Volume 1
The library of medicine / arranged and edited by Alexander Tweedie.
- Date:
- 1840-1841
Licence: Public Domain Mark
Credit: The library of medicine / arranged and edited by Alexander Tweedie. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
17/460 page 3
![Morbid actions or phenomena may occur singly ; but far more frequently they are observed in certain groups. The latter are what are generally known as special diseases, and are the subjects of nosology. The individual affections composing the groups are called symptoms, or coincidents, which are themselves instances of disease. Thus the disease called phthisis is a collection of morbid states, such as emaciation, hectic fever, cough, ex- pectoration, &c.; these are its symptoms : none of them individually could be called phthisis — a name which only belongs to them collectively. The study of morbid actions as to their association is highly important, but it is still more requisite to consider them in certain series, or as the necessary consequences of some other derangement, which is called the proximate cause. This is often spoken of as the disease par excellence, in contradistinction to the symptoms, which are merely its effects. We shall endeavour to trace some of the circumstances to which diseased actions owe their association and succession : — ]. The first of these is the direct mutual dependence of certain actions upon each other, so that when one is impaired or obstructed, the rest, whether prior or subsequent to it, must be necessarily affected. This principle is strikingly illustrated by contraction of the orifice of the aorta. The imeddi- ment offered to the exit of blood from the left ventricle must soon be felt in the pulmonary circulation, the obstruction of which will occasion difficulty of breathing, cough, and perhaps haemorrhage into the air-cells, or effu- sion of serum into the tissue of the lungs ; or a state bordering upon inflammation of the bronchial membrane ; and this again will obstruct the circulation in the right side of the heart, the effects of which may be co- extensive wdth the venous circulation, and consequently with the function of the capillaries throughout the body. And while such a host of evils may in this manner result from the primary lesion, scarcely fewer might be traced to the defective supply of blood in the arteries. This instance is one of the most forcible that could have been selected, because it involves a function of universal importance to the system. But the same connection of dependence between diseased actions may be observed on a much more limited scale, as in the constipation produced by want of the usual stimulus of the bile. 2. Another class of morbid actions, observed frequently to concur or to supervene upon each other, are derangements of functions allied for some common purpose. There is no mutual dependence between the action of the diaphragm, and that of the intercostal muscles, but they are often disordered at the same time from the operation of a cause common to both; for instance, the irritation of the bronchial membrane com- municated to the medulla oblongata, and reflected along the motor nerves to the muscles of respiration. The frequent coincidence of anorexia, nausea, and vomiting, with derangement of the liver ; of spasm of the muscles employed in evacuating the bladder and rectum, with irritation of the mucous linings of these organs ; of disease of the mamma with that of the ovaries and uterus ; illustrate the same principle. This consent of action is often called Sympathy — a term which, if used as extensively as its etymology warrants, might be applied to any coexistent disorders, even those which are necessarily consequent upon each other, or those just spoken of as ensuing upon some lesion common to them all. But it is better to restrict the term, at least in its pathological import, to certain actions, of which we shall speak directly. 3. A third class are those disordered actions which are connected by the continuity of structure. A simultaneous affection of different portions](https://iiif.wellcomecollection.org/image/b21929555_0001_0017.jp2/full/800%2C/0/default.jpg)
