Zoonomia; Or, the Laws of Organic Life, Vol. II

by Erasmus Darwin

MATERIA MEDICA.

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Art. [I].

NUTRIENTIA.

[I]. [1]. Those things, which preserve in their natural state the due exertions of all the irritative motions, are termed nutrientia; they produce the growth, and restore the waste, of the system. These consist of a variety of mild vegetable and animal substances, water, and air.

[2]. Where stronger stimuli have been long used, they become necessary for this purpose, as mustard, spice, salt, beer, wine, vinegar, alcohol, opium. Which however, as they are unnatural stimuli, and difficult to manage in respect to quantity, are liable to shorten the span of human life, sooner rendering the system incapable of being stimulated into action by the nutrientia. See Sect XXXVII. 4. On the same account life is shorter in warmer climates than in more temperate ones.

[II]. Observations on the Nutrientia.

[I]. [1]. The flesh of animals contains more nourishment, and stimulates our absorbent and secerning vessels more powerfully, than the vegetable productions, which we use as food; for the carnivorous animals can fast longer without injury than the graminivorous; and we feel ourselves warmer and stronger after a meal of flesh than of grain. Hence in diseases attended with cold extremities and general debility this kind of diet is preferred; as in rickets, dropsy, scrophula, and in hysteric and hypochondriac cases, and to prevent the returns of agues. Might not flesh in small quantities bruised to a pulp be more advantageously used in fevers attended with debility than vegetable diet?

That flesh, which is of the darkest colour, generally contains more nourishment, and stimulates our vessels more powerfully, than the white kinds. The flesh of the carnivorous and piscivorous animals is so stimulating, that it seldom enters into the food of European nations, except the swine, the Soland goose (Pelicanus Bassanus), and formerly the swan. Of these the swine and the swan are fed previously upon vegetable aliment; and the Soland goose is taken in very small quantity, only as a whet to the appetite. Next to these are the birds, that feed upon insects, which are perhaps the most stimulating and the most nutritive of our usual food.

It is said that a greater quantity of volatile alkali can be obtained from this kind of flesh, to which has been ascribed its stimulating quality. But it is more probable, that fresh flesh contains only the elements of volatile alkali.

[2]. Next to the dark coloured flesh of animals, the various tribes of shell-fish seem to claim their place, and the wholesome kinds of mushrooms, which must be esteemed animal food, both for their alkalescent tendency, their stimulating quality, and the quantity of nourishment, which they afford; as oysters, lobsters, crabfish, shrimps; mushrooms; to which perhaps might be added some of the fish without scales; as the eel, barbolt, tench, smelt, turbot, turtle.

The flesh of many kinds of fish, when it is supposed to have undergone a beginning putrefaction, becomes luminous in the dark. This seems to shew a tendency in the phosphorus to escape, and combine with the oxygen of the atmosphere; and would hence shew, that this kind of flesh is not so perfectly animalized as those before mentioned. This light, as it is frequently seen on rotten wood, and sometimes on veal, which has been kept too long, as I have been told, is commonly supposed to have its cause from putrefaction; but is nevertheless most probably of phosphoric origin, like that seen in the dark on oyster-shells, which have previously been ignited, and afterwards exposed to the sunshine, and on the Bolognian stone. See Botan. Gard. Vol. I. Cant. I. line 1 and 2, the note.

[3]. The flesh of young animals, as of lamb, veal, and sucking pigs, supplies us with a still less stimulating food. The broth of these is said to become sour, and continues so a considerable time before it changes into putridity; so much does their flesh partake of the chemical properties of the milk, with which these animals are nourished.

[4]. The white meats, as of turkey, partridge, pheasant, fowl, with their eggs, seem to be the next in mildness; and hence are generally first allowed to convalescents from inflammatory diseases.

[5]. Next to those should be ranked the white river-fish, which have scales, as pike, perch, gudgeon.

[II]. [1]. Milk unites the animal with the vegetable source of our nourishment, partaking of the properties of both. As it contains sugar, and will therefore ferment and produce a kind of wine or spirit, which is a common liquor in Siberia; or will run into an acid by simple agitation, as in the churning of cream; and lastly, as it contains coagulable lymph, which will undergo the process of putrefaction like other animal substances, as in old cheese.

[2]. Milk may be separated by rest or by agitation into cream, butter, butter-milk, whey, curd. The cream is easier of digestion to adults, because it contains less of the coagulum or cheesy part, and is also more nutritive. Butter consisting of oil between an animal and vegetable kind contains still more nutriment, and in its recent state is not difficult of digestion if taken in moderate quantity. See Art. [I. 2. 3. 2]. Butter-milk if it be not bitter is an agreeable and nutritive fluid, if it be bitter it has some putrid parts of the cream in it, which had been kept too long; but is perhaps not less wholesome for being sour to a certain degree: as the inferior people in Scotland choose sour milk in preference to skimmed milk before it is become sour. Whey is the least nutritive and easiest of digestion. And in the spring of the year, when the cows feed on young grass, it contains so much of vegetable properties, as to become a salutary potation, when drank to about a pint every morning to those, who during the winter have taken too little vegetable nourishment, and who are thence liable to bilious concretions.

[3]. Cheese is of various kinds, according to the greater or less quantity of cream, which it contains, and according to its age. Those cheeses, which are easiest broken to pieces in the mouth, are generally easiest of digestion, and contain most nutriment. Some kinds of cheese, though slow of digestion, are also slow in changing by chemical processes in the stomach, and therefore will frequently agree well with those, who have a weak digestion; as I have seen toasted cheese vomited up a whole day after it was eaten without having undergone any apparent change, or given any uneasiness to the patient. It is probable a portion of sugar, or of animal fat, or of the gravy of boiled or roasted meat, mixed with cheese at the time of making it, might add to its pleasant and nutritious quality.

[4]. The reason, why autumnal milk is so much thicker or coagulable than vernal milk, is not easy to understand, but as new milk is in many respects similar to chyle, it may be considered as food already in part digested by the animal it is taken from, and thence supplies a nutriment of easy digestion. But as it requires to be curdled by the gastric acid, before it can enter the lacteals, as is seen in the stomachs of calves, it seems more suitable to children, whose stomachs abound more with acidity, than to adults; but nevertheless supplies good nourishment to many of the latter, and particularly to those, who use vegetable food, and whose stomachs have not been much accustomed to the unnatural stimulus of spice, salt, and spirit. See Class [I. 1. 2. 5].

[III]. [1]. The seeds, roots, leaves, and fruits of plants, constitute the greatest part of the food of mankind; the respective quantities of nourishment, which these contain, may perhaps be estimated from the quantity of starch, or of sugar, they can be made to produce: in farinaceous seeds, the mucilage seems gradually to be converted into starch, while they remain in our granaries; and the starch by the germination of the young plant, as in making malt from barley, or by animal digestion, is converted into sugar. Hence old wheat and beans contain more starch than new; and in our stomachs other vegetable and animal materials are converted into sugar; which constitutes in all creatures a part of their chyle.

Hence it is probable, that sugar is the most nutritive part of vegetables; and that they are more nutritive, as they are convertible in greater quantity into sugar by the power of digestion; as appears from sugar being found in the chyle of all animals, and from its existing in great quantity in the urine of patients in the diabætes, of which a curious case is related in Sect. XXIX. 4. where a man labouring under this malady eat and drank an enormous quantity, and sometimes voided sixteen pints of water in a day, with an ounce of sugar in each pint.

[2]. Oil, when mixed with mucilage or coagulable lymph, as in cream or new milk, is easy of digestion, and constitutes probably the most nutritive part of animal diet; as oil is another part of the chyle of all animals. As these two materials, sugar and butter, contain much nutriment under a small volume, and readily undergo some chemical change so as to become acid or rancid; they are liable to disturb weak stomachs, when taken in large quantity, more than aliment, which contains less nourishment, and is at the same time less liable to chemical changes; because the chyle is produced quicker than the torpid lacteals can absorb it, and thence undergoes a further chemical process. Sugar and butter therefore are not so easily digested, when taken in large quantity, as those things, which contain less nutriment; hence, where the stomach is weak, they must be used in less quantity. But the custom of some people in restraining children entirely from them, is depriving them of a very wholesome, agreeable, and substantial part of their diet. Honey, manna, sap-juice, are different kinds of less pure sugar.

[3]. All the esculent vegetables contain a bland oil, or mucilage, or starch, or sugar, or acid; and, as their stimulus is moderate, are properly given alone as food in inflammatory diseases; and mixed with milk constitute the food of thousands. Other vegetables possess various degrees and various kinds of stimulus; and to these we are beholden for the greater part of our Materia Medica, which produce nausea, sickness, vomiting, catharsis, intoxication, inflammation, and even death, if unskilfully administered.

The acrid or intoxicating, and other kinds of vegetable juices, such as produce sickness, or evacuate the bowels, or such even as are only disagreeable to the palate, appear to be a part of the defence of those vegetables, which possess them, from the assaults of larger animals or of insects. As mentioned in the Botanic Garden, Part II. Cant. I. line 161, note. This appears in a forcible manner from the perusal of some travels, which have been published of those unfortunate people, who have suffered shipwreck on uncultivated countries, and have with difficulty found food to subsist, in otherwise not inhospitable climates.

[4]. As these acrid and intoxicating juices generally reside in the mucilage, and not in the starch of many roots, and seeds, according to the observation of M. Parmentier, the wholesome or nutritive parts of some vegetables may be thus separated from the medicinal parts of them. Thus if the root of white briony be rasped into cold water, by means of a bread-grater made of a tinned iron plate, and agitated in it, the acrid juice of the root along with the mucilage will be dissolved, or swim, in the water; while a starch perfectly wholesome and nutritious will subside, and may be used as food in times of scarcity.

M. Parmentier further observes, that potatoes contain too much mucilage in proportion to their starch, which prevents them from being converted into good bread. But that if the starch be collected from ten pounds of raw potatoes by grating them into cold water, and agitating them, as above mentioned; and if the starch thus procured be mixed with other ten pounds of boiled potatoes, and properly subjected to fermentation like wheat flour, that it will make as good bread as the finest wheat.

Good bread may also be made by mixing wheat-flour with boiled potatoes. Eighteen pounds of wheat flour are said to make twenty-two pounds and a half of bread. Eighteen pounds of wheat-flour mixed with nine pounds of boiled potatoes, are said to make twenty-nine pounds and a half of bread. This difference of weight must arise from the difference of the previous dryness of the two materials. The potatoes might probably make better flour, if they were boiled in steam, in a close vessel, made some degrees hotter than common boiling water.

Other vegetable matters may be deprived of their too great acrimony by boiling in water, as the great variety of the cabbage, the young tops of white briony, water-cresses, asparagus, with innumerable roots, and some fruits. Other plants have their acrid juices or bitter particles diminished by covering them from the light by what is termed blanching them, as the stems and leaves of cellery, endive, sea-kale. The former method either extracts or decomposes the acrid particles, and the latter prevents them from being formed. See Botanic Garden, Vol. I. additional note XXXIV. on the Etiolation of vegetables.

[5]. The art of cookery, by exposing vegetable and animal substances to heat, has contributed to increase the quantity of the food of mankind by other means besides that of destroying their acrimony. One of these is by converting the acerb juices of some fruits into sugar, as in the baking of unripe pears, and the bruising of unripe apples; in both which situations the life of the vegetable is destroyed, and the conversion of the harsh juice into a sweet one must be performed by a chemical process; and not by a vegetable one only, as the germination of barley in making malt has generally been supposed.

Some circumstances, which seem to injure the life of several fruits, seem to forward the saccharine process of their juices. Thus if some kinds of pears are gathered a week before they would ripen on the tree, and are laid on a heap and covered, their juice becomes sweet many days sooner. The taking off a circular piece of the bark from a branch of a pear-tree causes the fruit of that branch to ripen sooner by a fortnight, as I have more than once observed. The wounds made in apples by insects occasion those apples to ripen sooner; caprification, or the piercing of figs, in the island of Malta, is said to ripen them sooner; and I am well informed, that when bunches of grapes in this country have acquired their expected size, that if the stalk of each bunch be cut half through, that they will sooner ripen.

The germinating barley in the malt-house I believe acquires little sweetness, till the life of the seed is destroyed, and the saccharine process then continued or advanced by the heat in drying it. Thus in animal digestion, the sugar produced in the stomach is absorbed by the lacteals as fast as it is made, otherwise it ferments, and produces flatulency; so in the germination of barley in the malt-house, so long as the new plant lives, the sugar, I suppose, is absorbed as fast as it is made; but that, which we use in making beer, is the sugar produced by a chemical process after the death of the young plant, or which is made more expeditiously, than the plant can absorb it.

It is probably this saccharine process, which obtains in new hay-stacks too hastily, and which by immediately running into fermentation produces so much heat as to set them on fire. The greatest part of the grain, or seeds, or roots, used in the distilleries, as wheat, canary seed, potatoes, are not I believe previously subjected to germination, but are in part by a chemical process converted into sugar, and immediately subjected to vinous fermentation; and it is probable a process may sometime be discovered of producing sugar from starch or meal; and of separating it from them for domestic purposes by alcohol, which dissolves sugar but not mucilage; or by other means.

Another method of increasing the nutriment of mankind by cookery, is by dissolving cartilages and bones, and tendons, and probably some vegetables, in steam or water at a much higher degree of heat than that of boiling. This is to be done in a close vessel, which is called Papin's digester; in which, it is said, that water may be made red-hot, and will then dissolve all animal substances; and might thus add to our quantity of food in times of scarcity. This vessel should be made of iron, and should have an oval opening at top, with an oval lid of iron larger than the aperture; this lid should be slipped in endways, when the vessel is filled, and then turned, and raised by a screw above it into contact with the under edges of the aperture. There should also be a small tube or hole covered with a weighted valve to prevent the danger of bursting the digester.

Where the powers of digestion are weakened, broths made by boiling animal and vegetable substances in water afford a nutriment; though I suppose not so great as the flesh and vegetables would afford, if taken in their solid form, and mixed with saliva in the act of mastication. The aliment thus prepared should be boiled but a short time, nor should be suffered to continue in our common kitchen-utensils afterwards, as they are lined with a mixture of half lead and half tin, and are therefore unwholesome, though the copper is completely covered. And those soups, which have any acid or wine boiled in them, unless they be made in silver, or in china, or in those pot-vessels, which are not glazed by the addition of lead, are truly poisonous; as the acid, as lemon-juice or vinegar, when made hot, erodes or dissolves the lead and tin lining of the copper-vessels, and the leaden glaze of the porcelain ones. Hence, where silver cannot be had, iron vessels are preferable to tinned copper ones; or those made of tinned iron-plates in the common tin-shops, which are said to be covered with pure or block tin.

[6]. Another circumstance, which facilitates the nourishment of mankind, is the mechanic art of grinding farinaceous seeds into powder between mill-stones; which may be called the artificial teeth of society. It is probable, that some soft kinds of wood, especially when they have undergone a kind of fermentation, and become of looser texture, might be thus used as food in times of famine.

Nor is it improbable, that hay, which has been kept in stacks, so as to undergo the saccharine process, may be so managed by grinding and by fermentation with yeast like bread, as to serve in part for the sustenance of mankind in times of great scarcity. Dr. Priestley gave to a cow for some time a strong infusion of hay in large quantity for her drink, and found that she produced during this treatment above double the quantity of milk. Hence if bread cannot be made from ground hay, there is great reason to suspect, that a nutritive beverage may be thus prepared either in its saccharine state, or fermented into a kind of beer.

In times of great scarcity there are other vegetables, which though not in common use, would most probably afford wholesome nourishment, either by boiling them, or drying and grinding them, or by both those processes in succession. Of these are perhaps the tops and the bark of all those vegetables, which are armed with thorns or prickles, as gooseberry trees, holly, gorse, and perhaps hawthorn. The inner bark of the elm tree makes a kind of gruel. And the roots of fern, and probably of very many other roots, as of grass and of clover taken up in winter, might yield nourishment either by boiling or baking, and separating the fibres from the pulp by beating them; or by getting only the starch from those, which possess an acrid mucilage, as the white briony.

[7]. However the arts of cookery and of grinding may increase or facilitate the nourishment of mankind, the great source of it is from agriculture. In the savage state, where men live solely by hunting, I was informed by Dr. Franklin, that there was seldom more than one family existed in a circle of five miles diameter; which in a state of pasturage would support some hundred people, and in a state of agriculture many thousands. The art of feeding mankind on so small a grain as wheat, which seems to have been discovered in Egypt by the immortal name of Ceres, shewed greater ingenuity than feeding them with the large roots of potatoes, which seem to have been a discovery of ill-fated Mexico.

This greater production of food by agriculture than by pasturage, shews that a nation nourished by animal food will be less numerous than if nourished by vegetable; and the former will therefore be liable, if they are engaged in war, to be conquered by the latter, as Abel was slain by Cain. This is perhaps the only valid argument against inclosing open arable fields. The great production of human nourishment by agriculture and pasturage evinces the advantage of society over the savage state; as the number of mankind becomes increased a thousand fold by the arts of agriculture and pasturage; and their happiness is probably under good governments improved in as great a proportion, as they become liberated from the hourly fear of beasts of prey, from the daily fear of famine, and of the occasional incursions of their cannibal neighbours.

But pasturage cannot exist without property both in the soil, and the herds which it nurtures; and for the invention of arts, and production of tools necessary to agriculture, some must think, and others labour; and as the efforts of some will be crowned with greater success than that of others, an inequality of the ranks of society must succeed; but this inequality of mankind in the present state of the world is too great for the purposes of producing the greatest quantity of human nourishment, and the greatest sum of human happiness; there should be no slavery at one end of the chain of society, and no despotism at the other.—By the future improvements of human reason such governments may possibly hereafter be established, as may a hundred-fold increase the numbers of mankind, and a thousand-fold their happiness.

[IV]. [1]. Water must be considered as a part of our nutriment, because so much of it enters the composition of our solids as well as of our fluids; and because vegetables are now believed to draw almost the whole of their nourishment from this source. As in them the water is decomposed, as it is perspired by them in the sunshine, the oxygen gas increases the quantity and the purity of the atmosphere in their vicinity, and the hydrogen seems to be retained, and to form the nutritive juices, and consequent secretions of rosin, gum, wax, honey, oil, and other vegetable productions. See Botanic Garden, Part I. Cant. IV. line 25, note. It has however other uses in the system, besides that of a nourishing material, as it dilutes our fluids, and lubricates our solids; and on all these accounts a daily supply of it is required.

[2]. River-water is in general purer than spring-water; as the neutral salts washed down from the earth decompose each other, except perhaps the marine salt; and the earths, with which spring-water frequently abounds, is precipitated; yet it is not improbable, that the calcareous earth dissolved in the water of many springs may contribute to our nourishment, as the water from springs, which contain earth, is said to conduce to enrich those lands, which are flooded with it, more than river water.

[3]. Many arguments seem to shew, that calcareous earth contributes to the nourishment of animals and vegetables. First because calcareous earth constitutes a considerable part of them, and must therefore either be received from without, or formed by them, or both, as milk, when taken as food by a lactescent woman, is decomposed in the stomach by the process of digestion, and again in part converted into milk by the pectoral glands. Secondly, because from the analogy of all organic life, whatever has composed a part of a vegetable or animal may again after its chemical solution become a part of another vegetable or animal, such is the general transmigration of matter. And thirdly, because the great use of lime in agriculture on almost all kinds of soil and situation cannot be satisfactorily explained from its chemical properties alone. Though these may also in certain soils and situations have considerable effect.

The chemical uses of lime in agriculture may be, 1. from its destroying in a short time the cohesion of dead vegetable fibres, and thus reducing them to earth, which otherwise is effected by a slow process either by the consumption of insects or by a gradual putrefaction. Thus I am informed that a mixture of lime with oak bark, after the tanner has extracted from it whatever is soluble in water, will in two or three months reduce it to a fine black earth, which, if only laid in heaps, would require as many years to effect by its own spontaneous fermentation or putrefaction. This effect of lime must be particularly advantageous to newly inclosed commons when first broken up.

Secondly, lime for many months continues to attract moisture from the air or earth, which it deprives I suppose of carbonic acid, and then suffers it to exhale again, as is seen on the plastered walls of new houses. On this account it must be advantageous when mixed with dry or sandy soils, as it attracts moisture from the air above or the earth beneath, and this moisture is then absorbed by the lymphatics of the roots of vegetables. Thirdly, by mixing lime with clays it is believed to make them less cohesive, and thus to admit of their being more easily penetrated by vegetable fibres. A mixture of lime with clays destroys their superabundancy of acid, if such exists, and by uniting with it converts it into gypsum or alabaster. And lastly, fresh lime destroys worms, snails, and other insects, with which it happens to come in contact.

Yet do not all these chemical properties seem to account for the great uses of lime in almost all soils and situations, as it contributes so much to the melioration of the crops, as well as to their increase in quantity. Wheat from land well limed is believed by farmers, millers, and bakers, to be, as they suppose, thinner skinned; that is, it turns out more and better flour; which I suppose is owing to its containing more starch and less mucilage. In respect to grass-ground I am informed, that if a spadeful of lime be thrown on a tussock, which horses or cattle have refused to touch for years, they will for many succeeding seasons eat it quite close to the ground.

One property of lime is not perhaps yet well understood, I mean its producing so much heat, when it is mixed with water; which may be owing to the elementary fluid of heat consolidated in the lime. It is the steam occasioned by this heat, when water is sprinkled upon lime, if the water be not in too great quantity or too cold, which breaks the lime into such fine powder as almost to become fluid, which cannot be effected perhaps by any other means, and which I suppose must give great preference to lime in agriculture, and to the solutions of calcareous earth in water, over chalk or powdered limestone, when spread upon the land.

[4]. It was formerly believed that waters replete with calcareous earth, such as incrust the inside of tea-kettles, or are laid to petrify moss, were liable to produce or to increase the stone in the bladder. This mistaken idea has lately been exploded by the improved chemistry, as no calcareous earth, or a very minute quantity, was found in the calculi analysed by Scheel and Bergman. The waters of Matlock and of Carlsbad, both which cover the moss, which they pass through, with a calcareous crust, are so far from increasing the stone of the bladder or kidnies, that those of Carlsbad are celebrated for giving relief to those labouring under these diseases. Philos. Trans. Those of Matlock are drank in great quantities without any suspicion of injury; and I well know a person who for above ten years has drank about two pints a day of cold water from a spring, which very much incrusts the vessels, it is boiled in, with calcareous earth, and affords a copious calcareous sediment with a solution of salt of tartar, and who enjoys a state of uninterrupted health.

[V]. [1]. As animal bodies consist much both of oxygen and azote, which make up the composition of atmospheric air, these should be counted amongst nutritious substances. Besides that by the experiments of Dr. Priestley it appears, that the oxygen gains admittance into the blood through the moist membranes of the lungs; and seems to be of much more immediate consequence to the preservation of our lives than the other kinds of nutriment above specified.

As the basis of fixed air, or carbonic acid gas, is carbone, which also constitutes a great part both of vegetable and animal bodies; this air should likewise be reckoned amongst nutritive substances. Add to this, that when this carbonic acid air is swallowed, as it escapes from beer or cyder, or when water is charged with it as detruded from limestone by vitriolic acid, it affords an agreeable sensation both to the palate and stomach, and is therefore probably nutritive.

The immense quantity of carbone and of oxygen which constitute so great a part of the limestone countries is almost beyond conception, and, as it has been formed by animals, may again become a part of them, as well as the calcareous matter with which they are united. Whence it may be conceived, that the waters, which abound with limestone in solution, may supply nutriment both to animals and to vegetables, as mentioned above.

[VI]. [1]. The manner, in which nutritious particles are substituted in the place of those, which are mechanically abraded, or chemically decomposed, or which vanish by animal absorption, must be owing to animal appetency, as described in Sect. XXXVII. 3. and is probably similar to the process of inflammation, which produces new vessels and new fluids; or to that which constitutes the growth of the body to maturity. Thus the granulations of new flesh to repair the injuries of wounds are visible to the eye; as well as the callous matter, which cements broken bones; the calcareous matter, which repairs injured snail-shells; and the threads, which are formed by silk-worms and spiders; which are all secreted in a softer state, and harden by exsiccation, or by the contact of the air, or by absorption of their more fluid parts.

Whether the materials, which thus supply the waste of the system, can be given any other way than by the stomach, so as to preserve the body for a length of time, is worth our inquiry; as cases sometimes occur, in which food cannot be introduced into the stomach, as in obstructions of the œsophagus, inflammations of the throat, or in hydrophobia; and other cases are not unfrequent in which the power of digestion is nearly or totally destroyed, as in anorexia epileptica, and in many fevers.

In the former of these circumstances liquid nutriment may sometimes be got into the stomach through a flexible catheter; as described in Class [III. 1. 1. 15]. In the latter many kinds of mild aliment, as milk or broth, have frequently been injected as clysters, together with a small quantity of opium, as ten drops of the tincture, three or four times a day; to which also might be added very small quantities of vinous spirit. But these, as far as I have observed, will not long sustain a person, who cannot take any sustenance by the stomach.

[2]. Another mode of applying nutritive fluids might be by extensive fomentations, or by immerging the whole body in a bath of broth, or of warm milk, which might at the same time be coagulated by rennet, or the acid of the calf's stomach; broth or whey might thus probably be introduced, in part at least, into the circulation, as a solution of nitre is said to have been absorbed in a pediluvium, which was afterwards discovered by the manner in which paper dipped frequently in the urine of the patient and dried, burnt and sparkled like touch-paper. Great quantity of water is also known to be absorbed by those, who have bathed in the warm bath after exercise and abstinence from liquids. Cleopatra was said to travel with 4000 milch-asses in her train, and to bathe every morning in their milk, which she probably might use as a cosmetic rather than a nutritive.

[3]. The transfusion of blood from another animal into the vein of one, who could take no sustenance by the throat, or digest none by the stomach, might long continue to support him; and perhaps other nutriment, as milk or mucilage, might be this way introduced into the system, but we have not yet sufficient experiments on this subject. See Sect. XXXII. 4. and Class [I. 2. 3. 25]. and Sup. I. [14. 2].

[VII]. Various kinds of condiments, or sauces, have been taken along with vegetable or animal food, and have been thought by some to strengthen the process of digestion and consequent process of nutrition. Of these wine, or other fermented liquors, vinegar, salt, spices, and mustard, have been in most common use, and I believe to the injury of thousands. As the stomach by their violent stimulus at length loses its natural degree of irritability, and indigestion is the consequence; which is attended with flatulency and emaciation. Where any of these have been taken so long as to induce a habit, they must either be continued, but not increased; or the use of them should be gradually and cautiously diminished or discontinued, as directed in Sect. XII. 7. 8.

[III]. Catalogue of the Nutrientia.

[I]. [1]. Venison, beef, mutton, hare, goose, duck, woodcock, snipe, moor-game.

[2]. Oysters, lobsters, crabs, shrimps, mushrooms, eel, tench, barbolt, smelt, turbot, sole, turtle.

[3]. Lamb, veal, sucking-pig.

[4]. Turkey, partridge, pheasant, fowl, eggs.

[5]. Pike, perch, gudgeon, trout, grayling.

[II]. Milk, cream, butter, buttermilk, whey, cheese.

[III]. Wheat, barley, oats, peas, potatoes, turnips, carrots, cabbage, asparagus, artichoke, spinach, beet, apple, pear, plum, apricot, nectarine, peach, strawberry, grape, orange, melon, cucumber, dried figs, raisins, sugar, honey. With a great variety of other roots, seeds, leaves, and fruits.

[IV]. Water, river-water, spring-water, calcareous earth.

[V]. Air, oxygene, azote, carbonic acid gas.

[VI]. Nutritive baths and clysters, transfusion of blood.

[VII]. Condiments.

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Art. [II].

INCITANTIA.

[I]. [1]. Those things, which increase the exertions of all the irritative motions, are termed incitantia. As alcohol, or the spirituous part of fermented liquors, opium, and many drugs, which are still esteemed poisons, their proper doses not being ascertained. To these should be added the exhilarating passions of the mind, as joy, love: and externally the application of heat, electricity, æther, essential oils, friction, and exercise.

[2]. These promote both the secretions and absorptions, increase the natural heat, and remove those pains, which originate from the defect of irritative motions, termed nervous pains; and prevent the convulsions consequent to them. When given internally they induce costiveness, and deep coloured urine; and by a greater dose intoxication, and its consequences.

[II]. Observations on the Incitantia.

[I]. [1]. Opium and alcohol increase all the secretions and absorptions. The increase of the secretion of sensorial power appears from the violent exertions of drunken people; the secretion of sweat is more certainly excited by opium or wine than by any other medicine; and the increase of general heat, which these drugs produce, is an evidence of their effect in promoting all the secretions; since an increase of secretion is always attended with increase of heat in the part, as in hepatic and other inflammations.

[2]. But as they at the same time promote absorption; those fluids, which are secreted into receptacles, as the urine, bile, intestinal and pulmonary mucus, have again their thinner parts absorbed; and hence, though the quantity of secreted fluid was increased, yet as the absorption was also increased, the excretion from these receptacles is lessened; at the same time that it is deeper coloured or of thicker consistence, as the urine, alvine feces, and pulmonary mucus. Whereas the perspiration being secreted on the surface of the body is visible in its increased quantity, before it can be reabsorbed; whence arises that erroneous opinion, that opium increases the cutaneous secretion, and lessens all the others.

[3]. It must however be noted, that after evacuations opium seems to promote the absorptions more than the secretions; if you except that of the sensorial power in the brain, which probably suffers no absorption. Hence its efficacy in restraining hæmorrhages, after the vessels are emptied, by promoting venous absorption.

[4]. In ulcers the matter is thickened by the exhibition of opium from the increased absorption of the thinner parts of it; but it is probable, that the whole secretion, including the part which is absorbed, is increased; and hence new fibres are secreted along with the matter, and the ulcer fills with new granulations of flesh. But as no ulcer can heal, till it ceases to discharge; that is, till the absorption becomes as great as the excretion; those medicines, which promote absorption only, are more advantageous for the healing an ulcer after it is filled with new flesh; as the Peruvian bark internally; with bandages and solutions of lead externally.

[5]. There are many pains which originate from a want of due motion in the part, as those occasioned by cold; and all those pains which are attended with cold extremities, and are generally termed nervous. These are relieved by whatever excites the part into its proper actions, and hence by opium and alcohol; which are the most universal stimulants we are acquainted with. In these cases the effect of opium is produced, as soon as the body becomes generally warm; and a degree of intoxication or sleep follows the cessation of the pain.

These nervous pains (as they are called) frequently return at certain periods of time, and are also frequently succeeded by convulsions; in these cases if opium removes the pain, the convulsions do not come on. For this purpose it is best to exhibit it gradually, as a grain every hour, or half hour, till it intoxicates. Here it must be noted, that a much less quantity will prevent the periods of these cold pains, than is necessary to relieve them after their access. As a grain and half of opium given an hour before the expected paroxysm will prevent the cold fit of an intermittent fever, but will not soon remove it, when it is already formed. For in the former case the usual or healthy associations or catenations of motion favour the effect of the medicine; in the latter case these associations or catenations are disordered, or interrupted, and new ones are formed, which so far counteract the effect of the medicine.

When opium has been required in large doses to ease or prevent convulsions, some have advised the patient to omit the use of wine, as a greater quantity of opium might then be exhibited; and as opium seems to increase absorption more, and secretion less, than vinous spirit; it may in some cases be useful to exchange one for the other; as in diseases attended with too great evacuation, as diarrhœa, and dysentery, opium may be preferable; on the contrary in tetanus, or locked-jaw, where inflammation of the system might be of service, wine may be preferable to opium; see Class [III. 1. 1. 13]. I have generally observed, that a mixture of spirit of wine and warm water, given alternately with the doses of opium, has soonest and most certainly produced that degree of intoxication, which was necessary to relieve the patient in the epilepsia dolorifica.

[6]. There is likewise some relief given by opium to inflammatory pains, or those from excess of motion in the affected part; but with this difference, that this relief from the pains, and the sleep, which it occasions, does not occur till some hours after the exhibition of the opium. This requires to be explained; after the stimulus of opium or of alcohol ceases, as after common drunkenness, a consequent torpor comes on; and the whole habit becomes less irritable by the natural stimuli. Hence the head-achs, sickness, and languor, on the next day after intoxication, with cold skin, and general debility. Now in pains from excess of motion, called inflammatory pains, when opium is given, the pain is not relieved, till the debility comes on after the stimulus ceases to act; for then after the greater stimulus of the opium has exhausted much of the sensorial power; the less stimulus, which before caused the pain, does not now excite the part into unnatural action.

In these cases the stimulus of the opium first increases the pain; and it sometimes happens, that so great a torpor follows, as to produce the death or mortification of the affected part; whence the danger of giving opium in inflammatory diseases, especially in inflammation of the bowels; but in general the pain returns with its former violence, when the torpor above mentioned ceases. Hence these pains attended with inflammation are best relieved by copious venesection, other evacuations, and the class of medicines called torpentia.

[7]. These pains from excess of motion are attended with increased heat of the whole, or of the affected part, and a strong quick pulse; the pains from defect of motion are attended with cold extremities, and a weak pulse; which is also generally more frequent than natural, but not always so.

[8]. Opium and alcohol are the only two drugs, we are much acquainted with, which intoxicate; and by this circumstance are easily distinguished from the secernentia and sorbentia. Camphor, and cicuta, and nicotiana, are thought to induce a kind of intoxication; and there are many other drugs of this class, whose effects are less known, or their doses not ascertained; as atropa belladonna, hyocyamus, stramonium, prunus laurocerasus, menispermum, cynoglossum, some fungi, and the water distilled from black cherry-stones; the last of which was once much in use for the convulsions of children, and was said to have good effect; but is now improvidently left out of our pharmacopias. I have known one leaf of the laurocerasus, shred and made into tea, given every morning for a week with no ill consequence to a weak hysteric lady, but rather perhaps with advantage.

[9]. The pernicious effects of a continued use of much vinous spirit is daily seen and lamented by physicians; not only early debility, like premature age, but a dreadful catalogue of diseases is induced by this kind of intemperance; as dropsy, gout, leprosy, epilepsy, insanity, as described in Botanic Garden, Part II. Canto III. line 357. The stronger or less diluted the spirit is taken, the sooner it seems to destroy, as in dram-drinkers; but still sooner, when kernels of apricots, or bitter almonds, or laurel-leaf, are infused in the spirit, which is termed ratafia; as then two poisons are swallowed at the same time. And vinegar, as it contains much vinous spirit, is probably a noxious part of our diet. And the distilled vinegar, which is commonly sold in the shops, is truly poisonous, as it is generally distilled by means of a pewter or leaden alembic-head or worm-tube, and abounds with lead; which any one may detect by mixing with it a solution of liver of sulphur. Opium, when taken as a luxury, not as a medicine, is as pernicious as alcohol; as Baron de Tott relates in his account of the opium-eaters in Turkey.

[10]. It must be observed, that a frequent repetition of the use of this class of medicines so habituates the body to their stimulus, that their dose may gradually be increased to an astonishing quantity, such as otherwise would instantly destroy life; as is frequently seen in those, who accustom themselves to the daily use of alcohol and opium; and it would seem, that these unfortunate people become diseased as soon as they omit their usual potations; and that the consequent gout, dropsy, palsy, or pimpled face, occur from the debility occasioned from the want of accustomed stimulus, or to some change in the contractile fibres, which requires the continuance or increase of it. Whence the cautions necessary to be observed are mentioned in Sect. XII. 7. 8.

[11]. It is probable, that some of the articles in the subsequent catalogue do not induce intoxication, though they have been esteemed to do so; as tobacco, hemlock, nux vomica, stavisagria; and on this account should rather belong to other arrangements, as to the secernentia, or sorbentia, or invertentia.

[II]. [1]. Externally the application of heat, as the warm bath, by its stimulus on the skin excites the excretory ducts of the perspirative glands, and the mouths of the lymphatics, which open on its surface, into greater action; and in consequence many other irritative motions, which are associated with them. To this increased action is added pleasurable sensation, which adds further activity to the system; and thus many kinds of pain receive relief from this additional atmosphere of heat.

The use of a warm bath of about 96 or 98 degrees of heat, for half an hour once a day for three or four months, I have known of great service to weak people, and is perhaps the least noxious of all unnatural stimuli; which however, like all other great excitement, may be carried to excess, as complained of by the ancients. The unmeaning application of the words relaxation and bracing to warm and cold baths has much prevented the use of this grateful stimulus; and the misuse of the term warm-bath, when applied to baths colder than the body, as to those of Buxton and Matlock, and to artificial baths of less than 90 degrees of heat, which ought to be termed cold ones, has contributed to mislead the unwary in their application.

The stimulus of wine, or spice, or salt, increases the heat of the system by increasing all or some of the secretions; and hence the strength is diminished afterwards by the loss of fluids, as well as by the increased action of the fibres. But the stimulus of the warm-bath supplies heat rather than produces it; and rather fills the system by increased absorption, than empties it by increased secretion; and may hence be employed with advantage in almost all cases of debility with cold extremities, perhaps even in anasarca, and at the approach of death in fevers. In these cases a bath much beneath 98 degrees, as of 80 or 85, might do injury, as being a cold-bath compared with the heat of the body, though such a bath is generally called a warm one.

The activity of the system thus produced by a bath of 98 degrees of heat, or upwards, does not seem to render the patients liable to take cold, when they come out of it; for the system is less inclined to become torpid than before, as the warmth thus acquired by communication, rather than by increased action, continues long without any consequent chillness. Which accords with the observation of Dr. Fordyce, mentioned in Sup. I. [5. 1]. who says, that those who are confined some time in an atmosphere of 120 or 130 degrees of heat, do not feel cold or look pale on coming into a temperature of 30 or 40 degrees; which would produce great paleness and sensation of coldness in those, who had been some time confined in an atmosphere of only 86 or 90 degrees of heat. Treatise on Simple Fever, p. 168.

Hence heat, where it can be confined on a torpid part along with moisture, as on a scrophulous tumour, will contribute to produce suppuration or resolution. This is done by applying a warm poultice, which should be frequently repeated; or a plaster of resin, wax, or fat; or by covering the part with oiled silk; both which last prevent the perspirable matter from escaping as well as the heat of the part, as these substances repel moisture, and are bad conductors of heat. Another great use of the stimulus of heat is by applying it to torpid ulcers, which are generally termed scrophulous or scorbutic, and are much easier inclined to heal, when covered with several folds of flannel.

Mr. —— had for many months been afflicted with an ulcer in perinæo, which communicated with the urethra, through which a part of his urine was daily evacuated with considerable pain; and was reduced to a great degree of debility. He used a hot-bath of 96 or 98 degrees of heat every day for half an hour during about six months. By this agreeable stimulus repeated thus at uniform times not only the ulcer healed, contrary to the expectation of his friends, but he acquired greater health and strength, than he had for some years previously experienced.

Mrs. —— was affected with transient pains, which were called nervous spasms, and with great fear of diseases, which she did not labour under, with cold extremities, and general debility. She used a hot-bath every other day of 96 degrees of heat for about four months, and recovered a good state of health, with greater strength and courage, than she had possessed for many months before.

Mr. Z. a gentleman about 65 years of age, who had lived rather intemperately in respect to vinous potation, and had for many years had annual visits of the gout, which now became irregular, and he appeared to be losing his strength, and beginning to feel the effects of age. He used a bath, as hot as was agreeable to his sensations, twice a week for about a year and half, and greatly recovered his health and strength with less frequent and less violent returns of regular gout, and is now near 80 years of age.

When Dr. Franklin, the American philosopher, was in England many years ago, I recommended to him the use of a warm-bath twice a week to prevent the too speedy access of old age, which he then thought that he felt the approach of, and I have been informed, that he continued the use of it till near his death, which was at an advanced age.

All these patients were advised not to keep themselves warmer than their usual habits, after they came out of the bath, whether they went into bed or not; as the design was not to promote perspiration, which weakens all constitutions, and seldom is of service to any. Thus a flannel shirt, particularly if it be worn in warm weather, occasions weakness by stimulating the skin by its points into too great action, and producing heat in consequence; and occasions emaciation by increasing the discharge of perspirable matter; and in both these respects differs from the effect of warm bathing, which communicates heat to the system at the same time that it stimulates it, and causes absorption more than exhalation.

[2]. The effect of the passage of an electric shock through a paralytic limb in causing it to contract, besides the late experiments of Galvani and Volta on frogs, intitle it to be classed amongst universal stimulants. Electric shocks frequently repeated daily for a week or two remove chronical pains, as the pleurodyne chronica, Class [I. 2. 4. 14]. and other chronic pains, which are termed rheumatic, probably by promoting the absorption of some extravasated material. Scrophulous tumours are sometimes absorbed, and sometimes brought to suppurate by passing electric shocks through them daily for two or three weeks.

Miss ——, a young lady about eight years of age, had a swelling about the size of a pigeon's egg on her neck a little below her ear, which long continued in an indolent state. Thirty or forty small electric shocks were passed through it once or twice a day for two or three weeks, and it then suppurated and healed without difficulty. For this operation the coated jar of the electric machine had on its top an electrometer, which measured the shocks by the approach of a brass knob, which communicated with the external coating to another, which communicated with the internal one, and their distance was adjusted by a screw. So that the shocks were so small as not to alarm the child, and the accumulated electricity was frequently discharged, as the wheel continued turning. The tumour was inclosed between two other brass knobs, which were fixed on wires, which passed through glass tubes, the tubes were cemented in two grooves on a board, so that at one end they were nearer each other than at the other, and the knobs were pushed out so far as exactly to include the tumour, as described in the annexed plate, which is about half the size of the original apparatus.

Inflammations of the eyes without fever are frequently cured by taking a stream of very small electric sparks from them, or giving the electric sparks to them, once or twice a day for a week or two; that is, the new vessels, which constitute inflammation in these inirritable constitutions, are absorbed by the activity of the absorbents induced by the stimulus of the electric aura. For this operation the easiest method is to fix a pointed wire to a stick of sealing wax, or to an insulating handle of glass, one end of this wire communicates with the prime conductor, and the point is approached near the inflamed eye in every direction.

[III]. Externally the application of ether, and of essential oils, as of cloves or cinnamon, seem to possess a general stimulating effect. As they instantly relieve tooth-ach, and hiccough, when these pains are not in violent degree; and camphor in large doses is said to produce intoxication; this effect however I have not been witness to, and have reason to doubt.

The manner in which ether and the essential oil operate on the system when applied externally, is a curious question, as pain is so immediately relieved by them, that they must seem to penetrate by the great fluidity or expansive property of a part of them, as of their odoriferous exhalation or vapour, and that they thus stimulate the torpid part, and not by their being taken up by the absorbent vessels, and carried thither by the long course of circulation; nor is it probable, that these pains are relieved by the sympathy of the torpid membrane with the external skin, which is thus stimulated into action; as it does not succeed, unless it is applied over the pained part. Thus there appears to be three different modes by which extraneous bodies may be introduced into the system, besides that of absorption. 1st. By ethereal transition, as heat and electricity; 2d. by chemical attraction, as oxygen; and 3d. by expansive vapour, as ether and essential oils.

[IV]. The perpetual necessity of the mixture of oxygen gas with the blood in the lungs evinces, that it must act as a stimulus to the sanguiferous system, as the motions of the heart and arteries presently cease, when animals are immersed in airs which possess no oxygen. It may also subsequently answer another important purpose, as it probably affords the material for the production of the sensorial power; which is supposed to be secreted in the brain or medullary part of the nerves; and that the perpetual demand of this fluid in respiration is occasioned by the sensorial power, which is supposed to be produced from it, being too subtle to be long confined in any part of the system.

Another proof of the stimulant quality of oxygen appears from the increased acrimony, which the matter of a common abscess possesses, after it has been exposed to the air of the atmosphere, but not before; and probably all other contagious matters owe their fever-producing property to having been converted into acids by their union with oxygen.

As oxygen penetrates the fine moist membranes of the air-vessels of the lungs, and unites with the blood by a chemical attraction, as is seen to happen, when blood is drawn into a bason, the lower surface of the crassamentum is of a very dark red so long as it is covered from the air by the upper surface, but becomes florid in a short time on its being exposed to the atmosphere; the manner of its introduction into the system is not probably by animal absorption but by chemical attraction, in which circumstance it differs from the fluids before mentioned both of heat and electricity, and of ether and essential oils.

As oxygen has the property of passing through moist animal membranes, as first discovered by the great Dr. Priestley, it is probable it might be of use in vibices, and petechiæ in fevers, and in other bruises; if the skin over those parts was kept moist by warm water, and covered with oxygen gas by means of an inverted glass, or even by exposing the parts thus moistened to the atmosphere, as the dark coloured extravasated blood might thus become florid, and by its increase of stimulus facilitate its reabsorption.

Two weak patients, to whom I gave oxygen gas in as pure a state as it can easily be procured from Exeter manganese, and in the quantity of about four gallons a day, seemed to feel refreshed, and stronger, and to look better immediately after respiring it, and gained strength in a short time. Two others, one of whom laboured under confirmed hydrothorax, and the other under a permanent and uniform difficulty of respiration, were not refreshed, or in any way served by the use of oxygen in the above quantity of four gallons a day for a fortnight, which I ascribed to the inirritability of the diseased lungs. For other cases the reader is referred to the publications of Dr. Beddoes; Confederations on the Use of Factitious Airs, sold by Johnson, London.

Its effects would probably have been greater in respect to the quantity breathed, if it had been given in a dilute state, mixed with 10 or 20 times its quantity of atmospheric air, as otherwise much of it returns by expiration without being deprived of its quality, as may be seen by the person breathing on the flame of a candle, which it enlarges. See the Treatise of Dr. Beddoes above mentioned.

[V]. Those passions, which are attended with pleasurable sensation, excite the system into increased action in consequence of that sensation, as joy, and love, as is seen by the flush of the skin. Those passions, which are attended with disagreeable sensation, produce torpor in general by the expence of sensorial power occasioned by inactive pain; unless volition be excited in consequence of the painful sensation; and in that case an increased activity of the system occurs; thus paleness and coldness are the consequence of fear, but warmth and redness are the consequence of anger.

[VI]. Besides the exertions of the system occasioned by increased stimuli, and consequent irritation, and by the passions of the mind above described, the increased actions occasioned by exercise belong to this article. These may be divided into the actions of the body in consequence of volition, which is generally termed labour; or secondly, in consequence of agreeable sensation, which is termed play or sport; thirdly, the exercise occasioned by agitation, as in a carriage or on horseback; fourthly, that of friction, as with a brush or hand, so much used in the baths of Turkey; and lastly, the exercise of swinging.

The first of these modes of exercise is frequently carried to great excess even amongst our own labourers, and more so under the lash of slavery; so that the body becomes emaciated and sinks under either the present hardships, or by a premature old age. The second mode of exercise is seen in the play of all young animals, as kittens, and puppies, and children; and is so necessary to their health as well as to their pleasure, that those children, which are too much confined from it, not only become pale-faced and bloated, with tumid bellies, and consequent worms, but are liable to get habits of unnatural actions, as twitching of their limbs, or of some parts of their countenance; together with an ill-humoured or discontented mind.

Agitation in a carriage or on horseback, as it requires some little voluntary exertion to preserve the body perpendicular, but much less voluntary exertion than in walking, seems the best adapted to invalids; who by these means obtain exercise principally by the strength of the horse, and do not therefore too much exhaust their own sensorial power. The use of friction with a brush or hand, for half an hour or longer morning and evening, is still better adapted to those, who are reduced to extreme debility; and none of their own sensorial power is thus expended, and affords somewhat like the warm-bath activity without self-exertion, and is used as a luxury after warm bathing in many parts of Asia.

Another kind of exercise is that of swinging, which requires some exertion to keep the body perpendicular, or pointing towards the center of the swing, but is at the same time attended with a degree of vertigo; and is described in Class [II. 1. 6. 7]. [IV. 2. 1. 10]. Sup. I. [3]. and [15].

The necessity of much exercise has perhaps been more insisted upon by physicians, than nature seems to demand. Few animals exercise themselves so as to induce visible sweat, unless urged to it by mankind, or by fear, or hunger. And numbers of people in our market towns, of ladies particularly, with small fortunes, live to old age in health, without any kind of exercise of body, or much activity of mind.

In summer weak people cannot continue too long in the air, if it can be done without fatigue; and in winter they should go out several times in a day for a few minutes, using the cold air like a cold-bath, to invigorate and render them more hardy.

[III]. Catalogue of the Incitantia.

[I]. Papaver somniferum; poppy, opium.

Alcohol, wine, beer, cyder.

Prunus lauro-cerasus; laurel, distilled water from the leaves.

Prunus cerasus; black cherry, distilled water from the kernels.

Nicotiana tabacum; tobacco? the essential oil, decoction of the leaf.

Atropa belladona; deadly nightshade, the berries.

Datura stramoneum; thorn-apple, the fruit boiled in milk.

Hyoscyamus reticulatus; henbane, the seeds and leaves.

Cynoglossum; hounds tongue.

Menispermum, cocculus; Indian berry.

Amygdalus amarus; bitter almond.

Cicuta; hemlock. Conium maculatum?

Strychnos nux vomica?

Delphinium stavisagria?

[II]. Externally, heat, electricity.

[III]. Ether, essential oils.

[IV]. Oxygen gas.

[V]. Passions of love, joy, anger.

[VI]. Labour, play, agitation, friction.

---

Art. [III].

SECERNENTIA.

[I]. Those things which increase the irritative motions, which constitute secretion, are termed secernentia; which are as various as the glands, which they stimulate into action.

[1]. Diaphoretics, as aromatic vegetables, essential oils, ether, volatile alcali, neutral salts, antimonial preparations, external heat, exercise, friction, cold water for a time with subsequent warmth, blisters, electric fluid.

[2]. Sialagogues, as mercury internally, and pyrethrum externally.

[3]. Expectorants, as squill, onions, gum ammoniac, seneka root, mucilage: some of these increase the pulmonary perspiration, and perhaps the pulmonary mucus.

[4]. Diuretics, as neutral salts, fixed alcali, balsams, resins, asparagus, cantharides.

[5]. Cathartics of the mild kind, as sena, jalap, neutral salts, manna. They increase the secretions of bile, pancreatic juice, and intestinal mucus.

[6]. The mucus of the bladder is increased by cantharides, and perhaps by oil of turpentine.

[7]. The mucus of the rectum by aloe internally, by clysters and suppositories externally.

[8]. The mucus of the cellular membrane is increased by blisters and sinapisms.

[9]. The mucus of the nostrils is increased by errhines of the milder kind, as marum, common snuff.

[10]. The secretion of tears is increased by volatile salts, the vapour of onions, by grief, and joy.

[11]. All those medicines increase the heat of the body, and remove those pains, which originate from a defect of motion in the vessels, which perform secretion; as pepper produces a glow on the skin, and balsam of Peru is said to relieve the flatulent cholic. But these medicines differ from the preceding class, as they neither induce costiveness nor deep coloured urine in their usual dose, nor intoxication in any dose.

[12]. Yet if any of these are used unnecessarily, it is obvious, like the incitantia, that they must contribute to shorten our lives by sooner rendering peculiar parts of the system disobedient to their natural stimuli. Of those in daily use the great excess of common salt is probably the most pernicious, as it enters all our cookery, and is probably one cause of scrophula, and of sea-scurvy, when joined with other causes of debility. See Botanic Garden, Part II. Canto IV. line 221. Spices taken to excess by stimulating the stomach, and the vessels of the skin by association, into unnecessary action, contribute to weaken these parts of the system, but are probably less noxious than the general use of so much salt.

[II]. Observations on the Secernentia.

[I]. [1]. Some of the medicines of this class produce absorption in some degree, though their principal effect is exerted on the secerning part of our system. We shall have occasion to observe a similar circumstance in the next class of medicines termed Sorbentia; as of these some exert their effects in a smaller degree on the secerning system. Nor will this surprise any one, who has observed, that all natural objects are presented to us in a state of combination; and that hence the materials, which produce these different effects, are frequently found mingled in the same vegetable. Thus the pure aromatics increase the action of the vessels, which secrete the perspirable matter; and the pure astringents increase the action of the vessels, which absorb the mucus from the lungs, and other cavities of the body; hence it must happen, that nutmeg, which possesses both these qualities, should have the double effect above mentioned.

Other drugs have this double effect, and belong either to the class of Secernentia or Sorbentia, according to the dose in which they are exhibited. Thus a small dose of alum increases absorption, and induces costiveness; and a large one increases the secretions into the intestinal canal, and becomes cathartic. And this accounts for the constipation of the belly left after the purgative quality of rhubarb ceases, for it increases absorption in a smaller dose, and secretion in a greater. Hence when a part of the larger dose is carried out of the habit by stools, the small quantity which remains induces costiveness. Hence rhubarb exhibited in small doses, as 2 or 3 grains twice a day, strengthens the system by increasing the action of the absorbent vessels, and of the intestinal canal.

[2]. Diaphoretics. The perspiration is a secretion from the blood in its passage through the capillary vessels, as other secretions are produced in the termination of the arteries in the various glands. After this secretion the blood loses its florid colour, which it regains in its passage through the lungs; which evinces that something besides water is secreted on the skins of animals.

No statical experiments can ascertain the quantity of our perspiration; as a continued absorption of the moisture of the atmosphere exists at the same time both by the cutaneous and pulmonary lymphatics.

[3]. Every gland is capable of being excited into greater exertions by an appropriated stimulus applied either by its mixture with the blood immediately to the secerning vessel, or applied externally to its excretory duct. Thus mercury internally promotes an increased salivation, and pyrethrum externally applied to the excretory ducts of the salival glands. Aloes stimulate the rectum internally mixed with the circulating blood; and sea-salt by injection externally. Now as the capillaries, which secrete the perspirable matter, lie near the surface of the body, the application of external heat acts immediately on their excretory ducts, and promotes perspiration; internally those drugs which possess a fragrant essential oil, or spiritus rector, produce this effect, as the aromatic vegetables, of which the number is very great.

[4]. It must be remembered, that a due quantity of some aqueous vehicle must be given to support this evacuation; otherwise a burning heat without much visible sweat must be the consequence. When the skin acquires a degree of heat much above 108, as appears by Dr. Alexander's experiments, no visible sweat is produced; which is owing to the great heat of the skin evaporating it as hastily, as it is secreted; and, where the sweat is secreted in abundance, its evaporation cannot carry off the exuberant heat, like the vapour of boiling water; because a great part of it is wiped off, or absorbed by the bed-clothes; or the air about the patient is not changed sufficiently often, as it becomes saturated with the perspirable matter. And hence it is probable, that the waste of perspirable matter is as great, or greater, when the skin is hot and dry, as when it stands in drops on the skin; as appears from the inextinguishable thirst.

Hence Dr. Alexander found, that when the heat of the body was greater than 108, nothing produced sweats but repeated draughts of cold water; and of warm fluids, when the heat was much below that degree. And that cold water which procured sweats instantaneously when the heat was above 108, stopped them as certainly when it was below that heat; and that flannels, wrung out of warm water and wrapped round the legs and thighs, were then most certainly productive of sweats.

[5]. The diaphoretics are all said to succeed much better, if given early in the morning, about an hour before sun-rise, than at any other time; which is owing to the great excitability of every part of the system after the sensorial power has been accumulated during sleep. In those, who have hectic fever, or the febricula, or nocturnal fever of debility, the morning sweats are owing to the decline of the fever-fit, as explained in Sect. XXXII. 9. In some of these patients the sweat does not occur till they awake; because then the system is still more excitable than during sleep, because the assistance of the voluntary power in respiration facilitates the general circulation. See Class [I. 2. 1. 3].

[6]. It must be observed, that the skin is very dry and hard to the touch, where the absorbents, which open on its surface, do not act; as in some dropsies, and other diseases attended with great thirst. This dryness, and shrivelled appearance, and roughness, are owing to the mouths of the absorbents being empty of their accustomed fluid, and is distinguishable from the dryness of the skin above mentioned in the hot fits of fever, by its not being attended with heat.

As the heat of the skin in the usual temperature of the air always evinces an increased perspiration, whether visible or not, the heat being produced along with the increase of secretion; it follows, that a defect of perspiration can only exist, when the skin is cold.

[7]. Volatile alcali is a very powerful diaphoretic, and particularly if exhibited in wine-whey; 20 drops of spirit of hartshorn every half hour in half a pint of wine-whey, if the patient be kept in a moderately warm bed, will in a few hours elicit most profuse sweats.

Neutral salts promote invisible perspiration, when the skin is not warmed much externally, as is evinced from the great thirst, which succeeds a meal of salt provisions, as of red herrings. When these are sufficiently diluted with water, and the skin kept warm, copious sweats without inflaming the habit, are the consequence. Half an ounce of vinegar saturated with volatile alcali, taken every hour or two hours, well answers this purpose; and is preferable perhaps in general to all others, where sweating is advantageous. Boerhaave mentions one cured of a fever by eating red-herrings or anchovies, which, with repeated draughts of warm water or tea, would I suppose produce copious perspiration.

Antimonial preparations have also been of late much used with great advantage as diaphoretics. For the history and use of these preparations I shall refer the reader to the late writers on the Materia Medica, only observing that the stomach becomes so soon habituated to its stimulus, that the second dose may be considerably increased, if the first had no operation.

Where it is advisable to procure copious sweats, the emetics, as ipecacuanha, joined with opiates, as in Dover's powder, produce this effect with greater certainty than the above.

[8]. We must not dismiss this subject without observing, that perspiration is designed to keep the skin flexile, as the tears are intended to clean and lubricate the eye; and that neither of these fluids can be considered as excretions in their natural state, but as secretions. See Class [I. 1. 2. 3]. And that therefore the principal use of diaphoretic medicines is to warm the skin, and thence in consequence to produce the natural degree of insensible perspiration in languid habits.

[9]. When the skin of the extremities is cold, which is always a sign of present debility, the digestion becomes frequently impaired by association, and cardialgia or heartburn is induced from the vinous or acetous fermentation of the aliment. In this disease diaphoretics, which have been called cordials, by their action on the stomach restore its exertion, and that of the cutaneous capillaries by their association with it, and the skin becomes warm, and the digestion more vigorous.

[10]. But a blister acts with more permanent and certain effect by stimulating a part of the skin, and thence affecting the whole of it, and of the stomach by association, and thence removes the most obstinate heartburns and vomitings. From this the principal use of blisters is understood, which is to invigorate the exertions of the arterial and lymphatic vessels of the skin, producing an increase of insensible perspiration, and of cutaneous absorption; and to increase the action of the stomach, and the consequent power of digestion; and thence by sympathy to excite all the other irritative motions: hence they relieve pains of the cold kind, which originate from defect of motion; not from their introducing a greater pain, as some have imagined, but by stimulating the torpid vessels into their usual action; and thence increasing the action and consequent warmth of the whole skin, and of all the parts which are associated with it.

[II]. [1]. Sialagogues. The preparations of mercury consist of a solution or corrosion of that metal by some acid; and, when the dose is known, it is probable that they are all equally efficacious. As their principal use is in the cure of the venereal disease, they will be mentioned in the catalogue amongst the sorbentia. Where salivation is intended, it is much forwarded by a warm room and warm clothes; and prevented by exposing the patient to his usual habits of cool air and dress, as the mercury is then more liable to go off by the bowels.

[2]. Any acrid drug, as pyrethrum, held in the mouth acts as a sialagogue externally by stimulating the excretory ducts of the salivary glands; and the siliqua hirsuta applied externally to the parotid gland, and even hard substances in the ear, are said to have the same effect. Mastich chewed in the mouth emulges the salivary glands.

[3]. The unwise custom of chewing and smoking tobacco for many hours in a day not only injures the salivary glands, producing dryness in the mouth when this drug is not used, but I suspect that it also produces schirrhus of the pancreas. The use of tobacco in this immoderate degree injures the power of digestion, by occasioning the patient to spit out that saliva, which he ought to swallow; and hence produces that flatulency, which the vulgar unfortunately take it to prevent. The mucus, which is brought from the fauces by hawking, should be spit out, as well as that coughed up from the lungs; but that which comes spontaneously into the mouth from the salivary glands, should be swallowed mixed with our food or alone for the purposes of digestion. See Class [I. 2. 2. 7].

[III]. [1]. Expectorants are supposed to increase the secretion of mucus in the branches of the windpipe, or to increase the perspiration of the lungs secreted at the terminations of the bronchial artery.

[2]. If any thing promotes expectoration toward the end of peripneumonies, when the inflammation is reduced by bleeding and gentle cathartics, small repeated blisters about the chest, with tepid aqueous and mucilaginous or oily liquids, are more advantageous than the medicines generally enumerated under this head; the blisters by stimulating into action the vessels of the skin produce by association a greater activity of those of the mucous membrane, which lines the branches of the windpipe, and air-cells of the lungs; and thus after evacuation they promote the absorption of the mucus and consequent healing of the inflamed membrane, while the diluting liquids prevent this mucus from becoming too viscid for this purpose, or facilitate its expuition.

Blisters, one at a time, on the sides or back, or on the sternum, are also useful towards the end of peripneumonies, by preventing the evening access of cold fit, and thence preventing the hot fit by their stimulus on the skin; in the same manner as five drops of laudanum by its stimulus on the stomach. For the increased actions of the vessels of the skin or stomach excite a greater quantity of the sensorial power of association, and thus prevent the torpor of the other parts of the system; which, when patients are debilitated, is so liable to return in the evening.

[3]. Warm bathing is of great service towards the end of peripneumony to promote expectoration, especially in those children who drink too little aqueous fluids, as it gently increases the action of the pulmonary capillaries by their content with the cutaneous ones, and supplies the system with aqueous fluid, and thus dilutes the secreted mucus.

Some have recommended oil externally around the chest, as well as internally, to promote expectoration; and upon the nose, when its mucous membrane is inflamed, as in common catarrh.

[IV]. [1]. Diuretics. If the skin be kept warm, most of these medicines promote sweat instead of urine; and if their dose is enlarged, most of them become cathartic. Hence the neutral salts are used in general for all these purposes. Those indeed, which are composed of the vegetable acid, are most generally used as sudorifics; those with the nitrous acid as diuretics; and those with the vitriolic acid as cathartics: while those united with the marine acid enter our common nutriment, as a more general stimulus. All these increase the acrimony of the urine, hence it is retained a less time in the bladder; and in consequence less of it is reabsorbed into the system, and the apparent quantity is greater, as more is evacuated from the bladder; but it is not certain from thence, that a greater quantity is secreted by the kidnies. Hence nitre, and other neutral salts, are erroneously given in the gonorrhœa; as they augment the pain of making water by their stimulus on the excoriated or inflamed urethra. They are also erroneously given in catarrhs or coughs, where the discharge is too thin and saline, as they increase the frequency of coughing.

[2]. Balsam of Copaiva is thought to promote urine more than the other native balsams; and common resin is said to act as a powerful diuretic in horses. These are also much recommended in gleets, and in fluor albus, perhaps more than they deserve; they give a violet smell to the urine, and hence probably increase the secretion of it.

Calcined egg-shells are said to promote urine, perhaps from the phosphoric acid they contain.

[3]. Cold air and cold water will increase the quantity of urine by decreasing the absorption from the bladder; and neutral and alcalious salts and cantharides by stimulating the neck of the bladder to discharge the urine as soon as secreted; and alcohol as gin and rum at the beginning of intoxication, if the body be kept cool, occasion much urine by inverting the urinary lymphatics, and thence pouring a fluid into the bladder, which never passed the kidnies. But it is probable, that those medicines, which give a scent to the urine as the balsams and resins, but particularly asparagus and garlic, are the only drugs, which truly increase the secretion of the kidnies. Alcohol however, used as above mentioned, and perhaps great doses of tincture of cantharides, may be considered as drastic diuretics, as they pour a fluid into the bladder by the retrograde action of the lymphatics, which are in great abundance spread about the neck of it. See Sect. XXIX. 3.

[V]. Mild cathartics. The ancients believed that some purges evacuated the bile, and hence were termed Cholagogues; others the lymph, and were termed Hydragogues; and that in most each cathartic selected a peculiar humour, which it discharged. The moderns have too hastily rejected this system; the subject well deserves further observation.

Calomel given in the dose from ten to twenty grains, so as to induce purging without the assistance of other drugs, appears to me to particularly increase the secretion of bile, and to evacuate it; aloe seems to increase the secretion of the intestinal mucus; and it is probable that the pancreas and spleen may be peculiarly stimulated into action by some other of this tribe of medicines; whilst others of them may simply stimulate the intestinal canal to evacuate its contents, as the bile of animals. It must be remarked, that all these cathartic medicines are supposed to be exhibited in their usual doses, otherwise they become drastic purges, and are treated of in the Class of Invertentia.

[VI]. The mucus of the bladder is seen in the urine, when cantharides have been used, either internally or externally, in such doses as to induce the strangury. Spirit of turpentine is said to have the same effect. I have given above a dram of it twice a day floating on a glass of water in chronic lumbago without this effect, and the patient gradually recovered.

[VII]. Aloe given internally seems to act chiefly on the rectum and, spincter ani, producing tenesmus and piles. Externally in clysters or suppositories, common salt seems to act on that bowel with greater certainty. But where the thread-worm or ascarides exist, 60 or 100 grains of aloes reduced to powder and boiled in a pint of gruel, and used as a clyster twice a week for three months, has frequently destroyed them.

[VIII]. The external application of cantharides by stimulating the excretory ducts of the capillary glands produces a great secretion of subcutaneous mucus with pain and inflammation; which mucaginous fluid, not being able to permeate the cuticle, raises it up; a similar secretion and elevation of the cuticle is produced by actual fire; and by caustic materials, as by the application of the juice of the root of white briony, or bruised mustard-seed. Experiments are wanting to introduce some acrid application into practice instead of cantharides, which might not induce the strangury.

Mustard-seed alone is too acrid, and if it be suffered to lie on the skin many minutes is liable to produce a slough and consequent ulcer, and should therefore be mixed with flour when applied to cold extremities. Volatile alkali properly diluted might stimulate the skin without inducing strangury.

[IX]. The mild errhines are such as moderately stimulate the membrane of the nostrils, so as to increase the secretion of nasal mucus; as is seen in those, who are habituated to take snuff. The stronger errhines are mentioned in Art. [V. 2. 3].

[X]. The secretion of tears is increased either by applying acrid substances to the eye; or acrid vapours, which stimulate the excretory duct of the lacrymal gland; or by applying them to the nostrils, and stimulating the excretory duct of the lacrymal sack, as treated of in the Section on Instinct.

Or the secretion of tears is increased by the association of the motions of the excretory duct of the lacrymal sack with ideas of tender pleasure, or of hopeless distress, as explained in Sect. XVI. 8. 2. and 3.

[XI]. The secretion of sensorial power in the brain is probably increased by opium or wine, because when taken in certain quantity an immediate increase of strength and activity succeeds for a time, with consequent debility if the quantity taken be so great as to intoxicate in the least degree. The necessity of perpetual respiration shews, that the oxygen of the atmosphere supplies the source of the spirit of animation; which is constantly expended, and is probably too fine to be long contained in the nerves after its production in the brain. Whence it is probable, that the respiration of oxygen gas mixed with common air may increase the secretion of sensorial power; as indeed would appear from its exhilarating effect on most patients.

[III]. Catalogue of the Secernentia.

[I]. Diaphoretics.

[1]. Amomum zinziber, ginger. Caryophyllus aromaticus, cloves. Piper indicum, pepper. Capsicum. Cardamomum. Pimento, myrtus pimenta. Canella alba. Serpentaria virginiana, aristolochia serpentaria, guaiacum. Sassafras, laurus sassafras. Opium. Wine.

[2]. Essential oils of cinnamon, laurus cinnamomum. Nutmeg, myristica moschata. Cloves, caryophyllus aromaticus. Mint, mentha. Camphor, laurus camphora. Ether.

[3]. Volatile salts, as of ammoniac and of hartshorn. Sal cornu cervi.

[4]. Neutral salts, as those with vegetable acid; or with marine acid, as common salt. Halex. Red-herring, anchovy.

[5]. Preparations of antimony, as emetic tartar, antimonium tartarizatum, wine of antimony. James's powder.

[6]. External applications. Blisters. Warm bath. Warm air. Exercise. Friction.

[7]. Cold water with subsequent warmth.

[II]. Sialagogues. Preparations of mercury, hydrargyrus. Pyrethrum, anthemis pyrethrum, tobacco, cloves, pepper, cowhage, stizolobium siliqua hirsuta. Mastich, pistacia lentiscus.

[III]. Expectorants:

[1]. Squill, scilla maritima, garlic, leek, onion, allium, asafœtida, ferula asafœtida, gum ammoniac, benzoin, tar, pix liquida, balsam of Tolu.

[2]. Root of seneka, polygala seneka, of elicampane, inula helenium.

[3]. Marsh-mallow, althæa, coltsfoot, tussilago farfara, gum arabic, mimosa nilotica, gum tragacanth, astragalus tragacantha. Decoction of barley, hordeum distichon. Expressed oils. Spermaceti, soap. Extract of liquorice, glycyrrhiza glabra. Sugar. Honey.

[4]. Externally blisters. Oil. Warm bath.

[IV]. Mild diuretics.

[1]. Nitre, kali acetatum, other neutral salts.

[2]. Fixed alkali, soap, calcined egg-shells.

[3]. Turpentine. Balsam of Copaiva. Resin. Olibanum.

[4]. Asparagus, garlic, wild daucus. Parsley, apium. Fennel fæniculum, pareira brava, Cissampelos?

[5]. Externally cold air, cold water.

[6]. Alcohol. Tincture of cantharides. Opium.

[V]. Mild cathartics.

[1]. Sweet subacid fruits. Prunes, prunus domestica. Cassia sistula. Tamarinds, crystals of tartar, unrefined sugar. Manna. Honey.

[2]. Whey of milk, bile of animals.

[3]. Neutral salts, as Glauber's salt, vitriolated tartar, sea-water, magnesia alba, soap.

[4]. Gum guaiacum. Balsam of Peru. Oleum ricini, castor-oil, oil of almonds, oil of olives, sulphur.

[5]. Senna, cassia senna, jalap, aloe, rhubarb, rheum palmatum.

[6]. Calomel. Emetic tartar, antimonium tartarizatum.

[VI]. Secretion of mucus of the bladder is increased by cantharides, by spirit of turpentine?

[VII]. Secretion of mucus of the rectum is increased by aloe internally, by various clysters and suppositories externally.

[VIII]. Secretion of subcutaneous mucus is increased by blisters of cantharides, by application of a thin slice of the fresh root of white briony, by sinapisms, by root of horse-radish, cochlearia armoracia. Volatile alcali.

[IX]. Mild errhines. Marjoram. Origanum. Marum, tobacco.

[X]. Secretion of tears is increased by vapour of sliced onion, of volatile alcali. By pity, or ideas of hopeless distress.

[XI]. Secretion of sensorial power in the brain is probably increased by opium, by wine, and perhaps by oxygen gas added to the common air in respiration.

---

Art. [IV].

SORBENTIA.

[I]. Those things which increase the irritative motions, which constitute absorption, are termed sorbentia; and are as various as the absorbent vessels, which they stimulate into action.

[1]. Cutaneous absorption is increased by austere acids, as of vitriol; hence they are believed to check colliquative sweats, and to check the eruption of small-pox, and contribute to the cure of the itch, and tinea; hence they thicken the saliva in the mouth, as lemon-juice, crab-juice, sloes.

[2]. Absorption from the mucous membrane is increased by opium, and Peruvian bark, internally; and by blue vitriol externally. Hence the expectoration in coughs, and the mucous discharge from the urethra, are thickened and lessened.

[3]. Absorption from the cellular membrane is promoted by bitter vegetables, and by emetics, and cathartics. Hence matter is thickened and lessened in ulcers by opium and Peruvian bark; and serum is absorbed in anasarca by the operation of emetics and cathartics.

[4]. Venous absorption is increased by acrid vegetables; as water-cress, cellery, horse-radish, mustard. Hence their use in sea-scurvy, the vibices of which are owing to a defect of venous absorption; and by external stimulants, as vinegar, and by electricity, and perhaps by oxygen.

[5]. Intestinal absorption is increased by astringent vegetables, as rhubarb, galls; and by earthy salts, as alum; and by argillaceous and calcareous earth.

[6]. Hepatic absorption is increased by metallic salts, hence calomel and sal martis are so efficacious in jaundice, worms, chlorosis, dropsy.

[7]. Venereal virus in ulcers is absorbed by the stimulus of mercury; hence they heal by the use of this medicine.

[8]. Venesection, hunger, thirst, and violent evacuations, increase all absorptions; hence sweating produces costiveness.

[9]. Externally bitter astringent vegetables, earthy and metallic salts, and bandages, promote the absorption of the parts on which they are applied.

[10]. All these in their usual doses do not increase the natural heat; but they induce costiveness, and deep coloured urine with earthy sediment.

In greater doses they invert the motions of the stomach and lacteals; and hence vomit or purge, as carduus benedictus, rhubarb. They promote perspiration, if the skin be kept warm; as camomile tea, and testaceous powders, have been used as sudorifics.

The preparations of antimony vomit, purge, or sweat, either according to the quantity exhibited, or as a part of what is given is evacuated. Thus a quarter of a grain of emetic tartar (if well prepared) will promote a diaphoresis, if the skin be kept warm; half a grain will procure a stool or two first, and sweating afterwards; and a grain will generally vomit, and then purge, and lastly sweat the patient. In less quantity it is probable, that this medicine acts like other metallic salts, as steel, zinc, or copper in small doses; that is, that it strengthens the system by its stimulus. As camomile or rhubarb in different doses vomit, or purge, or act as stimulants so as to strengthen the system.

[II]. Observations on the Sorbentia.

[I]. [1]. As there is great difference in the apparent structure of the various glands, and of the fluids which they select from the blood, these glands must possess different kinds of irritability, and are therefore stimulated into stronger or unnatural actions by different articles of the materia medica, as shewn in the secernentia. Now as the absorbent vessels are likewise glands, and drink up or select different fluids, as chyle, water, mucus, with a part of every different secretion, as a part of the bile, a part of the saliva, a part of the urine, &c. it appears, that these absorbent vessels must likewise possess different kinds of irritability, and in consequence must require different articles of the materia medica to excite them into unusual action. This part of the subject has been so little attended to, that the candid reader will find in this article a great deal to excuse.

It was observed, that some of the secernentia did in a less degree increase absorption, from the combination of different properties in the same vegetable body; for the same reason some of the class of sorbentia produce secretion in a less degree, as those bitters which have also an aroma in their composition; these are known from their increasing the heat of the system above its usual degree.

It must also be noted, that the actions of every part of the absorbent system are so associated with each other, that the drugs which stimulate one branch increase the action of the whole; and the torpor or quiescence of one branch weakens the exertions of the whole; or when one branch is excited into stronger action, some other branch has its actions weakened or inverted. Yet though peculiar branches of the absorbent system are stimulated into action by peculiar substances, there are other substances which seem to stimulate the whole system, and that without immediately increasing any of the secretions; as those bitters which possess no aromatic scent, at the head of which stands the famed Peruvian bark, or cinchona.

[2]. Cutaneous absorption. I have heard of some experiments, in which the body was kept cold, and was thought to absorb more moisture from the atmosphere than at any other time. This however cannot be determined by statical experiments; as the capillary vessels, which secrete the perspirable matter, must at the same time have been benumbed by the cold; and from their inaction there could not have been the usual waste of the weight of the body; and as all other muscular exertions are best performed, when the body possesses its usual degree of warmth, it is conclusive, that the absorbent system should likewise do its office best, when it is not benumbed by external cold.

The austere acids, as of vitriol, lemon-juice, juice of crabs and sloes, strengthen digestion, and prevent that propensity to sweat so usual to weak convalescents, and diminish the colliquative sweats in hectic fevers; all which are owing to their increasing the action of the external and internal cutaneous absorption. Hence vitriolic acid is given in the small-pox to prevent the too hasty or too copious eruption, which it effects, by increasing the cutaneous absorption. Vinegar, from the quantity of alcohol which it contains, exerts a contrary effect to that here described, and belongs to the incitantia; as an ounce of it promotes sweat, and a flushing of the skin; at the same time externally it acts as a venous absorbent, as the lips become pale by moistening them with it. And it is said, when taken internally in great and continued quantity, to induce paleness of the skin, and softness of the bones.

The sweet vegetable acids, as of several ripe fruits, are among the torpentia; as they are less stimulating than the general food of this climate, and are hence used in inflammatory diseases.

Where the quantity of fluids in the system is much lessened, as in hectic fever, which has been of some continuance, or in spurious peripneumony, a grain of opium given at night will sometimes prevent the appearance of sweats; which is owing to the stimulus of opium increasing the actions of the cutaneous absorbents, more than those of the secerning vessels of the skin. Whence the secretion of perspirable matter is not decreased, but its appearance on the skin is prevented by its more facile absorption.

[3]. There is one kind of itch, which seldom appears between the fingers, is the least infectious, and most difficult to eradicate, and which has its cure much facilitated by the internal use of acid of vitriol. This disease consists of small ulcers in the skin, which are healed by whatever increases the cutaneous absorption. The external application of sulphur, mercury, and acrid vegetables, acts on the same principle; for the animalcula, which are seen in these pustules, are the effect, not the cause, of them; as all other stagnating animal fluids, as the semen itself, abounds with similar microscopic animals.

[4]. Young children have sometimes an eruption upon the head called Tinea, which discharges an acrimonius ichor inflaming the parts, on which it falls. This eruption I have seen submit to the internal use of vitriolic acid, when only wheat-flour was applied externally. This kind of eruption is likewise frequently cured by testaceous powders; two materials so widely different in their chemical properties, but agreeing in their power of promoting cutaneous absorption.

[II]. Absorption from the mucous membrane is increased by applying to its surface the austere acids, as of vitriol, lemon-juice, crab-juice, sloes. When these are taken into the mouth, they immediately thicken, and at the same time lessen the quantity of the saliva; which last circumstance cannot be owing to their coagulating the saliva, but to their increasing the absorption of the thinner parts of it. So alum applied to the tip of the tongue does not stop in its action there, but independent of its diffusion it induces cohesion and corrugation over the whole mouth. (Cullen's Mat. Med. Art. Astringentia.) Which is owing to the association of the motions of the parts or branches of the absorbent system with each other.

Absorption from the mucous membrane is increased by opium taken internally in small doses more than by any other medicine, as is seen in its thickening the expectoration in coughs, and the discharge from the nostrils in catarrh, and perhaps the discharge from the urethra in gonorrhoea. The bark seems next in power for all these purposes.

Externally slight solutions of blue vitriol, as two or three grains to an ounce of water, applied to ulcers of the mouth, or to chancres on the glans penis, more powerfully induces them to heal than any other material.

Where the lungs or urethra are inflamed to a considerable degree, and the absorption is so great, that the mucus is already too thick, and adheres to the membrane from its viscidity, opiates and bitter vegetable and austere acids are improper; and mucilaginous diluents should be used in their stead with venesection and torpentia.

[III]. [1]. Absorption from the cellular membrane, and from all the other cavities of the body, is too slowly performed in some constitutions; hence the bloated pale complexion; and when this occurs in its greatest degree, it becomes an universal dropsy. These habits are liable to intermittent fevers, hysteric paroxysms, cold extremities, indigestion, and all the symptoms of debility.

The absorbent system is more subject to torpor or quiescence than the secerning system, both from the coldness of the fluids which are applied to it, as the moisture of the atmosphere, and from the coldness of the fluids which we drink; and also from its being stimulated only by intervals, as when we take our food; whereas the secerning system is perpetually excited into action by the warm circulating blood; as explained in Sect. XXXII.

[2]. The Peruvian bark, camomile flowers, and other bitter drugs, by stimulating this cellular branch of the absorbent system prevents it from becoming quiescent; hence the cold paroxysms of those agues, which arise from the torpor of the cellular lymphatics, are prevented, and the hot fits in consequence. The patient thence preserves his natural heat, regains his healthy colour, and his accustomed strength.

Where the cold paroxysm of an ague originates in the absorbents of the liver, spleen, or other internal viscus, the addition of steel to vegetable bitters, and especially after the use of one dose of calomel, much advances the cure.

And where it originates in any part of the secerning system, as is probably the case in some kinds of agues, the addition of opium in the dose of a grain and half, given about an hour before the access of the paroxysm, or mixed with chalybeate and bitter medicines, ensures the cure. Or the same may be effected by wine given instead of opium before the paroxysm, so as nearly to intoxicate.

These three kinds of agues are thus distinguished; the first is not attended with any tumid or indurated viscus, which the people call an ague cake, and which is evident to the touch. The second is accompanied with a tumid viscus; and the last has generally, I believe, the quartan type, and is attended with some degree of arterial debility.

[3]. This class of absorbent medicines are said to decrease irritability. After any part of our system has been torpid or quiescent, by whatever cause that was produced, it becomes afterwards capable of being excited into greater motion by small stimuli; hence the hot fit of fever succeeds the cold one. As these medicines prevent torpor or quiescence of parts of the system, as cold hands or feet, which perpetually happen to weak constitutions, the subsequent increase of irritability of these parts is likewise prevented.

[4]. These absorbent medicines, including both the bitters, and metallic salts, and opiates, are of great use in the dropsy by their promoting universal absorption; but here evacuations are likewise to be produced, as will be treated of in the Invertentia.

[5]. The matter in ulcers is thickened, and thence rendered less corrosive, the saline part of it being reabsorbed by the use of bitter medicines; hence the bark is used with advantage in the cure of ulcers.

[6]. Bitter medicines strengthen digestion by promoting the absorption of chyle; hence the introduction of hop into the potation used at our meals, which as a medicine may be taken advantageously, but, like other unnecessary stimuli, must be injurious as an article of our daily diet.

The hop may perhaps in some degree contribute to the production of gravel in the kidnies, as our intemperate wine-drinkers are more subject to the gout, and ale-drinkers to the gravel; in the formation of both which diseases, there can be no doubt, but that the alcohol is the principal, if not the only agent.

[7]. Vomits greatly increase the absorption from the cellular membrane, as squill, and foxglove. The squill should be given in the dose of a grain of the dried root every hour, till it operates upwards and downwards. Four ounces of the fresh leaves of the foxglove should be boiled from two pounds of water to one, and half an ounce of the decoction taken every two hours for four or more doses. This medicine by stimulating into inverted action the absorbents of the stomach, increases the direct action of the cellular lymphatics.

Another more convenient way of ascertaining the dose of foxglove is by making a saturated tincture of it in proof spirit; which has the twofold advantage of being invariable in its original strength, and of keeping a long time as a shop-medicine without losing any of its virtue. Put two ounces of the leaves of purple foxglove, digitalis purpurea, nicely dried, and coarsely powdered, into a mixture of four ounces of rectified spirit of wine and four ounces of water; let the mixture stand by the fire-side twenty-four hours frequently shaking the bottle, and thus making a saturated tincture of digitalis; which must be poured from the sediment or passed through filtering paper.

As the size of a drop is greater or less according to the size of the rim of the phial from which it is dropped, a part of this saturated tincture is then directed to be put into a two-ounce phial, for the purpose of ascertaining the size of the drop. Thirty drops of this tincture is directed to be put into an ounce of mint-water for a draught to be taken twice or thrice a day, till it reduces the anasarca of the limbs, or removes the difficulty of breathing in hydrothorax, or till it induces sickness. And if these do not occur in two or three days, the dose must be gradually increased to forty or sixty drops, or further.

From the great stimulus of this medicine the stomach is rendered torpid with consequent sickness, which continues many hours and even days, owing to the great exhaustion of its sensorial power of irritation; and the action of the heart and arteries becomes feeble from the deficient excitement of the sensorial power of association; and lastly, the absorbents of the cellular membrane act more violently in consequence of the accumulation of the sensorial power of association in the torpid heart and arteries, as explained in Suppl. I. [12].

A circumstance curiously similar to this occurs to some people on smoking tobacco for a short time, who have not been accustomed to it. A degree of sickness is presently induced, and the pulsations of the heart and arteries become feeble for a short time, as in the approach to fainting, owing to the direct sympathy between these and the stomach, that is from defect of the excitement of the power of association. Then there succeeds a tingling, and heat, and sometimes sweat, owing to the increased action of the capillaries, or perspirative and mucous glands; which is occasioned by the accumulation of the sensorial power of association by the weaker action of the heart and arteries, which now increases the action of the capillaries.

[8]. Another method of increasing absorption from the cellular membrane is by warm air, or by warm steam. If the swelled legs of a dropsical patient are inclosed in a box, the air of which is made warm by a lamp or two, copious sweats are soon produced by the increased action of the capillary glands, which are seen to stand on the skin, as it cannot readily exhale in so small a quantity of air, which is only changed so fast as may be necessary to permit the lamps to burn. At the same time the lymphatics of the cellular membrane are stimulated by the heat into greater action, as appears by the speedy reduction of the tumid legs.

It would be well worth trying an experiment upon a person labouring under a general anasarca by putting him into a room filled with air heated to 120 or 130 degrees, which would probably excite a great general diaphoresis, and a general cellular absorption both from the lungs and every other part. And that air of so great heat may be borne for many minutes without great inconvenience was shewn by the experiments made in heated rooms by Dr. Fordyce and others. Philos. Trans.

Another experiment of using warmth in anasarca, or in other diseases, might be by immersing the patient in warm air, or in warm steam, received into an oil-skin bag, or bathing-tub of tin, so managed, that the current of warm air or steam should pass round and cover the whole of the body except the head, which might not be exposed to it; and thus the absorbents of the lungs might be induced to act more powerfully by sympathy with the skin, and not by the stimulus of heat. See Uses of Warm Bath, Art. [II. 2. 2. 1].

[IV]. [1]. Venous absorption. Cellary, water-cresses, cabbages, and many other vegetables of the Class Tetradynamia, do not increase the heat of the body (except those whose acrimony approaches to corrosion), and hence they seem alone, or principally, to act on the venous system; the extremities of which we have shewn are absorbents of the red blood, after it has passed the capillaries and glands.

[2]. In the sea-scurvy and petechial fever the veins do not perfectly perform this office of absorption; and hence the vibices are occasioned by blood stagnating at their extremities, or extravasated into the cellular membrane. And this class of vegetables, stimulating the veins to perform their natural absorption, without increasing the energy of the arterial action, prevents future petechiæ, and may assist the absorption of the blood already stagnated, as soon as its chemical change renders it proper for that operation.

[3]. The fluids, which are extravasated, and received into the cells of the cellular membrane, seem to continue there for many days, so as to undergo some chemical change, and are then taken up again by the mouths of the cellular absorbents. But the new vessels produced in inflamed parts, as they communicate with the veins, are probably absorbed again by the veins along with the blood which they contain in their cavities. Hence the blood, which is extravasated in bruises or vibices, is gradually many days in disappearing; but after due evacuations the inflamed vessels on the white of the eye, if any stimulant lotion is applied, totally disappear in a few hours.

Amongst absorbents affecting the veins we should therefore add the external application of stimulant materials; as of vinegar, which makes the lips pale on touching them. Friction, and electricity.

[4]. Hæmorrhages are of two kinds, either arterial, which are attended with inflammation; or venous, from a deficiency in the absorbent power of this set of vessels. In the former case the torpentia are efficacious; in the latter steel, opium, alum, and all the tribe of sorbentia, are used with success.

[5]. Sydenham recommends vegetables of the class Tetradynamia in rheumatic pains left after the cure of intermittents. These pains are perhaps similar to those of the sea-scurvy, and seem to arise from want of absorption in the affected part, and hence are relieved by the same medicines.

[V]. [1]. Intestinal absorption. Some astringent vegetables, as rhubarb, may be given in such doses as to prove cathartic; and, after a part of it is evacuated from the body, the remaining part augments the absorption of the intestines; and acts, as if a similar dose had been exhibited after the operation of any other purgative. Hence 4 grains of rhubarb strengthen the bowels, 30 grains first empty them.

[2]. The earthy salts, as alum, increase the intestinal absorption, and hence induce constipation in their usual dose; alum is said sometimes to cure intermittents, perhaps when their seat is in the intestines, when other remedies have failed. It is useful in the diabætes by exciting the absorbents of the bladder into their natural action; and combined with resin is esteemed in the fluor albus, and in gleets. Lime-stone or chalk, and probably gypsum, possess effects in some degree similar, and increase the absorption of the intestines; and thus in certain doses restrain some diarrhœas, but in greater doses alum I suppose will act as a cathartic. Five or ten grains produce constipation, 20 or 30 grains are either emetic or cathartic.

[3]. Earth of alum, tobacco-pipe clay, marl, Armenian bole, lime, crab's eyes or claws, and calcined hartshorn, or bone ashes, restrain fluxes; either mechanically by supplying something like mucilage, or oil, or rollers to abate the friction of the aliment over inflamed membranes; or by increasing their absorption. The two last consist of calcareous earth united to phosphoric acid, and the Armenian bole and marl may contain iron. By the consent between the intestines and the skin 20 grains of Armenian bole given at going into bed to hectic patients will frequently check their tendency to sweat as well as to purge, and the more certainly if joined with one grain of opium.

[VI]. [1]. Absorption from the liver, stomach, and other viscera. When inflammations of the liver are subdued to a certain degree by venesection, with calomel and other gentle purges, so that the arterial energy becomes weakened, four or eight grains of iron-filings, or of salt of steel, with the Peruvian bark, have wonderful effect in curing the cough, and restoring the liver to its usual size and sanity; which it seems to effect by increasing the absorption of this viscus. The same I suppose happens in respect to the tumours of other viscera, as of the spleen, or pancreas, some of which are frequently enlarged in agues.

[2]. Hæmorrhages from the nose, rectum, kidnies, uterus, and other parts, are frequently attendant on diseased livers; the blood being impeded in the vena portarum from the decreased power of absorption, and in consequence of the increased size of this viscus. These hæmorrhages after venesection, and a mercurial cathartic, are most certainly restrained by steel alone, or joined with an opiate; which increase the absorption, and diminish the size of the liver.

Chalybeates may also restrain these hæmorrhages by their promoting venous absorption, though they exert their principal effect upon the liver. Hence also opiates, and bitters, and vitriolic acid, are advantageously used along with them. It must be added that some hæmorrhages recur by periods like the paroxysms of intermittent fevers, and are thence cured by the same treatment.

[3]. The jaundice is frequently caused by the insipidity of the bile, which does not stimulate the gall-bladder and bile-ducts into their due action; hence it stagnates in the gall-bladder, and produces a kind of crystallization, which is too large to pass into the intestines, blocks up the bile-duct, and occasions a long and painful disease. A paralysis of the bile duct produces a similar jaundice, but without pain.

[4]. Worms in sheep called flukes are owing to the dilute state of the bile; hence they originate in the intestines, and thence migrate into the biliary ducts, and corroding the liver produce ulcers, cough, and hectic fever, called the rot. In human bodies it is probable the inert state of the bile is one cause of the production of worms; which insipid state of the bile is owing to deficient absorption of the thinner parts of it; hence the pale and bloated complexion, and swelled upper lip, of wormy children, is owing to the concomitant deficiency of absorption from the cellular membrane. Salt of steel, or the rust of it, or filings of it, with bitters, increase the acrimony of the bile by promoting the absorption of its aqueous part; and hence destroy worms, as well as by their immediate action on the intestines, or on the worms themselves. The cure is facilitated by premising a purge with calomel. See Class [I. 2. 3. 9].

[5]. The chlorosis is another disease owing to the deficient action of the absorbents of the liver, and perhaps in some degree also to that of the secretory vessels, or glands, which compose that viscus. Of this the want of the catameniæ, which is generally supposed to be a cause, is only a symptom or consequence. In this complaint the bile is deficient perhaps in quantity, but certainly in acrimony, the thinner parts not being absorbed from it. Now as the bile is probably of great consequence in the process of making the blood; it is on this account that the blood is so destitute of red globules; which is evinced by the great paleness of these patients. As this serous blood must exert less stimulus on the heart, and arteries, the pulse in consequence becomes quick as well as weak, as explained in Sect. XII. 1. 4.

The quickness of the pulse is frequently so great and permanent, that when attended by an accidental cough, the disease may be mistaken for hectic fever; but is cured by chalybeates, and bitters exhibited twice a day; with half a grain of opium, and a grain of aloe every night; and the expected catamenia appears in consequence of a restoration of the due quantity of red blood. This and the two former articles approach to the disease termed paralysis of the liver. Sect. XXX. 1. 4.

[6]. It seems paradoxical, that the same treatment with chalybeates, bitters, and opiates, which produces menstruation in chlorotic patients, should repress the too great or permanent menstruation, which occurs in weak constitutions at the time of life when it should cease. This complaint is an hæmorrhage owing to the debility of the absorbent power of the veins, and belongs to the paragraph on venous absorption above described, and is thence curable by chalybeates, alum, bitters, and particularly by the exhibition of a grain of opium every night with five grains of rhubarb.

[7]. Metallic salts supply us with very powerful remedies for promoting absorption in dropsical cases; which frequently are caused by enlargement of the liver. First, as they may be given in such quantities as to prove strongly cathartic, of which more will be said in the article on invertentia; and then, when their purgative quality ceases, like the effect of rhubarb, their absorbent quality continues to act. The salts of mercury, silver, copper, iron, zinc, antimony, have all been used in the dropsy; either singly for the former purpose, or united with bitters for the latter, and occasionally with moderate but repeated opiates.

[8]. From a quarter of a grain to half a grain of blue vitriol given every four or six hours, is said to be very efficacious in obstinate intermittents; which also frequently arise from an enlarged viscus, as the liver or spleen, and are thence owing to the deficient absorption of the lymphatics of that viscus. A quarter of a grain of white arsenic, as I was informed by a surgeon of the army, cures a quartan ague with great certainty, if it be given an hour before the expected fit. This dose he said was for a robust man, perhaps one eighth of a grain might be given and repeated with greater safety and equal efficacy.

Dr. Fowler has given many successful cases in his treatise on this subject. He prepares it by boiling sixty-four grains of white arsenic in a Florence flask along with as much pure vegetable fixed alcali in a pint of distilled water, till it is dissolved, and then adding to it as much distilled water as will make the whole exactly sixteen ounces. Hence there are four grains of arsenic in every ounce of the solution. This should be put into a phial of such a size of the edge of its aperture, that sixty drops may weigh one dram, which will contain half a grain of arsenic. To children from two years old to four he gives from two to five drops three or four times a day. From five years old to seven, he directs seven or eight drops. From eight years old to twelve, he directs from seven to ten drops. From thirteen years old to eighteen he directs from ten to twelve drops. From eighteen upwards, twelve drops. In so powerful a medicine it is always prudent to begin with smaller doses, and gradually to increase them.

A saturated solution of arsenic in water is preferable I think to the above operose preparation of it; as no error can happen in weighing the ingredients, and it more certainly therefore possesses an uniform strength. Put much more white arsenic reduced to powder into a given quantity of distilled water, than can be dissolved in it. Boil it for half an hour in a Florence flask, or in a tin sauce-pan; let it stand to subside, and filter it through paper. My friend Mr. Greene, a surgeon at Brewood in Staffordshire, assured me, that he had cured in one season agues without number with this saturated solution; that he found ten drops from a two-ounce phial given thrice a day was a full dose for a grown person, but that he generally began with five.

[9]. The manner, in which arsenic acts in curing intermittent fevers, cannot be by its general stimulus, because no intoxication or heat follows the use of it; nor by its peculiar stimulus on any part of the secreting system, since it is not in small doses succeeded by any increased evacuation, or heat, and must therefore exert its power, like other articles of the sorbentia, on the absorbent system. In what manner it destroys life so suddenly is difficult to understand, as it does not intoxicate like many vegetable poisons, nor produce fevers like contagious matter. When applied externally it seems chemically to destroy the part like other caustics. Does it chemically destroy the stomach, and life in consequence? or does it destroy the action of the stomach by its great stimulus, and life in consequence of the sympathy between the stomach and the heart? This last appears to be the most probable mode of its operation.

The success of arsenic in the cure of intermittent fevers I suspect to depend on its stimulating the stomach into stronger action, and thus, by the association of this viscus with the heart and arteries, preventing the torpor of any part of the sanguiferous system. I was led to this conclusion from the following considerations.

First. The effects of arsenic given a long time internally in small doses, or when used in larger quantities externally, seem to be similar to those of other great stimuli, as of wine or alcohol. These are a bloated countenance, swelled legs, hepatic tumours, and dropsy, and sometimes eruptions on the skin. The former of these I have seen, where arsenic has been used externally for curing the itch; and the latter appears on evidence in the famous trial of Miss Blandy at Chelmsford, about forty years ago.

Secondly. I saw an ague cured by arsenic in a child, who had in vain previously taken a very large quantity of bark with great regularity. And another case of a young officer, who had lived intemperately, and laboured under an intermittent fever, and had taken the bark repeatedly in considerable quantities, with a grain of opium at night, and though the paroxysms had been thrice thus for a time prevented, they recurred in about a week. On taking five drops of a saturated solution of arsenic thrice a day the paroxysms ceased, and returned no more, and at the same time his appetite became much improved.

Thirdly. A gentleman about 65 years of age had for about ten years been subject to an intermittent pulse, and to frequent palpitations of his heart. Lately the palpitations seemed to observe irregular periods, but the intermission of every third or fourth pulsation was almost perpetual. On giving him four drops of a saturated solution of arsenic from a two-ounce phial about every four hours for one day, not only the palpitation did not return, but the intermission ceased entirely, and did not return so long as he took the medicine, which was three or four days.

Now as when the stomach has its action much weakened by an over-dose of digitalis, the pulse is liable to intermit, this evinces a direct sympathy between these parts of the system, and as I have repeatedly observed, that when the pulse begins to intermit in elderly people, that an eructation from the stomach, voluntarily produced, will prevent the threatened stop of the heart; I am induced to think, that the torpid state of the stomach, at the instant of the production of air occasioned by its weak action, caused the intermission of the pulse. And that arsenic in this case, as well as in the cases of agues above mentioned, produced its effects by stimulating the stomach into more powerful action; and that the equality of the motions of the heart was thus restored by increasing the excitement of the sensorial power of association. See Sect. XXV. 17. Class [IV. 2. 1. 18].

[10]. Where arsenic has been given as a poison, it may be discovered in the contents of the stomach by the smell like garlic, when a few grains of it are thrown on a red-hot iron. 2. If a few grains are placed between two plates of copper, and subjected to a red heat, the copper becomes whitened. 3. Dissolve arsenic in water along with vegetable alcali, add to this a solution of blue vitriol in water, and the mixture becomes of a fine green, which gradually precipitates, as discovered by Bergman. 4. Where the quantity is sufficient, some wheat may be steeped in a solution of it, which given to sparrows or chickens will destroy them.

[VII]. Absorption of the matter from venereal ulcers. No ulcer can heal, unless the absorption from it is as great as the deposition in it. The preparations or oxydes of mercury in the cure of the venereal disease seem to act by their increasing the absorption of the matter in the ulcers it occasions; and that whether they are taken into the stomach, or applied on the skin, or on the surface of the ulcers. And this in the same manner as sugar of lead, or other metallic oxydes, promote so rapidly the healing of other ulcers by their external application; and probably when taken internally, as rust of iron given to children affected with scrophulous ulcers contributes to heal them, and solutions of lead were once famous in phthisis.

The matter deposited in large abscesses does not occasion hectic fever, till it has become oxygenated by being exposed to the open air, or to the air through a moist membrane; the same seems to happen to other kinds of matter, which produce fever, or which occasion spreading ulcers, and are thence termed contagious. See Class [II. 1. 3]. [II. 1. 5]. [II. 1. 6. 6]. This may perhaps occur from these matters not being generally absorbed, till they become oxygenated; and that it is the stimulus of the acid thus formed by their union with oxygen, which occasions their absorption into the circulation, and the fever, which they then produce. For though collections of matter, and milk, and mucus, are sometimes suddenly absorbed during the action of emetics or in sea-sickness, they are probably eliminated from the body without entering the circulation; that is, they are taken up by the increased action of one lymphatic branch, and evacuated by the inverted action of some other lymphatic branch, and thus carried off by stool or urine.

But as the matter in large abscesses is in general not absorbed, till it becomes by some means exposed to air, there is reason to conclude, that the stimulus of this new combination of the matter with oxygen occasions its absorption; and that hence the absorption of matter in ulcers of all kinds, is still more powerfully effected by the external application or internal use of metallic oxydes; which are also acids consisting of the metal united with oxygen; and lastly, because venereal ulcers, and those of itch, and tinea, will not heal without some stimulant application; that is, the secretion of matter in them continues to be greater, than the absorption of it; and the ulcers at the same time continue to enlarge, by the contagion affecting the edges of them; that is, by the stimulus of the oxygenated matter stimulating the capillary vessels in its vicinity into actions similar to those of the ulcer, which produces it.

This effect of the oxydes of mercury occurs, whether salivation attends its use or not. Salivation is much forwarded by external warmth, when mercury is given to promote this secretion; but as the cure of venereal complaints depends on its absorbent quality, the act of salivation is not necessary or useful. A quarter of a grain of good corrosive sublimate twice a day will seldom fail of curing the most confirmed pox; and will as seldom salivate, if the patient be kept cool. A quarter of a grain thrice a day I believe to be infallible, if it be good sublimate.

Mercury alone when swallowed does not act beyond the intestines, its active preparations are the salts formed by its union with the various acids, as mentioned in the catalogue. Its union with the vegetable acid, when triturated with manna, is said to compose Keyser's Pill. Triturated with gum arabic it is much recommended by Plenk; and triturated with sugar and a little essential oil, as directed in a former Edinburgh Dispensatory, it probably forms some of the syrups sold as nostrums.

United with sulphur it seldom enters the circulation, as when cinnabar, or Æthiop's mineral, are taken inwardly. But united with fat and rubbed on the skin, it is readily absorbed. I know not whether it can be united to charcoal, nor whether it has been given internally when united with animal fat.

[VIII]. [1]. Absorptions in general are increased by inanition; hence the use of evacuations in the cure of ulcers. Dr. Jurin absorbed in one night, after a day's abstinence and exercise, eighteen ounces from the atmosphere in his chamber; and every one must have observed, how soon his sheets became dry, after having been moistened by sweat, if he throws off part of the bed-clothes to cool himself; which is owing to the increased cutaneous absorption after the evacuation by previous sweat.

[2]. Now as opium is an universal stimulant, as explained in the article on Incitantia, it must stimulate into increased action both the secretory system, and the absorbent one; but after repeated evacuation by venesection, and cathartics, the absorbent system is already inclined to act more powerfully; as the blood-vessels being less distended, there is less resistance to the progress of the absorbed fluids into them. Hence after evacuations opium promotes absorption, if given in small doses, much more than it promotes secretion; and is thus eminently of service at the end of inflammations, as in pleurisy, or peripneumony, in the dose of four or five drops of the tincture, given before the access of the evening paroxysm; which I have seen succeed even when the risus sardonicus has existed. Some convulsions may originate in the want of the absorption of some acrid secretion, which occasions pain; hence these diseases are so much more certainly relieved by opium after venesection or other evacuations.

[IX]. [1]. Absorption is increased by the calces or solutions of mercury, lead, zinc, copper, iron, externally applied; and by arsenic, and by sulphur, and by the application of bitter vegetables in fine powder. Thus an ointment consisting of mercury and hog's fat rubbed on the skin cures venereal ulcers; and many kinds of herpetic eruptions are removed by an ointment consisting of 60 grains of white precipitate of mercury and an ounce of hog's fat.

[2]. The tumours about the necks of young people are often produced by the absorption of a saline or acrid material, which has been deposited from eruptions behind the ears, owing to deficient absorption in the surface of the ulcer, but which on running down on the skin below becomes absorbed, and swells the lymphatic glands of the neck; as the variolous matter, when inserted into the arm, swells the gland of the axilla. Sometimes the perspirative matter produced behind the ears becomes putrid from the want of daily washing them, and may also cause by its absorption the tumours of the lymphatics of the neck. In the former case the application of a cerate of lapis calaminaris, or of cerussa applied in dry powder, or of rags dipped in a solution of sugar of lead, increases the absorption in the ulcers, and prevents the effusion of the saline part of the secreted material. The latter is to be prevented by cleanliness.

After the eruptions or ulcers are healed a solution of corrosive sublimate of one grain to an ounce of water applied for some weeks behind the ear, and amongst the roots of the hair on one side of the head, where the mouths of the lymphatics of the neck open themselves, frequently removes these tumours.

[3]. Linen rags moistened with a solution of half an ounce of sugar of lead to a pint of water applied on the erysipelas on anasarcous legs, which have a tendency to mortification, is more efficacious than other applications. White vitriol six grains dissolved in one ounce of rose-water removes inflammations of the eyes after evacuation more certainly than solutions of lead. Blue vitriol two or three grains dissolved in an ounce of water cures ulcers in the mouth, and other mucous membranes, and a solution of arsenic externally applied cures the itch, but requires great caution in the use of it. See Class [II. 1. 5. 6].

[4]. Bitter vegetables, as the Peruvian bark, quilted between two shirts, or strewed in their beds, will cure the ague in children sometimes. Iron in solution, and some bitter extract, as in the form of ink, will cure one kind of herpes called the ringworm. And I have seen seven parts of bark in fine powder mixed with one part of ceruss, or white lead, in fine powder, applied dry to scrophulous ulcers, and renewed daily, with great advantage.

[5]. To these should be added electric sparks and shocks, which promote the absorption of the vessels in inflamed eyes of scrophulous children; and disperse, or bring to suppuration, scrophulous tumours about the neck. For this last purpose smart shocks should be passed through the tumours only, by inclosing them between two brass knobs communicating with the external and internal coating of a charged phial. See Art. [II. 2. 2. 2].

[X]. [1]. Bandages increase absorption, if they are made to fit nicely on the part; for which purpose it is necessary to spread some moderately adhesive plaster on the bandage, and to cut it into tails, or into shreds two inches wide; the ends are to be wrapped over each other; and it must be applied when the part is least tumid, as in the morning before the patient rises, if on the lower extremities. The emplastrum de minio made to cover the whole of a swelled leg in this manner, whether the swelling is hard, which is usually termed scorbutic; or more easily compressible, as in anasarca, reduces the limb in two or three days to its natural size; for this purpose I have sometimes used carpenter's glue, mixed with one twentieth part of honey to prevent its becoming too hard, instead of a resinous plaster; but the minium plaster of the shops is in general to be preferred. Nothing so much facilitates the cure of ulcers in the legs, as covering the whole limb from the toes to the knee with such a plaster-bandage; which increases the power of absorption in the surface of the sore.

[2]. The lymph is carried along the absorbent vessels, which are replete with valves, by the intermitted pressure of the arteries in their neighbourhood. Now if the external skin of the limb be lax, it rises, and gives way to the pressure of the arteries at every pulsation; and thence the lymphatic vessels are subject to the pressure of but half the arterial force. But when the external skin is tightened by the surrounding bandage, and thence is not elevated by the arterial diastole, the whole of this power is exerted in compressing the lymphatic vessels, and carrying on the lymph already absorbed; and thence the absorbent power is so amazingly increased by bandage nicely applied. Pains are sometimes left in the fleshy parts of the thighs or arms, after the inflammation is gone, in the acute rheumatism, or after the patient is too weak for further evacuation; in this case after internal absorbent medicines, as the bark, and opiates, have been used in vain, I have successfully applied a plaster-bandage, as above described, so as to compress the pained part.

[XI]. [1]. We shall conclude by observing, that the sorbentia strengthen the whole habit by preventing the escape of the fluid part of the secretions out of the body, before it has given up as much nourishment, as it is capable; as the liquid part of the secretion of urine, sweat, saliva, and of all other secretions, which are poured into receptacles. Hence they have been said to brace the body, and been called tonics, which are mechanical terms not applicable to the living bodies of animals; as explained in Sect. XXXII. 3. 2.

[2]. A continued use of bitter medicines for years together, as of Portland's powder, or of the bark, is supposed to induce apoplexy, or other fatal diseases. Two cases of this kind have fallen under my observation; the patients were both rather intemperate in respect to the use of fermented liquors, and one of them had been previously subject to the gout. As I believe the gout generally originates from a torpor of the liver, which instead of being succeeded by an inflammation of it, is succeeded by an inflammation of some of the joints; or by a pimpled face, which is another mode, by which the disease of the liver is terminated. I conceive, that the daily use of bitter medicine had in these patients prevented the removal of a gouty inflammation from the liver to the membranes of the joints of the extremities, or to the skin of the face, by preventing the necessary torpor of these parts previous to the inflammation of them; in the same manner as cold fits of fever are prevented by the same medicines; and, as I believe, the returns of the gout have sometimes for two or three years been prevented by them.

One of these patients died of the apoplexy in a few hours; and the other of an inflammation of the liver, which I believe was called the gout, and in consequence was not treated by venesection, and other evacuations. From hence it appears, that the daily use of hop in our malt liquor must add to the noxious quality of the spirit in it, when taken to excess, and contribute to the production of apoplexy, or inflammation of the liver.

[III]. Catalogue of the Sorbentia.

[I]. Sorbentia affecting the skin.

[1]. Acid of vitriol, of sea-salt, lemons, sloes, prunus spinosa, crabs, pyrus, quince, pyrus cydonia, opium.

[2]. Externally calx of zinc, of lead, of mercury.

[II]. Sorbentia affecting the mucous membranes.

[1]. Juice of sloes, crabs, Peruvian bark, cinchona, opium.

[2]. Externally blue vitriol.

[III]. Sorbentia affecting the cellular membrane.

[1]. Peruvian bark, wormwoods, artemisia maritima, artemisia absynthium, worm-seed, artemisia santonicum, chamomile, anthemis nobilis, tansey tanacetum, bogbean, menyanthes trifoliata, centaury, gentiana centaurium, gentian, gentiana lutea, artichoke-leaves, cynara scolymus, hop, humulus lupulus.

[2]. Orange-peel, cinnamon, nutmeg, mace.

[3]. Vomits, squill, digitalis, tobacco.

[4]. Bath of warm air, of steam.

[IV]. Sorbentia affecting the veins.

[1]. Water-cress, sisymbrium nasturtium aquaticum, mustard, sinapis, scurvy-grass cochlearia hortensis, horse-radish cochlearia armoracia, cuckoo-flower, cardamine, dog's-grass, dandelion, leontodon taraxacon, cellery apium, cabbage brassica.

[2]. Chalybeates, bitters, and opium, after sufficient evacuation.

[3]. Externally vinegar, friction, electricity.

[V]. Sorbentia affecting the intestines.

[1]. Rhubarb, rheum palmatum, oak-galls, gallæ quercinæ, tormentil, tormentilla erecta, cinquefoil potentilla, red-roses, uva ursi, simarouba.

[2]. Logwood, hæmatoxylum campechianum, succus acaciæ, dragon's blood, terra japonica, mimosa catechu.

[3]. Alum, earth of alum, Armenian bole, chalk, creta, crab's claws, chelæ cancrorum, white clay, cimolia, calcined hartshorn, cornu cervi calcinatum, bone-ashes.

[VI]. Sorbentia affecting the liver, stomach, and other viscera. Rust of iron, filings of iron, salt of steel, sal martis, blue vitriol, white vitriol, calomel, emetic tartar, sugar of lead, white arsenic.

[VII]. Sorbentia affecting venereal ulcers. Mercury dissolved or corroded by the following acids:

[1]. Dissolved in vitriolic acid, called turpeth mineral, or hydrargyrus vitriolatus.

[2]. Dissolved in nitrous acid, called hydrargyrus nitratus ruber.

[3]. Dissolved in muriatic acid, mercurius corrosivus sublimatus, or hydrargyrus muriatus.

[4]. Corroded by muriatic acid. Calomel.

[5]. Precipitated from muriatic acid, mercurius precipitatus albus, calx hydrargyri alba.

[6]. Corroded by carbonic acid? The black powder on crude mercury.

[7]. Calcined, or united with oxygen.

[8]. United with animal fat, mercurial ointment.

[9]. United with sulphur. Cinnabar.

[10]. Partially united with sulphur. Æthiops mineral.

[11]. Divided by calcareous earth. Hydrargyrus cum cretâ.

[12]. Divided by vegetable mucilage, by sugar, by balsams.

[VIII]. Sorbentia affecting the whole system. Evacuations by venesection and catharsis, and then by the exhibition of opium.

[IX]. Sorbentia externally applied.

[1]. Solutions of mercury, lead, zinc, copper, iron, arsenic; or metallic calces applied in dry powder, as cerussa, lapis calaminaris.

[2]. Bitter vegetables in decoctions and in dry powders, applied externally, as Peruvian bark, oak bark, leaves of wormwood, of tansey, camomile flowers or leaves.

[3]. Electric sparks, or shocks.

[X]. Bandage spread with emplastrum e minio, or with carpenter's glue mixed with one twentieth part of honey.

[XI]. Portland's powder its continued use pernicious, and of hops in beer.

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ART. [V].

INVERTENTIA.

[I]. Those things, which invert the natural order of the successive irritative motions, are termed invertentia.

[1]. Emetics invert the motions of the stomach, duodenum, and œsophagus.

[2]. Violent cathartics invert the motions of the lacteals, and intestinal lymphatics.

[3]. Violent errhines invert the nasal lymphatics, and those of the frontal and maxillary sinuses. And medicines producing nausea, invert the motions of the lymphatics about the sauces.

[4]. Medicines producing much pale urine, as a certain quantity of alcohol, invert the motions of the urinary absorbents; if the dose of alcohol is greater, it inverts the stomach, producing the drunken sickness.

[5]. Medicines producing cold sweats, palpitation of the heart, globus hystericus; as violent evacuations, some poisons, fear, anxiety, act by inverting the natural order of the vascular motions.

[II]. Observations on the Invertentia.

[I]. [1]. The action of vomiting seems originally to have been occasioned by disagreeable sensation from the distention or acrimony of the aliment; in the same manner as when any disgustful material is taken into the mouth, as a bitter drug, and is rejected by the retrograde motions of the tongue and lips; as explained in Class [IV. 1. 1. 2]. and mentioned in Sect. XXXV. 1. 3. Or the disagreeable sensation may thus excite the power of volition, which may also contribute to the retrograde actions of the stomach and œsophagus, as when cows bring up the contents of their first stomach to re-masticate it. To either of these is to be attributed the action of mild emetics, which soon cease to operate, and leave the stomach stronger, or more irritable, after their operation; owing to the accumulation of the sensorial power of irritation during its torpid or inverted action. Such appears to be the operation of ipecacuanha, or of antimonium tartarizatum, in small doses.

[2]. But there is reason to believe, that the stronger emetics, as digitalis, first stimulate the absorbent vessels of the stomach into greater action; and that the inverted motions of these absorbents next occur, pouring the lymph, lately taken up, or obtained from other lymphatic branches, into the stomach: the quantity of which in some diseases, as in the cholera morbus, is inconceivable. This inverted motion, first of the absorbents of the stomach, and afterwards of the stomach itself, seems to originate from the exhaustion or debility, which succeeds the unnatural degree of action, into which they had been previously stimulated. An unusual defect of stimulus, as of food without spice or wine in the stomachs of those, who have been much accustomed to spice or wine, will induce sickness or vomiting; in this case the defective energy of the stomach is owing to defect of accustomed stimulus; while the action of vomiting from digitalis is owing to a deficiency of sensorial power, which is previously exhausted by the excess of its stimulus. See Sect. XXXV. 1. 3. and Class [IV. 1. 1. 2].

For first, no increase of heat arises from this action of vomiting; which always occurs, when the secerning system is stimulated into action. Secondly, the motions of the absorbent vessels are as liable to inversion as the stomach itself; which last, with the œsophagus, may be considered as the absorbent mouth and belly of that great gland, the intestinal canal. Thirdly, the class of sorbentia, as bitters and metallic salts, given in large doses, become invertentia, and vomit, or purge. And lastly, the sickness and vomiting induced by large potations of wine, or opium, does not occur till next day in some people, in none till some time after their ingurgitation. And tincture of digitalis in the dose of 30 or 60 drops, though applied in solution, is a considerable time before it produces its effect; though vomiting is instantaneously induced by a nauseous idea, or a nauseous taste in the mouth. At the same time there seem to be some materials, which can immediately stimulate the stomach into such powerful action, as to be immediately succeeded by paralysis of it, and consequent continued fever, or immediate death; and this without exciting sensation, that is, without our perceiving it. Of these are the contagious matter of some fevers swallowed with the saliva, and probably a few grains of arsenic taken in solution. See Suppl. I. [8. 8]. Art. [IV. 2. 6. 9].

[3]. Some branches of the lymphatic system become inverted by their sympathy with other branches, which are only stimulated into too violent absorption. Thus when the stomach and duodenum are much stimulated by alcohol, by nitre, or by worms, in some persons the urinary lymphatics have their motion inverted, and pour that material into the bladder, which is absorbed from the intestines. Hence the drunken diabetes is produced; and hence chyle is seen in the urine in worm cases.

When on the contrary some branches of the absorbent systems have their motions inverted in consequence of the previous exhaustion of their sensorial power by any violent stimulus, other branches of it have their absorbent power greatly increased. Hence continued vomiting, or violent cathartics, produce great absorption from the cellular membrane in cases of dropsy; and the fluids thus absorbed are poured into the stomach and intestines by the inverted motions of the lacteals and lymphatics. See Sect. XXIX. 4. and 5.

[4]. The quantity of the dose of an emetic is not of so great consequence as of other medicines, as the greatest part of it is rejected with the first effort. All emetics are said to act with greater certainty when given in a morning, if an opiate had been given the night before. For the sensorial power of irritation of the stomach had thus been in some measure previously exhausted by the stimulus of the opium, which thus facilitates the action of the emetic; and which, when the dose of opium has been large, is frequently followed on the next day by spontaneous sickness and vomitings, as after violent intoxication.

Ipecacuanha is the most certain in its effect from five grains to thirty; white vitriol is the most expeditious in its effect, from twenty grains to thirty dissolved in warm water; but emetic tartar, antimonium tartarizatum, from one grain to four to sane people, and from thence to twenty to insane patients, will answer most of the useful purposes of emetics; but nothing equals the digitalis purpurea for the purpose of absorbing water from the cellular membrane in the anasarca pulmonum, or hydrops pectoris. See Art. [IV. 2. 3. 7].

[II]. Violent cathartics. [1]. Where violent cathartics are required, as in dropsies, the squill in dried powder made into small pills of a grain, or a grain and a half, one to be given every hour till they operate briskly, is very efficacious; or half a grain of emetic tartar dissolved in an ounce of peppermint-water, and given every hour, till it operates. Scammony, and other strong purges, are liable to produce hypercatharsis, if they are not nicely prepared, and accurately weighed, and are thence dangerous in common practice. Gamboge is uncertain in its effects, it has otherwise the good property of being tasteless; and on that account some preparation of it might be useful for children, by which its dose could be ascertained, and its effects rendered more uniform.

[2]. In inflammations of the bowels with constipation calomel, given in the dose from ten to twenty grains after due venesection, is most efficacious; and if made into very small pills is not liable to be rejected by vomiting, which generally attends those cases. When this fails, a grain of aloes every hour will find its way, if the bowel is not destroyed; and sometimes, I believe, if it be, when the mortification is not extensive. If the vomiting continues after the pain ceases, and especially if the bowels become tumid with air, which sounds on being struck with the finger, these patients seldom recover. Opiates given along with the cathartics I believe to be frequently injurious in inflammation of the bowels, though they may thus be given with advantage in the saturnine colic; the pain and constipation in which disease are owing to torpor or inactivity, and not to too great action.

[III]. Violent errhines and sialagogues. [1]. Turpeth mineral in the quantity of one grain mixed with ten grains of sugar answers every purpose to be expected from errhines. Their operation is by inverting the motions of the lymphatics of the membrane, which lines the nostrils, and the caverns of the forehead and cheeks; and may thence possibly be of service in the hydrocephalus internus.

Some other violent errhines, as the powder of white hellebore, or Cayan pepper, diluted with some less acrid powder, are said to cure some cold or nervous head-achs; which may be effected by inflaming the nostrils, and thus introducing the sensorial power of sensation, as well as increasing that of irritation; and thus to produce violent action of the membranes of the nostrils, and of the frontal and maxillary sinuses, which may by association excite into action the torpid membranes, which occasion the head-ach.

[2]. A copious salivation without any increase of heat often attends hysteric diseases, and fevers with debility, owing to an inversion of the lymphatics of the mouth, see Class [I. 1. 2. 6]. The same occurs in the nausea, which precedes vomiting; and is also excitable by disagreeable tastes, as by squills, or by nauseous smells, or by nauseous ideas. These are very similar to the occasional discharge of a thin fluid from the nostrils of some people, which recurs at certain periods, and differs from defective absorption.

[IV]. Violent diuretics. [1]. If nitre be given from a dram to half an ounce in a morning at repeated draughts, the patient becomes sickish, and much pale water is thrown into the bladder by the inverted action of the urinary lymphatics. Hence the absorption in ulcers is increased and the cure forwarded, as observed by Dr. Rowley.

[2]. Cantharides taken inwardly so stimulate the neck of the bladder as to increase the discharge of mucus, which appears in the urine; but I once saw a large dose taken by mistake, not less than half an ounce or an ounce of the tincture, by which I suppose the urinary lymphatics were thrown into violent inverted motions, for the patient drank repeated draughts of subtepid water to the quantity of a gallon or two in a few hours; and during the greatest part of that time he was not I believe two entire minutes together without making water. A little blood was seen in his water the next day, and a soreness continued a day longer without any other inconvenience.

[3]. The decoction of foxglove should also be mentioned here, as great effusions of urine frequently follow its exhibition. See Art. [IV. 2. 3. 7]. And an infusion or tincture of tobacco as recommended by Dr. Fowler of York.

[4]. Alcohol, and opium, if taken so as to induce slight intoxication, and the body be kept cool, and much diluting liquids taken along with them, have similar effect in producing for a time a greater flow of urine, as most intemperate drinkers must occasionally have observed. This circumstance seems to have introduced the use of gin, and other vinous spirits as a diuretic, unfortunately in the gravel, amongst ignorant people; which disease is generally produced by fermented or spirituous liquors, and always increased by them.

[5]. Fear and anxiety are well known to produce a great frequency of making water. A person, who believed he had made a bad purchase concerning an estate, told me, that he made five or six pints of water during a sleepless night, which succeeded his bargain; and it is usual, where young men are waiting in an anti-room to be examined for college preferment, to see the chamber-pot often wanted.

[V]. Cold sweats about the head, neck, and arms, frequently attend those, whose lungs are oppressed, as in some dropsies and asthma. A cold sweat is also frequently the harbinger of death. These are from the inverted motions of the cutaneous lymphatic branches of those parts.

[III]. Catalogue of Invertentia.

[I]. Emetics, ipecacuanha, emetic tartar, antimonium tartarisatum, squill, scilla maritima, carduus benedictus, cnicus acarna, chamœmile, anthemis nobilis, white vitriol, vitriolum zinci, foxglove, digitalis purpurea, clysters of tobacco.

[II]. Violent cathartics, emetic tartar, squill, buckthorn, rhamnus catharticus, scammonium, convolvulus scammonia, gamboge, elaterium, colocynth, cucumis colocynthis, veratrum.

[III]. Violent errhines and sialagogues, Turpeth mineral, hydrargyrus vitriolatus, asarum europæum, euphorbium, capsicum, veratrum, nauseous smells, nauseous ideas.

[IV]. Violent diuretics, nitre, squill, seneka, cantharides, alcohol, foxglove, tobacco, anxiety.

[V]. Cold sudorifics, poisons, fear, approaching death.

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ART. [VI].

REVERTENTIA.

[I]. Those things, which restore the natural order of the inverted irritative motions, are termed Revertentia.

[1]. As musk, castor, asafœtida, valerian, essential oils.

[2]. Externally the vapour of burnt feathers, of volatile salts, or oils, blisters, sinapisms.

These reclaim the inverted motions without increasing the heat of the body above its natural state, if given in their proper doses, as in the globus hystericus, and palpitation of the heart.

The incitantia revert these morbid motions more certainly, as opium and alcohol; and restore the natural heat more; but if they induce any degree of intoxication, they are succeeded by debility, when their stimulus ceases.

[II]. Observations on the Revertentia.

[I]. The hysteric disease is attended with inverted motions feebly exerted of the œsophagus, intestinal canal and lymphatics of the bladder. Hence the borborigmi, or rumbling of the bowels, owing to their fluid contents descending as the air beneath ascends. The globus hystericus consists in the retrograde motion of the œsophagus, and the great flow of urine from that of the lymphatics spread on the neck of the bladder; and a copious salivation sometimes happens to these patients from the inversion of the lymphatics of the mouth; and palpitation of the heart owing to weak or incipient inversion of its motions; and syncope, when this occurs in its greatest degree.

These hysteric affections are not necessarily attended with pain; though it sometimes happens, that pains, which originate from quiescence, afflict these patients, as the hemicrania, which has erroneously been termed the clavus hystericus; but which is owing solely to the inaction of the membranes of that part, like the pains attending the cold fits of intermittents, and which frequently returns like them at very regular periods of time.

Many of the above symptoms are relieved by musk, castor, the fœtid gums, valerian, oleum animale, oil of amber, which act in the usual dose without heating the body. The pains, which sometimes attend these constitutions, are relieved by the secernentia, as essential oils in common tooth-ach, and balsam of Peru in the flatulent colic. But the incitantia, as opium, or vinous spirit, reclaim these morbid inverted motions with more certainty, than the fœtids; and remove the pains, which attend these constitutions, with more certainty than the secernentia; but if given in large doses, a debility and return of the hysteric symptoms occurs, when the effect of the opium or alcohol ceases. Opiates and fœtids joined seem best to answer the purpose of alleviating the present symptoms; and the sorbentia, by stimulating the lymphatics and lacteals into continued action, prevent a relapse of their inversion, as Peruvian bark, and rust of iron. See Class [I. 3. 1. 10].

[II]. Vomiting consists in the inverted order of the motions of the stomach, and œsophagus; and is also attended with the inverted motions of a part of the duodenum, when bile is ejected; and of the lymphatics of the stomach and fauces, when nausea attends, and when much lymph is evacuated. Permanent vomiting is for a time relieved by the incitantia, as opium or alcohol; but is liable to return, when their action ceases. A blister on the back, or on the stomach, is more efficacious for restraining vomiting by their stimulating into action the external skin, and by sympathy affecting the membranes of the stomach. In some fevers attended with incessant vomiting Sydenham advised the patient to put his head under the bed-clothes, till a sweat appeared on the skin, as explained in Class [IV. 1. 1. 2].

In chronical vomiting I have observed crude mercury of good effect in the dose of half an ounce twice a day. The vomitings, or vain efforts to vomit, which sometimes attend hysteric or epileptic patients, are frequently instantly relieved for a time by applying flour of mustard-seed and water to the small of the leg; and removing it, as soon as the pain becomes considerable. If sinapisms lie on too long, especially in paralytic cases, they are liable to produce troublesome ulcers. A plaster or cataplasm, with opium and camphor on the region of the stomach, will sometimes revert its retrograde motions.

[III]. Violent catharsis, as in diarrhœa or dysentery, is attended with inverted motions of the lymphatics of the intestines, and is generally owing to some stimulating material. This is counteracted by plenty of mucilaginous liquids, as solutions of gum arabic, or small chicken broth, to wash away or dilute the stimulating material, which causes the disease. And then by the use of the intestinal sorbentia, Art. [IV. 2. 5]. as rhubarb, decoction of logwood, calcined hartshorn, Armenian bole; and lastly, by the incitantia, as opium.

[IV]. The diabætes consists in the inverted motions of the urinary lymphatics, which is generally I suppose owing to the too great action of some other branch of the absorbent system. The urinary branch should be stimulated by cantharides, turpentine, resin (which when taken in larger doses may possibly excite it into inverted action), by the sorbentia and opium. The intestinal lymphatics should be rendered less active by torpentia, as calcareous earth, earth of alum; and those of the skin by oil externally applied over the whole body; and by the warm-bath, which should be of 96 or 98 degrees of heat, and the patient should sit in it every day for half an hour.

[V]. Inverted motions of the intestinal canal with all the lymphatics, which open into it, constitute the ileus, or iliac passion; in which disease it sometimes happens, that clysters are returned by the mouth. After venesection from ten grains to twenty of calomel made into very small pills; if this is rejected, a grain of aloe every hour; a blister; crude mercury; warm-bath; if a clyster of iced water?

Many other inverted motions of different parts of the system are described in Class [I. 3]. and which are to be treated in a manner similar to those above described. It must be noted, that the medicines mentioned under number one in the catalogue of revertentia are the true articles belonging to this class of medicines. Those enumerated in the other four divisions are chiefly such things as tend to remove the stimulating causes, which have induced the inversion of the motions of the part, as acrimonious contents, or inflammation, of the bowels in diarrhœa, diabetes, or in ileus. But it is probable after these remote causes are destroyed, that the fetid gums, musk, castor, and balsams, might be given with advantage in all these cases.

[III]. Catalogue of Revertentia.

[I]. Inverted motions, which attend the hysteric disease, are reclaimed, [1]. By musk, castor. [2]. By asafœtida, galbanum, sagapænum, ammoniacum, valerian. [3]. Essential oils of cinnamon, nutmeg, cloves, infusion of penny-royal, mentha, pulegium, peppermint, mentha piperita, ether, camphor. [4]. Spirit of hartshorn, oleum animale, spunge burnt to charcoal, black-snuffs of candles, which consist principally of animal charcoal, wood-soot, oil of amber. [5]. The incitantia, as opium, alcohol, vinegar. [6]. Externally the smoke of burnt feathers, oil of amber, volatile salt applied to the nostrils, blisters, sinapisms.

[II]. Inverted motions of the stomach are reclaimed by opium, alcohol, blisters, crude mercury, sinapisms, camphor and opium externally, clysters with asafœtida.

[III]. Inverted motions of the intestinal lymphatics are reclaimed by mucilaginous diluents, and by intestinal sorbentia, as rhubarb, logwood, calcined hartshorn, Armenian bole; and lastly by incitantia, as opium.

[IV]. Inverted motions of the urinary lymphatics are reclaimed by cantharides, turpentine, rosin, the sorbentia, and opium, with calcareous earth, and earth of alum, by oil externally, warm-bath.

[V]. Inverted motions of the intestinal canal are reclaimed by calomel, aloe, crude mercury, blisters, warm-bath, clysters with asafœtida, clysters of iced water? or of spring water further cooled by salt dissolved in water contained in an exterior vessel? Where there exists an introsusception of the bowel in children, could the patient be held up for a time by the feet with his head downwards, or be laid with his body on an inclined plane with his head downwards, and crude mercury be injected as a clyster to the quantity of two or three pounds?

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Art. [VII].

TORPENTIA.

[I]. Those things, which diminish the exertion of the irritative motions, are termed torpentia.

[1]. As mucus, mucilage, water, bland oils, and whatever possesses less stimulus than our usual food. Diminution of heat, light, sound, oxygen, and of all other stimuli; venesection, nausea, and anxiety.

[2]. Those things which chemically destroy acrimony, as calcareous earth, soap, tin, alcalies, in cardialgia; or which prevent chemical acrimony, as acid of vitriol in cardialgia, which prevents the fermentation of the aliment in the stomach, and its consequent acidity. Secondly, which destroy worms, as calomel, iron filings or rust of iron, in the round worms; or amalgama of quicksilver and tin, or tin in very large doses, in the tape-worms. Will ether in clysters destroy ascarides? Thirdly, by chemically destroying extraneous bodies, as caustic alcali, lime, mild alcali in the stone. Fourthly, those things which lubricate the vessels, along which extraneous bodies slide, as oil in the stone in the urethra, and to expedite the expectoration of hardened mucus; or which lessen the friction of the contents in the intestinal canal in dysentery or aphtha, as calcined hartshorn, clay, Armenian bole, chalk, bone-ashes. Fifthly, such things as soften or extend the cuticle over tumors, or phlegmons, as warm water, poultices, fomentations, or by confining the perspirable matter on the part by cabbage-leaves, oil, fat, bee's-wax, plasters, oiled silk, externally applied.

These decrease the natural heat and remove pains occasioned by excess of irritative motions.

[II]. Observations on the Torpentia.

[I]. As the torpentia consist of such materials as are less stimulating than our usual diet, it is evident, that where this class of medicines is used, some regard must be had to the usual manner of living of the patient both in respect to quantity and quality. Hence wounds in those, who have been accustomed to the use of much wine, are very liable to mortify, unless the usual potation of wine be allowed the patient. And in these habits I have seen a delirium in a fever cured almost immediately by wine; which was occasioned by the too mild regimen directed by the attendants. On the contrary in great inflammation, the subduction of food, and of spirituous drink, contributes much to the cure of the disease. As by these means both the stimulus from distention of the vessels, as well as that from the acrimony of the fluids, is decreased; but in both these respects the previous habits of diet of the patients must be attended to. Thus if tea be made stronger, than the patient has usually drank it, it belongs to the article sorbentia; if weaker, it belongs to the torpentia.

[II]. Water in a quantity greater than usual diminishes the action of the system not only by diluting our fluids, and thence lessening their stimulus, but by lubricating the solids; for not only the parts of our solids have their sliding over each other facilitated by the interposition of aqueous particles; but the particles of mucaginous or saccharine solutions slide easier over each other by being mixed with a greater portion of water, and thence stimulate the vessels less.

At the same time it must be observed, that the particles of water themselves, and of animal gluten dissolved in water, as the glue used by carpenters, slide easier over each other by an additional quantity of the fluid matter of heat.

These two fluids of heat and of water may be esteemed the universal solvents or lubricants in respect to animal bodies, and thus facilitate the circulation, and the secretion of the various glands. At the same time it is possible, that these two fluids may occasionally assume an aerial form, as in the cavity of the chest, and by compressing the lungs may cause one kind of asthma, which is relieved by breathing colder air. An increased quantity of heat by adding stimulus to every part of the system belongs to the article Incitantia.

[III]. [1]. The application of cold to the skin, which is only another expression for the diminution of the degree of heat we are accustomed to, benumbs the cutaneous absorbents into inaction; and by sympathy the urinary and intestinal absorbents become also quiescent. The secerning vessels continuing their action somewhat longer, from the warmth of the blood. Hence the usual secretions are poured into the bladder and intestines, and no absorption is retaken from them. Hence sprinkling the skin with cold water increases the quantity of urine, which is pale; and of stool, which is fluid; these have erroneously been ascribed to increased secretion, or to obstructed perspiration.

The thin discharge from the nostrils of some people in cold weather is owing to the torpid state of the absorbent vessels of the membrana sneideriana, which as above are benumbed sooner than those, which perform the secretion of the mucus.

The quick anhelation, and palpitation of the heart, of those, who are immersed in cold water, depends on the quiescence of the external absorbent vessels and capillaries. Hence the cutaneous circulation is diminished, and by association an almost universal torpor of the system is induced; thence the heart becomes incapable to push forwards its blood through all the inactive capillaries and glands; and as the terminating vessels of the pulmonary artery suffer a similar inaction by association, the blood is with difficulty pushed through the lungs.

Some have imagined, that a spasmodic constriction of the smaller vessels took place, and have thus accounted for their resistance to the force of the heart. But there seems no necessity to introduce this imaginary spasm; since those, who are conversant in injecting bodies, find it necessary first to put them into warm water to take away the stiffness of the cold dead vessels; which become inflexible like the other muscles of dead animals, and prevent the injected fluid from passing.

All the same symptoms occur in the cold fits of intermittents; in these the coldness and paleness of the skin with thirst evince the diminution of cutaneous absorption; and the dryness of ulcers, and small secretion of urine, evince the torpor of the secerning system; and the anhelation, and coldness of the breath, shew the terminations of the pulmonary artery to be likewise affected with torpor.

After these vessels of the whole surface of the body both absorbent and secretory have been for a time torpid by the application of cold water; and all the internal secerning and absorbent ones have been made torpid from their association with the external; as soon as their usual stimulus of warmth is renewed, they are thrown into more than their usual energy of action; as the hands become hot and painful on approaching the fire after having been immersed some time in snow. Hence the face becomes of a red colour in a cold day on turning from the wind, and the insensible perspiration increased by repeatedly going into frosty air, but not continuing in it too long at a time.

[2]. When by the too great warmth of a room or of clothes, the secretion of perspirable matter is much increased, the strength of the patient is much exhausted by this unnecessary exertion of the capillary system, and thence of the whole secerning and arterial system by association. The diminution of external heat immediately induces a torpor or quiescence of these unnecessary exertions, and the patient instantly feels himself strengthened, and exhilarated; the animal power, which was thus wasted in vain, being now applied to more useful purposes. Thus when the limbs on one side are disabled by a stroke of the palsy, those of the other side are perpetually in motion. And hence all people bear riding and other exercises best in cold weather.

Patients in fevers, where the skin is hot, are immediately strengthened by cold air; which is therefore of great use in fevers attended with debility and heat; but may perhaps be of temporary disservice, if too hastily applied in some situations of fevers attended with internal topical inflammation, as in peripneumony or pleurisy, where the arterial strength is too great already, and the increased action of the external capillaries being destroyed by the cold, the action of the internal inflamed part may be suddenly increased, unless venesection and other evacuations are applied at the same time. Yet in most cases the application of cold is nevertheless salutary, as by decreasing the heat of the particles of blood in the cutaneous vessels, the stimulus of them, and the distention of the vessels becomes considerably lessened. In external inflammations, as the small-pox, and perhaps the gout and rheumatism, the application of cold air must be of great service by decreasing the action of the inflamed skin, though the contrary is too frequently the practice in those diseases. It must be observed, that for all these purposes the application of it should be continued a long time, otherwise an increased exertion follows the temporary torpor, before the disease is destroyed.

[3]. After immersion in cold water or in cold air the whole system becomes more exciteable by the natural degree of stimulus, as appears from the subsequent glow on the skin of people otherwise pale; and even by a degree of stimulus less than natural, as appears by their becoming warm in a short time during their continuance in a bath, of about 80 degrees of heat, as in Buxton bath. See Sect XII. 2. 1. XXXII. 3. 3.

This increased exertion happens to the absorbent vessels more particularly, as they are first and most affected by these temporary diminutions of heat; and hence like the medicines, which promote absorption, the cold-bath contributes to strengthen the constitution, that is to increase its irritability; for the diseases attended with weakness, as nervous fevers and hysteric diseases, are shewn in Section XXXII. 2. 1. to proceed from a want of irritability, not from an excess of it. Hence the digestion is greater in frosty weather, and the quantity of perspiration. For these purposes the application of cold must not be continued too long. For in riding a journey in cold weather, when the feet are long kept too cold, the digestion is impaired, and cardialgia produced.

[4]. If the diminution of external heat be too great, produced too hastily, or continued too long, the torpor of the system either becomes so great, that the animal ceases to live; or so great an energy of motion or orgasm of the vessels succeeds, as to produce fever or inflammation. This most frequently happens after the body has been temporarily heated by exercise, warm rooms, anger, or intemperance. Hence colds are produced in the external air by resting after exercise, or by drinking cold water. See Class [I. 2. 2. 1].

Frequent cold immersions harden or invigorate the constitution, which they effect by habituating the body to bear a diminution of heat on its surface without being thrown into such extensive torpor or quiescence by the consent of the vessels of the skin with the pulmonary and glandular system; as those experience, who frequently use the cold-bath. At first they have great anhelation and palpitation of heart at their ingress into cold water; but by the habit of a few weeks they are able to bear this diminution of heat with little or no inconvenience; for the power of volition has some influence over the muscles subservient to respiration, and by its counter efforts gradually prevents the quick breathing, and diminishes the associations of the pulmonary vessels with the cutaneous ones. And thus though the same quantity of heat is subducted from the skin, yet the torpor of the pulmonary vessels and internal glands does not follow. Hence during cold immersion less sensorial power is accumulated, and in consequence, less exertion of it succeeds on emerging from the bath. Whence such people are esteemed hardy, and bear the common variations of atmospheric temperature without inconvenience. See Sect. XXXII. 3. 2.

[IV]. Venesection has a just title to be classed amongst the torpentia in cases of fever with arterial strength, known by the fulness and hardness of the pulse. In these cases the heat becomes less by its use, and all exuberant secretions, as of bile or sweat, are diminished, and room is made in the blood-vessels for the absorption of mild fluids; and hence the absorption also of new vessels, or extravasated fluids, the produce of inflammation, is promoted. Hence venesection is properly classed amongst the sorbentia, as like other evacuations it promotes general absorption, restrains hæmorrhages, and cures those pains, which originate from the too great action of the secerning vessels, or from the torpor of the absorbents. I have more than once been witness to the sudden removal of nervous head-achs by venesection, though the patient was already exhausted, pale, and feeble; and to its great use in convulsions and madness, whether the patient was strong or weak; which diseases are the consequence of nervous pains; and to its stopping long debilitating hæmorrhages from the uterus, when other means had been in vain essayed. In inflammatory pains, and inflammatory hæmorrhages, every one justly applies to it, as the certain and only cure.

[V]. When the circulation is carried on too violently, as in inflammatory fevers, those medicines, which invert the motions of some parts of the system, retard the motions of some other parts, which are associated with them. Hence small doses of emetic tartar, and ipecacuanha, and large doses of nitre, by producing nausea debilitate and lessen the energy of the circulation, and are thence useful in inflammatory diseases. It must be added, that if nitre be swallowed in powder, or soon after it is dissolved, it contributes to lessen the circulation by the cold it generates, like ice-water, or the external application of cold air.

[VI]. The respiration of air mixed with a greater proportion of azote than is found in the common atmosphere, or of air mixed with hydrogen, or with carbonic acid gas, so that the quantity of oxygen might be less than usual, would probably act in cases of inflammation with great advantage. In consumptions this might be most conveniently and effectually applied, if a phthisical patient could reside day and night in a porter or ale brewery, where great quantities of those liquors were perpetually fermenting in vats or open barrels; or in some great manufactory of wines from raisins or from sugar.

Externally the application of carbonic acid gas to cancers and other ulcers instead of atmospheric air may prevent their enlargement, by preventing the union of oxygen with matter, and thus producing a new contagious animal acid.

[III]. Catalogue of Torpentia.

[1]. Venesection. Arteriotomy.

[2]. Cold water, cold air, respiration of air with less oxygen.

[3]. Vegetable mucilages.

a. Seeds.—Barley, oats, rice, young peas, flax, cucumber, melon, &c.

b. Gums.—Arabic, Tragacanth, Senegal, of cherry-trees.

c. Roots.—Turnip, potatoe, althea, orchis, snow-drop.

d. Herbs.—Spinach, brocoli, mercury.

[4]. Vegetable acids, lemon, orange, currants, gooseberries, apples, grape, &c. &c.

[5]. Animal mucus, hartshorn jelly, veal broth, chicken water, oil? fat? cream?

[6]. Mineral acids, of vitriol, nitre, sea-salt.

[7]. Silence, darkness.

[8]. Invertentia in small doses, nitre, emetic tartar, ipecacuanha given so as to induce nausea.

[9]. Antacids.—Soap, tin, alcalies, earths.

[10]. Medicines preventative of fermentation, acid of vitriol.

[11]. Anthelmintics.—Indian pink, tin, iron, cowhage, amalgama, smoak of tobacco.

[12]. Lithonthriptics, lixiv. saponarium, aqua calcis, fixable air.

[13]. Externally, warm bath, and poultices, oil, fat, wax, plasters, oiled silk, carbonic acid gas on cancers, and other ulcers.

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