■INFANCY. 
1 $ 
tity taken is apportioned to the age and 
constitution of the recipient, immediate, and 
temporary relief is perceptible. Worms are 
supposed to be expelled the system, and the 
infallible medicine is indiscriminately, and 
often fatally, circulated among the public. 
A further error with respect to the agency 
of calomel in mesenteric affections, is that of 
attributing its effects solely to its purgative 
quality. This last error is not confined to 
the unprofessional. Ill-founded notions, as 
we have above hinted, are still too general 
in regard to obstructing humours ; and the 
cure of this disorder, with all others which 
.are conjectured to arise' from obstruction, is 
consequently imagined to be performed by 
evacuating medicines. We are disposed to 
believe that a recent publication, although in 
the main extremely useful, has, by the un- 
qualified recommendation of purgatives, 
given too much encouragement to this mis- 
taken principle. 
Dr. Hamilton, the author of the work to 
which we allude, has classed, under the title 
of marasmus, the asthenic affections which 
are common to young persons, and of which 
the disorder now under consideration is one 
of the most genera! ; and these affections he 
“ is convinced have often been removed by 
the diligent exhibition of purgative medi- 
cines.” Now we are fully persuaded, al- 
though actual, and even repeated, purgations 
.are in many cases indispensable; that for the 
most part, especially in “ incipient maras- 
mus,” such a qualification in the dose of ca- 
thartics is to be preferred as may ensure an 
'■excitation of the glandular, lacteal, and lym- 
phatic organs (the organs principally con- 
cerned in the production of the complaints in 
question), without copious!) 1 evacuating the 
contents of the bowels. For this persuasion 
we have the authority of experience. Fur- 
ther, it is to be remarked, even where large 
and repeated evacuations, in these diseases of 
debility especially, have been followed by 
beneficial effects, that, even then, the evacua- 
tion itself has constituted but a share in the 
process of recovery. This principle may be 
evidenced imthe example of either vomiting 
or purging. Let a case be supposed of me- 
senteric affection carried to such an extent, 
that the torpid condition of the lacteal glands 
has extended itself to the hepatic and biliary 
organs ; where even dropsical effusions have 
taken place, and contributed to the enlarge- 
ment of the belly; and where this abdominal 
protuberance is contrasted, in a most dis- 
tressing degree, with the emaciation of the 
limbs. Under these circumstances, (and the 
writer of the present article has witnessed 
them in the full extent described), if either a 
quantity of ipgcacuana, emetic tartar, or any 
other emetic drug, is given sufficient to oc- 
casion vomiting, or such a dose of calomel as 
alone, or in combination, may produce a co- 
pious alvine discharge : the immediate result 
will prove, that the principal part of the medi- 
cinal agency has been constituted by a sud- 
den and powerful impulse communicated to 
the glandular and absorbent vessels. The 
liver shall commence a regular secretion of 
bile, the fieces in consequence assume a pro- 
per colour' and consistence, the skin shall 
•lose suddenly its sallow sickly hue, the size 
_of the abdomen be lessened, and even the 
swellings of the ancles be diminished ; ail 
evincing, in the most unequivocal manner, ' 
an increased action in the absorbent system. 
By those who are aware of the importance 
of acquiring correct notions in respect to me- 
dicinal agency, the above remarks, although 
perhaps in- some measure irregularly intro- 
duced, will not be deemed misplaced. They 
will, it is hoped, facilitate the conception, 
and serve to curtail the discussion, of -the re- 
maining disorders that are to be treated of in 
this article. 
We now recur to the more immediate sub • 
ject-of the present section. 
We have observed, that the first object of 
the physician, in cases of deeply rooted me- 
senteric disorder, is to produce an immediate 
and forcible excitement in the lacteal glands; 
the manner in which this object is to be at- 
tained may be gathered from the preceding 
remarks. Either calomel purgatives, or eme- 
tic substances, are to be employed, accord- 
ing to the circumstances of the case, or the 
inclination of the practitioner ; and now the 
judicious regulations of diet and regimen pre- 
scribed by Brown, are to be assisted by me- 
dicines, in order to accomplish the second 
purpose, that of preserving a due excitement 
to secure against the recurrence of the dis- 
ease. 
The physician will be careful to keep in 
view, that the absorbent system is principally 
concerned in this, as well as in the other as- 
thenia of infants. It is to this part of the 
frame that remedies are especially to be di- 
rected. Among the various stimuli, those 
therefore are to be preferred, the influence 
of which appears in an especial manner to 
be directed to this part of the organization. 
Clialybeates have this property in a remark- 
able degree ; and accordingly one or other 
of the various preparations of steel has been 
judiciously and successfully had recourse to 
in tabes mesenteriea : these are to be con- 
joined with pure air, and due exercise, with- 
out which the most appropriate medicines 
will be in vain administered. The continued 
use ot small doses of calomel, or other mer- 
curial preparations, either in conjunction 
with, and sometimes to the exclusion of, 
steel, will prove highly useful in restoring a 
due energy and action to the absorbents, 
"these, like all other active medic finals, re- 
quire much address and discrimination in 
their employment. It is from the presence 
of mercury, as above hinted, that both the 
utility and dangerous tendency of quack me- 
dicines are for the most part derived. 
In the practice of the writer of this article, 
extremely small, and very gradually aug- 
mented, doses of digitalis have appeared to 
restore, in a remarkable degree, the wonted 
vigour of the lacteal vessels. The free use of 
this very important and active medicine lias 
long been admitted in dropsy, an affection of 
the highest debility. In tabes mesenteriea 
we believe its employment is novel; but we 
are, at the same time, persuaded, from the 
result of several cases ot this and other modi- 
fications of infantile asthenia, that foxglove 
might be made, under due regulation, a very 
successful agent in the treatment of these 
complaints. Under these circumstances, on 
account ot the comparative minuteness of the 
dose, the digitalis is best given in the form of 
tincture: a preparation which has r.ot hither- 
to been received into the London Pharnia- 
£ 
copeia.'See Materia Medic a, and Phar- 
macy. 
Sect. II.— Hater in the head. (Hydroce- 
phalus.) 
The discriminating characters of this dis- 
ease demand assiduous attention from the 
medical practitioner, it cannot be doubted 
that a great number of children are con- 
stantly destroyed by water in the brain, v here 
the nature of the malady has been entirely 
misunderstood, and the symptoms referred to 
•other sources, most commonly worms ; while, 
on the other hand, hydrocephalus has been 
very frequently suspected, and the event has 
proved that the suspicion was destitute of any 
proper, foundation. 
Hydrocephalus is generally divided by au- 
thors into the internal, or that in which the 
fluid is contained in the ventricles of the 
brain ; and external, where the disease is ex- 
terior to the substance of this organ, and the 
water is found in its investing 'membranes. 
I iie first species has likewise been denomi- 
nated acute, the second chronic. This divi- 
sion, however* is calculated to mislead ; not 
merely on account of the frequent connec- 
tion between the two species (internal and 
external) of hydrocephalus, . but because the 
former, as well as the latter, is oftentimes 
chronic, and by no means necessarily pre- 
ceded by an inflammatory affection of the 
par ts concerned in its production. 
The chronic internal, chronic external, and 
the acute, species of hydrocephalus, would 
constitute a classification of the disease, ap- 
proaching nearer to accuracy than that which 
has been hitherto adopted ; and we shall pro- 
ceed to give a brief description of each, re- 
questing the reader to recollect that the dif- 
ferent kinds are often mixed, and conse- 
quently exhibit characters in an almost end- 
less variety. 
Chronic internal — This, although over- 
looked in the ordinary division, is perhaps the 
most usual form in which tire affection pre- 
sents itself; it arises from the same disposi- 
tion in the habit, and is ofteivtim.es combined 
with the disease treated of in the preceding 
section. More commonly, however, if. is in 
a manner vicarious of this last; and the same 
causes may, perhaps from accidental ci; nun- 
stances, at one time occasion tabes mesente- 
riea, which would at another have produced 
hydrocephalus. Its symptoms are less de- 
cided than those oft{ie' other species. When, 
how ever, in children of a sluggish habit, or 
scrophiilous constitution, an unusual drowsi- 
ness or stupor is present, the child gradually 
loses his vivacity and spirits, is indisposed 
to make any exertion ot his limbs, is unu- 
sually fretful and peevish, complains or exhi- 
bits signs of an uneasiness in the head, is af- 
fected with convulsive fits without any appa- 
rent cause, has an unusually tardy pulse, and 
more especially if the pupil of the eye is not 
round to contract upon the application of 
light, there is reason to suspect the presence 
of water in the brain, although there may be no 
symptoms of external disease, and no preter- 
natural enlargement of the head, except w hat 
is usually met with in young persons of a tor- 
pid scrophulous habit ; and the suspicion has 
been too often confirmed by dissection, even 
where a fatal termination has happened, with- 
out being preceded, during any period of the 
mak.dy, by the symptoms immediately to be 
