47964 
The hooping-cough, malignant fevers, 
fmall-pox, meafles, and {cariatina angi- 
nofay continue nearly in the fame pro- 
portion as during the ‘two preceding 
months. The fcarlatina anginofa has 
been very fatal in different quaiters of 
the city. 
In the lift of chronic difeafes, it feems 
proper to take fome notice of the article 
afthenia, comprehending the diforders, in 
common language termed nervous, which 
have occurred in a great proportion, efpe- 
cially during the f{ummer months. ‘The 
ftate of afthenia commences with general 
languor, a fenfe of laifitude, or acning in 
the limbs; and often withtremors. Thefe 
fymptoms are fucceeded by fhooring pains, 
headach, giddinefs, and a ftrong difpofi- 
tion to fleep, even inthe day-time. There 
is a fenfation of faintnefs, or depreilion, 
referred to the ftomach, which calls for a 
Frequent fupply of nourifhment: but as 
the craving is not feconded by a propor; 
tionate activity of the digeitive powers, 
an overcharge foon takes place, and pro- 
duces hearcburn, flatulency, violent pains 
of the ftomach, or naufea, with bilious 
vomitings, and diarrhea. Females, in 
thefe circumftances, are diftrefled with a 
pain in the left fide, fometimes alternat« 
ing with the pain of the ftomach. 
‘This complaint takes away the ability 
of any confderable corporeal exertions ; 
and aifo renders a long attention of the 
mind to any fubjecét, not only difficult 
but painful. The patient’s temper be- 
comes irritable, fretful, and capricious 5 
the judgment is defective and irrefolute ; 
the imagination fuygefis nothing but 
gloomy ideas, often extending to defpons 
dency. No tafte remains for accuftomed 
amufements; but eyery feeling, every 
feniation feems unpleafant. The night- 
fleep is difturbed by frightful dreams and 
ftartings ; and the patient awakes, in the 
morning, unrefrefhed, or feeling as if 
inuch bruifed and fatigued. 
Sauvages, in treating of afthenia, in- 
cludes under that title, the debility con- 
fequent on fevers, {mall-pox, fcurvy, hy- 
drocephalus, and feveral local complaints. 
He farther obferves, that in afthenia 
there is a general weaknefs of all the 
limbs, the vital powers retaining their 
full vigour ; or, that the debility of the 
voluntary motions is much greater than 
could be fuppofed from examining the 
flate of the pulfe. This remark feems 
to have been made with the view of fup- 
porting an hypothefis :—it has certainly 
mo foundation in truth. ‘The pulfe, in 
/ 
Account of Difeafes in London. 
829 
every inftance of afthernia, is much re- 
duced in force: In perfons of the fan- 
guine temperament: it is weak, and ufu- 
ally very frequent; but in melancholic 
habits it is always feeble, flow, and lan- 
guid. The former cafe conftitutes the 
predifpofition to fyncope, hyfteria, cho- 
rea, tetanus, and other convulfions; to 
mania, gaftrodynia, pyrofis, diarrhea, ta- 
bes mefenterica, fluor albus, urticaria, 
porrigo, and feveral puftular eruptions cn 
the fxin. ‘The latter predifpofes to in- 
digeftion, hemicranium, hy pochondriafis 
or melancholia; to epilepfy, catalepfys, 
-ephialres, chlorofis, conttipation, chronic 
rheumatifm, ftruma, internal fchirrofities, 
dropfy, diabetes, purpuya, and fcaly dif- 
eafes of the fkin. 
Impure air, fedentary occupations, anx- 
iety, and the irregular modes of living 
in a crowded city are the external caufes 
which lay the foundation of afthenia. 
Not only thofe inhabitants are afected 
with it, who live delicately, and with- 
hold themfelves from no indulgence ; but 
labourers, fervants, and all perions con~ 
fined toa dull, unvaried track of bufi- 
nels, are fenfible of its effects. In fum- 
mer, the complaint is much aggravated 
by the relaxing influence of awarm, duf- 
ty atmofphere; to which may be added 
the ftifling heat reflected from contigu- 
ous brick-walls, windows, and a burning 
pavement. Unhappy they whoare doom- 
ed to toil in fuch a fituation throughout 
the year ; who feldem enjoy the fun’s di- 
rect rays in the colder feafons; and dur= 
ing the hot months are never fanned by 
the weftern breeze. In the moments of 
languor, they court the delutive aid of 
fpirits, by which all their complaints are 
rendered more inveterate ; they graduai- 
ly droop and pine ; become heétical, con- 
fumptive, or paralytic: or, falling into 
the ftate of chronie weaknefs, fo well de= 
{cribed by Dr. Withers, remain, through 
life, a burthen to themielves, their friends, 
or the public. ; 
Patients in the firft ftage of afthenia, 
or whofe conftitutions have not been too 
deeply injured by a long refidence in 
town, retrieve their health by means of 
cold bathing, tonic medicines, and ocea- 
fiona! excurfions into the country. There, 
a change of purfuits, a more regular plan 
of diet and exercile, a clear and purer at 
mofphere, the falubrious exhalations from 
growing vegetables, and the grateful fti- 
mulus of their odours, in a fhort time ree 
ftore vigour to the body, and along with 
it, firmoeds and ferenity te the mind. 
gN 2 LIC 

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