INFANCY. 
limbs sprawls at pleasure. The new element 
in which he is to live is not entered with pain 
and tears. Daily bathed beneath his mo- 
ther’s eye he grows apace. Free to act he 
tries his coming powers ; rolls, crawls,, rises, 
and, should he fall, cannot much hurt himself 
©n the carpet or mat that covers the floor.” 
PART II. 
DISEASES OF INFANCY. 
Sec. I. — Mesenteric atrophy (Tabes mesen- 
terica. Atrophia infantilis). 
This is, in a great measure, the origin and 
root of the major part of infantile diseases. 
An affection of the mesenteric glands in chil- 
i; dren is often connected with, is no! unusually 
; the occasion of. and is still more frequently 
| mistaken tor, worms ; it is the medium 
through which rickets are produced; it is, in 
| general, the more immediate cause of diarr- 
| hceas, and other bowel complaints ; and in 
I several instances has been the “forerunner, 
if not the cause, of hydrocephalus, or dropsy 
in the brain.” 
Than this no complaint bears more evident 
characters. Tiie physician who has been ac- 
i customed to the general aspect ot infantile 
disorders, will most commonly commence 
his enquiries by an inspection ot the abdo- 
men. it lie perceives a fulness and tenseness 
about the rusvel, and a general protuberance 
, and hardness about the belly, attended some- 
| times with a knotty irregularity, indicating 
glandular tumefaction ; and if, combined 
I with this symptom, a tendency to atrophy, 
or, as it is called, falling away in flesh and 
if strength, is observed ; a greater or inferior de- 
gree of mesenteric consumption is present. 
Such then are the never-failing attendants ol 
j the disorder now under notice; they are its 
i distinct and prominent features. A variety, 
I however, of other adjunctive symptoms, for 
the most part, display themselves, and con- 
stitute part of the malady. Sometimes an 
universal languor and lisflessness will be con- 
nected with avexsion to food ; at others an 
inordinate appetite is present. The bowels 
are at times costive, but at others the con- 
trary ; the evacuations are discoloured, and 
unhealthy in their appearance ; they are, for 
the most part, slimy, or viscid in their con- 
sistence, but are discharged, both with re- 
spect to quantity and quality, with the utmost 
irregularity : the countenance is pale, “ ex- 
cept when the hectic flush prints its deceitful 
and ill-omened animation on the cheek :” the 
features are, for the most part, full and tumid : 
the eye is dull: the breathing is oppres-ed, 
and spasmodic : the pulse is invariably feeble, 
but is sometimes slow, and at others inordi- 
nately accelerated. In the advanced stages 
swellings of the feet and ancles are sometimes 
observed. The little sufferer generally moans 
piteously ; and this, if the disorder has ar- 
rived to any considerable extent, is almost 
the only sign which is given of consciousness 
or feeling. 
Causes. — Mesenteric atrophy is most pre- 
valent among the children of the poor, espe- 
cially in large cities, and in dirty confined 
situations. “ The noxious powers producing 
it,” in the language of Dr. Brown, (see 
Brunonian System, vol. I. p. 274) “arethe 
same with those of every other asthenia. 
They are want of food, or diet of watery 
matter and bread; cold and moisture, the 
li 
latter increasing the effects of the former ; too 
little nursing (gestationis justo minus) ; ha- 
bitual vomiting and purging ; irregularities in 
the times of sleep, meals, and every other 
part of infantile management; filth; impure 
air ; an inattention to the instincts of nature 
in the treatment of children.” Elementa Me- 
dicine. To these causes Dr. Brown ought 
to have added the practice of giving children 
fermented or spirituous liquors, and those 
other artificial stimuli, to which we have re- 
ferred in the former part of the present es- 
say. This custom is extremely prevalent in 
the inferior classes of society ; and hence, in 
part, the frequency of mesenteric atrophy 
among the offspring of the poor. 
Immediate cause of, and constitutions most 
obnoxious to, mesenteric consumptions . — 
The unusual bulk of the abdomen, which is 
so characteristic of this disease, obviously de- 
pends upon a deranged state of the mesenteric 
glands. The tumefaction, however, does 
not arise from the source to which it is vul- 
garly referred, “ the presence of tough, ropy 
humours, causing an obstruction in the tume- 
fied parts.” The theory of mechanical ob- 
struction is indeed totally founded in error. 
It is inconsistent with the laws of the animal 
economy. It is incompatible with living ac- 
tion ; and, as we shall immediately have 
occasion to observe, has been the cause of 
much and serious mischief, both in the do- 
mestic, and even the professional treatment, 
of this and other ailments. “ The idea of at- 
tenuating humours, purifying blood, and 
clearing passages, rests upon a wrong prin- 
ciple.” So far indeed from the glands of the 
mesentery being less permeable under dis- 
ease than when in a state of health, the exact 
contrary is the fact ; and not only is their 
area enlarged, but new vessels are olten at 
tiie same time formed ; and hence the morbid 
increase of bulk. 
The attendant atrophy is easy of explana- 
tion. The deranged action of the glands in 
question interferes with the due preparation 
of the chyle, the whole of which has to un- 
dergo a preparation in these organs. The, 
chyle is the fluid from which the blood is 
formed : on the quantity and quality of the 
blood depend health, growth, and life ; by 
its deficiency, or want of due proportion in 
its component principles, debility, disease, 
and atrophy, are produced. 
The attendant symptoms are not difficult 
to account for ; the torpid and irregular state 
of the bowels is partly owing to the general 
inactivity in the lymphatics of the liver ; 
hence the thinner portions of the bile remain 
unabsorbed, and this fluid is in cousequence 
too diluted to afford a due excitation to the in- 
testinal fibre. The sliminess and viscidity of 
the feces arise from the disordered state of 
the glands of the intestines; and the cedema- 
tous swellings of the feet are evidences of a 
general inactivity, or deficient excitement, 
pervading tiie whole lymphatic system. 
The constitutions in which tabes mesente- 
rica most readily makes its appearance, are 
those which are denominated scropluilous. 
The marks of scrophula we shall not here 
enumerate ; it may be sufficient to observe, 
that in habits of this description the lympha- 
tic and glandular systems are especially prone 
to suffer from the exciting causes of disease. 
This indeed is more or less the case in every 
individual during growth, as, at this period of 
15 
existence, the office which these vessels per- 
form in the animal economy, is more im- 
portant and complicated than in the succeed- 
ing stages of life. 
Treatment . — The most effectual remedies 
are necessarily the converse ot those which 
occasioned the disease. These we shall like- 
wise enumerate from the Elements ot Dr. 
Brown : “ nourishing exciting milk ; three or 
four meals in the course of the day, composed 
chiefly of warm milk; pure animal, and by ru» 
means weak, soups, mixed with wheaten flour 
or bread ; a due temperature, so that a ge- 
nial w armth may be preserved, without pro- 
ducing irritation, or occasioning too copious 
sweat; avoiding every species ot evacuation ; 
good nursing; a proper regulation of the 
times of sleep, food, and every other circum- 
stance connected with the management of the 
susceptible and tender condition of infancy ; 
cleanliness; tepid bathing in moderately cold 
weather, and cold bathing in warm ; pure air ; 
being sent out of doors as much as possible, 
excepting when the w eather is damp ; and, 
finallv, a judicious attention to desires and 
propensities ; this ought to be carried to such 
an extent as to obviate, ir possible, the most 
trifling local irritation, as by the scratching of 
a part that itches.” 
The above are necessarily adapted to the 
milder forms of the complaint. When the 
disorder has arrived to a certain extent, me- 
dicinal is now required in aid of domestic 
treatment : for although the mesenteric atro- 
phy, unless it is a consequence of tie'ective 
structure, may at all times be prevented, and 
in its earlier stages with facility combated, 
without the aid ©f drugs ; these, at length, 
come to be absolutely indispensable. It 
ought, however, to be impressed on the pub- 
lic mind, that pharmacy, although it may 
correct the errors, can in no wise become a 
substitute for, or supply the deficiencies of, 
regimen. 
The objects of the medical practitioner, in 
the treatment of the disease in question, will 
be twofold. 1st. That of immediately and 
forcibly stimulating the lacteals and mesen- 
teric glands ; and, 2dly, the preservation of 
a due and equable excitement in order to 
obviate the recurrence of the disorder. 
[N. B. For the explanation of any terms 
that may not be familiar, the reader is re- 
ferred to the articles Anatomy, Physio- 
logy, and Medicine.] 
The first of the above intentions is most 
speedily and effectually accomplished by 
mercurial purgatives ; and of these calomel 
(submurias hydrargyri) is generally to be 
preferred. The benefit which has often re- 
sulted from preparations of mercury, parti- 
cularly in the form of calomel, has frequent- 
ly been accounted for upon very erroneous 
principles. It is customary to attribute every 
complaint of childhood, where the stomach 
and intestines shew marks of derangement, 
to worms. Writh the signs of the actual ex- 
istence of these animalcufe, we have already 
remarked those of tabes mesenterica are, 
from their affinity, often confounded. Ad- 
vertisements of infallible cures for worms, as 
indeed for every other malady, are constant- 
ly before the public: these, for the most 
part, contain mercury, as the only agent of 
consequence in their composition ; and from 
the operation of this medicine upon the dis- 
eased glands, provided, by accident, the quan- 
