i80 
PATHOLOG Y. 
A'lcibiades is fuppofed to have laboured under this de¬ 
feat. It is alfo laid to be common to the Jews of China, 
who have dwelt among the Chinefe fo long as to have loft; 
the found of R, in confequence of its not exifting in the 
Chinefe tongue. 
y. Emolliens; the harfh letters exchanged for foft, as 
in the fubftitution of ansel for angel; capidol for capital ; 
eh t for that. 
Balbutiens ; labials, as B, M, P, too frequently in¬ 
troduced, or ufed inftead of other letters. So Feda is 
pronounced Beda, Fenares Benares, in Bengal, the Ben¬ 
galee having no V. Soimpringeisoften ufed for in/ringe; 
i&ory for itiory; though b and not v is here the radical 
letter, the Latin term being efmr. 
£. Mogilalia; labials omitted or exchanged for other 
letters. Moll commonly P for F, and F for V, as./ilfer 
for pilfer; tiifh for/dfh. So the Latin fiiilo is transformed 
by the French into filler. 
Dentiloquens, lifping: dentals, as C, S, T, Z, too 
frequently employed; producing the effeft of what is 
called, in common language, fpeaking through the 
teeth. 
v>. Gutturalis; imperfect utterance of the guttural let¬ 
ters; as G, J, H, X. This, and indeed all the varieties 
of the prefent fpecies, as well as many others that are 
connected with it, are moft ufually the refult of vicious 
habit, produced by want of attention to the articulation 
of founds in infancy, or to affectation. They are alfo 
fbmetimes dependant upon a mifconftruCtion of the vocal 
organs : of which the prefent variety furnillies us with 
an example; for a defective utterance of the guttural 
letters mull be a neceflary confequence of a fifl'ure in the 
palate. 
Order II. Pneumonica, [Gr. from breath.] Dif- 
orders affecting the Lungs, their membranes, or mo¬ 
tive power; and producing irregular, impeded, or pain¬ 
ful, refpiration. 
The refpiratory fyftem performs the talk of prefenting 
to the blood a certain aerial matter neceflary to that 
fluid ere it can perform many of the moll important 
functions of the animal economy. The powers in ufe 
are, i. Large fponge-like mafles called lungs, which paf- 
fiveiy receive and emit, and which in the remoteft termi¬ 
nation of their cells allow contadt (or nearly fo) between 
the blood and the atmofphere. 2. Moving powers, or 
mufcles of refpiration, which, alternately prefling or re¬ 
moving prefl'ure from the lungs, allow the weight of the 
atmofphere to inflate the fponge, or on the other hand 
expel the air evidently changed in its properties. Be¬ 
tween thefe two parts, viz. the mucous lining of the 
lungs and the refpiratory mufcles, a ftrongand perpetual 
fympathy exifts. No fooner have the lungs become filled 
with air to a certain extent, than the ftimulus applied is 
conveyed to the mufcles, which contract and empty thofe 
organs, while the contraction of other mufcles occurs to 
dilate the cheft again as foon as the uncharged blood, 
flowing into the lungs, produces an uneafy fenfation. 
This fympathy brings to our confideration the 3d agent 
concerned in refpiration ; viz. the nervous fyftem. 
Thefe are the agents which apply the air to the blood. 
The power which applies the blood to the air, namely 
the heart, is likewife to be taken into confideration, as 
this organ and the lungs are generally connected in dif- 
eafe and in health. Leaving out of thequeftion for the 
prefent the remote injury to the brain by deficiency of 
blood, and to the heart by depravation of the fame fluid, 
and premifing that no impediment exifts to breathing in 
the mouth, noftrils, or fauces; we remark, that the 
aerial change of the blood may be imperfectly or diffi¬ 
cultly performed in confequence of a want of the due 
expanfion of the lungs; from an altered aCtion of the 
refpiratory mufcles; or from an altered ftate of the re- 
fpired air. 
The due expanfion of the lungs may be prevented by 
an alteration of ftruCture, whether of the tubes and cells, 
or of the fubftance, of the lungs; as by oflification, by 
abfeefles, by hydatids, by tumours, by condenfation of 
the lungs; by earthy concretions; by plethora of the 
blood-veflels of the lungs generally, whether pulmonary 
or bronchial. The due expanfion of the lungs may alfo 
be prevented by anafarca or by emphyfema of the cellu¬ 
lar membrane which connects the bronchia ; perhaps by 
adhefions of the pleurae; by collections of fluid in the 
cavities of the pleurae ; by enlargement of the heart, or 
by enlargement of any of the parts fo fituated as to offer 
mechanical impediment to the enlargement of the tho¬ 
rax. Oflification of the cartilages of the ribs; gibbofity; 
anchylofis of the joints between the ribs and the fpine; 
irregular aCtion of the diaphragm ; or obftacles to its de- 
feent, as diftention of the ftomach or of the inteftines, or 
paralyfma, or hydrops, may likewife be enumerated as 
capable of hindering the expanfion of the lungs. 
The aClion of the refpiratory mufcles may be dimi- 
nifhed by contractility in their fibres, or by want of ner¬ 
vous power. It will be increafed by every circumftance 
capable of irritating the mucous membrane of the lungs, 
and thus exciting fympathy, in common with other muf¬ 
cles, by the aCtion of the brain, or by general increafe of 
contractility. 
The air which is refpired, may be deficient as to quan¬ 
tity, or it may be too much rarified, or it may contain 
noxious panicles, or it may confift of fome noxious gas ; 
or, in fhort, its compofition may be altered in various 
ways from the natural conftitution of the atmofphere. 
The firft and moft remarkable mode in which the refpi¬ 
ratory fyftem is deranged is in what is called coughing. 
In this aCtion a large quantity of air, furnifhed by a con- 
fulerable inlpiration, is violently and fuddenly expelled, 
with a confiderable noife, by a very ftrong and aimoft 
convulfive exfpiration, and in its paflage clears away mu¬ 
cus, or any thing el fe which may happen to be in the air- 
paflages. The air may be driven out at once or at feveral 
exfpirations : in the latter cafe the exfpirations are con¬ 
tinued often as long as any air can be expelled, and the 
emptied cheft is again fupplied by an infpiration accom¬ 
panied with noife. It is obvioufly nothing but a fudden 
and exalted difplay of that fympathy which produces 
refpiration, and is generally produced by nervous ex¬ 
citement of the bronchial membrane. We mult not for¬ 
get however, that, as a fympathy exifts between the ref¬ 
piratory mufcles and other parts as well as the lungs, fo 
coughing may be induced by other caufes than the ir;i- 
tation of the latter organs. Thus diforders of the vif- 
cera of the abdomen, efpecially of thofe which lie in 
contaft with the diaphragm, frequently bring on a cough. 
A fhort dry cough is an invariable fymptom of inflam¬ 
mation of the liver, whether acute or chronic, and ac¬ 
companies the various tubercular and other obftructions 
in that organ. Diforders of the ftomach are, alfo, often 
accompanied with a cough of the fame dry and teazing 
nature, efpecially when that organ is over-diftended with 
food, or is in the oppofite condition of emptinefs. In 
fhort, there is fcarcely a vifeus in the cavity <■>/ the ab¬ 
domen, the irritation of which, in a ftate of difeafe, has 
not excited cough. Diforders of the fpleen, pancreas, 
and even the kidneys, have all given rife to this fymptom; 
and external tumours, attached to them, have had the 
fame effeCt. (See Morgagni Epift. xix. art. 57, 58, &c.) 
Thus, in the afeites, or dropfy of the belly, the water; 
in tympanites, the air; in corpulency, the fat in the 
omentum; and, in pregnancy, the gravid uterus; have 
all, in fome cafes, the effeCt of exciting cough. 
Our readers fhould bear in mind, however, that each 
of the caufes here enumerated may injure the expanfion 
of the lungs permanently, and excite convulfive aCtion 
of the refpiratory mufcles only as a fecondary refult. But 
at prefent we are to confine ourfeWes to the difeuflion of 
4 thofe 
