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vitiated quality; thus occasion of the chronic diseases of the ing a continued difficulty of heart originate in this way, breathing, with constant cough, namely, in diseased lungs. vulgarly termed asthma, and General anasarca, first nothat fluctuates in point of se- ticed about the ankles, is also verity with season and wea- frequently induced by the same ther. The affection of the cause,inflammation of the parts pleura, in its turn, gives rise within the chest, impeding, by to adhesion and serous accu- pressure, or by the extension mulation in the cavity of the of inflammation to the great chest. While the continued trunks of the absorbing sysor frequentlyrepeated attacks tem, the free discharge of of inflammation, however lymph into the veins. Many slight, in the lungs themselves, of these cases of dropsy, if gradually, induce an alteration early attended to, and treated of structure in these parts, by moderate and repeated which, by slow degrees, de- bloodletting, and other antiphlogenerates into pulmonary con- gistic measures, admit of cure, sumption, a disease which we by the removal of the cause ; shall soon have to notice. whereas, if treated in a differ
Nor is this the whole of the ent way, by stimulants and the mischief that results from like, they soon terminate faslight and neglected inflamma- tally, tion in the pulmonary organs. The resistance the heart en
From this case of disease, and macounters in its endeavors to ny like it, the reflecting reader will propel the blood through the perceive the propriety of 'sending lungs in the diseased state of early for medical aid. In many disthese
eases, whether acute or insidious, becomes a source organs, of irritation to the heart, that cessful
, must be done early. Success
whatever is attempted, to be sucat length terminates in actual will also often depend on the trandisease, such as morbid en- quillity of the patient, and his strict largement or other change of compliance with the means devised, structure, either in the heart and directions given, for his relief. itself or the large vessels con- This, too, is one of the multitude of nected with it, attended of ne- diseases which so frequently arise cessity with disordered action, from inattention to the common discoverable in the pulse, and causes of catarrh, as too light clothwhich is productive of the ing io damp, chilly and cold weather, greatest possible distress to .-wet feet, and various habits more the patient, and not unfre or less repugoant to health, consistquently a sudden and fatal ter- ing a good deal in a neglect of those mination. A great proportion expedients which invigorate the sys
tem, and which would enable it to all desire to eat was removed, but a surmount the common influences of degree of disgust was excited by see. atmospheric changes.
ing others eat. · He, however, was We shall have occasion to return prevailed on to take a little bread
and milk, which in a very short time to this subject hereafter.
ran into the acetous fermentation, as
indicated by flatolence and acid erucRELATIONS OF THE DIGESTIVE FUNCTIONS tation. I do not mean to deny that WITH OUR SENSATIONS.
the presence of a portion of gastric Hunger. When the stomach is in juice may not contribute to the sea. a healthy condition, and has remain- sation of hunger; but I feel more ed for some time empty, the well- disposed to refer the phenomenon to koown seosation of hunger is produc- an energetic state of the gastric ed; to accouot for which, various nerves, occasioned by an interval of hypotheses have been devised. Some inactivity, during which their vital have attributed its origin to the fric- powers may be supposed to accumution of the sides of the stomach on late. With respect to the actual each other, or to the dragging of the quantity of gastric fluid in an empty liver on the diaphragm ; others to stomach, we know little or nothing. the action of bile or acid vapors on It seems probable that it is supplied the stomach; to the compression of during digestion, and that its secrethe nerves, or to the fatigue of the tion corresponds with the nature and contracted fibres of the stomach : but quantity of the ingesla. If a parcotic Buch theories are subverled by the be applied to the nerves, their powfact, that the stomach may remain er is paralyzed, and the sensation of empty for a long interval, during hunger ceases ; such an effect is prodisease, without any sensation of duced by the juice of tobacco, though hunger; and that when present, it by long habit the stomach may be. may cease or be allayed by various come indifferent to its operation. causes, though food should not baye Whenever the Indians of Asia and been taken; as often happens after America undertake a long journey, the accustomed period of repast is and are likely to be destitule of proover, or from the sudden communi- visions, they mix the juice of tobacco cation of news that overwhelms us with powdered shells, in the form of with grief or disappointment. The small balls, which they retain in their physiologists of the present day at- moutbs, the gradual solution of which tribute the phenomenon to the stim. serves to counteract the uneasy cravulant action of the gastric juice op-ing of the stomach. In like manner the nerves of the stomach; and to we may explain the operation of support this opinion, Dr Wilson Phil. spirit in taking away the appetite of ip relates the followiog experiment. those who are not accustomed to it; A person in good bealth was pre- while 'Those who indulge the habit vailed on to abstain from eating for receive its stimulant without its parmore than twentyfour hours, and cotic impression. during this interval to increase the Natural appetite, which is oply appetite by more than ordinary ex- the first degree of hunger, never apercise. At the end of this time he pears to recur till the aliment prewas extremely hungry; but, instead viously introduced has been duly as. of eating, be excited vomiting by similated. It cannot, therefore, strictdrinking warm water, and irritating ly speaking, be said to have an imthe fauces. The water returned mediate reference to the state of the mixed only with a ropy fluid, such stomach; for though all the chyme as the gastric juice is described to may long since bave passed out of be. After this operation, not only this organ, if any delay occurs in its
2. Difficult Respiration of a quence unable to receive the continued kind.—The breath- venous blood coming from difing is short and laborious, often ferent parts of the system; and with wheezing. This
This symp- thus a general stagnation of tom is occasioned by the prese circulation takes place in a sure made by the swelled por- greater or less degree, and action of lung on the aircells counts for the tumid and bloatand minute ramifications of the ed state of the face and extrebronchia, impeding thus the mities. The brain, from its admission of air into the lungs. proximity to the heart, is like
3. A livid hue of the skin in ly to suffer most from the imvarious parts, especially of the pediment to the return of blood cheeks, lips, and nails. This to the heart; and hence stuarises from the blood not hav- por, and not unfrequently deing undergone the necessary lirium, ensue. Something may changes in the lungs, owing to doubtless be astributed here the imperfect admission of the to the dark or venous characair in breathing. And as ani- ter of the blood itself, by which mal heat depends in a great it is less fitted to excite the measure on respiration, this brain, and other organs of the being imperfectly performed, body, whence the general torcoldness of the extremities like- por and inaction observed. wise takes place.
In severe cases of peripneu4. The same pressure which mony, the tongue assumes a acts on the airvessels, influ- brown hue, similar to what is ences also the bloodvessels of observed in low fever; and this the lungs, namely, the minute probably from the same cause, branches of the pulmonary ar- the oppressed condition of the tery and veins. The blood in brain. The thicker and darkconsequence is impeded in its er the crust on the tongue is in passage from the right to the these cases, the greater in gen left side of the heart, which is eral is the danger of the disease. thus deprived of its due and There is often no cough, regular supply of blood. The because the mucous membrane pulse in consequence is gene- is not always or generally afrally small, soft
, and feeble, fected, When cough does ocand sometimes irregular. cur, however, there is not
5. The obstructed state of much expectoration at first, the pulmonary artery leads to and the expectoration is often a gorged state of the right side of a brown or sanious appearof the heart, which cannot suf- ance; sometimes it is bloody, ficiently empty itself of its but the blood is rather of a blood.' It becomies in conse- dark than a florid hue.
The history I have now mica. The approach of this given, you are to consider as may be suspected from the an extreme case of the dis- continuance of the oppressed ease, and as it appears in its state of breathing, after the most simple and uncombined pain and febrile symptoms form, In most cases, it is a have declined. Occasional much milder disease than I shivering fits, also, indicate aphave now stated, and is most proaching suppuration. The frequently accompanied with abscess commonly bursts into more or less of inflammation the bronchia, when the matter of both the investing mem- is brought up by coughing. brane, the pleura, and of the Sometimes, though rarely, it mucous membrane, or that penetrates through the pleuwhich lines the bronchia.- ra, into the cavity of the chest, Hence the pain, and cough, and then constitutes what is and expectoration, that so come called empyema, that is, a colmonly are found in combina- lection of purulent fluid in the tion with the other symptoms. thorax. In many instances,
Progress and Terminations. the lungs adhering to the ribs, -The progress of inflamma- the matter makes its
betion of the lungs is according tween these, and is discharged to the violence of the disease at the skin, often very remote and the age of the patient. In from the opening into the infants, it often runs its course, chest. Patients occasionally and
proves fatal in little more recover under all these cirthan eight and forty hours ; cumstances, though slowly, and and the same is the case in after a long period. very old subjects.
4th, by hemoptysis. This Peripneumony terminates in occurring early in the disease, various ways; as, 1st, by reso- tends powerfully to take off lution, as it is called; that is, the inflammation, though, in by simply subsiding, without itself, it is not unattended with even expectoration or other danger. obvious change: 2d, More fre 5th, by deposition of blood quently it terminates in cough- or serum, or both, into the ing and expectoration. The cellular texture of the lungs, more early this takes place, and that to such a degree as and the more copious and easy to occasion suffocation. When the discharge of mueus be- the disease proves fatal in this comes, the more likely is the way, the lungs, on being cut disease to terminate favorably. into after death, resemble the
3d, by abscess, commonly liver in color; and hence have though needlessly-termed vo- been said to be hepatized. This
is a very upwarrantable use of and this often to a great exlanguage, as it tends to excite tent, the patient in many cases ideas that are without founda- requiring to be bled, once, or tion. Modern writers have a oftener, daily, according to the great deal of this sort to an- severity of the symptoms, for swer for,
many days in succession, till 6th, by apoplexy.—The im- either the disease gives way, pediment given to the return or the strength will no longer of blood from the head, and allow of this evacuation. Of which is evident in the bloat- this, you are to judge chiefly ed state of the face, the red, by the pulse. In proportion and starting, and suifused apo as this declines in strength and pearance of the eyes, and the fulness, you are to be cautious turgid state of the jugular in abstracting blood. You must veins, not only induces stupor, be aware, however, that the the effect of mere stagnation, pulse in this disease is not but becomes also, in some cases, wholly or exelusively to be a cause of irritation to the ar- trusted to; for, owing to the teries of the brain, urging blood retaining its venous charthem to an increase of propul acter, and thereby not stimusive action, and consequentlating the heart and arteries rupture and extravasation of sufficiently; and partly, also, blood.
to the imperfect transmission Prognosis.--The chief dan- of the blood through the pulger in peripneumony, arises monary artery; the pulse at the from the impeded respira- wrist may be weak and small, tion, and the interruption given though the general strength to the passage of the blood be still unimpaired. In such through the lungs. · The un- cases, you must judge of the favorable symptoms are, the general strength from other livid hue of the skin, with cold- circumstances, such as the duness of the extreme parts ; a ration of the disease, the quanfeeble and irregular pulse ; tity of blood already lost, and and the occurrence of stupor the state of the patient immeor delirium. A thickly coated diately previous to the attack. brown and dry tongue, also in In the advanced stage of the dicates danger.
disease, when the skin is livid, Treatment. The common the extremities cold, pulse feeremedies for inflammation are ble and irregular, and the all that are required in this tongue of a dark brown color, case. Bloodletting, commenced bloodletting is hardly admissiat an early stage of the dis-. ble, though we may ease, is particularly necessary, vinced the inflammation is still