miles
in twenty-eight days, fetout on his journey, and finifhed
it with great eafe. It feemed that he had laid by for bets ;
for in the two laft days, we are told, he had 106 miles to
walk, but walked them with fo little fatigue to himfelf;
that, to fhow his agility, he came the laft fix miles within
the hour, though he had full fix hours to do it in.

In July, 1765, ayoungwoman went from Blencogo to
within two or three miles of Newcaftle, in one day, being
72 miles. Notum quid fcemina pojfit.

But the moft famous champion of pedeftrianifm, the
man, at leaft, who firft fet the thing a-going, as we may
fay, inour time, was Mr. Fofter Powell, a lawyer’s clerk
in New Inn. He was born at Horfeforth, near Leeds, in
Yorkfhire, in the year 1734. His firft pedeftrian feat
upon record is in the year 1764, when he went a journey
on the Bath road, fifty miles, which he accompliflied in
(even hours, going the firft ten miles in one hour.

In the former part of his life, he travelled into feveral
parts of Swifferland and France. But the firft journey which
he undertook, that fpread his fame, was in the year 1773,
when he engaged to go on foot from London to York
and back again, (the diftance is 402 miles,) in fix days,
which he accompliflied in five days eighteen hours. He
fet off from Hicks’s Hall, and returned to the fame place.
After that he did not undertake any journey till the year
1786, when he engaged to go on-foot 100 miles on, the
Bath road in twenty-four hours, which he accompliflied
in twenty-three hours and a quarter. He fet off from
Hyde Park corner, and returned to the fame place. The
nextyear, 1787, he undertook to go on foot from Canter¬
bury to London and back again in twenty-four hours;
the diftance is 112 miles; which he accompliflied to the
great aftonifliment of many thoufand fpeftators, who
waited his return. The following year, 1788, he under¬
took, at Canterbury, to run one mile againft Mr. Smith
of the fame place. This wager he loft. The fame year
he engaged to perform, his favourite journey from
London to York, and back again, in fix days, which he
accompliflied in five days twenty hours. In the year
1789 he engaged to go on-foot from Canterbury to Lon¬

don and back again in twenty-four hours; and would
have accompliflied it but for the misfortune of lofing
his way on Blackheath, as he was coming to town, and
which detained him near an hour above the time allowed
him. The next year, 1790, he engaged to go on-foot
from London to York and back again in fix days, which
he accompliflied in five days eighteen hours. The fame
year he undertook to go againft Mr. Weft, of Windfor,
forty miles on the Bath road. In this undertaking Hfe
was beat, owing to tire great difference of age between
him and Weft. This bet was for twenty guineas on each
fide.

Havingnow convinced the world fo often that he could
accomplifti the journey to York and back again in lefs
than fix days, he was determined, for the laft time in his
life, to attempt it in a much ftiorter time, although he
was at the advanced age of fifty-eight years. Accor-
dingly, in the year 1792, he fet off from Shoreditch
Church to York Minfter and back again, and accom¬
pliflied it in five days fifteen hours and a quarter, to the
great aftonifliment of many thoufand fpeftators. This
fame year he walked, fora bet of twenty guineas, on the
Clapham road, fix miles in fifty minutes and a half. Af¬
ter that he went down to Brighton, and engaged to walk
one mile and run another in fifteen minutes, which he
performed in fourteen minutes forty-three feconds. He
walked the mile in nine minutes twenty feconds, and ran
the other in five minutes twenty-three feconds. So great
was his fame fpread as a pedeftrian, and fo defirous were
people in general to have a fight of him, that, abfurd as
it may appear, he was engaged at Aftley’s Amphitheatre
for twelve nights, where he had a benefit, and exhibited
the different paces at which he travelled, though in a
finall circle. Mr. Powell in perfon was tall and thin, his
height about five feet nine inches, made ftrong down¬
wards, and well calculated for walking. His complexion
was of a fallow colour. Fie was very particular in his
diet when he was about fetting out on his journeys ; and
feldom or never ate meat when travelling, but moltly
light food. His laft journey to York was fuppofed by
the faculty to be the caufe of his death, as he never re¬
covered the fatigue which he experienced in performing
it in fo (hort a time, and at fo advanced an age, his health
at that time being indifferent. He departed this life
Monday morning, about four o’clock, April 15, 1793, in
the fifty-ninth year of his age 5 and was interred in the
burying-ground of St. Faith, the eaft corner of St. Paul’s
church-yard, near Cheapfide, at his own defire.

The following inftance of exertion in {walking, per¬
formed by one Thomas Savager, which took place the
beginning of the year 1789, is related by the Rev. John
Lodge, in his Sketches towards a Topographical Hiftory
of the County of Hereford. “This man, who was at
that time about fifty years of age, five feet four inches
high, and lame, from one leg being confiderably ftiorter
than the other, undertook, for a wager of twenty gui¬
neas, to walk 404 miles in fix days. The line agreed
upon for the difplay of his agility, was on the turnpike
road from Hereford to Ludlow, and back again. Owing
to the unevennefs and badnefs of the road in general,
and efpecially to the lofty hill of Dunmore, which he was
obliged to pafs at leaft three times a-day, the odds at
ftarting were a guinea to a (hilling againft him, and were
ftill further increafed on the third day by a fall of (now,
which made the road exceedingly (lippery and dirty. He
continued his career, however, with infinite fpirit, and
won his wager five hours within the time allowed. It
appeared afterwards, by adding together the fuperfluous
ground he had walked to his lodgings at Hereford, Lud¬
low, and elfewhere contiguous to the road, that, inftead of
404, he had actually travelled no lefs than 429 miles,”
which makes more than three miles an hour for the whole
139 hours !

Jan. 10, 1810, a journeyman taylor, named Macdonald,
undertook for a trifling wager to walk from Weftminfter

bridge

453

P E D E S T

bridge to Chatham, and back again, being a diftance of
fixty-four miles, in fifteen hours ; which he performed in
forty minutes lefs than the given time. For the greater
expedition, he chofe to go without flioes and dockings.

July 12, 1809, Capt. Barclay completed at Newmarket
his (then thought very extraordinary) talk of walking
1 000 miles in 1000 fucceflive hours ; which certainly was
no trifling exertion, fince he mull have been kept out of
bed for fix weeks.

But the talk completed by Jofiah Eaton, in December
1815, upon Blackheath, not only exceeded all former ex¬
periments of this nature, but gave a convincing proof
that man is fcarcely acquainted with his own capacity
and powers, and that it needs but refolution and practice
to effeft even the moft apparently improbable objefts.
The match completed by Eaton with fo much eafe, was
imitative of that performed by Capt. Barclay with fo
much difficulty. Barclay, it is well known, endured the
utmoft fatigue and pain, and was roufed from his inter¬
vening hours of reft by the moft fevere treatment: but
Eaton was ever found upon the alert; and repaired from
his refting to the flatting place with cheerfulnefs and vi¬
gour. The fame uniform health and ftrength alfo which
marked his career diftiriguilhed his laft hour’s perform¬
ance ; at the conclulion of which he went before the
lord-mayor, and made the following affidavit, which,
with other certificates by perfons who witnefled his per¬
formance, removes all doubt as to the complete achieve¬
ment of this undertaking: “Having undertaken to walk
1100 miles in 1100 fucceflive hours, on Blackheath, I
hereby make oath, that I commenced the fame at twelve
o’clock at noon, on the 10th day of November laft, and
that from that time to the concluflon of the talk, at
eight o’clock on the morning of the 26th of December
inft. I continued to walk eight furlongs every hour, and
fo on fucceffively, until I completed 8800, which is 1100
miles. And this I declare to be the truth: fo help me
God. Josiah Eaton.”

In the preceding month, namely, on the 20th of No¬
vember, one Baker concluded a walk of 1000 miles in
twenty days. It appears, by meafurement, that Baker,
in performing the 1000 miles, had made 1,921,920 Heps,
and gone 8008 times up and down the courfe : on being
weighed, he had loft, during the time, only one-half pound
in weight.

Feb. 11, 1818, a Mr. Howard completed the talk of
walking 600 miles in ten days. This match is beyond
the powers of a horfe; and the man was greatly dif-
t refled at the latter end of his journey. It was for a
wager of 200 guineas.

May 9 of the fame year, D. Crifp accomplilhed the ex¬
traordinary undertaking of walking to and from Oxford
and London for feventeen fucceflive days, being fixty-
one miles each. He performed the whole within fifty-two
minutes of the allowed time.

James Bigmore, of Sudbury, in Suffolk, a poor lad
whole exertions in running by the fide of Itage-coaches
have been often noticed, accomplilhed an extraordinary
feat on the 26th of April, 1819. He ftarted from Sud¬
bury with the Phenomena coach at half-paft twelve at
noon, and ran elevfen miles in the fir ft hour. On flop¬
ping at the different ftages he took no reft, but aflilled in
putting in the horfes, and again fet off with alacrity.
In this manner he kept up with the coach the whole
way to Norwich, a diftance of nearly fixty miles, where
he arrived five minutes before feven : nor did he feem at
all diftreffed, but walked about to view the city. I11 or¬
der to breathe freely, he places a piece of cane between
his teeth, fo as to keep his lips partly open. The only
recompence he obtains for fo hard labour is the volun¬
tary contribution of accidental admirers of his feats.

In the year 1820, George Wilfon, calling himfelf
ci the Blackheath Pedeftrian,” publifhed the following
lift of his feats in this way.

“April 16, 1813. — At Newcaftle-upon-Tyne, 50 miles

R I A N I S M.

in 12 hours, in a fmall flagged yard, 33 feet by 25J, ta¬
king 10,300 turns to make up the diftance; and accom-
pliflied this talk four minutes and forty-three feconds
within the time ftfpulated.

Aug. 30, 31, 1814. — At Shooter’s Hill, on the Dover
road, in the county of Kent, between the feven and eight
mile Hones, 96 miles in 24 hours, and accompliflied this
talk 28 minutes within the time ftipulated.

Sept. 11-27, 1815. — At Blackheath, 7515 miles in 15
days, and on the morning of the fixteenth day was flop¬
ped, by order of part of the magillrates of the diftrift.

May 23, 24, 1816. — At Cambridge, 100 miles iff 24
hours, and loft this match by 3^ minutes, owing to a
very heavy fall of rain, which continued between three
and four hours. Commenced at fix o’clock in the even¬
ing, and finished at fix the following day, on the Hill’s
road, near Parker’s Pieces, in the county of Cambridge.

July 10, 1816. — At Norwich, in the Pruflia Gardens, 50
miles in 12 hours 5 and accompliflied this talk 15 mi¬
nutes within the time, in the mid ft of a fevere thunder-
ftorm.

Aug. 1, 2, 1816. — At Yarmouth in Norfolk, 100 miles
in 24 hours, in Vauxhall Garden, North Ferry ; and ac-
complifhed this talk minutes within the time.

Aug, 8, 1816. — At Loweftoft, Suffolk, 50 miles in 12
hours, on the Bowling Green ; and accompliflied this
tafk 15 minutes within the’ time, which took i6| rounds
to make a mile.

Aug. 27, 1816. — At Lynn, in Norfolk, 50 miles a-day,
for 5 fucceflive days, at 13 hours to the day, to begin at
6 o’clock in the morning and to finifli at 7 o’clock in the
evening; and was always done within the time ftipu¬
lated.

Oft. 14 to Nov, 2. — At Hull, in Yorkfliire, 1000
miles in 18 days ; which he accomplilhed 2 days fooner
than any other man in the kingdom, and finiflied his
talk 40 minutes and 50 feconds within the time amidll
a heavy fliower of rain, in a garden near the town.

July 7-26, 1817. — At Manchefter, in Vauxhall Garden,
which took five rounds to make a mile, 1000 miles in 18
days, being the fecond time of accomplifiiing this extra¬
ordinary tafk.

March 9, 1819. — At Weymouth, on the Efplanade,
50 miles in 12 hours; which lie performed 20 minutes
within the time, on a half-mile courfe.

June 1, 1819. — At Newport, in the Ifleof Wight, 100
mile, in 26 hours, which took fix rounds to make a mile;
and performed this tafk 5 minutes within the time.

Sept. 20-25, 1819. — At Lewes, in Suflex, 300 miles in
6 days, at 50 miles a-day, which took twelve rounds to
make a mile.

And, laftly, at Chelfea in Middlefex, 1000 miles in
18 days, with four rounds to make a mile; being the
third time of accomplifhing this extraordinary talk, and’
which he will not again attempt, being 54 years of age
on the 24th of June, 1820, and having accompliflied fo
many extenfive and arduous undertakings.”

1822. — Mr. Barnard Weft, a noted pedeftrian, ftart¬
ed at twelve o’clock on Monday, Sept. 30, to go from
Kenfington to Maidenhead Bridge and back, 48 miles
in 7 hours, for a flake of 200 guineas. The pedeftrian,
on his return, halted at Brentford, having the laft five
miles to do in 40 minutes. He won the match with
great difficulty, having only three minutes to f'pare.

A match, which equals any pedeftrian feat on record,
took place on Wednelday, Oft. 2, in Cranbourn Grove,
Windfor Foreft. Bumftead, a gentleman’s groom, was
matched by his mailer for one hundred guineas, to run
10 miles in 56 minutes. The firft five miles were done
in 27 minutes and 25 feconds, without vifible fatigue,
but in the ninth mile there feemed fomething amifs, and
betting was 2 to 1 on time. It was a momentary lofs of
wind, which the pedeftrian recovered, and won in 55
min. 51 fee. having 9 feconds to fpare.

On Monday, Oft. 14, at Sheffield, a man named Town.

fend

454 PEDESTRIANISM.

fend performed a furprifing talk ; viz. gathering with
his mouth one hundred ftones placed at the diftance of
one yard, and walking four miles backward, and running
eight, making in the whole eighteen miles, which he
performed in three hours and fifty-fix minutes, being
four minutes under the time fpecified. He gathered the
hundred ftones in forty-feven minutes, equal to a diftance
of nearly fix miles.

Captain Fairburn, on the 14th Oft. undertook to walk,
fair toe and heel, eighteen miles in three hours and a
quarter, for 200I. The ground felefted was Epping Fo-
reft, and he won in three hours nine minutes and ten fe-
conds.

One Skipper finiftied an arduous undertaking at New¬
market on Wednefday, Oft. 16, having walked 1000 miles
in toco fuccefiive half-hours. He appeared in good
health at the clofe. He had no backers.

Abernethy, a Scotch pedeftrian, this month performed
a match to from London to Nottingham and back, ma¬
king a circuitous route of 260 miles, in four fucceftive
days. He ftarted on the 16th of Oftober.

On Friday, Oftober 18, a match, which excited very
great intereft at the club-houfes, and upon which there
was heavy betting, was decided on the Kilburn-road.
Captain Smith, well known in the fporting world as a
good pedeftrian, undertook to run five miles in thirty mi¬
nutes, for a ftake of 50I. He ftarted at eight o’clock from
Maida-hill, a mile in and out, and finally performed the
match, not even having a lecond to fpare.

Another great pedeftrian feat was performed this month
by Mr. James Tinney, at Oundle. He engaged to walk
ninety-fix miles in twenty-four fuccefliv'e hours; and per¬
formed the talk one minute within the time, without appa¬
rent diftrefs, corning in to the winning point at the rate of
fix miles an-hour. He walked on the Peterborough road,
a mile out and in: twelve or fourteen miles of the journey
was on pavement as bad as any in the kingdom.

We have feen that Powell walked once from London
to York and back in five days fifteen hours fifteen mi¬
nutes. Townfend, whom we have mentioned above,
made a wager, that he would perform the fame journey
in lefs time than that celebrated pedeftrian. Townfend
ftarted from Yorkon Monday the 21ft of Oftober at noon;
arrived at Bawtry at eleven that night, and fiept till four
on Tuefday morning, when he ftarted in heavy rain and
very dark; arrived at Stamford at eleven at night, and
quitted it at half paft two on Wednefday morning; was
detained.cn the next ftage for an hour by illnefs ; arrived
at a village twenty-fix miles from London at eleven at
night ; went to bed ill ; rofe at two on Thurfday, was
detained another hour by illnefs, but reached St. Paul’s,
London, notwithllanding, at ten minutes after ten in
the forenoon of that day. Stopped in London only half
an hour; on returning this day had three hours drench¬
ing rain ; arrived at Royften at eleven at night, but,
though he had befpoken a bed and lupper at one of the
inns, found himfelf fhut out, and was obliged to walk
fome miles further, when, overcome by hunger, cold, and
fatigue, he retired into a hovel for a little repofe; arrived
at Huntingdon at fix on Friday morning, at Grantham a
little after eight at night, fiept till two on Saturday morn¬
ing, ftarted immediately ; arrived at Newark at five, ccn-
liderably indifpofed: took fome medicine; in a 'fliort
time became as frefti as ever; was at Redford at one, at
Bawtry at three, at Doncafter at five, at Ferrybridge at
nine, and at Tadcafter at twelve, nearly knocked up ; was
here met by a great number of fpeftators, vvhofe cheers
gave him frefti fpirits ; ftarted for York, and arrived at ten
minutes before three on Sunday morning! having thus
performed this Herculean talk in five days, fourteen
hours, and fifty minutes, and won the wager by twenty-
five minutes.

Ralph Abernethy, a Scotchman, walked, (Nov. 3,) on
the Bath road, feventy-two miles in twenty-four hours
and forty-five minutes.

Thus we have brought up the hiftory of pedeftrianifm
to within a month of the time we are writing. But we
muft now go back a few' years, in order to introduce to
our readers a very interefting charafter, who walked
thoufands of miles, not againft time and to get money,
but in the moft laudable purfuit, of increafing the know¬
ledge of countries little frequented. The following nar¬
rative is from the Gentleman’s Magazine for January
1796.

“A few days ago arrived in town from Halifax, in
Nova-Scotia, Mr. Spillard, the celebrated pedeftrian tra¬
veller, fo frequently mentioned in the European and
American publications. This fingular charafter has been
out near twelve years, and has travelled on foot, during
that time, the diftance of 69,000 miles and upwards,
through all Europe, a great part of Afiatic Turkey,
through Barbary, up to Mequinez and Fez in Morocco,
and through the Arabs country.

“ Being defirous to add America to the other three
quarters of the world, he took paflage from Gibraltar,
about fix years ago, for Bofton; and has travelled, during
that time, through all the United States, through Ealt
Florida, and from the river St. Mary’s, through the wil-
dernefs, to the Lower and Upper Creek Nation, where
he was kindly received by his friend Col. Magillevray.
Being protefted by him, he remained there for a confider-
able time, and was furnifhed by that gentleman with
notes of that nation, of Indian manners and cuftoms.
From the Creeks he vifited the Chickafaw, Cherokee, and
Chocktaw, nations of Indians, and was prefent at their
councils and talks. From the Creek nation he proceeded
to Penfacola, in Eaft Florida, where he procured letters
of recommendation from governor O’Neal, in the Spanilh
fervice, to the baron de Carondelft, at New Orleans, the
governor of Louifiana, who very politely received him,
and gave him a general pafi’port, with letters of recom¬
mendation to the governor of the Natchez, and to all
the commandants of diftrifts and out-pofts in this exten-
five province.

“ Mr. Spillard’s intention being to go up the Miflburi
to its fource, he fet out from New Orleans, accompanied
by fome gentlemen, who would infill upon feeing him
as far as the poll of the Walnut Hills. There he crofted
the Miftifiippi, with fix men in his company, and went up
it till he came to the confluence of the Miflburi with the
Mifliftippi. Having gone up the Miflburi a diftance of
more than 3000 miles, he fell in with fix white hunters,
from the Ouchita river, who advifed him not to attempt
going up any farther, as they themfelves had loft all their
peltry and horfes, and narrowly efcaped with their lives
from the Ouza Indians ; thefe Indians never give any
quarter to either red or white men. Thus deterred, he
came down to Natchez, and foon after came down the
Mifliftippi till he got to the confluence of the Red River,
the fource of which he was determined to find out at all
events. He accordingly went up as far as Alnoilife, where
he parted with his canoe, and ftruck off to Oppalufa,
which, as well as Atakapau and New Iberia, he carefully
examined. Here he ftruck acrofs the mountains to Na-
chitoches, which is the laft Spanifli port upon the Red
River. Previous to leaving New Orleans, the governor
gave him letters to the governor of the province of Thi-
kofs, in New Spain, where he arrived at the city of St.
Antoine in a month after his departure from Nachitoches.
The governor. Dr. John Curtefs, received him politely,
and, after refting a few days, gave him a fmall guard as
an efcort to the South Mountain of Santalee. Here he
fell-in with the fouth branch of the Red River, which
he continued down till hecainetothe north branch, and
fo continued along its banks in the great plain till he
came to the Pawnee nation of Indians, and fo on to the
Canfee Indians, continuing his route till he arrived again
at Nachitoches, and fo down to the mouth of the river.

“ Mr. Spillard is the firft perfon who has ever taken a
draught of this river from its fource, from the mountains

of

3

P E D

455

of Santalee to its junction with the MifTifiippi, a didance,
with its windings, little ftiort of 4000 miles. This gen¬
tleman, in attempting to get to England, had been twice
captured by French privateers out of Charleftown, and
dripped of every thing valuable about him ; but had the
good fortune to fave his journals and notes, which are
intended fhortly for publication. He came to England
in his majefty’s fhip the Thifbe.”

PEDES'TRIOUS, adj. Not winged ; going on foot.' — •
Men conceive they never lie down, and enjoy not the po-
fitionof reft, ordained unto all pedeflrious animals. Brown.

PEDICELLA'RIA, f. the Stalked Worm § in na¬
tural hiftory, a genus of the clafs vermes, order mollufca .
Generic chara£ters- — Body foft, and feated on a rigid
ftiff peduncle; aperture lingle. There are three fpecies.

1. Pedicellaria globifera : head fpherical, reddifh, with
the appearance of a fmall cherry ; no neck ; peduncle or
ftem tawny. This is fhown on the Helminthology Plate
III. fig. 7. in our ninth volume.

2. Pedicellaria triphylla : head three-lobed 5 lobes
fometimes nearly fquare, and unarmed; neck round.
The head has reddifh or hyaline lobes, fometimes ovate 5
the neck is flexuous and blue ; the peduncle or ftem is of a
chefnut-brown. See the preceding Plate, at p. 448. where
the lobes of the head are fhown both fhut and open, and
of the natural fize, at fig. 7. the fame magnified at fig. 8,
9. and a variety with the lobes fquare, and greatly mag¬
nified, at fig. 10.

3. Pedicellaria tridens : head three-lobed ; lobes oval,
and awned 5 neck round. The neck is frnooth and hya¬
line, fometimes reddifh ; the lobes of the head are fome¬
times four, and thrice as long as the neck, rarely un¬
armed with awns; the peduncle is reddifh, and three
times as long as the neck. This is fhown, with the awns
fhut and open, in three pofitions, of the natural fize, at
fig. 11. magnified at fig. 12, 13, 14. a four-awned variety
at fig. 15. a variety without awns, fig. 16. All the fpecies
and their varieties inhabit the Northern Seas among the
fpines of the Echini.

PED'ICLE, f. [pedicellus, a diminutive of pcs, Lat. a
foot.] Footftalk ; that little ftalk whereby the leaf, fruit,
or flower, is fuftajhed, and connefted to its branch or
ftem. — Flowers will keep frefh a long time after gather¬
ing, by immerging their pedicles in water. The great
fecret of preferving fruits for. the winter is to feal up
their pedicles with wax. Cherries with the fhorteft pedi¬
cles are efteemed the bell. The piftil of the flower fome¬
times becomes the pedicle of the fruit. Chambers.

PEDIC'UXAR, adj. [ pedicularis , from pediculus, a
loufe, Lat. pediculaire, Fr.] Having the phthiriafis, or
loufy diftemper. See Pediculus.

PEDICULA'RIS, f. [from pediculus , Lat. a loufe;
which alludes to a quality attributed to forne of the fpe¬
cies, of making fheep loufy that feed upon them. This
report might perhaps arife, as with refpeft to the Drofera
and Hydrocotyle, from their growing in watery paftures,
where fheep become unhealthy and fcabby, whether they
feed on any of thefe herbs, which is very doubtful, or not.]
Louse-wort; a very noble and beautiful genus of plants,
(notwithftanding its unpromifing name,) of the clafs di-
dynamia, order angiofpermia, natural order of perfonatse,
(pediculares, Juff.) Generic characters — Calyx s peri-
anthium one-leafed, roundifh, ven tricofe ; with a five-
cleft equal mouth ; permanent. Corolla : one-petalled,
ringent ; tube oblong, gibbous s upper lip galeate, ere£l,
comprefled, emarginate, narrower: lower fpreading, flat,
half-three-cleft, blunt: middle fegment narrower. Sta¬
mina : filaments four, the length of the upper lip, under
which they lie concealed : two fhorter ; anthers incum¬
bent, roundifh, comprefled. Piflillum : germen round¬
ifh ; ftyle filiform, in the fame fituation with the ftamens,
but longer ; ftigma blunt, bent in. Pericarpium : capfule
roundifh, mucronate, oblique, two-celled, opening at
top; partition contrary. Seeds : feveral, ovate, angular ;
receptacle fubglobular, in the bafe of the capfule. Effen~

Vol. XIX. No. 1316.

FED

tial Cfrara&er. Calyx five-cleft; capfule two-celled,
mucronate, oblique 5 feeds coated. There are nineteen
fpecies.

1. Pedicularis paluftris, marfh loufe-wort, or red rattle :
ftem branched, calyxes crefted callous-dotted, lip of the
corollas oblique. Root annual. Stem about a foot high,
upright, angular, purplifh, hollow, branched. Leaves
bipinnatifid ; or pinnate with about ten pairs of long
pinnas, which are femipinnate with fhort indented pin¬
nules. Leaves and flowers diftant. Flowers axillary,
folitary, on fhort peduncles, forming a loofe fpike 5 co¬
rolla purple, varying to white : helmet with a little tooth
on each fide, not notched at the end ; lower lip fringed
with fine foft hairs. Native of many parts of Europe,
particularly the northern parts, in marfhes and wet mea¬
dows; flowering in June and July. It is an unwelcome
gueft in meadows, being difagreeable to cattle, and
thought by fome to be definitive to fheep : it is fome-
what cauftic, and feems to be feldom eaten.

2. Pedicularis fylvatica, common or heath loufe-wort:
or red-rattle : ftem branched, calyxes oblong angular
even, lip of the corollas cordate. Stem very fhort.
Branches from the root, long, fpreading clofe to the
ground. Leaves limply pinnate, with roundifh acutely -
ferrate pinnas. Floral leaves deeply divided: fegments
toothed. Leaves and flowers crowded. Flowers in a '
duller at the top of the plant, and fparingly on the
branches ; calyx green within, purplifh without, nearly
half as long as the corolla, one of the clefts much deeper;
fegments toothed, that oppofite to the deepeft cleft nar-
roweft ; corolla purple, much more flender than the
calyx : tube comprefled : upper lip with a little tooth on
each fide; lower lip with three divifions, the middle feg¬
ment a little fmaller. Native of many parts of Europe
and Siberia, in wet paftures and heaths, alfo in woods ;
flowering in June. The exprefled juice, or a deco&ion
of this plant, has been ufed with advantage as an injec¬
tion for finuous ulcers.

The calyx is commonly fa id to be five-cleft, with one
fegment very fmall and often Ample; the other four-
crefted. To Villars it appeared to be four-cleft, like that
of the preceding, from which it is diftinguiflied by'being
a much fmaller plant, frequently only two or three in¬
ches in height, whereas the other is fometimes eighteen
inches, and in warm climates two and even three feet
high : procumbent ; and the flowers longer.

/3. A very remarkable variety of this fpecies is noticed
by Dr. Smith, prefident of the Linnaean Society, in the
tenth volume of their Tranfations, p. 227. It confifts,
fays Dr. Smith, of a folitary flower of that plant, which,
in Head of its proper ringent form, with two long and two
fhort ftamens, has a falver-fhaped regular corolla, with fix
ftamens, four of which are longer than the others. There
is alfo what appears to be the ftyle partly changed to a
petal, and yet bearing a membranous expanfion like one
fide of an anther. I conceive therefore that this is really
an attempt at a feventh ftamen, though become partly a
petal. There is however no other fign of a ftyle. “This
fpecinjen is very interefting to me, as being another in-
ftance of the fame kind of variety as I have noticed in
Galeopfis tetrahit at Matlock, (fee FI. Lapponica, ed.
2, 201.) I have alfo had in my own garden feme regular
falver-fhaped flowers of Chelone barbata on the very
fame branch with the proper ringent ones. Such acci¬
dents are frequent in various fpecies of Antirrhinum
and Bignonia. They fliould be kept in mind by all flu-
dents of fyflematical arrangement, as a warning not to
expeft that our, artificial rules can keep pace with the in¬
tricacies of nature.”

3. Pedicularis roftrata, or beaked loufe-wort : ftem de¬
clining, fomewhat branched ; helmet of the corollas acu¬
minate-beaked ; calyxes crefted, fubhirfute. Root black,
thick, having large fibres fwelling out a little in the
middle. Stem inclined, five or fix inches high, having
fometimes a lateral branch from the lower part, with one
6 A or

456

PEDICULARIS.

or two flowers on it ; and alfo, but very feldom, another
fhorter near the bafe of the fpike ; which is rounded, and
has few flowers, of a purple or deep red colour. Villars
remarks, that this fpecies not being always branched, to
diftinguifh it from his gyroflex a, we mult obferve that the
flowers of this are peduncled, in very fmall number, of a
deep red, with the upper lip very much lengthened out
and curved; the ftem alfo is thinner. Native of Swiffer-
land, Auftria, Carniola, Dauphine, Piedmont, and Silefia.

4. Pedicularis Sceptrum Carolinum, or fceptred loufe-
wort : ftem Ample, flowers by threes in whorls, corollas
clofed, calyxes crefted, capfules regular. This is diftin-
guifhed from the other fpecies by the gape of the corolla
being clofed, the pericarp roundifh, acuminate but regu¬
lar, whereas in the others it is bent in with an oblique
point. The fize is half that of a man ; the flow'ers four,
five, or fometimes three only, at each joint, remote, in
whorls ; the corolla of a golden yellow colour, except
that the lower lip is tinged with purple or blood-red at
top. Rudbeck named it Sceptrum Carolinum in honour
of Charles XII. king of Sweden, from its manner of
growth like a fceptre. Difcovered by Rudbeck in Lap-
land, where it was alfo found by Linnaeus, in fuch abun¬
dance in one place on the highway as to flop a horfe going
full fpeed. It grows alfo in Dalekarlia, Oftrobothnia be¬
tween Kerni and Uloa, near Upfala, in Weftrogothia, but
more rarely: Norway, in feveral places: Pruflia and
Ruftia : in bogs, wet woods, &c. It is reprefented on
the annexed Plate.

5. Pedicularis verticillata, or whorled Ioufe-vvort: ftem
Ample, leaves in fours. Root more Ample or lefs branched
than in the other forts. Stems feveral, Ample, with fmooth
bipinnate leaves on them, oppoftte by threes or fours.
Calyx rayed, often white, membranaceous, a little co¬
loured and puffed out after flowering. It is very fmall,
and has beautiful red flowers. It feems to be biennial.
Native of Swiflerland, Auftria, Carniola, the fouth of
France, Silefia, Siberia, See.

6. Pedicularis refupinata, or topfy-turvy loufe-wort :
ftem Ample, leaves lanceolate ferrate crenulate, flowers
refupine. Stem a foot high, even, quite Ample. Flowers
from the upper axils fclitary, feflile ; calyx even, blunt,
bifid, entire ; corolla of a very deep purple, turned up-
fide-down. It varies with flefli-coloured and milk-white
flowers. Native of Siberia.

7. Pedicularis recutita, or jagged-leaved loufe-wort:
ftem Ample, leaves pinnatifid ferrate, fpike leafy, calyxes
coloured, corollas blunt. Root perennial, woody. Stem
upright, even, not more than a foot high. Native of
Swiflerland, Auftria, and Silefia. Introduced in 1787, by
William Pitcairn, M. D.

8. Pedicularis triftis, or dull-coloured loufe-wort : ftem
Ample, helmet of the corollas villofe at the edge. This is
a very hairy plant. Stem quite Ample, a fpan high.
Flowers heaped into a fpike or head ; corolla blunt, yel¬
low ; with the helmet a little curved inwards, villofe at
the edge. Native of Siberia.

9. Pedicularis flammea, or upright loufe-wort : ftem
Ample, leaves pinnate imbricate backwards. This at firft
fight refembles Sceptrum Carolinum in miniature, but it
Is twenty times lei's. It differs from the other fpecies in
having the leaves very like thofe of Filipendula, with the
segments imbricate ; the root tuberous and fufiform, like
Ikirrets, with a few feales at the bafe ; the corolla tawny,
with the top of the upper lip purple, the lower lip fhorter
by half than the upper. Stem fcarcely a finger’s length,
round, upright, dark purple. Root-leaves very many,
i'preading, on filiform petioles, bluntly lanceolate, almoft
divided to the midrib; the divilions ovate, the edge of
one lying over the next, crenate and each notch crenulate.
Stem-leaves fewer, fome immediately under the fpike,
like the root-leaves. Spike terminating the ftem, and
covering a third part of it, upright, compreffed, oblong.
Calyx ltriated, thin, four-toothed, oblong. Corolla
narrow, the lower lip very fmall, the upper narrow, almoft

upright, blunt. Pericarp acuminate, with the tip curved
inwards. The calyxes are by no means ferrate ; and the
corolla is very dark purple, efpecially at the end. Haller
fays that the upper petal or helmet is ferruginous 5 the
lower or beard pale yellow. Native of Lapland, Swiffer-
land, Silefia, Siberia. Introduced in 1775, by Drs. Pit¬
cairn and Fothergill. It is reprefented at fig. 1. Plate II.

10. Pedicularis hirfuta, or hairy loufe-wort: ftem Ample,
leaves tooth-pinnatelinear, calyxes hirfute. Root peren¬
nial. Stem half a finger’s length, thick, with oblong
cluttered feales at the bafe. Root-leaves almoft linear
feales; ftem-leaves a little longer than the feales. Spike
terminating, very fliort, but thick and quadrangular :
flowers fix to twelve, feflile; pale flefh-colour, with a
deeper heart-fhaped fpot on the lower lip. It differs from
the reft in its wide embracing petioles, villofe calyxes,
the colour of the corolla, and the notches of the leaves.

Villars can fcarcely think that the little Lapland plant
is the fame with that of Dauphine and Piedmont. He
deferibes it to be only two or three inches high, with the
ftem and leaves fmooth. Leaves bipinnate, very fine and
flat : on the ftem only one or two, pinnate. Flowers
from five to feven, in a diftinft fpike ; calyx in five Ample
divifions, very villofe ; upper lip of the corolla blunt, a
little curved : the whole bright red. It is allied to P.
incarnata, but is only one fixth of the fize. Villars found
a plant at the Grande Chartreufe, connefling thefe two,
in the fize, and the form of the leaves, but the calyx lefs
villofe than either. Native of Lapland, Dauphine, Pied¬
mont, Siberia.

11. Pedicularis rofea, or rofe-coloured loufe-u'ort : ftem
Ample, leaves pinnate, pinnas oblong pinnatifid, calyxes
hirfute. Root branched, yellowifh white. Stems one,
two, or three, rifing amid abundance of root-leaves, not
much fhorter than the Hems, and having the appearance
of lanceolate bipinnate fronds. Stem upright, fomewhat
angular. Each flower rifes on a fliort red pedicle from
the axil of a leafy brafte, almoft exceeding the calyx,
green, pinnatifid-toothed ; but in the upper bradfes the
teeth decreafe to two, and even one. Calyx from an
ovate bafe tubularly cilindrical, five toothed : teeth equal,
Ample, acute, red, as are alfo the nerves of the tube : the
reft of the calyx is green, but the villofe hairs that cover
it are white and tranfparent; corolla elegant, red ;- with
a tube longer than the calyx, fading away from red to
white: helmet deep red ; ftyle rofe-coloured at top, with
a bluntifh yellowifh ftigma. Native of Carinthia ; flow*
ering in July.

1 a. Pedicularis incarnata, or flefli-coloured loufe-wort:
ftem Ample, leaves pinnate ferrate, calyxes rounded
fmooth, helmet of the corollas hooked acute. Stem from
a foot to eighteen inches in height, upright, not branched,
terminating in a very long fpike. This plant feldom has
more than one ftem from a root. Leaves large, bipinnate,
thick and folid, fmooth or very little villofe ; they are
better furnifhed, and the divifions are thicker and much
lefs deeply cut, than in P. comofa and foliofa. Flowers
many, red, in a long loofe fpike. There is one variety,
which is fmaller and fmooth ; and another, with the
leaves lefs cut and almoft Ample, the ftem lower, and the
flowers fewer, the colour of fire inclining more or lefs to
yellow. There is no doubt of this being the plant of
Allioniand Haller; but Villars hefitates refpefling Lin-
nseus, who deferibes the calyx as fmooth. Native of
Swiflerland, Auftria, Dauphine, Silefia, and Siberia.

13. Pedicularis Lapponica, or Lapland loufe-wort:
ftem Ample, leaves pinnatifid ferrate; calyxes bifid blunt.
Root perennial. Stem a fpan high, upright, almoft
ftraight, round, fmooth. Root-leaves fcarcely any.
Stem-leaves feven or eight, lanceolate, acute, narrowed
at the bafe into the petiole, alternate, divided to the
middle into from fourteen to twenty pinnas, each having
from two to five toothlets on each fide, fmooth. Spike
terminating, loofe, four-cornered, compofed of from fix
to fixteen flowers, declining from the perpendicular,

each

PEDICU LAE I S.

Plate IT .

P E D

P E D

457

each furnifhed with its bradte ; the lower bradtes longer
than the flowers, the upper ones fcarcely fo long as the
calyx; calyx f'mooth, tubular, with a bifid blunt mouth;
corolla yellow, with the upper lip comprefled, produced
at the tip, reflexed downwards, and prominent, like an
eagle’s beak.

In Flora Suecica it is defcribed as a palm in height ; all
the leaves of the fame fize, and not the root-leaves larger ;
pinnatifid, ferrate; calyxes fometimes quite entire, fome-
times with two or four teeth. It differs from P. tuberofa
in being fmaller, in having more, leaves on the ftalk,
fmaller flow'ers, the root-leaves the lame wfith thofe of the
ftem, the pinnas not fubdivided but merely lerrate, the
calyxes not ferrate, but, excepting three or four teeth,
quite entire at the edge, and the Hems fmooth, not hir-
fute. Native of the mountains of Lapland and Dalecar-
lia, Denmark and Siberia. This elegant fpecies is deli¬
neated on Plate II. at fig. a.

14. Pedicularis comofa, or fpiked loufe-wort: ftem
fimple, fpike leafy, helmet of the corollas acute emargi-
nate, calyxes five-toothed. By its port, fize, and difpo-
fition of the flowers, this fpecies holds the place between
P. tuberofa and foliofa. Lateral roots whitifti, tuberous,
thicker at the end, as reprefented in John Bauhin’s
figure (3.438.) the middle root is bigger and blackifh.
Stems commonly two, a foot high. Root-leaves tripin-
nate, the laft divifions terminating in a white thread or
fpine a quarter or a third of a line in length. Stem-
leaves two or three, fmaller, and with the leaflets fewer
and more feparated. Spike terminating, three or four
inches long, with white or yellow flowers, feparated by
brakes, which lengthen on their axis, and appear little
beyond the flower, though they are longer : helmet bent
back like a fickle, comprefled, ending in a narrow' but
truncated point: they are inclined or roll round to the
left, as in P. roftrata and gyroflexa. Native of the moun¬
tains of Italy, Dauphine, and Siberia. Introduced in
1775, by Drs. Pitcairn and Fothergill.

15. Pedicularis foliofa, or leafy-fpiked loufe-wort:
ftem fimple, fpike leafy, helmet of the corollas very blunt
entire, calyxes five-toothed. This is loftier and ftronger
than moft of the other fpecies. Stem from a foot to
eighteen inches in height, ftrong and thick, lofing the
root-leaves, as foon as it rifes to flower. Leaves very
large, tripinnate, with the divifions very narrow, diftindl
and (harp, without fenfible points; Item-leaves two or
three, fmaller and at the upper part only. The flowers
form a confiderable fpike, are of a yellow colour, and fe¬
parated by large bipinnate leaves.

Gouan remarks, that this is very different from the
other fpecies, even when it is not in flower. For the
root-leaves are pinnate, with the pinnas deeply pinnatifid,
and the lobules fliarply toothed: the ftem-leaves, on the
other hand, efpecially the upper ones, are decurfively pin¬
nate, the pinnas being confluent, as in Tanfey, Achillea,
&c. Native of Swifferland, Aultria, and the fouth of
France. Introduced in 1786, by Edmund Davall, efq.

16. Pedicularis Canadenfis, or Canadian loufe-wort:
ftem fimple, fpike fomewhat leafy, helmet of the corollas
briftly-two-toothed, calyxes truncated downwards. Root
perennial. Stem upright, a fpan high, pubefcent towards
the top. Found by Kahn in North America.

17. Pedicularis tuberofa, or tuberous loufe-wort : ftem
fimple, calyxes crefted, helmet of the corollas hooked-
beaked. Villars defcribes a plant under this name of P.
tuberofa, which is fo nearly allied to P. comofa, that it
may poflibly be no more than a variety of it. Stem fimple,
villofe, and very thick; height from eight inches to a
foot. Leaves villofe, almoft tripinnate, the divifions dif-
tinct, refembling a fmall fern ; each laft divifion ends in
a very ftiort recurved whitifli thread. The ftem has only
a leaf or two. The flowers form a very thick fpike, clofer
at top than at bottom : they are yellow or whitifh. The
leaves among the flowers and the divifions of the calyx
are both fimple. (According to Allioni they are divided.)

The upper lip of the corolla is fickle-fliaped, and pointed
at the end. According to Linnaeus, it is a native of the
Swifs, Italian, and Siberian, mountains. But Villars
doubts the exiftence of it; and refers the tuberofa of
Linnaeus, Allioni, and Scopoli, to his gyroflexa.

18. Pedicularis gyroflexa, orgyrated loufe-wort: leaves
bipinnate, leaflets fomewhat toothed, curled, and blunt ;
flowers turned to the left, hooked-headed. Root peren¬
nial, compofed of a dark black trunk, often carious,
three or four lines in diameter, from which fpring thick
lateral fibres, horizontal, quite fimple, pretty long, not at
all fwelling out, any more than the trunk of the root.
Stems one, two, fometimes feveral, rife bending to the
height of fix or eight inches, feldom a foot ; they are vil¬
lofe, firm, and have one or two bipinnate leaves at their
bafe, and as many, but fmaller, on the upper part ; they
are terminated by a fpike of a beautiful red colour, trun¬
cated and villofe, compofed of pinnatifid bradtes of fe¬
veral villofe calyxes, the divifions of which are toothed
or pinnatifid. Helmet of the corolla turned to the left.

There is a variety, with finer and more diltindt leaves,
a yellow flower, and the piftil longer than the corolla,
which, according to Bellardi, is the tuberofa of Linnaeus.
Native of the fouth of France, Swifferland, Carniola, and
Piedmont.

19. Pedicularis Groenlandica, or Greenland loufe-wort:
ftem fimple, leaves pinnate ferrate, calyxes oblong, fmooth,
helmet of the corollas awl-lhaped bowed longer. Native
of Greenland. Firft given by Retzius under the name of
P. incarnata, from which it differs in the leaves, fpike,
calyx, and helmet of the corolla.

The alpine fpecies of Pedicularis, that is, all, except
the two firft and the fixteenth, have fuccefiively occupied
feveral of the firft botanifts in the prefent age : Linnaeus
in Lapland, Haller in Swifferland, Gmelin in Siberia, Se-
guier and Allioni in Italy, and Villars in Dauphine.
Linnaeus has defcribed fix natives of Lapland ; Haller ten
of Swifferland, but he faid that he had thirty fpecies from
different countries ; Gmelin twelve; Allioni eleven ; and
Villars ten, befides feveral remarkable varieties. Thefe
plants have their leaves very much cut, and that in a very
regular manner. Their flowers are red, white, or yellow,
and the mixture or (hades of thefe three colours fome¬
times give the corolla the colour of fire. They grow in
general at a confiderable elevation, namely, more than
a thoufand toifes above the level of the fea. Villars has
taken much pains with thefe plants, and has corredted
fome miftakes into which Haller and Linnaeus have fallen.
He obferves with great modefty, that if the cedars have
bent, what are we to expect of the reeds ? and that he
could not pafs by a favourable opportunity of celebrating
their memories, by (howfing that their miftakes were almoft
unavoidable, and have even been ufeful to us. “ May I
not, fays he, in paying homage to truth and the memory
of the two firft botanifts of our time, hope for much in¬
dulgence from thofe learned men who have it in their
power to corredt my errors, and to complete the work
which I have only begun ?”

PEDIC'ULUS, f. the Louse 5 in entomology, a genus
of infedts of the order aptera. Generic charadters — Mouth
with a retradtile recurved fucker without probofcis ; with¬
out feelers ; the antennae areas long as the thorax; it
has two eyes ; the abdomen is deprefled ; it has fix legs
formed for running. The infedts of this genus live by
extradting animal juices ; the larvae and pupa: are fix¬
footed and nimble, refembling the perfedt infedt. Of
thefe ftrange and unpleafing animals, there are fixty-fix
fpecies, fome of which infeft the bodies of quadrupeds,
others of birds, and fome even of infedts themfelves. It
muft, however, be obferved, that many fmall infedts, in'-
fefting other animals, have been often referred to the ge¬
nus Pediculus, which in reality belong to thofe of Acarus,
Monoculus, &c. &c.

1. Pediculus humanus, the common loufe : this nau-
feous infedt is fo well known as to render any very par¬
ticular

458

P E D

ticular defcription unneceflary. As a fpecies, it is diftin-
guiflied by its pale livid colour, and lobated oval abdo¬
men, with five joints to the antennas. It is produced
from a fmall oval egg, popularly called a nit, which is
fattened or agglutinated by its fmaller end to the hair on
which it is depofited. From this egg proceeds the infedl,
complete in all its parts, fit to propagate its fpecies im¬
mediately, and therefore differing only from the parent
animal in its fmaller fize. Such diminutive fpecimens
are far preferable, for microfcopic obfervation, to the full-
grown infedl, fhowing in a more diftindl manner the dif-
pofition of the vifcera, mufcles, &c. &c. When thus
examined by the microfcope, the principal appearances,
according to Mr. Adams, are as follow: “In the head
we may diftinguifh two fine black eyes, looking back¬
ward and fenced with hair; near thefe are the two anten¬
nae, each of which has five joints fet with fhort briftles ;
the fore-part of the head is rather long, the hinder more
round or obtufe; there is a fmall part that projects from
the nofe or fnout, this ferves as a (heath or cafe to the
probofcis or piercer, which the creature thrufts into the
fkin to draw out the blood and humours which are its
deftined food, for it has no mouth which opens in the
common way. This probofcis has been eftimated to be
feven-hundred times fmaller than a hair; it is contained
in another cafe within the firft, and can be drawn in or
thruft out at pleafure. The (kin is hard and tranfparent.
From the under fide proceed fix legs, each of which has
five joints, and terminates in two unequal hooked claws ;
thefe it ufes as we would a thumb and finger; there are
hairs between the claws, as well as all over the legs ; the
body finifhes in a cloven tail, which is generally covered,
and partly concealed, by hairs. From the extreme tranf-
parency of its (kin, the internal parts may be feen to
greater advantage than in any other infedl; as, the va¬
rious ramifications of the veins and arteries, in which a
kind of regular pulfation may be obferved, as well as the
periftaltic motion of the inteftines, which is continued
from the ftomach to the tail. When the loufe feeds, the
blood ruflies like a torrent into the ftomach, moving
with fo ftrong a propultion and contraction, as appears
very curious. The digeftive powers are fo great, that the
colour of the blood changes in its pafiage from thickand
black at its firft entrance to a fine ruby colour in the in¬
teftines, and nearly white in the veins. Its greedinefs is
fo great, that the excrement contained in the inteftines is
ejected at the fame time, to make room for this new fup-

p'y-”

It is affirmed by Leeuwenhoek that the male is fur-
nifhed at the extremity of the abdomen with a fting; and
that it is this inftrument which caufes the chief irritation
fuffered from thefe animals ; the aCtion of the fucker
hardly feeming to have caufed any perceptible pain on
the (kin of his hand. The male is readily diftinguifhed
from the female by having the tail or tip of the abdomen
rounded : in the female it is forked or bifid. The fame
accurate obferver (Leeuwenhoek), being defirous of
earning the proportion and time of the increafe of thefe
infeCts, placed two lice in a black filk flocking, which
he continued to wear day and night. He found that in
fix days, one of them had laid fifty eggs ; and upon dif-
feCling it, he found as many more in the ovary : he there¬
fore concluded that in twelve days it would have laid
an hundred eggs : thefe eggs, hatching in fix days, which
he found to be their natural time, w'ould probably pro¬
duce fifty males, and as many females ; and thefe females,
coming to their full growth in eighteen days; might each
of them be fuppofed, after twelve days more, to lay alfo
an hundred eggs; which in fix days farther, (the time
required to hatch them,) might produce a younger brood
of five thoufand ; fo that in eight weeks a loufe might
fee five thoufand of its own defcendants !

■ It will be readily fuppofed, that the figures we (hall
give of thefe minute infeCts will be confiderably magni¬
fied, that their parts may be brought diftinClly before the

P E D

eye of the reader. Fig. i. however, of the annexed Plate,
(hows the common loufe of its natural fize; fig. a. the
fame magnified ; fig. 3. more confiderably magnified, and
lying on its back.

|3. Body-loufe: lefs compaCt and paler. Thefe pedi-
culi are bred abundantly among the inhabitants of fordid
dwellings, of gaols, and workhoufes, &c. and in fuch
fituations prey upon perfons of all ages indifcriminately.
There is, however, alfo a peculiar ftate of (kin in people
advanced in years, and connected with thedifeafe, which
has been denominated Prurigo fenilis by Dr. Willan, in
which they are generated, notwithftanding every atten¬
tion to cleanlinefs or regimen, and multiply fo rapidly,
that the patient endures extreme diftrefs from their per¬
petual irritation. The nits or eggs are depofited on the
fmall hairs of the (kin ; and the pediculi are only found
on the (kin or on the linen, and not under the cuticle, as
fome of the old authors have reprefented. Many mar¬
vellous (lories, indeed, are related by Foreflus, Schenckius,
and others, refpedling lice bred under the fkin, and dif-
charged in fwarms from abfcefles, ftrumous ulcers, and
vefications : and many individuals of great note are ftated
to have died, in ancient times, from the multitude of
thefe devouring pediculi. Thus Plutarch relates of
Sylla : “ It was long before he perceived that he had an
ulcer within his body ; but at laft the flefh putrefied, and
produced fuch a quantity of lice, that, though many
perfons were employed day and night in deftroying them,
yet they increafed much fader than they could be re¬
moved ; and to fuch a degree did the diftemper prevail,
that his clothes, baths,- bafins, and food, were polluted
with that perpetual flux of corruption and vermin. He
went many times in the day into the water, to fcower and
cleanfe his body, but all in vain; the vermin multiplied
fo fall as to baffle every attempt to deftroy them.” The
biographer adds, “It is faid, that among the ancients,
there died of this difeafe Acaftus the fon of Pelias, and
nearer our own times Alcmason the poet, Pherecydes the
philofopher, Callifthenes the Olynthian, during the time
of his imprifonment, and Mutius the lawyer : and, if it
be proper to add to thefe a perfon not diftinguifhed by
any merit or virtue, Eunus, a fugitive (lave, who was au¬
thor of the war in Sicily, called the fervile war, and who
was taken and carried prifoner to Rome, died likewife of
this ficknefs.” (See Plutarch’s Life of Sylla ; alfo, Plin.
Hid. Nat. lib. xxvi. cap. 13. who, fpeaking of phthiriafis,
obferves, “ qua Sylla dictator confumptus eft.”) Herod,
Ennius, and by fome Plato, are faid alfo to have been de-
flroyed by the loufy difeafe. In more recent times,
Amatus Lufitanus has affirmed, that he was witnefs to the
cafe of a gentleman, who perilhed miferably in this dif¬
eafe : “ for fo univerfally did thefe infedls fwarm over his
body, that two negro fervants were entirely employed
in collecting bafkets-full from his perfon, and carrying
them to the fea.” Amat. Lufit. Contur. iii. Cur. 58.
See alfo Foreft. Obf. Med. lib. viii. obf. 14. Johan. Schenck.
Obf. Med. lib. v. obf. 2.

The mode in which pediculi are generated being now
well afcertained, and fuch fatal fwarms of them being al¬
together unknown in modern experience, we can fcarcely
give credit to thefe accounts. They are not only in all
probability much exaggerated, but have actually origi¬
nated in miftake. The larvae, or grubs, of feveral winged
infeCts, efpecially thofe of the common fly (Mufca domef-
tica), and of the black beetle (Tenebrio inolitor), not
unfrequently breed, both in the internal paffages, and in
external wounds, of the human body. And in warm
climates, the flies are fo numerous about the perfons of
the fick, that the utmoft care is requifite to prevent the
generation of larvae from the eggs which they depofit,
not only in fuperficial wounds, but in the noftrils, mouth,
gums, &c. fometimes even penetrating to the brain itfelf,
and producing death. From this view of the lubjeCt,
therefore, little doubt can remain, that the fatal cales of
antiquity, above alluded to, occurring in the warmer re¬
gions

1

PEDICULUS.

IP'S

Enorcn/ed for die Ena/ clap cedia, Londimnsls. i8z3.

459

PEDICULUS.

gions of Europe, were in reality cafes of ulceration, arif-
ing from fcurvy or fome other cacheftic condition, which
afforded a nidus for the breeding of the maggots of flies;
and were not true inftances of the morbus pedicularis.

The generation of lice, however, in connexion with
the prurigo of elderly people, though not fatal, is fre¬
quently a very troublefome and obftinate malady, and
many external applications have been reforted to from
ancient times to deftroy thefe loathfome and irritating
paralites. But the deftru&ion of them is commonly a
mere alleviation ; fince their reproduction is extremely
rapid. A decodtion of the feeds of ftavefacre, or of the
cocculus indicus, or the powder of either of thefe fub-
Itances, alone or mixed with lard in the form of an oint¬
ment, are very effectual deftroyers of the pediculi of the
bead, and even of the body-lice. The mercurial oint¬
ments, fuch as. that of the. white precipitated oxyde, are
alfo very efficacious in the fame inftances. The fpike-
oil, as it has been called, which is the eflential oil of la¬
vender, mixed with oil of turpentine, has been deemed
the molt efficacious poifon for thefe pediculi : its virtue
depends perhaps principally upon the oil of turpentine,
which is doubtlefs the moft ready inftrunjent of deftruc-
tion to all the infeCt tribe. Sir Edward Wilmot is faid by
Dr. Heberden to have ufed, with complete fuccefs, in a
cafe of morbus pedicularis, a compofition fomewhat fimi-
lar to the fpike-oil ; viz. of rectified oil of turpentine,
and fpirit of wine, each fourounces, camphor fix drachms.
A folution of the corrofive muriate of mercury in fpirit
is alfo often efficacious in the pedicular prurigo of the
body, and tends to remove the pruriginous affeCtion of
the flan, which feems to give rife to the tendency to ge¬
nerate lice. It is to be obferved, however, as a matter
of caution, that none of thefe pungent Simulating fub-
ftances can be applied to the fltin, without inflicting ex¬
treme pain, unlefs its furface be unbroken : for where the
cuticle is abraded by fcratching, or by the breaking of
puftules and veficles, or by the formation of rhagades or
chaps, the irritation and fmarting excited by them is in¬
tolerable, and is followed by conliderable inflammation.
This diforder has been flightly mentioned, in our article
Pathology, under the name of Exormia prurigo fenilis.
See p. 353. Plate VII. fig. 1. B.

2. Pediculus pubis, the crab-loufe: abdomen emargi-
nate. behind; legs cheliform, hence its trivial name. In
the antennae are five articulations. It is found about the
hairs of the groin, and fometimes, though very rarely, on
the eye-brows of perfons who are not attentive to habits
of cleanlinefs; but never on the head or body. Thefe trou¬
blefome vifitors are inftantly and completely deftroyed by
inunClion wuth the common blue mercurial ointment.

3. Pediculus ricinoides: the abdomen is orbicular,
marked with a white line; the fcutellum is compofed of
three lobes; the fnout is white. It is a native of Ame¬
rica. It gets into the legs of the naked inhabitants,
where it draws blood, and depofiting its eggs>*in the
wound occafions very alarming ulcers.

4. Pediculus fuis : found on the body of fwine.

5. Pediculus porcelli : found on the body of the Cavia
cobaya, or Guinea pig.

6. Pediculus cameli : head projecting and pointed ;
body ferruginous ; abdomen ovate. It is found on the
camel.

7. Pediculus ovis : this infefts the body of flieep.

8. Pediculus cervi : on the flag and deer.

9. Pediculus bubali : yellowulh, with dufley-brown
ftreaJcs ; the abdomen has ten conic marginal tubercles.
It is found on the buffalo.

10. Pediculus bovis : abdomen with eight tfanfverfe
ferruginous lines. It inhabits the bodies of oxen, and
cattle in general.

11. Pediculus vituli : abdomen lead-colour, and
pointed at the end. Found on the bodies of heifers and
cattle.

12. Pediculus equi : found on the body of the horfe.
Vol. XIX. No. 1316.

13. Pediculus afini : head projecting, obtufe ; abdomen
ovate, brown ; legs cheliform. Found on the body of
the afs.

14. Pediculus vulturis : oblong ; abdomen brown,
with two yellowifli lines. It is found in the Eaft Indies
on the vulture, and is a large infeCt. It is farther cha¬
racterized as having a flat head, yellowifli, with black
margins; the thorax is yellowifli, with a black margin
and dorfal line.

1 5. Pediculus tinnunculi : head arrow-thaped, and mu-
cronate on each fide behind. Found on the Falco tin-
nunculus, or keftril.

16. Pediculus buteonis : abdomen margined : the feg-
ments with two imprefled dots on each fide. It infefts
the Falco buteo, or buzzard.

17. Pediculus ftrigis : abdomen ovate, white, edged
with red ; legs red. Found infefting various fpecies of
the Strix and Falco.

18. Pediculus corvi : abdomen ovate, with a ftriate
margin. Found on various fpecies of the crow.

19. Pediculus cornicis : abdomen ovate, pale, with la¬
teral black fpots, in which is a white pupil. Found on
the common crow. See the Plate, fig. 4.

20. Pediculus infaufti : thorax narrow ; abdomen
ovate, pale, diaphanous. It infefts the Corvus infauftus.

21. Pediculus picte : head obtufe, brown, with four
black dots. This is found on the Corvus pica, or magpie.

22. Pediculus orioli : white, with a brown line on the
abdomen. Found on the roller and oriole.

23. Pediculus cuculi : abdomen oblong, whitifh, with
brown bands. It infefts the Cuculus canorus, or cuckoo.

24. Pediculus cygni : head emarginate; abdomen
ovate ; the margin ftriate with black. It is found on the
fwan.

25. Pediculus anferis : filiform, pale ; the margin dotted
with black. It is found on the wild arjd tame goofe.
The1* animal reprefented at fig. 5. was taken from the
wild goofe.

26. Pediculus mofchatse: this is found on the Anas
mofchata, or Mufcovy duck.

27. Pediculus querquedulte -. this infefts th'e Anas
querquedula, or garganey.

28. Pediculus mergi : white, with a yellowifli head;
body long. Found on the Mergus ferrator.

29. Pediculus procellarite : long, filiform, brown ; with
pale legs. It inhabits Brafil, on the Procellaria, or petrel.

30. Pediculus vagelli : ovate, pale; thorax with two
brown lines. Found on the Procellaria glaciali?.

31. Pediculus diomedre: head obtufe; body white;
fides of the abdomen black. It inhabits Brafil ; on the
Diomedea, or albatrofs.

32. Pediculus pelecani : antennse double. Infefts the
Pelecanus finenfis, or corvorant ; and is fliown at fig. 6.

33. Pediculus fternse: head triangular; abdomen ovate,
pale; the back longitudinally blackifh. Found on va¬
rious fpecies of the tern and gull.

34. Pediculus plataleae: found on the Platalea leuco-
rodia, or fpoon-bill.

35. Pediculus ardese : found on feveral fpecies of the
Ardea,or crane.

, 36. Pediculus gruis : abdomen fubclavate, pale, wfith
fnowy fpiracles. It is found on ftorks and herons.

37. Pediculus ciconiae: long, filiform ; abdomen white ;
the fides dotted with black. It infefts ftorks.

38. Pediculus charadrii. This fpecies is found on the
Charadrius pluvialis, or golden plover.

39. Pediculus fulicas. This infefts theFulica atra, or
common coot ; and is fliown at fig. 7.

40. Pediculus recurviroftrse : oblong, with a triangular
grooved head. It is found on the Recurviroftra, or
avocet.

41. Pediculus hannatopi : glaucous; thorax very nar¬
row ; abdomen ovate; with pale incifures. Found on
the Haematopus oftralegus, or fea-pie.

42. Pediculus pavonis : head globular, and very large ;

6 B body

460 FED

body ftriate with pale and brown. Found on the pea¬
cock. See fig. 8.

43. Pediculus meleagrides: head triangular, obtufe;
abdomen ovate, grey. This in felts the turkey.

44. Pediculus gallinae : thorax and head mucronate on
each fide. This fpecies infefts poultry; and is deftroyed
by pepper.

45. Pediculus phafiani : head ovate and large ; abdo¬
men globular, obtufe. It is found on the pheafant.

46. Pediculus caponis : abdomen edged with black.
Found on common poultry.

47. Pediculus tetraonis. This fpecies is found on the
black game, partridge, &c. See fig. 9.

4?. Pediculus lagopi : on the Tetrao lagopus, or ptar¬
migan.

49. Pediculus columbse: body filiform, ferruginous,
and clavate behind. Found on common pigeons.

50. Pediculus emberizae : pale brown ; abdomen whi-
tifli, with lateral brown fpots ; head triangular. Found
on the bunting.

51. Pediculus pari : body ovate; tail ending in four
bridles. Found on various fpecies of the parus, or tit-
moufe.

52. Pediculus motacillse : head heart-lhaped, rufous ;
abdomen white and tapering at the bafe. It is found on
the wagtail.

53. Pediculus hirundinis : paliffi ; abdomen black,
fpotted with white. Found infefting the Hirundo apus,
or fwift. The abdomen is brifidy on both fides.

54. Pediculus gryllotalpae : blood-red, with white legs.
Found on the mole cricket. The fucker is long, inflefted,
black ; body red, immaculate.

55. Pediculus apis : body filiform, ferruginous. Inha¬
bits Europe, on bees.

56. Pediculus farionis: this is found on the Salmo fario,
or trout.

57. Pediculus anatis: whitiffi ; firlt fegment of the
thorax round, truncate on each fide; the abdomen linear
and long. On the wild duck.

58. Pediculus ortygometrae : oblong; with a heart-
fhaped head ; thorax narrow : fegments of the abdomen
briftly, with large fpotted fpiracles on each fide. This
infefts the land-rail.

59. Pediculus alaudas : on the Alauda ar vends, or Iky-
lark.

60. Pediculus fturni : on the Sturnus vulgaris, or ftar-

Mng.

61. Pediculus curviroftrae : this is found on the Loxia
curviroftra, or grofbeak.

62. Pediculus pyrrhulas : this infefts the Loxia pyrrhula,
or bull-finch.

63. Pediculus cloridis : this is found on the Loxia
chloris, or green-finch.

64. Pediculus citrinellse : this infefts the Emberiza
citrinella, or yellow-hammer.

65. Pediculus curructe : this is found on the Motacilla
curruca, or babbling warbler.

66. Pediculus rubeculae: on the M. rubecola, or red-
breaft. Gmelitis Linn. Adams on the Microfcope ; and,
for the figures, fee Redi and Degeer.

PED'IGREE, j [per and degre, Skinner.] Genealogy;
lineage ; account of defcent. — I am no herald to enquire
of men’s pedigrees ; itfufficeth me if I know their virtues.
Sidney. — The Jews preferved the pedigrees of their feve-
ral tribes with a more fcrupulous exaftnefs than any
other nation. Atterbury.

To the old heroes hence was given
A pedigree which reach’d to heaven. Waller.

PEDILU'VIUM, f. [from the Lat. pes, foot, and luo,
to wafli.] A bath for the feet; the aft of bathing the feet.

The older praftitioners reforted to the pediluvium in a
variety of dileafes upon hypothetical principles ; con¬
ceiving that, by drawing the blood into the veffels of the
feet, it relieved diftant organs, as the head or lungs.

P E D

which were overcharged by a ftate of inflammation in
congellion : hence it was recommended in apoplexy,
pleurify, and other topical affeftions of diftant parts.
This doftrine of revnlfon , however, as applied to the
operation of the pediluvium, is more queftionable than
under any other application of it ; for as, like the general
warm-bath, it fomewhat accelerates the general circula¬
tion, it muft be a doubtful remedy in cafes where the
motion of the heart and arteries is already too great.
The operation of the pediluvium is, in faft, Amply that
of a partial warm-bath; and its ufe is at prefent limited
to thofe diforders in which that more general remedy is
indicated ; being a more prafticable and eafy expedient,
though neceffarily much lefs effeftual in its influence.
The moft valuable and common application of the pedi¬
luvium is at the onfet of febrile difeafes, while a certain
degree of chillinefs is prefent. Ufed in this ftate pre¬
vious to going to bed, it contributes, by moderately ex¬
citing the heart and arteries, to equalife the circulation,
and determine the blood to the furface, whence a flight
diaphorefis often follows its ufe underthefe circumftances.
Thus the attack of a commencing catarrh or rlieumatifm
is often warded off by the ufe of pediluvium, aided by
other proper means ; and to this kind of treatment
its operation is probably to be limited. In the more
advanced ftage of febrile difeafes, efpecially when there
is delirium, or a general heat, its advantages are very pro¬
blematical.

PED'IMENT, /. [pedis, Lat.] In architecture, an or¬
nament that crowns the ordonances, finiffies the fronts of
buildings, and ferves as a decoration overgates, windows,
and niches: it is ordinarily of a triangular form, but
fometimes makes the arch of a circle. — The pedi¬
ment of the fouthern tranfept is pinnacled, not inele¬
gantly, with a flouriflied crofs. War ton’s Hijl. of Iiid-
dington.

PEDINABARUM', a town of Hindooftan : fixty miles
fouth-eaft of Travancore.

PED'INAIG-DUR'GAM, a town of Hindooftan, in
Myfore : ten miles fouth-eaft of Vencatighery.

PE'DIR, a town on the north coaft of the ifland of
Sumatra: twenty miles eaft of Acheen. Lat. 5.13. N.
Ion. 96. 5. E.

PED'LAR, or Pedler, f. [a petty dealer: “a con-
traftion producedby frequent ufe.” Dr.JohnJ'on. — Others
from pied pouldreux, dufty-foot, Todd.~\ One who tra¬
vels the country with fmall commodities. — A narrow
education may beget among fomeof the clergy in poffef-
fion fuch contempt for all innovators, as merchants have
for pedler s. Swift.

All as a poor pedler he did wend,

Bearing atrull’e of trifles at his backe;

As bells and babes and glaffes in his packe. Spenfer.
Atlas was fo exceeding ftrong,

He bore the fkies upon his back.

Juft as a pedler does his pack. Swift.

For the regulations, by afts of parliament, which re¬
gard thefe walking tradefmen, fee the article Hawker,
vol. ix. With 11s, pedlars are looked upon in a very
contemptible light ; and the reafon is, becaufe we have
fo little occafion for them, and becaufe they injure the
regular ftationary fhopkeepers in the villages they pafs
through. Before turnpike-roads were formed, and when
the communication between towns was very unfrequent
and difficult, thefe petty chapmen were very ufe ful in
bringing goods from London and other large cities and
towns to the fmaller towns and villages in various parts
of the kingdom. Neceflaries could be procured from
thefe laborious travellers which could hardly be other-
wife had, except at certain annual fairs, which more¬
over the poorer fort of villagers could not vifit, nor
could they afford to purchafe fuch a fupply as would
laft them till the next annual return. And wemayrea-
fonably fuppofe, what is really the faft, that in coun¬
tries

P E D

tries where towns are diftant from each other, and the
communication between them unfrequent and irregular,
pedlars are confidered as very ufeful members of the
community. In Spanifh America, for inftance, the bufi-
nefs was fo profitable, that it was thought by no means
difliono arable ; and many gentlemen in Old Spain, when
their circumftances were declining, fent their Tons to the
Indies to retrieve their fortunes in this way. Almoft all
the commodities of Europe are diftri buted through the
fouthern continent of America by means of thefe ped¬
lars. They come from Panama to Paita by fea ; and, in
the road from the port lafl mentioned, they make Peura
their firft voyage to Lima. Some take the road through
Caxamalia ; others through Truxillo, along (hare from
Lima. They take their paffage back to Panama by fea,
and perhaps take, with them a little cargo of brandy. At
Panama they again dock themfelves with European goods,
returning by fea to Paita, where they are put on-fhore ;
there they hire mules and load them, the Indians going
with them in order to lead them back. Their travelling
expenfes were next to nothing; for the Indians were
brought under fuch fubjeftion, that they found lodging
for them, and provender for their mules, thinking it an
honour done them for their guefts to accept of fuch en¬
tertainment, gratis, as they could furnifh. The above
account applies, of courfe, to a period anterior to the be¬
ginning of the revolution which is now in progrefs.

In Poland, where there are few or no manufactures,
almoft all the merchandife is carried on by pedlars, who
are faid to be generally Scotfmen, and who, in the reign
of king Charles II. are faid to have amounted to no fewer
than 53,000.

Mr. Heron, in his “Journey through the Weftern
Counties of Scotland, 1792,” has placed the profeffion
of a pedlar in a new and interefting point of view; and,
we. may fay, railed it to a degree of dignity and Importance:
“ I am induced to obferve, that chapmen or pedlars are
the great civilizers of countries and nations. We learn
from Caefar and other Roman writers, that the travelling
merchants who frequented Gaul and other barbarous
countries, either newly conquered by the Roman arms,
or bordering on the Roman conquefts, were ever the
firft to make the inhabitants of thofe countries fami¬
liarly acquainted with the Roman modes of life, and to
infpire them with an inclination to follow Roman fafhions,
and to enjoy Roman conveniences. In North America,
travelling merchants from the fettlements, have done
and continue to do much more towards civilizing the
Indian natives, than all the miffionaries, Papift or Pro-
teftant, who have ever been fent among them. There is
reafon to expeft, that much may be equally done for the
civilization of the natives of New Holland, by chapmen
travelling, with fuitable wares, from our new-formed
fettlements at Botany Bay. Nothing can be more natu¬
ral than that thefe things fhould fo happen. A rude
people will hardly go in learch of commodities of which
they know not the names, the nature, or the value, and
which they have little, if any, money to purchafe. Yet,
when fuch commodities are brought among them, ex-
pOfed to their view, and recommended as fafttionable or
ufeful, they feldom fail to take a fancy for them, and will
often give in exchange any thing, of however effential
utility, that they already poflefs. They learn to labour,
that, they may have means with which to purchafe thofe
foreign commodities. They learn to difdain the ufe of
thofe coarfe clothes, or rude utenfils, with which they
were before content; and, with- the new conveniences,
they infenfibly adopt that improved fyftem of manners
to which fuch conveniences properly correfpond. In the
ftage of the progrefs of fociety in which this change is
begun, no fuch alteration could poflibly take place,
without the intervention of chapmen or pedlars.”

The following will caufe a fmile on the face of the
London reader: “ It is further to be obferved, for the
credit of this mod ufeful clafs of men, that they com-

L A R. 461

monly contribute, by their perfonal manners no lefs
than by the fale of their wares, to the refinement of the
people among whom they travel. Their dealings form
them to great quicknefs of wit, and acutenefs of judg¬
ment. Having conftant occafion to recommend them¬
felves and their goods, they acquire habits of the molt
obliging attention, and the moft infinuating addrefs. As,
in their peregrinations, they have opportunity of con¬
templating the manners of various men and various ci¬
ties; they become eminently fkilled in the knowledge of
the world. As they wander, each alone, through thinly-
inhabited diftrifls, they form habits of refiedlion and of
fublime contemplation. With all thefe qualiftcatibns,
no wonder that they fhould often be, in remote parts of
the country, the bed mirrors of fajhion , and cenfors. of
manners; and fhould contribute much to polilli the
roughnefs, and foften the rufticity, of our peafantry. It
is not more than twenty or thirty years, fince a young
man going from any part of Scotland to England, on pur-
pofe to carry the pack, was confidered as going to lead the
life, and to acquire the fortune, of a gentleman. When,
after twenty years’ abfence in that honourable line of
employment, he returned, with his acquifitions, to his
native country, he was regarded as a gentleman to all in¬
tents and purpofes. When he had purchafed a little
eftate, he commonly made improvements, and fet up in a
ftyle of living by which the tafte of the whole country
was mightily correffed and refined. I believe in my con-
fcience, that at leaft a fifth part of our fecond-rate gentry,
whofe gentility is not of ancient military origin, may
trace it to the ufeful iiidultry of this deferved clafs of
citizens.

“ But, to trace fomewhat farther the progrefs of that
refinement which is begun through the mini ft rati on of
itinerant merchants. When curiofity, tafte, induftry,
and fancy, have, by their endeavours, been roufed ; the
purchafers of their commodities learn next to meet them
at fairs. By affembling upon thefe occafion s, they be¬
come more focial in their tempers, they are taught to
vie with one another in their manners and appearance,
they gain feme knowledge of traffic, and become ac¬
quainted with more of the conveniences of life. The
time of the fair becomes a period to which their hopes
look forward, and an asra from which every one dates
fame increafe or other of his perfonal importance.
Every one returns home from it, too, with refolutions
to earn money or to prepare commodities which may
enable him to make greater purchafes by the return of
next fair. The fpirit of induftry and of focial inter-
courfe which is by thefe means ftirred up, continues to
operate, till yet more frequent meetings for the purpofes
of traffic become requifite. Markets are next eftablilhed.
The chapmen become fhopkeepers. And the improve¬
ment of the country, if not impeded by the operation
of oppofite caufes, goes rapidly on. This is no fanciful
or ludicrous deduction. The progrefs of induftry and
of luxury advances by thefe very fteps. Chapmen are
undeniably of all that confequence in fociety which I
have aferibed £0 them. I know not if the Society for
Propagating Chriftian Knowledge in the Highlands
and I (lands of Scotland, had not better employ chapmen,
inftead of preaching miffionaries, or unite the two charac¬
ters of the chapman and the preaching miffionary in the
fame perfon.”

PED'LERESS, f. A female pedler.- — The companion
of his [the tinker’s] travels is fome foul fun-burnt
quean, that fince the terrible ftatute recanted gypfifme,
and is turned pedlerefs. Overhury's CliaraSl.

PED'LERY, adj. Sold by pedlers. — Images, reliques,
and other pedlarye wares. Bale on the Rev. — -The buffer¬
ings of thole of my rank are trifles in comparifon of
what all thofe are who travel with filh, poultry, ped/ery
ware, to fell. Swift.

PEJD'LERY, f. The articles fold by pedlers. — Fearing
that the quick-lighted proteftant’s eye may at one time

or

462

P E I)

or other look with good judgement into thefe their de¬
ceitful pedleries. Milton Of Ref. in Eng. — The employ¬
ment of felling petty articles. — My next lover was Fun-
.goh, the fon of a (lock-jobber : I durft not difmifs him;
and might perhaps have been doomed for ever to the
groffnefs of pedlary , and jargon of ufury, had not a
fraud been difcovered in the fettlement. Johnfon's Ram¬
bler, No. 1 1 9.

PED'MAN, a town of Hindooftan, in the circar of
Guntoor: ten miles fouth-fouth-weft of Guntoor.

PEDN BOAR POI'NT, a cape on the fouth coaft of
England, and county of Cornwall : fix miles fouth-ealt
of Lizard Point. Eat. 50. 6. N. Ion. 5. 8. W.

PEDOBAP'TISM. See Pjedo-baptism, vol. xviii.

•PEDOM'ANCY, f. [from the Gr. otj, a foot, and
p.a.v ana, magic.] Divination by the lines on the foies of
the feet.

PEDOM'ETER, f. [from ws?, foot, and mea-

fure.] A mechanical inftrument, In the form of a watch,
confifting of various wheels* with teeth catching in one
another, all difpofed in the fame plane ; which, by means
of a chain or firing, fattened to a man’s foot, or to the
wheel of a chariot, advance a notch each ftep, or each re¬
volution of the wheel ; fo that, the number being marked
on the edge of each wheel, one may number the paces,
or meafure exactly the diltance from one place to ano¬
ther.

An inftrument of this kind has been invented and
improved by Mr. Ralph Gout, of Bunhill Row. The pe¬
dometers of Mr. Gout have an advantage hitherto un¬
known, viz. the hour being attached to them, if required,
which makes this inftrument doubly ufeful. Thus, on
the fame dial is exhibited, at one view, time and diftance
by means of different hands. Their internal conftruction
is fo very fimple, as not to endanger their being put out
of order; and, if required to be cleaned, a perfon of the
fmalleft capacity may do it, the wheels being all marked
for that purpofe.

The patentee has been induced to make various trials
with his pedometers in public, one in the right, and one
in the left, pocket, in order to eftablith more efteftually
their high ftate of perfection, not only in point of accu¬
racy of the machinery, but to fhow the nicety of man’s
walking. The fame pedometer will, by a proper appli¬
cation to the faddle, afeertain every pace a horfe takes,
either in walk, trot, or gallop, and may be made to flop
performance in a fecond, lhould the horfe, in the courfe
of meafuring, go from one pace to another. In fhort,
we do not feel the lead difficulty in recommending this
invention, as the beft of the kind ever offered to the
public.

Pedometer is fometimes alfo ufed for the common
furveying-wheel, an inftrument chiefly ufed in meafu-
riwg lands and roads ; popularly called the way-wifer.
See Perameulator, and the article Surveying. ,

PE'DRA, a river of Africa, in the kingdom of Adel,
which runs into the Arabian Sea in lat. n. 25. N.

PE'DRA BRAN'CA, a large white rock in the Chi-
nefe fea. Lat. 22. 19. N. Ion. 1 14. 57. E.

PE'DRA DA GA'LE, a fmall ifland in the Atlantic,
near the coaft of Africa. Lat. 21.48. N.

PE'DRA DA SUREI'RA, a rock or fmall ifland in
the Atlantic, near the coaft of Portugal, at the mouth of
the Gopelha : four miles fouth of the bay of Oporto.
Laf. 41. 6. N. Ion. 8.23. W.

PEDRA'QA, a town of South America, in the go¬
vernment of Caraccas : twenty-five miles fouth-fouth-weft
of Varinas.

PEDRAGA'O,. a town of Portugal, in the province
of Eftramadura : thirty miles fouth-eaft of Coimbra.

PEDRAPALO'RE, a town of Hindooftan, in the
Carnatic : twenty miles fouth of Wandiwafli.

PE'DRAS, a river on the north-weft fide of Punta
des Padras, at the fouthern extremity of Amazon-river.

PEDRA'ZA, a town of Spain, in Old Caftile, with a

P E D

caftle, in which Francis the dauphin of France, and his
brother Henry, children to Francis I. were confined for
four,years. It was the birth-place of the emperor Tra¬
jan : twenty-one miles north-eaft of Segovia.

PED'RERO. See Pederero.

PE'DRICK I'SLAND, a townfhip of Plymouth coun¬
ty, in Maffachufetts, having feven perfons.

PE'DRO, a town on the north-weft coaft of the ifland
of Ternate. Lat. o. 50. N. Ion. 127. 10. E.

PE'DRO, a fmall ifland in the Indian Sea, near the
weft coaft of Madagafcar. Lat. 14. 50. S. Ion.' 47. 48. E.

PE'DRO BA'Y (Great), a bay on the fouth coaft of
Jamaica. Lat. 17. 53. N. Ion. 77.41. W. — Eaft of it lies
Little Pedro Point.

PE'DRO BLUFF', a cape on the fouth coaft of Ja¬
maica. Lat. 17. 52. N. Ion. 77. 39. W.

PE'DRO MU'NOZ, a town of Spain, in New Caftile :
forty-eight miles fouth-eaft of Toledo.

PE'DRO POI'NT, a cape on the north coaft of Ja¬
maica. 'Lat. 18. 28. N. Ion. 78. 12. W.

PE'DRO SHO'ALS, or Beroras, rocks in the Spanifti
main : thirty miles fouth of Jamaica. Lat. 17. 18. N. Ion.
77. to 78. 20. W.

PE'DRO (Saint), a river of Africa, on the Ivory coaft,
which runs into the Atlantic. Lat. 4. 50. N. Ion. 6. 50.
W. — Alfo, a town of South America, in the province of
Carthagena : fifty miles fouth of Mompox. — A town of
South America, in the province of Venezuela, on the
fouth coaft of lake Maracaybo : 100 miles fouth of Ma-
racaybo. — A town of Brafil, in the government of Para,
on the river Amazons : 440 miles weft of Port Rio Negro.
— A town of South America, in the province of Moxes,
on the Mamora : fifty miles fouth of Trinidad. — A town
of South America, in the audience of Quito : twenty
miles north-weft of St. Jofef de Huales. — A town of
Mexico, in the province of Mechoacan : fifteen miles
north of St. Luis de Potofi. — A fmall ifland in the Pacific
Ocean, near the coaft of Terra Firma. Lat. 4. 2. N. — A
fea-port of Mexico, in the province of Guaxaca: feven-
ty-five miles fouth of Guaxaca. Lat. 16. N. Ion. 99. 1.
W.— One of the Marquefas iflands, called by the natives
Onatcya, about three leagues in circuit. Lat. 9. 55. S.
Ion. 138. 55. E. — A town of the bifhopric ofTruxillo,
and jurifdi<5tion of Sana, fituated in a fertile foil, near
the coaft of the Pacific ocean : fifty miles north of Trux-
illo. Lat. 7. 26. S. — A town of Eaft Florida : forty-four
miles eaft-fouth-eaft of St. Mark. — A fmall ifland near
the coaft of Spain, fituated fouth-eaft of the city of Cadiz,
from which it is feparated by a narrow ftrait, called “ St.
Pedro’s Channel.” — A town of the ifland of Cuba:
thirty-one miles fouth-weft of Bayamo. — A town of
South America, in the province of Cordova : ninety-fix
miles north of Cordova. — A town of New Navarre: 180
miles w'eft of Cafa Grande. — A town of Mexico, in the
province of Honduras: fifteen miles u'eft-north-weft of
Naco. — Alfo, a bay of the Pacific Ocean, on the coaft of
New Albion, between Point Fermin and Point Lafuen.

PE'DRO NOLAS'CO (St.), a town of Brafil on the
Urubui: feventy miles north-north-eaft of Fort Rio
Negro.

PE'DRO NO'VO (St.), a town of Brafil, on a river
which runs into the bay of All Saints : fifty miles north-
Veft of St. Salvador.

PE'DRO E PA'BLO (St.), a river of Mexico, which
rifes in Tabafco, and runs into the bay of Campeachy in
lat. 18.20.N. Ion. 93. 2 6. W. — Alfo, a river of Mexico,
which rifes near Zacatlan, in the province of Tiafcala,
and runs into the gulf of Mexico in lat. 10. 52. N. Ion.
93. 26. W.

PE'DRO DE SUL' (St.), a town of Portugal, in the
province of Beira : nine miles north-weft of Vifeu.

PE'DRO DE TABER'NA (St.), a town of Spain, in
Arragon : twelve miles north of Aftifa.

PEDRO'AS (Os), a town of Portugal in Alentejo :
nine miles fouth-weft of Moura.

PEDRO'AS

PEE

PEDRO'AS DE PERCEVEI'RA, rocks near the weft
coaft of Portugal : two miles fouth-fouth-weft of Sines.
Lat. 37. 40. N. Ion. 8. 52. W.

PEDROGA'ON, a town of Portugal, in Eftremadura:
twenty-one miles north-eaft of Thomar.

PEDRO'SA, a town of Spain, in Old Caftile : five
miles fouth-eaft of Najera.

PEDRU'SI, or Pedruzzi (Paul), a learned antiquary,
was born of a noble family at Mantua in 1646. He en¬
tered among the Jefuits, and diftinguilhed himfelf by his
knowledge of hiftory and antiquities. He was chofen
by Rannucio duke of Parma, to arrange his rich and cu¬
rious cabinet of medals, and give explanations of them.
In 1 694 he began to publifh an account of this collection,
under the title of “ I Cefari in oro raccolti nel Farnefe
Mufeo e publicati colie loro congrue interpretazioni,
Parma, fol. and he continued his labours till his death
in 1721. At that time feven volumes had been publilhed:
the eighth was edited by Peter Piovene, a brother Jefuit.
The whole forms ten tomes, and bears the name of the
“ Mufeo Farnefe.”

PEDUN'CLE, f. [ pedunculus , Lat.] In botany, the
flower-ftalk. It iprings from the ftem, and bears the
flowers and fruit, but not the leaves. A flower-ftalk
originating immediately from the root, has an appropri¬
ate name, Scapus, fee that article ; though fome prefer
pedunculis radicalis. The flower-ftalk is either Ample or
compound. In the firft inftance it commonly bears a fo-
litary flower, though it may bear a number of completely
fefliie ones, conftituting a fpike, as in Potamogeton.
When compound, the ultimate divifions of this part are
called partial flower-ftalks. See Pedicellus.

To PEE, v.n. To look with one eye. In ufe to this
day in Cumberland. “H epees, he looks with one eye.”
Ray.

PEE CAIO'NI. See Vereesina.

— - CUPAM'ENI. See Tragia.

- INO'TA INO'DIEN. See Physalis.

- KAN'DEL. See Rhizophora.

- MOTTEN'GA. See Schcenus.

- - TAN'DALE COT'TI. See Crotalaria.

- TIAN'GA PULPA'NI. See Ruellia.

PEE'BLES, a town of Scotland, and capital of the
county to which it gives name, fituated on a fmall river,
alfo called Peebles, which feparates the town into Old and
New, andfoon after joins the Tweed. It is a royal burgh,
and is fuppofed to owe its name to the pebbles with which
the environs abound. ^

Peebles is of great antiquity, and was probably a town
even in the time of the Gadeni. At all events there
were undoubtedly a confiderable village and a church
here, before the commencement of the Scoto-Saxon pe¬
riod ; “ and there was here alfo as early, perhaps, a royal
caftle, with a chapel, and other accommodations, which a
town only can fupply.” This opinion derives much
fupport from the fact, that Peebles is mentioned in the
earlieft Scottifh records “ as a town of the royal demefne,
which yielded a firm into the royal exchequer.” Accor¬
ding to Dr. Pennycuick, it was occafionally honoured by
the refidence of the Scottifh monarchs, till the death of
Alexander III. (1285.) who conferred on it many fpe-
cial marks of his munificence and favour. In the con-
tefts for the fucceflion to the throne which enfued, the
inhabitants efpoufed the caufeof Baliol, and were after¬
wards compelled to fubmit to the ufurpation of Edward
I. of England. At this period the town appears to have
been governed by a bailiff, and a certain number of bur-
gefles,as we find them mentioned to have fworn fealty to
the Englifh kingatBerwick, on the 28th of Auguft, 1296.
In 1304, it was granted by that prince to Adomar de Va¬
lence, the warden of Scotland, and his heirs. The edi¬
tors of the Encyclopaedia Britannica are of opinion that
it was a royal refidence fo late as the time of James I.
(1430.) and that here he compofed his poem of “ Peebles
at the Play.” When it became a royal burgh, with fpe-

Vol. XIX. No. 1317.

PEE 403

cial privileges, is uncertain ; but it is known to have
fent two reprefentatives to the parliament called in 1357
to ratify and provide the ranfom of David II. This mo¬
narch afterwards granted Peebles a charter, dated Sep¬
tember 20, 1367, in which it is ftyled a royal burgh ; and
the fame was fubfequently confirmed by king James II.
and king James VI. with additional privileges. By vir¬
tue of thefe charters, the corporation of the town now
confiftsof feventeen members, a provoft, two baillies, a
dean of guild, a treafurer, eleven counfellers, and one
deacon. Its revenue is very confiderable, rnoft of the
lands in the vicinity being the property of the public.
Thefe lands were granted to the borough in the year 1560,
in confideration of “the loyalty, fidelity, and good fer-
vices,” of the inhabitants. This burgh, in conjunction
with Lanark, Linlithgow, and Selkirk, fends one mem¬
ber to parliament. Patron, or nominee, the duke of
Buccleugh.

The town of Peebles was much more extenfive formerly
than at prefent, and occupied a fome what different fcite,
extending from Eddleftone Water weftward, to the Mea-
dow-well-ftrand. Of its buildings at this period little is
known ; but they were probably of a comparatively fupe-
rior caft, as many of the houfes were occupied by the no¬
bility attending the court, when the monarch refided in
the caftle. Peebles in fact was to Edinburgh what Windfor
now is with refpeft to London. Previous to the reforma¬
tion it had threechurches, befides feveral chapels. The
High-church, which was dedicated to the Virgin Mary, is
fuppofed to have been ereftedin the eleventh century, on
the fcite of fome more ancient fabric. Its ruins ftill re¬
main at the weftern extremity of the old town. This
church was deftroyed at the time of the reformation ;
when the Crofs-church was converted into the parochial
place of worlhip j and continued to be fuch till the pre¬
fent handfome ilrufture was ereCted in 1784. Peebles ap¬
pears to have been ftrongly fortified both by nature and
by art. Over the Tweed is an ancient bridge of five
arches 5 and there are two fmaller ones over the Eddle¬
ftone, to conneft the new town with the old. The chief
fupport of the town is its manufacture of carpets, ferges,
and linen and cotton cloths ; but it is likewife much in¬
debted to its market whicli has been long celebrated for
oatmeal. The market day is on Tuefday, weekly; and
there are befides feven annual fairs.

The chief remains of antiquity in Peebles, are the
ruins of the Crofs-church, and of that which was dedi¬
cated to St. Andrew'. The former was part of the con¬
ventual church of a monaftery founded, according to
Boecius, Major, and others, by king Alexander III.
Some fay it was erefted on the fpot where the relics of St.
Nicholas the Martyr were difcovered in 1261, an event
which is particularly noticed by Fordun. This con¬
vent was filled with Red or Trinitarian friars, which or¬
der was inftituted for the redemption of Chriftian flaves
from the Turks; a third part of their annual income be¬
ing appropriated to that purpofe. Its buildings coniti-
tuted a fquare, having the church on the fouthern fide.
This edifice meafured 102 feet in length, and 32 in width,
and was, as well as the houfes and cloifters, entirely built
with whin-ftone, except the angles, doors, windows, cor¬
nices, See. which were of a white free-ftone. After the
fuppreffion, the convent was fuffered gradually to go to
decay; but part of the church, as already mentioned, was
fitted up for divine fervice, and the remainder was walled
off and converted into a public fchool. In this ftate it
remained till the building of the new church, when the
interior was ftripped of its feats and furniture, but the
walls, by a praifeworthy aft of council, were ordered to
be protefted, as a venerable moR>ument of ancient art.

The church of St. Andrew iso? greater antiquity than
the Crofs-church. The exaft period of its conftruftion
is not recorded ; but, as it is ftated to have been confe-
crated by Jofceline bilhop of Glafgow, who died A. D.
1199, its date giay be fixed a few years previous to that
6 C event.

PEEBLES. SHIRE.

464

event. Judging from its remains, it feems to have been a
large and capacious llrufture ; and is certainly of great
age, as all its doors and windows difplay femi-circular
arches, or at leaft fome fegment of a circle. This church
was the molt ancient parilh-church in Peebles. After it
loll that rank, in favour of the Crofs-church, it was al¬
lowed to fall into ruin. A party of Cromwell’s foldiers
ufed it for fome time as a liable, and at their departure
demolilhed the roof. The only portions of this ftru&ure
now Handing are the fquare tower, and fome fragments
of the fide walls. The church-yard is Hill ufed as a bu¬
rial ground. Of the royal caltle of Peebles 'no veltiges
can be traced, but its fcite yet retains the name of Caf-
tle-hill.

In the year 1793, the population amounted to 1480 in¬
habitants 5 but, according to the parliamentary returns
of 1801, the burgh and parilh contained 397 houfes, and
2088 inhabitants; in 1811, the returns were, 422 houfes,
and 2485 perfons ; in 1821, 2701 fouls.

PEE'BLES-SHIRE, or Tweedale, one of thefouthern
counties of Scotland, is fituated between 55.25. and 55.
50. of N. latitude, and from 2. 58. to 3. 34. of W. longi¬
tude from Greenwich. It is bounded on the fouth by
Dumfrieslhire, on the north and north-ealf by Edinburgh-
Ihire, on the weft by Lanarklhire, and on the eaft by the
county of Selkirk. According to Armftrong’s map, it
meafures in length from north to fouth about 28 miles,
and varies in breadth from xo to 18 miles 5 the mean
length being 27 miles, and the average breadth 135. Of
confequence, the fuperficial area ought to be 364 fquare
miles, and its content 232,960 Englilh acres ; but from
a minute calculation, made by Mr. Chalmers, the real
fuperlicies is eftimated at 338 fquare miles, or 216,320
acres ; of which about 20,000 area are arable, or under
tillage. According to the parliamentary returns of 1811,
this fhire contained 1820 houfes, and 9935 inhabitants ;
in 1821, the number was increafed to 10,046.

Tweedale, when viewed from a diftance, feems to form
one continued chain of mountains, and may perhaps be
generally defcribed as a mountainous country. Upon a
narrow inveftigation, however, it is found to poffefs many
rich and fertile valleys, or ftraths of arable land, lying
along the banks of its numerous rivers. Of thefe the
dale of the Tweed is the principal, interfering the cen¬
tre of the county throughout its whole extent. Hence
many vales branch off, following the channels of the
feveral ftreams which increafe that majeftic river. The
mod confiderable and the moll fruitful are the valleys of
the Lyne and Eddleftone waters. In general, the dales
and the dingles are molt ferule, and the hills moft pleafant,
in the north and weft divifions of the county; while, in
the fouth and eaft, the vales are more barren, and the hills
more bleak.

The furface of the land rifes on both fides of the great
central valley of the Tweed, to a very confiderable eleva¬
tion. The higheft hills are fituated towards the extremi¬
ties of the county ; and, indeed, thofe bordering on An-
nandale are the loftieft in fouthern Scotland. On the
boundary with Selkirklhire, Blackhoufe-hills meafure
2360 feet in height above the level of the German Ocean,
and Seamed Law, about two miles further to the north,
mounts to 2120 feet above the fame level. Minchmoor,
on the fouth-eaft of Peebles-fliire, rifes 2285 feet; and
Windleftraw Law, on thenorth-eaft of the county, 2295
feet above the fea. In the parilh of Manor are two very
high hills, called Scrape and Dollarburn, the latter of
which is calculated to reach an elevation of 2840 feet.
Cardon, or Cadow-hill, in the parilh of Kilbucko, is about
1400 feet above the level of the Tw'eed, or 2200 feet
above the level of the ocean. This is the higheft hill on
the weftern fide of the .nire, but there are many others
very little inferior in altitude. In the parilh of Kirkurd
is a hill called Hell’s Cleugh, the fummit of which is
diftinguilhed by a fmall cairn, called the Pykedftane,
whence is a view of the country beyond the Forth, and

of a chain of hills ftretching from the eaft part of Fife,
as far as Dumbartonlhire. South of the Forth, the view
extends as far eaft as North Berwick, likewife to the
Eildon hills, near Melrofe, and Cheviot hills in Nor¬
thumberland. Dundreigh, or Druids’ hill, in the parilh
of Eddlefton, alfo commands a moft extenfive and diver-
fified profpedl over Teviotdale, Annandale, Clydefdale,
Perthlliire, Fifelhire, and the three Lothians. This hill
is computed to rife 2100 feet above the level of the ocean.
Near the fource of the Tweed the hills are in general
extremely beautiful, being covered with grafs\ to their
very fummits : fome of them are of a great height, parti¬
cularly Hartfield and Broadlaw. which are ftated to reach
the altitude of 2800 feet from the level of the Forth.
Between Minchmoor and Hinderland the hills are more
black, craggy, and precipitous, than in any other diftrift
of the county, and are frequently interfered by deep
and tremendous chafms. One of thefe openings, called
Grimfcleugh, is upwards of half amile in length, and not
lefs than 300 feet in depth.

The rivers of this 'county are numerous; but all of
them, with the exception of the Megget and the North
and South Efks, difeharge their waters into the Tweed as
the common receiver. This celebrated river, whence the
familiarname of the (hire is derived, has its fource on the
mountainous ridge which feparates Tweedale from An¬
nandale, and can boaft of giving rife to the three firft
rivers in the fouth of Scotland : the Annan, which flows
fouthwards into the Sol way-frith ; the Clyde, which
runs north-weft into the Clyde-frith; and the Tweed,
which direfts its courfe to the German ocean at Berwick.
The laft-mentioned river flows above forty miles within
the county, in a curvilinear and ferpentine dire£tion, di¬
viding it nearly into two equal parts. Its current, par¬
ticularly in that part of its courfe above Peebles, during
which it defeends from a height of 1550 feet is extremely
rapid, as indeed are all the ftreams in the county. The
Tweed is the longed river in Scotland, the diftance from
its fource to its confluence with the ocean being upwards
of 100 miles. It abounds with falmon, as well as with
trout. Among the rivers which fall into it belonging to
Peebles-fliire, the moft confiderable are the Lyne, the Ed¬
dlefton, and the Leithen, on the north ; and the Manor
and theQuairon the fouth. The Lynerifes in the north¬
ern confines of the county, at a place called Cauldftane-
flap ; and after a courfe of twenty-one miles, reaches the
Tweed three miles above Peebles. Eddleftone- water
has its fource from King-Seat-Hill, in Eddleftone parilh,
and joins the Tweed at the county-town. Leithen wa¬
ter runs a courfe of twelve miles from Water-Head to
about a mile below Inverleithen church, which derives
its Celtic name from that influx, or inver. Manor-ftream
originates at Foulbrig, in the fouthern end of Manor
parilh, through which it runs a courfe of twelve miles;
and which it drains, as it courfes, with other ftreamlets,
to the common channel. The Quair iflues from a fpring
at Glendean banks, and, after watering the magnificent
pleafure grounds, falls into the Tweed near the noble feat
of Traquair.

The lakes in Peebles-fliire are neither numerous nor
extenfive. The moft confiderable of them, the Water-
loch in Eddleftone parilh, fcarcely exceeds three quarters
of a mile in length, and half a mile in breadth. It is,
however, a very beautiful Iheet of water, and gives birth
to the South Elk, which falls into the river Forth, along
with the North Elk, at Muflelburgh, in Mid Lothian.
The other lakes within the county are Gamelhope-loch,
and Slipperfield-loch ; the former of which occupies an
uninhabited glen in Tweedftnuir parilh, and is emptied
by Gamelhope rivulet, one of the fources of the Talla-
water. St. Mary loch, though it bounds this county for
more than a mile, and is hence claimed by fome Peebles-
fliire topographers, is, properly fpeaking, a Selkirklhire
lake, as it extends feveral miles into that county. The
Megget poursuts waters into this lake, whence they pafs

on

P E E B L E

on to the Yarrow and the Ettrick, two of the moft cele¬
brated rivers in Scottifh fong.

Peebles-fliire, as the mountainous nature of its furface
would promife, is fertile in minerals. If credit may be
given to our ancient hiftorians, Boece and Buchanan,
gold was formerly found in Glen-Gaber water, which
traverfes the parifh of Megget. In Lead-Law, a hill above
Linton, feveral lead-mines were formerly wrought, which
alfo produced a confiderable fupply of filver. The finks
of thefe mines are ftill apparent, and are diftinguifhed by
the appropriate name of Silver-holes. About fixty years
ago they were again tried, but the attempt proved un-
fuccefsful ; the quantity of ore obtained being fcarcely
adequate to defray the expences of the work. In Tra-
quair parifh feveral attempts have been made to difcover
lead-veins, and much ore has been found, but not fuffi-
ciently rich in filver to induce any adventurer to open
mines. A fpecimen of galena-ore was difcovered, a few
years ago, in one of the ftreams that fall into the Quair.
Coal is plentiful, particularly in the north-eaftern diftridt
of jhe county, where limeftone is alfo equally abundant.
The prevailing 'under-flratum in the'county is whinftone,
but there are likewife numerous quarries of white and
red freeftone in different parifhes. The Hate-quarries
here have long been celebrated. In Tramore hill, with¬
in Stobo parifh, are two feams of excellent blue flate,
which has been manufactured for various purpofes during
feveral years. In the lands of Lamancha there is a vaft
variety of clays, and in particular a very thick bed of fire
clay, like the Stourbridge clay. In the fame lands are
many veins of iron ore ; one of them is entirely grain ore,
and the remainder is mixed with the fame ore. Manga-
nefe is alfo found here, both by itfelf and incorporated
with the iron ores; and there are likewife here fotne
maffes or beds of iron-ftone, but there are no iron-works
yet effablifhed. White marble, according to Pennycuick,
was formerly dug up at Whitfield, in Linton parifli.

Several mineral fprings are found within Peebles-fhire,
but none of them are particularly diftinguifhed. North
from the village of Linton is a fpring, called “Heaven-
aqua water,” which bears fome affinity to that at Ton-
bridge. Another fpring, fimilar to the Harrowgate
waters, appears in the parifli of Inverleithen. There is
alfo a copious fulphureous well in the parifh ofKirkurd.
At Lamancha, in Newland parifli, is a chalybeate fpring,
called the “ Vertue Weil,” which contains a large quan¬
tity of fixed air, that holds the iron in folution.

Peebles-fliire, like every other county in Scotland, is
fubjeCfed to the jurifdiftion of a lord lieutenant, and a
fheriff depute, the latter of whom nominates a fubftitute
to hold courts in his abfence. When it was firft elevated
to the rank of a flieriffdom is not precifely fixed by record;
but we find mention of two ftieriffs in Tweedale, one in
Traquair, and the other at Peebles, about the year 1184.
Thefe two fherift'wics merged into one before the clofe of
the fourteenth century, under the title of the latter, and
have remained in the fame condition ever fince. The
earls of March were hereditary ftieriffs of Tweedale,
which beftows the title of viarquis on a branch of the an¬
cient houfe of Hay, earls of Errol, and hereditary high
conftables of Scotland. In the fliire of Tweedale there
are many ancient and honourable families of the gentry.
Among thefe, Douglas of Cavers, who was hereditary
fheriff of the county, ftill preferves the ftandard and the
iron mace of the gallant lord Douglas, who fell in the
battle of Otterburn, juft as his troops had defeated and
taken Henry Percy, furnamed Hotfpur .

The parishes within this fliire are fixteen in number;
and befides the royal burgh of Peebles, there are five very
confiderable villages that have markets and annual fairs for
ftieep, horfes, and cows : thefe are, Linton, Eddlefton,
Skirling, Broughton, and Inverleithen. The improvement
in roads within the lafl fifty years has been very great in
this county. . The public roads indeed are excellent.
One from Edinburgh towards Moffatt traverfes the whole

S - S H 1 R E. 465

length of the fliire, from north-eaft to fouth-weft. Ano¬
ther traverfes it in like manner from weft to eaft, from
Biggar, by Peebles and Inverleithen, towards Gallafhiels
and Kelfo. This road affords the means of conveying
towards Glafgow all the fuperfluous grain of this diftri£h
A road alfo runs from Inverleithen towards Middleton,
which fupplies a great part of Peebles-fliire with coal.
It was made in 1794, and fliortened the line of commu¬
nication no lefs than fourteen miles.

Tweedale cannot be called a manufacturing county ;
for, though a confiderable quantity of linen is made by
the inhabitants, none of it comes to fale, the whole being
confumed by their own families. Woollen and cotton
weavers, however, are faid to be increafing about Peebles
and its vicinity ; where are likewife a few flocking looms.
A woollen manufactory has been lately eftablifhed at
Inverleithen, which from its congenial fituation is calcu¬
lated to flourifh. It is furprifing that no woollen manu¬
factory has hitherto been fixed at Linton, confidering its
favourable pofition on the turnpike road to Edinburgh,
and the numerous advantages it poffeffes with refpeCt to
coal, lime, freeftone, water, and fheep- walks.

The remains of antiquity in Peebles-fliire are at once
numerous and various. Traces of the ancient Britons
can ftill be difcovered here in the names of places; as
alfo in their religious, fepulchral, and military, monu¬
ments. At Hairltanes, in Kirkurd parifh, are the re¬
mains of a Druid temple, confiding of a number of large
ftones ftanding in a circular form. Another curious
druidical temple is fituated on the remarkable peninfula
called Sherift'muir. From each of two ftanding ftones
there run out to the eaft, in a curvature, two rows of
fmaller ftones, which alfo ftand upright. A third monu¬
ment of a fimilar kind is feen near Tweedftnuir church,
and a fourth, fmaller one, on the borders between Peebles
and Selkirk. Several tumuli or barrows are fpread over
Kirkurd, Glenholm, and Linton, parifhes. In a cairn
upon King’s Muir, in Peebles parifli, were lately difco¬
vered an inverted urn, containing the allies of fome Bri-
tifli warrior, with the blade of his dagger. In Eddlefton
parifli, near the Ship-Law, there is a barrow called the
“ Ship-horns,” becaufe refembling the inverted hull of a
fliip. A number of fepulchral cairns are alfo difcovered
in the vale of the Tweed, and on Sheriffmuir. Thefe,
however, all yield in intereft to the grave of Merlin,
which is pointed out under a thorn-tree, near the influx
of the Powfail, or Panfel, with the Tweed. In that fa-
cred fpot, according to tradition, lie the remains of the
prophet, to whom fo many wonderful feats and predic¬
tions are attributed in the writings of the ancient bards.
There was an old traditional prophecy, that the two
kingdoms fliould be united when the waters of the Tweed
and the Panfel fliould meet at his grave. Accordingly,
the country people obferve that this meeting happened in
confequence of an inundation at the acceffion of James
VI. to the crown of England.

In Peebles-fliire there are many hill-forts, undoubtedly
of Britifti conftru&ion, and feveral ftanding ftones, fup-
pofed to be memorials of battles. The forts are gene¬
rally of a circular fiiape, but fometimes deviate from that
figure to fuit the fummit, or the ground whereon they
are plap.ed. On the hill called Cademuir are four Britifli
encampments, one of which is furrounded by a rampart
of ftones without cement. This rampart is in fome
places double; but in other parts it is Angle, and of pro¬
digious thicknefs. Janet’s Bray, in Peebles parifli, is alfo
diftinguifhed by tvvo entrenchments, which are each fur-
rounded by a fingle ditch and vallum. In the fame pa-
rifh are feveral other fimilar works ; particularly one on
the fummit of Meldum, another on the hill above
Hutchin field, a third near Hayfton Craig, a fourth on
the hill above Wham, and a fifth on the hill called Ew-
hill-rig. On a height near Inverleithen, are the remains
of a Britifli fortrefs, which appears to have had three ram¬
parts and ditches. The other principal Britifli military

works.

PEE

466

works, are at Milkington-Rings, and North-Shield-Rings,
in the parifh of Eddlefton ; on Terrace-hill, in Newlands
parilh ; on the rifing ground above Linton, and on the
top of Lead-Law. Befides thefe, however, there are nu¬
merous others which our limits will not permit us to
particularize.

The Romans, who were unqueftionably the fird people
that encroached upon the Britifli aborigines, have left
few traces of their refidence here, and thofe few are con¬
fined to military polls or encampments. Of thefe the
principal one is fituated on the eaftern fide of the Lyne,
about ten miles to the eadward of the Watling-dreet,
which traverfes the country within half a mile of the
weltern extremity of the fhire. This entrenchment is
called by the common people Randal’s Walls, from a
tradition that Randolph, earl of Murray, had a houfe
within its area. According to Armdrong it contains fix
acres and two roods of ground, which has been frequent¬
ly ploughed, when many Roman coins have been turned
up. Another Roman encampment is fituated on the
northern fide of Upper Whitfield, in the parilh of Linton.
It is in the form of a parallelogram, and is furrounded by
a fingle fofle and rampart, which are now nearly oblite¬
rated. A third entrenchment, in the parilh of Manor,
is alfo generally reprefented to be of Roman conftru&ion.

Amongll the other antiquities of this county, the mod
prominent are its terraces and caltles. RefpeCting the
origin and ufes of the former, much difficulty prevails ;
indeed ail that has been advanced concerning them is
merely conjectural. The opinion of Chalmers, however,
that they were intended for the accommodation of large
bodies of fpeClators to witnefs fome fport, carries with
it confiderable plaufibility ; and it likewifefeems probable
that feveral of them were fubfequently appropriated for
the adminiftration of judice. Of fuch works the molt
confiderable are thofe fin a beautiful green mount, called
Terrace-hill, above Newlands. Along the whoje face of
this hill there are eleven or twelve terraces, from fifteen
to twenty feet broad, which rife by a regular gradation
to the top. About half a mile to the north is another
eminence, called Moot-hill, which has likewife feveral
tiers or terraces. Similar terraces are to be feen at Kir-
kurd, at Skirling, and at Smithfield.

The remains of the caffes and fortified towers of this
county, are principally feated on the banks of the T weed,
and alternately on both fides of that river, and in fight of
each other, as happens in Selkirkfliire and Berwicklhire.
The object of this arrangement was the defence of the
country from the incurfions of the border-chiefs. On
the approach of an enemy, a fire was immediately lighted
on the top of the neared caftle, and thus notice of the
aggrefiion was fpread over a didriCt of at lead feventy
miles in length in the courfe of a few hours. Thefe
caftles were built of ftone and lime, ufually in a turreted
form, and for the mod part occupied an eminence of
difficult accefs. Thofe fituated within ten miles above
and below Peebles were at lead twenty-fix in number,
and much refembled each other,' except in the circum-
dance of greater or lefs magnitude. At Traquair the
Scottifh kings had a cadle in the twelfth century, where
they occafionally refided for the purpofe of hunting in
the fared. This cadle is now completely demolifhed, as
well as that at Peebles, which is likewife faid to have
been a royal refidence. On Woodhill are fome remains
of an ancient building, which is called Macbeth’s Cadle;
and in Broughton parifli is another, bearing the fame
name, which is traditionally faid to have belonged to
the celebrated Macbeth. The remains of Oliver-cadle,
the feat of the Frafers, are feen in Tweedfmuir paridi;
and on Fruid-water are the remains of Fruid-cadle, ano¬
ther baronial manfion, which alfo belonged to that
powerful family. Drummelzier-cadle is fituated clofe to
the river Tweed, and about a mile from it is Thanes-cadle,
or Tinnis-cadle, formerly occupied as a fort of redoubt
by theTweedies, the lords of Drummelzier. But thefe,

PEE

and indeed almod all the ancient cadles in this (hire, are
completely ruinous, with the exception of that of Nied-
path, in the vicinity of Peebles, which, being of vad
drength, dill continues in tolerable prefervation, and
confequently ad'ords an excellent fpecimen of fimilar
building. This cadle dands on a rock, projecting over
the north bank of the Tweed, which here runs through
a deep narrow glen well wooded on both fides. Towards
the land it commands an important pafs. The walls are
eleven feet in thicknefs, and cemented with lime almod
as hard as the drong whindone of which they are built.
Niedpath was anciently the chief refidence of the Frafers
above mentioned, and was mod probably the birth-place
of the brave fir Simon Frafer, the lad of the family in the
male line, who, in 1303, with only 16,000 men, repulfed
and defeated the Englilh, 30,000 drong, in three fuccef-
five battles, fought in one day on Roflyn-moor. In the
reign of Charles I. it was garrifoned for the king, and
held out againd Cromwell longer than anyplace in Scot¬
land fouth of the Forth. The fituation of this cadle is
extremely beautiful and commanding. Pennycuick, who
faj's it was of old called the “ Cadle of Peebles,” cele¬
brated it thus :

The noble Nidpath, Peebles overlooks

With its fair bridge and Tweed’s meand’ring brooks,

Upon a rock it proud and dately dands,

And to the fields about gives forth commands.

PEE'CE, or Piece, f [ piega , Span, a room.] Any
work of architecture or machinery. This ufage has been
partly revived of late in the word time-piece. To what
other parts of this extenfive definition it once applied,
the following enumeration will fliow. Mafon. — A capital
city :

Yet is Cleopolis for earthly frame

The faired peece that eye beholden can. Spenfer.

A. fortified cadle :

And evermore their wicked capitayn
Provoked them the breaches to aflay,

Sometimes with threats, fometimes with hope of gayn.
Which by the ranfack of that peece they fliould attayn.

Spenfer.

A fliip :

The wondred Argo, which in venturous peece

Fird through the Euxine feas boreall the flow’r of Greece.

Spenfer.

A tower that ferved for a movable battery :

Such hap befell that tower; for on that fide
Gaind which the Pagans force and batt’ry bend
Two wheels were broke, whereon the piece fliould ride ;
The maimed engine could no further wend. Fairfax.

A building. — He is an ill-defigned piece, built after the
rudic order, and all his parts look too big for their
height. Butler's Characters.

Yet dill he bet and bound upon the dore.

And thund’red flrokes thereon fo hideouflie.

That all th a peece he fliaked from the flore,

And filled all the houfe with fear and great uprore. Sp.

PEED, aclj. Blind of one eye. Ray. See To Pee.
PEE'ING-GHPE, a town of the Birman empire, fitu¬
ated on the Irawaddy, from which a great quantity of
teak-timber is carried to Rangoon. 1 he forefls extend
along on the wedern mountains; the trees aie felled in
the dry feafon, and when the monfoon fets in are borne
by the torrents to this town and Sahlahdam, a little above
it. Peeing-ghie is about twenty miles north-wed of
Mayadoun.

PEEK’S HILL, a fmall pod-town of America, in Wed-
Cheder county, New York, on the ead fide of Hudfon
river, and north fide of the creek of its name, five miles
from its mouth : fifty miles north of New York.

2 To

E L,

4(37

P E

To PEEL, v. a. [peler, Fr. from pellis, Lat. the fkin.]
To decorticate; to hay :

The fkilful (hepherd peel'd me certain wands;

And thick them up before the fuifome ewes. Shahefpeare.

From piller, Fr. to rob. — To plunder. According to
analogy this (hould be written pill ; and it is ufually fo
written by our old authors. — Go, ye fvvift meffengers, to
a nation Scattered and peeled. Ifaiah xviii. z.

Lord-like at eafe, with arbitrary pow’r,

To peel the chiefs, the people to devour ;

Thel'e, traitor, are thy talents. Dryden.

PEEL, /, [phi, old Fr. pellis, Lat.] The (kin or thin
rind of any thing.

PEEL, f. [pelle, Fr.] A broad thin board with a long
handle, ufed by bakers to put their bread in and out
of the oven. — A notable hot baker ’twas when he plied
the peel. B. Jonfon's Bartliol. Fair.

PEEL, a fmall fea-port town, fituated on the weftern
coaft of the I(le of Man, in the Irifh channel, was for¬
merly denominated Holme Peel ; and appears, from its
remains, to have been a place of confiderable importance
in the times of Mankifh independence. The annexation
of Man to the Britifh crown, and the fubfequent deftruc-
tion of the fmuggling-trade, however, have reduced it
greatly. The harbour, indeed, is now alinoft entirely
negle&ed, notwithftanding it is an excellent refort for
(hipping ; and the pier is completely deftroyed. In (hort,
this town offers to the prefent traveller an appearance of
decayed grandeur; and is confequently more an objeft
of intereil and curiofity than inviting as a place of refi-
dence, for the man of bufinefs or of pleafure. Woods,
in his Account of the Ifle of Man, computes the popu¬
lation of Peel at about twelve hundred perfons. The
only church in the town, now ufed for divine fervice, is
that dedicated to St. Peter; but there are befides the
ruins of other two, dedicated to St. Patrick and St. Ger¬
main. Thefe (land within the caftle, on a fmall rocky
ifland, which is feparated from the weftern extremity of
the town by a narrow channel, fcarcely a foot deep at
low water. This ifland and caftle are connected with
the mainland by a ftrong wall, (helving to the top, which
was built many years ago to fecure the harbour. The
entrance is on the eaftern fide, by a flight of fteps now fo
ruinous as to be dangerous of accefs. The walls of this
fortrefs meafure about four feet in thicknefs, and are
flanked with towers ; the whole inclofing a (pace of
fomewhat more than two acres of ground.

This caftle is faid to be haunted by feveral apparitions;
among which is that of Eleanor, wife to Humphrey duke
of Gloucefter, uncle to Henry the Sixth. She was con¬
fined and died here, and her ghoft has ever fince been
nightly heard to afeend a (tone (taircafe, leading to a
little houfe upon the wall. Waldron, an old Mankifii
writer, tells the following curious (lory of an apparition
in the fhape of a dog. “ They fay that an apparition,
called in their language the maiithe doog, in the (hape of
a large black fpaniel, with curled (baggy hair, was ufed
to haunt Peel-caftle ; and has been frequently feen in
every room, but particularly in the guard-chamber,
where, as foon as the candles were lighted, it came and
lay down before the fire, in prefence of all the foldiers,
who at length, by being fo much accuftomed to the fight
of it, loft great part of the terror they were feized with at
its firft appearance. They (till however retained a certain
awe, believing it to be an evil fpirit which waited to do
them hurt ; and for that reafon forbore fwearing and all
profane difeourfe while in its company. But, though
they endured the (hockiof fucha gueft when all together,
none cared to be left alone with it. It being the cuftom,
therefore, for one of the foldiers to lock the gates of the
caftle at a certain hour, and carry the keys to the cap¬
tain, to whofe apartment the way led through a church,
they agreed among themfelves, that whoever was to fuc-

Vol. XIX. No. 1317.

ceed, the enfuing night, his fellow on this errand, (liould
accompany him that went firft, and by this means no
man would be expofed fingly to the danger; for the
maiithe doog was always feen to come out from that paf-
fage at the clofe of day, and return to it as foon as the
morning dawned, which made them look upon this place
as its peculiar relidence. One night, a fellow being
drunk, and thus rendered more daring than ordinary,
laughed at the (implicity of his companions ; and, though
it was not his turn to go with the keys, would needs take
that office to teftify his courage. All the foldiers en¬
deavoured to difluade him ; but the more they faid the
more refolute he feeined, and fwore that he defired no¬
thing more than that the maiithe doog would follow him
as it had done the others ; for he would try whether it
was dog or devil. After having talked in a very repro¬
bate manner for fome time, he (hatched up the keys, and
went out of the guard-room. In fome time after his de¬
parture a noife was heard ; but nobody had the boldnefs
to fee what occafioned it, till, the adventurer returning,
they demanded the knowledge of him ; but, loud and
noify as he had been at leaving them, he was now become
fober and Client enough ; for he was never heard to
fpeak more: and though all the time he lived, which
was three days, he was entreated by all who came near
him either to fpeak, or, if he could not do that, to make
fome fign by which they might underftand what had hap¬
pened to him, yet nothing intelligible could be got from
him, only that by the diftortionof his limbs and features,
it might be gueffed that he died in; agonies, greater than
is common in a natural death. The maiithe doog was
however never feen afterwards, nor would any one at¬
tempt to go through that paflage ; for which reafon it
was clofed up, and another way made. This accident I
heard attelled by feveral, but efpecially by an old foldier
who affured me that he had feen the maiithe doogoftener
than he had hairs on his head.” Walter Scott alludes
to this tale in the following lines of his Lay of the Laft
Minftrel :

But none of all the aftonifli’d train

Were fo difmay’d as Doloraine :

His blood did freeze, his brain did burn,

’Twas fear’d his mind would ne’er return :

For he was fpeechlefs, ghaftly, wan,

Like him of whom the ltory ran,

That fpoke the fpe&re-houndin b/lan''

Before the fale of the royalty of Man to the Britifli go¬
vernment, a garrifon of troops, in the pay of the lord of
the ifland, was ftationed here; but fince that event the
caftle has been altogether neglefted, and the entire area
is occupied by the ruins of various buildings, walls, and
dwelling-houfes. About the centre of it is a fquare py-
rarnidical mound of earth, terminating obtufely, and
having each of its fides direfted to one of the cardinal
points. This tumulus is furrounded by a ditch five feet
and a half broad ; and is fuppofed either to have been an
eminence whence an officer might harangue his troops,
or the burial-place of fome great perfonage. Near this
mound Hand the ruined churches above mentioned, both
of which are of confiderable antiquity. Patrick’s, how¬
ever, is by far the older of the two, and is probably of
earlier date than the era of the Norman conqueft. St.
Germain’s was built about the year 1245, and is the ca¬
thedral of the ifland, but has not, for many years, been
ufed for any other purpofe than a burying-place. Its di-
menfions are feventy-fix feet by twenty; and beneath
one part of it is the ecclefiaftical prifon or dungeon,
where Inch perfons were confined as were fo unfortunate
as to incur the fpiritual cenfure. The length of this
vault is thirty-four feet, and its breadth fixteen. The
bottom is of earth, and at one corner are the remains of
an uncovered well, which muff: have rendered the place
damp in the extreme. The only light or air is admitted
through a fmall hole in the wall.

6 D

Three

468

PEE

Three miles from Peel is Tinwald Mount, where the
Manks parliaments and great councils were convened,
and where alfo the fuperior courts held judicial proceed¬
ings at Hated periods. It is an artificial eminence of
very lingular appearance, and of unknown antiquity.
According to fome etymologifts, its name is a com¬
pound of the Danifh word tin or ting, fignifying an a f-
fembly or meeting, and wald, a field or fenced place.
Modern authors, however, derive it from the Britilh
words tyng and val, fignifying “The Juridical Hill.”
The approach to the fummit of this mount is by a flight
of turf fteps on the eaftern'lide : the diameter at the top
is about feven feet, and three feet below it is an annular
plot four feet wide, which is fucceeded by another fix
feet broad, and this by a third ftill wider. The circum¬
ference of the outer circle is nearly eighty yards; all the
angles are rounded, and almoft the whole furface is of
turf.

At a fliort diftance from the Tinwald is a fmall chapel
dedicated to St. John, rebuilt about fourteen years ago,
after the model of the former chapel, which had fallen
completely to ruin. But it has no pews, never being
tiled for divine fervice except on the day of the promul¬
gation of the laws. Woods's IJle of Man , p. 151-162.

PEEL OF FOU'DREY, a little illand near the illand of
Walney and the town of Dalton in Lancalhire. Here
Hand the remains of an ancient caftle; concerning the
foundation, ufe, and diffolution, of which, there are no
records extant: all is conjecture. It appears to have been
a ftrong fortification, and furrounded by two ditches ;
the walls are how as firm as the folid rock; it may be
feen at many miles difiance on the fea, and ufed to be a
good land-mark till a light-houfe was lately erefted on
the fouth end of the illand of Walney. The port of Peel
of Foudrey is very large and commodious, and would
float a large man-of-war at low water. Upon the main
land, oppofite the illand, is fituate Rampfide, a molt de¬
lightful village, and excellent place for lea-bathing.
Willies' s Britijh Directory, vol. v.

PEE'LAS, a fmall illand in the Sooloo archipelago.
Lat. 6. 32. N. Ion. 121. 45. E.

PEELE (George), a dramatic writer who flourilhed in
the reign of queen Elizabeth, was a native of Devonlhire.
He became a Undent of Chrifi-Church college, Oxford,
about the year 1573, and was admitted M. A. in 1579.
After this he removed to London, where he became
the city-poet", and had the ordering of the pageants.
He lived on the Bank Side, over againft Black Friars ;
and maintained the eftimation in his poetical capacity
which he had acquired at the univerfity, and which feems
to have been of no inconfiderable rank. He was a good
pafioral poet; and Wood informs us, that “his plays
were not only often ailed with great applaufe in his life¬
time, but did alfo endure reading, with due commenda¬
tion, many years after his death.” The titles of the
plays written by this author, of which five’ only are
known, are, i.The Arraignment of Paris, 1584. a. Ed¬
ward the Firft, 1 593. 3. The Old Wives’ Tale, 3 comedy,
1595. 4. The Love of King David and Fair Bethfabe, a

tragedy, 1599. 5. The Turkilh Mahomet and Hirers the

Faire Greek. Wood and Winftanley, mifguided by
former catalogues, have attributed to him another trage¬
dy, entitled, Alphonfus, Emperor of Germany. But this,
Langbaine afi’ures 11s, was written by Chapman, he him-
lelf having the play in his pofleflion, with that author’s
name to it.

About the year 1593, Peele feems to have been taken
into the patronage of the earl of Northumberland, to
whom he dedicated, in that year, “The Honour of the
Garter, a Poem Gratulatorie ; the Firftling confecrated
to his noble name.” He was almofi as famous for his
tricks and merry pranks as Scoggan, Skelton, or Dick
Tarleton ; and, as there are books of theirs in print, fo
there is one of his, called “ Merrie conceited Jells of
George Peele, Gent, fome time Student in Oxford ; where-

P E E

in is fhewed the Courfe of his Life, how he lived, &c. 410.
1627.” Thefe jells, as they are called, might with more
propriety be termed the tricks of a lharper. Peele died
before the year 1598. Meres, in his Wit’s Treafury, p.
286, fays, “,As Anacreon died by the pot, fo George Peele
by the pox.” Oldys fays, he left behind him a wife and
a daughter. He feems to have been a perfon of a very ir¬
regular life; and Mr. Stevens, with great probability,
fuppofes that the character of George Pieboard, in The
Puritan, was defigned as a reprefentative of George Peele.
An extradl, with fome remarks on Peele and his Merrie
conceited Jells, will be found in the lalt number of the
Gent. Mag. for 1820. and the account there given agrees
in the main with what we have extrailed above from the
Biographia Dramatica.

PEE'LER, /’. One who ftrips or flays. — A robber; a
plunderer. — As ’tis a peeler of land, fow it upon lands that
are rank. Mortimer.

Yet otes with her fucking a peeler is found,

Both ill to the maillerand worfe to fome ground. Tuffer.

PEE'LING,_y’. The outward rind, that which is peeled
off.

PEE'LING, a town on the north part of New Hamp-
fhire : eighty miles north-weft of Portfmouth.

PEEM, a town of the duchy of Holftein : nine miles
weft of Huytyn.

PEEMDAHAT'TA, a town of Hindooftan, in the
circar of Ruttunpour : twenty-five miles north-north-eall
of Dumdah.

PEENANG', Pinang, or Pu'lo Pinang. See Prince
of Wales’s Island.

PEE'NDA,./. A cake prefented at the Hindoo temples
as an offering on account of the dead: which ceremony
is performed on the days of the new and full moon.
Roberts's Indian Gloffary.

PEENE, a river of France, which joins the Yperlee at
Fort Kenoque.

PEENE, a river which runs into the Baltic a little to
the weft of the illand of Ufedom. This river, for a confi-
derable part of its courfe, feparates Hinder Pomerania
from Anterior Pomerania. Lat. 54. 10. N. Ion. 13. 50. E.

PEE'NEMUNDE SCHAN'Z, a town and fort in the
illand of Ufedom, which it commands entirely, as it does
alfo the entrance and mouth of the Peene, near which it
Hands : fix miles north of Wolgaft. Lat. 54. 10. N. Ion.
13. 48. E.

PEE'NPACK, a town of New-York, in Orange county:
twenty-five miles weft of Newburgh.

To PEEP, v. n. [derivation unknown.] To make the
firft appearance. — Printing and letters had juft peeped
abroad in the world ; and the rellorers of learning wrote
very eagerly againft one another. Atterbury.

The timorous maiden-blofioms on each bough
Peept forth from their firft bl u flies ; lb that now
A thoufand ruddy hopes fmil’d in each bud,

And flatter’d every greedy eye that Hood. Cra/haw.
Earth, but not at once, her vifage rears,

And peeps upon the feas from upper grounds. Dryden .
Fair as the face of nature did appear,

When flowers firft peep'd, and trees did blofloms bear.
And winter had not yet deform’d th’ inverted year.

Dryden.

The increafing profpefl tires our vvand’ring eyes :

Hills peep o’er hills, and Alps on Alps arile. Pope.

To look fiily, clofely, or curioufly ; to look through any
crevice. — Thofe remote and vail bodies were formed not
merely to be peept at through an optick giafs. Bentley's
Serm. — Who is the fame, which at my window peeps’!
Spenfer.

Come thick night !

That my keen knife fee not the wound it makes ;

Nor heaven peep through the blanket of the dark.

To cry hold. Shakefpeare's Macbeth.

Nature

4G.9

PEE

Nature bad fram’d ftrange fellows in her time ;

Some that will evermore peep through their eyes,

And laugh like parrots at a bagpiper. Shakefpcare.

O my mufe, juft diftance keep ;

Thou art a maid, and muft not peep. Prior.

In vain his little children, peeping out

Into the mingling ftorm, demand their fire. Thomjim.

[From pipio, Lat. piepen, Teut. pepier, Fr.] To chirp; to
cry as young birds ; to utter in a fmall voice ; to whilper.
— By peeping and muttering are meant the anfwers of
thofe who, pretending to have familiar fpirits, muttered
or fpoke imperfe£t!y, as if their voice proceeded out of
the caverns of the earth ; or fpoke inwardly, fo that their
words feemed to come out of their belly; from whence
they were called syyarp*/*v0oi in Greek. W. Louth on
Ifaiah. — W i fa rd s that peep, and that mutter. Ifaiah viii.
19. — None that moved the wing, or opened the mouth, or
peeped. Ifaiah x. 14. — Thy fpeech fhall whilper [in the
margin, peep, or ehirp~\ out of the duft. Ifaiah xxix. 4.

The only oracle,

That ever peep'd or fpake out of a doublet. B. Jonfon.

PEEP, /. Firft appearance : as, At the peep and firft
break of day. — A fly look. — Would not one think the
almanack-maker was crept out of his grave to take t’other
peep at the (tars ? Swift.

PEE'P- HOLE, or Peeping-hole, /. Hole through
which one may look without being difeovered. — The fox
fpied him through a peepiug-hole he had found out to fee
what news. L'EJlrange.

By the peep-holes in his creft,

Is it not virtually confeft,

That there his eyes took diftant aim ? Prior.

PEEPAROOT, a town of Bengal : fix miles from
Nattore.

PEEPAROO'L, a town of Hindooftan, in Rohilcund :
fifteen miles weft-fouth-weft of Budayoon.

PEEPEC', a townfliip of Ohio, in Rofs-county ; con¬
taining 670 perfons.

PEE'PER,/ One that peeps. — In familiar language,
the eye. — A young chicken juft breaking the. (hell;

Difhes I chufe, though little, yet genteel ;

Snails the firft courfe, and peepers crown the meal.

Bramjlon.

PEE'PING, f. The a£l of looking flily into any thing.
PEE'PLY, a town of Hindooftan, in Cattack: five
miles fouth of Cattack.

PEER, /, [pair, Fr.] Equal ; one of the fame rank. —
As every one of the nobility, being a lord of parliament
is a peer, or equal to all the other lords, though of feveral
degrees; fo the commons are peers to one another, al¬
though diftinguifiied as knights, efquires, gentlemen, &c.
Peers (pares) fignify, in law, thofe who are impanelled
in an ir.queft upon a man, for convicting or clearing him
of any offence ; the reafon is, becaufe the cuftom of the
realm is to try every man in fuch cafe by his peers or
equals. Jacob.

His peers upon this evidence
Have found him guilty of high treafon. Shakefpeare.
One equal in excellence or endowments.— All thefe did
wife Uliffes lead, in counfell peer to Jove. Chapman.

In fong he never had his peer.

From fweet Cecilia down to chanticleer. Dryden.

Companion ; fellow. — He all his peers in beauty did fur-
pafs. Spenfer.

If you did move to night,

In the dances, with what fpight
Of your peers you were beheld,

That at every motion fwell’d. B. Jonfon.

PEE

Who bear the bows were knights in Arthur’s reign,
Twelve they, and twelve the peers of Charlemagne.

Dryden.

A nobleman as diftinct from a commoner ; of nobility
we have five degrees, who are all neverthelefs called peers,
becaufe their effential privileges are the fame. For almoft
every particular concerning the creation, privileges, de-
feent, &c. of the peers of Great Britain and Ireland, fee
the article Heraldry, vol. ix. p. 416, 487. and Parlia¬
ment, vol. xviii.

The House of Peers is the fupreme court of the
kingdom to reClify any injuftice or miftake of the law com¬
mitted in the courts below. To this authority they fuc-
ceeded of courfe upon the diffolution of the Aula Regia.
For, as the barons of parliament were conftituent mem¬
bers of that court, and the reft of its jurifdiftion was
dealt out to other tribunals, over which the great officers
who accompanied thofe barons were reflectively delega¬
ted to preiide, it followed, that the right of receiving ap¬
peals, and fuperintending all other jurifdiCtions, (till re¬
mained in that noble affembly from which every other
great court was derived. They are therefore in all cafes
the laft refort, from whofe judgment no farther appeal is
permitted ; but every fubordinate tribunal muft conform
to their determinations : the law repofing an entire con¬
fidence in the honour and confidence of the noble per¬
fons who compofe this important affembly, that they will
make themfelves mafters of thofe queftions upon which
they undertake to decide ; fince upon their decifion all
property muft finally depend. It was towards the latter
end of the reign of king Charles I. that the houfe of peers
firft afferted their jurifdidion of hearing appeals from the
Chancery, which they do upon a paper petition, without
any writ directed from the king; and for this their foun¬
dation is, that they are the great court of the king, and
that therefore the chancery is derived out of it, and by
confequence that a petition will bring the caufeand re¬
cord before them. This was much controverted by the
commons in the reign of Charles II. but is now pretty
well fiubmitted to, becaufe it has been thought too much
that the chancellor fhould bind the w'hole property of the
kingdom without appeal.

The peers of Scotland or Ireland had no privilege in
this kingdom before the union ; but, by claufes in the
refpeftive articles of union, the defied peers have all the
privileges of peers of parliament; alfo all the reft of the
peers of Scotland and Ireland have all the privileges of
the peerage of England, excepting only that of fitting
and voting in parliament, and of franking letters in Eng¬
land. A Roman-catholic peer is not entitled to the
privilege of franking letters.

The right of trial by their peers, it feems now gene¬
rally admitted, does not extend to bifliops. The bifhops
may however claim all the privileges of the lords tempo¬
ral; except that they cannot be tried by their peers, and
they cannot, in capital cafes, pafs upon the trial of any
other peers, they being prohibited by canon to be judges
of life and death, & c. They ufually therefore withdraw
voluntarily; but enter a proteft, declaring their right to
ftay.

The Peers of France were, anciently, the twelve
grand lords of that kingdom. The inftitution of thefe
peers is very uncertain. Some refer it to Charlemagne,
but with little probability; fince raoft of the fiefs,
which bear the names of duchies, &c. or give titles to
the peers, were not ereCted into duchies, & c. till long
after : the dukes, &c. in thofe days, being no more than
fimple governors of provinces, without any other title or
privileges. Others attribute it to Hugh Capet, at the
time when the dukes and counts changed the offices they
then'held of the king into perpetual fiefs: but this alfo
is impoffible ; Champaigne, one of the titles, not being
then ereCted into a county. Of thefe peers, fix were
dukes, and fix counts, comtes ; of thefe, again, fix were

ecclefiafticsa

1

470 PEE

ecclefiaftics, and fix laymen. The Archbifliop ofRheirns
and the Biftiops of Laon and of Langres, were dukes and
peers; and theBiftiops of Noyons, Chalons on the Marn,
and Beauvais, were counts and peers. The Dukes of
Burgundy, Normandy, and Aquitaine, were lay-peers
and dukes; and the Counts of Flanders, Champagne,
and Thouloufe, lay-peers and counts. Thefe peers af-
fifted at the coronation of the kings in ceremony, and by
way of reprefentatives ; where each performed the func¬
tions attached to his refpeftive dignity : but, as the lay-
peerftiips were in reality all, except that of Flanders, uni¬
ted to the crown, fix lords of the firft quality were chofen
to reprefent them. The ecclefiaftical peers ufually af-
lifted in perfon. The moft probable opinion is, that
peers were firft; inftituted by Philip the Young of France,
about the year 1179, and that they firft afted in capacity
of peers at the coronation of his fon.

At a later period, the title peer in France, was be-
ftowed, as in England, on every perfon whofe fee was
erefted into a lordlhip or peerlhip. And it is to be ob-
ferved, that the title and rank defcended to all the chil¬
dren, (as in Norway and fome other countries,) though
the property went to the eldeft alone. Hence the vaft
number of needy nobles depending on the court. And
Mr. Nichols, contrafting the French with the Englith
peerage, obferves, that “ the circurnftance which moft
contributed to the French revolution was the diftinftion
between noblejfe and bourgeoijie . Thirty thoufand noble
families were fuppofed to comprehend 150,000 individu¬
als. Thefe claimed exemption from the moft burdenfome
taxes, and exclufive advancement in the army, in the
navy, in the church, and in the parliaments. In Eng¬
land no fuch diftinftion exifts. Our hereditary nobles
are few, not exceeding in number two hundred and fifty;
they poffefs no exemption from the payment of any tax ;
nor are they entitled to exclufive advancement in the
army, the navy, the church, or the law : their children
are of the order of the commonalty. In truth, Britilh
peers are magiftrates, hereditary legiflators, hereditary
judges, and hereditary advifers of the crown: they have
as little refemblance to French noblejfe as they have to the
order of mandarins in China.” (Nicholls’s RecolIe6tions,
1820.) And in another place he adds, that after a ftrug-
gie of twenty-feven years, the French have obtained the
grand objects of their revolution, viz. “ the abolition of
the privileges of the noblejfe, of feudal fervices, of the
power and wealth of the church, and have fecured all
their rights by the eftablifhment of national reprefenta-
tion.”

A clafs of nobility, fuch as that which exifts in this
country, (Great Britain.) we hope will ever continue,
becaufe we believe it to be highly • beneficial to the
whole community, and one of the ftrongeft fafeguards
which can be devifed againft the oppreffion or ufurpations
of the crown : but a clafs of beings fuch as thofe which
exifted in France, who at home were the tyrants of their
wide domains, and in Paris the jackalis and retainers of a
profligate court ; who, as they were exempt from paying
taxes, in their own (hort-fightednefs fancied themfelves
merely interefted to maintain and extend the abufes of
the crown ; whofe immunities ferved only to pervert their
judgment and to deftroy their fenfe of juftice ; and whofe
ieignoral rights tended but to reduce the reft of the com¬
munity to the condition of bondfmen and brutes; we
rejoice that fuch a clafs of beings has been fwept away
from the furface of France. Wherefoever elfe on the
continent, alfo, fuch privileges ftill exift, not founded in
the general good of fociety, but which render one part of
the community the drones and caterpillars to feed on the
vitals of the reft, we truft that fuch loath fome impoft-
humes and excrefcences will in the courfe of time be dif-
cuffed or lopped off. We are therefore glad to announce,
that the prelent peerage of Norway is to be aboliflied ; to
ceafe at the death of thofe who now (Aug. 17, 1821) en¬
joy it, and their exilting children. But a new nobility is

PEE

to be created, (not till after 1824.) which will be tranf-
miftible to the eldeft fon of each peer only, as with us.

PEER, or Pere, f. According to Roberts’s Indian
Gloflary, this word has, in the Eaft Indies, very various
and contradictory fignifications. 1. Monday. 2. A
mendicant ; a monk ; a helper in a tavern. 3. A teacher ;
founder or chief of a fed ; prior of a Chriftian monaftery.
Peer Maghan, chief prieft of the Magi ; Peer Derwijhan,
fuperior of the Dervifes.

PEER, a town of France, in the department of the
Lower Meufe : thirty miles north-eaft of Louvain, and
thirty north of Liege.

PEER, a ftnall ifland in the Eaftern Indian Sea. Lat.
5. 18. S. Ion. 1 18, 20. E.

To PEER, v. n. [by contraction from appear .] To
come juft in light. — See how his gorget peers above his
gown. B.JonJbn.

As the fun breaketh through the darkeft clouds,

So honour peeret/i in the meaneft habit. Shakefpeare.

To look narrowly; to 'peep. — Now for a clod-like hare
in form they peer. Sidney.

Peering in maps for ports, and piers, and roads,

And every objeCt that might make me fear
Misfortune to my ventures. SkaheJ peace's Merck, of Veil.

PEE'RAGE, f. The dignity of a peer :

His friendlhips he to few confin’d;

No fools of rank or mongrel breed,

Who fain would pafs for lords indeed ;

Where titles give no right or power,

And peerage is a wither’d flower. Swift.

The body of peers. — Not only the penal laws are in force
againft papifts, and their number is contemptible, but
alfo the peerage and commons are excluded from parlia¬
ment. Dryden .

PEE'RDOM, /I Peerage. Ainf north.

PEERE- WI L/LIAMS (William), an Englilh law-wri¬
ter, died 1736.

PEE'RESS, f. A woman who is noble by defcent, crea¬
tion, or marriage; for, as we have noblemen of feveral
ranks, fo we may have noblewomen. Thus, king Henry
VIII. made Anne Bullen marchionefs of Pembroke;
James I. created the lady Compton, wife to fir Thomas
Compton, countefs of Buckingham, in the life-time of
her hufband, without any addition of honour to him ; and
alfo the fame king made the lady Finch, vifcountefs of
Maidftone, and afterwards countefs of Winc'nelfea, to
her and the heirs of her body; and George I. made the
lady Schulenberg, duchefs of Kendal.

If a peerefs by defcent or creation marry a perfon under
the degree of nobility, (he ftill continues noble : but, if
(lie obtain that dignity only by marriage, (lie lofes it on
her afterwards marrying a commoner, as noticed under
the article Heraldry; yet, by the courtefy of England,
(lie generally retains the title of her nobility. 1 In ft. 16.
2 lift. 50,

PEERGA'OW;a town of Hindooftan, in Dowlatabad :
thirty-five miles fouth of Amednagur.

PEERGOT'CHY, a town of Bengal : twenty-eight
miles weft of Dinagepour.

PEERGUN'GE, a town of Bengal: thirty-nine raiies
north-eaft of Purneah.

PEE'RLESS, adj. Unequalled ; having no peer. — The
peerlefs light of her immortal praife. Milton's Arcades.
Her peerlefs- features joined with her birth
Approve her fit for none but for a king. Shakefpeare.

PEE'RLESSLY, adv. Without an equal; matchlefsly.
— The gentlewoman is a good, pretty, proud, hard-fa-
vour’d, thing; marry, not fo peerlefsly to be doted
upon, I muft confefs. B. JonJ'on's Every Man out of his
Humour.

PEE'RLESSNESS, f. Univerfal fuperiority.

PEERNAGUR',

PEG

471

PEG

PEERNAGUR', a town of Hindooftan, in Oude : fe-
venteen miles north of Manickpour.

PEERPAR', a town of Bengal : five miles north of
Rajemal.

PEERPUN'CHAL, mountains which form the fou th¬
em boundary of Cachemire.

PEE'RWARTH, a town of Auftria : thirteen miles
fouth of Ips.

PEE'SKEN, a town of Pruffian Pomeralia: feventeen
miles fouth-fouth-well of Marienburg.

PEE'VISH, adj. [this word Junius fuppofes to be
formed by corruption from perverfe; Skinner rather de¬
rives it from beeijh, as we fay wafpijh.'] Petulant; wafpifit ;
eafily olfended ; irritable; irafcible ; foon angry; per¬
verfe; morofe; querulous ; full of expreffions of difcon-
tent ; hard to pleafe.— -Neither will it be fatire or peevi/h
inveftive to affirm, that infidelity and vice are not much
diminifhed. Swift.

She is peevi/h, fallen, froward,

Proud, diiobedient, ftubborn, lacking duty. Skahefp.

Expreffing difcontent, or fretfulnefs. — Tliofe deferve to
be doubly laughed at, that are peevi/h and angry for no¬
thing to no purpofe. Ef range.

For what can breed more peevi/h incongruities.

Than man to yield to female lamentations. Sidney.
Silly ; childilh. Obfolete. — Never was any fo peevi/h to
imagine the moon either capable of affection, or fhape of
a miftrefs. Lily's Endym. 1591.

How now ! a madman ? Why thou peevi/h fheep,

What (hip of Epidamnum flays for me ? Shahefpeare.

PEE'VISHLY, adv. Angrily; queruloufly ; morofely.
— He was fo pecvijhty opinionative and proud, that he
would neither a Ik nor hear the advice of any. Hayward.

PEE'VISHNESS, f. Irafcibility ; queruloufnefs ; fret¬
fulnefs; perverfenefs.- — It will be an unpardonable as
well as childifli peevijhnefs, if we undervalue the advan¬
tages of our knowledge, and negleft to improve it.
Locke.

You may find

Nothing but acid left behind :

From pafiion you may then be freed,

When peevijhnefs and fpleen fucceed. Swift.

PEG, f. [ptgghc, Teutonic; fuppofed by fome to be
from the Greek irriytva, to fallen or join.] A piece of
-wood driven into a hole, which does the office of an iron
nail.—1 The pegs and nails in a great building, though
they are but little valued in themfelves, are abfolutely
neceffary to keep the whole frame together. Addifon's
Speftator. — A finer petticoat can neither make you
richer, more virtuous or wife, than if it hung upon a peg.
Swift. — The pins of an inftrument in which the firings
are drained s

You are well tuned now ; but I’ll let down

The pegs that make this mufic. Shahefpeare' s Othello.

To PEG, v. a. To fallen with a peg.— Taking the
(hoots of the pad fpring, and pegging them down in very
rich earth, by that time twelvemonth they will be ready
to remove. Evelyn's Kalendur. ^

I will rend an oak,

And peg thee in his knotty entrails, till

Thou’ll howl’d away twelve winters. Shahefpeare.

To take a Peg lower. Todeprefs ; to fink. Evidently,
in the following example, from relaxing the cords of mu-
fical inllruments : but fee the next article.— Thofe only
know how to want, that have learned to frame their mind
to their eilate ; like to a Ikilful mufician, that can let
down his firings a peg lower , when the tune requires it.
Bp. Hall, Of Contcntation.

Remember how inarms and politicks
We Hill have worlled all your holy tricks,

Vol. XIX. No. 1317.

Trepann’d your party with intrigue,

And took your grandees down a peg . Iludibras.

PEG-TAN'KARD, f. A vefiel marked fo as to regu¬
late the quantity of drink each perfon Ihould take at a
draught. — Peg-tankards have in the in fide a row of eight
pins one above another, at exacl diftances, from top to
bottom ; the tankard holds two quarts, fo that there is a
gill of ale, i. e. half a pint of Wincheller meafure, be¬
tween each pin. The firil perfon that drank was to
empty the tankard to the firil peg; the fecond was to
empty to the next, See. by which means the pins were
fo many meafures to the compotators, making them all
drink alike, or the fame quantity. Pegge's Anonypiiana.

Our Saxon anceftors were remarkable for immoderate
drinking ; and, when intoxicated with their favourite ale,
were guilty of the moft outrageous violences. Dunftan
endeavoured to check this vicious habit, but durft not
totally obftrudl their much-loved intemperance : lie in¬
troduced, therefore, an ingenious cuftom of marking or
pegging their cups at certain diftances, to prevent one
man taking a greater draught than his companions,
which, fora time, leflened the evil, though it proved in
the end productive of much greater excefles than were
before indulged in : prior to that regulation, fome of their
parties ufed to avoid drinking to intoxication ; but, when
they were obliged to drink to the pegs, they no longer
had a choice, but were generally the fooner overcome ;
for, refining upon Dunftan’s plan, each was obliged to
drink precifely to a peg, whether he could fuftain a quan¬
tity of liquor equal to others or not : and to that end it
became a rule, that, whether they exceeded or fell (hort of
the preferibed bumper, they were alike compelled to
drink again until they reached the next mark. In A bp.
Anfelm’s canons, made in the Council at London in
1102, priefts are enjoined not to go to drinking-bouts,
nor to “drink to pegs.” The words are, Ut prejbyteri
non eant ad potationes, nec ad pinnas bibant. (Wilkins,
Vol. I. p. 382.) This (hows the antiquity of this inven¬
tion, which at lead was as old as the Conqueft.

Some of thefe peg cups, or bowls, or tankards, are yet
to be found in the cabinets of antiquaries 5 and we are
to trace, from their ufe, fome common terms yet current
among us. When a perfon is much elated, we fay he “ is
in a merry pin," which no doubt originally meant, he
had reached that mark which had deprived him of his
ufual fedatenefs and fobriety : we talk of taking a man
“ a peg lower,” when we imply we (hall check him in
any forwardnefs, a faying which originated from a regu¬
lation that deprived all thofe of their turn of drinking,
or of their peg, who had become troublefome in then-
liquor : from the like rule of fociety came alfo the ex-
preffion of “ he is a peg too low,” i.e. has been reftrained
too far, when we fay that a perfon is not in equal fpirits
with his company ; while we alfo remark of an individual
that he is getting on “peg by peg,” or, in other words,
he is taking greater freedoms than he ought to do, which
formerly meant he was either drinking out of his turn,
or, contrary to exp refs regulation, did not confine him-
felf to his proper portion, or peg, but drank on to the
next, thereby taking a double quantity. Brady's Clavis
Calendaria. *•

PEG'ANUM, f [from ntstywei, to congeal, or reprefs;
a Greek name adopted by Linnaeus for this genus, on ac¬
count of its affinity to rue 5 (fee Ruta.) Tl-nycivov is the
general name for rue in Diofcorides ; and this very plant
which is the liarmel of the Arabians, and thence called
harma/a by fome of the earlier modern botanifts, is the
nvyavov a-ypios, or wild rue, of that old Greek writer.] In
botany, a genus of the clafs dodecandria, order monogy-
nia, natural order of multifiliquse, (rutaceas, Jnjf.) Ge¬
neric characters — Calyx : perianthium five leaved s leaf¬
lets linear, often toothed, erefl, the length of the co¬
rolla, acute, permanent. Corolla: petals five, oblong-
ovate, from upright-fpreading. Stamina: filaments fif-
6 E teen,

472

PEG

teen, awl-fhaped, fliorter by half than the corolla, dila¬
ted at the bafe into a neftary under the germ ; antheras
oblong, eredh Piftillum : germ roundilh- three-cornered,
raifed on a receptacle from the bafe of the flower. Style
filiform, round, the length of the antheras; ftigma ob¬
long, three-fided. Pericarpium : capfule roundifh-three-
cornered, three-celled, three-valved, with contrary par¬
titions. Seeds very many, ovate, acuminate. Linnaeus
remarks, that Peganum differs from Rura, as Celaftrus
from Euonymus ; for what is taken from the number of
the piftil is added to the ftamens, and vice verfa. — EJJen-
tial Chara&er. Calyx five-leaved or none; corolla five-
petalled ; capfule three-celled, three- valved, many-feed-
ed. There are four fpecies.

1. Peganum harmala, or Syrian rue; (Ruta fylveftris,
Bauhin .) Leaves multifid. Root as large as a man’s lit¬
tle finger, by age becoming woody. The (talks decay
every autumn, and new ones arife in the fpring : they
grow about a foot long, and divide into feveral fmall
branches. Leaves thick, oblong, cut into feveral narrow
fegments, dark green, gummy, and of a bitterifli tafte.
The flowers are produced at the ends of the branches,
fitting clofe between the leaves; corolla white. Native
of Spain, the county of Nice, Syria, Cappadocia, Galatia,
and Siberia. It was cultivated here in 1570, as appears
from Lovel ; it flowers in July, and in warm fummers
the feeds will ripen herein the autumn.

2. Peganum crithmifoliutn : leaves many-cleft ; Item
fhrubby. Gathered near the Cafpian Sea by Pallas, who
lent feeds to Retzius. The latter diftinguifhes this, as a
fpecies, from P. harmala, on account of its fhrubby pe¬
rennial ftem, which is three or four feet high, whereas
the other is fcarcely half fo tall, and the fmaller fize of
its flowers. As to the calyx, whofe leaves he fays are di-
vided in the harmala, this is but rarely the cafe, and
chiefly, as it feetns to us, in garden fpecimens.

3. Peganum retufum : leaves wedge- fhaped, abrupt;
ftem fhrubby. Gathered by Forfkall in Egypt, near
Alexandria. The Arabians call it gharghed. This is a
fhrub, with fpinous downy branches, and fomevvhat
fiefhy leaves.

4. Peganum dauricum : leaves lanceolate, (lightly cre¬
mate; ftem herbaceous. Native of gravelly places in Si¬
beria. Root thick, wood}', perennial. Stems numerous,
ereft, flender, moftly Ample, leafy, round, fmooth,
fcarcely a foot high. Leaves fcattered, feflile, half an
inch long, glaucous, befprinkled with glandular dots.
Flowers few, fomewhat corymbofe, at the fumrnit of
each ftem, white, not half the fize of the firfl fpecies, and
differing widely from that in the form of the calyx-leaves,
which are very fliort and ovate. The capfule is defcribed
by Ammann as of three, rarely four, cells, with two or
three feeds in each.

Linnaeus feems to have been led by Gmelin’s plate to
fuppofe this had no calyx, and therefore he fays, in the
ihort generic character, “calyx five-leaved, or none,”
which Willdenow copies. The calyx however, though
final!, is prefent, and refembles in fhape, though not in
hairinefs, that of Ruta fruticulofa, (Labill. Syr. t. 4.
Willd. Sp. PL ii. 545.) to which P. dauricum has a con-
fiderable general relemblance. The plants neverthelefs
are fpecifically, and as it appears by Labiilardiere’s figure
of the fruit, genetically, diftiinSV.

Propagation and Culture. They are propagated by
feeds, fown thinly on a bed of light earth, the beginning
of April ; when the plants come up, keep them clean
from weeds : at the end of October or beginning of No¬
vember, when the ftalks decay, cover the bed with tan¬
ner’s bark, allies, or fawduft, to keep out the froft, for
the roots are fomewhat tender when young. In March
following tranf'plant them into a warm fituation and dry
foil, where they will continue feveral years.

PEGASE'AN, adj. Belonging to Pegaf’us.

PEGAS'IDES, a name given to the Mufes from the

PEG

liorfe Pegafus, or from the fountain which Pegafus had
raifed from the ground by ftriking it with his foot.

PEG'ASUS, in fabulous hiftory, a winged horfefprung
from the blood of Medufa, when Perfeus had cut off her
head. He received his name from his being born, accor¬
ding to Heliod, near the fources {irriyri) of the ocean.
As loon as born, he left the earth, and flew up into hea¬
ven ; or rather, according to Ovid, he fixed his refidence
on Mount Helicon, where, by ftriking the earth with his
foot, he inftantly raifed a fountain, which has been called
Hippocrene. He became the favourite of the Mufes;
and, being afterwards tamed by Neptune or Minerva, he
was given to Bellerophon to conquer the Chimaera. No
fooner was this fiery monfter deftroyed, than Pegafus
threw down his rider, becaule he was a mortal, or rather,
according to the more received opinion, becaufe he at¬
tempted to fly to heaven; for this aft of temerity in B„el-
lerophon was punifhed by Jupiter, who fen t an infeft to
torment Pegafus, which occafioned the melancholy fall of
his rider. Pegafus continued his flight up to heaven, and
was placed among the conftellations by Jupiter. Per¬
feus, according to Ovid, was mounted on the horfe Pe¬
gafus, when he deftroyed the fea-monfter which was going
to devour Andromache.

PEG'ASUS, in aftronomy, the name of a conftellation
of the northern hemifphere, figured in form of a flying
horfe. The (tars in this conftellation, in Ptolemy’s Cata¬
logue, are 20, in Tycho’s 19, in Hevelius’s 38, in the
Britannic Catalogue 89.

PEG'ASUS, f. in ichthyology, a genus of branchiofte-
gous fifties ; fo named, it is laid, from the fiiape of the
head and pefforal fins giving it the appearance of a flying
horfe; but this refemblance muft probably be referred to
the fecond fpecies, of which we have not been able to
procure a figure. Generic charaffers — Mouth beneath ;
fnout retraflile; upper jaw elongated, denticulate, enfi-
form, and linear; aperture of the gills Angle, before the
pectoral fins; body comprefled downwards, articulate
with bony incifures, and mailed ; ventral fins behind the
peftorals. There are three fpecies, which are all natives
of the Indian feas, and which are characterized by the
fhape of the fnout. They live upon (lime, the fpawn or
ova of other fifh, and upon worms. They were unknown
to the old writers on fifties.

1. Pegafus draconis, the fea-dragon : fnout conic. This
is a fmall fifh, three or four inches in length ; and is re¬
markable for the fize of its pecloral fins, which are fup-
pofed to enable it, like the Exocoeti, and fome other
fifties, to fuppcrt itfelf fora few feconds in the air, while
it fprings occafionally over the furface of the water. The
thorax, or fuperior parr of the body, is of a broad,
(lightly flattened, fquarifli form ; and is marked, both
above and beneath, by feveral radiated fliields, or bony
tubercles of conliderable fize: from each fide of the ab¬
domen fprings a lengthened cirrus, which may be confi-
dered as fupplying the place of a ventral fin. From the
thorax the body fuddenly decreafes in diameter, and is
marked into feveral divifions or tranfverfe fegments ; the
tail is final!, and fiightly rounded. ThepeCtora! fins are,
as it has been already obferved, large in proportion to the
fize of the animal, and of a rounder fhape, with a kind
of fcaliaped or indented outline. The fnout is of a fub-
conical form, but with. a flight dilatation towards the
tip, fo as to appear fpatule-fhaped when viewed from
above. .Both jaws are furnifhed with exceedingly fmall
teeth, and the mouth opens underneath. The eyes are
on the Tides of the head; they are protuberant, and have
a black pupil inclofed in a yellow iris; and this fifh can
fee perfectly well on each fide as well as forwards, the
pupil of the eye being very moveable. The noftrils are
near the eyes. The principal colour is bluifli ; but the
tubercles are brown. The fins have fitnple rays; each
ventral confifts of one long ray ; and there is a ray of the
fame length over each pectoral fin : thefe fingle rays it i$

probable

PE & ASUS.

PEGU.

JLng raved for die, Truyclopcedia, Londinensis. j 8x3 .

PEG

PEG

473

probable are inftruments for feizing prey, rather than
helps in fwimmings the dorfal fin is oppofite the anal.
This fpecies inhabits the Eaft Indies ; it is feldom more
than three or four inches long. It lives on the fpavvn
and young of other fifh, as may be gathered from the
ftrufture of the mouth. It is reprefen ted on the annexed
Plate, at fig. i.

2. Pegafus volans, the flying horfes fnout enfiform,
ferrated. This fpecies was hitherto little known, and
had been generally confounded with the preceding, till
it was more fully defcribed by Commerfon. The fnout
is very long and flatted, but rounded and larger at the
tip ; it has a longitudinal furrow underneath, with fmaller
furrows or wrinkles difpofed in a radiated form § there is
a fimilar furrow on the upper furface with railed and fer¬
rated brims. On the head, behind the eyes, there is a
rhomboidal indention ; and behind the fkull are two
deep holes of a pentagonal fliape. The laft rings of the
tail have a fmall fpineat each corner. The pefloral fins
are rounded, very broad, and calculated to impart the fa¬
culty of darting into the air, as defignated by the appel¬
lation. Like the other fpecies, this is found in the Indian
Sea ; Commerfon was able to obtain only one at the Tile
of France, (or Mauritius,) and that was a dried fpecimen,
fo that it is probably a rare fpecies.

3. Pegafus natans, the fwimmer: fnout enfiform, not
ferrated. The body is broad upwards, tapering towards
the tail, and covered with armour: it is of a yellow-
brown colour on the upper furface, white underneath.
The head is flat, and Ihort, ending in a long narrow'
fnout, Sightly ferrated at the end only. The mouth has
the fame pofition and fliape as in the firft fpecies. The
eyes are round and large, (landing at the Tides, near the
corners of the mouth; the pupil is black, iris yellow.
The gill-covert is radiated, and the opening at the fide.
The tail is covered with eleven plates of armour, dimi-
nifliing towards the end, and terminating in two fpir.es.
The fins have fimple rays 5 the dorfal and anal are fmall,
and oppofite each other; the tail narrow. The fins are
of a brown colour, except the pectorals which are blue,
and not fo large as in the other fpecies. The fize, coun¬
try, and way of life, of this fpecies, are the fame as the
firft fpecies. It is feldom eaten, having very little flefli.
Though never caught alive but in the Indian Sea, it has
been found among the petrified fifh dug out of Mount
Bolca, near Verona, in Italy. It is reprefented at fig. 2.
.and lying on its back at fig. 3, The figures are from
Cepede and Block.

PEGAU', a town of Saxony, in the circle of Leipfic.
on the Elder. It contains two churches and a convent :
ten miles fouth-fouth-weft of Leipfic, and fifty-eight weft
of Drefden. Lat. 51. 12. W. Ion. 12. 12. E.

PEGAU', a town of Lower Stiria : feven miles north,
of Gratz.

PEGER'SK, a town of Ruflia, in the government of
Pfkov, near the lake Tchudfkoes twenty miles weft-
north-weft: of P(kov. Lat. 57. 55. N. Ion. 27. 32. E.

PEGGE (Rev. Samuel), an induftrious antiquary, was
the fon of a perfon in trade, firft at Derby, and then at
Chefterfield, at which laft place Samuel was born in 1704.
He received his fchool-education at his native place ; and
in 1722 was admitted a penfsoner of St. John’s College,
Cambridge. He became a fellow of his college, took the
degree of M.A. in 1729, received prieft’s orders in the
following year, and went to ferve a curacy in Kent un¬
der Dr. Lynch, dean of Canterbury. Being prefented in
the following year to a vicarage, and poflefling an inde¬
pendent property, he married; and he continued in that
county twenty years, well refpedled by the bed families
in his neighbourhood. He had laid, in a good (lock of
claffical learning, and from an early period indulged a
propenfity to antiquarian ftudies, which at length became
the principal literary purfuit of his life. The great num¬
ber of papers he drew’ up on thefe fubjefls appeared chief¬
ly in the Archaeologia, the Bibliotheca Topographies

1

Britannica, and the Gentleman’s Magazine. After the
death of his wife, he was anxious to fettle in his native
county; and at length, by means of exchanges, he ob¬
tained, in 1751, the reflory of Whittington, near Chef¬
terfield, which was his refidence during the remainder of
his life. He alfo poffeffed, from the gift of the Devon-
fhire family, another reflory; and held a prebend in the
church of Lichfield, and another in that of Lincoln,

Mr. Pegge published a few pieces of the profelBonal
clafs; but he is here commemorated merely as an anti¬
quary. In the lift of his writings in this capacity, many
will probably appear inconfiderable, but many others ufe-
fully illuftrate points of hiftory or biography ; and, though
they poffeffed none of the. advantages of (lyle, they dil-
played diligent and accurate inveftigation. As a fpeci-
men, may be mentioned his refutation of the popular
(lory of king John’s death by poifon. Several others are
curious records of particulars relative to the way of life
and manners of our anceftors. His mod valuable bio¬
graphical produdlion is the Life of Robert Grofftete, the
celebrated Bilhop of Lincoln, publilhed feparately in
1793. To him alfo the curious were indebted for a new
tranflation of “ Fitz-Stephens’s Defcription of the City of
London,” with a commentary and differtation on the au¬
thor. For a catalogue of all his writings we refer to the
Gent. Mag. for 1796, where they occupy thirteen clofely-
printed pages.

On the celebration of the centenary of the revolution
in 1788, a kind of public proceffion was made from the
parifh of Whittington, which poffeffes the houfe at which
fome of the principal leaders in that great event held a
confultation, to the town of Chefterfield ; on which oc-
cafion the venerable reflor, then in his 85th year, preached
an appofite fermon. In 1791 he received, what may be
deemed a lingular honour at his age, the degree of LL.D.
from the univerfity of Oxford. He furvived, free from
any diilrefling infirmity, to Feb. 1796, when he gently
funk under the burden of old age in his 92c! year. The
manners of Dr. Pegge were thofe of a man of liberal edu¬
cation accullomed to good company. As he avoided
public bufinefs, he palled his latter years chiefly in re¬
tirement, performing his parochial duties with great
punctuality, and devoting the reft of his time to ftudy.
He readily communicated the knowledge he poffeffed to
all who applied to him, and was entirely difinterefted in
his communications to the works in which his writings
were publilhed. Nichols’s Lit. Ancccl, Gent. Mag. June,
Aug. Ofl. &c. 1796.

PEG'tJE R, f. One who fallens with pegs.

PEGM, or Peg'ma, f [Greek.] A fort of moving ma¬
chine in the old pageants. — In the centre or mid 11 of the
pegm there was an aback or fquare, wherein this elogy
was written. B. Jonfon's K. James I. Entertainment. — A
written explanation of a pageant. — What prefentments
are towards ; and who penned the pegmas ; and fo forth.
Chapman’s Widow’s Tears.

PEGMA'RES, f. A name by which certain gladiators
were diftinguilhed, who fought upon moveable fcaffolds
called pegmata , which were fometimes unexpectedly
railed.,1 and by this means furprifed the people with gladi¬
ators in hot contention. They were fometimes fo lud-
denly lifted up as to throw the combatants into the air ;
and fometimes they were let down into dark and deep
holes, and then fet on fire, thus becoming the funeral-
piles of thofe miferahle wretches, who were roalted alive
to divert the populace.

PEG'NA CO'VA, a town of Portugal, in the province
of Beira : feven miles north -eaft of Coimbra.

PEG'NA FIR'MA, a town on the weft coaft of Portu¬
gal, at the mouth of the river Mongols : nine miles fouth
of Peniche.

PEG'NA DA FRAN'CIA, a town of Spain, in the
province of Leon, anciently called Lancia; twenty-four
miles fouth-fouth-eaftof Civdad Rodrigo, fifty-five fouth-
fouth-weft of Salamanca.

PEG'NA

474 PEG

PEG'NA GAR'CIA, a town of Portugal, in the pro¬
vince of Beira, on the borders of Spain : twenty-fix
miles eaft of Cartel Branco. Lat. 39. 50. N. Ion. 6. 39. W.

PEG'NA MA'COR, a town of Portugal, in the province
of Beira, on the borders of Spain, fortified, and contain¬
ing three churches, a convent, and hofpital, and about
2000 inhabitants : nine miles fouth-weft of Alfayates,
thirty north-eaft of Caftel Branca. Lat. 39. 59. N. Ion. 6.
40. W.

PEG'NA MAYO'R, a town of Spain, in Galicia:
twelve miles eaft-fouth-eaft of Lugo.

PEGNAFEL', a town of Spain, in Old Caftile, fituated
at the foot of a mountain, and defended by a caftle :
twenty-five miles fouth-eaft of Valladolid.

PEGNAFLO'RA, a town of Spain, in Afturia, on the
weft fide of the Pravia : feven miles north-weft of Oviedo.

PEGNAFLO'RA, a town of Spain, in the province of
Cordova, on the Guadalquivir: thirty-two miles fouth-
weft of Cordova.

PEGNARAN'DA, a town of Spain, in Old Caftile:
eighteen miles weft of Ofrna.

PEGNARAN'DA, a town of Spain, in the province
of Leon : thirty miles fouth-eaft of Salamanca.

PEG'NITZ, a river of Germany, which runs into the
Rednitz at Forth.

PEG'NITZ, a town of Germany, in the principality of
Culmbach, on a river of the fame name : ten miles fouth
of Bayreuth, twenty-eight north-weft of Nuremburg.
Lat. 49 45. N. Ion . it. 33. E.

PEG'NON DE VE'LEZ, a fortrefs of Africa, fituated
on the north coaft of Morocco, on the coaft of the Medi¬
terranean, belonging to Spain. It was built in the year
1 508, by Don Pedro of Navarre : forty miles eaft of Go-
jnera, fixty-eight weft of Melilla.

PEGNONGMEW'. See Pagahm, vol. xviii. p. 196.

PEGOM'ANCY, f. [from the Greek myvi, a fountain,
and fAOi-JTEict, magic.] Divination drawn from the appear¬
ances in a fountain of water, by throwing into it a kind
of dice. When they funk to the bottom, they drew
happy prefages ; but, if they remained on the furface of
the water, it was a bad omen. See Hydromancy.

PEGU', a country of Afia, (the fouthern part of which
was the Golden Cherfonefe of the ancients,) bounded on
the north by Arracan and Ava, on the eaft and fouth by
Siam and the fea, and on the weft by part of Arracan and
the bay of Bengal. This country now forms a part of the
Birman empire, and occupies the lea-coaft as far as Mar¬
taban. It is for the molt parta level country, furrounded
by mountains, which lerve as a frontier on the land fide,
but towards the fea it is liable to invafion, and alfo in its
interior parts by means of the rivers which pafs through
the mountains. Thefe rivers, the chief of which are that
of Pegu (or Syriam), and that of Ava (or Irawaddy), fo
called from the capitals fituated on their banks, Hill con¬
tinue to roll down particles of gold ; and it is probable
that their lands inuft in ancient time have yielded this
precious metal in greater abundance. Hence it is not
unlikely that the practice of gilding the roofs and fpires
of temples and palaces may have been derived from a re¬
mote period, more efpecially as we are informed, that
Shoemadoo was built about 500 years before the Chriftian
era; and this fplendid appearance might naturally give
rife to the clalfical appellation of the country. We learn
from colonel Symes, that gold is difcovered in the fandy
beds of ftreams which defcend from the mountains. Be¬
tween the Keen Duam and the Irawaddy to the northward,
there is a fmall river called Sho Lien Kionp, or the
Stream of Golden Sand. The air of this kingdom is very
healthy; the foil is very rich, and produdfive of corn,
fruit, and roots ; and it produces various kinds of tim¬
ber, particularly the teak. The animals that principally
abound in Pegu are elephants. Befides the mines of the
richer metals which are found in this country, it abounds
with inferior minerals. But the nioft fingular produdt of
Pegu is the ruby, which is found in a mountain between

PEG

Syriam and Pegu, and which exceeds in value that of
any other country.

The kingdom of Pegu is faid to have been founded
about 1100 years ago. Its firft king was a feaman ; con¬
cerning whom and his fucceffors we know nothing till
the difcoveryof the Eaft Indies by the Portuguefe in the
beginning of the fixteenth century. In 1518 the throne
of Pegu was poflefied by one Breffagukan, with whom
Antony Correa the Portuguefe ambaffador folemnly con¬
cluded a peace in 1519. This monarch was pofleffed of
a very large and rich empire, nine kingdoms being in
fubjedtion to him, whofe revenues amounted to three
millions of gold. Among other nations, the Birmans
were at this time fubjedt to the king of Pegu ; but they
revolted about the middle of the fixteenth century, and
appear to have acquired a fuperiority over the Peguers
which continued down to about the year 1740. At that
period a war took place, which was profecuted on
both fides with favage ferocity ; but as the Peguers,
living to the fouthward near the mouth of the navigable
rivers already mentioned, had a confiderable intercourfe
with European traders, from whom they could purchafe
better arms than are manufadlured in the eaft, they gra¬
dually obtained a fuperiority, and gained feveral vidlo-
ries over the Birmans in 1750 and 1751. Thefe advan¬
tages were fo vigoroufly profecuted, that in the year 1752
the Birman capital Ava was inverted. The Birmans,
difpirited by repeated defeats, and probably ill com¬
manded, after a ftiort fiege, Diveepdee, the laft of a long
line of kings, was made prifoner with all his family, ex¬
cept two fons who efcaped to Siam. Beinga Della, king
of Pegu, left his brother Apporaza as governor of Ava,
and carried to Pegu the captive Birman king. Thus a
complete conqueft appeared to be effefted. The land¬
holders and principal inhabitants of the country round
Ava fubmitted, and took an oath of allegiance to the king
of Pegu, who, in an infolent proclamation, announced
the annexation of the Birman country to the Pegu mo¬
narchy.

After fome time, a Birman of low extraction, Alompra,
afpired to become the deliverer of his country. He had
fubmitted like the reft, and w'as continued by the con¬
queror in the command of an inconfiderable village, Mon-
chaboo. Here he had no more than one hundred de¬
voted followers, upon whofe intrepidity and fidelity he
could rely. This village, like moft of the Birman towns,
was furrounded by a ftockade. This he ftrengthened and
repaired, without awakening any fufpicion in the Pegu
conquerors, who never fufpefted that fo inconfiderable a
perfon would attempt a rebellion. In Alompra’s village
of Monchaboo there were no more than fifty Pegu foldiers,
who treated the Birmans with great arrogance. Taking
advantage of the indignation excited by fome particular
aCl of oppreftion, Alompra encouraged his followers to
attack the Pegu foldiers, and put every one of them
to the fword. Even after this aCI of rebellion, Alompra
difguifed his intention with a view to gain time. He
wrote to the brother of the Pegu king Apporaza, who had
been left governor of Ava, expreffing much humility and
regret for what had happened, profefling his fidelity to
the Pegu government, and reprefenting the maflacre as
the refult of an accidental quarrel between the Pegu
foldiers and the people of his village. Thefe affurances
prevented vigorous meafures from being taken with fuf-
ficient fpeed againft him. Apporaza, having prefting
bufinefs at Pegu, left Ava under the government of his
nephew Dotachew, with inftruftions to lecure Alompra as
a prifoner. Accordingly about a thoufand men were
fent to occupy Alompra’s turbulent village, and to fend
himfelf to Ava. They expended no oppofition, and came
ill prepared for it. They were not a little difconcerted
to find the gates of the ftockade around the village ftiut
againft them on their arrival, which was late in the even¬
ing; and at day-break next morning they were fuddenly
attacked and routed by the Birmans. Alompra, having

thus

P E

thus involved a fmall party of his countryman in rebel¬
lion againft their conquerors, reprefented to them that
there no longer exifted for them any fafety but in vi&ory;
that they would never be forgiven, and muft refolve to
conquer or perifh. He invited the Birmans of the neigh¬
bouring towns to join his ftandard, and he found a fmall
number who were willing to embrace his apparently def-
perate fortunes: with thefe he adopted the fudden refo-
lution of marching towards Ava, before the numerous
detachments of Peguers that were fcattered over the pro¬
vinces could be recalled for its defence. As he advanced,
fame magnified his numbers. The governor of Ava, who
had not more than 3000 men, was difconcerted ; and,
defpairing of fuccefs, defected that city with his troops,
and a few of his countrymen who remained behind him
were put to death by the populace. Inltead of advancing
in perfon, Alompra now fent his fecond fon Shembuan
to take poll'efiion of Ava. Thefe events occurred in au¬
tumn 1753.

In confequence of his firft fuccefs, Alompra’s reputa¬
tion became unbounded. His countrymen everywhere
revolted, and attached themfelves to him as their deli¬
verer. The Pegu king was alarmed for the northern dif-
trifts of his own territory, in which the Birman popula¬
tion exceeded that of the Peguers. A large force was
colle&ed under Apporaza, the Pegu king’s brother. It
confifted of an army, and of a numerous fleet of war-
boats, which failed up the Irawaddy to reduce the infur-
gents. He laid fiege to Ava, where Shembuan held out
forty days, till his father Alompra advanced to his aid.
Apporaza raifed the fiege, and went to encounter Alom¬
pra. The conteft was chiefly confined to the fleet; the
armies only fkirmifning on-fliore. Shembuan having ad¬
vanced from the fort of Ava to attack the rear of the Pe¬
guers, they gave way and fled with precipitation, buffer¬
ing great daughter in their retreat. The Peguers, en¬
raged by thefe misfortunes, put to death the dethroned
monarch of the Birmans, together with all the principal
men of his nation, to the amount of feveral hundreds,
that were in their power, under pretence that they had
been detefted in a plot againft their conquerors. This
only rendered the mutual hatred of the nations more vio¬
lent ; and in feveral towns the Birmans rofe upon the
Pegu garrifons, and maflacred the whole of them.

In the mean time Alompra continued to improve his
fortune, and avowedly endeavoured to eftablifh in his
own perfon the fovereignty of his country. When the
fon of the late king attempted to return, he drove him
back to his afylum among theSiamefe. Towards the end
of the year 1754, the Pegu king, Beinga Della, with a
confiderable army, laid fiege to Prome, a frontier town
defended by a folid u'all, a deep ditch, and a ltrong ftock-
ade. The Birmans fuccefsfully refilled a general alfault,
and the Peguers had recourfe to a blockade. Alompra
fent thirty-fix war-boats to the affiftance of the town,
which ftands upon a river ; the commander of thefe threw
himfelf with a confiderable fupply of men and provifions
into the town, and fent back his boats, only a few of
which were taken. After a further delay of fix weeks,
Alompra arrived in perfon, and attacked the Peguers
both by land and water. Inltead of keeping up a fire of
mufquetry as ufual, the boats clofed, and, after a defperate
engagement, the Peguers abandoned the fiege.

The tide of fuccefs was now fo completely turned, that
the war was become defenfive on the part of the king of
Pegu. He retired to his capital, which being near the
fea-coaft, the conteft became a kind of maritime warfare
in the mouths and creeks of the rivers; which laft are
extremely numerous in the low delta-land near their
mouth. At this time both the French and Englifli were
in pofleffion of factories in the Pegu country ; and both
the Peguers and Birmans folicited the affiftance of the
ftrangers, being abundantly fenfible that a few (hips of
burden furnifhed with guns would give a vaft advantage
to either party, in a conteft againft the war-boats ufed in
yOL. XIX. No. 1318.

G U. 475

their country. In the courfe of the year 1755 both the
French and Englifh appear to have entered fecretly into
feparate negotiations with each of the parties, and to have
promifed aid to each of them. Both of them ultimately
broke faith with Alompra, and joined the people of Pegu.
Notwithftanding this affiftance, the Birman leader conti¬
nued to enjoy a career of fuccefs. He was viftorious on
land, and the aid of the foreigners by water only pro¬
duced a flight degree of embarraflment. At one time
three Englifh fliips and one French flii p affifted the Pegu
force, confuting of zoo armed boats, while 10,000 men
marched along with them as a land-force ; but the Bir¬
mans difconcerted the attack by a ftratagem. With con¬
fiderable ingenuity they conftrufted fire-rafts, confifting
of a number of boats fattened together, and filled with
combuftibles. Thefe rafts were floated with a ftrong
fpring-tide to where the European fliips lay at anchor,
and directed with fuclr ikill and effeft as to oblige them
to flip their cables and remove, the French fliip narrowly
efcaping deftruttion. Alompra at laft fucceeded in
cutting oft’ the communication between Pegu and the
fea. A French fhip, coming to the affiftance of the Pe¬
guers, was taken by furprife ; and, as her papers proved
the object of her voyage, her officers were put to death by
the order of Alompra : other foreigners, however, parti¬
cularly the Englifli, taken in the important Pegu-town
of Syriam, were buffered to depart unmolefted, though he
had fufficient reafon to complain of their countrymen.

Alompra was at laft, in confequence of his fuccefs in
every quarter, enabled to lay fiege to Pegu itfelf, the ca¬
pital of his enemies. It was fituated on an extenfive
plain, furrounded with a high folid wall, flanked by fmall
towers, and ftrengthened on each face by demibaftions
equidiftant. A broad ditch contained about three feet
depth of water; and the pagoda ofShoemadoo, which will
be afterwards defcribed, ferved as a citadel. Circumval-
lation is a favourite mode of warfare with the Birmans,
as they are almoft deftitute of cannon, and therefore truft
rather to famine than to force. Having inverted Pegu,
and erefted numerous ftockades both to hem in the
town, and to fecure his own army againft external at¬
tack, Alompra, in the month of January 1757, refolved
to wait patiently till the want of fupplies fhould bring
the city into his power. After a fiege of two months the
numerous population of Pegu became mutinous in con¬
fequence of want. The king fummoned a council of
his family and chiefs, and propofed to fue for peace, on
condition of being allowed to govern his country, con-
fentingjo do homage for it to the Birman monarch. The
propofai was accepted by Alompra ; but, as a preliminary,
the Pegu king was under the r.eceffity of furrendering to
the conqueror his only unmarried daughter. For fome
days the peace feemed reftored, and the befiegers and the
beiieged mingled with each other in amity ; but Alom¬
pra, probably with a treacherous intention, having intro¬
duced fome foldiers in difguife into the town, they were
feized and put to death by order of the king of Pegu’s
nephew Choupavea. Hoftilities recommenced ; and at
laft the king of Pegu, who appears to have been a timid
man, privately admitted the Birmans into the city, on
condition that his own life fhould be fpared. And from
that time the whole kingdom of Pegu has continued
united to the Birman empire.

One attempt was, however, made by the Peguers,
about ten or twelve years after, to recover their indepen¬
dence; and the occafion was this. Shembuan, who had
now afcended the Birman throne, had w’aged fuccefsful
war againft the Siamefe in 1766, and had reduced the city
of Siam to pay tribute. But, being foon after engaged in
a war with the Chinefe, he found that, as foon as his ar¬
mies were recalled from Siam, his authority was difre-
garded there. He therefore fent one of his generals once
more into their country ; but he met with fuch oppofi-
tion as compelled him to retreat and to demand rein¬
forcements. This laft requeft was complied with, in a
6 F manner

476 P E

manner tl}at produced a ferious danger. One of the vice¬
roys of the fouthern parts of the empire was commanded
to raife the neceflary forces ; but, as his jurifdiCtion was
inhabited chiefly by families of Peguers, he had no fooner
aflembled his recruits and placed arms in their hands,
than they became confcious of their own ftrength, and
were feized with a defire to regain their empire. They
rofe upon their Birman officers and companions, and
commenced an indifcriminate (laughter. It was not till
after an army of 20,000 men was aflembled, with twenty-
four pieces of cannon, befides a great number of war-
boats, that they could be fubdued. Some time after,
Shembuan thought fit to vifit his Pegu territories, v^hich
had fo recently been involved in civil war. On this oc-
cafion he pretended to difcoverthat the old king of Pegu,
who had been taken by Alompra, and had remained all
this while in prifon, had engaged in fome kind of con-
fpiracy. Tn confequence of an accufation to this effeCt,
the dethroned monarch underwent the form of a trial,
was condemned and put to death. Many perfons of
rank, of the race of the Peguers, were alfo put to death
on this occafion, under pretence that they had given
countenance or aid to the late rebellion.

PEGU', a city of Afia, and formerly capital of the king¬
dom of the fame name. This city, in the year 1600, was
one of the moll fplendid, large, and populous, in the
whole of Afia; and is defcribed by thofe who faw it in
its profperity as fpacious, beautiful, and ftrong, fur-
rounded with ftone walls and very wide ditches. The
extent of the ancient city may ftill be accurately traced
by the ruins of the ditch and wall that encompafled it ;
from thefe it appears to have been a quadrangle, each
fide meafuring nearly one mile and a half; the ditch,
which was once no contemptible defence, is about lixty
yards, and its depth ten or twelve feet. The fragments
of the wall evince that it was a large and laborious ftruc-
ture, about thirty feet high, and at the bafe not lefs than
forty feet broad, compofed of brick, cemented with clay-
mortar. Small equi-diftant baftions, about 300 yards
afunder, are ftill difcoverable, and there had been a para¬
pet of mafonry ; but, in its prefent ruinous ftate, it is fo
covered with weeds and briars, as to exhibit very imper-
feCt veftiges of its former ftrength. In the centre of each
face of the fort, there was a gateway about thirty feet
wide; and thefe gateways were the principal entrances.
The paflage acrofs the ditch is over a catifeway raifed on
a mound of earth, that ferves as a bridge, and was for¬
merly defended by a retrenchment, of which there are
now no traces. That part of the city inhabit^ by the
king, the nobility, and the people of fafhion, was very
extenfive and populous ; its figure, fquare; and in each
fide of the wall were five gates of ftone, with many gilded
towers along it for polling centries ; it was encompafled
with broad ditches, in which were bred crocodiles, to de¬
ter people from wading over them. The ftreets were re¬
gular, running in a line from gate to gate, and fo wide,
that twelve men might go abreaft. Each houfe had a
palm-tree growing at the door, which formed a (hade for
paflengers. The king’s palace flood in the midft of this
city, built like a fortrefs, with walls and ditches. The
houfes and apartments within were of wood, all over
gilded, and adorned with battlements, covered with plates
of gold; within the gate was a fpacious court, with lodg¬
ings on the fides for the king’s choiceft elephants, amotigft
which were four of a white colour. That prince w'ould
not fufferany other to have white elephants; it was on
this account only that he made war on the king of Siam,
in 1567, from whom he took the famous white elephant;
and afterwards aflumed the title of King of the White
Elephant. Near the palace was a large court, furrounded
with ftone walls; and its two gates were always open,
feemingly regardlefs of the immenfe treafure within. In
the year 1596, the king of Siam befieged the king of Pe¬
gu in his capital for three months; but, for this time,
he was relieved by the afliftance of a body of Turks, in

G U.

conjunction with fome Portuguefe ; however, moil of
thofe whom war (pared, famine deftroyed ; for, out of
150,000 men, numbered in the city before the fiege, only
30,000 were left. The kings of Aracan and Tangu,
taking advantage of this diftrefled condition of Pegu,
marched to befiege it again ; and the king being at length
obliged to fubmit for want of provifions, fome time in the
year 1592, yielded himfelf and the city into the hands of
the king of Tangu ; whofe wife, though filter to the un¬
fortunate prince, caufed him and his family to be put to
death.

From that time Pegu ceafed to be the royal feat, and
fell to decay; fo that it is impoffible to conceive, fays co¬
lonel Symes, a more Itriking picture of fallen grandeur,
and the defolating hand of war, than the infide of thefe
walls difplays. Alompra, king of Birmah, when he got
pofleffion of the city in the year 1757, (fee the preceding
article,) razed every dwelling to the ground, and difper-
fed or led into captivity all the inhabitants. The tem¬
ples, or praws, which are very numerous, were the only
buildings that efcaped the fury of the conqueror ; and of
thefe the great pyramid of Shoemadoo has alone been re¬
verenced and kept in repair. The prefent king of the
Birmans (1807) has abrogated fome fevere penal laws im-
pofed by his predecefl’ors upon the native Peguers; and
the only diftinCtion fubfifting at prefent conlifts in the
exclufion of the latter from places of public truft and
power. Nothing has contributed more to reconcile the
Peguers to the Birman yoke, than the reftoration of their
ancient place of abode, and the prefervation and ernbel-
lifhment of the temple of Shoemadoo. Accordingly the
king fome time ago iffued orders to rebuild Pegu, encou¬
raged fettlers by grants of ground, and invited the {bat¬
tered families of former inhabitants to return and re¬
people their deferted city. His Birman majefty, on the
death of the late Mayu'oon, or viceroy, directed his fuc-
cefibr, the prefent governor, to quit Rangoon, and to
make Pegu the place of his future refidence, and the feat
of provincial government of the thirty-two diftriCts of
Henzawucldy, the fanfcrit name given by the Birmans to
the province of Pegu. The fuccefs of thefe ineafures has
been fuch, that a new town has been built within the (cite
of the ancient city ; but Rangoon poftefles fo many advan¬
tages over Pegu, in a commercial point of view, that per¬
fons of property in bufinefs will not eafily be prevailed
upon to leave one of the fineft fea-ports in the world, to
encounter the difficulties of a new fettlement, where
commerce, if any can fubfilt, mult be very confined for
the want of commodious navigation. The prefent inha¬
bitants who have been induced to return, confift chiefly
of priefts, and poor families, who were glad to gain a fet¬
tlement in their once-magnificent metropolis. Their
number, all together, does not, perhaps, exceed fix or
(even thoufand: thofe who dwelt in Pegu, during its
former days of fplendour, are now nearly extinCt, and
their defcendants and relatives fcattered over the provin¬
ces of Tongho, Martaban, and Talowmeou ; and many
alfo live under the protection of the Siamefe.

Pegu, in its renovated and contracted ftate, feems to
be built on the plan of the former city, and occupies
about one half of its area. It is fenced round by a ftock-
ade from ten to twelve feet high ; on the north and eaft
fides it borders on the old wall. The plane of the town
is not yet filled with houfes, but a number of new ones
are building. There is one main ftreet running eaft and
weft, crofted at right angles by two fmaller ftreets not
yet.finiflied. At each extremity of the principal ftreet,
there is a gate in the (tockade, which is (hut early in the
evening ; and after that time entrance during the night
is confined to a wicket. Each of thefe gates is defended
by a wretched piece of ordnance, and a few mufqueteers,
who never poll fentinels, and are ufually afleep in an ad¬
joining filed. There are two inferior gates on the north
and fouth fide of the ftockade. The ftreets of Pegu are
fpacious, and well paved with brick, which the ruins of the

\

PEGU.

477

old plentifully fupply ; and on each fide of the way there
is a drain to carry off the water. The houfes are raifed
from the ground either on wooden ports or bamboos, ac¬
cording to the fize of the building. The Mourns, or mo-
nafteries, and the habitations of the higher ranks, are
ufually elevated fix or eight, thofe of the lower claffes
from two to four/ feet. There are no brick buildings
either in Pegu or Rangoon, except fuch as belong to the
king, or are dedicated to their divinity Gaudma : his ma-
jefty having prohibited the ufe of brick or ftone in private
buildings, from the apprehenfion, as we were informed,
(fays Col. Symes,) that, if people got leave to build
brick houfes, they might eredt brick fortifications, dan¬
gerous to the fecurity of the ftate. The houfes, there¬
fore, are all made of mats, or flieathing-boards, fupported
on bamboos or ports ; but, from their being compofed of
l’uch combuftible materials, the inhabitants are under
continual dread of fire, againft which they take every pre¬
caution. The roofs are lightly covered, and at each door
ftands a long bamboo, with an iron hook at the end, to
pull down the thatch: there is alfo another pole, with a
grating of iron at the extremity, about three feet Square,
to fupprefs flame by preffure. Almort every houfe has
earthern pots, filled with water, on the roof ; and a par¬
ticular clafs of people, whofe hufinefs it is to prevent and
extinguilh fires, perambulate the ftreets during the night.
Thefe people are called Pagwaat ; they are flaves of go¬
vernment ; men who have been found guilty of theft,
and, through mercy, had their lives Ipared. They are
dirtinguifhed by a black circle on each cheek, caufed by
gunpowder and punctuation ; as well as by having on
their breaft, in Birman characters, the word tMef, and the
name of the article ftolen, as, on one that we afked to be
explained to us, Putchoo Khoo, cloth-tMef. Thefe men
patrole the ftreets at night, to put out all fires and lights
after a certain hour. They adt as conftables, and are the
public executioners.

The viceroy’s habitation, though not at all a magnifi¬
cent manfion for the reprefentative of royalty, is notwith-
ftanding a building of much refpedtability, compared to
the other houfes of Pegu. It pofieffes, however, but few
ornaments: gilding is forbidden to all fubjedts of the
Birman empire; liberty even to lacker and paint the
pillars of their houfes is granted to very few.

The objeft in Pegu that molt attracts and moll merits
notice, is the noble edifice of ' S ho emadoo, or the Golden
Supreme, of which we have given a reprefentation in the
lower part of the preceding Engraving, from the ad Vol.
of Symes’s Ava. This extraordinary pile of building is
ereCted on a double terrace, one raifed upon another.
The lower and greater terrace is about ten feet above the
natural level of the ground, forming an exaCt parallelo¬
gram : the upper and fmaller terrace is fimilar iri fhape,
and rifes about twenty feet above the lower terrace, or
thirty above the level of the country. Col. Symes, from
whom this account is taken, judged a fide of the lower
terrace to be 1391 feet; of the upper, 684. The walls
that fuftained the fides of the terrace, both upper and
lower, are in a ruinous ftate ; they were formerly covered
with plafter, wrought into various figures; the area of
the lower is ftrewed with the fragments of fmall decayed
buildings, but the upper is kept free from filth, and is in
tolerably good order. There is reafon to conclude that
this building and the fortrefs are coeval, as the earth of
which the terraces are compofed appears to have been
taken from the ditch ; there being no other excavation
in the city, or in its neighbourhood-, that could have af¬
forded a tenth part of the quantity. The terraces are af-
cended by flights of ftone fteps, which are now broken
and negleCted. On each fide are dwellings of the priefts,
raifed on timbers four or five feet from the ground ;
thefe houfes confift only of a large hall ; the wooden
pillars that fupport them are turned with neatnefs ; the
roofs are covered with tiles, and the fides are made of
boards ; and there is a number of bare benches in every

houfe, on which the priefts fleep ; but we faw no other
furniture. The building itfelf is pyramidical, compofed
of brick and mortar, without excavation or aperture of
any fort; oCtagonal at the bafe, and fpiral at top; each
fide of the bale meafures 162 feet ; this immenfe breadth
diminilhes abruptly, and a fimilar binding has not un¬
aptly been compared in lhape to a large fpeaking-trumpet.
Six feet from the ground there is a wide projection that
furrounds the bafe, on the plane of which are fifty-feven
fmall fpires of equal fize, and equi-diltant ; one of them
meafured twenty-feven feet in height, and forty in cir¬
cumference at the bottom. On a higher ledge there is
another row, confiding of fifty-three fpires of fimilar
lhape and meafurement. A great variety of mouldings
encircle the building; and ornaments fomewhat refem-
bling the fleur-de-lis Surround the lower part of the fpire ;
circular mouldings likewife girt it to a confiderable
height, above which there are ornaments in ftucco not
unlike the leaves of a Corinthian capital ; and the whole
is crowned by a tee, or umbrella, of open iron-work,
from which rifes a rod with a gilded pennant.

The tee, or umbrella, is to be feen on every facred
building that is of a fpiral form : the railing and conse¬
cration of this laft and indifpenfable appendage, is an aft
of high religious Solemnity, and a feafon of feftivity and
relaxation. The prefent king bellowed the tee that co¬
vers Shoemadoo. It was made at the capital ; and many
of the principal nobility came down from Ummerapoora
to be prefent at the ceremony of its elevation. The cir¬
cumference of the tee is fifty-fix feet; it relts on an iron
axis fixed in the building, and is farther Secured by large
chains ftrongly rivetted to the fpire. Round the lower
rim of the tee are appended a number of bells, which,
agitated by the wind, make a continual jingling. The
tee is gilt ; and all the minor pagodas are ornamented
with proportionable umbrellas of fimilar workmanfhip,
which are likewife encircled by fmall bells.

The extreme height of the edifice, from the level of the
country, is 361 feet, and above the interior terrace 331
feet. At each angle of the interior and higher terrace
there is a temple fixty-feven feet high, refembling, in mi¬
niature, the great temple: in front of that, in the South-
weft corner, are four gigantic representations, in mafonry,
of Palloo, or the Evil Genius, half bead, half human,
Seated on their hams, each with a large club on the
right (houlder. Thefe are guardians of the temple.
Nearly in the centre of the eaft face of the area are two
human figures in ftucco, beneath a gilded umbrella; one,
Handing* reprefents a man with a book 'before him and a
pen in his hand ; he is called Thafiamee, the recorder of
mortal merits and mortal mifdeeds ; the other, a female
figure kneeling, is Mahafumdera, the protedtrefs of the
univerfe, So long as the univerfe is doomed to laft; but,
when the time of general diffolution arrives, by her hand
the world is to be overwhelmed and everlailingly de-
ftroyed.

Along the whole extent of the north face of the upper
terrace there is a wooden filed for the convenience of
devotees who come from a diftant part of the country.
On the north fide of the temple are three large bells of
good workmanfhip, fufpended nigh the ground, between
pillars ; Several deer’s horns lie ftrewed around ; thofe
who come to pay their devotions firft take up one of the
horns, and ftrike the bell three times, giving an alternate
ftroke to the ground : this adl, we are told, is to an¬
nounce to the Spirit of Gaudma the approach of a Sup¬
pliant. There are Several low benches near the foot of
the temple, on which the perfon who comes to pray places
his offering, commonly confiding of boiled rice, a plate of
Sweetmeats, or cocoa-nut fried in oil ; when it is given,
the devotee cares not what becomes of it ; the crows and
wild dogs often devour it in prefence of the donor, who
never attempts to difturb them.

There are many fmall temples on the areas of both
terraces, which are neglected and Suffered to fall into de¬
cay.

478

PEGU.

cay. Numberlefs images of Gaudma lie indifcriminately
fcattered. A pious Birman who purchafes an idol, firft
procures the ceremony of confecration to be performed
by the rahaam, or priefts ; he then takes his purchafe
to whatever facred building is mod convenient, and there
places it within the (belter of a kioum, or on the open
ground before the temple; nor does he ever again feem
to have any anxiety about its prefervation, but leaves the
divinity to fhift for itfelf. Some of thofe idols are made
of marble that is found in the neighbourhood of the ca¬
pital of the Birman dominions, and admits of a very fine
polifh ; many are formed of wood, and gilded; and a few
are of filver ; the latter, however, are not ufually expofed
and neglefted like the others. Silver and gold are rarely
ufed, except in the compofition of houfehold gods.

On both the terraces are a number of white cylindrical
flags, raifed on bamboo poles ; thefe flags are peculiar to
the raliaans, or priefts, and are confidered as emblematic
of purity, and of their facred funftion. On the top of
the ftaff there is a henza, or goofe, the fymbol both of the
Birman and Pegu nations.

The raliaans, or priefts, are a kind of monks who pro-
fefs celibacy, and abftain from every (enfual indulgence.
The prefcribed punifhment for a rahaan detefted in an
a<5l of incontinence, is expulfion and public difgrace.
The delinquent is feated on an afs, and his face daubed
with black paint, interfperfed with fpots of white. He is
thus led through the ftreets, with a drum beating before
him, and afterwards turned out of the city. The juniors
only go abroad by the permiflion of the fuperior or prior
of the convent. They are drefled in a long loofe cloak,
and yellow is the only colour worn by them. The ra-
liaans never drefs their own viftuals, holding it an abufe
of time to perform any of the common functions of life,
which, fo long as they occupy, mult divert them from
the abftraft contemplation of the divine eflence. They
receive the contributions of the laity ready cooked, and
prefer cold food to hot. At the dawn of the morning
they begin to perambulate the town, to colled! fupplies
for the day : each convent fends forth a certain number
of its members, who walk at a quick pace through the
ftreets, fupporting with the right arm a blue lackered
box, in which the donations are depofited ; thefe ufually
confift of boiled rice mixed with oil, dried and pickled
fifli, fweetmeats, fruits, &c. During their walk they ne¬
ver caft their eyes to the right nor to the left, but keep
them fixed on the ground ; they do not ftop to folicit,
and feldom even look at the donors, who appear more
defirous to beftow than the others to receive. A much
larger quantity of provifions being commonly procured
than fuffices for the members of the convent, the furplus
is difpofed of as charitably as it was given, to the needy
ftranger, or the poor fcholars who daily attend them to
be inftrufted in letters, and taught their moral and reli¬
gious duties.

From the upper projeftion that furrounds the bafe of
Shoemadoo, the profpeft of the circumjacent country is
extenfive and pifturefque ; but it is a profpeft of nature
in her rudeft ftate : there are few inhabitants, and
fcarcely any cultivation. The hills of Martaban rife to
the ealtward, and the Sitang river, winding along the
plains, gives an interrupted view of its waters. To the
northward about forty miles are the Galadzet hills,
whence the Pegu river takes its rife; hills remarkable
only for the noifome eftefts of their atmofphere. In
every other direftion the eye looks over a boundlefs
plain, chequered by a wild intermixture of wood and
water.

The temple of Shoemadoo appears to be the largeft in
the province of Pegu. At the fame time they have many
others formed upon a fimilar plan and of great extent.
Of one of thefe we (hall take notice, on account of the
coincidence between its name and the name of a pagan
temple mentioned in the facred Scriptures. It is to be
obferved, that in the Birman tongue the word Jhoe . figni-

fies golden ; and the name of the temple to which we al¬
lude, is called Shoedag-on, or the Temple of the golden
Dagon. It is thus defcribed : “The temple of Shoeda-
gon, about two miles and a half north of Rangoon, is a
very grand building, although not fo high by 25 or 30
feet as that of Shoemadoo at Pegu. It is much more or¬
namented ; the terrace on which it ftands is raifed on a
rocky eminence, confiderably higher than the circumja¬
cent country. It is afcended by above one hundred
ftone fteps that have been fu(Fered to fall into decay. The
fituation renders Shoedagon a confpicuous objeft at the
diftance of many miles. The tee and the whole of the
fpire are richly gilded, which, when the fun fliines, ex¬
hibit a fingularly fplendid appearance. The fmalkaux-
iliary buildings are yet more numerous than thofe that
furround the bafe of the Pegu temple. Perceiving that
feveral of thefe were in a ruinous ftate, whilft the foun¬
dations of others were juft laid, and fome half finiftied, I
alked why they did not repair the damages of the old
before they erefted new ones ; and was told, that to mend
a decayed praw, or temple, though an aft of piety, was
not fo meritorious as to ereft a new one : and that fome-
tiines the old ones were repaired by thofe who were un¬
willing or unable to be at the expenfe of a complete
building. The borders of the terrace on which the tem¬
ple is raifed are planted with fliady trees in regular rows ;
from this eminence there is a beautiful and extenfive
profpeft ; the Pegu and Rangoon rivers are feen winding
through a level woody country; and the Temple of Sy¬
rian), little inferior to thofe that have been defcribed,
ftands near the junftion of the ftreains.”

The language of Pegu is called by Dr. Leyden a dif-
tinft original language ; but it is written in the Burrnan-
i(h charafter, and Adelung’s fpecimen differs fcarcely at
all from the Burmanilh. We may not improperly men¬
tion in this place, that the emperor of Burmah and
Pegu has employed an Englishman, Mr. Felix Carey, to
eftablifli, at his expenfe, a printing-prefs at Ava, the me¬
tropolis, for printing a verfion of the Scriptures in the
Burmanifli tongue.

Pegu is ninety miles from Rangoon by water, moftly
in a northern direftion ; but, on account of the windings
of the river, it would be by land, in a ftraight line,
much lefs. Lat. 17. 40. N. Ion. 96. 11. 15. E. Symes’s
Ava, vol. ii. Afiatic Refearches, vol. v. p. 111.

PEGU', a river of Afia, in the vicinity of the city of
the fame name. It is called by the natives “ Bagoo
Kioup,” or Pegue Rivulet, to diftinguifh it from “Mioup,”
or the River. This river is navigable but a very few
miles to the northward of the city of Pegu, and for this
it is indebted wholly to theaftionof the tide. It has no
communication with the fea, except by the Rangoon
river ; and, in the fair feafon, at low water, isalmoft dry.
This ftream has been fometimes miftaken for the Sitang
river, about fifteen miles eaft of Pegu, which is a large
and independent body of water, that partly defcribes the
courfe that in the map is given to what is called the Pegu
river.

PEGUN'NOCK, a branch of the Paflaic river, in New
Jerfey.

PEGUN'TIUM, or Pegun'ti^e, in ancient geography,
a town or citadel of Dalmatia, on the Adriatic, oppofite
to the ifland Brattia, fcarcely five miles oft’, and forty
miles to the eaft of Salonae. According to Fortis, a
mountain, a large hollow, and fubmarine fprings, are feen
here. “This hollow (fays he) feems to have been ex¬
cavated by fome ancient river. The fprings which bub¬
ble up from under the fea are fo confiderable, that they
might pafs for the rifing-again of a river funk under
ground. Vrullia has the fame derivation as the word
Vril, which in Sclavonian fignifies a fountain, and this
etymology, rendering the name of Vrullia the Berullia
of Porphyrogenitus analogous to that of Peguntium,
fince Tleyv and Vril are fynonymous, induces me to be¬
lieve, that the caftle named Peguntium by ancient geo¬
graphers

PEI

graphers was fituated at this place, and not at the mouth
of the Cettina. No remarkable veftiges of antiquity now
exift on the fpot; yet it is evident, by the quantity of frag¬
ments of vafes, tiles, and fepulchral infcriptions now and
then dug up, that this trail ofcoaftwas well inhabited in
the Roman times. The principal caufe why the tracks
of ancient habitations cannot be difcovered about Vrullia,
is the lleepnefs of the hill above it, and the quantity of
Hones brought down from thence by the waters. The
mouth of the hollow of Vrullia is dreaded by feamen, on
account of the hidden impetuous gulls of wind that blow
from thence, and in a moment raife a kind of hurricane-
in the channel between the Primorie and the ifland of
Brazza, to the great danger of barks furprifed by it.”
Fortis’s Travels in Dalmatia.

PEGYP'SENT, a town of Maine, in the county of
Cumberland, N. A. having 805 inhabitants.

PEHL, a town of Auftria : ifix miles well of Wells.

PE'I, a city of China, of the fecond rank, in Se-tchuen,
on the Kincha river: 720 miles fouth-fouth-well of Pe¬
king. Lat. 29. 50. N. Ion. 107. E.

PE'I, a town of China, of the third rank, in Kiang-
ii3n : forty miles north-north-well of Pefu.

PEI-CHAN', a town of China, of the third rank, in
Se-tchuen: twenty miles well of Tchong-king.

PEI-HO', or the White River, a river of China, form¬
ed by feveral llreams, in the province of Pe-tche-li, and
runs into the Gulf of Pe-tche-li. The mouth of the ri¬
ver is traverfed by a bar llretching north-north-eall and
fouth-fouth-well, over which, at low water, the depth is
not more than three or fourfeet, and in many places it is
almoll dry. The tides rife and fall fix or feven feet at
the mouth of the river: the time of high water at the
full and change of the moon, is about half after three ;
and five or fix miles outfide of the mouth of the river a
large bamboo beam is placed upon the bar, together with
lome of a fmaller fize, continued nearly in a ftraight line
to the (liore, intended as marks to diredl velfels entering
into the river. The town ofTa-coo lies within the Pei-
lio, and is the firll place of any note in this part of the
north-eall frontier of China. Yachts, or large covered
barges, and boats of burden, calculated to pals over the
Ihallowsof thePei-ho, may be obtained here, in order to
enable perfons to proceed as far as this river leads, to¬
wards Pekin, the capital of the empire.

The progrefs upon thePei-ho is neceffarily very flow,
as the courfe of the river is remarkably ferpentine. The
fields on each fide exhibit a high llate of cultivation, and
are generally covered with the Holcus forghum, or the
tailed of the vegetables producing efculent grain, com¬
monly called Barbadoes millet : it grows to ten or twelve
feet high, and the lowetl calculation of its increafe is one
h ur.dred-fold. The houfes in the villages near the river
are conftru&ed of bricks ill-burnt, or baked in the fun,
which, as well as the tiled roofs, are plaftered over with a
muddy-coloured fubftance, unmixed with lime. Near
foir.e of the towns and villages are pyramids about fifteen
feet high, but of different dimenfions as to both length
and thicknefs. They conlift of bags of fait, heaped
together in that form, and covered merely with common
matting. As foon as night comes on, the banks of this
river are illuminated with variegated lights, from lan¬
terns wliofe tranfparent fides are made of different co¬
loured paper. The different numbers of lanterns hoilled
on the malls’ head of the various velfels in the river de¬
note the rank of the paflengers they hold ; all which, to¬
gether with the lights from the cabins of the junks, re¬
flected from the water, produce a moving and parti- co¬
loured illumination. The fait, already mentioned,
brought from Quan-tong and Fo-chien into the Pei-ho,
is fulficient to load annually nearly 2000 velfels of 200
tons burden each.

At Tien-fing two rivers unite; one of which retains
the name of Pei-ho ; and the other is called Yun-leang-ho,
or “ Grain-bearing River,” from the quantities of wheat
Vol. XIX. No. 1318.

PEI 479

conveyed upon it from the province of Shen-fee, and fent
up by the Pei-ho to the neighbourhood of Pekin. About
thirty miles beyond Tien-fing, towards Pekin, the tide
of the Pei-ho ceafes, and the progrefs of the yachts, See. is
effefled by rowing with oars or towing with ropes; and
their advance is very flow againll the current of the ri¬
ver. Large junks, to the number of 1000, each of which
contains not lefs than fifty perfons, and therefore in the
whole amount to 50,000, are paffing bet ween Tong-choo-
foo and Tien-fing, and as many more of other kinds of
craft; fo that upon a branch of a Angle river, the popu¬
lation of its moveable habitations amounts to 100,000
perfons. Tong-choo-foo, where the water becomes
too fhallow for the navigation of yachts of any bur¬
den, is ninety miles diflant from Tien-fing, and twelve
miles from the city of Pekin. The mouth of the river
Pei-ho, in the gulf of Pe-tche-li, is in lat. 39. N.

PEI'CHELSTEIN, a town of the country of Tyrol :
five miles fouth-fouth-wefl of Reutten.

PEJEN'D, or Paja'na, the mofl confiderable lake of
Finland, about eighty miles in length by fifteen in
breadth, which gives fource to the river Kymmen.

PE'JF.PSCOT, a town of Maflachufetts, in the pro¬
vince of Maine : thirty miles north of Portland.

PEIL'LAC, a town of France, in the department of
the Morbihan : fix miles eafl of Rochefort.

PEIL'STEIN, a town of Auftria: four miles fouth of
Aigen.

PEI'NA, a town of Weflphalia, in the bifhopric of
Hildefheim, fituated in a marfhy country on the Fufe,
and formerly reckoned among the fortrefles. The great-
eft part of the inhabitants here are Lutherans. In a cor¬
ner of the town llands the epifcopal palace, with a capu¬
chin convent; and near them is a fuburb called the Damm,
which is chiefly inhabited by fliopkeepers and Jews. It
is fifteen miles north-north-eaft of Hildefheim, and
twenty-one eafl of Hanover. Lat. 52. 10. N. Ion. 10.
18. E.

PEINE FORTE ET DU'RE, or Pressing to Death.
See Mute, vol. xvi.

PEING-GHE'E, a town of Birmah, on the Irawaddy,
from whence teak-wood is fent to Rangoon : twenty
miles north-weft of Mayahoun.

PEINS, or Pentz (Gregory), a German engraver of
fome eminence, was born at Nuremberg in the year 1500.
He firll ftudied in the fchool of Albert Durer, and pro¬
fited much by the inftruflions of that diftinguifhed maf-
ter; but it was in Italy, and under Marc Antonio, that
he finifhed his tafte, formed his fly le of engraving, and
acquired that corre6lnefs of drawing which we regard
with fo much admiration in his beft works. His plates
are executed entirely with the graver, which he handled
with much fkill, uniting with great precifion a degree of
freedom which was unexampled. He appears to have
worked on fome of the beft plates that pafs under the
name of Marc Antonio. The far greater number of the
engravings of Peins are of final 1 dimenfions; wherefore
he is ufually clafled among “ the little mailers ;” but lie
has produced fome few large prints ; one efpecially of
great merit, of An Army palling a Ditch and Scaling the
Walls of a fortified City, after Julio Romano ; which, as
Strutt has faid, is “an admirable fpecimen of the artiil’s
fuperior abilities.” Peins died at the age of fifty-fix, but
where his biographers have not mentioned. His mono¬
gram will be found on the preceding plate.

The beft of the hiftorical works of Peins are, a pair of
Either before Ahafuerus, and The Temptation of Job ;
another fmall pair of Judith in the Tent of Holofernes,
and Judith appearing afterwards with his Head ; another
pair, finely executed, of Solomon’s Idolatry, and The
Judgment of Solomon. Peins appears to have poflefled
fome judgment, at leaft fome humour, in pairing his
prints; vvitnefs Sufannah folicited by the two Old Men,
and Lot intoxicated by the two Young Women, his
daughters.

6 G PRINT,

480

P E I

PEINT, a town of Plindooftan, inBaglana: twenty-
eight miles north-weft of Nafl’uck.

PEINT, a town of Hindooftan, in Guzerat : twenty
miles fouth of Dungerpour.

PEI'PUS LA'KE, or Tschud'skoe, a lake of Ruflia,
which lies between the governments of Pfcove, Reval,
Riga, and St. Peterfburg, extending in length to about
So and in breadth to 60 verfts. By means of a very broad
ftrait it is connected with the Pfcove-lake, the length of
which is ftated to be 50, and the breadth, which is always
decreafing, 40 verfts. This latter receives the river Ve-
likaia. Out of the Peipus comes the Narova, which
through the Embach has communication with the
Vertz-erb lake ; out of this, on the other hand, flows the
Fellin into the gulf of Riga ; and confequently a very
beneficial water- paflage might be made between Riga and
fome of the inland provinces, by way of the Peipus-lake.
In this lake there are a few fmall iflands, none of which
are fufficiently important to deferve notice except Perka
or Bork, called by the Efthonians Porkafaar , which is not
only inhabited, but furnifhed with forelts, and has no lefts
than three villages upon it. Among the feveral brooks
and rivers that flow into the Peipus, the Embach is the
moft confiderable. The exit is through the Narva river
into the gulf of Finland. The multitude of fifth that
breed in this lake afford a lucrative occupation to the
boors of thefte parts, and increafe the revenues of the ad¬
joining eftates, the owners of which let out the parts on
which their lands abut at a certain rent. The fifh are
principally rebj'e, a fpecies of herring, and barbel : be¬
tides thefte, here are pike, perch, a fpecies of carp, whi¬
ting, quebb, korufhki, gudgeons, &c. Lat. 58. to 59. 10.
N. Ion. 27. to 27. 28. E.

PEI'RAH, a town of Malacca, fituated on the weft
coaft : 100 miles north-weft of Malacca. Lat. 3. 40. N.

PEIRCE (James), a learned Englifh diflenting divine,
was the fon of reputable parents, and born at London in
the year 1673. Having had the misfortune to lofte both
his father and mother while yet a- child,, he was taken
under the care of his guardian, Mr. Matthew Mead, a
celebrated minifter at Stepney, in whole houfe he was in-
ftructed in the firft rudiments of learning by a private
tutor. Afterwards he was placed in different grammar-
fchools, till he was prepared for entering upon acourfe
of academical ftudies, when he was lent to the univerfity
of Utrecht. Here he conftantly attended the leCtures of
Witfius, Leydecker, Graevius, Leuftden, and other emi¬
nent profeffors ; and cultivated a friendfnip with fome of
the moft diftinguiflied of his fellow lludents, particularly
with Adrian Reland, who continued to be his correftpon-
~dent after he attained to confiderable celebrity as a pro-
feffor. From Utrecht Mr. Peirce removed to Leyden,
where he had the opportunity of hearing Gronovius,
Spanheim, and other profelfors of the higheft character
in the republic of letters. Having ftpent between five
and fix years in thefte feminaries, he returned to England,
and lived for fome time with his relations in London;
and then took private apartments at Oxford, where he
procured accefs to the Bodleian Library. After this, at
the requeft of his friends, he preached a Sunday-evening
lecture at Miles’s lane in London, and occafionally in
other places, without interefting himftelf with the dift-
putes then exifling between the Prefbyterians and Inde¬
pendents. With the minifters of the former denomina¬
tion he became well acquainted, and at their earned feli¬
citations fettled at Cambridge, where he acquired the
refpeCt and efteem of many members of the Univerfity.
From Cambridge he removed to Newbury in Berkfhire,
where he appeared to advantage, in the year 1707, in a
controverfy with Dr. Wells, a clergyman of Leicefter-
fthire. That gentleman, out of his zeal for the interefts of
the Church of England, had publifhed and circulated
with great activity, “A Letter to Mr. Peter Dowley,” a
diflenting minifter, by which he laid himftelf open to ani-
nujdverfion, in conftequence of the account which he

P E I

gave in it of the the principles and practices of the dif-
ftenters. This Mr. Peirce undertook to controvert, and
publifthed in fucceflion eight “ Letters” to the author, in
which he convi&ed him, not only of various miftakes,
but of unjuft and calumnious mifreprefentations. After
the termination of this controverfy, Mr. Peirce publifhed,
at different periods, various able polemical tracts, rela¬
ting to the rites impofted under the eftablifhment, the va¬
lidity of the diflenting miniftry and preftbyterian ordina¬
tion, and the imputed fin of ftchifm.

Mr. Peirce’s next publication, was a work of much
greater importance, and was called for by the appearance
of “ A Defence of the DoCtrine and Difcipline of the
Church of England,” written in the Latin tongue, and
fubmitted to the judgment of foreign divines, by Dr.
Nichols, Latin fecretary to the Society for the Propaga¬
tion of the Goftpel. In this work the author had given
fuch a view of the controverfy between the Church and
the Diffenters, as was intended to expofe the latter to
the cenfure and condemnation of their foreign brethren ;
on which account Mr. Peirce was earneftly folicited to
undertake their vindication in the fame language, for the
purpofte of counteracting the effeCts of Dr. Nichols’s
performance. He accordingly publifhed his “ Vindicias
Fratrum Diflentientium,” in which he gave a full and
very fatisfaCtory anfwer to his antagonift. This w:ork
was publifhed in 1717 in the Englifh language, with large
additions, under the title of “A Vindication of the Dif¬
fenters, &c.” It confifted of three parts : the firft con¬
tains the hiftory of nonconformity ; the fecond treats of
the doCtrine of the church of England ; and the third
contains all the heads relating to difcipline and worfhip.
It, in fact, prefents the reader with a view of almoft the
whole controverfy between the eftablifhed church and the
diffenters.

In 1718, Mr. Peirce took part in the controverfy rela¬
ting to the Teft Aft, and publifhed “Letters” on the
fubjeCt to a friend, and to Dr. Snape. He had previoufly
to this removed from Newbury to Exeter, having had a
general and moft unanimous invitation from the three
united congregations of the diffenters in that city. In
this fituation he gave the greateft fatisfaCtion in the dift-
charge of the paftoral duties, till there arofte a controver¬
fy concerning the explication of the Trinity, which w>as
productive of very difgraceful conftequences. He had
been educated in the trammels of orthodoxy as it was
called, but had, during his miniftry, learnt to fhake off
all thofte unfcriptural phraftes which then, as well as now,
were looked on as a kind of teft of a man’s religious opi¬
nions. Fie confidered the Scriptures as the only rule of
faith, and from a very early period he took care to ufte
their language in his fermens, when he introduced any
doCtrinal topic; and as he advanced in years he grew more
careful in his adherence to this practice. The doCtrine
of the Trinity he looked upon as a myftery , and was
averfte from ftpeaking or even thinking upon it. But his
attention was unavoidably drawn to it by the clamour
which was railed concerning his friend Mr. Whifton, for
whom he had a high efteem ; and at firft he was ex¬
ceedingly hurt to learn that Mr. Whifton had declared
againft the current doCtrines of the day. He expoftulated
with his friend ; but, inftead of convincing him of his er¬
ror, he himftelf became a convert to the herefty that he
had been ready to condemn. “ The reader,” fays Mr.
Peirce, “ will eaftily imagine that this muft have been a
terrible Ihock to me ; and that I muft have had a great
concern upon my mind, wdien I found myfeif at a lofts
about a doCtrine of which I had been all along fond, to a
degree of uncharitablenefs. However, this caufted me to
read the Bible with more care, and make it more my
prayer to God, that I might be led into the truth.” It
was not long before he was fully fatisfied that the com¬
mon opinion was not accordant with the doCtrines held
forth in Scripture. Being fufpeCted of holding heretical
opinions, he was attacked in the moft hoftile manner;

3 and

481

P E I

and there can be no doubt that, had his opponents pof-
feffied the power, they would mod cheerfully have burnt
him at the ftake. They required him to fubfcribe a ted :
he refufed, becaufe he believed that the word mifchief
liad been done to the church of God by impoling unfcrip-
tural creeds and teds upon men ; and he faid he would
never tamely furrender the liberty with which he had
been made free. They turned him out of his meeting,
and excited the clamour of the mob againd him, by ftig-
matizing him and his colleague Mr. Hallet with the then
opprobious epithet of Arians. Under thefe circumdances,
Mr. Peirce found it neceffary, for the vindication of his
own character, and that of his friends, to lay a true
date of the affair before the public ; and accordingly pub¬
lilhed “ The Cafe of the Miniders ejected at Exon.” In
1720 he gave the world a much larger work, entitled
“The Wedern Inquifition, or a Relation of the Contro-
verfv which has been lately among the Did'enters in the
Wed of England,” which contains a full account of the
origin, progrefs, and ittue, of the perfecution with which
our author was harafied. To this a reply was publilhed,
entitled “An Anfwer to Mr. Peirce’s Weltern Inquifi¬
tion, &c.” Mr. Peirce now took leave of the contro-
verfy by a very able and fatisfaclory piece, entitled “ In¬
quifition Honedy difplayed, or the Wedern Inquifition
defended againd the pretended Anfwer, &c.”

From this period Mr. Peirce applied himfelf to the di¬
ligent difcharge of his padoral duties among a refpec-
table flock, by whom he was highly honoured and be¬
loved, and to the completion of fome explanations of the
facred writings, in which he had made confiderabie pro¬
grefs. The firfl fruits of his learned dudies were given
to the world in 1725, but without his name, in “ A Pa-
raphrafe and Notes on the Epiflle of St. Paul to the Co-
loilians,” 4to. in which he endeavoured to follow the
admirable rules and example of Mr. Locke, whom hecon-
fidered as having done more than any other writer to¬
wards rendering St. Paul’s Epiflles eafy and intelligible.
This publication was well received; and in the fame year
he gave the world “ A Paraphrafe and Notes on the
Epiltle of St. Paul to the Philippians.” He intended to
proceed with fimilar commentaries on all the other
Epidles attributed to this apodle, excepting thofe that
had been before paraphrafed by Mr. Locke. His next
attempt was on “ The Epidle to the Hebrews,” which he
did not live to finilh ; for, while he w'as engaged in it, he
was attacked by a diforder which put an end to his life,
on the 30th of March, 1726, in the 53d year of his age.

The perfecution which he had met with during his
life purfued him even to the grave: for, his relations
having directed that a Latin infcription, containing an
encomium on his learning and virtues, (hould be cut on
a tomb-ftone, the re£lor of the church in which his re¬
mains were depofited would not permit it be placed in his
church-yard; Hating that he could not, in confcience,
fuffer a perfon fo notorious for lierefy to be warmly re¬
commended to pofterity in any place under his care and
infpeftion. When it was afterwards requefted that thefe
words might be infcribed on his tomb, “ Here lies the
reverend, learned, and pious, Mr. James Peirce,” ftill
it was refufed ; the reclor affuming that Mr. Peirce could
not be reverend, becaufe he was not lawfully ordained;
and that. he was not pious, becaufe he taught errors ; fo
that the only infcription allowed, was “ Mr. James
Peirce’s Tomb, 1726.” On a monument erecled to his
memory in the meethig-lioufe in which he latterly officia¬
ted, he is held out to the veneration of pofterity, as “ a
rational, judicious, and affeftionate, preacher; a very la¬
borious and fagacious interpreter of the Holy Scriptures;
a fincere lover and ftrenuous defender of the truth ; and a
courageous fufferer for maintaining the doftrines of the
gofpel of Chrift, and for aflerting the liberties of Chrif-
tians.”_ After his death, his “ Paraphrafe and Notes on
the Epiftle of St. Paul to the Hebrews, with Dittertations
on feveral Texts of Scripture,” were publilhed in 1727,

P E I

though evidently left in an unfiniflied ftate. The work
was afterwards completed by Mr. Jofeph Hallet. From
Mr. Peirce’s MSS. were alfo publilhed “ An Ettay in fa¬
vour of the ancient Pradtice of giving the Eucharift to
Children and other tracts. Gen. Biog.

PEIRES'C (Nicolas Claude Fabri), a man of multi¬
farious erudition, born in 1580, was defcended from an
ancient and noble family, feated originally at Pifa in
Italy. At ten years of age, he was fent to Avignon,
where he fpent five years in the Jefuits college, in the
ftudy of what in Scotland and on the continent is called
humanity. From Avignon he was, in 1595, removed to
Aix, and entered into the ftudy of philofophy. In the
interim he attended the proper matters for dancing, ri¬
ding, and handling arms ; in all which, though he per¬
formed the leflons regularly, it was with reluctance ; lor,
this being done only to pleafe an uncle, whofe heir he
was to be, he efteemed all the time loft that was not
fpent in the purfuits of literature. During this period,
his father being prefented with a medal of the emperor
Arcadius, which was found at Belgenfer, Peirefc begged
the favour of it; and, charmed with deciphering the
charadlers in the exergue, and reading the emperorjs
name, he carried the medal with a tranfport of joy to his
uncle ; who for his encouragement gave him two more,
together with fome books upon the fubjedt. This is the
epoch of his application to antiquities, for which he
became afterwards fo famous. In 1596 he was fent
to finilh his courfe of philofophy under the Jefuits
at Tournon, where he turned his attention particu¬
larly to cofmography, as being neceffary to the under-
ftanding of hiltory, abating, however, nothing of his ap¬
plication to antiquity, in which he was attifted by Petrus
Rogerus, one of the profeflors, and a flcilful medalift :
nor did he omit the ftudy of humanity in general, where=
in he was the matter and inftrudlor of a brother who was
with him. But to do all this he was Obliged to fit up
late at nights ; and fo much labour and attention, as he
was naturally of a tender conftitution, increafed the
weaknefs of his ftomach formerly contradled, and for
which he had ufed a kind of digeftive powder.

Being recalled by his uncle in 1597, he returned to
Aix, and entered there upon the ftudy of the law ; which
he profecuted, however, fo as to find leifure to vifit and
converfe frequently with Peter A. R. Bagarr, a molt Ikil-
ful antiquary, who was afterwards made matter of the
jewels to Henry IV. The following year he went again
to Avignon, to carry on his courfe of law under one
Peter David ; who, being well lkilled likewife in antiqui¬
ties, w'as pleafed to fee Peirefc join this ftudy to that of
the law. But Ghibertus of Naples, auditor to cardinal
Aquaviva, fed his curiofity the molt, in Ihowing him
fome rarities, fuch as he had never feen before. Ghiber¬
tus alfo lent him Goltzius’s Treatife upon Coins, and
advifed him to go into Italy, efpecially to Rome, where
he would meet with curiofities to fatisfy his molt ardent
willies. Accordingly, his uncle having procured a pro¬
per governor, he and his brother fet out upon that tour
in September 1599; and, patting through Florence, Bono-
nia, and Ferrara, when he had ftaid a few days at Venice,
he fixed his refidence at Padua, in order to complete his
courfe of law. But once a quarter, going to Venice to
get calh for bills of exchange, he took thefe opportuni¬
ties of introducing himfelf to the moll diftinguilhed lite¬
rati there; and was particularly careffed by F. Contarini
procurator of St. Mark, who was poffeffed of a curious
cabinet of medals, and other antiquities, without know¬
ing the value of them : this was fully Ihown to him by
Peirefc, who likewife explained the Greek infcriptions
upon his medals, and the monumental llones. After a
year’s Hay at Padua, he fet out for Rome, and arrived
there Odlober 1600, in order to be in time for feeing the
jubilee; to celebrate which, the Porta Sandla would be
opened in the beginning of the next year. He patted fix
months in this city, viewing the numberlefs curiofities

there,

482 P E I R E S C.

there, and in cultivating the friendffiip of Galileo, by
whom he was much beloved. This friendffiip led him to
carry his refearches into aftronomy and natural philofo-
phy ; and he was prefent when Fabricius ab Aquapen-
dente, out of a parcel of eggs upon which a hen was fit¬
ting, took one every day, to obferve the gradual forma¬
tion of the chick from firlt to laft. From this time it was
generally acknowledged, that he had taken the helm of
learning into his hand, and began to guide the common¬
wealth of letters. «

Having now fpentalmoft three years in Italy, he began
to prepare for his departure; and in the end of 1602,
having packed up all the rarities, gems, &c. which he had
procured, and put them into the road to Marfeilles, he
left Padua, and, eroding the Alps to Geneva, went to
Lyons ; where he made a liandfome prefent to his gover¬
nor, who took the route of Paris. From Lyons he went
to Montpelier, to improve himfelf in the law under Ju¬
lius Parius. From Montpelier he difpatched more rari¬
ties to his uncle; who fending for him home, lie arrived
at Aix in November; but, bringing Parius along with
him, he obtained leave to return to Montpelier in a few
days. He waited upon Parius back again, under whom
he continued purfuing hislaw-ftudies till the end of 1603,
when he returned to Aix at the earned: requeft of his
uncle, who, having refignedto him his fenatorial dignity,
bad ever fince the beginning of the year laboured to get
the king’s patent. The degree of doftor of law was a
neceffary qualification for that dignity. Peirefc, there¬
fore, having kept the ufual exercife, took that degree
Jan. 18, 1604, when the aforefiiid patent was given to the
fenate, and ordered to be recorded ; yet Peirefc procured
leave not to be prefently entered into the lift of fenators.
The bent of his inclination was not fo much to bufinefs
as to advance arts and fciences, and to aftift all the pro¬
moters of learning. For this purpofe, he refolved |to
lead a fingle life; fo that, when his father had concluded
a match for him with a refpedable lady, he begged to be
excufed.

In 1605, he accompanied G. Varius, firft prefident of
the fenate at Aix, who was very fond of him, to Paris;
whence, having vifited every thing curious, he crofted the
water, in company with the king’s ambafiador, 1606, to
England. Here he was very gracioufly received by king
James I. and having feen Oxford, and vifited Camden,
fir Robert Cotton, fir Henry Saville, and other learned
men, he pafled over to Holland ; and, after vifiting the
feveral towns and univerfities, with the literati in each,
he went through Antwerp to Bruffels, and thence back
to Paris, to fee the ceremony of the Dauphin’s baptifm ;
which being folemnized Auguft 24, he returned home in
September 1606, being expended for the ordering of the
family affairs.

Prefently after this, he purchafed the barony of Rians ;
and at the folicitation of his uncle, having approved
himfelf before that affembly, he was received a fenator on
the ift of July, 1607. January 1608, he loft his uncle ;
and the following year, falling himfelf into a dangerous
fever, recovered by eating mufk-melons. He was ordered
by his phyfician to eat them before his meals without
bread, and to drink a glafs of pure wine upon them.
He continued this method all his life afterwards; and
frequently experienced, that in the mufk-melon feafon
he was never troubled with the gravel. In 1618, having
procured a faithful copy of “ The A£fs of the Monaftery
of Maren in Switzerland,” he publiflied a fecond edition
of that work. As it was written in defence of the royal
line of France againft Theodoric Piefpordius, who had
attempted to prove the title of the Auftrian family to the
French crown by right of fucceflion, he was, upon this
publication, nominated the fame year, by Louis XIII.
abbot of Sanfta Maria Aquiftrienfis. He ftayed in France
till 1623; when, upon a meffage from his father, now
grown old and fickly, he left Paris, where he had fpent
ieven years and fome months. He arrived at Aix in Oc¬

*

tober; and not long after prefented to the court a patent
from the king, permitting him to continue in the fund ion
of his ancient dignity, and to exercife the office of a fe-
cularorlay perfon, notwithftanding that, being an abbot,
he had affumed the chara&er of a churchman. To this
the court of parliament not affenting, decreed unani-
moufly, that, being already admitted into the firft rank,
he Ihould abide perpetually therein; not returning, as
the cuftom of the court was, to the inferior auditory,
■wherein trials are ufually had of criminal cafes'. In 1625,
he buried his father, who had been long afflicted with the
gout. In 1627, he prevailed with the archbiffiop of Aix
to eftabliffi a poft thence to Lyons, and fo to Paris and all
Europe ; by which the correfpondence conftantly held
with the literati every-where was much facilitated. In
1629, he began to be much tormented with the ftrangury
and piles; and in 1631, having completed the marriage
of his nephew Claudius with Margaret Alrefia, a noble¬
woman of the county of Avignon, lie bellowed upon him
the barony of Rians, together with a grant of his fena¬
torial dignity, only referving the function to himfelf for
three years. But, the parliament not waiting his furren-
dry of it, he refented that affront fo heinoufly, that he
procured, in 1635, letters patent (from the king) to be
reftored, and to exercife the office for five years longer,
which happened to be till his death : for being feized,
June 1647, with a fever that brought on a ftoppage of
urine, this put an end to his life on the 24th of that
month, in his 57th year.

Peirefc was of a middle fize, and of a thin habit : his
forehead large, and his eyes grey; his cheeks tempered
with red ; the hair of his head yellow', as alfo his beard,
which he ufed to wear long; his whole countenance
bearing the marks of uncommon and rare courtefy and
affability. In his diet he affedled cleanlinefs, and in all
things about him; but nothing fuperfluous or coftly.
His clothes were fuitable to his dignity; yet he never
wore filk. In like manner the reft of his houfe was
adorned according to his condition, and very well fur-
niffied ; but he negle&ed his own chamber. His bed was
exceedingly plain ; and his table continually loaded and
covered with papers, books, letters, and other things ;
as alfo all the feats round about, and the greateft part of
the floor. Thefe were fo many evidences of the turn of
his mind ; in refpeft to which, the writer of his eloge
compares him to the Roman Atticus ; and Bayle, con-
fidering his univerfal correfpondence and general affiil-
ance to all the literati in Europe, daflied it out luckily
enough, when he called him “ the attorney-general of the
literary republic.” The works which he publiflied are,
1. Hiftoria provincis Gallis Narbonenfis. 2. Nobilium
ejufdem provincis familiaruin Origines, et feparatim Fa-
bricis. 3. Commentarii rerum omnium Memoria digna-
rum fua state geftarum. 4. Liber de ludicris naturae
operibus. 5. Mathematica et Aftronomica varia. 6. Ob-
fervationes Mathematics. 7. Epiftols ad S. P. Urbanum
VIII. cardinales Barberinos, &c. 7. Authores antiqui

Grsci et Latini de Ponderibus et Menfuris. 8. Elogiaet
Epitaphia. 9. Infcriptiones antiqus et novx, 10. Ge-
nealogia Domus Auftriacs. 11. Catalogus Librorum
Biblioth Reg. 12. Poemata varia. 13. Nummi Gallici,
Soxonici, Britannici, See. 14. Lingus Orientales, He-
brsa, Samaritans, Arabics, Egyptiaca, et Indices libro¬
rum harum linguarum. 15. Obfervationes in varios
au&ores. It is remarkable, that, though Peirefc bought
more books than any man of his time, yet his collection
left was not large. The reafon was, that, as fall as he
purchafed, he kept continually making prefents of them
to fuch learned men as he knew they would be ufeful to.
GaJJenfli's Life of Peirefc, in Englijh, Loud. 1 657.

PEI'SDORF, a town of Bohemia, in the circle of Ko-
nigingratz : fourteen miles north-eaft of Gitfchin.

To PEISE, v. a. [pefer, Fr.j To poife ; to balance;
to weigh. Obfoiete. See To Payse. — Not fpeaking
words as they changeably fall from the mouth, but

pevfng

P E K

P E K

pry zing each fyllable. Sidney's Def. of Poefy.~ Led leaden
dumber peizc me down. S/ia^cJpeare's Rich. III.

All the wrongs that he therein could lay,

Might not it pcize. Spenfer.

Again I view the parts fo pcized,

And thefe in number fo, and meafure, raifed. B. Jonfon.

PEISE, f. [pefa, Span.] A weight, or poife ; a blow ;
a ftroke. Obfolete. — With a great pcxfe they let the erode
and the body fall down togyder in to the morteffe. Lib.
Fcfi.

Great Ptoleme it for his leman’s fake
Ybuilded all of glade by magicke powre,

And alfo it impregnable did make ;

Yet, when his love was fali'e, he with a peaze it brake.

Spenfer.

PEISKREIT'SCHAM, or Pysko'yvice, a town of Si-
1-efia, in the principality of Oppeln : twelve miles weft-
north-weft of Beuthen, thirty fouth-eaft of Oppeln.

PEIT'SCHENDORF, a town of Pruflia, in Bartenland:
twenty-two miles fouth of Raftenburgh.

PEITZ, a town of Brandenburgh, in the UcRer Mark,
on a fmall river which runs into the Sprene. In the
neighbourhood are iron-mines, and manufadlures of
pitch and turpentine: twenty miles eaft-fouth-eaft of
Luben, thirty fouth-fouth-weft of Frankfort on the Oder.
Lat. 51. 53. N. Ion. 14. 40. E.

PE'KAH, J’. [Heb. one that opens.] A man’s name.
Pekah, the fon of Remaliah, was general of Pekahiah
king of Ifrael’s army. Together with Argoband Ariel),
and fifty Gileadites, he murdered his mafter in the fecond
year of his reign, and reigned twenty years in his ftead.
Entering into a league with Rezin king of Syria, they in¬
tended to dethrone Ahaz, and the whole family of David,
and let up the fon of one Tabeel to govern Judea, as their
tributary. Pekah’s army cut off no, 000 of Judah, and
took aoo,ooo prifoners, but they foon returned the latter
with great humanity. Inftigated by Ahaz, Tiglath Pile-
fer king of Afi’yria invaded the kingdom of Pekah, and
murdered and carried off into captivity a great part of
the Naphthalites, eaftern Manaffites, Reubenites, and
Gadites. At lalt Hofhea murdered Pekah, and reigned
in his Head. Ifaiah viL i. 2 Kings xv. 25. 2 Chron.

xxviii. 6.

PEKAHI'AH, [Heb. the Lord opens.] A man’s name.
See the preceding article.

PEKE'A, J'. in botany. See Rhizoeolus.
PEKE'NEN, a town of Africa, on the Grain Coaft:
fifteen miles fouth of Sanguin.

PE'KET, a town on the north coaft of the ifland of
Cumbava. Lat. 8. 15. S. Ion. 117. 36. E.

PE'KIN, a city of China, and capital of the empire,
lituated in a very fertile plain, twenty leagues diifant
from the Great Wall. This name, which fignifies the
Northern Court-, is given to diftinguifli it from Nankin,
or the Southern Court. The emperor formerly refided
in the latter; but the Tartars, a reftlefs and warlike
people, obliged the prince to remove his court to the
northern provinces, that he might more effedtually repel
the incurftons of thofe barbarians, by oppofmg to them
the numerous militia that he generally keeps around his
perfon.

This capital forms an exa£l fquare, and is divided into
two cities; the firft is inhabited by Chinefe, the fecond
by Tartars. Thefe two cities, without including the
fuburbs, are fix leagues in circumference, according to
the moft accurate meafurement made by the exprefs or¬
der of the emperor. The walls of the Tartar city are
very lofty, and fo thick, that twelve horfemen might eafily
ride abreaft upon them ; with fpacious towers at inter¬
vals, a bow-fhot diftant from one another, and large
.enough to contain bodies of troops. The city has nine
.gates, which are lofty, and well arched; over them are
.large pavilion-roofed towers, divided into nine ftories,
Vob. XIX. No. 1318.

483

each having feveral apertures or port-holes; the lower
ftory forms a large hall, for the life of the foldiers and
officers who quit guard, and thofe appointed to relieve
them. Before each gate a fpaceis left of more than 360
feet; this is a kind of place of arms, inclofed by a femi-
circular wall, equal in heightand thicknefs to that fur¬
rounding the city. The great road which ends here, is
commanded by a pavilion-roofed tower, like the firft, in
fach manner that, as the cannon of the former can batter
the houfes of the city, thole of the latter can lweep the
adjacent country.

Theftreets of Pekin are ftraight, about 120 feet wide,
a full league in length, and bordered with (hops. It is
aftonifiiing to fee the immenfe concourfe of people that
continually fills them, and the confufion caufed by the
prodigious number of horfes, camels, mules, and car¬
riages, which crofs or meet each other. Befules this in¬
convenience, one is every now and then flopped by
crowds, who (land liftening to fortune-tellers, jugglers,
ballad- fingers, and a thoufand other mountebanks and
buffoons, who read and relate (lories calculated to pro¬
mote mirth and laughter, or diftribute medicines, the
wonderful effefls of which they explain with all the elo¬
quence peculiar to them. People of diftindlion oblige
all their dependents to follow them. A mandarin of the
firft rank is always accompanied in his walks by his whole
tribunal ; and to augment his equipage, eacli of the in¬
ferior mandarins in his fuite is generally attended by fe¬
veral domeftics. The nobility of the court, and princes
of the blood, never appear in public without being fuc-
rounded by a large body of cavalry ; and, as their pre¬
fence is required at the palace every day, their train alone
would be fufficient to create confufion in the city.

As there is a continual influx of the riches and mer-
chandife of the whole empire into this city, the number
of ftrangers that refort hither is immenfe; they are car¬
ried in chairs or ride on horfeback ; the latter is .more
common : but they are always attended by a guide, ac¬
quainted with the ftreets, and who knows the houfes of
the nobility and principal people of the city. They are
alfo provided with a book, containing an account of the
different quarters, fquares, remarkable places, and of the
refider.ee of thofe in public offices. In fummer, there
are to be feen fmall temporary (hops, where people are
ferved with water, cooled by means of ice; and one finds
every-where eating-houfes, with refreffiments of tea and
fruits. “ I obferved,” fays Mr. Anderfon, “ a great num¬
ber of butcher’s (hops, whole mode of cutting up their
meat refembles our own ; nor can the markets of London
boaft a better fupply of flefh than is to be found in Pekin.
But they fell it cooked as well as raw ; and, on my en¬
tering the (hop, I faw on a ftall before it an earthen (love,
with a gridiron placed upon it ; and on my employing a
variety of figns to obtain the information I wanted, the'
butcher inftantly began to cut off fmall thin dices of
meat, about the fize of a crown piece, which he broiled
as fall as I could eat them. I took about a dozen of thefe
dices, which might all together weigh feven or eight
ounces ; and when I paid him, which I did by giving him
a ftring of caxee, or fmall coin, he pulled off, as I fuppofe,
the amount of his demand, which was one conderon, or
ten caxee, the only current money in the empire. I faw
numbers of people in other butcher’s diops, as I palled
along, regaling themfelves with beef and mutton in the
fame manner.

“The houfes for porcelain utenfils and ornaments are
peculiarly attra&ive, having a row of broad dielves,
ranged above each other, on the front of their diops, on
which they difpofe the moft beautiful fpecimens of their
trade in a manner full of fancy and effe£l.

“ Befides the variety of trades which are ftationary in
this great city, there are many thoufands of its inhabi¬
tants who cry their goods about, as we fee in our own
metropolis. They generally have a bamboo placed acrofs
their (boulders, and a balket at each end of it, in which
6 H they

PEKIN.

484

they carry fi(h, vegetables, eggs, and other flmilar arti¬
cles. There are alio great numbers of hawkers and ped¬
lars, who go about with bags (trapped on their (houlders
like a knapfack, which contain various kinds of ftuff-
goods, the folds of which areexpofed to view. In felling
thefe fluff’s, they ufe the cubic meafure of fixteen inches.
Barbers alfo are feen running about the ftreets in great
plenty, with every inftrument known in this country for
(having the head and cleanfing the ears : they carry with
them for this purpofe a portable chair, a portable ftove,
and a fmall veflel of water ; and whoever wifhes to under¬
go either of thefe operations, fits down in the ftreet,
while the operator performs his office, for which he re¬
ceives a mace. To diftinguifh their profeffion, they carry
a pair of large fteel tweezers, which they open with their
fingers, and let them clofe again with fome degree of vio¬
lence, which produces a (hrill found that is heard at a con-
fiderable diftance ; and fuch is their mode of feeking em¬
ployment. That this trade in China is a very profitable
one may be pronounced, becaufe every man muff be
fliaved on a part of the head where it is impoflibleto (have
liimfelf.

“ In feveral of the ftreets I faw perfons engaged in fell¬
ing off goods by auftion s the auctioneer flood on a plat¬
form furrounded with the various articles he had to fell :
he delivered liimfelf in aloud and bawling manner; but
the fmiling countenances of the audience, which was the
only language I could interpret, feemed to exprefs the
entertainment they received from his harangue.

“There are no carriages (landing in the ftreets for the
convenience of the inhabitants, like our hackney-coaches
in London : the higher clafles of people keep palanquins,
and others of lefs diftinCtion have covered carts drawn
by a horfe or mule.

“The opinion, that the Chinefe women are excluded
from the view of ftrangers, has very little, if any, founda¬
tion, as among the immenfe crowd affembled to fee the
cavalcade of the Englifli embafly, one-fourth of the whole
at lead were women ; a far greater proportion of that fex
than is to be feen in any concourfe of people whom cu-
riofity aflembles in our own country : and, if the idea is
founded in truth, that curiolity is a peculiar charadter-
iftic of the female difpofition in Europe, I (hall prefume
to fay, from the eagernefs which we obferved in the
looks of the Chinefe women as we palled by them, that
the quality which has juft been mentioned is equally pre¬
valent among the fair ones of Afia. The women we faw
on our pafi'age through Pekin poffefled, in general, great
delicacy of feature, and'fair (kins by nature, with which,
however, they are not content, and therefore whiten
them with cofmetics; they likewife employ vermilion,
but in a manner wholly different from the application of
rouge among our European ladies, for they mark the
middle of their lips with it by a ftripe of its deepeft co¬
lour, which, without pretending to reafon upon it, cer¬
tainly heightened the effedt of their features. Their
eyes are very fmall, but powerfully brilliant, and their
arms extremely long and (lender. The only difference
between the women of Pekin, and thefe we had already
feen, as it appeared to us, was that the former wear a
(harp peak of black velvet or filk, which is ornamented
with (tones, and defeends from the forehead almoft be¬
tween their eyes ; and that their feet, free from the ban¬
dages which have already been mentioned, were fuffered
toattain their natural growth.”

Pekin is merely the feat of government of the empire.
It is not a port, nor a place of inland trade or manufac¬
ture. No reprefentative diet, nor general (fates, with
numerous retainers, afl'emble there to affift, or check, or
examine, the meafures of the crown. It forms no ren¬
dezvous for pleafure and diffipation. Pekin owes little
of its extent and populoufnefs to the various circumftan-
ces that contribute to aggrandize and enlarge European
cities. Moll men there have ftations regularly allotted
them, or are occupied in attending or providing for thofe

who have. The governor of Pekin, who is a Manchoo
Tartar, is ftyled Governor of the Nine Gates ; his jurif-
didtion extends not only over the foldiers, but alfo over
the people in every thing that concerns the police. No
police can be more adtive. It is rare in a number of
years to hear of houfes being robbed, or people being af-
faffinated ; all the principal ftreets have guard-rooms,
and the foldiers patrole night and day, each having a
fabre hanging from his girdle, and a whip in his hand, to
corredt, without diftindlion, thofe who excite quarrels or
caufe diforder. The lanes are guarded in the fame man¬
ner, and have latticed gates, which do not prevent thofe
from being feen who walk in them; they are always kept
(hut during the night, and feldom opened even to thofe
who are known : if they are, the perfon to whom this in¬
dulgence is granted mud carry a lanthorn, and give fuf-
ficient reafon for his going out. ’

The emperor’s palace (lands in the middle of the Tartar
city. It prefents a prodigious affemblage of vaft build¬
ings, extenfive courts, and magnificent gardens, and is
(hut up on all fides by a double wall ; the intervening
fpace being occupied by houfes belonging to the officers
of the court, eunuchs, and by different tribunals. To
fome of thefe is affigned the care of providing neceflaries
for the ufe of the emperor; others are for determining
difputes, and punilhing faults committed by the domef-
tics of the imperial family. The exterior circumference
of this immenfe palace is reckoned a league and a half.
Although the Chinefe architedfure has no refemblance to
that of Europe, the imperial palace of Pekin does not fail
to (trike beholders by its extent, grandeur, and the re¬
gular difpofition of its apartments. The royal hall, called
Tai-liotien, or the Hall of the Grand Union, is built upon
a terrace about eighteen feet in height, incrufted with
white marble, and ornamented with baluftrades of ex¬
cellent workmanffiip. Before this hall, all the mandarins
range themfelves, when they go on certain days to renew
their homage, and perform thofe ceremonies that are ap¬
pointed by the laws of the empire. This hall is alrtioll
fquare, and about 130 feet in length. The ceiling is
carved, varniffied green, and loaded with gilt dragons,
covered with coarle carpets, after the Turkifli manner;
but the walls have no kind of ornament, neither tapeftry,
luftres, nor paintings. The throne, which is in the
middle of the hall, confifts of a pretty high alcove, ex¬
ceedingly neat. It has no infeription but the character
Citing, which fignifies holy, perfect, excellent. It was
here that the famous Britifh embafly, condudted by lord
Macartney in 1793, had its audience of Ttchien Lung,
then emperor of China. For the particulars, fee the ar¬
ticle China, vol. iv. p. 478-486.

The eftimated population of Pekin, fays fir G. Staun¬
ton, was carried in the laft century, by the Jefuit Gri¬
maldi, as quoted by Gemelli Carreri, to fixteen millions.
Another miffionary reduces, at leaft that of the Tartar
city, to one million and a quarter; according to the bed
information given to the embafly, the whole was about
three millions. The low houfes of Pekin feem fcarcely
fufficient for fo vaft a population ; but very little room
is occupied by a Chinefe family, at leaft in the middling
and lower clafles of life. In their houfes there are no fu-
perfluous apartments. A Chinefe dwelling is generally
furrounded by a wall fix or feven feet high ; within this
inclofure a whole family, of three generations, with all
their refpedlive wives and children, will frequently be
found. One fmall room is made to ferve for the indivi¬
duals of its branch of the family, (leeping in different
beds, divided only byi mats, hanging from the ceiling.
One common room is ufed for eating. '

The temples and the towers of this city are fo nume¬
rous, that it is difficult to count them. We have alrea¬
dy, under the article Observatory, mentioned the fa¬
mous obfervatory in this city, of which we (hall give this
further account from the Univerfal Hiftory. “ The Chi¬
nefe had thought nothing in the univerfe could equal in

magnificence

485

P E K

magnificence this famous place ; and one of the raoft ce¬
lebrated mathematicians of the Royal Academy of Paris
hath made no fcruple to reprefen t it as one of the greateft
prodigies of art and ingenuity, of beauty and magnifi¬
cence ; and yet, when this celebrated ftrufture came to
be viewed by more proper and unbiafled judges, it appears
to have been of little worth as to its ancient machines,
and lefs as to its fituation ; and that all that is now valu¬
able in it is owing to the improvements made by father
Verbieft, a Flemiffi Jefuit, whocaufed a new fet of inftru-
ments to be made, with extraordinary care, neatnefs, and
precifion. This fabric Hands in a court of moderate ex¬
tent, and is built in the form of a fquare tower, conti¬
guous to the city-wall on the infide, and raifed but ten
or twelve feet above its bulwark. The afcent up to the
top is by a very narrow ftaircafe ; and on the platform
above were placed all the old inftruments, which, though
but few, took up the whole room, till Verbieft introduced
his new apparatus, which he difpofed in a more conve¬
nient order. Thefe are large, well call and embelliffied;
and, were the neatnefs of the divifions anfwerable to the
work, and the telefcopes faftened to them according to
the new method, they would be equal to thofe of Europe;
but the Chinefe artificers were, it feems, either too negli¬
gent, or incapable of following his directions. As to the
old inftruments, they were, by order of the emperor
Kang-hi, fet afide as ufelefs, and laid in the hall near the
tower, where they may be feen through a crofs-barred
window, all covered with ruft, and buried in oblivion.
In this famed obfervatory there are five mathematicians
employed night and day, each in a proper apartment on
the top of the tower, to obferve all that pafl'es over their
heads: one of them is gazing towards the zenith, and
the others towards the four points of the compafs, that
nothing may efcape their notice. Their observations
extend not only to the motions of the heavenly bodies,
but to fires, meteors, winds, rain, thunder, hail-ftorms,
and other phenomena of the atmofphere ; and thefe are
carefully entered in their journals, and an account of
them is brought every morning to the furveyor of the
mathematics, and regiftered in his office.” Lat. 39. 55. N.
Ion. 1 16. 28. E. Earl of Macartney's Embaffy, by Sir
G. Staunton, vol. ii. Anderfon's Narrative. Barrow's
China. Grojier's China, vol. i.

PE'LA, J'. in botany. See Psidium.

PELA'GIA (St.), a town of Naples, in the province
of Otranto : three miles north of Tarento.

PELA'GIAN, f. One of the followers of Pelagius.
See that article. — Original fin ftandeth notin the follow-
ingof Adam, as the Pelagians do vainly talk; but is the
fault and corruption of every man that naturally is in-
gendered of the offspring of Adam, whereby man is very
tar gone from original righteoufnefs, and is of his own
nature inclined to evil, lo that the flelh lufteth always
contrary to the fpirit. Art. 9 th of Religion.

PELA'GIAN, adj. Belonging to the notions of the
Pelagians. — Throughout all this Pelagian fcheme, we
have not fo much as one word of man’s natural impo-
tency to fpiritual things. South.

PELA'GIANISM, J'. The doCtrine of Pelagius and
his followers. — This perfuafion of man’s being.'able to
merit of God, is the fource and foundation of two of the
greateft corruptions of religion that have infefted the
Chriftian church ; and thofe are pelagianifm and popery.
South.

PELAG'IC, adj. [from the Lat. pelagus, the fea.]
Belonging to the fea. Cole.

PELAGI'E, a river of Louifiana, which runs into the
Mifiouri in lat. 38. 30. N. Ion. 91. 30. W.

PELA'GIUS, after whom a Chriftian fed has been
diftinguiffied by the name of Pelagians, was a native of
Wales, where he was born on the 13th of November,
354,. 011 the fame day with his great antagonift St. Au-
guftine. His vernacular name was Morgan, or Marigena,
Signifying “ Sea-born,” which he changed into Pelagius,

P E K

a Greek word of the fame meaning. He embraced the
religious life, and probably in the celebrated monaftery
of Bangor in Wales ; but that he was ever abbot of that
houfe, and expelled by the fraternity on account of his
obnoxious opinions, though aflerted by various writers, is
a tale which is not fupported by any evidence. From the
accounts of him which have been tranfmitted to us by his
enemies as well as friends, it appears that he was diftin¬
guiffied by great ftrength and acutenefsof mind,extenfive
learning, ardent piety, irreproachable and exemplary mo¬
rals. About the year 400, accompanied by his intimate
friend Cseleftius, who was an Iriffi (or Scotch) monk, he
went to Rome ; and in that city thefe aflociates lived for
fomeyears in thegreateft reputation, and were univerfally
efteemed on account of their extraordinary piety and vir¬
tue. At this time a fuperftitious notion refpefting the
efficacy of baptifm was fpreading in the Chriftian world,
the advocates for it maintaining, that the mere aft of bap¬
tizing waffied away fin. This notion Pelagius firmly op-
pofed ; maintaining, that the waffling away of fin was to
be effefted by good works, and not by water. As one
principal argument in favour of his doftrine, he alleged
that the defign of baptifm could not be to waffi away tin,
fince it was applied to infants who had not finned.
This doftrine, according to the reprefentations of fome
ecclefiaftical hiftorians, gave no offence, and was even ge¬
nerally admitted at Rome ; but, according to others, Pe¬
lagius and his friend were too cautious to preach it in
public, contenting themfelves with propagating it in a
private manner, by which means they gained nume¬
rous difciples. About the year409 or 410, upon the ap¬
proach of the Goths towards that city, Pelagius and Crs-
leftius removed into Sicily, where they continued till the
year 41 1, when they paffed over into Africa, defirous of
being prefent at a conference which was to be held be¬
tween the Catholics and Donatifts.

In Africa, the fuperftitious notion refpefting the effi¬
cacy of baptifm was very generally prevalent, and was op-
pofed with great freedom by our two monks. On the
other hand, it was zealoufly maintained by feveral of the
African clergy, and particularly by the famous Auguftine
bifliop of Hippo. While arguing in defence of it, he in¬
filled on the doftrine of original fin, or, a natural prone-
nefs to fin, which was derived from Adam to all his pof-
terity; not the modification of it adopted by his follow¬
ers in after-ages, that the guilt of Adam’s particular
tranfgreffion was transferred and imputed to his whole
race. Auguftine alfo maintained, that until this prone-
nefs to fin, which might be called defilement, was done
away by the fpecial grace of God imparted at baptifm,
men had no power to do the will of God ; and that, con-
fequently, every good thought, word, and work, mull be
afcribed to fupernatural grace, or the influence and af-
fiftance of the Spirit of God. Againft thefe doftrines,
Pelagius and Cseleftius ftrenuoully contended, maintain¬
ing that they were as falfe as they were pernicious; that
we derive no corruption from the fall of ourfirft parents,
but are born as pure and unfpotted as Adam came out of
the forming hand of his Creator; that mankind, there¬
fore, are capable of repentance and amendment, and of
arriving at the higheft degrees of piety and virtue by the
ufe of their natural faculties and powers: that, indeed,
external grace, meaning by the term divine revelation, or
the gofpel, was neceflary to excite and direft their en¬
deavours, but that they have no need of internal preter¬
natural fuccours from the Divine Spirit.

Pelagius made no confiderable Hay in Africa, but, af¬
ter leaving Cseleftius in that country, proceeded by way
of Egypt to Palelline, where he was favourably received
by John biffiop of Jerufalem. In the mean time, Caelef-
tius continued to maintain the opinions of Pelagius in
Africa, till the biffiops of that country, who adopted the
doftrines of Auguftine, preferred the charge of herefy
againft them, and procured their condemnation in a coun¬
cil held at Carthage in the year 412 j upon which Cselei-

tius

4156

P E L A G l U S.

tins left that city, and went to join Pelagius in the eaft.
In Palefline our monks met with mere favourable treat¬
ment, fupported as they were by the bilhop of Jerufalem,
who, from his attachment to the principles of Origen,
was naturally led to countenance thofe of Pelagius, on
account of the conformity that there was in fome leading
points between the two fyftems. Under his powerful
prote&ion, Pelagius made a public profefTion of his opi¬
nions, and gained numerous adherents. In theyear4i5,
Auguftine Cent Orolius, a Spanifh prefbyter, into Palef¬
tine, with letters in which Pelagius was accufed of here¬
by. This charge was immediately taken into confidera-
tion by a council of bilhops at Jerufalem, who, after hear¬
ing Augultine’s letter read, as well as the defence of Pe¬
lagius, broke up without palling any cenfure on the
latter, after deliberating about referring the matter to the
judgment of Innocent I. bilhop of Rome. Towards the
dole of the year, another council, confiding of fourteen
bilhops, was held at Diofpolis ; before which Pelagius
was fummoned, tried, and fully acquitted of all errors.
Among his powerful friends in thefe councils, was the
learned and illultrious Theodore bilhop of Mopfueftia.

The acquittal of Pelagius highly incenled his enemies,
who reflefted on the bilhop of Jerufalem, imputing it to
his improper influence ; and Jerome reviled the council
that pronounced in his favour, flyling it, “ the pitiful
fynod of Diofpolis.” Augultine alfo wrote to John, en¬
deavouring, though in vain, to excite his prejudices
againft the perfecuted monks. What he could not effeft
in the eaft, however, he fucceeded in carrying according
to his w illies in Africa. In a council held at Carthage in
the year 416, he and his friends procured the opinions of
Pelagius to be condemned; and their judgment was foon
afterwards confirmed by the bilhops of Numidia, afle ru¬
bied at Milevum- They then wrote letters to Innocent
bilhop of Rome, to perfuade him to accede to their fen-
tence. In thefe circumftances, Pelagius was advifed to
appeal to Rome, and he lent a confefllon of his faith to
the pontiff, which was accompanied with a letter from
Praylus, fucceflor to John in the fee of Jerufalem, which
recommended the cafe of the perfecuted monks to him,
in very affeftionate terms. Thefe letters and confefiion
did not reach Rome before the death of Innocent, who
was fucceeded by Zofimus in the year 417. The new
pontiff, fully fatisfied with thefe letters and confeflion,
declared the monks found in the faith ; unjuftly perfecu¬
ted by their adverfaries ; and received them under his
protection at Rome.

The African bilhops, with Auguftine at their head,
little alfedfed by this declaration, continued obftinately
to maintain the judgment which they had formed in this
matter, and to llrengthen it by their exhortations, their
letters, and their writings. They alfo fucceeded in gain¬
ing the emperor Honorius to their fide ; and their re-
monftrances, fupported by his authority, produced a
wonderful converfion in the mind of Zofimus, who con¬
demned, with the utmoft feverity, the men whole prin¬
ciples he had publicly approved, and whom he had co¬
vered with his proteftion. From this time our two
monks and thofe who adopted their opinions were perfe¬
cuted with the utmoft rigour and cruelty, and condemned
by no lefs than twenty-four councils in different parts of
the world. Thus proferibed in Afia, Africa, and on the
continent of Europe, Pelagius and Caeleftius took refuge
in Britain, where they met with a fupporter in Agricola,'
the fon of Severian, who was a favourer of their opinions,
as were alfo multitudes, if not the great mafs of the in¬
habitants of the illand. This country, therefore, being
confidered as the principal remaining afylum of Pelagia-
r.ilm, Germanus bilhop of Auxerre, and Lupus bilhop of
Troyes, were deputed by a fynod in Gaul to pafs over
into it, and eftablilh the inhabitants in the faith of Rome
and of St. Auguftine. Accordingly, they undertook this
million in the year 420, and fucceeded in gaining the
Britilh prelates, who condemned the opinions of their
1

countrymen, and, by fo doing, contributed to promote
the afpiring views of the papal fee. However, after the
return of the miflionary bilhops to Gaul, Pelagianifm pre¬
vailed^ much again, that, in the year 427, it was judged
expedient that Germanus fliould vifit Britain once more,
accompanied by Severus bilhop of Treves, and the difei-
ple of Lupus of Troyes. So fuccefsfully did thefe prelates
exert themfelves during this million, that they procured
a more folemn condemnation of Pelagianifm, by the de¬
crees of a council aftembled at Verulam, or St. Alban’s ;
and, it is faid, obtained the confent of the inhabitants to
the banilhment from the illand ofsall who would not re¬
nounce the proferibed principles.

Of the perfonal hiftory of Pelagius, or of his aflociate
Caeleftius, after their return to Britain, we are not fur-
nilhed with any particulars. The following fummary of
their doctrines is given in the Encyclopaedia Britannica.
1. That Adam was by nature mortal; and, whether he
had finned or not, would certainly have died. 2. That
the confequences of Adam’s fin were confined to his own
perfon. 3. That new-born infants are in the fame fix¬
ation with Adam before the fall. 4. That the law quali¬
fied men for the kingdom of heaven, and was founded
upon equal promifes with the gofpel. 5. That the gene¬
ral refurreftion of the dead does not follow in virtue of
our Saviour’s refurreftion. 6. That the grace of God is
given according to our merits. 7. That this grace is not
granted for the performance of every moral aft; the
liberty of the will, and information in points of duty,
being fufiicient, See.

Dr. Kerry obferves, that both Pelagius and Caeleftius
were efteemed by St. Auguftine and Jerome, and main¬
tained a friendly correfpondence with them. But Pela¬
gius, after he had difeovered his opinions on the fubjeft
of grace and of baptifm, is reprefented b)' thefe good fa¬
thers, in the heat of their zeal, as a very ugly fellow ;
“ broad-lhouldered, thick-necked, fat-headed, lame of a
leg, and blind of an eye.” And Caeleftius, the indefati¬
gable and undaunted champion of thefe herefies, brought
upon himfelf many very bad names. St. Jerome, whofe
Commentaries on the Ephefians he had prefurned to cri-
ticife, calls him “ an ignorant ftupid fool, having his belly
fvvelled and diftended with Scots pottage ; a great corpu¬
lent barking dog, who was fitter to kick with heels than
to bite with his teeth ; a Cerberus, who, with his mailer
Pluto (Pelagius), deierved to be knocked on the head,
that they might be put to eternal filence.” Such were
the flowers of rhetoric which thefe good fathers employed
againll the enemies of the orthodox faith ! Both Pela¬
gius and Caeleftius were very great travellers ; having vi-
fited many different countries of Afiaand Africa, as well
as Europe, with a view to elude the perfecutions of their
enemies, and to propagate their opinions. It is no in-
confiderable evidence of their fuperior learning and abi¬
lities, that their opinions gained great ground in all the
provinces both of the eaftern and weftern empire, in fpite
of the writings of many learned fathers, and the decrees
of many councils againft them. “The Pelagian and
Caeleltian herefy (fays Photius) not only flouriftied in
great vigour in the weft, but was alfo propagated into
the eaft.”

The works of Pelagius dill extant, confift of, 1. Ex-
pofitionum in Epiftolas Paulinas, lib. xiv. which are in-
ierted in the works of St. Jerome, and were for a long
time attributed to that father. 2. Epiftola ad Demetria-
dem de Virginitate; which is preferved in the works of St.
Jerome and St. Auguftine, and has been by turns aferibed
to each of them. 3, Explanation^ Symboliad Damafum.
4. Epillolae ad Viduam duae. 5. De Libero Arbitrio. 6.
Libellus Fidei ad Innocentium Papam ; annexed to the
Letter of Pope Zofimus to the African Bilhops, in the 2d
vol. of the Colleft. Concil. For an account of his other
pieces which are loft, and the works in which fragments
of them may be found, we refer our readers to Cave’s
Hift. Lit. vol. i. Molli. Hill. Eccl. flee. v. and Prieltley’s

Hill

P E L A G I U S.

Hift. Chrift. Church, Per. xii. The hiftory of the Pela¬
gian controverfy, and of the Pelagians, has been written
by Archbilhop U flier, in his Antiq. Ecclef. Britan, by
Gerard Voflius ; Le Clerc ; Cardinal Noris ; Father Gar-
nier, in his Supplem. Oper. Theodoreti ; Janfenius, in
his Augtiftino ; and by Longueval, a French Jefuit, in
the preface to the 9th vol. of his Hift. Eccl. Gallic, and
others. Gen. Bing.

PEL'AGIUS I. (Pope), was a native of Rome. He
became a deacon of the Roman church, and was employed
in the capacity of nuncio at the court of Conftantinople
by feveral of the popes in fucceftion. About the year
539 he was commiftioned, together with Ephraim pa¬
triarch of Antioch, and Peter patriarch of Jerufalem, to
decide on the cafe of Paul, who had been banifhed to
Gaza, on account of a deacon’s death, to which he was
faid to have been privy. Having repaired to Gaza after
the trial of the African prelate, fentence of depofition
was pronounced upon him. While Pelagius was return¬
ing to Conftantinople, he met with fome Paleftine monks
on their journey to that city, in order to prefer com¬
plaints to the emperor againft the followers of Origen ;
and, having promifed them his intereft at court, he luc-
ceeded in obtaining an edidt from Juftinian in 541, by
which fentence of condemnation was parted upon the
Origenifts. In the mean time, he had betrayed the in-
terefts of pope Silverius at Conftantinople ; and, to in¬
gratiate himfelf with the emprefs, became privy to the
meafures for fecuring the popedom to Vigilius, the
ufurper of the fee. About the year 545 he returned to
Rome, being either recalled by Vigilius, or, according to
others, fent by Juftinian with a large fum of money for
the relief of that city, which was reduced to great d i it refs
by the incurftons of the Goths. In 547 he was deputed
by the citizens of Rome on an embafly to Totila, king of
the Goths, for the purpofe of diffuading that prince from
befieging that city, when, though he failed in the objedt
Of his million, by his interceftion he was the means of
preferving the lives and liberties of numbers of the
conquered Romans. In the fame year Totila fent him
in the character of ambafl’ador to Conftantinople, to ne¬
gotiate a peace between the Goths and Romans. He ad¬
hered to Vigilius in all his difputes ; in all his changes,
condemning or approving thofe articles which the pope
condemned or approved. With him he was banifhed for
rejecting the fifth council ; but, recanting when that pope
recanted, he was with him re lea fed from his exile and re¬
called to Conftantinople. He attended Vigilius on his
return from the eaft ; and, upon the death of the pope in
the iflantl of Sicily, in the year 555, lie haftened to Rome,
the emperor having promifed to raife him to that lee if
he furvived Vigilius, upon his engaging to caufe the fifth
council to be univerfally received in the weft. When
Pelagius arrived at Rome, he found the people and clergy
fo highly enraged againft him, that, in Head of electing
him their bifliop, they all with one confent feparated
themfelves from his communion. What induced many
to concur in this meafure, was a ftrong report, that, in
order to fecure the objedt of his ambition, he had been
accelfory to the death of his predeceffor. But Pelagius,
relying on the fupport of the emperor, refolved to have
himfelf ordained in defiance of the canons, as well as the
electors. No fooner was he fettled in the quiet poflelfion
of his fee, than he endeavoured to perform his engage¬
ment to the emperor, by perfuading the weftern bilhops
to receive the fifth council. With this view headdrefled
letters to them, in which he attempted to prove, that the
conftitution of Vigilius was in no refpedt derogatory to
the decrees of Chalcedon, and confequently that fuch as
did not receive it ought to be deemed fchifmatics. So
far, however, were his letters from producing the deli red
effedt, that the bilhops of Tufcany, Liguria, Venetia, Illy-
ricum, Gaul, Spain, and Ireland, declared loudly againft
that conftitution ; and the fifth council, and the Italian
bilhops, as well as the Iriflt, befides cenluring the pope in
Vo L. XIX. No. 1319.

487

the ftrongeft terms, feparated themfelves from his com¬
munion.

Thus abandoned by almoft all the bilhops in the weft,
and finding his endeavours to fatisfy them of his ortho¬
doxy were ineffectual, he wrote to the emperor’s chief
general Narfes, exhorting him to reftrain, by his authority
and power, thofe whom a reverence for St. Peter and his
fee could not reftrain, or bring to a fenfe of duty. Nar¬
fes, being of a mild and humane difpofition, inltead of
adting as the pope defined, endeavoured by entreaties and
perfuafion to gain over thofe Italian bilhops wdio were the
fubjedts of the empire; and, though he was at firlt not
fuccefsful, by fteadfly adhering to the fyftem of pacifica¬
tion, he in the end prevailed upon fome of the bilhops of
Tufcany and Liguria to renew their communion with
the fee of Rome.

About the year 557, a report was fpread in Gaul, that
the pope had departed from the genuine Catholic doc¬
trine. Childebert, king of the Franks, fent an ambafla-
dor to Rome, for the purpofe of examining into its
truth, and of demanding of Pelagius a confeffion of his
faith. In compliance with the king’s demand, the pope
tranfmitted to the monarch his confeftion, accompanied
with folemn declarations, that he not only received, but
was ready to defend, at the expenfe of his life, the holy
faith of Chalcedon ; yet maintaining, that nothing had
been defined in the fifth council, but what was entirely
agreeable to that faith and dodtrine. Pelagius died in
560, after a pontificate of nearly five years, during which
he had the mortification to fee his authority almoft uni¬
verfally difregarded by the weftern bilhops, who perfevered
in condemning and rejecting a council which he had ap¬
proved and received, and even fufpedted the orthodoxy of
his creed becaufe he received it. Sixteen Letters, which
have been attributed to him, may be found in the fifth
vol. of the Colledl. Concil. of which, however, the firft is
admitted by the editors of that work to be fpurious.

PELA'GIUS II. (Pope), was of Gothic extra&ion, but
a native of Rome. Upon the death of pope Benedict in
578, the fee continued vacant four months, at the expira¬
tion of which Pelagius was chofen to fill that dignity.
His eledtion having taken place at a time when the Lom¬
bards were matters of the greateft part of Italy, and kept
Rome itfelf clofely befieged, it was judged expedient that
he Ihould be ordained before the emperor’s confirmation
could be received ; but, as foon as the liege was raifed,
he fent Gregory, then deacon in the Roman church, and
afterwards his fuccelfor in the popedom, to excufe the in¬
formality, and to entreat the emperor's acquiefcence in
a proceeding which had been rendered necefiary by the
calamitous circumftances of the times. The Lombards,
by their ravages, had now fpread fuch devaftation and
terror in every part of Italy, that perfons who had the
charadter of holy men regarded them as the inftruments
of the divine vengeance to depopulate the country 5 and
fome of them fancied that they had revelations, which
foretold them that “ the Lombards were the forerunners
of the laft day, and that the end of the world was at hand."
By the report of their vifions, the credulous multitude
was terrified to fuch a degree, that, in Head of uniting
againft the common enemy, they abandoned themfelves
to defpair, and fullered the barbarians to plunder and de-
ftroy without oppofition. In this ftate of the empire in
the weft, the church continued to be divided by the
fchifm which had been occafioned by the conftitution of
pope Vigilius, and not terminated by his fuccefiors. The
talk of healing that fchifm, Pelagius confidered to be one
of the firft objedts that merited his attention, and he de¬
termined to apply to it with the utmoft zeal. The Lom¬
bards, however, occafioned the molt ferious alarms to the
church, and obliged his holinefs to pay more attention
to the fecular concerns of the ftate than to its fpirituali-
ties. They had conquered the important city of Pavia;
and, having made it the metropolis of their new king¬
dom, extended their con quells from thence over the ad-
6 I jacent

PEL

488

jacent provinces, threatening to advance a fecond time
againft Rome. This threat they were enabled to carry
into execution without delay, fince the exarch Longinus
had not fufficient forces to meet them in the field. Un¬
der conftant apprehenfions, therefore, that they would
fpeedily make their appearance at the gates of the city,
Pelagius fent new legates to the emperor Tiberius, in the
year 580, to lay before him an account of the defencelefs
(late of Italy, and to folicit a fupply of men and money,
that the city of Rome itfelf might not fall into the hands
of the barbarians. But the emperor, though wifhing
well to the caufe, had it not in his power to fend them
any relief. Finding Italy thus abandoned by the empe¬
ror, in 581 the pope applied to Guntram, king of Bur¬
gundy, who was diftinguifhed for his attachment to the
bifhops of Rome, and their fee, exhorting and entreating
him to renounce the alliance which he had lately con¬
cluded with the Lombards, and, by turning his arms
againft them, prevent the entire fubjugation of Italy.
In this application, however, he appears to have met
with no better fuccefs, than in his legation to Conftan-
tinople. During the following year, upon receiving in¬
telligence of the death of the emperor Tiberius, and the
fucceflion of Mauricius, Pelagius loft no time in charging
his nuncio Gregory to renew his application for impe¬
rial aid j which Mauricius promifed to grant ; and im¬
mediately iflued an order to difcharge the exarch Lon¬
ginus, who was not thought equal to fo great a truft,
and to appoint Zamaragdus, a perfon well {killed in mi¬
litary affairs, to command in his room.

In the year 583, the new exarch took with him into
Italy a confiderable reinforcement of chofen troops, and
a large fupply of money to defray the expenfes of the
war. Mauricius, however, fenfible that with thofe troops
alone he would not be in a condition to withftand the
numerous forces of the enemy, entered into a treaty
with Childibert king of the Franks, who engaged, for a
confiderable fum, which was paid beforehand, to fall
upon the Lombards on one fide, while the exarch at¬
tacked them on the other. But this faithlefs prince,
upon receiving a fimilar fum from the Lombards, agreed
to dilband his army, and obferve aftrift neutrality. He
had even the bafenefs, when ambafladors from the em¬
peror urged him either to perform his promife, or to re¬
fund the money which he had received, to difmifs them
■without any anfwer. This treacherous conduft proved
a great difappointment to the exarch, who, finding him-
felf unable to profecute hoftilities with his prefent forces,
refolved to try whether he could not amufe the enemy
with a pretence of negotiation, till further fupplies could
be fent to him. Accordingly, he propofed a ceflation of
arms, which was agreed to by the king of the Lombards,
who was defirous of fettling the affairs of his kingdom,
and of eftablifhing peace and good order in the conquered
countries.

From this time we meet with no particulars relating
to Pelagius before the year 588, when a council was held
at Conftantinople, for the trial of Gregory, patriarch of
Antioch, who had been accufed of inceft, and feveral
other crimes. After the trial had lafted nearly a whole
day, and the patriarch had been honourably acquitted,
the council confirmed to John of Conftantinople, fur-
named the jF 'after, on his own application, the title of
oecumenical or univerfal bifhop, to be enjoyed by him
and his fucceflbrs in that fee. Though it does not ap¬
pear that this title was attended with any acceflion of
power, much lefs with fuch pretenfions to univerfal ju-
rifdi&ion over the church as were afterwards claimed by
the bifhops of Rome, yet, when intelligence of what had
paffed was brought to Pelagius, his jealoufy was alarmed
left the dignity of his bifhopric fliould be eclipfed 5 and
he endeavoured to alarm the whole Chriftian world
againft John, as if he intended to engrofs all ecclefiafti-
cal power to himfelf and his fee. As much difturbed
a»d concerned as if the council had condemned fome

PEL

fundamental article of the Chriftian religion, he imme¬
diately, by the authority and in the name of St. Peter,
declared all the aflrs of that affembly null and void, ex¬
cepting their acquittal of Gregory. He alfo difpatched,
without delay, meflengers to Conftantinople, with letters
to the patriarch, and to his nuncio at the imperial court.
In his letter to the patriarch, Pelagius reproached him,
in very fevere terms, with pride and ambition ; pro¬
nouncing his wifh for fuch a diftinftion above his bre¬
thren, as the name of oecumenical bifhop imported, to be
wicked, deteftable, and diabolical; and threatening to
feparate himfelf from his communion- if he did not im¬
mediately relinquifh the antichriftian title which he had
afi’umed. In his letter to his nuncio, he ftriflly enjoined
him not to communicate, or to affift in divine fervice on
any occafion, with the bifhop of Conftantinople, till he
had renounced that diftinftion. However, as the pa¬
triarch Syriacus, who fucceeded John, affumed the fame
title, it is probable that John continued the ufe of it as
long as he lived, though Pelagius was prevented by
death from proceeding further in this affair.

In the year 589, the Catholic caufe received an accef-
fion of ftrength by the converfion of the Goths in Spain,
who, after having profeffed the doftrine of Arius dur¬
ing more than tw'o centuries, were perfuaded by their
king Recaredus to renounce it, and to embrace the Ca¬
tholic faith. This event gave great fatisfaftion to the
Catholic party, though Pelagius furvived but a fhort
time to enjoy it. In confequence of an inundation of
the Tiber, which laid under water a confiderable part of
the city of Rome^and the adjacent country, a very mor¬
tal peftilentia! diftetnper broke out, which proved fatal
to Pelagius in February 590, after he had prefided over
the Roman fee eleven years and between two and three
months. Ten Letters and fix Decrees, under his name,
are inferted in the fifth vol. of the Collefl. Concil. though
the editors of that work acknowledge the firft, fecond,
eighth, and ninth, letters, to be fuppofitious. Cave's
Hijl. Lit. vol. i.

PELAGNI'SI, an ifland in the Grecian Archipelago,
about eight miles in circumference. Lat. 39. 30. N. Ion.
24. 8. E.

PELAGO'NIA, in ancient geography, a country of
Macedonia, called alfo Tripolitis, on account of its three
cities, according to Strabo. — Alfo, a town of the fame
country. — Alfo, a town of the ifland of Sicily.

PELAGO'SA, an ifland in the Adriatic, near the coaft
of Dalmatia. This ifland, together with feveral rocks
that appear above water near it, are the remains of an
ancient volcano. The lava which forms the fubftance
of this ifland appears like the ordinary lava of Vefuvius.
The Liflan fifhermen fay, that Pelagofa is fubjefl to fre¬
quent and violent earthquakes ; and the afpe£t of the
ifland proves at firft fight that it has fuftered many revo¬
lutions ; for it is rugged, ruinous, and fubverted : fix-
teen miles fouth-weft of Agofta. Lat. 41. 45. N. Ion.
16. 10. E.

PELAI'AH, a Levite; (Nehem. viii. 7. x. 10.) He
was one of the principal Levites that returned from cap¬
tivity, and was one of thofe that figned the covenant that
Nehemiah renewed with the Lord.

PELALI'AH, fon of Amazi and father of Jeroham, of
the family of rafhur fon of Malchiah : he was of the race
of the priefts. Nehem. xi. 12.

PELANG', a town of Birmah : eight miles north-eaft
of Pegongmew.

PELARGO'NIUM, f. [fo called frorn a

ftork, in allufion to the beak of the fruit, which refembles
the bill of that bird ; as well as to preferve an analogy
with the Geranium, or crane’s-bill, and Erodium, which
might properly be called heron’s-bill.] Stork’s-bill, or
African Geranium ; in botany, a genus of the clafs
monadelphia, order heptandria, natural order of grui-
nales, (gerania, JuJJ.) Generic chara&ers — Calyx : pe-
rianthium one-leafed, five-parted j fegments ovate, acute,

concave,

PELARGONIUM.

concave, permanent ; upper fegment, ending in a capil¬
lary nectariferous tube, decurrent along the peduncle.
Corolla: petals five, obcordate or ovate, fpreading, large,
irregular. Stamina : filaments ten, awl-fhaped, united at
the bafe, fpreading at top, unequal in length, all fhorter
than the corolla, three of them (feldom five) callrated ;
anthers feven, oblong, verfatile. Piftillum: germ five
cornered, beaked ; ftyle awl-fhaped, longer than the fta-
mens, permanent: ftigmas five, reflex. Pericarpium:
capfule five-grained, beaked, the cells opening inwards ;
the beak fpiral, bearded on the infide. Seeds folitary,
ovate-oblong. — Effential ChuraEler. Calyx five-parted,
the upper fegment ending in a capillary nectariferous
tube running along the peduncle; corolla five petalled,
filaments ten, unequal, three of which (feldom five) are
caftrated ; fruit five-grained, beaked; beak fpiral,
bearded within.

This vaftand favourite genus, for which we are almoft
entirely indebted to the Cape of Good Hope, confifts of
a great number of well-marked fpecies. But that num¬
ber is greatly augmented, in almoft every book, by the
admiifion of fpurious hybrid fpecies or varieties, which
continually ftart up from feed wherever many of the pri¬
mary ones are cultivated, and are for a while propagated
by cuttings, or even by feed. Sooner or later, however,
they for the moft part vanifh, even before the eyes of
thole who witnefled their origin. Willdenow defines 120
fpecies, feveral of which we know to have been the pro¬
duction of European gardens; of thefe Mr. Profeflor
Martyn, in his edition of Miller’s Gardener’s Dictionary,
has admitted 82, which are divided into five diftinCt flec¬
tions, with about eight-and-twenty mifcellaneous fpecies
at the end. All thefe plants have rather a flefhy habit,
and more or lei's of a peculiar (cent, in fome inftances ex-
quifitely agreeable. Some are herbaceous, with a tube¬
rous root, that fupplies the place of the fhrubby Item ob-
fervable in moft of the others. Their foliage is moftly
downy, fometimes glaucous. Flowers more or lefs um¬
bellate, rarely endowed with any fcent, except what
arifes from the herbage; though fome, whole colours are
of the yellowifh-green or lurid kind, are delicioufly fra¬
grant at night. The prevailing colour, throughout the
greater part of the genus, is crimfon, fcarlet, or light
purple, in various beautiful fhades and combinations,
often intermingled with white; yellow and blue are both
equally rare in this natural order, and the latter fcarcely
occurs at ail in the genus of which we are treating.
Every known fpecies, except perhaps one or two, is pe¬
rennial. They are greenhoufe plants in England, flow¬
ering at various fealons, and conducing greatly to the
ornament of a collection. In fome few inftances the
number of petals, as well as of the ftamens, differs a little
from the generic deflcription.

The diftinCtions between this genus and thofe of Ero-
dium and Geranium, into which the natural genus or fa¬
mily of Geranium is now divided, may be feen under the
effential characters of the refpeCtive genera ; and the
reafons for the modern divifion, together with the cir-
cutnftances of agreement in the feveral branches of this
natural family, are given under Geranium, vol. vii.

I. Stemlefs; root turnip-like ; umbels compound.

1. Pelargonium hirfutum, or various leaved ftork’s-
bill : leaves obovate or lanceolate, quite entire or pinna-
tifid, rough-haired, ciliate. Root turbinate, perpendicu¬
lar, at the upper part thickened and imbricate as it were
with red ftipules. Stem none, except peduncles or fcapes,
on which there is one leaf near the origin of the umbels.
Root-leaves numerous, fome ovate almoft entire, others
laciniate and as it were pinnate, and all petioled. Sti¬
pules oblong, fattened to the bafe of the petiole, bifid.
Flowers umbelled ; fcape radical, two inches high, and
divided into three or more pedicels; corolla frnall, papi¬
lionaceous, pale in dried fpecimens, but, according to
Burman, dark purple. Capfules five, fhort, tomentofe :

489

the beak fcarcely half an inch in length, Introduced in
1788, by Mr. Francis Maflon. It flowers in March.

2. Pelargonium pinnatum, or pinnated ftork’s-bill:
umbel fubcompound; leaves pinnate j leaflets roundifh-
ovate, undivided, hirfute on both Aides. Root thick,
yellowifh, defcending, having few fibres. Stem fcarcely
any, except the fcapes, which have fometimes leaves,
fometimes none. Leaves long, often with an odd leaf¬
let : leaflets about fixteen, fubfeflile, ovate-acute, afh-co-
loured. Corolla papilionaceous, reddifh - white, with
deeper-coloured veins. Introduced in 1788 by Maflon.
It flowers in April.

3. Pelargonium rapaceum, or caraway-leaved ftork’s-
bill : leaves decompoundedly laciniate, villofe. Root
flefhy, tw'o inches thick and more, confifting of feveral
irregular tubers, and frequently half a foot in width,
white within, purple on the outfide, covered with a brown-
ifh bark, and perennial. Root-leaves very many, hairy
all over, from fix inches to a foot and more in length, but
fcarcely two inches wide. Flowers without fcent; calyx
filky and ciliate, green ; petals at firft whitifh, but after¬
wards rofe-coloured ; the two upper ones having blood-
red fpots at their bafe ; filaments pale; antherae and ftig-
ma purple. Introduced in 1788 by Maflon. It flowers
here in April.

II. Almoft ftemlefs; root tuberous.

4. Pelargonium lobatuin, or vine-leaved ftork’s-bill:
ftemlefs; umbel compound; leaves ternate or quinate,
lobed, tomentofe. This has tuberous roots, from which
come out three or four broad leaves, divided into feveral
lobes like a vine-leaf, fpreading flat on the ground, cre-
nated, on fhort foot-ftalks. Peduncles immediately
from the root, about a foot high, naked, terminated by "a
bunch of dark-purple flowers, with long tubes, feflile, and
having a very agreeable odour in the evening. Cultiva¬
ted in 1739, >n the botanic garden atChelfea. It flowers
in July and Auguft.

5. Pelargonium trifle, or night-fmelling ftork’s-bill :
fubcaulefcent ; umbel Ample; leaves multifid-laciniate,
villofe; fegments lanceolate. Root thick, roundifh, tu¬
berous, with feveral hairy leaves fpringing from it, which
are finely divided, almoft like thofe of the garden-carrot ;
they fpread near the ground, and among them come out
the Italics, about a foot high, having two or three leaves
of the fame fort, but fmaller and fitting clofe ; from the
ftalksarife two or three naked peduncles, terminated by
a bunch of yellowifh flowers, marked with dark purple
fpots, which fmell very fweet after the fun has left them.
It was introduced before 1632, by Mr. John Tradefcant,
fen. Johnfon faw it in flower about the end of July
1632, being the firft time that it flowered with the
owner.

6. Pelargonium flavum, or carrot-leaved ftork’s-bill :
fubcaulelcent; umbels Ample ; leaves decompoundedly la¬
ciniate, hirfute ; fegments linear. This is a rough-haired
plant. The leaves are multifid, like thofe of carrot,
often a fpan long, petioled, pale green, fmelling fweet
when handled, covered with very-fpreading long diftant
hairs on both Aides. Peduncle obliquely afcending, gib¬
bous at the bafe, covered with longer thicker hairs than
the other parts, fuftnining nine or ten flowers. Corolla
ftraw- white; petals wedge-lhaped, the two upper ones
wider, with an oblong purple fpot ; the three lower nar¬
rower, with two purple diverging ftreaks. Cultivated in
the Apothecaries’ garden at Chelfea in 1724; it flowers
from July to September.

III. Herbaceous or fuffruticofe.

7. Pelargonium tabulare, or rough-ftalked ftork’s-bill :
peduncles few-flowered; leaves roundifh-cordate, five-
lobed, blunt ; Items decumbent, hairy. Refembles Ge¬
ranium zonale, but the greateft part of the Item perilhes
above the root. Cavanilles defcribes it under the name
of G. elongatum : it varies with a biennial Item, un-

fpotted

490

PELARGONIUM.

fpotted leaves, more deeply lobed, and the common pe¬
duncles more than a foot long. Introduced in 1775 by
Maflon ; flowers during the greater part of the fummer.

8. Pelargonium alchemilloides, orlady’s-mantle-leaved
ftork’s- bill : peduncles four-flowered or thereabouts;
leaves orbiculate, palmate gafhed, very hairy; (tern her¬
baceous, decumbent ; Itigmas feflile. This fends out
feveral herbaceous (talks about a foot and a half in length.
Flowers pale blufh-colour, feveral together upon very
long peduncles. There is a fucceflion of them during
all the fummer-months ; and the feeds ripen about a
month afterthe flowers are fallen. There is a variety of
it, with a dark circle in the middle of the leaves. Cul¬
tivated in 1693 by Mr. Jacob Bobart.

9. Pelargonium odoratiflimum, or fweet-fcented (lork’s-
bill 1 peduncles five-flowered, or thereabouts: leaves
roundilh-cordate, very foft. This has a very (hort flefhy
(talk, dividing near the ground into feveral heads, each
having many leaves on feparate footftalks : they are loft
and downy, and have a (trong fcent like anifeed. From
thefe heads come out feveral (lender (talks, near a foot in
length, proftrate, with rounder leaves than thofe near the
root, but of the fame texture and odour. The flowers
are produced from the fide of thefe (talks, three, four, or
five, (landing together upon (lender peduncles; they are
white, but make little appearance. It was cultivated in
1724, in the garden belonging to the Apothecaries’ Com¬
pany at Chelfea, and flowers during molt part of the
fummer.

10. Pelargoniam groflularioides, or goofeberry-leaved
(tork’s-bill : peduncles fubbiflorous, filiform; leaves
cordate, roundilli, galhed, toothed; (terns very fmooth.
Stem proftrate, four-cornered, fmooth ; as is alfo the
whole plant. Leaves marked with lines. Peduncles ca¬
pillary, with two or three fmall flowers, of a pale flefti-
colour. They continue in fucceflion all the fummer; and
the feeds ripen in about five weeks after the flowers de¬
cay. Cultivated in 1731, by Mr. Miller.

11. Pelargonium anceps, or angular-ftalked (lork’s-
bill : umbels many-flow'ered ; flowers in a fort of head ;
leaves cordate-roundifti, obfoletely lobed; (tern three-
fided-ancipital. Introduced by Mr. Francis Maffon in
1788. It flowers here in May.

12. Pelargonium althaeoides, or althsea-leaved ftork’s-
bill : peduncles many-flowered ; leaves cordate-ovate,
finuate, toothed, theuppermoft pinnatifid ; petals equal
to the calyx. Plant deprefled, wholly fubtomentofe.
Petals the length of the calyx, dark purple on the out-
fide with a white edge, red within; the two upper ones
with blood-red dotted (freaks at the bafe. Cultivated in
the botanic garden at Chelfea in 1724.

13. Pelargonium fenecioides, or fmall white-flowered
dork’s -bill: peduncles three-flowered; involucres and
calyxes blunt ; leaves bipinnatifid-laciniate ; Item herba¬
ceous. This is an annual plant; introduced in 1775 by
Mr. Fr. Maflon. It flowers in June and July.

14. Pelargonium coriandrifolium, or coriander-leaved
(lork’s-biil : peduncles fubtriflorous ; corollas fubtetra-
petalous; leaves bipinnate, linear; Item herbaceous,
(moothifli. This is an annual (or rather biennial) plant,
with branching (talks near a foot high. The lower
leaves (land upon long footftalks, but thofe on the upper
part fit clofe to the (talks. The flowers (land upon na¬
ked peduncles, which proceed from the fide of the (talks,
on tiie fide oppofite to the leaves : they are of a pale flefh-
colour: appear in July ; and the feeds ripen in Septem¬
ber; foon after which the plants decay. Linnaeus re¬
marks, that the di(k of the leaf becomes brownifti, as in
the next fpecies ; and that the antherae are five or feven.
It was cultivated in the Chelfea garden in 1724, and
flowers from March to September.

15. Pelargonium myrrhifolium, or myrrh-leaved Itork’s-
bill : peduncle fubtriflorous ; corollas fubtetrapetalous ;
leaves bipinnatifid, the lower ones cordate, lobed; (tern
fomewhat llrigofe. Root knobbed, tuberous, like P.

trifte, from which come out feveral pretty-large leaves,
compofed of many lobes, fet along the midrib The pe¬
duncles arife immediately from the root, and terminate
in a bunch of pale reddifh flowers, which fmell fweet at
night. Cultivated by Mr. Miller in 1731. It flowers
from May to Auguft, and is fomewhat (hrubby.

IV. Shrubby, with a flefhy or thick (tern.

16. Pelargonium tenuifolium, or fine-leaved Jtork’s-
bill : umbels many-flowered ; leaves decompoundedly
pinnate, multifid, linear, hirfute; (tern fle(hy; flowering-
branches (lender. Introduced in 1768, by Mr. William
Malcolm. It flowers molt part of the fummer.

17. Pelargonium carnofum, or flefhy-ltalked ftork’s-
bill : umbels many-flowered ; leaves pinnatifid, lacini-
ate ; petals linear; joints flefhy-gibbofe. This has a
thick flefhy knotted (talk, riling about two feet high,
fending out a few (lender flefhy branches, thinly fet with
leaves, which on the lower part of the Italk are petioled,
but above are feflile. The flowers are produced in fmall
clufters at the ends of the branches : the petals are nar¬
row and white, making no great appearance, but they
continue in fucceflion molt part of the fummer. Culti¬
vated in Chelfea garden in 1724.

18. Pelargonium ceratophyllum, or horn-leaved
ftork’s-bill : umbels many flowered, leaves remotely-
pinnate, flefhy, round; fegments channelled, obfoletely
trifid. Native of the fouth-weft coaft of Africa. Intro¬
duced in 1786, by Mr. Anthony Hove. It flowers in
May, and continues to do fo during mod of the fummer-
months; the feeds ripen here.

19. Pelargonium crithmifolium, or fampire-leaved
(tork’s-bill: umbels many-flowered, panicled; leaves bipin¬
nate, flefhy, dilated, and jagged at the tips ; petals obtufe,
the upper ones crifped at the bafe. Root perennial. Sterna
foot or two in height, nearly ereft, Ample, fwelled, round,
glaucous, fmooth, leafy, flowering at the top. Flowers
very numerous, inodorous, rather elegant than fplendid.
This fpecies is allied to the preceding; but appears to be
diftindt, on account of the dilated, pointed, and not-
obtufe, divifions of the leaves ; more efpecially from the
crifping and waving of the upper petals, and all of them
being obtufe; not to mention its panicled (not folitary)
umbels. It flowered in April 1792, at the marchionefs
of Rockingham’s ; to whom the feeds, brought by cap¬
tain Riou of the Guardian, were given by the Rev. Mr.
Spragg.

20. Pelargonium gibbofum, or gouty (tork’s-bill : um¬
bels many-flowered ; leaves pinnate, pinnatifid-confluent
at the tip; joints flefhy, gibbofe. This has a round
flefhy (talk with fwelling knots at the joints, riling about
three feet high, and fending out feveral irregular fmooth
branches. Flowers four or five on a peduncle; petals
dark-purple, broader than in P. carnofum, and having a
very agreeable fcent in the evening. Cultivated in the
Chelfea garden in 1712 ; it flowers molt part of the fum¬
mer.

21. Pelargonium fulgidum, or celandine-leaved ftork’s-
biU : umbel twin ; leaves three-parted, pinnatifid-gaflied;
middle fegmentvery large. This has a flefliy (talk, which
feldom riles a foot high, and puts out very few branches*
Leaves fmooth, light green. Cultivated in 1732, in the
garden of James Sherard, M.D. at Eltham. It flowers
during moll part of the fummer.

22. Pelargonium quercifolium, or oak-leaved ftork’s-
bill : umbels fubmultiflorous ; leaves cordate, pinnatifid,
crenate, finufes rounded, filaments afcending at the tip.
Stem (hrubby, twilted, branched, more than four feet
high. Leaves oppolire, often (horter than the petioles,
oblong, with deep rounded finufes ; lobes oblique, wider
above, roundilh, crenate. There are two varieties, larger
and fmaller. Introduced in 1774 by Maflon : it flowers
from March to Auguft.

23. Pelargonium radula, or multifid-leaved (lork’s-
bill : umbels few-flowered; leaves pinnatifid-laciniate,

2 tugged,

PELARGONIUM. Hate

491

PELARGONIUM.

rugged, revolute; fegments linear. Stem flirubby, co¬
vered with an afh-coloured bark, branched, two feet high.
Leaves numerous, alternate, nearly equal to the petioles,
very deeply five-cleft ; the fegments pinnate and bipio-
nate, linear. Stipules wide, acuminate and fhrivelling.
Peduncles axillary, folitary, with one, two, or three,
flowers : involucre generally five-cleft, fhrivelling. Ca¬
lyx ovate-oblong, pubefcent, cut deeply into five ovate
fegments; corolla papilionaceous, rofe-coloured with red
lines; the claws white; the two upper petals reflex and
wider; antherae deep flelh-coloured. Germ very final!,
ovate-pentagon ; ftigmas villofe, purple, revolute. Cap-
fules villofe, acute at the bafe : awn or tail bearded,
twilled, near four lines in length. The whole plant has
a ftrong fmell of turpentine. The leaves in young plants
are often three inches long; but in old ones only one-
third of the fize, and more numerous. It takes the name
rad ula , from the rough rafp-like furface of its leaves.
There are two varieties of this, as of the preceding, a
larger and a fmaller : and, as it is readily raifed from
feeds, it affords many feminal varieties. The cafe is the
fame in other forts ; infomuch that we may hereafter find
it difficult to reduce thefe plants to their proper fpecies.
It was introduced by Mafibnin 1774; an<^ flowers from
March to July. It is reprefented on the annexed Plate,
at fig. 1.

24. Pelargonium graveolens, or ftrong-fcented ftork’s-
bill : umbels many-flowered, fubcapitate ; leaves pal¬
mate fevenlobed, fegments oblong, blunt, revolute at
the edge. Stem arborefcent, a fathom in height, branched;
the tender branches pubefcent. The wdtole plant has a
ftrong fmell; which varies, and refembles turpentine, or
lemon, or rofes. It was introduced by Maffon in 1774;
and flowers from March to July.

25. Pelargonium papilionaceum, or butterfly ftork’s-
bill : umbels many-flowered ; , leaves roundiffi-cordate,
angular; corollas papilionaceous; wings and keel mi¬
nute. This rifes with an upright fhrubby ftalk feven or
eight feet high, fending out feveral fide-branches, with
large angular rough leaves, on ffiort footftalks. The
flowers are produced in large panicles (umbels) at the
end of the branches. Cultivated in the botanic garden
at Chelfea in 1724; and flowers from April to July.

26. Pelargonium inquinans, or fcarlet-flowered ftork’s-
bill : umbels many-flowered ; leaves orbiculate-reniform,
fcarcely divided, crenate, tomentofe, and clammy. This
rife? with a foft fhrubby Hem to the height of eight or ten
feet, fending out feveral branches; which are generally
eredl. Flowers in loofe bunches (umbels), on long fliff
axillary peduncles ; corolla bright fcarlet. The flowers
make a fine appearance, and there is a fucceffion of them
during all the fumrner months. The leaves, when
bruifed, ftain the fingers of a ferruginous colour ; hence
Linnaeus’s trivial name, inquinans , defiling. It was cul¬
tivated in 1714, by Bifhop -Compton ; and flowers from
May to September.

27. Pelargonium hybridum, orbaftard ftork’s-bill : um¬
bels many-flowered; leaves obovate, crenate, fmootb,
flefhy ; petals linear. In the flowers this perfectly refem¬
bles the preceding; but the herb is fjnaller ; the leaves
are not tomentofe, but are very like thofe ofP. acetofum,
yet they are neither wedge-fliaped at the bafe nor kidney-
form ; they are alfo lefs four. Cultivated in 1732, by
James Sherard, M. D. It flowers with the other.

28. Pelargonium zonale, or common horfe-ffioe ftork’s-
bill : umbels many-flowered ; leaves cordate-orbiculate,
fcarcely lobed, toothed, zoned. This rifes with a flirubby
ftalk four or five feet high, and divides into a great num¬
ber of irregular branches, fo as to form a large bufli, fre¬
quently eight or ten feet in height. Leaves indented on
the edge in feveral obtufe fegments, cut into fhort teeth:
there is a purplilh curved zone in form of a horfe-fhoe,
from one fide of the bafe to the other, correfponding with
the border: when gently rubbed, the leaves have a feent
like fealded apples. The flowers are produced in pretty

Vol. XIX. No. 1319.

clofe bunches, on axillary peduncles, five or fix inches in
length, coming out towards the ends of the branches:
they are of a redd i fh purple colour, and continue in fuc¬
ceffion great part of the fumrner. There is a variety
with fine variegated leaves ; and the flowers vary much in
colour, from purple through the different fliades of red
to high fcarlet. Cultivated in 1710, by the duchefs of
Beaufort.

29. Pelargonium heterogamum, or red-flowered ftork’s-
bill : umbels many-flowered ; leaves fuborbiculate, gafh-
lobed, toothed ; ftem e‘re6l, flirubby. Cultivated in 1786,
by Meftrs. Lee and Kennedy.

30. Pelargonium monftrutn, or duller- leaved ftork’s-
bill: leaves orbiculate-reniform, obfoletely lobed, com¬
plicated, curled. Cultivated in 1784, by Mrs. Norman.

31. Pelargonium bicolor, or two-coloured ftork’s-bill:
umbels many-flow'ered ; leaves ternatifid, lobed, toothed,
waved, villofe. Stem flirubby, twilled, covered with an
afh-coloured bark ; branches round, villofe, fubherbace-
ous, a foot long. Jacquin obferves, that the whole has a
very ftrong fmell ; and Curtis, that it obvioufly differs
from all the other fpecies, in the particular fhape of its
leaves, and the colour of the flowers, which are ufually of
a rich and very dark purple edged with white. Intro¬
duced in 1778, by John earl of Bute. It flowers from
June to Auguft.

32. Pelargonium vitifolium, or balm-fcented ftork’s-
bill : flowers in heads ; leaves cordate, three-lobed, fome-
what rugged; ftems upright. This rifes with an upright
fhrubby ftalk to the height of feven or eight feet, fending
out many pretty ftrong branches. Leaves fomewhat like
thofe of the vine ; the lower on long petioles, the upper
on fhort ones; when rubbed, they have a feent of balm.
The flowers grow in compadl cl ufters, on the top of long
naked axillary peduncles, riling much higher than the
branches: being final], and of a pale-blue colour, they
make no great figure ; but there is a fucceffion of them
molt part of. the fumrner. It was cultivated in 1724, in
Chelfea garden. L’Heritier has figured a variety of it.

33. Pelargonium capitatum, or rofe-feented ftork’s-
bill: flowers in heads; leaves cordate, lobed, waved,
foft ; ftems diffufed. This rifes with a flirubby ftalk,
four or five feet high, dividing into feveral weak irregu¬
lar branches. The flowers grow in clofe roundifli heads,
forming a fort of corymb; they are of a purplifh-blue
colour, and continue in fucceffion great part of the Cum¬
mer. The leaves, when rubbed, have an odour like dried
rofes.

34. Pelargonium glutinofum, or clammy ftork’s-bill:
umbels few-flowered ; leaves cordate, haftate-quinquan-
gular, clammy. Stem flirubby, covered with a grey bark,
three feet high and more; branches decliningand decum¬
bent, green, clammy, as is the whole plant. Leaves al¬
ternate, the uppermoft fometimes oppolite, often fliorter
than the petioles, large, acute, finuate. Stipules wide-
acuminate, flirivelling. Common peduncles axillary,
lateral, or oppofite to a leaf, eredl, folitary, longer than
the leaves; involucre five-leaved, the leaflets ovate-acute,
flirivelling ; rays from three to eight, half an inch long.
Calyx ovate, villofe, deeply five-parted; the fegments re¬
flex. Corolla much larger than the calyx, papilionace¬
ous, pale purple, variegated with red ftreaks ; the two
upper petals wider, reflex. Seven of the filaments long,
purple, villofe, with oblong antherae; the other three
very fmall and barren. . Germ fmall, five-cornered, vil¬
lofe : ftyle pyramidal, villofe, white : ftigmas purple.
Capfule tomentofe, fharp at the bafe ; awn an inch long,
bearded, white, fpiral. The middle of the leaf is gene¬
rally ftained with purple. It was introduced about the
year 1777, by Meffrs. Kennedy and Lee; and flowers in
May and June, even to September. It is reprefented at
fig. 2.

35. Pelargonium cucullatum, or hooded ftork’s-bill:
ximbels fubmultiflorous ; leaves kidney-form, cowled,
toothed. This rifes with a flirubby ftalk eight or ten

6K feet

492

PELARGONIUM.

feet high} fending out feveral irregular branches. Leaves
r.oundifh, with the Tides erect, fo as to form a hollow or
hood ; whence Linnaeus calls them cucullatum, or cowled ;
they are heart-fhaped at the bafe, or kidney-fhaped accor¬
ding to Linnaeus ; and from the footftafk run many
nerves ariling from a point, but diverging towards the
fides. The flowers are produced in large panicles (or
umbels) on the tops of the branches ; calyx deeply cut,
and clofely covered with foft hairs; petals large, entire,
purple. It flowers from June to September; and the
feeds have fhort hairy beaks. The whole plant is pubef-
cent, higher than mod of the other fpecies, ftiffer, and
more upright. Introduced in 1690, by Mr. Bentick.

36. Pelargonium angulofum, or marfh-mallo.w-leaved
ftork’s-billi umbels many-flowered; leaves rounded,
cowled, angular, toothed. This bears much refemblance
to the preceding, and has been confounded with it; but
the leaves are of a thicker fubftance, divided into many
acute angles, having purple edges, which are acutely in¬
dented. The ftalks and leaves are very hairy. The
branches are not fo irregular as thofe of the former, nor
are the bunches of flowers near fo large. It was culti¬
vated in the'Chelfea garden in 1724; and flowers in July
and Auguft.

37. Pelargonium acerifolium, or maple-leaved ftork’s-
bill : umbels five-flowered, or thereabouts ; leaves pal-
mate-five-lobed, ferrate, wedge-fhaped, at bottom undi¬
vided. Cultivated in 1734, by Mr. Archibald Thomp-
fon. It. flowers in April and May.

38. Pelargonium cordatum, or heart-leaved ftork’s-
bill : umbels many-flowered ; leaves cordate, acute,
toothed ; lower petals linear, acute. Stem fhrubby,
branched : when young red, when very-young green and
villofe, when old covered, with an afh-coloured bark.
Flowers at the ends of the Hem and branches in nume¬
rous umbels; corolla papilionaceous, large, pale purple,
the two upper petals wider, longer, marked with deeper-
coloured lines, red from the claws to the middle; the
three lower whitifh, linear; antheras ovate-oblong, yel¬
low.* Introduced in 1774, by Mr. Maflon ; flowers from
March to July. There are feveral varieties.

39. Pelargonium echinatum, or prickly-ftalked ftork’s-
bill : flem flefny ; ftipules fpinefcent; leaves cordate-
roundifh, from three to five lobed ; flowers umbelled ;
umbels feven or eight flowered. Stalk green ; furface
fmooth, and fomewhat glofly, befet with fpines which
bend back and terminate in brownifli weakifii points;
t’hefe appear to have been primarily the ftipules, which
become thus flefliy and rigid. The flowering ftem pro¬
ceeds from the fummit of the ftalk, and is a foot or more
in height; flowers in an umbel of feven or eight toge¬
ther ; the three lowermoft petals are pure white, with a
little gibboflty at the bafe of each ; the two uppermoft
are marked with three irregular fpots, of a rich purple
colour, inclining to carmine, the two lower fpots nar-
roweft, and of the deeped colour; ftigma red, divided
into five parts^ and a little longer than the fertile fila¬
ments. In its habiothis plant fomewhat refembles the
preceding. It flowers from May to September, and in
favourable feafons produces feeds here. It varies with
petals of a rich purple colour, in which the fpots are
limilar, but not fo confpicuous.

40. Pelargonium tetragonum, or fquare-ftalked ftork’s-
bill : peduncles two flowered ; branches four-cornered,
flefliy ; corollas four-petalled. Stems angular; angles
four, fometimes three, fucculent, as is the whole plant;
procumbent when they fiioot out into length, at firft
hairy, afterwards very fmooth, much branched, and three
feet high. Leaves alternate, almoft equal to the petioles,
oi;bicu!ate, five-lobed ; the younger villofe, tooth-cre-
nate, violet-coloured underneath, aDd above having a
dark red zone; the older crenate, flefliy, dark green, with
a few villofe hail's, and frequently with a zone. Stipules
ftiort femicirc ular, fp reading, ftirivelling. Peduncles
axillary, ere if, rugged; with. four fubovate ftipules at

the forks. Calyx tubular, long, fegments acute, fpread-
ing ; the uppermoft wider. Corolla very handfome, pa¬
pilionaceous; the two upper petals an inch and a half in
diameter, femi-tubular at the bafe, upright, reflex at the
tip, purple on the outfide, white within, having two ob¬
long feathered fpots, of a deep purple colour; the two
others lateral, fickle- (liaped, parallel, with narrow claws ;
between thefe come out the ftamens and piftil, which are
long, perpendicular to the upper petals, and thence from
bowed upright; feven of the filaments very long, deep
red, with dark-purple ovate antheras ; the other three
fhorter and barren. Germ five-cornered, pubefcent :
ftyle pyramidal, at firft green, then purple. Capfules. ob¬
long, villofe, fliarp at the bafe : awn an inch long,
bearded, fpiral. Seeds fmooth, refembling a grain of
wheat.

“A vein of Angularity, ” fays Mr. Curtis, ‘-'runs
through the whole of this plant; its ftalks are unequally
and obtnfely quadrangular, fometimes more evidently
triangular; its leaves few, and remarkably fmall ; its
flowers, on the contrary, are uncommonly large, and,
what is more extraordinary, have only four petals ; pre¬
vious to their expanfion the body of filaments is bent fo
as to form a kind of bow, in which ftate we have repre-
fented one of the blofloms in our figure. It flowers
from June to September. When it flowers in perfeftion,
which it is not apt to do in all places, the largenefs of its
blofloms renders it one of the molt ornamental of the
genus. There is a variety of it with beautifully co¬
loured-leaves of which we have availed ourfelves in its
representation.” See Plate II. fig. 3. -

41. Pelargonium peltatum, or peltated ftork’s-biil :
umbels few-flowered ; leaves five-lobed, quite entire,
flefliy, peltated ; branches angular. This has many
weak flmibby ftalks, which require fupport, and extend
to the length of two or three feet. Leaves on (lender
footftalks, faftened into the dilk ; they are fmooth, of a
lucid green, with a circular purple mark in the middle ;
have an acid flavour, and are placed alternate on the
branches. A leaf, having its footftalk inferted into the
diflc or middle part of it, or near it, is called by Linnaeus
peltatum, targeted ; hence the name of this fpecies : it
may be obferved, however, that fome of the leaves have
this chara&er more perfectly than others. The flowers
are on pretty long axillary peduncles, each fuftaining
four or five purple flowers, coming out in fucceflion du¬
ring moft of the fummermonths, and the feeds frequent¬
ly ripen here. It was cultivated in 1701, by the duchefs
of Beaufort. See fig. 4.

42. Pelargonium lateripes, or ivy-leaved ftork’s-bill :
umbels many-flowered ; leaves cordate, five lobed, fome¬
what toothed, flefliy ; branches round. Cultivated in
1787, by Meflrs. Grimwood and Barret at Kenfmgton.
It flowers moft part of the fummer.

43. Pelargonium cortufaefolium, or cortufa - leaved
ftork’s-bill : umbels many-flowered; leaves cordate, gafli-
lobed, waved, bluntly toothed ; ftipules awl-fhaped. Na¬
tive of the fouth-weft coaft of Africa. Introduced in
1786 by Mr. Anthony Hove; it flowers in July. Jac-
quin gives Geranium tabulare of Burman and Cavanilles,
with Herm. Afr. p. 11. and Raii Suppl. 514. 36. as fyno-
nyms of this. See N° 7.

44. Pelargonium crafflcaule, or thick-ftalked ftork’s-
bill : umbels many-flowered ; leaves kidney-form, ob-
acuminate ; ftem flefliy, branched, even. Native of the
fouth-weft coaft of Africa. Introduced in 1786, by Mr.
Anthony Hove. It flowers in July.

45. Pelargonium cotyledonis, or hollyhock-leaved
ftork’s-bill: umbels compound; leaves cordate, peltate,
wrinkled ; ftem flefliy. Native of the ifland of St. He¬
lena. Introduced in 1765, by Mr. John Bufh. It flowers
fronrMay to July.

V. Shrubby, with a woody ftem.

46. Pelargonium ovale, cr oval-leaved fiork’s-bill : um-

3 bels

Plate

hr tht Encyckp&dia. Londuzsnsis , 1873.

Fla te III .

PELARGONIUM. 493

bels few-flowered ; pedicels elongated ; leaves elliptic,
toothed ; Items birfute. Introduced in 1774, by Maffon ;
it flowers from May to July.

47. Pelargonium betulinum, or birch-leaved ftork’s-
bill : umbels few- flowered ; leaves ovate, unequally fer¬
rate, levigated. Stem fhrubby, four or five feet high,
fending out feveral branches. The flowers vary confi-
derably both in fize and colour; its foliage is different
from that of the other fpecies, and, as its name im¬
ports, like that of the birch-tree. It flowers molt part
of the fummer, and was introduced in 1786, by Maffon.
Hence Mr. Miller’s betulinum is fuppofed not to be this
fpecies. <»

48. Pelargonium glaucum, or fpear-leaved ftork’s-biil :
peduncles two-flowered ; leaves lanceolate, quite entire,
acuminate, glaucous. The whole plant is very fmooth.
glaucous, and in a manner whitifh. Stem fhrubby, with
round, rod-like, declining branches, two feet high.
Leaves oppofite, often fnorter than the petioles, which
are round and eredt. Stipules lanceolate-acuminate,
flefhy, deciduous. Peduncles alternately axillary, very
long, one or two-flowered. Segments of the calyx acu¬
minate, the uppennoft and two lower ones wider, Co-
rollapapiiionaceous, white; the upper petals wider, reflex ;
claws purple. Antheras pale faft'ron : fometimes there are
only fix. It flowers from June to Auguft.

“ This elegant and very Angular fpecies (fays Mr. Cur¬
tis) appears to have been firft cultivated in this country;
its introduction was attended with circumftances rather
unufual. Mr. Lee, nurferyman of the vineyard at Ham-
therfmith, in looking over fome dried fpedmens in the
pcffeffion of fir Jofeph Banks, (1775,) which he had re¬
cently received from the Cape of Good Hope, was ftruck
with the Angular appearance of this geranium, no fpecies
having before been feen in this country with fpear-fiiaped
leaves; on examining the fpecimens attentively, he per¬
ceived a few ripe feeds in one of them ; thofe he folicited,
and obtained ; and to his fuccefs in making them vege¬
tate, we are indebted for the prefent fpecies. The iliape
of the leaf readily' fuggefted the name of lanceolatum, an
epithet by which it has been generally diftinguiflied in
this country, and which, from its extreme fitnefs, we have
continued, notwithftanding the younger Linnaeus has
given it that of glaucum , though, at the fame time, his
illuflrious father had diftinguifhed another fpecies by the
lynonymous term of glaucophi/llnrn." It is reprefented,
from the Botanical Magazine, on Plate III. fig. 5.

‘ 49. Pelargonium tricufpidatum,orthree-pointedftork’s-

bili : peduncles two-flowered; leaves three-pointed, mid¬
dle lobe more produced, fubferrate; midrib muricated
underneath. Root branched. Stem flirubby, two feet
high, and more, very much branched, fmooth, round,
the thicknefs of a reed or the little finger, almoft upright;
when old dufky, when young more or lets blood-red.
Introduced in 1780, by Meffrs. Kennedy and Lee. It
flowers from May to Auguft.

50. Pelargonium acetofum, or forrel ftork’s-bill : um¬
bels few-flowered ; leaves obovate, crenate, fmooth, flefhy;
petals linear. Stem fhrubby, fix or feven feet high, lend¬
ing out feveral Ade-branches. Leaves of a grey colour,
and having an acid tafte like forrel. Peduncles axillary,
long, fuftaining three or four flowers, with narrow un¬
equal petals, of a pale blufli-colour, with fome ftripes of a
light red. The flowers continue in fucceffion molt part
of the fummer. This is reprefented at fig. 6.

51, Pelargonium fcabrum, or rough-leaved flork’s bill:
umbels few-flowered ; leaves wedge-fhaped, femitrifid,
rugged; lobes lanceolate, loofely ferrate. Stem fhrubby,
round, three or four feet high, the thicknefs of a finger,
upright, of a reddifh bay colour, branching from the
axils, very rough, as is the whole plant, but becoming
f mooth with age. Common peduncles terminating and
axillary, fhort, fuftaining commonly from four to fix
flowers ; calyx green ; petals blunt, of a purple rofe-co-
lour ; the two upper ones twice as wide as the others,

with a dark blood-red fpot at the bafe; antheras oblong,
blood-red ; as are alfo the ftigmas. Seeds rough, with a
rough beak, an inch in length. Introduced in 1775, by
Meffrs. Kennedy and Lee. It flowers from Auguft to
November.

52. Pelargonium crifpum, or curled-leaved ftork’s-bill:
peduncles fubbiflorous ; leaves diftich, cordate, three-
jobed, curled, muricated. This is a ftift' flirub. Leaves
final!, five-lobed, having the fmell of balm. Flowers vio¬
let. Introduced in 1774, by Mr. Francis Maffon. It
flowers from July to November.

53. Pelargonium adulterinum, or hoary-trifid-leaved
ftork’s-bill : peduncles fubbiflorous ; leaves cordate,
three-lobed, waved, villofe, foft. Introduced in 1785,
by Mr. Archibald Thompfon. It flowers in April and
May.

54. Pelargonium ex-ftipulatum, or foft-leaved trifid
ftork’s-bill: unbeis few-flowered ; leaved cordate, tliree-
parted-lobed, toothed, hoary; ftipules fcarcely any. The
whole plant fmooth, and fomewhat glaucous. Stem
flirubby, a foot high, with round upright branches.
Leaves alternate, fhorter than the petioles, moftly divided
into three lobes ; each is three-lobed at the tip, and cre¬
nate ; they have a very fweet fmell, not unlike fweet
marjoram ; wdien young, and in the open air, whitifh
with a very fine nap, but in the ftove fmooth and green.
Found by Mr. William Paterfon ; and introduced at Kew,
in 1779, by thecountefs of Strathmore. It flowers from
May to Auguft.

VI. New Species, chiefly from Jacquin.

55. Pelargonium ternatum, or ternate ftork’s-bill: ftem
fhrubby, hifpid ; leaves oppofite, ternate ; leaflets wedge-
fhaped, gafh-trifid, ferrate, fcabrous. Stem fuffruticofe,
dichotomous, round, purple, villofe, erefft, two feet high
and more: branches Ample, fhort, refembling the ftem.
It differs very materially from the other fpecies in the
unufual roughnefs of the ftalks, as well as in its whole
habit.

56. Pelargonium tricolor, or three-coloured ftork’s-bill:
the two upper petals ragged at the bafe, with prominent
fliining dots. The plants of this newly-introduced fpe-
cies fcarcely exceed a foot in height here, growing up with
a fhrnbby ftem, and fpreading widely into numerous
flowering branches, fo much difpofed to produce flow¬
ers in a conftant fucceffion, that during molt of the fum¬
mer the plant is loaded with a profufion of them. For
the mod part they go off without feed ; and, when any is
produced, there is generally one perfect and four abor¬
tive. The fertile ftamens vary in number; four are
moft ufually apparent, three fuperior, one and often two
inferior. The whole plant is covered with fhort white
hairs, which give to the foliage a fomewhat filvery hue.
The two uppermofc petals are of a beautiful red, having
their bafes nearly black; the three lowermoft are white.
Inftances occur in which one or more of the white pe¬
tals have a ftripe of red ; and the dark colour at the bafe
of the upper petals is, in a certain degree, foluble in wa¬
ter; for, on the plants being watered, the white petals here
and there become ftained by the colouring matter, which
in a diluted ftate is purplifn ; as the flowers decay, this
apparently-biack part, diftinguiflied by the roughnefs of
its furface, arifing from prominent lucid points, is fome¬
times perforated with numerous fmall holes. Intro¬
duced by Maffon at Kew in 1792. Raifed alfo from Cape
feeds by Mr. Williams, nurferyman at Hamrnerfmith.

The above fpecies, with very few exceptions, are na¬
tives of the Cape of Good Hope. Thefe that follow are
defcribed by Jacquin in thelaft volume of his Colledta-
nea, and figured in the third volume of his leones Pian-
tarum rariprum.

57. Pelargonium carneum, or flefli-coloured ftork’s-
bill: ftemiefs ; root rapaceous, Ample ; leaves bipinnate ;
pinnules galhed, fmoothilh ; five filaments fertile. Root
like a turnip, oblong, brown, two inches long, perennial.

Root-

494 PELARGONIUM.

Root-leaves many, decumbent in a ring, with a few
fmaller that are upright, about five inches in length, ob¬
long, of a dulky-green colour, almoft fmooth, appearing
ciliate at the edge when examined by a magnifier; hav¬
ing fomething of a turpentine fmell. Peduncles two
inches long, thickifh, about feven in number, fomewhat
hairy, red ; petals fomewhat wedge-fhaped ; the two up¬
per ones three times as wide as the others, and having
branched red veins ; all pale the firft day, but afterwards
flefh-coloured, expanded in the day-time, but contracted
and (hut at night; antherse fcarlet ; germ filky; ftigma
purple. It flowers in March and April.

58. Pelargonium barbatum, or bearded ftork’s-bill :
ftemlefs; root rapaceous. Ample; leaves pinnate; pin-
nas pinnatifid, lanceolate-linear, acute, bearded at the tip ;
five filaments fertile. Refembles the preceding.

59. Pelargonium melananthon, ordark-flowered ftork’s-
bill : ftemlefs ; root rapaceous, Ample ; leaves pinnate,
fomewhat hifpid ; pinnas lobe-gaftied, blunt; five fila¬
ments fertile. Flowers in April and May.

60. Pelargonium triphyllum, or three-leaved ftork’s-
bill : ftemlefs; root rapaceous, fimple ; leaves ternate,
crenate, fmooth ; five filaments fertile. Root the length
and thicknefs of a finger, brown, perennial. Petals wedge-
ihaped, blunt, upright at bottom, and thence fpreading
very wide, rofe-coloured, a little longer than the calyx ;
the two upper ones with blood-red dots below ; ftyle and
ftigma of a very dark blood-red colour. It flowers in
April.

61. Pelargonium heterophyllum, or various-leaved
ftork’s-bill : ftemlefs ; root rapaceous, fimple ; leaves
ternate and entire, fmooth, ciliate ; leaflets often lobed ;
five filaments fertile. Root two inches long, black, pe¬
rennial ; root-leaves feveral, in a ring. It flowers in
March and April, and when bruifed has the fmell of
turpentine. Jacquin fufpedts that it may perhaps be only
a variety of P. hirfutum, N° 1.

62. Pelargonium nervifolium, or nerve-leaved ftork’s-
bill : ftemlefs; root rapaceous, fimple; leaves ternate,
three-lobed, and entire, many-nerved, fmooth, prickly-
ciliate at the edge; five filaments fertile. It flowers in
March and April, and when bruifed has a little fmell of
turpentine.

63. Pelargonium longifolium, or long-leaved ftork’s-
bill : ftemlefs ; root rapaceous, fimple ; leaves lanceolate,
acute, fmooth, the older ones often pinnate; four fila¬
ments fertile. Root roundifn, an inch in length, brown,
perennial. Style and ftigma red. It flowers in March
and April.

64. Pelargonium ciliatum, or ciliated ftork’s-bill : ftem¬
lefs ; root rapaceous, fubfirnple ; leaves lanceolate, acute
at both ends, ciliate, fmooth underneath, hairy above,
often appendicled ; five filaments fertile. Root brown,
three inches long, perennial. Leaves lanceolate, quite
entire, about three inches long. It flowers in May.

65. Pelargonium deprelfum : or flat-umbelled ftork’s-
bill : ftemlefs; root rapaceous, fimple; leaves narrow,
lanceolate, acute, fmooth ; umbels finely deprefl'ed,
fmooth ; four filaments fertile. It flowers in March and
April.

66. Pelargonium longiflorum, or long-flowered ftork’s-
bill : ftemlefs ; root rapaceous, fimple ; leaves lanceolate,
acute, fmoothilh ; petals very long; four filaments fer¬
tile. It flowers in May.

All the above fpecies, from N° 57 inclufive, are na¬
tives of the Cape of Good Hope, and belong to the firft
fefifion.

67. Pelargonium chamasdryfolium, orgermander-leaved
ftork’s-bill : peduncles one or two flowered ; Items her¬
baceous, decumbent ; leaves oblong, blunt, ferrate, vil-
lofe; five filaments fertile. Root branching, annual.
The whole plant villofe, and fmelling rather difagreeably.
Stems feveral, branched, diffufed, from fix to ten inches
in length, the thicknefs of a pigeon’s quill at the bafe,
round, jointed, knobbed, in the primary divifions dicho¬

tomous, more or lefts of a dufky-purple. Leaves petioled,
oppofite, entire, thickifh, hoary green, the largeft fcarcely
an inch long, but moft of them only half that length.
Flowers very fmall ; calyx green, and fomewhat rough¬
haired ; antherse yellow; ftigma five-cleft, purple. Seed
hirfute; the tail half an inch long, and bearded.

68. Pelargonium trichoftemon, or hairy-ftamened
ftork’s-bill: peduncles few-flowered; leaves roundifh-
ovate, bluntly ferrate, velvety ; ftem biennial, almoft ere<5t;
filaments hirfute, five fertile. Root branched, biennial.
Stem branching from the very bottom, fo that it appears
to be many-ftemmed; the thicknefs of a reed, round, a foot
high, when young very foft and like velvet, as are all'o
the other parts of the plant. Leaves fcatfered, blunt,
nerved and veined, flat, except that they are often a little
waved at the ferratures, thickifh, fomewhat hoary on
both fides, an inch or an inch and a half in lengrhl It
flowers in March and the following months.

69. Pelargonium coronopifolium, or buck’s-horn-plan-
tain-ieaved ftork’s-bill : peduncles two-flowered ; leaves
lanceolate-linear, tooth-ferrate, fmooth above, fomewhat
rough-haired underneath. Root branching, the thick¬
nefs of a reed, brown, long. Stems few, procumbent,
half a foot high, round, perennial, more (lender by half
than a reed, covered with the imbricate permanent brown
ftipules of fallen leaves. Peduncles oppofite to the leaves,
ereft, villofe, foft, three inches long, the lowed umbelled,
two-flowered, the reft three - flowered. Petals blunt,
fpreading very much, white at the claws, the reft purple ;
anthers tawny red ; ftigma fmooth, purple. The little
fmell it has is unpleafant. It flowers in June and July.

There is a variety which has fmaller flowers, with the
claw of the two upper petals white, and crowned with a
deep-red band: all the leaves are linear-lanceolate, and
gafh-ferrate almoft their whole length.

70. Pelargonium bullatum, or bladder-leaved ftork’s-
bill : peduncles two-flowered ; corollas four-petalled ;
ftem biennial; leaves ternate, pinnatifidly lobed, fome¬
what hifpid on both fides; five filaments fertile. Stem
round, the thicknefs of a reed, dufky, dividing into fe¬
veral branches a foot and a half long, appearing villofe
in the magnifier, but neither hairy nor hirfute. Petals
always four, very pale purple or fleth-colour, twice as long
as the calyx; antherse fcarlet; ftigma blood-red. It
flowers in thefummer, and when rubbed has an unplea¬
fant fmell.

71. Pelargonium betonicum, or betony-leaved ftork’s-
bill : peduncles few -flowered; corollas four-petalled,
feldom fi ve-petalled ; ftem biennial; leaves pinnatifidly
lobed, fomewhat rough haired ; five filaments fertile.
Root brown, round, the thicknefs of a reed, biennial.
Stems feveral, branched, herbaceous, round, attaining the
height of eighteen inches. Awn of the feed feathered,
and two inches long. It flowers in fummer; has but
little fmell ; and is rough-haired all over.

72. Pelargonium lacerum, or jagged-leaved ftork’s-bil! :
peduncles five-flowered ; corollas five-petalled ; ftem bi¬
ennial, hairy ; leaves pinnate-lobed, gaftied ; five filaments
fertile. Stem herbaceous, round, procumbent or almoft
ereft, the thicknefs of a reed, a foot and a half high,
branched, blood-red next the fun. It flowers from May
to July, and has an unpleafant fmell.

73. Pelargonium longicaule, or long-ftalked ftork’s-
bill : peduncles from one to five flowered ; corollas four-
petalled, feldom five-petalled ; ftem biennial, hirfute ;
leaves pinnate-lobed ; feven filaments fertile. Stems fe¬
veral, herbaceous, at moft the thicknefs of a reed at bot¬
tom, round, often jointed and knobbed, dulky purple,
wholly procumbent, and clofely hirfute with white hairs ;
three feet high, branched. It refembles the preceding
very much; but it has very feldom five petals, and has
always feven fertile filaments. It flowers from May to
July ; and has a difagreeable fmell.

74. Pelargonium multicaule, or many-ftalked ftork’s-
bill : peduncles five-flowered or thereabouts; corollas

- four-

PELARGONIU M.

four-petalled ; liera biennial, fmooth; leaves pinnate-
lobed, fmooth ; feven filaments fertile. Root the thick-
nefs of a reed and more, about three inches long, round,
branched, pale. Stems numerous, procumbent except
at the end, where they afcend in a bow ftiffiy branched,
round, fmooth, fomewhat villofe towards the top, knob¬
bed, blood-red at the joints, dufky purple at bottom, in
other parts green, with a tinge of purple here >and there,
herbaceous, two feet long, the thicknefs of a pigeon’s
quill. Leaves alternate, except the upper ones, which
are oppofite, two or three inches in length reckoning the
petioles, three-lobed, gafhed, blunt, fmooth, green. Ca-
lycine leaflets oblong, mucronate, ftreaked, fpreading,
blood-red, the uppermoft twice as wide as the others.
Petals fpreading, deep purple, with deeper purple bands
above the claw ; filaments awl-fhaped, fhorter than the
calyx, purple; anthers oblong, ereft, flelh-coloured,
with a yellow pollen ; ftigma purple. Seeds villofe, with
a feathered awn an inch in length. It flowers in April
and the following months, and is void of fmell.

75. Pelargonium anemonaefolium, or anemone-leaved
ftork’s-bill : peduncles four or five flowered ; corollas
five-petalled ; Item biennial ; leaves pinnate-lobed, fome¬
what rough-haired underneath, fmooth above ; feven fila¬
ments fertile. Root round, the thicknefs of a reed,
brownifh. Stem round, the thicknefs alfo of a reed, a
foot high, branched, fomewhat rugged, rough-haired,
hifpid, ereff, with the lower branches fomewhat fpread¬
ing. It flowers in the fummer, and when bruifed has an
unpleafant balfamic fmell.

76. Pelargonium hirtum, or rough-haired ftork’s-bill :
umbels five-flowered or thereabouts; leaves tripinnate,
hirfute; pinnules linear; ftein flefhy. Root round, the
thicknefs of the little finger, half a foot long. Stem
procumbent, twifted, fhrubby, branched, the fame fize
with the root, brown, rough with the indurated fears of
fallen leaves ; when young, flefhy and hirfute. Peduncles
hirfute, roughifh, fpreading, three or four inches long,
fuftaining from three to five flowers in an umbel. Pe¬
tals fpatulate, blunt, fpreading, red purple ; the two up¬
per ones nearly twice as wide as the others, and of a deep¬
er colour. Seven of the filaments have flefh-coloured
anthers with a yellow pollen. Stigma blood-red. It
flowers in March and April; and has little fmell, but
that unpleafant.

77. Pelargonium tomentofum, or downy ftork’s-bill :
umbels many-flowered, Ample, and compound ; leaves
cordate, moftly five-lobed, ferrate, tomentofe, very foft 5
ftem flefhy. Root branched. The whole plant is co¬
vered very clofely with villofe hairs, and has a ftrong un¬
pleafant fmell. Stem fhrubby, branched, ereft, round,
knobbed, tyo feet high and more. Leaves alternate,
three-lobed or five-lobed, bluntifh, veined, thickifh,
three or four inches in length and breadth. Petals ob¬
long, blunt, a little longer than the calyx, white with a
little longitudinal red band at the claw. Filaments
blood-red, the length of the calyx; anthers oblong,
flefn-coloured ; ftigma blood-red. It flowers in April
and the following months.

78. Pelargonium ribifolium, or currant-leaved ftork’s-
bill : umbels many-flowered, deprefled, fomewhat halved,
leaves cordate, three-lobed, ferrate, fomewhat hirfute;
lobes lobed, gafhed 5 ftem flefhy. The whole plant has a
ftrong fmell. Stem fhrubby, the thicknefs of a finger,
round, irregular with projecting fears, ereft, firm,
branched, three feet high ; when young hirfute, when
old fmooth and brown. Branches hirfute, pale green. It
flowers from June to Auguft.

79. Pelargonium fufeatum, or dark ftork’s-bill : um¬
bels four-flowered ; leaves cordate-roundifh, moftly five-
lobed, acutely ferrate, fmoothifli ; ftip.ules ovate; ftem
fhrubby, ereCt, when young rugged. Stem three or four
feet high, round, branched, brownifh, with afh-coloured
fears from the fallen leaves. It flowers here in the fum-

Vql.XIX. No. 1319.

495

mer. The leaves have hardly any fmell ; the flowers have
rather a difagreeable feent.

80. Pelargonium patulum, or broad-leaved ftork’s-bill :
peduncles two-flowered; leaves fomewhat kidney-fliaped,
lobe-gafhed, acutely crenate, fmooth above ; ftem fhrubby;
fix filaments fertile. From a branched root arife very
many weak Items, two feet high and more, round, fmooth,
almoft upright, of a pale bay-colour, irregular from the
fears of. fallen leaves. It flowers in fummer 5 and has lit¬
tle fmell.

81. Pelargonium balfameum, or fweet-feented ftork’s-
bill : umbels few-flowered ; leaves five-parted, fomewhat
rough-haired ; lobes lanceolate, acute, gafhed, fomewhat
rigid ; ftem fhrubby. Stem upright, three feet high,
woody, very much branched, ferruginous, when young
red, roughifh, appearing rough-haired in the magnifier,
the thicknefs of a finger at the bafe. It flowers in futn-
mer; and the whole plant has a balfamic feent, approach¬
ing to that of Tacamahaca.

82. Pelargonium hermanniaefolium, or hermanni.v
leaved ftork’s-bill : peduncles two-flowered ; leaves cu-
neate - roundifh, gafhed, rough-haired, rigid, diftich;
ftem fhrubby. Stem four or five feet high, almoft up¬
right ; branches rod-like, round, ferruginous ; thefe with
the leaves, ftipules, peduncles, involucres, and calyxes,
are rough-haired. Leaves clofely diftich, or in two rows,
all along the branches ; the upper ones converging, the
lower fpreading. Calycine le.'flets lanceolate, acumi¬
nate, green; petals white, or tinged with flefh col jur,
twice as long as the calyx ; filaments flefh-coloured,
one third fhorter than the petals; antherae vermilion;
ftyle and ftigma blood red. After flowering whilft the
feeds are growing, young branches are pufhed out be¬
yond them, and the peduncles ceafe to be terminating
It is eafily diftinguifhed from P. crifpum by having no
fmell, or at mod a flight fmell of turpentine when
bruifed : the leaves are larger, always on very fhort
petioles, of a true wedge fhape, fcarcely obfoletely three-
lobed, fcarcely curled ; and the ftature of the whole is
much greater.

Propagation and Culture. All the forts of Pelargoni¬
um, or African Geranium, may be propagated by feeds;
they may be fown upon a bed of light earth towards the
end of March, where the plants will appear in a month
or five weeks after, and by the beginning of June
will be fit to remove; when they fnould be carefully ta¬
ken up, and each planted into a feparate pot, filled with
light kitchen-garden earth, and placed in a fhady fitua-
tion till the plants have taken new root, when they may
be removed into a (heltered fituation, and placed among
other of the hardier green-houfe plants, where they may
remain till autumn, when they muft be removed into the
green-houfe, and treated in the fame manneras other hardy
kinds of green-houfe plants. But thofe who are defirous to
have their plants large, and flower foon, fow the feeds
upon a moderate hot-bed in the fpring, on which the
plants will come up much fooner, and will be fit to re¬
move long before thofe which are fown in the open air;
but, when thefe plants corne up, there muft be great care
taken not to draw them up weak ; and, when they are
tranfplanted, the pots fliould be plunged into another
moderate hot-bed, obferving to fnade them from the fun
till they have taken new root ; then they muft be gradu¬
ally inured to bear the open air, into which they fliould be
removed the beginning of June, and placed in a flickered
fituation with other exotic plants. If thefe plants are
brought forward in the fpring, moft of the forts will
flower the fame fummer, and, the plants being ftrong be¬
fore the winter, will make a better appearance in the
green-houfe.

Thejhruhby African Geraniums are commonly propa¬
gated by cuttings, which, if planted in a fhady border in
June or July, will take good root in five or fix weeks,
and may then be taken up and planted into feparate pots,
6 L placing

PELARGONIUM.

496

placing them in the (hade till they have taken new root ;
after which they may be removed into a (heltered fitua¬
tion, and treated in the fame manner as the feedling
plants. The 17th, 19th, 20th, and 34th, forts, have more
fucculent (talks than the others ; the cuttings, therefore,
of thefe, (hould be planted in pots filled with light kit¬
chen-garden earth, and plunged into a very moderate
hot-bed, where they {hould be (haded from the fun in the
heat of the day, and have but little water ; for thefe are
very apt to rot with much moifture. When thefe are
well rooted, they may be feparated and planted in pots
filled with the fame fort of earth, and placed in the (hade
till they have taken new root ; then they may be removed
into a (heltered fituation, where they may remain till au¬
tumn. Thefe four forts (hould be fparingly watered, but
efpecially in the winter, for they are apt to take a moul-
dinefs with moifture, or in a damp air: they will thrive
much better in an airy glafs-cafe than in a green-houfe,
becaufe in the former they will have more fun and air
than in the latter. But all the other (lirubby forts are
proper furniture for the green-houfe, where they will only
require protection from froft, but (hould have a large
(hare of free air when the weather is mild : they will re¬
quire water every week, in mild weather once or twice,
but it (liould not be given them in too great plenty, ef¬
pecially in frofty weather. Thefe plants (hould be hard¬
ened in the fpring gradually, and towards the middle or
end of May they may be taken out of the green-houfe,
and at firft placed under the (heiter of trees, where they
may remain a fortnight or three weeks to harden; then
(hould be removed into a fituation where they may be
defended from ftrong winds, and enjoy the morning fun
till eleven o’clock, where they will thrive better than in
a warmer fituation.

As thefe (lirubby forts grow pretty faft, they foon fill
the pots with their roots; and, if they (land long unre-
moved in fummer, they frequently put out their roots
through the holes at the bottom of the pots into the
ground, and then the plants will grow vigoroufly.
But, when they are fuffered to grow long in this man¬
ner, it will be difficult to remove them ; for, if their roots
are torn oft', all the younger branches will decay, and
many times the plants are killed. Therefore the pots
fhould be moved once in a fortnight or three weeks in
the fummer months, and the roots which may be then
pudiing through the holes in the pots cut off, to prevent
their ftriking into the ground. Thefe plants will alfo
require to be new potted at lead twice in the fummer:
the firft time (hould be after they have been three weeks
or a month out of the green-houfe; the fecond (hould be
towards the end of Auguft, or the beginning of Septem¬
ber, that the plants may have time toeftablifh their new
roots before they are removed into the green-houfe.
When new potted, all the roots on the outfide of the
balls of earth (hould be carefully pared off, and as much
of the old earth drawn away from the roots as can be
done with fafety to the plants ; then, if they require it,
they (liould be put into pots a fize larger than thofe out
of which they were taken, putting a quantity of frefli
earth into the bottom of the pot, then place the plants
upon that, being careful the ball about the roots of the
plant is not fo high as the rim of the pot, but that fome
room may be left to contain the water which may be
given to the plants. Then the cavity all round the ball
Should be filled up with frefii earth, which (liould be
gently preffed down, and the bottom of the pot beaten
upon the ground, to fettle down the earth ; then the
plant (liould be well watered, and the Item fattened to a
rail, to prevent the wind from difplacing the roots before
they are fixed in the new earth.

The compoft in which thefe plants thrive beft (where
there is not a conveniency of getting fome good kitchen-
garden earth) is frefti hazel-loam from a pafture, niixed
with a fourth or fifth part of rotten dung; if the earth
is inclinable to bind, then a mixture of rotten tan is pre¬

ferable to dung ; but, if it is light and warm, then a mix¬
ture of neat’s-dung is beft : this compoft (hould be mix¬
ed three or four months before it is ufed, and (liould be
turned over three or four times, that the parts may be
well mixed and incorporated ; but, where a quantity of
good kitchen-garden earth can be had, which has been
well worked, and is clean from the roots of bad weeds,
there will need no compofition, for in that they will
thrive full as well as in any mixture which can be made
for them, efpecially if the earth has lain in a heap for
fome time, and has been two or three times turned over
to break the clods, and make it fine : thefe plants (hould
not be planted in very rich earth, for that will caufe
them to grow very luxuriant, but they will not flower fo
well as in a poorer foil.

The (lirubby forts muft be looked over frequently dur¬
ing the winter, whilft they are in the green-houfe, to pick
off all decayed leaves from them, which, if left on, will
not only render the plants unfightly, but by their falling
off, will make a litter among the other plants; and, if they
are fuffered to rot in the houfe, they will often occafion a
foul nafty damp air, which will be very prejudicial to all
the plants ; therefore, to avoid this, they (hould be con-
ftantly picked off every week; and during the fummer
feafon they will require to be picked every fortnight or
three weeks to keep them clean from dead leaves ; for,
as the branches advance, and new leaves are produced on
their top, the under ones as conftantly decay; and, if left
on till they drop off, will render the plants very unfightly.

The fpecies of the two firft divifions are generally in-
creafed by parting the roots in Auguft. Every tuber
will grow, if it has a bud or eye to it. They may be
planted in the fame fort of earth as was before directed ;
and, if the pots are plunged into an old tan-bed, under a
good frame in winter, the plants will thrive better than
in a green-houfe : the glades may be drawn off every
day in mild weather ; and, if in fevere froft the glaffes are
well covered, it is all the (heiter they require : they
(liould have little wet in winter, and therefore the glaffes
(hould be kept over them in heavy rains, or in mild wea¬
ther raifed only at the top. They may alfo be propagat¬
ed by feeds.

PELAS'GIANS, in ancient geography, the mod an¬
cient people of Greece, according to Thucydides, Strabo,
and Herodotus. The laft author fays, that the whole
country, which in his time was called Hellos, was in a
former period denominated Pelafgia. Thefe people, as
fome fay, were denominated Pelafgi, becaufe they were
an unfettled wandering people, who often changed their
habitations. Others, among whom we may reckon He-
fiod, take them to have been Autochthones, which was the
defignation given to the natives of the country, or rather
to all whofe original was unknown. They firft inhabited
Argolis in Peloponnefus, which from them received the
name of Pelafgia; and, about 1383 years before the Chrif-
tian era, they paffed into Asmonia, and were afterwards
difperfed in feveral parts of Greece. Some of them fixed
their habitation in Epirus, others in Crete, others in
Italy, and others in Lefbos. From thefe different changes
of fituation in the Pelafgians, all the Greeks are ir.difcri-
minately called Pelafgians, and their country Pelafgia,
though, more properly fpeaking, it (hould be confined to
Theflaly, Epirus, and Peloponnefus, in Greece. Some of
the Pelafgians, that had been driven from Attica, fettled
in Lemnos, where fome time after they carried fome
Athenian women, whom they had feized in an expedi¬
tion on the coaft of Attica. They raifed fome children
by thefe captive females, but they afterwards deftroyed
them with their mothers, through jealoufy, becaufe they
differed in manners as well as language from them.
This horrid murder was attended by a dreadful peftilence,
and they were ordered, to expiate their crime, to do
whatever the Athenians commanded them. This was to
deliver their pofleftions into their hands. The Pelafgians
then eftablifhed themfelves, according to Herodotus, in

the

PEL

the town of Afte, a territory feparated from the continent
of Thrace by a canal ; by degrees they extended them-
felves to the continent, and occupied Creftonia.

Dionyfius informs us, that when fome of the Pelafgi,
under the reign of Deucalion, pafled into Italy, the ille
of Crete, and the Cyclades, Bceotia, the Phocide, and
Eubcea, others migrated into Afia. According to Strabo,
the Lefbians claim the honour in behalf of theirancedors
of having been in the war of Troy, under the conduft of
Pylteus, a chief of the Pelafgi. All the towns of the ma¬
ritime coaft of Ionia had been at one time inhabited by
the Pelafgi; the inhabitants of the ifle of Chios alfo pre¬
tend that the Pelafgi of Theflaly were their founders ;
nor indeed is there a country of Greece, Thrace, and
Afia Minor, in which the Pelafgi have not left traces of
their power. Soon after the war of Troy, the name of
Pelafgi began to fink into oblivion. Thofe who exifted
till the time of Herodotus, near the Hellefpont, and on
the coafts of Thrace, were fubjeft to foreign dominion ;
and the language which they fpoke was the only evidence
of their ancient origin, Thucydides fays, that the chief
caufe of the ruin of this nation was the confederation of
the Hellenes , who fprang from the Pelafgi themfelves.
The Hellenes made a league, formed among themfelves
a feparate body, and made conquefts. After reparation
from the Pelafgi, their parents, they edranged themfelves
from their manners and habits, and by little and little
changed their language, in confequence of the commer¬
cial intercourfe which they had with colonies from the
eaft. Thofe at length who were originally Pelafgi joined
this league, furrendered the name of Pelafgi, and adopted
that of Hellenes. Herodian relates, that the Athenians,
though reckoned to be Pelafgians at the time of the fa¬
mous emigration of thefe people, were become Hellenes,
when the Pelafgi, driven from Italy, returned to Greece.
About the lame time the Lacedaemonians, the Argians,
and the Arcadians, who had been alfo known under the
name of Pelafgians, laid afide the barbarifm of their pro¬
genitors, and aflumed the name of Hellenes.

PELASGIO'TIS, or Pelas'gia, a country of Greece,
whofe inhabitants are called Pelafgi, or Pelafgiotce. Every
country of Greece, and all Greece in general, is indifcri-
minately called Pelafgia, though the namelhould be more
particularly confined to a part of ThefiTaly, fituate between
the Peneus, the Aliacmon, and the Sperchius. The ma¬
ritime borders of this part of Theflaly were afterwards
called Magnejia, though the fea or its fliore ftill retained
the name of “ Pelafgicus Sinus,” now the Gulf of Volo.
Pelafgia is alfo one of the ancient names of Epirus, as
alfo of Peloponnefus.

PELAS'GUS, a fon of Jupiter and Niobe, who reigned
in Sicyon, and gave his name to the ancient inhabitants
of Peloponnefus. But feveral perlons of this name are
mentioned by ancient writers. The fcholiaft upon Apol-
lodorus Rhodius makes Pelafgus to have been the fon of
Inachus ; and this is the fame who, according to Hefiod,
was the father of Lycaon king of Arcadia. See the pre¬
ceding articles; and Greece, vol. viii. p. 828.

PELA'TiE, certain free-born citizens among the
Athenians, who by poverty w'ere reduced to the neceflity
of ferving for w-ages. During their fervitude they had
no vote in the management of public affairs, as having
no eftate to qualify them ; but this redriftion was re¬
moved whenever they had releafed themfelves from their
fervile fituation, which they w'ere allowed to do when
able to fupport themfelves. While they continued fer-
vant.s, they had alfo a right to change their mailers. Encij.
Brit.

PELATI'AH, [Heb. the Lord delivers.] Son of Ha-
naniah, and father of Ifhi, of the tribe of Simeon. He
fubdued the Amalekites upon Mount Seir ; (i Chron.
iv. 42.) The time of this aftion is unknowm.

PELATI'AH, fon of Benaiah, a prince of the people,
who lived.in the time of Zedekiah king of Judah, and op-
pofed the wholefome advice given by Jeremiah, to fubmit

PEL 497

to king Nebuchadnezzar. See farther concerning him,
Ezekiei xi. 1, 2, 3, 4.

PELCHIL'LEN, a town of Pruflia, in Natangen :
twenty-five miles foutli-fouth eall of Konigfberg.

PELDRZ'IMOW. See Pilgram.

PE'LE, in ancient geography. There were two towns
of this name in Theflaly ; the one fubjeft to Eurypylus,
the other to Achilles ; both extinft.

PELECA'NUS, f. [from tteAexus, Gr. a hatchet, on ac¬
count of the fliape of the bill and pouch.] The Pelican;
a genus of birds of the order of anferes ; including, be-
fides the pelicans properly fo called, the cormorants,
(hags, boobies, gannefs, See. amounting to thirty-three
fpecies, which are divifible into thole with plain bills,
and thofe with ferrated bills. Generic characters —Bill
ftraighr, the tip confiding of a hooked nail; nodrils ob-
feure chinks ; face fomewhat naked ; feet balanced ; all
the four toes palmated ; the nail of the mid-toe is ge¬
nerally ferrated.

In Hebrew the pelican was denominated kahili ; in
Arabic, link and alhaufal, meaning gullet ; in Perfian kik
tacab, which fignifies water-carrier; or tnifo, fheep, on ac¬
count of its bulk; in Egyptian, gemel-el bahr, water-ca¬
mel ; in Turkifh, JackaguJ'ch ; in Spanifh, groto ; in Ita¬
lian, agrotto ; at Rome, truo ; in the Alps of Savoy, goet-
trvfe , becaufe its bag refembles the goitres to which the
mountaineers are fubjeft ; in German, meergans, fchnee-
gans, fea-goofe, fnow-goofe ; in Aufiria, ohne-vogel, the
awme, or tierce-bird; in Polifli, bah cudzoziemjki ; in
Ruflia, baba; in modern Greek, toubano ; in the French
Welt-India \(\ands,gi-antlgoJier, great-gullet; in Mexico,
atototl ; and by the Spanifh lettlers alcatraz.

This bird has been long and early diflinguilhed by the
fabulous celebrity of its name, facred among the reli¬
gious emblems of ignorant nations. It has been em¬
ployed to reprefent maternal tendernefs, tearing its bread
to nourifh its ianguifhing family with its blood. This
hieroglyphic, which the Egyptians had before depicted of
the vulture, cannot apply judly to the pelican, which
lives in abundance, and even enjoys an advantage over
the other pifeivorous birds, being provided with a capa¬
cious bag for fioring its provifions. And the fa ft is,
that very few birds, if we except the odrich, fliow lefs af-
feftion for their helplefs odspring. It is with great re-
luftance that w'e deprive the bird of the honourable office
of being a true fymbol ofcharity;but,as w'eintend to let no
idea, though ever fo pleafing, intrude itfelf into the minds
of our young readers at the expenfe of truth, we mud un¬
deceive them, whenever we find an opportunity. This
bird is often reprefented fcratching her bread and feed¬
ing her young with the blood that gufhes out of the
wounds; and is ufed as a reprefentation of the unfpeak-
able goodnefs of him who fhed his blood to redeem man¬
kind. But all this has no other ground than the bird
having been fometimes, though feldom, feen picking off
the down of her bread to foften the ned (he is making.
However, as this pious pelican is often painted or drawn
more like a vulture than the bird of that name, wefliould
not be furprifed if the quality of the one had been trans¬
ferred to the other, by fome ancient and accidental mif-
take. Thus much of pelicans in general ; we now pro¬
ceed to enumerate the fpecies.

I. Bill not ferrated.

1. Pelecanus onocrotalus, [from the Gr. ovo;, an afs,
and y.poloKov, a rattle, becaufe of the gurgling in its throat
or pouch ;] the large white pelican : colour dirty white ;
gullet pouched. The bill is red; the upper mandible
deprefled and broad, the lowrer forked ; the bag at the
throat flaccid, membranaceous, capable of great didention;
the irides hazel-coloured ; the gape of the mouth wide;
the head is naked at the fides, covered with a flefh-co-
loured fkin ; the hind head is fomewhat creded ; the body
is faintly tinged with fledi-colour ; the fpurious wings
and fird quill-feathers are black ; the legs are of a lead

colour.

498

PELECANUS.

colour. It inhabits Afia, Africa, and South America.
In fiftiing, this bird does not immediately fwallow its
prey, but fills its bag, and returns to the (bore to devour
at its leifure the fruits of its induftry. As it has a very
quick digeftion, it has generally to fifii more than once in
a day. At night it retires to reft, a little way on the
fhore, with its head refting on its bread. In this ftate it
remains almoft motionlefs, till hunger calls it to break its
repofe. It then flies from its refting-place, and, raifing it-
felf thirty or forty feet above the furface of the fea, turns
its head with one eye downwards, and continues to fly in
that pollute till it lees a filh Sufficiently near the furface,
when it darts down with aftoniflting fwiftnefs, Seizes it
with unerring certainty, and ftores it up in its pouch.
It then riSes again, and continues the Same manoeuvres,
till it has procured a competent ftock. The female feeds
her young with fifli, macerated a long time in her bag.
The pelican generally builds in marffiy and uncultivated
places, particularly in iflands and lakes, making its neft,
which is deep, a foot and a half in diameter, of carices,
and lining it with grafs of a fofter texture. It lays two
or more white eggs, which, when haraffed, it Sometimes
hides in the water. When it builds in dry and defert
places, it brings water to its young. It walks flowly,
flies in flocks, and lives in Society with other birds.

This Singular fowl appears fufceptible of Some educa¬
tion, and even of a certain cheerful nefs, notwithftanding
its reclufe life. It has nothing Savage, but Soon becomes
familiar with man. Rzaczynfki Speaks of a pelican kept
fourteen years at the court of Bavaria, which was very
fond of company, and Seemed to take Singular pleafure in
hearing mufic. Belon Saw one in the ifle of Rhodes,
which walked freely through the town ; and Culmann,
in Gefner, relates the noted ftory of the pelican which
followed the emperor Maximilian, flying over the head
of his army when on a march, and riling Sometimes So
liigh as to (eem like a Swallow, though it meafured fifteen
feetacrofs the wings. This vaft power of flight would
be aftonifliing in a bird that weighs twenty-four or twen¬
ty-five pounds, were it not wonderfully aflifted by the
great quantity of air with which its body is inflated, and
alfo by the lightnefs of its fkeleton, which exceds not a
pound and a half; its bones are So thin, that they are
iomevvhat transparent, and Aldrovandus aflerts that they
have no marrow. It is no doubt owing to the nature
of thefe Solid parts, which are flow in offifying, that the
pelican enjoys its great longevity : even in captivity it
has been obferved to live longer than moft other birds.
Turner Speaks of a tame pelican that lived fifty years.
The one mentioned by Culmann attained the age of four-
lcore ; and in its latter years it was maintained by order
of the emperor, at the expenfe of four crowns a-day.

The pelican, though not entirely foreign, is very rare
in our climates : one was killed in England, at Horfey-
fen, in May 1663, which meafured twelve feet from tip
to tip of the wings ; and two were killed in France ; one
in Dauphiny, and the other on the Saone. Gefner Speaks
of one that was taken on the lake of Zurich, and was re¬
garded as an unknown bird. It is not common in the
north of Germany, though great numbers occur in the
Southern provinces watered by the Danube: this noble
river was an ancient haunt of thefe birds ; for Ariftotle,
ranging the pelicans with fome gregarious kinds, the
crane and the Swan, Says, that “they depart from the
Strymon, and, waiting for each other at the paflago of
the mountains, they all alight together, and neltle on
the banks of the Danube.” Thefe dreams, therefore,
Seem to bound the countries where thefe flocks advance
from north to fouth in our continent; and Pliny mull
have been ignorant of this route, when he reprefen ted
them as coming from the northern extremity of Gaul ;
for they are ftrangers there, and ftill more in Sweden and
the ardtic tra&s, at leaft if we judge from the Silence of
Linnaeus, Muller, &c. They are found in Red Ruffia,
and in Lithuania, as well as in Volhinia, in Podolia, and

in Pokutia, as Rzaczynfki teftifies : but they extend not
to the moft northern parts of Mufcovy, as Ellis pretends,
In general, thefe birds feem to aftedl more the warm than
the cold climates. One of the largeft fize, weighing twen¬
ty-five pounds, was killed in the ifland of Majorca, near
the bay of Alcudia, in June 1773. They appear regu¬
larly every year on the lakes of Mantua and Orbitello ;
and from a paffage of Martial we may infer that they
were common in the territory of Ravenna. They are
found alfo in Afia Minor, in Greece, and in many parts
of the Mediterranean and the Propontis. Belon even
obferved at fea their paffage between Rhodes and Alex¬
andria; they flew in bodies from north to fouth, ffiaping
their courfe towards Egypt : and the fame traveller en¬
joyed a Second time this fight near the confines of Arabia
and Paleftine. Voyagers alfo tell us, that the lakes of
Judea and of Egypt, the banks of the Nile in winter, and
thofe of the Strymon in fummer, Seen from the heights,
appear whitened by the multitude of pelicans which cover
them.

When we collefl the teftimonies of the various navi¬
gators, we fee that the pelicans inhabit all the louthern
countries of our continent, and that they occur, with
little difference, and in ftill greater numbers, in the cor¬
responding parallels in the new world. They are very
common in Africa, on the Sides of the Senegal, and of the
Gambia, where the negroes call them po/iko : the great
tongue of land, which bars the mouth of the fir ft of thefe
rivers, is filled with them. They are found likewife at
Loango, and on the coafts of Angola, of Sierra Leone,
and of Guinea : in the bay of Saldana they are inter¬
mingled with a multitude of birds, which feem, on that
flrore, to fill the air and the lea. They occur at Mada¬
gascar, at Siam, in China, at the ifle of Sunda, and at the
Philippines, especially on the filheries of the great lake of
Manilla, They are Sometimes met with at lea ; and they
have been Seen on the remote lands in the Indian ocean,
and at New Holland, where captain Cook Says they are
extremely large. Captain Keeling alfo, in his voyage to
Sierra Leone, Says the pelicans there are of a white co¬
lour, with exceeding long bills ; and M. Thevenot, in
his travels to the Levant, obferves, that the pelicans
about fome part of the Nile, near the Red Sea, Swim by
the bank-fide like geefe, in Such great numbers that they
cannot be counted. Father Morolla, in his voyage to
Congo, Says pelicans are often met with in the road to
Singa, and are all over black, except on their breaft,
which is of a flefh-colour like the neck of a turkey. He
adds further, that father Francis de Pavia informed him,
that on his journey to Singa he obferved certain large
white birds, with long beaks, necks, and feet, which,
whenever they heard the leaft found of an inftrument,
began immediately to dance, and leap about the rivers,
where they always refide, and whereof they were great
lovers : this, he Said, he took a great pleafure to contem¬
plate, and continued often upon the banks of the river
to obferve.

In America, the pelican is found from the Antilles
and Terra Firma, the ifthmus of Panama, and the bay of
Campeachy, as far as Louifiana, and the country adjoin¬
ing to HudSon’s bay. They are Seen alfo on the inha¬
bited ifles and inlets near St. Domingo ; and in greater
numbers on thofe Small ifles, clothed with the fineft ver¬
dure, which lie in the vicinity of Guadaloupe, and which
Seem to be occupied as the retreat of different Species of
birds : one of thefe ifles has even been called the Ifle of
Pelicans. They augment alfo the flocks of birds which
inhabit the ifland of Aves : the coaft of the Sambales,
which abounds with fiffi, attracts them in great numbers :
in that of Panama, they are Seen to alight in bodies on
the fhoals of pilchards left at Spring tides ; and all the
adjacent iflets are to Such a degree covered with thefe
birds, that their fat is melted for oil. They ftray little
from the coafts ; and, when met with at fea, it is regarded
as a Sign of the proximity of land. Of the two names

PELEC ANUS. 499

pelecanus and onocrotalus, the firft has milled the tranfla-
tors of Ariftotle, and even Cicero and Pliny: they have
rendered it by the word platea, which would confound
the pelican with the fpoon-bill. When Ariftotle fays
that the pelecanus fwallows thin (hell-filh, and cafts them
up half digefted,in order to feparate the meat which they
contain, he imputes it to a habit which agrees better
with the fpoon-bill, confidering the ftrufture of its
cefophagus ; for the pouch of the pelican is not a fto-
inach where digeftion is begun; and Pliny inaccurately
compared the manner in which the onocrotalus fwallows
and brings up its food, to the procefs carried on in ru¬
minating animals. “ There is nothing here,” M. Per-
rault very judicioufly remarks, “but what enters into
the general plan of the organization of birds s all of
them have a craw in which their food is lodged ; in the
pelican it lies without and under the bill, inftead of being
concealed within, and placed at the bottom of the cefo¬
phagus. But this exterior craw has not the digeftive
heat of that of other birds, and in this bag the pelican
carries the fifti entire to its young. To difgorge them it
prefl'es the pouch againft its breaft; and this very natural
aft may have given rife to the fable fo generally told,
that the pelican opens its breaft to nourilh its offspring
with its blood. The pelican, as voracious as it is de-
ftruftive, takes up in a tingle excurfion as many fith as
would feaft half a dozen men. It fwallows eafily a fifli
of feven or eight pounds : and we are told that it alfo
eats rats and other fmall animals. Pifon fays, that he
faw a kitten fwallowed alive by a pelican, which was fo
familiar that it walked into the market; where the filher-
men haftened to tie its bag, left it thould llily purloin
fome of their fith. It eats with the fide of its moyth,
and, when a perfon throws it a morfei, it fnaps at it.
The pouch, in which it ftores all its captures, confifts of
two tkins; the inner coat is continued from the mem¬
brane of the cefophagus, the outer is only a produftion
of the tkin of the neck : the wrinkles in which it is
folded ferve to contraft the bag, and when empty it be¬
comes flaccid. The bag of the pelican is ufed as a to¬
bacco-pouch; and, in the Weft-India iflands, is termed
blague, or blade, from the word bladder. It is aflerted,
that, when thefe are prepared, they are more beautiful
and fofter than lamb-lkins. Some failors make caps of
them; the Siamefe form mufical firings of the fubftance;
and the filhermen of the Nile ufe thefac attached to the
jaw as a fcoop for lading their boats, or for holding wa¬
ter ; as it neither rots with moifture nor can be penetrat¬
ed by it.

This very large fpecies occupies the wmole of the an¬
nexed Plate. It is copied from Edwards’s Nat. Hift. of
Birds, Part II. and we (hall tranfcribe alfo a part of his
defcription of it. “ This bird feemed to me to be more
than double the bignefs of the largeft fwan ; it meafured
from the point of the bill to the angle of the mouth
twenty inches of our Englilh meafure, which is fix in¬
ches more than any natural hiftorian has found it ; the
Academy of Paris having meafured one which was but
fourteen inches, Paris meafure I fuppofe ; and our coun¬
tryman, Willoughby, meafured one brought from Ruf-
fia, which he makes fourteen inches Englilh ; fo that I
believe this bird of mine muft be proportionably bigger
in all its parts than what have been before defcribed. I
thought it fomething incredible in Willoughby’s de¬
fcription, that a man Ihould put his head into the pouch
under the bill, till I faw it performed in this bird by its
keeper; and am fure a fecond man’s head might have
been put in with it at the fame time : indeed it is faid to
be capable of holding twenty quarts of water. The
upper mandible is ftraight and flat, having a ridge run¬
ning along its middle, and at the point a remarkable
hook; the Ikin round the eye is bare of feathers, of a
light flelh-colour; the noftrils are not perceivable; the
eyes are of a dark hazel- colour. The lower part of the
bill is compofed of two flexible fides, which it can open
Vol. XIX. No. 1320.

pretty wide, or draw together at pleafure ; thefe Tides are
joined the whole length, except at the point, by a loofe
Ikin of the confidence of thin tripe, of a yellowifh colour,
which it can either draw up clofe to the bill, or let fall to
a confiderable depth from it; this fkin extends itfelf un¬
der the throat; it hath rather the appearance of the root
of a tongue than what may be called a tongue. When
it extends its neck, it appears longer in proportion than
reprefented in the figure, and fometimes it is drawn in
ffiorter. This bird was brought from the Cape of Good
Hope by captain Felly, in the India company’s fervice,
anno 1745, who obliged me with a fight of it before it
was expofed in London. I find no material difference
between this and what has been defcribed by Willough¬
by, and the Academy of Paris, except its fize, fo that I
cannot pronounce it fpecifically different from what has
been defcribed before. The curious, who defire to ex¬
amine into the anatomy of this bird, may confult Mem.
de l’Academie Royale des Sciences, 16 66 to 1699. As
no Englifti author hath given a tolerable figure of this
bird, my hiftory in that refpeft will be new, as well as in
its extraordinary magnitude, which all the curious in
this city are witneffes of, it having been publicly fhown
here.”

2. Pelecanus rofeus, the rofe-coloured pelican : colour
rofy ; gullet pouched. The bill and legs are black; the
area of the eyes is naked ; the pouch yellow. It is about
the fize of a goofe ; and inhabits Manilla.

3. Pelecanus fufcus, the brown pelican: cinereous
brown ; gullet pouched. This is the American pelican
of Edwards ; he fays it is fomething larger than a full-
fixed tame goofe, its length being nearly four feet. The
bill is fhaped as in the firft fpecies, and is fifteen inches
long; at the bafe it is greenilh, but inclines to blue
mixed with red near the end : the pouch is of a bluifti-
afli-colour, ftreaked with reddilh lines : irides deep
bluilh-alh-colour : the bare Ikin round the eyes whitifh.
The head and neck are white ; the firft a little crefted at
the back part: back, fcapulars, and rump, cinereous
brown; the middle of each feather whitifh : the breaft and
tinder parts like the upper, but plain : the upper wing-
coverts like the back ; but fome of the outer great ones
are plain brown: the lhape of moft of the feathers is
pointed, narrow, and long: prime quills black ; the fe-
condaries hoary brown : tail the fame, and confifts of
eighteen feathers : legs lead-colour: claws black.

The brown pelican is very common in many parts of
the coafts of America ; and no-where more fo than in
the Weft-India iflands, Jamaica, Barbadoes, See. Alfo in
the Bay of Campeachy, and as low as Cartbagena. In
fummer it is found as far north as Hudfon’s Bay.
Thefe birds are celebrated for a moft affeftionate attach¬
ment to the fick and maimed of their own fpecies, to
whom they will conftantly carry a fupply of food ; a cir-
cumftance which the Americans take advantage of to
procure fiflr without trouble. They take a live pelican,
break its wing, and, after tying it to a tree, conceal them-
felves in the neighbourhood ; there they watch the
coming of the other pelicans with their provifions, and,
as foon as they fee thefe difeharge the fifli from their
pouch, they run in, and, after leaving a little for the
captive bird, carry off the refidue.

4. Pelecanus Manillenfis, the Manilla pelican: this
fpecies refembles the rofe-coloured pelican, except in
the plumage being wholly of a brown colour. It inha¬
bits Manilla, where it is found in great abundance, mak¬
ing its neft on the ground, and feems very unwieldy
while on land ; yet at times they fly very high. Their
flelh is rank and bad.

.5. Pelecanus Philippenfis, the Philippine pelican ;
white ; creft varied"\vhite and brown ; gullet pouched.
This is nearly four feet and a quarter in length; the bill
fourteen inches long, the colour reddilh white, with a
few fpots of brown on the fides of the upper mandible:
the bare fpace round the eyes is of the colour of the
6 M bill 5

500

PELECANUS.

bill : the pouch is very pale. The head and neck are
whitifti : from the hind head to the back is a ftripe of
feathers fomewhat longer than the reft, mixed white and
brown; thofe of the hind head (till longer, fo as to form
a creft ; the feathers of all thefe parts are very foft and
ftiky. The upper part of the back and fcapulars cine¬
reous grey ; the lower part of the neck, the breaft, the
lower part of the back, and rump, while : the wing-co¬
verts cinereous grey, with the fhafts and margins white;
the outer greater ones, and baftard wings, darker, almoft:
black: quills dufky black; the bafe of many of the fe-
eondaries white: tail compofed of eighteen feathers, co¬
lour greyilh white; all but the two middle ones white on
the inner webs at the bafe; fhafts black : legs red. This
inhabits the Philippine iflands, and is probably the bird
known there by the name of alcatraz. The natives fay
that the (kin of the breaft, drelfed with the feathers on,
has a fweet fmell; and, being worn on the ftomach of any
one afflifted with the afthma, proves a remedy for the
fame.

6. Pelecanus rubefcens, the red-backed pelican : co¬
lour reddifh ; head crefted ; tail dufky ; gullet pouched.
Length five feet; bill thirteen inches, of a* pale dirty
yellow; reaches eight inches down the neck. The
hind-head is crefted, fome of the feathers four inches in
length. The head and neck dirty reddifh white; the
back of a fine pale cinnamon colour: the wing-coverts
are like the neck, but darker : fcapulars pale greyifh lead-
colour. The legs are yellow. This bird was brought
to England by Mr. Lewis, a navy-furgeon, who had it
alive from the governor of one of our forts on the gold-
coaft in Africa, where it had been kept tame for a long
time, and was reckoned a fcarce bird. Like others of its
race, it was very voracious : an experiment was tried how
many fiflt it could take into the bill, and numbers of dif¬
ferent fizes were laid before the bird on the ground: it
firft attempted to take up one of ten pounds, but the bill
would by no means raife it from the ground ; it then
picked, up as far as ten of the others, each weighing a
pound, and flowed them carefully in the bag, arranging
them along-fide each other, with the heads towards
the throat; and after this it walked off very ftately,
with the bag hanging down to its feet. The pouch
held about two gallons of water.

7. Pelecanus Carolinenfis, the Charleftown pelican :
dufky above, white on the breaft and belly; guiiet
pouched. Thefe abound in the bay of Charleftown in
America, where they are continually fifhing. Two fpe-
cirnens of birds fimilar to the above, if not the fame, are
in the Hunterian Mufeurn. The fize conefponds : length
four feet; bill thirteen inches long, and differs from
many in having that part of the upper mandible w-hich is
next the bafe almoft cylindrical, and not flat, though
fpreading out confidenjbly near the end : the lower half
of the back, in one fpecimen, itriped black and dufky
white ; the feathers narrow, and edged with the lall
colour: in the other, the back is of a plain colour.
The bag is of an enormous fize, taking up the greateft
part of the neck before ; at the hind part of it, the fea¬
thers are much longer than the reft ; yet neither the nape
of the neck, nor back part of the head, were at all crefted.
Thefe were brought from Cayenne.

3. Pelecanus erythrorhynchos, the rough- billed peli¬
can : white, hind-head crefted; gullet pouched. The
fize of this fpecies is between a goofe and afwan : length
four feet fix inches ; bill thirteen inches, with the addi¬
tion of fome lingular protuberances on the top of the
upper mandible, from the bafe of which, for above feven
inches, the furface is plane, as in other pelicans : at this
part an elevated ridge begins, of about an inch and a
half in height, and one-third of an inch in thicknefs ;
this continues about an inch and a half on the bill, and
then other fmaller ones rife, of different fizes, and conti¬
nue growing fmaller, in an abrupt manner, to the end of
the bill. The colour of the bill and ridge is reddifh

yellow, here and there inclining to red : the under man¬
dible and pouch as in other fpecies ; but on each fide,
about the middle of the firft, is a fmall black fpot ; and
the bag is ftreaked with lines of black, which are pretty
numerous on the fore part of it, moflly fo next the end
of the bill. The plumage of the bird is wholly of a pure
white, except the greater quills, which are black: at the
hind head the feathers are greatly elongated, forming a
creft of four inches and a half in length: the legs are
black. This fpecies is found in feveral parts of America,
having been feen at New York and in South Carolina.
It is by fome confidered as a variety of the large white
pelican ; but it is a much fmaller and more delicate bird.
It is repr'efented on Plate II. at fig. 1.

9. Pelecanus aquilus, the frigate-pelican, or man-of-
war bird : tail forked; body ferruginous, orbits black;
bill red ; belly of the female white. It is three feet
long; the extent of the wings is full fourteen feet. The
bill is flender, five inches long, and much curved at the
point; colour dufky ; from the bafe a reddifti dark-co¬
loured tkin fpreads on each fide of the head, taking in
the eyes. From the under mandible hangs the pouch,
which is attached fome way down the throat ; the colour
of this is a fine deep red, fprinkled on the fides with a
few fcattered feathers; and when dilated, and refting on
the breaft, really looks as if it was pundtured and run¬
ning with blood, from whence the fabulous notion of
tearing open its bofom to feed its young might mod
eafily have been taken.

The whole plumage is brownifh black, exceptthe wing-
coverts, which have a rufous tinge. The tail is long,
and much forked : the outer feathers eighteen inches or
more in length ; the middle ones from feven to eight :
the legs are fmall, all the toes webbed together, and the
webs deeply indented ; the colour of them dufky red.

The frigate pelican, or man-of-war bird, is chiefly, if
not wholly, met with between the tropics, conftantly out
at fea, being only feen on the wing. It is ufual with
other birds, when fatigued with flying, to reft on the
furface of the water; but nature, from the exceeding
length of wing ordained to this, has made the rifing there¬
from utterly impoffible ; at leaft writers not only inform
us, but every one who has particularly noticed them avers
the fame ; though perhaps this is no defedt of nature, as
it fcarcely feems to require much reft; at lead, from the
length of wing, and its apparent eafy gliding motion
(much like that of the kite), itr appears capable of fuf-
taining very long flights ; for it is often feen above an
hundred, and not unfrequently above two hundred,
leagues from land. It has indeed been known to fettle
on the mafts of fhips ; but this is not a frequent circum-
flance, though it will often approach and hover about
the top-maft flag. Sometimes it foars fo high as to be
fcarcely vifible, and at other times approaches the furface
of the fea, where, hovering at fome diftance, the moment
it efpies a filh, it darts dowm on if with the utmoft ra¬
pidity, feldom without fuccefs, flying upwards again as
quick as it defcended. It is alio feen to attack other
birds which have caught a fiflt, when it obliges them to
difgorge it, and takes care to feize, it before it falls into
the water. It is an enemy to the flying-fifh; for, on
their being attacked by the dolphin, and other voracious
enemies in the fea, thefe femi-volatiles leap out of the
water in clufters ; and during their flight the frigate darts
in among them, and feizes one or two.

Thefe birds, though not uncommon every-where with¬
in the tropics, yet are lefs frequent in fome places than
in others. They w!ere feen by Cook in 30^ degrees. In
the old route of navigators they are mentioned frequent¬
ly, as being met with at Afcenfion Ifland, Ceylon, Eaft
Indies, and China. Dampier faw them in great plenty
in the ifland of Aves in the Weft Indies. Our later na¬
vigators defcribe them as frequenting various places of
the South Sea, about the Marquefas, Eafter Ifles, and
New Caledonia 5 alfo at Otaheite, though at this laft

place

PE LE CAN1JS.

Flare ]I

501

PELECANUS.

place not in fuch plenty as in fnany others. They are
laid to make their nefts on trees, if any are within a pro¬
per diftance, otherwife on the rocks. They lay one or
two eggs, of a flelh-colour, marked with crimfon fpots.
This fpecies is reprefented at fig. z.

10. Pelecanus minor, the fmaller frigate-pelican : tail
forked ; body ferruginous ; bill and orbits red. It re-
fembles the laft ; but is lefs, being only about three feet
long.

11. Pelecanus leucocephalus, the white-headed frigate-
pelican : tail forked ; body brown ; head, neck, breaff,
and belly, white 5 bill dufky, except at the tip, where it
is nearly white; legs reddifh brown. Total length
about three feet. This is in the Hunterian Mufeum.
In the fame collection there is another very like it, with
the head and half the neck all round white, palling on
the fore part down the bread, and ending between the
legs : fides of the body, and the vent, brown; which, as
in the other, is the general colour of the reft of the plu¬
mage : legs redd i Hi brown : middle toes ferrated. Nei¬
ther of thefe were bare on the fides of the head, nor had
any appearance of a pouch on the under mandible. Not
far different from the above is one mentioned by Ofbeck.
In his bird the cere at the bafe of the bill (he fays) is
blue, and extends to the eyes ; the temples, or fides of
the head, being naked : the tongue large, almoft trifid at
the top ; the corner at the bottom fplit : the head, fore
part of the neck, bread, and belly, white : the general
colour of the reft of the plumage black : tail forked,
giving the idea of a pair of fciflars : legs black. This he
met with at the Ifleof Afcenfion, where it is very tame,
and does not appear to be afraid of mankind. He fup-
pofes it incapable of fifhing for itfelf, as he obferved it to
be on the watch till fome other bird had caught a fifli ;
which it immediately purfued, and obliged the fuccefs-
ful captor to render up his prey.

12. Pelecanus Palmerftonii, the Pal merfton frigate-pe¬
lican ; bill five inches and a half long, black; fpace
round the eyes well feathered; body brown with a green-
ifli glofs ; beneath white; vent black; tail forked; the
Drafts of all the feathers white : legs dufky black ; the
middle claw ferrated on the infide. Inhabits the ifiand
of Palmerfton, in the South Seas. It is in the collection
of the late fir Jofeph Banks. Three feet two inches long.

13. Pelecanus carbo, the cormorant, or corvorant : tail
rounded; body black ; head fubcrefted. In Greek this
bird was called < pethoiy.goKogu.% , or bald raven ; the Spanifn
name, cuervo ca/vo, has the fame fignification ; and the
notion of water or fea raven is implied in modern Latin,
in Italian, in German, and Silefian, by the appellations of
corvus aquaticus, corvo marino, u'aj]'er-rabe,J'ee-rabe. In
fome of the French provinces it is ftyled crot-ppfcherot,
or dirt-fifher. Dr. Kay, in Gel'ner, conjeCt ures, that cor¬
morant is a corruption of corvorant, corvus vorans, or de¬
vouring raven ; and Pennant and Latham have adopted
corvorant. The name was formerly pronounced cormo-
ran or cormarin, contracted from corvus marinas, orfea-
raven: yet it refembles the raven in nothing but its black
plumage, and even this is downy, and of a lighter fliade.

The cormorant is fo dextrous in fifhing, and fo vora¬
cious, that, when it vifits a pool, it commits alone more
havoc than a whole flock of other pifcivorous birds.
Fortunately, it refides almoft conftantly on the fea-fhores,
and feldom occurs in inland countries. As it can re¬
main a long time plunged, and fwims under water with
the rapidity of a dart, its prey fcarcely ever efcapes, and
it almoft always emerges holding a fifh acrofs in its bill :
to fwallow the victim it employs a fingular expedient ;
it tolTes up the fifh in the air, and dextroufly catches the
head in falling, fo that the fins lie flat and favour the paf-
fage down the the throat, while the membranous fkin
that lines the under fide of its bill ftretches to admit the
■whole body of the fifh, which is often very large in pro¬
portion to the neck of the bird.

In fome countries, as in China, and formerly in Eng«

3

land, the fkill of the cormorant in fiftiing was turned to
profit : for, by buckling a ring about the lower part of
its neck, to prevent deglutition, and accuftoming it to
return with its acquifitions in its bill to its mafter, it
was made a domeftic fifher ; and this toil continued,
till its mafter, fatisfied with the earnings, loofed its col¬
lar, and permitted it to fifh on its own account. Hunger
alone gives activity to the cormorant; it becomes lazy
and fluggifh after its appetite is glutted. It inclines to
fat ; and, though it has a very ftrong fmell and an un-
pleafant tafte, it is not always defpifed by failors, to whom
the fimpleft and coarfell fare is often more delicious than
the conrtant repetition of fait meat.

Thefe birds are plentifully found in England, parti¬
cularly on the Needle and Frelhwater rocks, at the back
of the Ifle of Wight: on Dover cliff’s, and on moft of
our rocky fliores. They abound in many places of the
old continent ; on the fliores of the Cafpian Sea they
fometimes collect in immenfe flocks; and are frequent
in the Lake Baikal; they inhabit the Cape of Good
Hope ; and are common in the Philippine Ifles, New
Holland, New Zealand, &c. They are found in many
parts of the continent of America, being met with in
Hudfon’s Bay, New' York, and from thence as low as
Carolina : at the laft place they are feen in March and
April, when the herrings run up the creeks, at which
time they may be obferved fitting on the logs of wood
which fall into the water, waiting for the pafling-by of
the fifli. Our late navigators met with it in Nootka
Sound. The cormorant is likewife very frequent on all
the northern fliores, quite to Kamtfchatka : in Green¬
land it remains the whole year, and builds on the tops
of the crags, laying three or more pale green eggs, the
fize of thofe of a goofe ; but thefe prove fo very fetid
and difgufting, that the Greenlanders will fcarcely ever
eat them. The fkin is very tough, and is ufed by the
Greenlanders for garments ; they alfo fometimes eat the
flefh. The head of the cormorant is fenfibly flat, like
that of moft diving birds ; its eyes are placed very much
forward, and near the corners of the bill, whofe fubftance
is very hard, and ftiining like horn ; the feet are black,
fliorf, and very ftrong; the middle nail is ferrated inte¬
riorly, like that of the heron ; the pinions are very long,
but clothed with fliort quills, and hence it flies heavily.
It makes its neft with flicks, fea-weed, grafs, &c.

|3. P. c. criftatus, the crefted corvorant, is defcribed
by Mr. Montagu in the Supplement to his Ornithologi¬
cal Dictionary. “ The poflelfion of this bird has given
us much of its hiftory we were previoufly unacquainted
with. It is extremely docile, and of a grateful difpofition,
without the fmalleft tinCture of a favage or vindictive
fpirit, and by no means poflefling the bad qualities a ce¬
lebrated writer would induce us to believe, by making it
perfonify Satan. The bird in queftion was furprifed by
a Newfoundland dog, belonging to a fifherman, under
the banks of a rivulet that ran into the Britifh channel ;
it was taken home, and, not being in the accuftomed
plumage, was reported to be a curious and unknown
fpecies. When it had been made captive about a week,
it was perfectly familiarized, making one in the family
circle round the fire, and fuffering the cardies of the
children, who were very unwilling to part with it. That
mode, however, by which all earthly matters are obtain¬
ed, and by which kingdoms are loft and gained, fucceed-
ed; and it was conveyed to us by the coach, being placed
in a bafket. As foon as it arrived and was liberated, it
followed the fervant who releafed it, and was offered
every fort of food at hand, all of which was equally re¬
filled ; not even raw flefh was acceptable, and no fifli
could then be procured to fatisfy its hunger. We there¬
fore crammed it with flefh, which was taken ,very reluc¬
tantly ; but, even with this rough handling, its formi¬
dable bill was not made ufe of oftenfively. After feed¬
ing, it was placed on a ltool, in an adjoining room to
the library, where it fat perfectly contented, and adjufted

its

502 'PELEC

its difconcerted plumage. Obferving it fo perfeftly re¬
conciled to its new abode, and having retired to the li¬
brary, leaving both doors open, with intention of return¬
ing, we were aftoniflied, in a few minutes, to fee the
ftranger walk boldly into the room, and, coming towards
us with the greateft confidence and familiarity, joined us
at the fire-fide, where it re-aflumed the talk of pluming
and drefling its feathers. From hence we removed this
bird to an aquatic menagerie, to which it was carried
without offering the lead offenfive refinance; but the
fight of water made it reftlefs ; and, when liberated, it
inftantly plunged in and dived incefl'antly for a confider-
able time, in hopes of prey; but, after fearching every
part of the pond, without obtaining a fingle filh, it ap¬
peared to be convinced there was none, and never made
any other attempt for three days, during the whole of
which time, it was crammed with flefli, not being able
to procure any fill). It lives in perfeft harmony with a
whittling fwan, a bernacle goofe, various forts of ducks,
and other occafional birds; but, if it perceives a gull
with a piece of filh, it inftantly gives chace: if, however,
the gull has time to fwallow it, no refentment is ottered :
the fight of it created the defire of pofleftion, and that
defire ceafes with its difappearance. If it gets out, it
never attempts to ramble; but, walking direct to the
lioufe, enters the firft open door without deference to any
one, regardlefs even of a dog ; and in fadft is troublefome-
ly tame.”

14. Pelecanus graculus, the (hag: tail rounded ; body
black, brown beneath ; tail-feathers twelve. Weighs
about four pounds ; length twenty-nine inches. The
female weighs about three pounds and a quarter, and is
only twenty-feven inches long. The heavinefs or rather
indolence natural to all the cormorants, is ftill more re¬
markable in the prefent. This fpecies is not lefs diffufed
than the former: it occurs particularly in the illands
and the extremities of the fouthern continents. Cook
and Forfter found it on the ifland of Georgia; which,
though not inhabited, and almoft inacceffible by man, is
flocked with thefe little cormorants, which fhare the do¬
main with the penguins, and lodge among the tufts of
rufhy grafs, the only vegetable production in that weary
tradf. Staten-land is fimilar, and contains likewife great
numbers of thefe birds. An ifland in the Straits of Ma¬
gellan was fo full of them, that captain Cook called it
Shag Ifland. It is in thefe extremities of the globe that
nature, benumbed with cold, has allowed five or fix fpe¬
cies ftill to fubfift, the laft inhabitants of the territories
invaded by the progrefs of refrigeration ; they live in
calm apathy amiaft the dead filence which has there efta-
blifhed its gloomy reign. “ One is aftonifhed,” fays cap¬
tain Cook, “ at the peace which prevails in this land.
The animals that inhabit it would feem to have formed
a league not to dillurb their mutual tranquillity. The
fea-lions occupy the greateft part of the coatt ; the white
bear refides in the interior part of the ifland ; and the
fhags lodge in the loftieft rocks : the penguins fettle
where they have eafieft communication with the fea ; and
the other birds choofe places more retired. We have
feen all thefe animals intermingled and walking together,
like cattle or poultry in a farm-yard, without offering
the lead injury to each other.” In thefe dreary waftes,
naked, and almoft frozen, the flings breed in the ragged
fides of rocks, or the projecting cliffs that overhang the
ocean. In fome parts, their nefts are found among fmall
patches of flags, or in the tall tufts of the coarfe grafs
which we have mentioned. There they inhabit, collected
in thoufands: the report of a mufket does not difperfe
them ; they only rife a few feet, and alight again into
their nefts. Nor need we ufe fire-arms, for they may be
felled with flicks, and yet their companions will not be
alarmed, or endeavour to efcape from the maflacre.
Their flefii, efpecially that of the young ones, is pretty
good food. Thefe birds do not ftray far into the fea, and
feldom lofe fight of land. Like the penguins, they are
clothed with a very thick plumage, well adapted to guard

ANUS.

a gain ft the fevere and continual cold of the frozen re¬
gions which they inhabit.

The fhags are very numerous on the coafts of Cornwall,
and in the Irifli fea, particularly on the Ifle of Man.
They are found alfo on the (bores of Pruffia, and in Hol¬
land near Sevenhuis, where they breed on tall trees.
Willoughby fays, that they fwina with their body entirely
immerfed, and only their head out of the water; and
that they are as nimble and alert in that element as they
are fluggifli on land, and efcape the Ihot by diving the
inftant they perceive the flafh. In general, the (hag has
the fame natural habits with thofe of the cormorant, which
it refembles in its figure and in its colours : the difference
confifts in this, that its body and limbs are fmaller and
more (lender, its plumage brown under the body, its
throat not naked, and that there are only twelve quills
in the tail. Some ornithologifts have ftyled the (hag the
palmiped jay : but this is as little proper as the appella¬
tion of water-raven given to the cormorant. The cor¬
nea of the eye is of a bright red, and the cryftalline ap¬
proaches the fpherical form, as in fi(h: the bafe of the bill
is furniflied with a red (kin, which alfo furrounds the
eye: the aperture of the noftrils is fo narrow a (lit as to
have efcaped obfervers, who have aflerted, that the cor¬
morants, both the greater and the lefs, want the noftrils:
the greateft toe in thefe two fpecies is the outer, compofed
of five phalanges, the next one containing three, the
third three, and the laft, which is the (horteft, only two :
the feet are of a (hining black, and armed with pointed
nails: under the feathers there is a very fine down, as
thick as that of the fwan ; and fmall filky feathers, clofe
like velvet, cover the head.

There are two other varieties of this fpecies. In the
firft, the chin is yellow, and the tail wedged : it is found
in the Cape of Good Hope. The fecond is blackifh, but
underneath it is brown ; the feathers above are edged
with black: inhabits Cayenne, and the Caribbee iflands ;
anil is about twenty-fix inches long.

15. Pelecanus pygmseus, the dwarf (hag: tail w'edged,
the feathers twelve in number. This fpecies is fcarcely
fo big as a teal. The bill, legs, and (h3pe, exactly corres¬
ponding with thofe of the common (hag. The body
black, with a call of green about the neck and bread; :
wing-coverts obfcure-brown, each feather margined with
glofty black: about the eyes dotted with white, but the
lpots not very numerous ; on the neck, breaft, and fides,
are alfo a few fcattered (pots, which arife from pencils of
very tender hairs of that colour, which are intermixed,
and appear here and there among the feathers. The fe¬
male is wdiolly brown, or a dull black, and not fpotted.
This fpecies is met with about the Cafpian fea, among
others of the genus ; alfo on the river Jaick.

(3. This variety has the chin of a moufe-colour ; wing-
coverts and legs black ; head and neck chefnut, with a
few fnowy fpots ; belly hoary, fpotted with brown.

1 6. Pelecanus punttatus, the punffated (hag: crefted,
black ; tail rounded ; wings dark-afh, fpotted with black ;
fides of the neck with a white line. Bill lead-colour ;
orbits naked, reddifli; feathers on the middle of the back
and wings with a black fpot ; body above greenifli-black ;
varies in having the bill and legs yellow. Inhabits New
Zealand ; nearly two feet long.

17. Pelecanus criftatus, the crefted (hag : (hining green,
beneath dufky; bill and legs du(ky; head crefted.
Length two feet three inches ; breadth three feet fix ;
bill four inches long ; irides fine green. On each fide of
the head a long tuft of dufky feathers reaching beyond
the crown, forming a fine creft ; the tail of a dulky green,
confiding of twelve feathers. This inhabits Great Bri¬
tain, and the vaft precipices about Holyhead and the back
of the Ifle of Wight, in May and June; alfo Norway,
Iceland, and Greenland, but in the latter not very com¬
mon. Mr, Pennant obferves, that he met with feveral
(hags in the Hebrides, but faw none with the creft ; hence
we may fuppofe it to be fomewhat rare.

18. Pelecanus violaceus, the violet (hag : creft eretfl ;

body

PELECANUS.

body black, glofled with violet. It is found about Kamt-
fchatka and the ifles.

19. Pelecanus urile, the red-faced (hag: (hining green,
throat white, face bluifh red. Length two feet ten in¬
ches 5 bill three inches and a half long; the bafe of a
reddifh green, the end black : round the eye a bare white
(kin : back and wings duflcy black, but glofly ; the back
has alfo a glofs of green in fome lights, with here and
there a white (lender feather : the belly is wholly black :
on each fide of the rump a large patch of white feathers :
tail fix inches in length, confifting of twelve feathers :
colour of the quills black : legs black. It inhabits
Kamtfchatka, chiefly about the rocky and craggy places
cm the fea-coafts, where it builds its neft in June. The
eggs are the fize of a hen’s, of a green colour, and very ill
tafted ; notwithftanding which the natives think it worth
while torlimb the rocks for them at the hazard of their
lives. Like others of the genus, it feeds on fifli, fwallow-
ing them whole. It flies well and fwiftly ; but rifes with
difficulty from the ground. While fitting on the rocks
it is very ftupid, being overcome with deep, and not eafily
roufed ; hence the natives catch them eafily, 1>y means of
nets thrown over them, or noofes at the end of long
poles; and not unfrequently thefe filly birds fuffer them-
felves to be taken one after another to the very lad. As
food, every one but a Kamtfchadale mult refufe it ; yet
this nation think it very tolerable, whether owing to the
method of cooking or not, is uncertain : their method is
to road: it in holes in the earth, whole, without plucking
off the feathers, or taking out the entrails, and after it is
done enough they (kin and eat it. It is faid to have no
tongue ; yet it is averred that it cries morning and even¬
ing, not greatly unlike the blowing of a trumpet.

20. Pelecanus nasvius, the fpotted fliag : black; tail
rounded, orbits naked, dingy red; front and hind head
crefted ; a white curved ftripe from the eye to the wing;
wing-coverts fpotted with black.

This fpecies, which is fupprefied by Dr. Turton in his
tranflation of Gmelin, is the Crefted Shag of Cook’s laft
Voyage, vol. i. p. 151. and is reprefented on the annexed
Plate at fig. 3. It might indeed be called dotible-crefted,
or two-crefted ; for juft over the forehead arife fome long
feathers, forming a pointed creft ; and at the hind part of
the head a fecond, not unlike thefirft, but rather longer,
fome of the feathers meafuring an inch and a half. Juft
over the eye begins a ftripe of white, which pafles down
on each fide of the neck quite to the wing, and growing
broader as it proceeds downwards. The middle of the
back, and the wings, are of a brownifh afli-colour, each
feather tipped at the end with a round fpot of black,
largeft on the wing-coverts, but no where bigger than a
fmall pea : quills not fpotted : from the middle of the
back to the end of the tail, and from between the legs to
the vent, black glofled with green.: tail three inches in
length, rounded at the end 5 that and the quills plain
black : legs deep brown or black. This fpecies inhabits
New Zealand, and builds among the rocks ; it is met with
principally in Queen Charlotte’s Sound, where it is known
by the name of pa degga-degga. Length two feet, or more.

21. Pelecanus carunculatus, the carunculated drag:
black, beneath white ; bill duflcy : fides of the head bare of
feathers ; between the bill and eye much carunculated, and
red ; the reft of the fpace round the eye afh-colour ; the
orbits of a fine mazarine blue, and elevated; and over the
eye is a tubercle larger than the reft. The irides are
whitifti, or very pale brown : the head fomewhat flat on
the fides, and the crown rather full of feathers : the top
of the head, and fides of it, the hind part of the neck, and
all the upper parts of the body, the wings, and tail, are
black, except a longifli patch of white on the wing-co¬
verts: the forehead, chin, and all beneath, white: the
legs are fle(h-colour, or very pale brown.. This inhabits
New Zealand ; and is found in Queen Charlotte’s Sound,
though not in plenty ; but was met with by millions in

Vol. XIX. No. 1320.

503

Staaten-land ; and is faid by our voyagers to build in
towns. Length twenty inches.

22. Pelecanus Magellanicus, the Magellanic fliag;
b*lack, beneath white: bill three inches long, and black :
fides of the head, and chin, bare, and reddifti ; tail
wedged. The head and neck fomewhat glofly, and the
feathers of the firft feem full, making that part appear
larger than it is ; but the head is by no means crefted :
behind each eye a fpot of white. It inhabits Terra del
Fuego and Staaten-land : in Chriftmas Sound it builds by
thoufands among the rocks, choofing fuch places where
they projeft over the fea, or at leaft where they rife per¬
pendicularly, that, in cafe the young fall out, they may
take no harm, dropping only into the water. Length
thirty-fix inches.

23. Pelecanus varius, the pied fliag: brown, beneath
white; bill four inches and a half ; the top of it duflcy ;
the bare fpace about the eye, yellow : over the eyes a
narrow ftreak of a pale colour : the head, hind part of the
neck, back, wings, and tail, are brown; the middle of the
back, and wing-coverts, paleft; the margins of the laft
almoft white, or very pale : the lower part of the back,
rump, and thighs, very deep brown, nearly black : quills
black ; tail rounded, and fix inches or more in length ;
legs flefli-colour : claws duflcy. This fpecies inhabits
New Zealand, and was met with frequently in Queen
Charlotte’s Sound. It builds in trees, on which a dozen
or more are feen at once. The egg is two inches and a
half long, rather (mailer than that of a hen, and of a pale
bluifli white. Length of the full-grown bird, thirty
inches.

24. Pelecanus cirratus, the tufted (hag: black, beneath
white ; bill duflcy yellow ; round the eye bare : the head
crefted; on the wing-coverts is an oblong patch of white.The
tail is four inches and a half in length, rounded in fliape,
and compofed of fourteen feathers : the legs pale yellow
brown. This was brought from Queen Charlotte’s Sound ;
and is in the Hunterian Mufeum. Size of the preceding.

25. Pelecanus Africanus, the African fliag: brown, be¬
neath variegated, chin white; fcapulars and wing-coverts
blue grey, each feather margined all round, and tipped
with black : the three firft greater quills pale brown, in¬
clining to cinnamon ; the reft brown black: fecondaries
as long as the quills, of a duflcy black, edged with brown.
The tail confifts of twelve feathers, is cuneiform in fliape,
the two middle feathers being (even inches long, the
outer three inches and a half only ; the four middle ones,
and the outer on each fide, are pale brown, the others
black. Inhabits Africa; and is about twenty inches
long.

II. Bill ferrate.

26. Pelecanus thagus, the faw-billed pelican : brown ;
tail rounded ; gullet pouched, and covered with fliort ci¬
nereous feathers. Bill a foot long, each mandible hook¬
ed ; pouch very large ; legs black. Inhabits Chili; fize
of a turkey ; extent of wings nine feet.

27. Pelecanus baflanus, the gannet, or Soland goofe :
tail wedged; body white; bill and quill-feathers black;
face blue ; irides yellowifti ; tail-feathers twelve ; eyes
furrounded with a naked lkin of fine blue ; legs black,
and greenifh on the fore part ; the feet long.

Linnaeus gave the name of Bajfanus to this fpecies, be-
caufe it is a native of the Bafs-ifle, a ftupendous rock in
the Frith of Forth, near Edinburgh. It is about the fize
of a common goofe ; weight (even pounds; length near
three feet, alar extent fix. The gannet inhabits all the
northern ides, but in particular that of the Bafs in Scot¬
land. It generally firft makes its appearance in March,
and, after making a circuit of the ifland, departs in 0£lo-
ber or November. 'Phis race feems to be in purfuit after
the herrings and pilchards, whofe motions it watches; and
fifliermen know the coming of thele fifli by the appearance
of the birds. That this is the inducement feems pro-

6 N liable, ,

•304

P E L E C A N U S.

bable, as they are likewife Teen, in the month of Decem¬
ber, as far fouth as the coafl of Lilbon and Gibraltar,
plunging for fardines, a fpecies of pilchard. The gannet
is alio common on the coalls of Norway and thofeof Ice¬
land, and now and then are met with on the fouthern
coafls of Greenland. In America, they are found on the
coafls of Newfoundland, where they breed, migrating in
winter as far as Carolina. They were alfo met with fre¬
quently by our feveral voyagers in many parts of the
fouthern ocean. Their nell is compofed of grafs and fea-
plants, intermixed with any thing the bird finds floating
on the w’ater. It lays only one egg, which is white, ra¬
ther lefs than that of a goofe ; if this egg be taken away,
the bird will lay a fecond; and, fliould this be taken alfo,
a third ; but, on the lofs of the third, it can furnifli no
more that feafon. They place their nefl in the clefts of
the rock, and the common people believe that they per¬
form the office of incubation Handing on one foot, a no¬
tion fuggefted probably by the breadth of its foie.
Hence, it is alleged, they received the name of jnle-an-
geefe ; but Martin informs us, that this word is of Irifli
or Erfe derivation, and fignifies quick-fighted ; tliefe
birds being noted for the bright luftre of their eyes. The
foot, however, is widely palmated, and the middle and
outer toes are each near four inches long, and all the four
are ccnnefted by an entire piece of membrane.

Though large and heavy, they are very dexterous fill¬
ers ; they delcend from a vail height, and plunge many
fathoms under water. It is in Scotland that they are ufu-
ally called J'olan geeJ'e, in Cornwall and Ireland gannets,
and in Wales gun. The inhabitants of St. Kilda, we are
affiured by Martin, take above twenty thoufand of the
young birds annually, befides a prodigious number of
eggs. Thefe fpoils are the chief fubfiflence of thefe hardy
iflanders, and they (tore up their provifions in pyramidal
Hone buildings, covering them over with peat-affies.

It is very curious to obferve, that in thefe birds the Ikin
does not adhere to the body; it is ccnnefted to it only
by fmall bundles of fibres placed at equal diftances, fuch
as one or turn inches, and capable of being extended as
much; fo that the Ikin may be drawn out like a mem¬
brane, and inflated like a bladder. The following are
the remarks of Mr. Montagu upon this Angular confor¬
mation. “ If a duck or a goofe be attended to when the
ufual cry is emitted, it will be evident, that the preffure
of the abdomen propels the air which is therein contained
with much force into the anterior part of the body, which,
with what is there already, not being able to efcape
through the trachea, not only inflates the cellular mem¬
brane about the bread to an unufual fize, but, by com-
preffion, ruflies with violence through the larynx, and
produces a found more or lefs intenle, in proportion as
the mufcles are more or lefs exerted. Although this
contrivance is fo abfolutely neceflary to the exiflence of
every fpecies of bird, it is not immediately obvious for
what particular purpofe the property of inflation is fo
much further extended than ufual in the gannet. We
fliould not expect to find this power of inflating the Ikin
peculiar to thofe who obtain their fubfiftence by diving,
becaufe, in the add of immerfion, fuch power could not be
exerted without obflrudling that operation ; and it is ob¬
vious, that the air contained within the cavity of the
body is fufficient for all the ordinary purpofes of feeking
their prey under water. It will not be unreal'onable,
therefore, to conclude, that the gannet is endowed with
fuch Angular properties for very different purpofes than
that of long and continual immerfion. It cannot be
doubted, but fuch a power of inflation mud contribute
greatly to leflen the concuffion in its rapid defcent upon
the water, in order to feize its prey : beiides, as the en¬
largement of the l'urface, without materially adding to
the fpecific gravity, mud greatly contribute to its buoy¬
ancy both in air and water, it is well adapted for refiding
ia the midd of the mod tempeduous fea, floating on its
furface in perfeft fecurity, and following thofe flioals of

fiflt on which depends its whole exiflence : thus, when
all others are compelled to feek ftielterin bays and creeks,
the gannet is enabled to brave the fevered weather in all
feafons, w'ithout attempting to near the fliore. This
contrivance may alfo be of the mod important fervice to
an animal which is condantly expofed, even in the mod
inclement feafon, and cannot quit its flation without
darving : nothing could poffibly conduce more to its fe¬
curity againfl intenfe cold, or be better adapted to pre-
ferve the neceflary temperature of animal heat, than this
intermediate body of air between the fkin and the body,
fince that element is found to be a non-conduftor of
heat. Upon this principle, what animal can be more fe-
curely protefted againd cold, or retain its vital heat fo ef-
feftually, as the gannet, or fuch birds as are almofl fur-
rounded with a body of confined air, divided by cells, and
interfefted by membranes between the flcin and the body,
and that flcin fo amply covered with a light porous fub-
fiance, filled alfo with air, and impervious to water ?” An
account, by the fame gentleman, of a non-defcript infeft
which infelts the cellular membrane of this bird, will be
found under the word Cellularia, vol. iv. See alfo
Mem. of the Wernerian Society, vol. i.

Sula major, the great booby : brown fpotted with
white, beneath white ; orbits naked, blackiffi. This is
about the fize of a goofe, but the tail is longer ; the bill a
little more than five inches long, and of a grey brown;
i rides hazel, legs black. It inhabits the fhores of Flo¬
rida, where it is frequent.

43. Pelecanus pifcator, the little gannet: body whififli,
face red ; tail wedged, all the quill-feathers black. Size
of the Mufcovy duck : length two feet feven inches ; bill
five inches long. Throat naked, duflcy black, the fcapu-
lar feathers are alfo black at the ends. The tail confids
of fourteen feathers ; the bafe white, but black the red of
their length : the legs red; the middle claw broad and
ferrated. This fpecies is faid to inhabit China, where it
is called bubbi ; and is fuppofed to be one of the forts
ufed by the Chinefe to catch fiffi, a ring being placed
round the neck. Some birds have thofe parts of a deep
brown which in others are black.

(2. The lead gannet. Size of a duck: length twenty
inches. Bill flraight, as in the common gannet, and
fliaped like it. Colour reddiffi brown, with a dufky or
black point; the bafe, and fkin round the eye, cfa deep
red. The plumage is wholly white, except the wings,
fcapulars, and middle of the back, which are dufky, and
the quills black : the tail is even at the end : legs blood-
red. This bird was in the Leverian Mufeurri; and Dr.
Latham fuppofes it to be a variety of this fpecies. It dif¬
fers chiefly in being fmaller, and in having the taiNfea-
thers white throughout, which in the other are only
white at the bafe, the red of the length being black.

39. Pelecanus fula, the booby: body whitiffi, quill-
feathers tipt with black ; tail wedged. In every organized
being, inflinft difplays itfelf by a chain of confident ha¬
bits, which all tend to its prefervation ; and this internal
fenfe direfts them to fliun what is hurtful, and to feek
what may contribute to the fupport, and even the enjoy¬
ment, of life. Thefe birds, however, feem to have re¬
ceived from nature only half that faculty : armed with a
firm bill, provided with long wings, and with feet com¬
pletely and broadly palmated, they are fitted to exercife
their powers both in the air and in the water; they are
invited to aft and to live; yet they feem ignorant what
exertions they fliould make, or what precautions they
fliould obferve, to efcape that death which perpetually
awaits them. Though diffufed from one end of the
world to the other, from the feas of the north to thofe of
the fouth, they have no-where learnt t;o diflinguifli their
mod dangerous enemy: the fight of man does not inti¬
midate or difcompofe them. They fuffer themfelves to
be taken, not only at fea on the ffiips’ yards, but alfo at
land on the iflets and coafls, where they may be felled by
blows with a dick, in great numbers, one after another.

PELECANUS.

3nd yet the ftupid flock will make no effort to efcape.
Hence thefe birds are called boobies becaufe of their great
ftupidity, their filly afpeft, and their habit of continually
Shaking their head and fliivering as it were when they
alight. And, fince the mental powers and the moral qua¬
lities cf animals are derived from their conftitution, we
mud: attribute the exceflive fluggifhnefs and helplefs fe-
curity of the boobies to fome phyfical caufe ; and this,
in oft probably, is the difficulty of putting their long
wings in motion.

Man is not their only foe; their want of courage ex¬
poses them to another enemy, which perpetually harafles
them. This is the frigate, or man-of-war bird. It rufhes
upon the boobies, which it defcries at a diftance ; purfues
them without intermiffion, and obliges them, by blows
with its wings and its bill, to furrender their prey, which
it inllantly feizes and fwallows : the filly creatures then
return to feek new prey, which they often lofe by a fe-
cond piracy. The boobies hover above the furface of the
water, fcarcely moving their wings, and drop on the fiffi
the inftant it emerges. Their flight, though rapid and
well fupported, is greatly inferior to that of the frigate.
Accordingly, they do not roam fo far, and their appear¬
ance is regarded by navigators as a pretty certain fign
of the vicinity of fome land. Yet thefe birds frequent the
remoteft and moll fequeftered iflands in the midft of the
ocean. There they live in companies, with the gulls, the
tropic-birds, &c. and the frigate, their inveterate foe,
follows them to thefe retreats. Dampier gives a curious
account of the hoftilities between the man-of-war birds
and the boobies, in the Alcrane iflands, on the coaft of
Yucatan. “Thefe birds were crowded fo thick, that I
could not,” he fays, “ pafs their haunt without being in¬
commoded by their pecking. I obferved that they were
ranged in pairs, which made me prefume that they were
male and female. When I (truck them, fome flew away,
but the greater number remained, and w'ould not ftir for
all I could do to roufe them. I remarked alfo, that the
man-of-war birds and the boobies always placed fentinels
over their young, efpecially when they went to fea for
provifion. Of the man-of-war birds, many were fick or
maimed, and feemed unfit to procure their fubfiftence.
They lived not with the reft of their kind, whether they
were expelled from the fociety, or had feparated from
choice : thefe were difperfed in different places, probably
that they might have a better opportunity of pillaging.
I once faw more than twenty on one of the iflands (ally
out from time to time into the open country, to carry off
booty, and they returned again almoft immediately.
When one furprifed a young booby that had no guard,
he gave it a violent peck on the back to make it difgorge,
which it inllantly did : it caft up one or two fiffi about
the bulk of one’s hand, which the old man-of-war bird
fwallowed dill more haftily. The vigorous ones play the
fame game with the old boobies which they find at fea.
I faw one which flew agninft a booby, and, with one ftroke
of its bill, made him deliver up a fiffi which he had juft
fwallowed. The man-of-war bird darted fo rapidly as to
catch it in the air before it could fall into the water.”

The boobies referable mod the cormorants in their
fnape and organization, except that their bill is not termi¬
nated in a hook, but in a point (lightly curved ; and the
upper mandible is articulated, as it were, and formed of
three pieces joined by tw'o futures ; the firft is traced near
the point, which therefore appears like a detached nail;
the fecond is lituated at the root of the bill near the
head, which enables the bird to raife the tip of its upper
mandible two inches, without opening the bill.

Thefe birds utter a loud cry, partaking of the raven
and of the goofe ; and this is heard particularly when
they are purfued by the frigate, or when, affembled to¬
gether, they are feized by fome fudden panic. In flying
they ftretch out the neck, and difplay the tail. They
cannot begin their motion but from fome lofty ltation,and

505

therefore they perch like cormorants. Dampier remarks*
that in the ifle of Aves they breed on trees,- though in
other places they neftle on the ground, and always a num¬
ber in the fame haunt ; for a community, not of inftinfifc
but of weakr.efs, feems to colleft them together. They
lay only one or two eggs. The young ones continue
long covered, for the molt part, by a very foft and white
down. The common booby is fometimes met with on the
Britifn fliores. It is of a middle fize, between the duck
and the goofe : its length, from the end of the bill to that
of the tail, is two feet five inches ; the bill is four inches
and a half, and its tail near ten. The naked flcin which
encircles the eye is yellow, and fo is the bafe of the bill,
whole point is brown. The legs are draw-coloured. The
fleffi is black, and has a marffiy flavour ; yet the failors
and marine adventurers often feed on it. Dampier re¬
lates, that a French fleet, being caft on the ifle of Aves,
partly fubfiiled on thefe birds ; and made fuck confump-
tion of them, that the number there has fince been much
diminilhed. They are found in great numbers not only
on the ifle of Aves, but in that ot Remire, and on a rock
(haped like a fugar-loaf, rifing apart in the fea, within
fight of Cayenne. Multitudes alfo occur on the iflets
which lie along the fliores of New Spain and Caracca.
The fame fpecies is met with on the coaft of Brazil, and
on the Bahama iflands, where, it is afferted, they lay and
breed every month of the year. What makes thefe birds
fo extremely numerous on thole (bores, is the incredible
fwarms of fifli which attract them : a perfon can fcarce let
down into the water a line with twenty or thirty hooks,
but he finds, on drawing it up, a fifli hanging from each.
This harmlefs helplefs creature is reprefented on Plate
II. fig. +.

30. Pelecanus fiber, the brown booby: body browniffi,
quill-feathers blackifii, face red; tail wedged. Bigger
than a mallard : length two feet or more; bill three in¬
ches and three quarters ; that and the legs red. It inha¬
bits Cayenne, and other parts of America, as well as l’e-
veral of the Weft-lndia iflands; and is found alfo in
Africa.

31. Pelecanus maculatus, the fpotted booby: brown,
fpotted with white ; below, white waved and fpotted with
brown ; bill, wing-quills, tail, and feet, brown. In this
fpecies, the wings are remarkably fliort, much more fo
than in any other of the known fpecies. It inhabits
Cayenne. Turton makes it a variety of the P. baffanus.

32. Pelecanus parvus, the little booby. This is the
fmalleft of the boobies, and meafures in length lcarcely
eighteen inches. The bill is pretty ftraight; and the
(pace round the eye not bare; the throat, breaft, and
belly, white; all the reft of the plumage duficy black.
This alfo inhabits Cayenne.

33. Pelecanus Sinenfis, the leu-tze, or Chinefe filbing-
corvorant : tail rounded ; body brown, beneath whitiffi
fpotted with brown; throat white, bill yellow, irids blue.
Inhabits China, and is there tamed for the purpofe of
catching fiffi. On a large lake, near that part of the Im¬
perial Canal where the river runs into it, fir GeorgeStaun-
ton faw “ thoufands of frnall boats and rafts built entirely
for this fpecies of fifhery. On each boat (land ten or a
dozen birds, which at a fignal from the owner plunge
into the water; and it is aftonifliing to fee the enormous
fize of the fi(h which thefe birds bring up. They appear¬
ed to be fo well trained, that it did not require either
ring or cord about their throats, to prevent them from
fwallowing any portion of their prey, except what the
mailer was pleafed to return to them for encouragement
and food. The boat ufed for this mode of filhing is re¬
markably light, and is carried on the (boulder to the lakes,
together with the fifhing-birds, by thofe who gain a live¬
lihood by this employment.”

PELECHU'CHO, a town of Peru, in the diocefe of
Cufco: thirty-fix miles north-north- weft of Caravava.

PELECl'NUS, J\ in botany. See Biserrula.

PELE'E,

3

\

506 PEL

PELE'E, a /mail ifland in the Englifh chafinel, near the
coaft of France: three miles north-eaft of Cherbnrg.
Lat. 49. 41. N. Ion. 1. 28. W.

PE'LEG, fon of Eber, was born in the year of the
world 1757. The Scripture fays, his father gave him the
name of Peleg , fignifying “divifion,” becaufe in his
time the earth began to be divided, (Gen. xi. 16. x. 25.)
whether it was that Noah had begun to distribute the
earth among his defendants, fome years before the build¬
ing of Babel; or that Peleg/came into the world the fame
year that Babel was begun, and at the divifion of lan¬
guages ; or that Eber by a fpirit of prophecy gave his fon
the name of Pelcg fome years before the tower of Babel
was begun ; is not abfolutely certain. That which here
perplexes the interpreters is, Firft, that Pelegcame into the
world not above 100 years after the deluge ; and it lhould
feem, that the number of men was not then fufiicient for
fuch an undertaking as that of Babel. Secondly, Joktan,
the brother of Peleg, had already thirteen fons at the
time of this difperfion, which happened after the confu-
fion of Babel ; (Gen. x. 26, 27, 28, &c.) Peleg being
born in the thirty-fourth year of Eber, (Gen. xi. 16.)
it is impoflible his brother Joktan (hould have fuch a
number of children at the birth of Peleg. It feems there¬
fore that he was not born at the time of the difperfion.
To this may be anfwered, that Moles has there enume¬
rated the names of the thirteen fons of Joktan (in Gen.
x. 26.) by way of anticipation, though they were not
born till a good while after the confulion at Babel; but,
as they poffeffed a very large country, it was convenient
to take notice of them, and to name them among the
other defcendants of Noah, who divided the provinces of
the eaft among thetnfeives. Enc>/. Brit.

PELEGRI'NO.an ifiand in the Pacific Ocean, difcovered
by Quiros in 1606. Lat. 14. S. Ion. 162. W. — Alio a
mountain on the north coaft of the ifland of Sicily, near
Palermo, in which is a celebrated fanCtuary dedicated to
St. Rofalia.

PEL'ENGON, orGELENGON, a town ofPerfia, in the
province of Lariftan : lixty-fix miles north-eaft of Lar.

PE'LF.S, a town of Sweden, in the province of Savo-
lax : forty-eight miles eaft of Nyflot.

PEL'ETHITES. The Pelethites and Cherethites
were famous under the reign of king David. They were
the moft valiant men in the army of that prince, and had
the guard of his perfon. See Ezekiel xxv. 16. Zepha-
niah ii. 5. 1 Samuel xxx. 14. 2 Samuel xv. 18. xx. 7.

PELETHRO'NII, a name or epithet given to the La-
pithae, either becaufe they inhabited the town of Pele-
thronium at the foot of Mount Pelion in Theflaly, or
becaufe one of their number bore the name of Peletliro-
nius. It is to them, we are told, that mankind are in¬
debted for the invention of the bit with which they tamed
their horfes with lo much dexterity.

PELETHRO'NIUM, a town of Theflaly, fituated in
a flowery part of Mount Pelion ; and hence the appella¬
tion throna , fignifying, “flowers.” Lucan fays the Cen¬
taurs were natives of that place; to whom Virgil affigns
Mount Othrys. Moft authors, however, afcribe the
breaking of horfes to the Centaurs. Some make the
Lapithae and Centaurs the fame; others a different
people; allow'ed, however, to be both of Theflaly.
Their (lory is greatly involved in fable. See Lapithus,
vol. xii.

PE'LEUS, in fabulous hiftory, a king of Theflaly, fon
of .CEacusand Endeis, the daughter of Chiron. He w\as
concerned in the murder of his brother Phocus, and was
therefore obliged to leave his father’s dominions. He fled
to the court of Eurytus the fon of ACtor, who reigned
in Phthia, (or according to the opinion of Ovid, the
truth of which is queftioned/to Ceyx, king of Trachinia.)
He was purified of his murder by Eurytus, with the ufual
ceremonies, and the king gave him his daughter Anti¬
gone in marriage. After this, as Peleus and Eurytus
went tothechace of the Calydonian boar, the father-in-

P E L

law was accidentally killed by an arrow which his fon. in¬
law had aimed at the beaft. This unfortunate accident
obliged him to banilh himfelf from the court of Phthia,
and he went to Iolchos, where he was alfo purified of the
murder of Eurytus by Acartus the king of the country.
His refidence at Iolchos was (hort : Aftydamia, the wife
of Acaftus, fell in love with him ; but, w’hen (he found
him infenfible toiler paffionate declarations, (lie accufed
him of attempts upon her virtue. The king her huf-
band partly believed the accufations of his wife ; but,
not willing to violate the laws of hofpitality, by putting
him inftantly to death, he ordered his officers to conduit
him to Mount Pelion, on pretence of hunting, and there
to tie him to a tree and leave him a prey to the wild
beads of the place. The orders of Acaftus were obeyed :
but Jupiter, knowing the innocence of his grandfon Pe¬
leus, ordered Vulcan to fet him at liberty. As foon as
lie had been delivered from danger, Peleus affembled his
friends in order to punifli the ill treatment which he had
received from Acaftus. He took Iolchos by force, drove
the king from his poffeffions, and put to death the wicked
Aftydamia.

On the death of Antigone, Peleus made love to Thetis,
of whole fuperior charms Jupiter himfelf had been ena¬
moured. His pretenfions were rejected ; for, as he was
but a mortal, the goddefs fled from him with the utmoft
abhorrence ; and, the more effectually to evade his inqui¬
ries, fhe generally affumed the (hape of a bird, or a tree,
or of a tigrefs. Peleus’s paflion was fanned by refufal :
lie offered a facrifice to the gods ; and Proteus informed
him, that, to obtain Thetis, he muft furprife her while (he
was afleep in her grotto near the (hores of Theflaly.
This advice was immediately attended to; and Thetis,
unable to efcape from the grafp of Peleus, at Iaft confent-
ed to marry him. Their nuptials were celebrated with
the greateft folemnity, all the gods attending, and making
them each the moft valuable prefents. The goddefs of
Difcord was the only one of the deities who was abfent,
and (lie punifhed this feeming negleCt by throwing an ap¬
ple in the midft of the affembly of the gods, with the in-
fcription of Detur pulchriori, “ To be given to the fair-
eft.” The celebrated Achilles was the fruit of this mar¬
riage, wliofe education was early entrufted to the Cen¬
taur Chiron, and afterwards to Phoenix the fon of Amyn-
tor. Achilles, it is well known, went to the Trojan war,
at the head of his father’s troops 5 and Peleus gloried in
having a fon who was fuperior to all the Greeks in va¬
lour and intrepidity. His death, however, was the fource
of great grief to Peleus ; but Thetis, to comfort her lmf-
band, promifed him immortality, and ordered him to re¬
tire into the grottoes of the ifland of Leuce, where he
(hould fee and converfe with the manes of his fon.

PEL'EW I'SLANDS, or Pala'os, a group of iflands in
the weftern part of the Pacific Ocean, or in that exten-
five divifion of the globe called Polynefia, fituated be¬
tween the Philippine Iflands and the Caroline Iflands.

Various conjectures have been formed refpeCting the
time of their firft difcovery by Europeans. Mr. Keate,
the editor of the only voyage in which we have any ac¬
count of their climate, foil, and produce, together with
the manners of their inhabitants, thinks they were firft
noticed by the Spaniards from the Philippines, and by
them named Palos from the number of trees growing in
them refembling the mafts of (hips. This conjecture
has been vehemently oppofed by a critic, who affirms that
the whole of Mr. Keate’s introduction is erroneous, and
that the iflands in queftion were firft difcovered by fome
Jefuits of the Philippines, viz. the fathers Duberon and
Cortil, wdio left the Philippines for this purpole on the
14th of November, 1710. Before this time, it was only
known, that the largelt ifland, which was the moft north¬
erly, was called Panlog, and that the royal refidence was
in Falu or Pelew. After a voyage of fifteen days thefe
fathers difcovered land towards the north-eaft; and the two
ides that were feen were called thofe of St. Andrew, as hav¬
ing

P E L E W

ing been difcovered on the day of that apoftle. From fome
Peiewans, whom they accofted, they received information
that the true name of thefe ifles was Sonforol: that Pan¬
log was to the north-north-eaft, and Pulo to the fouth-
fouth-eaft. Panlog was afterwards difcovered about fifty
leagues from Sonforol, in lat. 7. 14. N. This feems to he
the ifiand now called Babelthouap, and the largeft of the
group, the fouth extremity of which in Arrowfmith’s maps
is about lat. 7. 25, Father Cantova’s letter, dated 1722,
and contained in the collection entitled Lettres Edifiantes ,
gives a brief account of the Pelews, and very unjuftly
reprefents the natives as cannibals. By his account, the
group called the Palaos or Pelews, confifted of feven
principal ifles, fituated from north to fouth. Their
names were Pelilieu, Coaengal, Tagaleteu, Cogeal, Yalap,
Mogulibee, and Nagarrol; the king was called Yaray,
and refided in Yalap. The natives were defended by the
jefuits as naked cannibals, who were regarded with hor¬
ror by the people of the Carolines.

It was not till the year 1783, that we were able to ob¬
tain a juft account of thefe iflands, and of their inhabitants.
When' captain Wilfon, commander of the Antelope
packet, in the fervice of the Eaft India Company, was
wrecked on one of thefe iflands, he derived that informa¬
tion which was communicated on his return to Mr.
Keate; and this ingenious writer, indulging perhaps in
fome degree the glow of his feelings and imagination,
drew up that very pleafing and interefting account,
which, from its firft publication, has paSTed through feve-
ral editions. The whole group is faid to contain eigh¬
teen iflands ; but thofe which Mr. Keate mentions are
Oroolong, Artingall, Pelelew', Emilligue, Emunga, Ara-
inalorgco, Arraguy, Caragaba, and Pethoull : but the
names of all were not difcovered ; and it was but lately
known thatPelew was only the name of the capital of
the island called Cooroora, and the refidence of the
king.

From Mr. Keate we learn that the natives of thefe
iflands, fo far from being favage cannibals, were remark¬
ably mild, hofpitable, and humane. The crew of the
Antelope confifted of thirty-three Europeans befides the
captain, and fixteen Cbinefe ; and the only pofiible
means by which they could be delivered from an ifland,
which at firft appeared to them uninhabited, was by
building a Ship capable of tranfporting them to the near-
eft European fettlement in that quarter of the globe.
Whilft they were meditating ujton this undertaking, the
natives appeared on the fecond day after their arrival ; and
their intercourfe with them was facilitated by means
which-appear as fingular as they were providential. Cap¬
tain Wilfon had a fervant recommended to him at Macao,
vvhofpoke both the Malay and Englifh languages perfectly
well ; and they had not been long at Pelew before they
had the good fortune to meet with a Malay, who had been
thrown by a tempeft upon this very fpot about a year be¬
fore, and had made himfelf acquainted with the language
of the country ; fo that by this extraordinary event each
party had an interpreter who could readily explain their
wants and defires.

After fome time it was agreed on by Captain Wilfon
and his people, that fome of the crew (hould be fent to
the king of the place, in order to folicit his friendlhip,
and intreat his permission to build a veflel that might
carry them back to their own country. This buiinefs
was allotted to the captain’s brother ; and during his ab-
fence, Raa Kook, the king’s brother, and feveral of the
natives, remained with our people. This amiable chief
feemed to place an entire confidence in thofe he was
among: he endeavoured to accommodate himfelf to
their manners; would fit at table as they did, inftead of
Squatting on his hams ; and inquired particularly into
the principles and caufes of every thing he obferved about
him, lending his perfonal affiftance in all that was going
forward, and even defiring the cook to let him aid him in
blowing the fire.

Vol, XIX. No. 1320.

ISLANDS. 507

In order to conciliate their affeCtions, Captain Wilfon
had presented Arra Kooker, another of the king’s bro¬
thers, with a pair of trowfers ; but, having conceived a
greater pafiion for a white ftiirt, one was immediately
given to him ; which he had no fooner put on, than
he began to dance and jump about with fo much joy,
that every body was diverted by his fingular geftures,
and the contrail which the linen formed with liis (kin.
This prince was about forty, of a Ihort ftature, but i o
plump and fat that he was nearly as broad as he was long.
He poflefied an abundant fliare of good humour, and a
wonderful turn formimickry; and had befides a coun¬
tenance fo lively and expreffive, that, though our people
at this time were ftrangers to almoft all he faid, yet his
face and geftures made them accurately comprehend
whatever he was deferibing.

After three or four days, Abba Thulle, the king, ar¬
rived with a great retinue. He was received with every
mark of refpedt by the ihip’s company, who were exer-
cifed before him, and fired three volleys in different po-
fitions. The furprife of the natives, their hooting, hal¬
looing, jumping, and chattering, produced a noife al-
inoft equal to the difeharge of the muSkets ; and, when one
of the men fiiot a bird, which was done to difplay the ef¬
fect of their arms, the furprife it occafioned was wonder¬
ful. Some of the natives ran for it, and carried it to the
king, who examined it with great attention, but was una¬
ble to comprehend how it could be wounded, not having
feen any thing pafs out of the gun.

The king then viiited the different tents, and inquired
about every thing he law: all was novelty, and of courle
interefted his attention. When begot to the tent where
the Ciiinefe men were, Raa Kook, whofe retentive mind
never loft a fingle trace of any thing he had been informed
of, acquainted the king that thele were a people quite
different from the Englifii, and that he had learnt there
were many other nations befides thefe interfperfed
through the world, fome of which fought with guns, and
others with boarding-pikes, an inftrument which he held
very cheap in comparifon with the former. When the
king heard his brother difeourfing about a variety of na¬
tions, who all fpoke differently, and had before him the
example of the Chinefe, whofe language was not the fame
with the Englifh, he appeared inftantly thoughtful and
ferious, as if ltruck with conceptions which had never be¬
fore crofted his mind. He remained a while penfive and
bewildered ; and this circumftance itnprefied on every one
at the time an idea that there was every reafon to ima¬
gine that there had never been a communication between
thofe people and any other nation : and indeed it is evi¬
dent, that, if the Jefuits did really vifit them in 1710, they
had before 1783 loft the remembrance of every trace of
European manners.

Some time after this, the king requefted five of Cap¬
tain Wilfon’s men to attend him in a war he was going
to make againft the inhabitants of a neighbouring ifland
called Oroolong, who, as he faid, had done him an injury.
In this enterprife little more was done than braving their
enemies, Stripping fome cocoa-nut trees of their fruit, and
carrying off’ a number of yams and other provisions; but
in another, which was undertaken againft the ifland of
Artingall, they were more fuccefsful, and Showed figns of
the fame Sanguinary difpofition which fome demon has
infufed into the whole human race. Nine prifoners of
war who had been taken upon this occafion were cruelly
put to death ; and, notwithstanding the English Strongly
remonstrated againft this proceeding, all the arguments
they could ufe were of no avail. In justification of their
conduft, they alleged the neceflity of doing it for their
own fecurity, declaring that they had formerly only de¬
tained them as menial fervants, but that they always
found means to get back to their own country, and
return with fuch a force as frequently made great de¬
predations.

Having given this general account of the charaCterand
6 O conduit

508

P E L E W ISLANDS,

conduit of thefe hitherto-unknovvn people, we now pro¬
ceed to lay before our readers what we have learned of
their government, cuftoms, manners, and arts; together
with a defcription of the face of their country. In this
■ the editor of Captain Wilfon’s Voyage mult be our guide;
and, if our narrative do not fatisfy the man of fcience, it.
is to be obferved, that the Antelope was not a ftiip
lent out purpofely to explore undifcovered regions, nor
were there people on-board properly qualified to eftimate
the manners of a new race of men ; they had amongft
them no philofophers, botanifts, or draughtfmen, expe¬
rienced in fucli fcientific purfuits as might enable
them to examine with judgment every objeit which pre-
fented itfelf. Diftrefs threw them upon thefe iflands ;
and, while they were there, all their thoughts were occu¬
pied on the means of liberating themfelves from afituation
of all others the moll affliifingto the mind, that of being
cut off for ever from the fociety of the reft of the world.

It however clearly appears, from their uniform tefti-
mony, that at Pelew the king was looked up to as the
father of his people; and, though diverted of all external
decorations of royalty, had every mark of diftindtion paid
to his perfon. His rupacks, or chiefs, approached him
with the greateft refpedl ; and his common fubjedts,
whenever they parted near him, or had occafion to addrefs
him, put their hands behind them, and crouched towards
the ground. Their councils were always held in the
open air, where the king firft ftated the bufinefs upon
which he had afi'embled them, and fubmitted it to their
confideration. Each rupack delivered his opinion, but
without rifing from his feat ; and, when the matter be¬
fore them was fettled, the king ftanding up put an end
to the council. When any meffage was brought him,
whether in council or elfewhere, if it came by one of the
common people, it was delivered at fome diftance in a
low voice to one of the inferior rupacks, who bending in
an humble manner at the king’s fide, delivered it in the
fame manner with his face turned. afide. His commands
appeared to be abfolute, though he adted in no important
bufinefs without the advice of his chiefs; and every day
in the afternoon, whether he was at Pelew or with the
Englifli, he went to fit in public for the purpofe of hear¬
ing any requefts, or of adj ufting any difference or dif-
pute which might have arifen among his fubjedls. But
thefe, according to our editor, feldom happened ; for, as
their real wants were but few, and they faw nothing to
create artificial ones, every one wras chiefly occupied with
his own humble purfuits; and, as faras the fhip’s crew, who
remained among them about three months, could decide,
they appeared to conduct themfelves towards each other
with the greateft civility and benevolence ; never wrang¬
ling or entering into quarrelfome contentions, as is cuf-
tomary among thole who call themfelves a polifhed and
enlightened people. Even when children fliowed a dif-
polition of this kind, they llrongly marked their difplea-
fure, by flirting with rebuke their little animofities.

Next in power to the king was his brother Raa Kook,
who was official general of all his forces. It was his duty
to fummon the rupacks to attend the king for whatever
purpofe they were wanted. He was alfo his prefumptive
heir; the fucceffion of Pelew not going to the king’s
children till it had parted through his brothers ; fo that
after the demife of Abba Thulle, the fovereignty would
have defcended to Raa Kook ; on his demife to Arra
Kooker ; and on the death of this laft it would have re¬
verted to Qui Bill, the king’s eldeft fon, when Lee Boo,
liis fecond fon, of whom we have much to fay, would have
become the hereditary general.

The office of firft minifter is defcribed as follows:
c‘ The king was always attended by a particular chief or
rupack, who did not appear to pofl'efs any hereditary of¬
fice, but only a delegated authority. He was always near
the king’s perfon, and the chief who was always firft
confulted ; but, whether Ids office was religious or civil,
or both, our people could not learn with any certainty.
He was not confidercd as a warrior, or ever bore arms,

and had only one wife, whereas the other rupacks had
two. The Englifli were never invited to his houfe, or
introduced into it, although they were conducted to
thofe of almoft every other chief.” Of the other rupacks
it is obferved “That they could only be regarded as
chiefs or nobles ; they were not all of the fame degree,
as wras plain by a difference in the bone they wore : this
was a mark of rank worn upon the wrift, with which
Captain Wilfon was inverted by the king; but what
animal it came from, our people could not iearn. They
generally attended the king, and were always ready at
his command to accompany him on any expedition with
a number of canoes properly manned, and armed with
darts and fpears, who were to remain with him till they
had his permiffion to return home with their dependents.
In this part of their government we may trace an outline
or the feudal fyftem ; but, from the few opportunities our
people had of inveftigating points of internal government,
it appeared that the titles of rvpaclis were perfonal badges
of rank and diftindtion ; nor did they apprehend they
were hereditary honours, unlefs in the reigning family,
who muft of neceffity be of this clafs.”

Thefe iflands are in general of a moderate height, and
covered with wood ; and encircled on the weft fide by a
reef of coral, from two to fix leagues from the fliore, and
of great length. Cooroora, the capital of which is Pe¬
lew, bears the marks of induftry and good cultivation.
All the iflands which the Englifli faw were covered with
trees of various kinds, and fome of them of large fize,
which appeared from their canoes, made of their trunks,
and capable of carrying twenty-eight or thirty men.
Among the trees in the foreft, they obferved the ebony,
and alfo a tree which, when pierced with a gimblet,
yielded a juice of the confiftence of cream; a fpecies of
the manchineel tree; a tree in fize and its branches refem-
bling the cherry-tree, and in its leaves the myrtle, and
having, inftead of bark, an outward coat of the thick-
nefs of a card, darker than the iniide, though equally
clofe in texture, the colour of the interior part being
nearly that of mahogany, and fo extremely hard, that few
of the tools which the Englifli had could work it with¬
out breaking their edges. Here were alfo the cabbage-
tree, and a tree whofe fruit refembled an almond ; the
carambola, and the wild bread-fruit, called by the na¬
tives riafna.il. Yams and cocoa-nuts, being the chief
means of fubliftence, are objects of particular attention.
Of the beetle-nut, which abounds, the natives make
great ufe ; and their iflands alfo afford plantains and ba¬
nanas, Seville oranges, and lemons. They furnifli fome
fugar-canes, great abundance of the bamboo, and like-
wife the turmeric, ufed as a dye, and -employed by the
women for rtaining their fkins. None of the iflands
which the Englifli vifited afforded any kind of grain, nor
any fort of quadruped, except fome rats, which were
found in the woods, and three or four meagre cats found
in the houfe, and which were probably drifted afhore
from fome wreck. Of birds, pigeons were the moft nu¬
merous; and they had plenty of cocks and hens, undo-
mefticated and running wild in the woods, of which they
had made no ufe as articles of food till they were in-
ftrudted by the Englifli to eat them. Several birds of
beautiful plumage were obferved to fly about, and fome
of a fmall fize, whofe notes were very melodious, and par¬
ticularly one, which .ufed to ling every morning and even¬
ing, with a pipe as fweet as a flageolet. Of fiili they had
great variety.

Thefe iflands, when feen from the fea, exhibit high
rugged land, covered with wood; the interior parts were
in many places mountainous, but the valleys were exten:
five and beautiful, and prefented many agreeable prof-
pedts. The foil was in general rich ; the grafs, as no
cattle ate it down, grew high, and was burnt up with the
heat of the fun. The Englifli faw no river in thefe
iflands; their lupplies of frefli water were derived from,
fmall ftrearns and ponds, of which there were many.
They had no fait, or any kind of feafoning with their

food.

PELEW 1

food, which confided chiefly of fifli ; and they had alfo a
kind of fweetmeats, which they prepared from the fugar-
cane, which feemed to be indigenous. The milk of the
cocoa-nut was their ufual beverage. They had no me¬
thod of meafuring time, but by the height of the fun ;
and they divided their feafons, like the inhabitants of
other tropical countries, into wet and dry. They ap¬
peared to have fome knowledge of the ftars, to feveral of
■which they gave names. Thofe iflands that were vifited
by the Englifli appeared to be populous, but the account
of their population was not afcertained. Their houfes
were placed upon large ftones, and railed about three feet
from the ground ; being conftrufted of planks and bam¬
boos, and having the fire-place in the middle, fee u red
with hard rubbifh. Their fifhing- hooks were of tortoife-
fhell: their twine, cord, and filhing-nets, were well manu¬
factured from the hulks of the cocoa-nuts. Th.e mats
on which they flept, and which they threw over them at
reft, were formed of plantain-leaf. At their meals they
ufed a plaintain-leaf inftead of a plate, and the (hell of a
cocoa-nut ferved them as a cup, which they fometimes
finely polilhed. Their beft knives were of mother-of-
pearl, and others of a large mufcle-lhell, or fplit bamboo,
They had alfo veflels of an oval lhape and reddifti- brown
colour, which were a kind of earthen-ware, and which
they ufed for heating their water, and for boiling their
fifli, yams, See. The principal weapons ufed in their
battles were fpears, about twelve feet long, formed of
the bamboo, having its pointed end of very hard wood :
thefe were barbed tranfverfely, nor could they be drawn
from the body without lacerating the flelh. Another
weapon was the dart and fling; the fling was a piece of
wood about two feet long, with a notch made in it,
wherein the head of the dart was fixed. The dart was of
bamboo, pointed with extremely hard wood. Their ca¬
noes were formed of the trunks of trees, and neatly orna¬
mented.

The natives of thefe i (lands are a. flout well-made
people, rather above the middling ftature ; their com¬
plexion is of a far deeper colour than what is under-
flood by the Indian copper, but . not black. They are
mild, affable, and indurtrious, and, like the inhabitants
of Otaheite, they form an exception to the general rule
of favage exiftence. Their hair is long and flowing, ra¬
ther difpofed to curl, which they rnoftly form into one
large loofe curl round their heads: fome of the women,
who wore remarkably long hair, let it hang loofe down
their backs. The men were entirely naked : the women
wore only two little aprons, or rather thick fringes, one
before and one behind, about ten inches deep and feven
wide: thefe were made of the hulks of the cocoa-nut
ftripped into narrow flips, which they dyed with different
(hades of yellow : this, which was their only drefs, they
tied round their waifts, commonly with a piece of line,
though fuch as were of higher rank ufed a ft ring of fome
kind of beads. Both men and women were tattooed, or, as
they called it, melgothecl ; an operation which is fuppofed
to have taken place at a certain period of youth, children
of either fex not being marked by it. The men had their
left ear bored, and the women both : a few of the firft
wore beads in the perforated ear; the latter put either
fome leaf through, or an ear-ring of tortoife-(hell inlaid.
The cartilage between the noftrils was alfo bored in both
fexes, through which they frequently put a little fprig or
blofibm of fome plant or ftirub that accidentally caught
their fancy. When the men and women grew up, their
teeth were blacked, which was done by means of fome
dye; and the operation was tedious and painful. For
this purpofe they ufed groundfel, with four other
herbs, bruifed together, and mixed with a little chinam
into a pafte, which was applied to the teeth every
morning, in order to dye them black ; the patients
lying with their heads upon the floor, and letting the
laliva run out of their mouths. At night the pafte
■was taken away, and they were permitted to eat a lit-

S L A N D S. 509

tie. The fame procefs was Repeated the day follow,
ing 5 and five days were neceflary to complete the opera¬
tion. This occafioned great trouble, and made them
extremely fick.

Perfons of both fexes were very expert at fwimming,
and appeared to be as perfectly at eafe in the water as on
land. The men were admirable divers. Their marriages
were probably no more than a civil contract, but at the
fame time the contract was regarded as inviolable. They
allowed a plurality of wives, but in general had not more
than two : the king had five, though not living together.
They did not appear to be in any degree jealous of them,
permitting them to partake of all their diverfions. When
a woman was pregnant, (he always feparated from her
hufband at night, and it was obferved that the utmoft
attention was paid to women in that fituation. Their
children are named foon after they are born, and proba¬
bly without any ceremony. Some peculiar circum-
ftances attended their funerals. At the place of inter¬
ment, an elderly woman was obferved to get out of the
new-made grave, who was fuppofed by thofe who attend¬
ed to be the mother or fome near relation, who had been
drawn by affeCtion to the melancholy feene, in order to
be fatisfied that every thing was duly prepared. When
the corpfe was laid in the earth, the lamentation of the
women that attended was very great. Thefe laft fad offices
feemed to be wholly left to the tendernel's of the weaker
fex : the men only alfembled round the body before it was
carried to the grave, where they preferved a folemn filence.
They had places appropriated to fepulture. Their graves
were made like ours in country church-yards ; having the
mould raifed up in a ridge over the place where the
body was depofited, fome flat ftones raifed above them,
with a flat one laid horizontally over, and furrounded by
a kind of hurdle-work, to prevent any one from treading
over them.

On the article of religion the editor obferves, that our
people during their continuance with the natives of Pe-
lew, never law any particular ceremonies, or obferved
any thing that had the appearance of public worfliip.
But it would perhaps be going too far to declare that the
people of Pelew had abfolutely no idea of religion. A
few occurrences, which are mentioned in the courfe of
the narrative, would lead us to believe that they could
not be altogether unacquainted with the nature of reli¬
gious worfliip ; for, when they were prefent at the public
prayers of the Englifli, they exprefled no furprife at what
was doing, but feemed defirous to join in them, and con-
ftantly preferved the mod profound filence. The general
even refufed to receive a meflage from the king which
arrived during divine fervice. And upon another occa-
fion, when Captain Wilfon told Lee Boo, that good men
would live again above, he replied, with great earneftnefs,
“ All fame Pelew : bad men flay in earth ; good men go
into (ky; become very beautiful holding his hand up,
and giving a fluttering motion to his fingers.

The mod wonderful circumftances in the hiftory of this
people, are the acutenefs of their underftanding, their
hofpitality, and the implicit confidence which they placed,
in utter Strangers. That their manners were pleafing,
and their fociety not difagreeable, is evident from the
conduit of-Madan Blanchard, one of the feamen, who,
when the veflel was built and ready to take her departure
with his captain and his companions, was left behind at
his own particular requeft. That they had the fulled
confidence in Capt. Wilfon and his crew, is put beyond a
doubt by the behaviour of the king and Raa Kook
when their guefts were to leave them. Raa Kook foli¬
ated his brother’s permifiion to accompany the Englifli,
but from prudential motives was refufed. The Sove¬
reign, however, rel'olved to entruft his fecond fon Lee
Boo to Capt. Wilfon’s care, that he might improve his
mind, and learn fuch things as at his return would bene¬
fit his country.

The inltruCtions which he gave the young man, and

the

P E L E W ISLANDS.

510

the fortitude which he (bowed upon this occafion, w'ould
have done honour to the moft enlightened mind. Upon
delivering him to Capt. Wilfon, he ufed thefe expreflions :
“I W'ould wifh you to inform Lee Boo of all things
which he ought to know, and make him an Englifhman.
The fubjefilof parting with my fon I have frequently re¬
volved ; I am well aware that the diftant countries he
mult go through, differing much from his own, may ex-
pofe him to dangers, as well as difeafes, that are unknown
to us here, in confequence of which he may die ; I have
prepared my thoughts to this ; I know that death is to
all men inevitable ; and whether my fon meets this event
at Pelew or elfewhere is immaterial. I am fatisfied, from
w'hat I have obferved of the humanity of your character,
that, if he is fick, you will be kind to him ; and, fhould that
happen which yourntmofl care cannot prevent, let it not
hinder you or your brother, or your fon, or any of your
countrymen, returning here ; I (hall receive you, or any
of your people, in friendfhip, and rejoice to fee you again.”
This is the language of a king, a father, and a philofo-
pher, who would have been delighted to fee his fon with
European accomplifhments. But, alas! the fubfequent
hiftory of this amiable youth mud force a tear from the
eye of every reader whofe heart is not callous to the ge¬
nuine feelings of nature and humanity.

As foon as they arrived at Macao, the houfe into which
he fir ft entered, and the different articles of furniture,
fixed him in filent admiration ; but what (truck his ima¬
gination moft was the upright w>alls and fiat ceilings of
the rooms, being utterly unable to comprehend how they
could be fo formed. When he was introduced to the la¬
dies of the family, his deportment was fo eafy and polite,
that it could be exceeded by nothing but his abundant
good-nature ; and at his departure, his behaviour left on
the mind of every one prefent the imprefiion, that, how¬
ever great the furprife might be which the fcenes of a new
world had awakened in him, it could hardly be exceeded
by that which his ow n amiable manners and native polifh
would excite in others.

They were now conducted to the houfe of an Englifh
gentleman, who introduced them into a large hall, which
was lighted up, with a table in the middle, covered for
fupper, and a fideboard handfomely decorated. Here a
new' fcene burft at once upon Lee Boo’s mind : he was all
eye, all admiration. The veflels of glafs particularly ri-
vetted his attention ; but, when he furveyed himfelf in a
large pier-glafs at the upper end of the hall, he was in
raptures with the deception. It was in truth, to him, a
fcene of magic, a fairy tale.

Soon after the people of the veflel came on-fhore, fome
of them went to purchafe things they were in want of ;
in doing which they did not forget Lee Boo, who was a
favourite with them all. Among the trinkets they
brought him was a firing of large glafs beads, the firft
fight of which almoft threw him into an ecftacy; he hugged
them with a tranfport which could not have been ex¬
ceeded by the interefted pofieffor of a firing of oriental
pearls. His imagination prefented to him that he held
in his hand all the wealth the world could afford him.
He ran with eagernefs to Capt. Wilfon to (how him his
riches, and begged he would get him a Chinefe veflel to
carry them to the king his father, that he might fee what
the Englifh had done for him ; adding, that if the people
faithfully executed their charge, 'he would at their return
prefent them with one or two beads as a reward for their
Cervices.

Having no quadrupeds at Pelew, the flieep, goats, and
other cattle, which he met with at Macao, were viewed
with wonder ; but foon after, feeing a man pafs the houfe
on horfeback, he was fo much aftonifhed, that he wanted
every one to go and look at the llrange fight. After
the matter, however, was explained to him, he was
eafily perfuaded to get upon horfeback himfelf ; and when
he was informed what a noble, docile, and uf'eful, animal

it was, he befought the captain to fend one to his uncle
Raa Kook, as he wras fure it would be of great fervice to
him.

Omitting a number of other particulars of this kind,
which excited his curioflty and fliowed the excellent dif-
pofition of his heart, we (hall follow him to England,
the country from which he was never to return. Here
he had not been long before he was fent to an academy,
to be inflrudled in reading and writing, which he was
extremely eager to attain, and moft afliduous in learn¬
ing. His temper was mild and compaftionate in the
higheft degree ; but it was at all times governed by dis¬
cretion and judgment. If he faw the young afking relief,
he would rebuke them with what little Englifh he had,
telling them it was afhameto beg when they were able to
work; but the intreaties of old age lie could never with-
ftand, faying, “ Mull give poor old man, old man no able
to work.”

He always addrefled Mr. Wilfon by the name of Cap¬
tain, but never would call Mrs. Wilfon by .any other
name than Mother, looking on that as a mark of the
greateft refpedl; and, fuch was the gratitude of his heart
for the kindnefs they fhowed him, that, if any of the fa¬
mily were ill, he always appeared unhappy, would creep
foftly up to the chamber, and fit filent by the bedfide for
a long time together without moving, peeping gently
from time to time between the curtains, to fee if they flept
or lay Hill.

He was now proceeding with liafly ftrides in gaining
the Englifh language, writing, and accounts, when he
was overtaken by that fatal difeafe, the fmall-pox, which
the greateft pains had been taken to guard him againft ;
and, notwithftanding the utmoft care and attention of his
phyfician, he fell a vi6llm to this fcourge of the human
race. Upon this trying occafion, his fpirit was above
complaining, his thoughts being all engrofled by the
kindnefs of his benefadtors and friends. He told his at¬
tendant that his father and mother would grieve very
much, for they knew he was lick. This lie repeated
feveral times, “ and begged him to go to Pelew, and
tell Abba Thulle that Lee Boo take much drink to
make fhiall-pox go away; but he die; that the captain
and mother very kind ; all EngiiPn very good men ;
much lorry he could not fpeak to the king the number
of fine things the Englifh had got.” Then he reckoned
up the prefents which had been given him, defiring that
they might be properly dillributed among the chiefs, and
requefling that particular care might be taken of two
glafs pedeftals, which he begged might be prefented to
liis father.

We have given this fhort hiftory of Lee Boo, becaufe
it exhibits in a ftrong light the manners of the natives of
the Pelew iflands, to which we know nothing fimilar in
the hiftory of man from the favage flate to that of civili¬
zation. They appear to have had no communication
with any other people ; and were yet neither treacherous,
cruel, nor cowardly. They are a ftriking inflance of the
weaknefs of all the philofophic theories by which man¬
kind are ufually traced from their origin through the fe¬
veral flages of favagifm, barbarifm, and civilization, down
to the period of refinement, ending in effeminacy.

Since the publication of Capt. Wilfon’s voyage we have
fome further accounts of thefe iflands, all confirming
what we were firft told of the gentlenefs of the people.
Two armed (hips were, by order of the courr of directors,
fitted out at Bombay, for the purpofe of furveying the
iflands of Pelew, and furnifhing the natives with doinef-
tic animals, and fuch other things as might add to the
comforts of life. Among the prefents to the king were
fwords and other European implements of war; of which'
it is at lead poffible that he and his people might have
been equally happy had they remained for ever in total
ignorance. The foundation of a fort was likewife laid on
one of the iflands, and pofleflion of it taken in the name

PEL

511

PEL

of the Englifti ; we trull with no remote view of enflaving
the people, or of driving them from their native country.

The following is the fequel of the adventure here al¬
luded to. The two veffels called the Panther and Endea¬
vour, under the command of Capt. M'Cluer, were fitted
out for a voyage to the Pelew iflands, to acquaint Abba
Thulle the king with the death of his favourite fon Lee
Boo. On the 24th of Augull, 1790, Capt. M'Cluer
failed from Bombay, having on-board Meflrs. White and
Wedgeborough, who had been fhipwrecked with Capt.
Wilfon, and were much edeemed by the king of thofe
iflands, at which he arrived in January 1791. Abba
Thulle, the king, received them with demonflrations of
joy, as Englifhmen of whom he had previoufly found
reafon to entertain a very favourable opinion. The pre-
fents which the company fent to Abba Thulle were land¬
ed with all convenient fpeed. Thefe confided of a con-
fiderable quantity of live flock, fuch as cows, bulls,
ewes, rams, goats, pigs, and poultry, together with arms,
ammunition, and packages of hardware, comprifing a
number of articles which could not fail to be of lingular
advantage to the natives. The grateful king was ado-
nifhed at the meaning of all thi^; and, being informed
that it was a fmall acknowledgment for his generous
treatment of the crew of the Antelope when wrecked on
his coaft, he expreffed his regret that it was not in his
power to have done more.

With the nature and fituation of thefe iflands, as well
as the amiable and engaging manners of the natives,
Capt. M‘Cluer was lo well pleafed, that he confidered
them as a paradife, where he could fpend with pleafure
the remainder of his days. The Panther failed in the
month of February from the Pelew iflands for China, the
Endeavour remaining behind till her return, which hap¬
pened on the 10th of June the fame year. Having vifited
thefe iflands a third time, after a furvey of the coafl of
New Guinea, Capt. M'Cluer formally fignified to the of¬
ficers of the Panther his intention of refigning the com¬
mand of the expedition, and remaining on the ifland.
To render his new fituation as comfortable as poflible,
he requefled from Mr. Wedgeborough about twenty nnif-
kets with bayonets, twelve piflols, twelve pole-axes, two
wall-pieces, fufil and piflol ammunition, an anvil, bellows,
frame-faw, flanding vice, &c. After a confutation with
the other officers, it was agreed to fend him thefe ar¬
ticles, on condition that they fhould be accounted for by
his attorneys, if the Eafl India Company fhould not be
fatisfied with the meafure. This relblution was carried
into effedl in the month of February 1793. Scarcely,
however, had he been fifteen months in his new fettle-
ment, when he became impatient to abandon it ; and he
foon after fet fail for Macao. He returned to the Pelew
iflands in the year 1795, for the purpofe of removing his
family ; and, failing from thence to Bombay, he touched
at Bencoolen, where he met with a frigate bound for
Bombay, into which he put a part of his family with fix
Pelew women, failing himfelf with the other natives to¬
wards Bengal, from which lafl place he fet fail fome time
after ; but neither he nor any of his crew have been fince
heard of. The iflands lie between lat. 6. 54. and 8. ta.
N. and between Ion. 1 34. 5. and 1 34. 40. E.

PELF, f. [in low Lat. pelfra, not known whence de¬
rived.] Money ; riches ; in contempt. — The thought of
this doth pafs all worldly pelf. Sidney.

I read thee rafh and heedlefs of thyfelf,

To trouble my Hill feat and heaps of precious pelf. Sp.
To the poor if he refus’d his pelf,

He us’d them full as kindly as himfelf. Swift.

Pelfray feems to have been the old original word. —
Indulgences, beades, pardons, pilgremages, and fuche
other pelfray. Crammer's Anfwer to Gardiner.

PEL'HAM, a town of North America, in Maflachu-
fetts : twelve miles north-eafl of Northampton. — A town
of New Hampfhire: thirty-fix miles north of Boflon.

Vol. XIX. No. 1321.

PEL'HAM. See Perouain.

PEL'HAM AR'SA, or Brent, Pelham Furneux, and
Pelham Stokin, are three villages in Hertfordfhire, on
the borders of EfTex, and near Saffron Walden, which
have each their church. The firft is neared to Clavering,
between Pelham Furneux and Cockenhatch. Pelham
Furneux, to the fouth-eafl of Hormeads. Pelham Sto¬
kin lies a little to the ead of the latter. Thefe three
villages were but one at the time of William the Con¬
queror.

PELHES'TRE (Peter), a learned French writer in
the department of ecclefiadical hidory, was a native of
Rouen, where he was born about the year 1645. At a
very early age he was infpired with the love of learning,
and he devoted his whole life to dudious purfuits. In
his courfe of reading, he did not confine himfelf to the
perufal of fuch authors as are fanftioned with the appro¬
bation of the Catholic church, but alfo freely confulted
the writings of Protedants. Having come to Paris at
the age of feventeen or eighteen, M. de Perefixe, who
was then archbifhop of that fee, fent for him, and faid,
“ I am informed, fir, that you read the works of here¬
tics : are you fufficiently learned to venture on fuch a
dangerous praftice ?” To which the young man replied,
“ Your quedion, my lord, greatly embarrafies me: for,
were I to anfwer in the affirmative, you might charge me
with prefumptuous vanity ; and, fhould I fay that I have
not fufficient learning, you would prohibit me from read¬
ing fuch books.” Pleafed with the ingenuity which he
difcovered, the archbifhop laid him under no reftriftion.
For fome time M. Pelhedre wore the ecclefiadical drefs,
and officiated in the inferior clerical orders, particularly
in Languedoc, as a miffionary for the converfion of pro¬
tedants to catholicifni. Afterwards he refumed the ha¬
bit of a layman, which he did not change upon his ap¬
pointment to the place of fub-librarian in the great con¬
vent of the Cordeliers at Paris. His motive for accept¬
ing of this pod, was the unredrained accefs which it gave
him to a valuable library. He vifited modof the religious
folitudes in France, and fpent fome time in that of Per-
recy in the Charolois ; but he told his friends, that, were
he to feclude himfelf entirely from the world, he fhould
make choice of one of the principal monaderies on mount
Athos, for the advantage of confulting the numerous
Greek manufcripts which they poffefs. When he had
any particular fubjedt in hand, it was ufual for him to
fhut himfelf up in a room from which daylight was ex¬
cluded, and there, wrapped up in a coverlet, and feated
in a large armed chair fluffed with draw, he applied in-
ceflantly, day and night, excepting when nature called
for red or refrefhment, till his labour was finifhed. He
died fuddenly in 1710, when about 65 years of age. He
was a man of prodigious reading, and particularly con-
verfantin theological controverfy, and the knowledge of
ecclefiadical authors. He wrote a fevere criticifm on va¬
rious paflages in M. Dupin’s Bibliotheque des Auteurs
Ecclefiadiques, and filled all the margins of Cave’s Hif-
toria Literaria with notes. The manufcripts of thefe
performances are faid to have fallen into the hands of
BenediSHnes, to whom they would prove ufeful in their
editorial and critical undertakings. He was the author
of the numerous additions and valuable notes to the fe-
cond impreffion of Father Bonaventure’s “Treatife on
the mod proper Method of Reading the Fathers of the
Church,” 1697, in a large izmo. volume. He revifed
the French verfion of “ the Letters of St. Paulinus,” pub-
liflied in 8vo. under the name of Claude Fraffen, a Cor¬
delier, but really executed by Claude deSanteul, brother
to the poet of that name ; and he was alfo for a long time
a confiderable contributor to the “Memoires de Tre-
voux.”

PELI'ALA, in ancient geography, a town of Alia, in
Mefopotamia, between Rhasfana and Alvanis. Ptolemy.

PE'LIAS, an idand on thecoad of Sicily, in the vici¬
nity of the promontory of Drepanum.

6 P

PE'LIAS,

PEL

512

PE'LIAS, in fabulous hiftory, twin-brother of Neleus,
was fon of Neptune by Tyro, daughter of Salmoneus.
His birth was concealed by his mother, who wilhed her
father to be ignorant of her incontinence. He was ex-
pofed in the woods, but his life was preferved by (hep-
herds ; and he received the name of Pelias, from a fpot
of the colour of lead in his face. Some time after, Tyro
married Cretheus, fon of Aiolus king of Iolchos,
and became mother of three children, of whom Aifon
was the eldeft. Pelias vifited his mother, and was re¬
ceived in her family ; and, after the death of Cretheus, he
unjuftly feized the kingdom, which belonged not to him,
but to the children of Tyro by the deceafed king. To
ftrengthen himfelfin his ufurpation, Pelias confulted the
oracle 5 and, when he was told to beware of one of the
defendants of Aiolus, who (hould come to his court
with one foot (hod and the other bare, he privately re¬
moved the fon of Aifon, after he had openly declared
that he was dead. Thefe precautions proved vain. Ja-
fon, the fon of AI fon, who had been educated by Chiron,
returned to Iolchos, when come to years of maturity}
and, having loft one of his (hoes in crofting the river
Anaurus or the Evenus, Pelias immediately perceived
that this was the perfon whom he had fo much dreaded.
But his aftoniftiment was greatly excited, when he faw
Jafon arrive at his palace, with his friends and his rela¬
tions, and boldly demand the kingdom. Pelias, con-
fcious that his complaints were well founded, endeavoured
to divert his attention, and told him, that he would vo¬
luntarily refign the crown to him, if he went to Colchis to
avenge the death of Phryxus, the fon of Athamas, whom
Aseres had cruelly murdered. This, fo warmly recommen-
ded,waswith equal warmth accepted by the young hero, and
his intended expedition was made known all over Greece.
While Jafon was abfent in the Argonautic expedition,
Pelias murdered AJfon and all his family; but, accord¬
ing to the more received opinion of Ovid, Asfon was (till
living when the Argonauts returned, and he was reftored
to the flower of youth by the magic of Medea. This
change in the vigour and the conftitution of Aifon afto-
ni(hed all the inhabitants of Iolchos; and the daughters
of Pelias, who have received the patronymic of Peliades,
exprefled their defire to fee their father’s infirmities vanilh
by the fame powerful magic. Medea, who wiflied to
avenge the injuries which her hulband Jafon had re¬
ceived from Pelias, raifed the defires of the Peliades,
by cutting an old ram to pieces, and boiling the flefti
in a cauldron, and then turning it into a fine young
lamb. After they had feen this fuccefsful experiment,
the Peliades cut their father’s body to pieces, after they
had drawn all the blood from his veins, on theafl'urance
that Medea would repleniftt them by her wonderful
power. The limbs were immediately put into a caul¬
dron of boiling water ; but Medea fuffered the flefti to
be totally conlumed, and refufed to give the promifed
afliftance; and the bones of Pelias did not even receive a
burial.

PEL'ICAN,/. [vreXsxav, Gr. pelicanus, low Lat. peli¬
can, Fr.] A large bird. See PelecaNus.— There are
two forts of pelicans ; one lives upon the water and feeds
upon fifli ; the other keeps in deferts, and feeds upon fer-
pents and other reptiles: the pelican has a peculiar ten-
dernefs for its young; it generally places its neftupon a
craggy rock 3 the pelican is fuppofed to admit its young
to fuck blood from its bread. Calmet. — The pelican hath
a beak broad and flat, like the (lice of apothecaries.
Hahewill on Providence.

Should difcarded fathers
Have this little mercy on their flefti ;

’Twas this flefti begot t\\ok pelican daughters. Shakefp

A glafs veflel ufed by chemifts : written alfo pellicane,
and pelecan.

Retorts, receivers, pellicanes, bolt-heads,

All (truck in (hivers ! B. Jonfon's Alchemijl.

PEL

An ancient piece of artillery which carried a fix-pound
weight of ball, and weighed two thoufand four hundred
pounds.

PEL'ICAN I'SLAND, a finall ifland near the north-
eaft coaft of Antigua. Lat. 17. 14. N. Ion. 61. 24. W. —
A fmall ifland near the fouth-weft coaft of Antigua.
Lat. 17. 10. N. Ion. 61. 35. W.

PEL'ICAN I'SLAND, a fmall ifland near the fouth
coaft of New Florida. Lat. 30. 14.. N. Ion. 88. 6. W.

PEL'ICAN I'SLANDS, a clufterof fmall iftands, near
the coaft of Weft Florida. Lat. 29. 48. N. Ion. 88.
55- W.

PEL'ICAN KEY (Great and Little), fmall iftands
near the fouth coaft of Jamaica. Lat. 17. 49. N. Ion. 76.
48. W.

PEL'ICAN ROC'KS, rocks on the north-weft coaft of
Antigua.

PEL'ICAN SHO'ALS, fmall fand-banks on the fouth-
weft coaft of Barbadoes.

PELICA'RE, a town of Cochin : fifty miles eaft of
Cochin.

PELICA'RO, a town of Naples, in the Bafilicata, at
the mouth of a river, which runs into the Adriatic : ten
miles eaft-north-eaft of Turfi.

PELICOI'DES, /. [from the Gr. vceXiyv;, a hatchetr
and HiSo;, a fhape.] A geometrical figure fo called on ac¬
count of its refemblance to a hatchet.

PELICON'DA, a town of Hindooftan, in thecircar of
Cicacole : twenty-five miles north-weft of Cicacole.

PELI'DES, a patronymic of Achilles and of Pyrrhus,
as being defcended from Peleus.

PEL'IGNI, a people of Italy, who dwelt near the Sa¬
bines and Marfi, and had Corfinium and Sulmofor their
chief towns. The mod expert magicians were among the
Peligni, according to Horace.

PELIJAR'VI, a town of Sweden, in the government
of Kuopio: joo miles fouth-eaft of Kuopio.

PELIKA'NI, a town of Lithuania, in the palatinate
of Wilna: fixteen miles fouth-fouth- weft of Braflaw.

PE'LIM, a town of Ruflia, in the government of To-
bolfk, on a lake of the fame name : feventy-two miles
north of Turinlk.

PE'LIM, a lake of Ruflia, in the government of To-
bollk, about fifty-fix miles in circumference. Lat. 59. 20.
N. Ion. 63. 50. E.

PE'LIM, a river of Ruflia, In the government of To-
bol(k, which runs into a lake of the fame name.

PE'LING, an ifland near the coaft of Corea, in the
Hoang-Hai, or Yellow Sea : ten miles long, and four
broad. Lat. 38. 24. N. Ion. 124. 28. E.

PE'LING, a fmall ifland in the Eaftern Indian Sea,
near the eaft coaft of Celebes ; fifty miles long, and four¬
teen broad. Lat. 1.45. S. Ion. 123. 20. E.

PE'LION (Mount), in ancient geography, a portion of
that long chain of mountains which lay on the eaftern
coaft of Theflaly, and which extended from the pe-
ninfula, inclofing towards the fouth the greateft part
of the country called Magnefia, as far as the moun¬
tains that feparated it from Macedonia. The portion
which bore the name of Pelion commenced at the fum-
mit of Rhifus, and reached almoft from the fea in advan¬
cing towards the north-weft. In a kind of angle which
this mountain formed in its return towards the eaft at the
bottom of the mountain flowed the fmall river Amyrus.
The coaft, in the direction of the mountain, formed in
this place a fmall gulf, in which was Melibcea. From
Meliboea, to the right bank of the mouth of the Peneus,
the chain of mountains, which approached very near to
the fea, was called Ofla. On the other fide of the Pe¬
neus, in afcending towards the north, it formed two
chains of mountains, one of which took the courfe of
the fea very exaflly, and the other inclined a little from
the fouth-eaft to the north-weft. Thefe two mountains
were connedted with the mountains which feparated
Theflaly from Macedonia. They were thofe two chains

PEL PEL 513

of mountains which the ancients comprehended under PELISSA'NE, a town of France, in the department of
the name of Olympus. When the giants are faid to have the Mouths of the Rhone : three miles eaft of Salon, and
piled OlTa upon Pelion, the meaning feems to be, that fifteen wefl-fouth-weft of Aix.

they had fortified thefe two mountains, whither they re- PELI'SSE, /. [French; from pelyce, Sax. from the
tired after their excurfions, and kept Jupiter’s garrifon Lat. pellis, a fkin.] A kind of coat or robe. See Pilch,
upon Mount Olympus in awe. The top of the mountain the old word. — Coats lined with thefe fkins are called pe-
was covered with pine-trees. The celebrated huge fpear lijjes. Guthrie of Grim Tartary.

of Achilles, which none but the hero could wield, had PELL, f. [ pellis , Lat.] Parchment or vellum upon
been cut down on this mountain, and was thence called which bills, deeds, &c. are written. — Clerk of the pells,
pelias. It was a prefent from his preceptor Chiron, who, an officer belonging to the exchequer, who enters every
like the other Centaurs, had fixed his refidence here, teller’s bill into a parchment roll called pellis acceptorum,
Letnpriere. the roll of receipts; and alfo makes another roll called

PELIOSAN'THES, [from weTuo;, livid or lurid, and pellis exituum, a roll of the difburfements. Bailey.
ouf0o;, a flower; fo named by the late Mr. George Jack- PELL (John), a divine of the church of England,
fon, in Andrews’s Repofitory, in allufion to the pale lead- and an eminent mathematician, was born at Southwick in
colour, for which the flowers are remarkable. Andr. Re- Suflex, of which his father was minifter, in the year 1610.
pof. ix. 605. Ker in Curt. Mag. 32.1302.] In botany, He was educated in grammar-learning at the free-fchool
a genus of the clafs hexandria, order monogynia, natu- of Steyning in the fame county; and made fo rapid a
ral order farmentacese, Linn, (afparagi, JitJJ.) Generic proficiency in the Latin and Greek languages, that at the
chara<5!ers — Calyx : none, unlefs the corolla be taken early age of thirteen he was fully qualified for entering
for fuch. Corolla: inferior, of one petal, permanent; upon academic ftudies, and fent to Trinity-College, Cam-
tube cylindrical 5 limb wheel-fhaped, in fix equal obovate bridge. Here he profecuted his ftudies with the greateft
fegmenls ; neftary of one leaf, globular, contracted at diligence and intenfenefs ; and, befides a wonderful faci-
the mouth, one-third the length of the petal. Stamina: lity in acquiring languages, he poflefled a peculiar turn
filaments very fhort, equal, inferted into the infide of the towards mathematical learning; fo that, in 1629, when
neCtary; antherae oblong, of two lobes and two cells, only eighteen years of age, he drew up “A Defcription
projecting juft beyond the neCtary. Piftillum : germen and Ufe of the Quadrant, written for the ufe ofa Friend, in
fuperior, enveloped in the neCtary, globofe ; ftyle fcarcely two Books.” In the fame year he held a correfpondence
any; ftigma of three obtufe furrowed lobes. Pericarpi- with the celebrated Henry Briggs, upon the fubjeCl of
um : berry ovate, of three cells. Seeds two in each cell, Logarithms. In 1630, he wrote “Modus fupputandi
fome of them frequently abortive. — EJfential Character. Ephemerides Aflronomicas (quantum ad motum Solis
Corolla tubular ; limb wheel-fhaped, in fix fegments ; fta- attinet) paradigmate ad An. 1630, accommodato 5” and
mens inferted into the globular neCtary ; berry with three “ A Key to unlock the meaning of Johannes Trithemius,
ceils, and fix feeds. There are two fpecies. ip his Difcourfe of Steganography.” He had been ad-

1. Peliofanthes teta, or grey-flowered teta : flower- mitted to the degree of B. A. at the regular period, and
ftalks taller than the leaves ; corolla obtufe. Gathered in the prefent year he proceeded M. A. He now quitted
by Dr. Roxburgh in Bengal. Living plants were fent by Cambridge, and paid a vifit to Oxford, where he was in-
him to the late lady Amelia Hume, in whofe ftove they corporated M. A. in 1631. During this year he wrote
flowered in the following fpring, for the firft time in Eng- “ A Letter to Mr. Edmund Wingate, on Logarithms ;”
land. Root fibrous, perennial; Item none ; leaves feve- and he drew up “ Commentationes in Cofmographiam
ral, radical, ereCt, a foot or more in height, on channelled Eftedii.”

ftalks, elliptical, pointed at each end, entire, rather rigid, Mr. Pell feems to have formed an early intention of enter-

evergreen, fmooth, plaited, with many longitudinal ribs, inginto the marriage-llate ; which was moft probably the
and fine tranfverfe veins. Flower-ftalks ereCI, round, fim- reafon that prevented him from offering himfelf a candi-
ple, fmooth, fomewhat glaucous, each bearing an up- date either for a fcholarfhip or fellowfhip in Trinity-col-
right clufter of numerous inodorous fmall flowers, feat- lege- Otherwife there can be no doubt but that his ex-
tered or in tufts, of a livid purplifh lead-colour, inter- traordinary accomplifhments would have fecured to him
mixed with dull green. BraCtes fcattered, ovate, pointed, any encouragement which his college could offer, to en-
concave, membranous, pale. The flowers fall off even gage his refidence in it: for, befides his reputation as a
before they wither, without producing any fruit in this mathematician, he was diftinguifhed, not only by his in¬
country. The natives of Bengal know this plant by the timate knowledge of the Hebrew, Greek, and Latin, but
name of teta; but we find nothing recorded of its quali- alfo of the Arabic, Italian, French, Spanifh, and High
ties or virtues. and Low-Dutch, languages. His inclination, however,

2. Peliofanthes humilis, or dwarf teta: flower-ftalks led him to renounce all chances of college-preferment

fhorter than the leaves; clufter Ample; corolla acute, for the enjoyment of domeftic felicity; and, in the year
Introduced from Prince of Wales’s Ifland, about the year 1732* he married a lady by whom he had four fons and
1808, by Mr. Evans of Stepney, in whofe hot-houfe it four daughters. But Mr. Pell’s matrimonial connexion
bloflomed in November. This differs from the former in did not diminifh his ardour for mathematical purfuits.
itsmuch humbler ftature, the leaves being not more than In 1633-4, he finifhed his “ Aftronomical Hiftory of Ob-
three inches high, and the flower-ftalk hardly two inches, fervations of Heavenly Motions and Appearances ;” and
bearing an ovate denfe Ample clufter of flowers, whofe foon afterwards his “ Eclipticaprognojlica, or the Eclipfe
fegments are acute, green with a white edge. Prognofticator, or Foreknower of Eclipfes; teaching how

Mr. Jackfon obferves, that he had feen two fpecies in by calculation to foreknow and foretell all forts of
Mr. Evans’s collection juft imported from Prince of Eclipfes of the Heavenly Lights.” In 1634, hetranflated
Wales’s Ifland, one of which had the leaves nearly of a out of Latin, “ The Everlalting Tables of Heavenly Mo-
blue colour, the other probably w'as our humilis. Mr. tions, grounded upon the obfervations of all times, and
Evans’s collector declared that he had found five or fix agreeing with them all, by Philip Lanfberg of Ghent in
diftinCt fpecies of this genus, growing wild in the ifland Flanders, Sec. from the Sexagifal to the Decimal Subdivi-
juft named, though he did not fucceed in his attempt to fions, for the more eafe in Calculations ;” and in the
bring them alive to England. fame year he wrote “ the Manner of his deducing his

PELIOU', a town of China, of the third rank, in Aftronomical Tables out of the Tables and Axioms of
Quang-fi : feventy miles fouth-weft of Ou-tcheou. Philip Lanfberg.” The year 1634 produced from him

PEL'ISE, a river of France, which rifes in Mount la two “Letters of Remarks on Mr. Gellibrand’s Difcourfe
Croix, pafles by Lucerna, and runs into the Clufon one mathematical on the Variation of the Magnetic Needle.”
mile fouth of Vigone. By thefe and other works, which it is not neceflary to

2 enumerate.

PEL

514

enumerate, Mr. Pell’s reputation for mathematical know¬
ledge was fo well eftablilhed, that he was confidered to be
deferving of a profelfor’s chair in that fcience. When,
therefore, a vacancy took place in one at Amfterdam in
1639, intereft was made to procure Mr. Pell the appoint¬
ment. The vacancy was not, however, filled up before
the latter end of the year 1643, when Mr. Pell was cho-
fen to it. Of the eftimation in which he was held in Hol¬
land, a good opinion may be formed from what was faid
of him by his colleague, Gerard John Vofiius, who ftyles
him “a perfon of various erudition, and a moil acute ma¬
thematician and he greatly applauds his ledlures upon
Diophantus.

In 1644, Mr. Pell publifhed at Amfterdam, in two
pages, a refutationof Longomontanus’s pretended quadra¬
ture of the circle, which obtained for him a high degree
of credit among the moft learned mathematicians in Eu¬
rope. Two years afterwards, Mr. Pell was called to the
difplay of his talents on a new fcene; for the prince of
Orange, having founded a Scholia illujlris at Breda, in¬
vited him to be profeflor of philofophy and mathematics
in the new inftitution, with an annual falary of a thoufand
guilders. This offer he accepted, and he filled the ma¬
thematical chair at Breda with the fame reputation and
f’uccefs which attended him at Amfterdam, having, among
his pupils, feveral who were afterwards diftinguifhed as
eminent algebraifts. The death of the prince of Orange,
in 1650, deprived him of his patron j and, the war which
broke out between the Englifh and Dutch in 1652 ren¬
dering it neceffary for him to withdraw from the territo¬
ries of the ftates, he returned to his native country. In
1654, Cromwell appointed him agent to the Proteftant
cantons in Swifferland; which chara£ter he retained till
the year 1658, when he returned to England a fhort time
before the death of Cromwell.

While he was abroad he is faid to have privately ren¬
dered no little fervice to the interefts of king Charles II.
and of the church of England. Be that as it may, it is
certain that after the reftoration he was encouraged to
enter into holy orders ; and, having been ordained deacon
and prieft in 1661, he was immediately inftituted to the
re ftory of Fobbing in Efl'ex, with the chapel of Battlefden
annexed, on the prefentation of the king. During the
month of December in the fame year, he brought into the
upper houfe of convocation the Calendar, reformed by
him, with the affiftance of Sancroft, afterwards archbifhop
of Canterbury. In 1663, he was prefented by Dr. Shel¬
don, then bilhop of London, to the redtory of Laingdon
in Efl'ex; and about the fame time he was created D. D.
Scarcely had he been honoured with this degree, when his
patron was tranflated to the archbiftiopric of Canterbury,
and made him one of his domeftic chaplains. Such an
appointment is generally confidered to be a ltep to higher
preferment; but Pell was fo intent on his ftudies, that he
neglected his own intereft; and was indeed fo imprudent
with refpeft to the management of his worldly affairs, that
he would have difgraced the ftation of a dignitary. An¬
thony Wood fays, that “ he was a lhiftlefs man, and his
tenants and relatfons dealt fo unkindly with him, that
they cozened him of the profits of his parfonages, and
kept him fo indigent, that he wanted neceffaries, and
even paper and ink, to his dying day.”

In the mean time he diftinguilhed himfelfin the Royal
Society, of which he was elefted a fellow in 1663. In the
following year he publifhed “ an Exercitation concerning
Eafter,” 4to. and in 1665 he made great alterations and
additions to Rhonius’s Algebra, which appeared in the
Englifh verfion of that work, printed in 1668, under the
title of, “ An Introduction to Algebra ; tranflated out of
the High Dutch into Englifh by Thomas Branker, much
altered and augmented by D. P.” See. 4to. After this,
he drew up “ A Table of ten thoufand Square Numbers,
namely, of all the Square Numbers between o and a hun¬
dred million, and of their Sides,” See. which were printed
in 1 672, folio. Dr. Pell alfo invented the method of rang-

P E L

ing the feveral fteps of an algebraical calculus in a proper
order, in fo many diftinCt lines, with the number affixed to
each ftep, and a fhort defeription or procefs in the line.
He was likewife the inventor of the character -j- for divi-
fion, for involution, tw for evolution, and v for ergo,
or therefore. But, in the midft of the inceffant applica¬
tion to his ftudies, owing to the negleCl of his affairs, his
embarraffments increafed, and he contracted debts, which
proved the occafion of his being thrown more than once
into the King’s-Bench prifon. Being at length reduced
to great indigence, Dr. Whiftler, then cenfor and regif-
trar to the College of Phyficians, invited him to his houfe,
in 1682, where he continued till, the ill ftate of his health
requiring particular attendance, he was removed, at firft
to the houfe of a grandchild, and afterwards to that of
the reader of the church of St. Giles’s in the Fields, where
he died in 1685, when in the 74th year of his age.

Befides the labours already noticed by us, in chronolo¬
gical order, Dr. Pell wrote a Demonftration of the Second
and Tenth Books of Euclid, and alfo of Archimedes’s
Arenarius, and the greateft part of Diophantus’s Six Books
of Arithmetic. Of the latter author he fpent fome time
in preparing a new edition, in which he intended to have
corrected the tranflation, and introduced new illuftrations.
Some of our author’s manuferipts were left by him at
Brereton in Chelhire, where he had refided for fome
time, it being the feat of lord Brereton, who had been
one of his pupils at Breda. A great many others came
into the poffeflion of Dr. Bufby, which Mr. Hook was di¬
rected to endeavour to obtain for the Royal Society.
They continued, however, mixed with the papers and
pamphlets of that gentleman, in four large boxes, till the
year 1755, when Dr. Birch, fecretary to the Royal Society,
procured them for that body from Dr. Bulby’s truftees.
The collection contains not only Dr. Pell’s mathematical
papers, letters to him, and copies of thofe fent by him,
but alfo feveral manuferipts of Mr. Walter Warner, an
eminent philofopher and mathematician in the reigns of
James I. and Charles I. Wood's Fajli Oxon. vol. i.
Hutton' s Math. Di6t.

PEL'LA, in ancient geography, a town of Macedonia,
near the fea, on the confines of Emathia. This city be¬
came the capital of the kingdom when Edeffa was anni¬
hilated, according to Ptolemy; and owed its grandeur
to Philip, who had been educated there, and to his fon
Alexander, who was born in this place. Livy defcribds
it as fituated on an eminence furrounded by marfhes, in
the midft of which was a fortrefs, appearing like an ifland,
and at a diftance feeming to be joined to the city ; it was,
however, feparated from it by a river, which ran between
their walls, and over which there was a bridge of commu¬
nication. This river was called Ludias, Loedias, and
Lydius.

M. de Pouqueville, a French traveller, vifited very re¬
cently the fite of Pella. This ancient capital of the kings
of Macedon, he informs us, does not announce itfelf, in
its defolation, to the eye of the ftranger, as at Athens
and Corinth, by the difplay of the remains of its ancient
fplendour. The pofition of Pella is known only from
its correfpondence with the deferiptions of its fite, pre-
ferved in hiftory. Thus it is deferibed by Livy, in the
conclufion of his forty-fourth book: “The conful M.
Aimilius Paulus, proceeding from Pydna, after the utter
difeomfiture of Perfeus of Macedon, arrived with his army
on the fecond day at Pella. Encamping about a mile
from the city, he there remained fome days, examining
the pofition on every fide, and acknowledging that not
without good reafon had the royal refidence been there
placed. Pella was feated on an eminence doping down
to the fouth-weft, and furrounded by marlhes of impaffa-
ble depth in fummer as well as in winter, produced by
feveral ftagnant lakes. Within the marlh itfelf, on the
fide next to the city, appeared, like an ifland, the caftle,
or citadel, erefted on a mound, a work of vaft labour,
which fuftained the fortifications, while it refilled all in¬
jury

PEL

PEL

515

jury from the inclofing waters. This citadel, confpicuous
from its fituation and ftrufture, was connected by a, wall
to the city, and within that wall was a dream of water,
over which was erefted a bridge. From its pofition it re-
fulted, that, although the city might be blockaded, yet
the citadel was wholly inacceflible ; nor, on the other
hand, if the king fliould (hut up any perfon within the
citadel, could he poffibly efcape but by the bridge, which
might be very eafily defended.” Conformably with this
reprelentation, the veftiges of Pella are found on an emi¬
nence (loping down to the fouth-wed, and encompaffed
by marfties. In vain, however, do we look for the walls
of the city, for the citadel, for the dykes conftrufted to
defend from inundation the temples, buildings, and other
monuments of its grandeur: the barbarians from the
north, the Romans, and the fucceflion of ages, have de¬
stroyed even the ruins.

To Philip of Macedon, Pella was indebted for its rank
and magnificence among the cities of the ead ; and it
mud have been with a view to its ftrength, in a pofition
inapproachable in ancient times by any holtile force, that
he felefted for his capital a fpot extremely unhealthy.
Enlarged and improved by his (bn Alexander and his fuc-
ceffors, Pella had attained a high degree of power and
fplendour, before it was taken and facked by the adven¬
turers from Gaul, the forerunners of the Romans, who
overthrew the city after the conqued of Macedonia.
Commanding, by its pofition, the mouths of the Axius
and the Lydias, Pella would naturally have become an im¬
portant commercial ftafion, had not Theffalonica, didant
only twenty-one miles, pofl'effed a fafe and commodious
port for (hipping. But in ancient times, military ftrength
and fecurity, and not commercial advantages, were the
objects contemplated, in the founding and improving of
cities.

“ Looking forward, at laft, we difcovered the miferable
village called Allah-Kiliffa, or Allah-Hiffar, (God’s
Tower or Caftle,) compofed of about threefcore huts, in¬
habited by Bulgarians, with a tower, garrifoned by a do¬
zen Albanians, with their officer. Such are the prefent
edifices, population, and military eftablifhment, of Pella,
the once powerful capital of Philip, and Alexander, and
Perfeus ! A low Mahometan now commands, whip in
hand, in the city where Alexander firft faw the light ; and
the paternal feat of that monarch whofe dominions ex¬
tended from the Adriatic to the Indus, is now the pro¬
perty of Ac h met, fon of Ifmael, bey of Serres. But, if
Pella be funk, well adapted to its fallen ftate are the in¬
habitants, diftinguiftied, even in Macedonia, by their grofs
ignorance and their brutal hatred of ftrangers. Notwith-
ftanding the orders of the commandant, and the abundant
offer of money, it was not without a long altercation that
we obtained entrance into a hovel, merely to depofit oar
baggage. Proceeding to furvey the place, we firft vifited
a church, built of ftone, dedicated to St. Paul, ufually
ftyled by the Greeks, the Great Apoftle. The children,
attrafted by the European drefs, followed us from place
to place; while the dogs, not lefs amazed, a (Tailed us in
the mod ferocious manner. Some of the people, how¬
ever, who had feen Franks in Theffalonica, offered to fale
antique coins and fmall figures in terra cotta , found in the
place. Traveriing a large (pace of ground, covered with
fragments of tombs, and maffes of brick and tile, we came
to the village-well, on a ftone of which were thefe words:
AIONYSIOS MEFAKAEOYS. Defending in a weft ward
direftion, we fully recognized the pofition of Pella, as de-
fcribed in the foregoing quotation from Livy, on the
(lope of a double eminence. The remains of the ramparts,
con drafted of (tones of very large fize, carried round the
fummit of the higheft hill, induced me to fuppofe them
to indicate the pofition of the citadel. Defending
fou th wards, I followed' the line of another inclofing wall,
(till called Pella by the inhabitants. The direction of
this wall points to a fquare bafin, of Turkifii workman-
fhi P : but the facing wall is founded on a broader wall, of
Vol.XIX, No, 1321,

ancient Greek conftruftion. In the lake Lydias, now
called Jenidge, I obferved the mouth of the river from the
town fo called, and thofe of the river Niagoufta, and of
feveral rivulets, proceeding from neighbouring fprings.

t: Having thus furveyed all that remains of Pella above
ground, and to attempt excavation was impracticable,
(although under the furface, a rich treafure of antiquities
muft undoubtedly be concealed,) we returned to our
Bulgarian hut, where our Janiffaries had prepared a dinner
of pilaw, the ufual food of travellers, and the favourite
difli of the people in the eaft. After dinner, I extended
my refearches towards Jenidge, a confiderable town, famed
for its tobacco, diftant about a league weft ward from
Pella. Entering on the road which runs not far from
the well before mentioned, I obferved a tumulus, or bar-
row, which had been opened. Going into it, by an open¬
ing made on the fouth fide, we found a fort of paffage,
thirty-one feet four inches, Englifh, in length, by feven
feet in breadth, which led to two fquare parallel rooms,
both much injured by the openings made to enter and
examine them. Continuing to descend to the fecond
paffage, by a deep (lope under a vault, which terminated
at a horizontal paffage or gallery fifty- feven feet long, and
eleven feet two inches broad, we obferved two niches in
the wall. Thefe left us no doubt that the galleries and
recedes, which externally appear as barrows, were cer¬
tainly conftrufted as places of fepulture. A third paffage
opened into another vaulted chamber, fourteen feet three
inches by twelve feet ten inches in length from north to
fouth. This tumulus having been opened and examined,
no difcoveries were left for 11s to make. We were, how¬
ever, convinced of the erroneoufnefs of the vulgar opi¬
nion, that the barrows found in various parts of the couii.
try were thrown up by the Turks, when they firft inva¬
ded Macedonia, as a place on which to ereft the precious
national ftandard of Mahomet. Nothing now remaining
to be feen at Pella, we returned to Theffalonica by the
road we had before purfued.” Tour from Theffalonica
to Pella. Monthly Mag. March 1822.

PEL'LA, a town of Ruffia, at the junftion of the Tofna
and the Neva : twenty miles fouth-eaft of Peter (burg.

PELLACON'TA, in ancient geography, a river of
Afia, in Mefopotamia. Pliny.

PELLACO'PAS, a river of Afia, in Mefopotamia.
Arrian de Exped. Alex,

PEL'LAGE,/ [from pell.] A cuftom or duty on tanned
hides.

PELLA'GRA, /. [probably from pellis, the (kin, and
agria, fcab.] A fort of cutaneous difeafe, which was firft
defcribed about the year 1771 by fome Italian phyficians,
as occurring in many perfons in the neighbourhood of
Milan and Venice. There is fomething bordering upon
the marvellous in this early hiftory of the pellagra ; but
fubfequent obfervation has confirmed it. A full account
of the difeafe may be found in Frapolli, “ Animadver-
fiones in Morbuin vulgo Pellagram diftum Milan,
1771, (the firft writer who noticed it;) and in an Ed ay by
W. X. Janfen, “ De Pellagra, Morbo in Mediolanenfi
Ducatu endemio,” Leyden, 1787. (This effay was re¬
printed in Dr. Frank’s Deledlus Opufculorum Medico-
rum, vol. ix. art. 9.) See alfo a long lift of references
toltalian writers on the fubjeft, under the article Pellagra,
in Dr. Parr’s London Medical Diftionary.

A more recent and reafonable account of the difeafe is
given by Dr. Holland, who had refided in the north of
Italy for fome time, and noted the fymptoms and progrefs
of it on the lpot. The Pellagra, according to this writer,
is a difeafe chiefly confined to the peafants of Lombardy,
and owing its birth to deficiency of food and clothing,
and the cacheftic habit confequent thereon. The difeafe
occurs in the fpring, and begins like a common erythema.
The patient perceives on the back of his hand, on his
feet, and fometimes, but more rarely, on other parts of
the body expofed to the fun, certain red fpots or blotches ;
whith gradually extend themfelves, with a flight elevation
6 Q of.

516 P £ L

of the cuticle, and a {hining furface, not unlike that of
lepra in its early ftage. The colour of this eruption is a
fomevvhat more obfcure and dulky red than that of ery-
iipelas : it is attended with no other uneafy fenfation than
a flight pricking or itching, and fome tenfion in the part.
After a fhort continuance in this Hate, fmall tubercles
are frequently obferved to arife on the inflamed furface;
the fkin almofl always becomes dry and fcaly, forming
rough patches, which are excoriated and divided by fur¬
rows and rhagades. Defquamation gradually takes place,
and leaves a Alining unhealthy furface in the parts affeCt-
ed ; but towards theclofe of the fummer, or occafionally
ftill earlier, the fkin refumes its natural appearance ; and,
but that the further progrefs of the difeale is familiar to
every inhabitant of the country, the patient might be led
to flatter himfelf that the evil was gone by, and that there
was no particular reafon to dread its recurrence.

The conftitutional fymptoms which precede the erup¬
tion are thofe ufually indicative of the cacheCtic habit ;
viz. languor, flabbinefsof flefli, and debility ; thofe which
follow it are debility of the whole body; vague and irre¬
gular pains of the trunk and limbs, but efpecially follow¬
ing the track of the fpine and dorfal mufcles ; headache,
with occafional vertigo; irregular appetite, and general
depreflion of fpirits. The bowels are for the moll part
relaxed ; and ufually continue fo in the further courfe of
thedifeafe. There are no febrile fymptoms ; and in fe¬
males the menftruation is generally continued without
irregularity.

The conftitutional, like the local, derangement, ufually
goes oft' towards the latter end of the fummer, but it re¬
turns the next year with increafed violence, and during
the third and fourth years acquires an horribly alarming
character, The local appearance changes from 'that of
the eryfipelatous eruption and defquamation before de-
icribed, to that of profound fcabs and fcales, or ill-con¬
ditioned ulcerations ; and the conftitutional derangement
is marked by a fevere impediment to the progrefs of the
afiimulative and the fenforial funClions, Nervous irri¬
tation manifefts itfelf, firftly, in a variety of fpafmodic
pains, uneafy fenfations, and vifual and aural deceptions;
and, fecondly, by defponding furious mania, and frequent
attempts at fuicide. No plan of treatment has been hi¬
therto applied to pellagra with advantage ; but the gene¬
ral indications, of courfe, are to cure the cachexy of the
bod}-, by removing.to healthy fituations, and the admi-
niftration of wholefome food. This difeafeis fuppofed by
fome learned authors to be the leprofy of the middle and
dark ages. See Leprosy, vol. xii. and London Med.
Journal for March 1818.

PELLA'NA, or Pellane, in ancient geography, a
town of Laconia, fouth-eaft of Belemina. It was wafhed
by the Eurotas ; and is thought to have been very an¬
cient. In the time of Paufanias it had a temple of Efcu-
lapius and a fountain called Pellanide.

PEL'LEGRIN (Simon Jofeph), a French poet and ec-
clefiaftic, was born at Marfeilles. He obtained, in 1704,
the prize of the academy for his “ Epiftle to the King on
the Succefs of his Arms.” He entered into the religious
order of the Servites, but afterwards obtained leave to
remove into that of Cluny. He wrote feveral pieces for
the theatres, and dramatized the Hiftory of the Old and
New Teftament, the Pfalms of David, &c. He is alfo
known as the tranflator of the works of Horace into the
French language. He died in 1745.

PELLEGRl'NI (Camillo), a learned hiftorian and an¬
tiquarian, was born at Capua in 1598. He was educated
at the Jefuits’ fchool at Naples, where, befides the ufual
ftudies, he acquired an accurate knowledge of civil and
eccleflaftical law and theology. He entered into the cle¬
rical order; and, having been fent to Rome, he diligently
confulted the archives and libraries of that capital, and
formed the defign of collecting all the ancient documents
relating to his native place, and to the whole kingdom of
Naples. For this purpofe he made many journeys, and
3

PEL

was at great expenfe in procuring copies of records and
manufcripts, and in forming a collection of antiquities,
The fir ft fruit of hisjabours was “ L’Apparato alle Anti-
chita di Capua,” printed in 1651, in which he minutely
defcribes all the parts of Campagna Felice, and relates its
hiftory and feveral revolutions. He afterwards publifhed
a work entitled “ Hiftoria Principum Longobardorum,”
containing the Chronicle of the Anonynuis Salernitanus,
and feveral other hiltorical pieces which had not yet feen
the light, illuftrated with learned annotations and difler-
tations. This publication was of great fervice in eluci¬
dating of the hiftory not onlyof thofe provinces of Naples
which were under the fway of the Lombard kings, but of
all Italy; it was therefore republiflred in the collections
of Burmann and Muratori, and has been re-edited, with
various additions, at Naples, 174.9, by Sig. Fr. Moria Pra-
tilli. This learned w'riter publilhed other works on dif¬
ferent fubjeCIs, and had a great collection of MSS. as well
of his own writing as others, which were unfortunately
loft to the world by the following incident. Being in a
bad ftate of health, he had given orders to a female do-
meftic, that, when he fhould be near his end, file fhould
burn a large bundle of papers which he pointed out.
One day, overhearing the phyficians prognofticate that he
had not many hours to live, file too faithfully executed
his commands, to his own great regret after he was fome-
what recovered. He died at Naples in 1660, at the age
of fixty-five.

PELLEGRI'NO of Modena, a celebrated Italian
painter, born 1511, and bred under Raphael, was killed in
an affray1.

PELLEGRI'NO -PELLEGRl'NI (Tibaldi), a cele¬
brated painter and architeCf, was born at Bologna in
1527, of a family from the Milanefe. He ftudied in the
fchool of Bagnacavallo in his native place; but his chief
education was derived from the works of Michael An¬
gelo at Rome, viewed with the eye of genius. It is not
eafy to determine whether he ought to be reckoned
among painters or architects ; for he ereCted edifices, and
ornamented them with his paintings ; but he was great
in both departments. At his vilit to Rome he was pa¬
tronized by cardinal Poggi, who fent him back to Bolog¬
na to finifli his palace there, which is now the Academi¬
cal Inftitute, and is decorated with his paintings. Thefe,
with thofe of the chapel of St. Jacopo of the Auguftine
friars, are the principal fpecimens of his art in Italy, and
were the ftudy and imitation of the Caracci. He went
from Bologna to Loretto, in the church of which he built
a chapel, and ornamented it with ftuccos and paintings.
At Ancona he gave decorations for two of the churches,
and built and adorned the merchants’ hall ; and he like-
wife fuperintended the fortifications of the place as mili¬
tary architeCf. At Pavia he conftruded the Palace of
Sapienza, called afterwards the Borromean College. The
city of Milan named him, before 1 570, architect of its ce¬
lebrated cathedral : he difencumbered its dome of gothic
-ornaments, and in their room enriched it with feveral
elegant chapels, and a majeftic choir. Having been en¬
gaged by Philip II. to prepare plans for the Efcurial, he
went into Spain in 1586, and during nine years was em¬
ployed as architect and painter of that vaft edifice. His
works would require a volume to defcribe, and they were
amply remunerated with riches and honours. He return¬
ed to Milan, where he continued his labours, under the
title of ducal engineer, to an advanced age. The year
of his death is not exaCtly known, but it was under the
pontificate of Clement VIII. and about the clofe of the
fixteenth century. He was buried in a tomb ereCled for
himfelf and his family in the dome of Milan.

Tibaldi is regarded as the greateft defigner of the Bo-
lognele and Lombard fchools. He' was called by the Ca¬
racci “ the reformed Michael Angelo,” poflefiing his
grandeur and energy, without his extravagance; and they
commended Del Tibaldi il decora e il fondamento, “ his
decoroufnefs joined with learning.” He is principally

known

PEL

known as a painter by his works in frefco, his pidlures in
oil being extremely fcarce : his pieces in the Inftitute of
Bologna, reprefenting ftories from the Odyfley in frefco,
are his moll remarkable remains. Of thefe a book has
been engraved. D' Argenville. Pilkington.

PELLEGRU'E, a town of France, in the department
of the Gironde: twelve miles north-north-eaft of La
Reolle, and thirty eaft of Bourdeaux.

PEL'LEN, a town of Prufiia, in the circle of Natangen:
fixteen miles fouth of Brandenburg.

PELLE'N A, in ancient geography, a town of the Pelo-
ponnefus, in the Argolide.

PEL'LENBECK, a village of the kingdom of the Ne¬
therlands, in the province of South Brabant ; three miles
of Louvain on the river Dyle ; and till the late peace was
included in the (French) department of the Dyle.

PEL'LENDORF, a town of Auftria : ten miles weft of
Zifterdorf. — A town of Auftria: eight miles fouth-eaft of
Vienna.

PELLE'NE, in ancient geography, a town of the Pelo-
ponnefus, in Achaia, fouth of Ariftonautae. It was built
round a mountain, and formed a beautiful amphitheatre.
The inhabitants pretended that it took the name from
Pallas, one of the Titans ; but the Argians with greater
probability afcribe its name to Pellene, the fon of Phorbas,
and grandfon of Triopas, who came from Argos to this
plage. Water was conveyed to this city by a beautiful
aquedudt; and at a fmall diftance was a gymnafium.
Near the tqwn was a temple, on a fpot confecrated to
Neptune. About two leagues towards the fouth-eaft
from Pellene was a famous temple of Ceres the Myftan.
In its vicinity feafts were celebrated for feven days. Pel¬
lene was defended by a fortrefs called Olurus towards the
fouth-eaft, and by the valour of its inhabitants long
maintained its liberty; at length it became a part of Si-
cyonia, retaining its liberty to the time when the Romans
took pofleffion of Greece.

PELLENIN'KEN, a town of Pruflian Lithuania : nine
miles north-eaft of Inlterburg.

PELLERIN' (Jofepli), an eminent medalift, born at
Paris in 1683, was commiffary-general of the French ma¬
rine. Having obtained his difmiflion after forty years’
fervice, he devoted the remainder of his life to the ftudy
of antiquity. His collection of medals, which was the
richeft and moft valuable that was ever made by a private
individual, was purchafed by the king in 1776. He con¬
tributed to the promotion of the numifmatic fcience by
a publication in nine volumes, ^to. enriched with a great
number of plates. It confifts of a collection of medals of
kings, hitherto inedited or little known ; a collection of
medals of people and towns, inedited or little known ;
mifcelianeous medals; fupplements to the above; and
letters on medallic fubjeCts. This is reckoned a very va¬
luable work, not only on account of the beauty of the
engravings, but of the learned and judicious explanations
fnbjoined. The author died at Paris in 1782, in the
ninety-ninth year of his age.

PELLERIN' a town of France, in the department of
the Lower Loire, on the Loire, with a harbour for fmall
veftels : nine miles north of Nantes, twelve fouth-eaft of
Painbceuf. ,

PEL1 LET, f. [from pila, Lat. pelote, Fr.] A little ball.
— That which is fold to the merchants, is made into little
pellets, and fealed. Sandijs. — I drelfed with little pe//<7s of
lint. Wijeman's Surgenj.-— A bullet; a ball to be fliot.—
The force of gunpowder hath been afcribed to rarefaClion
of the earthy fubftance into flame, and fo followeth a di¬
latation ; and therefore, left two bodies fliould be in one
place, there mull needs alfo follow an expulfion of the
pellet or blowing up of the mine : but thefe are ignorant
fpeculations ; for flame, if there were nothing elfe, will
be fuffocated with any hard body ; fuch as a pellet is, or
the barrel of a gun ; fo as the hard body would kill the
flame. Bacon. — In a fhooting-trunk, the longer it is to a

PEL 517

certain limit, the more forcibly the air pafles and drives
the pellet. Ray.

To PEL'LET, v. a. To form into little balls. Not in

■ufe :

Oft did (lie heave her napkin to her eyne,

Which on it had conceited characters,

Laundering the filken figures in the brine
That feafon’d woe had pelleted in tears. Shahefpeave.
PEL'LETED, adj. Confiding of bullets :

My brave Egyptians all,

By the difcandying of this pelleted ftorm,

Lie gravelefs. S/iahefpcare.

PELLETI'ER (Bertrand), a very able French chemift,
was the fon of an apothecary at Bayonne, where he was
born in 1761. He received his early education at the
college of that city, and diftinguifhed himfelf from child¬
hood by his ardour for ftudy. At the age of feventeen
he came to Paris, and particularly attached himfelf to
the eminent chemift Danet. He foon acquired an extra¬
ordinary paflion for chemical experiments, to the expen-
fes of which he lacrificed almoft the neceflaries of life.
At length a lover of the fcience offered him his labora¬
tory, which he gladly accepted, and for more than a year
he paid it a daily vifit. He had conduCled his experiments
with fo much care and accuracy, that at the age of twen¬
ty-one he made himfelf advantageoufly known by fome
obfervations on the arfenical acid and other fubftances,
printed in the Journal de Phyfique in 178a. In the next
year Danet entrufted him with the management of the
pharmaceutical eftablifhment of his father-in-law Rouelle.
His reputation caufed him to be aggregated to the com¬
pany of apothecaries at Paris earlier than the regulated
age; he alfo took his degrees in medicine; and in 178+
he married. Employing all his leifure in experimental
chemiftry, he gave to the public fucceflively a variety of
memoirs which have perpetuated his name among tiiofe
of the moft ingenious and fuccefsful cultivators of the
fcience. Of thefe, fome of the moft curious relate to
phofphorus. In five papers upon this production, he
confiders the beft method of preparing and purifying it,
its powers of decompoiing the arfenical acid, and the
mode of uniting it with the metals, 1b as to produce
phofphurets of almoft all metallic bodies. Other
memoirs relate to the analyfes of plumbago and molyb-
dena, to acetic ether, to cauftic alkalies, oils, and the pre¬
paration of foap, to bell-metal, muriate of tin, carbonate
of barytes and potaflium, and llfontian. The latter, with
many more, are inferted in the “ Annales de Chymie,”
in the compilation of which he was concerned from the
year 1792. In the preceding year he had been admitted
a member of the Academy of Sciences, an honour which
few have obtained at fo early an age. After that efta¬
blifhment was fupprefled, he was employed by the go¬
vernment in feveral important commifiions. He was in
fucceffion a member of the board of confultation for the
arts, infpeflor of the hofpitals of Belgium, commifi’ary of
gunpowder and faltpetre at Elfonne and La Fere, and
member of the council for fuperintending the health of
the armies. Notwithftanding his natural weaknefs of
conftitution, he made a point of performing all his duties
with the utmoll punctuality.

When the National Inftitute had taken the place of all
the other academical inftitutions, Pelletier was called to
a feat in it, which he occupied with diftinftion. During
the two laft years of his life he was employed to give a
courfe of chemiftry in the Polytechnic fchool ; and the
clearnefs, precifion, and method, of his leClures were uni-
verfally admired. His language was fimple, pure, and
devoid of all ornament foreign to the fubjeCt. He ex¬
actly defcribed what he had feen and proved ; and never
fuftered his imagination to wander in brilliant theories,
or to lead him to -exaggerate in his faCts. A timid difpo-
fition and feeble organization had caufed him to undergo

feveral

518 PEL

feveral fevere (hocks during the dorms of the revolution ;
and his tranquillity was all'o occafionally invaded by the
claims of other perfons to his difcoveries, the injuftice of
which deeply wounded him; but the metallic and car¬
bonic vapours to which he was fo much expofed in his
experiments were the immediate caufe of the pulmonary
affection that proved fatal to him. During the progrefs
of it, he felt no diminution of his zeal for chemical
fcience, and was often roufed from a fit of low fpirits by
the fight of fome curious preparation. He had deter¬
mined upon a journey to his native place, which he flat¬
tered himfelf would reflore him to health, when, in July
1797, he was carried off at the early age of thirty-fix, to
the great regret of his friends, and the public. He had
been made a member of feveral learned focieties, native
and foreign, among which were the Academy of Turin,
and the Paris and London Medical Societies. His works
were publilhed cclledlively in two volumes, 8vo. Paris,
1798 ; with an Eloge prefixed, from which the above ac¬
count is collected.

PEL'LICAN (Conrad), a learned German divine of
the reformed communion, was the fon of refpeflable but
not opulent Catholic parents, and born at Ruffach in
Alface, in the year 1478. His family furname was origi¬
nally Kin-finer (Skinner), which he changed to Pellican.
Having been inftrudted in the rudiments of learning at
his native town, he was fent by an uncle to the univerfity
of Heidelberg, and fupported there for about lixteen
months, when, the expenfe proving too heavy, ouryoung
(Indent was obliged to return to his father’s houfe. He
now for fome time gratuiloufly aflifted his old fchool-
mafter, and gladly availed himfelf of the permiffion which
was given him to read the books belonging to a neigh¬
bouring convent. Obferving his fondnefs for ftudy, the
monks ufed all their arts to engage him to enter into
their community; and by degrees made fuch an imprefliou
upon his mind, that he took the habit in 1493, when he
was in his fixteenth year, without the approbation or
knowledge of his parents. In this convent he applied
with unwearied diligence and diftinguiflied fuccefs to the
lludy of the Latin and Greek languages, polite literature,
philofophy, and divinity; and in the year 1496, he was
fent for further improvement to the univerfity of Tu¬
bingen. Here he fpent between four and five years in
attending the lectures of the different profeffors ; and
during this period, with incredible labour for want of
proper books, which reduced him to the neceflity of con-
ftrufting a grammar and diftionary for his own ufe, he
made himfelf a tolerable proficient in the Hebrew lan¬
guage. In the year 1500, John Capnio, who then came
to Tubingen, aflifted him in greatly improving his ac¬
quaintance with this tongue. In 1501, Pellican was or¬
dained prieft at Pfortzheim, and immediately returned to
the convent at Ruffach. He had now acquired fo high
a reputation for learning and knowledge, that in 1502 he
was appointed profeffor of divinity in the convent be¬
longing to his order at Bafil. This fituation was pecu¬
liarly acceptable to him, as it proved the means of intro¬
ducing him to the acquaintance of the eminent literary
characters who frequented that city; and alfoof the
learned printers for whom it was famous, who engaged
his affiftance in editing the complete works of St. Augul-
tine and St. Chryfoftom. He contracted an intimacy, in
particular, with the celebrated John Froben, who never
fuffered him to be in want of uleful books. In the year
1 504, cardinal Raymund, the legate of pope Alexander
VI. having been informed of the great merits of Pellican,
and tried him by an examination which laded fome hours,
created him licentiate in divinity ; and with this extra¬
ordinary diftinftion, that, when arrived at the age of
thirty, he (hould fucceed to the title of doctor in that fa¬
culty, without going through any other forms.

About this time he drew up, at the requeft of the bifhop
of Bafil, “ A Summary of Chriftian Doftrine,” in which
he adhered to the Catholic creed, and ufed the language

PEL

of the fchools ; but his mind was beginning to entertain
doubts on the fubjects of indulgencies, purgatory, con-
feflion, the eucharift, and the papal power. In the year
1508, he was appointed to fill the divinity-chair at Ruf¬
fach ; and was afterwards defied fucceflively guardian of
the convents belonging to his order at Pfortzheim and
in that town. While he held thefe offices, he made him-
felf mafter of the Chaldee dialed, and read with great at¬
tention the Targum of Onkelos on the Pentateuch, and
various Jewi(h commentators on the Old Teftament writ¬
ings. In 1516, he was deputed by his province to at¬
tend a general congregation of the Minorite order at
Rouen in Normandy; and he was afterwards their re-
prefentative in a general congregation held at Rome.
In 1519, to his great fatisfaflion, he was appointed
guardian of the convent at Bafil, and renewed his learned
connexions and intimacies in that place. By reading
the writings of Luther, which were about this time
brought to Bafil, the doubts which he had formerly be¬
gun to entertain refpefting fome of the leading tenets of
the papal church, were ftrengthened and confirmed, and
he gradually became an entire convert to the doftrine of
that great reformer. Under the influence of this change
in his principles, he delivered in the pulpit an expofition
of the gofpel of St. Matthew, which lafted nearly eighteen
months, and was attended by crowded auditories, among
whom were fome of the moft learned men in Bafil, who
heard him with the higheft fatisfadtion, and encouraged
him to proceed with his plan. But by this condudt he
exafperated the zealous adherents to popery ; and in the
year 1523, when the provincial Satzgerus vifited the con¬
vent at Bafil, fome doftors of the univerfity, and canons
of the great church, preferred a charge againft Pellican,
his vice-guardian, and other members of the fraternity,
that they were Lutherans, and encouragers of the books
of that daring heretic. By their reprefentations the pro¬
vincial was determined to remove the accufed from their
fituations; but he was prevented from taking that ftep
by the interference of the fenate of Bafil, who confirmed
them in their places, and appointed Pellican fellow-pro-
fefforof divinity with Oecolampadius. Some time after¬
wards, however, in a general congregation of the Minorite
order at Landfliut, on the reprefentation of Satzgerus,
Pellican was removed from the office of guardian ; but he
ft ill retained his poft in the univerfity, and filled the theo¬
logical chair alternately with his learned colleague. In
the mean while, fome of his fellow-monks were fecretly
employed in endeavouring to prejudice the citizens
againft him ; and they carried their hatred to fuch
a length in the convent, that his life was in danger, and
he was daily furnifhed with provifions by friends, that
he might not prove the victim of apprehended attempts
to poifon him. Thus circumftanced, his friends prevailed
upon him toconfult his perfonal fafety ; and in the year
1526, on the Invitation of Zuinglius, he privately with¬
drew to Zurich, where he was appointed profeffor of di¬
vinity and of the Hebrew language. Upon this event he
laid afide his cowl, and adopted the common drefs of ec-
clefiaftics. To (how, likewife, that he finally renounced
the papal communion, he followed the example of many
of the other clergy who embraced the reformation, by
taking to himfelf a wife. In the fame year, he edited a
fecond imprefiion of the “ Biblia Hebraica, cum Com¬
ment. R. Abraam, Abenezra, et R. Salomonis, in Pro-
phetas ;” and alfo'of the “ Sepher Michlol,” firft printed
at Conftantinople. In the year 1 528, he took part in the
celebrated difputation at Bern, on the fubjeft of the eu¬
charift ; and publilhed a volume of the debates and
fpeeches on that occalion. During the following year he
commenced his public expofition of the books of the Old
Teftament, which employed him till 1539, and exhibited
proof of very laborious application, extenfive learning,
aild, particularly, an intimate acquaintance with the Jew-
i(h commentators, ancient and modern. This Expofition
he afterwards publilhed, in four volumes folio; and then

devoted

PEL

PEL

519

devoted his labours to an illuftration of the New Tefta-
ment, which he gave to the world in a fifth volume. He
had, befides, a confiderable (hare in preparing for the
prefs and editing the Commentaries of Sebaftian Meyer
upon the Apocryphal Books. Pellican al(o tranflated
into Latin the Chaldee paraphrafes, including the Tar-
gum of Onkelos, Jonathan, and Jerufalem, various fmall
talmudical treatifes, and Elias Levita’s edition of the
Maflbra. He publifhed, in German, “An Expofition of
the Pentateuch, Jofiiua, Judges, Ruth, Samuel, and the
Books of Kings.” With the hope of introducing the
philofophy of Ariftotle and Cicero into Germany, he
tranflated feveral books from their works into the German
language ; and he bellowed immenfe labour in editing
various commentaries, diftionaries, &c. He died in
1556, about the age of feventy-eight, highly refpefted for
his learning, and elteemed for his integrity, candour,
modefty, and fimplicity of manners. His works have
been coilefled together, and publifhed in (even vols.
folio. Melchior. Adam. Vit. Germ. Tlieol. Gen. Biog.

PEL'LICER (Jofef de Oflau, Salas, y Tobar), a. long
name of confiderable eminence in the literary hiftory of
Spain. He was born at Saragoffa, April 22, 1602; and in¬
herited a difpofition to letters from his father D. Anto¬
nio Pellicer de Oflau, who left in manufcript an epitome
of Garibay’s Great Hiftory, and a poem called Batavia
Rehelde ; doubtlefs of a right Catholic complexion. He
took an honorary degree at Alcala, and from thence re¬
moved to Salamanca ; and at the age of twenty-two took
up his refidence in Madrid, full of academical honours,
and with as much learning as ever fo young a man could
poflibly have acquired. In 1629 he was made chronicler
or hiftoriographer of Caftille. The dates of Arragon
named him to the fame office for their kingdom ; but, as
this was already held by Francifco Ximinez de Urrec, it
was ultimately decided that the reverfion could not be
granted. Philip IV. made him amends by creating him
Arch-Hiftoriographer for the kingdoms of the crown of
Arragon, an office which had been invented for Lupercio
Leonardo de Argenfola, and which had remained vacant
fince the death of his brother Bartolous. The duty of this
arch-hiftoriographer was to revife and correft the works
of the chronicler of the particular kingdoms. As a far¬
ther honour, the habit of the order of Montefa was given
him, and afterwards exchanged for that of Santiago.

Thefe honours did not bring with them correfponding
profits, and Pellicer all his life was poor. He died at
feventy-feven, w’orn out, fay his biographers, by inceffant
literary application. He was author of a great number
of works, the titles of which, foine time previoufty to his
death, filled five folio pages. His learning is generally
acknowledged, and his learned works are Hill confulted
by the literati of different countries. Gen. Biog.

PELLE(TI'ER (James), a French phyfician, and medi¬
cal and mathematical writer; born at Mans 1517, died
1 582.

PEL'LICLE, /■ [ pellicula , Lat.] A thin (kin. — After
the difcharge of the fluid, the pellicle mull be broke.
Sharp's Surgery. — It is often ufed for the film which ga¬
thers upon liquors impregnated with falts or other Jub¬
ilances, and evaporated by heat.

PELLICULA'TION, /. [from the La t. pellicular, to
cover with a pellicle.] A deception. Cole.

PELLIC'ULATORJi A deceiver. Cole.

PELLIPA'RIUS, / [in old records.] A (kinner, one
that dreffes leather,

PEL'LIS, j. [Latin.] The (kin of a bead.

PELLISON' (Fontanier Paul), an eminent French
writer, born at Beziers in 1624, was defcended from a fa¬
mily in the law. He loft his father at an early age, and
\vas brought up by his mother, who educated him in the
Proteftant religion. He ftudied fucceffively at Cadres,
Montauban, and Touloufe; and acquired an intimate
knowledge of the bed authors in the ancient and mo¬
dern languages. He applied profeflionally to the ftudy

Vol. XIX. No. 1321.

of the law, and had already appeared with diftinflion at
the bar at Cadres, when he was attacked with the fmall-
pox. This cruel difeafe left a permanent weaknefs in his
eyes, and fo disfigured him that he became a model of
uglinefs. Under a forbidding exterior, however, dwelt
many fair qualities of the mind. He quitted the bar,
and retired for fome time into the country. He then
came to Paris, and made himfelf known as a man of
letters. In 1652 he obtained the place of a king’s fecre-
tary, and applied with diligence to the affairs of the coun¬
cil, with which he became intimately acquainted. In
the fame year he read before the French Academy a
hiftory which he had compofed of that inftitution, and
which was fo much approved, that a refolution was made
to admit him as a member on the firft vacancy, and in the
mean time to give him the privilege of being prefent and
fpeaking at the meetings of the academy. His Hiftory
was printed in 1653, and many fucceffive editions wrere
given of it. Although too minute and panegyrical in
the account of authors of little merit, negligent in its
ftyle, and not very correiff in its fa£ts, it is a curious and
interefting performance.

M. Pellifon was brought into a confpicuous public fitu-
ation in 1657, by being appointed firft clerk to the cele¬
brated fuperintendant Fouquet. The financial bufinefs
into which he was now plunged impaired neither the
difinterellednefs of his character nor the amenity of his
difpofition. His fervices were recompenfed in 1660 by
admiffion into the council of (late; but in the following
year he was involved in the fall of his patron, and, as
having been one of his principal confidents, was com¬
mitted to the Baftille. As it was found impoffible to cor¬
rupt his fidelity to his former mafter, attempts were made
to worm out his fecrets by means of a German, a pre¬
tended fellow-prifoner, who concealed craft under a grofs
and Ample exterior. Pellifon was aware of his artifices,
and treated him with fo much politenefs, that he con¬
verted him into a friend. During his imprifonment he
compofed three memoirs in favour of Fouquet, which are
reckoned among the molt eloquent and beft-written
pieces of the kind in any language, and have conferred
lading honour on his memory. They were, however, the
immediate caufe of increafed rigour in his confinement.
He was prohibited the ufe of ink and paper, and was re¬
duced to write with the lead of his cafement upon the
margins of books, or to ufe a kind of ink which he made
with burnt crufts tempered with wine. His whole com¬
pany was a ftupid Bafque, whofe only talent was playing
on the bagpipe. With infinite pains he trained afpider
to come out of its hole at the found of this inftrument,
and take flies from his hand. Books of controverfy were
another employment of his folitary hours ; and he re¬
ceived in the Baftille thofe impreffions which afterwards
produced a change of religious profeflion. He preferved
many friends in this forlorn fituation ; and Tannegui ie
Fevre had the courage to dedicate to him, whiift in prifon,
his Lucretius, and his tranflation of Plutarch’s Treatife
on Superftition. At length, after a confinement of four
years and a half, he obtained his liberty ; and thence¬
forth, fays Voltaire, “ he palled his life in lavifliing praifes
upon the fovereign who had deprived him of his liberty;
a thing feen only in monarchies !” He was taken into
favour, obtained a royal penfion and a brevet of entree,
and was made the king’s hiftoriographer. His public re¬
cantation of Proteftantifm, in 1670, was doubtlefs one of
the conditions of this favour. He foon after took the
order of fub-deacon, and was prefented to an abbacy and
a rich priory. It was with fome reafon, therefore, that
he annually celebrated his reconciliation with the church
of Rome. He gave a more interefting proof of the good-
nefs of his difpofition by commemorating the anniverfary
of his liberation from the Baftille with the annual releafe
of fome prifoners.

In 1671, Pelliffon delivered at the French Academy, a
“ Panegyric on Louis XIV.” which was tranflated into
6 R various

520 PEL

various languages, and even into Arabic by a patriarch of
Mount Lebanon. He accompanied his royal mafter in-
his campaigns, and for fome time was the only man of
letters engaged in writing his hiftory; but fome offence
which he gave to Mad. de Montefpan induced the king to
give the appointment of hiftoriographer royal to Boileau
and Racine, and take it from Pelliffon. He was, hovfi
ever, ordered to proceed in his own hiftorical labours;
and he produced a “ Hiftory of Louis XIV. from the
Death of Cardinal Mazarine in 1661 to the Peace of Ni-
meguen in 1678,” 3 vols. nmo. It is, as might be ex-
petted, more the work of a courtier than of a faithful
hiftorian ; yet Voltaire fpeaks with applaufe of his rela¬
tion of the conqueft of Franche-Comte. Pelliflon en¬
gaged with great zeal in what was called in France la
grande affaire, namely, the converfion of heretics. It is
to his credit that he difapproved of the dragooning fyftem
of profelyting ; and he ieems to have relied much more
on the judicious diftribution (which wasentrufted to him)
of the third of the favings deftined by the king for re¬
wards to fuch as fhould conform to the eftablifhed reli¬
gion. He alfo employed his pen in controverfy, and
wrote “Reflexions fur les Differences de la Religion,”
and “Traite de l’Euchariftie,’’ works compofed with art,
and in a laudable tone of moderation. Pelliffon was made
a mafterof requefts, and pafled all the latter part of his
life in great credit and profperity. As, in Roman-catho¬
lic countries, the laft fcene of a man’s life is generally
thought of more confequence than all the preceding part,
it was the caufe of much regret, and fome fcandal, that
he died (in February 1693) without confefflon or the
ufual facraments. It is probable, however, that this cir-
cumftance was rather owing to an unconfcioufnefs of his
own danger till too late, than to any doubts refpedling
his adopted faith. Befides the works above mentioned,
he wrote feveral pieces in verfe and profe, among which
were, 6. An Abridgment of the Life of Anne of Auftria.
7. Lettres' Hiftoriques, being a journal of the king’s
journeys and encampments. 8. Recueil de Pieces ga-
lantes. 9. Poefies Chretiennes et Morales. His poetry
is but indifferent; his profe is often eloquent and forci¬
ble. Boyle- Voltaire Siecle de Louis XIV.

PEL'LITORY,/ An herb. See Parietari a.

The pellitory healing fire contains,

That from a raging tooth thehumourdrains.Ta(e’sCW/<?y.

PEL'LITORY, Ballard. See Achillea.

- - - of Spain. See Anthemis.

- - i — - of the Wall. See Parietaria.

PELLMELL', adv. [ pejle-mejle , Fr.] Confufedly; tu-
multuoufly; one among another; with confufed vio¬
lence. — The battle was a confufed heap : the ground
unequal ; men, horfes, chariots, crowded pellmell. Mil-
ton s Hijl. of Eng.

He knew’ when to fall on pellmell,

To fall back and retreat as well. Hudibras.

PELLO'NIA, in mythology, a goddefs invoked at
Rome, when her votaries wiflied to be delivered from their
enemies, or from any thing that annoyed them.

PELLOUTI'ER (Simon), pallor of the French Pro-
teftant church at Berlin, member and librarian of the
academy in that capital, and ecclefiaftical counfellor,
was born in 169+ at Leipfic, of a family originally from
Lyons. He filled with reputation the pofts confided to
> him, and obtained a high character for erudition by his
work entitled “ Hiftoire des Celtes, et particulierement
des Gaulois et des Germains, depuis les Temps Fabu-
leux jufqu’a la Prife de Rome paries Gaulois.” Of this
work, which is replete with learned and curious refearch,
the beft edition is that of M. de la Baftide, Paris, 1770,
in eight vols. iamo. and two vols. 4.10. Pelioutier alfo
enriched the Memoirs of the Berlin Academy, with a
number of valuable papers. He died in 1757, univerfally
efteemed for has learning and beneficence.

PEL

PELLU'CID, adj. [ pellucidus , Lat.] Clear; tranfpa-
rent ; not opake ; not dark. — If water be made warm in
any pellucid veffel emptied of air, the water in the vacuum
will bubble and boil as vehemently as it would in the
open air in a veiTe! fet upon the fire, till it conceives a
much greater heat. Newton's Optics.

PELLUCID' ITY, or Pellu'cidness, /. Tranfparen-
cy ; clearnefs; not opacity. — The air is a clear and pel¬
lucid menftruum, in which the inlenfible particles of dif-
folved matter float, without troubling the pellucidity of
the air; when on a fudden by a precipitation they gather
into vilible mifty drops that make clouds. Locke. — We
confider their pellucidnefs and the vail quantity of light,
that pafles through them without refledtion. Keil.

PELLUSIN', a town of France, in the department of
the Rhone and Loire : twelve miles eaft of St. Etienne.

PELO'DES, in ancient geography, a port of Epirus,
between the gulf of Buthrotori and the promontory of
Thyamis,' — Alfo, a gulf of Afia, in Sufiana.

PEL'ONIA,/. in botany. See Antirrhinum.

PELON'TIUM, a town of Spain, in the Tarragonenfis
and country of the Lingones. Ptolemy.

PEL'OPE, a town of Afia Minor, in Lydia, on the
confines of Phrygia. Steph. Byz.

PELOP'IDAS, a celebrated Theban general. Seethe
article Greece, vol. viii. p. 209-16.

PELOPONNE'SIAN, adj. Belonging to the Pelopon -
nefus.

PELOPONNE'SUS, a celebrated peninfula, which
comprehends the moil fouthern part of Greece. It re¬
ceived this name from Pelops, who fettled there, as the
name indicates (the Ifland of Pelops). It had been
called before Argia, Pelajgia , and Argolis ; and, in its
form, it has been obferved by the moderns highly to re-
femble the leaf of the plane-tree. Its prefent name i«
Morea , which feems to be derived either from the Greek
word popa., or the Latin morus, which fignifies a “ mul¬
berry-tree,” which is found there in great abundance.
See GRiECiA Antiqua, vol. viii. p. 378.

The Peloponnefus was conquered, fome time after the
Trojan war, by the Heraclidae, or defendants of Her¬
cules, who had been forcibly expelled from it. The in¬
habitants of this peninfula rendered themfelves illuftrious
like the reft of the Greeks by their genius, their fondnefs
for the fine arts, the cultivation of learning, and the pro-
feflion of arms ; but in nothing more than by a celebrated
war which they carried on againft Athens and her allies
for twenty-feven years, and which from them received
the name of the Peloponnefian war ; for a full account of
which, fee the article Greece, vol. viii. p. 879-94. The
Peloponnefus fcarcely extended 200 miles in length, and
140 in breadth. It was leparated from Greece by the
narrow ifthmus of Corinth, which, as being only five
miles broad, Demetrius, Caefar, Nero, and fome others,
attempted in vain to cut, to make a communication be¬
tween the bay of Corinth and the Saronicus Sinus.

PE'LOPS, a celebrated prince, fon of Tantalus king of
Phrygia. His mother’s name was Euryanafla, or accord¬
ing to others Euprytone, or Euryftemifta, or Dione. He
was murdered by his father, who- wifhed to try the divi¬
nity of the gods who had vifited Phrygia, by placing on
their table the limbs of his fon. The gods perceived his
perfidious cruelty, and they refufed to touch the meat,
except Ceres, whom the recent lofs of her daughter had
rendered melancholy and inattentive. She ate one of the
(houlders of Pelops ; and therefore, when Jupiter had had
compaflion on his fate, and reftored him to life, he placed
a (boulder of ivory in (lead of that which Ceres had de¬
voured. This (houlder had an uncommon power, and it
could heal, by its very touch, every complaint, and re¬
move every diforder. Some time after, the kingdom of
Tantalus was invaded by Tros king of Troy, on pretence
that he had carried away his fon Ganymedes. This rape
had been committed by Jupiter himfelf ; the war, never-
thelefs, was carried on; and Tantalus, defeated and

ruined,

PEL

ruined, was obliged to fly with his fon Pelops, and to
feek a Ihelter in Greece. This tradition is confuted by
fome who fupport, that Tantalus did not fly into Greece,
as he had been fome time before confined by Jupiter in
the infernal regions for his impiety, and therefore Pelops
was the only one whom the enmity of Tros perfecuted.

Pelops came to Pifa, where he became one of the fui-
tors of Hippodamia, the daughter of king CEnomaus,
and he entered the lifts againft the father, who promifed
his daughter only to him who could outrun him in a
chariot-race. Pelops was not terrified at the fate of the
thirteen lovers, who before him had entered the courfe
againft CEnomaus, and had, according to the conditions
„ propofed, been put to death when conquered. He pre-
vioufly bribed Myrtilus, the charioteer of CEnomaus, and
therefore he eafily obtained the vi&ory. According to
fome authors, the horfes which drew Pelops’s chariot had
wings, and they had been given to him by Neptune ; the
meaning of which is, if u’e believe Pindar and Palasphatus,
that Pelops made ufe of a lhip with fails to carry off Hip¬
podamia.

When Pelops had eftablifhed himfelf on the throne of
Pifa, Hippodamia’s pofleflion, he extended his conquefts
over the neighbouring countries, and from him the pe-
ninfula, of which he was one of the monarchs, received
the name of Peloponnefus. Pelops, after death, received
divine honours; and he was as much revered among all
the other heroes of Greece, as Jupiter was above the reft
of the gods. He had a temple at Olympia, near that of
Jupiter, where Hercules confecrated to him a fmall por¬
tion of land, and offered to him a (acrifice. The place
where this, facrifice had been offered was religioufiy ob-
ferved, and the magiftrates of the country yearly, on
coming into office, made there an offering of a black ram.
During the facrifice, the foothfayer was not allowed, as
at other times, to have a fhare of the vi&im, but he alone
who furnifhed the wood was permitted to take the neck.
The. wood for facrifices, as may be obferved, was always
furnifhed by fome of the priefts, to all fuch as offered vic¬
tims, and they received a price equivalent to what they
gave. The white poplar was generally ufed in the facri¬
fices made to Jupiter and to Pelops.

The children of Pelops by Hippodamia were Pitheus,
Troezen, Atreus, Thyeftes, &c. befides fome by concu¬
bines. The time of his death is unknown, though it is
univerfally agreed, that he furvived for fome time Hippo¬
damia. See Hippodamia, vol. x.

The era of Pelops’s arrival in Greece muft have been
about the noth or 1 20th year before the Trojan war.
Among other fatalities of Troy, it is faid that it could
not be taken by the Greeks, unlefs they had the bones of
Pelops ; and they therefore fent for them to Pifa where
he had been interred. The vefl'el was fhipwrecked in its
return ; and fome time after a peafant found upon the
fhore the fhoulder of that prince, and hid it under the
fand. The Elaeans having gone to the temple of Del-
phos toconfult the oracle, in order to be delivered from
the plague, the prieftefs ordered them to go and dig up
the bones of Pelops ; and, perhaps in memory of this
event, they made an ivory fhoulder, which they confe¬
crated to Ceres, and the Pelopidae bore it afterwards upon
their enfigns.

PELO'RIA, in antiquity, feafts inftituted and cele¬
brated by the Theffalians. They had a confiderable affi¬
nity with the Saturnalia ; for in thefe the matters ferved
while their fervants fat at table, as in the Chronia cele¬
brated at Athens in honour of Chronos, or Saturn. At
the feftival of the Peloria, public entertainments were
made for ftrangers, and even for flaves, who were ferved
by their mailers : and it is faid, that the practice, as well
as the feaft, originated from this circumftance, that one
Pelorus was the perfon who firft gave intimation to Pe-
lafgus, that by means of an opening in the valley of
Tempe the waters of Deucalion’s deluge were removed ;
which intelligence gave that prince fo much joy, that he

PEL 321

regaled Pelorus in a magnificent manner, and infilled
upon ferving him at table.

PELO'RUS, in ancient geography, now Cape Faro,
one of the three great promontories of Sicily. It lies
near the coaft of Italy; and received its name from Pelo¬
rus, the pilot of the lhip which carried Hannibal away
from Ttaly. This celebrated general, as it is reported,
was carried by the tides into the (freights of Charybdis;
and, as he was ignorant of the coaft, he afked the pilot of
his (hip the name of a promontory which appeared at a
diftance. The pilot told him, it was one of the capes
of Sicily ; but Hannibal gave no credit to his information,
and murdered him on thefpot on the apprehenfion that
he would betray him into the hands of the Romans. He
was, however, foon convinced of his error; and therefore,
to pay honour to his memory, he gave him a magnificent
funeral, and ordered that the promontory (hould bear
his name, and from that time it was called Pelorum.
Some contend that this account is falfe, and obferve that
it bore that name before the age of Hannibal.

PELO'SO, a town of Italy, in the Cadorin : feven
miles north-eaft ofCadora.

PELOUAI'LLE, a town of France, in the department
of the Mayne and Loire : five miles north-eaft of Angers,
and fourteen weft ofBauge.

PELO'W, a town of Ava, on the left bank of the ri¬
ver Ava : fifteen miles from Prone.

PELT, f. [ pellis , Lat.] Skin; hide. — The church is
fleeced, and hath nothing but a bare pelt left upon her
back. Bp. Hall’s Contempt.— They ufed raw pelts clapped
about them for their clothes. Fuller's Holy War. — The
camel’s hair is taken for the Ikin or pelt with the hair upon
it. Broivn's Vulg. Err.

A fcabby tetter on their pelts will ftick,

When the raw rain has pierc’d them to the quick. Dryd.
The quarry of a hawk all torn. Ainfworth. — A blow from
fomething thrown ; a ftroke. — George hit the dragon
fuch a pelt ! Ballad of St. George for England..

To PELT, v. a. [ poltern , Germ. Skinner. Contracted
from pellet; Mr. Lye. Or from pellere, Lat. to drive or
pufli away.] To ftrike. It is generally ufed of fomething
thrown, rather with teazing frequency than deftruClive
violence. — Obfcure perfons have infulted men of great
worth, and pelted them from coverts with little objections.
Atterbury.

Do but Hand upon the foaming fiiore.

The chiding billows feem to pelt the clouds. Shakefp.

To throw; to call :

My Philljs me with pelted apples plies,

Then tripping to the woods the wanton hies. Dryden.

PELT'-MONGER, f [ pellio , Lat.] A dealer in raw
hides.

PEL'TA, f. [Greek.] A kind of buckler, ufed among
the ancients. The pelta was fmall, light, and more ma¬
nageable than the parma. It appears from Virgil, and
other authors, that the pelta was the buckler ufed by
the Amazons ; and Xenophon obferves, that the pelta of
the Amazons was fliaped like a leaf of ivy. Pliny, fpeak-
ing of the Indian fig-tree, fays its leaves are of the width
of the Amazonian pelta. Servius on the Asneid fays,
the pelta refembled the moon in her firft quarter. This
fmall (hield, or buckler was ufed by the Macedonians,
Cretans, Africans, and ancient Spaniards. Thofe who
carried Ihields of this defcription were called peltados.

PEL'T^E, in ancient geography, a town of Alia, in
Phrygia. This town was well peopled, and fituated at
the diftance of ten parafangs from Celenes. Cyrus fo-
journed here three days, and was a fpeClator of the Lu-
percalia which Xenias of Arcadia celebrated by facrifices
and games at which the prizes were currycombs of gold.
This town is not mentioned by Xenophon, Strabo, Pto¬
lemy, or Stephanus of Byzantium.

PELTAN' (Theodore Anthony), a learned Jefuit in

the

PEL

522

the 16th century, was born at Pelta, in the diocefe of
Liege, whence he derived his furname, but in what year
we are not informed. He became a member of the So¬
ciety of Jefus in the year 155a; and acquired celebrity by
his proficiency in the Latin, Greek, and Hebrew, Ian-
guages, and his knowledge of philofophy and divinity.
When Albert duke of Bavaria founded the Univerfity of
Ingoldftadt,in 1 556, he w'as appointed profeflor of Greek
and Hebrew literature in that feminary, and difcharged
the duties of his office with uncommon applaufe. At
different periods he was admitted to the fubordinate de¬
grees in the faculty of divinity, and in 1562 proceeded
DoCfor. Immediately afterwards he was called to the
theological chair, which he filled with great reputation
till the year 1574; when he retired to the college be¬
longing to his order at Augfburg, where he fpent his
time in laborious ftudy and writing till his death, which
took place in theyear 1584. He was the author of a work
entitled “ Theologia Naturalis, et Theologia Myftica ;”
together with numerous do&rinal and controverfial
Treatifes, Thefes, Propofitions, &c. and fundry tranfla-
tions from Greek into Latin. After his death were pub-
liflred from his manuferipts, 2. Catena Grascorum Pa-
trum in Proverbia Salomonis, Latine fa&a, 1604, 8vo.
3. Commentarii ac Paraphrafis in Proverbia Salomonis,
1606, 4to. Sotvelli Bill. Script. Soc. Jefu.

PELTA'RIA, f. [from the form of the feed-veffel,
round and flat, like the pelta, or round fhield.] In bo¬
tany, a genus of the clals tetradynamia, order filiculofa,
natural order of filiquofae, cruciformes, or cruciferae.
Generic characters — Calyx: perianthium four-leaved;
leaflets ovate, concave, ereCt, coloured, deciduous. Co¬
rolla: four-petalled, cruciform; petals obovate, entire,
flat, with claws fhorter than the calyx. Stamina: fila¬
ments fix, awl-fhaped ; of thefe two oppofite, fhorter, the
length of the calyx; antherae Ample. Piftillum : germ
roundilh, comprefled ; ftyle flrort ; ftigma Ample, blunt.
Pericarpium : filicle entire, fuborbiculate, comprefled
flat, one-celled, not opening. Seed one to three, round¬
ifh, comprefled-flat, emarginate. — EJfcntial Character . Sili-
cle entire, fuborbiculate, comprefled-flat, not opening.
There are two fpecies.

1. Peltaria alliacea, or garlie-feented peltaria : leaves
embracing, oblong, undivided. This is a biennial plant,
and generally dies foon after the feeds are perfected. It
rifes with an upright branching ftalk, about a foot high.
Leaves heart-fhaped, fmooth. White flowers terminate
the ftalk in form of umbels. It is a native of ftony
mountainous places in Auftria, near the lofty Schnee-
burg. It was introduced into our gardens in the time of
Clufius, as he himfelf mentions ; and is ftill preferved, for
the fake of curiofity, in botanical collections; flowering
in May and ripening feed a month or fix weeks later.
The herb when bruifed has an unpleafant garlic feent
fomewhat like that of Eryfimum alliaria. The feeds are
bitter and acrid.

2. Peltaria Capenfis, or Cape peltaria : Item-leaves
quinate-pinnate, linear, fomewhat flefhy. Stem upright,
branched, round, even, a foot high, leafy. Petals of the
flowers white, fubemarginate, four times as big as the
calyx, fpreading, feflile. Seeds in the centre as in Clype-
ola, folitary in each cell, comprefled. Native of the
Cape of Good Hope.

Juffieu reduces this genus to Clypeola, and he is fol¬
lowed by Lamarck ; but P. Capenfis (Linn. Suppl. 296.)
has, as Willdenow well obferves, a pouch of two cells,
with diftinCt valves and a membranous partition. Its ha¬
bit is like a Heliophila. Whatever it may be, it is no
Peltaria.

PEL'TATE, or Target-shaped, adj. in botany,
having the ftalk inferted in the difk of the leaf, and not
in the edge.

PEL'TER,/. A pinch-penny; one withered with co-
vetoufnefs : a mean paltry wretch. Not now in ufe.

PEL'TING, adj. “ This word in Shakefpeare Signifies,

PEL

I know not why, mean; paltry; pitiful.” Dr. Johnfon.
— “The word is not peculiar to Shakefpeare : it is ufed
by writers before and after him ; and appears to have been
common.” Todd. — They (hall not fuffer, that any of
thefe light wanderers in markets, and pelting fellers,
which carry about and fell pinnes, points, and other fmall
trifles, whom they call pedlars, to fet out theyr wares to
fale, either in the church-yeardes, or in the porches of
churches. Boohe of Certaine Canons, Sec. 1571. — Abufed
and baffled by every pelting paultry lull. Hammond.
Could great men thunder, Jove could ne’er be quiet ;

For every pelting petty officer

Would ufe his heaven for thunder. Shakefpeare.

PEL'TING, f. Aflault ; violence:

Poor naked wretches wherefoe’er you are,

That bide the pelting of this pitilefs ftorm,

How (hall your houfelefs heads, and unfed (Ides,

Your loop'd and window’d raggednefs, defend you !

Shakefpeare.

PELTRY, f. [ peltric , old Fr.] Furs or (kins in ge¬
neral. — The profits of a little traffick he drove in peltry.
Smollet.

PELTUTNUM, in ancient geography, a town of Italy,
in the territory of Samnium.

PEL'UA, a town of Illyria, on the route from Sir-
mium to Salonae, between Salva and aEquum, according
to the Itinerary of Antonine.

PELU'CHE, or Felud'sje, a fmall ifland in the north-
weft part of the gulf of Perfia, near the coaft of Arabia :
ten miles eaft of Koueit. Lat. 29. 45. N. Ion. 48. E.

PEL'VIS, f. [Lat. a bafon.] A large irregular bony
cavity, open above and below, and forming the inferior
end of the trunk of the human body. At the upper and
back part its parietes fupport the vertebral column, and
they are fuftained below and towards the front by the
thighs, to which they tranfmit the weight of the body ;
thus a well-marked (pace, which meafures the immediate
bafe of fupport of the trunk, is left between the plane
of the limbs and of the fpine. In a well-formed indi¬
vidual, the pelvis divides the body into two equal halves :
that is, if a line be drawn acrofs its middle, the upper
and lower portions of the body have the fame length.
This rule, however, is fubjeCt to fome exceptions: the
lower limbs are imperfectly developed in the feetus ; and,
in unufually tall or (hort adult individuals, the lower ex¬
tremities or the trunk exceed the juft proportion.

The pelvis is fymmetrical, but of a figure not eafily de¬
fined. It forms, by its upper portion, a cavity nearly
oval in the tranfverfe direction, expanded at the fides, and
hollowed out in front, communicating by an elliptic
opening, called the fuperior aperture, with its lower
portion, which is much fmaller in fize, and ends below
byjan opening called the inferior aperture.

The pofition of the pelvis is oblique, the back part be¬
ing confiderably higher than the front: this obliquity is
well feenin the fuperioraperture, which flants very mani-
feftlyfrom above downwards and forwards : the inferior
aperture looks downwards and backwards. Soemmerring
dates, that in the ereCl attitude the laft bone of the coc¬
cyx is an inch higher than the inferior edge of the fim-
phyfis pubis ; and that the promontory of the facrum
is higher than the fame point, by the whole depth of the
facrum and coccyx. The axis of the upper or broad
part of the pelvis is nearly perpendicular; that of the
lower or fmaller divifion flants from above downwards,
and from before backwards. It is faid to correfpond to
a line drawn from the apex of the os coccygis to the
umbilicus. This line would cut the level of the pelvis
nearly at a right angle ; that is, the meeting of the two
lines would form an angle of 75 degrees in front, and of
105 behind. The weight of the trunk being obliquely
tranfmitted to the thighs, in confequence of this inclina¬
tion of the pelvis, it follows, fays Bichat, that the latter
is the feat of a decompofition of motion in this tranf-
2 million,

PEL

miffion, proportioned to the degree of inclination, which
is about thirty-five or forty degrees at the upper part,
where we can eafily eftimate it by the line, which extends
from the facro-vertehral articulation to the upper edge of
the fympbyfis pubis.

The capacity of the pelvis differs remarkably in man
and woman. It is manifeftly larger in the latter in every
direction : thus the two iliac criftae, the two anterior
and the two pofterior fpines, the cotyloid cavities, the tu-
berofities of the ifchia, &c. &c. are further apart. Thefe
are all tranfverfe meafurements ; and thofe from before
backwards are greater, as we may lee in meafuring from
the facrum to t lie pubes, from the anterior to the pofte¬
rior fpine, from the facro-iliac articulation to the fora¬
men ovale, See. The oblique meafurements, from one
fide to the other, are alfo larger in the female. The fu-
perior aperture often exhibits deviations from the accuf-
tomed arrangement, in the diminution of its diameters
fubfequently to birth ; and thefe are generally caufed by
rachitis, which exerts itseft'e&s more on the antero-pofte-
rior than on the tranfverfe or oblique diameters, becaufe
the weight of the upper parts, tranfmitted by the fpine,
is the principal exciting circumftance.

The breadth of the pelvis in the female produces fome
difficulties in progreffion ; but the pafiage of the child in
parturition is facilitated. It performs an important part
in this fun&ion, befides having the fame offices as in
man, viz. thofe of forming the bafis of fupport to the
trunk, and of containing and protecting the vifeera.

The comparative height of the pelvis in the male and
female is exactly the inverfe of the breadth. The mea-
furement from the crifta of the ilium to the tuberofity of
the ifehium, the depth of the fymphyfis pubis, and the
length of the canal formed by the fmaller pelvis, are con-
fiderably greater in men than in women. There are fome
individual varieties in the dimenfions of the pelvis, but
they depend very little on ftature. Parturition is as eafy
in fmall as in large women, although the formerfrequently
produce very large children. See the article Parturi¬
tion, vol. xviii. p.691.

The pelvis is formed of few but very broad bones,
united in fuch a manner as not to admit of motion on
each other : it can be moved therefore only all together,
and not partially. Four bones enter into its compofition :
two pofterior, fymmetrical, and placed on the middle
line, are the facrum and coccyx ; two anterior and irre¬
gular, tranfmit to the thigh-bones the weight of the
trunk, which they have received from the facrum ; they
are the offa innominata. The facrum and coccyx, placed
at the back of the pelvis, form a continuation of the
vertebrae, and are conftruCted on a mode fimilar to that
of the vertebrae. In moft quadrupeds this prolongation
of the fpine is much more extenfive, and forms the tail,
which goes confiderably beyond the anus ; while in man,
that opening is fituated a little farther than the end of
the coccyx.

The organs' contained in the cavity of the pelvis are
excellently protected from all external fliocks. The kind
of arch formed by the offa pubis in front, the thick muf-
cles, the hip-joints, and the trochanter, at the fides, and
the mufcular maffes of the fpine behind, conftitute an ef¬
fectual provifion for the refiftance of injury. The pro¬
jection of the offa innominata beyond the facrum behind,
protects the latter bone in cafes of blows or falls on his
part of the pelvis. See the article Anatomy, vol. i. p.
548, 617. and Parturition, vol. xviii. p. 691.

PE'LUS, in ancient geography, the name of an ifland,
fituated in the vicinity of that of Chios. — Alfo, a moun¬
tain of Italy, in Etruria. — Alfo, a torrent of Sicily.

PE'LUS, a town of Perfia, in the province of Mecran :
fifty-four miles north-north-eaft ofKieh.

PELU'SIUM, in ancient geography, a town of Egypt,
at the eaftern extremity of the lake Menzale, near one of
the mouths of the Nile, and, according to Strabo, about
two miles from the fea. Its name, which in Greek fig-

Vol. XIX, No. 1322.

P E M 523

nifies mud, proves its fituation to be in the midft oflakes
and marfhes ; as does alfo the Hebrew term Sin, by which
the prophet Ezekiel denominates it; and alfo the Tineh
of the Arabians. The period of its foundation, as well
as that of the other ancient cities of Egypt, is loft in the
obfeurity of time. It flourilhed long before Herodotus.
As it commanded the entrance of the country on the fide
of Alia, the Pharaohs rendered it a confiderable fortrefs:
one of them raifed a rampart thirty leagues in length,
from the walls of this town to Heliopolis. This ram¬
part, which covered Pelufium, did not, however, flop
Cambyfes, who attacked it with a formidable army.
Cambyfes, after a bloody battle, in which he flaughtered
his enemies, entered Pelufium in triumph. Herodotus,
who vifited Pelufium fome years after the conqueft of
Cambyfes, fays that he furveyed the plain where the two
armies had fought, and found it covered with human
bones collected in heaps ; thofe of the Perfians on one
fide, and thofe of the Egyptians on the other. Pelufium,
after palling under the dominion of Perfia, was taken by
Alexander. The brave Antony, general of cavalry un-
derGabinius, took it from his fucceffors ; and Rome re-
ftored it to Ptolemy Auletes. Pompey, after the fatal
battle of Pharfalia, took refuge at Pelufium ; but he had
fcarcely landed on the Ihore, when he was murdered.
The affaffins cut off his head, fent it to Csefar, and left
his body naked on the Ihore. Pelufium was often ta¬
ken and pillaged, during the wars of the Romans, the
Greeks, and the Arabs ; but, in fpite of her difafters, file
preferved, to the time of the crufades, her riches and her
commerce. The Chriftian princes, having taken it by
ftorm, lacked it. It never again rofe from its ruins, and
the inhabitants went to Damietta.

Farama , founded by the Arabs, a little to theeaftward
of Pelufium, took place of it. But this town did not
long lubfift, for it was deftroyed in the 13th century. It
had a maufoleum, which fome have erroneoufly fuppofed
to be the tomb of Galen, but which in reality was that of
Pompey, placed by Pliny at fome diftance from Mount
Ceiius, in the vicinity of which are the ruins of Farama.
Savary's Travels in Egypt.

PELU'SO, a fmall itland in the Mediterranean, near
the coaft of Natolia. Lat. 36.45. N. Ion. 28. 36. E.

PE'LYN, a village in Cornwall. See Lestwitkiel,

PEMAQUID', a bay on the coaft of Maine, contain¬
ing feveral fmall iflands. Lat. 43. 45. N. Ion. 69. 30. W.

PEMAQUID' POl'NT, a cape on the coaft of Maine.
Lat. 43. 37. N. Ion. 69. 30. W.

PE'MAR, a town of Sweden, in the province of Fin¬
land : twelve miles eaft of Abo.

PEMA'RO, a town of Etruria: fifteen miles eaft-
fouth-eaft of Leghorn.

PEM'BA, a province of Congo, bounded on the north
by the province of Sundi, on the eaft by Batta, on the
fouth by Bamba, and on the weft by Songo. Some divide
the province into two; one called the province of St.
Salvador, and the other the marquifate of Bamba, from
the chief towns. The land is generally fertile, particu¬
larly towards the eaft. See Bamba, vol. ii.

PEM'BA, or Penda, an ifland in the Indian Sea, near
the coaft of Africa; about 100 miles in circumference,
governed by a king, tributary to the Portuguefe. Lat.
5. 55. S. Ion. 42. E.

PEM'BA BA'Y, a bay of the Indian Sea, on the coaft
of Africa. Lat. 13. S.

PEM'BERTON, a village in Lancafliire. The number
of inhabitants 2309, of whom 1366 are employed in trade
and manufactures : two miles fouth-fouth-w'eft of Wigan.

PEM'BREY, a village and diftriCt in South Wales.
The earl of Alhburnham has reclaimed 500 acres of fine
rich marfli-land from the conftant overflow of the tide at
this place. The length of the bank is two miles and a
half ; in many parts it is 12 feet high, and the bafe 84 feet
wide. Sept. 1818.

PEM'JBRIDGE, a town in the county of Hereford, on
6 S the

524

PEMB

the Arrow; with a manufafture of woollen cloth, a
weekly market on Tuefday, and fairs May 12 and Nov.
zz. The number of houfes, in the year 1821, was 288,
and of inhabitants 1138. It is fifteen miles north-north-
weft of Hereford, and 145 north-weft of London. Lat.
52.19. N. Ion. 2.48. W.

PEM'BRIDGE POI'NT, a cape on the eaft coaft of
the Ifle of Wight. Lat. 50. 42. N. Ion. 1. 56. W.

PEM'BROKE, a townlhip of America, in Plymouth
county, Maflachufetts : thirty miles fouth by eaft from
Bofton ; incorporated in 1752, and containing 2051 in¬
habitants. Some veflels have been built here. — 'Alfo, the
Siuicoofioi the Indians, a townlhip of Rockingham coun¬
ty, New Hampfhire, on the eaft fide of Merrimack river,
oppofite to Concord ; incorporated in 1759, and contain¬
ing 1153 inhabitants.

PEM'BROKE, a borough and market town in the
county of Pembroke, South Wales, fituated on a fingular
neck of land, dividing the fmall eftuary of Down-Pool,
which flows from Milford-haven. It is the county-town 5
and, next to Caermarthen, is one of the largeft and rich-
eft towns in the fouthern divifion of the principality.
The period of its foundation is unknown ; but it is cer¬
tainly of great antiquity, and is fuppofed to have derived
its name from the Britifh word Penfro, fignifying a cape,
or promontory. It was anciently fortified, and protected
by a moft magnificent caftle, the vaft ruins of which ftill
give it an appearance of uncommon grandeur ; and was
Jikewife defended by a ftrong wall, ftill nearly entire, on
the northern fide, where it is flanked by numerous baf-
tions of grfcat thicknefs and ftrength. Through this
wall were formerly three gates, on the eaft, north, and
weft, fides ; befides a fmall poftern on the fouth fide,
leading to the marfii. Of thefe gates, that facing the
north is the only one nowftanding; the other two hav¬
ing been long fince delfroyed. The eaft gate, which re¬
mained in Leland’s time, is defcribed by him as confid¬
ing of folid iron, and as being highly ornamented and
fortified.

The corporation of Pembroke is compofed of a mayor
and council, two bailiffs and ferjeants at mace, and
about 1500 burgefles. The mayor holds a court every
fortnight for the decifion of civil caufes arifing within
his jurifdidfion . Here are alfo held the petty fellions for
the hundred of Caftle-Martyn. The markets are on
Wednefday and Saturday; and the fairs on the 14th of
May, Trinity Monday, St. Peter’s day old ftyle, and 25th
of September. Pembroke, in conjunction with the neigh¬
bouring boroughs of Tenby and Wifton, fends one mem¬
ber to the Britifh parliament : the mayor is the returning
officer. The voters are eftimated at 500 in number; and
thefe boroughs have been reprefented by the family of
Owen, of Orielton-houfe, barts. and byperfons nomina¬
ted by them, ever fince the reftoration of Charles II. in
1660. This family having become extindt in the direct
male line, their eftates have been bequeathed to John
Lord, efq. a grandfon in the female line, who has aflumed
the name of Owen, and was created a baronet in 1813.
This gentleman is at prefent member for the county, and
patron of this diftrict of boroughs.

According to the population-returns of i8n,this town
contained 501 houfes, and 2415 inhabitants; in 1821 it
had 4925 inhabitants. The houfes are ranged principally
in one long ftreet, which extends from eaft to weft along
the ridge of a hill, and is terminated by the caftle at the
weft end ; bearing in general appearance, but on a fmaller
fcale, a ftrong refemblance to the towns of Edinburgh
and Stirling in Scotland. The public buildings are a
town-hall, a free gramtnar-fchool, and two parochial
churches, dedicated to St. Mary and St. Michael. St.
Mary’s church Hands near the centre of the town, and
coniiils of a nave, chancel, and north aide, with a fmall
chapel to the fouth. St. Michael’s bears evident marks
of great antiquity. The architecture is a rude fpecimen
of the Norman ftyle, the arches being maffive, and round-

R O K E.

ed, and entirely deftitute of ornament. Both thefe
churches are confolidated with that of Monckton in one
vicarage, the impropriation and prefentation of which
belong to vifcount Hereford, as proprietor of Monckton-
priory and its eftates. Attached to St. Michael’s was a
chapel, or hofpitium, dedicated to St. Mary Magdalen,
the ruins of which are now vulgarly known by the nabie
of the Marian’s Chapel. St. Mary’s had likewife its cha¬
pel, called St. Anne’s; but this edifice is now nearly de-
molilhed.

The caftle, as already mentioned, forms the weftern ex¬
tremity of the town, occupying a rocky termination of
the rid^e on which it is placed. It is a noble ruin, and
exhibits, in certain points of view, one of the fineft fub-
jeCls for the pencil which Wales can boaft of. The for-
trefs, according to Caradoc of Llancarvon, was founded
in 1092, by Arnulph de Montgomery, foil to the earl of
Shrewlhury, on the fcite of a more ancient Britifh work.
It feems, however, to have received great additions in the
reigns of Henry I. and Giraldus even refers its founda¬
tion to that period ; though he acknowledges the exift-
ence of another much more (lender eredtion of anterior
date. During the wars with the Wellh it was frequently
befieged ; but, owing to its great artificial ftrength, and
almoft impregnable natural pofition, it feems to' have re¬
filled fuccefsfully ail the efforts of the affailants to reduce
it. Oliver Cromwell alfo befieged it in perfon, and com¬
pelled its garrifon to furrender, after a long and vigorous
attack. From the period of its furrender, Pembroke caf¬
tle has been much neglected, and is now fo ruinous as to
be uninhabitable. It is divided into two parts, called the
inner and outer wards; the former of which comprifes
the keep and the Hate apartments; and the latter, the
buildings formerly appropriated to the garrifon; though
over the principal gateway from the town, and within it,
there are alfo fome very handfome apartments. Here,
according to Leland, was “ the chambre where king
Henri VII. was born, in knowlege whereof a chymneny
is new made, with the arms and badges of king Henri
VII.” This honour, however, is traditionally given to a
room in a very fplendid fuite of apartments built over “ the
marvellous vault, entitled theWogan, or Hogan,” which is
cut out of the folid limeftone rock, and forms one of the
moft extenfive and lofty excavations of its kind in Great
Britain. Its figure approaches that of a circle, the dia¬
meter from north and fouth being 76 feet 8 inches, and
from eaft to weft 57 feet 4 inches. The natural opening,
which was of great width, is built up, and contracted
into a fmall door-way, that appears to have been once
ftrongly barricaded. Above are the marks of four loop¬
hole windows, and of another door-way, now flopped up.
Of the ufes to which this vault was applied there is no
account upon record, but it was moft likely a depot for
ftores of every kind ; “ the ftuffura of the garrifon.” At
its fouth eaft corner is an adit, traditionally faid to com-
municate with Tenby ; and under the fouth-eaft baftion
of the caftle is another very curious paflage, in fome parts
fpacious, and in others extremely narrow, which has
been explored to a conliderable diltance, but its termina¬
tion is not known. This laft is doubtlefs, however, in a
great meafure a natural dudt; apertures of a fimilar kind
frequently appearing in moft limeftone rocks. It is fup¬
pofed by fome to penetrate under the keep that rears its
proud head in the centre of this magnificent ruin, termi¬
nating, as Leland obferves, “ with a rofe of ftone, almoft
in conum, the toppe whereof is keverid with a flat mill-
Itone.” This building is 75 feet in height to the dome,
and in girth 163 feet 7 inches at the bafe, the mean thick.-
nefsof the wall being about 14 feet. It is divided into
four ftories.

Pembroke is diftant from Caermarthen thirty miles,
Haverfordweft ten, Narbeth fifteen, Tenby ten, Coffiefton
two, Jamefton four, St. Florence eight, Lamphey two,
Hundleon two, Pwllchrochan fix, Templeton twelve,
Hubberftone eight, Angle ten, Lawrenny four, Maner-

bear

PEMBROKE,

bear.five, Hodgefton four, Stackpool four, Jefferfton nine,
and from London 237 weft. Lat. 51.37. N. Ion. 5. o. W.

On the fouth-eaft fide of the town of Pembroke is the
village of Monckton, fo called from its having been the
fcite of an ancient priory, founded by William Marfhall
about the year 1120, as a cell to the Benedidline abbey
of St. Martin at Sayes, in Normandy. Part of the priory-
church is ftill entire, as is likewife the prior’s manfion ;
but the other buildings are in a (late of great decay.
From the varied (lyle of the church, it has evidently been
erefled at different periods. That portion of it which
is now appropriated to public worfliip, is completely mo¬
dernized within, and fcarcely a veftige of its former or¬
naments remains. This ftruiSture has long been the
burying-place of the Owens of Orielton, and probably
alfo of their predecefl'ors the Wyrriots, as fome early mo¬
numents of the latter family dill appear here.

The village of Caftle-Martyn is fituated about three
miles to the weftward of Pembroke. This place was for¬
merly adorned with a magnificent caftle, erected by fome
Norman chieftain of the name of Marty n, on the fcite
of an extenfive Britifh earthen-work. Few veftiges of
of that pile now remain, but they appear to have been
pretty confideruble in the time of Leland. — Between this
village fend the county-town is a furzy moor, called Dry-
Burrow, which is covered with tumuli, fimilar to thofe
on the downs of Wiltfhire. — Northwards from the moor
(lands Orielton, the feat of the Wyrriot and C-wen fami¬
lies; and beyond it is the village of Pwllcrochon, memo¬
rable for a (kirmilh between the royal and parliamentary
forces, in March 1648. In the church are feveral an¬
cient monuments, in honour of theBenegers of Bangefton.
— In the adjoining parifh of Rhofcrowther is Jeftington,
the refidence of a branch of the royal family of Wales pre¬
vious to the conqueft : it is now the property of the fa¬
mily of Meares. — Further to the weftward is the village
of Nangle, which was formerly a place of very confiderable
confequence, and had a caftle attached to it, fome veftiges
of which are Hill vifible near the extreme point of the
curved promontory, which forms the bay of Nangle.

Creffely, the .feat of John Henfleigh Allen, efq. M. P.
for the town, is fituated about two miles and a half to the
weft of Pembroke. The houfe occupies an elevated
fcite, overlooking the river Crefwell. Beyond this, on
the fame road, (lands Carew-caftle, one of the mod con-
fpicuous features of this county, and celebrated as the
refidence of chara6lers of great diftin<5lion at different
eras. It was a royal refidence, and formed part of the
dowry of Nefta, daughter of Rhys ap Tewdor, who mar¬
ried Gerald de Windfor, lieutenant to Henry I. after the
outlawry of Arnulph de Montgomery. The defendants
of this lady took the name of Carew, and continued to
poflefs the caftle till the reign of Henry VIII. when it
reverted to the crown, and was granted to fir John Per-
rot. In the time of the rebellion it was garrifoned for
the king, and withllood a long fiege ; but, after the ill
fuccefs of the royalills at Tenby, it furrendered upon
quarter. Subfequent to that period it has been fuffered
to go to decay, and now conftitutes a mod magnificent
and piflurefque ruin. Its form is that of a quadrangle,
with a court in the centre, and an immenfe baftion at each
exterior angle. The architecture of this pile belongs to
various ages, but a great part of it is undoubtedly coeval
with the original llruClure. The north front is peculi¬
arly grand and majeftic, and can boaft of windows “ than
which nothing more nobly magnificent is known in the
kingdom.” On the fouth-weft fide appear a number of
old towers, all differing from each other in height, dia¬
meter, and form. On three fides this caftle is bounded
by water, but to the fouth was formerly a very extenfive
deer-park, the outer wall of which is yet apparent in
many places, though it is divided into feveral diftinCl in-
clofures, in one ot which fir Rhys ap Thomas held a tilt
and tournament, which was the firft (how of the kind re¬
corded to have been exhibited in Wales. Near this fpot

5

525

(lands one of the early erodes, richly ornamented with
true-love knots, See. and having an infeription upon it,
which, though often copied, and fubmitted to the exami¬
nation of the edrious, has never yet been accurately de¬
ciphered. The church here contains feveral ancient mo¬
numents, with effigies and inferiptions in memory of va¬
rious members of the Carew family.

Lamphey, or Lanfey, was once the favourite palace of
the bilhop of St- David’s. The ruins of this palace are
fituated a (liort diftance out of the road (on the north
fide) between Pembroke and Tenby. They occupy an
extenfive plot of ground; and though, literally fpeaking,
in ruins, and every part uninhabitable, yet large and
comparatively perfect portions of the principal buildings
are left (landing, the plain fubftantial walls of which are
covered with thick maffes of luxuriant ivy. The great
hall towards the fouth is plain both within and without,
and appears never to have been richly ornamented ; but
the arches of its windows and doors have well-carved
mouldings, and an arched parapet extended round the
building. The original entrance-gateway is entire, ex¬
cepting its roof. The lower part has a modern inclofure,
and is ufed for the purpofes of a (hed. But the mod or¬
namental portion of thefe ruins is the chapel, a (liort dif¬
tance from the north-eall angle of the hall, which ftill re¬
tains its eaft window with the tracery uninjured. To¬
wards the ea!l end of the hall is the kitchen, with a large
circular chimney, ftrongly maintaining its erebt pofition
above the ruins of furrounding walls. There are nume¬
rous other offices and buildings diftributed over a large
unevenarea of ruins; but none areornamented more than,
and few of them fo much as, thofe deferibed : from which
it appears that this noble palace, when perfeft, had but
little architectural decoration to enrich its fpacious walls,
and was greatly inferior to the refidence in the city,
though perhaps fuperior to any other of the epifcopal
palaces.

Stackpool-court, the feat of lord Cawdor, alfo deferves-
mention. It is built on the fcite of a former caftellated
ftruiiture, and is certainly one of the mod fplendid mo¬
dern manfions in Wales. It has two fronts, and is fur-
rounded by very extenfive and well-wooded pleafure-
grounds, which are further adorned by a beautiful lake,
and mod luxuriant gardens. The eftuary of Stackpool
being the only fafe and commodious landing-place on
this coall, it was much frequented by the predatory
chieftains of ancient times, and particularly by earl
Harold, fome of whofe fuccefles are fuppofed to be com¬
memorated by three large upright (tones, which are fixed
here at the diftance of about a mile from each other.
Beauties of England and Wales. Wilkes's Britifh Direct
tun/. Oldfield's liepr. Hifi. Gent. Mag. April 1820.

PEMBROKESHIRE, one of the fouthern counties
of Wales, is bounded on the fouth by the Briftol Chan¬
nel, on the weft and north by St. George’s Channel, and
on the north-eaft and eaft by the counties of Cardigan
and Caermarthen. It is irregular in its form, and deeply
interfered throughout its extenfive coaft by bays and
havens. Its extreme length from north to fouth is about
35 miles, and its greateft breadth from eaft to weft 29.
According to the mod accurate furveys, its fuperficial
content amounts to 335,600 acres. According to the
population report of 1811, this county is divided into
the hundreds of Caftle-Martyn, Dewifland, Dungleddy,
ICemefs, Kilgerron, Narberth, and Roofe; and contains
the city of St. David, and three towns, Pembroke, Ha¬
ve rford wed, and Tenby: it alfo comprifes 142 parifhes,
and 3 hamlets. The number of houfes in 1811 was dated
to be 13,024, inhabited by 60,615 perfons, viz. 27,453
males, and 33,162 females. The population in 1821 had
increafed to 74,009 perfons. The amount of affeflinenc
under the property-tax in 1806 was 322,700k and the
amount of money raifed for the maintenance of the
poor in 1803, was 13,213k at the rate of 11s. 8|d. in the
pound. The average fcale of mortality, according to the

regiftered

526

PEMBROKESHIRE,

regiftered burial for ten years, appears to have been as i
to 70 of the exifting population.

-At a very remote period this county formed part of
the kingdom of Demetia, or Dyvet, which fubfifted as an
independent monarchy till conquered by Ethelwolf king
ofEngland. Brodhmael, king of Demetia, is mentioned
as one of the princes who atfilted Caffibelanus in compel¬
ling Julius Csefar to evacuate Britain. How far this an¬
cient kingdom extended is uncertain ; fome fuppofing it
to have comprifed the three counties of Cardigan, Caer-
marthen, and Pembroke; and others, that it was con¬
fined to the laft-mentioned county only. In the time of
the Danith incurfions, this county fuffered more injury
than perhaps any other in the principality. Among the
chieftains who commanded in thefe depredations were
Hubba and Ivar, or Inguar, both of whom are defcribed
by the old writers as men of the “ moll dreadful ferocity,
and unheard-of courage.”

The name of Pembrokefhire, or rather Pembrochfhire,
was firft given to this county fhortly after the Norman
conqueft, and was evidently derived from that of the
town. In later times, Milford, a port in this county, is
remarkable as having been the landing-place of Henry
earl of Richmond, afterwaVds king Henry VII. when he
came from Brittany to wreft the throne of England from
the ufurpe'r Richard III. During the era of the civil
wars in the reign of Charles I. feveral of its cattles, par¬
ticularly thofe of Pembroke and Roch, were garrifoned
for the king, and withftood long and obftinate fieges in
the royal caufe. Some tkirmithes likewife appear to have
been fought within Pembrokefhire at the fame period,
and with various luccefs. See Milford-haven, vol. xv.
P. 370.

A confiderable trad of Pembrokefhire, confiding of the
country which lies weft of Milford-haven, and between
that bay and the Irifh Sea, is called by the Welch R/ios,
which fignifies alarge green field. King Henry I. fettled
in this diftriCl a colony of Flemings, who came over into
England upon an inundation of the lea, which drowned a
confiderable part of the Low Countries. Thefe Flemings,
being a warlike people, and proving very faithful to the
crown of England, were a great check upon the Welch,
who often attempted to turn them out and recover their
country, but without fuccefs ; for the Flemings main¬
tained their ground, and Rhos is at this day inhabited
by their defcendants, whofe language and cuftoms ftill
differ from thofe of the Welch.

The afpefl: of this county prefents an almoft continued
fuccefiion of fwells, or eafy flopes ; but there are no
mountainous ridges, excepting one which runs from the
coaft near Fifhguard to the borders of Caermarthenfhire.
Thefe hills are locally denominated “ The Mountains,”
and the inhabitants diftinguifh the country with refer¬
ence to them; the north fide being faid to be “above
the mountains,” and the fouth fide “ below the moun¬
tains.” The central portion of this ridge is known by
the name of Percelly, and its liigheft fummit by that of
Cwmkerwyn : it commands a view over the whole county.
Another high point is called Carn-Englie, as tradition
fays, from a giant who occupied it as his place of habita¬
tion. Vrenny-Vawr, or Vryn-Vawr, is alfo of confider¬
able altitude and fize, as its name imports; the words
Vryn Vawr fignifying in Englifh the Great Hill. The
climate of Pembrokefhire is temperate. Rains are per¬
haps more frequent here than in any part ofEngland, and
are particularly violent during wefterly winds. Frofts
are neither intenfe nor of long continuance; nor does
fnow ufually lie upon the ground more than two or three '
days.

Few counties are better watered with rivers, or are more
abundantly fupplied with excellent fprings. The names
of the chief rivers are the Tivy, the Clethy, and the
Dougledye'. The Tivy is more properly a river of Caer-
unarthenfhire. The name of the Clethy is a corruption
,if the ancient Britifh name gledheu, “ a fword.” This

river rifes at the foot of the hill called Vrenny Vawr,
fome miles eaft of Newport; and, running fouth, falls
into the mouth of the Dougledye, and its conflux with
a bay of the fea near Pembroke, called by the Englifh
Milford-haven, but by the Welch Aber dau Gledheu, or
the Haven of Two Swords. The name of the Dougledye
is alfo a corruption of the original Britifh name Dau
Gledheu, two fwords. It rifes fome miles north-eaft of
the city of St. David’s, and, running fouth-eaft, and paf-
fing by Haverfordweft, falls with the river Clethy into
Milford-Haven, as mentioned already. The lefs confi¬
derable rivers of this county are the Cvvch, which di¬
vides Pembrokefhire from Cardiganfhire ; the Nevern,
which flows by Newport; and the Gwain, which falls
into the fea at Fifhguard.

The mineralogical produ&s of Pembrokefhire are coal,
limeftone, freeltone, and that “ fpecics of marble called
pudding-ftone.” No metallic ores, except iron, we believe,
have yet been difcovered here ; at leaft none of any con-
fequence in a commercial eftimate. Some mineral fprings,
particularly one in the parifh of Fifhguard, however,
are ftrongly tinftured with that metal; and on the Trefin
are feveral works of iron and tin. The foil is various,
but in general tolerably fertile. The ftate of agriculture,
however, is defective ; and, though much improved
within the laft few years, it is ftill fufceptible of great ame¬
lioration. Woods are rather fcarce in this county, par¬
ticularly towards the weftern coaft, where, being much
expofed to the winds blowing from the fea, they are
fhorn in a very curious manner. Cattle are reared in
confiderable numbers, and a large quantity of butter is
made, both for home-confumption and for exportation.

Pembrokefhire cannot boaft of being either a manufac¬
turing or a trading county ; though it poflefles manifeft
advantages, for commerce at leaft, in its numerous na¬
tural harbours and great extent of coaft. Haverfordweft
is the only town within its limits which has a cotton-ma-
nufaCtory of any confequence ; and all the attempts hi¬
therto made for the introduction of the linen-bufinefs
have completely failed. Milford and Fifhguard alone can
juftly claim the appellation of trading-ports; and even in
thefe towns the exports and imports are extremely limited;
but they are certainly fufceptible of great augmentation,
with a very little exertion and expenfe. Indeed we have
no doubt, but that, if the fpirit of manufacturing and
commercial enterprife were once properly excited and fof-
tered, Pembrokefhire would, from its natural advantages
of fituation, foon become the trading emporium of Wales.
At Milford has lately been eftabliftied a South-Sea whale-
fifliery, which is in a flourifhing condition ; and we are
happy to obferve, that the fame thing may be affirmed of
the herring-fifhery of Fifhguard, though it might be im¬
proved to an almoft unlimited extent.

There is a peculiarity in the drefs of the Pembrokefhire
women, who, even in the midft of fummer, wear a heavy
cloth gown ; and, inftead of a cap, a large handkerchief
wrapt over their heads, and tied under their chin. This
cuftom is certainly peculiar to Pembrokefhire ; for in the
other parts of Wales the women as well as the men,
wear large beaver hats, with broad brims flapping over
their fhoulders.

Pembrokefhire was formerly a county palatine within
Wales, and its earl was comes palatinus, and had jura re¬
galia. Its jurifdiCtion was taken away by the llatute 27
Henry VIII. which enabled it to fend one knight of the
fhire, and two burgefles, one for Pembroke, &c. and one
for Haverfordweft. The political intereft in this county
has been difputed between lord Cawdor and fir John
Owen. At the general election in 1812, there was acon-
teft between fir John Owen and the hon. Mr. Campbell,
eldeft fon of lord Cawdor, which terminated in favour of
the former, who has maintained his feat ever fince, although
lord Milford had repref’ented the county in the eight pre¬
ceding parliaments, and was always chofen in cppofition
to the Owen intereft.

Pembrokefhire

P E M

P E M

Pembrokefliire abounds with objects of antiquaririn cu¬
rio fity and intereft, of aim oft every kind and era. Druid-
ical circles and cromlechs are frequent, of which the prin¬
cipal are thofe near Caftle-Hendrev, Drewfon, Trellys,
Long-houfe, Lech-y-dribedd, Pentre-Evan, and Caftle-
Martyn. Single ftone monuments are alfo numerous,
particularly along the coaft, where they are conjeCtured
to have been raifed as memorials of predatory battles.
The great Roman road to Menapia, St. David's, enters
the county near Llandewi-Velfry, and proceeds by Ha-
verford-weft and Roch-Caftle, almoft on the fame line
with the prefent turnpike-road from Caermarthen, which
it crolfes at different points. Another Roman road led
from the great road to the ftation called Ad-Vicefimum.
But the molt important antiquities are its caltles, of
which there are nineteen mentioned as belonging to
princes and great barons. Some of the churches in this
county are likewife objects worthy the attention of the
antiquary. The cathedral and palace of St. David’s are
particularly entitled to attention. See Saint David’s 5
alfo Norris’s ArchiteCiural Antiquities of Wales, 410.
Fenton’s Hiftorical Tour in Pembrokefliire, 1811. Cam¬
brian Regifter for 1796. Camden’s Britannia, vol. ii.
Britilh Directory, vol. iv. and Univerfal Magazine for
April 1766.

PEMIGEWAS'SET, a river of New Hamplhire, which,
united with the Winipifiokee, forms the Merrimack
river.

PEMISSISAQUEWAK'EE, a river of the diftria of
Maine, which runs into the fea in lat. 44. 23. N. Ion. 68.
20. W.

PEMNAGUR', a fort of Hindooftan, in Bahar : thirty-
one miles north- weft of Durbungah. Lat. 26. 29. N.
Ion. 85. 43. E.

PEM'PHIS, f. in botany, a genus of plants, fo named
by Forfter from wqxipi?, a globule, in allufion to the glo¬
bular protuberance of the germen above the calyx, or of
what, in Linnasan language, is the receptacle of the
flower. This genus confifts of but one fpecies, which is
the Lythrum pemphis, already defcribed in vol. xiii. p.
^49-

PEN, f according to Camden, originally fignifles a
high mountain, which was thus called among the ancient
Britons, and even the Gauls. And hence that tall range
which parts Italy and France is called Apennines.

Pen is often ufed for a pound, or head of water arti¬
ficially kept up. Hence Pen Stock, a fort of flu ice or
flood-gate placed in the water of a mill-pond, or a canal,
to retain or let it go at pleafure.

PEN,/. [ penna , Lat.] An inftrument for writing,] —
He remembers not that he took off pen from paper till he
had done. Fell.

Eternal deities !

Who write whatever time fliall bring to pafs.

With pens of adamant on plates of brafs. Dry den.

Fie takes the papers, lays them down again ;

And, with unwilling .fingers, tries the pen. Dryden.
Feather; [penne, old Fr. Old alfo, in this fenfe, in our
own language; and Hill foufed in the north of England.
Wicliffe employs it.] — The proud peacock, overcharg’d
with peas. ii. Jonfuns Staple of News.

The pews that did his pinions bind,

Were like main-yards with flying canvas lin’d. Spenfer.
Wing; though even here it may mean feather.

Feather’d foon and fledg’d,

They fumm’d their pens ; and, foaring the air fublime,
tv ith clang defpis’d the ground. Milton's P. L.

[From pennan, Sax.] A finall inclofure ; a coop. — The
cook' was ordered to drefs capons for fupper, and take
the belt in the pen. L'Ejlrange.

Ducks in thy ponds, and chickens in thy pens ;

And be thy turkeys numerous as thy hens. Kins:.
Vol. XIX. No. 1322.

527

As long as people wrote upon tables covered with wax,
they were obliged to ufe a ftyle or bodkin made of bone,
metal, or fome other hard fubftance; but, when they be¬
gan to write with coloured liquids, they then employed
a reed, and afterwards quills or feathers.

It is rather aftonilhing, that we are ignorant what kind
of reeds the ancients ufed for writing, though they have
mentioned the places where they grew wild, and where,
it is highly probable, they grow. Hill. Befides, we have
reafon to fuppofe, that the fame reeds are ufed even at
prefent by all the oriental nations ; for it is well known,
that among the people of the eaft old manners and inftru-
ments are not eafily banifhed by new modes and new in¬
ventions. Moft authors who have treated on the hiftory
of writing have contented themfelves with informing
their readers that a reed was employed ; but that genus
of plants called by the ancients calamus, and arundo, is
more numerous in fpecies than the genus of graffes, to
which the corn of the ancients belongs ; and it might
perhaps be as difficult to determine what kind of reed
they employed for writing, as to diftinguifli the fpecies of
grain called far, alien, and arena.

The moft beautiful reeds of this kind grew formerly in
Egypt ; near Cnidus, a city and dittriCt in the province
of Caria, in Ana Minor; and likewife in Armenia and
Italy. Thofe which grew in the laft-mentioned country,
feern to have been confidered by Pliny as too left and
fpongy: but his words are fo ohfcure, that little can be
gathered from them ; and, though the above places have
been explored in latter times by many experienced bota-
nifts, they have not fupplied 11s with much certain infor¬
mation refpeCting this fpecies of reed. As the old. bota¬
nists give no cbaraCterifing marks fufiiciently precife,
Linnaeus was not able to affign any place in his fyftem to
the arundo fcriptoria of Bauh'in.

Chardin fpeaks of the reeds which grow in the marfhes
of Perfia, and which are fold and much fought after in the
Levant, particularly for writing. He has even defcribed
them ; but his account has been of no fervice to enlarge
our botanical knowledge. Tournefort, who faw them col¬
lected in the neighbourhood ofTefiis, the capital of Geor¬
gia, though his defcription of them is far from complete,
has taught us more than any of his predeceffors. We
learn from his account, that this reed has finall leaves,
that Strifes only to the height of a man, and that it is not
hollow, but filled with a loft fpongy fubftance. He has
charaCierifed it, therefore, in the following manner in his
Syftem of Botany : Arundo orientals, tenuifolia, cattle
pleno, ex qua Favcce calamos parant. The fame words are
applied to it T>y Miller; but he obferves that no plants
of it had ever been introduced into England. That the
beft writing-reeds are procured from the fouthern provin¬
ces of Perfia is confirmed by Dapper and Hanway. The
former fays, that the reeds are Town and planted near the
Perfian gulf in the place mentioned by Chardin, and
gives the fame defcription as that traveller of the manner
in which they are prepared.

The circumftance exprefsly mentioned by Tournefort,
that thefe writing-reeds are not entirely hollow, feems :to
agree perfectly with the account given by Diofcorides. It
is probable that the pith dries and becomes fhrunk, efpe-
cially after the preparation defcribed by Chardin, fo that
the reed can be eafily freed from it in the fa median her
as the marrowy fubftance in writihg-quills is removed
from them when clarified. Something of the like kind
feems to be meant by Pliny, who fays, that the pith dried
up within the reed, which was hollow at the lower end,
but at the upper end woody and deftitute of pith. The
flowers of this reed were employed inftead of feathers for
beds, and alfo for caulking fliips. Forfkal only tells us
that a* great many reeds of different kinds grow near the
Nile, which ferve to make hedges, thatch, and wattled-
walls, and which are ufed for various other purpofes.

Thefe reeds were fplit, and formed to a point like our
quills 5 but certainly it was not poffible to make fo clean
6 T and

528

PEN.

and fine ftrokes, -and to write fo long and fo conveniently
with them, as one can with quills. The life of them,
however, was not entirely abandoned when people began
to write with quills, which in every country can be pro¬
cured from an animal extremely ufeful in many other re-
Ipecfts.

Some aflert, from a paflage of Juvenal, that quills were
ufed for writing in the time of that poet ; but what he
fays is only a metaphorical exprefiion, fuch as has been
employed by Horace and various ancient writers. Others
have endeavoured to prove the antiquity of writing-quills
from the figure of the goddefs Egeria, who is reprefented
with a book before her, and a feather in her right hand ;
but the period when this Egeria was formed is not known,
and it is probable that the feather was added by fome
modern artilt. No drawings in manufcripts, where the
authors appear with quills, are of great antiquity.
Among thefe is the portrait of Ariftotle, in a manufcript
in the library of Vienna, which, as exprefsly mentioned
at the end, was drawn at Rome in the year 14.57 ; and we
have great reafon to think that the artift delineated the
figure for ornamenting his work, not after an ancient
painting, but from his own imagination.

If we can give credit to the anonymous author of the
Hiitory of Conftantius, extracts from which have been
made known by Adrian de Valois, the ufe of quills for
writing is as old as the fifth century. We are informed
by this author, who lived in the above century, that
“ Theodoric, king of the Oftrogoths, was fo illiterate and
ftupid, that during the ten years of his reign he was not
able to learn to write four letters at the bottom of his
edidts. For this reafon the four letters were cut for him
in a plate of gold, and, the plate being laid upon paper,
he then traced out the ietters with a pen.” The weftern
empire was governed, almoft about the time of Theodo¬
ric, by the emperor Jultin, who alfo could not write, and
who ufed in the like manner a piece of wood having
letters cut in it; but with this difference, that, in trac¬
ing them out, he caufed his hand to be guided by one of
his fecretaries.

The oldeft certain account however known at prefent
refpedting writing-quills, is a palfage of Ifidore, who died
in the year 636, and who, among the inftruments employ¬
ed for writing, mentions “ reeds and feathers “ Inftru-
menta fcribse calamus et penna. Ex his enim verba pa-
ginis infiguntur ; fed calamus arboris eft, penna avis, cujus
acumen dividiturin duo; in toto corpore unitate fervata.”
Origines, vi. 13.

Another proof of’ quills being ufed in the fame cen¬
tury, is a fmall poem on a writing-pen, to be found in
. the works of Althelmus, called fometimes alfo Aldhel-
mus, Adelhemus, and Adelmus. This writer, defcended
of a noble family, was the firft Saxon who wrote Latin,
and who made the art of Latin poetry known to his
countrymen, and infpired them with a tafte for compo-
fitions of that kind. He died in the year 705. The
poem is as follows :

De Penna fcriptoria.

Me pridem genuit candens onocrotalus albam
Gutture qui patulo forbet in gurgite lymphas.

Pergo ad albentes diredto tramite campos,

Candentique viae veftigia caerula linquo,

Lucida nigratis fufcans anfraftibus arva.

Nec fatis eit unum per campos pandere callem ;

Semita quin potius milleno tramite tendit,

Quae non errantes ad coeli culmina vexit.

The author does not, fpeak here of a goofe-quill, but
of a pelican’s, ( onocrotalus , adopted from the Greek word,
compounded of oyo?, an afs, and x.pora.Xo, a rattle, from
the gurgling in the throat or pouch,) which, at any rate,
may be as good as that of a fwan.

In the eighth century writing-pens are mentioned by
Alcuinus,who at that period, in the time of Charlemagne,
was of lervice in extending literary knowledge.- He

compofed poetical infcriptiohs for every part of a monas¬
tery, among which there is one even for a privy, and ano¬
ther for a writing-ftudy. Speaking of the latter, he fays
that “ no one ought to talk in it, left the pen of the tran-
fcriber fhould commit a miftake.”

After the above period, proofs occur which place the
matter beyond all doubt. Mabillon law a manufcript of
the Gofpeis, which had been written in the ninth cen¬
tury under the reign of St. Louis, in which the evange-
lifts were reprefented with quills in their hands. The
fame author mentions a like figure of the eleventh cen¬
tury. In the twelfth century, Peter de Clugny, who by
fcholaftic writers is called Veneruhilis, and who died in
1 1 57, wrote to a friend, exhorting him to affume the pen
inftead of the plough, and to tranfcribe inftead of tilling
land. In fliort, writing-quills are often called calami by
ancient and modern authors who wrote good Latin; and
it is probable that this word is employed by older writers
than Ifidore to lignify writing-pens, where, for want of
other proofs, we underftand reeds.

Notwitliftanding the great advantage which quill-pens
have over reeds for writing, the latter however feem to
have continued long in ufe even with the former. Men
of letters, well verfed in diplomatics, allure us, from com¬
paring manufcripts, that writing-reeds were ufed along,
with quills in the eighth century, at leaft in France; and
that the latter firft began to be common in the ninth.
The papal afts, and thole of fynods, muft however have
been written with reeds much later. In convents they
w'ere retained for texts and initials, while, for fmall
writing, quills were every-where employed.

We can allow little credit to a conjecture fupported
merely by a fimilarity of the ftrokes in writing, becaufe
it is probable that people at firft would endeavour to w-rite
in as ftrong and coarfe a manner with quills as had been
before done with reeds, in order that the writing might
not feem much different from what was ufual ; and with
quills one can produce writing both coarfe and fine.
Meiners, however, refers to a paflage in a letter of Reuch-
lin, which removes all doubt on the fubjeCt. When this
worthy man, to whom pofterity is fo much indebted,
was obliged to fly by the cruelty of his enemies, famine,
and the plague, and to leave behind him all his property,
he was fupplied with the moft common necelfaries by
Pirkbeimer. Among other articles the latter fent to
him, in the year 1520, writing-materials, good paper, pen¬
knives, and, inftead of peacocks-feathers which he had
requefted, the belt fwan-quills. That nothing might be
wanting, lie added alfo proper reeds, of fo excellent a
fort, that Reuchlin confidered them to be Egyptian or
Cnidian. Thefe reeds at that period muft have been
fcarce and in great requeft, as it appears by fome letters
of Erafmus to Reuchlin, that the former received three
reeds from the latter, and exprefled a with that Reuchlin,
when he procured more, would fend fome of them to a
learned man in England, who was a common friend to
both.

Whatever may have been the caufe, about the year
14.33 writing-quills were fo fcarce at Venice, that it was
with great difficulty men of letters could procure them.
We learn at any rate, that the well-known Ambrofius
Traverfarius, a monk of Camaldtile, fent from Venice to
his brother, in the above year, a bunch of quills, together
with a letter, in which he faid, “ They are not the belt,
but fuch as I received in a prefent. Show the whole
bunch to our friend Nicholas, that he may feleiSt a quill ;
for thefe articles are indeed fcarcer in this city than at
Florence.”

“Had the ancients been acquainted with the art of
converting quills into writing-pens,” fays Mr. Profeffor
Beckmann, “ they would undoubtedly have dedicated to
Minerva, not the owl, but the goofe.” We think fo too;
yet there are fome men among us, as likely to rival the
goofe in underftanding as in ufefulnefs, who prefer writ¬
ing, or trying to write, with an iron pen, or a fteel pen,

or

PEN

or a (liver pen, becaufe thefe, they fay, do not wear out.
But fuppofe they do wear away, (as what does not ?) who
is to mend them? Thefe pens colt from a (hilling to half-
a crown apiece, the price of a fcore, or even a hundred,
of quills-or pens, which can be mended, and which are fo
obedient under the knife, that they can be made hard or
loft, fo as to fuit any hand, or any kind of character,
I'm a 1 1 or large, round or fquare, thick or thin; and the
celerity with which quills are converted into pens is afto-
niftiing. It is recorded, that an tifher at Rugby-fchool
made 2000 pens in little more than eight hours. This
vvasfin the year 1813. The man’s name was Thacker.

To PEN, v. a. [pret. and part. palf. penned.] To write.
It probably meant at fir ft only the manual exercife of the
pen, or mechanical part of writing; but it has been long
itfed with relation to the ftyle or compofition. — I would
be loth to call away my fpeech ; for, befides that it is ex¬
cellently well penn’d, I have taken great pains to con if.
Shaliefpeare's Tw. Night. — 'He frequented fermons, and
penned notes with his own hand. Hay ward' s Edw. VI. —
The precepts, penned or preached by the holy apoftles,
were as divine and as perpetual in refpedt of obligation.
While. — The digefting my thoughts into order, and the
fetting them down in writing, was neceffary; for, without
fuch drift examination as the penning them affords, they
would have been disjointed and roving ones. Dighy on
the Soul.

Twenty fools I never faw
Come with petitions fairly penn'd,

Defiring I fhould ftand their friend. Swift.

[Preter. and part. paff. pent.] To coop; to (hut up; to
incage; to imprifon in a narrow place. — Away with her,
and pen her up. Shajiefpeare. — The plaifter alone would
pen the humour already contained in the part, and forbid
new humour. Bacon. — The glafs, wherein it is penned
up, hinders it to deliver itfelf by an expanfion of its parts.
Boyle. — The prevention of mifehiefis preferibed by the
Jevvifli cuftom; they pen up their daughters, and permit
them to be acquainted with none. Harvey on Confump-
tions.

My heavy fon

Private in his chamber pens himfelf. Shahefpsare.
Their armour help’d tiieir harm, crufh’d in and bruis’d.
Into their fubftance pent. Milton’s P. L.

As when a prowling wolf,

Whom hunger drives to feek new haunt for prey,
Watching where fhepherds pen their flocks at eve
In hurdled cotes, amid the field fecure,

Leaps o’er the fence with eafe into the fold. Milton's P.L.

PEN. See Pen Selwood.

PEN AN'GLAS, a cape of South Wales, on the north
coaft of the county of Pembroke. Lat. 51. 57. N. Ion. 4.
59- w.

PEN Y DAR'RAN. See vol. xv. p. 164.

PEN DI'NAS, a cape of Wales, on the north coaft of
St. Bride’s Bay. Lat. 51. 48. N. Ion. 5. 10. W.

PEN PARK. See vol. iii. p. 414.

PEN SEL'WOOD, a village in the county of Somerfet,
on the borders of Wiltfhire and Dorfetfhire, on an ele¬
vated fituation, near the river Stour. In the year 658, a
battle was fought here between the Saxons and the Bri¬
tons, which proved in favour of the former, and in fo de-
cifive a manner, that the Britons never after made head
againft their enemies. In the year 879, the Danes are
faid to have been defeated here by king Alfred: in the
year 1001, a few of king Ethelred’s troops were defeated
by the Danes ; and in the year 1016, the Danes were de¬
feated here by king Edmund. It is four miles north-
eaft of Wincanton, 106 weft of London.

PE'NA (John), an able French mathematician, was
defeended from a noble family at Aix in Provence, and
born at Mouftiers, in the diocefe of Riez, about the year
i 530. He diftinguilhed himfelf by his proficiency in the

PEN 529

Latin and Greek languages, and philofophy; but the
bent of his genius particularly directed him to the ftudy
of the mathematical fciences. Ramus had been his tutor
in the belles-lettres, and is faid to have been infpired by
his pupil with a tafte for mathematical ftudies, and to
have profecuted them under his inftrudflions. M. de
Thou fays, that they both taught at the fame time in the
College de Prefles. About the year 1556, he was ap¬
pointed Profeffor of Mathematics in the College Royal ;
and, according tofome writers, his poft was a profefforfliip-
extraordinary, created out of compliment to his extraor¬
dinary merit, and fupprefled after his death. He publifn-
ed a Latin verfion of the Catoptrics of Euclid, with a
curious Preface, explaining and illuftrating the ufes of
the cylindrical mirror ; the Optics of the fame geome¬
trician ; Euclidis Elementa Mufices; Seftio Regulte
Harmonicas, in Greek and Latin ; and a Latin verfion
accompanying the Greek text of The Spherics ofTheo-
dofius, 1558, 4to. He alfo wrote fome papers on the
Mechanics of Hero, and the Geometry of Euclid, which
have not been given to the public. This very promifing
young mathematician was prematurely cut off by a vio¬
lent fever in 1560, when only about thirty years of age.
Teiffier's Eloges des Homnies Savans.

PE'NA, in geography. See Peene.

PE'NA CO'VA. See Pegna.Cova, p. 473.

PE'NAC, a town of Naples, in Abruzzo Citra : nine
miles eaft-fouth-eaft of Civita Borella.

PENyE'A,./! [received that appellation from Linnaeus,
in memory of the learned Peter Pena, a native of Jouques,
near Aix, in Provence; who afforded great afliftance to
Lobel, in the compofition of his ,£ Adverfaria.” Plumier
had already confecrated a plant to his honour, which
Linnasus reduced to Polygala ; fee that article.] In
botany, a genus of the clafs tetrandria, order monogynia.
Generic characters — Calyx : perianthium two-leaved :
leaflets oppofite, lanceolate, concave, equal, coloured,
ftiorter by half than the corolla, loofe, deciduous. Co¬
rolla : one-petalled, bell-fhaped : border four-cleft, fpread-
ing a little, much ftiorter than the tube; fegments (harp.
Stamina: filaments four, awl-ftiaped, extremely fhort,
placed on the tube of the corolla between the divifions
of it, upright, naked ; antherse upright, flattifh, emargi-
nate both ways. Piftillum : germen ovate, four-cornered;
ftyle four-cornered by four membranaceous longitudinal
wings; ftigmacruciform, blunt, permanent. Pericarpium:
capfule four-cornered, furniflied with the ftyle, four-celled,
four-valved. Seeds: two, fomewhat oblong, blunt. —
Efj'ential Charatter. Calyx two-leaved ; corolla bell-
fhaped ; ftyle quadrangular; capfule four-cornered, four-
ceiled, eight-feeded.

There are nine fpecies. They are flirubs, rugged below
with the veftiges of fallen leaves, leafy above; leaves op¬
pofite, croffwife, feflile, approximating imbricately in a
four-fold row, the upper ones near the flowers like feales
and coloured, whence the calyx in fome fpecies is as it
were many-leaved and imbricated ; flowers terminating,
feflile, folitary or feveral heaped together ; fruit as in the
order of Acanthi, but four-celled. Perhaps this genus
may be allied to them ; but, having been hitherto little
examined except in dried fpecimens, the natural order of
the genus Penasa null yet remain uncertain. The fpecies
are all natives of the Cape of Good Hope.

1. Penaea farcocolla, or ovate-leaved pentea : leaves
ovate, fomewhat rhomboid, acute ; bradtes wedge-fliaped,
pointed, coloured ; calyx-leaves linear. This is an hum¬
ble much-branched bufhy fhrub. The leaves are about
half an inch long, of a pale tawny glaucous hue in the
dried plant, their mid-rib rather convex. Flowers few
together, at the tops of the branches, rather longer than
the leaves, red. It has been generally believed that the
fubftance called farcocolla, or flefli-glue, is an exudation
from the flowers of this plant; but there is very good
reafon to doubt the truth of the opinion. It was firft
taken up by Linnsus, and has been maintained ever fince

upon

530 PEN

upon the authority of his name. Profeffor Thunberg has
publilhed an account of the genus Penaea in the Berlin
Magazine for 1807. The fpecies all grow at the Cape of
Good Hope, and have been feen no where elfe. The P.
farcocolla grows on the mountains of Hottentot Holland,
and in thole below the weft fide of the Table Mountain.
Now Thunberg, who was on the fpot, exprefsly affirms
that farcocol is neither colledted nor known in that coun¬
try. It would have fome tendency to throw light upon
the plants that yield feveral refins and gum-refins with
the hiftory of which we are at prefent unacquainted, if
any wholefale druggift, or merchant, in London, who is
in the habit of importing thefe articles, would ftate the
countries from which they are brought.

2. Penaea mucronata, or heart-leaved penaea : flowers
terminating, leaves acuminate fmocth. Style four-cor¬
nered. Leaves on the items and branches frequent, feffiie.
Flowers at the ends of the branches, heaped together, red.

3. Penaea marginata, or margined penaea : leaves cor¬
date margined, flowers lateral. This is a ftiff flirub, with
the branches commonly in threes. Leaves oppofite or
in threes, fubfeffile,bluntifh,fhining, with the edge curved
back, the fize of box-leaves. Flowers among the leaves,
i'ubfeffile, not longer than the leaves, white.

4. Penaea lateriflora, or fide-flowering penaea : leaves
ovate, flowers lateral feffiie. Stems red, with elongated
branches. Leaves feffiie, exadtly ovate, even, fharpifh,
quite entire, almoft keeled under the bafe, longer than
the interfaces. Flowers in the axils of the leaves, yel¬
low', the length of the leaves; calyx four-leaved, yellow,
fcariofe, the length of the leaves. Willdenow doubts
whether this be diftindt from the preceding.

5. Penaea tomentofa, or downy-leaved penaea : leaves
ovate tomentofe, flowers lateral. Of this we. have no de-
fcription.

6. Pen sea fucata, or painted penaea: leaves rhomb-ovate;
bradtes wedge-fhaped acute, coloured. Branches very
numerous, round ; branchlets angular. Leaves ovate,
narrower at the bafe, acute, fpreading, even. Flowers
purple, in terminating bundles ; bradtes fmaller than the
leaf, purple.

7. Penaea fquamofa, or fcaly penaea: leaves rhomb-
wedge-fhaped, fielhy ; bradfes fringed, glutinous, larger
than the leaves ; fegments of the corolla reflexed. Diftin-
guifhed by its large terminal flowers, enveloped in dark-
red, glutinous, broad, denfely-fringed, bradtes. The
leaves mod refemble the firft fpecies, but their mid-rib is
deprefled, not prominent, and their colour in a dried ftate
very dark. Linnaeus at firft marked his fpecimen farco-
colla, then refinofa, and finally fquamofa, under which
laft appellation he defcribed this fine plant. It may, per¬
haps, yield a gum, as well as the firft fpecies. The co¬
rolla feems to be white or yellowifh; its tube is above
an inch long; the fegments of the limb ovate, obtufe,
reflexed.

8. Penaea fruticulofa, or flirubby penaea : leaves fome-
what oblong blunt, bradtes orbiculate acute. This is a
little fhrub with round branches. Leaves oval or fome-
what oblong, thickilh, veinlefs, remote. Floral leaves
final), rhomb- orbiculate, or orbiculate-acute ; flowers at
the ends of the branches, fubfolitary, on very fhort pe¬
duncles, fharpifh.

9. Penaea myrtoides, or myrtle-leaved penaea leaves
lanceolate. Branches upright round red. Leaves feffiie
cluftered even, like thofe of Myrtus tarentina, fcarcely
nerved underneath. Flowers terminating, fubfolitary,
furrounded by fliarp green bradfes, under which are two
fmall leaves ; calyx acute, green, not at all coloured.

Loureiro has added two fpecies, natives of Cochinchina:
Penaea nitida, which he thinks is allied to Linnaeus’s P.
myrtoides ; and Pensea fcandens, to P. marginata. He
allows that they are not conformable to Linnaeus’s gene¬
ric charadter: and indeed they certainly belong to ano¬
ther genus. See Polygala.

PE'NAL, adj . [Fr. from pcena, Lat.] Denouncing pu-

P E N

nifliment ; enadiing punifhment. — Gratitude plants fuch
generofity in the heart of man, as fnall more eftedtually
incline him to what is brave and becoming than the ter-
rour of any penal law. South. — Ufed for the purpofes of
punifhment ; vindidfive. — Adamantine chains and penal
fire. Milton's P. L.

PENAL'ITY, f. Liablenefs to punilhnient ; condem¬
nation to punifhment. — Many of the ancients denied the
Antipodes, and fome unto the penality of contrary affir¬
mations; but the experience of navigation can now af-
fert them beyond all dubitation. Brown.

PEN'ALTY, f. Punifhment; cenfure; judicial inflic¬
tion. — Political power is a right of making laws whh pe¬
nalties of death, and confequentiy all lels penalties, for
preferving property, and employing the force of the com¬
munity in the execution of the laws. Locke.

Beneath her footftool, fcience groans in chains,

And wit dreads exile, penalties,, and pains. Pope'sDunciad.
Forfeiture upon non-performance :

Lend this money, not as to thy friend,

But lend it rather to thine enemy,

Who if he break, thou may’ll with better face
Exadt the penalty. S/takefpeare's Merck, of Veil.

PENAL'VA, a town of Portugal, in the province of
Beira : nine miles north of Coimbra.

PENAMOU'SHILY, a town of Hindooftan, in the
circar of Rajamundry : forty-two miles eaft of Rajamun-
dry.

PEN'ANCE,/. [penance, peneance, old Fr.for penitence.]
Inflidlion either public or private, fuffered as an expref-
fion of repentance for fin. — No penitentiary, though he
enjoined him never fo ftraight penance to expiate his firft
offence, would have counfelled him to have given over
purfuit of his right. Bacon. — A Lorain furgeon, who
whipped the naked part with a great rod of nettles till
all over bliftered, perfuaded him to perform this penance
in a fliarp fit he had. Temple.

And bitter Penance, with an iron whip,

Was w’ont him once to difple every day. Spenfers F. Q.

Mew her up.

And make her bear the penance of her tongue. Shakefp.

The fcourge

Inexorable, and the torturing hour

Calls us to penance. Milton's P. L.

Repentance. — Seeking to bring forth worthy fruits of pe¬
nance. Comminution, Comm. Prayer.

Penance is one of the feven facraments of the Romifli
church. Befides fading, alms, abftinence, and the like,
which are the general conditions of penance, there^are
others of a more particular kind ; as the repeating a cer¬
tain number of ave-marys, paternofters, and credos,
wearing a hair-fhirt, and giving one’s felf a certain num¬
ber of ftripes. In Italy and Spain it is ufual to fee Chrif-
-tians almoft naked, loaded with chains and a crofs, and
lalhing themfelves at every ftep.

This kind of penance is enjoined by the church, for
fins of omiflion or of commilfion. But in the very early
ages men practifed penance and mortification for no other
reafon than becaufe they believed that every indblgence
wasfinful; that whatever gratified the fenfes, however
apparently innocent, mult be injurious to the foul ; that
the ties of natural affedtion weaned the heart from God ;
that the duties of fociai life mult be abandoned by thofe
who regarded their own falvation; and that, in proportion
as man inflidted privations and torments upon himfelf,
he pleaded his Creator.

The extravagancies which grew out of this fyftem
might appear incredible, if they were not as well authen¬
ticated as any facts in hiftory. Some fliut themfelves up
in cells fo low that they could not Hand upright in them,
and of fuch dimenfions that they could neither lie at
length, nor place themfelves in any but painful pofitions.

Others

3

PENANCE. 581

Others took up their abode in tombs, like the demoniacs;
or dwelt in dens with wild beads ; or made dens for
themfelves, and burrowed in the ground. Men and wo¬
men lived promifcuoufly in the deferts, with no other
covering than what mere decency required, bare to the
fun, and the wind, and the fand-fliowers. Thefe perfons
renounced all fuch food as was ufed by their fellow-
creatures, and grazed and browfed Upon herbs and ftirubs;
for which, reafon they were called Batmen. They even af¬
fected to appear like beads, by going upon their hands
and kn,ees ; and like beads they fled -from the fight of
mar), and betook themfelves to the mod inacceilible
places for concealment. If this fydem had continued a
few generations, it might have been feen how far it is
poflible for man to degrade his phyfical as well as his in¬
tellectual nature; he would have degenerated into an
^nimal little fuperior to the ape or baboon, and more
loathfome than either.

St. Pior always walked while he was eating; becaufe
(to ufe his own words) “he did not confider eating as
a bufinefs for which time was to be fet apart, but as a
thing to be done when it did not interrupt his avoca¬
tions.” St. Pachomius, in order that he might fleep as
little as poflible, and with the lead poflible comfort and
convenience, never allowed himfelf to lie down, nor
even to recline againfl any thing that might fupport him,
but fat upon a done in the middle of his cell. And
among the rules which, according to the hidorians of the
Romiftj church, were given to him by an angel, and are
the fird code of monadic laws, is one whereby the monks
are enjoined in like manner to fleep fitting, and not re¬
cumbent. Beradat ufed for his clothing a clofe fack of
fleins, which had no other opening than one fmall one
for his mouth, and another for his nofe.

The female faint, Eufraxia, belonged to a convent
containing a hundred and thirty nuns, not one of whom
ever wafhed their feet, and the very mention of a bath
was an abomination among them : "De balneo verb fu-
perfluum eft loqui ; audientes enim vehementer vituper-
abant, confufionis et opprobrii plenam confentis, vel fo-
lam illius nrentionern, et tanquam rei abominabilis, nec
auditam quidem volebant tolerare.” St. Macarius, (for
all thefe madmen are faints !) having one day killed a
gnat which had bitten him, was ftruck with compunClion
at the fight of the infeCt’s blood, and by way of atone¬
ment went into the marlhes, and there for fix months
expofed himfelf to all winged and creeping infeCts, till
every part of his flefli was fwoilen and ulcerated with their
bites. Sozomen relates of him, that he had fo hardened
his body by aufterities, that the very beard could not
make Way through his (kin. This perfonage, when in
the full odour of filth and rags, returned one day to his
convent, humbled and mortified by the fenfe of his own
inferiority, exclaiming, “ I am not yet a monk, but I
have feen monks P’ for he had fallen in with two or three
wretches ftark naked.

The Englifli reader is familiar with the extraordinary
hiftory of St. Simeon Stylites. “ This godly man, while
yet in the flefli, imitated the life of the angels, withdrew
himfelf from earthly things, forced nature, which ever
inclineth downwards, afpired to things heavenly, and
placed himfelf between earth and heaven, on the top of
a pillar. He, together with the angels, praifed the Lord,
lifted up the prayers of men, and offered them to God,
and brought down the mercy of God to make men par¬
takers thereof.” Such is the language of Evagrius ! His
celebrity long furvived him. A church was built round
the pillar upon which “ this earthly and incarnate angel
led his heavenly life ; and every year, on the faint’s day,
a ftar was exhibited playing round the pillar.” Eva¬
grius fays he himfelf had feen it, and does not intimate
the flighted fufpicion of the trick. His body was remov¬
ed to Antioch, from whence the emperor Leo would
have tranflated it to Conftantinople ; but the people of
Antioch reprefented, “ that the fortifications of their city
Vol. XIX. No. 1332.

had been thrown down by an earthquake, and therefore
they had brought thither the holy body of Simeon, that
it might be to them inftead of a wall.”

The fame freaks and follies of the human mind, the
fame difeafes of the moral and intellectual nature, have
fhown themfelves in all ages s the Romifh church has had
the dexterity to turn them to account. In her fervice
there was a place for every one, faint or fage, the painful
ftudent and the expert fophift, the haughtieft temper
and the humbled, knave, madman, and idiot, all had their /
ufes, and were employed with excellent advantage to the
papacy. When, by fome lucky combination of events,
a monk had attained that fort of influence which enabled
him to inftitute a reform, it fuited the policy of the
church, and his order alfo, to accredit the fables forged
by himfelf apd his accomplices, and propagated by vulgar
credulity; to canonize the fanatic who during his life
had been an objefl of contempt to all his brethren ; and
to publifh for edification the ftrangeft pranks and the mod
difgufting adtions of infane and grovelling fuperftition.

The mod remarkable fanatic of the time we are lpeak-
ing of was the perfonage known by the name of St. Do¬
minic the Cuira flier, becaufe of an iron cuirafs which he
wore next his Hein, and which was never taken off till it
was neceflary to replace it by a new one. Dominic had
been intended for an ecclefiaftical life 5 but, when he re¬
ceived prieft’s orders, his parents prefented a furred robe
to the bifhop who ordained him; and Dominic, conceiv¬
ing that he had thus incurred the guilt of finning, not
only refrained from performing mafs, but refolved to do
penance for the crime as long as he lived. For this pur-
pofe he entered into the Congregation Santa Croce de
Fonte Avellana, the moft extravagant of all the orders
which had been produced by reforming the fyftem of St.
Beiredifh The monks of this congregation never
touched either wine or oil, and during five days in the
week only bread and water ; they were never allowed to
fpeak, except for a fliort time on Sundays, and then only
concerning fpi ritual things ; they went barefoot, and
each day after evening-fervice, they flogged one another.

In thofe days it was believed that a tinner might be
flogged into a faint, as it has been fuppofed, within our
own memory, that a dunce might be whipped into a
fcholar. Bur, befades the general utility of flagellation
as a means of obtaining the favour of heaven, the aftual
value of ftripes, the price at which they were taken by
the fcore in the treafury of good works, had been fettled,
according -to the moft minute and accurate calculation.
This well deferves to be explained.

It is a point of faith, fay the Catholics, that every
mortal fin deprives the {inner of the grace of God, and
makes him liable to eternal punilhment ; but, if he re¬
pents and confeffes, the mercy of God is fo great, that he
reftores the grace which had been forfeited, and com¬
mutes for temporal punifhment that which fhould ell'e
have been eternal. How long a time a foul has to remain
in purgatory for one mortal fin, or for many, whether
for one year, ten, twenty, or more, is what the divine
majefty has revealed to none s the popes, however, have
granted indulgencies, by fome of which they remitted a
certain number of years of purgatory, by others half the
term, and by others the whole. The monks of Fonte
Avellana had determined that thirty pfalms faid or fung,
with an accompaniment of one hundred ftripes to each
pfalm, making in all three thoufand, would be received
as a fet-off for one year of purgatory ; the whole pfalter,
with the full compliment of fifteen thoufand ftripes,
would redeem five years from the fame vaft crucible ; and
twenty pfalters with three hundred thoufand ftripes,
fairly entered in the recording angel’s book, would be
equal to a receipt in full for an hundred years of fire and
torments in the world to come. This fcale was fanftion-
ed (if not formally approved) by the popes.

Dominic the Cuiraffier was ambitious above all men in
laying up treafure of this kind in heaven j and to a man
6 U of

532

PENANCE.

of his temper it was a great excitement to know that he
was working by the piece. He talked himfelf ordinarily
at ten pfalters and thirty thoufand lathes a-day, at which
rate he would have redeemed three thoufand tix hundred
and' fifty years of purgatory per annum ; and, as Domi¬
nic is faid never to have committed any other fin in his
life than that of confenting to the prefent of the furred
robe, one year of fuch difcipline might have been thought
full meafure and overflowing for that offence. But, in
addition to this regular allowance, he ufed to petition
his fuperior in Lent for a fupplementary talk of an hun¬
dred years ; and then his day’s work was two pfalters
and a half, with thirty -four thoufand five hundred
ftripes. Even this did not fatisfy the ambitious Domi¬
nic. He was already creditor to a large amount in the
angel’s books; but no good works can be loft; all that
was over and above the fum neceflary for his own re¬
demption from purgatory would go to the great finking
fund of the holy Catholic church; and Dominic there¬
fore continued to flog himfelf with more fpirit than ever,
for the good of his fellow-creatures. He entreated and
obtained, during another Lent, the impofition of a thou¬
fand years; and St. Pietro Damiano affirms, that in thefe
forty days he aftually recited the pfalter two hundred
times, and inflifted upon himfelf fixty millions of ftripes,
working away during the recitation with a fcourge in
each hand. This was in addition to his regular talk ;
and I neither know, fays Yepes, how his head thould have
been capable of repeating fo many pfalms, nor how his
arms could have had ftrength to give him fo many blows,
nor how his fleffi, not being of iron, could have endured
fo inhuman a battery. In him, however, increafe of
appetite grew by what it fed on ; and like our pedef-
trians, who go on walking hour after hour, till they
afcertain theutmoft exertion which their abufed ftrength
is capable of enduring, he, in an heroic mood, determined
once to flog himfelf, in the jockey phrafe, a'gainft time.

’* In this noble feat, he fo far outdid all his former outdo-
ings, that beginning in the evening, and tinging and flog¬
ging through the day and night, at the end of twenty-four
hours he had gone through the pfalms twelve times, began
them a thirteenth time, and proceeded as faras Beati qua-
rum, the 32dpfalm; the quota of ftripes being 183,100,
thereby reducing purgatory- ftock in the amount of lixty-
one years, twelve days, and thirty-three minutes, to a
fraction.

With regard to the authenticity of this account, it
refts upon the authority of Pietro Damiano, faint and
cardinal ; and he relates it from his own perfonal know¬
ledge, in an epillle to pope Alexander II. It is laid down
as an axiom by Ambrofia Morales, that whatever one
fair.t relates of another, is to be implicitly believed ; and
Calmet, living in a lefs credulous age and country, pre-
mifing that the ftatement appears incredible, fays, that
after feeing it confirmed by St. Pietro Damiano, “there
ought to be no further hefitation ;” la chofe ve doit fair e
imcune dijjiculte. It feems, however, that certain awk¬
ward doubts refpedting the poffibility of Dominic’s ex¬
ploits obtruded themfelves upon the minds of thofe who
were very defirous of believing them if they could. It
appears, upon calculating the great achievement of the
four-and-twenty hours, that if during the whole of that
time he had given himfelf two blows (that is, one with
each hand, for he always ufed both) in every fecond, the
number would have been 172,800, being 10,300 fliort of
the ftated amount. Padre Maeftro Caftaniza fuppofes
that Dominic’s cats had ten tails each, and that every
tail was reckoned ; but this mode of reckoning would fa¬
vour fo much of vain-glory, not to fay deceit, that other
writers rejeft the folution, as derogatory both to the faint
and his canonized biographer. They therefore agree
with Caftaniza, that “ the divine grace which the
Almighty imparts to his fervants produces in them mar¬
vellous eftefts, however weak they may be by nature ;”
and fo they take the fum total without lcruple. But the

faying Credo quia impofflbile eft, will not pafs current out
of the pale of Catholicifm; and a Proteftant may be al¬
lowed toalk, how Dominic contrived to reckon the ftripes
while he was finging the pfalms? Another queftion will
have already occurred to the reader, was Dominic in his
cuirafs all the while ? if he were, he might have laid on
as luftily as Sancho upon the trees, and kept a whole {kin.
But the cardinal mentions that he ftripped himfelf for the
work. What, then, becomes of the affertion that the
cuirafs was never taken off till it was worn out ? The
ftory bears the ftamp of fraud as well as of folly and
madnefs ; and the church, which has accredited it by ca¬
nonizing the man, whether knave or fool, or both, thereby'
encouraging the groffeft fuperftition and the molt abfurd
practices, is implicated in the impofture.

As the mythology of Greece was lefs grofs than that
of Egypt, and that of Egypt lefs fo than that of India ;
fo the penances and felf-tortures of the Hindoo fakeers,
yogeys, and faniaffes, exceed in extravagance and folly
every thing that we have related above. See the article
Hindoostan, vol. x. p. 148-52.

Penance, in our common law, is an ecclefiaftical pu«
niffiment, ufed in the difcipline of the church of England,
and affefting the body of the penitent ; by which he is
obliged to give a public fatisfaftion to the church for
the Icandal he hath given by his evil example. In the cafe
ofinceft or incontinency, the offender is ufuaily enjoined
to do a public penance in the cathedral, or parifh-church,
or public market, barelegged and bareheaded, in a white
ffieet, and to make an open confeffion of his crime in a
prefcribed form of words, which is augmented or mode¬
rated according to the quality of the fault, and the dif-
cretion of the judge. So in fmaller faults and fcandals,
a public fatisfadtion or penance, as the judge ffiall decree,
is to be made before the minifter, churchwardens, or
fome of the pariffioners, refpedt being had to the quality
of the offence, and circumftances of the faSt, as in the
cafe of defamation, or laying violent hands on a minifter,
or the like. And, as thefe cenfures may be moderated by
the judge’s difcretion, according to the nature of the
offence, fo alfo they may be totally altered by a commu¬
tation of penance: and it hath been the ancient privi¬
lege of the ecclefiaftical judge to admit that an oblation
of a fum of money for pious ufes (hall be accepted in fa-
tisfadlion of public penance. But penance mull be firft
enjoined, before there can be a commutation; or other-
wile it is a commutation for nothing. Linwood and other
canonifts mention three forts of penance : viz. private,
enjoined by any prieftin hearing confeffion ; public, en¬
joined by the prieft for any notorious crime, either with
or without the bifhop’s licence according to the cuftom of
the country ; and folemn, the particulars of which are
prefcribed by the conftitution of archbiftiop Peckham.
By the ftatute of “ Circumfpedte agatis,” (13 Edw. I. flat.
4.) the kingtohis judges fendeth greeting: Ufe yourfelves
circumfpedtly concerning the biftiops and their clergy, not
punifiiing them if they hold plea in court-chriftian of fuch
things as be mere fpiritual ; that is, to acts of penance
enjoined by prelates for deadly fin, as fornication, adul¬
tery, and luch like ; for the which fometimes corporal pe¬
nance, and fometimes pecuniary is enjoined, (2 Roll.
Rep. 384,) in which cafes the lpiritual judge ffiall have
power to take knowledge, notwithrtanding the king’s
prohibitions. By the ftatute of “ Articuli Cleri,” (9
Edw. II. flat. 1. c. 2. ) if a prelate enjoins a penance pecu¬
niary to a man for his offence, and it be demanded, the
king’s prohibition (hall hold place 5 but, if prelates enjoin
a penance corporal, and they which be fopuniffied will
redeem upon their own accord fuch penance by money ;
if money be demanded before a fpiritual judge, the-king’s
prohibition ffiall hold no place. And by the fame ftatute,
(c. 3.) if any lay violent hands on a clerk, the amends
for the peace broken ffiall be before the king, and for the
excommunication before a prelate, that corporal penance
may be enjoined ; which if the offender will redeem of his

own

PEN

own good will, by giving money to the prelate, or to the
party grieved, it (hall be required before the prelate, and
the king’s prohibition (hall not lie.

PE'NAR VAL'LI, f. in botany. See Zanonia.

PENAT', a town of Hindooftan : thirty miles fouth-
fouth-eaft of Agra. „ .

PEN'ATES, in the ancient mythology, a term applied
to all the domeftic gods, whom the ancients adored in
their lioufes : whence they are ordinarily confounded with
the lares. See La r.

Authors are not all agreed about the origin of the dii
penates, who were properly the tutelary gods of the Tro¬
jans, and were only adopted by the Romans, who gave
them the title of penates.

The penates feem to have originated in a vulgar opinion
which prevailed very generally amongft mankind, that the
manes of their anceftors took pleafure after death to dwell
in their houfes, where indeed they were frequently in¬
terred, and where their piftures ufed to be preferved in
the places that were molt refpe£led. After having been
accuftomed toconfider them under the charafter of illuf-
trious perfons, they by degrees paid them refpeft and
homage, they then implored their affiftance, and laftly
they fucceeded to the worftiip and religious ceremonies.
The penates were therefore the manes of their anceftors,
which St. Auguftine (de Civ. Dei. ix. 11.) maintains, on
the authority of Apuleius and Photinus; and in procefs
of time they were alTociated with all the other gods with¬
out diftinftion.

The ftatues of thefe gods were made not only of wax, as
fome authors pretend, but indifferently of all forts of ma¬
terials, even of filver itfelf : they were confecrated in the
moft fecret places ; altars were erefted to them, lamps
kept burning, and fymbols added, all of them expreftive
of vigilance. Anciently children were offered to them in
facrifice; but Brutus, who expelled the Tarquins, dif-
continued this barbarous praftice ; and from that time
nothing was offered to them but wine, incenfe, fruits,
and fometimes bloody viftims, lambs, (beep, &c. their
ftatues were likewife crowned with feftoons of garlic
and poppy. In the public facrifices offered to the pe¬
nates, they facrificed to them a fow. It was in the time
of the Saturnalia that they celebrated the feftival of the
lares and penates ; and there was a day befides in each
month fet apart for the worfhip of thefe domeftic gods.
At the temple confecrated to thefe gods in Rome,
there was fet apart for them a holiday, which was obferved
with much folemnity; and this was the fecond of the ka¬
lends of January, or the laft day of December. To this
were added the games called Compitales. Indeed, the re-
fpebf paid to the penates was fo great, that no important
enterprife was undertaken without confulting them:
their figures were even fometimes carried about in jour¬
neys, as we learn from Apuleius: “ Wherever I go,” fays
he, “I always carry with mein my journey the figure of
fome god.”

Authors have conje&ured, that the idols which Jacob
brought from the houfe of Laban his father-in-law, and
which the Scripture denominates “ teraphim,” were gods
penates, whofe worfhip was propagated afterwards into
Phrygia, and tranfmitted from thence into Greece and
and ltaly. This, it is confidently afferted, was their true
origin.

PENATO'LEN, a town of Chili: twenty miles eaft of
St. Yago de la Nueva Eftremadura.

_ PENATOO'R, a town of Hindooftan, in the Carnatic :
eight miles weft of Gingee.

PENAUTI'ER, a town of France, in the department
of theAude: three miles north-weft of Carcaffonr.e.

PEN'BRAY, a cape on the Couth coaft of Wales, in
the Briftol Channel; three miles fouth of Kidwelly.

PENBUGHTO'E HEAD', a cape of South Wales,
on the north coaft of the county of Pembroke. Lat. 51.
56. N. Ion. 5. 5. W.

PENCA'DER, a village of South Wales, in the county
3

PEN 533

of Caermarthen. In the year 1038 a battle was fought
here between Griffith prince of North Wales, and Howel
prince of South Wales, in which the latter was defeated.
Hovvel’s wife was made prifoner, and the prince himfelf
very narrowly efcaped. It is ten miles fouth-fouth-weft
of Llanbeder.

PENCAR'ROW, a cape in the Englilh Channel, on
the fouth coaft of Cornwall : two miles eaft from the river
Fowey.

PEN'CIL, f. [penicillum, Lat.] A fmall bruflt of hair
which painters dip in their colours. — There are pencils
of various k'inds, and made of various matters; the moft
ufual are of badgers and fquirrels hair, thofe of fwans
down_, and thofe of boars briftles ; which laft are bound
to a (tick, bigger or lefs according to the ufes they are def-
tined for ; and, when large, are called brnjhes. The others
are inclofed in the barrel of a quill. The ancients, M.
Felibien obferves, had pencils made of little pieces of
fponge ; whence, doubtlefs, the ftory of the painter, who,
not able to exprefs the foam of a horfe, fucceeded by
throwing the fponge at the pi&ure. Chambers. — Black
lead (Graphites) laid between two grooved (lips of ce¬
dar, and then cut to point. — Black lead in fine powder
may be readily mixed with melted fulphur ; and, though
the compound remains fluid enough to be poured into
moulds, it looks nearly like the coarfer forts of black
lead itfelf. This was probably the method by which,
prince Rupert is faid to have made black lead run like a
metal in a mould, fo as to ferve for black lead again.
The German black-lead pencils, and thofe which are
hawked about among us, are prepared in this manner :
their melting or foftening, when held in a candle, or ap¬
plied to a red-hot iron, and yielding a bluifti flame, with
a ftrong fmell like that of briinftone, difeovers their com*
pofition. Pencils of this kind are hard and brittle, and
cut or fcratch the paper or wood, inftead of marking
them. The true Englilh pencils are formed of black lead
alone, (awed into (lips, which are fitted into a groove
made of the fofteft wood, as cedar, and another (lip of
wood glued over them. Thefe pencils, however, are of
different quality, on account of different forts of the
mineral being fraudulently joined together in one pencil,
the fore-part being commonly pretty good, and the reft
of an inferior kind. To avoid thefe inconveniences,
fome take the finer pieces of black lead itfelf, which they
faw into (lips, and fix for ufe in port crayons. Leivis’s
Commerce of Arts. — A black-lead pencil is certainly a
very neat and convenient inftrument; and we may join
in the prayer or thankfgiving of an old Nubian, who faw
Mr. Waddington ufinghis pencil: “ Praifed be God, the
Creator of the World, who has taught man to inclofe
ink in the centre of a bit of wood.” Waddington and
Hanbury’s Journal of a Vilit to Ethiopia, 1822. — Any
inftrument of writing without ink. A little flag or
((reamer; [ pcnnoncel , old Fr.] Obfolete. — She made him
wear a pcncell of her fleve. Chaucer's Tr. and Crej]'.

To PEN'CIL, v. a. To paint :

Smooth forehead, like the table of high Jove,

Small penciU'd eyebrows like two glorious rainbows.

Trag. of Soliman and Perfeda, 1599.

PENCK, a town of Germany, in the principality of
Culmbach : four miles north-eaft of Bayreuth.

PEN'CKUM, a town of Anterior Pomerania : thirteen
miles fouth-weft of Old Stettin, and forty-four north-
north-weft of Cuftrin. Lat. 53. 15. N. Ion. 14. 20. E.

PEN'CO. See Conception, vol. v. p. 13.

PEN'DANT, f. [French.] A jewel hanging to the
ear :

Some thrid the mazy ringlets of her hair,

Some hang upon the pendants of her ear. Pope ,

Any thing hanging by way of ornament :

Unripe fruit whole verdant (talks do cleave
Clofe to the tree, which grieves no lefs to leave

The

534 PEN

The finding pendant which adorns her fo,

And until autumn on the bough (hould grow. Waller.

The part of a watch to which the chain or ribbon is hung.
A pendulum. Obfolete. — To make the fame pendant go
twice as fall as it did, or make every undulation of it in
half the time it did, make the line, at which it hangs, dou¬
ble in geometrical proportion to the line at which it
hanged before. Digby on the Soul. — A fmall flag in fhips.

PENDAR'RYE, a town of Hindooftan, in Oude: fe-
venteen miles north-weft of Kairabad.

PENDAR'TY, a town of Hindooftan, in the Carnatic i
eight miles eaft of Ongole.

To PENDE, v. a. To hang up; to pen ; to ftiut up.
Chaucer.

PEN'DENCE, or Pendency, [from pencleo, Lat.]
Slopenefs ; inclination. — The Italians give the cover a
graceful pendence or flopenefs, dividing the whole breadth
into nine parts, whereof two fhall ferve for the elevation
of the higheft top or ridge from the loweft. Wotton on
Archi'tetture. — Sufpenfe; delay of decifion. — The judge
fhall pronounce in the principal caufe, nor can the appel¬
lant allege pendency of fuit. Ayliffe.

PENDE'NE-VO W', on the north conft of Cornwall,
near Penzance, has an unfathomable cave under the
earth, into which the fea flows at high water. The cliffs
between this and St. Ives glitter, as if they had ftore of
copper, of which there is abundance hereabouts within
land.

PENDEN'NIS CAS'TLE. See Falmouth, vol. vii.

PEN'DENT, adj. [pendens, Lat. fome write pendant ,
from the Fr.] Hanging:

I fometimes mournful verfe indite, and ling
Of defperate lady near a purling ftream,

Or lover pendent on a willow tree. Philips.

Quaint in green fhe fhall be loofe enrob’d

With ribbons pendant, flaring about her head. Shahefp.

Jutting over :

A pendent rock,

A forked mountain, or blue promontory. Slialiefpeare.
Supported above the ground :

They brought, by wondrous art

Pontifical, a ridge of pendent rock

Over the vex’d abyfs. Milton's P. L.

PENDEN'TIVES, f. in architedlure, are thofe parts in
the angles, between the arches of the nave, which fpring
from a point, and gradually advance in a concave direc¬
tion to receive the circular entablature of the cupola.
Or, if weifuppofea circle inferibed within a fquare, the
curvilinear triangles cut off will be the plans of the pen-
dentives.

PEN'DENTNESS, f. The ftate of being pendent.

PF.NDERA'CHI, or Ere'c-ri, a feaport town of
Afiatic Turkey, on the Black Sea, anciently Heraclea,
governed by a cadi ; at one time epifcopal : 100 miles eaft
of Conftantinople. Lat. 41. 36. N. Ion. 31. 18. E.

PEN'DICE. See Pentice.

PENDIL'HO, a town of Portugal, in the province of
Beira: twelve miles fouth-eaft of Lamego.

PEN'DING, adj. [pendente lite.'] Depending 5 remain¬
ing yet undecided. — A perfon, pending fuit with the dio-
cefan, fhall be defended in the pofielfion. Ayliffe.

PEN'DLETON, a village in Lancafhire, with a popu¬
lation of 3611, including 226 employed in trade and ma-
nufadhtres: two miles weft of Manchefter.

PEN'DLETON, a county of Virginia, in America,
bounded north-weft by Randolph, and fouth by Rock¬
ingham, counties; watered by the fouth branch of the
Patovvmack. It contains 4239 free inhabitants, and 202
flaves. Its chief town is Frankford. — Alfo, a diftridl of
South Carolina, on the Keow ee and Savannah rivers ; con¬
taining 22,897 inhabitants, of whom 3485 are flaves : fif-
■ty-two miles w'eft of Cambridge.— Alfo, a county of

PEN

Kentucky, containing 2940 people, of whom 34 6 are
flaves.

PEN'DOUN, a town of Birmah : twelve miles fouth of
Raynangong.

PENDRAG'ON CAS'TLE. See Kirkby Stephen,
vol. xi. p. 761.

PENDULOS'ITY, or Pen'dulousness, /. [from pen¬
dulous.'] The ftate of hanging; fufpenfion. — His flender
legs he encreafed by riding ; that is, the humours defen¬
ded upon their pendulofity, having no fupport or fuppe-
daneous liability. Brown's Vulg. Err.

PEN'DULOUS, adj. [pcndulus, Lat.] Hanging; not
fupported below. — Bellerophon’s horfe, fram’d of iron,
and placed between two loadftones wdth wings expanded,
hung pendulous in the air. Brown's Vulg. Errors. — The
grinders are furnifhed with three roots, and in the upper
jaw often four, becaufe thefe are pendulous. Ray.

All the plagues that in the pendulous air

Hang fated o’er men’s faults, light on thy daughter. Shall.

Doubtful; unfettled. — In apendulo us ftate of mind. At -
ter bury.

PEN'DULUM, f. [pendulus, Lat. pendule, Fr.] Any
weight hung fo as that it may eafily lwing to and fro, of
which the great law is, that its ofeiilations are always per¬
formed in equal time:

Upon the bench I will fo handle ’em,

That the vibration of this pendulum
Shall make all taylors’ yards of one
Unanimous opinion. Hudibras.

For a full explanation of the theory of pendulums, fee
the article Horology, vol. x. p. 307 & feq. We fhall
add here only two particulars which have fince occurred
to our notice.

1. Profeflor Bridge has calculated the following
little Table, on a fuppofition that the length of a fe-
conds pendulum is 39-2 inches in latitude 520, which is
taken as his ftandard ; and he has given the lengths
correfponding not only to fix different latitudes, but
to four different heights, fix at the earth’s furface, and
at one, two, and three, miles of elevation refpedtively.

Latitude.

Length of
Pendulum at
the Earth’s
Surface.

One Mile
above the
Earth.

Two Miles
above the
Earth.

1

Three Miles
above the
Earth.

At the Equator
Lat. 300

45

60

At the Pole

39-060

39’1I5

39-170

39-200

39-225

39-281

39-036

3 9 '°9 1
39-146
39-176
39*201
39*257

39‘01 3
39-068
39*122

3 9* 1 5 2
39'J77
39-233

38’997

39-052

39-107

3 9* 1 3 7
39-161
39-2ig

Thus we fee that the greateft variation in the length of a
pendulum vibrating at three miles above the equator,
and on the earth’s lurface at the pole, is only ‘284 of an
inch, which affords but a fmall fcale for determining ei¬
ther altitudes or the figure of the earth, to both which
purpofes the obferved variations in the lengths of the
pendulum have been propofed as a meafure.

2. When a pendulum of a given length has been ob¬
ferved to gain or lofe a certain quantity daily, it is con¬
venient, in making the adjuftment for exadt time, to
have fome concife theorem as a guide to bring it to
the point defired, at one trial, in all cafes, which the¬
orem profeflor Bridge has given in thefe words: “Mul¬
tiply twice the length of the pendulum by the num¬
ber of feconds gained or loft, and divide the refult by
the number of leconds in a day; the quotient will give
the number of inches, or parts of an inch, by which the
pendulum is to be lengthened or lhortened.” Suppofe
the gain of a feconds pendulum to be three minutes, or

180", in a folar day ; then ■ 39 2 ^ 2 1-8-°— — ’163 parts

864OO

of an inch, is the quantity, in this cafe, by which the

pendulum

P E N E L 0, P E.

535

pen dulu hi muft be lengthened to meafttre mean time;
but, if the three minutes had been lofs with a half-feconds

pendulum, then - — - = '041 of an inch, or the

fourth part of the former gain, will be the quantity by
which the faid pendulum will require to be (hortened'.
This rule is not only (hort in its application, but eafy
to be remembered.

PENEL'LA, a town of Portugal, in the province of
Beira : fifteen miles fouth-eaft of Coimbra.

PEN'EDON, a town of Portugal, in the province of
Beira : nineteen miles north-eafl of Vifeu.

PENEL'OPE, a celebrated princefs of Greece, daugh¬
ter of Icarius, and wife to Ulyfles king of Ithaca. Her
marriage with Ulyfles was celebrated about the fame time
that Menelatis married Helen; and (lie retired with her
hufband to Ithaca, againft the inclination of her father,
who wiflied to detain her at Sparta, her native country.
Siie foon after became mother of Telemachus, and was
obliged to part with great reluffance from her hufband,
whom the Greeks obliged to go to the Trojan war. The
continuation of hoftilities for ten years made her fad and
melancholy; but, when Ulyfles did not return like the
other princes of Greece at the conclufion of the war, her
fears and her anxieties were increafed. As fhe received
no intelligence of his fituation, (he was foon befet by a
number of importuning fuitors, who wiflied her to be¬
lieve that her hufband was fhipwrecked, and that there¬
fore fhe ought no longer to expeff his return, but forget
his lofs, and fix her choice and afteftfions on one of her
numerous admirers. She received their addrefles with
coldnefs and difdain ; but, as fhe was deftitute of power,
■and a prifoner as it w'ere in their hands, fhe yet flattered
•them with hopes and promifes, and declared that fhe
would make choice of one of them as foon as fhe had
■ finifhed a piece of tapeftry on which fhe was employed.
The work was done in a dilatory manner; and fhe baffled
their eager expeditions, by undoing in the night what
fhe had done in the day-time. This artifice of Penelope
has given rife to the proverb of Penelope's web, w’hich is
applied to whatever labour can never be ended. The re¬
turn of Ulyfles after an abfence of twenty years, how¬
ever, delivered her from fears, and from her dangerous
fuitors.

Thus Penelope is defcribed by Homer as a model of fe¬
male virtue and chaftity; but fome more modern writers
difpute her claims to modefty and continence, and they
reprefent her as the mod debauched and voluptuous of
her fex. According to their opinions, therefore, fhe libe¬
rally gratified the defires of her fuitors, in the abfence of
her hufband, and had a foil whom fhe called Pan, as if to
(how that he was the offspring of '‘all” her admirers.
Some however fuppofe that Pan was foil of Penelope by
Mercury, and that he was born before his mother’s mar¬
riage with Ulyfles. See Pan. After the return of Ulyfles,
Penelope had a daughter, who was called Ptoliporthe;
but, if we believe the traditions that were long preferved
at Matinea, Ulyfles repudiated his wife for her inconti¬
nence during his abfence, and Penelope fled to Sparta,
and afterwards to Mantinea, where fhe died and was bu¬
ried. After the death of Ulyfles, according to Hyginus,
file married Telegonus, her hufband’s fon by Circe, by
order of the goddefs Minerva. Some fay that her origi¬
nal name was'Arnea, or Amirace; and that, fhe was called
Penelope, when fome river-birds 'called Penelopes had
faved her from the waves of the fea, when her father had
expofed her. Icarius had attempted to deftroy her, be-
caufe the oracles had told him that his daughter by Peri-
bcea would be the molt diflblute of her fex, and a difgrace
to his family.

PENEL'OPE,/. the Turkey Pheasant ; a genus of
birds of the order gallinae. Generic characters — Bill na¬
ked at the bafe ; head covered with feathers ; chin naked ;
tail with twelve feathers; legs without fpurs.

This beautiful genus of birds partakes of the form
and nature of the Meleagris (turkey), the Phafianus

Vol. XIX. No. 1323.

(pheafant), and Crax (curaflow). It was inftituted by
Gmelip in his laft edition of the Sy ft. Naturae; fo that
the fix fpecies of which it confifts have been feleCted from
the Linnsean genera we have mentioned. See the article
Meleagris, vol. xv. p. 49.

1. Penelope fatyra, the horned turkey-pheafant : two
horns on the head ; body red, with ocellated fpots. This
elegant and lingular bird derives its name from two pro¬
tuberances which grow from its head like horns, which
are of a beautiful blue colour, a cylindrical fliape, blunt
at their ends, reclined backwards, and confiding of a fttb-
ftance refembling callous flefh. It has not that round
circle about its eyes which occurs in the pheafants, and
is fometimes dotted with black ; the fpace which furrounds
the eyes is fhaded with black hairs, like feathers. Un¬
der this fpace, and from the bottom of the lower mandi¬
ble, grows a kind of gorget, confiding of loofe fkin,
which falls down and floats freely on the throat and the
upper part of the neck: this gorget is black in the mid¬
dle, and is fprinkled with a few draggling hairs of the
fame colour. It is marked with wrinkles ; fo that it ap¬
pears to admit of extenfion in the living animal, and can
be inflated or cohtrafted at pleafure, like the caruncles
of the turkey-cock : the lateral parts are blue, with fome
fpots of orange, and without any hair on the outer fur-
face ; but the infide, which applies to the neck, is (haded
with little black feathers, as weil as that part of the neck
which it covers. The crown of the head and fore part
of the body are of a beautiful red, and the hind-part of
a dufky orange. Over the whole bird, including even
the tail and the wings, are a profufion of pellucid fpots,
furrounded with black, and difperfed with confiderable
regularity. Thefe fpots are round on the fore- part, and
oblong or fli3ped like tears of pearl on the hind-part,
with the point turned towards the head. In lize this
bird is between a fowl and a turkey, and (hnped very much
like the latter: “ the legs (Edwards fays) refemble thofe
of the cock pheafant, being armed, like them, with (harp
fpurs.” If fo, it is wrongly placed in this genus.

The female, contrary to the ufual ordination of nature
in the plumage of birds, is nearly if not quite as beauti¬
ful as the male. It is but of late date that thefe birds
have been known in England. The male was firlt figured
by Edwards, in his Gleanings of Natural Hiftory; and
the female appeared only in 1798, in Mr. Pennant’s View
of Hindooftan ; from the Britifli fettlements in which
country it was brought by Sir Elijah Impey, on his re¬
turn to England. The principal dirtin&ion of this fex
is, that it has not the horns, fo confpicuous in the male.
The feathers on the front of the head, and part of the
neck, are of a filky texture, black, glolfed with ultramarine
blue; the feathers on the hind head are a beautiful crim-
fon, forming a tuft or crefl flowing backward. The neck,
the bread, the belly, and thighs, are of the fame glowing
crimfon colour, which, as well as the back and wings,
are fpangled with the fame pearly tears as in the male,
though lefs numerous on. the wing-coverts : the back
and wings, and fmaller tail-feathers, are of a rich orange
ground, marked with minute black lines or bars ; the tip
of the tail black. Thefe bird's are by no means common
in Hindooftan, though frequently feen in paintings done
in India; where the male is called fmgec moory, or mar¬
bled bird ; and the female moory manmoorci, or the bright
bird.

2. Penelope criftata, the crefted penelope, or quan :
an upright crefl on the head ; temples violet. Marcgrave
was thefirfl who noticed this curious bird. Several or-
nithologifts, copying him, have ranged it with the phea¬
fants : whilfl Brifl'on, Edwards, and Latham, have clafl'ed
it with the turkey. It is rather larger than a fowl: length
two feet fix inches; bill two inches long, and black;
irides dull orange ; fides of the head covered with a naked
purplifhblue (kin, in which the eyes are placed ; beneath
the throat, for an inch and a half, the (kin is loofe, of a
fine red colour, and covered only with a few hairs ; the
top of the head is furniflied with long feathers, which

6 X the

PENELOPE.

536

the bird tan ere£l as a creft at will. The general colour of
the plumage is brownifh black, gloffed with copper in
fome lights; but the wing-coverts have a greenifh and
violet glofs: the quills moftly incline to purple. The fore
part of the neck, breaft, and belly, are marked with white
fpots ; the thighs, under tail-coverts, and the tail, brown¬
ifh black : the legs are red, and deftitute of fpurs ; claws
black. Some of thefe birds are obferved to have little or
no creft, and are fuppofcd to be females. It inhabits Bra-
fil, where it is often made tame. It frequently utters a
noife not unlike the word jacu. The flefn is much ef-
teemed.

Dr. John Latham, of Romfey, in a raoft elaborate
Efl'ay on the Tracheae of Birds, read before the Linnsean
Society in 1797, has noticed wherein fome fpecies of this
genus differ from the ordinary conformation in that par¬
ticular. But heprevioufly obferves, that “ in molt birds
the natural fhape of the trachea, afpera arteria, or wind¬
pipe, by all which names this part is known, is that of a
regularly-uniform cylinder of equal diameter, or nearly
fo, throughout, from its rife at the root of the tongue to
its entrance into the hollow of the thorax, fternum, or
breaft-bone, where it divides into two branches called
bronchi®, which ramify into air-veffels which compofe
the two lobes of the lungs. This, I fay, is the general
mode of conftrudtion : but ornithologifts pretty far back
have noticed nature’s deviation from this ufual ftrufture,
both in refpedt to the various curvatures of the windpipe
itfelf, as well as the difference of fome from others in re-
fpedt to conformation ; but their fentiments were penned
in too vague a manner to determine much thereon, not
anfwering the purpofe further than to ftimulate our fu¬
ture refearches. As far as the deviation from a cylindri¬
cal fhape is concerned, it is obfervable that the peculiar
difference in ftruff ure is feen only in the male fex, the fe¬
male not having theleaft enlargement, or increafed cavity,
as will hereafter be mentioned : but to what purpofe na¬
ture has intended this, is, I believe, at prefent un¬
known to us. Some authors have given as their opinion,
that the enlargement of the trachea in males, whenever
it happens, ferves to increafe the tone of voice; and that
this iex is enabled, by means of it, to cry out more forci¬
bly than thole birds which have no fuch conftrudtion of
parts, an inftance of which is pointed out in the golden-
eve duck, the Latin name of which ( Anas clavgula ) has
been given to it from this fuppcfed circumftance. In
refpeft to what affiftance fuch a conftruflion of parts as
above faid may afford to the tone of the voice, I will not
venture here to affirm ; for it cannot be denied that fome
birds are able to utter very loud founds without fuch
aid, witnefs the cock, peacock, and others. We fee Na¬
ture’s operations and admire them in courfe, yet cannot
always comprehend the utility of her works ; and this
feems one of her defigns concerning which we are net at
all clear.

“ In the quan, or guar, the wundpipe not only de-
feends much lower on the breaft, but at the bottom part
it doubles upwards for at leaft one-third of its length.
It differs alfo in another particular; for, inftead of ma¬
king a defeent on the left fide, it paffes down on the right,
and, contrary to the others, returns upwards, and goes
into the cavity of the thorax over the left clavicle.”

3. Penelope Cumanenfis, the Cayenne penelcpe, or
yacou : hlackifh ; creft and firft quill-feathers white.
This is alfo larger than a fow l. The bill black ; the head-
feathers long and pointed, forming a creft, which can be
erefted at pleafure; irides pale rufous; fpace round the
eyes naked, of a bluifh colour, and not unlike that of a
turkey : it has alfo a naked membrane, or kind of wattle,
of a dull black; the blue fkin comes forward on the bill,
but is not liable to change colour like that of the turkey.
The plumage has not much variation ; it is chiefly brown,
with fome white markings on the neck, breaft, wing-
coverts, and belly'; the tail is pretty long, and even at
the end ; legs red. This is found at Cayenne, but is a
rare bird, being met with only in the interior parts, cr

about the Amazons country : though it is in much greater
plenty up the river Oyapoc, efpecially towards Camoupi :
and indeed thofe that are feen at Cayenne are moftly tame
ones ; for it is a familiar bird, and will breed in that ftate,
and mix with other poultry. It makes its neft on the
ground, and hatches its young there, but is at other times
moftly feen on trees. It will frequently ereft its creft,
when pleafed or taken notice of, and likewife fpread the
tail upright, like a fan, in the manner of the turkey.
It has two kinds of cry ; one like that of a young turkey,
the other more plaintive : the firft of thefe is thought by
the Indians toexprefs the word couyavoit , the othert/aeo?*,

4.. Penelope marail, the green penelope, or marail :
upper furface green; naked orbits and legs red; throat
naked, fpeckled with white. This fpecies is of the fize of
a fowl, and not unlike it in fhape. The bill and irides
blackifh ; fpace round the eye bare, and of a pale red ;
chin, throat, and fore-part of the neck, barely covered
with feathers : but the throat itfelf is bare, and the mem¬
brane elongated to half an inch more; both this, and the
fkin round the eyes, change colour, and become deeper
and thicker when the bird is irritated : head-feathers
longifh, fo as to appear like a creft when raifed up, which
the bird often does when agitated ; at w’hich time it alfo
erefts thofe of the whole head, and fo disfigures itfelf as
to be fcarcely known. The general colour of the plumage
is a greenifh black ; the fore- part of the neck tipped with
white. The wings are fhort; the tail long, even at the
end, andean be lifted up and fpread out like that of a
turkey ; the legs and toes of a bright red ; claws crooked,
and fomewhat fharp. This fpecies is common in the
woods of Guiana, at a diftancefrom the fea, though it is
much lefs known than could be imagined. They are
generally found in fmall flocks, except in breeding-time,
when they are only feen by pairs, and then frequently on
the ground, or on low fhrubs; at other times on high trees,
where they rooft. The female makes her neft on fome
low bufhy tree, as near the trunk as poffible, and lays
three or four eggs. When the young are hatched, they
defeend with their mother, after ten or twelve days.
The mother a£ts as other fowls, fcratchingon the ground
like a hen, and brooding the young, which quit their
nurfe the moment they can fhift for themfelves. They
have two broods in a year; one in December or January,
the other in May or June. The young birds are eafiiy
tamed, and feldcm forfake the places where they have
been brought up; they need not be houfed,as they prefer
rooftingon tall trees to any other place. Their cry is not
inharmonious, except when irritated or w'ounded, when
it is liarfh and loud. The flefh is much efteemed.

Bufron fuppofes this bird to be the female of the yacou,
or at leaft a variety; but that this cannot be, the anato¬
mical infpedtion will at once determine. The windpipe
of this bird has a Angular conftrudtion, palling along the
neck to the entrance of the breaft, where it rifes on the
outfide of the flefh, and, after going a little way down¬
wards, returns, and then paffes into the cavity to the
lungs. It is kept in its place on the outfide by a muf-
cular ligament, which is perceivable quite to the breaft-
bone. This is found to be the cafe in both male and fe¬
male, and plainly proves that it differs from the yacou,
whole windpipe has been already deferibed.

If this be the bird mentioned by Fermin, in his hiftory
of Guiana, he fays that the creft is cuneiform, and of a
black-and-u'hite colour ; and obferves that they are very
fcarce at Surinam. Bancroft mentions a bird of Guiana
by the name of marrod.ee, which, he fays, is wholly of a
brownifh black ; the bill the fame ; legs grey. Thefe, he
fays, are common, and make a noife notunlike the name
given it, perching on trees. The Indians imitate their
cry fo exadlly as to lead to the difeovery of the place the
birds are in, by their anfwering it. The flefh of them is
like that of a fowl. This is probably a variety of our fpe¬
cies.

The figures on the annexed Plate correfpond with the
four fpecies above deferibed.

5. Penelope

PEN

5. Penelope pipile, the piping curalTovv i back brown
fpotted with black, belly black ; caruncle on the chin blue.
This fpecies was difcovered by Jacquin ; and is readily
didinguifiied by its hilling or piping noife. The Ikin is
bare on the neck, and of a dull green, with a blue carun¬
cle on its throat. The head is partly black, and partly
white; and adorned with a fliort creft, fimilar to, though
fmaller than, the other fpecies. The irides are black, and
the fpace round the eyes white: the belly and vent is
white; but the back and wing-coverts are brown, waved
or fpotted with deep black; legs and feet inclined to red.
It is about the fize of a common fowl ; and is found in
Guiana and Brafil; but is a fcarce bird.

6. Penelope vociferans, the crying curaffow : brown;
bill and bread blue, belly whitifh. This bird was fird in¬
troduced by Fernandez, who gives a very flight defcrip-
tior. ; viz. “ that the bill is bluifh ; the back brown ; the
bread blue ; and the belly of a whitifh brown ; and that
it is of the fame fize with the others.” It inhabits Mex¬
ico, and cries like other fowls, or rather like the whole
family of the poultry-yard together; for it is fo loud and
continual, that one of thefe often makes more noife than
all the red of them put together. The Mexican name
chachalacametl, fignifies crying bird. It is faid to frequent
mountainous places, where it brings up its young.
This lad has been removed by Dr. Turton to the end of
the genus Crax.

PENE'O, or Salam'pria, a river of Theflaly, which
runs into the Egean Sea twenty miles ead of Lariffa. See
Peneus.

PENERA'RIUS, J] in old records, a dandard-bearer,
the officer who bore the banner.

PENETRABIL'ITY, f Sufceptibility of imprefiion
from another body. — There being no mean between per
intr ability and impenetrability, paflivityand aftivity, they
being contrary ; therefore the infinite rarefaction of the
one quality is the pofition of its contrary. Cheyne's Phil.
Principles.

PEN'ETRABLE, adj. [Fr. penetrabilis, Lat.] Such as
may be pierced; luch as may admit the entrance of ano¬
ther body :

Let him try thy dart.

And pierce his only penetrable part. Dry den.

Sufceptive of moral or intellectual imprefiion :

I am not made of done,

But penetrable to your kind entreaties. Shahefpeare.

PEN'ETRAIL, f. [ penetralia , Lat.] Interior parts.
Not in vfe. — The heart refifts purulent fumes, into whole
penetrails to infinuate forne time mud -be allowed.
Harvey.

PEN'ETRAL, f. The inner open part of a houfe,
Vole.

PENETRATE, /. A facred room or chapel in private
bonfes, which was let apart for the worfliipof the houfe-
I’. eld gods among the ancient Romans. In temples alfo
there were penetralia, or apartments of didinguiflted fanc-
tity, where the images of the gods were kept, and certain
foiemn ceremonies performed.

PEN'ETR ANCY, f. Power of entering or piercing. —
The fubtility, aClivity, and penctrancy, of its effluvia, no
obdacle can flop or repel, but they will make their way
through all bodies. Kay cm the Creation.

PEN'ETRANT, adj. Having the power to pierce or
enter; fliarp ; fubtile. — The food, mingled with feme
difiblvent juices, is evacuated into the intedines, where it
is further fubtilized, and rendered fo fluid and penetrant,
that the finer part finds its way in at the flreight orifices
of the laCleous veins. Ray. — Having power to affeft the
mind. — A moded and friendly ffyle doth fuit truth ; it,
like its author, doth ufualiy refide (not in the rumbling
wind, nor in the fhaking earthquake, nor in the raging
fire, but) in the fmall dill voice: founding in this, it is
mod audible, mod penetrant , and mod effectual. Barrow's

PEN 537

Serm. 4 on Tit. iii. 2.— -The learned writings of St.Audin,
St. Hierom, &c. [and] penetrant and powerful argu¬
ments. Boyle's Style of H. Script.

To PEN'ETRATE, n-.a. [ penetro , Lat. penetrer, Fr.]
To pierce ; to enter beyond the furface ; to make way
into a body. — Marrow is, of all other oily fubdances,
the mod penetrating. Arbuthnol on Aliments.

Thy groans

Did make wolves howl, and penetrate the breads
Of ever-angry bears. Shahefpeare' s Tempejl.

To affeft the mind. To reach the meaning. — There
Ihall we clearly fee the ufes of thefe things, which here
were too fubtile for us to penetrate. Ray.

To PEN'ETRATE, v.n. To make way:

Court-virtues bear, like gems, the highed rate
Born where heav’n’s influence fcarce cm penetrate:
Though the fame fun, with all-diffufive rays.

Smile in the rofe, and in the diamond blaze,

We praife the dronger effort of his power.

And always fet the gem above the flower. Pope.

To make way by the mind. — If we reached no farther
than metaphor, we rather fancy than know, and have not
yet penetrated into the infide and reality of the thing.
Locke.

PENETRA'TION, f. The aft of entering into any
body :

It warms

The univerfe, and to each inward part
With gentle penetration, though unfeen.

Shoots invifible virtue even to the deep. Milton's P. L.

Mental entrance into any thing abdrufe. — A penetration
into the abdrufe difficulties and depths of modern alge¬
bra and fluxions, is not worth the labour of thofe who
defign either of the three learned profeflions. Watts. —
Acutenefs ; fagacity. — The prouded admirer of his own
parts might confult with others, though of inferior capa¬
city and penetration. Watts.

PEN'ETRATIVE, adj. Piercing; fliarp; fubtile. —
Let not air be too grofs, nor too penetrative, nor fubjeft to
any foggy noifomenefs from fens. Wotton. — Acute; faga-
cious ; difeerning :

O thou, whofe penetrative wifdom found

The South-fea rocks and fhelves, wlie re thoufands drown’d.

S iv i ft's Mifcellauies.

Having the power to imprefs the mind :

Would’d thou fee

Thy mader thus with pleacht arms bending down

His corrigible neck, his face fubdu’d

To penetrative fhame ? Shahefpeare.

PEN'ETRATIVENESS, /. The quality of being pe¬
netrative.

PE'NEUS, in ancient geography, a river of Theflaly,
rifing on mount Pindus, and falling into the Thermean
gulf, after a wandering courfe, between mount Offa and
Olympus, through the plains of Tempi:. It received its
name from Peneus, a fon of Oceanusand Tethys. The
Peneus anciently inundated the plains of Theflaly, tiil
an earthquake feparated the mountains Offa and Olympus,
and formed the beautiful vale of Tempe, where the wa¬
ters formerly dagnated. From this circumdance, there¬
fore, it obtained the name of Araxes, from to

cleave. The prefent name of Salampria is ancient, as,
according to Eudathius, this river was in his time called
Salimpi ius, a name, according to Hefychius, of Greek
origin, aa.'hafin and fignifying the ‘‘openings

of gates.”

Mod authors are of opinion, that Deucalion’s deluge
was occafioned by the river Peneus. To this purpoie,
Herodotus obferves, “ It is faid that Theflaly once was
nothing but a lake, being environed on all fides with hills.
The country which lies between thofe hills is what they
call Theflaly, which is watered with plenty of rivers, the

chief

538

P E

N

chief of which are the Penens, the Apidantis, the On-
fchones, theEripeus, and the Panito. Thefe five rivers,
falling down from the neighbouring mountains, after
having run through the low country, difembogue them-
i'elves into the fea by a very narrow canal, where they
all unite, and make but one great river, which retains the
name of Penens. They tell us farther, that before the
canal was made, thefe rivers flooded the whole country,
and turned it into a great lake ; but that, Neptune having
formed that great canal, all the waters retired.” Penens,
on account of its beauty, was an object of worfhip.
Daphne, the daughter of the Penens, according to the
fables of the mythologifts, was changed into a laurel on
the banks of this river. This tradition arifes from the
quantity of laurels which grow' near the Penens. Ovid's
Met. i. 452, & c.

PENGEHUR', a town of Perfia, in the province of
Mecran : 130 miles north of Kidge, and 180 eaft- north-
call: of Kish.

PENGHIOU'M, a town of the Birman empire, at the
confluence of a final! river with the Irawaddy : near Yay-
nangheoum, or Earth-oil creek.

PEN'GUIN, f. [from the Welch /?cn, head, and gain,
white.] See Aptenodytes, vol. i. — This bird was found
with this name, as is fuppofed, by the firfl: difeoverers of
America; and penguin fignifying in Welih a white head,
and the head of this fowl being white, it has been ima¬
gined that America was peopled from Wales ; whence
Hudibras : “Britifli Indians nam’d from penguins."
Grew gives another account of the name, deriving it
from pinguis, Lat. fat : “ The penguin is fo called from
his extraordinary fatnefs ; for, though he be no higher
than a large goofe, yet he weighs fometimes fixteen
pounds; his wings are extreme fliort and little, altoge¬
ther trnufeful for flight, but by the help whereof he fwims
very fw'iftly.” Grevv’s Mufeum. — But it is as unlikely that
the American Indians fhou Id derive the name of a bird from
the Latin as from the Welch. — The ifle is three miles
about, in which we faw abundance of pengwins, in Welch
“ white-heads,” agreeable to their colour. Sir T. Her¬
bert's Travels. — There are very many great lazy fowls
upon and about this ifland, with great coal-black bodies,
and very white heads, called penguins. Terry's Voy. to the
Eajl Indies , 1655 — A fruit. See Bromelia penguin. —
The penguin is very common in the Weft Indies, where the
juice of its fruit is often put into punch, being of a
iharp acid flavour : there is alfo a wine made of the juice
of this fruit, but it will not keep good long. Miller.

PEN'GUIN TSLAND, a fmall ifland near the coafl of
New Holland, at the entrance into Adventure Bay. Lat.
43. 21. N. Ion. 147. 33. E.

PEN'GUIN I'SLAND, a fmall ifland near the Cape of
Good Hope, a little to the north of Table Bay.

PEN'GUIN I'SLAND, an ifland near the fouth coafl
of Newfoundland. Lat. 47. 22. N. Ion. 56. 45. W.

PEN'GUIN I'SLAND, a fmall ifland near the coafl: of
Patagonia, abounding in feals and penguins: nine miles
fouth-eafl of Port Defire.

PEN'GUIN I'SLAND, one of the New Shetland
Iflands lately difeovered.' No official accounts of the dif-
covery of this antarciic country has yet been made pub¬
lic; and it is faid that no official account is meant to be
promulgated from that high branch of government to
which fuch matters more immediately belong. This re¬
port is, however, we truft, inaccurate. Since the fecond
voyage of the William, a journal of which voyage has
been publifhed in the Literary Gazette, it appears that
two Ruffian frigates on a voyage of difeovery circumna¬
vigated the New Shetland ljlands, (for iflands it is laid this
fuppofed antardlic land is ;) and the Sandwich Land of
Capt. Cook proved alfo to be an ifland. From the whole
of thefe difeoveries it refults, as far as is hitherto known,
that a very lucrative trade in feals may be carried on, as
the fea fwarms with thefe animals, which are of great fize,
full of oil, and have the fineft fur. In other refpedts ani-
3

PEN

rail exiftence is limited in variety, though not in the
number of particular fpecies. The (bores are covered
with penguins, which even difpute pofleffion with the hu¬
man vifitors. There are gulls, albatroffes, and one land-
bird about the fize of a pigeon. The fea-elephant alfo
inhabits thefe dreary parts; whales are alfo numerous,
but extremely poor. No fmall fifh were caught or feen ;
and the only conchological products on the fhores were
the empty (hells of limpets.

One of thefe iflands has been named Penguin Island :
the latitude of anchorage was afeertained to be 62. 6. S.
at the fouth-eafl end of the ifland ; the longitude where
the jack was planted, 53. 7. W. variation of the needle,
23. 39. E. In George's Bay , fo named in honour of his
majelty, on account of its being the firfl part in which
the Britifli flag was hoifted, the tides rife pretty regularly
from 14 to 16 feet, and appear to be entirely influenced
by the winds. The coafl at the bottom of the bay con-
fifis of high fnow-clift’s. Notwithflanding the fterility of
the land, there is a flight foil at the back of the watering-
place, a mixture of fand and mould, by digging into
which, not more than a foot in depth, water was found,
The fwampyland was covered with a fort of grafs and
mofs, both of which abound in great quantities, and are
all that deferves to be called vegetation. No land-ani¬
mal, except birds,, was feen. Snow of a reddifli tint was
feen here, as in the ardtic regions : the caufe of this colour
the obfervers could not account for; it could not be oc-
cafioned by the foil, fince under the chief place where the
fnow was found there ran a very-rapid ftream of confi-
derable depth, and the voyagers were then pafling over
valleys filled with fnow. The (tones and rocks confifte’d
principally of white and brown granite and lime-ftone,
together with fome varieties, of which fpecimens were
preferved.

PEN'FIA GA'RCIA. See Pegna Garcia.

PE'NIA, in mythology, the goddefs of Poverty and
mother of Love.

PENJANG'. See Panjang.

PEN'IBLE, adj. [French.] Painful. Chaucer.

PEN'ICHE, a feaport town of Portugal, in Eftrema-
dura fituated on a peninfula which runs into the At¬
lantic. It is fortified, and defended by a citadel ; it con¬
tains three parifhes, and about 2800 inhabitants. This
town is fometimes called New Lifbon: thirty- nine miles
north-north-weft of Lifbon, and thirty- four weft of San-
tarem. Lat. 39. 20. N. Ion. 9. 5. W.

PENICIL'LA, f. A lozenge, a form of medifcine.

PENICIL'LUS, f. A tent, a medicated roll to be put
into a deep wound or ulcer.

PENID'IUM, J'. A form of medicine prepared from
clarified fugar.

PENI'EL. See Penuel.

PENJEKO'REH, a town of Candahar, in Cabuliftan :
eight miles weft ofMafhanger.

PENJEKO'REH, a river of Afia, which runs into the
Sewad about five miles fouth of the town of Penjekoreh.

PE'NIGK, or Penig, a town of Saxony, and capital of
a lord fh i p in the principality of Schonburg, which is a
Saxon fief, on the Muldau. Here is a manufacture of
woollen fluffs and a pottery: thirty-eight miles weft of
Drefden, and twenty-eight fouth- fouth-eafl of Leipfic.
Lat. 50. 52. N. Ion. 12. 35. E.

PE'NING, a town of Bavaria, in the principality of
Aichftatt: nine miles eaft-north-eaft of Aichftatt.

PENIN'NAH, f. [Heb. a pearl.] The fecond wife of
Elkanah, the father of Samuel. Peninnah had feveral
children, (1 Sam. i. 2, 3, &c.) but Hannah, who after¬
wards was mother of Samuel, was fora great while bar¬
ren. Peninnah, inftead of giving the glory to God, the
author of fruitfulnefs, was elevated with pride, and in-
fulted her rival Hannah. But, the Lord having vifited
Hannah, Peninnah was thereupon humbled; and fome
interpreters think that God took away her children from
her, or at lead that (lie had no more after this time, ac¬
cording

PEN

cording to the words of the fong of Hannah, (i Sam. ii.
5.) “ The barren hath born feven, and (he that hath
m.i ny children is waxed feeble.”

PENIN'SULA, f [pene infu/a, Lat. peninfule, Fr.] A
piece of land almolt Surrounded by the fea, but joined by
a narrow neck to the main. — -Afide of Milbrook lieth the
peniij'ula of Infwork, on whole neckland ftandeth an
ancient houfe. Carew. — Spain, from its fituation, is gene¬
rally called, by way of diftinftion, the Peniij'ula. James's
Mil. DiB.

PENIN'SULA POI'NT, a cape on the weft coaft of the
ifland of Mindoro. Lat. 12.40. N. Ion. 120. 56. E.

PENIN'SULATF.D, udj. Almoft furrounded by water.

■ — The mountains, the river Neath, and its fttady banks,
form a beautiful back-ground and contraft to the bold
craggy (bore, and the broken peninfulatecl knolls, which
not unfrequently project from it. Wyndham's Tour.

PENI'NUS, in mythology, a god acknowledged by
the Penini, inhabitants of the Alps, from whom that
chain of mountains derived its name: as we' learn from
Livy, Dec. 3. xi. 38. Guichenon, in his Hiftory of Sa¬
voy, has preferved the infcription that was upon the pe-
deftal of a fine ftatue, that reprefented this god under the
figure of a young man naked, in thefe terms, “ L. Luci-
lius Deo Penino Optimo Maximo donum dedit.” Cato
and Servius (in 3 VEn.) fay, that this was not a god, but
a goddefs, whom'the one calls Penina, and the other
Apenina ; but both the figure and the infcription exprefs
the contrary. The ftatue of that god was afterwards
carried off, and that of Jupiter put in its place. Never-
thelefs, the worfhip of Penjnus was not abolifhed, but
the mountaineers continued to pay adoration to him.
Some fay that this god was Jupiter himfelf, which they
infer from the epithets “ Optimus Maximus;” but
others fay that he was the Sun ; and that the carbuncle
upon the ftatue, called Peninus’s eye, was the fame with
that of Ofiris, who, in Egypt, reprefented the Sun.

PENISAA'RI, an ifland of the Baltic, three verfts
long, and diftant fix verfts from Lavanfaari, which fee.
It is inhabited only by a few families, and has no water-
fprings.

PENISCO'LA, a town of Spain, in Valencia, fituated
on the coaft of the Mediterranean, furrounded on three
fides by the fea, and difficult of accefs by land: twenty-
four miles fouth of Tortofa, and 195 eaft of Madrid. Lat.
40. 24. N. Ion. o. 24. E.

PENISHE'HR, or Penjeshehr, a town of Candahar,
and capital of a diftrift, in the Cabuliftan, on the eaft fide
of the Hindoo-Kho Mountains : forty-fix miles north
of Cabul. Lat. 35. 16. N. Ion. 68. 24. E.

PEN'ISTONE, or Penniston, a final I market-town,
in the Weft Riding of Yorkfhire, fituated eight miles
weft-fouth-weft from Barnfley. The market is on Thurs¬
day, but it is little frequented. Here are four annual fairs,
which are chie-fly noted for the fale of moor-fheep. The
town is environed with dreary moors, efpecially to the
weftward, where nothing prefents itfelf to the eye but
bleak and barren mountains, covered with heath or ling.
Peniftone, according to the population returns, contains
115 houfes, and 515 inhabitants. The church is a large
ftrudture; and near the centre of the town is a well-en¬
dowed grammar- fchool. Beauties of England and Wales,
vol. xvi.

PEN'ITENCE, or Penitency, /. [ penitence , Fr. pee-
nilentia, Lat.] Repentance; forrow tor crimes; contri¬
tion for fin, with amendment of life of change of the af¬
fections. — Where penitency, not difturb’d may grieve.
Tailor's Hog hath loft his Pearl.

Death is deferr’d, and penitence has room
To mitigate, if not reverfe, the doom. Dryden.

Penitence is Sometimes ufed for thedifeipline, or pu-
nifhment, attending repentance ; more ufually called pe-
vance. It alfo gives title to feveral religious orders, con¬
fiding either of converted debauchees and reformed

Vol. XIX, No. 1323.

P E N 53f>

proftitutes, or of perfons who devote themfelves to the
office of reclaiming them. Of this latter kind is the

Order of Penitence of St. Magdalen, eftablilhed about
the year 1272 by one Bernard, a citizen of Marfeilles, who
devoted himfelf to the work of converting the courtezans
of that city. Bernard was feconded by feveral others ;
who, forming a kind of fociety, were at length erected
into a religious order by pope Nicholas III. under the
rule of St. Auguftine. Father Gefnay fays, that they,
alfo made a religious order of the penitents, or women
they converted, giving them the fame rules and obser¬
vances which they themfelves kept.

Congregation of Penitence of St. Magdalen at Paris,
owed its rife to the preaching of one Tifteran, a Francif-
can, who converted a vaft number of courtezans about
the year 1492. Louis duke of Orleans gave them his
houfe for a monaftery ; or rather, as appears by their
conftitutions, Charles VIII. gave them the hotel called
Bochaigne, whence they were removed to St. George’s
chapel in 1572. By virtue of a brief of pope Alexander,
Simon bifliop of Paris, in 1497, drew up for them a body
of Statutes, and gave them the rule of St. Auguftine. It
was neceffary, before a woman could be admitted, that
file had firft committed the fin of the flefli. None were
admitted who were above 35 years of age. Till the be-
ginningof the 17th century, none but penitents were
admitted ; but, fince its reformation by Mary Alvequin,
in 1616, none have been admitted but maids, who however
ftill retain the ancient name penitents.

PEN'ITENT, adj. Repentant; contrite for fin; Sor¬
rowful for paft tran fgreftions, and refolutely amending
life. — The proud he tam’d, the penitent he chear’d.
Dryden.

Much it joys me

To fee you become fo penitent. Shahefpcare.

PEN'ITENT, /’. One forrow'ful for fin.- The repent¬
ance, which is formed by a grateful fenfe of the divine
goodnefs towards him, is refolved on while all the appe¬
tites are in their Strength : the penitent conquers the
temptations of fin in their full force. Rogers. — One un¬
der cenfures of the church, but admitted to penance. —
The counterfeit Dionyfius deferibes the practice of the
church, that the catechumens and penitents were admitted
to the Leffonsand Pfalms,and then excluded. Stillingfleet,
— One under the diredtion of a confefTor.

Penitents, an appellation given to certain fraternities
of perfons diftinguifhed by the different fhape and colour
of their habits. Thefe are Secular Societies, who have
their rules, ftatutes, and churches, and make public pro-
ceffions under their particular croffes or banners. Of
thefe there are more than a hundred, the molt consider¬
able of which are as follow : The White Penitents, of
which there are feveral different forts at Rome, the 1110ft
ancient of which was conltituted in 1264; the brethren
of this fraternity every year give portions to a certain
number of young girls, in order to their being married:
their habit is a kind of white Sackcloth, and on the Shoul¬
der is. a circle, in the middle of which is a red-and-wdiite
crofs. Bla^k Penitents, the moft considerable of which
are the Brethren of Mercy, inftituted in 1488 by Some
Florentines, in order to affift criminals during their im¬
prisonment, and at the time of their death : on the day
of execution, they walk in proceffion before them, ting¬
ing the feven penitential pfalnis and the litanies; and, af¬
ter they are dead, they take them down from the gibbet
and bury them ; their habit is black fackcloth. There
are others whole bufinefs it is to bury fuch perfons as are
found dead in the ftreets: thefe wear a death’s head on
one fide of their habit. There are alfo blue, grey, red,
green, and violet, penitents ; all of whom are remarkable
for little elfe befides the different colour of their habits.
Mabillon tells us, that at Turin there are a fet of peni¬
tents kept in pay to walk through the ftreets in proceffion,
and cut their fhoulders with whips, &c.

Penitents of the Name of Jefus, a congregation of_re-
Y ligious

540

PEN

ligious at Seville in Spain, confiding of women who had
led a licentious life, founded in 1550. This monaftery
is divided into three quarters: one for profeffed reli¬
gious-, another for noyices ; a third for thofe who are
under correction. When thefe lad give figns of a real
repentance, they are removed into the quarter of the no¬
vices, where, if they do not behave themfelves well, they
are remanded to their correftion. They obferve the rule
of St. Auguftine.

Penitents of Oivieto. are an order of nuns, inftituted
by Antony Simoncelli, a gentleman of Orvieto, in Italy.
The monaftery he built was at firft defigned for the re¬
ception of poor girls abandoned by their parents, and in
danger of lofing their virtue. In 1662 it was eredted
into a monaftery, for the reception of fuch as, having
abandoned themfelves to impurity, were willing to re¬
form, and confecrate themfelves to God by folemn vows.
Their rule is that of the Carmelites. Thefe religious
have this in peculiar, that they undergo no noviciate.
Ail required is, that they continue a few months in the
monaftery in a fecular habit ; after which they are ad¬
mitted to the vows.

PENITEN'TI AL, adj. Exprefling penitence; en¬
joined as penance. — Is it not ftrange, that a rational
man (hould adore leeks and garlick, and filed penitential
tears at the fmell of a deified onion. South.

I have done penance for contemning love,

Wiiofe high imperious thoughts have punifli’d me
With bitter fafts and penitential groans. ShaheJ'peare.

PENITEN'TIAL, [ [ penitenciel , Fr. paenitentiale,
low Lat.] A book direfling the degrees of penance. —
The penitential, or book of penance, contained fuch mat¬
ters as related to the impofing cf penance, and the re¬
conciliation of the perfon that fuffered penance. Ayliffe.
— There are various penilentials, as the Roman peniten¬
tial, that of the venerable Bede, that of pope Gregory III.
See. Chambers.

PENITEN'TIARY, adj. Relating to the rules and
meafures of penance. — There needed 110 other penitentiary
tax. Bp. Bramhall's SchiJ'm Guarded.

PEN ITEN'TI ARY, J\ [penitencier, Fr. pcenitentiarius,
low Lat.] In the ancient Chriftian church, a name given
to certain prefbytersor priefts, appointed in every church
to receive the private confeflions of the people, in order
to facilitate public difcipline, by acquainting them what
fins were to be expiated by public penance, and to appoint
private penance for fuch private crimes as were not pro¬
per to be publicly cenfured. — Upon thelofsof Urbin, the
duke’s undoubted right, no penitentiary, though he had
enjoined him never fo ftraight penance to expiate his firft
offence, would have counfeiled him to have given over
purfuit of his right, which he profperoufly re-obtained.
Bacon. — At the court of Rome, an office in which are
examined and delivered out the fecret bulls, graces, or
difpenfations relating to cafes of confidence, confeflions,
See. — An officer, in fome of their cathedrals, veiled with
power from the bifiiop toabfolve in certain cafes. The
pope has at prefent his grand penitentiary, who is a cardi¬
nal, and the chief of the other penitentiary priefts efta-
bli died in the church of Rome, who confult him in all
difficult cafes. He prefides in the penitentiary, difpatch.es
difpenfations, absolutions, See. and has under him a re¬
gent and twenty-four proftors. — The great penitentiary
with his counfellors preferibes the meafure of penance,
Ayliffe — A penitent ; one who does penance. — A prifon
reftrained John Northampton’s liberty, who, for abufing
the fame in his unruly' mayoralty of London, was con¬
demned hither as a perpetual penitentiary. Carew. — To
maintain a painful fight againft the law of fin is the work
of the penitentiary. Hammond. — One kind of Francifcan.
— Many other reformations have been from time to time
of the Francil’cans, as by the Minims, Recollefts, Peni¬
tentiaries, Capuchins, See. Weever. — A place where pe¬
nance is enjoined 5 as the Penitentiary at Milbank.

PEN

PENITENTLY, adv. With repentance ; with forrow
for fin ; with contrition.

PEN'ITENTNESS, f. The ftate of being penitent.

PENK, a river of Engla_nd, in the county of Stafford,
which runs into the Sow about a mile below Stafford.

PENKE'MAS POI'NT, acape or headland on the weft
coaft of Wales, and north point of the county of Pem¬
broke, at the mouth of the Tivy, four miles below Car¬
digan.

PEN'KNIFE, f. A knife ufed to cut pens. — Some
fchoolmen, fitter to guide penknives than fwords, precifely
ftand upon it. Bacon. — We might as foon fell an oak
with a penknife. Holyday.

PENK'RIDGE, a market-town in Staffordftiire, feated
on the river Penk, whence its name is luppofed to have
been derived, at the diftance of fix miles to the fouth of
Stafford. It is of very great antiquity, and, according to
Camden, was the feite of the Roman ftation Pennocrucium,
mentioned in the Itinerary of Antoninus; but Plot,
Stukeley, and Horfley, place that ftation at the neigh¬
bouring village of Stretton; and Salmon transfers it to
Oldbury in Warwickfliire. However, though thus en¬
tertaining different opinions refpefting the aftual pofition
of Pennocrucium, all thefe authors agree in coniidering
the prefent town of Penkridge as the immediate offspring
of the deferted ftation. Some Roman remains were difeo-
vered here about the middle of the laft century ; and,
among other linaller articles, a brafs head of the bolt of
a catapulta.

Penkridge is but a fmall mean-looking town. The in¬
habitants are principally engaged in different depart¬
ments of the iron-trade. The market-day is Tuefday;
and there are, befides, two fairs annually ; one on the
30th of April ; and the other, on Oftober 10, forhorfes;
and to this fair is brought a prodigious number of the
fined and mod beautiful horfes that can any where be feen,
from Yorkfhire, the bifhoprick of Durham, and all the
horfe-breeding counties in England. It may be marked
for the greatell horfe-fair in the world for horfes of value,
efpecially faddle-horfes ; though there are great numbers
of fine large ftone-horfes for coach and draft fold like-
wife.

The church of Penkridge, olim Pencriz, is mentioned
in the charter of king Stephen and the bull of pope Lu¬
cius, as given to the bifhop and churches of Coventry and
Lichfield, in the fame manner with Wolverhampton and
Stafford, which were notorioufly royal free chapels, or
colleges, and which makes it probable that this of Pencriz
might be of the fame nature. The advowfon of the
church and the manor were granted by one Hugh Houfe
to the archbifhop of Dublin and his fucceffors, which gift
was confirmed by king John, anno regni 17 ; and in pro-
eefs of time that archbifhop was always dean ofthis church,
and had the collation of all the prebendaries, who were
thirteen in number about 26th Henry VIII. when they were
valued at 106I. 15s. The grant of king John to the arch¬
bifhop of Dublin bears date 13th Sept. 1216, and is done
away by the ift Edward VI. 1547, by which aft colleges
and chantries were veiled in the crown. King John’s
charter makes no mention how this church came to be
endowed and became collegiate. Here was fome foun¬
dation before the conqueft ; and it feems to have been
collegiate temp. Hen. II. and it undoubtedly was fo 20
Edw. I. In the time of Edw. III. that king gave to
John de St. Paul the prebend of St. Michael in the free cha¬
pel of Pencrich, Dec. 6, 1337; and he protefted Wm.de
Killefley in the prebend of Cauk (perhaps rather Cank)
in the chapel of Pencrich.

The church (a view of which was drawn and engraved
by T. Donaldfon for Shaw’s Hiftory of Staffordftiire, but
never publifhed) is dedicated to St. Michael; and at the
diffolution was granted, 2 Edw. VI. to John earl of War¬
wick ; and, 5 Phil, and Mary, to Win, Riggs and Win.
Buckbird. Penkridge church is a large handfome fabric
of ftone, in the gothic ftyle of architefture 5 the general

exterior

PEN

exterior appearance is magnificent, the walls being orna¬
mented with finall pinnacles and battlements; and con¬
tains fundry monumental memorials of the Littletons of
Teddefley and Pileworth, barts, which title became extinft
on the death of the third fir Edward, May 17, 1812, at
the age of 84. Edward John Littleton, efq. of Teddefley,
(about a mile from Penkridge,) who inherited the pro¬
perty, is fon-in-law to the marquis of Wellefley, and
M. P. for the county of Stafford : he pofl’efles the great
tythes of the parifli. This church, or free royal chapel,
has within its jurifdidlion four chapels, Dunftan, Coppen-
hall, Sharefhill, and Stretton.

Here is a charity fchool for twelve boys and eight girls.
In 1819 two excellent fchool-rooms for the children of
this and the neighbouring parifhes, and a houfe for the
mailer and miftrefs, were built by the above-named E. J.
Littleton, efq. The fchools are on the Madras fyftem,
and the whole of the expenfe defrayed by him.

According to the parliamentary returns of the popula¬
tion in 1821, the parifhof Penkridge contained 1136 males
and 1166 females; total of perfons, 2302. Penkridge is
ten miles from Wolverhampton, twenty-two from New-
caftle-under-line, twenty-four from Birmingham, fifty-
eight from Manchefter and 129 north-weft from London.
Lat. 52. 43. N. Ion. 2. 7. W.

Weft of Penkridge is the village of Whifton. — Eaft of
Penkridge is Wolafton. — Burton is near Penkridge ; it
had an abbey, built in 1004.

Cank, or Cannock, with its foreft, is on the fouth of
the Trent, near Penkridge. Here is an iron ore, called
cannock-ftone ; the workmen call it yellow (hare. The vil¬
lage of Cank is near five miles fouth of the wood.

Sharefhill is a fmall village belonging to the pariflt of
Penkridge, two miles from Cannock. At the north and
fouth entrance of this place are two fquare entrenchments,
the area of the largeft about one rood ; they are generally
fuppofed to have been Roman encampments, which their
proximity to the Watiing-ftreet road feems to favour.
The body of the church was rebuilt about fixty years fin|Ce ;
only the tower and a few monumehts wrere preferved from
the old church, which are of very old date, and on them
are feveral curious infcriptions.

Lapley, a fmall village to the fouth of this town, is
diftinguiftied as the fcite of an alien priory for black
monks, which was annexed as a cell to the abbey of St.
Remigins at Rheims, orf whom it was bellowed by Ayl¬
mer, earl of Chelter and Mercia, in the time of Edward
the Confefl'or. At its fupprefiion by Henry V. its Icite
and pofleflions were given to the college of Tong. The
church belonging to this priory is ftiil Handing, and is
now the parochial place of worfliip. It has a handfome
tower, which rifes between the chancel and the body of
the church.

Near this village is Stretton, mentioned above as the
fuppofed fcite of Pennocrucium. An elegant feat here,
belonging to the family of Monckton, w;as bnciently the
property of the Congreves, anceftors to the celebrated
dramatic poet of that name. The Roman road, called
the Watling ftreet, pafies clofe to the fouth fide of the
village. Tanner's Notit ia Monajlica. Camden's Britannia.
Beauties of England and Wales, vol- xiii. Britijh Direc¬
tory. , vol. iv. v.

PEN'KUM, a town of Anterior Pomerania, furround-
ed with walls in the year 1190. It has often fuffered
greatly by war and fire : fifteen miles fouth-weft of New
Stettin, and forty-three north-north-weft of Cuftrin. Lat.
53. 19. N. Ion. 14. 20. E.

PEN'LAU LEN'GAU, a river of Auftria, which flows
from Lake Alben, and runs into the Traun four miles
fouth-weft of Weis.

PEN'LEE POI'NT, a cape in the Englilh Channel, on
the fouth coaft of the county of Cornwall, weft of the en¬
trance into Plymouth Sound.

PEN'MAEN MAU'R, a large and lofty mountain of
Caernarvonfliire, North Wales, rifes with a rapid afcent

PEN 541

from the fouthern fltore of the Menai river. Its fummit
is about 1540 feet above the level of the fea. On the
top is an ancient Britifh fortrefs called Braich y Dinas ;
alfo a bardie , or Druidical circle of upright and proftrate
ftones. Near the bafe of the mountain, on the north fide,
is a turnpike-road from Aberconway to Bangor, &c.
which was formed, with much difficulty and expenfe, about
the year 1772. In fome parts it is conftrudled on arches
thrown acrofs fiffures, and in other parts it hangs over a
fteep and lofty precipice about 200 feet above the fea, and
prefents a terrific appearance to the traveller. A wall
has been built to guard againft dangers.

PEN'MAN, f. One who profefles the art of writing —
I fhall fpeak of this mailer and accountant, [E. Powell,]
not only as a dexterous penman, but alfo as a fcholar very
well verfed in the claflical learning. Majfey's Orig. and
Pragrefs of Letters. — An author ; a writer. — The four
evangelifts, within fifty years after our Saviour’s death,
configned to writing that hiftory, which had been pub-
liftted only by the apoftles and difciples ; the further
confideration of thefe holy penmen will fall under ano¬
ther part of this difcourfe. Addifon on the Chr. Religion.
And thou, the penman of my hiftorie,

Prepare fad verfe for my fad tragedie. Mir. for Mag.

PEN'MAN HEAD', a cape of Scotland, on the north
coaft of Aberdeenfliire. Lat. 57. 37. N. Ion. 2. 9. W.

PEN'MAN ROSS', a mountain in Denbighlhire, North
Wales, near which there is a narrow dangerous road to
St. Afaph.

PEN'MANSHIP, f. The ufe of the pen ; art of wri¬
ting. — In 1664 he [Cocker] publifhed his Guide to Pen-
manjhip. Majfey's Orig. and Progrefs of Letters.

PEN'MARCH POI'NT, a cape on the weft coaft of
France, fituated on the fouth of a bay, which takes its
rtame from the town of Audierne : eighteen miles fouth-
weft Quimper, fifteen fouth-fouth-eaft of Audierne. Lat.
47.48. N. Ion. 4. 17. W.

PEN'MARCH ROC'KS, rocks near the weft coaft of
France, and fouth-eaft coaft of the department of the
Finiftere, eaft of Penmarch Point. Lat. 47. 48. N. Ion.
4. 6. W.

PENMOR'SA, a village in Carnarvonfiiire, North
Wales, with three fairs ; Aug. 20, Sept. 5, and Nov. 12.

PENN (Sir William), an admiral of England, and one
Of the commanders at the taking of Jamaica, was born at
Briftol, 1621. Being addicted’ from his youth to the fea,
he became a captain at twenty-one ; and, after feveral in¬
termediate promotions was made admiral in the firil
Dutch war, at thirty-two years of age. In 1665 he came
home, and was chofen member of parliament for Wey¬
mouth, not without hereby incurring the difpleafure of
the republican government, by which he was committed
for a while to the Tower, on a charge of quitting his
command without leave, to the hazard of the army.
Upon the reftoration of the monarchy, he was made a
cornmiflioner of the admiralty and navy, governor of the
town and fort ofKinfale, vice-admiral of Munfter, and
one of the council of that province. After fuftaining
the chief command, under the duke of York, in the vic¬
tory over the Dutch in 1665, he took leave of the fea, but
continued in his otheremployments till 1669, when, grow¬
ing infirm, he retired to Wanftead, in Eflex, and died there
the year following. He is laid to have acquitted himfelf,
in his feveral high offices, with honour and fidelity.

PENN(William), an illuftrious perfon among the Qua¬
kers, and founder of the colony of Pennfylvania, was the
only fon of the admiral above mentioned, by his wife Mar¬
garet, daughter of John Jafper, a merchant of Rotterdam.
He was born in London, in the vicinity of the Tower, 14th
October, 1644. His father gave him a liberal education,
induced, no doubt, to greater care in the finiftiing of it,
by profpedls of his fon’s advancement at court, where he
himfelf was in high favour. But the mind of the fon was
formed for other purfuits; and, before he had palled his

twelfth

542

P E

twelfth year, was already glowing with a fenfihility to re¬
ligion, which eventually unfitted him for the employ¬
ments of a corrupt court, and gave him to others of a
more honourable and beneficent nature. He was placed
firftat Chigwell fchooi in Effex ; then at a private academy
on Tower Hill, with the advantage befides of a tutor ;
and laftly, in 1660, entered a gentleman commoner of
Chrift-Church college. He continued at Oxford two
years, and was intimate with Robert Spencer, afterwards
earl of Sunderland, and with John Locke. Though fond
at this time of youthful fports, die had ftrong religious
impreffions; and, together with fome other ftudents
withdrew from the national way of worfhip to hold private
meetings, at which they preached and prayed among
themfelves. This conduct; gave great offence to the
heads of the college; and a large fine, with fuitable ad¬
monitions, were impofed upon the young nonconformift.
J uft at this critical period, an order was unluckily received
from court to refume the ufe of the furplice, which it
teems had been dilcontinued almoft ever fince the period
of the Reformation; and the fight of this unfortunate
veftment “ operated,” as Mr. Clarkfon exprefies it, “fo
(lifagreeabh/ on William Penn, that he could not bear it;
and, joining himfelf with fome other young gentlemen,
he fell upon thofe ftudents who appeared in furplices, and
tore them every-where over their heads.” This, we con¬
ceive, was not quite correCV, even as a Quaker proceed¬
ing; and was but an unpromifing beginning for the fu¬
ture champion of religious liberty. Its natural confe-
quence, however, was, that he and his afl'ociates were,
without further ceremony, expelled from the univerfity;
and, when he went home to his father, and attempted
to juftify by argument the meafures he had adopted, it
was nolefs natural that the good admiral fhould give him
a box on the ear, and turn him out at the door.

The patience of young Penn held out under this rough
treatment, until (parental affeftion taking place of anger,
and pcffibly fuggefting the expedient) his father conclu¬
ded to fend him, in company with fome perfons of rank,
on a tour to France. This took place in 1662. Here,
though he fpent fome time in ftudy under the celebrated
Proteftant preacher MdfesAmyrault, the very different con¬
vention of other afl'ociates at length diverted his thoughts
from religion. He had howeveracquired the language, to¬
gether with the poliftied manners, of the French, when, in
1 664., hewas recalled by his father fromTurin, to which place
he had proceeded from Saumur, the refidence of Amyrault.
The admiral joyfully received his fon, concluding the
main point (of his fitnefs for promotion) was now gained.
He was admitted of Lincoln’s Inn to ftudy the law, where
he continued till the breaking out of the peftilence; foon
after which, being now twenty-two years of age, his fa¬
ther put under his management a confiderable eftate in
Ireland, and be went to refide in that kingdom.

In fclitude, the religious ftruggle in Penn’s breaft re¬
vived. On the one hand, natural vivacity, perfonal accom-
plifhments, and the refpeCt and favour of his friends, at¬
tracted his regard to the prefent world : on the other, de¬
votion, and an indelible fenfe of duty, fixed his contem¬
plations on the next. He had been affe&ed, about ten
years before this time, by the preaching of Thomas Loe,
a Quaker; and, being at Cork, was informed of a meeting
for worfhip, then about to be convened, as it feems, by
defire of the fame perfon. Penn attended it, and Loe
delivered a difcourfe, beginning with the words, “ There
is a faith that overcomes the world, and there is a faith
riiat is overcome by the world on which he is faid to
have expatiated with much clearnefs and energy. His
doftrine agreeing with the previous experience and pre¬
lent difpofition of Penn, he now inclined to enter into a
communion with the Quakers, and from this time con-
ftantly attended their meetings. At one of thefe held at
Cork, November 1667, he, with many others, was appre¬
hended by order of the mayor, who would have liberated
Penn upon his giving bond for his good behaviour j but

3

N N.

\

the latter, deeming the meeting no mifdemeanour, re-
fufed bond, and was fent to prifon with the reft. He
wrote a few lines to the earl of Orrery, containing ex¬
ceptions to the mayor’s proceedings, an argument again ft
perfecution, and a requeft “for the fpeedy relealement of
ail” who had been committed on the occafion. The
earl contented himfelf with ordering Penn’s difcharge.

His father, being informed by a nobleman of his ac¬
quaintance of the danger his fon was in of being prof'e-
lyted to Quakerifm, remanded him home, and was readily
obeyed. Penn had now again to pafs through the ordeal
of parental difpleafure; and in this a principal objeCf
feems to have been, his continuance in the exterior of
his education, or, as his biographer has it, in the cuftoms
and falhions of the age. But lb fixed was he in the refo-
lution to follow what heefteemed a manifeftation of the will
of God in his confcience to the contrary, that, although
he behaved on thefe occafions with Chriftian meeknefs .
and filial affeftion, neither threats nor entreaties could
move his conftancy. The honour of the hat (in thefe
times a matter of no light efteem) was efpecially contend¬
ed for by the pun&ilious admiral ; who, at halt, would
have tolerated his fon in other inftances of nonconformity,
on condition that he fhould be uncovered before the
king, the duke of York, and himfelf. Penn took time
to confider of this propofal in fecret; he even made it a
fubjeCt of fading and fupplication to God to be directed
aright; and he at length deliberately refufed the terms.
This was facrificing much to fincerity and confiftency in
his profeflion ; for his father, upon this, finding his hopes
of the courtier at an end, Could no longer endure the)oii
in his prefence, and he was a fecond time driven from the
paternal manfion. His integrity was now put to a fevere
proof : it appears, that he found a fhelter among his
adopted friends the Quakers,, while his mother privately
fupplied his wants. At length the admiral relented, fo
far as to wink at his return to the family ; and when, in
confequence of being found at religious meetings (by
the ftate then called feditious conventicles), he was at
any time imprifoned, would privately ufe his influence
to get him releafed.

The talents of Penn were foon devoted to the fupport
of the doCtrine he had efpoufed. He became a preacher
among the Quakers, and publifhed, in 1668, on their be¬
half, a piece entitled “ Truth exalted.” Another occafion,
however, more important in its confequences, prefently
occurred. A preacher named Thomas Vincent, irrita¬
ted by the going over of two of his hearers to the Quakers,
accufed the latter of holding erroneous do&rine concern¬
ing the Trinity. A difpute was held in confequence, in
a meeting-houfe belonging to a prefbyterian congregation
in London, chiefly between Vincent on the one part, and
George Whitehead, an eminent Quaker, on the other 5
but the difpute ended for the prefent to the fatisfaCtion
of neither fide. In profecution of the controverfy thus
railed, Penn wrote a piece with the following title : “ The
fandy Foundation Ihaken, or thofe fo generally believed
and applauded DoCtrines, of one God fubfifting in three
diftinCt and feparate Perfons; the Impoflibility of God’s
pardoning Sinners ; a plenary Satisfaction ; the J unifica¬
tion of impure Perfons by an imputative Righteoufnefs ;
refuted from the Authority of Scripture and right Rea-
fon.” The difpute with Vincent had excited much at¬
tention. This publication did more; it ftirred up the
vindictive fpirit of intolerance. It was evil fpoken of,
fays Sewel, the hiftorian of the Quakers ; and not long-
after Penn wfas committed to the Tower; and, as fome
thought, not without his father’s being acquainted with
it, perhaps to prevent a worfe treatment. From what
quarter this was apprehended we fhall fee prefently ; for
Penn being thus fecured in the Tower, and denied the
accefs of his friends, his fervant one day brought him
word (as it feems, from the admiral) that the billiop of
London w-as refolved he fhould either publicly recant, or
die a prifoner. His reply evinced a mind unterrified at

PENN.

543

the profpeft of fufferings, which he confidered as
inflifted for confcience fake : and he began to occupy his
folitude with religious compofitions, the moil confidera-
ble among which was a p radical treatil'e on the Chriftian
religion, entitled “ No Crofs No Crown.” In this work
Isis contemporary, Dr. Henry More, fays, he has treated
the fubjeft of a future life, and the immortality of the
foul, with a force and fpirit equal to moil writers. It has
palTed through many editions.

After near feven months’ durance, Penn wrote to the
fecretary of date, lord Arlington, requefting to be heard
in his own defence before the king, and complaining
warmly of the manner in which his fentiments had been
mifrepreferited by his enemies. In this letter feveral juft
and noble fentiments occur. He tells his lordihip, “ that
he is at a lofs to imagine how a diverfity of religious opi¬
nions can affeft the iafety of the (late, feeing that king¬
doms and commonwealths have lived under the balance
of divers parties. He conceives that they only are unfit
for political fociety, who maintain principles fubverfive
of induftry, fidelity, juftice, and obedience; but to fay
that men mud form their faith of things proper to ano¬
ther world according to the prefcriptions of other mor¬
tal men in this, and, if they do not, that they have no
right to be at liberty or to live in this, is both ridiculous
and dangerous. He maintains that the underftanding
can never be convinced by other arguments than what are
adequate to its own nature. Force may make hypocrites,
but can make no converts, &c. &c,” He now likewife
publifhed a ihort piece, entitled “ Innocency with her
open Face, prefen ted byway of Apology for the Book
entitled The Sandy Foundation ihaken.” He here fays,
“that which I am credibly informed to be the greateil
reafon of my imprifonment, and of that noife of blaf-
pbemy which hath pierced fo many ears of late, is my de¬
nying the divinity of Chrift, and di veiling him of his
eternal Godhead ; which moll bufily has been fuggefted,
as well to thofe in authority, as malicioufly inlinuated
among the people.” In confutation of which charges, he
proceeds to prove from Scripture the Godhead of Cbrifl.
Both of thefe t raffs were republilhed in the collection of
his works, in folio, 1771 ; and the reader, who defires to
obtain a juft view of his fentiments on the feveral contro¬
verted points, will do well to compare them with each
other, and with his doftrinal works at large. Soon after
this explanatory defence, Penn was liberated from the
Tower ; and went to Ireland, where he fee ms to have been
occupied for twelve months in the care of his father’s ef-
tate, and in various fervices to his friends, the Quakers ;
after which he returned to England.

In the year 1670, the Quakers, being perfecuted by
fome magiftrates under the aft againft conventicles, were
forcibly kept out of their meeting-houfe in Gracechurch-
ftreef. They met as near it as they could, in the ftreet,
agreeably to their praftice in fuch cafes ; and their firm-
nefs herein eventually procured them the free exercife of
their right. On the occafion alluded to, Penn, preach¬
ing in the ftreet, was apprehended by warrant from fir
Samuel Starling, lord-mayor, and committed to Newgate.
At the next feftions at the Old Bailey he was indifted,
along with William Mead, another eminent Quaker, for
meeting in, and confpiring to preach to, an unlawful and
tumultuous affembly. He made, fays his biographer, a
brave defence, difcovering both the free fpirit of an Eng-
lilhman, and the undaunted magnanimity of a Chriftian 5
infomuch that, notwithftanding the molt partial frowns
and menaces of the bench, the jury acquitted them both.
It ought to be added, that this jury exhibited an inftance
of firm perfevering juftice under mod tyrannical and in¬
decorous treatment by the court, worthy of the notice
and remembrance of every Englilhman. They were fined
forty marks each for the verdict which they had brought in,
and ordered to he imprifoned till the fines were paid. But
this dangerous afl'umption of power was afterwards ad¬
judged illegal by the court of Common Pleas, on which

Vol. XIX. No. 1323.

occafion the chief juftice Vaughan diftinguiftied himfelf
by a very able fpeech in vindication of the rights of juries.
The trial of Penn and Mead is inferted in the colleftion
of Penn’s Works, and has been alfo publifhed feparately.
(See Monthly Mag.' Mar. 1811.)

Not long after this event admiral Penn died, perfectly
reconciled to his fon, to whom he left an eftate of 1500!.
per annum. Penn engaged about this time in a public
difpute, at Wycombe, with Jeremy Ives, a celebrated
Baptift, on the univerfality of a divine light in the minds
of men; which doftrine Ives undertook to difprove, but
feems to have quitted the field to his antagonift imme¬
diately afterdating his argument. In the month called
February, 1670-1, Penn was again committed, on the pre¬
text of preaching publicly, to Newgate, where he re¬
mained fix months. It is obfervabie that he had recently
publifhed a piece in favour of liberty of confcience, and
another entitled “ A feafonable Caveat againft Popery
the one probably often five to the intolerant clergy, the
other to the court. At his commitment he held a fpi-
rited dialogue on perfecution with fir John Robinfon,
lieutenant of the Tower; at the clofe of which, the let¬
ter calling for an officer with a file of mufketters, “ No,,
no,” faid Penn, “fend thy lacquey, I know the way la
Newgate. ”

Early in 1672 he married Gulielmfi Maria, daughter
of fir William Springett, formerly of Darling in Suffiex„
He fettled at Rickmanfworth, Herts, continuing to ren¬
der fervice, both by preaching and writing, to the reli¬
gious caufe in which he was now engaged for life. Nor
did he negleft an attention to the intereils of his country,
but publifhed, in this year, a pamphlet entitled “ The
propofed Com prehenfion foberly and not unfeafonably
confidered and, in 1675, a larger work, the title of
which is, “ England’s prefent Intereft confidered, with
Honour to the Prince and Safety to the People, in Anfwsr
to this one Queftion, What is moft fit, eafy, and fafe, at
this- Junfture of Affairs, to be done for quieting of Dif¬
ferences, allaying the Heat of contrary Interefts, and mak¬
ing them fubfervient to the Intereft of the Government,
and confiftent with the Profperity of the Kingdom ?”

The year 1675 made a commencement of Penn’s con¬
nexion with the North- American colonies. A moiety
of the province of New-Jerfey having been granted by
Charles II. to fir George Berkeley, he fold his intereft in
it to one Billinge, a Quaker, who, being embarraffed in
his circumftances, transferred his right in trull to Wil¬
liam Penn and two others, for payment of his debts.
Through their means, that moiety, named Weft New-Jer¬
fey, became fettled principally by Quakers; and, through
the prudent conduft of the truftees and fettlers, it foon
put on the appearance of a fiourifliing colony, which it has
ever fince maintained.

In 1 677, Penn, in company with George Fox, Robert
Barclay, and others, went over to Holland, and a (lifted at
a general meeting of the Friends in thofe parts, held for
the purpofe of fettling their, religious difeipline ; and,
thofe at Dantzic being under perfecution, Penn wrote, in
their name, an Addrefs to the King of Poland, with a
Confeffion of Faith, and a requeft that he would interpofe
for them. He then proceeded with Barclay to Herwer-
den, the court of the princefs Elizabeth of the Rhine, elder
filler of Sophia eleftrefs of Hanover, on whom the fucceftion
of the crown of England was afterwards fettled. Their ob-
jeft was a religious vifit to this princefs and the countefs of
Hornes, her companion, both Proteftants, and the former
efteemed one of the mod learned of her fex in that age.
Some correfpondence, begun upon the report of their
extraordinary piety, had opened the way for a perfonal in¬
terview. Penn and his companion were well received at
Herwerden : a correfpondence by letter was afterwards
kept up between the former and the princefs 5 and, Ihe dy¬
ing in 1680, he inferted in the fecond edition of his “No
Crofs no Crown” a teftimony to her highly-exemplary
charafter. In returning through Germany and Holland,
6 Z he:

514 P E

lie preached in many places, at meetings convened for
the occafion. He was heard, this year, before a commit¬
tee of parliament, in fupportof a petition from the Qua¬
kers, who were opprefied by profecutions in the exche¬
quer, under ftatutes enafted againft thePapifts, but con¬
verted by fome magistrates into engines of annoyance to
Proteftant difl'enters. In 1679, and during two years
following, he publilhed feveral things ; as, “ An Addrefs
to Proteftants “ England’s great Intereft in the Choice
of this new Parliament,” a piece dedicated to the eleftors ;
and “ One Projedt for the Good of England,” which he
prefented to the parliament itfelf. He likewife exerted
himfelf to procure the return of Algernon Sidney as a
member of the houfe, firft at Guildford, and afterwards
at Bramber. About this time he was eledted a fellow of
the Royal Society.

We come now to the mod confiderable of Penn’s ac¬
tions, the fettlement of a colony in North America, on li¬
beral and pacific principles. A tradt of country on the
weft fide of the Delaware (formerly belonging to the
Dutch, and called the New Netherlands) was granted,
on petition, by Charles II. to William Penn, and his
heirs, in consideration of admiral Penn’s fervices, and of
debts due to him from the crown at his deceafe. To this
the duke of York added, by ceftion, a further contiguous
portion of territory feated lower on the Delaware. The
king’s patent bore date the 4th of March, 1680-1. Penn
originally intended, that the country Should have been
called New Wales; but the under fecretary offtate, being
a Welshman, thought, it feems, that this was ufing too
much liberty with the ancient principality, and objedled
to it. He then fuggefted Sylvania ; but the king himfelf
infilled upon adding Penn to it, and after fome ftruggles
of modefty, it was found necefiary to fubmit to his gra¬
cious defires, and Pennsylvania was the name adopted.

Penn, being thus conftituted abfolute proprietor and
governor, publilhed “A brief Account of the Province
of Pennfylvania,” in which he propofed terms of fettle¬
ment to fuch as might incline to remove thither, offering
land at forty Ihillings purchafe, and one Ihilling per an¬
num quit-rent, for one hundred acres. A great number
of buyers came forward, feveral of whom formed a com¬
pany, calling themfelves “The free Society of Traders in
Pennfylvania.” Three Ihips prefently departed, with ad¬
venturers from England and Wales, chiefly induftrious
and reputable perfons of Penn’s own communion. Two
of thefe Ihips arrived on the coaft in time to winter ; the
third was detained till fpring in the Weft-India illands.
Thus was the fettlement begun, the proprietor being oc¬
cupied meantime in providing a government for the co¬
lony, and in concerting meafures for its Security.

The native Americans, or Indians, having experienced,
in fome provinces on that continent, much injullice, had
madethemoft terrible reprifals; found policy, therefore,
confpiring with his own temper and principles, made it
Penn’s care to have them treated with candour, jullice,
and humanity; and his relation, W. Markham, failing
with the firft fettlers, he joined him with others in a
commiflion to open a friendly intercourfe with the natives,
to whom he fent out confiderable prefents, and a letter
couched in plain conciliatory terms. In the beginning
of j 68a he publilhed “ The Frame of the Government of
the Province of Pennfylvania in America, together with
certain Laws agreed upon in England, by the Governor
and divers Freemen of the aforefaid Province, to be fur¬
ther explained and confirmed there by the firft provincial
council that lhall be held, if they feein meet.” In the
preface to this work we have a Iketch of his fentiments
on the forms and fubftance of civil government. “That,”
he obferves, “ which makes a good government, mult
keep it fuch : to wit, men of wifdorn and virtue ; quali¬
ties that, becaufe they defcend not with worldly inheri¬
tances, mu/l be carefully propagated by a virtuous education
of youth." And, in order to give effect, where he had
power, to that great principleof good government, liberty

N N.

of confcience, in behalf of which he and his friends at
home fo deeply fuffered, he recognized it in the firft article
of his “ Constitutions,” and proceeded toeftablifh it by
the following “Law.” “ All perfons living in the pro¬
vince who lhall confefs and acknowledge the one Al¬
mighty and Eternal God, to be the creator, upholder,
and ruler, of the world, and that hold themfelves obliged
in confcience to live peaceably and juftly in civil fociety,
lhall in no ways be molefted or prejudiced for their reli¬
gious perfuafion, or practice in matters of faith and wor-
Ihip ; nor lhall they be compelled, at any time, to fre¬
quent or maintain any religious worfliip, place, or minif-
try, whatfoever.”

In order to enforce thefe excellent laws and conftitu-
tions, Penn now prepared for his voyage to North Ame¬
rica. As he intended to leave his family behind, he took
leave of them in a mod pathetic and inftrudtive letter,
from which, as it Ihows evidently the ftrength of his un-
derftanding and the benevolence of his mind, and con¬
tains matter of importance to every family, we lhall make
fome extracts.

“ My dear Wife and Children; My love, which nei¬
ther fea, norland, nor death itfelf, can extinguilh or lef-
fen toward you, molt endearedly vifits you with eternal
embraces, and will abide with you forever; and may the
God of my life watch over you, and blefs you, and do
you good in this world and for ever! Some things are
upon my fpirit to leave with you in your refpedlive capa¬
cities, as I am to one a hulband, and to the reft a father,
if I Should never fee you more in this world.

“ My dear Wife ! Remember thou waft the love of my
youth, and much the joy of my life ; the molt beloved,
as well as molt worthy, of all my earthly comforts: and
the reafon of that love was more thy inward than thy
outward excellencies, which yet were many. Now I am
to leave thee, and that without knowing whether I lhall
ever fee thee more in this world, take my counfei into
thy bofom, and let it dwell with thee in my Head while
thou liveft.

“ Call up thy income, and fee what it daily amounts
to ; by which thou mayeft be fure to have it in thy fight,
and power to keep within compafs ; and I befeech thee
to live low and fparingly till my debts are paid, and then
enlarge as thou feeft it convenient.

“ And now, my deareft, let me recommend to thy care
my dear children ; abundantly beloved of me, as the
Lord’s blellings, and the fweet pledges of our mutual and
endeared affedtion. Above all things endeavour to bring
them up in the love of virtue, and that holy plain way of
it which we have lived in, that the world in no part of it
get into my family. I had rather they were homely than
finely bred as to outward behaviour; yet I love fweet-
nefs mixed with gravity, and cheerfulnefs tempered with
fobriety. Next bring them up in a love one of another ;
tell them it is the charge I left behind me, and that it is
the way to have the love and blefiing of God upon them.
Sometimes feparate them, but not long ; and allow them
to fend and give each other fmall things to endear one
another with. Once more I fay, tell them it was my
counfei they Should be tender and affedtionate one to
another. For their learning be liberal. Spare no coll;
for by fuch parfimony all is loft that is faved : but let it
be ufeful knowledge, fuch as is confident with truth and.
godlinefs, not cherishing a vain con verfation or idle mind;
but ingenuity mixed with induftry is good for the body
and the mind too. I recommend the ufeful parts of ma¬
thematics, as building houfes or Ihips, meafuring, fur-
veying, dialling, navigation ; but agriculture is efpe-
cially in my eye : let my children be lnilbandmen and
houfewives; it is induftrious, healthy, honeft, and of good
example. Be fure to oblerve their genius, and do not
crofs it as to learning: let them not dwell too long on
one thing; but let their change be agreeable, and all
their diverfions have fome little bodily labour in them.”

He next addrelfes himfelf to his children. “ Be obe¬
dient

PENN.

dient to your dear mother, a woman whofe virtue and
good name is an honour to you ; for flie hath been ex¬
ceeded by none in her time for her integrity, humanity,
virtue, and good underllanding ; qualities not ufual
among women of her worldly condition and quality.
Therefore honour and obey her, my dear children, as
your mother, and your father’s love and delight ; nay
love her too, for fhe loved your father with a deep and
upright love, choofing him before all her many fuitors :
and, though (he be of a delicate conftitution and noble
1'pirit, yet ftie defcended to the utmoft tendernefs and
care for you, performing the painfulleft adds of fervice to
you in your infancy, as a mother and a nurfe too. I
charge you, before the Lord, honour and obey, love and
cherifh, your dear mother.

“Next: betake yourfelves to fome honeft induftrious
courfe of life, and that not of fordid covetoufnefs, but
for example and to avoid idlenefs. And if you change
your condition, and marry, choofe with the knowledge
and confent of your mother if living, or of guardians,
or thofe that have the charge of you. Mind neither beau¬
ty nor riches ; but the fear of the Lord, and a fweet and
amiable difpofition, fuch as you can love above all this
world, and that may make your habitations pleafant and
defirable to you. And, being married, be tender, affec¬
tionate, patient, and meek. Be fure to live within com-
pafs : borrow not, neither be beholden to any. Ruin
not yourfelves by kindnefs toothers; for that exceeds
the due bounds of friendfhip; neither will a true friend
expert it. Small matters I heed not. Know well your
in-comings, that your out-goings may be better regulated.
Love not money nor the world ; ufe them only, and they
will ferve you; but, if you love them, you ferve them,
which will debafe your fpirits, as well as offend the
Lord. In making friends, confider well firft ; and, when
you are fixed, be true, not wavering by reports, nor de¬
ferring in affliftion ; for that becomes not the good and
virtuous. Watch againft anger, neither fpeak noraft in
it; for, like drunkennefs, it makes a man a bead, and
throws people into defperate inconveniences. Avoid
flatterers, for they are thieves in difguife ; their praife is
coftly, defigning to get by thofe they befpeak ; they are
the worft of creatures; they lie to flatter, and flatter to
cheat; and, which is worfe, if you believe them, you cheat
yourfelves molt dangeroufly. But the virtuous, though
poor, love, cherifh, and prefer. Next, my children, be
temperate in all things ; in your diet, for that is phyfic by
prevention ; it keeps, nay it makes people healthy, and
their generation found ; this is exclufive of the fpiritual
advantage it bripgs. Be alfo plain in your apparel : keep
out that luft, which reigns too much over fome. Let
your virtues be your ornaments ; remembering that life
is more than food, and the body than raiment. Let your
furniture be Ample and cheap. Avoid pride, avarice, and
luxury.

“ And as for you who are likely to be concerned in
the government of Pennfylvania, and my parts of Eaft
Jerfey; efpecially the firft, I do charge you, before the
Lord God and his holy angels, that you be lowly, dili¬
gent, and tender; fearing God, loving the people, and
hating covetoufnefs. Let Juftice have its impartial courfe,
and the Law free paflage. Though to your lofs, proteft
no man againft it; for you are not above the law, but
the law above you. Live therefore the lives yourfelves,
you would have the people live, and then you have right
and boldnefs to punifh the tranfgreflors. Entertain no
lurchers, cherifh no informers for gain or revenge; ufe
no tricks : fly to no devices to fupport or cover inj uftice ;
but let your hearts be upright before the Lord, trufting
in him, above the contrivances of men, and none fhall be
able to hurt or fupplant. So farewell to my thrice dearly
beloved wife and children ! Dated Worminghurft, 4th
of Sixth Month, 1682. William Penn.”

Immediately after writing this letter, he embarked,
and arrived fafely in the Delaware with all his companions.

545

The country afllgned to him by the royal charter was
yet full of its original inhabitants ; ,and the principles of
William Penn did not allow him to look upon that gift
as a warrant to difpoflefs the firft proprietors of the land.
He had accordingly appointed his commiflioners, the
preceding year, to treat with them for the fair purchafe
of a part of their lands, and for their joint pofleflion of
the remainder; and, the terms of the fettlement being
now nearly agreed upon, he proceeded, very foon after
his arrival, to conclude the fettlement, and folemnly to
pledge his faith, and to ratify and confirm the treaty, in
fight both of the Indians and Planters. For this pur-
pofea grand convocation of the tribes had been appointed
near the fpot where Philadelphia now ftands ; and it was
agreed that he and the prefiding Sachems (hould meet
and exchange faith under the fpreading branches of a
prodigious elm-tree that grew on the bank of the river.
On the day appointed, accordingly, an innumerable
multitude of Indians aflembled in that neighbourhood ;
and were feen, with their dark vifages and brandilhed
arms, moving, in vaft fwarms, in the depth of the woods
which then overfhaded the whole of that now-cultivated
region. O11 the other hand, William Penn, with a mo¬
derate attendance of friends, advanced to meet them.
He came of courfe unarmed; in his ufual plain drefs;
without banners, or mace, or guards, or carriages ; and
only diftir.guiftied from his companions by wearing a blue
fafh of filk network (which it feems is ft ill preferved by
Mr. Kett of Seething-Hall, nearNorwich), and by having
in his hand a roll of parchment, on which was engrofled
the confirmation of the treaty of purchafe and amity.
As foon as he drew near the fpot where the Sachems
were aflembled, the whole multitude of Indians threw
down their weapons, and feated themfelveson the ground
in groups, each under his own chieftain ; and the prefi¬
ding chief intimated to William Penn, that the nations
were ready to hear him. Mr. Clarkfon regrets, and we
cordially join in the fentiment, that there is no written
contemporary account of the particulars attending this
interefting and truly-novel tranfaftion. He allures us,
however, that they are ftill in a great meafure preferved
in oral tradition, and that both what we have juft ftated,
and what follows, may be relied on as perfeftly accurate.
The fequel we give in his own words. “Having been thus
called upon, he began. The Great Spirit, he faid, who
made him and them, who ruled the heaven and the earth,
and who knew the innermoft thoughts of man, knew
that he and his friends had a hearty defire to live in peace
and friendfliip with them, and to ferve them to the utmoll
of their power. It was not their cuftom to ufe hoftile wea¬
pons againft their fellow-creatures; for which reafon they
had come unarmed. Their objeft was not to do injury,
and thus provoke the Great Spirit, but to do good.
They were then met on the broad pathway of good faith
and good will, fo that no advantage was to be taken on
either fide, but all was to be opennefs, brotherhood, and
love. After thefe and other words, he unrolled the parch¬
ment, and by means of the fame interpreter conveyed to
them, article by article, the conditions of the purchafe,
and the words of the compaft then made for their eternal
union. Among other things, they were not to be mo-
lefted in their lawful purfuitseven in the territory they
had alienated, for it was to be common to them and the
Englifti. They were to have the fame liberty to do all
things therein relating to the improvement of their
grounds, and providing fuftenance for their families,
which the Englilh had. If any difputes fliould arife be¬
tween the two, they fliould be fettled by twelve perfons,
half of whom fliould be Englifli, and half Indians. He
then paid them for the land, and made them many pre-
fents befides, from the merchandile which had been fpread
before them. Having done this, he laid the roll of parch¬
ment on the ground, obferving again, that the ground
fliould be common to both people. He then added, that
lie would not do as the Marylanders did, that is, call

them

546

PENN,

them “ children or brothers”only ; for often parents were
apt to whip their children too feverely, and brothers
fometimes would differ; neither would he compare the
friendfhip between him and them to a chain, for the rain
might fometimes ruft it, or a tree might fall and break it;
but he (hould confider them as the fame flefh and blood
with the Chriftians, and thefame.asif one man’s body were
to be divided into two parts. He then took up the parch¬
ment, and prefented it to the Sachem who wore the horn
in the chaplet, and defired him and the other Sachems
to preferve it carefully for three generations, that their
children might know what had pafied between them,
juft as if he had remained himfelf with them to re¬
peat it.”

The Indians, in return, made long and (lately harangues;
of which, however, no more feems to have been remem¬
bered, but that “they pledged themfelves to live in love
with William Penn and his children, as long as the fun
and moon (hould endure.” And thus ended this famous
treaty ; of wdiich Voltaire has remarked, with fo much
truth and feverity, “that it (vas the only one ever con¬
cluded between Savages and Chriftians that was not rati¬
fied by an oath, and the only one that never was bro¬
ken !”

Such, indeed, was the fpirit in which the negociation
W'as entered into, and the correfponding fettlement con-
duffed, that, for the fpace of more than feventy years,
and fo long indeed as the Quakers retained the chief
power in the government, the peace and amity which
had been thus folemnly promifed and concluded, never
was violated ; and a large and moft ftriking, though foli-
tary, example afforded, of the facility with which they
who are really fincere and friendly in their own views,
may live in harmony even with thofe who are fuppofed
to be peculiarly fierce and faithlefs.

William Penn now held an aflembly, in which fifty-nine
important laws were palled in the courfe of three days.
The moft remarkable were thofe which limited the num¬
ber of capital crimes to two, murder and high treafon ;
and which provided for the reformation as well as the pu-
nifhment of offenders, by making the prifons places of
compulfive induftry, fobriety, and inftruftion. It was
likewife enabled, that all children, of whatever rank,
fhould be inltructed in fonie art or trade. The fees of
law-proceedings were fixed, and infcribed on public ta¬
bles ; and the amount of fines to be levied for offences
alfo limited by legiflative authority. Many admirable
regulations were added, for the encouragement ofinduftry,
and mutual ufefulnefs and efteem.

Philadelphia, the capital of the province, was next to
be laid out, of which, at the time of Penn’s arrival, not
a houfe was completed; the colonifts having, in general,
no better lodgings than caves, hollowed out of the high
banks of the river : the very plot fixed on for the city
was claimed by fome Swedes, to whom the governor al¬
lowed a greater quantity cf land in exchange. This city,
extending two miles in length and one in breadth, and
abutting at each end on a navigable river, was now
planned, with admirable boldnefs, convenience, and re¬
gularity, and laid out under the infpeftion of Thomas
Holmes, furveyor-general to the province. Ere twelve
months had elapfed, the rudiments of the future metro¬
polis (liowed themfelves in about fourfeore dwellings,
the feats of freedom, peace, and induftry. The governor
difpatched his plan to the committee of the Free Society
of Traders, accompanied with a defeription (the beft
extant of thefe times) of the country, its natural hiftory,
and aborigines : this defeription is inlerted in the collec¬
tion of his works before mentioned. The firft jury was
impannelled here early in 1683 ; and one Pickering was
tried, w ith others his acceffaries, before the governor and
council, and convicted of counterfeiting the Spanifh filver
money current in that province. His fentence difcovers
the fame fpirit of mildnefs and equity, which, at this
day, conftitutes the praife and the efficacy of the criminal

code of Pennfylvania. He was to pay a fine of forty
pounds towards the building of a court-houfe, (landing
committed till payment; find fecurities for his good be¬
haviour; and make reftitution, in good filver, to the
holders of his bale com , which, being fir Jl melted clown, was
to be rejlored to him. Various legiflative, economical, and
religious, meafures, together with a tedious difpute with
lord Baltimore, on the fubjeft of the boundary-line be¬
tween this province and Maryland, continued to occupy
Penn till about Midfummer 1684; when he found it
needful, on various confiderations, to return to England.
His intereft at court had declined during his abfence :
but it was now reftored, upon the death of Charles II. by
the acceffion of his more immediate patron James II. He
made ufe of his influence for the ufe of his friends, the
Quakers, who ftill lay under the fcourge of penal ftatutes;
and for the gratuitous fervice of many others. I11 parti¬
cular he exerted himfelf in favour of the meafure at that
time fo much, though fo infincerely, held out by the
court, of univerfal liberty of confidence. His intimate
reception at court, and the appearance of being in fome
waytrufted or employed by the king, now fubje£led him
to the general imputation of being a concealed Papift.
Even his old acquaintance, Dr. Tillotfon (afterwards
archbifnop of Canterbury), fufpedled him : but, fome ex-
preflions of Tillotfon’s on the fubjedt coming to Penn’s
ears, a correfpondence enfued between them, at the clofe
of which Tillotfon acknowledged himfelf fully fatisfied
that there exifted no juft grounds for the furmife.
About this time (befides a further account of his pro¬
vince) Penn publifhed feveral pieces on his favourite to¬
pic, liberty of confcience, one of which was entitled
“ Good Advice to the Church of England, Roman Ca¬
tholic, and Proteftant Diflenter, in which it is endea¬
voured to be made appear, that it is their duty, principle,
and intereft, to abolifli the penal laws and tells.”

The lad occafion in which we have to view Penn in
connexion with the court of James, is in an occafional
attendance on the movements of the latter, this year,
through feveral of the midland counties. Penn feems to
have made ufe of feveral intervals in this progrejs, to pay
religious vifits to his friends, and to preach to the people.
On fome of the latter occafions the king too was prelent to
hear him. At Oxford he remonftrated with James on his
arbitrary treatment of the fellows of Magdalen-college,
and attempted a mediation between them and the king,
which he farther profecuted afterwards at Windfor; but
it proved abortive.

The revolution brought Penn again into difficulties, as
a fufpefled Papift, or Jefuit, and a fecret agent for the old
government. On the 10th of December, 1688, walking
in Whitehall, he was lent for by the lords of the council,
then fitting, who, though nothing was laid to his charge,
obliged him to give lureties for his appearance on the firft
day of the next term : he was continued on thefe to the
Ealler term following, on the lad day of which he was
cleared in open court. In 1690 he was again brought
before the council, on an accuiation of holding a corre¬
fpondence with the late king James ; he appealed to king
William, wdio, after a conference of near two hours, in¬
clined to acquit him ; but, to pleafe fome of the council,
lie was held upon bail for a while, and in Trinity term of
the fame year again difeharged. He was yet a third time
attacked, and his name inferred in a proclamation, dated
July 18th this year, wherein (among divers of the nobi¬
lity, and others to the number of eighteen) he was
charged with adhering to the king’s enemies ; but, proof
failing refpedling him, he was again cleared by order of
the court of King's Bench.

He now purpofed to go again to his province, and
gave out propofals for a new fettlement there. It appears
that, though his (lay in England might be neceflary to
the fecurity of his title as proprietary, it was highly de¬
trimental both to his interefts in America, and, through
deficiency hitherto of revenue from, it, to his private
1 eftate.

5i7

P E

eftate. His order for convoy had already pafl’ed the fecre-
rary of ftate, when the voyage was prevented by a new
charge again It him, backed by the oatii of one Fuller, a
wretch who was afterwards declared by parliament an im-
poftor : the charge, however, being that of partaking in
a plot to reftore the late king, a warrant was granted.for
his apprehenfion, which he narrowly efcaped at his return
from George Fox’s burial, on the 16th of the month
called January, 1690. Seeing now no probability of fair
treatment, he retired (or, as Burnet choofes to fay, ab*
fconded) for two or three years: during which time, be-
(ides a Preface to the collefted Works of Barclay, he
wrote the following pieces : 1. Juft Meafures ; an epiftle
to the Quakers in vindication of religious difeipline. 2.
A Key, or a treatife explanatory of their principles and
practice. 3. Refleftions and Maxims relating to the
Conduft of Human Life. The two latter of thefe have
gone through many editions.

In 1694 he wrote, as aPreface to George Fox’s Journals,
a “ Brief Account of the Rife and Progrefs of the People
called Quakers,” which has feveral times been reprinted.
Fie was alfo aftively employed in this and the fubfequent
years as a preacher in feveral parts of England and in
Ireland. Having in 1693 loft his wife, with whom he
had lived in perfeft harmony, he took, in 1696, a fecond
wife, the daughter of Thomas Caljowhill of Briftol, by
whom he had feveral children. His eldeft fon by his firft
marriage, a youth of great hopes, died of a confumption
in his 2 1 ft year, to his deep affliftion. A bill in 1697
being depending in the houfe of lords againft blafphemy,
Penn, ever vigilant againft reftridfions in matter of reli¬
gion, prefented to that houfe a “ Caution requifite in
the Confideration of that Bill,” advifing that the w'ord
blajphemy might be fo explained as to leave no ambiguity
by means of which ground might be given for malicious
profecutions. The bill itfelf. was, however, dropped.

During the prevalence of Penn’s enemies at court, he
had been deprived of his government of Pennfy Ivania,
which was annexed, in Oftober 1692, to that of New-
York, under colonel Fletcher. The oftenftble reafons for
this ftep were mal-adminiftration, and danger of the lofs
of the province thereupon : the real one probably was
a jealoufy excited by thegrowing profperity of the colony,
and by principles and pradiices in its jurifprudence too
liberal for the age. At length, in the latter end of 1693,
through the mediation of his friends, he was admitted
to plead his caufe before the king and council, by
whom he was acquitted, and his government was reftored.
This inftrument is dated Auguft 1694; but it was not
till five years after this, that he embarked a fecond time
for the province, accompanied by his family. Penn feems
now to have intended to fpend the remainder of his life
in America; and he applied himfelf diligently to the of¬
fices of government, in which the inevitable difficulties
arifing from a mixed population of various difpofitions
and interefts, and enjoying a great fhare of liberty, re¬
quired the exercife of both fkill and patience. His admi-
niftration was fuccefsful ; and the colony is ftated to have
been at this period, when compared with others of the
fame (landing on the continent, in an eafy and fiourifhing
condition. His old allies, the natives, were not over¬
looked; and, religion being evera predominant confider¬
ation with Penn, he engaged his friends, at a monthly
meeting for difeipline, held the beginning of 1700, in a
plan for the inltruftion of the natives and of the negroes,
who had now been introduced among them, in the prin¬
ciples of the Chriftian faith. Later experience has fhown
that Chriftianity, to obtain a cordial and general recep¬
tion among thefe people, fhould be preceded by her hand¬
maid, civilization. A public fchool (free to the children
of the poor) had been accordingly founded here. In Fe¬
bruary 1701 a treaty was held between the governor and
about forty of the chief perfons among the natives, in
which, belides renewing former covenants, the parties ef-

Vou XIX. No. 1324.

N N .

tablilhed fome regulations on the fubjeft of trade between
them: a principal care of the governor, on this occalion,
feems to have been to prevent the abominable p raft ice,
already ufed by fome unworthy colonifts, of drawing the
natives into a ruinous traffic, by offering them fpirituous
liquors.

During thefe tranfaftions, an attempt was making at
home, under pretence of advancing the prerogatives of
the crown, and of national benefit, to invade the feveral
proprietary governments in America, and reduce them to
regal ones. A bill for this purpofe was already before the
lords, when the land-owners of Pennfylvania, prefeht in
England, petitioned the houfe, and gained time for the
governor’s return ; who, on notice of the meafure, pre-
fently embarked, and arrived at Portfmouth in December
1701. The bill, which had been poftponed, was now
entirely dropped ; and theacceffion of queen Anne, foon
after, placed Penn once more in the funffiine at court.
His eftate, however, had now fuffered much, by liberal
difburfements, by inadequate returns, and by the conti¬
nual political impediments thrown in his way. He was
moreover involved, in 1707, in a fuit at law with the exe¬
cutors of aperfon who had been his fteward; and, his cafe
not admitting of relief by the court of chancery, he was
obliged to live within the rules of the Fleet until thedif-
pute could be adjufted.

It is not to be concealed, that a party in Pennfylvania
made heavy complaints againft his government of that
colony, and fo much difquieted him, that at one period
he was inclined to make over his right as governor to the
crown. How far there was real ground of blame in his
adminirtration it is not eafy to determine; in faft, all the
proprietary governments have been fubjeft to fimilar dif-
contents, naturally arifing from the double relation of
proprietorand governor. On the whole, it is certain that
the colony Pennfylvania foon became one of the molt
flourilhing of the Nortb-American fettlements, and Itill
reveres the memory of its founder.

The infirmities of age now began to creep upon him ;
and the air of London not agreeing with him, he took a
handfome feat at Rufhcomb, near Twyford, in Buck-
inghamffiire, where he palled the remainder of his life.
This proved to be a lengthened ftate of decline; for,
having been feized with fome fits of the apopleftic kind
in 1712, his bodily and mental powers began gradur.lly
to decay, though for a confiderable time not fo much as
to prevent his enjoyment of life. He was at length re¬
duced to perfeft imbecility; and died in July 1718, in
the 74th year of his agei He was interred at Jordans,
near Beaconsfield. His works were printed colleftively
in 1726 in two vols. 4to. Seleft editions have fince been
given, omitting molt of the controverlial pieces. Life
prefixed to Penn's Works. Proud's Hifi, of Pennjylvunia,
Seivell's Hiji. of the Quakers. Monthly Mag. vol. xxxi.
Clark fun's Life of William Penn, 1813.

PENN’s, a townlhip of Pennsylvania, on the river Suf-
quehannah, containing 3798 inhabitants. — Alfo, a town-
ffiip of Northumberland-county, with 2072 inhabitants.

PENN’s CO'VE, a bay on the eaft coaft of Whidbey’s
Illand, in the gulf of Georgia. Lat. 48. 16. N. Ion. 237.
39. E.

PENN’s CREE'K, a river of Pennfylvania, which
runs into the Sufquehanna in lat. 40. 48. N. Ion. 76.
56. W.

PENN’s FO'RT, lies at the mouth of a fmall creek, on
the weft fide of Delaware -river, in Northampton-county :
about twenty-one miles north of the line ofEafton, and
near feventy north of Philadelphia. Lat. 40. 59. N. Ion,
75. 1 3. W.

PENN’s NECK', a town of Saletn-county, New Jerfey,
in Old Man’s creek: twelve miles north-eaft by north of
Salem. Upper Penn’s Neck contains 1638, Lower 1163,
inhabitants. — Alfo, the name of a range of farms of ex¬
cellent foil, lituated about one mile and a half fouth-eaft
7 A of

548

PEN

of Princeton, in New Jerfey, on a point of land formed
by Millftone-river and ftony-creek; fo called from the
celebrated William Penn, who formerly owned this traft.

PENN’s ROC'KS, two clufters of rocky illets in the
fouth-weft part of Hudfon’s Bay.

PEN'NA (Lorenzo), an ecclefiaftic of Bologna, pub-
lithed a work entitled, “ Li primi Albori Mnficali, per li
Principianti della Mulica figurati;” one of the bed trea¬
ties on practical mufic that appeared in Italy during the
17th century. The firft fketch of this book was publifhed
in 1656 ; a fecond edition, enlarged, of the firft- book, ap¬
peared at Bologna, 1674; the fecond book at Venice,
1678; and the whole completed, in three books, 1684.
In 1696, the work had gone through five editions. The
author’s rules for counterpoint, and extemporary playing
on keyed inftruments, are concife and clear, as far as they
go; which is, however, veryfhort of what is now wanted,
fince the bounds of modulation and u(e of difcords have
been fo much extended.

PEN'NA, a town of the Popedom, in the marquifate
of Ancona : nine miles eaft of Cafnerinn.

PEN'NA n’AG'HER, a fmall ifland near the weft coaft
of Sardinia. Lat. 43. 33. N. Ion. 8. 16. E.

PEN'NA di BIL'I.I, a town of the Popedom, in the
dutchy of Urbino, the fee of a biftiop : fourteen miles
■weft-north-weft of Urbino, and eleven fouth-weft; of St.
Marino.

PENNA'CEOUS, adj. in botany, feathered like the
web of a quill.

PEN'NACHED, adj. [ pennaclie , Fr.] Applied to
flowers when the ground of the natural colour of their
leaves is radiated and diverlified neatly without any con-
fufion. Trevoux. — Carefully proteft from violent rain
your pennached tulips; covering them with matraftes.
Evelyn,

PEN'NANT, f. [prnnon, Fr.] A fmall flag, enfign, or
colours. See Pennon.

PEN'NANT (Thomas), an eminent naturalift and
tourift, was the fon of a gentleman of moderate fortune
at Downing in Flintfhire, where he was born in 1726.
He received his fchool-education at Wrexham and at
Fulham; and from the latter was removed to Oxford,
where he entered upon the ftudy of jurifprudence, but,
as appears, with no intention of purfuing the law as a
profefTion. He has himfelf recorded, that a prefent made
him at the age of twelve of Willoughby’s Ornithology
gave him the firft tafte for the ftudy of natural hiftory ;
and that a tour into Cornwall, which he made about
1746 from Oxford, in which he became acquainted with
Dr. Borlafe, infpired him with a ftrong paflion for mine¬
ralogy. In 1754 he made an extenfive tour in Ireland,
which feems, however, to have been rather an excurfion
for pleafure than for fcientific purpofes. In that year he
was elefted a Fellow of the Society of Antiquaries, whofe
purfuits he always combined with the ftudy of nature.
A paper on certain coralloid bodies found in Coalbrook-
dale, inferted in the Philofophical Tranfadlions of 1756,
was the firft of his publications in the department of na¬
tural hiftory. He had the year before commenced a cor-
relpondence with the illuftrious Linnaeus, to whom he
fent an account of a concha anomia from the Norwegian
feas ; and, in return, he was made a member of the
Royal Society of Upfal. Mr. Pennant about this time,
married an amiable woman, and palled fome years in do-
meftic retirement. By way of occupation, he began, in
1761, to prepare his “ Britilh Zoology,” in 132 coloured
plates, imperial folio, with explanations. It was pub-
lilhed for the benefit of the Welfti charity-fchool in
London. He came to the pofieffion of the eftate of Down¬
ing at the death of his father in 1763, and with it a rich
mine of lead-ore, which enabled him to make great im¬
provements.

The death of his wife interrupted his domeftic enjoy¬
ments; and in the fpring of 1765 he made a tour to the
continent. France, Swillerland, part of Germany, and

PEN

Holland, were vifited by him ; and he became perfonalty
known to feveral men of fcientific eminence, among
whom were Buffon, Haller, the Gefners, Trew, Gronovius,
and Pallas. His conference with the latter at the Hague,
gave rife to the plan of one of his moft valuable works, the
“Synopfis of Quadrupeds.” In 1767, he was elected a
Fellow of the Royal Society, and in the next year he re-
publifhed his Britifh Zoology, in 2 vols. 8vo. with re¬
duced plates ; another volume relative to reptiles and
fifties was added in 1769. An “Indian Zoology,” of
which 12 plates, with defcriptions, were publifhed by
him in 1769, remained a fragment. In the fame year he
undertook a journey to the remoteft point of Scotland;
and the numerous obfervations which he made were after¬
wards the bafisofa very interefting publication. In 1770
he publifhed 103 additional plates to his Britifh Zoology,
with feveral new defcriptions; and in the following year he
printed his Synopfis of Quadrupeds, in one vol. 8vo.
ilis well-earned reputation caufed him, in the fame year,
to receive the compliment, from his alma-mater, of the de¬
gree of dodtorof laws.

His firft “Tour in Scotland” was given to the public
in 1771, and was received with avidity. At that time
Scotland was little known to the fifter-kingdom, except
by flight and partial accounts ; and the curious and varied
information communicated by this liberal traveller, in a
fpirit of candour and good-humour, was equally accept¬
able to both fides of the Tweed. This reception of his
work, and the attachment he had contradled to his fub-
j eel, induced him, in 1772, to repeat his northern tour,
and extend it to the principal iflands of the Hebrides.
For the latter purpofe he hired a vefiel to convey him
from one ifland to another, and wait upon him at proper
Rations ; and the refult was a rich harveft of valuable and
entertaining obfervation. In 1773, he publifhed “ Ge¬
nera of Birds, “ in one volume; and likewife employed
himfelf in a journey through the northern counties of
England. Antiquities and family-hiftory were now be¬
come favourite objects of his enquiry, and he vifited every
place which was likely to afford curious matter of this
kind. A third edition in 4to. of his firft Tour in Scot¬
land, with additional plates, and the firft vol. 4to. of his
fecond Tour and Voyage to the Hebrides, were publifhed
in 1774.

Mr. Pennant was now become an habitual traveller;
and he found his excurlions, almoftalways made on horfe-
back, equally ferviceable to his health and fpirits. Few
men, indeed, have more enjoyed the viridis Jcnedus, or
better preferved their bodily and mental adlivity to an
advanced period. In all his journeys he laid up new ftores
of information ; and he found even the moft frequented
tracks fertile of thofe topographical memoranda, to which
hisattention was now chiefly direfted. In 1775, he pub-
lifhed the third vol. 4to. of his Tour in Scotland, which
he had the fatisfaftion of feeing a popular work both at
home and abroad.

Thinking it difgraceful for a literary native of Wales
to negleft his own country, fo abundant in objects inte¬
refting to all the different lpecies of travellers, he gave,
to the public, in 1778, the refult of feveral journeys
through the fix counties of North Wales, in one 410. vol.
with many plates, entitled “A Tour in Wales;” and in
1781 he added another volume, with the title of “ A
Journey to Snowden.” Thefe are particularly entertain¬
ing, on account of the many anecdotes interfperfed, ii-
luifrative of the manners and hiftory of that part of the
ifland. In the mean time he did not forfake his original
objeft of purfuit, natural hiftory. He had added, in
1777, a 4to. vol. to his Britifh Zoology, containing the
Vermes, including the teftaceous and cruftaceous ani¬
mals. His Synopfis of Quadrupeds, now greatly enlarged
and improved, and bearing the title of “ Hiftory of Qua¬
drupeds,” was publifhed in 2 vols. 4to. 1781 ; and in the
fame year, his “ Hiftory and Natural Hiftory of the Tur¬
key” was inferted in the Philofophical Tranfadlions,

Mnamued /?>itAr/8r/<ya/opf^o:/>iJJondutcn.si.i May j8w .

PEN

PEN

549

His “ Ar£lic Zoology,” in 2 vols. 4to. containing qua¬
drupeds and birds, appeared in 1785. There was prefixed
to it a copious Introduction, which is, perhaps, the molt
interefting and original of all his writings. It is a kind
of furvey of all the coafts of the arctic regions, beginning
from the Straits of Dover, and'proceeding to the remo-
tefl north, on the eaft and welt ; and filled with a great
variety of geographical, hiftorical, and phyfical, fads,
alfording a feries of the molt animated pictures. A Sup¬
plement to this work was given in 1787. “ A Journey

from Chelter to London,” 4to. 1782, and an account of
the antiquities of the capital irfelf, entitled “London,”
4to. 1790, were agreeable additions to his publications
of this clafs. The latter, in particular, was popular, and
reached a third edition. Several fmaller pieces of the po¬
litical and mifcellaneous kind, filled up the intervals of
liis greater works, and proved the continued adivity of
his mind.

Thus far Mr. Pennant has himfelf recorded the hiftory
of his literary life, in a work printed in 1793, together
with fome mifcellaneous traffs. He had at this time
taken a formal leave of the public, and had alluded to
Gil Bias’s archbifhop of Granada, as a memento not to
employ his pen till the defeCl of its powers fliould become
manifelf to his readers. But the habit of authorfhip was
too (trong to permit him to adhere to his refolution. In
1796 he pubiilhed “ The Hiftory of the Parifties of
Whiteford and Holywell,” 4to. the firft of thefe was his
native parilh ; and he took occafion to give many particu¬
lars of his family-hiftory, with a degree of fenile garrulity,
but enlivened by his ufual vivacity. The natural hiftory
of the parifties is curious and inftruClive. I11 his literary
life he had mentioned a great rhafs of manufcript which
he kept by him under the title of “ Outlines of the
Globe,” being compilations of geographical and other
matter, in the manner of the introduCIion to Arflic
Zoology above ment ioned, and which was a part of them.
From thefe he pu bl i tiled in 1798 two quarto volumes, en¬
titled, “ A View in Hindooftan,” which were well re¬
ceived by the public. He died in the courfe of that year,
at the age of 72. Befides the works above enumerated,
he wrote fome fmaller pieces; and was a promoter of the
publications of other men of fcience, particularly of Mr.
Lightfoot’s Flora Scotica. To the lift of his literary ho-
ncurs are to be added his eledlion into the Royal Aca¬
demy of Stockholm, and the American Philofophical So¬
ciety of Philadelphia, befides feveral minor focieties.
He had married a fecond wife in 1776, the filler of his
neighbour, fir Roger Moftyn ; and he left a family by
both marriages.

Mr. Pennant poffeffed a weil-compa£led frame of body,
an open and intelligent afpedl, and a cheerfulnefs and vi¬
vacity of difpofition, with gentlemanlike manners, which
rendered him highly agreeable in fociety. He was exem¬
plary in the relations of domeftic life, zealoufly attached
to the interefts of his country, both local and general, and
kindly attentive to the wants of his poor neighbours. As
an author, he was too rapid and various to be perfeflly
correfl either in matter or ftyle ; but he always meant
honeftly, and was ready to rectify miftakes. In the de¬
partment of natural hiftory, in which he Hands higheft,
he is clear and judicious in his fpecies of arrangement,
concife, energetic, and exa£t in his defcriptions. He is
regarded both by native and foreign naturalifts as very
reftpeflable authority. Pennant's Literary Life, and Hif¬
tory of Whiteford and Holywell. Gen. Bing.

PENNAN'TIA, f. [fo named by Forfter in honour of
the fubjeft of the preceding article.] In botany, a genus
of the clafs polygamia, order dioecia ; or ratherclafs pen-
tandria, order monogynia ; natural order uncertain ; per¬
haps akin to the urticse of Juftieu. Generic characters —
Calyx : none, unlefs the corolla be taken forfuch. Co¬
rolla: petals five, equal, lanceolate, acute, concave,
widely Ipreading. Stamina : filaments five, capillary, the
length of the petals; antherte oblong, incumbent. Pif-

tillum: germen fuperior, obtufely triangular; ftyle none;
ftigma flat, peltate, obfcurely three-lobed. Pericarpium :
capfule triangular, of two cells. Seeds folitary; fome-
what triangular. Some flowers, on a feparate plant, have
the filaments twice as long as in the above, with ovate
antherae, but no pillil. — Efential Charafler. Calyx none ;
petals five, equal ; ftyle none ; capfule of tw'o cells ; feeds
folitary.

Pennantia corymbofa, a fingle fpecies; native of New
Zealand. It is a tree or fhrub, with round leafy brandies,
dotted, and fomewdiat downy, when young. Leaves al¬
ternate, ftalked, two inches or rather more in length,
obovate ; either quite entire, or with two or three broad
blunt (hallow teeth, or fmall lobes; furniftied with a
midrib, and many tranfverfe interbranching veins ; dark
green above, nearly fmooth, except the rib, which is on
both fides minutely hairy; pale and fmooth beneath.
Footftalks not half an inch long, channelled, hairy.
Flowers about the fize of Lauruftinus ; as far as can be
judged of them in a dry ftate, they feem to be pale green
oryellowifli wdiite. The whole bears a general refem-
blance to fome kind of Viburnum, but the abfence of a
calyx is a ftriking difference.

Such is Foriter’s original fpecimen. The younger
Linnaeus, however, obtained in England, if we miftake
not, a fpecimen under the name of Pennantia, which is
a very different thing. The leaves are ovate, four inches
long, green on both fides, undivided and entire.
Branches and footftaik fmooth, with a folitary ftalked
gland at a little diftance above each of the latter, and no
llipules. Flowers numerous, in a terminal compound
fmooth duller; their ftyle as long as the corolla, their
ftamens longer; and, what is mod remarkable, each flower
has a calyx, deeply divided into five ovate fringed feg-
ments, and rather elongated at its bafe. This plant
therefore is unqueftionably altogether different from For-
fter’s Pennantia ; it may be an Ehretia, but we know no¬
thing of the fruit, nor is it to our prefent purpofe to in-,
veftigate this queftion.

PENNAQUID'. See Pemaouid.

PENNAR', a river of Hindooftan, which rifes in My-
fore, erodes the circar of Cuddapa and the Carnatic, and
runs into the bay of Bengal twelve miles eaft of Nellore,
in lat. 14. 26. N. Ion. 80. 13. E. This is the firft conlider-
able river to the north of Madras. It rifes nearly in mid¬
way between the two feas, near Chinna Balaburan, or
about twenty-five miles north of Bangalore. It has a
northern courfe as high as lat. 15. from whence it runs
eafterly till it reaches the fea. It is a confiderable river,
being three hundred yards wide feventy miles from the
fea, confined by mount:, ins on each fide. On the fouth-
ern part (lands the ltrong fortrefs of Gandicotta ; which
fee, vol. viii.

PENNA'RE POI'NT, a cape in the Englifh Channel,
on the fouth coaft of Cornwall: fix miles weft-fouth-weft
of Dedman’s Point. Lat. 50. 12. N. Ion. 4. 46. W.

PEN'NARTH BA'Y, a bay on the fouth coaft of
Wales, in the Severn, at the mouth of the Trave, below
Cardiff, to which it is a harbour. A point of land, called
Pennartk Point, bounds it on the fouth.

PEN'NAS (Las), a town of Peru, in the diocefe of La
Paz: feventy miles north of Potofi.

PEN'NATF.D, adj. [pennatus, Lat.] Winged. — - Pen -
nated, amongft botanifts, are thofe leaves of plants as grow
diredlly one againft another on the fame rib or ftalk ; as
thofe of afh and walnut-tree. Quincy.

PENNAT'ULA, f. [dim. of penna, Lat. a quill-fea¬
ther, from the appearance of fome of the fpecies.] The
Sea Pen; in helminthology, a genus of vermes zoophy-
ta, or plant-like worms, confiding of eighteen fpecies.
Generic characters — Animal not affixed, of various fhapes,
fupported by a bony part within, naked at the bafe, the
upper part with generally lateral ramifications, furniftied
with rows of tubular denticles, producing radiate polypes
from each tube.

This

550

PENNATULA,

This genus of animals differs remarkably from all the
other zoophytes by their fwimming freely about in the
fea, and many of them having a mufctilar motion as they
fwim along. They have no opening at the bottom as
was formerly thought, nor any other paffage but through
their polype mouths ; by thefe they take in their food,
and through thefe they produce their eggs, as in moll
zoophytes. When we compare them with the other zoo¬
phytes, they approach nearelt to the Gorgonia, as having
a bone in the inlide like them, which is covered with
ffefli, and their upper parts full of polype-like mouths.

1. Pennatula coccinea, the fcarlet fea-pen : ftem round,
radiating, with papillous polype-bearing fides, and cla-
vate at t lie top. It inhabits the deeps of the White Sea,
and unites the two genera, Alcyonium and Pennatula;
it is loft, red, an inch and half high, and as thick as
the little finger; it is wrinkled, with the papillae difpofed
in rows.

2. Pennatula grifea, the thorny fea-pen : ftem flelhy,
with a fmooth midrib and imbricate plaited fpinous ra¬
mifications. It is found in the Adriatic, and is about
eight inches long; it ftiines by night; back of the mid¬
rib lanceolate, fmoothilh; rays imbricate, and undulate
on the anterior margin, the lobules are armed with a
fpine, and obtufely crenate at the margin.

3. Pennatula phofphorea, the Britifh fea-pen : ftem
flelhy, with a rough midrib and imbricate ramifications.
It is about four inches long, and red. Dr. Solander calls
it the Britifh fea-pen, to diftinguilh it from the rubra,
which he calls the Italian fea-pen, and becaufeit is found
in great plenty flicking to the baits on the filhermen’s
lines round the coafts of this kingdom ; efpecially when
they make ufe of mufl'els to bait their hooks. Great num¬
bers have been taken on the coaft of Scotland, efpecially
near Aberdeen.

This animal was well known to the ancients by the name
of the fea-pen ; many of the old authors took it fora fucus,
or fea-plant. It has been found in the ocean from the coaft
of Norway to the moft remote parts of the Mediterranean;
and not only dragged up in trawls from great depths of
the fea, but often found floating near the furface. Dr.
Shaw, in his Hiftory of Algiers, remarks that they afford
lo great a light in the night to the fifhermen, that they
can plainly difcover the fifh fwimming about in various
depths of the fea. The luminous effect is confined to the
plumule of the quill, or that part which is inhabited by
the polype. Spallanzani, in a letter to Bonnet, ftates that
the light is only emitted when the fea-pen is in motion ;
and that there is a mucous luminous fubftance furnifhed
by the polype, which is foluble in water, and becomes
mixed with the fea- water that is admitted into the, pen
by means of a hole fituated at the extremity of its (talk.
(Mem. Soc. Ital. tomo ii.) But the exiftence of any hole
at the extremity is denied by Mr. Ellis, whofe defcrip-
tion (Phil. Tranf. liii.) is as follows :

“The outward appearance of this animal is not unlike
one of the quill-feathers of a bird’s wing; but they are
found of different fizes, from four to eight inches in
length; the lower half of it is naked, round, and white,
not unlike the quill-part of a writing-pen ; the upper part
reprefents that of the feathered part of the pen, and is of
a reddifh colour. This upper half, which arifes from the
quill, and is feathered on both fides, is a little compreffed,
and becomes fmaller and fmaller till it ends in a point at
the top; along the back of this, in the fame manner as in
the inner fide of a common writing-pen, there is a groove
in the middle, from the quill to the extremity; from each
fide of this upper part of the ftem proceed little parallel
feather-like fins ; thefe begin at the top of the quill-part,
very final) on each fide at firfl, but lengthen as they ad¬
vance towards the middle; hence they fhorten gradually
on each fide, till they end in a point at the top, their
terminations preferving on each fide the figure of the feg-
ment of a circle.

“To come now to confider more minutely thofe pin-

1

nulae, or feather-like fins, that projeCt on each fide, and
form the upper part of this animal. Thefe are evidently
defigned by nature to move the animal backward or for¬
ward in the fea, confequently to do the office of fins,
while at the fame time, by the appearance of the fuckers
or mouths furniftied with filaments or claws, they were
certainly intended to provide food for its fupport ; for,
notwithftanding what Linnaeus has faid in regard to its
mouth, in his Syftem of Nature, viz. Os bajeos commune
rotundum , Mr. E. could not, with the help of the beft
giafl'es, difcover that the point of the bafe was penetrated
in the leall ; fo that he is clearly of opinion, that this ani¬
mal, like the Hydra arCtica, or Greenland polype, de-
fcribed in his Eftay on Corallines, nourifties and lupports
itfelf by thefe fuckers or polype-like filaments ; that by
thefe both kinds take in their food, and have no other vi-
fible means of difcharging the exuviae of the animals they
feed on, than by the fame way which they take them in ;
and that, from attentively confidering the ftruCture and
manner of living of both thefe animals, he clafies them
in the fame genus of Pennatula, though they vary very
much in their exterior form and fize, and confequently
are of very different fpecies. The ftem of the fuckers of
this animal is of a cylindrical form; from the upper part
proceed eight fine white filaments or claws, to catch their
food : when they retreat on the alarm of danger, they
draw themfelves into their cafes, which are formed like
the denticles of the corallines, but here each denticle is
furnifhed with fpiculas, which clofe together round the
entrance of the denticle, and protect this tender part from
external injuries.”

Some of the moil curious remarks of Dr. Bohadfch on
the anatomy of this animal, as alfo on the appearance of
it while alive in fea-water, areas follow: “When the
trunk is opened lengthwife, a faltifh liquor flows out of
it, fo vifcid as to hang down an inch ; the whole trunk
of the ftem is hollow; its outward coriaceous membrane
is more than a line thick, and forms a llrong covering to
it : between this and another thinner membrane of the
pinnated part of the trunk, are innumerable little yellow-
i fli eggs, floating in a whitifh liquor, about the fize of a
white poppy feed; thefe are beft feen when the trunk is
cut acrofs ; this thin membrane lines the whole infide of
the trunk, in which we obferve nothing but a kind of
yellowifh bone, which takes up three parts of the cavity.
This bone, in fome of thefe animals, is above two inches
and a half long, and about half a line thick; in the mid¬
dle part of it, it is quadrangular; towards each end it
grows round and very taper: that end is fmallefl which is
neareft the top of the pinnated trunk. The whole bone
is covered with a yellowifh clear fkin, which at each end
changes into a ligament; one of which is inferted in the
top of the pinnated trunk, the other in the top of the
naked trunk; by the help of this upper ligament, the
end of this little bone is either contracted into a very
narrow arch, or difpofed into a ftraight line, according to
the motion of the trunk. The fins likewife are compofed
of two fkins : the outer one ftrong and leathery, and co¬
vered over with an infinite number of crimfon ftreaks,
the inner fkin is thin and clear : thecylindrical part of the
fuckers are in the fame manner, only with this difference,
their outer fkins may be fofter. Both the fins and the
fuckers are hollow, fo that the cavity of the fuckers may
communicate with the fins, as their cavity does with the
trunk.

“ We now come to the appearance which this animal
makes when alive in fea-water. The trunk then was
contracted circularly at the bottom of the naked part of
the Item, and by this contraction formed a zone of the
mod intenfe purple, which moved upwards and down¬
wards fuccefiively : when it moved upwards through the
length of the pinnated trunk, it there became paler, and
at length terminated at the top : the motion being fcarcely
finifhed, a like zone appeared at the end of the naked
trunk, which finifhed its motion in the fame manner as

the

P E N NAT U PA.

Engraved for the Enaydopadui Londuiensis. 2823

551

PENN i

the former. When this zone becomes very much con-
ftrifted on every fide, the trunk above it fwells and ac¬
quires the form of an onion; and then it appears as if a
compreffed globe moved along through the whole fpace
of the trunk ; this conftri&ion of the trunk gives that
fine red colour to the zone; for, when the fkin of the trunk
is outwardly full of purple papillae, the intermediate
fpaces are of a whitilh colour. In this conftri&ion then
of the Ikin, the intermediate fpaces are obliterated, and
the papillae are brought nearer together; confequently
only the purple colour prefents itfelf to the eye, and ap¬
pears more bright. The end or apex of the naked trunk
is fometimes curved like a hook, and fometimes extended
in a right line ; both thefe motions then mud be direfted
by the little bone in the infide, and from this motion of
this little internal bone, that finus or cavity at the lower
end of the trunk (thought by authors heretofore to be
the mouth) feeins plainly to be formed; for fometimes it
is deeper, fometimes Shallower ; it is deeper while the
movable globe appears in the middle of the pinnated part
of the trunk, and fhallower when it is in the bottom of
the naked trunk, at which time the bone is moft extended.
The fins, or pinnulae, have four different motions ; they
are moved both towards the naked Item, and towards the
pinnated ftem ; and fometimes they are drawn in very
much to the belly, a little after they are inclined to the
back; further, the flefhy filaments or claws move in all
directions, and the cylindrical part with the filaments is
either extended out or drawn in and hid in the fins.”

4. Pennatula filofa, the eye-fucker: ftem a little flefhy,
with a rib feathered on each fide, and furnifhed with two
filiform tentacula at the bafe. It inhabits the European
feas, and is from four to fix inches long.

Mr. Baker, author of Effays on the Microfcope, has de-
fcribed a worm which is faid to have been a mutilated
fpecimen of this fpecies. “I was lately prefented (he
fays) with a couple of fmall fea-infefts, by a gentleman,
who faid they were found fixed by the fnout to the eyes
offprats; that they are often obferved flicking there, and
may confequently be fuppofed to fuck their nourifhment
from thence. The length of this little creature, from end
to end, is near three inches, of which the head is about
one quarter-part. Its body is fomewhat thicker than a
hog’s briftle, and of a pleafant green colour. A gut feems
running through it, and terminates at the anus. The
iiead is light brown, twice the thicknefs of the body, and
of an oblong figure, tapering towards the fnout. It has
a pair of fine fmall black eyes, and a couple of holes, at
fome diftance forwards, which probably are its noftrils.
But the moft remarkable part of the head is its probofcis,
or fnout; which is nearly half its length,