B I L 



B I L 



"pn'th gum arable, and other vejretable demulcents. In 

 rhefe cafes, the fame author has found a tepid bath, of 

 90 degrees of Fahrenheit, to produce manifeft good etfcfts. 



2. OlJlniB'ion of B tie. After it is fccreted, the bile is 

 fometimcs prevented from pafTip.g into the duodenum. This 

 may happen from various caiifes ; viz. from an obliteration 

 of the cavities of the biliarv dufts, either by a thickening 

 of their coats, or by a tuberculous ftate of the hver, the 

 confequences of inflammation ; from prcfTurt produced by 

 enlargements of the neighbouring parts ; and from a too 

 vifcid and confident (late of the bile itfelf ; but, more than 

 all, from gall-flones impaftcd in the common duft. When- 

 ever in any of thefe ways, the biie, after being fecreted, is 

 hindered from pafling into the duodenum, it is either taken 

 into the cirtuliting fyftem by v?hat is termed regurgitation, 

 or by abforption ; producing great laiigour and oppreflion, 

 together with a yellownefs of the fiiin, and tunica conjunftiva 

 of the eves, &c. i. c. giving rife to jaundice. (See Gall- 

 Stones and Jaundice.) The tieatmeiit mull be varied, 

 according to the variety of conditions on which the obtlruc- 

 tion depends. In this place, it will be fufiicient to remark, 

 that fahne purgatives, mercurials, fapoimceous and alkaline 

 medicines, with tepid dilutioi:, and warm bathing, will be 

 fou;id fuited to the ma'iority of thefc cafes. 



3. Excefs, or redundancy of Bile, is a morbid affeftion, of 

 very frequent occurrence. Among its exciting caufcs may 

 be mentioned intemperance of living, the fummerand autum- 

 nal heats of our own latitudes, and more efpecially the 

 high t-mpcraturcs of the tropical climates; in a word, 

 whatever produces a hurried circulation, or irritates the vaf- 

 cnlar and f^crctiiig fyftem of the liver. A redundancy of 

 bile makes itfelf known by " a general languor of the body, 

 together with naufea, foul tongue, lofs of appetite, and in- 

 digellion : or, by being direftcd to the inteflines, excites 

 a painful diarrhoea, ultimatdv tending to weaken their tone, 

 and diihirb their regular perillaltic motion. It generally 

 happens, that, during the excefs and prevalence of bile in 

 the iirit pafTages, fome abforption of it takes place into the 

 habit, fo that the flciii becomes yellow, and the urine is fen- 

 fibly impregnated with it. The puUe is quicker than natu- 

 ral, and there is a confiderable degree of thirft, with an in- 

 create of heal ; the ufual fymploms of fever. The body 

 becomes emaciated, and the general afpefl of the patient is 

 extremely unhealthy." It may be added, that moft of the 

 fevers of hot climates, whether intermittent, remittent, or 

 continued are accompanied by an an overflow of bile. (See 

 Fevers.) When the increafed fecretion of bile affetls the 

 flomach and bowels in fuch manner as to excite both vomit- 

 ing and purging to a violent degree, it gives rife to that 

 form of difeafe which is termed cholera ; of which a particu- 

 lar defcription will be found under that title ; when it pro- 

 duces vomiting, joined with conftipation and acute pains 

 about the umbilical region, the difeafe i:i termed iilious colic 

 (fee Colic); andlaftlv. when the evacuation of bile is frequent 

 and copious by ftool only, without frequent vomiting, it 

 con{{\ti\ti:s iiHotis diarrljiei:. (See Diarrhoea. ) It is the 

 remark of that judicious writer to whofe work we have more 

 than once referred in this account of bilious diforders, that 

 it is more difBcult to fupply a deficiency of bile, than to 

 carry off its excefs. In taft, little more is required for the 

 fulfilment of this laft intention, than to promote the dif- 

 charge of the redundant bile by gentle faline cvacuants, (for 

 the bile has generally of iticll a purgative tendency), and to 

 prevent frefh accumulations, by diluting freely with water 

 heated to a proper temperature. For this purpofe, the pa- 

 tient fhould drink every morning (accordine to the excellent 

 (ILrtttioiiS of Dr, Saun krs), from half a pi;it to a pint of 



water, of a temperature from 90' to 114° of Fahrerhtit'* 

 thermometer, and ufe moderate exercife before breakfafl. 

 With the fame view, the Balh and Buxton waters, (pro- 

 vidcd their ufe be not contra-indicated by vifceral difeafe), 

 and the Cheltenham water alfo may be recommended. At 

 the fame time, a proper diet fhould be prcfcribed, confifting 

 of food that is eafy of digcflion, not over-ttimiilating, and 

 free from flatulency ; and fpirituous drinks and malt liquors 

 (hould be forbidden. Pallry is particularly improper. Water, 

 or vvine and water, will be the bed beverage. When the 

 bile has been fufficiently evacuated, b'tters and chaKbeates 

 may be given with advacitage. But where thefc complaints 

 are the confequsnce of refiding in the tropical regions, the 

 only eSeilual remedy is to remove to a temperate climate. 

 People, who have fuffered in thefe rtfpcdts from the heat of 

 climate, and to whom it is neccflary to return to this coun- 

 try for the recovery of their health, (hould endeavour (as 

 Dr. Lind has fuggefted), to arrive in the beginnin-r of fum- 

 mcr, as they will find the winters of Great Britain, on their 

 tirR arrival, too piercing and fevere for their conititutions. 



4. Vitinfion of the Bile. In alm.oll all cafes wherein the 

 fecretion of bile exceeds the natural quantity, it is at the 

 fame time vitiated in its quality. Thus in bilious fevers, 

 bilious diarrhoeas, bilious colic, and cholera morbus, it is 

 often vitiated both iii colour and tafte, appearing wholly of 

 a pure green colour, and poffeffing a lliarpnefs or aciditv 

 which fets the teeth on edge, and produces a burning and 

 corroding f.-nfation in the llo-nach, cefophagus and fauces, 

 and at the lame time vio'ent twitchings in the intediual canai. 

 Such vitiations of the bile are common to mfents, as well as 

 to adults. The remedial treatment confills in evacuating 

 the offending bile by the means fpecilied under the preced- 

 ing divifion (3), and correcting its vitiated qualities by the 

 employment of .alkalies, and by copious dilution with aque- 

 ous and mucilaginous liquors. After due evacuations, the 

 ftomach and bowels may be protefted Irom the irritating 

 aftion of the remaining bile by opiate medicines. Lind, 

 Clark, Winterbbttom, and other writers on the difeafes of 

 hot climates, may be referred to for manv excellent obfer- 

 vations on bilious diforders ; but the bell and mod compre- 

 henfive treatife on this fubjeft is that of Dr. Saunders. 



BILEDGIK, in Geography, a town of Afiatic Turkey, 

 in the province of Natolia, 32 miles N. AV. of Eiki-Shehr. 



BILEDULGERID, a country of Africa, comprehend- 

 ing, according to fome geographers, the fouthern part of 

 Algiers, together with the whole tract of land that lies in 

 this direction between the Atlantic ocean and Egypi, and 

 in this extent, including eight large tratls or provinces, viz. 

 Barca, Biledulgerid proper, Segelmeffa, or Sijilmiff?, Tafilet, 

 Tigoarin, Zeb or Zab, Darka or Darah, andTcfltl, befides 

 feveral inferior diih-i6ts, mentioned underthenames of Oguela, 

 or Augela, FalTan or Fezzan, and Gudainis or Gadamis, &c. 

 It was known to the ancients under the name of Numidia. 

 But in a more co'^tined and proper fenie, according to the' 

 arrangement of De Lifle, ar.d feveral modern geographers,. 

 Biledulgerid includes that traft of land which lies louth of- 

 Algiers and Tunis, and is bounded on the call by a ridge 

 of lofty mountains, which feparates it from Tripoli and part 

 of Gadamis, on the welt by the counti ies of Zab and Mezzab, 

 and on the fouth by the province of Verghela, or W'ergela. 

 Its dimenfions are not accurately afctrtamed ; but it is 

 fomewhat of a fquare form, luppofed to extend about 60 

 or 80 leagues, every way, or from about 31'' 15' to 34^^ le'. 

 N. lat. ; and from 5*^ 30' to 10° E. long. Some have 

 derived the appellation Biledulgerid from Behd el jerid, or 

 the "land of dates," under which denomination it is diilin- 

 guidicd in Rtnnell's map of North Africa ; but others, with. 



Dr. 



