Page:Cyclopaedia, Chambers - Supplement, Volume 1.djvu/601

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This figure is molt naturally placed in the exordium or intro- duction to a difcourfe. Fojf. Rhct. 1. 5. p, 384.. Sec Doubting, Cycl.

DIARRHOEA [Cycl )— The. Diarrhea, loofenefs or purging of the bowels, as it is ufually called by us, is properly an increas'd periftaltick motion of the guts, by means of' which nature at- tempts to throw off a mucous or bilious matter lodged in too great a quantity in the primae vise, and diilurbing her regular operations.

Phyficians diftinguifh Diarrhoeas into feveral kinds: I. The fimple Diarrhoea. This is when a ferous and mucous matter is voided by itool. • 2. The choleric Diarrhoea, in which a bilious foulnefs is thrown off". 3, The Lienteric Diarrhcea, in which cafe the food is thrown offfo fpeedily, that it appears in its natural ftate, and to have fuffered no concoction. 4. The cceliac Diarrhoea ; in this the excrements are a little different from the food when taken in, and are of a chylous appear- ance. 5. The dyfentcrick and hepatic Diarrhoea^ fee Dysen- TERVand Hepatic flux. 6. The critical Diarrhoea, which happens in fevers on the day of the crifis. This ufually is the cafe in quotidians of the continual kind, and fometimes in ter- tians in the time of the fit. 7. The femicritic. Thefe are Diarrhoeas which appear at irregular times in catarrhal and petechial fevers. 8. The fymptomatic Diarrhoeas, Thefe appear in the fmall-pox, mealies, and purple fever. 9. The icteric Diarrhoea, In this the {tools are whitilh as in the jaundice. 10. The periodic Diarrhoeas. Thefe are fuch as return upon the patient at certain regular times of the year, particularly at the fpnng and autumn. And finally, 1 1. The Colliquative Diarrhoea. This is that kind that appears toward the laft ftage of hectics and confumptions, and ufually car- ries off the pauent. Junker's Confp. Med. p. 551.

Signs of a Diarrhoea. — The figna which precede -^Diarrhoea of any kind are ufually a tenfive pain and rumbling, and noife in the abdomen, and pungent acute pains, particularly about the region of the navel. The appetite is ufually very bad In the beginning of a Diarrhoea, and In its future ftages the ftrength fails ; and the longer it continues, the wode fym- ptoms it brings on : a tenefmus is one common complaint, and the head is weaken'd and aches at times ; and, finally, an in- ternal heat is felt, which is a very bad fymptom, and threatens mifchiefs of various kinds.

Perfons moft fubjecl to Diarrhoeas.— The fimple Diarrhcea, in which a mucous and ferous matter is voided, is principally a difeafe incident to people of phlegmatic habits, whole {tools are generally watery. When this kind of- Diarrhcea obferves any regular period, it is a fign of a fanguine temperament in the perfon. The bilious Diarrhoeas are nioft frequent with perfons of choleric habits ; and the critical Diarrhoeas in fe- vers ufually happen to perfons of a fanguine one. Men of tender and delicate confti tut ions, if they walk about a room when hot with their feet naked, are ufually affected afterwards with a fimple Diarrhoea.

Caufes ^Diarrhoeas. — Among the principal Caufes of Diar- rhoeas may be reckoned the hidden repremon of fweats in a morning while the perfon is in bed.

Crude foods, and fuch as are difficult of digeftion, often throw people into Diarrhoeas, as alfo over fat meats, efpecially if perfons drink much after them ; and nothing fo frequently as the free eating of fummer fruits, efpecially if the perfon chance to i wallow a quantity of any thing liquid foon after them.

Feculent or fermenting liquors will alfo do it, and fometimes the drinking cold liquors in a large quantity, or even the ex- ternal cold ; but in this cafe the tender habit of the patient is as much to be accufed as any thing.

The caufe of a lienteric Diarrhoea is principally the cicatri- zing of the bowels after their erofion in a dyfentery, in which the lacteal vclTels have been alfo injured. The cceliac Diar- rhoea is ufually laid upon a fault in the ftomach ; but it is as often owing to an obftruction of the lacteal veffels, as to a weaknefs of that organ. The choleric Diarrhcea is ufually occafioned by an eftufion of a larger portion than ufual of bile into the interlines, and this is often occafioned by a vio- lent fit of paffion in the perfon. Junker's Confp. Med p. 553.

Prognojlics m Diarrhoeas. —All Diarrheas are difeafes of the greateft confequence when improperly treated, or raihly and iuddenly flopped by opiates and aftriiigents. On the contrary, the whole courfe of a fimple Diarrhcea, if nature be left to herlelf, is attended with no danger. When the molt fimple and, in itfelf, innocent Diarrhcea is treated in that manner, the confequences are violent and pungent pains in the abdo- men ; and, in old people efpecially, a tranflation of the mat- ter, which nature would have carried off" by that foft way, to the head and bread ; whence vertigos and fuffocative catarrhs are often brought on, and the perfons die fuddenly, and as it is fuppofed of apoplexies. The danger of flopping a bilious Diarrhoea is ftil! greater, for the frequent confequence of this is a caufus, or other violent fever of that kind ; but the great- eft danger of all attends the flopping of a critical Diarrhoea. The fymptomatick Diarrhoeas in the fmall-pox, meaflcs, and purple fevers are often of fatal confequence, Periodic Diar-

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rhceas, if nature be left to herfelf, are always fafutary. ' "The fimple lienteric and cceliac Diarrhoeas ufually give way eafily to medicines, and the choleric are of no dangerous confe- quence, unlefs they are attended with a fever. Finally, it ra to be obferved, that any Diarrhcea continuing an immoderate time will by degrees wafte the ftrength, and throw the patient into a flow fever and an atrophy. Method of curing Diarrhoeas.— In a fimple Diarrhcea the firft intention is to incide and attenuate the mucous matter, and then to abfterge it by digeftive, refolvent, and colliquating medicines ; fuch are the bitters and aromaticks, with fome of the acrid ones, as the roots of gentian, arum and zedoary, to- gether with ginger, galingals, and the aromatic feeds. Thefe may be affifted by the digeftive fate, as cream of tartar, arca- num duplicatum, and vitriolated tartar, with the fixed falts of wormwood, and the like. To thefe may be added occafional- ly the digeftive and attenuating gums, as zmmoniacum, and the like; and in fome cafes it is proper to reduce the vicious matter into a fort of pulpy confluence. This is to be done by the abforbents, as crabs-eyes, and the like. When there is a quantity of a bilious matter mixed with this, the admix- ture of fmall dofes of nitre with the other medicines is of great effect ; and when the peccant matter is by this means prepared for evacuation, nature is to be affifted in her attempt to throw it off by this proper paflige by fmall dofes of gently laxative medicines, fuch as rhubarb, and the like. After this if the motion of the bowels do not abate and come to its ufual ftand- ard on their being thus eafed of their load, thefe fymptoms are to be taken off by gentle allringents. For though thefe motions were no way to be impeded, when nature meant them for the throwing off what offended her, and were falutary in that ftate ; yet when they remain after the end is obtained, they are to be confider'd as a difeafe. The medicines proper on this occafion are dried quinces, the abforbent powders, fuch as red coral, and the like, gentle opiates, and the aftringent fy- rups of cinnamon, and the like ; and finally, the cure is to be compleated by reftoring the bowels to their due tone by gentle chalybeates.

The lienterick and cceliac Diarrhceas require the fame me- thod of treatment with thefe, except that in the lienterick a vomit in the beginning is ufually very proper : but in the cce- liac, when there is an obftruciion of the lacteal veffels, a vo- mit has no ufe; but the refolvents, aperients, and laxatives alone are to be depended upon.

Periodic Diarrhceas are to be treated in this manner like the fimple ones, and nature is to be affifted, not checked, in her operations in them. In thefe cafes a medicated wine prepared with rhubarb, gentian, zedoary, and black hellebore, is a ve- ry valuable medicine. When worms are fufpefled to be in the cafe, as they very frequently are, the ufual anthelmintics are to be joined to the medicines before directed. The critical and femicritical, as well as fymptomatic Diar- rhoeas in fevers, are to be treated as directed under the fevers to which they belong ; and the ifieric Diarrhoea, in which the ftools are white as in the jaundice, is to be treated as the jaundice. Junker's Confp. Med. p. 557. See the articles Worms, Fever, csV. Diarrhoea of Infants, fee Infant.

DIARTHROSIS [Cycl.)— In the Diarthrofts, or moveable arti- culations of the bones, the pieces are really feparated, and the parts in which they touch are each of them covered by a fmooth cartilage, by means of which they eafily Hide over one another ; whereas in the fynarthrofis, or immoveable articulation, the pieces are joined together in fuch a manner, that the parts in which they touch have nothing particular in their furface, and cannot Aide upon one another.

The Diarthrofts is either manifeft with large motion, or ob- fcure with fmall motion. Each of thefe is alfo again of two kinds, one indeterminate, with motion many different ways, as that of the os humeri upon the fcapula of the os fremoris on the os innominatum. The other alternative, or with motion, confined to the two oppofite fides only, as that of the ulna on the os humeri, and that of the two laft phalanges on the firft and fecond. A bone is faid to be moveable many different ways, when it can be turned upwards and downwards, forwards and backwards, to the right and to the left, or quite round. The motion quite round is made either on a pivot, that is, about an axis, or in manner of a fling, when the bone defcribes a fort of cone, or the figure of a funnel, one end of it moving in a very fmall fpace, the other in a large circle. The iirft of thefe round motions is termed rotation by anatomifts ; the other is only the refult of a combination of feveral different motions upwards, downwards, c?V. and it is to be remarked, that rotation is not to be met with in all the articulations for motion many different ways ; as the articulation of the firft phalanges with the metacarpal bones, &c. does not admit of it.

Moreover, this indeterminate Diarthrofts is of two kinds, the one orbicular or globular ; the other flat, or planiform. The orbicular Diarthrofts is when the round end of one bone moves in the cavity of another more or lefs proportionable to it. As the head of the os femoris in the acetabulum of os innomina-