m 
tarribus of authors, or night- mare, which is 
tkni i>t;ess placed erroneously among the dis- 
ctd: ts of the judgment, 
, 1 he former ot these is generally either con- 
P'mital, or induced by unknown causes ; it is 
perhaps principally curious, as it evinces the 
almost unlimited power ot one sense, when 
concentrated as it were, or employed to the 
exclusion ot the rest. Dr. Darwin relates 
tie ease of a gentleman who had lost his sight, 
entering his room, and immediately inform- 
ing 1dm of the length, breadth, and height of 
toe apartment, by the undivided exercise of 
Ls sense ot hearing; an accuracy which he 
tonid not have arrived at, had he retained 
f ie faculty of sight. In like manner the 
sleep-walker “ will unlock his door, wander 
Ur from home, avoid opposing obstacles, 
rod pass with satety over narrow bridges,” 
which during his waking hours he would have 
shunned as unable to accomplish. 
1 he incubus, or night-mare, appears to 
rrise from an interruption of the circulation 
ct blood through the lungs, from defective 
irritability in these organs, induced by fa- 
tigue, mental oppression, “ a full supper, 
aid wine;” which last, in some persons, will 
almost invariably induce the disease. 
/!/. AT. Temperance; especially moderate 
suppers. “ 'To sleep on a hard bed with the 
Lead raised.” Emetics. Purgatives of aloes 
and calomel. Tonics. Sleeping in a large 
ary apartment, and .without curtains to the 
tea. 
Class III. Cachexia. Cachexies. 
Previously to an acquaintance with the 
distinct structure and separate functions of 
the nervous system, before the important dis- 
covery ot the circulation of the blood, and 
tie more recent, but hardly less important, 
developement of the anatomy and physiology 
ct (lie secerning and absorbent vessels, the 
notions ot pathologists on the mode in which 
disease, local and general, is occasioned, 
were indistinct and erroneous. 
When, kor^ample, on the surface of the 
body appeared a peculiar eruption, which 
idler a certain time broke through the outer 
stin, and discharged an offensive matter, it 
was natural to infer that such discharge was 
engendered from a depraved condition of the 
solids or fluids of the living system, nearly in 
the same manner as exhalations proceed from 
dead and putrid animal or vegetable sub- 
stance, or as wort is formed in the fermenting 
vit. Hence the use of the_ terms bad habit 
o body, foulness of blood, peccancy of hu- 
nours, cachexies. 
These gross and indiscriminate opinions 
respecting the actual nature and immediate 
ciuse of disease, are now retained alone by 
tke vulgar; and as the nomenclature should 
keep pace with the advances of science, the 
word cachexy, as descriptive of those affec- 
tions we are now to notice, ought to be ba- 
nshed from the phraseology of the nosologist, 
aid a generic title substituted, indicative of 
dsordered or deranged action in the secern- 
iig, absorbing, and glandular organs. 
Order I. Marcores. 
A wasting of the body or general emacia- 
tim. 
Genus I> Tabes. Asthenia, emaciation, 
aid hectic. 
Genus II. Atrophia. Asthenia, and ema- 
cation without hectic. 
Dr. C ullen has properly distinguished the 
MEDICINE. 
emaciation connected in its origin with hectic 
lever, from that mdependunt of this as a pri- 
mary and essential character. The latter, 
however, or atrophia, should not appear in 
the last class of diseases. YV hen, for exam- 
ple, m consequence of mental affection, of 
sudden and too copious evacuation of any of 
the fluids, of deficiency in the quantity or de- 
pravation in the quality of the articles of 
diet, a loss of flesh and strength is perceiv- 
ed, the effect shall have been occasioned 
without any default in the absorbent vessels, 
and consequently without hectic ; for let it 
be retained in the recollection, as a principle 
of the utmost importance in practice, that 
"here hectic fever is present, a greater or 
less degree of derangement in the lymphatic 
vessels is likewise present. Hectic fever is a 
disease of the absorbent svstem. 
For the purpose of illustrating this dis- 
tinction between tabid and atrophic disorders, 
let two individuals be supposed equally ema- 
ciated and equally weak; but this weakness 
and emaciation in one shall have been in- 
duced by an indisposition to take a due quan- 
tity of nourishment, in order to supply the 
requisitions of the frame; in the other per- 
haps, notwithstanding the loss of bulk and of 
strength, an equal, or even greater quantity 
of aliment shall have been received into the 
stomach. Now, in this latter case, the tabid 
state has been occasioned by a torpid condi- 
tion or improper action of those vessels whose 
office it is to separate the nutritive part of 
the food, and convey it, properly prepar- 
ed, to the blood-vessels (see the article Di- 
gestion). In the former the mischief has 
proceeded from a want of those materials 
upon which these vessels exercise their func- 
tions. In the one the hectic flush from the 
very onset of the malady shall imprint the 
cheek ; in the other, hectic will not be occa- 
sioned until the absorbents, from not being 
properly exercised, come at length to be dis- 
ordered. The one complaint is the tabes of 
Dr. Cullen ; the other is the atrophia of the 
same author. 
We have been particular in pointing out 
this distinction, because it is not sufficiently 
noticed by writers in general, notwithstanding 
its extreme importance in practice ; and be- 
cause, by keeping it distinctly in view, we 
shall be enabled to reconcile the apparently 
contrary operation of those medicines which 
are employed with varied effect under dif- 
ferent circumstances of debility and emacia- 
tion. 
Steel, for instance, is one of those articles 
which, on account of their almost magic power 
over some diseases of debility, have been indis- 
criminately recommended in all; it has ac- 
quired the erroneous appellation of a tonic 
medicine, but as a tonic it often fails. 
Now let us trace its effects in the two spe- 
cies of emaciation just alluded to. In the 
first stage of atrophy its administration will 
be often followed by irritative action, in the 
place of due excitement; the attendant febrile 
heat (not hectic fever) will be augmented, 
costiveness and an arid skin will follow, and 
indeed all the symptoms of the malady be 
heightened and confirmed. 
In tabid diseases, on the other hand, the 
reverse effects will arise. Here the fever is 
hectic; and in the same degree that this va- 
luable medicine, when duly employed, had 
increased the febrile irritation in atrophia, it 
11 
will assuage the fever of tabes, end from the 
same cause, the stimulus which it imparts to 
the absorbent and lacteal vessels. 
How hectic fever originates, it is difficult 
to explain: its symptoms have been attribut- 
ed by a writer ol the present day to that 
overplus of excitement being expended upon 
toe aiterial, which is occasioned by the ciefi- 
cient excitability of the absorbent system. 
I ins, however, is rather a statement than an 
explanation ot its essence. The characteris- 
tics of hectic are principally the circumscrib- 
ed ledness on the cheek appearing more 
evidently once or twice in the course of the 
day, usually after meals, and alternating with 
a more than ordinary paleness of counte- 
nance; the pulse is feeble and quick ; like 
the crimson Hush of the cheek, it is accele- 
rated by anything received into the stomach; 
the urine is for the most part high-coloured, 
but deposits a bran-like sediment alter stand- 
ing for sometime; the tongue is not furred 
in the same manner as in fever in general, but 
is clean ; and often, as the disease advances, 
it increases in redness, the exact contrary to 
what is observed in genuine fever; the sweats 
are partial and irregular, and not attended 
with the same degree of temporary relief as 
in other- cases •; and, more especially ’in the ad- 
vanced periods ot tne complaint, principally 
break out about the neck, breast, arid shoul- 
ders ; as the disease proceeds, debility ami 
emaciation succeed, the legs and feet become 
oedematous, and (not however till nearly 
the fatal close of the malady on which the 
hectic depends) delirium at length super- 
venes. ■ 1 
dL. AT. In atrophia, a supply of nourish- 
ment, equivalent to the loss that may have 
been sustained ; if emaciation has " arisen 
from mental disturbance, the remedies must 
chiefly be made to apply to the mind. To- 
nics from the vegetable class, such as colorn- 
ba, quassia, and gentian ; not steel. Abate the 
febrile irritation, by keeping the bowels gently 
open by the milder purgatives, such as 
manna, senna, and castor oil. Preserve a 
slight moisture of the skin by small closes of 
antimonials. Regular and moderate, not 
violent or agitating, exercise. Shower-bath in 
very warm, tepid bathing in cold weather. 
Pure air. 
In tabes, or emaciation, accompanied bp 
primary hectic. An emetic, to accomplish 
the double purpose of forcibly expelling veil- 
tricular and intestinal acidities, and exciting 
the languid absorbents. Drastic purgatives, 
as jalap or aloes, with calomel, with the 
same intention. Steel, in conjunction with 
1 eruvian bark or bitters. Horse exercise. 
Warm bathing. 
N. B. I abes is for the most part symp- 
tomatic of other complaints, as of a disease of 
the lungs or the liver; and in such oases the 
treatment by which it is to be overcome is the 
treatment ot the original or radical-malady* 
Order II. Iniumescentia -, general swellings. 
Sect. I. Adiposx, Fatty swellings. 
Genus I. Polysarcia, obesity. This arises 
from the deposition of oil in the adipose mem- 
brane ‘becoming disproportionate to the re- 
quisitions ot the body. It proceeds in general 
from indolence and intemperance. 
M. AT. Temperance, exercise, less animal 
food, early rising. 
