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cording to the ordinary rules for cleansing and healing such abscesses and ulcers.

425. I might here consider the splenitis, or inflammation of the spleen; but it does not seem necessary, because the disease very seldom occurs. When it does, it may readily be known by the character given in our nosology; and its various termination, as well as the practice which it requires, may be understood from what has been already said with respect to the inflammations of the other abdominal viscera.

CHAP. XI.

OF THE NEPHRITIS, OR THE INFLAMMATION OF THE

KIDNEYS.

426. This disease, like other internal inflammations, is always attended with pyrexia; and is especially known from the region of the kidney being affected by pain, commonly obtuse, sometimes pungent. This pain is not increased by the motion of the trunk of the body, so much as a pain of the rheumatic kind affecting the same region. The pain of the nephritis may be often distinguished by its shooting along the course of the ureter; and is frequently attended with a drawing up of the testicle, and with a numbness of the limb on the side affected ; although, indeed, these symptoms most commonly accompany the inflam. mation arising from a calculus in the kidney or in the ureter. The nephritis is almost constantly attended with frequent vomiting, and often with costiveness and colic pains. Usually the state of the urine is changed; it is most commonly of a deep red colour, is voided frequently, and in small quantity at a time. In more violent cases, the urine is sometimes colourless.

auses

427. The remote causes of this disease may be various, as external contusion; violent or longcontinued riding; strains of the muscles of the back incumbent on the kidneys; various acrids in the course of the circulation conveyed to the kidneys; and perhaps some other internal causes not yet well known. The most frequent is that of calculous matter obstructing the tubuli uriniferi, or calculi formed in the pelvis of the kidneys, and either sticking there, or falling into the ureter.

428. The various event of this disease may be understood from what has been delivered on the subject of other inflammations.

429. Writers, in treating of the cure of nephritis, have commonly at the same time, treated

of the cure of the Calculus Renalis : but, though this may often produce nephritis, it is to be considered as a distinct and separate disease; and what I have to offer as to the mode of treating it, must be reserved to its proper place. Here I shall treat only of the cure of the Nephrits Vera or Idiopathica.

430. The cure of this proceeds upon the general plan, by bleeding, external fomentation, fre. quent emollient glysters, antiphlogistic purgatives, and the free use of mild and demulcent liquids. The application of blisters is hardly admissible; or, at least, will require great care, to avoid any considerable absorption of the cantharides.

431. The Cystitis, or inflammation of the bladder, is seldom a primary disease ; and therefore is not to be treated of here. The treatment of it, so far as necessary to be explained, may be readily understood from what has been already delivered.

432. Of the visceral inflammations, there re.. mains to be considered the inflammation of the uterus : but I omit it here, because the consideration of it cannot be separated from that of the diseases of child-bearing women,

CHAP. XII.

OF THE RHEUMATISM.

433. Of this disease there are two species, the one named the Acute, the other ine Chronic Rheumatism.

. 434. It is the Acute Rheumatism which especially belongs to this place, as from its causes, symptoms, and methods of cure, it will appear to be a species of phlegmasia or inflammation.

435. This disease is frequent in cold, and more uncommon in warm climates. It appears most frequently in autumn and spring, less frequently in winter when the cold is considerable and constant, and very seldom during the heat of summer.

436. The acute rheumatism generally arises from the application of cold to the body when any way unusually warm; or when one part of the body is exposed to cold whilst the other parts are kept warm; or, lastly, when the application of cold is long continued, as it is when wet or moist clothes are applied to any part of the body.

437. These causes may affect persons of all ages; but the rheumatism seldom appears in either very young or in elderly persons, and most com. monly occurs from the age of puberty to that of thirty-five years.

438. These causes (436) may also affect persons of any constitution; but they most commonly affect those of a sanguine temperament.

439. This disease is particularly distinguished by pains affecting the joints, for the most part the joints alone, but sometimes affecting also the muscular parts. Very often the pains shoot along the course of the muscles, from one joint to another, and are always much increased by the action of the muscles belonging to the joint or joints affected.

440. The larger joints are most frequently affected, such as the hip-joint, and knees of the lower, and the shoulders and elbows of the upper, extremities. The ankles and wrists are also frequently affected; but the smaller joints, such as those of the toes or fingers, seldom suffer.

441. This disease, although sometimes confined to one part of the body only, yet very often af fects many parts of it; and then it comes on with a cold stage, which is immediately succeeded by

VOL. I.

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