576 PRACTICE OF PHYSIC. 



toms which attend, the ascites may be considered as the primary 

 disease ; and therefore, that this combination does not exhibit a 

 proper species of the tympanites. 



MDCXXIX. As this last is not a proper species, and as 

 some of the others are not only extremely rare, but even, 

 when occurring, are neither primary, nor to be easily distin- 

 guished, nor, as considered in themselves, admitting of any cure, 

 I shall here take no further notice of them, confining myself in 

 what follows, to the consideration of the most frequent case, 

 and almost the only object of practice, the tympanites intesti- 

 nalis. 



MDCXXX. With respect to this, I cannot perceive that it 

 arises in any peculiar temperament, or depends upon any pre- 

 disposition, which can be discerned. It occurs in either sex, at 

 every age, and frequently in young persons. 



MDCXXXI. Various remote causes of it have been assign- 

 ed ; but many of these have not commonly the effect of pro- 

 ducing this disease ; and although some of them have been truly 

 antecedents of it, I can in few instances discover the manner in 

 which they produce the disease, and therefore cannot certainly 

 ascertain them to have been causes of it. 



MDCXXXII. The phenomena of this disease in its several 

 stages are the following : 



The tumour of the belly sometimes grows very quickly to a 

 considerable degree, and seldom in the slow manner the ascites 

 commonly comes on. In some cases, however, the tympanites 

 comes on gradually, and is introduced by an unusual flatulency 

 of the stomach and intestines, with frequent borborygmi, 

 and an uncommonly frequent expulsion of air upwards and 

 downwards. This state is also frequently attended with colic 

 pains, especially felt about the navel, and upon the sides to- 

 wards the back ; but generally, as the disease advances, these 

 pains become less considerable. As the disease advances, there 

 is a pretty constant desire to discharge air, but it is accomplish- 

 ed with difficulty; and when obtained, although it gives some 

 relief from the sense of distention, this relief is commonly tran- 

 sient and of short duration. While the disease is coming on, 

 some inequality of tumour and tension may be perceived in dif- 

 ferent parts of the belly ; but the distention soon becomes equal 



