P A T H O 
and enlargement of the heart accompanying thefe morbid 
Hates. 3. Aneurifm and edification of the thoracic por¬ 
tion of the aorta. 4. A difordered date of the chylopoietic 
organs, more efpecially of the ftomach, producing indi- 
gellion. 
When Sternalgia arifes from organic derangement, it 
admits only of palliation ; and, when fympathetic only, 
the difeafe producing the fympathetic manifeftation 
fhould be removed. On this account, to diftinguifh be¬ 
tween the two caufes is of the utmoft confequence. Dr. 
Powell, in the Tranfaftions of the College of Phyficians, 
thus details the diftinguifiling, fymptoms: “ When a 
patient complains of a flight difficulty in refpiration, 
increafed by exercife, and aggravated by a recum¬ 
bent pofture; if the pulfe does not beat with intermiffions, 
and the feveral ftrokes are not unequal in force, although 
the pulfations may be preternaturally flow, or, on the 
contrary, more than ufually quick, I know, from aftual 
examination after death under thefe different circum- 
ftances, that there fometimes is not any organic difeafe 
in the thorax. If refpiration be uneafy, and the patient, 
at firft experiencing fome difficulty in lying down, (hall 
in a little while fo adjuft his pofition as to deep comfor¬ 
tably, I believe there cannot be any organic mifehief in 
the thorax, although poflibly there may be effufion. If 
the patient cannot fleep in a recumbent pofture, or, when 
afleep, if, Aiding down gradually into his bed, he is fud- 
denly awaked with a fenfe of fpafmodic ftri&ure and 
ftrangulation, provided there hath not been previoufly 
obferved an irregular and an intermittent pulfe, I fhould 
fufpeft effufion within the cheft, rather than any difeafe 
of ft ru flu re. And if, in addition to the above circum- 
ftances, there fhould be anafarcous fwellings of the legs, 
and the countenance fhould be bloated and purple-co¬ 
loured, the cheft is certainly labouring under an effufion 
of fluid ; but even then it is not abfolutely clear that hy¬ 
drothorax is actually produced by mal-organization in 
the thoracic vifeera.” 
Dr. Hutchinfon, the late editor of the London Me¬ 
dical journal, has remarked the Angular and charaffer- 
iftic fymptoms of fwelling of the throat, painful deglu¬ 
tition, and hoarfenefs, as attendant difeafes of the heart 
which exhibit the form of Angina peftoris. None of the 
diagnoftics are however infallible 5 and indeed the dif- 
tindfion between nervous and organic difeafes of the 
thorax is one of the greateft difficulties in the whole lift 
of human maladies. 
In the treatment of Angina, we have to confider its 
palliation during the paroxyfm, and its effectual remo¬ 
val. Antifpafmodics are the ufual agents employed for 
the former purpofe. Dr. Reeder, in his treatife quoted 
before, objefts to the life of internal ftimuli, unlefs the 
heart appear unable, after the lapfe of fome time, to re¬ 
gain its ufual adlion, when weak wine and water, a fmall 
quantity of aether or fpirit of ammonia diluted, may be 
given. Some patients experience immediate relief by 
Itrong brandy and water. Should not thefe fucceed, we 
fhould apply a blifter over the cardiac region, and im- 
merfe the arm, when much affedled, in hot water, and 
afterwards diredl it to be rubbed with fome ftiniulant and 
anodyne liniment. Opium may be given with advantage 
in a protrafted paroxyfm ; and this medicine, or the ex- 
trafl of hyofeiamus, often prevents no&umal attacks, 
when given at bed-time. Should the fyncope remain an 
undue length of time, it will be neceffary to tranfmit elec¬ 
tric or galvanic ffiocks through the region of the heart, 
and to inflate the lungs by proper bellows, fo as to elta- 
blifti an artificial pulmonary and aortal circulation. 
_ A few drops of hydrocyanic acid have been faid to re¬ 
lieve the paroxyfm of Sternalgia very rapidly. In the 
intervals between the paroxylms, much may be effected 
to prevent their acceflion, by the patient obferving pro¬ 
per rules with refpeft to exercife and diet, and by avoid¬ 
ing exciting caufes. Exercife, particularly on horfeback, 
liquid not be had recourfe to when the ftomach is full. 
You. XIX. No. 1297. 
LOGY. 191 
Dr. R. advifes his patients to drink water, and to eat 
fparingly; to keep the bowels open ; to regulate the 
temperature of the body by clothing, and to avoid 
heated rooms and an impure atmofphere. Occafional 
plethora fhould be removed by bleeding in the recumbent 
pofition, or by cupping ; and its recurrence prevented as 
much as poffibie by the almoft exclufive ufe of farina¬ 
ceous food. I flues in the thighs or arms may be ufed, 
as well as the tartrite of antimony, to excite a puftular 
eruption ; but an occafional blifter will generally anfwer 
every purpofe, with much lefs inconvenience to the pa¬ 
tient. 
Genus VL Pteuralgia, [wAeup, the fide, and <*Ayo?, 
pain.] Sharp pain, or ftitch, in the fide; difficulty of 
breathing, without fever or inflammation j and thus dif- 
tinguiflied from Pleuritis, or pleurify. 
A ftitch or pain in the fide often occurs, independent¬ 
ly of any acute inflammation of the lungs, pleura, or con¬ 
tiguous organs, and it is generally increafed by the ac¬ 
tion of breathing. It has been often denominated a 
falfe or fpurious pleurify. The pain, however, is feldom 
feated in the membrane called the pleura, but often in 
the mufcles of the cheft, fometimes in the other membra¬ 
nous parts ; and it may arife from rheumatifm affecting 
thofe parts, from fpafm or cramp, from a plethoric con¬ 
dition, or from a nervous and hyfterical ftate, in which 
the circulation is languid and irregular: it may alfo be 
connected with a gouty, fiphilitic, or fcorbutic, habit. 
Sauvages has diftributed the PI eurodyne (his name for 
this genus) into eighteen fpecies, according to itsorigin 
from one or other of thefe caufes. But Dr. Good gives 
us only two fpecies. 
1. Pleuralgia acuta: fudden and temporary; fuper- 
vening on mufcular exercife; relieved by preffure. 
2. Chronica: permanent: augmented by preffure 5 in¬ 
ability of lying on the tide affedted. 
The firft fpecies found alio frequently as a fymptom in 
flatulence, hyfteria, and hypochondriafts. The fecond in 
plethora, worms, fiphilis, phthifis, rickets, catarrh, and 
rheumatifm. See Pleuritis. 
Class III. HAEMATIC A, [from the Gr. «-i blood.] 
Diseases of the Sanguineous Function. 
The chief modes in which the fanguineous fyftem is 
influenced in difeafe is in regard to the ftate of the con¬ 
tained fluid on the one hand, or the ftate of the con¬ 
taining veflfels on the other. The confideration of the 
firft occupied, as is well known, for a long time, the 
medical world ; and the inoft famous hypothefes of the 
feventeenth and early part of the eighteenth centuries 
were founded on fuppofed chemical changes in the blood 
during difeafed ftates. (See the hiftorical feftion of this 
article, p. 13'—16.) At prefent, though it is acknow¬ 
ledged that the contained fluids vary much as to their 
nature in different perfons and difeafes, and that the in¬ 
troduction of foreign bodies in an unajfimilated ftate is 
followed by. violent fymptoms, yet we have alfo afeer- 
tained that the conftitution accommodates itfelf in a 
great degree to thofe infeniible changes which unufual 
food or indigeftion produces, and that the blood exhibits 
a variety in the proportion of its conftituent parts even 
in healthy individuals. There can be no doubt that a ge¬ 
neral bad ftate of the fluid of the body exifts in fome 
difeafes; and thefe are neceflarily accompanied with 
alteration in the contraftile power of the blood-veffels. 
Of the nature, however, of this morbid alteration of the 
blood, we know fcarcejy any thing. We ftiall mention 
the fcaqty flock of fads we are furniffied with on this 
fubjefit when treating of the laft order of this clafs, 
Dyjpeptica, or Cachexies. 
The quantity of the blood in the animal frame varies 
in moft difeafes, and often without our being able to 
trace any very manifeft caufes. of this Variation. Some 
3 D diftinguilhed 
