6. The ancients are said to have possessed an art of increasing the livers of geese to a size greater than the remainder of the goose. Martial. l. 13.

epig. 58.--This is said to have been done by fat and figs. Horace, l. 2.

sat. 8.--Juvenal sets these large livers before an epicure as a great rarity. Sat. 5. l. 114; and Persius, sat. 6. l. 71. Pliny says these large goose-livers were soaked in mulled milk, that is, I suppose, milk mixed with honey and wine; and adds, "that it is uncertain whether Scipio Metellus, of consular dignity, or M. Sestius, a Roman knight, was the great discoverer of this excellent dish." A modern traveller, I believe Mr.

Brydone, a.s.serts that the art of enlarging the livers of geese still exists in Sicily; and it is to be lamented that he did not import it into his native country, as some method of affecting the human liver might perhaps have been collected from it; besides the honour he might have acquired in improving our giblet pies.

Our wiser caupones, I am told, know how to fatten their fowls, as well as their geese, for the London markets, by mixing gin instead of figs and fat with their food; by which they are said to become sleepy, and to fatten apace, and probably acquire enlarged livers; as the swine are a.s.serted to do, which are fed on the sediments of barrels in the distilleries; and which so frequently obtains in those, who ingurgitate much ale, or wine, or drams.

II. The irritative diseases of the kidneys, pancreas, spleen, and other glands, are a.n.a.logous to those of the liver above described, differing only in the consequences attending their inability to action. For instance, when the secretory vessels of the kidneys become disobedient to the stimulus of the pa.s.sing current of blood, no urine is separated or produced by them; their excretory mouths become filled with concreted mucus, or calculus matter, and in eight or ten days stupor and death supervenes in consequence of the retention of the feculent part of the blood.

This disease in a slighter degree, or when only a part of the kidney is affected, is succeeded by partial inflammation of the kidney in consequence of previous torpor. In that case greater actions of the secretory vessels occur, and the nucleus of gravel is formed by the inflamed mucous membranes of the tubuli uriniferi, as farther explained in its place.

This torpor, or paralysis of the secretory vessels of the kidneys, like that of the liver, owes its origin to their being previously habituated to too great stimulus; which in this country is generally owing to the alcohol contained in ale or wine; and hence must be registered amongst the diseases owing to inebriety; though it may be caused by whatever occasionally inflames the kidney; as too violent riding on horseback, or the cold from a damp bed, or by sleeping on the cold ground; or perhaps by drinking in general too little aqueous fluids.

III. I shall conclude this section on the diseases of the liver induced by spirituous liquors, with the well known story of Prometheus, which seems indeed to have been invented by physicians in those ancient times, when all things were clothed in hieroglyphic, or in fable. Prometheus was painted as stealing fire from heaven, which might well represent the inflammable spirit produced by fermentation; which may be said to animate or enliven the man of clay: whence the conquests of Bacchus, as well as the temporary mirth and noise of his devotees. But the after punishment of those, who steal this accursed fire, is a vulture gnawing the liver; and well allegorises the poor inebriate lingering for years under painful hepatic diseases. When the expediency of laying a further tax on the distillation of spirituous liquors from grain was canva.s.sed before the House of Commons some years ago, it was said of the distillers, with great truth, "_They take the bread from the people, and convert it into poison!_" Yet is this manufactory of disease permitted to continue, as appears by its paying into the treasury above 900,000l. near a million of money annually. And thus, under the names of rum, brandy, gin, whisky, usquebaugh, wine, cyder, beer, and porter, alcohol is become the bane of the Christian world, as opium of the Mahometan.

Evoe! parce, liber?

Parce, gravi metuende thirso!--Hor.

SECT. x.x.xI.

OF TEMPERAMENTS.

I. _The temperament of decreased irritability known by weak pulse, large pupils of the eyes, cold extremities. Are generally supposed to be too irritable. Bear pain better than labour. Natives of North-America contrasted with those upon the coast of Africa. Narrow and broad shouldered people. Irritable const.i.tutions bear labour better than pain._ II. _Temperament of increased sensibility. Liable to intoxication, to inflammation, haemoptoe, gutta serena, enthusiasm, delirium, reverie. These const.i.tutions are indolent to voluntary exertions, and dull to irritations. The natives of South-America, and brute animals of this temperament._ III. _Of increased voluntarity; these are subject to locked jaw, convulsions, epilepsy, mania. Are very active, bear cold, hunger, fatigue. Are suited to great exertions. This temperament distinguishes mankind from other animals._ IV. _Of increased a.s.sociation. These have great memories, are liable to quartan agues, and stronger sympathies of parts with each other._ V. _Change of temperaments into one another._

Antient writers have spoken much of temperaments, but without sufficient precision. By temperament of the system should be meant a permanent predisposition to certain cla.s.ses of diseases: without this definition a temporary predisposition to every distinct malady might be termed a temperament. There are four kinds of const.i.tution, which permanently deviate from good health, and are perhaps sufficiently marked to be distinguished from each other, and const.i.tute the temperaments or predispositions to the irritative, sensitive, voluntary, and a.s.sociate cla.s.ses of diseases.

I. _The Temperament of decreased Irritability._

The diseases, which are caused by irritation, most frequently originate from the defect of it; for those, which are immediately owing to the excess of it, as the hot fits of fever, are generally occasioned by an acc.u.mulation of sensorial power in consequence of a previous defect of irritation, as in the preceding cold fits of fever. Whereas the diseases, which are caused by sensation and volition, most frequently originate from the excess of those sensorial powers, as will be explained below.

The temperament of decreased irritability appears from the following circ.u.mstances, which shew that the muscular fibres or organs of sense are liable to become torpid or quiescent from less defect of stimulation than is productive of torpor or quiescence in other const.i.tutions.

1. The first is the weak pulse, which in some const.i.tutions is at the same time quick. 2. The next most marked criterion of this temperament is the largeness of the aperture of the iris, or pupil of the eye, which has been reckoned by some a beautiful feature in the female countenance, as an indication of delicacy, but to an experienced observer it is an indication of debility, and is therefore a defect, not an excellence. The third most marked circ.u.mstance in this const.i.tution is, that the extremities, as the hands and feet, or nose and ears, are liable to become cold and pale in situations in respect to warmth, where those of greater strength are not affected. Those of this temperament are subject to hysteric affections, nervous fevers, hydrocephalus, scrophula, and consumption, and to all other diseases of debility.

Those, who possess this kind of const.i.tution, are popularly supposed to be more irritable than is natural, but are in reality less so.

This mistake has arisen from their generally having a greater quickness of pulse, as explained in Sect. XII. 1. 4. XII. 3. 3.; but this frequency of pulse is not necessary to the temperament, like the debility of it.

Persons of this temperament are frequently found amongst the softer s.e.x, and amongst narrow-shouldered men; who are said to bear labour worse, and pain better than others. This last circ.u.mstance is supposed to have prevented the natives of North America from having been made slaves by the Europeans. They are a narrow-shouldered race of people, and will rather expire under the lash, than be made to labour. Some nations of Asia have small hands, as may be seen by the handles of their scymetars; which with their narrow shoulders shew, that they have not been accustomed to so great labour with their hands and arms, as the European nations in agriculture, and those on the coasts of Africa in swimming and rowing. Dr. Maningham, a popular accoucheur in the beginning of this century, observes in his aphorisms, that broad-shouldered men procreate broad-shouldered children.

Now as labour strengthens the muscles employed, and increases their bulk, it would seem that a few generations of labour or of indolence may in this respect change the form and temperament of the body.

On the contrary, those who are happily possessed of a great degree of irritability, bear labour better than pain; and are strong, active, and ingenious. But there is not properly a temperament of increased irritability tending to disease, because an increased quant.i.ty of irritative motions generally induces an increase of pleasure or pain, as in intoxication, or inflammation; and then the new motions are the immediate consequences of increased sensation, not of increased irritation; which have hence been so perpetually confounded with each other.

II. _Temperament of Sensibility._

There is not properly a temperament, or predisposition to disease, from decreased sensibility, since irritability and not sensibility is immediately necessary to bodily health. Hence it is the excess of sensation alone, as it is the defect of irritation, that most frequently produces disease. This temperament of increased sensibility is known from the increased activity of all those motions of the organs of sense and muscles, which are exerted in consequence of pleasure or pain, as in the beginning of drunkenness, and in inflammatory fever. Hence those of this const.i.tution are liable to inflammatory diseases, as hepat.i.tis; and to that kind of consumption which is hereditary, and commences with slight repeated haemoptoe. They have high-coloured lips, frequently dark hair and dark eyes with large pupils, and are in that case subject to gutta serena. They are liable to enthusiasm, delirium, and reverie. In this last circ.u.mstance they are liable to start at the clapping of a door; because the more intent any one is on the pa.s.sing current of his ideas, the greater surprise he experiences on their being dissevered by some external violence, as explained in Sect. XIX. on reverie.

As in these const.i.tutions more than the natural quant.i.ties of sensitive motions are produced by the increased quant.i.ty of sensation existing in the habit, it follows, that the irritative motions will be performed in some degree with less energy, owing to the great expenditure of sensorial power on the sensitive ones. Hence those of this temperament do not attend to slight stimulations, as explained in Sect. XIX. But when a stimulus is so great as to excite sensation, it produces greater sensitive actions of the system than in others; such as delirium or inflammation. Hence they are liable to be absent in company; sit or lie long in one posture; and in winter have the skin of their legs burnt into various colours by the fire.

Hence also they are fearful of pain; covet music and sleep; and delight in poetry and romance.

As the motions in consequence of sensation are more than natural, it also happens from the greater expenditure of sensorial power on them, that the voluntary motions are less easily exerted. Hence the subjects of this temperament are indolent in respect to all voluntary exertions, whether of mind or body.

A race of people of this description seems to have been found by the Spaniards in the islands of America, where they first landed, ten of whom are said not to have consumed more food than one Spaniard, nor to have been capable of more than one tenth of the exertion of a Spaniard. Robertson's History.--In a state similar to this the greatest part of the animal world pa.s.s their lives, between sleep or inactive reverie, except when they are excited by the call of hunger.

III. _The Temperament of increased Voluntarity._

Those of this const.i.tution differ from both the last mentioned in this, that the pain, which gradually subsides in the first, and is productive of inflammation or delirium in the second, is in this succeeded by the exertion of the muscles or ideas, which are most frequently connected with volition; and they are thence subject to locked jaw, convulsions, epilepsy, and mania, as explained in Sect. x.x.xIV. Those of this temperament attend to the slightest irritations or sensations, and immediately exert themselves to obtain or avoid the objects of them; they can at the same time bear cold and hunger better than others, of which Charles the Twelfth of Sweden was an instance. They are suited and generally prompted to all great exertions of genius or labour, as their desires are more extensive and more vehement, and their powers of attention and of labour greater. It is this facility of voluntary exertion, which distinguishes men from brutes, and which has made them lords of the creation.

IV. _The Temperament of increased a.s.sociation._

This const.i.tution consists in the too great facility, with which the fibrous motions acquire habits of a.s.sociation, and by which these a.s.sociations become proportionably stronger than in those of the other temperaments. Those of this temperament are slow in voluntary exertions, or in those dependent on sensation, or on irritation. Hence great memories have been said to be attended with less sense and less imagination from Aristotle down to the present time; for by the word memory these writers only understood the unmeaning repet.i.tion of words or numbers in the order they were received, without any voluntary efforts of the mind.

In this temperament those a.s.sociations of motions, which are commonly termed sympathies, act with greater certainty and energy, as those between disturbed vision and the inversion of the motion of the stomach, as in sea-sickness; and the pains in the shoulder from hepatic inflammation. Add to this, that the catenated circles of actions are of greater extent than in the other const.i.tutions. Thus if a strong vomit or cathartic be exhibited in this temperament, a smaller quant.i.ty will produce as great an effect, if it be given some weeks afterwards; whereas in other temperaments this is only to be expected, if it be exhibited in a few days after the first dose. Hence quartan agues are formed in those of this temperament, as explained in Section x.x.xII. on diseases from irritation, and other intermittents are liable to recur from slight causes many weeks after they have been cured by the bark.

V. The first of these temperaments differs from the standard of health from defect, and the others from excess of sensorial power; but it sometimes happens that the same individual, from the changes introduced into his habit by the different seasons of the year, modes or periods of life, or by accidental diseases, pa.s.ses from one of these temperaments to another. Thus a long use of too much fermented liquor produces the temperament of increased sensibility; great indolence and solitude that of decreased irritability; and want of the necessaries of life that of increased voluntarity.

SECT. x.x.xII.

DISEASES OF IRRITATION.

I. _Irritative fevers with strong pulse. With weak pulse. Symptoms of fever, Their source._ II. 1. _Quick pulse is owing to decreased irritability_. 2. _Not in sleep or in apoplexy._ 3. _From inanition.

Owing to deficiency of sensorial power._ III. 1. _Causes of fever. From defect of heat. Heat from secretions. Pain of cold in the loins and forehead._ 2. _Great expense of sensorial power in the vital motions.

Immersion in cold water. Succeeding glow of heat. Difficult respiration in cold bathing explained. Why the cold bath invigorates. Bracing and relaxation are mechanical terms._ 3. _Uses of cold bathing. Uses of cold air in fevers._ 4. _Ague fits from cold air. Whence their periodical returns._ IV. _Defect of distention a cause of fever.

Deficiency of blood. Transfusion of blood._ V. 1. _Defect of momentum of the blood from mechanic stimuli. 2. Air injected into the blood-vessels._ 3. _Exercise increases the momentum of the blood._ 4.

_Sometimes bleeding increases the momentum of it._ VI. _Influence of the sun and moon on diseases. The chemical stimulus of the blood.

Menstruation obeys the lunations. Queries._ VII. _Quiesence of large glands a cause of fever. Swelling of the praecordia._ VIII. _Other causes of quiescence, as hunger, bad air, fear, anxiety._ IX. 1.

_Symptoms of the cold fit._ 2. _Of the hot fit._ 3. _Second cold fit why._ 4. _Inflammation introduced, or delirium, or stupor._ X.

_Recapitulation. Fever not an effort of nature to relieve herself.

Doctrine of spasm._

I. When the contractile sides of the heart and arteries perform a greater number of pulsations in a given time, and move through a greater area at each pulsation, whether these motions are occasioned by the stimulus of the acrimony or quant.i.ty of the blood, or by their a.s.sociation with other irritative motions, or by the increased irritability of the arterial system, that is, by an increased quant.i.ty of sensorial power, one kind of fever is produced; which may be called Synocha irritativa, or Febris irritativa pulsu forti, or irritative fever with strong pulse.

When the contractile sides of the heart and arteries perform a greater number of pulsations in a given time, but move through a much less area at each pulsation, whether these motions are occasioned by defect of their natural stimuli, or by the defect of other irritative motions with which they are a.s.sociated, or from the inirritability of the arterial system, that is, from a decreased quant.i.ty of sensorial power, another kind of fever arises; which may be termed, Typhus irritativus, or Febris irritativa pulsu debili, or irritative fever with weak pulse. The former of these fevers is the synocha of nosologists, and the latter the typhus mitior, or nervous fever. In the former there appears to be an increase of sensorial power, in the latter a deficiency of it; which is shewn to be the immediate cause of strength and weakness, as defined in Sect. XII. 1. 3.

It should be added, that a temporary quant.i.ty of strength or debility may be induced by the defect or excess of stimulus above what is natural; and that in the same fever _debility always exists during the cold fit, though strength does not always exist during the hot fit._

These fevers are always connected with, and generally induced by, the disordered irritative motions of the organs of sense, or of the intestinal ca.n.a.l, or of the glandular system, or of the absorbent system; and hence are always complicated with some or many of these disordered motions, which are termed the symptoms of the fever, and which compose the great variety in these diseases.

The irritative fevers both with strong and with weak pulse, as well as the sensitive fevers with strong and with weak pulse, which are to be described in the next section, are liable to periodical remissions, and then they take the name of intermittent fevers, and are distinguished by the periodical times of their access.

II. For the better ill.u.s.tration of the phenomena of irritative fevers we must refer the reader to the circ.u.mstances of irritation explained in Sect.

XII. and shall commence this intricate subject by speaking of the quick pulse, and proceed by considering many of the causes, which either separately or in combination most frequently produce the cold fits of fevers.

1. If the arteries are dilated but to half their usual diameters, though they contract twice as frequently in a given time, they will circulate only half their usual quant.i.ty of blood: for as they are cylinders, the blood which they contain must be as the squares of their diameters. Hence when the pulse becomes quicker and smaller in the same proportion, the heart and arteries act with less energy than in their natural state. See Sect. XII.

1. 4.