Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). 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.)
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![action of lead, to the acid wines, or cider, or the spirits drank by the inhabitants, or to milk used in too great abundance, and other errors of regimen, it is now admitted generally to be induced by great atmosphe- rical vicissitudes, the operation of which is favoured by improper food, and probably some causes of an endemial nature which cannot be well appreciated. Hillary {Observations on the Changes of Air and the concomitant Epidemical Diseases in the Island of Barbadoes, &c. With Notes, by Benjamin Rush, M.D.) speaks of the class of persons most subject to dry bellyache, and especially those who live in America and the West Indies, in which countries it seems to be endemial. At times it assumed an obviously inflammatory type (p. 34), being, as Dr. Rush tells us in a note, complicated with bilious colic. It was, as we learn from the last mentioned distinguished writer in another note (p. 134), a common disease in Philadelphia between the years 1760 and 1770. Its rare occurrence [now] has been ascribed to the disuse of punch, and of late and heavy suppers; to the general use of flannel next the skin, and to the abolition of porches, which afforded a temptation to our citizens to expose them- selves for several hours, in a stale of inactivity, to the damp evening air. The causes of dry bellyache implied in this sentence, are pre- cisely those which I have described as giving rise to bilious colic. But in the absence generally of inflammation and fever, in the fre- quently protracted duration of the former disease, and the liability, when it does not end fatally, to cause paralysis of the limbs, we find differences between it and bilious colic. This state of costiveness, pain, and misery, says Hillary, has continued for twenty or thirty days, and sometimes longer ; for I remember a case which, being thus treated in a wrong manner, the patient continued, with some small intervals of being something easier, in this painful condition for six months, or more, and then recovered by a different method of treat- ment in one week's time. The following is a well-drawn picture of the progress of the disease, and especially that part which portrays the transmission of irritation from the viscera to the spinal marrow, and ils subsequent irradiation to the limbs, followed by deficient innervation and palsy. The passage would be particularly pleasing to Dr. Marshall Hall, as illustrative of his doctrine of reflex-function of a portion of the nervous system. When the sick fall into the hands of those who treat them in this wrong manner, the pain con- tinues to be very violent, and at times almost intolerable, and that for a longtime; and then the patient's breath commonly acquires a strong, fetid, stercoraceous smell like excrement, from a long retention of feces, and an absorption of the putrid effluvia from them into the lacteals, by the strong convulsive contractions of the guts; and when the pain in the bowels has continued long, and at last begins to abate, a pain in the shoulder-joints and adjoining muscles comes on, with an unusual sensation and tingling along the spinal marrow; which soon afterwards extends itself from thence to the nerves of the arms and legs, and they become weak, and their weakness increases till those extreme parts become paralytic, with a total loss of motion, though a benumbed sensation often remains. The author next adverts to the occasional metastasis from the bowels to the brain,](https://iiif.wellcomecollection.org/image/b21156955_0328.jp2/full/800%2C/0/default.jpg)
