DERANGED GENUS VII. EMPRESMA. Uisceral Inflammation. FUNCTION OF A VISCERAL ORGAN, MEMBRANOUS OR PARENCHYMATOUS; WITH LOCAL PAIN; FEVER MOSTLY A CAUMA; INFLAMMATION MOSTLY ADHESIVE. the genus as importing visceral in nating in itis. GEN. VII. THE genus of diseases upon which we now enter conGeneral ex- sists of that numerous collection of visceral inflammations planation of which from the time of Boerhaave, have been generally distinguished by anatomical terms derived from the organ flammation. affected with the Greek term itis added as a suffix, as Hitherto cephalitis, gastritis, carditis, and many others. Itis is expressed by terms termi. sufficiently significant of its purpose: it is immediately derived from pai, which is itself a ramification from w, and imports, not merely action, "putting or going forth", which is the strict and simple meaning of ew, but action in its fullest urgency, "violent or impetuous action ". As a suffix, therefore, we shall retain it in its common use, and proscribe it, to prevent confusion, from the few compounds, or proscribe the compounds themselves, in which this common use is departed from; as rachitis, hydro-rachitis, ascites, and tympanites, none of which convey any idea of violent or impetuous action, and some of which are peculiarly marked by a contrary state. Hence importing a common relation. This application of a common term in composition to so large a body of visceral inflammations, and the general use of the term for so long a period as that throughout which it has been employed, is a sufficient proof that practitioners have discovered between these inflamma Visceral tion. tions other features of resemblance than the general GEN. VII. symptoms of inflammatory disorder. In the prosecution Empres of the subject, we shall find that this is the fact; and I inflammahave already observed, in the opening remarks upon the present order, that, with a very few exceptions, the inflammation in all the diseases is of the adhesive kind, and the fever a cauma. ing of em presma. gical mean General With a view, therefore, of simplifying, as far as sim- Etymoloplicity may be of real use, the present system will, for the first time, comprise the whole of these under one genus, here distinguished by the name of EMPRESMA, or "internal inflammation", a term, in its simple form, employed both by Hippocrates and Galen; and which it seems necessary to revive for the present purpose. Many of the organs included under the genus before us, and which we shall presently follow up in their respective order, sympathize with each other, and most of them with the stomach. The necessary consequence especially of which is, that the constitution is disturbed generally, with the though in very different degrees according to the organ affected; or, in Mr. Hunter's opinion, according to the different degree of its connexion with the stomach. of the or sympathy gans con cerned : stomach. Inflammavital organs tion in the more ex tensively If the heart, the lungs, or the brain be inflamed, whether primarily or secondarily, as by sympathy, the stomach is peculiarly influenced, probably from the essential importance of these organs to the life itself (as felt than in all the vital organs, or those essential to the life, main- other ortain a very close degree of affinity); and the disease gans. originating in any of these, has, in consequence, a more violent effect upon the constitution than the same quantity of inflammation would have if it were not in a vital part, or in one with which the vital parts do not sympathize. The pulse, in such cases, is much quicker and smaller than when inflammation takes place in a common part, as a muscle, cellular membrane, or the skin. The More rapid progress, moreover, when the attack is so violent as to end. prove fatal, is, generally speaking, far more rapid than in other parts; so that, at its very beginning, it has the same effect upon the constitution as a farther advance and more Visceral inflamma GEN. VII. of an inflammation in other organs that is equally sure Empresma. of proving fatal in its result. The debility commences early because the inflammation itself is immediately interfering with actions essential to the life; and, as already observed, the sympathy between these organs is peculiarly close, insomuch so as almost to make any single action common to the whole *. tion. Inflamma tory sym ptoms vary in different organs. Inflammation of the brain. Inflammation of the heart. Inflamma stomach. In inflammation of the brain the pulse varies, perhaps, more than in inflammation in any other part; and we must rather depend upon other symptoms than upon the state of the pulse. It is sometimes quick, sometimes slow, sometimes depressed, sometimes full, according as the disease is characterized by acute pain, delirium, stupor, or other concomitants. When inflammation is seated in the heart its action becomes extremely agitated and irregular. When in the lungs, the heart, possibly from sympathy, does not seem to allow of a free diastole. If the stomach be inflamed, the patient feels an option of the pression and dejection through all the stages of the disease. The vital energy or simple animal life, seems to be impaired and lessened, in the same manner as sensation is lessened when the brain is injured. The pulse is generally low and quick; the pain obtuse, but urgent and overwhelming; so that the patient can hardly bear up under it. Inflammation of the intestines. Inflammation of the uterus. -If the intestines be effected, the symptoms are nearly of the same kind, especially if the inflammation be in the upper part of the canal; but if it be seated in the colon, the patient is more roused, and the pulse is fuller than when the stomach itself is inflamed. If the uterus be the organ attacked, the pulse is extremely quick, and low: if one of the testicles, the pain is depressing, and the pulse quick without much strength. With the uterus, the testicles, and the intestines, the stomach peculiarly sympathizes; often, indeed, as much as if itself were primarily affected. If we contrast these * Hunter, On Blood, &c. p. 325. Visceral in flammation. These symtrasted with those of ptoms con other parts species of inflammations with those that attack parts not GEN. VII. very essential to life, but with such a degree of violence Empresa. as to produce universal sympathy and affect the vital functions, we shall find that in the latter the pulse is fuller and stronger than common; and the blood is pushed further into the extreme arteries. The attack usually commences with rigor; the patient then becomes less essensomewhat roused because the action of the part is roused, tial to life. and the effects on the constitution are not yet such as to impede the operations of the vital organs. Much, however, will still depend upon the nature of the parts, whether active as muscles, or inactive as tendons; as also upon the situation of the same description of part, and especially upon the character of the constitution : for if the last be extremely irritable and weak, as in many women who lead sedentary lives, the pulse may be as quick, hard, and small, even at the commencement of the inflammation, as in inflammation of the vital parts. The blood, moreover, may be sizy, but will be loose and flat on the surface. Having premised these general remarks, we are the better prepared for examining the relations which the numerous species belonging to the present genus bear to each other; and satisfy ourselves with a more summary account of several of them than would otherwise be necessary. These species are as follow: PAIN IN THE HEAD; AVERSION TO LIGHT; FACE MORE GEN. VII. THE pathology of cephalitis, or inflammation of the SPEC. I. brain, is, in some degree, obscure and difficult, from the General pa- difference which occurs in several of its secondary or thological remarks. concomitant symptoms; occasioned partly, perhaps, by |