The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2).

Date:: 1849-59

Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

Title Page

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$EUTROPHIC-EXANTIIEMATA-EXPECTORANTS. certainly passes into the mass of blood, and doubtless, like eutroi)hics in general, modifies the condition of that fluid, so as to exert dyna- mically a new action on secretion and nutrition ; but as to the precise mode in which this is ac- complished, we know no more than we do of the modus operandi of other articles of the class, or, indeed, of any of the classes of therapeutical agents. It is impossible to depict every case in which this valuable agent is capable of affording benefit. It seems to be adapted for all cases in which it is desirable to induce a change in asso- ciated actions, and hence is an invaluable revellent in many febrile and inflammatory affections. As a eutrophic, it is chiefly indicated in chronic affec- tions, that are characterized by morbid depositions, or hypertrophies. The preparations of iodine are, likewise, admi- rable eutrophics; well adapted for cases in which it is desirable to modify the state of the fluid of the circulation. Hence, they are much used in the various cachexiae, and for the removal of dif- ferent morbid growths. The reputation of iodine is most decided in goitre. In scrophulosis it has attained great celebrity; and in certain of the constitutional forms of sypliilis has supplanted mercury. Burnt sponge, cod-liver oil, animal charcoal, chloride of calcium, chloride of barium; the pre- parations of arsenic, of gold, and of silver, of pla- tinum and of iron ; as well as alkalies, and the mineral acids ; chlorine and chlorinated prepara- tions ; sulphur ; the free internal use of sugar : sarsaparilla; guaiacum-wood; mezereon ; the root of aralia nudicaulis; bark of sassafras root; dul- camara, &c., are the chief eutrophics now used. For the precise cases to which they are respec- tively adapted, and for the forms of preparation of these and other eutrophics that are most advisa- ble, the reader is referred to another work—(Gene- ral Therapeutics and Mat. Med. ii. 290, Philad. ) ROBLEY DUNGLISON.] EXANTHEMATA.—The word exanthemata, ilerived from the Greek term i^avOiuo, to effloresce, or break forth, was applied, by the Greek writers, to cutaneous eruptions generally. By modern authors its application is confined to cutaneous eruptions accompanied with fever, arising from specific contagion. In the nosology of Cullen, the exanthemata constitute the third order of the class Pyrexiae, and we find he has included ten different genera, \'iz. variola, varicella, rubeola, scarlatina, pestis, erysipelas, miliaria, urticaria, pemphigus, and apkthcE- It is evident, however, he has included not only the eruptive fevers, strictly so called, but those diseases in which a vesicular efflorescence occasionally appears in their progress. Plenck, Frank, and others have fallen into a similar error. Willan and Bateman classify the exanthemata, according as the eruption agrees with their dcfini- vton of an exanthema or rash, viz. superficial red patches, variously figured and diffused irregu- larly over the body, leaving interstices of a natural colour, and terminating in desquamation of the cuticle. They therefore comprehend, under ex- anthemata, rubeola, scarlatina, urticaria, roseola, purpura, and erythema. In the article Feveii will be found the classifi- cation of fevers we propose to adopt in this work, viz. into 1. continued; 2. periodic; and 3. erup. tive. The eruptive fevers comprehend those dis- eases which wc submit should alone be included in the exanthemata, viz. variola (and its modifica- tions), rubeola, and scarlatina. In those diseases which bear a strong analogy to continued fever, we find that a certain order of febrile symptoms is followed by a particular eruption ; that the fever and exantheme run a definite course ; the efflores- cence going through a regular series of changes, and terminating in desquamation of the cuticle; that these eruptive fevers occur only once during the life of the individual; and lastly, that they are communicated by contagion. The regularity of the eruptive fever and the progress of the efflorescence are most precise. The eruption of small-pox appears on the third day from the commencement of the febrile indis- position, and maturates on the tenth; the rash of measles appears on the fourth, and declines on the seventh day ; and the efflorescence of scarlatina is visible on the second day, and begins to disap- pear on the fifth ; the progress of the fever being thus fixed and regular, and apparently keeping pace with the series of changes which the erup- tion successively undergoes. The circumstance that eruptive fevers occur only once in the course of life, though correct as a general rule, is liable to occasional exceptions. These, however, are comparatively so few, that they tend much to confirm this principle. Per- sons, on the other hand, occasionally escape one or more of the eruptive fevers; more frequently, however, scarlatina than either small-pox or measles. The last characteristic of the exanthemata — that they are communicable by contagion — ad- mits of positive proof as to small-pox, in the com- munication of this disease by inoculation. Dr. Home (Clinical Experiments) succeeded in communicating measles by introducing the blood of a patient affected with the disease into the sys- tem of another individual ; and the evidence of the contagious nature of scarlet fever is so strong that no one in the present day ventures to im- pugn the doctrine. (See Measles, Scahlatisa, Small-Pox, and Vauicella.) A. TWEEDIE. EXPECTORANTS, (from ex and pectus; expectoro, expectorans, Expectorantia,') are medi- cines intended to promote the exertion of mucus and other substances from the trachea, its branch- es, and the bronchial cells. In offering this defi- nition, it is proper to mention that the existence of any substances capable of unloading the pul- monary tubes has been doubted ; but experience has demonstrated that not only substances applied in the form of vapour or of gas to the parts now mentioned, promote expectoration, but that sub- stances taken into the stomach produce the same effect. The mucous membrane of the air-tubes of the lungs is tlie part intended to be influenced by ex- pectorants. This membrane, which lines the whole of these tubes, from their origin through their trunk, the trachea, and all its ramifications,$