Dysenteries, when they set in with fever, alvine discharges of a mixed character, or with inflammation of the liver, or of the hypochondrium, or of the stomach, such as are painful, with retention of the food and thirst, all these are bad; and the more of these symptoms there are, the greater the danger; and the fewer, the more hope is there of recovery. Children from five to ten years of age are the most apt to die of this complaint; the other ages less so. Such dysenteries as are of a beneficial nature, and are attended with blood and scrapings of the bowels, cease on the seventh, or fourteenth, or twentieth, or thirtieth day, or within that period. In such cases even a pregnant woman may recover and not suffer abortion.
All cases of lientery are said to be of a bad character when they are continued and protracted, both day and night, and when the dejections are either very crude, or black, soft, and fetid; for they occasion thirst and determine the fluids otherwise than to the bladder, give rise to ulcerations (aphthæ?) in the mouth, redness and ephelis[525] of all colors, and at the same time the belly is in a state of ferment, and has a foul, wrinkled appearance externally. This disease is most to be dreaded by old persons; it is formidable to men of middle age, but less so in the other ages. The indications of cure, it is acutely stated, are to determine the fluids to the urine, to relieve the body from its atrophy, and change the color of the skin.
All the other varieties of diarrhœa without fever are of short duration and mild; for they will all cease when washed out, or of their own accord. The discharge may be predicted as about to cease when, upon touching the belly, there is no movement, and flatulence passes with the discharge. Eversion of the gut takes place in the case of middle-aged persons having piles, of children affected with the stone, and in protracted and intense discharges from the bowels, and of old persons having mucous concretions (scybalæ?).
Women may be judged of whether they are in a fit state for conception or not by attending to the following circumstances:—In the first place to their shapes. Women of smaller stature more readily conceive than taller persons; the thin than the fat; the white than the ruddy; the dark than the pale; those who have prominent veins than the contrary. In oldish women it is bad to have much flesh, but a good thing to have swelled and large breasts. In addition, inquiry should be made whether or not the menstruation be regular as to time and quantity. And it should be ascertained whether the uterus be healthy, of a dry temperament, and soft; neither in a state of retraction nor prolapsus; and its mouth neither turned aside, nor too close, nor too open. When any of these obstructions come in the way, it is impossible that conception can take place.
Such women as cannot conceive, but appear green, without fever, and the viscera are not in fault; these will say that the head is pained, and that the menstrual discharge is vitiated and irregular. But such of these as have the proper color, are of a fat habit of body, the veins are inconspicuous, they have no pains, and the menses either never appear at all, or are scanty and intense, and this is one of the most difficult states of sterility to remove. In other cases the health is not to blame, but the fault lies in the position of the womb. The other contingencies in this place are attended with pains, discoloration, and wasting.
Ulceration in the womb from parturition, an abscess of a chronic nature, or from any other cause, is necessarily accompanied with fevers, buboes, and pains in the place; and if the lochial discharge be also suppressed, all these evils are more intense and inveterate, along with pains of the hypochondrium and head. And when the ulcer heals, the part necessarily is smoother and harder, and the woman is less adapted for conception. If, however, the ulceration be in the right side only, the woman may conceive of a female child, or if in the left, of a male. When a woman cannot conceive, and fever comes on with a slight cough, inquiry should be made whether she has any ulcer about the uterus, or any other of the complaints I have described; for if she has no complaint in that region to account for her loss of flesh and sterility, it may be expected that she will have vomiting of blood, and the catamenia will necessarily be suppressed. But if the fever be carried off by the evacuation of blood, and if the catamenia appear, she will then prove with child. But if looseness of the bowels having a bad character take place before there is an evacuation of blood, there is danger lest the woman perish before a vomiting of blood can take place.
In cases of false conception, in which women are deceived by the non-appearance of the menses, and by the increase of the belly and movement in it, they will be found to have had headache and pains about the neck and hypochondria, and there is no milk in the breasts except a little of a watery character. But when the swelling of the womb passes away they will conceive, unless there be any other impediment. For this affection is beneficial in so far as it produces a change in the uterus, so that afterwards the woman may prove with child. Women with child have not these pains unless the headache be habitual to them, and in addition they have milk in their breasts. Women affected with chronic discharges are to be asked whether they have pains in the head and loins, and in the lower part of the belly, and whether their teeth be set on edge, and if they have dimness of sight, and noises in their ears. Such women as vomit bile for several days while in a fasting state, though they are not with child nor have fever, are to be asked whether they have vomited up round lumbrici, and if they say not, they should be warned that this will happen to them. This affection happens principally to married women, then to virgins, and less seldom to other people.
Pains without fever are not deadly, but mostly prove protracted, and have many changes and relapses. Several varieties of headache are described, and the prognosis in each laid down. The natural cure of them is a coryza, a discharge of mucus from the nose, or sneezing. Pains spreading from the head to the neck and back, are relieved by abscesses, expectoration of pus, hemorrhoids, exanthemata on the body, or pityriasis on the head.
Heaviness and pruritus in the head, either in a part or through the whole of it, if, on inquiry, they extend to the tip of the tongue, indicate a confirmed disease, and one difficult to remove. They are best removed by the occurrence of an abscess. But those cases which are accompanied with vertigo are difficult to cure, and are apt to pass into mania. Other diseases in the head, of a very strong and protracted character, occur to both men and women, but especially to young persons, and virgins at the season of manhood, and especially at the catamenial period. Women, however, are less subject to pruritus and melancholic affections than the men, unless the menses have disappeared.
Both men and women who have long had a bad color, but not in the form of jaundice, are subject to headaches, eat stones and earth, and have piles. Those who have green colors, without decided jaundice, are affected in like manner, only instead of eating stones and earth, they are more subject to pains in the hypochondriac region. Persons who are pale for a length of time, and have the face tumid, will be found to have headache, or pains about the viscera, or some disease in the anus; and in most cases, not one, but many, or all these evils make their appearance.