PATHOLOGY. 
268 
of dijiemper, or fnuffles : among nofologifts it is called 
Catarrhus caninus. Dr. Good mentions it as a fingular 
well-afcertained faft, that dogs which have undergone 
this catarrh never generate lyfla, or canine madnefs, 
though they are capable of receiving it by contagion. 
Genus X. Sparganojis , [Gr. from o-wapyaw, to tumefy 
and diftend ; tumeo et dijlentus fum, as rendered by Sca¬ 
pula.] Generic characters—Pale, tenfe, glabrous, diffufed 
fwelling of a limb; great tendernefs ; inflammation fub- 
cutaneous, unfuppurative. There is only one fpecies. 
Sparganofis puerperarum, milk-fpread, or Phlegmafla 
dolens : occurring, for the moft part, during the fecond 
or third week after child-birth ; limited to the lower ex¬ 
tremity, and chiefly to one fide; exhibiting to the touch 
a feeling of numerous irregular prominences under the 
fkin: fever a heCtic. 
This complaint is not always confined to the puerperal 
ftate, but it is fo in moft cafes. In about twelve or fif¬ 
teen days after delivery, the patient is feized with great 
pain in the groin of one fide, accompanied with a confi- 
derable degree of fever, which however is feldom prece¬ 
ded by rigor or fhivering. This part foon becomes af¬ 
fected with fwelling and tenfion, which extend to the 
labium pudendi of the fame fide only, and down the in- 
fide of the thigh, to the ham, the leg, the foot, and the 
whole limb: the progrefs of the fwelling isfo quick, that 
in a day or two the limb becomes twice the fize of the 
other, is moved with great difficulty, and is hot and 
exquifitely tender, but without any external appearances 
of inflammation. The pain in the groin is generally 
preceded by a pain in the fmall of the back, and fome- 
times by a pain at the bottom of the belly on the fame 
fide; the parts which fuffer the moft pain are the groin, 
the ham, and the back part of the leg about its middle. 
The pain indeed extends over the whole limb, in confe- 
quence of the fudden diftention ; but in a day or two it 
becomes lefs fevere. The fwelling is general and equal 
over the whole limb ; it is much harder and firmer than 
in anafarca, in every ftage of the diforder; it is not fo 
cold, in any ftate of the difeafe, as the dropfical fwelling, 
nor fo much diminifhed by a horizontal pofition, neither 
does it pit when prefled upon by the finger, nor does any 
water ifl'ue from it when it is punCtured by means of a 
lancet. The furface is very fmooth, fhining, and pale ; 
and is even and equal to the touch in every part, except 
where the conglobated glands are fituated, which in fome 
cafes are knotty and hard, as in the groin, the ham, and 
about the middle of the leg at its back part. 
This diforder generally comes on in the fecond or early 
in the third week after parturition. But Mr. White 
mentions one inftance in which it commenced as early as 
twenty-four hours after delivery, and another as late as 
five weeks: but thefe are rare and extreme occurrences. 
The difeafe fubfides in the following order: firft the 
pain and fwelling of the groin and labium pudendi, be¬ 
gin to remit, next thofe of the thigh, and laftly thofe of 
the leg. 
The fever in fome patients fubfides in two or three 
weeks, in others it continues fix or eight weeks, attend¬ 
ed with quick pulfe and heCtic fymptoms. The difeafe 
fometimes attacks both extremities ; but this rarely hap¬ 
pens, perhaps not in one cafe in ten. After the diforder 
lias exifted a week or two, it is not uncommon for the 
found leg to fwell towards evening, and become cedema- 
tous ; but then the groin and thigh are not affeCled on 
that fide, and the leg is much fofterto the touch than the 
other, and pits when prefled upon by the finger. Mr. 
White (Inquiry into the Nature and Caufe of that Swel¬ 
ling in one or both of the Lower Extremities, which 
fometimes happens to Lying-in Women, 1784), affirms, 
that he has never known it to fuppurate or prove fatal, 
or to be followed by any material inconvenience, after a 
few months were elapfed, except a little fwelling of the 
leg after fatigue, particularly after walking. 
The caufes of this difeafe are not very obvious. It 
attacks women who are in full llrength, and thofe who are 
reduced by flooding; thofe who have a moderate dif- 
charge of the lochia, and thofe who have a fmall or a large 
quantity; thofe who give fuck and thofe who do not, 
whether their breafts be drawn or not, and whether they 
have a great deal or little milk. It attacks women in 
whatever pofition they have been delivered ; but of thofe 
who were delivered on the fide, it appears that th'e great¬ 
er number were affeCted on that fide in which they lay 
at the time of delivery. It attacks women of all ranks 
and of different habits, both the rich and the poor; the 
moft healthful, as well as thofe who have laboured under 
chronic difeafes : the ftrong and the weak, the lean and 
the corpulent; the fedentary and the aCtive; the young 
and the middle-aged ; after the firft or any other labour, 
and whether the labour be natural or preternatural. It 
happens at all feafons of the year indiferiminately ; and 
in the country as well as in large towns. It never attacks 
either of the arms, or other parts of the body; and, 
though it fometimes occurs in both the lower extremi¬ 
ties, in the fame or in different lyings-in, it never at¬ 
tacks the fame limb more than once. 
The complaint feems to confift of an inflammation 
feated in the mufcles, cellular membrane, and interior 
furface of the fkin, which produces a rapid effufion of 
ferum and coagulable lymph from the exhalants into the 
cellular membrane of the limb. Dr. Hull, in his learned 
treatife on Phlegmatia dolens, divides the difeafe into 
three ftages; and treats the firft, or inflammatory, ftage, 
upon antiphlogiftic principles, applying leeches and blif- 
ters to moderate the local aCfion ; and emollient fomen¬ 
tations, liniments, and ointments, to relieve the tenfion 
of the fkin. The fecond ftage does not require or bear 
evacuations; but the other parts of the antiphlogiftic 
treatment, fuch as reft, the removal of irritations, gentle 
diaphoretics and fedatives, the warm bath, &c. mult be 
continued ; and the topical affection is to be remedied by 
gently ftimulating liniments. The third, or afthenic, 
period, requires the adminiftration of tonics and ftimu- 
lants, and exercife, efpecially in a carriage ; while at the 
fame time the topical affection mult be treated by the 
application of a tight bandage, by the cold bath, or cold 
water dafhed on the limb, and by remedies which may 
increafe the aCtion of the abforbents, fuch as blifters, 
friction, heat, ele&ricity, See. and by the internal medi¬ 
cines which excite abforption, fuch as mercury, digi¬ 
talis, alkalies, Sec. Thefe remedies, particularly the 
evacuants, will of courfe be regulated according to the 
vigour and habit of the patient. 
Genus XI. Arthrofia, [Gr. from uffyov, a joint.] Arti¬ 
cular Inflammation, or Joint-ache. Generic characters 
—Inflammation moftly confined to the joints, feverely 
painful; occafionally extending to the furrounding muf¬ 
cles. This genus contains four fpecies, including gout, 
rheumatifm, Sec. 
The nature of neither gout nor rheumatifm is precifely 
known. The capfules of joints, the fheaths of tendonr, 
and indeed of the tunica propria mufculorum, appear to 
be the parts chiefly affeCted ; and it feems alio, that in¬ 
flammation is the affeCtion in queftion. The difeafes, 
however, of rheumatifm and gout vary in their antece¬ 
dent and concomitant fymptoms, and alfo in regard to 
the morbid depofitions to which they give rife. It does 
not feem clear, however, that either of thefe difeafes is 
unconnected with conftitutional malady; becaufe arte¬ 
rial inflammation of the membranes of the joints is not 
always attended with the fymptoms of gout and rheuma¬ 
tifm. The connexion of gout and indigeftion has been 
long obferved ; and, from all we have been able to ga¬ 
ther, this connexion has been almoft invariable. The 
difeafe has, in the majority of cafes, attacked ple¬ 
thoric and intemperate perfons; and even the exceptions 
which have happened have always prefented patients, 
who 
