The symptoms of disordered digestive organs, whether induced by the irrita tion of local disease, or by other causes, as sedentary life, impure air, anxiety, and too great exertion of mind or bo dy, are, diminution of the appetite and digestion, flatulence, and unnatural co lour and fetor of the excretions, which are generally deficient in quantity. The tongue is dry, whitish, and furred, parti cularly at the back part, and this symp tom is most apparent in the morning. As the disease advances, a tenderness is felt on pressing the epigastric region, and the urine is frequently turbid. Mr. Abernethy considers this affection toile a general disorder of all the organs con cerned in the assimilation of our food; and that it consists in a weakness and ir ritability of the affected parts, accompa nied by a deficiency or depravity of the fluids secreted by them ; upon the heal thy qualities of which the right per formance of their functions seems to de pend. The duration of the affection without fatal consequences, or indeed without any changes of structure in the parts, shows that it is only a disorder of functions.
When it is considered that this de rangement of the chylopoietic viscera may bring on various diseases, and that local affections, occurring during its ex istence, will become peculiar in their na ture and progress, and difficult of cure, the importance of the subject will be readily allowed. A particular attention to diet is a point of primary importance in the treatment ; and connected with this, the practice of taking five grains of powdered rhubarb an hour before dinner is very beneficial. A correction of any obvious irregularity in the intestines, and a regular diurnal evacuation of them, are the next points to which we must attend. Purging is by no means advisable in the weakened state of these organs. The administration of small doses of mercury every night, or every other night, has a powerful effect in correcting disorders of the biliary secretion, and consequently in bringing the stools to their natural co lour. Vegetable diet drinks, as the de coct. sarsaparill. comp. have been advan tageously combined with these means. The cause of the disorder may be more completely relieved by good air exer cise, and menial tranquillity, while the medical assistance above mentioned coun teracts the effects. By such simple treatment as we have just mentioned, obstinate and extensive local diseases of the most opposite classes, which have resisted all the ordinary methods, will often be either entirely cured, or very signally relieved.
Tetanus, or lock jaw, is one of the most alarming consequences of local in jury. It is most frequent in warm cli mates, in the male sex, and in the robust and vigorous. It does not appear till many days after the accident, and fre quently when the wound is quite healed. Injuries of the fingers and toes are its most frequent causes.
Symptoms. The muscles of the lower jaw first become stiff, and then rigidly contracted, so that the mouth cannot be opened. Those of the neck, back, and whole body, are successively affected in the same manner. The spasm, however, is not constant, as violent and most pain ful convulsions occasionally agitate the whole frame. The progress is various ; when rapid, the patient scarcely ever re covers ; but if he survive the fourth day, the prognostic is much more favourable. The vital functions are but little affected.
Metanient. When the symptoms have come on, there seems to be no connec tion between them and the original local cause ; so that no assistance can be deriv ed from this source. Opium in very large doses, as a grain in two hours, and then gradually increased ; and the same remedy by the way of clyster, and in fric tions, seems to have afforded the most relief The warm bath, camphor, vola tile alkali, and musk, according to cir cumstances. Large quantities of wine have been recommended ; and in some cases the cold bath during the spasm has relieved. Salivation is useless.
Initammation, in some of its states or varieties, is presented to our view in al most every surgical disease, and conse quently particularly demands the atten tion of the surgeon. It occurs as a na tural means of cure in many species of ac cidental injury ; and here it is considered as healthy : it may also be regarded in the same light, where it follows any local irritation in a healthy constitution and part. In other cases it is complicated with some morbid tendency, as in erysi pelas, scrophula, lues venerea, &c. and hence arise numerous species of unheal thy inflammation. Again, it may be acute or chronic, in respect to its duration.
Healthy acute inflammation has been called phlegmon. Its symptoms are, pre ternatural redness, increased heat, and a circumscribed, throbbing, painful swell ing of the inflamed part. The exciting cause is generally some external violence, of a mechanical or chemical nature. Sometimes it arises spontaneously; or, in other words, no perceptible cause can be assigned for it. The proximate cause is, an increased action of the vessels of the part.