MEDICINE. 
J54 
dropsical from this cause can never expect 
again to enjoy the pleasures of existence in 
full measure.” (Beddoes.) 
Genus V. Ascites. Dropsy of the ab- 
domen. 
The swelling of the abdomen is tense, 
scarcely elastic, but fluctuating; the fluctu- 
ation can sometimes be perceived by spread- 
ing one hand on one side of the abdomen, and 
striking with the other hand on the opposite 
side. Ascites is attended with scarcity of 
urine, thirst, and after some time a degree of 
hectic fever. 
Ascites most usually originates through 
tire medium of a diseased liver; and such dis- 
ease is, in the greater number of instances, 
itself induced bv intemperance in spirituous 
liquors. Like the disease, however, of the 
lungs preceding dropsy in the chest, liver 
complaints productive of -ascites, may be 
brought on by the precipitate application of 
cold succeeding to the extremes of heat, by 
indolence, mental affections, and other causes. 
Ast rites sometimes originates from debility in 
the abdominal lymphatics, without the inter- 
vention of any hepatic disease. 1 
d/. M. Ascertain by enquiry into previous 
and present symptoms, whether any degree 
of liver complaint has preceded the drop- 
sical accumulation ; whether there is any 
disposition to jaundice of the skin ; whether 
the a! vine excretions are insufficient, whitish, 
and slimy; whether there has been any 
pain in the region of the liver, difficulty of 
lying on the side, especially on the left side, 
high colour of the urine, pain in the right 
shoulder, & c. and adapt the treatment ac- 
cordingly. If the water is independant of 
disease in the liver, chryscals of tartar, digi- 
talis, other diuretics, and steel, may be im- 
mediately had recourse to, without the inter- 
vention of calomel purgatives and of emetics, 
which last are almost always indicated in the 
more usual form of ascites, that form a mor- 
bid affection of the biliary organs. Emetics 
in hepatic ascites are often attended with 
most beneficial effects, “ Per vomitus sol- 
vuntur cuncta tenacia, concutiuntur obstruc- 
ts, expe'lluntur staguantia, unde mirabiliter 
in hoc morbo prosunt.” (Boerhaave.) In 
the administration of ascitic purgatives, care 
must be taken that, from the violence of ex- 
citement whiph they occasion, they do not 
induce peritoneal inflammation. A combi- 
nation of gamboge, elaterium, and calomel, 
is frequently employed as a purgative in 
ascites. Mercurial ointment to the region of 
the liver. Tonics, especially steel. The 
inhalation of vital air, as recommended and 
employed by Dr. Thornton and others. 
‘Tapping. This is to be regarded in general 
as merely a palliative : if however there has 
not been any very considerable disease of 
the liver, or the debility is not extremely 
urgent, tapping may be advised with a pros- 
pect of effecting a radical cure, provided due 
care is at the same time employed to main- 
tain a proper excitement, or, as it is gene- 
rally expressed, to restore and preserve the 
tone of the system. 
Genus V. Hydrometria. Dropsy of the 
womb. 
This, like the physometra, already men- 
tioned, often assumes a deceitful resemblance 
to pregnancy. It is characterized by drop- 
sical swelling, confined to the region of the 
fe 
uterus, not being accompanied by other 
symptoms of dropsy. 
It is a disease to which the unmarried and 
the barren are principally obnoxious ; some- 
times it follows abortion. 
M. M. Stimulant fomentations. Drastic 
purgatives. Aromatic foetid gums. Fm- 
menagogues. 
Genus VII, Hydrocele. Dropsy of the 
scrotum. See Surge ry. 
Sect. IV. Solidcc. Swellings of solid 
parts. 
Genus I. Physconia. A swelling chiefly 
occupying a portion of the abdomen, in- 
creasing gradually, and neither tense nor 
sonorous as in pneumatosis, nor fluctuating 
as in dropsy. 
This disease is principally formed by a 
schirrous state of the several parts, and vis- 
cera, which form ils seat. These schirrous 
enlargements are generally incurable. 
Genus 1J. Rachitis. Tickets. See In- 
fancy. 
Order III. Tmpetigines. 
Deformities and discolourations of the ex- 
ternal surface from general disease. 
Genus I. Scrophuta. King’s evil. 
Swellings of the lymphatic glands, termi- 
nating in ulcer, are perhaps the only proper j 
characteristics of actual scrophula: the thick 
upper lip, transparent skin, aud other ap- 
pearances which are considered as symptoms 
of the disease, are merely marks of peculiar 
predisposition. 
A scrophulous habit is merely a suscepti- 
bility of disease, arising from torpor in the 
lymphatic vessels, and when brought on by 
the agency of exciting causes, consists in a pe- 
culiar action of the lymphatic glands, by which 
inflammation and at length ulceration, with 
a discharge of grumous matter, are induced. 
Its exciting causes are those which en- 
courage the original debility, and the dis- 
ease may almost certainly be avoided by 
attention to diet and regimen ; by nutritious 
food, a pure oxygenous atmosphere, clean- 
liness, exercise, &c. See Infancy. 
When by neglect, the predisposition has 
been permitted to break out into disease, 
calomel purges, steel, small doses of digita- 
lis, warm and sea-bathing, muriates and 
phosphates of barytes? above all cleanliness; 
ventilation, stimulating nutritious diet. Let 
the mind be preserved free from the errone- 
ous idea, that to cure scrophula is to purge 
away gross humours. See Surgery. 
Genus II. Syphilis. Venereal disease. 
After impure connection, a disorder of the 
genitals, ulcers in the mouth and nose. 
Eruptions on the skin of a copper colour, 
terminating in ulceration ; these are prin- 
cipally situated near the margin of the hair ; 
blotches on the surface of the body, especi- 
ally on the surface of the face. Nocturnal 
pains in the centre of the bones. 
M. M. Mercurials. Nitric acid. Tonics. 
N. B. For the local application to venereal 
ulcers, the more particular treatment of tire 
complaint, and the mode of curing gonorr- 
hea virulenta, see Surgery. 
Genus III. Scorbutus, scurvy. 
Indolence and lassitude ; gloomy and tumid 
countenance ; gums livid, and disposed to 
bleed spontaneously, or from the slighest irri- 
tation; skin dry, and covered with livid spots ; 
oedematous swellings of the ancles. Scurvy 
appears to originate from want of, or exhaust- 
ed excitement, both in the venous and ab*- 
sorbent system ; it is produced by a pro- 
tracted course of salt food, and by mental 
depression. 
M. M. Fresh animal and vegetable diet. 
Juice of lemon. Bark. Steel. Terrene atmo- 
sphere. Mental excitement. 
The elephantiasis, lepra, framba?sia, and 
trichoma, forming the fourth, fifth, sixth, and 
seventh genera of this order, are diseases of 
such rare occurrence in this country, as not to 
require any particular description. 
ior the more common eruptions which 
require local application, see Surgery. 
Genus III. Icterus, jaundice. 
Symptoms, Yellowness of the skin and 
eyes ; while and slimy faces; high-coloured 
urine, tinging linen yellow; langour, lassi- ; 
tude, and extreme depression of spirits. 
‘The yellow colour of the skin, which con- 
stitutes jaundice, arises from the diffusion 
through the system of that bile, which, in the- 
natural course, would pass through the bi- 
liary ducts into the intestinal canal. This \ 
impregnation of the system with bile lias, been 
supposed to be effected in three ways, viz. j 
through the medium of the lacteal vessels i 
and the thoracic duct, when the obstruction 
i is in the duodenum; and by regurgitation 
through the hepatic veins, or absorption by 
the lymphatics of the liver, when the obstruc- 
tion is in some part of the bile’s course- 
previous to its arrival in the duodenum. 
This interruption of the biliary secretion, ; 
may originate from a spasmodic affection . 
near the duct ; from chronic inflammations*, 
or other diseases of the liver interfering with: 
the secretion ; from certain concretions lodg- 
ing in some part of the hepatic organs, called, 
gall-stones ; and, as pointed out by Mr. ] 
Townsend, from viscid mucus stopping up or! 
obstructing the biliary passages. Indeed*. I 
whatever hinders the bile from passing into- 
the duodenum may prove a source of jaun— I 
dice. 
The first of the above species of jaundiced 
is generally of a temporary nature;, it occurs- 1 
principally in those who have much irritabi- 1 
lity of habit, inconsequence of violent pas- 
sions, and other sources of spasmodic aifec- 1 
tions. 
The second species is not of so decided a- 
nature; it loliows upon a long course of intern^ : 
perance in spirituous liquors, and is only to] 
be remedied by removing the disease of the- j 
liver itself. 
The biliary calculi, which give rise to the 
third species of jaundice, appear, like urinary- 1 
concretions, to arise from some defective ac- j 
tion in the secretory or absorbing vessels of 
the parts in which they are formed or lodg-1 
erl; their production, like the stone in the*] 
bladder, is evidently favoured by a reten- : 
tion of fluid, from which they are formed. It 
may therefore be inferred, that gall-stones-] 
are never, or seldom, produced without some j 
previous jaundice having taken place. Thus < 
they are both the cause and consequence of 
the disease. Their presence may be ascertain- j 
ed from jaundice frequently disappearing and ! 
returning, from the appearance of biliary 
concretions among the faeces, and from the 
disease being attended with shooting pains jr* 
the epigastric region, and right hypochon- 
drium. Nausea, difficult respiration, and 
sickness, often likewise accompany tins spe- ! 
cies of jaundice, 
