We have placed in this part of our system the disease of Tympanitis, an affection which is characterized by an enlargement of the abdomen, caused by a collection of air, either contained within the intestines, or diffused through the cavity of the peritomum. Although it is generally described as a primary affection, we think there is much obscurity attached to it, and we are even disposed to doubt of its existence as more than a mere symptom of Dyspepsia, at least in that variety where the air is retained within the bowels. With respect to the other variety, it must necessarily be the result of a struc tural derangement of the part, as consequent upon some other disease, and is obviously incompatible with the ex istence of the patient for any great length of time. Many of the cases which have been described as Tym pany we should be disposed to refer to Dropsy, and others to enlargement of the mesenteric glands, in both cases accompanied by flatulence, arising from the weakened state of the digestive organs, which usually attends this complaint.
The third genus of the Spasmi contains the diseases that originate front irregular contractions of the semi voluntary muscles, consisting almost exclusively of cer tain affections of the thorax, or the parts immediately connected with it. The diseases which may be regard ed as primary, or of sufficient importance to claim our attention, are Tussis, Pertussis, Dyspneea, Asthma, and Angina pectoris. Although we think that cases of cough occasionally occur, which cannot be referred to any more general affection, and which must be regard ed as merely nervous, yet, as the disease is generally symptomatic, and when it is not so, may depend upon a variety of causes, which must necessarily render it almost impossible to lay down any general principles for its cure, we shall not attempt to give any farther account of it in this place, but shall proceed to the consideration of the next species, Pet tussis. This is a peculiar kind of cough, which is charactet ized by se veral symptoms that point it out as a disease of a spe cific nature, a circumstance which is decidedly proved by the fact of its occurring only once doting the life of each individual, and by its being propagated by contagion. It conies on in violent paroxysms of re peated short expirations, which are succeeded by a quick, deep inspiration, attended with a peculiar sound, that has obtained the name of hoop, or whoop, from which one of its popular names, that of Hooping-cough, is derived. The paroxysm is often terminated by vo miting, and induces a state of great debility and ex haustion, which, however, is so transient, that after the patient has been struggling for breath, and appa rently almost expiring, in a few moments his functions resume their natural state, and ne exhibits scarcely any traces of disease. As the complaint is contagious, and occurs once only during life, it necessarily happens that children are the most frequent subjects of it ; but when it has not been gone tnrough during childhood, every age seems to be equally liable to its attacks. Tnere arc
few circumstances in pathology which are more diffi cult to explain than the manner in which a disease like Hooping-cough can prove contagious, which is not ne-' cessarily of a febrile nature, where there appears to be no matter generated which can be the medium of in fection, and where there is nothing of the putrid or ma lignant nature, which is supposed to indicate a tenden cy to decomposition in the constituents of the body. As a point of practical importance, it has been ques tioned whether the contagion can be conveyed by a third person. We are not in possession of any facts which can enable us to decide positively on this sub ject, but we should suppose that this could not be the case, but that the breath of the patient most be actually inhaled in order to produce the disease. But, whatever conclusion we may form upon this point, we have suffi cient evidence from our daily experience, that conta gion is its most usual, if not its only cause. When a pa tient is under the influence of the complaint, the indi vidual paroxysms are generally brought on by some obvious cause, as by muscular exertion, by taking food, or even by sudden mental emotions. At its commence ment, the symptoms are scarcely to be distinguished from those of a common catarrhal cough, and three or four weeks often elapse before the characteristic marks of Pertussis make their appearance. The cough gra dually becomes more severe, the expirations succeed each other more rapidly, and are followed by the so norous inspiration, vomiting then comes on, and the patient falls into a febrile state, which seems to aggra vate all the other symptoms. During the violent pa roxysm of coughing, the passage of the blood through the lungs is so much impeded as to produce a deep suf fusion of the face ; and it frequently happens that some of the small arteries are ruptured, and that blood is dis charged, mixed with the matter expectorated, or bursts out through the thin cuticle of the nose and mouth. When the disease has acquired its greatest degree of violence, it remains for some time stationary, and then declines. The period which it occupies in the whole process is very uncertain, and it is sometimes protract ed for many months. Whenever it exists in its aggra vated form it is accompanied with fever, and, although not necessarily of an inflammatory tendency, it often produces inflammation of the chest, and in this way proves fatal. In persons who are disposed by heredi tary constitution to Phthisis, this complaint is frequently brought on by the Hooping-cough, and occasionally it seems to lay the foundation for a state of general maras anus or tabes, which ultimately proves fatal without the lungs being the actual seat of disease.