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

by Erasmus Darwin

Another difficulty attending the names of diseases is, that one name frequently includes more than one disease, either existing at the same time or in succession. Thus the pain of the bowels from worms is caused by the increased action of the membrane from the stimulus of those animals; but the convulsions, which sometimes succeed these pains in children, are caused by the consequent volition, and belong to another class.

To discover under what class any disease should be arranged, we must first investigate the proximate cause; thus the pain of the tooth-ach is not the cause of any diseased motions, but the effect; the tooth-ach therefore does not belong to the class of Sensation. As the pain is caused by increased or decreased action of the membranes of the tooth, and these actions are owing to the increase or decrease of irritation, the disease is to be placed in the class of irritation.

To discover the order it must be inquired, whether the pain be owing to increased or defective motion of the pained membrane; which is known by the concomitant heat or coldness of the part. In tooth-ach without inflammation there is generally a coldness attends the cheek in its vicinity; as may be perceived by the hand of the patient himself, compared with the opposite cheek. Hence odontalgia is found to belong to the order of decreased irritation. The genus and species must be found by inspecting the synopsis of the second order of the class of Irritation. See Class [I. 2. 4. 12].

This may be further elucidated by considering the natural operation of parturition; the pain is occasioned by the increased action or distention of the vessels of the uterus, in consequence of the stimulus of the fetus; and is therefore caused by increased irritation; but the action of the abdominal muscles in its exclusion are caused by the pain, and belong to the class of increased sensation. See Class [II. 1. 1. 12]. Hence the difficulty of determining, under what class of diseases parturition should be arranged, consists in there being two kinds of diseased actions comprehended under one word; which have each their different proximate cause.

In Sect. XXXIX. 8. 4. and in Class [II. 1. 1. 1]. we have endeavoured to give names to four links of animal causation, which conveniently apply to the classification of diseases; thus in common nictitation, or winking with the eyes without our attention to it, the increased irritation is the proximate cause; the stimulus of the air on the dry cornea is the remote cause; the closing of the eyelid is the proximate effect; and the diffusion of tears over the eye-ball is the remote effect. In some cases two more links of causation may be introduced; one of them may be termed the pre-remote cause; as the warmth or motion of the atmosphere, which causes greater exhalation from the cornea. And the other the post-remote effect; as the renewed pellucidity of the cornea; and thus six links of causation may be expressed in words.

But if amid these remote links of animal causation any of the four powers or faculties of the sensorium be introduced, the reasoning is not just according to the method here proposed; for these powers of the sensorium are always the proximate causes of the contractions of animal fibres; and therefore in true language cannot be termed their remote causes. From this criterion it may always be determined, whether more diseases than one are comprehended under one name; a circumstance which has much impeded the investigation of the causes, and cures of diseases.

Thus the term fever, is generally given to a collection of morbid symptoms; which are indeed so many distinct diseases, that sometimes appear together, and sometimes separately; hence it has no determinate meaning, except it signifies simply a quick pulse, which continues for some hours; in which sense it is here used.

In naming diseases I have endeavoured to avoid the affectation of making new compound Greek words, where others equally expressive could be procured: as a short periphrasis is easier to be understood, and less burthensome to the memory.

In the Methodus Medendi, which is marked by M.M. at the end of many of the species of diseases, the words incitantia, sorbentia, torpentia, &c. refer to the subsequent articles of the Materia Medica, explaining the operations of medicines.

The remote causes of many diseases, their periods, and many circumstances concerning them, are treated of in the preceding volume; the descriptions of many of them, which I have omitted for the sake of brevity, may be seen in the Nosologia Methodica of Sauvages, and in the Synopsis Nosologiæ of Dr. Cullen, and in the authors to which they refer.