A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 9).
- James Copland
- Date:
- 1834-59
Licence: Public Domain Mark
Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 9). 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.)
![TYMPANITES—Definition of. Recorder, 1S25, p. CS1. — John W. Gloninger, Cases of Consumption successfully treated by Mercury, in Amer. Med. Recorder, 1S22, p. 514. — Wm. C. Wallace, Jewish Hygiene, in Bost. Med. and Surg. Joum., vol. xxxi., p. 349. On the Use of Charcoal in Consumption, Ibid., p. 419. — J. Comstock, in Ibid., vol. xxx., p. 489. — C. M. Durrant, on the Nature, Diagnosis, and Treatment of In- cipient Phthisis, in Ibid., vol. xxviii., p. 40i>, 429, 449, 469.—S. D. Gross, Elements of Fatholog. Anat, 2 vols., 1028. Bost., 1839.—H. G. Wiley, in Boston Medical and Surg. Journ., vol. xviii., 1848, p. S5.—Joseph Tuckerman, on the Climate of Santa Cruz, in Ibid., vol. xvi., 1S37, p. 357.—Thomas Glysson, Hajmorrhagic Phthisis, in Ibid., vol. xv., p. 16J, 1830.-5. W. Gold, on the Causes of Phthisis Pulmonalis, in Ibid., vol. xiii., p. 181, 1835.— Charles Macomber, Thoughts on Phthisis Pulm., Ibid., vol. xii., p. .8J.—J. A. Brereton, U. S. Army, Value of Chlorine Inhalations in Phthisis, in Bait. Medical and Surg. Journal and Keview, 1S34.—Andrew Anderson, on the Climate of St. Augustine as a resort for Consumptive Patients, in Boston Med. and Surg. Journal, vol. ii., p. 792; also Circular Letter, 1830.— Wm. P. Dewees, a Prac- tice of Physic, &c, 8vo. Phil., 1833.—John D. Fisher, Am. ed. of Forbes' Laennec, 8vo. N. Y., 1838.— J. E. Coxe, Practical Treatise on Medical Inhalation. Phila., 1S41.—C. B. Coventry, Essay on Tuberculosis and Tub. Pneumouia, New York State Med. Trans., vol. xi., 1856. —See also the various works on the Practice of Medicine, viz., Wood's, Dunglison's, Dickson's, Eberle's, Hosack's, &c. —X. Tessier, on Effects of Cold Climates in Pulmo- nary Consumption, New York Medical and Phys. Jour., vol. vii., p. 525.—Charles Drake, on the Effects of Respir- ing Cold Air in Pulmonary Diseases, Ibid., p. 199.—M. Mattson, The Curability of Consumption, Boston Med. and Surg. Journal, vol. xliii., p. 429.—J. G. F. Wurde- mann, Climates of Florida and the West Indies, South- ern Journal of Med., vol. ii., p. 509. — George Hayicard, Statistics of Pulm. Consumption in the Cities of Boston, New York, and Philadelphia, for 30 years, with Remarks, New England Med. Journ., vol. i., p. 297.] TYMPANITES.—(From rv/inavov, a drum.) HvfnraviTTjg, rvfircaviac, Hippocrates, Celsus, Galen. Tympanites, Tympanitis, Auct. Latin. Tympanites, Sauvages, Vogel, Sayar, Cullen, &c. Affectio Tympanitica, Hoffmann. Tym- panita, Sennert. Meteorismus, Sagar, et auct. var. Emphysema Tympanites, Parr. Tympa- nia, Ploucquet. Emph. Tympaniticum, Young. Emph. Abdominis, Good. Hydrops siccus, Auct. Windsucht, Trommelsucht, Germ. Tympanite, Fr. Tympanitide, Ital. Tympany, wind dropsy, dry dropsy, inflation of the abdomen. 1. Classif.—4th Class, 6th Order (Cullen). 6th Class, 2d Order (Good). I. Class, I. Order {Author in Preface). 2. Definit.—An inordinate generation and ac- cumulation of a gaseous fluid within the digestive canal, generally with retention of it, occurring chiefly symplomatically, either terminating acute disease, or complicating chronic affections, and oc- casioning great abdominal distention, and a drum- like sound on percussion. 3. I. Pathology.—Tympany is generally the result of greatly impaired vital power, as mani- fested chiefly through the organic or ganglial nervous system upon the digestive canal, whereby not only is the tonicity of the coats of the canal remarkably impaired, but also gaseous fluids are exhaled from the digestive mucous surface. That the air is generally contained in the canal, where it is retained either by spasm in parts of the canal near to its outlets, or by the inability of the muscular structure of the canal to expel it, can- not be doubted. It has been supposed by some writers that the air may be on some occasions ex- haled into the peritoneal cavity. If this occur- rence take place at all, it must result from the decomposition of matters effused into the cav- ity, as in cases of chronic peritonitis, or of puer- peral peritonitis, or of perforation of the intes- tines, when some of the intestinal contents have passed into this cavity. The occurrence of tym- pany from these changes is however, rare, but less rare when the intestines are perforated by any of the causes of this lesion of the intestines. (See art. Intestines, § 29.) 4. Several varieties of tympany have been enumerated by writers of the seventeenth and eighteenth centuries, according as the gaseous accumulation has occurred in the advanced course of acute maladies, or has complicated chronic diseases, the primary affections, with which tym- pany is associated, furnishing the basis of ar- rangement. Of these it is quite unnecessary to take any notice, as such occurrences of tym- pany are merely contingencies of advanced and dangerous diseases, and are merely symptoms of these or of hysterical or uterine disorders ; often, however, assuming very prominent and distress- ing characters, especially in the last stages of peritonitis, of puerperal and malignant fevers, &c. That the air which accumulates in the di- gestive tube in these and various other circum- stances of disease cannot arise, to any great amount, from the decomposition or retention of alimentary materials, or of morbid secretions ac- cumulated or retained in the canal, is demon- strated by the absence of these sources of the gaseous collection in the more extreme cases. We are compelled, therefore, to view the accumu- lation of air as the result of a morbidly increased exhalation of it from the digestive mucous sur- face, resulting from depressed vital or organic nervous power, in connexion with lost or im- paired tone of the muscular coats of the canal; this last condition, equally with the augmented exhalation, proceeding from the loss of vital power. According to this view tympany is merely an extreme state of flatulence (see that article), the gaseous exhalation having accumu- lated in the former, so as to produce extreme distention, but being discharged in the latter at intervals or absorbed. 5. That this exhalation must necessarily pro- ceed from the blood, in great measure, or, in as far as it does not arise from the decomposition of alimentary matters, or of the secretions, must necessarily be inferred, particularly in the more extreme and sudden accumulation of the gaseous fluid. John Hunter and Cullen believed that the fluid was thus generated, and Magendie and Gerardin endeavoured to prove the occurrence by experiment. They included a portion of in- testine between ligatures, returned it into the ab- domen, yet air, nevertheless, was found in it, al- though it contained no materials for the gener- ation of air. That the air was exhaled from the digestive mucous surface had long been believed in, and supported by observation and analogy. Fabricius Hildanus, Hoffmann, Portal, Vi- dal, Gaspard, Nysten, Merat, and many others, have contended for this doctrine, and have adduced facts in support of it. Bichat has shown that friction with sulphur communicates the odour of sulphureted hydrogen to the gas which collects in the bowels. The swimming- bladders of fishes are known to be supplied with air from the blood only ; and Blainville, Dumas, Magendie, and others, have shown that a division of the pneumo-gastric nerves is followed by gas- eous distention of the stomach. 6. Tympanitic distention of the abdomen may therefore be referred, firstly and chiefly, to the extrication of air from the digestive mucous sur- face, owing to the states of organic nervous en-](https://iiif.wellcomecollection.org/image/b21111078_0057.jp2/full/800%2C/0/default.jpg)
