[8]. Gonorrhœa frigida. Cold gleet. Where the gleet is thin and pellucid, it must arise from the want of absorption of the membranes of the urethra, rather than from an increased secretion from them. This I suppose to be a more common disease than that mentioned at Class [I. 1. 2. 10].
M. M. Metallic injections, partial cold bath, internal method as in the fluor albus above described. Balsam of copaiva. Tincture of cantharides.
[9]. Hepatis tumor. The liver becomes enlarged from defect of the absorption of mucus from its cells, as in anasarca, especially in feeble children; at the same time less bile is secreted from the torpid circulation in the vena portæ. And as the absorbents, which resume the thinner parts of the bile from the gall-bladder and hepatic ducts, are also torpid or quiescent, the bile is more dilute, as well as in less quantity. From the obstruction of the passage of the blood through the compressed vena porta these patients have tumid bellies, and pale bloated countenances; their paleness is probably owing to the deficiency of the quantity of red globules in the blood in consequence of the inert state of the bile.
These symptoms in children are generally attended with worms, the dilute bile and the weak digestion not destroying them. In sleep I have seen fleuke-worms in the gall-ducts themselves among the dilute bile; which gall-ducts they eat through, and then produce ulcers, and the hectic fever, called the rot. See Class [I. 1. 4. 10]. and Article [IV. 2. 6].
M. M. After a calomel purge, crude iron-filings are specific in this disease in children, and the worms are destroyed by the returning acrimony and quantity of the bile. A blister on the region of the liver. Sorbentia, as worm-seed, santonicum. Columbo. Bark.
[10]. Chlorosis. When the defect of the due action of both the absorbent and secerning vessels of the liver affects women, and is attended with obstruction of the catamenia, it is called chlorosis; and is cured by the exhibition of steel, which restores by its specific stimulus the absorbent power of the liver; and the menstruation, which was obstructed in consequence of debility, recurs.
Indigestion, owing to torpor of the stomach, and a consequent too great acidity of its contents, attend this disease; whence a desire of eating chalk, or marl. Sometimes a great quantity of pale urine is discharged in a morning, which is owing to the inaction of the absorbents, which are distributed on the neck of the bladder, during sleep. The swelling of the ankles, which frequently attends chlorosis, is another effect of deficient action of the absorbent system; and the pale countenance is occasioned by the deficient quantity of red globules of blood, caused by the deficient quantity or acrimony of the bile, and consequent weakness of the circulation. The pulse is so quick in some cases of chlorosis, that, when attended with an accidental cough, it may be mistaken for pulmonary consumption. This quick pulse is owing to the debility of the heart from the want of stimulus occasioned by the deficiency of the quantity, and acrimony of the blood.
M. M. Steel. Bitters. Constant moderate exercise. Friction with flannel all over the body and limbs night and morning. Rhubarb five grains, opium half a grain, every night. Flesh diet, with small beer, or wine and water. The disease continues some months, but at length subsides by the treatment above described. A bath of about eighty degrees, as Buxton Bath, is of service; a colder bath may do great injury.
[11]. Hydrocele. Dropsy of the vagina testis. Dropsies have been divided into the incysted and the diffused, meaning those of the cellular membrane, the cells of which communicate with each other like a sponge, and those of any other cavity of the body. The collections of mucous fluids in the various cells and cavities of the body arise from the torpor of the absorbent vessels of those parts. It is probable, that in dropsies attended with great thirst the cutaneous absorbents become paralytic first; and then from the great thirst, which is thus occasioned by the want of atmospheric moisture, the absorption of the fat ensues; as in fevers attended with great thirst, the fat is quickly taken up. See Obesitas [I. 2. 3. 17]. Some have believed, that the cellular and adipose membranes are different ones; as no fat is ever deposited in the eye-lids or scrotum, both which places are very liable to be distended with the mucilaginous fluid of the anasarca, and with air in Emphysema. Sometimes a gradual absorption of the accumulated fluid takes place, and the thinner parts being taken up, there remains a more viscid fluid, or almost a solid in the part, as in some swelled legs, which can not easily be indented by the pressure of the finger, and are called scorbutic. Sometimes the paralysis of the absorbents is completely removed, and the whole is again taken up into the circulation.
The Hydrocele is known by a tumor of the scrotum, which is without pain, gradually produced, with fluctuation, and a degree of pellucidity, when a candle is held behind it; it is the most simple incysted dropsy, as it is not in general complicated with other diseases, as ascites with schirrous liver, and hydrocephalus internus, with general debility. The cure of this disease is effected by different ways; it consists in discharging the water by an external aperture; and by so far inflaming the cyst and testicle, that they afterwards grow together, and thus prevent in future any secretion or effusion of mucus; the disease is thus cured, not by the revivescence of the absorbent power of the lymphatics, but by the prevention of secretion by the adhesion of the vagina to the testis. This I believe is performed with less pain, and is more certainly manageable by tapping, or discharging the fluid by means of a trocar, and after the evacuation of it to fill the cyst with a mixture of wine and water for a few minutes till the necessary degree of stimulus is produced, and then to withdraw it; as recommended by Mr. Earle. See also Medical Commentaries by Dr. Duncan, for 1793.