Page:Cyclopaedia, Chambers - Supplement, Volume 2.djvu/536

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have been alone fufficient to have laughed it out of the world ■, but numbers of people fubmitted to the operation, till a youth in Petersburg unhappily being killed by a blow of the kind here mentioned ; and his belly fwelling greatly, excited the curiofity of his relations to have it opened. The caufe of his death was found to be an hemorrhage, which had filled the cavity of the abdomen, and which proceeded from the fphen's having been burft by the blow. This convinced them, that attempts to wound the fpleen were no longer to be looked upon as the means of health. Act. Petrop. Vol. i. p. 381. Infarction of the Spleen, infarftus fonts, a difeafe confuting in an inflation of this lax and cellulofe vifcus, owing its origin to a reftriction of the blood toward the fpleaic branch, in which nature feems to have intended the relieving herfclf from the load of a plethora, by the difcharging a part of the mafs through the vafa brevia. Junker's Confp. Med. p. 194.

The infarflus lienis differs from an obftfu&ion of the fpleen, in that this laft is a total fuppreffion of the blood in it, this only a partial one. It is too often confounded with ne- phritic complaints, and is indeed, in general, of the clafs of hypocondriac maladies, but only arifes from a fpecial and peculiar derivation of the blood to that one vifcus, not to any other of the circumjacent parts. Signs of it. An infarfiicn of the fpleen is difcovered by an in- flation of the left fide, a little below the fpurious ribs, at- tended with permanent pains, but thefe not very acute, or violent: thefe complaints have frequent remiflions, feldom continuing above a day or two in the fame Urate. During the time of the fymptoms being worft, there is a difficulty of breathing, and an anxiety of the precordia, and gene- rally a Iownefs of fpirits : to thefe it may be added, that there is ufually a dry cough, and frequent belchings. Terfins fubjetf to it. Men are in general much more fubject to this difeafe ihan women, unlefs at the middle and more ' advanced periods of life, when they are more fubject to it than the men. People of a melancholic habit alfo are moft afflicted with it, and fuch as have before had hypocondriac complaints, and have been injudicioufly treated with aftrin- gents ; and all perfons of a fedentary and ftudious life, or who employ much time in thinking. Caufes of it. Thefe are a fedentary life, and a diet of too heavy and thick a kind ; an omiffion of habitual bleedings, or other evacuations, or a fuppreffion of the menftrual or hemorrhoidal difcharges ; an injudicious treatment of inter- mittent fevers with aftringents, or of acute ones with too cooling medicines, and an habitual coftivenefs : and to thefe may be added an hereditary difpofition. Prognojlics in it. This is a difeafe of no immediate danger to the patient, and the more recent it is when taken in ' hand, the eafier it is cured; if left to itfelf it becomes ha- bitual, and brings no danger of death with it, but if im- properly treated, it frequently becomes the bafis of the moft obftinate kind of quartans, or degenerates into a fcirrhus, which may be a long time fuffered without any danger of life; but finally, the whole too often ends in flow hectic fevers, and cedematous and afcitic fwellings. In women it often terminates in a vomiting of blood ; and fometimes, but very rarely, an inflammatory and fuppurating ftafis fu- pervenus, and a black, fetid, and purulent matter is voided by ftool or by vomiting. Method of cure. The plethoric habit, which gives rife to this complaint, is to be taken down by copious bleedings in the right foot, and then mould be repeated every fpring and au- tumn ; and the menfes muft be brought to a proper regu- larity in the ufual way, as muft alfo the haemorrhoids in the other fex, by the application of leeches to the part. The fpiflltude of" the blood is to be amended by decoctions of elecampane, hyflbp, and the like; and by moderate and repeated dofes of tartarum vitriolatum, gum ammoniacum, &c. and gentle dofes of rhubarb and fena in infufion muft be taken at times. To thefe may be added the external ufe of rcfolvents and ftrengthners, fuch as ointment of marfli- mallows, the plaifter of gum ammoniacum, and the like ; and finally, the preparations of fteel are to be given : to thefe fome add a number of things efteemed fpecifics, fuch are madder and caper roots, dodder, yarrow, white maiden- hair, and fpleenwort, and the bark of the afh-tree, and wood of the tamarifk. Junker's Confp. Med. p. 197. Scirrhus of the Spleen. This is an indurated tumor of the fpleen, caufed by a ftagnation and infpiflation of the humor; from the exhalation of their thinner parts. This complaint is fometimes compleat, and fometimes incompleat ; but in the moft favourable cafes it is a greatly more dangerous com- plaint than an infarction of the fpleen, and more difficult of cure. Junker's Confp. Med. p. 201. Signs of it. Thefe are a feniible and palpable hardnefs under the itbs on the left fide, extending toward the loins, with a fenfe of a weight, as it were, hanging in this part ; and hence the lying on the right fide is always very painful and imeafy. The face has dull deadnefs in the look, which fometimes is communicated alfo to the ftcin of the whole body, and there is ufually a blacknefs about the orbits of the

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eyes ; there is alfo a fenfation of a narrownefs in the breaft, with fome difficulty of breathing, and a dry cough. The appetite is ufually voracious, but fometimes it is affected with naufeas, without any apparent caufe. The bowels are ufually fomewhat coftive, but irregularly fo. The mind alfo feems affected, and a gloomy morofenefs, filence, and anxiety, opprefs the perfon, without any vifible caufe. Fi- nally, there ufually is a fwelling in the right foot, which by degrees extends itfelf farther, and is feldom regarded at firft.

Perfons of both fexes are equally fubject to this diforder, but it is not, however, very common. Men who have long been fubject to hypocondriac difordcrs, and women fubject to hyfteric complaints, are moft fubject to it ; and to thefe may be added, perfons of an indolent, fpeculative, and fe- dentary life, and thofe who have been imprudently treated with aftringents in intermittent cafes.

Caufes of it. Befide thofe before mentioned, a fcirrhus is fome- times brought on in the Jpleen by a violent blow, or other ex- ternal injury ; a too thick diet may alfo be very inftrumental in! laying the foundation for it ; and not a little may be added to all thefe cafes, by violent paffions of the mind.

Prognojlics in it. In recent firrhufes, and fuch as are yet' incompleat, there is fome hope of fucceeding in the attempt of a cure ; and on the contrary, in old cafes and compleat fcirrhufes, there is indeed very little hope : but there is this comfort for the patient, that even fuch a one, when wholly- left to itfelf, will remain many years without endangering life.

There is in a fcirrhus an eternal tendency to corruption, but this is rather to be expected from fpbacelation, than from an inflammatory fuppuration ; but when emollients are ufed, there is great and imminent danger : for as thefe are nearly allied to the maturating remedies, they may produce their effect; and it is certain, that no laudable fuppuration is ever to be expected in this cafe.

Method of treatment. This cafe is to be treated in the fame general manner with the infarctions of the fpleen, al- ready mentioned ; but the more powerful refolvents are to be ufed in this, as the more ftubborn cafe. Gentian, bryony, and arum root, with the fine aperient roots, and the capillary herbs, with the powerful gums, as galbanum, fagapenum, ammoniacum, and the reft. Bleeding muft alfo be ordered, as foon as the prime vie have been cleanfed ; and externally the plaifter of cicuta, with ammoniacum, may be applied : but if the cafe is fixed and obftinate, it is better to let all applications alone, and leave nature to do the beflr for herfelf. Junker's Confp. Med. p. 202.

Spleen, in ichthyology. The fpleen in fifties is ufually fitu- ated near the ftomach, in the left fide of the abdomen. Its figure is generally triangular, fometimes oblong. Its colour is always more dufky and obfeure than that of the liver.

SpLEEN-iiW/. See the article Lonchites.

SPLENECTOMIA, the name given to the chirurglcal ope- ration of cutting out the fpleen. Many have thought that the fpieen was an ufelefs part of the human body, and even noxious; but this feems to be a very rafh opinion.

SPLENIA, a word ufed by furgeons to exprefs comprefTes, or rags feveral times doubled, applied to wounds over the plaifters, or other dreffings.

SPLENII inferior, in anatomy, a name given by Cowper to a mufcle, called by Albinus fplenicus colli, and by Winflow, and others, majloideeus poflerior, and portio inferior fplenii. See the article Splenius.

SPLENITIS, in medicine, the name of a fpecics of fever, in which the blood is powerfully directed toward the fpleen by nature, in order to break and diflolve congeftions formed there. The fplenitis differs from what authors call an in- farclus lienis in degree, as in this the blood only ftagnates in fome degree, and is not wholly obftructed ; and as there is no acute inflammatory fever here, as there is in the fple- nitis.

The fplenitis is very various in degree ; in fome cafes the whole parenchymatous fubftance of the fpleen being affect- ed, in others only its membranaceous and fuperficial parts. It is eafy to conceive that the former cafe is greatly the more dangerous of the two.

Signs of it. This difeafe always firft attacks people with a very remarkable ftiivering and coldnefs ; this is fucceeded by a very terrible heat, and intolerable thirft; and there is a preffive pain," and a fenfible fwelling in the left hypocon- drium. If the patients expofe themfelves a little to the open - air, the extremities grow cold almoft immediately ; if a hemorrhage happens, it is always from the left noftril : and finally, the urine is reddifti and turbid, and after the fourth day depufits a rofe-coloured fediment, which has fomewhat of the appearance of matter. Plethoric perfons are more than all others fubject to this difeafe. Caufes of it. The general caufe is a plethora joined with a thicknefs of the blood, which forms ftafes, and fixed coa- gulations in the fpleen ; and the fever itfelf is no other, than the attempt of nature to break through thofe ftafes, by the additional velocity of the motion of the blood. The ufual accidents that bring on this bad ftatc of the blood,