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

by Erasmus Darwin

[6]. The purging stools, and pale urine, occasioned by exposing the naked body to cold air, or sprinkling it with cold water, originate from a similar cause; for the mouths of the cutaneous lymphatics being suddenly exposed to cold become torpid, and cease, or nearly cease, to act; whilst, by the sympathy above described, not only the lymphatics of the bladder and intestines cease also to absorb the more aqueous and saline part of the fluids secreted into them; but it is probable that these lymphatics invert their motions, and return the fluids, which were previously absorbed, into the intestines and bladder. At the very instant that the body is exposed naked to the cold air, an unusual movement is felt in the bowels; as is experienced by boys going into the cold bath: this could not occur from an obstruction of the perspirable matter, since there is not time, for that to be returned to the bowels by the course of the circulation.

There is also a chronic aqueous diarrhœa, in which the atmospheric moisture, drank up by the cutaneous and pulmonary lymphatics, is poured into the intestines, by the retrograde motions of the lacteals. This disease is most similar to the aqueous diabetes, and is frequently exchanged for it: a distinct instance of this is recorded by Benningerus, Cent. v. Obs. 98. in which an aqueous diarrhœa succeeded an aqueous diabetes, and destroyed the patient. There is a curious example of this, described by Sympson (De Re Medica)—"A young man (says he) was seized with a fever, upon which a diarrhœa came on, with great stupor; and he refused to drink any thing, though he was parched up with excessive heat: the better to supply him with moisture, I directed his feet to be immersed in cold water; immediately I observed a wonderful decrease of water in the vessel, and then an impetuous stream of a fluid, scarcely coloured, was discharged by stool, like a cataract."

[7]. There is another kind of diarrhœa, which has been called cæliaca; in this disease the chyle, drank up by the lacteals of the small intestines, is probably poured into the large intestines, by the retrograde motions of their lacteals: as in the chyliferous diabetes, the chyle is poured into the bladder, by the retrograde motions of the urinary branch of absorbents.

The chyliferous diabetes, like this chyliferous diarrhœa, produces sudden atrophy; since the nourishment, which ought to supply the hourly waste of the body, is expelled by the bladder, or rectum: whilst the aqueous diabetes, and the aqueous diarrhœa produce excessive thirst; because the moisture, which is obtained from the atmosphere, is not conveyed to the thoracic receptacle, as it ought to be, but to the bladder, or lower intestines; whence the chyle, blood, and whole system of glands, are robbed of their proportion of humidity.

[8]. There is a third species of diabetes, in which the urine is mucilaginous, and appears ropy in pouring it from one vessel into another; and will sometimes coagulate over the fire. This disease appears by intervals, and ceases again, and seems to be occasioned by a previous dropsy in some part of the body. When such a collection is reabsorbed, it is not always returned into the circulation; but the same irritation that stimulates one lymphatic branch to reabsorb the deposited fluid, inverts the urinary branch, and pours it into the bladder. Hence this mucilaginous diabetes is a cure, or the consequence of a cure, of a worse disease, rather than a disease itself.

Dr. Cotunnius gave half an ounce of cream of tartar, every morning, to a patient, who had the anasarca; and he voided a great quantity of urine; a part of which, put over the fire, coagulated, on the evaporation of half of it, so as to look like the white of an egg. De Ischiade Nervos.

This kind of diabetes frequently precedes a dropsy; and has this remarkable circumstance attending it, that it generally happens in the night; as during the recumbent state of the body, the fluid, that was accumulated in the cellular membrane, or in the lungs, is more readily absorbed, as it is less impeded by its gravity. I have seen more than one instance of this disease. Mr. D. a man in the decline of life, who had long accustomed himself to spirituous liquor, had swelled legs, and other symptoms of approaching anasarca; about once in a week, or ten days, for several months, he was seized, on going to bed, with great general uneasiness, which his attendants resembled to an hysteric fit; and which terminated in a great discharge of viscid urine; his legs became less swelled, and he continued in better health for some days afterwards. I had not the opportunity to try if this urine would coagulate over the fire, when part of it was evaporated, which I imagine would be the criterion of this kind of diabetes; as the mucilaginous fluid deposited in the cells and cysts of the body, which have no communication with the external air, seems to acquire, by stagnation, this property of coagulation by heat, which the secreted mucus of the intestines and bladder do not appear to possess; as I have found by experiment: and if any one should suppose this coagulable urine was separated from the blood by the kidneys, he may recollect, that in the most inflammatory diseases, in which the blood is most replete or most ready to part with the coagulable lymph, none of this appears in the urine.

[9]. Different kinds of diabetes require different methods of cure. For the first kind, or chyliferous diabetes, after clearing the stomach and intestines, by ipecacuanha and rhubarb, to evacuate any acid material, which may too powerfully stimulate the mouths of the lacteals, repeated and large doses of tincture of cantharides have been much recommended. The specific stimulus of this medicine, on the neck of the bladder, is likely to excite the numerous absorbent vessels, which are spread on that part, into stronger natural actions, and by that means prevent their retrograde ones; till, by persisting in the use of the medicine, their natural habits of motions might again be established. Another indication of cure, requires such medicines, as by lining the intestines with mucilaginous substances, or with such as consist of smooth particles, or which chemically destroy the acrimony of their contents, may prevent the too great action of the intestinal absorbents. For this purpose, I have found the earth precipitated from a solution of alum, by means of fixed alcali, given in the dose of half a dram every six hours, of great advantage, with a few grains of rhubarb, so as to produce a daily evacuation.

The food should consist of materials that have the least stimulus, with calcareous water, as of Bristol and Matlock; that the mouths of the lacteals may be as little stimulated as is necessary for their proper absorption; lest with their greater exertions, should be connected by sympathy, the inverted motions of the urinary lymphatics.

The same method may be employed with equal advantage in the aqueous diabetes, so great is the sympathy between the skin and the stomach. To which, however, some application to the skin might be usefully added; as rubbing the patient all over with oil, to prevent the too great action of the cutaneous absorbents. I knew an experiment of this kind made upon one patient with apparent advantage.