Inflammation of the stomach,
gastritis. Notwithstanding the incessant irritation and distinction of this sensible organ, by innumerable varieties of food and drink, yet its inflammation is a rare event. The symptoms, acute fever; fixed burning pain and heat in the region of the stomach, aggravated by pressure; frequent nausea and vomiting after taking any nourishment; anxiety, restlessness; weak, hard, intermittent pulse; frequently delirium; universal debility. It may prove fatal in the space of a few days, or even of a few hours: there are different gradations of severity and danger. The termination is by resolution, suppuration, gangrene. The predisposing and occasional causes are, all the causes of topical inflammations in general; poisons swallowed; cold water, ices, and fruits swallowed when the body is much heated; repletion from food and gormandizing; crude and difficultly digested nutriment; violent agitation of body or mind; external injuries: from repelled gout very rarely.
The three succeeding genera of the phlogistick tribe, so far as respects mere inflammation only, affect the external parts and circumference of the body, and do not suppurate. In other respects there is a distinct tripartite separation, both as to general outlines and minuter shades.
Erysipelas,
ignis sanct. antonii: gutta rosacea, zoster, zona, herpes. Some trifling pillage by this disease is noticed in the London bills. To adults it is most hostile. The symptoms are, more or less fever; superficial inflammation of some portion of the skin and cuticular membrane, with pain, tumefaction, burning heat, redness, and pruriency, like that from nettles; and variously, in different persons, assailing the face, the neck, the trunk, or one of the extremities: the eruption seldom appears until after the commencement of the febrile commotion; and often from a small point spreads gradually: it never rises to any conical eminence, nor suppurates, but often excites vesications; and if on the face and violent, blocks up the eyelids: the pulse is frequently full and hard; and with the eruptive expulsion the fever and heat do not cease. It is sometimes critical and salutary: the favourable crisis is usually in a few days, or within nine, by perspiration, urine, and desquamation of the inflamed cuticle; and sometimes without any perceptible revulsion to the excretories. Some have this cutaneous inflammation annually, or oftener, or at wider intervals; and those once affected, are more obnoxious to its returns. Presages of danger are, violent inflammation and intumescence on the face, or sometimes even on the legs, particularly in old age, or unsound constitutions; premature retrocession of the eruption; pale colour; frequent return, and repetition of the inflammation; delirium; coma; gangrene. On the legs it sometimes leaves behind a chronic enlargement. The zoster and zona is a species of erysipelatous inflammation, a hand’s breadth or more, affecting the breast, sides, or abdomen, and various in length.
The predisposing and occasional causes of Erysipelas are, epidemick influence of the air; obstructed perspiration; sudden refrigeration of the body when heated; plethora; suppressed evacuations, natural or artificial; luxurious living and indolence; intemperance; spirituous liquors in excess; poisons; unsound constitutions; contusions, wounds, burns, punctured nerves, blisters, acrids; dregs of fevers; scorbutick; lunar influence; passions of mind.
Rheumatism, acute and chronic.
From the Chart of diseases we may rank rheumatism as an inferior piratical foe amongst the morbid host; or rather as a scourge and instrument of torture than of execution. In the acute or chronic form, multitudes are molested by it, especially in this island, and in northern regions: and more so in winter, in spring, and autumn, and the interchanges of the seasons: it seldom molests very young or aged persons: adults are most annoyed by it; the male more than the female sex; the poor and indigent more than the affluent; and those most who are exposed to the inclemency and vicissitudes of the seasons and weather: hence, during war, soldiers and sailors are much more afflicted with it than in peace.
In the acute rheumatism, fever may commence before or after the pain, which variously and alternately seems to dilacerate different parts, especially about the joints of the ancles, knees, hips, shoulders, elbows, and wrists, sometimes the trunk; but rarely the small joints of the toes or fingers: and commonly succeeded by swelling and redness of the distracted joints, and with restlessness: at night the pains are exasperated, and often suddenly abating in one joint, seize upon another; thus harassing the body with a war of posts. In its diagnostic train also are, hard quick pulse, sizy blood, inflammatory urine; sweats sometimes copious, but not critical. Its continuance may be one, two, or three weeks; by which time the fever, if not mismanaged, abates with the pains: it very rarely terminates in suppuration, and in this instance resembles erysipelas and gout. The crisis of the acute is generally by sweats, cuticular efflorescence, nasal hemorrhage. It may terminate inauspiciously in chronic pains, or in consumption: indeed, emaciation is always a consequence.
Chronic rheumatism may occupy all the stations of the acute: in the hips it is called ischias, morbus coxendicis, and sciatica: in the loins, lumbago. In this there is no fever, redness, nor swelling, only pain and often inability to move the affected joints; and this aggravated by change of weather and cold. In the lumbago there is direful pain about the loins, with difficulty in erecting the trunk; but not, as in the nephritis, accompanied with nausea or vomiting, nor pain of the ureters, testicles, or thighs. In the ischias there is severe fixed pain about the hips, os sacrum, and pubis, and often extending down the thigh and leg along the fascia aponeurotica; with difficulty or incapacity of moving the thigh; and sometimes atrophy of that extremity, or sciatic tabes. Chronic rheumatism may harass months, years, with various degrees of severity and exacerbation, and interludes of ease; and is often extremely obstinate and difficult to be dislodged. In many instances also, we observe a contrariety and dilemma whether to affix the name of chronic rheumatism or gout to such pains. In general, rheumatic aches are not so periodical in their returns; and in several other features the two diseases divaricate.